Translating Physical Activity Intentions into Behavior: Reflective, Regulatory, and Reflexive Processes

Biomarkers of aging: from molecules and surrogates to physiology and function

Many countries face an unprecedented challenge in aging demographics. This has led to an exponential growth in research on aging, which, coupled to a massive financial influx of funding in the private and public sectors, has resulted in seminal insights into the underpinnings of this biological process. However, critical validation in humans has been hampered by the limited translatability of results obtained in model organisms, additionally confined by the need for extremely time-consuming clinical studies in the ostensible absence of robust biomarkers that would allow monitoring in shorter time frames. In the future, molecular parameters might hold great promise in this regard. In contrast, biomarkers centered on function, resilience, and frailty are available at the present time, with proven predictive value for morbidity and mortality. In this review, the current knowledge of molecular and physiological aspects of human aging, potential antiaging strategies, and the basis, evidence, and potential application of physiological biomarkers in human aging are discussed.

Examining the impact of perceived behavioral control and planning on closing the exercise intention-behavior gap: Insights from a meta-analytic structural equation modeling study

OBJECTIVE

This study aims to investigate the roles of perceived behavioral control (PBC), action planning, and coping planning in bridging the gap between exercise intention and behavior. By using a Meta-Analytic Structural Equation Model (MASEM), we quantify the specific effects of these variables and explore their mediating roles in the relationships between intention, PBC, and behavior. The study provides insights into how these constructs contribute to informing effective behavioral intervention strategies.

METHODS

A meta-analysis was conducted to calculate the correlation effect sizes between variables in the model, and MASEM was employed to examine the interrelationships among multiple variables. Data from 57 samples across 49 studies, with a total sample size of 19,883, were analyzed. We constructed an aggregated correlation matrix and performed path analysis using structural equation modeling. AMOS 26.0 software was used to estimate model parameters, including path coefficients, standard errors, and various model fit indices.

RESULTS

The results indicate that behavioral intention serves as a key predictor of behavior, showing a significant positive direct effect (β = 0.416, p < 0.001). Intention also significantly predicts both action planning (β = 0.439, p < 0.001) and coping planning (β = 0.360, p < 0.001), though its impact on behavior is mediated differently by these two forms of planning. Mediation analysis further revealed that intention indirectly predicts behavior through coping planning (β = 0.067, p < 0.001), while the mediation effect through action planning was not significant (β = -0.001, p > 0.05). PBC played multiple roles: it directly predicts behavior (β = 0.106, p < 0.001), indirectly predicts behavior through intention (β = 0.282, p < 0.001), and further mediates behavior through intention and coping planning (β = 0.046, p < 0.001), as well as through coping planning alone (β = 0.032, p < 0.001). Additionally, the mediation effect of PBC on behavior through action planning was statistically significant but negligible (β = 0.000, p = 0.003), reinforcing the stronger role of coping planning in driving behavior change.

CONCLUSION

This study highlights the important roles of behavioral intention and perceived behavioral control in promoting physical activity while challenging the effectiveness of focusing solely on action planning. The findings suggest that although action planning does not significantly impact behavior, coping planning plays a critical role in behavior implementation. By integrating action planning and coping planning, comprehensive behavioral intervention strategies can more effectively bridge the intention-behavior gap and promote sustained physical activity.

Goal conflict and the physical activity intention-behavior relationship: Insights from a study of People's daily experiences

Although intention is a strong predictor of moderate-to-vigorous intensity physical activity (MVPA), several factors moderate the intention-behavior relationship. People experience goal conflict when one or more of their goals makes it more difficult to pursue other goals. Goal conflict was examined as a moderator of the intention-behavior relation using data from ecological momentary assessments and accelerometer-derived estimates of MVPA. Participants (N = 100; 22 males) wore an accelerometer and responded to digital surveys assessing MVPA intentions and goal conflict up to four times daily for seven consecutive days. MVPA in the 180-min epoch following each survey prompt was recorded. Multilevel modelling was used to analyze the data using the disaggregated between- and within-person effects. Results revealed an intention-behavior gap of 30% and significant within-person effects for intention and goal conflict. Within-person goal conflict moderated the intention-behavior relationship such that when people had stronger intentions to be active compared to their average level of intention, they engaged in more MVPA; and when goal conflict was higher, compared to their average level of goal conflict, people engaged in less MVPA. Findings suggest experiencing higher goal conflict about engaging in MVPA thwarts people's abilities to follow through with their intentions to be active throughout the day.

The relationship between habit and identity in health behaviors: A systematic review and three-level meta-analysis

Habit and identity are two key determinants of health behavior maintenance. However, the relationship between habit and identity remains inconsistently interpreted, with empirical findings showing varying correlations. This meta-analytic review aimed to synthesize the effect sizes of the relationship between habit and identity in health behaviors and to further explore the moderators that influence this relationship. A search of eight databases (PubMed, Web of Science, Scopus, MEDLINE, CINAHL, PsycArticles, PsycINFO, and SPORTDiscus) was conducted up to October 9, 2024. Nineteen articles related to physical activity, healthy eating, and drinking were identified based on eligibility criteria, including 32 effect sizes and a total of 13,340 participants. The results indicated a significant positive correlation between habit and identity with a large effect size (r = 0.55, 95% CI [0.49, 0.74]). A multiple moderator analysis revealed that effect sizes were larger when identity was measured using explicit tests. The moderating effects of different types of health behaviors and geographic location were not sufficiently supported. Limited predictive studies imply that the relationship between habit and identity might not be unidirectional. Finally, this review calls for the integration of knowledge of habit and identity to facilitate the practice of health behavior change.

A Mobile Health App Informed by the Multi-Process Action Control Framework to Promote Physical Activity Among Inactive Adults: Iterative Usability Study

BACKGROUND

Mobile health apps have high potential to address the widespread deficit in physical activity (PA); however, they have demonstrated greater impact on short-term PA compared to long-term PA. The multi-process action control (M-PAC) framework promotes sustained PA behavior by combining reflective (eg, attitudes) and regulatory (eg, planning and emotion regulation) constructs with reflexive (eg, habits and identity) constructs. Usability testing is important to determine the integrity of a mobile health app's intrinsic properties and suggestions for improvement before feasibility and efficacy testing.

OBJECTIVE

This study aimed to gather usability feedback from end users on a first and a second version of an M-PAC app prototype.

METHODS

First, 3 workshops and focus groups, with 5 adult participants per group, were conducted to obtain first impressions of the M-PAC app interface and the first 3 lessons. The findings informed several modifications to the app program (eg, added cards with reduced content) and its interface (eg, created a link placeholder image and added a forgot password feature). Subsequently, a single-group pilot usability study was conducted with 14 adults who were not meeting 150 minutes per week of moderate-to-vigorous PA. They used the updated M-PAC app for 2 weeks, participated in semistructured interviews, and completed the Mobile App Usability Questionnaire (MAUQ) to provide usability and acceptability feedback. The focus groups and interviews were recorded, transcribed, and analyzed with content analysis informed by usability heuristics. The MAUQ scores were analyzed descriptively.

RESULTS

Participants from the workshops and focus groups (mean age 30.40, SD9.49 years) expressed overall satisfaction with the app layout and content. The language was deemed appropriate; however, some terms (eg, self-efficacy) and acronyms (eg, frequency, intensity, time, and type) needed definitions. Participants provided several recommendations for the visual design (eg, more cards with less text). They experienced challenges in accessing and using the help module and viewing some images, and were unsure how to create or reset the password. Findings from the usability pilot study (mean age 41.38, SD12.92 years; mean moderate-to-vigorous PA 66.07, SD57.92 min/week) revealed overall satisfaction with the app layout (13/13, 100%), content (10/13, 77%), and language (7/11, 64%). Suggestions included more enticing titles and additional and variable forms of content (eg, visual aids and videos). The app was easy to navigate (9/13, 69%); however, some errors were identified, such as PA monitoring connection problems, broken links, and difficulties entering and modifying data. The mean MAUQ total and subscale scores were as follows: total=5.06 (SD1.20), usefulness=4.17 (SD1.31), ease of use=5.36 (SD1.27), and interface and satisfaction=5.52 (SD1.42).

CONCLUSIONS

Overall, the M-PAC app was deemed usable and acceptable. The findings will inform the development of the minimum viable product, which will undergo subsequent feasibility testing.

Dynamic representations of theory testing in physical activity using ecological momentary assessment: an example guide utilizing multi-process action control

Behavioral theories are essential in understanding physical activity (PA) and developing effective intervention strategies, yet most theories have been developed alongside common research methods available at their inception. Contemporary data collection methods such as intensive longitudinal designs (e.g., Ecological Momentary Assessment; EMA) are beginning to facilitate more advanced approaches to theorizing. One of the primary challenges in applying traditional behavior change theories, however, relates to measurement, as traditional multi-item measures are not practical nor may they accurately capture the dynamic elements of the construct sought in intensive longitudinal sampling. The purpose of this paper was to provide a user's guide of measures of the Multi-Process Action Control (M-PAC) Framework for use in EMA, followed by preliminary working examples. EMA offers opportunities to sample and obtain real-time (or near real-time) information that include processes that are more automatically or immediately activated in response to environmental stimuli or informational cues. As a result, we propose a slight re-operationalization of M-PAC as it relates to the interacting psychological systems in determining PA. We outline some of the measurement challenges with M-PAC using EMA, and the opportunities to blend more traditional and contemporary real-time approaches to advance theory and our understanding of PA. Together, this paper is intended to be a starting point, acknowledging the need to adapt traditional behavioral theories to incorporate the dynamic factors in determining PA. By doing so, we can advance our understanding of PA and develop more effective, and theory-based, interventions tailored to individual needs and contexts.

Changes in identity and habit formation during 3 months of sport and physical activity participation among parents with young children

Understanding factors that might contribute to sustained moderate-to-vigorous intensity physical activity (MVPA) after the initial start of participation is important. The purpose of this study was to examine the changes in PA habit and identity, two constructs purported to drive behavioral maintenance, among parents of young (< 13 years of age) children participating in a PA intervention across 3 months. Parents (team sport n = 58; individual PA n = 60; control n = 66) completed measures of PA habit, PA identity, and self-reported MVPA at baseline, and post-randomization at 6 weeks and 3 months. Identity and habit showed an increase across time, and these changes interacted with group condition assignment. Identity increased for participants in the team sport condition and was significantly different from a stable profile among those assigned to the control condition. Participants in the individual PA condition increased identity from 6 weeks to 3 months. Habit had a more attenuated change across time, with participants in the team sport condition showing an increase from 6 weeks to 3 months compared with the other conditions. The findings contribute to our understanding of maintenance processes and represent the first exploration of how involvement in team sport might shape subsequent habit and identity development.

Adolescents' Daily Lives (ADL) project: an intensive longitudinal design study protocol examining the associations between physical literacy, movement behaviours, emotion regulation and mental health

INTRODUCTION

Adolescence represents a critical developmental period, with changes in emotional regulation capacities influencing physical and mental health. With less than 6% of Canadian youth currently meeting the 24-hour movement guidelines for physical activity, sleep and sedentary behaviour, there is an urgent need to understand the potential association between movement behaviours, physical literacy, emotional regulation and mental health during adolescence. Additionally, there is a need to better understand these associations among equity-deserving groups. We developed the Adolescents' Daily Lives (ADL) project to identify how, when, under what contexts and to whom to promote healthy engagement in movement behaviours to optimise youth mental health.

METHODS AND ANALYSIS

For the ADL project, we will employ a 14-day intensive longitudinal design to investigate the associations between physical literacy, movement behaviours, emotion regulation and mental health among a diverse sample of 120 adolescents (ages 13-17 years) living in the Greater Victoria Area, British Columbia, Canada. A comprehensive baseline survey and movement competence test, assessing physical and mental well-being, 24-hour movement behaviours (ie, physical activity, sleep and sedentary behaviours) and physical literacy, will be accompanied by daily diary surveys and accelerometer-based movement tracking (ie, Fitbit Inspire 3) to assess daily fluctuations in movement behaviour, emotional regulation and mood. Multivariate analyses, including multilevel modelling, multilevel structural equation modelling and Bayesian hierarchical continuous-time SEM, will be used to model the repeated measures data and understand the simultaneous variations in daily movement behaviours, emotion regulation and mental health.

ETHICS AND DISSEMINATION

The ADL project received ethical approval from the University of Victoria Behavioural Research Ethics Board (protocol #22-0262). Study participation is voluntary, and data collection will be anonymised to protect participant privacy and confidentiality. Research findings will be shared through academic publications and conference proceedings. Through knowledge mobilisation resources, cocreated with the youth community advisory board, relevant findings will be shared directly with the wider community of adolescents.

"We are an active family": a randomized trial protocol to evaluate a family-system social identity intervention to promote child physical activity

BACKGROUND

Regular engagement in moderate-to-vigorous physical activity (MVPA) during childhood yields a myriad of health benefits, and contributes to sustained MVPA behaviors into adulthood. Given the influence of parents on shaping their child's MVPA behaviour, the family system represents a viable target for intervention. The purpose of this study is to compare the effects of two intervention conditions designed to increase child MVPA: (1) A standard education + planning intervention providing information about benefits, action planning, and coping planning; and (2) An augmented physical activity education + planning intervention that includes the components of the standard intervention, as well as a focus on family identity promotion and developing as an active member of the family.

METHODS

A two-arm parallel single-blinded randomized trial will compare the two conditions over 6 months. Eligible families have at least one child aged 6-12 years who is not meeting the physical activity recommendations within the Canadian 24-Hour Movement Guidelines (i.e.,<60 min/day of MVPA). Intervention materials targeting family identity promotion will be delivered online via zoom following baseline assessment, with booster sessions at 6-weeks and 3-months. Child MVPA will be measured by wGT3X-BT Actigraph accelerometry at baseline, 6-weeks, 3-months, and 6-months as the primary outcome. At these same time points, parent cognition (e.g., attitudes, perceived control, behavioral regulation, habit, identity) and support behaviours, and parent-child co-activity will be assessed via questionnaire as secondary outcomes. Child-health fitness measures will be also administered through fitness testing at baseline and 6-months as secondary outcomes. Finally, upon completion of the trial's 6-month measures, a follow-up end-of-trial interview will be conducted with parents to examine parents' experiences with the intervention.

RESULTS

So far, 30 families have been enrolled from the Southern Vancouver Island and Vancouver Lower Mainland area. Recruitment will be continuing through 2026 with a target of 148 families.

DISCUSSION

This study will contribute to the understanding of effective strategies to increase child physical activity by comparing two intervention approaches. Both provide parents with education on physical activity benefits, action planning, and coping planning supports. However, one intervention also incorporates components focused on promoting an active family identity and involving all family members in physical activity together. The findings from this study have the potential to inform the design and implementation of public health initiatives aimed at improving physical activity participation in children and guide the development of more effective interventions that leverage the crucial role of parents and the family system in shaping children's physical activity behaviors.

TRIAL REGISTRATION

The clinical trial registration ID is NCT05794789. This trial was registered with clinicaltrials.gov on March 2nd, 2023, with the last updated release on September 28th, 2023.

"You are either sporty or you are not" a qualitative exploration of pre-teen girls of low-socioeconomic position experiences of being physically active

BACKGROUND

Eighty one percent of adolescents do not meet the recommended physical activity (PA) guidelines with levels of physical activity declining steadily with age and more pronounced in girls of low socioeconomic position (SEP). Furthermore, early adolescence is a time when the rate of decline in PA is most severe amongst girls, placing them at an increased likelihood of developing negative health outcomes associated with physical inactivity. In response, the aim of this study was to explore low-SEP pre-teen girls' experiences of being physically active and to understand their perceptions of the individual, social and environmental factors that influence these experiences.

METHODS

Focus groups were conducted with 107 girls aged 10-12 years from four urban and three rural primary schools. Reflexive thematic analysis was used to analyse the data, with themes mapped to the relevant domains of the Theoretical Domains Framework (TDF).

RESULTS

Themes highlighted how skills and confidence underpin girls' self-identity for PA. Girls described how their social network (i.e., peers, family, coaches and teachers) shaped their experiences of being active. Girls recognised how being active was impacted by the challenges and opportunities in their local community (e.g., lack of facilities and anti-social behaviour).

CONCLUSION

This study provides insight into low-SEP pre-teen girls' experiences of being physically active in both rural and urban locations, while highlighting the complex interplay of individual, social and environmental factors. Additionally, the use of the TDF presents an in-depth behavioural diagnosis which can be used to inform future theory-based interventions to promote low-SEP pre-teen girls PA.

Couples-based health behavior change interventions: A relationship science perspective on the unique opportunities and challenges to improve dyadic health

Epidemiological studies indicate that better marital quality is associated with less morbidity and premature mortality. A number of interpersonal processes related to marital quality are also associated with health-relevant surrogate biomarkers across different physiological systems. Despite these replicated correlational findings, few interventions have harnessed interpersonal processes as potential interventions to enhance health. Building on Dr. Janice Kiecolt-Glaser's model of relationships and health, we propose that couples-based health behavior change interventions may represent an effective way to decrease dysregulation across autonomic, endocrine and immune systems and, ultimately, improve dyadic health. Given that the cohabiting partner is an essential part of the social context in which the behavior change is being pursued, it is important to consider the relational issues triggered by dyadic interventions. Using a relationship science perspective, this article reviews the literature on couples' concordance in health behaviors and health outcomes, the potential pathways underlying this concordance, theories of the couple as a self-sustaining social system, dyadic adaptation of individual self-regulation strategies, effective and ineffective social support and social control in couple relationships, the integration of relationship-building and health behavior change strategies, and the consideration of key moderators related to the nature of the relationship and the context surrounding the relationship. These findings highlight the importance of adopting a relationship science perspective when designing and testing dyadic interventions to improve health outcomes. The data reviewed provide insights on how to optimize couples-based health behavior change interventions to reduce physiological dysregulation and improve dyadic health.

"I have to get up and exercise because that's how I'm going to get over this": a qualitative exploration of exercise identity and behavior in early cancer survivorship

PURPOSE

Exercise is beneficial for people living with and beyond cancer (LWBC); however, many people LWBC fail to meet the exercise guidelines. Having an identity related to exercise, a component of one's self-concept, correlates with exercising more frequently in general adult populations. Understanding how exercise identity influences exercise behaviors in people LWBC is warranted due to the many barriers people LWBC face in relation to physical activity. The purpose of this study was to explore the perceived impact of an exercise identity of the exercise behaviors and motivations among people LWBC.

METHODS

Thirteen participants of mixed diagnoses (Mage = 60.8 ± 10.8 years) in the early survivorship period (i.e., within five years of primary treatment completion or diagnosis) participated in semi-structured interviews to identify influences of exercise identity on exercise behavior. Interviews were transcribed verbatim and analyzed using thematic analysis.

RESULTS

Findings demonstrated that people LWBC with a strong exercise identity engage in high and varied exercise behaviors. Despite barriers such as changes in motivations and ability to engage in exercise, participants maintained exercise throughout cancer by constant adaptation of their outlook and behaviors related to exercise. These results demonstrate a maintenance of physical activity in relation to a strong exercise identity.

IMPLICATIONS FOR CANCER SURVIVORS

Results of this study have implications for the design and implementation of exercise behavior change programs for people LWBC as it provides insights into predictors of sustained exercise behavior during and following cancer treatment.