National Physical Activity Recommendations Research Articles

CSPAP Implementation During Student Teaching: Lessons Learned From the Field

In the United States, less than half of adolescents meet national recommendations for daily physical activity (PA). Schools are an integral intervention point for achievement of national PA youth guidelines. To help schools achieve PA guidelines, multicomponent Comprehensive School Physical Activity Programs (CSPAP) were developed. Each CSPAP component works synergistically to help students achieve 60 min of PA per school day. Physical educators are expected to implement CSPAP components in their schools, but little is known about the preservice physical education teacher (PPET) perception of CSPAP training experiences in teacher education. The purpose of this research study was to understand PPET perceptions of implementing a component of CSPAP at the elementary and secondary level during a student teaching course. Undergraduate (n = 5) and graduate (n = 4) physical education majors enrolled in a semester of student teaching were recruited. Data collection encompassed individual semistructured interviews at three distinct phases (N = 25): (a) pre–student teaching, (b) between student teaching school placements, and (c) post–student teaching. Data coding first revealed codes, then categories, and eventually four themes emerged, each with its own subthemes: (a) preparedness, (b) perceived challenges, (c) implementation, and (d) moving forward. Findings indicate PPETs developed confidence, achieved personal growth and self-actualization, perceived career benefit, and gained a desire for implementing CSPAP in the future. Additionally, implementing CSPAP components during student teaching can increase confidence and desire to implement CSPAP in the future. Further research needs to explore if CSPAP experiences during preservice training influence in-service teachers’ CSPAP involvement.

Reported barriers to physical activity and the role of built environment among overweight and obese youth attending a Canadian pediatric weight management clinic

ObjectiveTo assess activity levels and role of the built environment among overweight and obese youth referred to a pediatric weight management clinic. DesignA cross-sectional study using a caregiver-administered survey was completed from October 2017 to February 2018. ResultsThe study analyzed 210 surveys. Participants were 52 % male and average age was 11.6 years (3–18 years). Of those surveyed, 73 % of respondents reported ≥ 2 h of average daily screen time in the past 3 months, and 74 % of children partook in < 60 min of daily physical activity of any intensity. The most common location for physical activity was a recreational facility. The least common was nearby green spaces. Moreover, 77 % of caregivers felt that their child did not engage in enough physical activity, and the most common cited barrier was motivation. The built environment, however, was not cited as a barrier to active living as 90 % of caregivers reported their community was safe, and greater than 80 % of caregivers agreed their community was aesthetically beautiful, well connected with good infrastructure. The majority of commonly used spaces were located within 2 km of their home, however, it was uncommon for children to walk or bike to them. ConclusionOverweight and obese children referred to our clinic are not meeting national recommendations for physical activity and screen time. The built environment does not appear to be a large contributing factor to decreased physical activity in this population and the most common reason cited for lack of physical activity was motivation.

A mixed-methods approach to understanding barriers and facilitators to healthy eating and exercise from five European countries: highlighting the roles of enjoyment, emotion and social engagement

Healthy adults are consistently falling below national and international recommendations for physical activity and dietary intake across Europe. This study took a co-creative approach with adult samples from five European countries to qualitatively and quantitatively establish motivators, barriers and sustaining factors for positive health behaviour change. Stage 1 delivered a newly-designed online programme, creating a community who identified challenges, motivators and solutions to sustaining positive healthy eating and physical activity behaviours. Stage 2 administered an online survey (developed from Stage 1 findings) to a larger sample to quantify the relative importance of these motivators and barriers. Results from both stages indicated enjoyment, positive emotions, and reward as key motivators for both behaviours across all five countries. Barriers included habit-breaking difficulties, temptation and negative affective states. Those with a high BMI placed more importance on social pressure than those with healthy BMI. Participants’ reports of motivators and barriers reflected relevant approaches from consumer science, behavioural economics, and psychology. Interventions supporting adults who are not chronically ill but would benefit from improved diet and/or physical activity should not focus exclusively on health as a motivating factor. Emphasis on enjoyable behaviours, social engagement and reward will likely improve engagement and sustained behaviour change.

Parental Information Needs and Intervention Preferences for Preventing Multiple Lifestyle Risk Behaviors Among Adolescents: Cross-sectional Survey Among Parents.

Parents play an influential role in the health behaviors of their children, such as physical activity, dietary intake, sleep, screen time, and substance use. However, further research is needed to inform the development of more effective and engaging parent-based interventions targeting adolescent risk behaviors. This study aimed to assess parents' knowledge about adolescent risk behaviors, barriers and facilitators to engaging in healthy behaviors, and preferences for a parent-based prevention intervention. An anonymous web-based survey was conducted from June 2022 to August 2022. Eligible participants were parents of children aged 11 to 18 years and were residing in Australia at the time of this study. The survey assessed the parents' perceived and actual knowledge about Australian health guidelines for youth, parent and adolescent engagement in health behaviors, parenting style and attitudes, barriers and facilitators to engaging in healthy behaviors, and delivery and component preferences for a parent-based preventive intervention. Descriptive statistics and logistic regressions were conducted to analyze the data. A total of 179 eligible participants completed the survey. The mean age of the parents was 42.22 (SD 7.03) years, and 63.1% (101/160) were female. Parent-reported sleep duration was high for both parents (mean 8.31, SD 1.00 hours) and adolescents (mean 9.18, SD 0.94 hours). However, the proportion of parents who reported that their child met the national recommendations for physical activity (5/149, 3.4%), vegetable intake (7/126, 5.6%), and weekend recreational screen time (7/130, 5.4%) was very low. Overall, parents' perceived knowledge of health guidelines was moderate, ranging from 50.6% (80/158) for screen time to 72.8% (115/158) for sleep guidelines (for children aged 5-13 years). Actual knowledge was lowest for vegetable intake and physical activity, with only 44.2% (46/104) and 42% (31/74) of parents reporting correct guidelines for these behaviors, respectively. The key issues of concern reported by parents were excessive use of technology, mental health, e-cigarette use, and negative peer relationships. The top-rated delivery method for a parent-based intervention was via a website (53/129, 41.1%). The highest rated intervention component was opportunities for goal-setting (89/126, 70.7% rated very or extremely important), and other important program features were ease of use (89/122, 72.9%), paced learning (79/126, 62.7%), and appropriate program length (74/126, 58.8%). The findings suggest that such interventions should be brief and web based and should aim to increase parental knowledge of health guidelines; provide opportunities for skill-building, such as goal-setting; and include effective behavior change techniques, such as motivational interviewing and social support. This study will inform the development of future parent-based preventive interventions to prevent multiple lifestyle risk behaviors among adolescents.

Content and Area Income Disparities in Recreation Center Website Promotion of Physical Activity

Physical activity (PA) is associated with numerous health benefits; however, both children and adults in the U.S. fall short of national PA recommendations. Diverse agencies have identified the importance of recreation professionals playing an ac-tive role in providing and promoting PA, including via recreation centers. Few studies have examined the contributions public recreation centers make in pro-viding residents with opportunities for PA, and those that exist offer mixed results concerning the influence of neighborhood family income levels.Recreation center websites are a popular, cost-efficient, and flexible me-dium for providing information about PA and center programs. We completed a line-by-line analysis of the content of the websites of all public recreation centers (N = 58) in the city of San Diego, California. We extracted the days and hours the centers operated as well as PA facil-ity types and programs they provided. Program details were identified, includ-ing content, frequency/duration for classes, participants targeted, and enrollment costs. Additionally, we generated information about local neighborhoods, includ-ing family median income levels. Diverse statistical analyses were conducted, overall, and by a median split for neighborhood income status. On average, centers had 4.5 PA facilities and were open 59 hours/week, with no differences by neighborhood income. Meanwhile, centers in higher-income areas provided significantly more programs (5.3 vs 2.3). Overall, 33 distinct facility types were identified, but only gymnasia and outdoor basketball courts were listed by over 50% of centers. Fifty distinct programs were identified, with dance, teen center, basketball, and volleyball mentioned most frequently.

P484 Inflammatory Bowel Disease exercise and diet habits (IBDeat) study: chronic metabolic disease risk factors among IBD patients in New Zealand

Abstract Background Recent literature shows that patients with inflammatory bowel disease (IBD) are at higher risk of developing chronic metabolic diseases which may be amenable to a healthy lifestyle. However, this may be challenging for IBD patients as disease symptoms may result in unfavourable lifestyle habits such as avoidance of healthy foods and reduced physical activity. In this study, we aim to describe the nutritional status and lifestyle habits of adults with IBD in New Zealand (NZ). Methods A cross-sectional nationwide study was undertaken from December 2021 to October 2022 in NZ. Participants were recruited through social media and the Dunedin public hospital patient database. An online questionnaire collected demographics, disease severity scores (harvey-bradshaw index and simple clinical colitis activity index), quality of life (QoL), physical activity, and dietary intake data. A subset of patients living in Dunedin had anthropometrics, handgrip strength, blood pressure, body composition (bioelectrical impedance), blood nutritional markers (lipid profile, iron studies, vitamin D, vitamin B12, folate) and faecal calprotectin measured. Descriptive analysis was conducted and data were compared to population reference values. The study received University of Otago, Dunedin, NZ ethical approval (reference: H21/135). Results The questionnaire was completed by 197 adults, median age 37 (IQR 25, 51) of which 72% were female and predominantly NZ European ethnicity (82.4%). In this IBD cohort, 54% had Crohn’s disease and 46% had ulcerative colitis or IBD-unspecified with quiescent-mild disease activity. Two-thirds of patients had at least one comorbidity aside from IBD and one-third of patients had impaired QoL (defined by a score &amp;lt;45). Most patients had nutritional risk factors including low intakes of fruits (91.3%), vegetables (94.4%), fibre (38.3%), and excessive intakes of fat (73.2%) and saturated fat (98.0%). Two-thirds of patients reported IBD-related barriers to exercise mainly due to fatigue (53.9%), abdominal pain (25.7%), bowel incontinence (23.3%), and joint pain (22.3%) in which only 59.7% met national physical activity recommendations. The Dunedin cohort (n=102) had further chronic metabolic disease risk factors such as central adiposity (63.7%), high body fat percentage (43.9%), high cholesterol/HDL ratio (29.3%), high blood pressure (26.5%), and poor handgrip strength (43.9%). Conclusion Findings suggest that NZ adults with IBD have multiple risk factors for chronic metabolic diseases that could be amendable to lifestyle interventions. Future studies should explore the feasibility and efficacy of nutrition and exercise lifestyle interventions to mitigate these risk factors.

PHYSICAL ACTIVITY, COGNITIVE HEALTH, AND LONGEVITY IN OLDER ADULTHOOD

Abstract Research suggests that physical activity (PA) protects against cognitive impairment in older adulthood; however, the extent to which PA engagement throughout older adulthood influences the simultaneous risk of transitioning to cognitively impaired states and death is unclear. Applying coordinated data analysis across 14 studies, multi-state survival models (MSM) were independently fit to data from fourteen longitudinal studies (NTotal=52,039). PA was synthesized across studies using the metabolic equivalent of task approach. Adjusting for demographics and chronic conditions, meta-analytic results indicated that engaging in more PA was associated with a reduced risk of transitioning from no cognitive impairment to mildly impaired cognitive functioning (HR=0.94, 95%CI’s=0.89,0.99) and death (HR=0.72, 95%CI’s=0.65,0.80). Based on MSM estimates, multinomial regression models computed total life expectancy stratified by national PA recommendations. Meta-analytic results indicate a positive linear effect of PA, such that more PA is associated with longevity. This presentation will include discussion of knowledge translation efforts.

Health literacy and its association with health outcomes among students in upper secondary education

Abstract Background Health literacy (HL) - as a broad range of health-related competencies and skills- has been recognized as a determinant of health outcomes, and suggested to be a modifiable health resource and a factor contributing to empowerment and equity. Thus, there is a need to identify the state of HL in various population groups. The aim of this study was to investigate HL levels and associations between HL, physical activity and subjective health among students in general upper secondary and vocational Swedish-language schools in Finland. Methods The study used cross-sectional data from the Finnish LIITU-study among students in Swedish-speaking general upper secondary and vocational schools (N = 887; age 16-20 years) conducted in the spring and autumn 2020, during the covid-19-pandemic. Students answered a web-based questionnaire during school hours. HL was measured with the 10-item Health Literacy for School-Aged Children (HLSAC) instrument. Data was analyzed with descriptive statistics and logistic regression analyses. Results According to preliminary findings, one third of students had high HL. HL was higher among female than male students, general upper secondary school students than vocational school students, and in spring than in autumn 2020. A higher proportion of students with high HL, as compared to students with low/medium HL, reached the national recommendations for physical activity, perceived their health to be excellent and, moreover, did not have recurrent psychological symptoms. Conclusions The findings confirm previous research findings on the importance of HL in promoting health outcomes. The pandemic year 2020 provided a unique perspective to the subject. It would be important to survey and discuss the role of schools in providing equal opportunities for the promotion of HL as this may contribute to decreasing health disparities in the population. Key messages • One third of students in upper secondary education (age 16-20 years) had high HL; there were differences between genders, students on different educational paths, and in spring and autumn 2020. • High HL was associated with better self-rated health, less psychological symptoms and reaching national recommendations for physical activity among students in upper secondary education.

Interactivity, Quality, and Content of Websites Promoting Health Behaviors During Infancy: 6-Year Update of the Systematic Assessment.

BackgroundAs of 2021, 89% of the Australian population are active internet users. Although the internet is widely used, there are concerns about the quality, accuracy, and credibility of health-related websites. A 2015 systematic assessment of infant feeding websites and apps available in Australia found that 61% of websites were of poor quality and readability, with minimal coverage of infant feeding topics and lack of author credibility.ObjectiveWe aimed to systematically assess the quality, interactivity, readability, and comprehensibility of information targeting infant health behaviors on websites globally and provide an update of the 2015 systematic assessment.MethodsKeywords related to infant milk feeding behaviors, solid feeding behaviors, active play, screen time, and sleep were used to identify websites targeting infant health behaviors on the Google search engine on Safari. The websites were assessed by a subset of the authors using predetermined criteria between July 2021 and February 2022 and assessed for information content based on the Australian Infant Feeding Guidelines and National Physical Activity Recommendations. The Suitability Assessment of Materials, Quality Component Scoring System, the Health-Related Website Evaluation Form, and the adherence to the Health on the Net code were used to evaluate the suitability and quality of information. Readability was assessed using 3 web-based readability tools.ResultsOf the 450 websites screened, 66 were included based on the selection criteria and evaluated. Overall, the quality of websites was mostly adequate. Media-related sources, nongovernmental organizations, hospitals, and privately owned websites had the highest median quality scores, whereas university websites received the lowest median score (35%). The information covered within the websites was predominantly poor: 91% (60/66) of the websites received an overall score of ≤74% (mean 53%, SD 18%). The suitability of health information was mostly rated adequate for literacy demand, layout, and learning and motivation of readers. The median readability score for the websites was grade 8.5, which is higher than the government recommendations (<grade 8). Overall, 74% (49/66) of the websites obtained a poor rating for interactivity, measuring active control, 2-way communication, and synchronicity. The most common features found on websites were social media links (61/66, 92%), frequently asked questions (48/66, 73%), and videos (44/66, 67%). Only 14% (9/66) of websites presented culturally responsive information.ConclusionsQuality, content, readability, and interactivity of websites promoting health behaviors during infancy ranged between poor and adequate. Since the 2015 systematic assessment, there was a slight improvement in the quality of websites but no difference in the Suitability Assessment of Materials rating and readability of information. There is a need for researchers and health care providers to leverage innovative web-based platforms to provide culturally competent evidence-based information based on government guidelines that are accessible to those with limited English proficiency.

Multidisciplinary Network ActiveOncoKids guidelines for providing movement and exercise in pediatric oncology: Consensus-based recommendations.

Pediatric cancer leads to reduced participation in exercise and only few patients comply with national physical activity recommendations. Physically inactive behavior hinders motor development and increases physical and psychological adverse effects of therapy and incidence of sequelae. Currently, there is neither nationwide coverage nor uniform level of knowledge regarding exercise promotion. The objective of the guideline is to facilitate qualified exercise interventions through standardized procedures in addition to regular physiotherapy and overall avoid physical inactivity in pediatric cancer patients. This guideline addresses the multidisciplinary treatment team and informs physiotherapists and decision-makers in tertiary care hospitals and health insurance companies. The requirements of the Association of the Scientific Medical Societies in Germany were followed. Contents were based on best practice experience of experts, patient advocates, as well as on scientific evidence. The guideline includes 11 recommendations. Recommendations 1-4 declare the relevance of implementing exercise interventions and address general framework conditions. Recommendations 5-11 focus on the design of exercise programs, prevention and safety issues, relative contraindications for specific training loads, and options to overcome barriers to exercise. This guideline summarizes existing and established structures and evidence in the context of movement and exercise in pediatric oncology. It takes into consideration the rights, varying needs, and characteristics of children and adolescents as well as national and international experience in this field. In the future, relevant research gaps need to be addressed by high-quality intervention studies to provide the scientific background for a stronger evidence-based guideline.

Do school characteristics, based on the Comprehensive School Health Framework, contribute to youth meeting national physical activity recommendations over time?

Canadian youth are insufficiently active, and schools may play a role in promoting student physical activity (PA). Based on the Comprehensive School Health (CSH) framework, this study examined whether school characteristics are associated with secondary school students meeting national PA recommendations over time. We used COMPASS survey data from 78 schools in Ontario and Alberta and 9870 Grade 9 and 10 students attending those schools. Students who provided two years of linked PA data (2013/14 and 2015/16) and gender were included. Multilevel analysis was conducted by gender, evaluating the relationship of school-level characteristics (guided by CSH) with students achieving all three PA recommendations after two years (≥ 60 min/day of moderate-to-vigorous PA, vigorous PA ≥ 3 days/week, strengthening activities ≥ 3 days/week). More than half (56.9%) of students achieving the PA recommendations at baseline were no longer achieving them after two years, and just a quarter (25.6%) of students not achieving the recommendations at baseline achieved them after two years. School-level factors were significantly associated with students achieving the recommendations, but these factors differed by student strata (i.e. by gender and baseline PA status). Generally, student access to equipment, public health partnerships and staff time for health were associated with increased odds of achieving the PA recommendations for certain students. Modifications to school characteristics within CSH may play a role in supporting students in achieving or continuing to achieve the PA recommendations after two years. Further research is needed to better understand the underlying dynamics of the observed relationships.

S11-3 Implementation of Community-Based Physical Activity Promotion Focusing on Individuals with Social Disadvantages, Developed Using a Participatory Approach

BackgroundRecently, the German Federal Ministry of Health has provided funding aimed at the sustainable implementation of the National Recommendations for Physical Activity and Physical Activity Promotion in German municipalities. This presentation reports on an ongoing project that employs a participatory action model for population-based physical activity (PA) promotion in these municipalities and gives insights into real-world experiences made during project implementation.MethodsUsing a participatory approach, an action model for PA promotion was developed in collaboration with 64 nationwide stakeholders (Phase I). Based on systematic criteria and in cooperation with the Federal Centre for Health Education (BzGA) and the German Statutory Health Insurance (GKV), three rural districts and three cities were then selected as pilot municipalities. In phase II, the action model was implemented in these six communities. Implementation steps included (1) preparation, (2) assessment, and (3) setting up a steering committee and a cooperative planning group in all communities. The entire process was closely coordinated with local administrations. Currently, cocreated measures adapted to local needs are being (4) developed and (5) implemented, with a particular focus on improving access to the development and usage of these measures for people with social disadvantages.ResultsPreliminary results indicate that steps (1) to (3) have been successfully implemented in all pilot municipalities. ‘Champions’ (persons committed to the local project) were found to be particularly important for each step. The involvement of political stakeholders (n = 2-13), experts (n = 2-12), representatives from the administration (n = 8-25), multipliers (n = 5-16), and citizens (n = 0-4) in the cooperative planning process varied across pilot municipalities. Participants from the administration represented different sectors (e.g. city planning, sports, health administration). Preliminary results show that a broad range of measures was developed to promote personal skills, infrastructures, policy actions, and community action for PA.ConclusionsThe action model proved suitable to promote PA in the pilot municipalities. In all six cases, adaptations had to be made to accommodate the intervention to the respective community-specific context. Our results indicate that involving individuals from a socially disadvantaged background remains a particular challenge of participatory PA promotion.

O3-1 Key factors for sustainable implementation of community-based physical activity promotion with a focus on individuals with social disadvantages: a systematic review with narrative synthesis

Abstract Background According to the German prevention law (§ 20a SGB V) of 2016, statutory health insurances are legally bound to integrate sustainable setting-based health promotion in their activities. This includes the development of sustainable concepts for community-based physical activity promotion (cbPAP) with a focus on socially disadvantaged individuals (SDI) (e.g. individuals with low income, low social status) to improve health equity. The aim of the systematic review with a narrative synthesis is to identify context-specific factors for the sustainable implementation of cbPAP and further, to inform the project KOMBINE (German acronym for ‘Community-Based PA Promotion to Implement National Recommendations’) for a scientific and practice-based implementation of the National Recommendations for Physical Activity and Physical Activity Promotion in communities. Methods A systematic review with narrative synthesis was conducted. The search was carried out in the databases PubMed, Scopus, CINAHL, PsycINFO/SportDiscus, and WebofScience. Searches were limited to only include studies published up until 04/2020, in English and German. Altogether, qualitative, quantitative, “mixed-method” studies, reports and reviews were considered. Articles referring to factors of sustainable implementation of community-based physical activity promotion with a whole-system approach were included. Although this was not an inclusion criterion, articles addressing accessibility for SDI were specifically taken into account. The framework by Schell et al. (2013) was used for data extraction and analysis, while the four main elements from Popay et al. (2006) were applied in the narrative synthesis process. Results 29 studies (13 qualitative, 1 quantitative, 9 “mixed-method” studies, 3 reviews, 3 reports) were included in the review. 137 references to sustainability factors were identified. According to the framework by Schell et al. (2013), factors were most frequently reported in domains of organizational levels (21), partnerships (18) and financial stability (16). Additional factors in the domains of accessibilities for SDI (11), infrastructure (7), participation (9), and cultural context (10) were identified by the authors. The relationship between the factors and the context of the programs are considered as well. Conclusions The identified factors for sustainability should be systematically addressed at an early stage in the conception of cbPAP measures for SDI to ensure sustainability after implementation.

O6-6 The added value of using the HEPA PAT for physical activity policy monitoring: A four-country comparison

BackgroundPublic policy is increasingly recognized as an important component of physical activity (PA) promotion, as policy actions to address lifestyle behaviours have the potential to in?uence the health and well-being of an entire population. However, our knowledge about the current status, implementation and effectiveness of PA policies in individual countries is still very limited, and there is consequently no clear guidance on which policies governments should preferably use in different settings or under various preconditions. In order to improve the evidence-base, we conducted a detailed assessment of existing PA policies in four EU Member States using WHO's HEPA Policy Audit Tool (PAT) in the context of the Policy Evaluation Network (PEN).MethodsWe employed a six-step process to administer the HEPA PAT Version 2 in Ireland, the Netherlands, Germany, and Poland. This involved identifying stakeholders, pre-filling parts of the tool using existing survey data and desk-research, approaching select institutions to verify details, and obtaining expert opinion via workshops, interviews, and/or questionnaires. Based on the four completed PATs, we performed a comparative analysis to identify similarities and differences between countries and with previous studies using the tool.ResultsIn all four countries, the health and sport sector were found to be most active in PA promotion, followed by education, transport, and environment/urban planning. All countries have national systems to monitor population PA levels, and three out of four already have national PA recommendations. The study also showed that policy context (e.g. ministry portfolios, importance of subnational governments) varies substantially between countries. This influences policy implementation and made it necessary to employ a bespoke approach in each country to obtain the required information.ConclusionsOur findings largely confirm results of previous studies using the PAT in other countries. They also indicate that using the tool in combination with other policy monitoring tools, e.g. the EU Monitoring Framework for HEPA across Sectors, may provide added value and help countries monitor policy progress more consistently. Our experience also confirms some known limitations of the PAT, e.g. regarding subnational policies and a high level of dependence on cooperation from key policy actors.

S03-4 3PL: Promoting pupils’ physical literacy: a pilot study testing feasibility and acceptability of the Y-PATH intervention in a Danish school setting

BackgroundA considerable number of Danish children and adolescents do not currently meet the national physical activity (PA) recommendations. In recent years, the concept of physical literacy (PL), has gained popularity worldwide, and it is considered as a proximal measure for lifelong PA. However, only a few interventions targeting PL exist on a global scale. In Denmark, the development of theoretically driven and evidence-based PL interventions that aim to increase PL among children and adolescents has not begun. Yet, a promising, theory-based, and internationally tested intervention, the Youth Physical Activity Towards Health (Y-PATH), has proven to be effective on children and adolescents’ PA levels and motor skills. This presentation introduces the Promoting Pupils’ Physical Literacy (3PL) project which aims to test the feasibility and acceptability of the Y-PATH intervention in a Danish context among pupils 9-11 years of age.Methods and ResultsThe hypothesis is that a revised and adapted 3PL intervention protocol that aims to increase pupils’ PL is ready for effectiveness testing by the end of this project. Two public schools will be recruited and randomly assigned to intervention or control condition following a waitlist design. The primary outcomes include the feasibility and acceptability of the intervention. The feasibility of the practicality and the recruitment process will be assessed within a document log administered by research assistants. The acceptability, including demand and experiences, and the intervention implementation degree will be evaluated by short bimonthly questionnaires to teachers, and interviews with pupils, teachers, parents, and school managers. The preliminary effectiveness will be tested by comparing changes in pupils’ PL over time, assessed with the validated Danish Assessment of Physical Literacy tool.DiscussionA revised PL intervention, a Template for Intervention Description and Replication TIDieR checklist, and a protocol that offers a solid empirical and theoretical foundation for a future upscaled effectiveness study. Additionally, the development of such protocol and checklist provides a national as well as an international opportunity for researchers to use and compare effectiveness of the intervention across countries.

P06-11 Continuity and changes in commuting mode and influence on physical activity, BMI and waist circumference among Finnish adults

BackgroundRegular physical activity (PA) has been found to be important for cardiovascular health and longevity. However, notable proportion of adult population does not meet the national PA recommendations. Active transport is one domain of physical activity, that could be a time-efficient way to increase PA and reach the national recommendations. Additionally, it could have a positive effect to body composition.MethodsBased on longitudinal cohort study, active commuting modes and objectively measured PA were used to determine the influence of commuting mode to steps, aerobic steps, BMI and waist circumference. Linear regression models were fitted to test the associations between the change groups of commuting mode and the longitudinal changes of the response variables.ResultsWhen compared to passive commuters, participants with public transport (p = 0.09) and walking (p > 0.001-0.021) showed higher amounts of steps and aerobic during summertime and wintertime. Cyclers showed higher amounts of steps and aerobic steps only in wintertime (p = 0.001-0.002). Passive commuters had higher BMI than walkers (p = 0.05) and cyclers (p = 0.023) in summertime. Also, cyclers had lower waist circumference than passive commuters (p = 0.016-0.02). Among those who remained persistently active, number of steps did not change. When compared to persistently active, among those who changed from active to passive commuting, steps (-900 - -885) and aerobic steps (-500) declined (p = 0.010-0.036) while among those who changed from passive to active commuting steps (+900-1000) and aerobic steps (+650-750) increased (p = 0.023-0.011).ConclusionsCommuting actively to work and changing passive mode to active mode has a positive effect to number of daily steps and aerobic steps. Since the active commuting is part of the daily routine, promoting active commuting could be one of the key factors tackling the obesity and insufficient PA among adults. Continuity of active commuting seemed to be effective way to maintain body weight in balance over the years.

S03 A physical literacy eco-system in Denmark: from research to practice … and back again

The burden of non communicable diseases is a rising global problem and the increasing inactivity seen all over the world is extremely costly to societies (Ding et al., 2016). A recent Danish evaluation on physical activity (PA) showed that a considerable number of Danish children and adolescents do not meet national PA recommendations (The Ministry of Health, 2019). Viewing this problem through a life course perspective points to the solution of making sustainable behavioural changes with children (Frohlich & Potvin, 2010). Across the life span, there is clear evidence of the health-enhancing benefits of PA (Lee et al., 2012). However, at the same time, ample empirical evidence supports that extrinsic motives for participating in PA, such as increasing health, are insufficient when long term participation is the goal. This means that prevention and health promotion interventions should not blindly target the factors and behaviours that predict adult health, such as PA, but move towards intervening on the ‘so-called’ causes of the causes such as factors enabling a physical active lifestyle throughout life. Physical literacy (PL) is a comprehensive multidimensional concept that has been identified as a ‘cause of the causes’. PL consists of dimensions that lay the foundation for an individual’s capacity and tendency for engaging in physical activities throughout life (Whitehead, 2001). In this symposium, we aim to present four research and interventions projects from the education, sport and public health sectors that have emerged in the last couple of years, and through the presentation of these projects, how we in Denmark have established a PL ecosystem between research and practice – and how our national collaboration, PL-net, has contributed to this.Program 1) Introduction to the symposium2) Physical literacy, physical activity and wellbeing in Danish children3) The Child-COOP Denmark study: using physical literacy to guide and evaluate a systemic approach to health promotion4) Staying active together in sports: the importance of and how to promote the emotional domain of physical literacy5) 3PL: Promoting pupils’ physical literacy: a pilot study testing feasibility and acceptability of the Y-PATH intervention in a Danish school setting6) The symposium will be ended by a panel debate where it also will be possible for the participants to comment and ask questions.

Association of physical activity with utilization of long-term care in community-dwelling older adults in Germany: results from the population-based KORA-Age observational study

BackgroundPhysical activity (PA) is a proven strategy to prevent chronic diseases and reduce falls. Furthermore, it improves or at least maintains performance of activities of daily living, and thus fosters an independent lifestyle in older adults. However, evidence on the association of PA with relevant subgroups, such as older adults with utilization of long-term care (LTC), is sparse. This knowledge would be essential for establishing effective, need-based strategies to minimize the burden on healthcare systems due to the increasing need for LTC in old age.MethodsData originate from the 2011/12 (t1) baseline assessment and 2016 (t2) follow-up of the population-based Cooperative Health Research in the Region of Augsburg (KORA-)Age study in southern Germany. In 4812 observations of individuals ≥65 years, the association between various types of PA (walking, exercise (i. e., subcategory of PA with the objective to improve or maintain one or more components of physical fitness), walking+exercise) and utilization of LTC (yes/no) was analyzed using generalized estimating equation logistic models. Corresponding models stratified by sex (females: 2499 observations; males: 2313 observations) examined sex-specific associations. Descriptive analyses assessed the proportion of individuals meeting the suggested minimum values in the German National Physical Activity Recommendations for older adults (GNPAR).ResultsAll types of PA showed a statistically significant association with non-utilization of LTC in the entire cohort. “Walking+exercise” had the strongest association with non-utilization of LTC in the entire cohort (odds ratio (OR): 0.52, 95% confidence interval (CI): 0.39–0.70) and in males (OR: 0.41, CI: 0.26–0.65), whereas in females it was “exercise” (OR: 0.58; CI: 0.35–0.94). The proportion of individuals meeting the GNPAR was higher among those without utilization of LTC (32.7%) than among those with LTC (11.7%) and group differences were statistically significant (p ≤ 0.05).ConclusionsThe GNPAR are rarely met by older adults. However, doing any type of PA is associated with non-utilization of LTC in community-dwelling older adults. Therefore, older adults should be encouraged to walk or exercise regularly. Furthermore, future PA programs should consider target-groups’ particularities to reach individuals with the highest needs for support.

EFFECT OF ONLINE MESSAGING INTERVENTION TO ENGAGE ADULTS FROM THE QATAR COMMUNITY IN PHYSICAL ACTIVITY

In Qatar, physical inactivity amongst 18-64 years old adults is at risk of NCD diseases (obesity (41.4%), high cholesterol level (21.9%), diabetes (6.7%), low participation in physical activity (63.3%), with annual mortality due to physical inactivity of 9. 3% and 36.8%. not meeting current national physical activity recommendations. This study evaluates the effect of online messaging intervention and walking program to engage adults from Qatar community in PA. The concept of online messaging intervention as motivation and awareness of PA in Qatar is explored. Randomized pretest-posttest experimental study method with a follow-up period of 16 weeks was applied to a total of 299 healthy adults (18 to 64 years) in SIH community settings (143 adults control group, 156 adults experiment group, 68 (22.7%) adults IPAQ participants). Evaluation of PA levels and daily steps from pedometers and mob app classified into categories. Evaluation of IPAQ results calculated as MET minutes per week. The walking program combined with online messaging motivated a percentage of 22.7% of adults to continue an active lifestyle, at 16 weeks of follow-up. Self-rated PA level similar to data reported by pedometers demonstrates that adults in the IPAQ group (68 (22.7%)) have a good PA awareness. The statistical findings demonstrate that walking in combination with online messaging programs implemented among adults in the Qatari community can increase awareness of the health benefits of physical activity by forming the basis of an active lifestyle.

The knowledge, barriers and opportunities to improve nutrition and physical activity amongst young people attending an Australian youth mental health service: a mixed-methods study

BackgroundMental illnesses are the leading cause of disability in young people, and lifestyle interventions in young people at risk of mental illness remain a priority. Opportunities to improve nutrition and physical activity among young people through youth mental health services remain unclear. This study aimed to determine the knowledge and behaviors towards nutrition and physical activity, the barriers and enablers to improving behaviors, and the preferred providers and sources of information for nutrition and physical activity among a sample of young people attending a youth mental health service.MethodsA mixed-method study was conducted in regional Tasmania, Australia in a sample of young people (15–25 years) attending a youth mental health service (headspace). A quantitative survey (n = 48) determined young people’s nutrition and physical activity knowledge, behaviors, barriers and enablers to achieving recommendations, and their preferred providers and sources of information. Structured interviews and a focus group further explored these concepts (n = 8), including the role of the mental health service as a provider of this support.ResultsThe majority of participants did not meet national recommendations for nutrition and physical activity, despite possessing a high level of knowledge regarding their importance for mental health. Improving mental health was a common enabling factor for participants choosing to alter diet and physical activity habits, but also the leading barrier for participating in physical activity. Young people wanted to receive information from reputable health providers, ideally through social media sources. headspace was seen as an important potential provider of this information.ConclusionsOur results indicate that there is a clear need to improve diet and physical activity habits to enhance mental and physical health outcomes in this at-risk group, and youth mental health services could provide further interventions to support their clients. Specialized staff (e.g. dietitians and exercise physiologists) may provide additional benefits alongside existing mental health care support.