National Physical Activity Recommendations Research Articles

Using Cognitive Interviewing to Design Interventions for Implementation in Oncology Settings.

Implementation of effective interventions into clinical practice is slow, in large part, because researchers do not sufficiently attend to the realities of nurses who implement interventions. The aim of the study was to provide an exemplar of how cognitive interviewing-an important and underused method for developing nursing research-can be used to design survey items and assess multilevel implementation factors. We utilized the Consolidated Framework for Implementation Research to create a survey to assess factors that influence how oncology nurses deliver physical activity interventions. Two rounds of cognitive interviews were conducted with five purposively selected oncology nurses to assess survey items' clarity and effectiveness at eliciting desired information. We used a cognitive interviewing coding scheme to code data and revise unclear items. Participants completed the revised survey online and underwent a second interview to provide additional feedback. Seven important changes were made to the survey: how to assess nurses' perceptions of other nurses' beliefs and practices; language to capture data relating to nursing leadership and administration; increased detail to assess factors related to nurses' workplaces; language related to capturing factors related to policy; language to capture data related to equity, disparities, and cultural tailoring; terms replacement with language used by nurses; and strategy to capture data about nurses' knowledge of national physical activity recommendations for cancer survivors. Cognitive interviewing can be applied to develop survey items that capture real-world experiences and perspectives of practicing nurses. This is an essential step in developing nursing interventions that are ready to be implemented and increasing the uptake of evidence-based nursing care. Cognitive interviewing can be used across nursing settings, populations, and interventions to develop understandings of attitudes, attributes, characteristics, and perceptions for a variety of nursing interventions.

Physical Activity Recommendations for Adults in Yemen

Background: Physical inactivity is one of the most crucial global problems in spite of the approved impact of physical activity in enhancing health and preventing NCDs, osteoporosis and many other diseases. Thus, WHO encouraged the countries to set their own physical activity guidelines based on the international physical activity recommendations, however, many countries do not have their national Physical activity recommendations such as Yemen in Eastern Mediterranean Region.Objectives: To suggest proper physical activity recommendations for adults in Yemen based on physical activity recommendations in different countries in WHO regions particularly the Eastern Mediterranean Region.Discussion: Prevalence of national physical activity guidelines and physical activity factors vary among WHO regions. The absence of physical activity recommendations and statistical data in Yemen is obvious and surveillance using validated tools should be done to assess the recent PA and related factors. However, although Yemen has its own issues such as Khat chewing habit and conflict, it shares many factors with other Eastern Mediterranean Region countries in general and Qatar in particular such as unsupportive physical activity environment and limited outdoor activities for women. Conclusion: Qatar national physical activity guidelines can be suggested as applicable and affordable guidelines for adults in Yemen. According to Qatar guidelines, adults should do (30–60) min of moderate exercise ≥ 5 days per week or (20–60) min of vigorous exercise for ≥3 days per week and in case of promoting or maintaining weight loss, they should do (50-60) minutes daily exercise. Many studies should be done to assess recent physical activity and related barriers to draw evidence-based physical activity guidelines for adults in Yemen.Background: Physical inactivity is one of the most crucial global problems in spite of the approved impact of physical activity in enhancing health and preventing NCDs, osteoporosis and many other diseases. Thus, WHO encouraged the countries to set their own physical activity guidelines based on the international physical activity recommendations, however, many countries do not have their national Physical activity recommendations such as Yemen in Eastern Mediterranean Region.Objectives: To suggest proper physical activity recommendations for adults in Yemen based on physical activity recommendations in different countries in WHO regions particularly the Eastern Mediterranean Region.Discussion: Prevalence of national physical activity guidelines and physical activity factors vary among WHO regions. The absence of physical activity recommendations and statistical data in Yemen is obvious and surveillance using validated tools should be done to assess the recent PA and related factors. However, although Yemen has its own issues such as Khat chewing habit and conflict, it shares many factors with other Eastern Mediterranean Region countries in general and Qatar in particular such as unsupportive physical activity environment and limited outdoor activities for women. Conclusion: Qatar national physical activity guidelines can be suggested as applicable and affordable guidelines for adults in Yemen. According to Qatar guidelines, adults should do (30–60) min of moderate exercise ≥ 5 days per week or (20–60) min of vigorous exercise for ≥3 days per week and in case of promoting or maintaining weight loss, they should do (50-60) minutes daily exercise. Many studies should be done to assess recent physical activity and related barriers to draw evidence-based physical activity guidelines for adults in Yemen.

Diabetes risk status and physical activity in pregnancy: U.S. BRFSS 2011, 2013, 2015, 2017

BackgroundPregnant women without complications are advised to engage in physical activity (PA) to mitigate adverse outcomes. Differences may exist among pregnant women of diverging diabetes status in meeting national PA recommendations. We sought to examine differences in aerobic activity (AA) and muscle strengthening activity (MSA) by diabetes risk status (DRS) among pregnant women in the United States.MethodsThe sample (n = 9,597) included pregnant women, age 18–44 years, who participated in the 2011, 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System. Levels of DRS include: no diabetes (ND), high risk for diabetes (HRD) due to self-reported gestational diabetes or pre-diabetes, and overt diabetes due to self-reported, clinically diagnosed diabetes (DM). Odds ratios (ORs) and 95% confidence intervals (CI) for meeting PA recommendations were obtained. Covariates included age, race, education, household child count, alcohol consumption, and smoking status.ResultsFindings revealed that on average, DM had 46.5 fewer minutes of weekly AA compared to ND. Furthermore, a significantly lower OR (0.39; CI 0.19–0.82) for meeting both recommendations was observed in DM as compared to ND after adjustment.ConclusionsWe observed that pregnant women with overt diabetes had a lower odds of engaging in PA, while those at high risk were similar in their PA engagement to ND. Future studies aimed at assessing determinants of PA behavior may help guide efforts to promote exercise in pregnant women with diabetes.

Effectiveness of a resistance training program on physical function, muscle strength, and body composition in community-dwelling older adults receiving home care: a cluster-randomized controlled trial

BackgroundAging is associated with reduced muscle mass and strength leading to impaired physical function. Resistance training programs incorporated into older adults’ real-life settings may have the potential to counteract these changes. We evaluated the effectiveness of 8 months resistance training using easily available, low cost equipment compared to physical activity counselling on physical function, muscle strength, and body composition in community-dwelling older adults receiving home care.MethodsThis open label, two-armed, parallel group, cluster randomized trial recruited older adults above 70 years (median age 86.0 (Interquartile range 80–90) years) receiving home care. Participants were randomized at cluster level to the resistance training group (RTG) or the control group (CG). The RTG trained twice a week while the CG were informed about the national recommendations for physical activity and received a motivational talk every 6th week. Outcomes were assessed at participant level at baseline, after four, and 8 months and included tests of physical function (chair rise, 8 ft-up-and-go, preferred- and maximal gait speed, and stair climb), maximal strength, rate of force development, and body composition.ResultsTwelve clusters were allocated to RTG (7 clusters, 60 participants) or CG (5 clusters, 44 participants). The number of participants analyzed was 56–64 (6–7 clusters) in RTG and 20–42 (5 clusters) in CG. After 8 months, multilevel linear mixed models showed that RTG improved in all tests of physical function and maximal leg strength (9–24%, p = 0.01–0.03) compared to CG. No effects were seen for rate of force development or body composition.ConclusionThis study show that resistance training using easily available, low cost equipment is more effective than physical activity counselling for improving physical function and maximal strength in community-dwelling older adults receiving home care.Trial registrationISRCTN1067873

Years Spent In Secondary Physical Education And Levels Of Physical Activity In College Students And Adults

Physical education requirements in the United States vary and are often left to local districts in each state to decide. Considering the relationship between physical activity and obesity and physical fitness with mortality, requirements relating to national recommendations appear important. Long term implications of participation in physical education are contradictory at best with the limited studies performed concluding conflicting results. PURPOSE: To examine the relationship between years of participation in physical education at a high school level and levels of physical activity and fitness in college students and adults. METHODS: Forty-one participants ranging in age from 18-65 (mean age 33.6) were recruited utilizing an inter-collegiate mailing system. Participants completed a self-administered IPAQ long-form questionnaire as well as additional physical education related questions. Participants also completed a YMCA Step Test. RESULTS: When comparing participant results to national recommendations for physical activity 6 of 41 met vigorous physical activity guidelines (14.6%), and 0 met guidelines for moderate physical activity. When adding in vigorous outdoor housework those meeting vigorous guidelines went up to 11 of 41 participants (26.8%), and when adding in moderate outdoor and indoor housework those meeting moderate guidelines went up to 4 of 41 (9.7%). Mean score of 4.5 on the YMCA Step Test for all participants was between below average and poor with a standard deviation of nearly two scoring levels. No significant relationships were found when comparing time spent in physical education classes (required or total) to recalled moderate physical activity and fitness levels in college students and adults, while a significant relationship was seen when comparing the time spent in physical education classes (required and total) to recalled vigorous physical activity and fitness levels in college students and adults (p=0.02). CONCLUSION: Further study to examine the relationship between physical education and long-term physical activity is needed with particular attention being paid to physical education requirements and their variances.

The Effect Of Five-years Of Exercise On High-density Lipoprotein Cholesterol In Older Adults

PURPOSE: Dyslipidemia, is one of the major risk factors for cardiovascular disease (CVD), the leading cause of death in older adults. Aging is associated with an unfavorable change in the lipid-profile. High levels of LDL can be reduced by cholesterol lowering medications, while pharmacological treatment have not proven to be as efficient in increasing HDL as they are at decreasing LDL. Exercise is associated with lower risk of CVD and exercise is a potential approach for obtaining and/or maintaining an optimal lipid profile. However, the effects of exercise on HDL cholesterol in older adults are unclear. It has been suggested that the time-frame needed to achieve a change in lipid-metabolism is longer in older compare to younger adults. The aim of this study was to examine the effect of five-year of exercise on HDL in older adults. METHODS: A total of 1567 individuals (790 women) were included and randomized to either 5 years of two weekly sessions of high-intensity (HIIT) (10 min warm-up followed by 4×4 min intervals at ∼90% of peak heart rate) or moderate-intensity training (MICT) (50 min of continuous work at ∼70% of peak heart rate) or, to a control group (CON) that followed the national recommendations for physical activity. Serum HDL cholesterol was measured immediately using standard procedures at St.Olavs Hospital, Norway. Linear mixed models were used to determine within- and between-group differences over time. RESULTS: All groups had a significant reduction in HDL after 5 years, with no between group differences. In the per protocol analysis the reduction was less in HIIT, and significantly higher than CON and MICT (mean difference of 0.05 mmol/L, p=0.03 in both). CONCLUSION: Supervised exercise twice a week was not enough to hinder an unfavorable decline in HDL. However, HIIT resulted in a smaller reduction in HDL in older adults.

Walking Biomechanics Associated With Patellofemoral Pain In Sedentary And Active Emerging Adult Women

About 50% of emerging adults do not meet the national physical activity recommendations. Risk of injury, like patellofemoral pain (PFP) during walking, may be a barrier to meeting the physical activity recommendations for sedentary emerging adults. PURPOSE: To determine if sedentary emerging adult women had walking biomechanics related to PFP compared to active emerging adult women. METHODS: As part of a larger study, 26 (12 sedentary, 14 active) emerging adult women (age:22(3) years; height: 1.58(0.08) m; mass: 58.4(8.7) kg) participated in the study. Anatomical and tracking retro-reflective markers were placed on body segments to record movement. Participants completed 5 good walking trials at 1.4 m/s (± 5%). Three-dimensional gait analysis was performed using motion capture sampling at 200 Hz and force platforms sampling at 1000Hz. Joint angles were determined using the joint coordinate system and moment was determined using inverse dynamics. The variables of interest were peak knee flexion angle, peak internal knee extensor moment (PKEM), knee abduction and external rotation angles at PKEM, and hip adduction and internal rotation angles at PKEM. Independent t-tests compared variables between sedentary and active emerging adult women. Effect sizes (d) were calculated for each variable. RESULTS: Knee external rotation angle at PKEM was significantly larger in sedentary compared to active emerging adult women (Table 1). There were no other significant differences between the sedentary and active groups for the remaining variables of interest. CONCLUSION: A larger knee external rotation angle at PKEM suggests higher pressure on the lateral patella in the sedentary versus active group. According to the pathomechanical model for PFP, high lateral pressure and associated high cartilage stress is a mechanism for the develop of PFP. Therefore, sedentary women may be more at risk for developing PFP during walking for exercise compared to active women.Table 1:: hip and knee biomechanics during walking in sedentary and active emerging adult women

Relationship Of Internalized Weight Stigma To Sleep Quality And Physical Activity Among College Students

PURPOSE: Studies suggest weight stigma may be associated with negative health consequences, including a reduced ability to lose weight, reduced physical activity, and poor mental health outcomes. Less is known about the prevalence of weight stigma among college students and how this relates to behavioral health. METHODS: Students at a large Midwestern university completed an anonymous, online cross-sectional survey. Participants self-reported height and weight to determine BMI and weight status. Participants self-reported time spent in moderate, vigorous, and resistance-based physical activity. Participants completed to Pittsburgh Sleep Quality Index (PSQI) to determine sleep quality. RESULTS: A total of 328 students provided complete data and are included in this analysis. The majority of participants were female (n=256, 81%), and Caucasian (n=292, 89%). Eighty-nine participants (28.1%) had obesity based on BMI classification with no difference in prevalence between genders. Mean reported sleep time was 7.0 ± 1.3 hours for all participants. Female participants reported lower overall sleep quality (7.1 ± 3.4) compared to males (6.3 ± 3.6). Mann-Whitney U group comparisons demonstrated that participants reporting higher sleep quality had lower degrees of internalized weight stigma; this relationship was seen among females (md=7.0; P<0.001) and males (md=6.5; P<0.05). The majority of both male (77.9%) and female (73.0%) participants did not meet national physical activity recommendations. Mann-Whitney U groups comparisons demonstrated that participants with higher Participants meeting physical activity recommendations reported lower degrees of internalized weight stigma (md=4.20, P<0.01). CONCLUSIONS: There is evidence that higher internalized weight stigma is related to reduced sleep quality and lack of achievement of physical activity recommendations among college students. Further research should explore this relationship to improve lifestyle counseling within this population.

Perceived Barriers And Motivators For Physical Activity In Women With Perinatal Depression

Physical activity (PA) may help reduce severity of depressive symptoms in women with perinatal depression (depression during pregnancy or postpartum). However, less than one third of pregnant and postpartum women meet national PA recommendations, and PA is likely even lower in women with perinatal depression. Barriers and motivators for PA among women with perinatal depression are not well understood. PURPOSE: The aim of this study was to identify barriers and motivators for PA among women with perinatal depression. METHODS: Pregnant and postpartum women with perinatal depression were identified using Kaiser Permanente Northern California’s universal perinatal depression screening program. We conducted 8 focus groups totaling 35 women with prenatal (n=15) and postpartum depression (n=20). Focus groups were analyzed using an inductive approach. RESULTS: Pregnant women were, on average, 27 weeks gestation (range: 11-37) with mild to moderately severe depressive symptoms (Patient Health Questionnaire (PHQ)-8 mean: 10; range: 4-19). Postpartum women were, on average, 12.5 months postpartum (range: 8.5-16.5) with no to moderately severe depressive symptoms (PHQ-8 mean: 7; range: 0-16). Perceived barriers to PA identified by pregnant and postpartum women included low energy and mood, limited time due to other priorities, feeling discouraged when comparing to pre-pregnancy self, and limited geographic accessibility and high cost of group exercise classes. Unique barriers identified by pregnant women were physical discomfort and fear of judgement from others. Postpartum women identified lack of childcare as an additional barrier. Motivators for PA identified by pregnant and postpartum women included self-care (“me time”), improved mood after PA, making progress toward goals, being strong and fit to keep up with their children, and having a social support system. CONCLUSIONS: Interventions to increase PA in pregnant and postpartum women with perinatal depression should include components addressing motivation, time, geographic accessibility, and cost barriers. Interventions can also increase PA by promoting potential mood benefits, fostering a sense of accomplishment, and leveraging social support as motivators in pregnant and postpartum women with perinatal depression.

Physical activity level of kindergarten staff working with toddlers and older children in Norway.

BACKGROUND:Research suggests that one-third of Norwegian adults satisfy national health recommendations for physical activity, but little knowledge exists regarding activity levels in different occupations.OBJECTIVES:This study investigates the level at which kindergarten staff fulfil these health recommendations, and examines differences in physical activity levels of staff working mainly with toddlers (1–3 years) and older children (4–6 years). The study also investigates physical activity level during working time and leisure time.METHODS:Physical activity levels among 43 kindergarten staff members were measured utilizing accelerometers and questionnaires.RESULTS:The results demonstrate that 86% of kindergarten staff satisfy the health recommendations for physical activity. Moreover, kindergarten staff working with older children were significantly more physically active than staff working with toddlers.CONCLUSIONS:Physical activity level during working time was found to be of major significance for fulfilling the health recommendations among kindergarten staff working with toddlers.

Physical activity promotion for persons with multiple chronic diseases in the interface of health care, sport and leisure: a longitudinal pilot study

Purpose: Osteoarthritis (OA) as well as Diabetes mellitus type 2 (DMT2), overweight (OW), obesity (OB) and cardio-vascular diseases (CVD) are amongst the most prevalent civil diseases in industrial nations and the simultaneous occurrence of several diagnoses is often the rule. As an example: overweight is one main risk factor in the development of knee OA. OA is most often combined with hypertension and second most often with DMT2. Physical activity (PA) and exercise have many positive effects on chronic conditions and should be prescribed as a cost-effective therapy for all these disorders. But so far little research is conducted on the effects of PA in the treatment of multimorbidity. It must be further stated, that there is a shortfall of lifestyle interventions such as PA and exercise for this specific population on a structural and organisational level.This study therefore seeks to establish and evaluate a pilot model for patients with multimorbidity with the primary goal to increase PA in this patient group. Methods: The study includes only participants with at least two major risk factors or manifest disease signs for: OA of hip and/or knee, DMT2, OW/OB, CVD. End organ damage is an exclusion criteria. Only inactive participants, means fulfilling only less than 75% of the national PA recommendations, are included in the study. The study consists of a 12-week basic intervention, comprising a systematic aerobic and strength-oriented training intervention by use of different types of activity. The training intervention is based on national PA recommendations and complemented by theoretical background information on training science, nutrition and behavioral change techniques. Personal counselling is included to empower independent activity of the participants. After the basic intervention persons are encouraged to maintain the same level of PA in sport and leisure time. Data are assessed before (t0) and after the basic intervention (t3), and after the follow-up phase of three months (t6). The primary outcome is the physical activity status of the patients at t6 (binary: national recommendations are fulfilled/not fulfilled); secondary outcomes relate to general and disease specific objectives (reduction of: medication, pain etc.), physiological endpoints (i.e. blood pressure, Hba1c, triglycerides, cortisol levels etc.), as well as self-reported measures (i.e. WOMAC, exercise related self-efficacy etc.) and adherence to intervention. The study is still ongoing. Results refer to the basic intervention of the first of two waves and will be completed in April 2020. Results: Overall 26 participants were screened for the first study wave. 4 participants were excluded due to too less risk factors for the manifestation of the investigated diseases. Further two participants restrained from the study without giving reasons. Thus, 20 participants (14 female, 6 male) participated. The mean age was 53.8 ± 11.2 years. 9 Participants suffered from hip (n=2) or knee OA (n=7). Further 8 participants showed a WOMAC score >15 points for pain and function and were therefore classified as high-risk. 17 of the participants suffered from OV/OB, with a mean BMI of 30.7 ± 3.5 kg/m2. 14 persons had a diagnosis of hypertension of which 13 used medication on a regular basis. 15 participants were at high risk for DMT2 (Diabetes risk score ≥ 57 points), 1 already suffered from DMT2. 50% of the participants showed 2 manifested diseases and further 6 had one manifested disease and at least one risk factor for another disease. Interim analysis showed an increase in PA in all participants. On average 1 strength training and 2 cardio training sessions were completed during the first 12 weeks. One participant dropped-out of the study in week 11 due to persistent hip pain. The overall adherence for the instructed sessions (n=10) was 84%. 20% of the participants completed all instructed sessions. Further results will be evaluated and can be presented soon. Conclusions: Participants in the study showed a very good compliance and adherence throughout the first 12 weeks of the intervention. Further data analysis will provide information on whether this lifestyle change leads to subjective and objective health benefits and if PA can be sustained in succession of a supervised intervention period in a self-regulatory way.

Status and contents of physical activity recommendations in European Union countries: a systematic comparative analysis

ObjectivesWe analysed the information on current national physical activity recommendations in all EU Member States provided by governments in a joint EU/WHO survey on the implementation status of the EU...

Influence of Osteopathic Medical Students' Personal Health on Attitudes Toward Counseling Obese Pediatric Patients.

Research has shown that physicians with positive health and lifestyle behaviors have more positive attitudes toward effective counseling, but little is known about how personal health behaviors of medical students influence their attitudes regarding pediatric obesity counseling before entering practice. To determine whether the personal health status and habits of osteopathic medical students influence their attitudes toward counseling obese pediatric patients regarding lifestyle behaviors. A cross-sectional survey was distributed electronically to first- through fourth-year osteopathic medical students. The survey assessed students' personal lifestyle habits and their top anticipated barriers to providing pediatric weight counseling. A total of 200 participants completed the survey. National physical activity recommendations were met by 81 participants (40.5%). These 81 participants had significantly more positive attitudes toward pediatric physical activity counseling than participants who did not meet the recommendations (H=-35.06, P=.001) or those who only met resistance training recommendations (H=40.63, P=.021). Participants with obesity had significantly lower pediatric weight management counseling scores than overweight participants (H=40.77, P=.028). Thirty-one participants (15.5%) consumed a healthy amount of both vegetables and fruit. These 31 participants had significantly higher dietary mean item counseling scores than those who did not (H=-30.40, P=.048). Participants identified the barriers "Time" (137 [68.5%]) and "Difficult for patients to change behavior" (99 [49.5%]) most frequently. Clinical participants identified "Poor or lacking reimbursement" (21 [28.0%]) more frequently than preclinical participants (12 [9.6]). Medical students who exhibited healthier lifestyle habits were more likely to positively view pediatric obesity management counseling.

Acceptability of Robotic-Assisted Exercise Coaching Among Diverse Youth: Pilot Study.

BackgroundAlmost 80% of adolescents do not achieve 60 minutes or more of physical activity each day as recommended by current US national guidelines. There is a need to develop and promote interventions that increase physical activity among adolescents. With increased interest in digital technologies among adolescents, robotic-assisted platforms are a novel and engaging strategy to deliver physical activity interventions.ObjectiveThis study sought to assess the potential acceptability of robotic-assisted exercise coaching among diverse youth and to explore demographic factors associated with acceptance.MethodsThis pilot study used a cross-sectional survey design. We recruited adolescents aged 12-17 years at three community-based sites in Rochester, MN. Written informed consent was obtained from participants’ parents or guardians and participants gave consent. Participants watched a brief demonstration of the robotic system-human interface (ie, robotic human trainer). The exercise coaching was delivered in real time via an iPad tablet placed atop a mobile robotic wheel base and controlled remotely by the coach using an iOS device or computer. Following the demonstration, participants completed a 28-item survey that assessed sociodemographic information, smoking and depression history, weight, and exercise habits; the survey also included the eight-item Technology Acceptance Scale (TAS), a validated instrument used to assess perceived usefulness and ease of use of new technologies.ResultsA total of 190 adolescents participated in this study. Of the participants, 54.5% were (103/189) male, 42.6% (81/190) were racial minorities, 5.8% (11/190) were Hispanic, and 28.4% (54/190) lived in a lower-income community. Their mean age was 15.0 years (SD 2.0). A total of 24.7% (47/190) of participants met national recommendations for physical activity. Their mean body mass index (BMI) was 21.8 kg/m2 (SD 4.0). Of note, 18.4% (35/190) experienced depression now or in the past. The mean TAS total score was 32.8 (SD 7.8) out of a possible score of 40, indicating high potential receptivity to the technology. No significant associations were detected between TAS score and gender, age, racial minority status, participant neighborhood, BMI, meeting national recommendations for physical activity levels, or depression history (P>.05 for all). Of interest, 67.8% (129/190) of participants agreed that they and their friends were likely to use the robot to help them exercise.ConclusionsThis preliminary study found that among a racially and socioeconomically diverse group of adolescents, robotic-assisted exercise coaching is likely acceptable. The finding that all demographic groups represented had similarly high receptivity to the robotic human exercise trainer is encouraging for ultimate considerations of intervention scalability and reach among diverse adolescent populations. Next steps will be to evaluate consumer preferences for robotic-assisted exercise coaching (eg, location, duration, supervised or structured, choice of exercise, and/or lifestyle activity focus), develop the treatment protocol, and evaluate feasibility and consumer uptake of the intervention among diverse youth.

Effect of a Multi-Component, School-Based Intervention on Health Behaviors of Elementary School Students (FS16-04-19)

ObjectivesWe examined the effect of a three year, multi-component, school-based intervention on health behaviors of elementary school students. MethodsThe multi-component, obesity intervention was provided by community partners to 13 schools over three years. Schools were assigned into three varying Levels of Intervention: “Core” Schools (n = 4) received weekly interventions, “Level 1” Schools (n = 5) received monthly interventions, and Control Schools (n = 5) received no intervention. Participants completed self-reported questionnaires assessing several health behaviors, including fruit and vegetable consumption, and physical activity levels. Questionnaires were administered in the Fall and Spring of each year of the intervention. For this study, responses were analyzed from Year 3 and were compared to national recommendations. Descriptive statistics and chi-square tests of independence examined Level of Intervention and questionnaire responses. ResultsNo significant chi-square tests of independence were identified for the Level of Intervention and quantity of fruit or vegetable consumption. A significant (P = 0.003) chi-square test of independence assessing physical activity was identified in the Fall of Year 3. Descriptive analyses indicated that higher proportions of students in the Core and Level 1 Schools met national fruit, vegetable, and physical activity recommendations compared to students in Control Schools. ConclusionsThe higher frequency of intervention provided to students in the Core Schools did not influence the dietary behaviors of participants. However, receiving any intervention appeared to affect health behaviors of children receiving the intervention compared to the Control Schools. Funding SourcesThe Independence Blue Cross Foundation.

Associations of Awareness of National Physical Activity Recommendations and Self-Reported Physical Activity Behaviors among Students

Associations of Awareness of National Physical Activity Recommendations and Self-Reported Physical Activity Behaviors among Students

Does Eagerness for Physical Activity Matter? The Association Between Eagerness and Physical Activity Among Adolescents.

This study investigated the association between perceived parental support and eagerness for physical activity (EPA) among adolescents, and the association between EPA and physical activity. We further examined whether perceived athletic competence (PAC) mediates a presumed association between EPA and physical activity level, when controlling for gender. This study included 320 adolescents (aged 12–13) from 18 schools in two medium-sized Norwegian municipalities. Questionnaires and accelerometers were assessed during spring 2017. Structural equation modeling was applied to examine the associations. Standard regression coefficients are presented. Data demonstrated that perceived parental support was positively associated with EPA (β = 0.52), and eagerness was positively associated with PAC (β = 0.52). Both EPA (β = 0.20) and PAC (β = 0.24) were also positively associated with moderate to vigorous physical activity (MVPA). When mediating the relationship between EPA and MVPA, through PAC, the effect on MVPA increased (from β = 0.20 to β = 0.32). Analysis revealed that 87% of the adolescents fulfilled the national health recommendations for physical activity. This study highlights the relevance of EPA and PAC in studies of physical activity among adolescents, and the impact of perceived parental support for adolescents' EPA and physical activity level.

3235 Acceptability of Robotic-Assisted Exercise Coaching in Diverse Youth

OBJECTIVES/SPECIFIC AIMS: Approximately 80% of adolescents do not meet the current national guidelines of engaging in 60 minutes or more of physical activity daily. Physical activity is widely recognized as being beneficial for healthy growth as well as important for good mental health and fitness. Interventions are needed that promote and encourage physical activity among this population to reduce the risk of obesity and to encourage maintenance of a healthy weight. Since adolescents enjoy digital technologies, robotic-assisted platforms might be a novel, innovative and engaging mechanism to deliver physical activity interventions. The objective of this study was to assess the potential acceptability of robotic-assisted exercise coaching among diverse youth. METHODS/STUDY POPULATION: This was a pilot study that used a cross-sectional survey design. Adolescents ages 12-17 were recruited at 3 community-based sites. We obtained written informed consent from participants’ parents and guardians as well as assent from participants. We demonstrated the robotic system human interface (also known as the robotic human trainer) to groups of adolescents. We delivered the exercise coaching in real time via an iPad tablet placed atop a mobile robotic wheel base and controlled remotely by the coach using an iOS device or computer. After the demonstration participants were asked to complete a 28- item survey that included questions about socio demographics, smoking history, weight, exercise habits, and depression history. The survey also included the 8- item Technology Acceptance Scale (TAS). RESULTS/ANTICIPATED RESULTS: Participants (N = 190) were 55% (103/189) male, 43% (81/190) racial minority, 6% (11/190) Hispanic, and 28% (54/190) lived in a lower-income community. The mean age of participants was 15.0 years (SD=2.0). Approximately 25% (47/190) of participants met national recommendations for physical activity. Their mean body mass index (BMI) was 21.8(SD_4.0) kg/m2. Of note, 18% (35/190) had experienced depression now or in the past. The mean Technology Acceptance Scale (TAS) total score was 32.8 (SD 7.8) of a possible score of 40, indicating high potential receptivity to the technology. No significant associations were detected between TAS score and gender, age, racial minority status, median income of participant’s neighborhood, BMI, meeting national recommendations for physical activity levels, or depression history. Of interest, 68% (129/190) of participants agreed that they and their friends were likely to use the robot to help them exercise. DISCUSSION/SIGNIFICANCE OF IMPACT: This pilot survey study demonstrated that among a racially and socioeconomically diverse group of adolescents, robotic-assisted exercise coaching is likely acceptable. The discovery that all demographic groups represented in this sample had similarly high receptivity to the robotic human exercise trainer is encouraging for ultimate considerations of intervention scalability and reach among diverse adolescent populations. Next steps include a study to assess the impact of robotic-assisted exercise coaching on adolescents’ exercise and health outcomes.

Exploring the physical activity and screen-viewing-related knowledge, training, and self-efficacy of early childhood education candidates

BackgroundEarly childhood educators greatly influence young children’s physical activity and screen-viewing behaviours in childcare. However, educators have requested additional training in physical activity programming, and one logical place to provide this education is during their pre-service schooling. This study explored the physical activity and screen-viewing-related knowledge, training, and self-efficacy of early childhood education (ECE) candidates across Canada, to determine their confidence and ability to facilitate physical activity opportunities and limit screen-viewing among young children in childcare.MethodsKey program personnel at 61 (of 110) Canadian colleges/universities offering an ECE program agreed to participate in this cross-sectional study. An online survey (112 items; 9 domains), developed by experts using the Tailored Design Method, was administered via Qualtrics© to a sample of 1292 ECE candidates. Descriptive statistics, Mann-Whitney U-tests, and chi-square tests were used to report participant demographics and physical activity and screen-viewing-related knowledge (i.e., of physical activity and screen-viewing concepts), training (i.e., physical activity and screen-viewing courses/content received), and self-efficacy (i.e., to facilitate physical activity and limit screen-viewing in childcare) of candidates.ResultsECE candidates exhibited the least amount of knowledge regarding the impact of screen-viewing on physiological outcomes (i.e., blood pressure) in young children. Further, only 32.2 and 26.7% of candidates reported completing physical activity or screen-viewing courses during their post-secondary training, respectively. Candidates who completed one or more physical activity or screen-viewing courses exhibited significantly greater (p <.05) self-efficacy than those without such training related to ensuring children were engaging in adequate moderate-to-vigorous physical activity (MVPA). Confidence to limit screen time did not differ. Candidates reporting meeting national physical activity recommendations (i.e., 150+ minutes of MVPA/week) exhibited significantly greater (p <.05) physical activity-related self-efficacy than those not meeting these guidelines.ConclusionsFindings from this work highlight both the need for and the potential of supplementary physical activity and screen-viewing content in post-secondary ECE programs to benefit candidates’ knowledge and self-efficacy in these areas. Introducing this content at the post-secondary level will ensure that all early childhood educators are appropriately trained regarding physical activity and screen-viewing before entering a childcare-based profession, where they can positively influence young children’s health behaviours.

The association between income and leisure-time physical activity is moderated by utilitarian lifestyles: A nationally representative US population (NHANES 1999–2014)

The objective of this study was to determine whether the relationship between income and leisure-time physical activity (LTPA) persists after accounting for a person's utilitarian PA (all non-LTPA), sociodemographic characteristics and transportation PA. Data were from eight cycles (1999–2014) of the nationally representative samples of the US adult population from the National Health and Nutrition Examination Survey (n = 35,239). Whether the poverty income ratio (0–1.3, 1.3–1.86, 1.86+ [reference]) was associated with minutes of LTPA (moderate, vigorous) after stratifying for utilitarian PA (sedentary, light, moderate, and vigorous) was assessed in multiple linear regressions adjusted for age, sex, race, education, marital status, weight status, hours worked, and minutes of transportation-related PA in the past week. Likelihood of meeting national physical activity recommendations was also assessed in multiple logistic regressions adjusting for the covariates described. For both sedentary and light utilitarian PA levels, compared to the reference, persons living in households of the lowest poverty income ratio were consistently associated with approximately 17–30 less minutes of moderate LTPA minutes per week, and 20–25 less minutes of vigorous LTPA across all survey cycles. Compared to the reference, the likelihood of meeting national PA recommendations was approximately 31–55% less for these households. The known association between lower income and lower LTPA persist, but is the most persistent and consistent for those with less active utilitarian (such as sedentary) lifestyles. Interventions aimed at increasing LTPA among people with low income and sedentary utilitarian lifestyles whether or not they are in the workforce are particularly needed.