Adoption Of Physical Activity Research Articles

Testing Assumptions of the Physical Activity Adoption and Maintenance Model: A Longitudinal Perspective of the Relationships Between Intentions and Habits on Exercise Adherence.

In this study, we aimed to examine empirically the Physical Activity Adoption and Maintenance model (PAAM). We collected data on these variables at baseline (T0) and 6-months later (T1). We recruited 119 participants (42 male, 77 female) aged 18-81years old (Mage = 44.89, SD = 12.95). who reported, at baseline, that they exercised an average of 3.76days per week (SD = 1.33) in training periods lasting 15-60minutes (M = 38.69; SD = 23.28). We conducted hierarchical multiple regression analysis to test the association between each determinant (intentions, habits, and frequency) and future exercise adherence. We tested four models by entering blocks of predictors according to PAAM assumptions. The variance change (R2) between the first and fourth models (ΔR2 = .391) was statistically significant, showing that the fourth model accounted for 51.2% of variance for future exercise adherence, F (6, 112) = 21.631, p < .001, R2 = .73, adjusted R2 = .512. Exercise intention at T1 maintained its significant association (p = .021) with exercise frequency at T1 in all tested models. Exercise frequency at T0 was the most significant predictor (p < .01) of future exercise adherence, with past experience the second most significant predictor (p = .013). Interestingly, exercise habits at T1 and T0 did not predict exercise frequency at T1 in the fourth model. Among the variables we studied, having constantly high exercise intentions and high regular exercise frequency are significantly associated with maintaining or increasing regular future exercise behavior.

Promoting physical activity through supervised vs motivational behavior change interventions in breast cancer survivors on aromatase inhibitors (PAC-WOMAN): protocol for a 3-arm pragmatic randomized controlled trial

BackgroundAromatase inhibitors (AI) are frequently used to treat hormone-receptor-positive breast cancer, but they have multiple adverse effects (e.g., osteoporosis, arthralgia), resulting in premature therapy discontinuation/switch. Physical activity (PA) can attenuate these negative effects and improve quality of life (QoL). However, most cancer survivors fail to perform/sustain adequate PA levels, especially in the long-term. Theory-based interventions, using evidence-based behavior change techniques, aimed at promoting long-term behavior change in breast cancer survivors are effective, but remain scarce and fail to promote self-regulatory skills and better-quality motivations associated with sustained PA adoption. This paper describes the design of the PAC-WOMAN trial, which will test the long-term effectiveness and cost-effectiveness of two state of the art, group-based interventions encouraging sustained changes in PA, sedentary behavior, and QoL. Additional aims include examining the impact of both interventions on secondary outcomes (e.g., body composition, physical function), and key moderators/mediators of short and long-term changes in primary outcomes.MethodsA 3-arm pragmatic randomized controlled trial, involving a 4-month intervention and a 12-month follow-up, will be implemented, in a real exercise setting, to compare: 1) brief PA counseling/motivational intervention; 2) structured exercise program vs. waiting-list control group. Study recruitment goal is 122 hormone-receptor-positive breast cancer survivors (stage I-III), on AI therapy (post-primary treatment completion) ≥ 1 month, ECOG 0–1. Outcome measures will be obtained at baseline, 4 months (i.e., post-intervention), 10 and 16 months. Process evaluation, analyzing implementation determinants, will also be conducted.DiscussionPAC-WOMAN is expected to have a relevant impact on participants PA and QoL and provide insights for the improvement of interventions designed to promote sustained adherence to active lifestyle behaviors, facilitating its translation to community settings.Trial registrationApril 20, 2023 – NCT05860621.April 21, 2023 – https://doi.org/10.17605/OSF.IO/ZAQ9NApril 27, 2023 – UMIN000050945.

Exergaming Characteristics in Interventions Addressing Physical Activity and Nutrition: A Systematic Literature Review

INTRODUCTION: The increasing popularity of exergames to promote the adoption of physical activity and healthy nutrition among different population groups is well established. However, due to the use of various types of exergames, their effectiveness in addressing specific behaviours varies.OBJECTIVES: This systematic review aims to identify, classify exergaming elements, and examine their efficacy in enhancing physical activity levels, improve nutrition habits, or a combination of both, across various populations.METHODS: A systematic search was conducted to identify relevant publications. Data on study characteristics pertaining to types of exergames, purpose, focus, target population, technologies used, and the theoretical framework were extracted. A classification scheme of exergaming components and characteristics has been developed to facilitate this systematic review.RESULTS: A total of 34 studies were included and n=21 of them were experimental. Most studies (n=31) were focused on Physical Activity using exergames, whereas n=9 studies addressed both Physical Activity and Nutrition simultaneously.CONCLUSION: All of the studies reported positive behavioural outcomes, although, prolonged and sustained engagement with exergames were not consistently reported.

Which Intervention Strategies Promote the Adoption and Maintenance of Physical Activity? Evidence From Behavioral Trials With Cancer Survivors.

We address four questions about interventions to promote physical activity in cancer survivors: (a) How often is both the adoption and maintenance of behavior change tested in trials? (b) How often do interventions generate adoption-plus-maintenance of behavior change? (c) Are intervention strategies specifically geared at promoting maintenance of behavior change deployed in trials? and (d) Which intervention strategies distinguish trials that promote both the adoption and maintenance of physical activity from trials that promote adoption-only or generate no behavioral changes? Computerized literature searches identified 206 reports of randomized trials that measured physical activity in the wake of the intervention. Only 51 reports (24%) measured both behavioral adoption (postintervention) and behavioral maintenance (≥3 months follow-up). The 51 reports included 58 tests of interventions; 22% of tests observed both adoption and maintenance of physical activity, 26% reported adoption-only, and 52% found no change in behavior. Change techniques designed to promote behavioral maintenance were used much less frequently than adoption techniques or adoption and maintenance techniques. Interventions that aimed to improve quality of life, used supervised exercise sessions, were undertaken in community centers, and deployed fewer behavior change techniques were associated with adoption-plus-maintenance of physical activity in cancer survivors. The present findings offer new insights into the adoption and maintenance of physical activity and highlight the need to routinely assess these forms of behavior change in future trials. More extensive testing of intervention strategies specifically geared at maintenance of behavior change is warranted.

Trends in physical activity in adolescents participating and not participating in organized team or individual physical activity.

Participation of adolescents in organized physical activity (PA), together with physical education, is essential for the development of a habit of regular PA, achievement of PA recommendations and adoption of physical literacy. The aim of the study is to identify the trends and differences in PA levels between adolescents participating in organized team PA, organized individual PA, and those not participating in organized PA. Another aim is to formulate proposals to eliminate the negative effects of the pandemic on adolescents' participation in organized PA. The research took place between 2012-2021 in 51 secondary schools and involved a total of 1,202 boys and 1,561 girls. Participation in organized PA was examined using the 'Sports preferences survey'. Weekly PA was investigated by means of the 'International Physical Activity Questionnaire-Long Form'. The results confirmed the negative trend in participation in organized PA. However, this was predominantly caused by the negative effects of the pandemic in 2020-2021. Boys participating in organized team and individual PA had more school PA, recreation PA, vigorous PA, moderate PA and overall PA during the week, compared with boys not participating in organized PA (girls had more vigorous PA, moderate PA and overall PA). Participation in organized team PA and individual PA plays an important role, primarily in supporting vigorous PA but also in overall weekly PA among boys and girls. The negative effects of the pandemic should be eliminated by increasing adolescents' participation in various forms of organized PA with an emphasis on organized individual PA which can be regularly pursued, even under restrictive measures at home, in the countryside or in nature.

Association of physical activity with physical function and quality of life in people with hip and knee osteoarthritis: longitudinal analysis of a population-based cohort

Hip and knee osteoarthritis (HKOA) is a chronic disease characterized by joint pain that leads to reduced physical function and health-related quality of life (HRQoL). At present, no cure is available. Clinical trials indicate that people with HKOA benefit from physical activity in several health-related outcomes. However, few studies have evaluated the long-term positive effect of regular physical activity. This study analyzed participants with HKOA from a nationwide population-based cohort (EpiDoC Cohort) to assess the impact of physical activity on patients’ physical function and HRQoL over a long-term follow-up. The regular weekly frequency of intentional physical activity was self-reported as non-frequent (0 times/week), frequent (1–2 times/week), or very frequent (≥ 3 times/week). This study followed 1086 participants over a mean period of 4.7 ± 3.4 years, during which 6.3% and 14.9% of participants reported frequent and very frequent physical activity, respectively. Using linear mixed models, we found that frequent (β = − 0.101 [− 0.187, − 0.016]; β = 0.039 [− 0.002, 0.080]) and very frequent physical activity (β = − 0.061 [− 0.118, − 0.004]; β = 0.057 [0.029, 0.084]) were associated with improved physical function and HRQoL over time, respectively, when compared with non-frequent exercise, adjusting for years to baseline, sex, age, years of education, body mass index, multimorbidity, hospitalizations, clinical severity, and unmanageable pain levels. These findings raise awareness of the importance of maintaining exercise/physical activity long term to optimize HRQoL and physical function. Further studies must address barriers and facilitators to improve the adoption of regular physical activity among citizens with HKOA.

Effects of weight stigma on BMI and inflammatory markers among people living with obesity

ObjectiveWeight stigma (WS) and prejudice are one of the most prevalent ways of discrimination among adults, comparable with rates of racial discrimination. Exposure to WS among patients with obesity (PWO) may make the adoption of healthy dietary patterns and regular physical activity even more challenging and, therefore, the achievement of weight loss. Additionally, WS could also induce physiological responses such as increased levels of inflammatory markers, due to stress exposure. MethodSubjects attending two obesity clinics were evaluated at baseline and after a minimum follow-up of six months. The weight Bias Internalization Scale (WBIS) and the Stigmatizing Situations Inventory (SSI) were administered to evaluate WS. Also, anthropometric and inflammatory markers, including cortisol, ferritin and C-reactive protein (CRP), were recorded at baseline. Results79 PWO (87.3%♀, 45.5 ± 1.3 years, 35.9 ± 6.3 kg/m2) were included. At baseline, 72.2% started liraglutide as anti-obesity drug. Baseline body mass index (BMI) correlated positively with both WBIS (r = 0.23; p = 0.03) and SSI (r = 0.25; p = 0.02) scores. Mean percentual weight loss after a mean follow-up of six months was -7.28%. However, there was a negative, but not statistically significant, correlation between weight loss and both WBIS (r=-0.14; p = 0.2) and SSI (r=-0.19; p = 0.08). Regarding inflammatory markers, plasma cortisol levels at baseline correlated positively with WBIS (p = 0.005) and SSI (p = 0.02). CRP at baseline also presented a positive correlation with SSI (p = 0.03). No significant correlations were found for stigma tests and ferritin levels. DiscussionAs weight increases among PWO, so does stigma. Despite we did not find a significant negative association between the presence of WS and weight loss outcomes, there was an increase in inflammatory markers among PWO who experienced higher levels of WS.

Self-Compassion and Physical Activity: The Underpinning Role of Psychological Distress and Barrier Self-Efficacy.

Unlike other personality traits or dispositions, self-compassion can be nurtured and is likely a driving source for physical activity. Emerging research has started to examine self-compassion in physical activity contexts; however, most existing studies were underpowered and overlooked the psycho-behavioural factors underlying the link between self-compassion and physical activity. In a sample of 569 UK adults (mean age = 41.92 years, SD = 13.70; 47.8% female), we examined the hypothesis that self-compassion's positive influence on physical activity operates through reduced psychological distress and subsequently increased barrier self-efficacy. Results supported the prediction, with the positive influences of self-compassion being more prominent in more vigorous physical activity. The findings suggest that self-compassion is a good source of emotional resources (i.e., attenuated psychological distress) and confidence to overcome challenges and obstacles (i.e., increased barrier self-efficacy) in the context of physical activity. Future interventions and programs could consider incorporating self-compassion for physical activity adoption and maintenance.

FROM KNOWING TO DOING: WHAT IS NEEDED TO SUPPORT PATIENTS IN CHANGING PHYSICAL ACTIVITY

Abstract Physical therapists often treat pain and functional limitations associated with chronic musculoskeletal conditions common in aging adults. While patient report improvement after physical therapy, these results do not translate to sustained physical activity. This is a lost opportunity to support aging adults in adopting behaviors proven to improve quality of life and reduce comorbidity burden. We conducted semi-structured interviews with 30 physical therapists to understand how they support adoption of physical activity and identify what is needed to improve uptake. Physical therapists endorse physical activity as essential in the management of MSK conditions. Eliciting motivation, addressing psychosocial needs, and empowering patients to actively engage in solutions were identified as significant challenges in the effort to change physical activity. At the clinician level, physical therapists identified the need for improved skills in motivational interviewing and person-centered communication. Improved coordination with mental health providers and community resources were identified as environmental needs.

Being physically active with epilepsy: Insights from young people and their parents

IntroductionResearchers have called for innovative tailored interventions to address specific challenges to physical activity (PA) engagement for young people with epilepsy (YPE). Working with YPE and their parents, this study aimed to identify barriers and facilitators to adoption and maintenance of PA among YPE prior to and during the COVID-19 pandemic. MethodsTen YPE (all female) and their 13 caregivers, and five additional caregivers to males (N = 18; 72% mothers), completed virtual focus group sessions prior to and during the COVID-19 pandemic. Trained Child Life specialists asked questions about barriers and facilitators of PA engagement experienced by YWE, which included a specific focus on the impact of epilepsy. ResultsThematic analysis of the data identified both epilepsy-specific and generic themes that impact PA participation among YPE. These included: (i) epilepsy experience/impact and accommodation; (ii) safety precautions; (iii) concern about seizures; (iv) social connections and acceptance; (v) parent and family support; (vi) intrapersonal self-regulation and motivation; (vii) health benefits; and (viii) key factors in common with all youth. ConclusionThis study provides valuable insight into diverse social-ecological health factors that impact PA participation among YPE from two key stakeholder perspectives (YPE and their caregivers). By understanding these lived experiences, providers can better tailor individual support for YPE and their families to foster and maintain a healthy active lifestyle.

A Brief Intervention of Physical Activity Education and Counseling in Community Rehabilitation: A Feasibility Randomized Controlled Trial.

This study aimed to assess the feasibility of delivering a brief physical activity (PA) intervention to community rehabilitation clients. Participants were randomized to receive one session of stage-of-change-based PA education and counseling in addition to written educational material, or education material alone. Outcomes were measured at baseline and 3months; the primary outcome was feasibility, measured by the percentage of those who were eligible, consented, randomized, and followed-up. A total of 123 individuals were both eligible and interested in participating, 32% of those screened on admission to the program. Forty participants consented, and 35 were randomized, with mean age 72years (SD = 12.2). At baseline, 66% had recently commenced or intended to begin regular PA in the next 6months. A total of 30 participants were followed-up. It is feasible to deliver education and counseling designed to support the long-term adoption of regular PA to community rehabilitation clients. Further refinement of the protocol is warranted (ACTRN12617000519358).

The Effects of a Lifestyle Intervention Supported by the InterWalk Smartphone App on Increasing Physical Activity Among Persons With Type 2 Diabetes: Parallel-Group, Randomized Trial.

BackgroundEffective and sustainable implementation of physical activity (PA) in type 2 diabetes (T2D) health care has in general not been successful. Efficacious and contemporary approaches to support PA adherence and adoption are required.ObjectiveThe primary objective of this study was to investigate the effectiveness of including an app-based (InterWalk) approach in municipality-based rehabilitation to increase moderate-and-vigorous PA (MVPA) across 52 weeks compared with standard care among individuals with T2D.MethodsThe study was designed as a parallel-group, randomized trial with 52 weeks’ intervention and subsequent follow-up for effectiveness (52 weeks from baseline). Participants were recruited between January 2015 and December 2016 and randomly allocated (2:1) into 12 weeks of (1) standard care + InterWalk app–based interval walking training (IWT; IWT group; n=140), or (2) standard care + the standard exercise program (StC group; n=74). Following 12 weeks, the IWT group was encouraged to maintain InterWalk app–based IWT (3 times per week for 30-60 minutes) and the StC group was encouraged to maintain exercise without structured support. Moreover, half of the IWT group (IWTsupport group, n=54) received additional motivational support following the 12-week program until 52-week follow-up. The primary outcome was change in objectively measured MVPA time (minutes/day) from baseline to 52-week follow-up. Key secondary outcomes included changes in self-rated physical and mental health–related quality of life (HRQoL), physical fitness, weight, and waist circumference.ResultsParticipants had a mean age of 59.6 (SD 10.6) years and 128/214 (59.8%) were men. No changes in MVPA time were observed from baseline to 52-week follow-up in the StC and IWT groups (least squares means [95% CI] 0.6 [–4.6 to 5.8] and –0.2 [–3.8 to 3.3], respectively) and no differences were observed between the groups (mean difference [95% CI] –0.8 [–8.1 to 6.4] minutes/day; P=.82). Physical HRQoL increased by a mean of 4.3 (95% CI 1.8 to 6.9) 12-item Short-Form Health Survey (SF-12) points more in the IWT group compared with the StC group (Benjamini-Hochberg adjusted P=.007) and waist circumference apparently decreased a mean of –2.3 (95% CI –4.1 to –0.4) cm more in the IWT group compared with the StC group but with a Benjamini-Hochberg adjusted P=.06. No between-group differences were observed among the remaining key secondary outcomes.ConclusionsAmong individuals with T2D referred to municipality-based lifestyle programs, randomization to InterWalk app–based IWT did not increase objectively measured MVPA time over 52 weeks compared with standard health care, although apparent benefits were observed for physical HRQoL.Trial RegistrationClinicalTrials.gov NCT02341690; https://clinicaltrials.gov/ct2/show/NCT02341690

Adoption and maintenance of physical activity: Mediation analysis of a psychological intervention.

To analyze the cognitive mediation processes of an effective psychological group-based intervention promoting physical activity (based on motivational and volitional theories; MoVo-LISA) and to test for different underlying intervention mechanisms in the adoption and maintenance phase of physical activity behavior change. In an RCT, N = 202 patients with coronary heart disease were randomly allocated to the group-based MoVo-LISA intervention or a control group (treatment-as-usual). Primary outcome was physical activity (in minutes per week, significant group differences: posttreatment: d = 1.03; 12-months follow-up: d = .57). Potential mediator variables were self-efficacy, outcome expectations, intention strength, self-concordance, action planning and barrier management. A mediation analysis of longitudinal data in SPSS AMOS v.24 was conducted. The intervention was successful in modifying most of the examined cognitive variables in the adoption and/or the maintenance phase, with exception of self-concordance. Intention strength and self-concordance were significant predictors of behavior change in both phases. Findings suggest that the observed intervention effects on physical activity behavior were only partially mediated through the motivational variables self-efficacy and outcome expectation. The results contribute to opening "the black box" of processes behind an intervention and show that intervention effects of MoVo-LISA are partially mediated through the specified cognitive variables. The relevance of motivational variables (intention strength and self-concordance) in the adoption and maintenance phases is highlighted in this study and leads to relevant intervention design implications. Nevertheless, the differentiation of the two phases might help to improve intervention programs through a stronger focus on those cognitive parameters that are critical at a certain point in the behavior change process. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

P03-03 The impact of regular physical education, physical activity and sport provision in second level schools on adolescent physical activity behaviours: A systematic literature review

BackgroundRegular engagement in physical activity (PA) is cited as a powerful predicter of future health among adolescents. International guidelines recommend sixty-minutes of moderate-to-vigorous-intensity PA daily for adolescents. Prevalence of physical inactivity is high among adolescents and is regarded as a leading risk factor for death worldwide, contributing to the onset of non-communicable diseases with just 20% of adolescents meeting the recommended PA guidelines. Physical inactivity cost $67.5 billion worldwide in 2013 and is estimated to reach over? 110 billion in 2030. Physical Education (PE) is recognized as playing an integral role in the promotion of PA and health. Despite the worldwide adoption of school PE, PA and sport policies to promote PA and health, paralleled with significant investment, a gap in the literature exists that synthesises the impact of school PE, PA and sport on adolescent PA behavioursMethodsWeb of Science, SPORTDiscus, PsychINFO, ERIC and MEDLINE were searched for articles that examined the impact of regular school PE, PA and sport provision on adolescent (12-18 years) published between 2000-2020.ResultsPreliminary results indicate n = 39 articles have met the inclusion criteria. Gender differences are observed on the impact of PE on daily Moderate to Vigorous Physical Activity (MVPA) and overall daily PA. Studies that examined the impact of PE, PA and sport on adolescent PA behaviours outside of school are less frequent indicating a paucity of evidence in this research area.ConclusionSuch research is essential to synthesise a deeper understanding on whether current provision is impactful and/or requiring modification and thus will provide comprehensive evidence for 1) sustained financial investment; 2) modification of existing provision to potentiate positive impact and 3) reducing the international cost of physical inactivity. The central premise of this systematic literature review is that current provision is impactful and of enormous benefit.

Feasibility and Acceptability of an Active Video Game-Based Physical Activity Support Group (Pink Warrior) for Survivors of Breast Cancer: Randomized Controlled Pilot Trial.

BackgroundSurvivors of breast cancer with functional limitations have a 40% higher mortality rate than those without. Despite the known benefits of physical activity (PA), <40% of survivors of breast cancer meet the recommendations for PA. The combination of active video games (AVGs) and group-based PA counseling may hold potential for motivating PA adoption and improving physical function. However, this method has not been widely studied in survivors of breast cancer.ObjectiveWe aimed to determine the feasibility and acceptability of a group AVG-based multicomponent PA intervention and estimate its effect size and variability on PA and physical function in female survivors of breast cancer in a clinic setting.MethodsFemale survivors of breast cancer (N=60) were recruited through the clinic and randomly assigned to the intervention group (12 weekly sessions) or the control group (existing support group). The intervention group received game-based pedometers and participated in weekly group AVG sessions, PA behavioral coaching, and survivorship navigation discussions. A participant manual with weekly reflection worksheets was provided to reinforce the coaching lessons and promote self-led PA. The control group received conventional pedometers and participated in an existing breast cancer support group. Feasibility was assessed by enrollment rate (≥50%), retention rate (≥80%), group attendance rate (75% attending ≥9 sessions [intervention group]), and the number of technological issues and adverse events. Acceptability was measured by participants’ attitudes (from strongly disagree=1 to strongly agree=5) toward the use of AVGs and the overall program. The outcomes included PA (accelerometers) and physical function (Short Physical Performance Battery and gait speed). Analysis of covariance was used to determine differences in PA and physical function between the groups. The Cohen d and its 95% CI determined the effect size and variability, respectively. All the analyses followed the intention-to-treat principle.ResultsParticipants were an average of 57.4 (SD 10.5) years old, 70% (42/60) White, and 58% (35/60) off treatment. The enrollment rate was 55.9% (66/118). Despite substantial long-term hurricane-related disruptions, we achieved an 80% (48/60) retention. The intervention group’s attendance rate was 78% (14/18), whereas the control group’s attendance rate was 53% (9/17). Of the 26 game-based pedometers, 3 (12%) were damaged or lost. No study-related adverse events occurred. Acceptability items were highly rated. Steps (β=1621.64; P=.01; d=0.72), Short Physical Performance Battery (β=.47; P=.01; d=0.25), and gait speed (β=.12; P=.004; d=0.48) had a significant intervention effect.ConclusionsThe intervention was feasible and acceptable in this population despite the occurrence of a natural disaster. Pilot results indicate that group AVG sessions, PA coaching, and survivorship navigation produced moderate effects on PA and physical functioning. AVGs with PA counseling can potentially be used in existing breast cancer support groups to encourage PA and improve physical function.Trial RegistrationClinicalTrials.gov NCT02750241; https://clinicaltrials.gov/ct2/show/NCT02750241

Investigating Microtemporal Processes Underlying Health Behavior Adoption and Maintenance: Protocol for an Intensive Longitudinal Observational Study.

BackgroundYoung adulthood (ages 18-29 years) is marked by substantial weight gain, leading to increased lifetime risks of chronic diseases. Engaging in sufficient levels of physical activity and sleep, and limiting sedentary time are important contributors to the prevention of weight gain. Dual-process models of decision-making and behavior that delineate reflective (ie, deliberative, slow) and reactive (ie, automatic, fast) processes shed light on different mechanisms underlying the adoption versus maintenance of these energy-balance behaviors. However, reflective and reactive processes may unfold at different time scales and vary across people.ObjectiveThis paper describes the study design, recruitment, and data collection procedures for the Temporal Influences on Movement and Exercise (TIME) study, a 12-month intensive longitudinal data collection study to examine real-time microtemporal influences underlying the adoption and maintenance of physical activity, sedentary behavior, and sleep.MethodsIntermittent ecological momentary assessment (eg, intentions, self-control) and continuous, sensor-based passive monitoring (eg, location, phone/app use, activity levels) occur using smartwatches and smartphones. Data analyses will combine idiographic (person-specific, data-driven) and nomothetic (generalizable, theory-driven) approaches to build models that may predict within-subject variation in the likelihood of behavior “episodes” (eg, ≥10 minutes of physical activity, ≥120 minutes of sedentary time, ≥7 hours sleep) and “lapses” (ie, not attaining recommended levels for ≥7 days) as a function of reflective and reactive factors.ResultsThe study recruited young adults across the United States (N=246). Rolling recruitment began in March 2020 and ended August 2021. Data collection will continue until August 2022.ConclusionsResults from the TIME study will be used to build more predictive health behavior theories, and inform personalized behavior interventions to reduce obesity and improve public health.International Registered Report Identifier (IRRID)DERR1-10.2196/36666

Efficacy of Mobile Instant Messaging–Delivered Brief Motivational Interviewing for Parents to Promote Physical Activity in Pediatric Cancer Survivors

Physical activity has beneficial effects that mitigate cancer- and treatment-related late effects. However, children who survive cancer are often physically inactive. Brief motivational interviewing may be an effective approach for increasing children's physical activity levels. To examine the effects of mobile instant messaging-delivered brief motivational interviewing for parents in promoting regular physical activity in children who have survived cancer. An assessor-blinded randomized clinical trial was conducted at 2 Hong Kong pediatric oncology outpatient clinics from March 1, 2019, to January 29, 2021. A total of 161 children who had survived cancer, aged 9 to 16 years, and their parents were randomized (1:1) to an intervention or control group. The intervention group received a 6-month mobile instant messaging-delivered brief motivational interviewing using a strategy menu. Parent-child dyads in both groups received a health advice session and were directed to a physical activity website at baseline. The primary outcome was the children's physical activity levels at 12-month follow-up, measured by the Chinese University of Hong Kong: Physical Activity Rating for Children and Youth (total sores: 0-10, higher scores indicate greater physical activity levels). Secondary outcomes were cancer-related fatigue levels, handgrip strength, peak expiratory flow rate, and quality of life. Intention-to-treat analysis was performed. Of the 161 children included in the study, 93 were boys (57.8%), and the mean (SD) age was 12.4 (2.4) years. Generalized estimating equation analyses showed a significant improvement in outcomes in the intervention group compared with the control group: physical activity levels (group-by-time interaction, 6 months: β = 3.09; 95% CI, 2.65-3.53; P < .001; 12 months: β = 3.91; 95% CI, 3.45-4.36; P < .001), cancer-related fatigue (6 months: β = -5.69; 95% CI, -8.03 to -3.35; P < .001; 12 months: β = -9.16; 95% CI, -11.31 to -7.00; P < .001), left handgrip strength (6 months: β = 2.69; 95% CI, 0.96-4.43; P = .002; 12 months: β = 5.52; 95% CI, 3.70-7.33; P < .001), right handgrip strength (6 months: β = 2.75; 95% CI, 1.01-4.50; P = .002; 12 months: β = 5.45; 95% CI, 3.62-7.27; P < .001), peak expiratory flow rate (12 months: β = 28.51; 95% CI, 16.10-40.92; P < .001), and quality of life (6 months: β = 5.01; 95% CI, 1.19-8.82; P = .01); 12 months: β = 14.19; 95% CI, 10.84-17.54; P < .001). In this randomized clinical trial, mobile instant messaging-delivered brief motivational interviewing was effective in promoting the adoption and maintenance of regular physical activity and ameliorating cancer- or treatment-related adverse effects in children who survived cancer. ClinicalTrials.gov Identifier: NCT03859271.

How patients with diabetes experience physical activity promotion during nursing consultations in the Spanish context

ObjectiveAlthough physical activity (PA) is a key behaviour for controlling Type 2 Diabetes, problematic adoption and/or adherence continues to impair disease management. This study aims to understand how patients with T2D live and experience nurses PA promotion during consultations in Spanish context. MethodThe present study is a qualitative research. In 2019–2020, pre-COVID-19, Twenty-two people living with T2D from Barcelona province contributed either to focus groups (n = 5) or to semi-structured interviews (n = 4). All interviews were recorded, transcribed, and analysed using conventional content analysis approach through constant comparative method. ResultsData analysis revealed two major themes with sixteen subthemes. The two major themes include: “Intra-personal conscious PA adoption processes” and “Structural unconscious PA (non)adherence processes”. ConclusionPatients’ experiences reflect two concurrent and interconnected issues. First, most patients readily adopted new PA after encouragement from nurses, who were the main proponents of PA. Indeed, adoption seemed to be most nurses’ PA priority and it was effective for most patients. Second, few nurses discussed adherence, making it an almost universal problem and source of disappointment. For adherence, patients experience that nurses’ attention needs to focus on activating processes and skills that support continued involvement in already-adopted PA.

Delivering Physical Activity Recommendations in Daily Clinical Cancer Care: An Observational Interview Study in Prostate Cancer Out-Patient Clinics Using an Empirical Ethics of Care Approach.

Physical activity (PA) has shown to mitigate many of the common side effects of cancer treatments. The promotion of PA by health care professionals (HCPs) can facilitate the adoption of PA by patients with cancer. Drawing on an empirical ethics of care approach, this article explores how the delivery of PA recommendations is done within clinical cancer care. Based on 175 observations of consultations between doctors, nurses and patients and interviews with 27 doctors and nurses, we show how delivering PA recommendations was related to four care practices: "adjusting information to match the patient's needs and situation," "managing current and anticipated treatment-induced side effects," "using visual aids and quantifiable data," and "maintaining a good relationship between the patient and the HCP." Drawing on these findings, we discuss strategies to strengthen the delivery of PA recommendations in clinical cancer care.

Physical Activity Guidelines for the Brazilian Population: Recommendations Report.

This article presents the recommendations from the Physical Activity Guidelines for the Brazilian Population. A steering committee composed of a chair, 6 experts in physical activity, and representatives from the Ministry of Health/Brazil, Pan American Health Organization, Brazilian Society of Physical Activity and Health designed the guidelines, which was implemented by 8 working groups, as follows: (1)understanding physical activity, (2)children up to 5 years old, (3)children and youth from 6 to 17 years old, (4)adults, (5)older adults (60 years and above), (6)physical education at school, (7)pregnant and postpartum women, and (8)people with disabilities. The methodological steps included evidence syntheses, hearings with key stakeholders, and public consultation. Across 8 chapters, the guidelines provide definitions of physical activity and sedentary behavior, informing target groups on types of physical activity, dosage (frequency, intensity, and duration), benefits, and supporting network for physical activity adoption. The guidelines are openly available in Portuguese, Spanish, English, and Braille and in audio versions, with a supplementary guide for health professionals and decision makers, and a report about the preparation and references. The Physical Activity Guidelines for the Brazilian Population provide evidence-based recommendations, being a public-directed resource to contribute to the physical activity promotion in Brazil.