Promoting health behavior change presents an important challenge to theory and research in the field of health psychology. In this paper, we introduce a context-driven approach, the Acceptance and Commitment Therapy (ACT) model which is built on Relational Frame Theory. The ACT-based intervention aims to promote individuals’ new health behavior patterns through the improvement of the key construct of psychological flexibility, which is defined as the ability to contact the present moment more fully with acceptance and mindfulness as a conscious human being. Building on the psychological flexibility model, implemented through the six core ACT processes, individuals improve maintenance of long term health behavior change through committed acts in service of chosen values while acknowledging and accepting the existence of contrary thoughts, rules, and emotions as part of themselves but not determinant of their behaviors. Taking advantage of this context-driven approach of health behavior change, we recommend researchers and practitioners to design their health behavior change intervention programs based on ACT.

The purpose of this study was to construct and validate a “Perceived Physical Literacy Instrument” (PPLI) for physical education teachers. Based on literature review and focus group interviews, an 18-item instrument was developed for the initial tests. This self-report measure, using a 5-point Likert scale, formed the PPLI and was administered to 336 physical education teachers in Hong Kong. The sample was randomly split, and exploratory and confirmatory factor analyses resulted in a 9-item, 3-factor scale. Exploratory factor analysis (EFA) item loadings ranged from 0.69 to 0.87, and Cronbach’s alpha ranged from 0.73 to 0.76. Confirmatory factor analysis (CFA) showed that the construct demonstrated good fit to the model. The PPLI thus appeared to be reliable and valid to measure the perceived physical literacy of physical education teachers. It is argued that the instrument can be used for both research and applied purposes and potential uses for the instrument in physical education, medical and health settings are discussed.

The purpose of the present study was to examine the psychometric properties of the Chinese version of the Acceptance and Action Questionnaire–II (AAQ-II) across two samples of Chinese college students (n = 183 and n = 366) and a sample of elite Chinese athletes (n = 330). Exploratory and confirmatory factor analyses supported the existence of a unidimensional AAQ-II. Adequate internal consistency reliability, test–retest reliability (one-month interval), factorial validity, and nomological validity with mindfulness, well-being, positive and negative affect/mood for both students and athletic samples were demonstrated. The AAQ-II also showed incremental validity in college students in explaining variances of well-being, positive and negative affect, anxiety, and depression, beyond the mindfulness measure. Most important, factorial invariance of the AAQ-II was demonstrated across male and female college students as well as across male and female athletes. Partial factorial invariance was also demonstrated across adolescent and adult athletes. Overall, results of this study suggest that the Chinese version of the AAQ-II may be a useful self-report measure of experiential avoidance in Chinese college students and elite Chinese athletes.

Background: This study translated the International Positive and Negative Affect Schedule Short Form (I-PANAS-SF) into Chinese and examined its factor structure and measurement invariance in Chinese adolescents in Hong Kong. Methods: A sample of 4136 Chinese adolescents in Hong Kong was invited to complete a set of questionnaires. The factor structure of the I-PANA-SF was examined using confirmatory factor analysis (CFA) and exploratory structural equational modeling (ESEM). Internal consistency reliability was evaluated using Cronbach’s alpha coefficients, and nomological validity was assessed using bivariate correlations between positive affect (PA) and negative affect (NA) subscales with effort, worry and lack of concentration. Finally, measurement invariance across genders and grades was examined to evaluate the invariance of the I-PANAS-SF. Results: Factor structure analysis suggested that the ESEM model outperformed the CFA model. The results of ESEM analysis indicated that one item (“alert”) was problematic and a 9-item two-factor measurement model with that item removed was a better fit for the data. The Cronbach’s alpha values were above 0.70 (0.81 and 0.83), revealing excellent internal consistency reliability. The PA subscale was positively associated with effort and negatively associated with worry and lack of concentration. The NA subscale was negatively associated effort and positively associated with lack of concentration and worry, indicating nomological validity. Finally, measurement invariance analysis revealed strict invariance across genders and grades. Conclusions: The results of the study provide preliminary support for validity and reliability of the 9-item Chinese version of the I-PANAS-SF and suggest that it is suitable for use among Chinese adolescents in Hong Kong.

Mental health literacy (MHL) is recognised as a major factor in whether athletes seek help when they experience mental health difficulties. Therefore, the current study aimed to provide a systematic review of the effectiveness of MHL training programmes in improving mental health knowledge and help-seeking and reducing stigma among athletes. To identify intervention studies of MHL programmes, five electronic databases were systematically searched for articles published before May 2020. The selection procedure was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All kinds of study designs were included. Effect sizes were calculated for mental health knowledge, stigma reduction and help-seeking attitudes, intentions and behaviours. Risk of bias was assessed for each study using the Cochrane tool and the Newcastle–Ottawa quality assessment scale. Five studies (1239 participants in total) were selected for review. Overall, either small or medium effects were found for mental health knowledge, stigma reduction, help-seeking attitudes, and intentions for post- and follow-up interventions, whereas a null effect was found in help-seeking behaviours for both post- and follow-up interventions. Furthermore, three studies had a low risk of bias, and two had a high risk of bias. MHL interventions can enhance help-seeking attitudes and intentions and mental health knowledge and reduce stigma but do not increase help-seeking behaviours for now. Further studies should evaluate interventions to enhance help-seeking behaviours. Furthermore, the methodological quality of studies, including randomized controlled trials and other designs, should be improved in future research.

The purpose of the current study was to develop and validate a sport-specific mindfulness measure, the Athlete Mindfulness Questionnaire (AMQ), through 5 related studies using 4 separate samples of Chinese athletes. The AMQ is a 3-factor measure designed to assess mindfulness that reflects present-moment attention, awareness, and acceptance in a sport context. In Study 1, an initial pool of items was generated based on previous literature, existing mindfulness scales, as well as interviews with and feedback from the athletes, coaches, and mindfulness experts. Initial support for the 3-factor structure of the AMQ was established via exploratory factor analysis in Study 2, and cross-validated through confirmatory factor analysis in Studies 3 and 4. In Study 5, a modified 3-factor AMQ with direct-worded acceptance items was examined in a fourth independent sample. Convergent and concurrent validities of the acceptance subscale failed to be established in Studies 3 and 4 which may be due to the inattention and confusion of the athletes whilst interpreting the reverse-worded items. A modified 16-item AMQ in Study 5 displayed satisfactory model fit and acceptable internal consistencies. Most importantly, convergent and concurrent validities of the 16-item AMQ were supported. The 3 subscales showed significant positive associations with mindfulness, flow, well-being, and positive affect and significant negative associations with experiential avoidance, burnout, and negative affect. The AMQ is a psychometrically sound measure of mindfulness in a sport context. The importance of using direct-worded acceptance items is discussed.