The origins of exercise adherence in the Canadian seniors population

This research identified and examined the responses of 19 physically active seniors to determine why they were physically active. The participants were physically active seniors, from the Niagara region who participated in physical activity 2, or more times per week. The purpose to this research was to determine what specific experiences or characteristics those seniors' possessed which motivated them to follow an exercise regime in later life. Three focus group interviews were conducted and participants responded to a set of predetermined questions. Responses to the interview questions were transcribed and analysed by comparing words and participant responses. This method of analysis is known as ethnographic summary. Themes, concepts, and experiences that emerged from the focus group interviews were also recorded according to systematic coding by way of content analysis. From this study, factors that predispose, enable, reinforce and prevent seniors from participating in exercise have been identified. Nine recommendations for improving seniors quality of life have also emerged from the study. Additionally, the findings from the study illustrate that those responsible for planning programs for seniors need to consider senior's wants and needs. Finally, the study also has educational implications. All participants in the study experienced a positive introduction to daily phyiscal activity through their school setting. Participants of the study believed, that their positive experiences at school, directly influenced their lifelong involvement in exercise.

A Life without Gluten: Dietary Adherence, Physical Activity and Motives

The purpose of this study was to look at individuals living on a gluten-free diet (GFD), their dietary adherence, PA levels and the reasons why they engage in these lifestyle behaviours consistent with Organismic Integration Theory (Deci & Ryan, 2002). Participants (N = 202; Mage = 42.35 years, SDage = 12.43 years) completed a series of online questionnaires. GFD adherence (74.7%) across the previous week was consistent with existing literature (Dowd et al., 2013), but participant physical activity scores were higher than reported normative values (p = .00; Wilson et al., 2010). Specific motives predicted gluten-free dietary adherence (i.e., integrated and identified regulations) and PA (i.e., intrinsic and identified regulations; p < .05). Findings may be used by health professionals to inform behavioural interventions consistent with OIT (Deci & Ryan, 2002).

A physical activity intervention in a workplace setting

Physical inactivity poses a huge burden on Canada's health care system and is detrimental to the health of Canadians (Katzmarzyk & Janssen, 2004). Walking is a viable option for individuals to become physically active on a daily basis and is in fact the most commonly reported leisure time physical activity. It has been associated with many health benefits including weight loss/weight control, reduced risk of coronary artery disease and diabetes, lowered blood pressure, and improved psychological wellbeing (Brisson & Tudor-Locke, 2004). Specifically, individuals' stage of change, selfefficacy and health related quality of life (HRQL) are three psychological constructs that can be greatly improved with increased physical activity (Dishman, 1991; Penedo & Dahn, 2005; Poag & McAuley, 1992). Public health physical activity recommendations exist but many individuals find these difficult to meet due to overly busy lifestyles (Public Health Agency of Canada, 2003). Pedometers are inexpensive devices that can monitor individual bouts of walking so that the incorporation of physical activity into one's daily life is more plausible. They are also excellent tools for motivation, goalsetting, and immediate feedback (Brisson & Tudor-Locke, 2004). Since many people spend a large proportion of their time at their places of employment, workplaces have begun to be a common site for the development of physical activity interventions. These programs have been growing in popUlarity and have shown numerous benefits for both employees and employers (Voit, 2001). The purpose of the current study was to implement and evaluate the use of a pedometer-based physical activity intervention incorporating goal-setting and physical activity logs in a workplace setting, and to examine the relationship between different types of self-efficacy (task, barrier, and scheduling) and different phases of the intervention. Twenty male participants from a local steel manufacturing plant who exhibited health risk factors (e.g. hypertension, diabetes, etc.) were assigned to one of two groups (group A or group B). All participants were asked to wear pedometers on their waists, record their daily steps, set goals that were outlined on a step-tracking sheet (detennined by their baseline number of steps), and keep track of their work days, wakelbed time, sedentary time, and time spent doing other physical activity. Group A began the intervention immediately following the baseline measures, whereas group B continued with their regular routine for 4 weeks before beginning. Physiological measures (height, weight, blood pressure, relative body fat, waist and hip circumference, and body mass index) were taken and a battery of questionnaires that assessed barrier, task and scheduling self-efficacy, HRQL, and stage of change administered at baseline, week 5 (end of intervention for group A), week 9 (end of intervention for group B; follow-up for group A) and week 13 (follow-up for both groups). Results showed that this workplace physical activity intervention was successful at increasing the participants' daily steps, that task self-efficacy is a significant predictor of participants' exercise adherence during the initial stages of participation (intervention phase), and that the participants felt that this intervention was effective. Finally, further exploratory analyses showed that this intervention was effective for all participants, but most valuable for participants most in need of improvement - that is, those who were most sedentary prior to the intervention. This intervention is an inexpensive use of simple and effective tools (e.g. pedometers), has the potential to attract a wide variety of participants and become a pennanent part of any health promotion initiative.

Overcoming victim behaviour through physical education

This study presents infonnation gathered during personal interviews in which participants were asked how they, as physical educators, might possibly assist the victim of bullying through their programs. The research is a qualitative study, using an inductive approach. Five participants were chosen, based on convenience sampling, with semi-structured interviews which were audio recorded. The theoretical research found that the most stable characteristics of victimized boys were lack of strength and lack of physical fitness. This suggested that Physical Education class might be the best place in which to empower victimized students to reduce their own victimization by addressing these areas of strength and fitness. From the interviews it became clear that, while these educators showed a willingness to help bullying victims through their programs, their adherence to a Physical Education model based primarily on elitism, as opposed to individual fitness, would make it difficult for them to do so effectively.

Self-Esteem and Mastery in Maintenance Cardiac Rehabilitation

Background: CVD is the second leading cause of death in Canada. Mastery and self-esteem are psychosocial factors, suggested to be emerging risk factors for CVD. Purpose: The purpose of the study was two-fold; first to establish whether mastery and self-esteem predicted adherence to maintenance CR; and second, whether mastery and self-esteem improved after a 6-month maintenance CR program. Methods: Data were collected at the Brock University Heart Institute. The study involved a sample of 98 participants. At intake to the program and 6-month follow-up, participants completed a questionnaire battery which included the Rosenberg Self-Esteem Scale and the Pearlin-Schooler Mastery Scale. Results: Mastery and self-esteem scores did not alter the likelihood of adherence to the CR program. Mastery and self-esteem did significantly improve after 6-months of CR amongst participants with the lowest exercise capacity. Conclusion: Maintenance CR does improve mastery and self-esteem amongst those with diminished exercise capacity.

Clinician-Perceived Bridges and Barriers to Parental Implementation of Picture Exchange Communication System (PECS): An evaluation.

Picture Exchange Communication System (PECS) is an augmentative and alternative communicative system that improves communication and decreases problem behaviors in children with Developmental Disabilities and Autism. The mediator model is a validated approach that clinicians use to train parents to perform evidence-based interventions. Parental non-adherence to treatment recommendations is a documented problem. This qualitative study investigated clinician-perceived factors that influence parental adherence to PECS recommendations. Three focus groups (n=8) were conducted with Speech Language Pathologists and Behavior Therapists experienced in providing parents with PECS recommendations. Constant comparison analysis was used. In general, clinicians believed that PECS was complex to implement. Thirty-one bridges were identified to overcome complexity. Twenty-two barriers and 6 other factors also impacted parental adherence. Strategies to address these factors were proposed based on a review of the literature. Future research will be performed to validate these findings using parents and a larger sample size.

Can a Manipulated Mind Alter Matter? : The Effects of Verbal Feedback on Self-Efficacy, Exercise Intention, and Exercise Behaviour among Low-Active College-Aged Women

Self-efficacy (SE), a person’s confidence in the ability to perform a task, is an important predictor of the adoption and maintenance of physical activity. The present study examined the effects of SE manipulated through verbal persuasion on exercise intentions and behaviour during a 4-week follow-up period and investigated the role of social physique anxiety (SPA) as a moderator. Female college infrequent exercisers (n = 66) were randomly assigned into one of three groups (high-efficacy [HE], low-efficacy [LE], or control) and asked to complete several questionnaires at baseline. The HE and LE groups were provided with positive and negative exercise adherence feedback, respectively. The HE group reported higher SE from pre- to post-feedback. Both the HE and LE groups reported increases in exercise behaviour at the 4-week follow-up. Pre- to post-feedback changes in SE, exercise intention, and exercise behaviour did not depend on level of SPA reported.

Bridging the Conceptualization of Youth with Intellectual Disabilities to Sentencing under the YCJA

The current study examined how disability and the concepts of risk, need and responsivity are understood by criminal justice professionals and inform their perceptions of young offenders with ID at sentencing under the ‘different but equal’ philosophy. Semi-structured interviews were conducted with 11 lawyers and 8 mental health workers across 6 major urban areas in Ontario. Participants primarily perceived ID through a medical discourse, overlooking social and structural barriers that, in some cases, may hinder adherence to sentencing dispositions. Specifically, participants discussed balancing the reduced culpability of offenders (e.g., intent) – justifying lenient sentencing – with public safety concerns (i.e., ID viewed as a barrier to rehabilitation) – justifying increasing the severity of sentences. Participants assessed clients with ID and their risks, needs and responsivity within the context of other legal factors: criminal history, severity of the offence, and YCJA objectives. Participants articulated the importance of tailored courthouse identification programs, services/funding, and education/training.

The meaning of multiple medication use in adults: A qualitative study

Over half of prescribed medications are not taken as prescribed, resulting in health and economic consequences. Using constructivist grounded theory, 15 interviews were conducted to develop a theory on understanding the medication adherence choices of individuals, who were between the ages of 40 to 55, were diagnosed with a chronic condition, and taking three or more medications. The results indicate that participants are engaging in self-management strategies, with massive variance in adherence behaviours. Medications are sacrificed for personal and financial reasons, resonating with feelings of fear for the person’s current situation and future. Individuals are struggling with who they have become to who they once were, which becomes related to their medications. Finally, individuals are citing the impact of their physician; citing barriers to communication and Canada’s health care system. Participants’ experiences provided an understanding of the meanings individuals associate with their medications and how this impacts their decision-making.

Minimal Contact Intervention for Tobacco Dependence

This study was conducted to measure the degree of adherence by public health care providers to a policy that requires them to implement minimal contact intervention for tobacco cessation with their clients. This study also described what components of the intervention may have contributed to the adherence of the policy and how health care providers felt about adhering to the policy. The intervention consisted of a policy for implementation of minimal contact intervention, changes to documentation, a health care provider mentor trained, a training session for health care providers, and ongoing paper and people supports for implementation. Data for this study were collected through a health care provider questionnaire, focus group interviews, and a compliance protocol including a chart audit. The findings of this study showed a high degree of adherence to the policy, that health care providers thought minimal contact intervention was important to conduct with their clients, and that health care providers felt supported to implement the intervention. No statistically significant difference was found between new and experienced health care providers on 17 of the 18 questions on the health care provider questionnaire. However there was a statistically significant difference between new and experienced health care providers with respect to their perception that “clients often feel like they have to accept tobacco cessation information from me.” Changes could be made to the minimal contact intervention and to documentation of the intervention. Implications for future research include implementation within other programs within Hamilton Public Health Services and implementation of this model within other public health units and other types of health care providers within Ontario.