Guillaume Chevance

The adoption of physical activity and eating behaviors among persons with obesity and in the general population: the role of implicit attitudes within the Theory of Planned Behavior

Abstract Obesity can be prevented by the combined adoption of a regular physical activity (PA) and healthy eating behaviors (EB). Researchers mainly focused on socio-cognitive models, such as the Theory of Planned Behavior (TPB), to identify the psychological antecedents of these behaviors. However, few studies were interested in testing the potential contribution of automatic processes in the prediction of PA and EB. Thus, the main objective of this study was to explore the specific role of implicit attitudes in the pattern of prediction of self-reported PA and EB in the TPB framework, among persons with obesity and in adults from the general population. One hundred and fifty-three adults participated to this cross-sectional study among which 59 obese persons (74% women, age: 50.6 ± 12.3 years, BMI: 36.8 ± 4.03 kg m–²) and 94 people from the general population (51% women; age: 34.7 ± 8.9 years). Implicit attitudes toward PA and EB were estimated through two Implicit Association Tests. TPB variables, PA and EB were assessed by questionnaire. Regarding to the prediction of PA, a significant contribution of implicit attitudes emerged in obese people, β = .25; 95%[CI: .01, .50]; P = .044, beyond the TPB variables, contrary to participants from the general population. The present study suggests that implicit attitudes play a specific role among persons with obesity regarding PA. Other studies are needed to examine which kind of psychological processes are specifically associated with PA and EB among obese people.

Change in explicit and implicit motivation toward physical activity and sedentary behavior in pulmonary rehabilitation and associations with postrehabilitation behaviors.

Objective: The aim of this study was twofold: (a) to determine whether Theory of Planned Behavior (TPB) variables and implicit attitudes toward physical activity and sedentary behavior would change during a 5-week pulmonary rehabilitation (PR) program, and (b) to investigate the relationships between behavioral intentions, implicit attitudes, physical activity, and sedentary behavior in postrehabilitation. Design: Out of 142 patients with respiratory disease included in this study, 119 completed 2 questionnaires measuring TPB variables with regard to physical activity and sedentary behavior, and an Implicit Association Test (IAT) measuring implicit attitudes toward physical activity in contrast to sedentary behavior. The TPB questionnaires and the IAT were administered at the beginning (Time 1) and the end of the program (Time 2). Six months after the program (Time 3), 62 patients provided self-reported measures of their recreational physical activity and screen-based, leisure-time sedentary behavior. Results: Over the course of pulmonary rehabilitation, perceived behavioral control and intentions toward physical activity increased, as did social norms and perceived behavioral control toward sedentary behavior; implicit attitudes were also more positive toward physical activity. Implicit attitudes at the end of PR (Time 2) were significantly associated with postrehabilitation physical activity (Time 3). Conclusions: TPB variables toward physical activity and sedentary behavior as well as implicit attitudes were enhanced during PR. At 6 months, implicit attitudes were significantly associated with physical activity. These results suggest that motivation, particularly implicit attitudes, should be targeted in future behavioral interventions in order to optimize the effects of rehabilitation on physical activity maintenance.

Measuring implicit attitudes toward physical activity and sedentary behaviors: Test-retest reliability of three scoring algorithms of the Implicit Association Test and Single Category-Implicit Association Test

Objectives The Implicit Association Test (IAT) and the Single‐Category IAT (SC‐IAT) are two frequently used measures of implicit attitudes. Nonetheless, the test‐retest reliability of these measures has not been investigated. The aim of this study was to examine the test‐retest reliability of a physical activity versus sedentary behavior IAT, a physical activity SC‐IAT, and a sedentary behavior SC‐IAT. Method A total of 111 older adults living with chronic diseases were recruited. They either completed a physical activity versus sedentary behavior IAT (N = 54) or two independent SC‐IATs of physical activity and sedentary behavior (N = 57). These tests were administered twice in a one‐hour interval. Three scores were computed for each test (D‐Score, DW‐Score, IP‐Score). Both absolute and relative test‐retest reliability was computed. Results Regarding absolute reliability, the tests were comparable regardless of the scoring algorithm (Coefficients of Repeatability ranged from 1.27 for the two SC‐IATs with the D‐Score, to 1.36 for the IAT with the D‐Score and DW‐Score). Regarding relative test‐retest reliability, the IAT systematically showed better reliability than the two SC‐IATs. The DW‐Score systematically exhibited better reliability compared to other scores (Intraclass Correlation Coefficient ranged from 0.20 for the sedentary behavior SC‐IAT with the D‐Score to 0.78 for the IAT with the DW‐Score). Conclusion Adequate test‐retest reliability for the IAT was supported independently from the scoring algorithms. Test‐retest reliability for the two independent SC‐IATs was not supported in this study. The IAT is more sensitive to change than the SC‐IATs, which needs to be accounted for in future research on physical activity and sedentary behavior implicit attitudes. HighlightsThere is a growing interest in the literature for the automatic determinants of active behaviors, such as implicit attitudes.Authors are now calling for experimental studies testing the malleability of implicit attitudes.Little is known on the test‐retest reliability of the measures of implicit attitudes.The aim of this study was to test the test‐retest reliability of two implicit measures and 3 scoring procedures.Reliability differed according to the tests and scoring procedures, hence all tests are not suitable to study change in implicit attitudes.

Etat des connaissances sur les comportements sédentaires

Sedentary behaviors refer to any waking activity characterized by an energy expenditure ≤ 1.5 metabolic equivalent and a sitting or lying posture. Recent epidemiological data reported that in North America and Europe, citizens spend between 8 and 11 hours sitting per day. Sedentary behaviors and physical activity can coexist in the same person. It is possible to spend a lot of time sitting each day while completing recommendations for regular physical activity. Adverse health effects of sedentary behaviors are in part independent of the physical activity level. The physiological implications associated with sedentary behaviors are mainly metabolic. Regulary interrupting the sedentary behavior has favorable effects on health, regardless the total time spent sitting. Many interventional perspectives for reducing sedentary behaviors in France can be envisaged. Some countries have already launched interesting large-scale prevention programs.

Versatility of ‘hemorheologic fitness’ according to exercise intensity: emphasis on the “healthy primitive lifestyle”

We recently proposed a unifying hypothesis to reconcile unexpected findings in exercise hemorheology and the classical concepts of “hemorheologic fitness” and the “triphasic effects of exercise”, based on the “healthy primitive lifestyle” paradigm. This paradigm assumes that evolution has selected genetic polymorphisms leading to insulin resistance as an adaptative strategy to cope with continuous low intensity physical activity and a special alimentation moderately high in protein, rich in low glycemic index carbohydrates, and poor in saturated fat. According to this protocol the true physiological picture would be that of an individual whose exercise and nutritional habits are close from this lifestyle, both sedentary subjects and trained athletes representing situations on the edge of this model. Unfortunately samples of people truly adhering to this ancestral lifestyle are hard to obtain. In order to address this picture we tried to compare databases obtained with our preceding published studies. As a model of the “healthy primitive lifestyle” we selected patients trained at low intensity (LI) and given an advice of protein intake around 1.2 g/kg/day. Results show a continuum for plasma viscosity which seems to be lower in athletes than LI-trained and even more sedentaries. When sedentary subjects become obese the most obvious characteristic is an increase in red blood cell (RBC) aggregation correlated to the size of fat stores. It is clear that 3 months of LI are not a perfect model of “healthy primitive lifestyle”, but these data suggest that the most important effect of LI regular exercise is to decrease plasma viscosity and that sedentarity increases RBC aggregation mostly when it results in increased fat storage.

Implicit attitudes and the improvement of exercise capacity during pulmonary rehabilitation

Abstract The aim of this study was to examine the role of explicit and implicit attitudes in the improvement of exercise capacity during a 5-week pulmonary rehabilitation (PR). A total of 105 patients performed walking tests at baseline and at the end of PR. Change between performances was computed at the end of PR, and Minimal-Clinically-Important-Difference (MCID) were used to categorize patients as responders (i.e. change above MCID, N = 54) or non-responders (i.e. change below MCID, N = 51). At baseline, implicit attitudes were measured through a physical activity versus sedentary behavior Implicit Association Test; explicit attitudes toward physical activity and sedentary behavior were measured by questionnaires. Only implicit attitudes significantly differed between the two groups (p = .015), responders displaying implicit attitudes significantly more in favor of physical activity (M = .91, SD = .54) than non-responders (M = .60, SD = .71) at baseline. Measuring implicit attitudes in PR could help to accurately estimate patients’ motivation, and design more individualized rehabilitation programs.

Cognitive Behavior Therapy combined with Exercise for Adults with Chronic Diseases: Systematic Review and Meta-Analysis

Objective: The present meta-analysis aimed to determine the overall effect of cognitive behavior therapy combined with physical exercise (CBTEx) interventions on depression, anxiety, fatigue, and pain in adults with chronic illness; to identify the potential moderators of efficacy; and to compare the efficacy of CBTEx versus each condition alone (CBT and physical exercise). Method: Relevant randomized clinical trials, published before July 2017, were identified through database searches in PubMed, PsycArticles, CINAHL, SportDiscus, and the Cochrane Central Register for Controlled Trials. Results: A total of 30 studies were identified. CBTEx interventions yielded small to large effect sizes for depression (standardized mean change [SMC] = −0.34, 95% CI [−0.53, −0.14]), anxiety (SMC = −0.18, 95% CI [−0.34, −0.03]), and fatigue (SMC = −0.96, 95% CI [−1.43, −0.49]). Moderation analyses revealed that longer intervention was associated with greater effect sizes for depression and anxiety outcomes. Low methodological quality was also associated with increased CBTEx efficacy for depression. When compared directly, CBTEx interventions did not show greater efficacy than CBT alone or physical exercise alone for any of the outcomes. Conclusion: The current literature suggests that CBTEx interventions are effective for decreasing depression, anxiety, and fatigue symptoms but not pain. However, the findings do not support an additive effect of CBT and exercise on any of the 4 outcomes compared to each condition alone.

Interaction between self-regulation, intentions and implicit attitudes in the prediction of physical activity among persons with obesity.

Objective: Both explicit and implicit motivational processes predict physical activity (PA); however, their respective contributions may depend on interindividual differences. This study examined the moderating role of trait impulsivity and executive functions in the associations between PA intentions, implicit attitudes toward sedentary behavior, and PA measured with accelerometers in persons with obesity. Methods: Participants (N = 76; Mage = 56 years, SD = 11.9; MBody Mass Index = 39.1, SD = 6.5) completed baseline questionnaires measuring their PA intentions and trait impulsivity. They also performed 2 computerized tests measuring implicit attitudes toward sedentary behavior and executive functions. PA was assessed 4 months later with an accelerometer. Results: Implicit attitudes toward sedentary behavior and executive functions interacted to predict PA. Higher implicit attitudes were associated with significantly lower PA in participants with low and moderate executive functions but not high executive functions. Conclusions: These results support the role of implicit processes and cognitive factors in health-related behavior adoption through time. Practically, these variables may be useful to identify individuals at risk of abandoning PA after programs who thus may benefit from complementary interventions (e.g., provide feedback on implicit attitudes and develop self-regulatory skills).

Pour des interventions de changement de comportement factuelles

1 Département des Sciences de l’activité Physique, Université du Québec à Montréal, Montréal, Québec, Canada 2 Centre de Recherche de l’Institut Universitaire en Santé Mentale de Montréal, Montréal, Québec, Canada 3 Centre de Recherche du CHU de Montréal, Montréal, Québec, Canada 4 Laboratoire Epsylon, Dynamique des capacités humaines et des conduites de santé, EA 4556, Université de Montpellier, Montpellier, France 5 Les Cliniques du Souffle, Groupe 5 Santé, France Mots-clés activité physique, motivation, promotion, médecine comportementale

Intention and automaticity toward physical and sedentary screen-based leisure activities in adolescents: A profile perspective

Purpose Physical activity (PA) and sedentary behavior (SB) are increasingly considered independent health behaviors. Additionally, current research suggests that both controlled and automatic determinants account for their adoption. The purpose of this article was to identify intention–automaticity profiles toward PA and screen-based SB and to examine how those profiles are associated with different behavioral patterns. Method Two cross-sectional studies based on self-report questionnaires were conducted with French high school students (Study 1: n = 198; Study 2: n = 185). Results In all, 4 distinct motivational profiles appeared. The first 3 clusters emerged in both studies: “PA” (high levels of automaticity and intention for PA, low levels of automaticity and intention for screen-based SB); “screen” (high levels of automaticity and intention for screen-based SB, low levels of automaticity and intention for PA), and “mixed” (high levels of all variables), whereas the fourth cluster was observed only in Study 2: “high control” (below-mean levels of automaticity, high levels of intention toward both PA and screen-based SB). Adolescents with a screen profile displayed the least healthy behavioral pattern, whereas those in the PA profile demonstrated the most favorable behaviors. Conclusion Future research is needed to extend these results to other populations using complementary assessment methods of automatic psychological processes and PA and SB behaviors.