The role of social support on physical activity behaviour in adolescent girls:A systematic review and meta-analysis

ABSTRACT: Adolescent girls have been targeted as a priority group for promoting physical activity levels however it is unclear how this can be achieved. There is some evidence to suggest that social support could impact the physical activity levels of adolescent girls, although the relationship is complex and not well understood. We aimed to systematically review and meta-analyse the relationship between social support and physical activity in adolescent girls, exploring how different types and providers of social support might influence the relationship. Articles were identified through a systematic search of the literature using 14 electronic databases, personal resources, grey literature, and reference lists of included studies and previous reviews. Search terms representing social support, physical activity and adolescent girls were identified and used in various combinations to form a search strategy which was adapted for different databases. Cross-sectional or longitudinal articles published in English that reported an association between social support and physical activity in adolescent girls between the ages of 10 to 19 years were included. Studies that focused only on clinical or overweight populations were excluded. Data extraction was carried out by one reviewer using an electronic extraction form. A random 25 % of included articles were selected for data extraction by a second reviewer to check fidelity. Risk of bias was assessed using a custom tool informed by the Critical Appraisal Skills Programme Cohort Study Checklist in conjunction with data extraction. Cross-sectional results were meta-analysed and longitudinal results were presented narratively. Small but significant associations between all available providers of total social support (except teachers) and physical activity were found (r = .14-.24). Small but significant associations were also identified for emotional, instrumental and modelling support for some providers of support (r = .10-.21). Longitudinal research supported the cross-sectional analyses. Many of the meta-analysis results suggested high heterogeneity and there was some evidence of publication bias, therefore, the meta-analysis results should be interpreted with caution. In conclusion, the meta-analysis results suggest that social support is not a strong predictor of physical activity in adolescent girls though parents and friends may have a role in enhancing PA. TRIAL REGISTRATION: PROSPERO 2014:CRD42014006738 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12966-016-0405-7) contains supplementary material, which is available to authorized users

Dopamine and Glutamate in Antipsychotic-Responsive Compared With Antipsychotic-Nonresponsive Psychosis: A Multicenter Positron Emission Tomography and Magnetic Resonance Spectroscopy Study (STRATA)

The variability in the response to antipsychotic medication in schizophrenia may reflect between-patient differences in neurobiology. Recent cross-sectional neuroimaging studies suggest that a poorer therapeutic response is associated with relatively normal striatal dopamine synthesis capacity but elevated anterior cingulate cortex (ACC) glutamate levels. We sought to test whether these measures can differentiate patients with psychosis who are antipsychotic responsive from those who are antipsychotic nonresponsive in a multicenter cross-sectional study. 1H-magnetic resonance spectroscopy (1H-MRS) was used to measure glutamate levels (Glucorr) in the ACC and in the right striatum in 92 patients across 4 sites (48 responders [R] and 44 nonresponders [NR]). In 54 patients at 2 sites (25 R and 29 NR), we additionally acquired 3,4-dihydroxy-6-[18F]fluoro-L-phenylalanine (18F-DOPA) positron emission tomography (PET) to index striatal dopamine function (Kicer, min−1). The mean ACC Glucorr was higher in the NR than the R group after adjustment for age and sex (F1,80 = 4.27; P = .04). This was associated with an area under the curve for the group discrimination of 0.59. There were no group differences in striatal dopamine function or striatal Glucorr. The results provide partial further support for a role of ACC glutamate, but not striatal dopamine synthesis, in determining the nature of the response to antipsychotic medication. The low discriminative accuracy might be improved in groups with greater clinical separation or increased in future studies that focus on the antipsychotic response at an earlier stage of the disorder and integrate other candidate predictive biomarkers. Greater harmonization of multicenter PET and 1H-MRS may also improve sensitivity

Developing an intervention to increase physical activity in schizophrenia

BACKGROUND: People with schizophrenia die approximately 15-20 years earlier than those in the general population, largely due to poor physical health and related cardiovascular disease (CVD). Many of the risk factors for CVD are positively modifiable with regular physical activity (PA), but few people with schizophrenia engage in the recommended levels of PA and we do not yet know the best way to encourage the uptake and maintenance of regular PA in this patient group. METHOD: Drawing on the MRC guidelines for the development of interventions to improve health, a behavioural change intervention was developed to increase PA in people with schizophrenia. A narrative review was conducted to summarise potential barriers and facilitators to PA in people with schizophrenia in the relevant literature, which were categorised according to an ecological model encompassing the multiple levels of influence on PA. Then ten people with schizophrenia were interviewed in a qualitative study to further explore this topic, using the TDF as a framework for analysis. A12-week intervention to increase PA was then developed, based on previous work in stroke, current relevant research and informed by the findings of the narrative review and qualitative study. This intervention was then trialled to assess feasibility and acceptability. Results: The intervention proved to be feasible and acceptable to participants with schizophrenia who live in the community. Of the 20 people enrolled, 18 (90%) completed the full 12 weeks. Reasons for dropout were work commitments and illness. Of the 18 who completed the intervention, 16 (89%) increased their weekly step count, 10 (56%) experienced weight loss, 12 (67%) took up an additional health promotion opportunity, and 13 (72%) initiated another form of PA in addition to walking. Informal feedback from staff confirmed the need for such a service and indicated that, if it was to be implemented into mental health services, it would be a popular and useful resource. CONCLUSIONS: In the future, the intervention will be further developed based on participant feedback gathered at the end of the study. Then an RCT will be conducted with data collected at long-term follow-up to formerly assess the intervention’s efficacy to improving PA behaviour and other physical and mental health outcomes in community-dwelling people with schizophrenia

Schizophrenia, poor physical health and physical activity:Evidence-based interventions are required to reduce major health inequalities

In schizophrenia, life expectancy is reduced by 20 years, primarily due to cardiovascular disease (CVD). Physical activity modifies CVD risk factors, but physical activity levels are low in this patient group. We urgently need evidencebased interventions that increase physical activity to improve health and reduce premature mortality in people with schizophrenia.</p

Additional file 2: of The role of social support on physical activity behaviour in adolescent girls: a systematic review and meta-analysis

Moderators tested in meta-regression. (DOCX 12 kb

Additional file 4: of The role of social support on physical activity behaviour in adolescent girls: a systematic review and meta-analysis

Data extraction from included studies. (DOCX 233 kb

Additional file 3: of The role of social support on physical activity behaviour in adolescent girls: a systematic review and meta-analysis

Characteristics of included studies. (DOCX 12 kb

Additional file 1: of The role of social support on physical activity behaviour in adolescent girls: a systematic review and meta-analysis

Risk of bias assessment thresholds. (DOCX 14 kb

Educational aspirations of Malay youths from low-income families in Singapore

10.1080/02185385.2012.739473Asia Pacific Journal of Social Work and Development224253-26