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Peer Support and Exercise Adherence in Adolescents: The Chain-Mediated Effects of Self-Efficacy and Self-Regulation. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020401. [PMID: 36832530 PMCID: PMC9955246 DOI: 10.3390/children10020401] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/25/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023]
Abstract
In the context of exercise psychology, the mediating relationship between peer support, self-efficacy and self-regulation, and adolescents' exercise adherence was to be explored. METHODS A questionnaire was distributed among 2200 teenagers from twelve middle schools in Shanghai. The "process" program in SPSS and the bootstrap method were applied to construct and analyze the direct and indirect effects of peer support on adolescents' exercise adherence. RESULTS Peer support directly affected adolescents' exercise adherence (β = 0.135, p < 0.001, effect size of 59%) and self-efficacy (β = 0.493, p < 0.001, effect size accounted for 42%), and self-regulation (β = -0.184, p < 0.001, effect size of 11%) influenced exercise adherence indirectly. In addition, self-efficacy and self-regulation could impose a chain-mediated effect on peer support and exercise adherence (effect size of 6%). CONCLUSION Peer support could promote adolescents' exercise adherence. Self-efficacy and self-regulation are mediating factors of peer support on exercise adherence in teenagers, self-regulation as well as self-efficacy-imposed chain-mediating effects on peer support and adolescents' exercise adherence.
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Ricke E, Dijkstra A, Bakker EW. Prognostic factors of adherence to home-based exercise therapy in patients with chronic diseases: A systematic review and meta-analysis. Front Sports Act Living 2023; 5:1035023. [PMID: 37033885 PMCID: PMC10080001 DOI: 10.3389/fspor.2023.1035023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background Patients with a chronic disease may have an increased risk of non-adherence to prescribed home-based exercise therapy. We performed a systematic review with the aim to identify variables associated with adherence to home-based exercise therapy in patients with chronic diseases and to grade the quality of evidence for the association between these prognostic factors and adherence. Methods Cohort studies, cross-sectional studies and the experimental arm of randomized trials were identified using a search strategy applied to PubMed, Embase, PsychINFO and CINAHL from inception until August 1, 2022. We included studies with participants ≥18 years with a chronic disease as an indication for home-based exercise therapy and providing data on prognostic factors of adherence to home-based exercise. To structure the data, we categorized the identified prognostic factors into the five WHO-domains; (1) Patient-related, (2) Social/economic, (3) Therapy-related, (4) Condition-related, and (5) Health system factors. Risk of bias was assessed using the Quality in Prognostic Studies (QUIPS) tool. Prognostic factors of adherence were identified and the quality of the evidence between the prognostic factors and adherence were graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework for predictor studies. We performed a meta-analysis of the obtained information. Results A total of 57 studies were included. Within patient-related factors moderate- and high-quality evidence suggested that more self-efficacy, exercise history, motivation and perceived behavioral control predicted higher adherence. Within social-economic factors moderate-quality evidence suggested more education and physical health to be predictive of higher adherence and within condition-related factors moderate- and low-quality evidence suggested that less comorbidities, depression and fatigue predicted higher adherence. For the domains therapy-related and health-system factors there was not enough information to determine the quality evidence of the prognostic factors. Conclusion These findings might aid the development of future home-based exercise programs as well as the identification of individuals who may require extra support to benefit from prescribed home-based exercise therapy. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=277003, identifier PROSPERO CRD42021277003.
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Affiliation(s)
- Ellen Ricke
- Department of Social Psychology, University of Groningen, Groningen, Netherlands
- Correspondence: Ellen Ricke
| | - Arie Dijkstra
- Department of Social Psychology, University of Groningen, Groningen, Netherlands
| | - Eric W. Bakker
- Department of Epidemiology and Data Science | Division EBM, Academic Medical Centre, Amsterdam, Netherlands
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McNeil J, Fahim M, Stone CR, O'Reilly R, Courneya KS, Friedenreich CM. Adherence to a lower versus higher intensity physical activity intervention in the Breast Cancer & Physical Activity Level (BC-PAL) Trial. J Cancer Surviv 2021; 16:353-365. [PMID: 33754246 DOI: 10.1007/s11764-021-01030-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 03/16/2021] [Indexed: 12/30/2022]
Abstract
PURPOSE The first aim is to examine adherence to a lower versus higher intensity physical activity (PA) prescription in breast cancer survivors in the Breast Cancer & Physical Activity Level (BC-PAL) Trial. The second aim is to assess associations between baseline characteristics with mean PA adherence in both intervention groups combined. METHODS Forty-five participants were randomized to a 12-week, home-based lower (300 min/week, 40-59% heart rate reserve (HRR)) or higher (150 min/week, 60-80% HRR) intensity PA intervention, or no intervention/control. Both intervention groups received Polar A360® trackers and were included in this analysis (n=30). Study outcomes assessed on a weekly basis with the Polar A360® activity tracker throughout the intervention included relative adherence to the prescribed PA interventions (% of PA prescription goal met), and the absolute amount of PA time ≥40% of HRR. Baseline predictors of adherence included demographic characteristics, cardiorespiratory fitness, habitual PA and sedentary time, quality of life measures, and motivational variables from the Theory of Planned Behavior. For our primary aim, a linear mixed model was used to assess the effects of randomization group, time (intervention weeks 1-12), and the interaction of these factors on the natural logarithm of PA adherence. For our secondary aim, the association between each baseline predictor with the natural logarithm of mean weekly PA adherence was assessed, with randomization group added as a covariate. RESULTS Higher relative time within the prescribed HRR zone was noted in the lower versus higher intensity PA groups (eβ=3.12, 95% CI=1.97, 4.95). No differences in adherence across time were noted. Social support was inversely associated with relative PA time within the prescribed HRR zone (eβ=0.83, 95% CI=0.72, 0.97) and absolute PA time ≥40% of HRR (eβ= 0.82, 95% CI: 0.71, 0.93). Baseline VO2max was inversely associated with relative PA adherence (eβ=0.98, 95% CI=0.95, 0.99). No other baseline measures were associated with PA adherence. CONCLUSIONS There were no significant changes in absolute PA time ≥40% of HRR across time or between groups. However, the lower intensity PA group averaged over 3 times the relative amount of PA within the prescribed HRR zone compared to the higher intensity PA group. Finally, lower peer support and cardiorespiratory fitness at baseline were associated with higher PA adherence. IMPLICATIONS FOR CANCER SURVIVORS The recent rise in popularity of commercially available activity trackers provides new opportunities to promote PA participation remotely, and these devices can be used to continuously and objectively measure PA levels as an indicator of intervention adherence. Future studies are needed to explore baseline predictors, facilitators, and barriers to sustained activity tracker use to promote PA behavior change and intervention adherence in cancer survivors. TRIAL REGISTRATION This study was registered at www.clinicaltrials.gov (No. NCT03564899) on June 21, 2018.
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Affiliation(s)
- Jessica McNeil
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada. .,Department of Kinesiology, School of Health and Human Sciences, University of North Carolina Greensboro, Room 351D, Coleman Building, 1408 Walker Avenue, Greensboro, NC, 27412-5020, USA.
| | - Mina Fahim
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Chelsea R Stone
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Rachel O'Reilly
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada.,Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Jacot W, Arnaud A, Jarlier M, Lefeuvre-Plesse C, Dalivoust P, Senesse P, Azzedine A, Tredan O, Sadot-Lebouvier S, Mas S, Carayol M, Bleuse JP, Gourgou S, Janiszewski C, Launay S, D’Hondt V, Lauridant G, Grenier J, Romieu G, Ninot G, Vanlemmens L. Brief Hospital Supervision of Exercise and Diet During Adjuvant Breast Cancer Therapy Is Not Enough to Relieve Fatigue: A Multicenter Randomized Controlled Trial. Nutrients 2020; 12:nu12103081. [PMID: 33050321 PMCID: PMC7600233 DOI: 10.3390/nu12103081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/02/2020] [Accepted: 10/04/2020] [Indexed: 12/20/2022] Open
Abstract
Supervised exercise dietary programs are recommended to relieve cancer-related fatigue and weight increase induced by adjuvant treatment of early breast cancer (EBC). As this recommendation lacks a high level of evidence, we designed a multicenter randomized trial to evaluate the impact of an Adapted Physical Activity Diet (APAD) education program on fatigue. We randomized 360 women with EBC who were receiving adjuvant chemotherapy and radiotherapy to APAD or usual care at eight French cancer institutions. Data were collected at baseline, end of chemotherapy, end of radiotherapy, and 6 months post-treatment. The primary endpoint was the general cancer-related fatigue score using the MFI-20 questionnaire. Fatigue correlated with the level of precariousness, but we found no significant difference between the two groups in terms of general fatigue (p = 0.274). The APAD arm has a smaller proportion of patients with confirmed depression at the end of follow-up (p = 0.052). A transient modification in physical activity levels and dietary intake was reported in the experimental arm. However, a mixed hospital- and home-based APAD education program is not enough to improve fatigue caused by adjuvant treatment of EBC. Cancer care centers should consider integrating more proactive diet-exercise supportive care in this population, focusing on precarious patients.
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Affiliation(s)
- William Jacot
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, Parc Euromédecine, CEDEX 5, 34298 Montpellier, France; (M.J.); (P.S.); (S.M.); (J.-P.B.); (S.G.); (C.J.); (S.L.); (V.D.); (G.R.); (G.N.)
- Faculty of Medicine, University of Montpellier, Rue du Pr. Henri Serre, 34000 Montpellier, France
- Correspondence:
| | - Antoine Arnaud
- Sainte-Catherine Institute, 1750 Chemin Lavarin, 84000 Avignon, France; (A.A.); (J.G.)
| | - Marta Jarlier
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, Parc Euromédecine, CEDEX 5, 34298 Montpellier, France; (M.J.); (P.S.); (S.M.); (J.-P.B.); (S.G.); (C.J.); (S.L.); (V.D.); (G.R.); (G.N.)
| | - Claudia Lefeuvre-Plesse
- Eugène Marquis Center, Rue de la Bataille Flandres-Dunkerque, CS 44229, 35042 Rennes, France;
| | | | - Pierre Senesse
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, Parc Euromédecine, CEDEX 5, 34298 Montpellier, France; (M.J.); (P.S.); (S.M.); (J.-P.B.); (S.G.); (C.J.); (S.L.); (V.D.); (G.R.); (G.N.)
| | - Ahmed Azzedine
- Montélimar Hospital, Quartier Beausseret, BP 249-26, 26216 Montélimar, France;
| | | | | | - Sébastien Mas
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, Parc Euromédecine, CEDEX 5, 34298 Montpellier, France; (M.J.); (P.S.); (S.M.); (J.-P.B.); (S.G.); (C.J.); (S.L.); (V.D.); (G.R.); (G.N.)
- Faculty of Medicine, University of Montpellier, Rue du Pr. Henri Serre, 34000 Montpellier, France
| | - Marion Carayol
- IAPS Laboratory “Impact of Physical Activity on Health”, University of Toulon, Avenue de l’Université, 83957 La Garde, France;
| | - Jean-Pierre Bleuse
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, Parc Euromédecine, CEDEX 5, 34298 Montpellier, France; (M.J.); (P.S.); (S.M.); (J.-P.B.); (S.G.); (C.J.); (S.L.); (V.D.); (G.R.); (G.N.)
| | - Sophie Gourgou
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, Parc Euromédecine, CEDEX 5, 34298 Montpellier, France; (M.J.); (P.S.); (S.M.); (J.-P.B.); (S.G.); (C.J.); (S.L.); (V.D.); (G.R.); (G.N.)
| | - Chloé Janiszewski
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, Parc Euromédecine, CEDEX 5, 34298 Montpellier, France; (M.J.); (P.S.); (S.M.); (J.-P.B.); (S.G.); (C.J.); (S.L.); (V.D.); (G.R.); (G.N.)
| | - Silene Launay
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, Parc Euromédecine, CEDEX 5, 34298 Montpellier, France; (M.J.); (P.S.); (S.M.); (J.-P.B.); (S.G.); (C.J.); (S.L.); (V.D.); (G.R.); (G.N.)
| | - Véronique D’Hondt
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, Parc Euromédecine, CEDEX 5, 34298 Montpellier, France; (M.J.); (P.S.); (S.M.); (J.-P.B.); (S.G.); (C.J.); (S.L.); (V.D.); (G.R.); (G.N.)
| | - Géraldine Lauridant
- Oscar Lambret Center, 3 Rue Frédéric Combemale, 59000 Lille, France; (G.L.); (L.V.)
| | - Julien Grenier
- Sainte-Catherine Institute, 1750 Chemin Lavarin, 84000 Avignon, France; (A.A.); (J.G.)
| | - Gilles Romieu
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, Parc Euromédecine, CEDEX 5, 34298 Montpellier, France; (M.J.); (P.S.); (S.M.); (J.-P.B.); (S.G.); (C.J.); (S.L.); (V.D.); (G.R.); (G.N.)
| | - Gregory Ninot
- Val d’Aurelle Montpellier Cancer Institute (ICM), 208 Avenue des Apothicaires, Parc Euromédecine, CEDEX 5, 34298 Montpellier, France; (M.J.); (P.S.); (S.M.); (J.-P.B.); (S.G.); (C.J.); (S.L.); (V.D.); (G.R.); (G.N.)
- Faculty of Medicine, University of Montpellier, Rue du Pr. Henri Serre, 34000 Montpellier, France
| | - Laurence Vanlemmens
- Oscar Lambret Center, 3 Rue Frédéric Combemale, 59000 Lille, France; (G.L.); (L.V.)
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Gonzalo‐Encabo P, McNeil J, Boyne DJ, Courneya KS, Friedenreich CM. Dose‐response effects of exercise on bone mineral density and content in post‐menopausal women. Scand J Med Sci Sports 2019; 29:1121-1129. [DOI: 10.1111/sms.13443] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 01/23/2023]
Affiliation(s)
- Paola Gonzalo‐Encabo
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta Alberta Health Services Calgary Alberta Canada
- Department of Biomedical Sciences and Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences University of Alcalá Madrid Spain
| | - Jessica McNeil
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta Alberta Health Services Calgary Alberta Canada
| | - Devon J. Boyne
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta Alberta Health Services Calgary Alberta Canada
- Department of Community Health Sciences, Cumming School of Medicine University of Calgary Calgary Alberta Canada
| | - Kerry S. Courneya
- Faculty of Kinesiology, Sport and Recreation University of Alberta Edmonton Alberta Canada
| | - Christine M. Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta Alberta Health Services Calgary Alberta Canada
- Department of Community Health Sciences, Cumming School of Medicine University of Calgary Calgary Alberta Canada
- Department of Oncology, Cumming School of Medicine University of Calgary Calgary Alberta Canada
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McNeil J, Farris MS, Ruan Y, Merry H, Lynch BM, Matthews CE, Courneya KS, Friedenreich CM. Effects of prescribed aerobic exercise volume on physical activity and sedentary time in postmenopausal women: a randomized controlled trial. Int J Behav Nutr Phys Act 2018; 15:27. [PMID: 29562927 PMCID: PMC5863375 DOI: 10.1186/s12966-018-0659-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 03/12/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Physical activity has emerged as an important lifestyle factor for primary prevention of numerous diseases, including postmenopausal breast cancer. No study to date has assessed the acute and long-term effects of year-long aerobic exercise programs differing in prescribed exercise volume on physical activity and sedentary time in postmenopausal women. Therefore, we aimed to examine the effects of two moderate-vigorous intensity exercise doses on total, light and moderate-vigorous intensity physical activity times, and sedentary time in postmenopausal women during the year-long intervention and one year later. METHODS The Breast Cancer and Exercise Trial in Alberta (BETA) was a two-center, two-arm, 12-month randomized controlled trial that included 400 previously inactive postmenopausal women randomized to either 150 (MODERATE) or 300 (HIGH) minutes/week of aerobic exercise. Physical activity and sedentary time were assessed at baseline, 6- (intervention mid-point), 12- (prior to end of intervention) and 24-months (follow-up) with waist-mounted accelerometers (Actigraph GTX3®). Self-reported activity and sedentary time at baseline, 12- and 24-months was also assessed (Past Year Total Physical Activity Questionnaire and SIT-Q). Intention-to-treat analyses were conducted using linear mixed models and adjusted for baseline variables. RESULTS Both physical activity interventions led to increases in objective and subjective measures of total and moderate-vigorous intensity/recreational physical activity time, coupled with decreases in sedentary time, at 6- and 12-months compared to baseline. Additionally, greater increases in accelerometry-derived total physical activity time at 6- and 12-months, and self-reported recreational activity time at 12-months, compared to baseline were noted in the HIGH versus MODERATE groups. Decreases in total, light and moderate-vigorous intensity physical activity time, and an increase in sedentary time, in both groups were noted at 24-months compared to 12-months. A decrease in light intensity physical activity time in both groups at 24-months compared to baseline was also noted. CONCLUSION These findings have important health implications, suggesting that total physical activity time can be increased with greater volumes of prescribed exercise, but that additional support and resources could be used to promote the maintenance of these high levels of aerobic exercise participation following study completion. TRIAL REGISTRATION clinicaltrials.gov identifier: NCT01435005 (BETA Trial). Registred September 15th 2011 (retrospectively registered).
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Affiliation(s)
- Jessica McNeil
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Center, Room 514, Box ACB, 2210 2nd Street SW, Calgary, Alberta T2S 3C3 Canada
| | - Megan S. Farris
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Center, Room 514, Box ACB, 2210 2nd Street SW, Calgary, Alberta T2S 3C3 Canada
| | - Yibing Ruan
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Center, Room 514, Box ACB, 2210 2nd Street SW, Calgary, Alberta T2S 3C3 Canada
| | - Heather Merry
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Center, Room 514, Box ACB, 2210 2nd Street SW, Calgary, Alberta T2S 3C3 Canada
| | - Brigid M. Lynch
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, VIC Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC Australia
| | - Charles E. Matthews
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD USA
| | - Kerry S. Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB Canada
| | - Christine M. Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Holy Cross Center, Room 514, Box ACB, 2210 2nd Street SW, Calgary, Alberta T2S 3C3 Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB Canada
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