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Screen time shows higher health risks compared to other types of sedentary behaviors. A lockdown may simultaneously increase screen time, reduce physical activity (PA), and change time perception. Our goal was to compare self-reported against objectively measured smartphone screen time (SST) in a sample of active and inactive Portuguese adults before and during a social lockdown. This study was a cross-sectional analysis with 211 Portuguese adults (57.8% males), aged 25.2 ± 8.5 years, from two cohorts, one before the social lockdown and the other during the lockdown. SST was self-reported (SR-SST) and objectively measured using a smartphone (OM-SST). PA was self-reported. Linear regressions were performed to determine the association between SR-SST and OM-SST. A Bland and Altman analysis was used to assess agreement. Independent T-tests were performed for comparisons between cohorts and paired sample T-tests for comparisons within each cohort. The cohort assessed during the lockdown showed a higher SST than the cohort assessed before the lockdown (OM-SST; p p = 0.009). Before the lockdown, there was no difference between SR-SST and OM-SST (p = 0.100). However, during the social lockdown, although the agreement between SR-SST and OM-SST was good (ICC = 0.72), participants systematically underestimated their SST by ~ 71 min/day (p

ObjectiveWeight regain prevention is a critical public health challenge. Digital behaviour change interventions provide a scalable platform for applying and testing behaviour change theories in this challenging context. This study's goal was to analyse reciprocal effects between psychosocial variables (i.e., needs satisfaction, eating regulation, self-efficacy) and weight over 12 months using data from a large sample of participants engaged in a weight regain prevention trial. MethodsThe NoHoW study is a three-centre, large-scale weight regain prevention trial. Adults who lost >5% of their weight in the past year (N = 1627, 68.7% female, 44.10 +/- 11.86 years, 84.47 +/- 17.03 kg) participated in a 12-month' digital behaviour change-based intervention. Weight and validated measures of basic psychological needs satisfaction, eating regulation and self-efficacy were collected at baseline, six- and 12 months. Correlational, latent growth models and cross-lagged analysis were used to identify potential reciprocal effects. ResultsBaseline higher scores of needs satisfaction and self-efficacy were associated with six- and 12-month' weight loss. Baseline weight was linked to all psychosocial variables at six months, and six-months weight was associated with needs satisfaction and self-efficacy at 12 months. During the 12 months, increases in eating regulation, needs satisfaction and self-efficacy were associated with weight loss over the same period, and reciprocal effects were observed between the variables, suggesting the existence of Weight Management Cycles. ConclusionsWhile further studies are needed, during long-term weight regain prevention, weight decrease, needs satisfaction and self-efficacy may lead to Weight Management Cycles, which, if recurrent, may provide sustained prevention of weight regain.

Background: Using self-determination theory as a framework, the aim of this study was 2-fold: (1) identify different profiles of motivational strategies used by exercise professionals and (2) examine associations of these motivational profiles with work-related variables: measures, perceived job pressures, need satisfaction/frustration, and perceived exercisers’ motivation. Methods: Participants were 366 exercise professionals (193 males; experience = 7.7 [5.8] y) currently working in health and fitness settings. Results: Latent profile analysis identified a 3-profile model: (1) most need-supportive and least controlling (NS+; n = 225), (2) less need-supportive and slightly controlling (NS−; n = 42), and (3) most controlling and slightly need-supportive (mixed; n = 99). Professionals working less than 20 hours per week, more experienced, and female were more likely to integrate NS+, which was also associated with higher levels of work-related need satisfaction and clients’ perceived self-determination, and lower levels of job pressures and need-frustration. Conversely, NS− displayed the most maladaptive pattern of associations. Conclusions: The present findings highlight the importance of analyzing the correlates of different professional profiles, namely to help health and fitness organizations to provide high-quality motivational practices within an appropriate environment both for professionals and clients.

Long-term weight management requires sustained engagement with energy-balance-related behaviours. According to self-determination theory, behaviour goals can support or undermine motivation depending on the quality of their content (i.e., extrinsic and intrinsic motivation). This study aimed to develop and validate the goal content for weight loss maintenance scale (GCWMS). The GCWMS was administered to 1511 participants who had achieved clinically significant weight losses and were taking part in a large weight loss maintenance study: the NoHoW Trial (ISRCTN88405328). The scale derived from two well-established questionnaires regarding exercise goals. Construct validity was examined for 4 theory-driven domains: Health Management, Challenge, Image, and Social Recognition. Split-sample confirmatory factor analysis was conducted to test the factorial validity and multi-group measurement invariance (configural, metric, scalar, and residual invariance). The reliability estimates were also assessed, and discriminant validity was evaluated using 2 conceptually related questionnaires. The first analysis showed a poor fit of the original factorial structure. Subsequent investigation with a new specified model indicated close fit to the data after removal of 3 items χ2(58) = 599.982; p .775), convergent and divergent validity were verified through associations with other theoretical related constructs. Findings from multi-group invariance test demonstrated that the specified model of GCWMS achieved full measurement invariance for gender but did not support residual invariance across countries. Findings support the hypothesised four-dimension structure of the GCWMS, confirming reliability and multi-group invariance in factor structure. Analysis also supports valid group means comparisons on latent factors at gender and at cross-cultural level. Ways to improve the quality of the scale are discussed. Level V, cross-sectional descriptive

Background Weight-loss programmes often achieve short-term success though subsequent weight regain is common. The ability to identify predictive factors of regain early in the weight maintenance phase is crucial. Objective To investigate the associations between short-term weight variability and long-term weight outcomes in individuals engaged in a weight-loss maintenance intervention. Methods The study was a secondary analysis from The NoHoW trial, an 18-month weight maintenance intervention in individuals who recently lost ≥5% body weight. Eligible participants (n = 715, 64% women, BMI = 29.2 (SD 5.0) kg/m2, age = 45.8 (SD 11.5) years) provided body-weight data by smart scale (Fitbit Aria 2) over 18 months. Variability in body weight was calculated by linear and non-linear methods over the first 6, 9 and 12 weeks. These estimates were used to predict percentage weight change at 6, 12, and 18 months using both crude and adjusted multiple linear regression models. Results Greater non-linear weight variability over the first 6, 9 and 12 weeks was associated with increased subsequent weight in all comparisons; as was greater linear weight variability measured over 12 weeks (up to AdjR2 = 4.7%). Following adjustment, 6-week weight variability did not predict weight change in any model, though greater 9-week weight variability by non-linear methods was associated with increased body-weight change at 12 (∆AdjR2 = 1.2%) and 18 months (∆AdjR2 = 1.3%) and by linear methods at 18 months (∆AdjR2 = 1.1%). Greater non-linear weight variability measured over 12 weeks was associated with increased weight at 12 (∆AdjR2 = 1.4%) and 18 (∆AdjR2 = 2.2%) months; and 12-week linear variability was associated with increased weight at 12 (∆AdjR2 = 2.1%) and 18 (∆AdjR2 = 3.6%) months. Conclusion Body-weight variability over the first 9 and 12 weeks of a weight-loss maintenance intervention weakly predicted increased weight at 12 and 18 months. These results suggest a potentially important role in continuously measuring body weight and estimating weight variability.

Objetivo Descrever e explorar determinantes da promoção de Atividade Física (AF) por parte dos oncologistas, analisar a perceção de capacidade, oportunidade e motivação dos médicos quanto à promoção de AF, e analisar as preocupações relacionadas com a prática de exercício físico dos doentes oncológicos. Método Um total de 76 oncologistas preencheram um questionário constituído por demografia, questões sobre a promoção da AF ligadas às perceções de capacidade, oportunidade, motivação, comportamento, e necessidades. Foram realizadas análises de correlação de Pearson e Spearman, regressão linear múltipla, teste-t paramétrico e não paramétrico. Resultados Foram detetadas perceções de capacidade e oportunidade baixas e uma motivação elevada. A grande maioria promove atividade física, mas não promove exercício físico estruturado, contudo, reconhecem a sua importância. A capacidade é a variável mais preponderante no comportamento, mas as restantes variáveis estão associadas ao mesmo. É reportada uma necessidade de melhoria de condições para a promoção de AF. Conclusão Os resultados devem ser analisados com cautela devido à amostra reduzida, no entanto, sugerem que os médicos valorizam a prática de AF dos seus doentes mas não se sentem capazes para promovê-la, o que legitima a presença de fisiologistas do exercício nos serviços de saúde. A presença do fisiologista do exercício pode ser um fator desencadeador da promoção de AF e exercício físico.

©Elina Mattila, Susanne Hansen, Lise Bundgaard, Lauren Ramsey, Alice Dunning, Marlene N Silva, Marja Harjumaa, Miikka Ermes, Marta M Marques, Marcela Matos, Sofus C Larsen, Jorge Encantado, Inês Santos, Graham Horgan, Ruairi O'Driscoll, Jake Turicchi, Cristiana Duarte, António L Palmeira, R James Stubbs, Berit Lilienthal Heitmann, Liisa Lähteenmäki. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 10.01.2022. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in the Journal of Medical Internet Research, is properly cited. The complete bibliographic information, a link to the original publication on https://www.jmir.org/, as well as this copyright and license information must be included., Background: Digital behavior change interventions (DBCIs) offer a promising channel for providing health promotion services. However, user experience largely determines whether they are used, which is a precondition for effectiveness. Objective: The primary aim of this study is to evaluate user experiences with the NoHoW Toolkit (TK)-a DBCI that targets weight loss maintenance-over a 12-month period by using a mixed methods approach and to identify the main strengths and weaknesses of the TK and the external factors affecting its adoption. The secondary aim is to objectively describe the measured use of the TK and its association with user experience. Methods: An 18-month, 2×2 factorial randomized controlled trial was conducted. The trial included 3 intervention arms receiving an 18-week active intervention and a control arm. The user experience of the TK was assessed quantitatively through electronic questionnaires after 1, 3, 6, and 12 months of use. The questionnaires also included open-ended items that were thematically analyzed. Focus group interviews were conducted after 6 months of use and thematically analyzed to gain deeper insight into the user experience. Log files of the TK were used to evaluate the number of visits to the TK, the total duration of time spent in the TK, and information on intervention completion. Results: The usability level of the TK was rated as satisfactory. User acceptance was rated as modest; this declined during the trial in all the arms, as did the objectively measured use of the TK. The most appreciated features were weekly emails, graphs, goal setting, and interactive exercises. The following 4 themes were identified in the qualitative data: engagement with features, decline in use, external factors affecting user experience, and suggestions for improvements. Conclusions: The long-term user experience of the TK highlighted the need to optimize the technical functioning, appearance, and content of the DBCI before and during the trial, similar to how a commercial app would be optimized. In a trial setting, the users should be made aware of how to use the intervention and what its requirements are, especially when there is more intensive intervention content., This project has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement number 643309.

Prior reviews point to the superior benefits of exercising in nature vs in conventional indoor venues, particularly in terms of well-being. However, physical exercise performance, neither in terms of efficacy nor efficiency, has not been sufficiently addressed by past reviews of this topic. Therefore, we conducted both a systematic review and meta-analysis of the experimental literature that relates to differences in exercise performance and well-being between exercising in nature and in conventional indoor venues. Forty-nine relevant studies─the outcome data of which were used for the systematic review─were located within the Web of Science, PubMed, and Scopus databases. The meta-analyses, using data from twenty-four of the relevant studies, revealed no significant overall environmental effect on task performance efficacy outcomes (

BACKGROUND The use of digital interventions can be accurately monitored via log files. However, monitoring engagement with intervention goals or enactment of the actual behaviors targeted by the intervention is more difficult and is usually evaluated based on pre-post measurements in a controlled trial. OBJECTIVE The objective of this paper is to evaluate if engaging with 2 digital intervention modules focusing on (1) physical activity goals and action plans and (2) coping with barriers has immediate effects on the actual physical activity behavior. METHODS The NoHoW Toolkit (TK), a digital intervention developed to support long-term weight loss maintenance, was evaluated in a 2 x 2 factorial randomized controlled trial. The TK contained various modules based on behavioral self-regulation and motivation theories, as well as contextual emotion regulation approaches, and involved continuous tracking of weight and physical activity through connected commercial devices (Fitbit Aria and Charge 2). Of the 4 trial arms, 2 had access to 2 modules directly targeting physical activity: a module for goal setting and action planning (Goal) and a module for identifying barriers and coping planning (Barriers). Module visits and completion were determined based on TK log files and time spent in the module web page. Seven physical activity metrics (steps; activity; energy expenditure; fairly active, very active and total active minutes; and distance) were compared before and after visiting and completing the modules to examine whether the modules had immediate or sustained effects on physical activity. Immediate effect was determined based on 7-day windows before and after the visit, and sustained effects were evaluated for 1 to 8 weeks after module completion. RESULTS Out of the 811 participants, 498 (61.4%) visited the Goal module and 406 (50.1%) visited the Barriers module. The Barriers module had an immediate effect on very active and total active minutes (very active minutes: before median 24.2, IQR 10.4-43.0 vs after median 24.9, IQR 10.0-46.3; P=.047; total active minutes: before median 45.1, IQR 22.9-74.9 vs after median 46.9, IQR 22.4-78.4; P=.03). The differences were larger when only completed Barriers modules were considered. The Barriers module completion was also associated with sustained effects in fairly active and total active minutes for most of the 8 weeks following module completion and for 3 weeks in very active minutes. CONCLUSIONS The Barriers module had small, significant, immediate, and sustained effects on active minutes measured by a wrist-worn activity tracker. Future interventions should pay attention to assessing barriers and planning coping mechanisms to overcome them. CLINICALTRIAL ISRCTN Registry ISRCTN88405328; https://www.isrctn.com/ISRCTN88405328

The use of digital interventions can be accurately monitored via log files. However, monitoring engagement with intervention goals or enactment of the actual behaviors targeted by the intervention is more difficult and is usually evaluated based on pre-post measurements in a controlled trial.The objective of this paper is to evaluate if engaging with 2 digital intervention modules focusing on (1) physical activity goals and action plans and (2) coping with barriers has immediate effects on the actual physical activity behavior.The NoHoW Toolkit (TK), a digital intervention developed to support long-term weight loss maintenance, was evaluated in a 2 x 2 factorial randomized controlled trial. The TK contained various modules based on behavioral self-regulation and motivation theories, as well as contextual emotion regulation approaches, and involved continuous tracking of weight and physical activity through connected commercial devices (Fitbit Aria and Charge 2). Of the 4 trial arms, 2 had access to 2 modules directly targeting physical activity: a module for goal setting and action planning (Goal) and a module for identifying barriers and coping planning (Barriers). Module visits and completion were determined based on TK log files and time spent in the module web page. Seven physical activity metrics (steps; activity; energy expenditure; fairly active, very active and total active minutes; and distance) were compared before and after visiting and completing the modules to examine whether the modules had immediate or sustained effects on physical activity. Immediate effect was determined based on 7-day windows before and after the visit, and sustained effects were evaluated for 1 to 8 weeks after module completion.Out of the 811 participants, 498 (61.4%) visited the Goal module and 406 (50.1%) visited the Barriers module. The Barriers module had an immediate effect on very active and total active minutes (very active minutes: before median 24.2, IQR 10.4-43.0 vs after median 24.9, IQR 10.0-46.3; P=.047; total active minutes: before median 45.1, IQR 22.9-74.9 vs after median 46.9, IQR 22.4-78.4; P=.03). The differences were larger when only completed Barriers modules were considered. The Barriers module completion was also associated with sustained effects in fairly active and total active minutes for most of the 8 weeks following module completion and for 3 weeks in very active minutes.The Barriers module had small, significant, immediate, and sustained effects on active minutes measured by a wrist-worn activity tracker. Future interventions should pay attention to assessing barriers and planning coping mechanisms to overcome them.ISRCTN Registry ISRCTN88405328; https://www.isrctn.com/ISRCTN88405328.

Background Many weight loss programs show short-term effectiveness, but subsequent weight loss maintenance is difficult to achieve. Digital technologies offer a promising means of delivering behavior change approaches at low costs and on a wide scale. The Navigating to a Healthy Weight (NoHoW) project, which was funded by the European Union’s Horizon 2020 research and innovation program, aimed to develop, test, and evaluate a digital toolkit designed to promote successful long-term weight management. The toolkit was tested in an 18-month, large-scale, international, 2×2 factorial (motivation and self-regulation vs emotion regulation) randomized controlled trial that was conducted on adults with overweight or obesity who lost ≥5% of their body weight in the preceding 12 months before enrollment into the intervention. Objective This paper aims to describe the development of the NoHoW Toolkit, focusing on the logic models, content, and specifications, as well as the results from user testing. Methods The toolkit was developed by using a systematic approach, which included the development of the theory-based logic models, the selection of behavior change techniques, the translation of these techniques into a web-based app (NoHoW Toolkit components), technical development, and the user evaluation and refinement of the toolkit. Results The toolkit included a set of web-based tools and inputs from digital tracking devices (smart scales and activity trackers) and modules that targeted weight, physical activity, and dietary behaviors. The final toolkit comprised 34 sessions that were distributed through 15 modules and provided active content over a 4-month period. The motivation and self-regulation arm consisted of 8 modules (17 sessions), the emotion regulation arm was presented with 7 modules (17 sessions), and the combined arm received the full toolkit (15 modules; 34 sessions). The sessions included a range of implementations, such as videos, testimonies, and questionnaires. Furthermore, the toolkit contained 5 specific data tiles for monitoring weight, steps, healthy eating, mood, and sleep. Conclusions A systematic approach to the development of digital solutions based on theory, evidence, and user testing may significantly contribute to the advancement of the science of behavior change and improve current solutions for sustained weight management. Testing the toolkit by using a 2×2 design provided a unique opportunity to examine the effect of motivation and self-regulation and emotion regulation separately, as well as the effect of their interaction in weight loss maintenance.

Heterogeneity of interindividual and intraindividual responses to interventions is often observed in randomized, controlled trials for obesity. To address the global epidemic of obesity and move toward more personalized treatment regimens, the global research community must come together to identify factors that may drive these heterogeneous responses to interventions. This project, called OBEDIS (OBEsity Diverse Interventions Sharing - focusing on dietary and other interventions), provides a set of European guidelines for a minimal set of variables to include in future clinical trials on obesity, regardless of the specific endpoints. Broad adoption of these guidelines will enable researchers to harmonize and merge data from multiple intervention studies, allowing stratification of patients according to precise phenotyping criteria which are measured using standardized methods. In this way, studies across Europe may be pooled for better prediction of individuals' responses to an intervention for obesity - ultimately leading to better patient care and improved obesity outcomes. © 2020 The Author(s) Published by S. Karger AG, Basel.

Wearable devices are increasingly prevalent in research environments for the estimation of energy expenditure (EE) and heart rate (HR). The aim of this study was to validate the HR and EE estimates of the Fitbit charge 2 (FC2), and the EE estimates of the Sensewear armband mini (SWA). We recruited 59 healthy adults to participate in walking, running, cycling, sedentary and household tasks. Estimates of HR from the FC2 were compared to a HR chest strap (Polar) and EE to a stationary metabolic cart (Vyntus CPX). The SWA overestimated overall EE by 0.03 kcal/min−1 and was statistically equivalent to the criterion measure, with a mean absolute percentage error (MAPE) of 29%. In contrast, the FC2 was not equivalent overall (MAPE = 44%). In household tasks, MAPE values of 93% and 83% were observed for the FC2 and SWA, respectively. The FC2 HR estimates were equivalent to the criterion measure overall. The SWA is more accurate than the commercial-grade FC2. Neither device is consistently accurate across the range of activities used in this study. The HR data obtained from the FC2 is more accurate than its EE estimates and future research may focus more on this variable.

ObjectivesThe aim of this study was to design and develop a multidimensional observational coding system (Coach Interpersonal Style Observational System) to assess coaches' interpersonal style adopted during training sessions and matches.Equipment and methodsContent validity was established by 11 experts (with proven knowledge and experience in sport science, motivational psychology, and coaching) using qualitative (e.g. ease of comprehension, utility, and adequacy of examples) and quantitative (category scores) approaches. Coders were trained to test inter- and intra-rater reliability.ResultsQualitative analyses revealed global positive assessment. Experts' category scores were very high. After coder training, inter- and intra-rater reliability scores were acceptable. Discriminant validity was tested through the pilot application to eight soccer coaches. Overall, the results support the preliminary reliability and validity of an instrument to analyze interpersonal coach behavior.

BACKGROUND Digital behavior change interventions (DBCIs) offer a promising channel for providing health promotion services. However, user experience largely determines whether they are used, which is a precondition for effectiveness. OBJECTIVE The primary aim of this study is to evaluate user experiences with the NoHoW Toolkit (TK)—a DBCI that targets weight loss maintenance—over a 12-month period by using a mixed methods approach and to identify the main strengths and weaknesses of the TK and the external factors affecting its adoption. The secondary aim is to objectively describe the measured use of the TK and its association with user experience. METHODS An 18-month, 2×2 factorial randomized controlled trial was conducted. The trial included 3 intervention arms receiving an 18-week active intervention and a control arm. The user experience of the TK was assessed quantitatively through electronic questionnaires after 1, 3, 6, and 12 months of use. The questionnaires also included open-ended items that were thematically analyzed. Focus group interviews were conducted after 6 months of use and thematically analyzed to gain deeper insight into the user experience. Log files of the TK were used to evaluate the number of visits to the TK, the total duration of time spent in the TK, and information on intervention completion. RESULTS The usability level of the TK was rated as satisfactory. User acceptance was rated as modest; this declined during the trial in all the arms, as did the objectively measured use of the TK. The most appreciated features were weekly emails, graphs, goal setting, and interactive exercises. The following 4 themes were identified in the qualitative data: engagement with features, decline in use, external factors affecting user experience, and suggestions for improvements. CONCLUSIONS The long-term user experience of the TK highlighted the need to optimize the technical functioning, appearance, and content of the DBCI before and during the trial, similar to how a commercial app would be optimized. In a trial setting, the users should be made aware of how to use the intervention and what its requirements are, especially when there is more intensive intervention content. CLINICALTRIAL ISRCTN Registry ISRCTN88405328; https://www.isrctn.com/ISRCTN88405328 INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2019-029425

El objetivo del estudio fue evaluar, desde la teoría de la autodeterminación, el rol de los procesos motivacionales como predictores de la práctica de la actividad física durante el tiempo libre de los estudiantes universitarios colombianos. 193 estudiantes completaron cuestionarios autoadministrados sobre la percepción del apoyo del docente de educación física, satisfacción y frustración de necesidades psicológicas básicas, regulación motivacional, percepción del soporte social y actividad física durante el tiempo libre. El modelo evidenció correlación positiva y significativa entre el apoyo y la satisfacción de las necesidades psicológicas básicas, la motivación autodeterminada y el apoyo social para la actividad física total y la actividad física moderada-vigorosa, resultados coincidentes con el análisis de regresión multinomial y de manera parcial con la regresión lineal, en el cual se destacaron la edad, la motivación autónoma y el apoyo a la autonomía como predictores significativos. La actividad física durante el tiempo libre puede predecirse a partir de factores motivacionales y la experiencia de los estudiantes en la clase de educación física en el contexto escolar.

© 2021 The Author(s) Published by S. Karger AG, Basel. This article is licensed under the Creative Commons Attribution- NonCommercial-NoDerivatives 4.0 International License (CC BY- NC-ND) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission., There is substantial evidence documenting the effects of behavioural interventions on weight loss (WL). However, behavioural approaches to initial WL are followed by some degree of longer-term weight regain, and large trials focusing on evidence-based approaches to weight loss maintenance (WLM) have generally only demonstrated small beneficial effects. The current state-of-the-art in behavioural interventions for WL and WLM raises questions of (i) how we define the relationship between WL and WLM, (ii) how energy balance (EB) systems respond to WL and influence behaviours that primarily drive weight regain, (iii) how intervention content, mode of delivery and intensity should be targeted to keep weight off, (iv) which mechanisms of action in complex interventions may prevent weight regain and (v) how to design studies and interventions to maximise effective longer-term weight management. In considering these issues a writing team within the NoHoW Consortium was convened to elaborate a position statement, and behaviour change and obesity experts were invited to discuss these positions and to refine them. At present the evidence suggests that developing the skills to self-manage EB behaviours leads to more effective WLM. However, the effects of behaviour change interventions for WL and WLM are still relatively modest and our understanding of the factors that disrupt and undermine self-management of eating and physical activity is limited. These factors include physiological resistance to weight loss, gradual compensatory changes in eating and physical activity and reactive processes related to stress, emotions, rewards and desires that meet psychological needs. Better matching of evidence-based intervention content to quantitatively tracked EB behaviours and the specific needs of individuals may improve outcomes. Improving objective longitudinal tracking of energy intake and energy expenditure over time would provide a quantitative framework in which to understand the dynamics of behaviour change, mechanisms of action of behaviour change interventions and user engagement with intervention components to potentially improve weight management intervention design and evaluation., The NoHoW project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 643309. The Parker Institute, Bispebjerg and Frederiksberg Hospital is supported by a core grant from the Oak Foundation (grant agreement No. OCAY-18-774-OFIL).

BACKGROUND Behavioural interventions for weight loss maintenance have shown beneficial effects for weight loss maintenance. While the digital upgrade of behavioural interventions brings an enormous potential to tackle public health challenges, there is limited knowledge about the components of these interventions, i.e., its content, delivery and the theoretical approaches. OBJECTIVE To identify the core components of digital behaviour change interventions for weight loss maintenance targeting physical activity, in terms of: i) Behaviour Change Techniques; ii) Mechanisms of Action; iii) Modes of Delivery; iv) Dose; and v) Tailoring/Personalisation. In addition, the links between these components were investigated. METHODS A literature search was performed in 5 electronic databases: PubMed; Embase; CINHAL; PsycINFO, and Web of Science. Two reviewers independently screened the identified papers and extracted data related with the study characteristics and behaviour change techniques, mechanism of action, mode of delivery, dose, and tailoring, using standardized classifications whenever available (e.g., behaviour change techniques taxonomy). RESULTS Seventeen articles reporting eleven original studies were selected. Two studies were protocols, nine studies presented results for weight change and all but one showed no significant differences between the intervention and control groups. Eight studies (73%) provided adequate information on Behaviour Change Techniques. Five studies (45%) provided partial information about how the Behaviour Change Techniques were linked to mechanisms of action, and only one study (0.9%) described these links for all the techniques. Around half of the studies reported the modes through which behaviour change techniques were delivered. Descriptions of dose were present in most studies, but with minimal information. The use of tailoring or personalisation approaches was mentioned in eight studies (73%), but descriptions of what was tailored and how were minimal. CONCLUSIONS The compilation of information regarding intervention components was difficult due to the lack of information and systematisation in reporting across papers. This is particularly true for the reporting of the links between behaviour change techniques and the other core intervention components. This information is crucial to help us understand in the context of behaviour change interventions what works or does not work, how it works and why.

Objective To examine short- and long-term effects of a group singing program on older adults' perceived physical and mental health levels, and also investigate subjective well-being (life satisfaction, positive/negative affect and hedonic balance), body balance and serum biomarkers (C-reactive protein and erythrocyte sedimentation rate) as putative mediating mechanisms, controlling for the cognitive status of the participants. Design: The randomized controlled trial included 149 participants (60 to 95 years), allocated to an immediate intervention group (IG) or a wait-list active control group (WLG). The intervention comprised 34 sessions of group singing during 4-months. Main outcome measures: Self-report measures of physical health, anxiety, stress, and depression. Blinded assessments were conducted at baseline, post-intervention (4 months) and follow-up (6 months). Results: Participants in the IG reported a lower decline in perceived physical health after the intervention, as compared to the WLG. These benefits were maintained at follow-up. Singing-related changes in physical and mental health outcomes were mediated via an increase in positive affect. Moderation results showed that participants with very low cognitive functioning reported more anxiety and depression symptoms after the intervention. Conclusions: These findings provide further understanding on the psychological and physical mechanisms and effects of group singing in older adults. Portugal’s Participatory Budget (Project n.° 626, OPP 2017; Dispatch n.° 11409 C/2017) info:eu-repo/semantics/publishedVersion

Background The current approaches used to develop coaches within many sport organisations extend beyond merely the professional knowledge related to sport-specific aspects. Effective coaching notably entails intrapersonal skills related to learning through experience and developing one’s own approach, and these skills are often targeted in coach development. Recognising that researchers have delivered Coach Development Programs (CDPs) that use strategies like reflective practice to foster coaches’ strategies and attitudes toward reflection, reviewing research in this domain could inform the development of our field. We conducted the current review to examine nonformal intrapersonal CDPs within the academic literature with goals of summarising existing CDPs, while also identifying factors related to their implementation. Method: The PRISMA guidelines informed our search strategy, including a database search along with supplemental strategies to identify studies. In addition to describing the CDPs generally, each study was also coded for: (a) potential to be implemented and maintained in sport contexts, (b) behaviour change techniques (BCTs), and (c) risk of bias. Results: After screening the full-texts of studies, we identified 10 unique intrapersonal CDPs. Most CDPs entailed pilot investigations of small samples, involving both qualitative and quantitative methods focused on coaches’ experiences when using reflective strategies. The majority of CDPs were conducted in-person and in one-on-one contexts. The most frequently used BCT was self-monitoring of behaviour, and low-to-moderate information was reported regarding internal and external validity. Conclusions: Whereas reflective practice may enable coach development, researchers must seek opportunities to design higher-quality intervention studies that are designed to enhance both internal and external validity.

The World Health Organization (WHO) released the 2020 global guidelines on physical activity and sedentary behaviour. The new guidelines contain a significant change from the 2010 guidelines on physical activity for adults and older adults that has important implications for next-generation physical activity messaging: The removal of the need for aerobic activity to occur in bouts of at least 10 min duration. This change in the guidelines provides an opportunity to communicate in new ways that align with behavioural science, permitting physical activity communicators and promoters to better support people’s psychological needs, motivation, and ability to fit healthy levels of physical activity into their lives. The frames and messages we use to communicate about the guidelines matter because they influence whether activity is perceived as relevant, meaningful, and feasible – or not. When developing new physical activity communications there are some overarching principles, based on behavioural science, to keep in mind. Using established theory, this commentary aims to support the creation of more strategic frames and messages for increasing the value and integration of physical activity into daily living. Country-specific physical activity campaigns using these ideas will be discussed.

BACKGROUND Many weight loss programs show short-term effectiveness, but subsequent weight loss maintenance is difficult to achieve. Digital technologies offer a promising means of delivering behavior change approaches at low costs and on a wide scale. The Navigating to a Healthy Weight (NoHoW) project, which was funded by the European Union’s Horizon 2020 research and innovation program, aimed to develop, test, and evaluate a digital toolkit designed to promote successful long-term weight management. The toolkit was tested in an 18-month, large-scale, international, 2×2 factorial (motivation and self-regulation vs emotion regulation) randomized controlled trial that was conducted on adults with overweight or obesity who lost ≥5% of their body weight in the preceding 12 months before enrollment into the intervention. OBJECTIVE This paper aims to describe the development of the NoHoW Toolkit, focusing on the logic models, content, and specifications, as well as the results from user testing. METHODS The toolkit was developed by using a systematic approach, which included the development of the theory-based logic models, the selection of behavior change techniques, the translation of these techniques into a web-based app (NoHoW Toolkit components), technical development, and the user evaluation and refinement of the toolkit. RESULTS The toolkit included a set of web-based tools and inputs from digital tracking devices (smart scales and activity trackers) and modules that targeted weight, physical activity, and dietary behaviors. The final toolkit comprised 34 sessions that were distributed through 15 modules and provided active content over a 4-month period. The motivation and self-regulation arm consisted of 8 modules (17 sessions), the emotion regulation arm was presented with 7 modules (17 sessions), and the combined arm received the full toolkit (15 modules; 34 sessions). The sessions included a range of implementations, such as videos, testimonies, and questionnaires. Furthermore, the toolkit contained 5 specific data tiles for monitoring weight, steps, healthy eating, mood, and sleep. CONCLUSIONS A systematic approach to the development of digital solutions based on theory, evidence, and user testing may significantly contribute to the advancement of the science of behavior change and improve current solutions for sustained weight management. Testing the toolkit by using a 2×2 design provided a unique opportunity to examine the effect of motivation and self-regulation and emotion regulation separately, as well as the effect of their interaction in weight loss maintenance.

Background: Many weight loss programs show short-term effectiveness, but subsequent weight loss maintenance is difficult to achieve. Digital technologies offer promising means to delivering behaviour change approaches at low cost and on a wide scale. The NoHoW project was a European Commission H2020-funded project aimed to develop, test, and evaluate a digital Toolkit designed to promote successful long-term weight management. The Toolkit was tested in an 18-month large-scale international 2 x 2 factorial (motivation and self-regulation versus emotion regulation) randomised controlled trial, conducted in overweight/obese adults who lost ≥5% of their body weight in the preceding twelve months before enrolment into the intervention. Objective: This paper describes the development of the NoHoW Toolkit focusing on the logic models, content and specifications, and results from user testing.Methods: The Toolkit was developed using a systematic approach including (1) development of the theory-based logic models, (2) selection of behaviour change techniques, (3) translation of these techniques into a digital web-based app (NoHoW Toolkit components), (4) technical development, (5) user evaluation and refinement of the Toolkit.Results: The Toolkit included a set of web-based tools and inputs from digital tracking devices (smart scales and activity trackers), with modules targeting weight, physical activity, and dietary behaviours. The final Toolkit was comprised of 34 sessions, distributed through 15 modules, providing active content over a 4-month period. The motivation and self-regulation arm consisted of 8 modules (17 sessions), the emotion regulation arm was presented with 7 modules (17 sessions), and the combined arm received the full Toolkit (15 modules, 34 sessions). The sessions included a range of implementations, such as videos, testimonies, and questionnaires. Further, the Toolkit contained 5 specific data tiles for monitoring weight, steps, healthy eating, mood and sleep. Conclusions: A systematic approach to the development of digital solutions based on theory, evidence, and user testing, may significantly contribute to the advancement of the science of behaviour change and improve current solutions for sustained weight management. Testing the Toolkit using a 2x2 design provided a unique opportunity to examine the effect of motivation and self-regulation and emotion regulation separately, as well as the effect of their interaction in weight loss maintenance.

Neck circumference (NC) has been proposed as a simple and practical tool, independently associated with cardiometabolic risk factors. However, the association of NC with inter-muscular adipose tissue (IMAT) is still to be determined. We aimed to examine the association of NC with thigh IMAT, and visceral adipose tissue (VAT) measured with computed tomography (CT) in overweight/obese women. 142 premenopausal overweight and obese Caucasian women participated in this cross-sectional study. NC was measured with an inextensible metallic tape above the thyroid cartilage according to International Society for Advancement of Kinanthropometry protocol. Thigh IMAT and VAT volumes were measured with a single cross-sectional CT. Regarding the covariates, fat mass (FM) was assessed with dual-energy x-ray absorptiometry and physical activity was objectively measured with accelerometry. NC was positively associated with thigh IMAT and VAT volumes (standardized β coefficient: β = 0.45, P-value = ≤0.001, β = 0.60, P = ≤ 0.001; respectively), which persisted after adjusting for age, height, overall FM or moderate-to-vigorous physical activity. Our findings show that NC is associated with thigh IMAT volume in overweight and obese premenopausal Caucasian women, regardless of the amount of lower-body fatness. These results suggest underscoring the relevance of NC as a marker of adipose tissue content in thigh skeletal muscle.

Background Several studies have suggested that reduced sleep duration and quality are associated with an increased risk of obesity and related metabolic disorders, but the role of sleep in long-term weight loss maintenance (WLM) has not been thoroughly explored using prospective data. Methods and findings The present study is an ancillary study based on data collected on participants from the Navigating to a Healthy Weight (NoHoW) trial, for which the aim was to test the efficacy of an evidence-based digital toolkit, targeting self-regulation, motivation, and emotion regulation, on WLM among 1,627 British, Danish, and Portuguese adults. Before enrolment, participants had achieved a weight loss of ≥5% and had a BMI of ≥25 kg/m2 prior to losing weight. Participants were enrolled between March 2017 and March 2018 and followed during the subsequent 12-month period for change in weight (primary trial outcome), body composition, metabolic markers, diet, physical activity, sleep, and psychological mediators/moderators of WLM (secondary trial outcomes). For the present study, a total of 967 NoHoW participants were included, of which 69.6% were women, the mean age was 45.8 years (SD 11.5), the mean baseline BMI was 29.5 kg/m2 (SD 5.1), and the mean weight loss prior to baseline assessments was 11.4 kg (SD 6.4). Objectively measured sleep was collected using the Fitbit Charge 2 (FC2), from which sleep duration, sleep duration variability, sleep onset, and sleep onset variability were assessed across 14 days close to baseline examinations. The primary outcomes were 12-month changes in body weight (BW) and body fat percentage (BF%). The secondary outcomes were 12-month changes in obesity-related metabolic markers (blood pressure, low- and high-density lipoproteins [LDL and HDL], triglycerides [TGs], and glycated haemoglobin [HbA1c]). Analysis of covariance and multivariate linear regressions were conducted with sleep-related variables as explanatory and subsequent changes in BW, BF%, and metabolic markers as response variables. We found no evidence that sleep duration, sleep duration variability, or sleep onset were associated with 12-month weight regain or change in BF%. A higher between-day variability in sleep onset, assessed using the standard deviation across all nights recorded, was associated with weight regain (0.55 kg per hour [95% CI 0.10 to 0.99]; P = 0.016) and an increase in BF% (0.41% per hour [95% CI 0.04 to 0.78]; P = 0.031). Analyses of the secondary outcomes showed that a higher between-day variability in sleep duration was associated with an increase in HbA1c (0.02% per hour [95% CI 0.00 to 0.05]; P = 0.045). Participants with a sleep onset between 19:00 and 22:00 had the greatest reduction in diastolic blood pressure (DBP) (P = 0.02) but also the most pronounced increase in TGs (P = 0.03). The main limitation of this study is the observational design. Hence, the observed associations do not necessarily reflect causal effects. Conclusion Our results suggest that maintaining a consistent sleep onset is associated with improved WLM and body composition. Sleep onset and variability in sleep duration may be associated with subsequent change in different obesity-related metabolic markers, but due to multiple-testing, the secondary exploratory outcomes should be interpreted cautiously. Trial registration The trial was registered with the ISRCTN registry (ISRCTN88405328)., Sofus Larsen and colleagues reveal the importance of consistent sleep patterns to avoid weight gain after weight loss, Author summary Why was this study done? Weight loss maintenance (WLM) is the greatest challenge in successful treatment of obesity. While several studies have suggested that reduced sleep duration and quality are associated with an increased risk of obesity, the role of sleep in long-term WLM has not been thoroughly examined. What did the researchers do and find? This study included a total of 967 men and women who had achieved a clinically significant weight loss (≥5%) during the last 12 months and had a BMI of ≥25 kg/m2 prior to their weight loss. Sleep duration, sleep duration variability, sleep onset, and sleep onset variability were assessed across 14 days close to baseline examinations using the Fitbit Charge 2 (FC2) device, and changes in body weight (BW), composition, and obesity-related metabolic markers were followed up after 12 months. While no associations were found between sleep duration, sleep duration variability, or sleep onset and subsequent WLM, participants with a more variable sleep onset at baseline regained more weight and had a higher increase in body fat percentage (BF%) during the 12-month follow-up period. What do these findings mean? These results suggest that maintaining a consistent sleep onset may be associated with improved WLM and body composition. Due to the observational design, the study cannot confirm whether this relationship is causal or a reflection of different personality traits related to sleep onset variability and energy balance behaviours.

According to the Self-Determination Theory, perceived job pressures can coerce professionals to develop more controlled motivations towards their work, and consequently increase the probability of using controlling motivational strategies. This study sought to analyze work-related motivations as mediators between two types of perceived job pressures: organizational constraints and perceptions of clients&rsquo, controlled motivation and the use of controlling motivational strategies by exercise professionals. Using a cross-sectional design, involving 366 exercise professionals (172 women), mediation paths were assessed following Preacher and Hayes statistical procedures. Models were adjusted for gender, work experience (years), and the internal tendency to feel events as pressuring. Organizational constraints were associated with lower autonomous motivation for work and the use of controlling strategies. Perceptions of clients&rsquo, controlled motivation were associated with work-related amotivation and the use of controlling strategies. Amotivation mediated the association between organizational constraints and controlling strategies. Overall, results support theoretical predictions and previous research, extending it to the exercise domain, highlighting the interplay between job pressures, work-related motivations, and the use of controlling strategies. The understanding of what influences exercise professionals&rsquo, motivation, and consequently the motivational strategies they use, is of paramount importance for exercise promotion and the benefit of those who seek their expert guidance.

espanolLa actividad fisica tiene un papel prometedor en la gestion de los efectos colaterales de los canceres hematologicos, que son tumores de los tejidoshematopoyeticos o linfoides. En ese sentido, se realizo una revision sistematica con el objetivo de analizar la asociacion entre la actividad fisica y lacalidad de vida en sobrevivientes de cancer hematologico sin tratamiento. Se utilizaron las bases de datos: PsycINFO, SportDiscus y Pubmed, con loscriterios de inclusion en el estudio: estudios aleatorizados controlados, estudios clinicos controlados y estudios observacionales. Se encontraron 115estudios posiblemente relevantes y se incluyeron en la revision 6 estudios, con un total de 1502 participantes (50.01% mujeres, edad media de 60.8anos). La calidad de los metodos se considero debil. Aunque de las diferentes especificidades metodologicas, se verifico una asociacion positiva entre lapractica de actividad fisica y la calidad de vida en varios dominios. Para conclusiones mas consistentes, se necesitaran mas estudios sin las limitacionesobservadas. EnglishPhysical activity has a promising role in the management of collateral effects of hematologic cancers, which are tumors of hematopoietic or lymphoidtissues. In this sense, a systematic review was carried out to analyze the association between physical activity and quality of life in hematologic cancersurvivors not under treatment. PsycINFO, SportDiscus and Pubmed databases were screened for randomized controlled trials, controlled clinical studies,and observational studies. We found 115 potentialy relevant studies, from which six were selected in total of 1502 participants (50.01% women, meanage of 60.8 years). The quality of the methods was considered weak. Despite the different methodological characteristics, there was a positive associationbetween physical activity and quality of life and several domains. Aiming for consistent conclusions, further studies are needed. portuguesA atividade fisica tem um papel promissor na gestao dos efeitos colaterais dos cancros hematologicos, que sao tumores dos tecidos hematopoieticos oulinfoides. Nesse sentido, realizou-se uma revisao sistematica com o objetivo de analisar a associacao entre a atividade fisica e a qualidade de vida emsobreviventes de cancro hematologico nao sob tratamento. Foram utilizadas as bases de dados: PsycINFO, SportDiscus e Pubmed, com os criterios deinclusao no estudo: estudos randomizados controlados, estudos clinicos controlados e estudos observacionais. Encontraram-se 115 estudospossivelmente relevantes e foram incluidos na revisao 6 estudos, perfazendo um total de 1502 participantes (50.01% mulheres, idade media de 60.8anos). A qualidade dos metodos foi considerada fraca. Apesar das diferentes especificidades metodologicas, verificou-se uma associacao positiva entre apratica de atividade fisica e a qualidade de vida em varios dominios. Para conclusoes mais consistentes, serao necessarios mais estudos que colmatem aslimitacoes observadas.

Long-term weight management requires sustained engagement with energy-balance-related behaviours. According to self-determination theory, behaviour goals can support or undermine motivation depending on the quality of their content (i.e., extrinsic and intrinsic motivation). This study aimed to develop and validate the goal content for weight loss maintenance scale (GCWMS).The GCWMS was administered to 1511 participants who had achieved clinically significant weight losses and were taking part in a large weight loss maintenance study: the NoHoW Trial (ISRCTN88405328). The scale derived from two well-established questionnaires regarding exercise goals. Construct validity was examined for 4 theory-driven domains: Health Management, Challenge, Image, and Social Recognition. Split-sample confirmatory factor analysis was conducted to test the factorial validity and multi-group measurement invariance (configural, metric, scalar, and residual invariance). The reliability estimates were also assessed, and discriminant validity was evaluated using 2 conceptually related questionnaires.The first analysis showed a poor fit of the original factorial structure. Subsequent investigation with a new specified model indicated close fit to the data after removal of 3 items χFindings support the hypothesised four-dimension structure of the GCWMS, confirming reliability and multi-group invariance in factor structure. Analysis also supports valid group means comparisons on latent factors at gender and at cross-cultural level. Ways to improve the quality of the scale are discussed.Level V, cross-sectional descriptive.

Objective To identify the core components of digital behaviour change interventions for weight loss maintenance targeting physical activity, in terms of: (i) behaviour change techniques, (ii) mechanisms of action, (iii) modes of delivery, (iv) dose and (v) tailoring/personalization. In addition, the links between these components were investigated. Methods A literature search was performed in five electronic databases: PubMed, Embase, CINHAL, PsycINFO and Web of Science. Two reviewers independently screened the identified articles and extracted data related with the study characteristics and behaviour change techniques, mechanism of action, mode of delivery, dose, and tailoring, using standardized classifications whenever available (e.g. behaviour change techniques taxonomy). Results Seventeen articles reporting 11 original studies were selected. Two studies were protocols, 9 studies presented results for weight change and all but one showed no significant differences between the intervention and control groups. Eight studies (73%) provided adequate information on behaviour change techniques. Five studies (45%) provided partial information about how the behaviour change techniques were linked to mechanisms of action, and only one study (0.9%) described these links for all the techniques. Around half of the studies reported the modes through which behaviour change techniques were delivered. Descriptions of dose were present in most studies, but with minimal information. The use of tailoring or personalization approaches was mentioned in eight studies (73%), but descriptions of what was tailored and how were minimal. Conclusions The compilation of information regarding intervention components was difficult due to the lack of information and systematization in reporting across papers. This is particularly true for the reporting of the links between behaviour change techniques and the other core intervention components. This information is crucial to help us understand in the context of behaviour change interventions what works or does not work, how it works and why.

Not all exercisers experience the same psychological benefits. The understanding of motivational processes and their relation with emotional consequences of exercise should be considered in the context of the exercisers motivation. This was a cross-sectional study of 153 gym users (M = 36.21 years, SD = 8.44; 44.9% men, 55.1% women; M years exercise = 8). Weekly attendance averaged 4.3 (SD = 2.6) sessions per week; reported exertion intensity was 5.6 (SD = 2.1) (scale: 0–11). The basic psychological needs (BPNs) posited by self-determination theory, motivational regulation, and emotional response to physical activity, were measured. Possible mediators of BPN-emotion relationships were analyzed. BPN satisfaction was associated with a positive emotional response to exercise which was partially mediated by the effect of autonomous regulation on positive activation and psychological well-being. Mediation models indicated that the negative effects of BPN frustration were counteracted by autonomous regulation. Exercise professionals should be able to create psychologically supportive contexts and identify behaviors associated with need frustration so as to enhance emotional responses to exercise.

Purpose Coaches' motivation is central to their coaching, however, few studies have examined coaches' motivation in different cultures. The aim of this study was to provide initial validation of the Portuguese version of the Coach Motivation Questionnaire. Method The participants were 369 coaches from various sports (males = 288) aged between 18 and 67 years old (M = 32.4, SD = 11.04). Confirmatory factor analysis, discriminant and nomological validity, and invariance across gender, team/individual sports and coaching experience were analysed. Results The hypothesised six-factor structure obtained acceptable values with the following robust adjustment indices: RTLI = .902; RCFI = .921; RGFI = .904 and RRMSEA (90% CI) = .066 (.058–.074). The amended model also showed high factor weights (λ ≥ .500) and appropriate individual reliabilities (λ2 ≥ .25). The instrument's internal consistency was assessed by Cronbach's alpha (.646–.898) and composite reliability (.662–.900). Regarding discriminant validity, correlations among the factors were in general according to the hypothesised patterns, where closer factors were positively related and not close factors were less strongly related. Regarding nomological validity, results supported for the hypothesised relationships through the associations with measures of motivation at work, need satisfaction and need frustration. Lastly, the measurement model met configural and metric invariance across gender and coaching experience and also met configural invariance across team/individual sports. Conclusions The evidence from this study suggests that the Portuguese Coach Motivation Questionnaire is a promising and parsimonious questionnaire to assess coaches' motivation, albeit its development remains a work in progress.

Aim\ud Motivation to take up and maintain a healthy lifestyle is key to diabetes prevention and management. Motivations are driven by factors on the psychological, biological and environmental levels, which have each been studied extensively in various lines of research over the past 25 years. Here, we analyse and reflect on current and emerging knowledge on motivation in relation to lifestyle behaviours, with a focus on people with diabetes or obesity. Structured according to psychological, (neuro‐)biological and broader environmental levels, we provide a scoping review of the literature and highlight frameworks used to structure motivational concepts. Results are then put in perspective of applicability in (clinical) practice.\ud \ud Results\ud Over the past 25 years, research focusing on motivation has grown exponentially. Social–cognitive and self‐determination theories have driven research on the key motivational concepts ‘self‐efficacy’ and ‘self‐determination’. Neuro‐cognitive research has provided insights in the processes that are involved across various layers of a complex cortical network of motivation, reward and cognitive control. On an environmental – more upstream – level, motivations are influenced by characteristics in the built, social, economic and policy environments at various scales, which have provided entry points for environmental approaches influencing behaviour.\ud \ud Conclusions\ud Current evidence shows that motivation is strongly related to a person's self‐efficacy and capability to initiate and maintain healthy choices, and to a health climate that supports autonomous choices. Some approaches targeting motivations have been shown to be promising, but more research is warranted to sustainably reduce the burden of diabetes in individuals and populations.

Background\ud Commercial physical activity monitors have wide utility in the assessment of physical activity in research and clinical settings, however, the removal of devices results in missing data and has the potential to bias study conclusions. This study aimed to evaluate methods to address missingness in data collected from commercial activity monitors.\ud \ud Methods\ud This study utilised 1526 days of near complete data from 109 adults participating in a European weight loss maintenance study (NoHoW). We conducted simulation experiments to test a novel scaling methodology (NoHoW method) and alternative imputation strategies (overall/individual mean imputation, overall/individual multiple imputation, Kalman imputation and random forest imputation). Methods were compared for hourly, daily and 14-day physical activity estimates for steps, total daily energy expenditure (TDEE) and time in physical activity categories. In a second simulation study, individual multiple imputation, Kalman imputation and the NoHoW method were tested at different positions and quantities of missingness. Equivalence testing and root mean squared error (RMSE) were used to evaluate the ability of each of the strategies relative to the true data.\ud \ud Results\ud The NoHoW method, Kalman imputation and multiple imputation methods remained statistically equivalent (p

Luis Lopes is supported by the Portuguese Foundation for Science and Technology (CEECIND/01089/2017 and FCT/UIDB/00617/2020); Rute Santos is supported by the Portuguese Foundation for Science and Technology (CEECIND/01069/2017 and FCT/UIDB/00617/2020); Jorge Mota, Carla Moreira, Cesar Agostinis-Sobrinho, Pedro Silva and Eduarda Sousa-Sa are supported by the Portuguese Foundation for Science and Technology (FCT/UIDB/00617/2020); Erik Sigmund is supported by grant No. 19-03276S from the Czech Science Foundation; Irene Esteban-Cornejo is supported by the Spanish Ministry of Economy and Competitiveness (RTI2018-095284-J-100) and by the Spanish Ministry of of Science and Innovation (RYC2019-027287-I); Jaime Carcamo-Oyarzun is supported by the National Commission for Scientific Research and Technology of Chile (CONICYT-FONDECYT 11170525); Jonatan Ruiz is supported by the University of Granada Plan Propio de Investigacion 2016 (Excellence actions: Unit of Excellence on Exercise and Health [UCEES]), by the European Regional Development Fund (ERDF), by the Junta de Andalucia, Consejeria de Conocimiento, Investigacion y Universidades (ref. SOMM17/6107/UGR); Antonio Garcia-Hermoso is a Miguel Servet Fellow (Instituto de Salud Carlos III-FSE, CP18/0150)., Lack of physical activity is a global public health problem causing not only morbidity and premature mortality, but it is also a major economic burden worldwide. One of the cornerstones of a physically active lifestyle is Motor Competence (MC). MC is a complex biocultural attribute and therefore, its study requires a multi-sectoral, multi-, inter- and transdisciplinary approach. MC is a growing area of research, especially in children and adolescents due to its positive association with a plethora of health and developmental outcomes. Many questions, however, remain to be answered in this field of research, with regard to: (i) Health and Developmental-related Associations of MC; (ii) Assessment of MC; (iii) Prevalence and Trends of MC; (iv) Correlates and Determinants of MC; (v) MC Interventions, and (vi) Translating MC Research into Practice and Policy. This paper presents a narrative review of the literature, summarizing current knowledge, identifying key research gaps and presenting questions for future investigation on MC in children and adolescents. This is a collaborative effort from the International Motor Competence Network (IMCNetwork) a network of academics and researchers aiming to promote international collaborative research and knowledge translation in the expansive field of MC. The knowledge and deliverables generated by addressing and answering the aforementioned research questions on MC presented in this review have the potential to shape the ways in which researchers and practitioners promote MC and physical activity in children and adolescents across the world., Portuguese Foundation for Science and Technology FCT/UIDB/00617/2020 CEECIND/01089/2017 CEECIND/01069/2017, Grant Agency of the Czech Republic 19-03276S, Spanish Ministry of Economy and Competitiveness RTI2018-095284-J-100, Spanish Ministry of of Science and Innovation RYC2019-027287-I, National Commission for Scientific Research and Technology of Chile (CONICYT-FONDECYT) 11170525, University of Granada Plan Propio de Investigacion, European Commission, Junta de Andalucia SOMM17/6107/UGR, Miguel Servet Fellow (Instituto de Salud Carlos III-FSE) CP18/0150

Background Singing is a multimodal activity that requires physical, cognitive and psychosocial performance, with benefits to various domains of well-being and health in older adults. In recent years, research has increasingly studied group singing as an important cost-effective intervention to promote active and healthy aging. However, the specific factors responsible for these benefits need further experimental support, as most studies do not allow for causal inferences. This study responds to the need for further randomized controlled trials (RCT), with follow-up measurement, on the benefits of group singing in older adults from a low socioeconomic background. Also, while most studies often focus on specific outcome measure dimensions, in this study, the conjoint effect of several physical, psychosocial, psychoemotional and cognitive dimensions are analyzed, testing mediation effects of psychosocial and psychoemotional variables on the well-being and health of the participants. Methods We implement and measure the effects of a singing group program for older adults, with an RCT crossover design study, in a natural context, before and after the intervention and in a follow-up, 6 months after the intervention. Participants 140 retired older adults (> 60 years) users of a social support institution, will be invited to participate in a singing group program and randomly allocated to an experimental (n = 70) and a control (n = 70) group, which will enroll in the regular activities proposed by the institution. The intervention consists of 34 bi-weekly group singing sessions, of 2 h each, for 4 months. Measures on social and emotional well-being, cognitive function, and health indicators (e.g., blood pressure, glycemia, cholesterol, c-reactive protein, sedimentation rate, respiratory function, body balance, sleep quality, medication intake, and health services attendance) will be collected. Interviews will be conducted on the motivation and perceived benefits of participation. Discussion Significant improvements are expected in the outcome measures in the experimental group after the intervention, validating singing groups as a cost-effective intervention for healthy aging. Psychosocial and psychoemotional variables are expected to be mediators of the effects of the program in the cognitive function, well-being and health of the participants. Trial registration NCT03985917. Registered 14th June 2019 (retrospectively registered).

Research into the factors associated with the use of different motivational strategies by exercise professionals is of empirical and practical utility. Grounded in self-determination theory, this study sought to analyze putative antecedents, mediators, and work-related well- and ill-being consequences of two types of motivational strategies reported by exercise professionals. Participants were 366 exercise professionals (193 males; experience = 7.7 ± 5.8 years). Questionnaires assessing psychological need satisfaction frustration, self-determined work motivation, motivational strategies (need-supportive vs. controlling), emotional exhaustion, and personal accomplishment were completed online. Path analysis was used to test the hypothesized model. Model with good fit [χ 2 (5) = 9.174, p> .05; CFI = .984; TLI = .936; RMSEA = .048; SRMR = .022] showed need satisfaction as positively associated with supportive strategies and personal accomplishment (β between .267 and .399) and negatively with emotional exhaustion (β = −.145). Need frustration was negatively associated with work motivation and personal accomplishment (β = −.315; −.176), and positively with controlling strategies and emotional exhaustion (β = .195; .226). Furthermore, supportive strategies and work motivation were positively associated with personal accomplishment (β = .134; .184), whereas controlling strategies were positively associated with emotional exhaustion (β = .178). Findings have theoretical implications, providing evidence of need satisfaction and frustration as being differently associated with work-related motivation, type of strategies used, and work-related emotional outcomes. Practical implications convey the importance of these variables in relation to the standard of motivational strategies provided and their role on work-related well- and ill-being indicators.