Meeting Physical Activity Recommendations Research Articles

Physical activity and sedentarism among university students: an approach using a real-life survey

Abstract Background Evidence shows physical activity (PA) and sedentary behavior (SB) impact health-related outcomes. World Health Organization (WHO) provides PA guidelines for different life stages. A recent study revealed that engaging in SB > 6 hours/day increases all-cause mortality risk. Nevertheless many students spend a significant portion of their daily time on SB and PA levels are insufficient. Methods Students were selected by convenience sampling to complete a survey between October-November 2023. A validated PA questionnaire was included including PA Motivations and barriers. PA and SB were classified into 4 levels: Active but sedentary, extremely sedentary, physically active and discreetly active. Data were analyzed using Statistical Package for the Social Sciences (SPSS). Results Out of 2,216 surveys 1,648 were women, 568 men and 59.7% were in first university years. In our sample, 12.9% don’t do PA. Of those doing PA, 47.1% (n = 1043) don’t meet PA recommendations. Regarding SB, 84.7% spend >6 hours/day in SB. When grouped into PA/SB categories 40.5% were extremely sedentary in contrast to 8.8% physically active. Non-university facilities (41.1%) were preferred over university facilities (11.1%). Use of non-university and university facilities correlated with WHO compliance. Main barriers among inactive students were lack of time (48%) and lack of a workout partner (18.6%). Conclusions Most students don’t meet WHO guidelines. Less than 10% are considered active, while 40.5% are extremely sedentary. University sports facilities are underused even if linked to better compliance. To promote facilities as health-promoting spaces and investigate reasons for their underuse is necessary. Lack of company as a reason for not engaging in PA points out the need to strength university sports communities. Key messages • Although many students exercise, the majority do no meet World Health Organization recommendations. • We must intensify university programs to promote physical activity and reduce sedentary behavior.

Effects of the COVID-19 Pandemic on Physical Activity in Children: A Systematic Review

Background: Extended lockdowns established to minimize the spread of COVID-19, may have affected physical activity (PA). The objective of this systematic review was to report how PA of children was impacted by the COVID-19 pandemic. Methods: A database search of CINAHOL, Embase, MEDLINE, PsycInfo, and Web of Science was conducted on 03/29/2021 in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies were included if they reported a measure of PA for children ≤18 years and were published in English in a peer-reviewed journal. The search generated 673 unique citations. After applying the criteria above, 69 articles were included. The quality of the included articles was assessed using the NIH NHLBI Study Quality Assessment Toolbox. Results: Unstructured play, walking, and virtual PA (e.g., YouTube, online classes) were the most frequently reported modes of PA during the COVID-19 pandemic. The PA of children decreased among 89% of articles that reported changes in PA (e.g., frequency, intensity, duration, or the percentage of children who met PA recommendations) of children during the COVID-19 pandemic. Increased PA was reported more often among younger children, boys, children who lived with other children, and children with more outdoor space. Conclusion: Globally, PA of children decreased during the COVID-19 pandemic. Further work is needed to develop policies to support global PA increases. Limitations of this review include the use of online surveys which are limited by participants ability to recall PA behaviors and access to online resources.

Physical Activity and Sedentary Time in US Adults with and without Heart Failure: 2007-2018 NHANES.

Current evidence describing physical activity (PA) and sedentary time (ST) in people with and without heart failure (HF) is limited. This study examines PA participation and ST in a nationally representative sample of US adults with and without self-reported HF. The study sample (N = 21,633) included US adult (40 years old and older) participants from the 2007-2018 National Health and Nutrition Examination Survey. PA participation, ST, and HF status were assessed via a questionnaire. Compared with participants without HF (68%), 84% of participants with HF reported not meeting PA recommendations (P < 0.05). Compared with participants without HF (63%), 75% of participants with HF reported >4.5 hours/day of ST (P < 0.05). Unadjusted analysis suggests that participants with HF had 60% (P < 0.05) lower odds of reporting meeting PA recommendations when compared with those without HF. In a fully adjusted model, these odds were attenuated (odds ratio 0.74, P < 0.05). Similarly, unadjusted analysis illustrated those individuals with HF had 42% (P < 0.05) lower odds of reporting ≤4.5 hours/day of ST. In a fully adjusted model, these odds also were attenuated (odds ratio 0.66, P < 0.05). Our findings suggest that US adults with HF report significantly less PA and greater amounts of ST than those without HF.

Neighborhood Characteristics & Walking Behavior Among Adults with Arthritis: An NHIS Study.

This study investigated the association of perceived neighborhood qualities with likelihood of transit walking, leisure walking, neighborhood walking, and meeting physical activity (PA) recommendations among US adults with arthritis. This cross-sectional study utilized 2020 National Health Interview Survey data. Included participants were adults reporting clinician-diagnosed arthritis and who reported the ability to walk. Exposures of interest were perceived neighborhood attributes. Outcomes were transit walking, leisure walking, neighborhood walking, and meeting PA recommendations. Standardized mean difference percent (SMD%) was used to assess relationships between exposures and outcomes with SMD% >10% resulting in inclusion in final adjusted multivariate logistic regression models for odds of outcomes. All analyses were weighted to account for complex survey methodology. The analytic sample included 7,322 adults with arthritis. Fully adjusted logistic regression models showed presence of roads to walk on was associated with meeting PA recommendations (OR=1.26[95%CI=1.07-1.49]). Three attributes were positively associated with transit walking, while safety from crime was negatively associated (OR=2.33[95%CI=1.75-3.10], OR=1.49[95%CI=1.17-1.91], OR=1.67[95%CI=1.34-2.08]), OR=0.70[95%CI=0.53-0.92]). Roads to walk and places to walk and relax were associated with leisure and neighborhood walking (OR=1.46[95%CI=1.21-1.76], OR=1.56[95%CI=1.34-1.82], OR=1.58[95%CI=1.29-1.93], OR=1.63[95%CI=1.40-1.90], respectively). This study identified several neighborhood characteristics associated with higher likelihood of walking behaviors among adults with arthritis. Factors associated with walking behavior varied by type of walking. The shared correlates between leisure and neighborhood walking imply they occur in the same setting. Patients with arthritis may benefit from exercise recommendations that are informed by the presence or absence of facilitating infrastructure in their neighborhoods.

Physical activity levels in patients with chronic venous insufficiency.

Increasing the levels of physical activity (PA) is widely recommended for people with chronic venous insufficiency (CVI). However, studies investigating the patterns of PA and adherence to PA guidelines using objective measures are lacking. The primary aim was to examine the patterns of PA and adherence to PA guidelines among patients with CVI. A secondary aim was to identify whether adherence to PA recommendations differed according to patients' sociodemographic and clinical characteristics. This cross-sectional study included 96 patients with CVI with Clinical-Etiology-Anatomy-Pathology (CEAP) C3 to C6 (69.1% women 59 ± 11years; 51.5% C5-C6 on CEAP classification). Objective time spent in PA was measured by a triaxial accelerometer. To examine adherence to PA guidelines, patients were grouped as meeting (or) the recommendations if they had at least 150min/week of moderate to vigorous PA. Sociodemographic and clinic characteristics were obtained by self-report. Binary logistic regression was employed to examine whether sociodemographic and clinical characteristics were associated with adherence to PA guidelines. T-tests were employed to compare PA levels at different intensities according to patients' age. Patients spent an average of 311.4 ± 91.5min/week, 42.1 ± 28.0min/week, and 19.8 ± 17.8min/week in low-light PA, high-light PA, and moderate-to-vigorous PA, respectively. The proportion of patients meeting PA recommendations was 36.2%, and older patients had lower odds (OR = 0.94; 95%CI: 0.89 to 0.99). Additional analysis reinforced that by showing lower time in high-light PA (51.2 ± 30.0min/day vs. 31.9 ± 21.8min/day; p = .001) and moderate-to-vigorous PA (24.3 ± 15.8min/day vs. 14.8 ± 18.8min/day; p = .012) among older patients than their peers younger. Our findings showed that 36,2% of CVI patients met PA recommendations, with lower odds found among older patients. Public health interventions to enhance PA engagement among CVI patients should prioritize those who are older.

Parent–Child Associations in Accelerometer-Measured Physical Activity and Sedentary Behaviour: The FAMIPASS Study

Parent–child patterns in objectively measured movement behaviours were the highlight of this study. A total of 381 families (337 mothers, 256 fathers, 190 daughters, and 191 sons) from 36 randomly selected schools and kindergartens provided valid accelerometer data. Sedentary behaviour and physical activity (PA) were assessed using ActiGraph accelerometers. Spearman’s rho was used to evaluate parent–child associations, while logistic regression analysis (the backward LR method) was used to recognize factors related to children’s achievement of PA recommendations. Results indicated that girls engaged more in light PA, while boys showed higher levels of moderate and vigorous PA. Mothers spent less time sitting and more time in light PA compared to fathers, resulting in higher total PA levels. Father–son pairs showed a stronger association in total PA than mother–son pairs. Children aged 6–10 years and those with mothers who engaged in more vigorous PA were more likely to meet PA recommendations compared to younger children and those with less active mothers.

Domain matters: An examination of college student physical activity participation patterns by gender and race/ethnicity

Background Physical activity (PA) consists of multiple domains, including leisure-time PA (LTPA), occupational PA (OPA), and transportation PA (TPA), though limited research has examined these domains among college students. Methods This cross sectional, online survey asked undergraduate students to self-report demographics (gender, race/ethnicity, employment) and PA (LTPA, TPA, and OPA). Participants were categorized as meeting/not meeting current aerobic PA recommendations with only LTPA and with all domains of PA. Analyses examined differences by domain and demographics. Results For participants (n = 3732) when only considering LTPA, 79% met recommendations, while considering all forms of PA resulted in 94% of students meeting recommendations. Gender and race/ethnicity differences in the odds of meeting PA recommendations were present with only LTPA, however when considering all PA domains, some disparities were no longer present. Conclusions These findings highlight how different domains of activity contribute to overall PA and the relationship with gender and race/ethnicity.

Determinants and Factors of Physical Activity After Oncology Treatments (DEFACTO) in Metropolitan France: Protocol of a Mixed Methods Study and Intervention.

While the scientific community widely recognizes the benefits of physical activity (PA) in oncology supportive care, cancer survivors who have undergone chemo- or radio-immunotherapy treatments struggle to meet PA recommendations. This underscores the importance of identifying factors influencing active lifestyle adoption and maintenance and proposing a multilevel model (micro-, meso-, and macrolevel) to better understand facilitators and barriers. Currently, no socioecological model explains an active lifestyle in the posttreatment phase of breast, colorectal, prostate, and lung cancers. The objective is to identify factors influencing an active lifestyle in cancer survivorship and assess the feasibility of an individualized program targeting an active lifestyle. The objectives will be addressed in 3 stages. Stage 1 aims to elucidate factors associated with the active lifestyle of cancer survivors. Stage 2 involves developing an explanatory model based on previously identified factors to create a tailored health education program for an active lifestyle after oncology treatments. Stage 3 aims to evaluate the feasibility and potential effects of this personalized health education program after its national implementation. First, the exploration of factors influencing PA (stage 1) will be based on a mixed methods approach, using an explanatory sequential design and multilevel analysis. The quantitative phase involves completing a questionnaire from a socioecological perspective. Subsequently, a subset of respondents will engage in semistructured interviews to aid in interpreting the quantitative results. This phase aims to construct a model of the factors influencing an active lifestyle and develop an individualized 12-week program based on our earlier findings (stage 2). In stage 3, we will implement our multicenter, multimodal program for 150 physically inactive and sedentary cancer survivors across metropolitan France. Program feasibility will be evaluated. Measured PA level by connected device and multidimensional variables such as declared PA and sedentary behaviors, PA readiness, motivation, PA preferences, PA knowledge and skills, and barriers and facilitators will be assessed before and during the program and 52 weeks afterward. The institutional review board approved the mixed methods study (phase 1) in April 2020, and the intervention (phase 3) was approved in March 2022. Recruitment and data collection commenced in April 2022, with intervention implementation concluded in May 2023. Data collection and full analysis are expected to be finalized by July 2024. The Determinants and Factors of Physical Activity After Oncology Treatments (DEFACTO) study seeks to enhance our understanding, within our socioecological model, of factors influencing an active lifestyle among cancer survivors and to assess whether a tailored intervention based on this model can support an active lifestyle. ClinicalTrials.gov NCT05354882; https://www.clinicaltrials.gov/study/NCT05354882. DERR1-10.2196/52274.

Are cash incentives always king? A randomized controlled trial evaluating hedonic versus cash incentives (TEH-C).

Physical inactivity is a risk factor for obesity and non-communicable diseases. Despite myriad health and non-health benefits resulting from physical activity (PA), most individuals do not meet PA recommendations. Providing an incentive for meeting activity goals may increase activity levels. Classical economists argue that cash is the best incentive. Behavioral economists have posited that hedonic (pleasurable) incentives (e.g., massages, restaurant meals) may be superior to cash when incentives are offered over multiple time periods. To date, no studies have directly compared the effectiveness of cash versus hedonic incentives in promoting PA across multiple time periods. We conducted a two-arm, parallel, 4-month randomized controlled trial with healthy adults in Singapore where participants were randomized to either cash or hedonic incentives. Participants could earn up to SGD50 (≈USD37) in cash or hedonic incentives each month they met the study's step target of 10,000 steps daily on at least 20/25 days out of the first 28 days of a month. The primary objective was to compare the mean proportion of months that participants met the step target between the two arms. By month 4, participants in the cash (N = 154) and hedonic incentive (N = 156) arms increased their mean daily steps by 870 (p < 0.001) and 1,000 steps (p < 0.001), respectively. The mean proportion of months the step target was achieved was 90.53 and 88.34 for participants in the cash and hedonic incentive arms respectively, but differences across arms were small and not statistically significant for this or any outcome assessed. Our findings suggest that both cash and hedonic incentives are effective at promoting physical activity but that neither strategy is clearly superior.Clinical trial registration: ClinicalTrials.gov, NCT04618757 registered on November 6, 2020.

Expanding active living after cancer to underserved cancer survivors and their caregivers.

Physical activity improves physical and psychological health in cancer survivors. This study evaluated Active Living After Cancer (ALAC), a community-based program to improve physical activity, physical function, and quality of life (QOL) in minority and medically underserved cancer survivors and their caregivers. Participants completed 12 weekly ALAC sessions and assessments of physical activity, physical functioning, and QOL at baseline and follow-up (week 12). Paired samples t tests were used to assess changes in outcomes over time. A total of 540 cancer survivors (mean age = 61.1 [SD = 11.3] years) and 87 caregivers (mean age = 62.3 [SD = 13.1] years) were enrolled. Most were women (91.4%), Hispanic (61.1%) or non-Hispanic Black (19.3%), and medically underserved (86.4%). The percent of cancer survivors meeting physical activity recommendations increased from 28.9% to 60.2% (d = 0.75), and the number of sit-to-stand repetitions in a 30-second period increased from 12.3 to 14.3 (d = 0.39) from 0-12 weeks. Cancer survivors reported statistically significant improvements in physical (t score Δ = 1.7, d = 0.06) and mental (t score Δ = 2.3, d = 0.31) health-related QOL. Caregivers also improved their physical activity, physical function, and QOL, and there were no statistically significant differences between breast and other cancer survivors and between cancer survivors and caregivers. The ALAC program demonstrated increased physical activity, physical function, and QOL in medically underserved cancer survivors and their caregivers. Furthermore, ALAC was successfully implemented by community partners and serves as a good model for reaching medically underserved cancer survivors and improving survivorship. Additional efforts are warranted to further extend reach, improve cancer survivorship, and reduce cancer health disparities among underserved cancer survivors.

Psychosocial correlates of physical activity in cancer survivors: a systematic review and meta-analysis.

Physical activity (PA) is a non-pharmacological approach to optimize health benefits in cancer survivors and is recommended as part of care. However, most cancer survivors fail to meet PA recommendations. The current systematic review and meta-analysis aimed to identify psychosocial correlates of free-living PA in cancer survivors. Three electronic databases were searched (PubMed, PsycINFO, and SportDiscus). Meta-analyses were conducted for psychosocial correlates tested ≥ 3 times. Sixty-four articles were included. Eighty-eight different free-living PA correlates were identified. Meta-analyses (n = 32 studies) tested 23 PA correlates, of which 16 were significant (p < 0.05). Larger effect sizes (0.30 < ES > 0.45) were found for exercise self-efficacy, perceived behavioral control, intention, lower perceived barriers for exercise, enjoyment, perceived PA benefits, and attitudes. Small-to-moderate effects (0.18 < ES < 0.22) were found for subjective norms, physical functioning, quality of life, depression, and mental health. These findings were generally in line with narrative results. This systematic review highlights important psychosocial correlates of free-living PA that can be targeted in future PA promotion interventions for cancer survivors. Constructs mainly from SCT and TPB were the most studied and appear to be associated with free-living PA in this population. However, we cannot currently assert which frameworks might be more effective. Further studies of better methodological quality, per correlate and theory, exploring longer-term associations and across different types of cancer, are needed. Having higher exercise self-efficacy, perceived behavioral control, intention, enjoyment and perceived PA benefits, more positive attitudes towards PA, and lower perceived barriers for exercise, can help increase PA in cancer survivors.

Rural-urban differences in meeting of physical activity recommendations by sun exposure and protection behaviors in the United States

ObjectiveTo examine associations between sun protection behaviors and physical activity (PA) by rural and urban residence in the United States. MethodsWe analyzed data from the National Health and Nutrition Examination Survey (2013–2018), restricting to participants ages 20–59 with sun behavior data. Sunburns, sun exposure, and sun protection measures were dichotomized (yes/no): ≥1 sunburn in the past year, 2+ hour outside during workdays or non-workdays, and never/rarely/sometimes using sunscreen, wearing long sleeves, and staying in the shade. Meeting PA recommendations (yes/no) was defined as ≥150 min of vigorous/moderate or ≥ 75 min vigorous PA per week. Associations between sun behaviors and PA were analyzed using logistic regression models, which accounted for survey-weights and potential confounders, and stratified by rural-urban status. ResultsRural and urban individuals meeting PA recommendations had greater odds of spending 2+ hour outside during workdays (OR: 2.26 [1.88, 2.74] and 3.95 [2.72, 5.73]) and non-workdays (OR: 2.06 [1.78, 2.38] and 3.33 [2.47, 4.46]). Among urban residents, odds of staying in the shade were lower among those who met PA recommendations (OR: 0.78 [0.66, 0.92]). We did not observe differences in sunburns or other sun behaviors by PA status, regardless of rurality. ConclusionsMeeting PA recommendations was associated with greater sun exposure in both rural and urban populations. Additional exercise location (indoors/outside) data is needed to inform PA and skin cancer prevention interventions to reduce unintended increases in sun exposure and reductions in PA, respectively, especially among rural populations.

Urban‐Rural Disparity and Economic Geography Variation in the Likelihood of Meeting Physical Activity Recommendation–Results from the Study of Community Sports in China

Purpose. Maintaining physical activity (PA) has significant implications for health. According to the World Health Organization (WHO), adults aged 18–64 should engage in at least 150 to 300 minutes of moderate‐intensity aerobic PA per week. However, urban‐rural disparities and economic geography variations in PA levels have not received enough attention. This study aimed to examine these disparities in the likelihood of meeting PA recommendations by using data from the Study of Community Sports in China. Methods. This is a nationwide cross‐sectional community‐based study. A total of 5,000 participants were randomly selected using a multistage sampling strategy. They were asked to complete a survey including demographics data and PA levels. The data were analyzed using mixed‐effects logistic regression to evaluate the association between urban‐rural residency, economic geography regions, and the likelihood of meeting PA recommendations. Results. A total of 3,779 participants met the eligible criteria, and only 816 (21.6%) met the PA recommendation. The urban participants were more likely to meet the PA recommendation than their rural peers [OR (95% CI) of 1.72 (1.09, 2.71)]. The association remained significant among those aged ≥30 [OR = 2.53 (1.51, 4.24)] and those with the education of high school and below [OR = 1.88 (1.18, 1.77)], but not in their younger, and more‐educated peers (Pinteraction = 0.009 and 0.034, respectively). Compared with the east coastal residents, western ones had a greater chance of meeting the recommendation [OR = 2.68 (1.25, 5.74)]. The association was more prominent among the more‐educated [OR = 3.89 (1.58, 9.57)] than the less‐educated [1.90 (0.83, 4.35)](Pinteraction &lt;0.001), but not modified by age. Conclusion. Urban and western residents were more active than their rural and east coastal counterparts. Studies should carefully consider the interactions between age and education level with urbanization and region while evaluating PA levels. Moreover, policymakers should develop policies and programs according to urban‐rural disparity and regional variations to shorten the gaps.

"I Can Do It": Perceived Competence of Parents of Autistic Children After Participating in a Physical Activity Intervention.

Autistic children can benefit from physical activity (PA) in a variety of ways. However, autistic children tend not to meet PA recommendations and, consequently, may not experience the associated benefits. Parental PA support can facilitate PA participation among autistic children, but parents of autistic children may lack the skills to help their child engage in PA. Few studies, to date, have examined the outcomes of parent-mediated PA interventions for autistic children. The purpose of this study was to explore parents' perceived behavioral control (PBC) to support their autistic children in PA after their participation in a PA intervention. The theory of planned behavior served as the framework for this descriptive-qualitative investigation. Fifteen parents (each with 1 autistic child in the intervention) participated in semistructured interviews (3wk after the intervention), which were transcribed and then analyzed using thematic line-by-line analysis. Three themes characterized the changes to parents' PBC after completing the PA intervention. Those themes were: (1)I learned by son! (2)You are my coach! and (3)I can do it! The results showed that by participating in a parent-mediated PA intervention, parents experienced improved confidence and awareness of their child's abilities, thus enhancing their PBC. Future research is needed to examine how these improvements in PBC may influence the actual PA behaviors of autistic children.

Abstract B135: The impact of physical activity on cancer-associated cognitive decline, fatigue, and health outcomes among cancer survivors in the U.S.

Abstract Purpose: This study aimed to examine the influence of physical activity (PA) on cancer-associated cognitive decline (CACD) and CACD risk factors (e.g., age, fatigue, depression, sleep) among cancer survivors compared to those without a history of cancer. Methods: Using data from the 2020 National Health Interview Survey, differences in key health outcomes and the mediating effects of PA were explored. Chi-square tests were used to examine group differences. Multinomial logistic regression models were fit to examine associations between PA, CACD, CACD risk factors, and other health outcomes (cognition, fatigue, anxiety, depression, health status, sleep, work limitations, and body mass index [BMI]). Results: Cancer survivors were less likely to meet sufficient levels of PA to achieve health benefits when compared to those without a history of cancer. Cancer survivors were also more likely to experience cognitive difficulties, trouble remembering, frequent fatigue, depression, poor/fair health status, more likely to experience work limitations and miss work due to health, and less likely to be employed fulltime. Overall, physical activity (PA) had a significant positive impact on all measured health outcomes even after adjusting for age, sex, race/ethnicity, income, and education. Participants without a history of cancer and who met the PA criteria were less likely to experience cognitive difficulties, frequent fatigue, frequent anxiety, depression, poor/fair health, insufficient sleep, work limitations, and unhealthy BMI (underweight, overweight, or obese categories). These relationships were often strengthened by race and sex (male) and with higher levels of income and education. Unadjusted results showed a positive significant relationship between PA and all measured health outcomes for cancer survivors. Although cancer survivors did not see the same benefits from PA with underweight BMI or anxiety when adjusting for confounders, PA served as a protective factor with all other variables. Cancer survivors who meet PA recommendations in both aerobic and strengthening activities were less likely to report some or a lot of cognitive difficulty. Cancer survivors who met PA criteria were also less likely to experience frequent fatigue, depression, poor/fair health, work limitations, overweight and obesity, and more likely to get the recommended 7-9 hours of sleep at night. Again, most of these relationships were strengthened by higher levels of income and education. Health disparities based on race/ethnicity, sex, and age were more apparent in the cancer survivor group. Conclusion: PA has shown tremendous promise towards the lingering effects of cancer and cancer treatments. More research is needed to inform exercise prescriptions (i.e., frequency, intensity, time, type), optimal timing of interventions, and for whom physical activity may be most beneficial in relation to cognitive health. Citation Format: Jaimi Mimi L. Allen. The impact of physical activity on cancer-associated cognitive decline, fatigue, and health outcomes among cancer survivors in the U.S. [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B135.

Cultivating an Active Living Plan Through a Social-Ecological Evaluation.

Physical activity (PA) social-ecological model (SEM) posits the importance of several levels of influence critical for PA promotion within communities. The purpose of this study was to examine an SEM evaluation informing a county-wide active living plan in McLennan County, Texas in the United States. Mixed-methods evaluation occurred in 4 stages: (1) county policies (n = 15) were evaluated for PA promoting strategies; (2) PA resource assessments (PARAs) were conducted via Google Maps (n = 171); (3) surveys (n = 244) included the International Physical Activity Questionnaire and interpersonal and intrapersonal factors related to PA; and (4) focus groups (n = 5) were conducted with residents (n = 30), discussing barriers and facilitators to being active. Logistic regression determined significant associations between SEM factors and meeting PA recommendations. Policy scans and PARAs identified strengths and areas of improvement (eg, equitable project selection and disparities in resource quality). Residents reporting fewer barriers (OR = 0.89, P =.01), more perceived behavioral control (odds ratio [OR] = 1.38, P = .01), more social co-participation in PA (OR = 1.20, P = .03), and living in zip codes with higher mean PARA score (OR = 1.22, P = .04) were significantly more likely to meet PA recommendations (Nagelkerke R2 = 0.32). Focus groups also discussed safety and disparities in access and quality. This study suggests the utility of the SEM when evaluating and promoting community PA.

Knowledge and practice of the physical activity prescription by generalists and specialist physicians of the city of Kinshasa: a cross-sectional study

BackgroundThe health benefits of regular physical activity (PA) are well documented. However, several people in both developed and developing countries do not meet PA recommendations. Health professionals are believed to be potential PA promoters. The purpose of this study is to gain insight into general and specialist practitioners’ knowledge, practices and PA prescription-related factors in private and public hospitals in Kinshasa.MethodsA multicenter cross-sectional analytical study was conducted among general and specialist practitioners in the Democratic Republic of the Congo’s capital using a declarative and anonymous questionnaire.ResultsOverall, 40.2% of the participants were interested in their patient’s PA, 2.3% prescribed PA, and 0.9% did it correctly. Specialist physicians (SPs) prescribed PA more frequently than general practitioners (GP), and private hospital physicians prescribed PA more frequently than public hospital physicians. Five factors were independently associated with participants in prescribing PA: being in a private hospital increased the likelihood of prescribing PA by twofold (aOR, 1.83; 95% CI, 0.99–3.39; p = 0.055), being an SP increased the likelihood by sixfold (aOR, 6.22; 95% CI, 3.78–10.51; p = 0.000), being an internist increase the likelihood by sixfold (aOR, 5.81; 95% CI, 3.45–9.78; p = 0.000), being cardiologist by a factor of 12 (aOR, 12.91; 95% CI, 4.37–38.15; p = 0.000) and knowing the benefits of PA by a factor of 2 (aOR, 2.29; 95% CI, 1.29–4.08; p = 0.006). The most common reason given for a lack of interest in patients’ PA, followed by a lack of knowledge about current PA prescribing recommendations and a lack of time.ConclusionsSPs and professionals in the private health sector were the most interested in their patients’ PA. A small portion of them actually prescribed it, and only a tiny proportion did it correctly. This bleak picture highlights a need to rethink the undergraduate medical curricula, especially about teachings on the importance and use of PA as a medicine in its own right in disease prevention and treatment.

O.5.2-2 The relationship between moderate-vigorous physical activity and menopausal symptoms

Abstract Purpose There is growing evidence for the benefits of physical activity (PA) during the menopause lifestage (MLS), but limited understanding of women’s experiences of being PA at this time. This study aimed to understand how PA is related to menopausal symptoms during the MLS by: i) assessing the proportion of participants meeting the moderate-vigorous PA (MVPA) guidelines, and perceived PA changes during MLS; ii) assessing prevalence of menopausal symptoms; iii) examining participants’ perceptions of how menopausal symptoms impact PA; iv) investigating the relationship between experiencing symptoms and meeting PA recommendations. Methods Participants completed an online survey (Oct-Nov22, n = 655; average age 49.9 years; 56% peri-menopausal; 20% early-post menopause; 24% mid post-menopause) including questions related to meeting MVPA recommendations, experience of 14 menopausal symptoms, and perceptions of symptom impact on likelihood of PA engagement. Descriptive statistics were presented and Chi-squared tests used to examine associations between symptom experience and MVPA guideline compliance, with Bonferroni correction for multiple comparisons. Results Seventy-five percent of participants reported achieving MVPA guidelines (150 minutes/week). Fifty-seven percent reported PA levels had decreased during the current menopause life stage. Twelve out of 14 symptoms were experienced by &amp;gt; 50% participants, with changes in mood and brain fog most common (&amp;gt;80%). For 10 out of the 14 symptoms, &amp;gt;50% participants indicated a negative impact on likelihood to engage in PA, with changes to mood, difficulty sleeping (not due to night sweats), and muscle aches and joint pains most detrimental. Whilst not significant, for 10 of the 14 symptoms the proportion meeting the MVPA guidelines was lower amongst those who experienced the symptoms. Conclusions Participants had similar levels of MVPA to national norms, although the majority perceived their PA levels had declined. Participants experienced a range of symptoms which were perceived to negatively impact their PA levels, although not statistically evident. The MLS represents a time when being active can be difficult so it is important to find ways to better support women. Support/Funding Source This work was funded by SAMH, the Scottish Association for Mental Health.

O.4.6-11 MOVEOUT: a cluster randomised wait list design to investigate the effect of education outside the classroom on pupil’s physical activity

Abstract Purpose Education outside the classroom (EOtC) is a physical activity (PA)-integrating pedagogical approach that aligns PA with the primary goals of schools and is therefore thought to present an acceptable, feasible, and efficacious model for school-based PA. The aim of this study was to investigate the efficacy of an EOtC intervention that aims to increase adolescents’ (ages 10-16 years) school-based and overall PA by providing a course on the pedagogical and didactic methods of EOtC to teachers across 30 Danish schools, and subsequently the teachers implementing EOTC in their classes &amp;gt; 5 hours weekly over the course of one school year. We expect that pupils in the intervention group will retain higher PA intensities compared to the control group, specifically 1a) more MVPA, 1b) more LPA, 1c) less SED time. Further, we hypothesise that pupils in the intervention group will retain 2a) more running, 2b) more walking, 2c) more standing, 2d) less sitting time compared to the control group. Methods The intervention was evaluated using a cluster randomised wait list study comparing PA behaviours amongst pupils in the intervention group with pupils in the waitlist control group. Results In this presentation, we will present novel results from data that is currently underway. Data collection is expected to be finalised in June 2023. Conclusions Almost 20% of Danish schools practice some form of EOtC, and the findings of this study will inform whether such practice should be further encouraged in Denmark and elsewhere, or whether alterations are required to support more pupils in meeting PA recommendations. The findings have important implications for school-based PA promotion. Novo Nordisk Foundation (grant no. 0062703), ClinicalTrials.gov (NCT number: NCT05237674). Peter Elsborg and Lærke Mygind share first-authorship.

Physical Activity among Colorectal Cancer Patients and Survivors in Egypt.

Understanding physical activity (PA) levels is important when developing tertiary cancer prevention interventions, especially in Egypt where colorectal cancer (CRC) is more often diagnosed at later stages and at a younger age of onset (≤40 years). We assessed PA levels among CRC patients and survivors in Alexandria, Egypt. All participants completed two self-reported PA assessments: Global Physical Activity Questionnaire (GPAQ) and Godin Leisure-Time Exercise Questionnaire (GLTEQ). Participants could opt to wear an accelerometer for seven days. Results were compared against WHO recommendations of ≥150 minutes or ≥600 metabolic equivalents of tasks (METs) of moderate-to-vigorous PA weekly. Of 86 participants enrolled, all completed the surveys and 29 agreed to accelerometer use. Prevalence of meeting PA recommendations was 62.8% based on the GPAQ, 14.0% based on GLTEQ, and 41% based on accelerometer. Based on the GPAQ, very few respondents reported vigorous occupational, vigorous recreational, or moderate recreational activity (median = 0 with interquartile range [IQR] of 0 - 0 weekly minutes for all three) while most activity resulted from moderate occupational and transportation (median [IQR] of 60 [0-840] and 60 [0-187.5] weekly minutes, respectively). Participants meeting PA recommendations were less likely to be married (p = 0.043) according to GPAQ and more likely to be female (p=0.047) and early cancer stage (p=0.007) by GLTEQ. Non-leisure free-living PA is a major contributor to meeting PA recommendations while leisure-time PA is a potential target for future interventions that increase PA in this population.