Minutes Of Moderate-to-vigorous Physical Activity Research Articles

Criterion validity of the Saltin-Grimby Physical Activity Level Scale in adolescents. The Fit Futures Study.

The Saltin-Grimby Physical Activity Level Scale (SGPALS) is commonly used to measure physical activity (PA) in population studies, but its validity in adolescents is unknown. This study aimed to assess the criterion validity of the SGPALS against accelerometry in a large sample of adolescents. A secondary aim was to examine the validity across strata of sex, body mass index (BMI), parental educational level, study program and self-reported health. The study is based on data from 572 adolescents aged 15-17 years who participated in the Fit Futures Study 2010-11 in Northern Norway. The participants were invited to wear an accelerometer (GT3X) attached to their hip for seven consecutive days. We used Spearman's rho and linear regression models to assess the validity of the SGPALS against the following accelerometry estimates of PA; mean counts/minute (CPM), steps/day, and minutes/day of moderate-to-vigorous physical activity (MVPA). The SGPALS correlated with mean CPM (ρ = 0.40, p<0.01), steps/day (ρ = 0.35, p<0.01) and MVPA min/day (ρ = 0.35, p<0.01). We observed no differences between correlations within demographic strata (all p>0.001). Higher scores on SGPALS were associated with a higher CPM, higher number of steps per day and more minutes of MVPA per day, with the following mean differences in PA measurements between the SGPALS ranks: CPM increased by 53 counts (95% CI: 44 to 62), steps/day increased by 925 steps (95% CI: 731 to 1118), and MVPA by 8.4 min/day (95% CI: 6.7 to 10.0). Mean difference between the highest and lowest SGPALS category was 2947 steps/day (6509 vs. 9456 steps/day) and 26.4 min/day MVPA (35.2 minutes vs 61.6 minutes). We found satisfactory ranking validity of SGPALS measured against accelerometry in adolescents, which was fairly stable across strata of sex, BMI, and education. However, the validity of SGPALS in providing information on absolute physical activity levels seem limited.

ALCOHOL CONSUMPTION AND PHYSICAL ACTIVITY, SEDENTARY, AND SLEEP BEHAVIORS IN UNIVERSITY STUDENTS

PURPOSE: Excessive alcohol intake has been associated with negative health outcomes, but it is unclear if alcohol consumption is related to the different behaviors (moderate to vigorous physical activity (MVPA), sedentary behavior (SED), and total sleep duration) that make up a 24-hour day in university students. The purpose of the study was to examine the associations between alcohol consumption and self-reported MVPA, SED, and sleep in university students. METHODS: University students (n=660, 20.3±1.6 yr, 80% female) completed an online survey to assess demographics, total alcohol consumption per week, Greek Life membership, sleep duration (min/day) via Pittsburgh Sleep Quality Index, SED (min/day) via Sedentary Behavior Questionnaire, and MVPA (min/day) via Leisure Time Physical Activity Questionnaire. Multiple linear regression was used to examine associations between different alcohol consumption categories (Moderate = Females 1-7 drinks per week, Males 1-14 drinks per week; Heavy = Females > 7 drinks per week, Males > 14 drinks per week) with MVPA, SED, and sleep behaviors adjusting for possible confounding factors (sex, race/ethnicity, BMI, and Greek Life membership). RESULTS: Moderate (β=6.9, p=0.10) and heavy alcohol drinkers (β=6.4, p=0.21) self-reported higher MVPA compared to university students that do not consume alcohol (trend p =0.02). Moderate (β=20.5, p=0.29) and heavy (β=41.5, p=0.27) alcohol drinkers self-reported higher SED compared non-drinkers, although these differences were not statistically significant (trend p=0.17). Moderate (β=0.5, p=0.94) and heavy (β=-5.8 p=0.61) alcohol drinkers had sleep times that were similar to those who reported not consuming alcohol (trend p=0.78). CONCLUSIONS: In this university student sample, alcohol drinkers reported participating in 6-7 additional minutes of MVPA per day than students that reportedly do not drink alcohol. However, only moderate drinkers had statistically significant higher values. While this analysis controlled for several potential confounders, other unmeasured differences between drinkers and non-drinkers may account for the higher MVPA observed among drinkers. Alternatively, alcohol drinking among university students may be a marker for greater engagement in social activities that incorporate MVPA.

Refining index to measure physical activity inequality: which group of the population is the most vulnerable?

BackgroundThe existing body of research mostly discusses inequality in physical activity (PA) based on the difference in the level of moderate-to-vigorous physical activity (MVPA). Evidence is lacking on the quantified inequality measures (e.g., how big the inequality is, and the distribution) in order to identify the most vulnerable groups of a population. This study measured PA inequality among Thai adults by using three parameters to construct an inequality index: (1) Proportion of the population with sufficient MVPA; (2) Cumulative minutes of MVPA; and (3) The Gini coefficient.MethodsThis study employed three rounds of data from Thailand’s Surveillance on Physical Activity (SPA) 2019–2021. In each round, over 6,000 individuals age 18–64 years were selected as nationally-representative samples, and were included in the analysis. PA inequality was constructed by using three parameters, with a combination of the three as the final measure, to identify the sub-groups of the Thai adults who are most vulnerable: groups with the least MVPA, highest insufficiency, and highest inequality index (Gini).ResultsCovid-19 containment measures have widened the gap in PA inequality, as shown by a declining proportion of the population meeting the recommended guidelines, from 74.3% in 2019 to 56.7% in 2020 and 65.5% in 2021. PA inequality existed in all sub-populations. However, by combining three parameters, the most vulnerable groups during the Covid-19 epidemic were identified as follows: (1) Those with no income; (2) The unemployed; (3) Those who have no access to PA facilities; (4) Older adults aged 60 + years; and (5) Those earning < 3,500 baht per month. Further, residents of Bangkok, young adults aged 18–24, individuals who attained primary level education or less, those who had no exposure to a PA awareness campaign and those who have a debilitating chronic disease also had elevated risk of PA insufficiency.ConclusionA concerning level of PA inequality existed in all sub-populations. The use of combined indicators in measuring PA inequality should aid in determining the most vulnerable groups of the population with a refined procedure. This method can be applied in many settings since the baseline data used to measure inequality (i.e., percent sufficient and cumulative minutes of MVPA) are widely available.

P04-07 Factors associated with maintenance of physical activity in older adults undertaking a strength and balance programme for falls prevention

BackgroundFalls are a major cause of mortality and morbidity in older adults worldwide, yet those who are more physically active have a lower risk of falling. There is little information on which participants are most likely to complete falls prevention exercise programmes and increase their levels of physical activity (PA). This study aims to identify factors associated with completion of, and PA levels, at the end of the Falls Management Exercise (FaME) falls prevention exercise programme, a programme designed to increase balance and functional capacity, increase bone and muscle mass and reduce fear of falling.Methods356 community-dwelling adults provided routine data. Characteristics of participants were compared at baseline. Comparison of activity levels between completers and non-completers were carried out, and a regression analysis performed to identify factors associated with programme completion and achievement of 150 minutes of moderate to vigorous physical activity (MVPA) per week.Results143 participants completed the FaME programme. This group was significantly younger (range 50-96; mean=75.3, SD=8.1 in completers vs. mean=77.8, SD=8.3 in non-completers) and had significantly lower scores on the FRAT (median=1, IQR=0-2 in completers vs. median=2, IQR=1-3 in non-completers) and FES-I risk assessments (median=10, IQR=7-13 in completers vs. median=11, IQR=8-16 in non-completers) at baseline, and a significantly higher level of physical activity (PA) per week (median=673 minutes, IQR=252-1252 in completers vs. median=558, IQR=120-1127 in non-completers). Completers significantly increased their total minutes of PA per week, and the converse was true for non-completers. Multivariate regression analyses showed that FRAT score was significantly associated with completion of FaME, and 180 degree turn and FES-I score were significantly associated with achieving the recommended 150 minutes of MVPA per week.ConclusionsThis study has shown that a significant increase in PA levels is only demonstrated in those who complete the FaME programme. Scores from selected functional measures and risk assessments are associated with FaME completion and achievement of 150 minutes of MVPA. This information can be used to provide targeted support to improve completion rates and physical activity levels of participants.

S06-5 The Walking In ScHools (WISH) study: Development and evaluation of a peer-led school-based walking intervention in adolescent girls from pilot to fully-powered trial

Abstract Background Walking interventions, delivered within the school setting, have the potential to increase physical activity (PA) in adolescents. Previous research has shown that walking is an acceptable form of PA for adolescent girls, and that walking interventions may be effective at increasing PA in this group. Findings from the Walking In ScHools (WISH) pilot study (n199 female participants) found the intervention was effective in increasing light intensity PA in adolescent girls, but further research is needed to examine the effects of walking on overall PA and the role of peer leaders in delivering school-based interventions. The present study aims to build upon this pilot work and evaluate the effectiveness of a novel, low-cost, peer-led school-based walking intervention, delivered across the school year, at increasing accelerometer-measured PA levels of adolescent girls. Methods The WISH study is a school-based cluster randomised controlled trial targeting adolescent girls (aged 12-14 years) within the post-primary school setting. Data will be collected at four timepoints, baseline, mid-intervention, post-intervention, and 13 months post-baseline. Following baseline data collection, schools were randomly allocated to intervention (n = 9) or control (n = 9). In intervention schools, older pupils (aged 15-18 years) were trained as walk leaders and led the younger girls in 10-15min walks before school, at break, and during lunch, across the school year (20-22 weeks). The primary outcome measure is accelerometer-measured total PA (post-intervention) and secondary outcomes include anthropometry measures, and wellbeing. Results Some 590 participants (mean(SD) age 12.6(0.64)years) were recruited from 18 schools across Northern Ireland (n = 9) and the Border region of the Republic of Ireland (n9). Within the intervention schools, 149 walk leaders were trained. At baseline (n = 535), mean(SD) time spent in moderate to vigorous PA (MVPA) was 39.2(17.07)mins/day and 66 (12%) girls achieved PA guidelines of 60 minutes MVPA per day. Data collection and analysis is ongoing. Conclusions This research has outlined the development of a novel, peer-led walking intervention and demonstrated its effectiveness at increasing light intensity PA in adolescent girls. The ongoing fully powered trial will build upon this pilot work and further evaluate the effects of the WISH study on increasing PA in adolescent girls.

Relationship Between Moderate-to-Vigorous Physical Activity and Glycemia Among Young Adults with Type 1 Diabetes and Overweight or Obesity: Results from the Advancing Care for Type 1 Diabetes and Obesity Network (ACT1ON) Study.

Aims: Using data from the ACT1ON study, we conducted secondary analyses to assess the relationship between minutes of moderate-to-vigorous physical activity (MVPA) and glycemia in adults with type 1 diabetes (T1D) and overweight or obesity. Materials and Methods: Participants (n = 66) with T1D provided measures of glycemia (hemoglobin A1c [HbA1c], percent of time below range <70 mg/dL, time-in-range [TIR 70-180 mg/dL], and time above range [TAR >180 mg/dL]) and self-reported physical activity (Global Physical Activity Questionnaire [GPAQ] and Previous Day Physical Activity Recalls [PDPAR]) at baseline, 3, 6, and 9 months postintervention. Wearable activity data were available for a subset of participants (n = 27). Associations were estimated using mixed effects regression models adjusted for design, demographic, clinical, and dietary covariates. Results: Among young adults 19-30 years of age with a baseline HbA1c of 7.9% ± 1.4% and body mass index of 30.3 (interquartile range 27.9, 33.8), greater habitual weekly MVPA minutes were associated with higher HbA1c through the GPAQ (P < 0.01) and wearable activity data (P = 0.01). We did not observe a significant association between habitual MVPA and any continuous glucose monitoring metrics. Using PDPAR data, however, we observed that greater daily MVPA minutes were associated with more TAR (P < 0.01) and reduced TIR (P < 0.01) on the day following reported physical activity. Conclusions: Among young adults with T1D and overweight or obesity, increased MVPA was associated with worsened glycemia. As physical activity is vital to cardiovascular health and weight management, additional research is needed to determine how to best support young adults with T1D and overweight or obesity in their efforts to increase physical activity. Clinical Trial Registration number: NCT03651622.

Physical Activity, Glycemic Variability, and Parental Hypoglycemia Fear in Preschoolers With Type 1 Diabetes.

The authors examined associations between preschoolers' daily glycemic variability, parents' report of hypoglycemia fear, and preschoolers' daily moderate to vigorous physical activity (MVPA) and sedentary behavior (SB) in 25 families of preschoolers with type 1 diabetes. Parents completed a valid measure of hypoglycemia fear, and their child wore an accelerometer for up to 7days. Parents provided glucose data from their child's devices. The authors used multiple regression and multilevel modeling to analyze their data. Preschoolers (mean age 4.2 [1.7]y; 50% boys) engaged in a mean of 154.5 (59.6) and 339.2 (85.1)minutes of MVPA and SB per day, respectively, and parents reported relatively low levels of hypoglycemia worry and avoidance behaviors. Preschoolers' SB (r = .19, P = .02) and MVPA (r = -.20, P = .01) levels were significantly correlated with parental hypoglycemia worry scores but not with parents' hypoglycemia behavior scores (P = .15 and P = .92, respectively). While multilevel models did not show an association between MVPA and preschoolers' glycemic variability, preschoolers who engaged in more daily SB experienced higher glycemic variability (P = .04). Research exploring MVPA, SB, and parental hypoglycemia fear in preschoolers with type 1 diabetes could have important clinical implications because it may reveal modifiable treatment targets that can impact preschoolers' health and activity patterns.

Physical Behaviors and Their Association With Adiposity in Men and Women From a Low-Resourced African Setting.

We first explored the associations between physical behaviors and total and regional adiposity. Second, we examined how reallocating time in different physical behaviors was associated with total body fat mass in men and women from a low-income South African setting. This cross-sectional study included a sample of 692 participants (384 men and 308 women) aged 41-72 years. Physical behaviors were measured using integrated hip and thigh accelerometry to estimate total movement volume and time spent in sleeping, sitting/lying, standing, light physical activity, and moderate to vigorous physical activity (MVPA). Total body fat mass and regional adiposity were measured using dual-energy X-ray absorptiometry. The associations between total movement volume and measures of regional obesity were mediated by total body adiposity. In men, reallocating 30 minutes of sitting/lying to 30 minutes of MVPA was associated with 1.0% lower fat mass. In women, reallocation of 30 minutes of sitting/lying to MVPA and 30 minutes of standing to MVPA were associated with a 0.3% and 1.4% lower fat mass, respectively. Although the association between physical behaviors and fat mass differed between men and women, the overall public health message is similar; reallocating sedentary time to MVPA is associated with a reduction in fat mass in both men and women.

The longitudinal association between objectively-measured school-day physical activity and academic achievement in US elementary school students

BackgroundIt is recommended that school-aged children accrue 30 minutes of daily moderate-to-vigorous physical activity (MVPA) in school. Current literature is inconclusive about the long-term associations between school-based physical activity and academic achievement. In this study, we use a large sample and longitudinal design to rigorously evaluate whether school-day MVPA is associated with academic achievement.MethodsIn a diverse suburban public school district, 4936 Grade 4 students were recruited in 40 elementary schools. Students wore accelerometers to measure school-day MVPA for 15 days across three semesters. Academic performance data was collected across Grade 3 fall to Grade 5 spring, including teacher-assigned grades and standardized test scores. Multilevel modeling was conducted controlling for student demographics and school characteristics.ResultsCross-sectional analyses found small negative associations in Grade 4. Grade 4 full-year mean daily school-day MVPA had β = −-0.066, β = −-0.063, β = −-0.066, and β = −-0.058 associations (p < 0.001) with Grade 4 math, reading, spelling, and writing grades respectively, and Grade 4 full-year mean daily school-day MVPA had β = −-0.206 and β = −-0.283 (p < 0.001) associations with Grade 4 math and English Language Arts (ELA) standardized test scores respectively out of approximately 500 points. Longitudinal analyses found no significant associations between Grade 4 full-year mean daily school-day MVPA and Grade 5 Fall course grades. Results also indicated small negative associations for students attaining 30+ minutes of daily school-day MVPA compared to those attaining less than 15 minutes, but only in Grade 4 Fall cross-sectional analyses where teacher-assigned reading, spelling, and writing grades were − 1.666, − 1.638, and − 1.993 points lower respectively (p < 0.001).ConclusionThe cross-sectional findings, while statistically significant in a negative direction, have a negligible association when translated practically. For example, even if students attained twice the recommended amount of school-day MVPA – which would constitute an approximately 300% increase from current levels – results suggest that grades would only decrease by 2 points on a 100-point scale. Furthermore, longitudinal analyses suggest school-day MVPA does not have a predictive association with course grades or standardized test scores. Findings suggest school-based MVPA implemented in accordance with recommendations does not meaningfully detract from academic progress.Trial registrationClinicalTrials.gov, NCT03765047. Registered 05 December 2018 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03765047

School’s outdoor area as an educational and health-promoting resource for young teenagers

Regular physical activity (PA) is positive for the health of young people, but previous research has indicated that the proportion of the population attaining recommended levels of activity decreases with age. Several studies indicate that the PA pupils get during school hours represents an important part of their total PA. The purpose of this study was to examine the relation between the size of the school’s total outdoor area and pupils’ PA behavior during schooltime. ActiGraph GT1M accelerometers were used to measure objectively 12–13-year-old schoolchildren’s minutes of moderate-to-vigorous PA (MVPA) during schooltime. The pupils (n = 300, 155 girls and 145 boys) came from 18 primary schools in two medium-sized municipalities in mid-Norway. Linear regression analysis was used to examine the relationship between the schools’ total outdoor area and outdoor area per pupil in relation to pupils’ weekly minutes of MVPA during schooltime. The results show no association with either the schools’ total outdoor area or the outdoor area per pupil, and the pupils’ weekly minutes of MVPA during schooltime. This finding indicates that there are probably factors in the school environment affecting young people’s level of activity during schooltime, other than the size of the schools’ outdoor area.

Health effects and cost-effectiveness of a multilevel physical activity intervention in low-income older adults; results from the PEP4PA cluster randomized controlled trial

BackgroundOlder adults are the least active population in the U.S. Low-income communities have fewer physical activity (PA) resources, contributing to less PA and increased chronic disease risk. This study assessed the effect of the multilevel, peer-led, Peer Empowerment Program 4 Physical Activity (PEP4PA) on moderate-to-vigorous PA (MVPA) and health outcomes, over 2 years of follow up.MethodsIn a cluster-randomized controlled trial, 12 senior or community centers serving low-income older adults were assigned to a PA intervention (n = 6) or usual programming (n = 6) condition. PEP4PA included self-monitoring, health coaching, group walks, social support, and community advocacy to improve walking conditions. The primary outcome was daily minutes of MVPA (7-day accelerometer). Secondary outcomes included Perceived Quality of Life (PQoL), 6-Minute Walk Test (6-MWT), blood pressure (BP), and depressive symptoms at baseline, 6, 12, 18 and 24 months. Mixed effects regression models estimated the effects on outcomes between groups over time and included random effects for repeated measures and center clustering. Effect modification by sex and income status was assessed. We calculated the incremental cost per daily minute of MVPA gained in the intervention group relative to the control group to assess cost effectiveness.ResultsWe enrolled 476 older adults (50 + years). Participants were on average 71 years old, 76% female, 60% low income, and 38% identified as racial or ethnic minorities. Compared to the control group, intervention participants sustained roughly a 10 min/day increase in MVPA from baseline at all time points and increased mean PQoL scores from unsatisfied at baseline to satisfied at 12, 18 and 24 months. Males and higher-income groups had greater improvements in MVPA. No significant effects were observed for 6-MWT or depressive symptoms, and BP results were mixed. The incremental cost per minute MVPA gained per person was $0.25, $0.09, $0.06, and $0.05 at 6, 12, 18 and 24 months, respectively.ConclusionsPEP4PA achieved increases in MVPA and PQoL in low-income older adults, over 2 years of follow up. The peer-led, community-based intervention provides a sustainable and cost-effective model to improve health behaviors in underserved, aging populations.Trial registrationClinicalTrials.gov (NCT02405325) March 20, 2015.

Abstract CT509: Cook and Move for Your Life: A pilot study of an online intervention to improve diet and physical activity among breast cancer survivors

Abstract Purpose: The Cook &amp; Move for Your Life randomized pilot study assessed the feasibility and relative efficacy of two dose levels of a remotely-delivered diet and physical activity (PA) intervention for breast cancer (BC) survivors. Methods: Women with a history of stage 0-III BC who were &amp;gt;60 days post-treatment, ate &amp;lt;5 servings per day of fruits/vegetables or engaged in &amp;lt;150 minutes per week of moderate to vigorous physical activity (MVPA), and had smartphone or computer access were enrolled. Participants were randomized to receive one of two doses of an online diet and PA didactic and experiential program, with outcomes measured at 6 months. The low-dose arm received a single 2-hour Zoom session delivered by a dietitian, a chef, a culinary educator, and an exercise physiologist; the high-dose arm received 12 2-hour Zoom sessions over 6 months. All participants received weekly motivational text messages, a Fitbit to self-monitor PA, and study website access. The primary objective was to evaluate overall feasibility based on accrual, adherence, and retention. Prespecified feasibility endpoints were 75% retention at 6 months and 60% of high-dose arm participants attending at least 8 of the 12 sessions. Secondary objectives were to compare high vs. low dose intervention effects on 6-month changes in fruit/vegetable servings per day (24-hour dietary recall), MVPA minutes per week (accelerometry), and blood and stool biomarkers. Results: From December 2019 to January 2021, 74 women were accrued. On average, women were 57.9 years old, 4.8 years post-diagnosis, with body mass index of 29.1 kg/m2. Most were non-Hispanic white (89.2%), 51.4% were diagnosed at stage I, and 40.5% were on endocrine therapy. Questionnaire and biospecimen data collection at 6-months were completed for 93.2% and 83.8% of the sample, respectively. In the low-dose arm (n=36), 94.4% of participants attended the single class, while in the high-dose arm (n=38) 84.2% of participants attended at least 8 of the 12 sessions live or via video archived on the website (mean 9.4 sessions). On average over the 6-month intervention period, participants responded to 71.5% of the text messages, 73.0% wore their Fitbit device ≥50% of the time, and 77.0% accessed the study website. Mean vegetable intake increased by 1 serving per day among women in the high-dose arm and decreased slightly among women in the low-dose arm (P=0.03). Changes in fruit/vegetable intake and MVPA varied little by arm. Blood and stool biomarker analyses are ongoing. Conclusion: We successfully conducted a remotely-delivered diet and PA intervention for BC survivors with high accrual, adherence, and retention during the COVID-19 pandemic. Women in the high-dose arm increased vegetable intake relative to the low-dose arm. Future research will refine and test the intervention in a larger and more diverse study population. Citation Format: Heather Greenlee, Rachel Yung, Sofia Cobos, Eileen Rillamas-Sun, Hanjie Shen, Yuhan Huang, Sidney M. Donzella, Liza Schattenkerk, Kate Ueland, Matthew VanDoren, Samantha Myers, Theresa King, Margarita Santiago-Torres, Chongzhi Di, Neel Dey, Katherine A. Guthrie, Nancy E. Davidson. Cook and Move for Your Life: A pilot study of an online intervention to improve diet and physical activity among breast cancer survivors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr CT509.

Physical Activity in Fontan Patients Relates to Quality of Life and Sleep Quality.

Background and AimFontan patients tend to have reduced physical exercise capacity. This study investigates physical activity (PA) and its relationship to exercise capacity, heart rates, cardiac function, biomarkers, health-related quality of life (HRQoL), and sleep quality.MethodsCardiovascular magnetic resonance (CMR), exercise testing (CPET), 24 h-ECG, and blood samples were prospectively performed in 38 patients, age 13 (11–16) years. PA was assessed by accelerometer during 7 consecutive days. HRQoL was self-assessed with KIDSCREEN-27 and SF-36 according to patients' age; sleep quality with Pediatric Sleep Questionnaire (PSQ) and Pittsburgh Sleep Quality Index (PSQI).ResultsDaily moderate to vigorous physical activity (MVPA) was in median (IQR) 40 (28–57) mins; 7/38 (18%) patients reached the recommended 60 mins/day of MVPA. MVPA did not correlate with gender, age, single ventricle morphology, time from Fontan, heart rate, ventricular volumes, and ejection fraction at CMR, biomarkers, or CPET. Physical wellbeing (r = 0.33, p = 0.04), autonomy (r = 0.39, p = 0.03), and social support (r = 0.43, p = 0.009) assessed using the KIDSCREEN-27, and both physical (r = 0.57, p = 0.03) and mental (r = 0.54, p = 0.04) domains of the SF-36 questionnaire correlated with daily minutes of MVPA. PSQI global sleeping score (r = −0.7, p = 0.007), and PSQ scales for behavior (r = −0.36; p = 0.03) correlated with daily minutes of MVPA.ConclusionOnly 18% of the Fontan patients meet the recommendation for daily MVPA. Measures of exercise capacity, cardiac function or chronotropic competence are not correlated to daily physical activity. In contrast, HRQoL and sleep quality seem to be associated with regular physical activity.

A Theory-Informed, Personalized mHealth Intervention for Adolescents (Mobile App for Physical Activity): Development and Pilot Study.

BackgroundEvidence suggests that physical activity (PA) during childhood and adolescence is crucial as it usually results in adequate PA levels in adulthood. Given the ubiquitous use of smartphones by adolescents, these devices may offer feasible means to reach young populations and deliver interventions aiming to increase PA participation and decrease sedentary time. To date, very few studies have reported smartphone-based interventions promoting PA for adolescents. In addition, most available fitness apps do not include the latest evidence-based content.ObjectiveThis paper described the systematic development of a behavior change, theory-informed Mobile App for Physical Activity intervention with personalized prompts for adolescents aged 16 to 18 years. The within-subject trial results provided the first evidence of the general effectiveness of the intervention based on the outcomes step count, sedentary time, and moderate to vigorous PA (MVPA) minutes. The effectiveness of the intervention component personalized PA prompt was also assessed.MethodsA 4-week within-subject trial with 18 healthy adolescents aged 16 to 18 years was conducted (mean age 16.33, SD 0.57 years). After the baseline week, the participants used the Mobile App for Physical Activity intervention (Fitbit fitness tracker+app), which included a daily personalized PA prompt delivered via a pop-up notification. A paired 1-tailed t test was performed to assess the effectiveness of the intervention. Change-point analysis was performed to assess the effectiveness of a personalized PA prompt 30 and 60 minutes after prompt delivery.ResultsThe results showed that the intervention significantly reduced sedentary time in adolescents during the first week of the trial (t17=−1.79; P=.04; bootstrapped P=.02). This trend, although remaining positive, diminished over time. Our findings indicate that the intervention had no effect on metabolic equivalent of task–based MVPA minutes, although the descriptive increase may give reason for further investigation. Although the results suggested no overall change in heart rate–based MVPA minutes, the results from the change-point analyses suggest that the personalized PA prompts significantly increased heart rate per minute during the second week of the study (t16=1.84; P=.04; bootstrapped P=.04). There were no significant increases in participants’ overall step count; however, the personalized PA prompts resulted in a marginally significant increase in step counts per minute in the second week of the study (t17=1.35; P=.09; bootstrapped P=.05).ConclusionsThe results of the trial provide preliminary evidence of the benefit of the Mobile App for Physical Activity intervention for modest yet significant reductions in participants’ sedentary time and the beneficial role of personalized PA prompts. These results also provide further evidence of the benefits and relative efficacy of personalized activity suggestions for inclusion in smartphone-based PA interventions. This study provides an example of how to guide the development of smartphone-based mobile health PA interventions for adolescents.

Temporal stability of behavior, temporal cue-behavior associations, and physical activity habit strength among mothers with school-aged children

Objective: PA habits reflect stable, consistent patterns in behaviours that are performed automatically in response to temporal or contextual cues. Mothers face multiple demands and complex schedules related to parenting. This study examined how subject-level mean, variability, and slopes in device-measured moderate-to-vigorous physical activity (MVPA) over three different timescales were associated with mothers’ PA habits. Methods and Measures: Mothers (n = 125; Mage=41.4 years) completed six measurement periods across three years. Each measurement period consisted of seven days of accelerometry. MVPA minutes were processed across hours, days, and measurement periods. PA habits were assessed in the last measurement period. Results: Subject-level means of MVPA at all timescales were positively associated with stronger PA habits (βs = 0.42-0.48, ps<.01). Subject-level variability in day-level MVPA was positively associated with habits (β = 0.39, p=.01). Furthermore, mothers who engaged in higher mean day-level MVPA had a more positive association between subject-level variability in day-level MVPA and habit strength compared to mothers with lower mean day-level MVPA overall (β = 0.28, p=.04). Mothers who had steeper increases in MVPA across measurement periods (i.e. subject-level slope) reported stronger habits (β = 0.43; p = 0.03). Conclusion: Flexibly adjusting daily PA levels may be a necessary strategy to maintain habits in the face of parenting demands.

Measuring change in adolescent physical activity: Responsiveness of a single item.

Self-report measures are frequently used to assess change in physical activity (PA) levels. Given the limited data from adolescent populations, the primary objective of this study was to examine the responsiveness of a single item measure (SIM) of PA for adolescents to detect change in moderate-to-vigorous physical activity (MVPA) using accelerometer data as the reference measure. A secondary objective was to provide further data on the validity of the measure at one point in time. The validity of the SIM to determine the number of days ≥60 minutes of MVPA was based on data from 200 participants (62% female; age: 14.0 ± 1.6 years) and analysis of change was based on data from 177 participants (65% female; age: 14.0 ± 1.6 years). Validity of change in days ≥60 minutes of MVPA was examined through agreement in classification of change between the SIM and accelerometry as the reference measurement and Spearman’s correlation. Cohen’s d and standardised response means were used to assess the responsiveness to change of the measure. The responsiveness of the SIM and accelerometer data were comparable and modest (0.27–0.38). The correlation for change in number of days ≥60 minutes MVPA between the SIM and accelerometery was low (r = 0.11) and the accuracy of the SIM for detecting change, using accelerometry as the reference, was only marginally above chance (53%). Therefore, the adolescent version of the SIM is adequate for assessing PA at a single time point but not recommended for assessing change.

38-LB: Physical Activity and Glycemia among Young Adults with Type 1 Diabetes and Overweight or Obesity—Results from Advancing Care for Type 1 Diabetes and Obesity Network (ACT1ON)

The ACT1ON pilot study evaluated the feasibility of three dietary strategies to optimize weight and glycemic management among young adults with T1D and overweight or obesity. As a secondary measure, self-reported physical activity (PA) was collected at baseline, 3-, 6-, and 9-months from 68 young adults with T1D (age 25.5 ± 3.1 years, 72.1% female, HbA1c 7.9 ± 1.8%, BMI 30.4 (27.9 - 33.9)) . Using the Global Physical Activity Questionnaire (GPAQ, n=195) and Previous Day Physical Activity Recalls (PDPAR, n=123) , we estimated weekly minutes of moderate-to-vigorous physical activity (MVPA) . Following the COVID-19 outbreak, a subset of participants wore Garmin Vivosmart4® PA trackers for two weeks at each visit (44 measurements from 27 participants) . Mixed effects regression models assessed the relationship between weekly minutes of MVPA and HbA1c using each PA measure. Median weekly minutes of MVPA were 33% lower following the COVID-19 outbreak compared to pre-pandemic PA levels (p=0.02) per the GPAQ, but not PDPAR (-7.7%, p=0.34) . After adjusting for design, demographic, clinical, and dietary variables, a 1 standard deviation increase in weekly minutes of MVPA (GPAQ) was associated with an absolute increase of 0.27% HbA1c (p&amp;gt;0.001) . A small, statistically non-significant association was observed for PDPAR (β=0.13, p=0.19) ; however, we observed a borderline statistically significant association using the PA tracker data (β=0.231, p=0.08) , despite a smaller sample size (n=44) . These results suggest that among young adults with T1D and overweight and obesity, higher levels of PA may lead to challenges in achieving optimal glycemia. Future work is needed to determine how to best support young adults with T1D and overweight and obesity in attaining both their PA and glycemic management goals. Disclosure F. R. Muntis: None. R. E. Pratley: Other Relationship; Bayer AG, Corcept Therapeutics, Dexcom, Inc., Hanmi Pharm. Co., Ltd., Merck &amp; Co., Inc., Metavention, Novo Nordisk, Pfizer Inc., Poxel SA, Sanofi, Scohia Pharma Inc., Sun Pharmaceutical Industries Ltd. K. Corbin: None. E. J. Mayer-davis: None. D. P. Zaharieva: Research Support; Insulet Corporation, International Society for Pediatric and Adolescent Diabetes, Leona M. and Harry B. Helmsley Charitable Trust. D. Igudesman: None. A. Cristello: None. J. Thomas: None. N. Arrizon- ruiz: None. J. Hooper: None. A. Addala: None. J. Crandell: n/a. D. M. Maahs: Advisory Panel; Abbott Diabetes, Eli Lilly and Company, Medtronic, Novo Nordisk, Sanofi, Consultant; Aditx Therapeutics, Inc., Biospex. Funding National Institutes of Health (1DP3DK113358-01)

542-P: Determinants of Objectively Measured Physical Activity in Chinese Immigrants in the U.S. with Prior Gestational Diabetes

Background: Women with prior gestational diabetes (GD) have times the risk of developing type 2 diabetes (T2D) as women without prior GD. Chinese immigrants in the US are disproportionately affected by GD and T2D. Physical activity (PA) is a modifiable lifestyle strategy to reduce the risk of T2D. The aim of this study was to identify health beliefs, cultural, and psychosocial determinants of objectively-measured PA among Chinese immigrants in the US with prior GD. Methods: We conducted a cross-sectional study among 1Chinese immigrants with prior GD (6 months to 5 years postpartum) across the US, recruited primarily via WeChat. PA was measured by GT9X+ hip accelerometers for 7 consecutive days. Validated questionnaires in English and Chinese were used to assess health beliefs, cultural, and psychosocial characteristics. Descriptive, bivariate, and multiple regression analyses were performed to identify factors associated with PA levels. Results: The mean age of participants was 34.3±3.7 years, and mean body mass index was 21.7±2.6 kg/m2. Mean daily steps were 5912±2139. Only 28% met the PA guidelines of ≥150 minutes of moderate- to vigorous- physical activity (MVPA) per week. The duration of MVPA per week was 86 [IQR 39- 152] minutes. Participants had an average of 9.2±1.4 hours of sedentary time per day, which was about 64.7±7.8% of the total wear time. In the final adjusted model, participants who had higher acculturative stress [-0.25 (SE=0.14) , p=.006], were not living with parents [-0.21 (SE=0.22) , p=.020], had no knowledge of PA guidelines [-0.18 (SE=0.17) , p=.039], and had an annual household income of &amp;lt; $60K [-0.21 (SE=0.23) , p=.025] were had fewer MVPA minutes per week. Conclusion and implication: Strategies are needed to increase MVPA among this high-risk group, including decreasing acculturative stress and increasing knowledge of PA guidelines. The findings from this study will inform the development of culturally-sensitive interventions. Disclosure S.Huang: None. G.I.Ash: None. S.Nam: None. S.Jeon: None. E.Mcmahon: None. R.Whittemore: None. Funding Connecticut Nurses’ Foundation Scholarship Award

Skipping breakfast and excess weight among young people: the moderator role of moderate-to-vigorous physical activity

The present study aimed to test whether the daily minutes of moderate-to-vigorous physical activity (MVPA) engaged moderate the relationship between breakfast status and excess weight (i.e., overweight and/or obesity) in a Spanish sample of young people. A cross-sectional study involving a total sample of 2890 Spanish schoolchildren (46% girls) aged 6−17 years (M = 12.3 ± 2.6) was conducted. To determine the habit of having breakfast, a dichotomous item about breakfast status (yes/no) from the Mediterranean Diet Quality Index for children and teenagers (KIDMED) was used. Physical Activity Questionnaire for Older Children and the Physical Activity Questionnaire for Adolescents were fulfilled to offer an estimation of the minutes of MVPA that individuals had in the last seven days. Body mass index (BMI) was converted into z-scores and, therefore, excess weight status (i.e., overweight and/or obesity) was established according to World Health Organization criteria for sex and age. Skipping breakfast was positively related with BMI (z-score) and excess weight. Moderation analyses suggested that daily MVPA minutes moderated the association between skipping breakfast and BMI (boys: β = − 0.175; girls: β = − 0.073) or the excess weight (boys: OR = 1.10; CI 95%, 1.02 to 1.07; girls: OR = 1.14; CI 95%, 1.04 to 1.24), meaning that physical activity of sufficient intensity seems to reduce the effect of skipping breakfast on the body weight status of young people.Conclusion: Our results indicate that promotion of having breakfast should be accompanied by daily MVPA, as young participants who have breakfast and with higher daily MVPA seem to be more likely to have no excess weight.What is Known:• Some of the well-studied factors associated with childhood obesity have been skipping breakfast and insufficient physical activity.• Some studies have pointed out the association between having breakfast and both body mass index and physical activity level, in isolation.What is New:• Daily minutes of moderate-to-vigorous physical activity moderate the association between skipping breakfast and excess weight.• Breakfast promotion as a healthy eating habit should be accompanied by increases in moderate-to-vigorous physical activity, since participants who have breakfast and with higher moderate-to-vigorous physical activity seem to be more likely to have no excess weight.

Associations of neighborhood walkability with moderate to vigorous physical activity: an application of compositional data analysis comparing compositional and non-compositional approaches

BackgroundWe compared the relation between neighborhood features and moderate to vigorous physical activity (MVPA) using linear regression analysis and the more novel compositional data analysis (CoDA). Compositional data analysis allows us to take the time children allocate to different movement behaviours during a 24-hour time period into account.MethodologyData from youth participants (n = 409) in the QUALITY (QUebec Adipose and Lifestyle InvesTigation in Youth) cohort were included. Time spent in MVPA, light physical activity, sedentary behavior, and sleep (“24-hour movement behaviours”) was measured using accelerometers. Neighborhood data were collected using a geographic information system and through direct observation. In CoDA models, we used orthogonal logratio coordinates, which allows for the association of neighbourhood walkability with MVPA to be estimated with respect to the average composition of all other behaviours within a 24-hour time frame. In baseline linear regression models, MVPA was regressed cross-sectionally on neighborhood walkability. All models were stratified by sex, and controlled for BMI z-scores, pubertal development, seasonal variation, parental education, and neighbourhood safety.ResultsBased on CoDA, girls who lived in more walkable neighborhoods had 10% higher daily MVPA (95% CI: 2%, 19%), taking into account all other movement behaviours. Based on linear regression, girls who resided in more walkable neighborhoods engaged in 4.2 (95% confidence interval [CI]: 1.2, 6.6) more minutes of MVPA per day on average than girls residing in less walkable neighborhoods.ConclusionsUnlike with traditional linear models, all movement behaviours were included in a single model using CoDA, allowing for a more complete picture of the strength and direction of the association between neighbourhood Walkability and MVPA. Application of CoDA to investigate determinants of physical activity provides additional insight into potential mechanisms and the ways in which people allocate their time.