Zooming in on the Effects: a Controlled Trial on Motivation and Exercise Behaviour in a Digital Context
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Abstract
This study is a description of a short-term digital exercise intervention based on the theoretical framework self-determination theory and tested in a controlled trial. The sample consisted of 318 adult women (n = 279) and men (n = 40) aged 23–67 years (M = 46.7; SD = 9.4) participating in a digital step contest provided by their employer. All participants completed study baseline measures via validated web-based versions of the following instruments: Basic Psychological Needs in Exercise Scale, Behavioural Regulations in Exercise Questionnaire-2, and Leisure Time Exercise Questionnaire. These measures were repeated twice, 3 weeks (post-intervention) and 6 weeks (follow-up) after study baseline. The experimental group had access to the intervention platform for three weeks. Data were analysed by analyses of covariance and mediation variable analysis. Results showed the intervention to affect exercise level and intensity as well as basic psychological need satisfaction and behavioural regulations. Intervention effects on amotivation post-intervention were found to mediate total exercise behaviour at follow-up. Moderation analyses showed intervention effects on light exercise to be stronger for those participants engaging in moderate or high levels of light activities at study baseline. Also, the effect on identified regulation was stronger for those with low levels of identified regulation at study baseline. This study adds to the knowledge on exercise motivation based on short-term intervention effects on level and intensity of exercise and physical activity. The use of mediating and moderating analyses uncover processes underlying the main intervention effects. Findings are discussed in relation to self-determination theory and previous research.
Keywords
Exercise Intervention Mediation Moderation Self-determinationNotes
Acknowledgments
This study was funded by Halmstad University, University of Gothenburg and the Swedish KK-foundation.
Author’s Contributions
KWJ participated in the study design, data collection, drafting and finalizing the manuscript and was responsible for the statistical analyses. ML supervised and participated in the writing process, and UJ participated in study design and manuscript writing. All authors read and approved the final manuscript.
Compliance with Ethical Standards
Competing Interests
The authors declare that they have no competing interests.
Ethics, Consent and Permissions
The intervention trial was approved by the regional ethics board (Dnr. Etik 2014/336) and guided by the CONSORT checklist. Participation was voluntary and all respondents completed informed consent.
Supplementary material
References
- Abraham, C., & Michie, S. (2008). A taxonomy of behavior change techniques used in interventions. Health Psychology, 27, 379–387. doi: 10.1037/0278-6133.27.3.379.CrossRefPubMedGoogle Scholar
- Baranowski, T., Anderson, C., & Carmack, C. (1998). Mediating variable framework in physical activity interventions: how are we doing? How might we do better? American Journal of Preventive Medicine, 15(4), 266–297. doi: 10.1016/S0749-3797(98)00080-4.CrossRefPubMedGoogle Scholar
- Bauman, A. E., Reis, R. S., Sallis, J. F., Wells, J. C., Loos, R. J. F., & Martin, B. W. (2012). Correlates of physical activity: why are some people physically active and others not? The Lancet, 380(9838), 258–271. doi: 10.1016/S0140-6736(12)60735-1.CrossRefGoogle Scholar
- Brouwer, W., Kroeze, W., Crutzen, R., De Nooijer, J., De Vries, N., Brug, J., & Oenema, A. (2011). Which intervention characteristics are related to more exposure to internet-delivered healthy lifestyle promotion interventions? A systematic review. Journal of Medical Internet Research, 13(e2). doi: 10.2196/jmir.1639.
- Cerin, E., & Mackinnon, D. P. (2009). A commentary on current practice in mediating variable analyses in behavioural nutrition and physical activity. Public Health Nutrition, 12(8), 1182–1188. doi: 10.1017/S1368980008003649.CrossRefPubMedGoogle Scholar
- Cerin, E., Taylor, L. M., Leslie, E., & Owen, N. (2006). Small-scale randomized controlled trials need more powerful methods of mediational analysis than the baron-Kenny method. Journal of Clinical Epidemiology, 59(5), 457–464. doi: 10.1016/j.jclinepi.2005.11.008.CrossRefPubMedGoogle Scholar
- Cerin, E., Barnett, A., & Baranowski, T. (2009). Testing theories of dietary behavior change in youth using the mediating variable model with intervention programs. Journal of Nutrition Education and Behavior, 41, 309–318. doi: 10.1017/S1368980008003649.CrossRefPubMedGoogle Scholar
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2 ed.). Hillsdale, NJ: Erlbaum.Google Scholar
- Cole, D. A., & Maxwell, S. E. (2003). Testing mediational models with longitudinal data: questions and tips in the use of structural equation modeling. Journal of Abnormal Psychology, 112, 558–577. doi: 10.1037/0021-843X.112.4.558.CrossRefPubMedGoogle Scholar
- Davies, C. A., Spence, J. C., Vandelanotte, C., Caperchione, C. M., & Mummery, W. K. (2012). Meta-analysis of internet-delivered interventions to increase physical activity levels. International Journal of Behavioral Nutrition and Physical Activity, 9(52). doi: 10.1186/1479-5868-9-52.
- Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation and self-determination in human behavior. New York, NY: Plenum Press.CrossRefGoogle Scholar
- Deci, E. L., & Ryan, R. M. (2000). The “what” and “why” of goal pursuits: human needs and the self-determination of behavior. Psychological Inquiry, 4, 227–268. doi: 10.1207/S15327965PLI1104_01.CrossRefGoogle Scholar
- Duda, J. L., Williams, G. C., Ntoumanis, N., DAley, A., Eves, F. F., Mutrie, N., et al. (2014). Effects of a standard provision versus an autonomy supportive referral programme on physical activity, quality of life and well-being indicators: a cluster randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity, 11(10). doi: 10.1186/1479-5868-11-10.
- Edmunds, J., Ntoumanis, N., & Duda, J. L. (2008). Testing a self-determination theory-based teaching style intervention in the exercise domain. European Journal of Social Psychology, 38, 375–388. doi: 10.1002/ejsp.463.CrossRefGoogle Scholar
- Elfeddali, I., Bolman, C., Candel, M., Wiers, R., & de Vries, H. J. (2012). Preventing smoking relapse via Web-based computer-tailored feedback: a randomized controlled trial. Journal of Medical Internet Research, 14(14), e109. doi: 10.2196/jmir.2057.CrossRefPubMedPubMedCentralGoogle Scholar
- Epstein, R., & Street, R. (2007). Patient-centered communication in cancer care: promoting healing and reducing suffering. Bethesda, MD: National Institutes of Health.Google Scholar
- Eysenbach, G. (2005). The law of attrition. Journal of Medical Internet Research, 7, e11. doi: 10.2196/jmir.7.1.e11.CrossRefPubMedPubMedCentralGoogle Scholar
- Fortier, M. S., Sweet, S. N., O’Sullivan, T. L., & Williams, G. C. (2007). A self-determination process model of physical activity adoption in the context of a randomized controlled trial. Psychology of Sport and Exercise, 8(5), 741–757. doi: 10.1016/j.psychsport.2006.10.006.CrossRefGoogle Scholar
- Fortier, M. S., Wiseman, E., Sweet, S. N., O’Sullivan, T. L., Blanchard, C. M., Sigal, R. J., & Hogg, W. (2011). A moderated mediation of motivation on physical activity in the context of the physical activity counseling randomized control trial. Psychology of Sport and Exercise, 12(2), 71–78. doi: 10.1016/j.psychsport.2010.08.001.CrossRefGoogle Scholar
- Fortier, M. S., Duda, J. L., Guérin, E., & Teixeira, P. J. (2012). Promoting physical activity: development and testing of self-determination theory-based interventions. International Journal of Behavioral Nutrition and Physical Activity, 9(20). doi: 10.1186/1479-5868-9-20.
- French, J., Merritt, R., & Reynolds, L. (2011). Social marketing casebook. London, England: Sage.CrossRefGoogle Scholar
- Friederichs, S. A., Oenema, A., Bolman, C., & Lechner, L. (2015). Long term effects of self-determination theory and motivational interviewing in a web-based physical activity intervention: randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity, 12(1), 101. doi: 10.1186/s12966-015-0262-9.CrossRefPubMedGoogle Scholar
- Godin, G., & Shephard, R. J. (1985). A simple method to assess exercise behavior in the community. Canadian Journal of Applied Sport Sciences. Journal Canadien des Sciences Appliquees Au Sport, 10(3), 141–146.PubMedGoogle Scholar
- Godin, G., & Shephard, R. J. (1997). Godin Leisure-Time Exercise Questionnaire. Medicine and Science in Sports and Exercise, 29(Suppl), 36–38.Google Scholar
- Hardcastle, S. J., & Hagger, M. S. (2016). Psychographic profiling for effective health behavior change interventions. Frontiers in Psychology, 6. doi: 10.3389/fpsyg.2015.01988.
- Hardcastle, S. J., Hancox, J., Hattar, A., Maxwell-Smith, C., Thogersen-Ntoumani, C., & Hagger, M. S. (2015). Motivating the unmotivated: how can health behavior be changed in those unwilling to change? Frontiers in Psychology, 6, 835. doi: 10.3389/fpsyg.2015.00835.CrossRefPubMedPubMedCentralGoogle Scholar
- Hayes, A. F. (2009). Beyond Baron and Kenny: statistical mediation analysis in the new millennium. Communication Monographs, 76(4), 408–420. doi: 10.1080/03637750903310360.CrossRefGoogle Scholar
- Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York. NY: Guilford Press.Google Scholar
- Hesse, B. W. (2008). Enhancing consumer involvement in health care. In J. C. Parker & E. Thorson (Eds.), Healthcare communication in the new media landscape. New York, NY: Springer.Google Scholar
- Ivarsson, A., Andersen, M. B., Johnson, U., & Lindwall, M. (2013). To adjust or not adjust: nonparametric effect sizes, confidence intervals, and real-world meaning. Psychology of Sport and Exercise, 14(1), 97–102. doi: 10.1016/j.psychsport.2012.07.007.CrossRefGoogle Scholar
- Jacobs, D. T. R., Ainsworth, B. E., Hartman, T. J., & Leon, A. S. (1993). A simultaneous evaluation of 10 commonly used physical activity questionnaires. Medicine and Science in Sports and Exercise, 25, 81–91. doi: 10.1249/00005768-199301000-00012.CrossRefPubMedGoogle Scholar
- Kahn, E. B., Ramsey, L. T., Brownson, R. C., Heath, G. W., Howze, E. H., Powell, K. E., et al. (2002). The effectiveness of interventions to increase physical activity: a systemtic review. American Journal of Preventive Medicine, 22(4 (Suppl.)), 73–107. doi: 10.1016/S0749-3797(02)00434-8.CrossRefPubMedGoogle Scholar
- Larimer, M. E., Palmer, R. S., & Marlatt, G. A. (1999). Relapse prevention. An overview of Marlatt's cognitive-behavioral model. Alcohol Research and Health, 23(2), 151–160.PubMedGoogle Scholar
- Lubans, D. R., Foster, C., & Biddle, S. J. (2008). A review of mediators of behavior in interventions to promote physical activity among children and adolescents. Preventive Medicine, 47(5), 463–470. doi: 10.1016/j.ypmed.2008.07.011.CrossRefPubMedGoogle Scholar
- MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation analysis. Annual Review of Psychology, 58, 593–614. doi: 10.1146/annurev.psych.58.110405.085542.CrossRefPubMedPubMedCentralGoogle Scholar
- Markland, D., & Tobin, V. J. (2004). A modification of the behavioral regulation in exercise questionnaire to include an assesment of amotivation. Journal of Sport & Exercise Psychology, 26, 191–196.CrossRefGoogle Scholar
- Marsch, L. A., & Gustafson, D. H. (2013). The role of technology in health care innovation: a commentary. Journal of Dual Diagnosis, 9(1), 101–103. doi: 10.1080/15504263.2012.750105.CrossRefPubMedGoogle Scholar
- Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: preparing people for change (3rd ed.). NewYork, NY: GuildfordPress.Google Scholar
- Moustaka, F. C., Vlachopoulos, S. P., Vazou, S., Kaperoni, M., & Markland, D. A. (2010). Initial validity evidence for the behavioral regulation in exercise questionnaire-2 among Greek exercise participants. European Journal of Psychological Assessment, 26, 269–276. doi: 10.1027/1015-5759/a000036.CrossRefGoogle Scholar
- Murcia, J. A., Gimeno, E. C., & Camacho, A. M. (2007). Measuring self-determination motivation in a physical fitness setting: validation of the behavioral regulation in exercise questionnaire-2 (BREQ-2) in a Spanish sample. The Journal of Sports Medicine and Physical Fitness, 47(3), 366.PubMedGoogle Scholar
- Ng, J. Y. Y., Ntoumanis, N., Thogersen-Ntoumani, C., Deci, E. L., Ryan, R. M., Duda, J. L., & Williams, G. C. (2012). Self-determination theory applied to health contexts: a meta-analysis. Perspectives on Psychological Science, 7(4), 325–340. doi: 10.1177/1745691612447309.CrossRefPubMedGoogle Scholar
- Norman, G., Zabinski, M., Adams, M., Rosenberg, D., Yaroch, A., & Atienza, A. (2007). A review of eHealth interventions for physical activity and dietary behavior change. American Journal of Preventive Medicine, 33, 336–345 e316. doi: 10.1016/j.amepre.2007.05.007.CrossRefPubMedPubMedCentralGoogle Scholar
- Ogilvie, D., Foster, C. E., Rothnie, H., Cavill, N., Hamilton, V., Fitzsimons, C. F., et al. (2007). Interventions to promote walking: systematic review. British Medical Journal, 334. doi: 10.1136/bmj.39198.722720.BE.
- Palmeira, A., Teixeira, P., Silva, M., & Markland, D. (2007). Confirmatory factor analysis of the behavioural regulation in exercise questionnaire - Portuguese version.. Paper presented at the 12th European Congress of Sport Psychology, Halkidiki, Greece.Google Scholar
- Patrick, H., & Canavello, A. (2011). Methodological overview of a self-determination theory based computerized intervention to promote leisure-time physical activity. Psychology of Sport and Exercise, 12(1), 13–19. doi: 10.1016/j.psychsport.2010.04.011.CrossRefPubMedPubMedCentralGoogle Scholar
- Peels, D. A., Bolman, C., Golsteijn, R. H., de Vries, H., Mudde, A. N., & van Stralen, M. M. (2013). Long-term efficacy of a printed or a Web-based tailored physical activity intervention among older adults. International Journal of Behavioral Nutrition and Physical Activity, 10(104). doi: 10.1186/1479-5868-10-104.
- Peters, G.-J. Y., Ruiter, R. A. C., & Kok, G. (2013). Threatening communication: a critical re-analysis and a revised meta-analytic test of fear appeal theory. Health Psychology Review, 7, 8–31. doi: 10.1080/17437199.2012.703527.CrossRefGoogle Scholar
- Petersen, K. E. N., Johnsen, N. F., Olsen, A., Albieri, V., Olsen, L. K. H., Dragsted, L. O., et al. (2015). The combined impact of adherence to five lifestyle factors on all-cause, cancer and cardiovascular mortality: a prospective cohort study among Danish men and women. The British Journal of Nutrition, 113(5), 849–858. doi: 10.1017/S0007114515000070.CrossRefPubMedGoogle Scholar
- Pingree, S., Hawkins, R., Baker, T., duBenske, L., Roberts, L. J., & Gustafson, D. H. (2010). The value of theory for enhancing and understanding e-health interventions. American Journal of Preventive Medicine, 38(1), 103–109. doi: 10.1016/j.amepre.2009.09.035.CrossRefPubMedPubMedCentralGoogle Scholar
- Plotnikoff, R., McCargar, L., Wilson, P., & Loucaides, C. (2005). Efficacy of an e-mail intervention for the promotion of physical activity and nutrition behavior in the workplace context. American Journal of Health Promotion, 19, 422–429.CrossRefPubMedGoogle Scholar
- Preacher, K. J., & Hayes, A. F. (2004). SPSS ans SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, 36(4), 717–731.Google Scholar
- Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891. doi: 10.3758/brm.40.3.879.CrossRefPubMedGoogle Scholar
- Rhodes, R. E., & deBruijn, G. J. (2013). How big is the physical activity intention- behaviour gap? Ameta-analysis using the action control framework. British Journal of Health Psychology, 18, 296–309. doi: 10.1111/bjhp.12032.CrossRefPubMedGoogle Scholar
- Rhodes, R. E., & Pfaeffli, L. A. (2010). Mediators of physical activity behaviour change among adult non-clinical populations: a review update. The international journal of behavioral nutrition and physical activity, 7, 37. doi: 10.1186/1479-5868-7-37.
- Ryan, R. M., & Deci, E. L. (2002). Overview of self-determination theory: an organismic dialectical perspective. Rochester, NY: University of Rochester Press.Google Scholar
- Senn, S. (2006). Change from baseline and analysis of covariance revisited. Statistics in Medicine, 25(24), 4334–4344. doi: 10.1002/sim.2682.CrossRefPubMedGoogle Scholar
- Silva, M. N., Vieira, P. N., Coutinho, S. R., Minderico, C. S., Matos, M. G., Sardinha, L. B., & Teixeira, P. J. (2010). Using self-determination theory to promote physical activity and weight control: a randomized controlled trial in women. Journal of Behavioral Medicine, 33(2), 110–122. doi: 10.1007/s10865-009-9239-y.CrossRefPubMedGoogle Scholar
- Silva, M. N., Markland, D., Carraca, E. V., Vieira, P. N., Coutinho, S. R., Minderico, C. S., et al. (2011). Exercise autonomous motivation predicts 3-yr weight loss in women. Medicine and Science in Sports and Exercise, 43(4), 728–737. doi: 10.1249/MSS.0b013e3181f3818f.CrossRefPubMedGoogle Scholar
- Stetson, B. A., Beacham, A. O., Frommelt, K. N., Cole, J. D., Ziegler, C. H., & Looney, S. W. (2005). Exercise slips in high risk situations and activity patterns in long-term exercises: an application of the relapse prevention model. Annals of Behavioral Medicine, 30(1), 25–35. doi: 10.1207/s15324796abm3001_4.CrossRefPubMedGoogle Scholar
- Su, Y.-L., & Reeve, J. (2011). A meta-analysis of the effectiveness of intervention programs designed to support autonomy. Educational Psychology Review, 23(1), 159–188. doi: 10.1007/s10648-010-9142-7.CrossRefGoogle Scholar
- Teixeira, P. J., Carraca, E. V., Markland, D., Silva, M. N., & Ryan, R. M. (2012). Exercise, physical activity, and self-determination theory: a systematic review. International Journal of Behavioral Nutrition and Physical Activity, 9, 78. doi: 10.1186/1479-5868-9-78.CrossRefPubMedGoogle Scholar
- Thøgersen-Ntoumani, C., & Ntoumanis, N. (2006). The role of self-determined motivation in the understanding of exercise-related behaviours, cognitions and physical self-evaluations. Journal of Sports Sciences, 24, 393–404. doi: 10.1080/02640410500131670.CrossRefPubMedGoogle Scholar
- Thompson, B. (2002). Statistical", "practical", and "clinical": how many kinds of significance do counselors need to consider? Journal of Counseling and Development, 80, 64–71. doi: 10.1002/j.1556-6678.2002.tb00167.x.CrossRefGoogle Scholar
- Van den Berg, M., Schoones, J., & Vliet Vlieland, T. (2007). Internet-based physical activity interventions: a systematic review of the literature. Journal of Medical Internet Research, 9, e26.CrossRefPubMedPubMedCentralGoogle Scholar
- van Stralen, M. M., de Vries, H., Bolman, C., Mudde, A. N., & Lechner, L. (2010). Exploring the efficacy and moderators of two computer-tailored physical activity interventions for older adults: a randomized controlled trial. Annals of Behavioral Medicine, 39, 139–150. doi: 10.1007/s12160-010-9166-8.CrossRefPubMedGoogle Scholar
- Vandelanotte, C., Kirwan, M., Rebar, A., Alley, S., Short, C., Fallon, L., et al. (2014). Examining the use of evidence-based and social media supported tools in freely accessible physical activity intervention websites. International Journal of Behavioral Nutrition and Physical Activity, 11(105). doi: 10.1186/s12966-014-0105-0.
- Vansteenkiste, M., Sierens, E., Soenens, B., Luyckx, K., & Lens, W. (2009). Motivational profiles from a self-determination perspective: The quality of motivation matters. Journal of Educational Psychology, 101(3), 671–688. doi: 10.1037/a0015083.
- Vlachopoulos, S. P. (2008). The basic psychological needs in exercise scale: measurement invariance over gender. Structural Equation Modelling, 15, 114–135. doi: 10.1080/10705510701758398.CrossRefGoogle Scholar
- Vlachopoulos, S. P., & Michailidou, S. (2006). Development and initial validation of a measure of autonomy, competence, and relatedness in exercise: the basic psychological needs in exercise scale. Measurement in Physical Education and Exercise Science, 10(3), 179–201. doi: 10.1207/s15327841mpee1003_4.CrossRefGoogle Scholar
- Vlachopoulos, S. P., Ntoumanis, N., & Smith, A. L. (2010). The basic psychological needs in exercise scale: translation and evidence for cross-cultural validity. International Journal of Behavioral Nutrition and Physical Activity, 8, 394–412. doi: 10.1080/1612197X.2010.9671960.Google Scholar
- Walker, B., Albertson, C., & Freeberg, R. (2014). Psychographic segmentation and the health care consumer. Philadelphia, PA: Targeted Profitable Growth.Google Scholar
- Webber, K. H., Tate, D. F., Ward, D. S., & Bowling, J. M. (2010). Motivation and its relationship to adherence to self-monitoring and weight loss in a 16-week internet behavioral weight loss intervention. Journal of Nutrition Education and Behavior, 42(3), 161–167. doi: 10.1016/j.jneb.2009.03.001.CrossRefPubMedGoogle Scholar
- Weman-Josefsson, K. A., Halila F., Johnson U., Lindwall M., Wickström N., & Wärnestål P. (2014). Digital innovations and self-determined exercise motivation: A person-centred perspective. Paper presented at the VITALIS - Nordens ledande eHälsomöte; 2014, Göteborg, Sweden.Google Scholar
- Weman-Josefsson, K., Lindwall, M., & Ivarsson, A. (2015a). Need satisfaction, motivational regulations and exercise: moderation and mediation effects. International Journal of Behavioral Nutrition and Physical Activity, 12, 67. doi: 10.1186/s12966-015-0226-0.CrossRefPubMedGoogle Scholar
- Weman-Josefsson, K., Fröberg, K., Karlsson, S., & Lindwall, M. (2015b). Mechanisms in self-determined exercise motivation: effects of a theory informed pilot intervention. Current Psychology, 1–11. doi: 10.1007/s12144-015-9388-9.
- Williams, G. C., McGregor, H. A., Sharp, D., Levesque, C., Kouides, R. W., Ryan, R. M., & Deci, E. L. (2006). Testing a self-determination theory intervention for motivating tobacco cessation: supporting autonomy and competence in a clinical trial. Health Psychology, 25(1), 91–101. doi: 10.1037/0278-6133.25.1.91.CrossRefPubMedGoogle Scholar
- Williams, G. C., Niemiec, C. P., Elliot, A. J., LaGuardia, J. G., Gorin, A. A., & Rigby, C. S. (2014). Virtual look AHEAD program: initial support for a partly virtualized intensive lifestyle intervention in type 2 diabetes. Diabetes Care, 37(8), e169–e170. doi: 10.2337/dc14-0831.CrossRefPubMedPubMedCentralGoogle Scholar
- Wilson, P. M., Mack, D. E., Gunnell, K. E., Gregson, P., Cheung, S., Rimmer, S., & Sylvester, B. D. (2010). Assessing leisure-time physical activity in young adults with the Godin leisure-time exercise questionnaire: normative values, gender differences, and non-response error. Annals of Behavioral Medicine, 39, 188.Google Scholar
- World Health Organization [WHO] (2009). Interventions on diet and physical activity: what works, Summary report. Geneva, Switzerland: World Health Organization.Google Scholar