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This study aims to compare the effectiveness, engagement, usability, and acceptability of a web-based, computer-tailored physical activity intervention (provided as video or text) between participants who were matched or mismatched to their self-reported learning style (visual and auditory delivery through video or text-based information). Generalised linear mixed models were conducted to compare time (baseline, 3 months) by group (matched, mismatched) on ActiGraph-GT3X+measured moderate-to-vigorous physical activity (MVPA) and steps. Generalised linear models were used to compare group (matched and mismatched) on session completion, time-on-site, usability, and acceptability. MVPA and steps improved from baseline to 3-months, however this did not differ between participants whose learning styles were matched or mismatched to the intervention they received. Session completion, time-on-site, usability, and acceptability did not differ between matched and mismatched participants. Therefore, aligning intervention delivery format to learning style is unlikely to influence intervention effectiveness or engagement. [ABSTRACT FROM AUTHOR]

In Australia, 45% of adults meet the aerobic recommendations, and only 9%−30% meet the resistance training guidelines. Given the lack of at-scale community-based interventions promoting resistance training, the aim of this study was to assess the impact of an innovative mHealth intervention on upper- and lower-body muscular fitness, cardiorespiratory fitness, physical activity, and social-cognitive mediators among a sample of community-dwelling adults. Researchers evaluated the community-based ecofit intervention using a cluster RCT from September 2019 to March 2022 in 2 regional municipalities of New South Wales, Australia. Researchers recruited a sample of 245 participants (72% female, aged 53.4±13.9 years) who were randomized to the ecofit intervention group (n =122) or waitlist control (n =123) group. The intervention group received access to a smartphone application with standardized workouts tailored to 12 outdoor gym locations and an introductory session. Participants were encouraged to perform at least 2 ecofit workouts per week. Primary and secondary outcomes were assessed at baseline, 3 months, and 9 months. The coprimary muscular fitness outcomes were evaluated using the 90-degree push-up and the 60-second sit-to-stand test. Intervention effects were estimated using linear mixed models accounting for group-level clustering (participants could enroll in groups of up to 4). Statistical analysis was conducted in April 2022. Statistically significant improvements were observed in upper (1.4 repetitions, 95% CI=0.3, 2.6, p =0.018) and lower (2.6 repetitions, 95% CI=0.4, 4.8, p =0.020) body muscular fitness at 9 months but not at 3 months. Increases in self-reported resistance training, resistance training self-efficacy, and implementation intention for resistance training were statistically significant at 3 and 9 months. This study has shown that a mHealth intervention promoting resistance training using the built environment can improve muscular fitness, physical activity behavior, and related cognitions in a community sample of adults. This trial was preregistered with the Australian and New Zealand Clinical Trial Registry (ACTRN12619000868189). [ABSTRACT FROM AUTHOR]

This study examined the psychometric properties of a newly developed instrument to assess psychosocial determinants of sleep hygiene. Baseline data (n = 160) from an m-health physical activity and sleep intervention were analyzed to examine scale validity. Additional participants (n = 20) were recruited to compute test–retest reliability. Four of seven constructs correlated significantly with sleep hygiene practice (r = −0.17 to −0.36). The scales generally displayed unidimensional component structures. Internal consistency was good to excellent (α = 0.76–0.92). Test–retest reliability was good to excellent (ICC = 0.61–0.84). Though satisfactory, these findings warrant replication in larger samples. [ABSTRACT FROM AUTHOR]

Objectives: Examining mediators of intervention efficacy in an m-health intervention targeting physical activity and sleep in 160 Australian adults. Design: Nationwide randomised controlled trial. Main outcome measures: Moderate- and vigorous-intensity physical activity (MVPA), assessed using the Active Australia Questionnaire; sleep quality (Pittsburgh Sleep Quality Index); and sleep hygiene practices (Sleep Hygiene Index). Hypothesised psychosocial (e.g. self-efficacy) and behavioural (i.e. MVPA, sleep quality, sleep hygiene) mediators were tested on primary endpoint data at 3 months using bias-corrected bootstrapping (PROCESS 2 for SPSS). All outcomes and mediators were assessed using self-report. Results: At three months, the intervention had significantly improved sleep quality (d = 0.48, 95% CI: −2.26, −0.33, p = 0.009) and sleep hygiene (d = 0.40, 95% CI: −3.10, −0.19, p = 0.027). Differences in MVPA were not significant (d = 0.24, 95% CI: −35.53, 254.67, p = 0.139). Changes in MVPA were mediated by self-efficacy, perceived capability, environment, social support, intentions and planning, some of which showed inconsistent mediation (suppression). None of the hypothesised psychosocial factors mediated sleep outcomes. Changes in sleep hygiene mediated changes in sleep quality. Conclusions: Several psychosocial factors mediated changes in physical activity but not in sleep outcomes. Mediation effects of sleep hygiene on sleep quality highlight the importance of providing evidence-based strategies to improve sleep quality. [ABSTRACT FROM AUTHOR]

Humans in the industrialized world spend a large amount of daily time in sedentary behavior. Since sedentariness negatively impacts a variety of psychophysiological outcomes, the identification of antecedents that lead to sedentary behavior is an important public health issue. In this context, mood, a central indicator for both psychological well‐being and mental health, is severely understudied. To investigate whether mood dimensions influence subsequent sedentary behavior, we assessed both constructs at baseline via questionnaires and via ambulatory assessment (AA) over 5 days in 92 university employees. We continuously measured sedentary behavior using accelerometers and assessed mood repeatedly 10 times each day on smartphone diaries. We employed multiple regression analyses to analyze between‐subject effects and multilevel modeling to analyze within‐subject effects. Higher momentary ratings of valence (P <.05) and energetic arousal (P <.01) predicted lower amounts of subsequent sedentary behavior, whereas higher ratings of calmness (P <.01) predicted higher amounts of subsequent sedentary behavior. The context moderated the effect of energetic arousal and calmness on sedentary behavior with increased effects in the home compared to the work context. Mood significantly predicted sedentary behavior on a within‐subject level but not on a between‐subject level. Preliminary evidence suggests that mood regulates sedentary behavior in everyday life. Time‐sensitive analyses, such as from moment to moment revealed an association between mood and sedentary behavior (within‐subject), whereas analyses between different individuals revealed no associations (between‐subject). These preliminary findings may inform multicomponent intervention strategies that target mood, to reduce sedentary behavior in daily life. [ABSTRACT FROM AUTHOR]

Purpose: To explore whether there was a difference in objectively measured physical activity and study participation between people who received their preferred study group allocation (matched) and those who did not receive their preferred study group (mismatched).Design: Secondary data from the NewCOACH randomized controlled trial.Setting: Insufficiently active patients in the primary care settings in Sydney and Newcastle, Australia.Participants: One hundred seventy-two adults aged 20 to 81 years.Intervention: Participants indicated their intervention preference at baseline for (1) five face-to-face visits with an exercise specialist, (2) one face-to-face visit and 4 telephone follow-ups with an exercise specialist, (3) written material, or (4) slight-to-no preference. Participants were then allocated to an intervention group and categorized as either "matched" or "mismatched" based on their indications. Participants who reported a slight-to-no preference was categorized as "matched."Measures: Daily step count as measured by pedometers and study participation.Analysis: Mean differences between groups in daily step count at 3 and 12 months (multiple linear regression models) and study participation at baseline, 3 months, and 12 months (χ2 tests).Results: Preference for an intervention group prior to randomization did not significantly (all P's > .05 using 95% confidence interval) impact step counts (differences of <600 steps/day between groups) or study participation.Conclusion: Future research should continue to address whether the strength of preferences influence study outcome and participation and whether the study preferences change over time. [ABSTRACT FROM AUTHOR]

Introduction: Interventions that improve both physical activity and sleep quality may be more effective in improving overall health. The purpose of the Synergy Study is to test the efficacy of a mobile health combined behavior intervention targeting physical activity and sleep quality.Study Design: Randomized, waitlist-controlled trial.Setting/participants: This study had an app-based delivery mode, Australia-wide. The participants were 160 adults who reported insufficient physical activity and poor sleep quality in an eligibility survey.Intervention: The intervention was a mobile app providing educational resources, goal setting, self-monitoring, and feedback strategies. It included 12 weeks of personalized support including weekly reports, tool sheets, and prompts.Main Outcome Measures: Outcomes were assessed at baseline, 3 months (primary), and 6 months (secondary endpoint). Self-reported minutes of moderate-to-vigorous intensity physical activity and sleep quality were co-primary outcomes. Resistance training; sitting time; sleep hygiene; sleep timing variability; insomnia severity; daytime sleepiness; quality of life; and depression, anxiety, and stress symptoms were secondary outcomes. Data were collected between June 2017 and February 2018 and analyzed in August 2018.Results: At 3 months, between-group differences in moderate-to-vigorous intensity physical activity were not statistically significant (p=0.139). Significantly more participants in the intervention group engaged in ≥2 days/week (p=0.004) of resistance training. The intervention group reported better overall sleep quality (p=0.009), subjective sleep quality (p=0.017), sleep onset latency (p=0.013), waketime variability (p=0.018), sleep hygiene (p=0.027), insomnia severity (p=0.002), and lower stress symptoms (p=0.032) relative to waitlist controls. At 6 months, group differences were maintained for sleep hygiene (p=0.048), insomnia severity (p=0.002), and stress symptoms (p=0.006). Differences were observed for bedtime variability (p=0.023), sleepiness (p<0.001), daytime dysfunction (p=0.039), and anxiety symptoms (p=0.003) at 6 months, but not 3 months.Conclusions: This remotely delivered intervention did not produce statistically significant between-group differences in minutes of moderate-to-vigorous intensity physical activity. Significant short-term differences in resistance training and short- and medium-term differences in sleep health in favor of the intervention were observed.Trial Registration: This study is registered at anzctr.org.au ACTRN12617000376347. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of interventions targeting alcohol consumption, drug use and smoking for college/university students.Participants: College/University students.Methods: Studies were eligible if: (1)included students attending universities/colleges; (2)implemented in a university/college setting; (3)aimed to improve at least one of the following behaviors: alcohol and/or drug use and/or smoking; (4)were RCTs. The effect of the interventions on behaviors was determined by the percentage of studies that reported an effect. Due to the heterogeneity of outcomes meta-analysis was not conducted.Results: 88 studies met criteria. University-based interventions were effective for reducing alcohol-related outcomes (drinking patterns, BAC, consequences, problem drinking). Inconsistent findings for drug and smoking were observed.Conclusions: University-based interventions have the potential to improve health for students. While there is a breadth of research examining the efficacy of interventions to reduce alcohol consumption, further research is needed to determine the best approach for addressing smoking and drug use among students. [ABSTRACT FROM AUTHOR]

The risk and prevalence of Type 2 Diabetes (T2D) has dramatically increased over the past decade. The aim of this study was to develop, implement and evaluate a physical activity intervention to improve aerobic and muscular fitness among adults at risk of, or diagnosed with T2D. A 20-week, assessor blinded, parallel-group randomized controlled trial (RCT) was conducted at the University of Newcastle (June-December 2015). Adults were randomized to the intervention (n=42) or wait-list control group (n=42). The theory-based intervention included: Phase 1 (weeks 1-10) integrated group sessions (outdoor physical activity and cognitive mentoring), and the eCoFit smartphone application (app). Phase 2 (weeks 11-20) only included the eCoFit app. Participants were assessed at baseline, 10weeks and 20weeks. Linear mixed models (intention-to-treat) were used to determine group-by-time interactions at 10weeks (primary time-point) and 20weeks for the primary outcomes. Several secondary outcomes were also assessed. After 10weeks, significant group-by-time effects were observed for aerobic fitness (4.5mL/kg/min; 95% CI [1.3, 7.7], d=0.68) and muscular fitness (lower body) (3.4 reps, 95% CI [2.7, 4.2], d=1.45). Intervention effects for secondary outcomes included significant increased physical activity (1330steps/week), improved upper body muscular fitness (5 reps; arm-curl test), improved functionality (-1.8s; timed-up and go test) reduced waist circumference (2.8cm) and systolic blood pressure (-10.4mmHg). After 20weeks, significant effects were observed for lower body muscular fitness and health outcomes. eCoFit is an innovative lifestyle intervention which integrates smartphone technology, social support, and the outdoor environment to improve aerobic and muscular fitness. [ABSTRACT FROM AUTHOR]

Objectives: To examine the effect of a gender-tailored, Social Cognitive Theory (SCT)-based weight loss maintenance (WLM) intervention on men's physical activity and healthy eating cognitions and behaviours in the 12 months after completing a weight loss programme.Design: A two-phase, assessor-blinded, randomized controlled trial.Methods: Ninety-two overweight/obese men (mean [SD] age: 49.2 years [10.1], BMI: 30.7 [3.3] kg/m(2) ) who lost at least 4 kg after completing the 3-month SCT-based SHED-IT Weight Loss Program were randomly allocated to receive (1) the SCT-based SHED-IT WLM Program; or (2) no additional resources (self-help control group). The 6-month gender-tailored SHED-IT WLM Program was completely self-administered and operationalized SCT behaviour change principles to assist men to increase moderate-to-vigorous physical activity (MVPA) and decrease energy-dense, nutrient-poor (discretionary) food consumption after initial weight loss. After randomization (WLM baseline), men were reassessed at 6 months (WLM post-test) and 12 months (6-month WLM follow-up). SCT cognitions (e.g., self-efficacy, goal setting), MVPA, and discretionary food consumption were assessed with validated measures.Results: Following significant improvements in cognitions, MVPA and discretionary food consumption during the weight loss phase, intention-to-treat, linear mixed models revealed no significant group-by-time differences in cognitions or behaviours during the WLM phase. Initial improvements in MVPA and some cognitions (e.g., goal setting, planning, and social support) were largely maintained by both groups at the end of the study. Dietary effects were not as strongly maintained, with the intervention and control groups maintaining 57% and 75% of the Phase I improvements in discretionary food intake, respectively.Conclusions: An additional SCT-based WLM programme did not elicit further improvements over a self-help control in the cognitions or behaviours for MVPA or discretionary food intake of men who had lost weight with a SCT-based weight loss programme. Statement of contribution What is already known on this subject?Weight regain after weight loss (WL) is common. As successful weight loss maintenance (WLM) requires sustained improvements in cognitions and behaviours, health psychology can contribute to intervention development. However, little research has examined the utility of psychological theory in the context of a WLM randomised controlled trial. What does this study add? A theory-based WL program improved men's physical activity and dietary behaviours and cognitions. Men who also received a theory-based WLM program did not show further improvements in physical activity or dietary cognitions and behaviours compared to those that did not. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented which discusses a pilot study on the efficacy of behavior change intervention and supervised physical activity (PA) program in kidney cancer survivors.

This study examined factors associated with higher sitting time in general, chronic disease, and psychologically-distressed, adult populations (aged ≥45 years). A series of logistic regression models examined potential socio-demographic and health factors associated with higher sitting (≥6hrs/day) in adults from the 45 and Up Study (n = 227,187), including four separate subsamples for analysis comprising those who had ever had heart disease (n = 26,599), cancer (n = 36,381), diabetes (n = 19,550) or psychological distress (n = 48,334). Odds of higher sitting were significantly (p<.01) associated with a number of factors across these groups, with an effect size of ORs≥1.5 observed for the high-income ≥$70,000AUD, employed full-time and severe physical limitations demographics. Identification of key factors associated with higher sitting time in this population-based sample will assist development of broad-based, public health and targeted strategies to reduce sitting-time. In particular, those categorized as being high-income earners, full-time workers, as well as those with severe physical limitations need to be of priority, as higher sitting appears to be substantial across these groups. [ABSTRACT FROM AUTHOR]

To examine the effectiveness of interventions aimed at improving physical activity, diet, and/or weight-related behaviors amongst university/college students. Five online databases were searched (January 1970 to April 2014). Experimental study designs were eligible for inclusion. Data extraction was performed by one reviewer using a standardized form developed by the researchers and checked by a second reviewer. Data were described in a narrative synthesis and meta-analyses were conducted when appropriate. Study quality was also established. Forty-one studies were included; of these, 34 reported significant improvements in one of the key outcomes. Of the studies examining physical activity 18/29 yielded significant results, with meta-analysis demonstrating significant increases in moderate physical activity in intervention groups compared to control. Of the studies examining nutrition, 12/24 reported significantly improved outcomes; only 4/12 assessing weight loss outcomes found significant weight reduction. This appears to be the first systematic review of physical activity, diet and weight loss interventions targeting university and college students. Tertiary institutions are appropriate settings for implementing and evaluating lifestyle interventions, however more research is needed to improve such strategies. [ABSTRACT FROM AUTHOR]

Objectives: To examine potential mediators of adolescent girls' dietary behavior change in the Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) intervention for obesity prevention. Methods: Participants were 294 adolescent girls attending 12 secondary schools located in low-income communities of New South Wales, Australia. Hypothesized social cognitive mediators of dietary behavior change were assessed using valid and reliable scales. Results: The intervention effects on dietary outcomes and hypothesized mediators were not statistically significant. However, changes in hypothesized mediators were associated with changes in key dietary behaviors. Conclusions: Continued research is needed to examine effective strategies for improving dietary outcomes in youth, and to explore alternative theoretical mechanisms of dietary behavior change. [ABSTRACT FROM AUTHOR]

Objective Theory-based interventions to promote physical activity ( PA) are more effective than atheoretical approaches; however, the comparative utility of theoretical models is rarely tested in longitudinal designs with multiple time points. Further, there is limited research that has simultaneously tested social-cognitive models with self-report and objective PA measures. The primary aim of this study was to test the predictive ability of three theoretical models (social cognitive theory, theory of planned behaviour, and protection motivation theory) in explaining PA behaviour. Methods Participants were adults with type 2 diabetes ( n = 287, 53.8% males, mean age = 61.6 ± 11.8 years). Theoretical constructs across the three theories were tested to prospectively predict PA behaviour (objective and self-report) across three 6-month time intervals (baseline-6, 6-12, 12-18 months) using structural equation modelling. PA outcomes were steps/3 days (objective) and minutes of MET-weighted PA/week (self-report). Results The mean proportion of variance in PA explained by these models was 6.5% for objective PA and 8.8% for self-report PA. Direct pathways to PA outcomes were stronger for self-report compared with objective PA. Conclusions These theories explained a small proportion of the variance in longitudinal PA studies. Theory development to guide interventions for increasing and maintaining PA in adults with type 2 diabetes requires further research with objective measures. Theory integration across social-cognitive models and the inclusion of ecological levels are recommended to further explain PA behaviour change in this population. [ABSTRACT FROM AUTHOR]

Objectives: A limited understanding of the mechanisms of behavior change has hindered the development of more effective interventions. The aim of this study was to identify potential mediators of objectively measured physical activity (PA) behavior change in women with type 2 diabetes (T2DM). Design: Mediation test of a randomized controlled trial. Method: Women with T2DM (n = 93) from the control group (standard PA materials, n = 44) and the full intervention group (control + stage-matched printed material and telephone counseling, n = 49) of a larger PA intervention trial were included. PA outcomes were minutes of MET weighted moderate and vigorous PA/week (self-report) and steps/3-days (objective) recorded at baseline and 12-months. Social-cognitive constructs were measured and tested in a mediating variable framework. Results: Perceived behavioral control and barrier self-efficacy mediated intervention effects on objective PA (proportion of intervention effect mediated = 18% and 24% respectively). Intention was a mediator of objective PA (23%). Conclusion: Perceived behavior control, barrier self-efficacy, and intention are effective mechanisms of PA behavior change in women with T2DM. [Copyright &y& Elsevier]

Purpose: To systematically review and examine the explanatory power of key social-cognitive theories used to explain physical activity (PA) intention and behavior, among adolescents. Methods: A systematic review and meta-analysis of the literature was performed using the electronic databases Medline, Cumulative Index to Nursing and Allied Health Literature, SPORTdiscus, EBSCO and Education Resources Information Center, Proquest Education Journals Collection, Science Direct, Web of Science and Scopus for social-cognitive theories (i.e., Health Promotion Model, Theory of Planned Behavior, Theory of Reasoned Action, Protection Motivation Theory, Social Cognitive Theory/Self-Efficacy Theory, Health Belief Model, Self-Determination Theory, Transtheoretical Model) used to explain PA intention and behavior. Related keywords in titles, abstracts, or indexing fields were searched. Results: Twenty-three studies satisfied the inclusion criteria and were retained for data extraction and analysis; 16 were cross-sectional studies and seven were longitudinal studies. Most studies employed self-report measures. In general, the models explained greater proportions of variance for intention compared to behavior. The meta-analyses revealed 33% and 48% of the variance respectively for PA and intention were explained by social cognitive models. Conclusions: Few studies have tested the predictive capacity of social cognitive theories to explain objectively measured PA. The majority of PA variance remains unexplained and more theoretical research is needed. [Copyright &y& Elsevier]

Young adult cancer survivors (YACS) face unique challenges from their disease and treatments that may influence their sport participation choices as well as their psychosocial response. Objectives: To examine the prevalence, correlates, and psychosocial outcomes of sport participation in YACS. Design: A provincial, population-based mailed survey of 588 YACS in Alberta, Canada, was completed in May 2008 and included measures of sport participation, psychosocial health (depression, self-esteem, and stress), quality of life (QoL), and medical and demographic variables. Results: One third (32.5%) of YACS reported participating in a sport in the past month with the most common being golf (40.8%) and ice hockey (8.3%). YACS participating in sport reported an average frequency of 1.7 (SD = 1.0) days/week and an average duration of 119 min/session (SD = 68) for a total of 189 (SD = 164) min/week. Independent t-tests showed that YACS who participated in sport reported better psychosocial health and QoL including physical QoL (p < 0.001), mental QoL (p < 0.001), self-esteem (p < 0.001), depression (p < 0.001), and stress (p < 0.001). In multivariate regression analysis, 8.5% (p < 0.001) of the variance in sport participation was explained by being male (β = 0.17, p < 0.001), Caucasian (β = 0.15, p = 0.001), in better general health (β = 0.15, p < 0.001), and having a normal body mass index (β = −0.10, p = 0.024). Discussion/conclusions: Sport participation is associated with better psychosocial health and QoL in YACS but only a third participated in the past month. Randomized controlled trials examining sport as an intervention strategy to increase physical activity and improve health outcomes in YACS are warranted. [ABSTRACT FROM AUTHOR]

Abstract: Background: There have been very limited long-term prospective studies examining social-cognitive models in the PA domain with large, representative population samples. Objective: The primary objective was to examine the Theory of Planned Behaviour''s (TPB) ability to explain PA behaviour in a randomly selected national sample of Canadian adults over a 15-year period. A secondary objective was to test the moderating effects of gender on TPB. Design: The study employed a longitudinal design. Methods: A cohort of 1427 randomly-selected adults reported TPB constructs and PA behaviour in 1988, and again in 2003. Structural equation modelling techniques were employed to test TPB. Results: The full model including both 1988 and 2003 TPB measures accounted for 29% and 21% of the variance in intention, and 9% and 22% of the variance in PA in 1988 and 2003, respectively. Gender moderated aspects of the TPB in the full model. The core predictive model (1988 TPB constructs predicting 2003 PA behaviour) explained 13% of the variance in 2003 PA behaviour. Conclusions: The TPB''s long-term ability to predict PA behaviour is modest. [Copyright &y& Elsevier]

Aims Dietary modification is essential for the secondary prevention of cardiovascular disease. However, there are limited published evidence syntheses to guide practice in the cardiac rehabilitation (CR) setting. This systematic review's objective was to assess effectiveness and reporting of nutrition interventions to optimize dietary intake in adults attending CR. Methods and results Randomized controlled trials (RCTs) of nutrition interventions within CR were eligible for inclusion and had to have measured change in dietary intake. MEDLINE, Embase, Emcare, PsycINFO, CINAHL, Scopus, and The Cochrane Library were searched from 2000 to June 2020, limited to publications in English. Evidence from included RCTs was synthesized descriptively. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool. This review is registered on PROSPERO; CRD42020188723. Of 13 048 unique articles identified, 11 were eligible. Randomized controlled trials were conducted in 10 different countries, included 1542 participants, and evaluated 29 distinct dietary intake outcomes. Five studies reported statistically significant changes in diet across 13 outcomes. Most nutrition interventions were not reported in a manner that allowed replication in clinical practice or future research. Conclusion There is a gap in research testing high-quality nutrition interventions in CR settings. Findings should be interpreted in the light of limitations, given the overall body of evidence was heterogenous across outcomes and study quality; 6 of 11 studies were conducted more than 10 years old. Future research should investigate strategies to optimize and maintain nutrition improvements for patients attending CR. Registration PROSPERO; CRD42020188723. [ABSTRACT FROM AUTHOR]

Objectives: To examine the determinants of physical activity (PA) in young adult cancer survivors (YACS). Methods: A survey of 588 YACS in Alberta, Canada, assessed PA, medical and demographical factors, and theory of planned behavior variables. Results: Path analysis explained 38% (P<.001) of the variance in PA with significant contributions from intention, planning, affective attitude, education, and general health. In turn, 56% (P<.001) of the variance in intention was explained by perceived behavioral control, instrumental attitude, and affective attitude. Conclusion: PA interventions in YACS should focus on developing strong intentions by targeting perceived behavioral control, instrumental attitude, and affective attitude. [ABSTRACT FROM AUTHOR]

Abstract: Much of the research on the determinants of dietary behavior has been guided by Bandura’s Social Cognitive Theory (SCT), yet few studies have tested the utility of its proposed structural paths. The aim of this paper was to test the capacity of SCT to explain dietary behaviors in a sample of 357 adolescent girls (13.2±0.5years) from 12 secondary schools located in low-income communities in New South Wales, Australia. Participants completed validated SCT scales assessing nutrition-related self-efficacy, intention, behavioral strategies, family support, situation, outcome expectations, and outcome expectancies. Participants completed a validated food frequency questionnaire, from which, the percentage of total kilojoules from core-foods, non-core foods and saturated fat were calculated. The theoretical models were tested using structural equation modeling in AMOS. The models explained 48–51% and 13–19% of the variance in intention and dietary behavior, respectively. The models provided an adequate fit to the data, and self-efficacy was positively associated with healthy eating and inversely associated with unhealthy eating. However, the pathway from intention to behavior was not statistically significant in any of the models. While this study has demonstrated the utility of SCT constructs to explain behavior in adolescents girls, the proposed structural pathways were not supported. Further study of the role that implementation intentions play in explaining adolescent girls’ dietary behaviors is required. [Copyright &y& Elsevier]

Background: Over half of kidney cancer survivors (KCS) are completely inactive and only a quarter are meeting physical activity (PA) guidelines. This highlights the need to identify and understand the determinants of PA in this understudied population. The purpose of this study is to determine the social cognitive correlates of PA intention and behavior in KCS using the Theory of Planned Behavior (TPB). Methods: All 1,985 KCS diagnosed between 1996 and 2010 in Alberta, Canada were mailed a self-report survey that consisted of the Godin Leisure Time Exercise Questionnaire and standard TPB items for intention, planning, perceived behavioral control (PBC), affective and instrumental attitudes, and descriptive and injunctive norms. Standard demographic and medical variables were also collected. Results: Completed surveys were received from 703 of 1,654 (43%) eligible KCS. The TPB was tested using structural equation modelling and demonstrated an adequate-to-good fit to the data [χ2² = 256.88, p < .001; TLI = 0.97; CFI = 0.98; RMSEA = 0.06, 90% CI = 0.05-0.06]. There were significant pathways to PA from PBC (β = 0.18, p = 0.02), planning (ß = 0.22, p < 0.01), and intention (β = 0.31, p < 0.01); and to planning from intention (β = 0.81, p < 0.01). In addition, there were significant model pathways to intention from instrumental attitude (β = 0.28, p = 0.03), descriptive norm (β = 0.09, p = 0.01), and PBC (β = 0.52, p < 0.01). Overall, the TPB accounted for 69%, 63%, and 42% of the variance in intention, planning and PA, respectively. Conclusion: The TPB appears to be a useful model for explaining PA in KCS. All TPB constructs except injunctive norm and affective attitude were useful for explaining intention with PBC emerging as the largest correlate. Developing PA interventions based on the TPB may be effective in promoting PA in KCS and may lead to important improvements in health. [ABSTRACT FROM AUTHOR]

This study explored facilitators and barriers to capacity building for chronic disease prevention (CDP) activities with participants in community-based workshops on environments related to CDP. Three phases of research were conducted. Worksheet analysis (Phase A) indicated that participants (n = 34) identified priority strategies related to the physical environment as a primary focus for CDP, followed by sociocultural, economic, and political environments. Questionnaire completion (Phase B; n = 17) indicated that individuals' capacity was inhibited by a lack of organizational infrastructure (particularly, resources and public and research support). Interviews (Phase C; n = 11) revealed five factors that limited participants' capacity: (a) organizations' lack of competing priorities, (b) priorities secondary to the organizational mandate, (c) disconnect between organizational and government or funder priorities, (d) limited resources, and (e) larger community issues. Implications for research and practice are discussed. [ABSTRACT FROM AUTHOR]

Objectives: To determine demographic, medical, social cognitive, and environmental predictors of aerobic physical activity and resistance training in a population sample of adults with type 2 diabetes. Methods: Two hundred forty-four (244) participants completed questionnaires with a 3-month follow-up. Multiple and logistic regression models examined predictors of aerobic activity and resistance training. Results: Several factors were associated with higher levels of both aerobic physical activity and resistance training; self-efficacy was the strongest predictor for both modes of activity. Conclusions: The findings can guide physical activity promotion interventions and programs for this population, profiling those who are least active. [ABSTRACT FROM AUTHOR]

Objectives: To determine demographic, medical, social cognitive, and environmental predictors of aerobic physical activity and resistance training in a population sample of adults with type 2 diabetes. Methods: Two hundred forty-four (244) participants completed questionnaires with a 3-month follow-up. Multiple and logistic regression models examined predictors of aerobic activity and resistance training. Results: Several factors were associated with higher levels of both aerobic physical activity and resistance training; self-efficacy was the strongest predictor for both modes of activity. Conclusions: The findings can guide physical activity promotion interventions and programs for this population, profiling those who are least active. [ABSTRACT FROM AUTHOR]

Purpose. Determine the proportion of adults aware of Canada's Physical Activity Guide to Healthy Active Living (Guide) and its specific recommendations (objective 1); whether key demographic factors (objective 2a) and physical activity behavior (objective 2b) are associated with awareness and specific familiarity with the Guide; and if changes in awareness and specific recommendations with the Guide occurred over a 1-year period (objective 3a and 3b). Design. Random selection with computer-assisted telephone interviewing. Setting. Edmonton, Alberta, Canada. Subjects. A total of 2803 adults 18 years or older completed interviews from 4831 telephone contacts (response rate, 58.0%), and after 1 year, 1423 individuals (55%) completed interviews. Measures. Demographic, physical activity, Guide awareness. Analysis. Chi-square, analysis of variance. Results. At baseline, 27.3% were aware of the Guide, and 15.6% were familiar with the Guide's specific recommendations. Younger individuals (p = .01), women (p < .001), and those with a higher education (p < .001) were more likely to be generally aware of the Guide, and women were also more specifically aware (p = .01). Physical activity levels were positively associated with the general (p < .001) and specific (p < .001) awareness of the Guide. Changes in general familiarity and specific recommendations over 1 year were observed. Conclusions. The majority of those surveyed were not familiar with the Guide. Men, individuals with a lower education, and older individuals may need to be specifically targeted. [ABSTRACT FROM AUTHOR]

At a population level, the method used to determine those meeting physical activity guidelines has important implications, as estimating "sufficient" physical activity might be confounded by weight status. The objective of this study was to test the difference between three methods in estimating the prevalence of "sufficient activity" among Canadian adults with type 2 diabetes in a large population sample (N = 1614) while considering the role of weight status as a potential confounder. Our results revealed that estimates of physical activity levels vary by BMI categories, depending on the methods examined. Although physical activity levels were lower in the obese, their energy expenditure estimates were not different from those who were overweight or of a healthy weight. The implications of these findings are that biased estimates of physical activity at a population level may result in inappropriate classification of adults with type 2 diabetes as "sufficiently active" and that the inclusion of body weight in estimating physical activity prevalence should be approached with caution. [ABSTRACT FROM AUTHOR]

The transtheoretical model's (TTM's) ability to predict physical activity stage transitions that incorporates all social-cognitive constructs from the original model has not been conducted among adults with diabetes. The purpose of this study was to test the capacity of the TTM for predicting physical activity stage transitions among adults (≥18 years of age) with type 1 ( N = 517) or type 2 ( N = 1,157) diabetes over 6 months. Participants were identified by a random-digit dialing telephone protocol through the Alberta Diabetes Registry. Assessments of TTM's stage of physical activity behavior change, self-efficacy, pros and cons, cognitive Processes of Change, and behavioral Processes of Change at baseline (time 1) and 6 months (time 2) were assessed by questionnaire. Over this time period, participants were categorized as having regressed (moved back at least one stage), remained (no stage change), or progressed (moved forward at least one stage). Baseline TTM constructs were analyzed for their ability to predict transition over 6 months. Moderate support for the TTM constructs in predicting physical activity stage transitions was found. Self-efficacy, pros, and behavioral Processes of Change hold relatively strong predictive power for stage progression over 6 months, with very few differences found between the types 1 and 2 diabetes groups. The capacity of the model in predicting stage transition is partially supported. When promoting physical activity among adults with diabetes, targeting self-efficacy, pros, and cognitive Processes of Change may favorably support stage transition in the pre-action stages, while strategies to enhance the behavioral Processes of Change may be appropriate for the Action and Maintenance stages. [ABSTRACT FROM AUTHOR]

Objectives. To investigate the utility of the protection motivation theory (PMT) for explaining physical activity (PA) in an adult population with type I diabetes (TID) and type 2 diabetes (T2D). Design. Cross-sectional and 6-month longitudinal analysis using PMT. Methods. Two thousand three hundred and eleven individuals with TI D (N = 697) and T2D (N = 1,614) completed self-report PMT constructs of vulnerability, severity, response efficacy, self-efficacy, and intention, and PA behaviour at baseline and 6-month follow-up. Multi-group structural equation modelling was conducted to: (I) test the fit of the PMT structure; (2) determine the similarities and differences in the PMT structure between the two types of diabetes; and (3) examine the explained variance and compare the strength of association of the PMT constructs in predicting PA intention and behaviour. Results. The findings provide evidence for the utility of the PMT in both diabetes samples (χ2/df = 1.27 - 4.08, RMSEA = .02-.05). Self-efficacy was a stronger predictor of intention (β = 0.64-0.68) than response efficacy (β = 0.14-0.16) in individuals with TI D or T2D. Severity was significantly related to intention (13 = 0.06) in T2D individuals only, whereas vulnerability was not significantly related to intention or PA behaviour. Self-efficacy (β's = 0.20-0.28) and intention (β's = 0.12-0.30) were significantly associated with PA behaviour. Conclusions. Promotion of PA behaviour should primarily target self-efficacy to form intentions and to change behaviour. In addition, for individuals with T2D, severity information should be incorporated into PA intervention materials in this population. [ABSTRACT FROM AUTHOR]

Objectives: To examine predictors of physical activity (PA) 6 months after a randomized controlled trial. Methods: Breast cancer survivors (N=377) completed assessments at baseline, postintervention, and 6 months after the intervention. Data were collected on demographic, medical, psychosocial, motivational, and behavioral variables at baseline, postintervention, and 6 months. Results: Survivors meeting PA guidelines at baseline (OR=5.54, 95% CI=2.99-9.82, P<0.001) and postintervention (OR = 2.92, 95% CI=1.63-5.23, P<0.001) had a greater likelihood of meeting PA guidelines at 6 months follow-up. Conclusions: Interventions promoting PA maintenance should focus on optimizing PA behavior, psychosocial functioning, and motivation. [ABSTRACT FROM AUTHOR]

Purpose. To evaluate the effects of a 12-week e-mail intervention promoting physical activity and nutrition, and to describe participant use and satisfaction feedback. Design. A longitudinal, randomized trial. Setting. Five large workplaces in Alberta, Canada. Participants. One thousand forty-three participants completed all three assessments, and 1263 participants in the experimental group provided use and satisfaction feedback after receiving the 12-week intervention. Intervention. Paired physical activity and nutrition messages were e-mailed weekly to the experimental group. The control group received all messages in bulk (i.e., within a single e-mail message) at the conclusion of the intervention. Measures. Self-report measures of knowledge, cognitions, and behaviors related to physical activity and nutrition were used. Satisfaction with e-mail messages was assessed at Time 2. Analysis. Planned contrasts compared the experimental group measures at Time 3 with those reported at Time 2 and with control group measures reported at Time 3. Control group measures at Time 3 were also compared with control group measures at Time 2. Results. The small intervention effects previously reported between Time 1 and Time 2 were maintained at Time 3. Providing the e-mail messages in bulk also had a significant positive effect on many of the physical activity and nutrition variables. Conclusions. E-mail offers a promising medium for promoting health-enhancing knowledge, attitudes, and behaviors. Additional research is needed to determine optimal message dose and content. [ABSTRACT FROM AUTHOR]

Background: The primary aim of this study was to compare the efficacy of three physical activity (PA) behavioural intervention strategies in a sample of adults with type 2 diabetes. Method/Design: Participants (N = 287) were randomly assigned to one of three groups consisting of the following intervention strategies: (1) standard printed PA educational materials provided by the Canadian Diabetes Association [i.e., Group 1/control group)]; (2) standard printed PA educational materials as in Group 1, pedometers, a log book and printed PA information matched to individuals' PA stage of readiness provided every 3 months (i.e., Group 2); and (3) PA telephone counseling protocol matched to PA stage of readiness and tailored to personal characteristics, in addition to the materials provided in Groups 1 and 2 (i.e., Group 3). PA behaviour measured by the Godin Leisure Time Exercise Questionnaire and related social-cognitive measures were assessed at baseline, 3, 6, 9, 12 and 18-months (i.e., 6-month follow-up). Clinical (biomarkers) and health-related quality of life assessments were conducted at baseline, 12-months, and 18-months. Linear Mixed Model (LMM) analyses will be used to examine time-dependent changes from baseline across study time points for Groups 2 and 3 relative to Group 1. Discussion: ADAPT will determine whether tailored but low-cost interventions can lead to sustainable increases in PA behaviours. The results may have implications for practitioners in designing and implementing theory-based physical activity promotion programs for this population. Clinical Trials Registration: ClinicalTrials.gov identifier: NCT00221234 [ABSTRACT FROM AUTHOR]

Background: Attempts to demonstrate the efficacy of interventions aimed at increasing physical activity (PA) have been mixed. Further, studies are seldom designed in a manner that facilitates the understanding of how or why a treatment is effective or ineffective and PA intervention designs should be guided by a heavier reliance upon behavioral theory. The use of a mediating variable framework offers a systematic methodological approach to testing the role of theory, and could also identify the effectiveness of specific intervention components. The primary purpose of this paper was to test the mediating role that cognitive constructs may have played in regards to the positive effect that a workplace behavioral intervention had on leisure-time PA for women. A subsidiary purpose was to examine the cross-sectional relationships of these cognitive constructs with PA behavior. Methods: The Physical Activity Workplace Study was a randomized controlled trial which compared the effects of stage-matched and standard print materials upon self-reported leisure-time PA, within a workplace sample at 6 and 12-months. In this secondary analysis we examined the mediation effects of 14 psychosocial constructs across 3 major social-cognitive theories which were operationalized for the intervention materials and measured at baseline, 6 and 12-months. We examined change in PA and change in the psychological constructs employing a mediation strategy proposed by Baron and Kenny for: (1) the first 6-months (i.e., initial change), (2) the second 6-months (i.e., delayed change), and (3) the entire 12-months (overall change) of the study on 323 women (n = 213 control/standard materials group; n = 110 stage-matched materials group). Results: Of the 14 constructs and 42 tests (including initial, delayed and overall change) two positive results were identified (i.e., overall change in pros, initial change in experiential powerful intervention approaches processes), with very small effect sizes. However, these mediating results were eliminated after adjusting for the multiple statistical tests. Conclusions: The intervention did not change these mediators in any substantive way, and show a similar pattern to prior research where interventions generally do not result in a change in mediation of behavior change. It is important to report mediation results in randomized controlled trials whether the findings are null or positive. Future studies may wish to focus on more detailed dose-response issues between mediators and behavior, the inclusion of moderators that could affect individual change, or different mediator constructs at higher levels of measurement specificity. Continued work on innovative and more powerful PA intervention approaches are needed. [ABSTRACT FROM AUTHOR]

Physical activity (PA) plays a key role in the management of Type 1 (T1D) and Type 2 diabetes (T2D) but there are few theory-based, effective programs to promote PA for individuals with diabetes. The purpose of this study was to investigate the utility of the Theory of Planned Behaviour (TPB) in understanding PA in an adult population with T1D or T2D. A total of 2311 individuals (691 T1D; 1614 T2D) completed self-report TPB constructs of attitude, subjective norms, perceived behavioural control (PBC), intention and PA at baseline and 1717 (524 T1D; 1123 T2D) completed the PA measure again at 6-month follow-up. Multi-group Structural Equation Modelling was conducted to: (1) test the fit of the TPB structure (2) determine the TPB structural invariance between the two types of diabetes and (3) to examine the explained variances in PA and compare the strength of associations of the TPB constructs in the two types of diabetes. The TPB constructs explained ≥40% of the variance in intentions for both diabetes groups. In cross-sectional models, the TPB accounted for 23 and 19% of the variance in PA for T1D and T2D, respectively. In prospective models, the TPB explained 13 and 8% of the variance in PA for T1D and T2D, respectively. When adjusting for past PA behaviour, the impact of PBC and intention on behaviour was reduced in both groups. The findings provide evidence for the utility of the TPB for the design of PA promotion interventions for adults with either T1D or T2D. [ABSTRACT FROM AUTHOR]

Abstract: Consuming a diet lower in total fat is important for the prevention of many chronic diseases. Individual and population-based programs targeting this behavior must be theoretically grounded and consider the context within which dietary behavior change may be attempted. To identify the factors differentiating stage of readiness to follow a low-fat diet, a sample (N =1216) of adults was surveyed using 4 different staging algorithms to assess stages of change and associated social-cognitive variables (pros, cons, and temptation). Approximately 75% of the sample occupied the Action/Maintenance stages for all staging algorithms. In general, pros increased and cons decreased with higher stage occupation. Temptation decreased from the early pre-action to the action stages for the different staging algorithms. When developing programs to decrease dietary-fat intake, social-cognitive variables associated with stage transition for behaviors related to consuming a low-fat diet may have relevance to researchers and clinicians. [Copyright &y& Elsevier]

The purpose of this study was to examine the Protection Motivation Theory (PMT) to predict physical activity (PA) behaviour in a large, population-based sample of adults. One thousand six hundred and two randomly selected individuals completed two telephone interviews over two consecutive six-month periods assessing PMT constructs. PMT explained 35 per cent and 20 per cent of the variance in intention and behaviour respectively. Coping cognitions as moderators of threat explained 1 per cent of the variance in intention and behaviour. Age and gender as moderators of threat did not provide additional variance in the models. We conclude that salient PMT predictors (e.g. self-efficacy) may guide the development of effective PA interventions in the general population. [ABSTRACT FROM AUTHOR]

Abstract: Background: Stages of change are related to dietary fat consumption. Few studies have examined stage occupation within the context of purchasing low-fat foods. Objective: To determine the stage-prevalence of individuals for purchasing low-fat foods; identify the frequency of misclassification into action and maintenance (A/M) stages for purchasing for low-fat foods; and explain the demographic and cognitive-variable differences between pseudo (or false positive) A/M and true A/M individuals. Design: Data were collected using a self-administered questionnaire among English-speaking adults (n=1,001) who were randomly sampled by mail. Statistical analyses performed: Descriptive statistics were used to compare the characteristics of the stage groups. Groups were compared using χ2 tests and Student t test. Results: Of those who reported being in A/M stages, 32% were misclassified by the staging algorithm and were not true A/M low-fat food purchasers. Conclusions: Individuals who are in A/M stages for buying low-fat foods still purchase high-fat foods. Stage misclassification may be a persistent problem in studies of dietary change using the Transtheoretical Model. [Copyright &y& Elsevier]

Abstract: Background: It is well established that both aerobic physical activity (PA) and resistance training are essential in the treatment and management of type 2 diabetes (T2D), but few studies have examined the determinants of both modes of PA in the same sample. Purpose: The main objective was to investigate the utility of the Protection Motivation Theory (PMT) in predicting aerobic PA and resistance training in a population sample of T2D adults. Methods: A total of 244 individuals completed self-report PMT constructs of vulnerability, severity, fear, response efficacy, self-efficacy and intention, and a 3-month follow-up that assessed aerobic PA and resistance training. Results: PMT explained 19% (p <.001) and 20% (p <.001) of the variance respectively for aerobic PA and resistance training behaviour. Significant associations were found between self-efficacy (β =0.45, p <.001) and gender (β =0.15, p <.05) for aerobic PA, and self-efficacy (β =0.48, p <.001) and age (β =0.17, p <.05) for resistance training. PMT accounted for 43% (p <.001) and 56% (p <.001) of the variance respectively for aerobic PA and resistance training intentions. For aerobic PA, response efficacy (β =0.14, p <.05) and self-efficacy (β =0.59, p <.001) were significantly associated with intention, while response efficacy (β =0.23, p <.001), self-efficacy (β =0.64, p <.001) and age (β =0.10, p <.05) were significantly related with resistance training intention. Conclusions: None of the unique constructs of the PMT (i.e., perceived vulnerability, severity and fear) were significant with either aerobic and resistance training intention. These results may guide the development of effective PA interventions in people with T2D. [Copyright &y& Elsevier]

Objective. Two different theories of health behaviour have been chosen with the aim of theory integration: a continuous theory (protection motivation theory, PMT) and a stage model (transtheoretical model, TTM). This is the first study to test whether the stages of the TTM moderate the interrelation of PMT-variables and the mediation of motivation, as well as PMT-variables' interactions in predicting stage transitions. Design. Hypotheses were tested regarding (1) mean patterns, stage pair-comparisons and nonlinear trends using ANOVAs; (2) prediction-patterns for the different stage groups employing multi-group structural equation modelling (MSEM) and nested model analyses; and (3) stage transitions using binary logistic regression analyses. Method. Adults (N = 1,602) were assessed over a 6 month period on their physical activity stages, PMT-variables and subsequent behaviour. Results. (1) Particular mean differences and nonlinear trends in all test variables were found. (2) The PMT adequately fitted the five stage groups. The MSEM revealed that covariances within threat appraisal and coping appraisal were invariant and all other constrains were stage-specific, i.e. stage was a moderator. Except for self-efficacy, motivation fully mediated the relationship between the social-cognitive variables and behaviour. (3) Predicting stage transitions with the PMT-variables underscored the importance of self-efficacy. Only when threat appraisal and coping appraisal were high, stage movement was more likely in the preparation stage. Conclusions. Results emphasize stage-specific differences of the PMT mechanisms, and hence, support the stage construct. The findings may guide further theory building and research integrating different theoretical approaches. [ABSTRACT FROM AUTHOR]

Background -: This pilot study evaluated the feasibility (recruitment, retention, adherence and satisfaction) and preliminary efficacy of a 12-week website and email-linked counselling intervention on physical activity behaviour change in individuals with type 2 diabetes. Methods -: A total of 49 individuals with type 2 diabetes (59% female, average age 54.1 years) were randomized to the Diabetes NetPLAY intervention or control condition. The intervention condition received information grounded in the Social Cognitive Theory (SCT), personalized weekly emails, an on-line logbook and message board. Key outcomes included physical activity behaviour and related cognition changes. The control condition was provided links to the Canadian Diabetes Association's Clinical Practice Guidelines for Physical Activity and Canada's Guide to Physical Activity. Results -: Intervention participants indicated high levels of satisfaction for this mode of delivery and study results demonstrated the feasibility of web-based mediums for the delivery of physical activity information in this population. The intervention group demonstrated a significant improvement in total vigorous and moderate minutes of physical activity (p = 0.05) compared to the control group over the 12-week study. Among the SCT variables, behavioural capacity, showed a significant increase (p < 0.001) among intervention participants. Conclusion -: Web-based interventions for individuals with type 2 diabetes are feasible and show promise for improving positive physical activity outcomes. [ABSTRACT FROM AUTHOR]

Most of the population have positive intentions to engage in physical activity (PA) but fail to act; thus, the need to understand successful translation of intention into behavior is warranted in order to focus intervention efforts. The objective of the study is to examine constructs of the transtheoretical model, theory of planned behavior, and protection motivation theory as predictors of physical activity intention–behavior profiles across 6 months in a Canadian workplace sample. Employees from three large organizations in the province of Alberta ( n = 887) completed a baseline survey relating to their demographic and medical background, PA, and social–cognitive constructs. A total of 611 participants completed a second assessment 6 months later. Participants were grouped by five profiles: nonintenders, unsuccessful adopters, successful adopters, unsuccessful maintainers, and successful maintainers. Perceived importance and concern for PA (cognitive processes, instrumental attitude, perceived severity) distinguished nonintenders from the other four profiles, self-management and self-regulation of the behavior (behavioral processes, self-efficacy) distinguished successful adopters from unsuccessful adopters, while control over constraints (cons, perceived control, self-efficacy) were the key discriminators of successful maintainers from unsuccessful maintainers. The results provide useful information for intervention campaigns and demonstrate a need to consider adoption and maintenance profiles. [ABSTRACT FROM AUTHOR]

The purpose of the study was to test the Social Cognitive Theory (SCT; Bandura, 2004 ) for explaining physical activity (PA) in a large population sample of adults with type 1 or type 2 diabetes. Study objectives: (1) test the fit of the SCT structure in the total sample, and the diabetes sub-types; (2) determine the SCT structural invariance between the type 1 and type 2 groups; and (3) report explained variance and compare strength of association for the SCT constructs in predicting PA for both type 1 and type 2 groups. In all, 2,311 individuals with type 1 or type 2 diabetes were assessed on their self-efficacy, outcome expectancies, impediments, social support, goals, and physical activity at baseline and 1,717 (74.5%) completed these assessments again at 6 months. Multi-group Structural Equation Modeling was conducted. The findings provide evidence for the utility of the SCT in the diabetes samples. The SCT fits individuals with type 1 and type 2 diabetes except for SCT impediments, which appear to be obstructing goal-setting in individuals with type 2 diabetes only. Promotion of health behavior should target self-efficacy to set goals and change behavior. Outcome expectancies and social support are also important factors for setting goals and behavior performance. [ABSTRACT FROM AUTHOR]

Background: There is an emerging knowledge base on the effectiveness of strategies to close the knowledge-practice gap. However, less is known about how attributes of an innovation and other contextual and situational factors facilitate and impede an innovation's adoption. The Healthy Heart Kit (HHK) is a risk management and patient education resource for the prevention of cardiovascular disease (CVD) and promotion of cardiovascular health. Although previous studies have demonstrated the HHK's content validity and practical utility, no published study has examined physicians' uptake of the HHK and factors that shape its adoption. Objectives: Conceptually informed by Rogers' Diffusion of Innovation theory, and Theory of Planned Behaviour, this study had two objectives: (1) to determine if specific attributes of the HHK as well as contextual and situational factors are associated with physicians' intention and actual usage of the HHK kit; and (2), to determine if any contextual and situational factors are associated with individual or environmental barriers that prevent the uptake of the HHK among those physicians who do not plan to use the kit. Methods: A sample of 153 physicians who responded to an invitation letter sent to all family physicians in the province of Alberta, Canada were recruited for the study. Participating physicians were sent a HHK, and two months later a study questionnaire assessed primary factors on the physicians' clinical practice, attributes of the HHK (relative advantage, compatibility, complexity, trialability, observability), confidence and control using the HHK, barriers to use, and individual attributes. All measures were used in path analysis, employing a causal model based on Rogers' Diffusion of Innovations Theory and Theory of Planned Behaviour. Results: 115 physicians (follow up rate of 75%) completed the questionnaire. Use of the HHK was associated with intention to use the HHK, relative advantage, and years of experience. Relative advantage and the observability of the HHK benefits were also significantly associated with physicians' intention to use the HHK. Physicians working in solo medical practices reported experiencing more individual and environmental barriers to using the HHK. Conclusion: The results of this study suggest that future information innovations must demonstrate an advantage over current resources and the research evidence supporting the innovation must be clearly visible. Findings also suggest that the innovation adoption process has a social element, and collegial interactions and discussions may facilitate that process. These results could be valuable for knowledge translation researchers and health promotion developers in future innovation adoption planning. [ABSTRACT FROM AUTHOR]

Abstract: Physical activity plays a key role in diabetes management, and in reducing the risk factors related to the development of co-morbid conditions. This study examined predictors of physical activity (Static Model) and activity change (Change Model) for individuals with type 1 (T1D) or type 2 diabetes (T2D) in a population sample of 1662 adults (510 type 1; 1152 type 2) using self-reported measures of co-morbidities, perceived difficulties in performing tasks of daily living (TDL), time since diagnosis, and selected demographic factors. Since the motivation for physical activity could be influenced by the initial diagnosis of diabetes, analyses were conducted separately for newly diagnosed individuals (diagnosed with diabetes ≤1 year), and those that have been diagnosed for sometime (diagnosed with diabetes >1 year). In the Static Model, a younger age (β =−.11, p <.05) and having less perceived difficulties in performing TDL (β =−.12, p <.05) were associated with a higher physical activity in individuals with type 1 diabetes. The presence of difficulties in TDL (β =−.08, p <.05) and co-morbidities (β =−.08, p <.05) were associated with physical activity participation in type 2 individuals diagnosed for >1 year, but not in newly diagnosed individuals. A shorter duration of disease (β =−.07, p <.05), a higher body mass index (BMI) (β =.09, p <.05) and female gender (β =.07, p <.05) was associated with physical activity increase in individuals with type 2 diabetes. A higher BMI predicted physical activity change in both newly diagnosed individuals and those diagnosed for sometime. However, both genders were equally likely to increase their physical activity among newly diagnosed individuals. Although the magnitude of the study results are relatively modest, they could potentially guide and encourage future investigations in this area that could lead to useful insights in designing PA intervention programs for these specific populations. [Copyright &y& Elsevier]

Purpose. To compare the effects of stage-matched and standard print materials for physical activity (PA) change. Design. Participants were randomized into (1) a stage-matched intervention group (n = 165), (2) a standard intervention group (n = 176), or (3) a no-contact control group (n = 166). The stage-matched and standard intervention groups both received materials at baseline, 3 months, and 6 months. Assessments of all three groups were conducted at baseline, 6, and 12 months. Setting. Canadian worksites. Subjects. Employees (N = 507). Interventions. Five motivationally targeted booklets were developed for the stage-matched group. The standard group received Canada's Physical Activity Guide and handbook. Measures. The main dependent variable was PA, expressed as metabolic equivalent (MET) minutes and measured using the Godin Leisure-Time Exercise Questionnaire. Demographic characteristics and stages of change for PA were also assessed. Results. At 12 months mean weekly MET minutes for combined moderate and vigorous activity increased from baseline by 223, 67, and 78 for the stage-matched, standard, and control groups, respectively; however, differences were not significant (p > .05). Women in the stage-matched group over the 12-month period significantly increased their activity by 327 weekly MET minutes whereas the standard and control groups declined their activity (F = 3.01, p < .05). Conclusion. PA stage-matched materials delivered in the workplace are efficacious for women but not men. Future interventions should explore the use of these intervention materials in conjunction with multilevel strategies, and particular attention should be paid to possible gender differences. [ABSTRACT FROM AUTHOR]