Jamie Krzykowski, PhD Corrine Boyea, SPT Sara Kotschi, SPT Elizabeth Magdanz, SPT

1. Physical Activity and Nutrition Interventions and Education: The Increased Need on College Campuses • Jamie Krzykowski, PhD • Corrine Boyea, SPT • Sara Kotschi, SPT • Elizabeth Magdanz, SPT • Linda Senkowski, SPT • Halley Sparks, SPT

2. Weight gain, poor nutritional habits and decreased physical activity levels continue to be a dilemma with college students. In addition, obesity is aworldwide epidemic, and with college students gaining weight more rapidly than other adults, early interventionto help prevent weight gain is becoming more imperative. The purpose of this presentation is to establish the role andimplementation of physical activity and nutrition intervention strategieson college campuses after assessing outcomes following a specific physical activity and nutrition intervention program. Abstract

3. This topic is important to college health professionals because weight gain, decreased activity levels and poor nutritional habits have been proven to be a problem college students face beginning in their first semester. • The purpose of this study was to understand what methods were best to utilize when attempting to educate and motivate first year college students to participate in physical activity on a regular basis, make sound nutritional choices and maintain an ideal weight throughout their first semester and the rest of their college years. • This study also intended to demonstrate the direct influence an intervention program could have rather than merely discuss the need for intervention strategies. • Additionally, it is probable that generating positive changes in behavioral wellness that may become a way of life for individuals even after they have graduated from college, provides individual communities and the world as a whole with persons who have the ability to positively influence others and similarly improve their health and well being. Topic Relevance and Description

4. Weight gain • Poor nutritional habits • Decreased physical activity (PA) levels *All continue to be a dilemma with college students • Obesity is a worldwide epidemic, and with college students gaining weight more rapidly than adults, early intervention to help prevent weight gain is becoming more imperative. (Levitsky, Halbmaier, and Mrdjenovic, 2004) Overview of the Problem

5. Fall Semester 2007 • Freshman Year Seminar (FYS) Games Original Dissertation: Effectiveness of Structured Wellness Activities & Events: The Impact on First Year College Students

6. 2008 • Kickball Tournament • Yoga Class • Fitness Center Orientation • DDR Week • Nutrition Seminar • Swimming Week • Run / Walk • Volleyball Tournament • Climbing Wall Week • Aerobics Classes • 2009 • Kickball Tournament • Yoga Class • Fitness Center Orientation • DDR Week • Run / Walk • Health Seminar • Swimming Week • Volleyball Tournament • Climbing Wall Week • Aerobics Classes FYS Schedule 2007 Kickball Tournament Yoga Class Fitness Center Orientation DDR Week Nutrition Seminar Swimming Week Run / Walk Volleyball Tournament Climbing Wall Week Aerobics Classes

7. Freshman Year Seminar (FYS) Games • Purposes • To foster more community among FYS classmates • To increase use of the campus recreation facilities • To increase physical activity among students on the Carroll University campus. With the intent to develop immediate habits of incorporating fitness into the student lifestyle. • Rules • Each FYS class is a team • Students must show their ID to the worker to sign in. • Students MUST sign the "sign in" sheet to receive points, which will be located near the event worker at each event. • Each student will receive a point for participating in each activity. • Students may receive only one point per person per day. • Students may participate with another section (during tournaments), only if their class did not form a team. FYS Games

8. Study: pre-test and post-test measures • Purpose: to assess the effectiveness of a fitness and nutrition intervention for first year college students • Examined effect of structured activities on: • Physical activity (10 total activities) • Nutritional knowledge (1 activity and one FYS class) • Potential for weight gain • Overall well-being Original Dissertation: Effectiveness of Structured Wellness Activities & Events: The Impact on First Year College Students

9. Characteristics of Participants

10. Physical Measurements by Gender

11. On average participants had decreased PA levels Current Activity Level

12. Anticipated Actual 92.54% anticipated moderate, high or very high participation while only 23.9% reported participating at a moderate level or above. Anticipated Participation vs. Actual Participation in the FYS Games

13. Influence of FYS Games on Activity Levels

14. On average participants had decreased PA levels, gained weight and had an increase in body fat percentage • 61% of the lbs gained were from those who participated 1 or less FYS activity (50.75% of total participants) • 85.5% of the pounds gained were from those who participated in 0-3 FYS activities (76% of total participants) Key Points

15. FYS Activities vs. Weight Gain/Loss

16. Weight Gained

17. Weight Lost

18. On average participants had decreased PA levels, gained weight and had an increase in body fat percentage • 61% of the lbs gained were from those who participated 1 or less FYS activity (50.75% of total participants) • 85.5% of the pounds gained were from those who participated in 0-3 FYS activities (76% of total participants) • The level of overall participation in the FYS Games was less than optimal Key Points continued

19. Level of Participation in the FYS Games

20. Refining programs such as FYS are crucial to student interest in physical activity and nutritional knowledge • Instructor involvement and support was essential to getting students to participate • With some revisions, structured activities and events such as the FYS Games has tremendous potential to impact students long-term Conclusions

21. Summer 2010 • Graduate Physical Therapy students re-examined original dissertation work • Divided into 2 groups • Physical Activity • Nutrition • Purpose • Affirm correlations between interventions and outcomes • Establish the need for nutritional intervention in colleges and universities • Make suggestions for nutritional intervention programs

22. Methods • Inclusion/Exclusion Criteria • Data Analysis • Separate & analyze data • GraphPad InStat 3.10 • Nonparametric correlations for X & Y variables • Post-Hoc • Look at direction of change • Convert numbers into averages & percentages for comparison

23. Physical Activity: Results

24. Physical Activity: Results

25. Physical Activity: Results

26. Higher participation in FYS • ↓ weight gain • ↓ BMI • ↓ percent fat mass • ↑ rating of overall well-being • ↑ rating of influence of FYS Games on activity level • There is a great need for intervention strategies suited to the institution Conclusions from PA

27. Nutritional: Results

28. Nutritional: Results • On average, those in the nutritional intervention group… • Made gains in knowledge by 14% and non-nutritional group only 2% • Increased daily water intake by 3%, whereas non-nutritional group decreased by 10% • Were better able to maintain weight compared to non-nutritional group

29. Survey (N=21) and Physical Measurements (N=16) • Average increase of 3.66 lbs • How influential do you feel the FYS Games have been on your activity levels over the past 3 years? • 80.95% little or no influence • 9.52% some influence • 9.52% moderate influence • Comments on influence of the FYS Games: • “It got me going and open to the intramurals Carroll offers.” • “Our professor didn't push it so we didn't do it.” • “FYS only influenced my activity freshman year.” • “I was active before and continued to stay active.” • “It helped a bit in getting my acquainted with Ganfield…” 3 Year Follow-Up Data – Physical Activity

30. How influential do you feel FYS Games has been on your nutritional habits over the past 3 years? • 85.71% little or no influence • 9.52% some influence • 4.76% moderate influence • Comment on the influence of the FYS Games on nutrition: • I think FYS influenced my habits because I was in the healthy eating section. • I feel there are other classes I have taken that affect my nutrition habits more than FYS. • My class didn't participate in the games. 3 Year Follow-Up Data - Nutrition

31. Carry over into each year of college is necessary for long-term influence • A more evident nutritional component would be beneficial • Never underestimate the impact intervention programs have on a few people as this can translate exponentially Conclusions after follow-up

32. Developing your own intervention What can you do?

33. Define the demographics of your students • Identify expressed needs from student or alumni surveys • Determine programs that are already in place • Recognize barriers 1. What is the current need for physical activity or nutrition intervention programs at your institution?

34. Enrollment • 3,398 (279 graduate; 3,119 undergraduate) • # Facilities • 2 (Van Male, Ganfield); various outdoor areas • Indoor: weight room, basketball courts, indoor track, cardio equipment • Outdoor: track; tennis court; baseball diamond Carroll Demographics • http://www.carrollu.edu/about/fastfacts.asp?nav=5219 • Enrollment • 42,099 (28,690 undergraduate; 13,409 graduate+) • # Facilities • 5 facilities (Natatorium, SERF, Nielsen Tennis Stadium, Shell, Lathrop); various outdoor venues • Indoor: gymnasium, indoor track, weight room, pool, diving well, racquet ball, tennis, squash courts, ice rinks, basketball courts • Outdoor: tennis courts, football field, track baseball diamonds Madison Demographics • http://www.wisc.edu/about/facts/community.php#students • Enrollment • 30,455 ( 5,216 graduate; 25,239 undergraduate)2 • # Facilities • (Klotsche; Pavilion); various outdoor areas • Indoor: weight training; pool; racquetball / handball court; multi-purpose gymnasium; basketball courts; fitness center; sport courts; indoor track • Outdoor: soccer field • Milwaukee Demographics • https://www4.uwm.edu/about_uwm/uwm_glance/profile.cfm#enrollment 3 Wisconsin Universities

35. Carroll • # Sports • 20 • Intramurals • Club Sports • 3 • Fitness Classes • CORE (Carroll Outdoor Recreation Education) UW-Madison • # Sports • 24 • Intramurals • Club Sports • 12 • Group Fitness Classes (Group X) • Personal Training • Hoofers • UW-Milwaukee • # Sports • 15 • Intramurals • Club Sports • 18 • Fitness Classes • Personal Training 3 Wisconsin Universities

36. Gender • Nationwide colleges tend to have higher female population than males • Males participate in vigorous activity at higher rates • Less responsive to moderate-intensity physical activity interventions (Seo, Nehl, Agley, & Ma, 2007) Demographics of Midwestern College Students

37. 1. Are you regularly physically active (meaning at least 30 minutes, 3-5 days per week)? □ yes □ no 2. How many minutes of physical activity do you participate in per week? □ 0 □ <90 □ 90 □ 120 □ 150 □ >150 3. What kind of physical activity do you participate in (check all that apply)? • Walking to class • Walking • Running • Sports • Strength / weight lifting • Stretching • Core strengthening • Other ________________ 4.  Do you participate in athletics on campus or intramurals? And what months do you participate in these? • None • Sport • Intramurals Potential Needs Assessment Survey

38. 5. What are some barriers to participating in regular physical activity (90-150 min/wk) (check all that apply)? • Too much homework • Recreational facility too far away • Weather • No friends to go with • I don't know what is in the facility • Too crowded at the recreational facility • It's not fun; too much work • I don't feel comfortable working out in front of other people • I attend school and have a job; there's no time • Other ____________ Potential Needs Assessment Survey

39. 6. Do you use the exercise facility on campus? • Yes • June – August • September – December • January – May • No – I don't exercise at a facility • No – I exercise at another facility • No – I don't exercise at all 7. Whether you use the facility or not, what improvements would you like to see to increase your usage? More hours ____________ Weekend hours _________ More exercise classes ___________ More equipment ____________ Temperature change _______________ Other ______________ • Please provide comments or suggestions.  Potential Needs Assessment Survey

40. Smoking • Students who never smoked were more likely to participate in both moderate and vigorous physical activities • Students who currently smoke are more likely to be low activity level participants (Seo, et al., 2007) • Fruit Consumption • Students who consume fruit  2x per day, 7 days per week were more likely to participate in both moderate and vigorous physical activities (Seo, et al., 2007) • Perception of Body Weight • Students who perceive their weight as “about right” were more likely than their “overweight” counterparts to participate in both moderate and vigorous physical activities (Seo, et al., 2007) Predictors of Participation in Physical Activity

41. Intrapersonal • Lack of motivation to exercise • Limited time, reliance on pre-cooked meals, unhealthy foods, limited knowledge to shop or prepare healthful foods • Temptation, lack of discipline, “being bored” • Stress • Interpersonal • Social situations (i.e. going out to dinner) • Pressure to eat • Alcohol and “drunk eating” Barriers (Greaney, et al., 2009)

42. Environmental • Time • Unhealthy food served on campus • Access to unhealthy foods/lack of access to healthy foods • Transportation or lack of grocery stores • Money • Gym membership costs, perceived cost of healthful foods Barriers continued (Greaney, et al., 2009)

43. Define the demographics of your students • Identify expressed needs from student or alumni surveys • Determine programs that are already in place • Recognize barriers 1. What is the current need for physical activity or nutrition intervention programs at your institution?

44. Define the demographics of your students • Identify expressed needs from student or alumni surveys • Determine and assess programs that are already in place • Recognize barriers 2. What is the current need for physical activity or nutrition intervention programs at your institution?

45. Describe college trends • Identify student areas of interest • Conduct a needs assessment of your institution • Recognize barriers 3. Describe a plan to establish an intervention program at your institution.

46. Define the elements of a team or committee • Identify potential funding needs and resources • Develop a timeline • Recognize barriers 4. Establish a plan to implement an intervention

47. Greaney, M.L., Less, F.D., White, A.A., Dayton, S.F., Riebe, D., Blissmer, B., et al. (2009). Journal of Nutrition Education and Behavior, 41(4), 281-286. • Levitsky, D.A., Halbmaier, C.A., & Mrdjenovic, G. (2004). The freshman weight gain: A model of the study of the epidemic of obesity. International Journal of Obesity, 28, 1435-1442. • Seo, D., Nehl, E., Agley, J., Ma, S. (2009). Relations Between Physical Activity and Behavioral and perceptual Correlates Among Midwestern College Students. Journal of American College Health, 56(2), 187-198. Works Cited