Objective This scoping review examined current research on group-based exercise programs for adults with visual impairment (VI) and their outcomes. Data Source Searches were conducted using Ovid MEDLINE, Embase, CINAHL Complete, PsycInfo, AMED, and SPORTDiscus. Study Inclusion and Exclusion Criteria Included studies were peer-reviewed experimental articles published in English from 2000 to October 2024, reporting group-based exercise programs and outcomes for adults with VI. Studies exploring the experiences of adults with VI in informal group exercise were also included. Excluded were reviews, non-research or unpublished works, theses and dissertations, studies that focused on childhood participation, and those involving professional athletes. Data Extraction Data were extracted on program implementation, outcome measures, and key findings. The Template for Intervention Description and Replication (TIDieR) checklist guided reporting on implementation details. Data Synthesis The extracted data were analyzed descriptively to identify studies’ patterns and trends. Findings were summarized by study type, with intervention details reported alongside outcomes and assessments. Results Thirty-nine studies were included. Programs incorporated various exercise types with adjustments for VI, showing improvements in physical functioning, mental health, and psychosocial well-being. Conclusions Group-based exercise programs benefit adults with VI across multiple domains, yet evidence regarding daily functioning, social interaction, and exercise intensity was limited. Addressing these gaps is crucial to developing inclusive and effective programs that support their meaningful participation and well-being.

Purpose A Quality Improvement (QI) initiative was implemented to improve evidence-based pediatric obesity related clinical care. We evaluated changes in clinicians’ knowledge and confidence and their perception of improvements and challenges in obesity-related clinical care post-QI implementation. Approach The study included pre and post-intervention self-report surveys, semi-structured qualitative interviews, and randomized chart reviews. Setting The setting was two primary care centers in Washington, DC between March 2021-March 2022. Participants Of the 42 clinicians offered multi-modal interventions, 33% completed both surveys. Of the 17 clinicians offered a qualitative interview, 15 were completed (88%). Method Quantitative analysis was conducted using McNemar’s exact test and qualitative data underwent thematic analysis. Results Data analysis demonstrated an overall positive and significant change in clinician confidence in diagnosing and managing pediatric obesity ( Χ 2 = 12.0, P = 0.0005). The post-intervention thematic analysis of semi-structured clinician interviews identified three major themes: (1) improvement in clinical obesity management, (2) barriers to effective clinical obesity management, and (3) deeper self-reflection of obesity stigma on clinical weight management. Conclusions While barriers exist in managing obesity within medical homes, the implementation of a targeted QI initiative may improve pediatric clinicians’ confidence in providing evidence based culturally competent care.

PurposeUnderstanding reactions to health communication campaigns is essential to designing effective messaging. Multi-year campaigns through The Helping to End Addiction Long-term® Initiative (HEALing) Communities Study (HCS) were implemented from April 2020 – June 2022. Responses to HCS campaign messages and statewide campaign messages were evaluated.DesignCross-sectional, self-reported surveys of different respondents at 3 timepoints.SettingN = 33 communities across Kentucky, Ohio, Massachusetts, and New York.SubjectsN = 2368 respondents recruited from Facebook/Instagram.MeasuresMessage acceptability survey items assessed attention, understandability, and visuals/text match. Message influence items assessed whether the message made the respondent want to carry naloxone, learn more about medications for opioid use disorder (MOUD), or seek help for OUD. Items were scaled from 1 (strongly disagree) to 5 (strongly agree).AnalysisAll outcomes were analyzed using linear mixed models adjusted for community as a random effect.ResultsAmong naloxone campaigns, HCS message acceptability was higher than statewide messages (3.98, 95% CI = 3.94-4.02 vs 3.93, 95% CI = 3.89-3.97, P = 0.002). HCS message influence was also higher than those of statewide messages (3.44, 95% CI = 3.38-3.50 vs 3.40, 95% CI = 3.34-3.46, P = 0.034). Among HCS campaigns, naloxone messaging had the highest acceptability (3.96, 95% CI = 3.92-4.00), followed by MOUD stigma (3.73, 95% CI = 3.70-3.77) and MOUD awareness (3.71, 95% CI = 3.68-3.75, P < 0.001). The HCS naloxone campaign was also highest rated in terms of influence (3.47, 95% CI = 3.43-3.51, P < 0.001).ConclusionThis analysis provides insight into acceptability and potential influence of locally-tailored, opioid-related health campaign messaging.This work was performed under the HEALing Communities Study, ClinicalTrials.gov Identifier: NCT04111939, https://clinicaltrials.gov/study/NCT04111939.

PurposeBowel cancer screening (BCS) is a critical preventive health measure. However, participation in BCS remains suboptimal in some populations. We aimed to examine the association between psychosocial factors and participation in bowel cancer screening among adults aged 45 years and above in Australia.DesignProspective cohort study.Setting and sampleOur study utilised longitudinal data from four waves of the Household, Income, and Labour Dynamics in Australia (HILDA) Survey, comprising 29 334 person-year observations from 11 315 individuals.MeasuresWe employed social connection, social isolation, and community membership as proxies for psychosocial factors and explored their relationship with bowel cancer screening participation.AnalysisWe performed descriptive statistics and random-effects logistic regression. The relationships were also stratified by age groups and gender to highlight heterogeneous effects.ResultsAfter adjusting for various confounding factors, our findings demonstrated that high social connection (adjusted Odds Ratio [aOR]): 1.14, 95% CI: 1.06-1.22) and community membership (aOR: 1.23, 95% CI: 1.15-1.32) were significantly and positively associated with participation in bowel cancer screening. Further stratified analysis revealed that this association was heterogeneous; the link between high social connection was significant for men (aOR: 1.17, 95% CI: 1.06-1.30) but not for women. Additionally, while community membership served as a significant predictor across all age groups, the positive association with social connection was evident in adults aged 45 to 59 (aOR: 1.13, 95% CI: 1.01-1.27) and those aged 60 to 74 years (aOR: 1.13, 95% CI: 1.09-1.36).ConclusionOur study highlighted the role of psychosocial factors in influencing participation in bowel cancer screening. Our results suggest that public health policies should prioritise initiatives that promote social engagement and strengthen community ties.

PurposeThis study evaluated the feasibility of incorporating Virtual Reality (VR) technology into meditation exercises and using Electrocardiogram (ECG) devices for emotion regulation assessment. It also explored changes in emotion regulation, depression, and anxiety among participants.DesignA single-arm feasibility study.SubjectsPsychiatric hospital inpatients diagnosed by physicians with major depressive disorder or generalized anxiety disorder in the Midwestern United States (n = 25).InterventionVR meditation exercises 3 times weekly for 10 weeks.MeasuresPhysiological coherence, as an indicator of regulated emotional state, was assessed using ECGs, while depression and anxiety were measured through survey questionnaires.AnalysisPaired t-tests were employed to analyze changes in emotion regulation, depression, and anxiety.ResultsAfter 10 weeks, significant increases were observed in physiological coherence, suggesting more regulated emotional states (M = −35.25, SD = 22.25, 95% CI [−40.63, −29.86], Cohen’s d = −1.58). Reductions were also noted in depression (M = 3.48, SD = 3.29, 95% CI [1.84, 7.51], Cohen’s d = 1.06) and anxiety (M = 3.12, SD = 4.03, 95% CI [1.45, 4.78], Cohen’s d = 0.77).ConclusionsVR is a feasible technology for meditation exercises, with observed associations with more stable emotional states, and reductions in depression and anxiety symptoms, while the application of ECG-based assessment further addresses methodological shortfalls in this population. These results highlight the potential of applying VR technology in mindfulness exercises to leverage inherent digital healthcare strengths, such as user-centered care and tailored treatment.

PurposeTo examine associations between preschooler screen time trajectories and physical activity outcomes at age 5.5.DesignA longitudinal cohort study of Canadian parents with preschoolers.SettingData were collected in Nova Scotia, Canada, during the COVID-19 pandemic in Spring/Summer 2020 and 2021, and Summer/Fall 2022.SampleA community-based convenience sample of 315 parents of preschool-aged children (54% boys) was followed longitudinally when children were 3.5 (2020), 4.5 (2021), and 5.5 years old (2022).MethodsParent-reported screen time at 3.5, 4.5, and 5.5 years was used to estimate preschooler screen time trajectories. Using growth mixture modeling (GMM), three groups were identified: low (mean = 0.89 h/day, 23%), average (mean = 2.96 h/day, 56%), and high (mean = 6.42 h/day, 21%) screen time trajectory groups. At age 5.5, physical activity was directly assessed using accelerometers to capture light, moderate, and vigorous-intensity physical activity. Parents also reported child sex, family configuration, and educational attainment.ResultsChildren in the high screen time trajectory group engaged in significantly less light-intensity physical activity (b = −29.98, P < .05) compared to children in the average screen time trajectory. No significant differences were observed between the low and average screen time trajectory groups for light-intensity physical activity. Additionally, no significant differences in moderate or vigorous-intensity physical activity were observed between the screen time trajectory groups.ConclusionsHigher screen time in preschoolers is associated with reduced engagement in light-intensity physical activity. These findings highlight the importance of monitoring screen time to ensure that children have opportunities to engage in light-intensity physical activities such as active and outdoor play. Limiting early childhood screen time may support healthier physical activity patterns and promote early childhood development.

PurposePatient satisfaction is a key principle of high-quality care, important to all health systems. While evidenced-based guidelines recommend tobacco use counseling to all hospitalized patients who use tobacco, scant knowledge exists about patient satisfaction with these services. The Satisfaction with Inpatient Tobacco Treatment Study (1) proposes a novel survey tool to measure patient satisfaction with inpatient tobacco treatment and (2) provides survey results from our hospital’s Tobacco Treatment Program.DesignCreation and administration of an 8-item Likert scale survey to assess inpatient tobacco use counseling.Setting/SubjectsA random sample of inpatients who received remote inpatient tobacco use treatment at UNC Health’s Tobacco Treatment Program were selected for participation. The survey was administered by telephone and email.MeasuresSurvey items assessed constructs of patient satisfaction, resource availability pre- and post-discharge, the perceived benefits of inpatient tobacco treatment counseling, and patient-reported smoking cessation.AnalysisSurvey responses were analyzed using descriptive statistics and Fisher’s Exact Tests.ResultsThe majority of respondents reported satisfaction with tobacco use counseling. 92% strongly agreed or agreed that the consultations improved their overall hospital experience and 90% said they quit or cut down on their tobacco use after discharge. Results did not vary significantly by race, insurance status, or gender.ConclusionPatient satisfaction with inpatient tobacco cessation treatment was high across multiple domains, as was patient-reported smoking cessation. The survey instrument can be further validated and adapted for program assessment and quality improvement in other tobacco treatment programs.

ObjectiveThis scoping review aimed to synthesise research on the relationships between health literacy and adherence to physical activity guidelines in adults.Data SourceA search of MEDLINE, ProQuest, Scopus, CINAHL, Web of Science (Core Collection), PubMed, and PsycINFO was conducted using keywords. Observational and intervention studies written in English were reviewed.Inclusion and Exclusion CriteriaEligible research studies used a validated, objective measure of health literacy. Physical activity needed to be reported as either a primary or secondary outcome, and groups needed to be dichotomised as physically active, inactive, or similar.ExtractionOut of 2098 articles identified, 19 met the inclusion criteria.SynthesisA numerical analysis of the studies was performed. A narrative summary supplemented the analysis to synthesise the main themes and patterns.ResultsFifteen studies examined the association between total health literacy scores and achieving >150 minutes of moderate-to-vigorous physical activity weekly. Nine studies reported a positive association, while others found no significant association. In particular, studies using self-reported physical activity more frequently found an association, whereas no association was found when using objective physical activity measures.ConclusionThe findings of this review were inconclusive. The lack of a standardised health literacy instrument presents a barrier to progress in the field of physical activity and health literacy research. Moreover, longitudinal relationships between health literacy, mediators and physical activity must be investigated.

PurposeTo investigate how physical function performance and arthritis-related pain relate to sensor assessed movement behaviors in a diverse sample of inactive adults with various forms of arthritis.DesignCross-sectional study.SettingColumbia, SC.SubjectsAdults with arthritis (n = 267; 60.0% Black, 92.0% female, 64.1 ± 9.4 years) from a telephone-based walking intervention.MeasuresMovement behaviors (moderate to vigorous intensity physical activity, MVPA; sedentary time) were assessed with ActiGraph accelerometers at baseline. Physical function was assessed through the six-minute walk test (6MWT) and the 30-second chair stand test (30CST). Arthritis-related pain was measured through a visual analog scale.AnalysisMultiple linear regression was used to examine the extent to which physical function performance and pain predicted movement behaviors while adjusting for sociodemographic and health characteristics.ResultsBetter 6MWT performance was positively associated with more MVPA per week (P < 0.001). Worse performance in the 6MWT (P < 0.001) and less pain (P = 0.02) were associated with more daily time spent sedentary. Performance in the 30CST was not significantly associated with either movement behavior.ConclusionThese findings emphasize the importance of functional endurance and pain management in promoting physical activity and sedentary behavior among inactive adults with arthritis. Future public health interventions should prioritize strategies to enhance these components to effectively promote physical activity and less sedentary time.

PurposeDevelop a parsimonious model of individuals at heightened-risk for 3-year cardiometabolic multimorbidity (CM) onset.DesignAn observational, secondary analysis of Canadian Longitudinal Study on Aging (CLSA) data.SettingCLSA is a national cohort study in Canada. Baseline data were collected between 2010-2015, and follow-up data were collected between 2015-2018.SubjectsCLSA included community-dwelling adults aged 45-85 at recruitment from across Canada.MeasuresHealth conditions: stroke, heart disease or heart attack and diabetes. Personal factors: age, sex, marital status, household income, education, and ethnicity. Environmental factors: social support, personal assistance, and location of residence. CM cases: at least two of stroke, heart disease and diabetes at follow-up assessment.AnalysisHierarchical logistic regression analyses with backwards elimination procedures were used to develop a parsimonious prediction model.ResultsThe sample consisted of 41 841 individuals, representing a weighted population of 13 741 119. The population had a mean age of 62.3 years (SD = 10.1), was 53% female, predominantly married or in common-law relationships (77%), post-secondary graduates (61%), white (95%), and lived in an urban area (81%). Males (OR:1.93, 95%CI:1.65-2.25, P < 0.001), ≥65 years (OR:1.51, 95%CI:1.29-1.76), P < 0.001), who had stroke (OR:20.09, 95%CI:12.88-30.35, P < 0.001), heart disease (OR:15.55, 95%CI:12.60-19.26, P < 0.001), or diabetes (OR:12.57, 95%CI:10.37-15.31, P < 0.001), not completed post-secondary (OR:1.30, 95%CI:1.04-1.61, P = 0.017), income of <50k (OR:1.29, 95%CI:1.10-1.52, P = 0.002), and received home care (OR:1.56, 95%CI:1.17-2.04, P = 0.002) were at heightened risk of CM.ConclusionsDeveloping a profile of high-risk individuals may enhance the efficiency of CM prevention and reduce disease onset. Critical limitations include the CLSA exclusion criteria, and the small proportion of minoritized individuals that restrict generalizability in these populations.