Adolescence provides a significant opportunity to influence attitudes toward activity. It has been proposed that affective responses are the first link in the hypothesized exercise intensity-affect-adherence chain. The aim of this study was to explore young low-active adolescents' affective responses to different exercise intensities using quantitative and qualitative methodologies. Participants completed 15 min of exercise at four exercise intensities: three set in relation to the participants' ventilatory threshold (above, at, and below) and one self-selected. Affective valence was measured before, during, and after exercise, and participants were interviewed about their responses. Patterns in affective responses in quantitative data support tenets of the dual-mode theory. Qualitative data were presented as four narrative stories, and dominant themes associated with affective responses were identified. Consideration of individual preferences in the prescription of exercise, prescribing exercise set below the ventilatory threshold, or encouraging adolescents to self-select exercise intensity could positively influence adolescents' exercise experiences.
BackgroundInterventions promoting physical activity by General Practitioners (GPs) lack a strong evidence base. Recruiting participants to trials in primary care is challenging. We investigated the feasibility of (i) delivering three interventions to promote physical activity in inactive participants and (ii) different methods of participant recruitment and randomised allocation.MethodsWe recruited general practices from Devon, Bristol and Coventry. We used a 2-by-2 factorial design for participant recruitment and randomisation. Recruitment strategies were either opportunistic (approaching patients attending their GP surgery) or systematic (selecting patients from practice lists and approaching them by letter). Randomisation strategies were either individual or by practice cluster. Feasibility outcomes included time taken to recruit the target number of participants within each practice. Participants were randomly allocated to one of three interventions: (i) written advice (control); (ii) brief GP advice (written advice plus GP advice on physical activity), and (iii) brief GP advice plus a pedometer to self-monitor physical activity during the trial. Participants allocated to written advice or brief advice each received a sealed pedometer to record their physical activity, and were instructed not to unseal the pedometer before the scheduled day of data collection. Participant level outcomes were reported descriptively and included the mean number of pedometer steps over a 7-day period, and European Quality of Life (EuroQoL)-5 dimensions (EQ-5D) scores, recorded at 12 weeks’ follow-up.ResultsWe recruited 24 practices (12 using each recruitment method; 18 randomising by cluster, 6 randomising by individual participant), encompassing 131 participants. Opportunistic recruitment was associated with less time to target recruitment compared with systematic (mean difference (days) -54.9, 95% confidence interval (CI) -103.6; -6.2) but with greater loss to follow up (28.8% versus. 6.9%; mean difference 21.9% (95% CI 9.6%; 34.1%)). There were differences in the socio-demographic characteristics of participants according to recruitment method. There was no clear pattern of change in participant level outcomes from baseline to 12 weeks across the three arms.ConclusionsDelivering and trialling GP-led interventions to promote physical activity is feasible, but trial design influences time to participant recruitment, participant withdrawal, and possibly, the socio-demographic characteristics of participants.Trial registration numberISRCTN73725618.
I MAGE (Development and Implementation of a European Guideline and Training Standards for Diabetes Prevention) was a European Union funded project (2003)(2004)(2005)(2006)(2007)(2008) in the field of public health which focussed on diabetes prevention. The IMAGE study group comprised a Europe-wide consortium of healthcare professionals and behavioural and health scientists. This group has published guidelines, a toolkit and quality indicators for diabetes prevention and more recently a comprehensive curriculum for the training of diabetes prevention managers, the development of which is described herein.
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