Exercise Is Medicine® on Campus (EIM-OC), created by the American College of Sports Medicine (ACSM), is an initiative connecting college medical providers to exercise providers to better promote physical activity (PA) among students. At the University of North Carolina at Chapel Hill (UNC), PA has been incorporated as a vital sign within the campus health medical system, in which the provider assesses the patient’s current PA. If needed, the provider refers the patient to the UNC EIM-OC team. The UNC EIM-OC initiative began in fall 2016, but it was not until spring 2020 that a fully operational system was in place, and UNC EIM-OC was awarded “gold status” by the ACSM. However, just as the system was running smoothly, the COVID-19 pandemic spread to the United States. COVID-19 and its associated social distancing restrictions have led to many changes in the EIM-OC process. With respect to EIM-OC, this commentary reports on (i) the continuing importance of the initiative during COVID-19, (ii) COVID-related adaptations to UNC EIM-OC, and (iii) recommendations for the upcoming school year.

A ubiquitous aspect of contemporary societies is sedentary behavior (SB), defined as low intensity activities in a seated, reclined, or supine posture. Leading public health agencies, including the World Health Organization, have recognized the strong association between SB and poor health outcomes, particularly cardiovascular disease. However, while public health agencies have begun to advocate for “reductions” in SB, the current US guidelines are typically vague and non-specific. There is good reasoning behind this non-committal advocacy—there is limited mechanistic and clinical evidence to support policy development. To guide SB policy development, it is important to first consider the origins and evolution of SB, including the following: 1) is SB really a novel/contemporary behavior? i.e., how has this behavior evolved? 2) how did our ancestors sit and in what contexts? 3) how does SB interact with 24-hour activity behaviors, including physical activity and sleep? 4) what other historical and contemporary facets of life interact with SB? and 5) in what context do these behaviors occur and how might they provide different evolutionarily novel stressors? This perspective article will synthesize the available evidence that addresses these questions and stimulate discussion pertaining to the lessons that we can learn from an historical and evolutionary perspective. Last, it will outline the gaps in current SB interruption literature that are hindering development of feasible SB reduction policy.

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ContextAs many as 76.7% of U.S. young adults have at least one metabolic syndrome risk factor. Often undetected, metabolic syndrome risk factors cluster with other risk factors increasing risk of future cardiometabolic disease. The prevention of metabolic syndrome risk accrual through early behavioral interventions is crucial for at-risk populations.ObjectivesThis article outlines the protocol for the Health E Start study, including objectives, methodology, ethics, and dissemination. Additionally, we discuss the goals of the National Institutes of Health Research Enhancement Award (R15) that funded this project and how this funding will facilitate the comprehensive training of undergraduate researchers. The long-term goal of the study is to develop a theoretically driven intervention for the prevention of metabolic syndrome risk development in college students. To facilitate this goal, the aims are to identify 1) the behavioral targets for the prevention of metabolic syndrome risk development and 2) the motivations behind such behaviors to develop a theoretical framework for use in intervention design.DesignThis is a longitudinal observational design setting.SettingThis study focuses on the transition from living at home to independent living at colleges across the United States.ParticipantsThe participants of this study are high school seniors (n = 150) who will be transitioning to college within 3 months of graduating.Main Outcome MeasureFor aim 1, metabolic syndrome risk will be quantified into a risk score using a principal components analysis of traditional risk factors. Associations between changes in lifestyle behaviors and changes in the risk score will identify population-specific behavioral targets. For aim 2, changes in psychological, social, and environmental antecedents of observed behaviors will be identified.ConclusionsIdentifying the relationship between behavior change and metabolic syndrome risk and the psychosocial and environmental predictors of observed behavior changes will facilitate the design of targeted interventions for the prevention of metabolic syndrome risk progression in the early college years.