Physical Activity Self-regulation Research Articles

367 The Effect of a Culturally-tailored and Theory-based Resistance Exercise Intervention on Motivation, Self-Regulation, and Adherence in Young Black Women

OBJECTIVES/GOALS: Black women participate in the least amount of physical activity in the U.S., and determining methods to increase motivation and consistent exercise are warranted. Purpose: This study assessed differences in psychological and behavioral outcomes in young Black women in a culturally-tailored and theory-based resistance exercise (RE) study. METHODS/STUDY POPULATION: Women (M= 22.7 ± 3.6y) were randomized to the standard exercise group (SEG; n= 6) or motivational exercise group (MEG; n= 8), and completed 10 weeks of RE with a Black woman trainer and 11 weeks of unsupervised RE. The MEG discussed and received text messages about exercise education, self-regulation, autonomy, and competence. Motivation was measured by the Behavioral Regulation in Exercise Questionnaire-3, the Physical Activity Self-Regulation Scale-12 measured self-regulation, and the Basic Psychological Needs in Exercise Scale measured competence, autonomy, and relatedness. Adherence was calculated as # of completed/total sessions, and retention was the percent of women who completed ≥2 days/week of unsupervised RE. An ANOVA and Bonferroni post hoc analyses were used to determine significant findings. RESULTS/ANTICIPATED RESULTS: Significant time effects were found for intrinsic motivation (Λ = .691, F [11, 2]= 17.494, p< .001), basic psychological needs (Λ = .951, F [11, 2]= 22.691, p< .001), and self-regulation (Λ = .881, F [10, 2]= 40.942, p< .001), but no main interactions. Significant increases occurred from pre-testing to 3-mo follow-up for intrinsic motivation (pre: 1.80 ± .90 vs 3mo: 2.71 ± .63, p= .002), competence (pre: 1.98 ± .93 vs 3mo: 3.55±.81, p< .001), autonomy (pre: 2.14 ± .75 vs 3mo: 3.81 ± .74, p< .001) relatedness (pre: 2.78±1.60 vs 3mo: 4.32 ± .58, p< .001), and self-regulation (pre: 18.4 ± 2.88 vs 3mo: 33.79 ± 3.11, p< .001). Adherence rates for both groups were 93%. Retention rates were 33% for SEG and 25% for MEG. MEG had 38% complete RE 1 day/week opposed to none in SEG. DISCUSSION/SIGNIFICANCE: Ten weeks of culturally-tailored, supervised RE showed efficacy in significantly increasing motivation and behavioral practices to help sustain exercise. Future research should further explore strategies to use during unsupervised training to help increase exercise adherence in young Black women.

Abstract P466: A Culturally Tailored mHealth Lifestyle Intervention Improves Diet and Physical Activity Self-Regulation Among African Americans

Background: Physical inactivity and poor adherence to healthy eating guidelines impact cardiovascular health (CVH) outcomes in African American (AAs). Our randomized controlled trial (RCT) testing the FAITH! App, an mHealth lifestyle intervention, showed efficacy in promoting ideal CVH, particularly diet and physical activity (PA) among AAs, warranting exploration of underlying factors. Psychosocial factors (e.g., self-regulation, self-efficacy, social support) are key to healthy behavior adoption. Hypothesis: The intervention group would have greater improvements in diet and PA-related psychosocial factors than the control group after using the FAITH! App. Methods: A 2-arm cluster RCT was conducted among AAs from 16 churches in Minnesota comparing the FAITH! App intervention to a delayed intervention control group. The FAITH! App included culturally relevant, CVH-focused education modules, diet/PA self-monitoring and a sharing board. The outcomes were change in diet and PA self-regulation and self-efficacy (primary) and social support and barriers (secondary) at 6 months post-intervention. The intervention effect was assessed using linear regression. Results: Sixty-eight participants were included (71% female; mean age [SD]: 54.7 [12.6] years) ( Table 1 ). The intervention group showed a significantly greater increase in diet self-regulation [planning/tracking nutrition] (+0.66, p<.03) and PA self-regulation [step count strategies] (+0.47, p=.003) than the control group. Within groups, the intervention group demonstrated significant improvements across diet and PA self-regulation measures, while the control group showed an improvement only in fruit/vegetable and grain intake. No effect was observed in self-efficacy, social support, or barriers. Conclusions: Our culturally tailored mHealth lifestyle intervention was associated with notable increases in diet and PA self-regulation, suggesting a potential mechanism by which the FAITH! App improves healthy eating and PA among AAs.

A Multicomponent Workplace Environmental Intervention to Promote Physical Activity among the Staff of Universiti Malaysia Sarawak.

Physical inactivity is a significant public health issue affecting working adults because it can increase the risk of noncommunicable diseases. The objective is to determine the outcomes of a multi-component workplace environmental intervention that incorporated physical activity self-regulation (PASR) to promote physical activity (PA) among employees. This was a 6-month intervention with a two-group, parallel, quasi-experimental study. A total of 11 workplaces were randomly assigned to intervention group (IG) or control group (CG) using a 1:1 allocation ratio. In each group, 84 eligible participants were recruited. The IG was exposed to the organizational support and the PA support components throughout the study. The PASR Scale, International PA Questionnaire, and pedometer were used to measure the outcome at the baseline, 3rd-month, and 6th-month follow-ups, respectively. The repeated measures-analysis of variance analysis was used to determine the changes in the PASR skills, MET-min/week, and step/week over time. The IG had 75 participants (51 females and 24 males) and the CG had 73 participants (52 females and 21 males) at the 6th-month follow-up. Despite there was no statistically significant difference in the outcomes between groups over time, the IG showed significant improvements in total PASR (ηp2 = 0.021), goal setting (ηp2 = 0.024), total MET-min/week (ηp2 = 0.031), housework-related PA (ηp2 = 0.101), and step/week (ηp2 = 0.827) throughout this intervention. This intervention was found to be effective in improving the PASR skills, MET-min/week, and step/week of IG participants. Meanwhile, because some effect sizes were small, these findings should be interpreted with caution.

Perspective Review: The Influence of Gait Efficacy on Improving Physical Activity in Community-Dwelling Older Adults

Aging appears to be associated with a rise in the prevalence of inactivity. The Covid-19 pandemic was also reported associated with physical functioning and fall outcomes, with the greatest effect on individuals with reduced physical activity and social. Therefore, the elderly as the most populous group vulnerable need serious attention. Gait efficacy is defined as an individual’s perception of their level of confidence in order to perform safe walking tasks. Increasing older adults' gait-related self-efficacy is potentially necessary in order to promote self-regulation of physical activity and initiate the development of good physical activity habits as early prevention of disuse syndrome or inactivity in older adults.

Fit with Faith: An Exploratory Study Examining a Behavior Change Intervention for African-American Clergy and Their Spouses.

Fit with Faith is a 10-week, diet, physical activity, and stress reduction intervention for African-American clergy and spouses, which included: meetings, phone calls, a behavior tracking app. Survey, 24-h recall, accelerometer, anthropometric, and blood pressure data were collected. Wilcoxon signed ranked tests were used for analyses. In this one-arm study, clergy and spouses (n = 20) attended most meetings and calls, but only half posted daily goals or tracked behaviors using the app. Spouses' body mass index (BMI) decreased and physical activity self-regulation cognitive scores increased pre-post intervention. Statistically significant changes in BMI, systolic blood pressure, and self-regulations scores also were seen among younger (< 51years) participants (n = 8). As positive changes were seen mostly among women and younger participants, more research is needed on how to engage all clergy in behavior change programs.

Triathletes are experts in self-regulating physical activity – But what about self-regulating neural activity?

Regular exercise improves cognitive control abilities and successful self-regulation of physical activity. However, it is not clear whether exercising also improves the ability to self-regulate one’s own brain activity. We investigated this in 26 triathletes and 25 control participants who did not exercise regularly. Within each group half of the participants performed one session of sensorimotor rhythm (SMR, 12–15 Hz) upregulation neurofeedback training, the other half received a sham neurofeedback training. The neurofeedback training session took about 45 min. In a separate session, participants underwent structural magnetic resonance imaging (MRI) to investigate possible differences in brain structure between triathletes and controls. Triathletes and controls were able to voluntarily upregulate their SMR activity during neurofeedback when receiving real feedback. Triathletes showed a stronger increase in SMR activity in the second half of the training compared to controls, suggesting that triathletes are able to self-regulate their own brain activity over a longer period of time. Further, triathletes and controls showed differences in brain structure as reflected by larger gray and white matter volumes in the inferior frontal gyrus and insula compared to controls. These brain areas are generally involved in cognitive control mechanisms. Our results provide new evidence regarding self-regulation abilities of people who exercise regularly and might impact the practical application of neurofeedback.

Effects of mood on self-regulating physical activity and sweets intake within obesity treatments.

Background: Although emotional eating is associated with obesity in women, psychological correlates of their treatment-based weight-reduction behaviors are unclear. Aim: To test new model-based propositions of effects of mood on self-regulating physical activity and eating to inform interventions. Methods: Women in community-based obesity treatments with emphases on either self-regulation (n = 56) or weight-management education (n = 54) were assessed on psychological and behavioral variables over 12 months. Results: Emotional eating scores were significantly higher than general samples. Overall significant improvements were found in physical activity- and eating-related self-regulation, mood, physical activity, and sweets consumption. Improvements were more pronounced in the self-regulation-emphasis group. Mood significantly moderated self-regulation-behavior change relationships. Increased physical activity predicted improved mood. Discussion: Findings (a) suggested propensities for emotional eating in women with obesity seeking behavioral treatment, (b) clarified treatment effects and the effect of mood in the self-regulation of physical activity and eating behaviors, and (c) supported model-based treatment targets.

Abstract 12443: Predictors of Long-Term Adherence to Exercise in Adults With Heart Failure Enrolled in an Exercise Clinical Trial

Introduction: Exercise is recommended for adults with heart failure (HF), but long-term adherence to exercise is poor. The purpose of this analysis is to determine predictors of long-term adherence to exercise in adults with HF enrolled in a RCT testing effects of a behavioral intervention compared to enhanced usual care (EUC) on long-term adherence to exercise. Hypothesis: Unmodifiable (e.g. gender, race, age) and modifiable (e.g. physical function, self-regulation, attitudes) variables predict long-term adherence to exercise in adults with HF. Methods: All subjects (n=204) in this 2-group RCT received paid access to a fitness center for 18 months. Subjects in the intervention group (n=102) also received weekly coaching for 12 months. Adherence was defined as 120 minutes of moderate-intensity exercise weekly. Logistic regression models to examine predictors by group included baseline variables that significantly related to adherence at 12 or 18 months: gender, BMI, 6-minute walk test distance, attitudes, self-regulation, and health status. Results: The sample was 55% men, 47% non-white, and 71% HF with reduced ejection fraction. Mean age was 60.4 years. In the intervention group, gender predicted adherence at both 12 (B=-1.36, p=.01) and 18 months (B=-2.48, p=.003) with men achieving greater adherence at both time points. In the EUC group, no variables in the final model predicted adherence at 12 months and at 18 months, adherence was predicted by baseline scores on the Physical Activity Self-Regulation Scale (B=.084, p=.007) with higher self-regulation associated with a greater likelihood of adherence. Conclusions: To our knowledge, this is the first study to report predictors of long-term adherence to exercise in adults with HF. Men with HF achieved greater adherence to exercise than women following a behavioral coaching intervention. Future studies are necessary to identify behavioral strategies that will promote long-term adherence to exercise in women with HF. Adults with HF that can self-regulate at baseline adhere better to long-term exercise if given guidance to exercise and paid access to a fitness center. These findings are important as we move toward a precision health approach to improve long-term exercise adherence in adults with HF.

Improvements in Diet and Physical Activity-Related Psychosocial Factors Among African Americans Using a Mobile Health Lifestyle Intervention to Promote Cardiovascular Health: The FAITH! (Fostering African American Improvement in Total Health) App Pilot Study.

BackgroundAfrican Americans continue to have suboptimal cardiovascular health (CVH) related to diet and physical activity (PA) behaviors compared with White people. Mobile health (mHealth) interventions are innovative platforms to improve diet and PA and have the potential to mitigate these disparities. However, these are understudied among African Americans.ObjectiveThis study aims to examine whether an mHealth lifestyle intervention is associated with improved diet and PA-related psychosocial factors in African Americans and whether these changes correlate with diet and PA behavioral change.MethodsThis study is a retrospective analysis evaluating changes in diet and PA-related self-regulation, social support, perceived barriers, and CVH behaviors (daily fruit and vegetable intake and moderate-intensity PA [MPA] per week) in 45 African American adults (mean age 48.7 years, SD 12.9 years; 33/45, 73% women) enrolled in the FAITH! (Fostering African American Improvement in Total Health) app pilot study. The intervention is a 10-week, behavioral theory–informed, community-based mHealth lifestyle intervention delivered through a mobile app platform. Participants engaged with 3 core FAITH! app features: multimedia education modules focused on CVH with self-assessments of CVH knowledge, self-monitoring of daily fruit and vegetable intake and PA, and a sharing board for social networking. Changes in self-reported diet and PA-related self-regulation, social support, perceived barriers, and CVH behaviors were assessed by electronic surveys collected at baseline and 28 weeks postintervention. Changes in diet and PA-related psychosocial factors from pre- to postintervention were assessed using paired 2-tailed t tests. The association of changes in diet and PA-related psychosocial variables with daily fruit and vegetable intake and MPA per week was assessed using Spearman correlation. Associations between baseline and 28-week postintervention changes in diet and PA-related psychosocial measures and CVH behaviors with covariates were assessed by multivariable linear regression.ResultsParticipants reported improvements in 2 subscales of diet self-regulation (decrease fat and calorie intake, P=.01 and nutrition tracking, P<.001), one subscale of social support for healthy diet (friend discouragement, P=.001), perceived barriers to healthy diet (P<.001), and daily fruit and vegetable intake (P<.001). Improvements in diet self-regulation (increase fruit, vegetable, and grain intake, and nutrition tracking) and social support for healthy diet (friend encouragement) had moderate positive correlations with daily fruit and vegetable intake (r=0.46, r=0.34, and r=0.43, respectively). A moderate negative correlation was observed between perceived barriers to healthy diet and daily fruit and vegetable intake (r=−0.25). Participants reported increases in PA self-regulation (P<.001). Increase in social support subscales for PA (family and friend participation) had a moderate positive correlation with MPA per week (r=0.51 and r=0.61, respectively).ConclusionsOur findings highlight key diet and PA-related psychosocial factors to target in future mHealth lifestyle interventions aimed at promoting CVH in African Americans.

Perception of competence and self-regulation for physical activity in women with breast cancer

ABSTRACT The objective of this study was to examine the factors affecting physical activity among women undergoing breast cancer treatment, emphasising the constructs of the self-determination theory: competence and self-regulation for the practice of physical activity. One hundred and four women who are undergoing breast cancer treatment in the oncology sector of a hospital in the Midwest region of Santa Catarina, Brazil, participated in this study and answered questions about motivation for exercise (perception of competence and self-regulation for physical activity, autonomous or controlled regulation) and level of physical activity. The logistic regression analysis was then used to identify the factors associated with physical activity. The mean scores for perception of competence and autonomous regulation were higher in the group with high levels of physical activity. For controlled regulation the values were higher in the group with low levels of physical activity. A positive association was observed between the perception of competence and higher levels of physical activity, and the opposite happened with the controlled regulation, since a negative association was observed. The results of this study provide important information for the orientation of physical activity programmes and feedbacks to be transmitted to patients, which should emphasise the characteristics of competence and autonomy, to the detriment of the controlling regulation. Increasing the perception of competence and autonomy of breast cancer patients can improve their health behaviours in relation to the practice of physical activity.

"A Necessary Investment in Future Health": Perceptions of Physical Activity Maintenance Among People With Rheumatoid Arthritis.

ObjectiveA few studies with a qualitative design have addressed physical activity (PA) maintenance in people with rheumatoid arthritis (RA), but none of them focused specifically on maintenance of PA according to public health recommendations. The purpose of this study was to describe perceptions of PA maintenance during the second year of an outsourced 2-year support program among people with RA.MethodsFor this descriptive design with a qualitative inductive approach, semi-structured interviews were conducted with 18 participants with RA (3 men and 15 women). Variation in age, disease duration, activity limitation, pain, levels of PA, and PA maintenance was targeted through strategic sampling. Qualitative content analysis was used, and a pattern of theme, subthemes, and categories was constructed based on the participants’ perceptions of PA maintenance.ResultsA main overarching theme, “A necessary investment in future health”—with 3 subthemes of dedication, awareness, and affinity—was identified as participants’ perceptions of PA maintenance. Eight categories further described are a changed mindset, habits, commitments, monitoring, insights in PA, health gains, social support, and PA context.ConclusionsPA according to public health recommendations was perceived as a true investment in future health and wellness requiring dedication, awareness, and affinity. To promote PA maintenance, physical therapists working with people with chronic conditions should consider strengthening these prerequisites by targeting patients’ negative attitudes to PA, supporting their creation of PA habits to incorporate in daily routines, introducing monitoring of PA intensity, supporting development of PA self-regulation skills, and providing suitable gym facilities with the possibility of peer support.

Sensor-measured Physical Activity In Overweight And Obese Women In Early Pregnancy

Overweight and obese pregnant women may benefit from physical activity (PA) in pregnancy, yet few studies have examined sensor-measured PA in pregnancy. PURPOSE: To evaluate sensor-measured PA in overweight and obese pregnant women and its sociodemographic and psychological correlates. METHODS: We analyzed baseline data from an ongoing behavioral lifestyle intervention trial in Columbia, SC (n=202). PA was measured with the SenseWear Armband; compliance was set at wearing for 20+ hrs/d, 5+ days (including 1+ weekend day). PA measures were daily duration of light PA (LPA), moderate to vigorous PA (MVPA), daily steps, and meeting MVPA guidelines (≥150 min/wk of MVPA in ≥10 min bouts). PA was presented as median (interquartile range). Subgroup differences in medians were examined with quantile regression models. Correlations of PA measures with perceived stress, depressive symptoms, PA social support, PA self-efficacy, and PA self-regulation were studied. A logistic regression model was used to examine correlates of meeting MVPA guidelines. RESULTS: Participants (mean of 12.4 weeks gestation) had a median of 203 (154, 258) min/d LPA, 34 (20, 49) min/d MVPA, and 4,870 (3768, 6590) steps/d. LPA, MVPA, and steps were lower in African American and obese women (p<.05). LPA was lower in nulliparous women (p<.05). Participants with less than college education had lower MVPA and steps (p<0.05). Further, LPA, MVPA, and steps were positively associated with PA self-efficacy (r’s ranging from 0.13 to 0.16, p≤.05) and PA goal setting (r’s ranging from 0.16 to 0.21, p<.05). MVPA was positively associated with PA planning (r=0.16, p<.05). Only 10.4% of participants met MVPA guidelines, which was more prevalent in white (17.1%) vs African American (2.2%) women and in overweight (17.9%) vs obese women (3.7%) (p<0.05). After adjusting for age, parity, and marital status, white women and overweight women had higher odds of meeting MVPA recommendation than their counterparts: white: 5.8 (1.2-28.6); overweight: 5.2 (1.6, 16.9). CONCLUSION: Sensor-measured PA was low in overweight and obese pregnant women in early pregnancy with significant differences by race, education, parity, and pre-pregnancy weight status. Programs targeting PA are needed for this population. Funded by NIH/NICHD.

Exercise referral schemes enhanced by self-management strategies to reduce sedentary behaviour and increase physical activity among community-dwelling older adults from four European countries: protocol for the process evaluation of the SITLESS randomised controlled trial

IntroductionSITLESS is a randomised controlled trial determining whether exercise referral schemes can be enhanced by self-management strategies to reduce sedentary behaviour and increase physical activity in the long term, in...

Can behavioral strategies increase physical activity and influence depressive symptoms and quality of life among children with epilepsy? Results of a randomized controlled trial

PurposeThis study examined whether increasing physical activity (PA) through 6 months of behavioral counseling positively influenced depressive symptoms and quality of life (QoL) over 12 months among children with epilepsy (CWE). MethodsA longitudinal multisite randomized controlled trial (RCT) was conducted with 8–14-year-old children with active epilepsy. Participants wore a pedometer to track daily PA and completed 3 measures at 4 time points to examine depressive symptoms and QoL. Stratified by site and activity level, participants were randomized to an intervention or control group. The 6-month intervention included 11 behavioral counseling sessions targeting self-regulation of PA. To assess the associations among PA, depression scores, and QoL, primary analysis involved mixed-effects models. ResultsWe recruited 122 CWE, of whom 115 were randomized (Mage = 11 ± 2; 50% female) and included in the analysis. The intervention did not increase PA in the treatment compared with the control group. No differences were found between groups over time during the subsequent 6 months, where PA decreased among all participants. Results did not show differences between the groups and over time for measures of depressive symptoms and QoL. SignificanceThe intervention did not improve or sustain PA levels over 12 months. Both groups demonstrated declines in PA over one year, but there were no changes in depression scores or QoL. As most participants were already nearly reaching the Canadian average of step counts of children their age, with a baseline daily step count of over 9000, there may be a challenge for further increasing PA over a longer period.

Is there positive in the negative? Understanding the role of guilt and shame in physical activity self-regulation

The high rate of global physical inactivity has led researchers to explore the psychological variables that impact physical activity (PA) behaviours. Drawing from tenets of control theory and literature on self-conscious emotions, the current study investigated the experience of guilt and shame in response to engaged in and missed PA. One hundred and fifty-four adults (Mage = 34.02, SD = 12.27) completed online questionnaires over a three-week period. Paired sample t-tests showed participants experience more guilt and shame after a missed intended PA session than an engaged-in session and, of the two, guilt is felt more strongly (t (150) = 8.31, p < .001). Following a missed PA session, attribution dimensions were explored; locus of causality was associated with guilt (p = .02) and stability with shame (p =. 01). Logistic regressions showed guilt had a negative relationship with PA intentions, and guilt and shame did not predict future PA. This finding is at odds with control theory and past empirical evidence. This disparity suggests the need for future research to explore these emotions within the PA domain to further inform the nature of their relationship. This research was the first to measure and explore the acute, real-life experience and motivational qualities of guilt and shame relative to PA engagement. Research implications and future directions are discussed.

Associations between psychological factors and accelerometer-measured physical activity in urban Asian adults.

Examine the association between psychological variables and accelerometer-measured moderate-to-vigorous physical activity (MVPA) in urban Asians. A population-based cross-sectional study was conducted in Singapore. Participants wore an accelerometer for 7days to measure physical activity (PA). Demographic, anthropometric and psychological data were also collected. Psychological variables included PA guideline knowledge, motivational profile for PA self-regulation (5 subscales), perceived barriers to PA (4 subscales) and perceived social support for PA. Regression models with adjustment for socio-demographic variables were fitted. External regulation (b = - 13.03, 95% CI - 34.55; - 1.50) and perceived daily life barriers (b = - 12.63, 95% CI - 24.95; - 0.32) were significantly associated with fewer weekly MVPA minutes. A significant interaction between perceived social support and age (p = 0.046) was found. Social support was significantly negative associated with MVPA minutes in younger (< 28years), but not in older participants. Considering levels of self-determination to engage in PA and perceived daily life barriers may be important for planning PA interventions in urban Asian populations. Caution is required when promoting social support for PA as it was associated with lower MVPA in younger people.

Relations of change in fruit and vegetable intake with overall energy reduction and physical activity with weight change: Assessing theory-based psychosocial mediators

BackgroundIncreased physical activity and fruit and vegetable (FV) intake are typically suggested to counter obesity. Sustained behavior change in those areas has, however, been poor, possibly because of a lack of understanding of the effects of psychosocial factors. Using data from previous research, this study aimed to better define the role of physical activity and FV intake in short- and long-term weight loss via changes in malleable psychosocial mediators and moderators. MethodsWomen who were obese (n = 183; age = 50.0 ± 7.9 years; body mass index = 35.2 ± 3.2 kg/m2, mean ± SD) and who previously participated in 3 different community-based behavioral weight-loss treatments were assessed over 2 years. Changes in FV intake, physical activity, self-regulation of physical activity and eating (aggregated), negative mood, and weight were measured over 6 and 24 months. ResultsChanges in each variable over both 6 and 24 months were significant (all p values <0.001). The FV intake to the weight-related caloric intake relationship (β = −0.30, p < 0.001) was significantly mediated by self-regulation change over 6 months. The physical activity to weight-change relationship (β = −0.46, p < 0.001) was significantly mediated by both self-regulation and mood change over 24 months. Physical activity, itself, accounted for only 16% of weight-related caloric expenditure differences. Changes in physical activity and FV intake were each independent predictors of weight change over 24 months (overall R2 = 0.50, p < 0.001). ConclusionFindings clarified theory-based targets for weight-management treatments and suggested that future weight-loss treatments strongly focus on developing self-regulatory skills to address barriers to behavioral changes.

Effects of self‐regulatory skill usage on weight management behaviours: Mediating effects of induced self‐efficacy changes in non‐obese through morbidly obese women

Self-regulation is thought to play a role in overcoming barriers to weight management behaviour changes. This research assessed the extent that relationship is manifested through associated changes in self-efficacy, and effects based on degree of obesity. Data sets from three previous studies of the present research group were utilized. After assessment of change scores using repeated-measures ANOVA, mediation and moderation analyses assessed effects of changes in self-regulatory skill usage on changes in physical activity and fruit/vegetable intake through self-efficacy changes. Moderating effects of BMI were then assessed. Women with body compositions ranging from non-obese (BMI<30kg/m2 ) to those with morbid obesity (BMI≥40kg/m2 ) were administered similar cognitive-behavioural treatments, and assessed on theory-based psychosocial and behavioural measures over 6months. From baseline to Month 6, changes in self-regulation for physical activity and eating, physical activity behaviours, fruit/vegetable intake, and self-efficacy for controlled eating were significant in non-obese women (n=48) and women with Class 1 (n=43), Class 2 (n=70), and Class 3 (n=48) obesity. Positive effects were smaller in exercise self-efficacy. For each of the BMI-based groups, changes in self-efficacy significantly mediated the prediction of physical activity and fruit/vegetable intake by changes in self-regulation. In aggregated data, BMI significantly moderated the prediction of change in physical activity (higher BMI associated with a stronger association), but not fruit/vegetable intake, within those models. Increasing self-regulatory skills to overcome lifestyle barriers was found to be important for fostering improved weight loss behaviours, especially in the treatment of higher degrees of obesity in women. Statement of contribution What is already known on this subject? Self-efficacy is a malleable factor that predicts behaviour change within multiple theories. Learned self-regulatory skills may effectively deal with lifestyle barriers associated with improvements in weight management behaviours. Increased physical activity and fruit/vegetable consumption predicts success with weight loss. What does this study add? Much of self-regulation's effect on physical activity and eating behaviours is through its impact on self-efficacy. Weight management treatments should emphasize self-regulatory skills development over simply health education. Effects of interrelations of self-regulation and self-efficacy are more effective as female weight increases.

Changes in weight, physical activity and its theory-based psychosocial correlates within an adolescent bariatric clinic: contrasts with adults with extreme obesity.

Albeit their practical implications, psychosocial correlates of physical activity and related weight loss in the treatment of extreme obesity have been only sparsely addressed in adults; and even more minimally focused upon in adolescents. This research contrasted results of a 6-month social cognitive theory-based physical activity-support protocol along with standard nutrition counseling in groups of adolescents (n = 19; agemean = 15.4 years) and adults (n = 26, agemean = 44.7 years) with class 3 (extreme) obesity [overall body mass index (BMI)mean = 53.4 kg/m2, standard deviation (SD) = 8.2]. Although baseline total mood disturbance scores were significantly greater in both groups when contrasted with age-corresponding normative values, between-group scores did not significantly differ. BMI and physical activity changes over 3 and 6 months were significantly more favorable in the adult group. There were significant overall improvements in exercise self-efficacy, physical activity self-regulation and total mood disturbance scores, however, the self-efficacy and self-regulation increases were significant in only the adult group. Inverse relationships between changes in physical activity and BMI were stronger in the adult group. Regardless of group, simultaneous entry of changes in exercise self-efficacy, physical activity self-regulation and total mood disturbance scores, over both 3 and 6 months, significantly predicted physical activity changes (R2-values = 0.45-0.75, p-values < 0.001). In each model, self-regulation change was the most salient of those three psychosocial predictors. Although findings suggested that psychosocial correlates of physical activity, leading to weight change, are similar in adolescents and adults with extreme obesity, facilitation of larger effect sizes and/or foci on additional theory-based determinants may be required for clinically meaningful treatment outcomes in adolescents.

Physical Activity and Related Psychosocial Outcomes From a Pilot Randomized Trial of an Interactive Voice Response System-Supported Intervention in the Deep South.

Physical activity exerts cancer-protective effects, yet most Americans are inactive, especially in the South, where cancer incidence rates are generally higher. Telephone-based approaches can help overcome physical activity intervention barriers in this region (literacy, costs, lack of transportation/technology, distance from facilities) and can be automated via interactive voice response (IVR) systems for improved reach and cost-effectiveness. To evaluate the Deep South IVR-supported Active Lifestyle (DIAL) intervention. A pilot randomized controlled trial was conducted among 63 underactive adults in Birmingham, Alabama, from 2015 to 2017. Retention was 88.9% at 12 weeks, and ≥75% adherence (IVR contact on at least 63 out of 84 days) was noted among 62.5% of intervention participants. Intervention participants reported larger increases in self-reported minutes of moderate-to-vigorous intensity physical activity from baseline to 12 weeks than the wait-list control arm (median change = 47.5 vs. 5.0 minutes, respectively, p = .09). Moreover, the intervention produced significantly greater increases in physical activity self-regulation ( p < .001) and social support from family ( p = .001) and friends ( p = .009) from baseline to 12 weeks, compared with the wait-list control. Significant decreases in self-reported sleep disturbance also were found in the intervention arm but not among the controls, p < .05. Overall, intervention participants reported being satisfied with the DIAL program (71.4%) and would recommend it to friends (92.9%). Findings support the feasibility, acceptability, and preliminary efficacy of the DIAL intervention. Next steps include intervention refinement in preparation for a fully powered efficacy trial and eventual dissemination to rural counties.