Objective-To assess the prevalence of weight gain among male and female college freshmen.Methods-Study 1 examined weight change over freshman and sophomore years among 904 students attending a state university in Indiana, from [2002][2003][2004]. Study 2 examined weight and BMI change over the freshman year among 382 students attending a private university in Rhode Island, from 2004-2006. Results-77% of Study 1 participants and 70% of Study 2 participants gained weight during their freshman year, largely during the first semester. In Study 1, weight gain averaged 3.5 kg in females and males; in Study 2, weight gain averaged 1.6 kg for females and 2.5 kg for males. Students continued to gain weight their sophomore year, with females 4.2 kg and males 4.3 kg heavier than at start of college. Overweight/obesity rates increased from baseline to end of freshman year for Study 1 (21.6% to 36%) and Study 2 participants (14.7% to 17.8%). Conclusion-The first years of college may be a critical developmental window for establishing weight gain prevention efforts. Keywords weight gain; young adults; college health; college weight gain Obesity rates in the United States have more than doubled in the past fifty years, with 32.2% of adults considered obese in 2004 ((Ogden et al., 2006; Flegal et al., 2002). Obesity is directly related to a number of health conditions, such as type II diabetes, heart disease and hypertension (National Heart, Lung, and Blood Institute (NHLBI) Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, 1998). Rates of overweight Address correspondence and reprint requests to: Elizabeth E. Lloyd-Richardson, Ph.D., Psychology Department, University of Massachusetts Dartmouth, 285 Old Westport Road, North Dartmouth, MA 02747. Tel: 508.910.6954. Fax: 508.999.9169. Email: E-mail: erichardson@umassd.edu. Conflict of Interest statementThe authors declare that there are no conflicts of interest.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. and obesity appear to be increasing most dramatically among young adults, the 18-to-29-yearold age group (from 7.1% to 12.1% from 1991 to 1998), with those having some college education demonstrating even greater increases in overweight and obesity (from 10.6% to 17.8%) (Mokdad et al., 1999). Young adults gain an average of slightly less than one kilogram (kg) each year, although the majority of this appears to be gained during the early 20s. Furthermore, overweight during adolescence has been found to track into adult years (Guo et al., 2000). NIH Public AccessA life course ap...

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Using electronic health record data, we examined longitudinal changes in community health center (CHC) visit rates from 2013 through 2014 in Medicaid expansion versus non-expansion states. Visits from 219 CHCs in five expansion states and four non-expansion states were included. Rates were computed using generalized estimating equation Poisson models. Rates increased in expansion state CHCs for new patient, preventive, and limited-service visits (14%, 41%, and 23%, respectively, P<.01 for all), while these rates remained unchanged in non-expansion states. One year after ACA Medicaid expansions, CHCs in expansion states saw an influx of new patients and provided increased preventive services.

PURPOSEThe Affordable Care Act of 2010 supports marked expansions in Medicaid coverage in the United States. As of January 1, 2014, a total of 25 states and the District of Columbia expanded their Medicaid programs. We tested the hypothesis that rates of uninsured safety net clinic visits would significantly decrease in states that implemented Medicaid expansion, compared with states that did not. METHODSWe undertook a longitudinal observational study of coverage status for adult visits in community health centers, from 12 months before Medicaid expansion (January 1, 2013 to December 31, 2013) through 6 months after expansion (January 1, 2014 to June 30, 2014). We analyzed data from 156 clinics in the OCHIN practice-based research network, with a shared electronic health record, located in 9 states (5 expanded Medicaid coverage and 4 did not). RESULTSAnalyses were based on 333,655 nonpregnant adult patients and their 1,276,298 in-person billed encounters. Overall, clinics in the expansion states had a 40% decrease in the rate of uninsured visits in the postexpansion period and a 36% increase in the rate of Medicaid-covered visits. In contrast, clinics in the nonexpansion states had a significant 16% decline in the rate of uninsured visits but no change in the rate of Medicaid-covered visits.CONCLUSIONS There was a substantial decrease in uninsured community health center visits and a significant increase in Medicaid-covered visits in study clinics in states that expanded Medicaid in 2014, whereas study clinics in states opting out of the expansion continued to have a high rate of uninsured visits. These findings suggest that Affordable Care Act-related Medicaid expansions have successfully decreased the number of uninsured safety net patients in the United States.

IMPORTANCE Interventions to discourage the use of tobacco products (including electronic nicotine delivery systems or e-cigarettes) among children and adolescents may help decrease tobacco-related illness and injury.OBJECTIVE To update the 2013 review on primary care-relevant interventions for tobacco use prevention and cessation in children and adolescents to inform the US Preventive Services Task Force.

NCT02355132 [ https://clinicaltrials.gov/ct2/show/NCT02355132 ].

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