A Qualitative Analysis of a Positive Elite Parasport Performance Culture

Organizational culture in sports affects well-being, performance, and overall success. Although team culture has been explored within able-bodied teams, little is known about culture development within parasport. Using a descriptive case study approach, our study examined the culture development and experiences of an elite parasport team. Two semistructured individual telephone interviews were conducted with nine participants (athletes and staff), and one athlete-participant completed one interview. An inductive thematic analysis revealed two themes: approach to culture development and team culture components. Culture development was linked with facilitative leadership and important resources. This supported the team to create their shared values and mechanisms, including a behavioral framework, other artifacts (e.g., shared language and team motto), and a relaxed environment. These helped to maintain their agreed culture and benefited their well-being, progress, and team cohesion. Our results offer a starting point regarding research into the culture of elite parasport and have practical implications for managers, coaches, and psychologists.

Prospective study of beginner running groups: psychological predictors and outcomes of participation

Running is an example of vigorous activity that leads to important health benefits if maintained. Beginner running groups provide supportive training programs to help people progress from walking to sustained running. This study explored the characteristics of individuals joining beginner running groups and the outcomes they achieve. New members of beginner running groups (n = 141; mean age 43 years, 122 female) completed online assessments at the start of their group program with 63 participants (45%) also completing a follow-up assessment at the end of the program. Validated scales were used to assess exercise behavior, mental wellbeing, self-efficacy, running identity and social physique anxiety. The majority of participants had low exercise levels at the start of the program (63%, n = 89). By the program end, 47 participants (75% of those completing the follow-up assessment) reported meeting the training goal (running for 30 minutes continuously) with self-efficacy, program adherence and younger age representing significant predictors of success. Significant improvements in exercise levels, mental wellbeing, self-efficacy, running identity and social physique anxiety were observed by the end of the program. In conclusion, beginner running programs attract low active individuals and may lead to improved levels of exercise and psychological outcomes. Additional research is needed to examine the extent to which improvements are sustained longer term.

COVID-19 and coping: Absence of previous mental health issues as a potential risk factor for poor wellbeing in females

COVID-19 has caused unprecedented disruption to everyday life. Unsurprisingly, this has resulted in increased prevalence of poor mental wellbeing. While previous mental health issues have been consistently flagged as a risk factor, the absence of these may also leave individuals vulnerable due to a lack of psychological coping strategies. This study explored the change in symptoms of anxiety, depression, and trauma in 167 females who provided data at four timepoints over the course of the first year of the pandemic. There was a significant effect of time on the extent of the change in depression but, for all wellbeing measures, those with current or previous mental health issues experienced a similar magnitude of change as those with no previous issues. This suggests that low-risk individuals may be faring worse, relatively. Ensuring that this group is not overlooked will be imperative in protecting and re-building the wellbeing of the nation.

Family body culture, disordered eating and mental health among young adult females during COVID-19

Different family interactions related to body weight and shape may co-occur and represent a broader 'family body culture'. This may be important in the context of COVID-19 due to a heightened focus on body weight/shape, and many young adults living back with their families. This study aimed to, first, explore relationships between different family body-related interactions to assess the presence of a family body culture, and second, explore relationships between aspects of family body culture, disordered eating and mental health among young adult females during the COVID-19 pandemic. Participants were 233 females aged 18-25 years who completed measures of family body culture (family fat talk; family weight concern; family weight teasing), disordered eating, anxiety and depression. Results showed all aspects of family body culture were significantly, positively related. Engaging in fat talk with family members (self fat talk) was a key correlate of disordered eating, anxiety and depression. Family concern with weight was also significantly associated with disordered eating. Findings suggest that among some families there is a more problematic family body culture with a greater importance placed on body weight and shape through various body-related interactions. Additionally, findings highlight two key aspects of family body culture related to disordered eating and wellbeing among young adult females. Specifically, vocalising critical remarks about one's own body when with family and an environment that may indirectly communicate a high importance of body weight and shape (e.g., via dieting). These should be considered in future family interventions to support healthy eating behaviours.

An intervention mapping adaptation framework to develop a self-help intervention for athletes with eating disorder symptoms

OBJECTIVE

This research forum describes the use of the intervention mapping for adaptation (IMA) framework to develop and evaluate a novel intervention for athletes with mild eating disorder (ED) symptoms.

METHODS

The six IMA steps were followed. In step 1 (needs assessment), we conducted a systematic review of athlete ED interventions and held interviews/focus groups with athletes and sports professionals to inform intervention format and delivery. In step 2 (intervention search), needs assessment information guided the search for an evidence-based intervention suitable for adaptation to athletes. In steps 3 and 4 (intervention development), the identified intervention was adapted and feedback sought from athletes and sport professionals. In steps 5 and 6 (implementation and evaluation), a feasibility study was conducted with athletes (n = 35; females: n = 27; Mage  = 27.1).

RESULTS

The review highlighted poor evidence for the acceptability and relative efficacy of existing interventions, which were all delivered face-to-face in groups. Interview/focus group data suggested a need for more accessible intervention formats (e.g., self-help). One non-athlete self-help intervention was determined suitable for adaptation to athletes, and adaptations were made. Initial feedback suggested the adapted intervention was relevant within sport settings. The feasibility study revealed that the intervention (MOPED-A: Motivational and Psycho-Educational Self-Help Programme for Athletes with Mild Eating Disorder Symptoms) can be feasibly implemented, is acceptable to athletes and shows potential for reducing ED symptoms.

DISCUSSION

IMA is a useful framework for developing participant-centered and evidence-based interventions. The findings and approach taken provide a framework for other researchers and clinicians in developing similar interventions in the ED domain.

PUBLIC SIGNIFICANCE

The novel self-help intervention described in this article was developed using intervention mapping and provides promise as a tool for reducing eating disorder symptoms in athletes. We describe how adopting and systematically following a health intervention development approach, such as intervention mapping, can ensure that eating disorder interventions are participant-centered, contextually relevant, and evidence-based, which in turn could help to maximize their reach and effectiveness.

Effects of engaging in mass participation sporting events on physical activity behaviour,: a systematic review

Mass participation sports event (MPSE)s have been identified as a potential referral pathway for engaging inactive patients in regular physical activity. This study aimed to review evidence of physical activity behaviour and associated health-related outcomes of engaging in MPSEs among the general population. A systematic review was performed of quantitative studies that examined the relationship between MPSEs and physical activity behaviour or secondary outcomes (e.g. physical activity motivation or confidence, physical or mental health) or any intervention to maintain physical activity following MPSEs. Search methods included searching five electronic databases and checking reference lists. Methodological quality was assessed using the Mixed Methods Appraisal Tool. A total of 2079 papers were identified, 142 were independently assessed for eligibility and 39 were included. Data from prospective cohort studies suggested that levels of physical activity achieved in training for MPSEs tended to drop in the months after, but increases were reported in some studies of novice participants. Interventions involving health promotion materials provided post-event led to small increases in physical activity. Perceived benefits of participating in MPSEs included physical and mental health, fitness, self-efficacy and social connections. Existing evidence suggests that MPSEs can act as a motivator to initiate exercise in preparation for the event, but there is limited evidence on how best to sustain physical activity post-event. Given the short duration of most studies, longer prospective analyses are needed to delineate patterns of habitual and event-related activity and account for seasonal effects.

The impact of critical comments from teammates on athletes' eating and exercise psychopathology

Critical comments from parents or coaches about weight or shape have been associated with athletes' body dissatisfaction and disordered eating. However, research is yet to explore how critical comments from an athlete's teammates may impact on eating and exercise psychopathology. This study aimed to (1) explore whether athletes who reported receiving a teammate critical comment have higher eating/exercise psychopathology and poorer psychological wellbeing versus matched athletes who have not, (2) determine whether gender differences exist in the perceived severity of critical comments and (3) evaluate the moderating role of gender when establishing the relative importance of explicit teammate critical comments versus implicit teammate influences (e.g., modelling) on eating/exercise psychopathology. Athletes (N = 646, Mage=23 years, n = 391 female) completed a survey exploring explicit/implicit teammate influences, psychological wellbeing (self-esteem, anxiety, depression) and eating/exercise psychopathology. Athletes receiving a teammate critical comment (n = 323) had significantly higher eating/exercise psychopathology, anxiety, and lower self-esteem compared to those who had not (n = 323). Females (n = 196) perceived the severity of the comment to be significantly worse than males (n = 127). Explicit critical comments had a greater influence on athletes' eating/exercise psychopathology versus implicit teammate influences. Disordered eating/compulsive exercise prevention efforts with athlete populations should highlight the detrimental impact that athletes' comments can have on teammates' wellbeing and body satisfaction.

The link between non-suicidal self-injury (NSSI), body image and activity on social networking sites among female adolescents with an eating disorder

The link between engagement in non-suicidal self-injury (NSSI)-related activities on SNS (e.g. viewing, commenting, sharing and uploading NSSI content) with body image and NSSI behaviour remains under researched in adolescents with EDs. The main aim of the current research was to examine associations between NSSI-related activities on SNS with body image and NSSI behaviour severity among female adolescents diagnosed with an ED. A total of 52 female adolescents (mean age = 15.35 years, SD = 1.49) diagnosed with an ED completed self-report questionnaires related to NSSI behaviour, SNS usage and body image. Participants were divided into two groups: low NSSI behaviour severity (from 0 to 10 NSSI behaviours; n = 28) and high NSSI behaviour severity (more than ten NSSI behaviours; n = 24). Within the high NSSI severity group, individuals that comment and share NSSI online content significantly reported higher negative body image. A hierarchical binary logistic regression showed that the frequency of NSSI online content on SNS emerged as significant predictor of NSSI behaviour severity within last year after controlling for body image and searching for ED content on SNS. Our findings suggest that not only searching for ED content, but also being daily engaged in NSSI online activities may increase the risk of NSSI behaviour severity in female adolescents with EDs.

Adherence and Health-Related Outcomes of Beginner Running Programs: A 10-Week Observational Study

Purpose: This study aimed to explore the determinants of adherence and assess changes in fitness and health outcomes in participants of group-based beginner running programs. Methods: Participants completed adherence diaries (n = 34) during the 10-week program, and underwent fitness and health testing (n = 20) at the program start and end. Diaries included weekly visual analogue scales of enjoyment, motivation, confidence, fatigue, satisfaction, and support along with a record of training sessions. Space was provided for free-text comments. Fitness was assessed by the multi-stage 20-m shuttle run test, and measurements were taken of resting heart rate, blood pressure, body composition, and free-living physical activity. Results: Overall adherence to the 10-week program was 53 ± 27% with injury the most common reason for missing sessions and for discontinuing training. Adherence to group sessions was positively correlated with enjoyment, motivation, confidence, satisfaction with progress, and social support. Qualitative analysis of diary entries indicated three distinct themes (self-awareness, social support, personal challenge) underlying progression through the program. Significant changes were observed after 10 weeks in distance run on the fitness test (+189 ± 133 m), body mass index (-0.54 ± 0.72 kg/m²), and percentage body fat (-1.5 ± 1.6%). Blood pressure, resting heart rate, and physical activity were unchanged. Conclusion: Engagement in beginner running programs was associated with improvements in cardiorespiratory fitness and body composition within 10 weeks. A larger and longer-term study is required to determine if these programs can lead to sustained engagement in running and additional health benefits.

Evaluating a motivational and psycho-educational self-help intervention for athletes with mild eating disorder symptoms: A mixed methods feasibility study

Objective

The primary aim was to assess the feasibility of undertaking a study evaluating the novel Motivational and Psycho‐Educational Self‐Help Programme for Athletes with Mild Eating Disorder Symptoms (MOPED‐A). A mixed‐methods approach was adopted to explore the feasibility of recruiting and retaining participants, and to evaluate the acceptability of measures, procedures and the intervention. A secondary aim was to explore the potential efficacy of MOPED‐A in reducing athletes' eating disorder symptoms.

Method

Thirty‐five athletes were recruited. Participation involved completing MOPED‐A over a 6‐week period and completing self‐report measures at baseline (T1), post‐intervention (T2) and 4‐week follow‐up (T3). A subsample (n = 15) completed an interview at T2.

Results

Retention was good throughout the study (n = 28; 80%). Quantitative and qualitative feedback suggested the format, delivery, content and dosage of MOPED‐A were acceptable. Athletes valued that the intervention was tailored to them, and this facilitated both participation and completion. Over a third of participants reported disclosing their eating difficulties and deciding to seek further support. Large reductions in eating disorder symptoms were detected at T2 and sustained at T3.

Conclusions

The MOPED‐A intervention can be feasibly implemented, is acceptable to participants, and demonstrates potential for reducing symptoms in athletes. A larger, controlled trial is warranted.

Participant recruitment to the study was feasible, and an acceptable proportion of participants were retained throughout the study.

This is the first study to show that the format and delivery of a self‐help intervention is acceptable to athletes with mild eating disorder symptoms, and that athletes valued the intervention being tailored to them which facilitated participation and completion.

The intervention demonstrates potential for reducing athletes' eating disorder symptoms.

Teammate influences, psychological well-being, and athletes' eating and exercise psychopathology: A moderated mediation analysis

OBJECTIVE

Positive and negative influences from teammates (e.g., supportive teammate friendships, modelling of teammates' disordered eating) have been associated with athletes' eating/exercise psychopathology. However, research is yet to explore how an athlete's psychological well-being and gender may impact upon these relationships. This study aimed to explore whether psychological well-being mediates the relationship between teammate influences and eating/exercise psychopathology, and to determine whether gender moderates the significant mediation effects identified.

METHOD

Athletes (N = 195, mean age 18.35 years, n = 110 female, n = 81 lean sport athletes) completed a survey three times over an 8-month period exploring teammate influences, psychological well-being (self-esteem, anxiety, depression) and eating/exercise psychopathology. Mediation and moderated-mediation analyses were conducted.

RESULTS

Higher levels of anxiety significantly mediated the positive relationships between bulimia modelling and teammate pressure with eating and exercise psychopathology. Higher levels of depression significantly mediated the positive relationship between teammate pressure and body dissatisfaction, and the negative relationship between supportive friendships and body dissatisfaction. Higher levels of self-esteem mediated both inverse relationships between supportive friendships and a lower drive for thinness (fully) and body dissatisfaction (partially). Gender did not significantly moderate any mediation relationships.

DISCUSSION

Male and female athletes with poor psychological well-being (i.e., high levels of anxiety or depression) are more susceptible to negative teammate influences, while athletes with good psychological well-being (i.e., high self-esteem) reap the protective benefits of supportive teammate friendships. Understanding the circumstances under which teammates are influential is vital for the development of targeted intervention and prevention strategies to reduce athlete eating and exercise psychopathology.

Teammate influences and relationship quality are associated with eating and exercise psychopathology in athletes

Teammates have a powerful influence on athletes' eating attitudes/behaviours, but less is known about the relative importance of teammate influence mechanisms. The primary aim of this study was to explore the relationships and predictive associations between teammate influences (e.g., modelling of teammates' disordered eating; supportive teammate friendships) and athletes' eating and exercise attitudes and behaviours. A further aim was to identify the presence of any gender differences. Athletes (N = 1172, mean age 24 years, n = 727 female) completed a survey exploring multiple teammate influences, eating and exercise attitudes and behaviours, and psychological wellbeing (anxiety, depression, self-esteem). Many significant relationships were identified between teammate influences and eating/exercise psychopathology. Stepwise regression analysis revealed that a perceived pressure from teammates to lose weight/change shape and perceptions that teammates engaged in disordered eating practices were the best predictors of higher eating and exercise psychopathology. Supportive teammate friendships was the best predictor of lower eating psychopathology and higher levels of healthy exercise behaviours. Encouragement/discouragement to eat healthily were also significant predictors. Teammate influences explained more variance in exercise than eating psychopathology, and total variance explained by teammates was higher for females compared to males. Teammates may have a positive and negative influence on the eating and exercise attitudes/behaviours of athletes; however, gender differences are apparent. Understanding teammate influences on the eating and exercise practices of athletes is important for the development of team-based interventions to reduce or prevent disordered eating and exercise. Future research should explore these relationships longitudinally, considering the role of moderating factors (e.g., sport type, stage of season).

Monitoring eating and activity: Links with disordered eating, compulsive exercise, and general wellbeing among young adults

OBJECTIVE

To explore the relationships between the use of food intake and activity monitoring tools with compulsive exercise, eating psychopathology, and psychological wellbeing.

METHOD

Participants (N = 352; mean age 21.90 years) indicated their use of activity and food intake monitoring tools, and completed the Compulsive Exercise Test (CET), Eating Disorders Examination Questionnaire (EDE-Q), and the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS).

RESULTS

Users of monitoring tools reported significantly higher CET and EDE-Q scores than nonusers. Positive associations were detected between the frequency of activity monitoring tool use with CET and EDE-Q scores. Participants who reported using monitoring tools primarily to manage weight and shape reported higher levels of eating and compulsive exercise psychopathology than those who reported using tools to improve health and fitness.

DISCUSSION

Features of compulsive exercise and eating psychopathology are elevated among users of food intake and activity monitoring tools; and particularly among those who report using the tools for weight and shape purposes. Longitudinal and experimental research is needed to further our understanding of these observed associations, and specifically to explore the prospective relationships between monitoring tool use, eating psychopathology, and compulsive exercise.

Detecting Eating Psychopathology in Female Athletes by Asking About Exercise: Use of the Compulsive Exercise Test

The present study assessed the suitability of the Compulsive Exercise Test (athlete version; CET-A) for identifying female athletes with clinically significant features related to or comparable with eating psychopathology. Three hundred and sixty-one female athletes (including 12 with a clinically diagnosed eating disorder) completed the Eating Disorders Examination Questionnaire and the CET-A. Receiver operating curve analysis was employed to identify a cut-off value on the CET-A, which could indicate clinically significant features related to or comparable with eating psychopathology among female athletes. The analysis demonstrated that a CET-A score of 10 successfully discriminated female athletes with a current eating disorder. The results suggest that the CET-A may be a suitable tool for detecting eating psychopathology in female athletes. Additional longitudinal research is needed to evaluate the predictive value of the CET-A. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

Female athlete experiences of seeking and receiving treatment for an eating disorder

Clinical eating disorders are common among athletes; however research has yet to explore the process of seeking and receiving treatment for an eating disorder in this population. Semi-structured interviews were conducted with 13 female athletes currently receiving treatment for an eating disorder. A total of three themes emerged: challenges to treatment seeking, feeling out of place, and coping with exercise transitions. Athletes reported low levels of eating disorder literacy and lacked motivation to engage with therapy due to a lack of perceived relevance. Athletes found it challenging to relinquish exercise behaviours in treatment and expressed concerns around managing a return to sport. It may be necessary to provide additional support to athletes when embarking on and leaving treatment programs, particularly with regards to managing expectations about exercise.

Learning to eat again: Intuitive eating practices among retired female collegiate athletes

The present study used an open-ended survey to collect information about current eating practices and coping strategies among 218 retired female athletes. An inductive and deductive thematic analysis revealed three themes relevant to the intuitive eating framework-permission to eat; recognizing internal hunger and satiety cues; and eating to meet physical and nutritional needs. Athletes described feeling liberated with regards to their eating following retirement from sport, and for some this included an alleviation of disordered eating practices. These changes, however, required an effortful process of recalibration, during which athletes had to relearn and reinterpret their body's physiological signals of hunger and satiety. Additional research is needed to understand just how this process unfolds and how retired athletes can be supported in developing a healthier and more adaptive approach to eating.

From scientific theory to classroom practice

The importance of neuroscience in education is becoming widely recognized by both neuroscientists and educators. However, to date, there has been little effective collaboration between the two groups, resulting in the spread of ideas in education poorly based on neuroscience. For their part, educators are often too busy to develop sufficient scientific literacy, and neuroscientists are put off collaborations with risk of overinterpretation of their work. We designed and led a successful 6-month collaborative project between educators and neuroscientists. The project consisted of a series of seminars on topics chosen by both parties such as the neuroscience of attention, learning, and memory and aimed to create a dialog between the two. Here, we report that all teachers found the seminars relevant to their practice and that the majority felt the information was presented in an accessible manner. Such was the success of the project that teachers felt there were direct changes in their classroom practice as a consequence and that the course should be more widely available. We suggest that this format of co-constructed dialog allows for lucrative collaborations between neuroscientists and educators and may be a step to bridging the waters that separate these intrinsically linked disciplines.