Boris Cheval

Reflective and impulsive processes explain (in)effectiveness of messages promoting physical activity: A randomized controlled trial

OBJECTIVE The present study tested whether taking into account both the reflective and the impulsive processes of physical activity (PA) is helpful in understanding how, and for whom, PA-promoting messages will be (in)effective in changing behavior. METHOD Participants (N = 101) were presented with a persuasive message promoting either PA (experimental condition) or healthy eating (control condition). Reflective intentions to be physically active were assessed both at baseline and after exposure to the message. Impulsive approach tendencies toward PA (IAPA) and sedentary behaviors (IASB) were assessed using a manikin task. The main outcome variable was accelerometer-assessed free time spent in moderate to vigorous physical activity (MVPA) over 1 week after exposure to the message. RESULTS Although the PA-promoting message had no direct effect on MVPA, the results showed that (a) this message increased intentions to practice PA, notably among participants with low or moderate (but not high) baseline intentions; (b) objective MVPA was positively predicted by postmessage PA intentions and IAPA, and negatively predicted by IASB; and (c) postmessage PA intentions predicted MVPA for individuals with low or moderate (but not high) IASB. A follow-up moderated mediation analysis corroborated these earlier results, showing that PA-promoting messages positively predicted MVPA through postmessage intentions only among individuals with low or moderate baseline intentions and low or moderate IASB. CONCLUSIONS By identifying 2 boundary conditions, this study revealed important insights in explaining when PA-promoting messages will be effective to predict objective MVPA and when they will not.

Self-Rated Health and Sick Leave among Nurses and Physicians: The Role of Regret and Coping Strategies in Difficult Care-Related Situations

Moral distress – such as feeling strong regret over difficult patient situations – is common among nurses and physicians. Regret intensity, as well as the coping strategies used to manage regrets, may also influence the health and sickness absence of healthcare professionals. The objective of this study was to determine if the experience of regret related to difficult care-related situations is associated with poor health and sick leave and if coping strategies mediate these associations. Two cross-sectional surveys were conducted in Switzerland (Geneva, 2011 and Zurich, 2014). Outcomes were self-rated health (SRH) and sick leave in the last 6 months. We examined the associations of regret intensity with the most important care-related regret, number of recent care-related regrets, and coping strategies, using regressions models. Among 775 respondents, most reported very good SRH and 9.7% indicated absence from work during four working days or more. Intensity of the most important regret was associated with poor SRH among nurses and physicians, and with higher sick leave among nurses. Maladaptive emotion-focused strategies were associated with poor SRH among nurses, whereas adaptive emotion-focused strategies were positively associated with higher SRH and lower sick leave among physicians. Because care-related regret is an integral part of clinical practice in acute care hospitals, helping physicians and, especially, nurses to learn how to deal with negative events may yield beneficial consequences at the individual, patient care, and institutional level.

Developmental trajectories of physical activity during elementary school physical education.

OBJECTIVE Physical education (PE) during school provides an opportunity for children to be physically active. Few empirical studies have investigated developmental trajectories and determinants of objective moderate to vigorous physical activity (MVPA) during PE classes. The purpose of this study was to examine the developmental trajectories and determinants of MVPA during PE lessons in young children (8-12years of age) in primary schools. METHODS Students in grades 5-7 (n=1202; 51.2% girls) were recruited from 17 elementary schools from the Geneva canton in 2012-2013. The percentage of time spent in accelerometer-assessed MVPA during regular PE lessons was used as a dependent variable. RESULTS Linear mixed-model analyses revealed (a) that boys had a higher percentage of MVPA than girls, but none of the children reached the recommended activity levels (i.e., 50% of the PE class time spent in MVPA), (b) a linear decrease in the percentage of MVPA with age, (c) that higher perceived competence predicted a higher percentage of MVPA, and (d) that higher perceived competence reduced the negative linear effect of age among boys, but not among girls. CONCLUSION The percentage of PE time spent in MVPA did not reach recommendations made by Centers for Disease Control and Prevention and decreased from 8 to 12years old both for boys and girls. Perceived competence appears crucial to reduce MVPA decline for boys, but not for girls.

Effect of Retraining Approach-Avoidance Tendencies on an Exercise Task: A Randomized Controlled Trial

BACKGROUND Promoting regular physical activity (PA) and lessening sedentary behaviors (SB) constitute a public health priority. Recent evidence suggests that PA and SB are not only related to reflective processes (eg, behavioral intentions), but also to impulsive approach-avoidance tendencies (IAAT). This study aims to test the effect of a computerized IAAT intervention on an exercise task. METHODS Participants (N = 115) were randomly assigned to 1 of 3 experimental conditions, in which they were either trained to approach PA and avoid SB (ApPA-AvSB condition), to approach SB and avoid PA (ApSB-AvPA condition), or to approach and avoid PA and SB equally often (active control condition). The main outcome variable was the time spent carrying out a moderate intensity exercise task. RESULTS IAAT toward PA decreased in the ApSB-AvPA condition, tended to increase in the ApPA-AvSB condition, and remained stable in the control condition. Most importantly, the ApPA-AvSB manipulation led to more time spent exercising than the ApSB-AvPA condition. Sensitivity analyses excluding individuals who were highly physically active further revealed that participants in the ApPA-AvSB condition spent more time exercising than participants in the control condition. CONCLUSIONS These findings provide preliminary evidence that a single intervention session can successfully change impulsive approach tendencies toward PA and can increase the time devoted to an exercise task, especially among individuals who need to be more physically active. Potential implications for health behavior theories and behavior change interventions are outlined.

Behavioral and Neural Evidence of the Rewarding Value of Exercise Behaviors: A Systematic Review

BackgroundIn a time of physical inactivity pandemic, attempts to better understand the factors underlying the regulation of exercise behavior are important. The dominant neurobiological approach to exercise behavior considers physical activity to be a reward; however, negative affective responses during exercise challenge this idea.ObjectiveOur objective was to systematically review studies testing the automatic reactions triggered by stimuli associated with different types of exercise behavior (e.g. physical activity, sedentary behaviors) and energetic cost variations (e.g. decreased energetic cost, irrespective of the level of physical activity). We also examined evidence supporting the hypothesis that behaviors minimizing energetic cost (BMEC) are rewarding.MethodsTwo authors systematically searched, screened, extracted, and analyzed data from articles in the MEDLINE database.ResultsWe included 26 studies. Three outcomes of automatic processes were tested: affective reactions, attentional capture, and approach tendencies. Behavioral results show that physical activity can become attention-grabbing, automatically trigger positive affect, and elicit approach behaviors. These automatic reactions explain and predict exercise behaviors; however, the use of a wide variety of measures prevents drawing solid conclusions about the specific effects of automatic processes. Brain imaging results are scarce but show that stimuli associated with physical activity and, to a lesser extent, sedentary behaviors activate regions involved in reward processes. Studies investigating the rewarding value of behaviors driving energetic cost variations such as BMEC are lacking.ConclusionReward is an important factor in exercise behavior. The literature based on the investigation of automatic behaviors seems in line with the suggestion that physical activity is rewarding, at least for physically active individuals. Results suggest that sedentary behaviors could also be rewarding, although this evidence remains weak due to a lack of investigations. Finally, from an evolutionary perspective, BMEC are likely to be rewarding; however, no study has investigated this hypothesis. In sum, additional studies are required to establish a strong and complete framework of the reward processes underlying automatic exercise behavior.

Impact of CAre-related Regret Upon Sleep (ICARUS) cohort study: protocol of a 3-year multicentre, international, prospective cohort study of novice healthcare professionals

Introduction Healthcare professionals are particularly at risk of developing numerous physical and psychological health problems. The experiences of emotional burden associated with providing healthcare, notably care-related regret, have been associated with these health problems, but only using cross-sectional data so far. Evidence of a causal impact of regret has not been assessed. The Impact of CAre-related Regret Upon Sleep (ICARUS) study is the first prospective and international cohort study established to examine how newly practising healthcare professionals adapt to their challenging job by assessing the impact of care-related regret on sleep and job quitting. Method and analysis The ICARUS cohort study will include newly practising healthcare professionals working in acute care hospitals and clinics recruited between May 2017 and November 2019. Data collection, which will begin as soon as the participant starts working with patients, will consist of a 1-year weekly assessment using a secure web survey. Follow-up data will be collected at 6, 12, 18 and 24 months after the end of the first year. We will collect detailed information on the experience of care-related regret (ie, highest regret intensity, accumulation of regrets and coping strategies related to regrets), sleep problems and job quitting. Moreover, quality of life, health status and burnout will be assessed during the follow-up. Several confounders factors, including sociodemographic characteristics, personality, night shifts and work environment characteristics, will be assessed. Ethics and dissemination The study was approved by the Ethics Committee of Geneva Canton, Switzerland (CCER2016-02041), the Ethics Committee of London South Bank University (HSCSEP/17/06) and the University Research Ethics Committee of Bedfordshire (UREC106). Other study centres deemed local ethical approval unnecessary since the main ethics committee (Geneva) had already accepted the project. Results will be published in relevant scientific journals and be disseminated in international conferences. Fully anonymised data and questionnaires will be freely accessible to everyone (scientists and general public).

Temptations toward behaviors minimizing energetic costs (BMEC) automatically activate physical activity goals in successful exercisers

Objectives: With regard to the pivotal role of physical activity (PA) in health protection, understanding how individuals maintain regular PA despite ubiquitous opportunities to adopt behaviors minimizing energetic costs (BMEC) appears crucial. The purpose of the present research was to test whether BMEC primes act as temptations and activate PA goals in successful exercisers. Design: Within and between‐subjects experiments. Methods: Students in sports science (Experiment 1; N = 46) and individuals with high value of PA goals and low versus high PA levels (Experiment 2; N = 28) performed a primed‐lexical decision task. Results: Experiment 1 revealed that BMEC primes facilitated the recognition of PA‐related words, whereas PA primes did not facilitate the recognition of words related to BMEC. Experiment 2 showed that this facilitative effect was specific to individuals who were successful in reaching their PA goals. Conclusions: BMEC act as temptations that automatically activate the representation of PA goals in individual who manage to maintain regular PA. HighlightsBMEC act as temptations threatening physical activity goals.BMEC primes activated physical activity goals in successful exercisers.BMEC‐triggered physical activity activation explains self‐regulation success.

“We Won’t Retire Without Skeletons in the Closet”: Healthcare-Related Regrets Among Physicians and Nurses in German-Speaking Swiss Hospitals

Physicians and nurses are expected to systematically provide high-quality healthcare in a context marked by complexity, time pressure, heavy workload, and the influence of nonclinical factors on clinical decisions. Therefore, healthcare professionals must eventually deal with unfortunate events to which regret is a typical emotional reaction. Using semistructured interviews, 11 physicians and 13 nurses working in two different hospitals in the German-speaking part of Switzerland reported a total of 48 healthcare-related regret experiences. Intense feelings of healthcare-related regrets had far-reaching repercussions on participants’ health, work-life balance, and medical practice. Besides active compensation strategies, social capital was the most important coping resource. Receiving superiors’ support was crucial for reaffirming professional identity and helped prevent healthcare professionals from quitting their job. Findings suggest that training targeting emotional coping could be beneficial for quality of life and may ultimately lead to lower job turnover among healthcare professionals.

Neural predictors of motor control and impact of visuo-proprioceptive information in youth

For successful motor control, the central nervous system is required to combine information from the environment and the current body state, which is provided by vision and proprioception respectively. We investigated the relative contribution of visual and proprioceptive information to upper limb motor control and the extent to which structural brain measures predict this performance in youth (n = 40; age range 9–18 years). Participants performed a manual tracking task, adopting in‐phase and anti‐phase coordination modes. Results showed that, in contrast to older participants, younger participants performed the task with lower accuracy in general and poorer performance in anti‐phase than in‐phase modes. However, a proprioceptive advantage was found at all ages, that is, tracking accuracy was higher when proprioceptive information was available during both in‐ and anti‐phase modes at all ages. The microstructural organization of interhemispheric connections between homologous dorsolateral prefrontal cortices, and the cortical thickness of the primary motor cortex were associated with sensory‐specific accuracy of tracking performance. Overall, the findings suggest that manual tracking performance in youth does not only rely on brain regions involved in sensorimotor processing, but also on prefrontal regions involved in attention and working memory. Hum Brain Mapp 38:5628–5647, 2017.

Reciprocal relations between care-related emotional burden and sleep problems in healthcare professionals: a multicentre international cohort study

Objective To determine whether there are reciprocal relations between care-related regret and insomnia severity among healthcare professionals, and whether the use of different coping strategies influences these associations. Methods This is a multicentre international cohort study of 151 healthcare professionals working in acute care hospitals and clinics (87.4% female; mean age=30.4±8.0 years, 27.2% physicians, 48.3% nurses and 24.5% other professions) between 2014 and 2017. Weekly measures of regret intensity, number of regrets, and use of coping strategies (Regret Coping Scale) and sleep problems (Insomnia Severity Index) were assessed using a web survey. Results The associations between regret and insomnia severity were bidirectional. In a given week, regret intensity (bregret intensity→sleep=0.26, 95% credible interval (CI) (0.14 to 0.40)) and number of regrets (bnumber of regrets→sleep=0.43, 95% CI (0.07 to 0.53)) were significantly associated with increased insomnia severity the following week. Conversely, insomnia severity in a given week was significantly associated with higher regret intensity (bsleep→regret intensity=0.14, 95% CI (0.11 to 0.30)) and more regrets (bsleep→number of regrets=0.04, 95% CI (0.02 to 0.06)) the week after. The effects of regret on insomnia severity were much stronger than those in the opposite direction. The use of coping strategies, especially if they were maladaptive, modified the strength of these cross-lagged associations. Conclusions The present study showed that care-related regret and sleep problems are closely intertwined among healthcare professionals. Given the high prevalence of these issues, our findings call for the implementation of interventions that are specifically designed to help healthcare professionals to reduce their use of maladaptive coping strategies.