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Purpose: In young women with obesity, we sought to explore their: (1) psychosocial health; (2) perceptions of their and engagement in current health behaviors; (2) motivation to change their health behaviors; and (3) desired characteristics of a health behavior intervention. Approach: Convergent-parallel mixed methods study. Setting: Focus groups were conducted over zoom. Participants: 34 young women with obesity (M ± SD; age = 23.79 ± 4.22 years; BMI = 35.66 ± 5.56 kg/m2 ; 41.2% non-Hispanic White). Method: Quantitative data were collected via Qualtrics prior to focus groups. We conducted 8 semi-structured focus groups (2-7 participants per group; 32-93 minutes) to address the pre-specified objectives. Results: Participants reported poor psychosocial health, with 100% meeting the cut-point indicative of significant depressive symptoms and 79.4% for clinically meaningful anxiety. Participants expressed the interconnectedness of their physical and mental health and desire to improve consistency in their eating and physical activity behaviors. However, participants did not want to emphasize weight loss as the primary focus of a health behavior intervention. Preferences for the characteristics of a health behavior intervention were in support of a hybrid format, with in-person meetings focusing on active engagement (e.g., cooking classes). Conclusions: Our findings support shifting the focus from a weight-normative to a weight inclusive approach to health behavior interventions to meet the needs and preferences of young women with obesity. © The Author(s) 2025

Context: Access to athletic trainers (ATs) in high schools is crucial for student-athlete (SA) safety. Although most high schools in the United States have access to athletic training services (ATS), no authors have longitudinally compared ATS trends between public (PUB) and private (PVT) school sectors. Objective: To compare ATS trends between PUB and PVT schools from the 2018-2019 through 2022-2023 academic years. Design: Longitudinal cross-sectional study. Setting: Online survey. Main Outcome Measures: High school responses to the Athletic Training Locations and Services survey from all 50 US states and the District of Columbia were queried from the 2018-2019 to 2022-2023 academic years. Average numbers of SAs (SAs), sports (Sports), full-time ATs (FtATs), part-time ATs (PtATs), and the sum of full-time and part-time ATs (ATs), along with the average weekly contracted hours (CHrs) and actual hours (AHrs) per school, and ratios of SAs : ATs, Sports : ATs, CHrs : SAs, CHrs : Sports, AHrs : SAs, and AHrs : Sports were examined to track ATS trends over 5 years and compare PUB vs PVT schools. Results: Public schools had higher SAs and Sports vs PVT schools (both P < .001). Private schools had higher ATs, CHrs, and AHrs than PUB schools (all P < .050). Ratios of SAs : ATs and Sports : ATs were higher in PUB schools, whereas CHrs : SAs, AHrs : SAs, CHrs : Sports, and AHrs : Sports were higher in PVT schools (all P < .050). From 2018-2019 to 2022-2023, PUB schools increased Sports and Sports : ATs; PVT schools increased SAs, Sports, ATs, and SAs : ATs (all P < .050). Over the years, PUB schools decreased CHrs : Sports and AHrs : Sports; PVT decreased CHrs : SAs, AHrs : SAs, CHrs : Sports, and AHrs : Sports. FtATs increased in both sectors, whereas PtATs decreased in only PVT schools. Conclusions: Overall, ATS were more extensively provided in PVT schools, based on ATs and ATS hours. Both sectors increased FtATs, which is encouraging. However, as SAs and Sports increased, ATS provided per SA and sport declined. © by the National Athletic Trainers’ Association, Inc.

This article explains how to use and apply the SHAPE America position statement “Physical Activity Should Not Be Used as Punishment and/or Behavior Management” in one’s own teaching and as an advocacy tool. © 2025 SHAPE America.

Purpose: To explore associations between adolescent’s concern for their body weight/shape/size and engagement in unhealthy weight control behaviors (UWCBs). Design: Secondary data analysis. Setting: 2022 National Survey of Children’s Health. Subjects: Analyses included 23 357 (51.8% male) adolescents, ages 10-17 years (mean 13.8 ± 2.3 years). Measures: Reported concern for body weight/shape/size, and UWCBs including skipping meals/ fasting; low interest in food; picky eating; binge eating, purging; diet pills; and over-exercising. Analysis: Logistic regression models assessed the odds of engaging in UWCBs by reported concern for body weight/shape/size. Results: Engagement in UCWBs was low with 21.1% reporting picky eating, 13.5% fasting, 11.7% low interest in food, 5.3% binge eating, and <2% purging, over-exercising, or using diet pills. Compared to adolescents who were not at all concerned about their body weight/shape/size, adolescents who were somewhat or very much concerned had significantly higher odds (P’s < 0.05) of engaging in all UCWB outcomes except for using diet pills or laxatives, which was only significant for adolescents who reported being very concerned (OR = 12.74; CI: [19.16, 36.94]). Further, after stratification by gender and age, there was a significant p-for trend (P’s < 0.05), in engagement in UWCBs by concern for body weight/shape/size except for using diet pills or laxatives in 10-11- and 12-14-year-olds. Conclusion: Expressing concern for body weight/image/size is associated with an increased likelihood of engaging in UCWB in adolescents, regardless of gender or stage of adolescence. © The Author(s) 2025

For decades, adapted physical education advocates have passionately engaged in a debate over two adjectives: adapted vs. adaptive. This article explores the reasons why one is preferred over the other and why it matters, especially to students with disabilities. © 2025 SHAPE America.

Background: Numerous barriers to moderate to vigorous physical activity exist for youths with type 1 diabetes (T1D). The virtual exercise games for youth with T1D (ExerT1D) intervention implement synchronous support of moderate to vigorous physical activity including T1D peers and role models. Objective: This study aims to understand the acceptability of this intervention to participants. Methods: We conducted postprogram, semistructured, televideo interviews with participating youths to elicit perspectives on the acceptability of the intervention and experience with the program. Two coders independently reviewed and analyzed each transcript using a coding scheme developed inductively by senior researchers. Discrepancies were resolved by team discussion, and multiple codes were grouped together to produce 4 main thematic areas. Results: All 15 participants provided interviews (aged 14-19 years; 2 nonbinary, 6 females; median hemoglobin A1c level of 7.8% (IQR 7.4%-11.2%), 5 with a hemoglobin A1c level of ≥10%). Qualitative data revealed four themes: (1) motivation to engage in physical activity (PA)—improving their physical capabilities and stabilizing glucose levels were cited as motivation for PA and challenges of living with T1D were cited as PA barriers; (2) experience with and motivation to manage diabetes while engaging in PA—participants provided details of accommodating the inherent uncertainty or limitations of PA with diabetes and sometimes preparing for PA involved psychological and motivational adjustments while some relayed feelings of avoidance; (3) peer support encouraged engagement with the intervention—participants appreciated the peer aspects of components of ExerT1D and participants’ reflections of the facilitated group experience highlight many benefits of a small-group virtual program; and (4) improvements in PA and diabetes self-management efficacy—all participants credited the program with improving or at least raising awareness of T1D management skills. Conclusions: Our virtual PA intervention using an active video game and discussion component provided adolescents with T1D the confidence and peer support to engage in PA, improved awareness of diabetes-specific tasks to prepare for exercise, and improved understanding of the effect of PA on glucose levels. Engaging youths with a virtual video game intervention is a viable approach to overcome barriers to PA for adolescents with T1D. Trial Registration: ClinicalTrials.gov NCT05163912; https://clinicaltrials.gov/ct2/show/NCT05163912

Nutrition units are a staple in many health education courses. While nutrition units can support the acquisition of critical functional knowledge and the development of important skills, there is also the potential for harm and the potential to perpetuate beliefs, ideas, and norms that can lead to disordered eating, the development of unhealthy relationships with food, or shaming of self and others (e.g., fat shaming). The purpose of this article is to outline several factors that may influence how health educators think about and teach nutrition, as well as practical strategies for creating inclusive, affirming, and health-promoting nutrition units.

We investigated whether more arterial stiffness changes could be induced by fragmentation of Swiss ball balance, and examined the role exercise order played in the modulation of arterial stiffness when on-ball kneeling and sitting were combined. Twenty-three healthy young adults (23.8 ± 0.3 years) performed 7 trials in a randomized crossover fashion: CON (non-exercise control), K (on-ball kneeling, 5 min), fK (fragmented on-ball kneeling, 2 × 2.5 min), S (on-ball sitting, 5 min), fS (fragmented on-ball sitting, 2 × 2.5 min), SK (5-min sitting before 5-min kneeling) and KS (5-min kneeling before 5-min sitting). Arterial stiffness in Cardio-ankle vascular index (CAVI) was measured at baseline (BL), immediately (0 min), and every 10 min after exercise, and its changes from BL (ΔCAVI) were calculated. Area under curve (AUC) of ΔCAVI was calculated for SK and KS. The results showed that relative to CON, ΔCAVI decreased at 0 min and 10 min in K and fK, and remained decreased at 20 min in fK only. However, ΔCAVI in S and fS increased with time similarly, with no difference relative to CON. Though ΔCAVI decreased at 10 min in SK, it decreased at both 0 min and 10 min in KS, relative to CON. AUC of ΔCAVI was greater in KS than in SK. The study indicated that compared to continuous mode, fragmented kneeling results in more arterial stiffness improvements, while fragmented sitting exerts no additional effects. When kneeling and sitting are combined, kneeling before sitting elicits more arterial stiffness improvements than sitting before kneeling. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2025.

Purpose Cardiopulmonary rehabilitation, which often follows major acute cardiac events, is traditionally focused on aerobic exercise and has been associated with decreased morbidity and mortality. Its benefit among cardiac surgery patients is less clear, as is the role of resistance-based exercise programs and their sex-specific effects. This study seeks to evaluate the safety and feasibility of a 12-week resistance training program in patients post cardiac surgery through a sex-specific lens. Methods We conducted a nonrandomized feasibility trial with a 12-week strength training exercise intervention. The primary outcome was safety and feasibility. Secondary outcomes included changes in strength, endurance, and functional capacity; and sex differences among these. Adult participants post open-heart surgery who had completed traditional cardiac rehabilitation were consented. Both patients who completed (cases) or did not complete (controls) a tailored 12-week resistance training program underwent comprehensive assessment of physiologic and physical fitness measures pre- and postintervention. Findings Nine participants enrolled in the trial, including 6 in the intervention arm (median age 61 years; 67% male) and 3 in the control arm (median age 66 years; 67% male). No serious adverse events were noted, indicating safety of the intervention. Participants completed a mean of 34.8/36 (96.7%) of sessions, indicating the feasibility of the program. Although not powered for statistical significance, patients experienced positive trends of improvement in measures of hand grip strength, endurance, and functional capacity with the intervention. When stratified, females experienced greater gains than males in these measures. Implications This proof-of-concept study found that resistance-based exercise after cardiac surgery is well tolerated and feasible. Although all patients experienced improvements in exercise parameters, females reported greater relative improvement than males.

The percentage of US youths experiencing mental health and substance use problems has risen rapidly in recent years. Schools are important settings for prevention, but whether preventive programming meets student needs is unknown. This study examined trends in school programming related to mental health and substance use and teacher professional development across US middle and high schools from 2008-2020.