Health-enhancing Physical Activity Research Articles

The mSQUASH is a feasible and valid measurement tool to uniformly assess daily physical activity in patients with rheumatic diseases

BackgroundThe modified Short QUestionnaire to ASsess Health-enhancing physical activity (mSQUASH) was originally developed and validated in Dutch patients with axial spondyloarthritis (axSpA). To support world-wide distribution, applicability and comparability of...

Association of Nutritional Intake with Physical Activity and Handgrip Strength in Individuals with Airflow Limitation.

We investigated whether nutritional intake is associated with physical activity (PA) and handgrip strength (HGS) in individuals with airflow limitation. This study analyzed data from the 2014 to 2016 Korean National Health and Nutrition Examination Survey. We assessed total protein intake (g/day), caloric intake (kcal/day), and other nutritional intakes using a 24-hour dietary recall questionnaire. HGS was measured three times for each hand using a digital grip strength dynamometer, and PA was assessed as health-enhancing PA. Airflow limitation was defined as a forced expiratory volume/forced vital capacity ratio of 0.7 in individuals over 40 years of age. Participants were categorized into groups based on their PA levels and HGS measurements: active aerobic PA vs. non-active aerobic PA, and normal HGS vs. low HGS. Among the 622 individuals with airflow limitation, those involved in active aerobic PA and those with higher HGS had notably higher total food, calorie, water, protein, and lipid intake. The correlations between protein and caloric intake with HGS were strong (correlation coefficients = 0.344 and 0.346, respectively). The forest plots show that higher intakes of food, water, calories, protein, and lipids are positively associated with active aerobic PA, while higher intakes of these nutrients are inversely associated with low HGS. However, in the multivariate logistic regression analysis, no significant associations were observed between nutritional intake and active aerobic PA or HGS. Nutritional intake was not found to be an independent factor associated with PA and HGS. However, the observed correlations suggest potential indirect effects that warrant further investigation.

The Short Questionnaire to Assess Health-Enhancing Physical Activity in Syrian Adults’ Populations

Background: To date, no studies have evaluated the reliability and/or validity of methods for measuring physical activity (PA) in free-living conditions within the Syrian population.Methods: This study compared estimates of PA and sedentary behavior (SB) obtained from the ActiGraph WGT3X-TB (AG) accelerometer and the Short Questionnaire to Assess Health Enhancing Physical Activity (SQUASH). Forty-five adults (13 men and 32 women, mean age 36.9 ±8.3 years) completed the SQUASH twice, with a 45-day interval between administrations. Time spent in low, moderate, vigorous, and moderate-vigorous PA (MVPA) was calculated using the SQUASH and AG accelerometer data. Reliability was assessed by calculating the Spearman correlation coefficient between the PA items scores. Bland-Altman analysis was also performed. The validity of the SQUASH was determined using the AG accelerometer as the reference method.Results: PA levels were systematically higher when measured by the SQUASH compared to the AG accelerometer. The Spearman’s correlation coefficient for the overall SQUASH reproducibility was 0.64. The Spearman’s correlation coefficient between the calculated total activity score from the SQUASH and the AG accelerometer was 0.31, indicating moderate reliability and validity of the SQUASH.Conclusion: Given its simplicity, brevity, ease of use, and low cost, the SQUASH appears to be a suitable method for monitoring PA in Syrian adults. Further strengthening of the validity scores may be possible by providing more detailed information on the types of activities included in the questionnaire.

Identification of relevant mental health indicators for European community-based health enhancing physical activity initiatives: An adapted Delphi study

Health enhancing physical activity (HEPA) initiatives can improve mental health; however there is a lack of standardised measures to evaluate mental health impact. This study aimed to identify the relevant indicators of mental health and well-being in community-based HEPA initiatives in Europe as determined by specialists and practitioners in the field, and understand assessment methods commonly used.An adapted, two round, Delphi method was conducted with N = 20 specialists (practitioners and academics) in the field of mental health and physical activity from Denmark, the Netherlands, the UK, and Ireland. Specialists selected the most important indicators and agreed consensus on definitions and operationalisation, where consensus ≥50% signified important indicators.Specialists compiled 66 (n = 21 outcome, n = 45 determinant) indicators. Top rated indicators for the evaluation of HEPA initiatives were self-rated mental health (69.2%), physical activity (69.2%) life satisfaction (53.8%), stress (53.8%), loneliness (53.8%), social participation, network, connection and support (53.8%). Consensus on definition and application of the nine indicators varied (44.4%–100%), with no consensus on a standardised measurement tool reached, although specialists pointed to the need for culturally sensitive measurement tools.While this study highlights a lack of conformity for evaluating mental health and wellbeing outcomes, it suggests utility in an agreed definition and application of nine indicators for the evaluation of HEPA initiatives, with social determinants of particularly high importance across the relevant contexts. Further research is recommended to develop guidance on pragmatic measurement tools that can be utilised across other (European) countries and their implementation tested.

Competencies for health-enhancing physical activity are associated with body mass: results of an updated data pooling across 18 samples.

Although previous studies have illuminated associations between body mass and physical activity (PA), there have been scant insights regarding the physical, cognitive, and motivational determinants of PA in relationship to body mass. This study aimed to model courses of competencies for health-enhancing PA across the spectrum of BMI. We used cross-sectional data of 3670 individuals (mean [SD]: BMI, 25.54 [5.71] kg/m2; age, 46.11 [14.96] years) from a large data pooling with 18 primary samples employing the PA-related health competence (PAHCO) instrument. ANCOVA determined differences in 10PAHCO indicators by BMI categories (underweight, normal weight, overweight, and obesity). Covariate-adjusted multilevel models described the nonlinear courses of the PAHCO indicators across the BMI spectrum. The levels of all 10PAHCO indicators differed significantly among the BMI categories (F ≥ 14.8; p < 0.001). All competencies for health-enhancing PA could be best described by cubic functions having their maximum around normal weight while regressing with underweight and with increasing grades of obesity (0.02 ≤ ≤ 0.31). This study adds to associations between BMI and PA levels by specifying individuals' multidimensional requirements for health-enhancing PA. The present findings call for an integration of physical, motivational, and cognitive factors in practices of PA promotion and sustainable obesity treatment.

Health-enhancing physical activity in obesity management: the need to (seriously) go beyond weight loss.

There are many false hopes around the impact of physical activity and exercise in obesity management, especially regarding weight loss. Narrowly focusing on weight loss only leads to disappointment for patients and practitioners. Indeed, in persons with overweight or obesity, exercise training, specifically aerobic (i.e. endurance) training, is associated with significant additional weight and fat loss compared to the absence of training. However the magnitude of this effect remains modest, amounting to only 2-3 kg additional weight or fat loss on average. We therefore argue that this conversation needs to be re-oriented towards the many potential health benefits of physical activity that can be seen beyond weight loss. Exercise training has been shown to improve the cardiometabolic risk profile by effects including decreasing abdominal visceral fat and improving insulin sensitivity. Aerobic, as well as combined aerobic and resistance (i.e. strength) training, increase cardiorespiratory fitness, a major risk factor for ill health. Resistance training improves muscle strength, another major component of physical fitness, even in the absence of a significant change in muscle mass. Beyond body mass loss, recognizing the broad value of physical activity/exercise in improving health and quality of life of people with obesity is a crucial perspective shift.

72 The role of conservation projects for health enhancing physical activity (HEPA): holistic benefits for volunteers whilst enhancing environmental biodiversity - a blue space case study

72 The role of conservation projects for health enhancing physical activity (HEPA): holistic benefits for volunteers whilst enhancing environmental biodiversity - a blue space case study

199 EDUcational Course Assessment TOOLkit (EDUCATOOL): development and application in a Health-Enhancing Physical Activity (HEPA) promotion intervention

199 EDUcational Course Assessment TOOLkit (EDUCATOOL): development and application in a Health-Enhancing Physical Activity (HEPA) promotion intervention

171 Decline in adherence to Physical Activity Guidelines among the Dutch population

Abstract Purpose In the Netherlands, the number of people who meet the Physical Activity Guidelines in 2022 has dropped dramatically to a level lower than in 2019. In order to get more insight in this decline, we compared PA behavior in 2022 (after the coronavirus pandemic) with 2019 (before the pandemic). Methods For this study the 2019 and 2022 data collection of the Health Survey/Lifestyle Monitor (Statistics Netherlands (CBS) in collaboration with National Institute for Public Health and the Environment (RIVM)) was used. This is an annual survey including a random sample of the Dutch population (N ± 10,000). Physical activity was measured with the Short Questionnaire to Assess Health Enhancing Physical Activity (SQUASH). Specifically, time spend on walking and biking to work/school and in leisure time, playing sports, household activities, activities at work or school, gardening and, for children, playing outside and physical education was asked. Results In 2022, 44% of the Dutch population 4 years and older was sufficiently physically active compared to 49% in 2019. The decline was highest among young adults aged 18–29 (9.2 percent point), adolescents aged 12–17 (7.5 percent point), people who do paid work (6.4 percent point) and people educated to a higher level (7.5 percent point). All of these groups cycled less in their leisure time (-27, -51, -25 and -22 minutes per week, respectively), although for young adults this difference was not statistically significant. Adolescents also cycled less time to school (-48 minutes per week), but the mean number of days they cycled to school remained the same (4 days a week). In addition, young adults walked less, particularly in their leisure time (-39 minutes per week). Conclusions The decline in adherence to the Physical Activity Guidelines is mainly related to a decline in cycling time and, for young adults, a decline in walking time. Especially among adolescents the decrease in the number of minutes cycling between 2019 and 2022 is striking. However, in both 2019 and 2022, they cycled on average 4 days a week to school. A possible explanation for this is the increased use of electric bicycles.

S14-3: The adoption and implementation of a physical activity referral pathway integrated into a major U.S. health system

Abstract Background Regular physical activity (PA) is highly effective in improving mental, physical, and emotional health; yet, health systems experience challenges integrating PA referral pathways connecting eligible patients to health-enhancing PA resources and programs. Purpose To examine the adoption of a clinic-to-community PA referral pathway in primary care clinics in a major U.S. health system and identify provider- and patient-level barriers and facilitators associated with its implementation. Methods Exercise is Medicine Greenville® (EIMG®) is a clinic-to-community model that connects primary care patients to a 12-week, evidence-informed, PA program in community PA facilities. Resumption of EIMG® in March 2021 after COVID-19 closures provided a unique opportunity to comprehensively evaluate the PA referral pathway from inception. Referral provision, utilization, and program enrollment were tracked from reopening through September 2022 in twelve primary care clinics. Semi-structured interviews were conducted with providers (informed by the i-PARIHS framework) and referred patients who declined enrollment (informed by the COM-B model). Interviews were recorded, transcribed, and themes identified. Results Twenty-six providers completed interviews. Referral barriers included a lack of knowledge about EIMG®, a perceived time-consuming referral process, and placing incomplete referrals. Facilitators included acknowledgment of a high value for PA in healthcare, desire to incorporate EIMG® into patient visits, and the work of the EIMG® nurse navigator. Twenty-eight patients completed interviews. Enrollment barriers included time, financial constraints, inconvenient locations, disruptions due to COVID-19, and suboptimal communication. Facilitators included aligning EIMG® with patients’ health goals, enhanced trust due to provider referral, group-based format of the PA program, and friendly staff. Conclusions Improving communication, conducting refresher trainings, simplifying the referral process, and providing more resources (for providers), along with providing more program details, and offering more program times, locations, and financial support (for patients), may increase success of PA referral pathways implemented in primary care settings. Practical implications This work identifies modifiable factors that can guide improvements in the adoption and implementation of PA referral models in health settings. Funding The Duke Endowment and the National Heart, Lung, and Blood Institute (NHLBI)

37 Developing a practical tool for reaching consensus about shared outcome measurement in cross-sector health-enhancing physical activity partnerships

37 Developing a practical tool for reaching consensus about shared outcome measurement in cross-sector health-enhancing physical activity partnerships

43 Involvement in active transport is related to organizational factors and physical environment infrastructure

Abstract Purpose Active transport (AT) is considered the most sustainable and accessible mode for travel purposes. AT (walking and cycling) contributes to health-enhancing physical activity as it is a convenient and accessible way to increase physical activity levels. Convenient infrastructure promotion and support are important factors in shift from motor transport towards active travel. The purpose of this study was to determine how organizational factors and neighbourhood physical environment differ between using and not using AT among the Lithuanian young adult population. Methods This cross-sectional study included 250 Lithuanian young adults aged 18-39 years, with a mean age of 20.38 years. Of these, 80% were women. AT was measured using the Stages of Change Model-based Questionnaire. Infrastructure was measured by ALPHA Questionnaire–REVISED (Spittals et al., 2010). Organization-related items were developed by study researchers. Results Young Lithuanian people preferred cars and/or public transport (62.4%) instead of active transportation (AT) (27.6%) when choosing mobility. The results support a strong link between AT and organizational aspects. AT is more often chosen by people who belong to an organization where environmentally friendly behaviour is encouraged (waste sorting, using AT (p = 0.018); conditions are created to safely store a bicycle or scooter (p = 0.024); that talks about sustainable development, environmentally friendly behaviour, sustainability, etc. (p = 0.034). Quality of the neighbourhood physical environment, such as maintained bicycle paths (p = 0.011), maintained sidewalks (p = 0.049), maintained parks, and other open spaces (p = 0.050) significantly associated with the choice of AT. However, the choice of active transport was not significantly related to the infrastructure of pedestrian zones or paths, infrastructure of special lanes, routes for bicycles, or separation of bicycle paths from car traffic. Conclusions Young people’s involvement in AT is influenced by the attitude of the organization in which they work or study towards environmentally friendly behaviour, AT, and sustainable development. The quality of the neighbourhood physical environment also determines the involvement of young people in AT.

S04-4: The HEPA PAT: An in-depth tool to audit HEPA policies at national level

Abstract Purpose The Health-Enhancing Physical Activity Policy Audit Tool (HEPA PAT) a standardized protocol for the detailed compilation and communication of country-level policy responses on physical inactivity. This presentation aims to briefly present the structure of the tool as well as its use in PA policy research. Methods The 29 open-ended and closed questions of the HEPA PAT are structured around a set of 17 key criteria, which were identified based on experiences from several previous guidelines and comparisons of physical activity policy. It supports standardized data collection and is to be completed collaboratively by a team of national stakeholders from all relevant political sectors. However, the process of its application differed across countries. Results The HEPA PAT has been applied in 13 European countries (Belgium, Croatia, Finland, France, Germany, Ireland, Italy, the Netherlands, Norway, Poland, Portugal, Slovenia, Switzerland). These studies provided a detailed overview of physical activity policies for the different sections of the tool such as, for instance, leadership and partnerships, policy documents, evaluation, and funding. A recent study has shown that the tool can be applied to understand aspects influencing the policy process (agenda-setting, policy formulation, decision-making, policy implementation, evaluation). Conclusions The studies based on the HEPA PAT showed in which areas governments are already active to promote physical activity and what improvements can be made. Cross-country comparisons also showed that procedures and timelines of using the HEPA PAT have to be adapted to national contexts. Overall, the instrument can make an important contribution to understanding and informing physical activity policy, especially when used as an add-on to regular monitoring tools like the EU HEPA Monitoring Framework. The PAT completion also fostered new connections with policy makers and officials in government departments and among HEPA stakeholders within and outside of government, which in itself was seen to be extremely valuable. Funding Source No funding

Assessment of the intensity and attractiveness of physical exercise while playing table tennis in an immersive virtual environment depending on the game mode

BackgroundIt appears that active video games (AVGs) and training apps that allow for physical activity (PA) in immersive virtual reality (VR) may be useful for sports, health-enhancing PA, and physical education (PE). Therefore, research is needed to identify their potential.ObjectiveThe study aimed to evaluate the intensity and attractiveness of exercise during table tennis (TT) training in VR in arcade and simulation modes and to assess the potential for using such exercises in health-enhancing PA, sport, and PE.MethodsThe research used the Racket Fury: Table Tennis VR. Exercise intensity during TT training in VR was evaluated by heart rate (HR) monitoring and rating of perceived exertion (RPE 6–20). The effectiveness of short-term TT training in VR was estimated based on the user’s performance in playing against an opponent with artificial intelligence (AI), satisfaction with playing TT was measured using the Physical Activity Enjoyment Scale (PACES), and the potential usefulness of the tested app in PA, sport, and PE was assessed based on a questionnaire for participating PE teachers (30 participants).ResultsPA intensity during TT training in VR expressed as a percentage of maximum heart rate (HRmax) was moderate but was significantly (p < 0.001; d=-0.830) higher in the easier arcade mode (69.50 ± 12.58%HRmax) than in the simulation mode (64.10 ± 9.67%HRmax). Despite the greater fatigue of respondents, user satisfaction was significantly higher in arcade mode. Users’ performance when playing with AI was significantly better after 20 min of training in VR than before training. PE teachers recognize the great potential of the app.ConclusionsThe application tested is characterized by a beneficial PA intensity, with its level depending on the game mode. Facilitating strokes during a game of virtual TT promotes increased intensity of exercise and increased enjoyment of the PA. Short-term TT training in VR improves playing skills in a virtual environment. PE teachers spoke highly of the app and recognized the potential for using VR technology in PA, sports, and school PE.

Towards Health Promoting Schools: Pilot Training and Evaluation of the Updated Urbani School Health Kit (USHK) among School Teachers in Manila.

Committed to enhancing healthy living, learning, and working conditions, a health-promoting school is a potent influencer of behaviors and habits, reaching families and communities effectively. In the Western Pacific region, the Urbani School Health Kit (USHK) is one of the tools developed to integrate health promotion in schools; however, it needs to be updated to adapt to the evolving health challenges of lifestyle-related diseases. Hence, this study aimed to conduct a pilot training and evaluation of the updated USHK among school teachers in Manila. The USHK was updated with new materials on (1) health-enhancing physical activity; (2) healthy nutrition; and (3) family and community engagement. A two-day training-workshop with 30 school teachers was then conducted to facilitate the integration of the updated USHK in their class activities. We used a multi method evaluation design to assess the implementation of the USHK. Particularly, quantitative data were obtained from the participants' feedback on the toolkit and their knowledge of health-related practices. One month later, field visits were conducted to assess the participants' abilities in utilizing the toolkit into their classes or school activities. Qualitative interviews and classroom observations were also collected post-implementation to determine potential facilitators and barriers to program delivery, and suggestions for improvement. Descriptive statistics were used to summarize participant feedback, while Wilcoxon signed rank test was utilized to determine changes in participant knowledge pre- and post-training. Qualitative data were synthesized through content analysis. Participants provided high satisfaction ratings for the training they received, as well as high scores for the updated USHK, in terms of its appropriateness and acceptability. Significant improvements in participants' overall health promotion knowledge were also noted (Z = -4.456, p <0.001), particularly involving the domains of nutrition (Z = -2.972, p = 0.003), physical activity (Z = -3.564, p <0.001), and family/community engagement (Z = -2.531, p = 0.011). Meanwhile, participants also suggested further improvements in the toolkit to enhance its utilization in the local context. Administrative support was a crucial facilitator for implementing the USHK, while resource limitations were identified as significant barriers. The updated USHK, which provides a more comprehensive health promotion approach for schools, is potentially feasible for implementation in educational institutions in Manila. The toolkit can be utilized by teachers and school nurses to integrate health promotion activities into the school environment and classroom activities. To facilitate its wider uptake and implementation in other schools, government support and resource availability are crucial.

Higher levels of physical activity are associated with less evasive coping, better physical function and quality of life in patients with axial spondyloarthritis.

To evaluate daily physical activity (PA) in relation to psychosocial factors, such as anxiety, depression and different types of coping strategies, as well as patient- and disease-related factors in patients with axial spondyloarthritis (axSpA). Consecutive outpatients from the Groningen Leeuwarden AxSpA (GLAS) cohort completed the modified Short Questionnaire to assess health-enhancing PA (mSQUASH), Hospital Anxiety and Depression Scale (HADS) and Coping with Rheumatic Stressors (CORS) questionnaires, as well as standardized patient- and disease-related assessments. Univariable and multivariable linear regression analyses and comparison of lowest and highest PA tertiles were performed to explore associations between the HADS, CORS, patient- and disease-related factors and PA. In total, 84 axSpA patients were included; 60% male, mean age 49 (SD ±14) years, median symptom duration 20 (25th-75th percentiles: 12-31) years, mean ASDAS 2.1 (±1.0). Higher PA levels were significantly associated with better scores on patient-reported disease activity (BASDAI), physical function (BASFI) and quality of life (ASQoL). Furthermore, higher levels of PA were associated with less impact of axSpA on wellbeing and lower HADS depression scores. In the multivariable linear regression model, less use of the coping strategy 'decreasing activities' (β: -376.4; p 0.003) and lower BMI (β:-235.5; p: 0.030) were independently associated with higher level of PA. Comparison of patients from the lowest and highest PA tertiles showed results similar to those found in the regression analyses. In this cohort of axSpA patients, higher levels of daily PA were associated with better patient-reported outcomes and lower depression scores. Additionally, the passive coping strategy "decreasing activities" and lifestyle factor BMI were independently associated with PA. Besides anti-inflammatory treatment, coping strategies and lifestyle should be taken into account in the management of individual axSpA patients. Incorporating these aspects into patient education could increase patient awareness and self-efficacy. In the future, longitudinal studies are needed to better understand the complex relationship between patient-, disease- and psychosocial factors associated with daily PA.

Pedagogical approaches to health-related physical education (PE) in the context of digitalisation – a scoping review

ABSTRACT Introduction There are varied consequences of digital transformation processes within the fitness and health-related living environments of adolescents (e.g. increased physical activity through wearables, body dissatisfaction through social media) which could potentially provide fruitful health-related learning experiences within different pedagogical approaches to health in PE (e.g. biomedical vs. alternative, Mong and Standal, 2019, “Didactics of Health in Physical Education – a Review of Literature.” Physical Education and Sport Pedagogy 24 (5): 506–518. https://doi.org/10.1080/17408989.2019.1631270). However, concerns have been raised that the integration of digital media into health-related PE could reinforce biomedical approaches to health and lead, for example, to a focus on increasing fitness through technology. This one-sided focus would not be in line with the demands for a comprehensive health education. This paper aims to map the current trend of pedagogical approaches to health-related PE in the context of digitalisation and to identify typical learning goals against this background. Methods We conducted a scoping review based on the framework of Tricco et al. (2018, “PRISMA Extension for Scoping Reviews: Checklist and Explanation.” Annals of Internal Medicine 169 (7): 467–473. https://doi.org/10.7326/M18-0850). We searched nine databases using a search term covering three topic areas: digitalisation, health, and physical education. Considering the publication years from 2013 to 2023, we selected papers in a three-step process (title-, abstract-, and full-text-screening). In total, we included 103 empirical and theoretical papers in the analysis using qualitative content analysis (Kuckartz, 2019, “Qualitative Text Analysis: A Systematic Approach.” In Compendium for Early Career Researchers in Mathematics Education, edited by G. Kaiser and N. Presmeg, 181–197. Cham: Springer). To map the pedagogical approach to health, we applied the following main deductive categories: conceptualisation of health, paradigmatic approach to health and envisaged learning goals. To analyse learning goals with regard to digitalisation, we used the distinction between learning with and about digital media as a focus of analysis. Results The scoping review shows that most of the papers discussed a broad conceptualisation of health for PE by addressing biopsychosocial aspects of health. Many of the implications for health- and digitalisation-associated learning goals related to pre-reflective and functional-reflective learning goals in the area of learning with digital media. They mainly focused, from a pathogenic viewpoint, on how digital media can increase health-enhancing physical activity, affective determinants of health behaviour and health-related knowledge. Parts of these learning goals have already been empirically investigated. Only a few papers proposed critical-reflective learning goals in the area of learning about digital media, aiming at a socio-emancipatory engagement with digital media, health and society. No empirical study within the scoping review investigated the effectiveness of such critical health- and digitalisation-related PE. Discussion and conclusion In light of the results, it is important that future genuine pedagogical research about health- and digitalisation-related PE increasingly focuses on the development and empirical evaluation of theoretically sound concepts for PE that are in line with the educational demands of comprehensive – thus also critical and salutogenic – health and digital education.

German translation and linguistic validation of the modified short questionnaire to assess health-enhancing physical activity (mSQUASH) for patients with axial spondyloarthritis (axSpA)

Patients with axial spondyloarthritis (axSpA) often experience chronic pain and inflammation, resulting in physical impairments, reduced mobility and decreased physical activity. The modified short questionnaire to assess health-enhancing physical activity (mSQUASH) was developed to assess daily physical activity in patients with axSpA. To translate, cross-culturally adapt and linguistically validate the original mSQUASH into German for patients with axSpA. The original mSQUASH was translated from Dutch into German using amultistep process (Beaton method) with forward-backward translations into German by bilingual Dutch-German lay people and experts. Any remaining discrepancies were resolved by ascientific committee, resulting in aprefinal German version. Field testing with cognitive debriefing interviews with patients with axSpA from diverse backgrounds led to afinal German version. Minor discrepancies, primarily related to formalities, semantic errors and syntax were found during translations. These were addressed, resulting in slight wording modifications. The prefinal German version was validated through cognitive debriefing by 10patients with axSpA, confirming its linguistic validity and equivalence to the Dutch version. Overall, this study confirmed the final German mSQUASH as acomprehensive measurement instrument for daily physical activity. It can now be used as apatient-reported outcome by German patients with axSpA. This can enable cross-linguistic comparisons and expanding its utility across language barriers.

Physical activity with person-centered guidance supported by a digital platform or with telephone follow-up for persons with chronic widespread pain: Health economic considerations along a randomized controlled trial.

The aim was to investigate the resource use and costs associated with the co-creation of a physical activity plan for persons with chronic widespread pain (CWP) followed by support through a digital platform, compared to telephone follow-up. In this 12-month cost comparison study following up results after a randomized controlled trial, individuals with CWP, aged 20-65 years, were recruited at primary healthcare units in Western Sweden. All participants developed a person-centered health-enhancing physical activity plan together with a physiotherapist. Participants were then randomized to either an intervention group (n = 69) who had a follow-up visit after 2 weeks and was thereafter supported through a digital platform, or an active control group (n = 70) that was followed up through one phone call after a month. Costs to the health system were salary costs for the time recorded by physiotherapists when delivering the interventions. The reported time per person (2.8 h during the 12 months) corresponded to costs of SEK 958 (range: 746-1,517) for the initial visits and follow-up (both study groups), and an additional 2.5 h (corresponding to a mean SEK 833; range: 636-1,257) for the time spent in the digital platform to support the intervention group. After co-creation of a physical activity plan, it was more costly to support persons through a digital platform, compared to telephone follow-up.

Men’s matters—a health-enhancing physical activity intervention for men 50+

Men’s matters—a health-enhancing physical activity intervention for men 50+