Purpose: In this project, we analyzed behavior change content within an optimization trial of a physical activity intervention for older adults (Ready Steady 3.0). There are two core intervention components in the trial—a physical activity protocol and monitor--and two experimental components-- sets of interpersonal and intrapersonal behavior change strategies. To analyze intervention content we integrated Behavior Change Technique Taxonomy (BCTT v 1) coding and dosage assessment approaches to address these questions: 1) Which BCTs are used in the core and experimental intervention components? 2) What are the dosages of BCTs used?

Methods:   We obtained intervention materials, including scripted manuals with timings, and developed a protocol that tracked BCT codes and dosages. Dosage assessments included the amount (i.e., minutes spent delivering each BCT), frequency (i.e., number of meetings during which each BCT was delivered), and duration (i.e., number of weeks over which each BCT was delivered). We differentiated the amount into three types of prescribed (Rx) action for the participants: receive information about BCTs,  practice BCTs during meetings, and BCT implementation after meetings. Two trained researchers independently analyzed intervention materials.

Results:  Overall, 28 BCTs are used across the four intervention components. BCTs used most often in the core components are Behavioral practice/ rehearsal, with an amount of 341 minutes, frequency of 8, duration of 8 weeks; and, Self-monitoring with an amount of 8 minutes, frequency of 3, and duration of 6 weeks. The Rx action for each was practice. The interpersonal component's primary BCT codes emphasize social interaction (e.g., Social comparison) with an amount of 116 minutes (26% information; 56% practice; 18% implementation), frequency of 7, and duration of 7 weeks. The intrapersonal component's primary BCT codes emphasize personal thoughts (e.g., Goal setting [outcome]) with an amount of 112 minutes (36% information; 42% practice; 21% implementation), frequency of 7, and duration of 7 weeks.

Conclusions: Our integrated approach to analyzing behavior change content in the Ready Steady 3.0 optimization trial was feasible and provided in-depth details about both which and how BCTs were used. The results will help inform the evaluation of our trial results and future intervention development.

Purpose: The purpose of the present study is to determine if physical activity (PA) and self-determination theory’s basic psychological needs predict eudaimonic well-being in older adults, and if PA and basic psychological needs interact to predict eudaimonic well-being. Basic psychological needs have not been examined as moderators of the association between physical activity (a potential eudaimonic activity) and eudaimonic well-being among older adults.  

Methods: Members of the ALL IN for Health! volunteer registry aged ≥ 55 years, without severe cognitive impairment, were contacted via email to complete five online surveys. At baseline (T₁), participants [N = 430; mean age (years) = 64.65, SD = 6.40] reported on autonomy, competence, and relatedness experienced during PA. To improve the reliability in PA estimates, PA was assessed prospectively using the Physical Activity Scale for Elderly (recall period = 7 days), for four consecutive weeks (T₂, T₃, T₄, T₅), and weekly PA scores were averaged. At T₅, purpose in life and personal growth were measured according to Ryff’s theoretical model of psychological well-being.

Results: Ordinary least squares regression analyses revealed that PA was associated with purpose in life, but only for those reporting low levels of relatedness (average marginal effect, ∆_low =.23). Need for competence was more strongly positively associated with purpose in life for those high in relatedness (∆_high= .53) than for those low in relatedness (∆_low= .18; 2^nd difference = .36, p = .02). Furthermore, PA was associated with personal growth (b = .02; p =.03), and this effect was not moderated by any of the basic psychological needs. Need for autonomy was positively associated with personal growth, but only for those who also reported high competence. Multiple imputation analyses (N = 430) yielded findings and interpretations that were consistent with those from complete cases analysis (n = 182).

Conclusions: Both the quantity and quality of PA experiences impact older adult’s eudaimonic well-being. In line with self-determination theory, all three needs are necessary to optimize well-being, although they differentially interact with PA. Practically, results suggest that two different, tailored intervention options based on level of relatedness may be advantageous.

Cancer survivors can face marked internal barriers to physical activity attributable to cancer and its treatment (e.g., fatigue, pain, frustration). This population may benefit from a different approach to physical activity promotion than those featured by traditional interventions. The purpose of this study was to investigate the relevance and potential utility of an electronically delivered acceptance- and mindfulness-based approach to physical activity promotion for insufficiently active breast cancer survivors.

We used the Information Systems Research framework to develop intervention content in an iterative process with input from a convened panel of experts and cohorts of breast cancer survivors. The intervention consisted of audiovisual didactic content, experiential exercises, and electronic workbook-type activities that targeted principles and processes in Acceptance and Commitment Therapy. All intervention content was delivered to participants electronically via a secure, automated survey system (i.e., web pages) over the course of 4-8 weeks. We administered the System Usability Scale (SUS) and conducted individual interviews with participants after they experienced the intervention content. Interview proceedings were professionally transcribed, and three coders conducted thematic content analysis on the transcripts.

Of 30 recruited participants, 18 completed the SUS and 16 participated in an in-depth interview. The mean age of the sample was 58.4 years (SD = 13.8); the sample was relatively well-educated, mostly non-Hispanic white, and mostly overweight or obese. Results indicated high usability of intervention content (mean SUS score = 80.0, SD = 18.2). We identified three overarching themes from individual interviews. These were 1) barriers to physical activity adherence (subthemes: physical, psychological barriers), 2) the use of acceptance- and mindfulness-based techniques for physical activity promotion (acceptance, contact with the present moment, values, goal setting), and 3) digital behavior change intervention-related considerations (e.g., usability, usage patterns, participant burden, graphical design). Overall, intervention content was perceived to be relevant, uniquely empowering, and to fulfill important needs related to healthy living.

Electronically delivered acceptance- and mindfulness-based approaches hold promise for helping insufficiently active breast cancer survivors increase physical activity. Further research regarding the acceptability and potential efficacy of interventions that combine techniques from the field of psychotherapy with digital technologies is warranted.

Purpose: Telehealth interventions may offer a solution to the unique barriers that rural living presents to the delivery of health behaviour change interventions while simultaneously addressing the preferences of young adult cancer survivors (YACS). Although the effectiveness of online and mobile technologies for supporting behaviour change is growing, it remains unclear whether interventions delivered using teleconferencing technology can support YACS' motivation for behaviour change. The purpose of this study was to deliver a telehealth intervention to rural-living YACS and explore their physical activity (PA) levels, fruit and vegetable (FV) consumption, and the motivational processes underlying any behaviour changes.

Methods: The intervention was grounded in self-determination theory and embedded behaviour change techniques and motivational interviewing principles. Participants met with a health coach once a week for 60 minutes for 12 weeks. A concurrent triangulation design was used, wherein quantitative and qualitative data were collected and analyzed concurrently. Participants completed pre- and post-intervention surveys and a post-intervention interview. Survey data, used to describe the magnitude of differences in variables pre- to post-intervention, were analyzed using Wilcoxon matched-pairs signed rank tests. Interview data, used to explore the underlying mechanisms supporting behaviour change, were analyzed deductively using thematic analysis employing a self-determination theory lens.

Results/Findings: For the quantitative results, large effect sizes were observed for PA and FV consumption (rs=.63), perceptions of autonomy, competence, and relatedness related to PA and FV consumption (rs=.43-.63), and autonomous motivation for PA and FV consumption (rs=.51-.54). Medium effect sizes were observed for controlling motivation for PA and FV consumption (rs=.31-34). For the qualitative findings, five themes were created: (1) connecting with the health coach in an autonomy supportive environment; (2) developing capacity to have positive connections with others; (3) developing competence by autonomously mastering challenging tasks; (4) being in control of decisions promotes perceptions of autonomy, and; (5) motivation for behaviour change is dynamic and complex.

Conclusions: Results were aligned, suggesting motivation for behaviour change can be facilitated by one-on-one, synchronous sessions delivered via teleconferencing technology. Further, findings underscore the need to think beyond intervention content and consider  interpersonal style when communicating behaviour change techniques to participants.

Purpose: Recent studies suggest that the COVID-19 pandemic and related public health restrictions have resulted in changes in physical activity and sedentary behaviour. Qualitative studies exploring this phenomenon in depth are lacking. The purpose of this study was: 1) to explore the lived experiences of adults adapting their physical activity and sedentary behaviour during the COVID-19 pandemic; and 2) to describe impacts of COVID-19 on perceptions of health in relation to changes in physical activity and sedentary behaviour.

Methods: The study was undertaken in Calgary (Canada). Using a constructivist grounded theory methodology, semi-structured interviews were undertaken with 12 adults (50% female; 20-70 years old) from June to October 2020. A maximum variation sampling strategy to select participants was used to ensure diversity in the sample. Participants differed based on their sociodemographic characteristics, physical activity levels, and perceived seriousness and anxiety related to the COVID-19 pandemic. Interviews were conducted via telephone or video conferencing and focused on exploring experiences with physical activity and perceptions of health during the pandemic. Data were collected until saturation and thematic analysis undertaken.

Results: Four overarching themes were identified: 1) Disruption to Daily Routines; 2) Changes in Physical Activity; 3) Health Balancing, and; 4) Family Life. Many participants described how the pandemic has led to extensive change and disruption in their lives. Participants reported on facilitators and barriers they encountered in adapting their physical routines, including challenges related to the closure of recreation and fitness facilities. Negative mental health impacts, including anxiety and social isolation were also experienced by participants. Unexpectedly, some participants reflected on the positive opportunities COVID-19 had brought, including an enhanced feeling of balance in their lives.

Conclusions: Participants reported positive and negative impacts on physical activity due to the pandemic. Providing outdoor opportunities during public health restrictions because of recreational facility closures may be a viable strategy for maintaining adult’s regular physical activity during a pandemic. Supporting individuals with finding physical activities they find intrinsically enjoyable can support the adoption and adaptation process while improving mental well-being.

Purpose

Postpartum weight retention is a significant contributor to weight gain and obesity in women of reproductive age. Achieving and maintaining a healthy lifestyle during this period could be challenging. This study aimed to synthesise the barriers and facilitators to engaging in a healthy lifestyle during the first two years postpartum using the Capability, Opportunity, Motivation and Behaviour (COM-B) model.

Methods

Women who have given birth within the last two years and currently living with the child were recruited through convenience and snowball sampling to complete an interview (30-40 mins) via Zoom. Informed consent was obtained at the start of the interviews. Interviews were audio-recorded and transcribed using a professional transcription service. All interview transcripts were coded by one author (MS), with a 10% subset independently coded by other authors (SL, LM). Thematic analysis were conducted using an open coding approach. The main themes were subsequently mapped to the COM-B domains.

Results

A total of 21 postpartum women (mean age 37+10 years) completed the interviews. Of the facilitators, the main Capability was the ability to organise, plan and prioritise for healthy eating and exercise, mental well-being and sufficient sleep. The greatest source of Opportunity was that provided by partners, extended family and friends through practical and motivational support for healthy lifestyle. In addition, residential location was also an important factor in Opportunity for physical activity. Constructive self-talk and finding exercise that appeals were factors relating to Motivation that facilitates healthy lifestyle. Of the barriers, limitations in Capability included physical recovery from childbirth, sleep deprivation and reduced energy. Barriers in Opportunity included reduced income during maternity break and lack of social support for practical help. Barriers in Motivation included a lack of motivation and competing priorities from child’s needs.

Conclusions

This study summarised the key barriers and facilitators in terms of capability, opportunity and motivation for healthy lifestyle behaviours in postpartum women. Our findings suggest that postpartum lifestyle interventions should focus on organisational and planning skills, involve partners or extended families or friends, address infant and mother sleep issues, tailor exercise to women’s preference and include positive self-talk.