Impact Of Physical Activity Interventions Research Articles

Physical activity interventions to prevent and manage type 2 diabetes in Aboriginal and Torres Strait Islander people: a systematic review.

To review evidence regarding the impact of physical activity interventions for preventing and managing type 2 diabetes in Aboriginal and Torres Strait Islander Australians. We searched for published reports of physical activity interventions for preventing and managing type 2 diabetes in Indigenous adults (18 years or older). There were no exclusion criteria regarding study type or duration, frequency, length, or intensity of physical activity, except that short term interventions were excluded. We assessed the quality of each study using the Joanna Briggs Institute (JBI) critical appraisal tools and the ethical and methodological quality of studies from an Indigenous Australian perspective with the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange (CREATE) Critical Appraisal Tool. MEDLINE; Scopus, Embase (Elsevier); Cumulative Index to Nursing and Allied Health Literature (CINAHL), Sports Discus, PsycINFO (EBSCO); Informit Complete; ProQuest Dissertations and Theses, and ProQuest Health and Medicine; each from their inception to 30 October 2022. The database searches identified 703 potentially relevant records; after removing duplicates and initial screening, the full text of 27 articles was assessed for eligibility. Nine studies met our inclusion criteria: two randomised controlled trials, five cohort studies, one quasi-experimental study, and one repeated cross-sectional study. Eight studies were rated as being of low or medium quality (median JBI score, 54%; interquartile range [IQR], 36-64%); seven studies were rated as being of low to medium ethical and methodological quality from the Indigenous perspective (median CREATE score, 50%; IQR, 36-64%). Six studies reported changes in glycated haemoglobin (HbA1c) levels, of which two (both cohort studies) reported significantly lower mean HbA1c levels after the intervention, but only one publication provided detailed results. No randomised controlled trials that investigated the effect of a combination of physical activity and dietary change for Indigenous Australians diagnosed with type 2 diabetes were identified. Differences in study design, outcome variables, and the small number of studies precluded meta-analysis. Quality research into the impact of physical activity interventions on type 2 diabetes in Indigenous people is sparse. To improve research translation, studies that involve Indigenous community members at all levels of the research process are needed. PROSPERO CRD42021247496 (prospective).

Effect of different physical activity interventions on perinatal depression: a systematic review and network meta-analysis

BackgroundPerinatal depression can have profound impacts on both families and society. Exercise therapy is gradually becoming a widely used adjunct treatment for perinatal depression. Some studies have already focused on the relationship between physical activity and perinatal depression (PND). However, there is currently a lack of systematic and comprehensive evidence to address the crucial question of making optimal choices among different forms of physical activity. This study aims to compare and rank different physical activity intervention strategies and identify the most effective one for perinatal depression.MethodsFour databases, namely PubMed, Cochrane Library, Embase, and Web of Science, were searched for randomized controlled trials assessing the impact of physical activity interventions on perinatal depression. The search covered the period from the inception of the databases until May 2024. Two researchers independently conducted literature screening, data extraction, and quality assessment. Network meta-analysis was performed using Stata 15.1.ResultsA total of 48 studies were included in the analysis. The results indicate that relaxation therapy has the most effective outcome in reducing perinatal depression (SUCRA = 99.4%). Following that is mind-body exercise (SUCRA = 80.6%). Traditional aerobics and aquatic sports were also effective interventions (SUCRA = 70.9% and 67.1%, respectively).ConclusionOur study suggests that integrated mental and physical (MAP) training such as relaxation therapy and mind-body exercise show better performance in reducing perinatal depression. Additionally, while exercise has proven to be effective, the challenge lies in finding ways to encourage people to maintain a consistent exercise routine.Trial registrationThis study has been registered on PROSPERO (CRD 42,023,469,537).

Development and Evaluation of a Community Health Program to Promote Physical Activity Among Vulnerable Community-Dwelling Older Adults: Protocol for a Prospective Cohort Study.

Vulnerable older adults have a high risk of morbidity and mortality. Regular physical activity (PA) can have a positive effect on the health and health-related behavior of this specific target group. However, evidence of the impact and feasibility of community-based PA promotion interventions for vulnerable older adults is still limited. The BeTaSen (Bewegungs-Tandems in den Lebenswelten Chemnitzer Seniorinnen und Senioren: ein Beitrag zur kommunalen Gesundheitsförderung) study aims to evaluate the (1) impact as well as the (2) feasibility, acceptance, and usefulness of a 12-month low-threshold PA intervention program for community-dwelling vulnerable older adults. For our population-based prospective observational cohort study, a total of 120 vulnerable older adults (aged 75 years or older) in the area of Chemnitz (Germany) will be recruited to participate in (1) weekly neighborhood-based low-threshold PA meetings with trained mentors (activity tandems) and (2) monthly exercise meetings led by trained exercise instructors. Within the intervention, participants will be encouraged to perform the PA independently. Participants will complete assessments, which will include questionnaires as well as objective measurements of their physical, cognitive, and psychosocial health at 3 different time points (baseline, 6 months after the start, and 6 months after the end of the intervention). Additionally, a process evaluation will be performed, including questionnaires and qualitative interviews, involving the participants, mentors, and municipal project partner representatives. The BeTaSen project process began in October 2021, with the start of data collection and intervention in August 2022 in the first neighborhoods of the city of Chemnitz. A total of 86 participants were recruited at the time of submission of the manuscript. Longitudinal results are expected by 2025. This study's results will provide insights on (1) the PA behavior of vulnerable older adults as well as the impact of PA interventions on health-related outcomes such as cognitive, physical, and psychosocial health, and (2) the feasible and useful components of community-based PA interventions. Thus, this pilot study contributes to future recommendations and provides a basis for further research, such as the development of feasible and sustainable target group-specific interventions in community settings. DERR1-10.2196/51462.

Impact of Physical Activity Interventions on High-Risk Pregnancies: A Systematic Review and Meta-Analysis.

Pregnant women with absolute contraindications may be advised against physical activity throughout pregnancy. In this context, bed rest elevates the short-term risk of neonatal complications, thereby exacerbating negative long-term effects on childhood development. The aim of the current study was to investigate the impact of various physical activity interventions during bed rest or activity restriction in pregnancy on factors such as birth weight, preterm birth, maternal hypertension, gestational age at delivery, and the incidence of cesarean sections. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was designed. The protocol was registered in the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD42022370875). Nine studies, with a total sample of 3173 women, from six countries on four continents were included. There were significant differences in the relationship between bed rest status and birth weight (Z = 2.64; p = 0.008) (MD = 142.57, 95% CI = 36.56, 248.58, I2 = 0%, Pheterogeneity = 0.45) favourable to active groups. No significant differences were found in other analyzed outcomes. Pregnant women who experience this problem must maintain a minimum of daily activity to alleviate these physiological complications and the medical field must understand the consequences of physical inactivity during pregnancy.

Effectiveness of physical activity interventions on reducing perceived fatigue among adults with chronic conditions: a systematic review and meta-analysis of randomised controlled trials

Fatigue is barrier of physical activity participation in adults with chronic conditions. However, physical activity alleviates fatigue symptoms. This systematic review and meta-analysis aimed to (1) synthesise evidence from randomised controlled trials (RCTs) exploring the effects of physical activity interventions on fatigue reduction and (2) evaluate their effectiveness. Medline/CINAHL/EMBASE/Web of Science and Scopus were searched up to June 24th, 2023. Two reviewers independently conducted study screening and selection (RCTs), extracted data and assessed risk of bias (RoB2). Outcome was the standardised mean difference (SMD) with 95% confidence intervals in fatigue between experimental and control groups. 38 articles met the inclusion criteria. Overall, physical activity interventions moderately reduced fatigue (SMD = 0.54, p < 0.0001). Interventions lasting 2–6 weeks demonstrated a larger effect on fatigue reduction (SMD = 0.86, p < 0.00001). Interventions with 18–24 sessions showed a large effect on fatigue reduction (SMD = 0.97, p < 0.00001). Aerobic cycling and combination training interventions had a large to moderate effect (SMD = 0.66, p = 0.0005; SMD = 0.60, p = 0.0010, respectively). No long-term effects were found during follow-up. Physical activity interventions moderately reduced fatigue among adults with chronic conditions. Duration, total sessions, and mode of physical activity were identified as key factors in intervention effectiveness. Further research is needed to explore the impact of physical activity interventions on fatigue.

Physical Activity Interventions for Adults Aged 60+ Years in Low- and Middle-Income Countries: A Scoping Review.

Most reviews investigating physical activity interventions for older people consider evidence primarily from high-income countries. This review examined physical activity interventions for older people from low- and middle-income countries. We searched 9 electronic databases to identify randomized controlled trials or quasi-randomized trials studies investigating physical activity interventions for people aged 60+ in low- and middle-income countries. Following study selection, one reviewer extracted relevant data. A second reviewer double-checked the data extraction of a randomly selected sample of interventions (20%). Data were summarized using descriptive statistics. We included 234 studies from 19 countries, investigating 259 distinct physical activity interventions. Studies were mostly conducted in upper middle-income countries (89%), often assessing physical activity interventions through randomized controlled trials (82%). Most studies investigated a mixed population in terms of sex (68%), with a mean age between 65 and 70years (36%), not selected on the basis of having a specific health condition (55%). The intervention most commonly investigated was structured exercise (63%) and "no intervention" was the most frequent comparator (47%). The outcomes measured more often were intrinsic capacity (59%) and functional ability (51%), whereas physical activity, falls, and social outcomes were rare. Only 2 studies targeted underserved populations. Although we identified a substantial number of randomized controlled trials, most evidence for physical activity interventions for older people in low- and middle-income countries is limited to upper middle-income countries. Gaps identified included interventions targeting populations with underserved backgrounds, using sport as an intervention, and assessing the impact of physical activity interventions on physical activity, falls, and social outcomes.

Multi-Level Meta-Analysis of Physical Activity Interventions During Childhood: Effects of Physical Activity on Cognition and Academic Achievement

There is evidence that physical activity positively influences cognition and academic outcomes in childhood. This systematic review used a three-level meta-analytic approach, which handles nested effect sizes, to assess the impact of physical activity interventions. Ninety-two randomised control trials in typically developing children (5–12 years old, N = 25,334) were identified. Control group type and intervention characteristics including duration, frequency, and teacher qualification were explored as potential moderators. Results showed physical activity interventions improved on-task behaviour with a large effect size (g = 1.04, p = 0.03 (95% CI: 0.08–2.00), very low-certainty evidence) and led to moderate improvements in creativity (g = 0.70, p < 0.01 (0.20–1.20), low-certainty evidence). Small beneficial effects were found for fluid intelligence (g = 0.16, p = 0.03 (0.02, 0.30), moderate-certainty evidence) and working memory (g = 0.18, p = 0.01 (0.07–0.29), very low-certainty evidence), but no overall benefit was observed for attention, inhibitory control, planning, cognitive flexibility or academic outcomes. Heterogeneity was high, and moderator analyses indicated beneficial effects of physical activity (PA) with academic instruction of 6–10-week duration with moderate or moderate to vigorous intensity on mathematics outcomes and enriched PA programmes on language outcomes. In contrast, aerobic PA with moderate to vigorous intensity benefitted executive function outcomes. These results therefore suggest differential mechanisms of impact of different types of PA on different aspects of cognition.

The impact of physical activity intervention on creativity: Role of flexibility vs persistence pathways

Since creativity is at the root of innovation, researchers have shown immense interest in understanding what stimulates creativity and accordingly design interventions to enhance the human creative potential. Extending the literature on this subject, this study employs the Dual Pathway to Creativity model to examine the impact of physical activity on flexibility and persistence pathways in the creative process, using a between subjects randomized controlled trial experiment. The study measures the originality, flexibility, and persistence elements of divergent thinking before and after 15 min of dance vis-à-vis a regular class activity using Guilford Alternative Uses Task and Latent Semantics Analysis. The results show that compared to a regular class activity, physical activity improves originality and flexibility components of divergent thinking but does not lead to deterioration of persistence as much as a regular class activity. Further, the flexibility and persistence pathways do not mediate the relationship between physical activity and originality. The results have implications for the ego-depletion theory and dual pathway to creativity model, which are discussed in the study.

Physical Activity and Academic Performance in School-Age Children: A Systematic Review

This brief review aims to empirically summarize the expansive and ever-growing literature about the impact of physical activity interventions on cognitive function and academic performance. To better understand these relationships, this overview included research from different physical activity settings, such as school-based physical education, classroom-based physical activity and extracurricular physical activity. Given the findings adduced from the literature on this field, it could be argued that physical activity produces important changes in the brain, which mediate enhancements in cognitive performance as well as academic achievement. Therefore, the aim of this work is to analyze how physical activity may provide different pathways to improve cognitive health and academic performance among school-age children.

Physical Activity and Public Health among People with Disabilities: Research Gaps and Recommendations.

Physical activity has become an integral component of public health systems modeling the public health core functions of assessment, policy development, and assurance. However, people with disabilities have often not been included in public health efforts to assess, develop policies, or evaluate the impact of physical activity interventions to promote health and prevent disease among people with disabilities. Addressing the core function of assessment, current physical activity epidemiology, and surveillance among people with disabilities across the globe highlights the paucity of surveillance systems that include physical activity estimates among people with disabilities. The status of valid and reliable physical activity measures among people with condition-specific disabilities is explored, including self-report measures along with wearable devices, and deficiencies in measurement of physical activity. The core functions of policy development and assurance are described in the context of community-based intervention strategies to promote physical activity among people with disabilities. The identification of research gaps in health behavior change, policy, and environmental approaches to promoting physical activity among people with disabilities is explored, along with recommendations based on the principles of inclusive and engaged research partnerships between investigators and the members of the disability community.

Rates and patterns of physical activity among Hispanics with multiple sclerosis in the NARCOMS Registry

BackgroundMultiple sclerosis (MS) is the most common cause of non-traumatic neurological disability among adults with an estimated incidence of 2.9 cases per 100,000 Hispanic adults. Hispanics with MS experience disproportionate rates of mobility disability compared to non-Hispanic Whites with MS. The current study aimed to examine the rates and patterns of physical activity (PA) behavior among Hispanics with MS and compare physical activity behavior to non-Hispanic Whites with MS in the North American Research Committee on Multiple Sclerosis Registry (NARCOMS). MethodsNARCOMS registry participants who completed the physical activity questions in the Spring 2015 semi-annual survey were included in the analyses. Self-identified Hispanic and non-Hispanic Whites were compared. Rates and patterns of physical activity were based on the International Physical Activity Questionnaire. We performed a 2:1 propensity score matching for comparing non-Hispanic White and Hispanic participants. ResultsOf the 6,352 NARCOMS participants in Spring 2015, we included 136 Hispanic and 6,216 non-Hispanic White participants. Among the Hispanic sample, median number of days engaged in vigorous PA was 0 and moderate PA was 1 day. Mean number of minutes sitting per day was 531±266 (approximately 9 hours). Further, a minority of Hispanic participants classified themselves as moderate or heavy active for work (11%), home (24%), and leisure (33%) physical activity. There were no significant differences between participants who identified as Hispanic (n=119) and propensity-matched non-Hispanics White participants (n=238) in demographics, clinical characteristics, or physical activity variables. ConclusionRates of physical activity were low among Hispanics with MS. This highlights an opportunity for examining the impact of physical activity interventions for improving mobility disability.

Investigating the impact of physical activity interventions on delirium outcomes in intensive care unit patients: A systematic review and meta-analysis.

To investigate the impact of physical activity interventions, including early mobilisation, on delirium outcomes in critically ill patients. Electronic database literature searches were conducted, and studies were selected based on pre-specified eligibility criteria. Cochrane Risk of Bias-2 and Risk Of Bias In Non-randomised Studies-of Interventions quality assessment tools were utilised. Grading of Recommendations, Assessment, Development and Evaluations was used to assess levels of evidence for delirium outcomes. The study was prospectively registered on PROSPERO (CRD42020210872). Twelve studies were included; ten randomised controlled trials one observational case-matched study and one before-after quality improvement study. Only five of the included randomised controlled trial studies were judged to be at low risk of bias, with all others, including both non-randomised controlled trials deemed to be at high or moderate risk. The pooled relative risk for incidence was 0.85 (0.62-1.17) which was not statistically significant in favour of physical activity interventions. Narrative synthesis for effect on duration of delirium found favour towards physical activity interventions reducing delirium duration with median differences ranging from 0 to 2days in three comparative studies. Studies comparing varying intervention intensities showed positive outcomes in favour of greater intensity. Overall levels of evidence were low quality. Currently there is insufficient evidence to recommend physical activity as a stand-alone intervention to reduce delirium in Intensive Care Units. Physical activity intervention intensity may impact on delirium outcomes, but a lack of high-quality studies limits the current evidence base.

Forming Habits, Overcoming Obstacles, and Setting Realistic Goals: A Qualitative Study of Physical Activity Maintenance Among Latinas.

The impact of physical activity interventions for Latina women can be enhanced by identifying and implementing strategies to achieve long-term physical activity maintenance. Physical activity promotion research has mainly focused on physical activity initiation and we know little regarding individual, interpersonal, or environmental factors that influence maintenance of physical activity. This study aimed to qualitatively explore and understand factors associated with maintenance and non-maintenance of physical activity among Latinas. Semi-structured individual interviews were conducted with 21 Latinas who increased their physical activity as a result of an intervention, and who completed a 3-month maintenance period without contact from research staff. Data were analyzed using thematic analysis. Important facilitators of physical activity maintenance described by participants included having made physical activity a habit; the ability to proactively overcome obstacles to engaging in physical activity, and satisfaction with outcomes obtained from engaging in physical activity. Additional facilitators mentioned by both maintainers and non-maintainers included having motivation, social support, and opportunities to be active. Both maintainers and non-maintainers reported high self-efficacy for PA maintenance in the future. Guiding intervention participants to form habits and to set realistic expectations could help them to independently continue engaging in physical activity upon completion of physical activity interventions. Teaching them skills to proactively overcome obstacles may also be important for physical activity maintenance.

Review: Physical activity interventions for the mental health and well-being of adolescents - a systematic review.

Rates of physical activity decline throughout adolescence, and evidence indicates that this has an adverse impact on psychological health. This paper aims to synthesise available evidence for physical activity interventions on the mental health and well-being of young people (11-19years) from the general population. Nine databases were searched to identify studies published between January 2005 and June 2020: Web of Science, ProQuest Psychology Journals, PsycINFO, Pub Med, ASSIA, CINHAL PLUS, SPORTDiscus, EMBASE and Wiley Online Library. Key search terms included 'physical activity intervention', 'mental health' and 'adolescen*'. Eligible studies were independently screened by two authors based on inclusion/exclusion criteria. Twenty-eight interventions were narratively synthesised in four categories: Quality of Life (QOL), self-esteem, psychological well-being and psychological ill-being (e.g. depression, stress). A large proportion (67.9%) of interventions were multicomponent and combined physical activity with other features such as health education (e.g. nutrition). However, only a limited number (N=5) specifically addressed mental health. Findings suggest that interventions are useful in improving psychological well-being and QOL, yet evidence for self-esteem is mixed. Although effectiveness in improving well-being is evident, evidence for a reduction in the frequency and severity of mental health problems is less clear. A summary of the overall impact of physical activity interventions on the mental health of young people is presented.

Physical activity interventions for people with congenital heart disease.

Congenital heart disease (ConHD) affectsapproximately 1% of all live births. People with ConHD are living longer due to improved medical intervention and are at risk of developing non-communicable diseases. Cardiorespiratory fitness (CRF) is reduced in people with ConHD, who deterioratefaster compared to healthy people. CRF is known to be prognostic of future mortality and morbidity: itisthereforeimportant to assess the evidence base on physical activity interventions in this population to inform decision making. To assess the effectiveness and safety of all types of physical activity interventions versusstandard carein individuals with congenital heart disease. We undertook asystematicsearch on23September 2019 of the following databases: CENTRAL,MEDLINE, Embase,CINAHL, AMED, BIOSIS Citation Index,Web of Science Core Collection, LILACS andDARE. We also searched ClinicalTrials.gov and wereviewed the reference lists of relevant systematic reviews. We includedrandomised controlled trials(RCT) that compared any type of physical activity intervention against a 'no physical activity' (usual care) control. We included all individualswith a diagnosis ofcongenital heart disease, regardless of age or previous medical interventions. DATA COLLECTION AND ANALYSIS: Two review authors (CAW and CW)independently screened all the identified references for inclusion. We retrieved and read all full papers; and we contacted study authors if we needed any further information. The same two independent reviewers whoextracted the data thenprocessed the included papers, assessed their risk of bias using RoB 2and assessed the certainty of the evidence using the GRADE approach.The primary outcomes were: maximal cardiorespiratory fitness (CRF) assessed bypeak oxygen consumption; health-related quality of life (HRQoL) determined by a validated questionnaire; and device-worn 'objective' measures of physical activity. We included 15RCTswith 924participantsin the review. The median intervention length/follow-up length was 12 weeks (12 to 26 interquartile range (IQR)).There were five RCTs of children and adolescents (n = 500) and 10 adult RCTs (n = 424). We identified three types of intervention: physical activity promotion; exercise training; and inspiratory muscle training. We assessed the risk of bias of results for CRF as either being of some concern (n = 12) or ata high risk of bias (n=2), due to afailure to blindintervention staff. One study did not report this outcome. Using the GRADE method, we assessed the certainty of evidence as moderate to very low across measured outcomes. When we pooled all types of interventions (physical activity promotion, exercise training and inspiratory muscle training), compared to a 'noexercise' controlCRF may slightly increase, with amean difference (MD) of 1.89 mL/kg-1/min-1 (95% CI -0.22 to3.99; n = 732; moderate-certainty evidence).The evidence is very uncertain about the effect of physical activity and exercise interventions on HRQoL. There was a standardised mean difference (SMD) of 0.76(95% CI -0.13 to 1.65;n = 163; very low certainty evidence) in HRQoL. However, we could pool only threestudies in a meta-analysis, due to different ways of reporting. Only one study out of eight showed a positive effect on HRQoL. There may be a small improvement in mean daily physical activity (PA) (SMD 0.38,95% CI -0.15 to0.92; n = 328; low-certainty evidence), which equates toapproximately an additional 10 minutes of physical activity daily (95% CI -2.50 to22.20). Physical activity and exercise interventions likely result in an increase in submaximal cardiorespiratory fitness (MD 2.05,95% CI 0.05 to 4.05; n = 179; moderate-certainty evidence). Physical activity and exercise interventions likely increase muscular strength (MD 17.13, 95% CI 3.45 to 30.81; n = 18; moderate-certainty evidence).Eleven studies (n = 501) reported on the outcome of adverse events (73% of total studies). Of the 11 studies, sixstudies reported zeroadverse events. Fivestudies reported a total of 11 adverse events; 36% of adverse events were cardiac related(n= 4); there were, however, no serious adverse eventsrelated to the interventions or reportedfatalities (moderate-certainty evidence).No studies reported hospital admissions. This review summarises the latest evidence on CRF, HRQoL and PA. Although there were only small improvements in CRF and PA, and small to noimprovements in HRQoL, there were no reported seriousadverse events related to the interventions. Although these data are promising, there is currentlyinsufficient evidence to definitively determine the impact of physical activityinterventions in ConHD. Further high-quality randomised controlled trials are therefore needed, utilisinga longer duration of follow-up.

Equity impacts of interventions to increase physical activity: A health impact assessment

Abstract Background Behavioural interventions may increase social inequalities in health. This study aimed to project the equity impact of physical activity interventions that have differential effectiveness across education groups on the long-term health inequalities among older adults in Germany. Methods We created six hypothetical intervention scenarios targeting adults aged 55 years and above: Scenarios #1 to #4 applied realistic intervention effects that varied by education. Under scenario #5, the lower and medium educated group adapted the physical activity pattern of the higher educated. Under scenario #6, all persons increased their physical activity level to the recommended 300 minutes weekly. The number of incident ischemic heart disease, stroke and diabetes cases as well as deaths from all causes was simulated under each of these six intervention scenarios for males and females over a 10-year projection period using the DYNAMO-HIA tool, and compared against a reference scenario with unchanged physical activity pattern. Results For males, the highest reduction of disease cases and deaths would be achieved under scenario #4 (most effective in higher educated persons), while increasing inequalities between education groups. For females, the highest reduction would be achieved under scenario #3 (most effective in lower educated persons), while decreasing inequalities between education groups. Scenarios #1 to #4 would prevent only a fraction of the disease cases and deaths that would be avoided under scenario #5 or scenario #6. Conclusions This modelling study shows how the overall population health impact varies, depending on how intervention-induced physical activity changes differ across education groups. For decision-makers, both the assessment of health impacts overall as well as within a population is relevant, as interventions with the greatest population health gain might be accompanied by an unintended increase in health inequalities. Key messages Health impact assessments with a focus on equity are essential for decision-makers. In order to correctly project population health effects, and choose between options of intervention types from a public health perspective, data on subgroup-specific intervention effects are needed.

Equity impacts of interventions to increase physical activity among older adults: a quantitative health impact assessment

BackgroundBehavioural interventions may increase social inequalities in health. This study aimed to project the equity impact of physical activity interventions that have differential effectiveness across education groups on the long-term health inequalities by education and gender among older adults in Germany.MethodsWe created six intervention scenarios targeting the elderly population: Scenarios #1–#4 applied realistic intervention effects that varied by education (low, medium high). Under scenario #5, all older adults adapted the physical activity pattern of those with a high education. Under scenario #6, all increased their physical activity level to the recommended 300 min weekly. The number of incident ischemic heart disease, stroke and diabetes cases as well as deaths from all causes under each of these six intervention scenarios was simulated for males and females over a 10-year projection period using the DYNAMO-HIA tool. Results were compared against a reference-scenario with unchanged physical activity.ResultsUnder scenarios #1–#4, approximately 3589–5829 incident disease cases and 6248–10,320 deaths could be avoided among males over a 10-year projection period, as well as 4381–7163 disease cases and 6914–12,605 deaths among females. The highest reduction for males would be achieved under scenario #4, under which the intervention is most effective for those with a high education level. Scenario #4 realizes 2.7 and 2.4% of the prevented disease cases and deaths observed under scenario #6, while increasing inequalities between education groups. In females, the highest reduction would be achieved under scenario #3, under which the intervention is most effective amongst those with low levels of education. This scenario realizes 2.7 and 2.9% of the prevented disease cases and deaths under scenario #6, while decreasing inequalities between education groups. Under scenario #5, approximately 31,687 incident disease cases and 59,068 deaths could be prevented among males over a 10-year projection period, as well as 59,173 incident disease cases and 121,689 deaths among females. This translates to 14.4 and 22.2% of the prevented diseases cases among males and females under scenario #6, and 13.7 and 27.7% of the prevented deaths under scenario #6.ConclusionsThis study shows how the overall population health impact varies depending on how the intervention-induced physical activity change differs across education groups. For decision-makers, both the assessment of health impacts overall as well as within a population is relevant as interventions with the greatest population health gain might be accompanied by an unintended increase in health inequalities.

Evaluating physical activity in dementia: a systematic review of outcomes to inform the development of a core outcome set.

physical activity is recommended for people living with dementia, but evidence for the positive effects of physical activity is limited by the use of heterogeneous outcomes and measurement tools. This systematic literature review aimed to summarise previously reported outcomes and identify the measurement tools used most frequently in physical activity interventions for people with dementia. literature searches were conducted in April 2015, on Delphis and Medline. Qualitative, quantitative and mixed methods studies reporting on any type of physical activity, in any setting, across types of dementia, stages of disease progression and published from 2005 onwards were included. A content analysis approach was used to report on the frequency of reported outcomes and measurement tools. the 130 included studies reported on 133 different outcome domains and 267 different measurement tools. 'Functional abilities and independence' (n = 69), 'Global cognitive function' (n = 65), 'Balance' (n = 43), 'Global behavioural symptoms of dementia' (n = 42) and 'Health-related quality of life' (n = 40) were the most frequently reported outcome domains. 'Enjoyment' was the outcome most frequently sought by patients and carers. the need for the development and implementation of a Core Outcome Set has been reinforced. Ahead of the completion of the Core Outcome Set, researchers and clinicians are advised to measure the impact of physical activity interventions on these frequently reported outcome domains.

Is Team Sport the Key to Getting Everybody Active, Every Day? A Systematic Review of Physical Activity Interventions Aimed at Increasing Girls’ Participation in Team Sport

BackgroundIt is estimated that 21% of boys and 16% of girls in England meet recommended physical activity guidelines. Team sport has the potential to increase physical activity levels; however, studies show that gender-based factors can influence girls' participation in team sport. Furthermore, evidence for the effectiveness of interventions promoting team sport among girls is limited. This systematic review aimed to assess the impact of physical activity interventions on secondary school-aged girls' (aged 11-18 years) participation in team sport and to identify potential strategies for increasing participation.MethodsElectronic databases and grey literature were systematically searched for studies of interventions targeting team sport participation among girls in the UK. Results were exported to Refworks, duplicates removed and eligible studies identified. Extracted data included: participant details, such as sample size and age; components of the intervention; outcomes assessed; and each study was quality appraised. Due to heterogeneity across studies, results were presented narratively.ResultsFour studies sourced from the grey literature met the inclusion criteria. Findings suggest that physical activity interventions can encourage girls to try new sports, but evidence is limited in relation to sustained participation. Potential strategies for promoting participation included: consultation with girls, implementation of appropriate peer-leaders and friendship group strategies, early intervention and consideration of intervention setting.ConclusionsThis review highlights the limited availability of evidence on the effectiveness of physical activity interventions for promoting team sport participation among girls in the UK. Findings indicate that future research is needed to improve the methodological quality of complex intervention evaluation. Physical activity interventions may have the potential to encourage girls to try team sport, but their impact on sustained participation, and subsequent physical activity outcomes, is less apparent.

Health Promotion in Primary Schools- Evaluation of Side-Effects on Cognitive and Academic Performance in a Randomized Trial

Background: School-based lifestyle interventions are a cost-effective way to prevent pediatric overweight. The program “Join the Healthy Boat” focuses on physical activity, healthy diet and screen media use in German primary school children, implemented by regular classroom teachers including teaching units, physical activity exercises, and work with parents. Objective of the study was to measure potential side-effects on children’s cognitive and academic performance. Methods: The program was evaluated in a RCT design, measurements took place before and after one year of intervention. Stratification of randomization was carried out for number of classes and grade level. Participants were 1st and 2nd graders of primary schools. Intervention and assessment took place on site at school; questionnaires were issued. N=442 children performed a computer based test battery measuring inhibitory control, cognitive flexibility and sustained attention. Academic achievement was assessed via parental questionnaire. Results: Multiple regression analyses controlling for age, gender and parental education and Mann-Whitney-Utests revealed no significant differences between intervention and control group in cognitive changes or academic development from baseline to follow up. In Cognitive Flexibility, however, the number of children who improved was higher in the intervention group. Conclusion: Taking time from the regular school curriculum for health promotion had no negative impacts on children’s cognitive or academic development. To obtain more positive effects a longer period of time and a more intense intervention are presumably necessary. The findings are in line with a recent review indicating no negative effects of school health programs. Eventually there is a positive impact of physical activity interventions on specific cognitive functions but findings regarding academic outcomes are still inconclusive. Weak evidence is reported for nutrition services.