Physical Activity In Adults Research Articles

Evaluating Factors Associated With Patient-Perceived Applicability of the QuickDASH Survey in Reflecting Their Goals of Care Prior to Hand Surgery

Patient-reported outcome measures intend to capture patients' perspectives on their health status. However, the patient-perceived applicability of many of these patient-reported outcome measures is unknown. We hypothesized that patients experiencing greater upper extremity disability and greater pain interference would be more likely to report that the Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (QuickDASH) survey content is responsive to their daily lives and goals in seeking surgical care. Adult preoperative hand surgery patients at a single tertiary academic center were recruited prospectively. QuickDASH, Patient-Reported Outcomes Measurement Information System Pain Interference computerized-adaptive-testing, and the Godin Leisure-Time Exercise Questionnaire (GLTEQ)-a validated adult physical activity level metric-data were collected. The following two Likert response questions were also asked: question (1) "How applicable is the above questionnaire to your treatment goals for your upper extremity condition?" and question (2) "How applicable is the overall questionnaire to your daily life?" Multivariable binary logistic regression was performed to define the factors associated with patients reporting that the survey was "very applicable." Of the 133 included patients, the mean age was 49 ± 18 years, 40% were women, and the mean GLTEQ score was 54.1 ± 5.5 (consistent with a high level of activity). For questions 1 and 2, 32% and 29% of the patients reported that QuickDASH was "very applicable," respectively. The multivariable model demonstrated that for every 10-point increase in QuickDASH, there was a 45% to 49% greater odds of respondents reporting that the survey was "very applicable," and for every 5-point increase in pain interference computerized-adaptive-testing, the odds increased by 55% to 70%. No association with GLTEQ was observed. Patients with greater upper extremity disability and pain interference were more likely to find the QuickDASH content to be applicable to their daily lives and goals in seeking surgical care. These findings suggest that QuickDASH may not be an optimal instrument when evaluating upper extremity function in cohorts with mild disability and low pain interference.

Participation in youth sports influences sarcopenia parameters in older adults.

The degree of deterioration in sarcopenia parameters may be affected by a person's level of physical activity (PA) and sedentary behavior (SB). Our study focused on examining the PA and SB of active older adults including those with and without history of sports in youth. Forty-four participants (20 men and 24 women, mean age of total sample 76.1 ± 5.2 years) were included in analysis of PA, SB habits and sarcopenia parameters, determined by skeletal muscle index, hand-grip strength, gait speed, Timed Up and Go tests (TUG). PA and SB were recorded with accelerometers. Our primary aim was to compare participants with (AH) or without a sport history in youth (NAH), in their sarcopenia parameters and PA and SB habits. When divided participants in two groups (AH and NAH) and adjusting for age, we have detected the differences for skeletal muscle index (p = 0.007) and hand-grip strength (p = 0.004) in favor of participants who were engaged in sports in youth. We did not find any differences in PA and SB habits between the AH and NAH groups. After adjusting for age, participants with a higher number of daily steps, longer moderate to vigorous physical activity (MVPA) bouts, a higher number of MVPA bouts in a day and higher overall MVPA engagement achieved better results in hand-grip strength and TUG. Participants with lower SB had better TUG and gait speed results. Our findings suggest that engaging in sports activities in youth can make a difference with sarcopenia parameters. Although we found no differences in PA and SB habits between participants with AH and NAH, participants with an athlete history performed better results in sarcopenia parameters.

Association of Abnormal Sleep Duration and Sleep Disturbance with Physical Activity in Older Adults: Between- and within-Person Effects

ObjectivesSleep is associated with physical activity (PA), yet the nature and directions of this association are less understood. This study aimed to disentangle the long-term temporal sequences between sleep duration/disturbance and PA in older adults, distinguishing between- and within-person effects. DesignLongitudinal panel study. Setting and ParticipantsWe conducted a longitudinal study using 3 waves of data collected in 2008/09 (T1), 2012/13 (T2), and 2016/17(T3) from adults aged ≥50 years in the English Longitudinal Study of Ageing (N = 10,749 individuals). MeasuresSleep duration, sleep disturbance, and PA were assessed by self-reported questionnaires. We used cross-lagged panel models (CLPMs) to examine between-person effects and random intercept cross-lagged panel models (RI-CLPMs) to examine within-person effects. ResultsOur analyses revealed a reciprocal relationship between abnormal sleep duration and low PA levels at between-person level (abnormal sleep duration to PA: βT1-T2 = −0.053, βT2-T3 = −0.058, all P < .001; PA to abnormal sleep duration: βT1-T2 = −0.040, βT2-T3 = −0.045, all P < .05), with abnormal sleep duration being the driving force in the dynamic association. In addition, there was a unidirectional effect of more severe sleep disturbance on lower levels of PA at both between- and within-person levels (between-person level: βT1-T2 = −0.032, βT2-T3 = −0.028, all P < .001; within-person level: βT1-T2 and T2-T3 = −0.031, all P = .011). Conclusions and ImplicationsThis study adds novel insights into the temporal directionality of sleep and PA among community-dwelling older adults and highlights poor sleep as a potential risk factor for PA. Intervention strategies should aim to improve sleep to promote PA levels and successful aging.

Harnessing technology and gamification to increase adult physical activity: a cluster randomized controlled trial of the Columbia Moves pilot

BackgroundThe use of health technologies and gamification to promote physical activity has increasingly been examined, representing an opportunistic method for harnessing social support inherent within existing social ties. However, these prior studies have yielded mixed findings and lacked long-term follow-up periods. Thus, a pilot cluster randomized controlled trial was conducted to gauge the feasibility and preliminary efficacy of a digital gamification-based physical activity promotion approach among teams of insufficiently active adults with existing social ties.MethodsTeams (N = 24; 116 total participants) were randomized to either a 12-week intervention (Fitbit, step goals, app, feedback; TECH) or the same program plus gamification (TECH + Gamification). Mixed effects models were used to compare group differences in treatment adherence, and changes in social support, steps, and moderate-to-vigorous physical activity at 12 weeks and 52 weeks from baseline, adjusted for sociodemographic characteristics and team size.ResultsTECH had a lower mean number of days of Fitbit self-monitoring versus TECH + Gamification during the intervention (adjusted difference: -.30; 95% CI, -.54 to -.07; P = .01). Post-intervention, TECH had 47% lower odds of self-monitoring 7 days per week versus TECH + Gamification (.53; 95% CI, .31 to .89; P = .02). No differences were observed between TECH + Gamification and TECH in increases in social support (0.04; 95% CI, -.21 to .29; P = .76), ActiGraph-measured daily steps (-425; 95% CI, -1065 to 215; P = .19), or moderate-to-vigorous physical activity minutes (-3.36; 95% CI, -8.62 to 1.91; P = .21) from baseline to 12 weeks or in the regression of these improvements by 1 year (Ps > .05). Although not significant in the adjusted models (Ps > .05), clinically meaningful differences in Fitbit-measured daily steps (TECH, 7041 ± 2520; TECH + Gamification, 7988 ± 2707) and active minutes (TECH, 29.90 ± 29.76; TECH + Gamification, 36.38 ± 29.83) were found during the intervention.ConclusionsA gamified physical activity intervention targeting teams of adults with existing social ties was feasible and facilitated favorable, clinically meaningful additive physical activity effects while in place but did not drive enhanced, long-term physical activity participation. Future investigations should explore optimal team dynamics and more direct ways of leveraging social support (training teams; gamifying social support).Trial registrationClinicaltrials.gov (NCT03509129, April 26, 2018).

How behaviour change theories can be used to promote physical activity in adults with learning disabilities

How behaviour change theories can be used to promote physical activity in adults with learning disabilities

Physical activity in adults with and without rheumatoid arthritis: cross-sectional results from the Survey of Health, Ageing and Retirement in Europe (SHARE)

Objective Studies examining habitual physical activity levels and patterns in adults with rheumatoid arthritis (RA) using raw data from modern accelerometers are lacking. We aimed (i) to examine physical activity levels and patterns in adults with RA in their familiar environment, and (ii) to investigate whether physical activity levels differ throughout the day. Method Data were taken from Wave 8 of the Survey of Health, Ageing and Retirement in Europe, including N = 607 men and women who wore a triaxial accelerometer and had adequate information for RA and accelerometry data summarized as Euclidean norm minus one (ENMO, mg). Growth-curve models and simple contrast analysis were used to examine the effect of RA on daily patterns of physical activity levels, including mean total ENMO in mg, mean minutes of light-intensity physical activity (ENMO values ≥ 25 mg and ≤ 75 mg), and moderate-to-vigorous-intensity physical activity (ENMO values > 75 mg). Results Total physical activity averaged throughout the day was 25.0 and 28.6 mg for respondents with and without RA, respectively. Respondents with RA spent more time in light-intensity physical activity throughout the day (p < 0.001), but less time in moderate-to-vigorous-intensity physical activity between 4 am and 11 pm (p < 0.001) than respondents without RA. Conclusion Adults with RA were less physically active than adults without RA. However, there were no diurnal differences in physical activity.

Young Adult Physical Activity Trajectories and Midlife Nonalcoholic Fatty Liver Disease

Physical activity (PA) is recommended for preventing and treating nonalcoholic fatty liver disease (NAFLD). Yet, how long-term patterns of intensity-based physical activity, including moderate-intensity PA (MPA) and vigorous-intensity PA (VPA), might affect the prevalence of NAFLD in middle age remains unclear. To identify distinct intensity-based PA trajectories from young to middle adulthood and examine the associations between PA trajectories and NAFLD prevalence in midlife. This population-based cohort of 2833 participants used the Coronary Artery Risk Development in Young Adults study data. The setting included field clinics in Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California. Data analysis was completed in March 2023. PA was self-reported at 8 examinations over 25 years (1985-1986 to 2010-2011) and separately scored for MPA and VPA. NAFLD was defined as liver attenuation values less than 51 Hounsfield units after exclusion of other causes of liver fat, measured using computed tomography in year 25 (2010-2011). Among a total of 2833 participants included in the sample, 1379 (48.7%) self-identified as Black, 1454 (51.3%) as White, 1206 (42.6%) as male, and 1627 (57.4%) as female from baseline (1985-1986) (mean [SD] age, 25.0 [3.6] years) to year 25 (2010-2011) (mean [SD] age, 50.1 [3.6] years). Three MPA trajectories were identified: very low stable (1514 participants [53.4%]), low increasing (1096 [38.7%]), and moderate increasing (223 [7.9%]); and 3 VPA trajectories: low stable (1649 [58.2%]), moderate decreasing (1015 [35.8%]), and high decreasing (169 [6.0%]). After adjustment for covariates (sex, age, race, study center, education, smoking status, and alcohol consumption), participants in the moderate decreasing (risk ratio [RR], 0.74; 95% CI, 0.54-0.85) and the high decreasing (RR, 0.59; 95% CI, 0.44-0.80) VPA trajectories had a lower risk of NAFLD in middle age, relative to participants in the low stable VPA trajectory. Adjustments for baseline body mass index and waist circumference attenuated these estimates, but the results remained statistically significant. The adjusted RRs across the MPA trajectories were close to null and not statistically significant. This cohort study of Black and White participants found a reduced risk of NAFLD in middle age for individuals with higher levels of VPA throughout young to middle adulthood compared with those with lower VPA levels. These results suggest the need for promoting sustainable and equitable prevention programs focused on VPA over the life course to aid in lowering NAFLD risk.

Physical activity in childhood and later risk of inflammatory bowel disease: A Scandinavian birth cohort study.

Retrospective data have linked adult physical activity (PA) to reduced risk of inflammatory bowel disease (IBD). We aimed to prospectively examine the association of PA and screen time (ST) in childhood with later risk of IBD, for which data are scarce. Using two population-based birth cohorts (All Babies in Southeast Sweden [ABIS] and Norwegian Mother, Father, and Child Cohort Study [MoBa]), we retrieved parent-reported data on PA and ST degree at ages 3 and 8years. Data were modelled as binary (high vs. low) and numerical (hours/day) exposures. Inflammatory bowel disease was defined as ≥2 diagnostic records in national health registers. Cox regression estimated hazard ratios adjusted for potential confounding from parental IBD, country of origin, education, and smoking habits (Adjusted hazard ratio (aHR)). Our 8-year analyses included a 2-year lag period to reduce the risk of reverse causation. Cohort-specific estimates were pooled using random-effects model. Among 65,978 participants from ABIS (n=8810) and MoBa (n=57,168) with available data, 266 developed IBD. At 3years, children with high versus low PA had an aHR of 1.12 for IBD (95%CI=0.87-1.43); high versus low ST showed an aHR of 0.91 (95%CI=0.71-1.17). Conversely, at 8years, high versus low ST was associated with increased risk of later IBD (aHR=1.51; 95%CI=1.02-2.25), but PA at 8years, was not linked to IBD (aHR=1.19; 95%CI=0.80-1.76). Subtype-specific analyses for Crohn's disease and ulcerative colitis did not differ appreciably. Acknowledging possible confounding variables, children with high versus low ST at 8years were at increased risk of IBD. In contrast, PA degree was not linked to IBD at any age category.

Physical activity, residential greenness, and cardiac autonomic function.

This population-based study examines the associations between physical activity (PA), residential environmental greenness, and cardiac health measured by resting short-term heart rate variability (HRV). Residential greenness of a birth cohort sample (n = 5433) at 46 years was measured with normalized difference vegetation index (NDVI) by fixing a 1 km buffer around each participant's home. Daily light PA (LPA), moderate PA (MPA), vigorous PA (VPA), and the combination of both (MVPA) were measured using a wrist-worn accelerometer for 14 days. Resting HRV was measured with a heart rate monitor, and generalized additive modeling (GAM) was used to examine the association between PA, NDVI, and resting HRV. In nongreen areas, men had less PA at all intensity levels compared to men in green areas. Women had more LPA and total PA and less MPA, MVPA, and VPA in green residential areas compared to nongreen areas. In green residential areas, men had more MPA, MVPA, and VPA than women, whereas women had more LPA than men. GAM showed positive linear associations between LPA, MVPA and HRV in all models. Higher LPA and MVPA were significantly associated with increased HRV, irrespective of residential greenness. Greenness was positively associated with PA at all intensity levels in men, whereas in women, a positive association was found for LPA and total PA. A positive relationship of PA with resting HRV and greenness with PA was found. Residential greenness for promoting PA and heart health in adults should be considered in city planning.

The enactment of leisure-time physical activity policy for older adults in community leisure settings

ABSTRACT This paper examines the enactment of local government leisure policies in community leisure facilities through the lens of policy enactment. Leisure policies typically get enacted through a complex and contested process by a range of stakeholders. The paper explores how local government staff and leisure facility managers engage in the work of older adult policy enactment and how policies inform the strategic planning of programs and facilities. The research involved semi-structured interviews with local government employees and leisure facility managers across four local government areas in Victoria, Australia. Findings indicate that leisure facility managers exhibit a lack of engagement with policies, particularly those targeting older adults. To improve participation rates and justify significant public investment in leisure facilities, the study recommends leisure facility management and local government employees establish a negotiation process concerning older adult leisure and physical activity policy and facility managers interpret, re-contextualise, and make sense of policy.

Nutritional Avocado Intervention Improves Physical Activity Measures in Hispanic/Latino Families: A Cluster RCT

Nutrition and physical activity are key components for the prevention of cardiovascular disease. There remains a paucity of trial data on the effect of specific nutritional interventions on physical activity and sedentary time. One question is how a common nutrient-dense food such as avocado may impact physical activity and sedentary time in Hispanic/Latino families, a group that reports the lowest levels of physical activity. This is a 6-month clustered RCT. Seventy-two families (235 individuals) who identified as Hispanic/Latino were enrolled through the San Ysidro Health Center (San Diego, CA) between April 2017 and June 2018. After a 2-week run-in period, 35 families were randomized to the intervention arm (14 avocados/family/week), and 37 families were assigned to the control arm (3 avocados/family/week). Linear mixed-effects models were used to assess changes in physical activity (MET minutes per week) between the groups during the 6-month trial. Secondary outcomes included sedentary time (minutes/week), BMI, and systolic and diastolic blood pressures. An adherence goal of >80% was achieved for both arms. Total mean physical activity increased by 2,197 MET minutes per week more in the intervention group (p<0.01) than in the control group, driven by between-group differences in moderate (p<0.01) versus vigorous (p=0.06) physical activity. After accounting for longitudinal repeated measures per participant and nested family effects, total adult physical activity remained significantly higher in the intervention than in the control group (+1,163 MET minutes per week on average per participant), with a significant intervention interaction term (p<0.01). There were no significant changes in sedentary time, BMI, or blood pressure. Higher allocation of avocados was associated with significantly higher physical activity and no adverse changes in BMI or blood pressure, suggesting that this nutritional intervention may have beneficial pleiotropic effects.Trial registration: This study is registered at www.clinicaltrials.gov as NCT02903433.

Accelerometer Metrics: Healthy Adult Reference Values, Associations with Cardiorespiratory Fitness, and Clinical Implications.

Accelerometer-assessed physical activity (PA) can be summarized using cut-point-free or population-specific cut-point-based outcomes. We aimed to 1) examine the interrelationship between cut-point-free (intensity gradient (IG) and average acceleration (AvAcc)) and cut-point-based accelerometer metrics, 2) compare the association between cardiorespiratory fitness (CRF) and cut-point-free metrics to that with cut-point-based metrics in healthy adults aged 20 to 89 yr and patients with heart failure, and 3) provide age-, sex-, and CRF-related reference values for healthy adults. In the COmPLETE study, 463 healthy adults and 67 patients with heart failure wore GENEActiv accelerometers on their nondominant wrist and underwent cardiopulmonary exercise testing. Cut-point-free (IG: distribution of intensity of activity across the day; AvAcc: proxy of volume of activity) and traditional (moderate-to-vigorous and vigorous activity) metrics were generated. The "interpretablePA" R-package was developed to translate findings into clinical practice. IG and AvAcc yield complementary information on PA with both IG ( P = 0.009) and AvAcc ( P < 0.001) independently associated with CRF in healthy individuals (adjusted R2 = 73.9%). Only IG was independently associated with CRF in patients with heart failure ( P = 0.043, adjusted R2 = 38.4%). The best cut-point-free and cut-point-based model had similar predictive value for CRF in both cohorts. We produced age- and sex-specific reference values and percentile curves for IG, AvAcc, moderate-to-vigorous PA, and vigorous PA for healthy adults. IG and AvAcc are strongly associated with CRF and thus indirectly with the risk of noncommunicable diseases and mortality, in healthy adults and patients with heart failure. However, unlike cut-point-based metrics, IG and AvAcc are comparable across populations. Our reference values provide a healthy age- and sex-specific comparison that may enhance the translation and utility of cut-point-free metrics in clinical practice.

O.3.3-4 Development and validation of the obesity-specific decisional balance for Physical Activity questionnaire

Abstract Purpose Despite the crucial role of physical activity in obesity management, many patients remain insufficiently physically active. The decisional balance, from the transtheoretical model, represents the facilitators and the barriers associated with behavior change (e.g., engaging in regular physical activity). Studies have identified barriers to and facilitators of physical activity specific to the context of obesity. However, to date, there is no scale to measure them. The objective of this study was to develop and validate a preliminary version of the Obesity-specific Decisional Balance for Physical Activity (O-DBPA). Methods A series of studies was conducted with a total sample of 350 adults with obesity (Mage=44.3, SD = 14.7 years; MIMC=44.4, SD = 14.7 kg.m2). First, the clarity of the 50 items developed by the expert committee was examined. Second, the dimensionality of the scale was examined through confirmatory factor analyses. Third, reliability tests were performed (i.e., Cronbach's alphas, test-retest reliability). Fourth, theoretical validity of the O-DBPA was examined through its correlations with other theoretically related constructs (i.e., motivation, self-esteem). Results Clarity assessment revealed acceptable scores for all items (M = 6.2/7, SD = 1.1). Dimensionality testing led to reduce the scale to 21 items divided into two factors: facilitators of and barriers to physical activity. Each of these factors was composed of three subscales: physical, psychological, and environmental. The confirmatory two-factor model had the best fit indices: χ2(166)=323.67, CFI=0.95, TLI=0.93, RMSEA=0.052. Cronbach's alphas were acceptable or marginally acceptable (i.e., [0.61-0.88]). Temporal reliability, measured with a 4-week interval, was satisfactory. The O-DBPA subscales were significantly related to the motivation and self-esteem constructs in the expected directions, attesting to the theoretical validity of the scale. Conclusion The O-DBPA, composed of 21 items, presented good psychometric qualities. This new instrument allowed to examine the obesity-specific barriers to and facilitators of physical activity in French-speaking samples. This new scale offers promising clinical and research perspectives for the promotion of physical activity in adults with obesity.

O.4.5-2 Participation in organized and unorganized sports in adolescence: associations with physical activity levels in adulthood

Abstract Purpose Participation in organized youth sports (OYS) has been linked to higher levels of physical activity (PA) in adulthood. However, the longitudinal associations of OYS and PA compared to unorganized sports and non-participation have not been extensively studied. This study aims to explore the associations of both organized and unorganized sports in adolescence with PA levels in midlife. Methods Participants in this study were drawn from the on-going, population-based prospective Young Finns Study. Data from follow-ups conducted in the years 1980, 1983, 1986, and 1989 were utilized to divide the participants into groups of active OYS, active unorganized sports, and non-participants, separately at the ages of 9 (n = 548), 12 (n = 727), 15 (n = 752), and 18 (n = 767). The groups were formed according to self-reported frequency and intensity of leisure time PA and participation in sports club activities in adolescence. Accelerometer-derived PA (mean daily minutes of sedentary time [ST], light-intensity PA [LPA], and moderate-to-vigorous PA [MVPA]) in midlife was assessed in 2018-2020. Differences in adult PA between the youth PA groups were analyzed using analysis of covariance, separately in males and females. Results Compared to non-participants, boys who actively participated in OYS at age 9 had lower ST (mean difference [SE]: -38 [15], p = 0.045) and higher LPA (29 [12], p = 0.050) in midlife. No significant group differences were observed for girls at age 9 or for either sex at age 12 or 15, or for boys at age 18. In girls at age 18, significant group differences were found in MVPA in midlife in favor of both organized and unorganized sports compared to non-participants (15 [3], p &amp;lt; 0.001; 8 [3], p = 0.014, respectively). Conclusions Active participation in organized sports in boys at age 9 and active participation in both organized and unorganized sports in girls at age 18 associated with higher levels of physical activity in midlife. These findings suggest that promoting both types of sports participation in adolescence may contribute to the development of a physically active lifestyle across the life course. Support/Funding Source The work was supported by the Ministry of Education and Culture.

S9-2 Dutch national falls prevention program- implementation challenges

Abstract Purpose In the Netherlands, a very ambitious falls prevention program is being implemented in 2023 and 2024. Falls among older adults lead to a high burden on healthcare and high societal costs. This program is therefore part of the current government coalition agreement. Each year one in seven persons over 65 should be screened on fall risk and should be stimulated to reduce fall risk. The whole program includes specific falls prevention programs (FPPs) as well as Physical activity (PA) programs outside these FPPs to keep fall risk restricted. Large responsibility is given to municipalities for implementation at the local level, and to regional public health services at a higher level. Project description At present there is no good organisation of falls prevention. A whole infrastructure has to be set up to be able to carry out the prevention program. This is coordinated by VeiligheidNL. It involves a considerable number of stakeholders and different working packages on FFPs, implementation, and communication. Starting in 2022, a number of sessions have been held to inform municipalities, regional health services, and professionals. Funding frameworks are set up including refunding of FPP participation and support of coordination by municipalities. As part of the process, we evaluated among scientists, PA professionals and municipalities what is needed to organise PA for maintenance after FPPs and for people without increased risk. This includes more available organised PA, increase in frequency and intensity of current group PA, and involving regular sports clubs to increase overall capacity. Most municipalities need to take a much stronger coordinating role, including also a professional with ‘broker’ role, generally the so-called neighbourhood sports coach (NSC). This professional guides older people to suitable PA and is a connector between health, social care and PA professionals. Conclusions The ambitious falls prevention program, supported by considerable financial resources, has the potential to give a large boost to PA in older adults. There are still a lot of challenges at the national as well as local level before implementation is successful, but several locations have already managed to develop a good infrastructure.

S15-4 Challenges in translating research from controlled to real-life settings: preliminary results and evaluation of the “Take your brain for a walk” study

Abstract Purpose Developing strategies to promote healthy cognitive ageing is a priority given the growing ageing population. Recent research has shown that cognitive activity (CA) combined with physical activity (PA) improves cognitive functioning. However, most studies on PA+CA have been conducted in controlled settings, and there is a need for real-life PA+CA interventions. We developed a real-life cognitively enriched walking program “Take your brain for a walk” in co-creation with older adults and experts. Currently, we are conducting a six-month randomized controlled trial (RCT), including an outcome and process evaluation. Methods Participants are cognitively healthy community-dwelling adults aged 65+ years. They were randomly assigned to a: 1) cognitively enriched walking program (PA+CA) (performing cognitive tasks while walking); 2) walking program (PA only); or 3) passive control group. Both walking programs consist of two supervised 60-minute group-based walking sessions per week, with a total duration of six months (October 2022-April 2023). Memory and executive functioning are assessed using the Cambridge Neuropsychological Test Automated Battery at baseline (T0), three months (T1), six months (T2) and twelve months (T3; T1-T3 2023). Furthermore, a mixed-method process evaluation will be implemented based on the framework of Saunders et al. (2005), including a questionnaire and a semi-structured interview for the coaches and participants of the walking programs. Results At baseline, 148 participants were included with a mean age of 70.4 (4.3) years, 70.9% was female. Seventeen participants dropped out in the first 3 months of the study. Three- and six-months effects (data from T0, T1 and T2) of the program on memory and executive functioning will be presented. We expect to see positive changes in cognitive functioning in both the PA+CA and PA arms, with larger effects for the PA+CA arm. Furthermore, the process evaluation results regarding fidelity, dose (delivered or received), satisfaction, adherence and context will be presented. The focus will be on the challenges of research in real-life settings. Conclusions Findings will inform future lifestyle programs to promote cognitive functioning by simultaneously focusing on PA and CA for older adults in real-life settings. Support/Funding Source This project is funded by the Research Foundation Flanders (FWO).

O.4.3-5 Accelerometer-measured sedentary behavior among school-aged children, adolescents, and adults in Finnish population-based studies

Abstract Purpose Sedentary behavior (SB), mainly sitting, covers most of the waking hours in Western populations, and is found harmful to health and well-being, partly independently of physical activity (PA). The purpose of the present study was to describe trends of SB among school-aged children, adolescents, and adults in Finnish population-based studies. Methods The study is based on three cross-sectional population-based studies: Finnish School-aged PA (FSPA) study (2020 and 2022) for 7-20-year-olds, the FinFit 2021 study for 20-69-year-olds, and the Older Adults PA study (2017-2019) for 70+-year-olds. In each study participants’ physical behavior was measured by a tri-axial accelerometer 24/7 (UKK RM42, UKK Terveyspalvelut Oy, Tampere, Finland). During waking hours accelerometer was worn on an elastic hip-band and during time in bed, a rough proxy of sleep, on a wrist-band attached to a non-dominant wrist. Parameters of SB (sitting and laying down) and standing were based on the angle for posture estimation (APE) method and analyzed in terms of total daily times, different bout lengths, and patterns of SB during the day. Results SB covered the majority of waking hours in each participating group. The 7-year-olds had the smallest amount (on average 6h) and the 80-year-olds and older had the highest amount (over 11h) of daily SB. The amount of SB increased from younger to older participants during schoolyears, plateaued during working life, and increased again after retirement. Among children, most of the daily SB accumulated from less than 20-minute bouts, and the differences between the age groups were small. Among adults, these short bouts covered less than half of the total SB time. Bouts lasting 20-60 minutes or more than 60 minutes at a time were most frequent among the oldest participants. Conclusion SB is a prevalent behavior in the Finnish population, regardless of age. Since physical behavior, more precisely SB, standing, light, moderate and vigorous PA, and time in bed, form a continuum for 24 hours, an increase in one behavior decreases one or more of the others. Thus, the high prevalence of SB offers great potential for changing physical behavior patterns in a more active and healthier direction.

A qualitative study assessing the barriers and facilitators to physical activity in adults with hearing loss.

Growing epidemiological evidence has shown hearing loss is associated with physical inactivity. Currently, there is a dearth in evidence investigating why this occurs. This study aimed to investigate the barriers and facilitators to physical activity in middle-aged and older adults with hearing loss. Individual semi-structured qualitative interviews. A phenomenological approach was taken. Ten adults (≥40 years) were interviewed via videoconferencing. The interview schedule was underpinned by the capability, opportunity, motivation and behaviour (COM-B) model. Reflexive thematic analysis was used to generate themes, which were subsequently mapped onto the COM-B model and behaviour change wheel. Nine hearing loss specific themes were generated, which included the following barriers to physical activity: mental fatigue, interaction with the environment (acoustically challenging environments, difficulties with hearing aids when physically active) and social interactions (perceived stigma). Environmental modifications (digital capabilities of hearing aids), social support (hearing loss-only groups) and hearing loss self-efficacy were reported to facilitate physical activity. Middle-aged and older adults with hearing loss experience hearing-specific barriers to physical activity, which has a deleterious impact on their overall health and well-being. Interventions and public health programmes need to be tailored to account for these additional barriers. Further research is necessary to test potential behaviour change techniques.

Associations Between Adolescent Sport and Exercise Participation and Device-Assessed Physical Activity in Adulthood: Evidence From the 1970 British Cohort Study.

Adolescence is a critical period filled with life changes. Early implementation of effective health promotion strategies could help alleviate the morbidity and mortality associated with inactivity. This study investigated whether adolescent participation in exercise and sport is associated with device-assessed physical activity (PA) levels in midlife. A total of 2984 participants (41.2% male) from the 1970 British Cohort Study were included. Participants were surveyed at age 16years on 5 indicators of exercise and sport participation. Total daily PA and moderate to vigorous PA (MVPA) at age 46years were measured using a thigh-worn accelerometer, worn for 7days. Associations between each adolescent exercise or sport indicator and adulthood total daily PA and MVPA were examined using linear regressions, adjusting for sex, wear time, body mass index, smoking, disability, malaise, alcohol consumption, social class, education, and self-rated health. In fully adjusted models, adolescents who reported exercising "much more" than others (8.6min/d; 95% confidence interval, -0.1 to 17.1), who played sports at the park/playground more than once a week (8.5 [3.0-14.0]min/d), and who exercised on the most recent Saturday (3.8 [0.7-6.9]min/d) had higher adult total PA levels than those who reported the lowest activity levels. There was no evidence of an association between greater sport and exercise participation at age 16 y and MVPA at age 46 y. There was no association between sports at school and either measure of adult PA. Active adolescents, particularly those who engaged in out-of-school exercise, had higher total daily PA levels, but not MVPA levels, in midlife. This highlights the potential of early PA interventions to improve PA levels in adulthood.

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

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