Participation In Physical Activity Programs Research Articles

Situación actual de la actividad física para personas con discapacidad en la Comunidad de Madrid

El presente estudio tuvo por objetivo analizar la situación de la actividad física adaptada para personas con discapacidad en la Comunidad de Madrid. Para ello, se analizaron las fuentes oficiales de 2014 relativas a la demografía y a la participación en programas de actividad física. Los resultados indicaron un censo de 307.880 personas con discapacidad en la región (4,7 % de la población), siendo la discapacidad física la más representativa. Menos del 2,53 % de las personas con discapacidad practicaba deporte federado y el 21,49 % de los ciudadanos de Madrid con discapacidad disfrutaron del “Carné Especial” que da acceso a las instalaciones deportivas municipales. Sin embargo, no se encontraron indicadores de práctica físico-deportiva recreativa o saludable de personas con discapacidad en la Comunidad de Madrid. Estos resultados sugieren mejorar los indicadores de seguimiento oficiales y establecer pautas de acción que respondan al perfil demográfico analizado.

A snapshot of physical activity programs targeting Aboriginal and Torres Strait Islander people in Australia.

Issue addressed Participation in physical activity programs can be an effective strategy to reduce chronic disease risk factors and improve broader social outcomes. Health and social outcomes are worse among Aboriginal and Torres Strait Islanders than non-Indigenous Australians, who represent an important group for culturally specific programs. The extent of current practice in physical activity programs is largely unknown. This study identifies such programs targeting this population group and describes their characteristics. Methods Bibliographic and Internet searches and snowball sampling identified eligible programs operating between 2012 and 2015 in Australia (phase 1). Program coordinators were contacted to verify sourced information (phase 2). Descriptive characteristics were documented for each program. Results A total of 110 programs were identified across urban, rural and remote locations within all states and territories. Only 11 programs were located through bibliographic sources; the remainder through Internet searches. The programs aimed to influence physical activity for health or broader social outcomes. Sixty five took place in community settings and most involved multiple sectors such as sport, health and education. Almost all were free for participants and involved Indigenous stakeholders. The majority received Government funding and had commenced within the last decade. More than 20 programs reached over 1000 people each; 14 reached 0-100 participants. Most included process or impact evaluation indicators, typically reflecting their aims. Conclusion This snapshot provides a comprehensive description of current physical activity program provision for Aboriginal and Torres Strait Islander people across Australia. The majority of programs were only identified through the grey literature. Many programs collect evaluation data, yet this is underrepresented in academic literature. So what? Capturing current practice can inform future efforts to increase the impact of physical activity programs to improve health and social indicators. Targeted, culturally relevant programs are essential to reduce levels of disadvantage experienced by Aboriginal and Torres Strait Islanders.

Associations between aerobic exercise levels and physical and mental health outcomes in men with bone metastatic prostate cancer: a cross-sectional investigation.

Cancer patients with bone metastases have previously been excluded from participation in physical activity programmes due to concerns of skeletal fractures. Our aim was to provide initial information on the association between physical activity levels and physical and mental health outcomes in prostate cancer patients with bone metastases. Between 2012 and 2015, 55 prostate cancer patients (mean age 69.7±8.3; BMI 28.6±4.0) with bone metastases (58.2% >2 regions affected) undertook assessments for self-reported physical activity, physical and mental health outcomes (SF-36), objective physical performance measures and body composition by DXA. Sixteen men (29%) met the current aerobic exercise guidelines for cancer survivors, while 39 (71%) reported lower aerobic exercise levels. Men not meeting aerobic exercise guidelines had lower physical functioning (p=.004), role functioning (physical and emotional) (p<.05), general health scores (p=.014) as well all lower measures of physical performance (p<.05). Lower levels of aerobic exercise are associated with reduced physical and mental health outcomes in prostate cancer patients with bone metastases. While previous research has focused primarily in those with non-metastatic disease, our initial results suggest that higher levels of aerobic exercise may preserve physical and mental health outcomes in prostate cancer patients with bone metastases. Clinical Trial Registry: Trial Registration: ACTRN12611001158954.

How do we ensure sustainable physical activity options for people with disabilities?

This commentary is on the review by Verschuren et al. on pages 798–808 of this issue. Verschuren et al.1 have written a compelling article highlighting the importance of physical activity across the activity spectrum to address cardiovascular risk factors and muscle strength in children with cerebral palsy (CP). In addition to the health benefits of physical activity, it is clinically assumed that increasing fitness levels and muscle strength will translate into improvements in mobility and participation. For some children, this may be true; however, it is important to consider that engagement in an enjoyable physical activity program is participation. If the physical activity is enjoyable and meaningful to the child and family, participation is an important outcome in itself. Many families are focussed on psychosocial outcomes such as psychological well-being, socialization, inclusion, and participation in community activities. Participation in community physical activity programs, even if below the presumed therapeutic ‘dose’, may enable still families to achieve these goals. Verschuren et al.1 highlight the importance of long-term engagement in physical activity in order to sustain health benefits and the need for consideration of behaviour change strategies. This point raises an important question for rehabilitation professionals. What role should we play in facilitating sustainable physical activity for individuals with disabilities? In addition to the universal challenges associated with changing routines and behaviours, families with children with disabilities experience significant barriers to accessing community-based exercise programs. Families report poor accessibility, lack of knowledgeable trained staff who can adapt activities for children with disabilities, and attitudinal barriers.2 At a macro-level, advocates for the inclusion of individuals with disabilities can play a role in facilitating community change to encourage increased healthy behaviours for all children, including children with disabilities. Community-based guidelines for the inclusion of people with disabilities in healthy living activities can increase awareness of universal supports for inclusion. Communities can be encouraged to evaluate supports for facilitating the participation of individuals with disabilities in community programs. At a local level, the development of formal partnerships between rehabilitation and community-based fitness facilities can bridge the gap between hospitals and community by increasing awareness of access barriers and providing opportunities for families, therapists, and trainers collaboratively to develop safe, effective fitness programs.3 Finally, therapists can ensure that families are aware of the opportunities in their communities and work with families to explore programs and activities for their children. Given the breadth of family preferences regarding physical activity programs it is unlikely that a one-size-fits-all approach will be effective for long-term behaviour change. The authors point out the importance of applying knowledge about behaviour change when encouraging increased physical activity. A recent randomized controlled trial found that a 4-month physical activity program combined with motivational interviewing and home-based physical therapy did not increase the physical activity levels of children with CP compared to a regular therapy control group.4 Perhaps we need to focus more on the crucial role of psychosocial factors in decision-making regarding long-term participation in physical activity programs. Self-efficacy, a desire to be active, enjoyment of the activity, opportunities for fun and interaction, and feeling accepted as part of a group may influence the decision to engage in physical activity.5 All of these factors should be considered in multi-faceted strategies for encouraging increased physical activity. Thanks to Verschuren et al. for providing such a comprehensive and clinically relevant review of the literature on fitness for children CP.

Physical activity mediates the relationship between program participation and improved mental health in older adults

ObjectivesThere is an implicit assumption that increased physical activity (PA) levels are responsible for the mental health benefits resulting from participation in PA programs. Other factors associated with participation may in fact be responsible. The purpose of this study was to examine whether changes in PA mediated the effects of two PA programs (Active Choices [AC] and Active Living Every Day [ALED]) on mental health outcomes. Study designSecondary data analyses of quasi-experimental study. MethodsA sub-sample of older adults who participated in AC (n = 744) and ALED (n = 853) were included in the current analyses. MacKinnon's product of coefficients was used to test change in PA as a mediator of the relationship between program dose and change in mental health outcomes (depressive symptoms, stress, and number of days with poor mental health). ResultsChange in PA explained 19% (AC) and 13% (ALED) of the absolute effects of program dose on depressive symptoms, 18% (AC) and 14% (ALED) of the effects on stress, and 37% (ALED) of the effects on days with poor mental health. ConclusionsMounting evidence from both epidemiological studies and controlled trials suggests that PA can improve mental health. This study adds that increasing PA levels may improve mental health in older adults in ‘real-world’ settings.

Examınatıon Of Constraınts On Physıcal Actıvıty Programs Partıcıpatıon To Indıvıduals Wıth Autısm

The aim of this study was to examine perceptions of constraints on physical activity participation among people with autism. This qualitative study was conducted on 9 different family of people with autism who participating in physical activity program. The data were collected by using semi-structured interview form. The literature review was done with the purpose of preparing the interview questions and creating conceptual framework. A semi-structured form was developed that consists of 7 items and 7 themes. The data were collected by using face to face interview methods. The descriptive analyses were used to analyze the collected data. The analysis indicated that the most important constraints were the economical factors on physical activity participation. The most important reason for this occurring was the lack of such programs in the public schools or in institutions. In addition to, this services carried by only the private sector was the other important factor that affected this reason. Analysis also revealed that central government policies of individuals with autism was insufficient for the participation in such programs in the state (government) contact and also does not meet their needs. As a result, economic difficulties of individuals with autism to participate in physical activity programs was considered the most important constraints. However, it can be concluded that state (government) policies were inadequate that in the social life of individuals with autism use their potential in educational activities that support participation in physical activity programs.

Shared Use of School Facilities With Community Organizations and Afterschool Physical Activity Program Participation: A Cost‐Benefit Assessment

Partnerships between school districts and community-based organizations to share school facilities during afterschool hours can be an effective strategy for increasing physical activity. However, the perceived cost of shared use has been noted as an important reason for restricting community access to schools. This study examined shared use of middle school facilities, the amount and type of afterschool physical activity programs provided at middle schools together with the costs of operating the facilities. Afterschool programs were assessed for frequency, duration, and type of structured physical activity programs provided and the number of boys and girls in each program. School operating costs were used to calculate a cost per student and cost per building square foot measure. Data were collected at all 30 middle schools in a large school district over 12 months in 2010-2011. Policies that permitted more use of school facilities for community-sponsored programs increased participation in afterschool programs without a significant increase in operating expenses. These results suggest partnerships between schools and other community agencies to share facilities and create new opportunities for afterschool physical activity programs are a promising health promotion strategy.

Recent changes in school-based policies on physical activity and nutrition in Spain

This study evaluates the changes in Spain between 2006 and 2012, of school-based policies encouraging healthy eating and the undertaking of physical activity (PA). A longitudinal study was undertaken comprising 277 representative schools from all the regions of Spain. The questionnaires were completed by the school management board. An indicator for school policies on PA was constructed (score 0-4) from the following indicators: (i) participation in PA programmes, (ii) existence of written PA guidelines, (iii) training of teachers about PA and (iv) organization of extracurricular PA activities. For nutrition, indicators similar to the first three for PA were evaluated, together with access to healthy foods (score 0-4). In addition to comparing the scores for 2006 and 2012, multivariate linear regression was used to study the association between the characteristics of the schools and the changes in the scores. The indicators for school-based policies on nutrition and PA improved between 2006 and 2012: the average score for PA increased from 1.33 to 1.79 (P < 0.001) and that for nutrition from 1.28 to 1.92 (P < 0.001). The greatest changes were seen regarding the written guidelines for action and participation in PA and nutrition programmes as well as the training of teachers about nutrition. The schools with the least number of students had the highest changes in scores for policies on nutrition (P < 0.05). There has been an increase of school-based policies on PA and nutrition, although there is still room for improvement.

Barriers to and facilitators of physical activity program use among older adults.

Regular physical activity (PA) is important for maintaining long-term physical, cognitive, and emotional health. However, few older adults engage in routine PA, and even fewer take advantage of programs designed to enhance PA participation. Though most managed Medicare members have free access to the Silver Sneakers and EnhanceFitness PA programs, the vast majority of eligible seniors do not utilize these programs. The goal of this qualitative study was to better understand the barriers to and facilitators of PA and participation in PA programs among older adults. This was a qualitative study using focus group interviews. Focus groups took place at three Group Health clinics in King County, Washington. Fifty-two randomly selected Group Health Medicare members between the ages of 66 to 78 participated. We conducted four focus groups with 13 participants each. Focus group discussions were audio-recorded, transcribed, and analyzed using an inductive thematic approach and a social-ecological framework. Men and women were nearly equally represented among the participants, and the sample was largely white (77%), well-educated (69% college graduates), and relatively physically active. Prominent barriers to PA and PA program participation were physical limitations due to health conditions or aging, lack of professional guidance, and inadequate distribution of information on available and appropriate PA options and programs. Facilitators included the motivation to maintain physical and mental health and access to affordable, convenient, and stimulating PA options. Older adult populations may benefit from greater support and information from their providers and health care systems on how to safely and successfully improve or maintain PA levels through later adulthood. Efforts among health care systems to boost PA among older adults may need to consider patient-centered adjustments to current PA programs, as well as alternative methods for promoting overall active lifestyle choices.

Assessing Participation in Community-Based Physical Activity Programs in Brazil

This study aimed to develop and validate a risk prediction model to examine the characteristics that are associated with participation in community-based physical activity programs in Brazil. We used pooled data from three surveys conducted from 2007 to 2009 in state capitals of Brazil with 6166 adults. A risk prediction model was built considering program participation as an outcome. The predictive accuracy of the model was quantified through discrimination (C statistic) and calibration (Brier score) properties. Bootstrapping methods were used to validate the predictive accuracy of the final model. The final model showed sex (women: odds ratio [OR] = 3.18, 95% confidence interval [CI] = 2.14-4.71), having less than high school degree (OR = 1.71, 95% CI = 1.16-2.53), reporting a good health (OR = 1.58, 95% CI = 1.02-2.24) or very good/excellent health (OR = 1.62, 95% CI = 1.05-2.51), having any comorbidity (OR = 1.74, 95% CI = 1.26-2.39), and perceiving the environment as safe to walk at night (OR = 1.59, 95% CI = 1.18-2.15) as predictors of participation in physical activity programs. Accuracy indices were adequate (C index = 0.778, Brier score = 0.031) and similar to those obtained from bootstrapping (C index = 0.792, Brier score = 0.030). Sociodemographic and health characteristics as well as perceptions of the environment are strong predictors of participation in community-based programs in selected cities of Brazil.

Fear of falling and self-perception of health in older participants and non-participants of physical activity programs

Fear of falling, self-perception of health, and participation in physical activity programs have been associated with several variables related to health and performance in older adults. The purpose of this study was to evaluate self-perception of health and fear of falling in older adult participants and non-participants of physical activity programs, and to verify the relationship between these variables. A total of 40 healthy but sedentary older adults, and 45 physically active older adults were assessed through the Falls Efficacy Scale International-Brazil (FES-I) and a questionnaire that measured their self-perception of health. The older adults that did not participate in regular physical activity programs presented higher scores of fear of falling, which, in turn, is associated with an increase of risk for falls. Moreover, older adults, participants in regular physical activity programs exhibited a more positive health perception than did the non-participants. Also, non-participants of physical activity programs perceived their health status as being poor or very poor as well as expressing great concern about falling compared to those who considered their health as excellent, good or regular. The results of this study have important implications for making clinical decisions in prevention or rehabilitation of older people, and they justify recommendations to the public health system.

Understanding older adults' motivators and barriers to participating in organized programs supporting exercise behaviors.

Little is known about older adults' perceptions of organized programs that support exercise behavior. We conducted semi-structured interviews with 39 older adults residing in King County, Washington, who either declined to join, joined and participated, or joined and then quit a physical activity-oriented program. We sought to explore motivators and barriers to physical activity program participation and to elicit suggestions for marketing strategies to optimize participation. Two programs supporting exercise behavior and targeting older persons were the source of study participants: Enhance(®)Fitness and Physical Activity for a Lifetime of Success. We analyzed interview data using standard qualitative methods. We examined variations in themes by category of program participant (joiner, decliner, quitter) as well as by program and by race. Interview participants were mostly females in their early 70s. Approximately half were non-White, and about half had graduated from college. The most frequently cited personal factors motivating program participation were enjoying being with others while exercising and desiring a routine that promoted accountability. The most frequent environmental motivators were marketing materials, encouragement from a trusted person, lack of program fees, and the location of the program. The most common barriers to participation were already getting enough exercise, not being motivated or ready, and having poor health. Marketing messages focused on both personal benefits (feeling better, social opportunity, enjoyability) and desirable program features (tailored to individual needs), and marketing mechanisms ranged from traditional written materials to highly personalized approaches. These results suggest that organized programs tend to appeal to those who are more socially inclined and seek accountability. Certain program features also influence participation. Thoughtful marketing that involves a variety of messages and mechanisms is essential to successful program recruitment and continued attendance.

Survey of Australian mental health nurses on physical activity promotion

Physical activity is important to the physical and mental health of people with serious mental illness (SMI). This study investigated views of public mental health nurses on physical activity promotion for consumers with SMI, through a national electronic survey in Australia. Consumers with SMI were viewed to be less physically active than the general community. Two-thirds of nurses wanted training on exercise support of consumers. Motivation of consumers was indicated to be a major barrier. There was great variability in discussion frequency between nurses and exercise physiologists. An analysis of open comments revealed two themes: (1) access – opportunities for health education, participation in physical activity programmes and nurses' connections to exercise physiologists; and (2) commitment – nurses promoting physical activity and building competencies. Findings indicate that initiatives to increase physical activity promotion for people with SMI are likely to be supported by nurses in the mental hea...

Barriers and Enablers to Physical Activity Participation in Patients With COPD

Physical activity (PA) has been shown to improve symptoms in people with chronic obstructive pulmonary disease (COPD). Despite the high health and financial costs, the uptake of management strategies, particularly participation in PA and pulmonary rehabilitation (PR), are low. The review objective here was to identify potential barriers and enablers, which people with COPD report being associated with their participation in PA programs, including PR. A systematic search was undertaken to identify studies (published Jan 2000 to Aug 2011) reporting any barriers and enablers experienced by people with COPD regarding participation in PA and PR. Methodological quality of the studies was appraised using McMaster critical appraisal tools. A narrative summary of findings was undertaken reporting on individual study characteristics, country of origin, participants, and potential barriers and enablers. Eleven studies (8 qualitative and 3 quantitative) met the inclusion criteria for this systematic review. Several methodological issues (small sampling, poor description of data collection and analysis, issues with generalizability of the research findings) were common among included studies. Barriers identified included changing health status, personal issues, lack of support, external factors, ongoing smoking, and program-specific barriers. Enablers identified included social support, professional support, personal drivers, personal benefit, control of condition, specific goals, and program-specific enablers. The findings from this review may assist health professionals, patients, care givers and the wider community to develop effective strategies to promote participation in PA and PR among people with COPD.

Different Strategies Contribute to Community Physical Activity Program Participation in Rural versus Metropolitan Settings

Determine if recruitment methods are differentially related to the reach of a physical activity program in metro/urban vs. rural settings. Cross-sectional survey. Kansas counties. Ninety-four Cooperative Extension agents responsible for 102 counties. Promotional score, task force activity, and years of program delivery were assessed using a self-report survey. Reach was assessed for each county by dividing the number of participants by intended population using census data. Rural/urban comparisons on reach were completed using a Mann-Whitney test. Multiple linear regression models were used to determine the relationship between independent variables and participation rate by setting type. Metro/urban counties had lower mean participation rates than rural counties (z = -4.5; p < .001). In metro/urban counties, the regression on participation rate was significant (R(2) = .19; F = 4.09; p = .011), but only promotional score significantly contributed to the model (p = .003). In rural counties, the regression was also significant (R(2) = .34; F = 6.64; p = .001), with task force activity and years of delivery making significant contributions (p = .001 and p = .017, respectively). Interpersonal methods may be more effective in recruiting physical activity program participants in rural settings, whereas using a greater variety of promotional methods may be more effective in metro/urban settings.

Association of Children's After-School Activity Level and Organized Physical Activity Program Participation

Association of Children's After-School Activity Level and Organized Physical Activity Program Participation

Sports injury prevention: The proof of the pudding is in the eating: Brisbane City Council supported speaker

Sports injuries are an unwanted side-effect of participation in physical activity programmes and (un-)organized sports. In order to minimize the sports injury problem a systematic approach is needed in which first the extent of the problem is established. Next, the risk factors and mechanisms should be identified. Based on this information an intervention programme can be designed, of which the effectiveness should be evaluated, preferably by conducting a randomized clinical trial (RCT). This conceptual approach was suggested by me in 1992. At that time sports injury epidemiology was in its infancy and little systematic scientific research had been done up until that time. Purpose of this presentation is to give an overview of how the field has evolved since in terms of designing evidence-based (cost-)effective sports injury prevention interventions. The overview will be based on an analysis of studies listed in PubMed regarding three distinct research outcomes: (1) assessing the extent of the injury; (2) identifying risk factors for sports injuries; (3) evaluating the (cost-)effectiveness of sports injury prevention programmes. In addition, some reflections will be shared on the need for: the RCT as the preferred study design; intervention mapping as a tool for designing effective interventions and; conducting cost-effectiveness analysis along effectiveness trials.

Depression and Use of a Health Plan–Sponsored Physical Activity Program by Older Adults

The purpose of this study was to determine the associations between depression and the likelihood of enrollment in a health plan-sponsored physical activity program and pattern of program participation over 2 years; a secondary aim was to examine the association between participation dose and depression risk. There are no published studies on how depression influences participation in health plan-sponsored physical activity programs and how participation affects depression risk in older adults in nonresearch settings. This study used administrative data from a Medicare Advantage plan. Participants (n=4766) were enrolled in the plan for at least 1 year prior to participating in the plan-sponsored health club benefit (Silver Sneakers). Controls were age- and gender-matched to participants (n=9035). Members were identified as having depression based on ICD-9-CM codes. Multivariate regression and generalized estimating equations models were used. Data were collected between 1998 and 2003 and analyzed in 2008. Members who had a history of depression were as likely to participate in Silver Sneakers as nondepressed members (OR: 1.03; 95% CI=0.89, 1.20; p=0.67). The risk of lapse in Silver Sneakers attendance was 28%-55% (p<0.05) higher for depressed participants during months 15-24. For nondepressed Silver Sneakers participants, attendance of at least 2 visits/week during Year 1 was significantly associated with lower risk of depression in Year 2 (OR=0.54; 95% CI=0.37, 0.79; p=0.002); a similar but statistically nonsignificant association was observed for previously depressed participants (OR=0.51; 95% CI=0.26, 1.02; p=0.06). While depressed older adults are as likely to enroll in a health plan-sponsored physical activity as nondepressed members, they were at higher risk of attendance lapses. Greater participation in the physical activity program was associated with lower depression risk.

Barriers and Enabling Factors for Work-Site Physical Activity Programs: A Qualitative Examination

Work sites offer a productive setting for physical activity (PA) promoting interventions. Still, PA participation remains low. Thus, the purpose of this study was to examine the reasoning behind commonly reported barriers and enabling factors to participation in PA programs in a work-site setting. Employees from a large city government were recruited to participate in focus groups, stratified by white- and blue-collar occupations. Responses from open-ended questions about factors influencing participation in PA programs were audio recorded and transcribed verbatim. Resulting data were analyzed with open and axial coding. The sample consisted of 60 employees composing 9 focus groups. Although time was the most common barrier between both groups, white-collars workers responded that scheduling and work conflicts were the most common barrier concerning time. Blue-collar workers indicated shift work as their most common barrier. In addition, health was a significant enabling factor for both occupational categories. White-collar workers were much more concerned with appearances and were more highly motivated by weight loss and the hopefulness of quick results than were blue-collar workers. These findings are important in the understanding of PA as it relates to the reasoning behind participation in work-site programs in regard to occupational status.

Acute affective response to a moderate-intensity exercise stimulus predicts physical activity participation 6 and 12 months later

Objective Examine the relationship between acute affective responses during a moderate-intensity exercise stimulus and future physical activity participation. Design Longitudinal, observational study in the context of a randomized controlled trial. Methods Healthy, sedentary adults ( n=37) reported their basic affective response (i.e., feel good versus bad) prior to and during an acute, moderate-intensity exercise stimulus presented prior to randomization in a controlled physical activity promotion trial. At 6 and 12 months, 31 of the 37 participants reported their total weekly minutes of physical activity. Results As hypothesized, basic affective response to the moderate-intensity stimulus predicted 6-month physical activity ( β=.51, p=.013) when controlling for baseline physical activity and self-reported affect prior to the initial exercise stimulus, and 12-month physical activity ( β=.45, p=.047) when also controlling for 6-month physical activity. Conclusions Affective response to an acute moderate-intensity exercise stimulus predicted self-reported physical activity 6 and 12 months later. The findings could have implications for prescription of exercise intensity, as exercising at an intensity that yields a positive affective response may lead to greater participation in physical activity programs among previously sedentary adults.