A modified Delphi study to enhance and gain international consensus on the Physical Activity Messaging Framework (PAMF) and Checklist (PAMC)

Abstract Introduction Physical activity messaging is an important step in the pathway towards improving population physical activity levels, but best practice is not yet understood. A gap in the literature exists for a physical activity messaging framework to help guide creation and evaluation of messages. This study aimed to further develop and improve, and gain international expert consensus on, a standardised Physical Activity Messaging Framework and Checklist. Methods A modified Delphi study consisting of three online survey rounds was conducted. Each survey gathered feedback from an international expert panel using quantitative and qualitative methods. The framework and checklist were amended between each round based on survey results until consensus (defined a priori as 80% agreement) was reached. Results The final expert panel (n = 40, 55% female) came from nine countries and comprised academics (55%), healthcare and other professionals (22.5%) and government officials or policymakers (22.5%). Consensus was reached in survey 3 with 85 and 87.5% agreement on the framework and checklist, respectively. Conclusion This study presents an expert- and evidence-informed framework and checklist for physical activity messaging. If used consistently, the Physical Activity Messaging Framework and Checklist may improve practice by encouraging evidence-based and target audience-focused messages, as well as enhance the research base on physical activity messaging by harmonising key terminologies and improving quality of reporting. Key next steps include further refining the Physical Activity Messaging Framework and Checklist based on their use in real-world settings

Physical activity self-management interventions for adults with spinal cord injury: Part 2 – Exploring the generalizability of findings from research to practice

Despite the benefits associated with regular participation in physical activity, individuals with spinal cord injury (SCI) remain insufficiently active. The ability to self-manage participation may increase physical activity levels, but only if self-management interventions can be implemented in the ‘real world’. The purpose of this review was to examine the degree to which authors of published studies of LTPA self-management interventions for individuals with SCI have reported on factors that could increase the likelihood of translating this research into practice. A systematic search of five databases was conducted, yielding 33 eligible studies representing 31 interventions. Each intervention was assessed using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework and the PRECIS-2 (PRagmatic-Explanatory Continuum Indicator Summary) tool. The most commonly reported RE-AIM dimensions were Effectiveness (51.0% of interventions) and Reach (18.5%), followed by Implementation (14.2%), Maintenance (13.8%), and Adoption (4.0%). Overall, interventions were scored as primarily explanatory in five of the nine PRECIS-2 domains (recruitment, primary analysis, organization, flexibility [delivery], follow-up) and primarily pragmatic in one domain (setting). These findings suggest that while some LTPA self-management interventions for individuals with SCI are intended to be translated to real world settings, limited information is available to understand the degree to which this has been accomplished. Enhanced reporting of factors that could increase the likelihood of translating these interventions into practice is recommended

Rx Activité physique : Développement et implantation d’objectifs d’apprentissage en matière de counseling et de prescription d’activité physique dans les cursus des facultés de médecine canadiennes

Physical activity is an important component of health and well-being, and is effective in the prevention, management, and treatment of numerous non-communicable chronic diseases. Despite the known health benefits of physical activity in all populations, most Canadians do not meet physical activity recommendations. Physicians play a key role in assessing, counselling, and prescribing physical activity. Unfortunately, many barriers, including the lack of adequate education and training, prevent physicians from promoting this essential health behaviour. To support Canadian medical schools in physical activity curriculum development, a team of researchers, physicians, and exercise physiologists collaborated to develop a key set of learning objectives deemed essential to physican education in physical activity counselling and prescription. This commentary will review the newly developed Canadian Physical Activity Counselling Learning Objectives and give case examples of three Canadian medical schools that have implemented these learning objectives.L’activité physique est une composante importante de la santé et du bien-être, et elle est efficace dans la prévention, la prise en charge et le traitement de nombreuses maladies chroniques non transmissibles. Malgré les bienfaits qu’on lui reconnaît pour la santé des populations, la plupart des Canadiens ne suivent pas les recommandations en matière d’exercice. Les médecins jouent un rôle clé dans l’évaluation, le counseling et la prescription de l’activité physique, mais de nombreux obstacles, dont le manque de formation adéquate, les empêchent de promouvoir cette habitude de vie essentielle pour la santé. Afin d’aider les facultés de médecine canadiennes dans l’élaboration de leur cursus sur l’activité physique, une équipe composée de chercheurs, de médecins et de physiologistes de l’exercice a collaboré à la définition d’un ensemble d’objectifs d’apprentissage jugés indispensables à la formation des médecins pour qu’ils puissent offrir des conseils sur l’activité physique et la prescrire. Ce commentaire passe en revue les nouveaux objectifs d’apprentissage en matière de counseling en activité physique et donne des exemples de cas de trois facultés de médecine canadiennes qui ont mis en œuvre ces objectifs d’apprentissage

Physical activity self-management interventions for adults with spinal cord injury: Part 1–A systematic review of the use and effectiveness of behavior change techniques

Objectives: To determine which behavior change techniques (BCTs) have been used within leisure time physical activity (LTPA) self-management interventions for persons with spinal cord injury (SCI), and which BCTs were effective for improving LTPA behavior and/or its antecedents. Design: Systematic review informed by the PRISMA guidelines. Methods: A comprehensive literature search was conducted using five databases. Study characteristics were extracted from included articles and intervention descriptions were coded using the BCT Taxonomy V.1. Effectiveness and maintenance of BCTs as well as the level of behavior change theory use in the design of interventions were examined within experimental studies. Results: Thirty-one unique studies were included, 16 of which had an experimental design. Across all 31 studies, a total of 222 BCTs were identified, representing 32 out of a possible 93 BCTs. The most commonly used BCTs related to the core components of self-management (i.e., education, training/rehearsal of psychological strategies, and social support). Examination of the 16 experimental studies revealed that the use of BCTs corresponding to core self-management components were related to significant improvements and maintenance of LTPA outcomes, regardless of the number of BCTs used. Conclusions: This review offers a glimpse into the mechanisms by which self-management interventions lead to behavior change; however, more research is needed to explore and evaluate other elements (e.g., theory use, tailoring, dose, mode of delivery, and provider) that may comprise effective LTPA self-management interventions for persons with SCI. PROSPERO registration number: CRD42016037531

Developing physical activity interventions for adults with spinal cord injury. Part 2: Motivational counseling and peer-mediated interventions for people intending to be active

Objective: The majority of people with spinal cord injury (SCI) do not engage in sufficient leisure-time physical activity (LTPA) to attain fitness benefits; however, many have good intentions to be active. This paper describes two pilot interventions targeting people with SCI who are insufficiently active but intend to be active (i.e., intenders ). Method: Study 1 examined the effects of a single, telephone-based counseling session on self-regulatory efficacy, intentions, and action plans for LTPA among seven men and women with paraplegia or tetraplegia. Study 2 examined the effects of a home-based strengthtraining session, delivered by a peer and a fitness trainer, on strength-training task self-efficacy, intentions, action plans, and behavior. Participants were 11 men and women with paraplegia. Results: The counseling session (Study 1) yielded medium- to large-sized increases in participants\u27 confidence to set LTPA goals and intentions to be active. The home visit (Study 2) produced medium- to large-sized increases in task self-efficacy, barrier self-efficacy, intentions, action planning, and strength-training behavior from baseline to 4 weeks after the visit. Conclusions/Implications: Study 1 findings provide preliminary evidence that a single counseling session can impact key determinants of LTPA among intenders with SCI. Study 2 findings demonstrate the potential utility of a peer-mediated, home-based strength training session for positively influencing social cognitions and strength-training behavior. Together, these studies provide evidence and resources for intervention strategies to promote LTPA. among intenders with SCI, a population for whom LTPA interventions and resources are scarcely available. © 2013 American Psychological Association

Development of a ParticipACTION App–Based Intervention for Improving Postsecondary Students’ 24-Hour Movement Guideline Behaviors: Protocol for the Application of Intervention Mapping

Background:The Canadian 24-Hour Movement Guidelines for adults provide specific recommendations for levels of physical activity, sedentary behavior, and sleep (ie, the movement behaviors) required for optimal health. Performance of the movement behaviors is associated with improved mental well-being. However, most postsecondary students do not meet the movement behavior recommendations within the Canadian 24-Hour Movement Guidelines and experience increased stress and declining well-being, suggesting the need for an intervention targeting students’ movement behaviors.Objective:We aimed to develop and implement a theory-informed intervention intended to improve the movement behaviors and mental well-being of first-year postsecondary students.Methods:The Intervention Mapping protocol was applied in the development and implementation of the intervention. Intervention Mapping entailed performing a needs assessment, determining the intervention outcomes, selecting theory- and evidence-based change methods and applications, preparing and producing intervention plans and materials, developing the implementation plan, and finally developing an evaluation plan. The Theoretical Domains Framework and the Behavior Change Wheel were also used in conjunction with the Intervention Mapping protocol to ensure a solid theoretical basis for the intervention. This protocol led to the development and implementation of a 6-week, theory-informed ParticipACTION app–based intervention aimed at helping first-year postsecondary students improve their movement behaviors and mental well-being. The developed app content provided students with information on each of the movement behaviors and behavioral strategies (ie, goal setting, action planning, monitoring, and coping planning). The use of Intervention Mapping allowed for the continuous involvement of various multidisciplinary partners and end users, ensuring that the intervention design and implementation was appropriate for the target audience. The feasibility, acceptability, and potential impact of the intervention will be examined in a subsequent proof-of-concept study at 2 Canadian university campuses.Results:Participant recruitment occurred during September 2021, and the intervention was conducted from October to December 2021. The deadline for completion of the postintervention questionnaire by participants was mid-December 2021. The analysis of data examining the feasibility, acceptability, and potential impact of the intervention began in January 2022, with the publication of the proof-of-concept evaluation expected in 2023.Conclusions:Intervention Mapping with the Theoretical Domains Framework and Behavior Change Wheel was a useful approach to combine evidence and theoretical concepts to guide the design and implementation of a ParticipACTION app–based intervention targeting postsecondary students’ movement behaviors and mental well-being. This process may serve as an example for other researchers developing multiple behavior change app–based interventions. Should the forthcoming evaluation demonstrate the intervention’s acceptability, feasibility, and potential impact, the intervention may provide a scalable method of improving postsecondary students’ movement behaviors and mental well-being

Canadian 24-hour movement guidelines for adults aged 18-64 years and adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep

The Canadian Society for Exercise Physiology assembled a Consensus Panel representing national organizations, content experts, methodologists, stakeholders, and end-users and followed an established guideline development procedure to create the Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These guidelines underscore the importance of movement behaviours across the whole 24-h day. The development process followed the strategy outlined in the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. A large body of evidence was used to inform the guidelines including 2 de novo systematic reviews and 4 overviews of reviews examining the relationships among movement behaviours (physical activity, sedentary behaviour, sleep, and all behaviours together) and several health outcomes. Draft guideline recommendations were discussed at a 4-day in-person Consensus Panel meeting. Feedback from stakeholders was obtained by survey (n = 877) and the draft guidelines were revised accordingly. The final guidelines provide evidence-based recommendations for a healthy day (24-h), comprising a combination of sleep, sedentary behaviours, and light-intensity and moderate-to-vigorous-intensity physical activity. Dissemination and implementation efforts with corresponding evaluation plans are in place to help ensure that guideline awareness and use are optimized. Novelty First ever 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older with consideration of a balanced approach to physical activity, sedentary behaviour, and sleep Finalizes the suite of 24-Hour Movement Guidelines for Canadians across the lifespa

Supportive care needs of Canadian melanoma patients and survivors

The purpose of this study was to determine the supportive care needs of melanoma patients and survivors in Canada. Thirty-one melanoma patients and survivors completed the Supportive Needs Questionnaire—Melanoma Supplementary Module in addition to questions pertaining to information delivery and screening behaviour. Results demonstrated that the majority of patients in the study are having their needs met (61.1% of total participant responses). Unfortunately, a substantial proportion of individuals have unmet needs. Of the examined needs, educational and increased informational resource needs were among the greatest reported, particularly among individuals with less education (high school diploma or less). Although overall it appears the majority of needs are being met, more can be done to improve the care of melanoma patients in Canada

Cinq façons de contrer le discours capacitiste en éducation médicale dans le contexte de la promotion de comportements sains en l’activité physique

One in five Canadians have a disability and there are well-documented gaps in care for this equity-deserving group that have roots in medical education. In this paper, we highlight the unintended consequences of ableist messaging for persons living with disabilities, particularly in the context of promoting healthy movement behaviours. With its broad reach and public trust, the medical community has a responsibility to acknowledge the reality of ableism and take meaningful action. We propose five strategies to counter ableist messaging in medical education: (1) increase knowledge and confidence among physicians and trainees to optimize movement behaviours in persons living with disabilities, (2) perform personal and institutional language audits to ensure terminology related to disability is inclusive and avoids causing unintended harm, (3) challenge ableist messages effectively, (4) address the unmet healthcare needs of persons living with disabilities, and (5) engage in efforts to reform medical curricula so that persons living with disabilities are represented and treated equitably. Physicians and trainees are well-positioned to deliver competent and inclusive care, making medical education an opportune setting to address health inequities related to disability.Un Canadien sur cinq souffre d’un handicap. Cette population subit des inégalités bien documentées sur le plan des soins de santé, une situation qui une situation qui découle en partie de l’éducation médicale. Dans cet article, nous mettons en évidence les conséquences involontaires du discours capacitiste véhiculé dans le contexte de la promotion de l’activité physique pour les personnes vivant avec un handicap. Compte tenu de l’influence de la communauté médicale et la confiance que lui témoigne le public, elle se doit de reconnaître. Nous proposons cinq stratégies pour contrer les discours capacitistes en éducation médicale : (1) renforcer les connaissances et la confiance des médecins et des stagiaires pour leur permettre d’optimiser les comportements kinésiques chez les personnes vivant avec un handicap, (2) effectuer des vérifications linguistiques pour garantir que la terminologie liée au handicap qu’emploient les personnes et les établissements est inclusive et n’entraîne pas de préjudices involontaires, (3) contrer efficacement le discours capacitiste, (4) répondre aux besoins de santé non satisfaits des personnes vivant avec un handicap, et (5) participer aux efforts de réforme des programmes d’études médicales afin que les personnes vivant avec un handicap soient représentées et traitées équitablement. Les médecins et les stagiaires occupent une position privilégiée pour offrir des soins compétents et inclusifs, ce qui fait de l’éducation médicale un cadre opportun pour combattre les inégalités en matière de soins liées au handicap

Five ways to counter ableist messaging in medical education in the context of promoting healthy movement behaviours

One in five Canadians have a disability and there are well-documented gaps in care for this equity-deserving group that have roots in medical education. In this paper, we highlight the unintended consequences of ableist messaging for persons living with disabilities, particularly in the context of promoting healthy movement behaviours. With its broad reach and public trust, the medical community has a responsibility to acknowledge the reality of ableism and take meaningful action. We propose five strategies to counter ableist messaging in medical education: (1) increase knowledge and confidence among physicians and trainees to optimize movement behaviours in persons living with disabilities, (2) perform personal and institutional language audits to ensure terminology related to disability is inclusive and avoids causing unintended harm, (3) challenge ableist messages effectively, (4) address the unmet healthcare needs of persons living with disabilities, and (5) engage in efforts to reform medical curricula so that persons living with disabilities are represented and treated equitably. Physicians and trainees are well-positioned to deliver competent and inclusive care, making medical education an opportune setting to address health inequities related to disability.Un Canadien sur cinq souffre d’un handicap. Cette population subit des inégalités bien documentées sur le plan des soins de santé, une situation qui une situation qui découle en partie de l’éducation médicale. Dans cet article, nous mettons en évidence les conséquences involontaires du discours capacitiste véhiculé dans le contexte de la promotion de l’activité physique pour les personnes vivant avec un handicap. Compte tenu de l’influence de la communauté médicale et la confiance que lui témoigne le public, elle se doit de reconnaître. Nous proposons cinq stratégies pour contrer les discours capacitistes en éducation médicale : (1) renforcer les connaissances et la confiance des médecins et des stagiaires pour leur permettre d’optimiser les comportements kinésiques chez les personnes vivant avec un handicap, (2) effectuer des vérifications linguistiques pour garantir que la terminologie liée au handicap qu’emploient les personnes et les établissements est inclusive et n’entraîne pas de préjudices involontaires, (3) contrer efficacement le discours capacitiste, (4) répondre aux besoins de santé non satisfaits des personnes vivant avec un handicap, et (5) participer aux efforts de réforme des programmes d’études médicales afin que les personnes vivant avec un handicap soient représentées et traitées équitablement. Les médecins et les stagiaires occupent une position privilégiée pour offrir des soins compétents et inclusifs, ce qui fait de l’éducation médicale un cadre opportun pour combattre les inégalités en matière de soins liées au handicap