Physical Activity Facilities Research Articles

Neighborhood environment and socioeconomic inequalities in cancer admissions: a prospective study using UK Biobank and linked hospital records

PurposeNeighborhood environments may influence cancer risk. Average population effect estimates might mask differential effects by socioeconomic position. Improving neighborhood environments could inadvertently widen health inequalities if important differences are overlooked.MethodsUsing linked records of hospital admissions in UK Biobank, we assessed associations between admission with a primary diagnosis of cancer (any/breast/colorectal), and exposure to neighborhood greenspace, physical activity facilities, and takeaway food stores, and whether household income and area deprivation modify these associations. We used adjusted Cox proportional hazards models, and estimated relative excess risks due to interaction (RERI) to assess effect modification.ResultsAssociations between neighborhood exposures and cancer-related hospitalizations were weak to null overall, but with some evidence of effect modification. Most notably, more greenspace near home was associated with 16% lower hazard of cancer-related hospital admission in deprived areas (95% CI 2–29%). This was further pronounced for people in low-income households in deprived areas, and for breast cancer.ConclusionIn deprived neighborhoods, increasing the amount of greenspace may help reduce cancer-related hospitalizations. Examining effect modification by multiple socioeconomic indicators can yield greater insight into how social and environmental factors interact to influence cancer incidence. This may help avoid perpetuating cancer inequalities when designing neighborhood environment interventions.

Investigating how researcher-defined buffers and self-drawn neighbourhoods capture adolescent availability to physical activity facilities and greenspaces: An exploratory study

BackgroundModifying the environment is considered an effective population-level approach for increasing healthy behaviours, but associations remain ambiguous. This exploratory study aims to compare researcher-defined buffers and self-drawn neighbourhoods (SDN) to objectively measured availability of physical activity (PA) facilities and greenspaces in adolescents. MethodsSeven consecutive days of GPS data were collected in an adolescent sample of 14–18 year olds (n = 69). Using Points of Interest and greenspace data, availability of PA opportunities within activity spaces were determined. We compared 30 different definitions of researcher-defined neighbourhoods and SDNs to objectively measured availability. Results:Findings showed low agreement for all researcher-defined buffers in measuring the availability of PA facilities in activity spaces. However, results were less clear for greenspace. SDNs also demonstrate low agreement for capturing availability to the PA environment. ConclusionThis exploratory study highlights the inadequacy of researcher-defined buffers and SDNs to define availability to environmental features.

Refining index to measure physical activity inequality: which group of the population is the most vulnerable?

BackgroundThe existing body of research mostly discusses inequality in physical activity (PA) based on the difference in the level of moderate-to-vigorous physical activity (MVPA). Evidence is lacking on the quantified inequality measures (e.g., how big the inequality is, and the distribution) in order to identify the most vulnerable groups of a population. This study measured PA inequality among Thai adults by using three parameters to construct an inequality index: (1) Proportion of the population with sufficient MVPA; (2) Cumulative minutes of MVPA; and (3) The Gini coefficient.MethodsThis study employed three rounds of data from Thailand’s Surveillance on Physical Activity (SPA) 2019–2021. In each round, over 6,000 individuals age 18–64 years were selected as nationally-representative samples, and were included in the analysis. PA inequality was constructed by using three parameters, with a combination of the three as the final measure, to identify the sub-groups of the Thai adults who are most vulnerable: groups with the least MVPA, highest insufficiency, and highest inequality index (Gini).ResultsCovid-19 containment measures have widened the gap in PA inequality, as shown by a declining proportion of the population meeting the recommended guidelines, from 74.3% in 2019 to 56.7% in 2020 and 65.5% in 2021. PA inequality existed in all sub-populations. However, by combining three parameters, the most vulnerable groups during the Covid-19 epidemic were identified as follows: (1) Those with no income; (2) The unemployed; (3) Those who have no access to PA facilities; (4) Older adults aged 60 + years; and (5) Those earning < 3,500 baht per month. Further, residents of Bangkok, young adults aged 18–24, individuals who attained primary level education or less, those who had no exposure to a PA awareness campaign and those who have a debilitating chronic disease also had elevated risk of PA insufficiency.ConclusionA concerning level of PA inequality existed in all sub-populations. The use of combined indicators in measuring PA inequality should aid in determining the most vulnerable groups of the population with a refined procedure. This method can be applied in many settings since the baseline data used to measure inequality (i.e., percent sufficient and cumulative minutes of MVPA) are widely available.

O9-4 Barriers and facilitators in Belgian inactive desktop workers to participate in workplace based physical activity programs

BackgroundWorkplace based physical activity programs show great potential to improve health and wellbeing to a large part of the population. However, these programs appear to recruit mostly participants who already have an active lifestyle. This study aims to identify barriers and facilitators of inactive desktop workers, and can serve to inform policy makers or physical activity program designers to adapt current program in order to reach more inactive participants.MethodsDesktop workers were voluntarily recruited by use of social media and by direct communication to companies. Inactive participants were included by means of the International Physical Activity Questionnaire (IPAQ). Semi-structured interviews were conducted with 22 desktop workers, being employed in 15 different Belgian companies and being mostly female (n = 18). Interviews were transcribed verbatim and analysed using thematic analysis.ResultsResults indicate that interpersonal relationships can be both a potential facilitator (e.g. having a colleague who asks you to join the exercise program) as a barrier (e.g. being scared of negative reactions from colleagues). Furthermore, organisational factors such as a high workload or a perceived lack of time is claimed as an important mediating factor for participation. On the other hand, having permission to exercise during working hours or having a fixed time to exercise said to be an important facilitator. Also environmental factors are important, since not having an on-site physical activity facility or program is seen as an important barrier. Lastly, also communication from the management being supportive and emphasizing the importance of participating is found to be an important motivator.ConclusionsThis study shows several specific barriers and facilitators of inactive desktop workers to participate within workplace based physical activity programs. These results can support developers of physical activity programs to create more targeted interventions in order to reach more inactive employees.

Five-Year Trend in Adherence Rate to Aerobic Physical Activity Guidelines among Korean Adults in Metropolitan Cities: 2016-2020 Korea Community Health Survey.

This study investigated the five-year (2016–2020) trend in physical activity adherence rate (PAR)—before and after the onset of the COVID-19 pandemic—and its association with socioeconomic status and community environment among Korean adults. Data were analyzed from the Korea Community Health Survey 2016–2020 concerning adults (19–65 years old) living in seven metropolitan municipalities of South Korea (N = 190,761). The independent variables were socioeconomic status (household income and educational attainment) and community environment (density of physical activity facilities and social cohesion), and the dependent variable was the PAR, as measured by the International Physical Activity Questionnaire-Short Form, a recall-based subjective survey. Multilevel logistic regression models with age, sex, and body mass index as covariates were applied. The results showed that the PAR increased from 37.26% (2016) to 40.84% (2019), during the pre-COVID-19 pandemic, but it sharply decreased to 31.59% (2020) during the COVID-19 confinement (trend p < 0.001); PAR disparities were observed following socioeconomic status, as indicated by household income (trend p < 0.001) and educational attainment (trend p < 0.001). Furthermore, significant moderation effects were observed from socioeconomic status and community environment, but the direction of the effects varied by indicator and COVID-19-related confinement period. Lower educational attainment and higher income were associated with a greater decrease in PAR during the pandemic. This study shows that PAR substantively decreased in South Korea during the COVID-19 pandemic, although it had shown a steady increase through 2019. In addition, PAR disparities by socioeconomic status were found, and socioeconomic status and community environment had distinct influences on PAR trends, depending on their indicators and pre- and post-pandemic periods. Lower educational attainment is associated with greater decreases in PAR during the pandemic, suggesting the necessity for a public campaign to maintain a physically active lifestyle during such social disaster.

Low back pain and associated risk factors among medical students in Bangladesh: a cross-sectional study.

Background: Low back pain (LBP) is one of the leading causes of disability worldwide. Different studies showed the high prevalence of LBP among medical students. However, no study has been conducted on Bangladeshi medical students to estimate the prevalence of LBP. This study determined the prevalence, characteristics, and associated risk factors of LBP among medical students in Bangladesh. Methods: A cross-sectional study was conducted from October to December 2020 among randomly selected 270 medical students and medical interns in Faridpur Medical College, Bangladesh, using an online questionnaire. In data analysis, chi-square test and binary logistic regression were performed, and a p-value of < 0.05 was regarded as statistically significant. Results: A total of 207 participants responded fully to the survey, and were included in the analysis. The mean age of the participants was 22.4 ± 1.9 years. The point, 6-month, and 12-month prevalence of LBP was 25.6%, 46.9%, and 63.3%, respectively. In most participants, LBP was localized (53.2%), recurrent (64.9%), non-specific (70.8%), affected for a short period (55%), and relieved without receiving any treatment (60.4%). Participants who had a significantly higher 12-month prevalence of LBP included females (72.2% vs 52.2%), with BMI >25 kg/m 2 (73.2% vs 56.7%), those who performed physical activity at low to moderate frequency (72.4% vs 29.5%), those who spent > 6 hours/day by sitting (71.3% vs 45.3%), and those who did not have enough rest time (92.7% vs 56%). Ergonomic features of chairs, such as having back support, adjustable back support, and adjustable sitting surface, significantly (p < 0.05) influenced the outcomes. Conclusion: The prevalence of LBP among medical students in Bangladesh was high, and most of the risk factors associated with the high prevalence of LBP were modifiable. Hence, LBP can be prevented by implementing preventive strategies and providing ergonomic training and physical activity facilities.

Municipal resources to promote adult physical activity - a multilevel follow-up study

BackgroundIn Finland, local authorities (municipalities) provide many services, including sports and physical activity facilities such as pedestrian and bicycle ways and lanes, parks, sports arenas and pools. This study aimed to determine whether local authorities can promote physical activity by allocating resources to physical activity facilities.MethodsThe data on municipality expenditure on physical activity and sports, number of sports associations receiving subsidies from the municipality, kilometers of ways for pedestrians and bicycles and hectares of parks in 1999 and 2010 were gathered from national registers. These data were combined using unique municipal codes with individual survey data on leisure-time physical activity (N = 3193) and commuting physical activity (N = 1394). Panel data on physical activity originated from a national health survey, the Health 2000 study, conducted in 2000–2001 and 2011–2012. We used the data of persons who answered the physical activity questions twice and had the same place of residence in both years. In the data, the individuals are nested within municipalities, and multilevel analyses could therefore be applied. The data comprised a two-wave panel and the individuals were followed over 11 years.ResultsThe resources for physical activity varied between municipalities and years. Municipal expenditure for physical activity and total kilometers of pedestrian ways increased significantly during the 11 years, although a clear decrease was observed in individuals’ physical activity. In our models, individual characteristics including higher education level (OR 1.87) and better health status (OR 7.29) increased the odds of increasing physical activity. Female gender was associated with lower (OR 0.83) leisure-time physical activity. Living in rural areas (OR 0.37) decreased commuting physical activity, and age (OR 1.05) increased it. Women (OR 3.16) engaged in commuting physical activity more than men.ConclusionsIndividual-level factors were more important for physical activity than local resources. A large part of the variation in physical activity occurs between individuals, which suggests that some factors not detected in this study explain a large part of the overall variation in physical activity.

1223-P: CRP-Mediated Associations of the Individual and Neighborhood Stressors with T2D in the MESA Cohort

There has been growing interest in examining the link between individual/neighborhood stressors with T2D. Prior studies have not tested if inflammation (CRP) may mediate the associations between multi-level stressors and T2D. This study included baseline data from the Multi-Ethnic Study of Atherosclerosis (MESA; n=5405; age=61.9±10.1y; 52% female) . T2D was defined as FPG ≥126 mg/dL or the use of diabetes drugs. Individual stressors included perceived lifetime discrimination, chronic burden, and personal safety. Neighborhood stressors included perceived problems, social cohesion, and physical activity facility density. Log transformed CRP (mg/L) was tested as the potential mediator. Linear regression models were used to test for significant indirect effects, adjusting for covariates. Twelve percent of participants (n=650) had T2D. Chronic burden and physical activity facility density were indirectly related to T2D via CRP (Table) . That is, higher chronic burden and lower density of physical activity facilities were linked to higher CRP. In turn, higher CRP was positively associated with T2D. Other stressors were neither directly nor indirectly associated with T2D. The associations between these stressors and T2D appear to be mediated by higher CRP in the MESA cohort. Future research should test the longitudinal mediating role of inflammation on the associations of stressors on T2D. Disclosure K.Tamura: None. R.Jagannathan: None. L.Hu: None. S.Neally: None. Y.Baumer: None. K.Narayan: n/a. V.Vaccarino: None. T.Powell-wiley: None.

What are the environmental factors that affect implementation of the Manchester Healthy Schools programme? A qualitative exploration of staff perspectives

ObjectivesPrimary/elementary schools are crucial settings for early weight management interventions but effects on children’s weight are small. This may be because the environments in which these schools are situated support...

The Relationship Between Environmental Exposures and Post-Stroke Physical Activity

Post-stroke physical activity has widespread health benefits. Environmental exposures may shape post-stroke physical activity behavior. This study investigates the relationships between environmental exposures and post-stroke physical activity. Stroke survivors (n=374) from a cohort of Black and White adults with post-stroke accelerometer data (2009-2013) were eligible for this study. Participants' home addresses were linked with secondary data to capture environmental characteristics, including annual density of neighborhood resources (e.g., parks, physical activity facilities, and intellectual stimulation destinations), 2010 neighborhood SES, 2010 neighborhood crime, and daily information on extremely cold days. Post-stroke light physical activity and moderate-to-vigorous physical activity were captured using accelerometers over a 7-day period. Linear regression and 2-part/hurdle models were used to estimate the relationship between the density of neighborhood resources with light physical activity and with moderate-to-vigorous physical activity, respectively. Analyses were conducted in 2021. A 10% increase in the number of extremely cold days was associated with 6.37 fewer minutes of daily light physical activity (95% CI= -11.37, -1.37). A 1-SD increase in neighborhood SES was associated with greater odds (OR=1.10, 95% CI=1.02, 1.19) of doing any moderate-to-vigorous physical activity. Among participants obtaining any moderate-to-vigorous physical activity, a 1-unit (count/km2) increase in destinations for intellectual stimulation was associated with 0.99 (95% CI=0.02, 1.97) more minutes of daily moderate-to-vigorous physical activity. All other environmental exposures were not associated with post-stroke light physical activity or moderate-to-vigorous physical activity. Environmental exposures may facilitate physical activity participation among stroke survivors. This study found that weather, neighborhood SES, and proximity to destinations for intellectual stimulation were associated with physical activity over and above individual factors.

Exploring Female University Students' Participation in Physical Activity in Saudi Arabia: A Mixed-Methods Study.

BackgroundThe importance of physical activity in improving physical and mental health has been emphasized in many studies. Researchers in Saudi Arabia have reported an increase in physical inactivity among Saudis, especially among University female population. Current efforts in the field in Saudi Arabia have yet to explore barriers and facilitators that influence female University student's participation in physical activity. This study aims to provide an assessment of the situation regarding physical activity among female University students in Saudi Arabia.MethodsThis mixed method study preceded a participatory action research initiative. The first part of the mixed method consisted of a cross-sectional survey of 375 female University students in Saudi Arabia who completed the short form of the International Physical Activity Questionnaire. The second part consisted of semi-structured, in-depth interviews with 14 female University students and 16 female exercise trainers.ResultsResults showed that most participants (91%) spent more time in walking activity compared to moderate (66%) and vigorous activity (57%) for at least 10 min at a time over a period of 7 days. Results showed that 70% of participants did not meet the WHO recommendation of 150 min per week of moderate activity, while around 62% of participants did not meet the WHO recommendation of 75 min per week of vigorous activity. Barriers to participation included limited facilities for physical activities, academic workload, gender role, and the need to adhere to cultural standards. Facilitators included valuing positive results, general health concerns, and family support.ConclusionKnowledge gained from this study might support organizations and public health authorities to develop physical activity interventions that better address Saudi women's perceived needs. These findings are an important contribution to current knowledge in light of recent advances in women's rights in Saudi Arabia.

Engagement With Web-Based Fitness Videos on YouTube and Instagram During the COVID-19 Pandemic: Longitudinal Study.

BackgroundThe COVID-19 pandemic has drastically changed the physical activity (PA) landscape through the closures of gymnasiums, schools, and many outdoor spaces. Physical distancing guidelines have also reduced opportunity for PA. The popularity of free web-based home fitness videos on video hosting platforms (eg, YouTube and Instagram) has spiked during the pandemic. Many web-based fitness videos offer a convenient, accessible, and cost-effective means of engaging in PA through regularly posted videos or discrete programs. Notably, traditional PA programs often suffer from poor adherence and high dropout rates, despite many advantages over web-based workout programs (eg, equipment, feedback, and in-person engagement). Thus, notwithstanding clear advantages of these web-based fitness videos, their ability to maintain long-term engagement and adherence is unknown.ObjectiveWe explored patterns of engagement (ie, views, likes, and comments) for channels posting daily or program-based web-based fitness videos since the declaration of COVID-19 as a pandemic, over 4 months. Our secondary objective was to examine potential moderators of engagement metrics.MethodsAn environmental scan was used to identify eligible channels. Eligible channels were (1) freely available on YouTube or Instagram and (2) posted daily or weekday series workouts or offered quarantine-specific workout programs. Searches for eligible channels were conducted on June 1 and 4, 2020. Engagement metrics of views, likes, and comments were then collected from channels’ videos posted between March 11 and June 26 or 30, 2020, inclusive, on June 26 or July 8, 2020. A series of multilevel modeling analyses were conducted to examine longitudinal changes in each of the 3 outcome variables.ResultsTen channels were deemed eligible and included in analyses; 6 posted regularly, while the other 4 posted discrete workout programs. Multilevel models revealed that both views and likes significantly decreased across days. Visually, channels display the sharpest drop in engagement within the first week. Linear change estimate indicates that the number of views initially declined by 24,700 per day (95% CI –44,400 to –11,300, P=.01) on average across all the channels. Channels with more subscribers declined in their views, likes, and comments at a significantly higher rate than those with fewer subscribers (P≤.04). The day of the week a video is posted, “virality,” and content of a video appear to influence engagement. Integrating behavior change techniques and posting new and varied videos often may help garner further engagement with these videos. Future research should examine common elements of videos, which drive engagement.ConclusionsDespite raw engagement metrics, each channel demonstrated peak engagement with the initial video followed by decreased engagement with subsequent videos. As many countries maintain restrictions on traditional PA facilities owing to the COVID-19 pandemic, determining methods to improve engagement and adherence with web-based fitness videos becomes increasingly important.

Abstract MP41: Associations Of Neighborhood Food And Physical Activity Environments In Young Adulthood With Cardiovascular Health (CVH) In Midlife: The Coronary Artery Risk Development In Young Adults (CARDIA) Study

Background: Adults who maintain high CVH profiles up to midlife have lower risk of several chronic diseases and better quality of life. However, the relationship between the access to different neighborhood resources in young adulthood and the maintenance of CVH into midlife remain understudied. Methods: We used data from 2,317 CARDIA participants. Measures of the neighborhood food and physical activity environment (Table) were linked to participant addresses collected at the baseline exam (1985-1986), when participants were 18-30 years old. CVH was measured at baseline and the year 30 follow-up exam. We examined associations of neighborhood food and physical activity environments with year 30 CVH scores (moderate vs. high and low vs. high) using multinomial logistic regression. Individual- and neighborhood-level covariates (Table) were adjusted for sequentially. Results: At baseline, 31% of participants had high and 5% had low CVH scores, respectively, whereas 11% had high and 34% had low CVH scores 30 years later. At year 30, compared to those with low CVH scores, participants with high CVH scores had better baseline neighborhood conditions (e.g., mean distance to nearest major park 4767m vs. 7043m, mean count of community and public physical activity facilities 50.70 vs. 43.57, mean percentage of food outlets that are supermarkets 0.75% vs. 0.44%) and were more likely to be female (70.99% vs. 59.21%) and White (86.64% vs. 39.14%). In adjusted models, participants who lived in neighborhoods with a higher percentage of supermarkets and more community and public physical activity facilities were less likely to have low CVH scores compared to high CVH scores (Table). Participants who lived in neighborhoods with a higher percentage of convenience stores and further from a major park were more likely to have low vs. high CVH scores. Conclusion: Improving access to physical activity and healthy food resources in young adulthood may have significant implications in longevity and quality of life in midlife.

Understanding factors influencing uptake of healthy lifestyle practices among adults following a community cardiovascular disease prevention programme in Mukono and Buikwe districts in Uganda: A qualitative study.

IntroductionHealthy lifestyle practices including physical activity, healthy diets, non-smoking, reduced alcohol consumption and stress reduction are important in the prevention of metabollic CVD risk factors such as hypertension, overweight and obesity, diabetes and hyperlipidaemia. Owing to current lifestyle changes, the increasing burden of CVD and importance of healthy behaviours, the need for strategies to increase uptake of healthy lifestyles among sub-Saharan African populations are apparent. This study explored the factors influencing uptake of healthy lifestyle practices among adults following implementation of a community CVD prevention programme.MethodsThis was a descriptive qualitative study conducted among purposively selected adults who had engaged in a community CVD prevention programme. Data were collected using in-depth interviews, which were audio recorded and transcribed verbatim. Study transcripts were read into NVIVO 12.6 software for coding and analysis guided by thematic analysis following the semantic approach.ResultsThis study found variations in uptake of healthy lifestyle practices for CVD prevention with most changes reported for dietary behaviour especially in vegetable and fruit intake, reduction of salt intake and fats and oils consumption. Changes in physical activity were also notable. On the other hand, participants were slow in making changes in alcohol consumption, smoking behaviours and stress reduction. The barriers to uptake of healthy lifestyle practices were individual such as limited capability or skills, structural such as limited physical activity facilities, and social such as cultural and peer influence. Relatedly, the facilitators of practices uptake were individual including knowledge and personal determination to change, and social including social support from family and the community.ConclusionsInsights from understanding the uptake of lifestyle practices should guide planning and design of community programmes with an emphasis on removing barriers and strengthening facilitators building on the intermediate motivating factors and considering individual needs and expectations.

Associations between parental reasons for choosing a neighborhood and adolescents’ physical activity and commuting behaviors

IntroductionAdolescents' physical activity (PA) and commuting behaviors are related to their parents' perceptions of the neighborhood. This study analyzed the association between parental reasons for choosing a neighborhood to live in and their adolescent’ moderate-to-vigorous PA (MVPA), active commuting to/from school (ACS), and independent mobility (IM) excluding school travel. MethodsParticipants were adolescents (n = 373) and their parents (n = 373) in Spain. Parents reported their reasons for choosing a neighborhood, and adolescents reported their ACS and IM excluding school travel. Accelerometry was used to assess adolescents’ MVPA. Multilevel regressions were used to analyze the associations between parental reasons and the outcome variables (MVPA, ACS and IM). ResultsHigh importance of affordability/value for parents was associated with higher levels of weekday MVPA in adolescents (β = 2.17, 95% confidence interval [CI] 0.21, 4.16), whereas greater distance from busy streets (β = 2.08, 95% CI 0.12, 4.51) was positively associated with MVPA during the weekend. A higher percentage of ACS in adolescents was associated with having parents who valued proximity to the school (β = 3.43, 95% CI 0.17, 0.64). IM excluding school travel was higher when parents assigned relatively less value to the proximity of the school (β = −3.35, 95% CI −8.76, −2.28), safety from crime (β = −2.77, 95% CI −6.63, −1.39), and sense of community (β = −2.31, 95% CI −6.63, −0.53). ConclusionsIt is crucial to develop spaces and facilities for PA, and to increase the walkability of the neighborhoods, considering the distance from home to school, in order to promote MVPA and ACS in adolescents.

Association of public physical activity facilities and participation in community programs with leisure-time physical activity: does the association differ according to educational level and income?

BackgroundOur aim was to analyze the association of the presence of public physical activity (PA) facilities and participation in public PA programs with leisure-time PA, with an emphasis on the moderating role of educational level and income.MethodsWe used data of 88,531 adults (46,869 women), with a mean age of 47.2 ± 17.1y, from the 2019 Brazilian National Health Survey. Leisure-time PA (dichotomized considering 150 min/week), the presence of a public PA facility near the household (yes or no), participation in public PA programs (yes or no), educational level (divided into quintiles) and per capita income (divided into quintiles) were all self-reported through interviews. Adjusted logistic regression models were used for the analyses.ResultsThe presence of public PA facilities near the household and the participation in public PA programs were associated with higher leisure-time PA among all quintiles of income and educational level. However, multiplicative interactions revealed that participating in PA programs [Quintile (Q)1: OR: 13.99; 95%CI: 6.89–28.38 vs. Q5: OR: 3.48; 95%CI: 2.41–5.01] and the presence of public PA facilities near the household (Q1: OR: 3.07; 95%CI: 2.35–4.01 vs. Q5: OR: 1.38; 95%CI: 1.22–1.55) were more associated with higher odds of being active in the leisure-time among the lowest quintile of educational level.ConclusionsThe presence of public PA facilities and participation in public PA programs are environmental correlates that may be relevant for designing effective public health interventions to reduce social inequalities in leisure-time PA among adults in low-income areas.

Going Online?-Can Online Exercise Classes during COVID-19-Related Lockdowns Replace in-Person Offers?

Germany experienced a 6-month second lockdown (November 2020–April 2021) during the COVID-19 pandemic, which included the closure of all physical activity (PA) facilities. The use of online exercise classes (OECs) was promoted by public health and exercise organizations. Using the present cross-sectional online survey, we assess the use of and opinion towards OECs in Germany during the second lockdown. We used contingency tables and the Chi2 test to calculate the frequency of awareness and use of OECs according to PA status, well-being and demographic data, and conducted a binary logistic regression with OEC awareness or use and dichotomized independent predictors. The associations between opinion and activity status, frequency of use, educational attainment, age and body mass index were calculated using Spearman correlations. A total of 993 datasets were analyzed in detail. Of the 785 (79.1%) participants reporting awareness of OECs, 536 tried them, and 262, 188 and 85 used them <1 per week, 1–2 per week and ≥3 per week, respectively. The users were typically active, female participants with poorer mental well-being. The opinions towards OECs varied according to participant characteristics, such as activity status, BMI and age. Overall, regular OEC use was quite limited, and, as such, cannot replace in-person exercise opportunities. Keeping physical activity facilities open and safe must be prioritized in the ongoing pandemic.

Low back pain and associated risk factors among medical students in Bangladesh: a cross-sectional study.

Background: Low back pain (LBP) is one of the leading causes of disability worldwide. Different studies showed the high prevalence of LBP among medical students. However, no study has been conducted on Bangladeshi medical students to estimate the prevalence of LBP. This study determined the prevalence, characteristics, and associated risk factors of LBP among medical students in Bangladesh. Methods: A cross-sectional study was conducted from October to December 2020 among randomly selected 270 medical students and medical interns in Faridpur Medical College, Bangladesh, using an online questionnaire. In data analysis, chi-square test and binary logistic regression were performed, and a p-value of < 0.05 was regarded as statistically significant. Results: A total of 207 participants responded fully to the survey, and were included in the analysis. The mean age of the participants was 22.4 ± 1.9 years. The point, 6-month, and 12-month prevalence of LBP was 25.6%, 46.9%, and 63.3%, respectively. In most participants, LBP was localized (53.2%), recurrent (64.9%), non-specific (70.8%), affected for a short period (55%), and relieved without receiving any treatment (60.4%). Participants who had a significantly higher 12-month prevalence of LBP included females (72.2% vs 52.2%), with BMI >25 kg/m 2 (73.2% vs 56.7%), those who performed physical activity at low to moderate frequency (72.4% vs 29.5%), those who spent > 6 hours/day by sitting (71.3% vs 45.3%), and those who did not have enough rest time (92.7% vs 56%). Ergonomic features of chairs, such as having back support, adjustable back support, and adjustable sitting surface, significantly (p < 0.05) influenced the outcomes. Conclusion: The prevalence of LBP among medical students in Bangladesh was high, and most of the risk factors associated with the high prevalence of LBP were modifiable. Hence, LBP can be prevented by implementing preventive strategies and providing ergonomic training and physical activity facilities.

Low back pain and associated risk factors among medical students in Bangladesh: a cross-sectional study

Background: Low back pain (LBP) is one of the leading causes of disability worldwide. Different studies showed the high prevalence of LBP among medical students. However, no study has been conducted on Bangladeshi medical students to estimate the prevalence of LBP. This study determined the prevalence, characteristics, and associated risk factors of LBP among medical students in Bangladesh. Methods: A cross-sectional study was conducted from October to December 2020 among randomly selected 270 medical students and medical interns in Faridpur Medical College, Bangladesh, using an online questionnaire. In data analysis, chi-square test and binary logistic regression were performed, and a p-value of < 0.05 was regarded as statistically significant. Results: A total of 207 participants responded fully to the survey, and were included in the analysis. The mean age of the participants was 22.4 ± 1.9 years. The point, 6-month, and 12-month prevalence of LBP was 25.6%, 46.9%, and 63.3%, respectively. In most participants, LBP was localized (53.2%), recurrent (64.9%), non-specific (70.8%), affected for a short period (55%), and relieved without receiving any treatment (60.4%). Participants who had a significantly higher 12-month prevalence of LBP included females (72.2% vs 52.2%), with BMI >25 kg/m 2 (73.2% vs 56.7%), those who performed physical activity at low to moderate frequency (72.4% vs 29.5%), those who spent > 6 hours/day by sitting (71.3% vs 45.3%), and those who did not have enough rest time (92.7% vs 56%). Ergonomic features of chairs, such as having back support, adjustable back support, and adjustable sitting surface, significantly (p < 0.05) influenced the outcomes. Conclusion: The prevalence of LBP among medical students in Bangladesh was high, and most of the risk factors associated with the high prevalence of LBP were modifiable. Hence, LBP can be prevented by implementing preventive strategies and providing ergonomic training and physical activity facilities.

Examining non-linear associations between built environments around workplace and adults’ walking behaviour in Shanghai, China

Considering that most working adults spend nearly half their waking time at work, creating a supportive built environment around workplaces could be a feasible approach to maintain adequate levels of physical activity. However, the extent to which the built environment around workplaces influences walking behaviors in working adults remains unclear. Using survey data of 1009 full-time employees in Shanghai, China, this study assessed the nonlinear relationships between the built environment characteristics around workplaces and three domains of walking behaviors (commuting, utilitarian, and recreational walking). Using gradient boosting decision trees, our results showed that the built environment around workplaces is crucial for higher levels of walking behaviors, but built environment features tended to have distinctive associations with different domains of walking behaviors. Specifically, the number of physical activity facilities was positively associated with all three domains of walking behaviors, while a high floor area ratio was negatively associated with different domains of walking behaviors to some extent. Furthermore, several built environment characteristics, such as land use entropy, street view greenery, distance from home to the city center, and distance between the city center and workplaces had distinctive associations with different domains of walking behaviors. The findings of this study could provide nuanced guidance for creating pedestrian-friendly environments around workplaces to promote walking behaviors and overall physical activity levels in the working population.