Research Poster Abstracts / Journal of Adolescent Health 62 (2018) S37–S140
and third years were lower than that of those in the first year
(p = .045, p = .003, respectively).
Conclusions: This study revealed that students who belong to a sports
club have higher GSE than those who do not. However, sports club
participation did not enhance GSE in the senior high school period.
On the contrary, this study suggests that GSE tends to decline as the
grade advances. Future studies should focus on details of sports ac-
tivities, e.g. positive experiences or social support through the activities,
so as to find ways to enhance GSE in adolescents.
Sources of Support: N/A.
242.
INTRODUCTION OF A BREAKFAST IN THE CLASS-
ROOM PROGRAM IN AN URBAN MIDDLE SCHOOL
Nellie Wixom, RD 1, Chelsea Walther, RD 2, Kim Urbach, PNP 3,
Susan M. Yussman, MD, MPH 4
1 2
University of Rochester; University of Rochester School of Medicine;
3 4
University of Rochester School of Nursing; Unviersity of Rochester
School of Medicine and Dentistry.
Purpose: Students who eat nutritious breakfasts perform better in
school, have better attendance rates and exhibit fewer behavior prob-
lems. In 2016, an estimated 7 million adolescents (aged 10–17 yrs)
struggled with food insecurity in the United States. Expansion of free
or reduced-price breakfast programs was implemented to help address
this problem. Because free breakfasts in the cafeteria at an urban
middle school in our community were poorly utilized, we intro-
duced a Breakfast in the Classroom (BIC) program and assessed
satisfaction, feasibility and student participation over a 9-month school
year.
Methods: Participation in the new BIC program was monitored
daily throughout the 2016-17 academic year. Retrospective quanti-
tative and qualitative student data were examined half-way through
and at the end of the school year to assess satisfaction and accept-
ability. Quantitative data from teachers were examined at the end
of the year to assess acceptability and elicit ideas for potential
improvements. Simple frequencies and descriptive statistics were
used to analyze the data.
Results: Implementation of the BIC program proved feasible with
ongoing communication and coordination between research dieti-
cians and administrative staff, teachers, and food services team. Critical
supporting personnel for implementation were the principal and the
school district food service director. BIC resulted in an increased break-
fast participation rate from 29% in the prior school year (breakfast
in cafeteria only) to 66% in 2016-17 (accounting for 181 students).
The majority of students wanted to see more variety of food choices
in the upcoming year. Favorite items (cereal, egg sandwich, fruit) and
least favorite items (pancakes, waffles, breakfast pizza) were iden-
tified. Many students reported missing socialization in the cafeteria
environment. Among teachers, 54% agreed that BIC had positive in-
fluences on the school day by establishing a calmer morning. Teachers
were also pleased that students appeared less hungry in classes prior
to lunch.
Conclusions: Initiation of BIC can substantially increase student par-
ticipation in a free breakfast program. BIC was perceived by many
teachers to have a positive impact on students in this urban middle
school. BIC increases breakfast accessibility to an age group that is
particularly vulnerable to the risks of food insecurity, and may help
to build lifelong healthy eating patterns.
Sources of Support: None.
S123
243.
BUILDING GRIT IN JAPANESE MALE HIGH-SCHOOL
STUDENTS: EXAMINING THE ROLE OF BELONGING
TO AN ORGANIZED SPORTS ACTIVITY
Naruki Kitano, Ph.D. in Health and Sport Sciences 1,
Takashi Jindo, Ph.D. in Health and Sport Sciences 1,
Yuichi Nakahara-Gondoh, Ph.D. in Physical Education 2,
Shota Sakamoto, Master’s degree in Sports Performance 3,
Takeru Gushiken, Master’s degree in Physical Education 3,
Kazuhiro Suzukawa, Ph.D. in Medicine 3,
Toshiya Nagamatsu, Ph.D. in Health Care 1
1 2
Meiji Yasuda Life Foundation of Health and Welfare; Fukuoka
3
Prefectural University; Nippon Sport Science University.
Purpose: Recent studies have revealed that grit, defined as perse-
verance and passion toward long-term goals, relates to academic
achievement and retention within specific programs. Therefore, grit
seems one of the important personal traits to build in adolescents.
However, little is known about the relationship between participat-
ing in sports activities and grit, and ways to encourage this personality
trait in the youth. This study aimed to investigate the association of
belonging to organized sports activities with grit, and its determi-
nants in Japanese male high-school students.
Methods: Participants of this cross-sectional study were male high-
school students in their freshman year, selected from two research
fields. First, we conducted an inventory survey in an all-male high
school in Fukuoka, Japan, and gathered data from 786 students.
Additionally, 53 students who had been selected as a youth athlete
in J-League, a Japanese professional soccer league, were enrolled.
Thus, the final sample comprised 839 participants. Grit was evalu-
ated using the Japanese Short Grit Scale. Subsequently, using a
self-reported questionnaire, we gathered information on potential
determinants of grit, including physical activity, insomnia, enrich-
ment in school life, self-rated academic performance, career decision,
social support, and positive experience in junior high school. Par-
ticipants were divided into the following 3 groups: belonging to a
school or community sports club (N = 401), belonging to the J-League
youth team (N = 53), and not belonging to any organized sport ac-
tivity (N = 385). We compared grit scores among these 3 groups
using a one-way ANOVA. The determinants of grit were examined
using a step-wise multiple linear regression analysis with reference
to whether subjects belonged to any organized sports activity (N = 454)
or not (N = 385).
Results: Participants in the J-league youth team exhibited the highest
grit score among the 3 groups, and students who belonged to a school
or community sports club had a higher score than those who did not
belong to any organized sports activity (p < .05). Among students who
belonged to organized sports activities, the grit score was signifi-
cantly explained by self-rated academic performance (B = .274),
positive experiences in junior high school (B = .218), support from sig-
nificant others (B = .128), insomnia (B=-0109), and vigorous-intensity
physical activity (B = .089). Among students who did not belong to
any organized sports activity, the grit score was significantly ex-
plained by self-rated academic performance (B = .378), support from
significant others (B = .163), career decision (B = .125), and enrich-
ment in school life (B=-.122).
Conclusions: Present study suggested that belonging to organized
sports activities, especially to an elite athletic team, contributes to
building grit in high-school students. Furthermore, self-rated aca-
demic performance and support from significant others are important
factors that determine the level of grit. For individuals who
S124 Research Poster Abstracts / Journal of Adolescent Health 62 (2018) S37–S140
participate in organized sports activities, engaging in intense phys-
ical activity and good sleep quality may also be necessary for fostering
grit.
Sources of Support: N/A.
244.
EXAMINING PRE-OPERATIVE COMORBIDITIES AND
WEIGHT LOSS IN ADOLESCENT BARIATRIC SURGERY
Meari Taguchi, BS, Amy L. Weiss, MD, MPH
USF Health.
Purpose: Over the past thirty years, rates of adolescent obesity and
severe obesity have increased significantly along with metabolic
comorbidities once isolated to adults. Obesity treatment through diet
and exercise is often unsuccessful, particularly in older adolescents
and those with severe obesity. Surgical weight loss is becoming a more
commonly accepted treatment in adolescents as safety and efficacy
data are growing.
Methods: Our adolescent bariatric clinic sees patients ages 12 to 21
years within a well-established adult bariatric center. Surgical can-
didates are limited to post-pubertal adolescents age 16 years and
older with BMI ≥ 35 with severe comorbidities or BMI ≥ 40. Prior to
being considered for surgery, patients must attend at least 6 once-
monthly appointments with an interdisciplinary team comprised
of an adolescent medicine physician, psychologist, dietician, and
exercise physiologist. Appointments focus on medical weight loss,
work-up and treatment of comorbidities, extensive nutrition
and exercise education, comprehensive psychological evaluation,
assessment of family support, and evaluation of comprehension
and commitment. IRB approval was obtained for data collection,
descriptive statistics and ANOVA analysis were performed using
SPSS.
Results: From April, 2015 to August, 2016, 25 adolescent patients were
seen, 20 females and 5 males, with a mean age of 16.64 (SD 1.50) at
initial visit. Comorbidities included: obstructive sleep apnea (.36), PCOS
(.36), vitamin D deficiency (.32), hyperlipidemia (.28), pre-diabetes
(.24), pre-hypertension (.20), diabetes (.08), hypertension (.04), and
NAFLD (.04). Eleven adolescents (.44) self-reported current or past
depression, with 5 (.20) self-reporting thoughts of self-harm/
suicidal ideation in the past. Mean initial BMI was 51.15 (SD 11.09),
mean change in BMI at the end of 6 visits was -.5614 kg/m2. Seven
patients completed at least 6 visits, and 3 underwent laparoscopic
sleeve gastrectomy. One month after sleeve gastrectomy, there was
a decreased BMI of 6.45 kg/m2 in the two patients seen for follow-
up. ANOVA analysis was used to compare BMI change after one visit,
BMI change after 6 pre-operative visits, and vitamin D levels by BMI
group: 35 ≤ Group A < 40; 40 ≤ Group B < 45; 45 ≤ Group C < 50; Group
D ≥ 50; Group E ≥ 60. After initial visit, Group A’s BMI decreased most,
with Group E demonstrating the highest BMI increase, without sta-
tistical significance (p = .351). After six visits, Group C demonstrated
the greatest BMI reduction and Group E demonstrated the highest
BMI increase (p = .858). Groups A, B, and E were vitamin D deficient
(<20 ng/dL). There was a statistically significant difference between
the BMI groups for vitamin D levels (p = .038).
Conclusions: In our population of severely obese adolescents, medical
and psychological comorbidities are common, and medical weight
loss is difficult to achieve especially for those with the highest
BMIs. Limiting factors include small sample size and poor adher-
ence to appointments with loss to follow-up. Data from the past
year is being collected currently for analysis and includes more
completed surgeries with promising post-operative weight loss.
We hope to continue working on improving adherence and collect-
ing data to expand our knowledge of adolescent bariatric surgery
outcomes, including which patients would benefit most from
surgery.
Sources of Support: None.
245.
BEDTIME USE OF TECHNOLOGY: EFFECTS ON SLEEP
IN CHILDREN AND ADOLESCENTS
Caitlyn Fuller, Bachelor of Arts in Biology (magna cum laude) 1,
Marsha Novick, Bachelor of Arts, M.D 2,
Steven Hicks, MD/PhD, BS in Biological Sciences 3
1 2
Penn State University College of Medicine; The Milton S. Hershey
3
Medical Center; Milton S. Hershey Medical Center.
Purpose: Adolescents comprise one of the largest consumer groups
of technology. Sleep is fundamental to optimal functioning during
childhood, including health and behavior. The purpose of this study
was to explore bedtime electronic use and its impact on three health
consequences—sleep quantity and quality, inattention, and body mass
index (BMI). Parents of 234 children, ages 8–17 years old, were sur-
veyed to quantify hours of technology use (computer, video games,
cell phone and television), hours of sleep, and inattentive behav-
iors. We hypothesized that increased hours of tablet and phone based
screen time at bedtime would be inversely correlated with sleep quan-
tity and quality.
Methods: Surveys were distributed to 234 families of children and
adolescents, ages 8–17 years, between March, 2016 and September,
2016 at two sites: the Penn State General Pediatrics Clinic and the
Penn State Multidisciplinary Weight Loss Program. Surveys utilized
parental report to assess child electronic use patterns, child sleep and
child eating patterns. Child electronic use was evaluated by access
to computers, video games, cell phones and television at bedtime,
and by use of technology in the middle of the night. Child sleep pat-
terns were characterized by hours of sleep per night, difficulty falling
asleep, difficulty maintaining sleep, and reported morning fatigue.
Finally, child eating patterns were evaluated by consistent break-
fast consumption.
Results: A total of 234 surveys were collected. Of the 207 surveys ana-
lyzed, there were 93 patients who fell into the “Normal BMI” category,
24 who were classified as “Overweight BMI,” 35 who were classi-
fied as “Obese BMI,” and 55 who were classified as “Severely Obese
BMI.” Within the “Normal BMI” category the average age was 12 years
(+/- 2.8). Within the “Overweight BMI” category the average age was
13 years (+/- 2.7). Within the “Obese BMI” category the average age
was 12 years (+/- 2.8). Within the “Severely Obese BMI” category the
average age was 12 years (+/- 3.4). Using any device at bedtime was
associated with a statically significant increased use of multiple forms
of technology at bedtime and use in the middle of the night, reduc-
ing sleep quantity and quality. Little association was found between
technology use and inattention. A statistically significant associa-
tion was found between bedtime technology use and elevated BMI.
Clinicians should discuss the impact of technology at bedtime to
prevent harmful effects of overexposure.
Conclusions: These results suggest that technology (computer, video
games, cell phones and television) use at bedtime in children and ado-
lescents is associated with decreased sleep duration, increased
likelihood of texting in the middle of the night which reduces the
quality of sleep, and increased morning fatigue therefore decreased