Physical Activity-related Health Competence Research Articles

Promotion of physical activity-related health competence in the workplace—a qualitative evaluation of a pilot program

Zusammenfassung Hintergrund Körperliche Aktivität kann einen wichtigen Beitrag zur Prävention chronischer Erkrankungen leisten. Büroangestellte bewegen sich jedoch häufig zu wenig. Deshalb wurde ein digitales Bewegungsprogramm für diese Zielgruppe entwickelt, das sich direkt am Schreibtisch durchführen lässt. Es enthält wöchentliche Videoübungen, die durch wissensbasierte Aspekte und motivationsfördernde Informationen auf Basis des Modells der bewegungsbezogenen Gesundheitskompetenz ergänzt wurden. Begleitend wurden die Teilnahmemotivation am Bewegungsprogramm und potenzielle Barrieren aus der Perspektive der Nutzenden erhoben mit dem Ziel, das Programm zu evaluieren und anhand der Ergebnisse anzupassen. Studiendesign und Untersuchungsmethoden Auf Basis von leitfadengestützten Interviews wurden 11 Personen aus der Interventionsgruppe (5 Abbrecher*innen und 6, die die Studie abgeschlossen haben; Altersdurchschnitt: 49 ± 8 Jahre) zu ihrer Wahrnehmung des Bewegungsprogramms befragt. Der Leitfaden beinhaltete Fragen zur Bewegung im (Arbeits)alltag, dem Ablauf und der Bewertung des Bewegungsprogramms. Die Auswertung erfolgte anhand der strukturierenden qualitativen Inhaltsanalyse nach Kuckartz. Ergebnisse Die Befragten bewerten das Bewegungsprogramm, insbesondere die kurzen Videos, die jeweils eine Übung und Erklärungen dazu beinhalten, mehrheitlich positiv. Ein förderlicher Faktor zur Teilnahme am Bewegungsprogramm war dessen Design. Zu Barrieren für die Teilnahme zählen das Arbeitsumfeld, insbesondere die Bürosituation, potenzielle Reaktionen von Kolleg*innen, oder wahrgenommene Einstellungen der Vorgesetzten. Zum Abbruch der Teilnahme führten persönliche oder arbeitsbezogene Gründe wie Mehrarbeit oder ein eigenes Trainingsprogramm. Von den Teilnehmenden beschriebene Effekte des Programms beinhalten ein höheres Bewusstsein darüber, dass Bewegung wichtig ist, ebenso wie die Adaption von einzelnen passenden Übungen im eigenen Alltag. Schlussfolgerung Aus Sicht der Teilnehmenden besteht ein Bedarf nach mehr Bewegung am Arbeitsplatz. Damit die Implementierung gelingt, braucht es aber Unterstützung von den Organisationen (z. B. Unternehmen) und Kolleg*innen sowie Möglichkeiten, das Programm auf die eigene Arbeitssituation abzustimmen.

Implementation and dissemination of physical activity-related health competence in vocational nursing training: study protocol for a cluster-randomized controlled intervention trial

BackgroundAlthough the nursing sector gains growing importance in an aging society, students representing the future workforce often show insufficient health. Acknowledging the health-enhancing effects of adequate physical activity, the educational system in Bavaria, Germany, has recently integrated the promotion of physical activity-related health competence (PAHCO) into the nursing curriculum. However, it cannot be assumed that PAHCO has sufficiently permeated the educational practices and routines of the nursing schools. Therefore, the goal of the present study is to examine and compare the effectiveness as well as implementation of different intervention approaches to address PAHCO in the Bavarian nursing school system.MethodsWe randomly assign 16 nursing schools (cluster-based) to four study arms (bottom-up, top-down led by teachers, top down led by external physical activity experts, control group). Schools in intervention group 1 (IG-1) develop multicomponent inventions to target PAHCO via cooperative planning (preparation, planning, and implementation phase). Intervention groups 2 and 3 (IG-2, IG-3) receive both an expert-based intervention (developed through intervention mapping) via trained mediators to address PAHCO. External physical activity experts deliver the structured PAHCO intervention in IG-2, while teachers from the nursing schools themselves conduct the PAHCO intervention in IG-3. In line with a hybrid effectiveness implementation trial, we apply questionnaire-based pre-post measurements across all conditions (sample size calculation: nfinal = 636) to examine the effectiveness of the intervention approaches and, simultaneously, draw on questionnaires, interview, and protocol data to examine their implementation. We analyze quantitative effectiveness data via linear models (times-group interaction), and implementation data using descriptive distributions and content analyses.ConclusionThe study enables evidence-based decisions about the suitability of three intervention approaches to promote competencies for healthy, physically active lifestyles among nursing students. The findings inform dissemination activities to effectively reach all 185 schools of the Bavarian nursing system.Trial registrationClinical trials NCT05817396. Registered on April 18, 2023.

Fostering positive affective exercise experiences and affect-related competencies for a physically active lifestyle: The FEEL project

Introduction
 Interventions targeting physical inactive individuals have not yielded sufficient impact yet. This may be attributed to two reasons: Firstly, affective processes during physical activity (PA) are often inadequately acknowledged (e. g. shame, feeling bad; Hohberg et al. 2022). Secondly, individuals are often not empowered to PA that positively influences affective wellbeing and mental health (Sudeck & Pfeifer, 2016). The FEEL project addresses these two deficiencies by developing a program promoting pleasant experiences, affect regulation competence, wellbeing and consequently PA.
 The program is grounded in Ekkekakis et al.’s (2021) conceptual framework on affective exercise experiences and their antecedent appraisals. It consists of [a] an instructor workshop focused on creating an inclusive, socially supportive atmosphere. Additionally, the program features [b] group exercise sessions covering topics such as attentional focus, preferred intensity, and flexible goal setting. Experiential learning is employed during these sessions, encouraging participants to engage not only physically but also to reflect on and in action. Finally, the program incorporates [c] a PA counseling session, during which participants individual motives for exercise are assessed, and suitable activities are discussed (Schorno et al., 2022).
 Methods
 We plan a multicenter randomized controlled trial to investigate the impact of the 6-8 week FEEL program. Inactive individuals (meeting less than 75% of recommended PA guidelines) in the age of 16 to 35 will take part in the study. Participants will be recruited via schools, universities, companies, and social work institutions. Around 300 people will be assigned to either the intervention or control group. The control group will undergo a standard fitness program (usual care). The primary outcomes positive affective exercise experiences, affect regulation competence, wellbeing and PA will be measured pre- (0 weeks), post-intervention (6 weeks) and at follow-up (12 weeks). After piloting the FEEL program in April 2024, the main study will start in fall 2024.
 Discussion
 This study explores the impact of a multifaceted intervention in a primary care context. It may provide valuable insights for effective considerations of affective processes and related competencies in PA programs. Should the FEEL program showcase positive effects, there may be interest in extending its implementation in diverse settings (e.g., rehabilitation).
 References
 Ekkekakis, P., Zenko, Z., & Vazou, S. (2021). Do you find exercise pleasant or unpleasant? The Affective Exercise Experiences (AFFEXX) questionnaire. Psychology of Sport and Exercise, 55, Article 101930. https://doi.org/10.1016/j.psychsport.2021.101930
 Hohberg, V., Kreppke, J.‑N., Cody, R., Guthold, R., Woods, C., Brand, R., Dunton, G., Rothman, A., Ketelhut, S., & Nigg, C. (2022). What is needed to promote physical activity? Current Issues in Sport Science, 7, Article 005 https://doi.org/10.36950/2022ciss005
 Schorno, N., Gut, V., Conzelmann, A., & Schmid, J. (2022). Effectiveness of individual exercise and sport counseling based on motives and goals: A randomized controlled trial. Journal of Sport and Exercise Psychology, 44(2), 103-115. https://doi.org/10.1123/jsep.2021-0018
 Sudeck, G., & Pfeifer, K. (2016). Physical activity-related health competence as an integrative objective in exercise therapy and health sports – Conception and validation of a short questionnaire. Sportwissenschaft, 46, 74–87. https://doi.org/10.1007/s12662-016-0405-4

Toward a representative assessment of competencies for a healthy, physically active lifestyle in the German population: development and validation of a short version of the physical activity-related health competence questionnaire (PAHCO_12)

Representative studies assessing behavior-oriented determinants for physically active lifestyles in the German adult population are lacking due to the absence of validated assessment instruments. Drawing on the physical activity-related health competence (PAHCO) model, the goal of the present study was to develop and evaluate a short version of PAHCO differentiating between the three sub-competencies ’movement competence’, ’control competence’, and ’self-regulation competence’. In the first step, we reduced the number of items from existing PAHCO-related questionnaires, while adjusting them for a telephone survey mode. In the second step, we validated this 12-item version with N = 3986 adults between 18 and 97 years (57.0 ± 18.2 years; 52.0% male) within the representative survey “German health Update” (GEDA 2023). We also gathered information about participants’ age, gender, education, leisure-time physical activity, and self-reported health. The psychometric analyses revealed satisfactory item statistics. Confirmatory factor analyses suggested a model variant in which two items showed theory-conform parallel loadings on a second sub-competence (comparative fit index [CFI] = 0.924, root mean square error of approximation [RMSEA] = 0.073, standardized root mean square residual [SRMR] = 0.044). The latent sub-competencies were significantly related to physical activity (0.20 ≤ β ≤ 0.27) and health (0.50 ≤ β ≤ 0.65), thus indicating criterion validity. The factor structure turned out to be invariant across age, gender, and educational levels. In summary, this study gained initial insights about the reliability and validity of a 12-item version of the PAHCO questionnaire. We recommend the instrument for use within representative surveys, for initial screening, the reporting of descriptive trends, or secondary outcomes of a trial.

Development of the Perceived Physical Literacy Questionnaire (PPLQ) for the adult population

Background/objectiveIn physical literacy (PL) research, instruments for the adult population covering all relevant domians are currently lacking in German language. Therefore, the Perceived Physical Literacy Questionnaire (PPLQ) was developed as an assessment instrument of PL for the adult population. The purpose of this study is to describe the multistage development process leading to the aim to evaluate the psychometric properties of the PPLQ. MethodsBased on established questionnaires (subscales) operationalizing the six defined PL domains (motivation, confidence, physical competence, knowledge, understanding, and physical activity behavior), we generated a large item pool. Exploratory analyses on survey data (n = 506), compelemented through an expert panel, served to identify the best fitting items. Cognitive interviews (n = 7) and a language certification process (level A2) helped to enhance the content validity of the items. Finally, we assessed the hypothesized factor structure of the PPLQ and its convergent validity with the Physical Activity-related Health Competence (PAHCO) questionnaire in a second independent sample. ResultsValid data of 417 adults (66% women, 48 ± 16 years) entered the confirmatory factor analysis. We found empirical support for a theory-compatible 24-item version, after reducing complexity (i.e., domain subscales). Additionally, the six domains could be subsumed under an overall factor for PL (χ2247 = 450.70, χ2/df = 1.83, CFIRobust = 0.895, RMSEARobust = 0.074 [CI90 = 0.063–0.085], SRMR = 0.064). Factor loadings, composite reliability, and discriminant validity were sufficient, while acceptable convergent validity was achieved for the total PL score and three domains. ConclusionThe 24-item version of the PPLQ is appropriate for assessing PL among adults. However, some items (especially in the knowledge domain) can benefit from refinement in further studies.

O.5.3-8 Prospects and challenges of real-world labs in physical activity promotion

Abstract Purpose Participatory health promotion uses an array of different concepts to describe project processes and effects, including empowerment, capacity building, and capabilities. In practice, however, these concepts may hamper project scalability, compatibility with state-of-the-art health concepts, and efforts to counteract social inequities. We introduce the concept of real-world labs as a potential solution for current problems in participatory health promotion and investigate its practical applicability using the case example of an existing physical activity promotion project. Methods We analyze current problems in participatory health promotion that emanate from the utilization of certain popular theoretical concepts. We then introduce real-world labs as a potential solution. Using the PArC-AVE-Project (Physical Activity-related Health Competence in Apprenticeship and Vocational Education) as a case example, we show how the approach can be used retrospectively to address the aforementioned issues. Results Real-world labs are a type of transdisciplinary approach at the intersection of research and society. They help create an environment for flexibly testing innovative solutions under changing conditions using small-scale “real-world experiments” and feedback loops. However, the approach is so far not commonly used in participatory health promotion. The example of PArC-AVE illustrates that existing participatory projects can potentially be developed towards becoming real-world labs. Relevant perspectives for this include (a) the targeted integration of different actors into the participation process, (b) more variable approaches to scaling-up interventions, (c) a more flexible utilization of different participation methods, and (d) a better recognition of concepts such as planetary health. Conclusions The real-world lab approach has the potential to increase the range of options available to participatory health and physical activity promotion. However, only further practical testing will show whether it is indeed effective in overcoming social inequities and ameliorating the high degree of context-dependence of many participatory projects.

Physical activity-related health competence and symptom burden for exercise prescription in patients with multiple myeloma: a latent profile analysis

The purpose of this study is to ensure best possible supply of exercise therapy to patients with multiple myeloma (MM); it is helpful to identify patient groups with similar symptom burden and physical activity–related health competences (PAHCO). Latent profile analyses (LPA) of MM patients were used to identify profiles of patients with similar PAHCO and symptom burden. Analysis of variance was applied to investigate group differences in important covariates. N = 98 MM patients (57% male, age 64 ± 9 years) could be assigned to three distinct PAHCO profiles: 46% were patients with high PAHCO, 48% patients with moderate, and 5% were patients with low PAHCO. The mean probability to be assigned to a certain profile was over 99%. The first group showed significant higher physical activity (PA) and lower comorbidities. Regarding symptom burden, three different profiles exist, including group one (32% of patients) with very low symptom burden, profile two (40%) with medium symptom burden, and group three (15%) with very high symptom burden (mean probability ≥ 98%). Patients in profile one had a lower number of treatment lines compared to the other profiles. Patients who were assigned to the high PAHCO profile were more likely to display a milder symptoms profile. In this exploratory analysis, we identified different patient profiles for PAHCO and symptom burden that may be used to individualize exercise recommendations and supervision modalities in MM patients. PAHCO and symptom burden level may be used to stratify MM patients in order to provide more personalized and effective exercise counseling. The profiles require individualized exercise recommendations and different supervision modalities, including educational instructions tailored particularly to every patient’s needs, according to their PAHCO and symptom profile.Trial registration numberNCT04328038.

Promoting physical activity-related health competence to increase leisure-time physical activity and health-related quality of life in German private sector office workers

BackgroundOffice workers (OWs) are at risk of low levels of health-enhancing physical activity (HEPA) and impaired health-related quality of life (HRQOL). Interventions based on physical activity-related health competence (PAHCO) aim to facilitate long-term changes in HEPA and HRQOL. However, these assumptions rely on the changeability and temporal stability of PAHCO and have not been tested empirically. This study therefore aims to test the changeability and temporal stability of PAHCO in OWs within an interventional design and to examine the effect of PAHCO on leisure-time PA and HRQOL.MethodsThree hundred twenty-eight OWs (34% female, 50.4 ± 6.4 years) completed an in-person, three-week workplace health promotion program (WHPP) focusing on PAHCO and HEPA. The primary outcome of PAHCO as well as the secondary outcomes of leisure-time PA and HRQOL were examined at four measurement points over the course of 18 months in a pre-post design by employing linear mixed model regressions.ResultsPAHCO displayed a substantial increase from the baseline to the time point after completion of the WHPP (β = 0.44, p < 0.001). Furthermore, there was no decrease in PAHCO at the first (p = 0.14) and the second follow-up measurement (p = 0.56) compared with the level at the end of the WHPP. In addition, the PAHCO subscale of PA-specific self-regulation (PASR) had a small to moderate, positive effect on leisure-time PA (β = 0.18, p < 0.001) and HRQOL (β = 0.26, p < 0.001). The subscale of control competence for physical training (CCPT) also had a positive small to moderate effect on HRQOL (β = 0.22, p < 0.001).ConclusionThe results substantiate PAHCO’s theoretical characteristics of changeability and temporal stability, and underline the theoretically postulated effects on leisure-time PA and HRQOL. These findings highlight the potential of PAHCO for intervention development, which can be assumed to foster long-term improvements in HEPA and HRQOL in OWs.Trial registrationThe study was retrospectively registered in the German Clinical Trials Register, which is an approved Primary Register in the WHO network, at the 14/10/2022 (DRKS00030514).

Fostering physical activity-related health competence after bariatric surgery with a multimodal exercise programme: A randomised controlled trial

Regular physical activity (PA) supports the long-term success of bariatric surgery. However, integrating health-enhancing physical activity in daily life requires specific competences. In this study, we evaluated a multimodal exercise programme to build these competences.Forty adults who underwent bariatric surgery were randomised to a multimodal exercise programme or control group. Primary outcomes were the facets of PA-related health competences, namely the control competence for physical training, PA-specific affect regulation, motivational competence and PA-specific self-control. Secondary outcomes were PA behaviour and subjective vitality. Outcomes were assessed before, directly after the intervention and at 3 months follow-up.Significant treatment effects were found for control competence for physical training and PA-specific self-control but not for PA-specific affect regulation and motivational competence. Significant treatment effects were further observed for self-reported exercise and subjective vitality, all in favour of the intervention group. In contrast, no treatment effect was found for device-based PA. Overall, this study provides a foundation for future research to optimise long-term post bariatric surgery outcomes.

Promotion of physical activity-related health competence using digital workplace-based health promotion: protocol for a controlled before-and-after study

Physical activity (PA) has a high potential to prevent chronic diseases. At the same time, many people in Germany do not achieve PA recommendations due to trends such as digitalisation...

Long-term efficacy of exercise across diagnostically heterogenous mental disorders and the mediating role of affect regulation skills

BackgroundExercise interventions are efficacious in reducing disorder-specific symptoms in various mental disorders. However, little is known about long-term transdiagnostic efficacy of exercise across heterogenous mental disorders and the potential mechanisms underlying treatment effects. MethodsPhysically inactive outpatients, with depressive disorders, anxiety disorders, insomnia or attention deficit hyperactivity disorder were randomized to a standardized 12-week exercise intervention, combining moderate exercise with behavior change techniques (BCTs) (n = 38), or a passive control group (n = 36). Primary outcome was global symptom severity (Symptom Checklist-90, SCL-90-R) and secondary outcomes were self-reported exercise (Physical Activity, Exercise, and Sport Questionnaire), exercise-specific affect regulation (Physical Activity-related Health Competence Questionnaire) and depression (SCL-90-R) assessed at baseline (T1), post-treatment (T2) and one year after post-treatment (T3). Intention-to-treat analyses were conducted using linear mixed models and structural equations modeling. ResultsFrom T1 to T3, the intervention group significantly improved on global symptom severity (d = −0.43, p = .031), depression among a depressed subsample (d = −0.62, p = .014), exercise (d = 0.45, p = .011) and exercise-specific affect regulation (d = 0.44, p = .028) relative to the control group. The intervention group was more likely to reveal clinically significant changes from T1 to T3 (p = .033). Increases in exercise-specific affect regulation mediated intervention effects on global symptom severity (ß = −0.28, p = .037) and clinically significant changes (ß = −0.24, p = .042). ConclusionsThe exercise intervention showed long-term efficacy among a diagnostically heterogeneous outpatient sample and led to long-lasting exercise behavior change. Long-term increases in exercise-specific affect regulation within exercise interventions seem to be essential for long-lasting symptom reduction.

Effectiveness and implementation success of a co-produced physical activity referral scheme in Germany: study protocol of a pragmatic cluster randomised trial

BackgroundWhile effective physical activity referral schemes (PARSs) and related structures for promoting physical activity (PA) already exist in several countries, in Germany, PARSs have not yet been implemented systematically and nationwide. Through a co-production approach with relevant actors in the German healthcare system, a PARS was developed, and an implementation plan was created (e.g. financing). This study protocol aims to evaluate the developed PARS for people with non-communicable diseases (NCDs) in Germany regarding its potential effectiveness and implementation success.MethodsTo evaluate the effectiveness and implementation success of the PARS, we will apply a pragmatic cluster-randomised controlled trial (cRCT) in Hybrid II design by comparing two intervention groups (PARS vs PA advice [PAA]). The trial will take place in the Nürnberg metropolitan region, with 24 physician practices recruiting 567 people with NCDs. Both groups will receive brief PA advice from a physician to initially increase the participants’ motivation to change their activity level. Subsequently, the PARS group will be given individualised support from an exercise professional to increase their PA levels and be transferred to local exercise opportunities. In contrast, participants in the PAA group will receive only the brief PA advice as well as information and an overview of regional PA offerings to become more active at their own initiative. After 12 and 24 weeks, changes in moderate to vigorous PA and in physical activity-related health competence (movement competence, control competence, self-regulation competence) will be measured as primary outcomes. Secondary outcomes will include changes in quality of life. To measure implementation success, we refer to the RE-AIM framework and draw on patient documentation, interviews, focus groups and surveys of the participating actors (physicians, exercise professionals).DiscussionThrough a between-group comparison, we will investigate whether additional individual support by an exercise professional compared to brief PA advice alone leads to higher PA levels in people with NCDs. The acceptance and feasibility of both interventions in routine care in the German healthcare system will also be evaluated.Trial registrationClinicalTrials.gov, NCT04947787. Registered 01 June 2021.

Possibilities of educational technologies for forming the physical activity-related health competence of students in the course of distance learning

Youth’s health is currently considered at the level of universities: various programs and projects are implemented; teaching aids and methodological recommendations are introduced into the educational process. All this requires the development and use of new educational technologies to form the values-based attitude of students to their health. Due to the COVID-19 outbreak, the heads of many universities had to make a difficult decision to suspend the educational activities of their students, which requires quick adaptation to the new conditions. The study aims at determining the readiness of students to form physical activity-related health competence in the course of distance learning. The article provides an experimental assessment of students' readiness to form the physical activity-related health competence in the course of distance learning. The lack of it stipulates the need to determine specific activities to improve distance learning in physical education and sports. Consequently, the current need is to form the physical activity-related health competence of students, which ensures the improvement of their health and the possibility of realizing their potential abilities in the learning process.

The \u201ccan do, do do\u201d concept in individuals with chronic obstructive pulmonary disease: an exploration of psychological mechanisms

BackgroundThe “can do, do do” concept aims at identifying subgroups among persons with chronic obstructive pulmonary disease (COPD). Following a two-dimensional categorization, individuals are binarily classified with respect to their levels of physical capacity (“can’t do” or “can do”) and physical activity (“don’t do” or “do do”), resulting in four disjunct quadrants. The approach has been debated recently and the latest articles have concluded that the quadrants should be specifically examined in terms of psychological aspects of physical activity. Therefore, the goal of the present study was to explore the role of psychological variables in physical activity in the context of the “can do, do do” quadrant concept.MethodsWithin the scope of secondary data analyses of the “Stay Active After Rehabilitation” (STAR) randomized controlled trial, a total of 298 COPD rehabilitants of an inpatient pulmonary rehabilitation program were grouped into the suggested quadrants. We set fixed cut-offs at 70% of relative 6-min walking test performances for healthy individuals (physical capacity dimension) and 5.000 steps per day (physical activity dimension). Univariate and multivariate logistic regression analyses served to analyze whether depression scores, fear avoidance behaviors, disease-specific anxiety, self-concordance for physical activity, and five indicators of physical activity-related health competence (PAHCO) effectively discriminated between the “don’t do” and “do do” groups.ResultsAmong persons with lower relative physical capacity, depression scores, fear avoidance behaviors, and disease-specific anxiety (univariate case) significantly differentiated between the more and the less active. Among persons with higher relative physical capacity, fear avoidance behaviors, disease-specific anxiety, as well as three PAHCO indicators (physical activity-specific self-efficacy, self-control, and affect regulation) significantly separated the more and the less active. In multivariate analyses, only fear avoidance behaviors and affect regulation discriminated among individuals with better relative physical capacity.ConclusionThe findings identified important psychological and competence-oriented variables that explain discrepancies in the quadrant concept. Based on this, we discuss implications for physical activity promotion in individuals with COPD. Respiratory research can benefit from future studies complementing the quadrant concept through further behavioral analyses.Trial registration Clinicaltrials.gov, ID: NCT02966561. Registered 17 November, 2016, https://clinicaltrials.gov/ct2/show/NCT02966561.

The Role of Physical Activity-Related Health Competence and Leisure-Time Physical Activity for Physical Health and Metabolic Syndrome: A Structural Equation Modeling Approach for German Office Workers.

Office workers (OWs) are prone to insufficient physical activity (PA), which increases their risk of metabolic syndrome (MetS) and impaired physical health. The Physical Activity-related Health Competence (PAHCO) model holds the potential to facilitate a healthy physically active lifestyle. Therefore, in this study, we investigate the interplay between PAHCO, leisure-time PA, physical health, and MetS in OWs in Germany. In a cross-sectional study, OWs (N = 316, 25% female) completed self-report questionnaires along with an occupational health checkup to examine their Metabolic Syndrome Severity Score (MetSSS) values. Structural equation modeling indicated a strong positive association between PAHCO and leisure-time PA and a small positive association with physical health. PAHCO showed a considerable negative association with the MetSSS. Leisure-time PA was a positive mediator for the PAHCO–physical health association but was not a significant mediator for the association between PAHCO and the MetSSS. These findings underscore the importance of PAHCO in the context of leisure-time PA, physical health, and MetS in OWs. Furthermore, our findings highlight the health-enhancing value of the qualitative aspects of PA, such as motivational and volitional components in PA participation, with respect to physical health and MetS.

Promotion of physical activity-related health competence in physical education: A person-oriented approach for evaluating the GEKOS intervention within a cluster randomized controlled trial

A central goal of physical education (PE) is to empower students to be physically active in a health-enhancing way. Therefore, using a competence-based approach, the objective of the health- and fitness-related PE intervention ‘Promotion of physical activity-related health competence in PE’ (GEKOS) was to address practical and theoretical content regarding training, fitness, and health. The aim of this person-oriented study was to examine differential effects of the GEKOS intervention on control competence and related knowledge, skills, abilities, and motivation. A total of 860 ninth graders were randomly assigned to an intervention or control group. Intervention group students received six PE lessons that combined practical and theoretical content regarding training, fitness, and health. Measurements were taken before, directly after, and with a follow-up after 8–12 weeks. Students completed a knowledge test and a fitness test, and filled out scales considering motivation and perceived control competence. Latent profile analysis and multinomial logistic regression were estimated. Five patterns of outcome measures were found. Intervention group students transitioned significantly more often to patterns with improved outcome values. The intervention was especially effective for a subgroup of students who initially had rather low outcome values. For a small proportion of students, the intervention entailed a loss of health-related motivation. The study indicated that students with low control competence and related knowledge, skills, abilities, and motivation can benefit from the GEKOS intervention. Future studies should investigate modes of actions and interventions that explicitly address motivation and vary the content and methods used in PE.

Relationship Between Cancer Related Fatigue, Physical Activity Related Health Competence, and Leisure Time Physical Activity in Cancer Patients and Survivors.

Background: A large body of evidence supports the positive effects of leisure time physical activity (LTPA) and exercise on cancer survivors. However, only a fraction of survivors manages to attain international PA recommendations. This can be attributed to several external and internal barriers toward PA those patients seem to encounter, with cancer related fatigue (CRF) being the most reported internal barrier. Nevertheless, self-efficacy and knowledge about the utilization of LTPA can serve as facilitators of PA, which also correspond to certain constituents of physical activity related health competence (PAHCO). Since PAHCO is not investigated in cancer survivors we investigated if PAHCO can mediate the negative relationship between CRF and LTPA.Methods: We surveyed 398 cancer survivors with different cancer types and therapy status. The patients completed the EORTC QLQ-FA12 (EORTC FA12) to assess CRF, the PAHCO questionnaire to assess PAHCO and the SQUASH to assess LTPA. We followed a two-step structural equation modeling approach. The first step established the measurement model, in the second step we fitted the mediation model. Since 163 patients chose not to answer the SQUASH, the mediation model was only fitted to the data of the remaining 235 participants.Results: The proposed measurement model of the PAHCO offered an excellent fit. We found small to moderate positive associations between the PAHCO dimensions and the LTPA, and negative moderate relationships between the PAHCO and the EORTC FA12 dimensions. We did not observe a relationship between the EORTC FA12 dimensions and the LTPA (p > 0.05). The hypothesized mediation models did not display an appropriate fit.Conclusion: The PAHCO confirmed its factorial validity; furthermore, it appears to have a positive relationship to LTPA. Therefore, integrating psycho-educational aspects can be beneficial in order to increase the PAHCO in exercise interventions. Because of the cross-sectional character of this study, causal conclusions are not suitable, therefore the longitudinal relationships of LTPA, CRF, and PAHCO require further investigation.

The Relevance of Competences for a Healthy, Physically Active Lifestyle in Persons with Multiple Sclerosis: a Path Analytical Approach

To promote health and counteract the decline associated with the disease, persons with multiple sclerosis (pwMS) are advised to lead healthy, physically active lifestyles. The physical activity-related health competence (PAHCO) model posits that individuals must meet three integrated, person-related requirements for the adoption of such a lifestyle: movement competence, control competence, and self-regulation competence. To gain insights into the needs and challenges of pwMS, the goal of the present study was to empirically examine the roles of these competences within this target group. A total of 475 pwMS underwent a multidimensional, online-based assessment of PAHCO. These participants self-reported their amount of physical activity (PA), health status, disease-related, and sociodemographic information. We used a series of path analyses to investigate the relevance of the three competence areas for each individual’s PA level and subjective health. Stepwise multivariate analyses revealed that self-regulation competence was significantly associated with overall PA volume. In contrast, movement competence did not contribute to this prediction. Control competence was also not related to PA level. However, in accordance with the PAHCO model, this factor exerted an independent, qualitative effect on participant health. In summary, self-regulation competence appears to play a crucial role with regard to PA volume. Specifically, control competence appears to be key for the qualitative aspect of PA promotion, characterizing the individual’s application of an appropriate stimulus for the achievement of health. Integrating the promotion of self-regulation and control competences into rehabilitation practices can help to foster healthy, physically active lifestyles in pwMS. Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.1935437 .

What About the Environment? How the Physical Activity-Related Health Competence Model Can Benefit From Health Literacy Research.

Research cultivates a multitude of frameworks, models, and theories with different determinants internal and/or external to the individual contributing to the understanding and explaining of physical activity levels. The physical activity–related health competence (PAHCO) model can be located at the interface between research of health literacy and physical activity. Because of its primary person orientation, however, the model has not yet undergone discussions on the relevance of the environment. Encouraged by the developments in the area of health literacy, the goal of the present perspective article was to stimulate some initial reflections on potential solutions for the competence–environment relationship within the PAHCO model. We extracted three potential solutions for this issue. Dubbed the solution of integration, we first discussed that the PAHCO model could be placed into overarching, more holistic, and abstract models of health-enhancing physical activity, such as the capability approach or the socioecological model. Applying a solution of elaboration, researchers could second substantiate existing components of the PAHCO model, such as control competence or self-regulation competence, by further explanations. Characterizing the solution of extension, it would third be possible to introduce (a) separate competence component(s) that highlight(s) the manageability of the environment, for instance, by establishing a (socio)ecological competence. The article concludes with a short overview of potential empirical approaches, given their potential to assist researchers in identifying preferences for the theoretical advancement and to put the development on a stronger evidence base.

Effects of a physical education intervention programme for ninth-graders on physical activity-related health competence: Findings from the GEKOS cluster randomised controlled trial

The main purpose of this cluster randomised controlled trial was to investigate the effects of a physical education (PE) intervention programme combining theoretical and practical components on students' knowledge, skills, abilities and motivation related to competence for a healthy active lifestyle. The intervention used learning tasks to combine theory on health and physical fitness with either running/jumping activities or small-sided ball games and was compared to regular PE classes. Forty-eight PE classes were randomly assigned to intervention (IG-run, IG-game play; 27 classes) and control (CG-run, CG-game play; 21 classes) groups. Overall, 841 ninth-graders (51.1% girls, Mage = 14.20, SD = 0.51) were tested before and after the six-week intervention and in an eight-to-twelve-week follow-up. Students completed a health-related fitness knowledge test, questionnaires on control competence for physical training, health- and fitness-related interest and attitudes, and physical fitness tests. Regressions in structural equation models revealed positive treatment effects of the game play intervention on students' knowledge (βStdY = 0.33, 99.6% CI [0.12, 0.55]) and control competence for physical training (βStdY = 0.26, 99.6% CI [0.02, 0.50]) at the post-test. No significant effects were found at the follow-up test. Treatment effects were independent of gender. The results indicate the short-term effectiveness of learning tasks combining theory with ball games in order to develop knowledge and control competence for physical training in PE. Further studies have to clarify how to sustain effects over time and address students' physical fitness and health- and fitness-related interest and attitudes in interventions combining theory and practice. Trial registrationThis study was retrospectively registered with the German Clinical Trials Register (DRKS), DRKS-ID: DRKS00016349.