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To better explain daily fluctuations in physical activity and sedentary behavior, investigations of motivation are turning from social cognitive frameworks to those centered on affect, emotion and automaticity, such as the Affect and Health Behavior Framework (AHBF), Integrated Framework and Affective-Reflective Theory (ART). This shift has necessitated: (a) re-examination of older theories and their constructs, such as drives, needs and tensions and (b) an inspection of competing theories from other fields that also attempt to explain dynamic changes in health behaviors. The Dynamical Model of Desire, Elaborated Intrusion Theory and others commonly share with AHBF the idea that human behavior is driven strongly by desires and/or the similar concepts of wants, urges, and cravings. These affectively-charged motivation states (ACMS) change quickly and may better explain physical activity behavior from one moment to the next. Desires for movement predominantly derive from negative but also positive reinforcement. Data from clinical populations with movement dysfunction or psychiatric disorders provides further evidence of these drivers of movement. Those with Restless Legs Syndrome, akathisia, tic disorders and exercise dependence all report strong urges to move and relief when it is accomplished. Motor control research has identified centers of the brain responsible for wants and urges for muscular movement. Models elaborated herein differentiate between wants, desires, urges and cravings. The WANT model (Wants and Aversions for Neuromuscular Tasks) conceptualizes desires for movement and rest as varying by magnitude, approach or avoidance-orientation (wants versus aversions) and as occupying independent dimensions instead of opposite ends of the same axis. For instance, one hypothetically might be in a state of both high desire for movement and rest simultaneously. Variations in motivation states to move and rest may also be associated with various stress states, like freezing or fight and flight. The first validated instrument to measure feelings of desire/want for movement and rest, the CRAVE Scale (Cravings for Rest and Volitional Energy Expenditure) is already shedding light on the nature of these states. With these advances in theory, conceptual modeling and instrumentation, future investigations may explore the effects of desires and urges for movement and sedentary behavior in earnest. Copyright © 2020 Stults-Kolehmainen, Blacutt, Bartholomew, Gilson, Ash, McKee and Sinha.

Background: Numerous barriers to moderate to vigorous physical activity exist for youths with type 1 diabetes (T1D). The virtual exercise games for youth with T1D (ExerT1D) intervention implement synchronous support of moderate to vigorous physical activity including T1D peers and role models. Objective: This study aims to understand the acceptability of this intervention to participants. Methods: We conducted postprogram, semistructured, televideo interviews with participating youths to elicit perspectives on the acceptability of the intervention and experience with the program. Two coders independently reviewed and analyzed each transcript using a coding scheme developed inductively by senior researchers. Discrepancies were resolved by team discussion, and multiple codes were grouped together to produce 4 main thematic areas. Results: All 15 participants provided interviews (aged 14-19 years; 2 nonbinary, 6 females; median hemoglobin A1c level of 7.8% (IQR 7.4%-11.2%), 5 with a hemoglobin A1c level of ≥10%). Qualitative data revealed four themes: (1) motivation to engage in physical activity (PA)—improving their physical capabilities and stabilizing glucose levels were cited as motivation for PA and challenges of living with T1D were cited as PA barriers; (2) experience with and motivation to manage diabetes while engaging in PA—participants provided details of accommodating the inherent uncertainty or limitations of PA with diabetes and sometimes preparing for PA involved psychological and motivational adjustments while some relayed feelings of avoidance; (3) peer support encouraged engagement with the intervention—participants appreciated the peer aspects of components of ExerT1D and participants’ reflections of the facilitated group experience highlight many benefits of a small-group virtual program; and (4) improvements in PA and diabetes self-management efficacy—all participants credited the program with improving or at least raising awareness of T1D management skills. Conclusions: Our virtual PA intervention using an active video game and discussion component provided adolescents with T1D the confidence and peer support to engage in PA, improved awareness of diabetes-specific tasks to prepare for exercise, and improved understanding of the effect of PA on glucose levels. Engaging youths with a virtual video game intervention is a viable approach to overcome barriers to PA for adolescents with T1D. Trial Registration: ClinicalTrials.gov NCT05163912; https://clinicaltrials.gov/ct2/show/NCT05163912

Background/ObjectiveMany adolescents with type 1 diabetes do not achieve 60 minutes of daily moderate-to-vigorous intensity physical activity (MVPA). Recognizing the importance of peer influence during adolescence, we evaluated the feasibility and safety of a group MVPA intervention for this population. MethodsEighteen adolescents with type 1 diabetes (age 14.12 .3 years, female 67%, black or Latino 67%, median body mass index 92%ile, A1c 79.925.1 mmol/mol, 9.5 +/- 2.3%). Intervention sessions (35minutes MVPA and 45minutes discussion) occurred 1x/week for 12weeks. Feasibility and safety metrics were enrollment, completion of intervention and assessments, cost, and hypoglycemia rates. Participants completed MVPA (accelerometry), and exploratory nutritional, psychosocial, clinical, and fitness variable assessments at baseline, 3 months, and 7 months. Hedges' effect sizes were calculated. ResultsEnrollment was 16%, and intervention completion was 56%. Assessment completion at 7 months was 67% for MVPA, nutrition, and fitness, 83% for psychosocial assessments, and 94% for clinical assessments. Cost was $1241 per completing participant. One episode of mild hypoglycemia occurred during the sessions (0.6%). Self-reported daily fruit/vegetable servings (d=-0.72) and diabetes self-management behaviors decreased over time (d=-0.40). In the 10 completers, endurance run score improved (d=0.49) from low baseline levels, while systolic blood pressure decreased (d=-0.75) and low-density lipoprotein increased (d=0.49) but stayed within normal ranges. ConclusionsThe protocol for the group MVPA intervention was safe and had some feasibility metrics meriting further investigation. MVPA levels and glycemic control remained suboptimal, suggesting the need for more intensive interventions for this population.

The recent explosion of wearable technology and the associated concerns prompted the International Federation of Sports Medicine (FIMS) to create a quality assurance standard for wearable devices, which provides commissioned testing of marketing claims and endorsement of commercial wearables that test favorably. An open forum as announced in the conference advertising was held at the Annual Meeting of the New England Regional Chapter of the American College of Sports Medicine (NEACSM) November 7 to 8, 2019, in Providence, Rhode Island, USA for attending NEACSM members to voice their input on the process. Herein, we report the proceedings. The round table participants perceived the quality assurance standard to be important, but identified some practical process challenges that included the broad scope and complexity of the device universe, the need for a multiphase testing pathway, and the associated fees for product evaluation. The participants also supported the evaluation of device data analysis, behavioral influences, and user experience in the overall evaluation. Looking forward, the FIMS quality assurance standard faces the challenge of balancing these broader perspectives with practical constraints of budget, facilities, time, and human resources. © 2020 by the American College of Sports Medicine.

Physical activity, and likely the motivation for it, varies throughout the day. The aim of this investigation was to create a short assessment (CRAVE: Cravings for Rest and Volitional Energy Expenditure) to measure motivation states (wants, desires, urges) for physical activity and sedentary behaviors. Five studies were conducted to develop and evaluate the construct validity and reliability of the scale, with 1,035 participants completing the scale a total of 1,697 times. In Study 1, 402 university students completed a questionnaire inquiring about the want or desire to perform behaviors "at the present moment (right now). " Items related to physical activity (e.g., "move my body") and sedentary behaviors (e.g., "do nothing active"). An exploratory structural equation model (ESEM) revealed that 10 items should be retained, loading onto two factors (5 each for Move and Rest). In Study 2, an independent sample (n = 444) confirmed these results and found that Move and Rest desires were associated with stage-of-change for exercise behavior. In Study 3, 127 community-residing participants completed the CRAVE at 6-month intervals over two years- two times each session. Across-session interclass correlations (ICC) for Move (ICC = 0.72-0.95) and Rest (ICC = 0.69-0.88) were higher than when they were measured across 24-months (Move: ICC = 0.53; Rest: ICC = 0.49), indicating wants/desires have state-like qualities. In Study 4, a maximal treadmill test was completed by 21 university students. The CRAVE was completed immediately pre and post. Move desires decreased 26% and Rest increased 74%. Changes in Move and Rest desires were moderately associated with changes in perceived physical fatigue and energy. In Study 5, 41 university students sat quietly during a 50-min lecture. They completed the CRAVE at 3 time points. Move increased 19.6% and Rest decreased 16.7%. Small correlations were detected between move and both perceived energy and tiredness, but not calmness or tension. In conclusion, the CRAVE scale has good psychometric properties. These data also support tenets of the WANT model of motivation states for movement and rest (Stults-Kolehmainen et al., 2020a). Future studies need to explore how desires to move/rest relate to dynamic changes in physical activity and sedentarism. Copyright © 2021 Stults-Kolehmainen, Blacutt, Fogelman, Gilson, Stanforth, Divin, Bartholomew, Filgueiras, McKee, Ash, Ciccolo, Brotnow Decker, Williamson and Sinha.

Millions of consumer sport and fitness wearables (CSFWs) are used worldwide, and millions of datapoints are generated by each device. Moreover, these numbers are rapidly growing, and they contain a heterogeneity of devices, data types, and contexts for data collection. Companies and consumers would benefit from guiding standards on device quality and data formats. To address this growing need, we convened a virtual panel of industry and academic stakeholders, and this manuscript summarizes the outcomes of the discussion. Our objectives were to identify (1) key facilitators of and barriers to participation by CSFW manufacturers in guiding standards and (2) stakeholder priorities. The venues were the Yale Center for Biomedical Data Science Digital Health Monthly Seminar Series (62 participants) and the New England Chapter of the American College of Sports Medicine Annual Meeting (59 participants). In the discussion, stakeholders outlined both facilitators of (e.g., commercial return on investment in device quality, lucrative research partnerships, and transparent and multilevel evaluation of device quality) and barriers (e.g., competitive advantage conflict, lack of flexibility in previously developed devices) to participation in guiding standards. There was general agreement to adopt Keadle et al.’s standard pathway for testing devices (i.e., benchtop, laboratory, field-based, implementation) without consensus on the prioritization of these steps. Overall, there was enthusiasm not to add prescriptive or regulatory steps, but instead create a networking hub that connects companies to consumers and researchers for flexible guidance navigating the heterogeneity, multi-tiered development, dynamicity, and nebulousness of the CSFW field. © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.