Dropout from exercise trials among cancer survivors-An individual patient data meta-analysis from the POLARIS study.

INTRODUCTION: The number of randomized controlled trials (RCTs) investigating the effects of exercise among cancer survivors has increased in recent years; however, participants dropping out of the trials are rarely described. The objective of the present study was to assess which combinations of participant and exercise program characteristics were associated with dropout from the exercise arms of RCTs among cancer survivors. METHODS: This study used data collected in the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) study, an international database of RCTs investigating the effects of exercise among cancer survivors. Thirty-four exercise trials, with a total of 2467 patients without metastatic disease randomized to an exercise arm were included. Harmonized studies included a pre and a posttest, and participants were classified as dropouts when missing all assessments at the post-intervention test. Subgroups were identified with a conditional inference tree. RESULTS: Overall, 9.6% of the participants dropped out. Five subgroups were identified in the conditional inference tree based on four significant associations with dropout. Most dropout was observed for participants with BMI >28.4 kg/m2 , performing supervised resistance or unsupervised mixed exercise (19.8% dropout) or had low-medium education and performed aerobic or supervised mixed exercise (13.5%). The lowest dropout was found for participants with BMI >28.4 kg/m2 and high education performing aerobic or supervised mixed exercise (5.1%), and participants with BMI ≤28.4 kg/m2 exercising during (5.2%) or post (9.5%) treatment. CONCLUSIONS: There are several systematic differences between cancer survivors completing and dropping out from exercise trials, possibly affecting the external validity of exercise effects.

School-based physical activity in relation to active travel - a cluster randomized controlled trial among adolescents enrolled in the school in motion study in Norway.

BACKGROUND: Active travel and school settings are considered ideal for promoting physical activity. However, previous research suggests limited effect of school-based interventions on overall physical activity levels among adolescents. The relationship between physical activity in different domains remains inconclusive. In this study, we examined the effects of adding two weekly hours of school-based physical activity on active travel rates. METHOD: We analyzed data from 1370 pupils in the 9th-grade participating in the cluster RCT; the School In Motion (ScIM) project. Intervention schools (n = 19) implemented 120 min of class-scheduled physical activity and physical education, in addition to the normal 2 hours of weekly physical education in the control schools (n = 9), for 9 months. Active travel was defined as pupils who reported walking or cycling to school, while motorized travel was defined as pupils who commuted by bus or car, during the spring/summer half of the year (April-September), or autumn/winter (October-February). The participants were categorized based on their travel mode from pretest to posttest as; maintained active or motorized travel ("No change"), changing to active travel (motorized-active), or changing to motorized travel (active-motorized). Multilevel logistic regression was used to analyze the intervention effect on travel mode. RESULTS: During the intervention period, most participants maintained their travel habits. In total, 91% of pupils maintained their travel mode to school. Only 6% of pupils switched to motorized travel and 3% switched to active travel, with small variations according to season and trip direction. The intervention did not seem to influence the likelihood of changing travel mode. The odds ratios for changing travel habits in spring/summer season were from active to motorized travel 1.19 [95%CI: 0.53-2.15] and changing from motorized to active travel 1.18 [0.30-2.62], compared to the "No change" group. These findings were consistent to and from school, and for the autumn/winter season. CONCLUSION: The extra school-based physical activity does not seem to affect rates of active travel among adolescents in the ScIM project. TRIAL REGISTRATION: Clinicaltrials.gov ID nr: NCT03817047. Registered 01/25/2019' retrospectively registered'.

Self-determination theory and the smoking cessation process: Daily electronic self-reports can identify the initiation of quit attempts.

OBJECTIVES: To examine the motivational predictors of the smoking cessation process at the between-persons and within-persons levels. METHODS: Mediation analyses were conducted on self-report data (N = 236) that were collected using interval contingent sampling over a 39-day study period. RESULTS: There was a high rate of attrition, as nearly 50% of participants were lost to follow-up. There were credible indirect effects of autonomous self-regulation on smoking behavior on the next day and seven-day abstinence through perceived competence and medication use. At the between-persons level, these models explained 17% of the variance in smoking behavior on the next day and 31% of the variance in seven-day abstinence; at the within-persons level, these estimates were 39% and 57%, respectively. CONCLUSIONS: Day-to-day changes in autonomous self-regulation, perceived competence, and medication use are important initiators of the smoking cessation process. PRACTICE IMPLICATIONS: Smokers might be more likely to make a quit attempt if practitioners "tune into" the day-to-day fluctuations of their patients' motivation for stopping smoking, perhaps using an electronic platform to assess and compare smokers' current reports to their previous experiences. Such "motivational attunement" can afford practitioners an opportunity to provide need support when patients are willing and able to initiate a quit attempt.

Sports injury prevention in Swedish elite floorball players: evaluation of two consecutive floorball seasons.

PURPOSE: The objective was to evaluate the effect of a psychological group-based injury prevention, which was implemented throughout the first season, after the second season, in Swedish elite floorball teams (males and females). The secondary objective was to evaluate the effect of the intervention over the two consecutive floorball seasons as a whole. METHODS: Twenty-three teams in the premier leagues for males and females volunteered and were allocated to an intervention group, n = 175 players, and a control group n = 171 players. The intervention group participated in psychological skills training during the first season. The control group did not receive any alternative treatment. Neither of the groups received any intervention during the second season. All injuries were registered and documented according to time-loss definition and classified into either traumatic or overuse injuries. RESULTS: Ninety-three players (27 %) sustained 119 injuries during the second season. The intervention group 0.31 (95 % CI 0.22-0.39) and the control group 0.41 (95 % CI 0.29-0.53) injuries/player. The injury incidence decreased in the intervention group and was lower than the control group. The analysis showed no statistical differences when comparing the intervention group and the control group neither after the second season nor after the two seasons together, Cohen's d 0.2. CONCLUSION: This group-based training showed a small effect size after the second year resulting in fewer injuries, especially severe injuries, in the intervention group compared to the control group. It is, therefore, important not to overlook the potential of a group-based psychological injury prevention programme.