'It's been a lifelong thing for me': parents' experiences of facilitating a healthy lifestyle for their children with severe obesity.

OBJECTIVE: For parents and guardians, assisting children/adolescents with severe obesity to lose weight is often a key objective but a complex and difficult challenge. Our aim in this study was to explore parents' (and guardians') perspectives on the challenges they have faced in assisting their children/adolescents with severe obesity to lead a healthy lifestyle. METHODS: Thirteen parents/guardians were interviewed from a pool of families who had been referred but did not engage between 2016 and 2018 (N = 103), with the Perth Children's Hospital Healthy Weight Service, a clinical obesity program for children/adolescents (parent age M = 43.2 years, children age M = 10.3 years). Using semi-structured interviews and thematic analysis, we identified 3 broad themes. RESULTS: Parental weight-related factors reflected parents' own lifelong obesity narrative and its effect on their own and their families' ability to live a healthy lifestyle. Perceived inevitability of obesity in their child reflected parents' feelings that the obesity weight status of their children/adolescent was a persistent and overwhelming problem that felt 'out of control'. Lastly, parents reported challenges getting medical help stemming from co-morbid medical diagnosis in their child/adolescent, and difficulties with medical professionals. CONCLUSION: This study demonstrates that parents face challenges in supporting healthy lifestyle for children/adolescents with severe obesity due to parents own internal weight biases and their negative experiences within the healthcare system when seeking help.

Support needs and experiences of young people living in families with mental illness.

INTRODUCTION: Children and adolescents living in families affected by mental illness are at elevated risk of developing mental health problems. A range of interventions have been designed to help these young people; however, the effectiveness of these programs is, in some cases, mixed. Our aim was to understand in detail the support needs and experiences of a group of Australian children and adolescents living in families with mental illness. METHODS: Our study is a qualitative in nature. In 2020-2021, we interviewed 25 Australian young people (Mage = 13.60, SD = 2.26, 20 females and 5 males) living with family members affected by mental illness to understand their (the young people's) experiences, and to identify the types of support that these young people considered important or effective. We conducted reflexive thematic analyses of interview data, underpinned by interpretivist assumptions. RESULTS: We identified seven themes within two higher-order categories reflecting our aims to understand (1) lived experiences within families affected by mental illness (i.e., increased responsibilities, missing out, and stigmatization), and (2) support experiences, needs, and preferences (i.e., respite, shared experiences with like-minded others, education, and flexibility). CONCLUSIONS: Our findings hold substantial practical value by informing services, interventions, and conversations that better support young people living in families affected by mental illness.

The Right Advice, from the Right Person, in the Right Way: Non-Engaged Consumer Families' Preferences for Lifestyle Intervention Design Relating to Severe Obesity in Childhood.

Family-based lifestyle interventions for children/adolescents with severe levels of obesity are numerous, but evidence indicates programs fail to elicit short- or longer-term weight loss outcomes. Families with lived experience can provide valuable insight as we strive to improve outcomes from programs. Our aim was to explore elements that families desired in a program designed to treat severe levels of obesity in young people. We recruited a cross-sectional sample of 13 families (parents and young people) who had been referred but had not engaged with the state-wide Perth Children's Hospital, Healthy Weight Service (Perth, Australia), between 2016 and 2018. Utilizing semi-structured interviews and reflexive qualitative thematic analysis, we identified two broad themes, (1) bridging the gap between what to do and how to do it, and (2) peers doing it with you. The first theme reflected parents' and young people's feelings that programs ought to teach specialist-designed practical strategies utilizing non-generic information tailored to address the needs of the family, in a collaboratively supportive way, and encourage young people to learn for themselves. The second theme reflected the importance of social connection facilitated by peer support, and intervention programs should be offered in a group format to foster inclusion. Families indicated a willingness to engage in tertiary intervention programs but desired support from specialized health professionals/programs to be tailored to their needs, sensitive to their experiences and challenges and provide useful practical strategies that support the knowledge-to-action process.

Perceptions of a family-based lifestyle intervention for children with overweight and obesity: a qualitative study on sustainability, self-regulation, and program optimization.

BACKGROUND: Family-based lifestyle interventions (FBLIs) are an important method for treating childhood weight problems. Despite being recognized as an effective intervention method, the optimal structure of these interventions for children's overweight and obesity has yet to be determined. Our aim was to better understand participants' (a) implementation of behaviour strategies and long-term outcomes, (b) perceptions regarding the optimal structure of FBLIs, and (c) insights into psychological concepts that may explain the success of these programs. METHODS: Purposive sampling was used to recruit participants. We conducted focus groups as well as one-to-one interviews with parents (n = 53) and children (n = 50; aged 7-13, M = 9.4 yr, SD = 3.1) three months following their involvement in a 10-week, multi-component, FBLI involving education and activities relating to healthy nutrition, physical activity, and behavior modification. Using an interpretivist approach, a qualitative study design was employed to examine participant experiences. RESULTS: We identified three higher-order categories: (a) participants' program experiences and perceptions (b) lifestyle changes post-program, and (c) recommendations for optimizing family-based programs. Themes identified within these categories included (a) support and structure & content, (b) diet and physical activity, and (c) in-program recommendations and post-program recommendations. CONCLUSIONS: We identified several challenges that can impair lasting behavior change (e.g., physical activity participation) following involvement in a FBLI. On optimizing these programs, participants emphasized fun, interactive content, interpersonal support, appropriate educational content, and behavior change techniques. Concepts rooted in motivational theory could help address calls for greater theoretical and mechanistic insight in FBLIs. Findings may support research advancement and assist health professionals to more consistently realize the potential of these interventions.

MAN v FAT Soccer: Feasibility Study and Preliminary Efficacy of a Sport-Based Weight-Loss Intervention for Overweight and Obese Men in Australia.

MAN v FAT Soccer is a sport-based weight-loss program for overweight and obese men that originated in the United Kingdom (i.e., as MAN v FAT Football) and appears to successfully engage men with weight loss. We sought to explore whether the program would work in an Australian context by (a) establishing a foundation for the implementation of the program on a larger scale and (b) determining how large-scale implementation is most feasible. We conducted a nonrandomized, single intervention group feasibility trial of MAN v FAT Soccer in Australia with 418 male participants with a body mass index greater than 27.50 kg/m2. Results indicate that the program is acceptable, with participants reporting positive perceptions of the various components of the program and a high proportion reporting intentions to recommend the program to others (95.9%). Furthermore, preliminary effectiveness results indicate positive changes in weight (4.6% reduction) and physical activity (88.5% increase) and improvements in psychological outcomes such as depression (17.6% decrease), stress (19.0% decrease), and body appreciation (19.1% increase). Our findings provide general support for the feasibility of MAN v FAT Soccer and the notion that leveraging competition and masculinity may help drive men's health behavior change.

'They deserve a treat': the nature and antecedents of parental licensing surrounding children's physical activity.

OBJECTIVE: Little is known about parents' compensatory health beliefs (CHB) surrounding their children's engagement in physical activity (PA). Our aim was to provide evidence regarding the nature of, and factors underpinning, parents' PA-related compensatory beliefs for their children. DESIGN: A qualitative descriptive approach and thematic content analysis were employed. SETTING: Parents were recruited from community sport and PA programmes. PARTICIPANTS: Eighteen parents aged 32-52 years (mean age = 40·8 (sd 5·4) years; six males; twelve females). RESULTS: Analyses indicated that parents compensate through 'passive' or 'active' means. Among parents who compensated, most described their provision of 'treat' foods/drinks and a minority described allowing extended sedentary time to their children. Parents' reasons underpinning these beliefs related to their child's general physical/health status and psychological characteristics, and their own motivation and mood state. CONCLUSIONS: These findings provide the first evidence of unhealthy dietary and sedentary behaviour CHB that parents may hold regarding their children's involvement in PA.

Understanding the determinants of stress-induced eating - A qualitative study.

The relationship between stress and food consumption is complex and often characterised by substantial between- and within-person variation. From a theoretical and practical perspective, more research is needed to improve our understanding of the factors that influence this relationship. The aim of this study was to identify those factors, and to derive insight into the nature of their effects on the relationship between stress and food consumption. Using semi-structured interviews, 41 adult participants (M ± SD age = 26.7 ± 6.3 yr, BMI = 22.9 ± 3.0 kg/m2) were invited to reflect on their food consumption following stressor exposure, and to elaborate on the factors that influence stress-induced eating behaviour. Reflexive thematic analyses revealed insight into the different ways in which individuals respond to stress in terms of food quantity and choices, and more significantly, highlighted a range of factors that may influence stress-induced eating behaviours. These factors included the intensity and/or nature of the stressor, aspects of prioritisation, rewarding, knowledge of and perceptions about food, normative (e.g., family, friend) influences, automated or habituated behaviours, the availability of food, and selected coping mechanisms. These findings present important directions for researchers seeking to study the variation in stress-induced eating, and may hold substantial practical value by way of informing interventions designed to alleviate unhealthy dietary responses to stress.

Effects of diurnal exercise timing on appetite, energy intake and body composition: A parallel randomized trial.

OBJECTIVE: To determine the effect of diurnal exercise timing on appetite, energy intake and body composition in individuals with overweight or obesity. METHODS: Forty sedentary, individuals with overweight or obesity (17 males, 23 females; age: 51 ± 13 years; BMI: 30.9 ± 4.2 kg/m2) were randomly allocated to complete a 12-week supervised multi-modal exercise training program performed either in the morning (amEX) or evening (pmEX). Outcome measures included appetite in response to a standardised test meal, daily energy intake (EI), body weight and body composition. Measures of dietary behaviour were assessed at baseline and post-intervention, along with habitual physical activity, sleep quality and sleep quantity. Significance was set at p ≤ .05 and Hedge's g effect sizes were calculated. RESULTS: Regardless of timing, exercise training increased perceived fullness (AUC; g = 0.82-1.67; both p < .01), decreased daily EI (g = 0.73-0.93; both p < .01) and body-fat (g = 0.29-0.32; both p <. 01). The timing of exercise did not change the daily EI or body-fat response to training (all p ≥ .27), however, perceived fullness increased in the amEX group (p ≤ .01). DISINHIBITION: (g = 0.35-1.95; p ≤ .01) and Hunger (g = 0.05-0.4; p = .02) behaviours decreased following exercise training, with Disinhibition demonstrating greater improvements in the pmEX group (p = .01). Objective and subjective sleep quantity increased with training (all p ≤ .01), but sleep quality was not reported to change. CONCLUSIONS: Multi-modal exercise training improved body composition and some appetite outcomes, although changes were inconsistent and largely independent of exercise-timing. In the absence of dietary manipulation, the effect of diurnal exercise timing on appetite and body composition appear trivial compared to the overall benefits of exercise participation.

Overweight and obese men's experiences in a sport-based weight loss intervention for men.

In Western countries, such as Australia and the UK, a significantly greater proportion of men (relative to women) are overweight and obese, yet relatively few weight loss interventions have been developed that sufficiently target men. This lack of male-focused programming may be in part because 'traditional' weight loss programs are unappealing for what is considered a 'hard-to-reach' population. One program that appears to have such appeal for men is the MAN v FAT Football (MVFF) program, based out of the United Kingdom, which is designed for men with a body mass index of (or greater than) 27.5. MVFF encourages men's participation in a community-based weight loss program that incentivizes weight loss through participation in a football league, and since 2016 MVFF has supported the weight loss efforts of several thousand men. Using MVFF as an exemplar, our aim was to derive insight into how men experience a male-only competitive, sport-based weight loss program. We recruited twenty-seven players (Mage = 41.13, SD = 9.93), and ten coaches (Mage = 31.8, SD = 11.55) from program locations throughout the United Kingdom. Using semi-structured interviews and thematic analysis, we identified several appraisal aspects of the program that players and coaches considered important, including the appeal of sport, competition on a level playing field, being part of a team, camaraderie, accountability, men sharing issues with other men, gender-sensitized environment, likeminded and similar men, and perceptions that traditional weight loss programs are tailored towards women. Player experiences (i.e., competence and enjoyment) and functional supports in the program (e.g., player handbook, weight loss coach) were reported to drive outcomes of effective weight loss and program retention. Interventions aiming to target men may be more successful working with rather than against formulations of identity such as masculinities, and this can be achieved by tailoring program content (e.g., messaging), settings (e.g., among men sharing similar characteristics such as body-type or goals), and mode of delivery (e.g., through organized sports, and leveraging competition to drive healthy behaviours).

Pole Dancing for Fitness: The Physiological and Metabolic Demand of a 60-Minute Class.

Nicholas, JC, McDonald, KA, Peeling, P, Jackson, B, Dimmock, JA, Alderson, JA, and Donnelly, CJ. Pole dancing for fitness: The physiological and metabolic demand of a 60-minute class. J Strength Cond Res 33(10): 2704-2710, 2019-Little is understood about the acute physiological or metabolic demand of pole dancing classes. As such, the aims of this study were to quantify the demands of a standardized recreational pole dancing class, classifying outcomes according to American College of Sports Medicine (ACSM) exercise-intensity guidelines, and to explore differences in physiological and metabolic measures between skill- and routine-based class components. Fourteen advanced-level amateur female pole dancers completed three 60-minute standardized pole dancing classes. In one class, participants were fitted with a portable metabolic analysis unit. Overall, classes were performed at a mean VO2 of 16.0 ml·kg·min, total energy cost (EC) of 281.6 kcal (4.7 kcal·min), metabolic equivalent (METs) of 4.6, heart rate of 131 b·min, rate of perceived exertion (RPE) of 6.3/10, and blood lactate of 3.1 mM. When comparing skill- and routine-based components of the class, EC per minute (4.4 vs. 5.3 kcal·min), peak VO2 (21.5 vs. 29.6 ml·kg·min), METs (4.3 vs. 5.2), and RPE (7.2 vs. 8.4) were all greater in the routine-based component (p < 0.01), indicating that classes with an increased focus on routine-based training, as compared to skill-based training, may benefit those seeking to exercise at a higher intensity level, resulting in greater caloric expenditure. In accordance with ASCM guidelines, an advanced-level 60-minute pole dancing class can be classified as a moderate-intensity cardiorespiratory exercise; when completed for ≥30 minutes, ≥5 days per week (total ≥150 minutes) satisfies the recommended level of exercise for improved health and cardiorespiratory fitness.

Student Motivation in High School Physical Education: A Latent Profile Analysis Approach.

Guided by the principles of self-determination theory, the purpose of this study was to identify latent profiles representing high school students' motivational regulations for physical education (PE) and to model putative predictors and outcomes of profile membership. A sample of 532 Australian high school students, age 12-16 years (M = 13.83, SD = 1.13), reported their motivation for PE, perceptions of need satisfaction in PE, and effort expended in PE. Latent profile analysis revealed evidence of 3 distinct profiles that were consistent with continuum expectations outlined in self-determination theory (i.e., the moderately autonomous, moderately controlled, and highly autonomous profiles), alongside 2 profiles characterized by levels of introjected regulation that aligned with autonomous motives (i.e., the mixed motivation and amotivated profiles). Analyses also revealed that, on the whole, greater need satisfaction predicted membership of more autonomous profiles and that membership of such profiles was predictive of greater self-reported effort in PE. Analyses revealed evidence of qualitatively distinct motivation profiles that were differentially predicted by students' psychological need satisfaction and predictive of in-class effort. This study is not only the first to use latent profile analysis to explore the role of psychological need satisfaction in predicting PE motivation profiles. It also provides practical information regarding the prevalence and potential outcomes of students' motivation profiles.

Stress-induced eating and the relaxation response as a potential antidote: A review and hypothesis.

There is an accumulating body of evidence to indicate that stress leads to the consumption of unhealthy, energy-dense, palatable food, potentially contributing to the alarming global prevalence of chronic diseases, including obesity. However, comparatively little research has been devoted to addressing how best to remedy this growing problem. We provide an overview of the influence of stress on dietary intake, and then explore the novel, yet simple, possibility that regular elicitation of the relaxation response may effectively reduce stress-induced eating via both physiological neuroendocrine and reward pathways and psychological pathways involving emotion regulation, and habitual coping. If shown to be effective, the regular practice of relaxation may provide a convenient, cost efficient, patient-centered therapeutic practice to assist in the prevention of unhealthy weight gain and other negative consequences of unhealthy food intake.

The Impact of Agentic and Communal Exercise Messages on Individuals' Exercise Class Attitudes, Self-Efficacy Beliefs, and Intention to Attend.

We tested the effects of advertisements about a fictitious exercise class-derived using the theoretical constructs of agency and communion-on recipients' perceptions about, and interest in, the class. The final sample consisted of 150 adults (Mage = 44.69, SD = 15.83). Results revealed that participants who received a communal-oriented message reported significantly greater exercise task self-efficacy and more positive affective attitudes relative to those who received an agentic-oriented message. Communal (relative to agentic) messages were also indirectly responsible for greater intentions to attend the class, via more positive self-efficacy beliefs and affective attitudes. These findings were obtained despite the use of another manipulation to orient participants to either agency or communion goals. The results indicate that the primacy of communion over agency for message recipients may extend to exercise settings and may occur irrespective of whether participants are situationally oriented toward agency or communion.

An Exercise in Resistance: Inoculation Messaging as a Strategy for Protecting Motivation During a Monotonous and Controlling Exercise Class.

Sustained attention has been devoted to studying the factors that support (or thwart) individuals' enjoyment of, interest in, and value judgments regarding their exercise activities. We employed a resistance-inducing (i.e., inoculation theory) messaging technique with the aim of protecting these desirable perceptions in the face of environmental conditions designed to undermine one's positive exercise experiences. Autonomously motivated exercisers (N = 146, Mage = 20.57, SD = 4.02) performed a 25-min, group-based, instructor-led exercise circuit, in which the activities were deliberately monotonous, and during which the confederate instructor acted in a disinterested, unsupportive, and critical manner. Shortly before the session, participants received either a control message containing general information about the exercise class or an inoculation message containing a forewarning about potential challenges to participants' enjoyment/interest/value perceptions during the class, as well as information about how participants might maintain positive perceptions in the face of these challenges. Despite there being no between-conditions differences in presession mood or general exercise motives, inoculated (relative to control) participants reported greater interest/enjoyment in the exercise session and higher perceptions of need support from the instructor. Perceptions of need support mediated the relationship between message condition and interest/enjoyment.

A comparison of beliefs about exercise during pregnancy between Chinese and Australian pregnant women.

BACKGROUND: Despite the well-established benefits of exercise during pregnancy, many women remain inactive. This may be related, in part, to women's beliefs about exercise in pregnancy, which are likely influenced by cultural background. Accordingly, the aim of this study was to compare attitudes, subjective norms, and perceived behavioural control toward exercise, together with current levels of exercise participation between Chinese and Australian women during pregnancy. A second aim was to determine the extent to which these factors predict intention to exercise within a Theory of Planned Behaviour framework. METHODS: Pregnant women (22 ± 2 weeks of gestation) living in China (n = 240) and Australia (n = 215) completed a questionnaire designed to assess a) maternal beliefs regarding the importance of exercise in relation to other health behaviours, b) attitudes, subjective norms, perceived behavioural control and intentions toward exercise, and c) current levels of physical activity. One-way analyses of variance were used to compare the demographics, maternal beliefs, attitudes, subjective norms, perceived behavioural control, intentions to exercise, and current physical activity levels between the Chinese and Australian samples. Structural equation modelling was used to determine which factors predicted intention to exercise in the two samples. RESULTS: Australian women reported higher levels of current exercise and intentions to exercise in the next four weeks of pregnancy compared with Chinese women. These observations were associated with higher instrumental attitudes, ratings of subjective norm, and perceived behavioural control toward exercise in the Australian women. Instrumental attitudes and perceived behavioural control predicted intention to exercise in the Australian women, while perceived behavioural control was the only predictor of intentions to exercise in the Chinese sample. CONCLUSIONS: Beliefs, attitudes, barriers and intentions towards exercise during pregnancy differ between cultures. Understanding these differences may assist in the design of exercise interventions to maximise exercise adherence and lifelong physical activity patterns.

Moving to Self-Present: An Investigation Into Proposed Antecedents of 2 x 2 Self-Presentation Motives.

Two studies involving high school physical education students were conducted to investigate associations between 2 x 2 self-presentation motives and theorized antecedents. In Study 1 (n = 445), using path analysis, we found that positive predictive pathways emerged from fear of negative evaluation, trait agency and communion, self-presentational efficacy, and social self-efficacy to 2 x 2 motives. In Study 2 (n = 301), using cluster analysis, we found that approximately half the cohort was classified into a high motive endorsement cluster and half into a low motive endorsement cluster. The high cluster had significantly higher 2 x 2 motive, fear of negative evaluation, trait agency and communion, and self-efficacy scores. This work represents the first concerted effort to empirically examine proposed antecedents of 2 x 2 motives and serves to inform theorists and practitioners about dispositional and context-specific factors that may align with these motives.

The Self-Presentation Motives for Physical Activity Questionnaire: Instrument Development and Preliminary Construct Validity Evidence.

With the aim of advancing the literature on impression management in physical activity settings, we developed a theoretically derived 2 by 2 instrument that was designed to measure different types of context-specific self-presentation motives. Following item generation and expert review (Study 1), the instrument was completed by 206 group exercise class attendees (Study 2) and 463 high school physical education students (Study 3). Our analyses supported the intended factor structure (i.e., reflecting acquisitive-agentic, acquisitive-communal, protective-agentic, and protective-communal motives). We found some support for construct validity, and the self-presentation motives were associated with variables of theoretical and applied interest (e.g., impression motivation and construction, social anxiety, social and achievement goals, efficacy beliefs, engagement). Taken together, the results indicate that the Self-presentation Motives for Physical Activity Questionnaire (SMPAQ) may be useful for measuring various types of self-presentation motives in physical activity settings.

Self-control, self-regulation, and doping in sport: a test of the strength-energy model.

We applied the strength-energy model of self-control to understand the relationship between self-control and young athletes' behavioral responses to taking illegal performance-enhancing substances, or "doping." Measures of trait self-control, attitude and intention toward doping, intention toward, and adherence to, doping-avoidant behaviors, and the prevention of unintended doping behaviors were administered to 410 young Australian athletes. Participants also completed a "lollipop" decision-making protocol that simulated avoidance of unintended doping. Hierarchical linear multiple regression analyses revealed that self-control was negatively associated with doping attitude and intention, and positively associated with the intention and adherence to doping-avoidant behaviors, and refusal to take or eat the unfamiliar candy offered in the "lollipop" protocol. Consistent with the strength-energy model, athletes with low self-control were more likely to have heightened attitude and intention toward doping, and reduced intention, behavioral adherence, and awareness of doping avoidance.

The goose is (half) cooked: a consideration of the mechanisms and interpersonal context is needed to elucidate the effects of personal financial incentives on health behaviour.

While we agree that personal financial incentives (PFIs) may have some utility in public health interventions to motivate people in the uptake and persistence of health behaviour, we disagree with some of the sentiments outlined by Lynagh et al. (Int J Behav Med 20:114-120, 2012). Specifically, we feel that the article gives a much stronger impression that PFIs will likely lead to long-term behaviour change once the incentive has been removed than is warranted by current research. This claim has not received strong empirical support nor is it grounded in psychological theory on the role of incentives and motivation. We also feel that the presentation of some of the tenets of self-determination theory by the authors is misleading. Based on self-determination theory, we propose that PFIs, without sufficient consideration of the mechanisms by which external incentives affect motivation and the interpersonal context in which they are presented, are unlikely to lead to persistence in health behaviour once the incentive is removed. We argue that interventions that adopt PFIs as a strategy to promote health-behaviour change should incorporate strategies in the interpersonal context to minimise the undermining effect of the incentives on intrinsic motivation. Interventions should present incentives as informational regarding individuals' competence rather than as purely contingent on behavioural engagement and emphasise self-determined reasons for pursuing the behaviour.

Toward a multidimensional model of athletes' commitment to coach-athlete relationships and interdependent sport teams: a substantive-methodological synergy.

Drawing from a three-factor model of organizational commitment, we sought to provide validity evidence for a multidimensional conceptualization designed to capture adolescent athletes' commitment to their coach-athlete relationship or their team. In Study 1, 335 individual-sport athletes (Mage = 17.32, SD = 1.38) completed instruments assessing affective, normative, and continuance commitment to their relationship with their coach, and in Study 2, contextually modified instruments were administered to assess interdependent-sport athletes' (N = 286, Mage = 16.31, SD = 1.33) commitment to their team. Bayesian structural equation modeling revealed support for a three-factor (in comparison with a single-factor) model, along with relations between commitment dimensions and relevant correlates (e.g., satisfaction, return intentions, cohesion) that were largely consistent with theory. Guided by recent advancements in Bayesian modeling, these studies provide a new commitment instrument with the potential for use and refinement in team- and relationship-based settings and offer preliminary support for a conceptual framework that may help advance our understanding of the factors underpinning individuals' engagement in sport.