The Creation of a Novel Undergraduate Nursing Employee/Student Hybrid Role in the COVID-19 Response: An Alberta Experience.

The COVID-19 pandemic impacted nursing education and health care systems alike. Increases in staff absenteeism along with increased hospitalizations have strained health systems across the globe. Postsecondary institutions (PSIs) were required to remove students from clinical placements, thus delaying nursing students' ability to complete their programs, and in turn, contributing to the nursing workforce challenges. Health care organizations and PSIs had to collaborate innovatively to support the health care response to the pandemic while continuing to educate and graduate students to expand the nursing workforce. In Alberta, the collaboration between the health system and PSIs led to the creation of an undergraduate nursing employee/student hybrid (UNE/Hybrid) role. This role was not only a response to the nursing workforce challenges created by the pandemic, but it provided nursing students with positive learning clinical placements ensuring that they completed their program in a timely manner. This role was designed to assist with the fourth wave of the pandemic (omicron variant), which was expected to be the most severe wave in terms of hospitalizations and increased staff absences. The UNE/Hybrid role allowed nursing students to complete the required learning for their final preceptorships and/or complete leadership placements in a paid role while being integrated into the unit culture and becoming part of the team. The initiative's results, including its successes, challenges, and lessons, are discussed.

An Evaluation of a Commercialized mHealth Intervention to Promote Physical Activity in the Workplace.

Background: UPnGO with ParticipACTION (UPnGO) was a commercialized 12-month workplace physical activity intervention, aimed at encouraging employees to sit less and move more at work. Its design took advantage of the ubiquitous nature of mobile fitness trackers and aimed to be implemented in any office-based workplace in Canada. The program was available at cost from June 2017 to April 2020. The objectives of this study are to evaluate the program and identify key lessons from the commercialization of UPnGO. Methods: Using a quasi-experimental design over 3 time points: baseline, 6 months, 12 months, five evaluation indicators were measured as guided by the RE-AIM framework. Reach was defined as the number and percentage of employees who registered for UPnGO and the number and percentage of sedentary participants registered. Effectiveness was assessed through average daily step count. Adoption was determined by workplace champion and senior leadership responses to the off-platform survey. Implementation was assessed as the percentage of participants who engaged with specific program elements at the 3-evaluation time points. Maintenance was assessed by the number of companies who renewed their contracts for UPnGO. Results: Reach across 17 organizations, 1980 employees participated in UPnGO, with 27% of participants identified as sedentary at baseline. Effectiveness Daily step count declined from 7,116 ± 3,558 steps at baseline to 6,969 ± 6,702 (p = <0.001) at 12 months. Adoption Workplace champion and senior leadership engagement declined from 189 to 21 and 106 to 5 from baseline to 12 months, respectively. Maintenance Two companies renewed their contracts beyond the first year. Conclusions: The commercialization of UPnGO was an ambitious initiative that met with limited success; however, some key lessons can be generated from the attempt. The workplace remains an important environment for PA interventions but effective mHealth PA programs may be difficult to implement and sustain long-term.

Nurse champions as leaders for the implementation of CoACT Collaborative Care.

This is the first paper describing the unit level champion role in order to implement the Collaborative Care framework as an evidence-based practice in the province of Alberta. The clear selection criteria of Unit Lead, funding (.2 FTE) that allows for the dedication of the role, support with various education, coaching from the project management team, and community of practices were suggested as important factors for successful utilization of Unit Leads to implement quality improvement initiatives in a large scale. Future initiatives may consider using a peer-leader champion as a change agent who is committed to the change initiative, credible and personally connected to the unit staff, possesses knowledge about the organizational culture, and develops a unit-tailored strategy via performance monitoring data to fully implement an evidence-based practice for quality care.

Social-Ecological Correlates of Children's Independent Mobility: A Systematic Review.

Children's independent mobility (IM) is associated with a range of benefits and understanding the factors that influence IM can support creation of effective interventions. The review (Prospero CRD42016042174) systematically summarized the available literature for social-ecological correlates of children's IM in school-aged children and youth (aged 5-17 years). In this case, 53 studies were included and evaluated six individual, 15 interpersonal, 12 social environment, and 19 built environment- level variables. Most studies originated from Australia (n = 15) and Canada (n = 8) with most published in 2011 or later (n = 48). Variables that were consistently (positively and/or negatively) associated with children's IM were age, ethnicity/race, child's perceived competence, ownership of a house/access to house keys, having siblings, parents' attitude toward IM and perception of child's confidence, children's interest in environment and activities, parents' concern around traffic, housing/residential density, length of residency in one's home, distance to destinations, and proximity to green space. Given the inter-related social-ecological correlates identified, intervention to promote children's IM will likely need a multi-level and multi-sectoral approach. However, focus areas of building children's skills and confidence, helping parents gain confidence in their children's abilities, assuaging parental traffic concerns, and building environments with shorter distances to destinations of interest for children should be prioritized.

The Believability of Exercise Blogs Among Young Adults.

It is unknown how lifelong digital media users such as young adult women perceive exercise information found online. A total of 141 women aged 18-30 years and residing in Canada were randomized to read either a factually incorrect or a factually correct blog article. Participants completed Go/No-Go tasks to measure automatically activated believability and evaluations and questionnaires to explicitly measure believability, affective evaluations, and intentions to exercise. Participants did not show evidence of automatically activated believability of the content found in either blog article. However, participants reading the factually correct article reported significantly greater explicit disbelief than those reading the factually incorrect article, though this did not predict intentions. Being factually correct may not be an important component of message believability. Exercise professionals need to remain aware of the content of popular online sources of information in an effort to curb misinformation.

Are early increases in physical activity a behavioral marker for successful antidepressant treatment?

BACKGROUND: The aim of this study was to examine whether changes in physical activity predicted reductions in depression during the 8 weeks of antidepressant treatment with vortioxetine. METHODS: One hundred individuals were recruited for the (THINC-it ®)-sensitivity to change study. Self-reported moderate-to-vigorous physical activity (MVPA) and depression severity were assessed at baseline, week 4 and week 8. Linear mixed model analyses were performed to examine whether increases in MVPA were associated with reduction in depression severity over the course of treatment and hierarchical logistic regression analyses were performed to assess whether treatment response (responders vs. non-responders) at week 8 was predicted by early change in physical activity (MVPA at week 4), after controlling for individuals' demographics (sex, age, race, education level, BMI) and baseline MVPA and depression severity. RESULTS: After controlling for individuals' demographics, a significant increase in MVPA predicted reduction in depression severity, ß = -2.06, 95% CI -3.18, -0.94, p <0.001. Individuals with more physical activity at week 4 relative to baseline had higher odds of treatment response at endpoint, OR 1.97, 95% CI 1.11 - 3.48, p <0.05. Twenty-one percent of total variance of depression severity was explained by change in MVPA. CONCLUSIONS: The study suggests that early increases in physical activity may be a behavioral marker of antidepressant treatment response. The inclusion of physical activity measures in future clinical treatment trials of depression is recommended to explore whether changes in physical activity mediate or moderate reductions in depression severity associated with the primary treatment.

A Qualitative Systematic Review of Public-Private Partnership in Promoting Physical Activity.

The purpose of the study is to conduct a comprehensive review of public-private partnership (PPP) literature that pertains to promoting physical activity. A qualitative systematic review guided data search and screening process, and the findings were synthesized and interpreted using a qualitative content analysis method. Literature was searched from 16 academic and 6 gray literature databases. A total of 1,117 articles were initially searched, full texts of 186 articles were assessed, and 13 articles that met the inclusion criteria were finally included. PPPs have been initiated in various contexts including implementing the pledge policy, program coordination, and infrastructure supports. Public-sector partners were identified in a range of vertical and horizontal levels. Private partners were mainly manufacturers and/or retailers related to physical activity, sport facility operators, professional sport teams, or companies for providing infrastructures for active transportation. Public and private organizations have performed various roles of funding the initiatives, developing and implementing diverse resources, and taking actions to deliver benefits to the communities. Several challenges were reported when developing, implementing, and evaluating the partnership initiatives. The outcomes of the current review can be utilized to anticipate pragmatic issues when public and private partners jointly participate in physical activity promotion.

Application of an Ecological Momentary Assessment Protocol in a Workplace Intervention: Assessing Compliance, Criterion Validity, and Reactivity.

BACKGROUND: Ecological momentary assessment (EMA) is a method of collecting behavioral data in real time. The purpose of this study was to examine EMA compliance, identify factors predicting compliance, assess criterion validity of, and reactivity to, using EMA in a workplace intervention study. METHODS: Forty-five adults (91.1% female, 39.7 [9.6] y) were recruited for a workplace standing desk intervention. Participants received 5 surveys each day for 5 workdays via smartphone application. EMA items assessed current position (sitting/standing/stepping). EMA responses were time matched to objectively measured time in each position before and after each prompt. Multilevel logistic regression models estimated factors influencing EMA response. Cohen kappa measured interrater agreement between EMA-reported and device-measured position. Reactivity was assessed by comparing objectively measured sitting/standing/stepping in the 15 minutes before and after each EMA prompt using multilevel repeated-measures models. RESULTS: Participants answered 81.4% of EMA prompts. Differences in compliance differed by position. There was substantial agreement between EMA-reported and device-measured position (κ = .713; P < .001). Following the EMA prompt, participants sat 0.87 minutes more than before the prompt (P < .01). CONCLUSION: The use of EMA is a valid assessment of position when used in an intervention to reduce occupational sitting and did not appear to disrupt sitting in favor of the targeted outcome.

Political Orientation and Public Attributions for the Causes and Solutions of Physical Inactivity in Canada: Implications for Policy Support.

Objectives: To examine how public attributions for the causes and solutions of physical inactivity and individuals' self-identified political orientation are associated with support for different policy actions in addressing physical inactivity. Methods: A secondary data analysis was conducted with a sample of 2,044 Canadian adults. Two sets of 2 X 3 analyses of variance and post-hoc analyses were conducted to assess (1) the mean differences by the causes of the issue of physical inactivity (individual, or both internal and external/external) and political orientation (liberal, centrist, and conservative), and (2) responsibility for solutions (private matter, or both private and public health matter, and /public health matter) and political orientation on support for least, moderate, and most intrusive policy actions. Results: No interaction effects existed between causal attribution and political orientation on policy support, but a main effect of causal attributions for physical inactivity and political orientation was significant. Those who held internal attributions for the cause of physical inactivity showed less support for policies compared to those who held external causal attributions or both internal and external causal attributions. Conservative individuals reported the least support for all policy actions in comparison to liberal or centrist orientations. There were interaction effects between responsibility for solutions and political orientation on policy support. Conservative individuals who perceived the responsibility for solving physical inactivity as a private matter had less support for all three policy actions. Conclusions: Public acceptance of policy actions addressing physical inactivity varies by the attributions the public have regarding causes and responsibility for solving the problem, and by political orientation. Advocacy and messaging for policy implementation in the physical activity arena needs to be communicated in ways that encourage reflective and informed deliberation that is representative of the Canadian population.

Assessing the social climate of physical (in)activity in Canada.

BACKGROUND: Ecological models suggest that a strategy for increasing physical activity participation within a population is to reconstruct the "social climate". This can be accomplished through 1) changing norms and beliefs, 2) providing direct support for modifying environments, and 3) implementing policies to encourage physical activity. Nevertheless, surveillance efforts have paid limited attention to empirical assessment of social climate. This study responds to this gap by assessing the social climate of physical activity in Canada. METHODS: A representative sample of Canadian adults (n = 2519, male/female = 50.3%/49.7%, Mage = 49.1 ± 16.3 years) completed an online survey asking them to assess social climate dimensions including social norms of physical (in)activity, perceptions of who causes physical inactivity and who is responsible for solving physical inactivity, and support for physical activity-related policy. Descriptive statistics (frequencies) were calculated. Multinomial logistic regressions were constructed to identify whether demographic variables and physical activity participation associated with social climate dimensions. RESULTS: Physical inactivity was considered a serious public health concern by 55% of the respondents; similar to unhealthy diets (58%) and tobacco use (57%). Thirty-nine percent of the respondents reported that they often see other people exercising. Twenty-eight percent of the sample believed that society disapproves of physical inactivity. The majority of respondents (63%) viewed the cause of physical inactivity as both an individual responsibility and other factors beyond an individuals' control. Sixty-seven percent of respondents reported physical inactivity as being both a private matter and a public health matter. Strong support existed for environmental-, individual-, and economic-level policies but much less for legislative approaches. The social climate indicators were associated with respondents' level of physical activity participation and demographic variables in expected directions. CONCLUSION: This study is the first known attempt to assess social climate at a national level, addressing an important gap in knowledge related to advocating for, and implementing population-level physical activity interventions. Future tracking will be needed to identify any temporal (in)stability of these constructs over time and to explore the relationship between physical activity participation and indicators of the national social climate of physical activity.

Context Matters: Examining Perceived Health and Fitness Outcomes of Physical Activity Participation Among South Korean Adults and Youth.

PURPOSE: To examine associations between physical activity contexts and health and fitness perceptions among Korean adults and youth. METHOD: Data were from the Korean Survey on Citizens' Sports Participation in 2015. Korean youth (N = 832; Mage = 14.7) and adults (N = 6719; Mage = 41.3) were included in the hierarchical logistic and linear regressions. Youth physical activity was examined in school-based (i.e., school-based and after-school/Saturday school sports) and out of school (i.e., organized sports) settings. Adults who met the World Health Organization (WHO) physical activity guidelines or not, and participated in structured (e.g., sport) and unstructured (e.g., walking) physical activity were compared. The outcome variables were self-reported health and fitness. Gender interactions between physical activity and all outcomes were examined for the adult sample only. RESULTS: No associations existed between physical activity and perceived health or fitness among youth. Adults who met the WHO guidelines, or participated in structured physical activity showed higher odds of reporting good health. Unstructured physical activity was associated with lower odds of reporting good health. Positive perceptions of fitness were more likely to be reported by males who met physical activity guidelines compared to females. CONCLUSIONS: For youth, the potential benefit of physical activity, regardless of contexts, may be more apparent for psychological health than perceived physical health, and school should be used as a venue to promote physical activity. For adults, structured physical activity and achieving the WHO physical activity guidelines may be suggested for perceptions of overall health.

Examining implicit cognitions in the evaluation of a community-wide physical activity program.

The purpose of this study was to incorporate measures of attentional bias and implicit attitudes in the evaluation of a community-wide physical activity program, UWALK, by examining the relationships among proximal, intermediate, and distal outcomes of the program as outlined in the hierarchy of effects model. UWALK incorporated various communication and marketing strategies via mass media, on- and off-line platforms. Participants (N = 127) reported unprompted then prompted awareness of UWALK followed by measures of attentional bias and implicit attitudes, watched a 30-second UWALK video, then completed a thought listing task and questionnaires measuring instrumental and affective attitudes, leisure time physical activity, and demographics. Results showed that participants with unprompted awareness of UWALK demonstrated attentional bias toward UWALK images, positive implicit attitudes, and greater physical activity participation compared to unaware counterparts. Attentional bias, awareness, and implicit attitudes significantly predicted behavior, accounting for 15.2% of the variance. This study emphasizes the importance of including measures of automatic cognitions during evaluation can further inform the effects of a program. The results also showed that it is problematic to assume that visiting a website indicates a program will be remembered and related cognitions will be affected.

Exploring the impact of the 'new' ParticipACTION: overview and introduction of the special issue. / Exploration de l'impact du « nouveau ¼ ParticipACTION : aperçu et présentation du numéro spécial.

ParticipACTION is the Canadian physical activity communications and social marketing organization first launched in the fall of 1971 and then ceased operations in 2001. ParticipACTION was relaunched in 2007. Framed as a public health natural experiment, evidence was collected from a population-based survey of knowledge, awareness, understanding of physical activity, and physical activity levels among Canadians (individual level), and key informant surveys and interviews examining capacity, readiness and advocacy for physical activity promotion among physical activity organizations (organizational level). The purpose of this paper is to first provide an overview of some of the major initiatives undertaken by the 'new' ParticipACTION that may have contributed to any changes at these individual or organizational levels. Second, the paper sets the stage for the three empirical papers in this special series reporting follow-up results.

RÉSUMÉ: ParticipACTION est un organisme de communications et de marketing social voué à la promotion de l'activité physique au Canada, qui a été fondé à l'automne 1971, a cessé ses activités en 2001 et a été relancé en 2007. Conçues comme une expérience naturelle en santé publique, les données probantes ont été tirées à la fois d'une enquête fondée sur la population et portant sur les connaissances, la sensibilisation, la compréhension de l'activité physique et les niveaux d'activité physique des Canadiens (à l'échelle de l'individu) et de sondages et d'entrevues auprès d'informateurs clés visant à examiner le pouvoir d'action, l'état de préparation et le soutien des organisations en matière de promotion de l'activité physique (à l'échelle de l'organisation). Cet article vise en premier lieu à donner un aperçu de certaines des principales initiatives entreprises par la « nouvelle version ¼ de ParticipACTION susceptibles d'avoir contribué à des changements sur le plan individuel ou organisationnel. En second lieu, il prépare le terrain pour les trois études empiriques de cette série d'articles consacrée aux résultats de suivi.

A Systematic Review of Community-wide Media Physical Activity Campaigns: An Update From 2010.

BACKGROUND: Mass media campaign is an integral tool to influence physical activity participant behaviors. The purpose of the systematic review was to identify the effectiveness of mass media campaigns in promoting physical activity. METHODS: Literature update from January 2010 to September 2016 was conducted in 13 databases. Full text articles of 128 were screened, and 23 articles (18 campaigns) were selected from the initial 1692 articles. RESULTS: All campaigns involved mass media advertisements to promote physical activity to general individuals (n = 2), adults (8), children (4), older adults (2), and parents of children (n = 2). The campaign evaluation designs included clustered RCT (2), cohort (3), quasi-experimental (9), and cross-sectional (9). Eight articles demonstrated significant campaign impact on proximal, 6 on intermediate, 5 on distal outcomes, and 6 on distal change based on either proximal or intermediate outcome. CONCLUSION: The current review assessed the outcome evaluation of mass media physical activity campaigns that varied in their respective scope, target population and outcomes measured to identify individual changes at proximal, intermediate, and distal level. Results from formative and process evaluation as well as dose-response and cost-effective analysis are suggested to provide valuable evidence for campaign stakeholders and planners.

A Systematic Review of Interventions to Increase Stair Use.

CONTEXT: Stair climbing is an accessible activity that can be incorporated into one's daily lifestyle to increase physical activity levels and provide health benefits. This review summarizes the effectiveness of stair interventions and explores key differences that may influence intervention effectiveness. EVIDENCE ACQUISITION: Interventions to increase stair use published from January 1990 to July 2015 were identified in PubMed, Sport Discus, Web of Science, Environment Complete, CINAHL, Trial Register of Promoting Health Interventions, Embase, Scopus, and PsycINFO. Eligibility criteria included original studies, published in peer-reviewed journals, targeting adult samples, and clearly describing intervention design and results. Studies were also required to measure the use of stairs compared with an elevator, escalator, or moving stairway at baseline and during at least one timepoint when the intervention was in effect. Studies were required to provide data to determine if the intervention resulted in significant changes in stair use/climbing. EVIDENCE SYNTHESIS: The search results yielded 2,136 articles in total; 54 articles met the criteria, which resulted in a final sample of 67 studies included in the analyses. Interventions settings included public sites (75%), worksites (21%), or a combination of both (4%). For Phase 1 results, 72% of studies reported significant improvements in stair use (n=10 of 14) and stair climbing (n=38 of 53). CONCLUSIONS: Evidence from the review demonstrates support for the effectiveness of interventions to increase stair use and stair climbing. Although evidence supports the effectiveness of stair interventions in public settings, less support is provided for worksites.