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The aim of this pilot study was to examine the effects of a short-term adventure therapy program on the self-esteem and self-efficacy of individuals in treatment for substance use disorders. Adventure-based therapy intervention is an experiential approach, utilized by mental health clinicians, which can be used as a clinical tool to promote therapeutic change in participants. In this light, this pilot study investigated the effects of a 5-day adventure therapy program on the psychological resources of self-esteem and self-efficacy of drug addicts under recovery. Pre and post data were collected from 14 ex-drug addicts utilizing two self-report instruments: General Self-Efficacy Scale and the Self-Esteem Scale. The t-tests and the effect sizes indicated that there is a statistically significant increment in the self-esteem (p <.032, d =.73) and self-efficacy (p <.026, d =.93) of the participants, supporting, that adventure therapy interventions can work an alternative to or as a complementary therapeutic tool to use into traditional addiction recovery counseling. [ABSTRACT FROM AUTHOR]

The aim of the present study was to record the views of Greek physical education teachers regarding the socio-moral development of pupils in physical education lesson Ninety-three physical education teachers (38 males and 55 females) completed a questionnaire. Questions were both open and closed type and assessed what moral and social development includes, to which targets priority should be given, and judged and characterized moral and social development. According to the results, the most important dimension of socio-moral development was the development of the pupils' respect for themselves and for others. The highest ranking of the goals is the development of the ability to solve arguments peacefully, and learning to cooperate and to accept individual differences. Finally, physical education teachers consider moral and social development to be very important and useful, but they believe that it is difficult to achieve, although they think it may possibly happen. The results revealed a need for education and further education for teachers on how to develop socio-moral characteristics in pupils through the physical education lesson. [ABSTRACT FROM AUTHOR]

AIMS: The aim of this study was to examine the applicability of a smoking prevention educational resource for secondary education students named ;I do not smoke, I exercise'. The main focus of this program was the promotion of exercise as an alternative behaviour to smoking. METHODS: The applicability of the intervention was assessed through questionnaires regarding: (a) attitudes towards smoking, (b) interest in information about smoking, and (c) knowledge about health consequences of smoking. Moreover, interviews were taken from the educators and the school principals. The questionnaires were completed from 210 students (101 boys and 109 girls) before the beginning, at the end of the program, and 12 months after the completion of the programme. One-way repeated measure ANOVA was performed to examine the differences between the pre-, post-, and the follow-up measures. RESULTS: Results showed that the program succeeded in changing the students' attitudes, but the follow-up measures, 12 months later, showed that attitudes towards smoking and interest in information were relapsed to the pre-intervention levels. The only effect that was sustained was that for knowledge. The interviews also revealed positive comments about the program implementation and pointed some shortcomings. CONCLUSIONS: The program needs some modifications in order to overcome its weaknesses, have more lasting effects and to improve its applicability. [ABSTRACT FROM AUTHOR]

The article is dealing with a central problem of teaching physical education. The purpose of the paper is to examine students' motives for participation in physical education and the relation between students' intrinsic motivation and outcome expectancies in physical education. The analysis is carried out in four parts: Introduction, method, results, and conclusions. [ABSTRACT FROM AUTHOR]

Background: The role of exercise programs during substance use disorder (SUD) treatment is considered particularly supportive in fostering positive psychological and behavioral changes. The treatment of SUD is a challenging and demanding process. Therefore, it is crucial to discover innovative methods to enhance and facilitate it. Integrating exercise into a virtual environment is an innovative approach for drug rehabilitation, offering multiple benefits to individuals undergoing treatment. The aim of this feasibility study was to explore the acute effects of cycling exercise in an immersive virtual reality (VR) environment on attentional control and self-efficacy expectations of individuals undergoing SUD treatment., Methods: A total of 20 individuals (mean age of 37.75 years) enrolled in a SUD treatment program participated in the study. They were instructed to complete a single session of cycling with a self-selected duration within the VR system., Results: Following the cycling session, pre-post measures indicated a statistically significant improvement in self-efficacy expectations and attentional control measured with the Stroop test. The results revealed that participants expressed high levels of intention for future use, interest/enjoyment, and positive attitudes toward the VR exercise system. Qualitative data indicated that participants found the VR exercise system enjoyable, expressed a strong intention to use it, and did not encounter technical difficulties or negative emotions., Conclusions: In conclusion, it seems that engaging in a brief period of self-selected exercise within a virtual environment can result in temporary activation of cognitive changes, heightened self-efficacy expectations, and a motivating approach to increasing physical activity participation among individuals with SUD, thus suggesting the feasibility of this approach.

The global issue of substance abuse demands ongoing initiatives aligned with the United Nations Sustainable Development Goals. With drug use remaining prevalent worldwide, interventions are critical to addressing the associated health challenges and societal implications. Exercise and physical activities have emerged as integral components of substance use disorder (SUD) treatment, offering promising avenues for prevention, intervention, and recovery. Recent research underscores the efficacy of exercise in reducing substance cravings, promoting abstinence, and improving overall well-being. However, integrating exercise into SUD recovery programs presents challenges such as dropout rates and cultural considerations. This paper synthesizes existing literature on exercise integration into SUD recovery, highlighting strategies for enhancing treatment outcomes and addressing barriers to exercise adherence. Drawing on cognitive-behavioral therapy, experiential learning, motivational interviewing, and goal-setting techniques, the holistic approach outlined in this paper aims to empower individuals both mentally and physically, fostering resilience and supporting long-term recovery. In conclusion, new initiatives need to be taken by advocating for inclusive policies, promoting community engagement, and fostering collaborations across sectors. By doing so, stakeholders can optimize the effectiveness of exercise programs and contribute to sustainable rehabilitation efforts for individuals with SUD.

In this follow-up study, we aimed to assess the effectiveness of the " I do not smoke, I exercise " anti-smoking preventive health education program. The program was based on the theory of planned behavior supplemented with life skills teaching and targeted at high school students. The intervention comprised ten one-hour online sessions, administered by physical education instructors. The study cohort comprised 222 students (109 boys, 113 girls) from 11 secondary schools, with an average age of 16.42 ± 1.36 years. Data collection involved pre- and post-intervention self-assessment questionnaires. The examined variables included attitudes towards smoking, intention to smoke, subjective norm, perceived behavioral control (PBC), knowledge about smoking, smoking behavior, exercise behavior, attitudes toward the program's implementation, and satisfaction with the program. A separate paired samples t -test revealed a significant improvement in students' knowledge about smoking ( t 217 = -5.605, p < 0.001, d = 0.38) and perceived behavioral control ( t 220 = -2.166, p < 0.05, d = 0.15) following the intervention. However, no significant changes were observed in the remaining variables. In addition, students' overall satisfaction with the implementation of the present health education program was high ( M = 5.72 ± 1.39). These findings suggest that the health education smoking prevention intervention incorporates techniques and strategies that influence the perceived behavioral control variable, emphasizing students' strong interest in educationally theorized programs integrating technology into their design. Future studies should consider further examination of tobacco control strategies within the high school context.

Background: Low levels of physical activity are associated with numerous adverse health outcomes, yet sedentary lifestyles are common among both children and adults. Physical activity levels tend to decline steeply among children aged between 8 and 12 years, even though children's behavioral patterns are largely governed by familial structures. Similarly, parents' activity levels have been generally reported as lower than those of nonparents of comparable age. For this reason, family-based physical activity promotion interventions are a potentially valuable and relatively underresearched method for mitigating physical activity declines as children develop into adolescents and for increasing physical activity in parents., Objective: This study aims to assess the efficacy, feasibility, and acceptability of a novel theory-based web-based physical activity promotion intervention among parent-child dyads in Finland who do not meet physical activity recommendations at baseline., Methods: Participants (target N=254) will be recruited from the general population using a panel company and advertisements on social media and randomly assigned to either an immediate intervention group or a waitlist control group. The intervention consists of 4 web-based group workshops over the course of 10 weeks, web-based tasks and resources, and a social support chat group. Data on physical activity behavior and constructs from the integrated behavior change model will be collected through self-report surveys assessing physical activity, autonomy support, autonomous motivation, attitude, subjective norm, perceived behavioral control, intention, self-monitoring, habit, and accelerometer measurements at baseline, post intervention, and 3 months post intervention. Exit interviews with participants will assess the feasibility and acceptability of the intervention procedures., Results: This study will reveal whether the intervention changes leisure-time physical activity among intervention participants relative to the control group and will examine the intervention's effects on important theoretical predictors of physical activity. It will also yield data that can be used to refine intervention materials and inform further implementation. Trial recruitment commenced in September 2023, and data collection should be completed by December 2024., Conclusions: The planned intervention has potential implications for both theory and practice. Practically, the use of an entirely web-based intervention may have scalable future uses for improving physical activity in 2 key populations, while also potentially informing on the value of dyadic, family-based strategies for encouraging an active lifestyle as an alternative to strategies that target either parents or children independently. Further, by assessing change in psychological constructs alongside potential change in behavior, the intervention also allows for important tests of theory regarding which constructs are most linked to favorable behavior change outcomes., Trial Registration: ClinicalTrials.gov NCT06070038; https://clinicaltrials.gov/study/NCT06070038., International Registered Report Identifier (irrid): DERR1-10.2196/55960., (©Daniel Phipps, Weldon Thomas Green, Reetta Aho, Eeva Kettunen, Stuart Biddle, Kyra Hamilton, Arto Laukkanen, Kaisa Aunola, Derwin King Chan, Nelli Hankonen, Mary Hassandra, Tommi Kärkkäinen, Virpi-Liisa Kykyri, Juho Polet, Ryan Rhodes, Montse C Ruiz, Arja Sääkslahti, Jekaterina Schneider, Hanna-Mari Toivonen, Taru Lintunen, Martin Hagger, Keegan Knittle. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 21.03.2024.)

Background: Virtual reality (VR) technology has become increasingly used for assessment and intervention in the neuroscience field., Objective: We aimed to investigate the effects of a VR Training System, named VRADA (VR Exercise App for Dementia and Alzheimer's Patients), on the cognitive functioning of older people with mild cognitive impairment (MCI)., Methods: In this intervention study, 122 older adults with MCI were randomly assigned to five groups (the VRADA group ( n  = 28), a bike group ( n  = 11), a physical exercise group ( n  = 24), a mixed group (physical and cognitive exercise) ( n  = 31), and a non-contact control group ( n  = 28). The VRADA group underwent 32 physical and cognitive training sessions, performed 2 or 3 times weekly for 12 weeks in the VR environment. All participants had detailed neuropsychological assessments before and after intervention., Results: A series of linear regression models revealed that the VRADA group showed improvement or no deterioration in cognitive decline in global cognitive function (MMSE), verbal memory (Rey Auditory Verbal Learning Test and WAIS forward test), and executive functions, mental flexibility (Trail Making Test B)., Conclusions: This interventionstudy indicates that the VRADA system improves the cognitive function of elders with MCI., Competing Interests: The authors have no conflict of interest to report., (© 2023 – The authors. Published by IOS Press.)

Background: An integrated model based on self-determination and planned behavior theories has been used to explain physical activity and other health-related behaviors mainly among younger populations, not older adults. The present study aimed to conduct a secondary analysis to explore whether changes in theory-based constructs explain a change in activity level (including 17 activities in essential life areas) among 75- and 80-year-old individuals., Methods: Data came from the Promoting well-being through active aging (AGNES) study, a two-arm single-blinded randomized control trial, where participants in the intervention group (n = 101) received year-long individualized counseling between 2017-19 in Jyväskylä, Finland. Activity frequency was assessed using the University of Jyväskylä Active Aging Scale (UJACAS) activity sub-score, perceived autonomy support with the Health Climate Questionnaire, autonomous motivation with a sub-scale from the Self-Regulation Questionnaire, and attitude with three items. Subjective norm, perceived behavioral control, and intention were each assessed with one item. Change in variables between baseline and the 12-month follow-up was specified via latent factors. Various structural equation models were tested to assess whether the basic or modified model, including additional paths from baseline variables to change factors, provided a better data fit., Results: In the modified integrated model, baseline attitude and change in attitude directly explained the change in activity frequency. Moreover, statistically significant indirect paths were observed from baseline autonomous motivation through baseline attitude, and from activity frequency through change in attitude to change in activity frequency., Conclusions: The theoretical integrated model did not account for the change in active life engagement. The modified integrated model revealed significant change paths, highlighting autonomous motivation and attitudes as influential change constructs. For future intervention design, the modified integrated model appears useful in identifying behavior change pathways for older adults., Competing Interests: Declaration of competing interest The authors report no conflict of interest., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Long-post-coronavirus disease-2019 (COVID-19) patients tend to claim residual symptomatology from various systems, most importantly the respiratory and central nervous systems. Breathlessness and brain fog are the main complaints. The pulmonary function pattern is consistent with restrictive defects, which, in most cases, are self-resolved, while the cognitive profile may be impaired. Rehabilitation is an ongoing field for holistic management of long-post-COVID-19 patients. Virtual reality (VR) applications may represent an innovative implementation of rehabilitation. We aimed to investigate the effect of exercise with and without the VR system and to assess further breathlessness and functional fitness indicators in long-post-COVID-19 patients with mild cognitive impairment after self-selected exercise duration using the VR system. Twenty long-post-COVID-19 patients were enrolled in our study (age: 53.9 ± 9.1 years, male: 80%, body mass index: 28.1 ± 3.1 kg/m 2 ). Participants' anthropometric data were recorded, and they underwent pulmonary functional test evaluation as well as sleep quality and cognitive assessment. The participants randomly exercised with and without a VR system (VR vs. no-VR) and, later, self-selected the exercise duration using the VR system. The results showed that exercise with VR resulted in a lower dyspnea score than exercise without VR. In conclusion, VR applications seem to be an attractive and safe tool for implementing rehabilitation. They can enhance performance during exercise and benefit patients with both respiratory and cognitive symptoms., Competing Interests: The 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 © 2023 Stavrou, Vavougios, Kalogiannis, Tachoulas, Touloudi, Astara, Mysiris, Tsirimona, Papayianni, Boutlas, Hassandra, Daniil, Theodorakis and Gourgoulianis.)

The present study examined the effectiveness of a school-based health education program promoting healthy diet and exercise, named DIEX, implemented on adolescents. The program is based on the Theory of Planned Behavior (TPB) and is supported by life skills training. The recipients of the program were high school students ( n = 367; 168 boys and 199 girls) from 14 schools in Greece who attended 10 1 h sessions implemented by their schoolteachers. Data were collected before and after the program implementation through online questionnaires for: a. attitude, intention, subjective norms, and PBC toward healthy eating; b. knowledge about healthy eating; c. exercise behavior and attitude toward the DIEX program; and d. satisfaction with the DIEX program (only post-program). The results showed that there were significant differences among the pre- and post-measures of students' knowledge and behavior about healthy diet, as well as attitudes and satisfaction toward the program's application. The results show that the DIEX program may have improved nutrition behavior variables. Conclusively, a theory-based behavioral intervention with skills training may result in positive behavioral changes for young students during health education in school settings with the assistance of new technologies.

Virtual reality is a computer-generated simulation of a real or imaginary three-dimensional environment that has entered our lives, particularly for gaming. Lately, it has been permeating into many aspects of our everyday life, such as exercise. It is important to ascertain whether exercise in an immersive virtual reality environment can be accepted from employees and lead to positive outcomes for them. The aim of this exploratory study was to examine the acceptance, future adoption, interest/enjoyment and usability of an immersive virtual reality system for exercise training by office workers during breaks within their working hours. A total of 40 female employees participated in the study with a mean age of 42.58 years (SD 10.77). Participants were requested to complete two sequential 15-min dual task cycling sessions corresponding to two experimental conditions. The first, condition A, involved cycling in a virtual environment, wearing a virtual reality head mounted display, and responding to cognitive tasks by answering multiple choice questions-on a screen, using a joystick. The second, condition B, involved cycling on a static bicycle and simultaneously responding to cognitive tasks by answering multiple choice questions in a real environment. After completion of the two conditions, participants responded to a series of scales regarding each of the experimental conditions and to a semi-structured interview. The results showed that participants noted a significant preference for the immersive virtual reality exercise, condition A, compared to condition B (bike only); and their acceptance, interest/enjoyment, usability and intention for future use were high. The qualitative data showed increased intention for future use, feelings of control and presence and most of the participants did not encounter any difficulties or require extra help to understand the immersive virtual reality system. Overall, exercising during working hours with an immersive virtual reality exercise system was well perceived by office workers and applicable. However, the effects of the immersive virtual reality training system on physical and mental health and the employees' adherence to the exercise program should be tested with a longer intervention program.

The present study aimed to examine effects of motivational and social cognition constructs on children's leisure-time physical activity participation alongside constructs representing implicit processes using an extended trans-contextual model. The study adopted a correlational prospective design. Secondary-school students (N = 502) completed self-report measures of perceived autonomy support from physical education (PE) teachers, autonomous motivation in PE and leisure-time contexts, and social cognition constructs (attitudes, subjective norms, perceived behavioral control), intentions, trait self-control, habits, and past behavior in a leisure-time physical activity context. Five weeks later, students (N = 298) self-reported their leisure-time physical activity participation. Bayesian path analyses supported two key premises of the model: perceived autonomy support was related to autonomous motivation in PE, and autonomous motivation in PE was related to autonomous motivation in leisure time. Indirect effects indicated that both forms of autonomous motivation were related to social cognition constructs and intentions. However, intention was not related to leisure-time physical activity participation, so model variables reflecting motivational processes did not account for substantive variance in physical activity participation. Self-control, attitudes, and past behavior were direct predictors of intentions and leisure-time physical activity participation. There were indirect effects of autonomous motivation in leisure time on intentions and physical activity participation mediated by self-control. Specifying informative priors for key model relations using Bayesian analysis yielded greater precision for some model effects. Findings raise some questions on the predictive validity of constructs from the original trans-contextual model in the current sample, but highlight the value of extending the model to incorporate additional constructs representing non-conscious processes., Competing Interests: The authors have declared that no competing interests exist.

Most coaches and instructors would like to teach more than just sport skills to their athletes and children. However, to promote athletes' or children's holistic development and teach them to take responsibility and lead, requires the coaches and instructors to first master the skills themselves. Therefore, feasible, high quality leadership training programs where coaches and physical activity instructors are taught to teach and share leadership are needed. The aim of the current study was to evaluate the feasibility of a leadership training program to optimize it and to determine whether to proceed with its evaluation. In the leadership training program, eight Finnish novice physical activity instructors, aged 18 to 22, were taught to promote positive youth development, personal and social responsibility, and shared leadership in a physical activity context. The participants had minimal to no leadership training or experience. The training program consisted of seven meetings totaling 20 h. Helllison's teaching personal and social responsibility (TPSR) model was the theoretical and practical framework of the training program. Feasibility of the leadership training program was evaluated across four domains of an evidence-based framework: demand, practicality, acceptability, and implementation fidelity. Data of the current complex intervention were collected with application videos, questionnaires, researcher's log, lesson plans, video recordings, and a semi-structured focus group interview. The quantitative data were analyzed using descriptive statistics and the qualitative data using deductive and inductive content analysis. There was a demand for the leadership training program. The training program was perceived as practical and highly acceptable by the novice instructors and the trainers, and implemented with fidelity, indicating high overall feasibility. No implementation issues were found. Consequently, the current leadership training program has a high probability of efficacy and can be accepted for further evaluation., Competing Interests: The 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 © 2021 Toivonen, Hassandra, Wright, Hagger, Hankonen, Laine and Lintunen.)

Background: Therapeutic virtual reality (VR) has emerged as an effective treatment modality for cognitive and physical training in people with mild cognitive impairment (MCI). However, to replace existing nonpharmaceutical treatment training protocols, VR platforms need significant improvement if they are to appeal to older people with symptoms of cognitive decline and meet their specific needs., Objective: This study aims to design and test the acceptability, usability, and tolerability of an immersive VR platform that allows older people with MCI symptoms to simultaneously practice physical and cognitive skills on a dual task., Methods: On the basis of interviews with 20 older people with MCI symptoms (15 females; mean age 76.25, SD 5.03 years) and inputs from their health care providers (formative study VR1), an interdisciplinary group of experts developed a VR system called VRADA (VR Exercise App for Dementia and Alzheimer's Patients). Using an identical training protocol, the VRADA system was first tested with a group of 30 university students (16 females; mean age 20.86, SD 1.17 years) and then with 27 older people (19 females; mean age 73.22, SD 9.26 years) who had been diagnosed with MCI (feasibility studies VR2a and VR2b). Those in the latter group attended two Hellenic Association Day Care Centers for Alzheimer's Disease and Related Disorders. Participants in both groups were asked to perform a dual task training protocol that combined physical and cognitive exercises in two different training conditions. In condition A, participants performed a cycling task in a lab environment while being asked by the researcher to perform oral math calculations (single-digit additions and subtractions). In condition B, participants performed a cycling task in the virtual environment while performing calculations that appeared within the VR app. Participants in both groups were assessed in the same way; this included questionnaires and semistructured interviews immediately after the experiment to capture perceptions of acceptability, usability, and tolerability, and to determine which of the two training conditions each participant preferred., Results: Participants in both groups showed a significant preference for the VR condition (students: mean 0.66, SD 0.41, t 29 =8.74, P<.001; patients with MCI: mean 0.72, SD 0.51, t 26 =7.36, P<.001), as well as high acceptance scores for intended future use, attitude toward VR training, and enjoyment. System usability scale scores (82.66 for the students and 77.96 for the older group) were well above the acceptability threshold (75/100). The perceived adverse effects were minimal, indicating a satisfactory tolerability., Conclusions: The findings suggest that VRADA is an acceptable, usable, and tolerable system for physical and cognitive training of older people with MCI and university students. Randomized controlled trial studies are needed to assess the efficacy of VRADA as a tool to promote physical and cognitive health in patients with MCI., (©Mary Hassandra, Evangelos Galanis, Antonis Hatzigeorgiadis, Marios Goudas, Christos Mouzakidis, Eleni Maria Karathanasi, Niki Petridou, Magda Tsolaki, Paul Zikas, Giannis Evangelou, George Papagiannakis, George Bellis, Christos Kokkotis, Spyridon Rafail Panagiotopoulos, Giannis Giakas, Yannis Theodorakis. Originally published in JMIR Serious Games (http://games.jmir.org), 24.03.2021.)

Objectives: The aim of this study was to report preplanned secondary analyses of the effects of a 12-month individualized active aging counseling intervention on six mobility and physical activity outcomes. Methods: A two-arm, single-blinded randomized controlled trial was conducted among 75- and 80-year-old community-dwelling people. The intervention group (IG, n = 101) received counseling aimed at increasing self-selected, primarily out-of-home activity. The control group (CG, n = 103) received general health information. Data were analyzed with generalized estimating equations. Results: Physical performance improved in the IG more than that in the CG (group by time p = .022), self-reported physical activity increased in both groups (time p = .012), and autonomy in outdoor mobility declined in the IG and was enhanced in the CG (group by time p = .011). No change was observed for life-space mobility, proportion of persons perceiving difficulty walking 2 km, or monitored physical activity. Discussion: Individualized counseling aiming at increasing self-selected out-of-home activity had nonsystematic effects on mobility and positively affected physical performance only.

Background: We define active aging as a striving for activities as per one's goals, capacities and opportunities., Aim: To test the 1-year counselling intervention effects on active aging., Methods: In this two-arm single-blinded randomized controlled trial, the intervention group received individually tailored counselling supporting autonomous motivation for active life (one face-to-face session, four phone calls and supportive written material, n = 101) and the control group written health information (n = 103). Participants were community-dwelling men and women aged 75 or 80 years with intermediate mobility function and without cognitive impairment. The primary outcome was active aging total score measured with the University of Jyväskylä Active Aging Scale (UJACAS, range 0-272, higher values indicate more activity) and secondary outcomes were its subscores for goals, ability, opportunity and activity (range 0-68) and a quality of life (QoL) score. Measures took place at pre-trial, mid-trial (6 months) and post-trial (12 months), except for QoL only pre and post-trial. Data were analyzed with intention-to-treat principles using GEE-models., Results: The UJACAS total score increased in the intervention group slightly more than in the control group (group by time p-value = 0.050, effect size 0.011, net benefit 2%), but the group effect was not statistically significant. A small effect was observed for the activity subscore (p = 0.007)., Discussion: The individualized counselling supporting autonomous motivation for active life increased the UJACAS score slightly., Conclusions: It may be possible to promote active aging with individualized counselling, but the effect is small and it is unclear whether the change is meaningful.

Background: Inadequate physical activity in young people is associated with several physical and mental health concerns. Physical education (PE) is a potentially viable existing network for promoting physical activity in this population. However, little research has been conducted on whether PE teachers can influence students' engagement in leisure-time physical activity. The present study therefore examined the efficacy of an intervention aimed at increasing PE teachers' autonomy support on students' leisure-time physical activity (the PETALS trial). The intervention was guided by the trans-contextual model (TCM) explaining the processes by which PE teachers' provision of autonomy support during PE promotes students' motivation and engagement in physical activity in their leisure time., Methods: The study adopted a cluster-randomized, waitlist control intervention design with randomization by school. Participants were PE teachers (N = 29, 44.83%female; M age = 42.83, SD = 9.53 yrs) and their lower secondary school students (N = 502, 43.82%female; M age = 14.52, SD = 0.71 yrs). We measured TCM constructs, including perceived autonomy support, autonomous motivation in PE and leisure time, beliefs and intentions towards leisure-time physical activity, and physical activity behavior at baseline, post-intervention, and at one-, three-, and six-months. Study hypotheses were tested through a series of ANOVAs and structural equation models using post-intervention and one-month follow-up data., Results: We found no changes in TCM constructs or physical activity behavior in either group at post-intervention or at 1 month. Path analyses supported two propositions of the TCM as change variables: perceived autonomy support had a significant effect on autonomous motivation in PE and autonomous motivation in PE had a significant effect on autonomous motivation in leisure time. Although we found a direct effect of autonomous motivation in leisure time on physical activity, we did not find support for the third premise of the TCM that autonomous motivation in leisure time indirectly affects physical activity through beliefs and intentions., Conclusions: Current findings did not support the efficacy of the PETALS intervention at changing physical activity behavior and TCM constructs. More research is required to determine whether the TCM predictive validity is supported when other model variables are manipulated through experimental and intervention studies., Trial Registration: ISRCTN, ISRCTN39374060 . Registered 19 July 2018. Prospectively registered.

Background: Given the documented decline in levels of physical activity in early adolescence, promoting physical activity in young people is a priority for health promotion. School physical education (PE) is an important existing network in which participation in physical activity beyond school can be promoted to the captive young people. The objective of current article is to present the protocol for a PE teacher-delivered theory-based trial to promote secondary school students' participation in physical activity out-of-school contexts. The intervention will be guided by the trans-contextual model explaining the processes by which PE teachers' support for autonomous motivation in the classroom promotes students' motivation to engage in out-of-school physical activity. We hypothesize that school students receiving the teacher-delivered intervention to promote autonomous motivation toward physical activity will exhibit greater participation in physical activities outside of school, relative to students receiving a control intervention., Methods: The trial will adopt a waitlist-control design with cluster-randomization by school. PE teachers assigned to the intervention condition will receive a two-week, 12-h training program comprising basic information on how to promote out-of-school physical activity and theory-based training on strategies to promote students' autonomous motivation toward physical activity. Teachers assigned to the waitlist control condition will receive an alternative training on how to monitor physical functional capacity in children with special needs. PE teachers (n = 29) from eleven schools will apply the intervention program to students (n = 502) in PE classes for one month. Physical activity participation, the primary outcome variable, and psychological mediators from the trans-contextual model will be measured at pre-trial, post-trial, and at one-, three- and six-months post-trial. We will also assess teachers' autonomy-supportive techniques and behaviours by observation., Discussion: The study will make a unique contribution to the literature by testing a theory-based intervention delivered by PE teachers to promote school students' participation in out-of-school physical activity. Information will be useful for educators, community stakeholders and policy makers interested in developing programs to promote students' out-of-school physical activity., Trial Registration: ISRCTN39374060 . Registered 19.7.2018.

Background: Active aging has been established as a policy goal for aging societies. We define active aging at the individual level as striving for elements of well-being through activities in relation to a person's goals, functional capacities and opportunities. Increasing evidence suggests that any meaningful activity is beneficial for different aspects of well-being in older people. The aim of the present randomized controlled trial is to test the feasibility and effectiveness of a one-year community-based intervention on active aging. The AGNES intervention aims at increasing older peoples' participation in self-selected valued activities., Methods: The proposed study is a two-arm single-blinded randomized controlled trial. The intervention group receives individually tailored counselling for an active life (one face-to-face session, four phone calls and supportive written material) and the control group written general health information only. Two hundred older adults aged 75- and 80- year old, with intermediate mobility function and without cognitive impairment, living independently in the municipality of Jyväskylä, Finland, are recruited and randomized with a 1:1 allocation to the intervention and control group. Randomization is computer-generated stratified by sex and age. The primary outcome is active aging and secondary outcomes are well-being, depressive symptoms, quality of life, personal goals, mobility and physical activity. Measures are administered at pre-trial, mid-trial (at 6 months) and post-trial (12 months after baseline)., Discussion: The AGNES intervention study will provide new knowledge on the effects of individualized counselling on active aging and the potential of older people to promote their own well-being., Trial Registration: The trial is registered at ISRCTN - ISRCTN16172390 : Promoting well-being through active aging.

Background: Despite the strong evidence that physical activity (PA) is a key determinant of health, there is limited knowledge on the content and outcomes of PA promotion interventions among individuals with disabilities., Objective: To conduct a scoping review in order to examine the published literature on PA promotion interventions among adults with disabilities., Methods: A scoping review following the methodological framework provided by Arksey and O'Malley used electronic databases (MEDLINE, PsycINFO, and CINAHL), reference lists, and journals to locate studies. Inclusion criteria were based on study aim, outcome measures, and a disability definition by the WHO International Classification of Functioning, Disability and Health. The Behavior Change Techniques Taxonomy version 1 and Furlan and collaborators' risk of bias assessment were utilized during the data charting stage., Results: Thirty-eight articles met the inclusion criteria. Most of the studies (70%) reported a significant increase in PA behavior immediately following intervention. However, less than half of the studies (46%) examined the maintenance of pre-/post-test differences. The number of identified behavior change techniques was significantly higher for successful PA promotion interventions than for interventions with no effects on PA. Approximately one-third of studies (32%) were rated as having a high risk of bias., Conclusions: Although findings support the idea that PA promotion interventions produce positive changes in PA behavior for a variety of disability conditions, risk of bias assessment calls for prudence. There are opportunities for continued development of the area of PA promotion among individuals with disabilities through systematic reviews and meta-analyses., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Previous prospective studies have documented that mastery-approach goals are adaptive because they facilitate less negative psychological responses to unfavourable social comparisons than performance-approach goals., Aims: This study aimed to confirm this so-called 'mastery goal advantage' effect experimentally., Methods: A 2 × 3 design was adopted where achievement goals (mastery vs. performance) and normative information (favourable vs. no-normative information vs. unfavourable) were manipulated as between participant factors., Sample: Participants were 201 undergraduates, 57 males and 144 females, ranging in age from 17 to 55 years (M age  = 22.53, SD = 6.51)., Results: Regression analyses pointed out that experimentally induced mastery-approach goals facilitated higher levels of competence and happiness with task performance than experimentally induced performance-approach goals in conditions of unfavourable social comparisons. In contrast, although performance-approach goals yielded the highest levels of happiness with task performance in conditions of favourable social comparisons, this positive effect of performance-approach goals did not extend to perceptions of competence., Conclusion: Current findings broaden understanding of the adaptive nature of mastery-approach goals and suggest that it is possible to modulate aversive responses to unfavourable social comparisons by focusing attention on mastery-approach goals., (© 2017 The British Psychological Society.)

Background: While gains in reducing smoking rates in Finland have been made, prevalence rates are still substantial. Relapse rates among smokers engaged in quit-smoking programs are high. Physical activity has been proposed as one means to help smokers manage cravings. Software and apps on mobile phone and handheld devices offer an opportunity to communicate messages on how to use physical activity to manage cravings as part of quit-smoking programs., Objective: We aimed to test the feasibility, acceptability, usability, and preliminary efficacy of an mHealth mobile phone app, Physical activity over Smoking (PhoS), to assist smokers in quitting smoking in a randomized controlled trial. The app was designed to prompt smokers to engage in physical activities to manage their smoking cravings., Methods: Regular smokers (n=44) attended a group-based behavioral counselling program aimed at promoting physical activity as an additional aid to quit. After quit day, participants were randomly allocated to an intervention (n=25) or to a comparison (n=19) group. Participants in the intervention group were provided with the PhoS app and training on how to use it to assist with relapse prevention. Participants in the comparison condition were provided with generalized relapse prevention training., Results: Some participants reported that the PhoS app was useful in assisting them to successfully manage their cigarette cravings, although compliance across the sample was modest and participants reported low levels of usability. Participants receiving the PhoS app did not report greater abstinence than those who did not receive the app. However, participants receiving the app were more likely to report greater abstinence if they did not use pharmacological support, while those who did not receive the app reported greater abstinence when using pharmacological support. Participants receiving the app reported greater levels of physical activity than those who did not. Results revealed that the app resulted in better retention., Conclusions: The PhoS app showed some potential to reduce abstinence among participants not using pharmacological therapy and to increase physical activity. However, problems with usability and lack of effects on abstinence raise questions over the app's long-term effectiveness. Future research should prioritize further development of the app to maximize usability and test effects of the intervention independent of quit-smoking programs., Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): 55259451; http://www.controlled-trials.com/ISRCTN55259451 (Archived by WebCite at http://www.webcitation.org/6cKF2mzEI)., (©Mary Hassandra, Taru Lintunen, Martin S Hagger, Risto Heikkinen, Mauno Vanhala, Tarja Kettunen. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 26.05.2017.)

Background: Results from studies on the effects of exercise on smoking-related variables have provided strong evidence that physical activity acutely reduces cigarette cravings. Mobile technology may provide some valuable tools to move from explanatory randomized controlled trials to pragmatic randomized controlled trials by testing the acute effectiveness of exercise on quitters under real-life conditions. An mHealth app was developed to be used as a support tool for quitters to manage their cigarette cravings., Objective: The primary aim of this paper is to present the protocol of a study examining the effectiveness of the Physical over smoking app (Ph.o.S) by comparing the point prevalence abstinence rate of a group of users to a comparator group during a 6-month follow-up period., Methods: After initial Web-based screening, eligible participants are recruited to attend a smoking cessation program for 3 weeks to set a quit smoking date. Fifty participants who succeed in quitting will be randomly allocated to the comparator and experimental groups. Both groups will separately have 1 more counseling session on how to manage cravings. In this fourth session, the only difference in treatment between the groups is that the experimental group will have an extra 10-15 minutes of guidance on how to use the fully automated Ph.o.S app to manage cravings during the follow-up period. Data will be collected at baseline, as well as before and after the quit day, and follow-up Web-based measures will be collected for a period of 6 months. The primary efficacy outcome is the 7-day point prevalence abstinence rate, and secondary efficacy outcomes are number of relapses and cravings, self-efficacy of being aware of craving experience, self-efficacy in managing cravings, and power of control in managing cravings., Results: Recruitment for this project commenced in December 2014, and proceeded until May 2015. Follow-up data collection has commenced and will be completed by the end of December 2015., Conclusions: If the Ph.o.S app is shown to be effective, the study will provide evidence for the use of the app as a support tool for people who are trying to manage cravings during smoking cessation programs. It is anticipated that the results of the study will provide knowledge of how physical activity affects cigarette craving in real-life situations and inform the development and delivery of relapse prevention in smoking cessation treatment., Trial Registration: International Standard Randomized Controlled Trial Number (ISRCTN): ISRCTN55259451; http://www.controlled-trials.com/ISRCTN55259451 (Archived by WebCite at http://www.webcitation.org/6cKF2mzEI).

The purpose of this study was to evaluate an initial application of a smoking cessation program that integrated the promotion of physical activity (PA) as a cessation aid to Greek adults in antismoking clinics. From an initial pool of 50, 12 men and 28 women from Central Greece completed the program, and 18 of them succeeded in quitting for 1 year after the program. Additionally, after the program, they increased their PA. Suggestions for future applications of the program are further discussed.

Differences were examined in Theory of Planned Behaviour determinants of students' intention to smoke including parents' attitudes towards smoking and parents' current cigarette use among Greek students of different school grade levels. Students (N = 763) aged 10-18 years reported their attitudes towards smoking, subjective norms, perceived behavioural control, self-identity and intention to smoke while their parents (N = 525) reported their attitudes towards smoking and their current cigarette use. All the TPB variables increased from lower to higher school grade level. Multi-sample path analyses showed that parent's attitudes towards smoking positively predicted students' intention to smoke only for elementary school children. Parents' current cigarette use did not contribute significantly. Students' attitudes, perceived behavioural control and self-identity predicted systematically intention to smoke in contrast to the subjective norm that did not contribute at all. Perceived behavioural control contributed to a higher degree in intention to smoke for senior high school students compared to the junior high school and elementary students. Self-identity contributed to a higher degree in intention to smoke for elementary compared to the junior high school students. The results of this study suggests that the determinants of smoking vary between early and late adolescence.