The role of motivation in understanding social contextual influences on physical activity in underserved adolescents in the ACT Trial: a cross-sectional study

Musculoskeletal Pain and Non-Classroom Teaching in Times of the COVID-19 Pandemic: Analysis of the Impact on Students from Two Spanish Universities

The lockdown, due to the coronavirus, has led to a change in lifestyle and physical activity in Spanish university students. The objective of this study was to analyze the prevalence of musculoskeletal pain and changes in physical activity and self-perceived stress in the student bodies of two Spanish Universities during the lockdown. A cross-sectional study was carried out in a sample of 1198 students (70.6% women). The main instruments used for measuring were the Standardized Kuorinka Modified Nordic Questionnaire and the Perceived stress scale (the questionnaire regarding the practice of physical activity). A reduction in the prevalence of musculoskeletal pain (p < 0.001) was identified in the sample of men and women, an increase (12.5%) in the frequency of carrying out physical activity from moderate to frequent, and the preference for strength training (15.1%), especially among women, was identified. All of this may be taken into account by health institutions when implementing measures to encourage physical activity in both suitable amounts and types, which improves the quality of life of the students.

Formative Process Evaluation of the "Connect" Physical Activity Feasibility Trial for Adolescents

Most interventions do not reach full implementation in real-world settings. Due to this issue, formative process evaluation during pilot programs can be especially useful to understand implementation strengths and areas for improvement so that full implementation can be reached in future iterations. This study demonstrated how a formative process evaluation of the Connect through Positive Leisure Activities for Youth (Connect) pilot informed course corrections for year 2 implementation. Connect is an intervention to promote a positive social motivational climate for physical activity (PA) in pre-existing after school programs. Connect ran 3 days a week for 8 weeks and had 2 components: a 30-minute “Get-to-Know-You” (GTKY) session and a 60-minute PA session. Formative evaluation was assessed using an observational tool and staff surveys. Changes in youth PA during program hours was assessed as a process outcome using the System for Observing Children’s Activity and Relationships during Play (SOCARP). All Connect essential elements were assessed with the observational tool including (a) social goal-oriented support; (b) collaborative, cooperative play; (c) equal treatment/access; and (d) an inclusive and engaging climate. Adequate dose was achieved on all items in all sessions. Although GTKY and PA sessions both reached high fidelity in promoting equal treatment and access, success in reaching fidelity varied for the 3 remaining essential elements. Post-intervention staff surveys indicated acceptability/adoptability of the Connect program and SOCARP observations indicated significant increases in PA from baseline to post-intervention. Changes for year 2 implementation based on the findings are discussed.

The Relation Between Early Adolescent Physical Activity and Internalizing Problems: Variations in Exercise Motivations as a Critical Moderator

Inconsistencies exist regarding the relation between physical activity (PA) and internalizing symptomology in early adolescence, and there is need for investigation of potential moderators that may account for these discrepancies. The current study utilized a Self-Determination Theory Framework to investigate the main effects of five key motivations to exercise and their moderating effects between PA and internalizing problems in an underserved sample of adolescents (n = 167; mean age = 12.19 years; 73% African American). Analyses showed that intrinsic motivations were negatively related to internalizing problems and extrinsic motivations were positively related. PA was only protective against internalizing problems when intrinsic motivations were high and had iatrogenic effects when these were low. Exploratory analyses further delineated the unique effects of motivational orientations. Clinical implications and future research directions are discussed.

The interaction of behavioral context and motivational-volitional factors for exercise and sport in adolescence: patterns matter

Background

In order to generate more effective interventions to promote exercise and sport in adolescence, a better understanding of the interaction of influencing factors across different levels is needed. In particular, motivation and volition for exercise and sport, as well as the context in which adolescents are doing exercise and sport, have been identified as important factors. Behavioral context refers to both the organizational setting, e.g., doing exercise and sport in a club, and the social setting, e.g., doing exercise and sport with friends. Extending previous research, the present study applies a person-oriented approach and aims to identify typical behavioral context patterns and motivational-volitional patterns. To validate the patterns, it was examined whether they differ concerning the exercise and sport activity level. Furthermore, the study investigated how behavioral context patterns and motivational-volitional patterns interact.

Method

A cross-sectional design with 1155 adolescents (M_age = 15.29; 53% female) was applied. A latent profile analysis was used twice to identify typical patterns: once with eight organizational and social setting factors to examine behavioral context patterns, and once with five motivational-volitional factors to examine motivational-volitional patterns. To validate the patterns identified, the exercise and sport activity level were compared across the patterns using Wald-tests. Finally, transition probabilities and odds ratios were calculated in order to investigate the interaction of the behavioral context and motivational-volitional patterns.

Results

Four behavioral context patterns − differing in activity level − were identified: Mostly inactive, non-club-organized individualists, self-organized individualists and family sportspersons, and traditional competitive club athletes with friends. Furthermore, five motivational-volitional patterns emerged with differing activity levels: three level patterns with overall low, moderate or high motivation and volition, and two shape patterns called the intention- and plan-less and the plan-less motivated. Regarding interaction, the results indicate that one behavioral context pattern is not solely responsible for moderate to high motivation and volition in adolescents.

Conclusion

Applying a person-oriented approach allows a more differentiated view of how behavioral context and motivational-volitional factors interact within homogenous subgroups. This, in turn, provides a basis to design tailored multilevel interventions which account for the interaction of influencing factors across different levels.

Gender-specific correlates of sufficient physical activity among vulnerable children

AIM

We aimed to identify the levels and types of physical activity (PA) by gender, and to determine correlates of sufficient PA on a theoretical basis of self-determination and social support; moreover, if significant correlates with sufficient PA would differ by gender among vulnerable children.

METHODS

Participants were 319 children enrolled in public welfare systems in Seoul, South Korea. Sufficient PA was defined as daily activity with moderate or vigorous intensity for 60 min. Self-determined motivation was assessed by autonomous and controlled forms; social support was assessed as two types: family and peer support. Questionnaires were self-reported by children and their parents.

RESULTS

Of the participants, 20.4% achieved sufficient PA, specifically 15.0% for girls versus 27.3% for boys (P < .001). Girls were more likely to perform casual exercise types, while boys were more likely to perform sports types (P < .05 for all). The autonomous form of self-determined motivation, but not its controlled form, was significantly associated with sufficient PA in both girls (adjusted odds ratio [AOR] = 2.03, P = .028) and boys (AOR = 2.47, P = .007). Family support was not significantly associated in girls and boys; however, peer support was significantly associated only in boys (AOR = 3.72, P = .042).

DISCUSSION

Of the children, girls were less likely to achieve sufficient PA and to perform sports than were boys. Self-determined motivation was a PA correlate uniformly in girls and boys; however, peer support was a PA correlate only in boys. Self-determined motivation-enhanced strategies should be integrated with peer support provided through gender-specific strategies when employing a PA intervention for vulnerable children.

Empowering youth sport environments: Implications for daily moderate-to-vigorous physical activity and adiposity

BACKGROUND

Evidence suggests involvement in youth sport does not guarantee daily guidelines for moderate-to-vigorous physical activity (MVPA) are met, and participation may not mitigate the risks associated with physical inactivity. The need to promote higher habitual MVPA engagement amongst children active in the youth sport context has therefore been underlined. Framed by self-determination theory, the aim of the present study was to examine the implications of the motivational climate created in youth sport, for children's daily engagement in MVPA and associated adiposity. Specifically, we sought to test a motivational sequence in which children's perceptions of an empowering coach-created motivational climate were related to autonomous and controlled motivation, which in turn predicted sport-related enjoyment. Finally, enjoyment was assumed to predict accelerometer assessed daily MVPA and, following this, adiposity.

METHODS

Male and female youth sport participants aged 9-16 years (n = 112) completed multi-section questionnaires assessing their perceptions of the motivational climate created in youth sport (i.e., autonomy supportive, task involving, socially supportive), autonomous and controlled motivation, and sport-related enjoyment. Daily MVPA engagement was determined via 7 days of accelerometry. Percent body fat (BF%) was estimated using bio-electrical impedance analysis.

RESULTS

Path analysis revealed perceptions of an empowering motivational climate positively predicted players' autonomous motivation, and in turn, sport-related enjoyment. Enjoyment was also significantly negatively related to players' BF%, via a positive association with daily MVPA.

CONCLUSION

Fostering more empowering youth sport environments may hold implications for the prevention of excess adiposity, through encouraging higher habitual MVPA engagement. Findings may inform the optimal design of youth sport settings for MVPA promotion, and contribute towards associated healthy weight maintenance amongst youth active in this context. Longitudinal and intervention studies are required to confirm these results.

Systematic review of the relationships between objectively measured physical activity and health indicators in school-aged children and youth

Moderate-to-vigorous physical activity (MVPA) is essential for disease prevention and health promotion. Emerging evidence suggests other intensities of physical activity (PA), including light-intensity activity (LPA), may also be important, but there has been no rigorous evaluation of the evidence. The purpose of this systematic review was to examine the relationships between objectively measured PA (total and all intensities) and health indicators in school-aged children and youth. Online databases were searched for peer-reviewed studies that met the a priori inclusion criteria: population (apparently healthy, aged 5-17 years), intervention/exposure/comparator (volumes, durations, frequencies, intensities, and patterns of objectively measured PA), and outcome (body composition, cardiometabolic biomarkers, physical fitness, behavioural conduct/pro-social behaviour, cognition/academic achievement, quality of life/well-being, harms, bone health, motor skill development, psychological distress, self-esteem). Heterogeneity among studies precluded meta-analyses; narrative synthesis was conducted. A total of 162 studies were included (204 171 participants from 31 countries). Overall, total PA was favourably associated with physical, psychological/social, and cognitive health indicators. Relationships were more consistent and robust for higher (e.g., MVPA) versus lower (e.g., LPA) intensity PA. All patterns of activity (sporadic, bouts, continuous) provided benefit. LPA was favourably associated with cardiometabolic biomarkers; data were scarce for other outcomes. These findings continue to support the importance of at least 60 min/day of MVPA for disease prevention and health promotion in children and youth, but also highlight the potential benefits of LPA and total PA. All intensities of PA should be considered in future work aimed at better elucidating the health benefits of PA in children and youth.

A self-determination theory and motivational interviewing intervention to decrease racial/ethnic disparities in physical activity: rationale and design

Background

Although the mental and physical benefits of physical activity are well-established, there is a racial/ethnic disparity in activity such that minorities are much less likely to engage in physical activity than are White individuals. Research suggests that a lack of motivation may be an important barrier to physical activity for racial/ethnic minorities. Therefore, interventions that increase participants’ motivation may be especially useful in promoting physical activity within these groups. Physical activity interventions that utilized the clinical technique of motivational interviewing (MI) in conjunction with the theoretical background of self-determination theory (SDT) have been effective in increasing White individuals’ physical activity. Nevertheless, it remains unclear the extent to which these results apply to minority populations.

Methods/Design

The current study involves conducting a 12-week physical activity intervention based on SDT and MI to promote physical activity in a racially/ethnically-diverse sample. It is hypothesized that this intervention will successfully increase physical activity in participants. Specifically, it is expected that minorities will experience a greater relative increase in physical activity than Whites within the intervention group because minorities are expected to have lower baseline levels of activity.

Discussion

Results from this study will give us a greater understanding of the generalizability of SDT interventions designed to improve motivation for physical activity and level of physical activity.

Trial registration

Clinical Trials Gov. Identifier NCT02250950 Registered 24 September 2014.

Retail Environments as a Venue for Obesity Prevention

Increasing attention has been given to the role of retail food environments in shaping dietary behavior and obesity risk. Studies have generally shown an association between living in a neighborhood with or in close proximity to certain types of food outlets and/or the availability of healthy food options and better dietary quality, higher fruit/vegetable intakes, and a lower risk of overweight, even after controlling for individual/family level characteristics. However, research in this area has yielded mixed results, overall. Future research needs to identify consistent approaches for defining and measuring food retail environments.

Motivation and planning as mediators of the relation between social support and physical activity among U.S. adolescents: a nationally representative study

BACKGROUND

More than half of U.S. high-school students do not meet the moderate and vigorous physical activity (MVPA) 5 hours per week recommendation. The purpose of this study was to determine how individual dimensions (motivation and planning) mediate the relationship of social context with physical activity by integrating available measures of personal characteristic including internal/external motivations (derived from Self-Determination Theory -SDT]) for MVPA, MVPA planning, peer MVPA, and parental support to better understand adolescent MVPA.

METHODS

Survey responses of a nationally representative cohort of 11th graders (N=2439) in the NEXT Generation Health Study were analyzed with structural equation modeling.

RESULTS

Adolescent MVPA was directly, significantly associated with MVPA planning (β=0.17), peer MVPA (β=0.21), and internal motivation (β=0.50). Internal motivation was associated with peer MVPA (β=0.31), parental support for MVPA (β=0.16), and external motivation (β=0.40). A significant relation between parental support and external motivation (β=0.31) was also found.

CONCLUSIONS

Adolescents with higher internal motivation and more active friends were more likely to engage in MVPA. The results are consistent with SDT and suggest that planning is an important construct for adolescent MVPA.

Feasibility and preliminary outcomes from a pilot study of an integrated health-mental health promotion program in school mental health services

The prevalence of unmet health and mental health needs among youth has spurred the growing consensus to develop strategies that integrate services to promote overall well-being. This pilot study reports on the feasibility and outcomes of a theory-driven, family-focused, integrated health-mental health promotion program for underserved adolescents receiving school mental health services. Parent and adolescent assessments conducted prior to and following the brief, 6-session promotion program showed significant improvements in family support, youth self-efficacy, health behaviors, and mental health outcomes. Clinician reports contributed to a characterization of the feasibility, acceptability, and future recommendations for the integrated program.