Self-Compassion and Reactions to a Recalled Exercise Lapse: The Moderating Role of Gender-Role Schemas.

Exercise is good for health and well-being, yet people experience lapses when trying to adhere to exercise. Self-compassion may help people cope with exercise lapses. Most research on self-compassion and exercise has been conducted with women; men may also benefit from self-compassion. No research has examined whether gender-role schema influences responses to exercise lapses. The authors examined both male and female adult exercisers (N = 220) who reported their self-compassion, recalled an exercise lapse, their reactions to the lapse, and their self-identification of masculinity and femininity. After controlling for self-esteem, age, and lapse importance, self-compassion negatively related to emotional responses (p < .001), rumination (p < .001), extrinsic motivation (p = .004), and positively related to intrinsic motivation (p < .001). Masculinity moderated the relationships between self-compassion and amotivation (p = .006), and identified regulation (p = .01). Self-compassion may be an effective resource for exercisers, especially those who identify as highly masculine.

Adjusting Identities When Times Change: The Role of Self-Compassion.

Adjusting identity standards may be preferable to relentless pursuit or abandonment of an identity when facing an identity-challenging life transition. Self-compassion (SC) can help people adjust to challenges. The authors examined whether SC was associated with identity adjustment, exercise, and the moderating effect of identity-behavior discrepancy in 279 women exercisers who reported reduced exercise in motherhood. Participants completed the Self-Compassion Scale and reported the extent of and reflected on their identity discrepant behavior (reduced exercise). Reactions to discrepancy (acceptance, shame, guilt, and rumination), correlates of identity adjustment (subjective well-being, autonomous motivation, controlled motivation, and role conflict), and exercise behavior were assessed. SC associated positively with acceptance, correlates of successful identity adjustment, and exercise behavior. SC associated negatively with shame, rumination, and correlates of unsuccessful adjustment. SC may help exercise-identifying women who exercise less after becoming mothers adaptively cope with this identity challenge and continue exercising.

Understanding the role of mother guilt and self-compassion in health behaviors in mothers with young children.

We explored whether the guilt mothers of young children feel about engaging in health behaviors mediates the relationship between self-compassion and self-reported engagement in health-promoting behaviors such as physical activity, eating a healthy diet and getting enough sleep. In this online, cross-sectional study, 143 mothers of young children completed measures of self-compassion, guilt about taking time to engage in health-promoting behaviors, trait guilt, health-promoting behaviors, self-esteem, and demographics. Mediation analysis, using Hayes' PROCESS macro showed that mother guilt mediated the relationship between self-compassion and health-promoting behaviors, ß = .05, Bca CI (.0014, .1133) with a bootstrapped standard error of .03 and a 95% confidence interval. Self-compassion may offer mothers a positive way to deal with guilty feelings about looking after their health.

Self-Compassion and the Self-Regulation of Exercise: Reactions to Recalled Exercise Setbacks.

Self-compassion facilitates health behavior self-regulation; few studies have examined self-compassion and exercise. This online, cross-sectional study investigated self-compassion's relationship with exercise self-regulation of an exercise setback. Adults (N = 105) who had experienced an exercise setback within the last 6 months completed baseline measures, recalled an exercise setback, and completed questionnaires assessing self-regulation in this context. Self-compassion associated with self-determined motivations and exercise goal reengagement, and negatively related to extrinsic motivations, state rumination, and negative affect. Self-compassion predicted unique variance, beyond self-esteem, in exercise goal reengagement, external regulation, state rumination, and negative affect experienced after an exercise setback. Self-compassion and self-esteem had unique relationships with goal reengagement, state rumination, and situational motivation, while having a complementary relationship with negative affect. This research adds to the few studies that examine the role of self-compassion in exercise self-regulation by examining how self-compassion and self-esteem relate to reactions to a recalled exercise setback.

Narratives of athletic identity after acquiring a permanent physical disability.

Individuals with acquired physical disabilities report lower levels of athletic identity. The objective of this study was to further explore why athletic identity may be lost or (re)developed after acquiring a physical disability. Seven women and four men (range = 28-60 years) participated in approximately 1-hour-long semistructured interviews; data were subjected to a narrative analysis. The structural analysis revealed three narrative types. The nonathlete narrative described physical changes in the body as reasons for diminished athletic identity. The athlete as a future self primarily focused on present sport behavior and performance goals such that behavior changes diminished athletic identity. The present self as athlete narrative type focused on the aspects of their present sport involvement, such as feedback from other athletes and skill development, which supported their athletic identity. Implications of these narrative types with respect to sport promotion among people with acquired physical disabilities are discussed.

Virtual Motivational Interviewing (VIMINT) to support physical activity: Experiences of older adults and counsellors.

The aim of this study was to explore the experiences of older adults and counsellors involved in virtual motivational interviewing (MI). This study was part of the Virtual Motivational INTerviewing (VIMINT) feasibility trial of virtual MI for physical activity in older adults. A descriptive qualitative design utilized content analysis. Seven older adults and three counsellors were interviewed. Four categories were developed: (i) Benefits and limitations of using technology (ii) Relationships between older adults and counsellors (iii) MI skills and spirit and (iv) Effects of virtual MI. Older adults and counsellors reported that receiving/delivering MI virtually was convenient and flexible. They described reduced non-verbal communication in virtual MI. Virtual MI facilitates interpersonal relationships, and counsellors reported that MI skills and spirit can be applied virtually. This study showed that virtual MI offers potential benefits with some limitations. The findings could inform future research involving virtual delivery of MI.

Engaging patient and community stakeholders in the optimization of the Compassionate And Loving Mindset towards heart health risk (CALM Hearts) physical activity intervention: a description of initial work and protocol for future engagement activities.

BACKGROUND: Participatory research approaches systematically integrate the perspectives of individuals, organizations, or communities that have a direct interest in a study's processes and outcomes (i.e., stakeholders) in research design and implementation. This supports interventions that are developed "by, not for" end-users, thereby increasing acceptability, uptake, and adherence. However, participatory approaches are relatively under-utilized in intervention development and behavioral change intervention research, in part, due to inadequate reporting of methodology. Therefore, to improve transparency in planning and reporting, we (a) describe how we engaged patients and community organizations (i.e., patient and community partners) in grant development for a self-compassion and physical activity behaviour change intervention for women with cardiovascular risk factors and (b) present a protocol for engaging patient and community partners in the optimization and implementation of the intervention moving forward. METHODS: Our participatory research approach was guided by the Strategy for Patient-Oriented Research patient engagement framework and our prior stakeholder engagement work. Four patients and three community partners were engaged at the level of Involve, meaning their perspectives informed directions, processes, and decisions at major project milestones. Specifically, patient and community partners engaged in three separate meetings during grant development wherein they: (a) established a Terms of Reference to guide engagement activities and expectations; (b) shaped the grant through guided conversations about research priorities, outcomes, and intervention delivery components that could be targeted for optimization and (c) co-developed a protocol that specifies how relationships will be initiated with future patient partners, proposes engagement activities across the research cycle, and includes plans for formal evaluation of engagement processes. CONCLUSIONS: Participatory research approaches provide valuable insights into the development of behavioural interventions, especially when stakeholders can partner early and have a meaningful impact. By detailing our engagement activities to date, we hope to model an approach to engaging stakeholders in behavioral intervention development and demonstrate the impacts of doing so.

BACKGROUND: Participatory research engages individuals, organizations, or communities affected by a study's outcomes ("stakeholders"), in its design and conduct. Participatory research approaches are not commonly used in intervention development and behavioral intervention research, in part due to a lack of studies describing ways to engage stakeholders in this work. Therefore, our study aimed to (a) describe how we engaged patients and community organizations ("patient and community partners") in developing a grant application for a behaviour intervention for women with cardiovascular risk factors and (b) present a protocol for engaging patient and community partners in the future intervention. METHODS: Our approach was guided by the Strategy for Patient-Oriented Research patient engagement framework and our prior engagement work. Four patient and three community partners were engaged at the level of Involve, meaning their perspectives informed directions, processes, and decisions at project milestones. Across three sets of meetings, patient and community partners: (a) established a Terms of Reference to guide engagement activities and expectations; (b) shaped the grant through guided conversations about research priorities, outcomes, and intervention design; and (c) co-developed a protocol that described how relationships will be initiated with future patient partners, potential engagement activities across the research cycle, and evaluation plans. CONCLUSIONS: Participatory research approaches provide valuable insights into the development of behavioural interventions, especially when stakeholders can partner early and have a meaningful impact. By detailing our engagement activities, we hope to model an approach to engaging stakeholders in behavioral intervention development and demonstrate the impacts of doing so.

Counsellors' verbal behaviours and skills that elicit participants' change or sustain talk in virtual motivational interviewing for physical activity among older adults.

Exploring the influence of counsellors' verbal behaviours on participants' utterances in virtual motivational interviewing (MI) could broaden our understanding of how MI works. This study aims to determine counsellors' behaviours that are more or less likely than chance to elicit participants' change talk and sustain talk during a virtual MI intervention to promote physical activity among older adults. A sequential analysis was used to examine the transitional probability between the counsellors' and participants' behaviours. Thirty-five MI sessions were analysed from the virtual motivational interviewing (VIMINT) trial. MI-consistent behaviours (MICO) were significantly more likely than chance to be followed by change talk, sustain talk and follow/neutral talk. MI-inconsistent behaviours (MIIN) were more likely than chance to be followed by change talk, and 'other' counsellors' behaviours were more likely than chance to be followed by change talk and follow/neutral talk. In conclusion, all three types of counsellors' behaviours elicited change talk. This study re-emphasizes the link between MICO, change and sustain talk. The influence of MIIN and 'other' behaviours on change talk needs to be explored further. This study has implications for MI training and the need for counsellors to continuously develop skills or behaviours consistent with MI principles.

Communication between healthcare providers and communicatively-vulnerable patients with associated health outcomes: A scoping review of knowledge syntheses.

OBJECTIVE: Summarize literature on provider-patient communication linked to health outcomes in communicatively-vulnerable patient populations. METHODS: Scoping review of reviews: systematically searched six databases. INCLUSION CRITERIA: systematic searches and syntheses of literature; one or more providers and communicatively-vulnerable patients; synchronous in-person communication; intermediate or health outcome linked to communication. RESULTS: The search yielded 14,615 citations; 47 reviews - with wide range of providers, communication vulnerabilities, communication practices, and health outcomes - met inclusion criteria. Methodology included qualitative, quantitative, and mixed approaches. Quality ranged from very low to high. Six categories of communication practices linked to health outcomes were identified: 1) motivation-based; 2) accommodation of language, culture, gender, sexual identity, and other concordance with the patient; 3) cultural adaptations of interventions; 4) use of interpreters; 5) other provider-patient communication practices; 6) patient communication practices. CONCLUSION: Communication practices were studied in a wide range of providers, with common themes regarding best practices. A unique finding is the role of the patient's communication practices. The specificity of communication practices studied is heterogeneous, with many reviews providing insufficient details. PRACTICE IMPLICATIONS: Motivation-based practices and culturally- and linguistically-appropriate care have impacts on patient outcomes across a range of settings with different professions and communicatively-vulnerable groups.

Exercise identity and attribution properties predict negative self-conscious emotions for exercise relapse.

Research on exercise identity (EXID) indicates that it is related to negative affect when exercisers are inconsistent or relapse. Although identity theory suggests that causal attributions about this inconsistency elicit negative self-conscious emotions of shame and guilt, no EXID studies have examined this for exercise relapse. Weiner's attribution-based theory of interpersonal motivation (2010) offers a means of testing the attribution-emotion link. Using both frameworks, we examined whether EXID and attributional properties predicted negative emotions for exercise relapse. Participants (n = 224) read an exercise relapse vignette, and then completed EXID, attributions, and emotion measures. Hierarchical multiple regression models using EXID and the attributional property of controllability significantly predicted each of shame and guilt, R² adjusted = .09, ps ≤ .001. Results support identity theory suggestions and Weiner's specific attribution-emotion hypothesis. This first demonstration of an interlinking of EXID, controllability, and negative self-conscious emotions offers more predictive utility using complementary theories than either theory alone.

Effects of self-affirmation on university students' processing of health risk messages related to sedentary behavior.

OBJECTIVE: Examine effects of self-affirmation on university students' processing of health risk messages related to sedentary behavior. PARTICIPANTS: Eighty-eight students from a Canadian university (females = 53; males = 35; Mage = 21.74, SD = 5.36) participated during the 2018-2019 academic year. METHODS: Participants were randomized to a self-affirmation (n = 43) or control group (n = 45), watched a video conveying sedentary behavior risk messages, and completed measures of acceptance, derogation, risk perceptions, negative affect, and intentions. A one-way between-groups multivariate analysis of variance (MANOVA) examined effects of condition on the combined set of outcome variables. RESULTS: Self-affirmation had no observable effect on any outcome variables. CONCLUSION: Self-affirmation did not appear to impact students' reactions to sedentary behavior risk messages. Given the lack of a manipulation check, however, this finding must be interpreted with caution. The Trigger and Channel framework offers a useful account of factors that influence self-affirmation effects. Implications and future research directions are discussed.

Put MY mask on first: Mothers' reactions to prioritizing health behaviours as a function of self-compassion and fear of self-compassion.

Self-compassion predicts mothers' engagement in health behaviours yet some mothers fear self-compassion. We examined relationships between both self-compassion and fear of self-compassion with mothers' reactions to prioritizing health behaviours. Mothers rated their self-compassion, fear of self-compassion, read a scenario about prioritizing health behaviours and rated adjectives describing themselves if they behaved as described in the scenario. Self-compassion was positively related to positive reactions to engaging in health behaviours in the midst of motherhood. Fear of self-compassion led to negative reactions. This research provides insight into why some mothers feel better about incorporating health behaviours into their lives than others.

Self-compassion and sleep quality: Examining the mediating role of taking a proactive health focus and cognitive emotional regulation strategies.

Sleep quality (SQ) impacts health yet many university students get poor sleep. Self-compassion (SC)-care for oneself during challenging times-is associated with SQ yet how SC has these effects is unclear. This study cross-sectionally examined whether SC is negatively related to poor SQ and whether proactive health focus and cognitive emotional regulation strategies (CERS) mediate this relationship. University students (N = 193) self-reported SC, proactive health focus, CERS, and SQ. SC negatively associated with poor SQ (r = -0.34) and self-blame mediated this (b = 0.08, 95% CI [0.01, 0.16]). SC may improve SQ through reducing self-blame.

University students' knowledge, self-efficacy, outcome expectations, and barriers related to reducing sedentary behavior: a qualitative study.

ObjectiveTo explore university students' knowledge, self-efficacy, outcome expectations, barriers and ideas related to reducing sedentary behavior using a qualitative approach. Participants: Nineteen students from a Canadian university participated. Methods: Four focus groups were conducted. Discussions were recorded, transcribed, and coded to identify categories and themes. Results: Some students lacked knowledge of the concept, but most were generally aware of health risks associated with sedentary behavior. Most students were confident they could reduce sedentary behavior, but felt it would be unlikely they would actually do so because: (a) it is not a priority, (b) the health consequences are distal, (c) increasing standing and light-intensity activity would not provide meaningful health benefits, and (d) class schedules/norms/infrastructure encourage sitting and are not under their control to change. Conclusion: Findings from this study may help inform intervention strategies aimed at decreasing excessive sedentary behavior among university students.

A pilot and feasibility study of a randomized clinical trial testing a self-compassion intervention aimed to increase physical activity behaviour among people with prediabetes.

BACKGROUND: Seventy-five per cent of individuals with prediabetes will eventually be diagnosed with type 2 diabetes. Physical activity is a cornerstone in reducing type 2 diabetes risk but can be a challenging behaviour to adopt for those living with prediabetes. Individuals with prediabetes experience difficult emotions associated with being at risk for a chronic disease, which can undermine self-regulation. Self-compassion enhances self-regulation because it mitigates difficult emotions and promotes adaptive coping. We performed a pilot randomized controlled trial to determine the feasibility and acceptability of a self-compassion informed intervention to increase physical activity for persons with prediabetes. METHODS: This explanatory mixed methods study tested the feasibility and acceptability of a two-arm, randomized, single-blind, actively controlled, 6-week online intervention. Using a 1:1 allocation ratio, participants (identified as people with prediabetes, low physical activity, and low self-compassion) were randomized to a self-compassion (Mage = 60.22 years) or control condition (Mage = 56.13 years). All participants received behaviour change education (e.g. SMART goals, action-coping planning) and either other health knowledge (control condition: e.g. sleep, benefits of water) or self-compassion training (intervention condition: practising mindfulness, writing a letter to themselves offering the same support that they would offer to a friend). The primary outcome was to determine the feasibility and acceptability of the trial. To be considered feasible, our outcomes needed to meet or surpass our pre-determined criteria (e.g. time for group formation: 14-20 participants per month). Feasibility was assessed by examining the recruitment rates, retention, adherence, fidelity, and capacity. Semi-structured interviews were conducted with participants to determine trial acceptability. As a secondary purpose, we examined the means on key study variables (secondary and exploratory variables; see Table 1) at all planned time points (baseline, intervention-end, 6- and 12-week follow-up) to identify if they are suitable to include in the efficacy trial (see Additional Table 3). RESULTS: Eighteen participants were screened and randomized to one of two conditions. Retention, instructor fidelity, safety, capacity, adherence to most of the study aspects, and acceptability by participants and facilitators all met the criteria for feasibility. Recruitment rate, process time, and adherence to home practice were below our criteria, and we offer ways to address these shortcomings for the efficacy trial. CONCLUSION: The results from this study suggest that it should be feasible to deliver our intervention while highlighting the alterations to components that may be altered when delivering the efficacy trial. We outline our changes which should improve and enhance the feasibility and acceptability of our planned intervention. Funding for this study was from the Canadian Institutes of Health Research (CIHR). TRIAL REGISTRATION: ClinicalTrials.gov, NCT04402710 . Registered on 09 April 2020.

Self-compassion and responses to health information in middle-aged and older women: An observational cohort study.

The aim of this study was to determine whether self-compassion-orientation to care for oneself during challenges-helps people at risk of cardiovascular disease deal with emotional reactions and assist with self-regulating health behaviors. This observational study recruited women (N = 102) who attended three research visits over 3 weeks to gather information on emotions, intentions, and engagement in health behaviors after women received news they were at risk of cardiovascular disease. Self-compassion negatively associated with emotional responses and associated with intentions and engagement in health behaviors after receiving news of their cardiovascular disease risk. Self-compassion was associated with adaptive lifestyle behaviors.

Exploring physical activity and sedentary behaviour: perspectives of individuals with osteoarthritis and knee arthroplasty.

Purpose: To explore the understanding of physical activity and sedentary behaviour, including barriers and health influences in people with osteoarthritis and knee arthroplasty.Methods: Eight participants with knee osteoarthritis and 14 participants with total knee arthroplasty were recruited to five focus groups. Interpretive description was used with thematic analysis of data.Results: Three primary themes arose: (1) continuum of activity; (2) barriers to increasing physical activity and barriers to reducing sedentary behavior, and (3) knowledge gap. While participants were generally familiar with the concepts of physical activity and sedentary behaviour, they were not aware of health risks associated with high levels of sedentary time and did not consider substituting standing and light walking for activities typically done in sitting. Participants reported that extrinsic barriers (e.g., related to social and cultural contexts or the physical environment) influenced sedentary behaviour more than intrinsic factors.Conclusions: Patients would benefit from clinicians providing education about risks associated with sedentary behaviour and strategies to reduce and/or break up sitting time. Future research should continue to explore personal as well as societal, environmental, political, and economic influences on sedentary behaviour and physical activity to promote behaviour change.Implications for rehabilitationPeople with osteoarthritis and total knee arthroplasty are not aware of health risks associated with high levels of sedentary behaviour.This cohort tends to think about increasing moderate-to-vigorous physical activity levels (versus increasing light activity) when asked to consider ways to reduce sedentary behaviour.Social and environmental factors strongly influence sedentary behaviour. Clinicians need to be aware of the pervasive nature of sedentary behaviour and provide knowledge and strategies to change peoples' sitting habits.Addressing intrinsic factors (e.g., related to comorbidities, ageing, and personal preferences) with education and the use of existing behaviour change techniques may enable increased physical activity levels.

Self-Compassion, Adaptive Reactions and Health Behaviours Among Adults With Prediabetes and Type 1, Type 2 and Gestational Diabetes: A Scoping Review.

Engaging in health-promoting behaviours has health benefits for people with prediabetes or diabetes. People experience negative affect after diagnoses, which can impede self-regulation of health behaviours. Self-compassion, extending care to oneself in difficult times, can mitigate negative affect and promote self-regulation. This scoping review explored the relationship between self-compassion and adaptive affect, self-regulation and engagement in health-promoting/management behaviours among people with prediabetes or diabetes. We conducted a scoping literature search from 6 databases for studies and conference abstracts. Randomized controlled trials and cross-sectional, longitudinal, observational and qualitative designs focused on self-compassion were included. Eligible studies included adults with diabetes (prediabetes, type 1, type 2 and gestational), measured self-compassion using a validated Self-Compassion Scale (quantitative) or included the 3 components (qualitative) and investigated: negative affect, health promoting/management behaviours and/or self-regulation. After deduplication, 5,338 quantitative and 953 qualitative abstracts, and 18 conference proceedings were screened leaving 35 articles. Full-text screening retained 11 eligible studies (6 cross-sectional studies, 2 randomized controlled trials, 2 longitudinal studies and 1 qualitative study). Higher self-compassion was associated with decreased negative affect in 9 studies and was positively associated with well-being in 1 cross-sectional study. Self-compassion led to decreased negative affect and improved blood glucose in 2 interventions. Five studies found positive associations between self-compassion and health-promoting/management behaviours. One qualitative study found self-compassion to benefit affective reactions, health-promoting behaviours and self-regulation. This review shows that self-compassion is linked to adaptive behavioural and affective responding among people with prediabetes and diabetes, and the need for more research on self-compassion and self-regulation in these populations.

Healthy-eater identity and self-efficacy predict healthy eating behavior: a prospective view.

Identity and Self-efficacy Theories were used to examine the relationship between healthy-eater identity, self-efficacy for healthy eating and healthy eating. Measures of healthy-eater identity, perception of healthy eating, nutrition knowledge, self-efficacy for both intake of fruits and vegetables and foods of low nutritional value were completed by 101 university students and staff. Two weeks later, participants recalled recent consumption of (a) fruits and vegetables and (b) foods of low nutritional value. For both eating outcomes, healthy-eater identity was a significant predictor after controlling for nutrition knowledge. The addition of self-efficacy improved prediction in the case of both eating outcomes.

Self-Compassion and Psycho-Physiological Recovery From Recalled Sport Failure.

Failure inherent to high-performance sport can precipitate emotional distress that can impair athletes' performance and physical and mental health. Identifying factors that allow athletes to manage failure to sustain their health is critical. Self-compassion, treating oneself kindly in response to failure, may help athletes manage failure; it buffers against negative affective psychological responses, yet athletes often fear self-compassion. It is unknown whether the benefits of self-compassion extend to athletes' physiological responses to failure and whether fear of self-compassion has an influence on psychological and physiological responses to failure, beyond self-compassion. The purpose of this study was to examine the influence of self-compassion on athletes' psychological and physiological responses when recalling a sport failure and determine if fear of self-compassion exerted unique effects, beyond self-compassion. Participants (n = 91; M age = 21) were university or national-level athletes. In this laboratory-based, observational study, athletes were connected to a multi-modal biofeedback system to measure physiological responding at baseline, during a stress induction (imagining a past performance failure), and during a recovery period. Physiological responding was assessed according to athletes' high-frequency heart rate variability (HRV), indexing parasympathetic nervous system activity, during the stress induction and recovery phase. Next, to assess psychological reactivity, athletes completed a series of scales (behavioral reactions, thoughts, and emotions). Regression analyses revealed that self-compassion predicted athletes' HRV reactivity to the stress induction (ß = 0.30, p < 0.05). There was no relationship between self-compassion and HRV recovery. Further, self-compassion predicted adaptive behavioral reactions (ß = 0.46, p < 0.01), and negatively predicted maladaptive thoughts (ß = -0.34, p < 0.01) and negative affect (ß = -0.39, p < 0.01). Fear of self-compassion explained additional variance in some maladaptive thoughts and behavioral reactions. Results suggest that self-compassion promotes adaptive physiological and psychological responses in athletes relative to a recalled sport failure and may have implications for performance enhancement, recovery and health outcomes. Further, addressing athletes' fears of self-compassion may also be important in promoting optimal psychological recovery.