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01-10-2020 | Obesity | Original Paper

Health Behavior Change in the Classroom: A Means to a Healthy End?

Authors: Robert R. Wright, Reese Nelson, Spencer Garcia, Amanda Butler

Published in: Journal of Prevention | Issue 5/2020

Abstract

Obesity is a serious public health problem within the United States. One promising approach to obesity prevention is health behavior change among college students, focusing on diet, sleep, and exercise. However, it remains unclear whether a health behavior change promotion program implemented in the classroom will effectively improve these health behaviors and negative outcomes related to obesity, particularly within classes of different topics. We examined the impact of a 6-week health behavior change program based on the Theory of Planned Behavior. Across several years, with two seemingly distinct samples of students from either a health psychology (n = 433) or a home gardening (n = 155) course, we conducted two studies and employed a single group, pre/post design in which self-reported and objectively measured health outcomes were assessed for change relative to the health promotion program. Participants selected one of three health behaviors and sought to meet current Centers for Disease Control and Prevention recommendations by setting goals, tracking behavior, and meeting with social support groups. Within both studies, dramatic changes emerged in the targeted health behaviors of fruit and vegetable consumption, sleep quantity and quality, and exercise. Moreover, several other health indicators improved among our subjective and objective health variables, and a few outcomes (i.e., subjective health, sleep quality, flexibility, loneliness) improved across all health behavior groups. Collectively, these results suggest this health behavior change program may be an effective way to elicit behavior change and highlight avenues for future remediation and prevention of obesity and related disease.

Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.CrossRef

American College Health Association. (2014). American College Health Association-National College Health Assessment II: Undergraduate students reference group executive summary spring 2014. Hanover, MD: American College Health Association.

Armitage, C. J., & Connor, M. (2001). Efficacy of the theory of planned behavior: A meta-analytic review. British Journal of Social Psychology, 40, 471–499. https://doi.org/10.1348/014466601164939.CrossRefPubMed

Arnett, J. J. (2000). Emerging adulthood. A theory of development from the late teens through the twenties. American Psychologist, 55, 469–480. https://doi.org/10.1037/0003-066X.55.5.469.CrossRefPubMed

Baumeister, R. F., Bratslavsky, E., Muraven, M., & Tice, D. M. (1998). Ego-depletion: Is the active self a limited resource? Journal of Personality and Social Psychology, 74, 1252–1265.CrossRef

Bohannon, R. W., Maljanian, R., & Goethe, J. (2003). Screening for depression in clinical practice: Reliability and validity of a five-item subset of the CES-depression. Perceptual and Motor Skills, 97, 855–861. https://doi.org/10.2466/pms.2003.97.3.855.CrossRefPubMed

Buxton, O. M., Quintilliani, L. M., Yang, M. H., Ebbeling, C. B., Stoddard, A. M., Pereira, L. K., et al. (2009). Association of sleep adequacy with more healthful food choices and positive workplace experiences among motor freight workers. American Journal of Public Health, 99, 636–643. https://doi.org/10.2105/AJPH.2008.158501.CrossRef

Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index (PSQI): A new instrument for psychiatric research and practice. Psychiatry Research, 28, 193–213. https://doi.org/10.1016/j.psychres.2012.03.045.CrossRefPubMed

Cecchini, M. (2018). Use of healthcare services and expenditure in the US in 2025: The effect of obesity and morbid obesity. PLoS ONE, 13, 1–14. https://doi.org/10.1371/journal.pone.0206703re.CrossRef

Centers for Disease Control and Prevention. (2019). Adult obesity facts. https://www.cdc.gov/obesity/data/adult.html. Accessed 01 July 2019.

Chokshi, D. A., & Farley, T. A. (2014). Changing behaviors to prevent noncommunicable disease. Science, 345, 1243–1244. https://doi.org/10.1126/science.1259809.CrossRefPubMed

Christakis, N. A., & Fowler, J. H. (2007). The spread of obesity in a large social network over 32 years. New England Journal of Medicine, 357, 370–379. https://doi.org/10.1056/NEJMsa066082.CrossRefPubMed

Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates.

Cohen, S., & Hoberman, H. M. (1983). Positive events and social supports as buffers of life change stress. Journal of Applied Social Psychology, 13, 99–125.CrossRef

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396.CrossRef

Conner, M., Norman, P., & Bell, R. (2002). The theory of planned behavior and healthy eating. Health Psychology, 21, 194–201. https://doi.org/10.1037//0278-6133.21.2.194.CrossRefPubMed

Coughlin, J. W., & Smith, M. T. (2014). Sleep, obesity, and weight loss in adults: Is there a rationale for providing sleep interventions in the treatment of obesity? International Review of Psychiatry, 26, 177–188. https://doi.org/10.3109/09540261.2014.911150.CrossRefPubMed

Dennerlein, J. T., Hopcia, K., Sembajwe, G., Kenwood, C., Stoddard, A. M., Tveito, T. H., et al. (2012). Ergonomic practices within patient care units are associated with musculoskeletal pain and limitations. American Journal of Industrial Medicine, 55, 107–116. https://doi.org/10.1002/ajim.21036.CrossRefPubMed

Diehl, M., Semegon, A. B., & Schwarzer, R. (2010). Assessing attention control in goal pursuit: A component of dispositional self-regulation. Journal of Personality Assessment, 86, 306–317. https://doi.org/10.1207/s15327752jpa8603_06.CrossRef

Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The satisfaction with life scale. Journal of Personality Assessment, 49, 71–75.CrossRef

Dragano, R. V., Ferno, J., Dieguez, C., Lopez, M., & Milbank, E. (2020). Recent updates on obesity treatment: Available drugs and future directions. Neuroscience, 437, 215–239.CrossRef

Finkelstein, E. A., Trogdon, J. G., Cohen, J. W., & Dietz, W. (2009). Annual medical spending attributable to obesity: Payer- and service-specific estimates. Health Affairs, 28, 822–831. https://doi.org/10.1377/hlthaff.28.5.w822tr.CrossRef

Fontaine, K. R., Redden, D. T., Wang, C., Westfall, A. O., & Allison, D. B. (2003). Years of life lost due to obesity. Journal of the American Medical Association, 289, 187–193. https://doi.org/10.1001/jama.289.2.187.CrossRefPubMed

Ha, E. J., & Caine-Bish, N. (2009). Effect of nutrition intervention using a general nutrition course for promoting fruit and vegetable consumption among college students. Journal of Nutrition Education and Behavior, 41, 103–109. https://doi.org/10.1016/j.jneb.2008.07.001.CrossRefPubMed

Hales, C. M., Fryer, C. D., Carroll, M. D., Freedman, D. S., & Ogden, C. L. (2018). Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007–2008 to 2015–2016. Journal of American Medical Association, 319, 1723–1725. https://doi.org/10.1001/jama.2018.3060.CrossRef

Heath, G. W., Parra, D. C., Sarmiento, O. L., Andersen, L. B., Owen, N., Goenka, S., et al. (2012). Evidence-based intervention in physical activity: Lessons from around the world. The Lancet, 380(9838), 272–281. https://doi.org/10.1016/S0140-6736(12)60816-2.CrossRef

Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2008). A short scale for measuring loneliness in large surveys: Results from two population-based studies. Research on Aging, 26, 655–672. https://doi.org/10.1177/0164027504268574.CrossRef

Huxley, R., Mendis, S., Zheleznyakov, E., Reddy, S., & Chan, J. (2010). Body mass index, waist circumference, and waist:hip ratio as predictors of cardiovascular risk—A review of the literature. European Journal of Clinical Nutrition, 64, 16–22. https://doi.org/10.1038/ejcn.2009.68.CrossRefPubMed

Jakicic, J. M., & Otto, A. D. (2006). Treatment and prevention of obesity: What is the role of exercise? Nutrition Reviews, 64, 57–61. https://doi.org/10.1111/j.1753-4887.2006.tb00235.x.CrossRef

Kind, P., Brooks, R., & Rabin, R. (2005). EQ-5D concepts and methods: A developmental history. Dordrect: Springer.CrossRef

Kurz, C. F., & Laxy, M. (2020). Application of Mendelian Randomization to investigate the association of body mass index with health care costs. Medical Decision Making, 40, 156–169. https://doi.org/10.1177/0272989X20905809.CrossRefPubMed

Linder, A. D., Harper, A., Jung, J., & Woodson-Smith, A. (2017). Ajzen’s theory of planned behavior’s attitude and intention and their impact on physical activity among college students enrolled in lifetime fitness courses. College Student Journal, 51, 550–560.

Mann, T., Tomiyama, A. J., Westling, E., Lew, A. M., Samuels, B., & Chatman, J. (2007). Medicare’s search for effective obesity treatments: Diets are not the answer. American Psychologist, 62, 220–233. https://doi.org/10.1037/0003-066X.62.3.220.CrossRefPubMed

Martyn, P., & Brymer, E. (2016). The relationship between nature relatedness and anxiety. Journal of Health Psychology, 21, 1436–1445. https://doi.org/10.1177/1359105314555169.CrossRefPubMed

McEachan, R. R. C., Conner, M., Taylor, N. J., & Lawton, R. J. (2011). Prospective prediction of health-related behaviours with the theory of planned behaviour: A meta-analysis. Health Psychology Review, 5, 97–144. https://doi.org/10.1080/17437199.2010.521684.CrossRef

Nelson, M. C., Story, M., Larson, N. I., Neumark-Sztainer, D., & Lytle, L. A. (2008). Emerging adulthood and college-aged youth: An overlooked age for weight-related behavior change. Obesity, 16, 2205–2211. https://doi.org/10.1038/oby.2008.365.CrossRefPubMed

Orzech, K. M., Salfsky, D. B., & Hamilton, L. A. (2011). The state of sleep among college students at a large public university. Journal of American College Health, 59, 612–619. https://doi.org/10.1080/074481.2010.520051.CrossRefPubMed

Partridge, S. R., Juan, S. H., McGeechan, K., Bauman, A., & Allman-Farinelli, M. (2015). Poor quality of external validity reporting limits generalizability of overweight and/or obesity lifestyle prevention interventions in young adults: A systematic review. Obesity Reviews, 16, 13–31.CrossRef

Plotnikoff, R. C., Costigan, S. A., Williams, R. L., Hutchesson, M. J., Kennedy, S. G., Robards, S. L., et al. (2015). Effectiveness of interventions targeting physical activity, nutrition and healthy weight for university and college students: A systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 12, 1–10. https://doi.org/10.1186/s12966-015-0203-7.CrossRef

Popkin, B. M. (2012). Sugary beverages represent a threat to global health. Trends in Endocrinology and Metabolism, 23, 591–593. https://doi.org/10.1016/j.tem.2012.07.003.CrossRefPubMed

Reiner, M., Niermann, C., Jekauc, D., & Woll, A. (2013). Long-term health benefits of physical activity: A systematic review of longitudinal studies. BMC Public Health, 13, 1–9. https://doi.org/10.1186/1471-2458-13-813.CrossRef

Ruby, M. B., Dunn, E. W., Perrino, A., Gillis, R., & Viel, S. (2011). The invisible benefits of exercise. Health Psychology, 30, 67–74. https://doi.org/10.1037/a0021859.CrossRefPubMed

Sheeran, P., Maki, A., Montanaro, E., Avishai-Yitshak, A., Bryan, A., Klein, W. M., et al. (2016). The impact of changing attitudes, norms, and self-efficacy on health-related intentions and behavior: A meta-analysis. Health Psychology, 35, 1178–1188. https://doi.org/10.1037/hea0000387.CrossRefPubMed

Spector, P. E., & Jex, S. M. (1998). Development of four self-report measures of job stressors and strain: Interpersonal conflict at work scale, organizational constraints scale, quantitative workload inventory, and physical symptoms inventory. Journal of Occupational Health Psychology, 3, 356–367. https://doi.org/10.1037/1076-8998.3.4.356.CrossRefPubMed

Stice, E., Shaw, H., & Marti, C. N. (2006). A meta-analytic review of obesity prevention programs for children and adolescents: The skinny on interventions that work. Psychological Bulletin, 132, 667–691. https://doi.org/10.1037/0033-2909.132.5.667.CrossRefPubMedPubMedCentral

Ten Hoor, G. A., Kok, G., Peters, G.-J., Frissen, T., Schols, A., & Plasqui, G. (2017). The psychological effects of strength exercises in people who are overweight or obese: A systematic review. Sports Medicine, 47, 2069–2081. https://doi.org/10.1007/s40279-017-0748-5.CrossRefPubMed

Thompson, F. E., Subar, A. F., Smith, A. F., Midthune, D., Radimer, K. L., Kahle, L. L., et al. (2002). Fruit and vegetable assessment: Performance of 2 new short instruments and a food frequency questionnaire. Journal of the American Dietetic Association, 102, 1764–1772. https://doi.org/10.1016/S0002-8223(02)90379-2.CrossRefPubMed

Vartanian, L. R., Schwartz, M. B., & Brownell, K. D. (2007). Effects of soft drink consumption on nutrition and health: A systematic review and meta-analysis. American Journal of Public Health, 97, 667–675. https://doi.org/10.2105/AJPH.2005.083782.CrossRefPubMedPubMedCentral

Wardle, J., Chida, Y., Gibson, E. L., Whitaker, K. L., & Steptoe, A. (2011). Stress and adiposity: A meta-analysis of longitudinal studies. Obesity, 19, 771–778. https://doi.org/10.1038/oby.2010.241.CrossRefPubMed

Wilfley, D. E., Hayes, J. F., Balantekin, K. N., Van Buren, D. J., & Epstein, L. H. (2018). Behavioral interventions for obesity in children and adults: Evidence base, novel approaches, and translation into practice. American Psychologist, 73, 981–993. https://doi.org/10.1037/amp0000293.CrossRefPubMed

Winkeby, M. A., & Cubbin, C. (2004). Changing patterns in health behaviors and risk factor related to chronic diseases. American Journal of Health Promotion, 19, 19–27. https://doi.org/10.4278/0890-1171-19.1.19.CrossRef

Wright, R. R., Broadbent, C., Graves, A., & Gibson, J. (2016). Health behavior promotion among Latter-day Saint college students. Psi Chi Journal of Psychological Research, 21, 200–215. https://doi.org/10.24839/2164-8204.JN21.3.200.CrossRef

Wright, R. R., Nixon, A. E., Peterson, Z. B., Thompson, S. V., Olson, R., Martin, S., et al. (2017). The workplace interpersonal conflict scale: An alternative in conflict assessment. Psi Chi Journal of Psychological Research, 22, 163–180. https://doi.org/10.24839/2325-7342.JN22.3.163.CrossRef

Wright, R. R., Perkes, J. L., Schaeffer, C., Woodruff, J. B., Waldrip, K., & Dally, J. L. (2018). Investigating BMI discrepancies in subjective and objective reports among college students. Journal of Human Health Research, 1, 106–115.

Wright, R. R., Schaeffer, C., Mullins, R., Evans, A., & Cast, L. (2020). Comparison of student health and wellbeing profiles and social media use. Psi Chi Journal of Psychological Research, 25(1), 14–21. https://doi.org/10.24839/2325-7342.JN25.1.14.CrossRef

Title: Health Behavior Change in the Classroom: A Means to a Healthy End?
Authors: Robert R. Wright
Reese Nelson
Spencer Garcia
Amanda Butler
Publication date: 01-10-2020
Publisher: Springer US
Keywords: Obesity
Obesity
Published in: Journal of Prevention / Issue 5/2020
Print ISSN: 2731-5533
Electronic ISSN: 2731-5541
DOI: https://doi.org/10.1007/s10935-020-00605-0

ACC 2024 Congress

Springer Medicine

Health Behavior Change in the Classroom: A Means to a Healthy End?

Abstract

ACC 2024 Congress

Springer Medicine

Abstract

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