Latin Dance Effects on Cardiorespiratory Fitness and Physical Function in Middle-Aged and Older Latino Adults.

We tested if a dance trial yielded improvements in physical function and cardiorespiratory fitness (CRF) in middle-aged/older Latino adults. Physical activity was assessed using the Community Healthy Activities Model Program for Seniors, physical function with the Short Physical Performance Battery (SPPB) protocol, and estimated CRF with the Jurca nonexercise test model. Multivariate analysis of covariance models found significant change in SPPB protocol total scores, F(1, 329) = 4.23, p = .041, and CRF, F(1, 329) = 5.16, p = .024, between the two study arms in favor of the dance group. Mediation models found moderate- to vigorous-intensity physical activity to mediate to mediate between group and SPPB scores (ß = 0.054, 95% confidence interval [0.0142, 0.1247]). Moderate- to vigorous-intensity physical activity and total physical activity were found to partially mediate between group and CRF (ß = 0.02, 95% confidence interval [-0.0261, 0.0751]), with the direct pathway no longer being significant (p > .05). This provides support for Latin dance programs to have an effect on SPPB protocol and CRF.

Comparing exercise determinants between Black and White older adults with heart failure.

BACKGROUND: Heart Failure is a leading cause of mortality among older adults. Engaging in regular exercise at moderate-to-vigorous intensity has been shown to improve survival rates. Theory-informed methodologies have been recommended to promote exercise, but limited application of theoretical framework has been conducted for understanding racial disparities among older adults with heart failure. This study aimed to use the Health Belief Model to compare exercise behavior determinants between Black and White older adults diagnosed with heart failure. METHODS: The HF-ACTION Trial is a multi-site study designed to promote exercise among individuals with heart failure that randomized participants to an experimental (three months of group exercise sessions followed by home-based training) or control arm. The present study used structural equation modeling to test the change in Health Belief Model constructs and exercise behavior across 12 months among older adults. RESULTS: Participants (n = 671) were older adults, 72.28 (SD = 5.41) years old, (Black: n = 230; White, n = 441) diagnosed with heart failure and reduced ejection fraction. The model found perceived benefits, self-efficacy, perceived threats, and perceived barriers to predict exercise behavior among Black and White older adults. However, among these constructs, only perceived benefits and self-efficacy were facilitated via intervention for both races. Additionally, the intervention was effective for addressing perceived barriers to exercise only among White participants. Finally, the intervention did not result in a change of perceived threats for both races. CONCLUSIONS: Among health belief model constructs, perceived threats and barriers were not facilitated for both races in the experimental arm, and the intervention did not resolve barriers among Black older adults. Racial differences need to be considered when designing interventions for clinical populations as future studies are warranted to address barriers to exercise among Black older adults with heart failure.

Investigating the association between knee osteoarthritis symptoms with pain catastrophizing domains between Hispanics and non-Hispanic Whites.

Knee osteoarthritis (KOA) is a chronic disease accompanied by debilitating symptoms including pain, stiffness, and limited physical functionality, which have been shown to be associated with pain catastrophizing. Previous studies have revealed racial discrepancies in pain catastrophizing, notably between Hispanics and non-Hispanics while pointing to potential health disparities. Using a conceptual model, this study aimed to investigate racial differences in associations between KOA symptoms with specific pain catastrophizing domains (rumination, magnification, and helplessness). Patients with KOA (n = 253; 147 Hispanics, 106 non-Hispanic Whites) completed a survey that included measures of knee symptoms, pain catastrophizing, and demographic variables. Structural equation modeling revealed that among Hispanics, each pain catastrophizing domain (rumination, magnification, and helplessness) was associated with at least two symptomatic experiences, including pain severity and difficulty in physical function. Specifically, pain severity was associated with (a) rumination: ß = 0.48, p < 0.001, (b) magnification: ß = 0.31, p = 0.003; and (c) helplessness: ß = 0.39, p < 0.001). Additionally, a lower score in physical function was associated with higher magnification (ß = 0.26, p = 0.01), and helplessness (ß = 0.25, p = 0.01). Among non-Hispanic White patients, pain severity was further associated with two domains of pain catastrophizing, including rumination (ß = 0.39, p < 0.001) and helplessness (ß = 0.35, p = 0.01). In addition, association pathways for demographic variables revealed that older Hispanics experienced greater challenges with higher pain severity (ß = 0.26, p = 0.01) and greater difficulty with physical function (ß = 0.31, p < 0.001) while Hispanics females experienced higher pain (ß = 0.19, p = 0.03). These findings highlight the importance of designing tailored interventions that consider key demographic factors such as age, and gender, to improve physical function that might alleviate pain catastrophizing among Hispanics with KOA.

Investigating the Relationship Between Physical Activity Disparities and Health-Related Quality of Life Among Black People With Knee Osteoarthritis.

INTRODUCTION: Knee osteoarthritis (OA) is the most common form of arthritis, which is a leading cause of disability. Although no cure exists for knee OA, physical activity has been shown to improve functionality, which can improve an individual's health-related quality of life (HR-QOL). However, racial disparities exist in participating in physical activity, which can result in Black people with knee OA experiencing lower HR-QOL compared with their White counterparts. The purpose of this study was to investigate disparities of physical activity and related determinants, specifically pain and depression, and how these constructs explain why Black people with knee OA experience low HR-QOL. METHODS: Data were from the Osteoarthritis Initiative, a multicenter longitudinal study that collected data from people with knee OA. The study used a serial mediation model to test whether a change in scores for pain, depression, and physical activity over 96 months mediated the effects between race and HR-QOL. RESULTS: Analysis of variance models found Black race to be associated with high pain, depression, and lower physical activity and HR-QOL at baseline and month 96. The findings supported the prospective multi-mediation model, which found pain, depression, and physical activity to mediate between race and HR-QOL (ß = -0.11, SE = 0.047; 95% CI, -0.203 to -0.016). CONCLUSION: Disparities in pain, depression, and physical activity could explain why Black people with knee OA experience lower HR-QOL compared with their White counterparts. Future interventions should address sources of pain and depression disparities by improving health care delivery. Additionally, designing race- and culture-appropriate community physical activity programs would help to achieve physical activity equity.

BAILA: A Randomized Controlled Trial of Latin Dancing to Increase Physical Activity in Spanish-Speaking Older Latinos.

BACKGROUND: Latinos are the fastest growing minority group of the older adult population. Although physical activity (PA) has documented health benefits, older Latinos are less likely to engage in leisure time PA than older non-Latino whites. Dance, popular among Latinos, holds promise as a culturally relevant form of PA. PURPOSE: To describe self-reported and device-assessed changes in PA as a result of a randomized controlled trial of BAILAMOS, a 4-month Latin dance program with a 4-month maintenance program, versus a health education control group. METHODS: Adults, aged 55+, Latino/Hispanic, Spanish speaking, with low PA levels at baseline, and risk for disability were randomized to the dance program (n = 167) or health education condition (n = 166). Data were analyzed using multilevel modeling with full information maximum likelihood. RESULTS: A series of multilevel models revealed significant time × group interaction effects for moderate-to-vigorous physical activity (MVPA), dance PA, leisure PA, and total PA. Exploring the interaction revealed the dance group to significantly increase their MVPA, dance PA, leisure PA, and total PA at months 4 and 8. Household PA and activity counts from accelerometry data did not demonstrate significant interaction effects. CONCLUSIONS: The study supports organized Latin dance programs to be efficacious in promoting self-reported PA among older Latinos. Efforts are needed to make dancing programs available and accessible, and to find ways for older Latinos to add more PA to their daily lives. CLINICAL TRIAL INFORMATION: NCT01988233.

Determinants of Virtual Exercise Equipment Use: An Integrated Model Investigation.

BACKGROUND: Given the limited research on behavioral determinants of using virtual exercise machines to engage in exercise during the COVID-19 pandemic, this study applied an integrated behavior change model to identify behavioral determinants using these machines. METHOD: Adult owners of livestreaming virtual exercise equipment (N = 123) completed measures of social cognition, planning, motivation, virtual exercise machine features, and sociostructural variables at an initial occasion (T1) and 4 weeks later (T2). Hypothesized relations among model constructs were tested using a cross-lagged structural equation model with past behavior and sociostructural variables as covariates. RESULTS: Autonomous motivation predicted intentions and habit indirectly via attitudes and perceived behavioral control at T1; virtual exercise machine features predicted intention and habit indirectly via social cognition constructs at T1; and intention and habit at T1 predicted exercise behavior at T2. CONCLUSIONS: This study supports social cognition constructs and virtual features as predictors of exercise using virtual exercise machines.

The Effects of Multi-Component Exercise Training on Cognitive Functioning and Health-Related Quality of Life in Older Adults.

PURPOSE: Exercise has been shown to have various proximal and distal benefits among older adults such as improving physical fitness, cognitive functioning, and health-related quality of life (HR-QOL). Despite this evidence, limited research has investigated pathway change of these outcomes. The primary purpose of this study was to test if older adults who improved in physical fitness measures from engaging in multicomponent exercise training for 12 weeks predicted change in proximal (cognitive functioning) and distal (HR-QOL) outcomes, respectively. METHODS: Participants (n = 110) were healthy, older adults (M = 72, SD = 7.24) that comprised an exercise-intervention and control group. The intervention consisted of exercising in a supervised laboratory setting for 12 weeks. RESULTS: Structural equation modeling revealed group type to predict change in physical performance and the maximum walking test with comparable effect sizes. Physical performance in turn predicted improvement in processing speed (ß = 0.23, p = 0.013) executive functioning (ß = 0.26, p = 0.006), and HR-QOL (ß = 0.13, p = 0.031). However, only executive functioning was found to significantly predict HR-QOL (ß = 0.49, p < 0.001) over processing speed (p > 0.05). CONCLUSIONS: Between two fitness measures, the physical performance test demonstrated better predictive validity in proximal and distal health outcomes. In addition to physical fitness, older adults who engage in multi-component exercise sessions regularly can improve their executive functioning, which in turn enhances their HR-QOL.

Mediating Mechanisms in a Physical Activity Intervention: A Test of Habit Formation.

BACKGROUND: A recent randomized controlled trial found that an intervention focused on developing an exercise habit increased weekly minutes of moderate to vigorous physical activity (MVPA) over 8 wk compared to a control group. The purpose of the current study was to test if changes in habit, as well as other behavioral strategy constructs from the Multi-Process Action Control Test, mediated between group condition and MVPA (self-report and accelerometry). METHODS: Inactive new gym members (N = 94) were randomized into control or experimental (habit-building) groups. RESULTS: No construct entirely explained mediation condition (experimental and control) and changes in MVPA measured by accelerometry. Self-report MVPA found affective judgments, behavioral regulation, and preparatory habit to be mediated between group (experimental/control conditions) and changes in behavior (ß = 0.36, 95% confidence interval [.05-.78]). CONCLUSIONS: Self-reported and objectively measured behavior models demonstrated complete and partial mediation, respectively. New gym members could benefit from successful behavioral enactment by developing constructs to support habit formation.

Increasing Physical Activity Through Principles of Habit Formation in New Gym Members: a Randomized Controlled Trial.

BACKGROUND: The promotion of physical activity (PA) is paramount to public health, yet interventions in the social cognitive tradition have yielded negligible improvements. The limited progression may be due to an overreliance on intention as the proximal determinant of behavior and a lack of consideration of implicit/automatic processes. The purpose of this study was to examine the impact of a habit formation intervention on PA over 8 weeks in a two-arm parallel design, randomized controlled trial. METHODS: Participants (n = 94) were new gym members with the intention to engage in PA but below international PA guidelines at baseline, who were randomized into a control or habit experimental group. The experimental group attended a workshop (at baseline) and received a follow-up booster phone call at week 4. The primary outcome of the study was minutes of moderate-vigorous intensity PA (MVPA) at week 8. The secondary outcome was a manipulation check to determine if the experimental group effectively incorporated habit-building constructs (cues and practice consistency). RESULTS: The experimental group showed a significant increase in MVPA after 8 weeks in both accelerometry (d = 0.39, p = .04) and self-report (d = 0.53, p = .01) compared with the control group. The experimental group also showed an increase in use of cues (d = 0.56, p < .001) and practice consistency (d = 0.40, p = .01) at week 8. CONCLUSION: The results contribute to the initial validity of increasing PA through a focus on preparation cues and practice consistency. Future research should replicate these findings and extend the duration of assessment to evaluate whether PA changes are sustained. Registered Trial Number NCT02785107.

Exercise habit formation in new gym members: a longitudinal study.

Reasoned action approaches have primarily been applied to understand exercise behaviour for the past three decades, yet emerging findings in unconscious and Dual Process research show that behavior may also be predicted by automatic processes such as habit. The purpose of this study was to: (1) investigate the behavioral requirements for exercise habit formation, (2) how Dual Process approach predicts behaviour, and (3) what predicts habit by testing a model (Lally and Gardner in Health Psychol Rev 7:S137-S158, 2013). Participants (n = 111) were new gym members who completed surveys across 12 weeks. It was found that exercising for at least four bouts per week for 6 weeks was the minimum requirement to establish an exercise habit. Dual Process analysis using Linear Mixed Models (LMM) revealed habit and intention to be parallel predictors of exercise behavior in the trajectory analysis. Finally, the habit antecedent model in LLM showed that consistency (ß = .21), low behavioral complexity (ß = .19), environment (ß = .17) and affective judgments (ß = .13) all significantly (p < .05) predicted changes in habit formation over time. Trainers should keep exercises fun and simple for new clients and focus on consistency which could lead to habit formation in nearly 6 weeks.

The home physical environment and its relationship with physical activity and sedentary behavior: a systematic review.

Reviews of neighborhood (macro) environment characteristics such as the presence of sidewalks and esthetics have shown significant correlations with resident physical activity (PA) and sedentary (SD) behavior. Currently, no comprehensive review has appraised and collected available evidence on the home (micro) physical environment. The purpose of this review was to examine how the home physical environment relates to adult and child PA and SD behaviors. Articles were searched during May 2014 using Medline, PsycINFO, PubMed, Scopus, and SPORTDiscus databases which yielded 3265 potential studies. Papers were considered eligible if they investigated the presence of PA (ie. exercise equipment, exergaming devices) or SD (ie. television, videogames) equipment and PA or SD behavior. After, screening and manual cross-referencing, 49 studies (20 experimental and 29 observational designs) were found to meet the eligibility criteria. Interventions that reduced sedentary time by using TV limiting devices were shown to be effective for children but the results were limited for adults. Overall, large exercise equipment (ie. treadmills), and prominent exergaming materials (exergaming bike, dance mats) were found to be more effective than smaller devices. Observational studies revealed that location and quantity of televisions correlated with SD behavior with the latter having a greater effect on girls. This was similarly found for the quantity of PA equipment which also correlated with behavior in females. Given the large market for exercise equipment, videos and exergaming, the limited work performed on its effectiveness in homes is alarming. Future research should focus on developing stronger randomized controlled trials, investigate the location of PA equipment, and examine mediators of the gender discrepancy found in contemporary studies.

Identifying behavioral determinants and stage of readiness for performing knee massage among individuals with knee osteoarthritis: An observational study.

OBJECTIVE: Patients who experience knee osteoarthritis or chronic knee pain can alleviate their symptoms by performing self-knee massage. Understanding the readiness and types of determinants needed to facilitate self-knee massage is needed to design effective, theory-informed interventions. The primary objective of this study was to apply the transtheoretical model of behavior change to identify how factors, which include the type of knee condition and pain level, predict an individual's readiness to adopt self-knee massage. The secondary objective employed the capability, opportunity and motivation-behavior (COM-B) model to identify relevant determinants that are predictive of an individual's readiness to undertake self-knee massage. METHODS: An observational study design was used to recruit individuals with knee osteoarthritis (n = 270) and chronic knee pain (n = 130). Participants completed an online survey that assessed the transtheoretical model of behavior change stages, COM-B determinants (capability, opportunity and motivation), along with self-administered massage behavior. Multivariate analysis of covariance and structural equation modeling were used to test the primary and secondary objective, respectively. RESULTS: Participants who had knee osteoarthritis scored higher on the action stage compared to those with chronic pain (P = 0.003), and those who experienced greater level of pain scored higher in the contemplation (P < 0.001) and action phases (P < 0.001) of performing knee massage compared to those with milder pain. The COM-B structural equation model revealed self-administered knee massage to be predicted by capability (ß = 0.31, P = 0.004) and motivation (ß = 0.29, P < 0.001), but not opportunity (ß = -0.10, P = 0.39). Pain level predicted motivation (ß = 0.27, P < 0.001), but not capability (ß = 0.09, P = 0.07) or opportunity (ß = 0.01, P = 0.83). Tests for mediating effects found that determinants of COM-B (motivation and capability) mediate between pain level and self-administered massage behavior (ß = 0.10, P = 0.002). CONCLUSION: Clinicians and researchers can expect that patients diagnosed with knee osteoarthritis or who have chronic knee pain are ready (action stage) or are considering the behavior (contemplation stage) of self-knee massage. Individuals who report having knee osteoarthritis or chronic knee pain should be coached to develop the skills to perform self-knee massage and helped to develop the motivation to carry out the therapy. Please cite this article as: Nemati D, Munk N, Kaushal N. Identifying behavioral determinants and stage of readiness for performing knee massage among individuals with knee osteoarthritis: an observational study. J Integr Med. 2024; 22(1): 54-63.

A Longitudinal Theory-Based Investigation of how Environmental Aesthetics predicts Home-based Exercise.

INTRODUCTION: Environmental aesthetics is a recognized macro environmental correlate of physical activity participation. Extrapolating this effect, we hypothesize this variable to also function as a determinant of exercise participation in the microenvironment, such as the home. Specifically, we predict that the environmental aesthetics of the location of cardio and resistance training equipment will predict determinants of exercise participation within the Integrated Behavior Change (IBC) model. METHODS: Adult owners of exercise equipment (N = 231) completed measures on the environmental aesthetics of their cardio and resistance training equipment, exercise time, and constructs from the IBC model across three consecutive monthly surveys. Study hypotheses were tested using multilevel structural equation modeling with participants (level 2) nested within time (level 1). RESULTS: The model revealed predictive effects of intention, habit, and planning on exercise participation over time. The findings indicated a total effect of autonomous motivation on intention and habit. In addition, environmental aesthetics of cardio and strength training equipment predicted autonomous motivation, along with habit and intention when accounting for indirect effects. Finally, planning moderated the intention-behavior relationship, indicating that participants who scored higher on planning were more likely to translate their intentions to behavior. CONCLUSIONS: These findings provide informative notes for designing effective home-based exercise programs, which have increased in popularity over the past recent years. Specifically, experimental studies that provide exercise equipment should ensure that the location of the equipment is appealing to the participant to increase the likelihood equipment use and exercise engagement.

Alexa, let's train now! - A systematic review and classification approach to digital and home-based physical training interventions aiming to support healthy cognitive aging.

BACKGROUND: There is mounting evidence that regular physical activity is an important prerequisite for healthy cognitive aging. Consequently, the finding that almost one-third of the adult population does not reach the recommended level of regular physical activity calls for further public health actions. In this context, digital and home-based physical training interventions might be a promising alternative to center-based intervention programs. Thus, this systematic review aimed to summarize the current state of the literature on the effects of digital and home-based physical training interventions on adult cognitive performance. METHODS: In this pre-registered systematic review (PROSPERO; ID: CRD42022320031), 5 electronic databases (PubMed, Web of Science, PsycInfo, SPORTDiscus, and Cochrane Library) were searched by 2 independent researchers (FH and PT) to identify eligible studies investigating the effects of digital and home-based physical training interventions on cognitive performance in adults. The systematic literature search yielded 8258 records (extra 17 records from other sources), of which 27 controlled trials were considered relevant. Two reviewers (FH and PT) independently extracted data and assessed the risk of bias using a modified version of the Tool for the assEssment of Study qualiTy and reporting in EXercise (TESTEX scale). RESULTS: Of the 27 reviewed studies, 15 reported positive effects on cognitive and motor-cognitive outcomes (i.e., performance improvements in measures of executive functions, working memory, and choice stepping reaction test), and a considerable heterogeneity concerning study-related, population-related, and intervention-related characteristics was noticed. A more detailed analysis suggests that, in particular, interventions using online classes and technology-based exercise devices (i.e., step-based exergames) can improve cognitive performance in healthy older adults. Approximately one-half of the reviewed studies were rated as having a high risk of bias with respect to completion adherence (≤85%) and monitoring of the level of regular physical activity in the control group. CONCLUSION: The current state of evidence concerning the effectiveness of digital and home-based physical training interventions is mixed overall, though there is limited evidence that specific types of digital and home-based physical training interventions (e.g., online classes and step-based exergames) can be an effective strategy for improving cognitive performance in older adults. However, due to the limited number of available studies, future high-quality studies are needed to buttress this assumption empirically and to allow for more solid and nuanced conclusions.

The mediating role of lower body muscle strength and IGF-1 level in the relationship between age and cognition. A MIDUS substudy.

OBJECTIVE: Aging is a natural process associated with a decline in cognition. However, the mediating effect of physical function and circulating myokines on this relationship has yet to be fully clarified. This study investigated how muscle strength and circulating insulin-like growth factor-1 (IGF-1) levels mediate the relationship between age and cognitive functions. SUBJECTS AND METHODS: A total of 1255 participants aged 25-74 years included in the Midlife in the United States II study were retrospectively analyzed. In this cross-sectional analysis, we applied a serial mediation model to explore the mediating effects of muscle strength and circulating IGF-1 levels on the relationship between age and cognitive functions. We included potential confounding factors related to sociodemographics, lifestyle, and health status as covariates in the model. RESULTS: The results showed that aging had both direct and indirect effects on cognition. As predicted, muscle strength and IGF-1 levels mediated the relationship between age and specific cognitive functions. In addition, mediation analyses indicated that the association between aging and cognitive flexibility, immediate and delayed memory, and inductive reasoning were partially mediated by muscle strength and IGF-1 levels in a serial manner. CONCLUSIONS: Our study demonstrated the serial multiple mediation roles of muscle strength and IGF-1 levels on the relationship between age and specific cognitive functions. Further longitudinal research should be performed to confirm the serial mediation results.

A Protection Motivation Theory Approach to Understanding How Fear of Falling Affects Physical Activity Determinants in Older Adults.

OBJECTIVES: This study applied an extended Protection Motivation Theory to investigate the relative importance of fear of falling (FoF) among motivational and intentional determinants of physical activity (PA) behavior. METHODS: Older U.S. adults (N = 667, 65+) were surveyed using online research panels and completed measures of self-efficacy and response efficacy (coping appraisal), perceived vulnerability and perceived severity (threat appraisal), FoF, autonomous motivation, intention, physical health, and past PA level. RESULTS: Our structural equation model showed that past PA level and health predicted intention via cognitive constructs. PA and health predicted FoF and motivation via threat and coping appraisal. FoF did not directly predict intention. DISCUSSION: Results from this sample provide support for the predictive effects of threat appraisal on fear. However, findings suggest that FoF may not be of great importance for the formation of PA intention compared with an established habit of being physically active and a subsequently fostered coping appraisal and motivation.

Predicting Exercise Behavior among Caregivers of Persons with Dementia- A Longitudinal Investigation Using an Extended Health Belief Model.

BACKGROUND AND OBJECTIVES: Family caregivers of persons with dementia face an elevated risk of several chronic illnesses compared to their non-caregiver counterparts. While exercise is a strong preventive measure for several debilitating health conditions, longitudinal research guided by theoretical frameworks has not identified how behavioral determinants predict exercise among caregivers. This study aimed to investigate how intrapersonal exercise determinants contribute to caregivers' exercise participation while accounting for social-contextual factors, including perceived caregiving burden and pandemic-related distress, by employing an extended Health Belief Model. RESEARCH DESIGN AND METHODS: The study was a longitudinal observational design. Community-dwelling older adult family caregivers of individuals with dementia (n=127) were recruited with the support of a nonprofit organization. Participants completed measures of the Health Belief Model that also included dual process constructs (intention and habit), along with caregiving burden, pandemic-related distress, and exercise behavior across three consecutive months. Data were analyzed using a multilevel structural equation model with participants (level 2) nested within time (level 1). RESULTS: The model revealed direct effects of caregiving burden that debilitate perceived behavioral control, attitudes, threats, and worsen burden, in addition to hampering intention and habit when accounting for total effects. Pandemic-related distress exacerbated caregiving burden and weakened Health Belief Model constructs via total effects. DISCUSSION AND IMPLICATIONS: These findings inform constructs to develop a community-based education program for family caregivers to successfully adopt and maintain exercise behavior. Incorporating supportive resources and coping strategies for caregivers of persons with dementia are needed to address the effects of behavioral deterrents.

Predicting Decisional Determinants of Physical Activity Among Older Adults: An Integrated Behavior Approach.

ObjectivesThe present study applied the Integrated Behavior Change Model to investigate how behavioral decisions are predicted, namely, intention, planning, and habits, with respect to physical activity. Methods: Participants were older adults (ages 65+) residing in the U.S. (N = 667) who completed online measures of behavioral determinants (autonomous motivation, perceived behavioral control, subjective norms, attitudes, intention, habit, and consistency), in addition to past behavior. Results: A structural equation model revealed that intention was predicted by past behavior and social-cognitive determinants. Social cognitive determinants mediated between past behavior and habit, as well as between autonomous motivation and habit. Intention mediated between past behavior and planning. Discussion: This study highlights the importance of multiple processes (social cognitive, habit/automatic, and post-intentional/planning) that formulate physical activity intentions. Mediation pathways revealed the importance of autonomous motivation for establishing intentions and habit. Facilitating these processes among older adults could be effective for promoting physical activity.

Type of self-talk matters: Its effects on perceived exertion, cardiorespiratory, and cortisol responses during an iso-metabolic endurance exercise.

Self-talk is an effective mental training technique that has been shown to facilitate or debilitate an athlete's performance, depending on its valence. Although the effects of self-talk have been supported by observing change in sport performance, little is known about how self-talk can induce physiological changes. Specifically, it is important to understand if the type of self-talk (positive, neutral, or negative) and can influence stress-related parameters, such as perceived exertion, cardiorespiratory, and cortisol responses. The study's objective was therefore to investigate the top-down effect of positive and negative self-talk compared to a dissociative activity during an iso-metabolic running exercise on autonomic regulation of cardiorespiratory function. Twenty-nine well-trained male runners [38 ± 13 years, 177 ± 7 cm and 73 ± 7 kg] volunteered to participate in a randomized-group design study that included a negative self-talk (NST), a positive self-talk, and a dissociative group (DG). First, participants underwent an incremental running test on a treadmill to determine the maximal oxygen uptake (V̇O2max ). Next, participants received a mental training session on self-talk and created three positive and three negative self-talk statements. Finally, participants underwent a 60-min steady-state running exercise on a treadmill at 70% of V̇O2max , during which they were cued at 20-, 35-, and 50-min with their personal self-created positive or negative self-talk statements while the DG listened to a documentary. Cardiorespiratory parameters and rate of perceived exertion (RPE) were recorded throughout the 60-min endurance exercise. In addition, salivary cortisol samples were obtained at waking and after treatment. Although oxygen uptake, carbon dioxide production, RPE, and heart rate significantly changed overtime during the 60-min steady-state running exercise, no significant main treatment effect was found. However, RPE scores, minute ventilation, breathing frequency, and salivary cortisol were significantly higher in the NST group compared to the two other groups. These data suggest that NST [emotion-induced stress, as reflected by elevated cortisol] altered the breathing frequency response. In conclusion, manipulating self-talk alters hormonal response patterns, modulates cardiorespiratory function, and influences perceived exertion.

COVID-19: Implications for Physical Activity, Health Disparities, and Health Equity.

Physical activity is one of the most efficacious pathways to promoting mental and physical health, preventing disease, and, most important during the COVID-19 pandemic, bolstering a stronger immune system. Efforts to "flatten the curve" have resulted in the temporary closure of exercise facilities and gyms, suspension of sport activities, and advisories to avoid public recreational spaces. All of these changes have made traditional opportunities to be physically active difficult to access. These changes have also exacerbated existing disparities in access to social and environmental supports for physical activity, potentially contributing to a widening gap in physical activity participation among those at greatest risk for COVID-19. Physical activity can play a special role in reducing the inequitable consequences of COVID-19; however, expansion and better targeting of evidence-informed interventions are needed that address the unique barriers present in communities that have been economically and socially marginalized to achieve health equity in COVID-19 outcomes. This review highlights effective and feasible strategies that provide more equitable access to physical activity programs and spaces across the United States. With a renewed investment in physical activity, this behavior can play a crucial role in improving population health and reducing disparities during the COVID-19 pandemic and beyond.