1. Physical Activity in the Big Picture: Quality of Life, Well-Being, and Happiness EPHE 348

2. Terms Emotional well-being – Greater amount of positive or negative affect that leads to satisfaction with life Emotion (e.g., fear, pride) – States following an event (mental processing attached to the event) Mood (e.g., irritation, cheerfulness) – States that have a cognitive basis but may persist, and have no defining event Affect (e.g., tension, calmness) – Valenced response that does not require cognition

3. Quality of Life Describes both the subjective and objective evaluations of the “goodness” of one’s life overall and the domains that make-up one’s life

4. WHO

5. HRQOL Subcomponent that reflects the “goodness” of those dimensions that can be affected by health Disagreement over the important and relevant dimensions.

6. Satisfaction The ultimate outcome? Happiness & Satisfaction– total function – Vitality – Social – Functional – Physical – Spiritual – Meaningfulness/purpose

7. Measurement Objective vs. Subjective Domain approach vs. Generalized approach Generic vs. Disease specific

8. Moderators of QOL: Personality Optimism – shown to affect QOL post treatment for medical conditions – Looking on the bright side or just less realistic? Neuroticism – More daily negative affect Extraversion – Positive affect and tendency to have stronger social ties (buffer?)

9. Moderators of QOL: Beliefs Sense of control – Over pain – Over treatment – Over outcomes of daily living Religious or spiritual beliefs – Preliminary evidence for higher QOL

10. Moderators of QOL: Values Weight of importance on each domain – Former athletes? – Regular exercisers?

11. PA & QOL PA & HRQOL shows a positive relationship (small effect) in the general populace (Bize et al., 2007) PA & Happiness is a often a small to negligible effect. Lack of true experimental and longitudinal studies

12. Blacklock et al. (2007) Random sample of 341 adults Measured sociodemographics, SF-36, and self- reported walking and physical activity

13. QOL and Sociodemographics

14. QOL & Walking

15. QOL with Physical Activity

16. PA & QOL Cont. PA & QOL related with a medium ES in ageing populations (McAuley et al., 2006). Mechanisms also supported PA Task Efficacy Activities of Daily Living Physical QOL Satisfaction with Life

17. Research Focus: Cancer Survivors Conducted a randomized controlled trial to determine if exercise could improve QOL in cancer survivors beyond the known benefits of group psychotherapy (GP). Matched 22 GP classes (N=108) on content and then randomly assigned 11 (n=48) to GP alone and 11 (n=60) to GP plus home-based, moderate- intensity exercise (GP+EX). Participants completed a physical fitness test and QOL measures at the beginning and end of GP classes (about 10 weeks). We had excellent recruitment (81%), retention (89%), and adherence (84%) rates and a modest contamination (22%) rate.

18. Research Focus Using intention-to-treat repeated measures analyses of variance, we found significant Time by Condition interactions for functional well-being, fatigue, and sum of skinfolds. All interactions favored the GP+EX condition. Courneya, K.S., Friedenreich, C.M., Sela, R., Quinney, H.A., Rhodes, R.E., & Handman, M. (2003). The group psychotherapy and home-based physical exercise (GROUP-HOPE) trial in cancer survivors: Physical fitness and quality of life outcomes. Psycho-Oncology, 12, 357-374.

19. Fatigue

20. Functional Well-Being

21. Physical Well-Being

22. Practical Applications Passion vs. zealotry – Improving quality of life first – Physical activity has a role but it may not be the same for all Health Promotion vs. Health Facisim – Educate and facilitate but respect the right to decline – Removal of civil liberties via sedentary choices? – Do we know what is “good” for everybody?