Maternal practices and perceptions of child body mass status explain child energy expenditure behaviors and body mass.

This study investigated whether maternal perceptions of child body mass status would predict child body mass index (BMI) z-score via two sets of sequential mediators: (1) four maternal practices promoting child energy expenditure and (2) children's energy expenditure behaviors. The data of N = 729 mother-child dyads were collected at baseline [T1; n = 495 at 7- to 8-month follow-up (T2)]. Mothers reported perceptions of child body mass status and maternal practices (T1); children reported sedentary screen use and physical activity (T1, T2). Child body mass was assessed objectively (T1, T2). Higher stimulation to be active (T1) was related to a lower child BMI z-score (T2) via higher levels of child physical activity (T2). Higher levels of monitoring of screen use (T1) were associated with higher child BMI z-score (T2) via lower levels of child physical activity (T2). Encouraging parents to stimulate their children to be active may be beneficial for children's weight maintenance.

Moving in Sync: Hourly Physical Activity and Sedentary Behavior are Synchronized in Couples.

BACKGROUND: Overall time spent in moderate-to-vigorous intensity physical activity (MVPA) and sedentary behavior are both correlated in couples. Knowledge about the nature and psychosocial correlates of such dyadic covariation could inform important avenues for physical activity promotion. PURPOSE: The present study investigates hour-by-hour covariation between partners (i.e., synchrony) in MVPA and sedentary behavior as partners engage in their daily lives and links it with person-level MVPA/sedentary behavior, temporal characteristics, and relationship variables. METHODS: We used 7-day accelerometer data from two couple studies (Study 1, n = 306 couples, aged 18-80 years; Study 2, n = 108 couples, aged 60-87 years) to estimate dyadic covariation in hourly MVPA and sedentary behavior between partners. Data were analyzed using coordinated multilevel modeling. RESULTS: In both studies, hourly MVPA and sedentary behavior exhibited similarly sized dyadic covariation between partners in the low-to-medium range of effects. Higher MVPA synchrony between partners was linked with higher individual weekly MVPA and higher individual weekly sedentary levels, whereas higher sedentary synchrony between partners was associated with higher individual weekly MVPA but lower individual weekly sedentary levels. MVPA and sedentary synchrony were higher in the morning and evening, more pronounced on weekends, and associated with more time spent together, longer relationship duration, and time-varying perceptions of higher partner closeness. CONCLUSIONS: This study demonstrates that MVPA and sedentary behaviors do not occur in a social vacuum. Instead, they are linked with close others such as partners. Thus, capitalizing on social partners may increase the effectiveness of individual-level physical activity interventions.

Inter-Relations between Partner-Provided Support and Self-Efficacy: A Dyadic Longitudinal Analysis.

BACKGROUND: Existing evidence indicates that social support may enhance recipients' self-efficacy (enabling hypothesis) or that self-efficacy facilitates support receipt (cultivation hypothesis). However, less is known about the time-lagged support-self-efficacy relationship in couples. Our aim was to disentangle reciprocal interrelations among stable and time-varying components of support provision and self-efficacy in couples over time. METHODS: We conducted secondary analyses of a published randomised controlled trial with six assessments, spanning 1 year and N = 338 heterosexual couples (age range: 18-80 years). Women's and men's reports on physical activity-specific provided support and physical activity-specific self-efficacy were analysed. RESULTS: Based on the actor-partner interdependence model, we compared nested random intercepts cross-lagged panel models. The final model revealed no gender effects. Stable levels of both partners' support provision and self-efficacy were positively associated. At the time-varying level, one partner's self-efficacy predicted the other partner's support provision later on. No lagged-association emerged for the opposite predictive direction. CONCLUSIONS: Partners' stable shares of provided support and self-efficacy were interrelated, whereas higher time-varying self-efficacy of one partner seemed to activate support provision from the other partner, confirming the cultivation hypothesis but not the enabling hypothesis.

Sedentary behaviors and anxiety among children, adolescents and adults: a systematic review and meta-analysis.

BACKGROUND: Although the number of studies examining the relationships between sedentary behaviors (SB) and anxiety is growing, an overarching evidence, taking into account children, adolescents, and adults as well as different types of SB and different categories of anxiety outcomes, is still missing. Thus, this systematic review and meta-analysis aimed at obtaining a comprehensive overview of existing evidence. METHODS: A search in the following databases: PsycINFO, PsycARTICLES, Academic Search Complete, ERIC, HealthSource: Nursing/Academic Edition and MEDLINE, resulted in k = 31 original studies included in the systematic review (total N = 99,192) and k = 17 (total N = 27,443) included in the meta-analysis. Main inclusion criteria referred to testing the SB--anxiety relationship, the quality score (above the threshold of 65%), and the language of publications (English). The study was following the PRISMA statement and was registered at PROSPERO (CRD42017068517). RESULTS: Both the systematic review and meta-analysis indicated that overall average effects were small: higher levels of symptoms of anxiety were associated with higher levels of SB (weighted r = .093, 95% CI [.055, .130], p < .001). Moderator analyses indicated that trends for stronger effects were observed among adults, compared to children/adolescents (p = .085). CONCLUSIONS: Further longitudinal studies are necessary to elucidate the predictive direction of the anxiety-SB relationship and to clarify whether the effects depend on the type of anxiety indicators.

Parental strategies restricting screen use among children, screen home environment, and child screen use as predictors of child body fat: A prospective parent-child study.

OBJECTIVES: This study provides an insight into associations between: (1) parental and child perceptions of parental strategies restricting screen use among children, (2) child perceptions of the presence and availability of screen-based equipment at home, (3) child sedentary screen use behaviours, and (4) child body fat. DESIGN: A prospective study with two assessment periods (Time 1, T1; Time 2, T2), spanning 7-8 months. METHODS: At T1, 879 parent-child dyads (83.3% mothers; 52.3% girls) were enrolled and provided parental and child (5-11 years old) self-report data. T2 data were obtained from 603 dyads. Child body fat was measured with bioimpedance method (T1 and T2). Path analysis was used to test models calculated with and without additional covariates, such as parental and child age and gender, parental education, and economic status. RESULTS: Path analysis indicated indirect effects of the presence and availability of screen-based equipment at home (T1) on child body fat (T2), with screen use among children (T1) mediating this association. Parental perceptions of restrictions (T1) were unrelated to child body fat (T2). In contrast, child perceptions of parental restrictions (T1) predicted child body fat (T2). Children who perceived that their parents applied a higher level of restrictions (T1) had a lower body fat at the 7- to 8-month follow-up. These associations were found after controlling for baseline levels of child body fat, across models calculated with and without additional covariates. CONCLUSIONS: Child, not parental perceptions of parental restrictions, predicted better obesity-related outcomes in children, such as lower body fat. Statement of contribution What is already known on this subject? Little is known about effects of parental restrictions of screen use on child body fat. Evidence is mostly cross-sectional, except from a recent investigation by Sleddens, Gubbels, Kremers, van der Plas, and Thijs (). To date, effects of parental (not children's) reports of screen use restrictions were investigated. What does this study add? Children reporting more parental restrictions of screen use have less body fat at a follow-up. Parental reports of screen use restrictions are unrelated to child screen use and body fat. Frequent screen use mediate between the number of screen devices at home and higher child body fat.

Invisible Social Support and Invisible Social Control in Dual-smoker Couple's Everyday Life: A Dyadic Perspective.

BACKGROUND: Invisible exchange processes (i.e., invisible support, invisible control) are commonly operationalized as support or control provided by a partner, but unnoticed by the recipient, and have been reported to be beneficially related to affect. However, studies have almost exclusively focused on affect as an outcome and rather neglected other outcomes, such as health behavior. One study so far demonstrated a coupling of invisible support and increased unhealthy behavior. PURPOSE: The present study aimed to investigate differences in invisible exchanges within a dyadic context of heterosexual, romantic dual-smoker couples. We tested whether women's and men's invisible exchanges were associated with negative affect and smoking in everyday life of dual-smoker couples. METHODS: In a dyadic daily diary study, invisible emotional and instrumental support, invisible positive and negative control, negative affect, and daily smoking were independently assessed in both partners of 83 dual-smoker couples after a joint self-set quit date. RESULTS: Analyses based on the two-intercept model revealed that at the between-person level invisible support and control were both related to less negative affect, albeit in men only, and were unrelated to smoking behavior. At the within-person level, invisible exchanges were on the whole unrelated to negative affect and smoking. CONCLUSIONS: Invisible support and invisible control may serve as protective buffers for negative affect in a health-behavior change context for male partners of dual-smoker couples. Future research should clarify under what conditions invisible exchanges unfold positive effects on partners' well-being and health behavior in different health contexts.

Facilitating physical activity and reducing symptoms in patients with knee osteoarthritis: study protocol of a randomized controlled trial to test a theory-based PrevOP-psychological adherence program (PrevOP-PAP).

BACKGROUND: The present randomized controlled trial, which is crossed with the "PREVenting the impairment of primary Osteoarthritis by high impact long-term Physical exercise regimen" Main Medical Trial (PrevOP-MMT), aims to evaluate a psychological adherence program (PrevOP-PAP), and is designed to support persons with knee osteoarthritis (OAK) in the uptake and maintenance of regular physical activity to reduce OAK symptoms. The PrevOP-PAP is based on the Health Action Process Approach (HAPA), a social-cognitive theory predicting health behavior change in individuals, extended here by social network characteristics and social exchange processes. It is expected that participants with OAK receiving the PrevOP-PAP will maintain higher levels of regular physical activity throughout a 24-month period and consequently report lower levels of OAK symptoms than participants of an active control condition. METHODS: A total of N = 240 participants with medically verified moderate OAK will be randomly assigned to an intervention condition (PrevOP-PAP-I; 50%) or an active control condition (PrevOP-PAP-CTRL). The PrevOP-PAP-I includes a motivational intervention, repeated self-regulation interventions, and a network creation intervention delivered over 12 months. Modes of intervention delivery include a paper-pencil motivation leaflet with a quiz, a computer-assisted face-to-face intervention, four computer assisted phone-based interventions, and activity calendars. The PrevOP-PAP-CTRL includes the motivational intervention only. Primary outcome will be OAK symptoms. Secondary outcomes include objectively and subjectively measured physical activity and indicators of quality of life. Other outcomes are HAPA-derived self-regulatory indicators as well as proposed social network and social exchange mechanisms of health behavior change. Assessments take place at baseline, 6 months, 12 months, 18 months, and 24 months following baseline. DISCUSSION: Based on the extended HAPA, this study seeks to reveal the self-regulatory and social mechanisms of the uptake and maintenance of physical activity and their relation to disease symptoms in persons with OAK. The design and evaluation of this program are intended to become a yardstick for future development and implementation of digitalized psychological adherence programs in this population. TRIAL REGISTRATION: German Clinical Trials Register; also available at http://apps.who.int/trialsearch/ ; registration number: DRKS00009677 ; date of registration: 26 January 2016.

Inter-relations among negative social control, self-efficacy, and physical activity in healthy couples.

OBJECTIVES: In romantic relationships, partners can influence each other's health-relevant behaviour by exerting negative social control (e.g., pressuring), however, with mixed success. To elucidate this phenomenon, we examined couples motivated to increase their physical activity and investigated the degree to which both partners exerted negative control on each other, their self-efficacy, reciprocal associations among the two behaviour-specific constructs, and their relationship with moderate-to-vigorous physical activity (MVPA). DESIGN: This was a longitudinal study with three assessment periods (T0, T2, T3) spanning 7 weeks. METHODS: We performed secondary analyses with data from the control condition (N = 113 heterosexual couples) of a published randomized controlled trial. Dyadic mediator models specified either both partners' self-efficacy as predictors and provided negative partner control to each other as mediators or vice versa. The outcomes comprised both partners' accelerometer-assessed MVPA. Mediators and outcomes were controlled for their T0 values. RESULTS: The first model showed that women's and men's provided negative partner control (T0) was positively related to the other partners' self-efficacy (T2). Testing the alternative predictive direction, the second model showed that only women's self-efficacy (T0) was associated with more provided negative partner control (T2) by men. Women and men showed less MVPA (T3) when their partners had provided them with more negative control at T2. CONCLUSIONS: As negative control provided to partners may be detrimental to their behaviour change, interventionists should advise couples to avoid it. However, active ingredients of negative control that may benefit recipients' self-efficacy beliefs should be investigated in future work. Statement of contribution What is already known on this subject? Couples often try to change each other's health behaviour not just using supportive tactics, but also controlling ones. Negative partner control (e.g., rebuking and nagging) was found to have adverse or no effects on control recipients' health behaviour change. To understand underlying mechanisms of this relationship, reactance and negative affect of recipients have been investigated, but only rarely their self-efficacy, a consistent individual predictor of behaviour change that is likely to share reciprocal relations with social exchange processes, including negative social control. What does this study add? Although harmful for behaviour change, negative partner control may increase control recipients' self-efficacy. Higher self-efficacy of one partner may also increase provided negative partner control by the other.

Sedentary behaviours and health-related quality of life. A systematic review and meta-analysis.

Researchers have speculated that sedentary behaviour may reduce health-related quality of life (HRQOL), but the extent to which this is true remains unknown. Our study sought to systematically review and synthesise research on the relationship between sedentary behaviours and HRQOL and to investigate if these relationships are moderated by age, health status, and HRQOL domain. The review was registered with PROSPERO (no. CRD42016036342). We searched six electronic databases. The selection process resulted in including k = 27 original studies; k = 18 were included in a meta-analysis. Data were synthesised twice, using the methods of systematic review and meta-analysis, in order to reduce biases related to a small number of included studies. Both the systematic review and meta-analytical methods indicated that lower levels of sedentary behaviours were associated with higher physical HRQOL (estimate of average effect: r = -.140; 95% CI -.191, -.088). Moderator analyses indicated that associations between the physical HRQOL domain and sedentary behaviours may be similar in strength across age- and health status groups. Causal inferences could not be drawn as most studies were cross-sectional. Concluding, sedentary behaviours were related to better physical HRQOL but not reliably to mental and social HRQOL.

Which characteristics of planning matter? Individual and dyadic physical activity plans and their effects on plan enactment.

OBJECTIVE: Past research supports individual planning as an effective intervention strategy to increase physical activity in individuals. A similar strategy, dyadic planning, adds a planning partner who supports an individual's planning processes. Whether the two planning formats differ in terms of participants' entered plan content and whether and how different content characteristics are linked to plan enactment remains unknown. By investigating the content of generated plans, this study aimed at distinguishing plan characteristics of the two planning formats and examining their role as predictors of later plan enactment. METHODS: Secondary analyses of a three-arm RCT with German couples (data collection between 2013 and 2015). Couples were assigned to an individual (IPC, n = 114) or dyadic planning condition (DPC, n = 111) and formulated up to 5 physical activity plans for a target person. Couples assigned to a control condition were not included as they did not generate plans. The following characteristics were distinguished and coded for each plan: number of planned opportunities, presence of a planned routine, planned cue- or activity-related specificity, activity-related intensity, and chronological plan rank. One week before (T0) and two weeks following (T2) the intervention (T1), increase vs. no increase of the planned activity was coded as a dichotomous plan enactment variable. Multilevel logistic regressions were fit. RESULTS: Plan enactment was higher in dyadic than in individual planners. Findings indicated that routines (e.g., after work) were positively related to plan enactment, whereas a high specificity of when-cues (e.g., Friday at 6.30 p.m.) showed a negative relationship. None of the examined plan characteristics could explain differences in enactment between IPC and DPC. CONCLUSIONS: Linking health behaviours to other behavioural routines seems beneficial for subsequent plan enactment. Dyadic planning was linked with higher enactment rates than individual planning. However, as mechanisms underlying this effect remain unclear, they should be investigated further.

Predictors of dyadic planning: Perspectives of prostate cancer survivors and their partners.

OBJECTIVES: Extending individual planning of health behaviour change to the level of the dyad, dyadic planning refers to a target person and a planning partner jointly planning the target person's health behaviour change. To date, predictors of dyadic planning have not been systematically investigated. Integrating cognitive predictors of individual planning with four established predictor domains of social support provision, we propose a framework of predictors of dyadic planning. Including target persons' and partners' perspectives, we examine these predictor domains in the context of prostate cancer patients' rehabilitative pelvic floor exercise (PFE) following radical prostatectomy. DESIGN: Longitudinal data from 175 patients and their partners were analysed in a study with four post-surgery assessments across 6 months. METHODS: PFE-related dyadic planning was assessed from both partners together with indicators from four predictor domains: context, target person, partner, and relationship factors. Individual planning and social support served as covariates. RESULTS: Findings from two-level models nesting repeated assessments in individuals showed that context (patients' incontinence), target person (i.e., positive affect and self-efficacy), and relationship factors (i.e., relationship satisfaction) were uniquely associated with dyadic planning, whereas partner factors (i.e., positive and negative affects) were not. Factors predicting patients' and partners' accounts of dyadic planning differed. CONCLUSIONS: Resembling prior findings on antecedents of support provision in this context, partner factors did not prevail as unique predictors of dyadic planning, whereas indicators from all other predictor domains did. To establish predictive direction, future work should use lagged predictions with shorter intermeasurement intervals. Statement of contribution What is already known on this subject? Dyadic planning has been shown to be linked to health behaviour change. However, its role in behaviour regulation frameworks is not well investigated, especially regarding factors that might be predictive of dyadic planning. What does this study add? A framework of predictors of dyadic planning in the health behaviour change process is presented. The framework is investigated accounting for both planning partners' perspectives. Context, target person, and relationship factors were related to dyadic planning.

Effects of dyadic planning on physical activity in couples: A randomized controlled trial.

OBJECTIVE: Action planning can help translate physical activity intentions into action by linking situational cues with behavioral responses. Dyadic planning extends action planning and refers to target persons forming plans for their own behavior change together with partners. This study investigated whether a dyadic planning intervention could increase physical activity in target persons and their partners, whether these effects were moderated by relationship quality and mediated by action control, activity-specific received partner support, and control. METHOD: Couples (n = 338; target persons randomized) were randomly assigned to (a) a dyadic planning condition (DPC); (b) an individual planning condition (IPC), in which target persons planned and partners worked on a distractor task; or (c) a control condition (CC), in which couples worked on a distractor task. During 3 assessments up to 6 weeks postintervention, moderate (primary outcome) and vigorous activity were objectively measured; other variables were self-reported. Multilevel and path models were fit. RESULTS: There were no beneficial direct effects of the intervention for DPC target persons. Over time, DPC partners' vigorous activity increased, but decreased again. At lower relationship quality, DPC target persons' activity decreased, whereas IPC target persons' vigorous activity increased. Mediation hypotheses were not supported. Mutual influence models indicated positive effects of partners' on target persons' moderate activity in DPC and CC, whereas for IPC, negative effects of target persons' on partners' moderate activity emerged. CONCLUSIONS: Findings revealed the complexity of effects of dyadic planning on behavior change. Adding relationship quality to the equation clarified effects of DPC and IPC on physical activity. (PsycINFO Database Record

Enabling or Cultivating? The Role of Prostate Cancer Patients' Received Partner Support and Self-Efficacy in the Maintenance of Pelvic Floor Exercise Following Tumor Surgery.

BACKGROUND: To manage incontinence following tumor surgery, prostate cancer patients are advised to perform pelvic floor exercise (PFE). Patients' self-efficacy and support from partners were shown to facilitate PFE. Whereas support may enhance self-efficacy (enabling function), self-efficacy may also cultivate support (cultivation function). PURPOSE: Cross-lagged inter-relationships among self-efficacy, support, and PFE were investigated. METHOD: Post-surgery patient-reported received support, self-efficacy, PFE, and partner-reported provided support were assessed from 175 couples at four times. Autoregressive models tested interrelations among variables, using either patients' or partners' reports of support. RESULTS: Models using patients' data revealed positive associations between self-efficacy and changes in received support, which predicted increased PFE. Using partners' accounts of support provided, these associations were partially cross-validated. Furthermore, partner-provided support was related with increases in patients' self-efficacy. CONCLUSION: Patients' self-efficacy may cultivate partners' support provision for patients' PFE, whereas evidence of an enabling function of support as a predictor of self-efficacy was inconsistent.