A Serious Video Game Targeting HIV Testing and Counseling: A Randomized Controlled Trial.

PURPOSE: Adolescents are the age group that is least likely to know their HIV status and may unknowingly transmit the virus to others. A randomized controlled trial was conducted to evaluate the impact of the original video game intervention, PlayTest!, on behavioral antecedents for HIV testing and counseling (HTC). METHODS: Participants (N = 287 adolescents) were recruited between 2018 and 2020 and were 48% female, aged 14-18 years (mean age = 15.4 years), and 76% racial minorities. Participants were randomized 1:1 and assigned to either play PlayTest! or a set of control games, ∼one session per week for an hour per session over 4-6 weeks (gameplay) after school. The primary outcome measure was participants' attitudes around HTC at 6 months, with intentions, knowledge, self-efficacy, and behaviors assessed as secondary outcomes. RESULTS: Two hundred and ninety-six participants were enrolled/randomized; nine were withdrawn due to incomplete parental consent forms, leaving 287 participants: 145 were randomized to PlayTest! and 142 to the control condition. Mixed between-within subjects ANOVAs assessed the impact of the study conditions on outcomes. Improvements were seen in the PlayTest! group in HTC attitudes (p < .001), intentions (p < .001), knowledge (p < .001), and self-efficacy (p = .002) at all time-points. At 6 months, for those who had access to HTC (N = 134; prior to COVID-19) and for those who did not have access to HTC (N = 261; during COVID-19), there were no differences in self-reported HTC between the two groups (p = .289 and p = .074, respectively). DISCUSSION: PlayTest! impacted important behavioral antecedents related to HTC and has the potential to broadly increase HTC rates in adolescents.

"There may not be a rainbow sticker at the door, but there are my rainbow shoes": A qualitative exploration of resilience among LGBTQ+ adults in physical activity contexts.

Researchers have identified LGBTQ + -specific stressors that hinder physical activity participation; however, LGBTQ + resilience against these stressors has yet to be explored. The purpose of this study was to gain an understanding of how LGBTQ + resilience is experienced within physical activity. Ten focus groups with LGBTQ + adults (N = 36) were conducted online and subject to abductive thematic analysis. Experiences of individual resilience were conceptualized through the interplay of: (a) persistence-adaptability (ranging from being regimented with physical activity to being flexible and amenable to changes), (b) toughness-tenderness (possessing mental grit to self-kindness), and (c) complaisance-resistance (internalizing to resisting norms that govern physical activity). Participants also described three sites for community resilience: (a) LGBTQ + communities that provided pivotal social support, but rarely for physical activity, (b) digital communities that could support or thwart LGBTQ + resilience, but often prioritized aesthetics, and (c) physical activity communities that supported participation, but often perpetuated LGBTQ + exclusion.

An exploration and comparison of #BodyPositivity and #BodyNeutrality content on TikTok.

TikTok, one of the most popular visual social media platforms, has been criticized for perpetuating and glorifying eating disorders. In response, content focused on body positivity (loving your body) is growing on TikTok. However, body positivity content on other social platforms promotes positive body image but also perpetuates unrealistic beauty ideals. Body neutrality (deemphasizing the focus on the body's appearance) is an alternative concept that could portray less harmful content, but has yet to be explored. Therefore, the purpose of this study was to explore and compare the content under #BodyPositivity and #BodyNeutrality on TikTok. One hundred and fifty TikToks under each hashtag were downloaded. A thematic analysis of the TikToks was conducted. Three themes were generated that captured content across both hashtags, with only minor differences in content between the two: (1) Resisting societal ideologies (with subtheme: Normalizing insecurities), (2) (Re)producing disordered content (with subtheme: Toxic (body) positivity promotes the need for neutrality), and (3) Social critique. Within the themes, there was the promotion of body positivity through self-love and body acceptance, but also content that continued to emphasize standard beauty ideals and the thin-ideal. Certain TikToks provided educational content that explained the roots of the #BodyPositivity movement and what #BodyNeutrality means as a potentially more realistic approach to body acceptance. Findings suggest that #BodyNeutrality may provide a safer space for individuals online, and future research should assess the impact of such TikToks on those viewing them to assess body and eating attitudes and behaviours.

Performance-Based Measurement of eHealth Literacy: Systematic Scoping Review.

BACKGROUND: eHealth literacy describes the ability to locate, comprehend, evaluate, and apply web-based health information to a health problem. In studies of eHealth literacy, researchers have primarily assessed participants' perceived eHealth literacy using a short self-report instrument, for which ample research has shown little to no association with actual performed eHealth-related skills. Performance-based measures of eHealth literacy may be more effective at assessing actual eHealth skills, yet such measures seem to be scarcer in the literature. OBJECTIVE: The primary purpose of this study was to identify tools that currently exist to measure eHealth literacy based on objective performance. A secondary purpose of this study was to characterize the prevalence of performance-based measurement of eHealth literacy in the literature compared with subjective measurement. METHODS: We conducted a systematic scoping review of the literature, aligning with the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist, in 3 stages: conducting the search, screening articles, and extracting data into a summary table. The summary table includes terminology for eHealth literacy, description of participants, instrument design, health topics used, and a brief note on the evidence of validity for each performance-based measurement tool. A total of 1444 unique articles retrieved from 6 relevant databases (MEDLINE; PsycINFO; CINAHL; Library and Information Science Abstracts [LISA]; Library, Information Science & Technology Abstracts [LISTA]; and Education Resources Information Center [ERIC]) were considered for inclusion, of which 313 (21.68%) included a measure of eHealth literacy. RESULTS: Among the 313 articles that included a measure of eHealth literacy, we identified 33 (10.5%) that reported on 29 unique performance-based eHealth literacy measurement tools. The types of tools ranged from having participants answer health-related questions using the internet, having participants engage in simulated internet tasks, and having participants evaluate website quality to quizzing participants on their knowledge of health and the web-based health information-seeking process. In addition, among the 313 articles, we identified 280 (89.5%) that measured eHealth literacy using only a self-rating tool. CONCLUSIONS: This study is the first research synthesis looking specifically at performance-based measures of eHealth literacy and may direct researchers toward existing performance-based measurement tools to be applied in future projects. We discuss some of the key benefits and drawbacks of different approaches to performance-based measurement of eHealth literacy. Researchers with an interest in gauging participants' actual eHealth literacy (as opposed to perceived eHealth literacy) should make efforts to incorporate tools such as those identified in this systematic scoping review.

Feasibility, Acceptability, and Clinical Significance of a Dyadic, Web-Based, Psychosocial and Physical Activity Self-Management Program (TEMPO) Tailored to the Needs of Men with Prostate Cancer and Their Caregivers: A Multi-Center Randomized Pilot Trial.

BACKGROUND: Prostate cancer is the most common cancer diagnosis among men. Family caregivers (often female spouses) play a key role in ensuring patients' needs are met, frequently assuming their role with no formal training, which can contribute to a high burden. The purpose of this study was to pilot TEMPO-the first dyadic, Tailored, wEb-based, psychosocial and physical activity self-Management PrOgram for men with prostate cancer and their caregivers. METHODS: 49 men with prostate cancer and their caregivers were randomized to TEMPO or usual care. Baseline and follow-up questionnaires were completed to assess feasibility, acceptability, and clinical significance. A priori benchmarks for these outcomes were set. Thirteen exit interviews were conducted to further explore acceptability. RESULTS: Feasibility benchmarks were met with the exception for recruitment with on average 6.1 dyads recruited/month (benchmark: 8 dyads/month). Benchmarks of acceptability focused on attrition (<25%) and system usability, which were met. Using the strict criteria for adherence of 100% of the module viewed and participants spending at least 15 min on the module, 45% of participants were adherent. The clinical significance on anxiety and quality of life was supported for caregivers, and mostly supported for the men with prostate cancer. CONCLUSION: This pilot trial was successful, with minor modifications needed prior to a large trial.

Recommendations from LGBTQ+ adults for increased inclusion within physical activity: a qualitative content analysis.

For decades, physical activity contexts have been inherently exclusionary toward LGBTQ+ participation through their perpetuation of practices and systems that support sexuality- and gender-based discrimination. Progress toward LGBTQ+ inclusivity within physical activity has been severely limited by a lack of actionable and practical suggestions. The purpose of this study was to garner an extensive account of suggestions for inclusivity from LGBTQ+ adults. Using an online cross-sectional survey, LGBTQ+ adults (N = 766) were asked the following open-ended question, "in what ways do you think physical activity could be altered to be more inclusive of LGBTQ+ participation?" The resulting texts were coded using inductive qualitative content analysis. All coding was subject to critical peer review. Participants' suggestions have been organized and presented under two overarching points of improvement: (a) creation of safe(r) spaces and (b) challenging the gender binary. Participants (n = 558; 72.8%) outlined several components integral to the creation and maintenance of safe(r) spaces such as: (i) LGBTQ+ memberships, (ii) inclusivity training for fitness facility staff, (iii) informative advertisement of LGBTQ+ inclusion, (iv) antidiscrimination policies, and (v) diverse representation. Suggestions for challenging the gender binary (n = 483; 63.1%) called for the creation of single stalls or gender-neutral locker rooms, as well as for the questioning of gender-based stereotypes and binary divisions of gender within physical activity (e.g., using skill level and experience to divide sports teams as opposed to gender). The findings of this study represent a multitude of practical suggestions for LGBTQ+ inclusivity that can be applied to a myriad of physical activity contexts.

Physical activity contexts have a long history of being exclusionary toward people who identify as LGBTQ+. To better understand how to improve physical activity contexts, LGBTQ+ adults were asked, "in what ways do you think physical activity could be altered to be more inclusive of LGBTQ+ participation?" using an online survey. From the 766 responses collected, 72.8% detailed approaches to create safer spaces for LGBTQ+ participation, such as: clearly advertising if the space is LGBTQ+ friendly, the creation of LGBTQ+-only classes (specifically beginner courses) or times, creating LGBTQ+ exclusive gym spaces, comprehensive antidiscrimination policies, and LGBTQ+ sensitivity staff training. Additionally, 63.1% of responses provided suggestions to better support gender diverse participation through either the addition of single changing stalls or the creation of gender-neutral locker rooms, as well as through the reorganization of sport from gender categories (men vs. women) to categories based on age or experience. Respondents also recommended that common gender-based stereotypes should be questioned and eventually debunked.

Exploring Proximal LGBTQ+ Minority Stressors Within Physical Activity Contexts from a Self-determination Theory Perspective.

BACKGROUND: LGBTQ+ (lesbian, gay, bisexual, transgender, queer, etc.) individuals experience challenges such as discrimination and marginalization (referred to as minority stressors) that are detrimental to their mental and physical health. Specifically, proximal or internalized LGBTQ+ minority stressors may influence motivation for and willingness to participate in physical activity. PURPOSE: To explore whether proximal LGBTQ+ minority stressors relate to the basic psychological needs-motivation-physical activity pathway, as per self-determination theory. METHODS: An online cross-sectional survey was completed by 778 self-identified LGBTQ+ adults. Structural equation modelling analyses were used to examine how proximal LGBTQ+ minority stressors relate to the motivational sequence. RESULTS: Findings support that proximal LGBTQ+ minority stressors are negatively associated with psychological need satisfaction within physical activity (ß = -.36), which in turn is positively associated with autonomous motivation (ß = .53) and reported physical activity participation (ß = .32). Overall, the final model accounted for 13% of variance in need satisfaction (small effect size), 53% of variance in autonomous motivation (moderate-large effect size), and 10% of variance in moderate-to-vigorous physical activity levels (small effect size). CONCLUSIONS: Future research focused on increasing LGBTQ+ participation in physical activity should investigate the effects of (a) reducing proximal LGBTQ+ minority stressors and (b) better supporting LGBTQ+ adults' autonomy, competence, and relatedness within physical activity contexts.

A systematic review of treatment approaches for compulsive exercise among individuals with eating disorders.

Individuals with eating disorders often experience compulsive exercise which, if left untreated, can lead to longer treatment and worsened symptoms. Compulsive exercise must be addressed within eating disorder treatment to help individuals establish a healthy relationship with exercise. However, there are currently no standardized guidelines for treating compulsive exercise or a consensus on which forms of treatment are most effective. Therefore, the purpose of this review was to examine interventions that address compulsive exercise and their impact on treating compulsive exercise among individuals with eating disorders. A systematic review of the literature was conducted. Eleven studies testing treatments for compulsive exercise were included in this review. Participants were diagnosed with anorexia nervosa, bulimia nervosa, or EDNOS, and a small portion had BED. Improvements in compulsive exercise and eating psychopathology were observed across all studies. The interventions focused on exercise psychoeducation and often incorporated exercise sessions. The findings highlight the positive impact of treating compulsive exercise, suggesting it should be a standard component of eating disorder treatment. Future studies should examine differences in treatment approaches and outcomes specific to each eating disorder, and specific to males. More consistency across studies in the conceptualization and measurement of compulsive exercises is also needed.

Evaluation of a virtual reality E-cigarette prevention game for adolescents.

OBJECTIVE: To test preliminary efficacy and acceptability of Invite Only VR: A Vaping Prevention Game (Invite Only VR), an electronic cigarette (e-cigarette) prevention game that uses virtual reality (VR) hardware. METHODS: 285 adolescents (146 boys; ages 11-14; M = 12.45 years; SD = 0.57) were enrolled in this non-equivalent control groups design through their middle school. Participants who played Invite Only VR for 1.5 h were compared to treatment as usual at 4 timepoints: baseline, post gameplay, 3 and 6 months. Evidence of the efficacy of the game to influence e-cigarette use, e-cigarette knowledge, nicotine addiction knowledge, perceived addictiveness of e-cigarettes, perceived likelihood of using e-cigarettes, perceptions of harm, self-efficacy to refuse, social approval of e-cigarettes, and e-cigarette social perceptions was assessed using mixed between-within subjects ANOVAS. Intervention acceptability was indicated by measures of gameplay experience/satisfaction, VR experience, and perceived responsibility for game-based decisions. RESULTS: From baseline to 6 months, Invite Only VR players improved in e-cigarette knowledge, nicotine addiction knowledge, perceived addictiveness of e-cigarettes, perceptions of harm, and social perceptions about e-cigarette use compared to the control group. No significant changes were observed for the other dependent variables, including e-cigarette use. Ratings of gameplay experience and satisfaction, VR experience, and game-based decisions were high. CONCLUSIONS: Invite Only VR may help players develop knowledge about e-cigarettes and nicotine addiction, as well as encourage the development of healthy harm and social perceptions regarding e-cigarette use that persist 6 months beyond gameplay. Adolescents' satisfaction with the VR gameplay indicates preliminary intervention acceptability.

"Compulsive exercise is a socially acceptable prison cell": Exploring experiences with compulsive exercise across social media.

OBJECTIVE: Investigations into online eating disorder (ED) communities have allowed for a rich exploration of lived experiences focused on a number of aspects, such as recovery and support groups. There is a lack of understanding around compulsive exercise (CE), which is often a characterizing condition of EDs. Exploring the lived experiences of CE as discussed online could provide helpful insight towards a better understanding of CE. Therefore, the purpose of this study was to explore experiences around CE and EDs shared on social media sites. METHOD: Social media posts related to CE and EDs from Reddit, Twitter, Instagram, and forums were collected for 12 months. A thematic analysis of 881 posts was used to identify common themes among individuals' lived experiences with CE. RESULTS: Five themes (and three subthemes) were identified across the social media posts: (1) seeking control, but ultimately CE takes hold, (2) burning off binges, but at what expense?, (3) recovery is a battle, but worth it, (4) is my exercise healthy?, and (5) frustration with comments about CE. DISCUSSION: The lived experiences of CE among individuals with EDs have provided support for current definitions of CE and shared novel insight into the recovery experience. Individuals online also highlighted the need for improvement in treatment around CE specifically, and greater awareness around CE for the general public and healthcare providers.

A study protocol for a multicenter randomized pilot trial of a dyadic, tailored, web-based, psychosocial, and physical activity self-management program (TEMPO) for men with prostate cancer and their caregivers.

BACKGROUND: Prostate cancer predisposes patients and caregivers to a wide range of complex physical and psychosocial challenges, and interventions must incorporate a wide range of self-management strategies to help patients and their caregivers effectively cope with cancer challenges. To palliate this need, our team recently developed and evaluated the initial acceptability of a dyadic, Tailored, wEb-based, psychosocial, and physical activity self-Management PrOgram (TEMPO). TEMPO is a 10-week, interactive, web-based intervention consisting of five modules designed to help dyads manage their physical and psychosocial needs. It aims to teach dyads new self-management strategies and encourages them to increase their physical activity (PA) levels, mainly through walking and strength-based exercises. Initial acceptability evaluation of TEMPO revealed high user satisfaction, in addition to having a number of potential benefits for participants. After integrating suggested changes to TEMPO, the proposed pilot study aims to further test the acceptability and feasibility of TEMPO. METHODS: This study is a multicenter, stratified, parallel, two-group, pilot randomized control trial (RCT), where patient-caregiver dyads are randomized (stratified by anxiety level) to receive (a) TEMPO or (b) usual care. Participants (n goal = 40) are recruited across Canada at participating cancer centers and through self-referral (e.g., online recruitment). Patient inclusion criteria are (a) having received prostate cancer treatment within the past 2 years or scheduled to receive treatment, (b) identified a primary caregiver willing to participate in the study, and (c) has access to the Internet. Eligible caregivers are those identified by the patient as his primary source of support. Dyads complete a baseline questionnaire (T1) and another one 3 months later (T2) assessing various aspects of physical and emotional functioning (e.g., the Medical Outcomes Study (MOS) 12-item Short Form Health Survey (SF-12), the Hospital Anxiety and Depression Scale (HADS), and the Perceived Stress Scale (PSS)), self-management behaviors (e.g., the Health Education Impact Questionnaire (heiQ)), physical activity (the International Physical Activity Questionnaires (IPAQ) and the Multidimensional Self-efficacy for Exercise Scale (MSES)), and dyadic coping (the Dyadic Coping Inventory (DCI)). Dyads that used TEMPO are also asked to participate in a semi-structured exit interview exploring their overall experience with the program. DISCUSSION: This feasibility analysis will begin to develop the knowledge base on TEMPO's value for men with prostate cancer and their caregivers to inform a larger trial. TRIAL REGISTRATION: NCT04304196.

A quasi-experimental test of a virtual reality game prototype for adolescent E-Cigarette prevention.

OBJECTIVE: To test the preliminary impact and participant experience/satisfaction of Invite Only VR: A Vaping Prevention Game (Invite Only VR), an electronic cigarette (e-cigarette) prevention game prototype using virtual reality (VR) hardware. METHODS: Forty-seven adolescents (38 boys; mean age = 14.23 years, SD = 0.914) were enrolled to test the preliminary impact of Invite Only VR on knowledge, perceived likelihood of using e-cigarettes, perceptions of harm, attitudes, social norms, and self-efficacy to refuse e-cigarettes using a pre/post design. Experience/satisfaction was measured following gameplay. Paired-samples t-tests and associated effect sizes were used to assess changes in the dependent variables. Descriptive statistics were used to report on gameplay experience/satisfaction. RESULTS: From pre- to post-gameplay, players significantly increased in knowledge (t(34) = -5.594, p < .001, Cohen's d = 0.946) and perceptions of e-cigarette harm (t(34) = -3.370, p = .002, Cohen's d = 0.530) and decreased their perceived likelihood of using e-cigarettes in the future (t(35) = 2.140, p = .039, Cohen's d = 1.274). No significant change was found for attitudes towards e-cigarettes, social norm perceptions, nor refusal self-efficacy. Participants reported that they enjoyed playing the game (M = 3.00, SD = 0.99) and that they would tell their friends to play (M = 3.08, SD = 0.91). CONCLUSIONS: Invite Only VR may help players develop knowledge and correct harm perceptions regarding e-cigarettes while reducing their perceived likelihood of using them in the future. Participant enjoyment also provides an initial indication that the intervention may be acceptable for use with adolescents.

"This is just how I cope": An inductive thematic analysis of eating disorder recovery content created and shared on TikTok using #EDrecovery.

OBJECTIVE: To explore eating disorder (ED) recovery-related content created and shared on the social media platform TikTok. METHOD: A systematic review and inductive thematic analysis of 150 TikTok posts catalogued under hashtag (#) EDrecovery. Two coders independently analyzed the posts and a critical peer facilitated discussions about the resulting codes and themes. RESULTS: Creators on TikTok used #EDrecovery to share their personal experiences with recovery through the use and cooption of popular (or viral) video formats, succinct storytelling, and the production of educational content. Five themes were interpreted across the data: (a) ED awareness, (b) inpatient story time: "ED unit tings", (c) eating in recovery, (d) transformations: "how about a weight gain glow up?", and (e) trendy gallows humor: "let's confuse people who have a good relationship with food". DISCUSSION: TikTok as a user-friendly, creative media may provide the artistic and social tools for some creators to add their distinct voice to the ED recovery narrative and foster some semblance of community. Although all of the analyzed content was catalogued under #EDrecovery, some of the posts reified the increasingly blurred boundary that exists between ED recovery and pro-ED content on TikTok.

Prostate Cancer Survivors' and Caregivers' Experiences Using Behavior Change Techniques during a Web-Based Self-Management and Physical Activity Program: A Qualitative Study.

Both men with prostate cancer and their caregivers report experiencing a number of challenges and health consequences, and require programs to help support the cancer patient-caregiver dyad. A tailored, web-based, psychosocial and physical activity self-management program (TEMPO), which implements behavior change techniques to help facilitate behavior change for the dyads was created and its acceptability was tested in a qualitative study. The purpose of this secondary analysis was to explore the dyads' experiences using behavior change techniques to change behavior and address current needs and challenges while enrolled in TEMPO. Multiple semi-structured interviews were conducted with 19 prostate cancer-caregiver dyads over the course of the program, resulting in 46 transcripts that were analyzed using an inductive thematic analysis. Results revealed four main themes: (1) learning new behavior change techniques, (2) engaging with behavior change techniques learned in the past, (3) resisting full engagement with behavior change techniques, and (4) experiencing positive outcomes from using behavior change techniques. The dyads' discussions of encountering behavior change techniques provided unique insight into the process of learning and implementing behavior change techniques through a web-based self-management program, and the positive outcomes that resulted from behavior changes.

Locker-Room Experiences Among LGBTQ+ Adults.

Locker rooms operate as pivotal access points to physical activity across sports, physical education, and fitness facilities. However, locker rooms are predicated on cis-heterosexual assumptions that can be isolating to LGBTQ+ individuals. Using an online cross-sectional survey, LGBTQ+ adults (N = 1,067) were asked open-response questions about their past and present locker-room experiences. The resulting texts were independently coded by two researchers using thematic analysis and compared. All discrepancies were discussed with and rectified by a third researcher who acted as a critical peer. The results present distinct experiences across three intersecting aspects of embodiment: self-conscious-"I hate(d) being seen," sexual transgression, and gender transgression. The findings provide insight into how harmful LGBTQ+ stereotypes influence locker-room experiences and support the redesign of locker rooms to challenge the binary organization of these spaces.

Quit4hlth: a preliminary investigation of tobacco treatment with gain-framed and loss-framed text messages for quitline callers.

INTRODUCTION: Recent evidence suggests that quitline text messaging is an effective treatment for smoking cessation, but little is known about the relative effectiveness of the message content. AIMS: A pilot study of the effects of gain-framed (GF; focused on the benefits of quitting) versus loss-framed (LF; focused on the costs of continued smoking) text messages among smokers contacting a quitline. METHODS: Participants were randomized to receive LF (N = 300) or GF (N = 300) text messages for 30 weeks. Self-reported 7-day point prevalence abstinence and number of 24 h quit attempts were assessed at week 30. Intent-to-treat (ITT) and responder analyses for smoking cessation were conducted using logistic regression. RESULTS: The ITT analysis showed 17% of the GF group quit smoking compared to 15% in the LF group (P = 0.508). The responder analysis showed 44% of the GF group quit smoking compared to 35% in the LF group (P = 0.154). More participants in the GF group reported making a 24 h quit attempt compared to the LF group (98% vs. 93%, P = 0.046). CONCLUSIONS: Although there were no differences in abstinence rates between groups at the week 30 follow-up, participants in the GF group made more quit attempts than those in the LF group.

Behaviour change techniques in physical activity interventions for men with prostate cancer: A systematic review.

Physical activity interventions can improve prostate cancer survivors' health. Determining the behaviour change techniques used in physical activity interventions can help elucidate the mechanisms by which an intervention successfully changes behaviour. The purpose of this systematic review was to identify and evaluate behaviour change techniques in physical activity interventions for prostate cancer survivors. A total of 7 databases were searched and 15 studies were retained. The studies included a mean 6.87 behaviour change techniques (range = 3-10), and similar behaviour change techniques were implemented in all studies. Consideration of how behaviour change techniques are implemented may help identify how behaviour change techniques enhance physical activity interventions for prostate cancer survivors.

An Experimental Test of the Efficacy of Gain- and Loss-Framed Messages for Doping Prevention in Adolescent Athletes.

Background: Doping is a prevalent issue, not only among Olympians and professional athletes; young athletes and those at the sub-elite level have reported doping as well. Doping programs have been developed to target adolescent athletes and prevent doping initiation. The efficacy of primary doping prevention initiatives may be enhanced with health communication strategies, such as message framing. To date, there have been very few studies examining message framing among adolescents and none in the context of doping prevention. Objectives: The purpose of this study was to compare the efficacy of gain-framed and loss-framed messages on key psychological antecedents of doping among adolescent athletes. Methods: In a randomized controlled trial, 133 athletes aged 12 to 16 years old (Mage=13.73; 53% boys) from a variety of sports viewed either a gain- or loss-framed video. Intentions, attitudes, self-efficacy, and perceived norms were all assessed immediately before and after the videos. Results: Mixed between-within subjects ANOVAs revealed no differential influence for either message frame on changes in any of the outcomes. Attitudes, self-efficacy, and perceived norms all increased significantly over time for participants in both conditions. Conclusions/Importance: Overall, the findings suggest that a brief messaging intervention may have a beneficial influence on psychosocial constructs related to doping. There is no strong evidence to support definitive recommendations regarding optimal message framing for doping prevention among adolescent athletes.

A Qualitative Exploration of LGBTQ+ and Intersecting Identities Within Physical Activity Contexts.

LGBTQ+ (lesbian, gay, bisexual, transgender, queer, etc.) individuals face an array of challenges to physical activity participation, such as discrimination and exclusion. The purpose of this study was to gain an understanding of LGBTQ+ experiences in physical activity. Eight focus groups of LGBTQ+ individuals (N = 42) were conducted using a semistructured interview guide, and broad discussions about personal physical activity experiences were encouraged. All focus groups were audio-recorded, transcribed verbatim, and subject to thematic analysis. Three main themes emerged with the following considerations: (a) intersectionality-an intersectional approach is required to explore the complexity of LGBTQ+ experiences within physical activity; (b) the contested concept of "athlete"-LGBTQ+ communities have unique conceptions associated with "athlete" that can render sport, and by extension physical activity contexts, elitist and inaccessible; and (c) "a safe space for us"-LGBTQ+-friendly physical activity practices should be explored to provide practical suggestions for inclusive practices.

Understanding the Effects of Message Framing on Physical Activity Action Planning: the Role of Risk Perception and Elaboration.

PURPOSE: This study aimed to determine the effects of action planning, risk perception, and message elaboration on the creation and quality of physical activity action plans. Risk perception was hypothesized as a potential moderator and elaboration as a potential mediator of the message framing-action planning relationship. METHOD: Inactive adults (N = 180; 44% women; Mage = 29.7, SD = 9.92) were randomized to one of two framed action planning messages and responded to an online questionnaire pre- and post-message. Participants were asked about two types of risk perception towards action planning: emotional and plan creation risk perception. Post-message participants were asked about their elaboration regarding the message and presented with the opportunity to create action plans, which were scored for quality. A moderation model and a moderated mediation model were tested. RESULTS: Emotional risk perception moderated the message framing-action plan creation relationship. Individuals with increased emotional risk perception, as opposed to increased plan creation risk perception, were more likely to create an action plan when given a gain-framed message, as opposed to a loss-framed message. The moderated mediation model was not significant, but message elaboration predicted action plan creation. Individuals with greater message elaboration were more likely to create an action plan, regardless of the message frame. CONCLUSION: Gain-framed messages may be more effective than loss-framed messages at promoting action plan creation in individuals with greater emotional risk perception. One's elaboration of an action planning message may increase their likelihood of creating a physical activity action plan.