Development and Evaluation of the Dietary Pattern Calculator (DiPaC) for Personalized Assessment and Feedback.

This study aimed to develop and validate a diet assessment screener - the Dietary Pattern Calculator (DiPaC). A scoping review identified currently available short diet quality assessment tools. Twenty-one articles covering 19 unique tools were included. The current tools mainly focused on individual nutrients or food groups or were developed for a specific population, and few ascertained overall dietary patterns. The 24-hour dietary recalls from the nationally representative Canadian Community Health Survey (CCHS)-Nutrition 2015 (n = 13,958) were used to derive and validate a personalized dietary pattern informed by the scoping review using weighted partial least squares. The dominant dietary pattern in CCHS-Nutrition 2015 was characterized by high consumption of fast foods, carbonated drinks, and salty snacks and low consumption of whole fruits, orange vegetables, other vegetables and juices, whole grains, dark green vegetables, legumes, and soy. The dietary pattern assessment was used to create and evaluate DiPaC following an agile and user-centred research and development approach. DiPaC, which demonstrated high validity and intermediate reliability (internal consistency = 0.47-0.51), is publicly available at https://www.projectbiglife.ca/. DiPaC can be used by the public, clinicians, and researchers for quick and robust assessment of diet quality, providing immediate feedback with the advantage of being easy to implement.

Predicting the physical activity of new parents who participated in a physical activity intervention.

RATIONALE: The demands of early parenthood may limit the pursuit of moderate-to-vigorous intensity physical activity (MVPA); thus, understanding the predictors of MVPA among this population could help build targeted intervention programs. OBJECTIVE: The purpose of this study was to examine the correlates of MVPA, in the form of constructs subsumed within the theory of planned behavior (TPB) and multi-process action control (M-PAC) framework, among new parents participating in in a couple-based PA promotion randomized trial across a six-month period in the first year after birth. METHODS: In total, 264 participants (132 couples) at the two-month point of parenting their first child were enrolled in the trial through advertisements. MVPA, TPB, and M-PAC constructs were assessed via self-report at baseline, and six-week, three-month, and six-month after baseline time-periods. RESULTS: Dyadic path modeling of the TPB showed that intention only predicted MVPA for mothers and PBC did not predict MVPA. Most of the sample had intentions to be physically active, although the extent to which intentions predicted subsequent MVPA was dependent on mothers and fathers reported strength of planning, habits, and exercise identity (M-PAC variables). Intention was subsequently predicted by affective attitude and PBC for mothers and fathers. CONCLUSIONS: Interventions targeting affective attitude and perceived behavioral control may assist in improving MVPA intentions of new parents; yet, additional intervention strategies to increase planning, habit, and especially exercise identity seems warranted for many parents to close the gap between intention and PA. The findings highlight the complementary approach of intention formation and intention translation theories among new parents.

Couple-Based Physical Activity Planning for New Parents: A Randomized Trial.

INTRODUCTION: The demands of parenthood may limit the pursuit of moderate-to-vigorous intensity physical activity (MVPA), establish inactivity patterns into middle age, and lead to long-term poorer health and well-being. The purpose of this study was to examine the efficacy of a couple-based planning skills intervention to support MVPA from baseline (~2 months after birth) up to 6 months later in first-time parents. STUDY DESIGN: Randomized trial. PARTICIPANTS: 264 parents (132 couples) at the 2-month point of parenting their first child. INTERVENTION: Couples were randomized to either an education control (n=58 couples) or an education plus planning condition (n=74 couples). MAIN OUTCOME MEASURES: MVPA was assessed via accelerometry and self-report at baseline, 6 weeks, 3 months, and 6 months. Health-related fitness (aerobic fitness, muscular strength, flexibility) and BMI tests were conducted at baseline and 6 months. Rolling recruitment was between 2014 and 2017. RESULTS: The accelerometry results had large amounts of missing data that were not missing at random, so only self-reported MVPA was analyzed. Dyadic multilevel modeling conducted in 2020 showed that mothers' MVPA had a significant quadratic pattern over time that was similar for both conditions, and BMI decreased while strength and flexibility increased. Fathers did not have significant outcomes. Participants who were not meeting MVPA guidelines at baseline responded to the education plus planning condition with increased MVPA (father B=1.31, mother B=1.14, p<0.05) compared with those who initially met those guidelines. CONCLUSIONS: Mothers may be more responsive than fathers to MVPA interventions in early parenthood. Already active parents likely have little to be gained from additional intervention. Future research is needed to effectively promote MVPA during fatherhood and identify novel ways to sustain PA past the early response to an intervention. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT02290808.

Predicting Family and Child Physical Activity across Six-Months of a Family-Based Intervention: An Application of Theory of Planned Behaviour, Planning and Habit.

Family-based physical activity (PA) interventions have proven effective in modifying PA; yet, the underlying mechanisms are currently unclear. In this study, we follow-up upon prior trial data that showed changes to child moderate-to-vigorous PA (MVPA) as a result of a family education+planning intervention compared to an education-only condition. We examined parents' perceived family PA frequency, family PA social cognitions, and family PA habit over 26 weeks between the two conditions. One hundred and two parents (of children aged 6 to 12 yrs), were recruited through advertisements and randomized to either the planning + education condition (n = 52) or an education-only condition (n = 50). Self-reported family PA, and measures of theory of planned behaviour, planning intention, and habit were completed by the contact parent at baseline, six-week, 13-week, and 26-week time-periods. The education+planning intervention increased planning intention (p <.01) and family PA (p =.06) compared to the© education-only group. The effect of condition on the putative mediators did not explain these changes (all 95% CIs crossed 0), and family PA was associated with child MVPA only at 13 weeks (p <.01). Intervention 20 assignment had a small indirect effect on family PA (favouring©the education+planning group) via Habit. Perceived behavioural©control and habit were consistent predictors of family PA (p <.05), but not PA intention or planning intention (p >.05). The planning+education intervention showed improved family PA and planning intention, yet null mediation results suggest that other variables from the family system (e.g., child motivation, other parent's motivation and plans) are likely needed to fully understand the intervention effects. The promotion of perceived behavioural control and habit to assist in family PA is recommended for future research in this population.

Predicting personal physical activity of parents during participation in a family intervention targeting their children.

The purpose of this study was to examine the effect of two family interventions targeting inactive children on their parents' MVPA. Correlates of MVPA across the trial in the form of theory of planned behavior (TPB) and multi-process action control (M-PAC) were examined as exploratory outcomes. Parents (of children aged 6-12 years) were randomized to either a planning + education (n = 52) or an education only condition (n = 50) designed to improve child MVPA. Parental MVPA (accelerometry, self-report) was assessed at baseline, 6-week, 13-week, and 26-week time-periods. Parental MVPA increased from baseline to 26 weeks (p < .05), but there were no group differences. The TPB was unable to predict MVPA and application of M-PAC showed this was because nearly all participants possessed the intention to be active. Successful-compared to unsuccessful-intenders had stronger habit in four of the six tests employed (p < .05). Parent MVPA may benefit during a family-based intervention but the putative mediators of this increase are unclear.Registered trial clinicaltrials.gov #NCT01882192.

Family Physical Activity Planning and Child Physical Activity Outcomes: A Randomized Trial.

INTRODUCTION: Regular moderate-to-vigorous physical activity and high physical fitness are extremely important to the health of children and track to positive health profiles in adulthood. Family-based interventions to improve moderate-to-vigorous physical activity are essential given that children live within a structure of parental influence. The purpose of this study was to examine the effect of a parent planning skills intervention to support child physical activity on the subsequent moderate-to-vigorous physical activity (primary outcome) and fitness of their children across 26 weeks (primary endpoint). STUDY DESIGN: Two-arm randomized trial with physical activity assessment at baseline 6 weeks, 13 weeks, and 26 weeks and fitness and BMI tests at baseline and 26 weeks from 2012 and 2017. SETTING/PARTICIPANTS: One hundred and two children (aged 6-12 years) who were below international physical activity recommendations at baseline were recruited through advertisements. INTERVENTION: Participants received a planning plus education intervention (n=52) or an education-only intervention (n=50). MAIN OUTCOME MEASURES: Moderate-to-vigorous physical activity was assessed via accelerometry and fitness tests included aerobic fitness, muscular strength, flexibility. BMI was calculated by objectively assessed height and weight. RESULTS: Generalized linear mixed modeling conducted in 2019 showed that the patterns varied by condition over time (ß=-0.05, p<0.05), where children in the planning intervention significantly increased moderate-to-vigorous physical activity compared with the education condition at 6 weeks and 13 weeks but not at 26 weeks. Aerobic fitness (p=0.04, d=0.26) was the only significant health-related physical fitness change between the two groups and favored the planning group over the education group. CONCLUSIONS: There was initial efficacy of the planning intervention, but effectiveness waned by 26 weeks. These changes appeared to be sufficient for modest changes in aerobic fitness. Future research should aim to improve the maintenance of these early positive changes and assist parents in planning for activities that also include opportunities to improve child musculoskeletal fitness. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT01882192.

Family Exergaming: Correlates and Preferences.

OBJECTIVES: The family home is an important environment for reducing sedentary behavior and increasing physical activity (PA). Exergames are gaining attention as a possible modality for increasing energy expenditure within the home setting. The purpose of this study was to explore the use, correlates, and preferences of family exergaming. METHODS: An online survey of exergame preferences, social cognition (theory of planned behavior), and behaviors that parents perceive as displaced during exergaming was conducted among a representative sample of 483 Canadian parents with a child between the ages of 6 and 14 years of age who own a videogame platform in their family home. RESULTS: Three quarters of parents indicated that they played exergames with their children but play time averaged a single bout every second week (mean = 29 minutes per bout). Parents overwhelmingly preferred to play sports and dance exergames with their children on weekends (80.1%) and during inclement weather (i.e., rainy = 51.3%; snowy = 45.5%). Family exergame playtime was associated with intention, affective and instrumental attitudes, and descriptive norm. TV watching was reported as being the most common activity that exergames would displace (64.1%). DISCUSSION: Findings suggest that exergames could be a potentially viable option for family PA, especially during bad weather and on weekends to help increase total PA. Intervention efforts could benefit from promoting the social aspects of family exergaming and attitudinal factors.

Evaluation of a physical activity intervention for new parents: protocol paper for a randomized trial.

BACKGROUND: Identifying critical life transitions in people's physical activity behaviors may illuminate the most opportune intervention apertures for chronic disease prevention. A substantive evidence base now indicates that parenthood is one of these critical transition points for physical activity decline. This study will examine whether a brief theory-based intervention can prevent a decline in physical activity among new parents over 6 months following intervention. This study protocol represents the first dyad-based physical activity initiative in the parenthood literature involving both mothers and fathers; prior research has focused on only mothers or only fathers (albeit limited), and has shown only short-term changes in physical activity. This study will be investigating whether a theory-based physical activity intervention can maintain or improve moderate to vigorous intensity physical activity measured via accelerometry of new parents over a 6 month period following intervention compared to a control group. METHODS: This study is a 6-month longitudinal randomized controlled trial. Parents are measured at baseline (2 months postpartum) with two assessment points at 6 weeks (3.5 months postpartum) and 3 months (5 months postpartum) and a final follow-up assessment at 6 months (8 months postpartum). The content of the theory-based intervention was derived from the results of our prior longitudinal trial of new parents using an adapted theory of planned behavior framework to predict changes in physical activity. RESULTS: A total of 152 couples have been recruited to date. Sixteen couples dropped out after baseline and a total of 88 couples have completed their 6-month measures. DISCUSSION: If the intervention proves successful, couple-based physical activity promotion efforts among parents could be a promising avenue to pursue to help mitigate the declines of physical activity levels during parenthood. These findings could inform public health materials and practitioners. TRIAL REGISTRATION: This trial has been registered with the Clinical Trials Registry maintained by the National Library of Medicine at the National Institutes of Health on April 19, 2014. The registration ID is NCT02290808 .

Do other goals influence physical activity? A systematic review examining the relationship between other goals and physical activity behavior.

Promoting regular physical activity (PA) is essential to population health, yet intervention success has been modest. Most approaches have focused heavily on PA motivation but give limited attention to other facilitating and conflicting goals in daily life. The purpose of this review was to unite the literature examining other life goals and appraise their relationship with PA. Ten electronic databases were searched from February to December 2015 through EBSCO with the keywords: goal, facilitation, conflict, interference, intergoal, time displacement, behavioral resolve, cross-behavior, PA and exercise. Combined with manual bibliography and citation searches, 292 potentially relevant abstracts were screened, 40 of which full-text articles were retrieved. A total of 20 articles with 22 independent data-sets met the inclusion criteria and were included in the present review. Despite relatively heterogeneous measurement and a large proportion of cross sectional designs with student samples, the results indicated that PA is related to other life goals both in terms of facilitation (positive association) and conflict (negative association). Both facilitation and conflict goals had more consistent significant associations with PA when they were measured in terms of behavioral (e.g., study behavior, TV viewing) rather than higher-level objectives (e.g., getting healthy, being social). These goals explained additional variance in PA beyond PA intentions, plans, and perceived behavioral control and helped translate positive intentions into behavior. The results suggest that PA interventions should consider PA motivation with the integration of other facilitating and conflicting goals in one's daily life; however, better measurement of goals, with more diverse samples in experimental designs are needed.

Is physical activity a part of who I am? A review and meta-analysis of identity, schema and physical activity.

Two parallel literatures on the physical activity (PA) identity and schema constructs have the potential to supplement traditional social cognitive approaches used for PA promotion. The purpose of this paper was to review schema/identity research and appraise its relationship with PA via meta-analysis followed by thematic analyses of its correlates, as well as its proposed mechanisms on PA. Eligible studies were from English, peer-reviewed published articles that examined identity and/or schema in the context of PA. Searches were completed in June 2015 in five databases. Sixty-two independent data-sets (32 available for meta-analysis), primarily of modest quality, were identified. Results of the random effects meta-analysis showed that the point-estimate between identity/schema and behaviour was r = .44 (CI = .39-.48), and invariant to selected study characteristics. Thematic review showed that identity/schema was associated with commitment, ability, affective judgments, identified/integrated regulation and social comparison and predicted intention, self-regulatory efficacy, and self-regulation strategy use. It had reliable evidence as a moderator of the intention-behavior relationship, was associated with increases in the speed of processing of relevant information and created negative affect under hypothetical identity-behavior discrepant situations. While this initial research is promising, more rigorous research designs, including interventions to increase identity/schema, are warranted.

Family planning to promote physical activity: a randomized controlled trial protocol.

BACKGROUND: Physical activity is associated with the reduction of several chronic conditions in adults. Additionally, physical activity is extremely important for children for their development and cognitive functioning and also to create a physically active lifestyle that continues into adulthood. Despite the known benefits of physical activity, only one in five adults are achieving the public health recommendations of 150 minutes of moderate-to-vigorous physical activity per week and only 13 % of boys and 6 % of girls between the ages of 5 and 17 years are meeting the guidelines of 60 minutes per day. This study aims to evaluate whether a planning condition improves adherence to regular physical activity compared to an education-only control condition among families. Families are eligible if there is at least one child between the ages of 6 and 12 years who is not meeting the Canadian Physical Activity Guidelines. METHODS/DESIGN: A six-month longitudinal randomized controlled trial will be used to compare the two conditions. Materials will be delivered at baseline with 'booster' sessions at six weeks and three months. Participants will be assessed at baseline and at six months with a fitness test, as well as questionnaires and accelerometery at baseline, six weeks, three months and six months. A total of 137 families have been recruited thus far from Greater Victoria. This study is ongoing and recruitment will continue until December 2015 with the target goal of reaching 160 families. DISCUSSION: This protocol describes the implementation of a randomized controlled trial that utilizes planning strategies to try and increase physical activity among families. Research findings could be useful in public health in providing effective strategies to families to help decrease sedentary lifestyles. Additionally, findings may help to inform future interventions aimed at increasing physical activity among families. TRIAL REGISTRATION: This trial was registered on June 5, 2012 with the Clinical Trials Registry maintained by the National Library of Medicine at the National Institutes of Health. The registration ID is NCT01882192.

Predictors of physical activity change among adults using observational designs.

BACKGROUND: Regular physical activity (PA) is foundational to human health, yet most people are inactive. A sound understanding of the determinants of PA may be instructive for building interventions and/or identifying critical target groups to promote PA. Most research on PA correlates has been biased by cross-sectional or passive prospective designs that fail to examine within-person analysis of PA change. OBJECTIVE: The purpose of this review was to collect and appraise the available literature on the predictors of PA change conceived broadly in terms of increases/decreases from baseline assessment as well as specifically in terms of adoption and maintenance. METHODS: Eligible studies were from English, peer-reviewed published articles that examined predictors of natural change of PA over 3 months + using observational (non-experimental) data in adult samples. Searches were performed from June 2012 to January 2014 in eight databases. RESULTS: Sixty-seven independent data-sets, from 12 countries, primarily of medium quality/risk of bias, were identified with 26 correlates spanning demographic, behavioral, intra-individual, inter-individual, and environmental categories. Only intention and the onset of motherhood could reliably predict overall PA change. Among datasets configured to predict PA adoption, affective judgments and behavioral processes of change were the only reliable predictors, although both only have a small number of available studies. There were no reliable predictors of maintenance when compared to PA relapse. CONCLUSION: The results underscore the importance of individual-level motivation and behavioral regulation in PA change, but also denote critical social variables. These findings, however, are constrained by PA measurement bias and limited studies that employed time-varying covariation between predictor variables and PA.