(1) To assess the feasibility, acceptability of, and experience with heart rate variability (HRV)-guided physical activity (PA) in perimenopausal women; (2) explore associations between daily HRV and perimenopausal symptoms, sleep quality, and stress. A single-group mixed methods feasibility study was conducted. Participants completed assessments at baseline (T1) and were provided with a wearable smartwatch. Participants wore the smartwatch for a 3-week familiarization period (to establish one’s typical HRV), then completed a second assessment (T2) and were given a PA booklet providing information to support HRV-guided PA. Following this, participants were advised to utilize their HRV and guidebook to inform their PA over a 4-week intervention period. Following the intervention period, a semi-structured interview was conducted to explore the feasibility, acceptability, and experience of the HRV-guided PA (T3). Data were analyzed using means and standard deviations (SD), repeated measure correlations, and reflexive thematic analysis. Fifty-one participants were screened and 14 were included (mean age 47.1, SD 4.6). Participants reported moderate severity of symptomology and described the varied ways it influenced their well-being and levels of PA. Feasibility was mixed with low-to-moderate ratings and acceptability was rated low, which was expounded upon in interviews. Repeated correlations indicated that higher rated daily sleep was associated with higher daily HRV. While HRV-guided PA was neither feasible nor acceptable, participants appreciated that HRV-guided PA may be beneficial to support rest and recovery among active women. Continued exploration of the role of HRV-guided PA is needed in both active and inactive perimenopausal women.

Despite the known benefits of PA, many women do not engage in sufficient PA. This study explored postpartum women's perceptions of their body and PA and evaluated whether "realistic" PA imagery may influence perspectives around PA. We created imagery portraying safe, appropriate postpartum exercises and conducted an explanatory sequential mixed methods study. Given the influence of postpartum weight retention on body dissatisfaction we further explored experiences based on postpartum weight retention. Participants (n = 33, M = 31 years) <12 months postpartum completed a questionnaire, and n = 21 completed semi-structured interviews. Quantitative data were analyzed with descriptive statistics, qualitative data with reflexive thematic analysis. No significant differences were found in body dissatisfaction and PA between weight loss and weight retention groups. Three themes emerged: (1) perceptions of body image and size postpartum, (2) PA imagery preferences, (3) sources of PA information. Findings suggest women experience body dissatisfaction after viewing imagery and desire "realistic" PA imagery.

ABSTRACT Introduction Women report lower levels of physical activity (PA) postpartum due to numerous barriers to engagement such as lack of time, energy, motivation, social support, and fatigue. Despite these noted barriers, PA recommendations are universal and do not allow for a tailored PA approach. Therefore, we assessed the acceptability, feasibility, and impact of individualized postpartum PA guidance. Method Participants measured heart rate variability (HRV) for 3 min every morning for 2 wk. These baseline measures were used to create individualized HRV-guided PA recommendations. The goal was to create HRV-based zones with appropriate options for PA. Participants were instructed to measure and record their HRV daily for the 8-wk intervention period and choose a daily activity that was appropriate to their reading. A mixed-methods approach of pre- and post-intervention questionnaires and qualitative interviews were used to assess the impact of the intervention on participants and whether they felt the intervention was acceptable and feasible. Results The average age of women in the study was 33 (3.7) yr, and participants were, on average, 29 (7.4) wk (7.2 (1.9) months) postpartum. Participants reported recording their daily HRV on an average of 49 of the 56 d (88%) comprising the 8-wk intervention period. Participants reported completing, on average, 27 sessions (48%) in the correct categories (i.e., the zone indicated by the daily HRV reading). From baseline to post-intervention, there were significant improvements in PA, fatigue, and sleep. Participants noted high acceptability but low feasibility of the HRV method for individualized PA guidance. Conclusions Although a relatively simple intervention (i.e., daily HRV readings) may enhance PA and other outcomes, this intervention was only somewhat feasible and left women desiring greater support and accountability.

Heart rate variability (HRV) may provide feedback regarding need for recovery to post-partum women. We explored the associations between daily supine resting HRV and perceived stress and sleep quality using repeated measures correlation (rrm) between paired outcomes across two weeks. Repeated measures correlation between HRV and sleep quality, and between HRV and perceived stress were not significant. There was a significant correlation between sleep quality and stress across the two weeks, rrm(297) = -.412, 95% CI (-0.502, -0.313), p < .0001. Additional studies in this population are warranted to determine feasibility of using HRV to indicate sleep quality and stress.

The demands of motherhood have been shown to negatively impact physical activity (PA) engagement. Participants in a larger PA-based study in British Columbia, Canada were invited to participate in this sub study. Forty-eight photos and descriptions were provided by 9 participants with infants 3-7 months of age. Photos depicted challenges with PA, PA self-efficacy, body image and self-compassion in motherhood. We noted four themes that reflected the complex and gendered nature of postpartum PA engagement. First, gendered expectations of motherhood placed demands on time and space for PA engagement. Second, how mothers felt about their bodies both positively and negatively impacted their sense of self and PA engagement. Third, moments of self-compassion illustrated how navigating feelings of self-compassion about PA was messy. Fourth, PA self-efficacy was essential and required reimagining PA within the constraints of motherhood. In conclusion, PA postpartum is complex and impacted by broader concepts related to the expected duties of motherhood.

Background: With a warming climate, extreme wildfires are more likely to occur, which may adversely affect air quality, physical activity (PA), and therefore, mental well-being. Methods: We assessed PA engagement and mental well-being between periods with and without wildfire smoke, and whether there were associations between changes in PA behavior and mental well-being. Questionnaires on PA and mental well-being during a period of wildfire smoke were completed by 348 participants; of these participants, 162 also completed a follow-up PA and mental well-being questionnaire during a period without wildfire smoke. Data were analyzed using generalized/linear mixed models. Relationships between mental well-being and PA were analyzed using repeated-measures correlations. Results: Leisure-time walking, moderate PA, and vigorous PA were all significantly lower during periods of smoke compared to periods without smoke. Participants also experienced significantly higher symptoms of stress (11.63 [1.91] vs 10.20 [1.70], P = .039), anxiety (7.75 [2.24] vs 4.38 [1.32], P < .001), and depression (9.67 [0.90] vs 7.27 [0.76], P < .001) during the period of wildfire smoke. Vigorous PA, the proportion of PA time spent outdoors, and the sum of PA during leisure time, were significantly negatively correlated with mental well-being, therefore, it is possible that PA could be used as a tool during times of wildfire smoke. Conclusions: These data suggest that PA and mental well-being are adversely impacted during wildfire smoke events. Future research should consider the impact of strategies to support PA during wildfire events on PA and mental well-being.

Introduction: : Physical activity (PA) is essential for healthy aging, yet PA levels are low in older adults. Group-based nature programming may be an ideal opportunity for engaging older adults in PA and improving health-related quality of life. Methods: : Twenty-seven older adults, 55-75 - 75 years of age (n n = 14 active and n = 13 previously inactive), enrolled in a biweekly 8-week hiking program. At baseline, participants completed online questionnaires on health-related quality of life, behavioral and psychological outcomes, and a one-mile walk test to assess cardiorespiratory fi tness. Results: : Average attendance was 81% in the previously inactive groups and 74% in the active group. There was a significant fi cant increase in the physical component of quality of life over time in the previously inactive group (p p = .03, d= = 0.71). Participants significantly fi cantly improved their cardiorespiratory fi tness (p p = .003, d= = 0.77) and competency (p= p = .005, d= = 0.41) as assessed by the Basic Psychological Needs for Exercise Scale. The previously inactive group additionally increased their self-efficacy fi cacy for exercise (p p = .001, d= = 1.43). Both active and previously inactive groups exercised at a similar relative intensity during the hikes based on heart rate; however, perceived exertion at the end of the hike on average was lower among active participants (p p = .014). Conclusion: : Group-based hiking for previously inactive older adults significantly fi cantly improved physical health-related quality of life over an 8-week biweekly intervention. Hiking at an individualized pace may allow for hiking to be an appropriate PA program in previously inactive older adults.

Physical activity is a beneficial, yet complex, health behavior. To ensure more people experience the benefits of physical activity, we develop and test interventions to promote physical activity and its associated benefits. Nevertheless, we continue to see certain groups of people who choose not to, or are unable to, take part in research, resulting in "recruitment bias." In fact, we (and others) are seemingly missing large segments of people and are doing little to promote physical activity research to equity-deserving populations. So, how can we better address recruitment bias in the physical activity research we conduct? Based on our experience, we have identified 5 broad, interrelated, and applicable strategies to enhance recruitment and engagement within physical activity interventions: (1) gain trust, (2) increase community support and participation, (3) consider alternative approaches and designs, (4) rethink recruitment strategies, and (5) incentivize participants. While we recognize there is still a long way to go, and there are broader community and societal issues underlying recruitment to research, we hope this commentary prompts researchers to consider what they can do to try to address the ever-present limitation of "recruitment bias" and support greater participation among equity-deserving groups.

Objective: Test anxiety is common among nursing students. Yoga is one form of physical activity which may be beneficial for pretest anxiety. Participants: Thirteen undergraduate students (85% nursing majors, 15% awaiting program entry, 20 +/- 4.9 years of age) completed the crossover design study. Methods: Participants completed a yoga or control intervention (independent quiet study) on opposing testing days. At three time points, participants provided ratings of anxiety (visual analog scales), saliva samples for cortisol and alpha amylase, and seated heart rate variability (HRV, time and frequency domains) was recorded. Results: Yoga prior to a simulated exam had a positive impact on subjective measures of stress but did not positively impact cortisol or HRV compared to the control condition. Conclusions: There may be benefits to participating in 30 min of moderate intensity yoga for reduced perception of stress before a scholarly examination. Further research regarding the impacts of acute yoga on physiological measures of HRV and/or cortisol are warranted.

Objective: To explore the feasibility, acceptability, and potential benefits associated with a mind-body intervention and varied delivery styles among women during the postpartum period. Design: Mixed-methods feasibility study. Setting: Fraser Valley, British Columbia, Canada. Participants: Forty-three women (93% White), with an average age of 32.1 (SD 1 / 4 2.9) years, who had given birth within the last 6 months. Methods: Participants were randomized to three physical activity groups. Validated questionnaires were administered before and after the 12-week intervention. Attendance and feasibility metrics and qualitative semistructured interviews were conducted to assess the intervention. Results: The intervention and trial were partially feasible, and retention to the intervention was high; however, adherence as assessed by attendance was lower than expected. There was high acceptability among those in the group-based, in-person intervention. There was moderate acceptability among those in the individual, home-based asynchronous program. Conclusion: Findings highlight the necessity of better understanding what is desired by this population or simply providing more options to participants so that we can tailor physical activity to their needs and provide the necessary support.

Background: Access to exercise programming that addresses the unique needs of women living with and beyond ovarian cancer is limited. Feasible and accessible supportive care programs to enhance physical function and quality of life are needed. We aimed to assess the feasibility of a 12-week virtually delivered exercise program for women living with and beyond ovarian cancer. Methods: BE-BALANCED was a prospective single-arm feasibility pilot study. Women who had completed primary chemotherapy treatment of ovarian cancer within the past year were recruited through oncologist referrals or self-referral. The 12-week group exercise program targeting aerobic capacity, functional strength, balance, and range of motion was conducted virtually twice weekly using Zoom. Feasibility measures were accrual, attendance, adherence, and attrition. Physical function was evaluated using the Short Physical Performance Battery and selected components of the Senior Fitness Test. Results: Fourteen participants enrolled in the study (47% of the accrual target). Feasibility goals for the exercise sessions were met for attendance (84% ± 19%), adherence to virtual sessions (78% ± 19%), and fidelity of group belonging (18% ± 4%), and met for overall attrition (21%). Improvements were observed in gait speed, 30-second bicep curls, 6-minute walk, chair stand, and emotional well-being ( P < .05). Participant satisfaction with the program was high (4.4/5). Conclusion: Our findings demonstrated the feasibility of a virtually delivered exercise program for women living with and beyond ovarian cancer, with favorable attendance, adherence, and safety data. The program showed potential in improving physical outcomes and quality of life for participants. However, recruitment was a challenge. Future interventions could consider different approaches to increase recruitment.

Objectives: To explore inactive older adults experiences within a group based hiking program held twice weekly for 8 weeks. Methods: As part of a larger study exploring a hiking program among older adults, a purposeful sample of participants (n = 10; age = 66.9+/-8.0), who self-reported not meeting physical activity (PA) guidelines of 150 min per week were recruited. One-on-one, semi-structured interviews were conducted at the end of the hiking program. Interviews were transcribed verbatim and coded following guidelines for reflexive thematic analysis. Results: Participants shared that, (1) their experience with the hiking program was overwhelmingly positive and satisfying; (2) hiking helped them get in better shape; (3) being outdoors made them feel better, and (4) being with others in the hiking group was important to them. Discussion: Inactive older adults were satisfied with and benefited from a hiking program. Positive benefits may be due to the group and nature-based experience of the program and their benefit on accountability and enjoyment. Given the low rates of PA participation among older adults, hiking programs may be a way of increasing PA uptake in this population.

Points• Hiking promotes opportunity for individuals to be active based on varying fitness, skill, and sociodemographic levels.

We discuss using the qualitative arts-based method of autophotography by sharing our experiences conducting three studies with postpartum women as they navigated the psychosocial challenges of physical activity (PA) engagement. In working with this population, we used autophotography in conjunction with feminist theory by centering participants’ voices, highlighting the presence of the gendered expectations of motherhood in PA engagement, and providing tools for transformation and empowerment. Throughout our paper, we reflect on the process of conducting autophotography in our studies with postpartum women and theorize how this method provided an important medium for mothers to share their voices and stories.

ABSTRACTABSTRACTAccess to physically active leisure (PAL) is critical during the postpartum period. However, this period is fraught with drastic transformations to body and mind, altering PAL. Therefore, the purpose of this study was to explore postpartum women's experiences as they navigate PAL engagement. Specifically, we sought to understand supports women needed to engage in PAL within the first year postpartum. Twenty-three postpartum women participated in semi-structured interviews, which we then interpreted through narrative analysis. Three major stories emerged through the data: (a) engaging in PAL through the transformations of motherhood, (b) lacking postpartum PAL support, and (c) women supporting themselves and each other. Moreover, our findings uncovered the lacking social and healthcare supports postpartum women receive, and the importance of self-compassion and self-sufficiency in their PAL engagement. Findings can advance academic literature and inform healthcare teams in providing long-term postpartum support to women.RésuméL'accès à des loisirs physiquement actifs (LPA) est essentiel pendant la période postnatale. Cependant, cette période est marquée par des transformations radicales du corps et de l'esprit, ce qui modifie l'accès aux LPA. L'objectif de cette étude était donc d'explorer les expériences des femmes en post-partum lorsqu'elles s'engagent dans des activités de LPA. Plus précisément, nous avons cherché à comprendre les soutiens dont les femmes avaient besoin pour participer aux LPA au cours de la première année suivant l'accouchement. Vingt-trois femmes en post-partum ont participé à des entrevues semi-structurées, que nous avons ensuite interprétées au moyen d'une analyse narrative. Trois grandes histoires ont émergé des données : (a) la participation aux LPA au cours des transformations de la maternité, (b) le manque de soutien aux LPA après l'accouchement, et (c) les femmes qui se soutiennent elles-mêmes et les unes les autres. En outre, nos résultats ont mis en évidence le manque de soutien social et médical dont bénéficient les femmes en post-partum, ainsi que l'importance de l'autocompassion et de l'autosuffisance dans leur participation aux LPA. Les résultats peuvent faire avancer la littérature académique et informer les équipes de soins de santé dans la prestation d'un soutien post-partum à long terme aux femmesKEYWORDS: mothersqualitativeself-compassionidentityphysical activityMOTS-CLÉS: mèresqualitatifautocompassionidentité Disclosure statementNo potential competing interest was reported by the authors.Additional informationFundingBrock University's Vice President Research Discretionary Fund and Brock University's Faculty of Applied Health SciencesNotes on contributorsTalia RitondoTalia Ritondo is a doctoral student at the University of Ottawa. She is a master's graduate from Brock University in Leisure Studies, in which she was affiliated during time of data collection and analysis. Her research focuses on postnatal, physically active leisure, and sport participation through a critical feminist lens. She also works on multiple projects involving volunteer and sport board governance with a gender, family, and identity lens. Her Politics of Hope is to one day eradicate sexism in sport and ensure equitable sport participation for all.Corliss BeanCorliss Bean is an Assistant Professor in the Faculty of Applied Health Sciences at Brock University. Her research involves working in the community to foster healthy physical and psychosocial development in youth and adult populations.Iris LesserIris Lesser is an Assistant Professor in the School of Kinesiology at the University of the Fraser Valley. She holds a PhD in Biomedical Physiology and Kinesiology from Simon Fraser University. She is a certified exercise physiologist with the Canadian Society of Exercise Physiology and a Pre-Post Natal Exercise Specialist. Her research involves finding innovative ways to engage special populations in physical activity with the goal of making physical activity accessible to all.

Postpartum physical activity can positively impact mental and physical health. There is a need to better understand how physical activity is related to various psychological constructs to support physical activity in postpartum women. Thus, the purpose of this exploratory, quantitative, study was to examine differences between postpartum women who were physically active and those who were physically inactive on psychological (e.g., self-compassion) and mental health constructs. Five hundred twenty-five women ( M age = 28.4) completed an online survey. Participants who reported being active following the birth of their last child had significantly higher exercise self-efficacy, self-compassion, and basic psychological needs fulfillment for exercise and significantly lower levels of perceived fatigue, anxiety, and depression compared with their inactive counterparts. However, active mothers had lower body satisfaction than inactive mothers. Women who are active after the birth of a child have improved psychological constructs that may benefit overall well-being and mental health during this challenging transition.

Supportive care programming helps many adults affected by cancer manage concerns related to their disease. Public health restrictions imposed by the COVID-19 pandemic have undoubtedly changed the nature of supportive care programming delivery. Yet, access to supportive care programming and comfort gathering through the pandemic are unknown. As a first step towards informing ongoing supportive care programming for adults affected by cancer, this observational, mixed methods study described supportive care programming access through the COVID-19 pandemic and comfort returning to in-person supportive care programming as restrictions eased. Adults affected by cancer (n = 113; mean age = 61.9 ± 12.7 years; 68% female) completed an online survey, and descriptive statistics were computed. A purposeful sample of survey participants (n = 12; mean age = 58.0 ± 14.5 years; 58% female) was subsequently recruited to complete semi-structured interviews. Interviews were analyzed using reflexive thematic analysis. Less than half (41.6%) of the survey sample reported accessing supportive care programming during the pandemic, and of those who had accessed supportive care programming, most (65.6%) perceived similar or greater access than pre-pandemic. During interviews, participants described the ways online delivery enhanced their access and reduced barriers to supportive care programming. However, physical activity programming was described as challenging to navigate online. With restrictions easing, most of the survey sample (56.6%) reported being apprehensive about returning to in-person supportive care programming and identified the protocols that would make them feel safe to gather. During interviews, participants recounted struggling to balance their need for social connection with their health and safety. This study provides evidence to inform supportive care programming for adults affected by cancer through the COVID-19 pandemic. Findings suggest online delivery can enhance access to some types of supportive care programming for some adults affected by cancer, and that efforts are needed to ensure all adults affected by cancer feel comfortable gathering in-person.

Purpose Physical activity (PA) after the birth of a child is associated with improved physical and mental health benefits. The aim of the study was to explore new mothers’ experiences of PA before and after participation in a group-based PA program for new mothers. The study has three research questions: how new mothers felt; 1) about PA after the birth of their child 2) about engaging in a group-based PA program and 3) after the program ended about ongoing PA engagement. Methods We conducted an 8-week bi-weekly PA program for postpartum women. To understand the experience of postpartum women engaging in a group-based PA program we conducted one-on-one semi-structured interviews before, after, and at 6-month follow-up. Results Of the n = 21 participants in the Moms on the Move study; n = 17 completed pre interviews.s. One primary theme emerged from pre-program interviews where mothers shared how they were lost as to where to start PA. Post-program interviews produced two primary themes; engaging in PA helped mothers, and mothers learned to rethink PA. Conclusions Postpartum women who participated in this group-based PA program had positive benefits to their mental and physical health and were able to alter their PA behaviour.