Long-term Physical Activity Behaviour Research Articles

Maintaining long-term physical activity after cancer: a conceptual framework to inform intervention development.

This paper describes a conceptual framework of maintenance of physical activity (PA) and its application to future intervention design. Evidence from systematic literature reviews and in-depth (N = 27) qualitative interviews with individuals with cancer were used to develop a conceptual framework of long-term physical activity behaviour. Determinants of long-term PA were listed and linked with domains of the Theoretical Domains Framework which in turn were linked to associated behaviour change techniques (BCTs) and finally to proposed mechanisms of action (MoA). The conceptual framework is presented within the context of non-modifiable contextual factors (such as demographic and material resources) and in the presence of learnt and adapted behavioural determinants of skills, competence and autonomous motivation that must be established as part of the initiation of physical activity behaviour. An inventory of 8 determinants of engagement in long-term PA after cancer was developed. Clusters of BCTs are presented along with proposed MoA which can be tested using mediation analysis in future trials. Understanding the processes of PA maintenance after cancer and presentation of implementable and testable intervention components and mechanisms of action to promote continued PA can inform future intervention development. This resource can act as a starting point for selection of intervention components for those developing future interventions. This will facilitate effective support of individuals affected by cancer to maintain PA for the long term.

The effects of exercise therapy feedback on subjective treatment outcome and patient satisfaction: study protocol for a mono-centric, randomized, controlled trial in orthopedic rehabilitation (FeedYou)

BackgroundThe disease burden of musculoskeletal disorders necessitates multidisciplinary and patient-centered models of care. Exercise therapy represents a first-line treatment strategy and a central component of medical rehabilitation. In order to realize the goals of long-term physical activity and participation as proposed by the ICF, exercise therapy can be supplemented by interventional techniques from the field of psychotherapy. Although psychotherapist feedback has been shown to improve therapeutic outcome and patient satisfaction, feedback use in exercise therapy is mostly limited to motor learning and exercise instruction. The present paper therefore describes the use of multidimensional exercise therapy feedback in medical rehabilitation. The aims of the trial presented in this study protocol are to evaluate the effects of this novel feedback approach on rehabilitation outcomes in comparison to usual care.MethodsThe study is designed as a prospective, mono-centric, randomized controlled, superiority trial (RCT) with two parallel groups and three measuring points: T0 = start of three-week inpatient rehabilitation, T1 = end of three-week inpatient rehabilitation, T2 = 12-week follow-up. In total, 132 patients suffering from chronic neck, shoulder and/or lumbar spine disorders will be recruited. The intervention involves multidimensional exercise therapy feedbacks during the initial and final physical therapist examination, as well as short exercise therapy feedbacks during the course units of the mandatory group-based exercise therapy program. Primary outcomes are the subjective treatment outcome, assessed by BPI and indication-specific questionnaires, as well as patient satisfaction, assessed by ZUF-8 and an intervention-specific questionnaire. The final data collection is expected by May 2023.DiscussionThis study may provide a valuable insight into the effectiveness of multidimensional exercise therapy feedback to improve treatment outcomes and patient satisfaction in medical rehabilitation. This could contribute to rehabilitation quality assurance and the long-term physical activity behavior of rehabilitation patients.Trial registration The trial has been registered with the German Clinical Trial Register (DRKS) under the Registration Number DRKS00027263.

Factors predicting long-term physical activity of breast cancer survivors. 5-year-follow-up of the BREX exercise intervention study

Background The benefits of exercise training are well documented among breast cancer (BC) survivors. Patients decrease their physical activity during treatment, and many fail to regain their previous exercise levels. There is therefore a need to define factors supporting long-term physical activity behavior in this patient group, to target supporting interventions aimed at preventing the decline in physical activity (PA). Aim The aim of this study was to determine physical and psychosocial factors explaining long-term physical activity after the adjuvant treatments in BC survivors. Methods Four-hundred forty-six BC survivors followed for 5-years within a randomized exercise trial participated. Factors explaining (1) physical activity after the adjuvant treatments and (2) changes in physical activity in long-term were analyzed using linear regression models and general estimating equation models. Pretreatment leisure-time physical activity (LTPA), demographic, and treatment factors, physical fitness, and quality of life (Qol) at baseline were independent factors. Results Exercise levels increased during the first year, and thereafter remained mostly stable. Higher LTPA, higher fitness level, better Qol and older age at baseline were associated with higher physical activity level after adjuvant treatments (p < .001) in multivariate analysis. Higher levels of fatigue (p < .008) and better emotional functioning (p = .017) at baseline were the main factors associated with increased physical activity during the follow-up. Conclusion Previous exercise habits and Qol after adjuvant chemo-, and radiotherapy were the strongest determinants of long-term physical activity levels in breast cancer survivors. Patients with better emotional functioning increased their exercise activity most as did those patients with higher fatigue levels at baseline. Patients suffering from fatigue after adjuvant treatment managed to increase their exercise levels, in contrast to patients with low emotional functioning, and may benefit from physical exercise interventions. Emotionally deprived patients may benefit from psychosocial support to regain their previous exercise levels.

Applying Mobile Technology to Sustain Physical Activity After Completion of Cardiac Rehabilitation: Acceptability Study.

BackgroundMany patients do not meet the recommended levels of physical activity after completing a cardiac rehabilitation (CR) program. Wearable activity trackers and mobile phone apps are promising potential self-management tools for maintaining physical activity after CR completion.ObjectiveThis study aims to evaluate the acceptability of a wearable device, mobile app, and push messages to facilitate physical activity following CR completion.MethodsWe used semistructured interviews to assess the acceptability of various mobile technologies after participation in a pilot randomized controlled trial. Intervention patients in the randomized controlled trial wore the Fitbit Charge 2, used the Movn mobile app, and received push messages on cardiovascular disease prevention and physical activity for over 2 months. We asked 26 intervention group participants for feedback about their experience with the technology and conducted semistructured individual interviews with 7 representative participants. We used thematic analysis to create the main themes from individual interviews.ResultsOur sample included participants with a mean age of 66.7 (SD 8.6) years; 23% (6/26) were female. Overall, there were varying levels of satisfaction with different technology components. There were 7 participants who completed the satisfaction questionnaires and participated in the interviews. The Fitbit and Movn mobile app received high satisfaction scores of 4.86 and 4.5, respectively, whereas push messages had a score of 3.14 out of 5. We identified four main themes through the interviews: technology use increased motivation to be physically active, technology use served as a reminder to be physically active, recommendations for technology to improve user experience, and desire for personal feedback.ConclusionsBy applying a wearable activity tracker, mobile phone app, and push messages, our study showed strong potential for the adoption of new technologies by older adults to maintain physical activity after CR completion. Future research should include a larger sample over a longer period using a mixed methods approach to assess the efficacy of technology use for promoting long-term physical activity behavior in older adults.

Current and Long-Term Physical Activity Among Adults with Multiple Sclerosis in the United States: COM-B Variables as Explanatory Factors.

Physical activity is an evidence-based, safe second-line approach for improved multiple sclerosis (MS) symptoms and disease progression. This study examined the contributions of Capability-Opportunity-Motivation-Behavior (COM-B) factors for understanding engagement in current and long-term physical activity among persons with MS in the United States (U.S.). Adults with MS in the U.S. (N=854) completed an online survey that included questions regarding demographic and clinical characteristics, COM-B constructs, Godin Leisure Time Exercise Questionnaire (GLTEQ), and Physical Activity Staging Questionnaire (PASQ). Participants were classified into groups based on the GLTEQ regarding current physical activity behavior and PASQ for long-term physical activity behavior. MANOVA and discriminant function analysis (DFA) identified COM-B constructs that differentiated physical activity groups. MANOVA analyses indicated that all COM-B constructs were significantly different for both GLTEQ current physical activity groups (Wilks's λ=.5, F(44, 1432)=14.8) and PASQ long-term physical activity groups (Wilks's λ=.4, F(44, 1464)=16.9) status except Information Provision. DFA analysis regarding GLTEQ identified a function including exclusively Capability and Motivation sources of behavior that differentiated current physical activity groups such as intention and self-efficacy. DFA for PASQ identified a different function of the Capability and Motivation sources of behavior that differentiated long-term physical activity groups; the primary differentiating variables were action control and intention. Our results identify internal factors as the primary COM-B predictors of current and long-term physical activity among adults with MS in the U.S., and health promotion interventions may focus on assessing individual competencies and behavioral regulation for changing physical activity in MS.

Pragmatic evaluation of a coproduced physical activity referral scheme: a UK quasi-experimental study.

ObjectivesUK exercise referral schemes (ERSs) have been criticised for focusing too much on exercise prescription and not enough on sustainable physical activity (PA) behaviour change. Previously, a theoretically grounded intervention (coproduced PA referral scheme, Co-PARS) was coproduced to support long-term PA behaviour change in individuals with health conditions. The purpose of this study was to investigate the effectiveness of Co-PARS compared with a usual care ERS and no treatment for increasing cardiorespiratory fitness.DesignA three-arm quasi-experimental trial.SettingTwo leisure centres providing (1) Co-PARS, (2) usual exercise referral care and one no-treatment control.Participants68 adults with lifestyle-related health conditions (eg, cardiovascular, diabetes, depression) were recruited to co-PARS, usual care or no treatment.Intervention16-weeks of PA behaviour change support delivered at 4, 8, 12 and 18 weeks, in addition to the usual care 12-week leisure centre access.Outcome measuresCardiorespiratory fitness, vascular health, PA and mental well-being were measured at baseline, 12 weeks and 6 months (PA and mental well-being only). Fitness centre engagement (co-PARS and usual care) and behaviour change consultation attendance (co-PARS) were assessed. Following an intention-to-treat approach, repeated-measures linear mixed models were used to explore intervention effects.ResultsSignificant improvements in cardiorespiratory fitness (p=0.002) and vascular health (p=0.002) were found in co-PARS compared with usual care and no-treatment at 12 weeks. No significant changes in PA or well-being at 12 weeks or 6 months were noted. Intervention engagement was higher in co-PARS than usual care, though this was not statistically significant.ConclusionA coproduced PA behaviour change intervention led to promising improvements in cardiorespiratory and vascular health at 12 weeks, despite no effect for PA levels at 12 weeks or 6 months.Trial registration numberNCT03490747.

I ride for MS: The impact of bike MS participation on motivation for physical activity in individuals with multiple sclerosis

BackgroundMultiple Sclerosis (MS) is a chronic neurodegenerative disease that results in deficits in physical and cognitive functioning. Research supports the use of physical activity (PA) to aid in MS symptom management and slow disease progression, however individuals diagnosed with MS are generally physically inactive. Social support has been shown to increase PA behavior in group exercise settings. Events such as Bike MS, a charity bicycle ride where individuals raise money for MS, could increase motivation for participation and therefore may be an ideal setting to introduce PA to individuals diagnosed with MS. Objective/Hypothesis: The objective of the current research was to explore motives for participation in a Bike MS event in individuals diagnosed with MS and their family members, and examine if their Bike MS participation has translated to long-term PA behavior change and positive quality of life outcomes. MethodsA descriptive qualitative approach using semi-structured focus group, individual, and phone interviews, combined with observational field notes, was used to explore the experiences of seven individuals diagnosed with MS and four family members from two regional self-help groups who all actively participated in a Bike MS event. ResultsParticipants reported important social bonds, raising awareness for the cause, fundraising, long-term physical benefits, and overall increased quality of life as motives for participation. All participants reported long-term PA participation as a result of Bike MS participation. ConclusionResults support using Bike MS to increase long-term PA participation in individuals with MS, resulting in positive quality of life outcomes.

Sports-based recreation as a means to address social inequity in health: why, when, where, who, what, and how

The rising global burden of noncommunicable diseases (NCDs) among people with low socioeconomic status (SES) has heightened awareness of the need for primary prevention programs in low-SES neighborhoods. Social inequity in health is apparent in mental, social and physical aspects of health among people living in low-SES neighborhoods. Viewing this problem from a life course perspective and adopting a vulnerable population approach points to the importance of inducing sustainable health behavior changes in children and young people living in low-SES neighborhoods. One important factor in lowering the risk of many NCDs while improving mental health is the promotion of physical activity (PA). In this paper, we argue that lowering the risk of many NCDs and improving mental health is best achieved through setting-based programs that facilitate long-term PA behavior changes in children and adolescents living in marginalized neighborhoods. Empirical evidence indicates that extrinsic motives for participating in physical activities, such as improving health, are insufficient when long-term participation is the goal. Therefore, we argue that interventions with the aim of affecting long-term PA in low-SES neighborhoods and thereby reducing social inequities in health should include activities that aim to create more intrinsic and autonomous motivations by building on more broad and positive understandings of health and participation. Here, we advocate that sports-based recreation (SR) holds several advantages. If implemented well, SR has the potential to be a health-promoting activity that is meaningful and motivating in itself and that involves physiological health-promoting aspects (e.g., PA), a social aspect (e.g., positive relations with others), and a psychological aspect (e.g., positive experiences of oneself). Further, we suggest four practicalities that should be considered when conducting interventions: the cost of participating, the location, the facilities required, and the suitability of the SR activities.

Prescription and Utilization of Sports Therapy Programs following Cardiac Rehabilitation 2006-2013

Physical exercise interventions are well accepted and widely used in cardiac rehabilitation programs. To ensure long-lasting effects on physical fitness and the maintenance of work ability a subsequent transfer to rehabilitation sport programs following cardiac rehabilitation is intended in a timely manner. The aim of the present study is to evaluate prescription and utilization rates of rehabilitation sport programs following cardiac rehabilitation. The present paper analyzes referral rates and the actual utilization of those programs in patients who had a cardiac rehabilitation in the years 2006-2013 using insurance data of the German pension fund. Overall, reductions in the prescription of rehabilitation sport programs can be observed. In 2013 55.7% (m) and 62.6% (w) of patients received a prescription for rehabilitation sport programs following cardiac rehabilitation. In contrast to declining prescription rates from 64.2 to 55.7% (m) and 68.0 to 62.6% (w) an increase in sports participation between 3-7% can be observed. Overall, participation rates between 9.7% and 22.5% (2012) seem not sufficient to promote long-term physical activity behavior change. Next to our evaluation, determinants and barriers for program participation should be investigated.

Development of an Educational Program for Non-Professional Soccer Coaches in Charge of Community-Based Soccer in Men with Prostate Cancer: a Qualitative Study

BackgroundWhile clinical trials have demonstrated the benefits of structured exercise for prostate cancer survivors, few attempts have been made to investigate and implement sustainable community-based exercise programs supporting adoption of long-term physical activity behavior. Against this background, the aims of this study was to explore the perspectives of experts and stakeholders on the development of a training course and intervention manual used to support the delivery of community-based soccer training in men with prostate cancer (the FC Prostate Community [FCPC] trial).MethodsA two-step qualitative design including triangulation of methods, data sources, and researchers. Step 1 comprised key informant interviews with clinical and scientific experts (n = 4). Step 2 included stakeholder focus group interviews with nurses (n = 5), non-professional soccer coaches and club representatives (n = 5), and prostate cancer survivors (n = 7).ResultsFour themes emerged from the analysis of the key informant interviews: The Coach’s Qualifications, Structure of the Training, Prevention of Injuries, and A Non-Patient Environment, which informed development of the training course and intervention manual. The stakeholders added the importance of clarifying the Responsibility of the Coach, the value of Positive Competition, and Social Inclusion of the prostate cancer survivors in the club. Based on these results, we present the final templates for the training course and intervention manual.ConclusionsNo general set of rules or safety measures to promote or optimize the delivery of community-based exercise in cancer survivors is recommended. However, the general principles related to the necessary clarification of the coach’s responsibility in relation to the prevention and management of injuries and participant adherence through a non-patient environment may be transferable to the training and education of other groups of lay persons in charge of delivering exercise interventions to other clinical subpopulations in a non-hospital setting.

Exercise Maintenance After a Randomized Resistance Training Intervention in Breast Cancer Survivors Undergoing Adjuvant Therapy

Exercise is highly recommended for breast cancer patients and survivors and may be increased by supervised interventions. Yet, still little is known about factors influencing the longterm physical activity behavior after the end of an Intervention. PURPOSE: To investigate the course and determinants of physical activity of breast cancer patients during and up to 12 months after a supervised resistance exercise intervention concomitant to adjuvant cancer treatment. METHODS: Physical activity was assessed in 227 breast cancer survivors before, during, and 3, 6 and 12 months after they participated in two randomized controlled trials investigating 12-week supervised resistance exercise vs. a relaxation control group concomitant to adjuvant chemotherapy (BEATE-Study, NCT01106820) or radiotherapy (BEST-Study, NCT01468766). To identify determinants of physical activity multiple ordinal logistic regression analyses were performed. RESULTS: During adjuvant therapy the intervention group exercised a median 1.8 h per week (interquartile range: 1.4-2.5), while 68% of controls did not engage in any exercise. Yet, irrespective of the intervention 32% of patients did not engage in any exercise at 12-month follow-up. Of the patients who cycled for transportation pre-diagnosis about half stopped cycling in the long run in both groups. In contrast, walking was maintained over time. Low levels of exercise at 12 months were determined by low pre-diagnosis levels of exercise (p<.001), lower education (p=0.0032), being postmenopausal (p=0.028), and having breast problems (p=0.0099) or depressive symptoms (p=0.059). At 12-month follow-up strength exercise was more common in the exercise group compared to the control Group. CONCLUSIONS: Breast cancer patients markedly decreased the exercise level and cycling for transportation after diagnosis and treatment. Yet, our resistance training intervention effectively countervailed this decline and boosted strength exercise in the months following the intervention. However, in the longer term many survivors were insufficiently active. Our results that identified subgroups especially vulnerable to physical inactivity may help to develop better individually tailored strategies to improve the physical activity behavior in breast cancer survivors in the long run.

Long-term Physical Activity Behavior After Completion of Traditional Versus Fast-track Cardiac Rehabilitation.

Despite the health benefits associated with regular physical activity (PA), many cardiac patients fail to maintain optimal levels of PA after completing cardiac rehabilitation (CR). The long-term impact of different CR delivery models on the PA habits of cardiac patients is not completely understood. The purpose of this study is to use a multisensor accelerometer to compare the long-term impact of a traditional versus fast-track CR on the PA of patients with coronary artery disease 6 months after CR entry. Forty-four participants attended either traditional (twice a week, 12 weeks; n = 24) or fast-track (once a week, 8 weeks; n = 20) CR. Exercise capacity (ie, 6-minute walk test distance) and PA were assessed at baseline and at 12 weeks and 6 months after CR entry. At 12 weeks, exercise capacity increased significantly in both groups and remained elevated by the 6-month follow-up. Sedentary time decreased from baseline to 12 weeks. However, at 6 months, it was comparable with the baseline level. There was no significant change in any other PA marker (ie, steps/day, time in light and moderate-vigorous PA) over the course of the study. Findings support the long-term effectiveness of CR on exercise capacity irrespective of the delivery model. However, participation in CR program, whether it be a traditional or fast-track CR exercise program, may not lead to long-term PA behavior change. Thus, CR participants may benefit from structured strategies that promote long-term PA adherence in addition to facilitating exercise capacity improvement.

PP31 Physical activity facilitation to improve functional ability and independent living in older adults at risk of disability: a feasibility study and exploratory pilot RCT

Background As we get older, our risk of disability increases. Disability affects quality of life and increases health and social care costs. Preventing disability is therefore important, and identifying an effective intervention should improve the lives of many older people. Evidence suggests physical activity may reduce the risk of age-related disability, however it is unclear what approach is most cost-effective in changing long-term physical activity behaviour in older adults. A new theory-driven behavioural intervention has been developed, with the aim of increasing physical activity in the lives of older adults at risk of disability. This study tests the feasibility and acceptability of delivering the intervention to older adults. Methods Using postal invitations and opportunistic waiting room recruitment, participants were recruited from primary care practices around Bristol during 2014–15. Patients were eligible to participate if they were aged over 65, inactive, not disabled, and were at risk of developing disability in the future (Short Physical Performance Battery score Enrolled participants were randomised to intervention or control arms. Those randomised to the intervention arm received face-to-face and telephone support sessions with a trained Physical Activity Facilitator (PAF), delivering an intervention based on self-determination theory over six months. Control participants receive a booklet on healthy ageing. Following completion of the PAF intervention, or six months after enrolment, all participants were asked to attend a follow-up clinic where outcome measures were taken. The main outcomes of interest in the pilot study are recruitment, adherence, retention and acceptability. Data were also collected on: self-report and accelerometer-recorded physical activity; physical performance; depression; wellbeing; cognitive function; social support; quality of life, healthcare use, and adverse events. A mixed-methods process evaluation was run alongside the RCT, including qualitative interviews with participants and PAFs, and questionnaires measuring the theoretical components of the intervention. Results Out of 1875 postal invitations sent out by practices 1317 (70%) of patients responded with 349 (26%) expressing an interest in the study. 192 (55%) fitted the initial eligibility criteria and were invited to a clinical screening appointment. 51 patients (26%) fitted the full eligibility criteria and were enrolled. All participants were randomised (2:1 ratio) to either intervention (n = 34) or control (n = 17). Data on key outcome measures and qualitative findings will be presented. Discussion If cost-effective, this intervention could improve quality of life for older adults. Before proceeding to a full-scale trial this study is necessary to ensure intervention feasibility and acceptability, and to explore whether the intervention shows evidence of promise.

Behavioural physical activity interventions in participants with lower-limb osteoarthritis: a systematic review with meta-analysis

ObjectiveTo assess effectiveness of osteoarthritis interventions to promote long-term physical activity behaviour change.DesignA systematic review and meta-analysis. Protocol registration PROSPERO CRD4201300444 5 (http://www.crd.york.ac.uk/prospero/).Study selectionRandomised controlled trials (RCTs) comparing physical activity...

Physical ACtivity facilitation for Elders (PACE): study protocol for a randomised controlled trial.

BackgroundAs people live longer, their risk of disability increases. Disability affects quality of life and increases health and social care costs. Preventing or delaying disability is therefore an important objective, and identifying an effective intervention could improve the lives of many older people. Observational and interventional evidence suggests that physical activity may reduce the risk of age-related disability, as assessed by physical performance measures. However it is unclear what approach is the most cost-effective intervention in changing long-term physical activity behaviour in older adults. A new theory-driven behavioural intervention has been developed, with the aim of increasing physical activity in the everyday lives of older adults at risk of disability. This pilot study tests the feasibility and acceptability of delivering this intervention to older adults.Methods/DesignA randomised controlled trial (RCT) design will be used in the pilot study. Sixty patients aged 65 years and older will be recruited from primary care practices. Patients will be eligible to participate if they are inactive, not disabled at baseline, are at risk of developing disability in the future (Short Physical Performance Battery score <10/12), and have no contraindications to physical activity. Following baseline measures, participants will be randomised in a 2:1 ratio to the intervention or to a control arm and all participants will be followed-up after 6 months. Those randomised to the intervention arm will receive sessions with a trained Physical Activity Facilitator, delivering an intervention based on self-determination theory. Control participants receive a booklet on healthy ageing. The main outcomes of interest are recruitment, adherence, retention and acceptability. Data will also be collected on: self-report and accelerometer-recorded physical activity; physical performance; depression; wellbeing; cognitive function; social support; quality of life, healthcare use, and attitudes to physical activity. A mixed-methods process evaluation will run alongside the RCT.DiscussionThe intervention, if effective, has the potential to reduce disability and improve quality of life in older adults. Before proceeding to a full-scale trial a pilot trial is necessary to ensure intervention feasibility and acceptability, and that the intervention shows evidence of promise.Trial registrationCurrent Controlled Trials ISRCTN80470273. Registered 25 October 2013.

A grounded theory of successful long-term physical activity behaviour change

This paper presents a grounded theory of successful long-term physical activity (PA) behaviour change. Currently, a range of theoretical frameworks are available to guide researchers and practitioners in the development and implementation of PA behaviour change interventions. However, none of these theoretical approaches are specifically intended to account for PA-related behaviours. In addition, there is limited evidence to support the efficacy of current intervention strategies, particularly in the long term. To obtain a more ecologically valid explanation of successful PA behaviour change, this study describes the development of an explanatory model of successful PA behaviour change, grounded in relevant ‘real life’ experiences. To achieve this, a grounded theory methodology was adopted. Twenty-one adult participants, who had previously led sedentary lifestyles and had successfully completed a physical activity referral scheme to increase their PA participation, took part in in-depth interviews. All participants had been maintaining an increase in levels of PA participation for between four and seven years. An explanatory model of PA behaviour change is presented, which identifies individual core beliefs or values alongside various situational/informational cues, as key behavioural determinants. The results are discussed based on their contribution to the advancement of theoretical insights and applied practices within exercise psychology.

Physical Activity Behavior Two to Six Years Following Cardiac Rehabilitation: A Socioecological Analysis

Cardiac rehabilitation (CR) promotes long-term positive health behaviours, such as physical activity (PA), in patients following a cardiovascular event. We have limited knowledge of long-term PA and its correlates. Therefore, this research examined both PA behaviour and socioecological correlates among elderly graduates 2-6 years following CR. CR graduates will have a moderate PA level in the long term. Greater PA will be associated with various multilevel correlates. This was a retrospective, cross-sectional study which quantified PA using the Physical Activity Scale for the Elderly (PASE) and collected information about socioecological correlates at the intrapersonal, interpersonal and health service levels. Both univariate and multivariate analyses assessed PA and PA correlates. The majority of the 584 participants were older (69.8 ± 9.8), male (80.3%), and well educated (75.4% ≥ some post-secondary). Average time since CR graduation was 41.5 ± 11.5 months. Seventy five percent of CR graduates reported current weekly PA levels that met, or exceeded, Canadian PA guidelines (>150 minutes of moderate-vigorous PA). Univariate analyses identified 13 PASE score correlates. Multivariate analyses identified age, PA enjoyment, current work status, CR staff support, location of primary residence, and perceived health as significantly associated with higher PASE scores (p < 0.001). Three and a half years post-CR graduates had high PA levels. Greater PA was associated with several modifiable multilevel correlates at all levels of influence. Understanding correlates of long-term PA behaviour among CR graduates will help identify groups at risk for nonadherence and assist with continued program development.

Theoretical and practical outline of the Copenhagen PACT narrative-based exercise counselling manual to promote physical activity in post-therapy cancer survivors

Background. Sedentary behaviour and reduced exercise capacity are potential persisting effects of anti-cancer therapy that may predispose to serious health conditions. It is well-established that physical exercise may prevent some of these problems. However, the extent to which cancer survivors are able to adopt long-term physical activity habits depends largely on their motivation. Aim. This theoretical paper aims to outline how researchers and practitioners can draw from Antonovsky's salutogenetic theory and White & Epston's Narrative Therapy to develop and implement intervention efforts centered on promotion of long-term physical activity behaviour, while at the same time increasing the individual cancer survivor's sense of meaning and personal health resources. Material and methods. The Copenhagen PACT (Physical Activity after Cancer Treatment) Study targeting adoption and maintenance of regular physical activity in post-therapy cancer survivors is briefly presented including a brief review of the theoretical rationale behind the psychological component of the intervention, i.e. a narrative-based exercise counselling programme. Subsequently, particular attention is given to the core principles, different components and structure of the counselling manual including sample questions and examples of written documents that have emanated from the individual counselling sessions. Discussion. The discussion includes consideration of some methodological challenges that arise when attempting to evaluate narrative-based interventions in the context of physical activity promotion in cancer rehabilitation and survivorship care.

Effect Of 8-week Weight Training Class On PSPP Among Weight-preoccupied College Age Women

PURPOSE The college years represent an ideal time to instill healthful lifestyle practices such as regular physical activity, however effective strategies for doing so have not yet been identified. Physical activity levels have been shown to be related to Physical Self-Perception Profile (PSPP) scores, but little is known about how PSPP changes in response to exercise and whether this survey can be used to assess program effectiveness. Weight training (WT) has many health benefits for women, yet women are less likely to engage in strength building exercise than men, perhaps because of misconceptions about the effect of WT on body size. Thus, one of the objectives of the current pilot study was to assess the effect of engaging in a formal WT program on PSPP scores in young women who have heightened concerns about body appearance and thus might be averse to engaging in WT. METHODS Subjects consisted of college age women who met the criteria of no regular WT within the last 12 mths and increased preoccupation with body weight. Subjects enrolled in an activity course and received comprehensive instruction on proper technique prior to beginning an 8-wk progressive program targeting all major muscle groups. They completed the PSPP and other surveys before and after the program. RESULTS WT significantly increased 1RM strength (bench press, p<0.001; leg press, p=0.001) and body weight (p<0.001). WT significantly increased (p<0.005) PSPP physical self-worth, indicating that the subjects felt happier overall in regards to their physical self. All other PSPP subscale scores increased, but not significantly. However, positive changes in the PSPP conditioning score (perceptions of physical conditioning) was significantly related to improved feelings assessed by the Eating Disorders Inventory, such as decreased drive for thinness (DT, p<0.05) and body dissatisfaction (BD, p<0.005). Also, improvements in the PSPP strength score (perceived strength and muscular development) was related to decreased DT (p<0.01) and BD (p=0.078). Positive change in the PSPP conditioning score was also significantly correlated to positive changes in global self-esteem (Rosenberg, 1965) and self-concept clarity (Campbell, 1996). CONCLUSIONS These results suggest that a brief, progressive WT program that improves muscular strength leads to improved feelings about the self in young women. Follow-up is needed to determine if immediate changes in PSPP predict long-term physical activity behavior and feelings about the self. These preliminary findings also suggest that college campuses are ideally suited to promote positive attitudes and behaviors that have significant health impact.

Effect Of 8-week Weight Training Class On PSPP Among Weight-preoccupied College Age Women

PURPOSE The college years represent an ideal time to instill healthful lifestyle practices such as regular physical activity, however effective strategies for doing so have not yet been identified. Physical activity levels have been shown to be related to Physical Self-Perception Profile (PSPP) scores, but little is known about how PSPP changes in response to exercise and whether this survey can be used to assess program effectiveness. Weight training (WT) has many health benefits for women, yet women are less likely to engage in strength building exercise than men, perhaps because of misconceptions about the effect of WT on body size. Thus, one of the objectives of the current pilot study was to assess the effect of engaging in a formal WT program on PSPP scores in young women who have heightened concerns about body appearance and thus might be averse to engaging in WT. METHODS Subjects consisted of college age women who met the criteria of no regular WT within the last 12 mths and increased preoccupation with body weight. Subjects enrolled in an activity course and received comprehensive instruction on proper technique prior to beginning an 8-wk progressive program targeting all major muscle groups. They completed the PSPP and other surveys before and after the program. RESULTS WT significantly increased 1RM strength (bench press, p<0.001; leg press, p=0.001) and body weight (p<0.001). WT significantly increased (p<0.005) PSPP physical self-worth, indicating that the subjects felt happier overall in regards to their physical self. All other PSPP subscale scores increased, but not significantly. However, positive changes in the PSPP conditioning score (perceptions of physical conditioning) was significantly related to improved feelings assessed by the Eating Disorders Inventory, such as decreased drive for thinness (DT, p<0.05) and body dissatisfaction (BD, p<0.005). Also, improvements in the PSPP strength score (perceived strength and muscular development) was related to decreased DT (p<0.01) and BD (p=0.078). Positive change in the PSPP conditioning score was also significantly correlated to positive changes in global self-esteem (Rosenberg, 1965) and self-concept clarity (Campbell, 1996). CONCLUSIONS These results suggest that a brief, progressive WT program that improves muscular strength leads to improved feelings about the self in young women. Follow-up is needed to determine if immediate changes in PSPP predict long-term physical activity behavior and feelings about the self. These preliminary findings also suggest that college campuses are ideally suited to promote positive attitudes and behaviors that have significant health impact.