Minutes Of Physical Activity Research Articles

O.4.6-9 Physical activity during school time in Denmark: an accelerometer-based study

Abstract Purpose The Danish Primary School Act stipulates that each school day must include an average of 45 minutes of physical activity (PA) for pupils. However, the law does not specify the recommended level of intensity or whether breaks must be included. This study aimed to investigate the amount and intensity of PA during school time among 4th grade pupils in Danish public schools. An additional aim was to investigate if differences between low-intensity PA and moderate-to-vigorous PA (MVPA) exist. Thereby, this study can contribute with new perspectives on statutory PA during school time. Methods The study was conducted in Syddjurs Municipality, Denmark, in the spring of 2021. All 10 schools in the municipality chose to participate. Pupils from 4th grade carried an accelerometer on the wrist of their non-dominant arm during school time. Following a familiarization period of 10 days, data was collected for another 10 school days (Monday to Friday in two consecutive weeks). Complete days were defined as days where the pupil wore the accelerometer during the entire school day. Results A total of 411 pupils were included in the study. The analysis comprised 381 pupils with 2055 complete days. Low intensity PA for at least 45 minutes during the entire school day (including breaks) was performed by 99.6% (95%CI:99.2%;99.8%) of the pupils. Correspondingly for MVPA, 33.6% (95%CI:31.5%;35.7%) of the pupils had at least 45 minutes of MVPA during the entire school day. During lessons only (excluding breaks), 97.9% (95%CI:97.2;98.4%) of the pupils had at least 45 minutes of low intensity PA. The corresponding proportion of pupils performing MVPA during lessons was 16.8% (95%CI:15.2%;18.5%). Conclusions Most pupils in 4th grade accomplished to perform PA of low intensity during school time, while one third of the pupils performed at least 45 minutes of MVPA during the entire school time, although MVPA is known to promote physical, mental and social health. If the law is intended to promote the health of school children, the recommended level of intensity need to be further specified. Support/Funding Source The project was funded by Nordic Innovation.

O.4.3-9 Perceived COVID-19 impact and its relationship with Physical Activity in youths in Luxembourg: Health Behaviour in School-aged Children 2022 survey

Abstract Purpose The prevention measures undertaken due to the COVID-19 pandemic, such as lockdown and social distancing may have caused changes in the population’s lifestyle, including physical activity (PA). The current study aimed to investigate the PA level according to the perceived COVID-19 impact in youth in Luxembourg. Methods This representative cross-sectional study was based on the Health Behaviour in School-aged Children (HBSC) Luxembourg 2022 survey. The population includes 8018 participants aged 11 to 18 years old. The PA was measured on how many days per week they practice 60 or more minutes of moderate-vigorous (MVPA) and vigorous PA (VPA). The perceived COVID-19 impact on PA was measured by the question “What impact did the Covid-19 measures have on your PA?”, with 5 answers categories ranging from very negative to very positive. A chi-square test was performed to observe the association between the perceived COVID-19 impact on PA and gender. In addition, a linear regression was performed to analyse the relation between MVPA and VPA and the perceived COVID-19 impact, adjusted by age, splited by gender. Results An association was found between gender and the perceived COVID-19 impact on PA. 28.2% of boys perceived a very positive impacted of COVID-19 on PA, compared to 15.5% of girls. There was a relationship between MVPA, and the perceived COVID-19 impact on PA, in both genders. Participants who perceived a positive impact of the COVID-19 on PA practiced MVPA and VPA more frequently than the others, for both boys (β = 0.491, p < 0.001 and β = 0.491, p < 0.001, respectively) and girls (β = 0.543, p < 0.001 and β = 0.733, p < 0.001, respectively). Conclusions Findings suggest a rather positive impact of the COVID-19 on PA, especially for boys. In addition, those who perceived a positive impact practiced significantly more days of MVPA and VPA, in both gender. This study highlights adolescent’s perception of COVID-19 impacts on their PA and draw attention to the positive impact perceived and its relation to an increased PA practice. Future studies should further investigate the reasons behind the perception of a positive impact, in order to mimic the contextual factors favouring the increased practice of PA.

S12-5 Physical activity trends among second-level Active School Flag programme 2019-2021

Abstract Purpose Schools in the second level Active School Flag (ASF) programme are required to carry out a whole school survey to capture the student voice within the programme. Data from these surveys can be used to measure changes in physical activity behaviours at the school level. This presentation outlines the changes in physical activity levels over a three-year period from students in ASF schools. Methods From five schools involved in the ASF programme from 2019 to 2021, students reported frequencies of 60 minutes of aerobic physical activity, muscle strengthening, and active transport. Students were grouped into inactive (0-2 days), somewhat active (3-4 days), active (5-6 days) and daily active (7 days), as well as meeting muscle strengthening guidelines (3+ days/week) and not meeting (0 – 2 days). Furthermore, only students who lived within 5km of their school were included in the active transport analyses, where active transport was a combination of walking and cycling. Contingency tables were produced, and logistic regressions were used to analyse changes between 2019 (reference), 2020 (COVID-19 lockdown), and 2021, with age as confounders and stratified by gender. Results There was an 80% response rate across the five schools. Of the 7646 students (male 33%, female 65%, other 2%), minimal changes in ‘daily active’ students were observed from 2019 (12%), 2020 (13%), to 2021 (12%), whereas ‘inactive’ students decreased from 25% in 2019 to 23% in both 2020 and 2021. Rates of meeting muscle-strengthening guidelines remained steady over the years for both males and females. Active transport increased from 55% in 2019 to 66% in 2021 for males and 50% in 2019, 63% in 2020, to 65% in 2021 for females. In addition to these overall trends, idiosyncratic analyses of the schools revealed different trends from being in the ASF programme. Conclusions There were high level of responses from the whole school survey. The ASF intervention contains adaptable components due to the complex adaptive sub-systems and may shed light on the differences in physical activity over time. Furthermore, COVID-19 restrictions may have affected the program-related results.

O.4.1-1 Impact of a pre-pandemic, tele-exercise, fall-prevention intervention on outcomes in older adults

Abstract Purpose This pre-pandemic study used an alternative delivery mode to provide an evidence-based, fall-prevention exercise intervention to older adults. We delivered Tai Ji Quan: Moving for Better Balance® (TJQMBB) via tele-exercise and determined its impact on self-reported and performance-based outcomes in older adults. Methods Five community sites (3 urban, 2 rural) held 6, 1-hour, synchronous TJQMBB classes, over the internet, twice weekly for 16 weeks (32 hours). Baseline and 16-week self-reported data included fear of falling (Falls Efficacy Scale), depression (Geriatric Depression Scale-Short), physical and mental health-related quality of life (HRQOL) (SF-12 PCS and MCS), and total minutes of physical activity per week. Performance-based outcomes included a 5-Meter Walk Test (gait speed), the Timed Up-and-Go Test (mobility), the 4-Square Step Test (balance), and the 5-Times Sit-to-Stand Test (leg strength). Height and weight were used to calculate body mass index (BMI). Paired t-tests and Friedman 2-Way ANOVA tests examined changes in outcomes between baseline and 16 weeks. Results Sixty-three (79.7%) of 79 people were eligible, of which 52 (82.5%) enrolled. Participants were a mean ± SD age of 68.5 ± 7.7 years old, primarily white (96.2%), and female (80.8%). There were no significant improvements in fear of falling (X2r =3.8, p = 0.15), depression (X2r =0.19, p = 0.91), physical (X2r =1.2, p = 0.56) or mental (X2r =0.31, p = 0.86) HRQOL, or physical activity (X2r =3.7, p = 0.16). Gait speed (meters/second) significantly improved from baseline (1.1 ± 0.2) to 16 weeks (1.2 ± 0.2) (p = 0.02). Balance, leg strength, and BMI also improved significantly (balance [seconds]: baseline 10.9 ± 2.4, 16 weeks 10.2 ± 2.5, p = 0.045; strength [seconds]: baseline 14.7 ± 5.7, 16 weeks 12.4 ± 2.9, p = 0.01; BMI [kg/m2]: baseline 30.8 ± 6.3, 16 weeks 30.2 ± 5.6, p < 0.01). There were no changes in mobility (p = 0.16). Conclusions This tele-TJQMBB intervention improved physical function (gait speed, balance, leg strength) and BMI in older adults. Tele-TJQMBB provided an alternative delivery mode that could help overcome the barrier of identifying experienced instructors in rural areas, and could expand TJQMBB’s reach into the older adult population. Future comparative effectiveness studies could establish if outcomes are equivalent between in-person and tele-exercise delivery modes.

Effect of Tele-exercise to Promote Empowered Movement for Individuals With Spinal Cord Injury (TEEMS) Program on Physical Activity Determinants and Behavior: A Mixed Methods Assessment

ObjectiveTo assess the effects of group tele-exercise participation on physical activity (PA) determinants and behavior as identified by social cognitive theory (SCT) in individuals with spinal cord injury (SCI). DesignThis clinically registered non-randomized trial [NCT05360719] used a single-group parallel mixed methods design. Quantitative and qualitative primary measures were assessed at pre-program and after 8-week intervention completion (post-program), with an additional 8-week period retention to capture quantitative assessments only. SettingCommunity. ParticipantsIndividuals with chronic SCI (N=22, injury duration 2-50 years) aged 26-68 years (10 male/12 female). InterventionAn 8-week group tele-exercise program for individuals with SCI consisting of biweekly 60-minute classes delivered via live Web-conferencing software. Main Outcome MeasuresExercise self-efficacy (Exercise Self-efficacy Scale for SCI: ESES), outcome expectations for exercise (Multidimensional Outcome Expectations for Exercise: MOEES), weekly PA minutes measured through quantitative assessments (Leisure Time PA Questionnaire for SCI: LTPAQ), and parallel qualitative thematic analysis of focus group interview transcripts. ResultsCongruence between numeric and thematic findings was present for exercise self-efficacy and self-evaluative exercise outcome expectations. Improved exercise self-efficacy was influenced by exercise knowledge gained during program participation. Increased expectations of internal exercise outcomes, such as influence on psychological state and overall mood, occurred after program participation. Participant descriptions of the portability and sustainability of the program leading to added movement in everyday life were not reflected in the numeric scores of LTPAQ assessment. ConclusionsParticipation in an 8-week group tele-exercise program positively affected personal determinants of PA behavior immediately after participation. Future investigations should include a control group and biophysical PA measures such as wearable digital health devices.

Long-term effects of the COVID-19 pandemic on children's physical activity and sedentary behavior.

During the early months of the COVID-19 pandemic, decreases in physical activity (PA) and increases in sedentary behavior (SB) were reported among children in the United States (U.S.). This follow-up analysis examines 13-month effects of the COVID-19 pandemic on children's PA and SB one year into the pandemic. Parents of 5-13-year-old children in the U.S. (N=71) reported on their child's PA and SB during the early COVID-19 period (April-May 2020) and again 12-14months later (June-July 2021). Paired t-tests showed significant within-subject reductions in SB minutes per day (M diff=-86.20, t=3.26, p<0.01) but no changes in PA minutes per day. Separate mixed-model repeated-measures analysis of covariance procedures found that within-subject changes in PA and SB did not differ by child sex or age. As COVID-19 restrictions lessened, there were more opportunities for children to reduce SB, but there were still barriers to engage in PA.

Association Between Physical Activity, Sedentary Behaviors, and Sleep-Related Outcomes Among Cancer Survivors: a Cross-Sectional Study.

Limited research has examined the association between moderate to vigorous physical activity (MVPA), sedentary behavior (SB), and sleep-related outcomes in cancer survivors. Therefore, this study aimed to examine these associations using a nationally representative sample of US adults. Data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES) were analyzed. A total of 3229 adults with cancer histories were included. Physical activity was measured through accelerometry, and questions on daily activities, sedentary time, and sleep were collected during the household interview. Weighted multivariable analyses were conducted after accounting for the complex sampling design of the NHANES dataset. After adjustments, physical activity and SB outcomes were associated with several self-reported sleep-related parameters. Increases in minutes of self-reported MVPA and SB were associated with a decreased likelihood of reporting ≥ 8h of sleep (OR = 0.92, 95% CI = 0.86, 0.99 and OR = 0.88, 95% CI = 0.82, 0.95). Converse associations were found between device-measured MVPA and SB with the likelihood of reporting often/always feeling overly sleepy during the day (OR = 0.86, 95% CI = 0.75 and OR = 1.13, 95% CI = 1.05, respectively). However, an increased likelihood of waking up too early in the morning (OR = 1.22, 95% CI = 1.04) was observed with increases in minutes of device-measured MVPA. A sensible strategy to decrease the frequency of sedentary breaks and increase minutes of physical activity throughout the day may reduce sleep complaints reported in cancer survivors.

Impacting Children’s Physical and Mental Health through Kinesiology Support in Clinical Care: A Randomized Controlled Trial Protocol

Objectives: To enhance the confidence of children and adolescents with medical conditions and disabilities to engage in healthy, active lifestyles. Children with medical conditions and disabilities often exhibit more sedentary lifestyles relative to peers and are at increased risk of poor health outcomes. Clinical experience suggests physical activity confidence is an important factor influencing physical activity participation.Methods: This randomized controlled trial evaluates an evidence-based intervention targeting physical activity confidence among children and adolescents with medical conditions and disabilities. Potential participants, 8 to 18 years of age diagnosed with a medical condition or disability, will be screened for adequate physical activity motivation but a lack confidence. Consenting participants (n=128) will be randomized 1:1 to a 12-week in-person or virtual physical activity intervention (24 hours/week total) led by a Registered Kinesiologist or control (assessments only). The intervention will combine physical activity participation with education about physical activity knowledge, goal setting, motivation and self-management. Primary outcomes are self-reported physical activity confidence and motivation at baseline, post-intervention and three months following intervention completion. A secondary outcome will be daily physical activity minutes assessed by accelerometry. A repeated measures mixed model will be used to compare outcomes between the in-person intervention, virtual intervention, and control groups (alpha=0.05).Conclusions: This trial aims to assess the impact of a novel application of behaviour change theory on physical activity confidence among children and adolescents living with medical conditions or disabilities. Increased physical activity confidence, knowledge and skills could enable these youth to lead a more active lifestyle.

Changes in adult leisure-time physical activity during and after COVID-19 restrictions in Colorado Springs, Colorado

ABSTRACT The public health response to the COVID-19 pandemic may have changed leisure-time physical activity (PA) behaviour, as many ‘Stay-at-Home’ policies mandated closure of indoor recreational facilities. This study examined changes in adult leisure-time PA in more and less active groups during and after COVID-19 restrictions in a relatively active region where outdoor PA was not limited. Self-reported data on walking, moderate, and vigorous PA before, during, and after restrictions were collected via a retrospective internet survey with convenience and snowball sampling. Respondents (N = 183) were categorised as either meeting (n = 129) or not meeting (n = 54) the national recommendation of 150 minutes/week of moderate-to-vigorous aerobic PA (MVPA) during the period before restrictions. Minutes of walking, MVPA, and total PA were compared across groups and periods with two-way repeated-measure ANOVAs. Those who met PA guidelines decreased MVPA by 51.0 minutes/week during restrictions compared to before. Those not meeting PA guidelines increased total PA by 88.1 minutes/week during restrictions. This study highlights a need to better understand interactions between built environment and social cognitive factors related to leisure-time PA, which may help inform future PA interventions.

Impact of upper-body ergometer rowing exercise on aerobic fitness and cardiometabolic disease risk in individuals with spinal cord injury: A 6-month follow-up study

Objective We recently demonstrated that upper-body rowing exercise (UBROW) improved aerobic fitness in individuals with spinal cord injury (SCI), with no effect on traditional cardiometabolic risk factors. Here, we tested the hypothesis that the exercise-induced increase in aerobic fitness was maintained at 6-month (6M) follow-up. Design Six-month follow-up. Setting University/hospital. Participants Seventeen wheelchair-dependent participants with SCI. Interventions 12-week of exercise training (UBROW) or control (CON). Outcome Measures Aerobic fitness (POpeak and V̇O2peak), body composition, blood pressure, and blood biomarkers of cardiometabolic risk were assessed at 6M follow-up and compared to baseline (BL) and immediately post-intervention (12-week). Minutes of mild, moderate, and heavy intensity leisure time physical activity (LTPA) were assessed by self-report. Results Fourteen participants returned at 6M follow-up (CON, n = 6; UBROW, n = 8). In UBROW, POpeak (median (Q1-Q3)) increased from BL (70 W (37–84)) to 12-week (77 W (58–109), P = 0.01) and 6M follow-up (81 W (51–96), P = 0.01), with no difference between 12-week and 6M follow-up (P = 0.21). Similarly, V̇O2peak increased from BL (15.4 ml/kg/min (10.5–19.4)) to 12-week (16.6 ml/kg/min (12.8–21.3), P = 0.01) with no difference between 12-week and 6M follow-up (16.3 ml/kg/min (12.9–19.7), P = 0.74). No differences were found in CON for either POpeak (P = 0.22) or V̇O2peak (P = 0.27). There were no changes over time in traditional cardiometabolic risk factors or for minutes of different LTPA intensities. Conclusion We demonstrate that improvements in aerobic fitness are maintained for at least six months after completion of a 12-week exercise intervention, supporting the use of periodic exercise interventions to boost aerobic fitness level in individuals with SCI. Trial registration: ClinicalTrials.gov identifier: NCT04390087..

Volunteer-led online group exercise for community-dwelling older people: a feasibility and acceptability study

BackgroundDespite the clear benefits of physical activity in healthy ageing, engagement in regular physical activity among community-dwelling older adults remains low, with common barriers including exertional discomfort, concerns with falling, and access difficulties. The recent rise of the use of technology and the internet among older adults presents an opportunity to engage with older people online to promote increased physical activity. This study aims to determine the feasibility and acceptability of training volunteers to deliver online group exercises for older adults attending community social clubs.MethodsThis was a pre-post mixed-methods study. Older adults aged ≥ 65 years attending community social clubs who provided written consent and were not actively participating in exercise classes took part in the feasibility study. Older adults, volunteers, and staff were interviewed to determine the acceptability of the intervention. The intervention was a once weekly volunteer-led online group seated strength exercises using resistance bands. The duration of the intervention was 6 months. The primary outcome measures were the feasibility of the intervention (determined by the number of volunteers recruited, trained, and retained, participant recruitment and intervention adherence) and its acceptability to key stakeholders. Secondary outcome measures included physical activity levels (Community Health Model Activities Programme for Seniors (CHAMPS) questionnaire), modified Barthel Index, Health-related quality of life (EQ-5D-5L), frailty (PRISMA-7) and sarcopenia (SARC-F), at baseline and 6 months.ResultsNineteen volunteers were recruited, 15 (78.9%) completed training and 9 (47.3%) were retained after 1 year (mean age 68 years). Thirty older adults (mean age 77 years, 27 female) participated, attending 54% (IQR 37–67) of exercise sessions. Participants had no significant changes in secondary outcome measures, with a trend towards improvement in physical activity levels (physical activity in minutes per week at baseline was 1770 min, and 1909 min at six months, p = 0.13). Twenty volunteers, older adults, and staff were interviewed and found the intervention acceptable. The seated exercises were perceived as safe, manageable, and enjoyable.ConclusionsTrained volunteers can safely deliver online group exercise for community-dwelling older adults which was acceptable to older adults, volunteers, and club staff. Trials registrationNCT04672200.

Investigating real-time physical activity behavior using ecological momentary assessment: Effects of mental fatigue and benefit-cost valuations

BackgroundCurrent research investigating the relationship between mental fatigue and physical activity behaviors relies on laboratory-based, experimental studies which lack ecological validity. ObjectiveThis study used ecological momentary assessment (EMA) to assess feelings of mental fatigue and subjective evaluations (benefits and costs) as predictors of moderate-to-vigorous intensity physical activity in the everyday lives of young adults. MethodsOne hundred participants (n = 22 males, n = 78 females, Mage = 20.60 years, 70% meeting or exceeding physical activity guidelines) responded to digital survey prompts up to four times a day and wore an accelerometer for seven consecutive days. Moderate-to-vigorous intensity physical activity in the 180-min time window following each survey prompt was recorded. Data from the 28 survey-moderate-to-vigorous intensity physical activity epochs were analyzed using multilevel mixed-effects linear modelling. ResultsHigher levels of mental fatigue than one’s average level were associated with engaging in fewer moderate-to-vigorous intensity physical activity minutes (p = .004) and lower benefit vs. cost scores (p = .001). Higher benefit vs. cost scores than one’s average level were associated with engaging in more minutes of moderate-to-vigorous intensity physical activity (p < .001). ConclusionsResults are the first to demonstrate outside the lab, that mental fatigue experienced in everyday life may amplify the perceived costs of moderate-to-vigorous intensity physical activity, with both factors playing a potential role in moderate-to-vigorous intensity physical activity decision-making. Future research may apply insights gained from this study in design and testing of real-time interventions promoting moderate-to-vigorous intensity physical activity.

Adaptations of an Effective Evidence-Based Pediatric Weight Management Intervention

Current childhood obesity treatment programs do not address medically underserved populations or settings where all members of an interdisciplinary team may not exist—either within one organization or within the community. In this paper, we describe the use of a community-academic partnership to iteratively adapt Epstein’s Traffic Light Diet (TLD), into Building Healthy Families (BHF), a community-placed evidence-based pediatric weight management intervention (PWMI) and evaluate its effectiveness in reducing BMI z scores. Nine cohorts of families completed BHF. Participants included children aged 6–12 years with obesity (M = 9.46, SD = 1.74). The Framework for Reporting Adaptations and Modifications-Expanded guided our classification of modifications across BHF cohorts. Using the FRAME reporting structure, the changes that were documented were (1) planned and occurred pre-implementation, (2) based on decisions from local stakeholders (e.g., school administrator, members of the implementation team), and (3) specific to changes in content and context—with a focus on implementation and potential for local scale-up. The nature of the adaptations included adding elements (whole of family approach), removing elements (calorie counting), and substituting elements (steps for minutes of physical activity). Across 9 cohorts, 84 families initiated the BHF program, 69 families successfully completed the 12-week program, and 45 families returned for 6-month follow-up assessments. Results indicated that the BMI z score in children was reduced by 0.31 ± 0.17 at 6 months across all cohorts. Reduction in BMI z score ranged from 0.41 in cohort 4 to 0.13 in cohort 5. Iterative adaptations to BHF were completed to improve the fit of BHF to the setting and participants and have contributed to a sustained community PWMI that adheres to the underlying principles and core elements of other evidence-based PWMIs. Monitoring adaptations and related changes to outcomes can play a role in long-term sustainability and effectiveness.

Effect of an after-school physical activity program on physical fitness and academic performance of socioeconomically vulnerable children

Aim: To promote the practice of physical activity (PA) after school hours and verify the effects on the physical fitness and academic performance of children with socioeconomic vulnerability. Methods: The non-randomized experimental study was carried out in a school in a vulnerable area. Eighteen children performed 60 minutes of moderate-vigorous PA and 15 minutes of circuit exercise (muscle and bone strengthening) three times a week. The control group (n=10) only had school physical education as a weekly PA routine. To assess the program's impact, physical aptitude tests (pre- and post-test) were carried out in accordance with the recommendations of PROESP-Br and the School Performance Test, which assesses learning in three categories: reading, writing, and arithmetic. Results: Abdominal strength, flexibility, sprint, and lower limb power increased (d-Cohen&gt;0.20). Regarding academic performance, the effect was moderate (d-Cohen&gt;0.50) for reading and total scores. The effect size was small (d-Cohen&lt;0.50) for arithmetic and writing. Conclusion: An after-school PA program positively impacts physical fitness and academic performance in socioeconomically vulnerable children. The level of impact varies between small and medium according to different physical fitness capacities. School is an enabling environment for children to meet the World Health Organization PA recommendations.

Prevalence and factors influencing physical activity among secondary school adolescents: A cross-sectional study

Introduction: Physical inactivity is a major health concern among adolescents and is an independent, modifiable risk factor for several non-communicable diseases. Despite the World Health Organization recommended physical activity levels, many adolescents do not meet these guidelines. This study was conducted among secondary school students in Palpa district of Nepal to assess their physical activity levels and associated factors. Methods: A modified version of the Physical Activity Questionnaire Adolescents was used to collect data from 506 grade eight and nine students from six schools in Palpa district. Results: The results revealed that only 25.31% of students engaged in physical activity quite often or always, and only 23.10% met the daily WHO recommendation of at least 60 minutes of physical activity per day. Additionally, females were less likely to achieve the recommended physical activity level compared with males. Conclusions: The low levels of physical activity among secondary school students in Palpa district of Nepal highlight the need for interventions to promote physical activity. This study identified several factors associated with low physical activity levels, including limited break time at school, lack of parks or playgrounds near homes, and gender differences.

Prenatal physical activity and the gut microbiota of pregnant women: results from a preliminary investigation.

To determine whether physical activity (PA), specifically meeting the recommended 150 minutes of moderate-intensity PA per week, is associated with gut microbiota composition in pregnant women. In an ongoing birth cohort study, questions from the Behavioral Risk Factor Surveillance System, which provides data on PA variables, were used to determine whether pregnant women met or exceeded the PA recommendations. To profile the composition of gut bacterial microbiota, 16S rRNA sequencing was performed on stool samples obtained from pregnant women. Differences in alpha diversity metrics (richness, Pielou's evenness, and Shannon's diversity) according to PA were determined using linear regression, whereas beta diversity relationships (Canberra and Bray-Curtis) were assessed using Permutational multivariate analysis of variance (PERMANOVA). Differences in relative taxon abundance were determined using DESeq2. The complete analytical sample included 23 women that were evaluated for both PA and 16S rRNA sequencing data (median age [Q1; Q3] = 30.5 [26.6; 34.0] years; 17.4% Black), and 11 (47.8%) met or exceeded the PA recommendations. Meeting or exceeding the PA recommendations during pregnancy was not associated with gut microbiota richness, evenness, or diversity, but it was related to distinct bacterial composition using both Canberra (p = 0.005) and Bray-Curtis (p = 0.022) distances. Significantly lower abundances of Bacteroidales, Bifidobacteriaceae, Lactobacillaceae, and Streptococcaceae were observed in women who met or exceeded the PA recommendations (all false discovery rates adjusted, p &lt; 0.02). Pregnant women who met or exceeded the PA recommendations showed altered gut microbiota composition. This study forms the basis for future studies on the impact of PA on gut microbiota during pregnancy.

690-P: Variation in Physical Activity and Weight Loss by Demographic Characteristics among Participants in the National Diabetes Prevention Program

The National Diabetes Prevention Program lifestyle change program aims to prevent type 2 diabetes by promoting behavioral changes such as increased physical activity and improved nutrition, with a goal of losing ≥5% of body weight. We analyzed data from 2012-2019 from participants who reported weekly physical activity (PA) minutes and weight and who participated either in-person (N=127,092) or online (self-paced, asynchronous interactions with coach) (N=196,670). Among those retained through the core phase (16 sessions), average weekly PA minutes were higher among men than women (228 vs. 182 in-person and 277 vs. 204 online), higher for older than younger participants (210 vs. 187 vs. 164 in-person and 248 vs. 233 vs. 191 online for ≥65, 45-64, and 18-44 years), higher for those with lower BMI (213 vs. 184 in-person and 244 vs. 215 online for 23-29 BMI and ≥30 BMI) and varied by race/ethnicity (187 in-person and 183 online for non-Hispanic Black participants, 183 in-person and 207 online for Hispanic participants, and 198 in-person and 227 online for non-Hispanic White participants). Percent weight loss by session 16 was greater for men than women (6.0 vs. 5.2 in-person and 5.5 vs. 4.2 online), greater for older than younger participants (5.8 vs. 5.3 vs. 4.6 in-person and 5.5 vs. 4.7 vs. 4.0 online for ≥65, 45-64, and 18-44 years), greater for those with higher BMI (5.2 vs. 5.4 in-person and 4.4 vs. 4.6 online for 23-29 BMI and ≥30 BMI) and varied by race/ethnicity (3.8 in-person and 3.7 online for non-Hispanic Black participants, 4.4 in-person and 4.0 online for Hispanic participants, and 5.9 in-person and 4.8 online for non-Hispanic White participants). We found that participants with different demographic characteristics experience program successes differently despite similar time in the program, suggesting a need to understand the reasons for these differences and customize program delivery strategies to address them. Disclosure M.Cannon: None. B.Ng: None. E.Ely: None.

546-P: Impact of the COVID-19 Public Health Emergency on Enrollment and Outcomes in the National Diabetes Prevention Program

The National Diabetes Prevention Program is a partnership of public and private organizations working to build a nationwide delivery system for a lifestyle change program (LCP) to prevent or delay type 2 diabetes. Using data submitted to the Diabetes Prevention Recognition Program (DPRP), this study examines the impact of the COVID-19 public health emergency (PHE) on delivery of the LCP by looking at how adapting delivery from in-person to virtual allowed the 12-month intervention to continue. Participant start dates were categorized into 3 groups: 1) enrolled/concluded pre-PHE start, 2) enrolled pre-PHE start/concluded post-PHE start, and 3) enrolled/will conclude post-PHE start. As of October 2022, enrollment was at 658,385: 348,672 in group 1, 124,077 in group 2, and 185,636 in group 3. Mean reported weekly physical activity (PA) minutes and mean weight loss (WL) were calculated for each quarter of the LCP for each group. Despite the PHE causing abrupt changes in daily life, results show that participants whose time in the LCP overlapped or was entirely within the PHE, had strong PA and WL outcomes. Regardless of phase, participants who attended sessions in the 3rd quarter and the 4th quarter, on average, met programmatic goals of 150 PA minutes and 5% weight loss. These outcomes are indicative of lifestyle change, contributing to reducing the risk of developing type 2 diabetes. Disclosure E.Ely: None.

556-P: Early Results of Expanded Options for Demonstrating Risk Reduction in the National Diabetes Prevention Program (National DPP)

In 2012, CDC’s Diabetes Prevention Recognition Program (DPRP) released the first version of the DPRP Standards and Operating Procedures, which defined risk reduction as a minimum 5% mean weight loss for participants who completed the National DPP lifestyle change program (LCP). The most recent version of the Standards, implemented in May 2021, established 3 metrics to show risk reduction: a minimum 5% weight loss; or a minimum 4% weight loss plus a weekly mean of 150+ physical activity minutes; or a 0.2% reduction in HbA1c. As of October 2022, the DPRP has received data from 4,200+ organizations on 650,000+ participants ever enrolled in the LCP. This analysis is limited to 29,352 participants who completed the program after the 2021 Standards were implemented. This study focuses on the 765 participants who provided a pre-intervention HbA1c result within the prediabetes range (5.7%-6.4%), and a post-intervention HbA1c in months 9-12 of the yearlong program. Of those, 211 demonstrated a 0.2% reduction in HbA1c; 53 had a 0.1% reduction in HbA1c; 456 showed no change; and 45 had an increase in HbA1c. The median weight loss for participants who demonstrated a 0.2% reduction in HbA1c was 6.0%, and their median reported physical activity minutes per week was 182.6. This is compared to a 4.5% median weight loss and 156.9 median reported physical activity minutes per week among those who did not demonstrate a 0.2% HbA1c reduction. Those who provided a pre-intervention HbA1c in the prediabetes range (5.7%-6.4%), regardless of whether they provided a post-intervention HbA1c, had a median weight loss of 5.0% compared to those who did not provide a pre-intervention result (4.5% median weight loss). The DPRP has received data on an additional 9,295 participants who have provided a pre-intervention HbA1c but have not yet concluded the program. As a result, those achieving a 0.2% HbA1c reduction may increase over the next 12 months and will provide the opportunity for deeper analysis. Disclosure E.O.Landau: None. E.Ely: None.

The safety, feasibility, and efficacy of an 18-week exercise intervention for adults with primary brain cancer – the BRACE study

Purpose To determine the safety, feasibility, and potential effect of an 18-week exercise intervention for adults with primary brain cancer. Materials and methods Eligible patients were 12-26-weeks post-radiotherapy for brain cancer. The individually-prescribed weekly exercise was ≥150-minutes of moderate-intensity exercise, including two resistance-training sessions. The intervention was deemed “safe” if exercise-related, serious adverse events (SAE) were experienced by <10% of participants, and feasible if recruitment, retention, and adherence rates were ≥75%, and ≥75% compliance rates were achieved in ≥75% of weeks. Patient-reported and objectively-measured outcomes were assessed at baseline, mid-intervention, end-intervention, and 6-month follow-up, using generalized estimating equations. Results Twelve participants enrolled (51 ± 19.5 years, 5 females). There were no exercise-related SAEs. The intervention was feasible (recruitment:80%, retention:92%, adherence:83%). Participants completed a median of 172.8 (min:77.5, max:560.8) minutes of physical activity per week. 17% met the compliance outcome threshold for ≥75% of the intervention. Improvements in quality of life (mean change (95% CI): 7.9 units (1.9, 13.8)), functional well-being (4.3 units (1.4, 7.2)), depression (−2.0 units (−3.8, −0.2)), activity (112.8 min (42.1, 183.4)), fitness (56.4 meters (20.4, 92.5)), balance (4.9 s (0.9, 9.0)), and lower-body strength (15.2 kg (9.3, 21.1)) were observed end-intervention. Conclusion Preliminary evidence support that exercise is safe and beneficial to the quality of life and functional outcomes for people with brain cancer.Registration: ACTRN12617001577303