Moving together: Increasing physical activity in older adults with an intergenerational technology-based intervention. A feasibility study.

Robust evidence supports the role of physical activity and exercise in increasing longevity, decreasing morbidity and helping older adults maintain the highest quality of life attainable. However, the majority of older adults are not sufficiently physically active and interventions are needed to change their behaviors. Familial or intergenerational contact has been positively linked to health and well-being in older adults. Therefore, this study aimed to i) establish acceptability and test the functionality and useability of a novel technology-driven intergenerational intervention targeting physical activity and age stereotypes, and ii) identify any potential issues with recruitment and retention. Four familial dyads (adult ≥ 65 and child 7-11 years) engaged with the intervention. Working collaboratively during a four-week trial, they combined daily step-counts (acquired via any activity of their choice, using PA trackers) to complete a virtual walk route using online platform World Walking. Thematic analysis of three post-intervention focus groups (one older adult; one child; one additional parental cohort) identified eight subthemes: Engagement; Provision of a Positive Experience; Participant Stimuli; Generated Outcomes; Operationality; Limitations; Mediators; Facilitators, and Perceptions. Participants enjoyed and successfully engaged with the intervention; when designing behaviour change interventions for older adults, flexibility within pre-established routines, individual choice, and avoiding rigidly imposed structures, is important. Strategies to challenge negative perceptions of older adults' engagement with technology and PA should be integrated into recruitment processes.

Older adults' perspectives on physical activity and sedentary behaviour within their home using socio-ecological model.

BACKGROUND: There are few studies that focus explicitly on the impact of the home environment on older adults' sedentary behaviour (SB) and physical activity (PA) using the socio-ecological model (SEM). This study aims to investigate older adults' PA and SB within the home environment integrating the SEM as a theoretical framework. METHODS: A qualitative exploratory research design was employed to conduct 33 in-depth interviews (IDIs) and five focus group (FGs; n = 16) with multi-diverse ethnic older adults (mean age 72±5 years). Using reflexive thematic analysis themes were generated from the data set and were interpreted using the SEM. RESULTS: The findings indicate that different levels of the SEM had an impact on older adults' PA and SB. These include the 1) Individual level: Attitude, perception and motivation 2) Interpersonal level: Family and Friends: a motive to remain active 3) Organisational level: healthcare institutes, 4) Community level factors: Significance of social groups, 5) Physical Environment: Microenvironment and 6) Policy level factors (lockdown restrictions and healthcare system). This model can be utilised to foster activity within the home by focusing on the facilitators and barriers identified at each of these levels of influence. CONCLUSION: The study findings suggest that modifying PA and SB in the home environment is complex and is influenced across different levels of the SEM. Therefore, a holistic approach is required that integrates these multiple influences. This understanding can inform the design of interventions that seek to optimize PA and minimize SB within the home environment.

Heterogeneous Treatment Effects after Inspiratory Muscle Training during Recovery from Postacute COVID-19 Syndrome.

PURPOSE: The objective of this study is to investigate whether heterogeneous treatment effects occur for changes in inspiratory muscle strength, perceived dyspnea, and health-related quality of life after 8 wk of unsupervised home-based inspiratory muscle training (IMT) in adults with postacute coronavirus disease 2019 (COVID-19) syndrome. METHODS: In total, 147 adults with self-reported prior COVID-19 either completed an 8-wk home-based IMT intervention ( n = 111, 92 females, 48 ± 11 yr, 9.3 ± 3.6 months postacute COVID-19 infection) or acted as "usual care" wait list controls ( n = 36, 34 females, 49 ± 12 yr, 9.4 ± 3.2 months postacute COVID-19 infection). RESULTS: Applying a Bayesian framework, we found clear evidence of heterogeneity of treatment response for inspiratory muscle strength: the estimated difference between standard deviations (SD) of the IMT and control groups was 22.8 cm H 2 O (75% credible interval (CrI), 4.7-37.7) for changes in maximal inspiratory pressure (MIP) and 86.8 pressure time units (75% CrI, 55.7-116.7) for sustained MIP (SMIP). Conversely, there were minimal differences in the SD between the IMT and the control group for changes in perceived dyspnea and health-related quality of life, providing no evidence of heterogeneous treatment effects. Higher cumulative power during the IMT intervention was related to changes in MIP ( ß = 10.9 cm H 2 O (95% CrI, 5.3-16.8) per 1 SD) and SMIP ( ß = 63.7 (32.2-95.3) pressure time units per 1 SD), clearly indicating an IMT dose response for changes in inspiratory muscle strength. Older age (>50 yr), a longer time postacute COVID-19 (>3 months), and greater severity of dyspnea at baseline were also associated with smaller improvements in inspiratory muscle strength. CONCLUSIONS: Heterogeneous individual responses occurred after an 8-wk home-based IMT program in people with postacute COVID-19 syndrome. Consistent with standard exercise theory, larger improvements in inspiratory muscle strength are strongly related to a greater cumulative dose of IMT.

Battling the unknown: Using composite vignettes to portray lived experiences of COVID-19 and long-COVID.

Understanding the day-to-day lived experiences of individuals who have had or are still recovering from Coronavirus Disease-19 (COVID-19), whilst a complex challenge, presents the opportunity to listen and learn. Composite vignettes provide a novel approach to explore and present descriptive portrayals of the most commonly derived experiences and recovery journeys. The thematic analysis of 47 shared accounts (semi-structured interviews with adults aged ≥18 years; 40 females; 6-11 months post-COVID-19 infection) produced a series of four intricate character stories written through the lens of a single individual. Each vignette gives a voice to and captures a different experience trajectory. From the point of initial symptom development onwards, the vignettes depict how COVID-19 has affected everyday lives, focusing on the secondary non-biological socio-psychological effects and implications. The vignettes highlight in participants' own words: i) the potential negative implications of not addressing the psychological effects of COVID-19; ii) the lack of symptom and recovery linearity; iii) the ongoing 'lottery' of access to healthcare services; and iv) the highly variable, yet generally devastating, impacts that COVID-19 and consequent long-COVID has had across multiple facets of daily living.

Optimising older adults' home spaces to enhance their physical activity level: an exploratory qualitative study protocol.

INTRODUCTION: Housing is a major contributing factor to health, and better housing condition has been linked to improved general and psychological health. There has also been strong evidence that the physical environment within the home setting substantially impacts sedentary behaviour and physical activity in children. However, there is a lack of research that has investigated the physical environment within the home setting in the context of older adults' physical activity levels and sedentary behaviour. Given that with increasing age, older adults spend large proportions of their time in their homes it is important to optimise older adults' home settings to support healthy ageing. Therefore, this study aims to explore older adults' perceptions around optimising their physical environment within their home space to support physical activity and subsequently facilitate healthy ageing. METHODS AND ANALYSIS: In this formative research, a qualitative exploratory research design using in-depth interviews (IDIs) and a purposive sampling approach will be employed. IDIs will be conducted to collect data from study participants. Older adults from diverse community organisations in Swansea, Bridgend and Neath Port Talbot will formally request approval to recruit via its contacts for this formative research. The study data will be analysed thematically using NVivo V.12 Plus software. ETHICS AND DISSEMINATION: Ethical approval for this study has been obtained from the College of Engineering Research Ethics Committee (NM_31-03-22), Swansea University. The findings of the study will be disseminated to the scientific community and to the study participants. The results will enable us to explore the perceptions and attitudes of older adults towards physical activity within their home environment.

Qualitative changes in children's physical activity and sedentary behaviours throughout the COVID-19 pandemic: The HomeSPACE project.

Opportunities for children to be physically active during the COVID-19 pandemic were limited, resulting in a decrease in overall physical activity and an increase in sedentary behaviour during the lockdown restrictions of the pandemic. This study further explored these changes across various stages of the restrictions, starting during the first UK-wide lockdown in March 2020 through to the "new normal" in December 2021. Nine families, consisting of eleven children (36% girls, 64% boys; aged 13.38 years ± 1.14), eight mothers and one father were tracked throughout this time, using semi-structured interviews to explore the fluctuations in physical activity and sedentary behaviour in the home environment in the context of self-determination theory. Findings indicate that as restrictions eased, physical activity within the home decreased, as children were exposed to more opportunities at school and in the community; these opportunities seemingly increased children's motivation to be physically active through increasing levels of their basic psychological needs of autonomy, competence, and relatedness. Some children's physical activity levels have returned to pre-COVID-19 levels, with a newfound enjoyment for being physically active. Whilst others now prefer to pursue more sedentary behaviours that became habitual during the lockdown restrictions. Accessible opportunities now need to be promoted to drive up children's motivations to be physically active following the years of uncertainty around the COVID-19 pandemic.

Factors promoting and inhibiting exercise for older women in Kyoto, Japan.

The main objective of this research was to explore promoting and inhibiting factors of exercise among older women in Kyoto, Japan to seek effective strategies for exercise promotion. More specifically, this research aimed to explore the role of possible selves, which can influence the current view of self and act as an incentive for future behavior, as a facilitator and/or barrier to exercise. Data were collected using semi-structured questionnaires and in-depth interviews among women aged 65 and above in Kyoto city through snowball sampling from August to September 2018. Transcripts were analyzed using thematic analysis, then were summarized into a conceptual model. This research revealed a wide range of factors that promote or inhibit exercise. Beside well-known factors such as social factors, physical factors and beliefs about exercise, unexpected factors that seem strongly related to culture and aging in Japan were identified. The unique factors encapsulated in the category of {altruism} emerged as the significant barrier to exercise. In contrast, {egoism} emerged as an important facilitator of exercise. In conclusion, it may be possible to suggest that integrating the role of mother, wife, daughter or grandmother into exercise and its promotion may be beneficial for women aged 65 and above in Kyoto city. To generalize recommendations made, further research is required with a larger sample size and geographical area. Furthermore, findings may differ depending on the cultural background, generations and gender studied.

What are the motivators and barriers for older women in Japan to stay physically active? The main objective of this research was to explore promoting and inhibiting factors of exercise among older women in Kyoto, Japan to seek effective strategies for exercise promotion. A questionnaire prior to interview identified current physical activity, exercise and 'possible selves', which was expected to provide insight into the conceptual link between individuals' cognition and motivation related to exercise behavior. Beside well-known factors that promote or inhibit exercise such as social factors, physical factors and belief toward exercise, unexpected factors that seem strongly related to aging and the nature of the collective culture were identified. The unique factors encapsulated in the category of {altruism} emerged as the dominant barrier to exercise. In contrast, {egoism} emerged as an important facilitator of exercise. In conclusion, it may be possible to suggest that interlinking of the role of mother, wife, daughter or grandmother into exercise and its promotion may be beneficial for women aged 65 and above in Kyoto city. To generalize recommendations made, further research is required with a larger sample size and geographical spread. Furthermore, outcomes may differ depending on the cultural background, generations and gender studied.

Perceptions of inspiratory muscle training in adults recovering from COVID-19.

Post COVID-19 condition can occur following infection with SARS-CoV-2 and is characterised by persistent symptoms, including fatigue, breathlessness and cognitive dysfunction, impacting everyday functioning. This study explored how people living with post COVID-19 experienced an eight-week inspiratory muscle training (IMT) rehabilitation programme. Individualised semi-structured interviews with 33 adults (29 female; 49 ± 10 years; 6-11 months post-infection) explored expectations of IMT prior to the intervention, and post intervention interviews explored perceptions of IMT and its impact on recovery. Inductive thematic analysis was used to analyse the data. IMT helped many to feel proactive in managing their symptoms and was associated with perceived improvements in respiratory symptoms, exercise and work capacity, and daily functioning. IMT was well perceived and offers significant potential for use as part of a holistic recovery programme, although it is important to consider the complex, varied symptoms of post COVID-19, necessitating an individually tailored rehabilitation approach.

A Socioecological Perspective of How Physical Activity and Sedentary Behaviour at Home Changed during the First Lockdown of COVID-19 Restrictions: The HomeSPACE Project.

The COVID-19 pandemic forced school closures, resulting in home schooling, more time spent at home and fewer opportunities for physical activity (PA). This study explored factors influencing PA and sedentary behaviours (SB) within the home environment during the first lockdown, starting in March 2020. Twenty semi-structured interviews (20 parents and 23 children, 12 years ± 1.25) were conducted. Data were coded using thematic analysis on NVivo© and concepts from McLeroy's socioecological model for health promotion were used to analyse the data. Findings indicate that children's PA and SB at home were influenced by: (i) individual-level factors (e.g., gender, competence, attitudes and motivation); (ii) interpersonal-level factors (e.g., siblings, parents, pets, friends and coaches); (iii) organisation-level factors (e.g., school, clubs and societies), (iv) community-level factors (e.g., home and local environment, access to facilities, social norms, time constraints and home equipment), and (v) policy-level factors (e.g., lockdown restrictions). Stay-at-home mandates resulted in perceived reductions in PA and increases in SB within the home; however, this provided alternative positive opportunities for families, including more time to spend together and exploring green and blue spaces in the local area.

Inspiratory muscle training enhances recovery post-COVID-19: a randomised controlled trial.

BACKGROUND: Many people recovering from coronavirus disease 2019 (COVID-19) experience prolonged symptoms, particularly breathlessness. We urgently need to identify safe and effective COVID-19 rehabilitative strategies. The aim of the current study was to investigate the potential rehabilitative role of inspiratory muscle training (IMT). METHODS: 281 adults (age 46.6±12.2 years; 88% female) recovering from self-reported COVID-19 (9.0±4.2 months post-acute infection) were randomised 4:1 to an 8-week IMT or a "usual care" waitlist control arm. Health-related quality-of-life and breathlessness questionnaires (King's Brief Interstitial Lung Disease (K-BILD) and Transition Dyspnoea Index (TDI)), respiratory muscle strength, and fitness (Chester Step Test) were assessed pre- and post-intervention. The primary end-point was K-BILD total score, with the K-BILD domains and TDI being key secondary outcomes. RESULTS: According to intention to treat, there was no difference between groups in K-BILD total score post-intervention (control: 59.5±12.4; IMT: 58.2±12.3; p<0.05) but IMT elicited clinically meaningful improvements in the K-BILD domains for breathlessness (control: 59.8±12.6; IMT: 62.2±16.2; p<0.05) and chest symptoms (control: 59.2±18.7; IMT: 64.5±18.2; p<0.05), along with clinically meaningful improvements in breathlessness according to TDI (control: 0.9±1.7 versus 2.0±2.0; p<0.05). IMT also improved respiratory muscle strength and estimated aerobic fitness. CONCLUSIONS: IMT may represent an important home-based rehabilitation strategy for wider implementation as part of COVID-19 rehabilitative strategies. Given the diverse nature of long COVID, further research is warranted on the individual responses to rehabilitation; the withdrawal rate herein highlights that no one strategy is likely to be appropriate for all.

Do age stereotype-based interventions affect health-related outcomes in older adults? A systematic review and future directions.

PURPOSE: Developing interventions that target population-specific motivational barriers to promote health behaviours is crucial, especially for older adults who are confronted with negative age stereotypes. This systematic review evaluates randomized and non-randomized field studies that tested the effects of age stereotype-based interventions on health outcomes in adults aged 50 years and over. METHODS: MEDLINE, SPORTDiscus, Scopus, Web of Science Core Collection and PsychINFO were searched to identify articles published up until May 2019. Data were extracted from all articles independently and assessed for risk-of-bias using Cochrane Collaboration tools. RESULTS: Ten articles met the inclusion criteria. Health-related outcome measures were identified across three domains: physical, psychological/psychosocial well-being, and quality of life/subjective health, with age stereotypes reported as an additional outcome. Intervention structure varied substantially between studies regarding content, duration, frequency, and length of follow-up. CONCLUSIONS: Most studies showed that age stereotype-based interventions significantly improved physical function or physical activity as well as self-perceptions of ageing. However, more rigorous studies are needed. Indeed, given the detrimental health effects of age stereotypes, the potential for impact of interventions designed to challenge them is important. Future research should explore the implications of intervening on different stereotype mechanisms, whether intervention effects are comparable across health domains, and whether age stereotype-based interventions are more effective than non-age-specific interventions. PROSPERO Registration CRD42018094006.

'I Live a Kind of Shadow Life': Individual Experiences of COVID-19 Recovery and the Impact on Physical Activity Levels.

Understanding of strategies to support individuals recovering from coronavirus disease 2019 (COVID-19) is limited. 'Long COVID' is a multisystem disease characterised by a range of respiratory, gastrointestinal, cardiovascular, neurological, and musculoskeletal symptoms extending beyond 12 weeks. The aim of this study was to explore individuals' experiences of recovering from COVID-19 to provide a better understanding of the acute and long-term impact of the disease on physical activity (PA). Individualised semi-structured interviews were conducted with 48 adults recovering from COVID-19 at 6-11 months post-infection. An inductive thematic analysis approach was used, reaching saturation at 14 interviews (10 female; 47 ± 7 years). Four overarching themes were identified: (i) Living with COVID-19, including managing activities of daily living; (ii) Dealing with the Unknown and self-management strategies; (iii) Re-introducing physical activity; and (iv) Challenges of returning to work. The return to PA, whether through activities of daily living, work or exercise, is often associated with the exacerbation of symptoms, presenting a range of challenges for individuals recovering from COVID-19. Individually tailored support is therefore required to address the unique challenges posed by COVID-19.

Personality and motivational predictors of well-being and coping during COVID-19: A reversal theory analysis.

This study used reversal theory to examine motivational predictors of well-being and coping during the COVID-19 pandemic in 2020. 149 UK based respondents completed an online survey including measures of demographics, well-being, coping, motivational style, and dominance. Well-being was predicted by optimism (positively), autic and mastery (negatively) dominances, by alloic sympathy, optimism and paratelic motivation styles (positively), and, negatively by arousal seeking, arousability and pessimism. Coping was positively predicted by optimism and negativism dominances and by negativist, paratelic and telic motivations, and, negatively by arousability and pessimism. Using motivational dominances, indirect support was identified for the link between psychodiversity and well-being, but not coping. Findings suggest that well-being and, to a lesser degree, coping could be enhanced by encouraging individuals to experience a range of motivations, possibly focusing on those identified here as significant predictors. Future research needs to determine the context specificity of these findings and explore psychodiversity, well-being and coping using both metamotivational states and composite profiles incorporating the full range of motivational constructs.

Perceptions of Visualizing Physical Activity as a 3D-Printed Object: Formative Study.

BACKGROUND: The UK government recommends that children engage in moderate-to-vigorous physical activity for at least 60 min every day. Despite associated physiological and psychosocial benefits of physical activity, many youth fail to meet these guidelines partly due to sedentary screen-based pursuits displacing active behaviors. However, technological advances such as 3D printing have enabled innovative methods of visualizing and conceptualizing physical activity as a tangible output. OBJECTIVE: The aim of this study was to elicit children's, adolescents', parents', and teachers' perceptions and understanding of 3D physical activity objects to inform the design of future 3D models of physical activity. METHODS: A total of 28 primary school children (aged 8.4 [SD 0.3] years; 15 boys) and 42 secondary school adolescents (aged 14.4 [SD 0.3] years; 22 boys) participated in semistructured focus groups, with individual interviews conducted with 8 teachers (2 male) and 7 parents (2 male). Questions addressed understanding of the physical activity guidelines, 3D model design, and both motivation for and potential engagement with a 3D physical activity model intervention. Pupils were asked to use Play-Doh to create and describe a model that could represent their physical activity levels (PAL). Data were transcribed verbatim and thematically analyzed, and key emergent themes were represented using pen profiles. RESULTS: Pupils understood the concept of visualizing physical activity as a 3D object, although adolescents were able to better analyze and critique differences between low and high PAL. Both youths and adults preferred a 3D model representing a week of physical activity data when compared with other temporal representations. Furthermore, all participants highlighted that 3D models could act as a motivational tool to enhance youths' physical activity. From the Play-Doh designs, 2 key themes were identified by pupils, with preferences indicated for models of abstract representations of physical activity or bar charts depicting physical activity, respectively. CONCLUSIONS: These novel findings highlight the potential utility of 3D objects of physical activity as a mechanism to enhance children's and adolescents' understanding of, and motivation to increase, their PAL. This study suggests that 3D printing may offer a unique strategy for promoting physical activity in these groups.

Patients' experiences of coping with Idiopathic Pulmonary Fibrosis and their recommendations for its clinical management.

BACKGROUND: Idiopathic Pulmonary Fibrosis (IPF) is a chronic, progressive and life-limiting condition. From a healthcare perspective it is vital to establish effective methods of improving the quality of remaining life in these patients. This requires a detailed understanding of the multiple impacts of an IPF diagnosis on the individual. METHODS: We sought to understand how patients coped with their initial diagnosis, how they live with the disease day-to-day, and their experiences and opinions of the professional support they receive. A patient-centred approach was used to explore the social, psychological and physical impacts of IPF. Semi-structured interviews were conducted by an experienced academic. Interview questions were written by the researchers but guided by informal conversations with patients and clinicians. An inductive thematic approach was used to analyse the data, allowing us to identify common themes in the patients' experiences. RESULTS: Of fifty invited participants, ten took part in the study (aged 53-81 years; 9 male). Inductive analysis of interviews identified seven second-order themes and eleven first-order themes, represented by two General Dimensions: 'Patient experience with the condition' and 'Patient-led recommendations for practice'. The key message on 'coping' in these patients was that acceptance of their condition led to a sense of optimism. Participants reported using appraisal-focused coping strategies to change their perspectives (thinking positively) and emotion-focused strategies to overcome depression (the main opportunity for emotional expression being an IPF support group). The support group also facilitated problem-focused coping: individuals exchanged knowledge and experience and gave one another tips on how to live with their condition. CONCLUSIONS: Health professionals should provide patients with information that focuses on living with IPF, encouraging them to make lifestyle changes and adaptations to improve quality of life. Family members should receive education about IPF so that they can support such changes. Patients should be encouraged to join a support group and to participate in physical activity (again preferably group-based). This study offers novel findings that will help inform much-needed changes in the practice of supporting IPF patients to cope with their diagnosis and disease progression.

Acute Effects of Aerobic Exercise on Feelings of Energy in Relation to Age and Sex.

A crossover experiment was performed to determine whether age and sex, or their interaction, affect the impact of acute aerobic exercise on vigor-activity (VA). We also tested whether changes in VA mediated exercise effects on performance on various cognitive tasks. Sixty-eight physically inactive volunteers participated in exercise and TV-watching control conditions. They completed the VA subscale of the Profile of Mood States immediately before and 2 min after the intervention in each condition. They also performed the Trail Making Test 3 min after the intervention in each condition. Statistical analyses produced a condition . age . sex interaction characterized by a higher mean VA gain value in the exercise condition (compared with the VA gain value in the TV-watching condition) for young female participants only. In addition, the mediational analyses revealed that changes in VA fully mediated the effects of exercise on TMT-Part A performance.

UK adults' implicit and explicit attitudes towards obesity: a cross-sectional study.

BACKGROUND: Anti-fat attitudes may lead to stigmatisation of and lowered self-esteem in obese people. Examining anti-fat attitudes is warranted given that there is an association with anti-fat behaviours. Previous studies, mainly outside the UK, have demonstrated that anti-fat attitudes are increasing over time. METHODS: The study was cross-sectional with a sample of 2380 participants (74.2 % female; aged 18-65 years). In an online survey participants reported demographic characteristics and completed a range of implicit and explicit measures of obesity related attitudes. RESULTS: Perceptions of obesity were more negative than reported in previously. Main effects indicated more negative perceptions in males, younger respondents and more frequent exercisers. Attitudes about obesity differed in relation to weight category, and in general were more positive in obese than non-obese respondents. CONCLUSIONS: This is the first study to demonstrate anti-fat attitudes across different sections of the UK population. As such, this study provides the first indication of the prevalence of anti-fat attitudes in UK adults. Interventions to modify these attitudes could target specific groups of individuals with more negative perceptions as identified here. Future work would be useful that increases understanding of both implicit and explicit attitudes towards obesity.

Motivational processes and well-being in cardiac rehabilitation: a self-determination theory perspective.

This research examined the processes underpinning changes in psychological well-being and behavioural regulation in cardiac rehabilitation (CR) patients using self-determination theory (SDT). A repeated measures design was used to identify the longitudinal relationships between SDT variables, psychological well-being and exercise behaviour during and following a structured CR programme. Participants were 389 cardiac patients (aged 36-84 years; M(age) = 64 ± 9 years; 34.3% female) referred to a 12-week-supervised CR programme. Psychological need satisfaction, behavioural regulation, health-related quality of life, physical self-worth, anxiety and depression were measured at programme entry, exit and six month post-programme. During the programme, increases in autonomy satisfaction predicted positive changes in behavioural regulation, and improvements in competence and relatedness satisfaction predicted improvements in behavioural regulation and well-being. Competence satisfaction also positively predicted habitual physical activity. Decreases in external regulation and increases in intrinsic motivation predicted improvements in physical self-worth and physical well-being, respectively. Significant longitudinal relationships were identified whereby changes during the programme predicted changes in habitual physical activity and the mental quality of life from exit to six month follow-up. Findings provide insight into the factors explaining psychological changes seen during CR. They highlight the importance of increasing patients' perceptions of psychological need satisfaction and self-determined motivation to improve well-being during the structured component of a CR programme and longer term physical activity.

Development and initial validation of the Impression Motivation in Sport Questionnaire-Team.

Impression motivation is an important individual difference variable that has been under-researched in sport psychology, partly due to having no appropriate measure. This study was conducted to design a measure of impression motivation in team-sport athletes. Construct validity checks decreased the initial pool of items, factor analysis (n = 310) revealed the structure of the newly developed scale, and exploratory structural equation modeling procedures (n = 406) resulted in a modified scale that retained theoretical integrity and psychometric parsimony. This process produced a 15-item, 4-factor model; the Impression Motivation in Sport Questionnaire-Team (IMSQ-T) is forwarded as a valid measure of the respondent's dispositional strength of motivation to use self-presentation in striving for four distinct interpersonal objectives: self-development, social identity development, avoidance of negative outcomes, and avoidance of damaging impressions. The availability of this measure has contributed to theoretical development, will facilitate research, and offers a tool for use in applied settings.