Investigating the Effects of a Physical Education (PE) Kit Intervention on Female Adolescent Body Esteem.

It is widely acknowledged that adolescent females are particularly at risk of low body esteem. Low body esteem is associated with poor mental health and other negative outcomes. Interventions to help raise body esteem could have a considerable impact, especially if the intervention is low cost, easy to implement, and scalable. We investigated the efficacy of an intervention where participants could choose their clothes to wear during a physical education lesson (PE). PE is a context associated with low body esteem, a finding that is particularly evident among females. We hypothesized that body esteem would improve with choice. To show that body esteem does not randomly change, we tested its stability when assessed in a test-retest design when completed in a classroom setting, hypothesizing that body esteem would be stable. Participants (n = 110; Age M = 14.9 years; SD = 0.68 years) completed a 14-item body esteem scale eight times: (a) wearing the school uniform in a classroom and (b) during a PE lesson on two occasions in each context within a week. This was repeated at the re-test, which was separated by a two-week gap. The intervention was implemented and students were given a choice of PE kit and could wear their own (non-designer) clothes. The findings indicate that the choice of PE kit intervention was associated with improved body esteem in a PE context but was stable in a classroom context, which we hypothesized to be stable. We argue that this low-cost and scalable intervention represents a useful starting point for helping to support females with low body esteem among a potentially vulnerable population.

Digital consultations for weight management in the NHS: A qualitative evaluation.

Receiving digital healthcare consultations for weight management, in place of in-person appointments, has proliferated in recent years, accelerated by the COVID-19 pandemic. The objective of the present study was to investigate patients' experiences of digital weight management services (DWMS) provided by the National Health Service (NHS). Particular emphasis was placed on examining the perceived benefits and limitations of DWMS so as to identify potential means of improving provision. Sixteen patients (eight male; eight female) accessing digital consultations at one of two West Midlands (UK) NHS trusts, participated in semi-structured interviews. Interviews were transcribed verbatim and analysed via thematic analysis. We identified three overarching themes and associated sub-themes that reflect the perceived benefits and limitations of service provision as identified by patients. These were technology acceptability (sub-themes 'challenges', 'requirements/facilitators', and 'beneficial features'); treatment acceptability (sub-themes 'treatment features', 'patient attributes', and 'practitioner skills'); and treatment efficacy (sub-themes 'treatment features', 'patient attributes', and 'practitioner skills'). Themes identified in this study have informed recommendations intended to enhance acceptability of DWMS technology and treatment, potentially encouraging engagement and increasing treatment efficacy. Limitations of the present study and recommendations for further research are also presented.

Brief emotional eating scale: A multinational study of factor structure, validity, and invariance.

Emotional eating or the tendency to eat in response to emotional states can be assessed using self-report measures. The Emotional Eating Scale-II is a commonly used and reliable instrument that measures the desire to eat in response to a range of unpleasant and pleasant emotions. The current study aimed to corroborate the validity of the EES-II and expand its utility by investigating its dimensionality and testing its measurement invariance in samples from English-speaking and non-English-speaking countries. Convergent and predictive validity in respect of food craving, eating, and health indicators were also examined. This cross-national study included a total of 2485 adult participants recruited from Finland, North America, Philippines, United Kingdom, China, Italy, Spain, and South Korea, who completed the EES-II in six different languages. Factor analyses supported a four-factor structure including valence (pleasant, unpleasant) and activation (high, low) for a 12-item English version and slightly modified non-English adaptations. The model exhibited good fit in all samples, and convergent validity was demonstrated. Full invariance of factor loadings and partial invariance of factor loading, intercepts, and error variances was established across samples. Structural equation models revealed that high activation (pleasant and unpleasant) states predicted food cravings and reported eating. Overall findings across multiple samples and countries supported the factorial structure, reliability, invariance, and validity of the resulting Brief Emotional Eating Scale (BEES).

Brief Remote Intervention to Manage Food Cravings and Emotions During the COVID-19 Pandemic: A Pilot Study.

As a result of the COVID-19 pandemic people have endured potentially stressful challenges which have influenced behaviors such as eating. This pilot study examined the effectiveness of two brief interventions aimed to help individuals deal with food cravings and associated emotional experiences. Participants were 165 individuals residing in United Kingdom, Finland, Philippines, Spain, Italy, Brazil, North America, South Korea, and China. The study was implemented remotely, thus without any contact with researchers, and involved two groups. Group one participants were requested to use daily diaries for seven consecutive days to assess the frequency of experience of their food cravings, frequency of giving in to cravings, and difficulty resisting cravings, as well as emotional states associated with their cravings. In addition to completing daily food diaries, participants in group two were asked to engage in mindful eating practice and forming implementation intentions. Participants assessed their perceived changes in eating, wellbeing, and health at the beginning and end of the intervention. Repeated measures MANOVAs indicated that participants experienced significantly less food cravings (i.e., craving experience, acting on cravings, difficulty resisting), as well as lower intensities of unpleasant states associated with cravings across time (T1 vs. T7). In contrast to our hypothesis, the main effects of the group (food craving diary vs. food craving diary and mindful eating practice) were not significant. Participants reported less eating and enhanced wellbeing at the end of the study (T7 vs. T1). Our findings can be used to inform future remote interventions to manage food cravings and associated emotions and highlight the need for alternative solutions to increase participant engagement.

Considerations of Control Groups: Comparing Active-Control with No Treatment for Examining the Effects of Brief Intervention.

BACKGROUND: A large-scale online study completed by this research team found that brief psychological interventions were associated with high-intensity pleasant emotions and predicted performance. The present study extends this work using data from participants (n = 3376) who completed all self-report data and engaged in a performance task but who did not engage with an intervention or control condition and therefore present as an opportunistic no-treatment group. METHODS: 41,720 participants were selected from the process and outcome focus goals intervention groups, which were the successful interventions (n = 30,096), active-control (n = 3039), and no-treatment (n = 8585). Participants completed a competitive task four times: first as practice, second to establish a baseline, third following an opportunity to complete a brief psychological skills intervention, and lastly following an opportunity to repeat the intervention. Repeated measures MANOVA indicated that over four performance rounds, the intensity of positive emotions increased, performance improved, and the amount of effort participants exerted increased; however, these increases were significantly smaller in the no-treatment group. CONCLUSIONS: Findings suggest that not engaging in active training conditions had negative effects. We suggest that these findings have implications for the development and deployment of online interventions.

Toward Improved Triadic Functioning: Exploring the Interactions and Adaptations of Coaches, Parents and Athletes in Professional Academy Soccer Through the Adversity of COVID-19.

On March 23rd, 2020, elite soccer academies in the UK closed in compliance with the government enforced lockdown intended to contain the COVID-19 pandemic. This forced parents, players, and coaches to reconsider how they interacted with, and supported, one another. The aims of the present study were (a) to explore the perceptions of players, parents, and coaches (i.e., the athletic triangle) regarding how they interacted and collaborated with one another during the COVID-19 pandemic to support wellbeing and performance, and; (b) to identify opportunities to enhance workings of those within the athletic triangle resulting from adaptions made following enforced lockdown. Using an interpretive description methodology, semi-structured interviews were conducted with five coaches, six players, and six parents from an English elite academy soccer club. Interviews were analyzed using thematic analysis. Findings highlighted (a) the importance of support and the different means of communication used between members of the athletic triangle to facilitate such support; (b) the increased understanding of each member of the athletic triangle, leading to enhanced relationships, and; (c) how members of the athletic triangle adapted practice to facilitate relationship development during the pandemic and beyond. The identification of these considerations has implications for coach and parent education initiatives to allow for optimal functioning of the athletic triangle as elite academy soccer clubs return from lockdown. These include (a) the importance of continued communication between coach, athlete and parent; (b) increasing understanding of each individual within the athletic triangle; and (c) utilizing key interpersonal and technological skills learnt during the lockdown to further facilitate engagement within the athletic triangle.

A Cross-Cultural Exploratory Study of Health Behaviors and Wellbeing During COVID-19.

This study explored the influence of the COVID-19 pandemic on perceived health behaviors; physical activity, sleep, and diet behaviors, alongside associations with wellbeing. Participants were 1,140 individuals residing in the United Kingdom (n = 230), South Korea (n = 204), Finland (n = 171), Philippines (n = 132), Latin America (n = 124), Spain (n = 112), North America (n = 87), and Italy (n = 80). They completed an online survey reporting possible changes in the targeted behaviors as well as perceived changes in their physical and mental health. Multivariate analyses of covariance (MANCOVA) on the final sample (n = 1,131) revealed significant mean differences regarding perceived physical and mental health "over the last week," as well as changes in health behaviors during the pandemic by levels of physical activity and country of residence. Follow up analyses indicated that individuals with highest decrease in physical activity reported significantly lower physical and mental health, while those with highest increase in physical activity reported significantly higher increase in sleep and lower weight gain. United Kingdom participants reported lowest levels of physical health and highest increase in weight while Latin American participants reported being most affected by emotional problems. Finnish participants reported significantly higher ratings for physical health. The physical activity by country interaction was significant for wellbeing. MANCOVA also revealed significant differences across physical activity levels and four established age categories. Participants in the oldest category reported being significantly least affected by personal and emotional problems; youngest participants reported significantly more sleep. The age by physical activity interaction was significant for eating. Discussed in light of Hobfoll (1998) conservation of resources theory, findings endorse the policy of advocating physical activity as a means of generating and maintaining resources combative of stress and protective of health.

A systematic review of the association between emotions and eating behaviour in normal and overweight adult populations.

A systematic review was completed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search of four electronic databases (2004-2015) yielded 60,017 articles, of which 29 met inclusion criteria. Included studies performed poorly on data quality analysis in terms of randomisation and controlling for confounding factors. Participant's body mass index scores range from 19.73 (standard deviation = 1.54) to 28.4 (standard deviation = 1.4) kg/m2. Where positive and negative affects were compared, food was more likely to be consumed in response to positive affect. With regard to discrete emotions; stress, depression and sadness consistently elicited eating behaviours that fall outside of nutritional recommendations (e.g. increased food intake or poor nutritional food choices). The role of moderators including individual differences in dietary restraint and emotional eating, as well as methodological considerations, such as means of eliciting and measuring emotions, may account for equivocality with regard to some emotion and eating associations. This article concludes with recommendations for future research and implications for practice.

The Effects of Coping Interventions on Ability to Perform Under Pressure.

The ability to perform under pressure is necessary to achieve goals in various domains of life. We conducted a systematic review to synthesise findings from applied studies that focus on interventions developed to enhance an individual's ability to cope under performance pressure. Following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, a comprehensive search of five electronic databases was conducted. This yielded 66,618 records, of which 23 peer review papers met inclusion criteria of containing an intervention that targeted coping skills for performing under pressure. Using the Standard Quality Assessment for evaluation of primary research papers (Kmet et al., 2004) to assess quality, included studies performed well on reporting research objectives, research design, and statistical procedures. Sixteen studies showed poor quality in controlling for potentially confounding factors and small sample sizes. A narrative aggregate synthesis identified intervention studies that provided an educational focus (n = 9), consultancy sessions (n = 6), simulation training (n = 5) and emotion regulation strategies (n = 3). Findings highlight a need to; 1) establish a contextualized pressure task which will generate high levels of ecological validity for participants. Having established a suitable pressure task, 2) research should assess the effects of pressure by evaluating conscious and nonconscious effects and associated coping mechanisms, which should inform the subsequent development of interventions, and 3) assess interventions to enhance understanding of the ways in which they improve coping with pressure, or may fail, and the mechanisms which may explain these outcomes.

It's not just 'What' you do, it's also the 'Way' that you do it: Patient and Public Involvement in the Development of Health Research.

PURPOSE: This article presents a reflective account of Patient and Public Involvement (PPI) in the development of obesity and binge eating research. METHOD: We established Patient Advisory Groups (PAGs) at two English regional National Health Service (NHS) weight management services. PPI was evaluated as follows: (i) PAG members completed a Post Participation Evaluation Questionnaire, (ii) PAG meetings captured group discussion on PPI involvement, (iii) practitioner and researchers produced written reflections on PPI and (iv) sources one to three were consolidated during reflections that took place via e-mail and telephone correspondence between researchers and practitioners, culminating in a summary SKYPE meeting between one practitioner and one researcher involved in the PAGs. RESULTS: Results in the form of reflections suggest guidelines on undertaking PPI were helpful with regard 'what to do', but less helpful on 'how'. For example, suggestions for the management of interpersonal factors such as eliciting self-disclosure and managing power differentials are insufficiently addressed in existing guidelines. CONCLUSIONS: The present case study illustrated how interpersonal considerations can help or hinder the optimal use of PPI. Recommendations for practitioners and researchers planning PPI are offered.

The Influence of a Pacesetter on Psychological Responses and Pacing Behavior during a 1600 m Run.

This study compared the effects of following a pacer versus following a self-paced plan on psychological responses and pacing behavior in well-trained distance runners. Pacing in the present study was individually tailored where each participant developed a personal strategy to ensure their goal time was achieved. We expected that following a pacer would associate with goal achievement, higher pre-run confidence, positive emotions and lower perceived exertion during performance. In a mixed-design repeated-measures study, nineteen well-trained runners completed two 1600m running time trials. Ten runners had a pacer (paced group) who supported their individual pacing strategy, and nine participants self-paced running alone (control group). Both groups could check pace using their wrist watch. In contrast to our expectation, results indicated that the paced group reported higher pre-run anxiety with no significant differences in finish time, goal confidence, goal difficulty, perceived exertion, and self-rated performance between groups. We suggest that following a pacer is a skill that requires learning. Following a personalised pacer might associate with higher anxiety due to uncertainty in being able to keep up with the pacer and public visibility of dropping behind, something that is not so observable in a self-paced run completed alone. Future research should investigate mechanisms associated with effective pacing.

A Test and Extension of Lane and Terry's (2000) Conceptual Model of Mood-Performance Relationships Using a Large Internet Sample.

The present study tested and extended Lane and Terry (2000) conceptual model of mood-performance relationships using a large dataset from an online experiment. Methodological and theoretical advances included testing a more balanced model of pleasant and unpleasant emotions, and evaluating relationships among emotion regulation traits, states and beliefs, psychological skills use, perceptions of performance, mental preparation, and effort exerted during competition. Participants (N = 73,588) completed measures of trait emotion regulation, emotion regulation beliefs, regulation efficacy, use of psychological skills, and rated their anger, anxiety, dejection, excitement, energy, and happiness before completing a competitive concentration task. Post-competition, participants completed measures of effort exerted, beliefs about the quality of mental preparation, and subjective performance. Results showed that dejection associated with worse performance with the no-dejection group performing 3.2% better. Dejection associated with higher anxiety and anger scores and lower energy, excitement, and happiness scores. The proposed moderating effect of dejection was supported for the anxiety-performance relationship but not the anger-performance relationship. In the no-dejection group, participants who reported moderate or high anxiety outperformed those reporting low anxiety by about 1.6%. Overall, results showed partial support for Lane and Terry's model. In terms of extending the model, results showed dejection associated with greater use of suppression, less frequent use of re-appraisal and psychological skills, lower emotion regulation beliefs, and lower emotion regulation efficacy. Further, dejection associated with greater effort during performance, beliefs that pre-competition emotions did not assist goal achievement, and low subjective performance. Future research is required to investigate the role of intense emotions in emotion regulation and performance.

Inconsistency of decision-making, the Achilles heel of referees.

This study assessed whether decisions made by six qualified referees were consistent when watching the live 2016 televised Champions League Final. Referees were paired off into three separate rooms. Two referees watched the game with no supporters present. Two watched the game surrounded by Real Madrid supporters, and the remaining two watched the game surrounded by Athletic Madrid supporters. Referees were asked to decide whether each decision made by the on-field referee was either correct or incorrect. Results identified two types of refereeing inconsistency. The first type was a systematic tendency of the supporting crowds (both rooms) to influence the adjudicating referees to make fewer incorrect (disagree with the on-field referee) decisions (8 and 5) than referees in the "no supporters" room (19) (χ2 = 11.22 [df = 2], P = 0.004). The second type of inconsistency was the home advantage "bias", where the surrounding crowd influenced the adjudicating referees to favour their team, by disagreeing with the decision made by the on-field referee (χ2 = 6.0 [df = 2], P = 0.0498). One explanation for these inconsistencies is that referees adopt a coping strategy of "avoidance", i.e., when faced with difficult decisions, referees simply avoid making unpopular decisions by waving "play on".

Beyond the technical: The role of emotion regulation in lacrosse officiating.

Emotions can influence the performance of referees leading to a need to examine emotions experienced, and regulation strategies used by referees. The present study assessed emotions and emotion regulation strategies of 19 referees officiating at an Under-19 Lacrosse World Championship. Using survey methods and focus group interviews, officials responded to five questions: (a) What emotions were experienced? (b) What events elicited emotions? (c) How did lacrosse officials manage their own emotional states prior to, throughout, and following a competitive game? (d) How did officials manage others' emotional states? (e) What were the perceived consequences of these strategies? Results indicate that emotions fluctuated throughout the tournament as referees encountered intrapersonal and interpersonal emotion-eliciting events. These fluctuations are suggested to come from a progressively diminished capacity for emotion regulation. Participants used emotion regulation strategies that could be classified into Gross' (1999) families of emotion regulation strategies, often relying on suppression, emotion contagion, and preventative refereeing. Collectively, the results offer new insights into referee emotion regulation at international events.

Brief Online Training Enhances Competitive Performance: Findings of the BBC Lab UK Psychological Skills Intervention Study.

In conjunction with BBC Lab UK, the present study developed 12 brief psychological skill interventions for online delivery. A protocol was designed that captured data via self-report measures, used video recordings to deliver interventions, involved a competitive concentration task against an individually matched computer opponent, and provided feedback on the effects of the interventions. Three psychological skills were used; imagery, self-talk, and if-then planning, with each skill directed to one of four different foci: outcome goal, process goal, instruction, or arousal-control. This resulted in 12 different intervention participant groups (randomly assigned) with a 13th group acting as a control. Participants (n = 44,742) completed a competitive task four times-practice, baseline, following an intervention, and again after repeating the intervention. Results revealed performance improved following practice with incremental effects for imagery-outcome, imagery-process, and self-talk-outcome and self-talk-process over the control group, with the same interventions increasing the intensity of effort invested, arousal and pleasant emotion. Arousal-control interventions associated with pleasant emotions, low arousal, and low effort invested in performance. Instructional interventions were not effective. Results offer support for the utility of online interventions in teaching psychological skills and suggest brief interventions that focus on increasing motivation, increased arousal, effort invested, and pleasant emotions were the most effective.

The attitudes of student nurses towards obese patients: A questionnaire study exploring the association between perceived causal factors and advice giving.

BACKGROUND: Nurses acting in primary care roles are central in addressing obesity as a public health priority. Nurses with a lower Body Mass Index have been shown to have negative attitudes towards obesity. Additionally, where the patient is perceived as being responsible for their excess weight, a negative attitude may also be held. The extent to which negative attitudes may influence the advice provided by nurses to obese patients is unknown. OBJECTIVES: The present paper sought to examine whether the level of advice offered to obese patients by student nurses is associated with (i) the perceived causal factors of obesity, (ii) attitudes towards obesity and (iii) body mass index of the nurse. METHOD: Participants were 92 student nurses from a university in the Midlands, UK. Participants received one of four patient vignettes; three were affected by obesity, with reference to either a behavioural, social, or medical cause; and the fourth was normal weight. Student nurses elected advice they would offer from five staged options (from no active involvement in advising the patient, through to discussing dietary advice). Attitudes towards obesity and social desirability were measured using validated questionnaires. RESULTS: No association was found between the level of advice offered and either the causal factor of obesity, the student nurses' attitude towards obesity, or the nurses' Body Mass Index. Most students endorsed the highest level of advice-a patient centred discussion. CONCLUSION: Findings show that advice giving by student nurses was not associated with perceived cause of obesity, or attitude, but is in line with the current Nursing and Midwifery Council (2015) recommendations. That is, most students endorsed a patient centred discussion. This suggests that professional training guidelines for the non-judgemental treatment of obese patients are not only being recognised, but implemented.

How should I regulate my emotions if I want to run faster?

The present study investigated the effects of emotion regulation strategies on self-reported emotions and 1600 m track running performance. In stage 1 of a three-stage study, participants (N = 15) reported emotional states associated with best, worst and ideal performance. Results indicated that a best and ideal emotional state for performance composed of feeling happy, calm, energetic and moderately anxious whereas the worst emotional state for performance composed of feeling downhearted, sluggish and highly anxious. In stage 2, emotion regulation interventions were developed using online material and supported by electronic feedback. One intervention motivated participants to increase the intensity of unpleasant emotions (e.g. feel more angry and anxious). A second intervention motivated participants to reduce the intensity of unpleasant emotions (e.g. feel less angry and anxious). In stage 3, using a repeated measures design, participants used each intervention before running a 1600 m time trial. Data were compared with a no treatment control condition. The intervention designed to increase the intensity of unpleasant emotions resulted in higher anxiety and lower calmness scores but no significant effects on 1600 m running time. The intervention designed to reduce the intensity of unpleasant emotions was associated with significantly slower times for the first 400 m. We suggest future research should investigate emotion regulation, emotion and performance using quasi-experimental methods with performance measures that are meaningful to participants.

The BASES expert statement on emotion regulation in sport.

Emotions experienced before and during sports competition have been found to influence sports performance. Emotion regulation is defined as the automatic or deliberate use of strategies to initiate, maintain, modify or display emotions (Gross & Thompson, 2007) and is proposed to occur when a discrepancy exists between current and desired emotions. Two distinct motivations to regulate emotion - hedonic and instrumental (in short, for pleasure or for purpose) - have been proposed (Tamir, 2009). The instrumental approach might provide a more fruitful area of investigation for sports researchers as some athletes hold beliefs that supposedly pleasant emotions such as happiness and calmness associate with poor performance and supposedly unpleasant emotions such as anxiety and anger associate with good performance (Hanin, 2010). Athletes are more likely to try to regulate an emotion if they believe that doing so will facilitate performance. Strategies that encourage re-appraisal of factors that trigger emotions are proposed to be preferable. In this British Association of Sport and Exercise Sciences (BASES) expert statement, a summary of the key theoretical issues are offered leading to evidence-based recommendations for practitioners and researchers.

Keeping your cool: a case study of a female explorer's solo North Pole expedition.

OBJECTIVE: This study explored stress and coping experiences during a solo expedition to the North Pole using concurrent and retrospective methods. METHODS: A 47-year-old female explorer, with 12 years of polar experience, completed a daily diary during the expedition. On return, 2 semistructured interviews were completed to identify the challenges and coping efforts perceived as being most pertinent during her expedition. RESULTS: Inductive coding identified 4 broad stressors, including environmental conditions, personal challenges, supporting resources, and expedition progress. CONCLUSIONS: Findings highlight the importance of expedition preparation in establishing coping efficacy in managing the extreme demands placed upon polar explorers. Findings also evidence idiosyncrasies in the choice and application of coping strategies and, thus, highlight the need to avoid generalizations regarding coping outcomes.

Effects of music interventions on emotional States and running performance.

The present study compared the effects of two different music interventions on changes in emotional states before and during running, and also explored effects of music interventions upon performance outcome. Volunteer participants (n = 65) who regularly listened to music when running registered online to participate in a three-stage study. Participants attempted to attain a personally important running goal to establish baseline performance. Thereafter, participants were randomly assigned to either a self-selected music group or an Audiofuel music group. Audiofuel produce pieces of music designed to assist synchronous running. The self-selected music group followed guidelines for selecting motivating playlists. In both experimental groups, participants used the Brunel Music Rating Inventory-2 (BMRI-2) to facilitate selection of motivational music. Participants again completed the BMRI-2 post- intervention to assess the motivational qualities of Audiofuel music or the music they selected for use during the study. Results revealed no significant differences between self-selected music and Audiofuel music on all variables analyzed. Participants in both music groups reported increased pleasant emotions and decreased unpleasant emotions following intervention. Significant performance improvements were demonstrated post-intervention with participants reporting a belief that emotional states related to performance. Further analysis indicated that enhanced performance was significantly greater among participants reporting music to be motivational as indicated by high scores on the BMRI-2. Findings suggest that both individual athletes and practitioners should consider using the BMRI-2 when selecting music for running. Key pointsListening to music with a high motivational quotient as indicated by scores on the BMRI-2 was associated with enhanced running performance and meta-emotional beliefs that emotions experienced during running helped performance.Beliefs on the effectiveness of music intended to alter emotions were associated with high scores on the BMRI-2.Runners seeking to use music as an emotion regulating strategy should consider using the BMRI-2 as an effective means by which to identify potentially motivating tracks.