Exploring Proximal LGBTQ+ Minority Stressors Within Physical Activity Contexts from a Self-determination Theory Perspective.

BACKGROUND: LGBTQ+ (lesbian, gay, bisexual, transgender, queer, etc.) individuals experience challenges such as discrimination and marginalization (referred to as minority stressors) that are detrimental to their mental and physical health. Specifically, proximal or internalized LGBTQ+ minority stressors may influence motivation for and willingness to participate in physical activity. PURPOSE: To explore whether proximal LGBTQ+ minority stressors relate to the basic psychological needs-motivation-physical activity pathway, as per self-determination theory. METHODS: An online cross-sectional survey was completed by 778 self-identified LGBTQ+ adults. Structural equation modelling analyses were used to examine how proximal LGBTQ+ minority stressors relate to the motivational sequence. RESULTS: Findings support that proximal LGBTQ+ minority stressors are negatively associated with psychological need satisfaction within physical activity (ß = -.36), which in turn is positively associated with autonomous motivation (ß = .53) and reported physical activity participation (ß = .32). Overall, the final model accounted for 13% of variance in need satisfaction (small effect size), 53% of variance in autonomous motivation (moderate-large effect size), and 10% of variance in moderate-to-vigorous physical activity levels (small effect size). CONCLUSIONS: Future research focused on increasing LGBTQ+ participation in physical activity should investigate the effects of (a) reducing proximal LGBTQ+ minority stressors and (b) better supporting LGBTQ+ adults' autonomy, competence, and relatedness within physical activity contexts.

Exploring the Relationship Between Quality and Quantity of Physical Activity Participation in Community-Based Exercise Programs for Persons With Physical Disabilities.

Community-based exercise programs for persons with disabilities promote greater quantity of leisure-time physical activity (LTPA) participation among their members, perhaps because of the quality experiences fostered by the program. This study aimed to explore the relationship between quality and quantity of physical activity participation in the context of community-based exercise programming and the role that gender plays in this relationship. Adults with physical disabilities (N = 91; Mage = 55, 49 men) from three community-based exercise programs across Canada completed a survey asking about quality participation (Measure of Experiential Aspects of Participation [MeEAP]) and LTPA. Structural equation modeling was used to examine the relationship between MeEAP scores and LTPA. Quality participation was not related to LTPA, even with gender included as a moderator. Men reported higher levels of LTPA and quality participation than women, highlighting gender differences that should be considered when researching and designing exercise programs for individuals with disabilities.

Longitudinal Examination of Leisure-Time Physical Activity (LTPA), Participation, and Social Inclusion Upon Joining a Community-based LTPA Program for Adults With Physical Disabilities.

OBJECTIVE: First, to examine whether participants reported changes in (1) leisure-time physical activity (LTPA) participation and social inclusion variables and (2) well-being outcomes before and after joining a community-based LTPA program for adults with physical disabilities. Second, to explore the longitudinal relationship between LTPA and the other aforementioned outcomes. DESIGN: A double baseline longitudinal design with measurements at 4-6 weeks (baseline 1) and immediately (baseline 2) before and 2 and 4 months after joining the community-based LTPA program. SETTING: Community. PARTICIPANTS: Adults (N=43) with a physical disability who reported no cognitive impairment, were new members of the community-based LTPA program, and spoke English or French. INTERVENTIONS: A community-based physical activity program for adults with physical disabilities. Participants were provided an individualized exercise program and accessed the program at designated times during the week. MAIN OUTCOME MEASURES: Primary: LTPA (LTPA Questionnaire for People with Spinal Cord Injury), participation (Patient-Perceived Participation in Daily Activities Questionnaire), and social inclusion. Secondary: depression severity, self-esteem, resilience, and life satisfaction. RESULTS: After joining the program, participants reported an increase in total LTPA (meanbaseline2, 177.80±211.32; mean2months, 299.31±298.70; mean4months, 288.14±292.14), moderate-to-vigorous LTPA (meanbaseline2, 83.95±123.95; mean2months, 142.00±198.38; mean4months, 163.23±182.08), and participation in health (meanbaseline2, 6.24±1.16; mean2months, 6.58±1.25; mean4months, 6.97±0.82) and family-related activities (meanbaseline2, 12.18±2.43; mean2months, 12.60±2.30; mean4months, 13.47±2.01). A significant increase (ß=3.46, P<.001) in social inclusion before joining the program was followed by a decrease (ß=-1.09, P<.05) 4 months later. Improvements related to depression severity were noted (ßbaseline1-baseline2=-1.51, P<.05; ßbaseline2-4 months=-0.28, P>.05). CONCLUSIONS: The results support the role of a community-based LTPA program in increasing LTPA levels and enhancing participation in some activities among adults with physical disabilities.

Integrated Knowledge Translation Guiding Principles for Conducting and Disseminating Spinal Cord Injury Research in Partnership.

OBJECTIVE: To address a gap between spinal cord injury (SCI) research and practice by rigorously and systematically co-developing integrated knowledge translation (IKT) guiding principles for conducting and disseminating SCI research in partnership with research users. DESIGN: The process was guided by the internationally accepted The Appraisal of Guidelines for REsearch & Evaluation (AGREE) II Instrument for evaluating the development of clinical practice guidelines. SETTING: North American SCI research system (ie, SCI researchers, research users, funders). PARTICIPANTS: The multidisciplinary expert panel (n=17) and end users (n=35) included individuals from a North American partnership of SCI researchers, research users, and funders who have expertise in research partnerships. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Clarity, usefulness, and appropriateness of the principles. RESULTS: Data regarding 125 principles of partnered research were systematically collected from 4 sources (review of reviews, scoping review, interviews, Delphi consensus exercise). A multidisciplinary expert panel held a 2-day meeting to establish consensus, select guiding principles, and draft the guidance. The panel reached 100% consensus on the principles and guidance document. The final document includes a preamble, 8 guiding principles, and a glossary. Survey data showed that the principles and guidance document were perceived by potential end users as clear, useful, and appropriate. CONCLUSIONS: The IKT Guiding Principles represent the first rigorously co-developed, consensus-based guidance to support meaningful SCI research partnerships. The principles are a foundational tool with the potential to improve the relevance and impact of SCI research, mitigate tokenism, and advance the science of IKT.

Understanding peer mentorship programs delivered by Canadian SCI community-based organizations: perspectives on mentors and organizational considerations.

STUDY DESIGN: The study used a generic qualitative design. OBJECTIVES: This article set out to garner knowledge of peer mentorship programs delivered by SCI community-based organizations by interviewing people who are directly and in-directly involved with these programs. SETTING: Four provincial community-based SCI organizations across Canada. An integrated knowledge translation approach was applied in which researchers and SCI organization members co-constructed, co-conducted, and co-interpreted the study. METHODS: Thirty-six individuals (N = 36, including peer mentees, mentors, family members of mentees, and organizational staff) from four provincial SCI community-based organizations were interviewed. The participants' perspectives were combined and analyzed using a thematic analysis. RESULTS: Two overarching themes with respective subthemes were identified. Mentorship Mechanics describes the characteristics of mentors and mentees and components of the mentor-mentee relationship (e.g., establish a common ground). Under the theme Peer Mentorship Program Structures, participants described the organizational considerations for peer mentorship programs (e.g., format), and organizational responsibilities (e.g., funding; creating a peer mentorship team). CONCLUSION: This study provides an in-depth look at the characteristics of peer mentorship programs that are delivered by community-based organizations in Canada and highlights the complexity of delivering such programs.

Outcomes of peer mentorship for people living with spinal cord injury: perspectives from members of Canadian community-based SCI organizations.

STUDY DESIGN: A generic qualitative design. OBJECTIVES: To obtain a deeper understanding of the outcomes of spinal cord injury (SCI) peer mentorship programs delivered by community-based organizations. SETTING: Peer mentorship programs of community-based SCI organizations METHODS: We interviewed 36 individuals who shared their experiences of SCI peer mentorship from the perspective of a peer mentee, peer mentor, or family member of a peer mentee/mentor, or staff of SCI community-based organizations. Interview data were analyzed using an inductive thematic analysis approach. RESULTS: Four overarching themes with sub-themes were identified. (1) Positive outcomes for mentees such as understanding, emotional outlet/psychological support, inspiration/hope, and belonging. (2) Positive outcomes for mentors such as gaining gratitude, confidence, pride, and personal growth. (3) Reciprocity in positive/negative outcomes for mentors and mentees, such as shared learning and a lack of connection. (4) Negative outcomes for mentors such as impact of negativity, emotional toll, and time/energy demands. CONCLUSIONS: Peer mentorship programs delivered by community-based SCI organizations are important, impactful resources for individuals with SCI who engage in these programs. These results provide insights into the variety of positive and negative outcomes linked with these programs.

Research and Healthcare Priorities of Individuals Living with COPD.

This study describes the research and healthcare priorities of individuals living with COPD. On an online survey, individuals living with COPD assigned a percentage of funding to 22 research priorities and a percentage of time spent communicating with a healthcare provider to 24 healthcare priorities, indicating which topics were most important. For each research and healthcare priority, we examined the selection frequency of the priority and used chi-square analyses to examine differences in priority selection by quartiles of airflow obstruction (percent predicted forced expiratory volume in 1-sec (FEV1%predicted)) and breathlessness burden and exacerbation risk. Based on participants' responses (N = 148, 47% women; Mean ± Standard Deviation age = 68 ± 9 yrs) relief of breathlessness was the most often selected research (76% of respondents) and healthcare priority (61% of respondents). It was selected most often, regardless of disease severity or breathlessness burden and exacerbation risk. We found differences for disease severity and breathlessness burden and exacerbation risk in some research priorities (e.g., to improve the maximal amount of exercise of adults living with COPD in and out of the home (χ2(3) = 9.97, Cramer's V =.28) and healthcare priorities (e.g., increase your ability to exercise (χ2(3) = 9.72, Cramer's V =.27)). This study provides empirical evidence that relief of breathlessness is a top research and healthcare priority for individuals living with COPD. Future healthcare and research activities should align with the priorities of individuals with COPD to improve their care by minimizing disease/symptom burden and optimizing health-related quality of life.

Physical activity participation and mental health profiles in Canadian medical students: latent profile analysis using continuous latent profile indicators.

Rates of mental illness among Canadian medical students are higher than age-, gender-, and education-matched peers. One predictor of mental health is physical activity; though the relationship between different intensities of physical activity and mental health has not been investigated in medical students. The purpose of this study was to examine relationships between physical activity and mental health profiles in a sample of Canadian medical students. A total of N = 125 students completed an online survey. Latent profile analysis was performed to identify distinct profiles using four continuous latent profile indicators (emotional well-being, social well-being, psychological well-being,resilience). Three mental health profiles emerged, showing low (n = 18), moderate (n = 72) and high (n = 36) self-reported ratings of mental health. The classification quality was good (entropy = 0.81). Individuals in the high mental health profile engaged in more mild physical activity (M = 144.28 mins/week; SD = 22.12) and less moderate-to-vigorous physical activity (M = 195.86 mins/week; SD = 25.67) compared to students in the moderate and low profiles, though not significantly. This suggests that mild physical activity might be the most effective intensity in supporting mental health among medical students, though further research is recommended.

Demographic differences in Canadian medical students' motivation and confidence to promote physical activity.

BACKGROUND: Physical activity (PA) remains under prescribed by physicians. Motivation and confidence are clear drivers of frequency of promoting PA. Research shows demographic differences in physicians' preventive practices, yet none have included medical students who form habits during training. OBJECTIVES: Study objectives were to (i) examine how Canadian medical students' motivation to recommend PA to future patients differs according to six demographic variables (i.e. gender, ethnicity, year of study, university, proposed specialty and academic background) and (ii) examine how Canadian medical students' confidence to recommend PA to future patients differs according to these same demographic variables. METHODS: A cross-sectional design was used. First to fourth year medical students from three medical schools responded to an online survey (N = 221). RESULTS: Female participants were more motivated to counsel patients on PA and refer to an exercise specialist compared to males (P < 0.01). Second year students were more motivated to assess a patients' level of PA compared to third and fourth year students (P < 0.01). Students pursuing family medicine were more confident to assess and counsel compared to students pursuing paediatrics (P < 0.01). CONCLUSION: Given that motivation and confidence have a positive influence on frequency-promoting PA, these results suggest where future efforts should focus, to improve PA promotion in medical practice. Physical inactivity continues to be a major issue worldwide, and medical students as future physicians have a unique opportunity to enhance PA amongst the population.

Exploring how Chinese adults living with spinal cord injury viewed the prospect of inpatient peer support programs within a hospital-based rehabilitation setting.

STUDY DESIGN: Generic qualitative design. OBJECTIVES: To explore how Chinese adults living with spinal cord injury (SCI) viewed the prospect of inpatient peer support programs within a rehabilitation setting. SETTING: Hospital in China. METHODS: A purposive sample of adult inpatients with SCI (N = 6) currently undergoing rehabilitation was recruited. Each participant was interviewed twice. Twelve interview transcripts were analyzed using a thematic method. RESULTS: Five higher-order themes were developed. First, participants had unique backgrounds and personal lives before and after their SCI and reported frustrations about their lives resulting from their SCI. Second, participants reported varying degrees of satisfaction with their rehabilitation and identified the facilitators and barriers to their rehabilitation. Third, their perspectives on peer support were shaped by their rehabilitation goals. For example, participants who solely focused on the recovery of physical functioning noted that peers could help to supplement existing rehabilitation programming by guiding their rehabilitation exercises. Participants who concentrated on their future lives believed peers could teach them new skills to facilitate their integration in the community. However, some participants felt they could not trust peers' advice because peers are not healthcare providers. Fourth, peer support delivery options varied from online chat groups (i.e., WeChat), in-person conversations, and mentoring lectures. Finally, anticipated outcomes were related to obtaining practical and emotional support from peers, being motivated, and feeling understood. CONCLUSIONS: Participants harbored mixed views on potential use-value and necessity of hospital-based peer support programs, which could inform future utilization of SCI peer support within Chinese hospitals.

Description of Participation in Daily and Social Activities for Individuals with COPD.

This study described the participation in daily and social activities and the perceived barriers and facilitators to participation of individuals with chronic obstructive pulmonary disease (COPD). Individuals, recruited from outpatient clinics, responded to a survey on their participation in, and barriers and facilitators towards, 26 daily and social activities, divided into 3 categories: (1) physical activity and movement (PAM); (2) self-care; and (3) social engagement. For each activity, chi-square analyses were used to examine participation differences by individuals': quartiles of airflow obstruction [percent predicted forced expiratory volume in 1 second (FEV1%predicted)] and breathlessness burden and exacerbation risk. Of the 200 participants (47% women; mean ± standard deviation age = 68 ± 9 years), most wanted to increase their participation in PAM activities (range 21-75%) and significant differences were found in 5/10 PAM activities for individuals' breathlessness burden and exacerbation risk (e.g., more individuals than expected in group A (modified Medical Research Council breathlessness score <2 and 0-1 exacerbations in past 12 months) participated in regular exercise as much as they wanted (χ(9)2=20.43, Cramer's V=.23)). Regardless of the degree of airflow obstruction or breathlessness burden and exacerbation risk, the most common barrier to participation was breathlessness (p<.001, η2p=.86) and the most common facilitator was engaging as part of their routine (p<.001, η2p=.75). Individuals with COPD want to increase their participation in daily and social activities but are limited by breathlessness. Strategies to alleviate breathlessness should be identified/prioritized and incorporated into individuals' daily routines to meet their self-reported participation objectives in daily and social activities.

Development of the Measure of Experiential Aspects of Participation for People With Physical Disabilities.

OBJECTIVES: To create a parsimonious, psychometrically sound measure of experiential aspects of participation (MeEAP) for people with physical disabilities. DESIGN: Cross-sectional. SETTING: Online survey. PARTICIPANTS: Respondents were a purposive sample of adults (N=228, n=118 female, mean age=49.66±14.71, range=19-83). Each respondent indicated having a physical disability and participating in employment, mobility, sport, and/or exercise life domains. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The MeEAP was designed to be conceptually aligned with 6 experiential aspects of participation among people with physical disabilities: autonomy, belongingness, challenge, engagement, mastery, and meaning.1 The measure was also designed to be relevant across employment, mobility, sport, and exercise life domains. Higher scores on MeEAP items were hypothesized to be associated with higher levels of life satisfaction. RESULTS: The final 12-item scale (2 items per subscale) had strong model fit (Satorra-Bentler scaled χ2(39)=58.26, P<.001, comparative fit index=.98, Tucker-Lewis index=.96, root mean square error of approximation=.05, standardized root mean square residual=.03) and good reliability and validity estimates. Results of regression analyses indicated that the MeEAP explained 10%-29% of the variance in life satisfaction. CONCLUSIONS: The MeEAP is the first measure to capture all 6 experiential aspects of participation for individuals with physical disabilities across 4 major life domains. The MeEAP can be used as an outcome measure or as a mediator to help explain broader outcomes (eg, life satisfaction). The MeEAP could also be used for program evaluation to provide insights about the types of interventions needed to promote full participation.

Investigating Characteristics of Quality Peer Mentors With Spinal Cord Injury.

OBJECTIVE: To identify characteristics (1) of high- and low-quality spinal cord injury (SCI) peer mentors; (2) that should be used to match SCI peer mentors and mentees. DESIGN: The study was conducted in partnership with three Canadian provincial SCI organizations using an integrated knowledge translation approach. The Delphi exercise was completed in three rounds. In Round 1, people with SCI completed a thought-listing exercise to identify characteristics of high- and low-quality peer mentors and for matching. In Rounds 2 and 3, people with SCI and community organization staff rated characteristics from the previous round on an 11-point scale. After the final round, the remaining characteristics were thematically analyzed. SETTING: Community-based peer mentorship programs in three Canadian provinces. PARTICIPANTS: People with SCI and SCI community organization staff (Round 1, n=45; Round 2, n=27; Round 3, n=25). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Consensus-based list of characteristics. RESULTS: Participants reached consensus on 215 characteristics of quality peer mentors and 11 characteristics for peer mentor-mentee matching (ICC=0.96). A consensus-based characterization of high- and low-quality peer mentorship was created and included six overarching themes: competencies, personality characteristics, emotional state, mentor outlook, reason for mentoring, and role model. CONCLUSION: A consensus-based characterization of quality peer mentorship was co-developed with input from over 50 members of the SCI community. Findings highlight that peers have both interpersonal and intrapersonal characteristics that contribute to quality mentorship. The findings highlighted the importance of matching mentors on lived experience and shared interests. Findings will inform future research and SCI peer mentorship programs.

Operationalizing the reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework to evaluate the collective impact of autonomous community programs that promote health and well-being.

BACKGROUND: The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework is a useful tool for evaluating the impact of programs in community settings. RE-AIM has been applied to evaluate individual programs but seldom used to evaluate the collective impact of community-based, public health programming developed and delivered by multiple autonomous organizations. The purposes of this paper were to (a) demonstrate how RE-AIM can be operationalized and applied to evaluate the collective impact of similar autonomous programs that promote health and well-being and (b) provide preliminary data on the collective impact of Canadian spinal cord injury (SCI) peer mentorship programs on the delivery of peer mentorship services. METHODS: Criteria from all five RE-AIM dimensions were operationalized to evaluate multiple similar community-based programs. For this study, nine provincial organizations that serve people with SCI were recruited from across Canada. Organizations completed a structured self-report questionnaire and participated in a qualitative telephone interview to examine different elements of their peer mentorship program. Data were analyzed using summary statistics. RESULTS: Having multiple indicators to assess RE-AIM dimensions provided a broad evaluation of the impact of Canadian SCI peer mentorship programs. Peer mentorship programs reached 1.63% of the estimated Canadian SCI population. The majority (67%) of organizations tracked the effectiveness of peer mentorship through testimonials and reports. Setting-level adoption rates were high with 100% of organizations offering peer mentorship in community and hospital settings. On average, organizations allocated 10.4% of their operating budget and 9.8% of their staff to implement peer mentorship and 89% had maintained their programming for over 10 years. Full interpretation of the collective impact of peer mentorship programs was limited as complete data were only collected for 52% of survey questions. CONCLUSIONS: The lack of available organizational data highlights a significant challenge when using RE-AIM to evaluate the collective impact of multiple programs that promote health and well-being. Although researchers are encouraged to use RE-AIM to evaluate the collective impact of programs delivered by different organizations, documenting limitations and providing recommendations should be done to further the understanding of how best to operationalize RE-AIM in these contexts.

RE-AIMing conferences: evaluating the adoption, implementation and maintenance of the Rick Hansen Institute's Praxis 2016.

BACKGROUND: In April 2016, the Rick Hansen Institute (RHI) hosted an innovative, 2-day conference called Praxis 2016. RHI aimed to bring together a diverse group of stakeholders to develop solutions for overcoming the challenges of translating spinal cord injury (SCI) research into practice. To understand the impact of Praxis, RHI funded an independent team to evaluate Praxis at the individual and setting level using the RE-AIM framework. Individual-level findings are published elsewhere. The aim of this evaluation is to report on the impact of Praxis at the setting level in terms of its adoption, implementation and maintenance. METHODS: Data sources included interviews with attendees (n = 13) and organisers (n = 9), a fidelity assessment conducted at the conference, and observation notes provided by the evaluation team. RESULTS: Main findings indicated that the Praxis model was adopted by organisers and attendees, implemented by RHI as intended, and has the potential for long-term maintenance. Lessons learned highlighted the importance of including SCI community members throughout the entire process from development to post-conference activities as well as in the research process, the value of facilitation and fostering interactive problem solving, and the need to identify leadership and funds to foster long-term efforts. CONCLUSIONS: Developing and implementing a solutions-focused conference that brings together a diverse group of SCI stakeholders was challenging and rewarding for attendees and organisers. Other domains could learn from, adopt and build on the Praxis 2016 approach to address research-to-practice gaps.

Exploring Stereotypes of Athletes With a Disability: A Behaviors From Intergroup Affect and Stereotypes Map Comparison.

Identifying as a regular exerciser has been found to effectively alter stereotypes related to warmth and competence for adults with a physical disability; however, it remains unclear how sport participation can influence this trend. Therefore, this study aimed to examine warmth and competence perceptions of adults with a physical disability portrayed as elite and nonelite athletes relative to other athletic and nonathletic subgroups of adults with and without a physical disability in the context of the stereotype content model. Using survey data from able-bodied participants (N = 302), cluster analyses were applied to a behaviors from intergroup affect and stereotypes map for displaying the intersection of warmth and competence perceptions. The results demonstrated that adults with a physical disability who are described as elite athletes (i.e., Paralympians) are clustered with high warmth and high competence, similar to their able-bodied athletic counterparts (i.e., Olympians). The findings suggest that perceiving athletic and elite sport statuses for adults with a physical disability may counter the stereotypes commonly applied to this group.

Spinal Cord Injury Peer Mentorship: Applying Self-Determination Theory to Explain Quality of Life and Participation.

OBJECTIVES: To investigate the role of spinal cord injury (SCI) peer mentorship on quality of life (QoL)/participation, and test a self-determination theory model that explains the role of SCI peer mentorship on these outcomes. DESIGN: A static group comparison design. SETTING: Community. PARTICIPANTS: A convenience sample of mentees (individuals receiving peer mentorship) (n=68) and nonmentees (n=63) who had an SCI, were older than 18 years, and spoke either English or French. INTERVENTIONS: Mentees: at least 4 peer mentorship sessions over the past 5 years; nonpeer mentees: 0 or 1 brief introductory session. MAIN OUTCOME MEASURES: QoL (ie, life satisfaction and positive and negative affect), participation (eg, autonomous indoor; family role), and the psychological needs of autonomy, competence, and relatedness. RESULTS: No group differences were found, but years since injury was a moderator indicating that, generally, peer mentees living with SCI for longer (∼30y) appear to benefit more from peer mentorship interactions compared with nonmentees and mentees living with SCI for approximately 6 years. Competence and relatedness mediated the peer mentorship-outcome relationship for QoL and some participation variables, indicating that peer mentorship predicted competence and relatedness, which in turn were related to the outcomes. CONCLUSIONS: Satisfaction of competence and relatedness needs requires greater attention in SCI peer mentorship. Years since injury modified the relationship between peer mentorship and outcomes, which provided new insights on the role of SCI peer mentorship. Further studies are needed to determine SCI peer mentorship-specific outcomes that are important across the years-since-injury spectrum.

Understanding the Effects of Message Framing on Physical Activity Action Planning: the Role of Risk Perception and Elaboration.

PURPOSE: This study aimed to determine the effects of action planning, risk perception, and message elaboration on the creation and quality of physical activity action plans. Risk perception was hypothesized as a potential moderator and elaboration as a potential mediator of the message framing-action planning relationship. METHOD: Inactive adults (N = 180; 44% women; Mage = 29.7, SD = 9.92) were randomized to one of two framed action planning messages and responded to an online questionnaire pre- and post-message. Participants were asked about two types of risk perception towards action planning: emotional and plan creation risk perception. Post-message participants were asked about their elaboration regarding the message and presented with the opportunity to create action plans, which were scored for quality. A moderation model and a moderated mediation model were tested. RESULTS: Emotional risk perception moderated the message framing-action plan creation relationship. Individuals with increased emotional risk perception, as opposed to increased plan creation risk perception, were more likely to create an action plan when given a gain-framed message, as opposed to a loss-framed message. The moderated mediation model was not significant, but message elaboration predicted action plan creation. Individuals with greater message elaboration were more likely to create an action plan, regardless of the message frame. CONCLUSION: Gain-framed messages may be more effective than loss-framed messages at promoting action plan creation in individuals with greater emotional risk perception. One's elaboration of an action planning message may increase their likelihood of creating a physical activity action plan.

Accuracy of two Generic Prediction Equations and One Population-Specific Equation for Resting Energy Expenditure in Individuals with Spinal Cord Injury.

PURPOSE: The primary aim was to assess the accuracy of common prediction equations, the Harris-Benedict (HB) and the Mifflin St. Jeor (MSJ) equations, for estimating resting energy expenditure (REE) among people with spinal cord injury (SCI) against actual REE measurements. The secondary aim was to cross-validate the Buchholz et al. energy prediction equation created for people with SCI. METHODS: A metabolic cart with canopy was used to measure the actual REE. The HB, MSJ, and the Buchholz et al. equations were used for the prediction of REE. RESULTS: Thirty-nine participants (31 males and 8 females) were enrolled in this cross-sectional study. The REEs significantly differed from one another, F(1.52, 57.68) = 52.04, P < 0.001, where both the HB (M = 1703.06, SD = 265.1) and the MSJ (M = 1628.92, SD = 233.8) energy predictions were significantly higher (P < 0.001) than the measured REE (M = 1394.05, SD = 298.7). In contrast, the Buchholz et al. equation did not differ from the measured REE. CONCLUSIONS: Our data show that the HB and MSJ equations do not accurately predict the energy needs of this community. Using a SCI-specific equation would improve estimates of REE, such as the Buchholz et al. equation. More research into energy equations for this population may help health care professionals better tailor dietary requirements for weight management.

"I've Had Bad Experiences With Team Sport": Sport Participation, Peer Need-Thwarting, and Need-Supporting Behaviors Among Youth Identifying With Physical Disability.

This study was guided by self-determination theory to explore the sport experiences of youth with a physical disability and the role of peers within this context. Interviews were conducted with eight youths using a relational mapping technique and analyzed using a deductive thematic approach. Sport peers were broadly defined by the youth as individuals from a large age range and of all abilities. Youth perceived their sport peers to have dynamic roles throughout their participation in sport. The perceived roles of these sport peers included supporting and thwarting basic psychological needs, and influencing the youths' processing of sport internalization. Findings focus on the complexity of peer need-thwarting and need-supporting interactions in sport for youth with physical disabilities. Overall, peers have a multifaceted role in the sport experiences of youth identifying with a physical disability and may, in some cases, thwart youths' basic psychological needs.