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Healy L.C.,Newman University | Ntoumanis N.,Curtin University Australia | van Zanten J.J.C.S.V.,University of Birmingham | Paine N.,Concordia University at Montreal | Paine N.,Montreal Behavioral Medicine Center
Journal of Sport and Exercise Psychology | Year: 2014

This investigation sought to clarify mixed results in the literature exploring coach behaviors, basic psychological needs, goal motivation, and well- and ill-being. Regional-level team sport athletes (N = 241) completed questionnaires on the aforementioned variables at the beginning of the season. A subsample (n = 70) provided saliva samples to assess physical ill-being. At the end of the season, athletes (n = 98) reported their goal motivation and attainment. Structural equation modeling demonstrated that coach behaviors were related to needs satisfaction and thwarting, which were related to autonomous and controlled goal motives respectively. Autonomous motives were related to well- and ill-being; controlled motives were only related to ill-being. Over time, only end-of-season autonomous goal motives were related to goal attainment. The findings provide an insight into how coaches can facilitate optimum goal striving and well-being in their athletes. © 2014 Human Kinetics, Inc. Source


Rash J.A.,University of Calgary | Lavoie K.L.,University of Quebec at Montreal | Lavoie K.L.,Montreal Behavioral Medicine Center | Sigal R.J.,University of Calgary | And 4 more authors.
Contemporary Clinical Trials | Year: 2016

Background: Statins are a class of medications that are particularly effective for lowering cholesterol and reducing cardiovascular morbidity and mortality. Despite a range of benefits, non-adherence to statin medication is prevalent with 50% to 75% of patients failing to adhere to treatment within the first 2-years. A previous review on interventions to improve adherence to cholesterol lowering medication concluded that rigorous trials were needed with emphasis on the patient's perspective and shared decision making. Motivational interviewing (MInt) is a promising patient-centered approach for improving adherence in patients with chronic diseases. This manuscript describes the rational and design of a randomized controlled trial (RCT) testing the efficacy of MInt in improving adherence to statin medication. Methods: Patients filling their first statin prescription will be recruited to complete a 6-month observation run-in period (phase-1) after which medication possession ratio (MPR) will be assessed. Patients meeting criteria for non-adherence (MPR ≤ 60%) will be invited to participate in the trial. 336 non-adherent new statin users will undergo a fasting lipid panel, complete baseline questionnaires, and be randomly allocated to receive four sessions of adherence education delivered using MInt (EdMInt) or to an education control (EC) delivered at 3-month intervals. Final assessments will occur 12-months after the first EdMInt or EC session. The primary outcome is change in MPR adherence to statin medication from baseline to 12-months. Secondary outcomes include within-patient change in self-reported medication adherence, stage of change and self-efficacy for medication adherence, motivation to adhere to statin medication, and lipid profile. © 2016 Elsevier Inc. Source


Rash J.A.,University of Calgary | Lavoie K.L.,University of Quebec at Montreal | Lavoie K.L.,Montreal Behavioral Medicine Center | Feldman R.D.,University of Western Ontario | Campbell T.S.,University of Calgary
Current Cardiovascular Risk Reports | Year: 2014

Elevated blood pressure (BP) accounts for the largest global proportion of disease burden and is largely treatable through the use of antihypertensive medications. Adherence to antihypertensive medication may be defined as the extent to which patient behavior coincides with recommendations agreed upon by the health-care provider and the patient and encompasses initiation, implementation, and discontinuation. Despite the proven clinical efficacy of antihypertensive medications to control BP, approximately half of treated patients are nonadherent. Nonadherence to antihypertensive medications is a multifactorial concern. Barriers to antihypertensive medication adherence are numerous and include patient-related (e.g., beliefs about medication, motivation, mental health), provider-related (e.g., patient-provider communication, failure to appropriately escalate treatment), therapy-related (e.g., an asymptomatic disease, side effects, complexity of regimens), and system-related (e.g., medication cost, health literacy, uncoordinated delivery of services) influences. Several techniques to improve adherence to antihypertensive medications have been identified, with sufficient supporting evidence from randomized trials to inform clinical practice recommendations. This review summarizes the current understanding of the prevalence and impact of the failure to adhere to the medical management of hypertension. Factors linked to improved adherence and studies that assessed strategies to improve adherence are also summarized. © 2014, Springer Science+Business Media New York. Source


Rossi A.M.,Montreal Behavioral Medicine Center | Rossi A.M.,Montreal Heart Institute | Rossi A.M.,Concordia University at Montreal | Davies E.,Montreal Behavioral Medicine Center | And 17 more authors.
Obesity | Year: 2013

Objective: There is limited information regarding the synergistic or additive effects of metabolic syndrome (MS) and endothelial dysfunction (ED) on cardiovascular disease (CVD). Altered cardiovascular responses to exercise have been shown to predict future cardiovascular events as well as assess autonomic function. The present study evaluated the impact of MS and brachial artery reactivity (a proxy of ED) on peak exercise-induced cardiovascular changes. Design and Methods: Individuals (n = 303) undergoing a standard nuclear medicine exercise stress test were assessed for MS. Participants underwent a Forearm Hyperaemic Reactivity test and were considered to have dysfunctional reactivity if their rate of uptake ratio (RUR) was <3.55. Resting and peak blood pressure (BP) and heart rate (HR) were measured. Reactivity was calculated as the difference between peak and resting measures. Results: Analyses, adjusting for age, sex, resting HR, total metabolic equivalents (METs), and a history of major CVD, revealed a main effect of MS (F = 5.51, n2 = 0.02, P = 0.02) and RUR (F = 6.69, n2 = 0.02, P = 0.01) on HR reactivity, such that patients with MS and/or poor RUR had reduced HR reactivity. There were no interactive effects of RUR and MS. There were no effects of RUR or MS on systolic BP (SBP) or diastolic BP (DBP) reactivity or rate pressure product (RPP) reactivity. Conclusions: The presence of decreased HR reactivity among participants with MS or poor brachial artery reactivity, combined with the lack of difference in other exercise-induced cardiovascular changes, indicates that these patients may have some degree of parasympathetic dysregulation. Further longitudinal studies are needed to understand the long-term implications of MS and endothelial abnormalities in this context. Source

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