Physical Activity-related Outcomes Research Articles

Development and evaluation of the IPLAY program: A protocol for a mixed-methods feasibility study targeting newcomer youth.

Physical Literacy (PL) is a synthesis construct that ties together movement competencies with affective, motivational, and knowledge-based elements. It is considered foundational to the development of physical activity-related outcomes. Many diverse organizations and programs have embraced the concept and are implementing programs targeting each of those core elements. However, research has lagged behind its interest and adoption. Among the more prominent gaps is the design and evaluation of programs that aim to increase PL within special populations such as new immigrants or refugee youth. The Immigrant-focused Physical Literacy for Youth (IPLAY) program is a co-developed evidence-informed 8-week PL program designed for new immigrant and refugee youths who have recently settled in Calgary, Alberta, Canada. This study aims to use a convergent parallel mixed-methods approach to collect, analyse, and interpret quantitative and qualitative data in the evaluation and iteration of the IPLAY program. PL programs can be used as a tool to build confidence and physical competencies among newcomer youth. Furthermore, academic-community collaborations in the design and delivery of PL programs can help improve the access and interest for PL programs among newcomer youth. These partnerships are critical and timely considering the recent and upcoming waves of immigration to "arrival cities" across Canada.

Lifestyle Interventions with Mind-Body or Stress-Management Practices for Cancer Survivors: A Rapid Review.

This rapid review examined current evidence on lifestyle interventions with stress-management or mind-body practices that assessed dietary and/or physical activity outcomes among cancer survivors. Searches were conducted in PubMed, Embase, and PsycINFO based on Cochrane Rapid Reviews Methods Group rapid review recommendations using the keywords "diet," "physical activity," "mind-body," "stress," and "intervention." Of the 3624 articles identified from the initial search, 100 full-text articles were screened, and 33 articles met the inclusion criteria. Most studies focused on post-treatment cancer survivors and were conducted in-person. Theoretical frameworks were reported for five studies. Only one study was tailored for adolescent and young adult (AYA) cancer survivors, and none included pediatric survivors. Nine studies reported race and/or ethnicity; six reported that ≥90% participants were White. Many reported significant findings for diet and/or physical activity-related outcomes, but few used complete, validated dietary intake methods (e.g., 24-h recall; n = 5) or direct measures of physical activity (e.g., accelerometry; n = 4). This review indicated recent progress on evaluating lifestyle interventions with stress-management or mind-body practices for cancer survivors. Larger controlled trials investigating innovative, theory-based, personalized interventions that address stress and health behaviors in cancer survivors-particularly racial/ethnic minority and pediatric and AYA populations-are needed.

Are Preference and Tolerance Measured With the PRETIE-Q (Preference for and Tolerance of the Intensity of Exercise Questionnaire) Relevant Constructs for Understanding Exercise Intensity in Physical Activity? A Scoping Review

Individual preference and tolerance can be seen as relevant traits for the understanding of the relationship between exercise intensity and behavioral outcomes. To better understand that relationship, this scoping review aimed to analyze preference for, and tolerance of, exercise intensity constructs in physical activity settings by verifying the contextual utility and feasibility of the subscales in the multiple settings of their application, the interpretation of the subscales, associations with other variables, and the reported limitations of the subscales’ use. The search was conducted through PubMed, SPORTDiscus, PsycINFO, and B-on databases. Inclusion criteria were healthy individuals including athletes, experimental and nonexperimental studies written in English based on the assessment of subjective intensity in exercise; studies including the variables tolerance and/or preference. Exclusion criteria were instrument validation studies with no concurrent data, gray literature, and systematic reviews. Thirty-six studies published between 2005 and 2022 were analyzed. Results indicate that both constructs appear to be useful and feasible in various physical activity settings. No relevant limitations were reported for its use. Preference and tolerance constructs assessed with the PRETIE-Q (Preference for and Tolerance of the Intensity of Exercise Questionnaire) seem to offer a simple but useful understanding of the individual relation with exercise intensity in several physical activity–related outcomes.

Ambivalence is associated with decreased physical activity and cardiorespiratory fitness among adolescents with critical congenital heart disease

BackgroundAdolescents with congenital heart disease (CHD) are insufficiently physically active. Given that increasing physical activity may reduce their cardiovascular risk, it is important to identify correlates of this behavior. Perceived benefits of and barriers to physical activity are associated with physical activity engagement. Existing research has only considered these constructs separately. This population may be ambivalent toward physical activity (i.e., perceive both strong benefits and barriers). The association of ambivalence and physical activity related outcomes is unknown among this at-risk population. ObjectiveDetermine the association of ambivalence and sedentary behavior, moderate-to-vigorous physical activity (MVPA), and cardiorespiratory fitness (VO2Peak) among adolescents with CHD. MethodsThe present study is an analysis of data from an eligibility assessment for a randomized clinical trial of an intervention to promote MVPA among adolescents aged 15 to 18 years with moderate or complex CHD. Participants (N = 84) completed a survey assessing perceived benefits and barriers from which ambivalence toward physical activity was calculated, an exercise stress test to measure VO2Peak, and wore an accelerometer for one week to determine their engagement in sedentary behavior and MVPA. Linear regression analyses determined associations between ambivalence and physical activity related outcomes. ResultsGreater ambivalence toward physical activity was associated with increased sedentary behavior, decreased MVPA, and reduced VO2Peak, adjusting for demographic and clinical covariates. ConclusionsAmbivalence is associated with objectively measured physical activity (sedentary behavior, MVPA) and a biomarker of cardiovascular health (VO2Peak). Screening for ambivalence may help clinicians identify those most likely to benefit from physical activity-related education.

Exploratory analysis of eating- and physical activity-related outcomes from a randomized controlled trial for weight loss maintenance with exercise and liraglutide single or combination treatment

Weight regain after weight loss remains a major challenge in obesity treatment and may involve alteration of eating and sedentary behavior after weight loss. In this randomized, controlled, double-blind trial, adults with obesity were randomized, in a 1:1:1:1 ratio stratified by sex and age group (<40 years and ≥40 years), to one-year weight loss maintenance with exercise, the GLP-1 receptor agonist liraglutide, or the combination, as compared with placebo, after low-calorie diet-induced weight loss. Primary outcome was change in body weight, which has been published. Here, we investigated the effects of weight loss maintenance with exercise, liraglutide, or the combination on weight loss-induced changes in the pre-specified explorative outcomes, eating and sedentary behavior in 130 participants who completed the trial according to the study protocol (exercise (n = 26), liraglutide (n = 36), combination (n = 29), and placebo (n = 39)). One year after weight loss, the placebo group had decreased postprandial appetite suppression score by 14%, and increased sedentary time by 31 min/day and regained weight. Liraglutide prevented the decrease in postprandial appetite suppression score compared with placebo (0% vs. −14%; P = 0.023) and maintained weight loss. Exercise after weight loss did not increase appetite or sedentary behavior compared with placebo, despite increased exercise energy expenditure and maintained weight loss. The combination of exercise and liraglutide increased cognitive restraint score (13% vs. −9%; P = 0.042), reflecting a conscious restriction of food intake, and decreased sedentary time by 41 min/day (−10 vs. 31 min/day; 95%CI, −82.3 to −0.2; P = 0.049) compared with placebo, which may have facilitated the additional weight loss. Targeting both eating and sedentary behavior could be the most effective for preventing weight regain.Trial registration: EudraCT number, 2015-005585-32; clinicaltrials.gov number, NCT04122716.

Nutrition and physical activity interventions for the general population with and without cardiometabolic risk: a scoping review.

The objective of this scoping review was to examine the research question: In the adults with or without cardiometabolic risk, what is the availability of literature examining interventions to improve or maintain nutrition and physical activity-related outcomes? Sub-topics included: (1) behaviour counseling or coaching from a dietitian/nutritionist or exercise practitioner, (2) mobile applications to improve nutrition and physical activity and (3) nutritional ergogenic aids. The current study is a scoping review. A literature search of the Medline Complete, CINAHL Complete, Cochrane Database of Systematic Reviews and other databases was conducted to identify articles published in the English language from January 2005 until May 2020. Data were synthesised using bubble charts and heat maps. Out-patient, community and workplace. Adults with or without cardiometabolic risk factors living in economically developed countries. Searches resulted in 19 474 unique articles and 170 articles were included in this scoping review, including one guideline, thirty systematic reviews (SR), 134 randomised controlled trials and five non-randomised trials. Mobile applications (n 37) as well as ergogenic aids (n 87) have been addressed in several recent studies, including SR. While primary research has examined the effect of individual-level nutrition and physical activity counseling or coaching from a dietitian/nutritionist and/or exercise practitioner (n 48), interventions provided by these practitioners have not been recently synthesised in SR. SR of behaviour counseling or coaching provided by a dietitian/nutritionist and/or exercise practitioner are needed and can inform practice for practitioners working with individuals who are healthy or have cardiometabolic risk.

Physical activity interventions to prevent and manage type 2 diabetes among Aboriginal and Torres Strait Islander peoples: a systematic review protocol.

This systematic review aims to synthesize evidence to determine the effect of physical activity on the prevention and management of type 2 diabetes among Aboriginal and Torres Strait Islander Australians. Physical activity interventions have been shown to have a positive influence in the prevention and management of type 2 diabetes. A body of evidence for the impact among Aboriginal and Torres Strait Islander people is emerging, but a definitive understanding is yet to be realized. The review will include studies with Aboriginal and Torres Strait Islander populations of any age group and from any setting or region in Australia. Studies will be included if they report on physical activity interventions, programs, or activities to prevent or manage type 2 diabetes. Studies may compare physical activity interventions to usual care, alternate treatments, or no intervention, or may be pre-post studies. This review will consider studies that measure change in physical activity or exercise levels and/or change in HbA1c level. Nine databases will be searched, and studies published in English will be included. No date limits will be set. Methodological quality will be determined using critical appraisal checklists appropriate to the study design and the CREATE Critical Appraisal Tool to appraise research from Aboriginal and Torres Strait Islander perspectives. Data extracted will include population group, study design, methods, intervention components, and physical activity-related outcomes. Quantitative data will be pooled where possible to enable a meta-analysis to be conducted. Heterogeneous studies will be synthesized narratively.

The Application of an Evidence Framework for Obesity Prevention at the Population-Level.

To review existing frameworks for assessing the evidence of effectiveness of obesity prevention interventions, and discuss the application of a custom-developed evidence framework to inform an obesity prevention priority-setting study in Australia. There are a wide range of frameworks for grading evidence. However, most frameworks are not well suited to assess the effectiveness of obesity prevention interventions because they do not include processes to synthesise evidence from multiple study designs and outcome measures. The key features of the Obesity Prevention Evidence Assessment (OPEA) Framework are: [1] separately assessed weight-, diet- and physical activity-related outcomes; [2] consideration of the balance of evidence from multiple study types; and [3] a summary indication of the degree of certainty of intervention effectiveness. Evidence frameworks that recognise the complexities of obesity prevention research can support decision-makers in prioritising actions to address obesity alongside broader priority-setting considerations.

The effectiveness of incidental physical activity interventions compared to other interventions in the management of people with low back pain: A systematic review and meta-analysis of randomised controlled trials

ObjectivesTo investigate the effectiveness of incidental (non-structured) physical activity interventions for the management of people with low back pain (LBP). DesignSystematic review and meta-analyses of randomised controlled trials. SettingEligible published trials from the earliest date available to November 2017. ParticipantsPeople with non-specific LBP aged 18 years or over. Outcome measuresPain, disability and physical activity-related outcomes. ResultsThree trials were included (including a total of 422 participants). The quality of trials, assessed by PEDro scale, was high (7 out of 10). For pain, the pooled results did not show any significant effects between the incidental physical activity intervention and other interventions at any time point. For disability, incidental physical activity was not statistically more effective than other interventions at short-term; however, the pooled results favoured incidental physical activity at intermediate-term (weighted mean difference (WMD) = -6.05, 95%CI: -10.39 to −1.71) and long-term (WMD = −6.40 95%CI: -11.68 to −1.12) follow-ups among participants with chronic LBP. The overall quality of evidence was rated “moderate-quality” based on the GRADE system. ConclusionsThe incidental physical activity intervention provided improvement in disability in intermediate- and long-term for people with chronic LBP, although this improvement was small and may not be clinically significant.

Lexical neutrality in environmental health research: Reflections on the term walkability

Neighbourhood environments have important implications for human health. In this piece, we reflect on the environments and health literature and argue that precise use of language is critical for acknowledging the complex and multifaceted influence that neighbourhood environments may have on physical activity and physical activity-related outcomes. Specifically, we argue that the term “neighbourhood walkability”, commonly used in the neighbourhoods and health literature, constrains recognition of the breadth of influence that neighbourhood environments might have on a variety of physical activity behaviours. The term draws attention to a single type of physical activity and implies that a universal association exists when in fact the literature is quite mixed. To maintain neutrality in this area of research, we suggest that researchers adopt the term “neighbourhood physical activity environments” for collective measures of neighbourhood attributes that they wish to study in relation to physical activity behaviours or physical activity-related health outcomes.

The use of smartphones to influence lifestyle changes in overweight and obese youth with congenital heart disease: a single-arm study

BackgroundBoth obesity and congenital heart disease (CHD) are risk factors for the long-term cardiovascular health of children and adolescents. The addition of smart mobile technology to conventional lifestyle counseling for weight management offers great potential to appeal to technologically literate youth and can address a large geographical area with minimal burden to participants. This pilot study seeks to examine the influence of a 1-year lifestyle intervention on nutrition and physical activity-related health outcomes in overweight or obese children and adolescents with CHD.MethodsThis is a pilot and feasibility study which utilizes a single-arm, prospective design with a goal to recruit 40 overweight and obese patients. The feasibility metrics will evaluate the integrity of the study protocol, data collection and questionnaires, recruitment and consent, and acceptability of the intervention protocol and primary outcome measures. The primary clinical outcome metrics are anthropometry, body composition, and cardiorespiratory exercise capacity. The secondary clinical metrics include quality of life, nutrition and physical activity behavior, lung and muscle function, and cardio-metabolic risk factors. Outcomes are assessed at baseline, 6 months, and 1 year. To date, a total of 36 children and youth (11 girls), aged 7–17 years (mean = 14.4 years), have commenced the intervention. Recruitment for the study was initiated in June 2012 and is currently ongoing.DiscussionThe information provided in this paper is intended to help researchers and health professionals with the development and evaluation of similar lifestyle intervention programs. Since the application of smartphones to pediatric cardiac health and obesity management is a novel approach, and continued research in this area is warranted, this paper may serve as a foundation for further exploration of this health frontier and inform the development of a broader strategy for obesity management in pediatric cardiology.Trial registrationThis pilot study was retrospectively registered at the www.ClinicalTrials.gov registry as NCT02980393 in November 2016, with the study commencing in May 2012. Study protocol version 15OCT2014.

Disentangling the relationship between children's motor ability, executive function and academic achievement.

Even though positive relations between children’s motor ability and their academic achievement are frequently reported, the underlying mechanisms are still unclear. Executive function has indeed been proposed, but hardly tested as a potential mediator. The aim of the present study was therefore to examine the mediating role of executive function in the relationship between motor ability and academic achievement, also investigating the individual contribution of specific motor abilities to the hypothesized mediated linkage to academic achievement. At intervals of ten weeks, 236 children aged between 10 and 12 years were tested in terms of their motor ability (t1: cardiovascular endurance, muscular strength, motor coordination), core executive functions (t2: updating, inhibition, shifting), and academic achievement (t3: mathematics, reading, spelling). Structural equation modelling revealed executive function to be a mediator in the relation between motor ability and academic achievement, represented by a significant indirect effect. In separate analyses, each of the three motor abilities were positively related to children’s academic achievement. However, only in the case of children’s motor coordination, the mediation by executive function accounted for a significance percentage of variance of academic achievement data. The results provide evidence in support of models that conceive executive function as a mechanism explaining the relationship that links children’s physical activity-related outcomes to academic achievement and strengthen the advocacy for quality physical activity not merely focused on health-related physical fitness outcomes, but also on motor skill development and learning.

A systematic review of lifestyle counseling for diverse patients in primary care.

Prior research and systematic reviews have examined strategies related to weight management, less is known about lifestyle and behavioral counseling interventions optimally suited for implementation in primary care practices generally, and among racial and ethnic patient populations. Primary care practitioners may find it difficult to access and use available research findings on effective behavioral and lifestyle counseling strategies and to assess their effects on health behaviors among their patients. This systematic review compiled existing evidence from randomized trials to inform primary care providers about which lifestyle and behavioral change interventions are shown to be effective for changing patients' diet, physical activity and weight outcomes. Searches identified 444 abstracts from all sources (01/01/2004-05/15/2014). Duplicate abstracts were removed, selection criteria applied and dual abstractions conducted for 106 full text articles. As of June 12, 2015, 29 articles were retained for inclusion in the body of evidence. Randomized trials tested heterogeneous multi-component behavioral interventions for an equally wide array of outcomes in three population groups: diverse patient populations (23 studies), African American patients only (4 studies), and Hispanic/Mexican American/Latino patients only (2 studies). Significant and consistent findings among diverse populations showed that weight and physical activity related outcomes were more amenable to change via lifestyle and behavioral counseling interventions than those associated with diet modification. Evidence to support specific interventions for racial and ethnic minorities was promising, but insufficient based on the small number of studies.

Can policy ameliorate socioeconomic inequities in obesity and obesity-related behaviours? A systematic review of the impact of universal policies on adults and children.

This systematic review examined the impact of universal policies on socioeconomic inequities in obesity, dietary and physical activity behaviours among adults and children. PRISMA-Equity guidelines were followed. Database searches spanned from 2004 to August 2015. Eligible studies assessed the impact of universal policies on anthropometric, dietary or physical activity-related outcomes in adults or children according to socioeconomic position. Thirty-six studies were included. Policies were classified as agentic, agento-structural or structural, and their impact on inequities was rated as positive, neutral, negative or mixed according to the dominant associations observed. Most policies had neutral impacts on obesity-related inequities regardless of whether they were agentic (60% neutral), agento-structural (68% neutral) or structural (67% neutral). The proportion of positive impacts was similar across policy types (10% agentic, 18% agento-structural and 11% structural), with some differences for negative impacts (30% agentic, 14% agento-structural and 22% structural). The majority of associations remained neutral when stratified by participant population, implementation level and socioeconomic position measures and by anthropometric and behavioural outcomes. Fiscal measures had consistently neutral or positive impacts on inequities. Findings suggest an important role for policy in addressing obesity in an equitable manner and strengthen the case for implementing a broad complement of policies spanning the agency-structure continuum.

Reach of Supplemental Nutrition Assistance Program-Education (SNAP-Ed) interventions and nutrition and physical activity-related outcomes, California, 2011-2012.

IntroductionThis study combined information on the interventions of the US Department of Agriculture’s Supplemental Nutrition Assistance Program–Education with 5,927 interview responses from the California Health Interview Survey to investigate associations between levels of intervention reach in low-income census tracts in California and self-reported physical activity and consumption of fruits and vegetables, fast food, and sugar-sweetened beverages.MethodsWe determined 4 levels of intervention reach (low reach, moderate reach, high reach, and no intervention) across 1,273 program-eligible census tracts from data on actual and eligible number of intervention participants. The locations of California Health Interview Survey respondents were geocoded and linked with program data. Regression analyses included measures for sex, age, race/ethnicity, and education.ResultsAdults and children from high-reach census tracts reported eating more fruits and vegetables than adults and children from no-intervention census tracts. Adults from census tracts with low, moderate, or high levels of reach reported eating fast food less often than adults from no-intervention census tracts. Teenagers from low-reach census tracts reported more physical activity than teenagers in no-intervention census tracts.ConclusionThe greatest concentration of Supplemental Nutrition Assistance Program–Education interventions was associated with adults and children eating more fruits and vegetables and adults eating fast food less frequently. These findings demonstrate the potential impact of such interventions as implemented by numerous organizations with diverse populations; these interventions can play an important role in addressing the obesity epidemic in the United States. Limitations of this study include the absence of measures of exposure to the intervention at the individual level and low statistical power for the teenager sample.

Better Together: Outcomes of Cooperation Versus Competition in Social Exergaming.

Children and adolescents most often play active videogames, or exergames, in a social environment. Social play may enhance the potential benefits of an exergaming experience, much like group exercise and team sports are observed to improve physical activity-related outcomes above those of solitary exercise. Two ubiquitous elements of exergames are cooperation and competition. Previous literature suggests that cooperative and competitive aspects of exergames may affect physiological and psychosocial changes. Competitive play has been found to increase energy expenditure and aggression in short bouts of exergaming. Cooperative exergaming has been found to increase motivation, promote continued play, enhance self-efficacy, and increase pro-social behaviors. In one study, a cooperative exergaming condition also resulted in significant weight loss for overweight and obese adolescents. Individual player differences such as individual preferences, competitiveness, weight status, age, gender, and ethnicity may moderate effects. Although the current volume of literature on competition and cooperation in exergaming is small, social exergames hold promise as an engaging alternative to traditional physical activity interventions and may promote a broad range of positive outcomes for children and adolescents. Principles of cooperation and competition are applicable for developers of health-promoting games. Future research is needed to further understand the mechanisms of how competition and cooperation in social exergaming impact physiological and psychosocial outcomes.

Examining the evidence for policy and environmental strategies to prevent childhood obesity in black communities: new directions and next steps.

Exposure to physical and policy environments that limit availability, affordability and appeal of healthy eating and active living options is higher for U.S. blacks than whites. This may contribute to high risk of obesity in black communities and limit effectiveness of preventive interventions. Here, we assess applicability to black Americans of findings from a prior evidence review system designed to accelerate the discovery and application of policy and environmental strategies for childhood obesity prevention and assess external validity. The database included 600 peer-reviewed articles reporting data from 396 sets of studies (study groupings) published from January 2000 through May 2009 and pertained to 24 types of policy and environmental strategies. Only 33 study groupings (~8%) included ≥ 50% black Americans or reported subgroup analyses. Of 10 evaluation studies for interventions rated as effective for all populations in the primary review, 8 suggested effectiveness of child-focused interventions in school or child care settings for obesity- or physical activity-related outcomes in black Americans. Overall findings highlight the need for rigorous evaluations of interventions that reach black children in community or institutional settings, and conceptual frameworks and research designs geared to identifying ethnic or ethnicity-income group differences in intervention effects.

Efficacy of technology-based interventions for obesity prevention in adolescents: a systematic review.

About one third of adolescents in the USA are overweight and/or obese. Obesity during the adolescent years is associated with many adverse health consequences, including type 2 diabetes, hypertension, hyperlipidemia, and psychosocial problems. Because of substantial advances in technologies and wide acceptance by adolescents, it is now possible to use technology for healthy weight management and prevention of obesity. This systematic review used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and aimed to evaluate the existing literature reported on the effectiveness of technology-based intervention (web-based, e-learning, and active video games) in preventing obesity in adolescents. The primary aim of this review was to explore if components of specific interventions were associated with a reduction in body mass index. Research articles obtained from CINAHL, Embase, PubMed, PsycInfo, and the Cochrane database from1990 to 2014 were reviewed. A total of 131 published articles were identified, and 14 met the inclusion criteria of a randomized or nonrandomized clinical study with body mass index as primary outcome and/or secondary outcomes of diet/physical activity and/or psychosocial function, tested lifestyle interventions to prevent obesity, used technology, and studied adolescents (aged 12–18 years). The results indicated that six of 14 studies found body mass index and/or body fat decreased at short-term (less than 12 months) follow-up. Six of eleven studies that examined physical activity or physical activity-related outcomes found an improved physical activity outcome (time playing active video games and increase in physical activity time), while five of seven studies which assessed dietary outcomes indicated improvement in dietary behaviors. Five of seven studies suggested an improvement in psychosocial function (reduced depression, improved self-esteem and efficacy, improvement on Behavior Assessment Scale) in adolescents involved in the technology-based intervention. All effective interventions utilized dietary and physical activity strategies as part of intervention components. Because of the variation in duration of intervention (range 10 weeks to 2 years), it is not clear what length of intervention is most effective. Future research should assess the long-term impact of technology-based interventions and evaluate mediators and moderators for weight change in adolescents.

Long-term Student Outcomes of the Integrated Nutrition and Physical Activity Program

To examine the long-term effects of the Integrated Nutrition and Physical Activity Program (INPAP), a school-based nutrition education program. Quasi-experimental design comparing intervention and comparison cohorts at 3-6 years after delivery of the INPAP intervention on nutrition- and physical activity-related outcomes. This study was conducted in 1 school district in a low-income rural county of ∼15,000 residents in south-central Colorado. In second grade, intervention and comparison cohorts included 173 (fall 2000) and 190 (fall 1999) students, respectively. Approximately 60% of these students completed assessments in eighth grade. INPAP is an experiential school-based nutrition education program, grounded in social cognitive theory and Piaget's cognitive development theory and adapted for use in a rural setting. Nutrition and physical activity knowledge, self-efficacy, attitudes and behaviors, body mass index. Wilcoxon signed rank test, chi-square test for proportions, and t test for means. Long-term effects were observed in nutrition-related knowledge and attitudes but not self-efficacy or behavior change. The effects that did occur were attenuated over time. This study found that INPAP implemented in elementary school had limited lasting effects by the end of middle school, a time when students have increased autonomy to make food choices.

Using motivation regulations in a person-centered approach to examine the link between social physique anxiety in physical education and physical activity-related outcomes in adolescents

ObjectivesThis study explored how social physique anxiety (SPA) combined with different patterns of motivation regulations might facilitate versus deter effort and enjoyment in physical education (PE) and leisure-time physical activity. DesignCross-sectional survey. MethodsHigh school students (N = 298; Mage = 15.72, SDage = 1.24 years) completed an in-class survey including SPA in PE, motivation regulations for PE, enjoyment and effort in PE and leisure-time physical activity. ResultsFour profiles of students were identified in cluster analysis based on autonomous motivation, introjected regulation, external regulation and SPA. Profile one (“high diverse motivation”; n = 84) reflected relatively high motivation across all regulations and average SPA. Profile two (“moderate autonomous motivation”; n = 92) included those with average scores on autonomous motivation and relatively low scores on introjected and external regulation and SPA. Profile three (“moderate diverse motivation and anxious”; n = 59) had relatively high SPA combined with average motivation regulations. Profile four (“externally controlled and anxious”; n = 63) also had relatively high SPA but relatively low autonomous motivation and introjected regulation and relatively high external regulation. MANOVA results showed that “externally controlled and anxious” students reported the lowest physical activity behavior and enjoyment in PE. Conversely, the “moderate diverse motivation and anxious” students have physical activity experiences that do not differ from the two profiles that exhibited lower SPA. ConclusionsHigher feelings of SPA in PE appear linked with lower levels of enjoyment and effort in PE and leisure-time physical activity outside of school only when coupled with higher external regulation. This finding helps explain inconsistent associations between SPA and physical activity outcomes.