Source: SOUTH DAKOTA STATE UNIVERSITY submitted to NRP
DEVELOPMENT OF A RANDOMIZED TRIAL GUIDED BY THE PROCESS OF PRECEDE-PROCEED FOR PREVENTION OF EXCESSIVE WEIGHT GAIN IN COMMUNITIES OF YOUNG A
Sponsoring Institution
National Institute of Food and Agriculture
Project Status
COMPLETE
Funding Source
Reporting Frequency
Annual
Accession No.
0217242
Grant No.
2009-55215-05460
Cumulative Award Amt.
$1,499,491.00
Proposal No.
2008-04379
Multistate No.
(N/A)
Project Start Date
Aug 1, 2009
Project End Date
Jul 31, 2014
Grant Year
2009
Program Code
[31.5]- Human Nutrition and Obesity
Recipient Organization
SOUTH DAKOTA STATE UNIVERSITY
PO BOX 2275A
BROOKINGS,SD 57007
Performing Department
College of Education & Human Sciences
Non Technical Summary
Prevalence of overweight in young adults (YA) has more than doubled in the past 30 years and now approximately 64% are overweight or obese. To prevent excessive weight gain and encourage achievement of healthful weight, this project will use the community-based participatory research process (CBPR)of PRECEDE-PROCEED (PP) to develop and test a 12-week intervention tailored to the 18-24 year old for the prevention of obesity. The PP process of CBPR will be employed to identify and prioritize the problems of significance (quality of life/health/and environmental/behavioral determinants and predisposing/enabling and reinforcing factors) to YA which will then be linked to factors influencing weight gain. Per the tenets of CBPR, the target population will be involved in planning, developing, and implementing the intervention. Young adults (18-24 years old, n=2040) recruited from 12 states will be randomized into intervention or control groups to test the effectiveness of this model intervention. The intervention has the potential to reach widespread, diverse communities of young adults to promote and develop healthful habits that prevent excessive weight gain during this vulnerable phase of the lifecycle. This study will be the first to develop a model intervention for obesity prevention that uses the CBPR process to integrate research, Extension, and communities of YA. It is expected that the intervention will reduce the rate of weight gain over 15 months, increase eating competency, fruit and vegetable consumption, and physical activity compared to the control group who do not receive the intervention.
Animal Health Component
90%
Research Effort Categories
Basic
(N/A)
Applied
90%
Developmental
10%
Classification

Knowledge Area (KA)Subject of Investigation (SOI)Field of Science (FOS)Percent
7035010302050%
7036010302050%
Knowledge Area
703 - Nutrition Education and Behavior;

Subject Of Investigation
6010 - Individuals; 5010 - Food;

Field Of Science
3020 - Education;
Goals / Objectives
Twelve principal investigators, most with extensive experience in working with the 18-24 year old population will collaborate and use the PRECEDE-PROCEED (PP) process of community-based participatory research (CBPR) to develop and test an intervention for the prevention of obesity in communities of 18-24 year olds. The overarching difference between the intervention, as described in this study, and others previously reported is that the proposed intervention will be created with community partnerships/steering committees, including members of the target populations involved in all aspects of assessment, development, testing and evaluation of the intervention, with the objective of increasing the likelihood of not only effectiveness, but sustainability. The design is a 15-month, randomized, control trial testing the intervention for effectiveness to prevent excessive weight gain in the target population. Each state will recruit 170 participants (n=2040). Assessments will occur at 0, 3, and 15 months. The primary outcome measure will be body weight. Other outcome measures will include fruit and vegetable intake, physical activity, and quality of life indicators. Increased advocacy for environmental changes will be evaluated. The intervention will occur over 12 weeks between baseline and 3 months assessment and will be designed to capitalize on young adults' use of emerging technology mediums, such as an interactive web-based gaming formats and their social networking platforms and podcasting. The hypotheses that will be tested are: 1. Young adults enrolled in an intervention for prevention of excessive weight gain designed using the PP process will gain less weight over 15 months than participants in the non-intervention control condition. 2. Young adults receiving the interventions for prevention of excessive weight gain designed using the PP process will improve intermediary outcomes related to eating competence, physical activity, fruit and vegetable intake and waist circumference to a greater extent than those in the control condition. Successful completion of the proposed project will have three important immediate impacts: 1) the cadre of research, Extension and community-based personnel working on the project will further develop their skill in using CBPR process of P; 2) the usefulness of CBPR process of PP will be determined with a vulnerable population group-young adults aged 18-24; and 3) the usefulness of new approaches to prevent weight gain will be determined with this target audience. Demonstrated success with this approach to weight gain prevention could impact current and future weight gain prevention programs. The ultimate outcome of this work will be to demonstrate a best practices model for successful outreach to young adult audiences and educationally appropriate materials and interventions that meet young adults' needs in their acquisition of healthful eating and prevention of weight gain practices.
Project Methods
The funded project covers Phases 4 through 8 of the PRECEDE-PROCEED process. Phase 4, Program Administrative and Policy Design. Policy, organizational and administrative capabilities and resources that support obesity interventions will be assessed and teams will determine components that are needed and available to effect the desired changes. To ensure target population and partner input, the principal investigators (PI) will work through their state steering committees to tailor the intervention. This process will be an iterative procedure and will continue until the intervention under development meets the collective objectives of all the communities. The intervention will be for weight management through healthful eating and physical activity based on those qualities that contribute to young adult's life balance and will include a series of lessons, educational opportunities, or vignettes focusing on the components of becoming a competent eater, choosing a healthful diet (variety, portion sizes, eating enjoyment, and skills necessary for meal planning, grocery shopping and meal preparation), balancing life through time management, managing stress, and modifying lifestyle choices to support physical activity. The intervention will be 12 weeks, delivered weekly through emerging technology mediums and will include goal setting and frequent feedback on goal attainment. Phase 5. Implementation. This phase involves moving from PRECEDE into PROCEED. The PI from each state will work with the steering committee to implement the intervention. The intervention will be piloted with samples (20 per state) and after refinement will be tested using a randomized, control design. Each state will recruit 170 participants (n=2040) that will be randomly assigned to intervention or control group, stratified by gender. Primary outcome of weight and intermediary outcomes of eating competence, physical activity, fruit and vegetable intake and waist circumference will be measured in both control and intervention participants at baseline, 3 months and 15 months. Additional measures include resistance training, 3 factor eating questionnaire (cognitive restraint, uncontrolled and emotional eating), quality of life questionnaires and quality and quantity of sleep. Phase 6. Process Evaluation. In this phase, occurring in Year 2, we will evaluate on an on-going basis the fidelity with which the intervention is being implemented and whether the intervention is operating effectively. Feedback will be elicited from the partnership teams and the target audience. This phase will occur concurrently with phases 5, 7, and 8 through the end of the project. Phase 7 (Impact evaluation) and Phase 8 (Outcome evaluation) are the evaluation and outcomes of the randomized control trial. Data Analysis. The general analytical approach used to evaluate the effects of the intervention on the primary outcome of weight will be a 2 (groups) by 3 (occasions) repeated measures analysis of covariance.

Progress 08/01/09 to 07/31/14

Outputs
Target Audience: Young adults (N=1639, approximately 60% female) from public and private universities were enrolled as participants. Additionally,young adults (N=165; 112 males/ 53 females), 18-24 years old, attending the two residential job training programs in Maine were recruited to tailor the intervention to limited income audience. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? The project provided training on the community based participatory research process of PRECEDE-PROCEED to principle investigators, project directors, and graduate students. Furthermore, the numerous graduate students participated in the research process and developed and understanding of the research process. Trainings were also developed to train the graduate students on collection of anthropometric measurements and data. How have the results been disseminated to communities of interest? The results have been disseminated to communities of interest. PI and graduates students from respective institutions have reported results to administrators. Additionally, the results have been disseminated at national meetings such as Society for Nutrition Education and Behavior and American Society for Nutrition. What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? Project YEAH is one of the first studies to use the CBPR process of PRECEDE-PROCEED (PP) to develop a non-diet approach intervention reinforcing behaviors that prevent excessive weight gain in the young adult, college and a non-college vocational education population. Extensive work was conducted via the PRECEDE Phases to determine quality of life issues and respective predisposing, reinforcing, and enabling factors that needed to be addressed in the intervention to foster healthful behaviors supporting weight maintenance Furthermore, the intervention content was individually tailored by the Transtheoretical Model and educational materials developed using Dick and Carey’s Model for Instructional Design to enhance the attention, relevance, confidence, and satisfaction of the intervention.The intervention consisted of 21 mini-educational lessons and email messages (called nudges). The lessons addressed eating behavior, physical activity, stress management, and healthy weight management. Email “nudges” were short, entertaining messages with videos that were stage-tailored to precontemplators, contemplators/preparers, or actor/maintainers for fruit and vegetable consumption, physical activity, and stress management. The nudges reinforced behaviors promoted in the lessons; encouraged participants to visit the web portal to view the lessons and set goals. Delivery of the nudges to the non-college vocational population was individualized to meet the vocational education policies and were delivered via paper to participant residential rooms. During the intervention phase, each week participants received 3 stage-tailored nudges plus 1 encouraging them to view the new lessons. Participants were required to visit the website weekly to set goals for 1 or all 3 of targeted behavior(s). Within their personal web portal, participants could view a graph of their goal(s), progress towards goal, and recommendations for each target behavior. Participants who had not set a goal in the past 6 days were automatically sent emails prompting them to access their web portal and set a goal. Viewing lessons was voluntary. Vocational educational participants were allowed to view portal at specified times each day. During the follow-up phase (the period of time between post-intervention assessment and follow-up assessment), the frequency of email nudges was reduced to 4 per month (3 stage-based messages and a reminder to visit the website). The website remained active for review, but no new lessons were added. Although there were no differences between experimental and control participants in Project YEAH in weight change or BMI, the intervention supported positive change in behaviors that may mediate excessive weight gain such as increasing fruit and vegetable intake and planning for meal time behaviors. Experimental group participants reported a small, but significant, increase in fruit and vegetable intake during the intervention period, whereas, the control participants decreased their intakes. Other programs, including previous work from our groupreported similar outcomes in that they did not influence weight but affected health behaviors, such as fruit and vegetable intake, which may influence long-term weight maintenance. The majority of participants in college Project YEAH (68%) were at a normal weight. Weight gain is still a concern as the first year students in YEAH gained significantly more weight than the second year college students students. In contrast, the YEAH-VOC male participants were overweight and the females were obese. An increase in physical activity behavior was not reported in Project YEAH which may be in part due to ceiling affect.The YEAH participants were relatively active at baseline compared to national standards. Approximately 80% of YEAH participants self-reported meeting the recommended physical activity guidelines of 150 minutes of moderate physical activity per day at baseline. In the formative phases of the work to develop the Project YEAH, college students had identified stress from lack of finances and time to manage daily activities and school work as a factor that affected their quality of life and this stress was perceived as a barrier to healthful behavior. However, in contrast, when the college and vocational education students in this intervention were queried about perceived stressed, they reported relative satisfaction with life and had relatively low perceived stress scores similar to those reported by other student samples. Because lack of sleep and or the ability to manage schedules can interfere with obtaining adequate sleep, amount of sleep was used as a secondary indicator of stress management. Project YEAH included lessons on the importance of getting enough sleep and strategies on how to manage time to get enough sleep. The experimental college participants were able to maintain their sleep hours while the control group reported a decrease in the hours slept from baseline to post-intervention. This difference in behavior may be important when considered in context of the academic calendar. Baseline sleep measures occurred at the beginning of the semester as students returned from winter break, whereas, the post-intervention and follow-up measures both occurred near the semesters’ end. Increased end-of-semester academic demands may result in college students getting less sleep. Both groups reported a low average amount of sleep, however, closer to 7 than the 9 recommended hours of per day and less than amounts reported by other researchers. YEAH experimental college and vocational group participants reported greater self-instruction for intention to plan meals and snacks and self-regulation in execution of meals and snacks post intervention than control participants. Project YEAH eating lessons and corresponding nudges may have accounted for these differences in intention for/and or executing healthful mealtime behaviors. Eating lessons focused on activities to support healthful mealtime behaviors, such as planning for regular meals and snacks, shopping for food, budgeting, assembling meals and snacks, and choosing foods in campus food venues. Results indicate that the intervention was moderately successful; a greater proportion of experimental than control participants were in post-action stages at post intervention for consuming 5 or more cups of fruit and vegetable a day as well as completing 150 minutes of physical activity a week, but there was not a significant difference between groups for perceived stress. These differences were not maintained at follow-up. Although theory-based, web-delivered programs offer promise to support behavior changes for obesity prevention, and Transtheoretical Model tailored interventions have been effective,brief email nudges may not be sufficiently powerful for maintenance of behavior change. Project YEAH used an Internet delivery mode to reach young adult college students and an adapted Internet delivery mode for the non-college vocational education student. It was built on best practices, using the “ingredients” for success reported by others. The CBPR process of PP was used to guide the development of Project YEAH and Yeah-VOC and included extensive target audience input throughout the development and delivery of the interventions.However study findings make it clear that there is much more to learn about the “recipe” for using these ingredients to create interventions that successfully and substantially facilitate behavior changes that promote healthy weights. Yeah-VOC has the potential to provide a weight management program for disadvantaged, non-college young adults who are at-risk or already are obese. Project YEAH has potential to provide basic health and wellness information for the college student, particularly the incoming freshman.

Publications

  • Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Quick, V., Aljallad, C., Yorkin, M., McKinley, J., Yablonsky, C., Shu, E., Jackson, R., Burslem, R., Ciecierski, C., Byrd-Bredbenner, C. (2012) Young Adults Dietary Practices, Physical Activity Level, Perceived Stress, and Health Outcomes. New Jersey Dietetic Association, May, East Brunswick.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2011 Citation: Quick, V., Aljallad, C., Yorkin, M., McKinley, J., Yablonsky, C., Shu, E., Jackson, R., Burslem, R., Ciecierski, C., Byrd-Bredbenner, C. (2011) Anthropometric, Biochemical, And Clinical Assessments of Rutgers Students Enrolled in Project Y.E.A.H.. New Jersey Dietetic Association, New Brunswick, May.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Kattelmann K, White A, Greene G, Byrd-Bredbenner C, Nitzke S, Horacek T, Hoerr S, Kidd T, Colby S, Olfert M, Brown O, Shelnutt K, Phillips B, Stabile Morrell J. Development of a Randomized Trial Guided by the Process of PRECEDE-PROCEED for the Prevention of Excessive Weight Gain in Communities of Young Adults. J. Nutr.Education & Behavior 2014;46;S194.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Walsh J, Byrd-Bredbenner C, Kattelmann K, Colby S, Greene G, Hoerr S, White AA, Stabile-Morrell J, Horacek T, Brown-Esters O, Kidd T, Koenings M, Phillips B, Shelnutt KP, Olnert M. Examining Differences in Anthropometric Measures and Dietary Intake of Young Adults Attending College or Vocational Programs. J Nutr Educ & Behav. 2013;45:S57-S58.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2014 Citation: Koenings MM, Kattelmann KK, Olfert MD, Nitzke SA. College alcohol environment, student alcohol self-efficacy and alcohol consumption patterns. Food and Nutrition Conference and Expo. October 2014. Atlanta, Georgia, USA.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Koenings MM, Kattelmann KK, Olfert MD, Nitzke SA. College alcohol environment, student alcohol self-efficacy and alcohol consumption patterns. Nutrition, Food, Health & Animal Sciences Graduate Student Conference. April 2014. New Brunswick, New Jersey, USA.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2014 Citation: Koenings MM, Kattelmann KK, Olfert MD, Nitzke SA. Association between the college alcohol environment, student alcohol consumption, and physical activity. Nutrition, Food, Health & Animal Sciences Graduate Student Conference. April 2014. New Brunswick, New Jersey, USA.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Koenings MM, Olfert M, Kattelmann KK, Nitzke SA. Underage students access to alcohol on three college campuses. Research Frontiers in Nutritional Sciences. March 2012. Tucson, Arizona, USA.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2010 Citation: Koenings M, White A, Walsh J, Carey G, Esters O, Hoerr S, Nitzke S, Philips B, and Shelnutt K. Initial phase of developing a new Behavior and Environmental Changeability Survey (BECS) for use in young adults. Wisconsin Prevention of Obesity and Diabetes. June 2010. Madison, Wisconsin, USA.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Donovan M, Morrell JS, Kattelman KK. A Correlative Study of Perceived Stress and Emotional Support with Weight Gain in College Students: Expanding the Young Adults Eating and Active for Health Project April 2012, UNH Undergraduate Research Conference, Durham, New Hampshire.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Thompson-Snyder CA, Kidd T, Han J, Kattelmann K, Byrd-Bredbenner C, Colby S, Hoerr S, Olfert M, Morrell JS. Characteristics associated with hypertension guidelines of a young adult college population. M.I.N.K. Conference, 2013.
  • Type: Theses/Dissertations Status: Published Year Published: 2014 Citation: Hemmingson, K.Tailoring a Web-based Weight Maintenance Intervention for Northern Plains American Indian Public University Students, Thesis, South Dakota State University, May 2014.
  • Type: Theses/Dissertations Status: Published Year Published: 2013 Citation: Byer, C. MOVEMENT TO ACTION IN PROJECT Y.E.A.H., Thesis, South Dakota State University, May 2013
  • Type: Journal Articles Status: Awaiting Publication Year Published: 2014 Citation: " Kattelmann K, Byrd-Bredbenner C, White A, Greene G, Hoerr S, Kidd T, Colby S, Horacek T, Phillips B, Koenings M, Brown O, Olfert M, Shelnutt K, Morrell J. The effects of Young Adults Eating and Active for Health (YEAH): a theory-based web-delivered intervention. J. Nutr. Education & Behavior. 2014 (in press).


Progress 08/01/12 to 07/31/13

Outputs
Target Audience: 1639 young adult, college students and 165 young adult's residing in a vocational education campus were involved in development and testing the program. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? All PI, project personnel, and students have been trained in community based participatory research process of PRECEDE-PROCEED. Training manuals and on-line modules have been developed to train personnel on weight, height, and waist circumference. How have the results been disseminated to communities of interest? Results from college campus community have been disseminated via poster and conference presentations. What do you plan to do during the next reporting period to accomplish the goals? Manuscript development is in progress.

Impacts
What was accomplished under these goals? Project Y.E.A.H.College Campus.Researchers from 14 states collaborated and developed a tailored web-delivered, theory-based intervention focusing on life-style modifications for prevention of excessive weight gain in young adults. The intervention content and structure followed the CBPR process of PRECEDE-PROCEED to enhance its relevance and sustainability. Development of Project Y.E.A.H.The intervention components were available at a password protected website created for the program’s 21 mini-educational lessons, email reinforcement “nudges” tailored for stage of readiness to change, and goal setting features. Participants accessed intervention components via the Project Y.E.A.H. Participant Portal Welcome Page. The “Activities” tab on the Welcome Page took participants to the “Activities” landing page and gave them access to the lessons. The lessons were called “Activities” rather than lessons to make them seem less formal and decrease the academic feel. Lessons were designed to be short and interactive with attention-getting material, lesson goals, educational content and, encouragement suggestions for trying new activities or behavior and goal setting.The lessonsaddressed four topic categories: Eating, Physical Activity, Stress Management, My Healthy Weight, and also included an introduction, “Getting Started”, and a summary, “Moving Forward”. The “Getting Started” introduction video provided an explanation of the website, the expectations of the intervention, and the steps to get started. Each participant completed the Getting Started video before moving onto other lessons. One to three new lessons were released each week during the intervention. The Eating category contained seven lessons that helped participants learn to eat healthful foods, eat regularly, plan and prepare meals, enhance food variety, enjoy eating, and identify hunger and fullness signals. The Physical Activity category contained four lessons on the importance of exercise, how to find exercises that fit one’s lifestyle and preferences, how to have fun and stay fit, and fitness finesse. The Stress Management category contained six lessons on mindless eating, connecting mind and body, time management, sleep, smoking and alcohol, and balancing friends and classes. The My Healthy Weight category had a lesson on size acceptance and one on tips for managing weight. In “Moving Forward” all lesson content was summarized with encouragement to continue healthful habits. This lesson also provided directions for the 10-month follow-up portion of the intervention. The “nudges” tab contained brief messages reinforcing lesson content. Content was personalized by stating the participant’s name at the beginning of the message and tailored to each participant’s Stage of Change for eating, exercise, and stress behaviors (i.e., increase fruit and vegetable consumption, engage in 150 minutes of moderate physical activity per week, and manage stress most days of the week). Nudges were created for those in the precontemplation, contemplation/preparation, or action/maintenance stages. Based on previous research that the change processes used to move through the stages overlap, nudges were combined for the contemplation and preparation stages and for the action and maintenance stages.During then 10-week intervention, intervention participants were emailed four “nudges” per week (one stage-tailored for each of the three targeted behaviors and a fourth nudge to remind participants to access the website to view lessons and set a behavior change goal). After the 10-week intervention was complete, intervention participants received the four “nudges” each month for 10 months. Examples of the nudges for each topic by stage of readiness to change are presented in Table 2. To capture the targeted audience's interest and attention, short, entertaining videos were developed and linked to each of the nudges per feedback of the steering committee. The nudges and videos, once delivered by email, were available to the participants via the “Nudge” tab on the Welcome Page of the participant portal. The “My Comparison” tab on the Welcome Page provided access to the feedback component of goal setting for the three targeted behaviors. Intervention participants were encouraged to set goals for one to three behaviors: eating 5 cups of fruits and vegetables each day, getting 150 minutes of moderate physical activity each week, and coping constructively with stress most days of the week. Participants were able to set a goal for the week and later check their progress towards the goal. The participants were provided with a graph of the goal they set, what they reported doing, and the current recommendations for each goal behavior. To help participants personalize their own intervention participants were in control of their access to the lessons. They could decide, based on their desires and needs, which lessons they wanted to view and for how long. Participants were not required to complete any particular lesson or complete them in a specific order (other than the first lesson “Getting Started” and final lesson “Moving Forward”).The intervention participants were considered active if they either looked at a lesson or set a goal every 6 days. Intervention participants who had not viewed an activity or set a goal in 7 days were sent automatic email reminders to access the website. Development of Administrative Management Portal. The administrative management portal was simultaneously developed and evaluated with the web-based intervention during Phase 4. The lead researcher (KK) worked with the project software vendor to create a functional website for intervention delivery and administrative management. The website was developed using Microsoft’s Asp.net technology and all website data were stored in a Microsoft SQL Server database. The primary goal during the development of the administrative management portal was to provide a fully interactive tool for adding and updating lesson content and study data collection survey instruments, monitoring participant activity, and retrieving study data. Project Y.E.A.H-VOC. The educational materials were adapted by researchers from University of Maine to limited-income, young adults living on a vocational education campus.The adaptations and specialized attributes of the Y.E.A.H. program for this disadvantaged population were essential for feasibility and were facilitated by the use of CBPR. To ensure appropriate literacy of materials, all Y.E.A.H. modules were reviewed by a literacy expert. The researcher, also, has extensive plain language and health literacy training and modified all materials as needed. Stage-based nudges and survey instruments were pretested with participants and modified by the researcher. The goal was to maintain a reading level between fifth and eighth grade although a few survey instruments were as high as tenth. The researcher or job training program staff member was available at all times to assist with reading and comprehension .As with Y.E.A.H Campus, Y.E.A.H.-VOC consisted of on-line modules with weekly goal setting for cups of fruit and vegetable intake, days and minutes of physical activity, and days ofeffective stress management.Y.E.A.H.-VOC participants received their stage-based nudges as print rather than via email.Nudges were prepared by the researcher and hand-delivered by the residential staff to the participants in their dorm rooms. During the 12-week follow-up period, participants continued to receive nudges in the form of a booster letter once per week. Participants’ stage for the messages in the letter was based on post-assessment responses.

Publications

  • Type: Theses/Dissertations Status: Published Year Published: 2013 Citation: Relationships between the alcohol environment and alcohol behaviors of college students. Koenings, M. University of Wisconsin
  • Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Horacek T, Brown-Esters O, Byrd-Bredbenner C, Carey G, Colby S, Greene G, Hoerr S, Kattelmann K, Kidd T, Koenings M, Olfert M, Phillips P, Shelnutt K, White A. Obesity prevention behavior and environment relationships on U.S. post-secondary campuses. International Congress of Dietetics Proceedings, Sidney, Australia September, 2012.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: " Kattelmann, K., White, A., Byrd-Bredbenner, C., Greene, G., Koenings, M., Horacek, T., Hoerr, S., Phillips, B., Colby, S., Brown-Esters, Stabile-Morell, J., Kidd, T., Olfert, M., Shelnutt, K. Project YEAH: Development of a web-based intervention for preventing excess weight gain in young adults. International Congress of Dietetics, Sydney Australia, Sept 5-8, 2012.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Kattelmann K, White A, Greene G, Byrd-Bredbenner C, Koenings M, Horacek T, Hoerr S, Kidd T, Phillips B, Colby S, Brown O, Shelnutt K, Olfert M, Stabile-Morrell J. Project YEAH: Development of a web-based intervention guided by the PRECEDE-PROCEED Model for preventing excess weight gain in young adults. Society for Nutrition Education and Behavior. August 2013. Portland, Oregon, USA.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Byer C, White A, Byrd-Bredbenner C, Greene G, Koenings M, Horacek T, Hoerr S, Phillips B, Colby S, Brown-Esters O, Stabile-Morrell J, Kidd T, Olfert M, Shelnutt K, Ren C, Kattelmann K. Effectiveness of a theory-based, web-delivered intervention for increasing fruit and vegetable intake. Society for Nutrition Education and Behavior. August 2013. Portland, Oregon, USA.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Walsh JR, Byrd-Bredbenner C, Morrell JS, Colby S, Brown-Esters O, Greene G, Hoerr S, Horacek T, Kidd T, Koenings M, Phillips B, Shelnutt KP, Olfert M, White AA, Kattelmann K. Examining differences in anthropometric measures and dietary intake of young adults attending college or vocational programs. Society for Nutrition Education and Behavior. August 2013. Portland, Oregon, USA.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: 1. Quick, V., Aljallad, C., Yorkin, M., McKinley, J., Yablonsky, C., Shu, E., Jackson, R., Burslem, R., Ciecierski, C., Byrd-Bredbenner, C. (2012) Young Adults Dietary Practices, Physical Activity Level, Perceived Stress, and Health Outcomes. New Jersey Dietetic Association, May, East Brunswick.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Quick, V., Aljallad, C., Yorkin, M., McKinley, J., Yablonsky, C., Shu, E., Jackson, R., Burslem, R., Ciecierski, C., Byrd-Bredbenner, C. (2011) Anthropometric, Biochemical, And Clinical Assessments of Rutgers Students Enrolled in Project Y.E.A.H.. New Jersey Dietetic Association, New Brunswick, May.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Steven McPartland, Kathleen Melanson, Geoffery Greene, Bryan Blissmer Kingston, RI; Adrienne White Orono, ME; Melissa D. Olfert Morgantown, WV; Carol Byrd-Bredbenner New Brunswick, NJ; Jesse Stabile Morrell Durham, NH; Kendra Kattelmann Brookings, SD. Stress, Diet, and Lifestyle in College Students: Analysis of the YEAH Study. The Obesity Society. 2013.
  • Type: Theses/Dissertations Status: Published Year Published: 2012 Citation: Walsh, J. A community-based participatory research approach for weight management among disadvantaged young adults. PhD. Dissertation University of Maine, 2012.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2013 Citation: Morrell JS, Byrd-Bredbenner C, Quick V, Olfert M, Dent A, Carey GC. Impact of a tailored, Internet-based intervention on metabolic risk among college adults. Oral presentation. Annual Conference of the International Society for Behavior Nutrition & Physical Activity 2013, Ghent, Belgium.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2013 Citation: Morrell JS. Metabolic Syndrome: Comparison of prevalence in young adults at three land-grant universities. Invited presentation. New Hampshire Dietetic Association Spring Conference 2012, New Hampshire Audubon Center, Concord, NH.
  • Type: Theses/Dissertations Status: Published Year Published: 2013 Citation: Morrell JS. Metabolic Syndrome Among College Adults: Prevalence & Risk. Dissertation, University of New Hampshire. December 2013.
  • Type: Theses/Dissertations Status: Published Year Published: 2011 Citation: Hebert, Angel. Validation of the Behavior, Environment and Changeability Survey. Thesis. University of Maine. 2011.
  • Type: Theses/Dissertations Status: Published Year Published: 2011 Citation: Goff, Rebecca. Formative Evaluation of the Stress Management Modules of an Intervention to Prevent Obesity in Young Adults. Thesis. University of Maine. 2011.
  • Type: Theses/Dissertations Status: Published Year Published: 2012 Citation: Dent, A; Harshbarger, C; Matak, K; Olfert, M. Metabolic Syndrome Risk in Young Adults Attending West Virginia University. Thesis from the Department of Animal and Nutritional Sciences in the Davis College of Agriculture, Natural Resources and Design, West Virginia University. 2012.
  • Type: Theses/Dissertations Status: Published Year Published: 2013 Citation: 25. McPartland S. Stress, Lifestyle and Diet in College Students: Secondary Analysis of the YEAH Study. Nutrition and Food Sciences. Kingston, RI: University of Rhode Island.
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2012 Citation: Koenings MM, Horacek TM, Kattelmann KK, Byrd-Bredbenner C, Gurka M, Philips B, Olfert M. Vending machines, sugar-sweetened beverage (SSB) use and weight status of college students. Experimental Biology (Proceedings) April 2013. Boston, Massachusetts, USA. (published in The Journal of the Federation of American Societies for Experimental Biology. 2013;27(1_MeetingAbstracts):121.4)
  • Type: Conference Papers and Presentations Status: Accepted Year Published: 2013 Citation: Koenings MM, Kattelmann KK, Olfert M. The college alcohol environments affect on student alcohol consumption and physical activity. American College of Sports Medicine. June 2013. Indianapolis, Indiana, USA. (published in Medicine and Science in Sports and Exercise. 2013;45:(5suppl):C32-127).
  • Type: Journal Articles Status: Published Year Published: 2013 Citation: Koenings MM. Body weight and nutrition consequences of alcohol consumption in young adults. American Journal of Lifestyle Medicine. 2013;7(4):250-54.
  • Type: Journal Articles Status: Published Year Published: 2013 Citation: Koenings MM, Olfert M, Kattelmann KK, Nitzke S. Pseudo-underage students access to alcohol surrounding three college campuses. Journal of Hunger & Environmental Nutrition. 2013;8(1):95-105.


Progress 08/01/11 to 07/31/12

Outputs
Target Audience: Target audience are college and non-college 18-24 year old emerging adults. Changes/Problems: Nothing Reported What opportunities for training and professional development has the project provided? Nothing Reported How have the results been disseminated to communities of interest? Nothing Reported What do you plan to do during the next reporting period to accomplish the goals? Nothing Reported

Impacts
What was accomplished under these goals? A theory-based, web-delivered program was developed to prevent excessive weight gain in young adults. Community involvement in the development and implementation of YEAH enhanced the intervention and increased the likelihood of a sustainable weight management program.

Publications

  • Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Kattelmann, K., White, A., Byrd-Bredbenner, C., Greene, G., Koenings, M., Horacek, T., Hoerr, S., Phillips, B., Colby, S., Brown-Esters, Stabile-Morell, J., Kidd, T., Olfert, M., Shelnutt, K. Project YEAH: Development of a web-based intervention for preventing excess weight gain in young adults. International Congress of Dietetics, Sydney Australia, Sept 5-8, 2012.
  • Type: Conference Papers and Presentations Status: Published Year Published: 2012 Citation: Horacek, T., Brown-Esters, O., Byrd-Bredbenner, C., Carey, G., Colby, S., Greene, G., Hoerr, S., Kidd, T., Koenings, M., Olfert, M., Phillips, B., Shelnutt, K., White, A. Obesity prevention behavior and environment relationships on U.S. post-secondary. International Congress of Dietetics Proceedings, Sydney Australia, Sept 5-8, 2012.
  • Type: Journal Articles Status: Published Year Published: 2012 Citation: Horacek TM, Olfert M, Byrd-Bredbenner C, Garey G, Colby S, Greene G, Hoerr S, Kattelmann K, Kidd T, Koenings M, Brown-Esters O, Shelnutt K, White A. Environmental Supports for Physical Activity and Healthy Snacking Vary across Campus. J Acad Nutr Diet. 2012;112(9), A-62.
  • Type: Journal Articles Status: Published Year Published: 2012 Citation: Kemmer, T.M, Koszewski W., Meendering, J., Jensen, B., Fischer, J., Stluka, S, Kattelmann, K., Wey, H., Takahashi, H., Droke, E. Transdisciplinary Childhood Obesity Prevention (T.O.P.) Graduate Education Certificate Program: Innovative and Multi-institutional. Journal of Nutrition Education and Behavior, 2012;44:S93
  • Type: Journal Articles Status: Published Year Published: 2012 Citation: Kattelmann,K., White, A., Greene, G., Byrd-Bredbenner, C., Horacek, T., Hoerr, S., Kidd, T., Phillips, B., Colby,S., Brown-Esters, O., Koenings, M., Shelnutt, K., Olfert, M., Stabile Morrell, J. Development of a Randomized Trial Guided by the Process of PRECEDE-PROCEED for the Prevention of Excessive Weight Gain in Communities of Young Adults. Journal of Nutrition Education and Behavior, 2012;44:S93-S94.


Progress 08/01/10 to 07/31/11

Outputs
OUTPUTS: Principal investigators completed phase 4 (PRECEDE) and moved into the PROCEED (phases 5-8) process with the implementation of the web-based program to assist young adults in adapting lifestyle behaviors for weight management. Topics in the modules were identified through the previous phases of PRECEDE-PROCEED. A 10-week intervention (Young Adults Eating and Active for Health, YEAH) was developed with input from the target audience and tested. The intervention was delivered via the web supported by stage based email messages (nudges). Nudges were emailed once/week for behaviors of eating, physical activity, and coping with stress during the 10-week intervention and are being emailed once/month post intervention. The nudges reinforced the content of the new Activity that was available that week or reinforced the content of the previous week. Short entertaining videos were linked with each nudge. 20 Activities (6 categories) were developed using Dick and Carey's System of Instructional Design and Keller's Instructional Motivational Model. The first Activity (Getting Started) was a short video explaining the website, the intervention, and the expectations of the participant. There were 7 Eating Activities that focused on strategies for choosing healthful diets; 4 Exercise Activities that focused on increasing daily physical activity; 6 Stress Activities focused on strategies for coping to reduce stress such as time management strategies; and 2 My Healthy Weight Activities that focus on size acceptance and tips for managing weight. The last Activity, "Moving Forward", provided summary of the Activities and the next steps for the follow-up. All modules were designed to be short with interactive quizzes and informational web-links. New activities were made available each week during the intervention. Participants were encouraged to set and update weekly goals for consuming 5 cups of fruits and vegetables/day, 30 minutes of physical activity/day and coping with stress most days of the week. 1639 young adults (18-24 years, 66% female), non-nutrition, non-exercise science majors from SD, RI, NY, KS, WI, NJ, NC, MI, AL, IN, FL, WV, and NH were recruited and randomized into intervention (824) and control (815). Participants provided consent and were assessed at baseline and post-intervention for stage of readiness to change for consuming 5 cups of fruits and vegetables/day, completing 30 minutes of physical activity most days/week, and coping with stress on most days/week, height, weight, waist circumference, BMI, fruit and vegetable intake, minutes of physical activity/day, coping with stress, food self-regulation and instruction behaviors, perception on quality of life, hours of sleep/day, weight related eating behaviors, physical activity related behaviors, calories from alcohol and sweetened beverages, percentage of energy from fat, and servings of whole grains/day. Final outcome assessments are planned 10 months post-intervention. ME adapted the program for delivery to Job Corp population. 159 low-income were recruited from two residential training facilities for the adapted 10-week weight management program. PARTICIPANTS: Principal investigators and graduate students from South Dakota State University, Tuskegee University, Univerity of Florida, Kansas State University, Purdue University, University of Maine, Michigan State University, East Carolina University, University of New Hampshire, University of New Jersey (Rutgers), Syracuse University, University of Rhode Island, University of Wisconsin, and University of West Virginia were involved with the development and implementation of the intervention. Personnel from Interactive Technology, Sioux Falls, South Dakota are subcontracted to develop the software. TARGET AUDIENCES: Target audience for this project include young adults from 13 universities and Job Corp. PROJECT MODIFICATIONS: Not relevant to this project.

Impacts
Outcomes from the project to date are: 1) research and extension personnel further developed skills in community based process of research; 2) 10 week web-based intervention developed with the input of the target audience of college age for both socioeconomic level of college students and low-income young adults such as those in Job Corp; 3) a 10 week web-based intervention developed with the input of the target audience of Job Corp young adults; and 4) a web-based shell that can be tailored and used for other stage-based on-line curriculums. This product differs from others that are available in that the target audience was involved in the development of the curriculum. In the process of development, on-line course management software has been constructed that allows staging of the participants and delivery of the specific message. This course management software has the potential for use in other interventions as the content is easily edited and changed. The college population averaged 19 years old, BMI of 24.1, consumed 2.7 cups of fruits and vegetables/day, 166 kcalories/day from sweetened beverages and 334 kcalories/day from alcohol, and 2 servings of whole grains. The majority rated their weight as "about right", but continued to state that they desire to lose 10 #.

Publications

  • Mortinsen, K., Kattelmann, K., White, A., Quick, V., Nitzke, S., Greene, G., Horacek, T., Hoerr, S., Phillips, B., Colby, S., Brown-Esters, O., Olfert, M., Kidd, T., Shelnutt, K., & Morrell, J. Tailoring a management access system for use by campus coordinators in 14 states for a web-bates nutrition intervention. Society for Nutrition Education, July 2011, Kansas City, MO J. Nutr. Educ. & Behavior. 2011.
  • Walsh, J., Mathew, D, Maia, A., Kattelmann, K. & White, A. Perceptions of weigh and self-reported behavior among low-income young adults. Society for Nutrition Education, July 2011, Kansas City, MO J. Nutr. Educ. & Behavior. 2011;43:4S1.
  • Kattelmann, K., White, A., Byrd-Bredbenner, C., Nitzke, S., Greene, G., Horacek, T., Hoerr, S., Phillips, B., Colby, S., Brown-Esters, O., Olfert, M., Kidd, T., Shelnutt, K. & Morrell, J. Project Y.E.A.H.: development of a web-based intervention guided by the precede-proceed model for preventing excess weight gain in young adults. Poster, International Society for Behavioral Nutrition and Physical Activity, June, 2011, Melbourne, Australia.
  • Koenings MM, Nitzke SA, Kattelmann KK, Buckingham WR. Alcohol environments differ among five college campuses in the United States. International Society for Behavioral Nutrition and Physical Activity, Poster, June, 2011, Melbourne, Australia.


Progress 08/01/09 to 07/31/10

Outputs
OUTPUTS: Principal investigators completed phase 4 and 5 of the PRECEDE-PROCEED process and have developed an on-line web-based program to assist young adults in supporting lifestyle behaviors that are associated with prevention of excessive weight gain. Topics in the modules were identified through the previous phases 1-4 of PRECEDE-PROCEED process. A 10-week web-based intervention titled Y.E.A.H (Young Adults Eating and Active for Health) was developed with input from the target audience and was pilot tested. The intervention will be delivered via the web supported by stage based email messages. The web program consists of 19 mini-modules developed using the ARCS curriculum model focusing on healthful eating, incorporating physical activity into daily living, strategies to cope with stress through time management, appropriate sleep, and balancing friends and other distractors in young adult life such as alcohol. Participants will be encouraged to set weekly goals to consume target levels of fruit and vegetable consumption, participate in 30 minutes of physical activity and cope with stress most days of the week. PARTICIPANTS: The principal investigators and graduate and undergraduate students from South Dakota State University, Tuskegee University, University of Florida, Kansas State University, Purdue University, University of Maine, Michigan State University, East Carolina University, University of New Hampshire, University of New Jersey (Rutgers), Syracuse University, University of Rhode Island, University of Wisconsin, and University of West Virginia are involved with the development and implementation of the intervention. Personnel from Interactive Technology, Sioux Falls, South Dakota are subcontracted to develop the software. TARGET AUDIENCES: Target audience for this project include young college adults from 13 states and Job Corp young adults from Maine. PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.

Impacts
Outcomes from the project to date are: 1) research and extension personnel further developed skills in community based process of research; 2) a preliminary 10 week web-based intervention developed with the input of the target audience of college age; 3)a preliminary 10 week web-based intervention developed with the input of the target audience of Job Corp young adults; and 4) a web-based shell that can be tailored and used for other stage-based on-line curriculums. This product differs from others that are available in that the target audience was involved in the development of the curriculum. In the process of development, on-line course management software has been constructed that allows staging of the participants and delivery of the specific message. This course management software has the potential for use in other interventions as the content is easily edited and changed.

Publications

  • No publications reported this period