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Increasing Health Behaviors and Psychological Measures with an Adapted Version of the ACCELERATION Program.
Schwartz, J, Rhodes, RE, Oh, P, Bredin, SSD, Perotto, MB, González, AG, Warburton, DER
International journal of behavioral medicine. 2024
Abstract
BACKGROUND Recent evidence highlights the importance of interventions tackling physical inactivity and unhealthy eating in lower-income countries. The purpose of this study was to examine the effectiveness of the Canadian ACCELERATION lifestyle program adapted to Brazilians. The main outcomes of the study were changes in the engagement in weekly moderate-to-vigorous physical activity (MVPA) and in the daily consumption of fruits/vegetables. METHODS The adapted intervention consisted of a 12-week quasi-randomized controlled trial delivered through email. The data from the original Canadian experimental group (CE, n = 194) and the two groups of Portuguese-speaking Brazilians living in Canada in the adapted program - Brazilian experimental (BE, n = 41) and Brazilian control (BC, n = 35) - were assessed at baseline and post-intervention. The data of the 270 participants were analyzed using two-way repeated measures factorial ANCOVA (group x time) for ratio variables and Chi-square and McNemar tests for the categorical variables. RESULTS The BE group had a significant increase in MVPA (mean difference, 95% CI: 86.3, 38.1-134.4 min/week) and fruits/vegetables intake (3.2, 1.4-5.1 servings/day) after the intervention (both p < 0.001). The proportion of participants engaging in ≥ 150 min of MVPA increased from 4.9% to 73.2%, while adoption of a healthy diet increased from 4.9% to 53.7% in the BE group (both p < 0.001). The CE group also improved on these variables (p < 0.05) with no difference vs the BE group (p > 0.05), whereas BC did not show changes (p > 0.05). CONCLUSION The Brazilian version of the ACCELERATION program effectively promoted positive health behavior changes in its participants and has the potential to contribute to the fight against risk factors for chronic diseases in Brazilians.
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Use of Electronic Ecological Momentary Assessment Methodologies in Physical Activity, Sedentary Behavior, and Sleep Research in Young Adults: Systematic Review.
Hartson, KR, Huntington-Moskos, L, Sears, CG, Genova, G, Mathis, C, Ford, W, Rhodes, RE
Journal of medical Internet research. 2023;:e46783
Abstract
BACKGROUND Recent technological advances allow for the repeated sampling of real-time data in natural settings using electronic ecological momentary assessment (eEMA). These advances are particularly meaningful for investigating physical activity, sedentary behavior, and sleep in young adults who are in a critical life stage for the development of healthy lifestyle behaviors. OBJECTIVE This study aims to describe the use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults. METHODS The PubMed, CINAHL, PsycINFO, Embase, and Web of Science electronic databases were searched through August 2022. Inclusion criteria were use of eEMA; sample of young adults aged 18 to 25 years; at least 1 measurement of physical activity, sedentary behavior, or sleep; English language; and a peer-reviewed report of original research. Study reports were excluded if they were abstracts, protocols, or reviews. The risk of bias assessment was conducted using the National Heart, Lung, and Blood Institute's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Screening, data extraction, and risk of bias assessments were conducted by independent authors, with discrepancies resolved by consensus. Descriptive statistics and narrative synthesis were used to identify overarching patterns within the following categories guided by the Checklist for Reporting Ecological Momentary Assessments Studies: study characteristics, outcomes and measures, eEMA procedures, and compliance. RESULTS The search resulted in 1221 citations with a final sample of 37 reports describing 35 unique studies. Most reports (28/37, 76%) were published in the last 5 years (2017-2022), used observational designs (35/37, 95%), consisted of samples of college students or apprentices (28/35, 80%), and were conducted in the United States (22/37, 60%). The sample sizes ranged from 14 to 1584 young adults. Physical activity was measured more frequently (28/37, 76%) than sleep (16/37, 43%) or sedentary behavior (4/37, 11%). Of the 37 studies, 11 (30%) reports included 2 movement behaviors and no reports included 3 movement behaviors. eEMA was frequently used to measure potential correlates of movement behaviors, such as emotional states or feelings (25/37, 68%), cognitive processes (7/37, 19%), and contextual factors (9/37, 24%). There was wide variability in the implementation and reporting of eEMA procedures, measures, missing data, analysis, and compliance. CONCLUSIONS The use of eEMA methodologies in physical activity, sedentary behavior, and sleep research in young adults has greatly increased in recent years; however, reports continue to lack standardized reporting of features unique to the eEMA methodology. Additional areas in need of future research include the use of eEMA with more diverse populations and the incorporation of all 3 movement behaviors within a 24-hour period. The findings are intended to assist investigators in the design, implementation, and reporting of physical activity, sedentary behavior, and sleep research using eEMA in young adults. TRIAL REGISTRATION PROSPERO CRD42021279156; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021279156.
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Collaborative, dyadic, and individual planning and physical activity: A dyadic randomized controlled trial.
Kulis, E, Szczuka, Z, Keller, J, Banik, A, Boberska, M, Kruk, M, Knoll, N, Radtke, T, Scholz, U, Rhodes, RE, et al
Health psychology : official journal of the Division of Health Psychology, American Psychological Association. 2022;(2):134-144
Abstract
OBJECTIVE This study was designed to investigate the effects of collaborative, dyadic, and individual planning on moderate-to-vigorous physical activity (MVPA) in target person-partner dyads. Individual planning reflects an "I-for-me" planning of one person's behavior. Collaborative planning refers to joint planning of both dyad members' behavior ("We-for-us" planning), and dyadic planning refers to joint planning of only the target person's behavior ("We-for-me" planning). METHOD N = 320 dyads of target persons (M age: 43.86 years old) and partners (M age: 42.32 years old) participated in a randomized controlled trial (ClinicalTrials.gov registration no. NCT03011385) with three experimental planning conditions (collaborative, dyadic, or individual planning) and an active control condition (physical activity, sedentary behavior, and nutrition education). Target persons did not meet international MVPA guidelines or were recommended to increase their MVPA due to cardiovascular disease or type II diabetes. MVPA was measured with ActiGraph wGT3X-BT accelerometers at baseline, 1-week follow-up, and 36-week follow-up (6 months after the final intervention session; the primary endpoint). Linear mixed models were fit for target persons and partners separately. RESULTS At 1-week follow-up, there were no significant Time × Condition interaction effects among target persons and partners. At 36-week follow-up, target persons and partners in the dyadic planning conditions increased their MVPA, compared to the control condition. CONCLUSIONS Individuals with insufficient physical activity or with a cardiovascular disease/type II diabetes and their partners may benefit from dyadic planning, which is a promising strategy to achieve physical activity increases. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Perceptions of physical activity and sedentary behaviour guidelines among end-users and stakeholders: a systematic review.
Hollman, H, Updegraff, JA, Lipkus, IM, Rhodes, RE
The international journal of behavioral nutrition and physical activity. 2022;(1):21
Abstract
BACKGROUND Many of the world's population, across all age groups and abilities, are not meeting or even aware of internationally recommended physical activity (PA) and sedentary behaviour (SB) guidelines. In order to enhance awareness and uptake, guidelines should be perceived positively by targeted users. The purpose of this study was to review the literature on end-user and stakeholder perceptions of PA and SB guidelines. METHODS The electronic databases APA PsycInfo, CINAHL, MEDLINE, and SPORTDiscus, using EBSCOhost Research Platform, and Web of Science were searched from inception to June, 2021 with keyword synonyms for "perceptions", "PA guidelines", and "SB guidelines". Studies of any design that collected stakeholder and/or end-user responses to a PA and/or SB guideline were included and assessed for risk of bias. The PA and/or SB guideline could be any type of official form (e.g., national documents, organizational guidelines, expert consensus statements, etc.) from any country, that targets individuals at the regional, provincial/statewide, national, or international level, and includes all types of guidelines (e.g., strength, aerobic, clinical, nonclinical, screen-time, sitting, etc.). Data were extracted and analyzed using thematic synthesis. RESULTS After screening 1399 abstracts and applying citation screening, 304 full-texts were retrieved. A total of 31 articles met the inclusion criteria. End-users and stakeholders for PA guidelines across all age groups expressed the need for simplified language with more definitions, relatable examples and imagery, and quantification of PA behaviours. There was concern for the early years and child PA guidelines leading to guilt amongst parents and the SB guidelines, particularly the recommendations to limit screen-time, being unrealistic. General age group PA guidelines were not perceived as usable to populations with differing abilities, clinical conditions, and socioeconomic status. Guidelines that targeted clinical populations, such as persons with multiple sclerosis and persons with spinal cord injury, were well received. CONCLUSIONS There is a clear need to balance the evidence base with the pragmatic needs of translation and uptake so that the guidelines are not ignored or act as a barrier to actual engagement.
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Online-Delivered Group and Personal Exercise Programs to Support Low Active Older Adults' Mental Health During the COVID-19 Pandemic: Randomized Controlled Trial.
Beauchamp, MR, Hulteen, RM, Ruissen, GR, Liu, Y, Rhodes, RE, Wierts, CM, Waldhauser, KJ, Harden, SH, Puterman, E
Journal of medical Internet research. 2021;23(7):e30709
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A widely scalable, nonpharmacological, and cost-effective approach promoted by the World Health Organization to support mental health during the pandemic corresponds to regular physical activity. The aim of this study was to assess whether a group-based online exercise programme or a personal online exercise programme compared to a waitlist control can improve the psychological health of previously low active older adults during the early stages of the COVID-19 pandemic. The study is a prospective, 3-arm, parallel, randomized controlled trial. Two-hundred and forty-one low active older adults, aged between 65 and 69 years, were enrolled in the study. Participants were stratified to ensure equal distribution of men and women across conditions. Results indicate that both physical activity programmes showed improvements in mental health when compared with control participants, which represents a notable outcome for older adults in the current COVID-19 pandemic. Authors conclude that virtually delivered interventions are feasible and, when delivered in a group setting, can aid the retention of previously low active older adults.
Abstract
BACKGROUND In response to the COVID-19 pandemic, experts in mental health science emphasized the importance of developing and evaluating approaches to support and maintain the mental health of older adults. OBJECTIVE The aim of this study was to assess whether a group-based exercise program relative to a personal exercise program (both delivered online) and waitlist control (WLC) can improve the psychological health of previously low active older adults during the early stages of the COVID-19 pandemic. METHODS The Seniors COVID-19 Pandemic and Exercise (SCOPE) trial was a 3-arm, parallel randomized controlled trial conducted between May and September 2020 in which low active older adults (aged ≥65 years) were recruited via media outlets and social media. After baseline assessments, consented participants were randomized to one of two 12-week exercise programs (delivered online by older adult instructors) or a WLC condition. A total of 241 older adults (n=187 women) provided baseline measures (via online questionnaires), were randomized (ngroup=80, npersonal=82, ncontrol=79), and completed measures every 2 weeks for the duration of the trial. The trial's primary outcome was psychological flourishing. Secondary outcomes included global measures of mental and physical health, life satisfaction, and depression symptoms. RESULTS The results of latent growth modeling revealed no intervention effects for flourishing, life satisfaction, or depression symptoms (P>.05 for all). Participants in the group condition displayed improved mental health relative to WLC participants over the first 10 weeks (effect size [ES]=0.288-0.601), and although the week 12 effect (ES=0.375) was in the same direction the difference was not statistically significant (P=.089). Participants in the personal condition displayed improved mental health, when compared with WLC participants, in the same medium ES range (ES=0.293-0.565) over the first 8 weeks, and while the effects were of a similar magnitude at weeks 10 (ES=0.455, P=.069) and 12 (ES=0.258, P=.353), they were not statistically significant. In addition, participants in the group condition displayed improvements in physical health when compared with the WLC (ES=0.079-0.496) across all 12 weeks of the study following baseline. No differences were observed between the personal exercise condition and WLC for physical health (slope P=.271). CONCLUSIONS There were no intervention effects for the trial's primary outcome (ie, psychological flourishing). It is possible that the high levels of psychological flourishing at baseline may have limited the extent to which those indicators could continue to improve further through intervention (ie, potential ceiling effects). However, the intervention effects for mental and physical health point to the potential capacity of low-cost and scalable at-home programs to support the mental and physical health of previously inactive adults in the COVID-19 pandemic. TRIAL REGISTRATION ClinicalTrials.gov NCT04412343; https://clinicaltrials.gov/ct2/show/NCT04412343.
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Psychological mediators of exercise adherence among older adults in a group-based randomized trial.
Beauchamp, MR, Liu, Y, Dunlop, WL, Ruissen, GR, Schmader, T, Harden, SM, Wolf, SA, Puterman, E, Sheel, AW, Rhodes, RE
Health psychology : official journal of the Division of Health Psychology, American Psychological Association. 2021;(3):166-177
Abstract
OBJECTIVE To examine the psychological mediators of exercise adherence among older adults in a group-based physical activity randomized controlled trial. METHOD Older adults (≥65 years) were randomized to one of three conditions as part of the "GrOup-based physical Activity for oLder adults" (GOAL) randomized controlled trial. These included similar age same gender (SASG) and similar age mixed gender (SAMG) exercise programs that were informed by the tenets of self-categorization theory, and a "standard" mixed age mixed gender (MAMG) exercise program. Participants represented a subgroup (n = 483, Mage = 71.41 years) from the larger trial (n = 627) who completed measures of the trial's putative psychological mediators (i.e., group cohesion and affective attitudes) over the course of the 24-week exercise programs. RESULTS Piecewise latent growth modeling revealed different trajectories between participants in the two intervention conditions (SASG, SAMG) when compared with the comparison MAMG condition with regard to perceptions of group cohesion and affective attitudes. Results of subsequent cross-lagged panel modeling revealed that better program adherence in the two intervention conditions, when compared with the referent MAMG condition, was mediated by perceptions of group cohesion. CONCLUSIONS The findings provide insight into how the two intervention programs differentially strengthened perceptions of group cohesion and affective attitudes over time. Consistent with self-categorization theory, the results also shed light on the role of group cohesion, in particular, as a psychological mechanism of action to promote older adults' exercise adherence behaviors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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A Critical Review on New Approaches for Chronic Disease Prevention in Brazil and Canada: From Wholistic Dietary Guidelines to Physical Activity Security.
Schwartz, J, Oh, P, Perotto, MB, Rhodes, RE, Firth, W, Bredin, SSD, Gaytán-González, A, Warburton, DER
Frontiers in cardiovascular medicine. 2021;:730373
Abstract
In light of new evidence on the prevention of chronic diseases and the elevated rates of overweight and obesity in Brazil and Canada, this critical review aims to interpret and synthesize current aspects regarding dietary and physical activity initiatives in both countries and make future recommendations. The pioneering work presented in the last Brazilian dietary guidelines has been called a model that can be applied globally, given its conceptualization of healthy eating that translates easily to practical guidance. The new Canadian Food Guide has incorporated similar aspects, also putting the country as a leader in dietary guidance. With these new recommendations, citizens in both Brazil and Canada have access to impactful evidence-informed nutritional guidelines. Both documents propose eating patterns that focus not only on health benefits, such as chronic disease prevention, but also incorporate well-being concerning cultural, economic, sociodemographic, biological, and ecological dimensions. A similar approach is required for physical activity to allow individuals to have attainable health and life goals and thereby fully enjoy their lives, regardless of geographical location, health status, and socioeconomic condition, a concept recently described as physical activity security. The wholistic dietary guidelines from both countries represent a change in paradigm in public health. Likewise, national evidence-based policies are warranted to reduce disparities in physical activity, allowing healthier and more active lifestyles for everyone.
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Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep.
Ross, R, Chaput, JP, Giangregorio, LM, Janssen, I, Saunders, TJ, Kho, ME, Poitras, VJ, Tomasone, JR, El-Kotob, R, McLaughlin, EC, et al
Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme. 2020;(10 (Suppl. 2)):S57-S102
Abstract
The Canadian Society for Exercise Physiology assembled a Consensus Panel representing national organizations, content experts, methodologists, stakeholders, and end-users and followed an established guideline development procedure to create the Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These guidelines underscore the importance of movement behaviours across the whole 24-h day. The development process followed the strategy outlined in the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. A large body of evidence was used to inform the guidelines including 2 de novo systematic reviews and 4 overviews of reviews examining the relationships among movement behaviours (physical activity, sedentary behaviour, sleep, and all behaviours together) and several health outcomes. Draft guideline recommendations were discussed at a 4-day in-person Consensus Panel meeting. Feedback from stakeholders was obtained by survey (n = 877) and the draft guidelines were revised accordingly. The final guidelines provide evidence-based recommendations for a healthy day (24-h), comprising a combination of sleep, sedentary behaviours, and light-intensity and moderate-to-vigorous-intensity physical activity. Dissemination and implementation efforts with corresponding evaluation plans are in place to help ensure that guideline awareness and use are optimized. Novelty First ever 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older with consideration of a balanced approach to physical activity, sedentary behaviour, and sleep Finalizes the suite of 24-Hour Movement Guidelines for Canadians across the lifespan.
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Consistent Morning Exercise May Be Beneficial for Individuals With Obesity.
Schumacher, LM, Thomas, JG, Raynor, HA, Rhodes, RE, Bond, DS
Exercise and sport sciences reviews. 2020;(4):201-208
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Abstract
This review explores the hypothesis that a consistent exercise time, especially consistent morning exercise, improves exercise adherence and weight management for individuals with overweight or obesity. We discuss data supporting this premise, identify limitations of current research, and outline directions for future research on exercise timing to more robustly evaluate our thesis.
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Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth.
Rhodes, RE, Guerrero, MD, Vanderloo, LM, Barbeau, K, Birken, CS, Chaput, JP, Faulkner, G, Janssen, I, Madigan, S, Mâsse, LC, et al
The international journal of behavioral nutrition and physical activity. 2020;(1):74
Abstract
BACKGROUND Children and youth who meet the physical activity, sedentary, and sleep behaviour recommendations in the Canadian 24-Hour Movement Guidelines are more likely to have desirable physical and psychosocial health outcomes. Yet, few children and youth actually meet the recommendations. The family is a key source of influence that can affect lifestyle behaviours. The purpose of this paper is to describe the process used to develop the Consensus Statement on the Role of the Family in the Physical Activity, Sedentary, and Sleep Behaviours of Children and Youth (0-17 years) and present, explain, substantiate, and discuss the final Consensus Statement. METHODS The development of the Consensus Statement included the establishment of a multidisciplinary Expert Panel, completion of six reviews (three literature, two scoping, one systematic review of reviews), custom data analyses of Statistics Canada's Canadian Health Measures Survey, integration of related research identified by Expert Panel members, a stakeholder consultation, establishment of consensus, and the development of a media, public relations, communications and launch plan. RESULTS Evidence from the literature reviews provided substantial support for the importance of family on children's movement behaviours and highlighted the importance of inclusion of the entire family system as a source of influence and promotion of healthy child and youth movement behaviours. The Expert Panel incorporated the collective evidence from all reviews, the custom analyses, other related research identified, and stakeholder survey feedback, to develop a conceptual model and arrive at the Consensus Statement: Families can support children and youth in achieving healthy physical activity, sedentary and sleep behaviours by encouraging, facilitating, modelling, setting expectations and engaging in healthy movement behaviours with them. Other sources of influence are important (e.g., child care, school, health care, community, governments) and can support families in this pursuit. CONCLUSION Family is important for the support and promotion of healthy movement behaviours of children and youth. This Consensus Statement serves as a comprehensive, credible, and current synopsis of related evidence, recommendations, and resources for multiple stakeholders.