Most adolescent anabolic steroid (AS) users participate in High School (HS) sports. We tested the effect of an education intervention to prevent AS and promote healthy behaviors, that capitalizes on the social influences of a team sport setting. The trial was a controlled intervention, delivered to high-risk adolescent athletes. Thirty-one HS football teams were separated into experimental (n=547) and control schools (n=696). Seven weekly, 50 minute classroom sessions were presented by coaches and student team leaders, with weightroom sessions delivered by research staff. The interactive intervention included sports nutrition and strength training as alternatives to AS use, knowledge of drugs, drug refusal role play, and anti-AS media campaigns. A pre- and post-intervention questionnaire assessed attitudes and intent to use AS and other drugs; diet, exercise and theorized risk factors that lead to adolescent AS use. Compared to controls, experimental subjects had greater understanding of AS effects, greater belief in personal harm by use of AS, more anti-AS attitudes, reduced impulsivity and hostility, improved feeling of athletic abilities, stronger belief that coaches and parents were anti-AS, less belief in media and reduced intent to use AS (all, p<.05), after the education program. Also, the experimental group had reported healthier nutrition and exercise behaviors (all, p<.05). Improvement in healthy behaviors, reduced risk factors, and intent to use AS can be favorably modified with a comprehensive, team-based anabolic steroid prevention program.
ABSTRACT Prostate cancer survivors (PCS) receiving androgen deprivation therapy (ADT) often experience adverse effects that negatively affect physical function and quality of life. Exercise may ameliorate those treatment adverse effects, and effective, scalable interventions to increase exercise behaviors are needed. The objective of our review is to evaluate both the efficacy and the implementation methods of exercise interventions for PCS receiving ADT. We searched MEDLINE®, PsycINFO, and the Cochrane Central Register of Controlled Trials through May 2016. Randomized controlled trials of exercise intervention PCS receiving ADT were included. The protocol was registered with PROSPERO (#CRD42015017348). Two authors independently reviewed articles for inclusion and risk of bias. Nine articles describing eight randomized controlled trials were included. The included interventions varied in training type (resistance or aerobic), length of intervention, dose of training (number of exercise sessions per week), and whether training was supervised or unsupervised. Despite heterogeneous interventions, varied measures, and generally short duration of training (average of 12 wk), improvements in fitness, symptoms, physical function, and quality of life were reported. The exercise training sessions were well attended, because few participants discontinued their participation in the exercise interventions, and attendance at supervised exercise sessions ranged from 74% to 94%. Self-reported compliance with the unsupervised exercise component was lower than that with the supervised sessions for trials that reported these data. In conclusion, supervised programs may be less scalable or accessible to populations with limited access. Future efforts should focus on delivery of programs that can adequately scale and contain the features of successful supervised interventions so that broad uptake by PCS on ADT can be achieved.
Studies of carbohydrate-craving (CC) individuals use self-selected dieters who report poor mood and increased appetite. However, the generalizability of these reports is unknown, nor is whether CC affects physical health. PURPOSE: We assessed a random sample of 330/609 firefighters entering a prospective randomized health promotion study, characterized CC for the highest and lowest 25%, and compared them with the remaining 50%. METHOD: We collected extensive baseline data on all enrolling individuals, including self-report surveys, dietary information and physiologic measures. Using 100-mm horizontal visual analogue scales (VAS) ranging from “never” to “all of the time,” participants indicated how often they craved “foods high in sugar” during a one-month period. We used oneway ANOVAs to compare means for “high cravers” (HC; top 25%), “low cravers” (LC; bottom 25%) and the middle group (50%). RESULTS: Participants did not differ on age, gender or years in service. On one physiologic measure, HC were significantly more likely to have hypertension (p < .0001). On separate dimensions of mood and stress, HC were significantly were significantly more likely to report feeling stressed, tense, tired and anxious (ps < .01). On separate dimensions of eating behavior, HC were significantly more likely to report feeling more hunger, really full, wanting to eat when not hungry, and losing control over eating (ps < .01). CONCLUSION: VAS results are meaningful measures that relate to psychosocial and physiologic profiles. HC should be advised of the relation with blood pressure, and may require specific strategies that simultaneously address mood, stress and nutrition self-efficacy to meet the study objectives. Supported by NIH AR 450901-02
Objective To explain, through mediation analyses, the mechanisms by which ATHENA (Athletes Targeting Healthy Exercise and Nutrition Alternatives), a primary prevention and health promotion intervention designed to deter unhealthy body shaping behaviors among female high school athletes, produced immediate changes in intentions for unhealthy weight loss and steroid/creatine use, and to examine the link to long-term follow-up intentions and behaviors. Methods In a randomized trial of 1668 athletes, intervention participants completed coach-led peer-facilitated sessions during their sport season. Participants provided pre-test, immediate post-test, and 9-month follow-up assessments. Results ATHENA decreased intentions for steroid/creatine use and intentions for unhealthy weight loss behaviors at post-test. These effects were most strongly mediated by social norms and self-efficacy for healthy eating. Low post-test intentions were maintained 9 months later and predicted subsequent behavior. Conclusions ATHENA successfully modified mediators that in turn related to athletic-enhancing substance use and unhealthy weight loss practices. Mediation analyses aid in the understanding of health promotion interventions and inform program development.
Abstract Understanding dietary patterns of women who exceed gestational weight gain (GWG) recommendations is crucial to promote healthier pregnancies. This study assessed nutrient intake, diet quality and GWG of participants in the Pregnancy, Exercise, and Nutrition (PEN) feasibility study who met or exceeded weight gain recommendations during pregnancy. The ASA24-2011, a web-based tool, was used to collect dietary intake data and dietary quality was assessed with the Healthy Eating Index (HEI)-2010 and the Diet Quality Index-Pregnancy (DQI-P). Fifty-three percent of PEN participants exceeded the 2009 IOM GWG recommendations; no significant associations were found between reported dietary quality and gestational weight gain.
The purpose of this study was to identify the population prevalence across the stages of change (SoC) for regular physical activity and to establish the prevalence of people at risk. With support from the National Institutes of Health, the American Heart Association, and the Robert Wood Johnson Foundation, nine Behavior Change Consortium studies with a common physical activity SoC measure agreed to collaborate and share data. The distribution pattern identified in these predominantly reactively recruited studies was Precontemplation (PC) = 5% (± 10), Contemplation (C) = 10% (± 10), Preparation (P) = 40% (± 10), Action = 10% (± 10), and Maintenance = 35% (± 10). With reactively recruited studies, it can be anticipated that there will be a higher percentage of the sample that is ready to change and a greater percentage of currently active people compared to random representative samples. The at-risk stage distribution (i.e., those not at criteria or PC, C, and P) was approximately 10% PC, 20% C, and 70% P in specific samples and approximately 20% PC, 10% C, and 70% P in the clinical samples. Knowing SoC heuristics can inform public health practitioners and policymakers about the population's motivation for physical activity, help track changes over time, and assist in the allocation of resources.
This study aimed to assess the effect of the HEALTHY intervention on the metabolic syndrome (Met-S), fitness, and physical activity levels of US middle-school students.
BACKGROUND More than 3.1 million men in the United States are prostate cancer survivors. These men may improve their physical function, quality of life, and potentially their prognosis by adopting healthier lifestyle habits. The internet provides a scalable mechanism to deliver advice and support about improving physical activity and dietary habits, but the feasibility and acceptability of a Web-based lifestyle intervention and the dose of support necessary to improve health behaviors are not yet known. OBJECTIVES The Community of Wellness is a Web-based intervention focused on supporting exercise and healthy dietary practices for men with prostate cancer. The objectives of this study were to determine the feasibility, acceptability, and preliminary efficacy of the Community of Wellness Web portal among prostate cancer survivors by conducting a randomized controlled trial (RCT) comparing 4 levels of additive Web-based content and interaction with participants: Level 1 (Teaching; Control), Level 2 (Teaching + Tailoring), Level 3 (Teaching + Tailoring + Technology), and Level 4 (Teaching + Tailoring + Technology + Touch). METHODS This is a single-blinded RCT comparing 3 levels of behavioral support within the Community of Wellness Web portal intervention (Levels 2 to 4) with each other and with the control condition (Level 1). The control condition receives general static Web-based educational information only on physical activity and dietary habits, self-efficacy for behavior change, motivation for physical activity, and changes in anxiety and treatment-related side effects. We will enroll and randomize 200 men with prostate cancer equally to 4 levels of the Community of Wellness Web-based intervention for 3 months (50 men per level). Surveys will be completed by self-report at baseline, 3 months (immediately postintervention), and 6 months (3 months postintervention). Feasibility and acceptability will be assessed by enrollment statistics, Web-based usage metrics, and surveys at the 3-month time point. We will also conduct focus groups after the postintervention follow-up assessment in a sample of enrolled participants to evaluate elements of usability and acceptability that cannot be obtained via surveys. RESULTS Enrollment is ongoing, with 124 enrolled. Study completion (6-month follow-up) is expected by July 2019. CONCLUSIONS The goal of the study is to identify the level of support that is feasible, acceptable, promotes behavior change, and improves health in men with prostate cancer to inform future efforts to scale the program for broader reach. CLINICALTRIAL ClinicalTrials.gov NCT03406013; https://clinicaltrials.gov/ct2/show/NCT03406013 (Archived by WebCite at http://www.webcitation.org/73YpDIoTX). INTERNATIONAL REGISTERED REPOR PRR1-10.2196/11257
