RESUMEN
Research on experiencing workplace cyberbullying (WCB) and its underlying mechanisms that impact the well-being of teachers is scarce. We propose that cognitive reappraisal, which is a useful and adaptive emotion-regulation strategy for reinterpreting emotion-eliciting situations, is a mediator explaining the inverse relationships between experiencing WCB and well-being. A three-wave longitudinal survey (baseline, T1; 3 months, T2; and 1 year, T3) was conducted with a sample of 444 primary and secondary schoolteachers in Hong Kong, China. Exposure to WCB, cognitive reappraisal, affective well-being and work engagement of participants was assessed. In line with the hypotheses, results showed that cognitive reappraisal mediated the associations between WCB and well-being. WCB at T1 was negatively associated with cognitive reappraisal at T2, which in turn was positively associated with positive affect and work engagement and negatively associated with negative affect at T3. Findings suggest that the intrusive nature of WCB renders its victims emotionally exhausted and helpless, thus negatively impacting the process to reinterpret the situation in a positive light, resulting in undesirable consequences. This study has illuminated WCB's inhibitory mechanism and its long-term detrimental impact. Practical implications are discussed.
Asunto(s)
Neoplasias , Niño , Humanos , Lactante , Neoplasias/complicaciones , Neoplasias/diagnóstico por imagen , Estudios RetrospectivosRESUMEN
Strongly interacting topological matter1 exhibits fundamentally new phenomena with potential applications in quantum information technology2,3. Emblematic instances are fractional quantum Hall (FQH) states4, in which the interplay of a magnetic field and strong interactions gives rise to fractionally charged quasi-particles, long-ranged entanglement and anyonic exchange statistics. Progress in engineering synthetic magnetic fields5-21 has raised the hope to create these exotic states in controlled quantum systems. However, except for a recent Laughlin state of light22, preparing FQH states in engineered systems remains elusive. Here we realize a FQH state with ultracold atoms in an optical lattice. The state is a lattice version of a bosonic ν = 1/2 Laughlin state4,23 with two particles on 16 sites. This minimal system already captures many hallmark features of Laughlin-type FQH states24-28: we observe a suppression of two-body interactions, we find a distinctive vortex structure in the density correlations and we measure a fractional Hall conductivity of σH/σ0 = 0.6(2) by means of the bulk response to a magnetic perturbation. Furthermore, by tuning the magnetic field, we map out the transition point between the normal and the FQH regime through a spectroscopic investigation of the many-body gap. Our work provides a starting point for exploring highly entangled topological matter with ultracold atoms29-33.
RESUMEN
Organizational virtuousness is defined as collective positive attributes and behaviors supported by and characteristic of an organization that promote hedonic well-being, eudaimonic well-being, and optimal performance. The underlying mechanisms through which organizational virtuousness operate remain largely unknown. Drawing from the broaden-and-build theory, organizational virtuousness is proposed to broaden employees' attention and cognition toward positive stimuli and events, and over time, build psychological resources for managing future endeavors. Building resources in turn promotes well-being and organizational commitment. A 3-wave prospective study (baseline, T1; 3 months, T2; and 1 year, T3) was conducted with a sample of 444 primary and secondary schoolteachers in Hong Kong. Organizational virtuousness, cognitive reappraisal, psychological capital (PsyCap), life satisfaction, flourishing, affective commitment, and contextual performance were assessed. The results showed that cognitive reappraisal and PsyCap served as sequential mediators of the relationships between three components of organizational virtuousness and all four indicators of well-being and organizational commitment. Collective gratitude, kindness, and forgiveness at T1 had significant indirect effects through cognitive reappraisal at T2 and then PsyCap at T3 on satisfaction with life, state of flourishing, emotional attachment to the organization, and engagement in extra-role activities that contribute to the organization's efficacy. This study is among the first to provide prospective data on the effects of organizational virtuousness. The results lead to a discussion of how organizations might shape a grateful, kind, and forgiving work culture using virtue-based management to achieve optimal individual and organizational functioning.
RESUMEN
This study investigated the prevalence and clustering patterns of multiple health-risk behaviors and their associations with non-communicable diseases among Chinese adults in Hong Kong. A large sample survey was conducted in all 18 districts of Hong Kong between 21 June and 31 August 2021. A total of 5737 adults completed the survey. Overall, 4605 (80.3%) had at least one health-risk behavior and 2696 (47.0%) had two or more health-risk behaviors. Multiple health-risk behaviors were more prevalent among men. The prevalence of smoking and alcohol consumption among Hong Kong Chinese women was considerably lower than in most Western countries. In contrast to previous findings, this study revealed that a high proportion of adults with high educational attainment or household income had multiple health-risk behaviors. In addition, this study revealed that the health-risk behaviors in Chinese adults co-occurred in clusters, with smoking and alcohol consumption co-occurring with other health-risk behaviors. Those who smoked or consumed alcohol had the highest proportion of multiple health-risk behaviors and the highest proportion of non-communicable diseases. The findings of this study add further evidence that health-risk behaviors co-occur in clusters and can contribute to non-communicable diseases.
Asunto(s)
Enfermedades no Transmisibles , Adulto , Consumo de Bebidas Alcohólicas/epidemiología , Femenino , Conductas de Riesgo para la Salud , Hong Kong/epidemiología , Humanos , Masculino , Asunción de RiesgosRESUMEN
Tenosynovial giant cell tumor (TGCT) is a benign condition that arises from tendon sheaths, synovium, or bursae and is classified according to the site of involvement (intra-articular versus extra-articular) and pattern of growth (localized versus diffuse). The diffuse form tends to present as peri-articular masses and are locally aggressive. It usually presents as a mono-articular process affecting larger joints. Spinal involvement is extremely rare, particularly the cervical spine. In this case report, we present a pediatric case of spinal TGCT involving the C1-C2 joint which was incidentally detected in a 13-year-old girl undergoing surveillance for medulloblastoma recurrence. Although spinal TGCT is a benign condition, it remains a diagnostic challenge, which specific to our case can raise the concern for malignancy or metastasis. We also described a percutaneous biopsy approach using a spring-loaded blunt tip coaxial needle to avoid inadvertent vascular injury. The imaging features of spinal TGCT and biopsy approach for atlantoaxial lesion are discussed together with a comprehensive review of the literature.
Asunto(s)
Articulación Atlantoaxoidea , Neoplasias Cerebelosas , Tumor de Células Gigantes de las Vainas Tendinosas , Meduloblastoma , Adolescente , Articulación Atlantoaxoidea/diagnóstico por imagen , Articulación Atlantoaxoidea/patología , Vértebras Cervicales/diagnóstico por imagen , Vértebras Cervicales/patología , Niño , Femenino , Tumor de Células Gigantes de las Vainas Tendinosas/diagnóstico por imagen , Tumor de Células Gigantes de las Vainas Tendinosas/cirugía , Humanos , Meduloblastoma/diagnóstico por imagen , Meduloblastoma/cirugíaRESUMEN
Multimorbidity is associated with increased depression risks. Little research examines how physical exercise moderates this association. From an existing cohort of community-dwelling older adults in Hong Kong recruited in 2001-2003, the authors included participants who were successfully interviewed after 14 years (2015-2017). Geriatric depressive symptoms were used as the primary outcome and measured by the 15-item Geriatric Depression Scale, while multimorbidity was operationalized using a list of 19 conditions. Subscores of the Physical Activity Scale for the Elderly measuring light, moderate, and strenuous sport/recreational activities were included as moderators. In total, 1,056 participants were included, of whom 50.7% were multimorbid. Multimorbidity was associated with 12% more geriatric depressive symptoms, but strenuous physical activities were associated with a smaller risk elevation only among multimorbid patients (adjusted relative risk = 0.99, 95% confidence interval [0.98, 0.99]; p = .001). In conclusion, strenuous sport and recreational activities may attenuate the association between multimorbidity and geriatric depressive symptoms.
Asunto(s)
Depresión , Multimorbilidad , Anciano , Depresión/epidemiología , Ejercicio Físico , Estudios de Seguimiento , Humanos , Vida IndependienteRESUMEN
Ultrasound (US) has been increasingly used as an important imaging tool to assess the urethra in children. The earliest reports of pediatric urethral sonography involved imaging the urethra in a non-voiding state, during physiological voiding of urine, and after instillation of saline. The introduction of US contrast agents has continued to improve visualization of urethral anatomy. Contrast-enhanced US of the urethra can be performed during the voiding phase of a standard contrast-enhanced voiding urosonography (ceVUS) exam or with retrograde instillation of a contrast agent, depending on the exam indication. Both techniques are well tolerated by children and provide accurate information about urethral pathology and periurethral soft tissues. This article reviews the technical aspects and imaging findings of urethral pathologies in children using contrast-enhanced US, both by the voiding and retrograde instillation techniques.
Asunto(s)
Uretra , Micción , Niño , Medios de Contraste , Diagnóstico por Imagen , Humanos , Masculino , Ultrasonografía , Uretra/diagnóstico por imagenRESUMEN
Contrast-enhanced voiding urosonography (ceVUS) is a well-established, sensitive and safe ultrasound (US) modality for detecting and grading vesicoureteral reflux (VUR) and urethral imaging in children. Nearly three decades of remarkable advances in US technology and US contrast agents have refined ceVUS's diagnostic potential. The recent approval of Lumason/SonoVue in the United States, Europe and China for pediatric intravesical applications marked the beginning of a new era for this type of contrast US imaging. Consequently, the use of ceVUS in children has expanded to multiple places around the globe. In the first part of this review article, we describe the current experience in the use of ceVUS for VUR evaluation, with an emphasis on historical background, examination technique, image interpretation and diagnostic accuracy. In the second part, we will present the role of ceVUS for urethral imaging in children.
Asunto(s)
Reflujo Vesicoureteral , Niño , Medios de Contraste , Humanos , Lactante , Masculino , Ultrasonografía , Uretra , Micción , Reflujo Vesicoureteral/diagnóstico por imagenRESUMEN
Kenny-Caffey syndrome (KCS) type 2 (OMIM 127000) is a rare syndromic cause of hypoparathyroidism which is characterized by proportionate short stature, long bone abnormalities, delayed closure of anterior fontanelle, eye abnormalities, and normal intelligence. It is caused by variants in FAM111A (NM_001942519.1). In this review, we reported the first Chinese patients, a pair of monozygotic twins, with genetically confirmed KCS type 2 with over 20 years follow-up. We summarized the clinical features of 14 previously reported and genetically confirmed KCS type 2 patients; our twin patients exhibited a unique spinal manifestation which could be an important age-dependent feature of KCS type 2. In this review, over 60% KCS type 2 patients had dental problem and over 80% suffered from refractive errors or structural eye abnormalities. Therefore, early dental, ophthalmological, and orthopedic assessments are warranted for KCS type 2 patients. Micro-orchidism, previously reported in KCS type 2 patients, was also detected in our patients. The possibility of subfertility should be considered in male KCS type 2 patients. A multidisciplinary management approach for this rare syndrome is recommended.
Asunto(s)
Anomalías Múltiples/genética , Enanismo/genética , Anomalías del Ojo/genética , Hiperostosis Cortical Congénita/genética , Hipocalcemia/genética , Receptores Virales/genética , Anomalías Múltiples/diagnóstico , Anomalías Múltiples/epidemiología , Anomalías Múltiples/fisiopatología , Adulto , China/epidemiología , Enanismo/diagnóstico , Enanismo/epidemiología , Enanismo/fisiopatología , Anomalías del Ojo/diagnóstico , Anomalías del Ojo/epidemiología , Anomalías del Ojo/fisiopatología , Femenino , Humanos , Hiperostosis Cortical Congénita/diagnóstico , Hiperostosis Cortical Congénita/epidemiología , Hiperostosis Cortical Congénita/fisiopatología , Hipocalcemia/diagnóstico , Hipocalcemia/epidemiología , Hipocalcemia/fisiopatología , Masculino , Persona de Mediana Edad , Fenotipo , Gemelos/genéticaRESUMEN
Objective: This study tested the interactive relationships between college students' perceived capability of regulating negative emotions and savoring positive emotions on mental health outcomes, including anxiety and depressive symptoms. Participants: Participants were healthy undergraduates (n = 167) recruited from two universities in Hong Kong. Methods: Students completed four scales assessing their perceived capability of using strategies to regulate negative and positive emotions and their anxiety and depressive symptoms. Results: Findings revealed that both anxiety and depressive symptoms were negatively linked to perceived capabilities of regulating negative emotions and savoring positive emotions. Furthermore, regulating negative emotions interacted with savoring positive emotions to predict anxiety symptoms. Conclusions: The need to simultaneously perform negative and positive emotion regulation is highlighted. The results suggest the priority of regulating negative emotions over savoring positive emotions in alleviating anxiety symptoms. Nevertheless, enhancing positive emotion shows greater benefits for those who are less adept at regulating negative emotions.
Asunto(s)
Regulación Emocional/fisiología , Salud Mental/estadística & datos numéricos , Estudiantes/psicología , Adolescente , Adulto , Ansiedad/epidemiología , Depresión/epidemiología , Emociones/fisiología , Femenino , Hong Kong/epidemiología , Humanos , Masculino , Universidades , Adulto JovenRESUMEN
PURPOSE: Fatigue is the most common concern reported by childhood cancer survivors. Assessing its occurrence and severity is a prerequisite for planning and evaluating appropriate interventions. Nevertheless, there is a lack of large-scale surveys which examine the occurrence and severity of fatigue and its associated factors. The study aimed to shed light on this under researched area. METHODS: A cross-sectional study was used. A total of 400 childhood cancer survivors (7- to 18-year olds) were invited to participate in the study. The cancer-related fatigue, depressive symptoms, physical activity level, and quality of life of participants were assessed. RESULTS: An average of 46.4% of children and 48.4% of adolescents were found to display symptoms of cancer-related fatigue between "half the time" and "all the time" over the previous seven days. Besides, greater occurrence and severity of fatigue in childhood cancer survivors were associated with more self-reported depressive symptoms, lower level of physical activity and quality of life. In addition, the study revealed that physical activity level is a significant factor associated with cancer-related fatigue. CONCLUSION: The findings provide further support that cancer and its treatment have adverse effects on survivors' fatigue, which can manifest months or even years after the completion of treatment. Importantly, this study reveals that physical activity is a significant factor associated with fatigue in children and adolescents. It is crucial for healthcare professionals to identify strategies that can help children and adolescents surviving cancer increase their adoption and maintenance of regular activity throughout their life.
Asunto(s)
Pueblo Asiatico/psicología , Supervivientes de Cáncer/psicología , Depresión/etnología , Ejercicio Físico , Fatiga/etnología , Calidad de Vida , Adolescente , Factores de Edad , Niño , China , Estudios Transversales , Depresión/diagnóstico , Fatiga/diagnóstico , Femenino , Humanos , Masculino , Neoplasias/etnología , Neoplasias/enfermería , Neoplasias/psicología , Encuestas y CuestionariosRESUMEN
BACKGROUND: The effects of hematologic cancer and its treatment on Chinese children's physical activity level and quality of life (QoL) remain unclear despite numerous studies conducted in Western countries and Hong Kong. OBJECTIVE: The aim of this study was to examine the effects of hematologic cancer and its treatment on the physical activity level and QoL among Chinese children. METHODS: A cross-sectional study was conducted. One hundred twenty-five children who were admitted for treatment of hematologic cancer and 243 healthy counterparts of similar age participated in this study. All participants were asked to complete the Chinese University of Hong Kong: Physical Activity Rating for Children and Youth and Pediatric Quality of Life Inventory. The children with hematologic cancer also completed a therapy-related symptom checklist. RESULTS: There were statistically significant differences in the mean physical activity and QoL between children with hematologic cancer and their healthy counterparts. Multiple regression analyses showed that physical activity levels and the adverse effects of hematologic cancer treatment had statistically significant effects on the children's QoL. CONCLUSIONS: Physical activity level and QoL in children with hematologic cancer were both lower than those in their healthy counterparts. IMPLICATIONS FOR PRACTICE: This study provides further evidence that hematologic cancer and the adverse effects of its treatment have negative effects on Chinese children's QoL. Although a lack of physical activity is deeply embedded in Chinese culture, nurses should take a proactive role in effecting change by educating parents about the benefits to their children's physiologic and psychological well-being of physical activity during and after treatment.
Asunto(s)
Pueblo Asiatico/psicología , Pueblo Asiatico/estadística & datos numéricos , Ejercicio Físico/psicología , Neoplasias Hematológicas/psicología , Neoplasias Hematológicas/terapia , Calidad de Vida/psicología , Adolescente , Niño , China , Estudios Transversales , Femenino , Hong Kong , Humanos , Masculino , Análisis de RegresiónRESUMEN
Posterior reversible encephalopathy syndrome (PRES) is a well-documented pathology of the brain in systemic upsets. Majority of PRES cases present with edema in the cerebrum, most commonly in the territory of posterior circulation. It has been reported to show spinal cord involvement in a rare subgroup known as PRES with spinal cord involvement (PRES-SCI), with very limited existing literature even in adult patients. Our institution recently encountered a pediatric case with neurofibromatosis type I (NF 1) showing PRES with extensive reversible spinal cord changes. This case illustrates the features of this rare entity in the pediatric group of patients, and is the first reported case in NF 1 patients.
RESUMEN
Mediated moderation (meMO) occurs when the moderation effect of the moderator (W) on the relationship between the independent variable (X) and the dependent variable (Y) is transmitted through a mediator (M). To examine this process empirically, 2 different model specifications (Type I meMO and Type II meMO) have been proposed in the literature. However, both specifications are found to be problematic, either conceptually or statistically. For example, it can be shown that each type of meMO model is statistically equivalent to a particular form of moderated mediation (moME), another process that examines the condition when the indirect effect from X to Y through M varies as a function of W. Consequently, it is difficult for one to differentiate these 2 processes mathematically. This study therefore has 2 objectives. First, we attempt to differentiate moME and meMO by proposing an alternative specification for meMO. Conceptually, this alternative specification is intuitively meaningful and interpretable, and, statistically, it offers meMO a unique representation that is no longer identical to its moME counterpart. Second, using structural equation modeling, we propose an integrated approach for the analysis of meMO as well as for other general types of conditional path models. VS, a computer software program that implements the proposed approach, has been developed to facilitate the analysis of conditional path models for applied researchers. Real examples are considered to illustrate how the proposed approach works in practice and to compare its performance against the traditional methods. (PsycINFO Database Record
Asunto(s)
Interpretación Estadística de Datos , Modificador del Efecto Epidemiológico , Modelos Estadísticos , Psicología/métodos , HumanosRESUMEN
To facilitate effective tobacco control, it is important to identify the socioeconomic strata in which different quitting motives are more strongly associated with cessation. This study aims to examine such a moderating role of socioeconomic background. A total of 2022 past or current daily smoking men from the Hong Kong Thematic Household Survey 2010 who had attempted for cessation were analyzed. Binary socioeconomic indicators, quitting motives, and 1-year abstinence were entered in an exploratory backward-stepwise log-linear model, followed by a binary logistic regression to estimate the probability of one-year abstinence in each socioeconomic stratum. Results suggest that the association between cessation and health motives is stronger in less educated men ( P = .004) and nonmarried men ( P = .003). The estimated probability of cessation ranges from 0.02 (95% CI = 0.00-0.06) to 0.96 (95% CI = 0.89-1.00). Accordingly, policy makers should educate less-educated men and nonmarried men about the adverse health impacts of tobacco use.
Asunto(s)
Motivación , Cese del Hábito de Fumar/psicología , Cese del Hábito de Fumar/estadística & datos numéricos , Fumar/psicología , Adolescente , Adulto , Estudios de Cohortes , Escolaridad , Hong Kong , Humanos , Masculino , Estado Civil/estadística & datos numéricos , Persona de Mediana Edad , Factores Socioeconómicos , Adulto JovenRESUMEN
AIMS AND OBJECTIVES: To explore the factors contributing to the low physical activity level for Hong Kong Chinese children hospitalised with cancer. BACKGROUND: Notwithstanding the fact that regular physical activity can ameliorate cancer-related fatigue and other adverse effect of cancer treatment on children's physical and psychological well-being, physical inactivity is a common problem among children undergoing cancer treatment. Understanding the factors that affect their physical activity level is an important step towards planning and evaluating an appropriate intervention that promotes the adoption and maintenance of regular physical activity. DESIGN: A phenomenological design was used in this qualitative study. METHODS: A purposive sample of 25 children with cancer was recruited in a paediatric oncology unit of an acute care public hospital in Hong Kong. They were asked to participate in a semistructured interview by their bedside lasting about 30 minutes. All the interviews were tape-recorded and immediately transcribed. Content analysis was used to analyse the qualitative data. RESULTS: The findings revealed that the patients' physical condition, misunderstanding about physical activity by children, parents and healthcare professionals, emotional disturbances and social influences are four important factors impeding children from engaging in regular physical activity during cancer treatment. CONCLUSION: This study addresses a gap in the literature by identifying the factors that negatively influence the physical activity levels of Hong Kong Chinese children hospitalised with cancer. RELEVANCE TO CLINICAL PRACTICE: Understanding these factors, nurses can explore interventions that target on correcting the misunderstanding and providing relevant information about the importance of physical activity, eventually promoting the adoption and maintenance of regular physical activity and enhancing the quality of life.
Asunto(s)
Niño Hospitalizado/psicología , Ejercicio Físico , Neoplasias/psicología , Calidad de Vida , Adolescente , Pueblo Asiatico , Niño , China , Femenino , Humanos , Entrevistas como Asunto , Masculino , Neoplasias/enfermeríaRESUMEN
The practice guidelines aimed to identify appropriate nursing management for the prevention and treatment of tumor lysis syndrome, in line with the current evidence-based medical guidelines. Using a systematic approach, 15 relevant articles were identified for the review. The evaluation of patient risk factors for tumor lysis syndrome and the appropriate medical and nursing assessment were identified. The treatment algorithms for the prevention of tumor lysis syndrome from both the medical and nursing perspectives have been established. In particular, the guidelines highlight the importance of pediatric oncology nurses in contributing to the prevention and management of tumor lysis syndrome.
Asunto(s)
Antineoplásicos/efectos adversos , Neoplasias/complicaciones , Neoplasias/tratamiento farmacológico , Síndrome de Lisis Tumoral/etiología , Síndrome de Lisis Tumoral/enfermería , Niño , Humanos , Evaluación en Enfermería , Enfermería Oncológica/métodos , Enfermería Pediátrica/métodos , Factores de Riesgo , Síndrome de Lisis Tumoral/prevención & controlRESUMEN
BACKGROUND: Physical activity is of paramount importance to enhance the quality of life of childhood cancer survivors. OBJECTIVE: The objectives of this study were to examine the sustainability, feasibility, and acceptability of an adventure-based training and health education program in changing the exercise behavior and enhancing the physical activity levels, self-efficacy, and quality of life of childhood cancer survivors. METHODS: A follow-up study (12 and 18 months) of a previous study was conducted. Participants in the experimental group (n = 33) joined a 4-day integrated adventure-based training and health education program. The control group (n = 36) received the standard medical care. Changes in exercise behavior, levels of physical activity, self-efficacy, and quality of life were assessed from the time of recruitment, and at 12 and 18 months after starting the intervention. Process evaluation was conducted to determine whether the program was feasible and acceptable to participants. RESULTS: From baseline to 18 months after the intervention, the experimental group reported statistically significant differences in the stages of change in physical activity and higher levels of physical activity, self-efficacy, and quality of life than did the control group. The results of process evaluation revealed that the program was both feasible and acceptable to participants. CONCLUSIONS: The program was found to have substantial effects on enhancing the physical activity levels, self-efficacy, and quality of life of childhood cancer survivors over at least 18 months. IMPLICATIONS FOR PRACTICE: Healthcare professionals should consider adopting such programs to promote the regular physical activity among childhood cancer survivors.
Asunto(s)
Ejercicio Físico/psicología , Promoción de la Salud/métodos , Neoplasias/psicología , Educación del Paciente como Asunto/métodos , Sobrevivientes/psicología , Niño , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Hong Kong , Humanos , Masculino , Neoplasias/terapia , Evaluación de Programas y Proyectos de Salud , Calidad de Vida , Autoeficacia , Sobrevivientes/estadística & datos numéricosRESUMEN
BACKGROUND: There is growing concern about declining levels of physical activity in childhood cancer survivors. This study aimed to examine the effectiveness of an integrated adventure-based training and health education program in promoting changes in exercise behavior and enhancing the physical activity levels, self-efficacy, and quality of life of Hong Kong Chinese childhood cancer survivors. METHODS: A randomized controlled trial, two-group pretest and repeated post-test, between-subjects design was conducted to 71 childhood cancer survivors (9- to 16-year-olds). Participants in the experimental group joined a 4-day integrated adventure-based training and health education program. Control group participants received the same amount of time and attention as the experimental group but not in such a way as to have any specific effect on the outcome measures. Participants' exercise behavior changes, levels of physical activity, self-efficacy, and quality of life were assessed at the time of recruitment, 3, 6, and 9 months after starting the intervention. RESULTS: Participants in the experimental group reported statistically significant differences in physical activity stages of change (p < 0.001), higher levels of physical activity (p < 0.001) and self-efficacy (p = 0.04) than those in the control group. Besides, there were statistically significant mean differences (p < 0.001) in physical activity levels (-2.6), self-efficacy (-2.0), and quality of life (-4.3) of participants in the experimental group from baseline to 9 months after starting the intervention. CONCLUSIONS: The integrated adventure-based training and health education program was found to be