Does knowledge of physical activity recommendations increase physical activity among Chinese college students? Empirical investigations based on the transtheoretical model

Background: Based on the transtheoretical model, the current study investigated whether awareness of physical activity (PA) recommendations had an impact on the stages of PA behavior change and levels of PA among Chinese college students. Methods: In Study 1, with a cross-sectional study design, 9826 students were recruited, and their knowledge of international PA recommendations, PA stage distribution, and self-reported PA level were surveyed. Pearson's χ2 test was used to test whether those participants who were aware and not aware of PA guidelines were equally distributed across the stages of PA behavior, and independent t test was conducted to test the group difference in the actual levels of PA. In Study 2, 279 students who were not aware of the PA recommendations were randomly allocated to either an intervention group or a control group, and only those in the intervention group were presented with international PA guidelines. In both groups, students' PA stages and PA level were examined before the test and then 4 months post-test. McNemar's test for correlated proportions and repeated-measures analysis of variance were conducted to examine the changes in PA stage membership and PA level after the intervention. Results: Study 1 results revealed that only 4.4% of the surveyed students had correct knowledge of PA recommendations. Those who were aware of the recommendations were in later stages of PA behavior (χ2(4) = 167.19, p < 0.001). They were also significantly more physically active than those who were not aware of the recommendations (t(443.71) = 9.00, p < 0.001, Cohen's d = 0.53). Study 2 results demonstrated that the intervention group participants who were at the precontemplation and contemplation stages at the pre-test each progressed further in the PA stages in the post-test (χ2(1) = 112.06, p < 0.001; χ2(1) = 118.76, p = 0.03, respectively), although no significant change in PA level was observed (t(139) < 1, p = 0.89). Conclusion: The results showed that awareness of the PA recommendations was associated with higher stages and levels of PA behavior, and a brief educational exposure to PA recommendations led to improved stages of PA behavior but no change in the levels of PA among Chinese college students. More effective public health campaign strategies are needed to promote the dissemination of the PA recommendations and to raise the awareness of the Chinese student population

Autonomy support in physical education promotes autonomous motivation towards leisure-time physical activity: evidence from a sample of Chinese college students

Based on the trans-contextual model, two studies aimed to test whether autonomy-supportive physical education (PE) promotes autonomous motivation towards leisure-time physical activity among Chinese college students. Study 1 was conducted in September 2015 and used a cross-sectional design. Participants were students who provided data on perceived autonomy support and motivation for physical activity. Regression analysis was used to analyze the data. Study 2 took place from September to December 2015 and employed an experimental design. Participants were PE teachers and their students. The teachers were randomized to either an intervention or a control group and those in the intervention group received a 3-month long autonomy-supportive intervention program. Their students provided data on motivation. The data were analyzed with repeated measurement analysis of variance. A total of 681 students aged 16-26 years participated in Study 1. Perceived autonomy support predicted autonomous motivation in PE (β = 0.18, P = 0.001), which in turn predicted autonomous motivation towards leisure-time physical activity (β = 0.51, P = 0.001). Ten PE teachers (28-53 years) and 258 students (16-26 years) participated in Study 2. Students who were educated by the intervention teachers had significantly stronger autonomous motivation towards leisure-time physical activity than students educated by the control teachers after the intervention, (F = 12.41, P = 0.001). The results suggest that PE may serve as an effective platform to promote an active lifestyle among Chinese college students when teachers provide students with an experience of autonomy

Implementing a complex mental health intervention in occupational settings: process evaluation of the MENTUPP pilot study

Background According to the Medical Research Council (MRC) framework, the theorisation of how multilevel, multicomponent interventions work and the understanding of their interaction with their implementation context are necessary to be able to evaluate them beyond their complexity. More research is needed to provide good examples following this approach in order to produce evidence-based information on implementation practices.Objectives This article reports on the results of the process evaluation of a complex mental health intervention in small and medium enterprises (SMEs) tested through a pilot study. The overarching aim is to contribute to the evidence base related to the recruitment, engagement and implementation strategies of applied mental health interventions in the workplace.Method The Mental Health Promotion and Intervention in Occupational Settings (MENTUPP) intervention was pilot tested in 25 SMEs in three work sectors and nine countries. The evaluation strategy of the pilot test relied on a mixed-methods approach combining qualitative and quantitative research methods. The process evaluation was inspired by the RE-AIM framework and the taxonomy of implementation outcomes suggested by Proctor and colleagues and focused on seven dimensions: reach, adoption, implementation, acceptability, appropriateness, feasibility and maintenance.Results Factors facilitating implementation included the variety of the provided materials, the support provided by the research officers (ROs) and the existence of a structured plan for implementation, among others. Main barriers to implementation were the difficulty of talking about mental health, familiarisation with technology, difficulty in fitting the intervention into the daily routine and restrictions caused by COVID-19.Conclusions The results will be used to optimise the MENTUPP intervention and the theoretical framework that we developed to evaluate the causal mechanisms underlying MENTUPP. Conducting this systematic and comprehensive process evaluation contributes to the enhancement of the evidence base related to mental health interventions in the workplace and it can be used as a guide to overcome their contextual complexity.Trial registration number ISRCTN14582090