Abstract Background Virtual reality (VR) exercise is an alternative mode of physical activity with potential mental health benefits. The purpose of this study was to examine the effectiveness of a VR exercise program for improving community adults’ well-being (ie, subjective vitality), depression, anxiety, and executive functioning. Methods A 2-arm, parallel, single-blinded randomized controlled trial design was conducted to compare a 10-week home-based commercially available VR exercise program (Supernatural Fitness Application) (n = 73) with a waitlist control (WLC) condition (n = 81). Primary (well-being) and secondary (depression, anxiety, executive functioning) outcomes were self-reported at baseline, week 5, and week 10 of the study. Participants were enrolled between March 19, 2024, and March 18, 2025. Analyses were conducted using mixed-effects regression models. Results The VR exercise program resulted in statistically significant improvements (P < .01) in subjective vitality and decreases in depression and anxiety symptoms relative to the WLC condition across the 10-week study. At week 10, the VR exercise condition reported greater subjective vitality (d = 0.49; 95% CI, 0.17 to 0.81) and less depression (d = −0.42; 95% CI, −0.74 to −0.10) and anxiety (d = −0.22; 95% CI, −0.54 to 0.10) than the WLC condition. There were no statistically significant effects for executive functioning. Discussion Home-based commercially available VR exercise has similar effects on well-being and mental health compared to traditional modes of physical activity. Practitioners can recommend commercially available VR exercise to individuals as an alternative mode of physical activity to support mental health. Trial registration ClinicalTrials.gov NCT06367439 on April 11, 2024.

Conversations regarding health behaviours, mental health, and socioeconomic contexts are recommended during prenatal visits to optimize maternal and fetal health outcomes. This study was designed to develop and evaluate the acceptability of a clinical dialogue tool called Conversation Cards for Pregnancy (PregnancyCards for short). PregnancyCards are being designed as a practical, person-centered clinical dialogue tool to empower pregnant individuals to talk with their prenatal care providers about potentially sensitive topics regarding health behaviours that are important to them during their prenatal visits. This two-step, 3-year, multi-method study, guided by the Obesity-Related Behavioural Interventions Trial (ORBIT) model, is grounded in the Capability, Opportunity, and Motivation (COM-B) framework for understanding behaviour. Pregnant individuals and prenatal care providers will be recruited by our partners from across Canada, in clinical and community settings. Step 1: Identify topics of interest related to health behaviours by conducting virtual semi-structured interviews with pregnant individuals (n 20) and prenatal health care providers (n 10–15) and by analyzing data using thematic analysis. Step 2: Topics generated in Step 1 will be used to create a prototype deck of PregnancyCards that will be evaluated in clinical settings with pregnant individuals (n 40) to assess acceptability, appropriateness, and feasibility, and qualitative experiences of using the cards. Prenatal care providers (n 15) will be recruited at one time point to capture their perceptions of usability, acceptability and likability of the prototype cards as well. Currently, a total of 21 pregnant individuals and 14 prenatal care providers have already participated in Step 1 of this study. All participants (pregnant individuals and prenatal care providers) engaged in semi-structured interviews to determine the topics of interest related to health behaviours. Thematic analysis of interview data has been completed and the results informed the development of a prototype deck of PregnancyCards, which will be tested in Step 2. We seek to gain a better understanding of pregnant individuals’ perceived needs for conversations related to health behaviours and provide insight into the acceptability, appropriateness, and feasibility of PregnancyCards in clinical settings. PregnancyCards has the potential to serve as a practical clinical dialogue tool to help empower pregnant individuals and optimize discussions about health behaviours that matter to them during pregnancy. The two studies outlined in this protocol paper will inform future research to test the efficacy and effectiveness of PregnancyCards as a behavioural intervention aimed at improving health behaviours in pregnancy.

Introduction:Understanding how youth perceive and respond to climate change is essential for designing effective education and engagement strategies. This study assessed the psychosocial and behavioral profiles related to climate change among Korean youth. Materials and Methods:Data from the Youth-led Carbon Neutrality Promotion Survey conducted by the National Youth Policy Institute (n = 3024; age=11-18 years) were used. Descriptive and logistic regression analyses were conducted, adjusting for school grade and type (co-ed vs gender-segregated). Results:Most Korean youth believed that climate change is currently happening (83%) and caused by human activity (95%). Boys showed higher technical knowledge (e.g., familiarity with Net-Zero terminology) but were less likely than girls to believe climate change is happening, feel climate anxiety, or take personal pro-environmental actions. Conversely, boys were more optimistic and viewed institutional responses as effective. These patterns suggest girls engage more emotionally and behaviorally, while boys focus on policy-level solutions, which may contribute to lower psychosocial response and action. Youth placed importance on both systemic (e.g., government policies, climate education) and individual-level strategies (individual-level information, youth engagement) as potential solutions, but less importance was placed on incentive-based or punitive measures. Using public transportation emerged as the most frequently adopted climate action (48%), far surpassing other behaviors. Discussion:Findings suggest gendered pathways in climate engagement, primarily girls' affective-behavioral responses and boys' structural-policy optimism. Conclusion:These findings highlight the importance of tailored climate education and action programs that consider gendered patterns in psychosocial and behavioral profile to more effectively support youth as agents of climate action.

Introduction:Obesity is a chronic condition that impacts 650 million adults globally. Glucagon-like peptide 1 (GLP-1) medications have demonstrated efficacy in reducing body weight. However, weight loss can lead to reductions in muscle mass. Resistance training, known to counteract muscle loss during caloric deficit, has not been thoroughly investigated regarding its daily predictors among this population. In this study, we aimed to explore how reflective, reflexive, and self-regulatory factors influence the intention and behavior of resistance training among GLP-1 users.Methods:Utilizing a 7-d daily diary method, participants received morning and afternoon surveys to gauge reflective (affective attitudes, capability, opportunity, and intention), reflexive (incidental daily affect), and self-regulatory (self-monitoring) factors, alongside their resistance training activity and intention to engage in resistance training. Multilevel logistic regression analyses were used to discern within and between participant associations with resistance training engagement and intention formation.Results:Findings indicate that on days participants reported higher-than-average incidental affect, intention, and self-monitoring, they were more likely to engage in resistance training. Similarly, those with higher levels of incidental affect, intention, and self-monitoring consistently showed a greater likelihood of participating in resistance training. Additionally, on days with higher-than-average affective attitude and perceived capabilities, participants were more likely to intend to engage in resistance training. Those with higher affective attitudes were also more likely to intend to resistance train.Conclusion:In summary, the results support a tri-partite (reflective, reflexive, and regulatory) approach to understanding resistance training participation in GLP-1 users. Future studies should focus on targeting these constructs using behavior modification techniques to encourage resistance training among GLP-1 medication users.

Physical inactivity is a prevalent concern among people living with and beyond cancer (LWBC). Exercise identity, a construct thought to be important for exercise maintenance, has received limited attention in survivorship research. Within the Multi-Process Action Control (M-PAC) framework, identity and habit are key reflexive processes proposed to help sustain behavior. This study examined the applicability of the M-PAC framework in people LWBC and to identify how M-PAC, clinical, demographic, and behavioral variables are associated with exercise identity. In this cross-sectional survey, participants were recruited globally via cancer organizations, social media, and research platforms. Validated self-reported measures assessed exercise (Modified Godin Leisure-Time Exercise Questionnaire), reflective processes (affective attitude, instrumental attitude, perceived capability, and perceived opportunity), regulatory processes (regulatory behaviors including self-monitoring, goal-setting, and action planning), and reflexive processes (habit and exercise identity). Structural Equation Modeling (SEM) examined model fit and relationships; regression analyses examined factors associated with exercise identity. Participants (N = 477; Mage = 48.5 ± 15.4; 69.4

The purpose of this state-of-the-art review of reviews was to unify, describe and appraise the relationship between physical activity (PA) and social psychological constructs, using the social dimensions of health behavior (SDHB) framework, which represents a taxonomy of 10 social dimensions applicable to health behaviors. Eligible reviews were published in a peer-reviewed journal in English, included a review in which PA was operationalized as a focal predictor or outcome variable and with data also reported on at least one social construct reported in the results, and published between 2010 and July 2025. Literature searches were completed in August 2025 using seven common databases. The search yielded 54 reviews. We identified limited evidence for reviews of experimental research. Reviews of observational quantitative studies showed associations between PA with injunctive norm, perceived social support, and attachment ties with meta-analysis point estimates in the small, positive effect size range. Reviews of qualitative studies revealed positive associations with PA that covered the entire SDHB framework, yet most were conducted on specific populations so generalizability was not clear. The findings show domains in need of further examination to address gaps in knowledge, opportunities for theoretical integration, and highlight key social dimensions important in PA promotion.

This study investigated the longitudinal associations between adherence to the 24-h Movement Guidelines (24-HMG), specifically, meeting the recommendations for moderate-to-vigorous physical activity (MVPA) (≥ 60 min/day), recreational screen time (≤ 2 h/day), and sleep (9-11 h/night), and one-year changes in physical fitness and body composition among overweight and obese children. Particularly, the study identified whether the number and specific combinations of 24-HMG adherence were associated with more favorable health outcomes in this high-risk pediatric group. A prospective cohort of 337 children aged 6-12 years from six public schools in China was followed for one year. Physical activity, sedentary screen time, and sleep were assessed using triaxial accelerometers, validated questionnaires, and parental reports. Physical fitness was evaluated via the Chinese National Student Physical Fitness Battery, while body composition i.e., body fat percentage (BFP), fat-free mass (FFM), and skeletal muscle mass (SMM), was measured using bioelectrical impedance analysis. Covariates included demographic characteristics and parental support for healthy movement behaviors. Over the follow-up, sleep duration decreased and sedentary time increased, while MVPA showed no significant change. All physical fitness and body composition indicators increased over the one-year period. Adherence to two guidelines, especially those including MVPA, was associated with reductions in BFP and gains in FFM. Combinations of MVPA with reduced sedentary time or adequate sleep showed the strongest associations with improvements in physical fitness and FFM and decreases in BFP. Full adherence to all three guidelines was associated only with improvements in physical fitness and FFM. This study demonstrates that adherence to the 24-HMG, particularly combinations involving MVPA, is associated with improved physical fitness and body composition in overweight and obese children. The underlying mechanisms and intervention evidence warrant further investigation.Level of evidence Level III-well-designed cohort study.

Physical literacy is a pillar of life-long physical activity participation. This study examined the psychometric properties of a virtual assessment protocol for multiple physical literacy sub-components among preschool-aged children (3-5 years). Baseline data were from the Canadian PLAYshop randomized controlled trial involving 130 participants aged 3-5 years and their parents. Children's fundamental movement skills (FMS), motivation, confidence, enjoyment, physical activity, and age were measured. Acceptable inter-rater reliability (10% of videos) for TGMD-3 skills (ICC = 0.88-0.97) and internal consistency for parental-reported children's motivation/enjoyment/confidence (alpha = 0.72) and just the confidence items (2 items; alpha = 0.66) but not for FMS (alpha = 0.51) was observed. Positive correlations of physical activity and age with specific FMS skills provided preliminary support for convergent validity. Overall, findings indicate initial support for the PLAYshop's virtual assessment protocol. However, FMS should not be combined into a total FMS score, and the self-reported children's enjoyment score should be interpreted with caution.

Examine the efficacy and implementation of the expansion of a virtually delivered, parent-focused physical literacy intervention for early childhood called PLAYshop to families experiencing vulnerability. A randomized controlled trial was conducted in 35 parents (intervention: 16; control: 19) of preschool-aged children (3-5 years) from Alberta and British Columbia, Canada. PLAYshop included educational training (i.e. workshop), educational and material (i.e. handouts, active play equipment) resources, and follow-up support via an app with four bi-weekly booster lessons. Primary efficacy outcomes, including parental capability, opportunity, and motivation to support preschool-aged children's physical literacy development, were measured at baseline and post-workshop (intervention group)/1-week post-baseline questionnaire (control group). Secondary implementation outcomes (satisfaction, perceived usefulness, facilitators, barriers, and dose) were measured in the parental questionnaire and explored via parent (n = 11), agency partner staff (n = 9), and workshop leader (n = 3) interviews. Repeated measures analyses of variance (RM ANOVAs) were conducted. Increases in parental capability (i.e. knowledge: partial η2= 0.124; p = .038), opportunity (i.e. perceived availability of resources: partial η2= 0.420; p < .001), and motivation (i.e. confidence: partial η2= 0.128; p = .035) to support preschool-aged children's physical literacy development were observed in the intervention group, compared to the control group. All intervention parents found the workshop useful/extremely useful, were satisfied/extremely satisfied with the workshop content and delivery, and reported in interviews implementing physical literacy-related active play. Recruitment was challenging, and only 31% accessed ≥ 1 booster lesson. Efficacy for the PLAYshop intervention was observed for some outcomes in families experiencing vulnerability. Incorporating PLAYshop into existing programs of partner agencies may address implementation challenges.Trial Registration: NCT05436197.

Biological aging is a rapidly growing area of research, which entails characterizing the rate of aging independent of an individual’s chronological age. In this scoping review, we analyze the results of biological aging research in 435 papers published in a 12 year window spanning 2011 through June 2023, 309 of which focus on non-methylation-based biomarkers, revealing changing patterns of molecular markers of biological aging use over time as well as the development of novel metrics of biological aging. We further identify consistent and discordant research findings, as well as areas of potential future research focusing on questions of measurement with biomarker-based assessment and other variables relevant to the study of biological age.

BACKGROUND:Evidence supports the benefits of physical activity (PA); however, many adults do not achieve recommended PA levels. Identity theories have been used to understand PA, but the antecedents of PA identity remain less clear. PURPOSE:This study presents an exploratory test of a conceptual model predicting PA identity strength using candidate antecedents identified in a recent narrative review. METHODS:A three-week prospective survey was administered to 570 Canadian adults. Time 1 recorded weekly self-reported minutes of moderate-to-vigorous physical activity (MVPA), self-regulation domains and five candidate antecedents-social relatedness, personal investment, perceived capability, PA alignment and priority. PA identity was measured 3 weeks later (Time 2). Using a structural equation modelling approach, we explored the proposed pattern of direct and indirect paths. RESULTS:The model fit the data adequately, χ2 = 795.92, df = 324, CFI = .95, TLI = .95, RMSEA = .05 (90% CI = .05-.06) and SRMR = .07. Significant direct paths to Time 2 identity were observed for Time 1 MVPA, reactive regulation, self-monitoring, relatedness, perceived capability, alignment and priority (β = .11-.34, ps ≤ .04). Indirect paths from Time 1 relatedness, personal investment and priority to Time 2 identity-operating via Time 1 MVPA and self-regulation strategies (especially reactive regulation and self-monitoring)-were also significant (β = .09-.18, ps ≤ .01). CONCLUSION:PA identity may have multivariate inputs. These findings provide preliminary evidence for the proposed conceptual model and experimental work is needed to determine whether modifying these inputs changes PA identity.

Insufficient physical activity (PA) among children remains a public health concern, and parental support is a consistent correlate of child PA. Existing family-based PA interventions have shown modest effects, suggesting a need to address emotional barriers that interfere with parents’ support follow-through. This Phase IIa proof-of-concept study examined the acceptability and perceived feasibility of a remotely delivered Acceptance and Commitment Therapy-informed emotion regulation program for parents of children not meeting PA guidelines, and explored perceived changes in parental support. Twenty-one Canadian parents of children aged 6 to 12 years began three 20 to 30 min parent-only online workshops delivered over three weeks; 15 completed all workshops and 12 completed a semi-structured exit interview. Cross-case thematic analysis generated three themes. Parents described the program as acceptable, accessible, and supportive; reported that strategies were feasible to apply and helped them support PA in more flexible, less perfectionistic, and more values-consistent ways; and identified refinements, including stronger support for sustained engagement, greater interactivity, and child inclusion where appropriate. Findings suggest preliminary promise and support further optimization and mixed-method testing of measurable changes in parental support and child or family PA.

PROBLEM:The postpartum period is associated with poor maternal mental and physical health. BACKGROUND:Parental domestic labor may help support maternal health; little is known about how it may help during the postpartum period. STUDY AIMS:1) describe the trend of father's domestic labor (childcare and housework) across the postpartum period, 2) examine the agreement between perceived and reported domestic labor between mothers and fathers, and 3) explore the relationship between father's domestic labor and parental outcomes. METHODS:These secondary analyses included fathers and mothers from a 6-month longitudinal randomized controlled trial to increase new parents' physical activity (PA) in the postpartum period. Fathers and mothers self-reported their domestic labor (childcare and housework, levels: low [1-25 %], middle [26-50 %] or high [51-75 %]), perceptions of partner's domestic labor, PA, sleep, stress, and physical health at 2-months, 4-months, 6-months, and 8-months postpartum. FINDINGS:Among 164 individuals (52 intact couples, 31.5 ± 4.5 y, 53.6 % mothers, 82.8 % White), fathers self-reported they contributed a middle amount of childcare across time, and initially a high amount of housework (2-months) which was reduced to the middle amount at other time points. Mothers' perception was positively related to fathers' domestic labor. Fathers' perception was positively related to mothers' housework. Fathers were divided into three domestic labor involvement categories; these categories were associated with higher maternal PA. DISCUSSION:These findings highlight the fathers' contribution to domestic labor in the postpartum period, and opportunities to support parental health behaviors. CONCLUSIONS:Interventional evidence is required to optimize domestic labor and new parent's health.

Background: To promote regular physical activity (PA), health promotion campaigns must be relevant to the intended audience based on the process of developing, enacting, or maintaining their PA intentions. Previous research has identified 4 major PA persona profiles of campaign audiences based on intention, behavior, habit, and identity: "nonintenders," "unsuccessful adopters," "successful adopters," and "successful maintainers." To maximize uptake, PA promotion campaigns must also be tailored to the sociodemographic characteristics of the intended audiences. The purpose of this study was to assess sociodemographic differences across these persona profiles. Methods: Secondary cross-sectional analyses were conducted on a pooled sample of 3 survey data sets (ntotal= 8122): a national poll of the Canadian population and audience feedback from 2 Canada-wide PA promotion campaigns. Participants were classified into persona profiles using an existing classification. Univariate and multivariate logistic regression analyses assessed whether persona profiles differed on sociodemographic variables: age category, gender, sexual orientation, duration lived in Canada, race, education, and income. Results: With univariate analyses, persona profiles could be characterized by age, gender, sexual orientation, disability, race, and income; odds ratios ranged from very small to small. With multivariate analysis, disability (odds ratio: 1.68-2.51) and sexual orientation (odds ratio: 1.90-2.14) were the most distinct of other persona profiles compared with "successful maintainers." Conclusions: Participants with disability or who identified as 2SLGBTQIA+ (Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Intersex, and Asexual) were the least likely to enact or maintain PA intentions. These audiences with lower societal privilege are most likely to need tailored PA promotion campaign content addressing unique barriers and facilitators to becoming "successful maintainers."

Background: Young men experience substantial mental health and mortality-related risks, yet they often do not engage in conventional health promotion programs. This highlights the need for gender-specifc interventions that are acceptable, engaging, and feasible for young men. Purpose of Research: Guided by self-determination theory, this single-group proof-of-concept study evaluated the feasibility and acceptability of a dual-component intervention combining an in-person nature-based intervention (NBI; two days of group activities and guided reflection in a forested park) and a subsequent virtually supported resistance training (RT) program for young men and explored secondary, exploratory pre- to post-changes in depressive and anxiety symptoms. Methods: Eight men aged 18-34 not meeting RT recommendations (i.e., <2 sessions/week) completed a two-day, in-person NBI followed by six weeks of virtually supported RT with weekly group check-ins. Primary feasibility outcomes were satisfaction and qualitative acceptability for NBI/RT, recruitment, retention, and adherence. Secondary, exploratory quantitative outcomes were pre- to post-changes in depressive and anxiety symptom scores. Brief semi-structured exit interviews were conducted at the study end and audio-recorded for analysis. Results: Satisfaction met a priori thresholds for both components (NBI = 3.4/4; RT = 4.3/5; criteria ≥ 3.0 and ≥ 3.5). Recruitment was 46% and retention 100%, exceeding the 42% and 80% criteria, respectively. Exit interview themes highlighted guided learning, accountability, and feeling more connected to nature as acceptability drivers, with the scheduling burden noted but manageable. Depressive and anxiety symptom scores were lower post-intervention. Conclusions: Challenges in recruitment, group dynamics, and participant selection require refinement before the next phase; however, high satisfaction with both the NBI and RT segments, together with improvements in anxiety and depression symptom scores, supports progressing to a feasibility trial once these enhancements are in place.

BackgroundOne in 10 preschoolers (aged 3-4 y) meet the three 24-hour Movement Guidelines, that is, (1) physical activity, (2) sedentary screen time, and (3) sleep. ObjectiveThe overarching aim of this study is to evaluate the effectiveness and feasibility of a 12-week mobile health home-based intervention on 24-hour movement behaviors in preschoolers who meet few guidelines (zero or 1 guideline). MethodsWe will conduct a 12-week randomized controlled trial with a wait-list control in 80 families (40 per arm). Preliminary studies in this population informed intervention app content, features, and app development. Behavior change theories, including transfer theory and the multi-process action control framework, helped inform content presentation and topics. Primary outcomes include device-based and parent-report measures of 24-hour movement behaviors, and the secondary outcome is the feasibility and acceptability of the app. Exploratory outcomes include preschoolers’ cognitive and motor skills, changes within the home environment, and behavioral control processes. ResultsThis 2-phase study (K99/R00) received initial funding in March 2022, and preliminary studies were concluded in December 2023. The main grant received institutional review board approval in April 2024, and the grant funding began in May 2024. The study was registered in Clinical Trials in October 2024 and enrolled its first participant in January 2025. As of October 2025, the study has enrolled 39 families. We anticipate the trial will be completed in late 2026. ConclusionsThis research is designed to test a novel approach to improve all three 24-hour movement behaviors in preschoolers in home settings by using a mobile app. Results from this study will have implications for future 24-hour movement interventions, our understanding of improving all 3 behaviors, and ultimately, improvements in preschoolers’ health. Trial RegistrationClinicaltrials.gov NCT06667661; https://clinicaltrials.gov/study/NCT06667661 International Registered Report Identifier (IRRID)DERR1-10.2196/75621

OBJECTIVES:Exercise-induced affective responses (ARs) may encourage people with chronic diseases (PCD) to engage in future physical activity (PA). This study examined whether AR timing during exercise predicts daily moderate-to-vigorous PA (MVPA) in PCD and explored two mediating pathways: the reflective affect processing pathway (via remembered pleasure, forecasted pleasure and affective attitudes) and the self-efficacy pathway (via self-efficacy towards exercise and PA). DESIGN:Prospective correlational design. METHODS:A total of 109 adults (Mage = 66.6 years, 79% women) with chronic diseases reported ARs and perceived exertion four times during an exercise session. Post-exercise measures included remembered and forecasted pleasure, BMI, affective attitudes and self-efficacy. Daily MVPA was measured using accelerometers over eight days. Total PA (light-intensity PA and MVPA) was examined as a secondary outcome. RESULTS:The last AR predicted daily MVPA (β = .24, p = .041), but this association became non-significant after adjusting for confounders (BMI, perceived exertion). In contrast, the last AR predicted total PA independently of confounders (β = .30, p = .008). Exploratory mediation analyses partially supported the reflective affect processing pathway: ARs predicted affective attitudes via remembered and forecasted pleasure, though affective attitudes did not predict either PA outcome. The self-efficacy pathway was supported for MVPA only, albeit with a modest indirect effect (β = .05). CONCLUSIONS:The last AR did not predict daily MVPA after adjusting for confounders, questioning a spillover effect from exercise sessions to MVPA. Secondary analyses suggest the last AR may predict total PA regardless of confounders, hinting at an intensity-specific spillover. Findings should be interpreted cautiously given the limited sample size and the exploratory nature of secondary analyses.