Effects of 12 Weeks of At-Home, Application-Based Exercise on Health Care Workers' Depressive Symptoms, Burnout, and Absenteeism: A Randomized Clinical Trial.

Importance: During the COVID-19 pandemic, health care workers (HCWs) reported a significant decline in their mental health. One potential health behavior intervention that has been shown to be effective for improving mental health is exercise, which may be facilitated by taking advantage of mobile application (app) technologies. Objective: To determine the extent to which a 12-week app-based exercise intervention can reduce depressive symptoms, burnout, and absenteeism in HCWs, compared with a wait list control condition. Design, Setting, and Participants: A 2-group randomized clinical trial was conducted, with participants screened from April 6 to July 4, 2022. Participants were recruited from an urban health care organization in British Columbia, Canada. Participants completed measures before randomization and every 2 weeks thereafter. Interventions: Exercise condition participants were asked to complete four 20-minute sessions per week using a suite of body weight interval training, yoga, barre, and running apps. Wait-listed control participants received the apps at the end of the trial. Main Outcomes and Measures: The primary outcome consisted of the between-group difference in depressive symptoms measured with the 10-item Center for Epidemiological Studies Depression Scale. The secondary outcomes corresponded to 3 subfacets of burnout (cynicism, emotional exhaustion, and professional efficacy) and absenteeism. Intention-to-treat analyses were completed with multilevel structural equation modeling, and Feingold effect sizes (ES) were estimated every 2 weeks. Results: A total of 288 participants (mean [SD] age, 41.0 [10.8] years; 246 [85.4%] women) were randomized to either exercise (n = 142) or wait list control (n = 146) conditions. Results revealed that ESs for depressive symptoms were in the small to medium range by trial's end (week 12, -0.41 [95% CI, -0.69 to -0.13]). Significant and consistent treatment effects were revealed for 2 facets of burnout, namely cynicism (week 12 ES, -0.33 [95% CI, -0.53 to -0.13]) and emotional exhaustion (week 12 ES, -0.39 [95% CI, -0.64 to -0.14]), as well as absenteeism (r = 0.15 [95% CI, 0.03-0.26]). Adherence to the 80 minutes per week of exercise decreased from 78 (54.9%) to 33 (23.2%) participants between weeks 2 and 12. Conclusions and Relevance: Although exercise was able to reduce depressive symptoms among HCWs, adherence was low toward the end of the trial. Optimizing adherence to exercise programming represents an important challenge to help maintain improvements in mental health among HCWs. Trial Registration: ClinicalTrials.gov Identifier: NCT05271006.

Effects of older adults' social identification on psychological flourishing and exercise program adherence.

BACKGROUND: With the onset of the COVID-19 pandemic, many exercise programs moved online. The purpose of this study was to examine the extent to which older adults' social identification with other exercise program members contributed to their psychological flourishing and exercise program adherence. METHODS: The study represented a secondary analysis of data derived from the Seniors COVID-19 Pandemic and Exercise (SCOPE) Trial, in which older adults were randomized to a waitlist control condition or one of two online (personal v group) exercise programs. Only data from participants in the trial intervention conditions (N = 162; Mage = 73.52 years; SD = 5.61) were utilized in this secondary analysis. We assessed psychological flourishing and social identification at baseline and every two weeks, as well as program adherence over each 2-week block, for 12 weeks. RESULTS: Based on stepwise multilevel modeling the results revealed that older adults' social identification with others in their respective exercise program had a direct effect on psychological flourishing (ΔR2Unique Marginal = 0.063, p < .001) and program adherence (ΔR2Unique Marginal = 0.014, p = .03). CONCLUSIONS: The results highlight the value of bolstering older adults' social identification with others in an online exercise program to support adherence and well-being.

Combined effects of cumulative stress and daily stressors on daily health.

OBJECTIVE: It has been proposed that cumulative stress, one's experience of chronic stressors across multiple domains, worsens health by altering the extent to which daily stressors impact daily affect and physical symptoms. Recent work confirms that high cumulative stress exacerbates the association between daily stressor exposure and increased daily negative affect, though it remains untested the extent to which cumulative stress and daily stressor exposure interact to predict daily symptoms. METHOD: We employed data from the second wave of the midlife in the U.S. Survey (N = 2,022; Mage = 56.2; 57.2% female) to examine whether levels of cumulative stress compound daily symptoms on days with (vs. without) stressful events. Experiences of life stressors across eight domains, occurrence of daily stressors, and occurrence, number, and severity of daily physical symptoms were analyzed using multilevel modeling. RESULTS: Greater cumulative stress and experiencing (vs. not experiencing) a daily stressor independently increased the odds of occurrence, number, and severity of daily symptoms (ps ≤ .016). Moreover, after adjusting for covariates (e.g., sociodemographic characteristics, chronic health conditions, percent of days with reported stressors, and health behaviors), the associations between daily stressor exposure and odds of occurrence, number, and severity of daily symptoms were potentiated as levels of cumulative stress increased (ps ≤ .009). CONCLUSIONS: The negative implications of daily stressor exposure for daily health may be most pronounced in those who report higher levels of cumulative stress across multiple life domains and across time. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Continuous-Time Modeling of the Bidirectional Relationship Between Incidental Affect and Physical Activity.

BACKGROUND: Previous research suggests that there is a bidirectional relationship between incidental affect (i.e., how people feel in day-to-day life) and physical activity behavior. However, many inconsistencies exist in the body of work due to the lag interval between affect and physical activity measurements. PURPOSE: Using a novel continuous-time analysis paradigm, we examined the temporal specificity underlying the dynamic relationship between positive and negative incidental affective states and moderate-to-vigorous physical activity (MVPA). METHODS: A community sample of adults (n = 126, Mage = 27.71, 51.6% Male) completed a 14-day ambulatory assessment protocol measuring momentary positive and negative incidental affect six times a day while wearing a physical activity monitor (Fitbit). Hierarchical Bayesian continuous-time structural equation modeling was used to elucidate the underlying dynamics of the relationship between incidental affective states and MVPA. RESULTS: Based on the continuous-time cross-effects, positive and negative incidental affect predicted subsequent MVPA. Furthermore, engaging in MVPA predicted subsequent positive and negative incidental affect. Incidental affective states had a greater relative influence on predicting subsequent MVPA compared to the reciprocal relationship. Analysis of the discrete-time coefficients suggests that cross-lagged effects increase as the time interval between measurements increase, peaking at about 8 h between measurement occasions before beginning to dissipate. CONCLUSIONS: The results provide support for a recursive relationship between incidental affective states and MVPA, which is particularly strong at 7-9 hr time intervals. Future research designs should consider these medium-term dynamics, for both theory development and intervention.

Effects of Chronic Burden Across Multiple Domains and Experiences of Daily Stressors on Negative Affect.

BACKGROUND: Exposure to chronic psychological stress across multiple life domains (multi-domain chronic burden) is associated with poor health. This may be because multi-domain chronic burden influences daily-level emotional processes, though this hypothesis has not been thoroughly tested. PURPOSE: The current study tested whether (a) multi-domain chronic burden is associated with greater exposure to daily stressors and (b) multi-domain chronic burden compounds negative affect on days with stressors compared to stressor-free days. METHODS: The MIDUS Study (Wave II) and the National Study of Daily Experiences sub-study were conducted from 2004 to 2006 (N = 2,022). Participants reported on eight life domains of psychological stress used to create a multi-domain chronic burden summary score. For eight consecutive days, participants reported the daily occurrence of stressful events and daily negative affect. RESULTS: Participants with greater multi-domain chronic burden were significantly more likely to report daily stressors. There was also a significant interaction between multi-domain chronic burden and daily stressors on negative affect: participants with higher multi-domain chronic burden had greater negative affect on stressor days than stressor-free days compared to those with lower multi-domain chronic burden. CONCLUSION: Participants with higher multi-domain chronic burden were more likely to report daily stressors and there was a compounding effect of multi-domain chronic burden and daily stressors on negative affect. These results suggest that experiencing a greater amount of psychological stress across multiple life domains may make daily stressors more toxic for daily affect.

COVID-19 Pandemic and Exercise (COPE) trial: a multigroup pragmatic randomised controlled trial examining effects of app-based at-home exercise programs on depressive symptoms.

BACKGROUND: The number of adults across the globe with significant depressive symptoms has grown substantially during the COVID-19 pandemic. The extant literature supports exercise as a potent behaviour that can significantly reduce depressive symptoms in clinical and non-clinical populations. OBJECTIVE: Using a suite of mobile applications, at-home exercise, including high intensity interval training (HIIT) and/or yoga, was completed to reduce depressive symptoms in the general population in the early months of the pandemic. METHODS: A 6-week, parallel, multiarm, pragmatic randomised controlled trial was completed with four groups: (1) HIIT, (2) Yoga, (3) HIIT+yoga, and (4) waitlist control (WLC). Low active, English-speaking, non-retired Canadians aged 18-64 years were included. Depressive symptoms were measured at baseline and weekly following randomisation. RESULTS: A total of 334 participants were randomised to one of four groups. No differences in depressive symptoms were evident at baseline. The results of latent growth modelling showed significant treatment effects in depressive symptoms for each active group compared with the WLC, with small effect sizes (ESs) in the community-based sample of participants. Treatment groups were not significantly different from each other. Effect sizes were very large (eg, week 6 ES range=-2.34 to -2.52) when restricting the analysis only to participants with high depressive symptoms at baseline. CONCLUSIONS: At-home exercise is a potent behaviour to improve mental health in adults during the pandemic, especially in those with increased levels of depressive symptoms. Promotion of at-home exercise may be a global public health target with important personal, social and economic implications as the world emerges scathed by the pandemic. TRIAL REGISTRATION NUMBER: NCT04400279.

The Effects of Aerobic Exercise on Psychological Functioning in Family Caregivers: Secondary Analyses of a Randomized Controlled Trial.

BACKGROUND: The responsibility and stress of being a family caregiver are associated with reduced physical and mental health. PURPOSE: To examine whether a 24-week aerobic exercise program improves multiple aspects of psychological functioning in family caregivers. METHODS: Family caregivers of patients with Alzheimer's disease and other dementias (n = 68) were recruited and randomized into either an aerobic exercise group (n = 34) or a waitlist control group (n = 34). The exercise group was assigned a 24-week aerobic training program that incrementally increased the intensity, duration, and frequency of the exercise program until 150 min of moderate to vigorous activity were completed per week by the ninth week. Twelve measures of psychological functioning were administered at baseline and compared with responses completed following the intervention. RESULTS: Multilevel modeling revealed significant decreases in caregiver burden (ß = -4.60, 95% confidence interval [CI] = [-8.82, -0.38], RLMM2 = 0.11) and depression (ß = -2.59, 95% CI = [-4.79, -0.38], RLMM2 = 0.13), as well as increases in mastery (ß = 1.78, 95% CI = [0.09, 3.46], RLMM2 = .04) in the exercise intervention group compared to the control group. CONCLUSION: Family caregivers report high levels of depression and caregiver burden. Engagement in a 24-week exercise intervention can ameliorate the perceived burden of caregiving, symptoms of depression, and their sense of mastery.

Predicting mortality from 57 economic, behavioral, social, and psychological factors.

Behavioral and social scientists have identified many nonbiological predictors of mortality. An important limitation of much of this research, however, is that risk factors are not studied in comparison with one another or from across different fields of research. It therefore remains unclear which factors should be prioritized for interventions and policy to reduce mortality risk. In the current investigation, we compare 57 factors within a multidisciplinary framework. These include (i) adverse socioeconomic and psychosocial experiences during childhood and (ii) socioeconomic conditions, (iii) health behaviors, (iv) social connections, (v) psychological characteristics, and (vi) adverse experiences during adulthood. The current prospective cohort investigation with 13,611 adults from 52 to 104 y of age (mean age 69.3 y) from the nationally representative Health and Retirement Study used weighted traditional (i.e., multivariate Cox regressions) and machine-learning (i.e., lasso, random forest analysis) statistical approaches to identify the leading predictors of mortality over 6 y of follow-up time. We demonstrate that, in addition to the well-established behavioral risk factors of smoking, alcohol abuse, and lack of physical activity, economic (e.g., recent financial difficulties, unemployment history), social (e.g., childhood adversity, divorce history), and psychological (e.g., negative affectivity) factors were also among the strongest predictors of mortality among older American adults. The strength of these predictors should be used to guide future transdisciplinary investigations and intervention studies across the fields of epidemiology, psychology, sociology, economics, and medicine to understand how changes in these factors alter individual mortality risk.

Vascular effects of physical activity are not modified by short-term inhaled diesel exhaust: Results of a controlled human exposure study.

BACKGROUND: The combined effects of physical activity and air pollution exposure on vascular function are insufficiently understood, particularly after the inhalation of a ß2-agonist, a vasodilating agent. OBJECTIVE: To assess the micro- and macrovascular response to physical activity after ß2-agonist use while breathing diesel exhaust (DE) in individuals with exercise-induced bronchoconstriction. METHODS: On four exposure visits, eighteen adults inhaled either 400 µg of the ß2-agonist salbutamol or placebo before resting for 60 min, followed by a 30-min cycling bout. During rest and cycling, participants inhaled filtered air (FA) or DE (300 µg/m3 of PM2.5). Microvascular (central retinal arteriolar and venular equivalents, CRAE and CRVE, respectively) and macrovascular parameters (blood pressure (BP)) and heart rate (HR)) were assessed at baseline (T1), 10 min (T2) and 70 min (T3) after cycling. RESULTS: The cycling bout increased CRAE (T2-T1 difference (95th % confidence interval): 4.88 µm (4.73, 5.00 µm), p < 0.001; T3-T1 difference: 2.10 µm (1.62, 2.58 µm), p = 0.031) and CRVE (T2-T1 difference: 3.78 µm (3.63, 3.92 µm), p < 0.001; T3-T1 difference: 3.73 µm (3.63, 3.92 µm), p < 0.001). The exposure to DE had no effect on CRAE (FA-DE difference at T2: 0.46 µm (-0.02, 0.92 µm); p = 0.790; FA-DE difference at T3: 1.76 µm (1.36, 2.16 µm), p = 0.213) and CRVE (FA-DE difference at T2: 0.26 µm (-0.35, 0.88 µm), p = 0.906; FA-DE difference at T3: 0.55 µm (0.05, 1.06 µm), p = 0.750). Compared to T1, systolic BP was decreased at T2 by 2.5 mmHg (2.8, 2.3 mmHg, p = 0.047), independent of inhaled exposure. Heart rate at T2 was significantly increased by 3 bpm (2, 3 bpm, p = 0.025) after the DE-exposure when compared to FA. DISCUSSION: Acute physical activity induces a vasodilatory response in the micro- and macrovasculature in healthy adults by increasing CRAE and CRVE, and by reducing systolic BP post exercise, despite breathing DE. The DE-associated increase in HR might be indicative of an increased sympathetic response to physical activity while breathing DE.

Researching multiple publics through latent profile analysis: Similarities and differences in science and technology attitudes in China, Japan, South Korea and the United States.

How science and technology attitudes vary across the United States, China, South Korea and Japan - all of which top Bloomberg's list of high-tech centralization - is explored through data from the sixth wave of the World Values Survey (2010-2014). The following study examines the presence of different types of attitudinal groups using latent profile analysis. Not only do unique attitudinal groups exist in each country, but each group is uniquely influenced by select demographic characteristics, including education, age, gender, religiosity, employment status and individual interaction with technology. The findings provide insight into public attitudes towards science and technology across social and cultural contexts and generate nuanced understandings of similar and different attitudinal groups in East Asia and the United States.

Assessment of cardiovascular risk and preparticipation screening protocols in masters athletes: the Masters Athlete Screening Study (MASS): a cross-sectional study.

BACKGROUND: Underlying coronary artery disease (CAD) is the primary cause of sudden cardiac death in masters athletes (>35 years). Preparticipation screening may detect cardiovascular disease; however, the optimal screening method is undefined in this population. The Physical Activity Readiness Questionnaire for Everyone (PAR-Q+) and the American Heart Association (AHA) Preparticipation Screening Questionnaire are often currently used; however, a more comprehensive risk assessment may be required. We sought to ascertain the cardiovascular risk and to assess the effectiveness of screening tools in masters athletes. METHODS: This cross-sectional study performed preparticipation screening on masters athletes, which included an ECG, the AHA 14-element recommendations and Framingham Risk Score (FRS). If the preparticipation screening was abnormal, further evaluations were performed. The effectiveness of the screening tools was determined by their positive predictive value (PPV). RESULTS: 798 athletes were included in the preparticipation screening analysis (62.7% male, 54.6±9.5 years, range 35-81). The metabolic equivalent task hours per week was 80.8±44.0, and the average physical activity experience was 35.1±14.8 years. Sixty-four per cent underwent additional evaluations. Cardiovascular disease was detected in 11.4%, with CAD (7.9%) being the most common diagnosis. High FRS (>20%) was seen in 8.5% of the study population. Ten athletes were diagnosed with significant CAD; 90% were asymptomatic. A high FRS was most indicative of underlying CAD (PPV 38.2%). CONCLUSION: Masters athletes are not immune to elevated cardiovascular risk and cardiovascular disease. Comprehensive preparticipation screening including an ECG and FRS can detect cardiovascular disease. An exercise stress test should be considered in those with risk factors, regardless of fitness level.