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Background: Esports players are often referred to as sedentary athletes, as gaming requires prolonged sedentary screen exposure. As sedentary behavior and physical inactivity are major causes of noncommunicable diseases and premature death, esports players may be at an increased risk for health implications. Prior research has established esports players as having higher levels of body fat and lower levels of lean body mass versus age-matched controls, suggesting the need to assess further health and fitness outcomes of this demographic. However, while research interest is undoubtedly increasing, the majority of studies has focused on subjective self-report data and has lacked relevant objective health and fitness measurements., Objective: This study aimed to assess the health and fitness status of a group of competitive esports players in relation to an age- and sex-matched comparison group., Methods: In total, 51 competitive esports players (mean 23, SD 3 years, 2 female) and 51 nonesports players (mean 24, SD 3 years, 2 female) were enrolled in this cross-sectional laboratory study. The esports players and the nonesports players completed a questionnaire assessing demographic data and self-reported physical activity levels. Furthermore, physical parameters including BMI, waist-to-height ratio, body fat percentage, systolic blood pressure, diastolic blood pressure, pulse wave velocity, maximal grip strength, and maximal oxygen consumption were assessed., Results: There were no significant differences in BMI (t 100 =1.54; P=.13; d=0.30), waist-to-height ratio (t 100 =1.44; P=.16; d=0.28), body fat percentage (t 100 =-0.48; P=.63; d=-0.09), systolic blood pressure (t 100 =-0.06; P=.93; d=-0.01), diastolic blood pressure (t 100 =0.37; P=.71; d=0.07), pulse wave velocity (t 93 =-2.08; P=.15; d=-0.43), maximal grip strength (t 100 =-.08; P=.94; d=-0.02), maximal oxygen consumption (t 100 =-0.11; P=.92; d=-0.02), and physical activity (PA) levels (t 86 =2.17; P=.08; d=0.46) between the groups., Conclusions: While the health narrative directed toward esports players has been mainly negative, this laboratory-based study indicated that esports players are not less healthy or fit compared to their peers. However, it seems that esports players are very heterogeneous and seem to span across the whole range of the fitness and health spectrum. Thus, the generalized statements of the esports athlete as an obese and unhealthy individual may need to be reconsidered., (©Sascha Ketelhut, Alex Bodman, Thomas Ries, Claudio R Nigg. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 03.08.2023.)

Background: Physical function is the ability to perform both basic and instrumental activities of daily living, and the ability of older adults to reside in the community depends to a large extent on their level of physical function. Multiple physical and health-related variables may differentially affect physical function, but they have not been well characterized. The purpose of this investigation was to identify and examine physical and mental health-related correlates of physical function in a sample of community-dwelling older adults., Methods: Nine hundred and four community dwelling older men (n = 263) and women (n = 641) with a mean (95% Confidence Interval) age of 76.6 (76.1, 77.1) years underwent tests of physical function (Timed Up and Go; TUG), Body Mass Index (BMI) was calculated from measured height and weight, and data were collected on self-reported health quality of life (SF-36), falls during the past 6 months, number of medications per day, depression (Geriatric Depression Scale; GDS), social support, and sociodemographic variables., Results: Subjects completed the TUG in 8.7 (8.2, 9.2) seconds and expended 6,976 (6,669, 7,284) Kcal.wk-1 in physical activity. The older persons had a mean BMI of 27. 6 (27.2, 28.0), 62% took 3 or more medications per day, and 14.4% had fallen one or more times over the last 6 months. Mean scores on the Mental Component Summary (MCS) was 50.6 (50.2, 51,0) and the Physical Component Summary (PCS) was 41.3 (40.8, 41.8).Multiple sequential regression analysis showed that, after adjustment for TUG floor surface correlates of physical function included age, sex, education, physical activity (weekly energy expenditure), general health, bodily pain, number of medications taken per day, depression and Body Mass Index. Further, there is a dose response relationship such that greater degree of physical function impairment is associated with poorer scores on physical health-related variables., Conclusions: Physical function in community-dwelling older adults is associated with several physical and mental health-related factors. Further study examining the nature of the relationships between these variables is needed.

Determinants of exercise for middle school children were addressed by examining the validity of the Stages of Change (SOC) construct of the Transtheoretical Model, as well as the relation between the stages of change and barrier self-efficacy and decisional balance. Findings provided preliminary cognitive and behavioral support for the use of the SOC construct. (Author)

This study aimed to investigate the effects of a school-based exergame intervention on anthropometric parameters and physical fitness. Fifty-eight students (10.4 ± 0.8 years; 48% girls) were randomized into an intervention (IG) and a control (CG) group. Both groups participated in regular physical education classes during the three-month intervention period. The IG additionally received a 20-minute exergame intervention twice per week. At baseline and following the intervention period, body mass index (BMI) and waist-to-height ratio (WHtR) were assessed. Furthermore, a sprint test (ST), a countermovement jump test (CMJ), and a shuttle run test (SRT) were performed. Due to prescribed quarantine measures, only 34 students (18 IG; 16 CG) were included in the final analysis. A significant group–time interaction was determined in CMJ performance (p < 0.001; η2 = 0.403), with a significant increase (+2.6 ± 2.4 cm; p < 0.001; η2 = 0.315) in the IG and a significant decrease (−2.0 ± 3.1 cm; p = 0.009; η2 = 0.190) in the CG. Furthermore, ST performance significantly improved in the IG (−0.03 ± 0.08 s; p = 0.012; η2 = 0.180) but not in the CG (0.13 ± 0.16 s; p = 0.460; η2 = 0.017), revealing significant interaction effects (p = 0.02; η2 = 0.157). Significant group–time interaction was observed for the SRT (p = 0.046; η2 = 0.122), with a significant increase (+87.8 ± 98.9 m; p = 0.028; η2 = 0.147) in the IG and no changes (−29.4 ± 219.7 m; p = 0.485; η2 = 0.016) in the CG. Concerning BMI (p = 0.157; η2 = 0.063) and WHtR (p = 0.063; η2 = 0.114), no significant interaction effects were detected. School-based exergaming is a suitable tool to influence students' physical fitness positively. [ABSTRACT FROM AUTHOR]

Background: Persons with multiple sclerosis (PwMS) often have reduced aerobic capacity and report fatigue as the most disabling symptom impacting their health-related quality of life (HRQoL). A multidisciplinary rehabilitation approach is recommended for successful management of symptoms, although there is little supporting evidence. The aim of this study is to evaluate the effect of a multimodal therapy approach, including endurance training and patient education, during a three-week inpatient rehabilitation stay, on HRQoL in PwMS at six months follow-up. Inpatient energy management education (IEME) + high-intensity interval training (HIIT) will be compared with progressive muscle relaxation (PMR) + moderate continuous training (MCT).Methods: This study has a two-armed single-blind randomized controlled superiority trial design. One hundred six PwMS-related fatigue (relapsing-remitting or chronic progressive phenotypes; Expanded Disability Status Scale (EDSS) ≤ 6.5) will be recruited at the Valens clinic, Switzerland, and randomized into either an experimental (EG) or a control group (CG). EG: participants will perform IEME twice and HIIT three times per week during the three-week rehabilitation stay. IEME is a group-based intervention, lasting for 6.5 h over three weeks. HIIT contains of five 1.5-min high-intensive exercise bouts on a cycle ergometer at 95-100% of peak heart rate (HRpeak), followed by active breaks of unloaded pedalling for 2 min to achieve 60% of HRpeak. CG: participants will perform PMR twice and MCT three times per week during the three-week rehabilitation stay, representing local usual care. PMR consists of six 1-h relaxation group sessions. MCT consists of 24-min continuous cycling at 65% of HRpeak. The primary outcome is HRQoL (Physical and Mental Component Summaries of the Medical Outcome Study 36-item Short Form Health Survey; SF-36), measured at entry to the clinic (baseline, T0), three weeks after T0 (T1) and at four (T2) and six (T3) months after T0. Secondary outcomes comprise cardiorespiratory fitness, inflammatory markers (measured at T0 and T1), fatigue, mood, self-efficacy, occupational performance, physical activity (measured at T0, T1, T2 and T3) and behaviour changes in energy management (measured at T2 and T3).Discussion: This study will provide detailed information on a multimodal therapy approach to further improve rehabilitation for PwMS.Trial Registration: This trial was prospectively registered at ClinicalTrials.gov ( NCT04356248 ; 22 April 2020). [ABSTRACT FROM AUTHOR]

Longer life expectancy, rapid population growth, and low exercise-participation rates of adults 65 and older justify the need for better understanding of older adults' exercise behavior. The objectives of this focus-group study were to determine barriers to the exercise behavior of older adults. Six focus groups, three with exercisers and three with nonexercisers, were conducted at various sites throughout Rhode Island. The majority (n = 57) of the 66 individuals who participated were women, and all stated that they were 65 and older. Results from the focus-group data identified 13 barriers to exercise behavior. The most significant barriers mentioned by nonexercisers were fear of falling, inertia, and negative affect. Exercisers identified inertia, time constraints, and physical ailments as being the most significant barriers to exercise. Implications from these focus-group data can be useful in the development of exercise interventions for older adults, which could increase exercise participation. [ABSTRACT FROM AUTHOR]

Background Although surveillance data are limited in the US Affiliated Pacific, Alaska, and Hawaii, existing data suggest that the prevalence of childhood obesity is similar to or in excess of other minority groups in the contiguous US. Strategies for addressing the childhood obesity epidemic in the region support the use of community-based, environmentally targeted interventions. The Children's Healthy Living Program is a partnership formed across institutions in the US Affiliated Pacific, Alaska, and Hawaii to design a community randomized environmental intervention trial and a prevalence survey to address childhood obesity in the region through affecting the food and physical activity environment. Methods/Design The Children's Healthy Living Program community randomized trial is an environmental intervention trial in four matched-pair communities in American Samoa, the Commonwealth of the Northern Mariana Islands, Guam, and Hawaii and two matched-pair communities in Alaska. A cross-sectional sample of children (goal n = 180) in each of the intervention trial communities is being assessed for outcomes at baseline and at 24 months (18 months post-intervention). In addition to the collection of the participant-based measures of anthropometry, diet, physical activity, sleep and acanthosis nigricans, community assessments are also being conducted in intervention trial communities. The Freely Associated States of Micronesia (Federated States of Micronesia, and Republics of Marshall Islands and Palau) is only conducting elements of the Children's Healthy Living Program sampling framework and similar measurements to provide prevalence data. In addition, anthropometry information will be collected for two additional communities in each of the 5 intervention jurisdictions to be included in the prevalence survey. The effectiveness of the environmental intervention trial is being assessed based on the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. Discussion The Children's Healthy Living Program environmental trial is designed to focus on capacity building and to maximize the likelihood of sustainable impact on childhood obesity-related behaviors and outcomes. The multiple measures at the individual, community, and environment levels are designed to maximize the likelihood of detecting change. This approach enhances the likelihood for identifying and promoting the best methods to promote health and well-being of the children in the underserved US Affiliated Pacific Region. Trial registration NIH clinical trial # NCT01881373. [ABSTRACT FROM AUTHOR]

Objectives. We examined whether schoolyard improvements led to increased physical activity levels among both boys and girls and assessed the aspects of schoolyard design that have an impact on physical activity. Methods. In a quasi-experimental research design, 6 schools with renovated schoolyards and 3 control schools were divided into activity areas. We calculated measures of children's physical activity by area during school hours as well as after-school hours. Results. The volume of schoolyard use was significantly higher at schools with renovated schoolyards than at control schools, and students were significantly more active at these schools. Also, activity levels were significantly higher among both boys and girls in certain schoolyard areas, such as those with soft surfaces. Conclusions. Because few public elementary schools in the United States provide daily physical education or its equivalent for all students throughout the school year, noncurriculum approaches to increasing children's physical activity are important. Renovated schoolyards increase the number of children who are physically active, as well as their overall activity levels, and reduce sedentary behaviors. [ABSTRACT FROM AUTHOR]

Introduction: High intake of fruit and vegetables and being physically active are associated with reduced risk of chronic diseases. In the current study, we examined the associations of physical activity, fruit and vegetable consumption, and TV/video watching (indicator for physical inactivity) with perceived quality of life (QOL) in a sample of free living adults. Methods: A cohort (N = 139) from a random, multi-ethnic sample of 700 adults living in Hawaii was evaluated at 3-month intervals for the first year and 6-month intervals for the second year. QOL was assessed from self-reports of mental or physical health at the end of the study. Results: Overall, the cohort participants appeared to maintain relatively constant levels of physical activity, fruit and vegetable intake, and TV/video watching. Physical activity was positively related to mental health (p-values < 0.05), but not physical health, at all time points regardless of participants' fruit and vegetable consumption and hours of TV/video watching. Neither mental nor physical health was associated with fruit and vegetable intake or TV/video watching. Conclusion: Our study supports that physical activity is positively associated with mental health. Fruit and vegetable consumption and TV/video watching may be too specific to represent an individual's overall nutritional status and physical inactivity, respectively. [ABSTRACT FROM AUTHOR]

Background: Physical function is the ability to perform both basic and instrumental activities of daily living, and the ability of older adults to reside in the community depends to a large extent on their level of physical function. Multiple physical and health-related variables may differentially affect physical function, but they have not been well characterized. The purpose of this investigation was to identify and examine physical and mental healthrelated correlates of physical function in a sample of community-dwelling older adults. Methods: Nine hundred and four community dwelling older men (n = 263) and women (n = 641) with a mean (95% Confidence Interval) age of 76.6 (76.1, 77.1) years underwent tests of physical function (Timed Up and Go; TUG), Body Mass Index (BMI) was calculated from measured height and weight, and data were collected on selfreported health quality of life (SF-36), falls during the past 6 months, number of medications per day, depression (Geriatric Depression Scale; GDS), social support, and sociodemographic variables. Results: Subjects completed the TUG in 8.7 (8.2, 9.2) seconds and expended 6,976 (6,669, 7,284) Kcal.wk-1 in physical activity. The older persons had a mean BMI of 27. 6 (27.2, 28.0), 62% took 3 or more medications per day, and14.4% had fallen one or more times over the last 6 months. Mean scores on the Mental Component Summary (MCS) was 50.6 (50.2, 51,0) and the Physical Component Summary (PCS) was 41.3 (40.8, 41.8). Multiple sequential regression analysis showed that, after adjustment for TUG floor surface correlates of physical function included age, sex, education, physical activity (weekly energy expenditure), general health, bodily pain, number of medications taken per day, depression and Body Mass Index. Further, there is a dose response relationship such that greater degree of physical function impairment is associated with poorer scores on physical healthrelated variables. Conclusions: Physical function in community-dwelling older adults is associated with several physical and mental health-related factors. Further study examining the nature of the relationships between these variables is needed. [ABSTRACT FROM AUTHOR]

Predicting variation in meeting recommended levels of physical activity is important for public health evaluation. The purpose of this study is to determine the predictive value of stages of the Transtheoretical Model (TTM) for classifying people who meet the US Healthy People 2010 guideline for regular physical activity. A cohort ( N = 497) from a random, multiethnic sample of 700 adults living in Hawaii was assessed at 6-month intervals three or more times for 2 years. Latent transition analysis was used to classify people according to TTM stages and separately according to whether they met the guideline. The predictive value of pre- vs. post-action stages was then tested. Stages were more likely to falsely classify people as meeting the guideline than to falsely classify them as not meeting it. Probabilities of predicting 6-month transitions were about 50% for the stable class of meeting the guideline each time and just 25% for transitions between meeting and not meeting the guideline. The TTM post-action stages had limited usefulness in this cohort. Further longitudinal study is needed to determine whether TTM stages can accurately classify transitions from physical inactivity to physical activity below recommended levels. [ABSTRACT FROM AUTHOR]

Abstract: Objectives:: The present study assessed the generalizability of the Theory of Planned Behavior (TPB) applied to physical activity and to examine if the TPB operates equivalently across gender, age, and ethnic sub-groups. Design/Methods:: Measurement equivalence was evaluated for gender (male/female), age (19–34/35–54/55+) and ethnicity (Japanese/Hawaiian or part Hawaiian/Filipino/White) in a random sample (n =3533) using Multisample Structural Equation Modeling. Results:: Measurement equivalence was found for all variables and for their intercorrelations. Of the 100 possible TPB variable relationships between groups, only 6 were significant. The differences were found in explained variances of physical activity. Conclusions:: The findings indicate that TPB measures apply over a range of population sub-groups, and should be considered comprehensively when designing interventions. [Copyright &y& Elsevier]

The article provides a study to examine the factorial validity of the shortened Physical Activity Enjoyment Scale (S-PACES) in a multiethnic sample of young boys and girls and to evaluate the difference of the fundamental structure between opposite genders and across time points. Participants of the study include 533 youth from 12 A-Plus (A+) after-school programs in public elementary schools in Hawaii. Researchers conducted a survey using the S-PACES. This scale was used to measure physical activity enjoyment. It included seven negatively worded items from the PACES. Results of the study give proof for the factorial validity of a unidimensional model for the S-ACES and data of invariance between genders and across time. Several tables showing the results are provided in the article.

Purpose: We examined the efficacy of an intervention tailored to the individual's stage of change for exercise adoption on exercise stage of change, physical activity, and physical function in community-dwelling older adults. Design and Methods: We randomized participants to a print and telephone intervention or a contact comparison group. Through the use of longitudinal analyses we examined the intervention's effectiveness in promoting stage progression, altering decisional balance and the processes of change, increasing self-efficacy and physical activity, and improving physical function among older adults who completed the 24-month study (N = 966). We conducted similar analyses that excluded individuals who were in maintenance at baseline and 24 months. Results: At the end of the study, there were no differences in stage progression, self-efficacy, decisional balance, the processes of change, physical activity, or physical function by intervention assignment. When the analyses excluded those participants (n = 358) who were in the maintenance stage for exercise throughout the intervention, we found that, compared with the comparison group, a greater proportion of individuals who received the exercise intervention progressed in stage by 24 months. Conversely, more individuals in the comparison group remained stable or regressed in stage compared with the intervention group. Implications: Results indicate that a tailored intervention is effective in increasing motivational readiness for exercise in individuals who were in stages of change other than maintenance. [ABSTRACT FROM AUTHOR]

Purpose: Investigation of physical activity and related psychosocial factors reported by new mothers. Methods: Women (N = 79) were surveyed to determine their physical activity patterns before and after childbirth. Barriers and facilitators of physical activity were also identified. Findings: Most women (63%) were ethnic minorities, mean age was 31.8 ± 5.5 years, and their infants' mean age was 8.2 ± 3.8 months. Combining women's reported physical activities before their pregnancy and after childbirth resulted in four significantly different groups: (1) 21.5% were inactive before and after childbirth; (2) 22.7% were active before and after; (3) 12.6% were inactive before, but active after childbirth; and (4) 43.0% were active before but inactive or irregularly active postpartum (p < .0003). Barriers to physical activity included personal issues, including lack of support from a spouse, and parenting duties. Facilitators to being active included social support for exercise and availability of childcare. Conclusions: New mothers are at high risk for inactivity and reductions in previously established levels of physical activity. They also have specific barriers and facilitators to being physically active. Future research should develop effective methods for increasing physical activity in mothers of infants. [ABSTRACT FROM AUTHOR]

Objectives: To characterize physical activity and physical function by stage of change and age in older adults. Methods: One thousand two hundred thirty-four individuals completed The Yale physical activity survey (YPAS), stage of change for exercise, and the Up-and-Go physical function test. Results: Most subjects were in the maintenance (50.4%) or precontemplation stages (2 1/0%). YPAS scores were higher and Up- and-Go scores were lower as exercise stage increased. Physical activity and physical function scores were lower in older age groups. Conclusion: Higher stages were positively associated with physical activity and physical function. Age was a significant moderator variable affecting stage, physical activity, and physical function. [ABSTRACT FROM AUTHOR]

The research purposes were to examine the factorial and convergent validity, internal consistency, and test-retest reliability of the Exercise Dependence Scale (EDS). Two separate studies, containing a total of 1,263 college students, were undertaken to accomplish these purposes. Participants completed the EDS and measures of exercise behavior and perfectionism. Confirmatory factor analysis in Study 1 reduced the scale from 28 to 21 items (i.e., 3 items per subscale) and it supported a correlated seven-factor model in Study 2 (Tucker-Lewis Index = .96, comparative fit index = .97, root mean square error of approximation = .05, average absolute standardized residual = .02). Adequate internal consistency and test-rest reliability for the scale was evidenced. Consistent with the hypotheses and the EDS classifications for exercise dependence symptoms, individuals at risk for exercise dependence reported more exercise behavior and perfectionistic tendencies, compared to the nondependent-symptomatic and nondependent-asymptomatic groups. These studies provide evidence for the reliability and validity of the EDS. Research in more diverse populations is needed to further examine the general applicability of the EDS-Revised. [ABSTRACT FROM AUTHOR]

The authors examined the relationship between physical activity, exercise, and sedentary behaviors in 493 college students who were enrolled in 10 conditioning activity classes and had completed questionnaires at the beginning of the course. They analyzed sedentary activities and indicators of participation in exercise and physical activity by demographic variables. Surveyed men reported greater participation in physical activity and exercise than did women, and they also spent more time watching television/videos and using the computer. Older students were more likely to report more computer use, whereas younger students scored higher on several physical activity indicators. Of the sedentary behaviors, only computer use for men and television watching for women were negatively correlated with exercise and physical activity. In addition to accessibility and reinforcing properties of sedentary activities, the gender-related relationships between sedentary and active behaviors should be considered in designing interventions to promote exercise in this population. [ABSTRACT FROM AUTHOR]

Background and purpose. Research and application in the physical activity and exercise area are increasingly impacted by technology. The exponential growth of World Wide Web access and the proliferation of personal computers highlight the importance of this development. The purpose of this article is to discuss the current impact of technology on different aspects of physical activity interventions and potential future applications.Methods. Relevant literature is reviewed within each of the areas being discussed.Results and conclusions. Technology has contributed to a secular decline in physical activity; however, it allows a) the proactive recruitment of large populations, b) the individualization of interventions on a large scale, and c) the delivery of activity promoting interventions to large populations via differing channels. Support is emerging for individualized interactive physical activity interventions delivered to large samples. Yet-untested areas where technology may have a beneficial impact on physical activity adoption and maintenance are interactive TV and virtual reality. With the increased focus on environmental strategies, technology could also be used to modify home environments to facilitate incorporating physical activity into everyday life. Technology is also increasing its role in the business of physical activity/exercise. For example, web-based health sites are now listed on the stock market. Health and fitness centers are adopting high-tech entertainment capabilities to serve each client. Combining the individualized technology used in the adoption and maintenance research with the existing infrastructures in health and fitness centers could increase adherence within these centers. Currently, however, there is limited research and utilization of this technology for the promotion of physical activity and exercise at the population level. [Copyright &y& Elsevier]

Discusses the importance of physical activity to the youth. Goals of the Healthy People 2010 initiative; Benefits of physical activity to the youth and the correlates of physical activity in youth; Best practices of youth activity interventions.

Background: Few studies have examined the differences in physical activity levels between subgroups of Asian or Pacific Islanders riving in the United States. This study compared levels of physical activity for three subgroups of Asian or Pacific Islanders residing in Hawaii. Methods: Data on Native Hawaiian/Part Native Hawaian (N=585), Filipino(N=548), Japanese(N=871), and White(N=1728) adults were obtained from the Hawaii 2001 Behavioral Risk Factor Surveillance System (BRFSS), which contained more detailed questions on ethnicity than are collected by most states. Six physical activity categories were compared: inactive, insufficient (some activity but less than recommended activity), moderate activity (≥ 30 minutes of moderate activity ≥ 5 days a week), vigorous activity (≥ 20 minutes of vigorous activity ≥ 3 days a week), recommended activity (meeting either moderate or vigorous activity requirements), and a recently suggested target of ≥ 60 minutes of moderate activity 7 days a week or ≥ 20 minutes of vigorous activity ≥ 4 days a week. Results: Among Asians or Pacific Islanders, Native Hawaiians / Part Native Hawaiians were most active (38.9% moderate and 23.9% vigorous), followed by Japanese (32.1%, 20.4%) and Filipinos (31.8%, 18.6%) Whites were more active than any of these three subgroups (47.2%, 35.4%). Conclusions: Differences in physical activity levels between subgroups of Asians or Pacific Islanders in Hawaii suggests that aggregated data for all subgroups obscures important information about disparities in activity levels. State efforts to reduce disparities in activity levels should take into account differences between Asian or Pacific Islander subgroups. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Over 40% of Americans are sedentary and of those beginning an exercise program, 50% will drop out within 6 months. The Transtheoretical Model (TTM) is commonly used to describe exercise behavior and develop interventions for the initiation of exercise behavior. Less is known, however, about maintenance of exercise behavior and the construct associations for the action, maintenance, and termination stages of change. Thus, the purpose of this study was to examine which of the TTM constructs (i.e. decisional balance, processes of change, barriers-efficacy, and temptation) best distinguishes between the action, maintenance, and termination stages of change for men and women. Methods: Questionnaires measuring each of the TTM constructs were collected from 330 men (M age=27.14 years) and 380 women (M age=24.80years). Data were examined for sex differences and subsequently, two forward logistic regressions were conducted for each sex such that the dependent variables for the regressions were action/maintenance and maintenance/termination. Results: Compared to men, women reported significantly less barriers-efficacy (p=.04), greater pros of exercise (p=.004), and greater use of behavioral (p=.001) and experiential (p<.001) processes of change. For the men, affect temptation was the only significant correlate of action/maintenance (p=.02), while barriers efficacy (p=.001), environmental evaluation (p=.02), and affect temptation (p=.03) were associated with maintenance/termination. For the women, environmental reevaluation (p=.02) and social liberation (p=.05) were associated with action/maintenance, while barriers-efficacy (p=.003) was the only construct correlated with maintenance/termination. Conclusions: Stage and gender specific considerations are warranted when designing stage-matched exercise interventions for long-term maintenance of exercise behavior. [Copyright &y& Elsevier]

Abstract: Background: Most people experience weight regain following the termination of a weight management program. The failure to maintain changes in diet and exercise patterns is a major factor. This study presents 24-month outcomes of a healthy-lifestyle weight management program designed to promote long-term changes in diet and exercise behaviors. Methods: Overweight and obese adults (n = 144; BMI = 32.5 ± 3.8) completed a 6-month clinic-based weight management program and were followed for an additional 18 months. Assessments completed at baseline, 6, 12, and 24 months included weight, body composition, dietary recalls, self-reported physical activity, and mediator variables based on Transtheoretical Model of Health Behavior Change. Results: At 24 months, subjects maintained decreases in weight, % body fat, caloric intake, % kcal saturated fat, and increases in weekly exercise minutes (P < 0.05). Individuals who maintained regular exercise at 24 months had higher confidence scores and higher use of experiential and behavioral processes. Individuals who maintained a healthy diet at 24 months had lower temptation scores and higher use of experiential and behavioral processes. Conclusions: A healthy-lifestyle weight management program is successful at promoting long-term changes in exercise and dietary behaviors. Individuals who actively engage in the maintenance process are more likely to succeed. [Copyright &y& Elsevier]