Public Health Physical Activity Research Articles

Factors influencing midwives' conversations about smoking and referral to specialist support: a qualitative study informed by the Theoretical Domains Framework.

The aim of this study was to identify factors influencing midwives' conversations about smoking, and referral to specialist smoking cessation services, using an evidence-based theoretical framework. Semi-structured, qualitative interviews were undertaken with community midwives employed within one health board region of Wales. Deductive framework analysis was employed by coding data to the domains of the Theoretical Domains Framework (TDF) and then identifying themes within domains and across participants. Seven midwives took part in the study. 13, out of a possible 14 domains, were mapped from the TDF. Key enablers to conversations and referrals include knowledge of the risks of smoking in pregnancy, congruence with the professional identity of a midwife, and the use of carbon monoxide monitors in initiating conversations and referrals. Limited knowledge of the specialist service, confusion about the opt-out pathway, varied skills in communicating and engaging with women, low confidence in ability to influence women's decisions, limited appointment times, and competing priorities were identified as barriers. Midwives recognise the importance of their role within the provision of smoking cessation advice and referral to specialist services. While there are continued time pressures and competing priorities for midwives, enhancing skills and confidence in collaborative, empowering approaches to addressing smoking would further support in optimising the uptake of maternity smoking cessation support. This could also enhance conversations about other public health issues such diet, physical activity, and alcohol use.

Evolution of Public Health Physical Activity Applications of Accelerometers: A Personal Perspective

Accelerometer technology and applications have expanded and evolved rapidly over approximately the past two decades. This commentary, which reflects content presented at a keynote presentation at 8th International Conference on Ambulatory Monitoring of Physical Activity and Movement (ICAMPAM 2022), discusses aspects of this evolution from the author’s perspective. The goal is to provide historical context for newer investigators working with device-based measures of physical activity. The presentation includes discussion of the fielding of accelerometer devices in the 2003–2006 National Health and Nutrition Examination Survey, selected recommendations from relevant workshops between 2004 and 2010, and the author’s perspective on the current status of accelerometer use in population surveillance and public health. The important role of collaboration is emphasized.

Physical activity domains and incident clinical depression: A 4-year follow-up analysis from the ELSA-Brasil cohort

AimTo analyze the prospective dose-response relationships between total and domain-specific physical activity (PA) with incident clinical depression. MethodsWe used data from two waves (Wave 1: August/2008–December 2010; Wave 2: September/2012-December/2014) of the Brazilian Longitudinal Health Study (ELSA-Brasil) cohort study. Self-reported PA (total, transport, and leisure-time) was the main exposure. Incident clinical depression (new cases of depression between waves) was assessed through the Clinical Interview Schedule-Revised (CIS-R). Poisson regression models, adjusting for potential confounders, were used for data analysis. ResultsIn 12,709 adults (53.8 % women, mean age: 51.9 ± 9.0), moderate and high volumes of total PA (1-149 min/week: RR = 0.81, 0.58–1.13, 150–299 min/week: RR = 0.55, 95%CI: 0.40–0.76; ≥300 min/week: RR = 0.64, 95%CI: 0.52–0.80), and any volume of leisure-time PA (1-149 min/week: RR = 0.65, 95%CI: 0.50–0.83; 150–299 min/week: RR = 0.67, 95%CI: 0.52–0.88; RR = 0.61, 95%CI: 0.45–0.82) were associated with a lower risk of incident clinical depression. Transport PA protective only in the lower category (0.1–4.4 mMET-h/wk) (RR = 0.71, 95%CI: 0.54–0.94). LimitationsOther PA domains such as occupational and domestic were not assessed; the use of self-report measures for PA which may be subject to bias and recall issues; lack of assessment of additional potential confounders, such as sedentary behavior and family history of depression. ConclusionTotal and leisure-time PA were associated with lower incidence of clinical depression, even at lower doses. Low, moderate, and high volumes of total and leisure-time PA were associated with lower risk of incident clinical depression. Public health PA interventions aiming to prevent development of clinical depression should consider focusing on leisure-time PA.

Determinants of Physical Activity in Older Adults in South-Eastern Poland

The aim of our study is to assess factors determining the uptake of physical activity (PA) by older people living in south-eastern Poland. This is a cross-sectional study. The study included 858 older people aged 75 and over living in south-eastern Poland. PA was assessed by asking about the time spent on any at least moderate PA per week and about doing planned strengthening exercises to improve muscle strength and muscular endurance. Functional status, disability and quality of life in older people were also assessed. Logistic regression models were used to identify the factors related to PA. In the study group, only 25.64% performed a minimum of 150 min of moderate-intensity exercise, while strengthening exercises were performed by 22.49%. The most important factors influencing the uptake of PA were age, number of chronic diseases, place of residence, education, social activity, housing conditions, quality of life and health status. In summary, the study population represents a low level of PA uptake, with the majority not meeting the World Health Organization recommendations for PA uptake by older people. Our findings suggest individualized efforts to promote public health and increase PA among older people over 75 years of age.

The experiences and perceptions of female breast cancer patients regarding weight management during and after treatment for oestrogen-receptor positive disease: a qualitative study

BackgroundWeight gain is commonly observed during and after breast cancer treatment and is associated with poorer survival outcomes, notably in women with oestrogen-receptor positive disease. The aim of this qualitative study was to investigate the experiences and perceptions of oestrogen-receptor positive (ER +) female breast cancer patients (BCPs) regarding weight management behaviours during and after treatment. Secondly, to gain insight into the experiences of healthcare professionals (HCPs) regarding the provision of weight management advice to patients undergoing treatment.MethodsFour focus groups involving 16 BCPs having a median (range) age of 51 (35–70 y) and three focus groups involving 21 HCPs aged 46 (29–62) were held at a university campus, local cancer support centre or clinical site. Data were analysed using Framework analysis.ResultsFour overarching themes (and 10 subthemes) were identified: (1) Treatment; (2) Support for lifestyle behaviour change; (3) Information availability for BCPs; (4) Knowledge of current evidence amongst HCPs. The physical and psychological consequences of treatment influenced motivation for weight management amongst BCPs. Social support for health promoting behaviours was viewed as important but was conflicting, requiring context-specific considerations. BCPs said they would have welcomed access to credible information (guided by HCPs) about the potential detrimental health effects of excess body weight and weight gain, together with advice on weight management via healthy eating and physical activity. HCPs felt that they had insufficient knowledge of public health dietary and physical activity recommendations or evidence-based interventions to confidently offer such advice. HCPs expressed concern that raising weight management issues would exacerbate distress or invoke feelings of guilt amongst BCPs, and cited time pressures on patient consultations as additional barriers to providing weight management support.ConclusionThe study yielded novel insights into factors influencing weight management behaviours amongst overweight ER + BCPs. The results suggest that evidence-based information and support, which addresses key physical and psychological challenges to physical activity and dietary behaviours, offers the best route to sustainable weight management in this population.

The Influence of Easing COVID-19 Restrictions on the Physical Activity Intentions and Perceived Barriers to Physical Activity in UK Older Adults.

COVID-19 has had profound effects on physical activity behaviours of older adults, and understanding this impact is essential to driving public health policies to promote healthy ageing. The present study aimed to determine; (1) intended physical activity behaviours of older adults following the easing of UK COVID-19 restrictions; (2) the relationship between self-reported physical activity and intended physical activity behaviour; (3) perceived barriers to achieving the intended physical activity goal. Ninety-six participants (74.8 ± 4.4 years; 52 female) from a longitudinal study examining the impact of COVID-19 on physical activity were recruited. Participants outlined their future physical activity intentions and completed the COM-B Self Evaluation Questionnaire. Participants were split into groups based on their intention to ‘Maintain’ (n = 29), ‘Increase’ (n = 38) or ‘Return’ (n = 29) to pre-COVID-19 physical activity. Self-reported physical activity undulated over the pandemic but was mostly equivalent between groups. Intended physical activity behaviour was independent of self-report physical activity. Capability and motivation factors were the most frequently cited barriers to the intended physical activity behaviour, with a greater number of capability barriers in the ‘Return’ group. Such barriers should be considered in the COVID-19 recovery public health physical activity strategy for promoting healthy ageing.

Changes In Physical Activity Behavior After One Pandemic Year

PURPOSE: Decreased physical activity (PA) practice with pandemic stay-at-home measures has been well-documented. Less well-known is how behavior changes as restrictions ease. The aim of this study was to investigate change in behavior following lifted pandemic restrictions. METHODS: University staff (n = 154) who participated in a 2020 vaccination study and were receiving their second consecutive seasonal influenza vaccine agreed to data linkage. The April 2020 recruitment occurred ~7w into strict stay-at-home orders. 2021 participation occurred in May; blended on-campus/online teaching had begun ~2.5mo prior, preceded by on-campus working and the opening of community and commercial sporting facilities permitted for ~11mo prior. Participants self-reported health behaviors, including the number of days in the past week they had done ≥30 min PA which was enough to raise breathing rate; servings/d of fruit and vegetables; alcohol intake frequency; and emotional health (DASS-21). Sufficient PA was defined as ≥4 d PA. Chi-square and t-tests, with α = 0.05, were conducted to compare between years. Sydney University Ethics Approval: 2019/711. RESULTS: Respondents were mostly female (62%) with mean age of 44 yrs. BMI, fruit and vegetable intake, alcohol consumption and mental health indicators remained stable. Although overall sufficient PA was unchanged at 45%, shifts at either tail indicated less overall PA: the proportion of low exercisers (≤1 d/w) increased from 18% to 25% while high exercisers (≥6 d/w) decreased from 19% to 12%. Subgroup analyses suggested decreases at the high end were more notable in females (12% decrease) and in the middle age tertile (38-50y; 11% decrease). The youngest tertile (≤38y) were the least sufficiently physically active (35%) and they had the largest increase (13%) in low PA. CONCLUSIONS: Adults are insufficiently active and, following lockdown, have reduced PA despite returned access to facilities. Public health PA programs may need to target and better-support younger adults in particular. A government voucher program for children’s sport has increased their PA and another for post-pandemic dining, arts and tourism was well-utilized; these successes suggest that an adult sport voucher program could be well-received and provide positive health outcomes.

S10-1 Developing and monitoring physical activity policy: 1990 to today

BackgroundPhysical inactivity accounts for as many as 5 million deaths per year globally but has yet to be addressed effectively by most governments or the World Health Organization (WHO).Description of the problemReasonable evidence for effective strategies exist, and several countries have implemented consistent public health policies and programs that have increased population prevalence of regular physical activity. In 2018 WHO launched a Global Action Plan for Physical Activity (GAPPA). However, most countries do not have effective public health policies in place for physical activity. Evaluating the history of national and global policies to understand how some countries have developed sound public health programs for physical activity while most have not requires monitoring and evaluating policy, programmatic, and perhaps even research indicators for physical activity. Only recently have there been systematic efforts to do so.ResultsSeveral key questions about physical activity policy, starting with an examination of the evolution of public health physical activity policy and policy research from when it was first explicitly identified in the 1990s to the present will be addressed. Key recommendations, global statements, research reviews and action plans will be summarized to provide a clear picture of the evolution of this important aspect of public health. Evidence on the implementation of policy at national and global levels will also be reviewed. We will examine whether it feasible to track physical activity policy at the global and country levels, if the existence of ?good? physical activity policy is associated with less physical inactivity, how policy indicators may be used for advocacy and guidance.LessonsPhysical activity policy for public health is a relatively new concept that has evolved significantly in the last three decades with formal national and global policy statements, research, and evaluation efforts all increasing markedly since 1990.Main MessageDespite notable growth in policy research and the development of sophisticated national and global policies and action plans, implementation of effective national and global policies and programs for physical activity remains limited.

Adopting and maintaining a healthy lifestyle in low SES families: How the experience of motherhood shapes responses to dietary and physical activity public health guidance

BackgroundPublic health guidance and associated interventions seek to bring about change in diet and physical activity behaviours to improve life expectancy and healthy life expectancy in the population. Low socioeconomic status (SES) groups suffer from reduced life/healthy life expectancy compared with the population as a whole. This in-depth qualitative study, investigates the lives and experiences of mothers with young children living in a low SES area in a London (UK) borough, to understand the context in which current public health guidance on diet and physical activity is received and viewed, and how this understanding could be used to inform the development of public health guidance and interventions for this group.MethodsThe mothers (n = 20), were recruited from a Surestart Centre, Children’s Centres and through the local branch of a national charity. The mothers took part in a series of three in depth interviews over two years (2016–2017). Thematic analysis was used to generate an iterative set of codes informing an understanding of motherhood, diet and physical activity.ResultsMotherhood was found to be a major factor for understanding and interpreting how women in low SES areas respond to public health guidance on diet and physical activity. The mothers were well informed about dietary guidance, considered that provision of healthy food was critical to the mothering role, but found it difficult to implement the guidance in their own lives. In contrast, physical activity was not seen as integral to the mothering role, although it was acknowledged that it played a part in ensuring that the mothers remained healthy enough to fulfil all their duties. Constrained by the ethic of care, and a lack of material and time resources, the mothers prioritised their family’s health above their own. This study, enabled the mothers to articulate ideas for interventions that would be supportive of a healthy lifestyle and of practical application in their busy lives.ConclusionsMothers from this low SES area responded differently to the public health guidance on diet and on physical activity. Whilst providing and modelling a healthy diet was seen as an essential part of the mother’s role, participating in leisure based physical activity was problematic, and unless carefully framed, could be perceived as selfish behaviour, inappropriate for the “good” mother.

The concurrent and predictive validity of a tool to measure strength engagement during inclusive equestrian vaulting

Participation in muscle strengthening activities is a less examined component of public health physical activity guidelines for children and youth compared to participation in physical activity. In part, the lack of focus on strength is associated with the difficultly of measuring strength activities during participation. The aim of this pilot study was to develop and provide evidence of the concurrent and predictive validity of the Strength Observation during Vaulting (SOV) tool. Six female youth (4 with a disability and 2 without a disability) ranging in age from 11 – 22 years (Mage = 14.2 y, SD = 4.0) participating in a 5-day inclusive equestrian vaulting camp were recruited. Participants completed three measures of strength, and video of vaulters engaging in camp activities was coded using the System for Observing Fitness Instruction Time (SOFIT) and SOV tools. From a linear regression model (significant p = .020), the three measures of strength accounted for 98.7% of the shared variance with time spent in SOV levels 4 and 5. Bivariate correlation coefficients comparing SOV levels 4 and 5 and moderate-vigorous physical activity (MVPA) from SOFIT were r = .73 for all contexts, r = .89 for floor-work, r = .64 for barrel vaulting, r = .76 for horse vaulting, and r = .81 for stable chores. The predictive and concurrent validity of the SOV tool was more than adequate. Based on these results, the systematic observation is a feasible approach to assess engagement in strength activities during vaulting.

A distance-based, randomized controlled trial for reducing sedentary behavior among prostate cancer survivors: a study protocol

BackgroundProstate cancer survivors (PCS) experience long-term side effects beyond treatment such as fatigue, depression and anxiety. Quality and engaging supportive care programs are needed to reduce these chronic and debilitating effects. Independent of physical activity (PA), high volumes of sedentary behavior (SB) are associated with chronic disease-related risk factors and poorer cancer-specific quality of life (QoL). Simultaneously increasing PA and decreasing SB may be an effective health promotion strategy. Given that PCS may face several barriers to engaging in supervised programs, there is a need to develop and assess the efficacy of interventions that employ distance-based approaches for behavior change. The primary aim of this study is to determine the effects of a 12-week intervention (Fitbit + behavioral counselling) vs. Fitbit-only control group in reducing SB among PCS. Secondary outcomes include light-intensity PA, QoL, motivational outcomes, and patient satisfaction.MethodsThis two-armed, randomized controlled trial will recruit inactive PCS (stage I-IV) across Canada who self-report engaging in >8 hours/day of SB. Participants will be randomized to the intervention (n=60; Fitbit and behavioral support) or active control group (n=60; Fitbit-only). The intervention consists of the use of a Fitbit and a series of six behavioral support sessions (two group, four individual) to aid PCS in gradually replacing SB with light-intensity PA by increasing their daily step counts to 3,000 steps above their baseline values. The Fitbit-only control condition will receive a Fitbit and public health PA resources. The primary outcome is change in SB measured objectively using activPAL inclinometers. All secondary outcomes will be measured via self-report, except for PA which will be measuring using Fitbits. Data will be collected at baseline, post-intervention, and at 6-month post-intervention.DiscussionReducing SB and increasing light-intensity PA plays an important, yet often undervalued role in the health and well-being of PCS. This study will create a unique distance-based platform that can be used by clinical and community-based organizations as a low-cost, supportive care tool to improve health outcomes for PCS.Trial RegistrationClinicalTrials.gov Identifier NCT05214937. Registered January 28, 2022Protocol version: v.1

Knowledge of cardiovascular disease risk and exercise duration among asymptomatic sedentary male individuals participating in Islamic prayer (Salaah)

BackgroundThis study aimed to investigate the knowledge of cardiovascular disease risk among asymptomatic sedentary males participating in Islamic prayer, alongside various exercise durations and age groups.MethodsA cross-sectional study design was used. Sedentary male participants (n = 243) completed an online 78-point self-administered CVD risk questionnaire. Descriptive and inferential statistical methods were used to determine the research findings. For statistical rigour, participants were divided into two age groups. Participants were divided into three categories based on current exercise durations. Inter-group comparisons were completed using a one-way ANOVA, Kruskal–Wallis and Mann–Whitney test. The Pearson correlation coefficient was used to explore significant relationships. All statistical analyses were conducted using SPSS (Version 26, IBM). The level of significance was set at p < 0.05.ResultsThe 21–30 age group 71.09% (7.53) and the 31–40 age group 72.74% (5.53) presented with Knowledge of CVD risk and prevention scores which indicated that older individuals were more knowledgeable about CVD risk and prevention. A significant difference [95% CI (− 6.76: 1.28), (p = 0.002)] existed among the 10–60-min and 61–140-min exercise duration categories. A significant difference (p = 0.006) was also found for inter-group comparisons. This result confirmed variability with duration categories. Significant differences were found between overall knowledge of CVD scores within the two age groups (p = 0.03). A negative correlation was demonstrated regarding knowledge of CVD risk and prevention, and duration of exercise (r = − 0.252; p = 0.000).ConclusionsKnowledge about CVD risk and prevention is crucial for understanding the risk factors for CVD. The older individuals become, the more knowledgeable they are of CVD risk and prevention factors. Results show more inactive people are less likely to seek out knowledge of CVD risk and prevention. The study recommends that sedentary populations should engage in public health information interventions, physical activity (such as Salaah) and healthy lifestyle modifications. This will inform, increase awareness, and improve understanding of prevention strategies and risk factors for CVD.

The impact of COVID-19 restrictions on Australians' frequency and duration of participation in different types of sport and physical activity

BackgroundSports management and public health physical activity stakeholders need to understand changing patterns of participation to inform the development of sport and physical activity opportunities and strategies. This study investigated changes in the frequency and duration of participation in sport and physical activity in Australia from pre-COVID-19 to during-COVID-19, broken down by the specific type of activity and by gender, age and region.MethodsDuring the first pandemic restrictions and lockdowns in Australia in May–June 2020, 6140 survey respondents provided information about the types, frequency and duration of the sport and physical activity they participated in prior to and during COVID-19 restrictions. Differences between mean values were analyzed.ResultsThe greatest decline in participation during COVID-19 was in team sports, and the decline was greater for men than for women.ConclusionHow will sport respond to getting these men back in the game, and women back from home-based yoga and Pilates?

A class based intervention solution to help people achieve a long-term commitment to exercise

Purpose: One of the main causes of most preventable chronic and serious medical conditions, premature deaths and inequalities in health is lack of activity. As a sedentary society, over 40% of adults do not reach Public Health physical activity guidelines.1,2,4 A society-wide increase in physical activity could improve mental and physical health, reduce health inequalities and would save over £18bn of NHS costs, saving at least 15% of the NHS budget, however, there is a general lack of effective behaviour change interventions to increase long-term uptake of physical activity; therefore eliciting lasting behaviour change from the secondary-care physiotherapy setting is challenging.

The Support Person's Preferences and Perspectives of Physical Activity Programs for Older Adults With Cognitive Impairment.

Objectives: Physical activity (PA) is beneficial for older adults' cognition. There is limited research investigating perspectives of support persons (SPs) of next-of-kins (NOKs) with cognitive impairment. This exploratory study aimed to investigate perspectives of SPs of older adults with Alzheimer's Dementia (AD) or Mild Cognitive Impairment (MCI).Methods: A telephone survey of 213 SPs of NOKs from the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing (AIBL) was undertaken to quantitatively assess SPs' beliefs and knowledge about PA benefits, current PA level of their NOK, and PA program preferences. The contribution of age, gender, diagnosis and mental health symptoms was assessed using multiple logistic regression analyses.Results: Many SPs were aware of PA benefits for memory (64%) and believed it would help their NOK (72%). Older SP age was associated with less awareness of benefits (p = 0.016). SPs caring for male NOKs were more likely to believe that PA would be helpful than those caring for female NOKs (p = 0.049). NOK AD diagnosis (rather than MCI) (p = 0.014), older age (p = 0.005) and female gender (p = 0.043) were associated with lower PA levels. SPs were mixed regarding preference for their NOKs to participate in individual (45%) or group (54%) PA. Many SPs wanted to participate in PA with their NOK (63%).Conclusions: The results highlight that SPs have high levels of awareness of the cognitive benefits of PA, and describe their preferences regarding PA programs. The findings provide new information to inform targeted public health messaging, PA prescribers and providers, and future research directions.

Time and belief in exercise importance predict increased activity during initial COVID-19 restrictions in Ireland.

SummaryThe aim of this work was to investigate physical activity levels and the associated barriers and facilitators to physical activity in Irish adults during initial COVID-19 restrictions. Members of the general population completed an online questionnaire. Responses from 1274 participants (1274/1568, 81% completion rate) indicated that the majority (46.1%, n = 587) of people were more active than usual during the restrictions, however, 28.6% (n = 365) reported being less active. Fifty-five percent (55.3%, n = 702) of participants were meeting public health physical activity guidelines and more than half (53.3%, n = 679) reported finding new ways to be active. Walking (86%, n = 1101), physical activity in the home (47%, n = 593) and online resources (38%, n = 483) were the most frequently reported types of physical activity people engaged in. Having more time to be physically active [OR 2.326 (SD 1.948–2.794)] and a greater belief in the importance of physical activity [OR 1.192 (SD 1.001–1.444)] were predictive of exercising more than usual. Being unable to access their usual means of exercise [OR 1.612 (SD 1.369–1.902)], advised not to go outside the home [OR 1.402 (SD 1.165–1.698)] and working more than usual [OR 1.201 (SD 1.013–1.443)] were predictive of exercising less than usual. There was a positive trend in physical activity engagement by Irish adults during initial COVID-19 restrictions, likely influenced by increased time, belief that exercise was important and increased use of home-based and online exercise resources. However, almost one in three people reported being less active than usual, highlighting the need for targeted support during restriction periods.

A COVID-19 Crisis in Child Physical Fitness: Creating a Barometric Tool of Public Health Engagement for the Republic of Slovenia.

The Republic of Slovenia implements the largest longitudinal database of child physical fitness in the world–SLOfit. Slovenia has some of the most physically active children globally, and it has responded rapidly to incorporate national physical activity (PA) interventions throughout the COVID-19 pandemic. Despite aggressive campaigns to maintain PA at home, the country has seen a tremendous decrease in child physical fitness over the past several months as self-isolation measures have been mandated by national authorities. These trends prompted researchers to create a method of tracking and communicating government decisions which have a direct impact on child physical activity, fitness and overall health (i.e., the SLOfit Barometer). The research team assembled experts for consultation on creation of the SLOfit Barometer after processing preliminary data on 20,000 schoolchildren which found the greatest decline in child physical fitness since systematic testing began more than 30 years ago. Only 2 months of self-isolation erased over 10 years of hard-fought health gains acquired from national public health policies and PA interventions. This crisis in child fitness requires integrated community participation and a robust public health policy response, and with the SLOfit Barometer acting as a national bellwether system, it is envisioned that policy makers and the public will advocate for bold, progressive actions to combat this national health emergency. This surveillance tool tracks government action to combat the increasing child physical inactivity and obesity trends brought on as a direct result of COVID-19 isolation regulations.

The effects of substance use and physical activity on cognition: The impact of incongruent health behaviors

BackgroundCognitive functioning refers to storage and manipulation of information and includes executive functioning (EF) and attention (ATT). While physical activity (PA) improves cognitive functioning, decrements are associated with frequent substance use. This study examined PA on cognitive functioning within the context of past-year substance use. MethodsUsing NESARC–III data (N = 36,309), cross-sectional analysis examined interactions between self-reported past-year PA and substance use in relation to cognitive functioning. ResultsAs hypothesized, light-to-moderate, vigorous, and total PA conditional main effects were positively associated with both facets of cognition, while frequent substance use conditional main effects were negatively associated with ATT and EF. The positive association between PA and cognition was diminished by substance use. Frequent binge drinking, marijuana, cocaine, and opioid use weakened the impact of light-to-moderate PA on EF, and only frequent cocaine use lessened the relationship between vigorous PA on EF. When PA intensities were combined, frequent binge drinking and cocaine use weakened the PA and EF association. Infrequent stimulant use reduced the association between all levels of PA and ATT, while infrequent marijuana use unexpectedly enhanced the relation between vigorous PA and ATT. ConclusionsOverall, PA enhanced two facets of cognitive functioning across six substances. However, these benefits are reduced in the context of frequency of substance use. The positive association between light-to-moderate PA and EF appears to be more sensitive in the context of frequent substance use than vigorous PA. Implications for public health messaging and PA as cognitive remediation treatment for substance use disorders are discussed.

Investigating the environmental, behavioural, and sociodemographic determinants of attendance at a city-wide public health physical activity intervention: Longitudinal evidence over one year from 185,245 visits

Understanding the determinants of attendance at public health interventions is critical for effective policy development. Most research focuses on individual-level determinants of attendance, while less is known about environmental-level determinants. Data were obtained from the Leeds Let's Get Active public health intervention in Leeds, England. Longitudinal data (April 2015–March 2016) on attendance were obtained for n = 25,745 individuals (n = 185,245 total visits) with baseline data on sociodemographic determinants and lifestyle practices obtained for n = 3621 individuals. This resulted in a total of n = 744,468 days of attendance and non-attendance. Random forests were used to explore the relative importance of the determinants on attendance, while generalised linear models were applied to examine specific associations (n = 3621). The probability that a person will attend more than once, the number of return visits, and the probability that a person will attend on a particular day were investigated. When considering if a person returned to the same leisure centre after one visit, the most influential determinant was the distance from their home. When considering number of return visits overall however, age group was the most influential. While distance to a leisure centre was less important for predicting the number of return visits, the difference between estimates for 300 m and 15,000 m was 7–10 visits per year. Finally, calendar month was the most important determinant of daily attendance. This longitudinal study highlights the importance of both individual and environmental determinants in predicting various aspects of attendance. It has implications for strategies aiming to increase attendance at public health interventions.

Are young children with asthma more likely to be less physically active?

Previous research suggests that children who experience asthma may be less physically active; however, results have been inconclusive. This study aimed to investigate whether the presence of asthma or wheeze is associated with lower physical activity levels in children, and whether sex, body mass index or earlier asthma or wheeze status modifies the association. This study was conducted in 391 HealthNuts participants in Melbourne, Australia. Asthma and wheeze data were collected via questionnaire at age 4 and 6, and physical activity was measured through accelerometry. Using adjusted linear regression models, the cross-sectional and longitudinal associations were investigated. There was no evidence of a difference in time spent in moderate-to-vigorous physical activity (MVPA) at age 6years between children with and without asthma at age 4; children with asthma spent 8.3minutes more time physically active per day (95% CI: -5.6, 22.1, P=.24) than children without asthma. Similar results were seen for children with current wheeze (5.8minutes per day more, 95% CI: -5.9, 17.5, P=.33) or ever wheeze or asthma (7.7minutes per day more, 95% CI: -4.8, 20.2, P=.23) at age 4years. Comparable null results were observed in the cross-sectional analyses. Interaction with BMI could not be assessed; however, previous asthma or wheeze status and sex were not found to modify these associations. This analysis found no evidence of asthma hindering physical activity in these young children. These results are encouraging, as they indicate that the Australian asthma and physical activity public health campaigns are being effectively communicated and adopted by the public.