Increase Physical Activity Levels Research Articles

Risk ambassadors and saviours: Children and futuring public health interventions.

Schools are increasingly positioned as sites for intervening on the bodies and minds of children in the here and now in order to bring about health gain for the future. Public health interventions for schools bring together coalitions of commercial, statutory and philanthropic actors with children and their teachers and carers. Drawing on ethnographic case studies in London, UK, this paper explores two such interventions: one aiming to increase levels of physical activity and one to reduce exposure to air pollution. Both interventions not only evoke care for children's own current and future wellbeing but also fold in imaginaries of collective health futures, which orient and legitimise particular intervention logics and actions. As interventions unfold, children are recruited as monitors of health risks in the present. They are also positioned as risk ambassadors, who will leverage care about unhealthy environments and lifestyles across space, to risky domestic environments, and into imagined health futures. These 'futuring' school-based interventions open up small alternative spaces in which imaginaries of collective and resistant public health practices emerge. However, in the here and now, children appear to be bearing a disproportionate burden of responsibility, as ambassadors for, and imagined saviours of, public and environmental health.

Sustainable effects of a motor skill programme on physical activity levels in 7–8 years old children, in the Eastern Cape Province of South Africa

BackgroundDeteriorating global physical activity (PA) levels among children warrants new and sustainable approaches to increase PA levels. This study aimed to determine the immediate and sustainable influences of a 9-week movement program on the PA levels in 7 to 8-year-old school children in the Raymond Mhlaba Municipality in the Eastern Cape Province of South Africa.MethodsA randomized control trial including two groups (control group (CG) and intervention group (IG)), pre–post–retest (after six months of no intervention) design was used. Seventy school children, mean age 7.12 years (± 0.71) (n = 35 IG; n = 35 CG) participated in the study. A 9-week movement program was followed twice a week for 30 min during school hours. PA was measured for 7 consecutive days using a hip-mounted wGT3X-BT Actigraph accelerometer. The Test of Gross Motor Development-Third Edition (TGMD-3) was used to assess motor skills. Hierarchical Linear Modelling (HLM) was applied to analyze the data with time, sex, and group as predictors. Effect sizes were computed using Cohen’s d-cut points to assess the practical significance of changes over time. Estimated regression coefficients were also computed to determine the strength of the relationship between moderate-to-vigorous physical activity (MVPA) and fundamental movement skills (FMS).ResultsBefore the intervention, 60% of the IG met the 60 min of daily MVPA guideline, while light physical activity (LPA) per day was also higher than sedentary behavior (SB) in both groups. No immediate (p < 0.01) or sustainable (p < 0.01) increases in MVPA levels were found and no positive associations emerged between FMS and MVPA levels.ConclusionsThis intervention had little to no effect on children’s MVPA. More understanding of the activity behavior and interests of children is needed to improve their PA behavior through the content of movement programs. Strategies are also needed to communicate clear messages at a personalized but also parental level, focusing on enhancing health through regular PA, especially to promote PA in young children.

Adherence to physical activity recommendations and associations with self-efficacy among Norwegian adolescents: trends from 2017 to 2021

BackgroundThe crucial role of physical activity (PA) in promoting well-being and overall health of adolescents is widely acknowledged. Previous global studies have consistently revealed low adherence to PA recommendations among adolescents, emphasizing potential links between PA engagement and self-efficacy in school-based populations. However, there is a need for further exploration of this relationship, in particularly gender differences and taking into account the potential influences of the COVID-19 pandemic. The objective of this study is to provide a comprehensive description of adherence to PA recommendations and its associations with self-efficacy in Norwegian school-based adolescents over the period from 2017 to 2021.MethodsCross-sectional data on physical activity (PA) levels and self-efficacy among 13–19-year-old Norwegian adolescents were collected from the Norwegian Ungdata Survey during the period 2017 to 2021. The survey, conducted in Norwegian lower- and upper-secondary schools, was administered electronically during school hours. All data collected is anonymous and has received approval from the Norwegian Agency for Shared Services in Education and Research (SIKT). Statistical analyses were performed using SPSS software.ResultsGirls consistently exhibited lower adherence to PA recommendations (17.6–19.8%) compared to boys (27.7–31.1%) each year from 2017 to 2021 (all p &amp;lt; 0.01). Similarly, girls reported lower self-efficacy (14.1 to 14.8 out of 20) than boys (15.5 to 15.9) during the same period (all p &amp;lt; 0.01). Regression analyses highlighted robust positive associations between PA and self-efficacy in those adhering to PA recommendations (i.e., physically active at least 5 times a week) and strong inverse associations for those reporting inactivity (never active) in both girls and boys from 2017 to 2021.ConclusionAdolescents in Norway report PA adherence ranging from 15 to 30%, with girls consistently exhibiting lower adherence to PA recommendations and reporting lower self-efficacy than boys. Notably, there are substantial associations between self-efficacy and both adherence to PA recommendations and inactivity over time. These findings underscore the significance of promoting adherence to PA recommendations during adolescence, especially among girls. Policymakers in Norway should focus on initiatives to increase PA levels among adolescents in both lower and upper secondary schools.

Healthy Lifestyle Related to Executive Functions in Chilean University Students: A Pilot Study.

A negative lifestyle is reported to be related to cognitive problems. However, there is little information about this in relation to university students. The objective of the present study was to investigate the association between executive functions (EFs) and lifestyle parameters (i.e., physical activity (PA), sleep duration, screen time (ST), and food habits) among Chilean university students. This cross-sectional study included a total of 150 university students (94 females and 56 males, aged 21.28 ± 3.15 and 22.18 ± 2.90 years, respectively). Cognitive outcomes were measured using the CogniFit assessment battery. Lifestyle was measured through validated questionnaires. Across the total sample, attention exhibited a positive association with PA h/week (β: 24.34 95% CI: 12.46 to 36.22, p = 0.001). Additionally, coordination was positively associated with PA h/week (β: 15.06 95% CI: 0.62 to 29.50, p < 0.041). PA h/week was positively linked with reasoning (β: 20.34 95% CI: 4.52 to 36.17, p = 0.012) and perception (β: 13.81 95% CI: 4.14 to 23.49, p = 0.005). Moreover, PA h/week was significantly linked to memory (β: 23.01 95% CI: 7.62 to 38.40, p = 0.004). In terms of the EFs, PA h/week showed a positive association with cognitive flexibility (β: 45.60 95% CI: 23.22 to 67.69, p = 0.001). In conclusion, lifestyle (PA h/week) was positively associated with EFs. Therefore, an increase in PA levels among these students should be a target for community- and university-based interventions in order to promote cognitive development such as attention, coordination, reasoning, perception, memory, and cognitive flexibility.

Titration of sedentary behavior with varying physical activity levels reduces mortality in patients with type 2 diabetes.

Both physical activity (PA) and sedentary behavior (SB) exert important impact on type 2 diabetes, but it remains unclear how maximum impact on improving the mortality and optimized proportion of the two lifestyles combination exists. To explore the impacts of PA/SB combinations on mortality in patients with diabetes. Patients with type 2 diabetes patients samplings were collected from the National Health and Nutrition Examination Survey (NHANES) dataset. Their lifestyles were categorized into eight groups based on combinations of the PA and SB levels. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals. During the follow-up period, 1,148 deaths (18.94%) were recorded. High SB (sedentary time ≥6 hours/day) was significantly associated with higher all-cause mortality (HR 1.65). In participants with low SB (<6 hours/day), low PA was associated with lower all-cause mortality (HR 0.43), while further increase of PA level did not show further reduction in either all-cause or cardiovascular mortality. In contrast, in participants with high SB，all levels of PA were associated with lower all-cause mortality (p<0.05), but only moderate PA was associated with lower cardiovascular mortality (HR 0.30). In patients with type 2 diabetes, different combinations of various levels of PA and SB are associated with different degree of risk for all-cause or cardiovascular mortality.

Abstract PO2-11-07: Early Integration of Exercise into Breast Cancer Care: The MSK Healthy Living Program

Abstract Background: In patients with early-stage breast cancer, quality of life (QoL) worsens within 3-6 months following diagnosis. Physical activity (PA) can mitigate the adverse effects of treatment and improve QoL, and low PA level is associated with cancer recurrence and mortality. However, PA interventions are not included in standard cancer care. Early intervention to increase PA levels may improve QoL during active cancer therapy. The Healthy Living Program (HLP) at Memorial Sloan Kettering Cancer Center (MSK) is a lifestyle and survivorship program that engages early-stage breast cancer patients at the time of diagnosis using lifestyle risk stratification and matched referrals. We investigated whether early exercise intervention through the MSK HLP impacts QoL within the first months after cancer diagnosis. Methods: At the time of diagnosis, patients complete a lifestyle questionnaire (LQ), which is a composite of validated instruments, including the Godin Leisure Time Exercise Questionnaire (GLTEQ). Patients not meeting PA guidelines per the GLTEQ are offered a referral to an exercise physiologist (EP). The EP creates an individualized, home-based exercise program using the FITT Principle (Frequency, Intensity, Time, and Type). Patients meet with the EP every 4 weeks for 16 weeks; if exercise recommendations continue to be unmet, the program is extended. The Functional Assessment of Cancer Therapy-Breast (FACT-B) and 36-Item Short Form Survey Instrument (SF-36) were completed at baseline and the 16-week follow-up. Results: 252 patients enrolled between April 2020 – February 2023, of whom 92 volunteered to complete the QoL assessments. Median age was 53 years [range 23-84]; 12/252 (13.0%) of patients had ductal carcinoma in situ, 60/252 (65.2%) had Stage 1 disease, 17/252 (18.5%) had Stage 2 disease, and 3/252 (3.1%) had Stage 3 disease. 29/252 (31.5%) received chemotherapy, 62/252 (67.4%) received radiation, and 79/252 (85.9%) received hormone therapy. The mean baseline FACT scores were FACT-B: 116, FACT-G: 87, and FACT-B Trial Outcome Index (TOI): 73. At the 16-week follow-up, all QOL scores remained stable from baseline (means FACT-B: 118, FACT-G: 89, and TOI: 75). Improvements were observed among the subscales of the SF-36 from baseline to follow-up. The largest improvements were observed in physical and emotional role function scores, with 22% and 13% improvements from baseline to follow-up, respectively. Conclusions: A clinically implemented exercise intervention embedded in standard of care prevented decreases in QoL and improved physical and emotional functioning during the initial course of adjuvant breast cancer therapy. These findings support early implementation of lifestyle modification after a breast cancer diagnosis. Citation Format: Kylie Rowed, Sherry Shen, Andrea Smith, Bridget Kelly, Rocco Magnoli, Stacie Corcoran, Melissa Emerzian, Cynthia Cruz, Erica Salehi, Cara Anselmo, Mark Robson, Neil Iyengar. Early Integration of Exercise into Breast Cancer Care: The MSK Healthy Living Program [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-11-07.

P114 Promoting physical activity using mobile health technology in people living with Rheumatoid Arthritis: MOTIVATE RA

Abstract Background/Aims People living with rheumatoid arthritis (RA) tend to be less active than the general population which may be due to RA associated musculoskeletal pain, stiffness and fatigue. The health benefits of physical activity (PA) are widely recognised in the general population and studies in RA have also highlighted improvement in RA associated symptoms. However, encouraging increased PA in people living with RA is challenging and adherence to PA is usually low. Mobile health (mHealth) technology (i.e., fitness watches and apps) may provide an effective and economical solution to promoting PA in this high-risk population. The aims of the current study were to assess whether use of mHealth technology in RA i) increases PA levels and ii) reduces RA disease activity. Methods People with RA were randomised to either the MOTIVATE (mHealth intervention) or conventional care (CC) groups. The CC group were provided with online educational materials, as provided in routine care (e.g., PA information leaflets), to increase PA whereas the MOTIVATE group were provided with a personalised, progressive walking programme delivered via mHealth technology with ongoing, individualised support throughout the 12-week intervention. All participants received a self-testing kit, via mail, at baseline (week 0) and post-intervention (12 weeks). Measures included anthropometrics, blood pressure, PA monitoring, health questionnaires and all were requested to self-report RA disease activity using RADAI-5. Change data between weeks 0 and 12 were compared between groups using One-Way ANCOVA, controlling for baseline, and reported as mean difference (95% CI). Results Of 50 participants, 25 were randomised to the MOTIVATE group (age 50±11years; BMI 29±7kg/m2; females n=23), and 25 to CC (n=25, age 50±11years; BMI 26±6 kg/m2; females n=24). An increase in moderate-to-vigorous PA was observed in the MOTIVATE group, compared to a decrease in CC [81min (1, 160) vs. -35min (-123, 53); P=0.09)]. This was accompanied by an increase in steps per day in the MOTIVATE group, and a decrease in CC [763 (-432, 1957) vs. -76 (-1267, 1115); P=0.40]. A reduction in PHQ-9 depression score was evident in the MOTIVATE group whilst CC were unchanged [-2 (-2, -3) vs. 0 (-2, 0); P=0.07]. RADAI-5 decreased in the MOTIVATE group and stayed the same in CC [-2 (-2, 0) vs. 0(-2, 0), P=0.27]. Conclusion These findings identify the potential effectiveness of an mHealth PA programme to increase PA levels in people living with RA. Use of remote PA monitoring, with support from exercise specialists, may be an effective strategy to improve engagement in exercise and PA in the RA population. Data is suggestive this could improve RA related symptoms, although we did not observe statistical significance. Disclosure D.J. Bannell: Grants/research support; Research grant from the Aintree Arthritis Trust. M. France-Ratcliffe: None. K.L. Hesketh: None. M. Cocks: None. N. Goodson: None. C. Taylor: None. T. Pecanha: None. H. Jones: None. D.A. Low: None. V.S. Sprung: None.

Health and economic burden of insufficient physical activity in Saudi Arabia.

Insufficient physical activity (PA) was estimated to cause 4.8% of deaths and 2.6% of disability-adjusted life-years (DALYs) due to noncommunicable diseases in Saudi Arabia in 2019. While Saudi Arabia is already achieving great improvements, we predict the health and economic burden of insufficient PA up to 2040 to present a case for policy makers to invest more in the uptake of PA. Using a population health model to estimate avoidable health loss, we identified four causes of health loss related to low PA (cardiovascular diseases, diabetes, breast cancer, and colorectal cancer) and estimated the deaths and DALYs from these causes. We projected the expected disease burden until 2040 under alternative assumptions about future PA levels and trends by using three health scenarios: baseline (no change in 2019 PA levels), intervention (81% of the population achieving sufficient PA levels), and ideal (65% of population: moderate PA, 30%: high PA, and 5%: inactive). We applied an "intrinsic value" approach to estimate the economic impact of each scenario. Overall, we estimate that between 2023 and 2040, about 80,000 to 110,000 deaths from all causes and 2.0 million to 2.9 million DALYs could be avoided by increasing PA levels in Saudi Arabia. The average annual economic loss from insufficient PA is valued at 0.49% to 0.68% of the current gross domestic product, with an average of US$5.4 billion to US$7.6 billion annually till 2040. The most avoidable disease burden and economic losses are expected among males and because of ischemic heart disease. This study highlights that low PA levels will have considerable health and economic impacts in Saudi Arabia if people remain inactive and do not start following interventions. There is an urgent need to develop innovative programs and policies to encourage PA among all age and sex groups.

Are physical activity levels, cardiorespiratory fitness and peak power associated with Parkinson's disease severity?

IntroductionIncreased physical activity (PA) may slow Parkinson's disease (PD) progression. Associations between markers of PA and PD severity could justify further studies evaluating interventions increasing PA levels in PD. The objectives of the present study were to assess associations between PA, cardiorespiratory fitness (VO2-max), and muscle peak power and measures of the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), the Parkinson's disease questionnaire-39 (PDQ-39), and the four PD hallmark motor symptoms (rigidity, bradykinesia, postural instability, and tremor). MethodsData from 105 people with PD were used. PA was measured for seven consecutive days using accelerometers. Peak power was measured with a linear encoder during a chair rise test, while VO2-max was directly assessed during a graded bicycle test. Analyses included simple and multiple linear regression and hurdle exponential regression. ResultsPA was weakly to moderately associated with MDS-UPDRS II + III, rigidity, bradykinesia, and postural instability, as well as PDQ-39 mobility and activities of daily living sub-scores. VO2-max and peak power were weakly to moderately associated with MDS-UPDRS III, bradykinesia, and postural instability, while peak power was further weakly associated with the MDS-UPDRS II. Lastly, VO2-max was associated with PDQ-39 mobility and activities of daily living sub-scores. ConclusionPA, VO2-max, and peak power were associated with PD severity, thus highlighting the potential benefits of a physically active lifestyle. Furthermore, PA and VO2-max were associated with PDQ-39 sub-scores. This calls for confirmation of the potential effect of PA on quality of life in PD.

88 Feasibility of a Home-based Physiotherapy Program to Increase Physical Activity Levels in Older Adults with Diabetes Mellitus

OBJECTIVES/GOALS: The objective of this study is to assess the feasibility and preliminary impact of a physiotherapy protocol for developing an individualized home-based physical activity program to increase physical activity (PA) levels in sedentary older adults with Type II Diabetes Mellitus (T2DM) living in Puerto Rico (PR). METHODS/STUDY POPULATION: This will be a pilot study with two phases. In phase 1, we will design a novel patient-centered home-based PA program protocol for adults ≥65 years with T2DM based on the Information-Motivation-Behavioral Skills model. Its content validity will be assessed through focus groups with 10 experts and 10 older adults and analyzed using a directed content analysis. Phase 2 we will be program implementation using a one-group, repeated measures design with 12 adults ≥65 years with T2DM. PA levels will be assessed by recording active minutes with a Fitbit. Risk of falls, balance, strength, and physical function will be assessed through standardized tests validated for this population. Statistical analysis will include descriptive statistics, comparisons via chi-square/Fisher’s exact test, and non-parametric tests. RESULTS/ANTICIPATED RESULTS: We expect to recruit a minimum of 12 participants and to administer the program for 12 weeks at a frequency of two visits per week. We anticipate that implementing and supervising the home-based PA protocol will be feasible as determined by recruitment and retention rates, patients’ satisfaction, and compliance with the program. We also expect that this protocol will increase physical activity levels, improve general strength, balance, physical function, and reduce the risk of falls in sedentary older adults with T2DM. DISCUSSION/SIGNIFICANCE: As the third cause of death in PR, T2DM represents a public health challenge. An effective home-based PA program may decrease morbidity and mortality rates in older adults by increasing PA and functional health. This study will provide data for planning a randomized controlled trial to assess its effectiveness in the outcomes of interest.

Exploring the Feasibility of Using ChatGPT to Create Just-in-Time Adaptive Physical Activity mHealth Intervention Content: Case Study.

Achieving physical activity (PA) guidelines' recommendation of 150 minutes of moderate-to-vigorous PA per week has been shown to reduce the risk of many chronic conditions. Despite the overwhelming evidence in this field, PA levels remain low globally. By creating engaging mobile health (mHealth) interventions through strategies such as just-in-time adaptive interventions (JITAIs) that are tailored to an individual's dynamic state, there is potential to increase PA levels. However, generating personalized content can take a long time due to various versions of content required for the personalization algorithms. ChatGPT presents an incredible opportunity to rapidly produce tailored content; however, there is a lack of studies exploring its feasibility. This study aimed to (1) explore the feasibility of using ChatGPT to create content for a PA JITAI mobile app and (2) describe lessons learned and future recommendations for using ChatGPT in the development of mHealth JITAI content. During phase 1, we used Pathverse, a no-code app builder, and ChatGPT to develop a JITAI app to help parents support their child's PA levels. The intervention was developed based on the Multi-Process Action Control (M-PAC) framework, and the necessary behavior change techniques targeting the M-PAC constructs were implemented in the app design to help parents support their child's PA. The acceptability of using ChatGPT for this purpose was discussed to determine its feasibility. In phase 2, we summarized the lessons we learned during the JITAI content development process using ChatGPT and generated recommendations to inform future similar use cases. In phase 1, by using specific prompts, we efficiently generated content for 13 lessons relating to increasing parental support for their child's PA following the M-PAC framework. It was determined that using ChatGPT for this case study to develop PA content for a JITAI was acceptable. In phase 2, we summarized our recommendations into the following six steps when using ChatGPT to create content for mHealth behavior interventions: (1) determine target behavior, (2) ground the intervention in behavior change theory, (3) design the intervention structure, (4) input intervention structure and behavior change constructs into ChatGPT, (5) revise the ChatGPT response, and (6) customize the response to be used in the intervention. ChatGPT offers a remarkable opportunity for rapid content creation in the context of an mHealth JITAI. Although our case study demonstrated that ChatGPT was acceptable, it is essential to approach its use, along with other language models, with caution. Before delivering content to population groups, expert review is crucial to ensure accuracy and relevancy. Future research and application of these guidelines are imperative as we deepen our understanding of ChatGPT and its interactions with human input.

Social Support and Physical Activity in College and University Students: A Meta-Analysis.

Although physical activity (PA) has a profound impact on health, many college and university students are still physically inactive. There is some evidence to suggest that social support (SS) could impact the PA levels of students, but the internal relationship and specific effects are not very clear. The purpose of this review was to determine the strength of the relationship between SS and PA and examine whether any potential associations differed in terms of age, gender, and region among college and university students. Studies were identified using the following electronic databases: PubMed, SPORTDiscus, Web of Science, and Sociological Abstracts. Moderator analyses investigating the effects of students' age, gender, and region (nation) were performed. This review included 19 articles. The results showed total SS was significantly associated with PA (r = 0.30, 95% confidence interval [CI]: [0.22, 0.37], p < .001). With respect to different types of support, friend support was more strongly associated with PA than family support. Gender factors had a significant moderating effect on the correlation between SS and PA (QM = 17.433, p < .001). Separate analyses examining the moderating effects of gender (percentage of females) found that the association between SS and PA was stronger with the increase in female percentage. In conclusion, SS is an important factor associated with PA levels and should foster SS within intervention programs according to types of SS and gender differences to increase PA levels among college and university students.

Use of transtheoretical model to facilitate physical activity and promote cardiovascular health knowledge in an urban community setting

Background: There is increasing evidence that physical activity promotes cardiovascular health (CVH) and reduce the chances of cardiovascular disease (CVD). The aim of this study was to determine the impacts of a complex physical activity intervention designed collaboratively with the community and tailored to the needs of individual on physical activity knowledge and behaviour with the intention to improve CVH within an urban population context. Method: A physical activity programme involving 50 participants was developed and implemented collaboratively with the community, in a participatory approach at least twice a week, and monitored at two-week intervals throughout the project. Focus group interview was used to explore the barriers and ways of overcoming barriers to physical activity among the participants. One-to-one interviews were used to explore challenges that each participant encountered in trying to improve physical activity and to tailor specific advice depending on a participant’s peculiar circumstances. Questionnaire was used to monitor participants’ reported physical activity as well as evaluate changes in knowledge about how physical activity affects CVH. Results: At baseline, most participants reported that they were unaware of the importance of physical activity to cardiovascular health. At week 4, there was a shift, with more participants reporting awareness, contemplation, and intention to increase levels of physical activity, compared to baseline. At week 8, there was another shift, with more participants reporting attempting to exercise 30 minutes a day, five days a week, although not always meeting up to the challenge. At week 10 there was a shift to more participants in the adoption phase (compared to week 6) and many reporting that the behaviour had become sustainable (compared to week 4). By week 12 there was a significant shift towards more participants encouraging others to become more physically active, that continued to increase at week 14. Conclusion: Programmes such as this can have a significant impact on awareness within a few weeks, and many participants reported that they are maintaining a change in behaviour, that might impact on future health, after three months.

Exploring Infant Physical Activity Using a Population-Based Network Analysis Approach

Background: Physical activity (PA) is an important aspect of infant development and has been shown to have long-term effects on health and well-being. Accurate analysis of infant PA is crucial for understanding their physical development, monitoring health and wellness, as well as identifying areas for improvement. However, individual analysis of infant PA can be challenging and often leads to biased results due to an infant’s inability to self-report and constantly changing posture and movement. This manuscript explores a population-based network analysis approach to study infants’ PA. The network analysis approach allows us to draw conclusions that are generalizable to the entire population and to identify trends and patterns in PA levels. Methods: This study aims to analyze the PA of infants aged 6–15 months using accelerometer data. A total of 20 infants from different types of childcare settings were recruited, including home-based and center-based care. Each infant wore an accelerometer for four days (2 weekdays, 2 weekend days). Data were analyzed using a network analysis approach, exploring the relationship between PA and various demographic and social factors. Results: The results showed that infants in center-based care have significantly higher levels of PA than those in home-based care. Moreover, the ankle acceleration was much higher than the waist acceleration, and activity patterns differed on weekdays and weekends. Conclusions: This study highlights the need for further research to explore the factors contributing to disparities in PA levels among infants in different childcare settings. Additionally, there is a need to develop effective strategies to promote PA among infants, considering the findings from the network analysis approach. Such efforts can contribute to enhancing infant health and well-being through targeted interventions aimed at increasing PA levels.

Development of a behavior change intervention to improve physical activity in patients with COPD using the behavior change wheel: a non-randomized trial

The aim of this study was to evaluate whether a theory-based behavior change intervention could promote changes in physical activity (PA) and sedentary behavior (SB) among patients with chronic obstructive pulmonary disease (COPD), as well as its effects on symptoms of dyspnea, lung function, exercise capacity, self-efficacy, and health-related quality of life (HRQoL). A quasi-experimental design and convenience sampling were adopted. A total of 92 patients with stable COPD were recruited from outpatient and inpatient centers of two hospitals in Zhejiang Province, China. Both the experimental and control groups received standard medical care provided in the hospital. The experimental group performed a PA program based on the behavior change wheel theory. Outcomes were measured at baseline (T0) and after 4 weeks (T1), 8 weeks (T2), and 12 weeks of the intervention (T3). The primary outcome was PA measured by the International Physical Activity Questionnaire (IPAQ). Secondary outcomes included SB measured by the IPAQ, dyspnea measured by the modified Medical Research Council (mMRC) questionnaire, exercise capacity assessed by 6-min walk distance (6MWD), self-efficacy measured by the Exercise Self-Regulatory Efficacy Scale (EX-SRES), and HRQoL measured by the COPD Assessment Test (CAT). In addition, we measured lung function using a spirometer at baseline and 12 weeks. Of the 89 patients included in this study, 64 were male (71.91%), with a mean age of 67.03 ± 6.15 years. At 12 weeks, the improvements in PA, SB, mMRC, 6MWD, EX-SRES and CAT were all statistically significant (P < 0.05) in the experimental group compared to the control group. Repeated measures analysis of variance showed that there were group effects and time effects on total PA, SB, mMRC, 6MWD, EX-SRES, and CAT in both groups (P < 0.001). However, there was no significant difference in pulmonary function between the two groups before and after intervention (P < 0.05). The PA program based on theory significantly increased PA levels, reduced sedentary time, enhanced exercise capacity and self-efficacy as well as HRQoL in patients with stable COPD. Due to the limited intervention time in this study, the pulmonary function of COPD patients may not be reversed in a short time, and the long-term effect of this program on the pulmonary function of patients needs to be further explored.Trial registration: Clinical Trials.gov (ChiCTR2200060590). Registered 05/06/2022.

The effect of physical activity on cardiometabolic parameters in women with a history of hypertension during pregnancy

Background. The effect of physical activity (PA) on the state of the cardiovascular system and quality of life in patients with hypertension (HTN) remains insufficiently studied, while there is no data on the effect of PA and rehabilitation programs on cardiometabolic parameters, according to duration and recurrence of their effect in women with a history of HTN during pregnancy. Objective. To compare cardiometabolic parameters in women with a history of HTN during pregnancy versus women without HTN during pregnancy and measure the effects of an exercise program on their dynamics changes. Design and methods. The study included 66 women divided into two groups: group 1 — 33 women with a history of HTN during pregnancy. The distribution of different HTN disorders of pregnancy was the following: 75% — gestational HTN; 12,5% — chronic HTN; 12,5% — preeclampsia. Group 2 — 33 women with a history of normotension during pregnancy. Walking for at least 150 min per week (30 min a day, 5 times a week) for 9 months was a mandatory component of the physical training program in group 2. Women in group 2 continued clinical follow-up without physical training program. All participants filled in a specially designed questionnaire. Anthropometric, clinical, and biochemical parameters were evaluated, including PA level, quality of life (short questionnaire SF‑36), and serum leptin and adiponectin concentrations. Results. A PA training program for 9 months in women with a history of HTN during pregnancy led to a decrease in waist circumference and body mass index, a decrease in serum leptin levels and an increase in serum adiponectin levels, an increase in PA levels and an improvement in quality of life for account of the general physical and spiritual components.

Analysis of the status and factors influencing physical activity in patients undergoing ovarian cancer chemotherapy.

Ovarian cancer is a common gynecological malignancy, leading to approximately 200,000 deaths globally in 2020. Research has shown that regular physical activity can reduce the toxic side effects of cancer treatment, reduce morbidity and mortality, extend survival time, and improve quality of life. We aimed to evaluate physical activity regimens in patients undergoing chemotherapy for ovarian cancer and analyze the factors influencing physical activity levels. To facilitate the selection of patients with ovarian cancer hospitalized for chemotherapy in the Third Affiliated Hospital of Zhengzhou University and the First Affiliated Hospital of Zhengzhou University from August 2022 to February 2023, questionnaire surveys were conducted using the General Information Questionnaire, International Physical Activity Questionnaire, Hospital Anxiety and Depression Scale, and Revised Piper Fatigue Scale. Data were collected from 167 patients with ovarian cancer. Overall, 96 (57.5%) patients had low physical activity levels, 53 (31.7%) had moderate physical activity levels, and 18 (10.8%) had high physical activity levels. Logistic regression analysis revealed that sleep status, social support, anxiety, depression, and cancer-related fatigue were the main factors influencing physical activity in patients undergoing chemotherapy for ovarian cancer. Physical activity levels of patients undergoing ovarian cancer chemotherapy were generally low. Therefore, healthcare professionals should pay greater attention to the physical activity in these patients. Targeted and individualized health guidance is recommended, and activity interventions should be implemented according to the influencing factors to promote disease understanding and increase physical activity levels.

Age in Place, Move in VR: Investigating the Feasibility and Usability of a Custom‐made Virtual Reality Exergame to Promote the Well‐being of Community‐Dwelling Older Adults

AbstractBackgroundInteractive virtual reality (VR) games combined with exercise (exergames) are a plausible strategy to encourage physical activity (PA) among older adults. However, there is little systematic evaluation of the feasibility, usability, and potential benefits of deploying at‐home VR exergames among this population.MethodFifteen community‐dwelling older adults (M = 67.33 ± 5.3, age range 60‐77) (Table1) were recruited to play 18 sessions (each 15‐20 min) of a custom‐made VR exergame at home over six weeks. Recruitment, retention, and adherence rates were calculated to determine feasibility. The usability of the exergame was assessed through i) a game user experience questionnaire, ii) a self‐reported physical/emotional discomfort questionnaire, and iii) a perceived enjoyment scale. The exploratory outcome measures included changes in i) PA, ii) exercise self‐efficacy, iii) affect, iv) various cognitive and perceptual tasks and were assessed i) before and after acute data, and ii) before and after the intervention.ResultThirteen participants completed the study (13% attrition rate) without missing any exergaming session (100% adherence rate). The completion rate of cognitive assessments, perceptual tasks, and self‐reported questionnaires was = 97%. Low levels of cybersickness were reported (M = 0.9 ±1.0 out of 10). The average perceived enjoyment and perceived rate of exertion were 3.2. ±1.1 (out of 5) and 2.4±1.9 (out of 10), respectively. Most of the participants (92.3%) found the exergame’s instructions easy to follow and had an overall positive experience (84.6%). Whereas the exergame was perceived as useful for increasing PA levels (61.6%), mood enhancement was reported among less than half of participants (46.2%) and only 38% indicated that they would choose VR exergaming for at‐home PA. The likelihood of playing VR exergames in the future was also low (38.5%). The exploratory outcome measures are presented in Table 2.ConclusionOur study provides insights into the feasibility and usability of a custom‐made VR exergaming intervention to promote PA in community‐dwelling older adults which may potentially benefit their well‐being. Our findings inform the future adoption of VR at home. Our results can also be used to inform large‐scale trials and support the design and deployment of other remote exergames and assessments.

Does the Installation or the Improvement of Existing Outdoor Parks Increase Physical Activity Levels? A Systematic Review.

Investment in outdoor parks is proposed as a promising large-scale strategy to promote physical activity (PA). This study aimed to systematically review the impact of park renovations or installing new ones in increasing PA. Searches were conducted using predefined terms in three databases (PubMed, Scopus, and Web of Science) in March 2022. Studies examining the effectiveness of park renovations or developing new ones in increasing PA and having control or comparison were eligible for inclusion. Study quality was assessed using the Quality Assessment Tool for Quantitative Studies. Data were extracted from the included records using a predefined extraction table. The database search yielded 959 records, and 26 were included. For park renovations (n = 17), 11 (65%) studies presented findings supporting a positive effect on PA. The other six (35%) studies found no PA benefits when compared to control or pre-renovations/improvement levels. Regarding new installations (n = 9), five (56%) studies presented improvements in PA, and four (44%) did not. A promising positive impact of park renovations and new installations on park use and PA was observed. The review findings reflect the need to understand the context, daily routines, and interests of the surrounding population before renovating or installing new outdoor parks.

94 Physical Activity, Emotional Functioning, and Cognitive Concerns During the COVID-19 Pandemic Among Older Adults in the US

Objective:Physical inactivity is associated with a greater risk of frailty, neuropsychiatric symptoms, worse quality of life, and increased risk for Alzheimer’s disease. Little is known about how physical activity engagement of older adults during the COVID-19 pandemic relates to subjective cognitive concerns and management of emotional distress. This study aimed to examine whether there were changes in physical activity during the pandemic in older adults at baseline and 3 months compared to before the pandemic and whether these changes varied based on age, sex, income level, and employment status. Further, we examined whether individuals who reported engaging in less physical activity experienced greater subjective cognitive difficulties and symptoms of depression and anxiety than those who maintained or increased their physical activity levels.Participants and Methods:301 participants (73% non-Hispanic whites) completed an online survey in either English or Spanish between May and October 2020 and 3 months later. The Everyday Cognition Scale was used to measure subjective cognitive decline, the CES-D-R-10 scale to measure depressive symptoms, and the GAD-7 scale to measure anxiety symptoms. Changes in physical activity were measured with the question “Since the coronavirus disease pandemic began, what has changed for you or your family in regard to physical activity or exercise levels?” with options “less physical activity,” “increase in physical activity,” or “same activity level.” Income was self-reported as high, middle, or low. Analyses of chi-squared tests were used to examine differences in physical activity maintenance by age, income level, sex, and employment status.Results:Most individuals (60%) reported having decreased their physical activity levels during the pandemic, at baseline and 3-month followup. There were differences in physical activity levels based on income and age: participants with a high income reported engaging in more physical activity than those with low income (X^2=4.78, p =.029). At the 3-month follow-up, middle-income participants reported being less active than the high-income earners (X^2=8.92, p=.003), and younger participants (55-65 years, approximately) reported being less active than older participants (X^2=5.28, p =.022). Those who reported an increase in their physical activity levels had fewer cognitive concerns compared to those who were less active at baseline, but this difference was not seen in the 3-month follow-up. Participants of all ages who reported having maintained or increased their physical activity levels had fewer depressive symptoms than those who were less active (p &lt; 0.0001). Those who reported maintaining their physical activity levels exhibited fewer anxiety symptoms than those who were less active (p &lt; 0.01).Conclusions:Older adults reported changes in physical activity levels during the pandemic and some of these changes varied by sociodemographic factors. Further, maintaining physical activity levels was associated with lower symptoms of depression, anxiety, and cognitive concerns. Encouraging individuals and providing resources for increasing physical activity may be an effective way to mitigate some of the pandemic’s adverse effects on psychological wellbeing and may potentially help reduce the risk for cognitive decline. Alternately, it is possible that improving emotional distress could lead to an increase in physical activity levels and cognitive health.