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BackgroundAdolescents 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. ObjectiveThis 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. MethodsUsing 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. ResultsA total of 101 participants were invited to participate in the GUM intervention. Reporting of the results is projected for the fall of 2020. ConclusionsIt 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 RegistrationClinicaltrials.gov NCT03567200; https://clinicaltrials.gov/ct2/show/NCT03567200. International Registered Report Identifier (IRRID)DERR1-10.2196/15302

BackgroundThe high number of adult males engaging in low levels of physical activity and poor dietary practices, and the health risks posed by these behaviors, necessitate broad-reaching intervention strategies. Information technology (IT)-based (Web and mobile phone) interventions can be accessed by large numbers of people, yet there are few reported IT-based interventions targeting males’ physical activity and dietary practices. ObjectiveThis study examines the effectiveness of a 9-month IT-based intervention (ManUp) to improve the physical activity, dietary behaviors, and health literacy in middle-aged males compared to a print-based intervention. MethodsParticipants, recruited offline (eg, newspaper ads), were randomized into either an IT-based or print-based intervention arm on a 2:1 basis in favor of the fully automated IT-based arm. Participants were adult males aged 35-54 years living in 2 regional cities in Queensland, Australia, who could access the Internet, owned a mobile phone, and were able to increase their activity level. The intervention, ManUp, was based on social cognitive and self-regulation theories and specifically designed to target males. Educational materials were provided and self-monitoring of physical activity and nutrition behaviors was promoted. Intervention content was the same in both intervention arms; only the delivery mode differed. Content could be accessed throughout the 9-month study period. Participants’ physical activity, dietary behaviors, and health literacy were measured using online surveys at baseline, 3 months, and 9 months. ResultsA total of 301 participants completed baseline assessments, 205 in the IT-based arm and 96 in the print-based arm. A total of 124 participants completed all 3 assessments. There were no significant between-group differences in physical activity and dietary behaviors (P≥.05). Participants reported an increased number of minutes and sessions of physical activity at 3 months (exp(β)=1.45, 95% CI 1.09-1.95; exp(β)=1.61, 95% CI 1.17-2.22) and 9 months (exp(β)=1.55, 95% CI 1.14-2.10; exp(β)=1.51, 95% CI 1.15-2.00). Overall dietary behaviors improved at 3 months (exp(β)=1.07, 95% CI 1.03-1.11) and 9 months (exp(β)=1.10, 95% CI 1.05-1.13). The proportion of participants in both groups eating higher-fiber bread and low-fat milk increased at 3 months (exp(β)=2.25, 95% CI 1.29-3.92; exp(β)=1.65, 95% CI 1.07-2.55). Participants in the IT-based arm were less likely to report that 30 minutes of physical activity per day improves health (exp(β)=0.48, 95% CI 0.26-0.90) and more likely to report that vigorous intensity physical activity 3 times per week is essential (exp(β)=1.70, 95% CI 1.02-2.82). The average number of log-ins to the IT platform at 3 and 9 months was 6.99 (SE 0.86) and 9.22 (SE 1.47), respectively. The average number of self-monitoring entries at 3 and 9 months was 16.69 (SE 2.38) and 22.51 (SE 3.79), respectively. ConclusionsThe ManUp intervention was effective in improving physical activity and dietary behaviors in middle-aged males with no significant differences between IT- and print-based delivery modes. Trial RegistrationAustralian New Zealand Clinical Trials Registry: ACTRN12611000081910; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000081910 (Archived by WebCite at http://www.webcitation.org/6QHIWad63).

BackgroundEffectiveness of and engagement with website-delivered physical activity interventions is moderate at best. Increased exposure to Internet interventions is reported to increase their effectiveness; however, there is a lack of knowledge about which specific intervention elements are able to maintain website engagement. ObjectiveTo prospectively study the associations of website engagement and exposure to intervention components for a publicly available physical activity website (10,000 Steps Australia). MethodsBetween June and July 2006 a total of 348 members of 10,000 Steps completed a Web-based survey to collect demographic characteristics. Website engagement was subsequently assessed over a 2-year period and included engagement data on website components; individual challenges, team challenges, and virtual walking buddies; and indicators of website engagement (average steps logged, days logging steps, and active users). ResultsOn average participants logged steps on 169 (SD 228.25) days. Over a 2-year period this equated to an average of 1.6 logons per week. Binary logistic regression showed that individuals who participated in individual challenges were more likely to achieve an average of 10,000 steps per day (odds ratio [OR] = 2.80, 95% confidence interval [CI] 1.45–5.40), log steps on a higher than average number of days (OR = 6.81, 95% CI 2.87–13.31), and remain an active user (OR = 4.36, 95% CI 2.17–8.71). Additionally, those using virtual walking buddies (OR = 5.83, 95% CI 1.27–26.80) and of older age logged steps on a higher than average number of days. No significant associations were found for team challenges. ConclusionsOverall engagement with the 10,000 Steps website was high, and the results demonstrate the relative effectiveness of interactive components to enhance website engagement. However, only exposure to the interactive individual challenge feature was positively associated with all website engagement indicators. More research is needed to examine the influence of intervention components on website engagement, as well as the relationship between website engagement and physical activity change.

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[superscript -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-judgmental 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.

This cross-sectional study of 504 community-dwelling Australian adults (328 females, 176 males, mean age 50.8 ± 13.0 years) sought to examine the reliability and validity of measurement scales for physical activity (PA) self-efficacy and outcome expectations. Participants completed demographic and anthropometric measurements, and a 23-item psychosocial questionnaire pertinent to an intervention target of 10,000 steps per day. Exploratory (n = 252) and confirmatory (n = 252) factor analyses were conducted to determine psychometric properties of the measures. Based on theory and goodness-of-fit indices, six factors were extracted from the questionnaire: PA self-efficacy; PA barriers self-efficacy (including general, personal, and conflict); and physical and mental outcome expectations. From confirmatory factor analysis, the model demonstrated good data fit in four out of five indices: CFI = 0.99; TLI = 0.99; SRMR = 0.03; RMSEA = 0.03, 90%CI = 0.01-0.05, ?[superscript 2] = 113.14 (88), p = 0.04; including good fit by sex, age, weight status, education, and birth country. PA interventions can employ our psychometrically sound social cognitive measures.

Objectives: The value of workplace wellness programmes (WWPs) has been established in the literature. Such programmes, however, have an increased likelihood for success when both management and non-management employees' perspectives and needs are incorporated into development and implementation. This study aimed to identify the perspectives of each of these two employee groups as a means of informing the future development and implementation of WWPs. Methods: Nine focus groups (N = 56) were held in western Canada with participants employed at four diverse organisations consisting of >100 employees. Each participating organisation provided two separate groups, consisting of one management group and one non-management group. Participants were asked to share their perceptions, attitudes and beliefs concerning WWPs. Thematic inductive analysis was conducted to elicit emergent areas of focus. Results: Three areas of focus were identified: (1) role of the company in WWPs, (2) elements of successful WWPs and (3) mandatory participation in WWPs. Providing a clear indication of the roles and responsibilities of both employee groups, making these initiatives part of the organisational strategic plan, demonstrating a long term commitment to such programmes, and having employees play participatory roles in the design, implementation and decision making process, are components that need consideration. Conclusion: Both employee groups agreed that their organisation played a role in employee health. Similarities and discrepancies of the beliefs between groups are highlighted and key considerations are presented. Findings have implications for the future development and implementation of WWPs.

Objectives: To assess the effects of a 12-week pedometer-based intervention on the physical activity behavior, health-related quality of life (HRQOL), and psychological well-being of first-year university students. Participants: First-year university students (N = 184) were recruited during September 2012 and randomly assigned to an intervention or a control group. Methods: Intervention participants were provided with a pedometer, monthly tracking logs, and follow-up e-mails. Control participants received no intervention. Physical activity, HRQOL, and psychological well-being were measured at baseline and post intervention. Data were analyzed using multivariate/univariate analysis of variance (MANOVA/ANOVA). Results: All participants experienced an increase in mild physical activity (p < 0.01) from baseline to follow-up. The intervention failed to produce significant differences between groups for physical activity (p = 0.28), HRQOL (p = 0.80), or psychological well-being (p = 0.72). Psychological well-being (p < 0.001), vigorous physical activity (p = 0.04), and mental health status (p < 0.001) decreased across the duration of the study. Conclusions: More intensive interventions may be required to elicit physical activity behavior change.

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. [ABSTRACT FROM AUTHOR]

Physical activity and sport programs have been promoted as a strength-based way to enhance social and emotional wellbeing in young Aboriginal and Torres Strait Islanders. However, there is limited evidence that describes how these programs may be tailored for girls. Semi‐structured interviews with health promotion stakeholders (N = 11) explored organizational perceptions of the needs and preferences of young Aboriginal and Torres Strait Islander girls in relation to physical activity and social and emotional wellbeing. Interviews also investigated best practice approaches for implementing holistic health programs for the population. Thematic analysis revealed two overarching themes: (1) Perceived physical activity and health service needs, preferences and behaviours and (2) Best practice engagement strategies and associated challenges. A need for culturally safe, youth-friendly services was emphasized, where physical activity and sport may play an influential role. Program development recommendations included focussing upon health literacy, utilizing co-design and creating culturally secure, fun environments. [ABSTRACT FROM AUTHOR]

Purpose: To explore and describe the extent and quality of Mental Health Literacy (MHL) resources, information and education currently available within the Australian Football League (AFL) Next Generation Academy (NGA) programs and identify limitations/gaps in existing MHL practices within these programs. Methods: An exploratory mix ed -method descriptive design was utilised in two phases. Phase One consisted of a researcher led MHL audit of publicly available data associated with each NGA program. Phase Two included a web-based open-ended questionnaire distributed to key NGA personnel and focused on mental health practices within the programs. Descriptive statistics were used to present Phase One data and thematic analysis was utilised in Phase Two. Results: In Phase One, the total mean standardised score for resources on mental health, raising awareness on mental health and culture of support within the clubs were 47% (SD = 16, range 18–89), 51% (SD = 23, range 0–77) and 61% (SD = 27, range of 9–97). In Phase Two, eight participants responded to the questionnaire (44% response rate). Three themes emerged from the thematic analysis: 1) current initiatives and resources within the club; 2) training, education and support for staff; 3) the gender divide. Conclusion: Mainstream mental health resources do exist within the AFL and there is some support within the professional league. However, these are not effectively tailored for youth elite athletes, nor have they been implemented into NGA programs despite the willingness of staff in supporting the mental health of these athletes. [ABSTRACT FROM AUTHOR]

Objective: The RE-AIM framework has been recognized as a tool to evaluate the adoption, delivery, and sustainability of an intervention, and estimate its potential public health impact. In this study four dimensions of the RE-AIM framework (adoption, implementation, effectiveness, and maintenance) were used to evaluate the WellingTONNE Challenge Toolkit, a step-by-step resource explaining how to develop, implement and disseminate a healthy lifestyle community intervention. Design: Process evaluation. Methods: In association with the Commonwealth Department of Health and Ageing (DHA), a self-report questionnaire was distributed to individuals from health care organizations, local councils and community organizations throughout Australia who had received and/or requested the WellingTONNE Challenge Toolkit from the DHA. Results: The RE-AIM dimensions revealed a high adoption rate and confirmed that the toolkit was being implemented for what it was intended to be implemented for and was an effective resource for initiating, maintaining and encouraging a healthy lifestyle. Lastly, the evaluation highlighted that most participants would maintain use of the toolkit in future projects. Conclusion: The RE-AIM framework provided valuable information concerning the uptake, implementation and usability of the WellingTONNE Challenge Toolkit, however, future research should address the behavioural outcomes associated with using the toolkit in order to provide a clearer understanding of how research can be translated into public health practice. (Contains 2 tables.)