International Journal of Behavioral Nutrition and Physical Activity最新文献

{"title":"Leaders like us: landscape of physical activity leadership programmes for underserved young women in England.","authors":"Jamie Crowther, Sufyan Abid Dogra, Sally Barber, Nazaket Ali, Jennifer Hall","doi":"10.1186/s12966-026-01886-0","DOIUrl":"10.1186/s12966-026-01886-0","url":null,"abstract":"<p><p>BACKGROUND: Despite growing advocacy for youth-led and inclusive physical activity provision, there remains limited evidence on how to effectively support underserved young women aged (16–25) and those from minoritised genders into Physical Activity leadership roles. METHODS: We used a two-phase sequential design. Phase 1 involved systematic mapping of 53 PA leadership programmes in England to describe programme focus, target populations, delivery models and stated outcomes. Phase 2 comprised seven online focus groups with 41 practitioners involved in designing, delivering or overseeing such programmes. Mapping data were summarised using descriptive statistics and narrative synthesis; focus group data were analysed using hybrid inductive–deductive framework analysis informed by Critical Positive Youth Development and feminist–intersectional lenses. RESULTS: Only a minority of mapped programmes were explicitly designed for girls and young women from underserved groups. Programmes most commonly operated through school- or club-based delivery, using modular learning, mentoring and cascaded models, with fewer incorporating financial support, digital delivery or clearly defined progression routes. Practitioners described how recruitment frequently relied on institutional gatekeepers and digital communication, raising concerns about who is reached and who is missed. They emphasised the importance of relational and culturally grounded recruitment and support, care-oriented infrastructures, and broader conceptualisations of leadership that include advocacy, representation and community influence. CONCLUSION: Combining systematic mapping with practitioner insights provides an integrated descriptive and interpretive picture of current provision. The findings indicate uneven targeting of underserved girls and young women and variable support for their progression into leadership roles. Enhancing equity in PA leadership development will require attention to recruitment practices, relational support and progression pathways that recognise diverse forms of youth leadership. </p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A theoretically designed scale-up intervention increases adoption of an effective school nutrition program 'SWAP IT': outcomes of a randomised trial.","authors":"Rachel Sutherland, Demi Herdegen, Jannah Jones, Courtney Barnes, Nicole Nathan, Katie Robertson, Anna Rayward, Adrian Bauman, Tameka McFadyen, Andrew Milat, Philip Morgan, Penny Reeves, Christopher Oldmeadow, Serene Yoong, Megan Cobcroft, Simon Chiu, John Wiggers, Luke Wolfenden","doi":"10.1186/s12966-026-01887-z","DOIUrl":"10.1186/s12966-026-01887-z","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BACKGROUND: Scale-up (i.e., the intentional effort to increase the reach and impact of an intervention) of effective school-based interventions is recommended to improve public health nutrition and prevent chronic disease. However, limited evidence to guide effective scale-up exists. This study aimed to assess the effectiveness of a theoretically designed multi-component scale-up intervention, designed using the Theoretical Domains Framework and Behavior Change Wheel, to increase the adoption of an evidence-based school nutrition program (SWAP IT) within primary schools in NSW Australia. We also identify any differences in the characteristics of schools adopting the program and describe the fidelity of delivering, and reach of each scale-up strategy. METHODS: A parallel-group randomised controlled trial was conducted across 11 Local Health Districts (LHD) in New South Wales Australia (n = 337 schools). Primary schools which had not previously adopted the SWAP IT school nutrition program and used an existing parent communication app (Audiri) in each LHD were randomised to receive a theoretically designed multi-component scale-up intervention (n = 169 schools) or to a waitlist control, exposed to a single discrete scale up strategy (n = 168 schools). The scale-up intervention consisted of nine scale-up strategies: three ‘vertical’ strategies aiming to increase LHD Health Promotion Units capacity to scale-up and six ‘horizontal’ strategies aiming to overcome school barriers to adopting the programs. The primary outcome was school adoption of SWAP IT objectively assessed via electronic records at 6-months, assessed via logistic regression adjusting for baseline and stratification variables. RESULTS: Following the 6-month multi-component scale-up intervention, significantly more schools in the scale-up intervention group (n = 67/169, 40%) had adopted the SWAP IT program compared to schools in the control group (n = 0/168, 0%) (p &lt; 0.001). Schools with a higher enrolment of Aboriginal and Torres Strait Islander students were more likely to adopt the program (p = 0.02), however no other school characteristics were associated with program adoption. Most scale-up strategies were delivered by LHD Health Promotion Units to schools with high fidelity (72–100%), however reach of the strategies varied widely (4-100%). CONCLUSIONS: A theoretically designed approach to scale-up, increased schools’ adoption of an evidence-based school nutrition program across a large and socio-economically and geographically diverse population. Program adoption rates were similar across socio-demographic and geographic characteristics. This approach can inform efforts of improving public health nutrition equitably through large scale adoption of school nutrition initiatives. TRIAL REGISTRATION: The trial was prospectively registered on 13/02/2023 with the Australian New Zealand Clinical Trials Registry (ACTRN12623000145606). https://anzctr.org.au/Trial/Registration/TrialRev","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recess and after-hours behavior patterns associated with community schoolyard transformations.","authors":"Marnie F Hazlehurst, Kathleen L Wolf, Cary Simmons, Sarneshea Evans, Mary Kathleen Steiner, Kimberly A Garrett, Pooja S Tandon","doi":"10.1186/s12966-026-01899-9","DOIUrl":"10.1186/s12966-026-01899-9","url":null,"abstract":"<p><p>BACKGROUND: Spending time in nature and physical activity are both linked to better health outcomes for children. School environments provide the potential for multiple interventions to promote healthy behaviors. Transforming these existing public spaces to serve broader activity functions provides opportunities to support healthy child development and to increase nature access for local communities. METHODS: Our quasi-experimental design capitalized on a community-engaged schoolyard redesign and redevelopment project completed at two elementary schools in Tacoma, Washington, USA, led by the Trust for Public Land. Renovations included painting paved surfaces, installation of new play structures, adding walking paths and log seating areas, and planting trees. We used a validated momentary time sampling observational tool, the System for Observing Outdoor Play Environments in Neighborhood schools (SOOPEN), before and after for two schools undergoing the transformation and a control school. Moderate-to-vigorous physical activity (MVPA) and within-group behaviors in the schoolyard were observed. We used a difference-in-difference approach to estimate the effect of the schoolyard renovation on behavior during recess, and on community use of the schoolyard outside of school hours. RESULTS: The schoolyard transformation was associated with a 1.51-times greater increase (95% CI: 0.95, 2.40) in MVPA during recess at intervention schools compared to the control school, although this association was only statistically significant among groups of boys. After renovation, MVPA was highest in grassy areas at one school (69%), but highest in paved zones with newly painted markings at the other (75%). Renovations were not associated with changes in the prevalence of prosocial behavior during recess, which was high at baseline. The schoolyard transformation was also associated with increased community use outside of school hours, especially for groups of children (5.8-times [95% CI: 1.4, 23.8] greater increase in use over time at renovation schools compared to the control school). CONCLUSIONS: Schoolyard transformations have the potential to increase schoolyard use and physical activity both during and outside of school hours, if campuses are open to community use. Additional rigorous research can inform future projects to support the health of school-age children and address inequities in distribution of community greenspaces. </p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147460802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of exercise on cognitive function in patients with depression: a three-level meta-analysis with dose-response and exploratory mediation analyses.","authors":"Cong Liu, Rao Chen, Shuqi Jia, Zhaohui Guo, Chen Wei, Xing Wang","doi":"10.1186/s12966-026-01902-3","DOIUrl":"10.1186/s12966-026-01902-3","url":null,"abstract":"&lt;p&gt;&lt;p&gt;BACKGROUND: Cognitive impairment is common among individuals with depression and contributes to functional impairment and poor treatment outcomes. Exercise, as a non-pharmacological intervention, has been increasingly recognized as a promising approach for improving cognitive function. However, the dose-response relationship underlying these effects remains poorly understood, and the mechanisms through which exercise may influence cognition or depressive symptoms have yet to be clarified. To address these gaps, this study used a three-level meta-analysis to quantify the effects of exercise on cognitive function in depression, examine potential moderators and dose-response patterns, and conduct an exploratory mediation analysis testing whether cognitive changes mediate exercise-related improvements in depressive symptoms. METHODS: We searched China National Knowledge Infrastructure (CNKI), Wanfang Data, Web of Science, Embase, the Cochrane Library, and PubMed for experimental studies evaluating the effects of exercise interventions on cognitive function in patients with depression, from database inception to May 30, 2025. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool, and certainty of evidence was graded with GRADEpro. Three-level meta-analyses were conducted with the metafor package in R. RESULTS: Thirty-one studies, including 2,324 participants with depression, were included. Exercise type included aerobic, resistance/strength training, mind-body practices, and multicomponent exercises. Exercise frequency ranged from 1 to 5 sessions per week; intervention duration from 3 to 16 weeks; and exercise intensity was categorized as low, moderate, or moderate to high. Session duration ranged from 30 to 180 min. A three-level meta-analysis showed that exercise improved cognitive function (Hedges’ g (g) = 0.24; 95% confidence Interval (CI), 0.14 to 0.33; p &lt; 0.001). Moderator analyses indicated significant influences of exercise intensity, inpatient status, intervention content, study design, and weekly exercise time (all p &lt; 0.05). Moderate-intensity interventions produced the largest gains (g = 0.36; 95% CI, 0.23 to 0.50; p &lt; 0.05). Dose-response modelling suggested that weekly exercise volumes below approximately 176 min may yield limited benefit (prediction interval crossing zero). In an exploratory mediation analysis, the indirect effect of exercise on depressive symptoms via cognition was insignificant (a×b = 0.02; 95% CI, -0.00 to 0.04), corresponding to a proportion mediated of 5.3%. CONCLUSIONS: Exercise is associated with improvements in cognitive function among individuals with depression. Rather than indicating a universal recommended dose, the dose–response analysis revealed a minimum weekly activity threshold, with cognitive benefits becoming more likely when moderate-intensity exercise exceeds approximately 176 min per week. Current evidence does not support cognitive improvement as the primary mediating pat","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility, acceptability and preliminary impact on diet quality of the Healthy Weight for Life™ + medical nutrition therapy; a randomised controlled pilot study.","authors":"Erin D Clarke, Georgina M Britton, Nicole Hedditch, Ryan Gallagher, Hailey Donnelly, Clare E Collins","doi":"10.1186/s12966-026-01885-1","DOIUrl":"10.1186/s12966-026-01885-1","url":null,"abstract":"<p><p>BACKGROUND: Poor diet quality has been associated with greater risk of people developing overweight and obesity, type 2 diabetes, cardiovascular disease, and osteoarthritis. For each of these conditions, weight management is recommended in respective guidelines. Current weight management interventions, such as the Healthy Weight for Life™ (HWFL) program that uses meal replacements, have not been assessed for impact on diet quality. Further, the role of a dietitian providing medical nutrition therapy (MNT) in conjunction with the HWFL program has not been evaluated. MNT is an evidence-based approach where dietary interventions are tailored to the individuals needs, medical history, lifestyle, and dietary preferences. Therefore, the primary aim of this pilot study is to evaluate the feasibility, acceptability and preliminary impact of adding personalised (MNT) consultations to the HWFL program on diet quality. Secondary outcomes include weight and osteoarthritis scores . METHODS: An 18-week randomised control trial was undertaken, with eligible HWFL program participants randomised to either usual care arm (HWFL program) or HWFL + MNT. A food frequency questionnaire was used to assess diet quality (% energy from nutrient-dense core food) and provide intervention participants with personalised feedback on food and nutrient adequacy of their dietary patterns. Weight and knee osteoarthritis outcomes using the hip and knee osteoarthritis outcome scores, were self-reported and used to assess outcomes. Project acceptability was assessed by process evaluation questionnaire. An intention-to-treat analysis was undertaken using generalised linear mixed models with post-estimations reported as mean (95% CI). RESULTS: Forty participants (75% female, 62 ± 10years, 78% osteoarthritis) enrolled in the study. Baseline diet quality was poor (34% energy from non-core foods). Post-intervention both intervention and usual care groups significantly improved their diet quality and reduced weight, but there were no significant differences between groups. Sub-scores for knee osteoarthritis function significantly improved in the intervention compared to the control group (mean between group difference 17.4, 95% CI 1.6, 33.1), though after correcting for multiple testing this was no longer significant. Overall intervention acceptability was high. CONCLUSION: Both the intervention and usual care arms significantly improved diet quality. All intervention participants found MNT was highly acceptable. For those with knee osteoarthritis significant improvements in knee osteoarthritis function was reported in the intervention group. This should be further explored in future interventions. TRIAL REGISTRATION : Australian New Zealand Clinical Trials Registry (ACTRN12623001062617). </p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic scoping review of urban food environment research, interventions, and measurement approaches in eight low- and middle-income countries.","authors":"Amy Margolies, Dorcas Amunga, Esther M Choo","doi":"10.1186/s12966-026-01884-2","DOIUrl":"10.1186/s12966-026-01884-2","url":null,"abstract":"<p><p>BACKGROUND: Food environments in low- and middle-income countries (LMICs) are undergoing rapid transformation, particularly in urban and peri-urban settings. These shifts—characterized by changes in food retail landscapes, consumer purchasing behaviors, and the availability and affordability of nutritious foods—have significant implications for nutrition. Yet, the key characteristics of these environments, such as food desirability, convenience, accessibility, and marketing influences, remain underexplored. This systematic scoping review synthesizes evidence published between 2001 and 2023 across eight LMICs (Bangladesh, Sri Lanka, Philippines, Kenya, Ghana, Ethiopia, Rwanda, Peru) to examine how urban and peri-urban food environments shape dietary behaviors and nutrition outcomes. METHODS: Guided by a conceptual framework encompassing nine key food environment dimensions—availability, prices, marketing and regulation, vendor and product properties, accessibility, affordability, desirability, convenience, and sustainability—we analyzed descriptive, associative, and intervention studies. We searched Scopus and Web of Science, identified 1,609 records, and included 251 studies in the review. RESULTS: As might be expected in a growing body of evidence, most research is descriptive, with limited causal or intervention-based evidence. Studies frequently focus on characteristics of informal vendors, sociocultural factors influencing shifts in dietary choice toward unhealthier options, and the proliferation of ultra-processed foods, especially near schools and in informal markets. Associations between food environment and nutrition outcomes, such as elevated BMI and overweight, are often linked to supermarket and fast-food access, though these relationships are frequently confounded by socioeconomic variables. Methodological inconsistencies in defining and measuring food environment dimensions limit cross-context comparability. Only seven intervention studies were identified, with few demonstrating significant improvements in diet or nutrition. CONCLUSIONS: This review highlights critical evidence gaps in urban food environments in LMICs and underscores the need for standardized measurement and robust evaluations of diet-related interventions. Strengthening this evidence base is essential to inform food policy, urban planning, and public health strategies that promote healthier diets for populations in rapidly urbanizing settings. </p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of remote group-based exercise on physical activity and well-being in postpartum women: a randomized controlled trial.","authors":"Yumi Nomura, Mako Fukano, Kosuke Kashiwabara, Megumi Haruna","doi":"10.1186/s12966-026-01897-x","DOIUrl":"10.1186/s12966-026-01897-x","url":null,"abstract":"<p><p>BACKGROUND: Postpartum women frequently experience declines in physical activity (PA) resulting from lifestyle changes, caregiving demands, and physical recovery, which increases the risk of long-term physical and mental health issues. While behavioral strategies can promote PA, few interventions address the lifestyle-related barriers specific to postpartum women using objective PA measures, and remote, group-based approaches remain underexplored. This study evaluated the efficacy of an 8-week remotely delivered, group-based PA intervention in increasing objectively measured PA, exercise-related self-efficacy, and psychosocial well-being among postpartum women. METHODS: In this web-based, two-arm randomized controlled trial, 175 postpartum women (2–6 months postpartum) in Japan were allocated to either an intervention (n = 89) or waitlist control group (n = 86). The intervention combined weekly instructor-led online group sessions with a structured home-based exercise program, incorporating behavioral strategies grounded in self-determination and social cognitive theories. The primary outcome was daily moderate-to-vigorous PA (MVPA) measured via triaxial accelerometers. The secondary outcomes included daily step counts, health-related quality of life (HRQoL; Short Form-12 Health Survey version 2), sense of coherence (SOC; Sense of Coherence Scale), and exercise self-efficacy (decisional balance for exercise). Analyses used generalized estimating equations adjusting for baseline values and age. RESULTS: Retention was 98%–99%, with 94% attending at least four of six classes. Compared with controls, the intervention significantly increased MVPA by 5.97 min/day (95% confidence interval [CI]: 1.34, 10.60; p = 0.012) and daily steps by 576 (95% CI: 73, 1079; p = 0.025). SOC increased by 4.14 points (95% CI: 1.70, 6.58; p < 0.001) and exercise self-efficacy increased (balance score difference: 2.74; 95% CI: 0.71, 4.78; p = 0.008), mainly because of reduced perceived barriers. No significant changes in HRQoL were observed. CONCLUSIONS: This remote, group-based PA intervention, designed to accommodate the lifestyle demands of the postpartum period, effectively increased PA and enhanced psychosocial resources in postpartum women. By fostering self-efficacy, peer support, and accessible home-based participation, this program may support both short- and long-term physical and mental health. These findings highlight the potential of scalable online PA programs to overcome common postpartum barriers. TRIAL REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR): UMIN000053478, registered 31 January 2024. </p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of healthy lifestyles on the association between food security and all-cause mortality risk.","authors":"Jian Gao, Chuan Li, Huan Chen, Zhi-Hao Li, Dan Liu, Si-Yao Liu, Chen Mao","doi":"10.1186/s12966-026-01898-w","DOIUrl":"10.1186/s12966-026-01898-w","url":null,"abstract":"<p><p>BACKGROUND: Food insecurity is associated with increased mortality risk, but whether this association is modified by lifestyle behaviors in the general adult population remains unclear. METHODS: We analyzed seven NHANES cycles (2005–2018) including 41,161 adults (≥ 18 years). Food security was categorized per USDA guidelines. Four lifestyle factors—smoking status, alcohol consumption, physical activity, and sleep duration (< 6.5, 6.5-<7.5, or ≥ 7.5 h/night)—were assessed via standardized questionnaires, and a healthy lifestyle score (0–4) was constructed by summing these four components. All-cause mortality was determined through linkage to the National Death Index through December 31, 2019. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality across food security categories and by healthy lifestyle score, adjusting for demographic and socioeconomic characteristics, health status indicators (BMI, history of diabetes, hypertension, hypercholesterolemia, and health insurance coverage), and dietary factors (total daily energy intake and overall diet quality). We conducted prespecified subgroup analyses by age (< 65 vs. ≥ 65 years), sex, and health insurance status, and performed sensitivity analyses. RESULTS: During 204,944 person-years of follow-up, 2835 total deaths occurred. Food insecurity was associated with higher all-cause mortality (HR 1.85 [95% CI, 1.60–2.14]; P < 0.001). In joint analyses restricted to food-insecure adults, compared with those with the most unfavorable behaviors, participants who never smoked had a 51% lower hazard of mortality (HR, 0.49 [95% CI, 0.39–0.61]), those who never drank alcohol had a 27% lower hazard (HR, 0.73 [95% CI, 0.56–0.97]), those with moderate/regular physical activity had a 32% lower hazard (HR, 0.68 [95% CI, 0.49–0.96]), and those reporting sleep duration of 6.5-<7.5 h/night had a 26% lower hazard (HR, 0.74 [95% CI, 0.55–0.98]). The healthy lifestyle score showed a graded inverse association, among food-insecure adults, having 3–4 versus 0 healthy behaviors was associated with a 61% lower hazard of death (HR, 0.39 [95% CI, 0.23–0.66]). Associations were stronger among participants aged < 65 years and were robust in sensitivity analyses. CONCLUSION: Food insecurity is significantly associated with higher all-cause mortality risk, while healthy lifestyle behaviors can effectively buffer this risk, especially in food-insecure adults. </p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13040838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of a school-based cycling intervention on commuting to school behavior and device-measured activity in Spanish adolescents: the PACO cluster-randomized controlled trial.","authors":"Pablo Campos-Garzón, F Javier Huertas-Delgado, Cristina Cadenas-Sanchez, Javier Molina-García, Yaira Barranco-Ruiz, Palma Chillón","doi":"10.1186/s12966-026-01893-1","DOIUrl":"10.1186/s12966-026-01893-1","url":null,"abstract":"<p><p>BACKGROUND: Active commuting to/from school (ACS) is associated with multiple health and societal benefits, yet school-based interventions have shown limited success in changing adolescents’ commuting behavior, and their effects on psychosocial factors remain unclear. This study primarily examined the effects of a school-based cycling intervention on the usual mode and frequency of ACS, and ACS-related psychosocial outcomes in Spanish adolescents. Secondary outcomes included device-measured sedentary time and physical activity (PA). METHODS: A cluster-randomized controlled trial was conducted in eight Spanish secondary schools. A total of 256 adolescents (45.7% girls; mean age 14.4 years) were allocated to an intervention (n = 127) or control group. The intervention consisted of four weekly sessions delivered during Physical Education classes over one month, combining cycling theory, skills training in closed circuits, and supervised on-road cycling in urban environments. Outcomes were assessed at baseline and post-intervention and included usual mode and weekly frequency of ACS, perceived barriers to ACS, basic psychological need satisfaction in ACS, motivation for ACS, and device-measured sedentary time and PA across daily segments. RESULTS: No significant between-group effects were observed for usual mode or frequency of ACS, nor for device-measured sedentary time or PA. Most psychosocial outcomes did not differ between groups. However, perceived environmental/safety barriers increased in the intervention group compared with controls (Δ = 0.22, p = 0.041). Moderation analyses showed that girls in the intervention group reported greater increases in amotivation for ACS than girls in the control group (Δ = 0.54, p = 0.018). Per-protocol analyses revealed higher external motivation (Δ = 0.40, p = 0.029) and amotivation (Δ = 0.38, p = 0.037) in the intervention group, with stronger effects among girls and adolescents from higher socioeconomic backgrounds. CONCLUSIONS: The school-based cycling program did not change the commuting behavior or device-measured activity. Instead, participation was associated with increased awareness of environmental/safety barriers and higher amotivation, particularly among girls. Per-protocol analyses also revealed increases in external motivation and perceived barriers, particularly among girls and high-SES adolescents. These findings suggest that short-duration, skills-focused cycling interventions may heighten perceived constraints without being sufficient to support behavior change. Future programs may require longer duration, autonomy-supportive delivery, and complementary built environmental and family-level strategies to effectively promote ACS among adolescents. TRIAL REGISTRATION: ClinicalTrials.gov (Identifier: NCT03937336). </p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessibility, acceptability, and usage during COVID-19 of the evidence-based intervention Healthy Eating and Active Living Taught at Home (HEALTH): implications for implementation strategies.","authors":"Amanda Gilbert, Debra Haire-Joshu, Alexandra B Morshed, Cynthia D Schwarz, Allison Kemner, Rachel G Tabak","doi":"10.1186/s12966-026-01896-y","DOIUrl":"10.1186/s12966-026-01896-y","url":null,"abstract":"<p><p>BACKGROUND: Healthy Eating and Active Living Taught at Home (HEALTH) is an evidence-based intervention (EBI) embedded in Parents as Teachers (PAT) home visiting to improve weight outcomes among mothers. Public health impact of HEALTH relies on EBI coverage (accessibility, acceptability, usage). Therefore, the purpose of this study is to identify coverage strengths/gaps which can inform dissemination and implementation (D&I) strategies to increase HEALTH coverage. METHODS: We conducted descriptive analyses using baseline data and home visitor documentation of PAT visits from the HEALTH D&I study, which took place during COVID-19. Coverage was measured by expanding on RE-AIM with the adapted Shengelia et al. Access, utilization, quality, and effective coverage framework and included: accessibility (home visitor referrals to HEALTH), acceptability (mother self-report satisfaction), usage (number of visits mothers received from the home visitor, proportion of HEALTH content delivered, proportion of HEALTH lessons delivered). RESULTS: In the HEALTH D&I study, 67% of home visitors made at least one referral to HEALTH; however, 33% made no HEALTH referrals. The average number of referrals was 2.05 (SD = 2.38). Most mothers (80%) were satisfied with HEALTH. The average number of visits mothers received was 13.91 (SD = 10.62). On average 39% of all 24 HEALTH lessons, 66% of the eight core HEALTH lessons, and 33% of the HEALTH handouts were delivered. Only 26% of mothers received all 8 core HEALTH lessons. These lessons focus on goals and basic information on healthy eating and physical activity (e.g., Your Health Goals, Let’s Get Moving!, Making Healthy Beverage Habits) and make up the core section of the HEALTH curriculum. CONCLUSIONS: This study demonstrates integration of D&I frameworks to evaluate D&I outcomes and offers insights into strategies for EBIs in community settings and insights into service delivery during COVID-19. Findings show strong EBI coverage (acceptability) and gaps (accessibility; usage) supporting the need for implementation strategies to increase adoption (e.g., building partner relationships, choosing strategic partners, ) and support implementation (e.g., facilitate peer learning, create program guide). TRIAL REGISTRATION: NCT03758638 (https//clinicaltrials.gov/study/NCT03758638), registered Nov 29, 2018. </p>","PeriodicalId":50336,"journal":{"name":"International Journal of Behavioral Nutrition and Physical Activity","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13041336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}