Background:We examined associations among multilevel variables and girls’ physical activity to determine whether they vary at different adolescent ages.Methods:All field sites of the Trial of Activity for Adolescent Girls contributed participants from 6th (n = 1576) and 8th grades (n = 3085). The Maryland site contributed an 11th grade sample (n = 589). Questionnaires were used to obtain demographic and psychosocial information (individual- and social-level variables); height, weight, and triceps skinfold to assess body composition; interviews and surveys for school-level data; and geographical information systems and self-report for neighborhood-level variables. Moderate to vigorous physical activity minutes (MVPA) were assessed from accelerometers. Mixed models (13 individual, 5 social, 15 school, 12 neighborhood variables) were used to determine multilevel associations.Results:Variables at individual, social, school, and neighborhood levels were associated with MVPA, but differed across grades. Lower percent body fat, higher social support from friends, and lower school math scores were associated with higher MVPA at 6th and 8th grade. Higher physical activity self-efficacy was associated with higher MVPA at 11th grade. Only lower physical activity barriers were associated with higher MVPA at all grades.Conclusion:MVPA is a complex behavior with fluid, multilevel correlates that differ among girls across middle and high school.

Purpose Online information can influence attitudes toward vaccination. The aim of the present study is to provide a systematic evaluation of the search engine ranking, quality, and content of webpages that are critical versus noncritical of HPV vaccination. Methods We identified HPV vaccine-related webpages with the Google search engine by entering 20 terms. We then assessed each webpage for critical versus noncritical bias as well as for the following quality indicators: authorship disclosure, source disclosure, attribution of at least one reference, currency, exclusion of testimonial accounts, and readability level less than 9th grade. We also determined webpage comprehensiveness in terms of mention of 14 HPV vaccine relevant topics. Results Twenty searches yielded 116 unique webpages. HPV vaccine-critical webpages comprised roughly a third of the top, top 5 and top 10-ranking webpages. The prevalence of HPV vaccine-critical webpages was higher for queries that included term modifiers in addition to root terms. Compared with noncritical webpages, webpages critical of HPV vaccine overall had a lower quality score than those with a noncritical bias (p<.01) and covered fewer important HPV-related topics (p<.001). Critical webpages required viewers to have higher reading skills, were less likely to include an author byline, and were more likely to include testimonial accounts. They also were more likely to raise unsubstantiated concerns about vaccination. Conclusion Webpages critical of HPV vaccine may be frequently returned and highly ranked by search engine queries despite being of lower quality and less comprehensive than noncritical webpages.

Purpose Although the decline of physical activity in adolescent girls is well-documented, there are girls whose physical activity does not follow this pattern. This study examined the relationships between physical activity trajectories and personal, psychosocial and environmental factors among adolescent girls. Methods Participants were from the University of Maryland field site of the Trial of Activity for Adolescent Girls. Of 730 girls measured in 8th grade, 589 were re-measured in 11th grade. Moderate to vigorous physical activity was assessed by accelererometers; participants were categorized as active maintainers (n=31), inactive maintainers (n=410), adopters (n=64), or relapsers (n=56). Height and weight were measured, personal and psychosocial information was collected from surveys, and distance from home to school and parks was assessed from Geographical Information Systems. Multivariable logistic regression was used for data analysis. Results Variables at individual, social, and environmental levels predicted active maintainers and inactive maintainers, while only individual-level variables predicted adoption. None predicted relapse. Higher (favorable) scores for physical self-concept, perceived body fat, friend and family physical activity support, frequency of physical activity with friends, and shorter distance from home to a park predicted active maintainers. Overweight/obese status, earlier age at menses, and lower scores for physical self-concept, perceived body fat, friend physical activity support, and frequency of physical activity with friends, and further distance from home to school predicted inactive maintainers. High physical self-concept and not being overweight/obese predicted adopters. Conclusion Multi-level factors appear to predict behavior maintenance rather than actual change. Implications and Contribution Although physical activity declines among girls during adolescence, some maintain and others increase their physical activity. Our results identified factors across individual, social, and environmental levels that predicted physical activity maintenance over 3 years. These may guide future interventions to enhance adolescent girls’ physical activity and combat the overall decline.

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