Average Minutes Research Articles

0510 The Apnea and Insomnia Research (AIR) Trial: A Preliminary Report

Abstract Introduction Many sleep apnea patients suffer from comorbid insomnia disorder. Although cognitive behavioral insomnia therapy (CBTI) is recommended as the first line insomnia treatment for such patients, access to trained providers of this treatment remains limited. The current study is testing he efficacy of an online CBTI among CPAP treated sleep apnea patient with comorbid insomnia. Methods Patients enrolled in this trial complete baseline measures and then are randomized to either an online version of Cognitive Behavioral Insomnia Therapy (CBTI) or no additional treatment beyond their CPAP therapy (CTRL). After 8 weeks of treatment all patients are reassessed. The current report considers changes in scores on the ISI and Epworth Sleepiness Scale (ESS) as well as average minutes of nightly CPAP use from pre-treatment to the end of the initial 8 weeks of online treatment relative to the no treatment CTRL. The sample for this report included the first 170 participants enrolled in this trial (mean age = 56.5±12.5 yrs; 60.1% females). Results Those receiving online CBTI showed greater reductions in their ISI scores from baseline to the end of the initial 8-week treatment phase than did those in the CTRL group (p = .0009). Average ISI score improvements among those receiving online CBTI moved patients from moderately severe insomnia to mild insomnia symptoms. In contrast, no differences were noted between the online CBTI and CTRL groups in regard to pre- to post-treatments changes on the ESS (p= .3771) scores or amount of CPAP use (p = .8053). Conclusion Whereas online CBTI does not seem to reduce daytime sleepiness or improve CPAP adherence among patients with comorbid sleep apnea and insomnia, it appears to be an effective intervention for reducing insomnia severity for this patient group. Support National Heart. Lung and Blood Institute Grant # 1R01HL130559-01A1

Osteoarthritis physical activity care pathway (OA-PCP): results of a feasibility trial

BackgroundTo obtain information on feasibility and acceptability, as well as preliminary data on efficacy, of an Osteoarthritis Physical activity Care Pathway (OA-PCP).MethodsThis was a single group pilot study involving 60 participants with symptomatic, physician diagnosed knee or hip OA, recruited from primary care clinics. Participants self-reported completing less than 150 min per week of moderate-to-vigorous physical activity (MVPA) at baseline. The 3-month OA-PCP intervention involved 3 physical activity (PA) coaching calls (focused on goal setting), three check-in emails and linkage with community-based or online resources to support PA. Efficacy outcomes were collected at baseline and 4-month follow-up. The primary efficacy outcome was minutes of MVPA, assessed via accelerometer. Secondary outcomes included minutes of light intensity activity, sedentary minutes, step counts, and Western Ontario and McMaster Universities (WOMAC) pain and function subscales. Participants were also asked to rate the helpfulness of the OA-PCP intervention on a scale of 0–10. Differences in efficacy outcomes between baseline and 4-month follow-up were assessed using paired t-tests.ResultsAmong participants beginning the study, 88% completed follow-up assessments and ≥ 90% completed each of the intervention calls. Average daily minutes of MVPA was 8.0 at baseline (standard deviation (SD) = 9.9) and 8.9 at follow-up (SD = 12.1, p = 0.515). There were no statistically significant changes in light intensity activity, sedentary time or step counts. The mean WOMAC pain score improved from 8.1 (SD = 3.6) at baseline to 6.2 (SD = 3.8) at follow-up (p < 0.001); the mean WOMAC function score improved from 26.2 (SD = 13.2) to 20.2 (SD = 12.5; p < 0.001). The mean rating of helpfulness was 7.6 (SD = 2.5).ConclusionsResults supported the feasibility and acceptability of the study, and participants reported clinically relevant improvements in pain and function. PA metrics did not improve substantially. Based on these results and participant feedback, modifications including enhanced self-monitoring are being made to increase the impact of the OA-PCP intervention on PA behavior.Trial registrationNCT03780400, December 19, 2018.

Contributions of Prenatal Exposures and Child Lifestyle to Insulin Sensitivity.

Prenatal exposures and lifestyle factors are important for metabolic health. Determine how prenatal exposures to maternal obesity and/or gestational diabetes mellitus (GDM) and childhood lifestyle factors independently contribute to child insulin sensitivity. Ninety children aged 7 to 11 years (56% girls, 60% exposed to GDM), born at Kaiser-Permanente Southern California, completed an oral glucose tolerance test (OGTT) as part of the BrainChild Study. Matsuda insulin sensitivity index (ISI) was used to estimate insulin sensitivity. Participants completed two 24-hour dietary recalls, and daily energy intake (EI), dietary added sugar, and total sugar were calculated. The 3-day physical activity recall determined the average minutes per day of moderate to vigorous physical activity (MVPA) and the average minutes per day spent sedentary. Maternal prepregnancy body mass index (BMI) and GDM status were extracted from electronic medical records. Matsuda-ISI. Linear regression showed that children who spent more time in MVPA had better ISI (β = 0.33; P = 0.001), and results remained after adjustment for maternal prepregnancy BMI, GDM exposure, child age, sex, daily EI, dietary added sugar (β = 0.34; P = 0.001), and further adjustment for child adiposity (β = 0.29; P = 0.001). Time spent sedentary, maternal prepregnancy BMI, GDM exposure, dietary added sugar, total sugar, and EI were not associated with ISI. Physical activity was the only predictor of ISI at this age, suggesting that engaging in physical activity during childhood is beneficial for insulin sensitivity and may ameliorate future risk for metabolic disease.

SELF-REPORTED PHYSICAL ACTIVITY IN SPECIALIZED AND UNSPECIALIZED YOUTH

The benefits of physical activity cross all domains of health. Unfortunately, many children are not meeting the current American College of Sports Medicine recommendations of 60 minutes of moderate to vigorous physical activity (MVPA) 7 days a week. This is especially deleterious since physical activity patterns during childhood may carryover to adulthood. Research has also shown that participating in one sport may increase the risk of injury. The purpose of this study was to examine self-reported exercise levels in children reporting to a tertiary sports medicine clinic over a three year period. Subjects were asked “How many minutes of moderate to vigorous physical activity per day?” and “How many days per week do you participate in moderate to vigorous physical activity”. Minutes per week of MVPA was calculated. Age, sex, and current sports and recreational activities were recorded. There were 7427 unique patients (53% female) with an average age of 13.8±2.6. The average minutes per day of exercise was reported as 85.6±44.4, average days per week was 4.4±1.6 and minutes per week was 410.8±266.9. Females reported less minutes per day (83.5 vs. 87.8, p<.001), less days per week (4.2 vs 4.7, p<.001) and less minutes per week (384.1 vs 440.2, p<.001) than males. On average, females reported 56 minutes less activity per week than their male counterparts. There were 3618 participants who only reported one activity and were categorized as specialized in a single physical activity. Those that specialized in a single activity were significantly older (14.1 vs 13.4, p<.001). There were no significant differences between reported minutes per day between specialized and unspecialized athletes (85.8 vs 85.2, p=.57). Those who specialized in one activity reported more days per week (4.6 vs 4.2. p<.001) and more minutes per week (423.8 vs 397.0, p=.001) than unspecialized athletes. Research has consistently shown that females are less active than males. Those who specialized in one activity participated in more minutes per week of activity, mainly through participating in more days of physical activity. Children should be encouraged to participate in a variety of activities on a daily basis to ensure they receive the benefits of physical activity.

Network Effects on Adolescents' Perceived Barriers to Physical Activity.

Adolescent physical activity (PA) is widely linked to positive health outcomes. Unfortunately, 80% of adolescents do not meet recommendations, which may be due to perceived barriers to PA. Peer interactions significantly affect adolescent PA behaviors. This study aims to analyze distribution of PA barriers throughout adolescent friendship networks and barriers' associations with PA. Adolescents (N = 383, mean = 10.77y, SD = 1.30y, 51.4% male) reported frequency of experiencing PA barriers (body related, social, fitness, convenience, and resource) and names of their friends. Average steps and minutes of moderate- to vigorous-intensity PA per day were measured using accelerometers. Linear network autocorrelation models determined if friends perceived barriers similarly when compared with nonfriends and analyzed relationships between barriers and objective PA measures while controlling for network effects. Moderate- to vigorous-intensity PA, steps per day, body-related barriers, and social barriers displayed significant network effects, suggesting significant association with the scores of their friends. Average steps per day were significantly associated with age, sex, and social barriers, while inversely associated with fitness barriers. This research suggests adolescents' perceived PA barriers are significantly associated with those of their friends. Researchers and practitioners aiming to reduce barriers to PA among adolescents may wish to assess peer reinforcing effects.

Socioeconomic Patterning of Children's Accelerometer-Assessed Physical Activity Intensities and Adiposity: A Pooled Analysis of Individual-Level Data for 26,915 Children and Adolescents from 36 European Cohorts

Background: Childhood obesity is increasing globally with widening socioeconomic inequalities. It is unclear if differences in the accumulation and intensity distribution of children’s physical activity is contributing to these rising disparities. We investigated if the intensity patterning of physical activity differs between socioeconomic groups across Europe and if this relationship differs by national level income inequality and age to help explain obesity disparities. Methods: We pooled and harmonised individual-participant accelerometer-assessed activity and socioeconomic position (SEP) data from 36 European child studies. Included participants were between 5 to 16 years of age with valid accelerometer data (≥480 minutes of daily wear time on 3 days), parental education and anthropometric measurements. Study-level multivariable linear regression models were run to assess differences in moderate-vigorous physical activity (MVPA), vigorous physical activity (VPA) and adiposity by socioeconomic position (by parental education). Effects were pooled in random effect meta-analyses. Findings: 26,915 participants (mean age: 10·1y [SD:1.2]; 51·7% female) from 16 European countries met the inclusion criteria. Meta-analyses revealed proportionally more average daily minutes of VPA were performed by children from a higher socioeconomic position (High vs low SEP, b: 0·57, 95%CI: 0·28, 0·85 mins), despite lower overall levels of physical activity (MVPA; b: -1·51, 95%CI: -2·36, -0·67 mins). Higher intensity activity in children from a higher socioeconomic position was paralleled by lower levels of adiposity measured by BMI z-score (b: -0·20, 95%CI: -0·24, -0·16). Stepwise differences were apparent moving from low to medium to high socioeconomic position [e.g. BMI z-score: (Low vs Med SEP; b: -0·10, 95%CI: -0·14, -0·07) (Low vs High SEP; b: -0·20, 95%CI: -0·24, -0·16)]. Inequalities in VPA and BMI z-score widened with age and were not affected by national level income inequality. Interpretation: Lower levels of adiposity in children from a higher socioeconomic position are paralleled by relatively higher amounts of VPA despite overall lower levels of MVPA. Physical activity promotion efforts should focus on providing opportunities for less affluent children to be vigorously active. Funding Statement: BHF, CRUK, ESCR, MRC, Wellcome Trust, Research Council of Norway Declaration of Interests: All authors declare that they have no conflicts of interest. Ethics Approval Statement: The authors declared not applicable.

Abstract P117: Implementing the Physical Activity Vital Sign in an Academic Preventive Cardiology Clinic

Background: Physical activity (PA) can protect against cardiovascular disease but it is not routinely assessed in clinical settings. The current PA recommendations are 150 minutes of moderate- or 75 minutes vigorous-intensity PA/week. Purpose: The purpose of this study was to implement physical activity screening as part of the electronic kiosk check-in process in an adult preventive cardiology clinic in an academic medical center and assess factors related to patients’ self-reported PA. Methods: The physical activity vital sign (PAVS) was embedded into the Epic electronic health record and includes 3 questions about the average days, minutes and intensity (light, moderate, vigorous) of PA per week. Analysis of patient records from a recent 60-day period included descriptive statistics, bivariate analyses and logistic regression to identify sociodemographic factors associated with not meeting current PA recommendations. Results: A total of 1,322 patients checked into the clinic using a kiosk. Patients were 42% female, 71% White, 62% married, had a mean age 64±15 years, 41% worked full-time and the majority (57%) were never smokers. The three most common primary diagnoses were hyperlipidemia (n=197), coronary artery disease (n=189), and hypertension (n=127). Of those patients, 72% (n=951) completed the PAVS questions:10% reported no PA; 55% reported some PA; and 35% reported achieving at least 150 minutes moderate or 75 minutes vigorous PA/week. In bivariate analyses (at recommended PA vs. not at recommended PA), factors associated with not achieving recommended levels of PA included sex (p&lt;.001), race (p=.045), marital status (p&lt;.001), and employment (p&lt;.001). In the final logistic model, being female vs. male (OR=1.4, 95%CI: 0.99-1.8, p=.05), Black (OR=2.0, 95%CI: 1-3.7, p=.037) or ‘Other’ race (OR=1.5, 95%CI: 1-2.2, p=.04) vs. White, those reporting being partnered or in ‘other’ relationships vs. married (OR=.03, 95% CI: 0.14-0.55, p&lt;.001), and those who were retired (OR=2, 95% CI: 1.4-2.8, p&lt;.001) or unemployed (OR=2.2, 95%CI: 1.3-3.7, p=.002) vs. full-time workers were factors associated with not achieving recommended levels of PA. Conclusion: In a preventive cardiology clinic, only one-third reported achieving AHA recommended levels of PA. Our data support particular attention to PA counseling and prescription in female, Black, and retired or unemployed patients. Additionally, embedding the PAVS into a clinical electronic health system is a feasible and scalable intervention to collect data on this cardiovascular risk factor.

Online preschool teacher training to promote physical activity in young children: A pilot cluster randomized controlled trial.

This study tested the Wellness Enhancing Physical Activity in Young Children (WE PLAY) program, a 4-week online preschool teacher training, on children's moderate-to-vigorous physical activity (MVPA). In this cluster RCT, six Head Start preschools were randomized to an intervention and comparison group. Children's MVPA was measured using accelerometers at pre- and posttest. The magnitude of the difference in MVPA between groups at posttest was small, but in the expected direction: Δ min/hour = 1.60, 95% CI [-0.97, 4.18], p = .22, Cohen's d = 0.32. We observed a pre/post within group increase in average minutes per hour of MVPA in school with a medium effect size for the intervention group: Δ mean min/hour = 2.09, 95% CI [0.51, 3.67], p = .0096, Cohen's d = 0.42. An increase was not seen for the comparison group: Δ mean min/hour = 0.44, 95% CI [-0.70, 1.59], p = .45, Cohen's d = 0.07. WE PLAY children in 6 hr/day programs gained 63 min of MVPA per week in school, providing preliminary evidence of the benefits of WE PLAY on children's physical activity levels. WE PLAY deserves further testing with larger groups of children and teachers. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The Drug Overdose Epidemic Seen through Different Lenses

Background: The age-adjusted death rate from drug overdoses in the United States per 100,000 individuals rose from 6.8 in 2010 to 17.1 in 2018. The most common explanation offered is the “deaths of despair†hypothesis. We identify additional factors that have contributed to the rise in drug overdose deaths in cities and counties. Methods: We utilize a period fixed effects model with a multi-variate panel data set for 94 independent cities and counties in Virginia for the period 2008 through 2017. Results: The drug overdose mortality rate is: (a) an increasing function (prob. <.05) of the percentages of the population that smoke, are obese, are White, are incarcerated, are receiving SNAP payments, have earned a high diploma, and are employed in mining, as well as the average minutes workers must travel to their jobs and the number of prescriptions written; and, (b) a decreasing function (prob. < .05) of median household income, population density, and the degree of market concentration of pharmacies filling drug prescriptions. We provide estimates of the percent change in the drug overdose death rate one can expect in response to changes in each of these factors - information highly useful to decision-makers. Conclusions: Although the “deaths of despair†hypothesis has a degree of empirical validity, multidisciplinary analysis reveals that oft-neglected factors, including commuting time, local pharmacy market structures, prescription practices, and prevalence of SNAP payments, also have a major impact on drug overdose death rates. The factors influencing drug overdose mortality are much more complex than the deaths of despair hypothesis suggests.

Can Sleep Duration Help Explain Differences in the Happiness Index Across Nations?

Abstract Inadequate sleep is an important public health problem that can affect one in every three adults; however, it received little attention in the economics of happiness research. The objective of this article is to examine whether sleep adequacy contributes to the explanation of variation in happiness index levels across countries. Analysis was undertaken using ordinary least squares regression method. The dependent variable is the self-reported happiness index developed by the Gallup poll and published in the World Happiness Report. Two alternative model specifications were used. The first included average sleep minutes per country, GDP per capita(purchasing power parity), unemployment rate, and environmental performance index. The second model specification included average sleep minutes per country, GDP (purchasing power parity), and economic freedom index. Both model specifications met several robustness checks, and showed overall significance and significant coefficients. Results showed that an increase in average sleep duration by 10 minutes is associated with an improvement in the happiness score by 0.1 and 0.15 points in the first and second model specifications respectively, noting an average happiness score of 6.2 in the country sample. The conclusion that sleep duration contributes to explaining variation in happiness levels across countries is a call for policy makers to consider policies targeting improvement in sleep adequacy as priority, and to direct more resources to further research in the area of sleep economics. Previous studies in the area of happiness economics did not consider sleep in explaining differences in happiness among countries, and previous studies in the area of economics of sleep did not consider the happiness index at a global level.

A Multilevel Analysis of Neighbourhood, School, Friend and Individual-Level Variation in Primary School Children's Physical Activity.

Physical activity is influenced by individual, inter-personal and environmental factors. In this paper, we explore the variability in children’s moderate-to-vigorous physical activity (MVPA) at different individual, parent, friend, school and neighbourhood levels. Valid accelerometer data were collected for 1077 children aged 9, and 1129 at age 11, and the average minutes of MVPA were derived for weekdays and weekends. We used a multiple-membership, multiple-classification model (MMMC) multilevel model to compare the variation in physical activity outcomes at each of the different levels. There were differences in the proportion of variance attributable to the different levels between genders, for weekdays and weekends, at ages 9 and 11. The largest proportion of variability in MVPA was attributable to individual variation, accounting for half of the total residual variability for boys, and two thirds of the variability for girls. MVPA clustered within friendship groups, with friends influencing peer MVPA. Including covariates at the different levels explained only small amounts (3%–13%) of variability. There is a need to enhance our understanding of individual level influences on children’s physical activity.

Perceptions of time constraints among primary care physicians in Germany

BackgroundTime constraints during patient visits play a major role for the work stress of primary care physicians. Several studies suggest that there is a critical situation in terms of time constraints in primary care in Germany. Therefore, the following research questions are addressed: (1) What is the time allocated and needed for different types of consultations among primary care physicians in an urban area in Germany? (2) What is the extent of time stress? (3) Are there differences in time stress according to physician characteristics (gender and length of experience) and practice type (single vs. group/shared practice)?MethodsData stem from a face-to-face survey of primary care doctors in Hamburg and adjacent regions. A sample of 128 physicians stratified by a combination of physicians’ gender and length of experience (≤15 years or > 15 years) was used. Physicians were asked about the time needed (in minutes) to provide high quality of care for patients regarding six types of consultations: (1) new patient appointment, (2) routine consultation, (3) complete physical examination, (4) symptom-oriented examination, (5) check-up, and (6) home visit (without drive). Afterwards, they were asked about the average minutes allocated for the six consultations. Time stress was measured by calculating minutes needed minus minutes available.ResultsAverage perceived time needed was higher than time allocated for all six types of consultation. However, there were differences in the magnitude of time stress between the consultation types. Time stress was most pronounced and most prevalent in case of a new patient visit. No significant differences in time stress between male and female primary care physicians were found, while less experienced physicians reported more time stress than those with more experience (> 15 years). Physicians working in a single practice had less time stress than those working in a group or shared practice in case of a check-up visit.ConclusionsPerceived time needed is higher than time allocated for various types of consultation among primary care physicians in Germany. Time stress in primary care is particularly pronounced in case of new patient appointments. Early-career physicians are particularly affected by time stress.

Comparative Effects and Social Validation of Support Strategies to Promote Mindfulness Practices Among High School Students

We compared the effects of support strategies for promoting formal mindfulness practices of 9th grade high school students who participated in a 10-week school-based mindfulness education program. The students also completed social validity ratings of the support strategies they selected and the formal mindfulness practices they learned. All of the support strategies were associated with increased average minutes of formal mindfulness practices. Students who did not select an extra support strategy also had increased minutes of formal mindfulness practices but of less magnitude in contrast to the two most effective strategies. The social validity ratings of the support strategies ranged from equivocal to good approval, and the students gave positive ratings to the majority of formal mindfulness practices. We discuss the implications of these findings for designing mindfulness education programs, implementing practice-promoting support strategies, and conducting mindfulness research with school children and youth.

The Youth-Physical Activity Towards Health (Y-PATH) intervention: Results of a 24 month cluster randomised controlled trial.

Low levels of physical activity in youth are an issue internationally, with the age related decline in levels over the adolescent period of particular concern. This study evaluated a multi-component school-based intervention (Y-PATH: Youth-Physical Activity Towards Health), focused on halting the age-related decline in physical activity of youth in early adolescence. A cluster randomized controlled trial in 20 post primary schools (10 control, 10 intervention) was conducted. Data were collected from all 20 schools at baseline (2013), and 12 months (2014), and from 10 of these schools (5 intervention) at 24 months (2015). The setting was mixed gender post primary schools residing in the greater area of Dublin, Ireland. Principals from each school were asked to nominate one first year class group attending their school in September 2013 to participate in the study (N = 564). Intervention schools implemented the Y-PATH whole school intervention, comprising teacher component, parent component, and PE component; while control schools continued with usual care. The main outcome measure was accelerometer derived average minutes of daily moderate to vigorous physical activity (MVPA). Data were analysed from October 2015 –November 2017. At baseline 490 participants were assessed (mean age 12.78y ± .42). Results of the multilevel regression analysis confirmed that there was a significant time intervention effect, and this was predominantly contributed by the difference between control and intervention groups within females. Findings support the case for national dissemination of the Y-PATH intervention so that the knowledge learned can be translated to routine practice in schools.

Neighborhood Built Environment and Socioeconomic Status are Associated with Active Commuting and Sedentary Behavior, but not with Leisure-Time Physical Activity, in University Students.

The role of neighborhood characteristics in promoting physical activity and sedentary behaviors (SB) has not been extensively studied in university students. The study purpose was to analyze the associations of neighborhood built environment and neighborhood socioeconomic status (SES) with active commuting, leisure-time physical activity (LTPA), and SB among university students. This is a cross-sectional study of 308 undergraduate students from two urban universities in Valencia, Spain. Participants’ residential neighborhoods were classified according to walkability and SES levels. Walkability was defined as an index of three built environment attributes (i.e., residential density, land-use mix, and street connectivity) based on geographical information system data. Active commuting to and from university (ACU), active commuting in the neighborhood, LTPA, and SB were evaluated through a questionnaire. Mixed model regression analyses were performed. There were no significant SES–walkability interactions for any of the outcomes analyzed. However, university students living in more walkable areas reported two more ACU trips per week compared to those living in less walkable neighborhoods (p < 0.01). University students living in lower-SES neighborhoods reported more ACU trips per week than those living in higher-SES neighborhoods (p < 0.05). Regarding LTPA, there were no significant SES or walkability main effects. Neighborhood SES was negatively related to active commuting in the neighborhood and to time spent in SB (all p < 0.05). Participants living in lower-SES neighborhoods reported more active commuting per week and had the highest average minutes spent in SB. This study highlights the relevance of assessing university’s residential environment when active transportation and SB are analyzed.

The association of school-related active travel and active after-school clubs with children\u2019s physical activity: a cross-sectional study in 11-year-old UK children

BackgroundPhysical activity is associated with improved physical and mental health among children, but many children do not meet the recommended hour per day of moderate-to-vigorous-intensity physical activity (MVPA). The aim of this paper is to investigate participation in active after-school clubs and active travel to and from school at age 11 and estimate the average daily minutes of MVPA associated with active club attendance and active travel.MethodsAccelerometer data were collected on three weekdays for 1296 11-year-old children in a cross-sectional study. Children reported attendance at active after-school clubs and how they travelled to and from school for each day of the week. To account for repeat days within child and clustering within schools we used multilevel models with random effects at the school and child level, and fixed effects for all covariates. We calculated odds ratios for participation in active after-school clubs and active travel for gender, measures of socio-economic position and BMI category. We also explored the association between active club attendance, active travel and daily average MVPA.ResultsBoys and girls were equally likely to attend active after-school clubs. Boys were more likely to travel to school using active modes. Attendance at active after-school clubs and active travel home were not associated with each other. Attending an active after-school club was associated with an additional 7.6 min (95% CI: 5.0 to 10.3) average MVPA on that day among both boys and girls. Active travel was associated with an additional 4.7 min (95% CI: 2.9 to 6.5) average MVPA per journey for boys and 2.4 min (95% CI: 1.0 to 3.7) for girls.ConclusionsBoth active after-school clubs and active travel are associated with greater physical activity on the day that children participate in these, and we saw no evidence that those attending active clubs do so at the expense of active travel home afterwards. While the increased daily MVPA is small to moderate, active after-school clubs and active travel on multiple days of the week could make important contributions as part of complex interventions aimed at increasing population levels of physical activity in children.

Accelerometer-measured moderate-to-vigorous physical activity of Canadian adults, 2007 to 2017.

Surveillance of physical activity among Canadian adults has typically relied on questionnaire-based data, which have many limitations. The Canadian Health Measures Survey (CHMS) has been collecting objective, accelerometer-based physical activity data on a nationally representative sample of Canadian adults since 2007. Data are from Cycle 1 (2007 to 2009), Cycle 2 (2009 to 2011), Cycle 3 (2012 to 2013), Cycle 4 (2014 to 2015) and Cycle 5 (2016 to 2017) of the CHMS. The study sample included adults aged 18 to 79 years (Cycle 1: n = 2,952; Cycle 2: n = 2,959; Cycle 3: n = 2,517; Cycle 4: n = 2,390; Cycle 5: n = 2,355). Average daily minutes of moderate physical activity (MPA), vigorous physical activity (VPA) and moderate-to-vigorous physical activity (MVPAALL) were derived from minute-by-minute accelerometer data captured over seven consecutive days. MVPA accumulated in bouts of at least 10 minutes (MVPABOUTS) were also calculated, and adherence to the Canadian Physical Activity Guidelines was assessed. No significant linear trend was observed in accelerometer-measured MVPA from 2007 to 2017. According to the most recent cycle of CHMS data (2016 and 2017), Canadian adults accumulated an average of 26 minutes of MVPAALL per day, less than half of which (12 minutes per day, on average) was accumulated in bouts of at least 10 minutes. Average daily VPA was less than five minutes. About 3% of Canadian adults accumulated no MVPA at all, while approximately 36% did not accumulate any MVPA in bouts of at least 10 minutes; 16% of Canadian adults met the current physical activity guidelines of 150 minutes of MVPA per week in bouts of at least 10 minutes. These results may be important to governments and other organizations for initiatives geared toward increasing physical activity levels in Canadian adults.

Using mental contrasting with implementation intentions to reduce bedtime procrastination: two randomised trials

Objective: The importance of getting a good night sleep is critical, yet for many this remains elusive. Bedtime procrastination—the notion that people delay going to bed for no legitimate reason—is one area that has received little attention, despite its associations with worse sleep outcomes. In the present research, we investigated how to effectively self-regulate bedtime procrastination. Design: In two studies (N1 = 383, N2 = 221), undergraduate students participated either in an online self-regulation exercise called mental contrasting with implementation intentions (MCII) or a motivationally-relevant control exercise (Study 1) or a sleep hygiene control group (Study 2). We then assessed outcomes three weeks (Study 1) or one week (Study 2) later. Main Outcome Measures: We assessed commitment to reduce bedtime procrastination and self-reported bedtime procrastination using two different measures. Results: We found that MCII (compared to control) increased commitment to reduce bedtime procrastination. In both studies this corresponded to a reduction in the average minutes of bedtime procrastination per night. Conclusion: MCII is a simple and cost-effective self-regulation tool for reducing bedtime procrastination. Future research should seek to reveal the mechanisms that undergird bedtime procrastination, as well as understand the present findings in other populations and contexts.

Trends in Self-Management among Adults with Heart Failure from 2011 to 2016 Using the National Health and Nutrition Examination Surveys

Introduction Heart failure (HF) affects patients’ quality of life as it progresses. Given the unpredictability of HF pathways and complex medical treatments, self-management of HF is demanding work for patients and family caregivers. Patients with HF, for instance, have to monitor symptoms, adhere to dietary recommendation (e.g., DASH diet) and medication regimens, and maintain regular physical activities; thus, discovering such characteristics in a scientific way is important. This study aims to shed light on changes in health-related characteristics and to investigate the self-management status of adults with HF. Methods This study employed three public datasets provided by the National Health and Nutrition Examination Surveys undertaken between 2011 and 2016 at two-year intervals. The original surveys included a set of questions to measure the health and nutritional status of adults and children in the United States. Among the study cohort, 583 adults (ranging in age from 25 to 80) who self-reported the diagnosis of HF were filtered for this secondary data analysis (n=187 in 2011-2012, n=182 in 2013-2014, n=214 in 2015-2016). The selected variables for this report included as follows: laboratory data measuring physical health status; depression severity using patient health questionnaire (PHQ-9); comorbidities; prescribed medications; dietary intakes; and physical activities. Results The overall mean of the medications subjects were prescribed was 9.16 (SD=3.14). Figure 1 illustrates the heatmap for the patterns of comorbid disease. In dietary quality, the averages of sodium intake in each wave were 3093.45 (SD=1787.51), 3015.44 (SD=1567.25), and 3143.59 (SD=1629.42). While there were no significant differences (F=30.82, p=0.311), these values were higher than the AHA recommendation for maintaining sodium intake (less than 2,000mg/day). There were significant changes in the consumption of low-density lipoprotein (F=3.46, p=.033) and triglycerides (F=5.70, p =.004). The proportions of HF patients with moderate to severe depression were 17.11%, 21.98%, and 15.89% respectively. Lastly, subjects walked or bicycled approximately four days a week. However, the average minutes of sedentary activity a week ranged from 477.80 (SD=727.82) to 546.43 (SD=1150.56). Conclusion Contrary to our expectations, the self-management among HF patients were not improved even if clinical guidelines for HF management had been updated periodically. Findings suggest that strategies and potential resources for improving self-management of HF should be further investigated.

Longer, More Active Commute, but Still not Very Active: Five-Year Physical Activity and Travel Behavior Change in a University Population.

Active travel can support the achievement of recommended levels of physical activity. Monitoring travel behavior of university students and staff provides a useful insight into patterns of regional travel and population level changes in physical activity. This study sought to evaluate current travel and physical activity behaviors in a university population and to determine whether these changed over time. An online survey of travel behavior and physical activity was conducted at the University of Sydney, Australia. The survey was actively promoted for three weeks prior to the release of the survey among staff and students, which asked about travel behavior on a specific day in September 2017. The survey questions were the same as those used in a similar online survey conducted across the University in 2012. In total, 4359 People completed the survey, representing 10.8% of staff and 4.1% of students. Approximately two thirds of survey respondents were students, in both the 2012 and 2017 surveys. Compared with 2012, there was an increase in active travel to the University in 2017 from increased walking and train travel. Compared to 2012, in 2017 there was an increase in average minutes walked by about nine minutes, and less time spent sitting. Trip lengths increased, with 68% of trips taking longer than 30 min in 2017. The amount of time spent in low–moderate levels physical activity increased between 2012 and 2017, potentially related to active travel behavior. Citywide changes towards a system-wide transport fare structure was the biggest change in the transport environment between the two surveys and may have contributed to increased train travel.