The Effects of Physical Activity Messages on Physical Activity Support Behaviors and Motivation Among Parents of Children with Disabilities.

Persuasive messages can motivate parent support for physical activity (PA). Many PA messages targeting parents are not necessarily inclusive of parents of children with disabilities (CWD). Guided by the theory of planned behavior and multi-process action control model, the relative effects of PA messages were examined among parents of CWD. Parents (N = 135) were randomized to view one of four PA messages. Parent support for PA and various psychosocial antecedents were assessed before and after message viewing, along with message preference. Baseline parent support for PA acted as a moderator on the effects of messages. Effects of messages did not differ between message conditions. Overall message effects were observed for attitudes, subjective norms and planning. Parent support for PA increased only among parents with low baseline parent support and the inclusive message was most preferred. This study can inform the development of PA messages targeting this population.

Evidence-Informed Recommendations for Community-Based Organizations Developing Physical Activity Information Targeting Families of Children and Youth With Disabilities.

Parents of children and youth with disabilities (CYD) have expressed unique physical activity (PA) information needs. Community-based organizations (CBOs) require assistance to meet these needs. Guided by the Appraisal of Guidelines, Research and Evaluation II, this project established evidence-informed recommendations for developing PA information targeting families of CYD. This process involved a systematic scoping review to inform draft recommendations (k = 23), which were revised via a consensus meeting with researchers, knowledge users from CBOs, and families of CYD. Broader consultation with CBO knowledge users informed the final recommendations (k = 5) that fit within the following categories: (a) language and definitions, (b) program information, (c) benefits of PA, (d) barriers to PA, and (e) PA ideas and self-regulation tools. CBOs are encouraged to consider these recommendations when developing PA information for families of CYD. Future research will focus on the development of knowledge products to disseminate the recommendations to CBOs and support implementation.

Quality of life outcomes in children after surgery for Hirschsprung disease and anorectal malformations: a systematic review and meta-analysis.

Background: No systematic review and meta-analysis to date has examined multiple child and parent-reported social and physical quality of life (QoL) in pediatric populations affected by Hirschsprung's disease (HD) and anorectal malformations (ARM). The objective of this systematic review is to quantitatively summarize the parent-reported and child-reported psychosocial and physical functioning scores of such children. Methods: Records were sourced from the CENTRAL, EMBASE, and MEDLINE databases. Studies that reported child and parent reported QoL in children with HD and ARM, regardless of surgery intervention, versus children without HD and ARM, were included. The primary outcome was the psychosocial functioning scores, and the secondary outcomes were the presence of postoperative constipation, postoperative obstruction symptoms, fecal incontinence, and enterocolitis. A random effects meta-analysis was used. Results: Twenty-three studies were included in the systematic review, with 11 studies included in the meta-analysis. Totally, 1678 total pediatric patients with HD and ARM underwent surgery vs 392 healthy controls. Pooled parent-reported standardized mean (SM) scores showed better social functioning after surgery (SM 91.79, 95% CI (80.3 to 103.3), I2=0). The pooled standardized mean difference (SMD) showed evidence for parent-reported incontinence but not for constipation in children with HD and ARM after surgery that had a lower mean QoL score compared with the normal population (SMD -1.24 (-1.79 to -0.69), I2=76% and SMD -0.45, 95% CI (-1.12 to 0.21), I2=75%). The pooled prevalence of child-reported constipation was 22% (95% CI (16% to 28%), I2=0%). The pooled prevalence of parent-reported postoperative obstruction symptoms was 61% (95% CI (41% to 81%), I2=41%). Conclusion: The results demonstrate better social functioning after surgery, lower QoL scores for incontinence versus controls, and remaining constipation and postoperative obstruction symptoms after surgery in children with HD and ARM.

Development and evaluation of a patient decision aid for pediatric interval appendectomy.

Objective: One option for the treatment of perforated appendicitis in pediatric patients is interval appendectomy (IA). A patient decision aid (PDA) can be useful in the decision-making process regarding IA. The purpose of this study was to evaluate parents' decisional conflict before and after engaging with a developed PDA. Methods: Participants included (a) parents who are considering IA surgery for their child, (b) have not yet had their follow-up appointment postdischarge, and (c) were fluent in either the official languages of English or French. This study used a pretest and post-test design to measure participants' decisional conflict and treatment option choice. Perceptions and acceptability of the PDA were also assessed. Results: A total of 18 participants completed the study (16 mothers). Major findings include significant decreases in all Decisional Conflict Scale items from pre-PDA to post-PDA engagement, except for one item. The majority of participants perceived the PDA to be useful, easy to find information regarding risks and provided enough information to help them make a decision regarding their child's treatment. Conclusions: This is the first study to develop and evaluate a PDA among parents who are making a decision regarding IA surgery. The results showed a significant decrease in decisional conflict after using the PDA. The results also showed that the PDA was generally accepted among parents and had positive perceptions regarding length, content, and balance. The use of PDA for this population can help ease feelings of decisional conflict and equip parents with the information to make informed decisions.

Physical activity and life satisfaction among individuals with spinal cord injury: Exploring loneliness as a possible mediator.

Context: There has been no known research investigating the association between leisure time physical activity (LTPA), loneliness, and life satisfaction among people with spinal cord injury or dysfunction (SCI/D). The relationship between these constructs is worthy of consideration given the positive health impacts of LTPA, the negative health impacts of loneliness, and heightened negative effects of loneliness on life satisfaction for individuals with SCI/D.Objectives: To examine the relationship between LTPA and loneliness, and examine loneliness as a possible mediator of the relationship between LTPA and life satisfaction among individuals with SCI/D.Design and Participants: Community dwelling individuals with SCI/D (N = 170) participated in a telephone-based survey as part of a larger project.Measures: LTPA (i.e. The Leisure Time Physical Activity Questionnaire-SCI, UCLA Loneliness Scale-3, and the Life Satisfaction Questionnaire-11 were administered to the participants.Results: Significant bivariate relationships were observed between LTPA and life satisfaction (r = .18, P = .02), LTPA and loneliness (r = -.15, P = .045), and loneliness and life satisfaction (r = -.69, P < .001). Mediation analyses suggest that loneliness significantly mediated the relationship between LTPA and life satisfaction (indirect effect = .003, 95% bootstrap CI = .0004 to .0062, CSI = .113).Conclusion: This was the first study to show evidence of a negative association between LTPA and loneliness among people with SCI/D, and to establish a conceptual model for understanding the potential mediating role of loneliness in the relationship between LTPA and life satisfaction among people with SCI/D.

Developing and Disseminating Physical Activity Messages Targeting Parents: A Systematic Scoping Review.

BACKGROUND: Physical activity (PA) messages have demonstrated success in targeting parent support for PA. However, little research exists to inform the development and dissemination of optimally effective PA messages targeting parents. A synthesis of existing literature is necessary to inform message development and dissemination strategies. Unique considerations for parents of children with disabilities (CWD) should be identified given a need for inclusive PA messaging that consider the needs of CWD and their families. METHODS: Systematic scoping methodologies included a peer-reviewed literature search and expert consultation to identify literature regarding PA messages targeting parents, and considerations for parents of CWD. RESULTS: Thirty-four articles that met eligibility criteria were included for examination. Twenty-eight studies were identified regarding the PA messages targeting parents; six themes and 12 subthemes emerged from these articles. Six studies were identified regarding unique considerations for parents of CWD; three themes and four subthemes emerged from these articles. CONCLUSIONS: Through knowledge synthesis, this research can contribute to a knowledge translation process to inform practice guidelines for the development and dissemination of PA messages targeting parents, while also providing unique considerations for PA messages targeting parents of CWD.

Physical Activity Messages for Youth with Disabilities: An Evaluation of Attitudes, Intentions, and Preferences.

There is no known research examining the use of strategic messages to motivate youth with physical disabilities (YWPD), or how to create effective messages for them. Guided by the Social Issue Advertising Believability Model (SIABM), the study aimed to: (i) examine the effectiveness of physical activity (PA) messages on YWPD's attitudes and intentions to participate in PA, and (ii) consider factors related to message effectiveness. YWPD (N = 60) were randomized to view one of three PA messages: (a) no youth, (b) non-inclusive, and (c) targeted. Attitudes and intentions to participate in PA were assessed at baseline and immediately following viewing one of the three messages. Participants also evaluated the messages in terms of relevance, believability, attention, and attitudes. Repeated measures ANOVA and median split analyses indicated that attitudes toward PA increased after message viewing for participants with low baseline attitudes, but decreased for participants with high baseline attitudes. No significant changes in intentions emerged. The targeted message was most preferred and evaluated as most believable. Attention paid to the message was the only significant predictor of intention to participate in PA post-viewing (p = .001). PA campaigns should consider being inclusive of YWPD with low attitudes and intentions to engage in PA when developing messages.

"Even if someone has a physical disability, they can still participate": Youth with physical disabilities' motivational physical activity message preferences.

BACKGROUND: Youth with disabilities (YWD) experience unique physical activity (PA) needs and subsequently experience low levels of PA and are vulnerable to the risks associated with physical inactivity. Persuasive PA messages have been shown to motivate able-bodied youth to engage in PA, but there is no known research examining the PA motivational messaging needs preferences of YWD. OBJECTIVE: The objective of this study was to examine and understand the PA motivational messaging needs and preferences of YWD. METHODS: Sixty YWD were randomized to view three PA messages: a) no youth, b) non-inclusive, and c) targeted. After viewing the PA messages, participants completed a survey which consisted of three open-ended questions probing participants about their PA messaging needs and preferences. Responses were analyzed using a qualitative approach through an interpretivist lens. RESULTS: Two main themes emerged from the data: (1) factors that facilitate motivation for PA, with subthemes of reliability, happiness/hope, disability does not limit PA, thinking deeply, motivational, inclusivity, accessible information, and success stories; and (2) factors that negatively influence motivation for PA, with subthemes of sad and negative feelings, jealousy, not relatable, and reinforced physical limitations. CONCLUSIONS: An improved understanding of the messaging needs and preferences of YWD can inform the development of optimally effective targeted messages to promote and motivate PA among YWD. The results of this study can be useful for PA organizations in order to develop inclusive PA messages for YWD.