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Mediators of Physical Activity Behavior Change in the "Girls on the Move" Intervention.

ABSTRACT: BACKGROUND:The minimal effect of interventions to date on increasing young adolescent girls' physical activity (PA) may be due to inadequate understanding of the mechanisms underlying behavior change, yet sparse research testing a PA intervention has examined the capacity of theories to explain PA, particularly when using objective measures. OBJECTIVES:The aim of the study was to examine whether constructs from the health promotion model and self-determination theory mediated changes in moderate-to-vigorous physical activity (MVPA) following a 17-week intervention. METHODS:The study was a secondary analysis of data from a group randomized trial, including 12 intervention and 12 control schools in the Midwestern United States. Data were collected in 2012-2016. Girls (fifth- to eighth-grade, N = 1,519) completed surveys on perceived benefits and enjoyment of PA, PA self-efficacy, social support and motivation for PA, and barriers to PA and wore accelerometers. RESULTS:The final path model had a good fit: ?(4) = 2.48, p = .648; goodness-of-fit index = 1; comparative fit index = 1; root-mean-square error of approximation = 0; standardized root-mean-square residual = 0.01. For MVPA change from baseline to postintervention, enjoyment (B = 24.48, p < .001) and social support (B = 30.48, p < .001) had a positive direct effect, whereas the intervention had a positive indirect effect through enjoyment and social support (B = 9.13, p < .001). Enjoyment (B = -13.83, p < .001) and social support (B = -17.22, p < .001) had a negative indirect effect on MVPA change from postintervention to follow-up. DISCUSSION:Enjoyment of PA and social support for PA may be important mediators of PA in young adolescent girls and warrant consideration when designing interventions.

SUBMITTER: Robbins LB

PROVIDER: S-EPMC6602810 | biostudies-literature | 2019 Jul/Aug

REPOSITORIES: biostudies-literature

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Mediators of Physical Activity Behavior Change in the "Girls on the Move" Intervention.

Robbins Lorraine B LB Wen Fujun F Ling Jiying J

Nursing research 20190701 4

<h4>Background</h4>The minimal effect of interventions to date on increasing young adolescent girls' physical activity (PA) may be due to inadequate understanding of the mechanisms underlying behavior change, yet sparse research testing a PA intervention has examined the capacity of theories to explain PA, particularly when using objective measures.<h4>Objectives</h4>The aim of the study was to examine whether constructs from the health promotion model and self-determination theory mediated chan ...[more]

PMID: 30882562

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Project description:Increasing moderate to vigorous physical activity among urban girls of low socioeconomic status is both a challenge and a public health priority. Physical activity interventions targeting exclusively girls remain limited, and maintenance of moderate to vigorous physical activity during the post-intervention period has been difficult to maintain. The main aim of the 5-year "Girls on the Move" group randomized trial is to evaluate the efficacy of a comprehensive school-based intervention in increasing girls' minutes of moderate to vigorous physical activity and improving cardiovascular fitness, body mass index, and percent body fat immediately post-intervention (after 17 weeks) and at 9-month post-intervention follow-up (9 months after end of intervention).A total of 24 urban middle schools in the Midwestern U.S. will be randomized to either receive the intervention or serve as a control (N = 1200 girls). The intervention, based on the Health Promotion Model and Self-Determination Theory, will include: (1) two face-to-face motivational, individually tailored counseling sessions with a registered nurse, one at the beginning and the other at the end of the intervention period; (2) an interactive Internet-based session during which each girl receives individually tailored motivational and feedback messages via iPad at 11 weeks (shortly after midpoint of intervention); and (3) a 90-minute after-school physical activity club. Racially diverse, low-active, 10- to 14-year-old 5th to 8th-grade girls will complete questionnaires and physical measures at baseline and post-intervention (n = 50 per school). Minutes of moderate to vigorous physical activity will be assessed with accelerometers. Cardiovascular fitness will be assessed by estimating VO2 max with PACER (Progressive Aerobic Cardiovascular Endurance Run) scores. Height and weight will be assessed to calculate body mass index. Percent body fat will be estimated with a foot-to-foot bioelectric impedance scale. Linear mixed effects regression analyses will be performed to assess intervention effects.This multi-component approach is expected to improve girls' moderate to vigorous physical activity and related physical outcomes.ClinicalTrials.gov Identifier NCT01503333.

Project description:Objective: To determine whether psychosocial constructs targeted in an online physical activity intervention for Latinas mediated changes in moderate-to-vigorous physical activity (MVPA). Method: Data were taken from a randomized trial of a web-based MVPA intervention for Latina women age 18-65 (N = 205) based on social cognitive theory and the transtheoretical model. Baseline and 6-month measures included minutes/week of MVPA (ActiGraph GT3X + accelerometers and 7-Day Physical Activity Recall Interview) and theorized mediators (self-efficacy, behavioral processes, cognitive processes, social support, enjoyment). A multiple mediation model adjusting for baseline MVPA was fit using a products of coefficients method, simultaneously testing all hypothesized mediators. Results: MVPA increased more in the intervention group than controls by 50 min/week (self-report) and 31 min/week (accelerometers). For the self-reported MVPA model, there was an intervention effect (a-path coefficient) on self-efficacy (b = 0.43, p < .01), cognitive processes (b = 0.64, p < .01), behavioral processes (b = 0.54, p < .01), and enjoyment (b = 9.91, p = .01). Changes in self-efficacy (b = 24.54, p = .03), social support from friends (b = 2.36, p = .04), and enjoyment (a = 0.74, p = .08) were associated with changes in MVPA (b-path coefficient). However, only changes in self-efficacy (b = 10.49, 95% CI [2.46, 24.54]) and enjoyment (b = 7.30, 95% CI [0.92, 21.78]) mediated the intervention effect on MVPA (ab-path coefficient). For the accelerometer-measured MVPA model, intervention effects were significant for self-efficacy (b = 0.48, p < .01), cognitive processes (b = 0.62, p < .01), and behavioral processes (b = 0.61, p < .01), yet only self-efficacy was associated with changes in MVPA (b = 4.43, p = .03), and mediated intervention effects on MVPA (b = 12.15, 95% CI [11.25, 16.34]). Conclusions: Future MVPA interventions with Latinas should target self-efficacy and enjoyment to maximize efficacy. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Project description:BackgroundThe purpose was to explore whether baseline sociodemographic and physical characteristics moderated effects of an intervention on moderate-to-vigorous physical activity (MVPA), percent body fat, body mass index z-score, and cardiorespiratory fitness (CRF) at post intervention, relative to the control condition.MethodsA secondary analysis of data from a group randomized trial including 24 schools (12 intervention and 12 control; N = 1519 girls) was conducted. Age, ethnicity, race, socioeconomic status, and pubertal stage were assessed via survey. Height, weight, MVPA (min/h), percent body fat, and CRF were measured. Mixed-effects linear models were performed.ResultsCompared to the control, the intervention increased overweight and obese girls' CRF (b = 0.28, p = 0.049; b = 0.31, p < 0.01, respectively), but not healthy weight girls' CRF (b = 0.04, p = 0.706). Pre- to mid-puberty girls in the intervention group had slightly lower post-intervention MVPA than those in the control (3.04 vs. 3.31, p = 0.055), while late to post-puberty intervention and control girls' post-intervention MVPA was similar (3.12 vs. 3.04, p = 0.542).ConclusionsA PA intervention can improve overweight and obese girls' CRF, possibly attenuating their cardiovascular risk. Effective strategies are needed to assist adolescent girls, especially those in pre- to mid-puberty, in maintaining their MVPA after an intervention ends.ImpactModerators of physical activity intervention effects among adolescent girls are important to identify because the effectiveness of these interventions to date in this population has been limited. This article contributes to the notable gap in knowledge regarding moderators in physical activity interventions involving adolescent girls, particularly baseline characteristics that may moderate their responses to physical activity interventions. Awareness of the moderators can be useful for determining the type of intervention that may be successful in subgroups of adolescent girls and for tailoring a physical activity intervention to optimally meet each girl's needs to achieve maximal effects. Findings show that weight status moderated the intervention effects on cardiorespiratory fitness. Compared to the control condition, the intervention increased overweight and obese, but not healthy weight, girls' cardiorespiratory fitness. A physical activity intervention can improve overweight and obese girls' cardiorespiratory fitness, possibly attenuating their cardiovascular risk. Therefore, it is essential to include overweight and obese girls in PA interventions to help them reap this important benefit.

Project description:BackgroundAdolescents are highly susceptible to negative self-perceptions, likely due to their social cues and environment. The presence of these negative self-perceptions has been shown to adversely impact levels of physical activity (PA). Although PA has the ability to foster improved self-perceptions, the rates of PA among adolescents continue to descend, with girls appearing to be most susceptible to these declines. At-risk adolescent girls, who may experience a number of negative preceding lifestyle conditions, may be exceptionally vulnerable to declines in PA. There are a high number of adolescent girls from low-income and abusive households in British Columbia, Canada, thus indicating a need for a program to relay the importance of PA and healthy lifestyle behaviors.ObjectiveThis paper aims to describe the protocol of the Girls United and on the Move (GUM) pragmatic intervention, an integrated PA and psychosocial program aimed at improving self-compassion, social connectedness, and overall self-perceptions among at-risk adolescent girls.MethodsUsing a quasi-experimental mixed methods approach, the GUM intervention was conducted in 5 schools in British Columbia, Canada. Adolescent girls aged 11 to 15 years who were identified as at risk were included in the study. The 9-week intervention, co-delivered by a PA/health promotion-trained researcher and a registered social worker, involved a PA component and a psychosocial component with evidence-based topics addressing the concerns of the adolescent girls. The following outcomes were evaluated: PA, self-compassion, social support, leader supportiveness, and sport enjoyment and commitment. Program acceptability and satisfaction was also examined. Outcome measures were assessed at baseline (week 1), week 6, and postintervention (week 9), and interview data concerning program acceptability and satisfaction were collected at postintervention from a subsample of participants.ResultsA total of 101 participants were invited to participate in the GUM intervention. Reporting of the results is projected for the fall of 2020.ConclusionsIt is anticipated that the GUM intervention will enhance PA while also improving self-compassion, social connectedness, and overall self-perceptions among at-risk adolescent girls. The findings of this research will contribute to the literature concerning PA and various psychosocial factors that impact the physical and mental health of at-risk adolescent girls.Trial registrationClinicaltrials.gov NCT03567200; https://clinicaltrials.gov/ct2/show/NCT03567200.International registered report identifier (irrid)DERR1-10.2196/15302.

Project description:BackgroundLower-limb amputation (LLA) due to non-traumatic vascular etiology is linked to extremely low physical activity and high disability.ObjectiveTo test the feasibility of a biobehavioral intervention designed to promote physical activity.DesignA randomized, single-blind feasibility trial with a crossover design.SettingVeterans Administration Medical Center.ParticipantsMilitary veterans (age: 65.7 [7.8] years; mean [standard deviation]) with nontraumatic lower-limb amputation (LLA), randomized to two groups: GROUP1 (n = 16) and GROUP2 (n = 15). Both groups had similar baseline amputation characteristics (level of amputation and time since amputation).InterventionsTwelve weekly, 30-minute telehealth sessions of physical activity behavior-change intervention, with GROUP1 participating in weeks 1-12 and GROUP2 in weeks 13-24. GROUP1 noncontact phase in weeks 13-24 and GROUP2 attention control telehealth phase in weeks 1-12.Main outcome measuresFeasibility (participant retention, dose goal attainment, intervention acceptability [Intrinsic Motivation Inventory [IMI] Interest and Enjoyment scale], safety) and signal of efficacy (free-living physical activity [accelerometer-based average daily step count], Late Life Function and Disability Index - Disability Scale [LLFDI-DS]).ResultsParticipant retention rate was high (90%), with three participants lost to follow-up during the intervention period. Dose goal attainment was low, with only 10% of participants achieving an a priori walking dose goal. Intervention was rated as acceptable, with mean IMI Interest and Enjoyment score (5.8) statistically higher than the null value of 5.0 (P = .002). There were no between-group differences in adverse event rates (falls: P = .19, lower extremity wounds: P = .60). There was no signal of efficacy for change in average daily step count (d = -0.15) or LLFDI-DS (d = -0.22 and 0.17 for frequency and limitations scales, respectively).ConclusionsTelehealth delivered biobehavioral intervention resulted in acceptable participant retention, low dose goal attainment, high participant acceptability, and low safety risk, while having no signal of efficacy (physical activity, disability) for people with nontraumatic LLA.

Project description:BackgroundAfter-school programs represent a promising opportunity to assist adolescent girls' in attaining adequate physical activity. Although evaluating the process of intervention implementation is important for determining if an intervention was delivered and received as intended, comprehensive information about process evaluation methods and results are rarely reported. The purpose of this article was to evaluate the reach, dose, and fidelity of a 90-minute after-school physical activity club offered 3 days a week. The club is 1 of 3 components included in a 17-week intervention designed for 5th-8th grade girls, the majority of whom were of minority and/or low socioeconomic status.MethodsA total of 24 schools (12 intervention; 12 control) and 56-67 girls per school (total N = 1519 girls) were included in the Girls on the Move group randomized controlled trial. At the beginning of each of 3 academic years (2012-2015), 8 schools per year were randomized to receive either the intervention (n = 4) or control condition (n = 4). To evaluate the club, data collected via surveys from girls, club coaches and managers, and process evaluators were analyzed. To evaluate the opportunity for physical activity provided by the coaches and managers, process evaluators used an observation tool based on the System for Observing Fitness Instruction Time and Academic Learning Time - Physical Education. Girls wore accelerometers every other week during the club time.ResultsMean attendance was 41 % with the average attendance in year 3 being higher than rates for years 1 or 2. Mean moderate-to-vigorous physical activity time was 21.85 minutes measured via accelerometry and 21.81 minutes observed by process evaluators. Satisfaction with the intervention was high. For the most part, process evaluators perceived the club was delivered as planned and reflected constructs of the Health Promotion Model and Self-Determination Theory. Areas contributing to success included using incentives and offering a variety of activities. Issues negatively impacting implementation included managing behavioral problems, having limited space for moderate-to-vigorous physical activity, dealing with inclement weather, and getting coaches to actively participate in all physical activities with the girls.ConclusionsThis process evaluation provides important information to guide future school-based physical activity intervention delivery. Barriers to implementation have been identified. Ways to overcome them warrant consideration when designing physical activity interventions. Research is needed to test innovative approaches for enhancing attendance and increasing girls' moderate-to-vigorous physical activity in after-school programs.Trial registrationClinicalTrials.gov Identifier NCT01503333 . Registered 23 December, 2011.

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Mediators of Physical Activity Behavior Change in the "Girls on the Move" Intervention.

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Mediators of Physical Activity Behavior Change in the "Girls on the Move" Intervention.

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