The mediating role of self-compassion in positive education for student mental health during COVID-19.

In this quasi-experimental design, we tested the hypothesis that a quality of life (QOL) positive education course delivered online during COVID-19 would promote undergraduate students' mental health by improving self-compassion. A total of 104 students (69 enrolled in the QOL course and 35 in control courses) completed a questionnaire assessing mental health and self-compassion before and after completion of their courses. Two-way mixed ANCOVAs were used to analyse the effects of the positive education course on mental health and self-compassion over time. Compared to control students, QOL students' mental health and self-compassion significantly increased from baseline to endpoint. A simple mediation analysis confirmed the mediating role of self-compassion between the positive education course and enhanced mental health. This study adds to the emerging literature vis-à-vis positive education and its effects on student mental health through self-compassion.

Tools to guide clinical discussions on physical activity, sedentary behaviour, and/or sleep for health promotion between primary care providers and adults accessing care: a scoping review.

BACKGROUND: Health care providers have reported low knowledge, skill, and confidence for discussing movement behaviours (i.e., physical activity, sedentary behaviour, and sleep), which may be improved with the use of tools to guide movement behaviour discussions in their practice. Past reviews have examined the psychometric properties, scoring, and behavioural outcomes of physical activity discussion tools. However, the features, perceptions, and effectiveness of discussion tools for physical activity, sedentary behaviour, and/or sleep have not yet been synthesized. The aim of this review was to report and appraise tools for movement behaviour discussions between health care providers and adults 18 + years in a primary care context within Canada or analogous countries. METHODS: An integrated knowledge translation approach guided this review, whereby a working group of experts in medicine, knowledge translation, communications, kinesiology, and health promotion was engaged from research question formation to interpretation of findings. Three search approaches were used (i.e., peer-reviewed, grey literature, and forward searches) to identify studies reporting on perceptions and/or effectiveness of tools for physical activity, sedentary behaviour, and/or sleep. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. RESULTS: In total, 135 studies reporting on 61 tools (i.e., 51 on physical activity, one on sleep, and nine combining two movement behaviours) met inclusion criteria. Included tools served the purposes of assessment (n = 57), counselling (n = 50), prescription (n = 18), and/or referral (n = 12) of one or more movement behaviour. Most tools were used or intended for use by physicians, followed by nurses/nurse practitioners (n = 11), and adults accessing care (n = 10). Most tools were also used or intended to be used with adults without chronic conditions aged 18-64 years (n = 34), followed by adults with chronic conditions (n = 18). The quality of the 116 studies that evaluated tool effectiveness varied. CONCLUSIONS: Many tools were positively perceived and were deemed effective at enhancing knowledge of, confidence for, ability in, and frequency of movement behaviour discussions. Future tools should guide discussions of all movement behaviours in an integrated manner in line with the 24-Hour Movement Guidelines. Practically, this review offers seven evidence-based recommendations that may guide future tool development and implementation.

Developing and testing the usability, acceptability, and future implementation of the Whole Day Matters Tool and User Guide for primary care providers using think-aloud, near-live, and interview procedures.

BACKGROUND: Canada's 24-Hour Movement Guidelines for Adults have shifted the focus from considering movement behaviours (i.e., physical activity, sedentary behaviour, and sleep) separately to a 24-h paradigm, which considers how they are integrated. Accordingly, primary care providers (PCPs) have the opportunity to improve their practice to promote all movement behaviours cohesively. However, PCPs have faced barriers to discussing physical activity alone (e.g., time, competing priorities, inadequate training), leading to low frequency of physical activity discussions. Consequently, discussing three movement behaviours may seem challenging. Tools to facilitate primary care discussions about physical activity have been developed and used; however, few have undergone usability testing and none have integrated all movement behaviours. Following a synthesis of physical activity, sedentary behaviour, and sleep tools for PCPs, we developed the Whole Day Matters Tool and User Guide that incorporate all movement behaviours. The present study aimed to explore PCPs' perceptions on the usability, acceptability, and future implementation of the Whole Day Matters Tool and User Guide to improve their relevancy among PCPs. METHODS: Twenty-six PCPs were observed and audio-video recorded while using the Tool and User Guide in a think-aloud procedure, then in a near-live encounter with a mock service-user. A debriefing interview using a guide informed by Normalization Process Theory followed. Recordings were transcribed verbatim and analysed using content analysis and a critical friend to enhance rigour. RESULTS: PCPs valued aspects of the Tool and User Guide including their structure, user-friendliness, visual appeal, and multi-behaviour focus and suggested modifications to improve usability and acceptability. Findings are further discussed in the context of Normalization Process Theory and previous literature. CONCLUSIONS: The Tool and User Guide were revised, including adding plain language, reordering and renaming sections, reducing text, and clarifying instructions. Results also informed the addition of a Preamble and a Handout for adults accessing care (i.e., patients/clients/service-users) to explain the evidence underpinning the 24-Hour Movement Guidelines for Adults and support a person-centered approach. These four resources (i.e., Tool, User Guide, Preamble, Handout) have since undergone a consensus building process to arrive at their final versions before being disseminated into primary care practice.

Self-Compassion and Happiness: Exploring the Influence of the Subcomponents of Self-Compassion on Happiness and Vice Versa.

Self-compassion is a healthy conceptualization of the self and has been associated with a myriad of health benefits. There is limited research regarding the influence of the subcomponents of self-compassion on happiness and vice versa. This study investigated (1) the influence and relative strength of the relationships of the 6 subcomponents of self-compassion onto happiness, (2) the influence and relative strength of the relationships of happiness onto the 6 subcomponents of self-compassion and (3) the bi-directional relationship between total self-compassion variables and happiness across two timepoints. This study followed a pre-post design whereby 33 university students and employees undergoing a physical activity counselling (PAC) program filled out validated online questionnaires before and immediately after individualized sessions. Results revealed that there was a positive bi-directional relationship between self-compassion and happiness over time, with the stronger influence being from happiness to self-compassion. This is likely because happier individuals are kinder to themselves and strongly connected with others. Moreover, results showed that mindfulness was the strongest subcomponent of self-compassion to positively influence happiness, and happiness was the strongest negative predictor of isolation. This has practical implications in that PAC counsellors and other practitioners should try to emphasize mindfulness in their interventions to maximize feelings of happiness, and try to cultivate happiness to reduce feelings of isolation and increase total self-compassion.

Moving toward co-production: five ways to get a grip on collaborative implementation of Movement Behaviour curricula in undergraduate medical education.

Several "calls to action" have imposed upon medical schools to include physical activity content in their overextended curricula. These efforts have often neither considered medical education stakeholders' views nor the full complexity of medical education, such as competency-based learning and educational inflation. With this external pressure for change, few medical schools have implemented physical activity curricula. Moreover, Canada's new 24-Hour Movement Guidelines focus on the continuum of movement behaviours (physical activity, sedentary behaviour, and sleep). Thus, a more integrated process to overcome the "black ice" of targeting all movement behaviours, medical education stakeholder engagement, and the overextended curriculum is needed. We argue for co-production in curriculum change and offer five strategies to integrate movement behaviour curricula that acknowledge the complexity of the medical education context, helping to overcome our "black ice." Our objectives were to investigate 24-Hour Movement Guideline content in the medical curriculum and develop an integrated process for competency-based curriculum renewal. Stakeholders were equal collaborators in a two-phased environmental scan of 24-Hour Movement Guideline content in the Queen's University School of Medicine. Findings and a working curriculum map highlight how new, competency-based content may be embedded in an effort to guide more relevant and feasible curriculum changes.

À plusieurs reprises, les facultés de médecine ont été invitées à inclure du contenu en matière d'activité physique dans leurs cursus déjà chargés. Ces appels à l'action ont souvent omis de prendre en compte les points de vue des parties prenantes de l'éducation médicale ainsi que toute la complexité de cette dernière, y compris l'approche par compétence et les contenus de cursus qui ne cessent de croître. Malgré la pression externe, peu de facultés de médecine ont mis en place des programmes d'activité physique. De plus, les nouvelles directives canadiennes en matière de mouvement sur 24 heures sont axées sur le continuum des comportements de mouvement (activité physique, comportement sédentaire et sommeil). Une approche intégrée est de mise pour négocier le terrain glissant que constitue la nécessité de cibler tous les comportements de mouvement, de solliciter les parties prenantes de l'éducation médicale et de prendre en considération le cursus chargé. Nous prônons la collaboration pour effectuer ces modifications dans les programmes d'études par le biais de cinq stratégies d'intégration de contenu sur les comportements de mouvement qui reconnaissent la complexité du contexte de l'éducation médicale. Nos objectifs étaient d'étudier le contenu des directives en matière de mouvement sur 24 heures et de créer un processus intégré pour la révision du cursus basé sur les compétences. Les parties prenantes ont collaboré sur un pied d'égalité à une analyse environnementale en deux phases du contenu des directives en matière de mouvement sur 24 heures à la Faculté de médecine de l'Université Queen's. Les résultats et le projet de programme élaboré illustrent la manière d'intégrer du contenu nouveau basé sur les compétences et d'opérer ainsi des changements pertinents et réalisables dans le cursus.

Exploring the peer mentorship experiences of adults with spinal cord injury.

PURPOSE/OBJECTIVE: The purpose of this study was to understand the peer mentorship experiences of adults with spinal cord injury (SCI) through a self-determination theory (SDT) lens. Research Method/Design: Semi-structured qualitative interviews were conducted with 13 adults with SCI who received mentorship (i.e., mentees) from fellow adults with SCI (i.e., mentors) as part of an existing provincial peer mentorship program. There were two analyses conducted in this study. The first was deductive, which involved organizing relevant data as per the three basic psychological needs of self-determination theory (i.e., autonomy, competence, and relatedness). The second analysis was inductive and focused on the participants' descriptions of their experiences. RESULTS: For the SDT analysis, and concerning autonomy, mentees expressed they were able to make their own decisions and their mentors' personalized their sessions. Specific to relatedness, the mentees discussed that their mentors cared and empathized with them, which helped them connect with their mentor. In terms of competence, mentees explained that their mentors provided verbal encouragement and helped them realize they were capable of successfully completing tasks. Some mentees also highlighted how the mentors did not listen to their needs, indicating need thwarting behaviors. For the inductive analysis, mentees expressed the importance of their SCI community organization, the impact of mentoring on their families, and the positive outcomes they associated with peer mentorship, such as participation in daily and social activities. CONCLUSION/IMPLICATIONS: The present findings extend our understanding of SCI peer mentorship from the perspective of the mentee and particularly from an SDT angle. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Impact of a randomized possible selves experiment on new retirees' physical activity and identity.

BACKGROUND: Retirement is not always associated with greater engagement in physical activity. Previous interventions informed by possible selves, a type of future-oriented self-representation, proved useful to increase physical activity in young adults. We thus wanted to explore if a similar intervention would yield favorable outcomes in new retirees. We also examined whether possible selves could help increase identity relative to the physical activity context. Identity circumscribes the meanings which help individuals define who they are in a given role (i.e., what it means to be a physically active person). The strength of identification as a physically active person increases when individuals endorse these meanings more strongly. Possible selves may be tied to identity as they allow individuals to imagine themselves as physically active, which has been argued to incite changes to one's sense of self. Hence, the overall aim of this study was to determine whether a possible selves intervention would increase physical activity behaviour and physical activity identity in a group of newly-retired individuals. METHODS: A total of 294 participants were randomized into one of three groups: (a) a repeated group with three possible selves image generation exposures, (b) a one-time group with one possible selves image generation exposure, or (c) a control group. Participants completed self-report measures at baseline and follow-up assessments were taken at weeks 4, 8, and 12 of the study. The measures for the outcomes of interest were the Godin Leisure Time Exercise Questionnaire and the modified Exercise Identity Scale. RESULTS: Repeated measures mixed-effects models analyses with maximum likelihood estimation revealed no significant differences between groups on physical activity behaviour (p = 0.34) or physical activity identity (p = 0.97) at follow-up time points. However, a time effect was found for physical activity (p <.01) and physical activity identity (p <.01), which increased across time (baseline-to-12-week follow-up) in all three groups. Such a time effect (inconsequential to group assignment) suggests that the observed increases in physical activity and identity cannot be attributed to an exposure to a possible selves intervention. CONCLUSIONS: While the intervention failed to significantly increase physical activity identity and physical activity in newly retired individuals, we suggest future research directions for interventions targeting new retired individuals.

Possible Selves and Physical Activity in Retirees: The Mediating Role of Identity.

Many retirees remain insufficiently physically active for health benefits. Self-perceptions can influence physical activity. Possible selves and identity are two self-perceptions that, when examined relative to physical activity, may help explain physical activity levels among retirees. Scholars claim that a focus on possible selves may impact identity, which, in the physical activity domain, is a known physical activity correlate. The aim of this study was to examine the relationship between these variables, and more specifically, to determine whether exercise identity mediates the relationship between physical activity possible selves and physical activity. We examined the proposed mediation relationship in 531 new retirees. Data were collected across three time points (1 month apart). We conducted mediation analyses with bootstrapping. Identity mediated the relationship between possible selves (content and processes) and behavior-all related to physical activity. These findings represent an important first step toward designing relevant physical activity interventions for retirees.

Testing a Longitudinal Integrated Self-Efficacy and Self-Determination Theory Model for Physical Activity Post-Cardiac Rehabilitation.

Self-determination theory and self-efficacy theory are prominent theories in the physical activity literature, and studies have begun integrating their concepts. Sweet, Fortier, Strachan and Blanchard (2012) have integrated these two theories in a cross-sectional study. Therefore, this study sought to test a longitudinal integrated model to predict physical activity at the end of a 4-month cardiac rehabilitation program based on theory, research and Sweet et al.'s cross-sectional model. Participants from two cardiac rehabilitation programs (N=109) answered validated self-report questionnaires at baseline, two and four months. Data were analyzed using Amos to assess the path analysis and model fit. Prior to integration, perceived competence and self-efficacy were combined, and labeled as confidence. After controlling for 2-month physical activity and cardiac rehabilitation site, no motivational variables significantly predicted residual change in 4-month physical activity. Although confidence at two months did not predict residual change in 4-month physical activity, it had a strong positive relationship with 2-month physical activity (ß=0.30, P<0.001). The overall model retained good fit indices. In conclusion, results diverged from theoretical predictions of physical activity, but self-determination and self-efficacy theory were still partially supported. Because the model had good fit, this study demonstrated that theoretical integration is feasible.

Investigating motivational regulations and physical activity over 25 weeks.

BACKGROUND: Because motivation has been deemed a key barrier to physical activity, it is imperative that we know how motivational levels change over time and how that change relates to physical activity. Based in Self-Determination Theory, this study investigated fluctuations in physical activity and motivational regulations over 25 weeks and tested the relationship between these 2 variables. METHODS: Data from the Physical Activity Counseling trial were examined. Inactive adults recruited from a primary care center (N = 120) answered motivation and physical activity questionnaires during the intervention and postintervention phases. Hierarchical linear modeling was used to test the hypotheses. RESULTS: Quadratic changes were found for external regulation (γ20= 0.02, P < .05) and physical activity (γ20 = -2.64, P < .001), while identified (γ10= 0.04, P = .03) and intrinsic (γ10= 0.04, P = .01) regulations increased linearly over the course of the 25 weeks. Only identified regulation (γ30= 3.15, P = .01) and intrinsic motivation (γ30= 4.68, P < .001) were significantly and positively related with physical activity. CONCLUSION: Physical activity, external and identified regulations and intrinsic motivation changed over the 25 weeks. Intervention should aim at fostering identified regulation and intrinsic motivation as greater levels of these regulations were related with physical activity.

An Experience Sampling Study of Physical Activity and Positive Affect: Investigating the Role of Situational Motivation and Perceived Intensity Across Time.

The nature of the association between physical activity and positive affect is complex, prompting experts to recommend continued examination of moderating variables. The main purpose of this 2-week field study was to examine the influence of situational motivational regulations from self-determination theory (SDT) on changes in positive affect from pre- to post- to 3-hours post-physical activity. Another purpose was to clarify the relationship between physical activity intensity [i.e., Ratings of Perceived Exertion (RPE)] and positive affect at the stated time points. This study employed an experience sampling design using electronic questionnaires. Sixty-six healthy and active, multiple-role women provided recurrent assessments of their physical activity, situational motivation, and positive affect in their everyday lives over a 14-day period. Specifically, measures were obtained at the three time points of interest (i.e., pre-, post-, 3-hours post-physical activity). The data were analyzed using multilevel modeling. Results showed that intrinsic motivation was related to post-physical activity positive affect while the influence of identified regulation appeared 3-hours post-physical activity. In addition, RPE, which was significantly predicted by levels of introjection, was more strongly associated with an increase in positive affect post-physical activity than three hours later. The theoretical implications of these findings vis-à vis SDT, namely in regards to a viable motivational sequence predicting the influence of physical activity on affective states, are discussed. The findings regarding the differential influences of RPE and motivational regulations carries applications for facilitating women's well-being.

Situational motivation and perceived intensity: their interaction in predicting changes in positive affect from physical activity.

There is evidence that affective experiences surrounding physical activity can contribute to the proper self-regulation of an active lifestyle. Motivation toward physical activity, as portrayed by self-determination theory, has been linked to positive affect, as has the intensity of physical activity, especially of a preferred nature. The purpose of this experimental study was to examine the interaction between situational motivation and intensity [i.e., ratings of perceived exertion (RPE)] in predicting changes in positive affect following an acute bout of preferred physical activity, namely, running. Fourty-one female runners engaged in a 30-minute self-paced treadmill run in a laboratory context. Situational motivation for running, pre- and post-running positive affect, and RPE were assessed via validated self-report questionnaires. Hierarchical regression analyses revealed a significant interaction effect between RPE and introjection (P < .05) but not between RPE and identified regulation or intrinsic motivation. At low levels of introjection, the influence of RPE on the change in positive affect was considerable, with higher RPE ratings being associated with greater increases in positive affect. The implications of the findings in light of SDT principles as well as the potential contingencies between the regulations and RPE in predicting positive affect among women are discussed.

Promoting physical activity: development and testing of self-determination theory-based interventions.

A growing number of studies have pulled from Deci and Ryan's Self-Determination Theory to design interventions targeting health behavior change. More recently, researchers have begun using SDT to promote the adoption and maintenance of an active lifestyle. In this review, we aim to highlight how researchers and practitioners can draw from the SDT framework to develop, implement, and evaluate intervention efforts centered on increasing physical activity levels in different contexts and different populations. In the present paper, the rationale for using SDT to foster physical activity engagement is briefly reviewed before particular attention is given to three recent randomized controlled trials, the Canadian Physical Activity Counseling (PAC) Trial, the Empower trial from the UK, and the Portuguese PESO (Promotion of Health and Exercise in Obesity) trial, each of which focused on promoting physical activity behavior. The SDT-based intervention components, procedures, and participants are highlighted, and the key findings that have emanated from these three trials are presented. Lastly, we outline some of the limitations of the work conducted to date in this area and we acknowledge the challenges that arise when attempting to design, deliver, and test SDT-grounded interventions in the context of physical activity promotion.

Self-determination and exercise stages of change: results from the Diabetes Aerobic and Resistance Exercise trial.

Little longitudinal research exists on the relationship between exercise self-determination and stage of change. This study investigated how self-determined motivation changes in patients with type 2 diabetes (N = 175) as they moved through the stages of change over a six-month exercise trial. Hierarchical linear modelling revealed that patients who progressed through the stages of exercise change had an overall increase in self-determined motivation, while non-progressors experienced a reduction in self-determined motivation from three to six months. These results indicate that individuals engaging in regular exercise at six months maintain initial increases in self-determined motivation. Findings are discussed in light of self-determination theory.

Impact of integrating a physical activity counsellor into the primary health care team: physical activity and health outcomes of the Physical Activity Counselling randomized controlled trial.

The purpose of this paper was to report the physical activity and health outcomes results from the Physical Activity Counselling (PAC) trial. Patients (n = 120, mean age 47.3 ± 11.1 years, 69.2% female) who reported less than 150 min of physical activity per week were recruited from a large community-based Canadian primary care practice. After receiving brief physical activity counselling from their provider, they were randomized to receive 6 additional patient-centered counselling sessions over 3 months from a physical activity counsellor (intensive-counselling group; n = 61), or no further intervention (brief-counselling group; n = 59). Physical activity (self-reported and accelerometer) was measured every 6 weeks up to 25 weeks (12 weeks postintervention). Quality of life was also assessed, and physical and metabolic outcomes were evaluated in a randomly selected subset of patients (33%). In the intent-to-treat analyses of covariance, the intensive-counselling group self-reported significantly higher levels of physical activity at 6 weeks (p = 0.009) and 13 weeks (p = 0.01). There were no differences in self-reported physical activity between the groups after the intervention in the follow-up period, nor was there any increase in accelerometer-measured physical activity. Finally, the intensive-counselling patients showed greater decreases in percent body fat and total fat mass from 13 weeks to 25 weeks. Results for physical activity depended on the method used, with positive short-term results with self-report and no effects with the accelerometers. Between-group differences were found for body composition in that the intensive-counselling patients decreased more. A multisite randomized controlled trial with a longer intensive intervention and follow-up is warranted.

Patterns of motivation and ongoing exercise activity in cardiac rehabilitation settings: a 24-month exploration from the TEACH Study.

BACKGROUND: Few studies have explored exercise and motivational patterns of cardiac rehabilitation patients in the long term. PURPOSE: We explored differential patterns of exercise and motivation in cardiac rehabilitation patients over a 24-month period and examined the relationship between these emerging patterns. METHODS: Participants (n = 251) completed an exercise, barrier self-efficacy, outcome expectations and self-determined motivation questionnaire. Latent class growth modelling was used to classify patients in different exercise and motivational patterns. RESULTS: Three exercise patterns emerged: inactive, non-maintainers and maintainers (16%, 67% and 17% of sample per pattern, respectively). Multiple trajectories were found for barrier self-efficacy, outcome expectations and self-determined motivation (3, 5, and 4, respectively). Patients in high barrier self-efficacy, outcome expectation and self-determined groups had greater probability of being in the maintainer exercise group. CONCLUSIONS: Identifying a patient's exercise and motivational profile could help cardiac rehabilitation programmes tailor their intervention to optimize the potential for continued exercise activity.

Improving physical activity and dietary behaviours with single or multiple health behaviour interventions? A synthesis of meta-analyses and reviews.

Since multiple health behaviour interventions have gained popularity, it is important to investigate their effectiveness compared to single health behaviour interventions. This synthesis aims to determine whether single intervention (physical activity or dietary) or multiple interventions (physical activity and dietary) are more effective at increasing these behaviours by synthesizing reviews and meta-analyses. A sub-purpose also explored their impact on weight. Overall, reviews/meta-analyses showed that single health behaviour interventions were more effective at increasing the targeted behaviours, while multiple health behaviour interventions resulted in greater weight loss. This review may assist policies aiming at improving physical activity and nutrition and reversing the obesity epidemic.

Effect of exercise training on physical fitness in type II diabetes mellitus.

UNLABELLED: Few studies have compared changes in cardiorespiratory fitness between aerobic training only or in combination with resistance training. In addition, no study to date has compared strength gains between resistance training and combined exercise training in type II diabetes mellitus (T2DM). PURPOSE: We evaluated the effects of aerobic exercise training (A group), resistance exercise training (R group), combined aerobic and resistance training (A + R group), and sedentary lifestyle (C group) on cardiorespiratory fitness and muscular strength in individuals with T2DM. METHODS: Two hundred and fifty-one participants in the Diabetes Aerobic and Resistance Exercise trial were randomly allocated to A, R, A + R, or C. Peak oxygen consumption (V O(2peak)), workload, and treadmill time were determined after maximal exercise testing at 0 and 6 months. Muscular strength was measured as the eight-repetition maximum on the leg press, bench press, and seated row. Responses were compared between younger (aged 39-54 yr) and older (aged 55-70 yr) adults and between sexes. RESULTS: VO(2peak) improved by 1.73 and 1.93 mL O(2)*kg(-1)*min(-1) with A and A + R, respectively, compared with C (P < 0.05). Strength improvements were significant after A + R and R on the leg press (A + R: 48%, R: 65%), bench press (A + R: 38%, R: 57%), and seated row (A + R: 33%, R: 41%; P < 0.05). There was no main effect of age or sex on training performance outcomes. There was, however, a tendency for older participants to increase VO(2peak) more with A + R (+1.5 mL O(2)*kg(-1)*min(-1)) than with A only (+0.7 mL O(2)*kg(-1)*min(-1)). CONCLUSIONS: Combined training did not provide additional benefits nor did it mitigate improvements in fitness in younger subjects compared with aerobic and resistance training alone. In older subjects, there was a trend to greater aerobic fitness gains with A + R versus A alone.

Interdisciplinary physical activity counseling in primary care: a qualitative inquiry of the patient experience.

The Physical Activity Counseling randomized controlled trial integrated a physical activity (PA) counselor into a primary care practice to provide intensive counseling to sedentary patients following brief counseling from their regular health care provider. This article presents the voices of 15 patients, who through a series of 3 interviews, described their experience with this 3-month combined provider PA counseling intervention. Patient satisfaction was a dominant emergent theme, and the patients were particularly positive about the quality of care and educational support for lifestyle change. They favored the tailored approach and felt the strategies for overcoming PA barriers were helpful.

Understanding physical activity in adults with type 2 diabetes after completing an exercise intervention trial: A mediation model of self-efficacy and autonomous motivation.

This study was set out to test if autonomous motivation mediated the relationship between self-efficacy and 12-month physical activity (PA) in adults with type 2 diabetes involved in a randomized exercise trial. Participants (n = 234) completed questionnaires measuring barrier self-efficacy at 3 months, autonomous motivation at 6 months, and PA at 12 months. A mediational analysis of longitudinal data revealed that autonomous motivation mediated the relationship between barrier-self-efficacy and PA. High barrier self-efficacy can therefore help predict 12-month PA in adults with type 2 diabetes, although this effect is attenuated by autonomous motivation. Hence, participating in PA for autonomous reasons such as by choice and/or for fun further explains PA at 12 months in this population. Results of this study extend our understanding of the motivational constructs involved in PA in the maintenance phase. This study has important theoretical implications in that it helps to organize and consolidate well-known correlates of PA by proposing a temporal relationship between them that could be tailored in interventions.