Weight Loss 101: a healthy weight loss program for college students.Abstract: Obesity and overweight are complex conditions that contribute to many chronic diseases. Treatment should include a dietary regimen, physical activity, and behavior therapy behavior therapy or behavior modification, in psychology, treatment of human behavioral disorders through the reinforcement of acceptable behavior and suppression of undesirable behavior. . This manuscript describes Weight Loss 101: A Healthy Approach to Weight Loss, a college student health center based program that is designed to facilitate college students exerting self-control over their nutritional habits as part of a healthy weight lass process. The nutrition education covers such issues as a personal diet plan, portion control, and label reading. Self-monitoring, stimulus control Stimulus control We refer to stimulus control when a discriminative stimulus changes the probability of a behavior (operant response). The discriminative stimulus comes to control behavior when it predicts something about the consequences of that behavior. , and problem solving problem solving Process involved in finding a solution to a problem. Many animals routinely solve problems of locomotion, food finding, and shelter through trial and error. skills are behavior change Behavior change refers to any transformation or modification of human behavior. Such changes can occur intentionally, through behavior modification, without intention, or change rapidly in situations of mental illness. techniques included in Weight Loss 101. A step-by-step program model is provided. ********** The National Heart, Lung and Blood Institute (NHLBI NHLBI, n.pr See National Heart, Lung, and Blood Institute. ) Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (1998) state that the U.S. has approximately 97 million overweight and/or obese o·bese adj. Extremely fat; very overweight. obese characterized by obesity. obese adjective Characterized by obesity, see there; excessively fat adults. Outcomes of the Third National Health and Nutrition Examination Survey (NHANES III NHANES III Third National Health & Nutrition Examination Survey Public health A population-based survey conducted by the National Center for Health Statistics, designed to assess the health and nutritional status of the noninstitutionalized Americans ) show that the prevalence of obesity in the United States Obesity has been cited as a major and increasing health issue in the United States in recent decades. While many industrialized countries have experienced similar increases, American obesity rates lead the world with 64% of adults being overweight and almost a quarter being obese. continues to increase (Kuczmarski, Flegal, Campbell, & Johnson, 1994). The NHLBI (1998) linked obesity and overweight to conditions such as hypertension, type 2 diabetes type 2 diabetes n. See diabetes mellitus. , heart disease, and cancers. Even moderate weight loss has been shown (NHLBI, 1998) to reduce the chance of developing obesity-related chronic diseases. The increasing prevalence of obesity and overweight also affects mortality rates and health care costs. In 1995, approximately $99.2 billion of health care expenditures were attributed to obesity related diseases and conditions (NHLBI, 1998). Dietary factors and sedentary lifestyle
Sedentary lifestyle is a type of lifestyle most commonly found in modern (particularly Western) cultures. It is characterized by sitting or remaining inactive for most of the day (for example, in an office. contributed to 300,000 potentially avoidable deaths (McGinnis & Foege, 1993) Lifestyle factors that contribute to excess weight are usually broken into nutrition and activity factors. An over consumption of food energy often plays a major role in weight gain, especially when coupled with physical inactivity physical inactivity A sedentary state. Cf Physical activity. . Americans have cut back their intake of fat; however, they have not decreased the total amount of food energy, consumed (Rippe, Crossley, & Ringer, 1998). Physical inactivity also contributes to weight gain by Americans. Only 22% of American adults regularly exercise at 30 minutes per day while 24% are sedentary sedentary /sed·en·tary/ (sed´en-tar?e) 1. sitting habitually; of inactive habits. 2. pertaining to a sitting posture. sedentary of inactive habits; pertaining to a fat, castrated or confined animal. (Rippe, Crossley & Ringer, 1998). GUIDELINES FOR DEVELOPMENT OF EFFECTIVE WEIGHT LOSS PROGRAMS The NHLBI document Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults (1998), identifies three goals of weight loss and weight management programs. The goals are to: [] Reduce body weight, [] Maintain a lower body weight over the long term, and [] Prevent further weight gain. The goals of healthy weight loss programs are most effectively promoted by helping individuals learn to equalize e·qual·ize v. e·qual·ized, e·qual·iz·ing, e·qual·iz·es v.tr. 1. To make equal: equalized the responsibilities of the staff members. 2. To make uniform. energy consumed and energy used. A diet for weight loss and maintenance must also be adequate in protein, carbohydrates, dietary fat, dietary fiber dietary fiber n. Coarse, indigestible plant matter, consisting primarily of polysaccharides, that when eaten stimulates intestinal peristalsis. , vitamins, and minerals (Nonas, 1998). Dietary treatment for weight loss should consist of a calorie restricted nutrient dense nutrient dense, adj describes the ratio of beneficial chemicals to the number of calories in food when nutrient content is greater. diet that promotes steady consistent weight loss. Usually a calorie reduction of 500 to 1000 calories per day will be sufficient to decrease weight at the rate of 1 to 2 pounds per week (Lau, 1999; NHLBI, 1998). Health educators must also recognize the importance of behavior therapy in promoting the changes needed for individuals to successfully adhere to adhere to verb 1. follow, keep, maintain, respect, observe, be true, fulfil, obey, heed, keep to, abide by, be loyal, mind, be constant, be faithful 2. a weight loss regimen. New eating and eating-related habits often must be learned. The following behavior change strategies can be useful when paired with dietary treatments for weight control: * Self-monitoring, * Stimulus control, * Problem solving, * Cognitive restructuring Cognitive restructuring The process of replacing maladaptive thought patterns with constructive thoughts and beliefs. Mentioned in: Cognitive-Behavioral Therapy cognitive restructuring, n Self-monitoring helps an individual become more aware of behaviors that promote excess weight. Self-monitoring may consist of such strategies as recording food intake including amounts, calorie and nutrient content, and fat grams, and recording events or feelings that promote overeating overeating eating too much food too quickly; leads to acute gastric dilatation in dogs and horses, acute carbohydrate engorgement in ruminants, dietetic (dietary) diarrhea in young calves and foals, abomasal tympany in bottle fed lambs and calves. (NHLBI, 1998; Foreyt, & Poston, 1998). Stimulus control involves teaching the individual how to identify environmental stimuli that trigger overeating. By identifying these stimuli, one can learn to alter their environment by avoiding high-risk situations (NHLBI, 1998; Foreyt & Poston, 1998). After triggers are identified, problem-solving skills are taught to assist the individual in choosing a healthy way to alter their environment. Problem solving skills are used to identify problems, formulate a variety of solutions, then choose and implement the healthy solution that best fits their individual needs and interests (NHLBI, 1998; Shape Up America, 1996). Cognitive restructuring is an important technique that deals with one's self-talk. If an obese or overweight individual's self-talk is negative, it could undermine the efficacy of the weight loss diet. Cognitive restructuring consists of exercises that promote realistic goals and beliefs about weight loss and good nutrition (NHLBI, 1998; Foreyt & Poston, 1998). Table 1 provides some examples of methods used to address each of these behavior change strategies in the Weight Loss 101 program. WEIGHT LOSS PROGRAMS DESIGNED FOR COLLEGE STUDENTS Weight loss programs have been widely offered to a variety of participants and in many different settings. It is important to recognize that while some basic concepts (i.e. the calorie equation) contained in such programs may be universal, programs must also take into account the unique characteristics of the target audience. This is true not only in terms of the individual goals participants bring to the program but must also address convenience of access, economic factors and other important characteristics. In order to successfully conduct such a program for college students, health educators should consider the following points: * Students have limited time and funds * Easy accessibility to the program is needed * Students will come a variety of ethnic groups. * Program times must consider the class schedule of the university. The Centers for Disease Control (CDC See Control Data, century date change and Back Orifice. CDC - Control Data Corporation ) (1998) also established important guidelines to help plan effective nutrition education for young adults including: * Learning new skills not just new facts * Opportunities to practice nutritious nutritious /nu·tri·tious/ (noo-trish´us) affording nourishment. nu·tri·tious adj. Providing nourishment; nourishing. nutritious affording nourishment. eating skills and, * Nutritious education activities that are fun and innovative. The 5-A-Day promotion of fruits and vegetables (Nicklas, Johnson, Farris, Rice, Lyon, & Shi, 1997) used in high schools, found that appealing and relevant nutrition education was very effective in helping young adult populations make and maintain dietary changes. Weight Loss 101: A Healthy Approach to Weight Loss is a university sponsored program offered by the University's Student Health Center. The program utilizes the services of a Graduate Assistant trained in Nutrition/ Dietetics dietetics /di·e·tet·ics/ (-iks) the science of diet and nutrition. di·e·tet·ics n. The branch of therapeutics concerned with the practical application of diet in relation to health and disease. and supervised by a Registered Dietitian registered dietitian, n See dietitian, registered. . The program offers basic nutrition and weight control education in a one day per week (50 min/session) format over a period of four weeks. It is offered free of charge to students enrolled at the University. To accommodate students' time constraints In law, time constraints are placed on certain actions and filings in the interest of speedy justice, and additionally to prevent the evasion of the ends of justice by waiting until a matter is moot. , Weight Loss 101 offers a flexible schedule. Students may choose a 4-week program that meets every. Tuesday or one that meets every Thursday. Classes are held at the Student Health Center on campus to enhance student accessibility. Weight Loss 101 can be administered by a Health Education or Health Promotion graduate student who has a Bachelor of Science Noun 1. Bachelor of Science - a bachelor's degree in science BS, SB bachelor's degree, baccalaureate - an academic degree conferred on someone who has successfully completed undergraduate studies degree in nutrition or a similar subject. Also, experience dealing with weight loss programs would be helpful. The graduate student is not authorized to prescribe diets without approval from the registered dietitian supervising the program. The registered dietitian should also be available for consultation should any special conditions or contraindications be noted. Weight Loss 101 is advertised throughout campus, targeting areas most often utilized by students (i.e. student recreation center Student Recreation Center may refer to:
n. 1. The use of basic learning techniques, such as conditioning, biofeedback, reinforcement, or aversion therapy, to teach simple skills or alter undesirable behavior. 2. See behavior therapy. . Exercise is strongly encouraged, and assistance with developing a safe and effective program is available to students through referral to the university's student recreation center. All full time students receive membership to the recreation center as part of tuition and fees. Specific nutrition education content areas are included in the program based on documented effectiveness (Shape Up America, 1996; Domell, Alford, Cattlett, & Gench, 1992; Shannon, Linton, Hsu, Rollins, & Schwartz, 1986). Included are such issues as the Food Guide Pyramid Food Guide Pyramid n. A food pyramid devised by the US Department of Agriculture in 1992, in which grains and cereals represent the base beneath layers for fruits and vegetables, meats and dairy products, and fats and sweets at the peak. , portion control, reading the Nutrition Facts Label The nutrition facts label (also known as the nutrition information panel, and various other slight variations) is a label required on most pre-packaged foods in North America, United Kingdom and other countries. , the importance of exercise, and education about their personal diet regimen. Research has also reinforced the importance of theory driven behavior change programming, which is included in each education session to assist the individual in initiating and maintaining necessary lifestyle alterations (NHLBI, 1998; Foreyt & Poston, 1998; Shape Up America, 1996; Shannon et al, 1986). Each educational session consists of a brief presentation covering a specific nutritional topic, appropriate activities, discussions, and appropriate visual aids visual aids Noun, pl objects to be looked at that help the viewer to understand or remember something (a content outline is contained in Table 2). Since the main focus of Weight Loss 101 is to lose weight, the education modules will focus on principles of healthy caloric caloric /ca·lo·ric/ (kah-lor´ik) pertaining to heat or to calories. ca·lor·ic adj. 1. Of or relating to calories. 2. Of or relating to heat. deficit diets. The method used in Weight Loss 101 to determine calorie needs involves the following steps: 1. Determine the basal energy expenditure basal energy expenditure The amount of oxygen consumed while resting and fasting, extrapolated to 24 hrs, roughly equivalent to 25 kcal/kg; BEE is used to determine an individual's caloric needs; BEE is multipled by level of activity–eg, 1.2 for bed rest; 1. (BEE) based on height, current weight, and age, 2. Multiply the BEE times the appropriate activity factor e.g. sedentary, moderately active or very active, 3. Subtract A relational DBMS operation that generates a third file from all the records in one file that are not in a second file. 500 to 1000 calories from that to create an energy deficit (NIH "Not invented here." See digispeak. NIH - The United States National Institutes of Health. , 1998; Shape Up America, 1996). Two of the education sessions, "Your Weight Loss Diet" and "What is a Portion", are focused on educating students about their diet and how to use it to its fullest potential. The weight loss plan presented consists of an Exchange Lists diet and portion control is taught through the practice of measuring skills and use of the Plate Model. Exchange Lists are lists of foods that are similar in caloric and nutrient content. They are used because they promote consistency in calorie levels, while also offering a variety of food choices. Each food on a particular list has the same amount of carbohydrate, protein, fat, and calories in one serving. Since one serving of one food on a list is equal to one serving of another food on the same list, the foods can be "exchanged" for one another (McCarren, 1997). There are exchange lists for breads or starches starch n. 1. A naturally abundant nutrient carbohydrate, (C6H10O5)n, found chiefly in the seeds, fruits, tubers, roots, and stem pith of plants, notably in corn, potatoes, wheat, and rice, and , fruits, milk, vegetables, meats, and fats. After an appropriate calorie level is determined, the total number of calories desired is divided in the correct amount of carbohydrates, proteins, and fats. The carbohydrates, proteins, and fats are then divided between the different exchange lists. The result is a meal plan that allows an individual a set number of servings of from each list for each meal (McCarren, 1997). The individual can choose any combination of food items from the different lists to reach the approved number of servings. This meal plan offers a variety of healthy choices along with a consistent amount of nutrient-dense foods. A key element to adequately using exchange lists is portion control. A person must consume the suggested serving sizes to be assured of consistency. Since portion control is very important, Weight Loss 101 utilizes an effective method of teaching portion control known as the Plate Model (Camelon, Hadell, Jamsen, Ketonen, Kohtamaki, Makimatilla, Tormala & Valve, 1998). The Plate Model offers a visual representation of what the appropriate amounts of vegetable, milk, breads, meats, and fruits look like arranged on a plate (Camelon et al, 1998). The Plate Model offers one half of the plate to vegetables, one fourth of the plate to grains, and the final one fourth of the plate to meats or meat substitutes. A roll, piece of fruit, and milk are adequate side dishes side dish n. A dish served as an accompaniment to the main course. Noun 1. side dish - a dish that is served with, but is subordinate to, a main course entremets, side order (Camelon et al, 1998). The Plate Model is utilized in Weight Loss 101 as a visual strategy for learning portion control. First, the students will be given their own plate with the three sectors divided. By memorizing these sectors, the student recognizes the constituents of the meal (Camelon et al, 1998). During the hands-on activities, students are asked to use portioned food models to design healthy meals that fit their meal plan. This exercise helps the students to know what an appropriate portion size looks like on their plate. Students are encouraged to divide their plates as such at home and use measuring utensils to determine appropriate serving sizes. Evaluation is important to determine the effectiveness of the program and to determine the participant's progress of the participants. A nutrition knowledge pretest pre·test n. 1. a. A preliminary test administered to determine a student's baseline knowledge or preparedness for an educational experience or course of study. b. A test taken for practice. 2. and post-test relevant to the nutrition content areas is offered. Students are weighed weekly in order to reinforce progressive weight loss and the behavior change efforts made in the program. Those who are not making progress with weight loss are offered individual counseling with the graduate student in order to help identify factors limiting their success. Alterations in the diet plans, strategies to alter environmental cues, and other remedial strategies may be developed at that time. Food recalls gathered at the first and last meeting are used to indicate behavior changes in the area of food selection. It is anticipated that an increase in nutrition knowledge and skill development will contribute to a healthier final 24-hour recall when compared to the first recall. During class activities, students are asked to read food labels and determine certain factors, demonstrate healthy food selection using the food labels and food models, and demonstrate proper portion control that fits their meal plan by using The Plate Model. They are then provided with feedback concerning the accuracy with which each of the skills have been demonstrated and further instruction is given if necessary to reinforce the goals of the program. REFERENCES Camelon, K.M., Hadell, K., Jamsen, P.T., Ketonen, K.J., Kohtamaki, H.M., Makimatilla, S., Tormala, M.L., & Valve, R.H. (1998). The Plate Model: a visual method of teaching meal planning. Journal of the American Dietetic Association The American Dietetic Association (ADA) is the United States' largest organization of food and nutrition professionals, with nearly 65,000 members. Approximately 75 % of ADA's members are registered dietitians and about 4 % are dietetic technicians, registered. , 98 (10), 1155-1158. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesityin Adults. (1998). Bethesda, MD: National Institutes of Health, National Heart, Lung, and Blood Institute National Heart, Lung, and Blood Institute, n.pr established in 1948, this division of the National Institutes of Health is responsible for research and education on cardiovascular, pulmonary, systemic diseases, and sleep disorders. . NIH Publication # 98-4083. Domel, S.B., Alford, B.B., Cattlett, H.N., & Gench, B.E. (1992). Weight control for black women. Journal of the American Dietetic Association, 92 (3), 346-347. Exchange Lists for Weight Management. (1995). American Diabetes Association The American Diabetes Association, or the ADA, is an American health organization providing diabetes research, information and advocacy. Founded in 1940, the American Diabetes Association conducts programs in all 50 states and the District of Columbia, reaching hundreds of , Inc and The American Dietetic Association. Foreyt, J.P., & Poston, W.S.C. (1998). The role of the behavioral counselor in obesity treatment. Journal of the American Dietetic Association, 98 (10), S27-S30. Guidance for Treatment of Adult Obesity adult obesity Public health Overweight in an adult, defined as an average body-mass index of ≥ 27.8 in ♂ and 27.3 in ♀. See Morbid obesity, Obesity. Cf Childhood obesity. . (1996). Bethesda, MD: Shape Up America! and American Obesity Association This article or section needs sources or references that appear in reliable, third-party publications. Alone, primary sources and sources affiliated with the subject of this article are not sufficient for an accurate encyclopedia article. . Kuczmarski, R.L., Flegal, K.M., Campbell, S.M., and Johnson, C.L. (1994). Increasing prevalence of overweight among US adults: the National Health and Nutrition Examination Surveys, 1960-1991. Journal of the American Medical Association JAMA: The Journal of the American Medical Association is an international peer-reviewed general medical journal, published 48 times per year by the American Medical Association. JAMA is the most widely circulated medical journal in the world. , 272, 205-211. Lau, D.C.W. (1999). Call for action: prevention and managing the expansive and expensive obesity epidemic. Canadian Medical Association Journal The Canadian Medical Association Journal (CMAJ) is a general medical journal that is published biweekly by the Canadian Medical Association (CMA). It is considered to be one of the top six general medical journals; the others being the , 160 (4), 503-506. Mattfeldt-Beman, M.K., Corrigan, S.A., Stevens, V.J., Sugars, C.P., Dalcin, A.T., Givi, M.J., & Copeland, K.C. (1999). Participant's evaluation of a weight-loss program. Journal of the American Dietetic Association, 99 (1), 66-71. McCarren, M. (1997). Why use exchanges? Diabetes Forecast, 50 (5), 40-41. McGinnis, J.M., and Foege, W.H. (1993). Actual causes of death in the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. . Journal of the American Medical Association, 270 (18), 2207-2211. Nicklas, T.A., Johnson, C.C., Farris, R., Rice, R., Lyon, L., and Shi, R. (1997). Development of a school-based nutrition intervention for high school students: Gimme gim·me Informal Contraction of give me. adj. Slang Demanding material things or especially money; acquisitive: today's gimme society; tired of gimme letters. n. 5. American Journal of Health Promotion, 11 (5), 315-322. Nonas, C.A. (1998). A model of chronic care of obesity through dietary treatment. Journal of the American Dietetic Association, 98 (10), S16-S22. Rippe, J.M., Crossley, S., and Ringer, R. (1998). Obesity as a chronic disease: modern medical and lifestyle management. Journal of the American Dietetic Association, 9 (10), S9-S15. Shannon, B., Linton, B., Hsu, L., Rollins, P., and Schwartz, R.M. (1986). Development of a nutrition and weight control program for Atlantic Richfield Company employees. Journal of Nutrition Education, 18 (1), S47-S50.
Table 1. Program Activities Designed to Address Behavior Change
Strategies
Behavior Change Strategy Program Application Session(s)
Self-Monitoring [] Nutrition pre-test 1,2,4
[] 24-hour dietary recalls
[] Nutrition post-test
Stimulus Control [] Review of recall data to 3
Identify "triggers" of eating
behaviors
Problem Solving [] Decision-making based on 3
Nutrition Facts Label
[] Solutions for overeating
Cognitive Restructuring [] Food Guide Pyramid instruction 1,2,3
[] Practice portion control using
Plate Model and Exchange Lists
Table 2. Weight Loss Nutrition Content Area Outline.
BEHAVIOR
SESSION NAME & NUMBER NUTRITION TOPIC MQDIFICATION
1a. Getting started * Nutrition Pre-test N/A
and 24-hour recall
1b. What is a healthy * Food Guide Pyra- * Discuss goals,
diet? mid need, & impor-
* Education about tance of weight
The Plate Model.* loss.
1c. What is a * Explanation of * Review 24-hour
Portion? portion control. recall. Identify
* Discuss portion problem areas.
control when din-
ning out.
2. Your Personal * Explanation of diet. * Explain and begin
Weight Loss Diet * Explanation of self-monitoring
Exchange Lists.** through food
* Relate portion con- records,
trol to Exchange * Discuss problem-
Lists. solving techniques
* Discuss follow the for overeating,
meal plan when
dinning out.
3. Nutritious Reading * Explain how to * Continuous in-
easily read the Nu- struction on self-
trition Facts Label. monitoring via
* Explain how to use food records,
the Nutrition Facts * Look at previous
Label in relation to week of self-moni-
the diet. toring to identify
stimuli to overeat-
ing.
* Problem solving
practice: how to
make the right
decision based on
the Nutrition Facts
Label.
4. Weight Loss 101 * Discussion of exer- * Discuss any
Finale cise as it relates to questions.
weight loss and * Discuss the changes
weight mainte- in follow-up 24-hour
nance. recall.
* Go over any final * Discuss exercise
questions pertaining. behaviors.
to the diet or self- * Discuss plans to
monitoring, maintain weight or
continue weight loss
after program
concludes.
ACTIVITIES OR
SESSION NAME & NUMBER DISPLAYS
1a. Getting started
* Nutrition pre-test
1b. What is a healthy and 24-hour recall
diet?
* Look at food
models of correct
1c. What is a portions.
Portion? * Practice portion
control using The
Plate Model.
* Given certain food
models, have stu-
dents choose most
appropriate and
tell why.
2. Your Personal
Weight Loss Diet * Divide each
student's exchange
diet into a meal
pattern.
* Using food mod-
els, make meals and
snack that fit the
personal meal plan.
3. Nutritious Reading
* Look at examples.
* Have students
read and discuss
various labels.
* Given certain food
packages, have
students make a
choice and tell
why.
4. Weight Loss 101
Finale Nutrition post-
test.
Follow-up 24-
hour recall.
Final weight.
Sources Table 1: Mattfeldt et al, 1999; Camelon et al, 1998*: NIH,
1998; Shape Up America, 1996; Domel et al, 1992.
Barry P. Hunt, Ed. D., is an Associate Professor of Health Education at Mississippi State University Mississippi State University, at Mississippi State, near Starkville; land-grant and state supported; coeducational; chartered 1878 as an agricultural and mechanical college, opened 1880. From 1932 to 1958 it was known as Mississippi State College. . Virginia Bogle bo·gle n. A hobgoblin; a bogey. [Scots bogill, perhaps ultimately from Welsh bwg, ghost, hobgoblin. , M.S., R.D., is a Dietician dietician Nutritionist A health professional with specialized training in diet and nutrition at Southeast Alabama Southeast Alabama is the term used to identify the southeastern counties in the state of Alabama. Other names for the area are The Wiregrass and Lower Alabama. The area includeds the Counties of Dale, Pike, Houston, Coffee, Henry, Geneva, Barbour, Crenshaw and Covington. Medical Center. Andy Gillentine, Ph.D., is an Associate Professor of Physical Education at Mississippi State University. Clay Daughtrey, Ph.D., is an Assistant Professor of Marketing at Metropolitan State College of Denver This article or section needs sources or references that appear in reliable, third-party publications. Alone, primary sources and sources affiliated with the subject of this article are not sufficient for an accurate encyclopedia article. . Address all Correspondence to Dr. Hunt at the Department of HPERS; Box 6186; MSU MSU Michigan State University MSU Mississippi State University MSU Montana State University MSU Minnesota State University MSU Morehead State University (Kentycky) MSU Montclair State University , MS 39762; phone: 662-325-2963; FAX: 662-325-4525; email: bhunt@colled.msstate.edu. |
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