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      PEAK Mood, Mind, and Marks: a pilot study of an intervention to support university students’ mental and cognitive health through physical exercise

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          Abstract

          Introduction

          Regular exercise has the potential to enhance university students’ mental and cognitive health. The PEAK Mood, Mind and Marks program (i.e., PEAK) is a neuroscience-informed intervention developed using the Behaviour Change Wheel to support students to exercise three or more times per week to benefit their mental and cognitive health. This pilot study assessed the impact of PEAK on exercise, mental and cognitive health, and implementation outcomes.

          Methods

          PEAK was delivered to 115 undergraduate university students throughout a 12-week university semester. The primary outcome was weekly exercise frequency. Secondary outcomes were: time spent engaged in moderate-vigorous exercise, sedentary behaviour and perceived mental health and cognitive health. All were measured via online self-report questionnaires. Qualitative interviews with 15 students investigated influences on engagement, the acceptability and appropriateness of PEAK, and its mechanisms of behaviour change. Paired t-tests, Wilcoxon Signed-Rank tests and template analysis were used to analyse quantitative and qualitative data, respectively.

          Results

          On average, 48.4% of students engaged in the recommended frequency of three or more exercise sessions per week. This proportion decreased towards the end of PEAK. Sedentary behaviour significantly decreased from baseline to end-point, and moderate-vigorous exercise significantly increased among students’ who were non-exercisers. Mental wellbeing, stress, loneliness, and sense of belonging to the university significantly improved. There were no significant changes in psychological distress. Concentration, memory, and productivity significantly improved. Sixty-eight percent of students remained engaged in one or more components of PEAK at end-point. Qualitative data indicated students found PEAK to be acceptable and appropriate, and that it improved aspects of their capability, opportunity, and motivation to exercise.

          Conclusions

          Students are receptive to an exercise-based program to support their mental and cognitive health. Students exercise frequency decreased; however, these figures are likely a conservative estimate of students exercise engagement. Students valued the neuroscience-informed approach to motivational and educational content and that the program’s goals aligned with their academic goals. Students identified numerous areas PEAK’s content and implementation can be optimised, including use of a single digital delivery platform, more opportunities to connect with peers and to expand the content’s cultural inclusivity.

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          A Global Measure of Perceived Stress

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            International physical activity questionnaire: 12-country reliability and validity.

            Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.
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              The behaviour change wheel: A new method for characterising and designing behaviour change interventions

              Background Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. Methods A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity. Results Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence's guidance on reducing obesity. Conclusions Interventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Research is needed to establish how far the BCW can lead to more efficient design of effective interventions.
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                Author and article information

                Contributors
                URI : https://loop.frontiersin.org/people/2381127Role: Role: Role: Role: Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/686784Role: Role: Role: Role: Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/556100Role: Role: Role: Role: Role: Role: Role: Role: Role:
                URI : https://loop.frontiersin.org/people/1202301Role: Role: Role: Role: Role:
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                URI : https://loop.frontiersin.org/people/45197Role: Role:
                URI : https://loop.frontiersin.org/people/85256Role: Role: Role: Role: Role: Role: Role: Role: Role: Role:
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                10 June 2024
                2024
                : 15
                : 1379396
                Affiliations
                [1] 1BrainPark, Turner Institute for Brain and Mental Health, Monash University , Melbourne, VIC, Australia
                [2] 2Centre for Behaviour Change, University College London , London, United Kingdom
                [3] 3Queensland Institute of Medical Research (QIMR) Berghofer Medical Research Institute , Brisbane, QLD, Australia
                Author notes

                Edited by: Maj Britt Dahl Nielsen, University of Southern Denmark, Denmark

                Reviewed by: Eric Hall, Elon University, United States

                Eleanor Dommett, King’s College London, United Kingdom

                *Correspondence: Catherine E. B. Brown, catherine.brown4@ 123456monash.edu

                †These authors have contributed equally to this work and share senior authorship

                Article
                10.3389/fpsyt.2024.1379396
                11194434
                38915845
                f1feba76-a109-4fbb-aa12-38e515d6c6e7
                Copyright © 2024 Brown, Richardson, Halil-Pizzirani, Hughes, Atkins, Pitt, Yücel and Segrave

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 31 January 2024
                : 13 May 2024
                Page count
                Figures: 7, Tables: 5, Equations: 0, References: 101, Pages: 19, Words: 10094
                Funding
                The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was supported by nib foundation. The nib foundation had no role in the design of the study and collection, analysis, and interpretation of data, and in writing the manuscript. The views expressed are those of the authors and not necessarily those of the nib foundation.
                Categories
                Psychiatry
                Original Research
                Custom metadata
                Public Mental Health

                Clinical Psychology & Psychiatry
                university students,physical exercise,mental health,cognitive health,brain health,behavioural intervention,implementation evaluation,com-b

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