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Early childhood is a key time for the development of physical activity behaviors and physical literacy. A growing proportion of children spend a significant portion of their daytime in early childhood education and care settings where an early childhood educator cares for them. This systematic review (PROSPERO CRD42018087249) aimed to identify the differences between effective and noneffective educator-led interventions with a goal to improve physical literacy and/or physical activity in children aged 3–5 years in early childhood education and care settings. Interventions were included if they aimed to improve at least 1 physical literacy component or physical activity time in children aged 2–6 years through educator training. MEDLINE, Embase, CINAHL, ERIC, Australian Education Index, and Sport Discus were searched in March 2018 and April 2021. Risk of bias was assessed through a modified Cochrane assessment tool. Data from 51 studies were analyzed in 2021 and 2022 and summarized narratively. Thirty-seven interventions aimed to promote physical activity, and 28 sought to promote physical literacy; 54% and 63% of these were effective, respectively. Interventions that were underpinned by theory, included ongoing support, or measured intervention fidelity were more effective, especially when all 3 were done. This review was limited by a high risk of bias and inconsistency in reporting results across interventions. Reporting physical activity by minutes per hour and reporting both sub and total scores in physical literacy assessments will allow for greater cross-comparison between trials. Future training of educators should be underpinned by theory and incorporate ongoing support and objective fidelity checks. [ABSTRACT FROM AUTHOR]

Background: Emerging adulthood is a stressful time fraught with new challenges while attending higher education. Identifying protective factors to help reduce the psychological burden that many will experience during this period is therefore important. This study aimed to identify whether emerging adults attending post-secondary education can be classified into distinct profiles based on their 24-h movement behaviors, evaluate correlates of profile membership, and examine relationships between profile membership and indicators of mental health.Methods: This cross-sectional study used data from Cycle 1 of the Canadian Campus Wellbeing Survey. Emerging adults (N = 15,080; 67.6 % female; mean age = 20.78 ± 2.00) from 20 post-secondary institutions in Canada self-reported their movement behaviors - moderate-to-vigorous physical activity (MVPA), recreational screen time (ST) and sleep - and completed measures of psychological distress and mental wellbeing. Latent profile analysis was employed.Results: Five profiles were identified: low ST with very high (12.6 %), high (24.4 %) and low MVPA (51.2 %) as well as high ST with high (2.3 %) and low MVPA (9.4 %). Profiles had similar sleep patterns and were thus characterized by differences in MVPA and ST. Several socio-demographic variables were associated with profile membership. Profiles characterized by healthier combinations of MVPA, ST and sleep generally reported more favorable scores for indicators of mental health.Limitations: Cross-sectional data limits causal inference, whereas self-reports may be biased.Conclusions: Campus-based interventions should focus on getting students to engage in a healthy balance of physical activity and recreational screen use as it has the potential to reduce the mental health burden on emerging adults attending post-secondary education. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2007.01.011 Byline: John A. Cunningham (a), Peter L. Selby (a), Guy Faulkner (b) Keywords: Smoking; Motivation; Autonomy; Harm reduction Abstract: Using a representative sample of 434 daily smokers, this study tested the immediate impact of providing 'safer smoking tips'. As was predicted, a randomized half of respondents who were asked about their knowledge of 'safer smoking tips' before being asked about their perceptions of choice about smoking rated their perceived choice as higher than respondents who were not asked the safer smoking tips first. However, the present study also provided evidence of the need for caution because hearing about safer smoking tips was associated with lower ratings of perceptions of health risks from smoking. Perceived choice has been identified as an important factor in change from negative health behaviors, and the implications and future directions of this research are discussed. Author Affiliation: (a) Centre for Addiction and Mental Health, University of Toronto, Canada (b) Faculty of Physical Education and Health, University of Toronto, Canada Article Note: (footnote) [star] An Investigator Award from the Ontario Tobacco Research Unit supported this study.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.addbeh.2005.10.002 Byline: John A. Cunningham (a), Guy Faulkner (b), Peter Selby (a), Joanne Cordingley (a) Keywords: Smoking; Motivation; Perceived choice; Brief intervention; Health information; Harm reduction Abstract: Explored the hypothesis that framing health information as safer smoking tips might motivate change in cigarette smokers. Daily smokers were randomly assigned to a control condition or to an intervention condition in which respondents were asked if they knew about a range of different safer smoking tips. Respondents (43 daily smokers, 18 years or older, 58% male) who received safer smoking tips reported a small reduction in the number of cigarettes smoked (p =.05) by the 3-month follow-up as compared to respondents in the control condition. This pilot result is encouraging but requires replication before considering the value of including safer smoking tips in health messages for smokers in the general population. Author Affiliation: (a) Centre for Addiction and Mental Health, University of Toronto, 33 Russell Street, Toronto, Ontario, Canada M5S 2S1 (b) Faculty of Physical Education and Health, University of Toronto, Canada

Objectives: Muscle-strengthening activity (MSE e.g. push-ups, sit-ups, use of weight machines) is linked to multiple health benefits for youth, and is part of the global physical activity guidelines for children and adolescents (5-17 years). However, MSE is rarely assessed in youth health surveillance. This study describes the longitudinal trends and predictors of MSE among a cohort of Canadian youths.Design: Longitudinal.Methods: Data were drawn from a cohort of 3366 youths who participated in three waves of COMPASS, a longitudinal study of secondary school students across Canada [Wave 1 (T1) 2015/16, Wave 2 (T2) 2016/17, Wave 3 (T3) 2018/19]. The prevalence of the sample meeting the MSE guideline (≥3 days/week) was calculated for each wave. A multivariable logistic regression assessed the odds of meeting the MSE guideline for each wave (T1 and T2 and T3) across sociodemographic/lifestyle characteristics (e.g. sex, race, regionally, Body Mass Index, and aerobic physical activity).Results: For the total sample, MSE guideline adherence significantly declined across each study wave (T1 = 57.0%; T2 = 52.0%; T3 = 48.5%; p < 0.001 for linear trend). Population sub-groups less likely to meet the guideline at each wave included females, youth who were underweight or obese, those reporting insufficient aerobic physical activity, those from large urban settings, and youth who identify as Asian.Conclusions: Among a large sample of Canadian youths, approximately half met the MSE guideline, with this prevalence declining over time. Large-scale MSE interventions are needed to address the low and decreasing adherence to this key modifiable health-related behavior among Canadian youths. [ABSTRACT FROM AUTHOR]

• Movement behaviours consisted of sleep, physical activity, and screen time. • Mental health measures included flourishing, resiliency, anxiety and depression. • Best day scenarios maximized sleep and physical activity while minimizing screen. • For transgender youth small difference in activity associated better mental health. • Screen use associated with less severe poor mental health in boys. [ABSTRACT FROM AUTHOR]

Physical activity (PA) may predict or mark successful treatment from major depressive disorder after repeated-transcranial magnetic stimulation (r-TMS). To explore if r-TMS treatment responders were more physically active than non-responders at baseline, and to determine if treatment responders increased PA compared to non-responders post-treatment. Thirty subjects were included in the study. PA was measured through Actical accelerometers. Baseline PA levels were compared through separate independent t-tests, whereas post-treatment changes were compared through separate ANCOVAs. There were no differences in PA at baseline between groups. Controlling for baseline PA levels, ANCOVAs identified a non-significant treatment effect between moderate-to-vigorous physical activity levels post-treatment between groups [ p = 0.276, η2 = 0.044]. A significant treatment effect was found between groups for light physical activity favouring responders [ p = 0.009, η2 = 0.226]. Responders' LPA significantly increased in comparison to non-responders receiving r-TMS for major depressive disorder. • Responders to treatment increased light physical activity. • Increases in light physical activity may be a marker of r-TMS treatment success. • Assessing physical activity during depression treatment is recommended. [ABSTRACT FROM AUTHOR]

A 2011 review of reviews reported small to moderate associations between physical activity (PA) and depression, anxiety and self-esteem among children and youth (aged 5–17 years). Due to the increase in reviews examining PA and mental health outcomes in children and youth over the past decade, we conducted an umbrella review to determine the current state of the literature, including whether effects were moderated by dose and type of PA, age, sex, or severity of mental illness. We systematically reviewed literature published from 2010 onwards from six online databases to identify and summarize findings from systematic reviews examining PA and depression, anxiety, and self-esteem outcomes in children and youth. We assessed review quality using the AMSTAR 2 critical appraisal tool. We identified 26 reviews examining depression (n = 16), anxiety (n = 2), and self-esteem (n = 14). Half of the eligible reviews were considered to be of low or critically low quality (n = 13). PA had positive mental health outcomes for children and youth, specifically for reduction in depression/depressive symptoms and improvements in physical self-concept, a self-esteem sub-domain. Little research has examined PA and anxiety. The moderator analyses reviewed revealed stronger effects in populations with clinical diagnoses (e.g. depression) and for interventions consisting of regular, supervised, group-based aerobic exercise. PA appears to be an effective intervention for reducing depression/depressive symptoms and improving physical self-perceptions, although additional high-quality research and moderator analyses are needed to determine what type of PA interventions may result in better mental health outcomes for children and youth. • We examined physical activity and mental health outcomes in children and youth. • We conducted an umbrella review to summarize the evidence from 2010 to 2017. • Included reviews examined depression (n = 16), anxiety (n = 2), and self-esteem (n = 14). • PA was associated with lower depression and improved physical self-concept in children and youth. • Half of the eligible reviews were considered to be of low or critically low quality. [ABSTRACT FROM AUTHOR]

There is substantive evidence for the importance of physical activity (PA) for people with mental illness (MI). Health care providers play an integral role in helping individuals with MI engage in PA, yet there are numerous factors that impede the promotion of PA within clinical practice. The purpose of this review was to identify and theoretically analyze the barriers and facilitators for health care providers in promoting PA to individuals with MI. A scoping review with systematic searches was conducted. Eligible studies required sample populations of health care providers working with individuals with MI that reported empirical data on barriers and/or facilitators to PA promotion using quantitative and/or qualitative methods. Barriers and facilitators were extracted and classified into the fourteen domains of the Theoretical Domains Framework (TDF). Thirty-three studies were included (15 quantitative, 12 qualitative, 6 mixed-methods), with a total of 231 factors extracted and coded to the TDF domains. Barriers and facilitators were most often classified under the domains of 'Beliefs about Consequences' and 'Environmental Context & Resources'. The most common barriers to PA promotion was a belief that clients could not overcome barriers to PA engagement, and a lack of training on how to promote PA to individuals with MI. Education and training that incorporates behaviour change techniques for health care providers are needed to address the identified barriers and to facilitate implementation of clinical guidelines into practice. Greater integration of PA promotion within mental health care will likely require broader systemic change. • This review examines factors influencing the promotion of physical activity (PA) by mental health care providers. • The most prominent factors are within the 'Beliefs about Consequences' and 'Environmental Context & Resources' domains. • Training is needed to equip practitioners with strategies and skills to help clients overcome barriers to increasing PA. • Integration of PA promotion within mental health care will require systemic change. [ABSTRACT FROM AUTHOR]

ABSTRACT Purpose Cross-sectional evidence suggests that school connectedness is an important correlate of health-related behaviors among adolescents, but prospective studies are needed to strengthen the case for a causal relationship. This study investigated the prospective relationship between school connectedness and four health-related behaviors: cigarette smoking, marijuana use, binge drinking, and physical activity. Methods We analyzed 4 years of data from the COMPASS study. Participants included in this analysis were 33,313 students who provided information on sociodemographic, school connectedness, and the four health-related behaviors for at least two consecutive years. Generalized Estimating Equation models were used to examine whether the change in school connectedness scores predicted the change in an individual child's trajectory of health-related behaviors across 9th, 10th, 11th, and 12th grades. Results As students moved to higher grades, school connectedness decreased, and the likelihood of being a less frequent smoker, marijuana user, and binge drinker, and meeting physical activity guidelines declined. An increase in school connectedness scores was associated with an increased likelihood of meeting physical activity recommendations (OR = 1.06, p <.01), being a less frequent smoker, marijuana user, and binge drinker (OR = 1.30, 1.17, 1.10, respectively; p 's <.0001) across the 4 years. Conclusions : This study provides prospective evidence supporting the protective effects of school connectedness on substance abuse and physical activity, and highlights the importance of fostering school connectedness to support healthy adolescent development. [ABSTRACT FROM AUTHOR]

Abstract Objective To examine the impact of a school-based physical activity intervention on adolescents' self-esteem and subjective well-being, and to explore moderators and mediators of intervention effects. Methods Resistance Training for Teens was evaluated using a cluster RCT in 16 schools located in New South Wales, Australia. Adolescents (N = 508; 14.1 ± 0.5 years; 49.6% female) completed measures of global self-esteem, subjective well-being, and hypothesized mediators (i.e., perceived fitness, resistance training self-efficacy, and autonomous motivation) at baseline (April–June, 2015) and post-intervention (October–December). The school-based physical activity program was delivered by teachers over 10-weeks via Physical Education, co-curricular school sport, or an elective subject known as Physical Activity and Sport Studies, and involved once-weekly fitness sessions and additional lunch-time sessions. Intervention effects and moderator analyses were tested using multi-level linear regression analyses with interaction terms. Multi-level mediation analyses were used to explore potential mediators of changes in well-being outcomes. Results Intervention effects for self-esteem (β = 0.05, p =.194) and wellbeing (β = 0.03, p =.509) were not statistically significant. Moderator analyses showed effects for self-esteem were greater for the overweight/obese subgroup (p =.069 for interaction), and resistance training self-efficacy was a significant mediator of changes in self-esteem (product-of-coefficients [AB] = 0.021, SE = 0.010, 95% CIs = 0.002 to 0.040). No other significant indirect effects were observed. Conclusion Overall, Resistance Training for Teens did not improve adolescents' self-esteem or subjective well-being. However, our mediation findings lend support to resistance training self-efficacy as a mechanism explaining the positive effect of resistance training on self-esteem. Highlights • School-based physical activity interventions can positively influence youth well-being. • No intervention effects were observed for self-esteem or subjective well-being. • Changes in resistance training self-efficacy mediated changes in self-esteem. [ABSTRACT FROM AUTHOR]

Background Exercise is now recommended as a treatment for depression in Canada. What remains less clear is how best to encourage exercise uptake by individuals with mood disorders. The purpose of this scoping review is to identify barriers and facilitators to exercise and physical activity participation among individuals with depression. Method A scoping review with systematic searches was conducted. Eligible studies required samples >50% diagnosed with depression or a mood disorder, and reported empirical data on barriers and/or facilitators to physical activity using quantitative and/or qualitative methods. Extracted barriers and facilitators were classified into the fourteen domains of the Theoretical Domains Framework (TDF). Results Thirteen studies were included (seven quantitative, six qualitative). The most common barriers were classified under the TDF domains of Emotion, Environmental Context & Resources, Beliefs about Capabilities, and Intentions. The most common facilitators were classified under the domains of Beliefs about Consequences, Social Influences, Emotion and Behavioural Regulation. Conclusions Most identified domains are all common determinants of health behaviours in various models and theories applied to physical activity participation. However, the Emotion domain appears to be particularly important to individuals with depression, and yet is not covered by these traditional theories of behaviour change, and may be overlooked when trying to promote physical activity among this population. Future research should investigate the effectiveness of behaviour change interventions that specifically target the Emotion domain, and clearly report the behaviour change techniques employed to do so. [ABSTRACT FROM AUTHOR]

Introduction Physical activity may hold promise as a potential smoking cessation tactic. Further, increasing activity levels in smokers may lead to additional physical and mental health benefits beyond smoking cessation. This study evaluated Run to Quit, a national initiative targeting smoking cessation through group-based running clinics. Methods Adult male and female smokers (N = 168) took part in running clinics in 21 locations across Canada. The program was investigated using a pre-post design. Participants completed questionnaires assessing physical activity, running, smoking, and other markers of health at weeks 1, 3, and 10 in the 10-week program as well as at 6-month follow up. Carbon monoxide (CO) testing at weeks 1 and 10 provided an objective indicator of smoking status and weekly coach logs were used to assess implementation. Results 50.8% of participants who completed the program achieved 7-day point prevalence (intent-to-treat = 19.6%), 90.8% reported reducing their smoking, and there was a significant decrease in CO ( p = 0.001). There was a significant increase in self-reported running frequency (times/week) and physical and mental health from baseline to end of program, p 's < 0.05. Results of the 6-month follow-up indicated that 19.6% of participants self-reported not smoking and 20.8% were still running regularly ( M = 3 times/week). Conclusions Although attrition was high and future program refinement is required, Run to Quit demonstrates potential as a multiple health behaviour change intervention that may improve both physical and mental health in individuals who smoke. [ABSTRACT FROM AUTHOR]

Through a range of hypothetical mechanisms physical activity may provide benefits in the prevention of substance use across the lifespan. The primary objective of this study was to evaluate the prospective association between physical activity and the initiation of current substance use among youth. The secondary objective examined if school connectedness mediated any prospective association. This longitudinal study included grade 9–12 students (n = 3244) with three years of linked data (2017–2020) from the COMPASS study. Multi-level logistic regressions were built to explore the association between changes in physical activity (meeting MVPA guidelines, outside of school sport participation, competitive school sport and non-competitive school sport) and the initiation of current substance use behaviours (cigarette, e-cigarettes, cannabis and binge drinking). Analyses examined if school connectedness mediated the association between physical activity and substance use. Results indicated that females who initiated 60 min of MVPA daily had greater than three times the odds of initiating current cigarette smoking (OR = 3.26 [1.45, 7.33]). Additionally, males who consistently participated in outside-of-school sport had greater than two times the odds of initiating current binge drinking (OR = 2.28 [1.43, 3.63]). Our mediation analysis demonstrated that sport participation may lower current e-cigarette and cannabis use through school connectedness. Overall, there was no evidence that physical activity confers broad, universal benefits in preventing substance use among Canadian youth. However, this is the first work to indicate that sport participation may provide a contextual experience that enhances school connectedness which in turn is associated with substance use prevention. • Physical activity was positively associated with the initiation of current cigarette and binge drinking. • Sport participation may lower substance use through school connectedness. • This work highlights a more central role for school connectedness in preventing substance use among youth. [ABSTRACT FROM AUTHOR]

Despite multiple potential physical and mental benefits of aerobic exercise, individuals with bipolar disorder (BD) report low engagement in aerobic exercise and decreased cardiorespiratory fitness (CRF). Given the scarcity of interventions that focus on aerobic exercise and CRF in BD, a novel behaviour change counselling (BCC) intervention was developed and conducted to increase aerobic exercise in youth with BD. The aim of this study was to elucidate participant feedback on the BCC intervention, using post-intervention consultation forums. Of 20 youth with BD who enrolled in the 24-week BCC intervention, 11 attended consultation forums after completing the study. Five parents also participated in separate parent consultation forums. Questions included asking about participants' overall experiences, helpful/unhelpful components, feedback on core and optional modules, and recommendations for future interventions. Forums were audiotaped and transcribed verbatim. Forums were analysed using both content and thematic analyses, with deductive and inductive qualitative approaches. For feasibility, themes of ' managing mood and/or psychiatric symptoms' , ' adapting life to include exercise' , and ' providing structured support through an intervention' were identified. For acceptability, we identified themes of ' awareness of the importance of exercise' , ' adaptable approach to changing needs and wants' , and ' improving clarity of available components and materials'. For impact, themes of ' exercise change is gradual and ongoing' , and ' attitudes and beliefs around exercise can change' were elucidated. Youth with BD and their parents reported experiencing subjective benefits following the BCC intervention. Several challenges and barriers were also noted that will require consideration for future exercise intervention designs. NCT03562520. • We developed a 24-week behaviour change counselling intervention to increase aerobic fitness in youth with bipolar disorder. • Eleven participants and five parents attended consultation forums to provide feedback on the intervention. • Qualitative methods were used to elucidate content and themes related to intervention feasibility, acceptability, and impact. • The benefits, challenges, and barriers reported by participants and parents provide consideration for future interventions. [ABSTRACT FROM AUTHOR]

The impact of COVID-19 on adolescent mental health is a global concern. Increased screen time and reduced physical activity due to the lockdown measures have been linked to detrimental mental health outcomes; however, the literature remains limited by cross-sectional and retrospective designs, and consideration of behaviours in isolation. Prospective evidence is necessary to examine whether moderate-to-vigorous physical activity (MVPA), sleep and screen time influenced changes in mental health. Analyses used data from a prospective cohort study of secondary school students in Canada with baseline data from the 2018–2019 school year and linked follow-up data from online surveys completed during the initial COVID-19 outbreak (May–July 2020). Multilevel linear regression models were used to evaluate the within- and between-person isotemporal substitution effects of sleep, MVPA and screen time behaviours on depression, anxiety, subjective well-being, and trait emotional dysregulation. Linked longitudinal data from 2645 students attending 44 schools were available. Between-person effects indicated that individuals who engaged in more MVPA and sleep while minimizing screen time had lower depression scores, less severe emotional dysregulation, and better subjective well-being. While controlling for between-person effects, within-person year-on-year change suggests those who increased screen time while decreasing either MVPA or sleep experienced mental health decline on all outcomes. MVPA and sleep were associated with youth mental health during the early COVID-19 lockdown. Increasing MVPA and sleep (or at least mitigating the increase of screen time) compared to the prior year was associated with better mental health during the early pandemic. A limitation to consider is that the screen time measure represents a combination of screen behaviours, and effects of replacing screen time may have varied if distinctions were made. • Individuals accruing more sleep or physical activity had better mental health status. • During COVID-19 school closures, those who maintained/improved habits faired best. • Sacrificing sleep/physical activity for screen time was related to negative health changes. [ABSTRACT FROM AUTHOR]

In addition to offering many physical health benefits, exercise may help improve mental health among individuals with schizophrenia through regulating affect. Therefore, the purpose of this study is to characterize affective responses experienced before, during and after a 10-min bout of exercise versus passive sitting among individuals with schizophrenia. A randomized crossover design compared affect related to feelings of pleasure and arousal at baseline, 6-min into the task, immediately post-task, and 10 min post-task to sitting. Thirty participants enroled in the study; 28 participants completed the study. Separate mixed model analyses of variance were conducted for pleasure and arousal, with test order as the between-subject factor, and time and task as within-subject factors. For pleasure, a significant main effect for time and a time x task interaction effect emerged. Post-hoc Bonferroni corrected t -tests ( α =.0125) revealed significant differences between pleasure at baseline and both immediately post-task and 10 min post-task. No other main effects or interactions emerged. Individuals with schizophrenia derive acute feelings of pleasure from exercise. Thus, exercise may provide a method of regulating affect to improve mental health. Future studies should examine the links between affective responses to health behaviours such as long-term adherence to exercise within this population. [ABSTRACT FROM AUTHOR]

We propose the core affect hypothesis that physical activity enhances valence and activation for people with depression symptoms but only valence for people with anxiety symptoms. In an exploratory study, affective valence and activation were assessed before and after a bout of exercise at a self-selected intensity in a small sample of inpatients. For most people with depressive disorders, affective valence (57%) and activation (55%) increased; whereas for people with anxiety disorders, half (50%) experienced an increase in affective valence, but only some (35%) experienced increased activation. Although exploratory and underpowered to test for statistically significant differences, these findings provide tentative support for more robust exploration into the core affect hypothesis. It may be that practitioners can enhance the impact of physical activity on depression or anxiety symptoms by applying the core affect hypothesis. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Physical activity (PA) counselling in primary care increases PA but is not consistently practiced. This study examined factors that optimise the delivery and impact of PA counselling. METHODS: A realist systematic review based on the PRECEDE-PROCEED model and RAMESES principles was conducted to identify essential components of PA counselling. MEDLINE, EMBASE, Cochrane Library, PsycINFO, and Physical Education Index were searched from 2000 to 2013 for studies that evaluated family practice PA counselling. RESULTS: Of 1546 articles identified, 10 were eligible for review (3 systematic reviews, 5 randomised controlled trials, 2 observational studies). Counselling provided by clinicians or counsellors alone that explored motivation increased self-reported PA at least 12 months following intervention. Multiple sessions may sustain increased PA beyond 12 months. CONCLUSION: Given the paucity of eligible studies and limited detail reported about interventions, further research is needed to establish the optimal design and delivery of PA counselling. Research and planning should consider predisposing, reinforcing and enabling design features identified in these studies. PRACTICE IMPLICATIONS: Since research shows that PA counselling promotes PA but is not widely practiced, primary care providers will require training and tools to operationalize PA counselling. [ABSTRACT FROM AUTHOR]

Physical activity has been shown to help individuals with schizophrenia improve their physical and mental health. Despite these benefits, individuals with schizophrenia are less active than those in the general population. This mixed-methods study explored the feasibility of a theory-driven exercise counseling intervention on the psychological mediators of physical activity behaviors and levels of moderate and vigorous physical activity in obese adults with schizophrenia. A reversible A-B-A single-case experimental design was used to evaluate the effect of exercise counseling before, during, and after the intervention. Post-study interviews evaluated the acceptability of the intervention. Four obese adults with schizophrenia participated in the two-month study. Exercise counseling proved feasible with three participants progressing to the next stage of change. Increases in self-efficacy and perceived benefits of exercise were reported throughout the intervention. Accelerometry indicated moderate and vigorous physical activity levels did not change for three participants and decreased significantly for one. This study helped show that exercise counseling may be an effective way of strengthening the determinants of physical activity. Future research will need to address strategies to increase moderate and vigorous physical activity using exercise counseling. [ABSTRACT FROM AUTHOR]

Background: Active transportation (AT; e.g., walking and cycling) is increasingly promoted to increase youth physical activity (PA). Most previous research focused solely on school trips, and associations among AT and cardiovascular risk factors have seldom been examined in adolescents. Purpose: To address these important research gaps using data from the nationally representative 2007–2009 Canadian Health Measures Survey. Methods: A total of 1,016 adolescents aged 12–19 years reported their weekly time spent utilitarian walking and cycling, and wore an Actical accelerometer for 7 days. They underwent a series of physical tests (measures of fitness, body composition, blood pressure, and blood sampling) following standardized protocols. In 2013, differences in PA and health-related outcomes across levels of walking and cycling were assessed with ANCOVA analyses adjusted for age, gender, parental education, and usual daily PA. Results: Greater walking and cycling time was associated with higher moderate-to-vigorous PA (MVPA). Compared to adolescents reporting walking 1–5 hours/week, those reporting <1 hour/week had lower waist circumference and total cholesterol/high-density lipoprotein (HDL) ratio and higher glycohemoglobin; those reporting >5 hours/week had better grip strength, lower total cholesterol, and total cholesterol/HDL ratio. Compared to adolescents reporting no cycling, those reporting ≥1 hour/week accumulated more light PA, had greater aerobic fitness, and lower BMI, waist circumference, and total cholesterol/HDL ratio; those who reported cycling <1 hour/week had lower total cholesterol. Conclusions: Utilitarian walking and cycling were associated with higher daily MVPA in youth. Cycling was associated with a more consistent pattern of health benefits than walking. [Copyright &y& Elsevier]

Abstract: Background: Existing research suggests consistent negative mental health associations (e.g., self-esteem) with sedentary behaviour (primarily screen viewing) among children. Sedentary behaviour has typically been measured using self-report or by objective measures of time spent sedentary. Objective: The objective of this study was to examine the association between self-esteem and patterns of objectively measured sedentary behaviour in terms of frequency of sedentary bouts and frequency of breaks in sedentary time. Methods: Participants were 787 boys and girls [mean age (standard deviation) = 11 years (0.6)] from 16 secondary schools in Toronto, Canada. Height, weight, physical activity and sedentary behaviour (accelerometers), global self-esteem and physical self-worth were assessed. Results: After adjusting for sex, age, weight status, parental socioeconomic status, physical activity, and accelerometer daily wear time, global self-esteem and physical self-worth were not associated with any of the sedentary behaviour outcomes. There was a significant positive association between physical self-worth and minutes spent in moderate to vigorous physical activity (MVPA; b = 1.514, p = 0.002). The association between global self-esteem and MVPA was not statistically significant. Conclusions: What children are actually doing when sedentary is likely more important in terms of associations with mental health outcomes like self-esteem. The development of objective measures of specific sedentary behaviours and the context that they occur in is likely needed to advance understanding of the relationship between sedentary behaviour and mental health. [Copyright &y& Elsevier]

Context: Given its high prevalence and impact on quality of life, more research is needed in identifying factors that may prevent depression. This review examined whether physical activity (PA) is protective against the onset of depression. Evidence acquisition: A comprehensive search was conducted up until December 2012 in the following databases: MEDLINE, Embase, PubMed, PsycINFO, SPORTDiscus, and Cochrane Database of Systematic Reviews. Data were analyzed between July 2012 and February 2013. Articles were chosen for the review if the study used a prospective-based, longitudinal design and examined relationships between PA and depression over at least two time intervals. A formal quality assessment for each study also was conducted independently by the two reviewers. Evidence synthesis: The initial search yielded a total of 6363 citations. After a thorough selection process, 30 studies were included for analyses. Among these, 25 studies demonstrated that baseline PA was negatively associated with a risk of subsequent depression. The majority of these studies were of high methodologic quality, providing consistent evidence that PA may prevent future depression. There is promising evidence that any level of PA, including low levels (e.g., walking <150 minutes/weeks), can prevent future depression. Conclusions: From a population health perspective, promoting PA may serve as a valuable mental health promotion strategy in reducing the risk of developing depression. [Copyright &y& Elsevier]

Bipolar disorder (BD) is associated with decreased cardiorespiratory fitness (CRF) and exercise. Despite the potential benefits for physical and mental health, there is a gap in knowledge regarding treatments targeting improved CRF for BD. This treatment development and feasibility study sought to bridge the knowledge-to-action gap in this area. Twenty youth with BD, 18.0 ± 2.3 years old, enrolled in an exercise behavior change counselling (BCC) intervention targeting improved CRF. The 12-week active intervention included four in-person sessions, augmented by phone/texting sessions on intervening weeks. Optional modules included exercise coaching, family involvement, and peer support. Booster phone/texting sessions occurred at weeks 16 and 20. Participants completed CRF testing at weeks 0, 2, 8, 12, and 24. Seventy percent of participants (14/20) completed all study visits and measures. In the overall enrolled sample, 82% of CRF tests were completed (range 0–5 of 5). There were no significant changes in subjective (via self-report) and objective (via Fitbit) measures of physical activity or in CRF, though CRF testing was consistently associated with acute post-exercise improvement in mood. Most participants reported being very satisfied with the intervention following the 12-week active intervention (13/14) and at week 24 (12/14). Therapist fidelity to the BCC manual was high. Good attendance and study adherence provides preliminary evidence of the feasibility and acceptability of a behavioral intervention targeting CRF in youth with BD. Future studies refining the current intervention are warranted toward a goal of demonstrating improved CRF in a randomized controlled trial. • A multidisciplinary team developed a behavior change intervention for increasing cardiorespiratory fitness in youth with BD. • Twenty youth with BD were recruited and 14 completed the full 24-week intervention. • Among participants retained to week 24, study measure completion rate and overall satisfaction were high. • There were no significant changes in cardiorespiratory fitness after the active 12-week intervention and week 24 follow-up. • Cardiorespiratory fitness testing was consistently associated with acute post-exercise improvement in mood. [ABSTRACT FROM AUTHOR]

Abstract: The aims of this study were to identity the prevalence of carpooling as a school travel mode in the Greater Toronto and Hamilton Area (GTHA) and to examine attitudes toward automobile school travel and carpooling among adults who drive their children to school. Telephone interviews were conducted with 1,001 GTHA parents/guardians of elementary school-aged children. Analyses indicated that 1.7% of the sample used carpooling as the primary school travel mode in the a.m., while 33.8% of the sample drove their child to school in the a.m. One quarter (25%) of the total sample had participated in a carpool for school travel with neighbors or friends at times. The main reasons for automobile school travel were convenience and safety. Those drivers who indicated carpooling to be more convenient reported carpooling to be more appealing, to interfere less with their current household schedule, were more interested in carpooling, placed a greater importance on using an environment-friendly travel mode, and had a greater proportion of non-English speakers than drivers who indicated carpooling to be inconvenient. These findings confirm that carpooling is an under-utilized school travel mode, and that there may be some scope in intervening among parents/guardians who perceive carpooling to be potentially convenient. [Copyright &y& Elsevier]

Abstract: This study sought to identify and describe comfortable and uncomfortable body-related situations of young women, as well as describe their responses to such situations and strategies they used to cope with body-related threats, using Social Self-Preservation Theory (SSPT) as a guiding framework. Interviews were conducted with college women (N =23). A theoretical thematic analysis approach was taken to identify, code, and report themes. In general, participants found it difficult to identify specific comfortable situations and responses in those situations. Comfortable situations were characterized by the presence of supportive others and feelings of general calmness and lowered body awareness or self-presentational concerns. Findings regarding uncomfortable body-related situations indicated that the context (e.g., presence of others, body exposure), responses (e.g., embarrassment, inadequacy, awareness of others’ evaluations, faster heart rate), and coping strategies (e.g., avoidance, concealing behaviors) described by participants were consistent with SSPT. [Copyright &y& Elsevier]

Abstract: Objectives: The present pilot study examined the acute effects of exercise on cravings, mood and affect in 14 persons with severe mental illness (SMI) who were receiving smoking cessation treatment. Method: A randomized, within-subject design was used with three components: screening, 10-min passive sitting, and 10-min brisk walking. Measures of cravings, mood and affect were completed during the two testing sessions at pre-condition, mid-condition, 0-, 10- and 20-min post-condition. Results: Majority of participants were female, and diagnosed with concurrent types of SMI. All participants reported using nicotine replacement therapy (NRT). Results from the ANCOVA indicated significant effects of the intervention on affect, with participants reporting feeling more pleasant during the brisk walking condition than the passive sitting condition. A significant main effect for time was also found for the activation component of affect, with participants reporting slightly greater activation immediately following (0-min post) the two conditions than 20-min post-condition. No significant effects were found for cravings or mood. Conclusions: These findings demonstrate that short bouts of exercise can provide immediate benefit for individuals with SMI in terms of positive affective changes. Such bouts have minimal impact on cigarette cravings and withdrawal symptoms among individuals already receiving smoking cessation treatment. In terms of craving and mood disturbance, future research should examine if and how exercise can provide complementary assistance for quitters receiving NRT. [Copyright &y& Elsevier]

Abstract: Despite the benefits of physical activity for youth with cystic fibrosis (CF) and congenital heart disease (CHD), most are insufficiently active. More information is required on how to facilitate physical activity in these populations. Although there are no studies that provide information about participation in CF and CHD youth from the perspective of parents, the involvement of caregivers may be an important facilitator to physical activity in youth with chronic diseases. Objective: This qualitative study explored how the parents of youth with CF and CHD experience physical activity, and parents commented on both their own and their child’s physical activity. Methods: Twenty-nine parents from a CHD and CF clinic participated in a semi-structured interview, and a thematic analysis of the transcribed data was undertaken. Results: Parents discussed the numerous benefits and barriers associated with physical activity for both child and self. Role modeling was a critical social process to overcoming barriers. Parents experiences were situated within the broader family context characterized by a prevailing sense of stress and complexity. Conclusion: By illustrating how the parents of youth with CF and CHD understand the role of physical activity in their and their child’s life, this study provides valuable information regarding the development of interventions to increase physical activity among children with CF and CHD. [Copyright &y& Elsevier]

Abstract: Background: A number of websites on the Internet promote health-enhancing behaviors among people with spinal cord injury (SCI). However, the information available is of unknown accuracy and quality. Objective: To examine the accuracy, quality, and targeting strategies used in online physical activity (PA) information aimed at people with SCI. Methods: A purposive sample of 30 frequently accessed websites for individuals with SCI that included PA information was examined. Websites were evaluated based on their descriptive characteristics, level of accuracy in relation to newly defined PA recommendations for people with SCI, technical and theoretical quality (i.e., use of behavioral theories) characteristics, and targeting strategies to promote PA among people with SCI. Descriptive statistics were utilized to illustrate the results of the evaluation. Results: PA information was easily accessible, as rated by the number of clicks required to access information. Only 6 websites (20%) provided specific PA recommendations and these websites exhibited low accuracy. Technically, websites were of high quality with a mean score of 4.1 of a possible 6 points. In contrast, websites had a low level of theoretical quality, with 23 of the 30 websites (77%) scoring below 9 of a possible 14 points (i.e., 64% of a perfect score) for theoretical content. A majority of websites evaluated did not use cognitive (e.g., self-efficacy, self-talk, and perceived social norms) and behavioral (e.g., self-monitoring, motivational readiness, and realistic goal-setting) strategies in their messages. A majority (80%) of the evaluated websites customized information for persons with different injury levels and completeness. Less than half of the websites evaluated tailored PA information toward people at different stages of their injury rehabilitation (37%) or for their caregivers (30%). Conclusion: Accuracy and theoretical quality of PA information presented to people with SCI on the Internet may not be optimal. Websites should be improved to incorporate accepted PA recommendations and behavioral theory to better deliver health messages about PA. [Copyright &y& Elsevier]

Background: Children with complex heart defects are sedentary, with activity level unrelated to exercise capacity. We sought to identify factors associated with physical activity level for children who have the Fontan procedure. Methods: We used a cross-sectional study, 64 children (25 female, 5-11 years) after Fontan. Measurements were weekly minutes of moderate-to-vigorous physical activity, cardiac status, resting/exercise cardiopulmonary capacity, gross motor skill, health-related endurance/strength/body composition, and parent/child activity perceptions. Results: Participants performed 361 ± 137 minutes per week of moderate-to-vigorous physical activity. Increased activity related to antithrombotic medication use (86 min/wk), lower resting heart rate (3 min/wk), higher weekday outdoor time (0.7 minutes per outside minute), lower family income (13 minutes per $10,000), and higher parent rating of child''s activity relative to peers (36 min/wk). Factors related to decreased activity were winter season (−84 min/wk), history of arrhythmia (−96 min/wk), and greater child confidence in own ability to be active (−113 min/wk). Conclusions: Physical activity after the Fontan procedure is primarily associated with factors unrelated to cardiac status. Interventions that impact these modifiable factors would be expected to enable these children to achieve the recommended activity levels associated with optimal health. [Copyright &y& Elsevier]

Objective: The aim of this study was to investigate the potential role of exercise in smoking cessation in women with severe mental illness (SMI). Methods: Semistructured interviews with 12 women diagnosed with SMI receiving smoking cessation treatment were conducted. Results: Participants perceived three roles for exercise in assisting smoking cessation—addressing fears with preexisting chronic health conditions, emotion management and distraction, and weight management. Most participants identified health care providers (HCPs) as needing to play a supportive role in integrating exercise into smoking cessation attempts. Conclusion: Findings support a potential role for exercise in facilitating smoking cessation among women with SMI. Practice Implications: HCPs should consider developing referral links with exercise specialists to facilitate smoking cessation in women with SMI. [Copyright &y& Elsevier]

Purpose: South Asians experience high rates of cardiovascular disease, yet participate in cardiac rehabilitation (CR) at low rates. Drawing on the Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model, this qualitative descriptive study sought to identify cultural factors facilitating South Asians'' participation in CR programs. Methods: Two semistructured interviews were conducted with each of 16 Canadian South Asian participants enrolled in a 12-month CR program. Transcribed data were analyzed for common themes, and categorized in terms of predisposing, enabling, and reinforcing factors. Results: Primary cultural facilitators included descriptions of CR as a “medically supervised” program, family and physician support, and previous knowledge of CR via members of the South Asian community. Conclusion: Previous research identified barriers to CR participation in the South Asian community, and this study is the first to identify facilitators. Results suggest that families should be included in patient-education sessions, CR should be reinforced by healthcare providers, and the provider team should recognize cultural preferences. [Copyright &y& Elsevier]

Abstract: Smoking cessation success rates are generally dismal amongst self-quitters, with a discrepancy apparent among sexes with women having lower cessation rates than men (). The Getting Physical on Cigarettes project aims to be the first clinical trial to appropriately evaluate the effectiveness of home-based lifestyle exercise maintenance program in assisting women to prevent smoking relapse and maintain exercise and weight following the termination of a structured and supervised exercise and nicotine replacement therapy (NRT) smoking cessation intervention. This paper outlines the rationale and methods of the trial—a supervised exercise and NRT program lasting 14 weeks, which is followed by a home-based exercise maintenance program. Sedentary female smokers will be randomized into one of four research arms: Exercise Maintenance; Exercise Maintenance+Relapse Prevention Booklets; Relapse Prevention Booklets+Contact; Contact Control. The Exercise Maintenance groups will be counseled on maintaining exercise in their home environment, while the other groups will be counseled on health issues not involving exercise or smoking. The “Forever Free” booklet series () will be distributed to participants in the Relapse Prevention groups. The primary outcome measure is continuous smoking abstinence. Secondary outcomes are exercise behaviour, and selected physiological and psychological variables. Results will assist researchers and health professionals develop and implement similar treatment interventions that are grounded in behaviour change theory. [Copyright &y& Elsevier]

Abstract: Purpose: The aim of this study was to compare patterns of PA and its potential correlates in individuals with BD to the general population using a representative sample of Canadians. Methods: We used data from the 2002 Canadian Community Health Survey 1.2, a national, cross-sectional survey focusing on mental health and addiction (n = 36,984). We compared PA levels among individuals with BD (n = 831) to those diagnosed with major depression (n = 4713) and those with no identified mood disorder (n = 31,834). Using multivariable logistic regression, we then compared independent effects of sociodemographic and clinical factors in active and inactive BD individuals stratified by relative weight status. Results: There were no differences in the proportion of individuals characterized as active, moderately active or inactive among individuals with BD, major depressive disorder or the general population. No sociodemographic or clinical variables were related to PA in individuals with BD, and the relationships between these variables and PA level were not different than those observed in the general population. BD status was independently associated with being overweight (OR = 1.26, p = 0.03). An interaction between BD status and PA was also observed (OR = 1.12, p = 0.005), suggesting a reduced role for PA in reducing the risk of being overweight in person with BD. Conclusions: The results suggest that levels of self-reported PA are not lower among people with BD living in the community than in the general population. Future research should assess levels of PA using objective measures and determine whether PA improves psychosocial outcomes in this population. [Copyright &y& Elsevier]