Physical Activity Interventions Research Articles

Physical activity should be the primary intervention for individuals living with chronic pain A position paper from the European Pain Federation (EFIC) 'On the Move' Task Force.

There is clear evidence demonstrating the benefits of physical activity (PA) on pain and overall health, however, PA is challenging for many individuals living with chronic pain. Even non-exercise specialists can (cost) effectively promote PA, but many health professionals report a number of barriers in providing guidance on PA, suggesting that it is not consistently promoted. This expert position paper summarizes the evidence and provides five recommendations for health professionals to assess, advise and support individuals living with any chronic pain condition with a long life expectancy in adopting and sustaining physically active lifestyles. This position paper was prepared by the 'On The Move' Task Force of the European Pain Federation EFIC. Final recommendations were endorsed by the European Pain Forum, Pain Alliance Europe and the Executive Board of EFIC. We recommend that all health professionals (1) Take a history of the persons' PA levels, and put PA on the agenda, (2) Advise that PA is important and safe for individuals living with chronic pain, (3) Deliver a brief PA intervention and support individuals living with chronic pain in becoming physically active, (4) Discuss acceptable levels of PA-related soreness and pain and (5) Provide ongoing support in staying physically active. Physical activity is safe and offers several advantages, including general health benefits, low risk of side effects, low cost and not requiring access to healthcare. Adoption of these recommendations can improve the quality of care and life of individuals living with chronic pain and reduce their overall health risks.

Association between physical health and neurocognition in first-episode schizophrenia

IntroductionImpaired cognition is a core feature of schizophrenia that is evident early in the first episode and is frequently accompanied by compromised physical health. Although physical health confers benefits to cognition, it remains unclear whether physical activity, body mass index (BMI) and cardiorespiratory fitness are associated with neurocognition in first episode schizophrenia patients. The purpose of this study was to examine differences in stimulus categorization and motor response selection processes between first-episode schizophrenia patients compared to age-matched controls and explore associations between physical health and these stages of information processing.MethodsFourteen young adult patients receiving care following a first episode of psychosis and a matched sample of nonpsychiatric controls completed a visual oddball task from which the P3 and LRP (lateralized readiness potential) event-related potential (ERP) components were extracted to assess stimulus categorization and response selection processes, respectively. Physical activity, aerobic fitness, and BMI were correlated with ERP measures.ResultsCompared with controls, patients had lower physical activity levels and longer P3 and LRP latencies. Regardless of stimulus probability, patients had reduced accuracy and slower reaction times relative to controls. In patients, marginal associations were found between physical activity and P3 difference waveform amplitude, and BMI was negatively associated with parent P3 waveform amplitude.DiscussionThe present findings suggest that cognitive impairment in first-episode schizophrenia spans both stimulus- and response-related stages of information processing, and may be targeted through physical activity interventions.

Abstract PO2-11-07: Early Integration of Exercise into Breast Cancer Care: The MSK Healthy Living Program

Abstract Background: In patients with early-stage breast cancer, quality of life (QoL) worsens within 3-6 months following diagnosis. Physical activity (PA) can mitigate the adverse effects of treatment and improve QoL, and low PA level is associated with cancer recurrence and mortality. However, PA interventions are not included in standard cancer care. Early intervention to increase PA levels may improve QoL during active cancer therapy. The Healthy Living Program (HLP) at Memorial Sloan Kettering Cancer Center (MSK) is a lifestyle and survivorship program that engages early-stage breast cancer patients at the time of diagnosis using lifestyle risk stratification and matched referrals. We investigated whether early exercise intervention through the MSK HLP impacts QoL within the first months after cancer diagnosis. Methods: At the time of diagnosis, patients complete a lifestyle questionnaire (LQ), which is a composite of validated instruments, including the Godin Leisure Time Exercise Questionnaire (GLTEQ). Patients not meeting PA guidelines per the GLTEQ are offered a referral to an exercise physiologist (EP). The EP creates an individualized, home-based exercise program using the FITT Principle (Frequency, Intensity, Time, and Type). Patients meet with the EP every 4 weeks for 16 weeks; if exercise recommendations continue to be unmet, the program is extended. The Functional Assessment of Cancer Therapy-Breast (FACT-B) and 36-Item Short Form Survey Instrument (SF-36) were completed at baseline and the 16-week follow-up. Results: 252 patients enrolled between April 2020 – February 2023, of whom 92 volunteered to complete the QoL assessments. Median age was 53 years [range 23-84]; 12/252 (13.0%) of patients had ductal carcinoma in situ, 60/252 (65.2%) had Stage 1 disease, 17/252 (18.5%) had Stage 2 disease, and 3/252 (3.1%) had Stage 3 disease. 29/252 (31.5%) received chemotherapy, 62/252 (67.4%) received radiation, and 79/252 (85.9%) received hormone therapy. The mean baseline FACT scores were FACT-B: 116, FACT-G: 87, and FACT-B Trial Outcome Index (TOI): 73. At the 16-week follow-up, all QOL scores remained stable from baseline (means FACT-B: 118, FACT-G: 89, and TOI: 75). Improvements were observed among the subscales of the SF-36 from baseline to follow-up. The largest improvements were observed in physical and emotional role function scores, with 22% and 13% improvements from baseline to follow-up, respectively. Conclusions: A clinically implemented exercise intervention embedded in standard of care prevented decreases in QoL and improved physical and emotional functioning during the initial course of adjuvant breast cancer therapy. These findings support early implementation of lifestyle modification after a breast cancer diagnosis. Citation Format: Kylie Rowed, Sherry Shen, Andrea Smith, Bridget Kelly, Rocco Magnoli, Stacie Corcoran, Melissa Emerzian, Cynthia Cruz, Erica Salehi, Cara Anselmo, Mark Robson, Neil Iyengar. Early Integration of Exercise into Breast Cancer Care: The MSK Healthy Living Program [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-11-07.

Formation Mechanisms, Interrelationships, and Effects of Cognitive Factors on Diet and Physical Activity During the Post-Bariatric Surgery Period: A Cross-Sectional Study Based on Compensatory Carry-Over Action Model.

Diet and physical activity (PA) are pivotal behaviors for managing energy balance post-bariatric surgery. Given the need for dual behavioral management, understanding the interplay of cognitive factors influencing these behaviors is crucial. This study applied the compensatory carry-over action model (CCAM) to explore the impact of cognitive factors on behaviors and their subsequent effects on subjective health outcomes. This cross-sectional study was conducted among patients at the third month after bariatric surgery in China. Data on diet and PA status, behavioral cognitive factors (intention, self-efficacy, compensatory belief, transfer cognition), and subjective health outcomes (perceived stress, well-being, quality of life) were collected. Structural equation model (SEM) was employed to test hypotheses in CCAM and assess mediation relationships. Analysis of data from 239 patients revealed the following: (1) Among antecedent cognitive factors, only compensatory belief significantly influenced diet (P<0.001). (2) Intention and self-efficacy directly correlated with their respective behaviors, while compensatory belief affected intention, and transfer cognition impacted self-efficacy (P<0.05), aligning with CCAM hypotheses. (3) PA demonstrated significant influence only on perceived stress (P=0.004), whereas diet significantly affected all subjective health outcomes (P<0.05). (4) Mediation analysis indicated intention partially mediated the relationship between compensatory belief and diet and fully mediated the relationship between compensatory belief and PA. Self-efficacy completely mediated the relationship between transfer cognition and diet and PA. Transfer cognition's carry-over effect did not directly influence behaviors among antecedent cognitions. Interventions should primarily target improving diet by mitigating compensatory belief. Moreover, diet exhibited a more pronounced impact on overall health compared to PA. Consequently, prioritizing dietary intervention over PA intervention is warranted based on the analysis of CCAM and the aim of promoting joint behaviors post-bariatric surgery.

UNDERSTANDING THE BARRIERS AND ENABLERS TO ACCREDITED EXERCISE PHYSIOLOGIST’S INTEGRATION WITHIN THE AUSTRALIAN HEALTHCARE SETTING

INTRODUCTION Physical activity (PA) is crucial in managing the high rates of non-communicable disease (NCD) within Australia. Accredited Exercise Physiologists (AEPs) are well-placed to assist individuals in managing symptoms of NCD through PA intervention. However, General Practitioner referral rates to AEPs are very low (&amp;lt; 1%), with a lack of time and education reported as key barriers to their referral practices. Research has yet to explore the underutilization of AEPs from the AEP’s perspective. AIM: To explore the perspectives of Australian AEPs regarding their role and utilisation within the healthcare setting. METHODS Currently practicing AEPs (n=15) participated in audio-recorded, individual semi-structured interviews between May to July 2023. Interviews were transcribed and data were analysed via an inductive, semantic approach to reflexive thematic analysis. RESULTS Four primary themes emerged. The first, understanding is important, identified that a key barrier to AEP practice was the general population’s lack of understanding regarding the role of an AEP. The second, education and support of AEPs is crucial, reflected the perception that some recent graduates required further support to be better integrated within the healthcare setting and to provide a higher quality service. The third, interaction is key, highlighted that AEPs regarded communication with referrers as crucial to improve referral processes. The final theme, systematic and policy barriers impact AEP services, highlighted systematic barrier’s including time-consuming administration tasks and cost, as impacting AEP services. CONCLUSION The findings highlight a need to promote the role of AEPs to the general population. Ongoing support is required to ensure recent graduate AEPs can integrate effectively within the healthcare setting. Enhanced connection between AEPs and referrers may assist in generating referrals and broadening the understanding of the profession. Addressing systematic barriers, such as reducing clients’ financial constraints through increased funding, may help improve AEP service uptake.

A randomized controlled trial of an app-based intervention on physical activity and glycemic control in people with type 2 diabetes.

We investigated the effects of a physical activity encouragement intervention based on a smartphone personal health record (PHR) application (app) on step count increases, glycemic control, and body weight in patients with type 2 diabetes (T2D). In this 12-week,single-center, randomized controlled, 12-week extension study, patients with T2D who were overweight or obese were randomized using ratio 1:2 to a group using a smartphone PHR app (control group) or group using the app and received individualized motivational text messages (intervention group) for 12weeks. During the extension period, the sending of the encouraging text messages to the intervention group was discontinued. The primary outcome was a change in daily step count after 12weeks and analyzed by independent t-test. The secondary outcomes included HbA1c, fasting glucose, and body weight analyzed by paired or independent t-test. Of 200 participants, 62 (93.9%) and 118 (88.1%) in the control and intervention group, respectively, completed the 12-week main study. The change in daily step count from baseline to week 12 was not significantly different between the two groups (P = 0.365). Among participants with baseline step counts < 7,500 steps per day, the change in the mean daily step count at week 12 in the intervention group (1,319 ± 3,020) was significantly larger than that in control group (-139 ± 2,309) (P = 0.009). At week 12, HbA1c in the intervention group (6.7 ± 0.5%) was significantly lower than that in control group (6.9 ± 0.6%, P = 0.041) and at week 24, changes in HbA1c from baseline were significant in both groups but, comparable between groups. Decrease in HbA1c from baseline to week 12 of intervention group was greater in participants with baseline HbA1c ≥ 7.5% (-0.81 ± 0.84%) compared with those with baseline HbA1c < 7.5% (-0.22 ± 0.39%) (P for interaction = 0.014). A significant reduction in body weight from baseline to week 24 was observed in both groups without significant between-group differences (P = 0.370). App-based individualized motivational intervention for physical activity did not increase daily step count from baseline to week 12, and the changes in HbA1c levels from baseline to week 12 were comparable. ClinicalTrials.gov (NCT03407222).

Muva physical activity intervention improves social functioning in people with a severe mental illness: a pragmatic stepped wedge cluster controlled trial

Muva physical activity intervention improves social functioning in people with a severe mental illness: a pragmatic stepped wedge cluster controlled trial

IMPROVING MENTAL HEALTH, PAIN AND QUALITY OF LIFE IN PERSONS LIVING WITH OSTEOPOROSIS AND DEPRESSION OR ANXIETY: A SYSTEMATIC REVIEW

Osteoporosis (OP) is a progressive, age-related condition impacting approximately 3.8% of Australians. OP is associated with increased psychological distress, increased pain and decreased quality of life. Correlations exist between OP and psychological distress, with people living with OP three times more likely to experience very high levels of psychological distress compared to those without. Emerging evidence suggests a connection between bone loss and depressive symptoms. For people living with OP, depression and/or anxiety, increasing physical activity is recommended to improve overall health outcomes. Currently, no guidelines for exercise recommendations exist for people living with these co-occurring conditions. The aim of this systematic review is to identify the most effective physical activity intervention to improve mental and physical health, quality of life and pain in people with co-occurring OP and symptoms of depression and/or anxiety. The research question, eligibility criteria and search strategy were developed, and peer reviewed by the research team, and the search was registered through PROSPERO (CRD42023440020). A systematic search of the following databases was conducted using the Cochrane Highly Sensitive Search Strategy for identifying randomized trials and Polyglot search translator: PubMed, CINAHL, Embase, PsycInfo, Scopus &amp; Web of Science. From 7,405 results, 2,372 were excluded as duplicates leaving 5,033. Covidence was used to screen by title and abstract, with a further 5,009 excluded based on study design, population and outcome measures. Full-text screening by two researchers (CF &amp; KM) led to 19 studies included for data extraction, with 5 excluded based on population (OP diagnosis), questionnaire validity and availability of data. Data extraction and analysis is currently underway with results to be presented at the conference. Findings will be used to design and implement a tailored lifestyle intervention program for people living with OP and symptoms of anxiety and/or depression. This research has been generously funded by the Estate of the Late Faye Patricia Williams.

POSITIVE: experiences of an intervention aiming for reversing and preventing frailty using a home monitoring and communication platform within primary health care.

Frailty is increasing worldwide as the population ages. Physical activity is one component that has been shown to hinder and even reverse the process. The POSITIVE system (i.e., maintaining and imPrOving the intrinSIc capaciTy Involving primary care and caregiVErs) is a prevention program that consists of home-monitoring equipment and a communication platform to support the initial treatment of frailty symptoms in primary health care. The participants, older aged (+ 70) frail persons and those at risk for frailty, took part in the program that promoted physical activity at home for six months. The aim was to explore and describe older persons' experiences of participating in a new prevention program using the POSITIVE system including technological tools intended to prevent the development of frailty. Nine interviews were conducted about experiences of participating in an intervention including use of technological tools to support physical activity. Qualitative content analysis was applied. Two themes revealed: (1) Perceptions of being old are seldom positive, and (2) A rewarding and fruitful participation in the project with suggestions for improvement. Becoming older was related to physical pain and tiredness reducing the performance of former meaningful activities as well as an increase in mental stress. There was also a tendency to postpone the start of everyday activities, and in general, fewer activities were planned for one day than at younger ages. Participating in a physical activity intervention, including the use of technical tools, was considered meaningful and added motivation for engaging in other physical activities, this despite some difficulties with technical tools provided by the program. The contact with health care and the research team was appreciated. In addition, contact with other participants was requested and reported to be highly valued if added to the intervention, which could have been an expression of loneliness. Participation in a prevention program motivated activities and social interaction. Adding opportunities for participants to meet each other is suggested for improving the intervention in terms of increasing the social dimensions. Our findings conclude that despite difficulties with handling the technical tools for the home-monitoring and communication platform, participation in the POSITIVE intervention was in general a positive experience.

Online-Based Intervention as an Effort to Increase Physical Activity Among Adolescent

Background: Physical inactivity (PA) is an important contributor to morbidity and mortality globally. Adolescence is an important period of engaging in physical activity. 2 systematic reviews before 2022 concluded that studies need more methods and evaluations to prove the continued effect of Online-based interventions. It is therefore prudent to continue this research by considering how we can approach young people to grow healthy values into their day-to-day activities. Purpose: This study aims to determine online-based interventions for physical activity in adolescents. Method: A search of the literature databases Scopus, Science Direct and Springerlink using key words ‘Adolescents’, ’Teenagers’, ’E-health’, ’Internet-based’ , ‘Online-based’, and ’Physical Activity’ limited to 5 articles which fit the criteria for inclusion. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was used, and papers were excluded if they were disease focused, not specific to adolescents or did not measure PA as an outcome. Results: All of studies had significant increases in PA as a result of an Online-Based intervention Studies include using various implementation mechanisms. The majority of studies use a mix of web- tutorials and based lessons for participants to work on in addition to goal setting via online, app-based (4/5). That remaining studies they were given an accelerometer as a measuring device and instructed online to perform the physical activity used for the rest of the study using online forums and PA experts to emphasize the effect of goal setting. Various intervention such as giving messages about PA or Health related issues were performed few a week for about 2-3 month. Conclusion: Online-based interventions are a very successful way to increase PA. More research is required to look at what theoretical principles are best to underpin interventions and also to  assess the length of intervention required for optimal results after intervention. Ideas  surrounding implementation require more studies to evidence base these  interventions for schools, via intracurriculum or extracurriculum.

Community-based physical activity interventions for adolescents and adults with complex cerebral palsy: A scoping review.

Community-based physical activity interventions for adolescents and adults with complex cerebral palsy: A scoping review.

Beyond “Brain Breaks”: A New Model for Integrating Classroom-Based Active Breaks

Regular physical activity provides physical, mental and cognitive benefits for children. However, globally, only 20% of children meet the recommended levels of physical activity and, on average, students sit for three-quarters of the school day. Active breaks are a well-tested component of many school-based physical activity interventions, but there are many barriers to the sustainable implementation of active breaks by teachers in schools. To overcome these barriers, the narrow, traditional idea of the ‘brain break’ needs to be reconceptualized, where active breaks are viewed as being separate from learning and teaching, and where physical activity is perceived as an interruption to learning. This article presents the TransformUs Active Break (TAB) model, which positions active breaks as part of an overall approach to proactive classroom management and as a key contributor to effective teaching. The TAB model comprises five types of active breaks, each serving a specific educative function-structure, transition, manage, energize and learn. The model demonstrates how active breaks can be integrated meaningfully into lessons to enhance teaching and learning as an effective approach for sustained school-based physical activity.

Effects of Physical Activity on Quality of Life of Pregnant Women with Overweight or Obesity: A Systematic Review

There is evidence that the quality of life and mental health of pregnant women change during pregnancy. To evaluate the impact of physical activity on the quality of life and mental health of pregnant women with obesity or overweight, a systematic review was performed using six electronic databases (PubMed, Cochrane (CENTRAL), ScienceDirect, Scielo, BVS and PEDro). In total, 205 articles were collected, and after screening in accordance with the PRISMA declaration, six randomized clinical trials were selected. Methodological quality was assessed using the Cochrane RoB2 tool and a narrative synthesis of the results was performed. Physical activity interventions did not demonstrate statistically significant results on the quality of life and mental health of pregnant women with obesity or overweight. The effects of physical activity during pregnancy for women with obesity or overweight are varied due to the diversity of interventions implemented. Nonetheless, a discernible positive association emerges between stringent adherence to the prescribed physical activity regimen and enhanced physical well-being, weight management, and heightened aerobic capacity. In order to ascertain more definitive conclusions, rigorous clinical trials are needed that take into account the heterogeneity of interventions and ensure adequate adherence to the protocol.

Underreporting of implementation strategies and barriers in physical activity interventions for young people at risk of problematic substance use: a brief report

BackgroundSeveral studies have assessed whether physical activity interventions can reduce substance use in young people at risk of problematic substance use. This report identifies and describes the reporting of implementation characteristics within published studies of physical activity interventions for young people at risk of problematic substance use and provides recommendations for future reporting.MethodsReported implementation strategies (including intervention manualization), barriers, implementation fidelity, and personnel acceptance were extracted from studies of physical activity interventions for young people aged 12–25 years at risk of problematic substance use that were included in a previous systematic review of intervention efficacy.ResultsImplementation strategies were reported in less than half of the included studies (42.9%), implementation barriers in only 10.7% of studies, intervention fidelity in 21.4%, and personnel acceptance in a single study (3.6%).ConclusionsResults indicate insufficient reporting of implementation strategies, barriers, fidelity, and personnel acceptance. Consideration of implementation characteristics is essential for implementing physical activity interventions in practice. Inadequate or limited reporting of these characteristics may contribute to delayed uptake and adoption of evidence-based interventions in clinical practice. Recommendations to improve the reporting of implementation information include integrating standards for reporting implementation characteristics into existing reporting guidelines, developing an international taxonomy of implementation strategies, and upskilling intervention researchers in the fundamentals of implementation science.

In-classroom physical activity breaks program among school children in Sri Lanka: study protocol for a randomized controlled trial.

The problem of sedentary behavior among primary school children is alarming, with numbers gradually increasing worldwide, including Sri Lanka. Physical activity interventions within classroom settings have been acknowledged as a critical strategy to increase students' movement behaviors while enhancing their academic achievement and health. Yet, the busy curriculum and challenging educational demands encourage more sedentary classroom behavior. Hence, this study aims to develop and evaluate an in-classroom physical activity breaks (IcPAB) intervention among fifth graders in Sri Lanka. The study will adopt a randomized controlled trial (RCT), comprising an in-classroom physical activity breaks program group and a control group to evaluate the effects of IcPAB on academic achievement, movement behaviors and health outcomes. The intervention design is based on the capability (C), opportunity (O) and motivation (M) behavior (B) (COM-B) model. A least 198 fifth graders will be recruited from two schools in Uva province, Sri Lanka. The recruitment process will start in late 2022. Class teachers of the intervention group will implement 5-min activity breaks at least three times a day after completing a training session. The primary variables include mathematics and reading achievement. The secondary variables include physical activity levels, steps count, sedentary behavior, body mass index, aerobic fitness, and perceived stress. Data collection will be implemented at pre-test and post-test, respectively. Intervention fidelity and the process will also be evaluated. The IcPAB is designed to prevent pure educational time loss by introducing curriculum-integrated short bouts of physical active breaks into the classroom routine. If the IcPAB is effective, it can (1) improve the mathematics and reading achievement of fifth-grade girls and boys, which is a significant factor determining the performance at the Grade Five National Scholarship Examination in Sri Lanka; (2) improve movement behaviors as well as physical and mental health outcomes among primary school students. Sequentially, the IcPAB will enrich school-based physical activity intervention approaches which can in turn bring academic and health benefits to primary school children in Sri Lanka. The first version of the trial was registered with the ISRCTN registry (Ref: ISRCTN52180050) on 20/07/2022.

Physical activity and psychological support can replace “another pill” to manage cancer-related symptoms in children and adolescents diagnosed with cancer

Physical activity and psychological support can replace “another pill” to manage cancer-related symptoms in children and adolescents diagnosed with cancer

Implementation processes of social network interventions for physical activity and sedentary behavior among children and adolescents: a scoping review

BackgroundThe characteristics of the implementation process of interventions are essential for bridging the gap between research and practice. This scoping review aims to identify the implementation process of social network interventions (SNI) to address physical activity and sedentary behaviors in children and adolescents.MethodsThe scoping review was conducted adhering to the established guidelines. The search was carried out in the ERIC, EBSCO, EMBASE, SCOPUS, and Lilacs databases in April 2023. Social network intervention studies in children and adolescents were included, addressing physical activity or sedentary behaviors. Replicability (TIDieR), applicability (PRECIS-2), and generalizability (RE-AIM) were the explored components of the implementation process. Each component was quantitatively and separately analyzed. Then, a qualitative integration was carried out using a narrative method.ResultsMost SNI were theoretically framed on the self-determination theory, used social influence as a social mechanism, and used the individual typology of network intervention. Overall, SNI had strong replicability, tended to be pragmatic, and three RE-AIM domains (reach, adoption (staff), and implementation) showed an acceptable level of the generalizability of findings.ConclusionsThe analyzed SNI for physical activity and sedentary behaviors in adolescents tended to be reported with high replicability and were conducted pragmatically, i.e., with very similar conditions to real settings. The RE-AIM domains of reach, adoption (staff), and implementation support the generalizability of SNI. Some domains of the principles of implementation strategies of SNI had acceptable external validity (actor, action targets, temporality, dose, and theoretical justification).

Effective interventions in preventing gestational diabetes mellitus: A systematic review and meta-analysis.

Lifestyle choices, metformin, and dietary supplements may prevent GDM, but the effect of intervention characteristics has not been identified. This review evaluated intervention characteristics to inform the implementation of GDM prevention interventions. Ovid, MEDLINE/PubMed, and EMBASE databases were searched. The Template for Intervention Description and Replication (TIDieR) framework was used to examine intervention characteristics (who, what, when, where, and how). Subgroup analysis was performed by intervention characteristics. 116 studies involving 40,940 participants are included. Group-based physical activity interventions (RR 0.66; 95% CI 0.46, 0.95) reduce the incidence of GDM compared with individual or mixed (individual and group) delivery format (subgroup p-value = 0.04). Physical activity interventions delivered at healthcare facilities reduce the risk of GDM (RR 0.59; 95% CI 0.49, 0.72) compared with home-based interventions (subgroup p-value = 0.03). No other intervention characteristics impact the effectiveness of all other interventions. Dietary, physical activity, diet plus physical activity, metformin, and myoinositol interventions reduce the incidence of GDM compared with control interventions. Group and healthcare facility-based physical activity interventions show better effectiveness in preventing GDM than individual and community-based interventions. Other intervention characteristics (e.g. utilization of e-health) don't impact the effectiveness of lifestyle interventions, and thus, interventions may require consideration of the local context.

0901 Effects of a Physical Activity Intervention on Sleep Among Cancer Survivors in the Cancer Prevention Study-3

0901 Effects of a Physical Activity Intervention on Sleep Among Cancer Survivors in the Cancer Prevention Study-3

Effectiveness of implementing evidence-based approaches to promote physical activity in a Midwestern micropolitan area using a quasi-experimental hybrid type I study design.

Much evidence-based physical activity (PA) interventions have been tested and implemented in urban contexts. However, studies that adapt, implement, and evaluate the effectiveness of these interventions in micropolitan rural contexts are needed. The study aimed to evaluate the effectiveness of the Active Ottumwa intervention to promote PA in a micropolitan community. Between 2013 - 2019, we implemented Active Ottumwa in a micropolitan setting, and subsequently implemented and evaluated its effectiveness using a Hybrid Type I design. In this paper, we describe the intervention's effectiveness in promoting PA. We collected PA data over 24months from a cohort of community residents using accelerometers and PA data from two cross-sectional community surveys administered in 2013 and 2018, using the Global Physical Activity Questionnaire. From the cohort, we found significant change in PA over 24months (P = 0.03) corresponding to a 45-min daily decrease in sedentary activity, a daily increase of 35-min in light PA and 9min in moderate-to-vigorous PA. There was a statistically significant (P = 0.01) increasing trend at the population-level in the moderate-to-vigorous composition of 7min between the two cross-sectional assessments (95% CI: 0.1%-1.34%). The study demonstrates that the adapted evidence-based PA interventions in a micropolitan context is effective.