Mindfulness and acceptance-based training for elite adolescent athletes: a mixed-method exploratory study.

Objectives: This study aimed to examine the effectiveness of a specifically designed mindfulness-acceptance-insight-commitment (MAIC) training program on relevant psychological factors (i.e., mindfulness, acceptance, performance-related satisfaction) as well as sport training performance for elite adolescent athletes from Hong Kong. And it also aimed to explore the athletes' real experiences (i.e., receptiveness and perceptions) of completing the MAIC program. Methods and design: The mixed-method was used in this study, including a randomized controlled trial (RCT) and a qualitative exploration. The RCT employed a 2 (groups) x 3 (data collection points) design involving 40 elite adolescent athletes from the Hong Kong Sports Institute (HKSI). These athletes were randomly assigned to either the MAIC training group (MT; n = 20, Mage = 15.65) or the control group (CG; n = 20, Mage = 15.85) to further test the effectiveness of the MAIC intervention on mindfulness, acceptance, performance-related satisfaction, and sport training performance. Subsequent to the RCT, the qualitative exploration was used to explore the athletes' real experiences towards the MAIC program. In the qualitative exploration, all athletes who participated in the MAIC program were invited to participate in voluntary semi-structured interviews. Of these, 14 athletes chose to take part in the interviews. The RCT employed a 2×3 mixed-design ANOVA, while thematic analysis was applied to the qualitative exploration. Results: The results revealed that the MAIC training program significantly enhanced athletes' mindfulness, acceptance, satisfaction with performance, and sport training performance. However, these effects diminished at the follow-up assessment compared to post-training. Notably, the acceptance level of MT athletes did not significantly differ from CG athletes at the follow-up assessment. Additionally, the qualitative analysis identified four key dimensions: (a) Attitude towards MAIC training, (b) Reflection on the MAIC learning process, (c) Outcomes of MAIC training, and (d) Recommendations for future MAIC training. Overall, the qualitative findings complemented and reinforced the quantitative results, offering deeper insights into athletes' experiences and valuable suggestions for further enhancing the MAIC program. Conclusion: The findings suggested that the specifically designed MAIC training program in this study effectively enhanced sport training performance and various psychological factors among elite adolescent athletes from Hong Kong. Nevertheless, further investigations are still required to comprehensively evaluate and further develop the MAIC training program.

Associations of Reallocating Sedentary Time to Physical Activity and Sleep with Physical and Mental Health of Older Adults.

INTRODUCTION: 24-hour movement behaviors: moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SB) and sleep are crucial factors affecting older adults' health. Using a compositional data analysis approach, this study examined the associations of time spent in these four movement behaviors with cardiometabolic health, physical fitness, and mental health among older adults. Furthermore, this study identified the estimated changes in aforementioned health outcomes by reallocating SB time to other movement behaviors. METHODS: A population-based cross-sectional study of 4,562 participants (67.68 ± 5.03 years; 55.8% female) were implemented in Hubei China between 25-Jul and 19-Nov 2020. Measures included demographics, movement behaviors, cardiometabolic indicators (body mass index, BMI; waist circumference; waist-hip ratio, WHR; percentage body fat; systolic and diastolic blood pressure), physical fitness, and mental health outcomes (depressive symptoms and loneliness). Compositional data analyses were implemented in R. RESULTS: MVPA and sleep time was associated with greater health outcomes (all P < 0.001), except blood pressure (P = 0.13-0.83). LPA time was associated with waist circumference (B = 0.313, P = 0.009), WHR (B = 0.003, P = 0.003), physical fitness (B = 0.36, P < 0.001), and mental health indicators (both P < 0.001). Reallocating 30-min SB to MVPA and sleep was associated with predicated improvements in all health outcomes, except blood pressure, while reallocating 30-min SB to LPA resulted in predicted improvements in physical fitness (0.187 units), depressive symptoms (-0.264 units) and loneliness (-0.395 units). For dose-effect relationships, reallocating 5-60 min of SB to MVPA showed greatest benefits for all health outcomes. CONCLUSIONS: This study provides timely empirical evidence for future interventions and policymaking on promoting healthy aging during the post-covid-19 era. The findings underline the importance of including 24-hour movement behaviors in future health promotion among older adults.

Mental health literacy, mental health experiences and help-seeking behaviours of Chinese elite athletes: a qualitative study.

Introduction: Elite athletes' help-seeking on mental health might be influenced by their mental health literacy (MHL) and mental health experiences. The current study aimed to explore the MHL, experiences and help-seeking behaviours among elite athletes using a qualitative approach. Methods: Face-to-face semi-structured interviews were conducted among 20 Chinese elite athletes, 12 coaches, and 5 team officials. Interview data was analyzed using content analysis. Results: Seven main themes emerged from the analysis. The current study revealed that Chinese elite athletes suffered from various mental health issues and athletes' MHL levels, help-seeking attitudes and intentions, Chinese sports environments, and Chinese cultural background could impact their help-seeking behaviours. Conclusion: Support for Chinese elite athletes' mental health and help-seeking requires improvement.

Effects of a School-Based Physical Activity Intervention for Obesity, Health-Related Physical Fitness, and Blood Pressure in Children with Intellectual Disability: A Randomized Controlled Trial.

Children with intellectual disability (ID) are more vulnerable to health conditions than their typically developing peers. Evidence of effective interventions is scarce. A randomized controlled trial was conducted in 30 overweight and obese children with intellectual disability (ID) in China to evaluate a 12-week school-based physical activity intervention for obesity, health-related physical fitness (HRPF), and blood pressure. The intervention consisted of 24 physical activity (PA) sessions (2 sessions/week, 60 min/session), with exercise intensity progressively increasing from a moderate level to a vigorous level. All participants were followed up for 12 weeks after the intervention period to evaluate sustained effects. Outcomes were repeatedly measured at baseline, after the intervention, and after follow-up. The intervention was effective in reducing some obesity-related outcomes (including weight and body mass index) and improving some HRPF-related outcomes (including the 6 min walk test and the 30 s sit-to-stand test), with the significant effects being sustained after the 12-week follow-up. No effect was observed on blood pressure. The findings of this study contribute to the development and implementation of PA interventions to reduce obesity and improve HRPF in children with ID.

Further Examination of the Psychometric Properties of the Multicomponent Mental Health Literacy Scale: Evidence from Chinese Elite Athletes.

This study aimed to examine the psychometric properties of the Multicomponent Mental Health Literacy Scale (MMHLS) among Chinese elite athletes. Particularly, the factorial validity, convergent validity, discriminant validity, concurrent validity, internal-consistency reliability, and test-retest reliability of the MMHLS were examined. A total of 320 participants were recruited from the Guangdong provincial sports training center in China. Data collection was conducted between 30 June and 31 July 2020 using electronic questionnaires. Confirmatory factor analysis (CFA), Rasch analysis, correlation analysis and independent-sample t-tests were conducted using Mplus 8.3 and ConQuest 2.0. The CFA results supported the factorial validity of the three-dimensional MMHLS, consisting of knowledge-oriented MHL, beliefs-oriented MHL, and resource-oriented MHL. Cronbach's alpha and composite reliability coefficients supported the internal-consistency reliability of the MMHLS. Moreover, the convergent and discriminant validities were supported for the subdimension of MHL-Knowledge, MHL-Beliefs, and MHL-Resources. Concurrent validity was demonstrated through correlations between MMHLS, help-seeking attitudes, and stigma. Rasch analysis provided further evidence of the psychometric quality of the instrument in terms of its dimensionality, item fit statistics, and rating scale effectiveness. Finally, test-retest reliability was 0.66 after one month. In conclusion, the 24-item three-dimensional MMHLS was verified to be a reliable and valid measurement of mental health literacy in Chinese elite athletes.

Effects of a School-Based Physical Activity Intervention for Obesity and Health-Related Physical Fitness in Adolescents With Intellectual Disability: Protocol for a Randomized Controlled Trial.

BACKGROUND: Childhood obesity accompanied by lower levels of health-related physical fitness (HRPF) is a major threat to public health both internationally and locally. Children with intellectual disability, especially adolescents, have a higher risk of being overweight/obese and having poor HRPF levels. Therefore, more interventions are needed to help this population attain their optimal health levels. However, there has been relatively limited research on this population compared with on their typically developing peers. OBJECTIVE: The proposed study aims to fill this knowledge gap by developing and examining the success of a physical activity (PA) intervention for the target population. METHODS: The proposed study will be a 12-week, school-based randomized controlled trial. The participants (N=48) will be recruited from special schools for students with mild intellectual disability and then randomly allocated to either the intervention group (IG) or the wait-list control group (CG). During the intervention period, the participants in the IG will receive a fun game-based moderate-to-vigorous PA (MVPA) training program (2 sessions/week, 60 minutes/session, for a total of 24 sessions). The intensity of the activities will increase in a progressive manner. Participants in the CG will receive no program during the study period, but the same PA program will be provided to them after the completion of the study. To observe and evaluate the sustaining effects of the intervention, follow-up testing will be scheduled for the participants 12 weeks after the intervention concludes. The study outcomes will include primary outcomes (obesity- and fitness-related outcomes) and a secondary outcome (blood pressure). All of the measurements will be taken at 3 time points. After the follow-up tests, the same PA training program will be provided to the participants in the CG. RESULTS: This study is ongoing. The participants were recruited from October 2020 to November 2020. The total duration of the study is 13 months. Study results are expected at the end of 2021. CONCLUSIONS: The proposed study is expected to reduce obesity and improve HRPF levels in children with intellectual disability. If proven effective, the intervention will be made accessible to more special schools and mainstream schools with students with intellectual disability. Furthermore, the study can serve as an example for international researchers, policy makers, and members of the public who are seeking to tackle the problem of obesity and poor HRPF among children with intellectual disability. TRIAL REGISTRATION: ClinicalTrials.gov NCT04554355; https://www.clinicaltrials.gov/ct2/show/NCT04554355. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/25838.

Mental Health Literacy Intervention on Help-Seeking in Athletes: A Systematic Review.

Mental health literacy (MHL) is recognised as a major factor in whether athletes seek help when they experience mental health difficulties. Therefore, the current study aimed to provide a systematic review of the effectiveness of MHL training programmes in improving mental health knowledge and help-seeking and reducing stigma among athletes. To identify intervention studies of MHL programmes, five electronic databases were systematically searched for articles published before May 2020. The selection procedure was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All kinds of study designs were included. Effect sizes were calculated for mental health knowledge, stigma reduction and help-seeking attitudes, intentions and behaviours. Risk of bias was assessed for each study using the Cochrane tool and the Newcastle-Ottawa quality assessment scale. Five studies (1239 participants in total) were selected for review. Overall, either small or medium effects were found for mental health knowledge, stigma reduction, help-seeking attitudes, and intentions for post- and follow-up interventions, whereas a null effect was found in help-seeking behaviours for both post- and follow-up interventions. Furthermore, three studies had a low risk of bias, and two had a high risk of bias. MHL interventions can enhance help-seeking attitudes and intentions and mental health knowledge and reduce stigma but do not increase help-seeking behaviours for now. Further studies should evaluate interventions to enhance help-seeking behaviours. Furthermore, the methodological quality of studies, including randomized controlled trials and other designs, should be improved in future research.