Physical Activity In Adults Research Articles

Analyze the temporal trend of the prevalences of morbidity and risk and protection factors for non-communicable diseases (NCDs) in adults living in Brazilian capitals between 2006 and 2023. A time-series study using data from the Risk and Protection Factor Surveillance System for Chronic Diseases by Telephone Survey - Vigitel. Hypertension and diabetes morbidities were analyzed, as well as risk and protection factors for NCDs (smoking, Binge drinking, insufficient physical activity, overweight, obesity, recommended fruit and vegetable consumption, regular bean consumption and leisure-time physical activity in adults aged 18 years or older living in Brazilian capitals. Linear regression was used to analyze the trends. There was a reduction in the prevalences of smoking and regular bean consumption, and an increase in physical activity, overweight, obesity, hypertension and diabetes among the total study population and in both sexes. Alcohol consumption increased among women, who also showed a more significant rise in overweight and physical activity. The results suggests that the trends analyzed were similar between the sexes, except for alcohol consumption, which increased only among women, and physical activity and overweight, which showed greater increases among women.

Purpose: There is emerging evidence that physical education (PE) can be a negative experience for transgender and nonbinary people; however, it is unclear whether this impacts levels of physical activity in adulthood. Method: Forty-two transgender and nonbinary participants completed an online survey about their experience of PE at secondary school and current levels of physical activity. Results: Most participants had negative experiences of PE. Changing rooms were a particular challenge but views differed as to the preferred solution. Factors relating to enjoyment, included participant’s feelings of competence, safety, and physical comfort. Physical comfort was significantly correlated with current levels of physical activity. Conclusions: We conclude that cisnormative sex-separated model of PE, based on binary gender organization, negatively impacts trans and nonbinary students. In addition to rethinking this model and creating an inclusive environment, it is important that school policy is adapted to support individual trans and nonbinary students.

This essay aims to discuss walking and cycling as a means of transportation for the Brazilian population. Scientific evidence (mainly from high-income countries) shows their contributions to people's health, pointing out that these physical activities can constitute an important part of daily life and contribute to preventing diseases and to the health of municipalities by reducing air and noise pollution and the problems due to the excess of motor vehicles. We discuss the forms of measurement in national surveys and the new technologies that have been used. Trend analyses show a decrease in this type of physical activity in adults living in Brazilian capitals. However, analyzing walking and cycling together impairs interpretations and limits the study of factors associated with different types of commuting. We show that some Brazilian capitals are increasing their environmental structures, but population indicators show that groups of lower socioeconomic levels have less access to the. We discuss how much these activities are still practiced out of necessity - rather than out of choice - in Brazil due to transportation costs that remain high and unequal environments. However, most studies in Brazil being cross-sectional impairs the evaluation of possible effects on health and the influence of social variables and environmental changes on this behavior. New population surveys and longitudinal studies that support policies are essential to promote walking and cycling as a means of transportation.

Australian adults transitioning into retirement aged 55-75 years (> 50%) do not meet the World Health Organization recommendation of physical activity (PA). One potential strategy to promote PA is through vigorous intermittent lifestyle physical activity (VILPA). This study aimed to investigate barriers and facilitators from adults transitioning to retirement about participation in VILPA and to identify strategies to promote and implement VILPA. Thirty adults transitioning to retirement (mean age = 64 years) were recruited to participate in focus groups to provide their perceptions on VILPA. All participants' PAs were measured by accelerometers. A set of semi-structured questions developed from the findings of a previous scoping review was used to guide focus groups with participants. To increase awareness of PA bouts and intensity, the focus group discussions were prompted by participants' individualised accelerometer-measured PA reports. The identified barriers and facilitators were mapped to the Theoretical Domains Framework. Intervention strategies were derived from the framework domains. Three focus groups were conducted. Participants perceived barriers to participation in VILPA stem from health constraints, insufficient awareness about VILPA, and adverse weather conditions. To promote VILPA, adults transitioning to retirement require a better understanding of PA intensities, knowledge of identifying VILPA opportunities, and monitoring and feedback for engagement. Intervention to promote VILPA should include elements of education, persuasion, incentivisation and enablement. Adults transitioning to retirement perceived VILPA as feasible and convenient for increasing their overall PA. SO WHAT?: The study findings will directly inform the development of a targeted VILPA intervention with key stakeholders and an implementation plan to promote PA in adults transitioning to retirement.

Type-specific physical activity (PA) may be associated with different risks of ischemic heart disease (IHD), but few large studies have examined this. This study aimed to assess the incidence and dose-response relationships between total PA and 4 different types of PA and IHD risk in Chinese adults. The prospective China Kadoorie Biobank enrolled 35,508 adults from Qingdao from 2004 to 2008, including 33,342 IHD-free participants in this analysis. PA was collected through a self-report questionnaire, calculating metabolic equivalents of task-hours per day based on duration and frequency. Cox regression analysis was used to assess the association between PA and IHD risk. During a median 9.2years of follow-up, 2712 incident IHD cases were recorded. Total, occupational, commuting, and leisure-time PAs were inversely associated with IHD risk. Compared with the participants in the bottom quintiles of PA, the participants in the top quintiles of total PA, occupational PA, commuting PA, and leisure-time PA had 43% (hazard ratio [HR] = 0.57; 95%CI, 0.49-0.66), 38% (HR = 0.62; 95% CI, 0.50-0.75), 38% (HR = 0.62; 95% CI, 0.44-0.87), and 21% (HR = 0.79; 95% CI, 0.67-0.95) lower IHD risk, respectively. A negative association between household PA and IHD risk was found only in males (HR = 0.83; 95% CI, 0.70-0.98). The restricted cubic spline regression analysis revealed a linear relationship between total PA and IHD risk (P for nonlinear = .5687). Among Chinese adults, higher total, occupational, commuting, and leisure-time PA was associated with significantly lower risks of IHD, and increased household PA could reduce IHD risk in males.

Parkinson's disease (PD) affects motor and nonmotor functions, impacting PD-related quality of life. The role of physical activity (PA) in the management of PD symptoms is increasingly recognized. To examine the effects of PA levels on PD motor and nonmotor symptoms, and health-related quality of life, using the Fox Insight study's data set. It also examines PA's moderating effects on the age-PD motor function relationship. In this cross-sectional observational study, 1,288 participants with PD (55.8% men, age: 64.54 ± 9.99) from the Fox Insight study were divided into four groups (N = 322 each) based on their PA level as measured by the Physical Activity Scale for the Elderly (PASE). PD motor and nonmotor symptoms were assessed using the Unified Parkinson's Disease Rating Scale-2 (UPDRS-2), Parkinson's Disease Questionnaire-8 (PDQ-8), Geriatric Depression Scale-Short Form, Penn Parkinson's Daily Activities Questionnaire-15, and EuroQol-Visual Analog Scale. Statistical analyses included Kruskal-Wallis, Pearson's correlation, and multiple linear regression, with alpha set at .05. Higher PASE correlated with better UPDRS-2, Parkinson's Disease Questionnaire-8, Geriatric Depression Scale-Short Form, Penn Parkinson's Daily Activities Questionnaire-15, and EuroQol-Visual Analog Scale. The study found significant influences of PASE on UPDRS-2, age, Geriatric Depression Scale-Short Form, body mass index, and EQ-VAS (R2adj = .174, F = 53.998, p < .001). Notably, PASE moderated the relationship between age and UPDRS-2, suggesting a pivoting role in slowing PD-related symptom progression with age (R2adj = .145, F = 73.47, p < .001). Increased PA levels are associated with better outcomes in PD motor and nonmotor symptoms, improved PD-related quality of life, and a slowed progression of PD symptoms. Promoting higher levels of PA in older adults with PD effectively manages motor and nonmotor symptoms of PD. In addition, early and consistent PA is the key to moderating the progression of PD symptoms.

Abstract The population of older adults with autism is growing, yet the literature for this group is still relatively sparse (Mason et al., 2022). Adults with autism are reported to have comorbidities and a reduced lifespan (Hand et al., 2020). While physical activity (PA) is known to reduce chronic disease burden, extant research indicates young adults with autism do not engage in physical activity (PA) with the same frequency as neurotypical peers. Little is known about PA for older adults with autism. This scoping review aimed to explore research about PA for older adults with autism. Methods Following the PRISMA-ScR guidelines, 5 databases were searched (2018 and later) with keywords ‘autism,’ ‘older adults’, ‘PA,’ and age group delimiters. Results Initially, no articles were found, and the search was expanded to include all adults. After eliminating duplicates, 121 studies were reviewed, with 25 meeting the criteria (PA, autism, and no participants less than 18) and 9 having any participants over 50; in each of these 9 studies, the number of participants over 50 was less than 100. Only 2 studies focused on adults over 50. The level of evidence was low. The limited data suggests those aging with autism do not engage in recommended levels of PA and experience barriers to the same, but that interventions improve PA and possibly quality of life. IMPLICATIONS: There is a dire need to design interventional research to increase PA in older adults with autism to improve equitable health outcomes for this at-risk group.

To process wearables sensors data, end-users face a wide variety of choices influencing physical activity (PA) patterns estimation. This study investigated the impact of varying epoch length on PA patterns in adults and World Health Organization (WHO) PA guidelines prevalence, assessed by accelerometer. The study included 181 adults (18-74 years) from the Esteban Study (2014-2016). Participants wore an accelerometer for 7 consecutive days. Data were processed with ActiLife® software using epoch lengths from 1 to 60 seconds to assess PA patterns. Difference of PA patterns between epoch length was assessed using repeated measures ANOVA. Difference in meeting WHO PA guidelines was assesses using Fisher's exact test. Significant changes were observed in sedentary behaviour and PA intensities with epoch length variation (p<0.001). Longer epochs led to reduced moderate and vigorous PA, increased light PA, and less sedentary time, affecting adherence to WHO PA guidelines. Result underline the importance of careful epoch length selection when processing accelerometer data to accurately assess sedentary behaviour and PA in adults. Shorter epochs seem preferable to capture short and spontaneous PA bouts and preventing underestimation of MVPA along with prolonged PA bouts. Further investigation including a PA reference measure is needed to confirm these findings and their implications for adult health.

Abstract Older individuals who have experienced a fall often experience concerns about falling, impaired activities of daily living, and reduced physical activity (PA). Changes in PA following a fall are often influenced by moderators such as age or fall history; however, these moderators remain understudied. Therefore, this project investigates the association between moderators and changes in PA in older adults after a fall. Participants aged ≥60 years were recruited if they presented to the emergency department following a fall without hospital admission. Moderators were collected through a home-based geriatric assessment conducted within four weeks after the fall. PA was measured within four weeks and six months after the fall using an accelerometer (activPAL4, PAL Technologies Ltd., UK). Associations between moderators and changes in PA were calculated fitting Linear Mixed Model (LMM) in R (R Core Team, 2023 Version 4.3.2 (2023-10-31). A total of 178 valid datasets were analyzed. LMM analysis revealed a significant average increase in step count over time (p=0.006). Notably, female participants showed a significant larger increase in steps per day (+1,777.9, 95% CI: 292.2 – 3263.7, p=0.019) than male participants. In women, fall history (95% CI: -1009.5 – (-207.4), p=0.003) and age (95% CI: -315.8 – (-82.5), p&amp;lt; 0.01) were negatively associated with step counts. Given the healthcare challenges associated with falls in older adults, our findings underscore the importance of early identification of moderators in emergency department settings. Identifying these factors may enable targeted interventions for individuals at risk of functional decline post-fall, potentially preventing further functional decline.

Abstract Adults aged 60 years and older are the most sedentary group in the United States. Low levels of physical activity (PA) and high levels of sedentary behavior (SB) increase the risk for developing diseases. Therefore, it is crucial to investigate intervention strategies that help increase PA and decrease SB levels in older adults. This study was an 8-week, Physio-fEedback Exercise pRogram (PEER), aimed at improving PA levels and balance while reducing the fall risk of community-dwelling older adults by providing visual physio-feedback on balance and body composition, cognitive reframing to lower the fear of falling, and a peer-led group exercise. We conducted a preliminary analysis of 55 community-dwelling older adults aged 61 to 89 years (49 women, 6 men; mean age = 73.75 ± 7.28 years) in low-income settings to determine if the intervention influenced PA levels. Total PA levels were measured across 7 consecutive days using the ActiGraph GT9X Link wireless activity monitor at baseline and post-intervention for a control (n = 31) and intervention group (n = 24), and categorized as sedentary behavior (SB), light PA (LPA), and moderate-to-vigorous PA (MVPA). PA was compared between groups using Student’s t-test and Mann-Whitney U test, but significant differences were not found. However, the PEER group showed a decrease in total SB mean (208.64 min), increase in total LPA mean (89.99 min), and increase in total MVPA median (8.75 min) between baseline and post-intervention. The results show that PEER has the potential to impact PA levels, but more research is warranted.

Abstract Common pathways exist between cardiovascular and cerebrovascular diseases in aging adults; therefore, this study examined the associations between the frequency of physical activity (PA) and memory issues in older adults with or at risk for cardiovascular disease (CVD). Data from the 2022 National Health Interview Survey were used to examine the influence of CVD risk and physical activity on self-reported experiences of memory challenges using logistic regression. The sample (N = 13,432) was limited to adults ≥50 years of age. Most of the sample was female, White, married/partnered, and reported a good to excellent health status. Roughly a quarter (24.9%) reported some difficulty remembering or concentrating while the majority (89.1%) had some level of increased CVD risk based on Framingham criteria. Half of the sample (51%) did not meet the current PA guidelines for older adults. After controlling for age, sex, race, ethnicity, and region, those with a poor or fair health status (OR = 3.24, CI = 2.94–3.56, p &amp;lt; 0.001), increased CVD risk (OR = 1.26, CI = 1.09–1.47, p = 0.002), or who did not meet current PA guidelines (OR = 1.67, CI = 1.46–1.90, p &amp;lt; 0.001) more frequently reported challenges with remembering or concentrating. Given these findings, further research is warranted into the role of PA in memory issues, particularly for those at risk for CVD. Following guidelines for PA for these older adults may be helpful.

Introduction: The COVID-19 pandemic lockdowns have reduced physical activity (PA) among home-dwelling older adults. The main aim of this study was to investigate how real-life PA in home-dwelling older adults changed over a year with gradual eases in COVID-19 restrictions. Methods: Community-dwelling older adults (≥65 years) were recruited from local exercise groups aimed at preventing functional decline and falls. All participants had been involved in the exercise groups before the pandemic but had been without the offer for 6 months prior to inclusion because of COVID-19 restrictions. Sensor-based PA was measured using Axivity accelerometers worn on the lower back and right thigh for seven consecutive days at baseline (autumn 2020), 6 (spring 2021) and 12 (autumn 2021) months. PA activities were classified using the HAR70+ machine learning model, validated on older adults. Results: Ninety-one older adults (78 ± 6.4 years, 88% female) were included. At baseline, 9% used walking aids and 26.5% reported a fall in the previous year. Daily time spent upright did not change, while time spent walking decreased by 8.19 min from baseline to 12 months (p < 0.048). Walking bouts of >10 min decreased with 0.5 bouts per day (p < 0.001), and the longest walking bout showed a nonsignificant decrease of 17.7 min (p = 0.056). This shows a change toward a more sedentary activity pattern over the year despite a gradual ease of the restrictions. Conclusion: In a relatively well functioning group of older adults, PA did not increase with gradual ease in COVID-19 restrictions.

Abstract BackgroundModifiable risk factors are important for prevention of age‐related cognitive decline. Prior research has linked both physical activity (PA) and sleep with better memory outcomes. To better understand their potential synergistic effects, we examined independent and interactive effects of actigraphy‐based PA and total sleep time on cognitive functioning in cognitively unimpaired older adults.MethodParticipants included 40 cognitively unimpaired older adults (age = 71.1 ± 10.8yrs; 52% female; 75% White; mean education = 18.2yrs) enrolled in studies at the UCSF Memory and Aging Center. All participants completed in‐person neuropsychological assessments and 30 days of FitbitTM Inspire 2 monitoring, which tracked average nightly total sleep time and average daily step count. Average sleep time was dichotomized into optimal sleep (6‐8hrs) and sub‐optimal sleep (&lt;6hrs, &gt;8hr) based on previous literature, and average daily step count was dichotomized by median split (high PA ³ 8490 steps). Composite cognitive z‐scores were calculated for memory and executive functioning. Multiple linear regression models examined the interaction between sleep and PA on cognitive domain z‐scores, controlling for age, sex, and education.ResultNeither sleep nor average daily steps were independently related to memory (sleep:b = ‐0.58, 95%CI [‐1.36, 0.20], p = 0.141; steps: b = ‐0.27, 95%CI [‐0.86, 0.32], p = 0.357) or executive functioning (sleep:b = ‐0.68, 95%CI [‐1.46, 0.10], p = 0.087; steps: b = ‐0.21, 95%CI [‐0.82, 0.40], p = 0.487). In combination, however, sleep significantly moderated the effect of PA on memory (b = 1.47, 95%CI [0.03, 2.92], p = 0.046) such that higher PA related to better memory performance only among participants with optimal sleep times. The interaction between PA and sleep on executive functioning was not significant (b = 0.49, 95%CI [‐1.06, 2.03], p = 0.528).ConclusionUsing unobtrusive objective monitoring of modifiable lifestyle factors via wearable actigraphy, we found a beneficial synergistic relationship between sleep and PA on memory. Results highlight the clinical relevance of supporting multi‐domain improvements in modifiable lifestyle factors, including optimal sleep time and higher PA in older adults.

Obesity in the US: Exploring the paradox of increasing obesity rates alongside growing physical activity.

Many adults do not meet physical activity recommendations for optimal health, and this is often because people find it difficult to maintain physical activity in the long term. This study focuses on identifying and synthesising factors that may influence the maintenance of physical activity in adults with and without known health conditions. A systematic review and qualitative synthesis using thematic analysis was conducted. Four databases (MEDLINE, SPORT Discus, APA, and Web of Science) were systematically searched for studies published from inception to February 2023 that included qualitative data about people's experiences of maintaining physical activity. A total of 9337 abstracts were screened and 68 studies from 14 countries were included. Six main themes were identified: (1) influence of others (e.g. four forms of social support, accountability); (2) contextual and environmental influences (e.g. cost and access of physical activity, weather); (3) health-related influences (e.g. reflexivity about how physical activity improves health conditions, weight control); (4) making it work (e.g. flexibility, prioritising exercise); (5) habits; and (6) psychological processes (e.g. enjoyment, identifying as a physically active person). People who maintained their participation in physical activity found it enjoyable, prioritised it, and integrated it into their daily routine. Participants were motivated to continue being physically active when they realised the benefits for their health. Social support, in particular companion support, was a key component facilitating continued engagement. Findings specific to maintenance of physical activity included reflexivity of how physical activity benefited health, flexibility, and identifying as a physically active person.

BackgroundAdults who maintain ideal cardiovascular health (CVH) profiles up to midlife have lower risk of several chronic diseases and better quality of life. Some evidence suggests that individual‐level exposures earlier in life shape midlife CVH, but the impact of neighborhood‐level exposures over the life course remains understudied.Methods and ResultsParticipants were 3017 Black and White men and women aged 18 to 30 years at baseline (1985–1986), recruited from Birmingham, Alabama; Minneapolis, Minnesota; Chicago, Illinois; and Oakland, California, as part of the CARDIA (Coronary Artery Risk Development in Young Adults) study. Measures of the neighborhood food and physical activity environment were linked to participant addresses collected at baseline. CVH was measured on the basis of the American Heart Association's Life's Simple 7 criteria in young adulthood and 30 years later (2015–2016) when participants were midlife (aged 48–60 years). Associations of young adult neighborhood food environment and physical activity resources with midlife CVH (moderate versus high and low versus high) were examined using multinomial logistic regression. Models were adjusted for young adult sociodemographic factors. Participants who lived farther away from a major park in young adulthood were more likely to have low versus high CVH scores (odds ratio, 1.54 [95% CI, 1.22–1.96]) and more likely to have moderate versus high CVH scores (odds ratio, 1.39 [95% CI, 1.12–1.73]) in midlife. No other neighborhood measures were significantly associated with CVH.ConclusionsYoung adulthood may be a sensitive period in which having convenient access to physical activity–promoting resources may help them establish healthy habits that can carry into midlife.

Overweight and obesity can be caused by lack of physical activity and an imbalance in energy intake and energy expenditure, which can lead to excess energy which will be stored in the form of fat tissue in the body. Efforts to improve healthy lifestyles can be done with nutritional education. Technological developments can provide opportunities to increase telehealth activities in Indonesia, one of which is tele-nutrition. This study aims to determine the effect of tele-nutrition education on changes in percent fat, cholesterol and physical activity in overweight adults. This research uses a pre-test post-test control group design. A total of 46 adult respondents aged 19-49 years. Both groups were first given an initial test (pre-test) with the same test. Then the experimental group was given special treatment, namely tele-nutrition-based nutrition education, while the control group was given direct leaflet-based nutrition education treatment. Data analysis was used using the Paired T Test and Wilcoxon Test. Based on the results of the analysis, there was no effect on body fat percentage before and after being given nutritional education in the experimental group and control group (p&gt;0.05). There was an effect on cholesterol levels and physical activity before and after being given nutrition education in the experimental group, while in the control group there was no effect on cholesterol levels and physical activity before and after being given nutrition education (p&lt;0.05). Keywords: cholesterol levels, percent body fat, physical activity, tele-nutrition education

The interplay between physical activity (PA) and sedentary behavior (SB) significantly influences cognitive health in older adults, with executive functions (EFs) being particularly vulnerable to lifestyle factors. However, previous research on older adults focused mainly on PA and is limited due to the lack of comprehensive consideration of other factors that influence EFs. Current guidelines suggest an association between sedentary behavior (SB) and EFs, yet few studies have examined the combined effects of PA and SB on EFs. This cross-sectional study aimed to explore the relationship between PA, SB, and EFs in older adults. A total of 116healthy older adults aged ≥65 years were recruited and categorized into four groups based on activity lifestyles: higher PA and higher SB (PHSH); higher PA and lower SB (PHSL); lower PA and higher SB (PLSH); and lower PA and lower SB (PLSL). EFs were assessed using the Tower of London (TOL) task and the Stroop test, which measure high-order EFs (planning and problem-solving) and core EFs (inhibitory control), respectively. The PHSL group performed better on the TOL task, with lower total move scores and shorter total problem-solving times, compared to the PLSH group. The total move score of the PLSL group was better, and the total problem-solving time of the PHSH group was shorter than those of the PLSH group. However, the Stroop test scores did not differ between the four groups. These findings suggest that increasing PA or reducing SB selectively enhances executive functions, particularly in planning and problem-solving, while less impacting inhibitory control in older adults. This highlights the importance of considering the nuanced effects of PA and SB on different aspects of executing functioning in older adults.

BackgroundDespite the well-known benefits of physical activity (PA), non-communicable disease and premature mortality rates among adults continue to rise. The relationship between adults’ goals and exercise-specific motivation on the type of PA intensity one engages remains unclear. The purpose of this study was to identify physical activity (PA) profiles based on frequency and intensity (i.e., levels of PA) in an adult sample. A secondary purpose was to examine how the PA profiles differ on the reasons people have for exercising and behavioral regulation.MethodsA Cross-sectional survey was conducted with 1,169 (46.8 ± 16.7 years) participants solicited from a hospital-affiliated wellness center, social media promotions, and a research volunteer registry. The International PA Questionnaire (IPAQ) was used to determine frequency, intensity, and time spent engaging in PA. Additionally, the Reasons to Exercise (REX-2) scale, the Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3), and demographics were assessed. K-cluster analyses were performed to identify profiles based on PA levels using the IPAQ guidelines. Multivariate analysis of variance (MANOVA) was used to assess profile differences.ResultsFive distinct PA clusters were derived, and defined as: a Low, Walking, Moderate Intensity, High Intensity, and Sitting cluster (p < .001). These clusters differed significantly (p < .001) from each other with respect to motivation, the reasons adults have for exercise, and PA levels.ConclusionThe results from this study support the important role of psychological factors such as motivation and reasons for exercise on behavioral outcomes (i.e., physical activity). For future research investigating adults PA- related behaviors, whether it be on adults starting a new exercise program or for PA maintenance, it may be beneficial to develop programs that encourage participants to reflect on the reasons they identify as important for exercising, and how such reasons contribute to their overall PA engagement behaviors.

Abstract Background Mobile health (mHealth) interventions with virtual coaches (i.e. AI conversational agents) offer scalable and cost-effective solutions for health behavior change. We developed Perfect Fit, an mHealth intervention with a virtual coach providing personalized feedback to promote smoking cessation and physical activity simultaneously. Through innovative techniques (e.g. sensor technology) and iterative development involving end-users, we aim to overcome challenges faced by mHealth interventions, like insufficient personalization. This study examines Perfect Fit’s feasibility and acceptability. Methods A single-arm, mixed-method, real-world evaluation study was conducted with 100 adult smokers in the Netherlands. The intervention lasted approximately 16 weeks. Data were collected at baseline and post-intervention. Quantitative data included usage data and self-report questionnaires on feasibility, acceptability and participant characteristics (e.g. eHealth literacy). Qualitative data included semi-structured post-intervention interviews with a subsample of 12 participants. Descriptive analyses (quantitative) and the Framework Approach (qualitative) were used for data analysis, and quantitative and qualitative data were integrated during interpretation. Preliminary results Participants adapted the use of Perfect Fit to their preferences. Many participants were satisfied with the content but missed variations in conversations with the virtual coach. The coach offered anonymity, positively experienced by some (e.g. non-judgemental), but negatively by others (e.g. lower accountability). Many participants liked the combination of smoking cessation and physical activity enhancement. Conclusions Findings show the potential of interventions like Perfect Fit as a multiple health behavior change strategy in promoting public health and preventing chronic disease. Findings can inform intervention development and identify methods to foster feasibility and acceptability. Key messages • mHealth interventions with virtual coaches, like Perfect Fit, could promote public health. • Targeting multiple behaviors, like low physical activity and smoking, simultaneously seems beneficial.