Explicit and implicit attitudes towards food and physical activity in childhood obesity

This study investigated differences in the explicit and implicit attitudes towards food and physical activities between children with obesity (n=38) and a matched control group (n=38). The implicit attitude was assessed using the Extrinsic Affective Simon Task (EAST; J. Exp. Psychol. (50) (2003) 77), a modified version of the Implicit Association Test (IAT; J. Personality Social Psychol. (74) (1999) 1464). It was expected that both groups would report a positive explicit attitude towards healthy food and intense physical activities, and a negative explicit attitude towards unhealthy food and sedentary activities. Of particular interest was the hypothesis that children with obesity would have a more positive implicit attitude towards unhealthy food and sedentary activities than the control group. Results revealed no differences between groups in the explicit attitude towards food and physical activity. Children and adolescents with obesity had a more pronounced positive implicit attitude towards food in general. The relevance of these findings in terms of prevention, treatment and further research is discussed.     

Testing mediator variables in a physical activity intervention for women with type 2 diabetes

ObjectivesA limited understanding of the mechanisms of behavior change has hindered the development of more effective interventions. The aim of this study was to identify potential mediators of objectively measured physical activity (PA) behavior change in women with type 2 diabetes (T2DM).DesignMediation test of a randomized controlled trial.MethodWomen with T2DM (n = 93) from the control group (standard PA materials, n = 44) and the full intervention group (control + stage-matched printed material and telephone counseling, n = 49) of a larger PA intervention trial were included. PA outcomes were minutes of MET weighted moderate and vigorous PA/week (self-report) and steps/3-days (objective) recorded at baseline and 12-months. Social-cognitive constructs were measured and tested in a mediating variable framework.ResultsPerceived behavioral control and barrier self-efficacy mediated intervention effects on objective PA (proportion of intervention effect mediated = 18% and 24% respectively). Intention was a mediator of objective PA (23%).ConclusionPerceived behavior control, barrier self-efficacy, and intention are effective mechanisms of PA behavior change in women with T2DM.     

The effects of a physical activity and nutrition intervention on body dissatisfaction, drive for thinness, and weight concerns in pre-adolescents

The primary aim was to examine the effects of a physical activity and nutrition intervention on Body Dissatisfaction, Drive for Thinness, and Weight Concerns in pre-adolescents. Eighty-four 10–12 years old were studied as part of a larger trial of a family-based physical activity and nutrition intervention. Forty-nine children participated in the 8-week intervention (35 in control group) and completed Body Dissatisfaction, Drive for Thinness, and Weight Concerns measures at baseline and post-test. Participants in both groups showed positive but non-significant changes in body image and Drive for Thinness following the trial, but there were no significant between group differences. This was the first study to examine the effects of a physical activity and nutrition intervention on body image and related variables in pre-adolescents. Body Dissatisfaction, Drive for Thinness, and Weight Concerns were not positively or negatively influenced by the intervention.     

Mediators of behavior change in two tailored physical activity interventions for adolescent girls

ObjectivesIt has been suggested that the lack of knowledge regarding the mechanisms responsible for behavior change may be responsible for the low levels of effectiveness in physical activity interventions among youth. While it is common for physical activity interventions to cite a theoretical framework, few test the validity of their constructs using an established mediation analysis technique. The purpose of this study was to identify mediators of physical activity behavior change in two tailored interventions for adolescent girls.DesignThis study involved an experimental design.MethodsParticipants (N=161) were randomly allocated to a control (CON) group, an intervention based on the Health Promotion (HP) Model or an intervention developed from the HP Model that included two processes from the Transtheoretical Model (THP). Both interventions included school-based education sessions, individual counseling sessions, and two physical activity sessions completed with the participants' mothers. Measures were assessed prior to the intervention, at post-intervention and at a 6-month follow-up. The following constructs were included in the mediation analyses: perceived benefits, perceived barriers, self-efficacy, exposure to models, social support, interpersonal norms, planning, stimulus control, and counterconditioning.ResultsPerceived benefits, perceived barriers, self-efficacy, and commitment to planning satisfied the criteria for mediation in the THP intervention. Self-efficacy and commitment to planning were identified as mediators in the HP intervention.ConclusionThe results of this study provide evidence that both interventions were successful in increasing physical activity through changes in the theoretical constructs.     

Theoretical underpinnings of a need-supportive intervention to address sustained healthy lifestyle changes in overweight and obese adolescents

ObjectivesRecent figures indicate that nearly a quarter of Australian adolescents are overweight or obese. Despite the well-established role of physical activity and healthy eating in reducing prevalence of obesity, there remains a lack of effective interventions that promote sustained behavior engagement. This paper aims to describe the theory-based integration and implementation of self-determination theory and goal setting theory in a family-based lifestyle intervention. Although these theories have been shown to independently predict motivation for behavior, a limited number of studies have described behavior-change techniques at a level to allow for effective evaluation and replication, and no studies have combined the theories in a healthy lifestyle behavior intervention.MethodsBehavior change techniques and the associated change mediators are described in relation to need-supportive environments provided by instructors and extended to parents in the home environment. Methods for motivating and promoting sustained engagement in adolescent physical activity and healthy eating and parent behaviors to support these lifestyle changes are discussed within the context of need-satisfaction and goal setting.ConclusionsThis study will contribute to understanding processes for developing and implementing behavior-change techniques based on the integration of two theories of motivation. Future interventions aimed at promoting maintenance of physical activity and healthy eating behaviors in overweight and obese adolescents will benefit by being informed of which techniques are effective at enhancing motivation within the intervention context and home environment.     

Responding to the embodiment of distress in individuals defined as obese: Implications for research

This article examines the evidence for a relationship between body image distress (BID) and obesity, and between emotional eating and obesity. The need is highlighted for treatment programmes that are responsive to these complex issues and combine this with diet and physical activity. Weight loss programmes so far have had a poor success rate. They have often sought to capitalise on BID as a motivation to lose weight, but there is some evidence that such an emphasis may be self‐defeating, as seriously overweight individuals may eat either to self‐punish or self‐comfort and may also avoid social situations that could support healthy lifestyles. The case is made for new research that addresses the highlighted psychological aspects of obesity. There is a need for both a randomised controlled trial (RCT) that will enable a statistical inference of causality relating to new treatments and qualitative, interview‐based research to elicit information regarding individual responses to treatment. Dance Movement Therapy (DMT) is proposed as one new treatment option for those individuals whose obesity is linked to emotional eating. Theoretical support and empirical research evidence for DMT are explored. However, since this treatment has not so far been applied with obese individuals, a pilot study is proposed prior to a RCT.     

Physical activity participation and physical aggression in children and adolescents: A systematic review and meta-analysis

BackgroundAggressive behaviour is a substantial behavioural problem in children and adolescents. This review systematically summarises the current evidence on the relationship between physical activity participation and aggressive behaviour and quantifies the effects of physical activity interventions on aggression in children and adolescents.MethodsStudies were identified through a search of five electronic databases (PsycINFO, SPORTDiscus, MEDLINE, CINAHL and Web of Science) with combinations of three groups of keywords. Two independent reviewers screened and extracted data from the individual studies. The reporting quality and publication bias were assessed. The relationship between physical activity participation and aggressive behaviour was systematically summarized. Data (effect sizes) were pooled to investigate the effects of physical activity interventions on aggressive behaviour. A moderator meta-analysis was performed to identify potential moderators of the effects of physical activity interventions on aggressive behaviour.ResultsNineteen studies met the inclusion criteria. The relationship between physical activity participation and aggressive behaviour was mixed. A significant reduction in aggressive behaviour was observed after physical activity interventions (k = 8, SMD = −0.53, 95% CI [−0.27, −0.79], p < 0.001). The moderator meta-analysis showed that physical activity interventions involving team-based physical activity had greater effects than those involving individual-based physical activity (β = 0.42, SE = 0.18, p = 0.02). In addition, interventions involving physical activity alone were more effective in reducing aggressive behaviour than those that combined physical activity with other activities such as a philosophy course (β = −0.63, SE = 0.11, p < 0.001).ConclusionThe current meta-analysis presents evidence for the effect of physical activity interventions on aggressive behaviour in children and adolescents. Physical activity–only interventions involving team-based physical activity might be used for preventing or reducing aggressive behaviour in children and adolescents. Possible mechanisms, methodological strengths and weaknesses, implications, and suggestions for future studies were discussed.     

Comparing different boosters of planning interventions on changes in fat consumption in overweight and obese individuals: A randomized controlled trial

Single planning interventions have been found to promote short‐term dietary change. Repeated planning interventions may foster long‐term effects on behavior change. It remains unknown whether there is a critical number of boosters to establish long‐term maintenance of behavioral changes. This study aimed at investigating what social‐cognitive variables mediate the effects of the interventions on dietary behavior change. Overall, 373 participants (n = 270 women, 72.4%; age M = 52.42, SD = 12.79) were randomly allocated to one of five groups: a control group, a single planning group, and three groups with 3, 6, or 9 weeks’ repeated planning interventions. Follow‐ups took place 4, 6, and 12 months after baseline. Change in fat consumption was not promoted by any of the interventions. In terms of social‐cognitive variables, intentions, self‐efficacy and coping planning displayed a time × group interaction, with the 9 weeks’ planning group showing the most beneficial effects. Effect sizes, however, were very small. None of the tested planning interventions successfully promoted change in fat consumption across the 12 month period. This, however, could not be explained by problems with adherence to the intervention protocol. Potential explanations for this unexpected result are discussed.     

Physical activity interventions in the school setting: A systematic review

Objectives

To review the effectiveness of school-based interventions with a physical activity component by measuring changes in psychological determinants, physical activity, and health outcomes.

Design

Systematic Review.

Method

We conducted a literature search of school-based controlled studies that involved a physical activity intervention targeting school students. Study design, methodological quality, and effectiveness of interventions on three target levels, ‘health and fitness’ (BMI and motor performance), ‘physical activity’, and ‘psychological determinants’ (knowledge of physical activity effects, self-concept, and attitudes towards physical activity), were analysed. Furthermore, we examined the influence of specific factors (e.g., age and gender) and mediator effects.

Results

The literature search identified 129 studies. The majority of the studies examining motor performance, physical activity, and knowledge of physical activity achieved significant results (69.7%, 56.8% and 87.5%, respectively). Significant effects on self-concept and attitudes were also found but to a smaller extent (in 30% and 43.8% of the studies, respectively). Only a few studies examining BMI (2.7%), physical activity (6.8%), and attitudes towards physical activity (12.5%) revealed negative effects, with better results observed for the control group. Intervention effects were influenced by the students’ age, intervention type, and frequency of the interventions. Self-efficacy was found to mediate the relationship between the program and the students’ physical activity.

Conclusions

Numerous school-based physical activity interventions achieved positive effects on three target levels. Further research is needed to clarify the mediator effects of psychological variables on physical activity and health and to increase our knowledge about the mechanisms that underlie behavioural change.     

An experimental investigation of physical education teachers’ and coaches’ reactions to weight-based victimization in youth

Objectives

Overweight youth are frequent targets of weight-based victimization during Physical Education (PE) and sports. In addition, previous research indicates that teachers’ perceptions and expectations may influence their likelihood of intervening during victimization, and physical educators may endorse biased perceptions and expectations of overweight youth. Despite this evidence, no research has examined how physical educators respond to weight-based victimization of their students. Thus, the current study examined PE teachers’ and coaches’ responses to different types of victimization involving average weight and overweight students.

Design

This study utilized an experimental design that assessed participants’ reactions to situations of weight-related victimization using hypothetical scenarios accompanied by photographs of youth.

Methods

PE teachers and sport coaches (N = 162) were randomly presented with a scenario and follow-up questions about an average weight or an overweight student. Each participant completed two conditions: one with a male target, and one with a female target.

Results

Participants were more likely to take action when overweight female students were victims of bullying, specifically in situations of verbal and relational victimization. Male participants were less likely to respond to victimization than female participants.

Conclusions

Findings suggest the importance of increasing awareness about weight-based victimization and its consequences, especially among male physical educators. Implications for the psychological, social, and physical development of overweight youth are discussed.     

Momentary affective response to bouts of moderate-to-vigorous physical activity predicts changes in physical activity and sedentary behavior during behavioral weight loss

BackgroundAffective responses are posited to be key predictors of the uptake and maintenance of health behaviors. However, few studies have examined how individuals’ affective response to physical activity, as well as the degree to which their affect response changes, may predict changes in physical activity and sedentary time during behavioral weight loss treatment.PurposeThe current study examined how baseline momentary affective response (i.e., stress and anxiety) to moderate-to-vigorous physical activity (MVPA) and the degree of pre--post intervention change in this response predicted change in daily sedentary, light, and MVPA time during a three-month internet-based weight loss program.MethodsWomen with overweight/obesity (final N = 37) completed 14-day ecological momentary assessment (EMA) protocols with objective measurement of physical activity (i.e., bout-related MVPA time) before and after the intervention.ResultsWomen who had more reinforcing responses to MVPA (i.e., greater reductions in anxiety and stress response following MVPA bouts) at baseline had greater increases in overall MVPA at the end of the intervention. Those who had greater anxiety reductions after MVPA bouts at baseline also evidenced less sedentary time at the end of the intervention. Changes in affective responses across the intervention were not related to changes in physical activity levels.ConclusionsFindings suggest initial levels of affective reinforcement from MVPA bouts predict future change in MVPA and sedentary time during behavioral weight loss. Future work is needed to examine the utility of more precisely targeting affective responses to physical activity to optimize intervention approaches.     

A one-year intervention in 7th grade physical education classes aiming to change motivational climate and attitudes towards exercise

Objectives: To assess the effects of a year-long intervention in Greek junior high school physical education on motivational climate, goal orientations and attitudes towards exercise and healthy diet.Design: One-year pre-post experimental trial.Method: Eighty-eight daily lessons aiming to facilitate task-involvement were developed with 262 students in an intervention group and 521 acting as controls. All were at the first year of junior high school (7th grade). The intervention was assessed through questionnaires at the beginning and end of the school year and 10 months after the end of the intervention. Participants completed the measures of motivational climate, goal orientations and attitudes.Results: Confirmatory factor analyses, and reliability and correlation analyses, supported the psychometric properties of the questionnaires. Covariance analysis results revealed that, after adjusting for initial differences on the assessed constructs, students who took part in the intervention, compared with the control group: (1) had more positive attitudes towards exercise and healthy eating, (2) had lower ego and higher task orientation scores, and (3) perceived that their teacher gave more emphasis on task-involvement and less emphasis on ego-involvement.Conclusions: Physical educators can create a positive motivational climate facilitating students’ task orientation and attitudes towards exercise.     

A dual-process model of affective and instrumental attitudes in predicting physical activity

IntroductionA novel dual-process model based upon the affective-reflective theory which distinguishes between affective attitude and instrumental attitude at an explicit and implicit level was used to predict physical activity.MethodUndergraduate students (N = 114) completed a lab-based study at two time-points, spaced two weeks apart. Participants completed self-report measures of the theory of planned behavior constructs, including explicit affective attitude and explicit instrumental attitude. Implicit affective attitude and implicit instrumental attitude were measured using single category implicit association tests.ResultsExplicit affective attitude and perceived behavioral control indirectly predicted physical activity through intention, and explicit affective attitude, implicit affective attitude, and intention predicted physical activity directly with a modest effect size (R² = 0.24).DiscussionFindings suggest explicitly and implicitly held evaluative information are conceptually distinct, and affective evaluations are key in guiding physical activity behavior regardless of whether such evaluations are implicit or consciously accessible.     

Child care centre adherence to infant physical activity and screen time recommendations in Australia,Canada and the United States: An observational study

ObjectiveThe aim of this study was to compare adherence to physical activity and sedentary behaviour recommendations within the 2011 Institute of Medicine Early Childhood Obesity Prevention Policies as well as screen time recommendations from the 2013 American Academy of Pediatrics for samples of infants in child care centres in Australia, Canada, and the United States (US).MethodsThis cross-sectional study used data from: the Australian 2013 Standing Preschools (N = 9) and the 2014–2017 Early Start Baseline (N = 22) studies; the 2011 Canadian Healthy Living Habits in Pre-School Children study (N = 14); and the American 2008 (N = 31) and 2013–2017 (N = 31) Baby Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) trials. Data were compared on the above infant recommendations. Percentages were used to describe compliance to the recommendations and chi-square tests to determine whether compliance differed by country.ResultsChild care centres were most compliant (74%–95%) with recommendations to: provide daily indoor opportunities for infants to move freely under adult supervision, daily tummy time for infants less than 6 months of age, indoor and outdoor recreation areas that encourage infants to be physically active, and discourage screen time. Centres were least compliant (38%-41%) with adhering to recommendations to: limit the use of equipment that restricts an infant’s movement and provide education about physical activity to families. Compared with Canadian and US centres, Australian centres were less compliant (46%) with the recommendation to engage with infants on the ground each day, to optimize adult-infant interactions and to limit the use of equipment that restricts the infant’s movement. Canadian centres were less compliant (39%) with the recommendation to provide training to staff and education to parents about children’s physical activity. US centres were less compliant (25%–41%) with the recommendations to provide daily opportunities for infants to explore their outdoor environment, limit the use of equipment that restricts the infant’s movement and provide education to families about children’s physical activity.ConclusionsAssisting child care centres on limiting the use of equipment that restricts an infant’s movement, and providing education about children’s physical activity to families may be important targets for future interventions.     

The cognitive load of physical activity in individuals with high and low tolerance to effort: An ecological paradigm to contrast stepping on the spot and stepping through space

Performing a physical activity means dealing with the challenges and difficulties occurring during the task. The more a person possesses the cognitive ability to deal with the complexity of the task, the more that person will be able to face the difficulties in activity regulation. However, no studies have been designed to investigate the cognitive dimension of physical activity. In the present study, we present an original in-task methodology that offers the means to assess the cognitive and physical load of a physical activity. Through the application of a dual task paradigm, we report in-task changes in cognitive abilities and physiological experiences in low and high tolerant individuals during the practice of one of two whole-body stepping tasks. The findings confirmed that stepping through space is a physical activity that requires more cognitive resources and is perceived as more cognitively and physically challenging than stepping on the spot. We demonstrated also that the tolerance to effort, which is a psychological factor, plays a non-negligible role in the way the activity sessions were experienced. The affective states in low tolerant individuals were always more negative than those reported by high tolerant individuals. Our findings argue for the existence of a cognitive dimension to physical activity with tolerance to effort being a moderator of individuals’ affective experience to exercise.     

A self-regulation-based intervention to increase physical activity in cancer patients

The study examined whether a behavior-change intervention focusing on self-regulatory strategies and emphasizing role model support increases physical activity (PA) among insufficiently active (not meeting PA guidelines of 150 min/week) cancer patients. Ambulatory cancer patients [N = 72; 54% female; M = 56 years, SD = 12.34; most with breast or colon cancer (34, 15%)] were enrolled in the MOTIVACTION-study, a 4-week intervention (1-hr counseling, followed by weekly phone calls), with pretest (T1), posttest (T2) and a 10-week follow-up (T3). Participants were randomized to either an exercise or to a stress management intervention (active control). The exercise intervention emphasized self-regulatory strategies (e.g. action- and coping planning and self-monitoring); patients were also encouraged to contact a physically active same-sex role model as a potential exercise partner. The active control condition consisted of coping and relaxation techniques. Sixty-seven patients remained in the study and completed the SQUASH assessment of PA and a measure of perceived stress. PA was validated by Actigraph accelerometry. At T2, 46% of the patients in the exercise group and 19% of stress management patients increased their activity levels to meet PA guidelines (>150 min/week; χ²(1) = 5.51, p = .019). At T3, participants in the exercise intervention maintained their exercise level (46%), but also 31% of the stress management patients met the guidelines. All patients reported reductions in perceived stress. Additional analyses comparing patients in the exercise group by role model contact (63% realized contact) revealed that those who had contact with their role model were significantly more likely to adhere to the recommended guidelines (T2:50%; T3:64%) compared to those who did not have contact with a role model (T2:39%; T3:15%), suggesting the potential of mobilizing role model support to facilitate PA. In sum, cancer patients may not only benefit from an exercise intervention emphasizing self-regulation, but also from stress management, regarding both reducing stress and increasing PA.     

Effects of behaviour change interventions on physical activity in people with spinal cord injury: A systematic review and meta-analysis

ObjectivesThis review investigated the effectiveness of behaviour-change interventions to improve physical activity (PA) participation in individuals with a spinal cord injury. Additionally, the review sought to analyse the change in PA behaviour that might be expected by utilising behaviour change in PA interventions and what specific intervention characteristics, application of behaviour change theories, and behaviour change techniques are most efficacious.MethodsThe protocol was prospectively registered on PROSPERO: CRD42021252744, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed in this review. Eight databases were comprehensively searched using a well-defined strategy developed in collaboration with an academic liaison librarian. Randomised, non-randomised controlled, and non-controlled studies were included in this review; however, controlled and non-controlled studies were analysed separately. Studies were included if participants were older than 16 years and had an SCI of any cause, level or severity, regardless of the time since injury. The behaviour change technique taxonomy version 1 was used to code the intervention characteristics for behaviour modification. The combined effects across studies were pooled in a meta-analysis, and the risk of bias was assessed using the Cochrane Risk of Bias 2 tool.ResultsThe search retrieved 10,155 titles and abstracts. After duplicate removal and screening against the eligibility criteria, 23 studies were included. The overall effect estimate of the change in PA participation in the controlled trials post-intervention was medium (d = 0.50, 95% CI = 0.31–0.70) in favour of behaviour-targeted interventions. The mean difference in PA volume between pre- and post-intervention was an increase of 22 minutes per week (95% CI = 5.96–38.90). Interventions that provided practical support (d = 0.81, 95% CI = 0.46–1.16), which were individualised (d = 0.62, 95% CI = 0.34–0.90) and that utilised monitoring (d = 0.59, 95% CI = 0.34–0.83) had a greater effect on change to PA than those that were group-based and did not utilise those specific techniques.ConclusionsInterventions that target behaviour change to increase PA in people with SCI appear effective. Utilising behaviour change frameworks and specific behaviour change techniques augments PA uptake and levels, and interventions aimed at improving PA in people with SCI should incorporate a behaviour modification component. More research is needed on the isolated effect of intervention structure parameters and specific behaviour change techniques.     

A pilot study exploring the use of a telephone-assisted planning intervention to promote parental support for physical activity among children and youth with disabilities

Parent support is an important contributor to physical activity (PA) among children and youth with disabilities (CYD). Although many parents of CYD are motivated to provide parent PA support, CYD remain insufficiently active. The multi-process action control model has been applied to understand parent PA support and highlights behavioral regulation strategies such as action and coping planning as critical for translating intentions into behavior. Parents may struggle to create and carryout planning without support. There is no known research examining telephone support as a tool to promote planning and subsequent parent PA support behavior.MethodParents (43 mothers and 6 fathers) of CYD (child M_age = 12.53 years ± 5.53; 75% male; 38.6% developmental disability) completed a baseline questionnaire and were subsequently randomized to a telephone-assisted planning experimental group twice over four weeks (n = 23) or a control group who had access to planning tools but no telephone assistance (n = 26).ResultsNo significant main or interaction effects emerged for parent PA support behavior. However, a significant time × condition interaction was found for behavioral regulation strategies (i.e., action and coping planning and self-monitoring; F(1,44) = 5.05, p = 0.03) indicating a significant increase in the use of behavioral regulation strategies for parent PA support from baseline, for parents assigned to the telephone-assisted intervention.ConclusionThese findings suggest potential for planning support as a tool to enhance behavioral regulation strategies related to parent PA support among parents of CYD.