A daily process analysis of intentions and physical activity in college students

Within-Person Associations of Accelerometer-Assessed Physical Activity With Time-Varying Determinants in Older Adults: Time-Based Ecological Momentary Assessment Study

BACKGROUND

Despite the availability of physical activity (PA) interventions, many older adults are still not active enough. This might be partially explained by the often-limited effects of PA interventions. In general, health behavior change interventions often do not focus on contextual and time-varying determinants, which may limit their effectiveness. However, before the dynamic tailoring of interventions can be developed, one should know which time-dependent determinants are associated with PA and how strong these associations are.

OBJECTIVE

The aim of this study was to examine within-person associations between multiple determinants of the capability, opportunity, motivation, and behavior framework assessed using Ecological Momentary Assessment (EMA) and accelerometer-assessed light PA, moderate to vigorous PA, and total PA performed at 15, 30, 60, and 120 minutes after the EMA trigger.

METHODS

Observational data were collected from 64 healthy older adults (36/64, 56% men; mean age 72.1, SD 5.6 y). Participants were asked to answer a time-based EMA questionnaire 6 times per day that assessed emotions (ie, relaxation, satisfaction, irritation, and feeling down), the physical complaint fatigue, intention, intention, and self-efficacy. An Axivity AX3 was wrist worn to capture the participants' PA. Multilevel regression analyses in R were performed to examine these within-person associations.

RESULTS

Irritation, feeling down, intention, and self-efficacy were positively associated with subsequent light PA or moderate to vigorous PA at 15, 30, 60, or 120 minutes after the trigger, whereas relaxation, satisfaction, and fatigue were negatively associated.

CONCLUSIONS

Multiple associations were observed in this study. This knowledge in combination with the time dependency of the determinants is valuable information for future interventions so that suggestions to be active can be provided when the older adult is most receptive.

Within-person association of volitional factors and physical activity: Insights from an ecological momentary assessment study

OBJECTIVE

Current health behavior models of physical activity (PA) suggest that not all PA intentions are translated into actual PA behavior, resulting in a significant intention-behavior gap (IBG) of almost 50%. These models further suggest that higher self-efficacy and specific planning can aid in decreasing this gap. However, as most evidence stems from between-person (trait level), questionnaire-based research, it is unclear how large short-term IBGs are, how self-efficacy and planning covary within-persons across time and whether they similarly predict smaller IBGs. It is likely that day-to-day changes in circumstances and barriers affect these variables thus the applicability of theoretical models is uncertain. Here, within-person prospective analyses of ecological momentary assessment (EMA) data can provide insights.

METHODS

35 healthy participants (aged 23-67) completed four EMA-based questionnaires every day for three weeks. Each prompt assessed PA (retrospectively, "since the last EMA prompt"); PA intentions, planning specificity, self-efficacy, and intrinsic motivation (prospectively, "until the next EMA prompt") and momentary affect. Generalized logistic mixed-effect modeling was used to test predictors of PA.

RESULTS

Across the 2341 answered EMA prompts, PA intentions were not enacted in 25% of the episodes (IBG). In episodes with given intentions, PA likelihood increased with higher levels of self-efficacy, planning specificity, and intrinsic motivation. The latter two also positively predicted PA duration and intensity.

CONCLUSIONS

Short-term intention behavior gaps seem to be smaller than what is known from more long-term studies, most likely as individuals can anticipate the actual circumstances of PA. Further, current health behavior models show validity in explaining within-person dynamics in IBGs across time. Knowing the relevance of planning specificity, self-efficacy and intrinsic motivation for day-to-day variations in PA enactment can inform respective real-time mHealth interventions for facilitating PA.

Motivational Message Framing Effects on Physical Activity Dynamics in a Digital Messaging Intervention: Secondary Analysis

BACKGROUND

Digital smartphone messaging can be used to promote physical activity to large populations with limited cost. It is not clear which psychological constructs should be targeted by digital messages to promote physical activity. This gap presents a challenge for developing optimal content for digital messaging interventions.

OBJECTIVE

The aim of this study is to compare affectively framed and social cognitively framed messages on subsequent changes in physical activity using dynamical modeling techniques.

METHODS

We conducted a secondary analysis of data collected from a digital messaging intervention in insufficiently active young adults (18-29 years) recruited between April 2019 and July 2020 who wore a Fitbit smartwatch for 6 months. Participants received 0 to 6 messages at random per day across the intervention period. Messages were drawn from 3 content libraries: affectively framed, social cognitively framed, or inspirational quotes. Person-specific dynamical models were identified, and model features of impulse response and cumulative step response were extracted for comparison. Two-way repeated-measures ANOVAs evaluated the main effects and interaction of message type and day type on model features. This early-phase work with novel dynamic features may have been underpowered to detect differences between message types so results were interpreted descriptively.

RESULTS

Messages (n=20,689) were paired with valid physical activity monitoring data from 45 participants for analysis. Received messages were distributed as 40% affective (8299/20,689 messages), 39% social-cognitive (8187/20,689 messages), and 20% inspirational quotes (4219/20,689 messages). There were no statistically significant main effects for message type when evaluating the steady state of step responses. Participants demonstrated heterogeneity in intervention response: some had their strongest responses to affectively framed messages, some had their strongest responses to social cognitively framed messages, and some had their strongest responses to the inspirational quote messages.

CONCLUSIONS

No single type of digital message content universally promotes physical activity. Future work should evaluate the effects of multiple message types so that content can be continuously tuned based on person-specific responses to each message type.

Research on the influence of college students' participation in sports activities on their sense of inferiority based on self-esteem and general self-efficacy

College students need to face various problems and conflicts, and are prone to many negative emotions, such as depression, low self-esteem, social anxiety, low sense of belonging, lack of self-identity, and so on. The generation of these bad emotions will bring unexpected negative effects to college students. Taking Chinese college students as the research object, this study analyzes the influence of sports participation on inferiority. Furthermore, we explored whether self-esteem and general self-efficacy mediated the relationship between physical activity and inferiority. In this study, 115 students were selected to conduct the experiment for 12 weeks. After reliability testing, the collected data were analyzed by multivariate analysis of variance to verify the research model. The results show that sports has a significant positive correlation with the reduction of college students' inferiority complex. What is important in this model is that self-esteem and general self-efficacy are enhanced during physical activity and decreased during inferiority complex. In addition, this study created three sports situations: competition group, entertainment group and control group. The comparison results show that competitive sports situation is better than leisure sports situation in terms of the influence on college students' inferiority complex. Through the theoretical and empirical research on college students' inferiority complex, it is concluded that sports is an effective means to reduce college students' inferiority complex.

Associations Between Social Cognitive Determinants and Movement-Related Behaviors in Studies using Ecological Momentary Assessment Methods: A Systematic Review (Preprint)

BACKGROUND

The social cognitive framework is a long-standing framework within physical activity promotion literature to explain and predict movement-related behaviors. However, applications of the social cognitive framework to explain and predict movement-related behaviors have typically examined the relationships between determinants and behavior across macrotimescales (eg, weeks and months). There is more recent evidence suggesting that movement-related behaviors and their social cognitive determinants (eg, self-efficacy and intentions) change across microtimescales (eg, hours and days). Therefore, efforts have been devoted to examining the relationship between social cognitive determinants and movement-related behaviors across microtimescales. Ecological momentary assessment (EMA) is a growing methodology that can capture movement-related behaviors and social cognitive determinants as they change across microtimescales.

OBJECTIVE

The objective of this systematic review was to summarize evidence from EMA studies examining associations between social cognitive determinants and movement-related behaviors (ie, physical activity and sedentary behavior).

METHODS

Studies were included if they quantitatively tested such an association at the momentary or day level and excluded if they were an active intervention. Using keyword searches, articles were identified across the PubMed, SPORTDiscus, and PsycINFO databases. Articles were first assessed through abstract and title screening followed by full-text review. Each article was screened independently by 2 reviewers. For eligible articles, data regarding study design, associations between social cognitive determinants and movement-related behaviors, and study quality (ie, Methodological Quality Questionnaire and Checklist for Reporting Ecological Momentary Assessment Studies) were extracted. At least 4 articles were required to draw a conclusion regarding the overall associations between a social cognitive determinant and movement-related behavior. For the social cognitive determinants in which a conclusion regarding an overall association could be drawn, 60% of the articles needed to document a similar association (ie, positive, negative, or null) to conclude that the association existed in a particular direction.

RESULTS

A total of 24 articles including 1891 participants were eligible for the review. At the day level, intentions and self-efficacy were positively associated with physical activity. No other associations could be determined because of conflicting findings or the small number of studies investigating associations.

CONCLUSIONS

Future research would benefit from validating EMA assessments of social cognitive determinants and systematically investigating associations across different operationalizations of key constructs. Despite the only recent emergence of EMA to understand social cognitive determinants of movement-related behaviors, the findings indicate that daily intentions and self-efficacy play an important role in regulating physical activity in everyday life.

TRIAL REGISTRATION

PROSPERO CRD42022328500; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=328500.

Physical Activity Dynamics During a Digital Messaging Intervention Changed After the Pandemic Declaration

BACKGROUND

The COVID-19 pandemic adversely impacted physical activity, but little is known about how contextual changes following the pandemic declaration impacted either the dynamics of people's physical activity or their responses to micro-interventions for promoting physical activity.

PURPOSE

This paper explored the effect of the COVID-19 pandemic on the dynamics of physical activity responses to digital message interventions.

METHODS

Insufficiently-active young adults (18-29 years; N = 22) were recruited from November 2019 to January 2020 and wore a Fitbit smartwatch for 6 months. They received 0-6 messages/day via smartphone app notifications, timed and selected at random from three content libraries (Move More, Sit Less, and Inspirational Quotes). System identification techniques from control systems engineering were used to identify person-specific dynamical models of physical activity in response to messages before and after the pandemic declaration on March 13, 2020.

RESULTS

Daily step counts decreased significantly following the pandemic declaration on weekdays (Cohen's d = -1.40) but not on weekends (d = -0.26). The mean overall speed of the response describing physical activity (dominant pole magnitude) did not change significantly on either weekdays (d = -0.18) or weekends (d = -0.21). In contrast, there was limited rank-order consistency in specific features of intervention responses from before to after the pandemic declaration.

CONCLUSIONS

Generalizing models of behavioral dynamics across dramatically different environmental contexts (and participants) may lead to flawed decision rules for just-in-time physical activity interventions. Periodic model-based adaptations to person-specific decision rules (i.e., continuous tuning interventions) for digital messages are recommended when contexts change.

Within-person examination of the exercise intention-behavior gap among women in midlife with elevated cardiovascular disease risk

Engaging in moderate-to-vigorous intensity physical activity (MVPA) is important for protecting cardiovascular health among women in midlife (i.e., ages 40-60), particularly if they have already developed conditions that increase their risk for cardiovascular disease (e.g., hypertension). Although the gap between MVPA intentions and behavior is well documented in other populations, little is known about the intention-behavior gap in this at-risk group - particularly as it plays a role in daily life. The present study employed an ecological momentary assessment design to examine the relation between women's MVPA intentions and behavior in the subsequent 3 hours, as well as momentary moderators of this relation (i.e., affective states and body satisfaction). Surveys sent to women's smartphones 5 times per day for 10 days while they wore ActiGraph GT3X waistband accelerometers. Women achieved their exercise intentions at only 13% of occasions on which they set intentions. Although the most common intended exercise was walking, women engaged in more minutes of MVPA after setting intentions to do yoga or Pilates than any other type of exercise (sr = 0.25). Multilevel models showed a modest within-person relation between minutes of intended MVPA and observed MVPA in the next 3 hours (sr = 0.20). This relation was moderated within-person by the reported extent of positive affect (particularly contentment) and body satisfaction (srs = 0.35 and 0.28, respectively). Findings extend knowledge about the physical activity intention-behavior gap to an at-risk population of women and identify positive affect and body satisfaction as potential contextual influences for this group, which could inform improvements to existing interventions (e.g., delivering intervention content at times with lower-than-usual body satisfaction).

Momentary intentions and perceived behavioral control are within-person predictors of sedentary leisure time: preliminary findings from an ecological momentary assessment study in adolescents

Previous studies among adolescents conceptualize behavioral cognitions [e.g., intentions and perceived behavioral control (PBC)] as stable trait-like factors despite evidence suggesting they vary momentarily. We examined whether intentions and PBC momentarily relate to subsequent sedentary time during non-school periods. Healthy adolescents (N = 15, ages 11-15) reported their intentions and PBC regarding sedentary leisure behaviors via ecological momentary assessment (EMA) up to seven times/day for 14 days. Sedentary time in the two hours following each EMA prompt was measured by ActivPAL accelerometers. When participants reported greater sedentary intentions (within-person β = 1.1, 95% CI 0.2, 2.1, p = 0.0213) and sedentary PBC (within-person β = 1.7, 95% CI 0.6, 2.8, p = 0.0029), they accumulated greater sedentary time. This demonstrates that sedentary intentions and PBC are acutely associated with sedentary time among adolescents. Our findings highlight the potential for implementing just-in-time activity interventions among adolescents during at-risk periods within the day, characterized by deviations from one's usual intentions and PBC levels.

Daily Instrumental and Affective Attitudes About Exercise: An Ecological Momentary Assessment Study

BACKGROUND

Daily decisions to exercise may be influenced by day-to-day changes in affective attitudes (AA) and instrumental attitudes (IA) toward exercise. However, the within-day association between AA, IA, and exercise behavior has received little attention.

PURPOSE

To examine the effects of more temporally proximal (daily) AA and IA on daily exercise behavior beyond traditionally assessed distal (at the beginning of an exercise program) AA and IA.

METHODS

In the context of a 3-month exercise promotion program (N = 50), distal AA and IA were assessed at baseline. Ecological momentary assessment was used to assess proximal AA, IA, and exercise each day.

RESULTS

Between-subject differences in distal AA (OR = 1.28, p = .03) and distal IA (OR = 1.34, p = .01) were predictive of average likelihood of exercise each day over the 3-month period. Within-subject differences in proximal AA (OR = 1.19, p = .007), but not proximal IA (OR = 1.11, p = .18), predicted exercise each day beyond the between-subjects effects of distal AA and IA. Exploratory analysis revealed an interaction, such that the within-subjects impact of proximal AA on daily exercise was most evident among individuals who held more negative distal AA at baseline (OR = 0.80, p < .0001).

CONCLUSIONS

Attitude type (affective versus instrumental) and temporality (distal versus proximal) are important to consider in attempts to predict and understand exercise behavior. In addition to targeting change in distal attitudes, exercise interventions should target changes in daily AA to impact exercise later in the same day.

Social predictors of daily relations between college women's physical activity intentions and behavior

Women perform less physical activity (PA) than men, and this gap widens during college. This study examined college women's daily PA intentions and behavior, and whether social support or social comparison orientation (SCO) moderated the PA intention-behavior relation. College women (N = 80) completed measures of social support and SCO at baseline. For seven consecutive days, participants completed an electronic survey to assess PA intentions and wore an activity monitor to assess minutes of moderate-to-vigorous intensity physical activity (MVPA). Results indicated that intended and performed MVPA minutes were weakly related (p = 0.17, sr = 0.16). Social support did not moderate the intention-behavior relation, but SCO did (p = 0.04, sr = 0.21). Participants with stronger (vs. weaker) SCO, particularly a tendency to compare downward (i.e., to worse-off others), showed smaller discrepancies between intended and completed MVPA. College women frequently fail to achieve PA goals, but stronger tendencies to make (downward) social comparisons may minimize this gap and be a target for intervention.

Engineering Person-Specific Behavioral Interventions to Promote Physical Activity

Physical activity is dynamic, complex, and often regulated idiosyncratically. In this article, we review how techniques used in control systems engineering are being applied to refine physical activity theory and interventions. We hypothesize that person-specific adaptive behavioral interventions grounded in system identification and model predictive control will lead to greater physical activity than more generic, conventional intervention approaches.

Daily- and Person-Level Associations Between Physical Activity and Alcohol Use Among College Students

Emerging adults, particularly university students, who are physically active, drink more than their less physically active peers. We extended this between-person relationship to the within-person level of analysis, by examining whether students are more likely to drink on days when they exercise, and whether this within-person association remains after controlling for potential confounding factors. We also explored the temporal sequence of the physical activity (PA)-alcohol use association. University students (N = 426) completed a 30-day online diary. The small positive within-person association between PA and alcohol use was not retained after controlling for day of the week. However, previous day's drinking was inversely associated with next day's PA on weekdays. These findings suggest that the previously reported positive PA-alcohol association does not necessarily align with the within-person daily association. Future studies with more nuanced measurement strategies, such as ecological momentary assessment, are needed to better understand the association between PA and alcohol use.

An Ecological Momentary Assessment of Self-improvement and Self-evaluation Body Comparisons: Associations with College Women's Body Dissatisfaction and Exercise

Upward body comparisons are prevalent among college women and associated with body dissatisfaction and disordered eating. However, less is known about distinguishing features of the comparisons themselves as they occur in daily life. The primary purpose of the present study was to examine whether two types of upward body comparisons previously studied experimentally (self-improvement and self-evaluation) are differentially associated with body- and exercise-related outcomes in real-life settings using ecological momentary assessment (EMA). Undergraduate women (N = 74) between 18-25 years (Mage = 20.4, SD = 1.63) completed five surveys on smartphones daily for seven days. EMA measures assessed body comparisons, body dissatisfaction, and exercise cognitions and behaviors. Baseline body dissatisfaction, comparison tendency, and exercise behavior were examined as moderators. Multilevel analyses revealed that both self-improvement and self-evaluation were associated with greater exercise thoughts (ps < .05), but not with changes in body dissatisfaction (ps> .05). Moderator analyses revealed differences between the two types and their associations with outcomes for select subgroups. For example, self-improvement comparisons were associated with fewer exercise thoughts among participants with high baseline exercise behaviors (p < .01). Further research is needed to understand the differences between self-improvement and self-evaluation and the potential protective mechanisms of self-improvement.

Methods and design for the ADAPT study: Application of integrateD Approaches to understanding Physical activity during the Transition to emerging adulthood

BACKGROUND

The overarching objective of the study is to obtain a comprehensive understanding of the salient factors predicting changes in physical activity (PA) during adolescents' transition into emerging adulthood. Using the Multi-Process Action Control model as our guiding framework, we will examine how implicit and explicit psychological processes along with regulatory practices impact PA change during this major life transition. Additionally, we will use a real-time data capture method called Ecological Momentary Assessment to further investigate how environmental and contextual factors, and momentary psychosocial influences effect PA patterns across this dynamic life stage.

METHODS

The ADAPT study is a 4-year project comprised of two interrelated studies. Study I is a large prospective cohort study that will invite all grade 11 students across one large school board (a total of seven secondary schools) to participate by completing an online questionnaire. Using a cluster randomization approach, a subset of students from each school will be invited to participate in Study II, whereby participants will wear an accelerometer and complete Ecological Momentary Assessments 5 times a day over a 7-day study period. For both studies, following baseline assessments, there will be three annual follow-up assessments approximately 12 months apart.

DISCUSSION

The current study represents one of the largest longitudinal cohort studies examining PA and its determinants and associated consequences among adolescents transitioning out of high school into emerging adulthood. Findings from this study will provide a much more in-depth understanding of how and why changes in PA behaviour occur across this first major life transition.

Content validity and methodological considerations in ecological momentary assessment studies on physical activity and sedentary behaviour: a systematic review

Background

Ecological momentary assessment (EMA) is a method of collecting real-time data based on repeated measures and observations that take place in participant’s daily environment. EMA has many advantages over more traditional, retrospective questionnaires. However, EMA faces some challenges to reach its full potential. The aims of this systematic review are to (1) investigate whether and how content validity of the items (i.e. the specific questions that are part of a larger EMA questionnaire) used in EMA studies on physical activity and sedentary behaviour was assessed, and (2) provide an overview of important methodological considerations of EMA in measuring physical activity and sedentary behaviour.

Methods

Thirty papers (twenty unique studies) were systematically reviewed and variables were coded and analysed within the following 4 domains: (1) Content validity, (2) Sampling approach, (3) Data input modalities and (4) Degree of EMA completion.

Results

Only about half of the studies reported the specific items (n = 12) and the source of the items (n = 11). None of the studies specifically assessed the content validity of the items used. Only a minority (n = 5) of the studies reported any training, and one tested the comprehensibility of the EMA items. A wide variability was found in the design and methodology of the EMA. A minority of the studies (n = 7) reported a rationale for the used prompt frequency, time selection, and monitoring period. Retrospective assessment periods varied from ‘now’ to ‘in the last 3.5 hours’. In some studies there was a possibility to delay (n = 6) or deactivate (n = 10) the prompt, and some provided reminders after the first prompt (n = 9).

Conclusions

Almost no EMA studies reported the content validation of the items used. We recommend using the COSMIN checklist (COnsensus-based Standards for the selection of health Measurement INstruments) to report on the content validity of EMA items. Furthermore, as often no rationale was provided for several methodological decisions, the following three recommendations are made. First, provide a rationale for choosing the sampling modalities. Second, to ensure assessment ‘in the moment’, think carefully about the retrospective assessment period, reminders, and deactivation of the prompt. Third, as high completion rates are important for representativeness of the data and generalizability of the findings, report completion rates.

Trial registration

This review is registered in PROSPERO, the International prospective register of systematic reviews (registration number: CRD42017077996).

Daily Relations between Social Perceptions and Physical Activity among College Women

OBJECTIVES

There is a need to develop more effective physical activity (PA) promotion programs for college women. Theory and evidence suggest that perceptions of the social environment play a role in college women's PA, though little is known about how these perceptions are associated with PA at the day level. The goal of this study was to examine relations between changes in college women's daily social perceptions and objectively assessed PA over seven days.

DESIGN

Daily diary method.

METHOD

College women (n = 80, M Age = 20, M BMI = 23.1 kg/m2) wore Fitbit wristbands and completed daily self-reports of (1) the quantity and perceived intensity of their social interactions (positive/negative), and (2) the occurrence of social comparisons (based on appearance/health/status) for seven days.

RESULTS

Multilevel models showed daily variability in predictors and outcomes (ps < 0.0001), as well as relations between within-person changes in social perceptions and PA. Increases in negative interactions (particularly those with friends) were consistently associated with decreases in daily PA, whereas increases in positive interactions showed limited relations (srs = -0.22-0.34). Days with health comparisons were days with greater PA for women who had stronger overall interest in comparisons, but were days with less PA for women with weaker overall interest (srs = 0.22-0.33). PA did not differ between days with vs. without appearance comparisons.

CONCLUSIONS

Social perceptions show meaningful day-to-day variability and relations with college women's daily PA, and specific associations may be useful for improving tailored interventions for college women.

Application of health behaviour theory to sleep health improvement

Although sleep hygiene is often used for broad sleep health promotion efforts, sleep hygiene education programmes are largely ineffective. These programmes are limited by their lack of a theoretical foundation. Health behaviour theory (HBT) has been used for decades to successfully predict and modify many health behaviours, but its use in the study of sleep health is rare. The purpose of this review is threefold. First, four dominant HBTs will be introduced. Second, the brief literature on HBT and sleep health will be reviewed. Lastly, a translational research agenda will be proposed. The present review concludes that HBT shows potential in both the prediction and modification of sleep health, and that there are several short- and long- term research goals to advance these efforts.

Physical Activity Intentions and Behavior Mediate Treatment Response in an Acceptance-Based Weight Loss Intervention

BACKGROUND

Acceptance-based treatment (ABT) for weight loss has shown promise for improving outcomes relative to standard behavioral treatment (SBT). One way in which ABT may improve outcomes is through increasing physical activity (PA) intentions and behavior but little research has examined these as mediators of ABT on weight change.

PURPOSE

This study sought to examine ABT's effects on intentions for PA and several objectively measured PA variables during treatment and analyze PA intentions and behaviors as mediators of ABT's effect on weight loss.

METHODS

Participants (N = 189) with overweight/obesity randomized to 1 year of either ABT or SBT completed ecological momentary assessment of PA intentions, accelerometer-based PA assessment, and had weight measured at baseline, mid-treatment, and end of treatment.

RESULTS

ABT had a significantly higher increase than SBT in PA intention minutes at mid-treatment and end of treatment (p < 0.001), and both groups had nonlinear increases in moderate-to-vigorous physical activity (MVPA) that were not significantly different. Sequential mediation models found that ABT's effect on weight loss was partially mediated by higher PA intention minutes at mid-treatment leading to increased MVPA minutes per week. Increased MVPA minutes were obtained by participants increasing the number of days with MVPA bouts.

CONCLUSIONS

ABT's effect on weight loss throughout treatment resulted, in part, from participants increasing their intentions for PA. Controlling for group, higher PA intentions were associated with more PA obtained through more days with exercise.

Personalized models of physical activity responses to text message micro-interventions: A proof-of-concept application of control systems engineering methods

OBJECTIVES

The conceptual models underlying physical activity interventions have been based largely on differences between more and less active people. Yet physical activity is a dynamic behavior, and such models are not sensitive to factors that regulate behavior at a momentary level or how people respond to individual attempts at intervening. We demonstrate how a control systems engineering approach can be applied to develop personalized models of behavioral responses to an intensive text message-based intervention.

DESIGN & METHOD

To establish proof-of-concept for this approach, 10 adults wore activity monitors for 16 weeks and received five text messages daily at random times. Message content was randomly selected from three types of messages designed to target (1) social-cognitive processes associated with increasing physical activity, (2) social-cognitive processes associated with reducing sedentary behavior, or (3) general facts unrelated to either physical activity or sedentary behavior. A dynamical systems model was estimated for each participant to examine the magnitude and timing of responses to each type of text message.

RESULTS

Models revealed heterogeneous responses to different message types that varied between people and between weekdays and weekends.

CONCLUSIONS

This proof-of-concept demonstration suggests that parameters from this model can be used to develop personalized algorithms for intervention delivery. More generally, these results demonstrate the potential utility of control systems engineering models for optimizing physical activity interventions.

Time Series Visualizations of Mobile Phone-Based Daily Diary Reports of Stress, Physical Activity, and Diet Quality in Mostly Ethnic Minority Mothers: Feasibility Study

Background

Health behavior patterns reported through daily diary data are important to understand and intervene upon at the individual level in N-of-1 trials and related study designs. There is often interest in relationships between multiple outcomes, such as stress and health behavior. However, analyses often utilize regressions that evaluate aggregate effects across individuals, and standard analyses target single outcomes.

Objective

This paper aims to illustrate how individuals’ daily reports of stress and health behavior (time series) can be explored using visualization tools.

Methods

Secondary analysis was conducted on 6 months of daily diary reports of stress and health behavior (physical activity and diet quality) from mostly ethnic minority mothers who pilot-tested a self-monitoring mobile health app. Time series with minimal missing data from 14 of the 44 mothers were analyzed. Correlations between stress and health behavior within each time series were reported as a preliminary step. Stress and health behavior time series patterns were visualized by plotting moving averages and time points where mean shifts in the data occurred (changepoints).

Results

Median correlation was small and negative for associations of stress with physical activity (r=−.14) and diet quality (r=−.08). Moving averages and changepoints for stress and health behavior were aligned for some participants but not for others. A third subset of participants exhibited little variation in stress and health behavior reports.

Conclusions

Median correlations in this study corroborate prior findings. In addition, time series visualizations highlighted variations in stress and health behavior across individuals and time points, which are difficult to capture through correlations and regression-based summary measures.

Momentary assessment of physical activity intention-behavior coupling in adults

Research attempting to elucidate physical activity (PA) intention-behavior relations has focused on differences in long-term behavior forecasting between people. However, regular PA requires a repeated performance on a daily or within-daily basis. An empirical case study application is presented using intensive longitudinal data from a study of PA in adults to (a) describe the extent to which short-term intention-behavior coupling occurs and (b) explore time-varying predictors of intention formation and short-term intention-behavior coupling. Adults (n = 116) participated in three 4-day waves of ecological momentary assessment (EMA). Each day, participants received EMA questionnaires assessing short-term PA intentions and wore accelerometers to assess whether they engaged in ≥10 min of moderate-to-vigorous physical activity (MVPA) in the 3-hour period after each EMA prompt. Concurrent affective states and contexts were also assessed through EMA. Participants reported having short-term intentions to engage in PA in 41% of EMA prompts. However, participants only engaged in ≥10 min of MVPA following 16% of the prompts that short-term PA intentions were reported indicating an intention-behavior gap of 84%. Odds of intentions followed by PA were greater on occasions when individuals reported higher levels of positive affect than was typical for them. This study is the first to take an EMA approach to describe short-term intention-behavior coupling in adults. Results suggest that adults have difficulty translating intentions into behavior at the momentary level, more so than over longer timescales, and that positive affect may be a key to successfully translating intentions into behavior.

Precipitation and Physical Activity in Older Adults: The Moderating Role of Functional Mobility and Physical Activity Intentions

OBJECTIVES

Physical activity is a key health behavior that reduces disease risk, and yet most older adults are not very active. This study examined time-varying associations between physical activity and a recognized barrier, namely, precipitation. And it examined the moderating role of physical activity intentions and functional mobility on precipitation-physical activity associations.

METHOD

One hundred and twenty-six older adults (M age = 72 years; 64% women) from Metro Vancouver provided health and background information and wore triaxial accelerometers for up to 10 consecutive days. Daily weather information was collected from local weather stations.

RESULTS

Multilevel models corroborate previous research by showing that older adults engaged in less physical activity on days with increased precipitation across four indices: activity counts, step counts, minutes of moderate to vigorous physical activity (MVPA), and bout-corrected minutes of MVPA. Older adults with strong physical activity intentions engaged in more physical activity overall. Physical activity intentions also modified the association between time-varying precipitation and activity counts and step counts, whereas functional mobility moderated the negative association between precipitation and activity counts and minutes of MVPA.

DISCUSSION

Findings highlight the important role of time-varying influences on physical activity and how these associations are moderated by psychological and biological factors.

Correlates of sedentary behaviour in adults: a systematic review

OBJECTIVE

The objective of this study was to systematically review evidence to identify intrapersonal, social environmental, physical environmental and policy correlates of sedentary behaviour (SB) among adults.

METHODS

Six databases were searched to identify studies that reported on intrapersonal, social, physical environmental and/or policy correlates of SB across domains (i.e. occupational, leisure and transportation) in adults (mean ≥ 18 years old). Subgroup differences (sex, age, disease status, publication status and date, weekdays vs. weekend) were examined. Risk of bias was assessed, and a qualitative synthesis completed.

PROSPERO

CRD42014009814 RESULTS: Searching identified 22,779 articles; 257 were used in the analysis. Most studies used self-reported SB and were cross-sectional. The most studied domain of SB and correlate was leisure and intrapersonal, respectively. Consistent evidence found positive relationships between full-time employment and higher transportation and lower leisure SB; higher income/socioeconomic status and greater transportation and occupation SB; living in more urban areas and greater sitting time and total SB; ownership of televisions and greater leisure SB; and, active workstations and lower occupational SB.

CONCLUSIONS

The review identifies the need for longitudinal studies, as well as further research on factors in the physical, social and policy environments. The review also recognizes the need to standardize methodology for collecting, defining and reporting SB and correlates.

Lifestyle intervention effects on the frequency and duration of daily moderate-vigorous physical activity and leisure screen time

OBJECTIVE

How a healthy lifestyle intervention changes the frequency and duration of daily moderate-vigorous physical activity and sedentary behavior has not been well characterized. Secondary analyses of data from the Make Better Choices randomized controlled trial were conducted to evaluate how interventions to increase physical activity or reduce leisure screen time affected the frequency and duration of these behaviors during treatment initiation and follow-up.

METHOD

Participants were 202 adults who exhibited insufficient physical activity, excessive screen time and poor diet during a 14-day baseline screening period. The design was a randomized controlled trial with a 3-week intervention period followed by eight 3- to 7-day bursts of data collection over the 6-month follow-up period after intervention termination. Participants self-reported on their physical activity and screen time at the end of each day.

RESULTS

A 2-part multilevel model indicated that, relative to baseline levels, the physical activity intervention increased the odds of daily moderate-vigorous intensity physical activity (frequency) but not the duration of activity during the intervention period and these effects persisted (albeit somewhat more weakly) during the follow-up period. The screen time intervention reduced both the frequency and duration of daily screen time from the beginning of the intervention through the follow-up period.

CONCLUSIONS

A 3-week intervention increased daily physical activity frequency but not duration, and reduced both the frequency and duration of daily leisure screen time. These effects were maintained over 20 weeks following the end of the intervention. (PsycINFO Database Record

Within-Day Time-Varying Associations Between Behavioral Cognitions and Physical Activity in Adults

This study used time-varying effect modeling to examine time-of-day differences in how behavioral cognitions predict subsequent physical activity (PA). Adults (N = 116) participated in three 4-day "bursts" of ecological momentary assessment (EMA). Participants were prompted with eight EMA questionnaires per day assessing behavioral cognitions (i.e., intentions, self-efficacy, outcome expectations) and wore an accelerometer during waking hours. Subsequent PA was operationalized as accelerometer-derived minutes of moderate- or vigorousintensity PA in the 2 hr following the EMA prompt. On weekdays, intentions positively predicted subsequent PA in the morning (9:25 a.m.-11:45 a.m.) and in the evening (8:15 p.m.-10:00 p.m.). Self-efficacy positively predicted subsequent PA on weekday evenings (7:35 p.m.-10:00 p.m.). Outcome expectations were unrelated to subsequent PA on weekdays. On weekend days, behavior cognitions and subsequent PA were unrelated regardless of time of day. This study identifies windows of opportunity and vulnerability for motivation-based PA interventions aiming to deliver intervention content within the context of adults' daily lives.

Testing multi-theory model (MTM) in predicting initiation and sustenance of physical activity behavior among college students

BACKGROUND

Most college students do not adequately participate in enough physical activity (PA) to attain health benefits. A theory-based approach is critical in developing effective interventions to promote PA. The purpose of this study was to examine the utility of the newly proposed multi-theory model (MTM) of health behavior change in predicting initiation and sustenance of PA among college students.

METHODS

Using a cross-sectional design, a valid and reliable survey was administered in October 2015 electronically to students enrolled at a large Southern US University. The internal consistency Cronbach alphas of the subscales were acceptable (0.65-0.92). Only those who did not engage in more than 150 minutes of moderate to vigorous intensity aerobic PA during the past week were included in this study.

RESULTS

Of the 495 respondents, 190 met the inclusion criteria of which 141 completed the survey. The majority of participants were females (72.3%) and Caucasians (70.9%). Findings of the confirmatory factor analysis (CFA) confirmed construct validity of subscales (initiation model: χ2 = 253.92 [df = 143], P < 0.001, CFI = 0.91, RMSEA = 0.07, SRMR = 0.07; sustenance model: χ2= 19.40 [df = 22], P < 0.001, CFI = 1.00, RMSEA = 0.00, SRMR = 0.03). Multivariate regression analysis showed that 26% of the variance in the PA initiation was explained by advantages outweighing disadvantages, behavioral confidence, work status, and changes in physical environment. Additionally, 29.7% of the variance in PA sustenance was explained by emotional transformation, practice for change, and changes in social environment.

CONCLUSION

Based on this study's findings, MTM appears to be a robust theoretical framework for predicting PA behavior change. Future research directions and development of suitable intervention strategies are discussed.

Daily physical activity and life satisfaction across adulthood

Physical activity is considered a valuable tool for enhancing life satisfaction. However, the processes linking these constructs likely differ across the adult life span. In older adults the association between physical activity and life satisfaction appears to involve usual levels of physical activity (i.e., a between-person association driven by differences between more and less active people). In younger adults the association has consistently been based on day-to-day physical activity (i.e., a within-person association driven by differences between more and less active days). To resolve this inconsistency, a daily diary study was conducted with a life span sample of community-dwelling adults (age 18-89 years; N = 150) over three 21-day measurement bursts. Usual physical activity was positively associated with life satisfaction in middle and older adulthood; however, this association was not present in young adulthood. When present, this between-person association was mediated by physical and mental health. A within-person association between physical activity and life satisfaction was also present (and did not differ across age). Generally, on days when people were more physically active then was typical for them, they experienced greater life satisfaction. Age differences in life satisfaction followed a cubic trajectory: lower during emerging adulthood, higher during midlife, and lower during older adulthood. This study adds to accumulating evidence that daily fluctuations in physical activity have important implications for well-being regardless of age, and clarifies developmental differences in life satisfaction dynamics that can inform strategies for enhancing life satisfaction.

Prediction of attendance at fitness center: a comparison between the theory of planned behavior, the social cognitive theory, and the physical activity maintenance theory

In the processes of physical activity (PA) maintenance specific predictors are effective, which differ from other stages of PA development. Recently, Physical Activity Maintenance Theory (PAMT) was specifically developed for prediction of PA maintenance. The aim of the present study was to evaluate the predictability of the future behavior by the PAMT and compare it with the Theory of Planned Behavior (TPB) and Social Cognitive Theory (SCT). Participation rate in a fitness center was observed for 101 college students (53 female) aged between 19 and 32 years (M = 23.6; SD = 2.9) over 20 weeks using a magnetic card. In order to predict the pattern of participation TPB, SCT and PAMT were used. A latent class zero-inflated Poisson growth curve analysis identified two participation patterns: regular attenders and intermittent exercisers. SCT showed the highest predictive power followed by PAMT and TPB. Impeding aspects as life stress and barriers were the strongest predictors suggesting that overcoming barriers might be an important aspect for working out on a regular basis. Self-efficacy, perceived behavioral control, and social support could also significantly differentiate between the participation patterns.

Daily physical activity and alcohol use across the adult lifespan

OBJECTIVE

In contrast to proposals that physical activity (PA) can be a substitute for alcohol use, people who engage in greater overall PA generally consume more alcohol on average than less-active peers. Acknowledging that both PA and alcohol use vary considerably from day-to-day, this study evaluated whether established associations reflect daily behavioral coupling within-person, are an artifact of procedures that aggregate behavior over time, or both.

METHODS

A life span sample of 150 adults (aged 19-89 years) completed three 21-day measurement bursts of a daily diary study. At the end of each day, they reported on their PA and alcohol consumption. Data were analyzed in a negative binomial multilevel regression.

RESULTS

As expected, both behaviors exhibited limited between-person variation. After controlling for age, gender, and seasonal and social calendar influences, daily deviations in PA were significantly associated with daily total alcohol use. Once the within-person process linking PA and alcohol use was controlled, usual PA and total alcohol use were not associated.

CONCLUSIONS

The established between-person association linking PA and alcohol use reflects the aggregation of a daily process that unfolds within-people over time. Further work is needed to identify mediators of this daily association and to evaluate causality, as well as to investigate these relations in high-risk samples.

A Daily Process Analysis of Physical Activity, Sedentary Behavior, and Perceived Cognitive Abilities

OBJECTIVES

This study evaluated the role of both physical activity and sedentary behavior in daily perceptions of cognitive abilities and whether these relations exist within-person, between-person, or both.

DESIGN

Non-experimental, intensive longitudinal research using ecological momentary assessments.

METHOD

College students wore accelerometers and provided end-of-day reports on physical activity, sedentary behavior, and perceived cognitive abilities for 14 days.

RESULTS

Across self-reports and objective measures of behavior, daily deviations in physical activity were positively associated with perceived cognitive abilities. Daily deviations in self-reported, but not objectively-assessed, sedentary behavior also were negatively associated with perceived cognitive abilities. Contrary to previous research, overall levels of physical activity and sedentary behaviors were not associated with perceived cognitive abilities.

CONCLUSIONS

These findings indicate that physical activity has a within- rather than between-person association with perceived cognitive abilities although between-person associations effects may require longer monitoring periods to manifest. Further research is needed to establish the direction of causality and resolve whether the nature (rather than quantity) of sedentary activities influences cognition.