Do it for the cause: Feasibility of a theory-based virtual 5 K walk/run program to increase physical activity behavior.

Physical activity (PA) levels among the general population remain low despite well-known benefits. Previous research has demonstrated PA-based charity fundraising events may act as a catalyst for increased motivation for PA by fulfilling basic psychological needs while providing an emotional connection to a greater good. Therefore, the current study used a behavior-change based theoretical paradigm to develop and assess the feasibility of a 12-week charity-based virtual PA program intended to increase motivation and PA adherence. Forty-three participants were enrolled in a virtual 5 K run/walk charity event that included a structured training protocol, web-based motivation resources, and charity education. Eleven participants completed the program and results indicated no differences pre- and post-participation in motivation (t(10) = 1.16, p = .14) and self-efficacy (t(10) = 0.66, p = .26), but increased scores on charity knowledge (t(9) = -2.50, p = .02). Attrition was attributed to timing, weather, and isolated nature of a solo virtual program. Participants enjoyed the structure of the program and felt the training and educational information was beneficial, but could have been more robust. Thus, in its current format, the program design lacks efficacy. Integral changes to increase program feasibility should include group programming, participant-chosen charity, and more accountability.

Comparing the Primary Concerns of Injured Collegiate Athletes With the Content of Patient-Reported Outcome Measures.

CONTEXT: Patient-reported outcome measures (PROMs) have been endorsed for providing patient-centered care. However, PROMs must represent their target populations. OBJECTIVE: To identify the primary concerns of collegiate athletes experiencing injury and compare those with the content of established PROMs. DESIGN: Cross-sectional study. SETTING: Collegiate athletic training facilities. PATIENTS OR OTHER PARTICIPANTS: Collegiate athletes experiencing injury (N = 149). MAIN OUTCOME MEASURE(S): Open-ended responses to the Measure Yourself Medical Outcome Profile were used to identify primary concerns, which were linked to International Classification of Functioning, Disability and Health taxonomy codes. Items of the Patient-Reported Outcomes Measurement Information System; modified Disablement of the Physically Active Scale; Lower Extremity Functional Scale; Knee injury and Osteoarthritis Outcome Score (KOOS); International Knee Documentation Committee Subjective Knee Form (IKDC); Foot and Ankle Ability Measure; Disabilities of the Arm, Shoulder, and Hand; Functional Arm Scale for Throwers; and Kerlan-Jobe Orthopaedic Clinic questionnaire were linked to International Classification of Functioning, Disability and Health codes. We calculated χ2 single-sample goodness-of-fit tests to determine if 70% of the content was shared between PROMs and participant-generated codes. RESULTS: Participant-generated concerns were primarily related to sport participation (16%) and pain (23%). Chi-square tests showed that the Lower Extremity Functional Scale and Foot and Ankle Ability Measure presented significant content differences, with common participant-generated lower extremity responses at all levels. The Patient-Reported Outcomes Measurement Information System; modified Disablement of the Physically Active Scale; KOOS; IKDC; Disabilities of the Arm, Shoulder and Hand; Functional Arm Scale for Throwers; and Kerlan-Jobe Orthopaedic Clinic questionnaire did not have significant content differences for level 2 codes; still, significant differences were present for level 3 analyses except for the KOOS and IKDC (P < .001). All measures except the IKDC contained significant superfluous content (P < .05). CONCLUSIONS: The presence of significant content differences supports clinician-perceived barriers regarding the relevance of established PROMs. However, the IKDC was a relevant and efficient PROM for evaluating the primary concerns of collegiate athletes experiencing lower extremity injury. Clinicians should consider using patient-generated measures to support coverage of patient-specific concerns in care.

Central arterial stiffness, wave reflection, and heart rate variability following 4-week high-intensity resistance training intervention in young active women.

PURPOSE: Arterial stiffness, expedited wave reflection, and autonomic dysfunction are risk factors for cardiovascular disease, which is the leading cause of death in women in the United States. Evaluation of the effects of resistance training on these factors has been inconclusive, and even less is known about the effects of high-intensity resistance training (HIRT). This study evaluated the effects of a 4-week HIRT intervention on central arterial stiffness, wave reflection, and heart rate variability in young healthy and active women. METHODS: 9 women were recruited and underwent a 4-week control period followed by the intervention. Measurements were recorded pre-control, post-control/pre-intervention, and post-intervention. RESULTS: There were no significant changes to central arterial stiffness, wave reflection, or heart rate variability. There was a significant increase in resting heart rate (bpm: 62 ± 7, 66 ± 10; p = 0.003) and a significant decrease in baroreceptor sensitivity (30 ± 7, 21 ± 7; p = 0.018) pre- to post-intervention. There was a significant decrease in total peripheral resistance pre- to post-intervention (1.076 ± 0.281, 0.916 ± 0.250; p = 0.002). Squat, bench press, and deadlift increased pre- to post-intervention (kg: 62 ± 11, 71 ± 9, p = 0.000; 37 ± 7, 40 ± 7, p = 0.002; 76 ± 19, 84 ± 19, p = 0.000). CONCLUSION: 4 weeks of HIRT can supplement a healthy lifestyle in women by increasing strength while decreasing peripheral resistance and preserving arterial pressures. Further evaluation is necessary to investigate the observed increase in resting heart rate and decrease in baroreceptor sensitivity and to determine long-term effects of this training.

Medical Therapeutic Yoga for multiple sclerosis: examining self-efficacy for physical activity, motivation for physical activity, and quality of life outcomes.

PURPOSE: Multiple Sclerosis (MS) is an incurable neurodegenerative disease that results in deficits in physical and cognitive function, and often fosters low levels of self-efficacy for physical activity, motivation for physical activity, and quality of life [1]. Drug therapies, physical therapy rehabilitation, and lifestyle modifications such as increased physical activity are standard protocol for symptom management, yet persons with MS tend to be physically inactive [2,3]. Additionally, single-modality interventions do not inherently address the challenges faced concurrently by individuals with MS [4,5]. METHODS: This project examined the effects of a 5-week holistic biopsychosocial Medical Therapeutic Yoga program on physical activity behavior outcomes in individuals diagnosed with MS. A mixed-methods approach was used to examine self-efficacy for physical activity, motivation for physical activity, and quality of life outcomes in 15 participants. RESULTS: Quantitative measures demonstrated increased self-efficacy (t(14) = -2.23, p = 0.042), and emotional quality of life (t(14) = -2.66, p = 0.019). Responses to an open-ended written questionnaire and follow-up interviews indicated overall positive response to the program including increases in self-efficacy for physical activity, motivation for physical activity, and quality of life. These results may help future holistic programming for individuals with MS incorporate behavioral interventions with therapeutic rehabilitation to increase physical activity adherence.IMPLICATIONS FOR REHABILITATIONMultiple sclerosis is a neurological disease impacting physical and cognitive functioning that may be managed with a combination of drug therapies, rehabilitation, and physical activity.Individuals diagnosed with multiple sclerosis tend to be physically inactive and physical inactivity is a challenge for optimal disease management.Medical Therapeutic Yoga offers an interdisciplinary biopsychosocial framework to simultaneously address the behavioral challenges and physical impairments facing individuals diagnosed with multiple sclerosis.Health care providers should consider developing programs that use a biopsychosocial framework to aid in developing long-term adherence in health behaviors such as physical activity participation.

Understanding Motivation for Physical Activity Charity Event Participation.

Objectives: The positive health benefits of regular physical activity (PA) are widely known, yet PA levels remain low in the general population and those with neurological conditions like multiple sclerosis (MS). The goal of this study was to use the lens of behavioral economics to explore PA motivation for participation in PA-based MS charity fundraising events to elucidate the relationship between behavioral economics constructs and motivation. Methods: Mixed-methods survey data were collected from 114 individuals (47 diagnosed with MS; 67 without MS) who had participated in a PA-based MS charity fundraiser event. Results: Quantitative data showed 23 (41.8%) of participants without MS, and 16 (43.2%) of participants living with MS cited fundraising for MS as the primary reason for participation. Open-ended responses revealed behavioral economic constructs of framing, social support, and individual positive biases were key factors contributing to increased motivation for participation. Conclusion: Habit formation for PA behaviors may emerge due to personal biases (perceived importance of fundraising) and a sense of relatedness. Involvement in MS charity events may alter social norms, frame events as enjoyable, and foster a sense of community, thereby increasing the likelihood of continued participation.

Comparisons of Cooking, Dietary, and Food Safety Characteristics of Food Secure and Food Insecure Sophomores at a University in Appalachia.

Introduction: Food insecurity means lacking access to adequate, nutritious, and safe food. Collegiate food insecurity rates at ten Appalachian campuses range from 22.4% to 51.8% and have been associated with unfavorable health and academic outcomes. Purpose: This study compared cooking, dietary, and food safety characteristics of food secure (FS) and food insecure (FI) sophomores at a university in Appalachia in the context of the USDA definition of food security. Methods: Data were collected using an online questionnaire. Descriptive and inferential procedures compared FS and FI sophomores (p < 0.05). Results: Participants (n = 226) were 65.0% females, 76.1% whites, and 46% FI. About 40% of on-campus and 50% of off-campus residents were FI, and 70% of FI students reported needing help accessing food. Cooking was undertaken "less often" by 61.5% of FS and 55.8% of FI sophomores. Mean cooking self-efficacy scores for FS and FI students were 44.9, vs 43.4, (p > 0.05) out of 52 points. Grains were consumed most often by 40% of FS and FI students and vegetables were consumed least often by 70% of both groups. Mean food safety test scores for FS and FI students were 6.2 1.60 vs 6.6 1.52 (p > 0.05) out of 11 points. Requested educational activities included making a budget and planning balanced meals. Implications: The high rate of food insecurity reflects an ongoing need among sophomores for campus and community food assistance and for educational activities that teach purchasing and preparation of affordable, healthy and safe foods.

Does a Medical Therapeutic Yoga Group Intervention Remediate Impairments Commonly Found in People with Multiple Sclerosis? A Pilot Study.

BACKGROUND: Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system resulting in varied physical and cognitive deficits that often contribute to changes in postural control as well as decreased self-efficacy and lower perceived quality of life. One intervention often recommended for the control of MS symptoms is rehabilitation. While rehabilitation is often effective, it is traditionally delivered in a unidisciplinary manner in private-session format. This pilot study presents the use of a biopsychosocial interdisciplinary group yoga intervention to improve postural control, self-efficacy, and quality of life in individuals living with MS. METHODS: This pilot study examined 15 subjects who participated in a 5-week prospective Medical Therapeutic Yoga (MTY) program designed for individuals diagnosed with MS. Pre and post-testing was completed. RESULTS: The participants demonstrated improvements in overall balance (t(14)=3.42, p=0.004), dual-tasking (t(13)=2.30, p=0.034), dynamic gait (T(14)=-2.311, p=0.021), reactive balance (T(114)=-2.157, p=0.031), and self-efficacy (t(12)=3.40, p=0.006). CONCLUSIONS: MTY offers a biopsychosocial framework to provide integrative interdisciplinary care across disciplines. In this pilot investigation, postural control and feelings of self-efficacy improved. This modality of rehabilitation warrants further investigation.

Use and Perceptions of a Campus Food Pantry Among Food Insecure College Students An Exploratory Study from Appalachia.

Introduction: Food insecurity has emerged as a public health problem among college students in Appalachia, jeopardizing their physical, mental, and emotional health and academic success. Campus food pantries have been established in this region, but no data are available concerning student use or perception of services. Purpose: This study measured use and perceptions of a campus food pantry by students at a mid-sized university in rural North Carolina. Methods: An online questionnaire collected behavioral and perceptual data, and follow-up interviews explored these variables. Descriptive statistics with significance at p<0.05 and thematic analytical procedures were used. Results: Questionnaires were submitted by 896 of 6000 recruited students (14.9%), and four students granted interviews. Food insecurity affected 437 (48.8%) of participants, of whom 76 (17.4%) were pantry shoppers. Shoppers (n = 94) were 27.7% males, 65.1% females, and 7.2% non-cisgender, 63.8% non-Hispanic white, 84.5% undergraduate, and 14.3% graduate students. Reasons for non-pantry use by food insecure students included: others need it more (30.1%) and feel embarrassed (20.7%). Benefits of pantry use were: spent more on necessities (56.4%) and job performance improved (18.1%). Shoppers perceived the pantry's physical environment most favorably and food offerings less favorably. Implications: The low use of the campus food pantry by food insecure students suggests that these students may be jeopardizing their physical and mental health and academic success. Greater efforts by faculty, academic advisers, and student leaders are needed to promote pantry use and decrease the associated stigma.

Food Insecurity Among College Students with and without Medical Disorders at a University in Appalachia.

Objective: This study compared severity of food insecurity, characteristics, and behaviors of college students with and without diagnosed medical disorders. Design: Data were collected using a cross-sectional online questionnaire. Variables measured were food security status, disorders, coping strategies, and perceived barriers to food access. Descriptive and inferential statistics examined associations and compared groups. Statistical significance was p≤0.05. Setting: Data were collected at Appalachian State University in North Carolina. Participants: The sample was 247 food insecure students, of whom 60% were females, 50% 3rd- and 4th-year students, and 75% whites. Results: Medical disorders were reported by 67.2% of food insecure students, and a greater proportion of students with than without disorders experienced very low food security (63.3% vs. 43.2%, p=0.003). The most common disorder categories were psychiatric (40.5%) and gastrointestinal (31.6%). Characteristics of food insecure students with disorders included female gender, suboptimal academic performance, employed, off-campus residence. Coping strategies used by students with and without disorders, respectively, to improve food access, included brought food back to school after visiting family, friends, significant others (90.9% vs. 63.0%) and ate less healthy food so you could eat more (77.7% vs. 49.4%). Perceived barriers among students with disorders included feel overwhelmed making food choices (12.7%) and meal plan runs out (10.2%). Food insecure students with disorders made greater use of coping strategies and identified more perceived barriers. Conclusions: Food insecure students with disorders experienced more severe food deprivation and require multidimensional food assistance programs beyond those generally available on college campuses.

Why do they do it? Assessing self-report physical activity behavior and quality of life in individuals with multiple sclerosis.

Physical activity has been shown to effectively aid multiple sclerosis symptom management; however, individuals with multiple sclerosis tend to be inactive physically. Developing effective, sustainable, physical activity interventions involves first understanding motivators for physical activity. Open-ended surveys exploring physical activity motivators were collected from 215 individuals with multiple sclerosis. Responses indicate that self-efficacy and internalized motivation derived from physical activity outcomes were motivators for physical activity, and physical activity was cited as increasing overall quality of life. Future physical activity interventions should incorporate methods for building self-efficacy for physical activity and focus on increasing awareness of the long-term physical benefits derived from physical activity.

I ride for MS: The impact of bike MS participation on motivation for physical activity in individuals with multiple sclerosis.

BACKGROUND: Multiple Sclerosis (MS) is a chronic neurodegenerative disease that results in deficits in physical and cognitive functioning. Research supports the use of physical activity (PA) to aid in MS symptom management and slow disease progression, however individuals diagnosed with MS are generally physically inactive. Social support has been shown to increase PA behavior in group exercise settings. Events such as Bike MS, a charity bicycle ride where individuals raise money for MS, could increase motivation for participation and therefore may be an ideal setting to introduce PA to individuals diagnosed with MS. OBJECTIVE: /Hypothesis: The objective of the current research was to explore motives for participation in a Bike MS event in individuals diagnosed with MS and their family members, and examine if their Bike MS participation has translated to long-term PA behavior change and positive quality of life outcomes. METHODS: A descriptive qualitative approach using semi-structured focus group, individual, and phone interviews, combined with observational field notes, was used to explore the experiences of seven individuals diagnosed with MS and four family members from two regional self-help groups who all actively participated in a Bike MS event. RESULTS: Participants reported important social bonds, raising awareness for the cause, fundraising, long-term physical benefits, and overall increased quality of life as motives for participation. All participants reported long-term PA participation as a result of Bike MS participation. CONCLUSION: Results support using Bike MS to increase long-term PA participation in individuals with MS, resulting in positive quality of life outcomes.

A model of motivation for physical activity in individuals diagnosed with multiple sclerosis.

Purpose: Multiple sclerosis (MS) is an incurable chronic degenerative autoimmune disease of the central nervous system that presents with limited physical and/or cognitive functioning. Physical activity has been shown effective to aid in symptom management resulting in increased overall quality of life (QoL), yet this population is highly inactive. Understanding motivation for physical activity in individuals diagnosed with MS is the first step in developing an effective, sustainable, and physical activity intervention for disease management. Therefore, the aim of this study was to model the relationship among motivation for physical activity, physical activity participation, and QoL in individuals diagnosed with MS. Methods: Using Path analysis, this study explored potential predictors of motivation for physical activity in 215 individuals diagnosed with MS; examining self-determined motivation, in conjunction with self-efficacy, as predictors of physical activity participation, and self-efficacy and physical activity participation as predictors of QoL. Results: In the model, self-efficacy and identified regulation predicted physical activity participation, and physical activity participation predicted QoL, χ2(1) = 0.02, p = 0.867; RMSEA = 0.00; CFI = 1.0; SRMR = 0.002. Conclusions: The findings and resulting model may be used to develop more effective interventions to promote physical activity participation in individuals diagnosed with MS and consequently enhance long-term QoL. Implications for Rehabilitation Regular physical activity aids in symptom management and disease control in individuals diagnosed with multiple sclerosis, yet this population is consistently highly physically inactive. The complexity of the psychological factors influencing physical activity participation in individuals diagnosed with MS needs to be considered when developing physical activity interventions. Interventions that focus on increasing self-efficacy and identified regulation during physical activity are a means to increase long-term physical activity participation in individuals diagnosed with MS. Long-term increases in physical activity levels may directly contribute to increases in overall quality of life and should, therefore, be a priority for health care professionals when developing overall disease management protocols.

Beyond health messaging: a behavioural economics approach to increasing self-selected distance during an acute bout of cycling.

The purpose of this study was to explore the effects of the perceived purpose of exercising on the self-selected distance peddled during an acute cycling task. Participants were randomly assigned to one of three groups (health, wealth, charity). All participants watched a video emphasizing the health benefits of performing at least 30 min of daily exercise. Those in the health group were not provided any additional information. Those in the wealth group were then informed that they would earn money for every two kilometres cycled. Those in the charity group were informed that they would earn money for a charity for every two kilometres cycled. Participants were not given a time/distance limit and were instructed to cycle until they chose to stop. Analyses revealed that participants in the wealth and charity group cycled significantly farther than those in the health group (approximately twice as far). Additionally, a significant sex by group interaction showed that women cycled farther for charity while men cycled farther for wealth. These results suggest that health messages used to increase exercise behaviour may benefit from exploring how paradigms from behavioural economics influence behaviors that have relevance to public health.

Freshmen at a University in Appalachia Experience a Higher Rate of Campus than Family Food Insecurity.

Food insecurity means having limited or uncertain access, in socially acceptable ways, to an adequate and safe food supply. Ample evidence has identified college students as vulnerable to this problem, but little research has focused on freshmen. This cross-sectional study examined family and campus food insecurity among freshmen at a university in Appalachia. An online questionnaire contained sociodemographic items and scales that measured food security status, academic progress, coping strategies for accessing food, and social support. T-tests and Chi square analyses compared food insecure and food secure students. Statistical significance was p < .05. Participants were 456 freshmen, 118 males (26%) and 331 females (73%). Family and campus food insecurity were experienced by 32 (7.1%) and 98 (21.5%) of the freshmen, respectively, and 42.5% of those who experienced campus food insecurity believed their food access had worsened since starting college. Family and campus coping strategies, respectively, included stretching food (72.9 vs. 18.4%) and purchasing cheap, processed food (68.8 vs. 16.3%). Food secure students scored significantly higher on self-rated measures of academic progress (p < .01), and greater proportions of food secure students (60.7 vs. 43.9%, p < .01) perceived their eating habits since starting college as "healthy/very healthy," and perceived their health status as "good/excellent" (86.0 vs. 71.4%, p < .01). Students requested assistance with job opportunities (19.4%), affordable meal plans (18.4%), money management (13.3%), and eating healthy (11.2%). Findings suggest that college student food insecurity begins during the freshmen year, and that there is a need for campus and community-based interventions to increase food access among these freshmen and their families.

Physical activity motivation and benefits in people with multiple sclerosis.

PURPOSE: Multiple sclerosis is a degenerative neurological disease that affects 2.1 million people worldwide. There is no cure, but an expanding body of research supports the positive impact of physical activity and suggests physical activity has benefits for the individual's psychological and physical well-being. MATERIAL AND METHODS: Using Self-Determination Theory as a framework, mixed methods with a focus on qualitative interviews were used to explore physical activity motivation and benefits with a sample of highly active people with multiple sclerosis (n = 15). Disability level ranged from not disabled to wheelchair bound with the majority of participants reporting minimal impact from multiple sclerosis. Survey data were collected using a number of open-ended questions along with measures of self-efficacy, self-determined motivation, physical activity, and quality of life. Additionally, eight individuals participated in semistructured telephone interviews focused on (a) motivation and strategies used to maintain physical activity and (b) the benefits and impact of physical activity in their lives. RESULTS: The main findings were consistent with Self-Determination Theory; participants described feelings of accomplishment and competence in both their physical activity and daily life, as well as a sense of independence and autonomy. Similarly, all participants cited benefits, and the main themes were enhanced satisfaction with life and an overall positive outlook on life. CONCLUSION: Results provide insight into the role of physical activity in a highly active sample and have implications for professionals working in physical activity settings with the multiple sclerosis population. Interventions aimed at increasing long-term physical activity adherence should focus on increasing autonomy and competence for physical activity in the individual and promoting potential increased quality of life outcomes from physical activity participation. Implications for Rehabilitation Multiple sclerosis is a chronic degenerative neurological disease that the individual lives with for a majority of the lifespan. Physical activity is one means that has been shown to aid is the control of multiple sclerosis symptoms. Increasing patient understanding of the benefits of using physical activity as a means to control multiple sclerosis symptoms may result in long-term physical activity adherence. Physical activity interventions that develop feelings of competence and independent choice in the patient may be more successful for long-term participation.