title: The effects of Young Adults Eating and Active for Health (YEAH): a theory-based Web-delivered intervention.
abstract: OBJECTIVE
  To assess the effectiveness of a tailored theory-based, Web-delivered intervention (Young Adults Eating and Active for Health) developed using community-based participatory research process.
  
  
  METHODS
  A 15-month (10-week intensive intervention with a 12-month follow-up) randomized, controlled trial delivered via Internet and e-mail.
  
  
  METHODS
  Thirteen college campuses.
  
  
  METHODS
  A total of 1,639 college students.
  
  
  METHODS
  Twenty-one mini-educational lessons and e-mail messages (called nudges) developed with the non-diet approach and focusing on eating behavior, physical activity, stress management, and healthy weight management. Nudges were short, frequent, entertaining, and stage-tailored to each behavior, and reinforced lesson content.
  
  
  METHODS
  All participants were assessed at baseline, postintervention (3 months from baseline), and follow-up (15 months from baseline) for primary outcomes of weight, body mass index (BMI), fruit and vegetable intake (FVI), physical activity (PA), and perceived stress; and secondary outcomes of waist circumference, percent dietary fat, energy from sugar-sweetened beverages, servings of whole grains, self-instruction and regulation for mealtime behavior, hours of sleep, and stage of readiness for change for consuming 5 cups of FVI, completing 150 minutes of PA/wk, and managing stress on most days of the week. Demographics were collected at baseline.
  
  
  METHODS
  Chi-square analysis and mixed-models repeated measures analysis were performed to determine differences between experimental and control outcomes.
  
  
  RESULTS
  There were no differences between experimental and control participants in BMI, weight, and waist circumference. There were small improvements in FVI (P = .001), vigorous PA in females (P = .05), fat intake (P = .002), self-instruction (P = .001), and regulation (P = .004) for mealtime behavior, and hours of sleep (P = .05) at postintervention, but improvements were not maintained at follow-up. At postintervention, a greater proportion of experimental participants were in the action/maintenance stages for FVI (P = .019) and PA (P = .002) than control.
  
  
  CONCLUSIONS
  Young Adults Eating and Active for Health is one of the first studies to use the community-based participatory research process of PRECEDE-PROCEED to develop a non-diet approach intervention. Although there were no differences between experimental and control participants in weight change or BMI, the intervention supported positive change in behaviors that may mediate excessive weight gain, such as increasing FVI and more healthful self-regulation mealtime behaviors immediately postintervention. Additional strategies to maintain the behavior changes need to be explored.
authors.affiliation: Didactic Program in Dietetics, Health and Nutritional Sciences, South Dakota State University, Brookings, SD. Electronic address: kendra.kattelmann@sdstate.edu.
authors.forename: Kendra K
authors.initials: KK
authors.lastname: Kattelmann
authors.affiliation: Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ.
authors.forename: Carol Byrd
authors.initials: CB
authors.lastname: Bredbenner
authors.affiliation: School of Food and Agriculture, University of Maine, Orono, ME.
authors.forename: Adrienne A
authors.initials: AA
authors.lastname: White
authors.affiliation: Department of Nutrition and Food Science, University of Rhode Island, Kingston, RI.
authors.forename: Geoffrey W
authors.initials: GW
authors.lastname: Greene
authors.affiliation: Department of Food Science and Human Nutrition, Michigan State University, Lansing, MI.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Hoerr
authors.affiliation: Department of Human Nutrition, Kansas State University, Manhattan, KS.
authors.forename: Tandalayo
authors.initials: T
authors.lastname: Kidd
authors.affiliation: Department of Nutrition, University of Tennessee, Knoxville, TN.
authors.forename: Sarah
authors.initials: S
authors.lastname: Colby
authors.affiliation: Department of Public Health, Food Studies, and Nutrition, Syracuse University, Syracuse, NY.
authors.forename: Tanya M
authors.initials: TM
authors.lastname: Horacek
authors.affiliation: Department of Food Science and Nutrition, Tuskegee University, Tuskegee, AL.
authors.forename: Beatrice W
authors.initials: BW
authors.lastname: Phillips
authors.affiliation: Department of Nutritional Sciences, Rutgers University, New Brunswick, NJ.
authors.forename: Mallory M
authors.initials: MM
authors.lastname: Koenings
authors.affiliation: Department of Nutrition, Dietetics, and Hospitality Management, Auburn University, Auburn, AL.
authors.forename: Onikia N
authors.initials: ON
authors.lastname: Brown
authors.affiliation: Human Nutrition and Foods, West Virginia University, Morgantown, WV.
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Olfert
authors.affiliation: Department of Food Science and Nutrition, University of Florida, Gainesville, FL.
authors.forename: Karla P
authors.initials: KP
authors.lastname: Shelnutt
authors.affiliation: Nutrition Program, Department of Molecular, Cellular, and Biomedical Sciences, University of New Hampshire, Durham, NH.
authors.forename: Jesse Stabile
authors.initials: JS
authors.lastname: Morrell
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D034742:Electronic Mail; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D009043:Motor Activity; D018673:Nutrition Policy; D052756:Nutritional Sciences / Q000193:education*; D050177:Overweight / Q000453:epidemiology / Q000517:prevention & control*; D010349:Patient Compliance; D010353:Patient Education as Topic; D012306:Risk; D013334:Students; D014481:United States / Q000453:epidemiology; D014495:Universities; D055815:Young Adult
keywords: Web-delivered; obesity prevention; stage-tailored; young-adults