Longitudinal Analysis and Latent Growth Modeling of the Modified Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR).

The Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement (HOOS-JR) was developed as a short-form survey to measure progress after total hip arthroplasty (THA). However, the longitudinal validity of the scale structure pertaining to the modified five-item HOOS-JR has not been assessed. Therefore, the purpose of this study was to evaluate the structural validity, longitudinal invariance properties, and latent growth curve (LGC) modeling of the modified five-item HOOS-JR in a large multi-site sample of patients who underwent a THA. A longitudinal study was conducted using data from the Surgical Outcome System (SOS) database. Confirmatory factor analyses (CFAs) were conducted to assess the structural validity and longitudinal invariance across five time points. Additionally, LGC modeling was performed to assess the heterogeneity of the recovery patterns for different subgroups of patients. The resulting CFAs met most of the goodness-of-fit indices (CFI = 0.964-0.982; IFI = 0.965-0.986; SRMR = 0.021-0.035). Longitudinal analysis did not meet full invariance, exceeding the scalar invariance model (CFIDIFF = 0.012; χ2DIFF test = 702.67). Partial invariance requirements were met upon release of the intercept constraint associated with item five (CFIDIFF test = 0.010; χ2DIFF = 1073.83). The equal means model did not pass the recommended goodness-of-fit indices (CFIDIFF = 0.133; χ2DIFF = 3962.49). Scores significantly changed over time, with the highest scores identified preoperatively and the lowest scores identified at 2- and 3-years postoperatively. Upon conclusion, partial scalar invariance was identified within our model. We identified that patients self-report most improvements in their scores within 6 months postoperatively. Females reported more hip disability at preoperative time points and had faster improvement as measured by the scores of the modified five-item HOOS-JR.

Psychometric analysis of the Hip Disability and Osteoarthritis Outcome Score Joint Replacement (HOOS-JR).

Objective: Centers for Medicare and Medicaid Services (CMS) has requested hospitals collect and report patient-reported outcomes (PROs) beginning in 2024 including the Hip Disability and Osteoarthritis Outcome Score Joint Replacement (HOOS-JR). However, scale structural validity of the HOOS-JR has minimally been assessed. The purpose of this study was to assess internal consistency, structural validity, and multi-group invariance properties of the HOOS-JR in a large sample of patients who underwent a total hip arthroplasty (THA). Methods: A cross-sectional study using the Surgical Outcomes System was retrospectively queried for patients who underwent a THA. Internal consistency was assessed using Cronbach's alpha and McDonald's Omega. A confirmatory factor analysis (CFA) was performed on the HOOS-JR using a priori cut-off values. Multi-group invariance testing was also performed on the sample of patients across sex and age groups. Results: Internal consistency was acceptable for 6-item (alpha â€‹= â€‹0.88; omega â€‹= â€‹0.88) and 5-item (alpha â€‹= â€‹0.86; omega â€‹= â€‹0.86) HOOS-JR. The one-factor, 6-item CFA did not meet the recommended fit indices. The one-factor, 5-item CFA had acceptable fit for the sample data. Invariance testing criteria were met between the age groups; however, scalar invariance was not met for sex. Conclusion: The 6-item HOOS-JR did not meet contemporary model fit indices indicating that scale refinement is warranted. The 5-item met most goodness-of-fit indices and invariance criteria. However, further scale refinement may be warranted as localized fit issues were identified.

Confirmatory Factor Analysis of the Hip Disability and Osteoarthritis Outcome Score (HOOS) and Associated Sub-scales.

Background: Hip Disability and Osteoarthritis Outcome Score (HOOS), HOOS-Joint Replacement (JR), HOOS Physical Function (PS), and HOOS-12 item scale have been suggested as reliable and valid instruments for assessing hip disability. However, factorial validity, invariance across subgroups, and repeated measures of the scale across different populations have not been well supported in the literature. Purpose: The primary study objectives were to: (1) assess model fit and psychometric properties of the original 40-item HOOS scale, (2) assess model fit of the HOOS-JR, (3) assess model fit of the HOOS-PS, and (4) assess model fit of the HOOS-12. A secondary objective was to perform multigroup invariance testing across physical activity level and hip pathology subgroups for models that met recommended fit indices. Study Design: Cross-Sectional Study. Methods: Individual confirmatory factor analyses (CFAs) were conducted for the HOOS, HOOS-JR, HOOS-PS, and HOOS-12. Additionally, multigroup invariance testing (i.e., activity level, injury type) was conducted on the HOOS-JR and HOOS-PS. Results: Model fit indices did not meet contemporary recommendations for the HOOS and the HOOS-12. Model fit indices for the HOOS-JR and the HOOS-PS met some, but not all, contemporary recommendations. Invariance criteria was met for the HOOS-JR and HOOS-PS. Conclusion: The scale structure of the HOOS and HOOS-12 were not supported; however, preliminary evidence to support the scale structure of the HOOS-JR and HOOS-PS was found. Clinicians and researchers who utilize the scales should do so with caution due to their limitations and untested properties until further research establishes the full psychometric properties of these scales and recommendations for their continued use.

Confirmatory Factor Analysis of the Athlete Sleep Behavior Questionnaire.

CONTEXT: Sleep has long been understood as an essential component for overall well-being, substantially affecting physical health, cognitive functioning, mental health, and quality of life. Currently, the Athlete Sleep Behavior Questionnaire (ASBQ) is the only known instrument designed to measure sleep behaviors in the athletic population. However, the psychometric properties of the scale in a collegiate student-athlete and dance population have not been established. OBJECTIVE: To assess model fit of the ASBQ in a sample of collegiate traditional student-athletes and dancers. DESIGN: Observational study. SETTING: Twelve colleges and universities. PATIENTS OR OTHER PARTICIPANTS: A total of 556 (104 men, 452 women; age = 19.84 ± 1.62 years) traditional student-athletes and dancers competing at the collegiate level. MAIN OUTCOME MEASURE(S): A confirmatory factor analysis (CFA) was computed to assess the factor structure of the ASBQ. We performed principal component analysis extraction and covariance modeling analyses to identify an alternate model. Multigroup invariance testing was conducted on the alternate model to identify if group differences existed for sex, sport type, injury status, and level of competition. RESULTS: The CFA on the ASBQ indicated that the model did not meet recommended model fit indices. An alternate 3-factor, 9-item model with improved fit was identified; however, the scale structure was not consistently supported during multigroup invariance testing procedures. CONCLUSIONS: The original 3-factor, 18-item ASBQ was not supported for use with collegiate athletes in our study. The alternate ASBQ was substantially improved, although more research should be completed to ensure that the 9-item instrument accurately captures all dimensions of sleep behavior relevant for collegiate athletes.

Profiling Physical Activity Motivation Based on Reasons for Exercise: A Cluster Analysis Approach.

The purpose of this study is to identify profiles based on the reasons adults have for being physically active. A secondary purpose was to examine how profiles differ on motivational regulation and physical activity (PA). A total of 1275 (46.5 ± 16.8 years) participants were solicited from a hospital-affiliated wellness center, social media promotions, and a research volunteer registry. The Reasons to Exercise (REX-2) scale, International PA Questionnaire, Behavioral Regulation in Exercise Questionnaire-3, and demographic questionnaire were utilized to assess variables of interest with a cross-sectional survey. Using SPSS Version 26, K-cluster analysis was used to identify profiles based on the reasons for exercise that individuals identified as important. Multivariate analysis of variance (MANOVA) was used to assess profile differences followed by ANOVA. Four profiles were derived based on reason for exercise scores: a multi-reason positive (N = 361), a multi-reason negative (N = 232), an autonomous-focused (N = 259), and a control-focused cluster (N = 382) (p < .001). These unique clusters differed significantly (p < .001) from each other with respect to motivation to be active and PA. The multi-reason positive cluster engaged in higher levels of total moderate and vigorous PA minutes/week compared to the other clusters. Therefore, adult's motivation for PA may be likely to be affected by a combination of different informal goals and valuing a number of goals that are both extrinsic/controlling (e.g., to look good) and autonomous/intrinsic (e.g., to feel good), may promote greater autonomous motivation regulation and greater PA levels than highly autonomous/intrinsic goals alone.

Disablement in the Physically Active Scale Short Form-8: psychometric evaluation.

BACKGROUND: Patient-centered care and evidence-based practice (EBP) are core competencies for health care professionals. The importance of EBP has led to an increase in research involving clinical outcomes; current recommendations emphasize collecting patient focused measures, thus increasing the need for psychometrically sound patient reported outcome measures (PROMs) of health. Disablement has been identified as a valuable multi-dimensional construct for patient care. The Disablement in the Physically Active Scale Short Form-8 (DPA SF-8) has been proposed as a tool to be used in the physically active population that assesses a physical summary component of health and a quality of life component however, further analysis is necessary to ensure the instrument is psychometrically sound. METHODS: Confirmatory factor analyses (CFAs) were conducted on the DPA SF-8 at each time point to ensure factor structure. Reliability of the scale and internal consistency of the subscales were assessed, and a minimal detectable change (MDC) calculated. Additionally, a minimal clinically important difference (MCID) was also established, and invariance testing across three time points and groups was conducted. RESULTS: The CFAs at all three visits exceeded recommended model fit indices. The interclass correlation coefficient value (.924) calculated indicated excellent scale reliability and Cronbach's alpha for subscales PHY and QOL were within recommend values. The MDC value calculated was 5.83 and the MCID for persistent injuries were 2 points and for acute injuries, 3 points. The DPA SF-8 was invariant across time and across subgroups. CONCLUSIONS: The DPA SF-8 met CFA recommendations and criteria for multi-group and longitudinal invariance testing, which indicates the scale may be used to assess for differences between the groups or across time. Our overall analysis indicates the DPA SF-8 is a valid, reliable, and responsive instrument to assess patient improvement in the physically active population.

Invariance Testing of the Disablement in the Physically Active Scale Short Form-10.

CONTEXT: Psychometrically sound instruments are needed to accurately track the effectiveness of treatment and assess the quality of patient care. The Disablement in the Physically Active (DPA) scale Short Form-10 (SF-10) was developed as a more parsimonious version of the Disablement in the Physically Active scale to assess disablement in the physically active. Psychometric assessment of the DPA SF-10 has not been completed; specifically, the scale properties must be assessed among a sample of individuals who respond only to the 10-item scale at multiple time points. OBJECTIVE: To assess the psychometric properties of the DPA SF-10 using confirmatory factor analysis and invariance procedures across multiple time points. MAIN OUTCOME MEASURE(S): Confirmatory factor analyses and longitudinal invariance tests were conducted. RESULTS: The DPA SF-10 met contemporary fit index recommendations and demonstrated longitudinal invariance; however, localized fit concerns suggest further modification is needed. CONCLUSIONS: Adoption of the DPA SF-10 into widespread clinical practice and research is not recommended until further psychometric testing and scale modification are performed.

Invariance Testing of the Disablement in the Physically Active Scale.

CONTEXT: The increased emphasis on implementing evidence-based practice has reinforced the need to more accurately assess patient improvement. Psychometrically sound, patient-reported outcome measures are essential for evaluating patient care. A patient-reported outcome instrument that may be useful for clinicians is the Disablement in the Physically Active Scale (DPAS). Before adopting this scale, however, researchers must evaluate its psychometric properties, particularly across subpopulations. OBJECTIVE: To evaluate the psychometric properties of the DPAS in a large sample using confirmatory factor analysis procedures and assess structural invariance of the scale across sex, age, injury status, and athletic status groups. DESIGN: Observational study. SETTING: Twenty-two clinical sites. PATIENTS OR OTHER PARTICIPANTS: Of 1445 physically active individuals recruited from multiple athletic training clinical sites, data from 1276 were included in the analysis. Respondents were either healthy or experiencing an acute, subacute, or persistent musculoskeletal injury. MAIN OUTCOME MEASURE(S): A confirmatory factor analysis was performed on the full sample, and multigroup invariance testing was conducted to assess differences across sex, age, injury status, and athletic status. Given the poor model fit, alternate model generation was used to identify a more parsimonious factor structure. RESULTS: The DPAS did not meet contemporary fit index recommendations or the criteria to demonstrate structural invariance. We identified an 8-item model that met the model fit recommendations using alternate model generation. CONCLUSIONS: The 16-item DPAS did not meet the model fit recommendations and may not be the most parsimonious or reliable measure for assessing disablement and quality of life. Use of the 16-item DPAS across subpopulations of interest is not recommended. More examination involving a true cross-validation sample should be completed on the 8-item DPAS before this scale is adopted in research and practice.

Examining the factorial validity of the Quality of Life Scale.

BACKGROUND: Quality of life (QoL) is important to assess in patient care. Researchers have previously claimed validity of the Quality of Life Scale (QOLS) across multiple samples of individuals, but close inspection of results suggest further psychometric investigation of the instrument is warranted. Therefore, the purposes of this study were to: 1) evaluate the proposed five-factor, 15-item and three-factor, 16-item QOLS; 2) if the factor structure could not be confirmed, re-assess the QOLS using exploratory factor analysis (EFA) and covariance modeling to identify a parsimonious refinement of the QOLS structure for future investigation. METHODS: Participants varying in age, physical activity level, and identified medical condition(s) were recruited from clinical sites and ResearchMatch. Confirmatory factor analyses (CFA) were performed on the full sample (n = 1036) based on proposed 15- and 16-item QOLS versions. Subsequent EFA and covariance modeling was performed on a random subset of the data (n1 = 518) to identify a more parsimonious version of the QOLS. The psychometric properties of the newly proposed model were confirmed in the remaining half of participants (n2 = 518). Further examination of the scale psychometric properties was completed using invariance testing procedures across sex and health status sub-categories. RESULTS: Neither the 15- nor 16-item QOLS CFA met model fit recommendations. Subsequent EFA and covariance modeling analyses revealed a one-factor, five-item scale that satisfied contemporary statistical and model fit standards. Follow-up CFA confirmed the revised model structure; however, invariance testing requirements across sex and injury status subgroups were not met. CONCLUSIONS: Neither the 15- nor 16-item QOLS exhibited psychometric attributes that support construct validity. Our analyses indicate a new, short-form model, might offer a more appropriate and parsimonious scale from some of the original QOLS items; however, invariance testing across sex and injury status suggested the psychometric properties still vary between sub-groups. Given the scale design concerns and the results of this study, developing a new instrument, or identifying a different, better validated instrument to assess QoL in research and practice is recommended.

Confirmatory Factor Analysis of the Disablement in the Physically Active Scale and Preliminary Testing of Short-Form Versions: A Calibration and Validation Study.

CONTEXT: The Disablement in the Physically Active (DPA) scale is a patient-reported outcome instrument recommended for use in clinical practice and research. Analysis of the scale has indicated a need for further psychometric testing. OBJECTIVE: To assess the model fit of the original DPA scale using a larger and more diverse sample and explore the potential for a short-form (SF) version. DESIGN: Observational study. SETTING: Twenty-four clinical settings. PATIENTS OR OTHER PARTICIPANTS: Responses were randomly split into 2 samples: sample 1 (n = 690: 353 males, 330 females, and 7 not reported; mean age = 23.1 ± 9.3 years, age range = 11-75 years) and sample 2 (n = 690: 351 males, 337 females, and 2 not reported; mean age = 22.9 ± 9.3 years, age range = 8-74 years). Participants were physically active individuals who were healthy or experiencing acute, subacute, or persistent musculoskeletal injury. MAIN OUTCOME MEASURE(S): Confirmatory factor analysis was conducted to assess the factor structure of the original DPA scale. Exploratory factor, internal consistency, covariance modeling, correlational, and confirmatory factor analyses were conducted to assess potential DPA scale SFs. RESULTS: The subdimensions of the disablement construct were highly correlated (≥0.89). The fit indices for the DPA scale approached recommended levels, but the first-order correlational values and second-order path coefficients provided evidence for multicollinearity, suggesting that clear distinctions between the disablement subdimensions cannot be made. An 8-item, 2-dimensional solution and a 10-item, 3-dimensional solution were extracted to produce SF versions. The DPA SF-8 was highly correlated (r = 0.94, P ≤ .001, R2 = 0.88) with the DPA scale, and the fit indices exceeded all of the strictest recommendations. The DPA SF-10 was highly correlated (r = 0.97, P ≤ .001, R2 = 0.94) with the DPA scale, and its fit indices values also exceeded the strictest recommendations. CONCLUSIONS: The DPA SF-8 and SF-10 are psychometrically sound alternatives to the DPA scale.

Mental skills training with basic combat training soldiers: A group-randomized trial.

Cognitive skills training has been linked to greater skills, self-efficacy, and performance. Although research in a variety of organizational settings has demonstrated training efficacy, few studies have assessed cognitive skills training using rigorous, longitudinal, randomized trials with active controls. The present study examined cognitive skills training in a high-risk occupation by randomizing 48 platoons (N = 2,432 soldiers) in basic combat training to either (a) mental skills training or (b) an active comparison condition (military history). Surveys were conducted at baseline and 3 times across the 10-week course. Multilevel mixed-effects models revealed that soldiers in the mental skills training condition reported greater use of a range of cognitive skills and increased confidence relative to those in the control condition. Soldiers in the mental skills training condition also performed better on obstacle course events, rappelling, physical fitness, and initial weapons qualification scores, although effects were generally moderated by gender and previous experience. Overall, effects were small; however, given the rigor of the design, the findings clearly contribute to the broader literature by providing supporting evidence that cognitive training skills can enhance performance in occupational and sports settings. Future research should address gender and experience to determine the need for targeting such training appropriately.

Nature, correlates, and consequences of stress-related biological reactivity and regulation in Army nurses during combat casualty simulation.

This study examined the nature, concomitants, and consequences of stress-related biological reactivity and regulation among Army nurses. Saliva was collected, heart rate (HR) and blood pressure (BP) recorded from 38 Army nurses (74% female; mean age 28.5 years [SD=6.5]) before, during, and after participation in the Combat Casualty Stress Scenario (CCSS). Saliva was assayed for cortisol and alpha-amylase (sAA). The CCSS simulates emergency combat rescue, employing two simulated combat casualties, aversive body odors, recorded battlefield sounds, and smoke in a low light environment. Participants locate and conduct preliminary assessments of the simulated patients, triage based on injury severity, initiate treatment, and coordinate medical evacuation by radio. Results revealed large magnitude increases in cortisol, sAA, HR, systolic BP and diastolic BP in response to the CCSS, followed by recovery to baseline levels 30min after the task for all physiological parameters except cortisol. Age, gender, perceived difficulty of the CCSS, and previous nursing experience were associated with individual differences in the magnitude of the physiological responses. Lower levels of performance related to triage and treatment were associated with higher levels of reactivity and slower recovery for some of the physiological measures. The findings raise important questions regarding the utility of integrating measures of the psychobiology of the stress response into training programs designed to prepare first responders to handle highly complex and chaotic rescue situations.

The influence of mental skills on motivation and psychosocial characteristics.

The purpose of this observational, cross-sectional study was to assess psychosocial characteristics and intrinsic motivation in a convenience sample of Army soldiers with different mental skills profiles. Participants were recruited immediately before or immediately following regular training activities. Anonymous surveys were completed and collected in the training area. Instruments used in this study included the Ottawa Mental Skills Assessment Tool-3 Revised for Soldiers; Rosenberg Self-esteem Scale; Depression Anxiety Stress Scale-21; University of California, Los Angeles, Loneliness Scale; Beck Hopelessness Scale; Intrinsic Motivation Inventory; and an anger measure. Soldiers with strong mental skill profiles were more intrinsically motivated and psychosocially healthier than their peers with weaker mental skill profiles. It is recommended that a proactive approach to psychological health promotion practices in soldiers be sought rather than reactive treatment plans to psychological sequelae. Future research must examine the role of psychosocial fitness and adaptability to enhance mental skills fitness.

The effects of a supplemental, theory-based physical activity counseling intervention for adults with type 2 diabetes.

BACKGROUND: Physical activity (PA) is a cornerstone in the management of type 2 diabetes (T2DM). This pilot investigation explores the effects of a standard diabetes education program compared with a supplemental PA intervention on diabetes-related health outcomes. METHODS: Using a prospective 2-armed design, 96 adults with T2DM were randomly assigned to either standard care (diabetes education program; n = 49) or standard care supplemented with an 8-week, individualized-counseling and community-based PA component (n = 47). Measurements were taken at baseline, 3, 6, and 12 months. Primary outcomes were changes in PA (self-report) and HbA1c. Between group changes were compared using analysis of covariance (ANCOVA) and changes over time using repeated-measures ANOVA. RESULTS: In comparison with standard care, the supplemental group demonstrated an increase in PA (Ps < 0.01) and cardiorespiratory fitness (Ps < 0.05) from baseline to all follow-up time-points. HbA1c levels declined (P < .05) from baseline to all time points in the standard care group. Reduction in cholesterol-ratio (P < .01), increase in HDL (P < .05), and reductions in blood pressure, resting heart rate and BMI (approaching statistical significance Ps < 0.10) were also reported for both groups. CONCLUSIONS: PA counseling in addition to standard care is effective for promoting PA behavior change and positive health-related outcomes among individuals with T2DM.

Population-based estimates of physical activity for adults with type 2 diabetes: a cautionary tale of potential confounding by weight status.

At a population level, the method used to determine those meeting physical activity guidelines has important implications, as estimating "sufficient" physical activity might be confounded by weight status. The objective of this study was to test the difference between three methods in estimating the prevalence of "sufficient activity" among Canadian adults with type 2 diabetes in a large population sample (N = 1614) while considering the role of weight status as a potential confounder. Our results revealed that estimates of physical activity levels vary by BMI categories, depending on the methods examined. Although physical activity levels were lower in the obese, their energy expenditure estimates were not different from those who were overweight or of a healthy weight. The implications of these findings are that biased estimates of physical activity at a population level may result in inappropriate classification of adults with type 2 diabetes as "sufficiently active" and that the inclusion of body weight in estimating physical activity prevalence should be approached with caution.

An exploratory investigation of relationships among mental skills and resilience in Warrior Transition Unit cadre members.

Warrior transition unit (WTU) cadre members are exposed to a variety of stressors that put them at risk for adverse conditions and events. Resilience may be a construct capable of moderating some of these potential negative outcomes. In turn, mental toughness is a concept associated with resilience that may provide a unique framework from which to train resilient behavior. This article explored associations between resilience and several mental skills that are assumed to be related to mental toughness, in a sample (n = 27) of WTU cadre members in the U.S. Army. Instruments included the Ottawa Mental Skills Inventory (OMSAT-3) and the Resilience Scale (RS). Both cognitive mental skills and emotion management skills were positively associated with resilience. Results also indicated a model specifying emotion management as a mediator of the relationship between cognitive skills and resilience was consistent with the study data.

A test of cognitive mediation in a 12-month physical activity workplace intervention: does it explain behaviour change in women?

BACKGROUND: Attempts to demonstrate the efficacy of interventions aimed at increasing physical activity (PA) have been mixed. Further, studies are seldom designed in a manner that facilitates the understanding of how or why a treatment is effective or ineffective and PA intervention designs should be guided by a heavier reliance upon behavioral theory. The use of a mediating variable framework offers a systematic methodological approach to testing the role of theory, and could also identify the effectiveness of specific intervention components. The primary purpose of this paper was to test the mediating role that cognitive constructs may have played in regards to the positive effect that a workplace behavioral intervention had on leisure-time PA for women. A subsidiary purpose was to examine the cross-sectional relationships of these cognitive constructs with PA behavior. METHODS: The Physical Activity Workplace Study was a randomized controlled trial which compared the effects of stage-matched and standard print materials upon self-reported leisure-time PA, within a workplace sample at 6 and 12-months. In this secondary analysis we examined the mediation effects of 14 psychosocial constructs across 3 major social-cognitive theories which were operationalized for the intervention materials and measured at baseline, 6 and 12-months. We examined change in PA and change in the psychological constructs employing a mediation strategy proposed by Baron and Kenny for: (1) the first 6-months (i.e., initial change), (2) the second 6-months (i.e., delayed change), and (3) the entire 12-months (overall change) of the study on 323 women (n = 213 control/standard materials group; n = 110 stage-matched materials group). RESULTS: Of the 14 constructs and 42 tests (including initial, delayed and overall change) two positive results were identified (i.e., overall change in pros, initial change in experiential powerful intervention approaches processes), with very small effect sizes. However, these mediating results were eliminated after adjusting for the multiple statistical tests. CONCLUSIONS: The intervention did not change these mediators in any substantive way, and show a similar pattern to prior research where interventions generally do not result in a change in mediation of behavior change. It is important to report mediation results in randomized controlled trials whether the findings are null or positive. Future studies may wish to focus on more detailed dose-response issues between mediators and behavior, the inclusion of moderators that could affect individual change, or different mediator constructs at higher levels of measurement specificity. Continued work on innovative and more powerful PA intervention approaches are needed.

Six-month follow-up and participant use and satisfaction of an electronic mail intervention promoting physical activity and nutrition.

PURPOSE: To evaluate the effects of a 12-week e-mail intervention promoting physical activity and nutrition, and to describe participant use and satisfaction feedback. DESIGN: A longitudinal, randomized trial. SETTING: Five large workplaces in Alberta, Canada. PARTICIPANTS: One thousand forty-three participants completed all three assessments, and 1263 participants in the experimental group provided use and satisfaction feedback after receiving the 12-week intervention. INTERVENTION: Paired physical activity and nutrition messages were e-mailed weekly to the experimental group. The control group received all messages in bulk (i.e., within a single e-mail message) at the conclusion of the intervention. MEASURES: Self-report measures of knowledge, cognitions, and behaviors related to physical activity and nutrition were used. Satisfaction with e-mail messages was assessed at Time 2. ANALYSIS: Planned contrasts compared the experimental group measures at Time 3 with those reported at Time 2 and with control group measures reported at Time 3. Control group measures at Time 3 were also compared with control group measures at Time 2. RESULTS: The small intervention effects previously reported between Time 1 and Time 2 were maintained at Time 3. Providing the e-mail messages in bulk also had a significant positive effect on many of the physical activity and nutrition variables. CONCLUSIONS: E-mail offers a promising medium for promoting health-enhancing knowledge, attitudes, and behaviors. Additional research is needed to determine optimal message dose and content.

The role of self-efficacy on the relationship between the workplace environment and physical activity: a longitudinal mediation analysis.

Cross-sectional studies show that self-efficacy (SE) serves as a partial mediator of the effect that perceptions of workplace environment have on self-reported workplace physical activity (PA). To further explore the role SE plays in the relationship between perceptions of the workplace environment and workplace PA, cross-sectional mediation analyses were performed on adult employees at baseline (n = 897), 6 months (n = 616), and 12 months (n = 612); a longitudinal time-sequence was incorporated into the mediation model; and correlates of residual change version of the mediation were tested. The R (2) ranged from .05 to .08 for the three cross-sectional analyses, .03 for the longitudinal analyses, and from .02 to .03 for the residual analyses. The results from the residual change model analyses supported those of the cross-sectional and longitudinal analyses, suggesting the relationship between perceived workplace environment and PA was partially mediated by SE. Future research should include similar studies with different population groups and in different settings.

ParticipACTION: Baseline assessment of the 'new ParticipACTION': A quantitative survey of Canadian organizational awareness and capacity.

BACKGROUND: ParticipACTION is a Canadian physical activity (PA) communications and social marketing organization that was relaunched in 2007 after a six-year hiatus. This study assesses the baseline awareness and capacity of Canadian organizations that promote physical activity, to adopt, implement and promote ParticipACTION's physical activity campaign. The three objectives were: (1) to determine organizational awareness of both the 'original' and 'new' ParticipACTION; (2) to report baseline levels of three organizational capacity domains (i.e., to adopt, implement and externally promote physical activity initiatives); and, (3) to explore potential differences in those domains based on organizational size, sector and primary mandate. METHODS: Organizations at local, provincial/territorial, and national levels were sent an invitation via email prior to the official launch of ParticipACTION to complete an on-line survey. The survey assessed their organization's capacity to adopt, implement and externally promote a new physical activity campaign within their organizational mandates. Descriptive statistics were employed to address the first two study objectives. A series of one-way analysis of variance were conducted to examine the third objective. RESULTS: The response rate was 29.7% (268/902). The majority of responding organizations had over 40 employees and had operated for over 10 years. Education was the most common primary mandate, followed by sport and recreation. Organizations were evenly distributed between government and not-for-profits. Approximately 96% of respondents had heard of the 'original' ParticipACTION while 54.6% had heard of the 'new' ParticipACTION (Objective 1). Findings indicate good organizational capacity in Canada to promote physical activity (Objective 2) based on reported means of approximately 4.0 (on 5-point scales) for capacity to adopt, implement, and externally promote new physical activity campaigns. Capacity to adopt new physical activity campaigns differed by organizational sector and mandate, and capacity to implement differed by organizational mandate (Objective 3). CONCLUSION: At baseline, and without specific details of the campaign, respondents believe they have good capacity to work with ParticipACTION. ParticipACTION may do well to capitalize on the existing strong organizational capacity components of leadership, infrastructure and 'will' of national organizations to facilitate the success of its future campaigns.