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Doping is considered a critical deviant behavior in competitive sports, and particularly in cycling, even though the phenomenon remains limited in sports in general. Previous qualitative studies have contributed to identify situations of vulnerability to doping in athletes. However, much of the research tends to focus on singular dimensions of vulnerability, such as physical or psychological aspects. The present study aimed to extend existing knowledge by concurrently exploring and attempting to categorize different types of situations of vulnerability that predispose elite cyclists to engage in doping. Ten high-level French-speaking doped cyclists were recruited (Mage = 49; SD = 14.63, two women). Semi-structured interviews were conducted. Both deductive and inductive thematic analyses were performed. Our results highlighted four types of vulnerability situations: (a) psychological (e.g., negative affects, maladaptive motivation, depression), (b) physical (e.g., exhaustion, impairments, injuries), (c) relational (e.g., organized doping, control, psychological or sexual harassment, social approval of doping), and (d) contextual (e.g., cycling culture, weather conditions, competitive stakes). By providing a clearer categorization of the situations of vulnerability that converge toward doping in sport, this comprehensive study allows for a holistic understanding of the various vulnerabilities. It paves the way for future research on related vulnerabilities and dispositional factors. Practically, it should also improve doping screening and prevention, and provide more favorable conditions for athletes.

BackgroundCystic fibrosis (CF) is a genetic disease affecting the respiratory and digestive systems, with recent treatment advances improving life expectancy. However, many people with CF lack adequate physical activity (PA). PA can enhance lung function and quality of life, but barriers exist. The Cystic Fibrosis Decisional Balance of Physical Activity questionnaire assesses the decisional balance for PA in adults with CF, but it is not optimal for clinical use. A digital app might overcome this limitation by improving the efficiency of administration, interpretation of results, and communication between patients and health care professionals. ObjectiveThis paper presents the development process and reports on the acceptability of a web app designed to measure and monitor the decisional balance for PA in people with CF. MethodsThis study comprised two stages: (1) the co-design of a digital app and (2) the evaluation of its acceptability among health care professionals and people with CF. A participatory approach engaged stakeholders in the app’s creation. The app’s acceptability, based on factors outlined in the Unified Theory of Acceptance and Use of Technology 2, is vital for its successful adoption. Participants volunteered, gave informed consent, and were aged >18 years and fluent in French. Data collection was performed through qualitative interviews, video presentations, surveys, and individual semistructured interviews, followed by quantitative and qualitative data analyses. ResultsIn total, 11 health care professionals, 6 people with CF, and 5 researchers were involved in the co-design phase. Results of this phase led to the coconstruction of an app named MUCO_BALAD, designed for people with CF aged ≥18 years, health care professionals, and researchers to monitor the decisional balance for PA in people with CF. In the acceptability evaluation phase, the sample included 47 health care professionals, 44 people with CF, and 12 researchers. The analysis revealed that the acceptability measures were positive and that app acceptability did not differ according to user types. Semistructured interviews helped identify positive and negative perceptions of the app and the interface, as well as missing functionalities. ConclusionsThis study assessed the acceptability of an app and demonstrated promising qualitative and quantitative results. The digital tool for measuring the decisional balance in PA for people with CF is encouraging for health care professionals, people with CF, and researchers, according to the valuable insights gained from this study.

IntroductionHamstring strain injuries (HSIs) remain one of the most burdensome injuries in soccer. Current recommendations to prevent sports injuries suggest the importance for coaches and medical staff to consider psychological and contextual risk factors and to specify them according to the injury type and context. HSI risk factors in soccer have been widely investigated, mainly from physiological and biomechanical perspectives. However, psychological and health-related risk factors are still unexplored. Therefore, the objective of this study was to determine the psychological and health-related risk factors for a first HSI in male competitive soccer.MethodIndividual semi-structured interviews were conducted with ten male competitive soccer players, who had recently sustained a HSI. Based on multifactorial models of sports injury causation, soccer players' individual, contextual, and situational risk factors at the time of their first HSI were investigated. Interviews were analyzed using thematic analysis with deductive and inductive approaches.ResultsIndividual psychological risk factors included common at-risk personality traits, obsessive passion for soccer with competitive motivational goals, strong athletic identity, and poor health literacy. The injured players were exposed to a controlling coaching style, with a fear of negative staff evaluations, and had recently experienced life stressors. They were injured during matches or overload periods and were highly engaged in the activity.DiscussionPreviously injured soccer players exhibit a lack of perspective concerning the repercussions of their actions on their health. From a preventive viewpoint, these results suggest enhancing the players' health literacy, supporting their autonomy, and moderating the controlling coaching style.

Objective The purpose of this study was to develop and validate French versions of two questionnaires assessing competitive athletes' sleep: the Athens Insomnia Scale (AIS-FR) and the Athlete Sleep Behavior Questionnaire (ASBQ-FR).

Elite athletes are continually subjected to a range of constraints specific to high performance, and these can have a negative impact on their health. Although many studies have explored the individual factors related to risky behaviours and disorders in elite sport contexts, few have focused on health promotion. Consequently, the interpersonal, institutional, and policy factors of the health-related behaviours of elite athletes are still poorly explored. Based on the socioecological model, this study aimed to identify the factors involved in the health-related lifestyle of elite athletes. Semi-structured interviews were conducted with 45 participants: athletes (N = 32), their coaches (N = 6) and the managers of elite sport centres (N = 7). Both deductive and inductive thematic analyses were performed. Our results highlight the views of the actors. Regarding intrapersonal factors, resilience qualities and health literacy appeared as key factors in influencing the health-related lifestyle of elite athletes. At the interpersonal level, parents and coaches emerged as the main sources of educational support. Regarding institutional factors, the health policies of the elite sport centres were key factors in supporting the athletes’ healthy lifestyle. These results encourage the development of health promotion programs at different levels of intervention.

BackgroundAs people age, their physical capacities (eg, walking and balance) decline and the risk of falling rises. Yet, classic fall detection devices are poorly accepted by older adults. Because they often wear eyeglasses as they go about their daily activities, daily monitoring to detect and prevent falls with smart eyeglasses might be more easily accepted. ObjectiveOn the basis of the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), this study evaluated (1) the acceptability of smart eyeglasses for the detection and prevention of falls by older adults and (2) the associations with selected fall-related functional physical capacities. MethodsA total of 142 volunteer older adults (mean age 74.9 years, SD 6.5 years) completed the UTAUT2 questionnaire adapted for smart eyeglasses and then performed several physical tests: a unipodal balance test with eyes open and closed, a 10-m walk test, and a 6-minute walk test. An unsupervised analysis classified the participants into physical performance groups. Multivariate ANOVAs were performed to identify differences in acceptability constructs according to the performance group. ResultsThe UTAUT2 questionnaire adapted for eyeglasses presented good psychometric properties. Performance expectancy (β=.21, P=.005), social influence (β=.18, P=.007), facilitating conditions (β=.17, P=.04), and habit (β=.40, P

BackgroundBariatric surgery offers an opportunity for physical activity (PA) promotion due to patients’ increased ability to engage in PA. Technology-based PA interventions are promising tools for promoting PA to support patients in this key period. The Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model is a recognized theoretical model for examining technology acceptability. Although a previous study reported that 92% of women with obesity have high acceptability of at least one technology-based PA intervention, little is known about the factors that lead to different levels of acceptability between technologies and therefore the reasons for choosing a preferred intervention. ObjectiveThe purpose of this study was to (1) characterize the acceptability of 3 technology-based PA interventions (ie, telehealth, active video game, mobile app) in the context of bariatric surgery, and (2) explore patients’ preference motives. This study, using a qualitative design, examined the suitability of the UTAUT2 model in this specific context. MethodsParticipants (n=26) read written French descriptions of the technology-based PA interventions with illustrations and chose their preferred intervention. Semidirective interviews were conducted to explore the reasons for their choice of the preferred intervention, notably using the UTAUT2 framework. Data were analyzed based on inductive and deductive approaches. ResultsAll participants who preferred a technology-based PA intervention (ie, active video game, n=10; mobile app, n=10; telehealth, n=6) expressed a behavioral intention to use it. In addition, some of them expressed a high behavioral intention to use another technology (ie, active video game, n=4; mobile app, n=1; telehealth, n=7). All the constructs of the UTAUT2 emerged during the qualitative interviews and were specified through subcategories. Additional constructs also emerged, especially other motivational factors. ConclusionsThis study showed that, in the context of technology-based PA interventions for postbariatric patients, the UTAUT2 is suitable, although additional motivational factors (which were not considered by the UTAUT2 model) should be considered.

Although explicit measures of doping attitude are widely used, they are susceptible to bias due to social desirability. The current computerized measures of implicit attitudes are time-consuming and based on expensive software solutions. Recently, paper-and-pencil (p&p) Implicit Association Tests (IAT) have been developed, making it possible to test several participants simultaneously, anywhere, and with no need of computerized equipment and software. The present series of studies aimed at developing a French version of a p&p IAT to measure athletes’ attitudes toward doping (Chan et al., 2017): the IAT-Dop. Four studies, including 212 participants (Mage = 25.49, SD = 5.73), followed Bardin et al. (2016) and Boateng et al. (2018) validation recommendations: (a) development of a preliminary version of the IAT-Dop based on the proposal of Chan’s tool (2017), (b) dimensionality and criterion validity tests demonstrating the structure of the p&p version, (c) test-retest reliability, and (d) first approach to construct validity. The results showed that the IAT-Dop was able to measure implicit attitudes toward doping and was stable across time. Significant correlations between the computerized and p&p versions confirmed the construct validity. The p&p IAT-Dop showed several advantages over the computerized version (Lemm et al., 2008), including lower cost and ease of administration. By offering accurate measures and an easier, faster, and cheaper way to measure doping attitudes, this tool should contribute to the better assessment and understanding of the mechanisms related to doping, and it might be a useful new indicator in the evaluation of prevention programs.

Abstract Background People with cystic fibrosis (pwCF) derive several physiological and psychological benefits from regular physical activity (PA), but the practice is lower than recommended. Knowledge about the facilitators of and barriers to PA at the individual level is important to act positively on PA behaviors. This study validated the Cystic Fibrosis Decisional Balance for Physical Activity scale (CF-DB-PA) for adults with CF. Methods French adults with CF were recruited in several specialist centres in France. The CF-DB-PA scale was validated following a quantitative study protocol comprising four stages: (1) tests of the clarity and relevance of a preliminary 44-item version and reduction analysis, (2) confirmatory factor analysis and tests of dimensionality through equation modelling analysis, (3) tests of reliability with Cronbach alphas for the internal consistency and a test–retest with a 2-to-3 week interval for temporal stability, and 4) tests of construct validity with Spearman correlations to measure the associations between each subscale and the theoretically related constructs (i.e., quality of life, PA and exercise tolerance). Results A total of 201 French adults with CF participated in the validation study. The CF-DB-PA comprises 23 items divided into two factors: facilitators of and barriers to PA. Each factor is divided into three subscales: physical, psychological and environmental. The factors (facilitators and barriers) can be used independently or combined as a whole. A general score of decisional balance for PA can also be calculated. The bi-factor model presented satisfactory adjustment indexes: χ2 (194) = 362.33; p .01), quality of life (r = − .44, p

Abstract Background The drive for muscularity behaviors are very common in male athletes, especially in male bodybuilders. Studies have related drive for muscularity behaviors to body dissatisfaction, eating disorders and muscle dysmorphia. Methods This study applied the trans-contextual model of motivation to the drive for muscularity behaviors of male bodybuilders at risk of developing muscle dysmorphia. The relationships between self-determination theory constructs and drive for muscularity behaviors, via the theory of planned behavior variables (i.e., attitude, subjective norm, perceived behavioral control, and intention) were examined. A total of 175 Swiss male bodybuilders (M age = 27.34; SD age = 7.53) completed measures on motivation for sport, theory of planned behavior variables, and drive for muscularity behaviors. They practiced bodybuilding from three to 24 h per week (Mhours per week = 6.59; SDhours per week = 3.45) and had done so for 7.19 years on average (SDnumber of years = 6.91). Using bootstrapped maximum likelihood estimation with the AMOS 7.0 program, a series of confirmatory factor analyses was performed on each subscale and a series of path analyses was performed to determine the final model. Results The fit indices of the final model were satisfactory: χ2 (11) = 13.81; p = .244; TLI = .98; CFI = .99; RMSEA = .04. The model explained 29% of the variance of drive for muscularity behaviors. The final path analysis supported the motivational sequence, with autonomous motivation for sport showing a positive, significant and indirect association with the drive for muscularity behaviors via perceived behavioral control and intention to gain muscle mass, and controlled motivation for sport showing a positive association with the drive for muscularity behaviors both directly and via attitude and intention to gain muscle mass. Conclusions It was concluded that the trans-contextual model of motivation applies only partially to the drive for muscularity behaviors in male bodybuilders. Perspective The motivational mechanisms explaining the development of drive for muscularity behaviors might be better understood through complementary analyses of motivational profiles. Such investigations would guide the design of programs to lower the risks associated with these behaviors.

Objective: This study examined the relationships between ADHD symptomatology, the motivations for physical activity (PA) according to self-determination theory, and the acceptability of three PA promotion technologies (active video game, mobile application, and telehealth) according to the dimensions of the unified theory of acceptance and use of technology-2 (UTAUT2). Method: A total of 312 women, aged 30.7 ± 7.1 years, followed for obesity with an average body mass index of 34.5 ± 7.8 kg/m[superscript 2], were included in this sub-analysis. Results: Fifty-seven individuals (18.3%) were identified with positive screening symptoms of ADHD. No differences emerged regarding acceptability of technology-based PA. However, individuals with positive screening for ADHD tended to have higher scores for acceptability of active video game on the UTAUT2 dimensions of effort expectancy and hedonic motivation. Conclusion: This study suggests that active video game may be more appropriate than other technologies for individuals with obesity and ADHD symptoms

Abstract Background Physical activity programs (PAP) in patients with cardiovascular disease require evidence of cost-utility. To assess improvement in health-related quality of life (QoL) and reduction of health care consumption of patients following PAP, a randomized trial was used. Methods Patients from a health insurance company who had experienced coronary artery disease or moderate heart failure were invited to participate (N = 1891). Positive responders (N = 50) were randomly assigned to a progressively autonomous physical activity (PAPA) program or to a standard supervised physical activity (SPA) program. The SPA group had two supervised sessions per week over 5 months. PAPA group had one session per week and support to aid habit formation (written tips, exercise program, phone call). To measure health-related quality of life EQ-5D utility score were used, before intervention, 6 months (T6) and 1 year later. Health care costs were provided from reimbursement databases. Results Mobility, usual activities and discomfort improved significantly in both group (T6). One year later, EQ-5D utility score was improved in the PAPA group only. Total health care consumption in the intervention group decreased, from a mean of 4097 euros per year before intervention to 2877 euros per year after (p = 0.05), compared to a health care consumption of 4087 euros and 4180 euros per year, in the total population of patients (N = 1891) from the health insurance company. The incremental cost effectiveness ratio was 10,928 euros per QALYs. Conclusion A physical activity program is cost-effective in providing a better quality of life and reducing health care consumption in cardiovascular patients. Trial registration ISRCTN77313697, retrospectively registered on 20 November 2015.

Abstract Background The benefits of supervised physical activity programs in cardiac rehabilitation have been amply demonstrated, but the quantity of physical activity often declines quickly once supervision ends. This trial assesses the effectiveness of an experimental intervention drawing on habit formation theory to maintain physical activity. Methods Cardiovascular patients (N = 47) were randomly assigned to one of two groups. The first group participated in two supervised physical activity (SPA) sessions per week for 20 weeks. The second group was offered a progressively autonomous physical activity (PAPA) program as follows: the same supervised program as the SPA group for 10 weeks and then a further 10 weeks with one supervised session replaced by a strategy to build and sustain the habit of autonomous physical activity. The International Physical Activity Questionnaire (IPAQ; Craig et al. Med Sci Sports Exerc 35(8):1381–1395, 2003) was used to measure the quantity of physical activity, which was the primary outcome. The number of participants was limited, and we thus took multiple IPAQ measurements (at 0, 5, 7, 9 and 12 months after the start of the intervention) and used a mixed model for analysis. Physical condition, automaticity of the physical activity behavior, motivation, and quality of life were examined for changes. Results No significant between-group differences were noted for physical activity behaviors after the program, physical condition, motivation, or behavioral automaticity. The PAPA group nevertheless completed more PA sessions during the intervention, and their quality of life was significantly higher than that of the SPA group at 12 months. Conclusion Although the number of supervised sessions was lower, the progressively autonomous PA program resulted in the same or even higher positive outcomes than the fully supervised PA program. Trial registration Current Controlled Trials ISRCTN77313697, retrospectively registered on 20 November 2015.

Abstract Background Recent research suggests that exercise stereotypes may influence physical activity through ego depletion and internalization mechanisms. The objective of this study was to better understand exercise stereotypes mechanisms among people living with HIV (PLHIV) by further examining the role of exercise self-efficacy and perceived physical fatigue in the relationship between exercise stereotypes and physical activity. Methods Three hundred five people living with HIV were recruited to provide data on their stereotypes related to exercise, exercise self-efficacy, perceived physical fatigue as well as their level of physical activity (PA). Results From the different models tested, the serial mediation model with exercise self-efficacy and perceived physical fatigue as mediators of the relationship between exercise stereotypes and PA, as well as the moderated mediation model with exercise selfefficacy as a moderator of exercise stereotypes and perceived physical fatigue a mediator, provided good fits to the data. However, the moderated mediation model (with indirect associations between negative exercise stereotypes and PA via perceived physical fatigue being moderated by exercise self-efficacy) explained the most variance in PA (R2 = .27). Conclusion The moderated mediation model suggests that exercise stereotypes might influence PA through ego depletion mechanisms and be tempered by exercise self-efficacy.

Background: Many of the studies on worksite physical activity (PA) have investigated either the effectiveness of PA programs for employees and the work-related outcomes or health promotion interventions to increase PA. However, studies on barriers and enabling factors for participation are scarce and have generally not been theoretically grounded. The purpose of this qualitative study was to identify worksite PA barriers and facilitators from the perspective of the transtheoretical model of change (TTM).Methods: Thirty employees (15 females and 15 males; Mage = 44.70; SD = 5.20) were recruited to participate in semi-structured interviews lasting from 60 to 90 min. Participants came from several organizations that offered PA programs and were at different exercise stages of change. They were invited to describe: (a) general information on the place of PA in their daily lives and in the workplace, and the reasons for (b) worksite PA participation or (c) non-participation. The interview transcripts were analyzed both inductively and deductively with reference to the exercise stages of change.Results: Three categories of barriers and facilitators related to physical, psychological and environmental dimensions were identified. For all exercise stages of change combined, psychological and environmental barriers were significantly more reported than physical barriers, whereas physical and psychological facilitators were more cited than environmental facilitators. Further qualitative analysis suggested that these categories differed with the exercise stage of change. At the precontemplative and contemplative stages, all types of barriers predominated (e.g., physical constraints due to the workstation, fear of management disapproval, time constraints). At the preparation stage, physical, and psychological needs emerged in relation to worksite PA (e.g., need to compensate for sedentary work, stress regulation). At the action and maintenance levels, physical, psychological, and environmental facilitators were reported (e.g., enhanced physical condition, workplace well-being, social ties). At the relapse stage, specific life changes or events broke the physically active lifestyle dynamics.Conclusion: This study identified the contribution of different types of worksite PA barriers and facilitators according to the exercise stage of change. The identified facilitators are consistent with the general TTM processes of change, while being specific to the workplace. Practical strategies are discussed.

Although sport psychology research has mainly focused on stress and coping as intrapersonal processes, stressful circumstances are often experienced in social groups and coping emerges as a combination of individual and group effort (Tamminen and Gaudreau, 2014). Based on Lyons et al. (1998) model of communal coping, this study aimed to address the lack of knowledge about stress and coping as an interpersonal process, by exploring shared stressors and communal coping strategies within team sports. Semi-structured interviews were conducted with 10 team sport athletes (seven males, three females; Mage = 26.3 years, SDage = 7.67, range 15–38) who participated in different team sports (football, rugby, volleyball, ice hockey, and basketball). Data were analyzed using an inductive thematic analytic procedure. The results revealed four themes of shared stressors involving issues relating to social pressure, relationships between teammates, performance, or logistics and organization; and four themes of communal coping, namely: problem-focused communal efforts, relationship-focused coping, communal management of emotions, and communal goal withdrawal. The results provided empirical support to the communal coping model (Lyons et al., 1998) and extend understanding of coping processes as defined initially by the CMRT of emotion (Lazarus, 1999, 2000a). This study provided unique insight into the nature of communal coping in sport and performance setting, and specifically, how stressors are apprehended in team sports and how athletes can collaborate to deal with shared stressors during competitive encounters.

OBJECTIVE:Although research on the physiological and psychological factors of endurance performance has been extensive, the factors related to dropping out of ultra-trail races have not been well documented. The aim of this study was to examine psychosocial factors as predictors of dropout in ultra-trail runners. METHODS:Two hundred and twenty-one volunteer athletes completed a survey that included measures of: (a) motivational variables (self-determined motivation, basic needs satisfaction, achievement goals), (b) theory of planned behavior constructs (attitudes, subjective norms, self-efficacy and intention to finish the race), and (c) coping strategies in sport. RESULTS:The results showed that finishers had higher scores for self-efficacy and intention to finish the race than withdrawers, whereas withdrawers had higher scores for avoidance coping. Multiple logistic regression showed that the number of started and finished ultra-trail races (OR, 0.44; 95% CI 0.22-0.88; p

The purpose of this paper was to adapt and examine the psychometric properties of a French-language Drive for Muscularity Scale (DMS). First, a preliminary version of the scale, based on both the English-language version of the DMS and the literature on the drive for muscularity, was developed following a committee validation process. Second, the factor structure of the DMS-FR was investigated with principal component analysis (PCA) in a sample of 114 male athletes (Mage = 23.35; SDage = 4.93), leading to a nine-item scale (Study 1). Third, in Study 2, the internal factor structure, temporal stability, and concurrent validity were examined through a series of structural hypothetical modelisation in a sample of 129 male athletes (Mage = 27.03; SDage = 7.81). The results indicated that the scale has good psychometric properties. Specifically, the PCA, and the series of structural hypothetical modelisation, suggested two theoretical factors (i.e., Muscularity Body Dissatisfaction and Muscularity Behaviors), and more, with a bi-factor model in a SEM. The results also indicated sufficient concurrent validity with the Male Body Dissatisfaction Scale (MBDS) and adequate internal consistency (Cronbach's alphas were .87 for the Muscularity Body Dissatisfaction subscale, and .88 for the Muscularity Behaviors subscale). The findings overall suggest good reliability and construct validity for this French version of the DMS (DMS-FR), which will be useful for future research and clinical practice in French-speaking countries.

This article considers the factors that contribute to the psychosocial arduousness of teaching in France, with a focus on preservice teachers and the strategies they deploy during their first year of work. Within the theoretical framework of the social psychology of health and a psychodynamic approach to work, this study offers an original view of the relationship between coping strategies, defense mechanisms and professional attrition. Proposals are made to reduce attrition through the primary prevention of psychosocial risks during the first school assignment via continuing teacher education, in addition to the resources available at the end of initial education at the university

This article examines a method of evaluating psychosocial risk (PSR) based on Karasek’s model by taking into account the subject at work in the assessment of psychological health risk factors. The case under study concerns the introduction of a quality approach and its impact on women who work in the employment assistance sector and who accompany earned income supplement (EIS) recipients in their search for gainful employment. Using ergonomic analysis of work situations and activities, this longitudinal study of the real work activities of these employees provides insight into the multifactorial generation of work stress linked to seemingly “irrelevant” management decisions. The results also document the deleterious effects of a loss of the power to act and of a lack of discussion concerning the criteria for well-done work. Possible applications for these results in primary prevention are proposed.