A realist evaluation of a multi-component program with disengaged students.

Periods spent in the absence of education, employment, or training (NEET) are associated with adverse psychological wellbeing, social marginalisation, and premature mortality. Implementing effective programs to re-engage young people who are classified, or are at risk of becoming NEET, is of importance to these individuals, family, and society. We conducted a realist evaluation to understand how, and under which circumstances a multi-component program may impact the engagement, behavioural, and psychosocial outcomes of disengaged students at risk of becoming NEET. During the early project phase, a narrative review of the literature and key stakeholder discussions were conducted to develop our initial program theories regarding how the program was expected to achieve its outcomes. Participant observations, video footage, and forty-two interviews were then conducted with teachers and students to form context-mechanism-outcome configurations and to refine these theories. Overall, refined program theories relating to positions of authority, the power of collective experience, exploration of possible life directions, constructivist pedagogies and active learning, and the endorsement of an ethic of caring and strengths-based orientation were developed. Collectively, our findings provide a detailed understanding of the architecture of programs that may benefit disengaged students and help inform the design of future programs aimed at reducing disaffection.

Wellbeing in high-performance swimming: A grounded theory study.

The demands of elite sport have the potential to negatively impact on athletes' wellbeing (e.g., Arnold & Fletcher, 2012; Rice et al., 2016). Despite this, not all elite athletes experience detrimental effects, rather some individuals thrive in an elite sports environment. The reasons why some athletes experience positive wellbeing while others struggle remains unclear although, in part, due to methodological limitations of previous research. To overcome these limitations, the purpose of the current study was to examine how change in high-performance swimmers' wellbeing occurs. Grounded theory methodology was used to enable examination of processes of change. Semi-structured interviews with 22 current and five retired swimmers, eight coaches, and seven support staff were used to generate data alongside observations and field notes. The resultant theory illustrated how a dominant performance narrative influenced the development and maintenance of an exclusive swimmer identity that was tied to performance. Specifically, transitions were highlighted as critical points where wellbeing was likely to be affected, due to the increased potential for change and uncertainty to impact on performance and subsequently identity. However, the use of proactive coping strategies, such as anticipating and planning, as well as accessing and utilising appropriate support were shown to help minimise the impact on wellbeing.

Evaluating the Effect of Kaftrio on Perspectives of Health and Wellbeing in Individuals with Cystic Fibrosis.

BACKGROUND: Modulator therapy represents a significant step forward in CF care and is expected to have a significant impact on the health and mortality of many individuals with CF. Studies have predominantly explored the physiological effects of modulator therapy on clinical outcomes, with little consideration of the individual lived experience of modulator therapy among adults with Cystic Fibrosis. METHODS: To explore this, semi-structured interviews were conducted with 12 individuals currently taking Kaftrio, which were subsequently thematically analysed. RESULTS: Three overarching themes were identified: (i) positive perception of Kaftrio, (ii) negative perception of Kaftrio, and (iii) the relationships with the clinical team. The experience of modulator therapy should be recognised as being unique to the individual, with perceptions of illness, self-identity, and outcomes strongly dictating the lived experience. CONCLUSIONS: There is a consensus that, while for many, the quality of life is evidently increased through the use of Kaftrio, this is not without its own challenges. This highlights the need for both individuals with CF and their clinical teams to learn to navigate this new disease landscape.

Time-efficient and computer-guided sprint interval exercise training for improving health in the workplace: a randomised mixed-methods feasibility study in office-based employees.

BACKGROUND: The efficacy of high-intensity interval training (HIT) as a time-efficient exercise strategy for beneficially modifying risk factors for cardiovascular disease has repeatedly been demonstrated in controlled laboratory settings. However, the effectiveness of HIT in an unsupervised workplace setting has not been investigated. The objective of this study was to use mixed methods to investigate the feasibility, acceptability and effectiveness of a short-duration, high-intensity exercise intervention (REHIT) when applied unsupervised in a workplace setting. METHODS: Twenty-five office-workers (mean ± SD age: 47 ± 9 y, BMI: 27.5 ± 4.4 kg·m- 2, V̇O2max: 28 ± 7 mL·kg- 1·min- 1) completed a 6-week REHIT intervention unsupervised in their workplace (n = 13, 6 men), or acted as a no-intervention control (n = 12, 6 men). The intervention consisted of 2 sessions/week of low-intensity (~ 25 W) cycling interspersed with 2 'all-out' sprints, increasing in duration from 10 to 20 s per sprint over the 6 weeks (total time-commitment: 8:40 min per session). V̇O2max was assessed pre- and post-training, whilst questionnaire-based measures of exercise enjoyment, self-efficacy, and acceptability were completed post-training. Eight participants also completed post-intervention semi-structured interviews. RESULTS: V̇O2max significantly improved in the exercise group (2.25 ± 0.75 L·min- 1 vs. 2.42 ± 0.82 L·min- 1; + 7.4%) compared to the control group (2.22 ± 0.72 L·min- 1 vs. 2.17 ± 0.74 L·min- 1; - 2.3%; time*intervention interaction effect: p < 0.01). Participants considered the REHIT intervention acceptable and enjoyable (PACES: 89 ± 17 out of 119) and were confident in their ability to continue to perform REHIT (7.8 ± 1.2 out of 9). Qualitative data revealed that REHIT offered a time-efficient opportunity to exercise, that was perceived as achievable, and which encouraged highly valued post-exercise outcomes (e.g. progress towards health/fitness benefits). CONCLUSIONS: REHIT could be implemented as a feasible, effective and acceptable exercise intervention in a workplace setting, with a total time-commitment of < 20 min/week. Consideration of certain psycho-social factors and behaviour-change techniques may ensure adherence to the REHIT programme in the long term. TRIAL REGISTRATION: The study was registered on ClinicalTrials.gov on 07/05/2019 (registration: NCT03941145).

Midwives understanding of physical activity guidelines during pregnancy.

OBJECTIVE: to examine the current level of understanding held by midwives regarding the NICE physical activity guidelines in the UK, and to investigate the physical activity guidance given to women during pregnancy. DESIGN: an 11 question online survey comprising of a mixture of closed and open ended questions. SETTING: data reflects participants sampled across the United Kingdom. PARTICIPANTS: fifty-nine midwives completed the online survey MEASUREMENTS AND FINDINGS: an electronic survey was used to explore the midwives understanding of physical activity guidelines during pregnancy, and the advice they offered to women in their care. Qualitative content analysis was used to gain a more in-depth understanding of midwife knowledge. Two per cent of midwives correctly identified the physical activity guidelines, with 44% giving partially correct responses, 25% giving incorrect responses and 29% unsure of what the guidelines are. Despite the low level of correct responses, 59% of respondents reported they were confident or very confident in answering questions regarding physical activity. Only 4% of respondents reported having access to continual professional development (CPD) in the area of PA guidance. KEY CONCLUSIONS: there appears to be a misplaced confidence amongst midwives in their knowledge of the NICE PA guidelines for pregnancy. IMPLICATIONS FOR PRACTICE: as physical inactivity can be detrimental for the health of both mother and baby, there is a clear need for better dissemination of the current and future NICE physical activity guidelines in primary health care settings. The current study determined a substantial lack of CPD in the area of PA guidance, which may be a contributing factor to the lack of knowledge of the guidelines. As such, increasing CPD may in turn improve the accuracy of the advice given to pregnant women and consequently benefit the health of both mother and baby.

An exploration of pre-performance routines, self-efficacy, anxiety and performance in semi-professional soccer.

Whilst much research has suggested a positive link between pre-performance routines (PPRs) and performance, the specific mechanisms of the process have yet to be understood fully. It has been suggested that the PPR may influence performance through lowering the athlete's anxiety, and/or increasing their self-efficacy, but to date this has not specifically been explored in detail. As a result the aim of the current study was to explore the impact of specific individualised PPRs on performance, anxiety and self-efficacy in semi-professional soccer players. Participants were 20 male semi-professional soccer players (M = 19.45, SD = 2.81) recruited from clubs in England. Adopting a repeated measure design, players were tested on performance, anxiety, and self-efficacy pre- and post a 7-day intervention period in which the participants learnt a new PPR. The data were analysed using factorial mixed measures analysis of variance (ANOVAs), with the results revealing a significant difference in somatic anxiety for the experimental group and a decrease in performance for the control group. The study provides further support for the suggestion that the PPR can enhance performance by reducing experiences of anxiety prior to performance.