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"Plotnikoff, Ronald C."
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The Health Benefits of Muscular Fitness for Children and Adolescents: A Systematic Review and Meta-Analysis
by
Morgan, Philip J.
,
Plotnikoff, Ronald C.
,
Smith, Jordan J.
in
Adiposity
,
Adolescent
,
Bone Density
2014
Background
Physical fitness during childhood and adolescence has been identified as an important determinant of current and future health status. While research has traditionally focused on the association between cardio-respiratory fitness and health outcomes, the association between muscular fitness (MF) and health status has recently received increased attention.
Objective
The aim of this systematic review and meta-analysis was to evaluate the potential physiological and psychological benefits associated with MF among children and adolescents.
Methods
A systematic search of six electronic databases (PubMed, SPORTDiscus, Scopus, EMBASE, PsycINFO and OVID MEDLINE) was performed on the 20th May, 2013. Cross-sectional, longitudinal and experimental studies that quantitatively examined the association between MF and potential health benefits among children and adolescents were included. The search yielded 110 eligible studies, encompassing six health outcomes (i.e., adiposity, bone health, cardiovascular disease [CVD] and metabolic risk factors, musculoskeletal pain, psychological health and cognitive ability). The percentage of studies reporting statistically significant associations between MF and the outcome of interest was used to determine the strength of the evidence for an association and additional coding was conducted to account for risk of bias. Meta-analyses were also performed to determine the pooled effect size if there were at least three studies providing standardised coefficients.
Results
Strong evidence was found for an inverse association between MF and total and central adiposity, and CVD and metabolic risk factors. The pooled effect size for the relationship between MF and adiposity was
r
= −0.25 (95 % CI −0.41 to −0.08). Strong evidence was also found for a positive association between MF and bone health and self-esteem. The pooled effect size for the relationship between MF and perceived sports competence was
r
= 0.39 (95 % CI 0.34–0.45). The evidence for an association between MF and musculoskeletal pain and cognitive ability was inconsistent/uncertain. Where evidence of an association was found, the associations were generally low to moderate.
Conclusion
The findings of this review highlight the importance of developing MF in youth for a number of health-related benefits.
Journal Article
Examining social-cognitive theory constructs as mediators of behaviour change in the active team smartphone physical activity program: a mediation analysis
2021
Background
Regular engagement in physical activity has well-established physical and psychological health benefits. Despite this, over a quarter of the global adult population is insufficiently physically active. Physical activity interventions grounded in behaviour change theory, such as the social-cognitive theory, are widely considered to be more effective than non-theoretical approaches. Such interventions set out to intervene on the ultimate outcome (physical activity), but also influence intermediate factors (social-cognitive theory constructs) which in turn, are believed to influence physical activity behaviour. The primary aim of the study was to use mediation analysis to examine whether changes in the social-cognitive theory and related constructs, in particular self-efficacy, outcome expectations, intentions, barriers and goal setting, mediated the effects of a smartphone-based social networking physical activity intervention.
Methods
Mediation analyses were conducted using the PROCESS Macro in SPSS to (i) calculate the regression coefficients for the effect of the independent variable (group allocation) on the hypothesised mediators (social-cognitive theory constructs), (ii) calculate the regression coefficient for the effect of the hypothesised mediators (social-cognitive theory constructs) on the dependent variable (objectively measured physical activity or self-report physical activity), independent of group assignment and (iii) determine the total, direct and indirect intervention effects.
Results
Data from 243 participants were included in the mediation analysis. There was no evidence of mediation for change in objectively measured MVPA or self-reported MVPA.
Conclusions
There was no conclusive evidence that any of the social-cognitive theory constructs mediated the relationship between an app-based intervention and change in physical activity. Ongoing efforts to develop and understand components that make physical activity app-based interventions effective are recommended.
Trial registration
This trial was registered with the Australian and New Zealand Clinical Trial Registry (
ACTRN12617000113358
, date of registration 23 January, 2017).
Journal Article
Validity of muscular fitness self-assessments in the ecofit smartphone application: A correlation study
by
Duncan, Mitch J.
,
Jansson, Anna K.
,
Bauman, Adrian
in
Biology and Life Sciences
,
Computer and Information Sciences
,
Correlation of Data
2022
Mobile app-based interventions have the potential for wide-reach and therefore may be a useful tool in up-scaling physical activity interventions. In larger-scale interventions, face-to-face assessments are less cost-effective, and researchers often rely on surveys or activity trackers to assess outcomes. However, there is limited evidence of valid muscular fitness assessments that can be self-administered within mHealth interventions. As such, this study will evaluate the concurrent validity of upper and lower body muscular fitness that have been independently assessed by participants via the ecofit app, and face-to-face assessments conducted by a trained researcher.
This study compared baseline data from two muscular fitness tests from the ecofit two-armed randomised controlled trial and self-assessed data collected via the ecofit smartphone app (i.e., validated 90-degree push-up and 60-second sit-to-stand test). To assess the concurrent validity, the self-assessed push-up and sit-to-stand tests (i.e., collected via the ecofit app) were correlated using Spearman's correlation coefficient against the researcher-assessed results (i.e., objective results collected during baseline assessment for the ecofit trial). Bland-Altman plots were also used to allow visualisation of the differences between the self- and research-assessed tests.
Participants (N = 54) completed the push-up (24.1%) and sit-to-stand (100%) tests within 14-days of receiving the app. The results revealed a strong significant correlation for the push-up test (0.83, p<0.001) and a moderate significant correlation for the sit-to-stand test (0.63, p<0.001).
This study provides support for the concurrent validity of self-reported upper and lower body muscular fitness assessments (i.e., the push-up and sit-to-stand tests) in mHealth. While these tests may be a feasible option for large scale physical activity interventions, more research is needed to determine the generalisability of these results.
Journal Article
Effects of mHealth interventions to prescribe resistance training: a systematic review and meta-analysis of randomized controlled trials
by
Duncan, Mitch J.
,
Jansson, Anna K.
,
Wade, Levi
in
Behavior modification
,
Behavioral Sciences
,
Citation management software
2025
Background
This review evaluated the efficacy of resistance training mHealth interventions for improving neuromuscular fitness and resistance training participation. It also explored how resistance training is prescribed through mHealth, and the theoretical frameworks and behavior change techniques (BCTs) employed.
Methods
MEDLINE (OVID), Embase (OVID), Emcare (OVID), SPORTDiscus, Web of Science, Scopus and Cochrane (CINAHL) were searched from January 2010 to February 2025. Randomized controlled trials published in English, targeting adults, that prescribed resistance training via an mHealth platform and measured at least one outcome of neuromuscular fitness or resistance training participation were included.
Results
From the 12,059 records identified, 32 RCTs were included. mHealth-delivered resistance training interventions produced a small, statistically significant improvement in neuromuscular fitness compared with no intervention/usual care (Cohen’s
d
= 0.18, 95% CI [0.08, 0.28],
p
< .001, 18 studies). There was a significant, moderate effect for lower body neuromuscular fitness outcomes, but no significant effect for upper body outcomes. Only two studies measured changes to resistance training participation, precluding meta-analysis on this outcome. Studies targeted mostly clinical populations and used mobile applications or websites. Majority of studies included bodyweight exercises, prescribed via videos or pictures, along with text description. Exercise prescription was generally poorly reported across studies. Only 7 studies used a theoretical framework to inform their intervention. All studies incorporated BCTs (17 discrete BCTs used), with a focus on providing instruction and demonstrating behavior.
Conclusions
mHealth is a potentially scalable, effective method of prescribing resistance training. Better reporting of exercise prescription, along with clearer grounding in established theoretical frameworks, is recommended.
Review registration
The review was prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO; registration number CRD42025641142).
Journal Article
Effect of a physical activity and sleep m-health intervention on a composite activity-sleep behaviour score and mental health: a mediation analysis of two randomised controlled trials
by
Duncan, Mitch J.
,
Plotnikoff, Ronald C.
,
Murawski, Beatrice
in
Anxiety
,
Behavior
,
behavior change
2021
Background
To examine if a composite activity-sleep behaviour index (ASI) mediates the effects of a combined physical activity and sleep intervention on symptoms of depression, anxiety, or stress, quality of life (QOL), energy and fatigue in adults.
Methods
This analysis used data pooled from two studies: Synergy and Refresh. Synergy: Physically inactive adults (18–65 years) who reported poor sleep quality were recruited for a two-arm Randomised Controlled Trial (RCT) (Physical Activity and Sleep Health (PAS;
n
= 80), or Wait-list Control (CON;
n
= 80) groups). Refresh: Physically inactive adults (40–65 years) who reported poor sleep quality were recruited for a three-arm RCT (PAS (
n
= 110), Sleep Health-Only (SO;
n
= 110) or CON (
n
= 55) groups). The SO group was omitted from this study. The PAS groups received a pedometer, and accessed a smartphone/tablet “app” using behaviour change strategies (e.g., self-monitoring, goal setting, action planning), with additional email/SMS support. The ASI score comprised self-reported moderate-to-vigorous-intensity physical activity, resistance training, sitting time, sleep duration, efficiency, quality and timing. Outcomes were assessed using DASS-21 (depression, anxiety, stress), SF-12 (QOL-physical, QOL-mental) and SF-36 (Energy & Fatigue). Assessments were conducted at baseline, 3 months (primary time-point), and 6 months. Mediation effects were examined using Structural Equation Modelling and the product of coefficients approach (AB), with significance set at 0.05.
Results
At 3 months there were no direct intervention effects on mental health, QOL or energy and fatigue (all
p
> 0.05), and the intervention significantly improved the ASI (all
p
< 0.05). A more favourable ASI score was associated with improved symptoms of depression, anxiety, stress, QOL-mental and of energy and fatigue (all
p
< 0.05). The intervention effects on symptoms of depression ([AB; 95%CI] -0.31; − 0.60,-0.11), anxiety (− 0.11; − 0.27,-0.01), stress (− 0.37; − 0.65,-0.174), QOL-mental (0.53; 0.22, 1.01) and ratings of energy and fatigue (0.85; 0.33, 1.63) were mediated by ASI. At 6 months the magnitude of association was larger although the overall pattern of results remained similar.
Conclusions
Improvements in the overall physical activity and sleep behaviours of adults partially mediated the intervention effects on mental health and quality of life outcomes. This highlights the potential benefit of improving the overall pattern of physical activity and sleep on these outcomes.
Trial registration
Australian New Zealand Clinical Trial Registry:
ACTRN12617000680369
;
ACTRN12617000376347
.
Universal Trial number: U1111–1194-2680; U1111–1186-6588. Human Research Ethics Committee Approval: H-2016-0267; H-2016–0181.
Journal Article
Determinants of quality of life in adults with type 1 and type 2 diabetes
by
Imayama, Ikuyo
,
Plotnikoff, Ronald C
,
Courneya, Kerry S
in
adults with diabetes
,
Alberta
,
Diabetes
2011
Background
Limited evidence exists on the determinants of quality of life (QoL) specific to adults with type 1 diabetes (T1D). Further, it appears no study has compared the determinants of QoL between T1D and type 2 diabetes (T2D) groups. The objectives of this study were to examine: (1) determinants of QoL in adults with T1D; and, (2) differences in QoL determinants between T1D and T2D groups.
Methods
The Alberta Longitudinal Exercise and Diabetes Research Advancement (ALEXANDRA) study, a longitudinal study of adults with diabetes in Alberta, Canada. Adults (18 years and older) with T1D (N = 490) and T2D (N = 1,147) provided information on demographics (gender, marital status, education, and annual income), personality (activity trait), medical factors (diabetes duration, insulin use, number of comorbidities, and body mass index), lifestyle behaviors (smoking habits, physical activity, and diet), health-related quality of life (HRQL) and life satisfaction. Multiple regression models identified determinants of HRQL and life satisfaction in adults with T1D. These determinants were compared with determinants for T2D adults reported in a previous study from this population data set. Factors significantly associated with HRQL and life satisfaction in either T1D or T2D groups were further tested for interaction with diabetes type.
Results
In adults with T1D, higher activity trait (personality) score (β = 0.28, p < 0.01), fewer comorbidities (β =
-
0.27, p < 0.01), lower body mass index (BMI)(β =
-
0.12, p < 0.01), being a non-smoker (β =
-
0.14, p < 0.01), and higher physical activity levels (β = 0.16, p < 0.01) were associated with higher HRQL. Having a partner (β = 0.11, p < 0.05), high annual income (β = 0.16, p < 0.01), and high activity trait (personality) score (β = 0.27, p < 0.01) were significantly associated with higher life satisfaction. There was a significant age × diabetes type interaction for HRQL. The T2D group had a stronger positive relationship between advancing age and HRQL compared to the T1D group. No interaction was significant for life satisfaction.
Conclusions
Health services should target medical and lifestyle factors and provide support for T1D adults to increase their QoL. Additional social support for socioeconomically disadvantaged individuals living with this disease may be warranted. Health practitioners should also be aware that age has different effects on QoL between T1D and T2D adults.
Journal Article
Development and evaluation of social cognitive measures related to adolescent dietary behaviors
by
Morgan, Philip J
,
Plotnikoff, Ronald C
,
Dewar, Deborah L
in
Adolescent
,
Adolescents
,
behavior change
2012
Background
This study aimed to develop and evaluate the reliability and factorial validity, of social-cognitive measures related to adolescent healthy eating behaviors.
Methods
A questionnaire was developed based on constructs from Bandura’s Social Cognitive Theory and included the following scales:
self-efficacy
,
intentions
(proximal goals),
situation
(perceived environment),
social support
,
behavioral strategies
,
outcome expectations
and
expectancies
. The questionnaire was administered with a two week test-retest among secondary school students (n = 173, age = 13.72 ± 1.24). Confirmatory factor analysis was employed to examine model-fit for each scale using multiple indices including: chi-square index, comparative-fit index (CFI), goodness-of-fit index (GFI), and the root mean square error of approximation (RMSEA). Reliability properties were also examined (ICC and Cronbach’s alpha).
Results
The reliability and factorial validity of each scale is supported: fit indices suggest each model to be an adequate-to-exact fit to the data; internal consistency was acceptable-to-good (α=0.65−0.79); rank order repeatability was strong (ICC = 0.81−0.89).
Conclusions and implications
Results support the reliability and factorial validity of social cognitive scales relating to healthy eating behaviors among adolescents. As such, the developed scales have utility for identifying potential social cognitive correlates of adolescent dietary behavior, mediators of dietary behavior change and validity testing of theoretical models based on Social Cognitive Theory.
Journal Article
Efficacy of tailored-print interventions to promote physical activity: a systematic review of randomised trials
by
Short, Camille E
,
Girgis, Afaf
,
James, Erica L
in
Behavioral Sciences
,
Clinical Nutrition
,
Exercise
2011
Objective
Computer-tailored physical activity interventions are becoming increasingly popular. Recent reviews have comprehensively synthesised published research on computer-tailored interventions delivered via interactive technology (e.g. web-based programs) but there is a paucity of synthesis for interventions delivered via traditional print-based media in the physical activity domain (i.e. tailored-print interventions). The current study provides a systematic review of the tailored-print literature, to identify key factors relating to efficacy in tailored-print physical activity interventions.
Method
Computer-tailored print intervention studies published up until May 2010 were identified through a search of three databases: Medline, CINAHL, and Psycinfo; and by searching reference lists of relevant publications, hand searching journals and by reviewing publications lists of 11 key authors who have published in this field.
Results
The search identified 12 interventions with evaluations reported in 26 publications. Seven out of the 12 identified studies reported positive intervention effects on physical activity behaviour, ranging from one month to 24 months post-baseline and 3 months to 18 months post-intervention. The majority of studies reporting positive intervention effects were theory-based interventions with multiple intervention contacts.
Conclusion
There is preliminary evidence that tailored-print interventions are a promising approach to promoting physical activity in adult populations. Future research is needed to further identify key factors relating to efficacy and to determine if this approach is cost-effective and sustainable in the long-term.
Journal Article
Exploring changes in physical activity, sedentary behaviors and hypothesized mediators in the NEAT girls group randomized controlled trial
by
Dewar, Deborah L.
,
Morgan, Philip J.
,
Okely, Anthony D.
in
Accelerometers
,
Accelerometry
,
Adolescent
2014
To evaluate the impact of a 12-month school-based multi-component program on adolescent girls’ physical activity and sedentary behaviors, and hypothesized mediators of physical activity behavior change.
Group randomized controlled trial with 12-month follow-up.
The intervention, guided by Social Cognitive Theory, involved 357 adolescent girls (13.2±0.5 years) from 12 secondary schools (6 intervention schools, 6 control schools) in low-income communities in the Hunter and Central Coast regions of New South Wales, Australia.
The intervention included enhanced school sport, lunchtime physical activity sessions, interactive seminars, student handbooks, nutrition workshops, pedometers, parent newsletters and text messages to encourage physical activity and healthy eating, and a decrease in sedentary behavior. Outcomes were assessed at baseline and 12-months and included: physical activity (accelerometers), sedentary behaviors (questionnaire and accelerometers), and social-cognitive mediators of physical activity (questionnaire).
There were significant between group differences in favor of the intervention group for self-reported recreational computer use (−26.0min; 95% CI, −46.9 to −5.1), and sedentary activities summed (−56.4min; 95% CI, −110.1 to −2.7), however objective sedentary behavior showed no differences. There were no group-by-time effects for any of the physical activity outcomes or hypothesized mediators.
A school-based intervention tailored for adolescent girls from schools located in low-income communities significantly reduced time spent in sedentary activities. However, improvements in physical activity and hypothesized mediators of physical activity behavior were not observed. Future studies are encouraged to explore alternative mechanisms of behavior change derived from integrated and socio-ecological theories.
Journal Article
Physical Activity and Physical Self-Concept in Youth: Systematic Review and Meta-Analysis
by
Lonsdale, Chris
,
Babic, Mark J.
,
Morgan, Philip J.
in
Adolescent
,
Age Factors
,
Body Image - psychology
2014
Background
Evidence suggests that physical self-concept is associated with physical activity in children and adolescents, but no systematic review of this literature has been conducted.
Objective
The primary aim of this systematic review and meta-analysis was to determine the strength of associations between physical activity and physical self-concept (general and sub-domains) in children and adolescents. The secondary aim was to examine potential moderators of the association between physical activity and physical self-concept.
Methods
A systematic search of six electronic databases (MEDLINE, CINAHL, SPORTDiscus, ERIC, Web of Science and Scopus) with no date restrictions was conducted. Random effects meta-analyses with correction for measurement were employed. The associations between physical activity and general physical self-concept and sub-domains were explored. A risk of bias assessment was conducted by two reviewers.
Results
The search identified 64 studies to be included in the meta-analysis. Thirty-three studies addressed multiple outcomes of general physical self-concept: 28 studies examined general physical self-concept, 59 examined perceived competence, 25 examined perceived fitness, and 55 examined perceived appearance. Perceived competence was most strongly associated with physical activity (
r
= 0.30, 95 % CI 0.24–0.35,
p
< 0.001), followed by perceived fitness (
r
= 0.26, 95 % CI 0.20–0.32,
p
< 0.001), general physical self-concept (
r
= 0.25, 95 % CI 0.16–0.34,
p
< 0.001) and perceived physical appearance (
r
= 0.12, 95 % CI 0.08–0.16,
p
< 0.001). Sex was a significant moderator for general physical self-concept (
p
< 0.05), and age was a significant moderator for perceived appearance (
p
≤ 0.01) and perceived competence (
p
<
0.05). No significant moderators were found for perceived fitness.
Conclusion
Overall, a significant association has been consistently demonstrated between physical activity and physical self-concept and its various sub-domains in children and adolescents. Age and sex are key moderators of the association between physical activity and physical self-concept.
Journal Article