Background Physical activity and nutrition behaviors are important to reducing the prevalence of childhood obesity. Previous research has identified school-based interventions as effective strategies to improve physical activity and nutrition. However, the results are often mixed, and middle schoolers are an under-studied population. Objective Our study aims to fill this gap by developing an after-school intervention to increase physical activity and fruit and vegetable consumption that is influenced by national guidelines and formative research. Methods This study was an after-school, quasi-experimental study spanning 9 months. Enrollment began in September 2021 and continued on a rolling basis through February 2022. Weekly, middle schoolers were offered 2-3 physical activity sessions and 1 produce kit. Physical activity was measured using accelerometers and questionnaires. Nutrition behaviors were assessed using questionnaires, and physical literacy was assessed using researcher observations. Follow-up data collection occurred in December 2021 and in April 2022. Difference scores will be calculated and analyzed for each outcome variable. Results The intervention started in September 2021 and will conclude in May 2022. Published study results are expected in late 2022. Conclusions An increase in physical literacy, physical activity, and fruit and vegetable consumption is expected. If successful, future studies will focus on reach and sustainability. Lastly, this study may serve as a model for improving health outcomes in middle schools. International Registered Report Identifier (IRRID) DERR1-10.2196/37126

Background Effective and scalable interventions are needed to combat chronic low levels of youth physical activity. After-school sport sampling programs may be vital interventions for teaching sports and increasing physical literacy and physical activity, which result in healthy lifelong habits that are maintained into adulthood. Objective The purpose of this study was to test the effectiveness of an after-school sport sampling intervention among underserved youth in the Midwest. Methods Youth (n=81) in 3 middle schools within a large Midwest city participated in an 8-month, after-school physical activity intervention that aimed to increase moderate- and vigorous-intensity physical activity, improve physical literacy, and decrease BMI. Difference scores for this 2-group, posttest-only design were calculated. A series of 2-tailed t tests were conducted to assess between-group differences. Results The intervention group had significantly better physical literacy (t115=7.57; P=.004) and engaged in more moderate- and vigorous-intensity physical activity minutes per week (t115=4.28; P=.04) and steps per day (t115=4.29; P=.03). Conclusions An after-school sport sampling program may be an effective solution for combating youth physical inactivity. Future research should assess the scalability of this intervention with larger populations and in different areas. International Registered Report Identifier (IRRID) RR2-10.2196/37126

Housing and employment are key factors in the health and wellbeing of persons living with HIV (PLWH) in the United States. Approximately 14% of low-income PLWH report housing instability or temporary housing, and up to 70% report being unemployed. The purpose of this study was to examine the outcomes of an intervention to improve housing and employment for PLWH in the Midwest. Participants (N = 87) were recruited from the Kansas City metropolitan area to participate in a one-year intervention to improve housing and employment. All individuals were living with HIV and were not stably housed, fully employed, nor fully engaged in HIV medical care. A series of generalized estimating equations were conducted using client-level longitudinal data to examine how housing, employment, viral load, and retention in care changed over time. Housing improved from baseline to follow-up, with more individuals reporting having stable housing (OR = 23.5; p < 0.001). Employment also improved from baseline to follow-up, with more individuals reporting full-time employment (OR = 1.9; p < 0.001). Viral suppression improved from baseline to follow-up, with more individuals being virally suppressed (OR = 1.6; p < 0.05). Retention in care did not change significantly from baseline to follow-up (OR = 0.820; p = 0.370). Client navigation seems to be a promising intervention to improve housing and employment for PLWH in the Midwest. Additional research is needed on the impact of service coordination on client-level outcomes. Future studies should be conducted on the scalability of client navigation interventions to improve the lives of low-income, underserved PLWH.

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BackgroundSexually transmitted infection rates continue to increase across the US, further developing health disparities and economic burdens of disease, especially as migration occurs. In this study, we assessed the relationships among STI rates and migration at the county-level in Missouri from 2008–2017.MethodsTwo data sources were used: STI rates of chlamydia, gonorrhea, syphilis, HIV reported to Missouri DHSS and ACS 1-year county population estimates. Linear regression models and ANOVA tests were conducted in SPSS for each STI from year-to-year and 2008–2017. Covariates included in the analyzes were county-level income, employment rate, race, ethnicity, age, and percent poverty. Further, Akaike Information Criterion tests were performed to indicate the best predictor models and averaged standardized beta values.ResultsSignificant relationships among STI rates and population growth were identified. Chlamydia, syphilis, and HIV were positively associated with population growth from 2008–2017 (β = 0.15; β = 0.01; β = 0.05, respectively). Gonorrhea was negative associated with population growth (β= -0.02) but positively associated with unemployment rates (β = 0.01) highlighting the need to address population growth, as well as other variables in a population.ConclusionsThere seems to be a positive relationship among population change and rates of STIs. As populations change, rates of STIs change. Moving forward, quantitative work should be conducted in various states and the nation to understand this relationship in different contexts. Qualitative studies should assess individual county health departments, identifying strengths and weaknesses, implementation of community health improvement plans. Lastly, public policy should be implemented to buffer the impact of migration on health outcomes.

Purpose The purpose of this study was to evaluate a weekly school-based fruit and vegetable delivery via a mobile market on urban middle schoolers’ nutrition behaviors. Design One-group, pretest-posttest design, quasi-experimental intervention in middle schoolers (6th-8th graders, N = 158) in Kansas City, MO Intervention Weekly delivery of free produce via a mobile market over 12 weeks. Measures A self-administered survey to assess self-report consumption of fruits, vegetables, soda, and sports drinks. Analysis Univariate and bivariate analyses were used. Proportions were compared and chi-square tests were conducted to compare youth at baseline and 12 weeks. Results More youth reported consuming fresh fruit (73.8% to 83.3%; χ2 = 7.76, P = .005) and vegetables (66.4% to 71.3%; χ2 = 13.55, P = <.001) from baseline to follow-up. Less youth reported soda (49.0% to 52.8%; χ2= 6.33, P = .012) and sports drinks (41.8% to 38.2%; χ2= 12.32, P < .001) from baseline to follow-up. Conclusions A mobile produce delivery intervention, like the Healthy Harvest Mobile Market, may be an effective strategy to increase fruit and vegetable consumption for adolescents.

BACKGROUND Physical activity and nutrition behaviors are important to reducing the prevalence of childhood obesity. Previous research has identified school-based interventions as effective strategies to improve physical activity and nutrition. However, the results are often mixed, and middle schoolers are an under-studied population. OBJECTIVE Our study aims to fill this gap by developing an after-school intervention to increase physical activity and fruit and vegetable consumption that is influenced by national guidelines and formative research. METHODS This study was an after-school, quasi-experimental study spanning 9 months. Enrollment began in September 2021 and continued on a rolling basis through February 2022. Weekly, middle schoolers were offered 2-3 physical activity sessions and 1 produce kit. Physical activity was measured using accelerometers and questionnaires. Nutrition behaviors were assessed using questionnaires, and physical literacy was assessed using researcher observations. Follow-up data collection occurred in December 2021 and in April 2022. Difference scores will be calculated and analyzed for each outcome variable. RESULTS The intervention started in September 2021 and will conclude in May 2022. Published study results are expected in late 2022. CONCLUSIONS An increase in physical literacy, physical activity, and fruit and vegetable consumption is expected. If successful, future studies will focus on reach and sustainability. Lastly, this study may serve as a model for improving health outcomes in middle schools. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/37126