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Promoting maintenance of regular physical activity (PA) is a public health priority; however, to the authors' knowledge, no researchers to date have examined whether the expectancies of proximal PA enactment are similar to the expectancies of longer maintenance. Thus, the authors' purpose in this study was to evaluate whether PA expectancies, measured with constructs of the theory of planned behavior (TPB), varied as a function of time frame (no time frame, next week, next month, next 6 months). Undergraduate students (N = 409) completed randomly distributed self-report measures of the TPB; the authors then compared results across the 4 groups (formed on the basis of time frame). Analysis of variance tests showed that 13 of 37 constructs were significantly (p <.05) different, and post hoc follow-up tests identified that the proximal time frame (ie, next week) had the significantly lowest mean value. Chi-square tests of independent correlations, however, revealed few differences in TPB-intention correlations by time frame. The results suggest that social cognitive correlates of PA intention are robust to timeframe deviations but that time frame may affect the absolute values of some constructs. Overall, this is a positive finding because it suggests that PA promotion efforts focused on increasing expectancies do not have to be tailored to proximal or more distal maintenance applications. [ABSTRACT FROM AUTHOR]

Background: Exercise is associated with an improved quality of life among cancer survivors. Previous research has highlighted the utility of the theory of planned behavior in understanding cancer survivors' intention to exercise. The purpose of this study was to extend the research on the theory of planned behavior in relation to exercise intention in breast cancer survivors and to provide preliminary evidence supporting its application with prostate cancer survivors during treatment. METHODS: Participants consisted of 126 breast and 82 prostate cancer survivors receiving active treatment. Participants completed self-administered, mail-in questionnaires that assessed demographic and medical variables, past exercise, and the theory of planned behavior. RESULTS: For breast cancer survivors, the results revealed that attitudes, subjective norm, and perceived behavioral control explained 66% of the variance in exercise intention with the instrumental component of attitude, subjective norm, and perceived behavioral control making significant unique contributions to intention. For prostate cancer survivors, attitudes, subjective norm, and perceived behavioral control explained 57% of the variance in exercise intention, with subjective norm and perceived behavioral control making significant unique contributions to intention. CONCLUSIONS: The results provide further support that the theory of planned behavior is a useful framework for understanding determinants of exercise intention in breast cancer survivors undergoing active treatment and preliminary support for prostate cancer survivors undergoing active treatment. When designing exercise interventions, differences in breast and prostate cancer survivors' exercise intention merit consideration. [ABSTRACT FROM AUTHOR]

The theory of planned behavior (TPB) is a popular framework for under-standing the informational and motivational influences of exercise behavior. One tenet of this model that has not been examined is the belief that direct measures of TPB component constructs are organized through higher order constructs. The authors' purpose of this article was to test this higher order conceptualization in comparison with a multidimensional TPB model using structural equation modeling. Participants (N = 268) completed direct measures of the TPB and a 2-week follow-up of exercise behavior. The results generally supported multidimensional TPB constructs over higher order structures. Direct measures of attitude (ie, affective and instrumental) and subjective norm (ie, injunctive and descriptive) had better psychometric properties when considered multidimensionally. Perceived behavioral control (ie, self-efficacy, controllability), however, had estimation problems for both the multidimensional and the higher order model. Aggregation of TPB' components is not warranted, and the perceived behavioral control components may possess a structure more complex than simple multidimensionality or a super-ordinate higher order construct. [ABSTRACT FROM AUTHOR]

BACKGROUND: In this study, we describe the characteristics of the callers of the American Cancer Society's National Cancer Information Center (NCIC), why they called, how they learned about NCIC, and their satisfaction. METHODS: A random sample of callers (N = 19,487) completed a telephone survey. RESULTS: The majority were female, White, 45 to 74 years old, had incomes greater than 35,001 dollars, and were college educated. They learned about the NCIC through TV advertisements and requested information about specific cancers, local programs, or making donations. CONCLUSIONS: These findings validate the usefulness of the NCIC and are helpful in identifying and targeting persons who do not routinely use this service. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to compare cancer survivors on three different lifestyle behaviors (i.e., physical activity, fruit and vegetable (F&V) consumption, and smoking) and examine the association between these lifestyle behaviors and health-related quality of life (HRQOL). Breast (n = 123), colorectal (n = 86), and prostate (n = 107) cancer survivors completed a survey that included lifestyle behavior questions and the RAND-36 Health Status Inventory (HSI). Results showed that similar percentages of breast, colorectal, and prostate cancer survivors met the lifestyle behavior recommendations. Overall, 69.9 and 26.3% reported meeting the recommendations for physical activity and F&V consumption while 94.3% did not smoke. In addition, survivors who met the physical activity recommendation had significantly higher HRQOL than those who did not, however, meeting the F&V recommendation was not related to HRQOL. Nonetheless, survivors who met more than one lifestyle behavior recommendation had significantly higher HRQOL than those who only met one recommendation. Therefore, although it appears that F&V interventions are needed, it may be important to target more than one lifestyle behavior to obtain optimal HRQOL benefits. Importantly, results suggest that physical activity may be the key lifestyle behavior to include in multibehavioral interventions aimed at improving HRQOL. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the moderating influence of ethnicity on the theory of planned behavior (TPB) in the exercise domain and to generate common and ethnic-specific underlying accessible beliefs. METHODS: 90 Caucasian and 94 African American undergraduate students completed a TPB questionnaire. RESULTS: Multilevel modeling analyses indicated that ethnicity and gender interacted by moderating the relationships between exercise intention and effective (beta = -0.44) and instrumental (betaeta = 0.39) attitudes. Furthermore, common and ethnic-specific underlying accessible beliefs were identified. CONCLUSION: When exercise interventions are developed, ethnicity and gender may need to be considered when dealing with affective and instrumental attitudes. [ABSTRACT FROM AUTHOR]

Background: The present study examined the association between quality of life (QOL) in adult cancer survivors and the (a) absolute current amount of exercise and (b) change in exercise since cancer diagnosis.Methods: Three hundred fifty-two (mean age = 59.6) adult cancer survivors recruited from outpatient clinics in four states (Iowa, Wisconsin, Minnesota, and Georgia) and a minority support groups completed a survey including demographic, medical, exercise behavior, and QOL questions.Results: Hierarchical multiple regression analyses controlling for important demographic and medical variables showed that adult cancer survivors who currently exercised three times per week had significantly higher QOL than those who did not (beta = 0.13, P < 0.05). Furthermore, compared to adult cancer survivors who exercised less since their cancer diagnosis, those who maintained (beta = 0.28, P < 0.08) or increased (beta = 0.24, P < 0.01) the amount of exercise they performed since their cancer diagnosis had significantly higher QOL. Finally, examination of the DeltaR(2)(adjusted) between the two exercise models showed that the absolute current amount of exercise explained an additional 1% (DeltaR(2)(adjusted) = 0.01 P < 0.05) of the variance in QOL whereas the change in exercise explained an additional 7% (DeltaR(2)(adjusted) = 0.07, P < 0.01).Conclusion: Change in exercise since cancer diagnosis may be a more important correlate of QOL in adult cancer survivors than the absolute current amount of exercise. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine the effects of 5 different numerical response scales--continuous-open, dichotomous-yes/no, and continuous-closed numerical (CCN) with 3 different ranges of response frequencies (low, medium, high)--on the proportion of respondents defined as regular exercisers. METHODS: We randomly assigned 500 undergraduate students to complete 1 of the 5 numerical response scales. RESULTS: The percentage of participants defined as regular exercisers ranged from 14% in the CCN low-frequency group to 45% in the CCN high-frequency group [chi2 (4, 500) = 28.90; P<.001]. CONCLUSIONS: The different numerical response scales have a significant impact on the estimated percentage of regular exercisers. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine changes in lifestyle behaviors after a cancer diagnosis and medical and demographic influences on such changes. METHODS: Adult cancer survivors (n = 352) completed a survey including demographic, medical, and lifestyle behavior change questions. RESULTS: Results showed that since cancer diagnosis, 46% of smokers quit smoking, 47% improved their dietary habits, and 30.1% exercised less. Adult cancer survivors who changed their lifestyle behaviors varied, depending on various demographic and medical variables and physician recommendation. CONCLUSION: It appears from our data that cancer diagnosis in adults may have a positive influence on smoking and diet and a negative influence on exercise. [ABSTRACT FROM AUTHOR]

Purpose/Objectives: To examine the effects of an acute bout of exercise on state anxiety in breast cancer survivors. Design: A two-group (high and low state anxiety) by two-time (pre- and postexercise) mixed factorial design. Setting: Exercise physiology lab at the University of Alberta. Sample: 34 stage I or II breast cancer survivors ranging in age from 39-65 (mean=50.50; SD=6.62). Methods: Participants completed the State Anxiety Inventory prior to and five minutes following an acute bout of exercise. Main Research Variables: State anxiety. Findings: A main effect resulted for group (p<0.01) and time showing that state anxiety significantly decreased from pre- to postexercise (p<0.03). Group by time interaction showed that state anxiety for the low state anxiety group did not change from pre- to postexercise (p>0.05); however, state anxiety significantly decreased in the high state anxiety group (p<0.03). Conclusion: Acute exercise may be an effective intervention in reducing state anxiety in breast cancer survivors, especially those with high state anxiety. Implications for Nursing Practice: Oncology nurses should be aware that in addition to other traditional anxiolytic therapies (e.g., relaxation therapy) commonly prescribed, acute exercise is an effective method for reducing state anxiety in breast cancer survivors. [ABSTRACT FROM AUTHOR]

Background: Regular engagement in moderate-to-vigorous physical activity (MVPA) during childhood yields a myriad of health benefits, and contributes to sustained MVPA behaviors into adulthood. Given the influence of parents on shaping their child's MVPA behaviour, the family system represents a viable target for intervention. The purpose of this study is to compare the effects of two intervention conditions designed to increase child MVPA: (1) A standard education + planning intervention providing information about benefits, action planning, and coping planning; and (2) An augmented physical activity education + planning intervention that includes the components of the standard intervention, as well as a focus on family identity promotion and developing as an active member of the family., Methods: A two-arm parallel single-blinded randomized trial will compare the two conditions over 6 months. Eligible families have at least one child aged 6-12 years who is not meeting the physical activity recommendations within the Canadian 24-Hour Movement Guidelines (i.e.,<60 min/day of MVPA). Intervention materials targeting family identity promotion will be delivered online via zoom following baseline assessment, with booster sessions at 6-weeks and 3-months. Child MVPA will be measured by wGT3X-BT Actigraph accelerometry at baseline, 6-weeks, 3-months, and 6-months as the primary outcome. At these same time points, parent cognition (e.g., attitudes, perceived control, behavioral regulation, habit, identity) and support behaviours, and parent-child co-activity will be assessed via questionnaire as secondary outcomes. Child-health fitness measures will be also administered through fitness testing at baseline and 6-months as secondary outcomes. Finally, upon completion of the trial's 6-month measures, a follow-up end-of-trial interview will be conducted with parents to examine parents' experiences with the intervention., Results: So far, 30 families have been enrolled from the Southern Vancouver Island and Vancouver Lower Mainland area. Recruitment will be continuing through 2026 with a target of 148 families., Discussion: This study will contribute to the understanding of effective strategies to increase child physical activity by comparing two intervention approaches. Both provide parents with education on physical activity benefits, action planning, and coping planning supports. However, one intervention also incorporates components focused on promoting an active family identity and involving all family members in physical activity together. The findings from this study have the potential to inform the design and implementation of public health initiatives aimed at improving physical activity participation in children and guide the development of more effective interventions that leverage the crucial role of parents and the family system in shaping children's physical activity behaviors., Trial Registration: The clinical trial registration ID is NCT05794789. This trial was registered with clinicaltrials.gov on March 2nd, 2023, with the last updated release on September 28th, 2023., (© 2024. The Author(s).)

Objective: The aim of this study was to examine changes and the bi-directional relationship in sleep and movement, and health and well-being among new parents and differences by sex., Methods: This secondary data analysis included both conditions from a randomized control trial to improve new parents'physical activity [PA] and recruited couples. Parents ( n  = 181, 117 couples represented 31.5 ± 4.4 years, 51.3% women, 83.3% White) completed questionnaires on regular overnight sleep duration, PA, mental health (perceived stress), physical health (physical quality of life [PQoL]), and well-being (life satisfaction) at 2-, 4-, 6-, and 8-month postpartum. Random-intercept cross-lagged panel models were stratified by sex to examine changes in sleep and PA with health and well-being across time., Results: Sleep and stress were interrelated at different times for fathers (2 months), and mothers (8 months). Sleep and PQoL improved across time, with mothers reporting less sleep than fathers at 4 and 6 months. PQoL at 4 months was related to MVPA at 6-months. Life satisfaction and PA at 2 months was related to PA at 4 months., Conclusion: Mothers and fathers experienced different sleep and stress trajectories. Mental health improved postpartum with early connections to PA. Supporting the 24-hour movement behavior cycle and mental health across the parenthood transition may benefit couples.

Objective: Although the delivery of comprehensive medication management (CMM) in community pharmacies has been shown to improve health outcomes, inconsistent adoption hinders the benefit patients receive. Our objective was to examine the implementation of a novel value-based care model and the impact of educational and coaching support for pharmacists on patient access to CMM. The underlying care model provides a payment for CMM services combined with incentives to document and improve clinical outcomes and patient engagement., Design: Cross-sectional study., Setting and Participants: In addition to fee-for-service payments, performance-based incentives were provided to 12 participating pharmacy organizations to promote pharmacist documentation of clinical values (blood pressure and tobacco status for patients with vascular disease and additionally hemoglobin A1c [HbA1C] for patients with diabetes). To promote patient engagement, pharmacies that engaged a higher proportion of attributed patients received additional incentives., Outcome Measures: Implementation outcomes included penetration (the proportion of eligible patients who received CMM), adoption (variation in penetration across organizations), and fidelity (documentation of all required clinical values). Comparisons were made using t-tests and chi-square testing., Results: Among 1240 eligible patients, 478 (35.8%) had documentation of any service by a participating pharmacist during a one-year implementation period. Using diabetes as an example, documentation was consistently highest for tobacco status (38.1%), followed by blood pressure (29.7%), and HbA1C (38.1%). CMM recipients on average were older, used more medication, and were more likely to have at least one comorbid condition than non-recipients. 41.8% of patients with vascular disease had documentation of both blood pressure and tobacco status while 24.4% of patients with diabetes had blood pressure, tobacco, and HbA1C documentation., Conclusions: Improving pharmacist access to a patient's medical records could help improve access to CMM services for patients under value-based care models that rely on patient targeting and clinical measurements., (Copyright © 2022 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Background: Understanding the predictors of moderate to vigorous physical activity (MVPA) during early postpartum is important to improve promotion efforts. Affect-related constructs are key predictors of MVPA but have limited research in mothers during the postpartum period., Purpose: To examine two affect-related constructs (affective response to exercise and affective judgments) as predictors of MVPA intention and behavior across three months, among a sample of new mothers., Methods: Participants were 105 mothers (M age = 30.64 years; SD = 3.93) who completed measures during postpartum at 2-months post-birth of their first child. The affective response to exercise (assessed at baseline [2-months postpartum] during a submaximal treadmill test), affective judgments and intention (baseline, 6-weeks after baseline), and MVPA (baseline, 6- and 12-weeks after baseline) were assessed via self-report., Results: Path analysis, using ordinary least squares regression, showed that the affective response during exercise was a significant predictor of intention (baseline, 6-weeks), as well as change in intention from baseline to 6-weeks. By contrast, affective judgments predicted intention at 6-weeks, but not at baseline or in the change model. Past MVPA did not moderate these findings, although the affective response during exercise also had a significant indirect effect on MVPA through intention at 6-weeks and 12-weeks., Conclusions: Interventions targeting women's affective response during exercise may be important during postpartum, perhaps through self-paced physical activity guidance. Affective judgments may not be predictive of MVPA, in part due to unanticipated changes during early postpartum leading to inaccurate expectations of the physical activity experience., (© Society of Behavioral Medicine 2023. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objective: Lifestyle interventions have had limited effectiveness in work sites when evaluated in randomized trials. This study assessed the effectiveness of a novel lifestyle intervention for weight loss (Healthy Weight for Living [HWL]) implemented with or without meal replacements (MR) in work sites. HWL used a new behavioral approach emphasizing reducing hunger and building healthy food preferences, and, unlike traditional lifestyle interventions, it did not require calorie counting., Methods: Twelve work sites were randomized to an 18-month intervention (n = 8; randomization within work sites to HWL, HWL + MR) or 6-month wait-listed control (n = 4). Participants were employees with overweight or obesity (N = 335; age = 48 [SD 10] years; BMI = 33 [6] kg/m 2 ; 83% female). HWL was group-delivered in person or by videoconference. The primary outcome was 6-month weight change; secondary outcomes included weight and cardiometabolic risk factors measured at 6, 12, and 18 months in intervention groups., Results: Mean 6-month weight change was -8.8% (95% CI: -11.2% to -6.4%) for enrollees in HWL and -8.0% (-10.4% to -5.5%) for HWL + MR (p < 0.001 for both groups vs. controls), with no difference between interventions (p = 0.40). Clinically meaningful weight loss (≥5%) was maintained at 18 months in both groups (p < 0.001)., Conclusions: A new lifestyle intervention approach, deliverable by videoconference with or without MR, supported clinically impactful weight loss in employees., (© 2023 The Obesity Society.)

Objective: Implementation strategies are methods or techniques that facilitate adoption, implementation, and sustainability of a clinical program or practice. There has been a lack of widespread adoption of comprehensive medication management (CMM) in community pharmacies. The objective of this evaluation was to expand understanding of how select implementation strategies impacted pharmacists' experience implementing and delivering CMM in the community pharmacy setting., Methods: A community pharmacy CMM initiative, Slice of Partners in Excellence (PIE), employed a number of implementation strategies and key elements from the Institute for Healthcare Improvement's Breakthrough Series to support increased engagement and delivery of CMM within a local payer's CMM program. The program provides incentives to pharmacies for providing CMM to select patients and achieving predetermined quality metrics. To evaluate pharmacists' experience with the implementation strategies and the impact it had on implementing and delivering CMM, a focus group and survey were conducted., Results: Some of the implementation strategies were more frequently highlighted as generating value to participants (coaching, community-wide problem-solving) than others (monthly webinars). Pharmacists identified a need for more formal education regarding billing, documentation and patient engagement supports. Pharmacists expressed a desire for ongoing implementation supports extending beyond this initaitive., Conclusion: Understanding the types of implementation strategies that are deemed as influential by pharmacists delivering clinical services in the community pharmacy setting is critical to maximizing patient access to these services in the future., (Copyright © 2022 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Implementation of comprehensive medication management (CMM) in the community pharmacy setting remains sporadic despite its prevalence in other pharmacy contexts. One health plan has been investing in CMM since 2010. Their experience and perceptions in the payer-provider partnership could offer unique insights into the sustainability of CMM in community pharmacy. As part of a broader academic-payer-provider partnership, perceptions of CMM sustainability were explored with key stakeholders in the health plan through a semistructured group interview. Five themes emerged: (1) distinction between CMM and other patient care opportunities, (2) building a CMM program that delivers value requires an investment in network development, (3) payment design influences sustainability, (4) lack of push from community pharmacies to pay for CMM, and (5) the importance of an ongoing facilitated learning and action collaborative. Given previously demonstrated positive return-on-investment, CMM in community pharmacies shows promise for being a sustainable practice model. However, increased reach and performance of networks, as well as number of payers in the market, will be critical to scaling CMM in the community pharmacy setting.

Increasing rates of physical inactivity and sedentary behaviours among children and the youth are important determinants of chronic disease. Supporting children's participation in organised physical activities like sports has been promoted as a public health strategy to increase physical activity. Evidence shows that successful interventions are family-focused, although research on how parental eating and physical activity behaviours influence children's behaviours is deficient. In this commentary, we argue that interventions for countering physical inactivity and sedentary behaviours should include greater focus on home and social environments, specifically the influence and involvement of parents, siblings, and friends in supporting these health behaviours. We conclude that the design of interventions to prevent chronic diseases in children should also consider more carefully the conditions in which the behaviours of children and their parents occur. This means encouraging parents and children to be active together to address physical inactivity and sedentary behaviours, while being mindful of unintended consequences of focusing on one behaviour over another., Competing Interests: MB was employed by Nova Scotia Health, Halifax, NS, Canada. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Rainham, Bennett, Blanchard, Kirk, Rehman, Stone and Stevens.)

The science and tools of measuring energy intake and output in humans have rapidly advanced in the last decade. Engineered devices such as wearables and sensors, software applications, and Web-based tools are now ubiquitous in both research and consumer environments. The assessment of energy expenditure in particular has progressed from reliance on self-report instruments to advanced technologies requiring collaboration across multiple disciplines, from optics to accelerometry. In contrast, assessing energy intake still heavily relies on self-report mechanisms. Although these tools have improved, moving from paper-based to online reporting, considerable room for refinement remains in existing tools, and great opportunities exist for novel, transformational tools, including those using spectroscopy and chemo-sensing. This report reviews the state of the science, and the opportunities and challenges in existing and emerging technologies, from the perspectives of 3 key stakeholders: researchers, users, and developers. Each stakeholder approaches these tools with unique requirements: researchers are concerned with validity, accuracy, data detail and abundance, and ethical use; users with ease of use and privacy; and developers with high adherence and utilization, intellectual property, licensing rights, and monetization. Cross-cutting concerns include frequent updating and integration of the food and nutrient databases on which assessments rely, improving accessibility and reducing disparities in use, and maintaining reliable technical assistance. These contextual challenges are discussed in terms of opportunities and further steps in the direction of personalized health., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.)

Background: As a result of COVID-19, numerous adaptations were made to health care delivery, including comprehensive medication management (CMM) delivered in community pharmacies., Objective: Identify and describe the adaptations that have been made to the delivery of CMM among community pharmacies due to COVID-19., Methods: Community pharmacies participating in a CMM implementation and research initiative had regular coaching calls throughout COVID-19 and completed a survey of changes that occurred as a result of COVID-19. Coaching notes and survey results were summarized and mapped to the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) to systematically capture changes that occurred., Results: A number of reactive adaptations were made to CMM delivery as a result of COVID-19, including increased virtual or remote delivery of CMM, delaying CMM visits to allow pharmacies to provide care directly related to the pandemic including COVID-19 testing and vaccines, wearing personal protective equipment (PPE) in visits, new ways of obtaining clinical patient information, and shifting CMM staffing models., Conclusion: Adaptations that occurred to CMM during COVID-19 allowed pharmacists to continue to serve their patients and meet public health needs., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

Background: Sub-optimal medication use results in significant avoidable morbidity, mortality, and costs. Programs, such as comprehensive medication management (CMM), can help to optimize medication use, improve outcomes, and reduce costs. However, implementing programs like CMM can be challenging and differences in how CMM has been implemented may be responsible for observed heterogeneity in the outcomes associated with CMM., Objective(s): Describe the implementation strategies utilized in implementing CMM telephonically within a team-based at-home care program and evaluate the implementation process., Methods: The implementation of CMM was facilitated using various implementation strategies including: develop educational material and conduct training, change record system, audit and feedback, learning collaborative, quality monitoring, readiness assessment, and implementation team formation. The impact of these strategies as well as pharmacist and team member perspectives on the implementation of CMM were examined using mixed methods and guided by Proctor's conceptual model for implementation., Results: The pharmacists felt that most of the implementation strategies used to facilitate consistent delivery of CMM were useful, but were unable to successfully implement all of them. Despite this, significant increases in fidelity to steps of the patient care process was achieved. The pharmacists felt that CMM was acceptable, appropriate for patient population, and feasible, but barriers (e.g., the telephonic and remote nature of the practice, the evolving nature of the program, and the difficulty in coordinating care between the patients primary care team and the care team affiliated with the program) affected the feasibility and organizational fit of CMM within this team-based, at-home care program. General pharmacy services, however, were seen as acceptable, appropriate, and feasible., Conclusion: Deliberately designing and utilizing a variety of implementation strategies can facilitate the implementation of CMM and significantly increase fidelity to the patient care process. To improve feasibility and organizational fit of CMM, additional barriers and challenges need to be addressed., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Lifestyle interventions are the first-line treatment for obesity, but participant weight loss is typically low., Objectives: We evaluated the efficacy of an alternative lifestyle intervention [Healthy Weight for Living (HWL)] compared with a modified Diabetes Prevention Program (m-DPP). HWL was based on a revised health behavior change model emphasizing hunger management and the development of healthy food preferences. m-DPP was a standard Diabetes Prevention Program implemented with counselor time matched to HWL. Participants were adult dependents of military personnel and had overweight or obesity., Methods: Participants were randomly assigned to HWL (n = 121) or m-DPP (n = 117), delivered primarily by group videoconference with additional midweek emails. The primary outcome was 12-mo weight change. Secondary outcomes included 6-mo changes in cardiometabolic risk factors and diet. Intention-to-treat (ITT) and complete case (CC) analyses were performed using linear mixed models., Results: Retention did not differ between groups (72% and 66% for HWL and m-DPP at 12 mo, respectively; P = 0.30). Mean ± SE adjusted 12-mo weight loss in the ITT cohort was 7.46 ± 0.85 kg for HWL and 7.32 ± 0.87 kg for m-DPP (P = 0.91); in the CC cohort, it was 7.83 ± 0.82 kg for HWL and 6.86 ± 0.88 kg for m-DPP (P = 0.43). Thirty-eight percent of HWL and 30% of m-DPP completers achieved ≥10% weight loss (P = 0.32). Improvements in systolic blood pressure, LDL cholesterol, triglycerides, fasting glucose, general health, sleep, and mood were similar across groups; improvements in diastolic blood pressure were greater in m-DPP. Adjusted group mean reductions in energy intake were not significantly different between groups, but HWL participants were more adherent to their dietary prescription for lower glycemic index and high fiber and protein (P = 0.05 to <0.001 for ITT)., Conclusions: HWL and m-DPP showed equivalent and clinically impactful mean weight loss with cardiometabolic benefits. These results identify an alternative approach for behavioral treatment of overweight and obesity.This trial was registered at clinicaltrials.gov as NCT02348853., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.)

Introduction: The demands of parenthood may limit the pursuit of moderate-to-vigorous intensity physical activity (MVPA), establish inactivity patterns into middle age, and lead to long-term poorer health and well-being. The purpose of this study was to examine the efficacy of a couple-based planning skills intervention to support MVPA from baseline (~2 months after birth) up to 6 months later in first-time parents., Study Design: Randomized trial., Participants: 264 parents (132 couples) at the 2-month point of parenting their first child., Intervention: Couples were randomized to either an education control (n=58 couples) or an education plus planning condition (n=74 couples)., Main Outcome Measures: MVPA was assessed via accelerometry and self-report at baseline, 6 weeks, 3 months, and 6 months. Health-related fitness (aerobic fitness, muscular strength, flexibility) and BMI tests were conducted at baseline and 6 months. Rolling recruitment was between 2014 and 2017., Results: The accelerometry results had large amounts of missing data that were not missing at random, so only self-reported MVPA was analyzed. Dyadic multilevel modeling conducted in 2020 showed that mothers' MVPA had a significant quadratic pattern over time that was similar for both conditions, and BMI decreased while strength and flexibility increased. Fathers did not have significant outcomes. Participants who were not meeting MVPA guidelines at baseline responded to the education plus planning condition with increased MVPA (father B=1.31, mother B=1.14, p<0.05) compared with those who initially met those guidelines., Conclusions: Mothers may be more responsive than fathers to MVPA interventions in early parenthood. Already active parents likely have little to be gained from additional intervention. Future research is needed to effectively promote MVPA during fatherhood and identify novel ways to sustain PA past the early response to an intervention., Trial Registration: This study is registered at www.clinicaltrials.gov NCT02290808., (Copyright © 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Rationale: The demands of early parenthood may limit the pursuit of moderate-to-vigorous intensity physical activity (MVPA); thus, understanding the predictors of MVPA among this population could help build targeted intervention programs., Objective: The purpose of this study was to examine the correlates of MVPA, in the form of constructs subsumed within the theory of planned behavior (TPB) and multi-process action control (M-PAC) framework, among new parents participating in in a couple-based PA promotion randomized trial across a six-month period in the first year after birth., Methods: In total, 264 participants (132 couples) at the two-month point of parenting their first child were enrolled in the trial through advertisements. MVPA, TPB, and M-PAC constructs were assessed via self-report at baseline, and six-week, three-month, and six-month after baseline time-periods., Results: Dyadic path modeling of the TPB showed that intention only predicted MVPA for mothers and PBC did not predict MVPA. Most of the sample had intentions to be physically active, although the extent to which intentions predicted subsequent MVPA was dependent on mothers and fathers reported strength of planning, habits, and exercise identity (M-PAC variables). Intention was subsequently predicted by affective attitude and PBC for mothers and fathers., Conclusions: Interventions targeting affective attitude and perceived behavioral control may assist in improving MVPA intentions of new parents; yet, additional intervention strategies to increase planning, habit, and especially exercise identity seems warranted for many parents to close the gap between intention and PA. The findings highlight the complementary approach of intention formation and intention translation theories among new parents., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Introduction: Unmet health-related social needs contribute to high patient morbidity and poor population health. A potential solution to improve population health includes the adoption of care delivery models that alleviate unmet needs through screening, referral, and tracking of patients in health care settings, yet the overall impact of such models has remained unexplored. This review addresses an existing gap in the literature regarding the effectiveness of these models and assesses their overall impact on outcomes related to experience of care, population health, and costs., Methods: In March 2020, we searched for peer-reviewed articles published in PubMed over the past 10 years. Studies were included if they 1) used a screening tool for identifying unmet health-related social needs in a health care setting, 2) referred patients with positive screens to appropriate resources for addressing identified unmet health-related social needs, and 3) reported any outcomes related to patient experience of care, population health, or cost., Results: Of 1,821 articles identified, 35 met the inclusion criteria. All but 1 study demonstrated a tendency toward high risk of bias. Improved outcomes related to experience of care (eg, change in social needs, patient satisfaction, n = 34), population health (eg, diet quality, blood cholesterol levels, n = 7), and cost (eg, program costs, cost-effectiveness, n = 3) were reported. In some studies (n = 5), improved outcomes were found among participants who received direct referrals or additional assistance with indirect referrals compared with those who received indirect referrals only., Conclusion: Effective collaborations between health care organizations and community-based organizations are essential to facilitate necessary patient connection to resources for addressing their unmet needs. Although evidence indicated a positive influence of screening and referral programs on outcomes related to experience of care and population health, no definitive conclusions can be made on overall impact because of the potentially high risk of bias in the included studies.

Purpose: Sedentary time (ST) and lack of physical activity increase the risk of adverse outcomes for those living with coronary artery disease (CAD). Little is known about how much ST, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) that CAD participants not attending cardiac rehabilitation engage in, the locations where they engage in these behaviors, and how far from home the locations are., Methods: Participants completed a survey and wore an accelerometer and global positioning system receiver for 7 d at baseline and 6 mo later., Results: Accelerometer analyses (n = 318) showed that participants averaged 468.4 ± 102.7 of ST, 316.1 ± 86.5 of LPA, and 32.9 ± 28.9 of MVPA min/d at baseline. ST and LPA remained stable at 6 mo, whereas MVPA significantly declined. The global positioning system (GPS) analyses (n = 315) showed that most of participant ST, LPA, and MVPA time was spent at home followed by other residential, retail/hospitality, and work locations at baseline and 6 mo. When not at home, the average distance to a given location ranged from approximately 9 to 18 km., Conclusions: Participants with CAD spent the majority of their time being sedentary. Home was the location used the most to engage in ST, LPA, and MVPA. When not home, ST, LPA, and MVPA were distributed across a variety of locations. The average distance from home to a given location suggests that proximity to home may not be a barrier from an intervention perspective., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Family-based physical activity (PA) interventions have proven effective in modifying PA; yet, the underlying mechanisms are currently unclear. In this study, we follow-up upon prior trial data that showed changes to child moderate-to-vigorous PA (MVPA) as a result of a family education+planning intervention compared to an education-only condition. We examined parents' perceived family PA frequency, family PA social cognitions, and family PA habit over 26 weeks between the two conditions. One hundred and two parents (of children aged 6 to 12 yrs), were recruited through advertisements and randomized to either the planning + education condition (n = 52) or an education-only condition (n = 50). Self-reported family PA, and measures of theory of planned behaviour, planning intention, and habit were completed by the contact parent at baseline, six-week, 13-week, and 26-week time-periods. The education+planning intervention increased planning intention ( p <.01) and family PA ( p =.06) compared to the© education-only group. The effect of condition on the putative mediators did not explain these changes (all 95% CIs crossed 0), and family PA was associated with child MVPA only at 13 weeks ( p <.01). Intervention 20 assignment had a small indirect effect on family PA (favouring©the education+planning group) via Habit. Perceived behavioural©control and habit were consistent predictors of family PA ( p <.05), but not PA intention or planning intention ( p >.05). The planning+education intervention showed improved family PA and planning intention, yet null mediation results suggest that other variables from the family system (e.g., child motivation, other parent's motivation and plans) are likely needed to fully understand the intervention effects. The promotion of perceived behavioural control and habit to assist in family PA is recommended for future research in this population.

BACKGROUND: HealthPartners is an integrated health plan offering comprehensive medication management (CMM) under a value-based care model called Partners in Excellence (PIE). In PIE, participating organizations are incentivized to conduct CMM visits and are eligible for bonus payments if they achieve quality and engagement metrics. Engagement in PIE from community pharmacies has been lacking. Implementation science, specifically the assessment of implementation outcomes, provides key insights into the uptake of patient care services, such as CMM, into practice. OBJECTIVE: To evaluate the acceptability, appropriateness, and feasibility of the PIE program from the perspective of community pharmacists and pharmacy managers. METHODS: Semi-structured, one-on-one qualitative interviews were conducted with a group of 14 pharmacists and pharmacy managers participating in the PIE program. Interviews were coded inductively, and then codes were mapped to the implementation outcomes of acceptability, appropriateness, and feasibility. RESULTS: Twelve codes emerged from the interviews. Four codes (targeted conditions of PIE, achieving PIE metrics, comprehensiveness of PIE, and confusion and barriers) were mapped to acceptability; 3 codes (CMM documentation and billing, fitting CMM into limited time with patients, and community pharmacy's role in patient care) were mapped to appropriateness; and 1 code (collecting clinical patient information) was mapped to feasibility. Four codes (CMM payment model, targeting patients for CMM, personnel for CMM, and patient/provider buy-in of CMM) were considered a combination of more than 1 outcome. CONCLUSIONS: Although the acceptability, appropriateness, and feasibility of the PIE program was generally positive, participants cited a number of implementation challenges related to documentation and billing and producing a sustainable CMM model. The results shed light on how a value-based care model for CMM is perceived within community pharmacies and could inform the development and implementation of similar quality-based CMM programs. DISCLOSURES: This study was funded by the National Association of Chain Drug Stores (NACDS) Foundation and the UNC Eshelman Institute for Innovation. Pestka is affiliated with the University of Minnesota College of Pharmacy and reports grants from NACDS Foundation and UNC Eshelman Institute for Innovation for the conduct of the study; she has also received grants from UNC Eshelman Institute for Innovation and NACDS Foundation outside the submitted work. Stoa and Sorensen are also affiliated with the University of Minnesota College of Pharmacy. Blanchard is employed at the UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. This work was presented as a virtual poster at the 2020 American College of Clinical Pharmacy Annual Meeting, October 19-30, 2020.

Background: Accurate measurement of dietary intake is vital for providing nutrition interventions and understanding the complex role of diet in health. Traditional dietary assessment methods are very resource intensive and burdensome to participants. Technology may help mitigate these limitations and improve dietary data capture., Objective: Our objective was to evaluate the accuracy of a novel mobile application (PIQNIQ) in capturing dietary intake by self-report. Our secondary objective was to assess whether food capture using PIQNIQ was comparable with an interviewer-assisted 24-h recall (24HR)., Methods: This study was a single-center randomized clinical trial enrolling 132 adults aged 18 to 65 y from the general population. Under a provided-food protocol with 3 menus designed to include a variety of foods, participants were randomly assigned to 1 of 3 food capture methods: simultaneous entry using PIQNIQ, photo-assisted recall using PIQNIQ, and 24HR. Primary outcomes were energy and nutrient content (calories, total fat, carbohydrates, protein, added sugars, calcium, dietary fiber, folate, iron, magnesium, potassium, saturated fat, sodium, and vitamins A, C, D, and E) captured by the 3 methods., Results: The majority of nutrients reported were within 30% of consumed intake in all 3 food capture methods (n = 129 completers). Reported intake was highly (>30%) overestimated for added sugars in both PIQNIQ groups and underestimated for calcium in the photo-assisted recall group only (P < 0.001 for all). However, in general, both PIQNIQ methods had similar levels of accuracy and were comparable to the 24HR except in their overestimation (>30%) of added sugars and total fat (P < 0.001 for both)., Conclusions: Our results suggest that intuitive, technology-based methods of dietary data capture are well suited to modern users and, with proper execution, can provide data that are comparable to data obtained with traditional methods. This trial was registered at clinicaltrials.gov as NCT03578458., (© The Author(s) 2021. Published by Oxford University Press on behalf of the American Society for Nutrition.)

Background: Exercise maintenance interventions are needed for cardiac rehabilitation (CR) graduates to maintain moderate and vigorous-intensity physical activity (MVPA). We tested an exercise facilitator intervention (EFI) to promote exercise maintenance compared with usual care (UC) separately in men and women., Methods: This was a 3-site, randomized (1:1), parallel-group, superiority trial (ECO-PCR). CR graduates were stratified by site and sex and randomly allocated (concealed). EFI participants received a face-to-face introductory session, 5 small-group counseling teleconferences, and 3 personal calls from a trained facilitator over 50 weeks. In-person assessments were undertaken at baseline and 26 and 52 weeks after randomization. The primary outcome was weekly minutes of MVPA, measured by accelerometer. Secondary outcomes were exercise capacity, risk factors, quality of life, and enrollment in community-based exercise programs. Effects were tested with the use of linear mixed models., Results: A total of 449 CR graduates (135 women, 314 men) were randomised (n = 226 EFI, n = 223 UC). In the intention-to-treat analysis for men and for women, there were no significant effects for treatment or time on MVPA. In a planned secondary analysis that considered only those adherent to EFI (completed ≥ 66% of sessions; per-protocol), bouted MVPA (ie, in sustained bouts of ≥ 10 min) was higher in women in the EFI group (mean = 132.6 ± 135.2 min/wk at 52 weeks) compared with UC (111.8 ± 113.1; P = 0.013). Regarding secondary outcomes, in women, a treatment group main effect was observed for blood pressure (P = 0.011) and exercise capacity (P = 0.019; both per-protocol) favouring EFI; no other differences were observed., Conclusions: In this trial of CR completers, an EFI showed promise for women, but was ineffective in men., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

While community pharmacy-based telepharmacy services can expand medication access for underserved communities, the safety and quality of these services is uncertain. A systematic review was conducted in August 2020 exploring the effect of community pharmacy-based telepharmacy services on patient safety and care quality. Database searches identified 866 studies, of which six met the inclusion and the risk of bias measurement criteria. Medication dispensing errors, adherence, and patient satisfaction were the most frequently evaluated outcomes. Literature suggests no overall difference in medication safety and adherence, conflicting evidence on patient satisfaction, and insufficient evidence on inappropriate medication use in community pharmacy-based telepharmacies compared with traditional pharmacies. Due to the potential for high risk of bias, no definitive conclusions could be made about telepharmacy outcomes. Research with stronger study designs and more rigorous evaluation methodologies is needed to create conclusive evidence on the effectiveness of community pharmacy-based telepharmacy services.

Ensuring fit between a service and the implementing context is a critical but often overlooked precursor of implementation success. This commentary proposes five key considerations that should be evaluated when exploring fit: alignment with needs and metrics; alignment with organizational resources and capabilities; alignment with organizational priorities and culture; alignment with reimbursement mechanisms for long-term sustainability; and alignment with the regulatory environment. Successful uptake and implementation hinges on careful planning and, most importantly, appropriate fit between the service and the implementing environment., Competing Interests: CONFLICT OF INTEREST No conflicts of interest to disclose., (Copyright: © Pharmacy Practice and the Authors.)

Background: Regular physical activity (PA) is associated with many health benefits during childhood, and tracks into desirable PA patterns and health profiles in adulthood. Interventions designed to support these behaviours among young children are critical. Family-based interventions focusing on parent-child activities together (i.e., co-activity) among preschool-aged children are warranted. Targeting parental support practices can increase the frequency of co-activity, however interventions must move beyond merely building intention and planning skills for successful maintenance. Interventions designed to increase co-activity habit strength may facilitate the sustainability and thus impact child PA. The purpose of this study is to compare the effects of three intervention conditions designed to increase child PA through co-activity: a standard education condition (information about benefits), a planning (action planning, coping planning) + education condition and a habit (context-dependent repetition from prompts and cues) + planning +education condition., Methods/design: A longitudinal three-arm parallel design randomized trial will compare three conditions over six months. Families are eligible if they have at least one child between 3y and 5y that is not meeting 60mins/day of moderate to vigorous physical activity (MVPA). The primary outcome (child MVPA) is assessed via accelerometry at baseline, six weeks, three months and six months (primary endpoint). Intervention materials targeting co-activity are delivered post baseline assessment, with booster sessions at six weeks and three months. Parental co-activity habit, parent-child co-activity and other behavioural constructs are also assessed via questionnaire at all measurement occasions. As tertiary outcomes, parental PA is measured via accelerometry and co-activity is measured via a Bluetooth-enabled proximity feature. A total of 106 families have been recruited thus far from the Greater Victoria region. The study is ongoing with a minimum target of 150 families and an anticipated recruitment completion date of August 2022., Discussion: This protocol describes the implementation of a randomized trial evaluating the effectiveness of a habit formation group compared with a planning group and an education only group to increase child PA through targeting parent-child co-activity. This information could prove useful in informing public health initiatives to promote PA among families with preschool-aged children., Trial Registration: This trial was prospectively registered on clinicaltrials.gov in February 2016, identifier NCT03055871 .

Introduction: Regular physical activity (PA) participation has many important physical and psychological health benefits, managing and preventing over 25 chronic conditions. Being more physically active as a child is associated with being more active as an adult, but less than 10% of Canadian children are achieving the recommended PA guidelines of 60 minutes per day of moderate to vigorous PA. Parental support is a predictor of child PA, but parent intention to support child PA does not always predict enacted support. Targeting factors that assist in the sustainability of parent support behaviour of child PA may have an impact on child PA. The purpose of this study is to evaluate an intervention designed to promote habit formation of parental support (HABIT, independent variable) on child PA (dependant variable) compared with a planning and education group (PLANNING) and an education only group (EDUCATION)., Methods and Analysis: The three conditions will be compared using a 6-month longitudinal randomised trial. Eligible families have at least one child aged 6-12 years who is not meeting the 2011 Canadian PA Guidelines. Intervention materials are delivered at baseline, with check-in sessions at 6 weeks and 3 months. Child's moderate-to-vigorous PA, measured by accelerometry, is assessed at baseline, 6 weeks, 3 months and 6 months as the primary outcome. At baseline and 6 months, children perform fitness testing. Parents and children complete questionnaires at all timepoints. So far, 123 families have been recruited from the Greater Victoria and surrounding area. Recruitment will be continuing through 2020 with a target of 240 families., Ethics and Dissemination: This protocol has been approved by the University of Victoria Human Research Ethics Board (Victoria, Canada). Results will be shared at conferences as presentations and as published manuscripts. Study findings will be made available to interested participants., Trial Registration Number: NCT03145688; Pre-results., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The purpose of this study was to examine the effect of two family interventions targeting inactive children on their parents' MVPA. Correlates of MVPA across the trial in the form of theory of planned behavior (TPB) and multi-process action control (M-PAC) were examined as exploratory outcomes. Parents (of children aged 6-12 years) were randomized to either a planning + education (n = 52) or an education only condition (n = 50) designed to improve child MVPA. Parental MVPA (accelerometry, self-report) was assessed at baseline, 6-week, 13-week, and 26-week time-periods. Parental MVPA increased from baseline to 26 weeks (p < .05), but there were no group differences. The TPB was unable to predict MVPA and application of M-PAC showed this was because nearly all participants possessed the intention to be active. Successful-compared to unsuccessful-intenders had stronger habit in four of the six tests employed (p < .05). Parent MVPA may benefit during a family-based intervention but the putative mediators of this increase are unclear.Registered trial clinicaltrials.gov #NCT01882192.

Background: Cardiac rehabilitation is a mainstay treatment for patients experiencing an adverse cardiovascular event. Heart disease is important in frailty, but the impact of cardiac rehabilitation on frailty is unclear., Methods: Patients were referred to a 12-week group-based exercise and education cardiac rehabilitation program performed twice weekly. Frailty was measured with the use of a 25-item accumulation of deficits frailty index (range 0-1; higher values indicate greater frailty) at cardiac rehabilitation admission and completion. Patients were categorized by the degree of frailty in 0.1 increments., Results: Of the 4004 patients who enrolled, 2322 (58.0%) completed cardiac rehabilitation with complete data at admission and completion. There were 414 (17.8%), 642 (27.6%), 690 (29.7%), 401 (17.3%), and 175 (7.5%) patients with admission frailty levels of < 0.20, 0.20-0.30, 0.30-0.40, 0.40-0.50, and > 0.50, respectively. Frailty levels improved from cardiac rehabilitation admission (mean 0.34 [95% CI 0.32-0.35]) to completion (0.26 [0.25-0.28]) for those who completed the program (P < 0.001). After adjusting for age, sex, and number of exercise sessions attended, frailty improved in all frailty groups by mean differences of 0.03 (0.02-0.03), 0.05 (0.05-0.06), 0.08 (0.08-0.09), 0.10 (0.09-0.11), and 0.11 (0.10-0.13) in the < 0.20, 0.20-0.30, 0.30-0.40, 0.40-0.50, and > 0.50 frailty groups, respectively. The minimal improvement in frailty scores (≥ 0.03 reduction) was achieved by 48%, 65%, 72%, 76%, and 79% of patients in the the 5 frailty groups, respectively., Conclusions: Although higher frailty levels were associated with cardiac rehabilitation drop-out, finishing the program was related to improving frailty levels, especially in patients who were the frailest., (Copyright © 2019 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Background: Adult participation in sport is associated with important positive psychosocial outcomes. Despite the multitude of benefits that have been linked to sport participation, adult participation rates in Canada remain low. Parents with young children represent a demographic that may benefit considerably from sport participation, given the prevalence of inactivity coupled with increased levels of psychosocial distress among this group. This study aims to evaluate the efficacy of two types of sport participation (individual sport and team sport) on key psychosocial outcomes compared with a "personal time" control condition among parents with young children., Methods/design: The three-arm, parallel design, single-blind, randomized controlled trial will compare a team sport condition, an individual sport condition, and a "personal time" control condition over 3 months. Parents are eligible if they have a child under 13 years of age, are not participating in a sport at baseline, and are not meeting Canadian Physical Activity Guidelines. Psychosocial variables (quality of life, relationship satisfaction, social functioning, parental stress, and enjoyment) will be assessed at baseline, 6 weeks, and 3 months. A total of 161 parents have been recruited thus far from the Greater Victoria region in British Columbia, Canada. The study is ongoing with a target goal of 240 participants and an anticipated completion date of December 2021., Discussion: This protocol describes the implementation of a randomized controlled trial that evaluates the effectiveness of sport participation for increasing positive psychosocial outcomes. This information could prove useful for future adult sport participation and potentially inform public health initiatives involving parents and families., Trial Registration: ClinicalTrials.gov, NCT02898285. Registered 13 September 2016.

Purpose: Programs designed to sustainably improve employee well-being are urgently needed but insufficiently researched. This study evaluates the long-term effectiveness of a commercial well-being intervention in a worksite setting., Design: A pre/postintervention repeated analysis with follow-up at 6, 12, and 18 months., Setting: Office-based worksites (for-profit, nonprofit, and mixed work-type; n = 8)., Participants: One hundred sixty-three employees with a mean age of 47 (11) years (57% female)., Intervention: A 2.5-day group-based behavioral program emphasizing vitality and purpose in life (PiL)., Measures: Rand Medical Outcomes Survey (MOS) 36-Item Short Form (SF-36) with a focus on vitality (primary outcome), Ryff PiL Scale, Center for Epidemiologic Studies Depression Scale, Profile of Mood States, Rand MOS Sleep Scale, physical activity, body weight, blood pressure, and blood measures for glucose and lipids at baseline, 6, 12, and 18 months., Analysis: General linear models with repeated measures for mean values at baseline and follow-up., Results: At 18-month follow-up, sustained improvements were observed for vitality, general health, and mental health domains of SF-36 and PiL ( P < .001 for all measures). Sleep, mood, vigor, physical activity, and blood pressure were also improved at 18 months ( P < .05 for all measures)., Conclusions: An intensive 2.5-day intervention showed sustained improvement in employee quality of life, PiL, and other measures of well-being over 18 months.

Introduction: Regular moderate-to-vigorous physical activity and high physical fitness are extremely important to the health of children and track to positive health profiles in adulthood. Family-based interventions to improve moderate-to-vigorous physical activity are essential given that children live within a structure of parental influence. The purpose of this study was to examine the effect of a parent planning skills intervention to support child physical activity on the subsequent moderate-to-vigorous physical activity (primary outcome) and fitness of their children across 26 weeks (primary endpoint)., Study Design: Two-arm randomized trial with physical activity assessment at baseline 6 weeks, 13 weeks, and 26 weeks and fitness and BMI tests at baseline and 26 weeks from 2012 and 2017., Setting/participants: One hundred and two children (aged 6-12 years) who were below international physical activity recommendations at baseline were recruited through advertisements., Intervention: Participants received a planning plus education intervention (n=52) or an education-only intervention (n=50)., Main Outcome Measures: Moderate-to-vigorous physical activity was assessed via accelerometry and fitness tests included aerobic fitness, muscular strength, flexibility. BMI was calculated by objectively assessed height and weight., Results: Generalized linear mixed modeling conducted in 2019 showed that the patterns varied by condition over time (β=-0.05, p<0.05), where children in the planning intervention significantly increased moderate-to-vigorous physical activity compared with the education condition at 6 weeks and 13 weeks but not at 26 weeks. Aerobic fitness (p=0.04, d=0.26) was the only significant health-related physical fitness change between the two groups and favored the planning group over the education group., Conclusions: There was initial efficacy of the planning intervention, but effectiveness waned by 26 weeks. These changes appeared to be sufficient for modest changes in aerobic fitness. Future research should aim to improve the maintenance of these early positive changes and assist parents in planning for activities that also include opportunities to improve child musculoskeletal fitness., Trial Registration: This study is registered at www.clinicaltrials.gov NCT01882192., (Copyright © 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)