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In Australia, 45% of adults meet the aerobic recommendations, and only 9%−30% meet the resistance training guidelines. Given the lack of at-scale community-based interventions promoting resistance training, the aim of this study was to assess the impact of an innovative mHealth intervention on upper- and lower-body muscular fitness, cardiorespiratory fitness, physical activity, and social-cognitive mediators among a sample of community-dwelling adults. Researchers evaluated the community-based ecofit intervention using a cluster RCT from September 2019 to March 2022 in 2 regional municipalities of New South Wales, Australia. Researchers recruited a sample of 245 participants (72% female, aged 53.4±13.9 years) who were randomized to the ecofit intervention group (n =122) or waitlist control (n =123) group. The intervention group received access to a smartphone application with standardized workouts tailored to 12 outdoor gym locations and an introductory session. Participants were encouraged to perform at least 2 ecofit workouts per week. Primary and secondary outcomes were assessed at baseline, 3 months, and 9 months. The coprimary muscular fitness outcomes were evaluated using the 90-degree push-up and the 60-second sit-to-stand test. Intervention effects were estimated using linear mixed models accounting for group-level clustering (participants could enroll in groups of up to 4). Statistical analysis was conducted in April 2022. Statistically significant improvements were observed in upper (1.4 repetitions, 95% CI=0.3, 2.6, p =0.018) and lower (2.6 repetitions, 95% CI=0.4, 4.8, p =0.020) body muscular fitness at 9 months but not at 3 months. Increases in self-reported resistance training, resistance training self-efficacy, and implementation intention for resistance training were statistically significant at 3 and 9 months. This study has shown that a mHealth intervention promoting resistance training using the built environment can improve muscular fitness, physical activity behavior, and related cognitions in a community sample of adults. This trial was preregistered with the Australian and New Zealand Clinical Trial Registry (ACTRN12619000868189). [ABSTRACT FROM AUTHOR]

Supporting healthy ageing is a key priority worldwide. Physical activity, diet quality and sleep are all associated with health outcomes, but few studies have explored their independent associations with all-cause mortality in an older population in the same model. The study aim was to examine associations between step-count, self-reported diet quality, restless sleep, and all-cause mortality in adults aged 55–85 years. A prospective cohort study of adults in Newcastle, New South Wales, Australia. Data were from 1697 participants (49.3% women; baseline mean age 65.4 ± 7.1 years). Daily steps (measured by pedometer), diet quality (from a modified Australian Recommended Food Score), and frequency of restless sleep (by self-report) were assessed in relation to all-cause mortality using Cox proportional hazard regression with adjustment for sex, age, household income and smoking. Baseline data were collected between January 2005 and April 2008, and last follow-up was in March 2017 (median follow-up 9.6 years). Higher step count (HR: 0.93, 95%CI: 0.88–0.98 per 1000-step increment) and higher diet quality (HR: 0.86, 95%CI: 0.74–0.99 per 8-point increment in diet quality score) were associated with reduced mortality risk. Restless sleep for ≥3 nights/week was not associated with mortality risk (HR: 1.03, 95%CI: 0.78–1.39). Sensitivity analyses, adjusting for chronic disease and excluding deaths <1 year after baseline, did not change these estimates. Increased daily steps and consumption of a greater variety of nutrient-dense foods every week would result in substantial health benefits for older people. Future research should include a greater variety of sleep measures. [ABSTRACT FROM AUTHOR]

Objectives: While outdoor gyms are being rapidly installed around the globe, little is known about their implications on physical activity, and fitness and other health-related outcomes. The primary objective of this systematic review was to examine the effects of outdoor gyms on physical activity, fitness and other health-related outcomes. Secondary objectives were to describe outdoor gym characteristics, user characteristics, and outdoor gym usage.Design: Systematic review.Methods: Peer-reviewed papers published in English were obtained through online database searches of the following databases; EBSCO, SPORTdiscus, Medline, PsycINFO, Web of Science, Scopus and Informit. Searches covered the periods from database inception to January 2019. Studies that reported on the efficacy of outdoor gym use for physical activity, health-related outcomes or descriptive aspects of outdoor gyms and their users were eligible for inclusion.Results: There was some support that outdoor gyms may improve physical activity, fitness and other health-related outcomes, however few experimental studies have been conducted. There was no consistency between outdoor gyms in terms types and number of installed equipment for each facility. Further, this review found discrepancies of whom were the most likely users of outdoor gyms and when they were mainly used.Conclusions: This review contributes to the limited evidence on the impact and characteristics of outdoor gyms on physical activity and fitness and health-related outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Interventions that improve both physical activity and sleep quality may be more effective in improving overall health. The purpose of the Synergy Study is to test the efficacy of a mobile health combined behavior intervention targeting physical activity and sleep quality.Study Design: Randomized, waitlist-controlled trial.Setting/participants: This study had an app-based delivery mode, Australia-wide. The participants were 160 adults who reported insufficient physical activity and poor sleep quality in an eligibility survey.Intervention: The intervention was a mobile app providing educational resources, goal setting, self-monitoring, and feedback strategies. It included 12 weeks of personalized support including weekly reports, tool sheets, and prompts.Main Outcome Measures: Outcomes were assessed at baseline, 3 months (primary), and 6 months (secondary endpoint). Self-reported minutes of moderate-to-vigorous intensity physical activity and sleep quality were co-primary outcomes. Resistance training; sitting time; sleep hygiene; sleep timing variability; insomnia severity; daytime sleepiness; quality of life; and depression, anxiety, and stress symptoms were secondary outcomes. Data were collected between June 2017 and February 2018 and analyzed in August 2018.Results: At 3 months, between-group differences in moderate-to-vigorous intensity physical activity were not statistically significant (p=0.139). Significantly more participants in the intervention group engaged in ≥2 days/week (p=0.004) of resistance training. The intervention group reported better overall sleep quality (p=0.009), subjective sleep quality (p=0.017), sleep onset latency (p=0.013), waketime variability (p=0.018), sleep hygiene (p=0.027), insomnia severity (p=0.002), and lower stress symptoms (p=0.032) relative to waitlist controls. At 6 months, group differences were maintained for sleep hygiene (p=0.048), insomnia severity (p=0.002), and stress symptoms (p=0.006). Differences were observed for bedtime variability (p=0.023), sleepiness (p<0.001), daytime dysfunction (p=0.039), and anxiety symptoms (p=0.003) at 6 months, but not 3 months.Conclusions: This remotely delivered intervention did not produce statistically significant between-group differences in minutes of moderate-to-vigorous intensity physical activity. Significant short-term differences in resistance training and short- and medium-term differences in sleep health in favor of the intervention were observed.Trial Registration: This study is registered at anzctr.org.au ACTRN12617000376347. [ABSTRACT FROM AUTHOR]

Many adults without a diagnosed sleep disorder report poor sleep health, which is defined by dissatisfactory levels of sleep duration, sleep quality, or the timing of sleep. No previous review has summarized and described interventions targeting poor sleep health in this population. This meta-analysis aimed to quantify the efficacy of behavioral and cognitive sleep interventions in adults with poor sleep health, who do not have a sleep disorder. Electronic databases (Medline, Embase, PsycInfo, Cinahl) were searched with restrictions for age (18-64 y) and English language full-text, resulting in 18,009 records being screened and 592 full-texts being assessed. Eleven studies met inclusion criteria, seven of which reported a measure of overall sleep health (Pittsburgh sleep quality index [PSQI]). Following appraisal for risk of bias, extracted data were meta-analyzed using random-effects models. Meta-analyses showed interventions had a medium effect on sleep quality (Hedge's g = -0.54, [95% confidence interval (CI)] -0.90 to -0.19, p < 0.01). Baseline sleep health was the only significant effect moderator (p = 0.01). The most frequently used intervention components were stress management and relaxation practice, stimulus control, sleep hygiene, and exercise. Interventions targeting cognitive and behavioral self-regulation improve sleep quality in adults without clinical sleep disorder. [ABSTRACT FROM AUTHOR]

Objective: To determine the comparability and feasibility of wrist- and hip-worn accelerometers among free-living adolescents.Design: 89 adolescents (age=13-14years old) from eight secondary schools in New South Wales (NSW), Australia wore wrist-worn GENEActiv and hip-worn ActiGraph (GT3X+) accelerometers simultaneously for seven days and completed an accelerometry behavior questionnaire.Methods: Bivariate correlations between the wrist- and hip-worn out-put were used to determine concurrent validity. Paired samples t-test were used to compare minutes per day in moderate-to-vigorous physical activity (MVPA). Group means and paired sample t-tests were used to analyze participants' perceptions of the wrist- and hip-worn monitoring protocols to assist with determining the feasibility.Results: Wrist-worn accelerometry compared favorably with the hip-worn in average activity (r=0.88, p<0.001) and MVPA (r=0.84 p<0.001, mean difference=3.54min/day, SD=12.37). The wrist-worn accelerometer had 50% fewer non-valid days (75 days, 12%) than the hip-worn accelerometer (n=152, 24.4%). Participants reported they liked to wear the device on the wrist (p<0.01), and that it was less uncomfortable (p=0.02) and less embarrassing to wear on the wrist (p<0.01). Furthermore, that they would be more willing to wear the device again on the wrist over the hip (p<0.01).Conclusions: Our findings reveal there is a strong linear relationship between wrist- and hip-worn accelerometer out-put among adolescents in free-living conditions. Adolescent compliance was significantly higher with wrist placement, with participants reporting that it was more comfortable and less embarrassing to wear on the wrist. [ABSTRACT FROM AUTHOR]

Introduction The primary aim was to examine longitudinal associations between changes in screen-time and mental health outcomes among adolescents. Methods Adolescents (N = 322, 65.5% females, mean age = 14.4 ± 0.6 years) reported screen-time and mental health at two time points over a school year. Multi-level linear regression analyses were conducted after adjusting for covariates. Results Changes in total recreational screen-time ( β = −0.09 p = 0.048) and tablet/mobile phone use ( β = −0.18, p < 0.001) were negatively associated with physical self-concept. Changes in total recreational screen-time ( β = −0.20, p = 0.001) and computer use ( β = −0.23, p = 0.003) were negatively associated with psychological well-being. A positive association was found with television/DVD use and psychological difficulties ( β = 0.16, p = 0.015). No associations were found for non-recreational screen-time. Conclusion Changes in recreational screen-time were associated with changes in a range of mental health outcomes. [ABSTRACT FROM AUTHOR]

Few studies have investigated the impact of web-based physical activity interventions on mental health outcomes. Therefore, this study examined the impact of a web-based personally tailored physical activity intervention on depression, anxiety, stress and quality of life. 501 participants were randomised into either a control group or a pooled intervention condition who received a 3-month web-based personally tailored physical activity intervention. Previously, this intervention has demonstrated to improve self-reported physical activity, but not device-measured physical activity. At baseline, 3- and 9-months, depression, anxiety and stress were assessed using the DASS21, and quality of life was assessed using the SF-12V2. General linear mixed models examined differences between groups over time. Most participants (>80%) reported normal levels of depression, anxiety or stress. Relative to baseline levels, significant reductions of depression, anxiety, stress and the SF12 mental health component were observed in the pooled intervention group at 3 and 9 months. Relative to the control group, significant reductions were observed in the pooled intervention group for depression and stress (3-months only) and anxiety (3- and 9-months), but not quality of life. A web-based physical activity intervention can result in positive mental health outcomes, even in the absence of device-measured physical activity improvements. However, these findings need to be confirmed in future studies. ACTRN12615000057583. • The web-based intervention was able to improve depression, anxiety and stress. • The web-based physical activity intervention had little impact on quality of life. • Mental health outcomes improved even when device-measured physical activity did not. [ABSTRACT FROM AUTHOR]

Youth participation in organised sport and physical activity is important for healthy development, growth and wellbeing. In 2014, Active Healthy Kids Australia released its inaugural Report Card on Physical Activity for Children and Young People, which synthesised the best available national- and state-level data for children and young people (<18 years). This paper provides a more detailed examination of the evidence informing the grade for Organised Sport from the 2014 Report Card, compares Australia's Organised Sport grade with other countries, identifies future directions for research and surveillance, and explores possible beneficial strategies. The Report Card highlighted that between 64% and 85% of Australians aged 5-17 years participate in organised sports, a rate higher than alternate forms of physical activity such as active transportation, active play and school based physical activity. This finding reflects Australia's position as one of the global leaders for participating in organised sport. Future research and surveillance methodologies however, need to incorporate standardised metrics that aim to capture more detailed data regarding organised sport participation. Facilitating access for all children and preventing dropout from organised sports are important initiatives to improve current levels of sport participation. However, given that 80% of Australians aged 5-17 years are not sufficiently physically active to achieve the daily recommendation, participation in sport alone is not enough to ensure that children can accrue the health benefits associated with being physically active. As such, there is a pressing need to develop strategies that engage children in other forms of physical activity such as active transportation and active play. [ABSTRACT FROM AUTHOR]

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

Abstract: Objective: To evaluate the impact of a 12-month school-based multi-component program on adolescent girls’ physical activity and sedentary behaviors, and hypothesized mediators of physical activity behavior change. Design: Group randomized controlled trial with 12-month follow-up. Methods: The intervention, guided by Social Cognitive Theory, involved 357 adolescent girls (13.2±0.5 years) from 12 secondary schools (6 intervention schools, 6 control schools) in low-income communities in the Hunter and Central Coast regions of New South Wales, Australia. The intervention included enhanced school sport, lunchtime physical activity sessions, interactive seminars, student handbooks, nutrition workshops, pedometers, parent newsletters and text messages to encourage physical activity and healthy eating, and a decrease in sedentary behavior. Outcomes were assessed at baseline and 12-months and included: physical activity (accelerometers), sedentary behaviors (questionnaire and accelerometers), and social-cognitive mediators of physical activity (questionnaire). Results: There were significant between group differences in favor of the intervention group for self-reported recreational computer use (−26.0min; 95% CI, −46.9 to −5.1), and sedentary activities summed (−56.4min; 95% CI, −110.1 to −2.7), however objective sedentary behavior showed no differences. There were no group-by-time effects for any of the physical activity outcomes or hypothesized mediators. Conclusions: A school-based intervention tailored for adolescent girls from schools located in low-income communities significantly reduced time spent in sedentary activities. However, improvements in physical activity and hypothesized mediators of physical activity behavior were not observed. Future studies are encouraged to explore alternative mechanisms of behavior change derived from integrated and socio-ecological theories. [Copyright &y& Elsevier]

Abstract: Purpose: Evidence suggests sitting time is independently associated with a range of health issues in adults, yet the relationship between sedentary behavior and health indicators in young people is less clear. Age-related increases in sedentary behavior are well-documented; the behavioral patterns of adolescent girls are of particular concern. More than one third of adolescent girls’ sedentary behavior time is accumulated through use of recreational screen-based behaviors. The objective of this review was to investigate the association between recreational screen-based sedentary behavior and the physical, behavioral, and psychosocial health indicators for adolescent girls. A secondary objective was to identify studies that have adjusted sedentary behavior indicators for physical activity. Methods: A structured electronic search of all publication years (through December 2011) was conducted to identify studies in: CINAHL, Communications and Mass Media Complete, ERIC, MEDLINE with Full Text, PsycINFO, and SPORTDiscus with Full Text. Included publications were observational and interventional studies involving adolescent girls (12–18 years) that examined associations between screen-based, sedentary behavior and health indicators (physical, psychosocial, and/or behavioral). The search identified 33 studies that evaluated health indicators of screen-based sedentary behaviors among adolescent girls. Results: Strong evidence for a positive association between screen-based sedentary behavior and weight status was found. A positive association was observed between screen-time and sleep problems, musculoskeletal pain and depression. Negative associations were identified between screen time and physical activity/fitness, screen time and psychological well-being, and screen time and social support. The relationship between screen-based sedentary behavior and diet quality was inconclusive. Less than half of the studies adjusted sedentary behavior indicators for physical activity. Conclusions: Screen-based sedentary behavior is associated with a range of adverse health consequences, but additional longitudinal studies are needed to better understand the health impacts. In addition, screen-time guidelines for youth should be regularly revised and updated to reflect rapid technological changes. [Copyright &y& Elsevier]

Young adult cancer survivors (YACS) face unique challenges from their disease and treatments that may influence their sport participation choices as well as their psychosocial response. Objectives: To examine the prevalence, correlates, and psychosocial outcomes of sport participation in YACS. Design: A provincial, population-based mailed survey of 588 YACS in Alberta, Canada, was completed in May 2008 and included measures of sport participation, psychosocial health (depression, self-esteem, and stress), quality of life (QoL), and medical and demographic variables. Results: One third (32.5%) of YACS reported participating in a sport in the past month with the most common being golf (40.8%) and ice hockey (8.3%). YACS participating in sport reported an average frequency of 1.7 (SD = 1.0) days/week and an average duration of 119 min/session (SD = 68) for a total of 189 (SD = 164) min/week. Independent t-tests showed that YACS who participated in sport reported better psychosocial health and QoL including physical QoL (p < 0.001), mental QoL (p < 0.001), self-esteem (p < 0.001), depression (p < 0.001), and stress (p < 0.001). In multivariate regression analysis, 8.5% (p < 0.001) of the variance in sport participation was explained by being male (β = 0.17, p < 0.001), Caucasian (β = 0.15, p = 0.001), in better general health (β = 0.15, p < 0.001), and having a normal body mass index (β = −0.10, p = 0.024). Discussion/conclusions: Sport participation is associated with better psychosocial health and QoL in YACS but only a third participated in the past month. Randomized controlled trials examining sport as an intervention strategy to increase physical activity and improve health outcomes in YACS are warranted. [ABSTRACT FROM AUTHOR]

Abstract: Background: Adverse health effects of sedentary behaviour on cancer risk and health outcomes in cancer survivors have been reported but few studies have examined quality of life (QoL) and no study has focused on kidney cancer survivors (KCS). The purpose of this study was to estimate the prevalence of sitting time among KCS and to determine any associations with QoL. Methods: All 1985 KCS diagnosed between 1996 and 2010 identified through a Canadian provincial Registry were mailed a survey that consisted of the modified domain-specific sitting time questionnaire, the Godin Leisure Time Exercise Questionnaire and several Functional Assessment of Cancer Therapy (FACT) QoL scales. Standard demographic and medical variables were also reported. Results: Completed surveys were received from 540 KCS. The mean hours of sitting time were 8.0 ± 4.7 for a work-day and 6.5 ± 3.8 for a non-work day. After adjustment for key covariates, analyses of covariance indicated that the only significant relationship was an unexpected positive association between sitting time on a work day and emotional well-being (p = 0.019). Moreover, the only variable to moderate these associations was age, with younger KCS under age 60 showing the expected negative associations between sitting time and physical and functional aspects of QoL. Conclusion: KCS sit for a significant amount of time on work days and non-work days, however, there were few associations with QoL. Future observational studies and randomized controlled trials are warranted to examine sitting time and health outcomes among KCS. [Copyright &y& Elsevier]

Abstract: Background: There have been very limited long-term prospective studies examining social-cognitive models in the PA domain with large, representative population samples. Objective: The primary objective was to examine the Theory of Planned Behaviour''s (TPB) ability to explain PA behaviour in a randomly selected national sample of Canadian adults over a 15-year period. A secondary objective was to test the moderating effects of gender on TPB. Design: The study employed a longitudinal design. Methods: A cohort of 1427 randomly-selected adults reported TPB constructs and PA behaviour in 1988, and again in 2003. Structural equation modelling techniques were employed to test TPB. Results: The full model including both 1988 and 2003 TPB measures accounted for 29% and 21% of the variance in intention, and 9% and 22% of the variance in PA in 1988 and 2003, respectively. Gender moderated aspects of the TPB in the full model. The core predictive model (1988 TPB constructs predicting 2003 PA behaviour) explained 13% of the variance in 2003 PA behaviour. Conclusions: The TPB''s long-term ability to predict PA behaviour is modest. [Copyright &y& Elsevier]

Purpose: The objective of this investigation was to examine the mechanisms of physical activity and dietary behavior change in the Program X intervention. Methods: Program X involved a clustered randomized controlled design with six schools (N=124 participants, mean age=14.1±0.8 years) randomized to intervention or control conditions for the 6-month study period. Physical activity and fruit and vegetable consumption were assessed using pedometers and questionnaires, respectively. The theoretical framework of the intervention was assessed using structural equation modeling, mediation, and moderation analyses. Results: The model explained 56% of the variance in physical activity at 6-months, but did not represent a good fit to the data, χ2 =87.43, df =19, p < .001. The model explaining fruit and vegetable consumption explained 31% of the variance and provided a good fit to the data, χ2 =12.40, df =10, p =.259. None of the variables satisfied the criteria for mediation or moderation in the physical activity model, but gender moderated the effects of intervention on fruit and vegetable consumption. Conclusions: None of the hypothesized mediators were responsible for behavior change in the Program X intervention. Future studies should address the limitations of existing psychosocial scales and continue to explore the mechanisms of behavior change using model testing, mediation, and moderation analyses. [Copyright &y& Elsevier]

Abstract: Background: Stages of change are related to dietary fat consumption. Few studies have examined stage occupation within the context of purchasing low-fat foods. Objective: To determine the stage-prevalence of individuals for purchasing low-fat foods; identify the frequency of misclassification into action and maintenance (A/M) stages for purchasing for low-fat foods; and explain the demographic and cognitive-variable differences between pseudo (or false positive) A/M and true A/M individuals. Design: Data were collected using a self-administered questionnaire among English-speaking adults (n=1,001) who were randomly sampled by mail. Statistical analyses performed: Descriptive statistics were used to compare the characteristics of the stage groups. Groups were compared using χ2 tests and Student t test. Results: Of those who reported being in A/M stages, 32% were misclassified by the staging algorithm and were not true A/M low-fat food purchasers. Conclusions: Individuals who are in A/M stages for buying low-fat foods still purchase high-fat foods. Stage misclassification may be a persistent problem in studies of dietary change using the Transtheoretical Model. [Copyright &y& Elsevier]

Abstract: This study examined the prevalence, clustering, age trends, and gender differences of chronic-disease related risk factors among a large sample of adolescents (N = 4932) in Alberta, Canada. Approximately 43% of boys and 53% of girls displayed two or more risk factors. Age trends and gender differences were also observed. [Copyright &y& Elsevier]

Abstract: Background: It is well established that both aerobic physical activity (PA) and resistance training are essential in the treatment and management of type 2 diabetes (T2D), but few studies have examined the determinants of both modes of PA in the same sample. Purpose: The main objective was to investigate the utility of the Protection Motivation Theory (PMT) in predicting aerobic PA and resistance training in a population sample of T2D adults. Methods: A total of 244 individuals completed self-report PMT constructs of vulnerability, severity, fear, response efficacy, self-efficacy and intention, and a 3-month follow-up that assessed aerobic PA and resistance training. Results: PMT explained 19% (p <.001) and 20% (p <.001) of the variance respectively for aerobic PA and resistance training behaviour. Significant associations were found between self-efficacy (β =0.45, p <.001) and gender (β =0.15, p <.05) for aerobic PA, and self-efficacy (β =0.48, p <.001) and age (β =0.17, p <.05) for resistance training. PMT accounted for 43% (p <.001) and 56% (p <.001) of the variance respectively for aerobic PA and resistance training intentions. For aerobic PA, response efficacy (β =0.14, p <.05) and self-efficacy (β =0.59, p <.001) were significantly associated with intention, while response efficacy (β =0.23, p <.001), self-efficacy (β =0.64, p <.001) and age (β =0.10, p <.05) were significantly related with resistance training intention. Conclusions: None of the unique constructs of the PMT (i.e., perceived vulnerability, severity and fear) were significant with either aerobic and resistance training intention. These results may guide the development of effective PA interventions in people with T2D. [Copyright &y& Elsevier]

Abstract: Physical activity plays a key role in diabetes management, and in reducing the risk factors related to the development of co-morbid conditions. This study examined predictors of physical activity (Static Model) and activity change (Change Model) for individuals with type 1 (T1D) or type 2 diabetes (T2D) in a population sample of 1662 adults (510 type 1; 1152 type 2) using self-reported measures of co-morbidities, perceived difficulties in performing tasks of daily living (TDL), time since diagnosis, and selected demographic factors. Since the motivation for physical activity could be influenced by the initial diagnosis of diabetes, analyses were conducted separately for newly diagnosed individuals (diagnosed with diabetes ≤1 year), and those that have been diagnosed for sometime (diagnosed with diabetes >1 year). In the Static Model, a younger age (β =−.11, p <.05) and having less perceived difficulties in performing TDL (β =−.12, p <.05) were associated with a higher physical activity in individuals with type 1 diabetes. The presence of difficulties in TDL (β =−.08, p <.05) and co-morbidities (β =−.08, p <.05) were associated with physical activity participation in type 2 individuals diagnosed for >1 year, but not in newly diagnosed individuals. A shorter duration of disease (β =−.07, p <.05), a higher body mass index (BMI) (β =.09, p <.05) and female gender (β =.07, p <.05) was associated with physical activity increase in individuals with type 2 diabetes. A higher BMI predicted physical activity change in both newly diagnosed individuals and those diagnosed for sometime. However, both genders were equally likely to increase their physical activity among newly diagnosed individuals. Although the magnitude of the study results are relatively modest, they could potentially guide and encourage future investigations in this area that could lead to useful insights in designing PA intervention programs for these specific populations. [Copyright &y& Elsevier]

Abstract: Purpose: To test the Theory of Planned Behavior (TPB) in a large population sample of adolescents from Alberta, Canada. Methods: 4,073 adolescents completed a self-administered web-based survey related to physical activity (PA). Results: TPB explained 59% and 43% of the variance for intention and behavior, respectively. Moderating (by gender) and mediating tests were supported. Conclusions: TPB is useful for understanding PA in this population. [Copyright &y& Elsevier]

Objectives: Supporting healthy ageing is a key priority worldwide. Physical activity, diet quality and sleep are all associated with health outcomes, but few studies have explored their independent associations with all-cause mortality in an older population in the same model. The study aim was to examine associations between step-count, self-reported diet quality, restless sleep, and all-cause mortality in adults aged 55-85 years.Design: A prospective cohort study of adults in Newcastle, New South Wales, Australia.Method: Data were from 1697 participants (49.3% women; baseline mean age 65.4 ± 7.1 years). Daily steps (measured by pedometer), diet quality (from a modified Australian Recommended Food Score), and frequency of restless sleep (by self-report) were assessed in relation to all-cause mortality using Cox proportional hazard regression with adjustment for sex, age, household income and smoking. Baseline data were collected between January 2005 and April 2008, and last follow-up was in March 2017 (median follow-up 9.6 years).Results: Higher step count (HR: 0.93, 95%CI: 0.88-0.98 per 1000-step increment) and higher diet quality (HR: 0.86, 95%CI: 0.74-0.99 per 8-point increment in diet quality score) were associated with reduced mortality risk. Restless sleep for ≥3 nights/week was not associated with mortality risk (HR: 1.03, 95%CI: 0.78-1.39). Sensitivity analyses, adjusting for chronic disease and excluding deaths <1 year after baseline, did not change these estimates.Conclusions: Increased daily steps and consumption of a greater variety of nutrient-dense foods every week would result in substantial health benefits for older people. Future research should include a greater variety of sleep measures. [ABSTRACT FROM AUTHOR]

Abstract Introduction Poor sleep health is common and has a substantial negative health impact. Physical activity has been shown to improve sleep health. Many sleep interventions do not explicitly target physical activity, potentially limiting changes in activity and also sleep. Few intervention target those with poor sleep health but without a diagnosed disorder. This study aims to examine the efficacy of a combined physical activity and sleep intervention to improve sleep quality in middle-aged adults and its effect on physical activity, depression and quality of life. Methods A three-arm randomised trial with a three-month primary time-point, will be conducted. Adults (N = 275) aged 40–65 years, who report physical inactivity and poor sleep quality, will be randomly allocated to either a combined Physical Activity and Sleep Health, a Sleep Health-Only or a Wait List Control group. The multi-component m-health intervention will be delivered using a smartphone/tablet "app", supplemented with email and SMS. Participants will use the app to access educational material, set goals, self-monitor and receive feedback about behaviours. Assessments will be conducted at baseline, three-month primary time-point and six-month follow-up. Generalized linear models using an ANCOVA (baseline-adjusted) approach, will be used to identify between-group differences in sleep quality, following an intention-to-treat principle. Discussion This study will determine whether the addition of a physical activity intervention enhances the effectiveness of a sleep intervention to improve sleep quality, relative to a sleep-only intervention, in physically inactive middle-aged adults who report poor sleep health, but without a sleep disorder. [ABSTRACT FROM AUTHOR]

Summary: In a randomized controlled trial 145 sexually active overweight/obese men received either a male only SHED-IT (Self Help Exercise and Diet Using IT) weight loss program or a wait-list control. Erectile function (IIEF-5) was compared between men in the active intervention versus controls. IIEF-5 was assessed at baseline, 3 months (post-intervention) and 6 months (3-month follow-up). Intention-to-treat analysis revealed a significant intervention effect for erectile function (p =0.018) at 6 months (+1.4; 95% CI 0.3,2.4; d =0.32). A minimal contact, gender-tailored weight loss program significantly improved men's erectile function. Further studies evaluating change in erectile function with weight loss are warranted. [Copyright &y& Elsevier]

Objectives This study examined mediation effects of socio-ecological variables on accelerometer-determined physical activity among children in the Supporting Children's Outcomes using Rewards, Exercise and Skills (SCORES) intervention. Design Randomized control trial mediation analysis. Methods Primary school children were randomly assigned the SCORES multi-component intervention or control group for the 12-month study. The outcome was accelerometer derived total moderate-to-vigorous physical activity (MVPA). Hypothesized mediators measured in children were physical activity enjoyment and perceived sport competence and social support. Hypothesized mediators measured in parents were family social support, access to physical activity facilities and equipment at home, and perceived access to physical activity opportunities in the local community. Mediation analyses were conducted using multi-level linear analysis in MPlus. Results There were significant intervention effects for social support from teachers (A = 1.73, SE = 0.88, p = 0.048) and parental perceived access to physical opportunities in the local community (A = 2.69, SE = 1.12, p = 0.016). There were significant associations between changes in perceived sport competence (B = 0.48, SE = 0.36, p = 0.027), parental perceived access to physical activity opportunities in the local community (B = 0.60, SE = 0.26, p = 0.021), and changes in total MVPA. Parental perceived access to physical activity opportunities in the local community was found to have a significant mediating effect on total MVPA (AB = 1.61, 95% CI = 0.06 to 3.95, proportion 13%). Conclusions Parental perceived access to physical activity opportunities in the local community is a potential mechanism of behavior change for children and mediated the effect of the SCORES intervention on objectively measured physical activity. [ABSTRACT FROM AUTHOR]

Introduction Excessive recreational screen time (i.e., screen use for entertainment) is a global public health issue associated with adverse mental and physical health outcomes. Considering the growing popularity of screen-based recreation in adolescents, there is a need to identify effective strategies for reducing screen time among adolescents. The aim of this paper is to report the rationale and study protocol for the ‘Switch-off 4 Healthy Minds’ (S4HM) study, an intervention designed to reduce recreational screen time among adolescents. Methods The S4HM intervention will be evaluated using a cluster randomized controlled trial in eight secondary schools ( N = 322 students) in New South Wales, Australia. The 6-month multi-component intervention will encourage adolescents to manage their recreational screen time using a range of evidence-based strategies. The intervention is grounded in Self-Determination Theory (SDT) and includes the following components: an interactive seminar for students, eHealth messaging, behavioral contract and parental newsletters. All outcomes will be assessed at baseline and at 6-months (i.e., immediate post-test). The primary outcome is recreational screen time measured by the Adolescent Sedentary Activity Questionnaire (ASAQ). Secondary outcomes include: self-reported psychological well-being, psychological distress, global physical self-concept, resilience, pathological video gaming and aggression, and objectively measured physical activity (accelerometry) and body mass index (BMI). Hypothesized mediators of behavior change will also be explored. Discussion The S4HM study will involve the evaluation of an innovative, theory-driven, multi-component intervention that targets students and their parents and is designed to reduce recreational screen time in adolescents. The intervention has been designed for scalability and dissemination across Australian secondary schools. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: The negative consequences of unhealthy weight gain and the high likelihood of pediatric obesity tracking into adulthood highlight the importance of targeting youth who are ‘at risk’ of obesity. The aim of this paper is to report the rationale and study protocol for the ‘Active Teen Leaders Avoiding Screen-time’ (ATLAS) obesity prevention intervention for adolescent boys living in low-income communities. Methods/design: The ATLAS intervention will be evaluated using a cluster randomized controlled trial in 14 secondary schools in the state of New South Wales (NSW), Australia (2012 to 2014). ATLAS is an 8-month multi-component, school-based program informed by self-determination theory and social cognitive theory. The intervention consists of teacher professional development, enhanced school-sport sessions, researcher-led seminars, lunch-time physical activity mentoring sessions, pedometers for self-monitoring, provision of equipment to schools, parental newsletters, and a smartphone application and website. Assessments were conducted at baseline and will be completed again at 9- and 18-months from baseline. Primary outcomes are body mass index (BMI) and waist circumference. Secondary outcomes include BMI z-scores, body fat (bioelectrical impedance analysis), physical activity (accelerometers), muscular fitness (grip strength and push-ups), screen-time, sugar-sweetened beverage consumption, resistance training skill competency, daytime sleepiness, subjective well-being, physical self-perception, pathological video gaming, and aggression. Hypothesized mediators of behavior change will also be explored. Discussion: ATLAS is an innovative school-based intervention designed to improve the health behaviors and related outcomes of adolescent males in low-income communities. [Copyright &y& Elsevier]

Background: Obesity prevention among youth of low SES is a public health priority given the higher prevalence of youth obesity in this population subgroup. Purpose: To evaluate the 24-month impact of a school-based obesity prevention program among adolescent girls living in low-income communities. Design: The study was a school-based group RCT, the Nutrition and Enjoyable Activity for Teen Girls (NEAT Girls) intervention. Setting/participants: The study involved 12 secondary schools located in low-income communities in New South Wales, Australia. Participants were 357 adolescent girls (aged 13.2±0.5 years). Intervention: The 12-month multicomponent intervention was guided by social cognitive theory and involved strategies to promote physical activity, reduce sedentary behaviors, and improve dietary outcomes. Main outcome measures: The primary outcome was BMI, and secondary outcomes were BMI z-score; percentage body fat (bioelectrical impedance analysis); physical activity (accelerometers); dietary intake; and recreational screen-time (self-report). Data were collected in 2010–2012 and analyzed in 2012. Results: After 24 months, there were no intervention effects on BMI (adjusted mean difference −0.33, 95% CI= −0.97, 0.28, p=0.353) and BMI z-score (−0.12, 95% CI= −0.27, 0.04, p=0.178). However, there was a group-by-time interaction for percentage body fat (−1.96%, 95% CI= −3.02, −0.89, p=0.006). Intervention effects for physical activity, screen time, and dietary intake were not significant. Conclusions: The NEAT Girls intervention did not result in effects on the primary outcome. Further study of youth who are “at risk” of obesity should focus on strategies to improve retention and adherence in prevention programs. Trial registration: This study is registered at Australian New Zealand Clinical Trials ACTRN1261000033004. [ABSTRACT FROM AUTHOR]

Introduction: Appealing approaches to increasing physical activity levels are needed. This study evaluated whether a social and gamified smartphone app (Active Team) could be one such approach.Study Design: A 3-group cluster RCT compared the efficacy of Active Team with a basic self-monitoring app and waitlist control group.Setting/participants: Australian adults (N=444, mean age of 41 years, 74% female) were recruited in teams (n=121) and randomly assigned (1:1:1) to the Active Team (n=141, 39 teams), self-monitoring app (n=160, 42 teams), or waitlist group (n=143, 40 teams). Data were collected in 2016-2017, and analysis was conducted in 2018-2019.Intervention: Active Team is a 100-day app-based, gamified, online social networking physical activity intervention.Main Outcome Measures: The primary outcome was change in objective physical activity from baseline to 3-month follow-up. Secondary outcomes included objective physical activity at 9 months and self-reported physical activity, quality of life, depression, anxiety and stress, well-being, and engagement.Results: Mixed models indicated no significant differences in objective physical activity between groups at 3 (F=0.17, p=0.84; Cohen's d=0.03, 95% CI= -0.21, 0.26) or 9 months (F=0.23, p=0.92; d=0.06, 95% CI= -0.17, 0.29) and no significant differences for secondary outcomes of quality of life, depression, anxiety and stress, or well-being. Self-reported moderate-to-vigorous physical activity was significantly higher in the Active Team group at the 9-month follow-up (F=3.05, p=0.02; d=0.50, 95% CI=0.26, 0.73). Engagement was high; the Active Team group logged steps on an average of 72 (SD=35) days and used the social and gamified features an average of 89 (SD=118) times.Conclusions: A gamified, online social networking physical activity intervention did not change objective moderate-to-vigorous physical activity, though it did increase self-reported moderate-to-vigorous physical activity and achieve high levels of engagement. Future work is needed to understand if gamification, online social networks, and app-based approaches can be leveraged to achieve positive behavior change.Trial Registration: This study is registered at Australian and New Zealand Clinical Trial Registry (protocol: ANZCTR12617000113358). [ABSTRACT FROM AUTHOR]

Abstract Introduction Type 2 diabetes mellitus (T2DM) is a global public health concern. Aerobic physical activity (PA) and resistance training (RT) play significant roles in the prevention and management of T2DM. The aim of this pilot trial is to determine the preliminary efficacy and confirm feasibility of referral to exercise physiologists, psychologists, and provision of a technology-based behavior change support package to promote aerobic PA and RT in school teachers 'at risk' of or diagnosed with T2DM. Research design and methods The SMART (S upport, M otivation and P hysical A ctivity R esearch for T eachers') Health pilot study will be evaluated using a three-arm randomized controlled trial. The intervention will be guided by Social Cognitive Theory, Health Action Process Approach Model and Cognitive Behavioral Therapy strategies. The participants will be randomly allocated to one of three study groups: Group 1: wait-list control group; Group 2: 5 face-to-face visits with a psychologist and exercise specialist over 3 months; and Group 3: same as Group 2 plus technology-based behavior change support package for an additional 6 months. Assessments will be conducted at baseline, 3-, 9- (primary time-point) and 18-months post-baseline. The primary outcome will be PA measured with pedometers. Discussion SMART Health is an innovative, multi-component intervention, that integrates referral to exercise specialists, psychologists and provision of a technology-based behavior support package to promote PA and RT in adults diagnosed with T2DM or 'at risk' of T2DM. The findings will be used to guide future PA interventions and to develop effective community-based diabetes prevention and treatment programs. Trial Registration Australian New Zealand Clinical Trials Registry No: ACTRN12616001309471 [ABSTRACT FROM AUTHOR]

Introduction: Primary care physicians are well placed to offer physical activity counseling, but insufficient time is a barrier. Referral to an exercise specialist is an alternative. In Australia, exercise specialists are publicly funded to provide face-to-face counseling to patients who have an existing chronic illness. This trial aimed to (1) determine the efficacy of primary care physicians' referral of insufficiently active patients for counseling to increase physical activity, compared with usual care, and (2) compare the efficacy of face-to-face counseling with counseling predominantly via telephone.Study Design: Three-arm pragmatic RCT.Setting/participants: Two hundred three insufficiently active (<7,000 steps/day) primary care practice patients (mean age 57 years; 70% female) recruited in New South Wales, Australia, in 2011-2014.Intervention: (1) Five face-to-face counseling sessions by an exercise specialist, (2) one face-to-face counseling session followed by four telephone calls by an exercise specialist, or (3) a generic mailed physical activity brochure (usual care). The counseling sessions operationalized social cognitive theory via a behavior change counseling framework.Main Outcome Measures: Change in average daily step counts between baseline and 12 months. Data were analyzed in 2016.Results: Forty (20%) participants formally withdrew; completion rates at 3 and 6 months were 64% and 58%, respectively. Intervention attendance was high (75% received five sessions). The estimated mean difference between usual care and the combined intervention groups at 12 months was 1,002 steps/day (95% CI=244, 1,759, p=0.01). When comparing face-to-face with predominantly telephone counseling, the telephone group had a non-significant higher mean daily step count (by 619 steps) at 12 months.Conclusions: Provision of expert physical activity counseling to insufficiently active primary care patients resulted in a significant increase in physical activity (approximately 70 minutes of walking per week) at 12 months. Face-to-face only and counseling conducted predominantly via telephone were both effective. This trial provides evidence to expand public funding for expert physical activity counseling and for delivery via telephone in addition to face-to-face consultations.Trial Registration: This trial is registered at www.anzctr.org.au/ ACTRN12611000884909. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to identify how different patterns of physical activity, sleep duration and sleep quality cluster together, and to examine how the identified clusters differ in terms of socio-demographic and health characteristics.Study Design and Outcome Measures: Participants were adults from Brisbane, Australia, aged 42-72 years who reported their physical activity, sleep duration, sleep quality, socio-demographic and health characteristics in 2011 (n=5854). Two-step Cluster Analyses were used to identify clusters. Cluster differences in socio-demographic and health characteristics were examined using chi square tests (p<0.05).Results: Four clusters were identified: 'Poor Sleepers' (31.2%), 'Moderate Sleepers' (30.7%), 'Mixed Sleepers/Highly Active' (20.5%), and 'Excellent Sleepers/Mixed Activity' (17.6%). The 'Poor Sleepers' cluster had the highest proportion of participants with less-than-recommended sleep duration and poor sleep quality, had the poorest health characteristics and a high proportion of participants with low physical activity.Conclusion: Physical activity, sleep duration and sleep quality cluster together in distinct patterns and clusters of poor behaviours are associated with poor health status. Multiple health behaviour change interventions which target both physical activity and sleep should be prioritised to improve health outcomes in mid-aged adults. [ABSTRACT FROM AUTHOR]

Introduction The prevalence and risk of Type 2 Diabetes (T2D) has dramatically increased over the past decade. Physical activity (PA) has significant benefits for the treatment and prevention of T2D. The aim of this study is to develop, implement and evaluate a community-based PA intervention to improve aerobic and muscular fitness among adults at risk of, or diagnosed with T2D. Research design and methods The eCoFit pilot intervention will be evaluated using a randomized controlled trial (RCT) design. The 20-week (Phases 1 and 2) multi-component intervention was guided by Social Cognitive Theory, Health Action Process Approach Model, and Cognitive Behavior Therapy strategies. Phase 1 (Weeks 1–10) includes: i) 5 group face-to-face sessions consisting of outdoor training and cognitive mentoring; and ii) the use of the eCoFit smartphone application with a description of where and how to use the outdoor environment to be more physically active. Phase 2 (Weeks 11–20) includes the use of the eCoFit smartphone application only. Assessments are to be conducted at baseline, 10-weeks (primary end-point) and 20-weeks (secondary end-point) post-baseline. Primary outcomes are cardio-respiratory fitness and muscular fitness (lower body). Secondary outcomes include physical, behavioral, mental health and quality of life, and social–cognitive outcomes. Discussion eCoFit is an innovative, multi-component intervention, which integrates smartphone technology, social support and the outdoor physical environment to promote aerobic and resistance training PA among adults at risk of, or diagnosed with T2D. The findings will be used to guide future interventions and to develop and implement effective community-based prevention programs. Trial registration Australian New Zealand Clinical Trials Registry No: ACTRN12615000990527. [ABSTRACT FROM AUTHOR]

Introduction: Self-administered lifestyle interventions have been suggested as an alternative to face-to-face delivery modes, although their efficacy remains uncertain. The aim of this study was to evaluate the efficacy of the Type 2 diabetes mellitus Prevention Using LifeStyle Education (PULSE) Program, a self-administered and gender-tailored lifestyle intervention for men at high risk for developing Type 2 diabetes mellitus.Design/setting: A 6-month, assessor-blinded, parallel-group RCT was conducted at the University of Newcastle, Australia in 2012-2013.Participants: Men (aged 18-65 years, BMI 25-40 kg/m(2), high risk for developing Type 2 diabetes mellitus) were stratified by age (<50 and >50 years) and BMI category (25.0-29.9, 30.0-35.9, and 35.0-40 kg/m(2)) and individually randomized (1:1 ratio) to the intervention (n=53) or waitlist control groups (n=48).Intervention: The intervention group received the PULSE Program, which contained print and video resources on weight loss (Self-Help, Exercise and Diet using Internet Technology [SHED-IT] Weight Loss Program), diet modification, and exercise for Type 2 diabetes mellitus prevention. The waitlist control group received no information until 6 months.Main Outcome Measures: Data were collected from September 2012 to September 2013 and analyzed in 2014-2015. Linear mixed models (intention-to-treat) were used to determine group X time interactions (differences between groups in changes over time) at 6 months for the primary outcome (weight), glycated hemoglobin, and several secondary outcomes (significance level, p<0.05).Results: Differences between groups in mean changes from baseline to 6 months (group × time interaction) favored the intervention over control group for weight loss (-5.50 kg, 95% CI=-7.40 kg, -3.61 kg, p<0.001, Cohen's d=1.15), glycated hemoglobin (-0.2%, 95% CI=-0.3%, -0.1%, p=0.002, d=0.64), and BMI, waist circumference, body fat percentage, aerobic fitness, and lower body muscular fitness (all p<0.05). No group × time effects were observed for fasting plasma glucose, upper body muscular fitness, physical activity, or energy intake.Conclusions: The PULSE Program improved several Type 2 diabetes mellitus risk factors in men, including weight and glycated hemoglobin. These findings provide evidence for a self-administered and gender-tailored lifestyle intervention, which has potential for dissemination in community settings. [ABSTRACT FROM AUTHOR]

Aims The primary aim was to describe characteristics of men identified at high-risk for Type 2 diabetes mellitus (T2DM) using the Australian diabetes risk assessment (AUSDRISK) tool. Secondary aims were to determine the prevalence of pre-diabetes and metabolic syndrome in these men. Methods Men ( n = 209) completed the AUSDRISK tool, with 165 identified as high-risk for T2DM (score ≥ 12, maximum 38). Demographic, anthropometric, physiological and behavioural outcomes were assessed for 101 men. Comparisons (one-way ANOVA) among three AUSDRISK score groups (12–15, 16–19, ≥ 20) were performed (significance level, P < 0.05). Results Common risk factors (percentages) among high-risk men were waist circumference (> 90 cm; 93%), age (> 44 years; 79%), physical activity level (< 150 min wk −1 ; 59%), family history of diabetes (39%) and previously high blood glucose levels (32%). Men with AUSDRISK scores ≥ 20 had higher (mean ± SD) HbA 1C (6.0 ± 0.4% [42 ± 4.4 mmol.mol −1 ], P < 0.001), FPG (5.3 ± 0.6 mmol.L −1 , P = 0.001) and waist circumference (113.2 ± 9.8 cm, P = 0.026) than men with scores of 12–15. Mean FPG for the sample was 5.0 ± 0.6 mmol.L −1 , whereas mean HbA 1C was 5.8 ± 0.5% [40 ± 5.5 mmol.mol −1 ]. Pre-diabetes prevalence was 70% and metabolic syndrome prevalence was 62%. Conclusions The AUSDRISK tool identified men who were mostly older than 44, and had large waist circumferences and elevated HbA 1C . These findings provide evidence supporting the usefulness of the AUSDRISK screening tool for T2DM screening in clinical and research settings. [ABSTRACT FROM AUTHOR]

Background Intensive lifestyle interventions have been successful in reducing type 2 diabetes incidence. Whether intensive programmes requiring face-to-face contact, trained staff and access to facilities are feasible, on a larger scale, has been debated. Objectives The aim of this study is to determine the feasibility and efficacy of a lifestyle intervention for type 2 diabetes prevention in men using an assessor-blinded, parallel-group, randomised controlled trial. The ‘ Type 2 Diabetes PULSE ( Prevention Using LifeStyle Education ) Programme for Men ’ is a 6-month, self-administered, gender-tailored lifestyle intervention, with a multicomponent approach (weight loss, dietary modification, aerobic exercise and resistance training). Eligible men were aged 18–65 years, overweight/obese (BMI 25–40 kg·m − 2 ) and at high-risk for type 2 diabetes (score ≥ 12, Australian diabetes risk tool). Men with diagnosed prediabetes were eligible, but those with type 1 and 2 diabetes were ineligible. Randomisation was stratified by age (< 50 or ≥ 50 years) and BMI category (kg·m − 2 : 25–29.9; 30–34.9; 35–40) to the intervention or wait-list control group. Data are collected at study entry (baseline), 3 and 6 months. The primary outcome is weight change at 6 months. Secondary outcomes include: fasting plasma glucose, HbA 1C , waist circumference, body composition, blood pressure, diet quality, aerobic fitness, muscular fitness and physical activity. Generalised linear mixed models (intention-to-treat) will assess outcomes for treatment (intervention vs. control), time (baseline, 3 and 6-months) and the treatment-by-time interaction. Conclusion The results will determine the efficacy of a type 2 diabetes prevention programme for men with potential for wide reach and dissemination. Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN12612000721808). [ABSTRACT FROM AUTHOR]

Abstract: Despite short-term efficacy, many weight loss studies demonstrate poor long-term results and have difficulty recruiting men. Cost-effective treatments that help men achieve long-term weight loss are required. Using a two-phase, assessor-blinded, parallel-group randomised controlled trial design this study will test the effectiveness and cost-effectiveness of a male-only weight loss maintenance intervention. In Phase I (3months) 209 men received the SHED-IT Weight Loss Program. In Phase II (12months) 92 men who lost 4kg or more were randomised to either (i) a maintenance group who received the 6-month, gender-tailored SHED-IT Weight Loss Maintenance Program, which included no face-to-face contact (n=47), or (ii) a self-help control group (n=45). Randomisation was stratified by weight loss (4kg–7.4kg, ≥7.5kg) and BMI (<30kg/m2, ≥30kg/m2). Assessments occurred at 'study entry' (start of Phase I), 'baseline' (start of Phase II), '6 months' (post-test) and will occur at '12 months' (follow-up; primary endpoint). The primary outcome is weight change in Phase II (i.e. from 'baseline' at 12months after randomization). Secondary outcomes include waist circumference (umbilicus and narrowest), blood pressure, body composition, objectively measured physical activity, sedentary time, portion size, dietary intake, quality of life, depressive symptoms, and behavioural cognitions. Costing data will be collected for cost-effectiveness analysis. Generalised linear mixed models (intention-to-treat) will assess outcomes for treatment (maintenance vs. control), time (baseline, 6-month and 12-month) and the treatment-by-time interaction. This will be the first study to evaluate a male-only, gender-targeted weight loss maintenance program. Results will provide evidence regarding feasible and theoretically-driven obesity treatments for men with potential for long-term impact and widespread dissemination. Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN12612000749808). [Copyright &y& Elsevier]

Abstract: Objective: Patients on dialysis have low physical activity levels. The aim of the study was to examine the validity of action planning and coping planning within the theory of planned behaviour framework, for predicting physical activity behaviour of patients on haemodialysis. Design: This is a prospective study design. Methods: One hundred and forty-four patients who were undergoing haemodialysis were selected from dialysis centres. The mean age of the patients was 56.61 (SD =11.38) years. The patients completed a questionnaire including variables from the theory of planned behaviour, action planning and coping planning. Physical activity was prospectively assessed at 4-weeks with the validated International Physical Activity Questionnaire self-report measure. A hierarchical regression analysis was performed to examine the effects of action planning and coping planning on physical activity behaviour. Results: There was a main effect for coping planning but not for action planning. Moreover, the analyses resulted in a significant amount of incremental variance accounted for by the interaction of coping planning and intention. Conclusion: Results suggest the combination of high levels of coping planning and intention is associated with increases in physical activity. [Copyright &y& Elsevier]

Abstract: Objective: The objective of this study was to determine if differences existed in health-related quality of life (HRQoL) between individuals with prediabetes who are physically active (i.e., achieving ≥600METmin per week) compared to those who are inactive. Method: Individuals with prediabetes (N =232) residing in Northern Alberta, Canada completed a mailed questionnaire assessing self-reported PA, and health-related quality of life in August–September 2008. Results: Thirty-eight percent of individuals with prediabetes were meeting prediabetes PA guidelines. Covarying on age, gender, income, smoking and BMI, a significant multivariate analysis of covariance model [Wilks’λ =0.967, F(2,224)=3.791, p <.05] indicated those achieving PA guidelines reported higher Physical Health (Mean diff=2.7, p <.05, ES=.27) and Mental Health (Mean diff=3.0, p <.05, ES=.31) compared to those not achieving PA guidelines. Conclusion: These findings demonstrate people with prediabetes who achieve prediabetes PA guidelines have higher levels of physical and mental HRQoL than people who are inactive. Further, these results support the rationale for developing strategically designed PA programs for individuals with prediabetes. [ABSTRACT FROM AUTHOR]