Research Poster Abstracts / Journal of Adolescent Health 62 (2018) S37–S140 S123

and third years were lower than that of those in the first year 243.
(p = .045, p = .003, respectively).
Conclusions: This study revealed that students who belong to a sports BUILDING GRIT IN JAPANESE MALE HIGH-SCHOOL
club have higher GSE than those who do not. However, sports club STUDENTS: EXAMINING THE ROLE OF BELONGING
participation did not enhance GSE in the senior high school period. TO AN ORGANIZED SPORTS ACTIVITY
On the contrary, this study suggests that GSE tends to decline as the Naruki Kitano, Ph.D. in Health and Sport Sciences 1,
grade advances. Future studies should focus on details of sports ac- Takashi Jindo, Ph.D. in Health and Sport Sciences 1,
tivities, e.g. positive experiences or social support through the activities, Yuichi Nakahara-Gondoh, Ph.D. in Physical Education 2,
Shota Sakamoto, Master’s degree in Sports Performance 3,
so as to find ways to enhance GSE in adolescents.
Takeru Gushiken, Master’s degree in Physical Education 3,
Sources of Support: N/A.
Kazuhiro Suzukawa, Ph.D. in Medicine 3,
Toshiya Nagamatsu, Ph.D. in Health Care 1
1 2
242. Meiji Yasuda Life Foundation of Health and Welfare; Fukuoka
3
Prefectural University; Nippon Sport Science University.
INTRODUCTION OF A BREAKFAST IN THE CLASS-
ROOM PROGRAM IN AN URBAN MIDDLE SCHOOL Purpose: Recent studies have revealed that grit, defined as perse-
Nellie Wixom, RD 1, Chelsea Walther, RD 2, Kim Urbach, PNP 3, verance and passion toward long-term goals, relates to academic
Susan M. Yussman, MD, MPH 4 achievement and retention within specific programs. Therefore, grit
1 2
University of Rochester; University of Rochester School of Medicine; seems one of the important personal traits to build in adolescents.
3 4
University of Rochester School of Nursing; Unviersity of Rochester However, little is known about the relationship between participat-
School of Medicine and Dentistry. ing in sports activities and grit, and ways to encourage this personality
trait in the youth. This study aimed to investigate the association of
Purpose: Students who eat nutritious breakfasts perform better in belonging to organized sports activities with grit, and its determi-
school, have better attendance rates and exhibit fewer behavior prob- nants in Japanese male high-school students.
lems. In 2016, an estimated 7 million adolescents (aged 10–17 yrs) Methods: Participants of this cross-sectional study were male high-
struggled with food insecurity in the United States. Expansion of free school students in their freshman year, selected from two research
or reduced-price breakfast programs was implemented to help address fields. First, we conducted an inventory survey in an all-male high
this problem. Because free breakfasts in the cafeteria at an urban school in Fukuoka, Japan, and gathered data from 786 students.
middle school in our community were poorly utilized, we intro- Additionally, 53 students who had been selected as a youth athlete
duced a Breakfast in the Classroom (BIC) program and assessed in J-League, a Japanese professional soccer league, were enrolled.
satisfaction, feasibility and student participation over a 9-month school Thus, the final sample comprised 839 participants. Grit was evalu-
year. ated using the Japanese Short Grit Scale. Subsequently, using a
Methods: Participation in the new BIC program was monitored self-reported questionnaire, we gathered information on potential
daily throughout the 2016-17 academic year. Retrospective quanti- determinants of grit, including physical activity, insomnia, enrich-
tative and qualitative student data were examined half-way through ment in school life, self-rated academic performance, career decision,
and at the end of the school year to assess satisfaction and accept- social support, and positive experience in junior high school. Par-
ability. Quantitative data from teachers were examined at the end ticipants were divided into the following 3 groups: belonging to a
of the year to assess acceptability and elicit ideas for potential school or community sports club (N = 401), belonging to the J-League
improvements. Simple frequencies and descriptive statistics were youth team (N = 53), and not belonging to any organized sport ac-
used to analyze the data. tivity (N = 385). We compared grit scores among these 3 groups
Results: Implementation of the BIC program proved feasible with using a one-way ANOVA. The determinants of grit were examined
ongoing communication and coordination between research dieti- using a step-wise multiple linear regression analysis with reference
cians and administrative staff, teachers, and food services team. Critical to whether subjects belonged to any organized sports activity (N = 454)
supporting personnel for implementation were the principal and the or not (N = 385).
school district food service director. BIC resulted in an increased break- Results: Participants in the J-league youth team exhibited the highest
fast participation rate from 29% in the prior school year (breakfast grit score among the 3 groups, and students who belonged to a school
in cafeteria only) to 66% in 2016-17 (accounting for 181 students). or community sports club had a higher score than those who did not
The majority of students wanted to see more variety of food choices belong to any organized sports activity (p < .05). Among students who
in the upcoming year. Favorite items (cereal, egg sandwich, fruit) and belonged to organized sports activities, the grit score was signifi-
least favorite items (pancakes, waffles, breakfast pizza) were iden- cantly explained by self-rated academic performance (B = .274),
tified. Many students reported missing socialization in the cafeteria positive experiences in junior high school (B = .218), support from sig-
environment. Among teachers, 54% agreed that BIC had positive in- nificant others (B = .128), insomnia (B=-0109), and vigorous-intensity
fluences on the school day by establishing a calmer morning. Teachers physical activity (B = .089). Among students who did not belong to
were also pleased that students appeared less hungry in classes prior any organized sports activity, the grit score was significantly ex-
to lunch. plained by self-rated academic performance (B = .378), support from
Conclusions: Initiation of BIC can substantially increase student par- significant others (B = .163), career decision (B = .125), and enrich-
ticipation in a free breakfast program. BIC was perceived by many ment in school life (B=-.122).
teachers to have a positive impact on students in this urban middle Conclusions: Present study suggested that belonging to organized
school. BIC increases breakfast accessibility to an age group that is sports activities, especially to an elite athletic team, contributes to
particularly vulnerable to the risks of food insecurity, and may help building grit in high-school students. Furthermore, self-rated aca-
to build lifelong healthy eating patterns. demic performance and support from significant others are important
Sources of Support: None. 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- completed surgeries with promising post-operative weight loss.
ical activity and good sleep quality may also be necessary for fostering We hope to continue working on improving adherence and collect-
grit. ing data to expand our knowledge of adolescent bariatric surgery
Sources of Support: N/A. outcomes, including which patients would benefit most from
surgery.
Sources of Support: None.
244.

EXAMINING PRE-OPERATIVE COMORBIDITIES AND 245.

WEIGHT LOSS IN ADOLESCENT BARIATRIC SURGERY
Meari Taguchi, BS, Amy L. Weiss, MD, MPH BEDTIME USE OF TECHNOLOGY: EFFECTS ON SLEEP
USF Health. IN CHILDREN AND ADOLESCENTS
Caitlyn Fuller, Bachelor of Arts in Biology (magna cum laude) 1,
Marsha Novick, Bachelor of Arts, M.D 2,
Purpose: Over the past thirty years, rates of adolescent obesity and
Steven Hicks, MD/PhD, BS in Biological Sciences 3
severe obesity have increased significantly along with metabolic 1 2
comorbidities once isolated to adults. Obesity treatment through diet Penn State University College of Medicine; The Milton S. Hershey
3
and exercise is often unsuccessful, particularly in older adolescents Medical Center; Milton S. Hershey Medical Center.
and those with severe obesity. Surgical weight loss is becoming a more
commonly accepted treatment in adolescents as safety and efficacy Purpose: Adolescents comprise one of the largest consumer groups
data are growing. of technology. Sleep is fundamental to optimal functioning during
Methods: Our adolescent bariatric clinic sees patients ages 12 to 21 childhood, including health and behavior. The purpose of this study
years within a well-established adult bariatric center. Surgical can- was to explore bedtime electronic use and its impact on three health
didates are limited to post-pubertal adolescents age 16 years and consequences—sleep quantity and quality, inattention, and body mass
older with BMI ≥ 35 with severe comorbidities or BMI ≥ 40. Prior to index (BMI). Parents of 234 children, ages 8–17 years old, were sur-
being considered for surgery, patients must attend at least 6 once- veyed to quantify hours of technology use (computer, video games,
monthly appointments with an interdisciplinary team comprised cell phone and television), hours of sleep, and inattentive behav-
of an adolescent medicine physician, psychologist, dietician, and iors. We hypothesized that increased hours of tablet and phone based
exercise physiologist. Appointments focus on medical weight loss, screen time at bedtime would be inversely correlated with sleep quan-
work-up and treatment of comorbidities, extensive nutrition tity and quality.
and exercise education, comprehensive psychological evaluation, Methods: Surveys were distributed to 234 families of children and
assessment of family support, and evaluation of comprehension adolescents, ages 8–17 years, between March, 2016 and September,
and commitment. IRB approval was obtained for data collection, 2016 at two sites: the Penn State General Pediatrics Clinic and the
descriptive statistics and ANOVA analysis were performed using Penn State Multidisciplinary Weight Loss Program. Surveys utilized
SPSS. parental report to assess child electronic use patterns, child sleep and
Results: From April, 2015 to August, 2016, 25 adolescent patients were child eating patterns. Child electronic use was evaluated by access
seen, 20 females and 5 males, with a mean age of 16.64 (SD 1.50) at to computers, video games, cell phones and television at bedtime,
initial visit. Comorbidities included: obstructive sleep apnea (.36), PCOS and by use of technology in the middle of the night. Child sleep pat-
(.36), vitamin D deficiency (.32), hyperlipidemia (.28), pre-diabetes terns were characterized by hours of sleep per night, difficulty falling
(.24), pre-hypertension (.20), diabetes (.08), hypertension (.04), and asleep, difficulty maintaining sleep, and reported morning fatigue.
NAFLD (.04). Eleven adolescents (.44) self-reported current or past Finally, child eating patterns were evaluated by consistent break-
depression, with 5 (.20) self-reporting thoughts of self-harm/ fast consumption.
suicidal ideation in the past. Mean initial BMI was 51.15 (SD 11.09), Results: A total of 234 surveys were collected. Of the 207 surveys ana-
mean change in BMI at the end of 6 visits was -.5614 kg/m2. Seven lyzed, there were 93 patients who fell into the “Normal BMI” category,
patients completed at least 6 visits, and 3 underwent laparoscopic 24 who were classified as “Overweight BMI,” 35 who were classi-
sleeve gastrectomy. One month after sleeve gastrectomy, there was fied as “Obese BMI,” and 55 who were classified as “Severely Obese
a decreased BMI of 6.45 kg/m2 in the two patients seen for follow- BMI.” Within the “Normal BMI” category the average age was 12 years
up. ANOVA analysis was used to compare BMI change after one visit, (+/- 2.8). Within the “Overweight BMI” category the average age was
BMI change after 6 pre-operative visits, and vitamin D levels by BMI 13 years (+/- 2.7). Within the “Obese BMI” category the average age
group: 35 ≤ Group A < 40; 40 ≤ Group B < 45; 45 ≤ Group C < 50; Group was 12 years (+/- 2.8). Within the “Severely Obese BMI” category the
D ≥ 50; Group E ≥ 60. After initial visit, Group A’s BMI decreased most, average age was 12 years (+/- 3.4). Using any device at bedtime was
with Group E demonstrating the highest BMI increase, without sta- associated with a statically significant increased use of multiple forms
tistical significance (p = .351). After six visits, Group C demonstrated of technology at bedtime and use in the middle of the night, reduc-
the greatest BMI reduction and Group E demonstrated the highest ing sleep quantity and quality. Little association was found between
BMI increase (p = .858). Groups A, B, and E were vitamin D deficient technology use and inattention. A statistically significant associa-
(<20 ng/dL). There was a statistically significant difference between tion was found between bedtime technology use and elevated BMI.
the BMI groups for vitamin D levels (p = .038). Clinicians should discuss the impact of technology at bedtime to
Conclusions: In our population of severely obese adolescents, medical prevent harmful effects of overexposure.
and psychological comorbidities are common, and medical weight Conclusions: These results suggest that technology (computer, video
loss is difficult to achieve especially for those with the highest games, cell phones and television) use at bedtime in children and ado-
BMIs. Limiting factors include small sample size and poor adher- lescents is associated with decreased sleep duration, increased
ence to appointments with loss to follow-up. Data from the past likelihood of texting in the middle of the night which reduces the
year is being collected currently for analysis and includes more quality of sleep, and increased morning fatigue therefore decreased