Physical Activity Guidelines For Americans Research Articles

Physical Activity in Older Adults: What Every Internist Needs to Know

The Physical Activity Guidelines for Americans (Guidelines) advises older adults to be as active as possible. Yet, despite the many benefits of physical activity, less than 15% of people ages 65 years and older meet the Guidelines. To address this, the U.S. Department of Health and Human Services developed a Midcourse Report focused on the strategies and settings that can help increase physical activity levels among older adults. Internists are well positioned to encourage older adults to be more physically active. Health care providers can leverage this position to talk about the importance of regular physical activity; assess physical activity levels; share information and resources about how to safely get started; and provide counseling, guidance, and/or referrals to additional providers or programs for further support. This article provides an overview of the recently released Physical Activity Guidelines for Americans Midcourse Report: Implementation Strategies for Older Adult and highlights the role of internists and other health care providers to encourage and support their patients to be more physically active.

Abstract SY08-01: Does exercise or fitness deter cancer progression after diagnosis

Abstract In the U.S., 42% of cancer cases and 45% of cancer deaths are estimated to be attributable to modifiable factors, including tobacco use. Among women, the combination of excess body weight, poor diet, low physical activity, and alcohol consumption contributed to 22.4% of cases, ahead of tobacco (14.8%), due to prevalence of lifestyle behavior-related cancers in women (e.g. breast). Among men, 24% were due to tobacco, and 13.9% due to obesity, diet, physical activity, and alcohol. Evidence increasingly supports a role of these factors for improving cancer progression and death outcomes among cancer survivors. For example, healthy (e.g. Mediterranean) or unhealthy (e.g. “Western”) dietary patterns are associated with cancer progression or death among individuals diagnosed with colorectal, breast and/or prostate cancers (Rock, CA J Clin, 2022). For example, among 1101 men and women with stage III colon cancer enrolled in the CALGB adjuvant chemotherapy trial, those with a high vs low “Western” dietary pattern (high in meat, fat, refined grains and dessert) had 3.25 times higher risk of recurrence and death (Meyerhardt, JAMA, 2007). Long-term follow up of the Women’s Health Initiative trial participants indicates persistent reduction in deaths after breast cancer, among women randomized to the low fat/high fruit, vegetables and grains intervention compared to usual diet control (Chlebowski, J Clin Onc, 2020). Studies similarly suggest that physical activity after diagnosis of cancer is associated with a reduced risk all cause and cancer death. Evidence has accumulated such that the 2018 Physical Activity Guidelines for Americans recommended that physical activity after diagnosis is beneficial to reduce cancer death among those with breast, colorectal, and prostate cancer (U.S. Dept. of Health & Human Services, 2018). More recently, in a pan-cancer study of more than 11,000 people with 18 different types of cancer, exercise consistent with guidelines was linked to a 25% reduced hazard of death (95% confidence interval (CI) 0.70-0.80) and a 21% reduced hazard of cancer death (95% CI, 0.72 to 0.88); exercise according to guidelines was defined as moderate-intensity exercise ≥4 days per week, with sessions averaging ≥30 minutes and/or strenuous-intensity exercise ≥2 days per week, with sessions averaging ≥20 minutes) (Lavery JA et al, JCO 2023). There is also accumulating evidence from studies that examined the combination of multiple lifestyle factors, which indicate the combined benefits of healthy diet, regular physical activity, and weight control in cancer survivors. For example, in the CALGB study, those with a higher American Cancer Society (ACS) cancer prevention guidelines score (based on body mass index, physical activity, and healthy dietary pattern), had a 42% lower risk of death (Van Blarigan, JAMA, 2018). Studies examining combined lifestyle factors scores among men with prostate cancer have observed similar, though not entirely consistent, results for the outcomes of cancer progression and death (Graff RE, Br J Ca 2023; Langlais CS, Br J Ca, 2023). Purported mechanisms for improved outcomes with healthy diet and physical activity include beneficial effects on insulin resistance, inflammation, oxidative stress, and sex hormone pathways. Evidence gaps exist for less common cancers, and more research is needed to understand the impacts of energy balance and body composition on cancer outcomes. The evidence generated supporting the benefits of physical activity and high diet quality for cancer survivors has resulted in guidelines from multiple national and international organizations, including the American Cancer Society, American College of Sports Medicine, American Institute of Cancer Research/World Cancer Research Foundation, and the American Society of Clinical Oncology. While the publications of these guidelines represent an important milestone, much works remains to see them implemented in practice. Most cancer survivors are not physically active at recommended levels or following dietary recommendations. Programming and services tailored for survivors are needed, but a major challenge is the lack of reimbursement for nutritional and exercise counseling and services in cancer care. While some care settings and community organizations offer exercise and/or nutritional programming and information to people with cancer, this largely relies on institutional funding or philanthropy. Often these programs have limited reach or capacity, and the availability of programs may be particularly limited for cancer patients treated in safety net care settings. In order to address these gaps, wider availability of programs and services as well as clinical workflows to facilitate referral to services by healthcare providers is needed. In conclusion, evidence is growing that diet and physical activity after a diagnosis of cancer deters cancer-specific and all cause death. Innovative solutions are needed to increase nutritional quality and exercise in cancer survivors, in particular among those who are historically under-served and/or of lower socioeconomic status. Reimbursement for nutrition and exercise counseling for cancer survivors is warranted. Citation Format: June M. Chan. Does exercise or fitness deter cancer progression after diagnosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr SY08-01.

Abstract 2227: Physical activity at breast cancer diagnosis and incident cardiovascular disease in the Pathways Study

Abstract Background: Breast cancer survivors are at increased risk of cardiovascular disease (CVD) compared to women without a history of breast cancer. Although cardiotoxic cancer treatments influence these risks, lifestyles that are associated with both breast cancer and CVD also contribute. With the number of breast cancer survivors expected to increase, a growing need exists to identify modifiable risk factors that protect against the development of CVD after diagnosis. Physical activity at breast cancer diagnosis is associated with lower cancer recurrence and mortality risk. However, associations between physical activity at diagnosis and incident CVD have yet to be investigated in detail. Methods: The Pathways Study is a prospective cohort study of 4,504 women who were members of Kaiser Permanente Northern California (KPNC) when diagnosed with first primary invasive breast cancer between 2005 and 2013. At enrollment, women self-reported their frequency, duration, and intensity of physical activities during the previous six months using the Arizona Activity Frequency Questionnaire. This information was used to dichotomize the women’s physical activity levels by the CDC’s Physical Activity Guidelines for Americans (≥ 150 minutes of moderate-to-vigorous physical activity per week vs less). CVD events were obtained from electronic health records as part of the Pathways Heart Study and were defined as post-diagnostic incidence of ischemic heart disease, heart failure, cardiomyopathy, and stroke. Deaths were documented through several sources, including the National Death Index. Women were followed until the first of disenrollment from the KPNC health plan, death, or December 31, 2021. Competing risk Cox regression models were used to estimate associations between meeting CDC physical activity guidelines and CVD. Results: In this cohort of breast cancer survivors, women who self-reported meeting physical activity guidelines at diagnosis experienced lower rates of post-diagnostic CVD events (8.6% vs 13.1%). After adjustment for socio-demographic factors, meeting physical activity guidelines remained associated with lower risk of CVD (HR: 0.78, 95% CI: 0.61, 0.98); this association appeared to be driven by reduced risk of heart failure (HR: 0.68, 95% CI: 0.50, 0.93) and cardiomyopathy (HR: 0.51, 95% CI: 0.28, 0.92). Approximately 15% of the CVD risk reduction in Pathways Study participants can be attributed to meeting physical activity guidelines (population attributable risk percent: 14.5%, 95% CI: 8%, 21%). Conclusions: Compared to women who did not meet CDC physical activity guidelines, women who reported meeting guidelines near the time of their breast cancer diagnosis had decreased risk of future CVD, including heart failure and cardiomyopathy. Future studies investigating changes in post-diagnostic physical activity patterns and CVD risk are warranted. Citation Format: Jacob K. Kresovich, Alicia R. Richards, Isaac J. Ergas, Cecile A. Laurent, Rikki Cannioto, Jamal S. Rana, Janise M. Roh, Catherine Thomsen, Salma Shariff-Marco, Eileen Rillamas-Sun, Richard K. Cheng, Song Yao, Christine B. Ambrosone, Lawrence H. Kushi, Heather Greenlee, Marilyn L. Kwan. Physical activity at breast cancer diagnosis and incident cardiovascular disease in the Pathways Study [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2227.

Meeting the Aerobic and Muscle-Strengthening Physical Activity Guidelines Among Older US Adults, National Health Interview Survey 1998-2018.

The Physical Activity Guidelines for Americans, second edition, recommends older adults participate in ≥150minutes per week of moderate-intensity equivalent aerobic activity and ≥2days per week of muscle-strengthening activity. We estimated prevalence and trends of meeting the guidelines among US adults aged ≥65years from 1998 to 2018. Using the 1998-2018 National Health Interview Survey, we estimated the prevalence of meeting aerobic, muscle-strengthening, and combined physical activity guidelines stratified by age group, sex, race and ethnicity, and education level. Within age groups, we calculated prevalence differences by sociodemographic categories. Prevalence of meeting each guideline increased for all age groups and most sociodemographic subgroups. The increased magnitude of meeting the combined guideline from 1998-2000 to 2016-2018 differed across levels of educational attainment for most age groups. Despite increasing over time, the prevalence among older adults of meeting physical activity guidelines remains low (range for combined guideline: 7.2%-17.2%).

Physical Activity According to Diabetes and Metropolitan Status, U.S., 2020 and 2022

IntroductionPhysical activity (PA) can reduce morbidity and mortality among adults with diabetes. While rural disparities in PA exist among the general population, it is not known how these disparities manifest among adults with diabetes. MethodsData from the 2020 and 2022 National Health Interview Survey were analyzed in 2023 to assess prevalence of meeting aerobic and muscle-strengthening recommendations according to the 2018 Physical Activity Guidelines for Americans during leisure time. PA prevalence was computed by diabetes status, type of PA, and urban/rural residence (large central metro, large fringe metro, medium/small metro, and non-metro). Logistic regression models were used to estimate prevalence and prevalence ratios of meeting PA recommendations by urban/rural residence across diabetes status. ResultsAmong adults with diabetes in non-metro counties, only 23.8% met aerobic, 10.9% met muscle-strengthening, and 6.2% met both PA recommendations. By contrast, among adults with diabetes in large fringe metro counties, 32.1% met aerobic, 19.7% met strengthening, and 12.0% met both guidelines. Multivariable adjusted prevalence of meeting muscle-strengthening recommendations was higher among participants with diabetes in large fringe metro compared to large central metro counties (PR=1.27; 95% CI 1.03-1.56). Among those without diabetes, adjusted prevalence of meeting each recommendation or both was lower in non-metro and small/medium metro compared to large central metro counties. ConclusionsAdults with diabetes are less likely to meet the PA recommendations than those without, and differences exist according to urban/rural status. Improving PA among rural residents with diabetes may mitigate disparities in diabetes-related mortality.

Lower Physical Activity Is Associated With Objective But Not Subjective Cognitive Impairment In Older Adults Without Dementia

AbstractBackgroundPhysical activity has been associated with better performance on cognitive assessments for older adults in both observational and interventional studies. Older adults who exercise the 150 minutes a week recommended by the Physical Activity Guidelines for Americans were also less likely to report subjective cognitive decline on the Behavioral Risk Factor Surveillance System than those with lower levels of physical activity. Potential explanations for a cognitive benefit from exercise include reduction of vascular risk factors, preservation of brain mass and neuronal structural integrity, and promotion of psychological health and self‐efficacy.MethodCross‐sectional data on exercise habits, self‐reported memory problems, and cognition were collected for 137 older adults without dementia as part of a larger observational study. Participants were categorized as meeting (3 or more hours a week of physical activity) or not meeting (< 3 hours) physical activity recommendations. We used multivariable logistic regression to evaluate the association between exercise and self‐reported memory problem, and linear regression for association between exercise and total score on the Montreal Cognitive Assessment (MoCA) after adjusting for potential confounders including age, sex, level of education, cognitive status (CDR global score of 0 vs 0.5), and Geriatric Depression Scale score.ResultData on baseline exercise was available for 103 cognitively normal older adults and 34 with mild cognitive impairment (MCI). Mean participant age was 66.6 years and 58.4% were female. 48 participants (35%) reported exercising at least 3 hours per week. Participants with at least 3 hours a week of physical activity had significantly higher scores on the MoCA compared with those with less than 3 hours a week (B = 1.22, p = 0.040) after adjusting for age, sex, level of education, cognitive status, and depressive symptoms. There was no association between physical activity and participant‐reported memory symptoms using the same covariates (B = ‐0.50, p = 0.223).ConclusionWeekly physical activity levels consistent with current guidelines were associated with better performance on a cognitive assessment in older adults without dementia. Physical activity was not associated with presence or absence of a self‐reported memory problem in this sample.

Effects of physical activity on the levels of remnant cholesterol: A population-based study.

Physical activity (PA) has the potential to bring about favourable changes in plasma lipid profile. However, the relationship between PA and remnant cholesterol (RC) remains unclear. We aimed to study the link between PA and RC using the database of the 2007-2020 National Health and Nutrition Examination Survey (NHANES). PA was categorized based on Physical Activity Guidelines for Americans. A multivariate linear regression model was used to determine the correlations between PA and RC. The study involved a total of 18,396 participants and revealed that individuals whose PA met the guidelines by engaging in moderate-intensity PA at least 150 min per week had lower body mass index and showed decreased levels of triglyceride, TC, and haemoglobin A1c compared to those who were physically inactive, exercising <150 min per week. Participants whose intensity of PA meets PA guidelines had a lower level of RC than those who did not met PA guidelines (β = -1.3, 95% confidence interval [CI]: -1.9 to -0.7, p < 0.001), even after adjusting for confounders. During subgroup analysis, we observed that race (pinteraction  = 0.0089) emerged as a significant factor of interaction.

Personal and Professional Physical Activity Practices among Sports Medicine Physicians.

Less than a quarter of the population achieves the recommended Physical Activity Guidelines for Americans. Physicians who achieve the guidelines themselves may be more likely to promote them to patients given strong evidence physicians' personal health habits influence their patient counseling practices. We surveyed primary care and sports medicine specialty physicians about personal exercise habits and beliefs and patient counseling practices. Sports medicine physicians were significantly more likely to meet the Physical Activity Guidelines for Americans and believe that as physicians, they have an obligation to do so. They also were more likely to ask about, counsel, and refer patients to physical activity resources than other primary care physicians. Our results are consistent with previous evidence that physicians' personal habits influence their practice recommendations. This provides support that physicians' personal beliefs about the importance of exercise and sense of obligation to achieve recommended levels themselves plays a strong role in their patient care practices.

First-year College Students’ Adherence To The 2018 Physical Activity Guidelines For Americans

First-year College Students’ Adherence To The 2018 Physical Activity Guidelines For Americans

Evaluating the Science to Inform the Physical Activity Guidelines for Americans Midcourse Report

Abstract&#x0D; The Physical Activity Guidelines for Americans (Guidelines) advises older adults to be as active as possible. Yet, despite the well documented benefits of physical activity just 12.8% of those ages 65 and older meet the Guidelines. To address this, the U.S. Department of Health and Human Services (HHS) developed a Midcourse Report focused on effective strategies to improve older adult physical activity behaviors. The first step in this process was a systematic literature review.&#x0D; A literature review team was contracted to examine the evidence on key settings and effective behavioral intervention strategies, as well as effective policy, systems, and environmental (PSE) approaches, to improve physical activity among older adults. The PSE search employed an equity-centered framework adapted to researching PSE approaches for improving physical activity outcomes in older adults.&#x0D; Sixteen thousand eight hundred and eighty-three titles and abstracts were screened, and 734 full articles were reviewed for inclusion. Of those, 64 original research articles were included for the final review to answer two questions, one (plus 5 sub-questions) focused on Settings/Strategies literature (46 studies) and one (plus 2 sub-questions) focused on PSE literature (18 studies).&#x0D; The literature review process identified key settings and evidence-based strategies to support older adults in becoming more physically active, and provides a foundation for the Physical Activity Guidelines for Americans Midcourse Report: Implementation Strategies for Older Adults. More research is needed to address how factors related to equity and psychosocial constructs influence physical activity behaviors among older adults. &#x0D;  &#x0D; Key Words&#x0D; Physical activity, policy, older adults, systematic review, Policy-Systems-Environment, aerobic physical activity, muscle strengthening physical activity&#x0D;  &#x0D;  &#x0D; Introduction&#x0D; The Physical Activity Guidelines for Americans (Guidelines) (U.S. Department of Health and Human Services (HHS), 2018) serves as the benchmark and primary, authoritative voice of the federal government for providing science-based guidance on physical activity, fitness, and health for Americans. The most recent edition, released in 2018, provides evidence-based recommendations for Americans ages 3 and older to safely get the physical activity they need to stay healthy (HHS, 2018). In 2013, five years after the release of the first edition of the Guidelines, HHS released a midcourse report (Physical Activity Guidelines for Americans Midcourse Report Subcommittee of the President’s Council on Fitness, Sports &amp; Nutrition (PAG Midcourse Subcommittee), 2013). This report focused on strategies to increase physical activity among youth and focused on five key areas where youth live, learn, and play – preschool and childcare centers, schools, family and home, community (built environment), and primary care medical settings (PAG Midcourse, 2013). The next midcourse report focused on older adults (ages 65 and older).&#x0D; The benefits of regular physical activity occur throughout life and are essential for healthy aging. Research suggests it is never too late to start being physically active. Despite the many benefits of physical activity, only 12.8% of adults over age 65 meet the aerobic and muscle-strengthening Guidelines (HHS Office of Disease Prevention and Health Promotion (ODPHP), 2022). This rate may be influenced by several factors, as barriers to physical activity differ from individual to individual and are influenced by socioeconomic, cultural, built environment, and other community factors.&#x0D; The Guidelines contains quantitative recommendations for older adults but does not include implementation strategies. Therefore, a literature review was conducted to identify successful interventions to promote increased physical activity and adherence to the key guidelines for older adults and summarized in the Physical Activity and Older Adults Systematic Literature Review (ICF Next, 2023). The Physical Activity Guidelines for Americans Midcourse Report: Implementation Strategies for Older Adults (Midcourse Report) (HHS, 2023) serves to further the breadth of the Guidelines to facilitate the implementation of proven programs and other strategies that can increase levels of physical activity among older adults. This paper outlines the literature review methodology to support the Midcourse Report.&#x0D; Methods: Literature Review&#x0D; In 2022, HHS contracted with a Literature Review Team to review the evidence on effective strategies to increase physical activity among older adults. This work was supported by the President’s Council on Sports, Fitness &amp; Nutrition (PCSFN) Science Board (Science Board), made up of 11 experts in physical activity and older adult populations.  &#x0D; The Literature Review Team used a methodology supported by best practices for systematic literature reviews developed by the United States Department of Agriculture’s (USDA) Nutrition Evidence Systematic Review (NESR) (USDA NESR Branch, 2023), the Agency for Healthcare Research and Quality (AHRQ) (AHRQ, 2014), the Cochrane Collaboration (Higgins et al., 2022), and the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine standards to review, evaluate, and synthesize published, peer-reviewed physical activity research (Institute of Medicine (US) Committee on Standards for Systematic Reviews of Comparative Effectiveness Research, 2011). This review process was largely guided by the approach taken to review the literature for the 2018 Physical Activity Guidelines Advisory Committee Scientific Report (2018 Physical Activity Guidelines Advisory Committee, 2018; Torres et al., 2018). Paralleling the 2018 process, this protocol-driven review approach was undertaken to maximize transparency, minimize bias, and ensure the review conducted was timely, relevant, and high quality. There are two major distinctions between this review and that conducted by the 2018 Physical Activity Guidelines Advisory Committee: 1) the decision to review original articles instead of using a “review of reviews” approach; and 2) to focus on research with physical activity outcomes as opposed to health outcomes.&#x0D; All work completed by the Literature Review Team was under the direction and review of ODPHP, on behalf of the National Institutes of Health (NIH), the Centers for Disease Control and Prevention, and the PCSFN. The Literature Review Team coordinated the literature review process, developed an abstraction tool and accompanying abstraction and triage guides, and implemented training and quality control protocols. Several groups supported the literature review work:&#x0D; &#x0D; Librarians reviewed search strategies and provided guidance as needed.&#x0D; The Triage Team conducted title and abstract triage of articles identified through the literature searches.&#x0D; The Abstraction Team engaged in rigorous training before abstracting data from included articles. A portion of this group also assessed risk of bias on a subset of the included articles.&#x0D; The Science Board identified, aggregated, organized, and analyzed the scientific literature.&#x0D; &#x0D; A six-step process was used to examine the literature:&#x0D; &#x0D; Step 1: Develop systematic review questions&#x0D; Step 2: Develop systematic review strategy&#x0D; Step 3: Search, screen, and select evidence to review for each question&#x0D; Step 4: Abstract data and assess the risk of bias of the research&#x0D; Step 5: Describe the evidence&#x0D; Step 6: Complete evidence portfolios and draft Scientific Report&#x0D; &#x0D; Step 1: Developing Systematic Review Questions&#x0D; Following the cadence of previous editions of the Physical Activity Guidelines for Americans with an interim Midcourse Report, HHS initiated the process to review the scientific literature focused on effective approaches to promote physical activity among older adults. ODPHP outlined a need to examine intervention strategies and key settings that are effective in promoting movement and achievement of the key guidelines for physical activity for older adults. Additional factors of interest for the literature review included how engagement in physical activity interventions may influence mental health, well-being, social connection, and other related social and emotional factors; as well as how interventions implemented as policy, systems, and environmental approaches to change the context influence physical activity in older adult populations.&#x0D; Solidifying Systematic Review Questions. The Literature Review Team developed research questions focused on the previously specified topics. The research questions and corresponding sub-questions are as follows:&#x0D; Question 1: What are effective intervention strategies to increase physical activity among older adults?&#x0D; &#x0D; Does the mode of delivery (e.g., virtual, in person, phone) impact the effectiveness of interventions?&#x0D; Does the setting impact the effectiveness of the interventions?&#x0D; What barriers exist to engaging or participating in the intervention? What are the retention, attrition, and/or attendance rates?&#x0D; Do personal characteristics (e.g., ability, age, sex, race/ethnicity, socioeconomic status) or chronic health conditions influence participation?&#x0D; Do interventions assess changes in participant mental health, quality of life, well-being, resilience, or social connection and isolation?&#x0D; &#x0D; Question 2: What are effective policy, systems, and environmental (PSE) strategies to increase physical activity among older adults?&#x0D; &#x0D; Is there a dose-response relation between the scope and reach of the PSE strategy and “success”?&#x0D; Does the “success” of the PSE strategy vary by geographical location or by sociodemographic subgroup?&#x0D; &#x0D; Step 2: Develop Systematic Review Strategy&#x0D; Develop Analytical Frameworks. Analytical frameworks were developed for each research question. Analytical frameworks are graphic representations used to lay the groundwork and initial parameters for each search. The frameworks served as a guide to define key variables, inform the inclusion and exclusion criteria, and develop the literature review strategy. These frameworks were created using the PICO method (population, intervention, comparison, and outcomes) (Higgins et al., 2022) and were modeled on the approach used for the 2018 Physical Activity Guidelines Advisory Committee Scientific Report (2018 Physical Activity Guidelines Advisory Committee, 2018; Torres et al., 2018). The frameworks were constructed during weekly meetings (see supplementary materials).&#x0D; Develop Inclusion and Exclusion Criteria. The Literature Review Team created inclusion and exclusion criteria for each research question. The template used to draft inclusion and exclusion criteria was modeled off the approach used for the 2018 Physical Activity Guidelines Advisory Committee Scientific Report (2018 Physical Activity Guidelines Advisory Committee, 2018), and adapted to meet the needs of this particular review. These templates were used to determine whether studies were eligible to be selected for each respective systematic literature review and whether studies would provide data to support the focal research questions. To promote consistency and relevance, and to account for scope parameters, each template included similar sections (Tables 1 and 2).&#x0D; Table 1. Inclusion and Exclusion Criteria for Question 1: What are effective intervention strategies to increase physical activity among older adults?&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Include&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Published in English Language&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; English Language Publication&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Peer-Reviewed Literature&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Published From 2012 to 2022&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Original Research&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Human Participants&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Intervention Study (Comparison Required)&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Must Measure Physical Activity Outcome&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Older Adults (minimum or mean age of 65 years or older)&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Designs Include Randomized Controlled Trials, Non-Randomized Controlled Trials, and Quasi-Experimental Studies&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Exclude&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Studies of Older Adults in Long-Term, Memory, or Hospice Facilities&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Studies of Disease-Specific Therapeutic Exercise Delivered in Health/Medical Facility&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Table 2. Inclusion and Exclusion Criteria for Question 2: What are effective policy, systems, and environmental (PSE) strategies to increase physical activity among older adults?&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Include&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Published in English Language&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Peer-Reviewed Literature&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Published from 2012-2022&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Original Research&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Human Participants&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Study Conducted in the United States&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Intervention Study (PSE Intervention)&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Must Measure Physical Activity Outcome&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Older Adults, Middle Age (50+ years) and Older&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Designs Include Non-Randomized Controlled Trials, Prospective Cohort, Retrospective Cohort, Case-Control, Cross-Sectional, Before and After, Geospatial, Environmental, and Surveillance&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Exclude&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Studies of Older Adults in Long-Term, Memory, or Hospice Facilities&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Studies of Disease-Specific Therapeutic Exercise Delivered in Health/Medical Facility&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Develop Search Strategy. A search strategy was created to identify peer-reviewed original research for each systematic review conducted. Each search strategy included search terms, Boolean logic to join terms, databases used, and key limits relevant to the inclusion criteria (e.g., research type, date of publication, language, study population, and filters specific to databases). The three databases included in each review were PubMed, CINHAL, and PsychINFO. These databases were selected due to the subject matter of articles included within each database.&#x0D; The Literature Review Team developed sets of search terms most relevant to each review. These sets included terms capturing a broad range of articles based on older adult population, intervention study design, comparison approach, and physical activity outcomes. Once these search terms were drafted, library representatives from the literature review contractor and the NIH Library reviewed the search strategies and provided suggestions for updates. Throughout the search strategy development process, draft searches were run to assess the number of articles included in the search and if the collected articles represented the nature of the research questions. In response to these outputs, modifications were made to the search strategies as needed. The final search strategies were shared with the Science Board for review and affirmation. &#x0D; Step 3: Search, Screen, and Select Evidence to Review&#x0D; The searching and screening process was completed to collect a thorough body of original research needed to support each systematic review. Specifically, a primary search was completed within the original literature, and a supplemental search of existing meta-analyses and systematic literature reviews was conducted to support this process. A review of the original research was completed using the previously developed search strategies. Once results were generated, duplicates were removed, and results were triaged based on title and abstract.&#x0D; Triage Training. Once the search strategy was implemented, each title/abstract underwent two rounds of review by members of the triage team. Members of the triage team were provided with thorough training and required to complete a certification process to ensure consistency between reviews prior to initiating triage. This training involved a comprehensive instructional presentation that was supported by a triage training manual that included detailed instructions, definitions, reporting instructions, response options, and example titles/abstracts. In addition to the formal training, members of the leadership team met one-on-one with triagers on an as-needed basis to promote consistency and accuracy. Prior to initiating the triage process, all potential triagers were required to complete a certification process on a subset of abstracts. Triagers who did not display a high level of consistency with the group on the practice assignment were not authorized to participate in the formal abstraction process.&#x0D; Title and Abstract Triage. Triagers were instructed to first review titles to assess eligibility and then move to abstracts if the article appeared to be potentially relevant. Triagers were instructed to then include or exclude articles based on information provided within the abstract. If articles were removed from consideration at the abstract review stage, triagers were required to provide a reason. These reasons differed based on the search, but often included reasons such as ineligible age of participants, no physical activity outcome included, and/or no physical activity component of intervention reported. When conflicts existed in decisions made by screeners, discrepancies were resolved by a member of the triage team. The lists of included and excluded articles were shared with members of the Science Board.&#x0D; Additional Supplemental Search Activities. Additional search activities were undertaken to further fortify the pool of articles collected through the initial search of the original literature. First, using the pre-established search terms, a systematic search was undertaken to identify relevant meta-analyses and systematic literature reviews that could potentially include original research articles relevant to the focal inclusion criteria. In tandem with this, a snowball approach (Wohlin, 2014) was also used to locate any additional meta-analyses and systematic literature reviews that could be deemed relevant. Reference pages and results tables from each of these meta-analyses and systematic literature reviews were hand-reviewed to identify original research articles that should be included within the review. These selected articles were reviewed in full-text and added to the pool if they fit the specified inclusion criteria.&#x0D; Science Board members were encouraged to share additional articles that fit inclusion criteria with the Literature Review Team. These articles were identified through the Science Board’s expertise and familiarity with the subject matter. If an article was identified that met the inclusion criteria, it was reviewed in full text and abstracted by the Abstraction Team.&#x0D; Full Text Review. Full text review for the list of included articles was conducted by members of the Literature Review Team. Two reviewers assessed each full-length article based on the inclusion criteria to determine whether it should be included or excluded from the final pool for review. Further, any articles that were identified as potentially ineligible during the abstraction process were added to the list of excluded articles.&#x0D; Step 4: Abstract Data and Assess Risk of Bias&#x0D; The abstraction process was used to collect and summarize key characteristics of each study that supported the systematic literature review purpose. The goal of abstraction was to (a) document key elements of each study for ease of review, and (b) use this information to present trends across the full body of evidence.&#x0D; Abstraction Training. Abstractors were onboarded, trained, and certified to complete all abstraction activities. Abstraction candidates participated in a thorough and rigorous multi-phased process prior to initiating abstraction. This training involved a multi-hour instructional session. This session was supported by an abstractor training manual that included detailed instructions, definitions, reporting instructions, response options, example abstraction questions, and thoroughly annotated version of articles used in the training. In addition to the formal training, members of the Literature Review Team met with and/or delivered written feedback to the abstractors to ensure consistency and promote recalibration when needed. Prior to initiating the abstraction process, all potential abstractors were required to complete abstraction on practice articles. Abstractors who did not display a high level of consistency with the group during the practice sessions did not participate in the formal abstraction process.&#x0D; Abstraction Process Explanation and Quality Control. Abstractors worked in pairs to independently review articles, abstract articles, and document findings. Abstractors were provided with random assignments of articles from members of the Literature Review Team. When discrepancies in abstraction were identified by the Literature Review Team, abstractors were asked to review and discuss these discrepancies. When discrepancies could not be settled among abstractors, members of the Literature Review Team reviewed the situation/materials and provided input and clarification to settle on a decision. The Literature Review Team conducted quality control and independently conducted a third round of abstraction for 20% of all articles included in each respective review. This quality control process was completed to ensure accuracy, clarity, and consistency in abstraction.&#x0D; Data Documentation. An online database was created, and abstractors entered their data into this system using forms created by the Literature Review Team. All pairings of abstractors independently read and reviewed articles, abstracted key information, and entered it into the online database. After discrepancy resolution and quality control procedures were completed, the abstracted data was edited as needed and used to populate article evidence summary tables and inform trend tables demonstrating overarching themes in the data.&#x0D; Assessing Risk of Bias. Articles were assessed for internal validity, using either the ROBINS-I (Sterne et al., 2016) or ROBINS-E tool (ROBINS-E Development Group, 2022). These tools assess risk of bias in studies that compare the health effects of exposures or interventions across a range of study types (e.g., RCT’s, observational, etc.). These tools are tailored by study design and pose different sets of questions based on whether a study is a randomized controlled trial (RCT), non-randomized controlled trial, or an observational study. The risk of bias assessment for each study was completed by two reviewers (from either the Abstraction Team or the Science Board). When discrepancies arose, the reviewers discussed and resolved discrepancies. &#x0D; Additionally, the Policy, Systems, and Environments review used an equity-centered framework relevant to the research evidence and adapted to researching policy, systems, and environmental approaches for improving physical activity outcomes in older adults (Venkateswaran et al., 2023). The diversity-equity-inclusion frame was applied to studies assessed for risk of bias using ROBINS-E across relevant domains of bias (ROBINS-E Development Group, 2022) (i.e., confounding, selection of participants into the study, classification of exposures, departures from intended exposures, missing data, measurement of outcomes, and selection of reported results, aligned with PICO model).&#x0D; Step 5: Describe the Evidence                                            &#x0D; Evidence Portfolios. To facilitate the analysis of the evidence, the Literature Review Team prepared evidence portfolios for each question (see supplementary materials). The evidence portfolios documented the full process followed for both reviews, including the sources of evidence, conclusions, evidence grades, description of evidence, populations analyzed, individual evidence summary tables, risk of bias and quality assessment charts, search strategies, literature trees, references, and rationales for exclusion of articles during full-text triage.&#x0D; Step 6: Complete Evidence Portfolios and Draft Scientific Report&#x0D; Science Board members reviewed and deliberated on the body of evidence to develop conclusion statements that supported each of the research questions. Conclusion statements were tightly associated with the evidence, focused on general agreement among the studies around the independent variables and outcomes, and acknowledged areas of disagreement or limitations, where they existed. The conclusion statements reflected only the evidence reviewed and not information Science Board members might have known from another source.&#x0D; Along with the evidence portfolios, a rubric was developed to guide the assessment and grading of the strength of the evidence supporting each conclusion statement (Table 3). The rubric was adapted from the 2018 Physical Activity Guidelines Advisory Committee (2018 Physical Activity Guidelines Advisory Committee, 2018) and the 2020 Dietary Guidelines Advisory Committee (2020 Dietary Guidelines Advisory Committee, 2020). Grading the strength of the evidence was based on applicability of the populations, exposures, and outcomes studied; generalizability to the population of interest; risk of bias and study limitations; quantity and consistency of findings across studies; and magnitude and precision of effect.&#x0D; Table 3. Physical Activity and Older Adults Systematic Literature Review Grading Criteria&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Grade &#x0D; &#x0D; &#x0D; Definition &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Strong &#x0D; &#x0D; &#x0D; The conclusion statement is based on a strong body of evidence as assessed by risk of bias, consistency, directness, precision, and generalizability. The level of certainty in the conclusion is strong, such that if new evidence emerges, modifications to the conclusion are unlikely to be required. &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Moderate &#x0D; &#x0D; &#x0D; The conclusion statement is based on a moderate body of evidence as assessed by risk of bias, consistency, directness, precision, and generalizability. The level of certainty in the conclusion is moderate, such that if new evidence emerges, modifications to the conclusion may be required. &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Limited &#x0D; &#x0D; &#x0D; The conclusion statement is based on a limited body of evidence as assessed by risk of bias, consistency, directness, precision, and generalizability. The level of certainty in the conclusion is limited, such that if new evidence emerges, modifications to the conclusion are likely to be required. &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Grade Not Assignable &#x0D; &#x0D; &#x0D; A conclusion statement cannot be drawn due to either a lack of evidence or evidence that has severe limitations related to risk of bias, consistency, directness, precision, and/or generalizability. &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Results&#x0D; The Physical Activity and Older Adults Systematic Literature Review (ICF Next, 2023) used a rigorous and systematic methodology. The methodology allowed the Literature Review Team to search, screen, select, abstract, assess the risk of bias, and include considerations of equity in original research related to effective strategies to get older adults moving; and grade the evidence from insufficient to strong. Over nine months, two literature searches were conducted, resulting in 16,883 titles and abstracts screened, and 734 full articles reviewed for inclusion. Of those, 64 original research articles were included for the final review to answer two questions, one focused on Settings and Strategies literature (46 studies) with five sub-questions and one focused on Policy, Systems, and Environments literature (18 studies) with two sub-questions (Figures 1 and 2). The process is documented for each research question in an evidence portfolio (see supplementary materials).&#x0D; Figure 1. Literature Tree Diagram for Question 1: What are effective intervention strategies to increase physical activity among older adults?&#x0D; Figure 2. Literature Tree Diagram for Question 2: What are effective policy, systems, and environmental (PSE) strategies to increase physical activity among older adults?&#x0D;  &#x0D; Discussion&#x0D; The Physical Activity and Older Adults Systematic Literature Review (ICF Next, 2023) evaluated the current scientific literature on strategies to increase physical activity among older adults to inform the Physical Activity Guidelines for Americans Midcourse Report: Implementation Strategies for Older Adults (HHS, 2023). Several strategies emerged across a variety of settings; the most commonly researched were home, health care, and community. Several limitations to the Physical Activity and Older Adults Systematic Literature Review (ICF Next, 2023) and opportunities to strengthen the research base on physical activity interventions for older adults should be noted.&#x0D; While the literature review looked at original research articles rather than systematic reviews or meta-analyses, most included studies did not measure, analyze, or disaggregate findings based on important individual or group characteristics. For the  Settings and Strategies question, the team  attempted to determine if the personal characteristics (e.g., ability, age, sex, race/ethnicity, socioeconomic status) influence physical activity participation, but there was insufficient evidence to yield any analysis. For the Policy, Systems, and Environments question, equity considerations were applied, particularly concepts of diversity, inclusion, and access to study samples and intervention contexts to determine inequalities in physical activity outcomes. The samples did not reflect diverse populations and therefore an inability to grade the evidence or provide specific analysis for different subsets of older adults. For example, of the 18 included studies, only three studies examined specific racial/ethnic minority populations; two studies reported findings relative to disability-mobility limitations; and one study reported findings relative to health (multiple sclerosis status). Only two studies compared exposure to urban versus rural community geographies. Most studies of policy, systems, and environmental interventions employed cross-sectional design, examining residential neighborhoods (exposure context) in relation to physical activity outcomes, typically self-reported.&#x0D; Because of the importance of social connection and mental well-being, especially for older adults who are socially isolated or live alone, the review made efforts to examine these concepts in relation to physical activity outcomes and interventions. Unfortunately, most published studies of interventions for improving physical activity in older adults did not include social or mental well-being outcomes, such as social cohesion, quality of life, resilience, or mental health status.&#x0D; Lastly, few studies employed longitudinal designs, assessed long-term maintenance of outcomes, or investigated strategies to improve retention or prevent drop out in interventions to increase physical activity among the diversity of older adults, so physical activity maintenance, population and subpopulation effect remain uncertain.&#x0D; The Physical Activity and Older Adults Systematic Literature Review (ICF Next, 2023) provides a foundation suggesting what strategies work and in which settings to support physical activity in older adults. Several limitations to the literature review can be used as areas to strengthen future research to ensure more diverse populations are recruited, studied, analyzed, and outcomes documented in the scientific literature.&#x0D;  &#x0D; Conclusion&#x0D; The Systematic Review (ICF Next, 2023) and Midcourse Report (HHS, 2023) are useful for physical activity researchers; policy makers; exercise and health professionals; clinicians; gerontologists; built environment professionals; local, state, territorial, and Tribal leaders; and others working with older adults. These reports are necessary as a guide to apply evidence-based strategies to support older adults to be more physically activity and to expand the future evidence base to translate Guidelines into practice. &#x0D; Author Contributions&#x0D; Conceptualization: A.V.B. and K.L.P.; Data Curation: D.H.J.; Formal Analysis: D.H.J.; Funding Acquisition: A.V.B. and K.L.P.; Investigation: D.H.J.; Methodology: A.V.B., D.H.J., and K.L.P.; Project Administration: A.V.B. and K.L.P.; Resources: A.V.B. and K.L.P.; Supervision: A.V.B. and K.L.P.; Validation: D.H.J.; Writing – Original Draft: A.V.B., D.H.J., and K.L.P.; Writing – Review &amp; Editing: A.V.B. and K.L.P.&#x0D; Acknowledgments&#x0D; The authors are grateful to the 2022 President’s Council on Sports, Fitness &amp; Nutrition Science Board for their work on the literature review: Barbara J. Nicklas (Science Board Chair), Susan W. Buchholz, David E. Conroy, Cheryl Der Ananian, Loretta DiPietro, Mark Fenton, Deborah H. John, NiCole R. Keith, David X. Marquez, Jacqueline Osborne, and Dori Rosenberg. Additionally, the authors would like to acknowledge Sarah Caban, Rachel Fisher, Noelle Harada, Carolyn Hinton, and Malorie Polster for their contributions to this project.

Awareness and Knowledge of the Physical Activity Guidelines for Americans, 2nd Edition.

Assessing awareness and knowledge of the Physical Activity Guidelines for Americans, 2nd edition (Guidelines), released in 2018, is important for monitoring factors that contribute to increasing physical activity. We estimated prevalence of awareness and knowledge of the adult aerobic guideline (≥150min/wk of moderate-intensity equivalent aerobic physical activity preferably spread out over a week) among adults (n = 3471) and of the youth aerobic guideline (≥60min/d of mostly moderate- to vigorous-intensity aerobic physical activity) among a subset of parents (n = 744) from a nationwide sample of US adults in the 2019 FallStyles survey. We estimated odds ratios using logistic regression, adjusting for demographic and other characteristics. Approximately 1 in 10 US adults and parents reported being aware of the Guidelines. Only 3% of adults knew the correct adult aerobic guideline. The most common responses were "don't know/not sure" (44%) and "30minutes a day, 5 or more days a week" (28%). Among parents, 15% knew the youth aerobic guideline. Awareness and knowledge tended to be lower with lower education and income. Limited awareness and knowledge of the Guidelines suggest communication about the Guidelines could be strengthened, especially among adults with low income or education.

Physical Activity for Health—Every Minute Counts

This Viewpoint discusses the amount of physical activity recommended by the Physical Activity Guidelines for Americans, 2nd Edition, and how clinicians should use these recommendations to personalize and set achievable physical activity goals for their patients.

An Assessment of State-Level Planning for Physical Activity Promotion in the United States.

The prevalence and attributable risk of disease due to physical inactivity require it to be made a public health priority. Public health planning allows for prioritization and resource allocation, particularly at the state and local levels. The extent to which state planning efforts for physical activity exist in the United States is unknown. The purpose of this paper is to describe the scope in which physical activity is incorporated in state-level public health plans in the United States, with an emphasis on alignment with the national guidelines and the National Physical Activity Plan. A standardized internet search audit was developed and conducted for each of 50 US states and the District of Columbia between May 2017 and January 2018 to determine the prevalence and characteristics of health planning documents that include physical activity. Data abstracted for analysis used a standardized search protocol that included the components of the Physical Activity Guidelines for Americans and the US National Physical Activity Plan. Results found that most states had between 4 and 6 chronic disease prevention and control plans that mention physical activity; however, it was inconsistently aligned with recommendations from both the Guidelines and the National Plan. Only 2 states had stand-alone public health planning documents explicitly dedicated to physical activity promotion. No state planning documents addressed children and adolescents, adults, and older adults simultaneously. To be maximally effective, state public health planning for physical activity should be made a priority and these efforts should align as much as possible with current guidance from the Physical Activity Guidelines for Americans and the US National Physical Activity Plan.

Habitual exercise evokes fast and persistent adaptation during split-belt walking.

Changing movement patterns in response to environmental perturbations is a critical aspect of gait and is related to reducing the energetic cost of the movement. Exercise improves energetic capacity for submaximal exercise and may affect how people adapt movement to reach an energetic minimum. The purpose of this study was to determine whether self-reported exercise behavior influences gait adaptation in young adults. Young adults who met the optimal volume of exercise according to the Physical Activity Guidelines for Americans (MOVE; n = 19) and young adults who did not meet the optimal volume of exercise (notMOVE; n = 13) walked on a split-belt treadmill with one belt moving twice the speed of the other belt for 10 minutes. Step length asymmetry (SLA) and mechanical work done by each leg were measured. Nonlinear mixed effects models compared the time course of adaptation between MOVE and notMOVE, and t-tests compared net work at the end of adaptation between MOVE and notMOVE. Compared to notMOVE, MOVE had a faster initial response to the split belt treadmill, and continued to adapt over the duration of split-belt treadmill walking. Young adults who engage in sufficient amounts of exercise responded more quickly to the onset of a perturbation, and throughout the perturbation they continued to explore movement strategies, which might be related to reduction of energetic cost. Our findings provide insights into the multisystem positive effects of exercise, including walking adaptation.

Local Implementation of Move Your Way-A Federal Communications Campaign to Promote the Physical Activity Guidelines for Americans.

Background. The U.S. Department of Health and Human Services (HHS) developed the Move Your Way campaign to help more Americans increase their physical activity. The campaign includes more than 80 English and Spanish materials that can be used to promote physical activity. HHS also developed a community-based implementation strategy for the campaign. Methods. HHS collaborated with eight community-based organizations from across the United States to pilot campaign implementation in their communities. A mixed-methods process evaluation was conducted to assess events, partnership involvement, material distribution, and social media engagement. Results. More than 168,000 people participated in 55 campaign events, initiatives, and programs hosted by lead organizations and their 175 partners. More than 37,000 campaign materials were distributed, and there were over 72 million social media impressions. Conclusion. The community-based implementation strategy was effective at reaching the intended audience and driving traffic to Move Your Way resources. The flexibility of the Move Your Way materials and messages allowed communities to incorporate the campaign into diverse physical activity-promotion strategies. Findings demonstrate that the federal government and local community organizations can successfully work together to promote physical activity.

Effects of Temperature and Tempo: Evaluating How Much Time in a Typical Community-Based Yoga Class Is Moderate-Intensity Aerobic Activity.

The 2nd edition of the Physical Activity Guidelines for Americans (PAG) recommends, in part, 150 min of moderate-intensity aerobic physical activity. The PAG states that yoga may be able to help meet the guidelines for moderate-intensity aerobic exercise for adults and older adults. Our study aims to objectively measure the proportion of time participants' activity that is categorized as moderate-intensity aerobic activity based on heart rate data and to subjectively measure rate of perceived exertion (RPE). Participants completed the Stanford Leisure-Time Activity Categorical item to establish baseline PAG aerobic activity compliance. Participants then completed four separate 1-h yoga sessions at different tempos (cadence) and temperatures while wearing heart rate monitors. During and directly after the session they also marked their RPE on a modified 10-point scale. All participants reached moderate-intensity aerobic activity for at least some portion of a yoga session based on heart rate monitor data and RPE. The average duration of moderate intensity was 32.75% of the class across all four class types, with no significant differences by condition. Age was a significant factor in time spent in moderate-to-vigorous physical activity for only the thermo-neutral Hatha classes (p = 0.010). Tempo, temperature, and baseline activity levels were not significant factors in time spent in moderate-to-vigorous intensity physical activity based on Pearson Correlation and the Kruskal-Wallis test. Hatha and Vinyasa yoga classes, at room or hot temperatures, can be used to meet a portion of the PAG moderate-intensity activity recommendations.

Awareness of Social Presence on Virtual Fitness Platforms and Relationship with Exercise Motivation and Physical Activity Levels

The health benefits of physical activity are well-known, however, only 20% of the U.S. population meets the Physical Activity Guidelines for Americans. This study aimed to explore the association of awareness of social presence in a virtual fitness platform with motivation and physical activity levels (PAL). Virtual fitness users (n = 590, 42 &plusmn; 12.7 years old) completed the International Physical Activity Questionnaire and Behavioral Regulation of Exercise Questionnaire. Relative autonomy was correlated with PAL (r = .21, p &lt; .001, 95.00% CI = [.13, .29]) and predicted PAL (F(1,588) = 27.03, p &lt; .001). Awareness of social presence was significantly related to motivation (U = 41864.5, z = &ndash;5.99, p &lt; .001), and predictive of relative autonomy (F(1,588) = 27.03, p &lt; .001). The results suggest that higher relative autonomy is associated with higher PAL in virtual fitness users. Awareness of social presence on virtual platform appears to correlate to higher levels of relative autonomy, which may influence exercise adherence.

Understanding the Impact of Move Your Way® Campaign Exposure on Key Physical Activity Outcomes

Introduction: The Move Your Way® campaign was developed to encourage physical activity contemplators to get active. A pilot test of campaign implementation was conducted and evaluated in eight communities between March and October 2020. Methods: A web-based, cross-sectional survey of adults collected pilot campaign outcome data after campaign implementation. Differences in outcomes between exposed and unexposed groups across the communities were compared. Results: A total of n = 5,140 responded to the survey. Across eight communities, those who reported campaign exposure had 7.2 (95% CI, 6.1-8.6) greater odds of being aware of the Physical Activity Guidelines for Americans (Guidelines) compared to unexposed respondents. Additionally, they had greater odds of identifying the correct aerobic and muscle-strengthening dosages and had 1.4 (95% CI, 1.1-1.6) greater odds of reporting meeting both the aerobic and muscle-strengthening Guidelines. Discussion: In this pilot evaluation, reported exposure to Move Your Way is associated with higher odds of being aware of the Guidelines, knowing recommended dosages, likelihood of becoming more active in the future, higher self-efficacy, making a recent physical activity behavior change, and higher physical activity levels. The Move Your Way campaign can be used in communities to promote physical activity.

Using the Move Your Way Campaign to Promote Physical Activity in American Adults and to Advocate for the Enactment of the Promoting Physical Activity for Americans Act

ABSTRACT Background The Physical Activity Guidelines for Americans, 2nd edition (PAGA2) is an evidence-based policy for physical activity. The PAGA2 addresses sedentary behavior, promotes physical activity, and elaborates on improved health outcomes associated with physical activity. The Promoting Physical Activity for Americans Act is a bill passed by the Senate but not yet enacted. The Move Your Way campaign is a promotional campaign for the PAGA2. Purpose The study promoted physical activity in American adults at a Midwestern church after implementation of a PowerPoint presentation entailing the Move Your Way campaign. Methods The Global Physical Activity Questionnaire (GPAQ) was completed by participants prior to implementation of the Move Your Way campaign. Follow-up GPAQ assessments retrieved via telephone calls occurred at two, four, and eight weeks post intervention. Results The Move Your Way campaign produced a statistically significant increase in physical activity and reduction in sedentary behavior. The Move Your Way campaign successfully influenced adults to increase their physical activity and reduce their sedentary behavior. Translation to Health Education Practice This study provides evidence-based practice that promotes and easily assesses physical activity. The results can be used to advocate for the enactment of the Promoting Physical Activity for Americans Act.

Assessing The Feasibility And Characterizing The Energy Expenditure And Relative Intensity Of A High-intensity Functional Training Regimen For Obese Female Adults: A Feasibility Study

PURPOSE: To assess the feasibility and characterize the energy expenditure and relative intensity of participation of an obese cohort in a signature 35-minute group-based HIFT regimen. The demand for efficient and effective exercises has grown in concert with increased attention to fitness as a determinant of overall health, especially in the obese populations. While past studies have examined the benefits of traditional conditioning exercises, there have been limited investigations of high intensity functional training (HIFT). METHODS: During the regimen, 12 obese female adults (body mass index (BMI): 33.7 + -1.9 kg/min2, 29.3 + -4.8 years) donned a portable breath-by-breath gas analyzer and a heart rate monitor. The session was led by a group instructor and consisted of 30, 1-minute rounds of work (i.e., 15 functional upper and lower body resistive exercises alternating with the last 15 seconds on an air bike) for a culmination of 35 minutes. RESULTS: Mean caloric expenditure (509 ± 79 kcal), maximum heart rate (173 ± 5 bpm), and metabolic equivalents (12.1 ± 1.4 kcal/kg/h) were characterized as a vigorous-intensity activity according to the Compendium of Physical Activities guidelines. The majority (92%) of participants reportedly enjoyed HIFT and would include it as part of a comprehensive weight-loss exercise program. CONCLUSIONS: These HIFT time-efficient workouts fulfill national exercise guidelines for weekly vigorous-intensity activities, as outlined by the Physical Activity Guidelines for Americans. Moreover, implementing this high energy expenditure session twice weekly may comport with Physical Activity Guidelines for Americans weekly physical activity recommendations. HIFT training may provide a feasible, safe, and time-efficient mode of exercise for those seeking weight loss.