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Introduction: Latinas face an increased risk for chronic diseases associated with insufficient physical activity (PA). The researchers previously showed that a website-based intervention could increase PA among insufficiently active Latinas, yet rates of meeting national PA guidelines were low. The original intervention was enhanced by adding additional features, content, and points of contact, including via text messaging. This study tests the efficacy of the enhanced intervention compared with the original, aimed at maximizing and sustaining PA gains across 24 months. It also examines if increases in PA differed by baseline PA., Study Design: The researchers conducted a superiority randomized controlled trial (data collected 2018-2022, analyzed 2023)., Setting/participants: Participants were 195 Spanish-speaking Latinas ages 18-65 in the Providence, RI area., Intervention: The original intervention is an empirically supported Spanish-language, individually-tailored, website-delivered PA intervention. The enhanced intervention includes text messaging and additional data-driven content and interactive features., Main Outcome Measures: Total weekly minutes of moderate to vigorous PA (MVPA) was measured via accelerometry and self-report at 6, 12, 18, and 24 months., Results: Participants in both groups increased their MVPA over 24 months. There were no significant between-group differences at 6 or 12 months; at 18 months the enhanced intervention group had higher levels of self-reported (mean (sd): 90.35 (43.55) vs 70.18 [9.99]) and accelerometer-measured (66.21 [18.26] vs 60.27 [16.00]) MVPA compared to the original intervention group. They also had higher levels of self-reported (111.17 [23.35] vs 81.44 [1.82]) and accelerometer-measured (63.76 [15.12] vs 54.86 [14.59]) MVPA at 24 months. Baseline PA moderated the intervention effect., Conclusions: This study demonstrates the potential to enhance the efficacy of website-based PA interventions by utilizing text messaging, and adding more interactive features, content, and phone support. These enhancements may be particularly beneficial in supporting long-term PA maintenance., Trial Registration: This study is registered at www., Clinicaltrial: gov (NCT03491592)., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: This research aimed at understanding how changes in one behavior affect other behaviors, known as "transfer effect," could extend knowledge of shared constructs among compound health risk behaviors, and improve methods for promoting simultaneous behavior changes. The current study explored whether participants who completed a randomized controlled trial for physical activity (PA) improved their diet with no intervention in diet or nutrition., Methods: US adults (N = 283) were randomly assigned to 12 weeks of either exercise videogames, standard exercise, or an attention control. Secondary analyses were conducted to examine a possible transfer effect of the intervention on diet at end of intervention (EOT) and 6-month follow-up. Assessments of potential PA constructs (i.e., exercise enjoyment, self-efficacy) and demographics (e.g., age, gender) were conducted. PA, specifically moderate-to-vigorous levels of physical activity (MVPA), was measured using a self-report measure. Diet was measured using the Rate Your Plate dietary assessment., Results: Findings support that a randomization effect was associated with a higher likelihood of increasing MVPA (β = 30.00, 95% CI = 4.46, 64.46) and dietary improvement at EOT (β = 1.48, SE = .83, P = .01) and follow-up (β = 1.74, SE = .52, P = .02). At EOT, changes in diet were associated with higher PA enjoyment (β = 0.41, SE = 0.15, P = .01). This intervention effect on diet was moderated by gender, with women showing more dietary improvement than men (β =  - .78, SE = 13, P = .03). At 6 months, dietary improvement was associated with greater self-efficacy (β = .04, SE = .01, P = .01)., Conclusion: This study shows evidence of a transfer effect among two synergistic behaviors and expands understanding of factors that predict the occurrence of this type of behavior change., (© 2023. International Society of Behavioral Medicine.)

Objectives: Research on the association between hair concerns and physical activity (PA) constructs among African American (AA) women is lacking. Demographics such as age and income are indicated to influence hair concerns. In this study, quantitative methods were used to assess demographic differences in hair concerns and associations between hair concerns and PA. Qualitative interviewing explored AA women's views about their hair and engagement in PA., Methods: Participants (n = 48; M age = 37.57, SD = 13.72) completed a survey that included demographics, hair type and hairstyle management (HTHM), decisional balance (pros, cons), perceived benefits and perceived barriers scale, and level of physical activity. HTHM consists of six items measuring different factors related to hair concerns. 25 completed a qualitative interview. Chi-square or analysis of variance tests were conducted as appropriate. Qualitative data were analyzed using content analysis., Results: Proportion differences were noted between age groups (≤ 32 vs. ≥ 33) and average cost of haircare per month (p = .048). A statistically significant effect was noted for average monthly haircare cost and pros (p = .05), and for alter behavior due to hair concerns and perceived benefits to physical activity (p = .05). For level of physical activity, proportion differences were noted between exercisers and non-exercisers for average minutes spent on hair care (p = .009). Qualitative results showed few participants view hair concern as an important barrier to PA. Some participants suggested strategies for overcoming hair concerns to exercise (e.g., braids, twists)., Conclusion: Implications of findings including development of PA intervention approaches that may appeal to AA women are discussed., (© 2023. W. Montague Cobb-NMA Health Institute.)

Introduction: Latina women report disproportionately high rates of physical inactivity and related chronic health conditions. Physical activity (PA) efforts to date have shown modest success in this at-risk population; thus, more effective interventions are necessary to help Latinas reach national PA guidelines and reduce related health disparities. This paper describes the design, rationale, and baseline findings from the Seamos Activas II intervention., Methods/design: The ongoing RCT will test the efficacy of the Seamos Saludables PA print intervention vs. a theory-and technology-enhanced version (Seamos Activas II). The purpose of the study is to increase the percentage of Latinas meeting the national PA guidelines compared to the prior trial, improve biomarkers related to disease, and extend generalizability to a broader and more representative population of Latinas (i.e. Mexican/Mexican-Americans). Intervention refinements included further targeting key constructs of Social Cognitive Theory, and incorporating interactive text message-based self-monitoring strategies. The primary outcome is change in minutes per week of MVPA measured by ActiGraph GT3X+ accelerometers at 6- and 12-months. Secondary PA outcomes assessed by the 7-Day PA Recall will be used to corroborate findings., Results: Participants (N = 199) are Latinas 18-65 years (mean = 43.8) of predominantly Mexican origin (89%). At baseline, objectively measured MVPA was 39.51 min/week (SD = 71.20, median = 10) and self-reported MVPA was 12.47 min/week (SD = 22.54, median = 0).Participants reported generally low self-efficacy and higher cognitive vs. behavioral processes of change., Conclusion: Addressing interactivity and accountability through text messaging, and more rigorously targeting theoretical constructs may be key to helping Latinas achieve nationally recommended PA levels and thereby reducing health disparities., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Objective: Exercise video games (EVGs) may offer an attractive, sustainable alternative or supplement to traditional modes of exercise. Understanding the psychosocial factors that influence the appeal of EVGs is important for improving the efficacy of video games as a method of promoting the uptake and long-term maintenance of physical activity., Methods: This study examined changes in psychosocial constructs from self-determination theory and self-efficacy theory as mediators of intervention efficacy among 189 healthy, sedentary adults randomized to 12-week programs of either EVGs or standard exercise (e.g., treadmill walking, stationary cycling) followed by 6 months of follow-up. The EVG group engaged in significantly more weekly minutes of moderate to vigorous physical activity (MVPA) at the end of treatment compared with the standard exercise group. Univariate and multivariate mediational models were used to examine theoretically derived psychosocial constructs as potential mediators of differential intervention effects., Results: Univariate mediational models suggest a significant indirect effect of treatment on MVPA outcomes through enjoyment, self-efficacy, stress management, depressive symptoms, and positive engagement ( p < .05). Multiple mediational analyses confirm all the univariate results ( p < .05), with the exception of enjoyment., Conclusions: Differences in the efficacy of EVG versus standard exercise interventions were mediated by several psychosocial constructs, suggesting that qualities specific to game play may enhance adherence to physical activity both in and outside of the laboratory environment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Introduction: Adults who engage in regular physical activity have lower rates of morbidity and mortality than those who do not. Exercise videogames may offer an attractive, sustainable alternative or supplement to traditional modes of exercise. This study compared exercise videogames with standard exercise modalities for improving uptake and maintenance of moderate to vigorous physical activity, and health risk indices., Study Design: A three-arm clinical RCT including 12 weeks of supervised laboratory-based moderate to vigorous physical activity followed by 6 months follow-up., Setting/participants: This study was conducted at a university affiliated hospital research lab. Healthy, sedentary adults were eligible., Interventions: This study compared a 12-week program of supervised exercise videogames versus standard exercise (e.g., treadmill) versus control. Data were collected from January 2012 to September 2017 and analyzed in 2018., Main Outcome Measures: The primary outcome was weekly minutes of moderate to vigorous physical activity at end of treatment, assessed at 3 and 6 months post-intervention by using self-report and accelerometer data. Health risk indices (e.g., HbA1c, lipids) were also assessed., Results: Participants (N=283) had an average age of 46.2 ±13.5 years; 79% were female. At end of treatment, those in the exercise videogame arm engaged in 30 minutes/week more moderate to vigorous physical activity compared with standard exercise and 85 more minutes/week than controls (all p<0.05). Exercise videogame participants had greater reductions in cholesterol, HbA1c, and body fat versus other groups. Reductions in cholesterol were twice as large in exercise videogame versus standard participants., Conclusions: Exercise videogames produced greater uptake and maintenance of moderate to vigorous physical activity compared with standard exercise and improvements in multiple health risk indices. Exercise videogames may promote sustainable physical activity with significant health benefits., Trial Registration: This study is registered at www.clinicaltrials.gov NCT03298919., (Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Many national (US) and International guidelines for physical activity provide guidance that under-active and sedentary adults can begin by accumulating moderate-to-vigorous physical activity (MVPA) in bouts as brief as 10 minutes. This guidance fits well with Goal Setting theory in that goals should be realistic and achievable, and is also consistent with Social Cognitive theory since achieving small goals should boost self-efficacy and thus, encourage continued physical activity. In contrast, Behavioral Economics might suggest that fewer, longer bouts would be more conducive to the adoption of physical activity due to the costs incurred with each separate bout of MVPA. This paper examines patterns of MVPA adoption among a sample of under-active adults from the perspective of goal setting theory and behavioral economics to explore specific strategies to help people who are in the early stages of PA activity adoption. Under-active men and women (N = 225; mean age = 46 ± 10; mean BMI = 28 ± 4.48) who enrolled in a PA intervention participated in a single goal setting session at enrollment. Participants were encouraged to set realistic goals and to increase their activity to meet national recommendations (150 minutes/week of moderate to vigorous physical activity [MVPA]) by the 6-month follow up. This process included identifying a specific frequency goal (days/week) and session duration goal (minutes/day). At baseline, participants reported average weekly MVPA of 14.59 min (± 24), which increased to an average of 140.52 (± 143.55) at 6 months. MVPA goals at baseline averaged 33.24 min/day (± 18.08) and 3.85 days/week (± 1.31). Analyses showed that longer session duration goals set at baseline were associated with more weekly minutes of MVPA at 6 months (b = 1.26, SE = 0.58, t = 2.17, p = 0.03). There was no significant association between goals for number of days per week (frequency) or total minutes of weekly MVPA (minutes x frequency) and MVPA at 6 months. Widely promoted guidelines for uptake of physical activity recommend accumulating physical activity in bouts as short as 10 minutes. This recommendation may ultimately hinder the adoption of physical activity among under-active and sedentary individuals. For the purposes of behavioral adoption of MVPA, more ambitious session duration goals appear to result in higher levels of physical activity participation., Competing Interests: The authors have declared that no competing interests exist.

Background: Relational agents (RAs) are electronic computational figures designed to engage participants in the change process. A recent study, Project RAISE, tested the effectiveness of RAs, combined with existing computer-based interventions to increase regular exercise and sun protection behaviors. Results showed these interventions can be effective but need further development., Objective: The purpose of this study was to examine participants' experiences using RAs to increase participant engagement and promote behavior change ., Methods: A qualitative approach was primarily utilized. A 25-question interview guide assessed different components of participants' experiences with the intervention, including motivation, engagement, satisfaction or dissatisfaction, quality of their interaction with the RA, and behavior change. Quantitative assessment of satisfaction was based on a scale of 1 to 10, with 1 representing least satisfied and 10 representing most satisfied. A summative analytic approach was used to assess individuals' qualitative responses. A single analysis of variance (ANOVA) examined levels of satisfaction by gender., Results: Of the original 1354 participants enrolled in Project RAISE, 490 of 1354 (36%) were assigned to the RA group. A sample of 216 out of 490 (44%) participants assigned to the RA group completed the interventions, and follow-up assessments were contacted to participate in the semistructured interview. A total of 34 out of 216 (16%) completed the interview. Participants were motivated by, and satisfied with, the intervention. Participants viewed the RA as supportive, informative, caring, and reported positive behavior change in both exercise and sun protection. Some participants (15/34, 44%) noted the RA was less judgmental and less "overbearing" compared with a human counselor; other participants (12/34, 35%) said that the interaction was sometimes repetitive or overly general. The majority of participants (22/34, 65%) viewed the RA as an important contributor to their behavior change for exercise, sun protection, or both. Levels of satisfaction ranged between 7 and 10. There were no gender differences noted in levels of satisfaction (P=.51)., Conclusions: RAs provide an innovative and attractive platform to increase exercise and sun protection behaviors and potentially other health behaviors., (©Marie A Sillice, Patricia J Morokoff, Ginette Ferszt, Timothy Bickmore, Beth C Bock, Ryan Lantini, Wayne F Velicer. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 07.02.2018.)

Spanish-speaking Latinas have some of the lowest rates of meeting physical activity guidelines in the U.S. and are at high risk for many related chronic diseases. The purpose of the current study was to examine the maintenance of a culturally and individually-tailored Internet-based physical activity intervention for Spanish-speaking Latinas. Inactive Latinas (N  =  205) were randomly assigned to a 6-month Tailored Physical Activity Internet Intervention or a Wellness Contact Control Internet Group, with a 6-month follow-up. Maintenance was measured by assessing group differences in minutes per week of self-reported and accelerometer measured moderate to vigorous physical activity (MVPA) at 12 months after baseline and changes in MVPA between the end of the active intervention (month 6) and the end of the study (month 12). Potential moderators of the intervention were also examined. Data were collected between 2011 and 2014, and were analyzed in 2015 at the University of California, San Diego. The Intervention Group engaged in significantly more minutes of MVPA per week than the Control Group at the end of the maintenance period for both self-reported (mean diff. = 30.68, SE = 11.27, p = .007) and accelerometer measured (mean diff. = 11.47, SE = 3.19, p = .01) MVPA. There were no significant between- or within-group changes in MVPA from month 6 to 12. Greater intervention effects were seen for those with lower BMI (BMI × intervention = -6.67, SE = 2.88, p = .02) and lower perceived places to walk to in their neighborhood (access × intervention = -43.25, SE = 19.07, p = .02), with a trend for less family support (social support × intervention = -3.49, SE = 2.05, p = .08). Acculturation, health literacy, and physical activity related psychosocial variables were not significant moderators of the intervention effect during the maintenance period. Findings from the current study support the efficacy of an Internet-delivered individually tailored intervention for maintenance of MVPA gains over time.

Background: Internet access has grown markedly in Latinos during the past decade. However, there have been no Internet-based physical activity interventions designed for Latinos, despite large disparities in lifestyle-related conditions, such as obesity and diabetes, particularly in Latina women. The current study tested the efficacy of a 6-month culturally adapted, individually tailored, Spanish-language Internet-based physical activity intervention., Methods: Inactive Latinas (N = 205) were randomly assigned to the Tailored Physical Activity Internet Intervention or the Wellness Contact Control Internet Group. Participants in both groups received emails on a tapered schedule over 6 months to alert them to new content on the website. The primary outcome was minutes/week of moderate to vigorous physical activity (MVPA) at 6 months as measured by the 7-Day Physical Activity Recall; activity was also measured by accelerometers. Data were collected between 2011 and 2014 and analyzed in 2015 at the University of California, San Diego., Results: Increases in minutes/week of MVPA were significantly greater in the Intervention Group compared to the Control Group (mean difference = 50.00, SE = 9.5, p < 0.01). Increases in objectively measured MVPA were also significantly larger in the Intervention Group (mean differences = 31.0, SE = 10.7, p < .01). The Intervention Group was also significantly more likely to meet national physical activity guidelines at 6 months (OR = 3.12, 95% CI 1.46-6.66, p < .05)., Conclusion: Findings from the current study suggest that this Internet-delivered individually tailored intervention successfully increased MVPA in Latinas compared to a Wellness Contact Control Internet Group., Trial Registration: NCT01834287.

Background: More than 30% of the U.S. population is prehypertensive, and the recommended treatment of lifestyle modification includes increased physical activity. Exercise videogames (EVG) are widely marketed to Americans as a means of increasing fitness. This study aimed to examine EVG among a sample of prehypertensive adults, to determine (1) feasibility and acceptability of EVG for physical activity, and (2) assess changes in (1) estimates of cardiovascular fitness and risk indices, and psychosocial constructs., Methods: Participants with prehypertension completed a 12-week program including; 36, 1-hour sessions; supervised EVG program using Nintendo Wii platform and games. Assessments were at baseline and 13 weeks. Paired t-tests were conducted., Results: Fourteen adults (84% female; mean age=53 years; 93% Caucasian; 87% employed) completed the study. The study retention rate was 74% and all participants reported satisfaction and enjoyment in the intervention and using the Wii for exercise. Despite the small sample size, significant improvements were seen in: physical activity minutes (P<0.01), peak heart rate (P=0.02), resting systolic blood pressure (P=0.02), and hip circumference (P=0.03). Significant improvements were also seen in the 36-item short-form survey (SF-36) as for general health (P=0.05), role limitations due to emotional problems (P=0.04), and vitality (P=0.01)., Conclusions: Findings support that an EVG program is feasible, acceptable, and promising in promoting benefit to cardiovascular fitness and psychosocial health. These data provide pilot data for the necessary randomized clinical trials to examine efficacy and sustainability of EVG for adult engagement in physical activity for cardiovascular health promotion.

Background: Latinas in the U.S. are less physically active than non-Latino white women and also report higher levels of diabetes, obesity, and other conditions related to inactivity. Interventions are needed to address disparities in this high-risk group., Purpose: To evaluate the efficacy of a culturally adapted, Spanish-language, individually tailored, computer expert system-driven physical activity print-based intervention for adult Latinas., Design: RCT., Setting/participants: Participants were 266 inactive adult Latinas who participated between 2009 and 2012., Intervention: Participants were randomized to one of two treatment arms: a 6-month tailored physical activity intervention condition or wellness contact control. For both conditions, print materials were delivered by mail., Main Outcome Measures: The main outcome measure was change in weekly moderate-to-vigorous physical activity (MVPA) measured by the 7-Day Physical Activity Recall interview, which was administered at baseline and post-intervention (6 months). Participants also wore accelerometers for a week at baseline and follow-up. Analyses were conducted in 2013., Results: Increases in minutes/week of MVPA measured by the 7-Day PAR were significantly greater in the intervention group compared to the control group (mean difference=41.36, SE=7.93, p<0.01). This difference was corroborated by accelerometer readings (rho=0.44, p<0.01). Further, results indicate that intervention participants had greater increases in self-efficacy, cognitive processes, and behavioral processes at 3 months compared to control paricipants (p's<0.05)., Conclusions: The tailored Spanish-language intervention was effective in increasing MVPA among predominantly low-income, less-acculturated Latinas. Such print-based interventions are poised for widespread dissemination, and thus may help address health disparities., (© 2013 American Journal of Preventive Medicine.)

Background: Vigorous-intensity exercise has been shown to aid in smoking cessation, especially among women. In a previous trial, cognitive behavioral therapy (CBT) for smoking cessation plus regular vigorous aerobic exercise enhanced cessation rates, improved exercise capacity, and reduced weight gain compared to CBT plus equal contact time., Purpose: This study examined the effectiveness of this program adapted for and implemented in the YMCAs., Design: An RCT comparing CBT + Exercise (Exercise) to CBT + Contact Control (Control)., Setting/participants: Apparently healthy female smokers were recruited to four local YMCAs., Intervention: YMCA staff members were trained to lead the manualized CBT smoking-cessation intervention and a standardized YMCA exercise program., Main Outcome Measures: Seven-day point prevalence and continuous abstinence., Results: Participants (330 women, mean age=44 years) were randomized to the Exercise (n=166) or Control (n=164) group. Results revealed no differences in 7-day point prevalence (29.5% vs 29.9%) nor continuous abstinence (13.9% vs 14.0%) between the Exercise and Control groups, respectively, at end of treatment or at the 3-, 6-, and 12-month follow-up. An examination of the relationship between exercise dose and quit status at end of treatment revealed that over 12 weeks, the odds of being quit (7-day point prevalence) grew by 4.5% for each additional aerobic exercise session (OR=1.05, 95% CI=1.01, 1.08) and by 7.7% for each additional resistance training session (OR=1.08, 95% CI=1.02, 1.14). Analyses were conducted between August 19, 2010, and December 16, 2011., Conclusions: No differences were seen between groups in smoking outcomes. The association between greater exercise participation and higher odds of quitting within the exercise condition suggests that the lack of between-group differences might be a result of poor compliance with the exercise program., Trial Registration: This study is registered at clinicaltrials.govNCT01615380., (Copyright © 2012 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Objective: To examine putative mediators of a 12-month motivationally tailored physical activity (PA) promotion intervention., Design: We randomly assigned 239 healthy, underactive adults (moderate-vigorous physical activity <90 min/week; mean age = 47.5 years; 82% women) to receive (a) print-based feedback, (b) phone-based feedback, or (c) contact control., Primary Outcome: PA at baseline, 6, and 12 months, as measured by the 7-day physical activity recall interview. MEDIATORS: Four TransTheoretical Model constructs explicitly targeted by the intervention (i.e., self-efficacy, decisional balance, cognitive and behavioral processes of change), as well as four additional constructs linked to PA behavior change (i.e., social support, outcome expectancy, PA enjoyment, exercise-induced feelings)., Results: Multivariate mediation analyses were used to analyze longitudinal PA outcomes. Changes in behavioral processes and one aspect of exercise-induced feelings (revitalization) satisfied both action theory (i.e., treatment effects on mediators) and conceptual theory (i.e., mediator effects on PA) tests at 6 and 12 months and emerged as statistically significant mediators of treatment effects on PA across delivery channels (ps <.014). Cognitive processes, self-efficacy, decisional balance, and social support for PA participation satisfied Action Theory tests at both 6 and 12 months, but failed conceptual theory tests. Delayed intervention effects were observed on other aspects of exercise-induced feelings, PA enjoyment, and outcome expectancies, but these variables failed mediation testing at 12 months., Conclusion: Findings are consistent with previous research illustrating the importance of behavioral processes of change, but also indicate that affective response to PA may warrant more attention as a potential target of behavior change programs.

Objective: To enhance a previously efficacious individually tailored physical activity (PA) promotion intervention by adding theoretical constructs to the tailored feedback., Design: We randomly assigned 248 healthy, underactive (moderate to vigorous physical activity [MVPA] min/week < 90) adults (mean age = 48.8 years, SD = 10.0) to receive either (a) a theoretically tailored (based on 5 constructs from the transtheoretical model and social-cognitive theory [SCT]) print-based PA promotion intervention (print) or (b) the same theoretically tailored print-based PA promotion intervention plus enhanced tailoring addressing 5 additional SCT constructs (enhanced print)., Main Outcome Measure: The 7-day physical activity recall administered at baseline, Month 6, and Month 12, with outcomes operationalized as percentage achieving 150 min/week of MVPA., Results: When controlling for covariates, there was a nonsignificant trend in favor of the enhanced print condition reflecting 46% and 50% greater odds of achieving 150 min/week of MVPA at Month 6 and Month 12, respectively., Conclusion: Enhanced tailoring based on additional theoretical constructs may result in marginal improvements in physical activity outcomes.

Background: In the U.S., Latinos report particularly high levels of inactivity and related chronic illnesses and are in need of intervention. Thus, the purpose of the current study was to culturally and linguistically adapt an empirically supported, individually tailored physical activity print intervention for Latinos and then conduct an RCT of the modified program., Design: An RCT was conducted., Setting/participants: The sample included 93 overweight/obese (80%) Latinas with low income and acculturation., Intervention: Data were collected in 2007-2008 and analyzed by intent-to-treat in 2009. Participants were randomly assigned to either (1) a culturally and linguistically adapted physical activity intervention (Seamos Activas) or (2) a wellness contact control condition., Main Outcome Measures: Self-report physical activity, as measured pre- and post-intervention (6 months, 87% retention) by the 7-Day Physical Activity Recall., Results: Moderate-intensity (or greater) physical activity increased from an average of 16.56 minutes/week (SD=25.76) at baseline to 147.27 (SD=241.55) at 6 months in the intervention arm (n=45), and from 11.88 minutes/week (SD=21.99) to 96.79 (SD=118.49) in the wellness contact control arm (n=48). No between-group differences were seen in overall physical activity. Intervention participants reported significantly greater increases in cognitive (F[1, 91]=9.53, p=0.003) and behavioral processes of change (F[1, 91]=8.37, p=0.005) and available physical activity supplies and equipment at home (F[1, 91]=4.17, p=0.04) than control participants., Conclusions: Results supported the hypothesized feasibility, acceptability, and preliminary efficacy of individually tailored physical activity print interventions among Latinas. Although more research is needed to corroborate these findings, such high-reach, low-cost approaches have great potential to positively affect public health., Trial Registration: NCT00724165.

Exercise during pregnancy has been associated with reduced risk of gestational diabetes mellitus, however, twice as many women are sedentary during pregnancy as compared to when they are not pregnant. We conducted 3 focus groups among 20 pregnant Latina and non-Latina white women to identify barriers and facilitators to exercise in pregnancy to inform a gestational diabetes mellitus intervention study. Quantitative analyses of demographic data, and qualitative analyses of focus groups were conducted. Women identified physical limitations and restrictions, lack of resources, energy, and time as powerful exercise barriers. Social support, access to resources, information, proper diet, scheduling, and the weather were identified as powerful facilitators. Intervention programs designed for pregnant women should facilitate social support, provide information and resources, as well as promote short-term and long-term benefits.

Background: Most health behavior models do not distinguish between determinants of behavior adoption and maintenance., Purpose: This study compared psychosocial predictors of physical activity (PA) adoption and predictors of PA maintenance among 205 initially sedentary adults enrolled in a home-based PA promotion trial., Methods: Psychosocial variables were measured at 6 months (at which point 107 participants remained inactive and 98 participants adopted regular PA) and used to predict 12-month PA status (an indicator of PA adoption among those inactive at 6 months and an indicator of PA maintenance among those active at 6 months)., Results: Six-month PA status moderated the relationships between 6-month measures of home access to PA equipment (p = .049), self-efficacy (p = .086), and perceived satisfaction (p = .062) and 12-month PA status. Simple effects analyses revealed that home access to PA equipment was predictive of PA adoption (OR = 1.73; 95% CI: 1.05, 2.85), but not PA maintenance (OR = 0.88; 95% CI: 0.58, 1.35), whereas self-efficacy and perceived satisfaction were predictive of PA maintenance (OR = 2.65; 95% CI: 1.55, 4.52; OR = 1.95; 95% CI: 0.93, 4.06), but not PA adoption (OR = 1.50; 95% CI: 0.87, 2.57; OR = 0.82, CI: 0.44, 1.52)., Conclusion: Results suggest that these psychosocial variables may operate differently in predicting PA adoption versus maintenance.

Over two-thirds of Americans access the Internet and therefore, the Internet may be an important channel for reaching the large population of sedentary individuals. The purpose of this paper is to describe the methods for a randomized controlled trial examining the efficacy of an Internet-based physical activity intervention relative to a print intervention that has been shown to be effective in previous trials. Specifically, 249 sedentary participants were randomized to receive one of three interventions: 1) Internet-based motivationally-tailored individualized feedback (Tailored Internet); 2) print-based motivationally-tailored individualized feedback (Tailored Print); or 3) physical activity websites currently available to the public (Standard Internet). Participants completed the 7-Day Physical Activity Recall interview, wore an objective physical activity monitor (i.e., ActiGraph), and participated in a treadmill fitness test at baseline, 6, and 12 months. The sample consisted of mostly women (84.2%) and Caucasian individuals (76.4%) who reported exercising an average of 21 min per week at baseline. This is the first study that we are aware of, that has examined the efficacy of a tailored Internet-based physical activity intervention. This study will have implications for the dissemination of Internet-based physical activity interventions.

Background: Physical activity interventions tailored to individual characteristics and delivered via print produce greater increases in activity compared with nontailored interventions and controls. Using the Internet to deliver a tailored physical activity intervention offers an alternative to print that might be available to larger populations at a lower cost., Methods: Participants (N=249 adults; mean [SD] age, 44.5 [9.3] years; and mean [SD] body mass index [calculated as weight in kilograms divided by height in meters squared], 29.4 [6.1]) were randomized to 1 of 3 physical activity interventions: (1) motivationally tailored Internet (tailored Internet, n=81), (2) motivationally tailored print (tailored print, n=86); and (3) 6 researcher-selected Web sites available to the public (standard Internet, n=82). Participants in the tailored Internet and tailored print arms received the same tailored intervention content. Participants were assessed at baseline and at 6 and 12 months., Results: At 6 months, participants in the tailored print arm reported a median of 112.5 minutes of physical activity per week, those in the tailored Internet arm reported 120.0 minutes, and those in the standard Internet arm reported 90.0 minutes (P=.15). At 12 months, the physical activity minutes per week were 90.0, 90.0, and 80.0 for those in the tailored print, tailored Internet, and standard Internet arms, respectively (P=.74). Results indicated no significant differences between the 3 arms., Conclusions: The use of tailored Internet, tailored print, and standard Internet as part of a behavior change program increased physical activity behavior similarly. Because the use of the Internet was not different from the print-based intervention, this may be an opportunity to reach more sedentary adults in a more cost-effective way., Trial Registration: clinicaltrials.gov Identifier: NCT00200317.

Background: Project STRIDE is a 4-year randomized controlled trial comparing two computer-based expert system guided intervention delivery channels (phone vs. print) for physical activity adoption and short-term maintenance among previously sedentary adults., Methods: Sedentary adults (n=239) were randomized to one of the following (1) telephone-based, individualized motivationally-tailored feedback; (2) print-based, individualized motivationally-tailored feedback; (3) contact-control delayed treatment group (received intervention after 12 months as control). This paper: (1) outlines the study design, rationale, and participant sample; and (2) describes relationships between baseline variables to better understand their influence on the efficacy of the intervention., Results: Participants averaged 19.8+/-25.0 min of physical activity/week that was at least of moderate intensity, with no group differences. The average estimated VO(2) at 85% of maximum heart rate was 25.6 ml/kg/min. Body fat was 34.1% for women and 23.2% for men and the BMI of the sample averaged 28.5 kg/m(2)., Conclusions: Project STRIDE examines non face-to-face approaches for promoting physical activity behavior. It has unique features including a direct comparison of an expert system guided intervention delivered via phone or print. Future analyses will examine the cost-effectiveness of the interventions and this will likely yield important information for policy-makers.

This study examined exercise maintenance among patients after completing cardiac rehabilitation. Subjects were men and women who had completed a Phase II Cardiac Rehabilitation Program approximately 12 months previously. Subjects were classified according to whether they had (a) never participated in a Phase III program (G-I) (N = 37), (b) enrolled and completed a Phase III program (G-II) (N = 30), or (c) were currently enrolled in a Phase III maintenance program (G-III) (N = 33). Subjects were significantly more likely to be participating in regular exercise if they had participated in a Phase III program (p < .05). Individuals in G-II and G-III engaged in more minutes of physical activity per week and were more likely to meet recommended levels of physical activity compared to G-1 subjects. G-1 individuals who had longer Phase II programs were more likely to maintain their exercise habits following graduation (p < .05). Results suggest that Phase III maintenance programs and longer Phase II participation improved exercise maintenance following rehabilitation.

Background: To increase physical activity among college students, new approaches are needed including the exploration of home-based exercise. However, research related to potential facilitators and barriers to exercising at home is limited. Purpose: The goal of this study was to develop a reliable and valid measure that can assess predictors of home exercise. Methods: A systematic approach was used to develop items for the new measure and to examine its psychometric properties. Principal component analysis (PCA) was used to investigate the internal structure of the measure. External validity and initial construct validity were examined using correlations of the new subscale measures with existing valid measures of exercise. Results: Two hundred thirty-two adults (65% women and 72% white) completed a cross-sectional survey. The final PCA solution resulted in a 28-item measure with 7 distinct subscales with individual item loadings ranging from 0.64 to 0.91. These subscales comprised 3 higher order scales of Barriers to Home Exercise, Benefits of Home Exercise, and Barriers to Public Exercise. All demonstrated good internal consistency and external validity. Discussion: The measure developed in this study delineates important predictors of home exercise. Translation to Health Education Practice: This measure can be used to develop tailored interventions to promote home-based exercise.

Behavioral science theories have been used to develop physical activity interventions; however, little is known as to whether these interventions are effective due to changes in constructs related to these theories. Specifically, if the intervention is successful, does it work for the reasons hypothesized by the theory underlying it? The purpose of this study was to examine the importance of particular theoretical constructs among participants (n = 150) who had been randomly assigned to a physical activity intervention based on the Transtheoretical Model and Social Cognitive Theory (i.e., tailored group) or to a standard care group. Participants in the tailored group reported greater increases in behavioral processes and self-efficacy from baseline to 3 months than participants in the standard-care group. No between-group differences were found for cognitive processes and decisional balance. This study demonstrates that theory-based physical activity interventions may be effective through changes in particular theoretical constructs. [ABSTRACT FROM AUTHOR]

Aims: Physical activity plays an important role in blood glucose management, yet most adults with elevated blood glucose do not engage in regular physical activity. Exercise videogames (EVGs) may be an attractive alternative for persons who have not found standard exercise modalities appealing.Methods: This sub-study within a larger trial examined the effects of 12 weeks of EVGs versus standard exercise (e.g., treadmill, cycling) and a control condition among individuals with elevated HbA1c (100% prediabetic). This study was conducted at a university research lab. Outcomes included HbA1c and weekly minutes of moderate to vigorous physical activity (MVPA) assessed using self-report and accelerometer.Other health risk indices (e.g., lipids) and psychosocial constructs shown to influence exercise participation (e.g., intrinsic motivation) were assessed.Results: Participants (n = 84), averaged age 51.4 years (range 20-79), 80% were female, and 77.4% were non-Hispanic. Baseline HbA1c ranged from 5.7% to 6.4% (39-49 mmol/mol). At week 12, EVG participants demonstrated an average 2% reduction in HbA1c compared to a 0.6% reduction in Standard and Control groups (p's = 0.04 and 0.03). EVG participants engaged in significantly more MVPA than Standard (+17 min/week) and Controls (+54 min/week) (p's < 0.05), had reduced LDL cholesterol (p = 0.05) and trends suggesting reduced body fat (p = 0.10). EVG participants reported higher exercise enjoyment and motivation compared to other participants.Conclusions: EVGs may be an attractive and effective tool to improve management of blood glucose that might contribute toward preventing the onset of type 2 diabetes among those with prediabetes. [ABSTRACT FROM AUTHOR]

Diabetes is the seventh leading cause of death in the United States. For most patients, medication alone is not sufficient to achieve glycemic control; attention must also be paid to multiple healthy behaviors including diet, regular physical activity, and stress management. Yoga, a mindfulness practice with emphasis on relaxation, meditation, and deep breathing, may have special relevance to people with type 2 diabetes mellitus (T2DM). Yoga practice may positively affect stress and other self-care tasks that will contribute to improved glycemic control. The Healthy, Active, and in Control (HA1C) study is designed to examine the feasibility and acceptability of yoga among adult patients with T2DM. In this pilot randomized controlled trial, adults with T2DM were randomly assigned to either a 12-week Iyengar Yoga intervention given twice weekly, or a twice-weekly 12-week program of traditional exercise (e.g., walking, stationary cycling). Assessments are conducted at the end of treatment (12 weeks) and at 3 and 6 months postintervention. The HA1C study will assess feasibility and acceptability (e.g., attendance/retention rates, satisfaction with program), glycemic outcomes (e.g., HbA1c, fasting blood glucose, postprandial blood glucose), and changes in physiological (e.g., salivary cortisol) and behavioral factors (e.g., physical activity, diet) relevant to the management of T2DM. Focus groups are conducted at the end of the intervention to explore participants' experience with the program and their perception of the potential utility of yoga for diabetes management. [ABSTRACT FROM AUTHOR]

Background Despite recent declines, cigarette smoking remains prevalent among individuals with lower income, less education, and those with mental illness or HIV. Exercise is promoted as a quitting aid; however, the evidence for this recommendation is equivocal. To date, the majority of studies have only examined aerobic exercise; there is a poor understanding of the mechanisms of action; and there is an under-representation of male smokers. Methods/Design 206 male and female smokers will receive a smoking cessation education session prior to being randomized into a 12-week Resistance Training (RT) or Wellness Contact Control group. Both groups will have the option of using nicotine replacement therapy (NRT), and both will meet on-site twice per week during the intervention (24 total sessions). Follow-up assessments will occur at the end of the 12-weeks (3-month), and at a 6-month and 12-month (post-randomization) visit. Participants will not receive any additional cessation treatment during follow-up; however, the RT group will receive a 9-month membership to a fitness center to encourage continued resistance training as a way to maintain cessation. The primary outcome is salivary-cotinine-verified 7-Day Point Prevalence Abstinence at the 3-month assessment, and at the 6 and 12-month follow-ups. Secondary outcomes include effects of resistance training on nicotine withdrawal, indicators of mental health, and markers of disease risk. Discussion This study will produce new data on the efficacy of resistance training for smoking cessation, the potential mechanisms of action that may support its use, and the effects it has on markers of disease risk in smokers. [ABSTRACT FROM AUTHOR]

Examines predictors of exercise maintenance following completion of a physical activity intervention. Treatment effects; Physical activity maintenance; Psychological factors; Longitudinal changes; Patterns of change.

A more positive affective valence during exercise is predictive of adherence to physical activity programs. This study examines the relationship between affective response during exercise and longer-term maintenance of physical activity among individuals using exercise video games (EVGs) and standard modalities of physical activity (i.e., walking, cycling). Healthy adults (mean age 45.4, SD = 14.5) were randomly assigned to a 12-week supervised, thrice weekly program of EVGs (n = 93) or Standard exercise (n = 96), and were assessed for affect immediately before, at the mid-point, and immediately after one exercise session per week. Participation in moderate-to-vigorous physical activity (MVPA) was conducted at end of treatment (EOT) and 6-month follow up. EVG participants reported more positive affective valence during exercise compared to Standard participants (b = 0.63, SE = 0.08, p <.001), and perceived less exertion (b = 0.52, SE = 0.36, p =.04) compared to Standard participants. For both groups, a more positive affective valence during exercise was significantly predictive of continued physical activity at 6-months (b = 6.64, SE = 2.50, p =.01). EVG participants also showed a significant chronic effect such that week-to-week there were improvements in affect prior to exercise and this effect was significantly associated with greater MPVA at EOT and follow-up (b = 21.96, SE = 10.10, p =.03 at EOT). Among Standard participants no significant chronic effect was seen over time. EVGs may provide an effective means of promoting more positive shifts in affective valence both during, and in anticipation of, physical activity that encourages longer-term participation. • Sedentary adults endorsed more positive affect during exercise video games than during standard exercise. • Greater positive affect during exercise predicted more physical activity 6 months after the end of the intervention. • Both groups exercised at the same intensity as measured by heart rate monitors. • Video game participants reported lower perceived exertion than those in standard exercise. • Exercise video games are a promising physical activity intervention for sedentary adults. [ABSTRACT FROM AUTHOR]

Latent class modeling (LCM) offers a promising approach for examining correlates of heart rate (HR) patterns over multiple exercise sessions. This research examined biological and psychological variables associated with different patterns of HR response to physical activity (PA). In a three-arm randomized controlled trial (exercise video games vs. standard exercise vs. non-exercise control), HR was recorded during PA sessions over a 12-week period. LCM identified three patterns of HR during PA across 189 participants in active arms: 1) high HR across sessions with low variability within sessions, 2) linear increase in HR across sessions with low variability within sessions, and 3) high variability in HR across all sessions. Associations with biological (resting heart rate, blood pressure, BMI, age, cholesterol, triglycerides, HbA1c) and psychological (depression, motivations for PA, PA-induced feelings) predictors of latent class membership were iteratively tested. Psychological variables played as important a role in the final model as biological variables for predicting latent class membership. Few differences were found between LC1 and LC2, but LC3 differed from the other two groups in that participants were likelier to report that they feel revitalized after PA (vs. LC1 and LC2), to be less motivated for PA (vs. LC1), reported greater depression (vs. LC1 and LC2), and were younger (vs. LC1). These findings demonstrate the potential of LCM to identify biological and psychological factors associated with chronotropic responses to PA, and advance understanding of the role of psychological factors in chronotropic PA outcomes. • Latent class modeling found three patterns in heart rate during an exercise trial. • Baseline psychological variables were key predictors of these patterns. • Psychological covariates may be important to patterns of heart rate during exercise. • Results have implications for wearable fitness trackers. [ABSTRACT FROM AUTHOR]