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Giannouli E, Fillekes MP, Mellone S, Weibel R, Bock O, Zijlstra W. Predictors of real-life mobility in community-dwelling older adults: an exploration based on a comprehensive framework for analyzing mobility. Eur Rev Aging Phys Act 2019; 16:19. [PMID: 31700551 PMCID: PMC6825723 DOI: 10.1186/s11556-019-0225-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 10/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reduced mobility is associated with a plethora of adverse outcomes. To support older adults in maintaining their independence, it first is important to have deeper knowledge of factors that impact on their mobility. Based on a framework that encompasses demographical, environmental, physical, cognitive, psychological and social domains, this study explores predictors of different aspects of real-life mobility in community-dwelling older adults. METHODS Data were obtained in two study waves with a total sample of n = 154. Real-life mobility (physical activity-based mobility and life-space mobility) was assessed over one week using smartphones. Active and gait time and number of steps were calculated from inertial sensor data, and life-space area, total distance, and action range were calculated from GPS data. Demographic measures included age, gender and education. Physical functioning was assessed based on measures of cardiovascular fitness, leg and handgrip strength, balance and gait function; cognitive functioning was assessed based on measures of attention and executive function. Psychological and social assessments included measures of self-efficacy, depression, rigidity, arousal, and loneliness, sociableness, perceived help availability, perceived ageism and social networks. Maximum temperature was used to assess weather conditions on monitoring days. RESULTS Multiple regression analyses indicated just physical and psychological measures accounted for significant but rather low proportions of variance (5-30%) in real-life mobility. Strength measures were retained in most of the regression models. Cognitive and social measures did not remain as significant predictors in any of the models. CONCLUSIONS In older adults without mobility limitations, real-life mobility was associated primarily with measures of physical functioning. Psychological functioning also seemed to play a role for real-life mobility, though the associations were more pronounced for physical activity-based mobility than life-space mobility. Further factors should be assessed in order to achieve more conclusive results about predictors of real-life mobility in community-dwelling older adults.
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Affiliation(s)
- Eleftheria Giannouli
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Michelle Pasquale Fillekes
- University Research Priority Program ‘Dynamics of Healthy Aging’, University of Zurich, Andreasstrasse 15, 8050 Zurich, Switzerland
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - Sabato Mellone
- Department of Electrical, Electronic, and Information Engineering, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy
| | - Robert Weibel
- Department of Geography, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - Otmar Bock
- Institute of Physiology and Anatomy, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
| | - Wiebren Zijlstra
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany
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Murray JM, Brennan SF, French DP, Patterson CC, Kee F, Hunter RF. Mediators of Behavior Change Maintenance in Physical Activity Interventions for Young and Middle-Aged Adults: A Systematic Review. Ann Behav Med 2019; 52:513-529. [PMID: 29672666 DOI: 10.1093/abm/kay012] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Regular physical activity is important for maintaining physical and mental health. Benefits are optimized when physical activity is maintained. Understanding causal mechanisms is important to inform future interventions. Purpose To investigate mediators of physical activity maintenance. Methods Six databases were searched (Medline, EMBASE, PsycINFO, CINAHL, Cochrane Database of Systematic Reviews, and Web of Science). Eligibility criteria included adult nonclinical populations, validated measure of physical activity behavior at baseline and at least 6 months postbaseline, control/comparison group(s), and reported mediators of physical activity behavior change. Mediators were examined according to (i) formal mediation tests, (ii) mediator association with physical activity outcome, and (iii) intervention effects on mediators. Results There were few formal mediation tests conducted (n = 12/39 included studies), and various other methodological limitations were identified. There was some evidence that effective mediators in formal mediation tests at 6 months and later included the "behavioral processes of change" (n = 5/6). Many of the included interventions were not effective for changing targeted mediators (only 34% of 413 tests of mediator changes were significant). Conclusions There were a number of methodological and statistical limitations in the evidence base. In future, prespecified formal mediation tests should be carried out and could be aided by a formal framework. Social and environmental variables should be considered in addition to intrapersonal variables. Improving knowledge of how to change hypothesized mediators, based on theory and evidence, will reveal how physical activity behavior change maintenance can be achieved. Maintenance research would be enhanced by establishing a formal definition of behavior change "maintenance." PROSPERO registration: PROSPERO 2015:CRD- 42015025462.
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Affiliation(s)
- Jennifer M Murray
- Centre for Public Health Research/UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, UK
| | - Sarah F Brennan
- Centre for Public Health Research/UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, UK
| | - David P French
- Department for Health Psychology, Manchester Centre of Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK
| | - Christopher C Patterson
- Centre for Public Health Research/UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, UK
| | - Frank Kee
- Centre for Public Health Research/UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, UK
| | - Ruth F Hunter
- Centre for Public Health Research/UKCRC Centre of Excellence for Public Health, Queen's University Belfast, Institute of Clinical Sciences, Block B, Royal Victoria Hospital, Belfast, UK
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Zenko Z, Ekkekakis P. Critical Review of Measurement Practices in the Study of Automatic Associations of Sedentary Behavior, Physical Activity, and Exercise. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2019; 41:271-288. [PMID: 31469367 DOI: 10.1123/jsep.2017-0349] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 06/23/2019] [Accepted: 07/01/2019] [Indexed: 06/10/2023]
Abstract
Studies of automatic associations of sedentary behavior, physical activity, and exercise are proliferating, but the lack of information on the psychometric properties of relevant measures is a potential impediment to progress. The purpose of this review was to critically summarize measurement practices in studies examining automatic associations related to sedentary behavior, physical activity, and exercise. Of 37 studies, 27 (73%) did not include a justification for the measure chosen to assess automatic associations. Additional problems have been noted, including the nonreporting of psychometric information (validity, internal consistency, test-retest reliability) and the lack of standardization of procedures (e.g., number, type of stimuli). The authors emphasize the need to select measures based on conceptual arguments and psychometric evidence and to standardize measurement procedures. To facilitate progress, the review concludes with a proposal for conceptually appropriate validation criteria to be used in future studies.
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Bishop FL, Lauche R, Cramer H, Pinto JW, Leung B, Hall H, Leach M, Chung VC, Sundberg T, Zhang Y, Steel A, Ward L, Sibbritt D, Adams J. Health Behavior Change and Complementary Medicine Use: National Health Interview Survey 2012. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E632. [PMID: 31554323 PMCID: PMC6843558 DOI: 10.3390/medicina55100632] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 12/18/2022]
Abstract
Background and objectives: Complementary and alternative medicine (CAM) use has been associated with preventive health behaviors. However, the role of CAM use in patients' health behaviors remains unclear. This study aimed to determine the extent to which patients report that CAM use motivates them to make changes to their health behaviors. Materials and Methods: This secondary analysis of 2012 National Health Interview Survey data involved 10,201 CAM users living in the United States who identified up to three CAM therapies most important to their health. Analyses assessed the extent to which participants reported that their CAM use motivated positive health behavior changes, specifically: eating healthier, eating more organic foods, cutting back/stopping drinking alcohol, cutting back/quitting smoking cigarettes, and/or exercising more regularly. Results: Overall, 45.4% of CAM users reported being motivated by CAM to make positive health behavior changes, including exercising more regularly (34.9%), eating healthier (31.4%), eating more organic foods (17.2%), reducing/stopping smoking (16.6% of smokers), or reducing/stopping drinking alcohol (8.7% of drinkers). Individual CAM therapies motivated positive health behavior changes in 22% (massage) to 81% (special diets) of users. People were more likely to report being motivated to change health behaviors if they were: aged 18-64 compared to those aged over 65 years; of female gender; not in a relationship; of Hispanic or Black ethnicity, compared to White; reporting at least college education, compared to people with less than high school education; without health insurance. Conclusions: A sizeable proportion of respondents were motivated by their CAM use to undertake health behavior changes. CAM practices and practitioners could help improve patients' health behavior and have potentially significant implications for public health and preventive medicine initiatives; this warrants further research attention.
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Affiliation(s)
- Felicity L Bishop
- Department of Psychology, University of Southampton, Southampton SO17 1BJ, UK.
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Sozialstiftung Bamberg, 96049 Bamberg, Germany.
| | - Holger Cramer
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Department of Internal and Integrative Medicine, University of Duisburg-Essen, 45276 Essen, Germany.
| | - Jonquil W Pinto
- Department of Psychology, University of Southampton, Southampton SO17 1BJ, UK.
| | - Brenda Leung
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Faculty of Health Sciences, University of Lethbridge, Alberta T1K 3M4, Canada.
| | - Helen Hall
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Faculty of Medicine, Monash University, Clayton, VIC 3800, Australia.
| | - Matthew Leach
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Department of Rural Health, University of South Australia, Whyalla Norrie SA 5608, Australia.
| | - Vincent Ch Chung
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Jockey Club School of Public Health & Primary Care and School of Chinese Medicine, The Chinese University of Hong Kong, Sha Tin 999077, Hong Kong.
| | - Tobias Sundberg
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Musculoskeletal & Sports Injury Epidemiology Center (MUSIC), Institute of Environmental Medicine, Karolinska Institutet, 171 77 Stockholm, Sweden.
| | - Yan Zhang
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, Texas 76109, USA.
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
| | - Lesley Ward
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
- Department of Sport, Exercise & Rehabilitation, Northumbria University, Newcastle-upon-Tyne NE1 8ST, UK.
| | - David Sibbritt
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney PO Box 123, Broadway NSW 2007, Australia.
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Kim SY, Park JH, Lee MY, Oh KS, Shin DW, Shin YC. Physical activity and the prevention of depression: A cohort study. Gen Hosp Psychiatry 2019; 60:90-97. [PMID: 31376646 DOI: 10.1016/j.genhosppsych.2019.07.010] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 07/12/2019] [Accepted: 07/15/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study aims to identify the optimal amount and appropriate state of physical activity for reducing incident depressive symptoms. METHOD The data of 107,901 Korean adults who had undergone at least two annual health examinations from 2012 to 2015 were analyzed. At baseline, the amount of physical activity was measured using the International Physical Activity Questionnaire-Short Form and metabolic equivalents (METs)-min/wk., which is the amount of oxygen consumed while sitting at rest per week. In addition, one-year changes in physical activity were categorized into four groups: persistent sedentary, maintenance, relapse, and adoption groups. For the study's endpoint, new-onset depressive symptoms (score of ≥21) were considered, defined by the Center for Epidemiologic Studies Rating Scale for Depression. A Cox proportional hazards model was used to identify the optimal amount and appropriate state of physical activity for reducing incident depressive symptoms. RESULTS Compared with sedentary status (<600 METs-min/wk), achieving 1200-3000 METs-min/wk. was associated with a lower risk of incident depressive symptoms, illustrating a U-shaped relationship. The results show that the amount of physical activity for reducing the onset of depressive symptoms was higher for men (1800-3000 METs-min/wk.: HR, 0.84 [95% CI, 0.74-0.95]) than women (1200-1800 METs-min/wk.: HR, 0.84 [95% CI, 0.71-0.99]). In terms of one-year changes in physical activity, compared to the persistent sedentary group, the maintenance group was associated with a lower risk of the development of depressive symptoms in both sexes (men: HR, 0.81 [95% CI, 0.71-0.93]; women: HR, 0.84 [95% CI, 0.75-0.94]). Women in the adoption group showed a positive effect in terms of a decrease in incident depressive symptoms (HR, 0.87 [95% CI, 0.76-0.99]). CONCLUSIONS This study suggests an optimal amount of physical activity for reducing the onset of depressive symptoms. In addition, maintaining an appropriate level of physical activity for one year proved beneficial for decreasing incident depressive symptoms.
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Affiliation(s)
- Sun-Young Kim
- Department of Psychiatry, Ewha Woman's University Seoul Hospital, Ewha Women's University College of Medicine, 260, Gonghang-daero, Gangseo-gu, Seoul 07804, Republic of Korea
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, 2066, Seobu-ro, Jangan-gu, Suwon, Gyeonggi-do 16419, Republic of Korea
| | - Mi Yeon Lee
- Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Kang-Seob Oh
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Dong-Won Shin
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Young-Chul Shin
- Department of Psychiatry, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea; Workplace Mental Health Institute, Kangbuk Samsung Hospital, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea.
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56
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Kinsey AW, Segar ML, Barr-Anderson DJ, Whitt-Glover MC, Affuso O. Positive Outliers Among African American Women and the Factors Associated with Long-Term Physical Activity Maintenance. J Racial Ethn Health Disparities 2019; 6:603-617. [PMID: 30644068 PMCID: PMC6500467 DOI: 10.1007/s40615-018-00559-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 12/24/2018] [Accepted: 12/26/2018] [Indexed: 12/29/2022]
Abstract
Studying positive outliers, individuals who have achieved success with long-term (> 6-month) physical activity (PA) engagement, may be an important approach for understanding strategies for improving leisure-time PA maintenance among African American (AA) women. This cross-sectional, mixed-methods study (1) examined the personal characteristics, PA patterns, and behavioral practices of positive outliers among AA women and (2) compared characteristics of those who maintain PA at recommended levels (HIGH, ≥ 150 min/week > 6 months) with those who maintain low PA volumes (LOW, < 150 min/week > 6 months). A large sample of positive outliers completed this study (n = 290), and most became physically active on their own (76.2%). These AA women were committed to maintaining an active lifestyle, accumulated 249.7 ± 105.8 min of PA/week, and engaged in a variety of activities. Their behavioral practices included scheduling PA during the week (85.9%), goal-setting (82.4%), engaging in PA with others (55.9%), self-monitoring (78.3%), and having a backup plan for missed sessions (54.8%). HIGH maintainers (84.9%) made up most of the sample, and these women were characteristically similar to LOW maintainers with few differences. HIGH maintainers have been active longer, achieved higher commitment scores, and engaged in PA at a higher frequency, duration, and intensity, resulting in higher weekly PA volume compared to LOW maintainers (273.8 ± 96.1 vs. 114.4 ± 24.3 min per week, p ≤ 0.001). Our findings identify factors that may be important for successful PA maintenance among AA women and may help to inform the development of effective behavioral interventions to promote sustained, long-term PA engagement in this population.
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Affiliation(s)
- Amber W Kinsey
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, 35294-3360, USA.
| | - Michelle L Segar
- Sport, Health, and Activity Research and Policy Center, University of Michigan, Ann Arbor, MI, USA
| | | | - Melicia C Whitt-Glover
- Gramercy Research Group, Winston-Salem, NC, USA
- Winston-Salem State University, Winston-Salem, NC, USA
| | - Olivia Affuso
- Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, 35294-3360, USA
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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Bernhart JA, O'Neill JR. Walking and running to benefit breast cancer: descriptive characteristics of participants in the 2017 Walk for Life events. Perspect Public Health 2019; 139:303-307. [PMID: 31070509 DOI: 10.1177/1757913919833717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The prevalence of charities and other non-profit organisations sponsoring for-cause physical activity (PA) events has continued to rise. Few studies have examined for-cause events through a public health perspective to determine the reach and potential for public health and PA promotion. This study described participants in a for-cause event supporting breast cancer to determine the reach of the event and identified possible leverage points of for-cause events for public health promotion. METHODS Participants registered online for the Walk for Life events in Columbia, SC (Half marathon, 10k, 5k, and Walk-a-thon), were included in this study. Data were analyzed using Microsoft Excel. RESULTS Over 6,000 people participated in the event and 4,942 registered online. Of online registrants, most participants were women (n = 3,800, 78.95%) and most participants, completed the walk-a-thon (n = 3,539), followed by the 5k (n = 829), half-marathon (n = 236), and 10k (n = 209). The average age of participants was 39.79 years (SD = 1.35). CONCLUSIONS For-cause PA events often recruit high numbers of participants, particularly high-priority populations in PA interventions. Therefore, these events bear innovative implications for PA researchers and practitioners to leverage these events to promote health and PA while simultaneously supporting charity and non-profit organisations.
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Affiliation(s)
- J A Bernhart
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Public Health Research Center, 1st Floor, 921 Assembly Street, Columbia, SC 29208, USA.,Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - J R O'Neill
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Eynon M, Foad J, Downey J, Bowmer Y, Mills H. Assessing the psychosocial factors associated with adherence to exercise referral schemes: A systematic review. Scand J Med Sci Sports 2019; 29:638-650. [PMID: 30742334 DOI: 10.1111/sms.13403] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/04/2018] [Accepted: 02/05/2019] [Indexed: 12/30/2022]
Abstract
This paper aimed to systematically review the evidence base to uncover the key psychosocial factors that underpin adherence to an exercise referral scheme (ERS). Databases PsycINFO, MEDLINE, SPORTDiscus, Web of Science, PubMed, PsycARTICLES, Open Grey, and PsycEXTRA were systematically searched. A parallel results-based convergent synthesis was performed by identifying key themes from quantitative and qualitative studies separately. After applying inclusion and exclusion criteria, the review included 24 eligible studies. Key findings showed intrinsic motivation, psychological need satisfaction, social support, and self-efficacy to be the prominent psychosocial factors associated with ERS adherence. In addition, lower expectations for change when entering the scheme was associated with ERS adherence. This review should serve as a catalyst to provide evidence-based ERS and as such ERS providers should seek to place an emphasis on participants' expectations and beliefs when entering the scheme. Moreover, targeting the key factors of intrinsic motivation, psychological need satisfaction, social support, and self-efficacy throughout the duration of an ERS should serve to facilitate adherence.
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Affiliation(s)
- Michael Eynon
- Faculty of Sport, Health & Applied Science, St Mary's University, Twickenham, London, UK
| | - Jessica Foad
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, UK
| | - John Downey
- Faculty of Sport, Health & Applied Science, St Mary's University, Twickenham, London, UK
| | - Yasmin Bowmer
- Faculty of Sport, Health & Applied Science, St Mary's University, Twickenham, London, UK
| | - Hayley Mills
- School of Human and Life Sciences, Canterbury Christ Church University, Canterbury, UK
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Lee AM, Chavez S, Bian J, Thompson LA, Gurka MJ, Williamson VG, Modave F. Efficacy and Effectiveness of Mobile Health Technologies for Facilitating Physical Activity in Adolescents: Scoping Review. JMIR Mhealth Uhealth 2019; 7:e11847. [PMID: 30747716 PMCID: PMC6390191 DOI: 10.2196/11847] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 12/07/2018] [Accepted: 01/23/2019] [Indexed: 01/26/2023] Open
Abstract
Background Increasing physical activity (PA) levels in adolescents aged 12 to 18 years is associated with prevention of unhealthy weight gain and improvement in cardiovascular fitness. The widespread availability of mobile health (mHealth) and wearable devices offers self-monitoring and motivational features for increasing PA levels and improving adherence to exercise programs. Objective The aim of this scoping review was to identify the efficacy or effectiveness of mHealth intervention strategies for facilitating PA among adolescents aged 12 to 18 years. Methods We conducted a systematic search for peer-reviewed studies published between 2008 and 2018 in the following electronic databases: PubMed, Google Scholar, PsychINFO, or SportDiscus. The search terms used included mHealth or “mobile health” or apps, “physical activity” or exercise, children or adolescents or teens or “young adults” or kids, and efficacy or effectiveness. Articles published outside of the date range (July 2008 to October 2018) and non-English articles were removed before abstract review. Three reviewers assessed all abstracts against the inclusion and exclusion criteria. Any uncertainties or differences in opinion were discussed as a group. The inclusion criteria were that the studies should (1) have an mHealth component, (2) target participants aged between 12 and 18 years, (3) have results on efficacy or effectiveness, and (4) assess PA-related outcomes. Reviews, abstracts only, protocols without results, and short message service text messaging–only interventions were excluded. We also extracted potentially relevant papers from reviews. At least 2 reviewers examined all full articles for fit with the criteria and extracted data for analysis. Data extracted from selected studies included study population, study type, components of PA intervention, and PA outcome results. Results Overall, 126 articles were initially identified. Reviewers pulled 18 additional articles from excluded review papers. Only 18 articles were passed onto full review, and 16 were kept for analysis. The included studies differed in the sizes of the study populations (11-607 participants), locations of the study sites (7 countries), study setting, and study design. Overall, 5 mHealth intervention categories were identified: website, website+wearable, app, wearable+app, and website+wearable+app. The most common measures reported were subjective weekly PA (4/13) and objective daily moderate-to-vigorous PA (5/13) of the 19 different PA outcomes assessed. Furthermore, 5 of 13 studies with a control or comparison group showed a significant improvement in PA outcomes between the intervention group and the control or comparison group. Of those 5 studies, 3 permitted isolation of mHealth intervention components in the analysis. Conclusions PA outcomes for adolescents improved over time through mHealth intervention use; however, the lack of consistency in chosen PA outcome measures, paucity of significant outcomes via between-group analyses, and the various study designs that prevent separating the effects of intervention components calls into question their true effect.
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Affiliation(s)
- Alexandra M Lee
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Sarah Chavez
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Lindsay A Thompson
- Department of Pediatrics, Division of General Pediatrics, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Matthew J Gurka
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Victoria G Williamson
- Department of Psychology, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL, United States
| | - François Modave
- Center for Health Outcomes and Informatics Research, Health Sciences Division, Loyola University Chicago, Maywood, IL, United States
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Høj K, Vinther Skriver M, Terkildsen Maindal H, Christensen B, Sandbæk A. The effect of cardiorespiratory fitness assessment in preventive health checks: a randomised controlled trial. Eur J Public Health 2019; 28:173-179. [PMID: 29016823 DOI: 10.1093/eurpub/ckx108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Poor cardiorespiratory fitness (CRF) increases morbidity and mortality risks. Routine CRF assessment in clinical practice has thus been advocated, but little is known about the effect. In this study, we investigated the effect of CRF assessment on CRF in a preventive health check programme. Methods We used a randomised design, in which we invited 4153 middle-aged adults and included 2201 participants who received a preventive health check with CRF assessment (intervention) or without CRF assessment (control). After 1 year, participants were examined. The primary outcomes were adjusted absolute (l/min), relative (ml/kg/min), and poor (%) CRF assessed by the Astrand-Ryhming test. We adjusted for baseline physical activity and intra-cluster correlation within general practices. Results A total of 901 attended the 1-year follow-up. In the intervention group, absolute CRF, relative CRF, and poor CRF were 2.7 l/min (95% confidence interval [CI]: 2.6; 2.8), 34.5 ml/kg/min (95% CI: 33.5; 35.4), and 31.0% (95% CI: 26.8; 35.2). In the control group, the corresponding figures were 2.8 l/min (95% CI: 2.7; 2.9), 35.2 ml/kg/min (95% CI: 34.2; 36.1), and 25.9% (95% CI: 21.8; 30.0). Adjusted absolute CRF was lower in the intervention group (-0.1 l/min [95% CI: -0.2; -0.01]). Adjusted relative CRF (-0.7 ml/kg/min [95% CI: -2.0; 0.6]) and poor CRF (5.0% [95% CI: -0.002; 10.1]) did not differ between groups. No differences were found when adjusting for potential confounding factors. Conclusion Preventive health checks with CRF assessment did not provide higher CRF levels at 1-year follow-up than preventive health checks without CRF assessment.
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Affiliation(s)
- Kirsten Høj
- Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Mette Vinther Skriver
- Section for Health Promotion and Health Services, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Helle Terkildsen Maindal
- Section for Health Promotion and Health Services, Department of Public Health, Aarhus University, Aarhus, Denmark.,Health Promotion Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Bo Christensen
- Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Annelli Sandbæk
- Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.,Research Unit for General Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
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Bouma AJ, van Wilgen P, Lemmink KAPM, Stewart R, Dijkstra A, Diercks RL. Barrier-belief lifestyle counseling in primary care: A randomized controlled trial of efficacy. PATIENT EDUCATION AND COUNSELING 2018; 101:2134-2144. [PMID: 30072044 DOI: 10.1016/j.pec.2018.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 07/14/2018] [Accepted: 07/19/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Intervening on barrier beliefs (BBs) may inhibit the role of barriers as mediating factors in lifestyle behavior. The aim of this study was to analyze the effects of a barrier-belief counseling intervention (BBCI) on physical activity (PA) and healthy food intake. METHODS An RCT was conducted in a primary care setting among adults (aged 18-70), with two interventions: a BBCI (n = 123) and a standardized lifestyle group intervention (SLI) (n = 122). A non-treated hanging control group (n = 36) received no intervention. Outcomes on PA (accelerometer and SQUASH) and fruit and vegetable intake (self-report) were measured with follow-ups at 6, 12 and 18 months, and analyzed using multiple regression. RESULTS The BBCI was more effective on PA compared with the SLI (p < .01): in the short term all PA outcomes improved (p < .05), in the long term moderate-to-vigorous PA outcomes improved (p < .05), all with small effect sizes. No differences between interventions were found on fruit and vegetable intake. None of the outcomes in the control group changed over time. CONCLUSIONS BBCI in primary care improves PA compared with SLI. PRACTICE IMPLICATIONS The customized BB approach seems promising for implementation in healthcare practice to stimulate PA.
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Affiliation(s)
- Adrie J Bouma
- Hanze University of Applied Sciences Groningen, Institute of Sports Studies, Zernikeplein 17, 9766 AS Groningen, The Netherlands.
| | - Paul van Wilgen
- Transcare, Transdisciplinary Pain Management Centre, Barkmolenstraat 196, 9723 DM Groningen, The Netherlands.
| | - Koen A P M Lemmink
- Center for Human Movement Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
| | - Roy Stewart
- Faculty of Medical Sciences, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
| | - Arie Dijkstra
- Faculty of Behavioral and Society Sciences, Grote Kruisstraat 2/1, 9712 TS, University of Groningen, Groningen, The Netherlands.
| | - Ron L Diercks
- Department of Sports Medicine and Orthopedic Surgery, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands.
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Kendrick D, Orton E, Lafond N, Audsley S, Maula A, Morris R, Vedhara K, Iliffe S. Keeping active: maintenance of physical activity after exercise programmes for older adults. Public Health 2018; 164:118-127. [PMID: 30286342 DOI: 10.1016/j.puhe.2018.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 07/09/2018] [Accepted: 08/03/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To explore factors associated with maintenance of moderate-to-vigorous physical activity (MVPA) in community-dwelling adults aged ≥65 years after completing a 24-week exercise programme. STUDY DESIGN This is a cohort study nested within a randomised controlled trial evaluating group- and home-based exercise programmes for older people in England. METHODS MVPA levels and factors potentially associated with physical activity (PA) were self-reported at recruitment, 6, 12, 18 and 24 months after exercise programme. Multilevel logistic regression estimated odds ratios (ORs) for achieving target MVPA level (150 min/week) 6-24 months after exercise programmes ended. RESULTS Older people (OR per year increase: 0.89, 95% confidence interval [CI] 0.86, 0.93) and women (OR 0.47, 95% CI 0.33, 0.67) were less likely to achieve target MVPA. Those physically active at recruitment (OR 11.28, 95% CI 7.95, 16.01), with wider social networks (OR per unit increase in Lubben Social Network Scale: 1.06, 95% CI 1.03, 1.10) and performing more sit-to-stands in 30 s (OR for quartile 3 compared with quartile 1: 1.87, 95% CI 1.12, 3.10), were more likely to achieve target MVPA. Negative exercise expectations increased the odds of achieving target MVPA but only among the less active at recruitment (OR per unit increase in Outcome and Expectation for Exercise negative subscale: 1.90, 95% CI 1.39, 2.60). Associations did not differ significantly across the follow-up period. CONCLUSION A range of factors are associated with maintenance of PA 6-24 months after exercise programmes. Factors are not more strongly associated with shorter vs longer term PA maintenance. Commissioners and providers should consider targeting maintenance interventions to those least likely to maintain PA.
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Affiliation(s)
- D Kendrick
- School of Medicine, Division of Primary Care, Tower Building, University Park, Nottingham, NG7 2RD, UK.
| | - E Orton
- School of Medicine, Division of Primary Care, Tower Building, University Park, Nottingham, NG7 2RD, UK
| | - N Lafond
- School of Medicine, Division of Primary Care, Tower Building, University Park, Nottingham, NG7 2RD, UK
| | - S Audsley
- School of Medicine, Division of Primary Care, Tower Building, University Park, Nottingham, NG7 2RD, UK
| | - A Maula
- School of Medicine, Division of Primary Care, Tower Building, University Park, Nottingham, NG7 2RD, UK
| | - R Morris
- School of Social and Community Medicine, University of Bristol, Office 3.05, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, UK
| | - K Vedhara
- School of Medicine, Division of Primary Care, Tower Building, University Park, Nottingham, NG7 2RD, UK
| | - S Iliffe
- Research Department of Primary Care and Population Health, UCL, Royal Free Campus, Rowland Hill St, London NW3 2PF, UK
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63
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Fukuoka Y, Lindgren TG, Mintz YD, Hooper J, Aswani A. Applying Natural Language Processing to Understand Motivational Profiles for Maintaining Physical Activity After a Mobile App and Accelerometer-Based Intervention: The mPED Randomized Controlled Trial. JMIR Mhealth Uhealth 2018; 6:e10042. [PMID: 29925491 PMCID: PMC6031900 DOI: 10.2196/10042] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/24/2018] [Accepted: 04/24/2018] [Indexed: 11/13/2022] Open
Abstract
Background Regular physical activity is associated with reduced risk of chronic illnesses. Despite various types of successful physical activity interventions, maintenance of activity over the long term is extremely challenging. Objective The aims of this original paper are to 1) describe physical activity engagement post intervention, 2) identify motivational profiles using natural language processing (NLP) and clustering techniques in a sample of women who completed the physical activity intervention, and 3) compare sociodemographic and clinical data among these identified cluster groups. Methods In this cross-sectional analysis of 203 women completing a 12-month study exit (telephone) interview in the mobile phone-based physical activity education study were examined. The mobile phone-based physical activity education study was a randomized, controlled trial to test the efficacy of the app and accelerometer intervention and its sustainability over a 9-month period. All subjects returned the accelerometer and stopped accessing the app at the last 9-month research office visit. Physical engagement and motivational profiles were assessed by both closed and open-ended questions, such as “Since your 9-month study visit, has your physical activity been more, less, or about the same (compared to the first 9 months of the study)?” and, “What motivates you the most to be physically active?” NLP and cluster analysis were used to classify motivational profiles. Descriptive statistics were used to compare participants’ baseline characteristics among identified groups. Results Approximately half of the 2 intervention groups (Regular and Plus) reported that they were still wearing an accelerometer and engaging in brisk walking as they were directed during the intervention phases. These numbers in the 2 intervention groups were much higher than the control group (overall P=.01 and P=.003, respectively). Three clusters were identified through NLP and named as the Weight Loss group (n=19), the Illness Prevention group (n=138), and the Health Promotion group (n=46). The Weight Loss group was significantly younger than the Illness Prevention and Health Promotion groups (overall P<.001). The Illness Prevention group had a larger number of Caucasians as compared to the Weight Loss group (P=.001), which was composed mostly of those who identified as African American, Hispanic, or mixed race. Additionally, the Health Promotion group tended to have lower BMI scores compared to the Illness Prevention group (overall P=.02). However, no difference was noted in the baseline moderate-to-vigorous intensity activity level among the 3 groups (overall P>.05). Conclusions The findings could be relevant to tailoring a physical activity maintenance intervention. Furthermore, the findings from NLP and cluster analysis are useful methods to analyze short free text to differentiate motivational profiles. As more sophisticated NL tools are developed in the future, the potential of NLP application in behavioral research will broaden. Trial Registration ClinicalTrials.gov NCT01280812; https://clinicaltrials.gov/ct2/show/NCT01280812 (Archived by WebCite at http://www.webcitation.org/70IkGagAJ)
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Affiliation(s)
- Yoshimi Fukuoka
- Department of Physiological Nursing/Institute for Health & Aging, School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Teri G Lindgren
- School of Nursing, Rutgers University, Newark, NJ, United States
| | - Yonatan Dov Mintz
- Department of Industrial Engineering and Operations Research, University of California, Berkeley, Berkeley, CA, United States
| | - Julie Hooper
- Institute for Health & Aging, School of Nursing, University of California, San Francisco, San Francisco, CA, United States
| | - Anil Aswani
- Department of Industrial Engineering and Operations Research, University of California, Berkeley, Berkeley, CA, United States
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64
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Replacing Self-Efficacy in Physical Activity: Unconscious Intervention of the AR Game, Pokémon GO. SUSTAINABILITY 2018. [DOI: 10.3390/su10061971] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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65
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Eime RM, Harvey JT, Charity MJ, Nelson R. Demographic characteristics and type/frequency of physical activity participation in a large sample of 21,603 Australian people. BMC Public Health 2018; 18:692. [PMID: 29871601 PMCID: PMC5989390 DOI: 10.1186/s12889-018-5608-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/25/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Regular physical activity (PA) is imperative for good health and there are many different ways that people can be active. There are a range of health, PA and sport policies aiming to get more people active more often. Much research has been directed towards understanding the determinants of inactivity and PA. However, it is important to understand the differences not only between inactive and active people, but also between activity contexts (for example participation in sport compared to non-sport activities), in order to align policies and strategies to engage market segments who have different participation preferences and accessibility. The aim of this study was to investigate demographic correlates of the propensity to be physically inactive or active within different contexts, and at different levels of frequency of participation. METHODS Data from the Australian Exercise, Recreation and Sport Survey was used for this analysis. This included information on the type, frequency and duration of leisure-time PA for Australians aged 15 years and over. Reported PA participation in the two-week period prior to the survey was used to allocate respondents into three categories: no PA, non-sport PA only, and sport. Subsequently, sport participants were further categorised according to frequency of participation. Potential demographic correlates included sex, age, education, employment, marital status, language spoken, having a condition that restricts life, children, and socio-economic status. RESULTS The survey included 21,603 people. Bivariate chi-squared analysis showed that there were significant differences between the profiles of leisure-time PA participation across all demographic variables, except the variable languages spoken at home. Ordinal regression analysis showed that the same demographic variables were also correlated with the propensity to engage in more organised and competitive PA contexts, and to participate more frequently. CONCLUSIONS People who were female, older, married or had a disability were less likely to participate in sport. Therefore when designing PA opportunities to engage those who are inactive, particularly those that are organised by a club or group, we need to ensure that appropriate strategies are developed, and tailored sport products offered, to ensure greater opportunities for increased diversity of participation in sport.
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Affiliation(s)
- Rochelle M Eime
- School of Health Sciences and Psychology, Federation University, Ballarat, Australia. .,Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia.
| | - Jack T Harvey
- School of Health Sciences and Psychology, Federation University, Ballarat, Australia.,Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia
| | - Melanie J Charity
- School of Health Sciences and Psychology, Federation University, Ballarat, Australia.,Institute of Sport, Exercise and Active Living, Victoria University, Melbourne, Australia
| | - Rayoni Nelson
- Victorian Health Promotion Foundation (VicHealth), Melbourne, Australia
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66
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The role of learned optimism, proactive coping and goal adjustment in re-establishing regular exercise after a lapse. GERMAN JOURNAL OF EXERCISE AND SPORT RESEARCH 2017. [DOI: 10.1007/s12662-017-0465-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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67
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Garcia LMT, Diez Roux AV, Martins ACR, Yang Y, Florindo AA. Development of a dynamic framework to explain population patterns of leisure-time physical activity through agent-based modeling. Int J Behav Nutr Phys Act 2017; 14:111. [PMID: 28830527 PMCID: PMC5568398 DOI: 10.1186/s12966-017-0553-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 07/12/2017] [Indexed: 01/08/2023] Open
Abstract
Despite the increasing body of evidences on the factors influencing leisure-time physical activity, our understanding of the mechanisms and interactions that lead to the formation and evolution of population patterns is still limited. Moreover, most frameworks in this field fail to capture dynamic processes. Our aim was to create a dynamic conceptual model depicting the interaction between key psychological attributes of individuals and main aspects of the built and social environments in which they live. This conceptual model will inform and support the development of an agent-based model aimed to explore how population patterns of LTPA in adults may emerge from the dynamic interplay between psychological traits and built and social environments. We integrated existing theories and models as well as available empirical data (both from literature reviews), and expert opinions (based on a systematic expert assessment of an intermediary version of the model). The model explicitly presents intention as the proximal determinant of leisure-time physical activity, a relationship dynamically moderated by the built environment (access, quality, and available activities) – with the strength of the moderation varying as a function of the person’s intention– and influenced both by the social environment (proximal network’s and community’s behavior) and the person’s behavior. Our conceptual model is well supported by evidence and experts’ opinions and will inform the design of our agent-based model, as well as data collection and analysis of future investigations on population patterns of leisure-time physical activity among adults.
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Affiliation(s)
| | - Ana V Diez Roux
- Drexel University Dornsife School of Public Health, Philadelphia, USA
| | - André C R Martins
- University of Sao Paulo School of Arts, Sciences and Humanities, Sao Paulo, Brazil
| | - Yong Yang
- University of Memphis School of Public Health, Memphis, USA
| | - Alex A Florindo
- University of Sao Paulo School of Public Health, Sao Paulo, Brazil.,University of Sao Paulo School of Arts, Sciences and Humanities, Sao Paulo, Brazil
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68
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Warner LM, Wolff JK, Spuling SM, Wurm S. Perceived somatic and affective barriers for self-efficacy and physical activity. J Health Psychol 2017; 24:1850-1862. [PMID: 28810450 DOI: 10.1177/1359105317705979] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
According to Bandura's social-cognitive theory, perceptions of somatic and affective barriers are sources of self-efficacy. This longitudinal study compares general indicators of health barriers with measures of perceived somatic and affective barriers to predict self-efficacy and accelerometer-assessed physical activity in a subsample of n = 153 (selected at random from N = 310) community-dwelling German older adults. Perceived somatic and affective barriers longitudinally predicted physical activity mediated by self-efficacy, whereas general health barriers did not. Perceived health barriers to physical activity might be more important than more objective health barriers for older adults' physical activity levels.
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Affiliation(s)
| | | | | | - Susanne Wurm
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany
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69
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Boiché J, Gourlan M, Trouilloud D, Sarrazin P. Development and validation of the 'Echelle de Motivation envers l'Activité Physique en contexte de Santé': A motivation scale towards health-oriented physical activity in French. J Health Psychol 2016; 24:386-396. [PMID: 27872385 DOI: 10.1177/1359105316676626] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This article presents the validation of the 'Echelle de Motivation envers l'Activité Physique en contexte de Santé' including the six forms of motivation underlined by self-determination theory. Study 1 underlines the content validity of a pool of 30 items ( N = 20). Study 2 supports the six-factor structure validity of the 18-item Echelle de Motivation envers l'Activité Physique en contexte de Santé ( N = 309). Study 3 ( N = 191) confirms structure validity, as well as concurrent validity and 2-week temporal reliability. The Echelle de Motivation envers l'Activité Physique en contexte de Santé can be considered as a valid and reliable tool to use in prevention or rehabilitation contexts.
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70
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Hooker SA, Ross KM, Ranby KW, Masters KS, Peters JC, Hill JO. Identifying groups at risk for 1-year membership termination from a fitness center at enrollment. Prev Med Rep 2016; 4:563-568. [PMID: 27818915 PMCID: PMC5094673 DOI: 10.1016/j.pmedr.2016.10.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 10/06/2016] [Accepted: 10/27/2016] [Indexed: 12/03/2022] Open
Abstract
The vast majority of Americans do not engage in adequate regular physical activity despite its well-known health benefits. Even when individuals attempt to become more active by joining a fitness center, estimates suggest that nearly half terminate their membership within the first 6 months. A better understanding of who is at risk for early membership termination upon joining may help researchers develop targeted interventions to improve the likelihood that individuals will successfully maintain memberships and physical activity. This study's purpose was to identify, based on a wellness assessment (WA) used in fitness centers, individuals at risk for fitness membership termination prior to 1-year. Center members (N = 441; Mage = 41.9, SD = 13.1; 74.4% female) completed a comprehensive WA of stress, life satisfaction, physical fitness, metabolic health, and sleep quality at the beginning of their memberships and were followed for one year. Latent class analyses utilized the WA to identify four groups: (a) healthy, (b) unhealthy, (c) poor psychological wellness, and (d) poor physical wellness. Participants in the poor psychological wellness group (OR = 2.24, p = 0.007) and the unhealthy group (OR = 2.40, p = 0.037) were significantly more likely to terminate their memberships at 1-year as compared to the healthy group. Participants with poor physical wellness visited the fitness center less frequently than healthy participants (p < 0.01). Results suggest that poor psychological wellness is a risk factor for terminating memberships, whereas poor physical wellness is not. Future studies should replicate these latent classes and develop targeted interventions to address psychological wellness as a method to improve fitness membership retention. A person-centered analytical approach to identify at-risk individuals is proposed. Four wellness profiles are identified. Those with poor psychological and overall wellness are more likely to terminate. Those with poor physical wellness visit the fitness center less frequently. Interventions to prevent membership termination should target at-risk individuals.
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Affiliation(s)
- Stephanie A. Hooker
- Department of Psychology, University of Colorado Denver, United States
- Anschutz Health and Wellness Center, University of Colorado Denver, United States
- Corresponding author at: University of Colorado Denver, Campus Box 173, PO Box 173354, 1200 Larimer St., Denver, CO 80217, United States.University of Colorado DenverCampus Box 173PO Box 1733541200 Larimer St.DenverCO80217United States
| | - Kaile M. Ross
- Department of Psychology, University of Colorado Denver, United States
- Anschutz Health and Wellness Center, University of Colorado Denver, United States
| | - Krista W. Ranby
- Department of Psychology, University of Colorado Denver, United States
| | - Kevin S. Masters
- Department of Psychology, University of Colorado Denver, United States
- Anschutz Health and Wellness Center, University of Colorado Denver, United States
| | - John C. Peters
- Anschutz Health and Wellness Center, University of Colorado Denver, United States
- School of Medicine, University of Colorado Denver Anschutz Medical Campus, United States
| | - James O. Hill
- Anschutz Health and Wellness Center, University of Colorado Denver, United States
- School of Medicine, University of Colorado Denver Anschutz Medical Campus, United States
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Marcora S. Can Doping be a Good Thing? Using Psychoactive Drugs to Facilitate Physical Activity Behaviour. Sports Med 2016; 46:1-5. [PMID: 26497149 DOI: 10.1007/s40279-015-0412-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Samuele Marcora
- School of Sport and Exercise Sciences, University of Kent, Chatham, UK.
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72
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Wienke B, Jekauc D. A Qualitative Analysis of Emotional Facilitators in Exercise. Front Psychol 2016; 7:1296. [PMID: 27621718 PMCID: PMC5002432 DOI: 10.3389/fpsyg.2016.01296] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 08/12/2016] [Indexed: 11/26/2022] Open
Abstract
Although previous research has shown that emotions are consistently associated with sport and exercise behavior, the working mechanisms are not understood to the extent of creating an intervention. The aim of this study is to identify situations and aspects of recreational sport and exercise, which lead to positive emotional reactions in people taking part in regular and long-term exercise. In this study, 24 adults (12 female, 12 male) distributed over three age groups (young, middle, and late adulthood), took part in recreational sports (individual or team sport) for at least 5 years. Semi-structured in depth interviews with questions about sport and exercise habits, long term participation and emotional response in a sporting environment were conducted in order to ascertain those situations and aspects of the exercise program triggering positive emotions. Interviews were transcribed verbatim and followed Grounded Theory principles. Emerging concepts were grouped and merged into different categories representing the key aspects of sport and exercise. Four factors were identified which are associated with the emergence of positive emotions in recreational sport and exercise. Firstly, perceived competence is one of the major factors influencing emotions during exercise and can represent individual and collective success and progress, competition and challenge. Secondly, perceived social interaction is another factor comprising of all sorts of peer-related aspects such as communication with others, being part of a group and creating close relationships or friendships. Thirdly, novelty experience in contrast to other none-sporting activities such as work, family or other leisure activities was another factor. The last factor found was the perceived physical exertion comprising of the degree of exhaustion, a possibly delayed turnaround in the emotional response and the aspect of sport being a physical compensation for everyday sedentary life. The results of this study provide the starting point for the development of interventions to enhance positive emotions in sports in order to increase maintenance and adherence to recreational sport and exercise.
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Affiliation(s)
- Benjamin Wienke
- Department of Sport and Exercise Psychology, Humboldt University of Berlin, Berlin Germany
| | - Darko Jekauc
- Department of Sport and Exercise Psychology, Humboldt University of Berlin, BerlinGermany; Department for Sport Science, University of Konstanz, KonstanzGermany
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73
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Fournier M, d'Arripe-Longueville F, Radel R. Testing the effect of text messaging cues to promote physical activity habits: a worksite-based exploratory intervention. Scand J Med Sci Sports 2016; 27:1157-1165. [PMID: 27540899 DOI: 10.1111/sms.12730] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2016] [Indexed: 11/30/2022]
Abstract
This study aims to test the efficacy of text messaging cues (SMS) to promote physical activity (PA) habit formation in the workplace. Employees (N = 49; 28 females and 21 males, Mage = 47.5 ± 8.29 years) were randomized into two parallel groups: a PA group enrolled in a 28-week supervised PA program and a PA+SMS group enrolled in the same PA program with text messaging cues received before their PA sessions. The exercise habit was assessed every week from self-reports on an online application. PA maintenance and several physical fitness measures were also assessed prior to and after the intervention to evaluate its general impact. Mixed model analysis of the 603 observations indicated a small but significant effect of the SMS cues on the speed at which participants engaged in PA behaviors, as the significant interaction effect revealed that the slope of the exercise habit over time was slightly steeper in the PA+SMS group (B = 0.0462, P = 0.0001) than in the PA group (B = 0.0216, P = 0.01). SMS delivery had a marginal effect on the maintenance of PA behaviors 1 year after the intervention. The results suggest that text messaging can help to form PA habits at the workplace and might facilitate long-term maintenance of PA behaviors.
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Affiliation(s)
- M Fournier
- LAMHESS EA 6309, University of Nice Sophia Antipolis and University of Toulon, Nice, France
| | - F d'Arripe-Longueville
- LAMHESS EA 6309, University of Nice Sophia Antipolis and University of Toulon, Nice, France
| | - R Radel
- LAMHESS EA 6309, University of Nice Sophia Antipolis and University of Toulon, Nice, France
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74
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Predicting Changes Across 12 Months in Three Types of Parental Support Behaviors and Mothers' Perceptions of Child Physical Activity. Ann Behav Med 2016; 49:853-64. [PMID: 26162705 DOI: 10.1007/s12160-015-9721-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Parental support has been established as the critical family-level variable linked to child physical activity with encouragement, logistical support, and parent-child co-activity as key support behaviors. PURPOSE This study aims to model these parental support behaviors as well as family demographics as mediators of mothers' perceptions of child physical activity using theory of planned behavior (TPB) across two 6-month waves of longitudinal data. METHOD A representative sample of Canadian mothers (N = 1253) with children aged 5 to 13 years of age completed measures of TPB, support behaviors, and child physical activity. RESULTS Autoregressive structural equation models showed that intention and perceived behavioral control explained support behaviors, yet child age (inverse relationship) and family income were independent predictors. The three support behaviors explained 19-42 % of the variance in child physical activity between participants, but analyses of change showed much smaller effects. CONCLUSIONS Mothers' support behaviors are related to perceived child physical activity, but support is dependent on perception of control, child age, and family income.
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75
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Vahlberg B, Cederholm T, Lindmark B, Zetterberg L, Hellström K. Short-term and long-term effects of a progressive resistance and balance exercise program in individuals with chronic stroke: a randomized controlled trial. Disabil Rehabil 2016; 39:1615-1622. [PMID: 27415645 DOI: 10.1080/09638288.2016.1206631] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To evaluate the effects of progressive resistance and balance (PRB) exercises on physical and psychological functions of post-stroke individuals. MATERIALS AND METHODS In a randomized controlled trial with follow-up at 3, 6 and 15 months, 67 community-living individuals (76% male; 65-85 years) with a stroke 1-3 years previously were allocated to an intervention group (IG, n = 34; PRB exercises combined with motivational group discussions twice weekly for 3 months) or a control group (CG, n = 33). The primary outcomes were balance (Berg Balance Scale, 0-56 points) and mobility (Short Physical Performance Battery, 0-12 points) at 3 months. The secondary outcomes were 10 m comfortable walking speed, physical activity levels, health-related quality of life, depression and fall-related self-efficacy. RESULTS At 3 months, the IG exhibited significant improvements in balance (MD 2.5 versus 0 points; effect size [ES], 0.72; p < 0.01) and comfortable walking speed (MD 0.04 versus -0.05 m/s; ES, 0.68; p = 0.01) relative to the CG. A faster walking speed persisted at 6 months. No differences were found for the other outcomes. CONCLUSIONS In chronic stroke patients, 3 months of PRB exercises and motivational discussions induced improvements in balance at 3 months and in walking speed at 3 and 6 months. Implications for Rehabilitation A progressive resistance and balance exercise program supported by motivational group discussions and one home-based exercise appears to be an effective means of improving the short-term balance and the walking speed in individuals with chronic stroke. People with poor balance and motor function discontinued the study more often and may require additional support. There is a need for powerful and cost-effective strategies that target changes in behavior to obtain long-term changes in physical function after exercising.
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Affiliation(s)
- Birgit Vahlberg
- a Department of Neuroscience, Physiotherapy , Uppsala University , Uppsala , Sweden
| | - Tommy Cederholm
- b Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism , Uppsala University , Uppsala , Sweden
| | - Birgitta Lindmark
- a Department of Neuroscience, Physiotherapy , Uppsala University , Uppsala , Sweden
| | - Lena Zetterberg
- a Department of Neuroscience, Physiotherapy , Uppsala University , Uppsala , Sweden
| | - Karin Hellström
- a Department of Neuroscience, Physiotherapy , Uppsala University , Uppsala , Sweden
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Paech J, Luszczynska A, Lippke S. A Rolling Stone Gathers No Moss-The Long Way from Good Intentions to Physical Activity Mediated by Planning, Social Support, and Self-Regulation. Front Psychol 2016; 7:1024. [PMID: 27458417 PMCID: PMC4933707 DOI: 10.3389/fpsyg.2016.01024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Accepted: 06/21/2016] [Indexed: 11/13/2022] Open
Abstract
Background: Although many people know that an active lifestyle contributes to health they fail to translate their intentions into action. This has been explained by deficits in self-management and resources, such as enabling social support, planning, and self-regulation in the face of barriers. The present study examines the role of perceived social support, planning, and self-regulation in facilitating physical activity. Methods: In a prospective online study, intention was assessed at baseline (Time 1), planning and social support at 4-week follow-up (Time 2), self-regulation and physical activity at 6-month follow-up (Time 3). A path analysis was conducted to shed light on mediating psychological mechanisms contributing to maintenance of physical activity. Results: Perceived support (Time 2), planning (Time 2), and self-regulation (Time 3) mediated the link from intention (Time 1) to physical activity (Time 3); the specific and total indirect effects were significant. Conclusions: Findings suggest that perceived social support, planning, and self-regulation can bridge the intention-behavior gap. Behavior change interventions should target those mechanisms in vulnerable individuals.
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Affiliation(s)
- Juliane Paech
- Department of Health Psychology, Focus Area Diversity, Jacobs University Bremen Bremen, Germany
| | - Aleksandra Luszczynska
- Center for Applied Research on Health Behavior and Health, University of Social Sciences and HumanitiesWarsaw, Poland; Trauma, Health and Hazards Center, University of Colorado, Colorado SpringsColorado Springs, CO, USA
| | - Sonia Lippke
- Department of Health Psychology, Focus Area Diversity, Jacobs University Bremen Bremen, Germany
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Reyes Fernández B, Knoll N, Hamilton K, Schwarzer R. Social-cognitive antecedents of hand washing: Action control bridges the planning-behaviour gap. Psychol Health 2016; 31:993-1004. [PMID: 27049339 DOI: 10.1080/08870446.2016.1174236] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To examine motivational and volitional factors for hand washing in young adults, using the Health Action Process Approach (HAPA) as a theoretical framework. DESIGN In a longitudinal design with two measurement points, six weeks apart, university students (N = 440) completed paper-based questionnaires. MAIN OUTCOME MEASURES Prior hand washing frequency, self-efficacy, outcome expectancies, intention and action planning were measured at baseline, and coping planning, action control and hand washing frequency were measured at follow-up. RESULTS A theory-based structural equation model was specified. In line with the HAPA, the motivational factors of self-efficacy and outcome expectancies predicted intention, whereas the volitional factors of planning and action control mediated between intention and changes in hand washing frequency. Action control was confirmed as the most proximal factor on hand washing behaviour, thus representing a bridge of the planning-behaviour gap. CONCLUSIONS Both motivational and volitional processes are important to consider in the improvement of hand hygiene practices. Moreover, the statistically significant effects for planning and action control illustrate the importance of these key self-regulatory factors in the prediction of hand hygiene. The current study highlights the importance of adopting models that account for motivational and volitional factors to better understand hand washing behaviour.
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Affiliation(s)
| | - Nina Knoll
- b Department of Education and Psychology , Freie Universität Berlin , Berlin , Germany
| | - Kyra Hamilton
- c School of Applied Psychology, Menzies Health Institute Queensland , Griffith University , Australia
| | - Ralf Schwarzer
- d Institute for Positive Psychology and Education, Australian Catholic University , Sydney , Australia.,e University of Social Sciences and Humanities , Wroclaw , Poland
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Kelly S, Martin S, Kuhn I, Cowan A, Brayne C, Lafortune L. Barriers and Facilitators to the Uptake and Maintenance of Healthy Behaviours by People at Mid-Life: A Rapid Systematic Review. PLoS One 2016; 11:e0145074. [PMID: 26815199 PMCID: PMC4731386 DOI: 10.1371/journal.pone.0145074] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 11/26/2015] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND With an ageing population, there is an increasing societal impact of ill health in later life. People who adopt healthy behaviours are more likely to age successfully. To engage people in health promotion initiatives in mid-life, a good understanding is needed of why people do not undertake healthy behaviours or engage in unhealthy ones. METHODS Searches were conducted to identify systematic reviews and qualitative or longitudinal cohort studies that reported mid-life barriers and facilitators to healthy behaviours. Mid-life ranged from 40 to 64 years, but younger adults in disadvantaged or minority groups were also eligible to reflect potential earlier disease onset. Two reviewers independently conducted reference screening and study inclusion. Included studies were assessed for quality. Barriers and facilitators were identified and synthesised into broader themes to allow comparisons across behavioural risks. FINDINGS From 16,426 titles reviewed, 28 qualitative studies, 11 longitudinal cohort studies and 46 systematic reviews were included. Evidence was found relating to uptake and maintenance of physical activity, diet and eating behaviours, smoking, alcohol, eye care, and other health promoting behaviours and grouped into six themes: health and quality of life, sociocultural factors, the physical environment, access, psychological factors, evidence relating to health inequalities. Most of the available evidence was from developed countries. Barriers that recur across different health behaviours include lack of time (due to family, household and occupational responsibilities), access issues (to transport, facilities and resources), financial costs, entrenched attitudes and behaviours, restrictions in the physical environment, low socioeconomic status, lack of knowledge. Facilitators include a focus on enjoyment, health benefits including healthy ageing, social support, clear messages, and integration of behaviours into lifestyle. Specific issues relating to population and culture were identified relating to health inequalities. CONCLUSIONS The barriers and facilitators identified can inform the design of tailored interventions for people in mid-life.
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Affiliation(s)
- Sarah Kelly
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113 Cambridge Biomedical Campus, Cambridge CB2 0SR, United Kingdom
| | - Steven Martin
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113 Cambridge Biomedical Campus, Cambridge CB2 0SR, United Kingdom
| | - Isla Kuhn
- University of Cambridge Medical Library, University of Cambridge School of Clinical Medicine, Box 111 Cambridge Biomedical Campus, Cambridge CB2 0SP, United Kingdom
| | - Andy Cowan
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113 Cambridge Biomedical Campus, Cambridge CB2 0SR, United Kingdom
| | - Carol Brayne
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113 Cambridge Biomedical Campus, Cambridge CB2 0SR, United Kingdom
| | - Louise Lafortune
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Box 113 Cambridge Biomedical Campus, Cambridge CB2 0SR, United Kingdom
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Hundza S, Quartly C, Kim JM, Dunnett J, Dobrinsky J, Loots I, Choy K, Chow B, Hampshire A, Temple VA. Similar barriers and facilitators to physical activity across different clinical groups experiencing lower limb spasticity. Disabil Rehabil 2016; 38:1370-81. [PMID: 26726762 DOI: 10.3109/09638288.2015.1101789] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose Given the importance of physical activity in maintaining health and wellness, an improved understanding of physical activity patterns across different clinical populations is required. This study examines the facilitators for, and barriers to, participation in physical activity across multiple contexts for three clinical groups with chronic lower limb spasticity (individuals with stroke, multiple sclerosis and incomplete spinal cord injury). Method This cross-sectional study employed quantitative measures for spasticity, ankle range of motion, pain, falls, cognition, mobility, and physical activity as well as qualitative semi-structured interviews. Results There were similar impairments in body functions and structures and limitations in activities across the clinical groups. These impairments and limitations negatively impacted participation in physical activity, which was low. Environmental and personal factors exacerbated or mitigated the limiting effects of body functions and structures and activities on physical activity in many areas of life. Conclusions In this population, participation in physical activity includes activities such as housework which are different than what is typically considered as physical activity. Further, the presence of similar barriers and facilitators across the groups suggests that support and services to promote valued forms of physical activity could be organised and delivered based on limitations in mobility and functioning rather than clinical diagnosis. Implications for rehabilitation Physical activity is of utmost importance in maintaining health and wellness in clinical populations. This research highlights the desired and actual physical activity for these populations can look different than what may traditionally be considered as physical activity (e.g. housework is not typically considered participation physical activity). Therefore, rehabilitation interventions need to be directly designed to enhance clients' ability to perform these activities and these activities should be an integral focus of ongoing physical activity programs. Individuals who have lower limb spasticity shared similar impairments in body structures and functions and limitations in activities across the clinical groups and these impairments and limitations negatively impacted participation in physical in a similar way in all groups. Further, the environmental and personal factors exacerbated or mitigated the limiting effects of body functions and structures and activities on physical activity in many areas of life in a similar way in all groups. The presence of similar barriers and facilitators across the clinical groups suggests that rehabilitation assessment and treatment as well as support and services to promote valued forms of physical activity could be organised and delivered based on limitations in mobility and functioning rather than clinical diagnosis. This work affirms that a mixed methods research approach is critical for completely understanding the complexities of the barriers and facilitators engaging in physical activity across clinical groups, including multiple sclerosis, stroke, and incomplete spinal cord injury who have chronic lower limb spasticity.
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Affiliation(s)
- Sandra Hundza
- a School of Exercise Science, Physical and Health Education , University of Victoria , Victoria , British Columbia , Canada
| | - Caroline Quartly
- b Queen Alexandra Spasticity Clinic , Vancouver Island Health Authority , Victoria , British Columbia , Canada
| | - Jasmine M Kim
- a School of Exercise Science, Physical and Health Education , University of Victoria , Victoria , British Columbia , Canada
| | - James Dunnett
- b Queen Alexandra Spasticity Clinic , Vancouver Island Health Authority , Victoria , British Columbia , Canada
| | - Jill Dobrinsky
- a School of Exercise Science, Physical and Health Education , University of Victoria , Victoria , British Columbia , Canada
| | - Iris Loots
- a School of Exercise Science, Physical and Health Education , University of Victoria , Victoria , British Columbia , Canada
| | - Kim Choy
- a School of Exercise Science, Physical and Health Education , University of Victoria , Victoria , British Columbia , Canada
| | - Brayley Chow
- a School of Exercise Science, Physical and Health Education , University of Victoria , Victoria , British Columbia , Canada
| | - Alexis Hampshire
- b Queen Alexandra Spasticity Clinic , Vancouver Island Health Authority , Victoria , British Columbia , Canada
| | - Viviene A Temple
- a School of Exercise Science, Physical and Health Education , University of Victoria , Victoria , British Columbia , Canada
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Bredahl TVG, Særvoll CA, Kirkelund L, Sjøgaard G, Andersen LL. When Intervention Meets Organisation, a Qualitative Study of Motivation and Barriers to Physical Exercise at the Workplace. ScientificWorldJournal 2015; 2015:518561. [PMID: 26380361 PMCID: PMC4563103 DOI: 10.1155/2015/518561] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Revised: 09/05/2014] [Accepted: 09/25/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To provide a comprehensive understanding of the motivational factors and barriers that are important for compliance with high-intensity workplace physical exercise that is aimed at reducing musculoskeletal disorders. METHOD The present study, which used semideductive, thematic, and structured in-depth interviews, was nested in a 20-week cluster randomised controlled trial among office workers. Interviews were conducted with 18 informants with diverse fields of sedentary office work who participated in strength training at the workplace for 20 minutes, three times per week. Organisational, implementational, and individual motives and barriers were explored. RESULTS & DISCUSSION The results show that attention should be given to the interaction between the management, the employees, and the intervention, as the main barrier to compliance was the internal working culture. The results emphasised the need for a clear connection between the management's implementational intentions and the actual implementation. The results emphasise the importance of ensuring the legitimacy of the intervention among managers, participants, and colleagues. Moreover, it is important to centrally organise, structure, and ensure flexibility in the working day to free time for participants to attend the intervention. Recommendations from this study suggest that a thorough intervention mapping process should be performed to analyse organisational and implementational factors before initiating workplace physical exercise training.
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Affiliation(s)
| | | | - Lasse Kirkelund
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 København Ø, Denmark
| | - Gisela Sjøgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Lars Louis Andersen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 København Ø, Denmark
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81
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Zhou G, Sun C, Knoll N, Hamilton K, Schwarzer R. Self-efficacy, planning and action control in an oral self-care intervention. HEALTH EDUCATION RESEARCH 2015; 30:671-681. [PMID: 26187914 DOI: 10.1093/her/cyv032] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
To evaluate a theory-guided intervention on oral self-care and examine the possible mechanisms among self-regulatory factors, two brief intervention arms were compared, an information-based education treatment and a self-regulation treatment focusing on planning and action control. Young adults (N = 284; aged 18-29 years) were assessed at baseline and 1 month later. The self-regulation intervention improved levels of oral self-care, dental planning and action control. Moreover, a moderated mediation model with planning as the mediator between experimental conditions and dental outcome, and self-efficacy as well as action control as moderators elucidated the mechanism of change. More self-efficacious participants in the self-regulation condition benefitted in terms of more planning, and those who monitored their actions yielded higher levels of oral hygiene. Dental self-efficacy, dental planning and action control are involved in the improvement of oral self-care. Their joint consideration may contribute to a better understanding of health behavior change.
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Affiliation(s)
- Guangyu Zhou
- Department of Educational Science and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195 Berlin, Germany,
| | - Caiyun Sun
- Henan Vocational College of Chemical Technology, Zhengshanglu 548, 450042 Zhengzhou, Henan Province, China
| | - Nina Knoll
- Department of Educational Science and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195 Berlin, Germany
| | - Kyra Hamilton
- School of Applied Psychology, Griffith University, 176 Messines Ridge Rd, Mt Gravatt 4122, Australia, School of Psychology and Speech Pathology, Curtin University, Kent Street, Bentley, Perth 6102, Australia
| | - Ralf Schwarzer
- Institute for Positive Psychology and Education, Australian Catholic University, Barker Road 25A, 2135 Strathfield, Australia and University of Social Sciences and Humanities, Warsaw, Poland
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Abstract
BACKGROUND Regular physical activity (PA) is foundational to human health, yet most people are inactive. A sound understanding of the determinants of PA may be instructive for building interventions and/or identifying critical target groups to promote PA. Most research on PA correlates has been biased by cross-sectional or passive prospective designs that fail to examine within-person analysis of PA change. OBJECTIVE The purpose of this review was to collect and appraise the available literature on the predictors of PA change conceived broadly in terms of increases/decreases from baseline assessment as well as specifically in terms of adoption and maintenance. METHODS Eligible studies were from English, peer-reviewed published articles that examined predictors of natural change of PA over 3 months + using observational (non-experimental) data in adult samples. Searches were performed from June 2012 to January 2014 in eight databases. RESULTS Sixty-seven independent data-sets, from 12 countries, primarily of medium quality/risk of bias, were identified with 26 correlates spanning demographic, behavioral, intra-individual, inter-individual, and environmental categories. Only intention and the onset of motherhood could reliably predict overall PA change. Among datasets configured to predict PA adoption, affective judgments and behavioral processes of change were the only reliable predictors, although both only have a small number of available studies. There were no reliable predictors of maintenance when compared to PA relapse. CONCLUSION The results underscore the importance of individual-level motivation and behavioral regulation in PA change, but also denote critical social variables. These findings, however, are constrained by PA measurement bias and limited studies that employed time-varying covariation between predictor variables and PA.
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Affiliation(s)
- Ryan E Rhodes
- Behavioural Medicine Laboratory, Faculty of Education, University of Victoria, STN CSC, PO Box 3015, Victoria, BC, V8W 3P1, Canada,
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83
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Rebar AL, Stanton R, Geard D, Short C, Duncan MJ, Vandelanotte C. A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychol Rev 2015; 9:366-78. [PMID: 25739893 DOI: 10.1080/17437199.2015.1022901] [Citation(s) in RCA: 525] [Impact Index Per Article: 58.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Amidst strong efforts to promote the therapeutic benefits of physical activity for reducing depression and anxiety in clinical populations, little focus has been directed towards the mental health benefits of activity for non-clinical populations. The objective of this meta-meta-analysis was to systematically aggregate and quantify high-quality meta-analytic findings of the effects of physical activity on depression and anxiety for non-clinical populations. A systematic search identified eight meta-analytic outcomes of randomised trials that investigated the effects of physical activity on depression or anxiety. The subsequent meta-meta-analyses were based on a total of 92 studies with 4310 participants for the effect of physical activity on depression and 306 study effects with 10,755 participants for the effect of physical activity on anxiety. Physical activity reduced depression by a medium effect [standardised mean difference (SMD) = -0.50; 95% CI: -0.93 to -0.06] and anxiety by a small effect (SMD = -0.38; 95% CI: -0.66 to -0.11). Neither effect showed significant heterogeneity across meta-analyses. These findings represent a comprehensive body of high-quality evidence that physical activity reduces depression and anxiety in non-clinical populations.
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Affiliation(s)
- Amanda L Rebar
- a School of Human, Health, and Social Sciences , Central Queensland University , Rockhampton , QLD , Australia
| | - Robert Stanton
- b School of Medical and Applied Sciences , Central Queensland University , Rockhampton , QLD , Australia
| | - David Geard
- b School of Medical and Applied Sciences , Central Queensland University , Rockhampton , QLD , Australia
| | - Camille Short
- a School of Human, Health, and Social Sciences , Central Queensland University , Rockhampton , QLD , Australia.,c Faculty of Health Sciences, Freemasons Foundation Centre for Men's Health , University of Adelaide , Adelaide , SA , Australia
| | - Mitch J Duncan
- a School of Human, Health, and Social Sciences , Central Queensland University , Rockhampton , QLD , Australia.,d Faculty of Health and Medicine, School of Medicine & Public Health; Priority Research Centre in Physical Activity and Nutrition , The University of Newcastle , Callaghan , NSW , Australia
| | - Corneel Vandelanotte
- a School of Human, Health, and Social Sciences , Central Queensland University , Rockhampton , QLD , Australia
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O'Brien N, McDonald S, Araújo-Soares V, Lara J, Errington L, Godfrey A, Meyer TD, Rochester L, Mathers JC, White M, Sniehotta FF. The features of interventions associated with long-term effectiveness of physical activity interventions in adults aged 55-70 years: a systematic review and meta-analysis. Health Psychol Rev 2015; 9:417-33. [PMID: 25689096 DOI: 10.1080/17437199.2015.1012177] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Content, delivery and effects of physical activity (PA) interventions are heterogeneous. There is a need to identify intervention features (content and delivery) related to long-term effectiveness. Behaviour change techniques (BCTs) and modes of intervention delivery were coded in 19 randomised controlled trials included in a systematic review of PA interventions for adults aged 55-70 years, published between 2000 and 2010, with PA outcomes ≥ 12 months after randomisation; protocol registration: PROSPERO CRD42011001459. Meta-analysis, moderator analyses and meta-regression were conducted. Meta-analysis revealed that interventions were effective in promoting PA compared with no/minimal intervention comparators [d = 0.29, 95% CI = 0.19-0.40, I(2) = 79.8%, Q-value = 89.16 (df = 18, p < 0.01)]. Intervention features often concurred and goal setting was the most commonly used BCT. Subgroup analyses suggested that interventions using the BCT feedback may be more effective, whilst interventions using printed materials or the BCTs information on where and when to perform the behaviour and information on consequences of behaviour to the individual may be less effective. Meta-regression revealed that neither the number of BCTs nor self-regulatory BCTs significantly related to effect size. Feedback appears to be a potentially effective candidate BCT for future interventions promoting long-term PA. Considering concurrence of intervention features alongside moderator analyses is important.
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Affiliation(s)
- Nicola O'Brien
- a Institute of Health & Society, Newcastle University , Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX , UK
| | - Suzanne McDonald
- a Institute of Health & Society, Newcastle University , Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX , UK
| | - Vera Araújo-Soares
- a Institute of Health & Society, Newcastle University , Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX , UK
| | - Jose Lara
- b Human Nutrition Research Centre, Institute for Ageing and Health , Newcastle University , Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL , UK
| | - Linda Errington
- c Walton Library , Newcastle University , Newcastle upon Tyne NE2 4HH , UK
| | - Alan Godfrey
- d Clinical Ageing Research Unit , Newcastle University , Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL , UK
| | - Thomas D Meyer
- e Department of Psychiatry and Behavioral Sciences , University of Texas at Houston , 1941 East Road, BBSB 3118, Houston , TX 77054 , USA
| | - Lynn Rochester
- d Clinical Ageing Research Unit , Newcastle University , Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL , UK
| | - John C Mathers
- b Human Nutrition Research Centre, Institute for Ageing and Health , Newcastle University , Biomedical Research Building, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL , UK
| | - Martin White
- f Fuse, UKCRC Centre for Translational Research in Public Health , Institute of Health & Society, Newcastle University , Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX , UK
| | - Falko F Sniehotta
- f Fuse, UKCRC Centre for Translational Research in Public Health , Institute of Health & Society, Newcastle University , Baddiley-Clark Building, Richardson Road, Newcastle upon Tyne NE2 4AX , UK
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Gourlan M, Bernard P, Bortolon C, Romain AJ, Lareyre O, Carayol M, Ninot G, Boiché J. Efficacy of theory-based interventions to promote physical activity. A meta-analysis of randomised controlled trials. Health Psychol Rev 2015; 10:50-66. [DOI: 10.1080/17437199.2014.981777] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Abstract
Objective Physical activity has to be performed regularly in order to achieve long-term health benefits. Studying the maintenance of physical activity and comparing study results requires a shared descriptive definition and a derived operationalization. Both are still lacking. The goal of this article is to briefly summarize how "maintenance of physical activity" is used in the scientific literature. Further, a descriptive definition and its operational application are introduced. Method A rapid literature search was completed in order to summarize the different concepts and usages of the term “maintenance of physical activity.” Results "Maintenance of physical activity" is used and defined in different ways. All of them have strengths and weaknesses. An approach that respects the volatility of physical activity is lacking. That’s why the lapse–recovery relationship is introduced. Conclusion People’s physical activity volume is often volatile, which is crucial for defining and assessing "maintenance of physical activity". The lapse–recovery relationship is an individual-centered approach respecting this volatility. It refers to an intentionally changed behavior and uses lapses and recoveries as indicators to operationalize the maintenance of physical activity.
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Affiliation(s)
- Daniela Kahlert
- Exercise and Health-Science, Department of Sport and Exercise Science, University of Stuttgart, Nobelstr. 15, Stuttgart 70569, Germany
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87
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Loef M, Walach H. How applicable are results of systematic reviews and meta-analyses of health behaviour maintenance? A critical evaluation. Public Health 2015; 129:377-84. [PMID: 25707931 DOI: 10.1016/j.puhe.2015.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 01/10/2015] [Accepted: 01/17/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To evaluate the practical applicability of systematic reviews and meta-analyses to the maintenance of physical activity or weight loss by assessing methodological and reporting aspects. METHODS To identify relevant studies a literature search was conducted in MEDLINE, EMBASE, Cochrane Library, PsycINFO, PSYNDEX, Google scholar, and reference lists. Each article was evaluated for methodological quality, operationalization of maintenance, and practicability following the RE-AIM framework and the PRISMA statement. RESULTS Twenty-four systematic reviews and meta-analyses were included of which 14 were published in the last four years. There were multiple definitions of maintenance. In addition the instances of redundancy, and neglect of thematic fields are identified. Eighty-seven percent of the reviews showed methodological flaws. The potential practical use of the outcomes was limited. CONCLUSION The applicability of systematic reviews and meta-analyses regarding health behaviour maintenance is limited with regard to reporting, methodology and thematic coverage. For practitioners, synthesis of quantitative and qualitative evidence with theoretical models is lacking.
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Affiliation(s)
- M Loef
- European University Viadrina, Germany.
| | - H Walach
- European University Viadrina, Germany
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88
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Jekauc D, Völkle M, Wagner MO, Mess F, Reiner M, Renner B. Prediction of attendance at fitness center: a comparison between the theory of planned behavior, the social cognitive theory, and the physical activity maintenance theory. Front Psychol 2015; 6:121. [PMID: 25717313 PMCID: PMC4323998 DOI: 10.3389/fpsyg.2015.00121] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 01/22/2015] [Indexed: 11/13/2022] Open
Abstract
In the processes of physical activity (PA) maintenance specific predictors are effective, which differ from other stages of PA development. Recently, Physical Activity Maintenance Theory (PAMT) was specifically developed for prediction of PA maintenance. The aim of the present study was to evaluate the predictability of the future behavior by the PAMT and compare it with the Theory of Planned Behavior (TPB) and Social Cognitive Theory (SCT). Participation rate in a fitness center was observed for 101 college students (53 female) aged between 19 and 32 years (M = 23.6; SD = 2.9) over 20 weeks using a magnetic card. In order to predict the pattern of participation TPB, SCT and PAMT were used. A latent class zero-inflated Poisson growth curve analysis identified two participation patterns: regular attenders and intermittent exercisers. SCT showed the highest predictive power followed by PAMT and TPB. Impeding aspects as life stress and barriers were the strongest predictors suggesting that overcoming barriers might be an important aspect for working out on a regular basis. Self-efficacy, perceived behavioral control, and social support could also significantly differentiate between the participation patterns.
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Affiliation(s)
- Darko Jekauc
- Department for Sport Psychology, Institute for Sport Science, Humboldt University of BerlinBerlin, Germany
- Department for Sport Science, University of KonstanzKonstanz, Germany
| | - Manuel Völkle
- Max Planck Institute for Human DevelopmentBerlin, Germany
| | | | - Filip Mess
- Department for Health Sciences, University of Education Schwäbisch GmündSchwäbisch Gmünd, Germany
| | - Miriam Reiner
- Department for Sport Science, University of StuttgartStuttgart, Germany
| | - Britta Renner
- Department for Psychology, University of KonstanzKonstanz, Germany
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89
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Reyes Fernández B, Fleig L, Godinho CA, Montenegro Montenegro E, Knoll N, Schwarzer R. Action control bridges the planning-behaviour gap: a longitudinal study on physical exercise in young adults. Psychol Health 2015; 30:911-23. [PMID: 25587901 DOI: 10.1080/08870446.2015.1006222] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Maintaining physical exercise levels may not only require motivation and planning but also action control which is supposed to mediate between planning and exercise. DESIGN Behavioural intention, action planning, coping planning and past behaviour were assessed at baseline, and action control and concurrent exercise were measured one month later in 497 young adults. METHOD Three nested structural models were specified to examine different mediation mechanisms. One model reflected the intention-planning-behaviour chain, the other one focused on the intention-action control-behaviour chain and the third model comprised the full sequence. RESULTS Indirect effects from intentions on exercise involved either planning or action control as mediating variables. In Model 3, all three constructs (action planning, coping planning and action control) were sequential mediators between intentions and later physical exercise levels. Action and coping planning were not directly but indirectly related to exercise via action control. CONCLUSIONS Findings support the sequential mediation for planning and action control as antecedents of physical exercise. Action control is needed for exercise, because planning in itself is not always sufficient. Maintaining exercise levels may be attributed to effective self-regulatory strategies such as action control in combination with planning.
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90
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Bouma AJ, van Wilgen P, Dijkstra A. The barrier-belief approach in the counseling of physical activity. PATIENT EDUCATION AND COUNSELING 2015; 98:129-136. [PMID: 25455791 DOI: 10.1016/j.pec.2014.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2014] [Revised: 09/26/2014] [Accepted: 10/06/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To understand inactivity and relapse from PA, and to develop theory-based behavior change strategies to stimulate and support maintenance of PA. METHODS We conducted a literature search to explore barriers to PA. Social cognitive theories and empirical evidence were evaluated and guided the process developing a theoretical framework and counseling strategies. RESULTS A theoretical framework is presented to understand why people do not engage in PA and often relapse once they started PA. A distinction is made between three related types of BBs. In PA counseling these three beliefs are addressed using four different BB behavior change strategies. CONCLUSION BB counseling aims to develop an individual pattern of PA for the long term that is adapted to the (often limited) motivation of the client, thereby preventing the occurrence of BBs. The client will learn to cope with factors that may inhibit PA in the future. PRACTICE IMPLICATIONS The BBs approach composes a way of counseling around the central construct of barrier-beliefs to stimulate engagement in PA independently, in the long term.
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Affiliation(s)
- Adrie J Bouma
- Hanze University of Applied Sciences Groningen, Institute of Sports Studies, Groningen, The Netherlands.
| | - Paul van Wilgen
- Transcare, Transdisciplinairy Painmanagement Center, Groningen, The Netherlands; Pain in Motion Study Group, Department of Physiotherapy and Rehabilitation Sciences, Faculty of Physical Education & Physiotherapy, Free University of Brussels, Brussels, Belgium.
| | - Arie Dijkstra
- Department of Psychology, Faculty of Behavioral- and Social Sciences, Grote Kruisstraat 2/1, 9712 TS, University of Groningen, Groningen, The Netherlands.
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91
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Elvén M, Hochwälder J, Dean E, Söderlund A. A clinical reasoning model focused on clients’ behaviour change with reference to physiotherapists: its multiphase development and validation. Physiother Theory Pract 2014; 31:231-43. [DOI: 10.3109/09593985.2014.994250] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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92
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Høj K, Skriver MV, Hansen ALS, Christensen B, Maindal HT, Sandbæk A. Effect of including fitness testing in preventive health checks on cardiorespiratory fitness and motivation: study protocol of a randomized controlled trial. BMC Public Health 2014; 14:1057. [PMID: 25300392 PMCID: PMC4197288 DOI: 10.1186/1471-2458-14-1057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 10/02/2014] [Indexed: 11/24/2022] Open
Abstract
Background Preventive health checks may identify individuals with an unhealthy lifestyle and motivate them to change behaviour. However, knowledge about the impact of the different components included in preventive health checks is deficient. The aim of this trial is to evaluate whether including cardiorespiratory fitness testing in preventive health checks 1) increases cardiorespiratory fitness level and motivation to change physical activity behaviour and 2) reduces physical inactivity prevalence and improves self-rated health compared with preventive health checks without fitness testing. Methods/Design An open-label, household-cluster, randomized controlled trial with a two-group parallel design is used. The trial is embedded in a population-based health promotion program, “Check your Health Preventive Program”, in which all 30–49 year-old citizens in a Danish municipality are offered a preventive health check. In each arm of the trial, 750 citizens will be recruited (1,500 in total). The primary outcome is cardiorespiratory fitness level assessed by submaximal cycle ergometer testing after one year. An intermediate outcome is the percentage of participants increasing motivation for physical activity behaviour change between baseline and two-weeks follow-up assessed using the Transtheoretical Model´s stages of change. Secondary outcomes include changes from baseline to one-year follow-up in physical inactivity prevalence measured by a modified version of the questions developed by Saltin and Grimby, and in self-rated health measures using the Short-Form 12, Health Survey, version 2. Discussion This trial will contribute to a critical appraisal of the value of fitness testing as part of preventive health checks. The conduction in real-life community and general practice structures makes the trial findings applicable and transferable to other municipalities providing support to decision-makers in the development of approaches to increase levels of physical activity and improve health. Trial registration ClinicalTrials.gov Identifier: NCT02224248. Registered 8 August 2014.
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Affiliation(s)
- Kirsten Høj
- Section of General Practice, Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark.
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93
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Amireault S. Doing more than Just Acknowledging Attrition at Follow-Up: A Comment on Lu, Cheng, and Chen (2013). Psychol Rep 2014; 115:419-26. [DOI: 10.2466/03.pr0.115c19z5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Lu, Cheng, and Chen (2013) faced one of the most common challenges encountered in longitudinal studies: follow-up attrition. Using a correlational prospective design, 464 volunteers completed a questionnaire that measured the constructs of the theory of planned behavior, and subsequently 154 of them provided physical activity data at a 6-month follow-up. The proportion of participants (66.8%) for whom the investigators were not able to gather information on the behavioral outcome at follow-up may reflect a form of selection bias that may affect both the validity and generalizability of study results. Lu, et al.'s (2013) study is used here to explore the implication of follow-up attrition on the results and inference, to review what information should be reported in a scientific paper in such situations, and to give practical tips to handle follow-up attrition.
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Affiliation(s)
- Steve Amireault
- Faculty of Kinesiology & Physical Education, University of Toronto
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94
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Silva KS, Pizarro AN, Garcia LMT, Mota J, Santos MP. Which social support and psychological factors are associated to active commuting to school? Prev Med 2014; 63:20-3. [PMID: 24594100 DOI: 10.1016/j.ypmed.2014.02.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 02/17/2014] [Accepted: 02/23/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association between self-efficacy, enjoyment, and volitional control with active commuting, as well as to analyze the impact of social support from parents, friends, and teachers with active commuting to school. METHODS Participants in this cross-sectional study were 625 students (male: 46.3%) aged 10 to 15years from Porto, Portugal (2010/2011). A questionnaire was used to assess active commuting to/from school (walk/cycle), self-efficacy, enjoyment, volitional control and social support. Binary logistic regression was performed to identify significant associations between targeted variables and active commuting. RESULTS The results show positive associations in crude analyses for all variables, except for enjoyment for walk/cycle to school. In the adjusted model, higher likelihood of active commuting was found among students who reported having higher self-efficacy (OR=2.10; CI95%: 1.07; 4.11) to walk/cycle to school as well as among adolescents who reported being encouraged by their parents (OR=3.66; CI95%: 1.55; 8.69), and having the partnership of friends in active journeys (OR=4.31; CI95%: 1.79; 10.37). CONCLUSION Self-efficacy, encouragement from parents and companionship from friends were important indicators of active commuting to school among Portuguese adolescents. These findings provide support for further research to identify and understand factors that predict and explain the active commuting.
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Affiliation(s)
- Kelly Samara Silva
- Research Centre in Physical Activity and Health, Federal University of Santa Catarina, Florianopolis, Brazil.
| | | | | | - Jorge Mota
- Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.
| | - Maria Paula Santos
- Research Centre in Physical Activity, Health and Leisure, University of Porto, Porto, Portugal.
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Vézina-Im LA, Lavoie M, Krol P, Olivier-D’Avignon M. Motivations of physicians and nurses to practice voluntary euthanasia: a systematic review. BMC Palliat Care 2014; 13:20. [PMID: 24716567 PMCID: PMC4021095 DOI: 10.1186/1472-684x-13-20] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Accepted: 03/27/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While a number of reviews have explored the attitude of health professionals toward euthanasia, none of them documented their motivations to practice euthanasia. The objective of the present systematic review was to identify physicians' and nurses' motives for having the intention or for performing an act of voluntary euthanasia and compare findings from countries where the practice is legalized to those where it is not. METHODS The following databases were investigated: MEDLINE/PubMed (1950+), PsycINFO (1806+), CINAHL (1982+), EMBASE (1974+) and FRANCIS (1984+). Proquest Dissertations and Theses (1861+) was also investigated for gray literature. Additional studies were included by checking the references of the articles included in the systematic review as well as by looking at our personal collection of articles on euthanasia. RESULTS This paper reviews a total of 27 empirical quantitative studies out of the 1 703 articles identified at the beginning. Five studies were in countries where euthanasia is legal and 22 in countries where it is not. Seventeen studies were targeting physicians, 9 targeted nurses and 1 both health professionals. Six studies identified the motivations underlying the intention to practice euthanasia, 16 the behavior itself and 5 both intention and behavior. The category of variables most consistently associated with euthanasia is psychological variables. All categories collapsed, the four variables most frequently associated with euthanasia are past behavior, medical specialty, whether the patient is depressed and the patient's life expectancy. CONCLUSIONS The present review suggests that physicians and nurses are motivated to practice voluntary euthanasia especially when they are familiar with the act of euthanasia, when the patient does not have depressive symptoms and has a short life expectancy and their motivation varies according to their medical specialty. Additional studies among nurses and in countries where euthanasia is legal are needed.
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Affiliation(s)
| | - Mireille Lavoie
- Faculty of Nursing, Laval University, Québec, Canada
- Équipe de Recherche Michel-Sarrazin en Oncologie psychosociale et Soins palliatifs (ERMOS), Centre de recherche du CHU de Québec - Hôtel-Dieu de Québec, Québec, Canada
| | - Pawel Krol
- Faculty of Nursing, Laval University, Québec, Canada
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