Development of a self-guided web-based intervention to promote physical activity using the multi-process action control framework

PURPOSE

Physical activity promotion has mostly focused on theories of intention-formation, with the assumption that positive intentions will lead to behaviour. Though necessary, exercise intentions alone are often not sufficient to improve physical activity behaviour. The Multi-Process Action Control (M-PAC) framework builds on previous intention-based theories by including both determinants of intention formation and its translation into behaviour. The purpose of this study was to describe the process of developing a self-guided web-based intervention to promote physical activity among adults using the M-PAC model.

PROCEDURES

The development process consisted of the following three phases: 1) Intervention planning: determine intervention needs and requirements; 2) Intervention development: use an iterative process to design a web-based physical activity intervention based on the M-PAC framework; 3) Pilot testing: conduct usability and acceptability assessment on the web-based intervention to further enhance user experience.

PRINCIPAL RESULTS

The intervention planning phase suggested that there is a need for web-based physical activity interventions and there is currently no web-based intervention designed using the M-PAC model. In phase two, we adopted an iterative process to develop a 10-week self-guided web-based intervention to help adults (>18 years of age) to meet 150 min of moderate to vigorous physical activity per week. The pilot testing phase yielded valuable feedback on usability, content, and design of the web-based intervention.

MAJOR CONCLUSIONS

The development of a web-based physical activity intervention using the M-PAC model could further enhance the effectiveness of web-based interventions and have a significant impact on extending the reach of existing physical activity promotion programs. This study has reinforced the importance of an iterative development process that involves a multi-disciplinary team to design a web-based intervention to promote physical activity. The process enabled the team to clarify the needs for an intervention for our target users, and provided valuable feedback on the design and content of the web-based intervention. Future studies are now needed to evaluate the effectiveness of our web-based intervention.

The Prospective Association Between the Five Factor Personality Model With Health Behaviors and Health Behavior Clusters

To examine the prospective association of personality with individual behavior, multibehavior and clustered health behavior profiles. A prospective study design was employed. Two hundred young adults provided baseline data and 126 (mean age: 21.6 yrs) provide complete data for a 5-month follow-up assessment (63% response rate). Personality and health behaviors (and covariates) were assessed via validated questionnaires. A multibehavior index variable was created ranging from 0-5; two separate health behavior cluster indices were created, including high (4-5 behaviors) vs. low (2 or fewer) behavior adoption and an energy balance cluster (MVPA and diet). When examining MVPA as a continuous variable, the personality trait conscientiousness was prospectively associated with MVPA and a healthy diet. Extraversion was prospectively associated with high (vs. low) behavioral clustering (OR = 1.18; 95% CI: 1.00-1.40) and conscientiousness was prospectively associated with energy balance clustering (OR = 1.09; 95% CI: 1.01-1.17). Extraversion, conscientiousness, openness to experience, and agreeableness were associated with select health-related behaviors. Further, extraversion and conscientiousness were associated with health behavior clustering.

Assessing the social climate of physical (in)activity in Canada

BACKGROUND

Ecological models suggest that a strategy for increasing physical activity participation within a population is to reconstruct the "social climate". This can be accomplished through 1) changing norms and beliefs, 2) providing direct support for modifying environments, and 3) implementing policies to encourage physical activity. Nevertheless, surveillance efforts have paid limited attention to empirical assessment of social climate. This study responds to this gap by assessing the social climate of physical activity in Canada.

METHODS

A representative sample of Canadian adults (n = 2519, male/female = 50.3%/49.7%, Mage = 49.1 ± 16.3 years) completed an online survey asking them to assess social climate dimensions including social norms of physical (in)activity, perceptions of who causes physical inactivity and who is responsible for solving physical inactivity, and support for physical activity-related policy. Descriptive statistics (frequencies) were calculated. Multinomial logistic regressions were constructed to identify whether demographic variables and physical activity participation associated with social climate dimensions.

RESULTS

Physical inactivity was considered a serious public health concern by 55% of the respondents; similar to unhealthy diets (58%) and tobacco use (57%). Thirty-nine percent of the respondents reported that they often see other people exercising. Twenty-eight percent of the sample believed that society disapproves of physical inactivity. The majority of respondents (63%) viewed the cause of physical inactivity as both an individual responsibility and other factors beyond an individuals' control. Sixty-seven percent of respondents reported physical inactivity as being both a private matter and a public health matter. Strong support existed for environmental-, individual-, and economic-level policies but much less for legislative approaches. The social climate indicators were associated with respondents' level of physical activity participation and demographic variables in expected directions.

CONCLUSION

This study is the first known attempt to assess social climate at a national level, addressing an important gap in knowledge related to advocating for, and implementing population-level physical activity interventions. Future tracking will be needed to identify any temporal (in)stability of these constructs over time and to explore the relationship between physical activity participation and indicators of the national social climate of physical activity.

The short-term effects of a mass reach physical activity campaign: an evaluation using hierarchy of effects model and intention profiles

Background

Mass reach physical activity campaigns are designed to deliver physical-activity related messages to a large population across different media including print, television, radio, and websites. Few evaluations have examined the short-term effects of a mass reach campaign on participants who were engaged with the campaign. The current research examined the short-term effects of the ParticipACTION 150 Play List, a mass reach physical activity campaign, on participants who registered with the campaign website.

Methods

Participants (N = 7801) completed a registration questionnaire measuring demographic information, awareness and recall of physical activity and sport advertising, and self-reported number of activities tried or planned to try from the 150 Play List. A follow-up survey was completed by 1298 participants from the original sample. Additional questions assessed experience with the 150 Play List and attitudes towards campaign advertisements.

Results

Approximately 14.5% of participants cited the ParticipACTION 150 Play List and 23.6% mentioned a ‘getting active’ message when recalling advertisements. Those who named the 150 Play List or getting active reported more activities tried and more activities planned than those who did not. They were also more likely to say they had tried a new activity and planned ongoing participation. It was also found that participants with a disability were more likely to have tried a new activity compared to those not in a minority group. Other correlates of trying new activities at follow-up were younger age, more positive reported experience with the 150 Play List, and more favourable attitudes towards campaign advertisements. Those who did not intend continued participation, or who were unsure at baseline and then decided against continued participation at follow-up, reported they were less sedentary or encouraging others to be active.

Conclusions

This research addresses the gap in evidence regarding the efficacy of mass reach physical activity campaigns by informing whether a year-long campaign like the 150 Play List can be effective in influencing the behavior of those engaged with the campaign. The results reinforce the idea that ‘top of mind’ awareness should be measured. Investigating intention profiles can help inform campaign impacts and continuation intentions.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-6218-7) contains supplementary material, which is available to authorized users.

Decomposing the within-person and between-person sources of variation in physical activity-cognition associations for low-active older adults

OBJECTIVES

To examine within-person and between-person sources of variation in the relationship between physical activity and cognition in older adults participating in a walking program. To explore whether demographic, health and fitness variables, and their interactions with activity, are significant predictors of cognition.

DESIGN

Brief longitudinal burst design.

PARTICIPANTS

118 participants (91 females, mean age = 72.81 + 5.24 years).

MAIN OUTCOME MEASURES

Cognition, self-reported moderate-to-vigorous walking and self-reported moderate-to-vigorous physical activity were assessed at baseline and 6, 9, 12 and 16 weeks follow-up. Attendance at weekly walks was also recorded.

RESULTS

Within-persons, changes in physical activity were related to select measures of executive functioning, with increased activity predictive of better cognition (three of four cognitive functions, p<.05). Between-persons, activity was also associated with cognition (two of four cognitive functions, p<.05). Younger age and higher education were related to better cognition. Interactions of demographic, health, and fitness variables with changes in within-person activity were generally non-significant.

CONCLUSION

The results highlight the importance of distinguishing within- from between-person effects in longitudinal analyses of the association between physical activity and cognition. This stringent within-person test of association underscores the potential value of simple physical activity interventions for improving cognitive function.

Toward a better assessment of perceived social influence: The relative role of significant others on young athletes

The purpose of this three-study paper was to develop and validate the Perceived Social Influence in Sport Scale-2 (PSISS-2) that aimed to resolve the limitations of PSISS-1 in assessing the relative social influence of significant others in youth sport. In Study 1, a pool of 60 items generated from revisiting a qualitative dataset about significant others of young athletes were examined by two expert panel reviews in terms of content validity, clarity, coverage, and age-appropriateness, leading to the development of 16 items of the PSISS-2. In Study 2, multi-group exploratory structural equation model for PSISS-2 was conducted among 904 young athletes, and the results supported a model comprising positive influence (ie, conditional and unconditional positive influence combined), punishment (ie, conditional negative influence), and dysfunction (ie, unconditional negative influence) as three factors. The goodness of fit of the three-factor model was acceptable and invariant across the coach-, father-, mother-, and teammates-versions of PSISS-2. In support of the criterion validity of PSISS-2, the three factors explained substantial variance of young athletes' perceived competence, effort, enjoyment, and trait anxiety in sport. Study 3 examined the relationship between PSISS-2 factors, psychological need support, and controlling behaviors in a subsample of 452 young athletes, and the findings supported the concurrent validity and discriminant validity of the scale. In conclusion, the data are supportive of PSISS-2. The three factors of the scale (ie, positive influence, punishment, and dysfunction) may form a new framework for understanding and comparing the relative role of significant others in youth sport.

Perceptions of organizational capacity to promote physical activity in Canada and ParticipACTION's influence five years after its relaunch: a qualitative study

INTRODUCTION

ParticipACTION is a Canadian physical activity communications and social marketing organization relaunched in 2007. The purpose of this study was to qualitatively investigate organizational capacity for physical activity promotion among Canadian organizations, and the influence of ParticipACTION on capacity five years after relaunch.

METHODS

Using a purposive sampling strategy, semi-structured telephone interviews were conducted with 44 key informants representing national, provincial, and local organizations with a mandate to promote physical activity. Interview data were analyzed using a thematic analytic approach.

RESULTS

Organizational capacity in terms of partnerships and collaborations, and the general climate for physical activity promotion have improved since ParticipACTION's relaunch. Although financial resources reduced the ability of organizations to fulfil their mandates, internal factors such as skilled employees and sponsorships, and external factors such as technological improvements in communication and information sharing helped to offset this strain. There were mixed feelings on ParticipACTION's contribution to capacity. While ParticipACTION has brought more attention to inactivity, this was perceived as a complement to work already taking place. While some organizations perceived ParticipACTION's relaunch as competition to funding and access to popular media, others found it as an opportunity to co-brand social marketing campaigns, utilizing ParticipACTION's products and reputation.

CONCLUSION

According to participants, organizational capacity to promote physical activity in Canada has increased since 2007 in subtle but important ways because of a strong climate for physical activity promotion, skilled employees, and information sharing technology. Organizational capacity changes were minimally attributed to ParticipACTION.

Experimental manipulation of affective judgments about physical activity: a systematic review and meta-analysis of adults

The purpose of this meta-analysis was to examine the current effectiveness of physical activity (PA) interventions to change affective judgements (AJ) and subsequent behaviour and explore potential moderators. Eligible studies were published in a peer-reviewed English journal and included an experimental design in the PA domain with a measure of AJ as the dependent variable, among adults (>17 years). Literature searches concluded in July 2017 using 11 common databases, with additional hand searching conducted in February 2018. The search yielded 32 independent studies. Random-effects meta-analysis showed positive changes in AJ favouring intervention over control groups, g = 0.43 (95% CI = 0.26-0.60). These changes predicted (β = 0.64) positive changes in PA, g = 0.38 (95% CI = 0.16-0.60), among a sub-sample (k = 14) of studies that also provided behavioural data. Moderator analyses showed the effects were inflated by potential publication bias, participant gender, baseline PA and focus of the intervention. AJ may show change from intervention but larger sample studies are required to obtain a more reliable effect size estimate. Further, few studies have employed behaviour change techniques that would align with the theoretical reasons for changes in AJ, so our evidence for practical intervention content is limited.

Increasing Physical Activity Through Principles of Habit Formation in New Gym Members: a Randomized Controlled Trial

BACKGROUND

The promotion of physical activity (PA) is paramount to public health, yet interventions in the social cognitive tradition have yielded negligible improvements. The limited progression may be due to an overreliance on intention as the proximal determinant of behavior and a lack of consideration of implicit/automatic processes. The purpose of this study was to examine the impact of a habit formation intervention on PA over 8 weeks in a two-arm parallel design, randomized controlled trial.

METHODS

Participants (n = 94) were new gym members with the intention to engage in PA but below international PA guidelines at baseline, who were randomized into a control or habit experimental group. The experimental group attended a workshop (at baseline) and received a follow-up booster phone call at week 4. The primary outcome of the study was minutes of moderate-vigorous intensity PA (MVPA) at week 8. The secondary outcome was a manipulation check to determine if the experimental group effectively incorporated habit-building constructs (cues and practice consistency).

RESULTS

The experimental group showed a significant increase in MVPA after 8 weeks in both accelerometry (d = 0.39, p = .04) and self-report (d = 0.53, p = .01) compared with the control group. The experimental group also showed an increase in use of cues (d = 0.56, p < .001) and practice consistency (d = 0.40, p = .01) at week 8.

CONCLUSION

The results contribute to the initial validity of increasing PA through a focus on preparation cues and practice consistency. Future research should replicate these findings and extend the duration of assessment to evaluate whether PA changes are sustained. Registered Trial Number NCT02785107.

Predictors of physical therapists' intentions to counsel for smoking cessation: Implications for practice and professional education

OBJECTIVE

This study explored factors predicting intention (predominant construct in social cognitive behavioral models) for smoking cessation (SC) counseling that may provide salient information for designing/targeting SC counseling training for physical therapists (PTs). Design: Cross-sectional questionnaire survey of PTs licensed to practice in Canada. Methods: Self-efficacy items and PT views were assessed for internal consistency (Cronbach's α) and data reduced using principal axis factor analysis. Hierarchical linear regression modeling assessed predictors of intention to counsel for SC. Results: Internal consistency: self-efficacy and PT views: r = 0.937, r = 0.821, respectively. Factor structures from self-efficacy: "skills and knowledge" and "clinic incidentals" (57% total variance); from PT views': "professional role" and "role modeling" (63.8% total variance). Significant predictors of intent to counsel for SC were "professional role" (β = 0.54, p ≤ 0.001), and "skills and knowledge" (β = 0.23, p ≤ 0.001). Conclusions: Physical therapists' intent to engage in SC counseling increases when they consider it their "professional role." Encouraging PTs to view SC counseling as a professional role as well as increasing SC counseling self-efficacy focusing on skills and knowledge to do so needs to be incorporated into entry-level academic physical therapy programs and continuing professional PT education.

Effects of home-based exergaming on child social cognition and subsequent prediction of behavior

The use of exergames may be one viable way to increase child physical activity, but investigation of its effects on motivation over time and prediction of adherence have seen little research attention. The purpose of this study was to compare the effect of two cycling exergame interventions (single-player, multi-player) among children aged 9-12 years on motivational variables (theory of planned behavior) and to explore whether these variables could predict objective assessment of playtime across 6 weeks. Sixty-nine insufficiently active children were recruited through advertisements within the community/schools and randomized to either the single play condition (n = 30) or multi-player condition (n = 39). Exergaming use was recorded objectively via game logs and motivational variables were assessed after a familiarization session, at 2 weeks, and at 4 weeks. Participants played the exergames M = 133.45 (SD = 81.27) minutes in week 1 to M = 77.23 (SD = 84.09) minutes in week 6. The two exergame conditions did not result in differences among theory of planned behavior variables (P > .05). Mean levels of these constructs declined across the first 4 weeks (P < .05), with the exception of injunctive norm. Positive bivariate associations (P < .05) between game play and perceived control (0-6 weeks), and intention (weeks 3-4 and weeks 5-6) were identified, but only affective attitude (assessed at week 2) predicted (P < .05) game play (3-4 weeks) in a multivariate examination of the theory of planned behavior model. The results demonstrate that social cognitive motives wane across time when exposed to repeated exergame play.

Encouraging Dog Walking for Health Promotion and Disease Prevention

Regular physical activity is associated with numerous health benefits, including the prevention of many chronic diseases and conditions or a reduction in their adverse effects. Intervention studies suggest that promoting dog walking among dog owners who do not routinely walk their dogs may be an effective strategy for increasing and maintaining regular physical activity. Strategies that emphasize the value of dog walking for both dogs and people, promote the context-dependent repetition of dog walking, enhance the social-interaction benefits, encourage family dog walking, and ensure availability of public space for dog walking may encourage increased dog walking. Research also supports organizing buddy systems via "loaner" dogs to facilitate informal walking by dog owners and non-dog owners. Given the number of homes that have dogs, strategies that promote dog walking could be effective at increasing physical activity levels among a significant proportion of the population. Maximizing the potential for dog walking to positively influence the health of individual people (and dogs) will only occur through implementing programs with broad population-level reach. Policies that facilitate dog walking at the community and population levels, such as "dogs allowed" places, off-leash zones, and dog-friendly built environments and parks, may contribute to greater physical activity through dog walking.

Associations of Parenthood with Physical Activity, Sedentary Behavior, and Sleep

OBJECTIVE

We examined the associations of the presence, number, and the age of children living in the household with adult physical activity, sedentary behavior (sitting and screen time), and sleep behaviors in a large representative sample.

METHODS

Participants were 8312 adults aged 20-65 from the 2011-2014 cycles of the National Health and Nutrition Examination Survey (NHANES). Presence (yes/no), the number of children (none, 1, ≥2), the age of the youngest child (none, ≤5 years, 6-17 years) as well as leisure time physical activity, sitting, screen time, and sleep benchmarks were derived from the home interview.

RESULTS

Compared to women with no children in the household, women who reported the presence of a child living in the household were significantly less likely to meet optimal physical activity (OR = 0.69; 95% CI:0.56-0.84) and sleep (OR = 0.73; 95% CI:0.60-0.87) benchmarks, and significantly more likely to meet optimal sitting (OR = 2.08; 95% CI:1.68-2.58) and screen time (OR = 2.42; 95% CI:1.93-3.02) benchmarks. Findings were similar in men for sitting and screen time, however effect sizes were smaller. Findings were mainly consistent regardless of the number of children and the age of the youngest child in the household.

CONCLUSION

Integrated approaches that promote healthy 24-hour behavioral patterns among parents, especially mothers, should be considered.

Use of in-home stationary cycling equipment among parents in a family-based randomized trial intervention

OBJECTIVES

The purpose of this study was to examine the use of home exercise equipment in the form of exergame cycling compared to a stationary recumbent bicycle ergometer in front of TV in the home over 3 months among parents of an intervention with their inactive children. The primary outcome was bike use (total weekly duration). Predictors of bike use in the form of theory of planned behavior and self-determination theory were also examined.

DESIGN

Randomized controlled trial.

METHOD

Sixty eight parents of children aged 10-14 were randomized to either the exergame condition (n=36) or the standard bike condition (n=32). Weekly bike use was recorded in a log-book.

RESULTS

The exergame bike and a standard bike in front of a TV had similar use across three months (p=.13, η_p²=.02), which declined over time (p<.01, η_p²=.14). Parents who were active at baseline and had the intention to use the bikes were more likely to use the bikes (p<.05). Furthermore, those who reported higher perceived control, intrinsic motivation, and affective attitude were more likely to use the bikes (p<.05).

CONCLUSIONS

The findings suggested that irrespective of modality, use of exercise equipment declined considerably for parents over three-months. Parents may also benefit from family physical activity interventions, but it depends on their physical activity status, how much they would enjoy using the equipment, and their overall perceived control over being physically active.

TRIAL REGISTRATION

clinicaltrials.gov #NCT01373762. Registered 1 June 2011.

Awareness of ParticipACTION among Canadian adults: a seven-year cross-sectional follow-up

INTRODUCTION

In this cross-sectional follow-up study, we explored Canadian's awareness of ParticipACTION and their levels of physical activity (PA) after seven years of campaigns.

METHODS

A population-based survey was conducted with 7282 adults over a period of 14 months from February 2014 to May 2015. The survey consisted of questions on the 2014-2015 Physical Activity Monitor relating to awareness and knowledge of ParticipACTION. Weighted logistic models were constructed to examine whether awareness was associated with PA-related beliefs, intentions, and leisure time physical activity (LTPA).

RESULTS

Approximately 20% of Canadians reported unprompted awareness of ParticipACTION and 82% reported prompted awareness. Education, income, and having children were significant correlates of awareness among Canadians. The adjusted odds of people being aware of ParticipACTION (prompted and unprompted) were greater if they were more educated (OR = 1.57, 95% CI: 1.04-2.39; OR = 2.00, 95% CI: 1.24-3.24), reported higher income (OR = 3.92, 95% CI: 2.35-6.53; OR = 2.29, 95% CI: 1.44-3.62), and had children (OR = 1.93, 95% CI: 1.40-2.66; OR = 1.70, 95% CI: 1.26-2.30). Furthermore, awareness of ParticipACTION was positively associated with outcome expectations and self-efficacy, and negatively associated with LTPA status.

CONCLUSION

Levels of unprompted awareness of ParticipACTION are higher than previously reported and, in comparison to active Canadians, inactive Canadians are more likely to be aware of the organization. Given that it had primarily targeted parents of inactive children over the past seven years, it appears the organization has been partially effective in achieving its communication goals.

Mediating Mechanisms in a Physical Activity Intervention: A Test of Habit Formation

BACKGROUND

A recent randomized controlled trial found that an intervention focused on developing an exercise habit increased weekly minutes of moderate to vigorous physical activity (MVPA) over 8 wk compared to a control group. The purpose of the current study was to test if changes in habit, as well as other behavioral strategy constructs from the Multi-Process Action Control Test, mediated between group condition and MVPA (self-report and accelerometry).

METHODS

Inactive new gym members (N = 94) were randomized into control or experimental (habit-building) groups.

RESULTS

No construct entirely explained mediation condition (experimental and control) and changes in MVPA measured by accelerometry. Self-report MVPA found affective judgments, behavioral regulation, and preparatory habit to be mediated between group (experimental/control conditions) and changes in behavior (β = 0.36, 95% confidence interval [.05-.78]).

CONCLUSIONS

Self-reported and objectively measured behavior models demonstrated complete and partial mediation, respectively. New gym members could benefit from successful behavioral enactment by developing constructs to support habit formation.

ParticipACTION after 5 years of relaunch: a quantitative survey of Canadian organizational awareness and capacity regarding physical activity initiatives

INTRODUCTION

ParticipACTION is a Canadian physical activity communications and social marketing organization relaunched in 2007. This study assesses the capacity of Canadian organizations to adopt, implement, and promote physical activity initiatives. The four objectives were to compare findings from baseline (2008) and follow-up (2013) with respect to: (1) awareness of ParticipACTION; (2) organizational capacity to adopt, implement and promote physical activity initiatives; (3) potential differences in capacity based on organizational size, sector, and mandate; and (4) assess perceptions of ParticipACTION five years after relaunch.

METHODS

In this cross-sectional study, representatives from local, provincial/territorial, and national organizations completed an online survey assessing capacity to adopt, implement, and promote physical activity. Descriptive statistics and one-way analyses of variance were conducted to examine the objectives.

RESULTS

Response rate for opening an email survey invitation and consenting to participate was 40.6% (685/1688) and 540 surveys were completed. Awareness of ParticipACTION increased from 54.6% at baseline to 93.9% at follow-up (Objective 1). Findings at both baseline and follow-up reflected good organizational capacity to adopt, implement and promote physical activity (Objective 2) although some varied by organizational sector and mandate (Objective 3). Most respondents reported that ParticipACTION provided positive leadership (65.3%), but there was less agreement regarding ParticipACTION's facilitation of infrastructure (44.0%) or organizational will/motivation (47.1%)(Objective 4).

CONCLUSION

Canadian organizations continue to report having good capacity to adopt, implement, and promote physical activity. There was no discernible change in capacity indicators five years after ParticipACTION's relaunch although its broader contribution to the physical activity sector was endorsed.

Momentary assessment of physical activity intention-behavior coupling in adults

Research attempting to elucidate physical activity (PA) intention-behavior relations has focused on differences in long-term behavior forecasting between people. However, regular PA requires a repeated performance on a daily or within-daily basis. An empirical case study application is presented using intensive longitudinal data from a study of PA in adults to (a) describe the extent to which short-term intention-behavior coupling occurs and (b) explore time-varying predictors of intention formation and short-term intention-behavior coupling. Adults (n = 116) participated in three 4-day waves of ecological momentary assessment (EMA). Each day, participants received EMA questionnaires assessing short-term PA intentions and wore accelerometers to assess whether they engaged in ≥10 min of moderate-to-vigorous physical activity (MVPA) in the 3-hour period after each EMA prompt. Concurrent affective states and contexts were also assessed through EMA. Participants reported having short-term intentions to engage in PA in 41% of EMA prompts. However, participants only engaged in ≥10 min of MVPA following 16% of the prompts that short-term PA intentions were reported indicating an intention-behavior gap of 84%. Odds of intentions followed by PA were greater on occasions when individuals reported higher levels of positive affect than was typical for them. This study is the first to take an EMA approach to describe short-term intention-behavior coupling in adults. Results suggest that adults have difficulty translating intentions into behavior at the momentary level, more so than over longer timescales, and that positive affect may be a key to successfully translating intentions into behavior.

Role of parental and environmental characteristics in toddlers' physical activity and screen time: Bayesian analysis of structural equation models

Background

Guided by the Socialization Model of Child Behavior (SMCB), this cross-sectional study examined direct and indirect associations of parental cognitions and behavior, the home and neighborhood environment, and toddlers’ personal attributes with toddlers’ physical activity and screen time.

Methods

Participants included 193 toddlers (1.6 ± 0.2 years) from the Parents’ Role in Establishing healthy Physical activity and Sedentary behavior habits (PREPS) project. Toddlers’ screen time and personal attributes, physical activity- or screen time-specific parental cognitions and behaviors, and the home and neighborhood environment were measured via parental-report using the PREPS questionnaire. Accelerometry-measured physical activity was available in 123 toddlers. Bayesian estimation in structural equation modeling (SEM) using the Markov Chain Monte Carlo algorithm was performed to test an SMCB hypothesized model. Covariates included toddlers’ age, sex, race/ethnicity, main type of childcare, and family household income.

Results

In the SMCB hypothesized screen time model, higher parental barrier self-efficacy for limiting toddlers’ screen time was associated with higher parental screen time limiting practices (β = 0.451), while higher parental negative outcome expectations for limiting toddlers’ screen time was associated with lower parental screen time limiting practices (β = − 0.147). In turn, higher parental screen time limiting practices was associated with lower screen time among toddlers (β = − 0.179). Parental modeling of higher screen time was associated with higher screen time among toddlers directly (β = 0.212) and indirectly through the home environment. Specifically, higher screen time among parents was associated with having at least one electronic device in toddlers’ bedrooms (β = 0.146) and, in turn, having electronics in the bedroom, compared to none, was associated with higher screen time among toddlers (β = 0.250). Neighborhood safety was not associated with toddlers’ screen time in the SEM analysis. No significant correlations were observed between the SMCB variables and toddlers’ physical activity; thus, no further analyses were performed for physical activity.

Conclusions

Parents and their interactions with the home environment may play an important role in shaping toddlers’ screen time. Findings can inform family-based interventions aiming to minimize toddlers’ screen time. Future research is needed to identify correlates of toddlers’ physical activity.

Feasibility and preliminary efficacy of an exercise telephone counseling intervention for hematologic cancer survivors: a phase II randomized controlled trial

BACKGROUND

Supervised exercise interventions produce the largest improvements in patient-reported outcomes in cancer survivors but their scalability has been questioned. Telephone counseling has been proposed as a more feasible alternative but its impact on exercise behavior and health outcomes have been modest. Basing telephone counseling exercise (TCE) interventions on the theoretical advances described in the multi-process action control framework (M-PAC) may improve these outcomes.

PURPOSE

To assess the feasibility and preliminary efficacy of a M-PAC-based TCE intervention for increasing aerobic exercise behavior in hematologic cancer survivors (HCS).

METHODS

We recruited 51 HCS who were randomized to either a weekly TCE group (n = 26) or a self-directed exercise (SDE) group (n = 25). Participants completed online measures of self-reported aerobic exercise behavior, quality of life (QoL), fatigue, and program satisfaction at baseline and post-intervention (12 weeks).

RESULTS

Adherence to the TCE intervention was 93% and retention was 100%. Participants receiving TCE increased their weekly aerobic exercise by 218 min compared to 93 min in the SDE group [mean-adjusted between-group difference (MBGD_adj) = 139, 95%CI = 65 to 213, p < .001, effect size (d) = 2.19]. Clinically meaningful QoL improvements favored the TCE group for mental health (MBGD_adj = 3.7, 95%CI = - 0.4 to 7.9, p = .08, d = 0.42) and mental health component (MBGD_adj = 3.6, 95%CI = - 0.8 to 8.1, p = .10, d = 0.35) subscales.

CONCLUSIONS

The 12-week TCE intervention substantially increased exercise behavior and may have meaningfully improved QoL in HCS.

IMPLICATIONS FOR CANCER SURVIVORS

Though more definitive trials are needed, remote TCE interventions based on the M-PAC may improve exercise behavior and QoL in HCS and perhaps other cancer survivor groups.

TRIAL REGISTRATION NUMBER

Clinical Trials ID: NCT03052777.

Reflective and Non-conscious Responses to Exercise Images

Images portraying exercise are commonly used to promote exercise behavior and to measure automatic associations of exercise (e.g., via implicit association tests). The effectiveness of these promotion efforts and the validity of measurement techniques partially rely on the untested assumption that the images being used are perceived by the general public as portrayals of exercise that is pleasant and motivating. The aim of this study was to investigate how content of images impacted people's automatic and reflective evaluations of exercise images. Participants (N = 90) completed a response time categorization task (similar to the implicit association test) to capture how automatically people perceived each image as relevant to Exercise or Not exercise. Participants also self-reported their evaluations of the images using visual analog scales with the anchors: Exercise/Not exercise, Does not motivate me to exercise/Motivates me to exercise, Pleasant/Unpleasant, and Energizing/Deactivating. People tended to more strongly automatically associate images with exercise if the images were of an outdoor setting, presented sport (as opposed to active labor or gym-based) activities, and included young (as opposed to middle-aged) adults. People tended to reflectively find images of young adults more motivating and relevant to exercise than images of older adults. The content of exercise images is an often overlooked source of systematic variability that may impact measurement validity and intervention effectiveness.

Effects of acute aerobic exercise or meditation on emotional regulation

Effective emotional regulation is critical for overall psychological well-being; as such, it is important to investigate potential methods to optimize emotion regulation abilities. The purpose of this study was to examine the effects of an acute bout of aerobic exercise and meditation on emotional regulation among young adults. Participants (N=63, mean age=21.3yrs) were randomly assigned to stretch (control group, n=21), walk (n=21), or meditate (n=21) for 10-min, after which they were exposed to a film clip (3min) intended to elicit a negative emotional state (e.g., sadness, anger). Participants then viewed 12 International Affective Picture System images validated to elicit a negative valence. Participants' affect (valence and arousal) states were monitored before, during, and after the stretching, walking, and meditation bouts using the Feeling Scale (FS) and Felt Arousal Scale (FAS). Distinct affect was assessed utilizing an affective circumplex measure before and after the stretch/walk/meditation bout, as well as following the film clip and image viewing. A significant group×time interaction effect was present when evaluating circumplex excited: P=0.001 (η²=0.21). Additionally, an interaction effect of meditation and emotional regulation was observed (P=0.009) among those with varying degrees of meditation experience. A 10-min bout of brisk walking and meditation, prior to exposure to a negative emotion cue, did not differentially effect the ability to regulate sadness, anger, or anxiousness when compared to an active stretching control group. Future replicative work addressing this paradigm, which is in support of positive psychology theory, is warranted.