Physical Activity Initiatives Research Articles

Implementation characteristics that may promote sustainability of a rural physical activity initiative: examination of Play Streets through the lens of community implementers

BackgroundPlay Streets, which are community-based environmental initiatives where public spaces/streets are temporarily closed to create safe, low-cost physical activity opportunities, have demonstrated feasibility and physical activity benefit in rural US areas. Yet, information is needed to identify implementation characteristics that may promote sustainability. This study examined rural Play Streets implementation characteristics that could impact sustainability from local partners’ perspectives.MethodsSixteen Play Streets implementation team members in rural Maryland, North Carolina, Oklahoma, and Texas, USA, participated in interviews. Semi-structured in-person individual and group interviews were conducted in the fall of 2018 (after Play Streets implementation in 2017 and 2018), recorded, and transcribed verbatim. Transcripts were analyzed using iterative, content analyses. Coding frameworks were based on the Public Health Program Capacity for Sustainability Framework, and emergent themes were also identified.ResultsInterviewees’ perceived characteristics for facilitating Play Streets implementation aligned with the Public Health Program Capacity for Sustainability Framework: funding stability, political support, partnerships, organizational capacity, program adaption, and communication. Interviewees also noted the importance of cultural alignment/support and the reciprocal impact of community connectedness/engagement.ConclusionsFuture research should examine the reciprocal role of public health impacts, as both outcomes and factors which may influence sustainability.

Engaging underrepresented groups in community physical activity initiatives: a qualitative study of parkrun in the UK

BackgroundUnderrepresented groups, including racial/ethnic minority groups and individuals with low socioeconomic status face complex barriers to engaging in community-based health initiatives. This research uses parkrun, an outdoor, mass-participation, weekly physical activity and volunteering initiative, to explore the engagement strategies (‘outreach activities’) that have been used to promote the inclusivity and diversity of parkrun events.MethodsTen adult parkrun Ambassadors who fulfilled volunteer roles that involved promoting parkrun to underrepresented groups in the UK were interviewed. Interviews took place via telephone or video call in April-July 2021. Interview transcripts were analysed thematically.ResultsEngagement strategies implemented by Ambassadors varied from opportunistic promotion within communities to strategic negotiations at higher decision-making levels. Approaches were characterised by a community-centred focus that ensured community networks and assets were utilised. Stories were considered valuable indicators of successful outreach. A common challenge to outreach for Ambassadors was limited personal and organisational capacity that impeded the widescale scope, reach and scalability of parkrun’s engagement attempts.ConclusionsParkrun Ambassadors have used a wide range of outreach activities at different levels of influence. A number of challenges to doing sustainable and effective outreach have been highlighted that need to be addressed. Working with and alongside communities where community-based health initiatives events take place to understand how to address inclusivity issues could contribute to greater participation by underrepresented groups.

Predicting school uptake of The Daily Mile in Northern Ireland- a data linkage study with School Census Data and Multiple Deprivation Measures

BackgroundParticipating in physical activity benefits health, yet a majority of children remain inactive. The Daily Mile™(TDM) originated in Scotland in 2012 with the aim of increasing primary school children’s physical fitness. Despite being a practically feasible and popular initiative, it remains unclear the extent to which schools implement TDM, and whether TDM core principles are adhered to (i.e., run or jogat least3-days per week). In Northern Ireland it is unknown how many schools regularly participate in TDM, and whether there is an association between TDM participation with school type, school location, size, total number of children attending the school, school deprivation level, and/or motivation as measured by the COM-B model (Capabilities, Opportunities, Motivation model of behaviour). Therefore, this study aimed to quantify the uptake of TDM in Northern Ireland, assess whether schools are following the core principles, and analyse if there is an association between aforesaid demographic factors and TDM participation.MethodsAn online cross-sectional survey was sent to all primary and special education schools in Northern Ireland with the support of the Education Authority for Northern Ireland and the Public Health Agency for Northern Ireland. The survey was completed by the school principal or teacher, and was available from 31stAugust until 16thDecember 2022. Survey results were linked with the 2021/2022 Northern Ireland School Census Data and Northern Ireland Multiple Deprivation Measure 2017. Quantitative and qualitative questions were included in the survey to assess participation and implementation of TDM.ResultsThe survey received 609 school responses. After data cleaning, and removal of duplicates from schools a sample of 358 primary schools (45%) and 19 special education schools (47.5%) was analysed. Over half (54.7%) of primary schools and 36.8% of special education schools reported taking part in TDM. More special education needs schools reported taking part in their own version of an ‘active mile’ rather than TDM formally, and qualitative findings showed TDM was not perceived as appropriate for many children in special educational settings. There was wide variation in adherence to TDM core principles. A multivariate binary logistic regression model was fitted to the data, but it was not statistically significant (χ2(17) = 22.689, p = .160). However, univariate effects showed that increasing levels on COM-B (Capability) was associated with increased likelihood of TDM participation (OR = 2.506), and Catholic Maintained schools were almost twice as likely as Controlled schools to be delivering TDM (OR = 1.919). There was no association found between deprivation and TDM uptake.ConclusionEncouragingly over 50% of schools in Northern Ireland reported taking part in TDM. However, despite being a low-cost and practically feasible physical activity initiative, further intervention work with sound research methodology is needed to promote adherence to TDM core principles to maximise benefits to children’s health. Furthermore, concerted efforts are required to adjust TDM so that it is inclusive for all educational settings, and children’s abilities.

How Societal Forces of Change Are Transforming Youth Physical Activity Promotion in North America.

Climate change, increasing recognition of institutionalized discrimination, and the COVID-19 pandemic are large-scale, societal events (ie,forces of change) that affect the timing, settings, and modes of youth physical activity. Despite the impact that forces of change have on youth physical activity and physical activity environments, few studies consider how they affect physical activity promotion. The authors use 2 established frameworks, the ecological model of physical activity and the youth physical activity timing, how, and setting framework, to highlight changes in physical activity patterns of youth in North America that have resulted from contemporary forces of change. North American countries-Canada, Mexico, and the United States-have faced similar but contextually different challenges for promoting physical activity in response to climate change, increasing recognition of institutionalized discrimination, and the COVID-19 pandemic. Innovative applications of implementation science, digital health technologies, and community-based participatory research methodologies may be practical for increasing and sustaining youth physical activity in response to these forces of change. Thoughtful synthesis of existing physical activity frameworks can help to guide the design and evaluation of new and existing physical activity initiatives. Researchers, practitioners, and policymakers are encouraged to carefully consider the intended and unintended consequences of actions designed to respond to forces of change.

O.4.4-9 Organized sport and physical activity for older adults – salutogenic settings-based recommendations

Abstract Sport and physical activity is important to address healthy aging. There are recommendations on how much physical activity people should do, but no recommendations for how organizations should organize activities to suit as many as possible. The purpose of this study was to explore the characteristics of sport and physical activity initiatives that older adults participate in. Different ongoing sport and physical activity initiatives that involve older adults were investigated regarding their focus, organization, intensity and organizer, and in relation to their costs, booking opportunities and recruitment. The study was conducted with a cross-sectional design using the Salutogenic Physical Activity Health Resources Questionnaire (SPAHRQ). The study included 27 different initiatives with 372 participants (60% women) ranging from 60 to 96 years of age. A health-promoting, salutogenic, settings-based approach, and specifically the concepts drop-in, drop-through and drop-over (Geidne and Quennerstedt, 2021) were used in discussing recommendations for the organization of sport and physical activity for older adults. The main findings were that who (sports clubs or senior associations) organizes the sport and physical activity initiative seems to affect the characteristics of how (for example intensity and characteristics of the activities) it is organized and what characterizes the participants in it. Despite the differing characters of sport and physical activity initiatives, the majority of older adults are recruited by internal contacts like friends and family. The lowest costs are found in senior associations, leisure-focused initiatives, individual initiatives, and low-intensity activities. In senior associations, most activities were booked per semester 60%. In sport clubs the most common booking system was per occasion, 40%. In team sports (almost always in sport clubs), the most common way of booking was per semester (46%). Which older adults participate in which initiatives is explained mostly by the age and gender of the participants. In conclusion, to attract as many older adults as possible, organizations should work with lowering the thresholds into, as well as within and between, organizations, and raise the threshold for dropping out of sports and physical activity. Support/Funding Source The study was funded in a PhD-project at Örebro University.

S8-5 INTERACT capacity building framework for sport for all among sports federations

Abstract Purpose International Sports Organisations (ISOs) have increasing interest in investing on sport for all and have been called by policy-makers through different policies (e.g. WHO Global Action Plan for physical activity, UN Sustainable Development Goals) to leverage their health and physical activity potential towards the society. This presentation showcase a training (in-person, informal education workshop) that aims to empower the staff and volunteers of ISOs promote Sport for All and physical activity and act as multipliers to train their national federations and grassroot sport organisations. Project The INTERACT Capacity-Building Framework which was designed by INTERACT Erasmus+ project partners (TAFISA and 8 International Sports Organisation) through different meetings and a co-construction approach, addresses key elements, identified as part of the INTERACT project, to support ISOs and continental/national sport federations in developing their own Sport for All and physical activity initiatives and engage with their members in the field. It provides exchange of knowledge and training to empower ISOs, their staff and volunteers in Sport for All and place physical activity promotion at the core of their activities. This will in turn increase participation in sport and physical activity. By using different sensory channels (e.g. visual, acoustic, tactile), our approach satisfies the participant’s different learning types and primary ways of absorbing and processing information. Composed of three steps (advocacy, diagnostic, training), it alternates theory and practice as well as tension and relaxation, movement and rest. Participant-oriented educational work includes the conscious handling of diversity and diversity of people (e.g. in relation to sex/gender, nationality, ethnicity, religious belief, disability, sexual orientation etc.). A first pilot has been launched among 12 ISOs, and evaluation framework will be created this spring, based on a litterature review. Conclusion The INTERACT Capacity-building programme is developed to become a full-fetched service that is offered in the coming years to any ISO willing to step up its promotion of Sport for All activity.

O.1.1-3 Measuring the mental health benefits of community-based physical activity programmes-what are the most important indicators for pragmatic evaluation?

Abstract Purpose While health enhancing physical activity (HEPA) initiatives can improve mental health, there is a lack of standardised measures to evaluate mental health outcomes. The need for the current work emerged from discussions amongst researcher and practitioner members of the HEPA promotion in socially disadvantaged groups Working Group of the HEPA Europe network. This study aimed to identify the most relevant indicators of mental health and well-being in community-based HEPA initiatives in Europe, and determine optimal assessment methods. Methods An adapted, two round, Delphi method (guided by an indicator framework to categorise mental health indicators based on the dual-continua and socio-ecological models) was conducted with 20 experts in the field of mental health and physical activity from Denmark, the Netherlands, the UK, and Ireland. Experts selected the most important indicators and agreed consensus on definitions and their application, where consensus ≥50% signified important indicators. Results Experts compiled 66 (n = 21 outcome, n = 45 determinant) indicators. Top rated indicators for the evaluation of HEPA initiatives were self-rated mental health (69.2%), physical activity (69.2%) life satisfaction (53.8%), stress (53.8%), loneliness (53.8%), social participation, network, connection and support (53.8%). Consensus on definition and application of the nine indicators varied (44.4% - 100%), with no consensus on a standardised measurement tool reached. Conclusions While this study highlights a lack of conformity for evaluating mental health and wellbeing outcomes, it suggests utility in an agreed definition and application of nine indicators for the evaluation of HEPA initiatives, with social determinants of particularly high importance across all countries. Suggested measures are provided to aid community based practitioners measure mental health outcomes of physical activity programmes. Further research is recommended to develop a standardised measurement tool that can be utilised across other European countries and its implementation tested.

O.3.3-5 Is parkrun an equitable health intervention? A qualitative study exploring how a free, weekly, community-based physical activity initiative engages with underrepresented groups in the UK

Abstract Purpose Underrepresented groups face unique and complex barriers to community-based physical activities. This study used the worldwide initiative parkrun to explore how it has engaged with underrepresented groups in the UK. It sought to explore the challenges faced by the organisation and its volunteers when striving for equity and outline the inclusive promotion strategies that could be used by parkrun and other community initiatives. Methods Adult parkrun Ambassadors who fulfilled volunteer roles that involved ‘outreach’ to underrepresented groups across the UK were invited. Ten volunteers provided informed consent to be interviewed via telephone in April-July 2021. Interview transcripts were analysed using a thematic approach by the same researcher who conducted the interviews. Ethical approval was received from the University of Sheffield REC. Results The Ambassadors had volunteering experience from two to five or more years. The outreach approaches implemented varied from opportunistic promotion within communities to strategic negotiations at higher decision-making levels. Ambassadors described a community-centred focus that ensured that existing community networks and assets were utilised when promoting parkrun. It was advantageous to identify influential ‘community connectors’ within the target community with power to mobilise others. These could be local people or organisations in more traditional positions of influence e.g., General Practices and schools. The volunteers conveyed many challenges to their attempts to increase engagement in parkrun by underrepresented groups. Limited personal and organisational capacity meant that the reach and impact of engagement was restricted. The Ambassadors would benefit from robust mechanisms for reflecting, evaluating, learning and monitoring progress to better understand what is working (or not) and why. Conclusion parkrun takes a community-centred approach to outreach. Community initiatives like parkrun may benefit from a whole-system approach that is adaptive to local contexts, considers where the greatest opportunities for change are and fosters a learning mindset among those delivering the initiative. The findings only represent the views of ten Ambassadors interviewed and so further collaborative work with people from the underrepresented groups is needed to develop co-produced solutions to equitable participation. Funding Funded by a National Institute for Health Research School for Public Health Research post-doctoral launching fellowship.

The characteristics of organized sport and physical activity initiatives for older adults in Sweden.

There is a common understanding that sport and physical activity can be important to address healthy aging. There are individual-level recommendations about how much physical activity people of different ages should engage in to gain health benefits, but at the same time there are no recommendations for how organizations should organize physical activities to suit as many people as possible for as long as possible. The purpose of this study was to explore the characteristics of sport and physical activity initiatives that older adults participate in. Different ongoing sport and physical activity initiatives that involve older adults were investigated regarding their focus, organization, intensity and organizer, and in relation to their costs, booking opportunities and recruitment. The study was conducted with a cross-sectional design using the Salutogenic Physical Activity Health Resources Questionnaire (SPAHRQ). The study included 27 different initiatives with 372 participants (60% women) ranging from 60 to 96 years of age. A health-promoting, salutogenic settings-based approach, and specifically the concepts drop-in, drop-through and drop-over were used in discussing recommendations for the organization of sport and physical activity for older adults. The main findings were that who organizes the sport and physical activity initiative seems to affect the characteristics of how it is organized and what characterizes the participants in it. Despite the differing characters of sport and physical activity initiatives, the majority of older adults are recruited by internal contacts like friends and family. Which older adults participate in which initiatives is explained mostly by the age and gender of the participants. In conclusion, to attract as many older adults as possible, organizations should work with lowering the thresholds, as well as within and between, organizations, and raise the threshold for dropping out of sports and physical activity.

Exploring the gap between refugee-background communities' needs and existing community-based physical activity programs in Australia.

Physical activity programs run by local government, public health and not-for-profit sectors are a key public health strategy for improving rates of physical activity within local communities. However, these programs are underutilized. This is especially the case among members of refugee-background communities whose participation could have far-ranging and multilevel benefits. To explore how greater engagement among refugee-background communities with these programs could be fostered in Brisbane, Queensland, Australia, a qualitative study was undertaken from the perspectives of both community-based physical activity program providers and agencies involved in delivering services to refugee-background communities. This study involved a series of semi-structured interviews with a purposive sample of personnel from agencies that work with individuals and families from refugee-background communities and organizations that provide low-cost or no-cost physical activity programs and initiatives. Reflexive thematic analysis was used to interpret meaning from these data. Three themes relating to how participation in community-based physical activity programs could be improved among refugee-background communities were identified: improving cultural safety through intersectoral collaboration; confronting constraints imposed by the broader public health policy environment; and building capacity and empowering the community to diversify the sector. The findings highlight the importance of localized, deep-level intersectoral collaborations in bridging the gap between the health and social care needs of refugee-background communities and existing physical activity programs. However, a range of systems-produced barriers to the creation of such collaborations must be addressed to enable local actors to help mitigate and address the systemic exclusion of marginalized populations from participation in broader society.

Start small and let it build; a mixed-method evaluation of a school-based physical activity program, Kilometre Club

BackgroundDespite the benefits of physical activity, there is minimal research focusing on factors that influence real-world school-based physical activity programs. Kilometre (KM) Club is an Australian grassroots program which aims to increase physical activity in students through the completion of an outside walk or run at school. This small-scale pilot evaluation aimed to examine families, teachers and principals’ perceptions of the benefits, enablers and barriers of KM Club. It also aimed to examine the effects of KM Club on student’s physical activity levels during the school day.MethodsFour regional New South Wales (NSW) primary schools participated in this study. 26 families, four teachers, and two principals from School A, C, B and D completed semi-structured interviews to understand their perceptions of KM Club. 21 students completed emotional state-scales to understand their emotions when participating in KM Club. 141 students from Schools B, C and D participated in step-count measures using accelerometers.ResultsFamilies, teachers and principals reported a range of benefits such as improved social connectedness, wellbeing, home and classroom behaviours, participation in sport and fitness levels. Enablers consisted of champion engagement, incentives, versatile facilities and integration with other school activities. Identified barriers included the weather and environment, program timing and health issues. Most students reported that participating in KM Club made them feel proud, confident and fantastic. School B reported a significant increase in students' daily step counts on KM Club days compared to non-KM Club days (+ 15%; p = 0.001), while School C reported no significant changes (-5%; p = 0.26). School D reported a significant increase in the number of daily steps taken by KM Club participants compared with non-KM club participants (+ 10%; p = 0.024).ConclusionThere is no one-size-fits-all approach to implementing school-based physical activity initiatives. However, it appears that flexible and adaptable factors are important to the successful implementation of school-based programs, such as KM Club. This study revealed a variety of self-reported health, wellbeing and educational benefits for students, as well as an increase in student’s physical activity levels at 2 of the 3 schools participating in the quantitative data collection. This pilot evaluation may help to inform future design, implementation and scale-up of KM Club and school-based health promotion programs, potentially improving child health, wellbeing and educational outcomes.Trial registration(LNR223 – LNR/19/NCC/45).

The positive impact of a care–physical activity initiative for people with low socioeconomic status

Abstract Background Overweight and obesity rates are increasing worldwide, particularly among people with a low socioeconomic status (SES). Care-physical activity (care-PA) initiatives may lower overweight and obesity rates. A two-year care-PA initiative specifically developed for citizens with a low SES, X-Fittt 2.0, included 12 weeks of intensive guidance and sports sessions, and 21 months of aftercare. We answered the research question: what are the short- and long-term outcomes of participation in X-Fittt 2.0 in terms of health, quality of life and societal participation? Methods Questionnaires and body measurements were taken from 208 participants at the start of X-Fittt 2.0 (t0) and after 12 weeks (t1), 1 year (t2) and 2 years (t3). We also held 17 group discussions (t1, n = 71) and 68 semi-structured interviews (t2 and t3). Continuous variables were analysed using linear mixed-model analysis, while we used descriptive statistics for the categorical variables. Qualitative data were analysed using thematic analysis. Results Body weight was significantly lower at all three post-initiative time points compared with t0, with a maximum of 3.8 kg difference at t2 (p < 0.05). BMI, waist circumference, blood pressure and self-perceived health only significantly improved during the first 12 weeks (p < 0.05). A positive trend regarding paid work was observed, participants reported increased PA levels (including sports) and a few stopped smoking or drinking alcohol. Participants felt healthier and more energetic, reported improved self-esteem and stress levels, and had become more socially active. However, barriers to being physically active included a lack of money or time, or physical or mental health problems. Conclusions X-Fittt 2.0 improved the physical health, QoL and societal participation of the participants. Future initiatives should take into account the aforementioned barriers, and consider a longer intervention period for more sustainable results. Key messages

O9-7 Community-based physical activity promotion for mental health and wellbeing in ‘hard-to-reach' groups

Community-based health enhancing physical activity (PA) initiatives often lead to important mental health and wellbeing outcomes beyond improvements in physical activity levels. However, identifying what outcomes to measure and how to measure them is a challenge in community-based work. There is a lack of practical guidance on how to strengthen mental health and wellbeing outcomes within the context of PA initiatives. This presentation will share the work on a project with community based practitioners and mental health/physical activity experts which is being led by the HEPA Europe Working Group on HEPA promotion in socially disadvantaged groups, supported by WHO Europe.The presentation will engage participants in discussions around the following questions: What are the most important mental health and wellbeing outcomes of community-based health enhancing physical activity initiatives in Europe, and how can these best (i.e., adequately, and pragmatically) be assessed for evaluation purposes?What are the needs of practitioners (from physical activity sectors and mental health sectors) working in communities to promote mental health through physical activity?

O4-3 An evaluation of the Time to Move workplace physical activity intervention

BackgroundWorkplace physical activity interventions have shown positive outcomes for employee health, productivity and absenteeism (1,2). However, the majority prescribe the duration and/or type of activity to be undertaken. In response to strong public opinion that employers should do more to improve the health of their workforce, Public Health Wales, the public health agency for Wales, developed a 12-month pilot physical activity initiative - Time to Move (TTM). TTM allowed participants to use one hour/week (pro rata) of paid work time for any physical activity. We evaluated TTM to understand its impact and identify learning.MethodsUsing pre-experimental time series design, data were collected from participating employees: baseline (June-August 2018), mid-initiative (December 2018) and at 12-months (June-August 2019). Using validated scales where possible, questionnaires recorded: physical activity (MET-minutes/week), general health (0, poor-100, good), mental well-being (SWEMWBS), job satisfaction (1, very dissatisfied-5, very satisfied) and demographics. Biometric measures (baseline, 12-months) included Body Mass Index (BMI) and blood pressure. Analyses used descriptive statistics, bivariate analysis and generalized linear modelling. Focus groups explored participants' perceptions of TTM, analysed thematically.Results542 participants completed all measures (63.1% of baseline). Compared to baseline, at 12-months 57.7% reported increased physical activity (30.6% decreased; 11.6% no change) with 75.3% meeting UK activity guidelines (58.8% baseline). Those with the lowest levels of physical activity at baseline (n = 223) increased their weekly moderate activity by > 2.5 hours, whilst those with moderate activity (n = 269) increased by 58 minutes/week. A small improvement was reported in mental well-being (mean scores; 22.4 baseline, 23.2 12-months), with participants with low mental well-being at baseline improving the most. Self-reported health and job satisfaction also improved. However, BMI and blood pressure changes were non-meaningful. Employee attitudes to TTM were positive. Organisational support was a motivating factor for participation, with competing demands a barrier.ConclusionsThe provision of paid time to engage in physical activity can improve employee health and well-being. TTM provides an example of how organisations can promote physical activity and change workplace culture. However, further research should explore the long-term impact of the intervention, including the potential impact of COVID-19-related restrictions.

P04-08 The art of ageing well - a salutogenic study of physically active old adults

BackgroundPeople aged 60 years and over has doubled since 1980 and WHO predicts that this population will reach 2 billion by the year 2050. However, increases in life spans do not directly lead to increases in health. An aging population poses both challenges and opportunities for society and for individuals. In order to address this, scholars argue for the benefits of being physically active, especially in a group of peers. However, the relation between physical activity and health is often based on an understanding of what causes or prevents illness rather than what promotes health. The purpose of this study is thus to contribute to knowledge about which health resources older adults develop in their participation in organised physical activity initiatives. The study will consider to what extent older adults develop health resources, differences in demographic background and the relation between the health resources and Sense of coherence (SOC).MethodsThis is the first data collection in a longitudinal study. Participants were old adult men and women, 60 years and above. All participants were active in ongoing organised physical activity initiatives in different organisations on a voluntary basis. A survey included demographics, overall health, health resources (McCuaig & Quennerstedt, 2018) and SOC-13. The data collection is ongoing (preliminary n = 200) and ends spring 2020. Statistical analyses were descriptive and included bivariate analyses.ResultsPreliminary results show that the most frequent health resources are social relations, positive energy and embodied identity for both men and women. A positive related correlation of the health resource habit of exercising were observed with a high sense of coherence.ConclusionThe Salutogenic idea of having access to various health resources linked to a high sense of coherence is in line with the result of a positively related correlation direction and also with the health resource habit of exercising. The results of the study can contribute to knowledge about which health resources older adults develop in their participation in organised physical activity initiatives.

P04-11 A physical activity intervention designed to improve multi-dimensional health and functional capacity of frail older adults in residential care: a randomised controlled feasibility study

BackgroundFrailty is a common and clinically significant multi-dimensional syndrome associated with adverse health outcomes such as hospitalisation, disability, and mortality among older adults. Physical activity interventions have been shown to be effective in the prevention and treatment of functional decline and frailty, with strength training protocols reporting improvements in mobility, balance, preservation of muscle function and independence. Due to the trial's exploratory and feasibility design a small sample was used to investigate the acceptability and practicality in long term care. This includes addressing the HEPA priority of improving the health and well-being of people with chronic conditions and/or frailty.MethodsEleven older adults (aged >65 years) were randomised to the intervention or wait-list control. A 6-week strength training protocol for 35 mins 3x/week used resistance machines, specially designed for older adults, in a residential care home. Mixed methods were used to assess the feasibility and acceptability of the intervention and research measures and indicate meaningful differences in outcomes. Feasibility was measured through adherence statistics and focus groups/interviews with staff and participants. Pre- and post-intervention levels are given as descriptive statistics for physiological, psychosocial, cognitive, and functional measures. Intervention effect is illustrated through mean difference (95% Confidence Intervals) pre- to post-intervention in the intervention group.ResultsIntervention group (n = 6) adherence was 98.9%. Interviews revealed participants and staff found the measures and intervention acceptable, practicable and beneficial. Mean differences pre- to post-intervention indicated meaningful clinical difference in measures of strength, functional capacity and frailty. Psychosocial variables (stress, depression, social support), immunological measures, cognition and Activities of Daily Living Scores did not show meaningful change.ConclusionA strength training intervention protocol for frail care home residents was beneficial, with findings supporting a future randomised controlled trial. High adherence and clinically meaningful differences for frailty and physical function support the use of such interventions to improve multi-dimensional health, maintain functional capacity and independence, and enhance social participation in frail older adults. This study and further research may help inform practical physical activity initiatives for frail older adults, and support strategies prioritising health and well-being, and the prevention of functional decline and frailty.

The positive impact of a care–physical activity initiative for people with a low socioeconomic status on health, quality of life and societal participation: a mixed-methods study

BackgroundOverweight and obesity rates are increasing worldwide, particularly among people with a low socioeconomic status (SES). Care–physical activity (care–PA) initiatives may improve participants’ lifestyles and thereby lower overweight and obesity rates. A two-year care–PA initiative specifically developed for citizens with a low SES, X-Fittt 2.0, was offered free of charge to participants, and included 12 weeks of intensive guidance and sports sessions, and 21 months of aftercare. Here, we study the impact of X-Fittt 2.0 on health, quality of life (QoL) and societal participation using a mixed-methods design.MethodsQuestionnaires and body measurements were taken from 208 participants at the start of X-Fittt 2.0 (t0) and after 12 weeks (t1), one year (t2) and two to three years (t3). We also held 17 group discussions (t1, n = 71) and 68 semi-structured interviews (t2 and t3). Continuous variables were analysed using a linear mixed-model analysis (corrected for gender, age at t0, height, education level and employment status at the different time points), while we used descriptive statistics for the categorical variables. Qualitative data were analysed using a thematic analysis.ResultsBody weight was significantly lower at all three post-initiative time points compared with the baseline, with a maximum of 3.8 kg difference at t2. Body Mass Index, waist circumference, blood pressure and self-perceived health only significantly improved during the first 12 weeks. A positive trend regarding paid work was observed, while social visits decreased. The latter might be explained by the COVID-19 pandemic, as lockdowns limited social life. Furthermore, participants reported increased PA (including sports) and a few stopped smoking or drinking alcohol. Participants mentioned feeling healthier, fitter and more energetic. Additionally, participants’ self-esteem and stress levels improved, stimulating them to become more socially active. However, the participants also mentioned barriers to being physically active, such as a lack of money or time, or physical or mental health problems.ConclusionsX-Fittt 2.0 improved the health, QoL and societal participation of the participants. Future initiatives should take into account the aforementioned barriers, and consider a longer intervention period for more sustainable results. More complete data are needed to confirm the findings.

Prevention and treatment of psychiatric disorders through physical activity, exercise, and sport

Prevention and treatment of psychiatric disorders through physical activity, exercise, and sport

Developing a physical activity initiative for a community mental health service

Developing a physical activity initiative for a community mental health service

Physical activity opportunities for secondary school students: International best practices for whole-of-school physical activity programs

The World Health Organization ([WHO], 2018 ) encourages schools to engage with a multi-component, whole-of-school approach to physical activity promotion. However, little evidence exists describing the practices of schools that successfully promote a physically active school culture. The purpose of this study was to explore and describe the best practices of “active” secondary schools. Three schools, each in a different country (i.e. the United States, Finland, and Ireland), were identified as sites for investigation based on the presence of nationally established whole-of-school physical activity initiatives. Data were collected in one secondary school in each country and were generated from several sources including semi-structured interviews with stakeholders, field notes, three days of on-site observation, and artifact collection. Inductive analysis using open and axial coding was conducted ( Corbin and Strauss, 2008 ). Three common themes related to best practices were evident at each site: an established school-based leader, support from the school community, and many available physical activity opportunities. Successful school-based physical activity promotion is possible if there is a motivated physical activity champion and if their promotion efforts are supported. These schools created multiple physical activity opportunities for students and have developed a strong physical activity culture.