Daily associations between sleep and physical activity : a systematic review and meta-analysis

The day-to-day variations of sleep and physical activity are associated with various health outcomes in adults, and previous studies suggested a bidirectional association between these behaviors. The daily associations between sleep and physical activity have been examined in observational or interventional contexts. The primary goal of the current systematic review and meta-analysis was to summarize existing evidence about daily associations between sleep and physical activity outcomes at inter- and intra-individual level in adults. A systematic search of records in eight databases from inception to July 2019 identified 33 peer-reviewed empirical publications that examined daily sleep – physical activity association in adults. The qualitative and quantitative analyses of included studies did not support a bidirectional daily association between sleep outcomes and physical activity. Multilevel meta-analyses showed that three sleep parameters were associated with physical activity the following day: sleep quality, sleep efficiency, and wake after sleep onset. However, the associations were small, and varied in terms of direction and level of variability (e.g. inter- or intra-individual). Daytime physical activity was associated with lower total sleep time the following night at an inter-person level with a small effect size. From a clinical perspective, care providers should monitor the effects of better sleep promotion on physical activity behaviours in their patients. Future studies should examine sleep and physical activity during a longer period and perform additional sophisticated statistical analyses

Matched or nonmatched interventions based on the transtheoretical model to promote physical activity. A meta-analysis of randomized controlled trials

The aim of this study was to examine whether the efficacy of transtheoretical model (TTM)–based interventions on physical activity (PA) varied according to the following criteria: (1) interventions targeted the actual stages of change (SOCs) or did not; (2) participants were selected according to their SOC or were not; and (3) its theoretical constructs (decisional balance, temptation, self-efficacy, processes of change). Thirty-three randomized controlled trials assessing TTM-based interventions promoting PA in adults were systematically identified. The between-group heterogeneity statistic (Qb) did not reveal any differential efficacy either in interventions targeting the actual SOC compared with those that did not (Qb = 1.28, p = 0.22) or in interventions selecting participants according to their SOC compared with those that did not (Qb = 0.01, p = 0.91). TTM-based interventions enhanced PA behavior whether they targeted the actual SOC (Cohen's d = 0.36; 95% confidence interval (CI): 0.22–0.49)) or not (d = 0.23; 95% CI: 0.09–0.38) and whether they selected their participants according to their SOC (d = 0.33; 95% CI: 0.13–0.53) or not (d = 0.32; 95% CI: 0.19–0.44). The moderators of the efficacy of TTM-based interventions were the number of theoretical constructs used to tailor the intervention (Qb = 8.82, p = 0.003), the use of self-efficacy (Qb =6.09, p = 0.01), and the processes of change (Qb = 3.51, p = 0.06). TTM-based interventions significantly improved PA behavior, and their efficacy was not moderated by SOC but by the TTM theoretical constructs

Thinking Health-related Behaviors in a Climate Change Context:A Narrative Review

Background: Human activities have changed the environment so profoundly over the past two centuries that human-induced climate change is now posing serious health-related threats to current and future generations. Rapid action from all scientific fields, including behavioral medicine, is needed to contribute to both mitigation of, and adaption to, climate change.Purpose: This article aims to identify potential bi-directional associations between climate change impacts and health-related behaviors, as well as a set of key actions for the behavioral medicine community.Methods: We synthesized the existing literature about (i) the impacts of rising temperatures, extreme weather events, air pollution, and rising sea level on individual behaviors (e.g., eating behaviors, physical activity, sleep, substance use, and preventive care) as well as the structural factors related to these behaviors (e.g., the food system); and (ii) the concurrent positive and negative roles that health-related behaviors can play in mitigation and adaptation to climate change.Results: Based on this literature review, we propose a first conceptual model of climate change and health-related behavior feedback loops. Key actions are proposed, with particular consideration for health equity implications of future behavioral interventions. Actions to bridge the fields of behavioral medicine and climate sciences are also discussed.Conclusions: We contend that climate change is among the most urgent issues facing all scientists and should become a central priority for the behavioral medicine community.</p

Exercise and bariatric surgery: A systematic review and meta-analysis of the feasibility and acceptability of exercise and controlled trial methods

This systematic review and meta-analysis assessed the feasibility and acceptability of exercise and controlled trial methods in adults awaiting or having undergone bariatric surgery (BS). Search methods used to identify relevant articles were inclusion of articles identified in a systematic review, new database search of articles published 2019–2021, and hand searching reference lists. Titles/abstracts and full-texts were screened by two reviewers independently against inclusion criteria: adults awaiting or having undergone BS, controlled trial, exercise group compared with a comparison group without exercise. Twenty-eight articles were reviewed; most interventions were supervised, performed after BS, and lasted ≤13 weeks. Pooled data for exercise intervention attendance and dropout rates were 84% (k = 10) and 5% (k = 19), respectively, though possibly misestimated due to poor/selective reporting. Median study and recruitment duration were 18 weeks and 24 months, respectively, with a pooled enrollment rate of 2.5 participants/month. Pooled data for refusal to participate, enrollment, and retention rates were 23% (k = 16), 43% (k = 18), and 87% (k = 26), respectively. Despite the lack of data available in studies included, exercise and controlled trial methods seem feasible and acceptable for adults awaiting or having undergone BS. To better identify methodological or practical challenges, and assess bias, better reporting of feasibility and acceptability indicators is needed in future studies

Acceptability and Feasibility of the Telehealth Bariatric Behavioral Intervention to Increase Physical Activity: Protocol for a Single-Case Experimental Study

Background: Regular physical activity (PA) is recommended to optimize weight and health outcomes in patients who have undergone metabolic and bariatric surgery (MBS). However, >70% of patients have low PA levels before MBS that persist after MBS. Although behavioral interventions delivered face-to-face have shown promise for increasing PA among patients who have undergone MBS, many may experience barriers, preventing enrollment into and adherence to such interventions. Delivering PA behavior change interventions via telehealth to patients who have undergone MBS may be an effective strategy to increase accessibility and reach, as well as adherence. Objective: This paper reports the protocol for a study that aims to assess the feasibility and acceptability of the protocol or methods and the Telehealth Bariatric Behavioral Intervention (TELE-BariACTIV). The intervention is designed to increase moderate-to-vigorous intensity PA (MVPA) in patients awaiting bariatric surgery and is guided by a multitheory approach and a patient perspective. Another objective is to estimate the effect of the TELE-BariACTIV intervention on presurgical MVPA to determine the appropriate sample size for a multicenter trial. Methods: This study is a multicenter trial using a repeated (ABAB’A) single-case experimental design. The A phases are observational phases without intervention (A1=pre-MBS phase; A2=length personalized according to the MBS date; A3=7 months post-MBS phase). The B phases are interventional phases with PA counseling (B1=6 weekly pre-MBS sessions; B2=3 monthly sessions starting 3 months after MBS). The target sample size is set to 12. Participants are inactive adults awaiting sleeve gastrectomy who have access to a computer with internet and an interface with a camera. The participants are randomly allocated to a 1- or 2-week baseline period (A1). Protocol and intervention feasibility and acceptability (primary outcomes) will be assessed by recording missing data, refusal, recruitment, retention, attendance, and attrition rates, as well as via web-based acceptability questionnaires and semistructured interviews. Data collected via accelerometry (7-14 days) on 8 occasions and via questionnaires on 10 occasions will be analyzed to estimate the effect of the intervention on MVPA. Generalization measures assessing the quality of life, anxiety and depressive symptoms, and theory-based constructs (ie, motivational regulations for PA, self-efficacy to overcome barriers to PA, basic psychological needs satisfaction and frustration, PA enjoyment, and social support for PA; secondary outcomes for a future large-scale trial) will be completed via web-based questionnaires on 6-10 occasions. The institutional review board provided ethics approval for the study in June 2021. Results: Recruitment began in September 2021, and all the participants were enrolled (n=12). Data collection is expected to end in fall 2023, depending on the MBS date of the recruited participants. Conclusions: The TELE-BariACTIV intervention has the potential for implementation across multiple settings owing to its collaborative construction that can be offered remotely

Un système complexe pour mieux comprendre les enjeux de la promotion de l’activité physique

Un court texte publié dans le bulletin de l'Organisation Mondiale de la Santé propose d'utiliser la théorie des systèmes complexes pour mieux comprendre et relever le défi de la promotion de l'activité physique à une échelle locale, régionale, nationale, voire internationale (1). Les auteurs considèrent qu'un système est plus que la somme des parties, qu'il englobe des interactions entre toutes les parties ainsi que les acteurs impliqués. Cela diffère des modèles plus traditionnels linéaires ..

Augmenter l’activité physique par des stratégies de ‘nudging’ : peu de preuves scientifiques disponibles

La question de l’économie comportementale, plus particulièrement d’une de ses sous-composantes très médiatisée est le nudging ou l’incitation ‘douce’.Un blogue en donne un définition claire  « Un nudge est une incitation douce à adopter ou modifier un comportement, qui préserve le libre choix de l’individu, tout en l’orientant plus ou moins consciemment vers un choix souhaité par le décideur, bénéfique pour toutes les parties (les utilisateurs d’un service, l’acteur économique, la collectiv..

Aider les étudiants de médecine à promouvoir l'Activité physique: une intervention brève ?

Nous avons abordé à plusieurs reprises la question de la promotion de l’activité physique par des médecins de famille, des médecins généralistes. Les lecteurs assidus connaissent les facteurs qui prédisent la promotion de l’AP, ou se rappellent aussi qu’en dépit des nombreuses recommandations l’AP est quasi-absente des formations en médecine (Si l’activité physique est une médecine où est l’activité physique en médecine ?). Une équipe d’Irlande du nord a décidé d’avancer sur cette question, a..