Physical Activity Counselling and Exercise Prescription Practices among Dietitians Across Nova Scotia.

The purpose of this study was to assess the perceptions and practices around physical activity counselling and exercise prescription of dietitians in Nova Scotia. Dietitians (n = 95) across Nova Scotia completed an online self-reflection survey regarding their current physical activity and exercise (PAE) practices. Most (51%; n = 48) reported no previous PAE educational training. Dietitians infrequently prescribed exercise to their patients (16% ± 26% of appointments) or provided PAE referrals (17% ± 24%). Dietitians reported moderate confidence (57% ± 21%) performing PAE counselling and included PAE-related content in half of patient appointments (52% ± 31%). Almost all respondents (95%) identified interest in further PAE education or training. Open-ended responses also demonstrated the need for community-based exercise programs (28% of providers) and qualified exercise professionals to refer to (25%). Overall, dietitians report rarely providing patients with written exercise prescriptions or referrals to other professionals for PAE content but do frequently include PAE in patient appointments. Dietitians in Nova Scotia are well positioned to promote PAE, but more educational training and improved referral systems to qualified exercise professionals or community exercise programs is strongly desired. Exercise professionals and dietitians should concurrently advocate for these changes and collaborate to help more patients lead physically active lifestyles.

Comparing Class-Based and Home-Based Exercise for Older Adults With Chronic Health Conditions: 12-Month Follow-Up of a Randomized Clinical Trial.

OBJECTIVE: To assess the maintenance of physical activity (PA) and health gains among participants in a class-based (CB) or home-based (HB) PA intervention over a 12-month study period. METHODS: A total of 172 adults aged 50 years and older were randomly allocated to either a CB or an HB intervention, each involving an intensive 3-month phase with a 9-month follow-up period. Measures at baseline, 3, 6, and 12 months included self-reported PA and health, body mass index, waist circumference (WC), blood pressure, cardiovascular endurance (6-min walk test), physical function, and functional fitness (senior fitness test). Outcomes were analyzed using generalized estimating equations. RESULTS: Maximum improvement was typically observed at 3 or 6 months followed by a modest diminution, with no differences between groups. For body mass index, waist circumference, 6-min walk test, and senior fitness test, there was progressive improvement through the study period. Greater improvement was seen in the CB group compared with the HB group on three items on the senior fitness test (lower body strength and endurance [29% vs. 21%, p < .01], lower body flexibility [2.8 cm vs. 0.4 cm, p < .05], and dynamic agility [14% vs. 7%, p < .05]). CONCLUSION: The interventions were largely comparable; thus, availability, preferences, and cost may better guide program choice.

Effects of a print-mediated intervention on physical activity during transition to the first year of university.

Transition to the first year of university is linked to steep declines in moderate-vigorous physical activity (MVPA). The purpose of this study was to investigate the effects of a targeted, theory-driven, print-based intervention on MVPA during transition to university. Volunteer participants from five Canadian universities (n=255) completed measures of MVPA at the start of their first semester at university and were randomly assigned to conditions receiving a first-year-student physical activity and action-planning brochure, Canada's Physical Activity Guide (CPAG), or a no-intervention control group. Six weeks later, a follow-up measure of MVPA was obtained as well as retrospective accounts of physical activity action-planning strategies and self-efficacy for scheduling physical activity. At the follow-up, students who received the targeted first-year student physical activity brochure reported significantly higher levels of MVPA compared to controls (p<.05) and a trend towards higher MVPA compared to the CPAG group (p=.06). However, there were no differences between groups on action planning or self-efficacy. A theory-driven and targeted print media intervention can offer low-cost and broad-reaching effects that may help students stay more active or curb declining levels of MVPA that occur during transition to university.

Partners' attachment styles and overprotective support as predictors of patient outcomes in cardiac rehabilitation.

OBJECTIVE: This study investigates whether the adult attachment styles of support partners in a cardiac rehabilitation context predict their use of overprotective support strategies, and whether such overprotection in turn predicts lower self-efficacy and poorer program attendance in cardiac rehabilitation patients. RESEARCH METHOD: Participants were 69 partner-patient dyads, mostly older adults (mean age = 65 years) in long-term relationships (M = 35 years). During the first week of a 10-week cardiac rehabilitation program in a midsized rural hospital, participants completed self-report questionnaires that were used to assess partners' attachment styles and levels of overprotection, as well as patients' health-related self-efficacy. Attendance at each session of the program was then tracked by cardiac rehabilitation staff members. RESULTS: A moderated mediation model using bootstrapping showed that when partners were insecurely attached (high in both attachment avoidance and attachment anxiety), a mediational model held, such that more insecure partner attachment predicted more extensive use of overprotective support strategies, which in turn predicted lower patient self-efficacy for exercise and less-frequent program attendance. IMPLICATIONS: Implications for training support partners in more-effective support strategies are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Perceptions and Practices of Providing Physical Activity Counselling and Exercise Prescriptions among Physiotherapists in Nova Scotia.

Purpose: We assessed the perceptions and practices of physical activity counselling and exercise prescription of physiotherapists in Nova Scotia. Method: A total of 146 physiotherapists in Nova Scotia completed an online self-reflection survey regarding their current practice of, confidence in, barriers to, and facilitators of providing physical activity and exercise (PAE) counselling to their patients. Results: Physiotherapists included physical activity counselling and exercise content in 85% of patient counselling appointments. They reported a high level of confidence (> 90%) in providing PAE information and answering patients' PAE questions and moderate confidence in their patients' abilities to maintain PAE over the long term (73%) and to follow through on their PAE recommendations (66%). Patients' interest in PAE was the greatest barrier to providing PAE counselling. The physiotherapists reported being most comfortable when prescribing exercise for patients with musculoskeletal conditions and least comfortable with patients with cancer, insulin-dependent diabetes, and respiratory conditions. Most physiotherapists (71%) reported being interested in pursuing further education or training in PAE counselling and prescription. Conclusions: The physiotherapists frequently recommended PAE to their patients, had moderate confidence in their patients' ability to follow through on their advice, and experienced patients' disinterest in PAE as the greatest barrier to providing PAE counselling. The results of this study suggest a desire by physiotherapists for educational training opportunities, which we recommend be focused on providing behavioural strategies and further information to help overcome patient-focused barriers; this will help patients adopt and maintain physically active lifestyles.

Objectif : évaluer les perceptions et les pratiques des physiothérapeutes de la Nouvelle-Écosse en matière de conseils sur l'activité physique et de prescription d'exercice. Méthodologie : au total, 146 physiothérapeutes de la Nouvelle-Écosse ont rempli un sondage d'autoréflexion en ligne sur les conseils qu'ils donnent à leurs patients en matière d'activité physique et d'exercice (APE) à leurs patients, leur confiance, les obstacles et les incitations à cet égard. Résultats : les physiothérapeutes incluaient des conseils en matière d'activité physique et un contenu d'exercice lors de 85 % des rendez-vous de conseils aux patients. Ils déclaraient un taux de confiance élevé (> 90 %) quant à l'information en matière d'APE et aux réponses aux questions des patients à ce sujet, et un taux de confiance modéré envers les capacités de leurs patients à maintenir leur APE à long terme (73 %) et à donner suite à leurs recommandations en matière d'APE (66 %). L'intérêt des patients envers l'APE était le principal obstacles aux conseils sur l'APE. Les physiothérapeutes ont déclaré être plus à l'aise de prescrire des exercices aux patients ayant des affections musculosquelettiques, mais moins à l'aise auprès des patients atteints de cancer, de diabète insulinodépendant et de troubles respiratoires. La plupart des physiothérapeutes (71 %) déclaraient souhaiter poursuivre leur formation sur les conseils et la prescription d'APE. Conclusions : les physiothérapeutes recommandaient fréquemment l'APE à leurs patients, avaient une confiance modérée dans les capacités de leurs patients à donner suite à leurs conseils et trouvaient que le désintérêt de leurs patients envers l'APE était le principal obstacle aux conseils en matière d'APE. Selon les résultats de cette étude, les physiothérapeutes souhaitent pouvoir suivre des formations. Les auteurs recommandent qu'elles portent sur des stratégies comportementales et sur l'information plus approfondie pour vaincre les obstacles liés aux patients, car ces stratégies aideront les patients à adopter et à maintenir un mode de vie actif.

Youth and adolescent physical activity lapsers: examining self-efficacy as a mediator of the relationship between family social influence and physical activity.

The present study examined whether self-efficacy mediates the relationship between family social influence and physical activity among youth who have experienced a recent lapse in their physical activity participation. Using a prospective, longitudinal design, participants completed measures of social influence, self-regulatory efficacy and physical activity. Only those participants whose physical activity declined were retained for further analysis. Self-regulatory efficacy partially mediated the relationship between family social influence and physical activity, with self-efficacy mediating 36 percent of the total effect. The results provide support for self-regulatory efficacy as a mediator and provide preliminary insight into the potential mechanisms for preventing lapses in activity from developing into prolonged periods of inactivity within this population.

Limiting exercise options: depending on a proxy may inhibit exercise self-management.

We examined the influence of proxy-assistance on exercisers' social cognitions and behavior. Fifty-six fitness class participants reported preference for proxy-assistance and reacted to exercising in different contexts. A 2 (proxy-led vs self-managed exercise context) by 2 (preferred assistance) MANOVA revealed significant assistance by context interactions for self-regulatory efficacy (SRE) and difficulty. Regarding self-managed exercise, high-assistance individuals expressed lower SRE and higher difficulty. Chi-square analysis revealed that significantly fewer high-assistance participants chose self-managed exercise. A one-way MANOVA on preferred assistance indicated that high-assistance participants were less confident, satisfied and perceived their self-managed exercise as more difficult. Results support Bandura's theorizing that use of a proxy can limit SRE of those preferring the proxy's control of their behavior.

A pilot study: Validity and reliability of the CSEP-PATH PASB-Q and a new leisure time physical activity questionnaire to assess physical activity and sedentary behaviours.

The purpose of this study was to evaluate the accuracy of 2 newly developed physical activity questionnaires: the Canadian Society for Exercise Physiology (CSEP) Physical Activity and Sedentary Behaviour Questionnaire (PASB-Q) and a newly modified Leisure-Time Physical Activity Questionnaire (mLTPA-Q). These questionnaires were compared with objective measurements of physical activity and fitness (accelerometry and physiological assessments) in 35 adults, before and after a week of daily living activity. Objectively measured moderate- to vigorous-intensity aerobic physical activity (MVPA) was moderately correlated with the PASB-Q's physical activity vital sign (PAVS) (r = 0.50, p = 0.004) and the mLTPA-Q (r = 0.56, p = 0.001). Bland-Altman plots suggest minimal bias from self-reported to objective measures of MVPA. The ability of PAVS to accurately distinguish who does and does not achieve Canadian physical activity guidelines was 83% and 60%, respectively, compared with 82% and 73% of the mLTPA-Q. Self-reported sedentary time was greatly underestimated in the PASB-Q compared with the objective measure (6.4 ± 3.5 vs 12.2 ± 1.2 h/day). The results of this study suggest the PASB-Q and mLTPA-Q are valid and reliable measures of adult physical activity and provide reasonable indication of those individuals who meet physical activity guidelines. Future questionnaire development should take into account the underestimation of time spent engaging in sedentary activities.

Health care provider confidence and exercise prescription practices of Exercise is Medicine Canada workshop attendees.

The Exercise is Medicine Canada (EIMC) initiative promotes physical activity counselling and exercise prescription within health care. The purpose of this study was to evaluate perceptions and practices around physical activity counselling and exercise prescription in health care professionals before and after EIMC training. Prior to and directly following EIMC workshops, 209 participants (physicians (n = 113); allied health professionals (AHPs) (n = 54), including primarily nurses (n = 36) and others; and exercise professionals (EPs) (n = 23), including kinesiologists (n = 16), physiotherapists (n = 5), and personal trainers (n = 2)) from 7 provinces completed self-reflection questionnaires. Compared with AHPs, physicians saw more patients (78% > 15 patients/day vs 93% < 15 patients/day; p < 0.001) and reported lower frequencies of exercise counselling during routine client encounters (48% vs 72% in most sessions; p < 0.001). EPs had higher confidence providing physical activity information (92 ± 11%) compared with both physicians (52 ± 25%; p < 0.001) and AHPs (56 ± 24%; p < 0.001). Physicians indicated that they experienced greater difficulty including physical activity and exercise counselling into sessions (2.74 ± 0.71, out of 5) compared with AHPs (2.17 ± 0.94; p = 0.001) and EPs (1.43 ± 0.66; p < 0.001). Physicians rated the most impactful barriers to exercise prescription as lack of patient interest (2.77 ± 0.85 out of 4), resources (2.65 ± 0.82 out of 4), and time (2.62 ± 0.71 out of 4). The majority of physicians (85%) provided a written prescription for exercise in <10% of appointments. Following the workshop, 87% of physician attendees proposed at least one change to practice; 47% intended on changing their practice by prescribing exercise routinely, and 33% planned on increasing physical activity and exercise counselling, measured through open-ended responses.

Ties That Bond: Youth Sport as a Vehicle for Social Identity and Positive Youth Development.

An emerging area of research has focused on understanding how the group dynamics of a sport team influence positive youth development (PYD). The identities that youth form through their membership in sport teams (i.e., social identities) have been found to influence teammate behavior and team performance. Yet, minimal work exists on social identity and PYD in youth sport. PURPOSE: The purpose of this study was to investigate the relationship between social identity and PYD in sport. METHOD: Youth engaged in recreational sport (N = 219; Mage = 11.61 years, SD = 1.39 years) completed measures of social identity and PYD in sport. The social identity measure assessed 3 dimensions including ingroup ties (IGT; perceptions of similarity, bonding, belongingness), cognitive centrality (importance of being a team member), and ingroup affect (IGA; feelings associated with group membership). A regression analysis was performed separately for 4 PYD outcomes (personal and social skills, goal setting, initiative, negative experiences) with the 3 dimensions of social identity entered as predictors. RESULTS: Regression analyses revealed that IGT and IGA were positively associated with personal and social skills (R2 Adj. = .29). Further, IGT predicted initiative (R2 Adj. = .16), whereas IGA was positively associated with goal setting (R2 Adj. = .17) and negatively associated with negative experiences (R2 Adj. = .08). CONCLUSION: The findings extend previous research highlighting the benefits of social identity on teammate behavior and team performance and demonstrate how social identity may contribute to PYD through sport.

Preferring proxy-agency: impact on self-efficacy for exercise.

We examined: (a) the social-cognitions of those who differ in preferred level of proxy-assistance in both proxy-led and independent exercise contexts; and (b) the relationships between proxy-agency and reliance. Sixty-five fitness class participants completed measures of self-regulatory efficacy, task self-efficacy, exercise intentions, proxy-efficacy and perceived reliance. A 2 (exercise context) by 2 (preferred assistance) MANOVA revealed significant main effects for assistance and context. Also, significant assistance by context interactions was found for both efficacies. When facing exercise without a proxy, individuals preferring high proxy assistance expressed lower self-regulatory and task self-efficacy. Finally, proxy- and self-regulatory efficacy were shown to be separate predictors of reliance on a proxy. Results support Bandura's theorizing about the proxy-led context and its influence on self-regulatory efficacy.

The relationship between transformational teaching and adolescent physical activity: the mediating roles of personal and relational efficacy beliefs.

The purpose of this study was to examine the extent to which transformational teaching, exhibited by secondary school physical education teachers, predicts within-class physical activity and leisure-time physical activity among adolescents. The study used a prospective observational design and involved data collected from 874 Grade 10 adolescents (M age = 15.41, (SD) = .61). Through use of structural equation modeling, the results revealed that adolescents' perceptions of transformational teaching were positively related to within-class physical activity and leisure-time physical activity, and these effects were mediated by adolescents' estimation of their teacher's confidence in their abilities (i.e. relation-inferred self-efficacy) and self-efficacy beliefs.

Increasing diabetes educators' confidence in physical activity and exercise counselling: the effectiveness of the "physical activity and exercise toolkit" training intervention.

OBJECTIVE: The objective of this action research was to examine the effectiveness of a comprehensive intervention (the toolkit) in improving diabetes educators' (DEs') perceptions of their abilities and their patients' abilities related to physical activity as part of regular diabetes self-management. METHODS: Two separate studies were conducted. Participants completed measures assessing confidence, attitudes and perceived difficulty. In study 1, a quasi-experimental design was used to examine the impact of the training intervention at 6 months. Cross-sectional sampling at baseline and 12 months then was used to assess the longer-term impact of the intervention. In study 2, a pre-post design was used to test the impact of the intervention at 12-months in a separate sample. RESULTS: The primary finding was a consistent increase in DEs' confidence in their ability to provide physical activity and exercise counselling with increases of up to 20% after the training intervention. Furthermore, DEs reported greater knowledge about physical activity (p<0.03) yet perceived physical activity counselling to be more difficult after receiving the training (p<0.05). In study 2, the DEs reported increases in perceived patient knowledge and confidence in their patients (p<0.03) after the intervention. Secondary analyses showed that frequently referring to the toolkit was associated with higher counselling efficacy and lower perceived difficulty (p<0.03). CONCLUSIONS: These findings suggest that the toolkit is an effective resource to improve DEs' confidence in the area of physical activity counselling. As a result of this work, the toolkit has been adopted as standard diabetes care across Nova Scotia and as a foundational resource for DEs across Canada.