"You Measure Us and You Depress Us": Healthism and the Subjective Impact of Body Measurements on Secondary School Students.

This study explores adolescents' subjective experiences when facing body measurements at school, performed to evaluate the effects of a school-based intervention to promote physical activity. Three semi-structured interviews (n = 3) and two focus groups (n = 7 and 3) were conducted with adolescents after measuring some variables related to their weight and adiposity. Observational data (n = 88) collected by the two researchers in charge of the measurements were also obtained. Findings derived from our thematic analysis question the suitability of body measurements as social contexts where the core ideas of healthism emerge. Some adolescents lived body measurements as negative social experiences, promoting body dissatisfaction, social comparison, embarrassment, and simplistic associations between health and body shape, which could hinder their adherence to healthy habits. We emphasize the role of qualitative research when evaluating pre/posttests of school-based intervention studies, not just the interventions themselves, to generate knowledge to improve research protocols and prevent unwanted psychological outcomes in participants.

Active commuting to school among 36,781 Spanish children and adolescents: A temporal trend study.

This study examines trends in the rates of active commuting to school (ACS) in Spanish children (n = 18 343; 8.93 ± 1.68) and adolescents (n = 18 438; 14.11 ± 1.58) aged 6-18 years from 2010 to 2017. Given the study period included the economic crisis in Spain (2008-2013), the second aim of this study was to compare ACS rates during and after the economic crisis. Data were obtained from 28 studies conducted across Spain. The overall trends in ACS were evaluated using multilevel logistic regression analysis. Among Spanish children and adolescents, the rates of ACS to school ranged around 60% between 2010 and 2017. The rates of ACS in Spanish youth did not change significantly during the 2010-2017 period, except a sporadic increase in the rate of ACS in adolescents in 2012-2013. No significant association between the ACS and the economic crisis time period in youth was found. As conclusion, the ACS remains stable in Spain during the last decade, which is a promising result regarding the evidenced decreasing trend in many countries. Further educational and policy strategies are important to continue promoting this behavior in children and adolescents in the long term.

Autonomy support in an exercise intervention with colorectal cancer patients during chemotherapy: a qualitative perspective.

OBJECTIVE: Physical activity (PA) has emerged as an important element of supportive care for cancer patients, but few patients engage with exercise. Considering that autonomy support is associated with healthy lifestyles, it would be useful to know the specific autonomy-supportive techniques that can help to encourage PA in colorectal cancer (CRC) patients. This study aims to qualitatively explore autonomy support perceptions through a self-determination-theory-based exercise program (FIT-CANCER) with CRC patients during chemotherapy treatment. METHODS AND MEASURES: A total of 27 participants were included, 16 CRC patients, six relatives, and five healthcare professionals. Qualitative data from semi-structured interviews and observational field notes were analyzed with thematic analysis. RESULTS: Three main themes were identified: Healthcare professionals encouraging enrollment in the exercise program, Relatives supporting attendance to the exercise sessions, Exercise instructor favoring adherence to the exercise program. The different subthemes showed autonomy-supportive techniques from these social agents to promote CRC patients' participation in the exercise program. CONCLUSION: The present research showed the importance of autonomy support from healthcare professionals, relatives and the exercise instructor to promote the initiation and maintenance of CRC patients' PA behavior and improve their quality of life, health and well-being.

"To be myself again": Perceived benefits of group-based exercise for colorectal cancer patients.

PURPOSE: To explore the perceived benefits of a group-based exercise program for patients with colorectal cancer (CRC) undergoing chemotherapy treatment. METHODS: In-depth semi-structured interviews were conducted with all participants (n = 27) at the end of the exercise program (patients, relatives and healthcare professionals). The exercise instructor in charge of the exercise program with CRC patients also collected observational field notes throughout a research diary. RESULTS: Three main themes related to exercise as a coping strategy were obtained: (a) physical recovery; (b) psychosocial well-being, and (c) reconnection with their embodied selves and normal lives. Physical recovery included a perceived increase in fitness and a reduction in physical side-effects. Psychosocial well-being included perceived benefits in self-confidence, sense of control, reduced fear, feeling of being useful, sense of achievement, positive thinking and avoiding depression. All the physical and psychosocial benefits helped patients reconnect with their embodied selves, engage in activities practised before the diagnoses, improve their body image, avoid stigma, and increase their social life beyond cancer diagnoses. In this sense, some patients held on to their past selves, trying to keep or recover normality in their lives, while others acknowledged that they might not be the same person anymore, with exercise being part of this new identity. CONCLUSIONS: This study shows that exercise is a coping strategy that benefitted CRC patients in several ways related to their physical and psychosocial quality of life.

Elements behind sedentary lifestyles and unhealthy eating habits in individuals with severe obesity.

PURPOSE: This study examines elements behind sedentary lifestyles and unhealthy eating habits in individuals who lived with severe obesity during many years of their lives. METHODS: Ten post-bariatric surgery patients participated in semi-structured interviews 7 months after surgery. A year later, a second round of interviews was also conducted to address some knowledge gaps related to the study purpose. The qualitative data collected were analysed through content analysis. RESULTS: Embarrassment about showing their body publicly, pain and poor physical condition, and bad experiences in non-inclusive physical activity contexts were found as potential elements that contributed to their adherence to sedentary lifestyles. Poor family food education, loss of a loved one, family problems, arguments or disputes, and past traumatic events (e.g., childhood sexual abuses) could be related to their development of unhealthy eating behaviours. Findings also pointed out that participants' failed attempts to lose weight provoked them anxiety, feelings of failure and rebellion, and influenced their return to an unhealthy diet and a sedentary lifestyle. CONCLUSIONS: This study may be helpful to reveal some elements which could be related to the origin and perpetuation of severe obesity, and to design prevention/treatment strategies from a more holistic, sensitive, and respectful perspective.

Dependence and physical exercise: Spanish validation of the Exercise Dependence Scale-Revised (EDS-R).

The purpose of this study was to validate the Spanish version of the Exercise Dependence Scale-Revised (EDS-R). To achieve this goal, a sample of 531 sport center users was used and the psychometric properties of the EDS-R were examined through different analyses. The results supported both the first-order seven-factor model and the higher-order model (seven first-order factors and one second-order factor). The structure of both models was invariant across age. Correlations among the subscales indicated a related factor model, supporting construct validity of the scale. Alpha values over .70 (except for Reduction in Other Activities) and suitable levels of temporal stability were obtained. Users practicing more than three days per week had higher scores in all subscales than the group practicing with a frequency of three days or fewer. The findings of this study provided reliability and validity for the EDS-R in a Spanish context.

Influence of perceived sport competence and body attractiveness on physical activity and other healthy lifestyle habits in adolescents.

The purpose of this study was to test an explanatory model of the relationships between physical self-concept and some healthy habits. A sample of 472 adolescents aged 16 to 20 answered different questionnaires assessing physical self-concept, physical activity, intention to be physically active and consumption of alcohol and tobacco. The results of the structural equation model showed that perceived sport competence positively correlated with current physical activity. Body attractiveness positively correlated with physical activity in boys and negatively in girls. Current physical activity positively correlated with the intention to be physically active in the future and negatively with the consumption of alcohol and tobacco. Nevertheless, this last relationship was only significant in boys. The results are discussed in connection with the promotion of healthy lifestyle guidelines among adolescents. This model shows the importance of physical self-concept for engaging in physical activity in adolescence. It also suggests that physical activity is associated with the intention to continue being physically active and with healthy lifestyle habits.

Interplay of different contextual motivations and their implications for exercise motivation.

The aim of this study was to analyze the interaction between different contextual motivations and exercise motivation. The sample consisted of 449 exercisers aged between 16 and 53 years. Questionnaires were used to measure the satisfaction of basic psychological needs, self-determined motivation and the autotelic experience during exercise. The level of self-determined motivation regarding health, leisure and interpersonal relationships was also measured. The results of the structural equation modeling demonstrated that basic psychological needs and self-determined motivations about health and leisure positively predicted the self-determined motivation to exercise. Moreover, the self-determined motivation to exercise positively predicted the autotelic experience. The model was invariant across age, although some gender differences were found. Specifically, the self-determined motivation towards health in men did not significantly predict the self-determined motivation to exercise. These results represent to evaluate the role that other contextual motivations play in exercise motivation. Key pointsSelf-determined motivations about health and leisure positively predicted exercise motivation.Motivation in interpersonal relationships did not relate to exercise motivation.Relationships were invariant across age, although some gender differences were found. Self-determined motivation towards health in men did not significantly predict self-determined motivation to exercise, whereas leisure motivation played a major role in explaining this variable.

[Toward a deeper understanding of motivation towards exercise: measurement of integrated regulation in the Spanish context]. / Hacia una mayor comprensión de la motivación en el ejercicio físico: medición de la regulación integrada en el contexto español.

The purpose of this study was to validate the Behavioural Regulation in Exercise Questionnaire in the Spanish context, including items to measure integrated regulation. Participants were 524 exercisers, mean age 29.59 years. The results revealed acceptable fit indices in the confirmatory factor analysis and good internal consistency (with a Cronbach alpha of .87 for integrated regulation). The diverse subscales also conformed to a simplex pattern and the factor structure was invariant across gender and age. Integrated regulation reflected high temporal stability over a 4-week period (ICC=.90). The criterion validity analysis of integrated regulation indicated that this variable was positively predicted by satisfaction of the needs for competence and autonomy. The results regarding the importance of measuring integrated regulation in exercise are discussed.

Motivation and performance in physical education: an experimental test.

The purpose of this study was to analyse, experimentally, the relationships between motivation and performance in a lateral movement test in physical education. The study group consisted of 363 students (227 boys and 136 girls), aged between 12 and 16, who were randomly divided into three groups: an experimental group in which an incremental ability belief was induced, another experimental group in which an entity ability belief was induced, and a control group where there was no intervention. Measurements were made of situational intrinsic motivation, perceived competence in executing the task and performance. The results revealed that the incremental group reported higher scores on the situational intrinsic motivation scale. The entity group demonstrated better performance in the first test attempt than the incremental group but, in the second attempt, the performance was similar in the different groups. Perhaps the initial differences in performance disappeared because the incremental group counted on improving in the second attempt. These results are discussed in relation to the intensity with which the teacher conveys information relating to incremental ability belief of the pupil to increase intrinsic motivation and performance. Key pointsThe incremental group showed more situational intrinsic motivation.The entity group showed higher performance in the first test attempt, but significant differences disappeared in the second attempt.It seems that this incremental belief and greater intrinsic motivation made the students trust they would improve their performance in the second attempt at the lateral movement test.

Changes in Bariatric Patients' Physical Activity Levels and Health-Related Quality of Life Following a Postoperative Motivational Physical Activity Intervention.

PURPOSE: Self-determination theory (SDT) has been widely used as a useful motivational framework for improving long-term adherence to physical activity (PA) and health-related quality of life (HRQoL). The aim of this study was to examine the effects of a 6-month motivational PA intervention (MPAI) on bariatric patients' PA levels and HRQoL from pre-surgery to the end of the MPAI (7 months post-surgery). Additionally, a re-test was performed 13 months post-surgery. METHODS: A total of 40 participants undergoing sleeve gastrectomy were assigned to a 6-month MPAI or to a control group. The MPAI was based on techniques and messages from SDT. At baseline and post-intervention measures, both groups wore accelerometers for one week and completed the SF-36 questionnaire. RESULTS: A total of 32 participants (78.1% female) completed all measures and were included in the final analyses. PA levels did not significantly differ between groups as a consequence of the intervention. Clinically significant differences (d ≥ 0.5) favoring the MPAI group were found for SF-36 domains of bodily pain (at pre-surgery, increasing at 7 and 13 months post-surgery), general health and vitality (7 months post-surgery), and physical functioning and physical component score (both 7 and 13 months post-surgery). Social functioning also showed clinically significant differences favoring the MPAI group at pre-surgery, increasing at 7 months post-surgery. These differences disappeared at 13 months post-surgery. CONCLUSIONS: SDT-based PA interventions could enhance several dimensions of bariatric patients' HRQoL after surgery. Further research is needed to understand what motivational processes are key aspects to promote PA participation in these patients.

Effects of a physical activity program on post-bariatric patients: A qualitative study from a self-determination theory perspective.

This study provides an in-depth analysis of the psychosocial benefits that 10 post-bariatric patients (nine female, 31-59 years) perceived from their participation in an exercise program grounded in self-determination theory. Qualitative data were collected through observations and interviews. Participants reported many factors which facilitated basic psychological need satisfaction such as the instructors caring about their opinion, affection, fitness improvement, pain reduction, and knowledge acquisition. These factors were associated with autonomous motivation, enjoyment, intention to be physically active, happiness, and self-confidence. The results suggest that self-determination theory-based exercise programs could be designed to achieve positive outcomes in this population.

Barriers to physical activity participation in colorectal cancer patients during chemotherapy treatment: A qualitative study.

PURPOSE: To explore the barriers that colorectal cancer patients (stage II and III) perceive to participate in physical activity (PA) when involved in adjuvant chemotherapy. Views of relatives and physicians concerning this issue were also included. METHOD: Qualitative data from ten patients, ten relatives, and ten health professionals were obtained through semi-structured interviews (n = 30). RESULTS: Two main themes were identified after data analysis: (a) barriers to PA related to ostomy and adjuvant chemotherapy and (b) barriers related to perceived lack of support for PA. In regard to the first theme, participants reported difficulties associated with the ostomy, limitations of the intravenous chemotherapy device, fatigue and reduced physical fitness, and focusing on cancer and restructuring priorities. Concerning the perceived lack of support for PA, participants referred to their families' overprotection, the health professionals' lack of knowledge and time to prescribe PA, and the lack of PA services in health centres. CONCLUSIONS: Further information from health professionals about the recommendations of PA and its benefits during adjuvant chemotherapy could palliate these PA barriers. The offer of specific PA programmes for these patients is also recommended.

Intrinsic motivation and sportsmanship: mediating role of interpersonal relationships.

This study analyzed the mediating role of interpersonal relations between intrinsic motivation and sportsmanship. Athletes (98 men, 97 women), ages 11 to 43 years, completed measures of intrinsic motivation toward sports, self-concept of social and family relations, and sportsmanship orientation. A structural equation model indicated that self-concept of interpersonal relations mediated the relation between intrinsic motivation and sportsmanship. Also, intrinsic motivation was directly and positively associated with self-concept of interpersonal relations, which, in turn, was positively and significantly related to sportsmanship. Variances explained by self-concept of interpersonal relations and by sportsmanship were 32 and 56%, respectively. The motivational interaction between the context of interpersonal relations and the sports context proposed in the hierarchical model of intrinsic and extrinsic motivation was discussed.

Exploring the socio-ecological factors behind the (in)active lifestyles of Spanish post-bariatric surgery patients.

Purpose: Physical activity (PA) is considered essential for the treatment of morbid obesity and the optimization of bariatric surgery outcomes. The objective of this article was to identify the facilitators and barriers that bariatric patients perceived to do PA one year after finishing a PA programme for the promotion of a long-term active lifestyle. This objective was addressed from a socio-ecological and qualitative perspective. Methods: Nine patients (eight women and one man), aged between 31 and 59 years, participated in semi-structured interviews directly following the PA programme and one year after it. A content analysis was carried out to analyze the qualitative data. Results: Weight loss, improvement of physical fitness, perceived competence, and enjoyment were the main facilitators of PA. Complexes related to skin folds, osteoarthritis, perceived unfavourable weather conditions, lack of social support and economic resources, long workdays, lack of specific PA programmes, and other passive leisure preferences were the main barriers to participate in PA. Conclusions: Results highlight the important interplay between personal, social environmental, and physical environmental factors to explain (in)active behaviours of bariatric patients. The findings of this article could be useful for future research and interventions aimed at promoting PA in bariatric patients.

Peers' influence on exercise enjoyment: a self-determination theory approach.

The purpose of this research was to study the influence of motivational climate perceived in peers and basic psychological needs (competence, autonomy and relatedness) on self-determined motivation and enjoyment in exercise. A sample comprised of 394 non- competitive physical exercisers, 156 women and 238 men aged between 16 and 54 (M = 21.64, SD = 7. 18), completed the Motivational Climate Perceived in Peers Scale, Scale of Motivational Mediators in Physical Activity, Behavioural Regulation in Exercise Questionnaire-2 and Physical Activity Enjoyment Scale. A correlation analysis between the variables studied, a confirmatory factor analysis (CFA) and structural equation analysis were performed. The results showed that the task- involving peer motivational climate positively predicted the three basic psychological needs (competence, autonomy and relatedness). In turn, meeting the needs for competence and relatedness positively predicted self-determined motivation, which also positively predicted the enjoyment the exercisers had during the activity. There were no significant associations between the ego- involving peer motivational climate and psychological needs. A multisample analysis indicated that the model was invariant across age and degree of exercise involvement. This study reiterates the importance of increasing exercisers' self-determined motivation in order to obtain more enjoyment and to be more committed to the exercise. Therefore, it is essential to foster perceptions of competence, autonomy and relatedness by means of a task-involving climate. The findings provide evidence for the importance of peer motivational climate in sports motivation. Key pointsTask-involving peer motivational climate positively predicted the three basic psychological needs (competence, autonomy and relatedness). There were no significant associations between the ego-involving peer motivational climate and psychological needs.Needs for competence and relatedness positively predicted self-determined motivation.Self-determined motivation positively predicted enjoyment.

The impact of living with morbid obesity on psychological need frustration: A study with bariatric patients.

Guided by self-determination theory, the purpose of this study was to gain an understanding of the previous experiences of living with morbid obesity of 10 postbariatric patients enrolled in a physical activity programme. Qualitative data were collected through interviews and diarized observations. A thematic analysis revealed that participants suffered from health and mobility troubles in their daily life and experienced stigmatization and discrimination in most areas of their social functioning. Participants described how these experiences resulted in the thwarting of their basic psychological needs for autonomy, competence and relatedness. In turn, psychological need frustration contributed to negative consequences such as body image concerns, low self-esteem, anxiety and depression; controlled regulation of their eating behaviour and extrinsic goals; rigid behaviours such as avoiding social situations; and compensatory and self-defeating behaviours such as giving up diet and physical activity regimens and binge eating (i.e., oppositional defiance). This study highlights how living with morbid obesity can impair optimal functioning and well-being via experiences of psychological need frustration.

Social Physique Anxiety and Intention to Be Physically Active: A Self-Determination Theory Approach.

PURPOSE: Based on self-determination theory, the purpose of this study was to analyze the relationship between social physique anxiety and intention to be physically active, while taking into account the mediating effects of the basic psychological needs and behavioral regulations in exercise. METHOD: Having obtained parents' prior consent, 390 students in secondary school (218 boys, 172 girls; Mage = 15.10 years, SD = 1.94 years) completed a self-administered questionnaire during physical education class that assessed the target variables. Preliminary analyses included means, standard deviations, and bivariate correlations among the target variables. Next, a path analysis was performed using the maximum likelihood estimation method with the bootstrapping procedure in the statistical package AMOS 19. RESULTS: Analysis revealed that social physique anxiety negatively predicted intention to be physically active through mediation of the basic psychological needs and the 3 autonomous forms of motivation (i.e., intrinsic motivation, integrated regulation, and identified regulation). CONCLUSION: The results suggest that social physique anxiety is an internal source of controlling influence that hinders basic psychological need satisfaction and autonomous motivation in exercise, and interventions aimed at reducing social physique anxiety could promote future exercise.

Psychometric properties of the Social Physique Anxiety Scale (SPAS-7) in Spanish adolescents.

The purpose of this study was to validate the Spanish version of Motl and Conroy's model of the Social Physique Anxiety Scale (SPAS-7). To achieve this goal, a sample of 398 secondary school students was used, and the psychometric properties of the SPAS-7 were examined through different analyses. The results supported the seven-item model, although the item 5 did not show any significant correlation with two items from this model and had a lower factor loading than the rest of items. The structure of the model was invariant across gender and Body Mass Index (BMI). Alpha value over .70 and suitable levels of temporal stability were obtained. Girls and students classified according to the BMI as overweight and obese had higher scores in social physique anxiety than boys and the group classified as underweight and normal range. The findings of this study provided reliability and validity for the SPAS-7 in a Spanish adolescent sample.