Objective Physical activity can improve the health and well‐being of individuals receiving adjuvant treatment for breast cancer, but engagement in physical activity can be low. This review synthesises the barriers and facilitators to engaging with and participating in physical activity whilst receiving treatment. Methods The metasynthesis of qualitative studies is reported in line with the PRISMA statement. We systematically searched eight databases (MEDLINE, EMBASE, CENTRAL, PsycINFO, CINAHL, British Library, OpenGrey, and Conference Proceedings Citation Index) from inception to November 30, 2017. A total of 1276 abstracts were retrieved and screened by two reviewers independently. Data from eligible studies were extracted and critically appraised. As this review concerns qualitative studies only, a CER‐QUAL GRADE assessment was completed. Results A total of 13 studies were included. Four clear themes emerged (side effects of treatment, beliefs about physical activity, focus on health not illness, and social factors) each containing both barriers and facilitators. Key facilitators to participating in physical activity during adjuvant treatment included positive physical benefits, improvements in psychological well‐being, and increased self‐esteem and empowerment. Further, having a knowledgeable instructor, tailored information, and a supportive environment were important to women undergoing treatment. Main barriers included fatigue and pain, as well as work and caring responsibilities. Conclusions Incorporating physical activity into treatment regimens is important. Focusing on being less sedentary and providing accurate, tailored information should be prioritised within future interventions. Having a supportive environment and accounting for the particular barriers or facilitators to engagement identified here should aid the success of future interventions.
Objectives Engaging in physical activity following a diagnosis in breast cancer patients improves both survival rates and psychosocial health outcomes. The factors influencing the effectiveness of physical activity interventions for breast cancer patients remain unclear. This systematic review focuses on two questions: are there differences in outcomes depending on; the mode of physical activity undertaken; and whether group‐based, or individual, programmes are proposed. Methods Five databases were searched (PsycINFO, CINAHL, MEDLINE, EMBASE, and Central). Randomised control trials were included if they reported an intervention aiming to increase physical activity amongst breast cancer patients. A total of 1561 records were screened with 17 studies identified for final inclusion. Data extraction and risk of bias analysis were undertaken. A meta‐analysis was not possible due to methodological differences between studies. Results Findings indicate no evident differences in outcomes based on exercise mode adopted. There are some indications that group interventions may have additional beneficial outcomes, in comparison to individual interventions, but this conclusion cannot be drawn definitively due to confounds within study designs, lack of group‐based intervention designs, and overall lack of long‐term intervention effects. Conclusions Although there are no indications of negative intervention effects, only 6 of 17 trials demonstrated significant intervention effects were maintained. Greater transparency in reporting of interventions, and research enabling a comparison of physical activity delivery and mode is needed to determine optimum physical activity interventions to maintain patient physical activity and outcomes.
Objective: The goal conflict model of eating (Stroebe, Mensink, Aarts, Schut, & Kruglanski, ( 2008) proposes differences in eating behaviour result from peoples’ experience of holding conflicting goals of eating enjoyment and weight maintenance. However, little is understood about the relationship between eating behaviour and the cognitive processes involved in conflict. This study aims to investigate associations between eating behaviour traits and cognitive conflict processes, specifically the application of cognitive control when processing distracting food pictures. Method: A flanker task using food and non-food pictures was used to examine individual differences in conflict adaptation. Participants responded to target pictures whilst ignoring distracting flanking pictures. Individual differences in eating behaviour traits, attention towards target pictures, and ability to apply cognitive control through adaptation to conflicting picture trials were analysed. Results: Increased levels of external and emotional eating were related to slower responses to food pictures indicating food target avoidance. All participants showed greater distraction by food compared to non-food pictures. Of particular significance, increased levels of emotional eating were associated with greater conflict adaptation for conflicting food pictures only. Conclusion: Emotional eaters demonstrate greater application of cognitive control for conflicting food pictures as part of a food avoidance strategy. This could represent an attempt to inhibit their eating enjoyment goal in order for their weight maintenance goal to dominate
Obesity surgery is the most effective treatment method for the severely obese but does not work for everyone. Indications are that weight-loss success may be related to individuals' sense of investment in surgery, with failure linked to higher automatic hedonic motivations to consume food and greater susceptibility to food in the environment. A pilot study using an independent experimental design recruited bariatric surgery patients (n = 91) via a UK obesity-surgery charity website who were randomly allocated to either the intervention or the control condition. The intervention involved raising the salience of the personal investment made in having weight-loss surgery in an attempt to reduce automatic hedonic thoughts about food and aid weight loss. Data was collected initially with subsequent weight loss measured at 3 months of follow-up. Following the intervention, participants reported significantly reduced hedonic thoughts, increased liking for low-fat foods, reduced liking of high-fat food, and higher self-efficacy for achieving sustained weight loss than controls. By 3 months, this was translated into significant differences in mean weight losses of 6.77 kg for the intervention group and 0.91 kg for control participants. To conclude, a quick simple cost-effective intervention encouraging participants to focus on investment helped weight loss and changed hedonic thoughts about food in bariatric patients.
Objective: Immunization is a primary method for addressing COVID-19. Uptake in high-risk groups has been strong, however, vaccination hesitancy is more prominent among younger adults. This research sought to identify the factors influencing vaccine uptake in 18–55-year-olds. Method: Study 1, a qualitative survey (n = 80), identified beliefs about COVID vaccines and immunization programs. Study 2 (n = 473) tested whether the factors identified in study 1 predicted intention for self-vaccination and parental intention to vaccinate children. Data on vaccination behavior was obtained in Study 3 (n = 309). Results: Analysis showed individuals recognized the benefits of vaccination as a path to “return to normality” and “protect others” but concerns, such as side-effects to fertility, were apparent and for some, the personal value in vaccination was questioned. Data were interpreted as largely reflective of Health Belief Model constructs. Study 2 supported this interpretation. Specifically, Benefits of, and Barriers to, vaccination predicted intention to vaccinate oneself and their children, across Black, Asian, other minority groups (BAME) and White communities. Additionally, for BAME communities, cues to action positively predicted intention. For vaccine behavior, benefits of, and Barriers to, vaccination remained relevant in predicting vaccination behaviors, along with susceptivity and severity of COVID (no differences between ethnic communities were found). Willingness to vaccinate children decreases as the age of the child is reduced. Conclusions: Addressing vaccine hesitancy is crucial to managing COVID-19. Findings indicate emphasizing specific benefits, such as protecting others, while addressing barriers, including side-effect misinformation, is key to driving vaccine uptake.
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