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Aims: The aim of this work was to measure the impact of P2P (i.e. peer‐to‐peer), a peer‐led smoking prevention intervention, on daily smoking prevalence of adolescents over 2 school years. Design: A cluster‐randomized controlled trial was performed over a 16‐month follow‐up (trial status: closed to follow‐up). P2P was implemented 1–3 and 13–15 months after baseline. Assessments took place at baseline and 4, 10 and 16 months after baseline. The research team, assessors and adolescents were blinded to the study‐arm assignment only at baseline. Setting: Fifteen vocational high schools in France were randomized into two clusters, using a 1:1 allocation ratio per French department (n intervention = 7, n control = 8). Participants: Participants comprised a sample of 2010 students in year 11 (i.e. 15–16 years) in vocational high schools. A total of 437 students could not be assessed at baseline (absent or left school), yielding a total sample of 1573 students (n intervention = 749, n control = 824). Intervention and comparator: The P2P programme trained voluntary students to become peer educators and design smoking prevention actions for their schoolmates in the intervention group (n = 945 students), compared with a passive control group (n = 1065 students). Measurements The primary outcome was change from baseline in the prevalence of self‐reported daily smoking (i.e. at least one cigarette per day) at 16 months. Findings The 'time × group' interaction indicated that, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 16 months [odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.20, 0.53]. Similarly, compared with the control group, the intervention group had statistically significantly fewer daily smokers after 4 months (OR = 0.50, 95% CI = 0.30, 0.82) and 10 months (OR = 0.60, 95% CI = 0.37, 0.98). No adverse events of P2P2 were reported. Conclusions: A cluster‐randomized trial found evidence that the peer‐led P2P (peer‐to‐peer) smoking prevention intervention reduced the uptake of daily smoking among high school students in France over 16 months. [ABSTRACT FROM AUTHOR]

Purpose: The theory of planned behavior (TPB) has been criticized for not including interactions between the variables assumed to predict behavior. This study sought to test how TPB variables interact to predict physical activity (PA) in children. Method: Four hundred thirty-eight children (M[subscript age] = 8.6 years, SD = 1.6 years) completed a TPB questionnaire and a PA questionnaire at Time 1. The PA measure was repeated 2 months later. Path analyses were performed to test the hypothesized model including interaction terms between TPB variables. Simple slopes analyses were also carried out to examine the statistically significant interaction terms. Results: Path analyses confirmed the classical hypotheses of TPB (R[superscript 2] for intentions = 0.39, R[superscript 2] for PA = 0.12) and also demonstrated only statistically significant Attitudes × Perceived Behavioral Control and Subjective Norms × Attitudes interactions (R[superscript 2] change for intentions = 0.01, p = 0.009). Simple slopes analyses revealed that the strength of the association between perceived behavioral control and intentions was only statistically significantly higher (t = 2.18, p = 0.05, d = 0.34, 95% CI [0.03, 0.65]) when attitudes were high compared with when attitudes were low. The link between attitudes and intentions was only statistically significant at a low level of subjective norms but not at a high level. Conclusion: The integration of interaction effects between TPB variables did not increase for the variance of PA explained by the model. More research appears to be necessary to explore how the TPB could be augmented to better predict PA in children.

A meta-analysis of randomized controlled trials (RCTs) has recently showed that theory-based interventions designed to promote physical activity (PA) significantly increased PA behavior. The objective of the present study was to investigate the moderators of the efficacy of these theory-based interventions. Seventy-seven RCTs evaluating theory-based interventions were systematically identified. Sample, intervention, methodology, and theory implementation characteristics were extracted, coded by three duos of independent investigators, and tested as moderators of interventions effect in a multiple-meta-regression model. Three moderators were negatively associated with the efficacy of theory-based interventions on PA behavior: intervention length (=14 weeks; ß = -0.22, p = 0.004), number of experimental patients (ß = -0.10, p = 0.002), and global methodological quality score (ß = -0.08, p = 0.04). Our findings suggest that the efficacy of theory-based interventions to promote PA could be overestimated consequently due to methodological weaknesses of RCTs and that interventions shorter than 14 weeks could maximize the increase of PA behavior.

Most previous research based on the Theory of Planned Behaviour (TPB) to explain children's physical activity (PA) remains cross-sectional and the moderating role of demographic variables on the link between TPB variables is rarely explored. This study aims to (1) test a longitudinal cross-lagged panel model based on the TPB to explain PA in children, and (2) examine in what extent this model operates equivalently across age and gender. Children (N = 363, M = 8.6 years) completed measures of TPB constructs and PA at two measurement times (T1 and T2) within three months. Self-reported PA. Path analyses revealed that the model tested accounted for 25% of the variance in PA at T2. Subgroups analyses revealed that age significantly moderated the links between subjective norms at T1 and T2, between PA at T1 and T2, and between PA at T1 and subjective norms at T2. Gender significantly moderated the links between intentions at T1 and T2, and between PA at T1 and perceived behavioural control at T2. The temporal stability of the variables of the TPB and the link between initial PA and subsequent TPB variables may vary by children's gender and age. [ABSTRACT FROM AUTHOR]

Explore the perceptions and beliefs related to pressure ulcers (PU), their prevention and treatment strategies, in order to discuss potential learning objectives for PU-related therapeutic education in persons with spinal cord injury (SCI). Qualitative study, using grounded theory for the analysis of data collected via a questionnaire. Nine SCI referral centers, inpatient care. 131 persons with SCI were included. 76% were male, and 65% presented with paraplegia. The median age was 48 years (33.5; 58) and median time since injury was 11 years (3; 24.5). 70% had experience with PU. None. Data collection via an open-ended questionnaire on the representation of PU, its prevention and life experience of having a PU. Six categories were identified: (1) identifying what might become problematic, (2) daily preventive actions, (3) detecting the early signs, (4) managing the early signs, (5) need for care, (6) experience with PU and being bedridden. Pressure ulcers have dramatic consequences on psychosocial health. Prevention and treatment require self-management skills, such as self-risk assessment abilities, self-detection skills and problem-solving strategies, to optimise daily PU prevention in persons with SCI. PU prevention tackled by persons with SCI bears some specificities that the physician must take into account in the construction of a self-management program in this high-risk population. • Persons with SCI develop their own perception of PU risk and their own strategy to self-manage the early signs of PU. • In self-management programs, it is important to focus on how a person with SCI perceives his own likelihood to develop a PU. • Patients should be accompanied to create a personalized strategy to self-screen for beginning PUs. • Self-management interventions should promote problem-solving strategies to face with early stages of PU. [ABSTRACT FROM AUTHOR]

This article presents the validation of the 'Echelle de Motivation envers l'Activité Physique en contexte de Santé' including the six forms of motivation underlined by self-determination theory. Study 1 underlines the content validity of a pool of 30 items (N = 20). Study 2 supports the six-factor structure validity of the 18-item Echelle de Motivation envers l'Activité Physique en contexte de Santé (N = 309). Study 3 (N = 191) confirms structure validity, as well as concurrent validity and 2-week temporal reliability. The Echelle de Motivation envers l'Activité Physique en contexte de Santé can be considered as a valid and reliable tool to use in prevention or rehabilitation contexts. [ABSTRACT FROM AUTHOR]

Purpose: The theory of planned behavior (TPB) has been criticized for not including interactions between the variables assumed to predict behavior. This study sought to test how TPB variables interact to predict physical activity (PA) in children.Method: Four hundred thirty-eight children (Mage = 8.6 years, SD = 1.6 years) completed a TPB questionnaire and a PA questionnaire at Time 1. The PA measure was repeated 2 months later. Path analyses were performed to test the hypothesized model including interaction terms between TPB variables. Simple slopes analyses were also carried out to examine the statistically significant interaction terms.Results: Path analyses confirmed the classical hypotheses of TPB (R2 for intentions = .39, R2 for PA = .12) and also demonstrated only statistically significant Attitudes × Perceived Behavioral Control and Subjective Norms × Attitudes interactions (R2 change for intentions = .01, p = .009). Simple slopes analyses revealed that the strength of the association between perceived behavioral control and intentions was only statistically significantly higher (t = 2.18, p = .05, d = 0.34, 95% CI  [0.03, 0.65]) when attitudes were high compared with when attitudes were low. The link between attitudes and intentions was only statistically significant at a low level of subjective norms but not at a high level.Conclusion: The integration of interaction effects between TPB variables did not increase for the variance of PA explained by the model. More research appears to be necessary to explore how the TPB could be augmented to better predict PA in children. [ABSTRACT FROM AUTHOR]

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Objective: The present meta-analysis aimed to determine the overall effect of cognitive behavior therapy combined with physical exercise (CBTEx) interventions on depression, anxiety, fatigue, and pain in adults with chronic illness; to identify the potential moderators of efficacy; and to compare the efficacy of CBTEx versus each condition alone (CBT and physical exercise). Method: Relevant randomized clinical trials, published before July 2017, were identified through database searches in PubMed, PsycARTICLES, CINAHL, SportDiscus, and the Cochrane Central Register for Controlled Trials. Results: A total of 30 studies were identified. CBTEx interventions yielded small to large effect sizes for depression (standardized mean change [SMC] = -0.34, 95% CI [-0.53, -0.14]), anxiety (SMC = -0.18, 95% CI [-0.34, -0.03]), and fatigue (SMC = -0.96, 95% CI [-1.43, -0.49]). Moderation analyses revealed that longer intervention was associated with greater effect sizes for depression and anxiety outcomes. Low methodological quality was also associated with increased CBTEx efficacy for depression. When compared directly, CBTEx interventions did not show greater efficacy than CBT alone or physical exercise alone for any of the outcomes. Conclusion: The current literature suggests that CBTEx interventions are effective for decreasing depression, anxiety, and fatigue symptoms but not pain. However, the findings do not support an additive effect of CBT and exercise on any of the 4 outcomes compared to each condition alone. [ABSTRACT FROM AUTHOR]

This pilot study pursued three objectives: to assess the effect of a 1-month multilevel intervention on the PA of children, to assess the impact of the intervention on the theory of planned behavior (TPB) variables, and to evaluate the extent to which the impact of the intervention on PA and TPB variables varied according to personal (i.e., gender and age) and situational (i.e., class and school) moderating variables. Children were aged 7 to 11 years (n = 306). Analyses revealed a significant increase of PA practice and TPB variables (ps < .001). Age (i.e., being a younger child) was associated with a higher increase on attitude and perceived control (ps < .01). The class or the school levels explained a meaningful variance in the evolution of PA or TPB variables (intraclass correlation coefficients > .10). The present study reports the interest and feasibility of a multilevel intervention to increase PA and TPB variables in children. [ABSTRACT FROM AUTHOR]

Drawing on Self-Determination Theory, this study explored the motivational profiles toward Physical Activity (PA) among adults with type 2 diabetes and the relationships between motivational profile, perceived competence and PA. Participants were 350 men and women (Mean age 62.77 years) who were interviewed on their motivations toward PA, perceived level of competence to practice, and PA practice. Cluster analyses reveal the existence of three distinct profiles: "High Combined" (ie, high scores on motivations ranging from intrinsic to external regulation, moderate level on amotivation), "Self-Determined" (ie, high scores on intrinsic, integrated, and identified regulations; low scores on other regulations), and "Moderate" (ie, moderate scores on all regulations). Participants with "High Combined" and "Self-Determined" profiles reported higher perceived competence and longer leisure-time PA practice in comparison to those with a "Moderate" profile. This study highlights the necessity of adopting a person-centered approach to better understand motivation toward PA among type 2 diabetics. [ABSTRACT FROM AUTHOR]

Using self-determination theory (SDT) as an explanatory framework, this randomised-controlled study evaluates the effect of a motivational interviewing (MI)-based intervention as an addition to a standard weight loss programme (SWLP) on physical activity (PA) practice in obese adolescents over a six-month period. Fifty-four obese adolescents (mean age = 13 years, mean BMI = 29.57 kg/m²) were randomly assigned to an SWLP group (n = 28) or SWLP + MI group (n = 26). Both groups received two SWLP sessions, supplemented for the SWLP + MI group, by six MI sessions. Perceived autonomy support, perceived competence, motivational regulations, PA and BMI were assessed at baseline, three and six months (i.e. the end of the programme). MLM analyses revealed that compared to SWLP, the SWLP + MI group had a greater BMI decrease and a greater PA practice increase over time. Moreover, the SWLP + MI group reported greater autonomy support from medical staff at the end of the programme, greater increase in integrated and identified regulations and a stronger decrease in amotivation. MI appears as an efficient counselling method as an addition to an SWLP to promote PA in the context of pediatric obesity. [ABSTRACT FROM PUBLISHER]

Objective: The “Great Live and Move Challenge” (GLMC) is an intervention designed to promote physical activity (PA) in schools and the community among 6- to 11-year-old schoolchildren and their families.Method: This project, implemented in the Montpellier and Pays Coeur d’Hérault regions since 2013, encourages children to quantify their daily PA level by illustrating each 15 minutes of exercise by an “energy cube”. Based on collaboration between pilots, teachers and policymakers, this project is implemented over a 6-week period in schools, municipalities and recreation centres. “Great Challenge” events are organized to promote PA. The GLMC is also a theory-based intervention based on the tenets of the planned behaviour theory.Results: Since the 2014-2015 edition, 2,243 children have taken part in the GLMC and have accumulated 391,102 “energy cubes”. In addition, more than 30 “Great Challenge” events have been organized. Since its launch during the 2012-2013 school year, the numbers of children who have taken part in the GLMC have been multiplied by 5.58. The mean number of daily “energy cubes” accumulated by children has increased from 4.04 in the first year to 6.22 in 2014-2015.Conclusion: The “energy cube” can provide a measure of the commitment of children and their surrounding community in a comprehensive approach to PA promotion.