Health-enhancing Levels Of Physical Activity Research Articles

Physically active primary care physicians consult more on physical activity and exercise for patients: A public teaching-hospital study

Physical activity and exercise (PAE) improve quality of life and reduce the effects of chronic diseases. Primary care physicians (PCPs) play an important role to encourage PAE in patients. We aim to assess PCPs' current PAE consultation practices and their enablers/barriers in daily clinical practice. We had 64 PCPs (age [35.3 ​± ​4.7] y, 47 women) that completed self-administered questionnaires on PAE consultation practices, training, and confidence levels. PCPs (n ​= ​42) also completed the International Physical Activity Questionnaire-Short Form to assess their physical activity (PA) levels. We conducted correlation, one-way analysis of variance and a linear regression to assess the associations between enablers, barriers and PA levels to PAE consultation practices. On average, PCPs consulted on PAE in 49.7% of their daily clinical appointments. Majority of PCPs (70%) strongly agreed that more PAE knowledge were needed to increase consultation practices. Top three barriers related (p ​< ​0.001) to practices were lack of PAE education (r ​= ​0.47), patients’ preference of pharmaceutical interventions (r ​= ​0.45) and lack of continuing education in PAE for PCPs (r ​= ​0.37). Physically active PCPs (health-enhancing PA levels, n ​= ​6) gave significantly more daily consultations in PAE, 73.2% ​± ​21.9%, compared to inactive PCPs (n ​= ​13), 37.4% ​± ​22.8% (p ​= ​0.013). In our regression output, PCPs who had higher PA levels consulted more on PAE daily (R2 ​= ​0.38, p ​< ​0.001) while controlling for age. Conclusion, PCPs require more knowledge on PAE and need be physically active themselves to increase PAE consultation for patients in their daily practice. Medical education should consider including more PA and exercise topics that may benefit both physicians and their patients.

S10-3 Research on policy audits for promoting physical activity at the local level in Japan

Abstract Purpose Increasing levels of health-enhancing physical activity (HEPA) requires a comprehensive policy framework across all political levels. At the local level, Japan has a two-tier system of government: prefectures and municipalities. We developed specific tools to identify the strengths and weaknesses of the implementation of national HEPA policies by the different local governments. Methods We started by developing and testing the Local Policy Audit Tool (L-PAT) in all 47 Japanese prefectures (Takeda et al. 2019). It comprises 11 items based on WHO’s HEPA Policy Audit Tool (PAT), covering key policy actions such as: the presence of a local action plan; its implementation; and cross-sectoral cooperation. The L-PAT was sent to key government departments (e.g. health, sports, urban planning and transport) in all prefectures. As a second step, we assessed the development and implementation of local action plans for HEPA promotion in municipalities using the City PAT (C-PAT), which employs six questions based on the HEPA PAT. We surveyed a random selection of 272 out of Japan’s 1,700+ municipalities, stratified by administrative division and population. Results The results of the L-PAT indicate that health and sports are the most active departments in promoting HEPA policy at prefecture level. Some prefectures also reported HEPA actions by the urban planning and transport sectors, although these sectors are not covered by the national policy. A major result of the C-PAT survey was that the scale and contents of projects implemented differed depending on the size of the municipality. Both tools revealed that local governments have a low awareness of the “Japanese physical activity guidelines for health promotion 2013” in their policy planning and implementation. Conclusions In 2023, both the Japanese physical activity guidelines and the government's most comprehensive health policy, “Healthy Japan 21”, will undergo major revisions. The next step after the L-PAT and C-PAT would be to revise the content of the C-PAT questionnaire to increase its usefulness; that is, a policy audit tool for continuously monitoring local HEPA policies will be created on this occasion, aimed at supporting future national planning processes for HEPA promotion.

O.1.1-11 Are stress symptoms associated to health-enhancing physical activity levels in university students? The case of a Belgian French-speaking university in 2022

Abstract Purpose Starting university is often associated with a decrease in physical activity and an increase in stress levels. In students, higher levels of stress have been associated with lower PA participation. During the pandemic, students’ levels of PA seem to have decreased whilst stress symptoms (SS) have increased. The purpose of this study was to investigate the association between health-enhancing physical activity (HEPA) and SS in students attending a French-speaking university in Brussels in spring 2022. Methods Data was collected using an online questionnaire in 1,754 voluntary students. HEPA was measured using the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and SS were assessed using the Stress single item measure. Binary logistic regressions were used to investigate how much HEPA (yes/no) was associated to SS in three categories: minimally to not at all; very stressed; and highly stressed. Models were adjusted for sociodemographic characteristics. All analyses were weighed to calibrate estimates to the entire university population. Results Among the study population (females: 59.3%), over a third of students (35.3%) were classified as HEPA active. This prevalence was the lowest amongst those who were “highly” stressed (28.8%), intermediate in those who were “very” stressed (34.0%) and the highest amongst those who were “minimally or not at all” stressed (39.6%) (p = 0.0005). After adjusting for sociodemographic characteristics, compared to those who were “highly” stressed, those who were “minimally or not at all” stressed were more likely to be HEPA active (aOR: 1.30; 95%CI: 1.00-1.70). There was no difference in the likelihood of being HEPA active for those who were “very” stressed (vs. highly stressed: aOR: 1.16; 95%CI: 0.87-1.56). Among the sociodemographic characteristics, sex and year of study were associated to HEPA. Females were less likely to be HEPA active compared to males (aOR: 0.38; 95%CI: 0.30-0.47), whereas undergraduate students were more likely to undertake HEPA than master’s students (1st year: aOR: 1.30; 95%CI: 1.00-1.69, 2nd-3rd year: aOR: 1.33; 95%CI: 1.03-1.72). Conclusions These findings indicate an association between HEPA and SS in students attending a French-speaking university in Belgium in 2022. They will enable to inform health promotion initiatives encouraging HEPA at the university.

Promoting physical activity-related health competence to increase leisure-time physical activity and health-related quality of life in German private sector office workers

BackgroundOffice workers (OWs) are at risk of low levels of health-enhancing physical activity (HEPA) and impaired health-related quality of life (HRQOL). Interventions based on physical activity-related health competence (PAHCO) aim to facilitate long-term changes in HEPA and HRQOL. However, these assumptions rely on the changeability and temporal stability of PAHCO and have not been tested empirically. This study therefore aims to test the changeability and temporal stability of PAHCO in OWs within an interventional design and to examine the effect of PAHCO on leisure-time PA and HRQOL.MethodsThree hundred twenty-eight OWs (34% female, 50.4 ± 6.4 years) completed an in-person, three-week workplace health promotion program (WHPP) focusing on PAHCO and HEPA. The primary outcome of PAHCO as well as the secondary outcomes of leisure-time PA and HRQOL were examined at four measurement points over the course of 18 months in a pre-post design by employing linear mixed model regressions.ResultsPAHCO displayed a substantial increase from the baseline to the time point after completion of the WHPP (β = 0.44, p < 0.001). Furthermore, there was no decrease in PAHCO at the first (p = 0.14) and the second follow-up measurement (p = 0.56) compared with the level at the end of the WHPP. In addition, the PAHCO subscale of PA-specific self-regulation (PASR) had a small to moderate, positive effect on leisure-time PA (β = 0.18, p < 0.001) and HRQOL (β = 0.26, p < 0.001). The subscale of control competence for physical training (CCPT) also had a positive small to moderate effect on HRQOL (β = 0.22, p < 0.001).ConclusionThe results substantiate PAHCO’s theoretical characteristics of changeability and temporal stability, and underline the theoretically postulated effects on leisure-time PA and HRQOL. These findings highlight the potential of PAHCO for intervention development, which can be assumed to foster long-term improvements in HEPA and HRQOL in OWs.Trial registrationThe study was retrospectively registered in the German Clinical Trials Register, which is an approved Primary Register in the WHO network, at the 14/10/2022 (DRKS00030514).

Assessment of Energy Expenditure During Discrete Skill Performance Using Systematic Observation and Indirect Calorimetry

Purpose: To determine the accuracy of three systematic observation (SO) tools to estimate energy expenditure (EE) using different skill performance and observation intervals. Method: Three SO tools (Observational System for Recording Physical Activity in Children-Preschool, System for Observing Fitness Instruction Time, and System for Observing Play and Leisure Activity in Youth) were used to observe children (N = 42, Mage = 8.1 ± 0.7) during motor skill testing sessions. EE was measured using indirect calorimetry (COSMED K4b2). Results: Paired samples t tests, repeated-measures analysis of variance, and regression analyses were performed to compare the EE estimated from SO tools with EE measured by indirect calorimetry. The average mean difference between the estimated metabolic equivalence of task (METS) and actual METS ranged between −1.24 METS (SD = 1.62, p &lt; .01) and −3.46 METS (SD = 1.31, p &lt; .01) depending on skill performance interval or SO tool analyzed. Conclusions: SO tools did not accurately estimate EE during object control skill testing sessions. Physical educators should consider utilizing discrete motor skill practice to accumulate health-enhancing levels of physical activity while adhering to national standards.

Mobility and muscle strength trajectories in old age: the beneficial effect of Mediterranean diet in combination with physical activity and social support

IntroductionDecline in physical function varies substantially across older individuals due to several extrinsic modifiable factors such as dietary patterns, physical activity and social support. We aimed to determine the association of these factors and their interaction with mobility and muscle strength decline.MethodsWe analyzed data from 1686 functionally healthy individuals aged 60 + from the population-based Swedish National study on Aging and Care in Kungsholmen (SNAC-K). The Mediterranean Diet Score (MDS) was calculated based on a validated food frequency questionnaire. Self-reported physical activity was categorized based on current recommendations, and social support was measured according to participants’ perceived material and psychological support from relatives and friends. Participants’ physical function was assessed over 12 years through changes in walking speed (m/s) and chair stand time (s). Linear mixed models adjusted for socio-demographic and clinical factors were used. In order to explore the combined effect of the different exposures, two indicator variables were created by cross-classifying individuals' levels of Mediterranean diet adherence and social support or physical activity.ResultsParticipants with a high adherence to Mediterranean diet were primarily < 78 years (82.3%), women (56.1%), married (61.1%), with university education (52.8%), high levels of social support (39.3%) and health-enhancing levels of physical activity (51.5%). A one-point increase in MDS (score range 0–9) was associated with less annual deterioration in walking speed (β*time[year] = 0.001; p = 0.024) and chair-stand time (β*time[year] = -0.014; p = 0.008). The potential protective effect of Mediterranean diet was highest among participants reporting high social support (β*time[year] = -0.065, p = 0.026 for chair stands) and high physical activity (β*time[year] = 0.010, p = 0.001 for walking speed), beyond the effect of each exposure individually.ConclusionA higher adherence to Mediterranean diet, especially in combination with recommended levels of physical activity and high social support, may contribute to delay the decline in physical function observed with aging.

Promoting health-enhancing physical activity in Europe: Surveillance, policy development and implementation 2015–2018

In the European Union (EU), the low levels of health-enhancing physical activity (HEPA) and high levels of sedentary behaviour are a concerning public health issue common to all Member States. In 2013, the Council of the EU recognized the need for more data related to HEPA to support policymaking across the region and proposed a monitoring framework that included 23 indicators covering different themes relevant to HEPA promotion in the EU context. In 2014, the EU Physical Activity Focal Points Network was established to support the implementation of the monitoring framework and in 2015 and 2018 surveys were conducted to collect epidemiological and policy information related to HEPA for each Member State. This paper aims to provide an update on the status of HEPA policies and surveillance in the EU and describe the changes that have occurred since 2015. In 2018, all countries had implemented more than 10 indicators, 8/28 had implemented 20 or more indicators, and only one country had completed all 23 indicators. From 2015 to 2018, 19 indicators improved, one remained unchanged, and three regressed. From the country perspective, 17 improved the number of accomplished indicators, five maintained the indicators, and five worsened the number of indicators. Overall, there has been a clear increase in the number of countries implementing HEPA policies and strategies across the different sectors, although some heterogeneity between Members Sates was still observed. Implementation of regional physical activity strategies and the establishment of the EU-wide monitoring framework appears to have had an overall positive impact on HEPA policy development and implementation.

Reconceptualizing and Operationalizing Seefeldt’s Proficiency Barrier: Applications and Future Directions

In 1980, Seefeldt introduced the concept of a motor skill "proficiency barrier" that provides a conceptual basis for understanding the importance of a motor skill barrier as it relates to critical public health initiatives. While the intent of Seefeldt's proficiency barrier hypothesis had great potential to advance the field of motor development, the notion of a proficiency barrier was not empirically tested. Instead, this concept lay dormant for several decades. The purpose of this paper was to expand upon Seefeldt's proficiency barrier concept in greater detail by addressing the following questions: (1) what constitutes a motor proficiency barrier? (2) how do we assess/measure the existence of a proficiency barrier? and (3) how do we break through the proficiency barrier in order to maximize the likelihood of participation in health-enhancing levels of physical activity later on in life? We conclude with a future research suggestion to explore the existence of the proficiency barrier.

SAT0618-HPR PATIENTS WITH INFLAMMATORY MYOPATHIES WHO DO NOT REACH HEALTH ENHANCING LEVELS OF PHYSICAL ACTIVITY REPORT HIGHER LEVELS OF ANXIETY AND DEPRESSION - A CROSS-SECTIONAL STUDY OF SELF-REPORTED DATA

Background:The adult idiopathic inflammatory myopathies (IIM) comprise dermatomyositis (DM), polymyositis (PM), immune-mediated necrotizing myopathy (IMNM), antisynthetase syndrome (ASS), overlap myositis and inclusion body myositis (IBM). Impaired physical capacity, self-reported fatigue and pain are common features in IIM. Quality of life is reduced compared to population-based reference values. To our knowledge self-reported levels of physical activity has not been studied in patients with IIM. Further, anxiety and depression are common in other rheumatic diseases, such as SLE, but is less studied in IIM, and not previously in relation to levels of physical activity. There is evidence for symptom reducing effects of exercise for patients suffering from depression (1).Objectives:The objective of this study is to assess the levels of self-reported physical activity, depression and anxiety amongst adult patients with IIM. A further aim is to evaluate differences in anxiety/depression based on levels of physical activity as well as to analyze relationships between physical activity and anxiety/depression.Methods:All patients with IIM visiting the Rheumatology clinic at Karolinska University Hospital in Solna between February 2019 and January 2020 where asked to fill in questionnaires about their levels of physical activity for the last seven days using the International Physical Activities Questionnaire – short form (IPAQ), and anxiety and depression using Hospital Anxiety and Depression Scale (HADS). The myositis team nurse distributed the questionnaires. Spearman’s rho was used for correlation analysis. Kruskal-Wallis test and post-hoc adjustment with Bonferroni correction was used to analyze group differences. HADS is scored in two separate scales, one for depression (HADS-D) and one for anxiety (HADS-A). The cut-off value for probable depression or anxiety is ≥8 of a maximum of 21 per scale (2). IPAQ-results was scored as 1 (low, &lt; 150 min/w), 2 (moderate, ≥ 150 min/w – health-enhancing levels of physical activity, HEPA, according to WHO) and 3 (high, ≥ 300 min/w).Results:A total of 61 patients answered the questionnaires. 52 (85 %) of the patients reported to reach HEPA and 24 of these patients reported to be active on a high level. 22 patients (36 %) scored probable anxiety or depression, with six scoring ≥8 for both depression and anxiety. Patients with low levels of physical activity (IPAQ-1) scored significantly higher anxiety and depression compared to those reaching HEPA (IPAQ-2 and IPAQ-3) p&lt;0.0001 – 0.020. The correlation between physical activity and depression (Fig. 1) was rs=-0.48 (-0.66; -0.26) and between physical activity and anxiety (Fig. 2), rs=-0.27 (-0.49; -0.02).Conclusion:Self-reported data indicates that most patients with IIM in this sample reached HEPA level or higher. Patients who do not reach HEPA score significantly higher anxiety and depression compared to those reaching HEPA. However, levels of physical activity correlates moderately to depression and weakly to anxiety. The number of patients who reached HEPA is high compared to studies in rheumatoid arthritis or the general population. This could be explained by frequent visits to physical therapists early in the disease and yearly check-ups with a focus on exercise and physical activity. Further the inter-professional myositis team also has a focus on exercise and the importance of everyday physical activity. This is cross-sectional, self-reported data and longitudinal studies are needed also including objective measures. This is preliminary data with data collection ongoing throughout 2020.

Motor competence deficit in urban-area Brazilian children based on chronological age

BACKGROUND: Previous studies have confirmed that there is a developmental delay in the fundamental motor skills (FMS) of Brazilian children based on various samples. However, none of these previous studies included a comprehensive and direct diagnosis of motor competence levels of children in the urban areas of Brazil, which tend to encompass a wide range of socioeconomic and cultural environments. AIM: The purpose of this study was to directly assess children’s FMS competence levels in the city of São Paulo, Brazil. METHOD: Three hundred and eighty-three children (ages 6, 8, and 10) from elementary schools in all five geographic regions of São Paulo participated in this study. The FMS of children were assessed using the Test of Gross Motor Development-Second Edition. RESULTS: The results indicated that children from all five geographic areas of São Paulo demonstrated low competence levels (below the 15th percentile) across all FMS. Moreover, the observed motor competence deficit increased with age. Children’s competence levels were classified as poor in 6-year-old children and very poor in 8- and 10-year-old children. CONCLUSION: The developmental delay in motor competence is associated with decreased levels of health-enhancing physical activity, physical fitness, executive function, and perceived competence and increased obesity.

Discussions of lifestyle habits as an integral part of care management: a cross-sectional cohort study in patients with established rheumatoid arthritis in Sweden

ObjectivesThe primary aim was to determine whether patients with RA recalled having discussions concerning lifestyle habits during their health-care visits. The secondary aim was to study the association between patients' reported lifestyle and their wish to discuss it.MethodsA postal questionnaire sent to 1542 eligible patients from the Better Anti-Rheumatic Pharmacotherapy (BARFOT) study included questions on lifestyle habits (physical activity, diet, smoking and alcohol), on whether these were discussed during health-care visits and on whether there was an interest in such discussions.ResultsA total of 1061 patients (68%) responded [mean age 67 (s.d. 13) years, 73% women]. Half of the patients (49%) recalled discussions on physical activity, and 23% recalled discussions about diet. Those who reported health-enhancing levels of physical activity were more likely to discuss physical activity with their health professionals. Likewise, patients who reported having a non-traditional mixed diet were more likely to discuss diet. Smoking was discussed with 25% of the patients, more often with current smokers than with non-smokers (32 vs 17%; P < 0.001). Alcohol was discussed with 17% of the patients. Of those patients who reported having hazardous drinking habits, 77% had not discussed alcohol use with any health professional.ConclusionDiscussions about lifestyle were recalled by half of the patients with established RA. There is a need for improvement, because lifestyle habits may affect the long-term outcome in a chronic disease, such as RA. Patient education concerning lifestyle habits should be an integral part of care management and an interactive process.

The perceived neighborhood environment is associated with health-enhancing physical activity among adults: a cross-sectional survey of 13 townships in Taiwan

BackgroundMany environmental factors have been associated with physical activity. The environment is considered a key factor in terms of the rate of engagement in physical activity. This study examined the perceived effect of environmental factors on different levels of health-enhancing physical activity among Taiwanese adults.MethodsData were collected from 549 adults aged at least 18 years from the northern, central, southern and eastern regions of Taiwan. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) showcard version, and participants were divided into three categories: those who performed low-, moderate-, or high-levels of physical activity, as suggested by the IPAQ scoring protocol. The perceived neighborhood environment in relation to physical activity was adapted from the Physical Activity Neighborhood Environment Scale. A multinomial logistic regression was conducted to ascertain associations between individual perceptions of the neighborhood environment and different physical activity levels.ResultsRespondents who perceived their neighborhood environment as having easy access to services and stores, and higher traffic safety were more likely to be moderate level of physical activity (odds ratio [OR]: 1.90, 95% confidence interval [CI]: 1.07–3.37; OR: 1.77, 95% CI: 1.12–2.80). The perception of having easy access to services and stores and seeing many physically active people in the neighborhood were both positively associated with a high level of physical activity (OR: 2.25, 95% CI: 1.01–5.01; OR: 2.40, 95% CI: 1.11–5.23).ConclusionsDifferent perceived neighborhood environmental factors were associated with moderate and high levels of physical activity, respectively. These findings highlight the importance of an activity-friendly neighborhood environment to stimulate engagement in physical activity among adults in Taiwan. Therefore, policies and programs should focus on improving friendliness and diversity in neighborhoods to facilitate individuals’ transitions from inactive to active lifestyles.

Active travel as stable source of physical activity for one third of German adults: Evidence from longitudinal data

Walking and cycling—active travel—can help adults achieve the World Health Organization’s recommended 150+ min of moderate-intensity aerobic physical activity per week. Based on a nationally representative panel-survey of daily travel in Germany, this study assesses weekly minutes of active travel by adult respondents participating in a weeklong survey in two consecutive years. The paper first identifies person-level covariates for achieving 150+ min of active travel during a week in year 1 of panel participation. The analysis then compares the patterns of individuals falling into four groups of active travel over the two survey years: ‘high maintainers’ who achieved 150+ min in both year 1 and year 2; ‘low maintainers’ who did not achieve 150+ min in neither year 1 nor year 2; ‘adopters’ who did not achieve 150+ min in year 1, but did so in year 2; and ‘relapsers’ who achieved 150+ min in year 1, but not in year 2.About half (48%) of respondents achieved 150+ min of active travel per week in their first year of panel participation. Of those, about three-quarters were ‘high maintainers’ with 150+ min of active travel in both years. Logistic regressions showed that ‘high maintainers’ were more likely to be 30 years or older, not employed, have a monthly public transport pass, live within 2 km of a shopping destination, and less likely to own cars. Transport and land-use policies can help influence several of these factors. Compared to ‘low maintainers,’ policy interventions to increase population shares achieving health-enhancing levels of physical activity from active travel may be most promising when targeting ‘adopters’ and ‘relapsers.’ These groups are more similar to the ‘high maintainers,’ with at least one year reporting of health-enhancing physical activity from active travel—compared to the ‘low maintainers.’

Psychiatric In-Patients Are More Likely to Meet Recommended Levels of Health-Enhancing Physical Activity If They Engage in Exercise and Sport Therapy Programs.

Background: People with mental disorders engage in sedentary behaviors more often than their healthy counterparts. In Switzerland, nearly all psychiatric hospitals offer structured exercise and sport therapy as part of their standard therapeutic treatment. However, little is known about the degree to which psychiatric patients make use of these treatment offers. The aim of this study is to examine, in a sample of psychiatric in-patients (a) how many participate in the structured exercise and sport therapy programs offered by the clinic, (b) how many engage in exercise and sport activities on an individual basis, and (c) how many meet recommended levels of health-enhancing physical activity during their stay at the clinic. Furthermore, we examine whether those who engage in exercise and sport activities are more likely to meet internationally accepted physical activity recommendations.Methods: 107 psychiatric in-patients (49% women, Mage = 39.9 years) were recruited at three psychiatric clinics in the German-speaking part of Switzerland. All participants were engaged in treatment and received usual care. Based on accelerometer data, participants were classified as either meeting or not meeting physical activity recommendations (≥150 min of moderate-to-vigorous physical activity per week). Participation in structured and individually performed exercise and sport activities was assessed with the Simple Physical Activity Questionnaire.Results: In total, 57% of all patients met physical activity recommendations. 55% participated in structured exercise and sport therapy activities, whereas only 22% of all patients engaged in exercise and sport activities independently. Psychiatric patients were significantly more likely to meet recommended levels of health-enhancing physical activity if they engaged in at least 60 min per week of structured exercise and sport therapy or in at least 30 min of individually performed exercise and sport activity.Conclusions: Given that prolonged immobilization and sedentary behavior have harmful effects on patients' physical and mental well-being, promoting exercise and sport activities is an important endeavor in psychiatric care. Clinics currently succeed in involving between 50 and 60% of all patients in sufficient physical activity. While this is encouraging, more systematic efforts are needed to ensure that all patients get enough physical activity.

Characteristics of insufficiently active participants that benefit from health-enhancing physical activity (HEPA) promotion programs implemented in the sports club setting

BackgroundHealth-enhancing physical activity (HEPA) promotion programs are implemented in sports clubs. The purpose of this study was to examine the characteristics of the insufficiently active participants that benefit from these programs.MethodsData of three sporting programs, developed for insufficiently active adults, were used for this study. These sporting programs were implemented in different sports clubs in the Netherlands. Participants completed an online questionnaire at baseline and after six months (n = 458). Of this sample, 35.1% (n = 161) was insufficiently active (i.e. not meeting HEPA levels) at baseline. Accordingly, two groups were compared: participants who were insufficiently active at baseline, but increased their physical activity to HEPA levels after six months (activated group, n = 86) versus participants who were insufficiently active both at baseline and after six months (non-activated group, n = 75). Potential associated characteristics (demographic, social, sport history, physical activity) were included as independent variables in bivariate and multivariate logistic regression analyses.ResultsThe percentage of active participants increased significantly from baseline to six months (from 64.9 to 76.9%, p < 0.05). The bivariate logistic regression analyses showed that participants in the activated group were more likely to receive support from family members with regard to their sport participation (62.8% vs. 42.7%, p = 0.02) and spent more time in moderate-intensity physical activity (128 ± 191 min/week vs. 70 ± 106 min/week, p = 0.02) at baseline compared with participants in the non-activated group. These results were confirmed in the multivariate logistic regression analyses: when receiving support from most family members, there is a 216% increase in the odds of being in the activated group (OR = 2.155; 95% CI: 1.118–4.154, p = 0.02) and for each additional 1 min/week spent in moderate-intensity physical activity, the odds increases with 0.3% (OR = 1.003; 95% CI: 1.001–1.006, p = 0.02).ConclusionsThe results suggest that HEPA sporting programs can be used to increase HEPA levels of insufficiently active people, but it seems a challenge to reach the least active ones. It is important that promotional strategies and channels are tailored to the target group. Furthermore, strategies that promote family support may enhance the impact of the programs.

Sports participation, physical activity, and health in the European regions

ABSTRACTIn a context of stagnation of the level of health-enhancing physical activity in Europe, this study examines the geographical stratification of sports participation and physical activity (PA) at the regional level in 28 European countries. While previous research has focused on the national approach, this study considers the regional level across 208 European regions. Individual survey data from the Eurobarometer 80.2 is combined with a regional-level approach to the 208 regions to quantify sports participation and PA at the regional level. The results show important differences and a geographical stratification of sports participation and PA among the European regions, albeit following different patterns. In particular, a north–south gap is identified in terms of PA rates and an east–west gap is detected in terms of sports participation levels. Applying the cluster technique, a taxonomy of four different European regions is developed considering both types of indicators. Finally, the existence of sports spatial spillovers among regions is verified, obtaining a positive autocorrelation among neighbouring regions for being involved in PA and sporting activities. The results may have significant implications in terms of policy measures to improve health through PA and sports participation at the regional level in Europe.

The Start2Bike program is effective in increasing health-enhancing physical activity: a controlled study

BackgroundThe sports club is seen as a new relevant setting to promote health-enhancing physical activity (HEPA) among inactive population groups. Little is known about the effectiveness of strategies and activities implemented in the sports club setting on increasing HEPA levels. This study investigated the effects of Start2Bike, a six-week training program for inactive adults and adult novice cyclers, on HEPA levels of participants in the Netherlands.MethodsTo measure physical activity, the Short QUestionnaire to ASsess Health-enhancing physical activity was used (SQUASH). Start2Bike participants were measured at baseline, six weeks and six months. A matched control group was measured at baseline and six months. The main outcome measure was whether participants met the Dutch Norm for Health-enhancing Physical Activity (DNHPA: 30 min of moderate-intensity activity on five days a week); Fit-norm (20 min of vigorous-intensity activity on three days a week); and Combi-norm (meeting the DNHPA and/or Fit-norm). Other outcome measures included: total minutes of physical activity per week; and minutes of physical activity per week per domain and intensity category. Statistical analyses consisted of McNemar tests and paired t-tests (within-group changes); and multiple logistic and linear regression analyses (between-group changes).ResultsIn the Start2Bike group, compliance with Dutch physical activity norms increased significantly, both after six weeks and six months. Control group members did not alter their physical activity behavior. Between-group analyses showed that participants in the Start2Bike group were more likely to meet the Fit-norm at the six-month measurement compared to the control group (odds ratio = 2.5; 95% confidence interval (CI) = 1.1–5.8, p = 0.03). This was due to the Start2Bike participants spending on average 193 min/week more in vigorous-intensity activities (b = 193; 95% CI = 94–293, p < 0.001) and 130 min/week more in sports activities (b = 130; 95% CI = 82–178, p < 0.001) than control group members.ConclusionsStart2Bike positively influences HEPA levels of participants by increasing participation in sport. A relatively short sporting program, offered by a sports club, can be used to encourage less active people to engage in and continue sport at HEPA levels. Overall, sport can contribute to health through increased HEPA and the sports club can serve as a setting to stimulate this.

The unrealised potential of bike share schemes to influence population physical activity levels – A narrative review

The recent proliferation of bike share schemes (BSS, also known as public bicycle use programs) in many cities has focused attention on their potential for reducing motorised traffic congestion, improving air quality and reducing car use. Since 2005, hundreds of bike share schemes have been implemented in many cities, with bike share usage patterns monitored in many of them. This paper assesses the development of BSS and provides a rationale for their potential health benefits. The key research question, as yet unanswered, is whether BSS themselves can contribute to improving population health, particularly through increasing population cycling, which would increase population levels of health-enhancing physical activity. This paper presents a framework for evaluating the contribution of BSS to population physical activity, and uses examples of new data analyses to indicate the challenges in answering this question. These illustrative analyses examine cycling in Australia, and [i] compares rates of cycling to work in BSS cities compared to the rest of Australia over time, and [ii] modelling trends in bike counts in Central Melbourne before and after introduction of the BSS in 2010, and compared to adjacent regions in nearby suburbs unexposed to a BSS. These indicative examples point to difficulties in attributing causal increases in cycling for transport to the introduction of a BSS alone. There is an evidence gap, and a need to identify opportunities to improve the health-related components of BSS evaluations, to answer the question whether they have any impact on population physical activity levels.

Health enhancing physical activity in patients with hip or knee osteoarthritis - an observational intervention study

BackgroundOsteoarthritis is one of the leading causes of inactivity worldwide. The recommended level of health enhancing physical activity (HEPA) is at least 150 min of moderate intensity physical activity per week. The purpose of this study was to explore how the proportion of patients, who reached the recommended level of HEPA, changed following a supported osteoarthritis self-management programme in primary care, and to explore how reaching the level of HEPA was influenced by body mass index (BMI), gender, age and comorbidity.MethodsAn observational study was conducted using data from a National Quality Registry in which 6810 patients in primary care with clinically verified hip or knee osteoarthritis with complete data at baseline, 3 and 12 months follow-up before December 31st 2013 were included. HEPA was defined as self-reported physical activity of at least moderate intensity either a) at least 30 min per day on four days or more per week, or b) at least 150 min per week. HEPA was assessed at baseline, and again at 3 and 12 months follow-up. Cochran’s Q test was used to determine change in physical activity over time. The association between reaching the level of HEPA and time, age, BMI, gender, and Charnley classification was investigated using the generalized estimation equation (GEE) model.ResultsThe proportion of patients who reached the level of HEPA increased by 345 patients, from 77 to 82%, from baseline to 3 months follow-up. At 12 months, the proportion of patients who reached the level of HEPA decreased to 76%. Not reaching the level of HEPA was associated with overweight, obesity, male gender and Charnley category C, i.e. osteoarthritis in multiple joint sites (hip and knee), or presence of any other disease that affects walking ability.ConclusionsFollowing the supported osteoarthritis self-management programme there was a significant increase in the proportion of patients who reached the recommended level of HEPA after 3 months. Improvements were lost after 12 months. To increase physical activity and reach long-lasting changes in levels of physical activity, more follow-up sessions might be needed.

How to Assess Physical Activity in Clinical Practice and for Scholarly Work

Nurse practitioners can assess their patients’ physical activity levels using questionnaires, pedometers, and accelerometers. Questionnaires can be used as a vital sign during clinic visits to categorize patients as meeting national physical recommendations and/or to identify the time per week patients engage in health-enhancing physical activity levels. Alternatively, pedometers and accelerometers can be used by nurse practitioners to monitor patients’ progress in meeting recommended physical activity guidelines and/or to suggest a way for patients to monitor their own physical activity behaviors. These measures can also be used to measure physical activity in research and other scholarly work.