Short- and long-term theory-based predictors of physical activity in women who participated in a weight-management program

Lifestyle Intervention for Patients with Nonalcoholic Fatty Liver Disease: A Randomized Clinical Trial Based on the Theory of Planned Behavior

Introduction

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, accounting for about 25% and 33% of the world's adult population and Iranians, respectively. There is currently no effective therapeutic agent available for the treatment of NAFLD. However, lifestyle modifications aimed at weight loss have been introduced as a cornerstone of NAFLD management. The aim of the present study was to evaluate the effect of educational intervention on lifestyle and anthropometric indices in patients with NAFLD.

Methods

The randomized controlled clinical trial was performed on 87 overweight or obese patients with NAFLD, including intervention (n = 42) and control (n = 45) groups. The intervention received 8 training sessions based on theory of planned behavior (TPB), while the control groups received nutritional and physical activity recommendations from their internal specialist and nutritionist. Analyses were carried out based on data collected from TPB constructs and anthropometric indices (weight, body mass index (BMI), waist size, and waist-hip ratio (WHR)) at three stages (before intervention and two and 12 weeks after the intervention), as well as data obtained from liver enzymes (alanine aminotransferase (ALT) and aspartate aminotransferase (AST)), and ultrasound-based grading of NAFLD at two stages (before and 12 weeks after the intervention).

Results

After the intervention, a significant difference was found between the intervention and control groups, resulting in the increased mean scores of TPB constructs, decreased liver enzymes, and decreased degree of NAFLD ultrasound. In addition, the intervention group experienced more activity and healthy diet as compared with the control group. Anthropometric indices showed only a significant decrease in BMI in the intervention group (p < 0.05).

Conclusions

TPB-based training, as compared with traditional training, is a more effective and cost-effective strategy for altering nutritional behavior and physical activity of patients with NAFLD.

Motivational profiles and change in physical activity during a weight loss intervention: a secondary data analysis

BACKGROUND

High levels of moderate-to-vigorous intensity physical activity (MVPA) are strongly associated with sustained weight loss, however the majority of adults are unsuccessful in maintaining high levels of MVPA long-term. Our goal was to identify profiles based on exercise motives, and examine the association between motivational profile and longitudinal changes in MVPA during a weight loss intervention.

METHODS

Adults with overweight or obesity (n = 169, mean ± SE; age 39 ± 0.7 years, BMI 34.4 ± 0.3 kg/m2, 83% female) underwent an 18-month behavioral weight loss program, including 6 months of supervised exercise, followed by 6 months of unsupervised exercise. Participants self-reported behavioral regulations for exercise at baseline (BREQ-2). Latent profile analysis identified subgroups from external, introjected, identified, and intrinsic regulations measured at baseline. Mean differences in device-measured total MVPA were compared across motivational profiles at baseline, after 6 months of supervised exercise and after a subsequent 6 months of unsupervised exercise.

RESULTS

Three motivational profiles emerged: high autonomous (high identified and intrinsic, low external regulations; n = 52), high combined (high scores on all exercise regulations; n = 25), and moderate combined (moderate scores on all exercise regulations; n = 92). Motivational profile was not associated with baseline level of MVPA or the increase in MVPA over the 6-month supervised exercise intervention (high autonomous: 21 ± 6 min/d; high combined: 20 ± 9 min/d; moderate combined: 33 ± 5 min/d; overall P > 0.05). However, during the transition from supervised to unsupervised exercise, MVPA decreased, on average, within all three profiles, but the high autonomous profile demonstrated the least attenuation in MVPA (- 3 ± 6 min/d) compared to the moderate combined profile (- 20 ± 5 min/d; P = 0.043).

CONCLUSIONS

Results were in alignment with the Self-Determination Theory. Adults motivated by autonomous reasons (value benefits of exercise, intrinsic enjoyment) may be more likely to sustain increases in MVPA once support is removed, whereas participants with moderate-to-high scores on all types of exercise regulations may need additional long-term support in order to sustain initial increases in MVPA.

CLINICAL TRIAL REGISTRATION

NCT01985568. Registered 24 October 2013.

Physical Literacy Assessment Tools: A Systematic Literature Review for Why, What, Who, and How

Physical literacy (PL) has been acknowledged to be an individual journey, in view of this contention, objective assessment of such a developing construct has become a debatable issue for the last couple of decades apart from physical domain of observable domain. The purpose of this systematic review was to scrutinise what is currently known regarding the PL assessment tools-the existing PL assessment tools, their pioneers and year of publication, the philosophy behind their initiation, what they have been assessing (assessment domains), the category of population being assessed in relation to their age group, validity of the tools, other scholars notes, as well as the approaches being used, whether assessment for, as or of learning during physical activity participation. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to undertake a comprehensive search from six electronic databases-ScienceDirect, Scopus, Eric, PubMed, Google Scholar, and SportDiscus retrieved 52 research articles and review papers, whereby only 22 articles were included after identification, screening, and eligibility selection criteria process. The study established that the majority-70%-of PL assessment tools were developed to promote either fundamental movement skills, athlete development or long-term health and well-being, instead of lifelong participation in physical activity. It was also ascertained that only 30% of PL assessment tools address both three domains comprising PL. Of a particular concern, it was explored that only the International Physical Literacy Association (IPLA) PL matrix takes into account everyone of any age group, while the rest of the others segregate participants falling in a specific age groups to be based on. Afterward, the majority of PL assessment tools were identified at 70% to adopt assessment for learning or at a certain time combination with assessment as learning while assessing individuals' PL progress. The conclusion was therefore drawn that the overall purpose of PL- to value and take responsibility of engaging in physical activity for life is still largely absent among the majority of existing PL assessment tools and both the ideal of what to assess and who to be assessed are far less to be met, while the effective PL assessment approaches remain critical. After all, in light of this conclusion future agenda has been suggested in view of designing PL assessment tools effective enough to promote PL for all.

Changes in Chinese Adults' Physical Activity Behavior and Determinants before and during the COVID-19 Pandemic

Purpose: To investigate the changes in Chinese adults’ physical activity (PA) behavior and determinants before and during the COVID-19 pandemic. Method: A total of 1028 adults (aged 19–59 years) were recruited from 127 urban and rural neighborhoods in China using stratified three-stage probability sampling. Data collection was conducted in December 2019 and July 2020. Results: Compared with the data before the pandemic, individuals’ weekly moderate-to-vigorous-intensity PA (MVPA) decreased significantly from 139 min to 120 min, seven months after the outbreak (p = 0.01), with female and rural populations displaying a more significant decrease (p = 0.02). Overall, 13.7% of participants met the PA guidelines (World Health Organization) both before and during the pandemic, while 21.8% met the guidelines only before the pandemic and 18.1% increased their PA and met the PA guidelines during the pandemic. A total of 46.4% did not meet the PA guidelines before or during the pandemic. Determinants of PA behavior change before and during the pandemic included sports skills, self-determined motivation and support from sports organizations. Conclusions: The Chinese adults’ PA levels decreased significantly from before to during the COVID-19 pandemic, particularly among the female population. It is suggested that the enhancement of self-determined motivation, improvement of sport skills, and support from sports organizations might be effective in facilitating individuals’ engagement in PA during the pandemic.

Independent Associations and Interactions of Perceived Neighborhood and Psychosocial Constructs on Adults' Physical Activity

BACKGROUND

Neighborhood and psychosocial variables are related to physical activity (PA), yet interactions between these factors in predicting PA are infrequently studied.

METHODS

This analysis examines the independent associations and interactions between self-reported neighborhood and psychosocial variables in relation to moderate to vigorous PA (MVPA) among adults from a US panel sample.

RESULTS

In adjusted models, neighborhood social capital was positively associated with meeting MVPA guidelines. Fewer barriers, greater self-efficacy, and greater autonomous motivation also corresponded with greater odds of meeting MVPA guidelines. An interaction between social capital and autonomous motivation showed that social capital was only associated with MVPA when autonomous motivation was high. Participants who reported both high autonomous motivation and high social capital were most likely to meet MVPA guidelines.

CONCLUSIONS

Neighborhood social capital, barriers, self-efficacy, and autonomous motivation may be important correlates in promoting adults' PA. Future directions include using objective neighborhood and PA data in similar analyses and investigating associations of neighborhood and psychosocial variables with multiple PA activities. Intervention research to promote PA should also examine whether effects of interventions targeting psychosocial constructs are moderated by features of an individual's neighborhood or whether perceived social capital can be addressed in interventions in conjunction with psychosocial variables.

Exploring the working mechanisms of a web-based physical activity intervention, based on self-determination theory and motivational interviewing

The aim of this study was to compare a web-based computer tailored physical activity intervention based on self-determination theory and motivational interviewing (I Move) to a traditional web-based computer tailored physical activity intervention (Active Plus) with regard to their basic psychological need supporting capabilities. We also aimed to assess the extent to whether self-determination constructs played a stronger mediating role in the effects of I Move than in the effects of Active Plus. A randomized controlled trial was conducted among 3089 participants (age 44.9 ± 12.9, 69.1% women), comparing 1) I Move, 2) Active Plus, and 3) a waiting list control condition. Physical activity behavior (measured at baseline, and at six months after baseline), potential mediators (intrinsic motivation, identified regulation, perceived competence and perceived choice, measured at baseline, and at three months after baseline) and basic psychological need support (measured six weeks and six months after baseline) were assessed through self-report, using web-based questionnaires. I Move was found to be more effective in supporting participants' basic psychological needs (sessions 1 and 2; p = .001; sessions 3 and 4; p = .004). The results of the mediation analyses show that the effects of both interventions were (equally) mediated by perceived competence, but not by intrinsic motivation, identified regulation or perceived choice.