Research Screener: a machine learning tool to semi-automate abstract screening for systematic reviews

BACKGROUND

Systematic reviews and meta-analyses provide the highest level of evidence to help inform policy and practice, yet their rigorous nature is associated with significant time and economic demands. The screening of titles and abstracts is the most time consuming part of the review process with analysts required review thousands of articles manually, taking on average 33 days. New technologies aimed at streamlining the screening process have provided initial promising findings, yet there are limitations with current approaches and barriers to the widespread use of these tools. In this paper, we introduce and report initial evidence on the utility of Research Screener, a semi-automated machine learning tool to facilitate abstract screening.

METHODS

Three sets of analyses (simulation, interactive and sensitivity) were conducted to provide evidence of the utility of the tool through both simulated and real-world examples.

RESULTS

Research Screener delivered a workload saving of between 60 and 96% across nine systematic reviews and two scoping reviews. Findings from the real-world interactive analysis demonstrated a time saving of 12.53 days compared to the manual screening, which equates to a financial saving of USD 2444. Conservatively, our results suggest that analysts who scan 50% of the total pool of articles identified via a systematic search are highly likely to have identified 100% of eligible papers.

CONCLUSIONS

In light of these findings, Research Screener is able to reduce the burden for researchers wishing to conduct a comprehensive systematic review without reducing the scientific rigour for which they strive to achieve.

Patterns of Change in Device-Based Physical Activity and Sedentary Time Following Bariatric Surgery: a Longitudinal Observational Study

PURPOSE

The aim of this study is to investigate changes in physical activity (PA) and sedentary time (ST) over 12 months following bariatric surgery.

METHODS

Pre-surgery and at 3, 6, 9, and 12 months post-surgery, wearable devices were used to measure PA at different intensities, grouped according to energy expenditure and daily step count, and ST. Measures were also collected of weight and self-efficacy for exercise. Pre- and 12 months post-surgery, measures were collected of body composition and cardiovascular fitness.

RESULTS

Thirty adults scheduled for bariatric surgery were recruited (20 females, 44.1 [range, 22.0 to 65.0] years, body mass index 39.6 [range, 30.9 to 50.9] kg/m²). When compared to pre-surgery measures, over the 12 months post-surgery, there were no changes in the percentage of waking hours (mean [95% CI]) spent in ST (- 2% [- 6 to 3]), light intensity PA (1% [- 3 to 5]), and moderate-to-vigorous intensity PA (1% [- 1 to 3]). At all time points, participants spent most (> 70%) of their waking hours accumulating ST, with little time spent in light intensity PA (~ 21%) and almost no time in moderate-to-vigorous intensity PA (~ 5%). Step count and cardiovascular fitness were also unchanged. There were significant changes in weight, self-efficacy for exercise, and body composition.

CONCLUSIONS

Although bariatric surgery resulted in substantial weight loss and improved self-efficacy for exercise, it was insufficient to effect change in PA, ST or cardiovascular fitness. Complementing surgical intervention with behavioral interventions may optimize change in PA and ST.

A clustered-randomized controlled trial of a self-reflection resilience-strengthening intervention and novel mediators

This study tests the efficacy of a unique resilience-strengthening intervention using a clustered-randomized controlled trial. It was hypothesized that the training, which encourages adaptive self-reflection on stressor events and the effectiveness of coping strategies and resources, would exert a positive effect on mental health outcomes via increased reflection and decreased brooding. The trial was conducted during a significant stressor period with a final sample of 204 second-class Officer Cadets from the Royal Military College, Australia. Platoons of Cadets were randomly allocated to either Self-Reflection Resilience Training (SRT; n = 96) or an exposure-matched active control group that received training as usual (i.e., cognitive-behavioral skill development training) and communication skills seminars (n = 108). Compared to the active control group, SRT was more effective at preventing the onset of depression symptoms and promoting stable levels of perceived stress during a period of increased exposure to training stressors, consistent with a resilient trajectory. The Self-Reflection group unexpectedly demonstrated higher anxiety symptoms than the Control group at immediate follow-up, but these symptoms returned to baseline levels at longer term follow-up. In contrast, the Control group experienced increasing anxiety symptoms between immediate and longer term follow-up. Mediation analyses supported an indirect effect of SRT on all three outcome measures via brooding, but not via reflection. This study provides support for the capacity of a practical, sustainable, and scalable intervention based on self-reflection to strengthen resilience in the military training setting. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Can an online exercise prescription tool improve adherence to home exercise programmes in children with cerebral palsy and other neurodevelopmental disabilities? A randomised controlled trial

OBJECTIVE

Determine the adherence to and effectiveness of an 8-week home exercise programme for children with disabilities delivered using Physitrack, an online exercise prescription tool, compared with traditional paper-based methods.

DESIGN

Single-blinded, parallel-groups, randomised controlled trial (RCT).

SETTING

Intervention took place in participants' homes in Western Australia.

PARTICIPANTS

Children aged 6 to 17 years, with neurodevelopmental disabilities including cerebral palsy (CP), receiving community therapy services.

INTERVENTION

All participants completed an individualised home exercise programme, which was delivered to the intervention group using Physitrack and conventional paper-based methods for the control group.

PRIMARY OUTCOME MEASURES

Adherence to exercise programme, goal achievement and exercise performance.

SECONDARY OUTCOME MEASURES

Enjoyment, confidence and usability of Physitrack.

RESULTS

Fifty-four participants with CP (n=37) or other neurodevelopmental disabilities (n=17) were recruited. Fifty-three were randomised after one early withdrawal. Forty-six completed the 8-week programme, with 24 in the intervention group and 22 in the control group. There was no difference between the two groups for percentage of exercises completed (intervention (n=22): 62.8% (SD 27.7), control (n=22): 55.8% (SD 19.4), between group mean difference -7.0% (95% CI: -21.6 to 7.5, p=0.34)). Both groups showed significant improvement in their self-rated performance of individualised goal activities, however there was no statistically significant difference between groups for goal achievement, quality of exercise performance, enjoyment, confidence or preferred method of delivery. There were no adverse events.

CONCLUSION

Physitrack provides a therapist with a new means of providing an exercise programme with online tools such as exercise videos, but our preliminary findings indicate that it may be no better than a traditional paper-based method for improving exercise adherence or the other outcomes measured. Exercise programmes remain an intervention supported by evidence, but a larger RCT is required to fully evaluate online delivery methods.

TRIAL REGISTRATION DETAILS

Australian New Zealand Clinical Trials Registry; ACTRN12616000743460.

OPTImising the implementation of pulMonary rehAbiLitation in people with chronic obstructive pulmonary disease (the OPTIMAL study): mixed methods study protocol

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a common respiratory condition characterised by dyspnoea during daily life. As the disease progresses, people with COPD can experience poor quality of life, reduced exercise capacity, worsening of symptoms and increased hospital admissions. Pulmonary rehabilitation, which includes exercise training, optimises both psychological and physical function, reduces symptoms and mitigates healthcare utilisation in people with COPD. There is, however, a gap in implementation of pulmonary rehabilitation programs, with global access limited to a small fraction of people with COPD. The overall aim of this study is to gather evidence that will optimise the implementation of pulmonary rehabilitation in people with COPD living in Perth, Western Australia.

METHODS

This is a mixed methods study protocol informed by a critical realist perspective. The study will comprise four phases. In Phase 1, we will quantify target behaviours of healthcare professionals and people with COPD which are related to the implementation of pulmonary rehabilitation at three tertiary hospitals. In Phase 2, we will conduct semi-structured interviews to explore the determinants of these target behaviours from the perspectives of healthcare professionals, people with COPD and their primary support person. In Phase 3, knowledge gained in Phases 1 and 2 will be used by healthcare professionals and people with COPD to co-create, field test and apply strategies that optimise these target behaviours. In Phase 4, we will re-quantify these target behaviours to determine the influence of co-created strategies. The cost effectiveness of implementing the co-created strategies will be explored by an economic analysis.

DISCUSSION

Understanding current clinical practice and the determinants of target behaviours pertaining to the implementation of pulmonary rehabilitation is crucial when developing strategies that successfully bridge the pulmonary rehabilitation implementation gap. If co-created strategies are effective, more people with COPD living in Perth, Western Australia will have access to pulmonary rehabilitation enabling them to derive the health benefits associated with this intervention.

An intervention to optimise coach-created motivational climates and reduce athlete willingness to dope (CoachMADE): a three-country cluster randomised controlled trial

Objectives

Coach-centred antidoping education is scarce. We tested the efficacy of a motivationally informed antidoping intervention for coaches, with their athletes’ willingness to dope as the primary outcome.

Methods

We delivered a cluster randomised controlled trial in Australia, the UK and Greece. This study was a parallel group, two-condition, superiority trial. Participants were 130 coaches and 919 athletes. Coaches in the intervention group attended two workshops and received supplementary information to support them in adopting a motivationally supportive communication style when discussing doping-related issues with their athletes. Coaches in the control condition attended a standard antidoping workshop that provided up-to-date information on antidoping issues yet excluded any motivation-related content. Assessments of willingness to dope (primary outcome) and other secondary outcomes were taken at baseline, postintervention (3 months) and at a 2-month follow up.

Results

Compared with athletes in the control group, athletes in the intervention group reported greater reductions in willingness to take prohibited substances (effect size g=0.17) and psychological need frustration (g=0.23) at postintervention, and greater increases in antidoping knowledge (g=0.27) at follow-up. Coaches in the intervention group reported at postintervention greater increases in efficacy to create an antidoping culture (g=0.40) and in perceived effectiveness of need supporting behaviours (g=0.45) to deal with doping-related situations. They also reported greater decreases in doping attitudes (g=0.24) and perceived effectiveness of need thwarting behaviours (g=0.35).

Conclusions

Antidoping education programmes should consider incorporating principles of motivation, as these could be beneficial to coaches and their athletes. We offer suggestions to strengthen these programmes, as most of the effects we observed were not sustained at follow-up.

Trial registration number

This trial has been registered with the Australian New Zealand Clinical Trials Registry (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371465&isReview=true).

A Multi-Study Exploration of Factors That Optimize Hardiness in Sport Coaches and the Role of Reflective Practice in Facilitating Hardy Attitudes

Hardiness has been identified as a key personal characteristic that may moderate the ill-effects of stress on health and performance. However, little is known about how hardiness might be developed, particularly in sport coaches. To systematically address this gap, we present two linked studies. First, interviews were conducted with pre-determined high-hardy, elite coaches (n = 13) to explore how they had developed their hardy dispositions through the associated attitudinal sub-components of control, commitment, and challenge. Utilizing thematic analysis, we identified that hardiness was developed through experiential learning, external support, and the use of specific coping mechanisms. Key to all of these themes was the concept of reflective practice, which was thought to facilitate more meaningful learning from the participants' experiences and, subsequently, enhance the self-awareness and insight required to augment hardiness and its sub-components. To investigate further the potential relationship between coaches' reflective practices and their level of hardiness, we conducted a follow-up study. Specifically, a sample of 402 sports coaches completed the Dispositional Resilience Scale-15, the Self-Reflection and Insight Scale, and the Questionnaire for Reflective Thinking. Using latent profile analysis (LPA), we clustered participants into groups based on their reflective profiles (e.g., type of engagement, level of reflective thinking). We then examined differences in hardiness between the five latent sub-groups using multinomial regression. Findings revealed that the sub-group of highly engaged, intentionally critical reflective thinkers reported significantly higher levels of all three hardiness sub-components than all other sub-groups; these effect sizes were typically moderate-to-large in magnitude (standardized mean differences = -1.50 to -0.10). Conversely, the profile of highly disengaged, non-reflective, habitual actors reported the lowest level of all three dimensions. Collectively, our findings offer novel insights into the potential factors that may influence a coaches' level of hardiness. We provide particular support for the importance of reflective practice as a meta-cognitive strategy that helps coaches to develop hardy dispositions through augmenting its attitudinal sub-components. Consequently, our research makes a significant contribution by providing a comprehensive insight into how we might better train and support coaches to demonstrate the adaptive qualities required to thrive in demanding situations.

A gender-sensitised weight-loss and healthy living program for men with overweight and obesity in Australian Football League settings (Aussie-FIT): A pilot randomised controlled trial

BACKGROUND

Recent evidence shows that sport settings can act as a powerful draw to engage men in weight loss. The primary objective of this pilot study was to test the feasibility of delivering and to evaluate preliminary efficacy of Aussie-FIT, a weight-loss program for men with overweight/obesity delivered in Australian Football League (AFL) settings, in preparation for a future definitive trial.

METHODS AND FINDINGS

This 6-month pilot trial took place in Perth, Australia. Participants were overweight/obese (Body Mass Index [BMI] ≥ 28 kg/m2), middle-aged (35-65 years old) men. Participants were recruited in May 2018, and the intervention took place between June and December 2018. The intervention involved 12 weekly 90-min face-to-face sessions, incorporating physical activity, nutrition, and behaviour change information and practical activities delivered by coaches at 2 clubs. Data were collected at baseline and immediately postintervention. For trial feasibility purposes, 6-month follow-ups were completed. Outcomes were differences in weight loss (primary outcome) and recruitment and retention rates, self-reported measures (for example, psychological well-being), device-measured physical activity, waist size, and blood pressure at 3 months. Within 3 days of advertising at each club, 426 men registered interest; 306 (72%) were eligible. Men were selected on a first-come first-served basis (n = 130; M age = 45.8, SD = 8; M BMI = 34.48 kg/m2, SD = 4.87) and randomised by a blinded researcher. Trial retention was 86% and 63% at 3- and 6-month follow-ups (respectively). No adverse events were reported. At 3 months, mean difference in weight between groups, adjusted for baseline weight and group, was 3.3 kg (95% CI 1.9, 4.8) in favour of the intervention group (p < 0.001). The intervention group's moderate-to-vigorous physical activity (MVPA) was higher than the control group by 8.54 min/day (95% CI 1.37, 15.71, p = 0.02). MVPA among men attracted to Aussie-FIT was high at baseline (intervention arm 35.61 min/day, control arm 38.38 min/day), which may have limited the scope for improvement.

CONCLUSIONS

Aussie-FIT was feasible to deliver; participants increased physical activity, decreased weight, and reported improvements in other outcomes. Issues with retention were a limitation of this trial. In a future, fully powered randomised controlled trial (RCT), retention could be improved by conducting assessments outside of holiday seasons.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry: ACTRN12617000515392.

Qualitative investigation of perceived barriers to and enablers of sport participation for young people with first episode psychosis

AIMS

The aim and objective of the study was building on a previous call for the development of sport-based life skills interventions for young people with first episode of psychosis (FEP) (Brooke, Lin, Ntoumanis, & Gucciardi, 2018), to explore the barriers and enablers to sport participation for young people with FEP.

METHOD

We used a semi-structured interview format to conduct one-to-one interviews with young people (aged 16-25; n = 10) with FEP, and one-to-one interviews and focus groups with their clinicians (n = 33). Questions focused on barriers and facilitators (intrapersonal, interpersonal, psychological, environment, health/safety, logistical) to sport participation young people with FEP. Thematic analysis was used to analyse the data.

RESULTS

Four themes (and 11 sub-themes) emerged from the analysis: (a) the need for sport in FEP recovery (perceived benefits; resource gap); (b) barriers (logistical; psychological); (c) enablers (positive environmental expectations and experiences) and (d) programme design (sport programme/type; life skills training; application to barriers/enablers).

CONCLUSION

The participants responded favourably to the idea of using sport to promote recovery post-FEP, and provided an insight into why sport is currently underutilized within FEP recovery efforts. The barriers, enablers, and specific suggestions for how to limit the barriers and strengthen the enablers are valuable for sport-based intervention design, and may be applicable to non-sport-based interventions for people with FEP.

The Assessment of Physiotherapy Practice tool provides informative assessments of clinical and professional dimensions of student performance in undergraduate placements: a longitudinal validity and reliability study

QUESTIONS

Do one or two factors best represent clinical performance scores obtained via the Assessment of Physiotherapy Practice (APP) and what is the nature of their characterisation? To what extent are the same number of factors and their interpretation, and item scaling captured equally over time and across contexts (eg, clinical subdisciplines) for assessments of clinical performance via the APP?

DESIGN

Archival and longitudinal study of undergraduate students' clinical performances for each of four final-year clinical placements.

PARTICIPANTS

A total of 561 undergraduate physiotherapy students from one Australian university who were enrolled to complete their final-year clinical placements between 2014 and 2017.

OUTCOME MEASURES

Clinical educators' assessments of student performance across seven key domains of clinical practice: professional behaviour, communication, assessment, analysis and planning, intervention, evidence-based practice and risk management.

RESULTS

Factor analyses supported the superiority of a two-factor representation of the APP, including dimensions characterised by professional and clinical domains, when compared with a unidimensional structure of an overarching 'clinical performance' factor. It was also found that the two-factor representation and item scaling was consistent across four clinical placements covering typical areas of physiotherapy practice. In other words, the same constructs are being assessed equally well across context and time.

CONCLUSIONS

The APP is the nationally adopted assessment tool that is used to evaluate clinical competence to practise as a physiotherapist in Australia and New Zealand. These findings provide new evidence for an updated scoring protocol in which clinical factors are distinguished from professional competencies.

Cross-sectional and longitudinal comparisons of self-reported and device-assessed physical activity and sedentary behaviour

OBJECTIVES

To examine the longitudinal associations and differences between self-reported and device-assessed physical activity (PA) and sedentary behaviour (SB), using a multifaceted statistical approach.

DESIGN

Longitudinal measurement burst.

METHODS

In total, 52 university students (78% female) aged 18-38 years (mean=21.94±4.57 years) participated. The study consisted of three blocks of six days of measurement, during which participants wore an accelerometer on their wrist for the entire block, and self-reported their PA over the 6 days at the end of each block.

RESULTS

Meaningful latent differences between methods were observed for moderate PA and SB across all three assessment periods, such that participants underreported the time spent in each activity. Bland-Altman plots revealed a positive mean difference for vigorous PA, with over-reporting increasing as mean levels increased. Negative mean differences were observed for all other intensities. Underreporting of moderate PA increased as the mean level increased, whereas for light PA and SB, underreporting decreased at high levels. Repeated measures correlations revealed a meaningful association for vigorous PA only, suggesting that as self-reported minutes increase so too do device-measured minutes.

CONCLUSIONS

We found evidence of cross-sectional and longitudinal differences and weak associations between self-reported and device-assessed PA and SB. Future work is needed to enhance the quality of self-reported methods to assess PA and SB (e.g., face and content validity), and consider improvements to the processing of device-based data.

Motivational Climate in the Classroom

Abstract. Adaptive motivation is central to positive functioning. Social agents such as teachers play a significant role in shaping the motivation of people with whom they interact by satisfying or thwarting their psychological needs of autonomy, competence, and relatedness. The development and validation of tools that assess the types of behaviors social agents adopt to satisfy these psychological needs are important agenda items for substantive and applied researchers. In this study, we examined factorial and convergent validity evidence of a need support scale adapted from the physical education context for use in tertiary settings with health science students. Factor analyses of responses from 290 health science students indicated that need-supportive behaviors are best captured by one latent factor, rather than the a priori 4-factor structure designed to capture needs for autonomy, relatedness, and competence. Regression analyses supported the convergent validity of the unidimensional structure, such that students who perceived higher levels of need-supportive behaviors from their tutor reported higher levels of behavioral engagement, and experiences of vitality and learning. Validation of a scale that assesses need-supportive behaviors within a health science context provides researchers with a tool to employ in future research that aims to investigate the antecedents and outcomes of such behaviors, as well as the effects of interventions designed to equip educators with the skills, motivation, and knowledge to employ successfully such behaviors.

Feasibility and preliminary effects of a peer-led motivationally-embellished workplace walking intervention: A pilot cluster randomized trial (the START trial)

Walking interventions can be effective in increasing physical activity amongst physically inactive employees. However, despite their promising potential regarding sustainability and scalability, peer-led workplace walking interventions have not been tested. We evaluated a peer-led workplace group walking intervention designed to engage physically inactive employees. A 16-week pilot cluster randomized controlled trial consisted of enhanced (5 worksites; n = 50 participants) and minimal treatment (3 worksites; n = 47) conditions. All participants were provided with a Fitbit Zip and information on health benefits of walking. Enhanced treatment participants had access to a mobile phone app incorporating behavior change techniques, were trained on principles of autonomous motivation, and had a peer leader trained in a motivationally supportive communication style. Feasibility assessments included recruitment and drop-out rates, assessment completion rates, training acceptability (walkers and peer leaders), and intervention acceptability (walkers only). Outcomes assessed included movement-related behaviors (assessed via activPAL devices), cardio-metabolic risk factors, motivation to walk, and well-being, and these measures were taken at baseline and post-intervention. The results supported intervention feasibility. Preliminary efficacy evidence was mixed. Markers of cardio-metabolic risk improved in the enhanced treatment only. Autonomous motivation increased in both conditions. There were no changes in step counts, standing, and sitting time, or well-being. Further fine tuning is needed before a definitive RCT. Australian and New Zealand Clinical Trials Registry: ACTRN12618000807257.

A qualitative exploration of mentally tough behaviour in Australian football

The primary aim of this research was to generate insight into observable mentally tough behaviours, or MTb, across different contexts (e.g., training and competition) in an Australian football (AF) environment. A second aim of this research was to explore the utility of MTb as a distinct concept, and identify common behavioural qualities associated with MTb that separate it from other similar constructs. In total, 10 experienced full-time football operations staff were interviewed using a semi-structured interview guide, with inductive thematic analysis employed to analyse the data. Five main themes relating to MTb were identified: adaptive development, consistent training conduct, composed performance actions, responsible and accountable, and team supportive. Overall, the findings of the research provided preliminary support for the proposition that there exists a collection of MTb that are displayed more frequently by athletes considered to possess high levels of mental toughness compared to athletes who are perceived to have low levels of this psychological capacity. We propose a collection of necessary and sufficient behavioural qualities and a working definition of MTb to further our understanding of potential strategies to develop MT.

Validity and reliability evidence of a point of care assessment of salivary cortisol and α-amylase: a pre-registered study

PURPOSE

The iPro Cube is a small portable point-of-care device designed to analyse salivary markers of stress in a user-friendly manner (e.g., fast, convenient). Our aim was to test the reliability and validity of the iPro Cube to measure salivary cortisol and α-amylase as compared to the common laboratory standard method (ELISA immunoassay) prior to and after moderate intensity exercise.

METHODS

The study was a repeated measures, pre-registered design, and statistical framework that incorporated prior knowledge directly into the estimation process. Twenty-nine individuals (age = 27.4 ± 6.6 y; body-mass = 70.8 ± 11.3 kg; height = 1.74 ± 0.92 m; 18 males) completed a single PWC75%HRmax, with repeated measures of salivary cortisol and -amylase pre, immediately post, and 30 min post-exercise.

RESULTS

Correlation between the iPro Cube and laboratory-based assessments of salivary cortisol was moderate-to-large (0.53 > r < 0.81) across all three testing points. In contrast, correlation between the iPro Cube and laboratory-based assessments of -amylase was small-to-moderate (0.25 > r < 0.46). We found a large correlation between duplicate samples of iPro Cube cortisol assessment (0.75 > r < 0.82), and a moderate-to-large correlation for -amylase (0.51> r < 0.77).

CONCLUSIONS

The iPro Cube is capable of taking measures of salivary cortisol that are moderately correlated to values obtained via ELISA immunoassay, however the unit underestimates salivary cortisol and overestimates salivary -amylase at rest and post-moderate intensity exercise. It is recommended that researchers continue using standard laboratory techniques to assess these salivary stress markers.

Is sport an untapped resource for recovery from first episode psychosis? A narrative review and call to action

AIM

The objective of this narrative review is to address the question: Should sport-based life skills interventions be developed for young people recovering from first episode psychosis?

METHODS

A prose was developed through a broad, critical narrative review of literatures on (1) first episode psychosis recovery (FEP); and (2) life skills and sport, highlighting the conceptual (and limited empirical) links between the two. This style of review allowed for a critical examination of evidence from seemingly distinct literatures to address a question yet to be explored empirically.

RESULTS

The review process highlighted important overlaps between psychosis recovery and sport. A review of the FEP recovery literature reveals that important components of an individual's recovery following a psychotic episode are: (1) physical activity, (2) opportunities to build life skills, and (3) social connectivity. A review of the sport and life skills literature suggests that sport can be a powerful platform from which to: (1) promote physical activity, (2) teach life skills, and (3) foster social connectivity within vulnerable populations. Despite the clear links between the two fields, mental health interventions that combine both life skills training components and physical activity in a context that promotes social connectivity are scarce to none.

CONCLUSIONS

We suggest that sport-based interventions could be an opportunity to provide life skills training, social connectivity and physical activity opportunities in one intervention to individuals recovering from their first psychotic episode. We call for their development, and provide empirically-based recommendations for intervention design.

Profiles of adversity and resilience resources: A latent class analysis of two samples

Adversities refer to events that are characterized by perceived or actual threat to human functioning. Often considered deleterious for health and well-being, recent work supports an alternative picture of the effects of adversity on human functioning, such that a moderate amount of adversity - when compared with none or high levels - can be beneficial. We extend this body of work in the current study by considering the breadth or type of adversities experienced simultaneously (referred to as polyadversity), with a focus on individual profiles of lifetime adversities. Latent class analysis was employed to explore different configurations of lifetime adversity experiences in two independent samples and examine how these latent classes differed with regard to resilience resources (i.e., optimism, hope, self-efficacy, and bounce-back ability). University students (N = 348) and members from the broader community (N = 1,506) completed measures of lifetime adversity exposure and resilience resources. Three polyadversity classes were revealed in each sample, with both producing a high and a low polyadversity class. The third class differed between samples; in the student sample, this class represented experiences of vicarious adversity, whereas in the community sample, it represented moderate levels of exposure to adversity. Support for the adaptive nature of a moderate amount of adversity exposure was found in the community sample but not in the student sample. This study produces initial evidence of how lifetime adversity experiences group together and how class membership is related to resilience resources.

Protocol for a gender-sensitised weight loss and healthy living programme for overweight and obese men delivered in Australian football league settings (Aussie-FIT): A feasibility and pilot randomised controlled trial

INTRODUCTION

Overweight and obesity are highly prevalent among Australian men. Professional sports settings can act as a powerful 'hook' to engage men in weight loss programmes; the Football Fans in Training programme delivered in professional UK soccer clubs was successful and cost-effective in helping men lose weight. The Australian Football League (AFL) is a potentially attractive setting to engage men in a weight loss programme. We aim to develop, pilot and evaluate the feasibility of a weight loss intervention for overweight/obese middle-aged men, delivered in AFL settings, to promote weight loss and healthier lifestyles and determine its suitability for a future randomised control trial.

METHODS AND ANALYSIS

120 overweight/obese male fans will complete baseline physical and psychological health measures and objective measures of physical activity (PA), weight, waist size and blood pressure prior to randomisation into the intervention or waitlist comparison group. The intervention group will receive 12 weekly 90 min workshops incorporating PA, nutrition education, behaviour change techniques and principles of effective motivation. Four community coaches will be trained to deliver Aussie-FIT at two AFL clubs in Western Australia. Measurements will be repeated in both groups at 3 months (post-intervention) and 6 months (follow-up). Outcomes will include programme uptake, attendance, changes in lifestyle and weight variables to inform power calculations for a future definitive trial, fidelity of programme delivery, acceptability, satisfaction with the programme and perceptions of effectiveness. We will also determine trial feasibility and potential to gather cost-effectiveness data.

ETHICS AND DISSEMINATION

Ethics approval was granted by Curtin University's Human Research Ethics Committee (HREC2017-0458). Results will be disseminated via peer-reviewed publications, conference presentations and reports. A multicomponent dissemination strategy will include targeted translation and stakeholder engagement events to establish strategies for sustainability and policy change.

TRIAL REGISTRATION NUMBER

ACTRN12617000515392; Pre-results.