The Association between Short Periods of Everyday Life Activities and Affective States: A Replication Study Using Ambulatory Assessment

The pleasure of moving: A compositional data analysis of the association between replacing sedentary time with physical activity on affective valence in daily life

Although the independent within-person association between physical activity and sedentary behaviour with valence in daily life has been extensively studied, few studies have used compositional data analysis to examine how different movement behaviour compositions are related to valence in daily life. This study aimed to examine the within-person association between wake-time movement behaviour compositions with affective valence and the extent to which replacing time spent sedentary with physical activity was associated with valence within individuals in daily life. A 7-day ecological momentary study design was used whereby 94 Canadian university students (Mage = 19.45, SD = 2.21, 78.7 % female) reported on affective valence using an adapted version of the Feeling Scale at 7 randomly timed prompts each day. In addition, activPAL accelerometers were worn continuously by participants on their right thigh for the duration of the study to determine time spent engaging in sedentary behaviours and physical activity. Compositional data analysis with isotemporal substitution models were used to examine the within-person association between movement behaviour compositions and affective valence. The within-person association between movement behaviours and affective valence was weak (r2 = 0.013). Nevertheless, engaging in less sedentary time than usual and instead engaging in physical activity was significantly related to more positive affective valence. Considering light intensity physical activity (LPA) and moderate-to-vigorous intensity physical activity (MVPA) separately, replacing time spent sedentary with time engaged in MVPA and LPA both had a significant positive association on affective valence, although the association with MVPA was stronger than the association with LPA. The results provide unique insights into how replacing sedentary time with physical activity in daily life, especially MVPA, may be associated with more feelings of pleasure. These results may be useful to help inform the development of just-in-time adaptive interventions.

Relationship between nonexercise activity and mood in patients with eating disorders

INTRODUCTION

Many patients with eating disorders (EDs) engage in excessive and compulsive physical activity (pathological exercise, PE) to regulate negative mood or to "burn calories." PE can lead to negative health consequences. Non-exercise activity (NEA) bears the potential to serve as intervention target to counteract PE and problematic eating behaviors since it has been associated with positive mood effects. However, to date, there is no investigation on whether the positive link between NEA and mood seen in the healthy translates to patients with ED.

MATERIAL AND METHODS

To study potential associations of NEA and mood in ED, we subjected 29 ED-patients and 35 healthy controls (HCs) to an ambulatory assessment study across 7 days. We measured NEA via accelerometers and repeatedly assessed mood on electronic smartphone diaries via a mixed sampling strategy based on events, activity and time. Within- and between-subject effects of NEA on mood, PE as moderator, and the temporal course of effects were analyzed via multilevel modeling.

RESULTS

NEA increased valence (β = 2.12, p < 0.001) and energetic arousal (β = 4.02, p < 0.001) but showed no significant effect on calmness. The effects of NEA on energetic arousal where significantly stronger for HCs (βHC = 6.26, p < 0.001) than for EDs (βED = 4.02, p < 0.001; βinteraction = 2.24, p = 0.0135). Effects of NEA were robust across most timeframes of NEA and significantly moderated by PE, that is, Lower PE levels exhibited stronger NEA effects on energetic arousal.

CONCLUSION

Patients with ED and HC show an affective benefit from NEA, partly depending on the level of PE. If replicated in experimental daily life studies, this evidence may pave the way towards expedient NEA interventions to cope with negative mood. Interventions could be especially promising if delivered as Just-in-time adaptive interventions (JITAIs) and should be tailored according to the PE level.

Bi-directional associations of core affect and physical activity in adults with higher body weight: An ecological momentary assessment study

Affect is known to be predictive of and enhanced by higher physical activity (PA) levels in the general population. This secondary analysis aimed to increase the understanding of the bi-directional relationship between PA and core affect (i.e. valence, energetic arousal, and calmness) among adults with higher body weight. Affect and PA were assessed in naturalistic settings via ecological momentary assessment using a mixed sampling scheme from 157 participants (body mass index: 32.99 ± 3.78 kg/m2). Multilevel models revealed that being more physically active in the 15 minutes prior to the assessment predicted an increase in energetic arousal and a decrease in calmness. Subsequently, feeling more energetic and agitated was associated with increased PA within the following 15 minutes. Valence (i.e. pleasure-displeasure) was not associated with PA nor predictive of subsequent PA. Digital PA interventions may target the enhancement of feelings of energy and present psychoeducation about these distinct psychological benefits.

The Within-Subject Association of Physical Behavior and Affective Well-Being in Everyday Life: A Systematic Literature Review

BACKGROUND

The interplay of physical activity (PA) with affective well-being (AWB) is highly critical to both health behaviors and health outcomes. Current prominent theories presume AWB to be crucial for PA maintenance, and PA is evidenced to foster mental health. However, thus far, PA-AWB associations have mainly been researched in laboratory settings and with interventional designs, but the everyday life perspective had not been focused on, mostly due to technological limitations. In the course of digitization, the number of studies using device-based methods to research the within-subject association of physical activity and affective well-being (PA-AWB) under ecological valid conditions increased rapidly, but a recent comprehensive systematic review of evidence across populations, age groups, and distinct AWB components remained inconclusive.

OBJECTIVES

Therefore, we aimed to firstly review daily-life studies that assessed intensive longitudinal device-based (e.g., electronic smartphone diaries and accelerometry) and real-time PA-AWB data, secondly to develop and apply a quality assessment tool applicable to those studies, and thirdly to discuss findings and draw implications for research and practice.

METHODS

To this end, the literature was searched in three databases (Web of Science, PubMed, Scopus) up to November 2022. The systematic review followed the PRISMA guidelines and had been pre-registered (PROSPERO id: CRD42021277327). A modified quality assessment tool was developed to illustrate the risk of bias of included studies.

RESULTS

The review of findings showed that, in general, already short PA bouts in everyday life, which clearly differ from structured exercise sessions, are positively associated with AWB. In particular, feelings of energy relate to incidental (non-exercise and unstructured) activity, and PA-AWB associations depend on population characteristics. The quality assessment revealed overall moderate study quality; however, the methods applied were largely heterogeneous between investigations. Overall, the reviewed evidence on PA-AWB associations in everyday life is ambiguous; for example, no clear patterns of directions and strengths of PA-AWB relationships depending on PA and AWB components (such as intensity, emotions, affect, mood) emerged.

CONCLUSIONS

The reviewed evidence can fuel discussions on whether the World Health Organization's notion "every move counts" may be extended to everyday life AWB. Concurrently, the PA-AWB relationship findings endorse prominent theories highlighting the critical role of AWB in everyday PA engagement and maintenance. However, the review also clearly highlights the need to advance and harmonize methodological approaches for more fine-grained investigations on which specific PA/AWB characteristics, contextual factors, and biological determinants underly PA-AWB associations in everyday life. This will enable the field to tackle pressing challenges such as the issue of causality of PA-AWB associations, which will help to shape and refine existing theories to ultimately predict and improve health behavior, thereby feeding into precision medicine approaches.

University Students' Well-Being and Engagement in Activities in the Early Days of Covid-19

Governments worldwide took measures to contain the spread of the coronavirus COVID-19. Universities moved to online teaching almost overnight. This paper explores Belgian university students' perceptions, behaviors, and emotional well-being during the first weeks of strict preventive measures. We conducted a survey with 614 business administration students at the University of Antwerp. The results indicate that, in comparison to the pre-lockdown period, students feel less productive, engage less in healthy behaviors (e.g., healthy snacking, exercising alone), and report more study problems. Based on the emotional quality of their everyday experience, students can be clustered into two groups. One group (54.5%) experiences mostly negative affect, while the other reports experiencing mostly positive affect and personal optimism. The "negative affect" group consists of more women and students in the early years of their bachelor's. This group experiences more financial difficulties and spends more time on social media. These students seem to have a more challenging time coping with the lockdown: they perceive higher study load increase and more significant reduction of social contacts while facing more study problems, studying fewer hours, and perceiving a lower study efficiency. They also engage in less healthy behaviors (e.g., unhealthy snacking more, drinking more alcohol, and exercising alone less) to a greater extent than the positive affect group. These results confirm previous research, demonstrating a positive relationship between emotional well-being and the engagement in and the intensity of productive and healthy activities. Several recommendations are provided in light of these findings.

A Group Videogame-Based Physical Activity Program Improves Walking Speed in Older Adults Living With a Serious Mental Illness

Background and Objectives

One of the most overlooked populations in our society and in health care are middle-aged and older adults living with a serious mental illness (SMI) despite the growing numbers of this population. Health care communities, including both inpatient and outpatient mental health programs, have a responsibility to provide care that nurtures clients’ mental as well as physical health needs. Providing accessible and engaging physical activity programs is an excellent way to provide this type of holistic care. The purpose of this article is to describe the impact of a pilot videogame-based physical activity program on walking speed in older adults with SMI.

Research Design and Methods

A one-group pretest post-test pilot study was conducted with a sample of 52 older adults with SMI recruited from community-based mental health programs. Participants played an active videogame (using the Kinect for Xbox 360 game system; Microsoft, Redmond, WA) for 50-minute group sessions 3 times a week for 10 weeks. Walking speed was assessed with the timed 3-m walk from the Short Physical Performance Battery at enrollment, 5 weeks, and 10 weeks.

Results

Participants achieved statistically significant improvement in walking speed (0.10 m/s, bias-corrected confidence interval Lower Limit (LL) 0.04, Upper Limit (UL) 0.15) over a 10-week period. This change represents a clinically and statistically (p ≤ .05) significant improvement in walking speed. Best estimates for clinically meaningful changes in walking speed are 0.05 m/s for a small change and 0.10 m/s for a substantial change.

Discussion and Implications

Results suggest that engagement in a group videogame-based physical activity program has the potential to improve walking speed in older adults with SMI. In turn, walking speed is an important indicator of premature mortality and cardiorespiratory fitness.

The Role of the Context of Physical Activity for Its Association with Affective Well-Being: An Experience Sampling Study in Young Adults

Physical activity and being outdoors both improve affective well-being. However, little is known about the synergistic effects between them and the influences of contextual factors such as the life domain of physical activity (work-, chores-, leisure, or sports-related) or the type of the outdoor environment (green space, blue space, or city area) on mood. This study investigates the synergistic effects of physical activity and being outdoors as well as the potential role of contextual factors on mood. A total of 158 individuals aged 18-25 years (133 females) participated in a 14-day experience sampling study. Participants received seven prompts per day and answered questions about their physical activity, contextual factors, and affective well-being. Physical activity and being outdoors were associated with concurrent higher levels of positive and lower levels of negative affect compared to being physically inactive or being indoors, respectively. However, no synergistic effects were found. Being outdoors in a city area was associated with a less positive and more negative affect than being in nature. Work- and chores-related physical activity was associated with less positive affect and more negative affect compared to sports- or leisure-related physical activity. To foster positive affect, people should schedule leisure-related physical activity in nature.

Temporal associations between objectively measured physical activity and depressive symptoms: An experience sampling study

Background

This study aimed to examine the relationship between the timing of physical activity and within-individual differences in depressive symptoms, positive affect, and negative affect in individuals with different baseline levels of depressive symptoms.

Methods

Experience sampling methodology (ESM) was used to measure real-time depressive symptoms, positive affect, and negative affect in a convenience sample of 78 healthy adults (aged M = 25.46 years, SD = 6.18; 57 females) five times per day for 14 days. We measured physical activity throughout the 14 days by using activity sensors. Baseline levels of depressive symptoms were assessed with the PHQ-9 to build subgroups with low vs. mild-moderate depressive symptoms.

Results

Physical activity predicted decreased depressive symptom levels, negative affect, and increased positive affect. Associations were stronger for individuals with higher baseline levels of depressive symptoms and for physical activity between 0 and 30 min compared to physical activity between 30 and 180 min before the mood rating. Conversely, levels of depressive symptoms, positive and negative affect did not predict physical activity.

Limitations

The convenience sample may not have been representative of the general population or people with depression. Accelerometers may not have detected some types of physical activities such as bicycling. Causality could not be inferred because of the observational study design.

Conclusion

Individuals with higher levels of depressive symptoms may benefit from physical activity. While the effects were strongest for physical activity immediately before the mood ratings, the effects were in the same direction for up to 3 h before the mood ratings.

Bidirectional Associations of Momentary Affect with Physical Activity and Sedentary Behaviors in Working Adults

BACKGROUND

Affective experiences and movement-based behaviors form a system that has been shown to influence exercise adherence and mental health outcomes. Little is known about the naturalistic dynamics of the reciprocal associations in this system.

PURPOSE

We examined the time intervals at which momentary affect precedes and follows movement-based behaviors in everyday life.

METHODS

A community sample of working adults (n = 111) completed ecological momentary assessments (EMA) asking about current affect states (sad, happy, tired, and interested) six times a day for three consecutive days. Ratings were used to generate scores for momentary affective arousal and valence. Participants also wore an activity monitor. Total activity counts and sedentary duration in the shorter to longer time intervals (5-120 min) before or after EMA were used as indicators of movement-based behaviors.

RESULTS

Multilevel modeling showed that current affective arousal predicted higher subsequent activity counts in the longer time intervals (120 min) and less subsequent sedentary behavior in the shorter to longer time intervals (5, 60, and 120 min). For the reversed sequence, neither movement-based behavior predicted subsequent momentary arousal or valence. Affective valence was unrelated to movement-based behaviors in either temporal direction.

CONCLUSIONS

Some naturally occurring affective experiences (i.e., arousal) might precede, rather than follow, movement-based behaviors. Understanding affective arousal may contribute to improved management of subsequent movement-based behaviors in everyday life.

Geographically-explicit Ecological Momentary Assessment (GEMA) Architecture and Components: Lessons Learned from PMOMS

Geographically explicit Ecological Momentary Assessment (GEMA), an extension of Ecological Momentary Assessment (EMA), allows to record time-stamped geographic location information for behavioral data in the every-day environments of study participants. Considering that GEMA studies are continually gaining the attention of researchers and currently there is no single approach in collecting GEMA data, in this paper, we propose and present a GEMA architecture that can be used to conduct any GEMA study based on our experience developing and maintaining the Postpartum Mothers Mobile Study (PMOMS). Our GEMA client-server architecture can be customized to meet the specific requirements of each GEMA study. Key features of our proposed GEMA architecture include: utilization of widely used smartphones to make GEMA studies practical; alleviation of the burden of activities on participants by designing clients (mobile applications) that are very lightweight and servers that are heavyweight in terms of functionality; utilization of at least one positioning sensor to determine EMA contexts marked with locations; and communication through the Internet. We believe that our proposed GEMA architecture, with the illustrated foundation for GEMA studies in our exemplar study (PMOMS), will help researchers from any field conduct GEMA studies efficiently and effectively.

Associations between naturalistically assessed physical activity patterns, affect, and eating in youth with overweight and obesity

Insufficient physical activity (PA) and excessive stationary behavior (SB) are contributors to pediatric obesity, though antecedents and consequences of these behaviors in this population are relatively unknown. This pilot study examined affect, loss of control eating (LOCE), overeating, and hunger surrounding PA and SB in 17 youth with overweight/obesity. Participants completed a 14-day ecological momentary assessment (EMA) wearing accelerometers. At the momentary level, higher negative affect and lower positive affect predicted SB increases and PA decreases following EMA prompts; higher PA and lower SB also predicted increases in positive affect. Higher LOCE predicted SB increases and PA decreases, while increases in PA and decreases in SB predicted short-term increases in LOCE and overeating. At the individual level, higher SB and lower PA were related to lower positive affect and higher negative affect, LOCE, overeating, and hunger. Findings suggest affect is a relevant antecedent and consequence of PA/SB, and dysregulated eating may acutely impact PA/SB.

"Looking Forward": a qualitative evaluation of a physical activity program for middle-aged and older adults with serious mental illness

OBJECTIVES

Older adults with serious mental illness (SMI) often have poor physical health in addition to serious mental health issues. Sustained engagement in a group physical activity program may provide necessary physical and mental health benefits. The purpose of this report is to describe participants' feedback about a video game-based group physical activity program using the Kinect for Xbox 360 game system (Microsoft, Redmond, WA). In particular, we wanted to understand what worked about the program, what was not ideal, and how it impacted their lives.

DESIGN

Semi-structured interviews were collected and analyzed with grounded theory methodology.

SETTING

Mental health facility.

PARTICIPANTS

Sixteen older adults with SMI.

MEASUREMENTS

Participants played an active video game for 50-minute sessions, three times a week for 10 weeks. Qualitative interviews were conducted with 16 participants upon completion of the program.

RESULTS

Participants expressed enthusiasm for the physical activity program, indicating it was an activity that they looked forward to doing. The results of the study provide insight into how the program may be implemented into practice at mental health facilities. Three implementation to practice categories were identified: (1) programmatic considerations, such as when to hold the groups and where; (2) the critical importance of staff involvement; and (3) harnessing patients' interest in the program.

CONCLUSION

Our results suggest that engagement in an intense video game-based group physical activity program has a positive impact on participants' overall health. The group atmosphere, staff involvement, availability of the program at a mental health facility, and health benefits were critical.

Smartphone-Based Ecological Momentary Assessment of Well-Being: A Systematic Review and Recommendations for Future Studies

Feelings of well-being and happiness fluctuate over time and contexts. Ecological Momentary Assessment (EMA) studies can capture fluctuations in momentary behavior, and experiences by assessing these multiple times per day. Traditionally, EMA was performed using pen and paper. Recently, due to technological advances EMA studies can be conducted more easily with smartphones, a device ubiquitous in our society. The goal of this review was to evaluate the literature on smartphone-based EMA in well-being research in healthy subjects. The systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Searching PubMed and Web of Science, we identified 53 studies using smartphone-based EMA of well-being. Studies were heterogeneous in designs, context, and measures. The average study duration was 12.8 days, with well-being assessed 2-12 times per day. Half of the studies included objective data (e.g. location). Only 47.2% reported compliance, indicating a mean of 71.6%. Well-being fluctuated daily and weekly, with higher well-being in evenings and weekends. These fluctuations disappeared when location and activity were accounted for. On average, being in nature and physical activity relates to higher well-being. Working relates to lower well-being, but workplace and company do influence well-being. The important advantages of using smartphones instead of other devices to collect EMAs are the easier data collection and flexible designs. Smartphone-based EMA reach far larger maximum sample sizes and more easily add objective data to their designs than palm-top/PDA studies. Smartphone-based EMA research is feasible to gain insight in well-being fluctuations and its determinants and offers the opportunity for parallel objective data collection. Most studies currently focus on group comparisons, while studies on individual differences in well-being patterns and fluctuations are lacking. We provide recommendations for future smartphone-based EMA research regarding measures, objective data and analyses.

Ecological momentary assessment of mood and physical activity in people with depression

BACKGROUND

This study aimed to examine temporal associations between physical activity and subsequent mood in people with moderate to severe depression.

METHODS

The study used ecological momentary assessment to associate mood, measured via text messaging twice daily for five days, using a 10-point Likert scale, with objectively measured physical activity (accelerometer data) in people with moderate-to-severe depression. Multilevel regression models were used to explore the relationship between physical activity undertaken at different intensities over the previous one and three hours, and subsequent affect score. A total of 388 paired data points were collected from 43 participants.

RESULTS

There was no association between minutes of moderate-vigorous physical activity in the previous hour and subsequent affect score (which we had hypothesised). However, exploratory analyses found a significant relationship between affect and combined physical activity in the previous hour (β₁ coefficient = 0.023, p = 0.037).

LIMITATIONS

Periods of moderate-vigorous activity were infrequent, reducing the statistical power for analysing associations with this intensity of activity. Only one dimension of mood was sampled.

CONCLUSIONS

The data suggest that, in people with moderate-to-severe depression, time spent engaging in any intensity of physical activity was significantly associated with subsequent mood. Further research is needed to more clearly define the dynamics of the relationship between physical activity and low mood. This will aid identification of optimal prescription criteria for physical activity in people with depression.

Tracking momentary experience in the evaluation of arts-on-prescription services: using mood changes during art workshops to predict global wellbeing change

Aims:

To measure the immediate impact of participating in arts-on-prescription workshops on multiple dimensions of mood and to evaluate whether improvement in mood is a mechanism for change, predicting improvements in global wellbeing before and after participation in arts-on-prescription programmes.

Methods:

The evaluation drew upon the experience sampling method, asking participants to complete a six-item mood questionnaire at the beginning and end of each workshop in a 12-week-long arts-on-prescription programme. Participants also completed a measure of global wellbeing at the beginning and end of the programme.

Results:

Multilevel modelling was used to test hypotheses since the data were hierarchical (with 1491 mood reports nested within 66 participants). There was a significant improvement in global wellbeing across participation in the arts-on-prescription programme. After each art workshop there was a significant increase on all dimensions of mood: hedonic tone (contentment); tense arousal (calmness); and energetic arousal (alertness). There was also a significant improvement in these dimensions of mood, over time, upon arrival at the art workshops each week. Furthermore, reduction in tense arousal after art workshops significantly predicted changes in global wellbeing.

Conclusion:

The findings suggest that a reduction in tense arousal (feeling less nervous, anxious and stressed) is a crucial component of arts-on-prescription services and make a direct link between experiences during art workshops and changes in global wellbeing for the first time. This strengthens the evidence base for arts-on-prescription and suggests that tracking experience across interventions is a useful evaluation tool, with much potential.

Affect Improvements and Measurement Concordance Between a Subjective and an Accelerometric Estimate of Physical Activity

Abstract. Objectives: Physical activity (PA) positively influences several aspects of mental well-being including affect improvements. Yet, the fact that subjective and objective measures of PA often diverge challenges research on the relationship of PA and affect. Methods: Subjective (ecological momentary assessment, EMA) and objective (combined heart rate and accelerometric activity tracker) measures of PA alongside repeated ratings of positive and negative affects were obtained from 37 participants over 7 consecutive days. Results: Subjective and objective PA were significantly positively correlated. Affect improvements, that is, negative affect decrease as well as positive affect increase, were predicted by both subjective (EMA) and objective (activity tracker) data. Conclusions: Measurement concordance supports the validity of both assessment strategies. Affect improvements result from both subjective representations of one’s own activity as well as from physiological mechanisms of PA that one is not aware of, suggesting two independent routes to affect improvements.

mHealth technology for ecological momentary assessment in physical activity research: a systematic review

OBJECTIVE

To systematically review the publications on ecological momentary assessment (EMA) relating to physical activity (PA) behavior in order to classify the methodologies, and to identify the main mHealth technology-based tools and procedures that have been applied during the first 10 years since the emergence of smartphones. As a result of this review, we want to ask if there is enough evidence to propose the use of the term "mEMA" (mobile-based EMA).

DESIGN

A systematic review according to PRISMA Statement (PROSPERO registration: CRD42018088136).

METHOD

Four databases (PsycINFO, CINALH, Medline and Web of Science Core Collection) were searched electronically from 2008 to February 2018.

RESULTS

A total of 76 studies from 297 potential articles on the use of EMA and PA were included in this review. It was found that 71% of studies specifically used "EMA" for assessing PA behaviors but the rest used other terminology that also adjusted to the inclusion criteria. Just over half (51.3%) of studies (39) used mHealth technology, mainly smartphones, for collecting EMA data. The majority (79.5%) of these studies (31 out of 39) were published during the last 4 years. On the other hand, 58.8% of studies that only used paper-and-pencil were published during the first 3 years of the 10-year period analyzed. An accelerometer was the main built-in sensor used for collecting PA behavior by means of mHealth (69%). Most of the studies were carried out on young-adult samples, with only three studies in older adults. Women were included in 60% of studies, and healthy people in 82%. The studies lasted between 1 and 7 days in 57.9%, and between three and seven assessments per day were carried out in 37%. The most popular topics evaluated together with PA were psychological state and social and environmental context.

CONCLUSIONS

We have classified the EMA methodologies used for assessing PA behaviors. A total of 71% of studies used the term "EMA" and 51.3% used mHealth technology. Accelerometers have been the main built-in sensor used for collecting PA. The change of trend in the use of tools for EMA in PA coincides with the technological advances of the last decade due to the emergence of smartphones and mHealth technology. There is enough evidence to use the term mEMA when mHealth technology is being used for monitoring real-time lifestyle behaviors in natural situations. We define mEMA as the use of mobile computing and communication technologies for the EMA of health and lifestyle behaviors. It is clear that the use of mHealth is increasing, but there is still a lot to be gained from taking advantage of all the capabilities of this technology in order to apply EMA to PA behavior. Thus, mEMA methodology can help in the monitoring of healthy lifestyles under both subjective and objective perspectives. The tendency for future research should be the automatic recognition of the PA of the user without interrupting their behavior. The ecological information could be completed with voice messages, image captures or brief text selections on the touch screen made in real time, all managed through smartphone apps. This methodology could be extended when EMA combined with mHealth are used to evaluate other lifestyle behaviors.

Associations between Health Behaviors and Factors on Markers of Healthy Psychological and Physiological Functioning: a Daily Diary Study

Background

Cross-sectional and experimental knowledge highlight the contribution of various health-promoting behaviors, such as physical activity, regular sleep, and healthy nutrition to mental and physical health. Beyond these well-studied lifestyle behaviors, music listening and perceived respect in social interactions are just recently proposed everyday life experiences, which may act as health-promoting factors.

Purpose

This study tested the simultaneous contribution of several health-promoting behaviors and factors and examined listening to music and positive social interaction by means of perceived respect as new potentially preventive and health-promoting behaviors and factors using an ambulatory assessment design.

Methods

Seventy-seven young healthy adults (38 women, 23.9 ± 4.5 years) completed surveys on their psychological state (i.e., mood, stress, and fatigue) five times a day for four consecutive days. A saliva sample was collected with each data entry to explore the physiological stress markers salivary cortisol, alpha-amylase, and flow rate as further outcome variables. As predictors, perceived respect, self-reported physical activity, the sleep’s restfulness, daily coffee, alcohol, vegetable/fruit consumption, and music listening behavior were recorded.

Results

Overall, restful sleep, mean daily perceived respect, and listening to music were most clearly associated with more positive psychological states, that is, better mood and lower fatigue and perceived stress. Associations with daily alcohol, coffee, and vegetable/fruit consumption appeared rather minor. While perceived respect scores were associated with lower daily cortisol output, coffee consumption was positively related to daily cortisol and alpha-amylase. Self-reported physical activity was unrelated to either outcome measure.

Conclusions

These findings provide important insights regarding potential resources of health (i.e., music and respect), their covariation, and which psycho-physiological mechanisms may underlie the links between health factors and well-being. Findings also have implications for the development of interventions aiming to increase resilience and foster health. Here, strategies for improving sleep quality, the use of music, and approaches that emphasize mutual respect and appreciation appear useful additions.

INTERACT: A comprehensive approach to assess urban form interventions through natural experiments

BACKGROUND

Urban form interventions can result in positive and negative impacts on physical activity, social participation, and well-being, and inequities in these outcomes. Natural experiment studies can advance our understanding of causal effects and processes related to urban form interventions. The INTErventions, Research, and Action in Cities Team (INTERACT) is a pan-Canadian collaboration of interdisciplinary scientists, urban planners, and public health decision makers advancing research on the design of healthy and sustainable cities for all. Our objectives are to use natural experiment studies to deliver timely evidence about how urban form interventions influence health, and to develop methods and tools to facilitate such studies going forward.

METHODS

INTERACT will evaluate natural experiments in four Canadian cities: the Arbutus Greenway in Vancouver, British Columbia; the All Ages and Abilities Cycling Network in Victoria, BC; a new Bus Rapid Transit system in Saskatoon, Saskatchewan; and components of the Sustainable Development Plan 2016-2020 in Montreal, Quebec, a plan that includes urban form changes initiated by the city and approximately 230 partnering organizations. We will recruit a cohort of between 300 and 3000 adult participants, age 18 or older, in each city and collect data at three time points. Participants will complete health and activity space surveys and provide sensor-based location and physical activity data. We will conduct qualitative interviews with a subsample of participants in each city. Our analysis methods will combine machine learning methods for detecting transportation mode use and physical activity, use temporal Geographic Information Systems to quantify changes to urban intervention exposure, and apply analytic methods for natural experiment studies including interrupted time series analysis.

DISCUSSION

INTERACT aims to advance the evidence base on population health intervention research and address challenges related to big data, knowledge mobilization and engagement, ethics, and causality. We will collect ~ 100 TB of sensor data from participants over 5 years. We will address these challenges using interdisciplinary partnerships, training of highly qualified personnel, and modern methodologies for using sensor-based data.

dynr.mi: An R Program for Multiple Imputation in Dynamic Modeling

Assessing several individuals intensively over time yields intensive longitudinal data (ILD). Even though ILD provide rich information, they also bring other data analytic challenges. One of these is the increased occurrence of missingness with increased study length, possibly under non-ignorable missingness scenarios. Multiple imputation (MI) handles missing data by creating several imputed data sets, and pooling the estimation results across imputed data sets to yield final estimates for inferential purposes. In this article, we introduce dynr.mi(), a function in the R package, Dynamic Modeling in R (dynr). The package dynr provides a suite of fast and accessible functions for estimating and visualizing the results from fitting linear and nonlinear dynamic systems models in discrete as well as continuous time. By integrating the estimation functions in dynr and the MI procedures available from the R package, Multivariate Imputation by Chained Equations (MICE), the dynr.mi() routine is designed to handle possibly non-ignorable missingness in the dependent variables and/or covariates in a user-specified dynamic systems model via MI, with convergence diagnostic check. We utilized dynr.mi() to examine, in the context of a vector autoregressive model, the relationships among individuals' ambulatory physiological measures, and self-report affect valence and arousal. The results from MI were compared to those from listwise deletion of entries with missingness in the covariates. When we determined the number of iterations based on the convergence diagnostics available from dynr.mi(), differences in the statistical significance of the covariate parameters were observed between the listwise deletion and MI approaches. These results underscore the importance of considering diagnostic information in the implementation of MI procedures.

Affective response during physical activity: Within-subject differences across phases of behavior change

OBJECTIVE

Affective response during physical activity may be a key factor reinforcing future behavior. However, little is known about how affective responses during physical activity may differ across phases of behavior change. This study used real-time Ecological Momentary Assessment (EMA) to examine within-subject differences in affective response during physical activity in daily life as individuals transitioned across phases of behavior change.

METHOD

A sample of 115 adults (M = 41.0 years, 74% female) participated in an intensive longitudinal study with measurement bursts at 0, 6, and 12-months. Each burst consisted of 8 randomly-prompted EMA occasions per day across 4 days. EMA self-report items assessed current activity level (i.e., physical activity or nonphysical activity), and positive and negative affect. Questionnaires measured phase of behavior change (e.g., preaction [no regular physical activity], action [regular physical activity <6 months], and maintenance [regular physical activity ≥6 months]) at each burst. Three-level (Level-1 = occasion, Level-2 = burst, Level-3 = person) linear regression models tested Phase of Change (Level-2, within-subject) × Physical Activity Level (Level-1, within-subject) interactions controlling for day of week, time of day, and sex.

RESULTS

Positive affective response during physical activity (vs. nonphysical activity) was higher when individuals were in preaction phases (vs. action). Negative affective response during physical activity (vs. nonphysical activity) was lower when individuals were in the maintenance phase (vs. action).

CONCLUSIONS

Long-term maintenance of physical activity may be particularly challenging, given the lack of positive reinforcement that is thought to be needed to sustain behavior. (PsycINFO Database Record

A Practical Guide to Analyzing Time-Varying Associations between Physical Activity and Affect Using Multilevel Modeling

There is growing interest in within-person associations of objectively measured physical and physiological variables with psychological states in daily life. Here we provide a practical guide with SAS code of multilevel modeling for analyzing physical activity data obtained by accelerometer and self-report data from intensive and repeated measures using ecological momentary assessments (EMA). We review previous applications of EMA in research and clinical settings and the analytical tools that are useful for EMA research. We exemplify the analyses of EMA data with cases on physical activity data and affect and discuss the future challenges in the field.

Mood Dimensions Show Distinct Within-Subject Associations With Non-exercise Activity in Adolescents: An Ambulatory Assessment Study

Physical activity is known to preserve both physical and mental health. However, the physical activity levels of a large proportion of adolescents are insufficient. This is critical, since physical activity levels in youth have been shown to translate into adulthood. Whereas in adult populations, mood has been supposed to be one important psychological factor that drives physical activity in everyday life, this issue has been poorly studied in adolescent populations. Ambulatory Assessment is the state-of-the-art approach to investigate how mood and non-exercise activity fluctuate within persons in everyday life. Through assessments in real time and real life, this method provides ecological validity, bypassing several limitations of traditional assessment methods (e.g., recall biases). To investigate whether mood is associated with non-exercise activity in adolescents, we equipped a community-based sample comprising 113 participants, aged 12–17 years, with GPS-triggered e-diaries querying for valence, energetic arousal, and calmness, and with accelerometers continuously measuring physical activity in their everyday lives for 1 week. We excluded all acceleration data due to participants' exercise activities and thereafter we parameterized non-exercise activity as the mean value across 10-min intervals of movement acceleration intensity following each e-diary prompt. We used multilevel analyses to compute the effects of the mood dimensions on non-exercise activity within 10-min intervals directly following each e-diary prompt. Additionally, we conducted explorative analyses of the time course of the effects, i.e., on different timeframes of non-exercise activity up to 300 min following the mood assessment. The results showed that valence (p < 0.001) and energetic arousal (p < 0.001) were positively associated with non-exercise activity within the 10 min interval, whereas calmness (p < 0.001) was negatively associated with non-exercise activity. Specifically, adolescents who felt more content, full of energy, or less calm were more physically active in subsequent timeframes. Overall, our results demonstrate significant associations of mood with non-exercise activity in younger ages and converge with the previously observed association between mood and physical activity in adults. This knowledge on distinct associations of mood-dimensions with non-exercise activity may help to foster physical activity levels in adolescents.

A systematic review of the psychometric properties, usability and clinical impacts of mobile mood-monitoring applications in young people

BACKGROUND

Mobile mood-monitoring applications are increasingly used by mental health providers, widely advocated within research, and a potentially effective method to engage young people. However, little is known about their efficacy and usability in young populations.

METHOD

A systematic review addressing three research questions focused on young people: (1) what are the psychometric properties of mobile mood-monitoring applications; (2) what is their usability; and (3) what are their positive and negative clinical impacts? Findings were synthesised narratively, study quality assessed and compared with evidence from adult studies.

RESULTS

We reviewed 25 articles. Studies on the psychometric properties of mobile mood-monitoring applications were sparse, but indicate questionable to excellent internal consistency, moderate concurrent validity and good usability. Participation rates ranged from 30% to 99% across studies, and appeared to be affected by methodological factors (e.g. payments) and individual characteristics (e.g. IQ score). Mobile mood-monitoring applications are positively perceived by youth, may reduce depressive symptoms by increasing emotional awareness, and could aid in the detection of mental health and substance use problems. There was very limited evidence on potential negative impacts.

CONCLUSIONS

Evidence for the use of mood-monitoring applications in youth is promising but limited due to a lack of high-quality studies. Future work should explicate the effects of mobile mood-monitoring applications on effective self-regulation, clinical outcomes across disorders and young people's engagement with mental health services. Potential negative impacts in this population should also be investigated, as the adult literature suggests that application use could potentially increase negativity and depression symptoms.

Physical Activity and Depressive Mood in the Daily Life of Older Adults

Abstract. Empirical evidence suggests that physical activity is related to less depressive moods. However, little is known about this association in the everyday life of older adults, limiting the ecological validity of prior findings. This study examined within-person associations between physical activity and depressive mood in older adults across 7 days. Moreover, the study tested the extent to which need-fulfillment can explain this association. The sample consisted of 68 adults aged 65 to 93 years. Physical activity was assessed objectively with accelerometers, whereas need-fulfillment and depressive mood were assessed at the end of each day using self-reports. Results from multilevel analysis suggest that daily physical activity was negatively related to daily depressive mood within persons. Although need-fulfillment did not explain the association between physical activity and depressive mood, it was a statistically significant predictor of daily depressive mood and even attenuated the effect of physical activity on depressive mood to nonsignificance.

Physical Activity Increases after an Affectively Arousing Daily Life Event

Evidence that structured physical activity can help to regulate affective state has spurred interest in identifying associations between unstructured physical activity and affective states during daily life. The present study examined whether stressful daily life situations that elicit affective arousal also elicit increased physical activity in the form of restless movement. The study compared the physical activity of professors (n = 25) after presenting a classroom lecture to their physical activity at the same time of day on a non-lecture workday. The expectation was that lecturing would increase affective arousal, leading to greater restless movement following the lecture compared to the non-lecture control day. The study assessed subjective arousal to confirm that arousal was higher during the lecture. The primary outcome measures were actigraphy-measured standing and stepping times and number of steps and posture transitions. Results indicate that energetic and tense arousal were higher during the lecture than during the control period. Mean (±SE) up time (standing and stepping) for the 1st minute of the 20 minute post-lecture period was double that of the last minute (32.8 ± 5.73 s to 16.5 ± 5.41 s), while it remained low throughout the comparison period on the control day (p = 0.01). Subjects also took more steps (p = 0.006) and engaged in more transitions between sitting and standing (p = 0.02) after the lecture than after the control period. These results support the conclusion that stressful daily life situations that elicit affective arousal also elicit increased physical activity in the form of restless movement and suggest that affective responses to stressful situations may be important determinants of physical activity during daily life.

Physical activity buffers fatigue only under low chronic stress

Fatigue is one of the most commonly reported complaints in the general population. As physical activity (PA) has been shown to have beneficial effects, we hypothesized that everyday life PA improves fatigue. Thirty-three healthy students (21 women, 22.8 ± 3.3 years, 21.7 ± 2.3 kg/m(2)) completed two ambulatory assessment periods. During five days at the beginning of the semester (control condition) and five days during final examination preparation (examination condition), participants repeatedly reported on general fatigue (awakening, 10 am, 2 pm, 6 pm and 9 pm) by means of an electronic diary, collected saliva samples for the assessment of cortisol and α-amylase immediately after providing information on fatigue and wore a triaxial accelerometer to continuously record PA. Self-perceived chronic stress was assessed as a moderator. Using hierarchical linear modeling, including PA, condition (control vs. examination), sex and chronic stress as predictors, PA level during the 15 min prior to data entry did not predict momentary fatigue level. Furthermore, there was no effect of condition. However, a significant cross-level interaction of perceived chronic stress with PA was observed. In fact, the (negative) relationship between PA and fatigue was stronger in those participants with less chronic stress. Neither cortisol nor α-amylase was significantly related to physical activity or fatigue. Our study showed an immediate short-term buffering effect of everyday life PA on general fatigue, but only when experiencing lower chronic stress. There seems to be no short-term benefit of PA in the face of higher chronic stress. These findings highlight the importance of considering chronic stress when evaluating the effectiveness of PA interventions in different target populations, in particular among chronically stressed and fatigued subjects.

Within-Subject Associations between Mood Dimensions and Non-exercise Activity: An Ambulatory Assessment Approach Using Repeated Real-Time and Objective Data

A physically active lifestyle has been related to positive health outcomes and high life expectancy, but the underlying psychological mechanisms maintaining physical activity are rarely investigated. Tremendous technological progress yielding sophisticated methodological approaches, i.e., ambulatory assessment, have recently enabled the study of these mechanisms in everyday life. In practice, accelerometers allow to continuously and objectively monitor physical activity. The combination with e-diaries makes it feasible to repeatedly assess mood states in real-time and real life and to relate them to physical activity. This state-of-the-art methodology comes with several advantages, like bypassing systematic distortions of retrospective methods, avoiding distortions seen in laboratory settings, and revealing an objective physical activity assessment. Most importantly, ambulatory assessment studies enable to analyze how physical activity and mood wax and wane within persons over time in contrast to existing studies on physical activity and mood which mostly investigated between-person associations. However, there are very few studies on how mood dimensions (i.e., feeling well, energetic and calm) drive non-exercise activity (NEA; such as climbing stairs) within persons. Recent reviews argued that some of these studies have methodological limitations, e.g., scarcely representative samples, short study periods, physical activity assessment via self-reports, and low sampling frequencies. To overcome these limitations, we conducted an ambulatory assessment study in a community-based sample of 106 adults over 1 week. Participants were asked to report mood ratings on e-diaries and to wear an accelerometer in daily life. We conducted multilevel analyses to investigate whether mood predicted NEA, which was defined as the mean acceleration within the 10-min interval directly following an e-diary assessment. Additionally, we analyzed the effects of NEA on different time frames following the e-diary prompts in an exploratory manner. Our results revealed that valence significantly and positively predicted NEA within persons (p = 0.001). Feeling more energetic was associated with significantly increased NEA (p < 0.001), whereas feeling calmer was associated with significantly decreased NEA (p < 0.001) on the within-person level. The analyses on different time frames of NEA largely confirmed our findings. In conclusion, we showed that mood predicted NEA within adults but with distinct magnitudes and directions of effects for each mood dimension.

Momentary assessment of contextual influences on affective response during physical activity

OBJECTIVE

Higher positive and lower negative affective response during physical activity may reinforce motivation to engage in future activity. However, affective response during physical activity is typically examined under controlled laboratory conditions. This research used ecological momentary assessment (EMA) to examine social and physical contextual influences on momentary affective response during physical activity in naturalistic settings.

METHOD

Participants included 116 adults (mean age = 40.3 years, 73% female) who completed 8 randomly prompted EMA surveys per day for 4 days across 3 semiannual waves. EMA surveys measured current activity level, social context, and physical context. Participants also rated their current positive and negative affect. Multilevel models assessed whether momentary physical activity level moderated differences in affective response across contexts controlling for day of the week, time of day, and activity intensity (measured by accelerometer).

RESULTS

The Activity Level × Alone interaction was significant for predicting positive affect (β = -0.302, SE = 0.133, p = .024). Greater positive affect during physical activity was reported when with other people (vs. alone). The Activity Level × Outdoors interaction was significant for predicting negative affect (β = -0.206, SE = 0.097, p = .034). Lower negative affect during physical activity was reported outdoors (vs. indoors).

CONCLUSIONS

Being with other people may enhance positive affective response during physical activity, and being outdoors may dampen negative affective response during physical activity.

Using activity triggered e-diaries to reveal the associations between physical activity and affective states in older adult's daily living

Background

Evidence suggests that older adults show positive affects after participating in exercise bouts. However, it is less clear, if and how physical activities in daily living enhance affective states, too. This is dissatisfying, as most of older adults’ physical activities are part of their daily living. To answer these questions we used activity-triggered e-diaries to investigate the within-subject effects of physical activity on three dimensions of affective states (valence, energetic arousal, calmness) during everyday life.

Methods

Older adults (N = 74) between 50 and 70 years took part in the study during three consecutive days. Physical activity in daily living was objectively assessed using accelerometers. Affects were measured 10 min after a study participant surpassed a predefined threshold for activity or inactivity. The participants were prompted by an acoustic signal to assess their momentary affective states on an e-diary. Data were analyzed with hierarchical multilevel analyses.

Results

Whenever older individuals were more physically active, they felt more energized (energetic arousal) and agitated (calmness). However, they did not feel better (valence). Interestingly, body mass index (BMI) and valence were associated in a significant cross-level interaction. BMI acts as a moderating variable in the way that lower BMI scores were associated with higher levels of valence scores after being physically active.

Conclusions

The innovative ambulatory assessment used here affords an interesting insight to the affective effects of daily activity of older adults. These effects are no simple and no linear ones, i.e. physical activity is not associated with positive affects per se as shown several times in experimental studies with single activity bouts. Rather there is a differentiating association seen as an enhanced feeling of energy and agitation, which is not accompanied by a better feeling. Socio-emotional selectivity theory may support the finding that older individuals are emotionally more stable during their day-to-day life, which might explain the non-significant effect on the affect dimension valence.

Virtues, ecological momentary assessment/intervention and smartphone technology

Virtues, broadly understood as stable and robust dispositions for certain responses across morally relevant situations, have been a growing topic of interest in psychology. A central topic of discussion has been whether studies showing that situations can strongly influence our responses provide evidence against the existence of virtues (as a kind of stable and robust disposition). In this review, we examine reasons for thinking that the prevailing methods for examining situational influences are limited in their ability to test dispositional stability and robustness; or, then, whether virtues exist. We make the case that these limitations can be addressed by aggregating repeated, cross-situational assessments of environmental, psychological and physiological variables within everyday life-a form of assessment often called ecological momentary assessment (EMA, or experience sampling). We, then, examine how advances in smartphone application (app) technology, and their mass adoption, make these mobile devices an unprecedented vehicle for EMA and, thus, the psychological study of virtue. We, additionally, examine how smartphones might be used for virtue development by promoting changes in thought and behavior within daily life; a technique often called ecological momentary intervention (EMI). While EMA/I have become widely employed since the 1980s for the purposes of understanding and promoting change amongst clinical populations, few EMA/I studies have been devoted to understanding or promoting virtues within non-clinical populations. Further, most EMA/I studies have relied on journaling, PDAs, phone calls and/or text messaging systems. We explore how smartphone app technology provides a means of making EMA a more robust psychological method, EMI a more robust way of promoting positive change, and, as a result, opens up new possibilities for studying and promoting virtues.

The Impact of a Videogame-Based Pilot Physical Activity Program in Older Adults with Schizophrenia on Subjectively and Objectively Measured Physical Activity

OBJECTIVES

The purpose of this report is to describe the impact of a videogame-based pilot physical activity program using the Kinect for Xbox 360 game system (Microsoft, Redmond, WA, USA) on physical activity in older adults with schizophrenia.

METHODS

In this one group pre-test, post-test pilot study, 20 participants played an active videogame for 30 min, once a week for 6 weeks. Physical activity was measured by self-report with the Yale Physical Activity Survey and objectively with the Sensewear Pro armband at enrollment and at the end of the 6-week program.

RESULTS

There was a significant increase in frequency of self-reported vigorous physical activity. We did not detect a statistically significant difference in objectively measured physical activity although increase in number of steps and sedentary activity were in the desired direction.

CONCLUSION

These results suggest participants' perception of physical activity intensity differs from the intensity objectively captured with a valid and reliable physical activity monitor.

Adherence to a Videogame-Based Physical Activity Program for Older Adults with Schizophrenia

OBJECTIVES

Adults with schizophrenia are a growing segment of the older adult population. Evidence suggests that they engage in limited physical activity. Interventions are needed that are tailored around their unique limitations. An active videogame-based physical activity program that can be offered at a treatment facility can overcome these barriers and increase motivation to engage in physical activity. The purpose of this report is to describe the adherence to a videogame-based physical activity program using the Kinect(®) for Xbox(®) 360 game system (Microsoft(®), Redmond, WA) in older adults with schizophrenia.

MATERIALS AND METHODS

This was a descriptive longitudinal study among 34 older adults with schizophrenia to establish the adherence to an active videogame-based physical activity program. In our ongoing program, once a week for 6 weeks, participants played an active videogame, using the Kinect for Xbox 360 game system, for 30 minutes. Adherence was measured with a count of sessions attended and with the total minutes attended out of the possible total minutes of attendance (180 minutes).

RESULTS

Thirty-four adults with schizophrenia enrolled in the study. The mean number of groups attended was five out of six total (standard deviation=2), and the mean total minutes attended were 139 out of 180 possible (standard deviation=55). Fifty percent had perfect attendance.

CONCLUSIONS

Older adults with schizophrenia need effective physical activity programs. Adherence to our program suggests that videogames that use the Kinect for Xbox 360 game system are an innovative way to make physical activity accessible to this population.

Physical activity and affect in elementary school children's daily lives

A positive influence of physical activity (PA) on affect has been shown in numerous studies. However, this relationship has not yet been studied in the daily life of children. We present a part of the FLUX study that attempts to contribute to filling that gap. To this end, a proper way to measure PA and affect in the daily life of children is needed. In pre-studies of the FLUX study, we were able to show that affect can be measured in children with self-report items that are answered using smartphones. In the current article, we show that it is feasible to objectively measure children's PA with accelerometers for a period of several weeks and report descriptive information on the amount of activity of 51 children from 3rd and 4th grade. Additionally, we investigate the influence of daily PA on daily affect in children. Mixed effects models show no effect of PA on any of the four measured dimensions of affect. We discuss that this might be due to effects taking place at shorter time intervals, which can be investigated in future analyses.