Physical Activity Promotion Programs Research Articles

Effects of substituting sedentary time with physical activity on body mass index in Japanese adults with Down syndrome: A cross-sectional study

Objectiveand Rationale: Obesity is a health challenge for adults with Down syndrome. Therefore, a physical activity promotion program is required to prevent or reduce obesity in adults with this condition. However, there is a lack of evidence of useful risk reduction initiatives. The objective of this study was to suggest a rationale for behaviors that should replace time of inactivity to reduce obesity in Japanese adults with Down syndrome. MethodsThe participants were adults with Down syndrome, aged 18–48 years, living in Japan. The snowball sampling method was used. To detect an effect size of 0.20 for body mass index using an F-test, 80 participants were required, generating a statistical power of 0.8 and a risk level of 0.05. Survey items included sex, age, height, weight, body mass index, and physical activity (min/d). Physical activity was categorized by intensity and further divided into ambulatory and non-ambulatory activities. The body mass index categories were compared using analysis of covariance. An isotemporal substitution model was used to confirm the interdependence of behaviors. ResultsHalf of the participants were obese, with a body mass index of 25 kg/m2 or higher. The obese group had significantly fewer light physical activity, moderate-to-vigorous physical activity, and ambulatory moderate-to-vigorous physical activity times than the non-obese group. Replacing 10 min of sedentary behavior with ambulatory moderate-to-vigorous physical activity was significantly associated with a lower body mass index. ConclusionsThis study suggests a rationale for behaviors that should replace time of inactivity to reduce obesity in adults with Down syndrome. Specifically, replacing 10 min of sedentary behavior with ambulatory moderate-to-vigorous physical activity time may contribute to obesity reduction.

Novel motivational interviewing-based intervention improves engagement in physical activity and readiness to change among adolescents with chronic pain.

Engaging adolescents with chronic pain in physical activities is challenging. Motivational interviewing (MI) combined with activity promotion may encourage teens to make behavioural changes. This research aimed to assess the feasibility and acceptability of our MI-based physical activity promotion programme, the M3 training. In our exploratory study with 35 adolescent-parent dyads, we evaluated the feasibility by enrolment, drop-out and retention rates. Acceptability of the M3 training was examined by adherence rates and participation experiences through open-ended questions. We also assessed changes in pain self-efficacy and readiness to change after the M3 training intervention. The M3 training was feasible with an adequate enrolment (77.8%) and retention (85.7%) rate. Both teens and parents found the M3 training acceptable and considered exercise and physical activity the most helpful elements of the programme (36% and 37%, respectively). While self-efficacy remained unchanged, we identified a significant increase in the readiness to change for adolescents and parents. M3 training improved physical activity engagement while prioritising adolescents' autonomy. Furthermore, it appears to be a clinically relevant approach and could result in a positive shift in readiness to change within a shorter timeframe. The preliminary version of the M3 training was reviewed and commented upon by the public (adolescents and adults). Adolescents who participated in this study were designing their own movement programme, considering their lived experiences. Participants' feedback was used to create the online version of the M3 training (which will be published elsewhere).

Pilot Study of the FitMoms2B Physical Activity Promotion Program Among Black Women With High-Risk Pregnancies

ObjectiveTo explore the feasibility of recruitment, adherence, and retention and the acceptability of the FitMoms2B physical activity promotion program and study measures among non-Hispanic Black women with high-risk pregnancies. DesignOne-arm pilot feasibility study. SettingA large regional high-risk prenatal clinic in the southeastern United States. ParticipantsNon-Hispanic Black women who had singleton, high-risk pregnancies at 16 to 23 weeks gestation with no contraindications to physical activity (N = 13). MethodWe evaluated the feasibility and acceptability of a multicomponent intervention, which included physical activity coaching, support from a workout partner, and an activity tracker. We also assessed the feasibility of study measures for future trials of the program. ResultsOf 179 patients screened, 20 were eligible, and 13 consented and enrolled (65%). Of the 13 participants, 9 completed data collection at Time Point (T) 1 (16–23 weeks gestation) and T2 (24–30 weeks), and 8 completed data collection at T3 (31 or more weeks). Adherence met expectations for coaching (63%), exercise with a workout partner (100%), and use of the activity tracker (92%). Acceptability was high (100%). ConclusionWe found that recruitment, retention, and adherence are feasible for the FitMoms2B physical activity promotion program. The program and study measures were acceptable to participants in our sample. We provide preliminary support for a randomized controlled trial to study physical activity promotion with virtual coaching, workout partner support, and activity tracking among Black pregnant women with high-risk pregnancies without contraindications to physical activity.

Physical activity and its correlates among school teachers in a semi-urban district of Nepal.

Regular physical activity (PA) is one of the effective strategies for mitigating non-communicable diseases, promoting healthy ageing, and preventing premature mortality. In South Asia, up to 34.0% of adults are insufficiently active, and up to 44.1% of adults in Nepal. We sought to assess self-reported PA status and its correlates among teachers in the semi-urban district of Nepal. A cross-sectional descriptive study was conducted among teachers at randomly selected public secondary schools in Bhaktapur, Nepal, from November 2018-April 2019. PA status was assessed in Metabolic Equivalent to task minutes per week using the International Physical Activity Questionnaire (IPAQ)-Long Form. Point estimates and odds ratios were calculated at a 95% confidence interval, and a p-value <0.05 was considered statistically significant. Among the 360 participants, the mean (SD) age was 40.3 (10.2) years, with 52.5% female participation. A low level of PA was seen among 11.9% (95% CI: 8.4-15.2) of teachers, and more than half (56.0%) of the activity was only moderate intensity. Domestic and garden work was the main contributor (43.0%) of total PA, while leisure time was the least (14.0%). Among the socio-demographic factors, only sex was significantly associated (p = 0.005) with PA. Participants living in locations with walkable areas were 3.4 times (95% CI: 1.6-7.3) more likely to be engaged in moderate-to-high level PA than those without. In our study, the point prevalence of insufficient PA among teachers working at public secondary schools was higher than the national point prevalence. PA promotion programs targeting sedentary populations like school teachers should be developed to reduce the point prevalence of insufficient PA.

Effects of a physical activity promotion programme on body composition in emerging adults with physical inactivity: a study protocol of a randomised controlled trial

IntroductionA dramatic decline in physical activity may occur in emerging adulthood because of a major transition over the course of a life. The potential for implementing structured behaviour modification strategies...

S10-4 A comparative evaluation of local governments’ roles in HEPA policy promotion in municipalities from 4 EU countries and Japan

Abstract Purpose Local governments’ engagement and performance in physical activity promotion is essential to try to reach the nationally and internationally planned population physical activity goals. However, currently, in most countries/settings, local HEPA policy monitoring and evaluation is largely voluntary and often too context specific, using instruments and methods tailored for that specific contexts. The aim of the Erasmus + Sport co-financed project LoGoPAS was to assess, promote and support local governments' involvement in HEPA (policy) promotion. Methods We used complementary qualitative methods (literature review, document analysis, stakeholders’ interviews, stakeholders’ meetings) to analyze and describe the legally binding roles and voluntary based activities of local governments in PA (policy) promotion in selected municipalities from Finland, France, Germany, Japan, and Romania. The data was compiled and presented comparatively between municipalities using an already validated policy monitoring &amp; evaluation tool, the CAPLA- Santé. Results The 5 selected municipalities were: Jyväskylä – Finland, Nice – France, Erlangen-Germany, Fujisawa – Japan, Cluj-Napoca – Romania. Following the methods described above and the chapters structure of the CAPLA- Santé we noticed a few similarities (e.g., the existence of a dedicated structure within the municipality, focus of the policy on several population sub-groups, heavy reliance on national or local budgets) and several differences (e.g., the different levels of evidence used in policy development and implementation, differences in the levels and means of monitoring and evaluation) between settings. There are examples of good practice from each setting, e.g. the strength of financing and evaluation in Jyväskylä, the focus on vulnerable populations in Nice, the collaborative approach in Erlangen, the diversity of physical activity promotion programs in Fujisawa and the opportunistic use of external (EU) financing in Cluj-Napoca. Conclusion EU and global Comparative analyses of HEPA policy using a validated instrument can offer insight into different approaches, support and stimulate the further engagement of local administrations in physical activity promotion. The efforts to monitor and evaluate physical activity policy should be intensified and potentially/ideally institutionalized.

O.2.1-1 Development of a physical activity prescription by practitioners using a modified-Delphi method

Abstract Purpose In Luxembourg, only a small minority of patients with chronic diseases regularly participate in therapeutical physical activity (PA) organised by dedicated associations. As recommended by the World Health Organisation (WHO), the practitioners should advise their patients to be active. However, Luxembourg practitioners only provide PA counselling to 1 in 4 of their patients. In this context, we aimed to develop a PA prescription (PAP) that would help efficiently promote PA by Luxembourg practitioners. Methods We used a modified-Delphi method which is an iterative survey method to obtain experts opinion with the aim of establishing a consensus. In the first phase, 17 independent experts (medical doctors, sport and exercise scientists, physiotherapists) developed an initial PAP model (the front page contained the PAP, and the reverse page the WHO recommendations, examples of good practice, and contact information) and its user guide. They also created a questionnaire evaluating the front page of the PAP using 39 5-point Likert-scale questions (ranging from totally disagree to totally agree), and the reverse page of the PAP and its user guide using one 5-point Likert-scale question each. In the second phase, this questionnaire was sent to a panel of Luxembourg practitioners. The questions that had not reached consensus among the panellists were sent anew, with the results concerning these items, for re-evaluation. Results The panel included sixty-six medical doctors. Of the 39 items on the front page of the PAP, six did not reach consensus and had to be re-evaluated in a 2nd round, in which 50 practitioners participated. After this 2nd round, four items still did not reach consensus and were made optional. As of the first round, a consensus was reached concerning the reverse page of the PAP and its user guide. Conclusion This modified-Delphi study has enabled the development of a consensual and valuable tool for the promotion of PA by practitioners for practitioners. At present, this tool has yet to be implemented, preferably in the framework of a national PA promotion program that addresses the public health challenges associated with physical inactivity. Support/Funding Source No funding.

Resilient communities? A qualitative interview study on sustaining a community project for health promotion among socially disadvantaged women during the first two years of the COVID-19 pandemic

ObjectivesWith the emergence of SARS-CoV-2 a global pandemic impacted on health promotion, overlapping and hindering efforts to overcome the worldwide pandemic of lacking physical activity (PA). Nationwide lockdowns, the closure of public facilities and sports venues, made it significantly more difficult to sustain community-run PA projects. In our case study, we explore (a) under which circumstances a community-basedhealth promotion project can be maintained during crisis and (b) what resilience capacities are important for community project coordinators to deal with those aggravating circumstances.MethodsOur case study looks at a community-based project called BIG, an exercise promotion project for women in difficult life circumstances. The case study was conducted between July 2021 and January 2022 with six municipalities implementing the project. Following a triangulation approach, we used minutes from short exchanges (n=17) with community project coordinators, information brochures about current exercise classes (n=6) and semi-structured qualitative interviews with project coordinators (n=6). All data were analyzed using the framework approach.ResultsAll sites showed a high level of willingness to adapt to the pandemic situation and to maintain the project as best as possible. Findings highlight that coordinators whose work routine was characterized by intense relationship management with participants and trainers demonstrated higher levels of adaptive and absorptive capacities on an individual level than coordinators of those communities with less social cohesion. At a community level, important resources for strengthening adaptive and absorptive resilience capacities were job security of the coordinators, sufficient financial resources to adapt classes to changing circumstances, and a supportive organizational climate in the coordinators’ working environment to allow them to react flexibly according to current pandemic regulations.ConclusionDespite high resilience capacities especially on an individual level, the low-threshold nature of the project could not be maintained at a pre-pandemic level. For many women, participation in the project was no longer possible at times. Awareness should be raised in communities that PA promotion programs are crucial to strengthening physical and mental health, even in times of crisis. It seems necessary to find permanent funding options for such programs, to integrate them permanently into municipal structures.

Validity of activity wristbands for estimating daily physical activity in primary schoolchildren under free-living conditions: School-Fit study.

The use of activity wristbands to monitor and promote schoolchildren's physical activity (PA) is increasingly widespread. However, their validity has not been sufficiently studied, especially among primary schoolchildren. Consequently, the main purpose was to examine the validity of the daily steps and moderate-to-vigorous PA (MVPA) scores estimated by the activity wristbands Fitbit Ace 2, Garmin Vivofit Jr 2, and the Xiaomi Mi Band 5 in primary schoolchildren under free-living conditions. An initial sample of 67 schoolchildren (final sample = 62; 50% females), aged 9-12 years old (mean = 10.4 ± 1.0 years), participated in the present study. Each participant wore three activity wristbands (Fitbit Ace 2, Garmin Vivofit Jr 2, and Xiaomi Mi Band 5) on his/her non-dominant wrist and a research-grade accelerometer (ActiGraph wGT3X-BT) on his/her hip as the reference standard (number of steps and time in MVPA) during the waking time of one day. Results showed that the validity of the daily step scores estimated by the Garmin Vivofit Jr 2 and Xiaomi Mi Band 5 were good and acceptable (e.g., MAPE = 9.6/11.3%, and lower 95% IC of ICC = 0.87/0.73), respectively, as well as correctly classified schoolchildren as meeting or not meeting the daily 10,000/12,000-step-based recommendations, obtaining excellent/good and good/acceptable results (e.g., Garmin Vivofit Jr 2, k = 0.75/0.62; Xiaomi Mi Band 5, k = 0.73/0.53), respectively. However, the Fitbit Ace 2 did not show an acceptable validity (e.g., daily steps: MAPE = 21.1%, and lower 95% IC of ICC = 0.00; step-based recommendations: k = 0.48/0.36). None of the three activity wristbands showed an adequate validity for estimating daily MVPA (e.g., MAPE = 36.6-90.3%, and lower 95% IC of ICC = 0.00-0.41) and the validity for the MVPA-based recommendation tended to be considerably lower (e.g., k = -0.03-0.54). The activity wristband Garmin Vivofit Jr 2 obtained the best validity for monitoring primary schoolchildren's daily steps, offering a feasible alternative to the research-grade accelerometers. Furthermore, this activity wristband could be used during PA promotion programs to provide accurate feedback to primary schoolchildren to ensure their accomplishment with the PA recommendations.

MHealth Interventions to Promote Physical Activity of Adults in Korea: Health Equity-Focused Systematic Review

Objectives: This study systematically review the existing literatures to identify the effectiveness of physical activity promotion programs using mobile health (mHealth) among Korean adults, with a focus on factors affecting health equity.Methods: To search for studies published in the past 10 years (from January 2013 to April 2023), Korean DBs (KoreaMed, KMBASE, KISS, RISS) were used. Hedge’g values were calculated to present uniform quantitative effect estimates for each study and to present pooled effect sizes for the same variables. Additionally, GRADE was used to assess the certainty of evidence and the review was conducted using the PROGRESS-Plus framework for health equity review.Results: Of the 1,204 literatures, 15 literatures were selected. Six prevention-based mHealth interventions and nine management-based mHealth interventions had significant effect sizes on multiple physical activity-related variables. A review of the PROGRESS-Plus factors revealed that personal characteristics (age, illness), occupation, and gender were the most frequently considered factors affecting health equity, while race, ethnicity, culture, language, religion, features of relationships , and time-dependent relationships were not considered.Conclusions: The results of the current study confirm the potential of mHealth-enabled physical activity promotion interventions to manage health and prevent disease in Korean adults. It also highlights the need to consider health equity in all phases of research design, implementation, and evaluation to provide opportunities for inclusive participation of a broad range of populations.

Effect of physical activity promotion program on adherence to physical exercise among patients with type II diabetes in North Shoa Zone Amhara region: a quasi-experimental study

BackgroundDiabetes is a significant global public health issue that necessitates self-management. However, this is difficult to put into practice and requires a new approach. The purpose of this study was to assess the effects of a physical activity promotion program on adherence to recommended physical activity and lessons to improve self-management.MethodsA quasi-experimental study was conducted from January 2020 to February 2021 at North Shoa Zone Public Hospital. The study enrolled 216 type II diabetic patients from four public hospitals. Data were entered into Epi Data V.3.1 and analyzed using SPSS version 22. Data were presented as means of standard deviations for continuous variables and percentages for categorical variables. Intervention and control groups were compared before and after intervention using independent t-tests. A p-value less than 0.05 was considered significant for all statistical tests.ResultsA total of 216 type II diabetics participated in this study. Physical activity promotion programs increased adherence to the recommended number of days and duration (spending time) of physical activity (p < 0.0001). Participants who engaged in the physical activity promotion program significantly increased the mean scores for exercising moderate-intensity activities and spending time (p < 0.05), walking for at least 10 min continuously and spending time (p < 0.05), exercising moderate-intensity recreational activities and spending time (p < 0.05).There was a significant reduction in mean fasting blood glucose after participating in a physical activity program (p < 0.05).ConclusionThis study demonstrates that a physical activity promotion program makes a significant difference in patient compliance with recommended physical activity and effectively improves patient glycemic control. Health care providers should integrate physical activity programs into existing systems as a common therapeutic service. Primary care platforms such as health posts and health centers can play a key role in integrating health promotion programs to improve self-management behaviors.

The application of social cognitive theory (SCT) to the mHealth diabetes physical activity (PA) app to control blood sugar levels of type 2 diabetes mellitus (T2DM) patients in Takalar regency.

Background: People with Diabetes Mellitus (DM) experience an increased health risk due to reduced physical activities. Cellular health technology (mHealth) offers a way that people with DM can engage in more complex physical activities. Social Cognitive Theory (SCT) is the most commonly used theory in increasing physical activities. This study aims to find out the application of SCT in mHealth app to control blood sugar (GDP, HbA1C) of T2DM patients. Design and Method: This present study used a mixed method sequential explanatory design related to the application of mHealth Diabetes Physical Activity in Takalar Regency. The first step was to use qualitative methods with rapid assessment procedures in developing the application of SCT in mHealth. The second step was to validate and test the app through usability testing. The last step was intervening the development of mHealth app using quasi-experimental designs related to the influence of mHealth Diabetes Physical activity interventions in controlling blood sugar (GDP, HbA1c) in T2DM patients. The first group was the mHealth diabetes Physical activity (PA) intervention group; the second intervention group was a group monitored through Whatsapp group; and the third group was the group with physical activity module but without monitoring. Expected outcome: The findings of this study are expected to be the basis of evidence for nurses holding DM programs to make relevant policies and design an app-based physical activity promotion programs for T2DM patients. Conclusion: This protocol qualifies to be the basis of evidence for nurses holding Diabetes Mellitus programs in improving health services through IT-based health promotion programs.

Tele-Physical Activity Promotion Program among College Students during the COVID-19 Pandemic

Background and Objectives: During the COVID-19 pandemic, lockdown and distance learning affected physical activity (PA) levels among college students. The aims were to assess the effectiveness of a tele-health PA promotion program for 6 weeks, among junior college students, on PA level and on the proportion of physically active students during the pandemic. Materials and Methods: A pre-post study design was conducted on 46 students aged 19 (±0.9) years old in Saudi Arabia. The study consisted of online introductory and educational PA classes, followed by a 6-week course during which students received daily online PA promotive messages. Wilcoxon signed-rank and McNemar's tests were used to measure the mean differences in PA level and the changes in proportion of physically active students before and after the program, respectively. Results: The proportion of students who perform walking increased significantly from 47.4% to 68.4% (p = 0.02), while the number of students who perform moderate PA in their leisure time increased significantly from 38.9% to 69.4% (p = 0.02). No significant differences were detected between other PA levels. Conclusions: This program is effective in encouraging more college students to be physically active, but not in improving PA levels. Larger scale studies using PA objective measurement tools are needed.

Do executive functions predict physical activity behavior? A meta-analysis

BackgroundExecutive functions (EFs) are important determinants of health behaviors. In the present study, a meta-analysis was conducted to investigate the relationship between EFs and physical activity (PA) behavior.MethodsSystematic searches were carried out in PsycInfo, MEDLINE, and SPORTDiscus databases throughout April 2021. Prospective empirical studies conducted with general healthy populations across the lifespan, which reported the relationship between baseline EFs and later PA behavior were selected.ResultsEight studies were found eligible. Results of the multilevel meta-analysis revealed a small but significant total effect size for EFs on PA behavior of z = 0.12. High heterogeneity was observed among studies. When potential moderators were tested, residual heterogeneity remained significant and the effects of the moderators were not significant. The effect size dropped when accounted for publication bias.ConclusionsDespite limitations, the study provided evidence for EFs’ determinant role on PA behavior. More research is however encouraged to inform PA promotion programs that are well-prepared for individual differences in EFs.

What Influences Children's Physical Activity? Investigating the Effects of Physical Self-Concept, Physical Self-Guides, Self-Efficacy, and Motivation.

Physical fitness self-concept (PFSC) is an important predictor of motivation and physical activity in children. Recent studies revealed that not only PFSC but also its interplay with perceptions of one's ideal and ought physical fitness self are related to motivation and physical activity. As the meaning of ideal and ought selves in children is yet unclear, this study aimed to investigate how PFSC, ideal physical fitness self, and ought physical fitness self are related to children's motivation and physical activity. Six hundred forty-five children (Mage = 8.87years) filled out questionnaires twice with an interval of approximately 8 months. Polynomial regression with response surface analyses and mediation analyses was conducted. Results showed that PFSC, rather than ideal and ought self-perceptions, is associated with autonomous motivation, self-efficacy, and physical activity. The relationship between PFSC and physical activity was mediated by self-efficacy. Findings indicate that physical activity promotion programs should include PFSC and self-efficacy enhancement in childhood.

Are adolescents' physical activity and body-related factors associated with medically attended injuries?

Injuries are the major cause of disability and death during adolescence, representing a significant public health burden among youth. Body-related factors such as body composition and cardiovascular fitness (CVF) may affect adolescents' vulnerability to injuries. As evidence is lacking, we aimed to explore the associations of medically attended injuries with adolescents' physical activity (PA) and body-related factors, and whether these associations are modified by age, gender and family affluence. We used data on 888 11- to 15-year-old adolescents (mean age = 13.5, 56% boys) from the Health Behaviour in School-aged Children study conducted in 2018 in Slovakia. We used binary logistic regression analysis to assess the association of medically attended injuries with adolescents' PA and body-related factors (body composition, CVF), considering age, gender and family affluence. Adolescents were more likely to report medically attended injuries if they were physically very active (odds ratio/confidence interval OR/CI:2.76/1.83-4.15) or active (OR/CI:1.91/1.27-2.87) rather than inactive. Body-related factors were not associated with medically attended injuries among adolescents. Moreover, age, gender and family affluence did not modify the association of medically attended injuries with adolescents' PA and body-related factors. The only exception was the modifying effect of gender: the association of medically attended injuries with being very active was stronger in boys (OR/CI: 3.04/1.32-6.99). Very physically active adolescent boys are the most vulnerable group of adolescents in terms of injuries. PA promotion programmes should further consider gender-specific strategies aimed at preventing injuries.

Associations Between Obesity, Rural-Urban Continuum Codes, And Physical Activity Program Preferences Among Breast Cancer Survivors

PURPOSE: Many cancer survivors in rural areas with obesity fail to meet the American College of Sports Medicine physical activity (PA) guidelines. PA promotion programs are needed for these populations. This study examined the associations between obesity, rural-urban continuum (RUCC) codes, and PA program preferences. METHODS: Physically inactive breast cancer survivors (N=222) completed the baseline assessment for a randomized controlled PA trial including surveys to assess PA program preferences (i.e., location, exercise counseling source, exercise counseling delivery, exercise type [walking vs yoga], program type [aerobic vs resistance training], supervised vs unsupervised exercise, individual vs group exercise, flexible vs scheduled, amount willing to pay for exercise program, distance willing to travel, and distance willing to travel if gas costs were covered). Chi-Square analyses using dichotomized variables were conducted. Obesity was defined as body mass index ≥ 30. RUCC codes were classified as metro [RUCC=1 and3] vs non-metro [RUCC=6]. RESULTS: Participants were primarily white (85%), non-Hispanic (98%), and employed (71%) with an average age of 54.4 ± 8.5 years; half (51%) were obese. Most resided in metro areas with <250,000 population (RUCC=3; 73.6%) while the remaining resided in metro areas with >1 million population (RUCC=1; 22%) or nonmetro with 2,500-19,999 population (RUCC=6, 5%). When compared with non-obese, survivors with obesity were more likely to prefer exercise counseling from a personal trainer rather than a cancer exercise specialist, health club exercise specialist, or other cancer survivor (44% of non-obese vs. 57% of obese, p=.03). RUCC was associated with the farthest distance willing to travel (≥16 miles acceptable to 95% of RUCC 1 and 3 vs. 5% of RUCC 6, p<.001) and farthest distance willing to travel if gas costs were covered (≥16 miles acceptable to 42% of RUCC 1 and 3 vs 4% of RUCC 6, p=.027). No other preferences were associated with obesity or RUCC. CONCLUSIONS: Exercise counseling source and distance traveled are preferences associated with obesity or metro vs. nonmetro residency. Future PA programs should consider these factors along with potential reach and access concerns when targeting breast cancer survivors with obesity or living in nonmetro areas.

P02-02 Evaluating community-based programmes for health promotion: a novel approach considering the complexity perspective

BackgroundFor the past decade, community-based programmes have been a popular strategy for physical activity promotion. The implementation of these programmes is a complex process, characterized by (a) objectives that vary locally, (b) adaptions to the programme over time in response to a community's shifting needs, challenges and opportunities, (c) emergent outcomes, and (d) non-linear causality. This poses several challenges for evaluation, as commonly used evaluation designs mainly focus on predetermined programme components and outcomes. Such a traditional evaluation approach may overlook necessary but unanticipated programme developments or outcomes and provide limited opportunity to learn from these. The aim of this study was to develop a novel evaluation approach that considers the complexity perspective, in order to evaluate a large community-based programme for children's physical activity and health promotion in the Netherlands.MethodsAn exploratory review of theoretical and methodological literature regarding community-based health promotion, complexity theory, developmental evaluation and theory based evaluation was conducted. Based on this review a novel evaluation approach was developed.ResultsThe developed evaluation framework focusses on elements of the complex and adaptive implementation process of community-based health promotion. These include the local programme theory, implementation, adaption, the influence of context and feedback loops, and intended as well as emergent and unintended outcomes. By studying each of these elements in practice using innovative qualitative methods, including Ripple Effects Mapping and the Critical Event Card tool, principles that guide effective health promotion across community contexts can be extracted. Practice-based knowledge can subsequently be validated in other contexts.ConclusionsThe proposed evaluation approach aims to inform both research and practice (local and national programme planners and policy makers), by considering the implementation of community-based programmes as a complex process in evaluation. Using this evaluation approach will provide insight in how community-based health promotion programmes impact communities, and which mechanisms underly success or failure. The proposed evaluation approach may be relevant for other physical activity promotion programmes or policies. Since considering complexity in evaluation is a relatively new challenge in public health, we believe it is essential to share and deliberate on innovative evaluation approaches and methods.

O3-2 Evaluation of implementation and impact of a national mass media campaign to promote active lifestyles in Portugal: ‘Follow the Whistle: Physical Activity is Calling You'

Abstract Background Portugal has one of the highest rates of physical inactivity in Europe. To raise the profile of physical activity (PA) among adults, the Portuguese National Physical Activity Promotion Program of the Directorate-General of Health developed and implemented a national mass media campaign in 2019 named ?Follow the Whistle?. The campaign was based on social marketing principles and behavior change theory, namely the COM-B model, and was developed through formative research. We aim to describe the implementation process and short-term impact evaluation data. Methods ‘Follow the Whistle' was launched in June 2019 and continued for 4 weeks (TV, Radio, Online and Cinema, newspapers, outdoors). Pre (n = 878, 57%women) and post (n = 1319, 58%women) independent adult population samples were used to assess campaign impact. Participants were recruited through the mailing list of a Portuguese mutual insurance company, a network from across Portugal. The online questionnaire comprised socio-demographic factors, campaign awareness and recall, and psychosocial and behavioral measures linked to the four targets of the COM-B model, including items to assess perceived capability for physical activity(C), perceived opportunity for practice/ ease of integration of PA in daily living(O), motivation for PA practice(M) and behavior(B) assessed with IPAQ and the Activity Choice Index. Results Pre-and post-campaign samples were broadly demographically similar. Campaign recall increased significantly from 1% to 24% in prompted tagline recall (1/3 at post-campaign correctly recalled specific campaign images). All the targeted COM-B indicators changed in the expected direction, suggesting increases in perceived capability to engage in PA, perceived daily opportunities for being physically active, and in motivation (considering PA as fun, important, and compatible with other important things in life) (all p &amp;gt; 0.05). Results from PA behavior measures revealed increases only for vigorous activities (p &amp;gt; 0.001). Conclusions The GAPPA recommends the creation of active societies starting with best-practice community-wide communications campaigns. Although one focus of the ?Follow-the whistle? (i.e. promotion of active transport and incidental everyday forms of physical activity) was not entirely achieved (i.e. changes only in vigorous activities), the initial campaign objectives of increases in awareness, and influencing intermediate outcomes were achieved. Further campaign waves are planned for future years.

Developing practice guidelines to integrate physical activity promotion as part of routine cancer care: A knowledge-to-action protocol.

BackgroundCancer is a leading cause of disease burden worldwide and the first cause of mortality in Canada with 30.2% of deaths attributable to cancer. Given aging of the population and the improvement of prevention and treatment protocols, the number of cancer survivors is steadily increasing. These individuals have unique physical and mental health needs some of which can be addressed by integrating physical activity promotion into ongoing and long-term care. Despite the benefits of being active, delivery of PA programs for cancer patients in both clinical and community settings remains challenging. This knowledge-to-action protocol–called Kiné-Onco–aims to develop a practice guideline for the delivery, implementation, and scaling-up of cancer-specific physical activity promotion programs and services in clinical and community settings located in Québec, Canada.MethodThe Kiné-Onco project involves knowledge synthesis of scientific and grey literature to establish the benefits and added value of physical activity for cancer patients and survivors, describes current practices in delivering physical activity programs, analyses quantitative data from electronic health records (EHR) of patients participating in a novel hospital-based physical activity program, collects and analyses qualitative data from patients and healthcare providers interviews about lived experience, facilitators, and barriers to physical activity promotion, outlines deliberative workshops among multidisciplinary team members to develop implementation guidelines for physical activity promotion, and summarizes a variety of knowledge transfer and exchange activities to disseminate the practice guidelines.DiscussionThis paper describes the protocol for a knowledge-to-action project aimed at producing and sharing actionable evidence. Our aim is that physical activity promotion programs and services be scaled up in such a way as to successfully integrate physical activity promotion throughout cancer treatment and survivorship in order to improve the physical and mental health of the growing population of individuals having received a cancer diagnosis.