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Objectives: Multiple health behaviour change is a viable strategy to promote health outcomes. An example is the use of running behaviour to support smoking cessation in the group-mediated Run to Quit program. On the basis that changes in running and smoking identity were related to changes in running and smoking behaviour among individuals in the Run to Quit program, the purpose of this study was to extend these findings by examining key predictors of change in both running and smoking identity. Methods: We analyzed data collected from 450 adult individuals (70.67% female, and 92.44% white) during the program evaluation of Run to Quit from 2016 to 2018. Participants completed assessments at week 1 (baseline), week 3 (mid-program), and week 10 (follow-up) of the program. Relevant predictor variables for change in identity were identified by drawing from theory (identity theory, identity control theory, physical activity self-definition model, social identity theory) and past research regarding exercise and smoking identity. Potential predictors of changes in running and smoking identity included changes in behaviour, self-efficacy, perceptions of the social environment (task and social cohesion, descriptive norms), as well as smoking identity and running identity, respectively. Two regression models, using residualized change scores (for each variable) and relative Pratt indices, were constructed 15 for both running and smoking identity. Results: Changes in running self-efficacy, running frequency, and individual attractions to the group exercise tasks were significant and meaningful predictors of change in running identity, whereas changes in objectively measured smoking behaviour and running identity were significant and meaningful predictors of change in smoking identity. Conclusion: Consistent with identity theories and past research, ensuring individuals develop a sense of efficacy and enjoy group exercise tasks both represent viable strategies to enhance exercise identity. Including an exercise component within smoking cessation programs may help individuals replace their existing smoking identity with a healthier exercise identity.

Objective: Psychological need satisfaction, from a self-determination theory (SDT) perspective, has been applied extensively to understand predictors of exercise behaviour. Dweck (2017) proposed a psychological needs framework that includes basic needs (optimal predictability, competence, acceptance), compound needs derived from combinations of basic needs (self-esteem/status, trust, control), and a superordinate compound need for self-coherence that includes identity and meaning. The purpose was to examine whether psychological needs operationalized within Dweck’s model account for variance in exercise behaviour in ways that the SDT model does not. Methods and Measures: A community sample of 403 adults completed measures of 10 demographics, psychological needs, and exercise motivation at Time 1, and self-reported 11 moderate-to-vigorous minutes of exercise at both Times 1 and 2 four weeks later. Results: Two structural equation models operationalizing Dweck’s needs framework and SDT (basic needs and motivation) were examined in relation to exercise behaviour. In both models, exercise identity and integrated regulation (conceptually similar) were the most salient correlates of prospectively measured exercise behaviour, and both accounted for the relationship between competence and exercise behaviour. Conclusion: The results support the importance of identity in the context of exercise behaviour. Future research should investigate factors associated with adopting and maintaining an exercise identity.

The early years are critical for physical literacy and physical activity (PA). With increasing numbers of children attending early childhood education and care (ECEC), educators play a significant role in childhood development and may play an influential role in young children’s physical literacy journey. Educators receive minimal training in physical literacy and PA, but receive increasing direction to integrate these concepts into ECEC learning. The purpose of this study was to assess educator (n=94) physical literacy, and determine which components of their physical literacy were associated with self-reported intentions and behaviours to promote physical literacy and PA. Educator physical literacy was moderate. Self-reported intentions and behaviours to provide physical literacy and PA opportunities were high. Except for understanding, there were no associations between physical literacy components and intentions and behaviours. The physical literacy of educators may not inform intentions and behaviours to provide physical literacy and PA opportunities were high. Except for understanding, there were no associations between physical literacy components and intentions and behaviours. The physical literacy of educators may not inform intentions and behaviours to provide physical literacy and PA within ECEC frameworks.

Additional file 1: Supplementary 1. Differences in movement behaviors during school days and weekends by gender and the achievement of Canadian 24-H movement guidelines.

Additional file 1: File S1. Scoping Reviews (PRISMA-ScR) Checklist. File S2. Search strategy. File S3. Detailed summary of topics and key findings.

Additional file 2: Supplementary 2. Comparisons in movement behaviors between school days and weekends stratified by gender and the achievement of Canadian 24-H movement guidelines.

Behavioural therapy and pharmaceutical treatments are typically recommended first treatment approaches for depression. However, more than half of patients do not achieve remission after first-line antidepressant treatment, and about 30% do not reach remission after multiple treatment trials (Rush et al., 2006). Repetitive transcranial magnetic stimulation (rTMS) is a well-tolerated and promising neuromodulatory approach for patients with treatment resistant depression (Milev et al., 2016). It has shown success in treating traditional treatment-resistant individuals with MDD (Sehatzadeh et al., 2019). Furthermore, through depression treatment, habitual physical activity may increase and serve as a behavioral marker of successful treatment (Yun et al., 2020). This possibility has received little research attention. As Cuijper and colleagues (2014) noted, it is remarkable that there is so little evidence on whether treatments for depression among adults have an impact on physical activity and whether changes in physical activity mediate the outcomes of these treatments. Future work should systematically examine the role of PA before, during and after depression treatments as important synergistic mechanisms may be at play in the treatment of MDD (Fagan et al., 2019). One mechanism through which physical activity may confer mental health benefits is by improving affect. Positive activated affect is described as a subjective mental state of positive energy and engagement. In two well-cited meta-analyses, both acute (Reed & Ones, 2006) and regular aerobic physical activity (Reed & Buck, 2009) are associated with a moderate increase in self-reported positive activated affect. Simply, exercise can help people “feel good” in the right circumstances. Demonstrating a bidirectional relationship, evidence suggests that individuals who experience higher levels of positive incidental affect are more likely to be physically active (Liao et al., 2015). We are not aware of any research examining the physical activity-affect relationship among individuals receiving treatment for depression. Accordingly, this study will first examine changes in physical activity during a six-week r-TMS treatment period and identify when and how (minutes of light, moderate-to-vigorous physical activity) changes in physical activity occurs among responders (individuals who have a 50% reduction in depressive symptoms at the end of treatment) compared to non-responders. Second, we will examine the bidirectional relationship between affect and physical activity during the treatment period.

Healthcare workers (HCWs, i.e., nurses, physicians, hospital staffs) report greater distress, depression, and poorer physical health than the average employed global citizen. These disparities have only been amplified in the context of the COVID-19 pandemic. Recent international studies have shown that there is an increase in reported depression, anxiety, insomnia, and distress (34.0-71.4%) in healthcare workers (HCW) who have been exposed to COVID-19 patients. These negative outcomes during the pandemic are supported by a large (N = 105338) international study on which I am co-investigator (iCARE Study). Preliminary analyses with Canadian representative data (Total N = 18018; HCW N=1069 identify that from June 2020 to June 2021, HCW’s quality of life has worsened (26% to 48%; 10% more among women) and HCWs feel anxious (to a great extent: 19% to 24%; and somewhat: 29% to 36%) and depressed (to a great extent: 10% to 14%; and somewhat: 29% to 34%%). These findings, along with several international studies, suggest that the COVID-19 pandemic has more negatively impacted HCWs than in the general population. The temporal effect, access to resources, and sociodemographic index will be considered in this meta-meta-analysis.

There is a high prevalence of anxiety in children and adolescents, however, having a disability may further heighten the risk of developing an anxiety disorder. Physical activity may be one way for children and adolescents with disabilities to alleviate anxiety, yet, little is known about the relationship between anxiety and physical activity among this population. For children and adolescents with disabilities, physical activity may lessen the effect of anxiety, assist in anxiety symptom management, or act as a protective mechanism through decreasing the likelihood of developing anxiety disorders later in life. This review will synthesize the available evidence in order to identify future research priorities concerning the relationship between anxiety and physical activity in children and adolescents with disabilities.

A scoping review protocol to systematically map the emerging evidence on the impact of COVID-19 on the physical activity, sleep and sedentary behaviour of children and youth.

Mood disorders, also known as affective disorders, are the leading causes of disability in Canada and globally. The Diagnostic and Statistical Manual of Mental Disorder (DSM-5-TR; American Psychiatric Association & PsychiatryOnline Premium Package, 2022) distinguishes between two major categories of mood disorders: depressive and bipolar disorders. It is estimated that 4.4% of individuals globally experience depression each year (World Health Organization, 2017), and 1% experience type I or type II bipolar disorder (BD；Merikangas et al., 2011). The lifetime prevalence of depression is estimated to be even higher in Western industrialized nations, such as Canada (9.9%；Patten et al., 2015) and the United States (20.6%；Hasin et al., 2018)). It is generally acknowledged that all types of mood disorders are negatively correlated with quality of life (Cramer et al., 2010). Moreover, Cavanagh et al. (2003) reported that 90% of all suicide-related deaths occur among people who are experiencing mental disorders, especially bipolar disorder and depression. A subsequent meta-analysis concluded that suicide attempts are prevalent both among individuals with BD I (36.3%) and BD II (32.4%) (Dennehy et al., 2011). The heavy burden of mood disorders on individuals, families, and society warrants effective and cost-effective treatments. There is strong evidence for bidirectional relationships between the movement behaviours (physical activity, sedentary behaviour and sleep; Ross et al., 2020) and mental health. On one hand, engagement in movement behaviours has been found to promote mental health; whereas insufficient engagement is associated with poor mental health (Baglioni et al., 2011; Rollo et al., 2020). Regular physical activity has been recommended to treat mild-to-moderate depression in Canada (Ravindran et al., 2016), and has been suggested to be effective in the treatment of BD (Miranda-Pettersen et al., 2020). Moreover, it is well known that physical inactivity, high levels of sedentary behaviour, especially high volumes of screen time, and sleep problems have been linked to increased risk of depression and BDs (Franzen & Buysse, 2022; Kandola et al., 2019; Kandola et al., 2021; Schuch et al., 2018). On the other hand, being ‘mentally healthy’ may also be an important antecedent of engaging in optimal doses of those movement behaviours. For example, symptoms such as fatigue, psychomotor retardation, and anhedonia may actively discourage engagement in physical activity (Glowacki et al., 2017). Canada’s 24-hour movement guidelines for adults and older adults (Ross et al., 2020) recommend that adults (1) accumulate of at least 150 minutes of moderate-vigorous physical activity (MVPA) per week and (2) participate in muscle strengthening activities at least twice a week. Additionally, older adults are encouraged to participate in activities that challenge balance. Children and youth are encouraged to accumulate at least 60 minutes of MVPA per day (Tremblay et al., 2016). Sedentary behaviour, defined as waking activity characterized by a sitting, reclining, or lying posture that requires low energy expenditure (i.e., less than 1.5 metabolic equivalents), should be limited 8 hours per day or less for adults. Screen-based activities are common contributors to sedentary behaviour in many populations (Leask et al., 2015; Rideout et al., 2010; Thorp et al., 2011). Not only might these behaviours independently influence health outcomes, but they have also potential impacts on sleep behaviour (Costigan et al., 2013). Adults should also aim for 7 to 9 hours of good-quality sleep on a regular basis, with consistent bed and wake-up times. Both individually and collectively, the movement behaviours have been shown to provide numerous health benefits. An important aspect of the guidelines is recognition that the four movement behaviours interact to influence health. Movement behaviours are characterized by temporal variability and are influenced by a range of dynamic psychological processes (e.g., affect) and co-occurring events (e.g., social/environmental factors, interpersonal dynamics) (Ruissen et al., 2021). Problematic fluctuations of affect are one of the common features of mood disorders. People with depression (Wichers et al., 2007) and BDs (Curtiss et al., 2019; Havermans et al., 2010) have showed altered patterns in affective responses to stressors. A previous meta-analysis suggested that exercise has been associated with elevated positive affect (Reed & Ones, 2006). Also, insufficient sleep is believed to increase negative emotion (van der Helm & Walker, 2010). However, much research employs cross-sectional designs using one-time assessments of affective phenomena (affect, emotion, and mood) and movement behaviours. Such designs cannot address the dynamic nature of interactions between movement behaviours and affective phenomena, and are not able to reveal the directional associations among these variables (Kanning et al., 2013; Shiyko & Ram, 2011; Wilson et al., 1982). Recent years has seen increased interest in ecological momentary assessment (EMA) as a tool for real-time data capture for examining temporal relationships between adaptive behaviours and mental health (Hamaker & Wichers, 2017). EMA allows researchers to capture data immediately or within a short amount of time after an event occurs, therefore improving the precision of relationship evaluations (Stone & Shiffman, 1994; Wenze & Miller, 2010). In conjunction with advanced statistical modelling techniques (Ruissen et al., 2021), there is great potential in using EMA to tease apart relationships between movement behaviours and affective phenomena among individuals with mood disorders. Moreover, Wenze and Miller (2010) have suggested that it is feasible to use EMA methodology among people with mood disorders. Understanding the temporal relationships between affective phenomena and movement behaviours may inform clinical management and well-being intervention development including just-in-time adaptive interventions (Hardeman et al., 2019). To the best of our knowledge, no previous reviews have examined the temporal relationships between affective phenomena and movement behaviours among people with mood disorders. Thus, the purpose of this scoping review was to both synthesize what have been done and examine how research was conducted on this topic (Munn et al., 2018; Sabiston et al., 2022). Results have the potential to inform whether a systematic review is needed and guide future research about the use of EMA in evaluating relationships between affective phenomena and movement behaviours among people with mood disorders. Methods: This scoping review will follow the six-stage framework for conducting scoping reviews, developed by Arksey and O'Malley (2005), and later revised by Levac et al. (2010). This study will report the results and outcomes following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA-ScR) (Tricco et al., 2018). Stage 1: Identifying the research questions The objective of this review is to summarize current evidence regarding the use of EMA methodology among people with mood disorders in studies exploring the relationship between movement behaviours and affective phenomena. Notably, affective phenomena including mood, emotion, and affect, have been interchangeably used in previous literature, which may cause pitfalls (Ekkekakis, 2013, p. 33). In this review, emotion is a short-term reaction to a personally-significant stimuli, whereas mood refers to a more general and sustained disposition toward a particular emotion, and can occur without a specific stimulus. In short, emotion is a state, whereas mood is a trait. Affect is a less consistently defined concept in the literature. Niven (2013) defined affect as an umbrella concept which includes both mood and emotion. Note that, in clinical settings, it is also sometimes used to refer to a person’s emotional expression. Whereas, Ekkekakis (2013) suggested that affect is a momentary and dimensional (positive or negative) feeling that could constantly exist alone or be part of emotion or mood. Kirkland and Cunningham (2011) also considered affect as a necessary but insufficient component of emotions. Research questions: The purpose of this scoping review is to summarize the application of EMA in examining the association between the affective phenomena (mood, emotion, affect) and movement behaviour (physical activity, sedentary behaviour, sleep). Specifically, this scoping review will examine: 1. What is known about the relationship between movement behaviours and mood/emotion/affect among individuals with mood disorders? 2. How are the constructs of mood/emotion/affect conceptually and operationally defined within included studies? 3. What EMA technologies have been utilized? 4. What methodologies are typically adopted? For example: Duration of EMA monitoring, EMA prompts frequency, mental health screening tools, and use of comparison groups. 5. What is participant retention? 6. What methodological limitations have been identified? 7. What are recommended future research directions? Stage 2: Identifying relevant studies Searches will be conducted in the eight following electronic databases: PubMed, Medline (via Ovid), Embase (via Ovid), PsycINFO (via EBSCO), CINAHL (via EBSCO), SPORTDiscus (via EBSCO), Scopus, and Web of Science from their inception to June 10th, 2022. The databases will be searched using controlled vocabulary (e.g., MeSH terms in Medline) and keywords. Relevant terms included keywords related to EMA (e.g., experience sampling), mood disorders (e.g., depression, bipolar disorders) and movement behaviours (e.g., physical activity, exercise, sleep, screen time, sedentary behaviour). The search strategy was drafted by YL, and was refined based on the discussion with a university librarian and team members (Appendix 1). Reference lists of included studies will also be checked for identifying additional studies. Stage 3: Study selection Covidence, a review management software, will be employed to remove duplicates and conduct the selecting processes. Two authors will independently conduct the title and abstract screening. Full-texts will be independently reviewed by two authors for the remaining articles that passed title and abstract screening. Conflicts will be resolved by discussion. When necessary, a third author will be consulted for reaching a consensus. Inclusion and exclusion criteria: Peer-reviewed publications will be included if they were: 1) written in English, 2) include participants diagnosed with a mood disorder (e.g., major depressive disorder, bipolar I disorder) or using validated clinical scales, 3) use EMA to assess mood/emotion/affect, 4) include a measure of movement behaviours (e.g., minutes of physical activity), and 5) assess the relationships between mood/emotion/affect and movement behaviours. Only quantitative studies will be considered. Grey literature, theses/dissertations, reviews, qualitative studies and case studies will be excluded. Additionally, studies that do not quantify the amount of movement behaviours will be excluded: for example, studies that examine perceived sleep quality rather than amount of sleep. There are no restrictions with regard to participant gender, age, or the measurements of movement behaviours (self-reported or device-based). Stage 4: Data charting A data-charting form will be developed by one author and will be further refined by other authors by discussion. The following items will be extracted by two authors independently: 1) authors and year, 2) country, 3) methodological approach, 4) participant characteristics (e.g., sample size, age, gender, diagnosis), 5) EMA characteristics (e.g., schedule, device, attrition rate), 6) measurement of affect, 7) definitions of mood/emotion/affect, 8) measurements of movement behaviours, 9) main findings, and 10) future research directions. Disagreements will be solved by discussion. The extraction spreadsheet will be managed using Microsoft Excel. Stage 5: Collating, summarizing, and reporting the results We will summarize the evidence in both narrative format and descriptive tables. The manuscript will be submitted to a peer-reviewed journal. Stage 6: Consultation Once the data has been charted, an experienced researcher (GF) will be consulted to advise throughout the process. References: American Psychiatric Association, & PsychiatryOnline Premium Package. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR (Fifth, text revision. ed.). American Psychiatric Association Publishing. https://go.exlibris.link/Vk4rmlBb Arksey, H., & O'Malley, L. (2005). Scoping studies: towards a methodological framework. International journal of social research methodology, 8(1), 19-32. Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U., Lombardo, C., & Riemann, D. (2011). Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. Journal of affective disorders, 135(1-3), 10-19. Costigan, S. A., Barnett, L., Plotnikoff, R. C., & Lubans, D. R. (2013). The health indicators associated with screen-based sedentary behavior among adolescent girls: a systematic review. Journal of Adolescent Health, 52(4), 382-392. Cramer, V., Torgersen, S., & Kringlen, E. (2010). Mood disorders and quality of life. A community study. Nordic Journal of Psychiatry, 64(1), 58-62. Curtiss, J., Fulford, D., Hofmann, S. G., & Gershon, A. (2019). Network dynamics of positive and negative affect in bipolar disorder. Journal of affective disorders, 249, 270-277. Dennehy, E. B., Marangell, L. B., Allen, M. H., Chessick, C., Wisniewski, S. R., & Thase, M. E. (2011). Suicide and suicide attempts in the systematic treatment enhancement program for bipolar disorder (STEP-BD). Journal of affective disorders, 133(3), 423-427. Ekkekakis, P. (2013). The measurement of affect, mood, and emotion: A guide for health-behavioral research. Cambridge University Press. Franzen, P. L., & Buysse, D. J. (2022). Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications. Dialogues in clinical neuroscience. Glowacki, K., Duncan, M. J., Gainforth, H., & Faulkner, G. (2017). Barriers and facilitators to physical activity and exercise among adults with depression: A scoping review. Mental Health and Physical Activity, 13, 108-119. https://doi.org/10.1016/j.mhpa.2017.10.001 Hamaker, E. L., & Wichers, M. (2017). No time like the present: Discovering the hidden dynamics in intensive longitudinal data. Current Directions in Psychological Science, 26(1), 10-15. Hardeman, W., Houghton, J., Lane, K., Jones, A., & Naughton, F. (2019). A systematic review of just-in-time adaptive interventions (JITAIs) to promote physical activity. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 1-21. Hasin, D. S., Sarvet, A. L., Meyers, J. L., Saha, T. D., Ruan, W. J., Stohl, M., & Grant, B. F. (2018). Epidemiology of adult DSM-5 major depressive disorder and its specifiers in the United States. JAMA psychiatry, 75(4), 336-346. Havermans, R., Nicolson, N. A., Berkhof, J., & deVries, M. W. (2010). Mood reactivity to daily events in patients with remitted bipolar disorder. Psychiatry Research, 179(1), 47-52. Kandola, A., Ashdown-Franks, G., Hendrikse, J., Sabiston, C. M., & Stubbs, B. (2019). Physical activity and depression: Towards understanding the antidepressant mechanisms of physical activity. Neuroscience & Biobehavioral Reviews, 107, 525-539. https://doi.org/https://doi.org/10.1016/j.neubiorev.2019.09.040 Kandola, A., Owen, N., Dunstan, D., & Hallgren, M. (2021). Prospective relationships of adolescents’ screen-based sedentary behaviour with depressive symptoms: the Millennium Cohort Study. Psychological medicine, 1-9. Kanning, M. K., Ebner-Priemer, U. W., & Schlicht, W. M. (2013). How to investigate within-subject associations between physical activity and momentary affective states in everyday life: A position statement based on a literature overview. Frontiers in psychology, 4, 187. Kirkland, T., & Cunningham, W. A. (2011). Neural basis of affect and emotion. Wiley Interdisciplinary Reviews: Cognitive Science, 2(6), 656-665. Leask, C. F., Harvey, J. A., Skelton, D. A., & Chastin, S. F. (2015). Exploring the context of sedentary behaviour in older adults (what, where, why, when and with whom). European Review of Aging and Physical Activity, 12(1), 1-8. Levac, D., Colquhoun, H., & O'Brien, K. K. (2010). Scoping studies: advancing the methodology. Implementation science, 5(1), 1-9. Merikangas, K. R., Jin, R., He, J.-P., Kessler, R. C., Lee, S., Sampson, N. A., Viana, M. C., Andrade, L. H., Hu, C., & Karam, E. G. (2011). Prevalence and correlates of bipolar spectrum disorder in the world mental health survey initiative. Archives of general psychiatry, 68(3), 241-251. Munn, Z., Peters, M. D., Stern, C., Tufanaru, C., McArthur, A., & Aromataris, E. (2018). Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC medical research methodology, 18(1), 1-7. Niven, K. (2013). Affect. In M. D. Gellman & J. R. Turner (Eds.), Encyclopedia of Behavioral Medicine (pp. 49-50). Springer New York. https://doi.org/10.1007/978-1-4419-1005-9_1088 Patten, S. B., Williams, J. V., Lavorato, D. H., Wang, J. L., McDonald, K., & Bulloch, A. G. (2015). Descriptive epidemiology of major depressive disorder in Canada in 2012. The Canadian Journal of Psychiatry, 60(1), 23-30. Reed, J., & Ones, D. S. (2006). The effect of acute aerobic exercise on positive activated affect: A meta-analysis. Psychology of Sport and Exercise, 7(5), 477-514. Rideout, V. J., Foehr, U. G., & Roberts, D. F. (2010). Generation m 2: Media in the lives of 8-to 18-year-olds. Henry J. Kaiser Family Foundation. Rollo, S., Antsygina, O., & Tremblay, M. S. (2020). The whole day matters: understanding 24-hour movement guideline adherence and relationships with health indicators across the lifespan. Journal of sport and health science, 9(6), 493-510. Ross, R., Chaput, J.-P., Giangregorio, L. M., Janssen, I., Saunders, T. J., Kho, M. E., Poitras, V. J., Tomasone, J. R., El-Kotob, R., & McLaughlin, E. C. (2020). Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep. Applied Physiology, Nutrition, and Metabolism, 45(10), S57-S102. Ruissen, G. R., Zumbo, B. D., Rhodes, R. E., Puterman, E., & Beauchamp, M. R. (2021). Analysis of dynamic psychological processes to understand and promote physical activity behaviour using intensive longitudinal methods: A primer. Health psychology review, 1-34. Sabiston, C. M., Vani, M., de Jonge, M., & Nesbitt, A. (2022). Scoping reviews and rapid reviews. International Review of Sport and Exercise Psychology, 15(1), 91-119. Schuch, F. B., Vancampfort, D., Firth, J., Rosenbaum, S., Ward, P. B., Silva, E. S., Hallgren, M., Ponce De Leon, A., Dunn, A. L., & Deslandes, A. C. (2018). Physical activity and incident depression: a meta-analysis of prospective cohort studies. American Journal of Psychiatry, 175(7), 631-648. Shiyko, M. P., & Ram, N. (2011). Conceptualizing and estimating process speed in studies employing ecological momentary assessment designs: A multilevel variance decomposition approach. Multivariate Behavioral Research, 46(6), 875-899. Stone, A. A., & Shiffman, S. (1994). Ecological momentary assessment (EMA) in behavorial medicine. Annals of behavioral medicine. Thorp, A. A., Owen, N., Neuhaus, M., & Dunstan, D. W. (2011). Sedentary behaviors and subsequent health outcomes in adults: a systematic review of longitudinal studies, 1996–2011. American journal of preventive medicine, 41(2), 207-215. Tremblay, M. S., Carson, V., Chaput, J.-P., Connor Gorber, S., Dinh, T., Duggan, M., Faulkner, G., Gray, C. E., Gruber, R., & Janson, K. (2016). Canadian 24-hour movement guidelines for children and youth: an integration of physical activity, sedentary behaviour, and sleep. Applied Physiology, Nutrition, and Metabolism, 41(6), S311-S327. Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D., Horsley, T., & Weeks, L. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Annals of internal medicine, 169(7), 467-473. van der Helm, E., & Walker, M. P. (2010). The role of sleep in emotional brain regulation. Wenze, S. J., & Miller, I. W. (2010). Use of ecological momentary assessment in mood disorders research. Clinical psychology review, 30(6), 794-804. Wichers, M., Myin-Germeys, I., Jacobs, N., Peeters, F., Kenis, G., Derom, C., Vlietinck, R., Delespaul, P., & Van Os, J. (2007). Genetic risk of depression and stress-induced negative affect in daily life. The British journal of psychiatry, 191(3), 218-223. Wilson, T. D., Laser, P. S., & Stone, J. I. (1982). Judging the predictors of one's own mood: Accuracy and the use of shared theories. Journal of Experimental Social Psychology, 18(6), 537-556. World Health Organization. (2017). Depression and other common mental disorders: global health estimates. https://apps.who.int/iris/bitstream/handle/10665/254610/WHOMSD?sequence=1

Background: Children���s active transportation (AT) and independent mobility (IM) are associated with higher physical activity. COVID-19 restrictions have drastically reduced opportunities for physical activity, but their effects on AT and IM remain unknown. Purpose: Using two national surveys of parents across Canada conducted by separate survey firms in October and December 2020, we examined changes in AT and IM since the COVID-19 pandemic. We assessed potential disparities in changes by gender, household income, and disability status. Methods: Survey 1 included 1,568 parents of 5- to 17-year-olds and Survey 2 included 2,291 parents of 7- to 12-year-olds. We assessed changes associated with COVID-19 retrospectively on 5-point scales ranging from a lot less to a lot more. Changes in IM were only assessed in survey 2. We summarized changes in AT and IM with descriptive statistics and examined disparities with linear regression models. Results: In surveys 1 and 2 respectively, 33.4 and 37.5% of parents reported a decline in AT, 48.9 and 48.4% reported no change, and 16.8 and 14.0% reported an increase. 32.8% of parents reported a decline in IM, 56.5% reported no change and 10.7% reported an increase. In both surveys, decreases in AT were significantly larger among children from households earning CAD$ 20,000-79,999 versus >$100,000 with no disparities related to gender or disabilities (p>0.05). We obtained similar results for IM in survey 2. Conclusions: These findings emphasize the need for public health authorities and policymakers to promote AT and IM as activities that can comply with physical distancing requirements. Funding: Study 1 was funded by Dalhousie University, the Province of Nova Scotia, and ParticipACTION. Study 2 was funded by the Heart and Stroke Foundation of Canada (grant # G-19-0026216)., The Health & Fitness Journal of Canada, Vol. 14 No. 3 (2021): Proceedings from the 8th International Society for Physical Activity and Health Congress

Purpose: This symposium will explore what we know and what we have yet to learn about physical activity policy monitoring, evaluation, and benchmarking. Description: Chair: Professor Guy Faulkner, University of British Columbia, Canada. The UN Sustainable Development Goals and the WHO Global Action Plan on Physical Activity highlight the need to move beyond individual behaviour change to broader policy and system approaches, focusing not only on health but also on sustainability. Despite initial progress the systematic evaluation, benchmarking and continuous monitoring of public policies to promote physical activity (PA) are in their infancy and remain a challenge both from an academic and a practical perspective. Using lessons from international research, this symposium will take a deep look at promising approaches in addressing the inactivity, obesity and climate challenges through policy solutions in a systematic way. Presenter 1: Professor Catherine Woods, University of Limerick, Ireland. Title: Examining what the scientific literature adds to our understanding of PA policy effectiveness. Description: This presentation will assess the contribution of existing scientific evidence from sport, education, transport and mass media to PA policy benchmarking and to informing policy-makers��� choice of appropriate policy instruments. Presenter 2: Dr. Peter Gelius, FAU Erlangen-Nuremberg, Germany. Title: The usefulness of existing tools for policy monitoring and evaluation. Description: This presentation will examine the usefulness of existing tools for monitoring national and cross-national PA policy, e.g. the WHO HEPA Policy Audit Tool (PAT) and the EU Monitoring Framework on HEPA across sectors. Presenter 3: Professor John C. Spence, University of Alberta, Canada. Title: Common Vision���: Canada���s PA plan and how it is to be evaluated. Description: This presentation will analyse the evaluation of national PA policy, using Canada as a case study. Results: Preliminary evidence from a review of reviews (Gelius et al., 2020) and a review of studies (Woods et al., 2021) indicates that evidence for the effectiveness of PA policy is rather solid in some areas (especially school-based and infrastructural policies) but remains insufficient in others (especially economic policies). Both the WHO HEPA PAT and the EU Monitoring Framework were found to be useful across several EU countries, and data suggests these tools can provide an overview of national policy, while also aiding in valid cross-country comparisons (Gelius et al., 2021). However, sufficient resources and adaptation to national contexts are essential. Experience from the Canadian ���Common Vision��� PA plan indicates that evaluation is necessary, achievable and does not have to be expensive. Conclusions: The Discussant, Mr. Matt Hermann, BC Ministry of Health, previously responsible for strategic leadership for PA, injury prevention, built environment, healthy communities and workplace with various levels of government will critique the evidence with respect to its usefulness to policy-makers. Further research is necessary to arrive at proper policy benchmarking; existing monitoring tools or bespoke frameworks - allowing for adaptation to national contexts - may serve as a basis for gathering information on policy implementation. They may also become an additional source of inspiration for countries wishing to undertake PA policy monitoring and evaluation., The Health & Fitness Journal of Canada, Vol. 14 No. 3 (2021): Proceedings from the 8th International Society for Physical Activity and Health Congress

Background: Mind Fit is an 8-week, group-based, physical activity and mental wellness program for adolescents experiencing mild-to-moderate symptoms of depression and/or anxiety in British Columbia, Canada offered by the YMCA of Greater Vancouver. Purpose: To conduct an outcome and process evaluation to assess the short-term and 3-month effects on targeted health outcomes and examine the facilitators and barriers related to program implementation. Methods: The sample consisted of 184 adolescents from 10 participating sites (64% female; mean age 15 years). Surveys were administered at baseline, post-program, and 3-months. Interviews were conducted with adolescents and staff post-program. Device-based measures of physical activity were collected at select local sites. Results: There were significant reductions in depression and anxiety from baseline to post-program and 3-month follow-up [PHQ-9 ( p=.001; d=.41), GAD-7 ( p=.000; d=.51) respectively]. Descriptive statistics demonstrated a greater reduction in PHQ-9 and GAD-7 scores at high-implementation sites. There was no self-reported increase in physical activity. Eighty interviews were conducted with adolescents and staff. Facilitators included: strong motivation and staff buy-in, uniqueness of Mind Fit in the community/organization, social connections among participants, supportive instructors, and comprehensive curriculum. Barriers included: available space and equipment, staff training, and adolescent recruitment. Conclusions: Findings demonstrate the effectiveness of community-based, early-interventions delivered ���at-scale��� to improve the mental health of teens. Identified facilitators and barriers of program implementation and success can be used to inform future development of similar interventions. Funding: YMCA of Greater Vancouver., The Health & Fitness Journal of Canada, Vol. 14 No. 3 (2021): Proceedings from the 8th International Society for Physical Activity and Health Congress

Background: The first English language authored textbook on exercise psychology was published 30 years ago (Biddle & Mutrie, 1991, Psychology of Physical Activity & Exercise). The publication of the 4th edition of the follow-up to this book in 2021 (Biddle, Mutrie, Gorely & Faulkner, 2021, Psychology of Physical Activity), allows for a 30-year retrospective view of changes in this field concerning physical activity behaviour change. Purpose: To review progress concerning research about physical activity behaviour change since the 1st edition and speculate on future developments. Results: Significant progress has been made concerning methodology and measurement for physical activity behaviour change, including standardised guidelines for intervention development. Research syntheses have enabled large volumes of intervention research to be summarised but global effect sizes remain modest and often unexplained. Progress has been ���weak-to-moderate��� for understanding behavioural maintenance or for use of long-term data; there is ���weak��� progress on moving from efficacy to effectiveness trials; ���good��� progress has been made involving research participants in intervention planning and design; and ���moderate-to-good��� progress is evident in the use of explanatory process evaluations. Conclusions: These trends reflect changes in our understanding across the 30 years of the textbook publication process and suggest future research directions for those interested in the field of physical activity for health, especially from a behavioural perspective., The Health & Fitness Journal of Canada, Vol. 14 No. 3 (2021): Proceedings from the 8th International Society for Physical Activity and Health Congress

Background: Depression is one of the most common and debilitating mental disorders and one of the top contributors to the burden of disability in Canada and around the world. Exercise has been recommended as a monotherapy for mild-moderate depression and adjunctive treatment for severe depression. However, access to supervised and structured exercise interventions for depression may not always be available. EHealth interventions may be effective in increasing physical activity among people with depression who cannot, or prefer not to, access supervised exercise treatment. Purpose: The purpose of this systematic review (PROSPERO 2020 CRD42020221713) is to evaluate the impact of eHealth interventions on increasing physical activity among adults with depression. Methods: Systematic literature searches for Randomized Controlled Trials (RCTs) and quasi-experimental studies were performed in nine electronic databases (e.g., Medline, PsycINFO) from inception to November 2020. Results: Four RCTs (440 participants) met the inclusion criteria. Three were web-based and one was app-based. All studies indicated that eHealth interventions are effective in decreasing depressive symptoms compared to waitlist group. Three studies showed medium to large effect sizes. However, we found inconsistent evidence of effectiveness in increasing physical activity behavior. Three studies showed increased physical activity in intervention groups but no significant difference between groups. Dropout rates were relatively low in intervention groups (0% - 21.9%). Conclusions: Physical activity eHealth interventions appear feasible in this population. Tailored eHealth interventions and well controlled studies are needed to assess the effectiveness and feasibility of using eHealth interventions to help people with depression increase physical activity. Funding: Four Year Doctoral Fellowship to Yiling Tang from the University of British Columbia, Canada, The Health & Fitness Journal of Canada, Vol. 14 No. 3 (2021): Proceedings from the 8th International Society for Physical Activity and Health Congress

Purpose: To outline the iKT process used to develop a multiple behaviour change intervention among post-secondary students using the 24-Hour Movement Guidelines. Methods: Data from focus groups examining barriers and facilitators to guideline implementation were deductively mapped to the Theoretical Domains Framework and Consolidated Framework for Implementation Research to capture individual and systems-level change required, respectively. Intervention mapping was conducted by linking salient domains to the Capability Opportunity Motivation-Behaviour (COM-B) model, which were subsequently mapped to intervention functions, behaviour change techniques, and modes of delivery using the Behaviour Change Wheel. Iterative consultations between students, campus stakeholders, and the iKT team allowed for refinement and tailoring of intervention components. Results: An evidence- and theory-informed multiple behaviour change intervention tailored for post-secondary students was created. The 6-week long intervention will be delivered through the ParticipACTION app and will be evaluated in a proof-of-concept study using subjective (COM-B) and device-based (Fitbit) measures, as well as a process evaluation. Conclusions: The use of an iKT approach with intervention mapping facilitated the development of an intervention that was evidence- and theory-informed and reflected the needs of participating stakeholders. Funding: Study is supported by the Public Health Agency of Canada (grant number 1920-HQ-000004) and the Canadian Society for Exercise Physiology., The Health & Fitness Journal of Canada, Vol. 14 No. 3 (2021): Proceedings from the 8th International Society for Physical Activity and Health Congress

Background: The first English language authored textbook on exercise psychology was published 30 years ago (Biddle & Mutrie, 1991, Psychology of Physical Activity & Exercise). With the publication of the 4th edition of the follow-up to this book in 2021 (Biddle, Mutrie, Gorely & Faulkner, 2021, Psychology of Physical Activity), it allows for a 30-year retrospective view of changes in this field. Purpose: To review progress concerning physical activity and mental health since the 1st edition and speculate on future developments. Results: Research has grown beyond typical mental outcomes (e.g., depression, self-esteem) with marked increase in cognitive functioning across the lifespan. With recognition of cognitive impairment as a transdiagnostic concern this research focus will expand. The use of large prospective studies is much more evident and this has increased the evidence base considerably. Bi-directional effects between the physical activity and mental health remain uncertain and should remain a research focus. While there is recognition of the multiple mechanisms for linking physical activity and mental health the evidence is somewhat speculative and repetitious. There has been limited progress over the past decade although the importance of definitively identifying mechanisms of action can be questioned. Given the mature evidence base for clinical populations (e.g., depression) a future focus must remain on moving from efficacy to effectiveness and real-world implementation. Conclusions: These trends reflect our changes in understanding across the 30 years of the textbook publication process and suggest future research directions for those interested in the field of physical activity for health., The Health & Fitness Journal of Canada, Vol. 14 No. 3 (2021): Proceedings from the 8th International Society for Physical Activity and Health Congress

Additional file 4..

Additional file 2..

Background: Outdoor risky play, such as climbing, racing, and independent exploration, is an important part of childhood and is associated with various positive physical, mental, and developmental outcomes for children. Parental attitudes and fears, particularly mothers’, are a major deterrent to children’s opportunities for outdoor risky play. Objective: The aim of this study was to evaluate the efficacy of 2 versions of an intervention to reframe mothers’ perceptions of risk and change parenting behaviors: a web-based intervention or an in-person workshop, compared with the control condition.

Additional file 3..

Supplemental material, sj-docx-2-sjp-10.1177_14034948211031392 for The epidemiology of muscle-strengthening activity among adolescents from 28 European countries by Jason A. Bennie, Guy Faulkner and Jordan J. Smith in Scandinavian Journal of Public Health

Supplemental material, sj-docx-1-sjp-10.1177_14034948211031392 for The epidemiology of muscle-strengthening activity among adolescents from 28 European countries by Jason A. Bennie, Guy Faulkner and Jordan J. Smith in Scandinavian Journal of Public Health

Background: In response to the COVID-19 pandemic, physical distancing measures have been implemented globally. Canadians have been instructed to stay at home, which has likely resulted in significant changes in their physical activity. Using data from a national physical activity tracking app (PAC app), we aimed to determine device-measured physical activity levels immediately prior to and following the implementation of physical distancing measures in Canada to provide evidence for the development of physical activity recommendations for future pandemics or second wave infections. Methods: Demographic and physical activity data were extracted from the ParticipACTION app (PAC app), using a 10-week (10 February to 19 April 2020) quasi-experimental design to determine changes in physical activity 4 weeks pre-pandemic and 6 weeks postpandemic declaration. Weekly physical activity levels were monitored through wearable fitness trackers and health apps linked to the PAC app, to record moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and steps. Repeated measure ANOVA was used to determine changes over time (mean ± SE). Findings: A total of 2,338 Canadians who were mostly 35–44 years old (26.6%) and female (90.2%) were included in the analysis. MVPA, LPA, and steps significantly declined immediately following the declaration of the pandemic (MVPA: pre-pandemic: 194.2 ± 5.2 min, post-pandemic: 176.7 ± 5.0 min, p < 0.001; LPA: pre-pandemic: 1,000.5 ± 17.0 min, post-pandemic: 874.1 ± 15.6 min, p < 0.001; steps: pre-pandemic: 48,625 ± 745 steps, post-pandemic: 43,395 ± 705 steps, p < 0.001). However, 6 weeks following pandemic declaration, MVPA (week 6: 204.4 ± 5.4 min, p = 0.498) had returned to pre-pandemic levels. LPA (week 6: 732.0 ± 14.3 min, p = < 0.001) and steps (week 6: 41,946 ± 763, p < 0.001) remained significantly lower than pre-pandemic levels at week 6. Interpretation: Although MVPA returned to pre-pandemic levels, significant and sustained declines in incidental LPA and steps were observed. Attenuating the loss of incidental physical activity should be a public health priority in response to future pandemics or a second wave of a COVID-19 infection, as it may have significant long-term implications for the physical and mental health of Canadians.

Supplemental material, sj-docx-2-sjp-10.1177_14034948211031392 for The epidemiology of muscle-strengthening activity among adolescents from 28 European countries by Jason A. Bennie, Guy Faulkner and Jordan J. Smith in Scandinavian Journal of Public Health

Additional file 1.

Objectives: Physical activity guidelines are evidence-based statements on recommended physical activity levels for good health. Guidelines, in isolation, are unlikely to increase population levels of physical activity; appropriate and effective communication is fundamental to maximising their impact. The aim of this paper is to provide a planning framework for physical activity guideline communication, including an overview of key audiences, aims and approaches.Methods: All authors considered and agreed on the three broad issues to address by consensus. We identified key sources of evidence through scoping of the literature and our knowledge of the research area. Results: Whether guidelines are global or national, communication of the physical activity guidelines should be informed by: (i) a situational analysis that considers the context in which the communication will take place; and (ii) a stakeholder analysis to determine the key target audiences for the communication and their values, needs, and preferences. Audiences include policymakers within and outside the health sector, other key stakeholders, the general public, specific population sub-groups, health professionals and non-health professionals with a role in physical activity promotion. The aims and approach to communication will differ depending on the target audience. Conclusion: Communication to raise awareness and knowledge of the physical activity guidelines must be supported by policies, environments and opportunities for physical activity. Besides the intrinsic value of the physical activity guidelines, it is essential that substantial effort is put into to diligently planning, funding and implementing their communication from the outset.

Additional file 1:. Complete children and youth movement and play behaviours survey items.

Additional file 4. Review #2 (docx.). Search Process for Family and Sedentary Behaviour Literature Review (review #2). Themes from the sedentary behaviour literature review (review #2). References for the papers included in the family and sedentary behaviour review (review #2), organized by theme.

Additional file 2. Table S1 (docx). Inclusion and exclusion criteria for systematic literature searches on family and the physical activity (review #1), sedentary (review #2), and sleep (review #3) behaviours of children and youth.

Additional file 6. Table S2 (doc.). Inclusion and exclusion criteria for systematic literature searches on family systems theory (review #4), parental correlates (review #5), and family interventions (review #6) for movement behaviours of children and youth.

Additional file 3. Review #1 (docx.). Search Process for Family and Physical Activity Literature Review (review #1). Themes from the physical activity literature review (review #1). References for the papers included in the family and physical activity review (review #1), organized by theme.

Additional file 1: STROBE Checklist.

Additional file 9:. Figure S1 (doc.). Search process of the Review of Reviews on Interventions Involving the Family to Change Child and Youth Physical Activity, Sedentary Behaviour, and Sleep (review #6).

Additional file 1 Survey (PDF file of on-line survey). Full survey questions used to solicit assessments and comments from stakeholders on the draft Consensus Statement.

Additional file 7. Review #4 (docx.). Search Process for the Family Systems in the Context of Child Health Behaviour Change and Family-Based Interventions Scoping Review (review #4). References extracted from the Family Systems in the Context of Child Health Behaviour Change Scoping Review (review #4).

Additional file 8. Review #5 (docx.). Search Process for the Correlates of Parental Support of Child and Youth Physical Activity, Sedentary Behaviour, and Sleep Systematic Review (review #5). References Extracted from the Correlates of Parental Support of Child and Youth Physical Activity, Sedentary Behaviour, and Sleep Systematic Review (review #5).

Additional file 2: Mobile Application Rating Scale (MARS) and self-score.

Additional file 3: Table 1. Inside and outside hobbies during COVID-19 virus outbreak. Table 2. New or returning family hobbies during the COVID-19 virus outbreak. Table 3. Use of online resources during the COVID-19 virus outbreak.

Additional file 2:. STROBE statement checklist of items for cross-sectional studies.

Additional file 5. Review #3 (docx.). Search Process for Family and Sleep Behaviour Literature Review (review #3). Themes from the sleep literature review (review #3). References for the papers included in the family and sleep review (review #3), organized by theme.

Background: Taking regular exercise, whether cardiovascular‐type exercise or resistance exercise, may help people to give up smoking, particularly by reducing cigarette withdrawal symptoms and cravings, and by helping to manage weight gain. Objectives: To determine the effectiveness of exercise‐based interventions alone, or combined with a smoking cessation programme, for achieving long‐term smoking cessation, compared with a smoking cessation intervention alone or other non‐exercise intervention. Search Methods: We searched the Cochrane Tobacco Addiction Group Specialised Register for studies, using the term 'exercise' or 'physical activity' in the title, abstract or keywords. The date of the most recent search was May 2019. Selection Criteria: We included randomised controlled trials that compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme alone or another non‐exercise control group. Trials were required to recruit smokers wishing to quit or recent quitters, to assess abstinence as an outcome and have follow‐up of at least six months. Data Collection and Analysis: We followed standard Cochrane methods. Smoking cessation was measured after at least six months, using the most rigorous definition available, on an intention‐to‐treat basis. We calculated risk ratios (RRs) and 95% confidence intervals (CIs) for smoking cessation for each study, where possible. We grouped eligible studies according to the type of comparison, as either smoking cessation or relapse prevention. We carried out meta‐analyses where appropriate, using Mantel‐Haenszel random‐effects models. Main Results: We identified 24 eligible trials with a total of 7279 adult participants randomised. Two studies focused on relapse prevention among smokers who had recently stopped smoking, and the remaining 22 studies were concerned with smoking cessation for smokers who wished to quit. Eleven studies were with women only and one with men only. Most studies recruited fairly inactive people. Most of the trials employed supervised, group‐based cardiovascular‐type exercise supplemented by a home‐based exercise programme and combined with a multi‐session cognitive behavioural smoking cessation programme. The comparator in most cases was a multi‐session cognitive behavioural smoking cessation programme alone. Overall, we judged two studies to be at low risk of bias, 11 at high risk of bias, and 11 at unclear risk of bias. Among the 21 studies analysed, we found low‐certainty evidence, limited by potential publication bias and by imprecision, comparing the effect of exercise plus smoking cessation support with smoking cessation support alone on smoking cessation outcomes (RR 1.08, 95% CI 0.96 to 1.22; I2 = 0%; 6607 participants). We excluded one study from this analysis as smoking abstinence rates for the study groups were not reported. There was no evidence of subgroup differences according to the type of exercise promoted; the subgroups considered were: cardiovascular‐type exercise alone (17 studies), resistance training alone (one study), combined cardiovascular‐type and resistance exercise (one study) and type of exercise not specified (two studies). The results were not significantly altered when we excluded trials with high risk of bias, or those with special populations, or those where smoking cessation intervention support was not matched between the intervention and control arms. Among the two relapse prevention studies, we found very low‐certainty evidence, limited by risk of bias and imprecision, that adding exercise to relapse prevention did not improve long‐term abstinence compared with relapse prevention alone (RR 0.98, 95% CI 0.65 to 1.47; I2 = 0%; 453 participants). Authors' Conclusions: There is no evidence that adding exercise to smoking cessation support improves abstinence compared with support alone, but the evidence is insufficient to assess whether there is a modest benefit. Estimates of treatment effect were of low or very low certainty, because of concerns about bias in the trials, imprecision and publication bias. Consequently, future trials may change these conclusions.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To determine the effects of pharmacological interventions for treating weight gain in people with schizophrenia.

Results from the complete case analyses. (DOCX 52 kb)

Additional file 4. Post-Summit Stakeholder Engagement Survey (Day 2)

Additional file 1. Pre-Meeting Survey (Day 1)

List of all of the variables included in the imputation model. (DOCX 22 kb)

Additional file 2: Measures of Health Behaviors

Additional file 3. Post-Workshop Stakeholder Engagement Survey (Day 1)