Effects of a physical activity and endometriosis-based education program delivered by videoconference on endometriosis symptoms: the CRESCENDO program (inCRease physical Exercise and Sport to Combat ENDOmetriosis) protocol study

BACKGROUND

Endometriosis is a chronic disease characterized by growth of endometrial tissue outside the uterine cavity which could affect 200 million women (The term "woman" is used for convenience. Individuals gendered as man or as nonbinary can also suffer from this disease) worldwide. One of the most common symptoms of endometriosis is pelvic chronic pain associated with fatigue. This pain can cause psychological distress and interpersonal difficulties. As for several chronic diseases, adapted physical activity could help to manage the physical and psychological symptoms. The present study will investigate the effects of a videoconference-based adapted physical activity combined with endometriosis-based education program on quality of life, pain, fatigue, and other psychological symptoms and on physical activity.

METHODS

This multicentric randomized-controlled trial will propose to 200 patients with endometriosis to be part of a trial which includes a 6-month program with 45 min to more than 120 min a week of adapted physical activity and/or 12 sessions of endometriosis-based education program. Effects of the program will be compared to a control group in which patients will be placed on a waiting list. All participants will be followed up 3 and 6 months after the intervention. None of the participants will be blind to the allocated trial arm. The primary outcome measure will be quality of life. Secondary outcomes will include endometriosis-related perceived pain, fatigue, physical activity, and also self-image, stereotypes, motivational variables, perceived support, kinesiophobia, basic psychological need related to physical activity, and physical activity barriers. General linear models and multilevel models will be performed. Predictor, moderator, and mediator variables will be investigated.

DISCUSSION

This study is one of the first trials to test the effects of a combined adapted physical activity and education program for improving endometriosis symptoms and physical activity. The results will help to improve care for patients with endometriosis.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT05831735 . Date of registration: April 25, 2023.

Adopting the Situation in School Questionnaire to Examine Physical Education Teachers' Motivating and Demotivating Styles Using a Circumplex Approach

Grounded in SDT, several studies have highlighted the role of teachers’ motivating and demotivating styles for students’ motivation, learning, and physical activity in physical education (PE). However, most of these studies focused on a restricted number of motivating strategies (e.g., offering choice) or dimensions (e.g., autonomy support). Recently, researchers have developed the Situations-in-School (i.e., SIS-Education) questionnaire, which allows one to gain a more integrative and fine-grained insight into teachers’ engagement in autonomy-support, structure, control, and chaos through a circular structure (i.e., a circumplex). Although teaching in PE resembles teaching in academic courses in many ways, some of the items of the original situation-based questionnaire (e.g., regarding homework) are irrelevant to the PE context. In the present study, we therefore sought to develop a modified, PE-friendly version of this earlier validated SIS-questionnaire—the SIS-PE. Findings in a sample of Belgian (N = 136) and French (N = 259) PE teachers, examined together and as independent samples, showed that the variation in PE teachers’ motivating styles in this adapted version is also best captured by a circumplex structure, with four overarching styles and eight subareas differing in their level of need support and directiveness. The SIS-PE possesses excellent convergent and concurrent validity. With the adaptations being successful, great opportunities for future research on PE teachers (de-)motivating styles are created.

Cognitions and behaviours of general practitioners in France regarding HPV vaccination: A theory-based systematic review

Human papillomavirus (HPV) vaccination is safe and efficacious to prevent persistent HPV infection, precancerous anogenital lesions and cervical cancer. However, in countries where vaccination programmes are implemented outside of schools, such as France, reaching high HPV vaccination coverage of the target population is challenging. Many studies have been performed in France to assess cognitions of general practitioners (GPs) regarding HPV vaccination. However, the evidence is not consistent about which cognitions are key. To provide a comprehensive overview, we performed a systematic review of studies conducted in France on GPs' cognitions regarding HPV vaccination and used the reasoned action approach to extract and synthesize data. The systematic search was performed up to July 2020 in Medline via PubMed, PsycINFO, PsycARTICLES, Embase, CINAHL Plus, Web of Science, Pascal and Francis databases. Grey literature was searched for in the French Public Health Database, Cairn. Info, yahoo.fr, and Google Scholar. Twenty-five scientific publications were selected based on eligibility criteria and assessed for quality. Our qualitative synthesis highlights that although 73% of GPs report recommending HPV vaccination, up to 50% would not recommend it because of concerns, including changes in patients' health behaviours and doubts about safety and/or efficacy. GPs' injunctive norms, i.e. trust in institutional information, were shown to be associated positively with GPs' willingness to recommend HPV vaccination. Parents' fears, girls' age, and potential connection with sexuality do not seem to affect GPs' recommendations. These results will inform the development of a professional educational intervention targeting GPs in France.

Promoting Physical Activity during School Closures Imposed by the First Wave of the COVID-19 Pandemic: Physical Education Teachers' Behaviors in France, Italy and Turkey

The COVID-19 pandemic has drastically reduced physical activity (PA) behaviors of many people. Physical education (PE) is considered one of the privileged instruments to promote youths' PA. We aimed to investigate the effects of lockdown on PE teachers' behaviors promoting their students' out-of-school PA and differences between three European countries. A sample of 1146 PE teachers (59.5% females) from France, Italy, and Turkey answered an online questionnaire about guiding students to engage in out-of-school PA, helping them to set PA goals, encouraging in self-monitoring PA, the pedagogical formats of these behaviors and feedback asked to students. RM-MANCOVAs were performed with a two-time (before and during the lockdown), three country (France, Italy, Turkey), two gender factorial design, using teaching years and perceived health as covariates. A significant multivariate main effect time × country × gender (p < 0.001) was reported for the behaviors promoting students' PA, with French and Italian teachers increasing some behaviors, while Turkish teachers showing opposite trends. Significant multivariate main effects time × country were found for formats supporting the behaviors (p < 0.001) and for asked feedback formats (p < 0.001). The massive contextual change imposed by lockdown caused different reactions in teachers from the three countries. Findings are informative for PA promotion and PE teachers' education.