Levels and predictors of exercise referral scheme uptake and adherence: A systematic review

Background The effectiveness of exercise referral schemes (ERS) is influenced by uptake and adherence to the scheme. The identification of factors influencing low uptake and adherence could lead to the refinement of schemes to optimise investment. Objectives To quantify the levels of ERS uptake and adherence and to identify factors predictive of uptake and adherence. Methods A systematic review and meta-analysis was undertaken. MEDLINE, EMBASE, PsycINFO, Cochrane Library, ISI WOS, SPORTDiscus and ongoing trial registries were searched (to October 2009) and included study references were checked. Included studies were required to report at least one of the following: (1) a numerical measure of ERS uptake or adherence and (2) an estimate of the statistical association between participant demographic or psychosocial factors (eg, level of motivation, self-efficacy) or programme factors and uptake or adherence to ERS. Results Twenty studies met the inclusion criteria, six randomised controlled trials (RCTs) and 14 observational studies. The pooled level of uptake in ERS was 66% (95% CI 57% to 75%) across the observational studies and 81% (95% CI 68% to 94%) across the RCTs. The pooled level of ERS adherence was 49% (95% CI 40% to 59%) across the observational studies and 43% (95% CI 32% to 54%) across the RCTs. Few studies considered anything other than gender and age. Women were more likely to begin an ERS but were less likely to adhere to it than men. Older people were more likely to begin and adhere to an ERS. Limitations Substantial heterogeneity was evident across the ERS studies. Without standardised definitions, the heterogeneity may have been reflective of differences in methods of defining uptake and adherence across studies. Conclusions To enhance our understanding of the variation in uptake and adherence across ERS and how these variations might affect physical activity outcomes, future trials need to use quantitative and qualitative methods.

Online learning an effective means for developing small business owner-managers’ capabilities?

Purpose If owner-managers engage in management development activities then chances of success may be improved for small businesses. But small business owner-managers (SBOMs) are a difficult group to engage in management development activities. While practitioners worry about timing, content and location of development activities, the purpose of this paper is to examine what drives SBOMs to participate in an online discussion forum (ODF) as a form of management development. An ODF was run with SBOMs and the factors affecting their participation are reported from this exploratory study. Design/methodology/approach A qualitative methodology was used where data gathered from three sources, the ODF posts, in-depth interviews with participants and a focus group with non-participants. These were analysed to evaluate factors affecting participation of SBOMs in an ODF. Findings The findings point to the importance of owner-managers’ attitudes. Attitudes that positively affected SBOMs participation in the ODF included; appreciating that learning leads to business success; positive self-efficacy developed through prior online experience; and an occupational identity as a business manager. Research limitations/implications Few SBOMs participated in the ODF, which is consistent with research finding that they are a difficult group to engage in management development learning activities. Three forms of data were analysed to strengthen results. Practical implications Caution should be exercised when considering investment in e-learning to develop the managerial capabilities of SBOMs. Originality/value Evidence of the factors important for participation in an informal voluntary ODF. The findings suggest greater emphasis should be placed on changing attitudes if SBOMs are to be encouraged to participate in management development activities.

Women’s Wellness after Cancer Program Study (WWACP)– A multi centre randomised controlled trial examining the benefits and cost effectiveness of an Evidenced Based, e-health intervention

Background Advances in cancer diagnosis and treatment have significantly improved survival rates, through their subsequent health needs are often not adequately addressed by current health services. National Health and Medical Research Council (NHMRC) Partnerships Project awarded a national collaborative project to develop, trial and evaluate clinical benefits and cost effectiveness of an e-health enabled structured health promotion intervention - The Women’s Wellness after Cancer Program (WWACP). The aim of this e-health enabled multimodal intervention is to improve health related quality of life in women previously treated for target cancers. Aim The WWACP is a 12-week web based, interactive, holistic program. Primary outcomes for this project are to promote a positive change in health-related quality of life (HRQoL) and reduction in Body Mass Index (BMI) in the women undertaking WWACP compared to women who receive usual care. Secondary outcomes include managing other side effects of cancer treatment through evidence-based nutrition and exercise practices, dealing with stress, sleep, menopause and sexuality issues. Methods The single-blinded multi-center randomized controlled trial recruited a toatl of 330 women within 24 months of completion of chemotherapy and /or radiotherapy. Women were randomly assigned to either a usual care or intervention group. Women provided with the intervention were provided with an interactive iBook and journal, web interface, and three virtual consultations by experienced cancer nurses. A variety of methods were utilized, to enable positive self- efficacy and lifestyle changes. These include online coaching with a registered nurse trained in the intervention, plus written educational and health promotional information. The program has been delivered through the e-health enabled interfaces, which enables virtual delivery via desktop and mobile computing devices. Importantly this enables accessibility for rural and regional women in Australia who are frequently geographically disadvantaged in terms of health care provision. Results Research focusing on alternative methods of delivering post treatment / or survivorship care in cancer utilizing web based interfaces is limited, but emerging evidence suggests that Internet interventions can increase psychological and physical wellbeing in cancer patients. The WWACP trial aims to establish the effectiveness of delivery of the program in terms of positive patient outcomes and cost effective, flexibility. The trial will be completed in September and results will be presented at the conference. Conclusions Women after acute hematological, breast and gynecological cancer treatments demonstrate good cancer survival rates and face residual health problems which are amenable to behavioral interventions. The conclusion of active treatment is a key 'teachable moment' in which sustainable positive lifestyle change can be achieved if patients receive education and psychological support which targets key treatment related health problems and known chronic disease risk factors.

Does gender moderate the relationship between polydrug use and sexual risk-taking among Australian secondary school students under 16 years of age?

Introduction and Aims This study examines the association of alcohol and polydrug use with risky sexual behaviour in adolescents under 16 years of age and if this association differs by gender. Design and Methods The sample consisted of 5412 secondary school students under 16 years of age from Victoria, Australia. Participants completed an anonymous and confidential survey during class time. The key measures were having had sex before legal age of consent (16 years), unprotected sex before 16 (no condom) and latent-class derived alcohol and polydrug use variables based on alcohol, tobacco, cannabis, inhalants and other illegal drug use in the past month. Results There were 7.52% and 2.55% of adolescents who reported having sex and having unprotected sex before 16 years of age, respectively. After adjusting for antisocial behaviours, peers' drug use and family and school risk factors, girls were less likely to have unprotected sex (odds ratio = 0.31, P = 0.003). However, the interaction of being female and polydrug use (odds ratio = 4.52, P = 0.004) was significant, indicating that girls who engaged in polydrug use were at higher risk of having unprotected sex. For boys, the effect of polydrug use was non-significant (odds ratio = 1.44, P = 0.310). Discussion and Conclusions For girls, polydrug use was significantly associated with unprotected sex after adjusting for a range of risk factors, and this relationship was non-significant for boys. Future prevention programs for adolescent risky sexual behaviour and polydrug use might benefit from a tailored approach to gender differences.

Unraveling the “passion orchestra” in academia

This paper disentangles how organization members' “passion orchestra” is related to their entrepreneurial intentions in the particularly relevant context of academia. Drawing on passion literature and identity theory, we propose and test a model linking two central parts of researchers' “passion orchestra”, namely entrepreneurial and obsessive scientific passion, directly and indirectly, to spin-off and start-up intentions. While spin-off intentions refer to intentions to found a firm based upon research results, start-up intentions denote intentions to start any type of company. Using a sample of 2308 researchers from 24 European universities, our findings reveal that higher levels of entrepreneurial passion are associated with both stronger spin-off and start-up intentions. Further, obsessive scientific passion is positively associated with researchers' intentions to create a spin-off, and negatively with their propensity to establish a start-up. Entrepreneurial self-efficacy and affective organizational commitment mediate these effects. Finally, the two types of passion show characteristic interactions. Obsessive scientific passion moderates the entrepreneurial passion–intentions relationship such that it strengthens spin-off intentions. Our results highlight that recasting the individual driven by a singular passion to one with a “passion orchestra” provides a more holistic understanding of the new venture creation process. Implications for research and practice are discussed.