InDependent but not Alone: A Web-Based Intervention to Promote Physical and Mental Health among Military Spouses.

BACKGROUND: Military spouses must cope with multiple threats to their physical and mental health, yet few interventions have been developed to promote health in this population. METHODS: For this quasi-experimental study, military spouses (N = 231) received a standard educational intervention or an interactive, theory-based intervention; both were delivered online and lasted 10 weeks. The educational intervention directed participants to content on the existing website, Operation Live Well. The interactive intervention was based on Self-Determination Theory, delivered weekly content via podcasts, and encouraged participants to complete weekly challenges to improve physical activity, diet, and mental health. Linear mixed effects models were used to examine self-reported changes in stress, anxiety, depression, loneliness, self-esteem, physical activity, and diet from pre- to post-intervention. RESULTS: Significant improvements were observed for all mental health outcomes, total physical activity, and sugar consumption. However, there were no significant group by time interaction effects. CONCLUSIONS: Web-based interventions may promote positive changes in mental health and health behaviours among military spouses. In this study, an interactive theory-based intervention was no more effective than an information-based intervention. Future studies should aim to determine the minimum "dose" needed to elicit meaningful changes in this population.

"Everything else comes first": a mixed-methods analysis of barriers to health behaviors among military spouses.

BACKGROUND: Military spouses are integral to the health of their families, but have demonstrated elevated levels of stress, depression, and anxiety. Participating in health behaviors such as physical activity and healthy eating may have a positive impact on spouses' physical and mental health, but emerging evidence suggests spouses' participation in these behaviors is scarce. Thus, the purpose of this study was to examine the most frequently reported barriers to health behaviors among military spouses. METHODS: Military spouses were recruited to complete surveys (N = 230) or participate in focus group sessions (N = 22). On the surveys, participants indicated up to 3 of their most frequent barriers to physical activity, diet, social connection, and stress management. Responses were coded and summed to identify the most commonly reported barriers to each health behavior. Subsequently, focus group sessions were conducted to gain a more in-depth understanding of the challenges military spouses face when trying to maintain a healthy lifestyle. Focus group transcripts were coded using thematic data analysis to identify the most frequently discussed barriers for each behavior. RESULTS: On the surveys, lack of time was the most prevalent barrier for physical activity, social connection, and stress management, and the second most prevalent barrier for diet. Financial concerns were the most prevalent barrier to maintaining a healthy diet. Barriers related to parent/family responsibilities were commonly reported across all health behaviors. During the focus group sessions, the transient military lifestyle was reported to have a significant impact on all of the health behaviors. Other military-related stressors including deployments and the necessity to "do it all" alone were frequently discussed. Many participants exhibited rigid definitions of what "counts" as exercise or health eating. Overall, participants reported sacrificing participation in health behaviors to attend to other priorities. CONCLUSIONS: Military spouses reported numerous barriers to health behaviors that made it difficult for them to prioritize their own health and well-being. Although some of the barriers reported were similar to barriers reported by civilians, unique stressors associated with military life further impeded participation in health behaviors. These findings can be used to inform future health promotion interventions for military spouses.

Changes in Social Integration Predict Changes in Physical Activity: A 25-Year Prospective Study.

BACKGROUND: Social relationships are among the strongest predictors of health. The extent to which one is embedded in social networks, also referred to as social integration, has been associated with physical activity in short-term longitudinal and cross-sectional studies. How changes in social integration impact physical activity over longer periods of time is not well understood. METHODS: Longitudinal data from 5 waves of the Americans' Changing Lives study were used (wave 1: n = 3617; wave 5: n = 1427). Data were modeled using latent growth curves to understand the trajectories of social integration and physical activity, separately. Latent interlocking growth curve methods were used to understand if and how changes in social integration predicted changes in physical activity. RESULTS: Physical activity did not change over the 25-year period (P = .68). Social integration significantly decreased (P = .025). Changes in social integration predicted changes in physical activity (ß = 0.12, P < .05). CONCLUSIONS: Changes in how often adults speak to family and friends predict changes in physical activity across a 25-year period. Group- and social network-focused physical activity research, advocacy, and interventions are warranted.

The Impact of Social Category Diversity on Motivation Gains in Exercise Groups.

OBJECTIVES: Exercising with a virtual partner can increase motivation by 208%, but may be moderated by partner characteristics. We tested the impact of social category diversity (ingroup/outgroup membership) on motivation with a virtual exercise partner. METHODS: Participants (N = 96) were randomized in a 3 (CONDITION: individual, partner-ingroup, partner-outgroup) x 2 (sex) x 2 (performance block: Block 1 & Block 2) design. Participants performed 2 sets of 5 abdominal plank exercises. Partnered conditions completed the second set of exercises with a virtual partner from either an ingroup ('Us') or outgroup ('Them'). Motivation was measured as fatigue-corrected exercise persistence (s). RESULTS: Partnered conditions exercised longer (M = 67.31s, SD = 63.53s) than the individual condition. The 'Us' condition persisted longer (M = 79.61s, SD = 61.92s) than the 'Them' condition (M = 55.02s, SD = 65.14s), although this difference only approached significance (p = .127). CONCLUSIONS: Social category diversity is unlikely to undermine motivating effects of a moderately superior virtual partner. Group leaders and algorithms for group-based online interventions should consider partnering those who struggle to meet recommended levels of intensity and duration of physical activity with a moderately superior partner.

Feasibility and Effectiveness of a Web-Based Physical Activity Intervention for Working Mothers.

BACKGROUND: The purpose of this study was to examine the feasibility and effectiveness of a web-based intervention to promote physical activity and self-worth among working mothers. METHODS: Participants (N = 69) were randomly assigned to receive a standard web-based intervention or an enhanced intervention that included group dynamics strategies to promote engagement. The 8-week intervention was guided by self-determination theory. Each week, participants were instructed to complete 3 tasks: listen to a podcast related to well-being, complete a workbook assignment, and communicate with other participants on a discussion board. Participants in the enhanced condition received an additional weekly task to enhance group cohesion. Data were collected at baseline, week 8, and week 16. RESULTS: Physical activity (P < .001, η2 = 0.35) and self-worth (P < .001, η2 = 0.39) increased significantly in both groups following the intervention, and introjected (P < .001, η2 = 0.30) and external motivation (P = .04, η2 = 0.10) decreased. Website use declined across the 8-week intervention in both groups (P < .001, η2 = 0.48); however, discussion board use was higher in the enhanced condition (P = .04, η2 = 0.21). CONCLUSIONS: These findings suggest web-based interventions can improve physical activity and self-worth among working mothers. Group dynamics strategies only minimally enhanced user engagement, and future studies are needed to optimize web-based intervention designs.

Silence is golden: effect of encouragement in motivating the weak link in an online exercise video game.

BACKGROUND: Despite the physical and mental health benefits, few adults meet US Department of Health and Human Services physical activity guidelines for exercise frequency, intensity, and duration. One strategy that may increase physical activity duration is exercising with an Internet partner (ie, someone who is virtually present, as in video chat). Internet partners help people overcome many barriers associated with face-to-face exercise groups (eg, time, coordinating schedules, social physique anxiety). Past research examining individual performance in groups suggests that an increase in effort occurs when performing a task conjunctively, ie, when a participant is (1) less capable than fellow group members, and (2) participants efforts are particularly indispensable for group success (ie, where the group's potential productivity is equal to the productivity of its least capable member). This boost in effort is more commonly known as the Köhler effect, named after the German psychologist who first observed the effect. While encouragement between group members is common practice in face-to-face group exercise, the effect of encouragement between partners exercising conjunctively across the Internet is unknown. OBJECTIVE: To examine the impact of exercising alone, compared to exercising conjunctively with an Internet partner, both with and without encouragement, on exercise persistence (primary outcomes) and secondary psychosocial outcomes (self-efficacy, enjoyment, exercise intention). METHODS: Participants were recruited online and face-to-face from the campus of Michigan State University. With the assistance of the experimenter, participants (n=115) played an exercise video game in a laboratory, performing a series of five abdominal plank exercises where they were asked to hold the plank for as long as possible (Time 1). They were then randomized to a condition (Individual, Partner-without-encouragement, or Partner-with-encouragement), where they performed the exercises again (Time 2). The impact of condition on the primary outcome measures and secondary outcome measures were evaluated using a 2 (Gender) x 3 (Condition) ANOVA on change scores (Time 2-Time 1). RESULTS: Those who exercised in online teams (n=80) exercised significantly longer (time=78.8s, P<.001) than those who worked individually (n=35). However, exercise duration was shorter when one's more capable partner gave verbal encouragement (n=55) than when s/he did not (n=25) (a mean difference of 31.14s). These increases in effort were not accompanied by altered task self-efficacy, enjoyment of the task, or intention to exercise in the future. CONCLUSIONS: Exercising conjunctively with an Internet partner can boost one's duration of exercise. However, encouragement from the stronger to the weaker member can mitigate these gains, especially if one perceives such comments being directed at someone other than themselves. To boost exercise duration, Internet-based physical activity interventions involving group interaction should make relative abilities of participants known and communication clear.

Aerobic exercise is promoted when individual performance affects the group: a test of the Kohler motivation gain effect.

BACKGROUND: A key barrier to achieving recommended intensity and duration of physical activity is motivation. PURPOSE: We investigated whether a virtually present partner would influence participants' motivation (duration) during aerobic exercise. METHOD: Fifty-eight females (M(age) = 20.54 ± 1.86) were randomly assigned to either a coactive condition (exercising alongside another person, independently), a conjunctive condition (performance determined by whichever partner stops exercising first) where they exercised with a superior partner, or to an individual condition. Participants exercised on a stationary bike at 65 % of heart rate reserve on six separate days. RESULTS: Across sessions, conjunctive condition participants exercised significantly longer (M = 21.89 min, SD = ±10.08 min) than those in coactive (M = 19.77 min, SD = ± 9.00 min) and individual (M = 10.6 min, SD = ±5.84 min) conditions (p < 0.05). CONCLUSION: Exercising with a virtually present partner can improve performance on an aerobic exercise task across multiple sessions.

Is My Exercise Partner Similar Enough? Partner Characteristics as a Moderator of the Köhler Effect in Exergames.

OBJECTIVE: Recent research has shown the Köhler motivation gain effect (working at a task with a more capable partner where one's performance is indispensable to the group) leads to greater effort in partnered exercise videogame play. The purpose of this article was to examine potential moderators of the Köhler effect by exploring dissimilarities in one's partner's appearance, namely, having an older partner (compared with a same-age partner) and having a heavier-weight partner (compared with a same-weight partner). SUBJECTS AND METHODS: One hundred fifty-three male and female college students completed a series of plank exercises using the "EyeToy: Kinetic™" for the PlayStation(®) 2 (Sony, Tokyo, Japan). Participants first completed the exercises individually and, after a rest, completed the same exercises with a virtually present partner. Exercise persistence, subjective effort, self-efficacy beliefs, enjoyment, and intentions to exercise were recorded and analyzed. RESULTS: A significant Köhler motivation gain was observed in all partner conditions (compared with individual controls) such that participants with a partner held the plank exercises longer (P<0.001) and reported higher subjective effort (P<0.01). These results were unmoderated by partner's age and weight, with one exception: Males tended to persist longer when paired with an obese partner (P=0.08). CONCLUSIONS: These results suggest that differences in age and weight do not attenuate the Köhler effect in exergames and may even strengthen it.

Buddy up: the Köhler effect applied to health games.

The present investigation examined the Köhler motivation gain effect in a health game using an absent partner, presented virtually. The Köhler effect occurs when an inferior team member performs a difficult task better in a team or coaction situation than one would expect from knowledge of his or her individual performance. The effect has been strongest in conjunctive task conditions in which the group's potential productivity is equal to the productivity of its least capable member. Participants were randomly assigned to one of four conditions (individual control, coaction, additive, and conjunctive) in a 4 (conditions) • 2 (gender) factorial design and performed a series of isometric plank exercises within an exercise game. They performed the first series of five exercises alone holding each position for as long as they could, and, after a rest period, those in the partner conditions were told they would do remaining trials with a same-sex virtual partner whom they could observe during their performance. The partner's performance was manipulated to be always superior to the participant's. Results showed that task persistence was significantly greater in all experimental conditions than in the individual control condition. The conjunctive condition was no more motivating than either the additive or coactive conditions. Results suggest that working out with virtually present, superior partners can improve persistence motivation on exercise game tasks.