Qualitative Elicitation of Physical Activity Salient Beliefs Among Turkish Adolescent Girls

BACKGROUND

This study aims to investigate salient beliefs toward physical activity by gathering qualitative data through open-ended questions among high school-aged female adolescents in Turkey.

METHODS

A sample of 259 Turkish high school students, aged between 14 and 17, were randomly selected to participate in this study. Open-ended questions address 3 main components of the Theory of Planned Behavior, attitudes, perceived control, and social norms. Content analysis is employed to categorize the data according to themes, during the elicitation process.

RESULTS

The results were categorized as variables of the Theory of Planned Behavior. Positive attitude contributors included health expectations, emotions, fitness expectations, learning, and socialization, while negative attitude contributors encompassed adverse health outcomes and emotions. Second, perceived competence and efficacy emerged as positive contributors to perceived behavior control, whereas factors, such as time constraints, health-related barriers, fitness barriers, environmental and economic barriers, and perceived negative competence and efficacy were identified as negative influencers of perceived behavior control. Last, it was found that families, friends, and teachers played significant roles in shaping social norms.

CONCLUSIONS

Offering attractive choices for physical activities while explaining the positive impact on both physical, and mental health, as well as physical fitness is important for positive attitudes. Providing positive experiences and emphasizing the aspects of physical activity that support academic productivity are important factors in supporting perceived behavioral control. Finally, advocating for environments that promote physical activity behaviors among peers and ensure comprehensive support from families and educators is valuable in terms of subjective norms to increase physical activity intentions.

Associations between socioeconomic status and physical activity: A cross-sectional analysis of Chinese children and adolescents

Objectives

Although socioeconomic status (SES) has been shown to be an important determinant of physical activity (PA) in adults, the association in children and adolescents remains less consistent based on evidence from western developed countries. The purpose of this study, therefore, is to investigate associations between SES and PA among Chinese children and adolescents.

Methods

A cross-sectional study was conducted with a self-reported questionnaire in China. The multi-stage stratified cluster sampling method was used, and 2,955 children and adolescents (8–17 years old, 53.4% girls) were enrolled in this study. SES was assessed by measuring parental education levels, perceived family wealth, and Family Affluence Scale II (FAS II). PA was assessed by reliable and valid items from the Health Behavior School-aged Children Surveillance questionnaires. Descriptive statistics were used to report sample characteristics, including demographic characteristics, levels of PA, and SES. The Chi-square test was applied to analyze the differences of PA in gender and school period. Binary logistic regression was used to analyze the association between SES and PA among children and adolescents.

Results

Overall, 10.4% of children and adolescents accumulated moderate-to-vigorous physical activity (MVPA) at least 60 min per day. Boys were more physically active than girls (14.1% vs. 7.2%, p < 0.001). Higher socioeconomic status was positively associated with higher physical activity levels among children and adolescents, especially using FAS and mother education level as SES measures. The association between SES and PA varied by gender and grade group, and the effects of SES are also different on weekdays and weekends.

Conclusion

This study found socioeconomic disparities in PA among Chinese children and adolescents, and showed the importance of targeting children and adolescents with low SES intervention priority. Based on these research findings, it is suggested that SES, especially for FAS and mother education level, should be considered when designing and implementing the promotion of regular PA in children and adolescents. Health policymakers may use this information to develop interventions to reduce health inequalities among children and adolescents in the future.

Comprando Rico y Sano: Increasing Latino nutrition knowledge, healthful diets, and food access through a national community-based intervention

PURPOSE

Evaluation findings from "X" a culturally relevant, community-based intervention addressing nutrition knowledge and food access are presented.

DESIGN

No-control quasi-experimental intervention with pre, post, and follow-up assessments.

SETTING

"X" was promotores-led through "X" community-based partners.

SAMPLE

Low-income Latino adults (N=966) receiving services at 25 partner sites.

INTERVENTION

"X" was a six-hour intervention focused on nutrition knowledge and consumption of fruits, vegetables, and home-prepared meals. It also provided guidance for health-conscious grocery shopping, Supplemental Nutrition Assistance Program (SNAP) information, and enrollment assistance.

MEASURES

Self-report surveys assessed nutrition knowledge; intention to change; and frequency of fruit, vegetable, and home-prepared meal consumption. Sites reported monthly SNAP enrollment data.

ANALYSIS

Paired-samples t-tests and repeated-measures ANOVAs assessed changes in knowledge, intentions, and behavior from pre-to-post (n=960) and pre-to-follow-up (n=115).

RESULTS

Pre-to-follow-up increases in nutrition knowledge (p<.001) were observed. Intention to consume more vegetables (p=.027) and home-prepared meals (p<.001) also improved between pre and follow-up. Increases from pre-to-follow-up were observed for frequency of consuming fruits (p=.007), vegetables (p=.001), and home-prepared meals (p<.001). Across 16 months, 24,359 Latinos enrolled for SNAP.

CONCLUSION

Large-scale community collaborations to deliver culturally relevant nutrition education and SNAP enrollment assistance can increase food access, health literacy, and promote healthful diets for Latinos.

Adolescents' Physical Activity and Depressive Symptoms: A Psychosocial Mechanism

Guided by the Theory of Planned Behavior (TPB; Ajzen, 1991), this study aimed to test a hypothesized path model of TPB variables (i.e., attitude toward behavior, subjective norm, perceived behavioral control, and intention) with physical activity (PA) and depressive symptoms. A total of 792 Chinese adolescents (M_age = 16.9; SD = 0.82; 54.5% females) completed previously validated questionnaires assessing their TPB variables, PA, and depressive symptoms. Correlation analysis revealed TPB variables were positively associated with PA (p < 0.01), and negatively correlated to depressive symptoms (p < 0.01). The path analyses indicated that the hypothesized model produces a goodness of fit (χ²/df = 16.14/5, CFI = 0.99, RMSEA = 0.06). The findings support the theoretical tenets of TPB and provide empirical evidence of the psychosocial mechanism of PA and depressive symptoms in Chinese adolescents. It suggests that building PA intervention strategies while considering the TPB framework may promote adolescents' physical and mental health.

The role of motivation on physical activity and screen time behaviors among parent-adolescent dyads: The FLASHE study

Behavioral theories inform the development of lifestyle interventions to address low participation in physical activity (PA); however, relatively little is known about the value of self-determination theory (SDT) for explaining screen time (ST) behaviors or in extending SDT into a dyadic context. Actor-partner (i.e., parent-adolescent) interdependence models (APIMs) allow for examination of these interpersonal relationships. The purpose of this study was to examine PA and ST among parent-adolescent dyads using the cross-sectional Family Life, Activity, Sun, Health, and Eating (FLASHE) Study. Parent-adolescent dyads provided responses to online surveys addressing PA (n = 1177 dyads) and ST (n = 1489 dyads) behaviors. We examined the influence of SDT-based constructs (perceived competence and motivation) on PA and ST behaviors. Structural equations were used to estimate APIMs in STATA 15.1. Full models provided a good fit to the data. For both PA and ST, perceived competence was more strongly associated with motivation among adolescents compared with parents (PA: β = 0.72 vs. 0.58, ST: β = 0.34 vs. 0.22, p's < 0.001). Parental motivation was associated with parental PA and both adolescent motivation for PA and ST (p's < 0.001). Parental motivation was not associated with adolescent ST-behavior. Adolescent motivation was only associated with parent motivation for PA. In the FLASHE study, SDT constructs extend acceptably to the dyadic setting, with PA models providing a slightly better fit to the data than ST models. Longitudinal studies that target perceived competence and the self-regulation of motivation in parents and their adolescents are a next logical step to understanding both PA and ST behaviors.

What Predicts the Physical Activity Intention-Behavior Gap? A Systematic Review

BACKGROUND

Intention is theorized as the proximal determinant of behavior in many leading theories and yet intention-behavior discordance is prevalent.

PURPOSE

To theme and appraise the variables that have been evaluated as potential moderators of the intention-physical activity (I-PA) relationship using the capability-opportunity-motivation- behavior model as an organizational frame.

METHODS

Literature searches were concluded in August 2020 using seven common databases. Eligible studies were selected from English language peer-reviewed journals and had to report an empirical test of moderation of I-PA with a third variable. Findings were grouped by the moderator variable for the main analysis, and population sample, study design, type of PA, and study quality were explored in subanalyses.

RESULTS

The search yielded 1,197 hits, which was reduced to 129 independent studies (138 independent samples) of primarily moderate quality after screening for eligibility criteria. Moderators of the I-PA relationship were present among select variables within sociodemographic (employment status) and personality (conscientiousness) categories. Physical capability, and social and environmental opportunity did not show evidence of interacting with I-PA relations, while psychological capability had inconclusive findings. By contrast, key factors underlying reflective (intention stability, intention commitment, low goal conflict, affective attitude, anticipated regret, perceived behavioral control/self-efficacy) and automatic (identity) motivation were moderators of I-PA relations. Findings were generally invariant to study characteristics.

CONCLUSIONS

Traditional intention theories may need to better account for key I-PA moderators. Action control theories that include these moderators may identify individuals at risk for not realizing their PA intentions. Prospero # CRD42020142629.

Physical Activity Among Female Adolescents in Jeddah, Saudi Arabia: A Health Promotion Model-Based Path Analysis

BACKGROUND

In Saudi Arabia, about 14.8% of female children and adolescents of less than 20 years old are obese, compared with only 9.4% of male children and adolescents. One major factor linked to the high prevalence of obesity and related chronic illnesses involves inadequate physical activity (PA). Only 25% of female adolescents in Saudi Arabia meet the recommendation calling for 60 minutes of moderate to vigorous PA per day.

OBJECTIVE

The aim of this research was to examine relationships among self-reported PA and cognitive and affective variables, including perceived barriers to PA, PA self-efficacy, enjoyment of PA, social support for PA, and commitment to PA.

METHODS

Female Saudi adolescents 13-18 years of age were recruited from 10 public intermediate and high schools in Jeddah, Saudi Arabia. Female adolescents who met the inclusion criteria completed surveys and participated in height and weight measurements at schools. A structural equation model based on the health promotion model was estimated, with commitment to PA hypothesized to mediate relationships between health promotion model (HPM) predictors and self-reported PA.

RESULTS

A total of 405 female adolescents with a mean age of 15.4 years took part in the study, of whom 25.3% were overweight or obese. Mean PA level measured via the Physical Activity Questionnaire for Adolescents was 2.1 (SD = 0.66), which is low. Commitment to PA partially mediated the relationships of PA self-efficacy, enjoyment of PA, and social support for PA; 25.4% of the variance in PA was explained. The model did not support the indirect relationship of perceived barriers through commitment or the direct relationship between enjoyment and PA.

DISCUSSION

This study indicates that Saudi female adolescents are in need of interventions to increase their PA. The findings suggest that addressing perceived barriers to PA and targeting PA self-efficacy, enjoyment of PA, and social support for PA to enhance commitment to PA may be a fruitful approach in nursing interventions to increase PA among Saudi female adolescents.

Misremembering Past Affect Predicts Adolescents' Future Affective Experience During Exercise

PURPOSE

Increasing physical activity among adolescents is a public health priority. Because people are motivated to engage in activities that make them feel good, this study examined predictors of adolescents' feelings during exercise.

METHOD

During the 1st semester of the school year, we assessed 6th-grade students' (N = 136) cognitive appraisals of the importance of exercise. Participants also reported their affect during a cardiovascular fitness test and recalled their affect during the fitness test later that semester. During the 2nd semester, the same participants rated their affect during a moderate-intensity exercise task.

RESULTS

Affect reported during the moderate-intensity exercise task was predicted by cognitive appraisals of the importance of exercise and by misremembering affect during the fitness test as more positive than it actually was. This memory bias mediated the association between appraising exercise as important and experiencing a positive change in affect during the moderate-intensity exercise task.

CONCLUSION

These findings highlight the roles of both cognitive appraisals and memory as factors that may influence affect during exercise. Future work should explore whether affect during exercise can be modified by targeting appraisals and memories related to exercise experiences.

Mediating Mechanisms of Theory-Based Psychosocial Determinants on Behavioral Changes in a Middle School Obesity Risk Reduction Curriculum Intervention, Choice, Control, and Change

BACKGROUND

A limited number of school-based intervention studies have explored mediating mechanisms of theory-based psychosocial variables on obesity risk behavior changes. The current study investigated how theory-based psychosocial determinants mediated changes in energy balance-related behaviors (EBRBs) among urban youth.

METHODS

A secondary analysis study was conducted using data from a cluster randomized controlled trial. Data from students at 10 middle schools in New York City (n = 1136) were used. The intervention, Choice, Control, and Change curriculum, was based on social cognitive and self-determination theories. Theory-based psychosocial determinants (goal intention, cognitive outcome expectations, affective outcome expectations, self-efficacy, perceived barriers, and autonomous motivation) and EBRBs were measured with self-report questionnaires. Mediation mechanisms were examined using structural equation modeling, Results: Mediating mechanisms for daily sugar-sweetened beverage (SSB) consumption and purposeful stair climbing were identified. Models with best fit indices (root mean square error of approximation = 0.039/0.045, normed fit index = 0.916/0.882; comparative fit index = 0.945/0.932; Tucker-Lewis index = 0.896/0.882, respectively) suggested that goal intention and reduced perceived barriers were significant proximal mediators for reducing SSB consumption among both boys and girls or increasing physical activity by stair climbing among boys. Cognitive outcome expectations, affective outcome expectations, self-efficacy, and autonomous motivation indirectly mediated behavioral changes through goal intention or perceived barriers (p < 0.05 to p < 0.001). The final models explained 25%-27% of behavioral outcome variances.

CONCLUSIONS

Theory-based psychosocial determinants targeted in Choice, Control, and Change in fact mediated behavior changes in middle school students. Strategies targeting these mediators might benefit future success of behavioral interventions. Further studies are needed to determine other potential mediators of EBRBs in youth.

The Association Between Built Environment Attributes and Physical Activity in East Asian Adolescents: A Systematic Review

Asian adolescents living in Australia and England were found to be less active than their Western peers. We aimed to systematically examine evidence of the associations between attributes of the built environment and physical activity in adolescents dwelling in East Asian countries. A total of 10 electronic databases for relevant observational studies without time limit were searched. Five studies met the eligibility criteria, which involved a total of 43 817 schoolchildren aged 11 to 17 years. The majority of the built environment attributes measured was significantly associated with reported physical activity. Difficult access to public facilities was associated with physical inactivity. Inconsistent finding of the association between residential density and physical activity was found. Further studies comparing participants from different Asian countries using a longitudinal design with an appropriate period of follow-up and both objective and reported measures of built environment attributes and physical activity are needed.

An extended version of the theory of planned behaviour: the role of self-efficacy and past behaviour in predicting the physical activity of Chinese adolescents

This study aimed to use an extended theory of planned behaviour (TPB), which incorporated additional self-efficacy and past behaviour, to predict the intention to engage in moderate-to-vigorous physical activity (MVPA) and the MVPA level of Chinese adolescents. Questionnaires that focused on MVPA, attitude, subjective norm, perceived behavioural control (PBC), self-efficacy and past behaviour related to the MVPA engagement were administered to a sample of 488 young people. Multiple regression analyses provided moderate support for TPB. Three TPB constructs predicted 28.7% of the variance in intentions to engage in MVPA, and that PBC, but not intention, explained 3.4% of the variance in MVPA. Self-efficacy significantly affected intention and behaviour over and above the influence of TPB. Past behaviour had a small but significant improvement in the prediction of intention, but no improvement in the prediction of MVPA. Based on the results, interventions should target adolescent self-efficacy and PBC in physical activity participation.

Using the EZ-Diffusion Model to Score a Single-Category Implicit Association Test of Physical Activity

OBJECTIVE

The Single-Category Implicit Association Test (SC-IAT) has been used as a method for assessing automatic evaluations of physical activity, but measurement artifact or consciously-held attitudes could be confounding the outcome scores of these measures. The objective of these two studies was to address these measurement concerns by testing the validity of a novel SC-IAT scoring technique.

DESIGN

Study 1 was a cross-sectional study, and study 2 was a prospective study.

METHOD

In study 1, undergraduate students (N = 104) completed SC-IATs for physical activity, flowers, and sedentary behavior. In study 2, undergraduate students (N = 91) completed a SC-IAT for physical activity, self-reported affective and instrumental attitudes toward physical activity, physical activity intentions, and wore an accelerometer for two weeks. The EZ-diffusion model was used to decompose the SC-IAT into three process component scores including the information processing efficiency score.

RESULTS

In study 1, a series of structural equation model comparisons revealed that the information processing score did not share variability across distinct SC-IATs, suggesting it does not represent systematic measurement artifact. In study 2, the information processing efficiency score was shown to be unrelated to self-reported affective and instrumental attitudes toward physical activity, and positively related to physical activity behavior, above and beyond the traditional D-score of the SC-IAT.

CONCLUSIONS

The information processing efficiency score is a valid measure of automatic evaluations of physical activity.

Factors related to rural young adolescents' participation in outdoor, noncompetitive physical activity

PURPOSE

Young adolescents who have little interest in participating in competitive team sports are at an increased risk for physical inactivity. Noncompetitive outdoor physical activity can provide young adolescents with increased opportunities to participate in physical activities that appeal to them and have positive health effects. The purpose of this study was to examine factors related to rural young adolescents' participation in noncompetitive outdoor physical activity to inform intervention design.

METHOD

Young adolescents aged 10 to 14 years old (N = 1,032) from 1 rural county completed a self-administered questionnaire assessing constructs from self-determination theory (SDT) and the theory of planned behavior (TPB) related to noncompetitive outdoor physical activity. Structural equation modeling was used to examine an integrated conceptual model of hypothesized relationships among constructs.

RESULTS

The hypothesized conceptual model provided a good fit to the data with greater perceptions of autonomy support and self-determined motivation having statistically significant positive indirect effects on participation in noncompetitive outdoor physical activity mediated by the constructs of the TPB. All direct paths in the model were statistically significant; however, the direct effect of attitudes on intention was weak (.08) and self-determined motivation had no indirect effect on intention through attitudes (.03).

CONCLUSIONS

Constructs of SDT and TPB should be accounted for by interventions targeting noncompetitive outdoor physical activity among young adolescents. More research is needed to determine young adolescents' preferences for noncompetitive and competitive physical activity and the potential influence that noncompetitive outdoor physical activity may have on total daily physical activity.

Is Attitude a Key Factor to Consider When Designing Physical Activity Interventions for Black Adolescent Girls

Chronic diseases continue to be disproportionately higher in Black women in comparison with other ethnic groups, with physical inactivity being linked to the growing incidences of many of these diseases. The review of the literature indicates that attitude which is shaped by beliefs, self-efficacy, and cultural factors is a key variable in promoting physical activity (PA) in Black adolescent girls. Specific aims of this review were to identify PA interventions designed specifically for adolescent girls, with an emphasis on Black adolescent girls, and to identify what factor promotes PA in this group. The long-term goal is to use the information from this review to design effective PA programs aimed at Black adolescent girls. Physical activity and fitness were improved in four of the interventions in this review that focused on enhanced self-efficacy, goal setting, social support, and measures aimed at changing attitudes. Overall, this review shows that more effective interventions targeting Black adolescent girls are needed that consider the cultural factors (beliefs, self-efficacy, and family dynamics) that shape one’s attitude toward being physically active.

Influence of self-efficacy on compliance to workplace exercise

Background

Continuous neck and shoulder pain is a common musculoskeletal complaint. Physical exercise can reduce pain symptoms, but compliance to exercise is a challenge. Exercise-specific self-efficacy has been found to be a predictor of participation in preplanned exercise. Little is known about the influence of exercise-specific self-efficacy on compliance to workplace physical exercise.

Purpose

To determine the influence of exercise-specific self-efficacy on compliance to specific strength exercises during working hours for laboratory technicians.

Methods

We performed a cluster-randomized controlled trial, including laboratory technicians from two industrial production units in Copenhagen, Denmark. The participants were randomized to supervised specific strength exercises for the neck and shoulder muscles for 20 minutes three times a week (n = 282) or to a reference group (n = 255). The participants answered baseline and follow-up questions regarding self-efficacy and registered all exercises in a diary.

Results

Overall compliance to exercises was 45 %. Compliance in company A (private sector) differed significantly between the three self-efficacy groups after 20 weeks. The odds ratio of compliance was 2.37 for moderate versus low self-efficacy, and 2.93 for high versus low self-efficacy. No significant difference was found in company B (public sector) or in the intervention group as a whole.

Conclusion

We did not find self-efficacy to be a general statistically significant predictor of compliance to exercises during 20 weeks, but found self-efficacy to be a predictor of compliance in a private sector setting. Workplace-specific differences might be present and should be taken into account.

An exploratory study on the relationship between parents' passion for sport/exercise and children's self- and task-perceptions in sport/exercise

This study investigated the relationship between parents' passion for sport/exercise and children's self- and task-perceptions in sport and exercise. Paired samples of 312 children, 312 fathers, and 312 mothers were collected using two-stage sampling; parents were classified based on their passion for sport and exercise as high concordance if both parents had a high passion for sport and exercise, low concordance if neither parent had a passion for sport and exercise, or discordant. Intrinsic interest value, attainment value/importance, extrinsic utility value, ability/expectancy, task difficulty, and required effort were measured, as well as harmonious and obsessive passion. Children's self- and task-perceptions in sport and exercise were examined with respect to parents' passion for sport and exercise. The results of the study indicated that children of parents with high concordance in harmonious passion for sport and exercise scored higher on intrinsic interest value, attainment value/importance, extrinsic utility value, ability/expectancy, task difficulty, and required effort in sport and exercise than counterparts with discordant and low concordance parents. Similar patterns were found for obsessive passion in parents.

Neighbourhood social capital as a moderator between individual cognitions and sports behaviour among Dutch adolescents

This study aimed to explore whether individual cognitions and neighbourhood social capital strengthen each other in their relation with engaging in sports at least three times per week. Cross-sectional analyses on data from the last wave of the YouRAction trial (2009-2010, Rotterdam, the Netherlands; baseline response: 98%) were conducted. In total 1129 had data on the last wave questionnaire (93%) and 832 of them had complete data on a self-administered questionnaire on frequency of sports participation, perceived neighbourhood social capital, cognitions (attitude, subjective norm, perceived behavioural control and intention toward sport participation) and demographics. Ecometric methods were used to aggregate perceived neighbourhood social capital to the neighbourhood level. Multilevel logistic regression analyses (neighbourhood and individual as levels) were conducted to examine associations of cognitions, neighbourhood social capital and the social capital by individual cognition interaction with fit norm compliance. If the interaction was significant, simple slopes analyses were conducted to decompose interaction effects. It was found that neighbourhood social capital was significantly associated with fit norm compliance (OR: 5.40; 95% CI: 1.13-25.74). Moreover, neighbourhood social capital moderated the association of attitude, perceived behavioural control and intention with fit norm compliance. The simple slope analyses visualized that the associations of cognitions with fit norm compliance were stronger in case of more neighbourhood social capital. Hence, higher levels of neighbourhood social capital strengthen the associations of attitude, perceived behavioural control and intention in their association with fit norm compliance.

A pedometer based physical activity self-management program for children and adolescents with physical disability - design and methods of the StepUp study

Background

Physical activity affords a wide range of physiological and psychological benefits for children and adolescents, yet many children with physical disabilities are insufficiently active to achieve these benefits. The StepUp program is a newly developed 6-week pedometer-based self-management program for children and adolescents with physical disability. Participants use a pedometer to undertake a 6-week physical activity challenge, with personalised daily step count goals set in consultation with a physiotherapist. The study aims to evaluate the effectiveness of the StepUp program, using a randomised control trial design.

Methods/design

A target sample of 70 young people with physical disabilities (aged 8–17 years, ambulant with or without aid, residing in Adelaide) will be recruited. Participants will be randomly allocated to either intervention or control following completion of baseline assessments. Assessments are repeated at 8 weeks (immediately post intervention) and 20 weeks (12 weeks post intervention). The primary outcome is objective physical activity determined from 7 day accelerometry, and the secondary outcomes are exercise intention, physical self-worth, quality of life and fatigue. Analyses will be undertaken on an intention-to-treat basis using random effects mixed modelling.

Discussion

This study will provide information about the potential of a low-touch and low-cost physical activity intervention for children and adolescents with cerebral palsy.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12613000023752.

Affective judgment and physical activity in youth: review and meta-analyses

BACKGROUND

A recent meta-analysis on affective judgment and physical activity in adults yielded a medium effect-sized relationship. Despite narrative reviews and topic interest, a meta-analysis in youth has not yet been conducted.

PURPOSE

This study aims to appraise the overall effect of affective judgment on physical activity in youth via meta-analyses and explore moderators of this relationship.

METHODS

Literature searches were conducted between 1990 and 2011. Fixed and random effects meta-analysis with correction for sampling, measurement, and publication bias were employed.

RESULTS

Fifty-six correlational studies and 14 interventions met the inclusion criteria. Among correlational studies, the corrected summary r was 0.26 (95 % CI 0.18-0.32). Significant moderators were gender, measure of physical activity, and recruitment context. Among intervention studies, Cohen's d was 0.25 (95 % CI 0.11-0.40).

CONCLUSIONS

The results are close to a medium effect size which is larger than other meta-analytic physical activity correlates among youth. The construct should be included in our contemporary theories for understanding and intervening upon youth physical activity.

Psychosocial benefits and implications of exercise

This review is based on a case report that concerns a young female athlete who experienced some of the negative aspects of exercise. Overtraining, a negative byproduct of excessive exercise, can turn the positive psychosocial and physiologic benefits of regular physical activity into an activity detrimental to one's health. With the proper psychological skills and appropriate exercise regimen, these negatives can be turned into positives. Once learned, the psychosocial benefits of exercise, as well as the positive implications, will become more prevalent, similar to the way in which proper physical training helps one become more fit over time.

Social cognitive theories used to explain physical activity behavior in adolescents: a systematic review and meta-analysis

PURPOSE

To systematically review and examine the explanatory power of key social-cognitive theories used to explain physical activity (PA) intention and behavior, among adolescents.

METHODS

A systematic review and meta-analysis of the literature was performed using the electronic databases Medline, Cumulative Index to Nursing and Allied Health Literature, SPORTdiscus, EBSCO and Education Resources Information Center, Proquest Education Journals Collection, Science Direct, Web of Science and Scopus for social-cognitive theories (i.e., Health Promotion Model, Theory of Planned Behavior, Theory of Reasoned Action, Protection Motivation Theory, Social Cognitive Theory/Self-Efficacy Theory, Health Belief Model, Self-Determination Theory, Transtheoretical Model) used to explain PA intention and behavior. Related keywords in titles, abstracts, or indexing fields were searched.

RESULTS

Twenty-three studies satisfied the inclusion criteria and were retained for data extraction and analysis; 16 were cross-sectional studies and seven were longitudinal studies. Most studies employed self-report measures. In general, the models explained greater proportions of variance for intention compared to behavior. The meta-analyses revealed 33% and 48% of the variance respectively for PA and intention were explained by social cognitive models.

CONCLUSIONS

Few studies have tested the predictive capacity of social cognitive theories to explain objectively measured PA. The majority of PA variance remains unexplained and more theoretical research is needed.

Explaining socio-demographic differences in disengagement from sports in adolescence

PURPOSE

The purpose of this longitudinal study is to identify risk groups for disengagement from sports during adolescence. In addition, it will be explored whether cognitive and environmental factors can explain socio-demographic differences in disengagement from sports.

METHODS

Data were obtained from the Environmental Determinants of Obesity in Rotterdam Schoolchildren study, and 357 adolescents were eligible for analysis. Socio-demographics (gender, ethnicity, education), individual cognitions and neighbourhood perceptions were assessed at baseline (2005/2006), and sports participation at baseline and at follow-up (2007/2008). Two dichotomous outcome variables were constructed: (i) disengagement from sports (yes/no) and (ii) ceased compliance with the fitnorm (i.e. cease engaging in sports ≥3 times/wk) (yes/no). In logistic regression and mediation analyses, we identified socio-demographic differences in the two outcomes. Subsequently, we applied mediation analyses to identify the contribution of cognitive and environmental explanatory factors of the socio-demographic differences.

RESULTS

Girls [odds ratio (OR): 2.5, 95% confidence interval (CI): 1.5-4.5] were more likely than boys to disengage from sports. Girls (OR: 2.5, 95% CI: 1.4-4.2), adolescents of non-Western background (OR: 1.8, 95% CI: 1.0-3.0) and those in lower educational levels (OR: 1.7, 95% CI: 1.0-2.9) were more likely to cease compliance with the fitnorm. Perceived neighbourhood safety partly explained gender differences in disengagement from sports (8%). Intention partly explained ethnical (32%) and educational differences (37%) in ceasing compliance with the fitnorm.

CONCLUSIONS

Girls, lower-educated adolescents and those with a non-Western background showed more pronounced reductions in sports participation and compliance with the fitnorm. Intention and perceived neighbourhood safety could partially explain these differences.

Moderators of Youth Exercise Intention and Behavior

This study tested moderators of the theory of planned behavior (TPB) based on geographical region, gender, race, and income among adolescents in an exercise context using multigroup path analyses. Participants were eighth- and ninth-grade students from Louisiana (LA; N = 448, Mage = 14.37 years) and Pennsylvania (PA; N = 681, Mage = 14.28 years). They completed measures of intention, attitude, subjective norm, perceived behavioral control, and exercise behavior. Based on two path analyses, geographical region was a significant moderator ( p < .001); therefore, the moderating effects of gender, race, and income were analyzed separately for each state. Gender was a significant moderator for LA ( p < .001) but not for PA ( p = .90). Race and income did not moderate the TPB relationships within each state. Findings support the moderating effect of geographical region on the TPB construct relationships and indicate that gender moderates the TPB construct relationships in LA youth.

Behavioral Self-Regulation and Weight-Related Behaviors in Inner-City Adolescents: A Model of Direct and Indirect Effects

BACKGROUND: This study examined the association of two distinct self-regulation constructs, effortful control and dysregulation, with weight-related behaviors in adolescents and tested whether these effects were mediated by self-efficacy variables. METHODS: A school-based survey was conducted with 1771 adolescents from 11 public schools in the Bronx, New York. Self-regulation was assessed by multiple indicators and defined as two latent constructs. Dependent variables included fruit/vegetable intake, intake of snack/junk food, frequency of physical activity, and time spent in sedentary behaviors. Structural equation modeling examined the relation of effortful control and dysregulation to lifestyle behaviors, with self-efficacy variables as possible mediators. RESULTS: Study results showed that effortful control had a positive indirect effect on fruit and vegetable intake, mediated by self-efficacy, as well as a direct effect. Effortful control also had a positive indirect effect on physical activity, mediated by self-efficacy. Dysregulation had direct effects on intake of junk food/snacks and time spent in sedentary behaviors. CONCLUSIONS: These findings indicate that self-regulation characteristics are related to diet and physical activity and that some of these effects are mediated by self-efficacy. Different effects were noted for the two domains of self-regulation. Prevention researchers should consider including self-regulation processes in programs to improve health behaviors in adolescents.

Adolescents' attitudes toward sports, exercise, and fitness predict physical activity 5 and 10 years later

OBJECTIVE

To determine whether adolescent attitudes towards sports, exercise, and fitness predict moderate-to-vigorous physical activity 5 and 10 years later.

METHOD

A diverse group of 1902 adolescents participating in Project Eating and Activity in Teens, reported weekly moderate-to-vigorous physical activity and attitudes toward sports, exercise, and fitness in Eating and Activity in Teens-I (1998-99), Eating and Activity in Teens-II (2003-04), and Eating and Activity in Teens-III (2008-09).

RESULTS

Mean moderate-to-vigorous physical activity was 6.4, 5.1, and 4.0 hours/week at baseline, 5-year, and 10-year follow-up, respectively. Attitudes toward sports, exercise, and fitness together predicted moderate-to-vigorous physical activity at 5 and 10 years. Among the predictors of 5- and 10-year moderate-to-vigorous physical activity, attitude's effect size, though modest, was comparable to the effect sizes for sports participation and body mass index. Adolescents with more-favorable attitudes toward sports, exercise, and fitness engaged in approximately 30%-40% more weekly moderate-to-vigorous physical activity at follow-up (2.1 hour/week at 5 years and 1.2 hour/week at 10 years) than those with less-favorable attitudes.

CONCLUSION

Adolescents' exercise-related attitudes predict subsequent moderate-to-vigorous physical activity independent of baseline behavior suggesting that youth moderate-to-vigorous physical activity promotion efforts may provide long-term benefits by helping youth develop favorable exercise attitudes.

Psychometric Characteristics of the Physical Education Activities Scale

Measuring adolescent perceptions of physical education (PE) activities is necessary in understanding determinants of school PE activity participation. The purpose of this study was to test initial estimates of reliability and validity of a new scale assessing high school adolescent perceptions of school PE activity with the Physical Education Activities Scale (PEAS). The 41-item visual analog scale consisted of 6 subscales: Self-Efficacy, PE Enjoyment, Personal Factors Influencing PE Participation, Behavioral Control, Barriers, and Subjective Norms that were tested on a sample (N = 90) interurban high school adolescents Grades 9–12. Cronbach’s alpha coefficient of the total PEAS was α = .89, and for the subscales α ranged from .57–.81. Using known-groups analysis with male vs. female data, initial estimates of construct validity were supported with t tests for the total scale showing boys scoring significantly higher than girls for the total scale (t = −3.26, df = 88, p = .002) and for 5 of the 6 subscales: Self-Efficacy (t = −2.65, df = 88, p = .01); PE Enjoyment (t = −3.05, df = 88, p = .003); Personal Factors Influencing PE Participation (t = −2.66, df = 88, p = .009); Behavioral Control (t = −2.20, df = 88, p = .03), and Barriers (t = −3.41, df = 88, p = .001). There was not a gender difference for the subjective norms subscale. Evidence indicated that the PEAS was sensitive enough to distinguish between female and male perceptions in the expected direction on factors that influence PE activity participation. The PEAS demonstrated acceptable reliability and validity evidence in measuring adolescents’ perception of school PE activities.

Systematic Development of the YouRAction program, a computer-tailored physical activity promotion intervention for Dutch adolescents, targeting personal motivations and environmental opportunities

BACKGROUND

Increasing physical activity (PA) among adolescents is an important health promotion goal. PA has numerous positive health effects, but the majority of Dutch adolescents do not meet PA requirements. The present paper describes the systematic development of a theory-based computer-tailored intervention, YouRAction, which targets individual and environmental factors determining PA among adolescents.

DESIGN

The intervention development was guided by the Intervention Mapping protocol, in order to define clear program objectives, theoretical methods and practical strategies, ensure systematic program planning and pilot-testing, and anticipate on implementation and evaluation. Two versions of YouRAction were developed: one that targets individual determinants and an extended version that also provides feedback on opportunities to be active in the neighbourhood. Key determinants that were targeted included: knowledge and awareness, attitudes, self-efficacy and subjective norms. The extended version also addressed perceived availability of neighbourhood PA facilities. Both versions aimed to increase levels of moderate-to-vigorous PA among adolescents. The intervention structure was based on self-regulation theory, comprising of five steps in the process of successful goal pursuit. Monitoring of PA behaviour and behavioural and normative feedback were used to increase awareness of PA behaviour; motivation was enhanced by targeting self-efficacy and attitudes, by means of various interactive strategies, such as web movies; the perceived environment was targeted by visualizing opportunities to be active in an interactive geographical map of the home environment; in the goal setting phase, the adolescents were guided in setting a goal and developing an action plan to achieve this goal; in the phase of active goal pursuit adolescents try to achieve their goal and in the evaluation phase the achievements are evaluated. Based on the results of the evaluation adolescents could revise their goal or choose another behaviour to focus on. The intervention is delivered in a classroom setting in three lessons. YouRAction will be evaluated in a cluster-randomized trial, with classes as unit of randomization. Evaluation will focus on PA outcomes, cognitive mediators/moderators and process measures.

DISCUSSION

The planned development of YouRAction resulted in two computer-tailored interventions aimed at the promotion of PA in a Dutch secondary school setting.

TRIAL REGISTRATION

NTR1923.

Availability of sports facilities as moderator of the intention-sports participation relationship among adolescents

This longitudinal study aimed to identify individual and environmental predictors of adolescents' sports participation and to examine whether availability of sports facilities moderated the intention-behaviour relation. Data were obtained from the ENvironmental Determinants of Obesity in Rotterdam SchoolchildrEn study (2005/2006 to 2007/2008). A total of 247 adolescents (48% boys, mean age at follow-up 15 years) completed the surveys at baseline and follow-up. At baseline, adolescents completed a survey that assessed engagement in sports participation, attitude, subjective norm, perceived behavioural control and intention towards sports participation. Availability of sports facilities (availability) was assessed using a geographic information system. At follow-up, sports participation was again examined. Multiple logistic regression analyses were conducted to test associations between availability of sports facilities, theory of planned behaviour variables and the interaction of intention by availability of sports facilities, with sports participation at follow-up. Simple slopes analysis was conducted to decompose the interaction effect. A significant availability x intention interaction effect [odds ratio: 1.10; 95% confidence interval: 1.00-1.20] was found. Simple slopes analysis showed that intention was more strongly associated with sports participation when sports facilities were more readily available. The results of this study indicate that the intention-sports participation association appears to be stronger when more facilities are available.

Social-cognitive correlates of physical activity in a multi-ethnic cohort of middle-school girls: two-year prospective study

OBJECTIVE

The study examined social-cognitive correlates of physical activity in a multi-ethnic cohort of girls from six regions of the United States who participated in the Trial of Activity for Adolescent Girls during their 6th and 8th grade school years.

METHODS

Girls completed validated questionnaires and wore accelerometers that measured weekly physical activity in the spring of 2002 and 2005.

RESULTS

In 8th grade, self-efficacy and perceived social support had indirect relations with physical activity mediated through perceived barriers, which was inversely related to physical activity. Self-efficacy also had a direct relation with physical activity.

CONCLUSIONS

Correlations were smaller than those obtained in studies that measured physical activity by self-reports, suggesting that previous estimates were inflated by common method artifact. Nonetheless, physical activity trials among girls during early adolescence might focus on increasing self-efficacy for overcoming barriers to physical activity and on ways by which perceived barriers can otherwise be reduced.

The utility of shorter epochs in direct motion monitoring

This cross-sectional study using direct motion monitoring evaluated whether short epochs increased estimates of moderate or vigorous physical activity (MPA or VPA) and enhanced differences in daily VPA comparing overweight (OW) and nonoverweight (NOW) children. Seventy-seven children (ages 8-10 years) wore accelerometers for 7 days. We calculated two estimates (mean minutes per day) of MPA and VPA using motion counts based on a 15-s epoch and a calculated 60-s epoch produced by totaling each consecutive group of four 15-s motion counts. We compared estimates as a function of mean motion count x min(-1) for sex, age, and status as OW or NOW. The results showed that a 15-s epoch produced higher estimates of VPA (mean difference of 7 min per day, p < .001). The average number of VPA minutes added using the 15-s epoch vs. the 60-s epoch was 8.8 for more active children compared with 5.8 for less active children (p < .001). There was no difference in VPA minutes between OW and NOW children. These findings suggest modestly increased sensitivity to VPA using shorter epochs; this was particularly true for the most active children. Shorter epochs, however might not be useful in clarifying the relationship between VPA and obesity in children.

Web-based weight management programs for children and adolescents: a systematic review of randomized controlled trial studies

More than 17% of children aged 6 to 19 years living in the United States are classified as overweight. Medical costs related to overweight and obesity were recently estimated to approximate $100 billion annually. The purpose of this systematic review was to provide the scientific evidence regarding Web-based weight management programs for overweight children and adolescents. Results suggest the potential for Web-based behavioral change programs for weight management in overweight children and adolescents. Future research should emphasize rigorous methodological adequacies, develop theory-based standardized frameworks, investigate types of interventions appropriate for boys and girls in this age group, evaluate long-term effect of interventions, and examine cost as well as clinical effectiveness.

Self-efficacy moderates the relation between declines in physical activity and perceived social support in high school girls

OBJECTIVE

To test whether self-efficacy for overcoming barriers to physical activity has direct, indirect (i.e., mediated), or moderating relations with naturally occurring change in perceived social support and declines in physical activity during high school.

METHODS

Latent growth modeling was used with measures completed in the 8th, 9th, and 12th grades by a cohort of 195 Black and White girls.

RESULTS

Self-efficacy was stable and moderated the relation between changes in physical activity and perceived social support. Girls who maintained a perception of strong social support had less of a decline in physical activity if they also had high self-efficacy. However, girls having high self-efficacy had a greater decline in physical activity if they perceived declines in social support.

CONCLUSIONS

Randomized controlled trials of physical activity interventions based on social cognitive theory should consider that the influence of girls' perceptions of social support on their physical activity may differ according to their efficacy beliefs about barriers to physical activity.

Ethnicity as a moderator of the theory of planned behavior and physical activity in college students

Most college students do not meet physical activity (PA) guidelines, and ethnic disparities exist. The present study examined the utility of the theory of planned behavior (TPB) in explaining PA intentions and behavior in black and white college students and whether any TPB relationships were moderated by ethnicity. Black (n=170) and white (n=180) students completed a baseline TPB questionnaire and PA assessment 2 weeks later Hierarchical latent variable regression analyses showed that affective attitude, subjective norm, and perceived behavioral control (PBC) were significant predictors of intention for both ethnic groups, whereas the PBC-intention relationship was significantly stronger for white students. Intention significantly predicted PA for both ethnic groups. Furthermore, common and ethnic-specific beliefs were identified.

A Brief Review on Correlates of Physical Activity and Sedentariness in Youth

INTRODUCTION

Better understanding of the correlates of physical activity and sedentary behaviors in youth will support the development of effective interventions that promote a physically active lifestyle and prevent a sedentary lifestyle. The main goal of this systematic review is to summarize and update the existing literature on correlates of young people's physical activity, insufficient physical activity, and sedentary behavior.

METHODS

A systematic review was conducted and included studies published between January 1999 and January 2005.

RESULTS

The 60 reviewed studies showed that for children (age range 4-12), gender (male), self-efficacy, parental physical activity (for boys), and parent support were positively associated with physical activity. For adolescents (age range 13-18), positive associations with physical activity were found for gender (male), parental education, attitude, self-efficacy, goal orientation/motivation, physical education/school sports, family influences, and friend support. For adolescents, a positive association was found between gender (male) and sedentary behavior, whereas an inverse association was found between gender and insufficient physical activity. Ethnicity (Caucasian), socioeconomic status, and parent education were found to be inversely associated with adolescents' sedentary behaviors. For children, the evidence was insufficient to draw conclusions about correlates of insufficient physical activity and sedentary behavior.

CONCLUSION

To gain more insight in the correlates of change in physical activity levels, more prospective studies are needed. Moreover, further research is needed examining the correlates of insufficient physical activity and sedentary behaviors, to develop effective interventions that may help children and adolescents diminish the time they spend on inactive behaviors.

Intention to Be Physically Active: A Theory-Guided Study in Italian Teenagers

This study investigated the relationship of self-efficacy, outcome expectancies, and risk perception on intention to increase physical activity in a group of adolescents. The 833 participants ( M age = 16.2 yr., SD =1.5) completed a Survey of Health Behavior anonymously. 88% of the sample said that they engaged in physical activity; 42.1% said that they spent 4 hours per week exercising. Boys appeared to be more active than girls. The results indicated self-efficacy, outcome expectancies, and risk perception as key factors in explaining behavioural intention in teenagers. As regards outcome expectancies, it seems that adolescents are effectively motivated by objectives which affect them closely, such as maintaining the right weight, and which may influence their everyday life.

Family support for physical activity in girls from 8th to 12th grade in South Carolina

OBJECTIVE

To examine the relationship between perceived family support and other selected correlates of physical activity (PA) with changes in PA over time.

METHODS

A total of 421 girls in South Carolina completed questionnaires at 8th, 9th and 12th grades (1998-2003). Family support for PA, PA self-efficacy, perceived behavioral control, attitudes, availability of equipment, and PA were measured.

RESULTS

Growth curve analysis showed that family support, perceived behavioral control, and self-efficacy were independently related to age-related changes in PA as reflected by total METs. Girls who reported lower family support at the 8th grade measure had more rapid declines in PA, and a unit change in family support was related to approximately 1/3 of a standard deviation change in total METs.

CONCLUSIONS

Maintenance of support from family members may reduce the decline in PA independent of girls' self-efficacy and perceived behavioral control.

Causal ordering of physical self-concept and exercise behavior: reciprocal effects model and the influence of physical education teachers

Does prior physical self-concept influence subsequent exercise behavior? On the basis of a large sample of physical education classes (2,786 students, 200 classes, 67 teachers) collected early (Time 1) and late (Time 2) in the school year, findings support a reciprocal effects model in which prior physical self-concept and exercise behavior both influence subsequent physical self-concept and exercise behavior. Whereas variables from the theory of planned behavior (TOPB; behavioral intentions, perceived behavioral control, exercise attitudes) also contributed to the prediction of subsequent exercise behavior, the effect of prior physical self-concept was significant for subsequent outcomes after controlling these variables, suggesting that the TOPB should be supplemented with self-concept measures. On the basis of multilevel models, there were systematic differences in these variables for students taught by different teachers that generalized over time and across different classes taught by the same teacher. Support for the reciprocal effects model was robust.

A comparison of Web and print media for physical activity promotion among adolescent girls

PURPOSE

To compare the effectiveness of a Web-based physical activity (PA) intervention with identical content delivered in a printed workbook among a sample of adolescent girls.

METHODS

Participants consisted of 319 girls with home Internet access enrolled in four middle schools within one school district. A randomized trial design was used to compare changes in PA self-efficacy and intentions after two weeks of exposure to either a Web- or print-based intervention delivered to their home. Self-reported physical activity was assessed as a secondary outcome. Analysis of covariance was conducted to determine changes between the intervention groups while controlling for baseline levels of PA constructs.

RESULTS

Both Web and print groups had significant changes in physical activity self-efficacy (Web: t[155] = 2.58, p = .01; print: t[156] = 3.11, p = .002) and intentions (Web: t[157] = 2.27, p = .02; print: t[159] = 6.32, p < or = .001). The print group demonstrated significantly greater increases in intentions compared with the Web group (F [1,315] = 13.53, p < or = .001). Self-reported physical activity increased significantly in the print group only (t[159] = 3.21, p = .002).

CONCLUSIONS

It cannot be assumed that new media technologies are superior to traditional media such as print for health communication to adolescents. These results suggest that a printed workbook was more effective than an identical website for increasing physical activity intentions and behavior among a sample of middle school girls.

Social-Cognitive Determinants of Physical Activity Attendance in Older Adults

The present study evaluated whether, and to what extent, the constructs implicated in the theory of planned behavior could predict behavioral intention to exercise and exercise-class attendance of older adults (age 65–90 years) already enrolled in a physical activity program. The study also evaluated whether including self-efficacy judgments might improve the predictive capacity of the model. Participants (N = 1,095) were randomly sampled Italian volunteers from exercise classes for older adults. First, they completed questionnaires assessing the above-mentioned constructs. Then, class attendance was recorded during the following 3 months. Results indicated a substantial correspondence between the model and the data. Perceived behavioral control and self-efficacy were the strongest predictors of behavioral intention, whereas attitudes and subjective norms only partially contributed to its prediction. The inclusion of self-efficacy improved the predictive capacity of the overall model. Finally, results showed a weak relation between behavioral intention and attendance rate in physical activity sessions.

Attitudes toward physical activity in adolescents with cystic fibrosis: sex differences after training: a pilot study

This study compared the attitudes of 16 adolescents (8 males and 8 females) with cystic fibrosis (CF) toward exercise and physical activity (PA) before and after a 6-week exercise program. Although the boys and girls had similar ages (12-18 years), the boys were fitter and leaner and had higher pulmonary function. Subjects reported both positive exercise attitudes of self and perceived attitudes of parents/friends that remained essentially unchanged after strenuous training. Boys reported higher vigorous activities at baseline than girls, but all subjects increased participation in very hard PAs after training. Girls had small but nonsignificant increases in PA at each (mild-vigorous) level. Results emphasize that adolescents with a mild to moderate lung disease can significantly increase PA in a nursing intervention.

Perceptions of physical and social environment variables and self-efficacy as correlates of self-reported physical activity among adolescent girls

OBJECTIVE

This cross-sectional study examined the direct and indirect effects of perceived equipment accessibility, neighborhood safety, and social support on self-reported physical activity among older adolescent girls.

METHODS

Adolescent girls (n = 1,655) who were in the 12th grade completed a battery of questionnaires that included self-report measures of the perceived physical environment, social support, barriers self-efficacy, and physical activity.

RESULTS

Perceived neighborhood safety did not exhibit direct or indirect effects on self-reported physical activity. Perceived equipment accessibility exhibited an indirect effect on self-reported physical activity that was accounted for by barriers self-efficacy. Perceived social support exhibited direct and indirect effects on self-reported physical activity; the indirect effect was accounted for by barriers self-efficacy. The relationships were independent of parental education and body mass index (BMI).

CONCLUSIONS

Perceived physical environmental factors indirectly influenced self-reported physical activity, and perceived social environmental factors both directly and indirectly influenced self-reported physical activity in this sample of older adolescent girls.