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Background: The majority of cancer patients and cancer care clinicians-CCCs (e.g., oncologists) believe that exercise is an important adjunct therapy that should be embedded in standard practice. Yet, CCCs do not routinely discuss exercise with their patients, nor do they regularly refer them to exercise professionals (e.g., exercise physiologists-EPs). This study evaluated the feasibility and acceptability of an evidence-based approach to improving exercise communication between CCCs and their patients, including an exercise referral pathway., Methods: Implementation and testing of the Exercise Communication and Referral Pathway (ECRP) occurred in Sydney, Australia. The ECRP included a brief oncology-initiated communication exchange with patients, CCC exercise referral to an EP, followed by EP-initiated telephone consultation with patients concerning tailored exercise advice. Participant perceptions concerning the feasibility and applicability of the ECPR were evaluated. Semi-structured interviews were conducted with CCCs (n = 3), cancer patients (n = 21), and an EP (n = 1). Inductive thematic analysis was undertaken., Results: Analysis generated three themes: (1) Navigating the role of CCCs in the ECRP, suggesting that oncology-initiated communication is a cue to action, however there was a lack of role clarity regarding exercise referral; (2) Implementing Patient-Orientated Care within a Standardised Pathway, highlighting the need for tailored information and advice for patients that reflects individual disease, socio-cultural, and environmental factors, and; (3) Taking Steps Towards Action, revealing the need for structural (e.g., EP initiated contact with patients) and policy changes (i.e., changes to Medicare, direct oncologist referral) to engage patients and better integrate exercise as part of standard care., Conclusions: Findings provide important insights into improving oncology-patient exercise communication and developing an exercise referral pathway to increase engagement and patient reach. However, individual (e.g., experience, knowledge) and contextual factors (e.g., time, resources) need consideration when implementing an ECRP., Trial Registration: This trial was prospectively registered with the Australian New Zealand Clinical (#ACTRN12620000358943) on March 13, 2020., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objectives: Elite sport coaches often rely on their discretion when assisting athletes struggling with mental health, with clear guidelines yet to be broadly adopted. This study aimed to explore how coaches perceive their role in athlete mental health and their role clarity., Design: This study employed a descriptive qualitative approach with semi-structured interviews., Methods: 17 Australian elite level swimming coaches were interviewed, focusing on their perceived experiences with athlete mental health and any discrepancies between what their role is currently and what they perceive it should be. Thematic analysis was used to analyse results., Results: Analysis revealed that coaches perceive their role to include open communication, actively observing their athletes' mood, and acknowledging their potential mental health knowledge deficits. They also indicated a lack of clarity for when to refer an athlete on to a medical professional. Athletes were perceived as responsible for maintaining self-awareness and help-seeking, whilst the organisational role included providing education and funding. Barriers for supporting athlete mental health included a lack of resources and poor mental health literacy. Coaches suggested a variety of recommendations to ameliorate these barriers including education and redesigning systems of support., Conclusions: Australian swimming coaches would greatly benefit from formal guidelines on how to identify, manage, and support athlete mental health. These guidelines should be established with input from coaches and key staff, in addition to clinical professionals and utilising evidence-based measures, including consideration of boundaries around coaches as non-mental health professionals., Competing Interests: Declaration of interest statement None., (Copyright © 2023 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

Purpose: This study asked consumers (patients, carers) and healthcare professionals (HCPs) to identify the most important symptoms for adults with cancer and potential treatment interventions., Methods: A modified Delphi study was conducted involving two rounds of electronic surveys based on prevalent cancer symptoms identified from the literature. Round 1 gathered information on participant demographics, opinions and/or experience on cancer symptom frequency and impact, and suggestions for interventions and/or service delivery models for further research to improve management of cancer symptoms. In Round 2, respondents ranked the importance of the top ten interventions identified in Round 1. In Round 3, separate expert panels of consumers and healthcare professionals (HCPs) attempted to reach consensus on the symptoms and interventions previously identified., Results: Consensus was reached for six symptoms across both groups: fatigue, constipation, diarrhoea, incontinence, and difficulty with urination. Notably, fatigue was the only symptom to reach consensus across both groups in Round 1. Similarly, consensus was reached for six interventions across both groups. These were the following: medicinal cannabis, physical activity, psychological therapies, non-opioid interventions for pain, opioids for breathlessness and cough, and other pharmacological interventions., Conclusions: Consumers and HCPs prioritise differently; however, the symptoms and interventions that reached consensus provide a basis for future research. Fatigue should be considered a high priority given its prevalence and its influence on other symptoms. The lack of consumer consensus indicates the uniqueness of their experience and the need for a patient-centred approach. Understanding individual consumer experience is important when planning research into better symptom management., (© 2023. The Author(s).)

Despite progression in the ethical and methodological conduct of Aboriginal and Torres Strait Islander health research, disparities still pervade, indicating limitations in knowledge translation. One identified gap is a lack of documented experiences detailing how ethical guidelines may be practically applied. This paper aims to (i) describe the research processes involved in co-designing a physical activity and psychosocial health program for Aboriginal and Torres Strait Islander girls and (ii) highlight learnings of the collaborative research journey. The Criteria for Strengthening Reporting of Health Research involving Indigenous Peoples (CONSIDER) statement was used to document participatory research activities undertaken with an Aboriginal community partner. Building upon the CONSIDER statement, Aboriginal (N = 3), Torres Strait Islander (N = 1) and non-Indigenous (N = 4) research team members engaged in critical reflection to identify lessons learnt. Researchers identified a tension between participatory research principles and the expectations of funding agencies and research institutions. Consequently, timelines must be flexible to foster meaningful community engagement and participatory processes. Additionally, researchers and community stakeholders are encouraged to embrace tensions that may associated with participatory research or the pressures Aboriginal and Torres Strait Islander researchers face from their community and organization. Furthermore, differences in professional (i.e. occupational) and cultural knowledge systems need to be acknowledged and accounted for within the early stages of a project to ensure informed decision-making. Identified lessons will assist relevant stakeholders in the development of future Aboriginal and Torres Strait Islander health programming, ensuring the most appropriate health solutions are devised with community., (© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Issue Addressed: Firefighting is physically and mentally taxing and recruits are expected to have optimal health and fitness. However, physical fitness tends to decline following initial training, placing firefighters at an increased risk for stress and injury. Efforts are needed to engage and support firefighters in maintaining adequate health and fitness to withstand the rigorous demands of their occupation. This study examined the feasibility of TARP, a pragmatic strength and conditioning intervention for metropolitan-based firefighters, delivered in collaboration with a professional National Rugby League club., Methods: A mixed-methods approach was utilised to examine program implementation, recruitment and sample characteristics, intervention satisfaction and acceptability, and participants' response to the intervention. Evaluation measures included field notes taken during steering committee meetings, participant flow data, baseline and follow-up outcome measures, self-report questionnaires, and telephone interviews with a sample of participants., Results: Participants (N = 113) were predominantly men (82%) with a mean age of 43 ± 9.3 years and BMI of 26.6 ± 2.9 kg/m 2 . Program satisfaction was high (95% very satisfied or somewhat satisfied) among program completers (42% retention). Key strengths of the program included delivery through the professional sports club, quality of facilities and equipment, and scheduling flexibility. Future programs should consider incorporating education or training to support behaviour change maintenance and strategies to retain participants at follow-up., Conclusions: Results provide valuable insights into the design and delivery of interventions for firefighters and demonstrate the importance of strong partnerships between community stakeholders., (© 2022 The Authors. Health Promotion Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of Australian Health Promotion Association.)

Regular physical activity supports children's physical and psychological health and wellbeing, and provides opportunities to build social and emotional skills such as resilience, confidence, and self-efficacy. Research has demonstrated that mass participant sporting events can serve as important social and environmental correlates of physical activity. This study sought to explore parents and children's perceived motivations and perspectives of participation in the Australian Sanitarium Weet-Bix Kids TRYathlon (a non-competitive triathlon series), on children's health and well-being. An exploratory qualitative design utilizing seven focus groups were conducted with 27 family units including 31 parents and 61 children (age 7-15 years old). Data were recorded, professionally transcribed and then analyzed using thematic analysis. Three overarching themes were identified, including (1) motivations for event and physical activity participation, revealing social interaction, peer support and friendly competition as motivators for participation as well as parents' interest in supporting the development of healthy habits; (2) Perceived physical activity, fitness, and developmental benefits, detailing changes to the types of physical activity children performed as well as opportunities for children to develop physical skills and competencies; and (3) Perceived psychosocial benefits of participation, highlighting opportunities for children to develop and demonstrate independence and autonomy through event participation. Notably, parents and children identified benefits beyond immediate participation including increased family engagement and social support. Mass participant events hold the potential to elicit a range of benefits for children and their families; however, further efforts may be needed to engage less active or disengaged families., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Aims: This study aimed to (1) explore the perceptions of people living with cancer about exercise in general and exercise as an adjunct form of cancer care, (2) explore their perceptions regarding exercise counselling needs and preferences, and (3) investigate how these perceptions of exercise as an adjunct form of cancer care shape survivors exercise levels postcancer diagnosis., Methods: A cross-sectional design and online survey were used to recruit cancer survivors via cancer-related networks throughout Australia. Two factor analyses were conducted to examine the structure and reduce the number of variables pertaining to exercise during and after the cancer treatment. Extracted components were used in one-way analysis of variance to compare differences in physical activity levels postcancer diagnosis., Results: Participants (N = 288) had very positive perceptions of exercise, yet only 50% of participants would prefer to receive exercise counselling. Those who were more active postcancer diagnosis had higher exercise beliefs than those who were similarly active (p = 0.04, r = 0.27) and less active (p = 0.03, r = 0.24) postdiagnosis. Those who were less active also had lower exercise knowledge than those who were similarly active (p = 0.01, r = 0.31) and more active (p = 0.03, r = 0.26). Safety beliefs did not significantly differ between cancer survivors' activity levels (p = 0.16) CONCLUSION: This survey highlights the potential benefits of a concentrated effort in connecting survivors to relevant services and resources, and utilizing cancer clinicians to communicate with survivors about the role of exercise in cancer care., (© 2022 John Wiley & Sons Australia, Ltd.)

Objective: This study aimed to 1) understand factors impacting the implementation of exercise communication and referral, and 2) explore integrated clinical approaches to exercise communication and referral in cancer care., Methods: Seven focus groups (N = 53) were conducted with clinicians and exercise professionals throughout Sydney, Australia. A sub-sample of participants (n = 9) attended a half-day workshop to identifying best practice approaches for moving forward. Data were analysed using thematic content analysis., Results: Two themes emerged: 1) Factors impacting the knowledge-to-action gap, inclusive of limited exercise specific knowledge and training opportunities, funding structure, and current referral process, and 2) Recommendations for a consistent and efficient way forward, detailing the need for oncologist-initiated communication, distribution of cancer-exercise resources, and access to exercise professionals with cancer expertise., Conclusions: This study identified factors (e.g., cancer-exercise specific training, integration of exercise physiologists) influencing exercise counselling and referral. A potential implementation-referral approach accounting for these factors and how to incorporate exercise into a standard model of cancer care, is described. Future testing is required to determine feasibility and practicality of these approaches., Practical Implications: A pragmatic model is provided to guide implementation-referral, inclusive of oncologist-initiated communication exchange, relevant resources, and access to exercise professionals with cancer expertise., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Issue Addressed: Running since 1999, the Sanitarium Weet-Bix Kids TRYathlon (SWKT) is the world's largest triathlon series for children and adolescents up to 16 years. This report seeks to describe participants of the TRYathlon and their perceptions of the event., Methods: An online survey was made available to Australian parents/guardians of participants enrolled in the 2020 SWKT. Organisational data was also employed to describe the reach of the SWKT since its inception., Results: Parents/guardians (n = 568) reported that the average child age was 9.12 (SD = 1.95, range = 6-16) and 58.6% were male. Parents/guardians identified 12 children as Aboriginal and/or Torres Strait Islander (2.0%) and 87 (14.6%) spoke a language other than English. The majority of parents/guardians rated their child's physical activity (PA) competencies as pretty good, or really good, for cycling (87.5%), swimming (80.9%) and running (79.5%). Most parents (66.0%) stated that their child was glowing with pride after completing the event, enjoyed or really enjoyed the event (98.8%), and thought their child would maintain their PA levels following the event (72.9%)., Conclusions: The SWKT series has demonstrated longevity and an ability to reach a large number of participants, providing opportunities to build health promotion awareness. Importantly the event instils a sense of confidence and pride related to PA competency in its participants; however, its long-term effectiveness requires further exploration. SO WHAT?: Mass participation events such as SWKT could be incorporated into larger health promotion strategies to encourage childhood PA and foster healthy physical and psychosocial development., (© 2021 Australian Health Promotion Association.)

Objective: The purpose of this qualitative study was to explore working men's perspectives about sleep health and the intersecting influences of gender and work, describing participant's views on current and potential programming and organizational support to promote sleep health., Methods: Twenty men employed in male-dominated industries in the north-central region of Alberta, Canada, participated in 4 consultation group discussions addressing motivators, facilitators and barriers to sleep health., Results: Participants reported sleeping an average of 6.36 (SD ±1.1) hours per night, and the majority worked more than 40 hours per week. Data were analyzed using an inductive approach. The findings provided important insights. In normalizing sleep deprivation and prioritizing the need to "just keep going" on six or less hours of sleep, the men subscribed to masculine ideals related to workplace perseverance, stamina and resilience. Workplace cultures and practices were implicated including normative dimensions of overtime and high productivity and output, amid masculine cultures constraining emotions and conversations about sleep, the sum of which muted avenues for discussing, let alone promoting sleep. Challenges to good sleep were primarily constructed around time constraints, and worry about meeting work and home responsibilities. Men's preferences for workplace support included providing and incentivizing the use of sleep health resources, designing work for sleep health (e.g., shift schedules, overtime policies) and getting advice from experienced coworkers and experts external to the workplace organization., Conclusion: These findings hold potential for informing future gender-sensitive programming and organizational practices to support sleep health among working men.

Men's mental health promotion presents unique challenges including gender-related barriers and stigmas, which demand novel approaches to prevention, treatment, and management. The aim of this study was to explore men's perceptions of mental health and preferences for mental health promotion. Seven focus groups (N = 59) were conducted in Sydney, Australia, including 5 groups of men (M = 50.65, SD = 13.75 years) and 2 groups of stakeholders who had frontline experience working with men (e.g., men's groups, health clubs, mental health advocates). Data were analysed using thematic analysis and interpreted using a gender relations approach to explore connections between gender roles, relations and identities, and men's mental health. Three overarching themes were identified; (1) Roles, identities, and the conceptualisation and concealment of mental health challenges, revealing challenges to mental health promotion related to perceptions of men's restrictive emotionality and emotional awareness as well as difficulties with conceptualising the internalised experiences of mental health, (2) Constraining social contexts of stigma and gender relations, identifying how social context and the policing of gender roles often obscured opportunities for discussing mental health and help-seeking behaviour, (3) Anchoring mental health promotion to acceptable lifestyle practices, highlighting potential remedies included leveraging men's social practices related to reciprocity, normalising mental health promotion relative to other behaviours, and embedding mental health promotion within acceptable masculine practices. Discussed are directions for men's community-based mental health promotion and opportunities for how masculinities may be negotiated and expanded to embody mental health promoting values., Competing Interests: The authors have declared that no competing interests exist.

Background: The COVID-19 pandemic imposed major changes on daily-life routine worldwide. To the best of our knowledge, no study quantified the changes on moderate to vigorous physical activity (MVPA) and sedentary behaviors (SB) and its correlates in Brazilians. This study aimed to (i) evaluate the changes (pre versus during pandemic) in time spent in MVPA and SB in self-isolating Brazilians during the COVID-19 pandemic, and (ii) to explore correlates., Methods: A cross-sectional, retrospective, self-report online web survey, evaluating the time spent in MVPA and SB pre and during the COVID-19 pandemic in self-isolating people in Brazil. Sociodemographic, behavioral, and clinical measures, and time in self-isolation were also obtained. Changes in MVPA and SB and their correlates were explored using generalized estimating equations (GEE). Models were adjusted for covariates., Results: A total of 877 participants (72.7% women, 53.7% young adults [18-34 years]) were included. Overall, participants reported a 59.7% reduction (95% CI 35.6-82.2) in time spent on MVPA during the pandemic, equivalent to 64.28 (95% CI 36.06-83.33) minutes per day. Time spent in SB increased 42.0% (95% CI 31.7-52.5), corresponding to an increase of 152.3 (95% CI 111.9-192.7) minutes per day. Greater reductions in MVPA and increases in SB were seen in younger adults, those not married, those employed, and those with a self-reported previous diagnosis of a mental disorder., Conclusions: People in self-isolation significantly reduced MVPA levels and increased SB. Public health strategies are needed to mitigate the impact of self-isolation on MVPA and SB., Supplementary Information: The online version contains supplementary material available at 10.1007/s11332-021-00788-x., Competing Interests: Conflict of interestThe authors have no conflict of interest to declare., (© The Author(s), under exclusive licence to Springer-Verlag Italia S.r.l., part of Springer Nature 2021.)

This review aimed to identify and assess existing evidence of the impact of sport and physical activity programs on mental health and social and emotional wellbeing outcomes within young Aboriginal and Torres Strait Islander people. The review also aimed to highlight limitations of current practice within the research area. A systematic search of literature was undertaken on three peer-reviewed databases (PsycINFO, MEDLINE and SPORTSDiscus) and grey literature from January to March 2021. Studies were included if they described a sport and physical activity program for young (10-24 years) Aboriginal and Torres Strait Islander people and reported mental health or social and emotional wellbeing outcomes. Seventeen studies were selected for this review. Within these studies, the most commonly reported outcomes were related to psychosocial development (N = 12) and a sense of connectedness (N = 12). Mental illness related outcomes (N = 1) were rarely reported, as were substance use (N = 2) and social and emotional literacy (N = 1). Promising outcomes included increased connection to culture, self-esteem and confidence. Nonetheless, due to indirectness and suboptimal study design the precise impact on these outcomes could not be determined. A relevant evidence base is emerging on the impact sport and physical activity programs have on the mental health and social and emotional wellbeing of young Aboriginal and Torres Strait Islander people. However, further research that utilises robust, culturally appropriate methodologies and tools needs to be undertaken before the effects of sport and physical activity programs can reliably be discerned., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

Background: Although perceptions of what constitutes physical activity (PA) may vary between culturally diverse populations, very little research has explored the perceptions of PA among Indian migrants. This study aimed to identify how PA and sedentary behaviour (SB) are defined and describe how these definitions are shaped by cultural background and migration among a sample of Indian migrants living in Australia., Methods: Using an exploratory qualitative approach, semi-structured interviews were conducted with twenty-one Indian migrants living in Melbourne (10 men and 11 women; age range: 18 to 65 years). Interviews were audio-recorded and transcribed verbatim. Data were coded and analysed inductively using thematic analyses., Results: Data revealed two emerging themes: 1) Holistic perspectives related to PA, where although the majority of participants described PA as "any sort of movement", or "physical exercise", several of these descriptions had interwoven ideas related to the mind (mind-body connect), social, cultural, and to the outdoor environment; 2) Broader perspectives for SB, where descriptions of SB as "not having movement", "doing nothing" or "being lazy", were shaped with ideas of purpose and duration. Women spoke about how their perspectives of PA and SB may be shaped by native Indian experiences, particularly the gender roles, social caste, and regional subcultural norms which they perceived were important to consider among women who migrate to western settings., Conclusions: Cultural background is important in shaping the perspectives of PA and SB among Indian migrants in Australia. Practitioners and researchers should consider the varying perspectives of PA to communicate and promote PA among migrant populations more effectively., (© 2021. The Author(s).)

Engaging men in mental health promotion can be difficult because of reticence about help-seeking, especially for gender neutral programmes. Developments in men's health research has pointed to the success of gender-sensitized programmes to increase men's engagement in healthy lifestyle interventions targeting physical activity and healthy eating; however, less is known about the impact of these interventions on men's mental health. This study explored changes to men's depression risk and health-related quality of life at post-intervention (12 weeks) and 9-month follow-up, after participating in HAT TRICK, a gender-sensitized lifestyle intervention for overweight men. Participants completed validated self-report measures of mental health at baseline, post-intervention (12 weeks) and 9-month follow-up. Men's scores on the Male Depression Risk Scale (MDRS) and the SF-12 questionnaire, including physical health (PH12) and mental health (MH12) composite scores, were analyzed using mixed linear models to assess linear trends. At baseline, men (N = 62) had a mean age of 50.98 (SD = 10.09) years and BMI of 35.87 (SD = 5.51) kg/m2. Results show that both the MDRS and the MH12 showed improvements in participants' mental health, with significant linear trends (p = 0.003; p = 0.003) qualified with significant quadratic trends over time (p = 0.02; p = 0.03). There were no significant changes in the PH12 over time. Gender-sensitized programmes for overweight men, such as HAT TRICK, are a promising approach to positively influence components of men's mental health, with the potential for sustained improvements over the long term., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Competing Interests: Competing interests: None declared.

The worldwide prevalence of insufficient physical activity (PA) and prolonged sedentary behavior (SB) were high before the coronavirus (COVID-19) pandemic. Measures that were taken by governments (such as home confinement) to control the spread of COVID-19 may have affected levels of PA and SB. This cross-sectional study among South American adults during the first months of COVID-19 aims to (i) compare sitting time (ST), screen exposure, moderate PA (MPA), vigorous PA (VPA), and moderate-to-vigorous PA (MVPA) before and during lockdown to sociodemographic correlates and (ii) to assess the impact of lockdown on combinations of groups reporting meeting/not-meeting PA recommendations and engaging/not-engaging excessive ST (≥7 h/day). Bivariate associations, effect sizes, and multivariable linear regressions were used. Adults from Argentina ( n = 575) and Chile ( n = 730) completed an online survey with questions regarding demographics, lifestyle factors, and chronic diseases. Mean reductions of 42.7 and 22.0 min./day were shown in MPA and VPA, respectively; while increases of 212.4 and 164.3 min./day were observed in screen and ST, respectively. Those who met PA recommendations and spent <7 h/day of ST experienced greatest changes, reporting greater than 3 h/day higher ST and more than 1.5 h/day lower MVPA. Findings from the present study suggest that efforts to promote PA to South American adults during and after COVID-19 restrictions are needed.

Purpose: To estimate program effectiveness regarding physical activity (PA), diet, and social connectedness as part of a feasibility study., Design: Pre-post quasi-experimental., Setting: HAT TRICK was delivered in collaboration with a Canadian semi-professional ice hockey team and offered at the arena where they trained and played games., Participants: Participants (N = 62) at baseline were overweight (BMI >25kg/m 2 ) and inactive (<150 minutes of MVPA/week) men age 35+ years., Intervention: Gender-sensitized 12-week intervention for men targeting PA, healthy eating and social connectedness., Method: Baseline, post-intervention (12 weeks) and 9-month follow-up self-report and accelerometer data were collected. Multi-level modeling assessed growth trajectories of outcome measures across time., Results: Accelerometer measured weekly/min. of moderate PA showed significant linear trends (95%CI: 42.9 - 175.3) from baseline (147.0 ± 104.6), 12-week (237.7 ± 135.5) and 9-month follow-up (204.89 ± 137.7) qualified with a quadratic trend. Self-reported weekly/min of moderate and vigorous PA showed significant linear trends (95%CI: 94.1, 264.1; 95%CI: 35.1, 109.6) from baseline (52.6 ± 83.8, 22.42 ± 44.9), 12 week (160.1 ± 157.4, 66.6 ± 74.4) and 9-month follow-up (118.6 ± 104.6, 52.2 ± 59.2) qualified with quadratic trends. DINE measured fat score rating showed linear trends over time (95%CI -14.24, -6.8), qualified with a quadratic trend. DINE fibre score and social connectedness showed no trends., Conclusion: Findings yield valuable information about the implementation of gender-sensitized lifestyle interventions for men and demonstrate the importance of male-specific strategies for reaching and engaging overweight, physically inactive men.

Objectives: To summarize the current available evidence on the use of behavior change theories to explain and change physical activity behavior in urological cancer survivors., Data Sources: Five electronic databases including Medline, Web of Science, Embase, Cochrane, and Psych INFO and reference lists of key studies were searched between database inception and November 2020. Peer-reviewed articles on the use of behavior change theories to understand or change physical activity in urological cancer survivors were included., Conclusion: The theory of planned behavior and the social cognitive theory were the most used theories to explain and change physical activity behavior in urological cancers, respectively. However, the use of behavior change theories in physical activity interventions for urological cancers is still low across all urological tumor groups. Planning frameworks such as the intervention mapping approach should be used to enhance the systematic use of behavior change theories during every phase of intervention development. In addition, more research is needed to identity which behavior change techniques are most effective to change physical activity behavior in urological cancer survivors., Implications for Nursing Practice: Nurses play a key role in the urological cancer patients' clinical pathway and should be able to motivate patients to engage in sufficient physical activity levels. Therefore, it is important that nurses understand the underlying reasons why patients (do not) engage in physical activity and which behavior change techniques are most effective in changing a patients' behavior., (Copyright © 2020 Elsevier Inc. All rights reserved.)

The workplace provides an important delivery point for health promotion, yet many programs fail to engage men. A gender-sensitive 8-week team challenge-based intervention targeting increased physical activity was delivered at a petrochemical worksite. The purpose of this study was to examine men's pre-post physical activity and sleep following the intervention, as well as to explore program acceptability and gather men's recommendations for health promotion. Pre-post surveys assessed physical activity, sleep, program exposure, acceptability, and suggestions for continued support. Overall, 328 men completed baseline surveys and 186 (57%) completed follow-up surveys. Walking increased by 156.5 min/week, 95% confidence interval (61.2, 251.8), p = .001. Men with higher program exposure increased moderate and vigorous activity 49.4 min more than those with low exposure ( p = .026). Sleep duration and quality were higher postintervention, though changes were modest. Program acceptability was high as was intention to maintain physical activity. Men's suggestions to enable physical activity involved workplace practices/resources, reducing workload, and leadership support. These findings suggest that a gender-sensitive physical activity workplace intervention showed promise for improving physical activity and sleep among men. The men's suggestions reflected workplace health promotion strategies, reinforcing the need for employers to support ongoing health promotion efforts.

Preventive lifestyle interventions are needed to address challenges in engaging men in conventional health programmes. This process evaluation examined the feasibility and acceptability of HAT TRICK, a gender-sensitized programme targeting physical activity, healthy eating and social connectedness. A mixed-methods approach was utilized to examine the effectiveness of recruitment and selection processes, facilitators' experiences and challenges and participant experiences with the programme. Evaluation measures included participant flow data and baseline assessments, facilitator debriefs, a post-intervention process evaluation questionnaire and telephone interviews with a subsample of participants. Participants (n = 62) were overweight (body mass index [BMI] > 25 kg m-2) and inactive (<150 min of moderate to vigorous physical activity [MVPA] per week) men with a mean age 51 ± 10.1 years. Participants reported high levels of satisfaction, acceptability and engagement with the intervention programme, content and resources. Facilitators noted the importance of creating a friendly, non-judgemental environment and observed that intervention content was best received when delivered in an interactive and engaging manner. Future programme refinements should consider strategies for strengthening social support, as well as opportunities for leveraging participants' interest in other health-related issues (e.g. mental health). Findings yield valuable information about the implementation of gender-sensitized interventions for men and demonstrate the importance of male-specific engagement strategies for reaching and engaging overweight, inactive men., (© The Author(s) 2020. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

This is a cross-sectional study evaluating the associations of self-reported moderate to vigorous physical activity, and sedentary behavior with depressive, anxiety, and co-occurring depressive and anxiety symptoms (D&A) in self-isolating Brazilians during the COVID-19 pandemic. Depressive and anxiety symptoms were collected using the Beck Depression and Anxiety Inventories (BDI and BAI). Among the 937 participants (females=72.3%), those performing ≥30 min/day of moderate to vigorous or ≥15 min/day of vigorous physical activity had lower odds of prevalent depressive, anxiety, and co-occurring D&A symptoms. Those spending ≥10 h/day sedentary were more likely to have depressive symptoms., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objective: To determine the effects of behaviour change interventions on men's physical activity (postintervention), sustained change in physical activity behaviour (≥12 months postintervention) and to identify variations in effects due to potential moderating variables (eg, theoretical underpinning, gender-tailored, contact frequency)., Design: Systematic review with meta-analysis. Pooled effect size (Cohen's d ) was calculated assuming a random-effects model. Homogeneity and subsequent exploratory moderator analyses were assessed using Q, T 2 and I 2 ., Data Sources: Medline, EMBASE, CINAHL, SportDiscus and Web of Science to April 2019., Eligibility Criteria for Selected Studies: Randomised control trials of behaviour change interventions in men (≥18 years) where physical activity was an outcome and data were from men-only studies or disaggregated by sex., Results: Twenty-six articles described 24 eligible studies. The overall mean intervention effect on men's physical activity was 0.35 (SE=0.05; 95% CI 0.26 to 0.45; p<0.001). This effect size is consistent with an increase of approximately 97 min of total physical activity per week or 980 steps per day. Intervention moderators associated with greater increases in physical activity included objective physical activity outcome measures, a gender-tailored design, use of a theoretical framework, shorter length programmes (≤12 weeks), using four or more types of behaviour change techniques and frequent contact with participants (≥1 contact per week). 12 studies included additional follow-up assessments (≥12 months postintervention) and the overall mean effect was 0.32 (SE=0.09; 95% CI 0.15 to 0.48; p<0.001) for that sustained increase in physical activity., Summary: Behaviour change interventions targeting men's physical activity can be effective. Moderator analyses are preliminary and suggest research directions., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Adolescents are highly susceptible to negative self-perceptions, likely due to their social cues and environment. The presence of these negative self-perceptions has been shown to adversely impact levels of physical activity (PA). Although PA has the ability to foster improved self-perceptions, the rates of PA among adolescents continue to descend, with girls appearing to be most susceptible to these declines. At-risk adolescent girls, who may experience a number of negative preceding lifestyle conditions, may be exceptionally vulnerable to declines in PA. There are a high number of adolescent girls from low-income and abusive households in British Columbia, Canada, thus indicating a need for a program to relay the importance of PA and healthy lifestyle behaviors., Objective: This paper aims to describe the protocol of the Girls United and on the Move (GUM) pragmatic intervention, an integrated PA and psychosocial program aimed at improving self-compassion, social connectedness, and overall self-perceptions among at-risk adolescent girls., Methods: Using a quasi-experimental mixed methods approach, the GUM intervention was conducted in 5 schools in British Columbia, Canada. Adolescent girls aged 11 to 15 years who were identified as at risk were included in the study. The 9-week intervention, co-delivered by a PA/health promotion-trained researcher and a registered social worker, involved a PA component and a psychosocial component with evidence-based topics addressing the concerns of the adolescent girls. The following outcomes were evaluated: PA, self-compassion, social support, leader supportiveness, and sport enjoyment and commitment. Program acceptability and satisfaction was also examined. Outcome measures were assessed at baseline (week 1), week 6, and postintervention (week 9), and interview data concerning program acceptability and satisfaction were collected at postintervention from a subsample of participants., Results: A total of 101 participants were invited to participate in the GUM intervention. Reporting of the results is projected for the fall of 2020., Conclusions: It is anticipated that the GUM intervention will enhance PA while also improving self-compassion, social connectedness, and overall self-perceptions among at-risk adolescent girls. The findings of this research will contribute to the literature concerning PA and various psychosocial factors that impact the physical and mental health of at-risk adolescent girls., Trial Registration: Clinicaltrials.gov NCT03567200; https://clinicaltrials.gov/ct2/show/NCT03567200., International Registered Report Identifier (irrid): DERR1-10.2196/15302., (©Cristina M Caperchione, Nicole Hargreaves, Catherine M Sabiston, Stephen Berg, Kent C Kowalski, Leah J Ferguson. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 09.06.2020.)

Sleep health is an important aspect of wellbeing and merits incorporation into workplace health promotion programs for employees. Men are a unique population with whom many traditional workplace health promotion programs have had limited success. This systematic review posed the question do workplace health promotion programs improve sleep among men, and what program design features contribute to improving sleep among working men? Databases searched were MEDLINE, EMBASE, the Cochrane Library, CINHAL, Academic Search Complete and Health Source: Nursing/Academic Edition and Google Scholar. Empirical research reporting non-pharmacological behavioral sleep programs and/or interventions for working men were eligible for review. 1049 articles were identified; 15 intervention studies were included: 13 interventions were delivered through workplaces, and two recruited workers to programs delivered outside of work. Interventions incorporated health education, stress reduction/relaxation, and/or physical activity components. Eleven studies reported positive findings for sleep health outcome(s) in men. A moderate level of evidence exists for sleep health programs with physical activity and stress management components. Evidence for the effectiveness of sleep health education programs was mixed. That only one study included a gender-sensitized intervention, where men's preferences shaped the content of a stress-reduction program which resulted in improved sleep quality, attests to the insufficient evidence and lack of gender-specific content and analyses. Next research steps should include considering cultural constructions of masculinity in program design in order to strengthen the appeal and engagement of men, and optimize health benefits for working men., (Copyright © 2020 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.)

Background: Predictors of men's health behaviors and interest in workplace health promotion are not well known. The aim of this study was to describe men's interest in workplace health promotion and associated health behaviors. Method : Male employees ( N = 781) at six workplaces in British Columbia, Canada, were invited to complete a survey of their health behaviors, demographics, and interest in health promotion prior to implementation of a workplace health program. Findings : A total of 227 male employees ( M age = 43.6 years; SD = 12.1) completed the survey (response rate = 29%). Regarding health behaviors, 62.1% reported 150 weekly minutes of moderate-to-vigorous physical activity (MVPA), 29.3% consumed 5+ servings of fruit/vegetables per day, 56.8% reported 7+ hours sleep/night, 14.4% smoked, and 81.3% consumed alcohol. Men spent 50% of their workday sitting, and higher body mass index (BMI), higher income, and greater hours worked were related to greater hours sitting. Age was inversely related to MVPA. Alcohol consumption was lower among men who were older, had higher income, and worked fewer hours. Most men were interested in being physically active (85%), managing stress (85%), eating healthy (89%), and cancer screening (91%). Higher stage of change for physical activity (β = .20, p = .003) and fruit/vegetable consumption (β = .18, p = .027) were related to interest in these activities. Conclusions/Application to Practice : Occupational health providers should consider worker demographics and could support interventions that target individuals with varying levels of health behaviors given the importance of meeting the needs of often sedentary workers.

Health behaviour change programs that utilise IT-based delivery have great potential to improve health. Whilst more static Web 1.0 technologies have been somewhat effective, they often failed to promote longer-term user engagement required for greater health promotion impact. With Web 2.0 technologies, however, there is potential for greater engagement and retention, through allowing individuals to determine how information is generated, modified, and shared collaboratively. The WALK 2.0 study utilised a Web 2.0-based platform to engage participants in health behaviour change aimed at increasing physical activity levels. The program included two trials: (1) a three-arm randomised controlled trial (RCT) that compared the effectiveness of Web 2.0, Web 1.0, and paper-based logbook interventions; and (2) a real-world randomised ecological trial (RET) that compared a Web 2.0 and Web 1.0 intervention. The aim of this paper is not to focus on the research trial results per se, but rather the success factors and challenges in both the RCT and RET. Both the RCT and RET demonstrated successful outcomes, with greater improvements in physical activity for the Web 2.0 groups. A range of challenges, however, were identified in designing, implementing, and evaluating such interventions. These include IT-based intervention development within a research context, the ability to establish a self-sustaining online community, the rapid pace of change in web-based technology and implications for trial design, the selection of best outcome measures for ecological trials, and managing engagement, non-usage and study attrition in real-world trials. Future research and developments in this area must look to broader research designs that allow for the ever-changing IT-user landscape and behaviour, and greater reliance on development and testing in real-world settings.

Competing Interests: Competing interests: CV (ID 100427) and MJD (ID 100029) are supported by a Future Leader Fellowship from the National Heart Foundation of Australia.

Objective: To assess the use of diet and the use of exercise for prostate cancer (and/or its treatments' side effects) by long-term survivors and whether such use is associated with selected socio-demographic, clinical, health-related quality-of-life (HRQOL) and psychological factors., Design, Setting and Participants: Population-based cohort study in New South Wales, Australia of prostate cancer survivors aged <70 years at diagnosis and who returned a 10-year follow-up questionnaire., Methods: Validated instruments assessed patient's HRQOL and psychological well-being. Poisson regression was used to estimate adjusted relative proportions (RRs) of prostate cancer survivor groups who were currently eating differently ('using diet') or exercise differently ('using exercise') to help with their prostate cancer., Results: 996 (61.0% of 1634) participants completed the 10-year questionnaire of whom 118 (11.8%; 95%CI[9.8-13.9]) were using diet and 78 (7.8%; 95%CI[6.2-9.5]) were using exercise to help with their prostate cancer. Men were more likely to use diet or use exercise for prostate cancer if they were younger (p-trend = 0.020 for diet, p-trend = 0.045 for exercise), more educated (p-trend<0.001, p-trend = 0.011), support group participants (p-nominal<0.001, p-nominal = 0.005), had higher Gleason score at diagnosis (p-trend<0.001, p-trend = 0.002) and had knowledge of cancer spread (p-nominal = 0.002, p-nominal = 0.001). Use of diet was also associated with receipt of androgen deprivation therapy (RR = 1.59; 95%CI[1.04-2.45]), a greater fear of cancer recurrence (p-trend = 0.010), cognitive avoidance (p-trend = 0.025) and greater perceived control of cancer course (p-trend = 0.014). Use of exercise was also associated with receipt of prostatectomy (RR = 2.02; 95%CI[1.12-3.63]), receipt of androgen deprivation therapy (RR = 2.20; 95%CI[1.34-3.61]) and less satisfaction with medical treatments (p-trend = 0.044)., Conclusions: Few long-term prostate cancer survivors use diet or exercise to help with their prostate cancer. Survivors may benefit from counselling on the scientific evidence supporting healthy eating and regular exercise for improving quality-of-life and cancer-related outcomes., Competing Interests: The authors have declared that no competing interests exist.

Objective: This study examines the reach, effectiveness, adoption, implementation, and maintenance of the 10,000 Steps Pedometer Microgrant Scheme using the RE-AIM framework., Methods: The study used a mixed methods pre-post design. RE-AIM indicators were examined using employee surveys and workplace reports of microgrant implementation, adoption, and maintenance., Results: A total of 259 microgrants and 21,211 pedometers were awarded (reach). Significant increases in physical activity were observed (P < 0.05) (effectiveness). Many (78%) workplaces reported using at least one challenge resource (adoption). Barriers were higher (26.5%) or lower (20.5%) than anticipated participation rates (implementation). Fifty percent of workplaces would continue to promote physical activity (maintenance)., Conclusions: The microgrant reached a large number of employees and workplaces, increased physical activity, and achieved good levels of adoption and implementation. Employee and workplace levels of maintenance were mixed and need to be improved.

Translating effective research into community practice is critical for improving breast cancer (BC) survivor health. The purpose of this study is to utilize the RE-AIM framework to evaluate the translational potential of Project MOVE, an innovative intervention focused on increasing physical activity (PA) in BC survivors. A mixed-methods design, including a self-report questionnaire, accelerometry, focus groups, and interviews, was used to inform each RE-AIM dimension. Reach was evaluated by the representativeness of participants. Effectiveness was reflected by change in PA levels and perceptions of satisfaction and acceptability. Adoption was examined using participants' perceived barriers/facilitators to program uptake. Implementation was examined by participants' perceived barriers/facilitators to implementing the program. Maintenance was assessed by participant retention. Assessments occurred at baseline and 6-months. Mixed analysis of variance and content analysis were used to analyze the data. A total of 87 participants participated in Project MOVE and were demographically comparable to similar studies (Reach). Participants indicated high levels of program satisfaction (88%) and previously inactive survivors' significantly increased PA levels from baseline to 6-month follow-up (Effectiveness). Participants reported that a program focused on PA rather than disease helped them overcome barriers to PA (Adoption) and having leaders with BC and exercise expertise was essential to accommodate population specific barriers (Implementation). At 6-months, participant retention was 83% (Maintenance). Project MOVE is an acceptable, practical, and effective program for engaging BC survivors in PA and has the potential to be highly transferable to other populations and regions., (© The Author(s) 2018. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.)

Background: This study aimed to investigate the validity of the Active Australia Survey across different subgroups and its responsiveness to change, as few previous studies have examined this., Methods: The Active Australia Survey was validated against the ActiGraph as an objective measure of physical activity. Participants (n = 465) wore the ActiGraph for 7 days and subsequently completed the Active Australia Survey. Moderate activity, vigorous activity and total moderate and vigorous physical activity were compared using Spearman rank-order correlations. Changes in physical activity between baseline and 3-month assessments were correlated to examine responsiveness to change. The data were stratified to assess outcomes according to different subgroups (e.g., gender, age, weight, activity levels)., Results: With regards to the validity, a significant correlation of ρ = 0.19 was found for moderate physical activity, ρ = 0.33 for vigorous physical activity and ρ = 0.23 for moderate and vigorous physical activity combined. For vigorous physical activity correlations were higher than 0.3 for most subgroups, whereas they were only higher than 0.3 in those with a healthy weight for the other activity outcomes. With regards to responsiveness to change, a correlation of ρ = 0.32 was found for moderate physical activity, ρ = 0.19 for vigorous physical activity and ρ = 0.35 for moderate and vigorous physical activity combined. For moderate and vigorous activity combined correlations were higher than 0.4 for several subgroups, but never for vigorous physical activity., Conclusions: Little evidence for the validity of Active Australia Survey was found, although the responsiveness to change was acceptable for several subgroups. Findings from studies using the Active Australia Survey should be interpreted with caution., Trial Registration: World Health Organisation Universal Trial Number: U111-1119-1755. Australian New Zealand Clinical Trials Registry, ACTRN12611000157976 . Registration date: 8 March 2011.

Background: Physical activity (PA) is a safe and effective strategy to help mitigate health challenges associated with breast cancer (BC) survivorship. However, the majority of BC survivors are not meeting the minimum recommended PA (≥150 min of moderate to vigorous intensity). Project MOVE was developed as a model for increasing PA that combined a) Microgrants: funds ($2000) awarded to applicant groups to develop and implement a PA initiative and b) Financial incentives: a reward ($500) for increasing group PA. The purpose of this paper was to provide an exploratory analysis of effectiveness of Project MOVE on PA behavior, PA motivation, and quality of life (QoL) in female BC survivors. The differential outcomes between women meeting and not meeting PA guidelines were also investigated., Methods: This pre-post test, preliminary trial included groups of adult (18+ years) self-identified female BC survivors, who were post-surgery and primary systemic chemo- and radiation therapy, and living in British Columbia, Canada. PA was assessed by accelerometry. PA motivation and QoL were assessed by self-report. Data were collected at baseline, 6-months, and 12-month time points. Repeated measures mixed ANOVAs were used to test changes in the main outcomes., Results: A total of 10 groups were awarded microgrants between May 2015 and January 2016. Groups comprised of 8 to 12 women with a total of 87 participants. A statistically significant increase was found between time points on weekly moderate to vigorous PA (p = .012). This was mediated by a significant interaction between those meeting PA guidelines and those not meeting guidelines at baseline by time points (p = .004), with those not meeting guidelines at baseline showing the greatest increase in MVPA. A statistically significant difference across time points was found for intrinsic motivation (p = .02), physical functioning (p < .001), physical health limitations (p = .001), emotional health limitations (p = .023), social functioning (p = .001) and general health (p = .004)., Conclusion: These results provide promising support for a unique approach to increasing PA among BC survivors by empowering women and optimizing PA experiences through the use of microgrants and financial incentives., Trial Registration: ClinicalTrials.gov NCT03548636 , Retrospectively registered June 7, 2018.

There is a need for tailored smoking cessation programs specifically for Indigenous fathers who want to quit smoking.The aim of this study was to engage Indigenous men and key informants in guiding cultural adaptations to the Dads in Gear (DIG) cessation program. In Phase 1 of this qualitative participatory study, Indigenous men were engaged in group sessions and key informants in semistructured interviews to gather advice related to cultural adaptations to the DIG program. These data were used to guide the development of program prototypes. In Phase 2, the prototypes were evaluated with Indigenous fathers who were using tobacco (smoking or chewing) or were ex-users. Data were analyzed inductively. Recommendations for programming included ways to incorporate cultural values and practices to advance men's cultural knowledge and the need for a flexible program design to enhance feasibility and acceptability among diverse Indigenous groups. Men also emphasized the importance of positive message framing, building trust by providing "honest information," and including activities that enabled discussions about their aspirations as fathers as well as cultural expectations of current-day Indigenous men. That the Indigenous men's level of involvement with their children was diverse but generally less prescriptive than contemporary "involved fathering" discourse was also a key consideration in terms of program content. Strategies were afforded by these insights for meeting the men where they are in terms of their fathering-as well as their smoking and physical activity. This research provides a model for developing evidence-based, gender-specific health promotion programs with Indigenous men.

Men in high income countries have poorer dietary habits and higher rates of overweight and obesity than women. A major challenge with engaging men in health promotion is the perception that attention to one's health runs counter to masculine identities. Contemporary health promotion programs are believed to hold little "manly" appeal and often fail to engage and retain men. The HAT TRICK program was designed to engage men with their health by delivering an intervention in collaboration with a semi-professional ice hockey team. The program included 12 weekly sessions promoting healthy eating, active living, and social connectedness among men. Gender-sensitized elements were reflected in the program design, setting, content, and delivery. Semistructured telephone interviews were conducted with 23 men to explore perspectives of their participation in the gender-sensitized intervention. Participants were white (100%) with a mean age of 53 years ( SD ± 9.9), Body Mass Index (BMI) of 37 kg/m 2 ( SD ± 6.8), and waist circumference of 127 centimeters ( SD ± 14.5). Inductive thematic analysis revealed three overarching themes, including: (a) Harnessing nostalgia for past masculinities: "Closet athletes from 30 years ago," (2) Offsetting resistance to change with sensible health advice: "Don't give up drinking beer, just have less," and (3) Gendered social spaces for doing health: "A night out with the guys," The findings support the value of gender-sensitized approaches to men's health promotion. Further research is needed to identify which gender-sensitized elements are critical to engaging men in healthy lifestyle changes.

Objective: Despite the benefits associated with workplace health programs, many organizations are unable to offer them due to financial constraints. To address this barrier, the existing 10,000 Steps program trialed the 10,000 Steps Pedometer Microgrant Scheme. This study assessed the feasibility and acceptability of the Microgrant Scheme., Methods: Semi-structured interviews with employee representatives (n = 19) were used to explore perceptions of the Microgrant Scheme. Thematic inductive analysis was conducted., Results: Three main themes emerged: 1) the need for workplace initiatives to address health promotion issues (The Need); 2) the factors associated with the application and implementation process (The Process); and 3) employee and employer benefits associated with the Microgrant Scheme (The Outcomes)., Conclusion: These findings highlight the potential utility of a Microgrant Scheme to extend the reach and long-term sustainability of workplace health promotion activities.

Purpose: Due to the suboptimal uptake of cardiac rehabilitation (CR), alternative models have been proposed. This study compared the effectiveness of a traditional supervised program in a medical setting versus a hybrid CR model, where patients transition to unsupervised programming., Methods: This was a prospective, 2-arm, nonrandomized study. Health-related quality of life (HRQoL), functional capacity, physical activity, diet, smoking, blood pressure, lipids, blood glucose, anthropometrics, and depressive symptoms were assessed before and after the 8-week program models. Program adherence and completion were also recorded. Both models offered outpatient supervised exercise sessions, group health education classes, and a resource manual. The hybrid model involved a blend of supervised and unsupervised, independent home-based exercise, and followup phone calls., Results: One hundred twenty-five cardiac patients consented to the study, of whom 72 (57.6%) and 53 chose the traditional and hybrid programs, respectively. One hundred ten (traditional: n = 62, 86.1%; hybrid: n = 48, 92.3%; P > .05) participants completed their program. Significant improvements were observed for both models over time in HRQoL (P < .001), physical activity (P < .001), and diet (P < .001). Significant reductions in smoking (P = .043), systolic blood pressure (P < .001), total cholesterol (P < .001), low-density lipoprotein (P < .001), waist circumference (P < .001), and depressive symptoms (P < .001) were also observed. There were no significant differences pre- and postprograms between models for any outcome., Conclusions: Hybrid CR was not significantly different from the traditional model in terms of HRQoL, functional capacity, heart health behaviors, and risk factors, with no differences in completion rates.

Exercise prescription is suggested to help manage exercise abuse and improve overall eating disorder (ED) prognosis. This study explored emerging perceptions of ED health professionals concerning the role of exercise as a supportive treatment for EDs. Semi-structured interviews were conducted with international health professionals (n=13) with expertise in ED treatment. Verbatim transcripts were analyzed through thematic analysis. Four themes were revealed and titled 1) understanding the current state; 2) gaining perspectives; 3) barriers and benefits; 4) one size does not fit all. Within these themes, participants described the current state of exercise in ED treatment and suggested there exists a gap in research knowledge and practice. Participants also identified the implications of incorporating exercise into treatment and how an exercise protocol may be designed. Results enhance the understanding of the role of exercise in ED treatment and how it may further benefit individuals with EDs.

Objective: To explore published empirical literature in order to identify factors that facilitate or inhibit collaborative approaches for health promotion using a scoping review methodology., Data Source: A comprehensive search of MEDLINE, CINAHL, ScienceDirect, PsycINFO, and Academic Search Complete for articles published between January 2001 and October 2015 was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines., Study Inclusion and Exclusion Criteria: To be included studies had to: be an original research article, published in English, involve at least 2 organizations in a health promotion partnership, and identify factors contributing to or constraining the success of an established (or prior) partnership. Studies were excluded if they focused on primary care collaboration or organizations jointly lobbying for a cause., Data Extraction: Data extraction was completed by 2 members of the author team using a summary chart to extract information relevant to the factors that facilitated or constrained collaboration success., Data Synthesis: NVivo 10 was used to code article content into the thematic categories identified in the data extraction., Results: Twenty-five studies across 8 countries were identified. Several key factors contributed to collaborative effectiveness, including a shared vision, leadership, member characteristics, organizational commitment, available resources, clear roles/responsibilities, trust/clear communication, and engagement of the target population., Conclusion: In general, the findings were consistent with previous reviews; however, additional novel themes did emerge.

Objective: Despite the physical and psychological health benefits associated with physical activity (PA) for breast cancer (BC) survivors, up to 70% of female BC survivors are not meeting minimum recommended PA guidelines. The objective of this study was to evaluate acceptability and satisfaction with Project MOVE, an innovative approach to increase PA among BC survivors through the combination of microgrants and financial incentives., Methods: A mixed-methods design was used. Participants were BC survivors and support individuals with a mean age of 58.5 years. At 6-month follow-up, participants completed a program evaluation questionnaire (n = 72) and participated in focus groups (n = 52) to explore their experience with Project MOVE., Results: Participants reported that they were satisfied with Project MOVE (86.6%) and that the program was appropriate for BC survivors (96.3%). Four main themes emerged from focus groups: (1) acceptability and satisfaction of Project MOVE, detailing the value of the model in developing tailored group-base PA programs; (2) the importance of Project MOVE leaders, highlighting the value of a leader that was organized and a good communicator; (3) breaking down barriers with Project MOVE, describing how the program helped to address common BC related barriers; and (4) motivation to MOVE, outlining how the microgrants enabled survivors to be active, while the financial incentive motivated them to increase and maintain their PA., Conclusion: The findings provide support for the acceptability of Project MOVE as a strategy for increasing PA among BC survivors., (© 2018 The Authors. Psycho-Oncology Published by John Wiley & Sons Ltd.)

Background: Interactive web-based physical activity interventions using Web 2.0 features (e.g., social networking) have the potential to improve engagement and effectiveness compared to static Web 1.0 interventions. However, older adults may engage with Web 2.0 interventions differently than younger adults. The aims of this study were to determine whether an interaction between intervention (Web 2.0 and Web 1.0) and age group (<55y and ≥55y) exists for website usage and to determine whether an interaction between intervention (Web 2.0, Web 1.0 and logbook) and age group (<55y and ≥55y) exists for intervention effectiveness (changes in physical activity)., Methods: As part of the WALK 2.0 trial, 504 Australian adults were randomly assigned to receive either a paper logbook (n = 171), a Web 1.0 (n = 165) or a Web 2.0 (n = 168) physical activity intervention. Moderate to vigorous physical activity was measured using ActiGraph monitors at baseline 3, 12 and 18 months. Website usage statistics including time on site, number of log-ins and number of step entries were also recorded. Generalised linear and intention-to-treat linear mixed models were used to test interactions between intervention and age groups (<55y and ≥55y) for website usage and moderate to vigorous physical activity changes., Results: Time on site was higher for the Web 2.0 compared to the Web 1.0 intervention from baseline to 3 months, and this difference was significantly greater in the older group (OR = 1.47, 95%CI = 1.01-2.14, p = .047). Participants in the Web 2.0 group increased their activity more than the logbook group at 3 months, and this difference was significantly greater in the older group (moderate to vigorous physical activity adjusted mean difference = 13.74, 95%CI = 1.08-26.40 min per day, p = .03). No intervention by age interactions were observed for Web 1.0 and logbook groups., Conclusions: Results partially support the use of Web 2.0 features to improve adults over 55 s' engagement in and behaviour changes from web-based physical activity interventions., Trial Registration: ACTRN ACTRN12611000157976 , Registered 7 March 2011.

Background: The translation of Web-based physical activity intervention research into the real world is lacking and becoming increasingly important., Objective: To compare usage and effectiveness, in real-world settings, of a traditional Web 1.0 Web-based physical activity intervention, providing limited interactivity, to a Web 2.0 Web-based physical activity intervention that includes interactive features, such as social networking (ie, status updates, online "friends," and personalized profile pages), blogs, and Google Maps mash-ups., Methods: Adults spontaneously signing up for the freely available 10,000 Steps website were randomized to the 10,000 Steps website (Web 1.0) or the newly developed WALK 2.0 website (Web 2.0). Physical activity (Active Australia Survey), quality of life (RAND 36), and body mass index (BMI) were assessed at baseline, 3 months, and 12 months. Website usage was measured continuously. Analyses of covariance were used to assess change over time in continuous outcome measures. Multiple imputation was used to deal with missing data., Results: A total of 1328 participants completed baseline assessments. Only 3-month outcomes (224 completers) were analyzed due to high attrition at 12 months (77 completers). Web 2.0 group participants increased physical activity by 92.8 minutes per week more than those in the Web 1.0 group (95% CI 28.8-156.8; P=.005); their BMI values also decreased more (-1.03 kg/m2, 95% CI -1.65 to -0.41; P=.001). For quality of life, only the physical functioning domain score significantly improved more in the Web 2.0 group (3.6, 95% CI 1.7-5.5; P<.001). The time between the first and last visit to the website (3.57 vs 2.22 weeks; P<.001) and the mean number of days the website was visited (9.02 vs 5.71 days; P=.002) were significantly greater in the Web 2.0 group compared to the Web 1.0 group. The difference in time-to-nonusage attrition was not statistically significant between groups (Hazard Ratio=0.97, 95% CI 0.86-1.09; P=.59). Only 21.99% (292/1328) of participants (n=292 summed for both groups) were still using either website after 2 weeks and 6.55% (87/1328) were using either website after 10 weeks., Conclusions: The website that provided more interactive and social features was more effective in improving physical activity in real-world conditions. While the Web 2.0 website was visited significantly more, both groups nevertheless displayed high nonusage attrition and low intervention engagement. More research is needed to examine the external validity and generalizability of Web-based physical activity interventions., Trial Registration: Australian New Zealand Clinical Trials Registry: ACTRN12611000253909; https://anzctr.org.au /Trial/Registration/TrialReview.aspx?id=336588&isReview=true (Archived by WebCite at http://www.webcitation.org/6ufzw 2HxD)., (©Corneel Vandelanotte, Gregory S Kolt, Cristina M Caperchione, Trevor N Savage, Richard R Rosenkranz, Anthony J Maeder, Anetta Van Itallie, Rhys Tague, Christopher Oldmeadow, W Kerry Mummery, Mitch J Duncan. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 13.11.2017.)

The workplace health promotion program, POWERPLAY, was developed, implemented, and comprehensively evaluated among men working in four male-dominated worksites in northern British Columbia, Canada. The purpose of this study was to explore the POWERPLAY program's acceptability and gather recommendations for program refinement. The mixed-method study included end-of-program survey data collected from 103 male POWERPLAY program participants, interviews with workplace leads, and field notes recorded during program implementation. Data analyses involved descriptive statistics for quantitative data and inductive analysis of open-ended questions and qualitative data. Among participants, 70 (69%) reported being satisfied with the program, 51 (51%) perceived the program to be tailored for northern men, 56 (62%) believed the handouts provided useful information, and 75 (74%) would recommend this program to other men. The findings also highlight program implementation experiences with respect to employee engagement, feedback, and recommendations for future delivery. The POWERPLAY program provides an acceptable approach for health promotion that can serve as a model for advancing men's health in other contexts.

There is a pressing need for health promotion programs focused on increasing healthy eating and active living among "unreached" rural-based men. The purpose of the current study was to describe rural-based working men's views about health to distil acceptable workplace approaches to promoting men's healthy lifestyles. Two focus group interviews included 21 men who worked and lived in northern British Columbia, Canada. Interviews were approximately 2 hours in duration; data were analyzed using thematic analysis. Themes inductively derived included (a) food as quick filling fuels, (b) work strength and recreational exercise, and (c) (re)working masculine health norms. Participants positioned foods as quick filling fuels both at work and home as reflecting time constraints and the need to bolster energy levels. In the theme work strength and recreational exercise, men highlighted the physical labor demands pointing to the need to be resilient in overcoming the subarctic climate and/or work fatigue in order to fit in exercise. In the context of workplace health promotion programs for men, participants advised how clear messaging and linkages between health and work performance and productivity and cultivating friendly competition among male employees were central to reworking, as well as working, with established masculine health norms. Overall, the study findings indicate that the workplace can be an important means to reaching men in rural communities and promoting healthy eating and active living. That said, the development of workplace programs should be guided by strength-based masculine virtues and values that proactively embrace work and family life.

Background/aim: Web 2.0 internet technology has great potential in promoting physical activity. This trial investigated the effectiveness of a Web 2.0-based intervention on physical activity behaviour, and the impact on website usage and engagement., Methods: 504 (328 women, 126 men) insufficiently active adult participants were randomly allocated to one of two web-based interventions or a paper-based Logbook group. The Web 1.0 group participated in the existing 10 000 Steps programme, while the Web 2.0 group participated in a Web 2.0-enabled physical activity intervention including user-to-user interaction through social networking capabilities. ActiGraph GT3X activity monitors were used to assess physical activity at four points across the intervention (0, 3, 12 and 18 months), and usage and engagement were assessed continuously through website usage statistics., Results: Treatment groups differed significantly in trajectories of minutes/day of physical activity (p=0.0198), through a greater change at 3 months for Web 2.0 than Web 1.0 (7.3 min/day, 95% CI 2.4 to 12.3). In the Web 2.0 group, physical activity increased at 3 (mean change 6.8 min/day, 95% CI 3.9 to 9.6) and 12 months (3.8 min/day, 95% CI 0.5 to 7.0), but not 18 months. The Logbook group also increased physical activity at 3 (4.8 min/day, 95% CI 1.8 to 7.7) and 12 months (4.9 min/day, 95% CI 0.7 to 9.1), but not 18 months. The Web 1.0 group increased physical activity at 12 months only (4.9 min/day, 95% CI 0.5 to 9.3). The Web 2.0 group demonstrated higher levels of website engagement (p=0.3964)., Conclusions: In comparison to a Web 1.0 intervention, a more interactive Web 2.0 intervention, as well as the paper-based Logbook intervention, improved physical activity in the short term, but that effect reduced over time, despite higher levels of engagement of the Web 2.0 group., Trial Registration Number: ACTRN12611000157976., Competing Interests: Competing interests: None declared., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)

Introduction: Physical activity, healthy eating and maintaining a healthy weight are associated with reduced risk of cardiovascular disease, type 2 diabetes and cancer and with improved mental health. Despite these benefits, many men do not meet recommended physical activity guidelines and have poor eating behaviours. Many health promotion programmes hold little appeal to men and consequently fail to influence men's health practices. HAT TRICK was designed as a 12-week face-to-face, gender-sensitised intervention for overweight and inactive men focusing on physical activity, healthy eating and social connectedness and was delivered in collaboration with a major junior Canadian ice hockey team (age range 16-20 years). The programme was implemented and evaluated to assess its feasibility. This article describes the intervention design and study protocol of HAT TRICK., Methods and Analysis: HAT TRICK participants (n=60) were men age 35 years, residing in the Okanagan Region of British Columbia, who accumulate 150 min of moderate to vigorous physical activity a week, with a body mass index of >25 kg/m 2 and a pant waist size of >38'. Each 90 min weekly session included targeted health education and theory-guided behavioural change techniques, as well as a progressive (ie, an increase in duration and intensity) group physical activity component. Outcome measures were collected at baseline, 12 weeks and 9 months and included the following: objectively measured anthropometrics, blood pressure, heart rate, physical activity and sedentary behaviour, as well as self-reported physical activity, sedentary behaviour, diet, smoking, alcohol consumption, sleep habits, risk of depression, health-related quality of life and social connectedness. Programme feasibility data (eg, recruitment, satisfaction, adherence, content delivery) were assessed at 12 weeks via interviews and self-report., Ethics and Dissemination: Ethical approval was obtained from the University of British Columbia Okanagan Behavioural Research Ethics Board (reference no H1600736). Study findings will be disseminated through academic meetings, peer-reviewed publication, web-based podcasts, social media, plain language summaries and co-delivered community presentations., Trial Registration Number: ISRCTN43361357,Pre results., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

While physical and mental health benefits of regular physical activity are well known, increasing evidence suggests that limiting sedentary behaviour is also important for health. Evidence shows associations of physical activity and sedentary behaviour with health-related quality of life (HRQoL), however, these findings are based predominantly on duration measures of physical activity and sedentary behaviour (e.g., minutes/week), with less attention on frequency measures (e.g., number of bouts). We examined the association of HRQoL with physical activity and sedentary behaviour, using both continuous duration (average daily minutes) and frequency (average daily bouts≥10 min) measures. Baseline data from the WALK 2.0 trial were analysed. WALK 2.0 is a randomised controlled trial investigating the effects of Web 2.0 applications on engagement, retention, and subsequent physical activity change. Daily physical activity and sedentary behaviour (duration = average minutes, frequency = average number of bouts ≥10 minutes) were measured (ActiGraph GT3X) across one week, and HRQoL was assessed with the 'general health' subscale of the RAND 36-Item Health Survey. Structural equation modelling was used to evaluate associations. Participants (N = 504) were 50.8±13.1 (mean±SD) years old with a BMI of 29.3±6.0. The 465 participants with valid accelerometer data engaged in an average of 24.0±18.3 minutes and 0.64±0.74 bouts of moderate-vigorous physical activity per day, 535.2±83.8 minutes and 17.0±3.4 bouts of sedentary behaviour per day, and reported moderate-high general HRQoL (64.5±20.0). After adjusting for covariates, the duration measures of physical activity (path correlation = 0.294, p<0.05) and sedentary behaviour were related to general HRQoL (path coefficient = -0.217, p<0.05). The frequency measure of physical activity was also significant (path coefficient = -0.226, p<0.05) but the frequency of sedentary behaviour was not significantly associated with general HRQoL. Higher duration levels of physical activity in fewer bouts, and lower duration of sedentary behaviour are associated with better general HRQoL. Further prospective studies are required to investigate these associations in different population groups over time.

Background: Requiring individuals to obtain medical clearance to exercise prior to participation in physical activity interventions is common. The impact this has on the socio-demographic characteristic profiles of participants who end up participating in the intervention is not clear., Methods: As part of the multi-component eligibility screening for inclusion in a three-arm randomised controlled trial examining the efficacy of a web-based physical activity intervention, individuals interested in participating were required to complete the Physical Activity Readiness Questionnaire (PAR-Q). The PAR-Q identified individuals as having lower or higher risk. Higher-risk individuals were required to obtain medical exercise clearance prior to enrolment. Comparisons of the socio-demographic characteristics of the lower- and higher-risk individuals were performed using t tests and chi-square tests (p = 0.05)., Results: A total of 1244 individuals expressed interest in participating, and 432 were enrolled without needing to undergo further screening. Of the 251 individuals required to obtain medical clearance, 148 received clearance, 15 did not receive clearance and 88 did not return any form of clearance. A total of 105 individuals were enrolled after obtaining clearance, and the most frequent reason for being required to seek clearance was for using blood pressure/heart condition medication. Higher-risk individuals were significantly older, had a higher body mass index and engaged in more sedentary behaviour than lower-risk individuals., Conclusions: Use of more inclusive participant screening protocols that maintain high levels of participant safety are encouraged. Allowing individuals to obtain medical clearance to participate can result in including a more diverse population likely to benefit most from participation., Trial Registration: Australian New Zealand Clinical Trials Registry ( ACTRN12611000157976 ). Registered on 9 February 2011.

Background: The purpose of this study was to examine changes in physical activity and healthy eating knowledge and behaviors associated with the level of exposure to POWERPLAY, a men-centered workplace health promotion program., Methods: This study is based on a quasi-experimental prepost design. Using a computer assisted telephone interview survey, data regarding program exposure and physical activity and health eating knowledge and behaviors were collected from men (N = 103) in 4 workplaces., Results: Exposure scores were calculated and participants were categorized as having low (n = 54) or high exposure (n = 49) to POWERPLAY. Compared with the low exposure group, those reporting high exposure scored significantly higher on physical activity knowledge (F (1, 99) =14.17, P < .001, eta2 = .125) and health eating knowledge (F (1, 99) =14.37, P = .001, eta2 = .111). The high exposure group also reported significantly more minutes walked place to place (F (2, 206) = 3.91, P = .022, eta 2 = .037) and on minutes walked for leisure (F (2, 230) = 3.08, P = .048, eta 2 = .026)., Conclusions: POWERPLAY shows significant promise as a workplace health promotion approach and may have an even greater impact when program exposure is augmented with environmental and policy changes.

Introduction: Physical activity is a cost-effective and non-pharmaceutical strategy that can help mitigate the physical and psychological health challenges associated with breast cancer survivorship. However, up to 70% of women breast cancer survivors are not meeting minimum recommended physical activity guidelines. Project MOVE is an innovative approach to increase physical activity among breast cancer survivors through the use of Action Grants, a combination of microgrants (small amounts of money awarded to groups of individuals to support a physical activity initiative) and financial incentives. The purpose of this paper is to describe the rationale and protocol of Project MOVE., Method and Analysis: A quasi-experimental pre-post design will be used. Twelve groups of 8-12 adult women who are breast cancer survivors (N=132) were recruited for the study via face-to-face meetings with breast cancer-related stakeholders, local print and radio media, social media, and pamphlets and posters at community organisations and medical clinics. Each group submitted a microgrant application outlining their proposed physical activity initiative. Successful applicants were determined by a grant review panel and informed of a financial incentive on meeting their physical activity goals. An evaluation of feasibility will be guided by the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework and assessed through focus groups, interviews and project-related reports. Physical activity will be assessed through accelerometry and by self-report. Quality of life, motivation to exercise and social connection will also be assessed through self-report. Assessments will occur at baseline, 6 months and 1 year., Ethics and Dissemination: Ethical approval was obtained from the University of British Columbia's Behavioural Research Ethics Board (#H14-02502) and has been funded by the Canadian Cancer Society Research Institute (project number #702913). Study findings will be disseminated widely through peer-reviewed publications, academic conferences, local community-based presentations, as well as partner organisations, including the Canadian Cancer Society., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)