Physical Activity Goals Research Articles

Risk factor control and adherence to recommended Lifestyle among US hypertension patients

BackgroundAlthough hypertension is a significant public health challenge globally, only a few studies have assessed the effectiveness of risk factor control and adherence to recommended lifestyle among United States hypertension patients.MethodsIn this study, a detailed, stratified analysis of the 1999–2018 National Health and Nutrition Examination Survey was conducted to assess the adequacy of risk factor control and conformity to recommended lifestyle among United States patients with hypertension. Logistic regression analysis was used to identify influencing factors associated with not acheving risk factors and lifestyle targets.ResultsA total of 21,770 participants (mean age, 62 ± 15 years) were enrolled in this study. About one in five (20%) participants achieved the recommended body mass index goal, 40% achieved the low-density lipoprotein cholesterol goal, and 30% achieved the recommended waist circumference. Most patients (80%) achieved the recommended smoking goal, 58% met the recommended alcohol consumption, and 19% achieved the recommended physical activity goal. Multivariate analysis demonstrated that age, gender, race, education, metabolic syndrome, and diabetes mellitus were independent predictors of not achieving risk factors and lifestyle targets.ConclusionsControlling risk factors and adherence to recommended lifestyles are not ideal for hypertension patients. Therefore, further research should assess how to improve the compliance rate and take targeted measures based on influencing factors for long-term prognosis.

Device-based 24-hour movement behaviours in adult phase III cardiac rehabilitation service-users during the COVID-19 pandemic: a mixed-methods prospective observational study

Purpose To examine changes in device-based 24-hour movement behaviours (MB), and facilitators and barriers to physical activity (PA) and exercise, during remotely-delivered cardiac rehabilitation (RDCR). Materials and methods This prospective observational study used wrist-worn GENEActiv accelerometers to assess MB of 10 service-users (63 ± 10 years) at the start, middle, and end of three-months of RDCR. Barriers and facilitators to PA and exercise were explored through self-report diaries and analysed using content analysis. Results At start, service-users were sedentary for 12.6 ± 0.7 h · day−1 and accumulated most PA at a light-intensity (133.52 ± 28.57 min · day−1) – neither changed significantly during RDCR. Sleep efficiency significantly reduced from start (88.80 ± 4.2%) to the end (86.1 ± 4.76%) of CR, with values meeting health-based recommendations (≥85%). Barriers to RDCR exercise included exertional discomfort and cardiac symptoms, and reduced confidence when exercising alone. Setting meaningful PA goals, self-monitoring health targets, and having social support, facilitated PA and exercise during RDCR. Conclusions Our RDCR programme failed to elicit significant changes in MB or sleep. To increase the likelihood of successful RDCR, it is important to promote a variety of exercise and PA options, target sedentary time, and apply theory to RDCR design, delivery, and support strategies.

Increasing adolescents’ physical activity levels through a comprehensive school-based physical activity program: study protocol of the cluster randomized controlled trial Active School

BackgroundThe positive effects of regular physical activity on children and adolescents’ physical and mental health are well-established. Despite these health benefits, most Swiss adolescents do not meet WHO’s recommended level of physical activity, which includes a daily minimum of 60 min of moderate-to-vigorous physical activity. Due to their inclusivity, schools are identified as a key setting to promote physical activity. Recently, the comprehensive school physical activity program (CSPAP), in which teachers as physical activity leaders (PALs) play a crucial role to advance comprehensive school-based physical activity promotion, has been discussed. However, such comprehensive approaches are still lacking in Switzerland, and specific PAL trainings do not exist. Therefore, the aim of this study is to implement and evaluate Active School, a comprehensive school-based physical activity program for Swiss secondary schools with integrated PAL training.Methods/designA cluster randomized controlled trial (RCT) involving 12 secondary schools (6 experimental, 6 waiting control schools) will assess baseline data and effectiveness of Active School at 12 and 24 months. Active School includes five components based on the CSPAP. Each school is encouraged to set individual physical activity goals in this regard. This process is guided by the PALs, who will participate in professional development training before and during Active School implementation. As a primary outcome, students’ moderate-to-vigorous physical activity will be assessed via accelerometers. As secondary outcomes, inactivity, light physical activity, step counts, aerobic fitness and coordination will be measured, and students’ general wellbeing, learning behavior, and multiple psychosocial measures related to physical activity will be assessed by questionnaires. The effectiveness evaluation is accompanied by a process evaluation that focuses on the implementation outcomes of dose of delivery, reach, feasibility, and sustainability. A mixed methods approach, including ripple effect mapping, will be employed to reconstruct and understand the implementation process.DiscussionThis study will be the first to implement and evaluate a CSPAP in the Swiss school system. The specific PAL training and the simultaneous application of effectiveness and process evaluation are considered strengths of the study.Trial registrationGerman Clinical Trials Register (DRKS00033362). Date of registration: January 25, 2024. Retrospectively registered.

Goal Setting Moderates Behavior Change Outcomes in College Students After an Online Health Coaching Intervention

ABSTRACT Background Health coaching sessions that incorporate goal setting may help improve college students' health behaviors. Purpose This study examined whether specific goal-setting practices moderated changes in health behaviors during an online wellness intervention in college students. Methods Participants were 90 college students recruited from one US university. The intervention was a one-hour virtual one-on-one health coaching session where participants set two goals for either physical activity (Metabolic Equivalent Task (MET)-minutes or MET-minutes), nutrition, sleep, or stress management. Self-reported baseline behaviors were collected, and follow-up surveys were completed at 6- and 12-weeks. Mixed effects models examined behavior change outcomes across the follow-up timepoints while testing the moderating effect of goal setting using interactions. Results The Goal×Time interaction was significant for moderate MET-minutes at 1st follow-up (b = 443, p = .003), and for total MET-minutes at the 2nd follow-up (b = 717, p = .047). The Goal×Time interaction was also significant for stress management at 1st follow-up (Odds Ratio = 7.3, p = .042). Discussion Participants who set physical activity and stress management goals had significantly higher physical activity and utilized more stress management techniques. Translation to Health Education Practice The use of specific goal-setting strategies for physical activity and stress management is recommended during online health coaching sessions. A AJHE Self-Study quiz is online for this article via the SHAPE America Online Institute (SAOI) http://portal.shapeamerica.org/trn-Webinars.

Design & Baseline Characteristics of Preactive-PD Telehealth Coaching to Increase Physical Activity in Early-Stage Parkinson’s Disease: A Randomized Controlled Trial

Abstract Date Presented 03/23/24 PreActive-PD, a randomized controlled trial, will evaluate the effects of telehealth coaching to support physical activity goal setting and participation in people with early-stage Parkinson’s disease. Design and baseline characteristics will be discussed. Primary Author and Speaker: Katrina M. Long Additional Authors and Speakers: Alissa C. Pacheco Contributing Authors: Lori Quinn

KArAT (Knee Arthroplasty Activity Trial): rationale and design features of a multicenter randomized controlled trial

BackgroundTotal knee arthroplasty (TKA) is commonly performed to relieve pain in persons with severe knee osteoarthritis. Despite substantial pain reduction and functional improvements, physical activity (PA) does not necessarily increase post TKA. The premise for this randomized trial is that a behavioral intervention invoking internal and external motivators could lead to improvement in PA uptake post TKA. MethodsKArAT (the Knee Arthroplasty Activity Trial) is a three-arm multi-center randomized controlled trial designed to establish the efficacy and sustainability of a personalized behavioral intervention in improving PA among TKA recipients with a primary diagnosis of knee osteoarthritis. The three arms include: 1) usual care, 2) attention control with Fitbit activity trackers, and 3) health coaching and financial incentives for reaching personalized PA goals. The primary outcome is defined as the proportion of participants engaged in at least 150 minutes of moderate-to-vigorous physical activity over a given week after the 6-month intervention. We also plan to conduct a cost-effectiveness analysis to establish the value and affordability of the KArAT interventions. DiscussionThis paper aims to outline the rationale, study design, and implementation of KArAT. Trial RegistrationClinicaltrials.gov NCT04107649

Development of a Novel Mobile Health App to Empower Young People With Type 1 Diabetes to Exercise Safely: Co-Design Approach.

Blood glucose management around exercise is challenging for youth with type 1 diabetes (T1D). Previous research has indicated interventions including decision-support aids to better support youth to effectively contextualize blood glucose results and take appropriate action to optimize glucose levels during and after exercise. Mobile health (mHealth) apps help deliver health behavior interventions to youth with T1D, given the use of technology for glucose monitoring, insulin dosing, and carbohydrate counting. We aimed to develop a novel prototype mHealth app to support exercise management among youth with T1D, detail the application of a co-design process and design thinking principles to inform app design and development, and identify app content and functionality that youth with T1D need to meet their physical activity goals. A co-design approach with a user-centered design thinking framework was used to develop a prototype mHealth app "acT1ve" during the 18-month design process (March 2018 to September 2019). To better understand and respond to the challenges among youth with diabetes when physically active, 10 focus groups were conducted with youth aged 13-25 years with T1D and parents of youth with T1D. Thereafter, we conducted participatory design workshops with youth to identify key app features that would support individual needs when physically active. These features were incorporated into a wireframe, which was critically reviewed by participants. A beta version of "acT1ve" was built in iOS and android operating systems, which underwent critical review by end users, clinicians, researchers, experts in exercise and T1D, and app designers. Sixty youth with T1D, 14 parents, 6 researchers, and 10 clinicians were engaged in the development of "acT1ve." acT1ve included key features identified by youth, which would support their individual needs when physically active. It provided advice on carbohydrates and insulin during exercise, information on hypoglycemia treatment, pre- and postexercise advice, and an educational food guide regarding exercise management. "acT1ve" contained an exercise advisor algorithm comprising 240 pathways developed by experts in diabetes and exercise research. Based on participant input during exercise, acT1ve provided personalized insulin and carbohydrate advice for exercise lasting up to 60 minutes. It also contains other features including an activity log, which displays a complete record of the end users' activities and associated exercise advice provided by the app's algorithm for later reference, and regular reminder notifications for end users to check or monitor their glucose levels. The co-design approach and the practical application of the user-centered design thinking framework were successfully applied in developing "acT1ve." The design thinking processes allowed youth with T1D to identify app features that would support them to be physically active, and particularly enabled the delivery of individualized advice. Furthermore, app development has been described in detail to help guide others embarking on a similar project. Australian New Zealand Clinical Trials Registry ACTRN12619001414101; https://tinyurl.com/mu9jvn2d.

Walk to recovery: an evaluation of adventure therapy in an early intervention for psychosis service

ABSTRACT Background It was considered useful to describe service-users’ and staff’s experience of Adventure Therapy (AT) in an Early Intervention for Psychosis (EIP) service, exploring the impact on personal wellbeing and feasibility of use. Method Focus groups were conducted with 14 participants, immediately following, and three months after a four day hiking trip. Transcripts were analysed using inductive thematic analysis. Questionnaires were administered pre and post trip to describe service-users’ physical activity, recovery and personal goals. Results A majority of participants reported progress towards personal goals on the AT trip and improvements in confidence and connectedness. Questionnaire items did not show improvements in physical activity and recovery measures at 3- and 6-month follow-up. Four key themes emerged from the focus groups. The themes centred around the social experience of being in relation to others and a more personal emotional experience: (a) social connectedness, (b) challenging perceptions of self-capabilities, (c) positive reaction to new experiences and (d) motivation for more. Discussion AT was positively experienced by both staff and service-users. Key areas of benefit were recognised and considered for utilisation in services in different ways. Further studies are warranted exploring maintaining and supporting benefits gained following AT.

Predictive Model of the Relationship between Appearance, Eating Attitudes, and Physical Activity Behavior in Young People amid COVID-19.

This cross-sectional study conducted in Poland explored the relationship between the fear of negative appearance evaluations, eating disorders, and physical activity objectives, particularly during the COVID-19 pandemic. The Fear of Negative Appearance Evaluation Scale (FNAES), the Eating Attitude Test (EAT-26), and the Physical Activity Goals Inventory (IPAO) were administered to 644 participants (455 males with a mean age of 35.2 ± 6.2 years and 189 females with a mean age of 30.18 ± 5.7 years). This study explored the effects of gender, age, and body mass index (BMI) on FNAES, EAT-26, and IPAO scores. The results of this study demonstrated that females scored higher on fear of negative appearance, peaking at 41-50 years of age. Distinct BMI categories were associated with different negative appearance fear scores, eating attitudes, and physical activity objectives. Significant correlations were also found between the fear of negative appearance, dietary attitudes, and physical activity goals. Eating attitudes completely moderated the relationship between the fear of negative appearance and physical activity objectives. A significant interaction effect of age and body mass index on physical activity objectives was also revealed. These results highlight the relevance of considering gender, age, and body mass index when examining the associations between the fear of negative appearance, eating attitudes, and physical activity objectives.

Virtual fitness buddy ecosystem: a mixed reality precision health physical activity intervention for children

6–11-year-old children provide a critical window for physical activity (PA) interventions. The Virtual Fitness Buddy ecosystem is a precision health PA intervention for children integrating mixed reality technology to connect people and devices. A cluster randomized, controlled trial was conducted across 19 afterschool sites over two 6-month cohorts to test its efficacy in increasing PA and decreasing sedentary behavior. In the treatment group, a custom virtual dog via a mixed reality kiosk helped children set PA goals while sharing progress with parents to receive feedback and support. Children in the control group set PA goals using a computer without support from the virtual dog or parents. 303 children had 8+ hours of PA data on at least one day of each of the 3 intervention time intervals. Conversion of sedentary time was primarily to light-intensity PA and was strongest for children with low baseline moderate-to-vigorous PA than children above 45 min of baseline moderate-to-vigorous PA. Findings suggest that the VFB ecosystem can promote sustainable PA in children and may be rapidly diffused for widespread public health impact.

Feasibility of a Physical Activity Index in Clinical Practice: Perspectives of Providers and Cancer Patients

In Brief Physical activity is a common clinical recommendation for cancer survivors, yet the use of clinical tools to counsel patients is understudied. We developed an integrated Physical Activity Index to assist with this task. The purpose of this project was to conduct interviews to assess the feasibility and clinical utility of the Physical Activity Index from both provider and patient perspectives. Our findings indicate that a Physical Activity Index may be a useful tool to facilitate productive patient-provider communication about physical activity goals.

Physical Activity with Sports Scientist (PASS) programme to promote physical activity among patients with non-communicable diseases: a pragmatic randomised controlled trial protocol

Physical activity (PA) effectively prevents and treats non-communicable diseases in clinical settings. PA promotion needs to be more consistent, especially in busy primary care. Sports scientists have the potential to...

Re-signifying HIV through exercise: from death sentence stigma to healthy self-perception

ABSTRACT Despite HIV being considered a chronic disease and the benefits that exercise interventions can bring to HIV-infected patients, the application of physical activity is currently low. Some qualitative studies have been conducted; however, it is currently little known about the meaning of the experience of exercising in people with HIV. This hermeneutic research used 21 in-depth, semi-structured interviews with patients with this condition. The analysis was based on a grounded Theory methodology, which is theoretically supported by symbolic interactionism. It was possible to advance in re-signifying HIV from a social stigma context. This process, through exercise and social, family and medical support, comes from the breaking of individual and collective perception paradigms. Particularly, exercise changes the perspective from a HIV-infected person on the verge of death to a healthy, active and functional individual with personal goals. Thus, by contributing to functionality and health recovery, exercise re-signifies life. Moreover, commitment to physical activity goals is influenced by inner tensions that can hinder or encourage this habit and demand further research. HIV infection shifts from being a death sentence to a healthy self-perception beyond the diagnosis.

The Impact of Monetary Incentives on Delay Discounting Within a Year-Long Physical Activity Intervention.

Delay discounting is the depreciation in a reward's perceived value as a function of the time until receipt. Monetary incentive programs that provide rewards contingent on meeting daily physical activity (PA) goals may change participants' delay discounting preferences. Determine if monetary incentives provided in close temporal proximity to meeting PA goals changed delay discounting, and if such changes mediated intervention effects. Inactive adults (n = 512) wore accelerometers during a 12-month intervention where they received proximal monetary incentives for meeting daily moderate-to-vigorous PA (MVPA) goals or delayed incentives for study participation. Delay discount rate and average MVPA were assessed at baseline, end of intervention, and a 24-month follow-up. Using structural equation modeling, we tested effects of proximal versus delayed rewards on delay discounting and whether any changes mediated intervention effects on MVPA. PA self-efficacy was also evaluated as a potential mediator, and both self-efficacy and delay discounting were assessed as potential moderators of intervention effects. Proximal rewards significantly increased participants' delay discounting (β = 0.238, confidence interval [CI]: -0.078, 0.380), indicating greater sensitivity to reinforcement timing. This change did not mediate incentive-associated increases in MVPA at the end of the 12-month intervention (β = -0.016, CI: -0.053, 0.019) or at a 24-month follow-up (β = -0.020, CI: -0.059, 0.018). Moderation effects were not found. Incentive-induced increases in delay discounting did not deleteriously impact MVPA. This finding may help assuage concerns about using monetary incentives for PA promotion, but further research regarding the consequences of changes in delay discounting is warranted.

Abstract P469: Ambient Weather is Associated With Sleep and Activity in Rural South

Background: Physical activity and sleep are two of the Life’s Essential 8 steps for a healthy lifestyle and prevention of cardiovascular disease. The role of weather on an individual’s ability to meet physical activity and sleep goals is unknown. This is relevant in rural settings where the risk of cardiovascular disease is disproportionately high and extreme weather patterns are common. Objective: To investigate the association between local weather conditions and physical activity and sleep, as measured by Fitbit devices among participants in rural Alabama. Methods: Participants were enrolled from rural counties in Alabama as part of an observational study to understand cardiovascular risk in the rural Southeast. Each enrolled participant was given a Fitbit device to collect physical activity and sleep data, including total steps per day and sleep duration for six months. Weather data were obtained from a NOAA Regional Climate Center’s Applied Climate Information System for the dates each participant collected physical activity and sleep data using the participants’ zip code as location. A linear mixed effects model was used to examine the associations of daily precipitation, minimum and maximum daily ambient temperature (modeled as tertiles), BMI, gender, and age with sleep duration and daily physical activity. Results: A total of 942 participants were enrolled in the subcohort from the Alabama counties and 716 (76%) received a Fitbit device. Complete data were available from 561 participants generating 63,176 study-days. The subcohort average age was 48.8 with average BMI of 36.0 Kg/m 2 , 70% (n =660) female, and 78.7% (n = 751) Black. On average, women slept 29.1 more minutes every night (p< 0.001) but recorded 1,225 fewer steps (p <0.001) in comparison to men. An increase in BMI (1 Kg/m 2 increment) was associated with lesser sleep duration (0.98 minutes; p = 0.02) and lower daily step count (70.5, p <0.001). After adjusting for confounders, the upper tertile of ambient daily maximum temperature was associated with lesser sleep duration (5.3 minutes, p<0.001) and physical activity (218 steps, p < 0.001) in comparison to the middle tertile (referent). Conversely lowest tertile of ambient daily maximum temperature was associated with longer sleep duration (5.7 minutes, p=0.003) but not physical activity (22.0 steps, p = 0.71). An increase of an inch of ambient daily precipitation was not significantly associated with sleep duration (p=.49) but was associated with decreased physical activity (251 steps p <0.001). Conclusions: In our cross-sectional study, local temperature and precipitation were associated with lesser sleep duration and physical activity. Further analyses are warranted to understand patterns of these associations and the identification of factors that exacerbate or mitigate these weather-related associations may inform clinical practices and research direction.

Key strategies for improving physical activity of the population within a global dimension

Topicality. As a result of the war before Ukraine has faced extremely difficult challenges. General situation remains dynamic and unstable. Based on research results it is determined that a lot of things, in particular, direction and pace of further transformations in Ukraine in the post-war period, depend on the level and quality of life of the population. The quality of life in the human health context is determined by certain factors, among which the physical activity is as the leading one. Its lack is considered as the fourth leading factor risk of global mortality. The purpose of the study is to carry out an analysis of the international key strategies experience for improving physical activity of the working-age population. Methodology. A semantic bibliography method followed by content analysis of research papers and e-resources have been used. The research novelty. Investigating the negative impact of physical activity lack on public health, World Health Organization (WHO) and the European Union (EU) reported global efforts to improve the situation by developing national programs and recommendations on the issue of increasing the levels of physical activity and reducing a sedentary lifestyle. Most of the member states already have, or currently have, physical activity recommendations, or some of them are being at the development stage. Key findings. There is a general trend the use of the WHO Global Recommendations, which indicates a common scientific consensus on the importance of physical activity and sustainable nature of these recommendations in the global health context. In addition, coordination of national health monitoring programs will allow monitor progress towards both national and global goals of physical activity and reduction of the sedentary lifestyle. It a significant component of assessment the effectiveness of national view and programs on solving issues related to the health of the nation.

Increasing Employee Physical Activity Using Goal Setting and a Smartphone App.

Physical inactivity is a high-priority public health issue in U.S. worksites. There is evidence that physical activity (PA) goal-setting interventions can be effective. Smartphone apps have also been used to deliver accessible and appealing PA interventions. This article describes the use of goal setting and a no-cost PA smartphone app to pilot an 8-week PA intervention, Project Move 2.0, to increase PA among a nonprofit health and social assistance workforce. The community-based partnership identified intervention strategies that addressed moderators for setting PA goals: feedback, goal commitment, situational factors, and ability. The intervention included the use of a no-cost smartphone app for tracking steps/goal setting, an orientation/health education session, weekly text messages, as well as pre- and post-measures for goal setting for PA behaviors and an intervention evaluation questionnaire. There is limited knowledge on the practical aspects of applying goal setting and the use of a no-cost smartphone app to increase employee PA through a workplace PA intervention. Applying goal setting and the use of a no-cost smartphone app shows promise for workplace health promoters to successfully address employee PA.

Telehealth for healthy gestational weight gain among overweight pregnant women: A systematic review

Introduction: Excessive Gestational Weight Gain (GWG) is associated with various complications during pregnancy and childbirth. In contrast, digital interventions like telehealth offer cost-effective solutions with broader accessibility. Therefore, our outcomes are to analyze the effectiveness of telehealth interventions for healthy GWG among overweight and obese pregnant women and to know which features are needed in telehealth for healthier GWG.Methods: We undertook a systematic review to address the objectives mentioned above. Initially, we employed the keywords telehealth, pregnant women, and overweight, which were subsequently refined using Medical Subject Headings provided by the National Center for Biotechnology Information. To identify relevant articles, we searched six databases—Scopus, SAGE Journals, Web of Science, PubMed, ScienceDirect, and ProQuest.Results: We included 15 articles in this review according to the criteria. Eleven papers show a positive effect of telehealth in promoting healthy GWG. Telehealth encompasses various functionalities, such as providing information, push notifications, self-monitoring, and feedback features related to gestational weight gain (GWG), maintaining a healthy diet, engaging in physical activity, receiving reminders, managing stress, and setting goals. On the other hand, four papers show no significant difference between telehealth and regular interventions.Conclusions: Telehealth is alternatively effective to use as an additional intervention to promote healthier GWG in overweight pregnant women. Keywords: gestational weight gain; overweight; pregnant women; telemedicine

Qualitative Description of Exercise Perceptions and Experiences Among People With Human Immunodeficiency Virus in the High-Intensity Exercise to Attenuate Limitations and Train Habits Study.

The benefits of physical activity (PA), specifically exercise, among older adults in general are well known. Yet globally, there is concern regarding limited engagement in PA, increased obesity, and frailty among older people with human immunodeficiency virus related to low levels of PA. We conducted in-depth interviews among 30 older, sedentary people with human immunodeficiency virus participating in the ongoing High-Intensity Exercise to Attenuate Limitations and Train Habits (HEALTH study, NCT04550676) between February 2021 and August 2022. A semistructured interview guide, informed by two minds theory, which frames behavior change as an intention-behavior gap between 2 neurocognitive systems, was used to elicit data from participants. Interviews explored general exercise perceptions, self-efficacy for exercise, mobile health intervention tailoring, outcome expectations, and PA goals. Thirty interviews from 33 participants were recorded and transcribed verbatim, and deductive and inductive thematic analysis were used using Dedoose. Physical activity was defined as maintaining daily living activities and addressing health goals. Previous experiences with PA varied among participants and were influenced by chronic illnesses, including human immunodeficiency virus; motivation; work commitments; interest; and social support. Reported barriers to PA included antiretroviral adverse effects, comorbidities, aging, and the COVID-19 pandemic. Changes in health status, body changes, and relationships were identified as benefits of PA. Conversations with healthcare providers supporting exercise goals were perceived to be important but rarely received by the participants. Understanding how older people with human immunodeficiency virus perceive PA is crucial to developing tailored strategies and structuring service delivery within the healthcare setting to promote a physically active life.

Does exposure to sedentary temptations activate physical activity goals? A high-powered replication study.

Does exposure to sedentary temptations activate physical activity goals? A high-powered replication study.