Business as usual? Drinking games participation before and during an academic pandemic (COVID-19) year among university students.

Objective: A drinking game (DG) is a risky social drinking activity that is prevalent among university students and promotes rapid alcohol consumption. We examined university students' DG behaviors before and during the COVID-19 pandemic. Method: Students (N = 368; Mage=21.12; women = 72.6%; Hispanic = 44.7%) from seven universities completed an online survey in 2021 (spring/summer). Results: 57% played DGs in-person before the pandemic and continued to play during the pandemic. These students were less worried about their health/symptoms if they were to contract COVID-19, had lower confidence in wearing a mask properly/socially distancing while under the influence of alcohol, consumed more alcohol during the pandemic, and endorsed higher enhancement drinking motives than students who played DGs before but stopped playing during the pandemic (30%). Conclusions: College health practitioners could pay close attention to students who endorse high enhancement motives as they are susceptible to risky DG play.

Elementary school staff perspectives on the implementation of physical activity approaches in practice: an exploratory sequential mixed methods study.

Introduction: A whole-of-school approach is best to promote physical activity before, during, and after school. However, multicomponent programming is often complex and difficult to deliver in school settings. There is a need to better understand how components of a whole-of-school approach are implemented in practice. The objectives of this mixed methods study were to: (1) qualitatively explore physical activity approaches and their implementation in elementary schools, (2) quantitatively assess implementation levels, and (3) examine associations between school-level physical activity promotion and academic ratings. Methods: We used an exploratory sequential mixed methods design. We conducted semi-structured qualitative interviews with elementary school staff from a Texas school district and used a directed content analysis to explore physical activity approaches and their implementation. Using qualitative findings, we designed a survey to quantitatively examine the implementation of physical activity approaches, which we distributed to elementary staff district wide. We used Pearson correlation coefficients to examine the association between the amount of physical activity opportunities present in individual schools and school-level academic ratings. Results: We completed 15 interviews (7 principals/assistant principals, 4 physical educators, and 4 classroom teachers). Elementary school teachers and staff indicated PE and recess implementation was driven from the top-down by state and district policies, while implementation of classroom-based approaches, before and after school programming, and active transport were largely driven from the bottom-up by teachers and school leaders. Teachers and staff also discussed implementation challenges across approaches. Survey respondents (n = 247 from 22 schools) indicated 54.6% of schools were implementing ≥135 min/week of physical education and 72.7% were implementing 30 min/day of recess. Classroom-based approaches were less common. Twenty-four percent of schools reported accessible before school programs, 72.7% reported accessible after school programs, and 27% promoted active transport. There was a direct association between the number of physical activity opportunities provided and school-level academic ratings r(22) = 0.53, p = 0.01. Conclusion: Schools provided physical activity opportunities consistent with a whole-of-school approach, although there was variability between schools and implementation challenges were present. Leveraging existing school assets while providing school-specific implementation strategies may be most beneficial for supporting successful physical activity promotion in elementary schools.

Observed and perceived benefits of providing physical activity opportunities in elementary schools: a qualitative study.

Introduction: Schools play an important role in promoting physical activity for youth. However, school-based physical activity opportunities often compete with other academic priorities, limiting their implementation. The purpose of this study was to qualitatively explore elementary school teacher and staff perspectives on providing physical activity opportunities and how they impact students and learning. Methods: We partnered with a school district in Texas to conduct semi-structured individual interviews. We used a purposeful sampling approach to recruit elementary teachers and staff knowledgeable about the physical activity opportunities provided at their school. Interviews included questions about participant opinions of providing physical activity opportunities and the types of opportunities provided. We analyzed data using a directed content analysis and iterative categorization approach. Results: Fifteen participants (4 teachers, 4 physical education teachers, 3 assistant principals, and 4 principals) completed interviews from 10 elementary schools. Participants discussed observed and perceived benefits when providing physical activity opportunities, which emerged into four themes and subthemes: (1) academic benefits (learning readiness, learning engagement, and academic performance); (2) social-emotional benefits (behavior, interpersonal and social skills, and classroom culture); (3) physical benefits (brain health, skill development, physical health); and (4) instructional benefits (quality teaching time, helpful teaching tools, and teacher-student relationships). Conclusions: Teachers and staff observed numerous benefits when students had opportunities to be physically active, including the positive impact on academic and social-emotional outcomes. Our findings highlight the alignment of physical activity with other school priorities. Physical activity programming can be used in ways to support academics, learning, behavior, and other important outcomes.

The CRAVE and ARGE scales for motivation states for physical activity and sedentarism: Brazilian Portuguese translation and single-item versions.

Motivation states for physical activity and sedentarism potentially vary from moment to moment. The CRAVE scale (Cravings for Rest and Volitional Energy Expenditure) was developed to assess transient wants and desires to move. Three studies were conducted with the aims of: (1) translating and validating the scale in Brazilian Portuguese, (2) examining changes with exercise, and (3) determining the best single-item for Move and Rest subscales for English and Portuguese. In Study 1, six bilingual speakers translated the scale into Brazilian Portuguese [named Anseios por Repouso e Gastos com Energia (ARGE)]. The ARGE had good content validity coefficients across three dimensions (0.89-0.91), as determined by three independent, bilingual referees. 1,168 participants (mean age = 30.6, SD = 12.2) from across Brazil completed an online version of the ARGE. An Exploratory Factor Analysis found two clear, oblique, and inversely related factors (Move and Rest; GFI = 1.00, RMSR = 0.03). Reliability was good (Cronbach α's: 0.93 and 0.92). Two models of the scale (10 vs. 13 items) were compared with Confirmatory Factor Analysis. The previously validated version using 10 scored items (GFI = 1.00, RMSEA = 0.07, RMSR = 0.02) outperformed the version scored with 13 items. State anxiety and exercise behavior had small associations with Move and Rest (-0.20 to 0.26). In Study 2, ARGE Move scores had high correspondence post-session (ICC = 0.83) for 9 women performing short Sprint Interval Training (sSIT; 6 sessions). Large, but non-significant, effects were detected for changes in motivation states with sSIT. In Study 3, IRT analyses found that for the United States sample, "be physically active" and "be still" were the most representative items for Move and Rest, respectively, while for the Brazil sample they were "exert my muscles" and "be a couch potato." Overall, it was found that: (A) the ARGE scale demonstrated good psychometric properties, (B) the original scoring (with 10 items) resulted in the best model, (C) it had small associations with exercise behavior, and (D) the subscales were reduced to single items that varied by country, indicating potential cultural differences in the concept of motivation states for physical activity.

Initial insights into the impact and implementation of Creating Active Schools in Bradford, UK.

BACKGROUND: Few whole-school physical activity programmes integrate implementation science frameworks within the design, delivery, and evaluation. As a result, knowledge of the key factors that support implementation at scale is lacking. The Creating Active Schools (CAS) programme was co-designed and is underpinned by the Capability, Opportunity, Motivation and Behaviour (COM-B) model and the Consolidated Framework for Implementation Research (CFIR). The study aims to understand the initial impact and implementation of CAS in Bradford over 9 months using McKay's et al.'s (2019) implementation evaluation roadmap. METHODS: Focus groups and interviews were conducted with school staff (n = 30, schools = 25), CAS Champions (n = 9), and the CAS strategic lead (n = 1). Qualitative data were analysed both inductively and deductively. The deductive analysis involved coding data into a priori themes based on McKay et al's implementation evaluation roadmap, using a codebook approach to thematic analysis. The inductive analysis included producing initial codes and reviewing themes before finalising. RESULTS: Identified themes aligned into three categories: (i) key ingredients for successful adoption and implementation of CAS, (ii) CAS implementation: challenges and solutions, and (iv) the perceived effectiveness of CAS at the school level. This included the willingness of schools to adopt and implement whole-school approaches when they are perceived as high quality and aligned with current school values. The programme implementation processes were seen as supportive; schools identified and valued the step-change approach to implementing CAS long-term. Formal and informal communities of practice provided "safe spaces" for cross-school support. Conversely, challenges persisted with gaining broader reach within schools, school staff's self-competence and shifting school culture around physical activity. This resulted in varied uptake between and within schools. CONCLUSIONS: This study provides novel insights into the implementation of CAS, with outcomes aligning to the adoption, reach, and sustainability. Successful implementation of CAS was underpinned by determinants including acceptability, intervention complexity, school culture and school stakeholders' perceived self-efficacy. The combination of McKay's evaluation roadmap and CFIR establishes a rigorous approach for evaluating activity promotion programmes underpinned by behavioural and implementation science. Resultantly this study offers originality and progression in understanding the implementation and effectiveness of whole-school approaches to physical activity.

The role of personal identity as a resource for college students during COVID-19.

Objective: We examined the role of personal identity vis-à-vis COVID-related outcomes among college students from seven U.S. campuses during spring/summer 2021. Participants: The present sample consisted of 1,688 students (74.5% female, age range 18-29). The sample was ethnically diverse, and 57.3% were first-generation students. Procedures: Students completed an online survey assessing personal identity synthesis and confusion, COVID-related worries, general internalizing symptoms, positive adaptation, and general well-being. Results: Personal identity synthesis was negatively related to COVID-related worries and general internalizing symptoms, and positively related to positive adaptation, both directly and indirectly through life satisfaction and psychological well-being. Personal identity confusion evidenced an opposing set of direct and indirect associations with outcome variables. Conclusions: Personal identity may potentially be protective against pandemic-related distress among college students, in part through its association with well-being. Reducing identity confusion and promoting identity synthesis are essential among college students during this and future pandemics.

Motivation states to move, be physically active and sedentary vary like circadian rhythms and are associated with affect and arousal.

Introduction: Motivation to be physically active and sedentary is a transient state that varies in response to previous behavior. It is not known: (a) if motivational states vary from morning to evening, (b) if they are related to feeling states (arousal/hedonic tone), and (c) whether they predict current behavior and intentions. The primary purpose of this study was to determine if motivation states vary across the day and in what pattern. Thirty adults from the United States were recruited from Amazon MTurk. Methods: Participants completed 6 identical online surveys each day for 8 days beginning after waking and every 2-3 h thereafter until bedtime. Participants completed: (a) the CRAVE scale (Right now version) to measure motivation states for Move and Rest, (b) Feeling Scale, (c) Felt Arousal Scale, and (d) surveys about current movement behavior (e.g., currently sitting, standing, laying down) and intentions for exercise and sleep. Of these, 21 participants (mean age 37.7 y; 52.4% female) had complete and valid data. Results: Visual inspection of data determined that: a) motivation states varied widely across the day, and b) most participants had a single wave cycle each day. Hierarchical linear modelling revealed that there were significant linear and quadratic time trends for both Move and Rest. Move peaked near 1500 h when Rest was at its nadir. Cosinor analysis determined that the functional waveform was circadian for Move for 81% of participants and 62% for Rest. Pleasure/displeasure and arousal independently predicted motivation states (all p's < .001), but arousal had an association twice as large. Eating, exercise and sleep behaviors, especially those over 2 h before assessment, predicted current motivation states. Move-motivation predicted current body position (e.g., laying down, sitting, walking) and intentions for exercise and sleep more consistently than rest, with the strongest prediction of behaviors planned for the next 30 min. Discussion: While these data must be replicated with a larger sample, results suggest that motivation states to be active or sedentary have a circadian waveform for most people and influence future behavioral intentions. These novel results highlight the need to rethink the traditional approaches typically utilized to increase physical activity levels.

Qualitative and quantitative evidence of motivation states for physical activity, exercise and being sedentary from university student focus groups.

Motivation for physical activity and sedentary behaviors (e.g., desires, urges, wants, cravings) varies from moment to moment. According to the WANT model, these motivation states may be affectively-charged (e.g., felt as tension), particularly after periods of maximal exercise or extended rest. The purpose of this study was to examine postulates of the WANT model utilizing a mixed-methods approach. We hypothesized that: (1) qualitative evidence would emerge from interviews to support this model, and (2) motivation states would quantitatively change over the course of an interview period. Seventeen undergraduate students (mean age = 18.6y, 13 women) engaged in focus groups where 12 structured questions were presented. Participants completed the "right now" version of the CRAVE scale before and after interviews. Qualitative data were analyzed with content analysis. A total of 410 unique lower-order themes were classified and grouped into 43 higher order themes (HOTs). From HOTs, six super higher order themes (SHOTs) were designated: (1) wants and aversions, (2) change and stability, (3) autonomy and automaticity, (4) objectives and impulses, (5) restraining and propelling forces, and (6) stress and boredom. Participants stated that they experienced desires to move and rest, including during the interview, but these states changed rapidly and varied both randomly as well as systematically across periods of minutes to months. Some also described a total absence of desire or even aversion to move and rest. Of note, strong urges and cravings for movement, typically from conditions of deprivation (e.g., sudden withdrawal from exercise training) were associated with physical and mental manifestations, such as fidgeting and feeling restless. Urges were often consummated with behavior (e.g., exercise sessions, naps), which commonly resulted in satiation and subsequent drop in desire. Importantly, stress was frequently described as both an inhibitor and instigator of motivation states. CRAVE-Move increased pre-to-post interviews (p < .01). CRAVE-Rest demonstrated a trend to decline (p = .057). Overall, qualitative and quantitative data largely corroborated postulates of the WANT model, demonstrating that people experience wants and cravings to move and rest, and that these states appear to fluctuate significantly, especially in the context of stress, boredom, satiety, and deprivation.

Assessing the Impacts of Creating Active Schools on Organisational Culture for Physical Activity.

BACKGROUND: National and international guidance recommends whole-school approaches to physical activity, but there are few studies assessing their effectiveness, especially at an organisational level. This study assesses the impact of the Creating Active School's (CAS) programme on organisational changes to physical activity provision. METHODS: In-school CAS leads completed a 77-item questionnaire assessing school-level organisational change. The questionnaire comprised 19 domains aligned with the CAS framework and COM-B model of behaviour change. Wilcoxon Signed Rank Tests assessed the pre-to-nine-month change. RESULTS: >70% of schools (n = 53) pre-CAS had inadequate whole-school physical activity provision. After nine months (n = 32), CAS had a significant positive effect on organisational physical activity. The positive change was observed for: whole-school culture and ethos, teachers and wider school staff, academic lessons, physical education (PE) lessons, commute to/from school and stakeholder behaviour. CONCLUSIONS: This study provides preliminary evidence that CAS is a viable model to facilitate system-level change for physical activity in schools located within deprived areas of a multi-ethnic city. To confirm the results, future studies are required which adopt controlled designs combined with a holistic understanding of implementation determinants and underlying mechanisms.

Individual- and Environmental- Level Predictors of Recess Activity and Sedentary Behavior: Findings from the I-CAN! study.

Introduction/Purpose: Recess represents a prime opportunity for physical activity during the school day. However, evidence is mixed with regard to factors associated with activity during recess. Methods: Data were collected as a part of the Texas Initiative for Children's Activity and Nutrition (I-CAN!) program from 14 elementary schools and 1,049 4th-grade students. Percent of time in moderate-to-vigorous physical activity (MVPA) and sedentary behavior during recess was measured using GT3X+ accelerometers. Students' demographics, aerobic fitness, and body mass index (BMI) were collected from school records and FITNESSGRAM® data. Aspects of the playground environment supporting activity (e.g. soccer goals) or sedentary behavior (e.g. benches) were calculated following the procedures of the System for Observing Play and Leisure Activity in Youth (SOPLAY), with recess spatial area calculated via the polygon measurement tool in Google™ Earth Pro software. Recess time was collected from school data. Weather during recess was determined using time-stamped archived weather data from Weather Underground. Two-level, linear mixed model regression examined associations between individual- and school-level characteristics and percent time in MVPA. Results: At the student-level, boys were more active than girls (effect size (ES)=0.50) and percent time in MVPA was directly associated with aerobic fitness (ES=0.35). At the school-level, recess infrastructure was associated with percent time in MVPA (ES=1.45), except for factors related to sedentary behavior, which were indirectly associated with percent time in MVPA (ES=-1.98). Patterns for sedentary behavior mirrored these effects. Conclusions: This is one of the few studies to test the associations of fitness and sedentary upgrades to play areas with MVPA and sedentary behavior. The results suggest that recess is most likely to support MVPA in boys and those who are already most fit (i.e., those who would not be the target of intervention). This is not surprising because the focus of recess is on free choice of play, and thus recess might be supported more for social and emotional benefits than the impact on physical activity.

Urges to Move and Other Motivation States for Physical Activity in Clinical and Healthy Populations: A Scoping Review Protocol.

Motivation for bodily movement, physical activity and exercise varies from moment to moment. These motivation states may be "affectively-charged," ranging from instances of lower tension (e.g., desires, wants) to higher tension (e.g., cravings and urges). Currently, it is not known how often these states have been investigated in clinical populations (e.g., eating disorders, exercise dependence/addiction, Restless Legs Syndrome, diabetes, obesity) vs. healthy populations (e.g., in studies of motor control; groove in music psychology). The objective of this scoping review protocol is to quantify the literature on motivation states, to determine what topical areas are represented in investigations of clinical and healthy populations, and to discover pertinent details, such as instrumentation, terminology, theories, and conceptual models, correlates and mechanisms of action. Iterative searches of scholarly databases will take place to determine which combination of search terms (e.g., "motivation states" and "physical activity"; "desire to be physically active," etc.) captures the greatest number of relevant results. Studies will be included if motivation states for movement (e.g., desires, urges) are specifically measured or addressed. Studies will be excluded if referring to motivation as a trait. A charting data form was developed to scan all relevant documents for later data extraction. The primary outcome is simply the extent of the literature on the topic. Results will be stratified by population/condition. This scoping review will unify a diverse literature, which may result in the creation of unique models or paradigms that can be utilized to better understand motivation for bodily movement and exercise.

Interventions to Manage Pain Catastrophizing Following Total Knee Replacement: A Systematic Review.

Background: Pain catastrophizing is a maladaptive cognitive strategy that is associated with increased emotional responses and poor pain outcomes. Total knee replacement procedures are on the rise and 20% of those who have the procedure go on to have ongoing pain. Pain catastrophizing complicates this pain and management of this is important for recovery from surgery and prevention of chronic pain. This study examines the effect of interventions on PC for patients undergoing total knee replacement (TKR). Methods: Multiple search engines were searched from inception up to March 2021 for relevant studies measuring PC in adults who have undergone TKR. Studies were screened using the Downs and Black Checklist. We included 10 studies (n = 574) which recruited peri surgical TKR participants. Effect sizes were calculated and compared on effect of intervention on PC. Results: Five studies examined the effect of cognitive behavioral therapy-based intervention on PC with low to moderate effects. Two studies examined the effect of a pain neuroscience education on PC with small effects short term. One study examined the effect of hypnotic therapy on PC with small, short-term effect (1 month) but large effect at 6 months. One study compared the effect of an isometric quadricep exercise with auditory and visual feedback on PC to treatment as usual with small, short-term effects. One study compared the effects of an activity and goal setting diary on PC with a moderate effect at 4 weeks. Conclusion: PC is a modifiable characteristic. Several interventions show modest benefit, however more research is needed to aid in clinical decision-making for this population. Interventions are most likely to produce benefits when they are targeted to people with high levels of PC.

The Impact of a Multimodal Sport Science-Based Prehabilitation Program on Clinical Outcomes in Abdominal Cancer Patients: A Cohort Study.

BACKGROUND: The potential for prehabilitation programs to impact clinical outcomes is uncertain in abdominal cancer patients due to the short window of time to intervene and the weakened state of the patients. To improve the effectiveness of prehabilitation intervention, a multimodal sports science approach was implemented. METHODS: Prior to cancer-related surgery, 21 patients participated in a 4-week exercise and nutrition prehabilitation program comprised of blood flow restriction exercise (BFR) and a sports nutrition supplement. Retrospective data of 71 abdominal cancer patients who underwent usual preoperative care was used as a comparator control group (CON). At 90 days post-surgery, clinical outcomes were quantified. RESULTS: Prehabilitation was associated with a shorter length of hospital stay (P = .02) with 5.5 fewer days (4.7 ± 2.1 vs 10.2 ± 1.2 days in CON) and decreased incidence of any complications (P = .03). Prehabilitation was not related to incidence of serious complications (P = .17) or readmission rate (P = .59). The prehabilitation group recorded 58% more steps on day 5 after surgery (P = .043). DISCUSSION: A 4-week home-based prehabilitation program composed of BFR training and sports nutrition supplementation was effective in reducing postoperative complications and length of hospital stay in older patients with abdominal cancer.ClinicalTrials.gov Identifier: NCT04073381.

Using Implementation Mapping to develop and test an implementation strategy for active learning to promote physical activity in children: a feasibility study using a hybrid type 2 design.

BACKGROUND: Incorporating physical movement in the teaching of academic content (active learning) is a promising approach to improve children's health and academic performance. Despite documented benefits, implementation of active learning remains challenging for schools. The aims of this study are to develop an implementation strategy to support the delivery of active learning in elementary schools and examine the impact of the developed implementation strategy on the implementation and effectiveness of active learning. METHODS: Aim 1 will use Implementation Mapping, which is a multi-step approach that guides the use of theory, stakeholder input, and existing literature to develop a scientifically based implementation strategy for active learning in elementary schools. Aim 2 will feature a feasibility study to examine the impact of the implementation strategy on both implementation and effectiveness outcomes, consistent with a Hybrid Type 2 design. Acceptability and implementation fidelity will be the primary implementation outcomes, and student physical activity levels will be the primary effectiveness outcome. We will recruit two elementary schools within our partner district, and one will be randomly assigned to receive usual support while the other will receive the newly developed implementation strategy. Participants from each school will complete baseline, 6-, and 12-month assessments. Bayesian statistical approaches will quantitatively examine preliminary effectiveness outcomes. We will also use an embedded mixed methods approach to triangulate findings. DISCUSSION: This study's innovative overarching conceptual framework (centered on Implementation Mapping) will inform the development and testing of the implementation strategy. This study also uses methodological approaches optimal for feasibility studies, including mixed methods and Bayesian statistics. As a result, we will be able to gain a thorough understanding about the feasibility and preliminary effectiveness of the implementation strategy, which will inform subsequent research and practice for implementing active learning in schools. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05048433 , registered on September 8, 2021.

Children's Enjoyment, Perceived Competency, and Vigorous Physical Activity During High-Intensity Interval Training in Physical Education.

Purpose: Little is known about children's experience with high-intensity interval training (HIIT) during elementary school. Perceptions of enjoyment, perceived competence, and motivation are likely to drive long-term adherence and are, therefore, critical to understanding how HIIT might be implemented in this setting. The purpose of this study was to describe children's vigorous physical activity (VPA), enjoyment, and perceived competency of HIIT activities within a Self-Determination Theory framework (autonomy) in elementary school physical education (PE) classes. Methods: Participants were 402 children from a single, diverse elementary school (49.4% female, 59.6% Non-Hispanic white). Student enjoyment and perceived competency were collected following teacher- (non-autonomous) and student-led (autonomous) conditions. A sub-set of 201 children wore accelerometers to measure percent of time in VPA during HIIT conditions. This mixed factorial design was assessed through a series of repeated measures ANOVAs. Results: While children reported generally positive enjoyment and perceived competence in both conditions (rating over 4.0 on a 5-point scale), children significantly enjoyed (d = 0.44) and felt more competent (d = 0.11) during the autonomous HIIT condition compared to the nonautonomous HIIT condition. In contrast, the percent of time in VPA (d = 0.94) was significantly lower in the autonomous condition. Conclusions: These data illustrate a challenging trade-off with the design of HIIT trials. Increasing autonomy through the inclusion of student choice increased enjoyment and perceived competence of HIIT, which are likely to improve adherence, but lowered VPA, which is likely to reduce cardiometabolic impact.Abbreviations: U.S.: United States; PA: Physical activity; MVPA; Moderate-to-vigorous physical activity; PE: Physical education; CDC: Centers for Disease Control and Prevention; Randomized control trial, RCT; SDT: Self-Determination Theory; HIIT: High-intensity interval training; RCT: Randomized control trial; VPA: Vigorous physical activity; IRB; Institutional Review Board; HFZ: Healthy Fitness Zone; PACES: Physical Activity Enjoyment Scale; M: Mean; SD: Standard deviation.

Predictors of on-task Behaviors: Evaluating Student-level Characteristics.

OBJECTIVE: In this study, we examined students' fitness, body mass index (BMI), and demographics as predictors of observed time on-task (TOT) behaviors as an indicator of behavioral inattention. METHODS: We collected demographics, fitness estimates, and BMI from 2020 fourth-graders (Mean age = 8.6 (SD = 0.5); 47% girls; 49% white) from 28 schools. We measured TOT through momentary time sampling observations. Three-level linear models were conducted to determine whether characteristics predicted differences in TOT. We tested interactions between characteristics and TOT. RESULTS: Older students exhibited greater percent of TOT (estimate = 2.34, SE = 1.02, df = 919, t = 2.30, p < .05). Additionally, boys spent less percent TOT (estimate = -3.59, SE = 1.03, df = 906, t = -3.49, p < .05). There were no differences by race/ethnicity, SES, BMI, fitness, or time of day and percent TOT. Furthermore, none of the interactions were statistically significant (p > .15). CONCLUSIONS: Girls and older students spent more TOT. These findings are of interest to educators and psychologists working on the development of research-based guidelines aimed to support elementary students' engagement in the classroom.

Prehabilitation program composed of blood flow restriction training and sports nutrition improves physical functions in abdominal cancer patients awaiting surgery.

INTRODUCTION: The impact of prehabilitation remains controversial due to a short presurgical waiting period and the diminished capacity of the patient population. A strategy to augment and optimize the effectiveness of prehabilitations for abdominal cancer patients may be found in the unlikely field of sport science. We investigated the use of blood flow restriction training and sport nutrition supplementation to augment functional capacity and increase muscle strength in twenty-four abdominal cancer patients awaiting surgery. MATERIALS AND METHODS: The sport science-based program was comprised of blood flow restriction exercise 5 to 6 times per week and a daily sports nutrition supplement containing l-citrulline, creatine monohydrate, and whey protein. RESULTS: After 4 weeks of prehabilitation, 6-min walk test, timed up and go, short physical performance battery, 5-chair stand test and physical component score of quality of life were significantly improved (all p < 0.05). Total body and appendicular lean mass as assessed by dual energy X-ray absorptiometry increased by 0.73 ± 1.04 kg (p = 0.004) and 0.42 ± 0.64 kg (p = 0.006), respectively. Total body fat mass and trunk fat mass decreased (p = 0.004 and p = 0.021). There were no significant changes in hand grip strength, fear of falling, the mental component summary of quality of life, or fasting serum concentrations of myostatin, follistatin, and growth hormone. CONCLUSION: A multimodal prehabilitation program, which encompasses blood flow restriction training and sports nutrition supplements, is both feasible and effective in improving lean mass and physical function in abdominal cancer patients prior to surgery.

Measurement of Motivation States for Physical Activity and Sedentary Behavior: Development and Validation of the CRAVE Scale.

Physical activity, and likely the motivation for it, varies throughout the day. The aim of this investigation was to create a short assessment (CRAVE: Cravings for Rest and Volitional Energy Expenditure) to measure motivation states (wants, desires, urges) for physical activity and sedentary behaviors. Five studies were conducted to develop and evaluate the construct validity and reliability of the scale, with 1,035 participants completing the scale a total of 1,697 times. In Study 1, 402 university students completed a questionnaire inquiring about the want or desire to perform behaviors "at the present moment (right now)." Items related to physical activity (e.g., "move my body") and sedentary behaviors (e.g., "do nothing active"). An exploratory structural equation model (ESEM) revealed that 10 items should be retained, loading onto two factors (5 each for Move and Rest). In Study 2, an independent sample (n = 444) confirmed these results and found that Move and Rest desires were associated with stage-of-change for exercise behavior. In Study 3, 127 community-residing participants completed the CRAVE at 6-month intervals over two years- two times each session. Across-session interclass correlations (ICC) for Move (ICC = 0.72-0.95) and Rest (ICC = 0.69-0.88) were higher than when they were measured across 24-months (Move: ICC = 0.53; Rest: ICC = 0.49), indicating wants/desires have state-like qualities. In Study 4, a maximal treadmill test was completed by 21 university students. The CRAVE was completed immediately pre and post. Move desires decreased 26% and Rest increased 74%. Changes in Move and Rest desires were moderately associated with changes in perceived physical fatigue and energy. In Study 5, 41 university students sat quietly during a 50-min lecture. They completed the CRAVE at 3 time points. Move increased 19.6% and Rest decreased 16.7%. Small correlations were detected between move and both perceived energy and tiredness, but not calmness or tension. In conclusion, the CRAVE scale has good psychometric properties. These data also support tenets of the WANT model of motivation states for movement and rest (Stults-Kolehmainen et al., 2020a). Future studies need to explore how desires to move/rest relate to dynamic changes in physical activity and sedentarism.

Implementation Quality Impacts Fourth Grade Students' Participation in Physically Active Academic Lessons.

It is important to assess implementation of active learning interventions to maximize their impact. Implementation quality, or how well one engages program participants, has been less studied than other implementation components (e.g., dose, fidelity). This cross-sectional, exploratory study examined associations between teacher engagement behaviors, quality of teacher engagement (i.e., teacher feedback), and student physical activity outcomes during active classroom lessons. This study used data from the Texas Initiatives for Children's Activity and Nutrition (I-CAN!) randomized controlled trial. Fixed effects regressions investigated the impact of teacher engagement behaviors on student physical activity outcomes. Bivariate correlations examined associations between teacher feedback and student physical activity outcomes. A latent profile analysis explored whether there were subsets of teachers with similar feedback profiles. The final analytic sample included 82 teachers. Teacher-directed changes and teacher participation in physical activity were each associated with higher ratings for how many and how often children were active during lessons. Teacher participation in physical activity was also significantly related to higher ratings for student physical activity intensity (all p < .05). Physical Activity Reinforcement and Technical Instruction feedback were positively associated with activity intensity (r = - .20, p < .05 and r = .34, p < .01, respectively). Technical Instruction feedback was positively associated with how many (r = .25, p < .01) and how often (r = .41, p < .01) students were active during lessons. Negative feedback was negatively associated with how often (r = - .25, p < .05) students were active and activity intensity (r = - .25, p < .05). Game Instruction was negatively related to how often students were active (r = -.23, p < .05). All teachers were represented by high levels of Game Instruction and Classroom Management feedback, moderate levels of Content Reinforcement and Content Instruction feedback, and low levels of Negative, Technical Instruction, and Physical Activity Reinforcement feedback. These data did not indicate the existence of multiple feedback profiles. Findings suggest that teacher engagement and feedback to students during active lessons can promote student physical activity. Teachers are primarily responsible for implementing school-based interventions, so it is critical to develop strategies that increase their ability to implement them successfully. Opportunities to maximize intervention delivery, such as co-designing with teachers, should be utilized when designing school-based, physical activity interventions.

Motivation States for Physical Activity and Sedentary Behavior: Desire, Urge, Wanting, and Craving.

To better explain daily fluctuations in physical activity and sedentary behavior, investigations of motivation are turning from social cognitive frameworks to those centered on affect, emotion and automaticity, such as the Affect and Health Behavior Framework (AHBF), Integrated Framework and Affective-Reflective Theory (ART). This shift has necessitated: (a) re-examination of older theories and their constructs, such as drives, needs and tensions and (b) an inspection of competing theories from other fields that also attempt to explain dynamic changes in health behaviors. The Dynamical Model of Desire, Elaborated Intrusion Theory and others commonly share with AHBF the idea that human behavior is driven strongly by desires and/or the similar concepts of wants, urges, and cravings. These affectively-charged motivation states (ACMS) change quickly and may better explain physical activity behavior from one moment to the next. Desires for movement predominantly derive from negative but also positive reinforcement. Data from clinical populations with movement dysfunction or psychiatric disorders provides further evidence of these drivers of movement. Those with Restless Legs Syndrome, akathisia, tic disorders and exercise dependence all report strong urges to move and relief when it is accomplished. Motor control research has identified centers of the brain responsible for wants and urges for muscular movement. Models elaborated herein differentiate between wants, desires, urges and cravings. The WANT model (Wants and Aversions for Neuromuscular Tasks) conceptualizes desires for movement and rest as varying by magnitude, approach or avoidance-orientation (wants versus aversions) and as occupying independent dimensions instead of opposite ends of the same axis. For instance, one hypothetically might be in a state of both high desire for movement and rest simultaneously. Variations in motivation states to move and rest may also be associated with various stress states, like freezing or fight and flight. The first validated instrument to measure feelings of desire/want for movement and rest, the CRAVE Scale (Cravings for Rest and Volitional Energy Expenditure) is already shedding light on the nature of these states. With these advances in theory, conceptual modeling and instrumentation, future investigations may explore the effects of desires and urges for movement and sedentary behavior in earnest.