Physical Activity Promotion Practices Research Articles

Children's physical activity and sedentary behaviour in before school care: An observational study

ObjectiveIn Australia, less than one quarter of children aged 5–12 years meet national physical activity (PA) guidelines. Before school care operates as part of Out of School Hours Care (OSHC) services and provide opportunities for children to meet their daily PA recommendations. The aim of this study was to explore factors associated with children meeting 15 min of moderate-to-vigorous-intensity physical activity (MVPA) while attending before school care. MethodsA cross-sectional study was conducted in 25 services in New South Wales, Australia. Each service was visited twice between March and June 2021. Staff behaviours and PA type and context were captured using staff interviews and the validated System for Observing Staff Promotion of Physical Activity and Nutrition (SOSPAN) time sampling tool. Child PA data were collected using Actigraph accelerometers and associations between program practices and child MVPA analysed. ResultsPA data were analysed for 654 children who spent an average of 39.2% (±17.6) of their time sedentary; 45.4% (±11.4) in light PA; and 14.9% (±11.7) in MVPA. Only 17% of children (n = 112) reached ≥15 min MVPA, with boys more likely to achieve this. Children were more likely to meet this recommendation in services where staff promoted and engaged in PA; PA equipment was available; children were observed in child-led free play; and a written PA policy existed. ConclusionsBefore school care should be supported to improve physical activity promotion practices by offering staff professional development and guidance on PA policy development and implementation practices.

S4-2 Target group specific policy monitoring for physical activity promotion: development of a new tool in Germany

Abstract Purpose While there are several approaches to collect basic information on physical activity (PA) promotion policies, some governments require more in-depth overviews on the situation in their country. In 2021, the German Federal Ministry of Health expressed its interest in collecting detailed data on target group specific PA promotion, as relevant competences in Germany are distributed across a wide range of political levels and sectors. This study describes a new tool developed to reflect German policymakers’ needs for rapid, adaptable, and target group specific monitoring, with a focus on routine national PA promotion practices. Methods Based on relevant national and international guidelines, a tool was co-produced by researchers and ministry officials. It includes (1) PA recommendations, (2) national prevalence rates, (3) recommendations for PA promotion, and data on national (4) routine practices, (5) pilot projects and (6) policies. In a pilot study, data were collected for children and adolescents in Germany using desk research, semi-structured interviews and secondary data analysis. Results A policy brief and scientific background document were developed. Results showed that 46% of the 4–5-year-olds fulfil WHO recommendations but only 15% of the 11–17-year-olds, and that girls are less active than boys. Currently, no valid data are available on the PA behaviour of 0–3-year-olds in Germany. An overview of routine practices for PA promotion for children and adolescents was compiled, and experts were asked to critically assess their effectiveness, reach and durability. Overall, 339 target group specific projects for PA promotion were found, with 22 classified as examples of good practice. National PA policies for children and adolescents were identified across different sectors and settings. Conclusions The new tool provides an added value for PA policy monitoring as it is target group specific, has a unique focus on routine practices in PA promotion, and systematically identifies policy gaps. Starting in 2023, it will serve as a conceptual basis for the development of three additional PA policy briefs tendered by the German government. While developed to specifically suit the German context, it has the potential to be adapted to other countries.

Indian nurses' beliefs on physical activity promotion practices for cancer survivors in a tertiary care hospital-a cross-sectional survey.

PurposeTo describe the physical activity (PA) promotion practices, beliefs, and barriers of Indian nurses working with cancer survivors, and to gain preliminary insights into how their educational qualification might affect PA promotion practices.MethodsA validated questionnaire was used to obtain the data (N = 388). Sub-group comparisons were performed based on nursing qualification i.e., Bachelor of Science in Nursing (BSc) and General Nursing and Midwifery (GNM) using Mann-Whitney U test and chi square analysis for continuous and categorical variables, respectively.ResultsThe nurses believed that oncologists (47%) followed by physiotherapists (28.9%) were primarily responsible for providing information regarding PA to cancer survivors. The most common period in which the nurses’ promoted PA was post treatment (31.7%), although very few nurses (13.3%) promoted PA across more than one of the three treatment periods. Nurses felt that PA had many benefits for cancer survivors; improved mental health (87.7%) and HRQoL (81.1%). Lack of knowledge (42.2%) and lack of time (41.6%) were the most frequently cited barriers. The comparisons based on educational qualification did not typically reveal many significant differences.ConclusionIndian nurses both BSc and GNM qualified, wish to promote PA to cancer survivors despite numerous barriers, across various stages of treatment and believe PA is beneficial to the survivors in the process of recovery. Overcoming these barriers might aid in better promotion of PA to cancer survivors.Implication for cancer survivorsNurses working in a tertiary care hospital in India are willing to promote PA amongst cancer survivors but require more training and support in this area of practice.

Physical Therapists' Knowledge, Skills, Beliefs, and Organizations Impact Physical Activity Promotion: A Systematic Review and Meta-Analysis.

The purpose of this study was to characterize factors that influence physical therapists' physical activity (PA) promotion practices and map these factors to the Theoretical Domains Framework (TDF) to inform future implementation efforts. Six databases (MEDLINE, EMBASE, Scopus, CINAHL, PsychInfo, and Web of Science) were searched from inception to March 11, 2021. Studies were included if they reported physical therapists' PA promotion practices and factors influencing these practices. Study quality was assessed with a modified Newcastle-Ottawa Scale and the Critical Appraisal Skills Programme checklist. Studies were excluded if they did not separate physical therapist PA promotion practices and influencing factors from other health professionals. The search yielded 12,835 references and 27 included studies. Twenty studies were included in a meta-analysis of proportions, whereas 15 studies were included in a meta-analysis of correlations. Very-low to moderate-quality evidence suggests that factors at the individual and organizational levels have very small to moderate associations with PA promotion practices. Efforts to improve PA promotion by physical therapists should consider incorporating combinations of individual and organizational factors. Limitations to the body of evidence highlight the need for future research. With PA projected to decrease in the general population by an additional 20% by 2050, PA promotion is urgently needed to maximize physical therapists' impact on the health of society. This study identifies factors that may prove useful for guiding the development of strategies to encourage greater engagement in PA promotion by physical therapists.

Physical activity in out of school hours care: an observational study

BackgroundOpportunities for physical activity within out of school hours care (OSHC) are not well documented in Australia. This study explored factors associated with children (5–12 years) meeting 30 min of moderate to vigorous physical activity (MVPA) while attending OSHC in the afternoon period.MethodsA cross-sectional study, conducted in 89 OSHC services in New South Wales, Australia, serving 4,408 children. Each service was visited twice between 2018–2019. Physical activity promotion practices were captured via short interviews and System for Observing Staff Promotion of Physical Activity and Nutrition (SOSPAN). Physical activity spaces was measured (m2) and physical activity of 3,614 child days (42% girls), were collected using Acti-Graph accelerometers. Association between program practices and children accumulation of MVPA was tested using mixed effects logistic regression, adjusted by OSHC service and child.ResultsTwenty-six percent of children (n = 925) accumulated 30 min or more of MVPA. Factors associated with children reaching MVPA recommendations included: services scheduling greater amounts of child-led free play, both 30–59 min (OR 2.6, 95%CI 1.70, 3.98) and ≥ 60 min (OR 6.4, 95%CI 3.90, 10.49); opportunities for staff-led organised play of ≥ 30 min (OR 2.3, 95%CI 1.47, 3.83); and active games that engaged the majority of children (OR 1.7, 95%CI 1.11, 2.61). Children were less likely to meet MVPA recommendations if services played games with elimination components (OR 0.56, 95%CI 0.37, 0.86).ConclusionImprovements to service-level physical activity promotion practices, specifically the type of physical activity scheduled and the structure of games, may be an effective strategy to increase MVPA of children attending OSHC afterschool in NSW, Australia.

Physical Activity Promotion Attitudes and Practices Among Outpatient Physical Therapists: Results of a National Survey.

Physical activity (PA) promotion delivered by physical therapists is effective. However, little is known about how much PA promotion is integrated into outpatient US physical therapist practice. The purpose of this study was to determine the current PA promotion practices and factors that influence those practices among outpatient US physical therapists. A sample of outpatient US physical therapists from the Academy of Orthopaedic Physical Therapy and American Physical Therapy Association (APTA) Geriatrics completed an adaptive online survey that included questions related to PA promotion practices and factors that influence those practices. We dichotomized levels of PA promotion as regular and irregular. Multivariable logistic regression was used to determine what factors predicted regular PA promotion. A total of 522 individuals participated and 393 surveys were included in the analyses (75.3%). Most participants (58.5%) irregularly promoted PA and few reported always screening for patients' PA levels (12.7%). The strongest predictor of regularly promoting PA was screening for baseline PA (odds ratio = 5.07, 95% confidence interval = 2.23, 11.57). Physical therapists' own PA levels compared favorably to the US adult population and other health professionals and predicted PA promotion. Other factors related to capability, opportunity, and environment were predictors of PA promotion. Perceived lack of financial support from insurance companies, lack of support from clinical employers, and a perception of competing priorities were barriers to PA promotion. Despite being a public health priority, the majority of physical therapists surveyed infrequently screen for baseline PA and irregularly promote PA. Perceived financial barriers, lack of organizational support, and prioritizing other patient problems hinder PA promotion in the outpatient setting. Despite guidance from national and international governing bodies, US outpatient physical therapists do not regularly promote PA to patients and perceive financial constraints and competing priorities as key barriers. Professional and patient stakeholders should be involved in designing pathways to improve PA promotion practices among outpatient US physical therapists.

What happened next? Exploring the sustainability of a whole-of-school physical activity initiative

ABSTRACT Increasing physical activity (PA) opportunities in schools have emerged as a global priority. The ‘Active School Flag’ (ASF) is an example of an initiative that aims to promote participation in PA in school settings by achieving a physically educated and physically active school community. While there is some evidence of the short-term gains resulting from such initiatives, less is known about the medium and longer-term effects. Insight on the medium-term effects of the ASF can contribute to the literature on whole-of-school PA promotion. The purpose of the study was to determine the medium-term impact of the ASF initiative on whole-of-school PA promotion practices in Irish schools. Semi-structured interviews with lead teachers and/or principals in seven primary schools, who were awarded the ASF status more than two years prior to the interview, were conducted. Perspectives on how award of the ASF had influenced policy and practices related to PA promotion were explored. Specific examples of targeted projects within individual schools were examined with consideration of what aspects were sustained, who was involved and how they had evolved over time. Data were analysed inductively through a constant comparative approach. Results revealed that while some lasting changes were maintained in these schools, many threats to sustainability existed. The results provide insight into the medium-term impact of whole-of-school PA promotion that could be valuable for practitioners, policymakers, and researchers.

Active Health Care Providers’ Practices and Views on Counseling Patients to be Active

ABSTRACT It is of public health importance to identify strategies for increasing U.S. physical activity levels because of the strong relationship between physical activity and health. One strategy is by having health care providers prescribe physical activity to their patients. The purposes of this study were to assess health care providers’ physical activity levels, to evaluate knowledge of benefits of physical activity, to examine barriers to counseling physical activity to patients, and to determine whether a relationship exists between health care providers’ physical activity levels and barriers to physical activity counseling. Health care providers (N = 30) wore an accelerometer for 1 wk and completed the International Physical Activity Questionnaire and a physical activity counseling questionnaire. Ninety-three percent of providers met physical activity guidelines. Only 7% of providers reported knowing physical activity recommendations; however, 87% reported providing physical activity counseling to patients. The benefits of physical activity reported were maintaining overall health and reducing the risk for disease development. The physical activity counseling barriers reported were lack of time and patient interest. Among this active sample of health care providers, personal activity habits did not influence physical activity promotion practices with patients. The main physical activity counseling barriers reported were lack of time and lack of patient interest. More research is needed to determine whether this finding and the barriers of time and the perception of lack of patient interest persist among providers who are not as physically active. From a translational perspective, health care providers should be educated to promote physical activity for their patients. These education opportunities should occur through professional coursework and continuing education credits.

Practicing What They Preach? Physical Activity Promotion among Clergy

A key public health goal in the U.S. is to increase the number of people that engage in regular physical activity. Faith-based organizations are prominent in many communities, making them a viable partner in pursuit of this goal. As leaders of FBOs, clergy are uniquely positioned to promote physical activity to a large segment of the U.S. population. The purpose of this study was to examine factors associated with physical activity promotion among clergy. A convenience sample of clergy (N = 497) from the largest denominations in Pennsylvania completed web-based questionnaires about their physical activity promotion practices. Multiple logistic regression was used to calculate odds ratios of clergy promoting physical activity. Forty-five percent of clergy reported that they had promoted physical activity to their congregation during sermons and 14% reported promoting physical activity during one-on-one counseling. Notable findings were that clergy who were female, reported fewer chronic diseases, had more health-related education, and were meeting physical activity recommendations were more likely to promote physical activity. The results of this study indicate that gender, health status, health-related education, and engaging in regular physical activity may be important influences on whether clergy promote physical activity to their congregations. More research is needed to better understand additional characteristics of clergy who engage in physical activity promotion, as well as whether changes in physical activity behavior would lead to changes in physical activity promotion practices among clergy.

Initial Outcomes of a Participatory-Based, Competency-Building Approach to Increasing Physical Education Teachers' Physical Activity Promotion and Students' Physical Activity: A Pilot Study.

This study examined the initial effects of a participatory-based, competency-/skill-building professional development workshop for physical education (PE) teachers on the use of physical activity (PA) promotion practices (e.g., eliminating lines, small-sided games) and students' moderate-to-vigorous physical activity (MVPA). A total of 823 students (52.8% boys) wore accelerometers at baseline (fall 2015) and outcome (spring 2016) on PE and non-PE days. The System for Observing Fitness Instruction Time+ measured changes in PA promotion practices. Teachers ( n = 9) attended a 90-minute workshop prior to outcome data collection. Mixed-model linear regressions estimated changes in teacher practices and students' MVPA. Three of the nine targeted PA promotion practices changed in the desired direction (i.e., p < .05; increased motor content and lessons taught outdoors, reduced activities with lines), with three more teacher practices trending in the desired direction (i.e., reduced management time and activities with elimination, increased small-sided games). During PE, boys and girls increased MVPA by 2.0 (95% confidence interval [1.1, 3.0]), and 1.3 (95% confidence interval [0.5-2.0]) minutes, respectively. However, there were no statistically significant changes in boys' or girls' MVPA during the school day. Greater implementation of promotion practices by the PE teachers was associated with boys', but not girls', MVPA during PE. Girls in high- and low-implementing teachers' lessons experienced increases in MVPA, suggesting that even small changes in PA promotion practices can increase girls' MVPA during PE. Overall, the workshops were effective at increasing teachers' PA promotion and students' MVPA in PE. Other school-based strategies that complement and extend efforts targeting PE are recommended to increase children's total daily PA.

Physical Activity Promotion, Beliefs, and Barriers Among Australasian Oncology Nurses.

To describe the physical activity (PA) promotion practices, beliefs, and barriers of Australasian oncology nurses and gain preliminary insight into how PA promotion practices may be affected by the demographics of the nurses. . Cross-sectional survey. . Australia and New Zealand. . 119 registered oncology nurses. . Self-reported online survey completed once per participant. . Questions assessed the PA promotion beliefs (e.g., primary healthcare professionals responsible for PA promotion, treatment stage), PA benefits (e.g., primary benefits, evidence base), and PA promotion barriers of oncology nurses. . Oncology nurses believed they were the major providers of PA advice to their patients. They promoted PA prior to, during, and post-treatment. The three most commonly cited benefits of PA for their patients were improved quality of life, mental health, and activities of daily living. Lack of time, lack of adequate support structures, and risk to patient were the most common barriers to PA promotion. Relatively few significant differences in the oncology nurses' PA promotion practices, beliefs, and barriers were observed based on hospital location or years of experience. . Despite numerous barriers, Australasian oncology nurses wish to promote PA to their patients with cancer across multiple treatment stages because they believe PA is beneficial for their patients. . Hospitals may need to better support oncology nurses in promoting PA to their patients and provide better referral pathways to exercise physiologists and physiotherapists.

Insight from health professionals on physical activity promotion within routine diabetes care

AbstractThe aim of this qualitative study was to explore the views of health professionals on the current and future provision of physical activity promotion within routine diabetes care. Responses were collected from participants (n=23) in two phases. An online survey (Phase 1, n=16) and semi‐structured interviews (Phase 2, n=7) were used to explore the experiences of health professionals on the provision of physical activity promotion. Qualitative responses were analysed using Interpretative phenomenological analysis and categorised into themes and sub‐themes.Three main themes were identified: (1) current physical activity promotion practices; (2) delivery of physical activity promotion by health professionals; and (3) future physical activity promotion. Findings demonstrated that a lack of structure for physical activity promotion and ineffective behaviour change training made physical activity promotion within routine diabetes care challenging. Health professionals struggled to prioritise physical activity within routine consultations. They were clinically driven to provide physical activity advice to patients; however, they lacked the skills to elicit significant behaviour change. Five recommendations were presented to improve physical activity promotion within diabetes care: (1) having a key member of staff responsible for physical activity promotion; (2) access to a referral route for physical activity support; (3) inclusion of diabetes‐specific information in behaviour change training; (4) linking the delivery of physical activity promotion with clinical outcomes; and (5) using ‘champions’ to raise the profile of physical activity within the health service.Incorporation of these recommendations by health professionals and health boards may significantly improve the provision of physical activity promotion within routine diabetes care. Copyright © 2014 John Wiley &amp; Sons.

Physical Activity Promotion Among Oncology Nurses

Oncology nurses may be influential for providing physical activity guidance to cancer patients. The purposes of this study were to examine physical activity promotion practices of oncology nurses and to explore nurses' perceived benefits of physical activity for cancer patients and barriers to physical activity promotion. Two thousand e-mails were sent by a data service company to a random selection of oncology nurses throughout the United States with a link to a Web-based survey. To be eligible, nurses had to be currently seeing patients. Completed surveys were received from 274 oncology nurses. Most participants inquired about physical activity on at least some office visits (74.9%) and gave physical activity recommendations to 65.7% and 66.9% of on-treatment and posttreatment patients. "Lack of time" and that "patients are not interested" were the most prominent barriers identified by nurses, whereas perceived benefits for patients were rated favorably, with the exception of "reducing risk of recurrence." Almost all perceived benefits and barriers were correlated with physical activity promotion, with the strongest correlates being "unsure what to recommend" and "unsure that physical activity is safe." Although most oncology nurses frequently inquire about patient physical activity, they may be less apt to provide recommendations. A number of barriers and perceived benefits may influence physical activity promotion, especially concerning what to recommend and patient safety. Oncology nurses would benefit from education opportunities about the benefits of physical activity for survival outcomes and types of physical activity to recommend.

The relationship between physicians’ and nurses’ personal physical activity habits and their health-promotion practice: A systematic review

Background: Sedentary lifestyles are rising in many countries which has implications for global health. Health professionals are well placed to promote increased physical activity levels to their patients. Objective: To examine the relationship between physicians’ and nurses’ personal physical activity and their physical activity promotion practices. Methods: Cochrane Library, PubMed, MEDLINE, EMBASE, CINAHL, PsychInfo, British Nursing Index and four Chinese databases were searched to March 2011. Extracted data were verified by a second researcher. Results: Thirteen studies met the inclusion criteria and were cross-sectional surveys employing a variety of self-report questionnaires. The majority of studies found that a higher personal physical activity level was associated with higher physical activity-promoting practices, and that health professionals with positive attitudes towards physical activity were more likely to promote physical activity to their clients. Conclusion: The findings of this review need to be confirmed by well-designed large studies which employ validated measures of physical activity and physical activity-promoting practices and involve multivariate analyses to identify the relative contribution of personal physical activity levels to physical activity-promoting practices.

Use of physical activity as a health tool for cancer patients and oncologists

9634 Background: Regular physical activity can be beneficial to health for both patients and their providers. Research suggests that health care providers can potentially provide an important role in changing patients’ health behaviors. The purpose of this study is to (a) explore factors that influence whether or not oncologists recommend physical activity to their patients and (b) to examine physical activity levels of oncologists. Methods: 199 practicing medical and radiation oncologists throughout the United States responded to a mailed survey (response rate = 30%). Oncologists self-reported their physical activity promotion practices, their own physical activity behaviors, and provided demographic and practice related information. Results: Approximately 64% of oncologists reported inquiring about their patients’ physical activity on most or all visits. Further, 57% of oncologists reported regularly meeting American College of Sports Medicine guidelines for physical activity (i.e., 150 minutes of moderate or 60 minutes of vigorous physical activity per week). Potential predictors of physical activity promotion (i.e., age, ethnicity, number of years practicing, tumor types treated and own physical activity participation) were tested using univariate statistics. A logistic regression analysis indicated that number of years practicing (OR = 2.84, 95% CI = 1.465–5.521) and their own physical activity participation (OR = 1.87, 95% CI = 1.025–3.426) were both significant and independent predictors of physical activity promotion. No other factors were identified as predictors of physical activity promotion. Conclusions: Approximately half of oncologists do not meet public health physical activity guidelines and fewer than two thirds regularly inquire about the physical activity levels of their patients. Data from this study suggest that these findings are linked: inactive oncologists tend to promote physical activity less to their patients. More physical activity adoption by oncologists may ultimately lead to increased activity levels in their patients, leading to greater health benefits for both patients and providers. No significant financial relationships to disclose.