Distinguishing between translational science and translational research in CTSA pilot studies: A collaborative project across 12 CTSA hubs.

Introduction: The institutions (i.e., hubs) making up the National Institutes of Health (NIH)-funded network of Clinical and Translational Science Awards (CTSAs) share a mission to turn observations into interventions to improve public health. Recently, the focus of the CTSAs has turned increasingly from translational research (TR) to translational science (TS). The current NIH Funding Opportunity Announcement (PAR-21-293) for CTSAs stipulates that pilot studies funded through the CTSAs must be "focused on understanding a scientific or operational principle underlying a step of the translational process with the goal of developing generalizable solutions to accelerate translational research." This new directive places Pilot Program administrators in the position of arbiters with the task of distinguishing between TR and TS projects. The purpose of this study was to explore the utility of a set of TS principles set forth by NCATS for distinguishing between TR and TS. Methods: Twelve CTSA hubs collaborated to generate a list of Translational Science Principles questions. Twenty-nine Pilot Program administrators used these questions to evaluate 26 CTSA-funded pilot studies. Results: Factor analysis yielded three factors: Generalizability/Efficiency, Disruptive Innovation, and Team Science. The Generalizability/Efficiency factor explained the largest amount of variance in the questions and was significantly able to distinguish between projects that were verified as TS or TR (t = 6.92, p < .001) by an expert panel. Conclusions: The seven questions in this factor may be useful for informing deliberations regarding whether a study addresses a question that aligns with NCATS' vision of TS.

Development of a tool for quantifying need-supportive coaching in technology-mediated exercise classes.

Technology-mediated interventions to promote physical activity are growing in popularity and appear to be effective for supporting continued adherence for some people. Some of this efficacy may be related to the cultivation of motivation that is self-determined (i.e., autonomous), which is posited to arise from the satisfaction of three basic psychological needs: competence, relatedness, and autonomy. We developed an observational coding tool for quantifying the frequency of needs-supportive and needs-indifferent coaching during technology-mediated exercise classes. The Peloton Instructor Needs-Supportive Coaching (PINC) tool shows evidence of reliability (average kappa = .91). We also demonstrated the utility of the PINC for characterizing needs-supportive coaching profiles across 4 different types of classes (Beginner, Power Zone, Groove, and High-Intensity Interval Training) and the construct validity of the PINC with respect to examining the relationship of needs-supportive coaching to intrinsic motivation. The PINC offers a useful tool with which future studies could evaluate whether and how instructor coaching impacts self-determined motivation to exercise within a technology-mediated context.

Formative Evaluation of a Student Symptom Decision Tree for COVID-19.

Objectives: In support of schools restarting during the COVID-19 pandemic, some schools partnered with local experts in academia, education, community, and public health to provide decision-support tools for determining what actions to take when presented with students at risk for spreading infection at school. Methods: The Student Symptom Decision Tree, developed in Orange County, California, is a flow chart consisting of branching logic and definitions to assist school personnel in making decisions regarding possible COVID-19 cases in schools which was repeatedly updated to reflect evolving evidence-based guidelines. A survey of 56 school personnel evaluated the frequency of use, acceptability, feasibility, appropriateness, usability, and helpfulness of the Decision Tree. Results: The tool was used at least 6 times a week by 66% of respondents. The Decision Tree was generally perceived as acceptable (91%), feasible (70%), appropriate (89%), usable (71%) and helpful (95%). Suggestions for improvement included reducing the complexity in content and formatting of the tool. Conclusions: The data suggest that school personnel found value in the Decision Tree, which was intended to assist them with making decisions in a challenging and rapidly evolving pandemic.

The Relationship Between Exercise Habits and Stress Among Individuals With Access to Internet-Connected Home Fitness Equipment: Single-Group Prospective Analysis.

BACKGROUND: Physical activity (PA) confers numerous benefits to health and health care costs, yet most adults are not meeting recommended PA guidelines. Stress may be a factor that influences PA behavior. Research investigating the impact of stress on PA has yielded inconsistent findings. Most studies find that stress negatively impacts PA, but there is some evidence that habitual exercising buffers this association. OBJECTIVE: This study aims to examine the relationship between stress and exercise habits among habitual exercisers with internet-connected home fitness equipment (Peloton Bike) during the COVID-19 lockdown. METHODS: Participants were recruited through Facebook (N=146) and asked to complete an internet-based survey that assessed COVID-19-related stressors, perceived stress associated with those stressors, and general perceived stress. Self-reported exercise was assessed on the survey using the Godin Leisure-time Exercise Questionnaire (GLTEQ). Participants were also asked for consent to access their Peloton usage data through the Peloton platform. From their usage data, the frequency and duration of cycling classes was calculated for 4 weeks prior to and 12 weeks following the survey. Hierarchical regression equations tested the association between stress reported on the survey and subsequent exercise participation. Exercise participation was quantified both as the frequency and duration of Peloton cycling over the 12 weeks following the survey and as self-reported moderate to vigorous activity on a second survey completed by a subset of participants 12 weeks after the initial survey. RESULTS: There were 146 participants in our Peloton analysis sample and 66 in the self-reported exercise analysis. Peloton user data showed that study participants cycled frequently (mean 5.9 times per week) in the month prior to the initial survey, and that presurvey Peloton use was a strong predictor of exercise frequency (R2=0.57; F2,143=95.27; P<.001) and duration (R2=0.58; F2,143=102.58; P<.001) for the 12 subsequent weeks. Self-reported overall exercise likewise showed that this sample was very active, with an average of more than 8 times per week of moderate to vigorous exercise at the initial survey. Self-reported exercise on the initial survey was a strong predictor of self-reported exercise 12 weeks later (R2=0.31; F1,64=29.03; P<.001). Perceived stress did not impact Peloton cycling duration or frequency (P=.81 and .76, respectively) or self-reported exercise (P=.28). CONCLUSIONS: The results suggest that stress did not negatively impact exercise participation among habitually active adults with access to internet-connected home fitness equipment. Habitual exercise may buffer the impact of stress on participation in regular moderate to vigorous activity. Future research should examine the role that the availability of home-based internet-connected exercise equipment may play in this buffering.

Critical Evaluation of the Case for Pausing California's School-based Fitness Testing.

OBJECTIVE: We undertook a literature review to evaluate the evidence for an association among school-based fitness testing and bullying, weight-based teasing (WBT), and/or gender discrimination. METHODS: We searched the peer-reviewed literature using PubMed, ERIC and GOOGLE Scholar to identify articles related to school-based physical fitness testing (K-12) on the one hand and bullying, WBT, and/or gender discrimination on the other. RESULTS: We identified 12 studies on the impact of school-based physical fitness testing (PFT) on bullying and WBT. These studies do not support the assertion that PFT places students at elevated risk for bullying and/or WBT as compared to other school settings. There is a dearth of studies investigating an association between PFT and gender discrimination. CONCLUSIONS: The concerns about PFT as a widespread cause of bullying and WBT are not supported by the evidence. It is likely that school climate is a stronger determinant overall of these negative student interactions and that more rigorous teacher training would ameliorate student concerns about fitness testing. Nevertheless, more rigorous research is warranted to determine with confidence that PFT does not elevate students' risks for bullying and WBT and to examine the risks for students with non-binary gender.

Pilot Trial of an Acceptance-Based Behavioral Intervention to Promote Physical Activity Among Adolescents.

Prior interventions have shown limited efficacy in increasing the number of adolescents engaging in adequate physical activity (PA). Preliminary evidence suggests acceptance-based behavioral treatments (ABTs) may increase PA; however, this approach has not been tested in adolescents. This was a nonrandomized experimental pilot study that examined feasibility, acceptability, and treatment outcomes of a school-based, acceptance-based behavioral intervention for PA. Adolescents (n = 20) with low activity received a PA tracking device and were allocated to device use only or device use plus 10-weeks of ABT. PA, cardiovascular fitness, and physiological outcomes were measured pre- and postintervention. The intervention was found to be feasible and acceptable. PA, cardiovascular fitness, and physiological outcomes improved over time in the intervention group, but not in the comparison condition. This study demonstrated feasibility, acceptability, and preliminary treatment efficacy based on effect sizes for an acceptance-based behavioral intervention to increase PA in adolescents.