The Effect of Acute Exercise on State Anxiety: A Systematic Review.

Acute exercise has been shown to induce a small reduction in state anxiety, yet the most beneficial exercise stimulus is not clear. This review provides an update on the papers published since the last comprehensive review in 2015, with specific emphasis on whether study quality has improved. Randomised control trials, conducted in samples of healthy adults with non-clinical anxiety, were sourced from PubMed, PsycInfo, and Scopus. Study characteristics and study quality were assessed in nine studies comprising thirteen exercise conditions. Acute exercise significantly reduced anxiety in 53% (N = 7/13) of the exercise conditions. In comparison to a control condition, four showed exercising to be more effective, and one was as effective as the control. Two of the effective studies did not contain a control group. Six conditions were ineffective in reducing anxiety. There was no clear pattern of what combination of exercise mode, duration, and intensity was most effective, suggesting a variety may be effective in reducing anxiety. Methodological limitations still exist within the research, e.g., participant recruitment not considering baseline anxiety; variations in the control condition content. Future research should include participant samples exhibiting moderate-to-high levels of anxiety and examine self-selected exercise intensities.

Feasibility and Pilot Outcomes of the Move More @ Work Intervention Designed to Encourage Employees to be Physically Active for 2 Minutes After Every 30 Minutes of Sitting.

OBJECTIVE: The aim of the study is to evaluate the feasibility of a workplace intervention supporting employees to interrupt sitting time with short bouts of activity (termed an opportunity to move [OTM]). METHODS: Using an interrupted time series design, 58 sedentary employees provided baseline assessments of physical activity, health, and work-related outcomes and completed the 12-week intervention. Assessments were repeated immediately and 12 weeks after intervention. Focus groups explored intervention acceptability. RESULTS: Accelerometer data showed no change in the number of OTMs taken before to after intervention, while participants self-reported 62-69% intervention adherence. Physical activity at work, productivity, and musculoskeletal health improved but cardiometabolic health and psychological well-being did not. Intervention components were viewed favorably (pending amendments), but taking an OTM every 30 minutes was not feasible. CONCLUSIONS: The Move More @ Work intervention has potential, but adaptations are required to increase adherence.

Rugby Fans in Training New Zealand (RUFIT NZ): a randomized controlled trial to assess the effectiveness of a healthy lifestyle program for overweight men delivered through professional rugby clubs.

BACKGROUND: A healthy lifestyle program that appeals to, and supports, overweight and obese New Zealand (NZ) European, Maori (indigenous) and Pasifika men to achieve weight loss is urgently needed. A pilot program inspired by the successful Football Fans in Training program but delivered via professional rugby clubs in NZ (n = 96) was shown to be effective in weight loss, adherence to healthy lifestyle behaviors, and cardiorespiratory fitness in overweight and obese men. A full effectiveness trial is now needed. AIMS: To determine the effectiveness and cost effectiveness of Rugby Fans In Training-NZ (RUFIT-NZ) on weight loss, fitness, blood pressure, lifestyle change, and health related quality of life (HRQoL) at 12- and 52-weeks. METHODS: We conducted a pragmatic, two-arm, multi-center, randomized controlled trial in NZ with 378 (target 308) overweight and obese men aged 30-65 years, randomized to an intervention group or wait-list control group. The 12-week RUFIT-NZ program was a gender-sensitised, healthy lifestyle intervention delivered through professional rugby clubs. Each intervention session included: i) a 1-h workshop-based education component focused on nutrition, physical activity, sleep, sedentary behavior, and learning evidence-based behavior change strategies for sustaining a healthier lifestyle; and 2) a 1-h group-based, but individually tailored, exercise training session. The control group were offered RUFIT-NZ after 52-weeks. The primary outcome was change in body weight from baseline to 52-weeks. Secondary outcomes included change in body weight at 12-weeks, waist circumference, blood pressure, fitness (cardiorespiratory and musculoskeletal), lifestyle behaviors (leisure-time physical activity, sleep, smoking status, and alcohol and dietary quality), and health-related quality of life at 12- and 52-weeks. RESULTS: Our final analysis included 200 participants (intervention n = 103; control n = 97) who were able to complete the RUFIT-NZ intervention prior to COVID-19 restrictions. At 52-weeks, the adjusted mean group difference in weight change (primary outcome) was -2.77 kg (95% CI -4.92 to -0.61), which favored the intervention group. The intervention also resulted in favorable significant differences in weight change and fruit and vegetable consumption at 12-weeks; and waist circumference, fitness outcomes, physical activity levels, and health-related quality of life at both 12 and 52 weeks. No significant intervention effects were observed for blood pressure, or sleep. Incremental cost-effective ratios estimated were $259 per kg lost, or $40,269 per quality adjusted life year (QALY) gained. CONCLUSION: RUFIT-NZ resulted in sustained positive changes in weight, waist circumference, physical fitness, self-reported physical activity, selected dietary outcomes, and health-related quality of life in overweight/obese men. As such, the program should be recommended for sustained delivery beyond this trial, involving other rugby clubs across NZ. TRIAL REGISTRATION: Australia New Zealand Clinical Trials Registry, ACTRN12619000069156. Registered 18 January 2019, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376740 Universal Trial Number, U1111-1245-0645.

Nature-Based Physical Activity and Hedonic and Eudaimonic Wellbeing: The Mediating Roles of Motivational Quality and Nature Relatedness.

The current study evaluated the degree to which nature-based physical activity (NPA) influenced two distinct types of psychological wellbeing: hedonic wellbeing and eudaimonic wellbeing. The type of motivation an individual experiences for physical activity, and the extent to which individuals have a sense of relatedness with nature, have been shown to influence the specific type of psychological wellbeing that is experienced as a result of NPA. However, the role of these two variables in the relationship between NPA and psychological wellbeing has not been examined. Thus, this study assessed the potential mediating influence of (1) motivational quality and (2) nature relatedness on the relationships between NPA and hedonic and eudaimonic wellbeing, respectively. Participants (N = 262) completed an online survey assessing hedonic and eudaimonic wellbeing, NPA, intrinsic motivation, autonomous extrinsic motivation, and nature relatedness. Data were analysed using Partial Least Squares Structural Equation Modelling. Results showed that motivational quality and nature relatedness both fully mediated the relationships between NPA and hedonic and eudaimonic wellbeing. Specifically, intrinsic motivation positively mediated the relationship between NPA and hedonic wellbeing. Autonomous extrinsic motivation and nature relatedness positively mediated the relationship between NPA and eudaimonic wellbeing. These findings suggest that the associations between NPA and eudaimonic wellbeing and hedonic wellbeing, respectively, are driven by different mechanisms relating to an individual's (1) underlying motivation and (2) sense of connection to nature. These findings suggest that promoting distinct types of wellbeing (hedonic vs. eudaimonic) through NPA requires distinct approaches. Emphasising enjoyment, pleasure, and positive kinaesthetic experiences within NPA may be more conducive to hedonic wellbeing, while highlighting opportunities for connecting with nature or experiencing valued outcomes of NPA may be more conducive to eudaimonic wellbeing.

Factors Influencing Men's Experiences and Engagement with the Rugby Fans in Training-New Zealand Pilot Trial: A Healthy Lifestyle Intervention for Men.

Health promotion programs designed specifically to support men to improve their lifestyle behaviours are required to improve men's health. This study explored factors that influenced men's experiences of, and engagement with, the Rugby Fans in Training-New Zealand pilot trial, a professional sport-based healthy lifestyle intervention for overweight men. Thirty-five men (mean age = 45, SD = 10 years) who completed the 12-week intervention participated in one of eight semi-structured focus groups. Using inductive thematic analysis, five themes represented the meanings in the data. First, a group of like-minded men all in the same boat recognised the importance of being in similar life situations and having similar reasons for joining the programme. Second, the men described the importance of the support and motivation provided by the team atmosphere created through the programme. Third, the motivational coach recognised the characteristics, skills and knowledge of the coach delivering the programme which created engagement with it. Fourth, the education sessions were valued for the knowledge gained and underpinning philosophies that guided them. Finally, the involvement of the rugby franchise influenced commitment to the programme and created initial interest. These results provide evidence for the key components that should be incorporated into the future development of and improvement to healthy lifestyle interventions for men.

Protocol for a pilot trial to assess the feasibility of the Move More @ Work intervention to encourage employees to take the opportunity to move (be physically active) after every 30 min of sitting.

BACKGROUND: Prolonged sitting increases the risk of cardio-metabolic disease. Office-based employees are particularly susceptible to high rates of this sedentary behaviour during work hours. Laboratory studies indicate that regularly interrupting periods of prolonged sitting with short bouts (2 min) of physical activity can improve markers of cardio-metabolic health. This method of interrupting sitting time is yet to be tested in an occupational setting and may provide an alternative to providing sit-to-stand desks. Drawing on the Behaviour Change Wheel and evidence on the barriers and motivators to performing regular activity breaks, the Move More @ Work intervention was developed. The objectives of this pilot study are to examine the feasibility, and preliminary outcomes, of this intervention designed to encourage participants to perform 1-2 min of activity after every 30 min of continuous sitting throughout the work day. The study will inform if progress to a full effectiveness trial is warranted. METHODS: An interrupted time series design consisting of a 4-week baseline (control period), a 12-week intervention, and a 12-week follow-up will be utilised. At least 57 university employees who self-report spending > 5 h per day sitting at work on at least 3 days per week will be recruited to participate. The intervention consists of (1) a structured consultation with a Move More @ Work coach, containing a number of behaviour change techniques to create an individualised plan of how to incorporate the activity breaks into the working day, and (2) strategies to create a supportive workplace culture for performing the activity breaks. Feasibility will be assessed by recruitment and retention rates, and acceptability of the intervention. Pilot outcomes are the number of regular activity breaks taken during the workday, cardio-metabolic risk score and self-reported health, and work-related productivity outcomes. DISCUSSION: If the Move More @ Work intervention is shown to be feasible, acceptable, and shows evidence of effectiveness, this will provide justification for the progression to a full scale evaluation of the intervention. In the longer-term, this intervention may provide an alternative means of improving health outcomes through interrupting sedentary time than that offered by current sedentary behaviour interventions. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12620000354987 . Registered on 12 March 2020.

Changes in Physical Activity Pre-, During and Post-lockdown COVID-19 Restrictions in New Zealand and the Explanatory Role of Daily Hassles.

Covid-19 lockdown restrictions constitute a population-wide "life-change event" disrupting normal daily routines. It was proposed that as a result of these lockdown restrictions, physical activity levels would likely decline. However, it could also be argued that lifestyle disruption may result in the formation of increased physical activity habits. Using a longitudinal design, the purpose of this study was to investigate changes in physical activity of different intensities, across individuals who differed in activity levels prior to lockdown restrictions being imposed, and across three time periods: pre-, during- and post-lockdown. This study also examined the extent to which the experience of daily hassles explained any changes in physical activity. A convenience sample (N = 759) recruited through social media, provided data from an online survey administered during weeks 2-3 of a 5-week lockdown and 231 participants provided complete data again 6 weeks post-lockdown (72% female, M age = 43 years). Participants completed the International Physical Activity Questionnaire-Short Form and the Daily Hassles Scale. Results showed that vigorous and moderate intensity PA were significantly lower during- and post-lockdown compared to pre-lockdown in those individuals who had been highly active pre-lockdown. In contrast, for moderately active individuals pre-lockdown, vigorous and moderate intensity PA was significantly higher during-lockdown compared to pre-lockdown, and these increased levels of vigorous PA were maintained post-lockdown. Participants experienced daily hassles due to inner concerns, time pressures, family, and financial concerns to the same extent during- and post-lockdown. Those daily hassles had a small negative (Standardized ß = -0.11; p < 0.05) predictive effect on post-lockdown PA. It appears that to understand the effect of COVID-19 restrictions on PA, the activity status of individuals pre-lockdown needs to be taken into account. The daily hassles appeared to play a role in post-lockdown PA behavior, but future research should investigate why these results occurred.

Physical Activity and Psychological Well-Being During the COVID-19 Lockdown: Relationships With Motivational Quality and Nature Contexts.

The COVID-19 pandemic is a global event that has already had substantive negative impacts on psychological well-being. This study investigated the relationship between physical activity (PA) and psychological well-being during a country-wide COVID-19 lockdown in New Zealand. Motivational quality and PA context (nature-based or non-nature-based) were included as potential mediating and moderating variables within this relationship, respectively. Participants completed an online survey assessing psychological well-being, weekly PA levels, and PA during the second and third weeks of the 7 week COVID-19 lockdown period in New Zealand. Data were analysed using Partial Least Squares Structural Equation Modelling. Results showed that PA significantly predicted psychological well-being, with no significant difference evident in psychological well-being dependent on whether PA was nature or non-nature-based. Nature-based PA was a stronger predictor of intrinsic motivation compared to non-nature-based PA, and intrinsic motivation was positively associated with psychological well-being. In contrast, non-nature-based PA was a stronger predictor of introjected regulation compared to nature-based PA, which was negatively associated with psychological well-being. Overall, these findings suggest that (1) weekly PA was associated with increased psychological well-being during the lockdown, and (2) nature-based PA may foster psychological well-being via effects on motivation. The implications for continued participation in PA will be discussed.

Examining the Relationships Among Cognitive Acceptance, Behavioral Commitment, Autonomous Extrinsic Motivation, and Physical Activity.

This study examined the relationships among cognitive acceptance, behavioral commitment, psychological need satisfaction, autonomous extrinsic motivation (EM) for physical activity (PA), and PA behavior. Participants (N = 456, M age = 40.7 years) completed online measures of these variables, and data were analyzed using structural equation modeling. Results indicated a direct pathway from behavioral commitment to autonomous EM, plus indirect effects via autonomy, competence, and relatedness. There was no direct pathway from cognitive acceptance to autonomous EM, but there were indirect effects via competence and autonomy satisfaction. There was a direct pathway from cognitive acceptance to self-reported PA plus indirect effects via autonomous EM. There was no direct pathway from behavioral commitment to self-reported PA, but there were indirect effects via autonomous EM. Cognitive acceptance and behavioral commitment potentially support the development of autonomous EM for PA. Future research using longitudinal and intervention-based research designs is required to determine the causal relationships among these variables.

Rugby Fans in Training New Zealand (RUFIT-NZ): protocol for a randomized controlled trial to assess the effectiveness and cost-effectiveness of a healthy lifestyle program for overweight men delivered through professional rugby clubs in New Zealand.

BACKGROUND: A healthy lifestyle program that appeals to, and supports, obese New Zealand (NZ) European, Maori (indigenous) and Pasifika men to achieve weight loss is urgently needed. In Scotland, Football Fans in Training (FFIT), a weight management and healthy lifestyle program for overweight and obese men aged 35-65 years , delivered by community coaching staff at professional football clubs, has been shown to be beneficial and cost-effective. A pilot program inspired by FFIT but delivered by professional rugby clubs in NZ (n = 96) was shown to be effective in weight loss, improved physiological outcomes, and adherence to healthy lifestyle behaviors in overweight and obese men. The objective of this trial is to determine the effectiveness and cost-effectiveness of the Rugby Fans in Training New Zealand (RUFIT-NZ) program. METHODS: A pragmatic, two-arm, multi-center, randomized controlled trial involving 308 overweight and obese men aged 30-65 years, randomized to either an intervention group (n = 154) or a wait-list control group (n = 154). The intervention-group participated in the 12-week RUFIT-NZ program, a gender-sensitized, healthy lifestyle intervention adapted to the environment and cultural diversity of NZ and delivered through professional rugby clubs. Participants in the intervention group undergo physical training sessions, in addition to workshop-based sessions to learn about nutrition, physical activity, sleep, sedentary behavior, and a range of behavior-change strategies for sustaining a healthier lifestyle. The control group receives the program after 52 weeks. The primary outcome is change in body weight from baseline to 52 weeks. Secondary outcomes include change in body weight at 12 weeks; waist circumference, blood pressure, fitness, and lifestyle behaviors at 12 and 52 weeks; and cost-effectiveness. A process evaluation informed by the RE-AIM framework will evaluate potential implementation of RUFIT-NZ as an ongoing program in NZ after the trial. DISCUSSION: This trial will investigate the effectiveness and cost-effectiveness of the RUFIT-NZ program in overweight and obese NZ men. TRIAL REGISTRATION: Australia New Zealand Clinical Trials Registry, ACTRN12619000069156. Registered on 18 January 2019, according to the World Health Organization Trial Registration Data Set. Universal Trial Number, U1111-1245-0645.

Interrupting Sedentary Time in the Workplace Using Regular Short Activity Breaks: Practicality From an Employee Perspective.

OBJECTIVE: To understand the practicalities of undertaking 2 to 3 minutes of light to moderate intensity physical activity after every 30 minutes of prolonged sitting by examining barriers and facilitators. METHODS: Around 27 (n = 22 women) employees working in higher education who sat for greater than 5 hours during a work day participated in a focus group discussion. RESULTS: Through inductive thematic analysis, themes characterising workplace culture and having the knowledge (or not) of benefits were found to be a facilitator and a barrier. Additional barriers were a perceived reduction in work productivity and specific work tasks that precluded taking activity breaks. Extrinsic motivators and prompts were suggested to facilitate participation. CONCLUSIONS: Environmental and individual strategies are required to build capability, opportunity, and motivation for undertaking regular activity breaks and should inform the development of an ecologically valid workplace intervention.

Great Expectations: A Qualitative Analysis of the Factors That Influence Affective Forecasts for Exercise.

The extent to which people expect to feel pleasure during exercise is proposed to influence an individual's decision to be active. In order to identify the factors that shape this affective forecast for exercise, this study explored what people think about when creating their affective forecast for exercise. Thirty-one inactive participants provided an affective forecast for a moderate intensity exercise session using the global affective forecast questionnaire. Immediately after, they were asked a series of questions to verbally explain what they were thinking about in order to generate their forecast. Thematic analysis identified four themes relating to the exercise intensity, the exercise outcomes, the exercise environment, and the enjoyment of exercise that influenced affective forecast creation. Exercise practitioners should design strategies to manipulate these factors, and structure exercise environments to support a positive affective forecast and better motivate exercise participation.

The Role of Psychological Flexibility in Physical Activity Maintenance.

The purpose of this study was to investigate the role of the constituent processes of psychological flexibility (contact with the present moment, acceptance, cognitive defusion, self-as-context, value clarification, and committed action) in supporting physical activity (PA) maintenance. A total of 9 physically active participants were interviewed using the Scanlan collaborative interview method. Participants were asked to discuss their strategies for maintaining PA, before being asked whether the 6 psychological flexibility processes played a role in their PA behavior. Data were analyzed using a combination of deductive and inductive thematic analyses. Acceptance, cognitive defusion, value clarification, and committed action played a role in participants' experiences of maintaining PA. Contact with the present moment and self-as-context were reported to be relatively unimportant to participants' PA maintenance. Cultivating acceptance of PA-related discomfort, defusion from unhelpful thoughts, clarifying the value of PA, and encouraging commitment to PA would likely benefit individuals' efforts to maintain PA.

Rugby Fans in Training New Zealand (RUFIT-NZ): a pilot randomized controlled trial of a healthy lifestyle program for overweight men delivered through professional rugby clubs in New Zealand.

BACKGROUND: Healthy lifestyle programs that are designed specifically to appeal to and support men to improve lifestyle behaviors and lose weight are needed. The Rugby Fans in Training-New Zealand (RUFIT-NZ) program is delivered by professional rugby clubs and inspired by the successful Football Fans In Training program (FFIT), a gender sensitized weight loss program for obese middle-aged men delivered by professional football clubs in Scotland. RUFIT-NZ required development and evaluation for feasibility. METHODS: To develop the intervention we reviewed content from the FFIT program and evidence-based physical activity, dietary and weight management guidelines, and undertook a series of focus groups and key informant interviews. We then evaluated the feasibility of the intervention in a two-arm, parallel, pilot randomized controlled trial in New Zealand. Ninety-six participants were randomized to either the 12-week RUFIT-NZ intervention (N = 49) or a control group (N = 47). The intervention was delivered through professional rugby clubs and involved physical activity training and classroom sessions on healthy lifestyle behaviors. Pilot trial outcomes included body weight, heart rate, blood pressure, cardiorespiratory fitness, and lifestyle behaviors. Feasibility was assessed by recruitment and retention rates, and acceptability of the intervention. RESULTS: At 12 weeks the mean difference in body weight was 2.5 kg (95% CI -0.4 to 5.4), which favored the intervention. Statistically significant differences in favor of the intervention group were also observed for waist circumference, resting heart rate, diastolic blood pressure, cardiorespiratory fitness, and the proportion of participants that were adherent to 3 or more healthy lifestyle behaviors. The intervention was considered feasible to test in a full trial given the good recruitment and retention rates, and positive feedback from participants. CONCLUSIONS: A pilot study of a healthy lifestyle intervention delivered via professional rugby clubs in New Zealand demonstrated positive effects on weight and physiological outcomes, as well as adherence to lifestyle behaviors. Feasibility issues in terms of recruitment, retention, and participant acceptability were assessed and findings will be used to inform the design of a definitive trial. TRIAL REGISTRATION: The trial was prospectively registered with the Australian New Zealand Clinical Trials Registry ACTRN12616000137493 , 05/12/2016.

Let the Pleasure Guide Your Resistance Training Intensity.

PURPOSE: The purpose of this study was to evaluate the feasibility and reliability of the Feeling Scale (FS) to self-regulate resistance training (RT) intensity. METHODS: Sixteen sedentary men (39.7 ± 7.5 yr) performed 3 familiarization sessions, 2 one-repetition maximum (1RM) testing, and 16 RT sessions (four sessions for each FS descriptor; randomized). The FS descriptors were "very good" (FS + 5), "good" (FS + 3), "fairly good" (FS + 1), and "fairly bad" (FS - 1). Resistance exercises were leg press, chest press, knee extension, and seated biceps curl. Participants were instructed to select a load associated with the verbal/numerical descriptor of the FS to perform three sets of 10 repetitions. RESULTS: Participants lifted a significantly greater %1RM as the FS level decreased from FS + 5 to FS - 1 (P < 0.001). The mean %1RM values for the FS descriptors of +5, +3, +1, and -1, respectively, were as follows: leg press, 42.5% ± 9.5%, 58.2% ± 7.4%, 69.9% ± 7.0%, and 80.7% ± 5.4%; knee extensor, 37.4% ± 9.6%, 54.5% ± 9.3%, 65.3% ± 8.7%, and 78.2% ± 5.9%; chest press, 42.4% ± 11.3%, 54.9% ± 11.4%, 66.4% ± 12.6%, and 78.2% ± 13.5%; and biceps curl, 39.0% ± 8.1%, 54.0% ± 9.7%, 68.4% ± 5.9%, and 83.2% ± 3.0%. The interclass correlation coefficient over the four experimental sessions ranged from 0.73 to 0.99 for %1RM and from 0.77 to 0.99 for weight lifted, with a coefficient of variation of approximately 7%, 4%, 2%, and 2% for FS descriptors of +5, +3, +1, and -1, respectively. CONCLUSION: This study is the first to demonstrate that the FS can be used to self-regulate exercise intensity in RT. The lower the FS descriptor, the higher the weight lifted. In addition, the load self-selected for each FS descriptor was reliable across the four sessions.

A Web-Based Intervention to Encourage Walking (StepWise): Pilot Randomized Controlled Trial.

BACKGROUND: Despite Internet-based interventions that incorporate pedometers with appropriate goal-setting processes and other theoretically-based behavior change strategies being proposed as a means of increasing walking behavior, few have incorporated all of these key features or assessed maintenance of behavior change. OBJECTIVE: The objective of our study was to investigate the effect of a 12-week pedometer step goal walking program individually tailored to baseline step counts, combined with an interactive support website for step counts, health parameters and motivation over 12 and 24 weeks. METHODS: Low active participants (mean [SD] 46.2 [11.2] years) were randomly assigned to the Stepwise (SW) intervention group (n=49) or a comparison (CP) group (n=48). SW received a pedometer, step goal walking program and access to the SW website (containing interactive self-monitoring and goal feedback tools, motivational messages and action and coping planning strategies). CP received a pedometer and locally available physical activity information. Step counts, BMI, resting heart rate, blood pressure and glucose, cholesterol and triglyceride levels, psychological well-being, perceived health, self-efficacy and self-determined motivation were measured at baseline, 12 and 24 weeks. RESULTS: Linear mixed model analysis found that both groups' step counts increased from baseline to week 12 (ß = 11,002, CI 5739-16,266, P<.001) and 24 (ß = 6810, CI 1190-12,431; P=.02). Group step counts were significantly different at week 24 with SW taking 8939 (CI 274-17604, P=.04) more steps compared to CP. Compared to baseline, both groups had improved triglyceride levels (0.14 mmol/L, CI -0.25 to -0.02, P=.02) at week 12, decreased diastolic blood pressure (4.22 mmHg, CI -6.73 to -1.72) at weeks 12 and 24 (3.17 mmHg, CI -5.55 to -0.78), improved positive (ß = .21, CI 0.03-0.38, P=.02) and negative affect (ß = -.15, CI -0.28 to -0.03, P=.02) at week 12, and perceived health at week 12 (ß = 6.37, CI 2.10-10.65, P=.004) and 24 (ß = 8.52, CI 3.98-13.06, P<.001). Total cholesterol increased at week 12 (0.26 mmol/L, CI 0.099-0.423, P=.006) and week 24 (0.38 mmol/L, CI 0.20-0.56, P<.001). Repeated measures ANOVA found motivation for walking improved from baseline with higher task self-efficacy (P<.001, η(2) = .13) and autonomous motivation (P<.001, η(2)=.14) at weeks 12 and 24 and decreased controlled motivation (P=.004, η(2)=.08) at week 24. CONCLUSIONS: Both groups had similar improvements in step counts and physical and psychological health after 12 weeks but only the SW group successfully maintained the increased step-counts 24 weeks post-intervention. This suggests the step-goal based walking program combined with Internet-based behavior change tools were important for sustained behavior change.

Using motivational interviewing for weight feedback to parents of young children.

AIM: To determine whether a single session of motivational interviewing (MI) for feedback of a child's overweight status promotes engagement in treatment following screening. METHODS: One thousand ninety-three children aged 4-8 years were recruited through primary and secondary care to attend health screening, including assessment of parenting practices and motivation (questionnaire). Families with normal-weight children were informed about their child's weight but had no further involvement. Parents of overweight (body mass index ≥ 85th percentile) children (n = 271) were randomised to receive weight feedback via MI or best practice care (BPC) using a traffic light concept to indicate degree of health risk. Follow-up interviews were held 2 weeks later to examine intervention uptake, changes to motivation and behaviour, and parental response to feedback. RESULTS: Recruitment into the intervention was high (76%) and not altered by feedback condition (percentage difference 6.6 (95% confidence interval -2.9, 16.0). High scores on the Health Care Climate Questionnaire (rating of the interviewer) indicated satisfaction with how the information was provided to parents. No differences were observed in multiple indicators of harm. However, self-determined motivation for healthy life-styles was significantly higher in the MI condition at follow-up (0.18: 0.00, 0.35), after only a single session of MI. CONCLUSIONS: MI and BPC were both successful in encouraging parents to participate in a family-based intervention, with MI offering little significant benefit over BPC. A traffic light approach to weight feedback is a suitable way of providing sensitive information to parents not expecting such news.

Psychological mechanisms underlying doping attitudes in sport: motivation and moral disengagement.

We examined whether constructs outlined in self-determination theory (Deci & Ryan, 2002), namely, autonomy-supportive and controlling motivational climates and autonomous and controlled motivation, were related to attitudes toward performance-enhancing drugs (PEDs) in sport and drug-taking susceptibility. We also investigated moral disengagement as a potential mediator. We surveyed a sample of 224 competitive athletes (59% female; M age = 20.3 years; M = 10.2 years of experience participating in their sport), including 81 elite athletes. Using structural equation modeling analyses, our hypothesis proposing positive relationships with controlling climates, controlled motivation, and PEDs attitudes and susceptibility was largely supported, whereas our hypothesis proposing negative relationships among autonomous climate, autonomous motivation, and PEDs attitudes and susceptibility was not supported. Moral disengagement was a strong predictor of positive attitudes toward PEDs, which, in turn, was a strong predictor of PEDs susceptibility. These findings are discussed from both motivational and moral disengagement viewpoints.