Physical Activity Messages Research Articles

164 Is it time to rethink the communication of physical activity messages with adolescents? Findings from the Active School Flag programme

Abstract Purpose The Active School Flag (ASF) is a multi-stage, multi-component, whole-of-school physical activity (PA) programme in Ireland. This study assessed health literacy, PA knowledge, beliefs about consequences of PA and programme awareness among ASF secondary school students. Survey findings prompted an inquiry with ASF programme implementers to explore the communication of PA in the school. Methods Seventeen schools were invited to take part. Five schools took part in the survey (Nov 2021) assessing health literacy, knowledge and beliefs about consequences of PA, and programme awareness. Multiple linear regression was used to determine the factors influencing adolescents’ health literacy, 484 students were included in the analysis. Programme implementers from the 17 schools were invited to a focus group at the end of the year (May 2022). Ten schools engaged in the process aiming to understand how PA messages were communicated in the schools. Data were analysed using thematic analysis. Results Comparisons between gender(s) showed significant differences for health literacy (p = .002), PA knowledge (p = .021) and beliefs about consequences (p = .007). No significant differences were found for school stage i.e. junior vs senior. The overall model significantly predicted health literacy, F(5, 478) = 56.08, p = <.001. Significant predictors included knowledge of PA (B= .869, p<.001) and beliefs about the consequences (B = 2.34, p<.001). Gender, year group and designated-disadvantage status were not significant predictors of health literacy. Findings described the manner in which PA messages are communicated in relation to the i) types of communication, ii) the content of the messages, and iii) the mode of delivery. However, disparities between schools highlighted the lack of a clear communication plan. Conclusions Low levels of PA knowledge, its’ consequences and health literacy among adolescents in the ASF programme warranted further exploration into the methods used to communicate PA messages in ASF schools. The methods used to communicate PA in Irish secondary schools, varied and a clear communication plan was missing. Further research is needed to improve the communication of PA messages with adolescents and increase levels of knowledge, awareness and health literacy. Support/funding source Mayo Education Centre and the Irish Research Council Government of Ireland Postgraduate Scholarship.

140 Development of public facing physical activity messages to accompany the updated National Physical Activity and Sedentary Behaviour Guidelines for Ireland

140 Development of public facing physical activity messages to accompany the updated National Physical Activity and Sedentary Behaviour Guidelines for Ireland

159 Qualitative insights into the skills development, health outcomes, and school experience of adolescent peer-leaders of a physical activity programme in second level schools

Abstract Purpose The Active School Flag (ASF) is a whole-of-school, physical activity (PA) programme in Ireland. At second level, student leadership is central to ASF, as adolescents aged 15–16 years in Transition Year (TY), are peer-leaders (PL) of ASF in their school. TY is a one-year programme unique to Ireland, that provides adolescents with skills and personal development opportunities. PLs receive leadership training and have a dedicated weekly class to plan the delivery of whole-of-school PA events and surveys. This study explored the impact on PL skills development, health outcomes, and school experience. Methods In April and May 2023, focus groups were conducted with PL (n = 33, 67% female) in eight schools during their second year of ASF. PL were asked about their experience of implementing ASF. Data were analysed using reflexive thematic analysis informed by Braun and Clarke, (2019). Five themes and 29 subthemes were generated. Results Themes included: (1) Enhanced personal development through ASF, (2) ASF builds community in the school, (3) Value and recognition of ASF in the school community, (4) Without ASF school would be plainer, (5) PL experience of their participation in ASF. Findings demonstrate the impact of key ASF intervention components on PL skills, health, and school experience. PL developed transferable skills including verbal and written communication (theme 1) through dissemination of whole-of-school survey results and sharing PA messages with school members. Shared leadership training supported PL to feel part of a group (theme 2) and facilitated a comfortable social and learning environment (theme 4). Attending ASF weekly timetabled class stimulated a positive mood among PL (theme 5). Although PL felt school members supported them (theme 3) during whole-of-school PA events, some PL experienced anxiety and frustration working with school members (theme 5). Conclusions Results provide valuable information to inform school staff and management how leading ASF can influence adolescents, including developing transferable skills, enhancing social and mental health, and supporting a positive school experience. These insights highlight the potential impact of a whole-school PA programme on a broad range of outcomes, demonstrating the added value of student-led initiatives. Funding Source Mayo Education Centre, Healthy Ireland

‘It's just one step too far’: Negotiating physical activity for perinatal mental health

BackgroundPhysical activity is recommended as a self-help strategy for some mild to moderate perinatal mental illnesses. Despite this, we know very little about how women remain active, or take up physical activity, in the context of changing family life and perinatal mental illness. We seek to explore: a) how women negotiate physical activity for their mental health during transitions into parenthood and the early years; and b) the experiences of women with perinatal mental illness in relation to physical activity. MethodsAn anonymous UK-wide qualitative online survey was used to better understand how physical activity may be used for perinatal mental health, barriers to activity and changes over time. 186 women with babies and children up to four years completed the survey. Reflexive thematic analysis was used to analyse the qualitative data and generate themes. ResultsThemes generated from this data were: 1) negotiating being active for perinatal mental health (the benefits and how these women remained active); 2) barriers to PA associated with mental illness (some women were active but still experienced general barriers to further PA, and there were several emotional barriers from mental illness); and 3) PA, guilt and the importance of valuing walking (guilt about not being active enough, guilt and feelings of failure exacerbated by questions about PA levels without support offered; regular walking not valued as PA exacerbating feelings of guilt). Conclusions and ImplicationsThis study provides new empirical data on the experiences of new mothers’, physical activity and mental health with important implications for physical activity messaging and support for women during this time through maternity care. Individualised conversations are important and the value of walking and incidental activity from activities that mothers and families find enjoyable should be promoted.

Agreement with weight-neutral compared to weight-centric physical activity messages and relationships to sedentary behavior, physical activity, and internalized weight bias in people living in larger bodies

Agreement with weight-neutral compared to weight-centric physical activity messages and relationships to sedentary behavior, physical activity, and internalized weight bias in people living in larger bodies

Misaligned or misheard? Physical activity and healthy eating messaging to ethnic minority communities during the COVID-19 pandemic: A qualitative study and scoping review.

This mixed-methods study identified physical activity (PA) and healthy eating messages produced during the COVID-19 pandemic and explored how they were received by UK ethnic minority communities. A scoping review of research and grey literature identified categories of PA and healthy eating messaging targeted at ethnic minorities. Individual and group interviews were conducted, audio-recorded, transcribed and analysed using inductive thematic analysis. There was active community engagement in all study phases to ensure relevance and co-production of findings. Interviews were held with 41 study participants aged 18-86 years (20 men) residing in England and Wales using digital conferencing and in person. The scoping review identified 24 records containing messages grouped into three categories: 1) PA messages; 2) healthy eating messages; 3) risk messages. Five themes described participants' views of these messages: 1) lack of awareness of messaging; 2) responses to PA messaging; 3) responses to healthy eating messaging; 4) perceptions of risk messaging and 5) perceptions of conflict in messages. The review revealed that physical activity and healthy eating messaging specifically targeting ethnic minority communities is limited. This limited messaging was almost entirely missed by these communities. When received, the messaging was not interpreted as intended, perceived to be conflicting and risk messaging was perceived as blaming. More work with ethnic minority communities needs to be done to co-produce meaningful and appropriate PA and healthy eating messaging in a timely manner.

The Effects of Physical Activity Messages on Physical Activity Support Behaviors and Motivation Among Parents of Children with Disabilities

ABSTRACTPersuasive messages can motivate parent support for physical activity (PA). Many PA messages targeting parents are not necessarily inclusive of parents of children with disabilities (CWD). Guided by the theory of planned behavior and multi-process action control model, the relative effects of PA messages were examined among parents of CWD. Parents (N = 135) were randomized to view one of four PA messages. Parent support for PA and various psychosocial antecedents were assessed before and after message viewing, along with message preference. Baseline parent support for PA acted as a moderator on the effects of messages. Effects of messages did not differ between message conditions. Overall message effects were observed for attitudes, subjective norms and planning. Parent support for PA increased only among parents with low baseline parent support and the inclusive message was most preferred. This study can inform the development of PA messages targeting this population.

How Do You Move? Everyday stories of physical activity.

Stories can be a powerful method of exploring complexity, and the factors affecting everyday physical activity within a modern urban setting are nothing if not complex. The first part of our How Do You Move? study focused on the communication of physical activity guidelines to under-served communities. A key finding was that adults especially wanted physical activity messages to come from 'everyday people, people like us'. This finding also reflects a wider move to use more relatable imagery in health promotion campaigns. Using a portrait vignette approach to create monologues, we set out to explore the experiences of people from diverse backgrounds living in Bristol, all of whom took part in varied leisure time physical activities but would also be considered to lead 'normal' lives. We aim to demonstrate that stories of such 'experts by experience' can contribute to how physical activity is perceived and elucidate the complex interplay of barriers and enablers in everyday experiences of physical activity.

Promoting Achievable Goals to Increase Physical Activity

Abstract Background Physical inactivity is a leading contributor to the development of non-communicable diseases including cardiovascular disease, diabetes, and cancer. Public health messages that advocate activity guidelines with specific duration thresholds (e.g., 30 minutes per day) have had limited success. This approach may risk an ‘all or nothing’ mindset whereby people feel exercise is not worthwhile unless they can meet recommended guidelines. World Health Organization guidelines recognise that any activity is better than none. In line with this, the present study aimed to test the effectiveness of two messages that referred to relative rather than absolute increases in physical activity: ‘Sit less, move more’ and ‘Add 2000 steps to your day’. Methods A representative sample of 7995 Australian adults responded to three surveys over six-weeks, with random assignment to a control condition (non-physical activity message) or one of two physical activity message conditions: Sit less, move more or Add 2000 steps to your day at each time point. At all three time points, respondents were exposed to their allocated message and reported their frequency of enacting the recommended behaviours. To account for attrition over the surveys, an intention-to-treat approach was adopted. Two generalised estimating equations models were run to examine time-by-condition interactions for the enactment of each message. Results Compared to control, respondents in the Add 2000 steps to your day condition significantly increased their enactment of adding 2000 steps to their day over time (B=.161, p=.011). Those in the Sit less, move more condition did not significantly differ from control in the frequency of enacting this message. Conclusions Promoting a specific physical activity goal that was relative to baseline activity increased the enactment of the recommended behaviour. Messages seeking to promote physical activity may be more effective if they include goals that are clear and feasible. Key messages • A message encouraging people to add 2000 steps to their day successfully increased physical activity. • Promoting achievable goals in physical activity messages might be a useful public health strategy.

Acceptability of physical activity signposting for pre-frail older adults: a qualitative study to inform intervention development

Frailty is a medical condition common in older adults characterised by diminished strength and reduced physiologic function in which individuals are more vulnerable to multiple adverse health outcomes. Pre-frailty is an intermediate stage associated with some minor health outcomes. However, the main risk is progression toward moderate/severe frailty. Evidence shows physical activity interventions to be effective in slowing or modifying the progression of frailty. Researchers at the University of Manchester are developing a behaviour change intervention targeting pre-frail older adults, signposting them to group-based physical activity classes known to be effective for delaying/slowing frailty. This paper reports on the initial intervention development work with key stakeholders exploring the practicality of taking forward this intervention and identifying uncertainties to be explored in the feasibility stage. These included issues around physical activity messaging, the use of the term ‘frail’, identification/recruitment of pre-frail older adults, and the acceptability of behaviour change techniques. There was overwhelming support for a proactive approach to addressing pre-frailty issues. Given that a large proportion of older adults are estimated to be pre-frail, interventions aimed at this group have the potential to support healthy ageing, positively impacting on frailty outcomes and providing wider population health benefits.

Trust in science moderates the effects of high/low threat communication on psychological reactance to COVID-19-related public health messages

ABSTRACT Background As illustrated by the COVID-19 pandemic, communicating evidence-based health recommendations represents a tremendous challenge; among some recipients, public health messages can cause anger and negative cognitions, also known as psychological reactance, and consequently lead to negative attitudes and low intentions to perform the promoted behavior. The present study investigated the role of message characteristics (i.e. high vs. low freedom-threat messages), individuals’ trust in science (i.e. high vs. low trust in science), and their interaction in determining responses to public health messages. Methods We conducted an experimental study, in which participants (N = 228) with high or low trust in science were exposed to high or low freedom-threat messages promoting mask-wearing to reduce the spread of COVID-19 and regular physical activity. Results We found support for the notion that messages imposing high threat to freedom lead to higher state psychological reactance, and more negative attitudes and behavioral intentions. Moreover, our results showed that trust in science has a main and interaction effect (together with message characteristics) on state reactance, behavioral intentions, and – to a lesser degree – attitudes, in the case of COVID-19, but not physical activity messages. The findings remained the same regardless of controlling for other relevant variables. Conclusions While our study has some limitations, such as a rather homogeneous sample, a limited number of experimental stimuli, and a relatively artificial experimental environment, it offers some insight into the important role of health communication recipients’ trust in science and provides advice on how to communicate health recommendations to skeptics.

O.4.4-1 Moving messages: development of the physical activity messaging framework and checklist

Abstract Purpose Physical activity (PA) messaging is an important step in the pathway towards improving population PA levels, but best practice is not yet understood. A gap in the literature existed for a PA messaging framework to help guide creation and evaluation of messages. This study aimed to further develop and improve, and gain international expert consensus on, a Physical Activity Messaging Framework and Checklist. Methods A modified Delphi study consisting of three online survey rounds was conducted. A preliminary version of the framework and checklist developed using findings from a scoping review of PA messaging were used as a starting point for this study. Each survey gathered feedback from an international expert panel using quantitative and qualitative methods. The framework and checklist were amended each round based on survey results until consensus (defined a priori as 80% agreement) was reached. Results The final expert panel (n = 40, 55% female) came from nine countries and comprised academics (55%), healthcare and other professionals (22.5%) and government officials or policymakers (22.5%). Consensus was reached in survey 3 with 85% and 87.5% agreement on the framework and checklist, respectively. The Physical Activity Messaging Framework (PAMF) and Checklist (PAMC) comprise several PA messaging concepts organised into three overarching sections: (1) who, when, what, how and why, (2) message content, and (3) message format and delivery. Conclusion This study presents an expert- and evidence-informed framework and checklist for physical activity messaging. The PAMF and PAMC can be used to create physical activity messages, plan evaluation of messages, and aid understanding and categorisation of existing messages. The PAMF and PAMC may improve practice by encouraging development of evidence-based and target audience-focused messages, as well as enhance the research base on physical activity messaging by harmonising key terminologies and improving quality of reporting. Funding source This research was conducted as part of CW’s PhD, funded by the University of Edinburgh’s Principal’s Career Development Scholarship, Oct 2018 - Jan 2021.

O.5.2-6 Using the Physical Activity Messaging Framework to investigate physical activity messaging preferences in new mothers

Abstract Purpose Evidence suggests PA levels decline during pregnancy and remain low during the postpartum period. PA can reduce risk of excessive gestational weight gain, gestational diabetes, and symptoms of postpartum depression. One way to encourage postpartum to engage in PA is through PA messaging. This study aimed to apply the novel Physical Activity Messaging Framework (PAMF) to develop targeted messaging recommendations for postpartum women. Methods Proof-of-concept study. Semi-structured individual interviews were conducted with seven new mothers from North Tyneside and Northumberland (mean age 33.6 years). The interview schedule aligned with sections of the PAMF to explore preferences around: (1) message aim and pathway, (2) message content, and (3) message format and delivery. Interviews were audio recorded and transcribed verbatim. Framework analysis was used to identify trends, similarities, and differences in the data. Results Key findings related to the three sections of the PAMF. (1) This study identified important potential aims and working pathways for messages to this group, such as reducing barriers to PA and educating new mums on benefits. (2) Findings included that tone and language used in messages should be empathetic and reassuring, and that messages should be gain-framed. New mums value the social and acute mental health benefits of PA, such as connecting with other mums and relaxing. This study also demonstrated the importance of using realistic and inclusive images in PA messages. New mums may find the 150-minute PA guideline unachievable, with a preference for shorter bouts of PA and clear, practical advice. (3) Social media was identified as an viable delivery platform for new mums, and healthcare providers were identified as important messengers. Conclusion This study found the PAMF to be a helpful tool to inform data collection, data analysis and organisation of findings in a study aiming to develop PA messages. Findings relating to message aim and pathway, message content, and message format and delivery were identified, and specific targeted PA messaging recommendations for new mums were provided. Funding source This research was conducted as part of CW’s PhD, funded by the University of Edinburgh’s Principal’s Career Development Scholarship, Oct 2018 - Jan 2021.

Promoting Physical Activity During Pregnancy and the Postpartum Period.

Physical activity is important for improving and maintaining overall health across the life span, including during and after pregnancy. Achieving recommended levels of physical activity can be challenging during pregnancy and the postpartum period. The US Office of Disease Prevention and Health Promotion sought to promote physical activity during and after pregnancy through the development of health education materials for the Move Your Way campaign. Research was conducted with pregnant and postpartum people to learn what types of messages and materials would encourage physical activity in these populations. Participants were recruited from 3 regions of the United States to participate in 90-minute virtual focus groups. Eligible participants were aged 18 years or older and either pregnant or 6 weeks to 1 year postpartum. Participants were asked questions about their beliefs, attitudes, and perceptions about physical activity and prompted to provide feedback on health promotion messages and images. Sessions were recorded, transcribed, and analyzed for key themes. Twenty-four focus groups were conducted with 48 pregnant participants and 52 postpartum participants. Sixteen sessions were conducted in English and 8 were conducted in Spanish. Most participants had questions about how much physical activity is recommended, and many cited their health care provider as a trusted source of information. Participants responded positively to materials that acknowledged the uniqueness of each pregnant or postpartum experience, referenced gradually increasing physical activity levels, highlighted the benefits of physical activity, focused on safety, addressed common barriers, and displayed realistic representations of physical activity. There is an opportunity to improve messaging about physical activity during and after pregnancy. To better promote physical activity, perinatal health care providers and other health professionals can share information about recommended amounts of physical activity, communicate the benefits, and promote realistic and achievable physical activity messages that address common barriers in these populations.

Creation of a Holistic Platform for Health Boosting Using a Blockchain-Based Approach: Development Study

Low adherence to healthy habits, which is associated with a higher risk of disease and death, among citizens of Organization for Economic Co-operation and Development countries is a serious concern. The World Health Organization (WHO) and the physical activity (PA) guidelines for Americans provide recommendations on PA and healthy diets. To promote these habits, we suggest using a blockchain-based platform, using the PA Messaging Framework to deliver messages and rewards to users. Blockchain is a decentralized secure platform for data management, which can be used for value-added controls and services such as smart contracts (SCs), oracles, and decentralized applications (dApps). Of note, there is a substantial penetration of blockchain technologies in the field of PA, but there is a need for more implementations of dApps to take advantage of features such as nonfungible tokens. This study aimed to create a comprehensive platform for promoting healthy habits, using scientific evidence and blockchain technology. The platform will use gamification to encourage healthy PA and eating habits; in addition, it will monitor the activities through noninvasive means, evaluate them using open-source software, and follow up through blockchain messages. A literature search was conducted on the use of blockchain technology in the field of PA and healthy eating. On the basis of the results of this search, it is possible to define an innovative platform for promoting and monitoring healthy habits through health-related challenges on a dApp. Contact with the user will be maintained through messages following a proposed model in the literature to improve adherence to the challenges. The proposed strategy is based on a dApp that relies on blockchain technology. The challenges include PA and healthy eating habits based on the recommendations of the WHO and the Food and Agriculture Organization. The system is constituted of a blockchain network where challenge-related achievements are stored and verified using SCs. The user interacts with the system through a dApp that runs on their local device, monitors the challenge, and self-authenticates by providing their public and private keys. The SC verifies challenge fulfillment and generates messages, and the information stored in the network can be used to encourage competition among participants. The ultimate goal is to create a habit of healthy activities through rewards and peer competition. The use of blockchain technology has the potential to improve people's quality of life through the development of relevant services. In this work, strategies using gamification and blockchain are proposed for monitoring healthy activities, with a focus on transparency and reward allocation. The results are promising, but compliance with the General Data Protection Regulation is still a concern. Personal data are stored on personal devices, whereas challenge data are recorded on the blockchain.

Investigating the feasibility and acceptability of using Instagram to engage post-graduate students in a mass communication social media-based health intervention, #WeeStepsToHealth

BackgroundInstagram’s popularity among young adults continues to rise, and previous work has identified diffusion of unhealthy messages and misinformation throughout the platform. However, we know little about how to use Instagram to promote health messages. This study aims to assess the feasibility and acceptability of using Instagram to engage post-graduate students in a mass communication social media (SM)-based health intervention.MethodsA 4-week intervention targeting post-graduate students with physical activity (PA), nutrition, and general wellbeing messages was conducted via Instagram. Feasibility and acceptability were assessed using SM metrics (likes, comments, and shares), pre- and post-intervention online surveys (knowledge, attitude, and behavioural outcomes), and a focus group conducted with a sample of individuals in the target population (to assess intervention recall, feedback on message framing, and acceptability of Instagram).ResultsThe two independent samples captured by online surveys (pre-intervention, n = 43, post-intervention, n = 41, representing 12.3% and 11.7% of Instagram followers, respectively) were predominantly female (88.4%, 80.5%) aged 18–34 (95.4%, 95.1%). Respondents in the second survey reported higher weekly PA levels (+ 13.7%) and more frequent nutritional behaviours including consumption of five or more fruits and vegetables (+ 23.3%) and looking at nutritional labels (+ 10.3%). However, respondents in the second survey also reported less frequent meal preparation (− 18.0%) and a small increase in fast food consumption (+ 2.8% consuming fast food 3–4 days a week). A total of 247 ‘likes’ were collected from 28 Instagram posts (mean 8.8 likes per post). Humorous posts achieved a moderately higher level of engagement than non-humorous posts (median 10 and 8 likes, respectively). Focus group participants liked the campaign content and trusted the information source.ConclusionsFindings indicate that Instagram could be a feasible and acceptable platform for engaging post-graduate students in a SM-based mass communication health intervention, and that humour may have the potential to encourage further engagement.

Understanding the challenges and impact of training on referral of postnatal women to a community physical activity programme by health professionals: A qualitative study using the COM-B model

ObjectiveTo understand the value of training for health professionals for improving their ability to effectively refer postnatal women to a targeted community physical activity programme. The study also sought to understand challenges to effective referral of postnatal women from deprived areas. Design, setting and participantsSemi-structured interviews were conducted in January-February 2020 with early years practitioners (n = 4), health visitors (n = 1) and community midwives (n = 2) who had participated in a training workshop implemented as part of a targeted community physical activity referral programme for postnatal women from deprived areas in the North East of England. Two follow up interviews were also conducted with one midwife and one early years practitioner during the Covid-19 pandemic. Data were analysed thematically and the Capability, Opportunity, Motivation, Behaviour (COM-B) model was employed to facilitate identification of the impact of training and the challenges in referral from the health professionals’ perspective. FindingsThe training increased capability to refer by improving knowledge and confidence of health professionals in being able to give appropriate guidance to postnatal women about physical activity without having to refer to other professionals. Health professionals reported adequate opportunities to engage with postnatal women, were motivated to refer and perceived this to be part of their role. The timing and method of message delivery were key contexts for perceived successful referral, particularly for midwives who wanted to ensure the messaging began in the antenatal period. Low staffing levels, limited interprofessional collaboration and finding strategies to engage women from deprived areas were key challenges to effective delivery of physical activity messages. These challenges were exacerbated during Covid-19, with increased mental health issues amongst postnatal women. Key conclusions and implications for practiceTraining health professionals for physical activity messaging can be a useful way to increase capability, opportunity, and motivation to refer to physical activity interventions for postnatal women in deprived areas to potentially increase physical wellbeing and reduce postnatal depression. The COM-B is a relevant framework to underpin training. A clearly identified referral pathway and staffing issues need to be addressed to improve referrals by health professionals.

Influence of implementation strategies on implementation outcomes in a statewide dissemination of Faith, Activity, and Nutrition (FAN).

Faith-based organizations are promising settings for implementation science because they can reach populations bearing a disproportionate burden of chronic disease. This study examined how implementation strategies influenced implementation outcomes in Faith, Activity, and Nutrition (FAN) statewide dissemination. Ninety-three (9%) of 985 invited churches enrolled; 91 (98%) and 83 (89%) completed baseline and 12-month assessments. Community Health Advisors trained and provided phone technical assistance to church committees, led by a FAN coordinator. Church committees were charged with developing plans and installing healthy eating (HE) and physical activity (PA) policies, opportunities, messages and pastor support (implementation outcomes). Structural equation modeling examined how implementation strategies influenced implementation outcomes. Nearly all (99%) FAN coordinators and 60% of pastors attended training, 57% of committees submitted program plans and 51%/54% (HE/PA) of committees met 'every few months'. Statistically significant (P < 0.05) model paths showed positive influences of strategies on implementation outcomes: pastor training on HE and PA pastor support; plan completion on HE and PA messages, PA policies and opportunities as well as FAN committee meetings and committee meetings on HE pastor support, HE policies, PA opportunities and HE and PA messages. This study advances implementation science and provides a model applicable to organizations such as worksites and schools.

Communicating Physical Activity with Adolescents: What works? A scoping review protocol.

Background: Worldwide, adolescents are not meeting the minimum recommended physical activity (PA) guidelines to achieve health benefits. Awareness of the guidelines among adolescents is low, only 3.6% can report them correctly. The school is an ideal PA promotion setting, no other institute has the same reach or influence on the adolescent population. There is a need for an effective communication strategy for PA messages for adolescents. The purpose of this review is to explore how, when, who, where and what i.e. the content, context and mode of delivery of PA messages to communicate with adolescents to improve their awareness and understanding of PA that will potentially lead to an increase in PA levels. Methods: A scoping review was selected as the most appropriate methodology due to the broad nature of the research question. The PCC mnemonic (Population, concept, context), recommended by the Joanna Briggs Institute, was used to develop the search strategy and research question. This review will follow the scoping review framework developed by Arksey and O'Malley (2005) which was later updated by Levac et al (2010) to ensure the methods are systematic. It will also follow the PRISMA extension for scoping reviews checklist. Sources include databases (CINAHL, Education Source, Scopus, PubMED), grey literature from the World Health Organisation, Global Index Medicus and the reference lists of extracted articles will be checked from the year 1995 onwards. Results: A PRISMA flow diagram will demonstrate the final articles included and results will be presented and summarised as recurring themes. The results will be discussed in relation to existing literature and future implications for research, policy and practice. Conclusion: This will be the first review to explore the PA messaging context among adolescents and the findings will help inform a strategy for communicating PA to adolescents.

Views of men with Parkinson's disease regarding physical activity health messaging

BackgroundMany men with Parkinson's Disease (PD) do not meet the recommended levels of physical activity (PA) for health benefits. Tailored, meaningful, and culturally sensitive PA health messages may be a catalyst to shape men's motivations toward participation. ObjectiveWe explored the views of New Zealand (NZ) men with PD about existing PA health messages, and how these could be adapted to be more effective. MethodsThis qualitative study recruited six community dwelling, regularly physically active, NZ European men with PD (aged 54–69 years, 2–18 years post-diagnosis) from a community exercise class in Canterbury, NZ. Participants engaged in semi-structured interviews which were audio-recorded, transcribed verbatim, and analyzed inductively for themes. ResultsParticipants expressed that effective PA health messages should reflect men's motivations for PA which included physical and mental well-being and social connection. Inclusive, positive, and relatable language and imagery were considered crucial PA message communication strategies. Participants viewed health professionals' PA advice as superficial and unhelpful; however, celebrities with PD were considered inspirational messengers. Messages endorsed by trustworthy sources, such as the Parkinson's Society, were perceived to enhance the credibility. ConclusionsEffective PA messages should be gain framed and tailored to the target audience. We recommend health professionals provide comprehensive PA advice or consider onward referral. Future research which uses a co-design participatory methodology to collaborate with men with PD from culturally diverse backgrounds and represent all stages of PA behaviour change is recommended to provide comprehensive insights for meaningful, effective, and culturally sensitive PA health messaging.