Papers by Amanda Szabo-reed
Medicine and Science in Sports and Exercise, Nov 1, 2017
Participation in classroom physical activity (PA) may improve time-on-task (TOT), however, the in... more Participation in classroom physical activity (PA) may improve time-on-task (TOT), however, the influence of sustained moderate-to-vigorous PA (MVPA) on TOT is unknown. Purpose-To explore the influence of classroom PA delivered with academic lessons on TOT, determine if the relationship between classroom PA and TOT differs by age, sex, race/ethnicity, weight or baseline fitness, and identify the influence of MVPA on TOT when controlling for demographic variables. Methods-Teachers in intervention schools were asked to deliver two, 10-minute PA lessons/day, 5 days/week. PA was observed in both intervention and control schools to determine the amount and intensity of PA. TOT was observed prior to and immediately following PA. Anthropometrics and fitness were assessed at baseline and end of the school year for 3 years. Multilevel modeling was utilized to estimate overall group difference, change over the study, and group difference in change while accounting for covariates. Results-Students who participated in PA lessons engaged in significantly more MVPA than those in the control schools in all three years (all p<.001). There was a significant linear increase in the percent of TOT before PA lessons for both control and intervention groups over the 3-year period (p<.001), with no group difference. The intervention group spent significantly more TOT (p=.01) following PA than the control group. The percent of time spent in MVPA was significantly associated with the percent of TOT (p<.01). Conclusion-Results indicate that children who received PA lessons participated in significantly more MVPA than those who did not and that PA was significantly associated with more TOT. These findings provide support for classroom PA as a means of increasing TOT in elementary aged children.
Contemporary Clinical Trials, Oct 1, 2018
Adults with intellectual and developmental disabilities (IDD) represent an underserved segment of... more Adults with intellectual and developmental disabilities (IDD) represent an underserved segment of the US population with a high prevalence of obesity and limited options for weight management. Previous research has demonstrated clinically meaningful weight loss of 7% of total body weight in in adults with IDD using an enhanced Stop Light Diet (eSLD) in combination with monthly athome face-to-face (FTF) behavioral sessions, and a recommendation for increased physical activity. However, the time and cost associated with FTF delivery (travel + sessions) limits the potential for scaling and implementation and suggests the need for the evaluation of less costly and burdensome strategies for intervention delivery. Therefore, we will conduct a 24-mo. randomized trial to compare a weight management intervention (6 mos. weight loss, 12 mos. maintenance, 6 mos. no-contact follow-up) delivered to 120 overweight/obese adults with IDD in their home, either remotely (RD) using video conferencing on a tablet computer, or during FTF visits. Our primary aim is whether RD is non-inferior to FTF for weight loss (0-6 mos.). Secondarily, we will compare the RD and FTF groups on mean weight loss, the proportion of participants who achieve clinically meaningful weight loss, and changes in quality of life across 24 months. We will also conduct cost analysis, cost-effectiveness, and contingent valuation analyses to compare the RD and FTF groups.
PubMed, Jun 15, 2019
Objectives: Determine the impact of classroom-based physically active lessons on time-on-task. Se... more Objectives: Determine the impact of classroom-based physically active lessons on time-on-task. Secondarily, determine the relationship of time-on-task with academic achievement controlling for key demographic variables. Methods: Seventeen elementary schools were cluster randomized to receive classroom physical activity (A+PAAC, N=9) or control (i.e., no physical activity, N=8) for a 3-year trial. Teachers were trained to deliver physically active lessons with moderate-to-vigorous intensity targeting 100 minutes per week. Outcome measures included academic achievement (Weschler Individual Achievement Test-III), administered at baseline and repeated each spring for 3 years, time spent in moderate-to-vigorous physical activity (MVPA), and time spent on task (TOT) pre- and post-physical activity. Multilevel modeling was utilized to estimate the impacts of percent time spent in MVPA and percent TOT post-lesson on academic achievement and the change in these impacts over 3 years, accounting for dependency among observations and covariates including age, gender, race, free or reduced lunch, BMI, and fitness. Results: A greater percentage of time performing MVPA were each significantly associated with higher math scores (p=.034) and spelling scores (p<.001), but not reading scores. Academic achievement was not associated with TOT. Conclusion: Findings suggest that a greater percentage of time spent participating in MVPA results in higher math scores and spelling scores, but not reading scores, independent of TOT. Future studies should continue to evaluate the influence of physically active classroom lessons on time spent on task and its impact on academic achievement. Furthermore, strategies are needed to maximize impact and to determine the sustainability of physical activity's effect on classroom behavior and academic achievement.
Journal of Physical Activity and Health, Jun 1, 2019
Background: High-intensity functional training (HIFT) may offer an attractive, time-efficient alt... more Background: High-intensity functional training (HIFT) may offer an attractive, time-efficient alternative to traditional aerobic exercise. However, limited information is available in the literature regarding HIFT meeting exercise guidelines for energy expenditure (improve health outcomes: ≥1000 kcal/wk; weight management: ≥2000 kcal/wk) and level of intensity (moderate:
Journal of Telemedicine and Telecare, Jul 9, 2016
Introduction-Currently, no systematic review/meta-analysis has examined studies that used online ... more Introduction-Currently, no systematic review/meta-analysis has examined studies that used online social networks (OSN) as a primary intervention platform. Therefore the purpose if this review was to evaluate the effectiveness of weight management interventions delivered through OSN. Methods-PubMed, Embase, PsycINFO, Web of Science, and Scopus were searched (January 1990-November 2015) for studies with data on the effect OSNs on weight loss. Only primary source articles that utilized OSN as the main platform for delivery of weight management/healthy lifestyle interventions, were published in English language peer-reviewed journals, and reported outcome data on weight were eligible for inclusion in this systematic review. Five articles were included in this review. Results-One-hundred percent of the studies (n=5) reported a reduction in baseline weight. Three of the five studies (60%) reported significant decreases in body weight when OSN was paired with health educator support. Only one study reported a clinical significant weight loss of ≥5%. Conclusion-Using OSN for weight management is in its early stages of development and while these few studies show promise, more research is needed to acquire information about optimizing these interventions to increase their efficacy.
Contemporary Clinical Trials, Nov 1, 2020
Adults with Alzheimer's disease and related dementia (ADRD) and their caregivers represent a size... more Adults with Alzheimer's disease and related dementia (ADRD) and their caregivers represent a sizeable and underserved segment of the population with low levels of moderate physical activity (MPA). Options for increasing MPA in community dwelling adults with ADRD and their caregivers are limited. A home-based physical activity intervention delivered remotely via video conferencing to groups of adults with ADRD and their caregivers (RGV), represents a potentially effective approach for increasing MPA in this group. We will conduct an 18-month randomized trial (6 mos. active intervention, 6 mos. maintenance, 6 mos. no contact) to compare the effectiveness of the RGV approach with usual care, enhanced with caregiver support (EUC), for increasing MPA in 100 community dwelling adults with ADRD and their caregiver. The primary aim is to compare MPA (min/wk.), assessed by accelerometer, across the 6-mo. active intervention in adults with ADRD randomized to RGV or EUC. Secondarily, we will compare adults with ADRD and their caregivers randomized to RGV or ECU on the following outcomes across 18 mos.: MPA (min/wk.), sedentary time (min/wk.), percentage meeting 150 min/wk. MPA goal, functional fitness, activities of daily living, quality of life, residential transitions, cognitive function, and caregiver burden. Additionally, we will evaluate the influence of age, sex, BMI,
Obesity science & practice, May 5, 2017
The increase in technology and online social networks (OSNs) may present healthcare providers wit... more The increase in technology and online social networks (OSNs) may present healthcare providers with an innovative modality for delivering weight management programmes that could have an impact on health care at the population level. The objective of this study was to evaluate the feasibility and efficacy of using an OSN to deliver a weight loss programme to inform future, large-scale trials. Methods Seventy individuals (age = 47 AE 12.4, minority = 24.3%) with obesity (BMI = 36.2 AE 4.0) completed a 6-month weight loss intervention and were randomized to either a conference call or OSN delivery group. Weight loss was achieved by reducing energy intake by 500-700 kcal•d À1 below estimated total daily energy expenditure and progressing physical activity to 300 min/week. Behavioural weight loss strategies were delivered weekly throughout the intervention. Results Conference call and OSN groups produced clinically meaningful weight loss of ≥5% from baseline to 6 months (phone = À6.3 AE 6.4%, OSN = À5.8 AE 6.7%). There was no significant difference in weight change between groups (p = 0.765). Conclusion The phone and OSN groups met the American Heart Association/American College of Cardiology/The Obesity Society's Guidelines by reducing baseline weight by 5-10% within 6 months. OSNs appear to be a viable delivery platform for weight loss interventions; however, larger scale adequately powered trials are needed.
Annals of Behavioral Medicine, Sep 30, 2015
Background-Identification of weight change patterns may allow tailored interventions to improve l... more Background-Identification of weight change patterns may allow tailored interventions to improve long-term weight loss. Purpose-To identify patterns of weight change over 18 mos., and assess participant characteristics and intervention adherence factors associated with weight change patterns in a sample of 359 overweight/obese adults. Methods-Weight loss (0-6 mos.) was achieved with reduced energy intake and increased physical activity (PA). Maintenance (7-18 mos.) provided adequate energy to maintain weight and continued PA. Results-Latent profile analysis identified 3 weight change profiles. During weight loss/ maintenance, participants in profiles 2 and 3 (18 mos. weight loss ~14%) attended more behavioral sessions, and performed more PA, compared with profile 1 (18 mo. weight loss <1%). Self-efficacy for both weight management and exercise barriers were higher in profiles 2 and 3 compared with profile 1 following weight loss and during maintenance. Conclusion-Weight change patterns can be identified and are associated with both participant characteristics and intervention adherence.
Contemporary Clinical Trials, Mar 1, 2020
Only 43% of children in the U.S., ages 6-11 yrs., meet current physical activity (PA) guidelines.... more Only 43% of children in the U.S., ages 6-11 yrs., meet current physical activity (PA) guidelines. To satisfy the MVPA requirement, schools have begun incorporating MVPA in the form of activity breaks or MVPA academic lessons. We completed two, 3 academic-yr. cluster randomized trials (DK61489, DK85317) called “Physical Activity Across the Curriculum” (PAAC) which involved increasing MVPA in the classroom. Across 3-yrs. teachers in PAAC schools delivered ~60 min/wk. (12 min/day) of MVPA. Although short of our MVPA goal (20 min/d), the PAAC approach substantially increased in-school MVPA. Teacher reluctance to devote additional time to develop and integrate PA lessons into their curriculum was the overwhelming barrier to meeting the MVPA goal. Therefore, to reduce barriers to delivery of classroom PA we developed a 3-academic yr. cluster randomized trial (2 yrs. active intervention, 1 yr. follow-up) to compare the effectiveness and sustainability of technology delivered (PAAC-R) and classroom teacher delivered (PAAC-T) activity breaks for increasing classroom MVPA in elementary school students in grades 2 and 3 at baseline who will progress to grades 4-5.
Translational Journal of the American College of Sports Medicine
Objectives This study aimed to determine the effect of classroom-based physically active lessons ... more Objectives This study aimed to determine the effect of classroom-based physically active lessons on time on task (TOT) and the relationship of TOT with academic achievement controlling for key demographic variables. Methods Seventeen elementary schools were cluster randomized to receive classroom physical activity (Academic Achievement and Physical Activity Across the Curriculum, n = 9) or control (i.e., no physical activity, n = 8) for a 3-yr trial. Teachers were trained to deliver physically active lessons with moderate to vigorous intensity targeting 100 min·wk−1. Outcome measures included academic achievement (Wechsler Individual Achievement Test III), administered at baseline and repeated each spring for 3 yr; time spent in moderate to vigorous physical activity (MVPA); and TOT pre- and postphysical activity. Multilevel modeling was used to estimate the effects of percent time spent in MVPA and percent TOT postlesson on academic achievement and the change in these effects over ...
Obesity, 2020
ObjectiveThis study aimed to evaluate the effectiveness of three levels of exercise on weight reg... more ObjectiveThis study aimed to evaluate the effectiveness of three levels of exercise on weight regain subsequent to clinically meaningful weight loss (WL).MethodsAdults with overweight or obesity (n = 298) initiated a 3‐month behavioral WL intervention, which included reduced energy intake, increased exercise, and weekly behavioral counseling. Participants achieving ≥5% WL (n = 235) began a 12‐month behavioral WL maintenance intervention and were randomized to 150 min/wk (n = 76), 225 min/wk (n = 80), or 300 min/wk (n = 79) of partially supervised moderate‐to‐vigorous–intensity exercise.ResultsParticipants randomized to 150, 225, and 300 minutes of exercise completed 129 ± 30, 153 ± 49 and 179 ± 62 min/wk of exercise (supervised + unsupervised), respectively. Mean WL at 3 months (9.5 ± 3.1 kg) was similar across randomized groups (P = 0.68). Weight change across 12 months was 1.1 ± 6.5 kg, 3.2 ± 5.7 kg, and 2.8 ± 6.9 kg in the 150, 225, and 300 min/wk groups, respectively. Intent‐to‐...
Full and diverse participant enrollment is critical to the success and generalizability of all la... more Full and diverse participant enrollment is critical to the success and generalizability of all large-scale Phase III trials. Recruitment of sufficient participants is among the most significant challenges for many studies. The novel SARS-CoV-2 coronavirus pandemic has further changed and challenged the landscape for clinical trial execution, including screening and randomization. The Investigating Gains in Neurocognition in an Intervention Trial of Exercise (IGNITE) study has been designed as the most comprehensive test of aerobic exercise effects on cognition and brain health. Here we assess recruitment into IGNITE prior to the increased infection rates in the United States, and examine new challenges and opportunities for recruitment with a goal of informing the remaining required recruitment as infection containment procedures are lifted. The results may assist the design and implementation of recruitment for future exercise studies, and outline opportunities for study design tha...
Medicine & Science in Sports & Exercise, 2018
Obesity Science & Practice, 2020
Introduction: Obesity is linked to altered activation in reward and control brain circuitry; howe... more Introduction: Obesity is linked to altered activation in reward and control brain circuitry; however, the associated brain activity related to successful or unsuccessful weight loss (WL) is unclear. Methods: Adults with obesity (N = 75) completed a baseline functional magnetic resonance imaging (fMRI) scan before entering a WL intervention (ie,3-month diet and physical activity [PA] program). We conducted an exploratory analysis to identify the contributions of baseline brain activation, adherence behavior patterns, and the associated connections to WL at the conclusion of a 3-month WL intervention. Food cue-reactivity brain regions were functionally identified using fMRI to index brain activation to food vs nonfood cues. Food consumption, PA, and class attendance were collected weekly during the 3-month intervention. Results: The left middle frontal gyrus (L-MFG, BA 46) and right middle frontal gyrus (R-MFG; BA 9) were positively activated when viewing food compared with nonfood images. Structural equation modeling with bootstrapping was used to investigate a hypothesized path model and revealed the following significant paths: (1) attendance to 3-month WL, (2) R-MFG to attendance, and (3) indirect effects of R-MFG through attendance on WL. Conclusion: Findings suggest that brain activation to appetitive food cues predicts future WL through mediating session attendance, diet, and PA. This study contributes to the growing evidence of the importance of food cue reactivity and selfregulation brain regions and their impact on WL outcomes.
Contemporary Clinical Trials, 2019
Adolescents with intellectual and developmental disabilities (IDD) are less physically active and... more Adolescents with intellectual and developmental disabilities (IDD) are less physically active and have lower cardiovascular fitness compared with their typically developing peers. This population faces additional barriers to participation in moderate-to-vigorous physical activity (MVPA) such as reliance on parents, lack of peersupport, and lack of inclusive physical activity opportunities. Previous interventions to increase MVPA in adolescents with IDD have met with limited success, at least in part due to requiring parents to transport their adolescent to an exercise facility. We recently developed a remote system to deliver MVPA to groups of adolescents with IDD in their homes via video conferencing on a tablet computer. This approach eliminates the need for transportation and provides social interaction and support from both a health coach and other participants. We will conduct a 18-mo. trial (6 mos. active, 6 mos. maintenance, 6 mos. no-contact follow-up) to compare changes in objectively assessed MVPA in 114 adolescents with IDD randomized to a single level intervention delivered only to the adolescent (AO) or a multi-level intervention delivered to both the adolescent and a parent (A + P). Our primary aim is to compare increases in MVPA (min/d) between the AO and A + P groups from 0 to 6 mos. Secondarily we will compare changes in MVPA, sedentary time, cardiovascular fitness, muscular strength, motor ability, quality of life, and the percentage of adolescents achieving the US recommendation of 60 min. MVPA/d across 18 mos. We will also explore the influence of process variables/participant characteristics on changes in MVPA across 18 mos. NCT registration: NCT03684512
Obesity (Silver Spring, Md.), Sep 19, 2016
To compare regional brain volume predictors of percent weight loss (WL) in dieters with obesity (... more To compare regional brain volume predictors of percent weight loss (WL) in dieters with obesity (DwO) and in the same participants categorized as "successful" (≥7% WL) or "unsuccessful" dieters (<7% WL). DwO (n = 72) and participants with healthy weight (n = 22) completed a structural MRI at baseline and 3 months. All DwO participants were enrolled in a 12-week program consisting of a reduced calorie diet, increased physical activity, and behavioral modification. SPM8-based voxel-based morphometry processing streams were used for measurements of regional gray (GMV) and white matter volume and longitudinal changes in volume. Correlations between WL and baseline brain volume and change in brain volume, as well as differences between groups, were then tested. %WL was positively correlated with baseline GMV in right parahippocampal and orbitofrontal gyri in DwO. Successful dieters showed greater GMV loss in the left precentral gyrus and the insula compared with un...
Journal of telemedicine and telecare, Jan 15, 2016
Currently, no systematic review/meta-analysis has examined studies that used online social networ... more Currently, no systematic review/meta-analysis has examined studies that used online social networks (OSN) as a primary intervention platform. Therefore, the purpose of this review was to evaluate the effectiveness of weight management interventions delivered through OSN. PubMed, EMBASE, PsycINFO, Web of Science, and Scopus were searched (January 1990-November 2015) for studies with data on the effect of OSNs on weight loss. Only primary source articles that utilized OSN as the main platform for delivery of weight management/healthy lifestyle interventions, were published in English language peer-reviewed journals, and reported outcome data on weight were eligible for inclusion in this systematic review. Five articles were included in this review. One-hundred percent of the studies (n = 5) reported a reduction in baseline weight. Three of the five studies (60%) reported significant decreases in body weight when OSN was paired with health educator support. Only one study reported a cl...
Contemporary clinical trials, Jan 12, 2016
Management of obesity in the context of the primary care physician visit is of limited efficacy i... more Management of obesity in the context of the primary care physician visit is of limited efficacy in part because of limited ability to engage participants in sustained behavior change between physician visits. Therefore, healthcare systems must find methods to address obesity that reach beyond the walls of clinics and hospitals and address the issues of lifestyle modification in a cost-conscious way. The dramatic increase in technology and online social networks may present healthcare providers with innovative ways to deliver weight management programs that could have an impact on health care at the population level. A randomized study will be conducted in 70 obese adults (BMI 30.0-45.0 kg/m(2)) to determine if weight loss (6 months) is equivalent between weight management interventions utilizing behavioral strategies by either a conference call or social media approach. The primary outcome, body weight, will be assessed at baseline and 6 months. Secondary outcomes including waist ci...
Journal of the American College of Nutrition, Jan 23, 2015
To determine whether breakfast consumption or content affects academic achievement measured by st... more To determine whether breakfast consumption or content affects academic achievement measured by standardized tests. Baseline data were collected in fall of 2011 from 698 students (50.5% female, age = 7.5 ± 0.6 years) living in the state of Kansas. Academic achievement was assessed using 3 components from the Wechsler Individual Achievement Test (WIAT-III). Prior to taking the WIAT-III, participants completed a breakfast recall of all foods and drinks consumed that morning, which was analyzed using Nutrition Data System for Research (NDS-R). WIAT-III scores were compared between breakfast and non-breakfast consumers in a sample (n = 162) matched for age, sex, race, education level of both parents, household income, body mass index (BMI), and cardiovascular fitness, and Pearson correlations were calculated from all breakfast eaters (n = 617) between test performance and components of the breakfast. When compared to non-breakfast consumers, the breakfast consumers had significantly high...
Annals of Behavioral Medicine, 2015
Background-Identification of weight change patterns may allow tailored interventions to improve l... more Background-Identification of weight change patterns may allow tailored interventions to improve long-term weight loss. Purpose-To identify patterns of weight change over 18 mos., and assess participant characteristics and intervention adherence factors associated with weight change patterns in a sample of 359 overweight/obese adults. Methods-Weight loss (0-6 mos.) was achieved with reduced energy intake and increased physical activity (PA). Maintenance (7-18 mos.) provided adequate energy to maintain weight and continued PA. Results-Latent profile analysis identified 3 weight change profiles. During weight loss/ maintenance, participants in profiles 2 and 3 (18 mos. weight loss ~14%) attended more behavioral sessions, and performed more PA, compared with profile 1 (18 mo. weight loss <1%). Self-efficacy for both weight management and exercise barriers were higher in profiles 2 and 3 compared with profile 1 following weight loss and during maintenance. Conclusion-Weight change patterns can be identified and are associated with both participant characteristics and intervention adherence.
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Papers by Amanda Szabo-reed