Women Exercising, Active, and Learning Together 2.0

Secondary outcomes related to depression/sadness will be assessed using the 8-item NIH Toolbox Sadness Short Form. Exemplar items include marking the frequency in the past week for items such as "I felt worthless" or "I felt depressed". This measure uses a five-point scale from "Never" (1) to "Always" (5). This short form has shown both adequate internal consistency α = 0.88) and convergent validity (coefficient = 0.88; compared to the Center for Epidemiologic Studies Depression Scale.

Anxiety will be assessed using the 8-item PROMIS-Anxiety Short Form questionnaire. Exemplar items include marking the frequency in the past week for items such as "I felt uneasy" or "I felt anxious." This measure uses a five-point scale from "Never" (1) to "Always" (5). This measure has demonstrated adequate internal consistency in adult populations (α= 0.93).

Social health will be measured using the Emotional Support subscale from the NIH Toolbox Item Bank v3.0 will be used to measure social health. Exemplar items include "I have someone I trust to talk with about my problems" and "I have someone to turn to for suggestions about how to deal with a problem." All items are assessed using a five-point scale with anchors representing frequency in the past month from "Never" (1) to "Always" (5). This measure has demonstrated adequate internal consistency in adult populations (α = 0.97) and construct validity.

The secondary outcome of perceived stress will be assessed using the 10-item NIH Toolbox Perceived Stress Survey. Exemplar items include "How often have you felt nervous and 'stressed'?" and "How often have you felt that things were going your way?". All items are assessed using a five-point scale with anchors representing frequency in the past month from "Never" (1) to "Very often" (5). This measure has demonstrated adequate internal consistency in adult populations (α = 0.91).

The Multidimensional Body-Self Relations Questionnaire will assess body image. It explores the following constructs: self-esteem, physical fitness, health, concentration on body weight, and concerns about gaining weight. There are 69 items on a scale from 1-5. The higher the score, the greater the satisfaction with body constructs. The following constructs are evaluated in this scale: appearance evaluation, appearance orientation, fitness evaluation, fitness orientation, health evaluation, health orientation, illness orientation, body area satisfaction, overweight preoccupation, and self-classified weight.

Physical activity will be measured with an ActiGraph GT9X Link wrist worn accelerometer worn for 7 days at all times during waking hours. A minimum of 4 days (three weekdays and one weekend day) and a wear time of 10 hours are needed to be included in subsequent analysis. Cut points developed by Montoye et al. will be used to assign sedentary, light, and moderate-to-vigorous physical activity. Participants will receive the accelerometer via the U.S. mail. Written instructions, a QR code for a video demonstration, and contact details of the investigative team will be sent to ensure proper fitting and wearing of the device. The accelerometer will be returned to the research team via prepaid mail envelopes.