National Physical Activity Guidelines Research Articles

Disparities in adherence to physical activity guidelines among US adults: A population-based study.

The objective of this study was to determine adherence to national guidelines for aerobic and muscle-strengthening physical activity among United States (US) adults and identify factors associated with guideline nonadherence. The 2022 National Health Interview Survey data were analyzed to evaluate self-reported physical activity among 26,494 US adults. Adherence to national guidelines was defined as engaging in ≥150 minutes moderate-intensity or ≥75 minutes vigorous-intensity aerobic activity/week, and muscle-strengthening activity ≥2 days/week. A multivariable logistic regression model evaluated associations between 24 sociodemographic and health variables with nonadherence to physical activity guidelines. Shapley Additive Explanations were used to assess the relative importance of each factor in the model. The population-weighted analysis revealed that only 24.3% of US adults met both the aerobic and muscle-strengthening activity guidelines. The regression model identified 17 factors significantly associated with nonadherence. When evaluating the relative importance of these variables, older age, lower educational attainment, and lower household income emerged as the primary determinants of nonadherence. Guideline adherence was lowest among subgroups with multiple risk factors, with only 6.5% of older adults with lower income and education meeting the guidelines. In contrast, adherence was 42.7% in younger respondents with higher incomes and educational attainment. In conclusion, physical activity rates among US adults remain below public health targets, with significant disparities among sociodemographic groups. Expanded outreach efforts targeting higher-risk populations are urgently needed to address barriers, promote physical activity engagement, and achieve health equity.

Trends in Plant-Based Diets and the Associated Health Characteristics among Canadians.

In Canada, unhealthy dietary patterns comprise diets with poor nutrient density and are associated with chronic conditions. Plant-based diets have gained popularity due to their ability to provide a nutritionally adequate healthy diet. This study aims to compare sociodemographic, socioeconomic, and health characteristics, and diet quality between Canadian adults following plant-based and omnivore diets as well as assess the extent to which key nutrient intakes are of public health concern among Canadians following plant-based diets. The study used nationally representative nutritional data from the 2015 Canadian Community Health Survey and descriptive statistics were computed. The analysis determined that Canadians following strict plant-based diets (1% of total population) were significantly more likely to be an immigrant to Canada, less likely to meet national physical activity guidelines, and less likely to be overweight, compared to Canadians following omnivore diets. Compared to omnivore diets, plant-based diets were nutritionally superior according to the Nutrient-Rich Food index. Continued knowledge translation on what comprises healthy plant-based diets, public guidance on the intersection between diet and health, and the completion of prospective cohort studies are needed. To conclude, the research suggests well-planned plant-based diets, in comparison to omnivore diets, offer a nutrient-dense diet.

Exercise Therapy to Reduce Anxiety (ExTRA) in mid-life and later-life adults: study protocol

BackgroundAnxiety in mid-life and later-life is highly prevalent and causes significant distress and disability. There is increasing evidence supporting the potential effectiveness of exercise interventions for reducing clinically significant anxiety. Self-directed online interventions can be scalable and thus reach more people. AimsThe Exercise Therapy to Reduce Anxiety (ExTRA) project aims to assess the feasibility and acceptability of an 8-week web-based exercise intervention with the innovation of being self-directed, and facilitated by wearable activity monitors (WAMs) and tailored behaviour change strategies to reduce anxiety in mid-life and later-life adults with clinically significant anxiety. MethodsExTRA will recruit 20-30 community dwelling adults aged 40-79 years with clinically significant anxiety. The self-directed 8-week web-based exercise intervention includes information and strategies to support participants to meet Australian national physical activity guidelines. The intervention is adapted from previous face-to-face trials and includes strategies to support participants living with anxiety. Feasibility will be measured by screening and retention rates. Acceptability will be measured by website usage data, online outcome measure completion, and an evaluation questionnaire. Other outcome measures include anxiety measured by the Depression Anxiety Stress Scales, and physical activity measured by the Global Physical Activity Questionnaire and a WAM. ResultsFindings will demonstrate whether this intervention is feasible and acceptable, and provide preliminary efficacy data. ConclusionsThe findings of this pragmatic real-world study will be valuable in guiding development of future trials, including randomised controlled trials of scalable and accessible exercise interventions to reduce the distress, disability and cost of anxiety.

Impact of exercise on chemotherapy-induced peripheral neuropathy in survivors with post-treatment primary breast cancer.

Chemotherapy-induced peripheral neuropathy (CIPN) is a debilitating side effect of neurotoxic chemotherapy. Exercise activates neuromuscular function and may improve CIPN. We examined the association between exercise and CIPN symptoms in breast cancer survivors. In a retrospective cross-sectional study, we included patients completing a survey assessing exercise exposure and neuropathy symptoms in a tertiary cancer center survivorship clinic. We evaluated exercise duration and intensity using a standardized questionnaire quantified in metabolic equivalent tasks (MET-h/wk). We defined exercisers as patients meeting the National Physical Activity Guidelines' criteria. We used multivariable logistic regressions to examine the relationship between exercise and CIPN and if this differed as a function of chemotherapy regimen adjusting for age, gender, and race. We identified 5444 breast cancer survivors post-chemotherapy (median age 62years (interquartile range [IQR]: 55, 71); median 4.7years post-chemotherapy (IQR: 3.3, 7.6)) from 2017 to 2022. CIPN overall prevalence was 34% (95% confidence interval [CI]: 33%, 36%), 33% for non-taxane, and 37% for taxane-based chemotherapy. CIPN prevalence was 28% (95% CI: 26%, 30%) among exercisers and 38% (95% CI: 37%, 40%) among non-exercisers (difference 11%; 95% CI: 8%, 13%; p < 0.001). Compared to patients with low (<6 MET-h/wk) levels of exercise (42%), 11% fewer patients with moderate (6-20.24 MET-h/wk) to high (>20.25 MET-h/wk) levels of exercise reported CIPN. Exercise was associated with reduced prevalence of all CIPN symptoms regardless of chemotherapy type. CIPN may persist several years following chemotherapy among patients with breast cancer but is significantly reduced by exercise in a dose-dependent manner.

Abstract PO4-12-09: National Physical Activity Guidelines and It’s Association with Fatigue in Patients with Breast Cancer Pre- and Post-Chemotherapy in a Prospective, Nationwide Study

Abstract Background: Cancer-related fatigue (CRF) is one of the most pervasive side effects of cancer and its treatment, reported by nearly 90% of patients. Physical activity (PA) during treatment may prevent or lessen CRF burden. Current aerobic PA guidelines for cancer patients recommend at least 150 minutes of moderate PA or 75 minutes of vigorous PA or some equivalent combination of moderate and vigorous PA (MVPA). Many patients have difficulty meeting these guidelines during treatment, however, meeting these guidelines may not be necessary to alleviate CRF. This study evaluated patterns of PA below the recommended guidelines and their association with CRF in cancer patients during treatment. Methods: In a nationwide, prospective cohort study of patients with stage I-IIIC breast cancer (n=580) we assessed the relationship between self-reported PA (Aerobics Center Longitudinal Study PA) and CRF (Multidimensional Fatigue Symptom Inventory, MFSI) pre- and post-chemotherapy. Spearman correlations were utilized to evaluate the association of all PA (MET hr/wk) and MVPA (MET hr/wk) with overall CRF (total MFSI) and 5 CRF subdimensions (general, physical, emotional, mental CRF and vigor) at pre- and post-chemotherapy. ANCOVA estimated mean CRF score according to whether patients weekly MVPA (1) met 100% of the PA guidelines, (2) met 50%-99% of the PA guidelines (75-149 minutes), or (3) did not meet 50% of the PA guidelines (&amp;lt; 75 minutes). Results: Pre-chemotherapy, only 34% of participants met the PA guidelines, post-chemotherapy, only 21% of patients met the PA guidelines. At both time points, we observed small to moderate inverse correlations of MVPA with overall CRF and several subdimensions of CRF (Table 1; r = -0.11, -0.19). Pre-chemotherapy, those who did not meet 50% of the PA guidelines report significantly higher total CRF compared to those who met the PA guidelines (12.5 ± 1.2 vs 5.3 ± 1.5; p&amp;lt; 0.001). However, those who met only 50%-99% of the PA guidelines, had comparable total CRF to those who fully met the PA guidelines (7.2 ± 2.2; p=0.474). A similar pattern was observed for the subdimensions general, mental, and physical CRF. Those who met 50% of the guidelines also had significantly lower vigor compared to those who met the guidelines (11.9 ± 0.3 vs 13.8 ± 0.4; p&amp;lt; 0.001), while those who met 50%-99% of the guidelines had comparable vigor to those who fully met guidelines (13.1 ± 0.6; p=0.278). Post-chemotherapy CRF was higher among all patient’s, again there was no significant difference in total, general, physical CRF and vigor between those who met the PA guidelines and those who met 50%-99% of the PA guidelines. Conclusions: All PA was consistently inversely associated with CRF pre- and post-chemotherapy for patients with breast cancer. Current minimum aerobic PA guidelines for patients with cancer are difficult to achieve during treatment. Lower doses of MVPA than the current PA guidelines suggest may provide equal benefit and represent a more achievable goal for patients with cancer. Table 1: Spearman correlations of CRF and physical activity in patients with breast cancer pre- and post-chemotherapy. Table 2: ANCOVA; Mean CRF score according to the PA guidelines. Citation Format: Lindsey Mattick, Hongying Sun, Karen Mustian, Luke Peppone, AnnaLynn Williams, Po-Ju Lin, Evelyn Arana, Jeremy McGuire, Amarinthia Curtis, Alison Conlin, Lora Weiselberg, Michelle Janelsins. National Physical Activity Guidelines and It’s Association with Fatigue in Patients with Breast Cancer Pre- and Post-Chemotherapy in a Prospective, Nationwide Study [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 PO4-12-09.

Influence of parental nativity and perceived neighborhood environment on physical activity and screen time of United States youth

ObjectiveThis study assessed how parental nativity and perceived environment are associated with physical activity and screen time of U.S. children and adolescents. MethodsData originated from the 2020–21 U.S. National Survey of Children's Health. We conducted multivariable Poisson regression to assess the cross-sectional association of parental nativity and perceived neighborhood environment variables on parental reports of youth meeting national physical activity and screen time guidelines. We tested interactions of parental nativity and neighborhood environment variables on both outcomes. Analyses were conducted using STATA v17 and p < 0.05 indicated statistical significance. ResultsThe sample of 24,928 children and 30,951 adolescents was 11.6 years of age, on average, with approximately 39% under 200% of the federal poverty level. About one-third of the sample (27.5%) had foreign-born parents. In adjusted models, we found that compared to youth with U.S.-born parents, those with foreign-born parents had a lower prevalence of meeting physical activity guidelines. Youth whose parents reported living in safe neighborhoods had a higher prevalence of meeting guidelines for physical activity (children: PR = 1.20, 95%CI 1.14, 1.27; adolescents: PR = 1.23, 95%CI 1.14, 1.32) and screen time (children: PR = 1.19, 95%CI 1.13, 1.26; adolescents: PR = 1.16, 95%CI 1.06, 1.28) than youth whose parents reported unsafe neighborhoods. We found similar associations between neighborhoods considered supportive or with many amenities and meeting physical activity and screen time guidelines. ConclusionsYouth whose parents are foreign-born have a lower prevalence of sufficient activity, and perceived parental neighborhood safety and support may be significant influences on youth physical activity and screen time.

A narrative review of global and national physical activity and sedentary behaviour guidelines development processes - The GUidelines Standards (GUS) project

BackgroundClinical and public health guidelines serve to direct clinical practice and policy, based on the best available evidence. The World Health Organization (WHO) and national health bodies of many countries have released physical activity and sedentary behaviour guidelines. Despite significant overlap in the body of evidence reviewed, the guidelines differ across jurisdictions. This study aimed to review the processes used to develop global and national physical activity and sedentary behaviour guidelines and examine the extent to which they conform with a recommended methodological standard for the development of guidelines. MethodsWe extracted data on nine sets of guidelines from seven jurisdictions (WHO, Australia, Canada, Japan, the Netherlands, United Kingdom, and United States). We rated each set of guidelines as high, medium, or low quality on criteria related to the rigour of the development process. ResultsWe observed variation in the quality of guidelines development processes across jurisdictions and across different criteria. Guidelines received the strongest overall ratings for criteria on clearly describing the evidence selected and stating an explicit link between the recommendations and the supporting evidence. Guidelines received the weakest overall ratings for criteria related to clearly describing the methods used to formulate the recommendations and reporting external review by experts prior to publication. Evaluated against the selected criteria, the strongest processes were undertaken by the WHO and Canada. ConclusionsReaching agreement on acceptable guideline development processes, as well as the inclusion and appraisal procedures of different types of evidence, would help to strengthen and align future guidelines.

Pasos Hacia La Salud II: A Superiority RCT Utilizing Technology to Promote Physical Activity in Latinas

IntroductionLatinas face increased risk for chronic diseases associated with insufficient physical activity (PA). The researchers previously showed that a website-based intervention could increase PA among insufficiently active Latinas, yet rates of meeting national PA guidelines were low. The original intervention was enhanced by adding additional features, content, and points of contact, including via text messaging. This study tests the efficacy of the enhanced intervention compared with the original, aimed at maximizing and sustaining PA gains across 24 months. It also examines if increases in PA differed by baseline PA. Study designThe researchers conducted a superiority randomized controlled trial (data collected 2018-2022, analyzed 2023). Setting/participantsParticipants were 195 Spanish-speaking Latinas ages 18-65 in the Providence, RI area. InterventionThe original intervention is an empirically supported Spanish-language, individually-tailored, website-delivered PA intervention. The enhanced intervention includes text messaging and additional data-driven content and interactive features. Main outcome measuresTotal weekly minutes of moderate to vigorous PA (MVPA) was measured via accelerometry and self-report at 6, 12, 18, and 24 months. ResultsParticipants in both groups increased their MVPA over 24 months. There were no significant between-group differences at 6 or 12 months; at 18 months the enhanced intervention group had higher levels of self-reported (mean (sd): 90.35 (43.55) vs. 70.18 (9.99)) and accelerometer-measured (66.21 (18.26) vs. 60.27 (16.00)) MVPA compared to the original intervention group. They also had higher levels of self-reported (111.17 (23.35) vs. 81.44 (1.82)) and accelerometer-measured (63.76 (15.12) vs. 54.86 (14.59)) MVPA at 24 months. Baseline PA moderated the intervention effect. ConclusionsThis study demonstrates the potential to enhance the efficacy of website-based PA interventions by utilizing text messaging, and adding more interactive features, content, and phone support. These enhancements may be particularly beneficial in supporting long-term PA maintenance. Trial registrationThis study is registered at www.clinicaltrial.gov (NCT03491592).

Effect of Intrapersonal and Interpersonal Behavior Change Strategies on Physical Activity Among Older Adults

Despite guidelines that recommend physical activity (PA), little is known about which types of behavior change strategies (BCSs) effectively promote sustained increases in PA in older adults who are insufficiently active. To determine whether intrapersonal BCSs (eg, goal setting) or interpersonal BCSs (eg, peer-to-peer sharing or learning) combined with the Otago Exercise Program (17 strength and balance exercises and a walking program that are learned and individually tailored, with instruction to perform 3 times per week at home or location of choice) and a wearable PA monitor help older adults sustain increases in their PA. This 2 × 2 factorial randomized clinical trial (Community-Based Intervention Effects on Older Adults' Physical Activity) of community-dwelling older adults 70 years or older with PA levels below minimum national PA guidelines was conducted in urban community centers. Dates of enrollment were from November 17, 2017, to June 15, 2021, with final follow-up assessments completed on September 2, 2022. Participants were randomized to intrapersonal (eg, goal setting) BCSs, interpersonal (eg, problem-solving with peer-to-peer sharing and learning) BCSs, intrapersonal and interpersonal BCSs, or an attention control group. All interventions included a PA monitor and 8 weekly small-group meetings with discussion, practice, and instructions to implement the exercise program and relevant BCSs independently between meetings and after the intervention. The primary outcome was daily minutes of objectively measured total PA (light, moderate, or vigorous intensities) averaged over 7 to 10 days, measured at baseline and after the intervention at 1 week, 6 months, and 12 months. Among 309 participants (mean [SD] age, 77.4 [5.0] years; 240 women [77.7%]), 305 (98.7%) completed the intervention, and 302 (97.7%) had complete data. Participants receiving PA interventions with interpersonal BCS components exhibited greater increases in total PA than did those who did not at 1 week (204 vs 177 PA minutes per day; adjusted difference, 27.1 [95% CI, 17.2-37.0]; P < .001), 6 months (195 vs 175 PA minutes per day; adjusted difference, 20.8 [95% CI, 10.0-31.6]; P < .001), and 12 months (195 vs 168 PA minutes per day; adjusted difference, 27.5 [95% CI, 16.2-38.8]; P < .001) after the intervention. Compared with participants who did not receive interventions with intrapersonal BCS components, participants who received intrapersonal BCSs exhibited no significant changes in total PA at 1 week (192 vs 190 PA minutes per day; adjusted difference, 1.8 [95% CI, -8.6 to 12.2]; P = .73), 6 months (183 vs 187 PA minutes per day; adjusted difference, -3.9 [95% CI, -15.0 to 7.1]; P = .49), or 12 months (177 vs 186 PA minutes per day; adjusted difference, -8.8 [95% CI, -20.5 to 2.9]; P = .14) after the intervention. Interactions between intrapersonal and interpersonal BCSs were not significant. In this randomized clinical trial, older adults with low levels of PA who received interpersonal BCSs, the exercise program, and a PA monitor exhibited significant increases in their PA for up to 12 months after the intervention. Intrapersonal BCSs elicited no significant PA changes and did not interact with interpersonal BCSs. Our findings suggest that because effects of a PA intervention on sustained increases in older adults' PA were augmented with interpersonal but not intrapersonal BCSs, approaches to disseminating and implementing the intervention should be considered. ClinicalTrials.gov Identifier: NCT03326141.

Physical Activity Intervention for Urban Black Women With Asthma: Protocol for a Randomized Controlled Efficacy Study.

Black women experience a higher prevalence of poor asthma outcomes and physical inactivity than their White counterparts. Black women comprise a particularly vulnerable group of patients with asthma, with some of the highest rates of asthma in adults, high health care use (emergency department visits and hospitalizations), and the highest crude asthma mortality rate of all race or ethnicity groups. Despite recommendations to engage in regular physical activity, fewer than 15% of Black women meet the 2008 National Physical Activity Guidelines, the lowest of all racial subgroups of adults. Given the connection between physical inactivity and poor asthma outcomes, addressing physical activity among Black women with asthma is imperative. This 2-arm randomized controlled trial aims to (1) determine the efficacy of a lifestyle walking intervention on asthma control compared to an education (control) group over 24 weeks, (2) examine the maintenance effects of the lifestyle walking intervention on asthma control at 48 weeks, (3) explore the behavioral mediators (eg, self-efficacy, social support, self-regulation, and daily physical activity levels) and contextual moderators (eg, baseline asthma severity, neighborhood environment, comorbid conditions, and social determinants of health) that contribute to treatment responsiveness, and (4) assess the reach and implementation potential of the intervention. The proposed study (ACTION [A Lifestyle Physical Activity Intervention for Minority Women with Asthma]) delivers a 24-week lifestyle walking intervention designed for and by urban Black women with asthma. Participants (n=224) will be recruited through 2 urban health care systems that care for a diverse Black population. Patients will be randomized to one of two groups: (1) ACTION intervention (group sessions, physical activity self-monitoring-Fitbit, and text-based support for step goal setting) or (2) education control (an individual asthma education session and SMS text messages related to asthma education). Outcome assessments will take place at baseline, 12, 24, and 48 weeks. The primary outcome is a change in asthma control from baseline to week 24 as assessed by the asthma control questionnaire-6 (ACQ-6). Secondary outcomes include asthma-related quality of life, health care use, and asthma exacerbations and behavioral outcomes such as self-efficacy, self-regulation, social support, and physical activity. This study was funded by the National Institute of Minority Health Disparities in August 2022. We pilot-tested our recruitment and intervention procedures and began recruitment in April 2023, with the enrollment of our first participant in May 2023. The anticipated completion of the study is April 2027. This study will deliver a new approach to physical activity interventions in Black women with asthma and help to provide guidance for addressing physical activity within this subgroup. This study will also provide a potential framework for future studies in minoritized populations with other disease conditions associated with low levels of physical activity. ClinicalTrials.gov NCT05726487; https://clinicaltrials.gov/study/NCT05726487. DERR1-10.2196/55700.

Perceived barriers and facilitators of childcare providers’ physical activity: A mixed-methods study

Background: Childcare providers’ work demands have been associated with high rates of stress and health conditions. Physical activity (PA) may help to alleviate some of these issues, yet few studies have explored this topic. The purpose of the study was to assess childcare providers’ PA levels and to explore their perceived barriers and facilitators to PA. Methods: This was a mixed-methods concurrent triangulation study with childcare providers ( n = 27) from both family childcare homes and childcare centres from urban ( n = 14) and rural ( n = 13) areas. Accelerometers and the Global Physical Activity Questionnaire (GPAQ) measured the amount of PA (leisure, transport-related, occupational), and a semi-structured interview explored barriers and facilitators to PA. Descriptive statistics were calculated for PA data. Qualitative data were analysed using thematic content analysis. Results: For accelerometer data, on average per day, childcare providers accumulated 199.5 ± 62.5 minutes of light activity, 125.9 ± 68.1 minutes of moderate to vigorous PA (MVPA) and 666.3 ± 23.7 minutes of sedentary time. For GPAQ data, childcare providers reported 114.5 ± 48.4 minutes/day of MVPA and 295.6 ± 141.4 minutes/day of sedentary time. Common barriers included time constraints and health issues, while common facilitators included knowledge of PA health benefits and family/peer support. Conclusion: The study suggests an estimated 92% of childcare providers met the US national PA guidelines of 150 minutes of MVPA per week. However, they exhibited prolonged periods of sedentary behaviour (~11 hours). Programmes and interventions could address barriers to PA such as providing short movement breaks to decrease sedentary time and improve childcare providers’ health.

The KID Study (Kids Interacting With Dogs): Piloting a Novel Approach for Measuring Dog-Facilitated Youth Physical Activity

Background: Two-thirds of children in the United States do not meet the National Physical Activity Guidelines, leaving a majority at higher risk for negative health outcomes. Novel, effective children’s physical activity (PA) interventions are urgently needed. Dog-facilitated PA (e.g., dog walking and active play) is a promising intervention target, as dogs support many of the known correlates of children’s PA. There is a need for accurate methods of quantifying dog-facilitated PA. Purpose: The study purpose was to determine the feasibility and acceptability of a novel method for quantifying the volume and intensity of dog-facilitated PA among dog-owning children. Methods: Children and their dog(s) wore ActiGraph accelerometers with a Bluetooth proximity feature for 7 days. Additionally, parents logged child PA with the family dog(s). Total minutes of dog-facilitated PA and percentage of overall daily moderate to vigorous PA performed with the dog were calculated. Results: Twelve children (mean age = 7.8 ± 2.9 years) participated. There was high feasibility, with 100% retention, valid device data (at least 4 days ≥6-hr wear time), and completion of daily parent log and questionnaire packets. On average, dog-facilitated PA contributed 22.9% (9.2 min) and 15.1% (7.3 min) of the overall daily moderate to vigorous PA for children according to Bluetooth proximity data and parent report, respectively. Conclusions: This pilot study demonstrated the feasibility of utilizing an accelerometer with a proximity feature to quantify dog-facilitated PA. Future research should use this protocol with a larger, more diverse sample to determine whether dog-facilitated PA contributes a clinically significant amount toward overall PA in dog-owning youth.

Wearable Activity Trackers That Motivate Women to Increase Physical Activity: Mixed Methods Study.

Physical inactivity is a significant public health concern, particularly among women in the United States. Wearable activity trackers (WATs) have been proposed as a potential solution to increase awareness of and engagement in physical activity (PA). However, to be effective, WATs must include features and designs that encourage daily use. This study aims to explore the features and designs of WATs that appeal to women and determine whether devices with these attributes are effective motivators for women to be physically active. A mixed methods study guided by the self-determination theory was conducted among 15 women. Participants trialed 3 WATs with influence in their respective accessory domains: Apple Watch for the wrist; Oura Ring for the finger; and Bellabeat Leaf Urban for multiple sites (it can be worn as a bracelet, necklace, or clip). Participants documented their daily PA levels and rated their satisfaction with each device's comfort, features, and motivational effect. Focus groups were also conducted to gather additional feedback and experiences within the a priori areas of comfort, features, and motivation. Behavioral Regulation in Exercise Questionnaire-2 scores indicated that most participants (14/15, 93%) were motivated at baseline (amotivation score: mean 0.13, SD 0.45), but on average, participants did not meet the national minimum PA guidelines according to the self-reported Physical Activity Vital Sign questionnaire (moderate to vigorous PA score: mean 144, SD 97.5 min/wk). Mean WAT wear time was 16.9 (SD 4.4) hours, 19.4 (SD 5.3) hours, and 20.4 (SD 4.7) hours for Apple Watch, Bellabeat Leaf Urban, and Oura Ring, respectively. During focus groups, participants reinforced their quantitative ratings and rankings of the WATs based on personal experiences. Participants shared a variety of both activity-related and non-activity-related features that they look for in a motivating device. When considering what the ideal WAT would be for a woman, participants suggested features of (1) comfort, (2) extended battery life, (3) durability, (4) immediate PA feedback, (5) intuitive PA sensing, and (6) programmability. This study is the first to specifically address women's experiences with and preferences for different types of WATs. Those who work with women should realize how they view WATs and the role they play in motivation to be active.

Children's physical activity and sedentary behaviour in before school care: An observational study

ObjectiveIn Australia, less than one quarter of children aged 5–12 years meet national physical activity (PA) guidelines. Before school care operates as part of Out of School Hours Care (OSHC) services and provide opportunities for children to meet their daily PA recommendations. The aim of this study was to explore factors associated with children meeting 15 min of moderate-to-vigorous-intensity physical activity (MVPA) while attending before school care. MethodsA cross-sectional study was conducted in 25 services in New South Wales, Australia. Each service was visited twice between March and June 2021. Staff behaviours and PA type and context were captured using staff interviews and the validated System for Observing Staff Promotion of Physical Activity and Nutrition (SOSPAN) time sampling tool. Child PA data were collected using Actigraph accelerometers and associations between program practices and child MVPA analysed. ResultsPA data were analysed for 654 children who spent an average of 39.2% (±17.6) of their time sedentary; 45.4% (±11.4) in light PA; and 14.9% (±11.7) in MVPA. Only 17% of children (n = 112) reached ≥15 min MVPA, with boys more likely to achieve this. Children were more likely to meet this recommendation in services where staff promoted and engaged in PA; PA equipment was available; children were observed in child-led free play; and a written PA policy existed. ConclusionsBefore school care should be supported to improve physical activity promotion practices by offering staff professional development and guidance on PA policy development and implementation practices.

Comparison of national and international sedentary behaviour and physical activity guidelines for older adults: A systematic review and quality appraisal with AGREE II.

Most older adults 65 years and older accumulate over 8.5 hours/day of sedentary time, which is associated with increased risk of metabolic syndromes and falls. The impact of increased sedentary time in older adults has prompted development of sedentary behaviour guidelines. The purpose of our review was to compare national and international sedentary behaviour and physical activity guidelines for older adults and appraise the quality of guidelines using AGREE II. We conducted our search in Medline, Embase, Global Health, Web of Science, CINAHL, and relevant grey literature. We included the most recent guidelines for older adults written in English. We identified 18 national and international guidelines; ten of the 18 guidelines included sedentary behaviour recommendations while all 18 included physical activity recommendations for older adults. The ten sedentary behaviour guidelines were developed using cohort studies, knowledge users' opinions, systematic reviews, or other guidelines while the physical activity guidelines were developed using randomized controlled trials, systematic reviews, meta-analysis, and overview of reviews. The definition of sedentary behaviour and the recommendations were inconsistent between the guidelines and were based on very low to low quality and certainty of evidence. All guidelines provided consistent recommendations for aerobic and resistance training; the recommendations were developed using moderate to high quality and certainty of evidence. Only eight physical activity guidelines provided recommendations for balance training and six on flexibility training; the balance training recommendations were consistent between guidelines and based on moderate quality evidence. Further work is needed to develop evidenced-based sedentary behaviour recommendations and flexibility training recommendations for older adults.

Leveraging Recess and Physical Education to Promote Social–Emotional Learning

Recess is ideal for students to accumulate recommended physical activity minutes and work on social-emotional learning skills. However, many students fail to meet national physical activity guidelines, and recess is often withheld from students for a myriad of reasons, including behavioral issues. Helping students build social-emotional skills and providing opportunities to utilize skills at school can help them succeed in school and their future careers. Furthermore, teaching students low organized, student-initiated games provides students with activities they can use at recess, which may keep them more physically active. Thus, the purpose of this article is to share how one physical educator implemented a recess unit into physical education to (a) work on students’ social-emotional learning skills, particularly those needed in gameplay, (b) introduce games that can be played at recess, and (c) how to evaluate recess before and after a recess unit. The article will share games, social-emotional skill-building activities, and evaluation tools. As a physical educator, you can build social-emotional skills and teach recess games with physical education. These efforts can potentially improve the school recess environment from a behavioral perspective and increase students’ physical activity time.

Promotion of physical activity among people who identify as women through the ParticipACTION mobile app

Objective Health and fitness mobile applications can increase users’ physical activity (PA) levels (Lister et al., 2014). ParticipACTION is a national non-profit organization that developed a mobile app to target PA among adults (Truelove et al., 2020). The aim of this research was to examine how women’s PA is related to their use of the ParticipACTION app. Methods and Measurement Using a mixed-methods design, participants (n = 3,493) completed a survey regarding their PA levels, motivation for PA (capability, opportunity, motivation; COM-B, Keyworth et al., 2020), and motivation for using the ParticipACTION app. Nine focus groups were conducted (n = 37) to discuss the mobile app further. Results Path analyses revealed that users’ app use was positively associated with motivations for various app functions (e.g. self-monitoring, seeking exercise guidance), however, only motivation in-turn predicted PA. Descriptive results indicated that many women in Canada who used the app do not meet national guidelines for PA per week. Qualitative findings highlight women’s motivation for using the app, concerns with app functionality, and feelings of guilt for not engaging in PA. Conclusion The ParticipACTION app may have some benefit for improving women’s PA; intervention studies are needed to determine efficacy of mobile applications.

Intrinsic motivation for physical activity, healthy eating, and self-weighing in association with corresponding behaviors in early pregnancy

Healthy lifestyle behaviors influence maternal cardiovascular health, but motivation for them in pregnancy is poorly understood. We examined whether intrinsic motivation (assessed on 5-point scales for each behavior) is associated with three lifestyle behaviors in early pregnancy: physical activity, by intensity level; healthy eating, quantified with the Alternate Healthy Eating Index for Pregnancy (AHEI-P); and weight self-monitoring, a standard weight management technique. Participants in the Northern California Pregnancy, Lifestyle and Environment Study (PETALS) population-based cohort completed validated surveys in early pregnancy (2017–18; N = 472; 22 % Asian, 6 % Black, 30 % Hispanic, 13 % multiracial, 30 % White). Cross-sectional data were analyzed in 2021–22. Overall, 40.7 % (n = 192) met United States national physical activity guidelines; the average AHEI-P score was 62.3 out of 130 (SD 11.4); and 36.9 % reported regular self-weighing (≥once/week; n = 174). In models adjusted for participant characteristics, 1-unit increases in intrinsic motivation were associated with increased likelihood of meeting physical activity guidelines (risk ratio [95 % CI]: 1.66 [1.48, 1.86], p < 0.0001); meeting sample-specific 75th percentiles for vigorous physical activity (1.70 [1.44, 1.99], p < 0.0001) and AHEI-P (1.75 [1.33, 2.31], p < 0.0001); and regular self-weighing (2.13 [1.92, 2.37], p < 0.0001). A 1-unit increase in intrinsic motivation lowered the risk of meeting the 75th percentile for sedentary behavior (0.79 [0.67, 0.92], p < 0.003). Intrinsic motivation was not associated with reaching 75th percentiles for total, light, or moderate activity. Intrinsic motivation is associated with physical activity, healthy eating, and self-weighing among diverse individuals in early pregnancy. Results can inform intervention design to promote maternal health via increased enjoyment of lifestyle behaviors.

Occupational and leisure-time physical activity and associated factors among shift-working registered nurses: A cross-sectional study

BackgroundLifestyle behaviors, including physical activity, may help to mitigate the chronic disease and mental health consequences of shift work in nurses at the individual level. The physical activity levels of shift-working nurses and factors that predict physical activity in this population are unclear. ObjectiveThe primary aim of this study was to describe work and leisure-time physical activity behaviors in shift-working hospital nurses and determine behavioral, biological, or work-related factors that influence physical activity. DesignObservational; cross-sectional. Setting(s)Acute care hospital system. ParticipantsCurrent registered nurses (N = 112) with a shift work schedule (rotating, mixed, or permanent night shift) MethodsOnline validated questionnaires were used to assess work and leisure physical activity levels (International Physical Activity Questionnaire); Theory of Planned Behavior constructs (attitudes, subjective norms, perceived behavioral control, and intention) related to physical activity; and morningness-eveningness. Work-related characteristics were also assessed. Structural equation models were examined for the Theory of Planned Behavior constructs. ResultsShift-working nurses reported 227 (±265) minutes/week of leisure-time and 566 (±868) minutes/week of occupational moderate-to-vigorous physical activity. Attitude (standardized coefficient = 0.63; p < 0.05) was the strongest predictor of physical activity intention, and intention (standardized coefficient = 0.40; p < 0.05) was a significant predictor of leisure-time physical activity behavior. There were no statistically significant differences in physical activity type and amount between those who identified as “morning”, “intermediate”, or “evening” types. Clinical nurse leaders engaged in statistically significantly less leisure-time physical activity than direct care nurses (703 ± 1142 vs. 1202 ± 1372 MET-minutes/week) (p = 0.013). ConclusionsOur findings suggest that on average, shift-working registered nurses report meeting national physical activity guidelines for leisure and occupational physical activity; however, there is considerable interindividual variability. Theory of Planned Behavior constructs, especially attitude and intention, were significantly associated with leisure-time physical activity but not occupational physical activity, emphasizing the importance of targeting them in interventions to increase physical activity levels among shift-working nurses.

The Connection Between Chronic Illness and Physical Activity

Chronic diseases have become a focal point of public health worldwide with estimates of trillions of dollars in annual health care cost and causing more than 36 million deaths a year. Lifestyle factors such as physical inactivity are heavily correlated with the development of many chronic diseases. New strategies for primary and secondary disease prevention are desperately needed to aid in blunting the negative economic and social impact of these diseases. Physical activity (PA) and exercise are now considered principal interventions for use in primary and secondary prevention of chronic diseases. Currently, more emphasis in primary prevention of disease is necessary to reduce disease risk in youth and adults; however with chronic disease prevalence so high, similar emphasis is also necessary for secondary prevention in those children and adults already inflicted with chronic diseases. Conditions such as cardiovascular disease, type 2 diabetes, obesity, and cancer are drastically improved when PA and exercise are part of a medical management plan. In addition, the national PA guidelines in conjunction with PA promotion tools like Exercise is Medicine™ are needed to promote increased PA and exercise levels worldwide