Population-based Physical Activity Research Articles

Scoping Review of Population-Based Physical Activity and Sedentary Behavior in Saudi Arabia.

Saudi Arabia is experiencing rapid development of the built environment and implementing policy changes to promote physical activity (PA) and reduce sedentary behavior (SB) among its population. In light of these developments, this scoping review systematically summarized population levels of PA/SB in Saudi Arabia. The authors searched 6 databases on December 13, 2021, for articles published in English or Arabic from 2018 to the search date. Studies using population-based sampling in Saudi Arabia and measuring PA/SB were included. Of the 1272 records found, 797 were screened, and 19 studies (9 on children/adolescents age 6-19y and 10 on adults age 15-75y) were included. All studies were cross-sectional in design, and 18 studies collected data at only one point in time, ranging from 2009 to 2020. A total of 18 studies relied on self-reporting to assess PA/SB using a variety of questionnaires. Among children/adolescents, approximately 80% to 90% did not attain at least 60minutes per day of moderate to vigorous PA and 50% to 80% engaged in ≥2hours per day of screen time or SB. Among adults, approximately 50% to 95% had low or insufficient PA (eg,less than meeting PA guidelines) and about half had a sitting time of ≥5hours per day. Population-based studies were not found among children <10years and adults >75years. A high proportion of participants in the reviewed studies did not meet PA recommendations and spent excessive time in SB. Ongoing surveillance efforts for all ages may help identify target populations for interventions and prioritize the national strategy on PA/SB in Saudi Arabia.

S11-3 Implementation of Community-Based Physical Activity Promotion Focusing on Individuals with Social Disadvantages, Developed Using a Participatory Approach

BackgroundRecently, the German Federal Ministry of Health has provided funding aimed at the sustainable implementation of the National Recommendations for Physical Activity and Physical Activity Promotion in German municipalities. This presentation reports on an ongoing project that employs a participatory action model for population-based physical activity (PA) promotion in these municipalities and gives insights into real-world experiences made during project implementation.MethodsUsing a participatory approach, an action model for PA promotion was developed in collaboration with 64 nationwide stakeholders (Phase I). Based on systematic criteria and in cooperation with the Federal Centre for Health Education (BzGA) and the German Statutory Health Insurance (GKV), three rural districts and three cities were then selected as pilot municipalities. In phase II, the action model was implemented in these six communities. Implementation steps included (1) preparation, (2) assessment, and (3) setting up a steering committee and a cooperative planning group in all communities. The entire process was closely coordinated with local administrations. Currently, cocreated measures adapted to local needs are being (4) developed and (5) implemented, with a particular focus on improving access to the development and usage of these measures for people with social disadvantages.ResultsPreliminary results indicate that steps (1) to (3) have been successfully implemented in all pilot municipalities. ‘Champions’ (persons committed to the local project) were found to be particularly important for each step. The involvement of political stakeholders (n = 2-13), experts (n = 2-12), representatives from the administration (n = 8-25), multipliers (n = 5-16), and citizens (n = 0-4) in the cooperative planning process varied across pilot municipalities. Participants from the administration represented different sectors (e.g. city planning, sports, health administration). Preliminary results show that a broad range of measures was developed to promote personal skills, infrastructures, policy actions, and community action for PA.ConclusionsThe action model proved suitable to promote PA in the pilot municipalities. In all six cases, adaptations had to be made to accommodate the intervention to the respective community-specific context. Our results indicate that involving individuals from a socially disadvantaged background remains a particular challenge of participatory PA promotion.

Potential Cost Savings for the Healthcare System by Physical Activity in Different Chronic Diseases: A Pilot Study in the Veneto Region of Italy.

Background: Sedentary behaviour (SB) and physical inactivity (PI) are associated with an increased risk of chronic diseases and a significant economic burden. This pilot study aims to estimate the possible cost savings for the Veneto Regional Health Service (Italy) due to a population-based physical activity (PA) intervention. Methods: The PA-related cost-savings were assessed for four chronic diseases in the whole and sedentary populations of the Veneto region. The SB and PA epidemiological data, regarding an additional percutaneous coronary intervention in coronary artery disease, hospitalizations in chronic obstructive pulmonary disease, surgery for colorectal cancer, and femur fracture, were obtained from national and regional administrative sources. A relative risk reduction, due to PA, was obtained from the recent literature. The annual healthcare costs were estimated using the regional diagnosis-related group tariffs. Results: The annual estimated cost-savings for the regional healthcare service related to these four outcomes: an amount between EUR 5,310,179 (if a conservative analysis was performed) and EUR 17,411,317. Conclusion: By a downward estimate, regarding the direct healthcare costs, PA interventions could lead to important cost-savings in the Veneto region. The savings would be greater when considering the cross-sectional impact on other healthcare costs, comorbidities, and indirect costs.

Scaling up urban infrastructure for physical activity in the COVID-19 pandemic and beyond

Scaling up urban infrastructure for physical activity in the COVID-19 pandemic and beyond

‘Summer of Sport’: the development of a 6-week programme in increasing physical activity to improve public health outcomes

ObjectivesA population-based physical activity (PA) programme was implemented to increase PA levels and encourage individuals to join the local council leisure facility. Study designThis is a cross-sectional design. MethodsThe 6-week programme Summer of Sport (SOS) involved a total of 487 individuals registered for PA sessions. The sessions were held at three local council leisure facilities included badminton, swimming, table tennis, squash and group cycle. The programme was assessed using a survey based on the Theory of Planned Behaviour. Individuals were asked for their current fitness levels, whether the programme encouraged them to be more active and for their intentions to join the leisure centre after the programme. ResultsOf the 487 who originally registered for the programme, there were 161 users of SOS, with 112 not already members of the leisure facility. After the programme, 83% considered themselves already being active, with 78% stating that they partook in at least 30 min of exercise, 3 times per week. Although a large proportion of individuals were already physically active, 78% stated that taking part encouraged them to become more active. More than half suggested that they would not join the leisure facility, 30% said that they had joined after the programme and 17% stated their intention to join. Many individuals highlighted that the programme provided an opportunity to be active with their family. ConclusionsPublic health teams should work with partner organisations to embed robust processes for measuring outcomes that impact on population health.

Umbrella and Systematic Review Methodology to Support the 2018 Physical Activity Guidelines Advisory Committee.

In 2016, the 2018 Physical Activity Guidelines Advisory Committee, a group of experts in exercise science and health, began an extensive review of the literature to inform the second edition of the Physical Activity Guidelines for Americans. The purpose of this paper is to describe the evidence-based methodology used to review, evaluate, and synthesize published, peer-reviewed physical activity research. The protocol-driven methodology was designed to maximize transparency, minimize bias, and ensure relevant, timely, and high-quality systematic reviews. Training protocols, quality control procedures, search strategies, assessment instruments, abstraction guides and forms, and reporting templates were developed. A systematic approach was used to select the evidence for the 2018 Physical Activity Guidelines Advisory Committee Scientific Report that included umbrella reviews and systematic reviews. Within 16 months, 38 searches were conducted; and 20,838 titles, 4913 abstracts, and 2139 full texts were triaged. Of those, 1130 articles were abstracted to answer 38 research questions. To inform population-based physical activity guidelines, this systematic process facilitated a vast review of the literature on physical activity and health in a short period of time. This flexible, yet rigorous and transparent process included a clear and detailed methodology with a focus on training and quality control.

A Multinomial Logistic Regression Examination of TV Time and Two Different Measures of Obesity in U.S. Adults

Background: Physical inactivity and sedentary behavior are known factors related to the growing obesity rates in US adults. However, most population-based physical activity research primarily use a single measure of obesity. Therefore, the purpose of this study was to examine the relationship between television (TV) time and two different measures of obesity in US adults. Methods: This study used data from adults 20+ years of age participating in the 2015-2016 National Health and Nutrition Examination Survey (NHANES). Using body mass index (BMI), participants were categorized as obese if their values were 30 kg/m2 or greater. Using waist circumference (WC), participants were categorized as obese if their values were greater than 88 (females) or 102 cm (males). TV time was assessed from a survey question and adults were categorized into one of four different groups. Multinomial logistic regression was used to model the relationship between TV time and three different obese status categories. Results: In fully adjusted models, odds of being BMI obese (OR=1.98; 95% CI: 1.32-2.98) and WC obese (OR=2.76; 95% CI: 1.88-4.05) were significantly greater in adults with 5+ hours of TV time as compared to those with Conclusion: Results from this study indicate that TV time is clearly related to both overall and abdominal obesity in US adults. Furthermore, this relationship remains in light of MVPA and appears stronger for adults with both types of obesity.

Are Interventions Promoting Physical Activity Cost-Effective? A Systematic Review of Reviews

On the basis of international published reviews, this systematic review aims to determine the health economic benefits of interventions promoting physical activity.This review of reviews is based on a systematic literature research in 10 databases (e. g. PubMed, Scopus, SPORTDiscus) supplemented by hand searches from January 2000 to October 2015. Publications were considered in the English or German language only. Results of identified reviews were derived.In total, 18 reviews were identified that could be attributed to interventions promoting physical activity (2 reviews focusing on population-based physical activity interventions, 10 reviews on individual-based and 6 reviews on both population-based and individual-based physical activity interventions). Results showed that population-based physical activity interventions are of great health economic potential if reaching a wider population at comparably low costs. Outstanding are political and environmental strategies, as well as interventions supporting behavioural change through information. The most comprehensive documentation for interventions promoting physical activity could be found for individual-based strategies (i. e. exercise advice or exercise programs). However, such programs are comparatively less cost-effective due to limited reach and higher utilization of resources.The present study provides an extensive review and analysis of the current international state of research regarding the health economic evaluation of interventions promoting physical activity. Results show favourable cost-effectiveness for interventions promoting physical activity, though significant differences in the effectiveness between various interventions were noticed. The greatest potential for cost-effectiveness can be seen in population-based interventions. At the same time, there is a need to acknowledge the limitations of the economic evidence in this field which are attributable to methodological challenges and research deficits.

My Activity Coach - using video-coaching to assist a web-based computer-tailored physical activity intervention: a randomised controlled trial protocol.

BackgroundThere is a need for effective population-based physical activity interventions. The internet provides a good platform to deliver physical activity interventions and reach large numbers of people at low cost. Personalised advice in web-based physical activity interventions has shown to improve engagement and behavioural outcomes, though it is unclear if the effectiveness of such interventions may further be improved when providing brief video-based coaching sessions with participants. The purpose of this study is to determine the effectiveness, in terms of engagement, retention, satisfaction and physical activity changes, of a web-based and computer-tailored physical activity intervention with and without the addition of a brief video-based coaching session in comparison to a control group.Methods/DesignParticipants will be randomly assigned to one of three groups (tailoring + online video-coaching, tailoring-only and wait-list control). The tailoring + video-coaching participants will receive a computer-tailored web-based physical activity intervention (‘My Activity Coach’) with brief coaching sessions with a physical activity expert over an online video calling program (e.g. Skype). The tailoring-only participants will receive the intervention but not the counselling sessions. The primary time point’s for outcome assessment will be immediately post intervention (week 9). The secondary time points will be at 6 and 12 months post-baseline. The primary outcome, physical activity change, will be assessed via the Active Australia Questionnaire (AAQ). Secondary outcome measures include correlates of physical activity (mediators and moderators), quality of life (measured via the SF-12v2), participant satisfaction, engagement (using web-site user statistics) and study retention.DiscussionStudy findings will inform researchers and practitioners about the feasibility and effectiveness of brief online video-coaching sessions in combination with computer-tailored physical activity advice. This may increase intervention effectiveness at an acceptable cost and will inform the development of future web-based physical activity interventions.Trial registrationACTRN12614000339651Date: 31/03/2014.

Abstract PL04-03: Working in innovative settings to enhance reach and improve population-based physical activity levels

Abstract Physically active individuals accrue a wide range of health benefits including reduced risk of cardiovascular disease, stroke, diabetes and metabolic syndrome, certain types of cancer; as well as improving mental health, mood, bone and muscular strength, and reduced risk of falls. However, less than half of US adults (age 18+) meet the national Surgeon General recommendations of at least 150 minutes of moderate physical activity, including 2 days of strength training, each week. Certain subgroups of the population, Blacks, Hispanics, lower education and income levels, and those living in rural locations, are more likely to not meet the guidelines. In addition, 33.9% of the US population are considered “inactive” (e.g. less than 10 minutes of activity/week)….and inactive subgroups are also quite similar to those who do not meet physical activity guidelines. To address key health and cancer disparities, we must consider intervention strategies that improve reach and effectiveness within these subgroups. This presentation will share examples of working within innovative settings to improve physical activity levels, as well as decrease inactivity. We will introduce constructs of the RE-AIM framework to guide this discussion. Citation Format: Laura Linnan. Working in innovative settings to enhance reach and improve population-based physical activity levels. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr PL04-03.

Synthesising evidence for equity impacts of population-based physical activity interventions: a pilot study

BackgroundThis study applied an equity lens to existing research to investigate what is known about the impact of population-level physical activity interventions on social inequalities.MethodsWe performed a pilot systematic review to assess the availability of information on the social distribution of intervention effects, the targeting or allocation of interventions, and the baseline characteristics of participants. This comprised (i) a rapid review of systematic reviews and (ii) a review and synthesis of a sample of primary studies included in the eligible systematic reviews.ResultsWe found 19 systematic reviews of environmental and policy interventions. Relatively few of these (26%, n=5) were prospectively designed to examine effects on inequalities, and none were able to fully synthesise evidence of distributional effects. Over 40% of primary studies reported subgroup intervention effects; 18% reported socio-demographic interaction effects. Studies most often compared effectiveness by gender, followed by age, ethnicity, and socio-economic status. For gender, effects appeared to be evenly distributed overall, although heterogeneity in gradients between studies suggested that some interventions affect males and females differently.ConclusionsOur findings suggest that it is feasible to generate better evidence about how public health interventions may affect health inequalities using existing data and innovative methods of research synthesis.

Measurement of Physical Activity by Self-Report in Low- and Middle-Income Countries: More of the Same Is not Enough

In spite of the growing use of motion sensors, particularly accelerometers, for the measurement of physical activity in high-income countries,1 virtually all population-based physical activity studies from lowand middle-income countries (LMICs) still rely on selfreport.2,3 In addition to the well known financial aspect of this inequality, availability of trained personnel is another challenge in LMICs. Also, less widely known barriers, such as importation regulations also play a role.4 The measurement of physical activity in LMICs is particularly challenging. First, literacy issues need to be taken into account; low literacy makes self-administration of instruments in population-based samples virtually impossible. Second, the low coverage of telephone lines in several areas makes it unfeasible to conduct phone survey; for example, the Brazilian phone surveillance system takes place in state capitals only. Third, internet access is still a luxury in several parts of the world, and therefore, computer-based instruments are unlikely to be appropriate for large scale studies in LMICs.5 Over the last years, a series of papers tried to highlight underlying principles of physical activity measurement. However, most were developed in high-income countries and very little was said on the measurement of physical activity in LMICs. Some aspects that deserve special consideration are

Participation in a population-based physical activity programme as an aid for smoking cessation: a randomised trial

ObjectivesExercise combined with nicotine therapy may help smoking cessation and minimise weight gain after quitting. Low participation in vigorous-intensity physical activity programmes precludes their population-wide applicability. In a randomised controlled...

Environmental, psychological, and social influences on physical activity among Japanese adults: structural equation modeling analysis

BackgroundAn understanding of the contributing factors to be considered when examining how individuals engage in physical activity is important for promoting population-based physical activity. The environment influences long-term effects on population-based health behaviors. Personal variables, such as self-efficacy and social support, can act as mediators of the predictive relationship between the environment and physical activity. The present study examines the direct and indirect effects of environmental, psychological, and social factors on walking, moderate-intensity activity excluding walking, and vigorous-intensity activity among Japanese adults.MethodsThe participants included 1,928 Japanese adults aged 20-79 years. Seven sociodemographic attributes (e.g., gender, age, education level, employment status), psychological variables (self-efficacy, pros, and cons), social variables (social support), environmental variables (home fitness equipment, access to facilities, neighborhood safety, aesthetic sensibilities, and frequency of observing others exercising), and the International Physical Activity Questionnaire were assessed via an Internet-based survey. Structural equation modeling was conducted to determine associations between environmental, psychological, and social factors with physical activity.ResultsEnvironmental factors could be seen to have indirect effects on physical activity through their influence on psychological and social variables such as self-efficacy, pros and cons, and social support. The strongest indirect effects could be observed by examining the consequences of environmental factors on physical activity through cons to self-efficacy. The total effects of environmental factors on physical activity were 0.02 on walking, 0.02 on moderate-intensity activity excluding walking, and 0.05 on vigorous-intensity activity.ConclusionsThe present study indicates that environmental factors had indirect effects on walking, moderate-intensity activity excluding walking and vigorous-intensity activity among Japanese adults, especially through the effects on these factors of self-efficacy, social support, and pros and cons. The findings of the present study imply that intervention strategies to promote more engagement in physical activity for population-based health promotion may be necessary.

Lack of association between physical activity in smokers and plasma glutathione peroxidase levels.

One proposed mechanism for the protective effect of physical activity on cancer development is through increasing endogenous antioxidant enzyme systems such as glutathione peroxidase (GPX; ref. [1][1]). GPX reduces hydrogen and lipid peroxides to less toxic hydroxy fatty acids using glutathione as a

Prediction of leisure-time walking: an integration of social cognitive, perceived environmental, and personality factors

BackgroundWalking is the primary focus of population-based physical activity initiatives but a theoretical understanding of this behaviour is still elusive. The purpose of this study was to integrate personality, the perceived environment, and planning into a theory of planned behaviour (TPB) framework to predict leisure-time walking.MethodsParticipants were a random sample (N = 358) of Canadian adults who completed measures of the TPB, planning, perceived neighbourhood environment, and personality at Time 1 and self-reported walking behaviour two months later.ResultsAnalyses using structural equation modelling provided evidence that leisure-time walking is largely predicted by intention (standardized effect = .42) with an additional independent contribution from proximity to neighbourhood retail shops (standardized effect = .18). Intention, in turn, was predicted by attitudes toward walking and perceived behavioural control. Effects of perceived neighbourhood aesthetics and walking infrastructure on walking were mediated through attitudes and intention. Moderated regression analysis showed that the intention-walking relationship was moderated by conscientiousness and proximity to neighbourhood recreation facilities but not planning.ConclusionOverall, walking behaviour is theoretically complex but may best be addressed at a population level by facilitating strong intentions in a receptive environment even though individual differences may persist.

Estimating human energy expenditure: a review of techniques with particular reference to doubly labelled water.

This review includes an historical overview of the techniques for measuring energy expenditure (EE). Following this overview, the "gold standard" method of measuring EE, the doubly labelled water (DLW) method, is emphasised. Other methods, such as direct calorimetry, indirect calorimetry systems, heart rate and EE relationships, questionnaires and activity recall, motion sensors, combined heart rate and motion sensors for the estimation of EE are then highlighted in relation to their validation against the DLW method. The major advantages and disadvantages for each method are then considered. The preferred method to determine EE is likely to depend principally on factors such as the number of study participants to be monitored, the time period of measurements and the finances available. Small study participant numbers over a short period may be measured accurately by means of indirect calorimetric methods (stationary and portable systems). For periods over 3-4 days, EE should ideally be measured using the DLW method. However, the use of motion sensors is very promising in the measurement of EE, and has a number of advantages over the DLW method. Furthermore, if used correctly, both heart rate and questionnaire methods may provide valuable estimates of EE. Additional studies are needed to examine the possibility of improving the accuracy of measurement by combining two or more techniques. Such information, if confirmed by scientific rigour, may lead to an improvement in the estimation of EE and population-based physical activity levels. The accurate measurement of physical activity and EE is critical from both a research and health prospective. A consideration of the relevant techniques used for the estimation of EE may also help improve the quality of these frequently reported measurements.