Impact of physical activity intervention programs on self-efficacy in youths: a systematic review

Association between orthodontic treatment and psychosocial factors in adolescents: a cross-sectional study

BACKGROUND

Orthodontic treatment is one of the longest and most common medical interventions in adolescence. There are certain inequalities in care leading to risk factors associated with higher rates of untreated tooth malocclusion, resulting in a significant burden on oral health. Little is known about that certain psychosocial and personal risk factors influence the uptake of orthodontic treatment. Therefore, the aim was to explore factors that might influence orthodontic treatment and psychosocial and personal factors in a representative sample in Germany.

METHODS

The data are based on the KiGGS Survey Wave 2, a representative cross-sectional study of children and adolescents in Germany. Sociodemographic data, uptake of orthodontic treatment, parental socioeconomic status, social support, self-efficacy, and perceived health status were collected through a self-reported questionnaire.

RESULTS

A total of 6599 children and adolescents between 11 and 17 years were included in the analysis. Girls, non-immigrants, children, and adolescents with higher levels of social support, and children and adolescents who have visited a dentist or orthodontist more often in the past 12 months are more likely to have received orthodontic treatment. Among 14- to 17-year-olds, the likelihood of seeking orthodontic treatment is also associated with an increasing parental socioeconomic status (odds ratio 1.07 [95% CI 1.02; 1.14] P = .013).

CONCLUSIONS

Certain protective and risk factors as well as personal and psychosocial factors are associated with orthodontic treatment. This knowledge can be used to determine which individuals should be targeted for need-based care to ensure that health care is provided without over- or undertreatment.

Associations between levels of physical activity and satisfaction with life among Norwegian adolescents: a cross-sectional study

Background

A robust association between physical activity (PA) and satisfaction with life (SWL) has been established, wherein self-efficacy has been identified as a mediator across different populations. However, there is a need to further examine the relationship between PA and SWL and whether self-efficacy act a as mediator within different levels of PA among Norwegian adolescents. Thus, the objective of this study was to explore the relationship between levels of PA and SWL by testing for self-efficacy as a possible mediator.

Methods

Cross-sectional data from the 2022 Norwegian Ungdata Survey was utilized. Data included demographics and various health data that was collected anonymously. The electronic survey took place in classrooms and was administered by the respective teacher. Permission to access and use data was approved by the Norwegian Agency for Shared Services in Education and Research (SIKT). Statistical analyses were conducted using the PROCESS macro by Andrew Hayes for SPSS software.

Results

Descriptive findings revealed that girls reported lower self-efficacy than boys (14.2 vs. 15.5, with a maximum of 20) and lower SWL (6.8 vs. 7.6, with a maximum of 10). About one out of five girls and one out of seven boys reported no days of weekly PA, whereas 4% of girls and 9.5% of boys adhered to the PA-recommendation of 60-min of daily exercise. Associations between PA levels and SWL was mediated by self-efficacy (all p < 0.05), with the highest indirect effect (56.3%) revealed in the association between those adhering to the PA-recommendations and SWL.

Conclusions

Norwegian girls reported more sedentary behavior, less PA, lower self-efficacy, and lower SWL than boys across all grade levels. Mediation analysis revealed that up to 56.3% of the enhancement in SWL among those adhering to 60-min of PA recommendations was explained by increased self-efficacy. Norwegian government and policymakers should promote initiatives and regulations focusing on higher levels of PA to foster a resilient adolescent population with higher individual beliefs and higher subjective wellbeing.

The Perceived Benefits and Self-Efficacy of an Exercise Intervention on Tobacco Withdrawal Symptoms: A Qualitative Study Based on the Health Belief Model

Background

This study examined the effectiveness of an exercise programme as an adjunct to smoking cessation treatments. The effects of exercise on smoking habits and tobacco withdrawal symptoms (TWS) were evaluated among smokers who were in the pre-contemplation and contemplation stages.

Methods

This was a case study with convenience sampling techniques. This study lasted approximately 2 years, beginning in February 2016. This study was divided into two phases: an intervention phase followed by an interview. The participants were invited to undergo the 8-week supervised moderate aerobic exercise programme. This qualitative study involved 14 participants selected from the intervention phase. They were interviewed about their experiences using a semi-structured questionnaire guided by the health belief model.

Results

This study involved 14 participants who were aged between 26 years old and 40 years old and smoked from 11 to 20 cigarettes per day. Most participants perceived benefits and self-efficacy regarding smoking habits and tobacco withdrawal symptoms (TWS) following the exercise intervention.

Conclusion

This study demonstrated that moderate exercise might be helpful in increasing self-efficacy in smoking cessation and the findings encourage further research on exercise programmes as an adjunct to smoking cessation treatments in Malaysia.

Physical activity and self-efficacy in college students: the mediating role of grit and the moderating role of gender

Background

There is a paucity of knowledge concerning the psychological variables that serve to facilitate the connection between physical activity and self-efficacy, and the factors capable of moderating these pathways. This study aimed to examine the relationship between physical activity and self-efficacy among college students, with a focus on the mediating effect of grit and the moderating effect of gender.

Methods

This study recruited 3,228 undergraduate students from a university in Shanghai, China. They completed the General Self-Efficacy Scale, the Short Grit Scale, and the International Physical Activity Questionnaire. Statistical analysis was conducted using SPSS 26.0 and the Process v4.0 plugin.

Results

Physical activity had both a direct effect on self-efficacy (β = 0.07, 95% CI [0.04-0.11]) and an indirect effect through the two dimensions of grit: perseverance of effort (β = 0.06, 95% CI [0.04-0.07]) and consistency of interest (β = 0.03, 95% CI [0.02-0.04]). The mediating effect explained 53.27% of the total effect. Furthermore, gender moderated the relationship between perseverance of effort and self-efficacy, with a stronger effect observed in males (β = 0.08, t = 3.27, p < 0.01).

Conclusion

The results revealed that grit is an underlying psychological mechanism that links physical activity and self-efficacy. Moreover, gender moderates the effect of perseverance of effort on self-efficacy, with a stronger effect observed in males. These findings have practical implications for educators to design tailored physical activity interventions that foster grit and self-efficacy among college students.

Adherence to physical activity recommendations and associations with self-efficacy among Norwegian adolescents: trends from 2017 to 2021

Background

The crucial role of physical activity (PA) in promoting well-being and overall health of adolescents is widely acknowledged. Previous global studies have consistently revealed low adherence to PA recommendations among adolescents, emphasizing potential links between PA engagement and self-efficacy in school-based populations. However, there is a need for further exploration of this relationship, in particularly gender differences and taking into account the potential influences of the COVID-19 pandemic. The objective of this study is to provide a comprehensive description of adherence to PA recommendations and its associations with self-efficacy in Norwegian school-based adolescents over the period from 2017 to 2021.

Methods

Cross-sectional data on physical activity (PA) levels and self-efficacy among 13-19-year-old Norwegian adolescents were collected from the Norwegian Ungdata Survey during the period 2017 to 2021. The survey, conducted in Norwegian lower- and upper-secondary schools, was administered electronically during school hours. All data collected is anonymous and has received approval from the Norwegian Agency for Shared Services in Education and Research (SIKT). Statistical analyses were performed using SPSS software.

Results

Girls consistently exhibited lower adherence to PA recommendations (17.6-19.8%) compared to boys (27.7-31.1%) each year from 2017 to 2021 (all p < 0.01). Similarly, girls reported lower self-efficacy (14.1 to 14.8 out of 20) than boys (15.5 to 15.9) during the same period (all p < 0.01). Regression analyses highlighted robust positive associations between PA and self-efficacy in those adhering to PA recommendations (i.e., physically active at least 5 times a week) and strong inverse associations for those reporting inactivity (never active) in both girls and boys from 2017 to 2021.

Conclusion

Adolescents in Norway report PA adherence ranging from 15 to 30%, with girls consistently exhibiting lower adherence to PA recommendations and reporting lower self-efficacy than boys. Notably, there are substantial associations between self-efficacy and both adherence to PA recommendations and inactivity over time. These findings underscore the significance of promoting adherence to PA recommendations during adolescence, especially among girls. Policymakers in Norway should focus on initiatives to increase PA levels among adolescents in both lower and upper secondary schools.

Associations between changes in physical activity and perceived social exclusion and loneliness within middle-aged adults - longitudinal evidence from the German ageing survey

BACKGROUND

Previous research showed negative associations between physical activity and loneliness in older adults. However, information on associations among middle-aged adults is scarce. In this prognostic factor study, we investigated if starting or stopping to follow the WHO physical activity recommendations was associated with changes in perceived social exclusion and loneliness in this age bracket.

METHODS

We used longitudinal representative data of participants aged 40 to 64 years from the German Ageing Survey waves in 2014 and 2017 (analytical sample = 4,264 observations, 54% women). Perceived social exclusion was investigated with the scale from Bude and Lantermann. Loneliness was quantified with the 6-items loneliness scale from De Jong Gierveld. Information from the International Physical Activity Survey items on the time spend in moderate and vigorous physical activity per week was dichotomized. Participants were coded as either following or not following the WHO´s physical activity recommendations of spending at least 150 min of moderate, 75 min of vigorous or an appropriated combination of physical activity per week. We investigated the within (individual) association between starting and stopping to follow WHO´s physical activity recommendations and perceived social exclusion as well as loneliness in asymmetric fixed effects regressions. Analyses were adjusted for age, marital status, employment status, social-network size, general self-efficacy, depressive symptoms, self-rated health, BMI, comorbidities, and physical functioning (SF-36).

RESULTS

Stopping to follow the physical activity recommendations from the WHO was associated with perceived social exclusion (ß= 0.09 p = 0.04) but not with loneliness (ß=-0.01, p = 0.71). Starting to follow the WHO physical activity recommendations was neither associated with social exclusion (ß=-0.02, p = 0.54) nor with loneliness (ß=-0.01, p = 0.74) in adjusted asymmetric fixed effects regressions.

CONCLUSION

In middle-aged adults, longitudinal associations were found for physical activity and perceived social exclusion. Perceived social exclusion may be prevented by maintaining at least 150 min of moderate physical activities per week, which is the WHO physical activity recommendation. Future research should investigate moderators and mediators in the association between physical activity and social exclusion as well as loneliness.

The Influence of Physical Education on Self-Efficacy in Overweight Schoolgirls: A 12-Week Training Program

The purpose of this randomized controlled study was to investigate the impact of a 12-week physical education (PE) program on the self-efficacy of overweight schoolgirls. We randomly assigned 60 overweight schoolgirls (15–17 years) to either an experimental moderate to vigorous aerobic exercise (∼90 min, three times a week) group (n = 30) or a control group (CG) (n = 30) that received non-specific regular PE lessons with activities chosen by the curricular teacher mainly focused on team games and sports skills that aimed to achieve general psycho-physical wellness (∼90 min, three times a week). To assess the starting level of students and significant changes reached, at baseline and after training, a battery of standardized assessment motor tests and a psychometric scale (generalized self-efficacy scale, GES) were administered. At the end of the intervention, the experimental group reported a considerable decrease in body mass index (BMI) and a large improvement in self-efficacy (p < 0.001). No significant changes were found in the CG. The results suggested that the 12-week moderate to a vigorous aerobic exercise program is an effective weight loss intervention and a vehicle to promote a range of outcomes important to the qualitative growth of adolescents. In fact, it could provide a positive and significant impact on the self-efficacy of overweight schoolgirls.

Exercising With a Six Pack in Virtual Reality: Examining the Proteus Effect of Avatar Body Shape and Sex on Self-Efficacy for Core-Muscle Exercise, Self-Concept of Body Shape, and Actual Physical Activity

This study investigates the Proteus effect from the first-person perspective and during avatar embodiment in actual exercise. In addition to the immediate measurements of the Proteus effect, prolonged effects such as next-day perception and exercise-related outcomes are also explored. We theorized the Proteus effect as altered perceived self-concept and explored the association between virtual reality (VR) avatar manipulation and self-concept in the exercise context. While existing studies have mainly investigated the Proteus effect in a non-VR environment or after VR embodiment, we aim to contribute to the literature by addressing this concern to explore how the Proteus effect works in actual VR exercise. Through a 2 (avatar body shape: with a six pack vs. normal) × 2 (sex: male vs. female) between-subject experiment, the results partially support the Proteus effect. Regarding actual physical activity, embodying an avatar with a six pack during exercise creates fewer body movements. No significant effect was found for perceived exertion. We also explored the role of sex as a potential moderator in the association of the Proteus effect on exercise outcomes. The Proteus effect was supported by immediate and next-day self-efficacy for core-muscle exercise only among female participants. The between-subject design allowed us to probe how avatar manipulation of muscular body shape with a six pack as opposed to normal body shape influences participants’ self-concept and exercise outcomes, as limited VR studies have employed within-subject comparisons. This also contributes to the literature by providing an upward comparison (e.g., muscular with a six pack vs. normal) as opposed to the previous downward comparison regarding body fitness (e.g., normal vs. obese). The overall results supported the Proteus effect in the context of core-muscle exercise when comparing normal and ideal body shape avatars. However, the Proteus effect as an altered self-concept and its effects on self-efficacy for exercise were supported among females but not males. Whereas the female participants who embodied avatars with a six pack associated themselves more with the muscular concept than other people, the male participants who embodied avatars with a six pack perceived themselves as more normal than others. 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.

Effects of School-Based Exercise Program on Obesity and Physical Fitness of Urban Youth: A Quasi-Experiment

(1) Purpose: The purpose of this study was to evaluate if an after-school intervention program could prevent obesity and promote the physical fitness of urban sedentary school children. (2) Methods: A 16-week after-school physical fitness program was provided to 36 middle school students (7th, 8th, and 9th graders) recruited from a middle school for three days a week. They were high-risk youth showing poor health status (level 4 or 5) in the regular physical fitness evaluation conducted. Their body mass index (BMI), cardiovascular endurance, muscular strength and endurance, quickness, and flexibility were evaluated. (3) Results: A paired sample t-test was used (α = 0.05). There were statistical differences ((x ± s), p < 0.05) between the pre-Progressive Aerobic Cardiovascular Endurance Run (PACER) (13.36 ± 4.98 (# of laps)) and post-PACER (18.64 ± 6.31 (# of laps)) (p < 0.001), between the pre-sit-up (18.06 ± 7.22 (# of sit-ups)) and post-sit-up (24.89 ± 7.52 (# of sit-ups)) (p < 0.001), and between the pre-Trunk Flexion (2.64 ± 3.49 ((cm))) and post-Trunk Flexion (5.97 ± 2.78 ((cm)) (p < 0.001). There was no statistical difference between the pre-50m-Run (10.74 ± 1.30 ((sec))) and post-50m-Run results (10.69 ± 1.25 (sec)) (p = 0.063) or between the pre-BMI (24.84 ± 3.97 (kg/m2)) and post-BMI (24.76 ± 3.61 (kg/m2)) (p = 0.458). Overall, the physical fitness measures improved, whereas BMI did not change after 16 weeks. (4) Conclusion: Sixteen weeks of the school-based Health-related Physical Fitness (HrPF) program can be effective in improving overall physical fitness levels of adolescents, although additional treatments would be required to change BMI, which showed no improvement in the present study. It is concluded that in order for adolescents to maintain and promote physical fitness and health, participation in a school-based HrPF program is recommended for at least 30 min a day, three days a week. In addition, schools should provide high-risk youth with easy access to physical activities that are similar to the objectives of the physical education curriculum. In order to promote the health of school-age children, each school should establish and operate school-based systematic intervention programs.

Predicting psychological factors affecting regular physical activity in hypertensive patients: Application of health action process approach model

Aim

The aim of this study was to determine the factors affecting the behaviour of regular physical activity in patients with hypertension using the health action process approach (HAPA) model.

Design

This cross-sectional study was conducted on 176 hypertension patients, in Astaneh-e-Ashrafiyeh, Guilan, Iran, 2018-2019.

Methods

Data collection tools included demographic characteristics, medical history, the short form of International Physical Activity Questionnaire (IPAQ) and scales related to the HAPA model. The data were analysed using chi-square, independent t test, one-way ANOVA, Pearson's correlation coefficient and path analysis on AMOS, version 23.0.

Results

Action self-efficacy (β = 0.59), outcome expectancy (β = 0.20) and risk perception (β = 0.18) had a statistically significant effect on intention. Moreover, the path coefficient between intention (β = 0.35) and coping self-efficacy (β = 0.29) with physical activity was statistically significant. The results revealed that HAPA constructs were able to describe 45% of the variance in intention and 31% of the variance in physical activity behaviour.

Conclusion

The HAPA model is a useful framework for describing the factors affecting physical activity in hypertension patients.

Predicting physical activity among urban adolescent girls: A test of the health promotion model

The purpose of this study was to test hypothesized relationships of the health promotion model (HPM) as a means of predicting moderate-to-vigorous physical activity (MVPA) among urban, adolescent girls. A secondary analysis of baseline data from a group randomized controlled trial was conducted. The study involved eight urban schools in the Midwestern United States. The sample included girls (N = 517) in the 5th-8th grades. Data were collected on age, body mass index, pubertal status, enjoyment, self-efficacy, social support, options for physical activity (PA), and commitment to PA. MVPA was measured via accelerometers worn by the girls for 7 days. Structural equation modeling was used to analyze study aims. Mean age of the sample was 11.8 years (standard deviation [SD] = 1.0). Girls attained an average of 3.0 (SD = 1.2) minutes per hour of MVPA. Self-efficacy had a positive direct (β = .337; p < .001) and total effect (β = .310; p < .001) on MVPA. Social support and options for PA were not significant predictors of commitment to PA or MVPA. Commitment to PA had a negative but nonsignificant effect (β = -.056; p = .357) on MVPA. The model predicted 10.1% of the variance in MVPA with 9.6% of the variance predicted by self-efficacy. Limitations include lack of longitudinal analysis and inability to generalize the results to other populations such as boys. PA self-efficacy continues to emerge as a significant predictor of MVPA in the HPM. Continued theory testing is needed to better understand the correlates and determinants of PA among adolescent girls before designing theory-based interventions to promote PA.

Physical activity self-efficacy mediates the effect of symptom distress on exercise involvement among adolescents undergoing cancer treatment

The objective of this study was to examine whether physical activity self-efficacy mediated the adverse effect of symptom distress on exercise involvement among adolescents undergoing cancer treatment. A secondary data analysis approach was used to analyse a pooled sample of 97 adolescents who were undergoing cancer treatment in paediatric oncology/haematology wards and ambulatory settings in northern Taiwan. Mediation analysis was performed to examine the mediation relationship among physical activity self-efficacy, symptom distress and exercise involvement. The total effect (path c) (p < 0.001), the indirect effect (paths a and b) (p < 0.05 and p < 0.01) and the direct effect (path c') (p < 0.001) were significant. The bootstrapping test was significant (95% CI: -0.356 to -0.016), indicating that physical activity self-efficacy partially mediated the adverse effect of symptom distress on exercise involvement after adjusting for age, gender and cancer diagnosis. Physical activity self-efficacy partially mediates the relationship between symptom distress and exercise involvement for adolescents undergoing cancer treatment. There is an imperative need for healthcare professionals to design interventions to enhance these adolescents' physical activity self-efficacy, increase their exercise involvement and thus improve their quality of life.

Effects of Short Practice of Climbing on Barriers Self-Efficacy within a Physical Education and Sport Intervention in Germany

The study examined the effects of an indoor wall climbing intervention within the context of a regular Physical Education and Sport (PES) program on barriers self-efficacy (SE) of adolescents in Germany. The study used a field experiment with a wait-list control group. Seventy-eight 8th-graders were included (age: 14.41 ± 0.71 years), with 37 randomly assigned for the intervention group and 41 for the control group. The intervention group participated in two half-day indoor wall climbing excursions (duration: 180 min each) based on SE building strategies. Both groups were pre-and post-tested in SE of indoor wall climbing and belaying. The control group did not receive any treatment before post-test. After the intervention, significant improvements were found in the experimental group on SE of belaying (F(1,76) = 23.45, p = 0.000, η2p = 0.24) using repeated-measures ANOVA. This study provides the first evidence from a German PES field experiment on increasing an important SE facet related to indoor wall climbing among 8th-graders. The program may be improved and further analyzed to install a short-term method to achieve one important educational goal within ordinary PES programs in Germany and to contribute to the personal development of the students.

White Matter Microstructural Changes Following Quadrato Motor Training: A Longitudinal Study

Diffusion tensor imaging (DTI) is an important way to characterize white matter (WM) microstructural changes. While several cross-sectional DTI studies investigated possible links between mindfulness practices and WM, only few longitudinal investigations focused on the effects of these practices on WM architecture, behavioral change, and the relationship between them. To this aim, in the current study, we chose to conduct an unbiased tract-based spatial statistics (TBSS) analysis (n = 35 healthy participants) to identify longitudinal changes in WM diffusion parameters following 6 and 12 weeks of daily Quadrato Motor Training (QMT), a whole-body mindful movement practice aimed at improving well-being by enhancing attention, coordination, and creativity. We also investigated the possible relationship between training-induced WM changes and concomitant changes in creativity, self-efficacy, and motivation. Our results indicate that following 6 weeks of daily QMT, there was a bilateral increase of fractional anisotropy (FA) in tracts related to sensorimotor and cognitive functions, including the corticospinal tracts, anterior thalamic radiations, and uncinate fasciculi, as well as in the left inferior fronto-occipital, superior and inferior longitudinal fasciculi. Interestingly, significant FA increments were still present after 12 weeks of QMT in most of the above WM tracts, but only in the left hemisphere. FA increase was accompanied by a significant decrease of radial diffusivity (RD), supporting the leading role of myelination processes in training-related FA changes. Finally, significant correlations were found between training-induced diffusion changes and increased self-efficacy as well as creativity. Together, these findings suggest that QMT can improve WM integrity and support the existence of possible relationships between training-related WM microstructural changes and behavioral change.

[Prevention of overweight and obesity in children and adolescents : Critical appraisal of the evidence base]

BACKGROUND

Despite careful planning and implementation, overweight/obesity prevention interventions in children and adolescents typically show no, inconsistent or merely weak effects. Such programs usually aim at behavior changes, rarely also at environmental changes, that draw upon conventional wisdom regarding the commonly accepted determinants of childhood overweight/obesity.

OBJECTIVE

This paper evaluates the evidence base of the apparently overweight-/obesity-related determinants diet, physical activity and stress. The results of international intervention studies are discussed against this background.

METHODS AND MATERIALS

Based on the mediating-moderating variable model, we investigate the effect of theory specified mediating variables and how potential moderating variables may impact these relationships.

RESULTS

Contrary to common beliefs, recent research has revealed inconsistent evidence regarding associations between potentially obesogenic behaviors and overweight/obesity in youth. Moreover, the evidence for strong and causal relationships between mediating variables and targeted behaviors seems to be inconsistent. In addition, inadequate attention is paid to moderating effects.

DISCUSSION

The etiology of overweight/obesity in youth is likely the result of a complex interplay of multi-causal influences. Future prevention interventions would benefit from a more thorough understanding of the complex relationships that have been hypothesized and of the mechanisms of suspected behaviors for affecting overweight/obesity. Only if substantial change can be demonstrated in mediators with reasonable effort under real world circumstances, it will make sense to progress to community behavior change trials.

Identifying eating behavior phenotypes and their correlates: A novel direction toward improving weight management interventions

Common reports of over-response to food cues, difficulties with calorie restriction, and difficulty adhering to dietary guidelines suggest that eating behaviors could be interrelated in ways that influence weight management efforts. The feasibility of identifying robust eating phenotypes (showing face, content, and criterion validity) was explored based on well-validated individual eating behavior assessments. Adults (n = 260; mean age 34 years) completed online questionnaires with measurements of nine eating behaviors including: appetite for palatable foods, binge eating, bitter taste sensitivity, disinhibition, food neophobia, pickiness and satiety responsiveness. Discovery-based visualization procedures that have the combined strengths of heatmaps and hierarchical clustering were used to investigate: 1) how eating behaviors cluster, 2) how participants can be grouped within eating behavior clusters, and 3) whether group clustering is associated with body mass index (BMI) and dietary self-efficacy levels. Two distinct eating behavior clusters and participant groups that aligned within these clusters were identified: one with higher drive to eat and another with food avoidance behaviors. Participants' BMI (p = 0.0002) and dietary self-efficacy (p < 0.0001) were associated with cluster membership. Eating behavior clusters showed content and criterion validity based on their association with BMI (associated, but not entirely overlapping) and dietary self-efficacy. Identifying eating behavior phenotypes appears viable. These efforts could be expanded and ultimately inform tailored weight management interventions.

The effect of a text message and telephone follow-up program on cardiac self-efficacy of patients with coronary artery disease: A randomized controlled trial

Background:

Cardiac self-efficacy is an essential factor in persistence of healthy behaviors in patients with coronary artery disease (CAD). Today, telenursing methods have numerous applications in health care. Therefore, this study aimed to determine the effect of a text message and telephone follow-up program on cardiac self-efficacy of patients with CAD.

Materials and Methods:

This was a randomized controlled trial on 70 patients with CAD who were hospitalized in Shahid Chamran Hospital (Isfahan, Iran). The participants were randomly assigned to the experimental and control groups. Collection of data on cardiac self-efficacy was performed before, 3 months after, and 4 months after the beginning of the intervention using Cardiac Self-Efficacy Scale designed by Sullivan et al. During the 3 months of intervention, six messages were sent to the subjects each week and calls were made twice a week in the first month and once a week during the second and third months. The statistical analysis of data was performed using independent t-test, Chi-square, Mann-Whitney U test, and repeated measures analysis of variance (ANOVA).

Results:

Before the intervention, there was no significant difference between the mean scores of cardiac self-efficacy of the two groups. However, 3 months and 4 months after the beginning of the intervention, the mean score of cardiac self-efficacy in the experimental group was significantly higher than in the control group (P < 0.001).

Conclusions:

The text message and telephone follow-up program is effective in promoting the cardiac self-efficacy of patients with CAD.