Healthy Physical Activity Research Articles

Healthy aging and physical activity practice: The missing link

Healthy aging and physical activity practice: The missing link Isabelle J. Dionne, PhD, Professor, Université de Sherbrooke, walks us through physical activity practice and how it impacts research on healthy aging. Major public health agencies around the world urge the older population to get on the move while cities and states invest more and more in safe and attractive infrastructures and programs. Nonetheless, physical activity (PA) levels of aging adults remain low in most developed societies. It appears that the healthcare systems and the general public do not take advantage of the skills and competencies of qualified PA professionals trained in universities around the globe to support evidence- based physical activity practice and healthy aging. This weakest link needs reinforcement.

Covariates of a healthy diet and physical activity self-management one year after Bariatric surgery: A cross-sectional study.

Healthy diet and physical activity self-management is important in maintaining weight loss and preventing weight regain after bariatric surgery. We aimed at evaluating covariates of healthy diet and physical activity self-management among patients undergone bariatric surgery using Health Action Process Approach (HAPA) model. In this cross-sectional study, 272 patients with a history of bariatric surgery were selected from the data registry of Tehran Obesity Treatment Study (TOTS). Data were collected using bariatric surgery self-management standard questionnaire (BSSQ), and items based on HAPA model for healthy diet and physical activity self-management. Data were analyzed using Path analysis and AMOS version 24. The mean score of self-management was (32 ± 10SD). Coping planning construct (β = 0.22; p<0.001) and risk perception (β = 0.02; p<0.01) in dietary self-management and action planning (β = 0.16; p = 0.001) and risk perception (β = 0.001; p = 0.17) in physical activity self-management had the highest and lowest effect powers, respectively. Coping planning (β = 0.22; p<0.001) and action planning (β = 0.17; p<0.03) in diet, and action planning (β = 0.16; p = 0.010) in physical activity were significantly related to self-management. Also, task-coping self-efficacy (β = 0.28; and p<0.001), outcome expectancies (β = 0.37; p<0.001), risk perception (β = 0.13; p = 0.015) in diet and coping self-efficacy (β = 0.50; p<0.001), outcome expectancies (β = 0.12; p = 0.021) in physical activity were significantly related to behavioral intention. The values of CFI = 0.939 and RMSEA = 0.052 for diet and CFI = 0.948 and RMSEA = 0.048 for physical activity indicated adequate fit. HAPA was applicable as a framework for interventions promoting healthy diet and physical activity self-management in patients who have undergone bariatric surgery.

Enabling mothers of young children in a low SES area to co-design the support they are seeking for the adoption of healthy behaviours.

There is a need for interventions that meet the needs of low socioeconomic status (SES) groups, to encourage the adoption of healthy diets and physical activity, in line with current public health guidance. This qualitative research used co-production, a method which actively involves the relevant community, to identify and describe public health interventions to support a group of mothers of young children living in a low SES area. A group of 20 mothers took part in three in-depth qualitative interviews to discuss in detail the type of support that would be of value to them for the adoption and maintenance of healthy behaviours. The mothers were subsequently invited to take part in a public engagement project, a community-based self-help group. Four themes explained the principles of interventions that would be of value in supporting the mothers with the adoption of healthy behaviours, namely, a community-based self-help group, support for the whole family and support in the home and influencing the environment. These were then further developed into two types of intervention (1) learning for self-help and family care, which encompassed the first three learning-based themes and (2) community of support, which covered influencing the environment and the experience of the community-based self-help group. Co-production enabled a group of mothers of young children, from a low SES area, to describe the type of support that would help them with the establishment and maintenance of healthy lifestyle behaviours. A community-based self-help group warrants further research.

Long-term benefits of physical activity in adult patients with late onset Pompe disease: a retrospective cohort study with 10 years of follow-up

BackgroundIn 2011 a 12 weeks personalized exercise training program in 23 mildly affected adult late onset Pompe patients (age 19.6–70.5 years) improved endurance, muscle strength and function. Data on long-term effects of this program or of other physical activity in Pompe disease are absent. This retrospective cohort study aimed to explore effects of long-term healthy physical activity according to the WHO norm and the former exercise training program on the disease course.ResultsA total of 29 adult late onset Pompe patients were included: 19 former exercise training program participants and 10 comparable control patients. Patients, who based on interviews, met the 2010 WHO healthy physical activity norm (active, n = 16) performed better on endurance (maximal cardiopulmonary exercise test), muscle strength and function compared to patients not meeting this norm (inactive, n = 13) (p < 0.05). Majority of the outcomes, including endurance and manually tested muscle strength, tended to be higher in the active patients of the 2011 training cohort who continued the program compared to active control patients (p > 0.05).ConclusionIn Pompe disease long-term healthy physical activity according to the 2010 WHO norm leads to physical benefits and a personalized exercise training program may have additional favorable effects and both should be recommended as standard of care.

Association of a healthy lifestyle with mortality in older people

BackgroundUnhealthy lifestyle behaviours such as smoking, high alcohol consumption, poor diet or low physical activity are associated with morbidity and mortality. Public health guidelines provide recommendations for adherence to these four factors, however, their relationship to the health of older people is less certain.MethodsThe study involved 11,340 Australian participants (median age 7.39 [Interquartile Range (IQR) 71.7, 77.3]) from the ASPirin in Reducing Events in the Elderly study, followed for a median of 6.8 years (IQR: 5.7, 7.9). We investigated whether a point-based lifestyle score based on adherence to guidelines for a healthy diet, physical activity, non-smoking and moderate alcohol consumption was associated with subsequent all-cause and cause-specific mortality.ResultsIn multivariable adjusted models, compared to those in the unfavourable lifestyle group, individuals in the moderate lifestyle group (Hazard Ratio (HR) 0.73 [95% CI 0.61, 0.88]) and favourable lifestyle group (HR 0.68 [95% CI 0.56, 0.83]) had lower risk of all-cause mortality. A similar pattern was observed for cardiovascular related mortality and non-cancer/non-cardiovascular related mortality. There was no association of lifestyle with cancer-related mortality.ConclusionsIn a large cohort of initially healthy older people, reported adherence to a healthy lifestyle is associated with reduced risk of all-cause and cause-specific mortality. Adherence to all four lifestyle factors resulted in the strongest protection.

Implementation of healthy eating and physical activity practices in Australian early childhood education and care services: A cross-sectional study

BackgroundThe monitoring of healthy eating and physical activity environments is recommended to support population health. Early childhood education and care (ECEC) services are a key setting to deliver obesity prevention strategies as they reach the majority of children aged under five years and have existing supporting infrastructure. ObjectivesThe aim of this study was to i) describe the prevalence of implementation of evidence-based healthy eating and physical activity practices in an Australian sample of ECEC services, and ii) examine associations between implementation of practices and service characteristics. MethodsA random sample of 2,100 centre-based ECEC services across Australia were invited to participate in a cross-sectional survey online or via telephone (August 2021-April 2022). Service characteristics and implementation of 18 evidence-based healthy eating and physical activity practices were assessed. Descriptive statistics and linear mixed regression analyses were performed. ResultsA total of 1,028 (51.8%) eligible services participated. The healthy eating and physical activity practices with the lowest prevalence of implementation were related to encouraging children to consume age-appropriate beverages (17.9%) and providing families with child physical activity education via workshops or meetings (14.6%), respectively. There was a statistically significant difference in the implementation of healthy eating practices by service characteristics, with long day care services implementing significantly more practices than preschools (p < 0.01). ConclusionThere is room to improve the implementation of evidence-based healthy eating and physical activity practices ECEC services. Implementation efforts should be directed towards preschools.

Update and validation of the Canadian Behavior, Attitude and Nutrition Knowledge Survey (C-BANKS 2.0).

Understanding knowledge, attitudes and behaviors related to nutrition is crucial in developing effective intervention strategies to promote healthy eating habits. This study revised and updated the Canadian Behavior, Attitude and Nutrition Knowledge Survey (C-BANKS) to align with the current Canada's Food Guide and dietary guidance and report on its reliability and validity with a new population. Data from 167 early childhood educators were recruited to test the revised C-BANKS' reliability and validity. Reliability, as measured by internal consistency, was assessed using Cronbach's alpha, while concurrent validity was determined by correlating the C-BANKS 2.0 scores with the CHEERS (Creating Healthy Eating and Active Environments Survey) and Mindful Eating Questionnaire (MEQ). Responsiveness was assessed by comparing a baseline C-BANKS 2.0 score to a post-test score after completing an online healthy eating and physical activity educational intervention. The adapted C-BANKS 2.0 questionnaire demonstrated good internal consistency (Cronbach's alpha >0.70) and construct validity with related measures CHEERS and MEQ (p < 0.05). The C-BANKS 2.0 demonstrated strong responsiveness. Specifically, C-BANKS 2.0 scores increased after the nutrition education intervention (p < 0.001). Additionally, there were no signs of floor or ceiling effects. The adapted C-BANKS 2.0 demonstrated satisfactory internal consistency, construct validity, and responsiveness to measure of nutrition knowledge, attitudes, and behaviors in an early childhood educator population. The revised C-BANKS 2.0 provides insight into the key factors that influence dietary habits thereby informing the design and evaluation of effective nutrition community intervention programs.

Beneficial role of healthy eating Index-2015 score & physical activity on COVID-19 outcomes

BackgroundNutritional status and physical activity are essential to maintain a strong immune system. No definite pharmacological strategies for Coronavirus disease 2019 treatment are presently available, so natural enhancement of the immune system is in need. Our goal was to assess the correlation of healthy diet and physical activity on COVID-19 disease outcome.MethodsThis cohort study was conducted on 68 adult patients who contracted mild (38) or moderate [30] cases of COVID-19, recruited via a convenience sampling technique from the outpatient clinic, Kasr Al-Aini Faculty of Medicine, Cairo University Hospital. Patients’ Healthy Eating Index (HEI) and degree of physical activity as measured by the Global Physical Activity Questionnaire were evaluated and linked with several inflammatory markers.ResultsMost of patients with mild COVID-19 patients (92.1%) were physically active, compared to only 50% of moderate COVID-19. The total Metabolic Equivalent Task-min/week was positively correlated with the lymphocyte percentage. The median total HEI score was significantly higher in the patients with mild COVID-19 than with moderate COVID. Significant positive correlations observed among the lymphocyte count and total HEI-2015. There was approximately a 64% reduction in the probability of acquiring moderate COVID-19 illness for each unit rise in The HEI.ConclusionHealthier nutrition and Physical activity correlated with reduced COVID-19 disease severity.Trial registrationThe study was registered on clinical trial.gov maintained by the US National Library of Medicine (CinicalTrials.gov identifier = NCT04447144; https://clinicaltrials.gov/) (25/06/2020).

Why Treat Patients with a Major Orthopaedic Surgery Only to Send Them Back to the Vulnerable Conditions That Made Them Sick in the First Place? A Conceptual Scenario to Improve Patient's Journey.

Individuals with severe cartilage degeneration of the hip or knee or collapsed vertebrae that cause spine deformities can suffer from joint and neuropathic pain in the back, disuse of the affected limb, and restriction of movements. Surgical intervention is the most widespread and successful solution to date. There is a general belief that eating healthy and staying physically and mentally active might have a preventive role against musculoskeletal disease occurrence, while instead, we are more certain of the benefits deriving from a healthy diet and exercise therapy after major orthopaedic procedures. These aspects are in fact vital components in enhanced recovery after surgery programmes. However, they are applied in hospital settings, are often centre-dependent, and lack primary and tertiary preventive efficacy since end once the patient is discharged. There is the lack of initiatives at the territorial level that ensure a continuum in the patient's journey towards orthopaedic surgery, home transition, and a healthy and long-lasting life. The expert panel advocates the integration of an intermediate lifestyle clinic that promotes healthy eating, physical activity, and sleep hygiene. In this facility directed by professionals in enhancing recovery after surgery, patients can be referred after the surgical indication and before home discharge. Surgery is in fact a moment when individuals are more curious to do their best to heal and stay healthy, representing a timepoint and opportunity for educating patients on how lifestyle changes may optimise not only their surgical recovery but also long-term future health state.

Healthier Together: Implementation and evaluation of a co-designed, culturally tailored childhood obesity community prevention program for Māori and Pacific Islander children and families.

Co-designed and culturally tailored preventive initiatives delivered in childhood have high potential to close the cross-cultural gap in health outcomes of priority populations. Māori and Pacific Islander people living in Australia exhibit a higher prevalence of overweight and obesity and higher rates of multimorbidity, including heart disease, cancer and diabetes. This mixed-methods, pilot implementation and evaluation study, aimed to evaluate the implementation of a community-based, co-designed and culturally tailored childhood obesity prevention program, using quantitative (pre-post anthropometric measurement, pre-post health behaviour questionnaire) and qualitative (semi-structured interview) methods. Sessions relating to healthy eating, physical activity and positive parenting practices were delivered to families residing in Brisbane (Australia) over 8-weeks. Data were collected from a total of 66 children (mean age 11, SD 4) and 38 parents (mean age 40, SD 8) of Māori and Pacific Islander background, from July 2018 to November 2019. Anthropometric changes included a reduction in Body Mass Index (BMI) z-score among 59% of children (median change -0.02, n = 38, p = 0.17) and BMI among 47% of adults (median change +0.06 kg/m2, n = 18, p = 0.64). Significant improvements (p < 0.05) in self-reported health behaviours from pre- to post-program included increased vegetable consumption among children, decreased discretionary food intake of children, decreased discretionary drink consumption among both children and adults, increased minutes of daily physical activity among adults and increased parental confidence in the healthy diets of their children. Qualitative data revealed participants valued the inclusion of all family members, learning of practical skills and cultural tailoring delivered by the Multicultural Health Coaches. This study provides preliminary evidence that the Healthier Together program improved self-reported health behaviours and physical activity levels among Māori and Pacific Islander children and their families in the short-term; however, due to the small sample size, these results must be interpreted carefully. The program empowered change via cultural tailoring and accessibility; however, long-term implementation and evaluation with a larger cohort is needed to validate the observed health behaviour improvements and their sustainability. SO WHAT?: The co-design framework that informed program development and key learnings of implementation will provide guidance to health practitioners, health workers, public health professionals and policy makers to develop inclusive and pragmatic co-design solutions for priority cultural populations in Australia. Health outcomes will improve as a result, promoting health equity for future generations.

Increase in Postoperative Body Mass Index in Patients After Total Knee Arthroplasty.

Objectives The aim of this is to investigate the changes in body mass index (BMI) following knee arthroplasty and to evaluate their impact on patient-reported outcomes and functional evaluations. Methods This observational study included 90 patients who underwent total knee arthroplasty (TKA) and were followed up for a median period of 2.6 years. BMI measurements were recorded before and after surgery, and patient-reported outcomes and functional evaluations were assessed using standardized scales and tests. Results Following TKA, BMI increased statistically significantly (Wilcoxon signed-rank test, p < 0.000). In addition, half of the patients experienced an increase in BMI, with 32% moving up in their BMI category. However, there were no clinically significant differences in patient-reported outcomes or functional evaluations between the group that gained BMI and the group that maintained or lost BMI. Conclusion This study reveals that patients tend to have increased BMI following TKA. However, these BMI changes do not significantly impact patient-reported outcomes or functional evaluations. It underscores the importance of patient education regarding healthy lifestyle habits, including diet and physical activity, to address postoperative weight gain effectively.

Dietary trends among young adults during the COVID-19 lockdown: socioeconomic and gender disparities

BackgroundHealthy eating is vital to well-being and during the COVID-19 pandemic, it was especially important for boosting immunity and protecting against viral infections. Yet, by many accounts, keeping a nutritious diet was a casualty of the pandemic rather than a means to fight it. Young adults experienced disproportionate pandemic-related disruptions during a formative stage of development while little is still known about dietary outcomes.MethodsWe employed a cross-sectional design to examine dietary disparities targeting young adults (ages 18–28) during the COVID-19 lockdown period. Participants (N = 254) responded to a 15–20-min online survey with questions related to food composition and sources of food, perceptions of healthy eating, weight change, physical activity, and food insecurity. Comparisons were made by household income and gender. Multiple regression analyses were conducted to investigate factors that predicted perceptions of healthy eating behaviors while controlling for other sociodemographic factors.ResultsA clear overall trend toward unhealthy behaviors was found while positive changes were also identified. Consumption of junk food significantly increased (+ 3%), 40% gained weight, a third were less active, and 5–8% were food insecure on a regular basis. Meanwhile, eating food from restaurants declined and, for some, home-based cooking increased. Lower income participants were overly represented in unhealthy changes and higher income participants were disproportionately represented in healthy changes. Males reported more changes in dietary composition while females reported more fluctuation in weight. Reduced activity, weight gain, and food insecurity predicted unhealthy eating behaviors. Living with friend(s)/roommate(s) predicted healthier eating, but only among lower income participants.ConclusionsIt is recommended that pandemic minded public health interventions account for negative dietary trends with particular attention to low-income young adults. Solutions should be geared toward reshaping fiscal, social and physical environments, rather than relying solely on behavioral interventions.

Association between sleep quality/physical activity and metabolic syndrome in urban population of Xinjiang

Objective: To explore the relationship between sleep/physical activity and metabolic syndrome (MS) in urban population of Xinjiang. Methods: This is a prospective, cross-sectional study. From July 2019 to September 2021, a two-stage random sampling method was used to randomly select residents aged 30-74 years from two communities in Urumqi of northern Xinjiang and Korla of southern Xinjiang. General situation questionnaire, Pittsburgh Sleep Quality Index Scale (PSQI) survey, International Physical Activity Questionnaire (IPAQ) survey, physical examination, physiological and biochemical indicators were obtained and analyzed. The dose-response curves of healthy sleep score and physical activity with metabolic syndrome were plotted using restricted cubic spline curves. Multivariate logistic regression model was used to analyze the independent and combined effects of sleep quality and physical activity on MS risk. Results: A total of 10 209 participants were included. The mean age of the subjects was (47.1±9.1) years, and males accounted for 51.3% (5 275/10 209). The prevalence of MS was significantly associated with the healthy sleep score and physical activity. Compared to the subjects with healthy sleep, OR (95%CI) of MS with intermediate, and poor sleep were 1.20(1.06-1.35), 1.23(1.04-1.45), respectively. Compared to the subjects with high physical activity, OR (95%CI) of MS with medium, low physical activity was 1.34(1.15-1.56), 1.42(1.19-1.70), respectively. There was a significant interaction between sleep and physical activity in MS (P for interaction=0.002). Compared to the subjects with high physical activity and healthy sleep, OR (95%CI) of MS with poor sleep and high physical activity was 2.03 (1.24-3.33, P for trend=0.016). Conclusion: Poor sleep quality and lack of physical activity are not only independent risk factors for an increased risk of MS but also have a combined effect with an increased risk of MS.

Enhancing Driving Ability in Older Adults through Health Exercises and Physical Activity: A Randomized Controlled Trial.

The global rise in the aging driving population has heightened concerns about traffic incidents involving this demographic. Beyond transportation, automobiles represent a vital lifeline for older adults, fostering social activities and influencing their health-related quality of life. This study explores improving and sustaining driving ability among older adults with anticipated declines through health-conscious exercises. Sixty-eight participants were randomly allocated into two groups. The exercise-oriented group (E-group) engaged in twelve 90 min health and exercise sessions over twelve weeks, while the control group (C-group) maintained their regular daily routines and did not receive any specific interventions during this period. The focal point of assessment was driving ability, as evaluated by a person using a real car on public roads without using a simulator. Driving ability and physical fitness were assessed before the intervention in both groups. Post-intervention measurements occurred twelve weeks after the initial gauging, encompassing both cohorts. Comparative analysis of pre- and post-intervention changes was executed between the two groups. The E-group demonstrated improved overall driving ability compared to the C-group. The results suggest that healthy exercise and physical activity may maintain and enhance driving ability for older adults.

Associations among risk perception, health efficacy, and health behaviors for cardiovascular disease: an application of risk perception attitude framework.

There is currently a pervasive prevalence of cardiovascular disease (CVD) risk worldwide and an inadequate amount of action is being taken to promote healthy lifestyle habits. The risk perception attitude (RPA) framework, which classifies individuals based on their risk perception and efficacy belief, enables us to predict their preventive behaviors. We applied the RPA framework to analyze CVD prevention behaviors among Chinese adults and extended its application to CVD objective risk. A cross-sectional survey was performed in two sites in Zhejiang Province, from March to August 2022, which contained self-reported CVD risk perception, objective CVD risk, efficacy belief, physical activity, healthy diet, and covariates. We used the RPA framework to categorize participants into four groups, then analysis was conducted to estimate inter-group differences in healthy behaviors. We further conducted a hierarchical logistic regression analysis with individuals' health behaviors as the dependent variable, using three blocks of independent variables. Among 739 participants, healthy physical activity and healthy diet had significant differences among four RPA groups, post hoc tests clarified that the proportion of respondents with healthy PA in the responsive group (61.6%) was significantly higher than that in the other three groups. Risk perception and efficacy belief significantly predicted health behavior against CVD; the relationship between absolute CVD risk and health behavior was moderated by efficacy belief. Early CVD risk screening is crucial, but tailored support and a proper understanding of personal risk are essential to promote healthy behaviors. Developing communication and behavioral counseling intervention strategies on the basis of the RPA framework has the potential to promote healthy behaviors for CVD prevention.

O.2.1-4 Physical activity program for people with intellectual disability: results from an implementation study

Abstract Purpose Many people with an intellectual disability (ID) are inactive and have low physical fitness. A physical activity (PA) program was specially developed for this group and found to be effective to increase PA and preventing or delaying deterioration in physical fitness. However, implementation in practice has not yet been successful. The aim of this project is to study the implementation of this PA program, to be able to increase successful implementation and scaling up in the future. Methods we are systematically implementing the PA program on three sites within the care for people with ID in the Netherlands. The key elements of the PA program are: three times a week for 45-60 minutes; training in a group; focus on increasing endurance, strength, balance and flexibility; increasing intensity and duration; under supervision of a PA expert; including education on healthy PA. Implementation is guided by implementation support practitioners, who are using the Grol and Wensing implementation model as a guide for the implementation. Implementation is studied by collecting data on i.a. acceptability, feasibility, fidelity, and determinants on three moments (three months after start of implementation process, one and six months after start of the PA program). This was done by interviewing the implementation support practitioners and the staff implementing the PA program on site. Furthermore, field notes and logs are collected. Interview data are verbally transcribed and coded. All data are thematically analyzed, both inductive and deductive. Results Four to five months after start of the implementation process, the PA program started. Preliminary results of the first data collection show that acceptability, feasibility and fidelity of the program is moderate. Not all key elements are implemented as prescribed, like frequency and the way of involvement of the PA expert. Suggestions are made to improve the chance of successful implementation of the PA program. Conclusions Some of the original key elements and preconditions should be reconsidered to make the program more suitable for further implementation and scaling up within the care for people with an ID. Funding This study was funded by ZonMW.

S13-4 Supporting health-enhancing research for cities - peer to peer collaboration, impact and dissemination in the Healthy Cities Helix Community

Abstract Support for research and dissemination of project results are often different activities even though they can have a similar target audience. To help support its impact and dissemination activities, while also supporting new collaboration focused on improving the health and wellbeing in cities, the VARCITIES project has launched the Healthy Cities Helix - an international Open Innovation community of specialists in the fields of environment, smart cities, health and related disciplines. The new Helix is calibrated to support VARCITIES through its various development stages, including post-project. It will accelerate the project’s dissemination, communication and commercialisation strategies, by building a strong, self-sustaining community of like-minded stakeholders that will have access to updates on the project and collaborate with experts in their fields of interest. The community acts as a virtual accelerator for knowledge transfer and the project’s impact objectives - by linking profiles and outputs from the project to external actors from outside the project consortium who will be part of the Helix. This will not only help enable and facilitate disseminating the results to key STKs, with specific focus on healthy cities, health, and physical activity, but will also drive new forms of international and cross-sectoral partnerships and open innovation activity in these areas. Currently the community hosts members from 183 organisations across 38 countries, but it can also support researchers to connect in a timely manner to relevant partners by tapping into the 10,000 users profiled on the Crowdhelix platform. This means that users can easily collaborate with people from various fields such as social sciences, citizen science, various areas of health, etc. The Helix has been set-up as a self-sustaining community hosted on the Crowdhelix Platform beyond the lifetime of the project thereby promoting existing and creating new long-lasting impacts.

Global Self-Esteem, Body Composition, and Physical Activity in Polish University Students.

Global self-esteem is a psychological concept that refers to the overall assessment of oneself as a person of value. Body composition is measured by indices such as BMI, BF, and LBM, which have implications for health and self-esteem. Physical activity is associated with numerous health and self-esteem benefits. The purpose of this study focuses on assessing the relationship between global self-esteem, body composition, and physical activity among Polish students. The study was conducted on a group of 305 students between the ages of 19 and 26. The participants were divided into groups according to their level of physical activity. The SES scale by M. Rosenberg assessed the subjects' global self-esteem. The results showed a negative correlation between body weight and BMI and global self-esteem, that is, the higher the body weight, the lower the self-esteem. On the other hand, higher levels of physical activity were associated with higher global self-esteem. The study suggests that maintaining healthy physical activity and body composition can help improve global self-esteem. The study highlights the importance of physical activity for mental health and self-esteem. It is worth encouraging and promoting physical activity among students to support an individual's physical and emotional health. Ultimately, this study may have implications for health policy, education, and intervention for students to emphasize the importance of physical activity for self-esteem and overall health.

GamerFit-ASD beta test: adapting an evidence-based exergaming and telehealth coaching intervention for autistic youth.

Health disparities faced by autistic youth are exacerbated by inadequate physical activity (PA) and sleep, whereas healthy PA and sleep may improve mood and function. Adaptive Game Squad (AGS) is an evidence-based telehealth coaching and exergaming intervention to improve PA and sleep for adolescents with diverse neurodevelopmental and psychiatric conditions. This study aimed to adapt AGS for autistic youth ages 10-15 years; beta-test the modified intervention for feasibility, accessibility, and engagement; and further refine the intervention for a larger planned demonstration pilot. Interdisciplinary experts adapted AGS to create GamerFit-ASD, a 12-week intervention that included a progressive exergame schedule, Fitbit step-tracking, weekly health coaching, and health tip/exercise videos. For beta testing, the intervention was shortened to a 4-week trial with 5 parent/child dyads. Children completed exit surveys and parents and children were interviewed about intervention feasibility, accessibility, and engagement. Exit survey data were summarized with descriptive statistics. Qualitative data were analyzed using a modified grounded-theory approach. All participants (n = 5; ages 10-14 years) attended all 4 planned coaching sessions and completed an average of 9 of 12 planned exergame challenges for a weekly average of 50 min. All participants reported enjoying coaching sessions, 4 of 5 reported enjoying exergames, and 3 of 5 reported enjoying on-demand exercise videos. In interviews, children generally reported finding participation feasible, exergaming challenges active and fun, and coaches friendly and helpful. Parents reported high feasibility of supporting their children's involvement and valued child goal-setting and intervention flexibility; however, some found telehealth sessions overly scripted. Several adaptations to coaching scripts, coach training, and parent materials were made for the larger demonstration pilot, including changes to reduce scriptedness of coaching sessions, to provide parents with more information specific to autism, and to make video content more appropriate to children's needs/preferences. A telehealth coaching and exergaming intervention appears feasible, accessible, and engaging for autistic youth aged 10-15. Future studies with larger, more diverse samples, longer study durations and/or follow-up periods, and more rigorous study designs are needed to advance understanding of the appropriateness and effectiveness of this type of intervention for this population.

Barriers to brain health behaviours: results from the Five Lives Brain Health Ireland Survey.

Modifiable risk factors for dementia remain prevalent in Ireland. A detailed examination of barriers to risk reduction behaviours in an Irish context has heretofore been lacking. Many existing studies examining barriers to brain health behaviours fail to examine how they might vary across different modifiable risk factors. This study undertook a detailed assessment of barriers to individual risk reduction behaviours. As existing research suggests that barriers may vary across sociodemographic factors, we sought to investigate the distribution of barriers across age, gender, educational status, and household income. The Five Lives Brain Health Ireland Survey is a cross-sectional survey that was distributed online amongst a non-patient population. The survey captured the following: (1) Sociodemographic factors; (2) Barriers to brain health behaviours; (3) Exposure to, and knowledge of, modifiable risk factors for dementia, namely diet, social interaction, exercise, hypertension, sleep, current low mood/depression, current smoking, alcohol consumption, cognitive stimulation, hearing impairment, diabetes, air pollution, and head injury; (4) Participants' perceptions regarding potential for dementia prevention, and risk reduction. Lack of motivation was the most prevalent barrier to consuming a healthy diet (64%, n = 213), physical activity (77.7%, n = 167), smoking cessation (68%, n = 85), and moderation of alcohol intake (56.3%, n = 67). Practical factors were the most prevalent barriers to addressing low mood (56.5%, n = 87), air pollution (30.1%, n = 58), hearing impairment (63.8%, n = 44), diabetes (11.1%, n = 5), and head injury (80%, n = 8). Emotional factors were the most prevalent barriers to engaging in mentally stimulating activity (56.9%, n = 66), social activity (54.9%, n = 302), and good sleep (70.1%, n = 129). Lack of knowledge was the most prevalent barrier to hypertension control (14.4%, n = 29). Distribution of barriers varied across age, gender, educational status, and household income. This study investigated barriers to lifestyle change to improve brain health in an Irish sample of adults aged 50 and above. Detailed subtyping of barriers, as well as examination of differences according to age, gender, education, and income were undertaken. The heterogeneity of barriers to brain health behaviours revealed in this study highlights the necessity to tailor public health interventions to their target population, taking into account the gender, age, educational status, and income of recipients.