VSU healthy habit study: Preliminary findings

Last time I wrote, I promised to share with you what I presented at the American Psychological Sciences annual conference that was held last week in Washington DC. As you may recall, These findings are part of an on-going study focused on VSU students and their health. The presentation focused on three different types of research methods- a paper/pencil survey, focus groups and a pilot study. The goal is to eventually create an effective campus-wide intervention that will have students leave VSU healthier and engaging healthier habits than when they came.

SURVEY RESULTS (Fall 2011)

Participants and Procedures 
672 students, or nearly 10% of the student population at a mid-Atlantic historically Black university (HBCU) participated in this study.  Students were given extra credit for taking the National College Health Assessment (NCHA) in selected classes. The NCHA includes 66 items and covers 7 topics. Only items associated with eating and exercise are reported here. 

Result Summary
Although the BMI of male and female student did not differ, female students were more likely to want to lose weight. Female students were less likely to engage in moderate or vigorous exercise than male students. All students ate far fewer fruits and vegetables than the recommended amount of 9 servings per day. Students received adequate health information on campus. The survey did not indicate the reasons for low exercise rates by female students and low fruit and vegetable consumption by all students.


FOCUS GROUP RESULTS (Fall 2012)

Participants
 and Procedures
11  African American students. Ages 18-28 years.    Freshmen students were recruited in selected classes to participate in a 90-minute focus group discussion aimed at adding to the survey data. Specifically, we sought to know why students didn't eat more fruit and vegetables and also why so few students exercised.  The focus group was audio recorded and transcribed by the undergraduate research assistants involved in the study.

Results
 Participants indicated the following:
    Because this is a largely residential campus, access to fresh vegetable and fruits is limited to what is served in cafeteria. Salad is served on a limited basis and vegetables are often overcooked.
    Exercise facilities on campus feel small and cramped.
    Exercise facilities seem to be for athletes or people that are already in shape.  
    Walking on campus not considered safe after dark.
    Would be more likely to exercise with other women that were not already "in shape"
     Because there are 5 fast-food establishments and 3 convenience stores but no grocery store within a short distance of campus it is not easy to eat healthy.

PILOT STUDY RESULTS (Spring 2013)

Participants
 and Procedures
   30  African American female freshmen. Ages 18-19 years.    Freshmen students were recruited from residence halls to participate in a pilot study aimed at increasing health awareness. The pilot study utilized a Community Based Participatory Research approach and consisted of six hour long weekly meetings held in a residence hall. This study was based on findings by Lally et al, (2008) in which overweight individuals were able to lose weight and maintain weight-loss by using a simple habit formation model. The 5 habits were created from focus group discussion and follow-up interviews and reflect the lifestyle of freshmen women at Virginia State University. In the present study, one new habit was introduced each week for five weeks and all habits were monitored and measured for adherence using social networking sites and mobile apps.  The goal of the study was habit formation, not weight loss. The five habits were:
Walk 3 times per week for 30 mins
Healthy snacks/Reading labels
Drink more water
Monitor portion sizes
Create and adhere to individualized meal/exercise routine


The Self-Report Index of Habit Strength (2003) was given before and after the program to measure whether students were more likely to adhere to the new behaviors over time. A follow-up assessment will take place in September 2013 to assess the permanence of the new habits.

Results
 Preliminary findings indicate that the number of days walking per week was positively coorelated with scores of habit strength over a 3 week period.  We concluded that a lifestyle modification plan focusing on habit formation may be more effective than a urging students to lose weight. Because VSU students can gain as much as 30 pounds between freshmen and senior years, a life-style approach is recommended for attaining long term health habits rather than short-term weight loss goals.

Health is a habit.

I am convinced that the goals of a healthy lifestyle should not be  measured in weight but in the number of healthy daily habits a person adopts and now I have data.

I  recently conducted a study on my campus in which around 20 freshmen young women participated in a six week health program called Healthy VSU. Two years ago, one of my graduate students in the Behavioral Health Ph.D. program collected data on 675 Virginia State University students using a national college health survey. We found that our female students were heavier on average than males but did not classify themselves as overweight or obese.  Most of the female survey participants were currently trying to lose weight yet they did not exercise on a regular basis and a major portion didn't exercise at all. We found that the participants thought that people should eat fruits and vegetable every day. Yet, they themselves ate 0-2 servings per day (the recommendation is 9).  You can probably see how attitudes and practices such as these could contribute to some of the chronic health problems that affect African American women. So I wondered, if college was a time to introduce an intervention. Our goal was to change habits.

This past year, my 4 undergraduate research assistants and one of my colleagues designed a study based on a successful intervention model from England. The goal of the program is the formation of healthy habits. There are no pre/post measures like BMI or dress size or waist circumference or anything like that. What is measured are the number of glasses of water (fruit infused water is better than diet soda), the minutes spent moving (walking across campus is better than waiting for parking) , the number of healthy snacks eaten (raw anything is better than anything packaged), the proportion of colored vegetables/fruit on the serving plate   (it should be half of the food) and the adherence to a self-created life-style health plan.  The other goal- No more dieting, ever.

We ran our program this spring focusing on the formation of 5 habits. The website is here.

I understood from a year of studying the literature, that a life of dieting takes a mental and emotional toll. The toll  is akin to battle fatigue from warring factions -the body that I see when I look in the mirror vs the body that I want to see when I look in the mirror. However the issue is not the body. The issue is the mind  When the mind gets focused on making the body different, it becomes like any other obsession, creating a lens of distortion about a host of other things, not just the body.  I felt that the antidote was to be in the present moment and focused on present moment experience.

In an effort to address this war situation and to begin a practice of being here now, the first session focused on gratitude - not necessarily being  grateful for the body, that would be too hard. Rather, being grateful for your life, grateful for friends and for people that love you. Grateful for your health. Grateful for being in college. Grateful to be yourself.

What I learned from this study is that most of these beautiful, talented and smart young women thought of themselves most of the time in terms of their bodies and therefore spent more time on what they considered negative aspects of themselves. Asking them to identify something to be grateful for (and writing it down on a daily basis) forced an inward looking that few had practiced. Now, this was an overwhelmingly Christian group. Yet when I asked how many prayed on a daily basis less than 1% raised their hands. They were "too busy", "too rushed", "too sleepy", "too occupied" for self-inquiry. They were also clueless as to how being too busy, too rushed, too sleepy and too occupied contributed to their current eating habits and their persistent complaints about their bodies.

I am still sifting through the data that I will be presenting at a national conference in two weeks. However, in the next few blogs, I'll share with you what we found. This is not the usual way one shares behavioral science but since you, my Sacred and Fit community, have contributed so much to my own understanding about health and wholeness,  I wanted you to be the first to know. My hope is that there is something that you can use, also.

....BTW I'm sorry that while working on two research studies this semester, along with teaching and traveling etc, I was left too busy, too rushed, too sleepy and too occupied to keep up with my blog. I'm back now. It's summer!