Physical Activity Promotion Programs Research Articles

Increasing Life-Space Mobility in Community-Dwelling Older Persons With Cognitive Impairment Following Rehabilitation: A Randomized Controlled Trial.

Community-dwelling older persons with cognitive impairment (CI) following discharge from geriatric rehabilitation are at high risk of losing life-space mobility (LSM). Interventions to improve their LSM are, however, still lacking. The aim of this study was to evaluate the effects of a CI-specific, home-based physical training and activity promotion program on LSM. Older persons with mild-to-moderate CI (Mini-Mental State Examination: 17-26 points) discharged home from rehabilitation were included in this double-blinded, randomized, placebo-controlled trial with a 12-week intervention period and 12-week follow-up period. The intervention group received a CI-specific, home-based strength, balance, and walking training supported by tailored motivational strategies. The control group received a placebo activity. LSM was evaluated by the Life-Space Assessment in Persons with Cognitive Impairment, including a composite score for LSM and 3 subscores for maximal, equipment-assisted, and independent life space. Mixed-model repeated-measures analyses were used. One hundred eighteen participants (82.3 ± 6.0 years) with CI (Mini-Mental State Examination: 23.3 ± 2.4) were randomized. After the intervention, the home-based training program resulted in a significant benefit in the Life-Space Assessment in Persons with Cognitive Impairment composite scores (b = 8.15; 95% confidence interval: 2.89-13.41; p = .003) and independent life-space subscores (b = 0.39; 95% confidence interval: 0.00-0.78; p = .048) in the intervention group (n = 63) compared to control group (n = 55). Other subscores and follow-up results were not significantly different. The home-based training program improved LSM and independent life space significantly in this vulnerable population. Effects were not sustained over the follow-up. The program may represent a model for improved transition from rehabilitation to the community to prevent high risk of LSM restriction.

Physical activity and health promotion programs in the workplace: A meta-analysis of effectiveness in European organizations

Scientific literature shows numerous examples of the influence of physical activity on people’s health. Other reviews have focused on physical activity in the workplace, but none of them deals exclusively with European companies and interventions. The aim of this study was to analyze the effects of physical activity and health interventions conducted within European companies. A meta-analysis was conducted, which assessed 661 relevant studies found through both electronic and manual search. An electronic search was conducted through the use of several databases. A manual search was conducted through the consultation of references from other reviews and experts who are a reference in the field of physical activity, health and companies. Once the main variables were clustered, the effect size of such interventions was calculated. The methodological quality was rated using the PEDro scale, based on the Delphi list. In 18 analyzed studies, a small effect of the programs over the variables, in general, was found (ES = 0.21; CI 95% 0.07–0.35). Additionally, the effect of the interventions on some of the predominant variables was also small. These results suggest a high variability. It would be useful to develop more interventions in the future, as well as to obtain global health indicators that may help clear such variability and move toward designing successful approaches.

Exploring maintenance of physical activity behaviour change among people living with and beyond gastrointestinal cancer: a cross-sectional qualitative study and typology

ObjectivesIn the last decade, there has been a rapid expansion of physical activity (PA) promotion programmes and interventions targeting people living with and beyond cancer (LWBC). The impact that these...

Trajectories of health-related quality of life among people with a physical disability and/or chronic disease during and after rehabilitation: a longitudinal cohort study

PurposeTo identify Health-related Quality of Life (HR-QoL) trajectories in a large heterogeneous cohort of people with a physical disability and/or chronic disease during and after rehabilitation and to determine which factors before discharge are associated with longitudinal trajectory membership.MethodsA total of 1100 people with a physical disability and/or chronic disease were included from the longitudinal cohort study Rehabilitation, Sports and Active lifestyle. All participants participated in a physical activity promotion programme in Dutch rehabilitation care. HR-QoL was assessed using the RAND-12 Health Status Inventory questionnaire at baseline (T0: 3–6 weeks before discharge) and at 14 (T1), 33 (T2) and 52 (T3) weeks after discharge from rehabilitation. A data-driven approach using Latent Class Growth Mixture modelling was used to determine HR-QoL trajectories. Multiple binomial multivariable logistic regression analyses were used to determine person-, disease- and lifestyle-related factors associated with trajectory membership.ResultsThree HR-QoL trajectories were identified: moderate (N = 635), high (N = 429) and recovery (N = 36). Trajectory membership was associated with person-related factors (age and body mass index), disease-related factors (perceived fatigue, perceived pain and acceptance of the disease) and one lifestyle-related factor (alcohol consumption) before discharge from rehabilitation.ConclusionsMost of the people who participated in a physical activity promotion programme obtained a relatively stable but moderate HR-QoL. The identified HR-QoL trajectories among our heterogeneous cohort are disease-overarching. Our findings suggest that people in rehabilitation may benefit from person-centred advice on management of fatigue and pain (e.g. activity pacing) and the acceptance of the disability.

A social network analysis approach to group and individual perceptions of child physical activity.

Child physical activity (PA) is influenced by social environment. Self-perception and perception of others' behaviors may impact health behaviors such as PA. This study examines associations between child networks, perception of their own PA and the network's perception of their PA. Children (n = 89, M age = 10.00, SD = 1.34) at a summer care program reported demographics (54% female; 46% Black), PA, and physical skill competency. Children indicated up to five people they interacted with the most while at the program and how active they perceived each person to be. Multilevel modeling was used to determine significant associations between skill competency, network measures, and child's perception of their own PA, the network's perception of their PA, and the absolute difference between the two. Children perceived themselves to be more physically active if they perceived their friends were more physically active. Children who were central in the network and more physically competent were perceived as more active by their peers. Absolute differences between self-reported and network perceived PA were significantly larger for females. This work builds on understanding of how network position may impact child PA perceptions at summer care programs. Implications of these perceptions for PA promotion programs are discussed.

Effect of An Online Physical Activity Promotion Program and Cardiovascular Symptoms Among Asian American Women at Midlife.

Despite an increasing number of online programs to promote physical activity, they have rarely been evaluated for their effects on cardiovascular symptoms of racial/ethnic minority women at midlife. This study aimed to determine the preliminary efficacy of a newly developed online program for physical activity promotion on cardiovascular symptoms of Asian American midlife women. This study was a pilot repeated-measures randomized controlled trial (pretest/posttest) among 26 Asian American midlife women. The variables were measured using multiple instruments on background features, physical activity, and cardiovascular symptoms at three points of time (baseline, after 1 month, and after 3 months). Linear mixed models were used to analyze the data. The prevalence and severity of cardiovascular symptoms did not show a statistically significant group-time interaction. However, the increase in lifestyle physical activity over time was significant only among the intervention group (Δ = 0.49, P = .016). The results supported the program's preliminary efficacy on lifestyle physical activity for Asian American women at midlife, but not on cardiovascular symptoms.

Using system mapping to help plan and implement city-wide action to promote physical activity.

Background: There is growing interest in conceptualising public health problems such as physical inactivity as the outcome of multiple interacting factors within complex systems. A systems approach includes consideration of the indirect as well as direct impacts of interventions, the contexts within which they take place, the relations between the multiple factors at play, and the ways in which systems adapt in response to changes. This study involved working with stakeholders involved in a city-wide physical activity promotion programme in Derby, UK to investigate whether a conceptual map of the local physical activity system could be a useful tool to help improve the planning and implementation of the programme.Methods: We produced draft conceptual maps of the major modifiable drivers of physical activity in the city, based on the existing literature on determinants and correlates of physical activity, then refined them in a series of stakeholder meetings. The maps were used to explore ways in which the existing programme took a systems approach, and how it might be enhanced. Semistructured interviews were subsequently undertaken with stakeholders to assess their views on the contribution of the mapping approach.Results: Feedback from stakeholders described the mapping as valuable, especially in helping to identify the limitations of the original approach taken in the city.Conclusions: Even a very simple application of systems thinking can be a useful tool for disaggregating the key factors driving a system, helping to identify areas that merit greater attention, and supporting effective action.Significance for public healthThis paper has shown the value of using systems mapping to help stakeholders interested in complex public health problems take a broader view of the topic. This includes disaggregating the key factors driving a system, helping to identify areas that merit greater attention, and supporting effective action. This approach can be applied to any complex public health problem.

Comparison Of Handgrip Strength Test Values From International Cohorts Of Normal And Active Older Adults

The hand-grip strength test (HST) is one of the most utilized tests to measure muscle strength in older adults. It has been used to assess sarcopenia and fragility in older adults’ populations. PURPOSE: The aim of this study is to compare HST data from active older adults engaged in a physical activity promotion program in Spain with normative values of the general population in the same age ranges in Colombia (Ramírez-Vélez et al., 2019) and South Korea (Yoo et al., 2017). METHODS: 1,862 older adults aged ≥60 years old who participated in a physical activity promotion program were evaluated with the HST measured with a dynamo-meter. For the comparison with the other international cohorts [Colombian NC=5237 (≥60) and South Korean NSK=935 and 147 (≥65 and ≥80, respectively)], we divided the study by gender (W = women and M = men) and by age ranges (≥60=1, ≥65=2 ≥80=3). From our 1,862 sample, we included all of them in 1 (W=1632 and M=230), 1840 in 2 (W=1608, M=232) and 807 in 3 (W=695, M=112). RESULTS: Sample (n) and population (NSK and NC) averages HST vales (kg) were obtained in the three age groups (1, 2, and 3). The means were 1 = n (W:20.3; M:34.2) and N (W:16.7; M:26.7); 2 = n (W:19.8; M:33.1) and N (W:20.5; M:33.6); and 3 = n (W:18.9; M:31.1) and N (W:16.7; M:26.9). The Cohen's d effect size as the standardized mean difference between n and N using the standard deviation of N due to the large sample size was calculated. The results were as follows: 1 = (W:0.63; M:0.88); 2 = (W:-0.14; M:-0.07); and 3 = (W:0.48; M:0.70). CONCLUSION: The comparison shows that our sample data obtained higher values in HST by gender as well as by age, with moderate (0.63) to high (0.88) effect sizes when compared to Colombian data over 60 years old. The comparison with South Korean age groups shows that there are no differences when comparing our sample data with over 65 years data however the effect sizes are moderate when comparing older age groups (≥80). These findings suggest that physical activity could be an optimal therapeutic treatment against the muscle lost assessed with the HST even in older adults aged ≥80 years old.

Efficacy of an Internet-Based Program to Promote Physical Activity and Exercise after Inpatient Rehabilitation in Persons with Multiple Sclerosis: A Randomized, Single-Blind, Controlled Study.

Background: Multimodal rehabilitation improves fatigue and mobility in persons with multiple sclerosis (PwMS). Effects are transient and may be conserved by internet-based physical activity promotion programs. Objective: Evaluate the effects of internet-based physical activity and exercise promotion on fatigue, quality of life, and gait in PwMS after inpatient rehabilitation. Methods: PwMS (Expanded Disability Status Scale (EDSS) ≤ 6.0, fatigue: Würzburg Fatigue Inventory for Multiple Sclerosis (WEIMuS) ≥ 32) were randomized into an intervention group (IG) or a control group (CG). After rehabilitation, IG received 3 months of internet-based physical activity promotion, while CG received no intervention. Primary outcome: self-reported fatigue (WEIMuS). Secondary outcomes: quality of life (Multiple Sclerosis Impact Scale 29, MSIS-29), gait (2min/10m walking test, Tinetti score). Measurements: beginning (T0) and end (T1) of inpatient rehabilitation, 3 (T2) and 6 (T3) months afterwards. Results: 64 of 84 PwMS were analyzed (IG: 34, CG: 30). After rehabilitation, fatigue decreased in both groups. At T2 and T3, fatigue increased again in CG but was improved in IG (p < 0.001). MSIS-29 improved in both groups at T1 but remained improved at T2 and T3 only in IG. Gait improvements were more pronounced in IG at T2. Conclusions: The study provides Class II evidence that the effects of rehabilitation on fatigue, quality of life, and gait can be maintained for 3–6 months with an internet-based physical activity and exercise promotion program.

The Associations Between Self-Perceived Actual and Ideal Body Sizes and Physical Activity Among Early Adolescents.

This study examined the association between self-perceived actual and ideal body sizes and objectively assessed moderate-to-vigorous physical activity (MVPA) among adolescents, controlling for puberty, fat mass index, and sex. A secondary objective was to explore the association between objectively assessed fat mass index and MVPA. Participants were 438 early adolescents (Mage = 11.61, SD = 0.92). Participants selected body sizes that represented their self-perceived actual and ideal bodies. Participants then wore an accelerometer for 1 week to assess MVPA. Polynomial regression analysis with response surface methods was used to explore MVPA in relation to the discrepancy and agreement (ie,no discrepancy) between self-perceived actual and ideal body sizes. When self-perceived actual and ideal body sizes were in agreement and represented smaller and larger bodies, MVPA was low. Participants with similar self-perceived actual and ideal bodies in the middle of the body-size spectrum demonstrated the highest levels of MVPA. The direction and degree of the discrepancy between self-perceived actual and ideal bodies were not significantly associated with MVPA. Fat mass index was significantly and negatively associated with MVPA. These findings may inform physical activity promotion programs and provide methodological contributions to the study of how body image and MVPA are related.

Physical activity as a tool for health promotion: the evolution of international strategies and interventions.

Physical activity (PA) has a great potential impact in the prevention and control of non-communicable diseases. However, epidemiologic data reporting a high percentage of inactive people, still indicate a scarce perception of PA benefits. Therefore, in the past decades, a number of documents has been produced by international organizations with the aim of changing policies and institutional actions towards the promotion of PA. Several actions have been put in place and an evolution process in international strategies for PA promotion is ongoing. Nevertheless, there is a need to continue updating these policies in light of new knowledge about evidence-based PA health effects. A stimulating discussion about effective PA promotion programs is useful for future planning of interventions. The aim of this work is to report the evolution of international strategies aimed to PA promotion, from early PA recommendations, to the recent WHO Global Action Plan on Physical Activity 2018-2030.

Accelerometer-assessed outdoor physical activity is associated with meteorological conditions among older adults: Cross-sectional results from the OUTDOOR ACTIVE study.

Meteorological conditions are potential determinants of physical activity (PA). A profound understanding of the determinants of PA behaviour is required for PA promotion. This study examined the association between accelerometer-assessed PA and meteorological conditions among older adults. This cross-sectional study included data of 577 adults aged 65-75 years living in Bremen, Germany (52% female; 3278 days). PA was measured with accelerometers for seven consecutive days (10/15-08/16). A threshold of 240 lx was used to differentiate between outdoor physical activity (OPA) and indoor physical activity (IPA). Linear mixed models estimated the association between PA (daily accelerometer counts per minute (CPM)) and meteorological factors (temperature, cloud cover, wind, and no precipitation) derived by principal component analysis. The analyses showed associations between PA in CPM and the meteorological factors temperature (93.7; 95%-CL: 64.9, 122.5) and no precipitation (48.4; 95%-CL: 19.8, 77.0) in women and wind (-40.3; 95%-CL: -59.7, -20.8) and no precipitation (30.1; 95%-CL: 5.6, 54.6) in men. After distinguishing in OPA and IPA for a subsample of 128 participants (473 days), the sex differences were no longer present. OPA in CPM was associated with temperature (women: 174.5; 95%-CL: 81.3, 267.6; men: 183.3; 95%-CL: 81.2, 285.4), cloud cover (women: -153.0; 95%-CL: -200.3, -105.7; men: -123.2; 95%-CL: -174.7, -71.7), and wind (women: -118.6; 95%-CL: -189.6; -47.7; men: -96.9; 95%-CL: -177.0, -16.7). No association between OPA and no precipitation was found (women: 2.9; 95%-CL: -89.0, 94.8; men: -17.1; 95%-CL: -116.7, 82.4). The results of this study emphasize the importance of meteorological conditions as environmental determinants of PA among older adults. Meteorological conditions should be accounted for in the unbiased assessment of habitual PA and the development of PA promotion programs. Future research should focus on the associations of OPA and IPA with meteorological conditions in different climatic regions.

Adhering to the 2017 Dutch Physical Activity Guidelines: A Trend over Time 2001-2018.

Recently, new physical activity (PA) guidelines were adopted in the Netherlands consisting of two components: (1) addressing duration of moderate and vigorous PA, (2) bone and muscle strengthening activities. The aim of this study is to retrospectively assess the long-term trend in fulfilling the criteria of the new PA guidelines and to gain insight into which activities contribute to changes over time. Data were available for 2001–2018 of a nationally representative sample of approximately 7000 Dutch citizens aged 12 years and over using the Short Questionnaire to Assess Health-enhancing physical activity (SQUASH). Multiple logistic regression analysis was performed by age, sex, and level of education. Overall, a positive trend was found from 39.9% adherence in 2001 to 46.0% in 2018. Adherence levels among adolescents decreased and increased among adults and seniors. Intermediate and higher educated groups showed positive trends over time whereas a stable trend was observed among lower educated. Activities contributing most to changes over time were sports, leisure time walking, and strenuous occupational activities. In the period 2001–2018, though an increasing trend was found, less than half of the population was sufficiently active. Special effort is necessary to reach adolescents, seniors, and lower educated groups in PA promotion programs.

Increasing Physical Activity in Persons With Dementia: A Randomized Controlled Trial.

This study investigated the effectivity and sustainability of a physical activity (PA) promotion and motor training programs and analyzed predictors for PA changes in persons with dementia. A total of 122 participants with mild-to-moderate dementia were randomized to the intervention program designed for persons with dementia (intervention group) or a motor placebo activity (control group). The primary outcome was the Physical Activity Questionnaire for the Elderly assessed at the baseline, after the 3-month intervention, and at a 3-month follow-up. The PA promotion program significantly increased PA in the intervention group compared with the control group during the training intervention phase. Both groups showed an increase in habitual PA when intervention-induced activities were excluded. PA was sustainably increased in both groups at follow-up. Low baseline PA was predictive for increased PA after the intervention and low baseline PA, high motor performance, and low comorbidity for increased PA at follow-up.

Analysis of the involvement of participants in a school-based physical activity promotion programme in adolescence

ABSTRACT The objective of this article is to evaluate ‘Sigue la Huella’ (‘Follow the Footprint’), a 2-year Spanish school-based physical activity promotion intervention, taking into account the viewpoints of the different agents involved. The evaluation entails a qualitative analysis of the strengths and weaknesses associated with the agents’ participation, providing recommendations to improve the future application of this and other interventions. We draw on participatory research data collected through six focus groups with 35 participants (11 students, 14 teachers and 10 parents), semi-structured interviews with the two intervention facilitators, and an analysis of the strengths and weaknesses by the community advisory group. The results of this study identify some recommendations that focus on a new policy proposal within the school context, driven by the responsible institutions, for the programme to improve the participation of the different stakeholders in future replication and institutionalisation efforts. In the opinion of all the participants, including stakeholders, the need for an organisational and cultural change in the schools is considered; one that will support Physical Education (PE) teachers in order for them to head this type of interventions and ensure their sustainability. Reference is also made to the need for school education projects, and for the effective collaboration between teachers and students, as well as their empowerment. Furthermore, greater engagement of all agents involved in promoting school physical activity (PA), especially among girls and older teenagers, parents and non-PE teachers, must be achieved.

Social Support and Modelling in Relation to Physical Activity Participation and Outdoor Play in Preschool Children.

Physical activity during early childhood is a prerequisite for healthy development in many cases. The aim of this study was to assess the relationships of social modelling and support from parents, peers, and siblings and domain-specific physical activity participation in a nationwide sample of preschool boys and girls from Germany. 519 preschool children aged 4–6 and one of their parents participated in the ‘MoMo’ Wave 1 Study between 2009 and 2012. Participants and their parents provided self-reported data on social support modelling, and domain-specific physical activity participation (physical activity in sports clubs, physical activity outside of sports clubs, and outdoor play). Parental, peer, and sibling support and modelling were related to domain-specific physical activity: Parental support was particularly relevant for physical activity in sports clubs, and peer support for outdoor play. Parental modelling was only related to physical activity outside of sports clubs: Maternal modelling was a positive correlate in girls and paternal modelling in boys, respectively. Sibling and peer modelling were especially relevant for physical activity in sports clubs. The results were heterogeneous regarding types and providers of support and modelling. Thus, different providers and types of support should be targeted in physical activity promotion programs for preschool children.

Recruitment and Retention of Asian Americans in Web-Based Physical Activity Promotion Programs: A Discussion Paper.

CIN: Computers, Informatics, Nursing 37(9):p 491-492, September 2019. | DOI: 10.1097/01.NCN.0000576724.96272.9f

Recruitment and Retention of Asian Americans in Web-Based Physical Activity Promotion Programs: A Discussion Paper.

Web-based interventions that promote physical activity have been tested in various populations and proven effective. However, information on recruiting and retaining ethnic minorities in these interventions is limited. This study discusses practical issues in recruitment and retention of Asian Americans using three strategies: (1) only Web-based intervention (Group 1), (2) one with Fitbit Charge HR (Group 2), and (3) one with Fitbit Charge HR and office visits (Group 3). Recruitment and retention rates, minutes of weekly research team meetings, and the researchers' memos were collected. Retention rates were analyzed using descriptive statistics, and the minutes and memos were content analyzed following Weber's methods. Retention rates varied by the end of the first (12% in Group 3, 36.9% in Group 2) and third month (0% in Group 3, 36.9% in Group 2). The practical issues were (1) difficulties in recruitment across strategies, (2) the necessity of using community consultants/leaders across strategies, (3) subethnic differences across strategies, (4) timing issues across strategies, (5) Fitbit as a facilitator with several hindrances, and (6) office visits as an inhibitor. Fitbits with user guidelines and community consultants'/leaders' involvement are proposed for future Web-based interventions to promote physical activity in Asian Americans.

Applying machine learning to predict future adherence to physical activity programs

BackgroundIdentifying individuals who are unlikely to adhere to a physical exercise regime has potential to improve physical activity interventions. The aim of this paper is to develop and test adherence prediction models using objectively measured physical activity data in the Mobile Phone-Based Physical Activity Education program (mPED) trial. To the best of our knowledge, this is the first to apply Machine Learning methods to predict exercise relapse using accelerometer-recorded physical activity data.MethodsWe use logistic regression and support vector machine methods to design two versions of a Discontinuation Prediction Score (DiPS), which uses objectively measured past data (e.g., steps and goal achievement) to provide a numerical quantity indicating the likelihood of exercise relapse in the upcoming week. The respective prediction accuracy of these two versions of DiPS are compared, and then numerical simulation is performed to explore the potential of using DiPS to selectively allocate financial incentives to participants to encourage them to increase physical activity.Resultswe had access to a physical activity trial data that were continuously collected every 60 sec every day for 9 months in 210 participants. By using the first 15 weeks of data as training and test on weeks 16–30, we show that both versions of DiPS have a test AUC of 0.9 with high sensitivity and specificity in predicting the probability of exercise adherence. Simulation results assuming different intervention regimes suggest the potential benefit of using DiPS as a score to allocate resources in physical activity intervention programs in reducing costs over other allocation schemes.ConclusionsDiPS is capable of making accurate and robust predictions for future weeks. The most predictive features are steps and physical activity intensity. Furthermore, the use of DiPS scores can be a promising approach to determine when or if to provide just-in-time messages and step goal adjustments to improve compliance. Further studies on the use of DiPS in the design of physical activity promotion programs are warranted.Trial registrationClinicalTrials.gov NCT01280812 Registered on January 21, 2011.

Active Gaming Prevalence and Correlates by Type of Day in Spanish Youth.

Active gaming has emerged as a new option to foster physical activity in youth. The aim of this study was to estimate the prevalence of active gaming in adolescents, to determine differences between active and nonactive gamers by type of day, and to examine predictors of being an active gamer. A cross-sectional study was conducted with 3095 Spanish adolescents aged 12 to 18 years who self-reported their involvement in moderate to vigorous physical activity, sedentary behaviors, and active gaming. Those engaging in active gaming for at least 10 minutes per day were considered active gamers. Student's 2-tailed t tests, chi-square test, and binomial logistic regression were performed. About 25.9% of the adolescents were active gamers. They were younger, had higher body mass index, and spent more time on moderate to vigorous physical activity, television viewing, and sedentary video games with computer/console than nonactive gamers. There were more active gamers on weekends than on weekdays. On weekdays, more males than females were active gamers. Adolescents who did not meet sleep time guidelines were more likely to be active gamers on weekdays, whereas on weekends, being a girl, overweight/obese, and having a high socioeconomic status were predictors of being an active gamer. Because active gaming may contribute to meeting physical activity guidelines, the present findings could enable better targeting of physical activity promotion programs.