Community-based Physical Activity Research Articles

The long road back to physical activity: the experience of people with moderate-to-severe traumatic brain injury

Purpose People with moderate-to-severe traumatic brain injury (TBI) are frequently inactive with increased risk of higher rates of chronic health conditions, mortality and economic burden than peers without TBI. Understanding how this population experience physical activity participation may help us develop better pathways and supports to community-based physical activity. Materials and methods Using an interpretive description approach, we conducted a secondary analysis of focus group and interview data. Themes were generated in two stages of inductive coding and refined in a workshop by the author team which comprised multidisciplinary researchers, clinicians and people with lived experience of moderate-to-severe TBI. Results Twenty-two people with moderate-to-severe TBI took part. They experienced physical activity in diverse and often changing ways, reflecting the numerous, powerful tensions that people with TBI are striving to navigate. Four themes were identified: 1. What is my new normal?, 2. Invisible injuries, hidden needs, 3. The long road back to physical activity, and 4. Expanding horizons. Conclusions People with moderate-to-severe TBI have to work hard to be physically active. Results indicate that physical activity promotion should include person-centred information and support, appropriate community-based options that go beyond rehabilitation, and insurance funding that recognises the value of life-long physical activity.

Co-development of a programme to improve physical activity support for women after breast cancer treatment: a pre-protocol for PURE-EX

Background Breast cancer and its treatment can have long-term adverse effects on physical and mental health. Evidence-based guidelines recommend that healthcare professionals (HCPs) advise women with breast cancer to engage in physical activity to improve health outcomes. However, support to be active is not standard care. The PURE-EX (EXpanding into communities to imProve physical activity sUpport foR womEn after breast cancer) programme aims to address this knowledge-practice gap. Aim To co-develop a programme that integrates physical activity referrals into standard care for women after treatment for early-stage and locally-advanced breast cancer. Programme components will include: 1. A referral pathway enabling HCPs to refer women to community-based physical activity programmes after they have completed primary treatment for breast cancer; 2. An online training course to support community providers in adapting their existing physical activity programmes for women who have undergone breast cancer treatment. Work Packages We will co-develop, refine, and evaluate PURE-EX programme components through four work packages (WPs): WP1. Conduct a systematic scoping review to describe the characteristics of community-based physical activity programmes for women with breast cancer reported in the literature. WP2. Undertake qualitative research with: (i) women with breast cancer, (ii) HCPs responsible for their care, and (ii) exercise professionals, to explore barriers and facilitators to incorporating physical activity into breast cancer care from different perspectives. WP3. Hold co-development events to develop and refine components of the PURE-EX programme and gain insights as to how it could be operationalised in practice. WP4. Conduct a feasibility trial in 45 women who have finished primary treatment for breast cancer to assess the feasibility and acceptability of the PURE-EX programme. Discussion The PURE-EX programme will be an evidence-based, theory-informed, and person-centred intervention, with the potential to make physical activity support routinely available for women after breast cancer treatment.

Understanding how intermediaries connect adults to community-based physical activity: A qualitative study.

Intermediaries facilitate connections to community-based services and supports, including physical activity and exercise groups, and are an emerging method to promote physical activity participation. However, their processes when establishing connections to community-based physical activities are unclear. The aim of this study was to explore the processes, practices, and procedures of Irish intermediaries when connecting people to community-based physical activity. This was a qualitative descriptive design study. Semi-structured interviews were carried out with n = 27 intermediaries from a variety of sectors-Health Promotion and Improvement [HPO], Local Sports Partnerships [LSO] and Social Prescribing [SP]. Four themes were identified using qualitative content analysis; 1) the processes of connecting to an intermediary, 2) connecting individuals to physical activity, 3) exiting from the intermediary service and 4) working in the local context. Intermediaries reported that they received referrals for individuals with physical, mental, and social health needs, but that referrals to improve physical activity specifically were low. They used a person-centred approach throughout their process, often addressing barriers to physical activity. However, only LSO and SP facilitated connections to physical activity, as HPO mainly focused on delivering smoking cessation support and services. Levels of support given and length of follow-up varied between LSO and SP, with the latter providing more intensive support. To facilitate their work, they developed extensive local knowledge and networks of partners, which enabled connections to a variety of community-based physical activities. Intermediaries may be an under-utilized resource to promote physical activity. Understanding the processes used in their interventions can inform future research, which is needed to investigate the effectiveness of intermediaries in improving physical activity levels and to inform future referral pathways.

Community-based physical and social activity for older adults with mild frailty: a rapid qualitative study of a collaborative intervention pilot

BackgroundIntervening to modify frailty trajectories may be critical to maintain health and independence in later life. The Active Ageing Programme (AAP) is a 16-week community-based intervention for older people with mild frailty that combines physical activity and social interaction. The programme aims to positively impact resilience and wellbeing, changing the physical, mental and social factors that impact on frailty trajectories. We conducted a rapid qualitative study with the first cohort to understand the acceptability and feasibility of the AAP.MethodsPurposive sampling was used to identify and recruit staff and participants involved in the AAP for semi-structured interviews. The topic guides covered experiences and perceptions of training and referral, delivery and participation in activities, and benefits and challenges. Data from 20 interviews were analysed using a reflexive thematic approach with inductive coding. The Theoretical Domains Framework prompted consideration of potential individual, social and environmental factors influencing changes in behaviour and practice.ResultsSixteen AAP staff (10) and participants (6) completed interviews. Two themes were developed: combining motivating components; addressing what matters. The AAP brought together a number of components that supported its acceptability and successful implementation by motivating older people and staff and sustaining their engagement. These included the convenient and familiar location, the opportunity to improve physical health (participants) and to gain experience of an activity intervention, training and confidence (staff), and the variety of activities on offer. The programme was perceived to have potential to improve physical and mental health and increase the personal resources (e.g. knowledge, confidence, motivation) of those taking part. Areas identified as important for the AAP’s future sustainability and success were: tailoring recruitment practices; enhancing organisational communication; and strengthening support for participants to achieve long-term increased physical and social activity and resilience.ConclusionsOur findings suggest that community-based physical and social activity interventions targeting frailty may be acceptable, feasible and useful. Further work is needed to investigate the impact of such programmes on health and service utilisation. Efforts should be targeted at improving the potential for long-term sustainability of programmes and their impacts.

Social prescribing initiatives connecting general practice patients with community-based physical activity: A scoping review with expert interviews.

The World Health Organization states that physical inactivity is one of the leading behavioural risk factors for disability and mortality in Europe. Social prescribing holds promise as a possible solution by connecting patients from general practice to community-based physical activity. Although research within social prescribing exists, the process of connecting general practice patients to community-based physical activity is not well investigated. This scoping review aimed to summarise and synthesise knowledge on social prescribing provided by health professionals in general practice towards community-based physical activity. A systematic search for literature in PubMed, Embase, Scopus, SportsDiscus and other sources was conducted to identify initiatives connecting general practice to community-based physical activity. Semi-structured interviews were then conducted with subject-specific national experts. Finally, preliminary findings from the literature and the interviews were used in a co-creation process with experts to synthesise and finalise the results of a thematic analysis across data sources. Based on 19 records, five expert interviews and subsequent co-creation, we identified three themes: (a) barriers and facilitators, (b) organisational perspectives and (c) value-based considerations. This review illuminates the complex nature of social prescribing programmes that connect general practice patients to community-based physical activity in Denmark. It also presents practical and fundamental considerations when applying social prescribing across different settings.

Enhancing adapted physical activity training for community organizations: co-construction and evaluation of training modules.

Community-based physical activity programmes benefit persons with disabilities. However, there is a lack of evidence-based tools to support kinesiologists' training in such programmes. This study aimed to co-create and evaluate physical activity training modules for community-based adapted physical activity (APA) programmes. In Phase 1, a working group (n = 8) consisting of staff, kinesiologists from two community-based APA programmes, and researchers met over four online meetings to discuss needs, co-create training modules, and assess usability. In Phase 2, a pre-post quasi-experimental design evaluated changes in capability, opportunity, and motivation of kinesiologists (n = 14) after completing the training modules, which included standardized mock client assessments and participant ratings of module feasibility. Means and standard deviations were computed for feasibility, followed by paired-samples t-tests, along with Hedge's correction effect size. Mock client sessions underwent coding and reliability assessment. The working group meetings generated two main themes: training in (i) motivational interviewing and behaviour change techniques and (ii) optimizing APA prescription. Nine online training modules were created. In Phase 2, medium to large effects of training modules were observed in capability (Hedge's g = 0.67-1.19) for 8/9 modules, opportunity (Hedge's g = 0.77-1.38) for 9/9 modules, and motivation (Hedge's g = 0.58-1.03) for 6/9 modules. In mock client assessments, over 78% of participants appropriately used five behaviour change techniques and, on average, participants demonstrated good use of motivational interviewing strategies. The findings indicate that training kinesiologists was feasible and has the potential to enhance community-based physical activity programmes for persons with disabilities.

Keep it Movin’: Design and methods of a church-based physical activity program to improve physical function among midlife and older black adults

BackgroundOlder Black adults have high rates of physical function (PF) limitations. Physical activity (PA) is effective for improving PF and reducing mobility disability risk; however, community-based PA interventions focused on improving PF for older Black adults are lacking. Given the importance of churches as trusted institutions in Black communities, church-based interventions developed through community collaborations may help increase access to PA interventions. MethodsKeep it Movin’ is a church-based cluster randomized controlled trial testing the effectiveness of a 24-week group-based (intervention arm) versus a self-guided (comparator arm) program in improving PF among Black adults aged ≥ 40 years with PF limitations (short physical performance battery [SPPB] score ≤ 9). A church-wide virtual walking program is available to congregants in both arms. The intervention arm receives weekly group-based classes held at the church that include education, goal setting, and structured PA (walking, lower-extremity strength, balance, and stretching). The comparator arm receives educational materials about PA appropriate for people with PF limitations. Outcomes are assessed at 6 (program completion) and 12 months (maintenance). The primary outcome is PF change as measured by the SPPB at 6 months. Secondary outcomes include change in moderate-to-vigorous PA, social support and self-efficacy for PA, quality of life, and self-reported PF. Factors related to successful adoption, implementation, and maintenance are assessed using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. ConclusionThis is the first study to evaluate the effectiveness of a group-based PA program delivered in Black churches to improve PF.

Living with COPD and its psychological effects on participating in community-based physical activity in Brazil: a qualitative study. Findings from the Breathe Well group

Physical activity (PA) improves dyspnoea, psychological wellbeing and quality of life (QoL) for people with COPD reducing their risk of exacerbation. However, engagement in PA is low especially amongst those with anxiety and depression, and PA programmes are limited in countries with limited resources such as Brazil. We explored perceptions of 21 people with COPD about the impact of their disease on taking part in community-based PA programmes in Sao Paulo, Brazil through semi-structured telephone interviews from October 2020 to April 2021. Discussions were audio-recorded, transcribed, and analysed using the Framework method. Five themes were identified: Knowledge about COPD and its management; Self-perception of life with COPD; Knowledge and experiences of depression and anxiety; Opinions on PA and repercussions of COVID-19. PA was considered to be important in bringing physical and mental health benefits but there were barriers in accessibility of formal PR programmes and therefore local community PA programmes were considered to be important. People with mental health conditions tended to view PA more negatively. COVID-19 had reduced PA opportunities, access to COPD treatment and social interaction, and was associated with more exacerbations and emotional suffering. In general, this study showed an urgent need to improve knowledge about COPD and its risk factors and management among both patients, the public and primary healthcare professionals. We provide important content for the formulation of public policies for the implementation of specific activity programmes for people with COPD in community spaces using local resources and intersectoral partnerships.

Neurological conditions and community-based physical activity: physical therapists' belief and actions.

Physical therapists (PTs) are key actors in physical activity (PA) promotion. However, it remains unclear whether PTs in community settings promote community-based PA such as adapted physical activity (APA) and adaptive sports (AS) to their patients with neurological conditions (NCs). The main purposes were to evaluate the beliefs PTs have of APA and AS, and to explore actions they undertake to promote it to their patients with NCs. An online survey was created specifically for the study. PT associations and institutions were contacted and licensed PTs working in community-based settings, treating at least one patient with a NC, were invited to participate. Questionnaires were analyzed only if all mandatory questions had been answered. A total of 165 questionnaires were analyzed. PTs reported prioritizing active treatment. They viewed APA and AS as beneficial for their patients with NCs; however, its promotion remained largely infrequent due to a number of barriers. The PTs' own level of PA seemed to significantly influence their beliefs of the benefits of APA and AS (p = 0.001), while being specialized in neurologic physical therapy enabled the PTs to increase frequency of promotion (p = 0.003). Though community-based PTs are aware of the importance of PA for individuals with NCs, they face difficulties in promoting it to their patients. However, these difficulties are reduced among PTs who are specialized in neurologic physical therapy. Efforts should be made toward educating PTs to neurological pathologies and their specificities when it comes to PA.

Vitalidad en movimiento: la experiencia de la actividad física musicalizada en la calidad de vida del adulto mayor

To establish the impact of musicalized physical activity on the quality of life of older adults. The present research adopts a qualitative approach through a narrative design, using semi-structured interviews as a method of data collection. Content analysis was used to address dimensions such as self-concept, socioemotional skills, health, and physical well-being. A positive impact on self-esteem and interpersonal relationships, improvements in conflict resolution and communication skills, as well as gains in vitality, physical and mental well-being are highlighted. In addition, the constant motivation to remain active in the area of physical wellbeing is highlighted. The findings provide contextualized evidence of the positive impacts that community-based physical activity programs have on the overall quality of life of older adults. The experiences and testimonies of the participants highlight concrete impacts on fundamental biopsychosocial dimensions to promote active and healthy aging.

Developing community-based physical activity interventions and recreational programming for children in rural and smaller urban centres: a qualitative exploration of service provider and parent experiences

BackgroundChildren’s physical inactivity is a persisting international public health concern. While there is a large body of literature examining physical activity interventions for children, the unique physical activity context of low-density communities in rural areas and smaller urban centres remains largely underexplored. With an influx of families migrating to rural communities and small towns, evaluations of health promotion efforts that support physical activity are needed to ensure they are meeting the needs of the growing populations in these settings. The aim of this community-based research was to explore service providers’ and parents’ perspectives on physical activity opportunities available in their community and recommendations toward the development and implementation of efficacious physical activity programming for children in rural communities and smaller urban centres.MethodsThree in-person community forums with recreation service providers (n = 37 participants) and 1 online community forum with the parents of school-aged children (n = 9 participants) were hosted. An online survey and Mentimeter activity were conducted prior to the community forums to gather participants’ views on the barriers and facilitators to physical activities and suggestions for activity-promoting programs. The service provider and parent discussions were audio-recorded, transcribed verbatim, and analyzed following a deductive approach guided by Hseih and Shannon’s (2005) procedure for direct content analysis. A code list developed from the responses to the pre-forum survey and Mentimeter activity was used to guide the analysis and category development.ResultsSeven distinct categories related to the existing physical activity opportunities and recommendations for programs in rural communities and smaller urban centres were identified during the analysis: (1) Recovery from Pandemic-Related Measures, (2) Knowledge and Access to Programs, (3) Availability, (4) Personnel Support, (5) Quality of Programs and Facilities, (6) Expenses and Subsidies, and (7) Inclusivity and Preferences.ConclusionTo improve the health and well-being of children who reside in low-density areas, the results of this study highlight service provider and parent recommendations when developing and implementing community-based physical activity programs and interventions in rural and smaller urban settings, including skill development programs, non-competitive activity options, maximizing existing spaces for activities, and financial support.

84 Context Analysis for Scaling-Up a Community-Based Physical Activity Promotion Approach: a Comparative Case Study of 10 German Pilot Communities

84 Context Analysis for Scaling-Up a Community-Based Physical Activity Promotion Approach: a Comparative Case Study of 10 German Pilot Communities

109 Optimising Community-Based Physical Activity for Chronic Condition Management in Ireland: A Comprehensive Systems Analysis guided by RE-AIM

109 Optimising Community-Based Physical Activity for Chronic Condition Management in Ireland: A Comprehensive Systems Analysis guided by RE-AIM

202 Football Cooperative, a community-based physical activity social intervention for men: The development of an implementation strategy for scale-up

Abstract Purpose Gender-sensitised health promotion strategies are crucial for men for several reasons including; Addressing male-specific health issues, Improving mental health, and promoting healthy lifestyles. Football Cooperative (FC) provides social games aimed at enhancing overall health and well-being among men and has the potential to return benefits including decreased blood pressure, heart rate, and fat mass, which presents solutions to address existing challenges in men’s health. This study aims to evaluate FC and gain insights into operating characteristics, both internally and externally, and learn from good practices, to develop a scalable implementation strategy for FC. Methods The Consolidated Framework for Implementation Research (CFIR) guided qualitative data collection from various stakeholders for this study, including; Interviews (n = 26), Ad hoc Interviews (n = 9), and Focus Groups (n = 3). Ethnographic data was collected through researcher participation in weekly games and completing reflective logs (n = 8). Data was recorded, transcribed verbatim, and analysed via thematic analysis. This analytical approach was guided by CFIR and in collaboration with a multi-disciplinary research team. Results Six main determinants were identified from the data including 1: Culture defined by inclusivity and diversity, developing community, creating a pressure-free environment and embracing values such as respect, 2: Game Characteristics - which are the structure of how games are implemented, 3: Motivations to Participate - which are the key factors that bring men to FC games, 4: Benefits of Participation is concerned with the positive benefits the games have on their lives, 5: Facilitators of Participation defined by anything that makes games accessible to men, and 6: Barriers to Participation is defined by anything that make participation challenging. Conclusions Various elements are essential to replicating FC at new sites and their inclusion should form a final strategy. Bringing the FC Culture to new venues, avoiding late start times, and ensuring flexibility when working with new stakeholders regionally are important, as are branding and communication alignment. Volunteer recruitment and management are at the core of FC and policy to support this is critical, as is the accessibility of games in terms of price, ability, and ease of joining games. Funding South East Technological University & UEFA

175 FunFit: A Collaborative Community-based Physical Activity Programme for Children aged 6-12 with Diagnosed Delayed Gross Motor Skill Development

175 FunFit: A Collaborative Community-based Physical Activity Programme for Children aged 6-12 with Diagnosed Delayed Gross Motor Skill Development

Impacts of a Prescribed Physical Activity Program for People with Chronic Diseases Living in Community Settings in France.

Sedentary behavior and physical inactivity are modifiable risk factors at the forefront of prevention and health promotion strategies. The health benefits of physical activity (PA) have been widely demonstrated in chronic diseases and have led to the prescription of adapted PA. To date, French scientific data are insufficient to evaluate the effectiveness of prescribing adapted PA. This study aimed (1) to evaluate the effectiveness of a community-based program and (2) to identify patient characteristics at inclusion that could be associated with improved post-program anthropometric data. Our sample was composed of 113 participants with a chronic disease (83.18% women) with a mean age of 55.4 ± 13.9 years. Participants benefited from an 8-week adapted PA program. All participants were evaluated at the beginning and end of the program by anthropometric measurements, a subjective measure of the level of PA and a measure of physical condition. Almost 86% of the participants were overweight and two-thirds were obese. Statistical analyses showed a significant improvement in physical condition, expressed by a better cardiorespiratory endurance (up to +14% for a 2 min walk test; MT0 = 78.1 m vs. MT1 = 89 m; p < 0.001 with a 2 min walk test), improved flexibility (+12.5%; MT0 = 2.4 vs. MT1 = 2.7; p < 0.001), and increased muscle strength in the lower limbs (+22.7%; MT0 = 11.9 vs. MT1 = 14.6; p < 0.001). The level of physical activity increased significantly for all participants (57.52% of inactive individuals at T0 vs. 5.31% at T1; p = 0.004). Correlational analyses revealed that the decrease in BMI and weight throughout the program correlated positively with age (r = 0.252 and p = 0.007, and r = 0.247 and p = 0.008, respectively) and negatively with BMI from baseline (r = -0.271; p = 0.004). The key points of this community-based PA program are the following: (1) It improves participants' physical condition. (2) It improves anthropometric parameters. (3) It modifies physical activity behavior. Furthermore, in the context of the program set up specifically for this purpose, it would appear that elderly and overweight people are more likely to exhibit beneficial effects on anthropometric parameters than younger participants or those with a high level of obesity. However, these results need to be confirmed by a long-term evaluation of the effectiveness of such devices.

Mental Health, Declining Physical Activity and Social Connection during Transitions into Fatherhood in the UK.

This paper addresses an under-explored area of sociologically oriented health research, namely, the mental health and physical activity (PA) experiences of new fathers. Drawing upon responses to an online qualitative survey from 32 fathers, aged 18 or over, and living in the UK, we show how the decline in these fathers' overall PA was associated with poor mental health and the changing constraints that characterised their increasingly complex networks of interdependence. These constraints corresponded with shifts in fathers' PA engagement from team sports towards individualised, flexible, and more recreationally oriented lifestyle activities like running and the gym. Fathers' engagement in these activities appeared to exacerbate the complex feelings of guilt and isolation that they already encountered as new fathers. These experiences were simultaneously associated with feelings of shame associated with being insufficiently active and fearing judgement about their engagement in fathering responsibilities. The paper has important policy implications, highlighting the need for tailored support for new fathers in the perinatal period, and implications for practice, suggesting that co-produced community-based PA programmes are potentially effective settings for engaging new fathers in PA and promoting their mental health.

Brisk Walking Exercise Has Benefits of Lowering Blood Pressure in Hypertension Sufferers: A Systematic Review and Meta-Analysis.

Brisk walking exercise is an aerobic exercise with the moderate intensity that can reduce the risk in people with hypertension. This systematic review and meta-analysis aimed to investigate the effects of interventions related to brisk walking and blood pressure reduction in hypertensive patients. Search strategy through the PubMed, Science Direct, ProQuest, and Google Scholar databases limited from 2018 to 2023. The components measured are systolic blood pressure and diastolic blood pressure. This study uses the Black and Downs checklist to measure the quality of the study, which consists of 3, namely high quality, medium quality, and low quality. Effect size analysis of the study used the standard mean difference between brisk walking exercise and not doing brisk walking exercise. The results of the identification of the database obtained 1700 articles, then limited by title, year, abstract (n = 381), and full-text article feasibility (n = 76) to obtain nine articles included. Nine articles were included in the systematic review and meta-analysis by study quality: six studies of high quality, 2 of medium quality, and 1 of low quality. Systolic blood pressure had a substantial effect size in all studies (P<0.05; SMD: -0.55) while diastolic blood pressure had an effect medium size (P=0.05; SMD: 0.13). Brisk walking exercise can significantly reduce blood pressure in people with hypertension-recommendations for the future to carry out community-based physical activity in improving physical health, including heart health.

Differential relationships between physical activity and pain phenotypes in individuals with spinal cord injury

Background Chronic pain affects 70% of individuals with spinal cord injury (SCI) and leads to declines in health and quality of life. Neuropathic and nociceptive pain are phenotypes derived from different mechanisms that contribute to pain perception. The objective of this research was to investigate differential pain responses to moderate-to-vigorous physical activity (MVPA) in two chronic pain phenotypes: neuropathic and nociceptive pain. Methods Community-based physical activity levels were collected for one week in 17 individuals with SCI using a wrist-worn accelerometer, and daily pain ratings were assessed and categorized by phenotype. Physical activity levels were summarized to calculate minutes of MVPA. Correlational analyses were conducted to compare relationships between pain intensity and MVPA across individual participants and between pain phenotype groups. Results The neuropathic pain group revealed significant negative correlation between MVPA and pain intensity. In the nociceptive pain group, there was no significant correlation between MVPA and pain intensity. Further analysis revealed two subgroups of positive (N = 4) and negative (N = 3) correlations between MVPA and pain intensity. Pain location differed between the subgroups of nociceptive pain. Individuals with negative correlation experienced neck and upper back pain, whereas individuals with positive correlation experienced unilateral upper extremity pain. Conclusion Differential relationships exist between pain phenotypes and MVPA in individuals with SCI. Pain location differed between the subgroups of nociceptive pain, which we presume may indicate the presence of nociplastic pain in some individuals. These results may contribute to the advancement of personalized pain management by targeting non-pharmacological interventions for specific pain phenotypes. Trial registration: ClinicalTrials.gov identifier: NCT05236933..

Community-based physical activity interventions for adolescents and adults with complex cerebral palsy: A scoping review.

https://onlinelibrary.wiley.com/doi/10.1111/dmcn.15611