The impact of physical exercise on university students' life satisfaction: The chain mediation effects of general self-efficacy and health literacy

OBJECTIVE

This study aims to explore the impact of physical exercise on university students' life satisfaction and analyses the chain mediation effect of general self-efficacy and health literacy, providing empirical reference and theoretical foundation for the comprehensive enhancement and optimization of students' mental health.

METHOD

Based on data from the "China University Student Physical Activity and Health Tracking Survey" (CPAHLS-CS) 2024, the measurement scales used included the Physical Activity Rating Scale (PARS-3), the Satisfaction with Life Scale (SWLS), the General Self-Efficacy Scale (GSES), and the 9-item Short Form Health Literacy Scale (HLS-SF9). A total of 4575 valid samples were analyzed.

RESULTS

A significant positive correlation was found between physical exercise and life satisfaction (r = 0.137, P < 0.01). The total effect of physical exercise on university students' life satisfaction was significant, with an effect value of 0.045 (95%CI = [0.035, 0.054]). The chain mediation effect of general self-efficacy and health literacy in the relationship between physical exercise and life satisfaction was significant, with an effect value of 0.005 (95%CI = [0.004, 0.006]), accounting for 11.4% of the total effect. The direct effect of physical exercise on life satisfaction had a standardized regression coefficient of 0.001, which was not significant.

CONCLUSION

University students' life satisfaction is closely related to physical exercise, general self-efficacy, and health literacy. General self-efficacy and health literacy play a full mediating role in the effect of physical exercise on life satisfaction.

The effect of peer relationships on college students' behavioral intentions to be physically active: The chain-mediated role of social support and exercise self-efficacy

PURPOSE

Physical activity behavioral intentions have a positive impact on individuals' physical and mental health, social adjustment, and academic work. This study explored the effects of peer relationships on college students' behavioral intentions for physical activity and analyzed the mediating role of social support and exercise self-efficacy.

METHODS

The Peer Relationship Inventory, the Physical Activity Rating Scale-Intentions to Physical Activity Behavior subscale, the Social Support Scale, and the Exercise Self-Efficacy Scale were used to psychometrically measure 514 college students (age = 19.00 ± 1.27) from June 3, 2024, to June 7, 2024, and the Bootstrap method was used to mediate the relationship between social support and exercise self-efficacy.

RESULTS

(1) Peer relationships, social support, exercise self-efficacy and intention to engage in physical activity behaviors were positively correlated (all p < 0.01); (2) gender differences in exercise self-efficacy and intention to engage in physical activity behaviors existed (p < 0.001), and male students scored higher than female students (M ± SD: 3.18 ± 0.55 > 2.98 ± 0.59; 3.23 ± 0.62 > 2.95 ± 0.61); (3) the mediating effect size of social support (peer relationship→social support→behavioral intention to exercise) was 0.078, which accounted for 8.83% of the total effect, and that of exercise self-efficacy (peer relationship→exercise self-efficacy→behavioral intention to exercise) was 0.314, which accounted for 35.56% of the total effect, the chained mediation effect of social support and exercise The chain mediation effect size of self-efficacy (peer relationship→social support→exercise self-efficacy→behavioral intention to exercise) was 0.057, accounting for 6.46% of the total effect, and none of the confidence intervals contained 0.

CONCLUSIONS

(1) College students' peer relationships can significantly and positively predict behavioral intention to exercise; (2) college students' peer relationships can have a simple influence on the behavioral intention to exercise through social support and exercise self-efficacy, respectively; (3) College student peer relationships can also influence intention to engage in physical activity through social support and exercise self-efficacy in a chained manner.

Do adolescent experiences help shape college students' physical activity beliefs and behaviors? A mixed methods study

Objective: This study examined college students' current physical activity (PA) beliefs and behaviors, as well as the perceived influence of their adolescent experiences on their current PA habits. Participants: 156 college students (M age = 19.88 years, Male n = 27, Female n = 128) attending a mid-sized midwestern public university. Methods: Students reported on current PA behaviors/beliefs and recollections of adolescent experiences (age 12-18) through surveys (n = 156) and focus groups (n = 17). Linear regression analyses examined whether adolescent experiences (parent support, friend support, physical education experiences, community support) and current perceptions (enjoyment, self-efficacy, and friend support) were associated with current PA. Thematic analyses qualitatively explored participants' perceptions. Results: Quantitative results revealed only current enjoyment, self-efficacy, and friend support were significantly associated with current PA (R2=0.34, p < 0.001). However, qualitative analysis revealed lasting influences of adolescent experiences, particularly social experiences with friends, parental support, and community resources. Conclusions: Findings indicate that while college students' physical activity is more strongly influenced by current self-efficacy, enjoyment, and friend support, positive adolescent experiences may indirectly shape ongoing attitudes and perceptions toward physical activity.

The Effect of Exercise Atmosphere on College Students' Physical Exercise-A Moderated Chain Mediation Model

To explore the influence of exercise atmosphere on college students' physical exercise and its mechanism of action, the Exercise Atmosphere Scale, Enjoyment Scale, Exercise Self-efficacy Scale, Social Physique Anxiety Scale, and Physical Exercise Rating Scale were used to investigate 1265 college students. The results showed that: (1) exercise atmosphere directly impacted physical exercise and indirectly influenced physical exercise through three mediating pathways (e.g., the mediating role of enjoyment, the mediating role of exercise self-efficacy, and the chain mediating role of enjoyment and exercise self-efficacy); (2) social physique anxiety negatively moderated the influence of exercise atmosphere on enjoyment and exercise self-efficacy, respectively, and negatively moderated three mediating pathways of exercise atmosphere influencing physical exercise through enjoyment and exercise self-efficacy. The results are helpful in enriching the research on exercise atmosphere and college students' physical exercise and provide useful insights for schools and related organizations to strengthen college students' physical exercise.

The impact of multiple supports on university students' physical education learning motivation: a dual analysis based on SEM and fsQCA

Background

During their physical education courses, university students may encounter various academic pressures and difficulties, which significantly undermine their physical education learning motivation and affect their overall development. Multiple supports from teachers, parents, and peers can effectively help students maintain confidence and enhance their physical education learning motivation. However, the underlying mechanisms by which these multiple supports influence motivation for physical education remain unclear.

Objective

This study aims to explore the underlying mechanisms by which multiple supports influence learning motivation during physical education, specifically examining the mediating roles of self-efficacy and positive coping style. Additionally, it seeks to elucidate the complex configurational relationships among multiple supports, self-efficacy, coping style, and physical education learning motivation.

Methods

This study employs a cross-sectional survey method to investigate Chinese university students. Through convenience sampling, 969 students were recruited from four universities in Shandong Province. The participants completed the Teacher Support Scale, Parent Support Scale, Peer Support Scale, Self-Efficacy Scale, Positive Coping Style Scale, and Learning Motivation Scale. For data analysis, statistical processing was conducted using SPSS 26.0, Amos 22.0, and fsQCA 4.1.

Results

The results indicate that multiple supports from teachers, parents, and peers have significant direct effects on individual physical education learning motivation, with effect sizes of 0.132, 0.090, and 0.237, respectively. Self-efficacy acts as an independent mediator between multiple supports and physical education learning motivation, with effect sizes of 0.111, 0.076, and 0.197, respectively. Positive coping style also serve as an independent mediator in these relationships, with effect sizes of 0.091, 0.019, and 0.072; Self-efficacy and positive coping style function as a chain mediating mechanism between multiple supports and physical education learning motivation, with effect sizes of 0.021, 0.015, and 0.038; There are five equivalent configurations identified among multiple supports, self-efficacy, coping style, and physical education learning motivation.

Conclusion

Support from teachers, parents, and peers not only directly influences students' physical education learning motivation but also indirectly predicts students' physical education learning motivation through the independent and chain mediating roles of self-efficacy and coping style. Additionally, this study elucidates the complex configurational relationships among multiple supports, self-efficacy, coping style, and physical education learning motivation, thereby validating and supplementing the results of linear analysis.

Parental SES and family support as predictors of educational level: Testing the buffering effect of effortful control and peer support

INTRODUCTION

Exposure to family risk factors increases adolescents' chances of attaining a lower educational level. However, some adolescents attain a high educational level despite being exposed to family risk factors such as a lower parental socioeconomic status (SES) or receiving less family support.

METHOD

Using data from the Dutch TRAILS cohort study (NT1 = 2175; Mage = 11.1, SD = 0.55, 50.8% female), we investigated if higher levels of effortful control and peer support can buffer against the negative effects of a lower parental SES and less family support on educational level. Two multinomial logistic regressions were performed (from early to mid-adolescence and from mid-adolescence to young adulthood) with post hoc tests to contrast four ordinal educational levels: practical vocational, theoretical vocational, higher general, and (pre-)university.

RESULTS

Adolescents with a higher parental SES were consistently more likely to end up at a higher educational level, but family support was hardly associated with educational level. Neither effortful control nor peer support buffered the associations of parental SES and family support with educational level. Effortful control did have a positive direct (compensatory) effect on the educational level.

CONCLUSION

We conclude that other individual competencies or more structural changes may be more helpful buffers for reducing socioeconomic inequalities in educational attainment.

The effect of physical activity on anxiety symptoms among children and adolescents with mental health disorders: a research brief

Background

Anxiety is prevalent among children and adolescents (termed youths), and leads to reduced quality of life, disability, loss of education and reduced life-span. Physical activity has shown promising effects on symptoms of anxiety in adult populations, and an increasing amount of research has also demonstrated some effect in youth. However, physical activity is not widely used in youth mental health care, and research is very limited.

Methods/design

This single arm, pre-post study explores the effect of a manualized physical activity-based 14-session intervention termed Confident, Active and Happy Youth. Participants are youth attending specialized mental health care (N=51, M age = 13.4, SD = 2.2). Changes in anxiety symptoms are examined using mixed models with residual maximum likelihood (REML). The potential effect of anxiety subtype differences, participant age, comorbidity, and time spent in out-patient care are explored.

Results

Youths did not report any effect on anxiety symptoms after participation in CAHY, however, their parents report a significant reduction in youth's anxiety symptoms in general (b = -0.11, 95%, CI: -0.21 to -0.01) and specifically for social phobia (b = -0.19, 95% CI: -0.35 to -0.03). Age and comorbidity showed no significant effect on anxiety symptoms post treatment. Prior treatment time in youth mental health care demonstrated inconclusive results.

Conclusion

The study finds initial evidence of symptomatic change in a clinical population of youth's receiving a physical activity-based intervention. Our research provides preliminary support for physical activity as a supplementary treatment method for mental health disorders among youths.

Clinical Trial Registration

clinicaltrials.gov, NCT05049759.

Enjoyment of Physical Activity among Children and Adolescents: A Concept Analysis

Although enjoyment has been linked to participation in physical activity (PA), a thorough analysis of the concept is lacking. Health-related behavior research emphasizes the necessity of focusing on individual psychological requirements, such as enjoyment in PA, to boost children and adolescents' motivation for PA. The current paper is a report on a conceptual analysis of the enjoyment of PA among children and adolescents. We adopted the concept analysis procedure by Walker and Avant. Several databases (PubMed, CINAHL, ERIC, PsychInfo, and Sport Discus) were searched and used to extract relevant articles about the enjoyment of PA. The review process yielded a final set of 72 papers. A refined definition of enjoyment in PA, attributes, cases, antecedents, and consequences of enjoyment in PA were presented. A conceptual understanding of enjoyment in PA can enable nurses to plan interventions that help children and adolescents get appropriate PA and improve their health habits.

A meta-analysis of the relationship between social support and physical activity in adolescents: the mediating role of self-efficacy

Introduction

Social support influences physical activity (PA) in adolescents. However, whether mediating and moderating effects impact the relationship between them or the underlying mechanism remains unclear. This study aimed to investigate the mediating effects of self-efficacy as well as a series of moderating influences using a meta-analytic approach.

Methods

A total of 56 studies published between January 2001 and May 2023 were obtained from the Web of Science, EBSCO, Taylor and Francis, Scopus, Wiley, ProQuest, and CNKI (core) databases, comprising 65 independent samples (total sample size = 47,196).

Results and discussion

The mean weighted correlation coefficients between social, family, peer, and school support and adolescent PA were 0.298, 0.226, 0.256, and 0.142, respectively, which were significant, except for school support. Family support and teenage PA were related, although the connection was moderated by gender and socioeconomic characteristics. While social, family, and peer support had a direct influence on adolescent PA, school support did not. Self-efficacy mediated the relationship between social support and its subtypes and adolescent PA.

Examining the association between peer support and English enjoyment in Chinese university students: the mediating role of regulatory emotional self-efficacy

As positive psychology is imported into second language acquisition, we witness the increasing interest in the research of English enjoyment. Therefore, investigating the antecedents of English enjoyment is of paramount importance. Although internal and external factors have been scrutinized by researchers, scarce studies have explored the effect of peer support and regulatory emotional self-efficacy on English enjoyment. Thus, this study was designed to further clarify the association between these two constructs and English enjoyment. A questionnaire involving the three variables of peer support, English enjoyment, and regulatory emotional self-efficacy was administered to 324 non-English major undergraduate students at a comprehensive university in Eastern China. Correlation analysis and mediation effect tests indicated that peer support and regulatory emotional self-efficacy positively predicted English enjoyment, and regulatory emotional self-efficacy played a mediating role between peer support and English enjoyment. This study highlights the significance of peer support and positive emotions in second language learning and extends our understanding of enhancing students' learning enjoyment through teachers' positive intervention to facilitate peer support and regulatory emotional self-efficacy.

Effects of personal and interpersonal factors on changes of food choices and physical activity among college students

BACKGROUND

Health behaviors developed in the college years tend to persist in adulthood. However, distinct changing patterns of food choices and physical activity (PA) and their predictors are still less clear among college students. The current study sought to explore changes of food choices and PA, as well as the effects of personal and interpersonal factors.

METHOD

Two-wave longitudinal data was collected from a sample of 431 Chinese college students (Mean baseline age = 19.15 ± 0.61 years; 45.7% male). A validated self-reported food frequency questionnaire was used to assess the frequency of food choices. The Chinese revised version of physical activity rating scale was used to assess physical activity. Latent profile analysis, latent transition analysis, and multinomial logistic regression analysis were used to analyze the data.

RESULTS

Two profiles of food choices, i.e., Avoiding staples (5.1% at Time 1) and Varied diet (94.9% at Time 1), were identified at both timepoints. 90.9% remained the same profiles over time, 63.6% participants in the Avoiding staples profile shifted to the Varied diet profile, and only 6.3% of those in the Varied diet profile shifted to the Avoiding staples profile. Negative body shape-related belief was related to the translation from the Varied diet profile to the Avoiding staples profile. Further, four profiles of PA, i.e., Inactives (51.0% at Time 1), Low activies (26.0% at Time 1), Moderate activies (15.3% at Time 1), and Activies (7.7% at Time 1), were identified at both timepoints. 50.8% remained the same profiles over time, 38.6% Inactivies shifted to the other profiles, and 48.5% Activies shifted to the other profiles over time. Participants with higher self-efficacy showed an increase in PA over time, and those with lower self-efficacy and lower peer support showed a decrease in PA over time.

CONCLUSIONS

Overall, most of college students remained the same food choices profiles, and body shape-related belief contributed to changes in food choices profiles. About half of college students experienced changes in PA, and the predictors of such changes were peer support and self-efficacy. The findings extend the understanding of the personal and interpersonal predictors of health behaviors among college students from a dynamic perspective.

Exercise health belief model mediates the relationship between physical activity and peer support among Chinese college students: A cross-sectional survey

This study explored the influence of the exercise health belief model and peer support on university students' physical activity PA and clarified the related mechanism. Three hundred and thirty-six healthy university students (aged 19.4 ± 1.3 years, 166 male and 170 female) from Sichuan University of Arts and Science in China were evaluated by the peer support scale, the health belief model scale for exercise, and the physical activity scale (short volume). The results showed that the male students' exercise self-efficacy and PA were markedly higher than female university students. Peer support was positively correlated with perceived benefits, exercise self-efficacy, perceived severity, and cues to action, and was adversely associated with perceived objective and subjective barriers. PA was positively correlated with perceived benefits and exercise self-efficacy, and negatively correlated with perceived objective and subjective barriers. Among the components of the exercise health belief model, only exercise self-efficacy was suitable for constructing a structural equation model (SEM) with peer support and PA. The analysis showed that the predictive effect of exercise self-efficacy on PA was more significant than peer support, and exercise self-efficacy played a critical intermediary role. It is worth noting that, in the grouping model, the effect of male college students' exercise self-efficacy on PA was greater than that of female students, and the model fit of male peer support was better than that of female students. Although the impact of peer support on PA was less than that of exercise self-efficacy and the direct effect of peer support was less than the indirect effect, the impact of peer support on the PA of female university students was higher than that of male university students. This study revealed the impact of exercise self-efficacy and peer support on university students' PA and suggested that exercise self-efficacy is the main path to promoting university students' PA, followed by peer support. Peer support could affect university students' PA not only through direct effects but also through indirect effects. This study also suggested that female university students' peer support has a higher impact on PA than male students. Therefore, when formulating physical exercise courses in the future, it is necessary to give more peer support to female university students to compensate for their low exercise self-efficacy.

The Peer Effect in Promoting Physical Activity among Adolescents: Evidence from the China Education Panel Survey

For a long time, studies on the peer effect of physical activity among adolescents have focused on relevance rather than causality. This article provides empirical evidence of the peer effect of physical activity among adolescents using data from the China Education Panel Survey. The results show that the peer effect increases physical activity by about 6.757-8.984 min per week among classmates, a finding consistent with previous studies. Using the instrumental variable approach and considering the potential missing variables, the peer effect increases physical activity by 23.923-27.410 min per week, representing a threefold increase. In addition, the general attitude towards sports in class plays a significantly influential role, accounting for 20% of the peer effect of physical activity.

What factors can support students' deep learning in the online environment: The mediating role of learning self-efficacy and positive academic emotions?

Introduction

In 2020, COVID-19 forced higher education institutions in many countries to turn to online distance learning. The trend of using online education has accelerated across the world. However, this change in the teaching mode has led to the decline of students' online learning quality and resulted in students being unable to do deep learning. Therefore, the current research, aimed at promoting deep learning in the online environment, constructed a theoretical model with learning self-efficacy and positive academic emotions as mediators, deep learning as the dependent variable, perceived TPACK support, peer support, technical usefulness, and ease of use as independent variables.

Methods

The theoretical model was verified by SPSS26.0 and smartPLS3.0, and to assess the measurement and structural models, the PLS approach to structural equation modeling (SEM) was performed.

Results

The study found that (a) positive academic emotions play a mediating role between perceived TPACK support and deep learning, perceived peer support and deep learning, and perceived technology usefulness and ease of use and deep learning; (b) learning self-efficacy plays a mediating role between perceived TPACK support and deep learning, perceived peer support and deep learning, and perceived technology usefulness and ease of use and deep learning.

Discussion

The findings of this study fill the gaps in the research on the theoretical models of deep learning in the online environment and provide a theoretical basis for online teaching, learning quality, and practical improvement strategies.

The influence of social support on the physical exercise behavior of college students: The mediating role of self-efficacy

OBJECTIVES

To study the influencing factors on college students' physical exercise behavior and the mediating relationship of self-efficacy based on the theory of social support and self-efficacy; to provide theoretical support and practical guidance for college students engaging independently in physical exercise.

METHODS

A total of 1,440 college students from six universities in the Inner Mongolia Autonomous Region of China were selected as the research objects, and three scales (Self-Efficacy Scale, Social Support Scale, and Physical Exercise Rating Scale) were used to construct a structural equation model.

RESULTS

(1) A comprehensive sports facility environment is conducive to college students' physical activities and the emotional support of friends and family and the campus cultural atmosphere cannot be ignored. (2) Peer support has a direct impact on physical exercise behavior, family support and school support indirectly affect college students' physical exercise behavior, based on the intermediary role of self-efficacy. (3) According to the total effect, social support was ranked as school support (0.444), peer support (0.312), and family support (0.145).

CONCLUSION

Social support not only directly affects physical exercise behavior but also indirectly affects physical exercise behavior based on the mediating effect of self-efficacy.

Positive Influence of Cooperative Learning and Emotion Regulation on EFL Learners' Foreign Language Enjoyment

This study approaches foreign language enjoyment (FLE) through the lenses of positive psychology, and in particular, examines how enjoyment is affected by emotion regulation (ER) and two factors concerning cooperative learning (CL) in a classroom climate, namely positive goal interdependence (PGI) and peer personal support (PPS). To achieve this goal, 115 Chinese university freshmen (male 47; female 68) aged between 18 to 20 (M = 18.69; SD = 0.65) were invited to complete a questionnaire. Regression analyses revealed a clear three-factor structure determining the FLE of students learning English as a foreign language (EFL), which are ER, PGI that highlights cooperation, and PPS that emphasizes the interpersonal relationship between peers. It also showed that PGI and PPS significantly influence each other while positively and jointly shaping FLE. The findings suggest that university EFL students with higher ER abilities are more likely to obtain enjoyment in the learning process and that positive interdependence and interpersonal support during CL also play an effective role in deciding students' FLE. The study not only confirms the importance of ER and CL which may lead to high-level learning enjoyment, but also provides practical implications for the realization of an enjoyable second language acquisition (SLA) experience.

Evaluation of the validity of the physical exercise peer support questionnaire for college students

Peer support for physical exercise is defined as behaviors such as mutual or one-way provision of material help and/or emotional care and companionship between peers in the physical environment and/or physical behavior. The assessment of peer support is complex and based on reasoning. Trustworthy assessment processes need to provide sufficient evidence of validity. The purpose of this study was to organize, collect, and use Kane's validity framework to provide validity evidence for the identification of peer support for physical exercise among college students. The article describes the experience of using the framework in this study, considers data related to the four inferences (scoring, generalization, extrapolation, and implication) that emerge from the assessment process. The findings of the study are then interpreted through the four inferences to determine whether this evidence supports the purpose of this study. Based on Kane's framework to explain the validity process of this study, the study concludes that the evidence in terms of scoring, generalization, extrapolation, and implication supports the use of the PEPSQ for the identification of physical exercise peer support among college students.

Is prosocial behaviour a missing link between green space quality and child health-related outcomes?

BACKGROUND

This study aimed to investigate prosocial behaviour-those behaviours that benefit others or enhance relationships with others-as a mediator of the associations between green space quality and child health-related outcomes (physical activity, mental health, and health-related quality of life (HRQOL)).

METHODS

This study involved data from 4983 children with 10-year follow-up (2004-2014) retrieved from the Longitudinal Study of Australian Children. Green space quality (the exposure), prosocial behaviour (the candidate mediator), and child health-related outcomes were assessed biennially based on caregiver reports. Causal mediation analysis was used, with four mediation models developed for each outcome.

RESULTS

Mediation by prosocial behaviour appeared in the late childhood mediation model with higher mediation proportions reported compared to models of earlier and middle childhood. Prosocial behaviour had moderate mediation consistency for the association between green space quality and physical activity enjoyment, but no mediation was evident for other physical activity variables. Prosocial behaviour had low mediation consistency for child mental health (internalising and externalising subscales). Similarly, low mediation consistency of prosocial behaviour was also evident for all HRQOL variables, such as physical, emotional, social, school functioning, psychosocial health, and total quality of life (QOL).

CONCLUSION

Prosocial behaviour partially mediated the association between green space quality and child health-related outcomes (physical activity enjoyment, mental health, and HRQOL). Improving the quality of neighbourhood green space that supports the development of prosocial behaviour may result in better child health-related outcomes. Other physical activity variables might not specifically relate to social interactions, and therefore, no mediation by prosocial behaviour was apparent.

It doesn't hurt to TRY - Experiences of youths participating in a TRYathlon event series

ISSUE ADDRESSED

Running since 1999, the Sanitarium Weet-Bix Kids TRYathlon (SWKT) is the world's largest triathlon series for children and adolescents up to 16 years. This report seeks to describe participants of the TRYathlon and their perceptions of the event.

METHODS

An online survey was made available to Australian parents/guardians of participants enrolled in the 2020 SWKT. Organisational data was also employed to describe the reach of the SWKT since its inception.

RESULTS

Parents/guardians (n = 568) reported that the average child age was 9.12 (SD = 1.95, range = 6-16) and 58.6% were male. Parents/guardians identified 12 children as Aboriginal and/or Torres Strait Islander (2.0%) and 87 (14.6%) spoke a language other than English. The majority of parents/guardians rated their child's physical activity (PA) competencies as pretty good, or really good, for cycling (87.5%), swimming (80.9%) and running (79.5%). Most parents (66.0%) stated that their child was glowing with pride after completing the event, enjoyed or really enjoyed the event (98.8%), and thought their child would maintain their PA levels following the event (72.9%).

CONCLUSIONS

The SWKT series has demonstrated longevity and an ability to reach a large number of participants, providing opportunities to build health promotion awareness. Importantly the event instils a sense of confidence and pride related to PA competency in its participants; however, its long-term effectiveness requires further exploration. SO WHAT?: Mass participation events such as SWKT could be incorporated into larger health promotion strategies to encourage childhood PA and foster healthy physical and psychosocial development.

Examining if changes in gender-specific and co-ed intramural programs affect youth physical activity over time: a natural experiment evaluation using school- and student-level data from the COMPASS study

BACKGROUND

Despite the benefits of physical activity (PA), the majority of Canadian youth are falling short of the recommended 60 min of moderate-to-vigorous physical activity (MVPA) per day. School-based physical activity programs such as intramurals, are important opportunities for youth to be physically active. There is limited evidence available on the impact of gender-specific (e.g., female-only, male-only) and co-ed intramurals on youth PA over time, however, evidence suggests female-only intramurals may be important for female MVPA. This research aims to capitalize on a natural experiment to generate practice-based evidence on the impact of changes in gender-specific and co-ed intramurals on youth MVPA over time.

METHODS

This study used linked longitudinal school- and student-level data from Ontario secondary schools in year 5 (Y5:2016-2017), year 6 (Y6: 2017-2018) and year 7 (Y7: 2018-2019) of the COMPASS study. Data on intramurals from 55 schools were used to determine the changes to gender-specific and co-ed intramurals that occurred from Y5 to Y6. Baseline demographic characteristics were measured and data on PA and sport participation were collected in Y5, Y6 and Y7 on a sample of 4417 students. Hierarchical linear mixed regression models were used to estimate how changes in gender-specific and co-ed intramurals were associated with youth MVPA over time.

RESULTS

Participation in intramural, varsity and community sport were all positively and significantly associated with youth MVPA. Changes in gender-specific and co-ed intramurals were not significantly associated with youth MVPA in Y6 or Y7. However, the positive association between maintaining the addition of gender-specific intramurals on female MVPA in Y7 was on par with the significance level of α = 0.05, suggesting that adding gender-specific intramurals may be important for female MVPA.

CONCLUSIONS

Adding gender-specific and co-ed intramurals may not be sufficient strategies to increase PA among youth. Further research should explore the effect of gender-specific intramurals on youth PA, as this study may have been underpowered at the school-level. Gender-specific intramurals may promote a supportive PA environment that promotes MVPA, especially among females. These intramurals may be an important component of more comprehensive strategies to increase youth MVPA.

A Short Version of the Physical Activity Enjoyment Scale: Development and Psychometric Properties

Objective: The purposes of this paper were to (a) develop a new short, theory-driven, version of the physical activity enjoyment scale (PACES-S) using content analysis; and (b) subsequently to measure the psychometric properties (construct validity, internal consistency, test–retest reliability, and concurrent validity) of the PACES-S for adolescents. Methods: Six experts used a four-point Likert scale to assess the content validity of each of the 16 items of the physical activity enjoyment scale according to a provided definition of physical activity enjoyment. Based on the results, exploratory factor analysis was used to analyze survey data from a longitudinal study of 182 individuals (Measure 1 of Study 1: 15.75 ± 3.39 yrs; 56.6% boys, 43.4% girls), and confirmatory factor analysis (Measure 2 of Study 1: 15.69 ± 3.44 yrs; 56.3% boys, 43.7% girls) was used to analyze the survey data from a cross-sectional study of 3219 individuals (Study 2; 15.99 ± 3.10 yrs; 47.8% boys, 52.2% girls) to assess the construct validity of the new measure. To assess the reliability, test–retest reliability was assessed in Study 1 and internal consistency in Study 1 and 2. For the concurrent validity, correlations with self-reported and device-based physical activity behavior were assessed in both studies. Results: Four out of sixteen items were selected for PACES-S. Exploratory factor analysis and confirmatory factor analyses identified and supported its factorial validity (χ² = 53.62, df = 2, p < 0.001; RMSEA = 0.073; CFI = 0.99; RFI = 0.96; NFI = 0.99; TLI = 0.96; IFI = 0.99). Results showed good test–retest reliability (r = 0.76) and internal consistency (a = 0.82 to 0.88). Regarding concurrent validity, the results showed positive correlations with a physical activity questionnaire (Study 1: r = 0.36), with a physical activity diary (Study 1: r = 0.44), and with accelerometer-recorded data (Study 1: r = 0.32; Study 2: r = 0.21). Conclusions: The results indicate that PACES-S is a reliable and valid instrument that may be particularly useful to measure physical activity enjoyment in large-scale studies. It shows comparable measurement properties as the long version of PACES.

Parental influence on urban adolescents' physical activity experience

As important socializing agents of adolescents, parents may substantially influence adolescents' physical activity but their roles in adolescents' physical activity experience have not been sufficiently studied. Furthermore, there is a dearth of research on potential mechanisms through which parents may promote adolescents' positive physical activity experience. Using a longitudinal sample of 464 urban and primarily Hispanic and African American adolescents, this study examined the impact of parental support on adolescents' physical activity experience. Results of structural equation modeling showed that after controlling for adolescents' gender, body mass index, and perceived overall health, parental support positively affected adolescents' restructuring ability (i.e., ability to construct meaningful and satisfying activities during unpleasant experiences) and intrinsic motivation (i.e., activity participation driven by inherent interest and enjoyment) in physical activity, which in turn positively affected adolescents' physical activity experience. No significant gender differences were found in these relationships. Theoretical and practical implications are discussed.

Better health indicators of FitSpirit participants meeting 24-h movement guidelines for Canadian children and youth

This study aims to determine the proportion of girls who meet the recommendations for moderate-to-vigorous physical activity (MVPA), screen time and sleep duration among FitSpirit participants and evaluate the associations of these recommendations with perceived health-related quality of life (QOL), perceived health, physical activity (PA), self-efficacy and body mass index. Cross-sectional analyses of FitSpirit data were performed. All variables were collected through an online questionnaire. The proportion of girls meeting all recommendations was 2.2%, while 72.5% met either one or two and 25.4% met none. A greater percentage of girls with ≥3 years in FitSpirit met MVPA and sleep recommendations combined when compared with fewer years (12.9% vs. 1.7% with 1 year; vs. 10.1% with 2 years; p < 0.05). Meeting the combinations of MVPA and screen time (β = 0.19, 95% CI = 0.40, 1.68), MVPA and sleep (β = 0.20, 95% CI = 0.27, 1.04) and all three combined (β = 0.17, 95% CI = 0.33, 1.71) was the most significant predictors of better perceived QOL. Respecting MVPA recommendations predicted a better perceived health (β = 0.18, 95% CI = 0.18, 0.87) while girls who slept as recommended had a better PA-related self-efficacy (β = 0.23, 95% CI = 0.51, 2.11). Not meeting any recommendation was associated with inferior PA-related self-efficacy (β = -0.32, 95% CI = -3.03, -1.21). Lastly, meeting MVPA and sleep recommendations was significantly associated with lower body mass index z-scores (β = -0.14, 95% CI = -1.16, -0.11). There was a small percentage of girls following all of the recommendations. Furthermore, meeting individual and combined recommendations was associated with better perceived QOL and health, PA self-efficacy as well as healthier body mass index z-score.

Self-efficacy as a crucial psychological predictor of treatment adherence among elderly people living with HIV: analyses based on the health belief model

Medication adherence to antiretroviral therapy (ART) among elderly people living with HIV (PLWH) is of serious concern. Our study aimed to understand the medication adherence of elderly PLWH under ART based on the health belief model (HBM). A baseline survey with a total of 529 elderly PLWH was conducted in Sichuan. Logistic and linear regression analysis, mediation analysis, and path analysis based on prior evidence were used. Only self-efficacy showed direct associations with medication adherence in the last four days (ORm = 1.37, 95%CI: 1.11, 1.70) and the last month (ORm = 1.39, 95%CI: 1.18, 1.63) in the multivariate analysis. Self-efficacy mediated the relations between perceived benefits, perceived barriers, cues to action and medication adherence. Inner relations existed within the HBM. In addition to the direct effects, perceived benefits (β = 0.149, p = 0.031; β = 0.093, p = 0.005), perceived barriers (β = -0.070, p = 0.008; β = -0.062, p = 0.012), and cues to action (β = 0.184, p = 0.013; β = 0.135, p = 0.014) showed indirect effects on medication adherence in the last four days and the last month, respectively. HBM may be effective in predicting medication adherence of elderly PLWH, and self-efficacy may be a crucial predictor and mediator. Efforts should be focused on how to enhance elderly PLWH's self-efficacy without neglect of other medication beliefs.

Associations between Psychosocial Variables, Availability of Physical Activity Resources in Neighborhood Environment, and Out-of-School Physical Activity among Chinese Adolescents

This study aimed to evaluate the relationship between psychosocial variables (peer support, parental support, autonomous motivation, and controlled motivation), availability of physical activity resources in a neighborhood environment, and out-of-school moderate to vigorous physical activity (MVPA) among Chinese adolescents. The questionnaire of Family Life, Activity, Sun, Health, and Eating (FLASHE) Study was used to collect information on demographics, socioeconomic status, psychosocial variables, available physical activity resources in the neighborhood environment, and minutes of out-of-school MVPA. ANOVA analysis and multiple regression analysis were performed. The mean age of the 3833 adolescents included in our analysis was 14.7 years old (SD = 1.7). Peer support (b = 9.35, 95% CI: 7.55–11.15), autonomous motivation (b = 6.46, 95% CI: 4.09–8.82), parental support (b = 3.90, 95% CI: 1.75–6.07), and availability of physical activity resources in neighborhood environment (b = 3.18, 95% CI: 1.99–4.36) were significantly associated with out-of-school MVPA (p < 0.05). Controlled motivation was insignificantly related to minutes of out-of-school MVPA. Boys spent more time on out-of-school MVPA than girls (p < 0.001) and had a high level of peer support, parental support, and motivation (p < 0.05). Our findings suggest that interventions targeting the out-of-school MVPA among Chinese adolescents should focus on the psychosocial variables and neighborhood environment.

A school-based, peer-led programme to increase physical activity among 13- to 14-year-old adolescents: the GoActive cluster RCT

Background

Adolescent physical activity levels are low and are associated with rising disease risk and social disadvantage. The Get Others Active (GoActive) intervention was co-designed with adolescents and teachers to increase physical activity in adolescents.

Objective

To assess the effectiveness and cost-effectiveness of the school-based GoActive programme in increasing adolescents’ moderate-to-vigorous physical activity.

Design

A cluster randomised controlled trial with an embedded mixed-methods process evaluation.

Setting

Non-fee-paying schools in Cambridgeshire and Essex, UK (n = 16). Schools were computer randomised and stratified by socioeconomic position and county.

Participants

A total of 2862 Year 9 students (aged 13–14 years; 84% of eligible students).

Intervention

The iteratively developed feasibility-tested refined 12-week intervention trained older adolescents (mentors) and in-class peer leaders to encourage classes to undertake two new weekly activities. Mentors met with classes weekly. Students and classes gained points and rewards for activity in and out of school.

Main outcome measures

The primary outcome was average daily minutes of accelerometer-assessed moderate-to-vigorous physical activity at 10 months post intervention. Secondary outcomes included accelerometer-assessed activity during school, after school and at weekends; self-reported physical activity and psychosocial outcomes; cost-effectiveness; well-being and a mixed-methods process evaluation. Measurement staff were blinded to allocation.

Results

Of 2862 recruited participants, 2167 (76%) attended 10-month follow-up measurements and we analysed the primary outcome for 1874 (65.5%) participants. At 10 months, there was a mean decrease in moderate-to-vigorous physical activity of 8.3 (standard deviation 19.3) minutes in control participants and 10.4 (standard deviation 22.7) minutes in intervention participants (baseline-adjusted difference –1.91 minutes, 95% confidence interval –5.53 to 1.70 minutes; p = 0.316). The programme cost £13 per student compared with control. Therefore, it was not cost-effective. Non-significant indications of differential impacts suggested detrimental effects among boys (boys –3.44, 95% confidence interval –7.42 to 0.54; girls –0.20, 95% confidence interval –3.56 to 3.16), but favoured adolescents from lower socioeconomic backgrounds (medium/low 4.25, 95% confidence interval –0.66 to 9.16; high –2.72, 95% confidence interval –6.33 to 0.89). Mediation analysis did not support the use of any included intervention components to increase physical activity. Some may have potential for improving well-being. Students, teachers and mentors mostly reported enjoying the GoActive intervention (56%, 87% and 50%, respectively), but struggled to conceptualise their roles. Facilitators of implementation included school support, embedding a routine, and mentor and tutor support. Challenges to implementation included having limited school space for activities, time, and uncertainty of teacher and mentor roles.

Limitations

Retention on the primary outcome at 10-month follow-up was low (65.5%), but we achieved our intended sample size, with retention comparable to similar trials.

Conclusions

A rigorously developed school-based intervention (i.e. GoActive) was not effective in countering the age-related decline in adolescent physical activity. Overall, this mixed-methods evaluation provides transferable insights for future intervention development, implementation and evaluation.

Future work

Interdisciplinary research is required to understand educational setting-specific implementation challenges. School leaders and authorities should be realistic about expectations of the effect of school-based physical activity promotion strategies implemented at scale.

Trial registration

Current Controlled Trials ISRCTN31583496.

Funding

This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 9, No. 6. See the NIHR Journals Library website for further project information. This work was additionally supported by the Medical Research Council (London, UK) (Unit Programme number MC_UU_12015/7) and undertaken under the auspices of the Centre for Diet and Activity Research (Cambridge, UK), a UK Clinical Research Collaboration Public Health Research Centre of Excellence. Funding from the British Heart Foundation (London, UK), Cancer Research UK (London, UK), Economic and Social Research Council (Swindon, UK), Medical Research Council, the National Institute for Health Research (Southampton, UK) and the Wellcome Trust (London, UK), under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged (087636/Z/08/Z; ES/G007462/1; MR/K023187/1). GoActive facilitator costs were borne by Essex and Cambridgeshire County Councils.

Determinants of student's physical activity: a 12-month follow-up study in Ningxia province

Background

Physical activity has many health benefits for children and adolescents. However, the prevalence of physical inactivity in school-aged children and adolescents remains high in China. Many factors impact the levels of moderate and vigorous physical activity (MVPA) among students. This study investigated the factors associated with students’ MVPA levels and the determinants of changes in their MVPA behaviour.

Methods

This is a longitudinal study with a 12-month follow-up. The study samples were obtained from 2016 and 2017 Physical Activity and Fitness in China—The Youth Study, and they included 1597 students (aged 9–18 years) from 31 primary, junior high, and high schools in Ningxia Province. Factors related to the individual (Age, Sex, BMI and attitude to PA), school (school exercise facility, PE class, teacher support, PA time and PA environment) and neighbourhood (free skill training, sport events, sport organization, sport facility) factors were measured via questionnaire at baseline and after 12 months. Multiple logistic regression was performed to examine the factors that impact students’ MVPA level and the determinants of changes in students’ MVPA behaviour.

Results

There was no difference in students’ MVPA levels between 2016 and 2017. Boys were more physically active than girls at baseline (RR 1.55, 95% CI 1.10, 2.20). Neighbourhood factors associated students’ MVPA levels were significant, but all of these factors (neighbourhood sport events, organizations, facilities, etc.) were removed from the longitudinal model. Individual and school factors were important for students’ MVPA maintenance and positive development (e.g., gender, attitude, school PE class and PA time).

Conclusions

In conclusion, both neighbourhood and school factors may affect students’ MVPA, but school appears to plays a more critical role in maintaining and promoting students’ MVPA levels. In addition, individual factors may be more important than school and neighbourhood factors in influencing students’ MVPA levels. Our research demonstrates that students’ attitudes towards PA and school factors should be considered targets for future intervention programmes to promote MVPA. More education programmes may help enhance students’ attitudes towards PA, but more studies with large samples and objective assessments are needed to explore the determinants of MVPA.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10525-1.

Mediating effects of achievement emotions between peer support and learning satisfaction in graduate nursing students

Graduate nursing students experience considerable stress due to their multiple responsibilities, including professional responsibilities, graduate coursework and family commitments. Peer support can help graduate students overcome stress and may heavily influence their learning satisfaction. However, the mechanisms underlying the influence of peer support on learning satisfaction in graduate students remain unclear. Thus, this cross-sectional study examined the relationship between peer support, achievement emotions (learner-specific emotions related to achievement activities) and learning satisfaction, as well as the mediating effects of achievement emotions among 225 graduate nursing students working in the Korean health care system. Participants completed a questionnaire assessing these variables. Pearson correlation was conducted to investigate the relationship between the variables and Baron and Kenny's regression analysis and Sobel test were conducted to examine the mediating effects of achievement emotions. Peer support correlated positively with positive achievement emotions and learning satisfaction and negatively with negative emotions. Positive emotions were positively and negative emotions were negatively, correlated with learning satisfaction. Achievement emotions mediated the relationship between peer support and learning satisfaction. Our findings indicate that peer support plays an important role in improving learning satisfaction, emphasizing the advantages of positive emotions and the disadvantages of negative emotions in graduate nursing students.

Use of a Smartphone App to Increase Physical Activity Levels in Insufficiently Active Adults: Feasibility Sequential Multiple Assignment Randomized Trial (SMART)

Background

The sequential multiple assignment randomized trial (SMART) design allows for changes in the intervention during the trial period. Despite its potential and feasibility for defining the best sequence of interventions, so far, it has not been utilized in a smartphone/gamified intervention for physical activity.

Objective

We aimed to investigate the feasibility of the SMART design for assessing the effects of a smartphone app intervention to improve physical activity in adults. We also aimed to describe the participants’ perception regarding the protocol and the use of the app for physical activity qualitatively.

Methods

We conducted a feasibility 24-week/two-stage SMART in which 18 insufficiently active participants (<10,000 steps/day) were first randomized to group 1 (smartphone app only), group 2 (smartphone app + tailored messages), and a control group (usual routine during the protocol). Participants were motivated to increase their step count by at least 2000 steps/day each week. Based on the 12-week intermediate outcome, responders continued the intervention and nonresponders were rerandomized to subsequent treatment, including a new group 3 (smartphone app + tailored messages + gamification) in which they were instructed to form groups to use several game elements available in the chosen app (Pacer). We considered responders as those with any positive slope in the linear relationship between weeks and steps per day at the end of the first stage of the intervention. We compared the accelerometer-based steps per day before and after the intervention, as well as the slopes of the app-based steps per day between the first and second stages of the intervention.

Results

Twelve participants, including five controls, finished the intervention. We identified two responders in group 1. We did not observe relevant changes in the steps per day either throughout the intervention or compared with the control group. However, the rerandomization of five nonresponders led to a change in the slope of the steps per day (median −198 steps/day [IQR −279 to −103] to 20 steps/day [IQR −204 to 145]; P=.08). Finally, in three participants from group 2, we observed an increase in the number of steps per day up to the sixth week, followed by an inflection to baseline values or even lower (ie, a quadratic relationship). The qualitative analysis showed that participants’ reports could be classified into the following: (1) difficulty in managing the app and technology or problems with the device, (2) suitable response to the app, and (3) difficulties to achieve the goals.

Conclusions

The SMART design was feasible and changed the behavior of steps per day after rerandomization. Rerandomization should be implemented earlier to take advantage of tailored messages. Additionally, difficulties with technology and realistic and individualized goals should be considered in interventions for physical activity using smartphones.

Trial Registration

Brazilian Registry of Clinical Trials RBR-8xtc9c; http://www.ensaiosclinicos.gov.br/rg/RBR-8xtc9c/.

Individual and Environmental Factors Associated with Participation in Physical Activity as Adolescents Transition to Secondary School: A Qualitative Inquiry

The transition from elementary to secondary school is an emotionally and socially complex time when adverse behaviors appear, such as decreased levels of physical activity (PA). Behavioral and environmental factors that influence PA during this time are poorly understood. Therefore, we aimed to identify factors that influence PA as adolescents transition to secondary school. Qualitative interviews were conducted with a sample of 27 ethnically diverse child–parent dyads within the public-school system in British Columbia, Canada (50% boys, 68% mothers, 25% White). The interviews probed for environmental and behavioral factors in school, family, and social contexts that potentially initiated changes in PA, specifically related to the adolescents’ transitions. Interviews were recorded and transcribed verbatim. Thematic analyses identified factors at the individual, social, familial, and school levels that may trigger adolescents to change their participation in PA as they transition from elementary to secondary school. Twenty-two factors emerged from the qualitative analysis including school factors (8), household factors (3), social factors (4), and intrapersonal factors (7). These findings contribute to a better understanding of adolescents’ PA behaviors and highlight the influence of changing environments as they transition from elementary school to secondary school.

Social Cognitive Orientations, Social Support, and Physical Activity among at-Risk Urban Children: Insights from a Structural Equation Model

This study investigates the effects of cognitive orientations associated with social cognitive theory (SCT) and exercise enjoyment on physical activity (PA) of urban at-risk children, accounting for mediating effects associated with various sources of social support. We use 2016–2017 survey data from 725 school-age children in an urban school district in Akron, Ohio in the United States (US) to inform a structural equation model, which assesses direct and indirect effects of self-efficacy, behavioral intention, and exercise enjoyment on children’s PA, using mediating variables that measure social support that children report receiving from parents, Physical Education (PE) teachers, and peers. We find that self-efficacy and exercise enjoyment have notable direct and indirect effects on the children’s PA. We also find that the support children receive from PE teachers and peers appears to have greater effects on PA than does the children’s reported social support from parents. These findings suggest that children’s social cognitive orientations may influence both sources of perceived social support and the extent to which children engage in PA. While these findings have potential implications for intervention strategies to increase PA among at-risk children, further research is appropriate to improve our understanding of the determinants of PA among at-risk urban children.

Parental and Peer Support are Associated with Physical Activity in Adolescents: Evidence from 74 Countries

Although parental and peer support can influence adolescents’ physical activity (PA), these associations have not been fully examined through a global assessment. This study examined the associations of parental and peer support with PA among adolescents from 74 countries. The Global School-based Student Health Survey data from 250,317 adolescents aged 11–17 years (48.8% girls), collected between 2007 and 2016, were analysed. Adolescents were asked how many days/week they were physically active and about their parental and peer support. Meta-analysis showed that adolescents who had high parental or peer support had higher odds of attaining sufficient PA (odds ratio (OR): 1.40, 95% confidence interval (CI): 1.34–1.46; OR: 1.57, 95% CI: 1.49–1.65, respectively). Pooled estimates of association were significant across all World Health Organization (WHO) regions and country-income categories with the highest estimate from the low-income countries. The Western Pacific region showed the highest association between parental support and adolescents’ PA (OR: 1.49, 95% CI: 1.41–1.59), while South-East Asia exhibited the highest association between peer support and adolescents’ PA (OR: 1.80, 95% CI: 1.59–2.04). Country-level estimates of associations are presented. Future studies should use robust assessment of PA and PA-specific parental and peer support with emphasis on qualitative investigation to understand the complexity of the relationships.

The Influence of Social Support on Physical Activity in Chinese Adolescents: The Mediating Role of Exercise Self-Efficacy

The purpose of this study was to examine the associations of social support and self-efficacy with physical Activity (PA) and the mediating effect of self-efficacy on the relationship between social support and PA in Chinese adolescents. Participants included a total of 2341 Chinese adolescents (aged 12.75 ± 1.46 years). Self-reported instruments, including the physical activity questionnaire for adolescents, the social support revalued scale and the exercise self-efficacy scale, were used to measure physical activity, social support and exercise self-efficacy. Results showed that social support (r = 0.29, p < 0.05) and exercise self-efficacy (r = 0.43, p < 0.05) were significant and positive predictors of PA among Chinese adolescents, and exercise self-efficacy was a significant mediator in the relationship between social support and PA (standardized effect size = 0.15, p < 0.001). Such findings were evident with similar patterns in both male and female adolescents. The findings of this study have indicated the importance of social support and exercise self-efficacy on PA promotion in adolescents, which will aid the development of effective interventions in this population.

Effects of a HAPA-based multicomponent intervention to improve self-management precursors of older adults with tuberculosis: A community-based randomised controlled trial

OBJECTIVE

To evaluate the effectiveness of a multicomponent intervention based on the Health Action Process Approach (HAPA) model to improve the self-management precursors of older adults with tuberculosis (TB).

METHODS

A cluster-randomised controlled trial was conducted. Older adults with TB in the intervention communities received HAPA-based multicomponent interventions at the beginning of treatment and in the first and sixth months after treatment initiation, and those in the control communities received health education alone. Self-management precursors were measured at baseline and 1 week after each intervention.

RESULTS

Among 262 randomized patients, 244 (93%) completed the trial. Compared with the control group, self-management precursor scores for the intervention group increased significantly over time (β_group*time = 2.92, p < 0.001) in the following 3 precursors: behaviour belief (β_group*time = 0.35, p < 0.001), behaviour plan (β_group*time = 0.72, p < 0.001), and self-efficacy (β_group*time = 1.85, p < 0.001). Education was significantly associated with behaviour belief (β = 0.18, p < 0.05). Chronic comorbidity was significantly associated with behaviour plan (β=-0.26, p < 0.05).

CONCLUSION

Compared with single health education, the HAPA-based multicomponent interventions significantly improved the self-management precursor of older adults with TB.

PRACTICE IMPLICATIONS

This HAPA-based multicomponent intervention strategy may be a promising self-management mode for the routine health care of TB patients.

Pathways to Increasing Adolescent Physical Activity and Wellbeing: A Mediation Analysis of Intervention Components Designed Using a Participatory Approach

We assessed which intervention components were associated with change in moderate-to-vigorous physical activity (MVPA) and wellbeing through proposed psychosocial mediators. Eight schools (n = 1319; 13–14 years) ran GoActive, where older mentors and in-class-peer-leaders encouraged classes to conduct two new activities/week; students gained points and rewards for activity. We assessed exposures: participant-perceived engagement with components (post-intervention): older mentorship, peer leadership, class sessions, competition, rewards, points entered online; potential mediators (change from baseline): social support, self-efficacy, group cohesion, friendship quality, self-esteem; and outcomes (change from baseline): accelerometer-assessed MVPA (min/day), wellbeing (Warwick-Edinburgh). Mediation was assessed using linear regression models stratified by gender (adjusted for age, ethnicity, language, school, BMI z-score, baseline values), assessing associations between (1) exposures and mediators, (2) exposures and outcomes (without mediators) and (3) exposure and mediator with outcome using bootstrap resampling. No evidence was found to support the use of these components to increase physical activity. Among boys, higher perceived teacher and mentor support were associated with improved wellbeing via various mediators. Among girls, higher perceived mentor support and perception of competition and rewards were positively associated with wellbeing via self-efficacy, self-esteem and social support. If implemented well, mentorship could increase wellbeing among adolescents. Teacher support and class-based activity sessions may be important for boys’ wellbeing, whereas rewards and competition warrant consideration among girls.

Physical Activity of Children with Physical Disabilities: Associations with Environmental and Behavioral Variables at Home and School

The purpose of this study was to examine the physical activity (PA) of children with physical disabilities (PD) and its associated environmental and behavioral factors at home and at school. One hundred and forty-seven Hong Kong children (mean age = 13.5 ± 2.5 years) with PD from three special schools participated. We used BEACHES (Behaviors of Eating and Activity for Children's Health: Evaluation System) to assess their PA and associated variables at home (before dinner) and during four school settings (before classes, recess, lunch breaks, after classes) on four school days. Overall, the children were typically inactive and spent little time in moderate-to-vigorous physical activity (MVPA), range = 6.3% to 17.0% across settings. At home, children were more active when fathers were present (p < 0.001). At school, prompts to be active contributed to their MVPA% before classes (p < 0.01) and during recess and lunch breaks (both p < 0.001). The presence of a child's mother was positively associated with MVPA% before classes (p < 0.001) and the presence of other children was associated with MVPA% during recess and lunch breaks (both p < 0.05). With children with PD accruing small amounts of MVPA in both home and school settings, multifaceted interventions reflecting both contextual and personal factors should be considered in order to increase the health-enhancing PA of this population.

Effect of an Active Video Gaming Classroom Curriculum on Health-Related Fitness, School Day Step Counts, and Motivation in Sixth Graders

BACKGROUND

The purpose of this study was to explore the effect of an active video gaming (AVG) classroom curriculum on health-related fitness, school day steps, and motivation in sixth graders.

METHODS

A convenience sample of 65 sixth graders were recruited from 2 classrooms from a school located in the Western United States. One classroom served as the comparison group (n = 32) that participated in active free play, and one classroom served as the intervention group (n = 33) that participated in an AVG curriculum for 30 minutes per day, 3 days per week, for 18 weeks. Cardiorespiratory endurance was assessed using Progressive Aerobic Cardiovascular Endurance Run laps. School day steps were recorded, and motivational variables were collected using questionnaires. Measures were collected at baseline and an 18-week posttest time point.

RESULTS

There was a significant group × time interaction for Progressive Aerobic Cardiovascular Endurance Run laps (b = 20.7 laps; 95% confidence interval, 14.6 to 26.8; P < .001). No statistically significant interactions were found for step counts or any of the motivational variables.

CONCLUSIONS

An 18-week AVG classroom curriculum improved cardiorespiratory endurance relative to the comparison group in sixth graders. This study supports the use of low-cost AVG curricula to improve the health-related fitness of youth.