Health care providers (HCPs) are an important source of physical activity (PA) information. Two studies were conducted to qualitatively and quantitatively examine nurse practitioners'(NPs) and physician assistants' current PA counseling practices, knowledge and confidence to provide PA counseling and providers' perceptions about their current PA counseling practices. The specific aims for these two studies included quantitatively and qualitatively identifying the prevalence of PA counseling, perceived counseling knowledge and confidence, and educational training related to counseling. In study 1, survey respondents were currently practicing NPs and physician assistants. Participants completed a modified version of the Promotion of Physical Activity by Nurse Practitioners Questionnaire either online or in person during a population specific conference. The majority of both NP and physician assistant respondents reported routinely counseling patients about PA. There were no differences in perceived knowledge or confidence to provide PA counseling between the two populations. Approximately half of all respondents reported receiving training to provide PA counseling as part of their educational preparation for becoming a health practitioner. Nearly three-quarters of respondents reported interest in receiving additional PA counseling training. In study 2, five focus groups (FGs), stratified by practice type, were conducted with NPs and physician assistants. Both NPs and physician assistants reported discussing PA with their patients, particularly those with chronic illness. Participants reported that discussing lifestyle modifications with patients was the most common type of PA counseling provided. Increased confidence to counsel was associated with having PA knowledge and providing simple counseling, such as lifestyle modifications. Barriers to counseling included having more important things to discuss, lack of time during appointments, the current healthcare system, lack of reimbursement and perceived patient financial barriers. PA recommendation knowledge was highly variable, with few participants reporting specific guidelines. FG participants, while not familiar with the American College of Sports Medicines' "Exercise is Medicine" initiative indicated interest in its use and learning more about it. The findings of these two studies indicate that while NPs and physician assistants are knowledgeable, confident and currently providing some amount of PA counseling to patients, additional training in PA counseling is needed and desired.

Obesity rates among adults have steadily grown in recent decades all the way up to 42.4% in 2018. This is a 12% increase from the turn of the century (Center for Disease Control and Prevention, 2021). A major reason for this rise is increased consumption of processed, high-calorie foods. People eat these foods at a young age and develop bad eating habits that can last for the rest of their lives. It is essential to intervene early and help adolescents form balanced, healthy eating habits before bad habits are already formed. Our solution to this problem is Green Gamers. Green Gamers combines adolescent’s passion for gaming with healthy eating via in-game rewards for healthy eating. People will be able to purchase healthy food items, such as a bag of carrots, and on the packaging there will be a QR code. They will then be able to scan the code on our website, and earn points which will unlock in-game items and other rewards. Video game rewards act as effective motivators for you people to eat more healthy foods. After the solution was formulated, a preliminary survey was conducted to confirm that video game related rewards would inspire children to eat more healthy foods. Based on those results, we are currently in the process of running a secondary market research campaign to learn if gift card rewards are a stronger motivator. Our end goal for Green Gamers would be to partner with large gaming studios and food producers. This would allow us access to many gaming franchises, so that rewards are available from a wide variety of games: making the platform appealing to a diverse audience of gamers. Similarly, a relationship with large food producers would give us the ability to place QR codes on a greater assortment of healthy food items. Although no relationships with large companies have been forged yet, we plan to utilize funding to test our concept on small focus groups in schools.