Identifying and Measuring Multilevel Influences on College-Aged Athletes’ Multiple Health Behavior: A Pilot Study

Abstract

The current study gathered preliminary data relative to the influences on intercollegiate athletes’ multiple health behavior. A secondary objective was to inform future measurement of identified factors. A sample of 20 intercollegiate athletes participated in an open-ended survey, followed by a corresponding focus groups (≈90-minute). Qualitative data were gathered relative to the factors impacting athletes’ excessive alcohol intake, fruit and vegetable consumption (FVC), and maintenance of physical activity after college. In general, participating athletes reported influences within their social and physical environments (friends, bar accessibility, etc.) as the leading enablers of their excessive alcohol intake, while individual level influences were the most salient reasons not to drink excessively (responsibilities, health, etc.). Individual characteristics (taste preference, health, and expense) and the physical environment (availability and accessibility) were reported as the most salient levels of influence on athletes’ FVC. And when anticipating future maintenance of physical activity, athletes mostly reported individual level influences (outcome expectation, intrinsic motivation, etc.), with mention of family and friend influences. An in-depth comparison of current outcomes to similar research among young adult and athlete populations is provided, including validated measurement scales and future research suggestions. Current results provide an essential foundation for progressive research examinations among similar populations.

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Geller, K. and Herbert, M. (2014) Identifying and Measuring Multilevel Influences on College-Aged Athletes’ Multiple Health Behavior: A Pilot Study. Health, 6, 576-586. doi: 10.4236/health.2014.67076.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Berrigan, D., Dodd, K., Troiano, R.P., Krebs-Smith, S.M. and Barbash, R.B. (2003) Patterns of Health Behavior in U.S. Adults. Preventive Medicine, 36, 615-623.
http://dx.doi.org/10.1016/S0091-7435(02)00067-1
[2] Fine, L.J., Philogene, G.S., Gramling, R., Coups, E.J. and Sinha, S. (2004) Prevalence of Multiple Chronic Disease Risk Factors: 2001 National Health Interview Survey. American Journal of Preventive Medicine, 27, 18-24.
http://dx.doi.org/10.1016/j.amepre.2004.04.017
[3] Poortinga, W. (2007) The Prevalence and Clustering of Four Major Lifestyle Risk Factors in an English Adult Population. Preventive Medicine, 44, 124-128.
http://dx.doi.org/10.1016/j.ypmed.2006.10.006
[4] Prochaska, J.J., Spring, B. and Nigg, C.R. (2008) Multiple Health Behavior Change Research: An Introduction and Overview. Preventive Medicine, 46, 181-188.
http://dx.doi.org/10.1016/j.ypmed.2008.02.001
[5] Edington, D.W. (2001) Emerging Research: A View from One Research Center. American Journal of Health Promotion, 15, 341-349.
http://dx.doi.org/10.4278/0890-1171-15.5.341
[6] Shinton, R. (1997) Lifelong Exposures and the Potential for Stroke Prevention: The Contribution of Cigarette Smoking, Exercise, and Body Fat. Journal of Epidemiology & Community Health, 51, 138-143.
http://dx.doi.org/10.1136/jech.51.2.138
[7] French, S.A., Hennrikus, D.J. and Jeffery, R.W. (1996) Smoking Status, Dietary Intake, and Physical Activity in a Sample of Working Adults. Journal of Health Psychology, 15, 448-454.
http://dx.doi.org/10.1037/0278-6133.15.6.448
[8] Johnson, S.S., Paiva, A.L., Cummins, C.O., et al. (2008) Transtheoretical Model-Based Multiple Behavior Intervention for Weight Management: Effectiveness on a Population Basis. Preventive Medicine, 46, 238-246.
http://dx.doi.org/10.1016/j.ypmed.2007.09.010
[9] Perkins, K.A., Rohay, J., Meilahn, E.N., Wing, R.R., Matthews, K.A. and Kuller, L.H. (1993) Diet, Alcohol, and Physical Activity as a Function of Smoking Status in Middle-Aged Women. Journal of Health Psychology, 12, 410-415.
http://dx.doi.org/10.1037/0278-6133.12.5.410
[10] Ford, E.S., Bergmann, M.M., Kroger, J., Schienkiewitz, A., Weikert, C. and Boeing, H. (2009) Healthy Living Is the Best Revenge. Archives of Internal Medicine, 24, 1355-1362.
[11] Harrington, J., Perry, I.J., Lutomski, J., et al. (2010) Living Longer and Feeling Better: Healthy Lifestyle, Self-Rated Health, Obesity and Depression in Ireland. European Journal of Public Health, 20, 91-95.
http://dx.doi.org/10.1093/eurpub/ckp102
[12] Baronowski, T., Cullen, K.W. and Basen-Enguist, K. (1997) Transition Out of High School: A Time of Increased Cancer Risk? Preventive Medicine, 6, 694-703.
http://dx.doi.org/10.1006/pmed.1997.0193
[13] Cullen, K.W., Koehly, L.M., Anderson, C., et al. (1999) Gender Differences in Chronic Disease Risk Behaviors through the Transition Out of High School. American Journal of Preventive Medicine, 17, 1-8.
http://dx.doi.org/10.1016/S0749-3797(99)00038-0
[14] Aurelia, N., Puffer, J.C. and Green, G.A. (1997) Lifestyles and Health Risks of Collegiate Athletes: A Multi-Center Study. Clinical Journal of Sport Medicine, 7, 262-272.
http://dx.doi.org/10.1097/00042752-199710000-00004
[15] Friery, K.B. (2008) Incidence of Injury and Disease among Former Athletes: A Review. Journal of Exercise Physiology, 11, 26-45.
[16] Drenowatz, C., Eisenmann, J.C., Carlson, J.J., Pfeiffer, K.A. and Pivarnik, J.M. (2012) Energy Expenditure and Dietary Intake during High-Volume and Low-Volume Training Periods among Male Endurance Athletes. Applied Physiology, Nutrition, and Metabolism, 37, 199-205.
http://dx.doi.org/10.1139/h11-155
[17] Rodriguez, N.R., DiMarco, N.M. and Langley, S. (2009) Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and Athletic Performance. Journal of the American Dietetic Association, 109, 509-527.
http://dx.doi.org/10.1016/j.jada.2009.01.005
[18] Frye, W.S., Allen, B. and Drinnon, J. (2010) Alcohol Consumption among Athletes and Non-Athletes in Christian Colleges. Journal of Research on Christian Education, 19, 313-324.
http://dx.doi.org/10.1080/10656219.2010.526482
[19] Surujlal, J., Nolan, V.T. and Ubane, T. (2012) Drinking Patterns and Related Consequences among University Student-Athletes: Health and Physical Activity. African Journal for Physical Health Education, Recreation and Dance, 18, 281-292.
[20] Basilico, F. (1999) Cardiovascular Disease in Athletes. The American Journal of Sports Medicine, 27, 108-121.
[21] Dey, S., Ghosh, C., Debray, P. and Chatterjee, M. (2002) Coronary Artery Disease Risk Factors and Their Association with Physical Activity in Older Athletes. Journal of Cardiovascular Risk, 9, 383-392.
http://dx.doi.org/10.1097/00043798-200212000-00013
[22] Kujala, U., Marti, P., Kaprio, J., Hernelahti, M., Tikkanen, H. and Sarna, S. (2003) Occurrence of Chronic Disease in Former Top-Level Athletes. Predominance of Benefits, Risks or Selection Effects. Sports Medicine, 33, 553-561.
http://dx.doi.org/10.2165/00007256-200333080-00001
[23] Paffenbarger, S. and Lee, M. (1998) A Natural History of Athleticism, Health, and Longevity. Journal of Sports Sciences, 16, 31-46.
http://dx.doi.org/10.1080/026404198366957
[24] Wyshak, G. (2003) Behavioral Practices and Mortality in Women Former College Athletes and Nonathletes. Health Care for Women International, 24, 808-821.
http://dx.doi.org/10.1080/07399330390229920
[25] Nigg, C.R., Allegrante, J.P. and Ory, M. (2002) Theory-Comparison and Multiple-Behavior Research: Common Themes Advancing Health Behavior Research. Health Education Research, 17, 670-679.
http://dx.doi.org/10.1093/her/17.5.670
[26] Ronksley, P.E., Brien, S.E., Turner, B.J., Mukamal, K.J. and Ghali, W.A. (2011) Association of Alcohol Consumption with Selected Cardiovascular Disease Outcomes: A Systematic Review and Meta-Analysis. British Medical Journal, 342, d671.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043109/pdf/bmj.d671.pdf
http://dx.doi.org/10.1136/bmj.d671
[27] Stockwell, T. (2013) A Reply to Roerecke & Rehm: Continuing Questions about Alcohol and Health Benefits. Addiction, 108, 428-429.
http://dx.doi.org/10.1111/j.1360-0443.2012.04076.x
[28] American College Health Association (2007) National College Health Assessment.
http://www.acha-ncha.org
[29] Wechsler, H., Dowdell, G.W., Davenport, A.E. and Rimm, E.B. (1995) A Gender-Specific Measure of Binge Drinking among College Students. American Journal of Public Health, 85, 982-985.
http://dx.doi.org/10.2105/AJPH.85.7.982
[30] Pandina, R.J., Labouvie, E.W. and White, H.R. (1984) Potential Contributions of the Life Span Developmental Approach to the Study of Adolescent Alcohol and Drug Use: The Rutgers Health and Human Development Project, a Working Model. Journal of Drug Issues, 14, 253-268.
[31] Collins, R.L., Parks, G.A. and Marlatt, G.A. (1985) Social Determinants of Alcohol Consumption: The Effects of Social Interaction and Model Status on the Self-Administration of Alcohol. Journal of Consulting and Clinical Psychology, 53, 189-200.
http://dx.doi.org/10.1037/0022-006X.53.2.189
[32] Baer, J.S., Kivlahan, D.R., Blume, A.W., McKnight, P. and Marlatt, A. (2001) Brief Intervention for Heavy-Drinking College Students: 4-Year Follow-Up and Natural History. American Journal of Public Health, 91, 1310-1316.
http://dx.doi.org/10.2105/AJPH.91.8.1310
[33] Larimer, M.E., Turner, A.P., Anderson, B.K., et al. (2001) Evaluating a Brief Alcohol Intervention with Fraternities. Journal of Studies on Alcohol, 62, 370-380.
[34] Thombs, D.L. and Hamilton, M.J. (2002) Effects of a Social Norm Feedback Campaign on the Drinking Norms and Behavior of Division I Student-Athletes. Journal of Drug Education, 32, 227-244.
http://dx.doi.org/10.2190/2UYU-6X9M-RJ65-3YYH
[35] Dawson, D.A. (2003) Methodological Issues in Measuring Alcohol Use. Alcohol Research & Health, 27, 18-29.
[36] US Department of Health and Human Services (USDHHS) and US Department of Agriculture (USDA) (2005) Dietary Guidelines for Americans. 6th Edition, US Government Printing Office, Washington DC.
[37] Thompson, F.E., Subar, A.F., Smith, A.F., Midthune, D., Radimer, K.L., Kahle, L.L. and Kipnis, V. (2002) Fruit and Vegetable Assessment: Performance of 2 New Short Instruments and a Food Frequency Questionnaire. Journal of the American Dietetic Association, 102, 1764-1772.
http://dx.doi.org/10.1016/S0002-8223(02)90379-2
[38] The Food Guide Pyramid (1992) United States Department of Agriculture (USDA), Center for Nutrition Policy and Promotion, Report No. 252, Washington DC.
[39] Greene, G.W., Resnicow, K., Thompson, F.E., Peterson, K.E., Hurley, T.G., Hebert, J.R., Toobert, D.J., Williams, G.C., Elliot, D.L., Goldman Sher, T., Domas, A., Midthune, D., Stacewicz-Sapuntzakis, M., Yaroch, A.L. and Nebeling, L. (2008) Correspondence of the NCI Fruit and Vegetable Screener to Repeat 24-H Recalls and Serum Carotenoids in Behavioral Intervention Trials. Journal of Nutrition, 138, 200S-204S.
[40] Resnicow, K., Odom, E., Wang, T., Dudley, W.N., Mitchell, D., Vaughan, R., Jackson, A. and Baranowski, T. (2000) Validation of Three Food Frequency Questionnaires and 24-Hour Recalls with Serum Carotenoid Levels in a Sample of African-American Adults. American Journal of Epidemiology, 152, 1072-1780.
http://dx.doi.org/10.1093/aje/152.11.1072
[41] Physical Activity Guidelines Advisory Committee (2008) Physical Activity Guidelines Advisory Committee Report, US Department of Health and Human Services (USDHHS), Washington DC.
[42] Godin, G. and Shepherd, R. (1985) A Simple Method to Assess Exercise Behavior in the Community. Canadian Journal of Applied Sport Sciences, 10, 141-146.
[43] Godin, G. (2011) The Godin-Shephard Leisure-Time Physical Activity Questionnaire. Health and Fitness Journal of Canada, 4, 18-22.
[44] Jacbos, D., Ainsworth, B., Hartman, T. and Leon, A. (1993) A Simultaneous Evaluation of 10 Commonly Used Physical Activity Questionnaires. Medicine & Science in Sports & Exercise, 25, 81-91.
http://dx.doi.org/10.1249/00005768-199301000-00012
[45] Craig, C.L., Marshall, A.L., Sjöström, M., Bauman, A.E., Booth, M.L., Ainsworth, B.E., Pratt, M., Ekelund, U.L.F., Yngve, A., Sallis, J.F. and Oja, P. (2003) International Physical Activity Questionnaire (IPAQ): 12-Country Reliability and Validity. Medicine & Science in Sports & Exercise, 35, 1381-1395.
http://dx.doi.org/10.1249/01.MSS.0000078924.61453.FB
[46] Booth, M.L. (2000) Assessment of Physical Activity: An International Perspective. Research Quarterly for Exercise and Sport, 71, S114-S120.
[47] Stokols, D. (2006) Translating Social Ecological Theory into Guidelines for Community Health Promotion. American Journal of Health Promotion, 10, 282-298.
[48] Abbey, A., Scott, O., Oliansky, D., Quinn, B. and Andreski, P.M. (1990) Subjective, Social, and Physical Availability II. Their Simultaneous Effects on Alcohol Consumption. Substance Use & Misuse, 25, 1011-1023.
http://dx.doi.org/10.3109/10826089009058869
[49] Abbey, A., Scott, R.O. and Smith, M.J. (1993) Physical, Subjective, and Social Availability: Their Relationship to Alcohol Consumption in Rural and Urban Areas. Addiction, 88, 489-499.
http://dx.doi.org/10.1111/j.1360-0443.1993.tb02055.x
[50] Callas, P.W., Flynn, B.S. and Worden, J.K. (2004) Potentially Modifiable Psychosocial Factors Associated with Alcohol Use during Early Adolescence. Addictive Behaviors, 29, 1503-1515.
http://dx.doi.org/10.1016/j.addbeh.2004.02.028
[51] Wood, M.D., Read, J.P., Palfai, T.P. and Stevenson, J.F. (2001) Social Influence Processes and College Student Drinking: The Mediational Role of Alcohol Outcome Expectancies. Journal of Studies on Alcohol, 62, 32-43.
[52] Doumas, D.M. (2013) Alcohol-Related Consequences among Intercollegiate Student Athletes: The Role of Drinking Motives. Journal of Addictions & Offender Counseling, 34, 51-64.
http://dx.doi.org/10.1002/j.2161-1874.2013.00014.x
[53] Evans, M., Weinberg, R. and Jackson, A. (1992) Psychological Factors Related to Drug Use in College Athletes. The Sport Psychologist, 6, 24-41.
[54] Ford, J.A. (2007) Substance Used among College Athletes: A Comparison Based on Sport/Team Affiliation. Journal of American College Health, 55, 367-373.
http://dx.doi.org/10.3200/JACH.55.6.367-373
[55] Wilson, G.S., Pritchard, M.E. and Schaffer, J. (2004) Athletic Status and Drinking Behavior in College Students: The Influence of Gender and Coping Styles. Journal of American College Health, 52, 269-275.
http://dx.doi.org/10.3200/JACH.52.6.269-275
[56] Geller, K.S. and Dzewaltowski, D.A. (2009) Longitudinal and Cross-Sectional Influences on Youth Fruit and Vegetable Consumption. Nutrition Reviews, 67, 65-76.
http://dx.doi.org/10.1111/j.1753-4887.2008.00142.x
[57] Larson, N., Laska, M.N., Story, M. and Neumark-Sztainer, D. (2012) Predictors of Fruit and Vegetable Intake in Young Adulthood. Journal of the Academy of Nutrition and Dietetics, 112, 1216-1222.
http://dx.doi.org/10.1016/j.jand.2012.03.035
[58] Weitzman, E.R., Folkman, A., Folkman, K. and Wechsler, H. (2003) The Relationship of Alcohol Outlet Density to Heavy and Frequent Drinking and Drinking-Related Problems among College Students at Eight Universities. Health & Place, 9, 1-6.
http://dx.doi.org/10.1016/S1353-8292(02)00014-X
[59] Williams, R., Perko, M., Usdan, S., Leeper, J., Belcher, D. and Leaver-Dunn, D. (2008) Influences on Alcohol Use among NCAA Athletes: Application of the Social Ecology Model. American Journal of Health Studies, 23, 151-159.
[60] Baer, J.S., Stacy, A. and Larimer, M. (1991) Biases in the Perception of Drinking Norms among College Students. Journal of Studies on Alcohol, 52, 580-586.
[61] Thombs, D.L. (1998) A Test of the Perceived Norms Model to Explain Drinking Patterns among University Student-Athletes. Journal of American College Health, 49, 75-83.
http://dx.doi.org/10.1080/07448480009596287
[62] Thombs, D.L., Wolcott, B.J. and Farkash, L.G.E. (1997) Social Context, Perceived Norms and Drinking Behavior in Young People. Journal of Substance Abuse, 9, 257-267.
http://dx.doi.org/10.1016/S0899-3289(97)90020-1
[63] Thombs, D.L. and Hamilton, M.J. (2002) Effects of a Social Norm Feedback Campaign on the Drinking Norms and Behavior of Division I Student-Athletes. Journal of Drug Education, 32, 227-244.
http://dx.doi.org/10.2190/2UYU-6X9M-RJ65-3YYH
[64] Martens, M.P., Dams-O’Conner, K., Duffy-Paiement, C. and Gibson, J.T. (2006) Perceived Alcohol Use among Friends and Alcohol Consumption among College Athletes. Psychology of Addictive Behaviors, 20, 178-184.
http://dx.doi.org/10.1037/0893-164X.20.2.178
[65] Dams-O’Conner, K., Martin, J.L. and Martens, M.P. (2007) Social Norms and Alcohol Consumption among Intercollegiate Athletes: The Role of Athlete and Nonathlete Reference Groups. Addictive Behaviors, 32, 2657-2666.
http://dx.doi.org/10.1016/j.addbeh.2007.04.030
[66] Cooper, M.L. (1994) Motivations for Alcohol Use among Adolescents: Development and Validation of a Four-Factor Model. Psychological Assessment, 6, 117-128.
http://dx.doi.org/10.1037/1040-3590.6.2.117
[67] Cooper, M.L., Russell, M., Skinner, J.B. and Windle, M. (1992) Development and Validation of a Three-Dimensional Measure of Drinking Motives. Psychological Assessment, 4, 123-132.
http://dx.doi.org/10.1037/1040-3590.4.2.123
[68] Martens, M.P., Watson, J.C., Roylan, E.M. and Beck, N.C. (2005) Development of the Athlete Drinking Scale. Psychology of Addictive Behaviors, 19, 158-164.
http://dx.doi.org/10.1037/0893-164X.19.2.158
[69] Schonlau, M., Scribner, R., Farley, T.A., Theall, K., Bluthenthal, R.N., Scott, M. and Cohen, D.A. (2008) Alcohol Outlet Density and Alcohol Consumption in Los Angeles County and Southern Louisiana. Geospatial Health, 3, 91-101.
[70] Halonen, J.I., Kivimäki, M., Virtanen, M., Pentti, J., Subramanian, S.V., Kawachi, I. and Vahtera, J. (2013) Living in Proximity of a Bar and Risky Alcohol Behaviours: A Longitudinal Study. Addiction, 108, 320-328.
http://dx.doi.org/10.1111/j.1360-0443.2012.04053.x
[71] Smart, R.G. (1980) Availability and the Prevention of Alcohol-Related Problems. In: Harford, T.C., Parker, D.A. and Light, L., Eds., Normative Approaches to the Prevention of Alcohol Abuse and Alcoholism: Proceedings of a Symposium, Department of Health, Education and Welfare, Washington DC, 123-146.
[72] Adams, T.B. and Colner, W. (2008) The Association of Multiple Risk Factors with Fruit and Vegetable Intake among a Nationwide Sample of College Students. Journal of American College Health, 56, 455-461.
http://dx.doi.org/10.3200/JACH.56.44.455-464
[73] Ollberding, N.J., Nigg, C.R., Geller, K.S., Horwath, C.C., Motl, R.W. and Dishman, R.K. (2012) Food Outlet Accessibility and Fruit and Vegetable Consumption. American Journal of Health Promotion, 26, 366-370.
http://dx.doi.org/10.4278/ajhp.101215-ARB-401
[74] Moore, L.V., Roux, A.V.D. and Franco, M. (2012) Measuring Availability of Healthy Foods: Agreement between Directly Measured and Self-Reported Data. American Journal of Epidemiology, 175, 1037-1044.
http://dx.doi.org/10.1093/aje/kwr445
[75] Gustafson, A.A., Sharkey, J., Samuel-Hodge, C.D., Jones-Smith, J., Folds, M.C., Cai, J. and Ammerman, A.S. (2011) Perceived and Objective Measures of the Food Store Environment and the Association with Weight and Diet among Low-Income Women in North Carolina. Public Health Nutrition, 14, 1032-1038.
http://dx.doi.org/10.1017/S1368980011000115
[76] Caldwell, E.M., Kobayashi, M.M., DuBow, W.M. and Wytinck, S.M. (2009) Perceived Access to Fruits and Vegetables Associated with Increased Consumption. Public Health Nutrition, 12, 1743-1750.
http://dx.doi.org/10.1017/S1368980008004308
[77] Nelson, M.C. and Story, M. (2009) Food Environments in University Dorms: 20,000 Calories per Dorm Room and Counting. American Journal of Preventive Medicine, 36, 523-526.
http://dx.doi.org/10.1016/j.amepre.2009.01.030
[78] Hodson, K.T. (2012) The Impact of the Collegiate Athletic Dining Hall on the Well-Being of Student-Athletes.
http://hdl.handle.net/2346/11534.
[79] Ding, D., Sallis, J.F., Norman, G.J., Saelens, B.E., Harris, S.K., Kerr, J., Rosenberg, D., Durant, N. and Glanz, K. (2012) Community Food Environment, Home Food Environment, and Fruit and Vegetable Intake of Children and Adolescents. Journal of Nutrition Education and Behavior, 44, 634-638.
http://dx.doi.org/10.1016/j.jneb.2010.07.003
[80] Ingledew, D.K. and Markland, D. (2008) The Role of Motives in Exercise Participation. Psychology and Health, 23, 807-828.
http://dx.doi.org/10.1080/08870440701405704
[81] Guerin, E., Fortier, M.S., O’Sullivan, T. and Neilson, C. (2012) Physical Activity Maintenance in Middle Aged Women: A Qualitative Ecological Study. Journal of Health Behavior and Public Health, 2, 1-13.
[82] Deci, E. and Ryan, R. (1985) Intrinsic Motivation and Self-Determination in Human Behavior. Plenum, New York.
http://dx.doi.org/10.1007/978-1-4899-2271-7
[83] Deci, E. and Ryan, R. (2000) The “What” and “Why” of Goal Pursuits: Human Needs and the Self-Determination of Behavior. Psychological Inquiry, 11, 227-268.
http://dx.doi.org/10.1207/S15327965PLI1104_01
[84] Deci, E. and Ryan, R. (2008) Self-Determination Theory: A Macrotheory of Human Motivation, Development, and Health. Canadian Psychology, 49, 182-185.
http://dx.doi.org/10.1037/a0012801

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