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Background Despite the well-known benefits of physical activity (PA), non-communicable disease and premature mortality rates among adults continue to rise. The relationship between adults’ goals and exercise-specific motivation on the type of PA intensity one engages remains unclear. The purpose of this study was to identify physical activity (PA) profiles based on frequency and intensity (i.e., levels of PA) in an adult sample. A secondary purpose was to examine how the PA profiles differ on the reasons people have for exercising and behavioral regulation. Methods A Cross-sectional survey was conducted with 1,169 (46.8 ± 16.7 years) participants solicited from a hospital-affiliated wellness center, social media promotions, and a research volunteer registry. The International PA Questionnaire (IPAQ) was used to determine frequency, intensity, and time spent engaging in PA. Additionally, the Reasons to Exercise (REX-2) scale, the Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3), and demographics were assessed. K-cluster analyses were performed to identify profiles based on PA levels using the IPAQ guidelines. Multivariate analysis of variance (MANOVA) was used to assess profile differences. Results Five distinct PA clusters were derived, and defined as: a Low, Walking, Moderate Intensity, High Intensity, and Sitting cluster (p < .001). These clusters differed significantly ( p  < .001) from each other with respect to motivation, the reasons adults have for exercise, and PA levels. Conclusion The results from this study support the important role of psychological factors such as motivation and reasons for exercise on behavioral outcomes (i.e., physical activity). For future research investigating adults PA- related behaviors, whether it be on adults starting a new exercise program or for PA maintenance, it may be beneficial to develop programs that encourage participants to reflect on the reasons they identify as important for exercising, and how such reasons contribute to their overall PA engagement behaviors.

Background Quality of life (QoL) is important to assess in patient care. Researchers have previously claimed validity of the Quality of Life Scale (QOLS) across multiple samples of individuals, but close inspection of results suggest further psychometric investigation of the instrument is warranted. Therefore, the purposes of this study were to: 1) evaluate the proposed five-factor, 15-item and three-factor, 16-item QOLS; 2) if the factor structure could not be confirmed, re-assess the QOLS using exploratory factor analysis (EFA) and covariance modeling to identify a parsimonious refinement of the QOLS structure for future investigation. Methods Participants varying in age, physical activity level, and identified medical condition(s) were recruited from clinical sites and ResearchMatch. Confirmatory factor analyses (CFA) were performed on the full sample ( n  = 1036) based on proposed 15- and 16-item QOLS versions. Subsequent EFA and covariance modeling was performed on a random subset of the data (n 1  = 518) to identify a more parsimonious version of the QOLS. The psychometric properties of the newly proposed model were confirmed in the remaining half of participants (n 2  = 518). Further examination of the scale psychometric properties was completed using invariance testing procedures across sex and health status sub-categories. Results Neither the 15- nor 16-item QOLS CFA met model fit recommendations. Subsequent EFA and covariance modeling analyses revealed a one-factor, five-item scale that satisfied contemporary statistical and model fit standards. Follow-up CFA confirmed the revised model structure; however, invariance testing requirements across sex and injury status subgroups were not met. Conclusions Neither the 15- nor 16-item QOLS exhibited psychometric attributes that support construct validity. Our analyses indicate a new, short-form model, might offer a more appropriate and parsimonious scale from some of the original QOLS items; however, invariance testing across sex and injury status suggested the psychometric properties still vary between sub-groups. Given the scale design concerns and the results of this study, developing a new instrument, or identifying a different, better validated instrument to assess QoL in research and practice is recommended.

Background Patient-centered care and evidence-based practice (EBP) are core competencies for health care professionals. The importance of EBP has led to an increase in research involving clinical outcomes; current recommendations emphasize collecting patient focused measures, thus increasing the need for psychometrically sound patient reported outcome measures (PROMs) of health. Disablement has been identified as a valuable multi-dimensional construct for patient care. The Disablement in the Physically Active Scale Short Form-8 (DPA SF-8) has been proposed as a tool to be used in the physically active population that assesses a physical summary component of health and a quality of life component however, further analysis is necessary to ensure the instrument is psychometrically sound. Methods Confirmatory factor analyses (CFAs) were conducted on the DPA SF-8 at each time point to ensure factor structure. Reliability of the scale and internal consistency of the subscales were assessed, and a minimal detectable change (MDC) calculated. Additionally, a minimal clinically important difference (MCID) was also established, and invariance testing across three time points and groups was conducted. Results The CFAs at all three visits exceeded recommended model fit indices. The interclass correlation coefficient value (.924) calculated indicated excellent scale reliability and Cronbach’s alpha for subscales PHY and QOL were within recommend values. The MDC value calculated was 5.83 and the MCID for persistent injuries were 2 points and for acute injuries, 3 points. The DPA SF-8 was invariant across time and across subgroups. Conclusions The DPA SF-8 met CFA recommendations and criteria for multi-group and longitudinal invariance testing, which indicates the scale may be used to assess for differences between the groups or across time. Our overall analysis indicates the DPA SF-8 is a valid, reliable, and responsive instrument to assess patient improvement in the physically active population.

Background Suicide is a public health concern, with an estimated 1 million individuals dying each year worldwide. Individual psychological pain is believed to be a contributing motivating factor. Therefore, establishing a psychometrically sound tool to adequately measure psychological pain is important. The Orbach and Mikulincer Mental Pain Scale (OMMP) has been proposed; however, previous psychometric analysis on the OMMP has not yielded a consistent scale structure, and the internal consistency of the subscales has not met recommended values. Therefore, the primary purpose of this study was to assess the psychometric properties of the OMMP in a diverse sample. Methods A confirmatory factor analysis (CFA) on the 9-factor, 44-item OMMP was conducted on the full sample ( n = 1151). Because model fit indices were not met, an exploratory factor analysis (EFA) was conducted on a random subset of the data ( n = 576) to identify a more parsimonious structure. The EFA structure was then tested in a covariance model in the remaining subset of participants ( n = 575). Multigroup invariance testing was subsequently performed to examine psychometric properties of the refined scale. Results The CFA of the original 9-factor, 44-item OMMP did not meet recommended model fit recommendations. The EFA analysis results revealed a 3-factor, 9-item scale (i.e., OMMP-9). The covariance model of the OMMP-9 indicated further refinement was necessary. Multigroup invariance testing conducted on the final 3-factor, 8-item scale (i.e., OMMP-8) across mental health diagnoses, sex, injury status, age, activity level, and athlete classification met all criteria for invariance. Conclusions The 9-factor, 44-item OMMP does not meet recommended measurement criteria and should not be recommended for use in research and clinical practice in its current form. The refined OMMP-8 may be a more viable option to use; however, more research should be completed prior to adoption.

Nearly 40% of mortality in the United States is linked to social and behavioral factors such as smoking, diet and sedentary lifestyle. Autonomous self-regulation of health-related behaviors is thus an important aspect of human behavior to assess. In 1997, the Behavior Change Consortium (BCC) was formed. Within the BCC, seven health behaviors, 18 theoretical models, five intervention settings and 26 mediating variables were studied across diverse populations. One of the measures included across settings and health behaviors was the Treatment Self-Regulation Questionnaire (TSRQ). The purpose of the present study was to examine the validity of the TSRQ across settings and health behaviors (tobacco, diet and exercise). The TSRQ is composed of subscales assessing different forms of motivation: amotivation, external, introjection, identification and integration. Data were obtained from four different sites and a total of 2731 participants completed the TSRQ. Invariance analyses support the validity of the TSRQ across all four sites and all three health behaviors. Overall, the internal consistency of each subscale was acceptable (most α values >0.73). The present study provides further evidence of the validity of the TSRQ and its usefulness as an assessment tool across various settings and for different health behaviors.

Sleep has long been understood as an essential component for overall well-being, substantially affecting physical health, cognitive functioning, mental health, and quality of life. Currently, the Athlete Sleep Behavior Questionnaire (ASBQ) is the only known instrument designed to measure sleep behaviors in the athletic population. However, the psychometric properties of the scale in a collegiate student-athlete and dance population have not been established. To assess model fit of the ASBQ in a sample of collegiate traditional student-athletes and dancers. Observational study. Twelve colleges and universities. A total of 556 (104 men, 452 women; age = 19.84 ± 1.62 years) traditional student-athletes and dancers competing at the collegiate level. A confirmatory factor analysis (CFA) was computed to assess the factor structure of the ASBQ. We performed principal component analysis extraction and covariance modeling analyses to identify an alternate model. Multigroup invariance testing was conducted on the alternate model to identify if group differences existed for sex, sport type, injury status, and level of competition. The CFA on the ASBQ indicated that the model did not meet recommended model fit indices. An alternate 3-factor, 9-item model with improved fit was identified; however, the scale structure was not consistently supported during multigroup invariance testing procedures. The original 3-factor, 18-item ASBQ was not supported for use with collegiate athletes in our study. The alternate ASBQ was substantially improved, although more research should be completed to ensure that the 9-item instrument accurately captures all dimensions of sleep behavior relevant for collegiate athletes.

The purpose of this observational, cross-sectional study was to assess psychosocial characteristics and intrinsic motivation in a convenience sample of Army soldiers with different mental skills profiles. Participants were recruited immediately before or immediately following regular training activities. Anonymous surveys were completed and collected in the training area. Instruments used in this study included the Ottawa Mental Skills Assessment Tool-3 Revised for Soldiers; Rosenberg Self-esteem Scale; Depression Anxiety Stress Scale-21; University of California, Los Angeles, Loneliness Scale; Beck Hopelessness Scale; Intrinsic Motivation Inventory; and an anger measure. Soldiers with strong mental skill profiles were more intrinsically motivated and psychosocially healthier than their peers with weaker mental skill profiles. It is recommended that a proactive approach to psychological health promotion practices in soldiers be sought rather than reactive treatment plans to psychological sequelae. Future research must examine the role of psychosocial fitness and adaptability to enhance mental skills fitness.

The Disablement in the Physically Active (DPA) scale is a patient-reported outcome instrument recommended for use in clinical practice and research. Analysis of the scale has indicated a need for further psychometric testing. To assess the model fit of the original DPA scale using a larger and more diverse sample and explore the potential for a short-form (SF) version. Observational study. Twenty-four clinical settings. Responses were randomly split into 2 samples: sample 1 (n = 690: 353 males, 330 females, and 7 not reported; mean age = 23.1 ± 9.3 years, age range = 11-75 years) and sample 2 (n = 690: 351 males, 337 females, and 2 not reported; mean age = 22.9 ± 9.3 years, age range = 8-74 years). Participants were physically active individuals who were healthy or experiencing acute, subacute, or persistent musculoskeletal injury. Confirmatory factor analysis was conducted to assess the factor structure of the original DPA scale. Exploratory factor, internal consistency, covariance modeling, correlational, and confirmatory factor analyses were conducted to assess potential DPA scale SFs. The subdimensions of the disablement construct were highly correlated (≥0.89). The fit indices for the DPA scale approached recommended levels, but the first-order correlational values and second-order path coefficients provided evidence for multicollinearity, suggesting that clear distinctions between the disablement subdimensions cannot be made. An 8-item, 2-dimensional solution and a 10-item, 3-dimensional solution were extracted to produce SF versions. The DPA SF-8 was highly correlated ( = 0.94, ≤ .001, = 0.88) with the DPA scale, and the fit indices exceeded all of the strictest recommendations. The DPA SF-10 was highly correlated ( = 0.97, ≤ .001, = 0.94) with the DPA scale, and its fit indices values also exceeded the strictest recommendations. The DPA SF-8 and SF-10 are psychometrically sound alternatives to the DPA scale.

Introduction: Psychometrically sound instruments are needed to accurately track treatment effectiveness and assess quality of patient care. The Disablement in Physically Active Scale Short Form-10 (DPAS-10) was developed as a more parsimonious version of the DPA Scale to assess disablement in the physically active. Psychometric assessment of the DPAS-10 has not been completed; specifically, scale properties must be assessed in a sample of individuals who only respond to the 10-item scale at multiple time points. Objectives: To assess the psychometric properties of the DPAS-10 using confirmatory factor analysis (CFA) and invariance procedures across multiple time points. Methods: Confirmatory factor analyses and longitudinal invariance tests were conducted. Results: The DPAS-10 met contemporary fit index recommendations and demonstrated longitudinal invariance; however, localized fit issues suggest further modification is needed. Conclusion: Adoption of the DPAS-10 into widespread clinical practice and research is not recommended until further psychometric testing and scale modification is performed.

The increased emphasis on implementing evidence-based practice has reinforced the need to more accurately assess patient improvement. Psychometrically sound, patient-reported outcome measures are essential for evaluating patient care. A patient-reported outcome instrument that may be useful for clinicians is the Disablement in the Physically Active Scale (DPAS). Before adopting this scale, however, researchers must evaluate its psychometric properties, particularly across subpopulations. To evaluate the psychometric properties of the DPAS in a large sample using confirmatory factor analysis procedures and assess structural invariance of the scale across sex, age, injury status, and athletic status groups. Observational study. Twenty-two clinical sites. Of 1445 physically active individuals recruited from multiple athletic training clinical sites, data from 1276 were included in the analysis. Respondents were either healthy or experiencing an acute, subacute, or persistent musculoskeletal injury. A confirmatory factor analysis was performed on the full sample, and multigroup invariance testing was conducted to assess differences across sex, age, injury status, and athletic status. Given the poor model fit, alternate model generation was used to identify a more parsimonious factor structure. The DPAS did not meet contemporary fit index recommendations or the criteria to demonstrate structural invariance. We identified an 8-item model that met the model fit recommendations using alternate model generation. The 16-item DPAS did not meet the model fit recommendations and may not be the most parsimonious or reliable measure for assessing disablement and quality of life. Use of the 16-item DPAS across subpopulations of interest is not recommended. More examination involving a true cross-validation sample should be completed on the 8-item DPAS before this scale is adopted in research and practice.