Reflexive Process Research Articles

Crisis reflexivity: the fragile regime of citizenship in Greece’s compounded crises

The paper explores how the crisis imaginary shapes citizen identity in relation to the migrant noncitizen as well as the media’s role in enhancing or containing the crisis. The communicative process of crisis reflexivity offers a conceptual tool to understand the consequences of limited or absent encounters with noncitizen Others for the citizens’ construction of identity. Within the spatio-temporality of compounded crises in an Athenian neighbourhood, the study’s multi-method approach combines 30 in-depth interviews with Greek citizens with offline and online participant observation. The empirical findings reveal that embodied encounters shape the perception of citizens as victims in light of structural inequalities and the existential uncertainty tied to media disinformation and fear. However, for those with progressive views, predominantly mediated encounters can open up an avenue for a politics of justice and generate feelings of cosmopolitanism towards citizens-in-the-making.

Deconstructing Professionalism as Code for White (Power): Authenticity as Resistance in Nursing.

The concept of professionalism is embedded into all aspects of nursing education and practice yet is rarely critically interrogated in nursing scholarship. This paper describes how professionalism in nursing is based on whiteness. When actualized, this oppressive construct homogenizes individuals' identities to assist nurses in building and wielding power against each other and against patients, and results in dehumanization and disconnection. Foregrounding an ethic of authenticity as a practice of resistance against white professionalism offers an alternative possibility for how nursing could be taught, practiced and theorized. As such a practice must begin with oneself, the authors outline a reflexive process from which to begin this work.

Critical Reflexivity of the Researcher as an Exploratory Vehicle in Sensitive Research

Qualitative research requires in-depth immersion in the topic of concern for the findings to be valid and pertinent. However, in doing so, qualitative researchers may encounter certain challenges that address beyond the methodological concern. There is limited research that explores the impact on researchers who undertake research on sensitive or challenging research and marginalized groups. Considering that the researcher is the central figure who influences the research project across all steps from conceptualization to action, researcher reflexivity can be used as a strategy to look behind the curtain of the research project. Through practicing critical reflexive experiential analysis, I reflect on my journey on conducting research on the topic of sexual violence. I address the silence of researcher vulnerability by documenting and analyzing my emotional journey through each stage of the research project in my reflexive journal and how I resolved each dilemma at both personal and professional levels. The aim of this article is, therefore, to highlight the process of critical reflexivity of my journey as a sexual violence researcher in Indian context.

Features of developing toilet skills in young children: Information for clinicians and parents. A review

The upbringing and teaching of toilet skills to young children is an important stage in the physiological development of the child. Control over urination and defecation in infants develops gradually, starting with a completely reflexive process and moving on to conscious control. This process is of great importance in the formation of a healthy and independent personality, preparing the child for the next stages of growing up and acquiring new skills. The article presents historical aspects of the formation of toilet skills among different peoples and at different stages of society development. Interesting facts about potty training in different countries of the world, anatomical features of urination and defecation, signs of readiness for potty training and toilet training, the age recommended for potty training, and what a potty should be like are shown. Approaches to teaching this level of independence are important not only for the child’s physical health, but also for understanding his psychological readiness, social development, and adaptation in children’s groups.

4.A. Skills building seminar: Waves of community health engagement and governance: innovating through a design-as-policy approach

Abstract In this workshop we will engage our participants in a practice oriented exercise to experiment with a collaborative design-as-policy approach for a community health action plan. The exercise will be based on the lessons learned in two large evaluation projects: 1) an 8-year evaluation of the Dutch All about Health (AaH) platform of social health initiatives on the local, regional and national level; and 2) a comparative multiple case study, including Portugal, building a framework for sustainable citizen engagement, published in the WHO Handbook ‘Voice, Agency, Empowerment: The Handbook on Social Participation for UHC’. Both projects show striking similarities in findings, and developed guidance for devising collaborative action through (a) the use of community platforms, (b) concrete engagement mechanisms and (c) mediating civil society organizations. These will be brought together in a Guidance Tool that participants will work with in the exercise. The aim of the tool is to support initiatives to bring together both top-down participatory efforts and bottom-up grassroots movements in order to anchor community and minority voices into policy decision-making for a more level playing field for policy influence. The aim of the workshop is to let participants experiment with the Guidance Tool and develop collaborative design-as-policy skills. The outline of the skills building exercise: 1. Group introductions using Mentimeter and invitation to pick a particular complex health issue from participants’ own work or community setting (5 mins). 2. Three pitches on the projects, the Portugal case and the Guidance Tool (10 mins). 3. Exercise instructions (5 mins). 4. Exercise (35 mins) a. Upon room entrance participants receive a colored badge based on their professional background: public health professional/practitioner, community resident, researcher or policymaker; b. Form small sub groups of 6-8 participants with different backgrounds (2 mins); c. Introduce with key words on paper their respective complex community health issues and sub group jointly selects one issue for which most information and experience is present (6 mins); d. First round in duos within sub group: participants work through the guidance steps to an initial idea for the collaborative action approach consisting of a community platform, engagement mechanisms, and mediating civil society organizations, drawn out on paper (10 mins); e. Second round in duos within the sub group: duos review another duos initial design idea and conduct an intuitive SWOT analysis of feasibility, acceptability, and practicability (8 mins); f. Third round in sub group: compare the three proposals in SWOT perspective, select the most salient one, and improve with strong elements from other proposals (8 mins); g. Summarize in key words the final proposal and enter into Mentimeter. 5. Plenary wrap up using Mentimeter: select the winning proposal, and evaluate the exercise (5 mins). Key messages • Collaborative action is enhanced considerably through (a) the use of community platforms, (b) concrete engagement mechanisms and (c) mediating civil society organizations. • The Guidance Tool offers concrete steps for designing a reflexive and adaptive structure and process for community collaborative action and self-governance. Speakers/Panelists Marleen Bekker Wageningen University & Research, Wageningen, Netherlands Dheepa Rajan WHO, Brussels, Belgium Goncalo Figueiredo Augusto National Health Council, Lisbon, Portugal

Reflection and reflexivity in influencing the developmental trajectories of ideal multilingual selves: a longitudinal qualitative inquiry

ABSTRACT This study conducted a longitudinal inquiry into how reflection and reflexivity influenced the development of ideal multilingual selves (IMS). The Dominant Language Constellations (DLC) was adopted to understand the operationalisation and development of IMS and how students’ reflection and reflexivity at different cognitive levels influenced the maintenance or development of their IMS. Five rounds of interviews and two rounds of written journals were collected from nine Chinese learners of German over 28 months. Findings suggested that most participants reflected on their multilingual experiences at lower cognitive levels, which could hardly maintain the vision of being multilingual longitudinally. In comparison, learners who continued to strengthen their IMS tended to demonstrate higher levels of reflection on multilingual experiences. They were also likely to activate more languages, including their first languages (L1s), in their DLCs during the reflective and reflexive process and identify the meaning of being multilingual for constructing their future selves. This research emphasised the significance of different levels of reflections and reflexivity in influencing the development of IMS and underscored the role of a holistic view of language in evoking higher-level reflective and reflexive thinking during LOTE learning.

Collaborative Autoethnography of Cancer Patients' Dynamic Sense of Agency.

Through collaborative autoethnography, we studied shifts in cancer patients' sense of agency and the meaning of cancer during the diagnostic and treatment phases. This article contributes to the illness management literature by adopting sense of agency perspective that provides new understanding of retrospective interpretation of cancer patients' agency. The authors' experiences of receiving cancer diagnoses and a related, collectively written story illustrate how relational and contextual elements facilitate rapid shifts in cancer patients' sense of agency and illness management. The findings illustrate shifts in the sense of agency as a collaborative and reflexive process between cognitive, emotional, and bodily constraints and adjustments. We demonstrate how shifts in patients' sense of agency and respective changes in meanings attached to cancer were shaped by near ones, healthcare actors, and other cancer patients, as well as the COVID-19 pandemic and the fear of military conflict due to Finland neighbor Russia's war on Ukraine. Furthermore, the study illustrates how shifts in sense of agency shape and are shaped by changes in the understanding of cancer as either a secondary issue, ambiguous stranger, travel companion, or enemy.

Navigating Ethical Tensions Through Critical Reflexivity: A Participatory Filmmaking Research Project With Children With Disabilities

This paper illustrates the importance of critical reflexivity in guiding socially and ethically responsible participatory research through an analysis of reflexive notes pertaining to the process of a participatory filmmaking research project with children with disabilities. Within this process, numerous ethical tensions emerged in the field regarding the participation of children with disabilities, authenticity of stories shared, navigating facilitator’s voice, issues of representation of child co-researchers, safety and risks associated with sharing everyday realities within the film, and limits to immediate action. The practice of individual and shared critical reflexivity among researchers, and inclusivity of child co-researchers, was central in navigating ethical tensions. This paper makes transparent the process of critical reflexivity within a participatory action research project by highlighting the ethical tensions faced, contextualizing them within cultural practices and power relations, and sharing strategies used to address ‘ethics in practice.’ We end by proposing practical strategies to enhance reflexive research practices in participatory work.

Reflex Testing of Endometrial Carcinoma For Next Generation Sequencing: An Institutional Experience

Abstract Introduction/Objective Endometrioid carcinoma is now separated into four subgroups based on molecular profiling. These subgroups (POLE mutant [POLEmut], mismatch repair-deficient [MMRd], p53 abnormal [p53abnl], and no specific molecular profile [NSMP]) have been shown to be diagnostically and prognostically relevant. This is especially highlighted by the inclusion of molecular classification into the 2023 FIGO staging for EMCA. In conjunction with our gynecologic oncologists (gynonc) and colleagues in molecular pathology, we developed and implemented a reflex process by which next generation sequencing (NGS) is done on all hysterectomies performed at our institution for EMCA. Methods/Case Report In collaboration between gynonc, molecular diagnostics, surgical pathology and operations personnel, an order set was built within our LIS. At the time of sign-out, the gynecologic pathologist (GYNP) selects the block for NGS testing and orders the cuts for NGS, digital scanning of the corresponding H&E and the NGS testing. Histology in turn processes the cuts, scans the H&E and transfers the material for NGS. The digital slides are stored in an accessible repository and annotated by the GYNP. Results of NGS testing are released into the patient’s EMR and molecular/histologic correlation is subsequently performed by the GYNPs. Results (if a Case Study enter NA) In the period between 1/1/23 and 2/28/24, we processed 131 EMCA cases through this pathway. Of 103 endometrioid-type EMCA reflexed during this period, 7 were classified as POLEmut, 23 as MMRd, 13 as p53abnl, and 60 as NSMP. 16 cases required re-review of IHC and/or NGS results due to discrepancies. 4 p53abnl cases required upstaging according to the new FIGO, while no POLEmut cases required downstaging as they were all stage I. Conclusion Overall, our pilot pathway was considered a success and continues. We believe our process can serve as a framework for other institutions and can be applied to other malignancies.

Cultural Humility in Nursing: A Concept Analysis.

The ability of nurses to deliver culturally mindful health care may be vital to improving the patient-clinician relationship and subsequent health outcomes for marginalized populations. Continuing education in cultural training should be designed to enhance a nurse's cultural humility. This study explores the concept of nurse cultural humility using the methods outlined by Walker and Avant (2018): define the attributes, offer a model case exemplifying the attributes, discuss the antecedents and consequences, and determine empirical referents. The defining attributes of cultural humility in nursing are a lifelong process of reflexivity, an understanding and appreciation that the cultural backgrounds of both nurse and patient influence health care encounters, and a commitment to redress and mitigate power imbalances in the patient-clinician relationship. By clearly defining nurse cultural humility, leaders will be able to develop cultural training interventions to enhance nurse cultural humility and measure the concept accurately. [J Contin Educ Nurs. 202x;5x(x):xx-xx.].

Understanding Perceptions and Experiences on Acceptability of Oral Ivermectin, Topical Permethrin, and their Combination in the Treatment of Adult Filipino Patients with Scabies: A Multiple Case Study.

Oral ivermectin, a broad-spectrum anti-parasitic drug, alone or in combination with permethrin, may be a cheaper and more convenient alternative drug to topical permethrin alone in the treatment of classic scabies. There are no previous studies on the treatment acceptability of the three interventions among individual patients with scabies in the Philippines.The purpose of this study was to understand the experiences and perceptions on treatment acceptability for oral ivermectin, topical permethrin or combination treatment among patients with scabies using the multiple-case study approach. We conducted a qualitative multiple case study among adult Filipino patients with classic scabies who were prescribed oral ivermectin, topical permethrin or its combination at a government tertiary hospital dermatology outpatient clinic from December 2022 to September 2023. Semi-structured interviews were used as the primary source of data and analyzed together with chart reviews, Dermatology Life Quality Index (DLQI) scores, and clinical images. Interviews were transcribed, coded, and triangulated with other secondary data. A three-person research team employed a reflexive and iterative process of familiarization, coding, and thematic analysis using a modified Theoretical Framework of Acceptability (TFA) to generate case descriptions, within-case analyses, and cross-case syntheses. The acceptability of scabies treatments (permethrin, ivermectin, and combination therapy) was generally positive. Permethrin, used in three patient cases, was generally perceived as effective but itch relief varied. The burden of whole-body application of permethrin was context-dependent, influenced by living arrangements and family support. Perceived affordability of permethrin was linked to socioeconomic status. Ivermectin, used by one patient case, was perceived as highly effective with no side effects. Its single dose use did not interfere with patient routine. Combination therapy was also considered effective but potential antagonistic effects and the cost of adding permethrin made it less preferred. Reluctance in taking oral pills was noted. All patients valued medical advice and deferred to their physicians for treatment decisions. All three treatment options were considered effective and safe. Patients generally preferred permethrin over oral ivermectin due to its topical nature and perceived lower side effects. However, affordability and logistical challenges, especially for large households and low-income families, were noted with permethrin. Oral ivermectin elicited hesitation due to its controversial role in COVID-19 and veterinary use. Concerns about added costs and potential antagonism in combination therapy were raised. Despite these considerations, patients ultimately relied on physicians for treatment decisions. This study underscores the importance of understanding patient perspectives, experiences, and the patient-physician relationship in choosing scabies interventions. Addressing patient concerns, providing education, and ensuring ease of use and affordability can enhance treatment acceptability and adherence for better outcomes.

Predictive Utility of the Multi-Process Action Control Framework for Self-Reported and Device-Measured Physical Activity Behavior of Adolescents.

Understanding the correlates of physical activity behavior is imperative for informing the development of interventions to address the low rates of physical activity guideline adherence among adolescents living in the United States. This cross-sectional study examined the predictive utility of the Multi-Process Action Control (M-PAC) framework for explaining self-reported and device-measured physical activity behavior among a Hispanic-majority sample of adolescents. A total of 1849 high school students (mean age = 16.0 ± 1.22 SD years; 52.3% women; 87.8% Hispanic) enrolled in one school district in south-central Texas completed a survey including instruments to assess M-PAC framework constructs (instrumental and affective attitudes, perceived capability and opportunity, behavioral regulation, habit, identity) and moderate-to-vigorous physical activity (MVPA) behavior. A subsample (n = 435) wore accelerometers for seven days. The results from robust linear regression models revealed role identity and habit were significant predictors of self-reported MVPA. Role identity was a significant predictor of accelerometer-derived daily MVPA and raw acceleration in the most active hour but not daily raw acceleration. The findings indicated reflexive processes are robust predictors of adolescent physical activity and should be the focus of interventions designed to promote adoption and maintenance of physical activity during this developmental life stage.

Theoretical sensitivity and reflexivity in grounded theory.

Grounded theory (GT) has become one of the foremost tools in qualitative nursing research. There are different approaches to GT but a feature common to all of them is theoretical sensitivity, which facilitates GT's iterative process. However, differences between the approaches in how to apply theoretical sensitivity and how much influence existing knowledge should play have contributed to tribalism. To critically evaluate the role of theoretical sensitivity and reflexivity in GT and the involvement they can have, as well as explore what steps researchers can take to improve their insight. Theoretical sensitivity enables researchers to steer their studies to answer their research questions, gain insight into their study's findings and develop theory grounded in the data. However, reflection is required for researchers to understand their effect on the theories that emerge, prevent them from applying preconceived ideas and allow for the unfettered emergence of theory. Researchers who do not demonstrate insight into their own philosophical positions and influences risk being accused of bias; this may result in the perceived value of their theoretical outcomes being reduced. Applying a reflexive process may mitigate this, enabling them to understand and refine their methodological processes and produce high-quality GT research. All researchers should consider using reflexivity when conducting research. Understanding influences and positionality in qualitative methodologies allows for transparency and improves the rigour of their outcomes.

Reflections on being an insider researcher: a study exploring the experiences of men accessing rural mental health services.

An embedded single case-study design was used to explore the experiences of men in rural New Zealand accessing mental health services. It is essential for researchers to acknowledge positionality in case study research and the lead author used reflexive practice to acknowledge his values and beliefs. To explore and demonstrate the reflexive process of the lead author's position as an inside researcher. Three groups were involved in the research: men with mental health challenges, their partners, and mental health clinicians. The article presents the initial research through memos and diarying in the context of current literature. Reflexivity is essential for ensuring the research process is complete and biases are identified. Positionality exists on a continuum and it is critical for researchers to be honest with themselves, the topic and the group being investigated, to show respect for the participants and the people they represent, as well as to be committed to revealing the truth. Insider research has the potential to bridge the gap between academia and practice. It facilitates the transfer of research knowledge directly to practitioners, leading to more evidence-informed decision-making and practice.

Conducting mixed methods research with women in a forensic mental health setting: A reflexive account from a nurse as researcher.

To describe a reflexive account of a mental health nurse as researcher undertaking a mixed methods study as part of a doctoral degree, with women in a secure forensic hospital. A discursive paper that draws upon the primary author's experience of dual roles as a mental health nurse and a novice researcher, and relevant literature pertaining to positionality and reflexivity in the context of conducting mixed methods research. A mixed methods study was conducted within a secure forensic hospital in Australia, to identify factors associated with the frequency and duration of seclusion for women and, to explore their experiences of seclusion. Notes and a reflective diary were used to demonstrate the reflexive approach and strategies used throughout the study design and data collection stages of the research. Women in the secure forensic hospital setting often have complex histories and experiences and are considered a vulnerable group, which can add additional challenges when undertaking research with this population. As a doctoral student with clinical experience in mental health undertaking research in the forensic hospital setting with women, positionality and the connection with reflexivity requires exploration to understand self and the influence on research. This understanding along with identified strategies to enhance reflexivity, supports the management of the dual nurse as researcher roles to enhance all stages of the research process. Doctoral nursing candidates undertaking clinical research in their area of clinical practice and at the location of previous employment, may experience challenges in relation to identity and the dichotomy of roles. Further challenges can be posed when research involves complex populations and/or controversial practices. Support to balance role conflict and maintain reflexivity is critical to understanding the role of self in research and to enhance credibility. Women are a complex, yet minority population in forensic mental health settings, however the numbers of women being admitted to services is increasing. Future research may consider the use of the strategies explored here to enhance the reflexive process, and support future researchers in this field to conduct research that aims to support an often-misheard population to better support health outcomes. There was no patient or public contribution to this paper, however the study in which this paper is based on, is grounded in the experience of patients (women).

Network governance and reflexivity in fisheries management: a case study of Northern Ireland

ABSTRACT Network governance arrangements, wherein resource users are empowered, are vital for ocean sustainability. These arrangements are critical to implementing innovative practices, particularly those developed to address the negative impacts of top-down management. The adoption of networked governance can foster resource management capacity and equitable decision-making. Research has focused on social ties within networks but has provided a somewhat limited account of how networks evolve to instil novel practices. To implement new practices, networks must engage in reflexive governance. Reflexivity is underpinned by actors’ receptivity to change and network learning. Actors’ receptivity to change relates to whether they acknowledge past failures and how novel management ideas become accepted. Network learning is the degree of change instigated by actors’ reflexive processes. Drawing on the receptivity and network learning theories, and informed by semi-structured interviews, an assessment was conducted on how a fisheries management network in Northern Ireland has reflexively evolved to implement new practices. Findings illustrate that the network has reflexively redesigned how they collaborate, share knowledge, and contribute to policymaking. Demonstrating single– and double-loop learning, these developments have been derived from reflections on the failure of past processes and the instigation of more co-creative processes that benefit all network actors.

Applying Experienced-Based Co-Design principles to improve digital health demand management processes in a large metropolitan multi-hospital health system

ObjectiveThis study describes the application of Experienced-Based Co-Design (EBCD) principles with an embedded implementation technology framework for improving digital health and informatics demand management processes in a multi-hospital healthcare system. The study identified barriers and enablers within the existing demand management system, proposed interventions to address these challenges and engaged in collaborative co-design with stakeholders. MethodsA multi-method qualitative approach aligning with EBCD principles was used. Framework mapping (Non-adoption, Abandonment, Scale-up, Spread, Sustainability) was applied to barriers and enablers associated with baseline practices. Reflexive thematic mapping and process charts were used to inform stakeholder priorities and co-design. Prototyping was iterative using feedback for continuous improvement with ongoing monitoring. ResultsFragmentation of information was a technological barrier, decentralized processes and service duplication were organizational barriers, and opportunities to improve clarity of governance policies were identified. Solutions were co-generated and prioritised by stakeholders. The co-design and prototyping phase followed an iterative approach which generated two interventions. For centralizing intake and management, a new workflow process was devised. For improving project portfolio visibility and developing a weighted scoring criterion, a single tool to track projects across the lifecycle and a scoring model based on prioritization techniques were created. ConclusionA novel application of an EBCD approach was used to improve demand management processes in a digital health and informatics service context in a large health system. It highlights the value and agility of EBCD to generate flexible and modular solutions for this digital health context and compares favorably to analogous approaches. Public interest summaryIn today's fast-paced digital age, it is vital for hospitals to manage health information innovation efficiently. This study used an Experienced-Based Co-Design design (EBCD) approach to improve how a multi-hospital health system handles and prioritizes digital health projects. We listened to stakeholders, identified challenges, including fragmented information and unclear processes, then co-created solutions. The EBCD produced an implementable streamlined method for managing digital health project requests, including prioritizing and tracking projects from start to finish. This outcome of the exemplar EBCD process is likely to ensure that the most critical health projects are prioritized. For the public, this means better, faster, and more efficient digital health services in the future.

Place-responsive principles of sustainable networked learning

This work builds on the work of Hodgson and McConnell by extending the principles of networked learning to incorporate aspects of place-responsive pedagogy and sustainable education. Place[1]responsive education is traditionally situated within the outdoor education field, and invites a deeper recognition of the interwoven nature of learning. It aligns with a postdigital perspective of networked learning, embracing the complex entanglement of learners, environment, technology and everything else. Sustainable education focuses on the creative, participative and reflexive processes which underpin transformative pedagogies, recognising the importance of collaboration and time. The goal is learning to live sustainably as part of the ecosystem. This extension of the principles was undertaken in order to strengthen the recognition of place and place-knowledge as part of the postdigital network, to find a way to give voice to the non-human participants in the learning environment. It will also demonstrate how networked learning is a sustainable educational approach. I will start by outlining the place-responsive framework that will guide the review of the principles. This will be followed by an overview of sustainable education, explaining what role this plays in networked learning and the importance in developing future-proof skills. Next, the eight principles will be extended, building on the framework. Finally, a case example will illustrate how this can be applied in practice.

Developing reflexivity and self-compassion in group psychotherapy: A dialogical and narrative approach

ABSTRACT In this paper, we apply dialogical concepts to understand the development of self-reflexivity and self-compassion during psychotherapy. Specifically, we present a study that mapped clients’ voices and explored their changes in group psychotherapy. Thematic narrative analysis was used to study 20 two-hour group therapy sessions of a systemic informed approach. The analysis involved mapping of the voices of each group member, categorizing them as compassionate and/or reflexive and a sequential depiction of the group voices through timelines. The last step of the analysis included studying the development of self-reflexive and self-compassionate voices through time. It showed an important change, not on the number of clients’ self-reflexive voices that appeared during psychotherapy, but mostly on the quality of the self-reflexive voices in favor of voices that were both self-reflexive and self-compassionate. This change seems to take place as a result of the internalization and “rehearsal” of more kind and compassionate voices that appear in the group dialogues. Hence, this study suggests that, in parallel with focusing on the presence and amount of the reflexive processes that occur in psychotherapy, psychotherapy research should also focus on the changes in the quality of these processes, and particularly the development of self-compassion in psychotherapy.

Predicting physical activity behavior among university students using the multi-process action control framework

Most university students do not engage in enough physical activity (PA) despite the known physical and mental health benefits. Action control theories such as the Multi-Process Action Control (M-PAC) framework have been proposed to better understand the translation of intentions into action by incorporating post-intentional processes. However, the explanatory power of the M-PAC framework beyond traditional social cognitive constructs has received limited attention. This study examined the predictive utility of the M-PAC framework for explaining variance in self-reported and device-measured PA behavior among university students. A total of 2418 undergraduate students (Mean age = 19.1 ± 1.73 [SD] years) completed an online survey that included a self-reported measure of moderate-to-vigorous PA (MVPA) as well as constructs outlined in the M-PAC framework: instrumental and affective attitudes, perceived capability and opportunity, behavioral regulation, habit and identity. A subsample (n = 376) also wore an ActiGraph wGT3x-BT accelerometer on their non-dominant wrist for seven full days to assess MVPA. Robust linear regression models were computed to investigate associations between M-PAC framework constructs and PA behavior. Findings showed the M-PAC framework explained as high as 14.3 % and 37.9 % of the variance in device-measured and self-reported MVPA, respectively. Regulatory (behavioral regulation), and reflexive (habit and identity) processes were significant predictors of self-reported MVPA when examining the full M-PAC framework, whereas the role identity dimension of PA identity was the only significant predictor of device-assessed MVPA. Taken together, these results reinforce the importance of post-intentional processes, specifically role identity, in understanding PA behavior among university students.