Promote Physical Activity Levels Research Articles

Home-based exercise interventions' impact on breast cancer survivors' functional performance: a systematic review.

Home-based exercise (HBE) programs can be a feasible strategy to enhance functional performance and promote physical activity (PA) in breast cancer survivors. A deeper analysis of the effects of HBE interventions, structured by HBE program type and treatment phase, is needed. This systematic review aimed to synthesize the evidence on HBE interventions' impact on breast cancer survivors' functional performance, PA levels, and program adherence rates, according to HBE intervention type and treatment phase. A comprehensive search of peer-reviewed articles reporting HBE interventions' effects on the outcomes of interest was performed in Pubmed, Google Scholar, EBSCO, Web of Science, Science Direct, and B-ON until January 15th, 2024. Data were synthesized according to Denton's domains to classify HBE interventions (prescription: structured vs. unstructured; Delivery method: supervised vs. facilitated vs. unsupervised) and treatment phase. Methodological quality appraisal was performed using the Effective Public Health Practice Project tool. Twenty-six studies were included. Most studies conducted structured/facilitated interventions and reported positive effects on functional performance (particularly aerobic capacity), increases in PA levels, and high adherence rates (> 70%) during and post-treatment. HBE interventions may be feasible to improve functional performance and promote physical activity among breast cancer survivors. Further studies are needed to confirm which HBE intervention type is more appropriate for each treatment phase. More evidence applying HBE interventions with different designs is required to allow the drawing of more solid conclusions. Studies exploring the effects of HBE interventions on the pre-treatment phase are needed.

Effectiveness of lifestyle interventions to promote physical activity on glycated hemoglobin and physical activity in type 2 diabetes patients - Systematic review with meta-analysis

Introduction
 An increase in Type 2 diabetes (T2D) cases worldwide can be attributed to the prevalence of an unhealthy lifestyle. Engaging in regular exercise can significantly benefit individuals with T2D (Colberg et al., 2016). A multitude of studies have explored this impact through controlled exercise interventions (Hou et al., 2023). Nevertheless, our understanding of how lifestyle interventions can effectively promote physical activity (PA) and positively influence the progression of T2D in practical, real-world scenarios remains limited. The objective of this systematic review with meta-analysis is to investigate the impact of lifestyle interventions targeting the promotion of PA on glycated hemoglobin (HbA1c) levels and PA outcomes. Furthermore, the aim is to examine whether lifestyle interventions influence PA and therefore HbA1c.
 Methods
 We searched three databases (MEDLINE via PubMed, PsycINFO, and SPORTdiscus) using the expanded search strategy of “Type 2 diabetes” AND “lifestyle intervention” AND “randomized controlled trial” AND “physical activity” AND “HEMOGLOBIN A1C”. In order to provide a comprehensive overview, we examine the design of the studies and the structure of the lifestyle interventions. To address the aim of this study, we conducted a meta-analysis with the outcomes PA and HbA1c. Moreover, we performed a multivariate meta-regression analysis to explore the impact of the moderator variable, PA, on the study effect sizes of HbA1c.
 Results
 This review incorporated 12 studies (n = 2513 patients), exploring multiple lifestyle interventions with heterogeneity in design, components, and duration. Regarding PA outcomes, we found an increase in PA (g = 0.33, 95% CI = 0.21,0.45), with no disparity between objective and self-reported measurements of PA. For HbA1c, the effect size was g = -0.07 (95% CI -0.17,0.04). In multivariate meta-regression, the intercept was 0.004 (SE = 0.06, 95% CI -0.11,0.12), and the PA coefficient as a moderator was -0.05 (SE = 0.06, 95% CI -0.18,0.07). These findings suggest that physical activity does not act as a moderator for changes in HbA1c in the examined studies.
 Discussion/Conclusion
 The studies showed a small effect in increasing PA. Lifestyle interventions had no relevant impact on HbA1c compared to control conditions, and the role of PA as a moderator was inconclusive. Further research is required to determine if structured exercise programs, known for positively affecting HbA1c, could be a better alternative to lifestyle interventions for individuals with T2D. Additionally, there is a need to investigate ways to enhance the efficacy of lifestyle interventions in influencing PA and HbA1c levels.
 References
 Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., Horton, E. S., Castorino, K., & Tate, D. F. (2016). Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065-2079. https://doi.org/10.2337/dc16-1728
 Hou, L., Wang, Q., Pan, B., Li, R., Li, Y., He, J., Qin, T., Cao, L., Zhang, N., & Cao, C. (2023). Exercise modalities for type 2 diabetes: A systematic review and network meta‐analysis of randomized trials. Diabetes/Metabolism Research and Reviews, 39(1), Article e3591. https://doi.org/10.1002/dmrr.3591

Revisiting the Transtheoretical Model for Physical Activity: A Large-Scale Cross-Sectional Study on Japanese-Speaking Adults.

The Transtheoretical Model (TTM) has been the basis of health promotion programs, which are, for example, used to tailor behavioral interventions according to the stages of change. Empirical studies have shown that the TTM effectively describes the processes of behavioral adaptation to acquire healthier lifestyles; however, it has been argued that TTM-based interventions are not superior to non-TTM-based interventions for promoting physical activity (PA). Evidence has also highlighted some inconsistencies with theoretical assumptions, especially regarding how each process-of-change strategy emerges across the stages. Therefore, we investigated (a) how well the TTM describes the distributional characteristics of PA levels as well as other relevant variables (e.g., process of change, self-efficacy) across stages, and (b) how predictive the TTM variables are of PA levels within each stage. We analyzed data from 20,573 Japanese-speaking adults who completed online questionnaires on PA and TTM variables. The results replicated previous findings that stage membership is associated with PA, the process of change, decisional balance, and self-efficacy, albeit with inconclusive evidence of temptations. Regression analyses revealed that some processes of change (self-reevaluation, reinforcement management, and self-liberation) were more predictive of PA in pre-active stages than in post-action stages; self-efficacy was predictive of PA only in the maintenance stage but not in the other stages. Overall, the data support the theoretical assumptions of the TTM, but the stage specificity of the active processes may not always be consistent with the theory.

ASSOCIATION BETWEEN PET OWNERS’ AND PETS’ PHYSICAL ACTIVITY LEVELS: A SYSTEMATIC REVIEW

Abstract Social support can promote physical activity (PA) participation. According to socioemotional selectivity theory, engaging in PA with or for important social partners may be particularly motivating for older adults. Recently, pets have been recognized as important social partners. Although studies and literature syntheses have compared PA levels of people with vs. without pets, less is known about whether humans and pets are actually active together, i.e., whether their activity levels are associated. We examined this question in a systematic literature review. Through searches in Web of Science and PubMed with a priori specified inclusion and exclusion criteria, we identified 17,565 potential records. A two-step screening process yielded 9 studies for inclusion in the systematic review. Using a modified version of the STROBE checklist, we rated their quality as M = 21.89 (SD = 2.93) out of 30 possible points. Of the 9 included studies, only 5 explicitly calculated the association between human and pet PA; 4 found a positive association and 1 found no association. Of the 9 included studies, 4 studies explicitly included older adults 60+ years. However, variations in the association between human and pet PA by age were not examined. It seems that humans and their pets are active together. A more thorough examination of this question could provide a basis for an intervention aimed at increasing human PA by incorporating pets. Such an intervention may be particularly suitable for older adults who have lost important human social partners or who have difficulty accessing PA group programs.

Association of Abnormal Sleep Duration and Sleep Disturbance with Physical Activity in Older Adults: Between- and within-Person Effects

ObjectivesSleep is associated with physical activity (PA), yet the nature and directions of this association are less understood. This study aimed to disentangle the long-term temporal sequences between sleep duration/disturbance and PA in older adults, distinguishing between- and within-person effects. DesignLongitudinal panel study. Setting and ParticipantsWe conducted a longitudinal study using 3 waves of data collected in 2008/09 (T1), 2012/13 (T2), and 2016/17(T3) from adults aged ≥50 years in the English Longitudinal Study of Ageing (N = 10,749 individuals). MeasuresSleep duration, sleep disturbance, and PA were assessed by self-reported questionnaires. We used cross-lagged panel models (CLPMs) to examine between-person effects and random intercept cross-lagged panel models (RI-CLPMs) to examine within-person effects. ResultsOur analyses revealed a reciprocal relationship between abnormal sleep duration and low PA levels at between-person level (abnormal sleep duration to PA: βT1-T2 = −0.053, βT2-T3 = −0.058, all P < .001; PA to abnormal sleep duration: βT1-T2 = −0.040, βT2-T3 = −0.045, all P < .05), with abnormal sleep duration being the driving force in the dynamic association. In addition, there was a unidirectional effect of more severe sleep disturbance on lower levels of PA at both between- and within-person levels (between-person level: βT1-T2 = −0.032, βT2-T3 = −0.028, all P < .001; within-person level: βT1-T2 and T2-T3 = −0.031, all P = .011). Conclusions and ImplicationsThis study adds novel insights into the temporal directionality of sleep and PA among community-dwelling older adults and highlights poor sleep as a potential risk factor for PA. Intervention strategies should aim to improve sleep to promote PA levels and successful aging.

Intervention Research In Health Promotion: The Challenges of Transferability of a Youth Nutrition Project

Abstract Recent evidence reports the efficacy of theory-based interventions to promote physical activity (PA) among population (Gourlan et al., 2015). However, despite those encouraging results reported in the scientific literature, few documents currently exists to help professionals in the health and educational domains to implement theory-based interventions (Marcus &amp; Forsyth, 2009). The “Great Live and Move Challenge” (GLMC) is an intervention based on the tenets of the theory of planned behavior (TPB, Ajzen, 1991) which aim to promote PA among 7-11 years old French school-aged children and their parents (Cousson-Gélie et al., 2019). Throughout the GLMC, children are asked to quantify their daily PA level by illustrating each 15 minutes of PA achieved with an “energy cube”. The cluster randomised controlled trial showed the effectiveness of GLMC in 3121 children by significantly increasing the proportion of children doing one hour of physical activity per day. During a two-year follow-up, children answered each year a questionnaire measuring TPB constructs and weekly physical activity practice both at pre- and post-intervention. A subsample of 157 children also wore an accelerometer (i.e., Actigraph GT3X+). Results notably show that the intervention had a positive impact on the proportion of children who comply with physical activity guidelines during the two years of follow-up, with an increase each year. The GLMC is now implemented in 7 French departments and reaches over 24,000 children. Based on these results, we would like to propose an adaptation of the GLMC for adults, by adapting this intervention in the professional environment, in order to maintain the community aspect of the project. After the presentation of the project and its transferability in different spaces, an interactive debate will be organised on the challenges of transferability.

Effects of School Nurse-Led Interventions in Collaboration with Kinesiologists in Promoting Physical Activity and Reducing Sedentary Behaviors in Children and Adolescents: A Systematic Review.

The World Health Organization (WHO) recommends that schools adopt a whole-school strategy for healthy behaviors involving different health professionals. The present systematic review aimed to evaluate the efficacy of nurse-led interventions in collaboration with kinesiologists on physical activity and lifestyle behaviors' outcomes in school settings. The protocol was registered in PROSPERO (ID: CRD42022343410). The primary research study was developed through the PICOS question: children and adolescence 6-18 years (P); school nurse-led interventions in promoting physical activity (PA) and reducing sedentary behaviors (I); usual lessons, no intervention focusing on PA (C); PA levels, sedentary behaviors, and healthy lifestyle behaviors (O); experimental or observational study with original primary data and full-text studies written in English (S). Seven studies were included. Interventions were heterogeneous: besides physical activities carried out in all studies, the interventions were based on different health models and strategies (counselling, face-to-face motivation, education). Five out of seven articles investigated PA levels or their related behaviors using questionnaires, and two used ActiGraph accelerometers. Lifestyle behaviors were assessed with heterogeneous methods. Five out of seven articles showed an improvement in at least one outcome after the interventions, whereas two papers showed a statistically non-significant improvement. In conclusion, school interventions involving nurses, also in association with other professionals such as kinesiologists, can be effective in reducing sedentary behaviors and improving healthy lifestyles in children and adolescents.

Effects of Face-to-Face and eHealth Blended Interventions on Physical Activity, Diet, and Weight-Related Outcomes among Adults: A Systematic Review and Meta-Analysis.

An increasing number of studies are blending face-to-face interventions and electronic health (eHealth) interventions to jointly promote physical activity (PA) and diet among people. However, a comprehensive summary of these studies is lacking. This study aimed to synthesize the characteristics of blended interventions and meta-analyze the effectiveness of blended interventions in promoting PA, diet, and weight-related outcomes among adults. Following the PRISMA guidelines, PubMed, SPORTDiscus, PsycINFO, Embase, and Web of Science were systematically searched to identify eligible articles according to a series of inclusion criteria. The search was limited to English language literature and publication dates between January 2002 and July 2022. Effect sizes were calculated as standardized mean difference (SMD) for three intervention outcomes (physical activity, healthy diet, and weight-related). Random effect models were used to calculate the effect sizes. A sensitivity analysis and publication bias tests were conducted. Of the 1561 identified studies, 17 were eligible for the systematic review. Studies varied in participants, intervention characteristics, and outcome measures. A total of 14 studies were included in the meta-analyses. There was evidence of no significant publication bias. The meta-analyses indicated that the blended intervention could lead to a significant increase in walking steps (p < 0.001), total PA level (p = 0.01), and diet quality (p = 0.044), a significant decrease in energy intake (p = 0.004), weight (p < 0.001), BMI (p < 0.001), and waist circumferences (p = 0.008), but had no influence on more moderate-to-vigorous physical activity (MVPA) or fruit and vegetable intake among adults, compared with a control group. The study findings showed that blended interventions achieve preliminary success in promoting PA, diet, and weight-related outcomes among adults. Future studies could improve the blended intervention design to achieve better intervention effectiveness.

DOES EXERGAME HELP IMPROVE PRE-SERVICE TEACHERS’ PERCEPTIONS, KNOWLEDGE AND MOTIVATION TO ENGAGE IN PHYSICAL ACTIVITY?

This study aims to explore participants’ insights and feelings towards exergame concepts to promote physical activity (PA). Specifically, aspects such as participants’ perceptions, knowledge and motivation towards exergame were analysed to investigate how exergame influences their engagement with PA and learning during online distance learning (ODL). This study adopted a qualitative research design. Both video recording (2 minutes/video) and drawings (i.e., discussed in part two) were utilised to explore the participants’ perceptions, knowledge, and motivation with exergame. Convenience sampling was utilised to gather participants who comprised of 45 first-year undergraduate physical and health education (PHE), biology and chemistry major students ages between 20-25 years (i.e., 13 males and 32 females, respectively). The Interpretive Phenomenological Analysis approach was referred to develop the procedures and instruments while Consider.ly software (Usertime Solutions GmbH) was used to analyse data from the videos and drawings. Additionally, the keywords and significant answers were also noted, clustered into main themes to ease understanding and superordinate themes related to this study. Findings indicate that: (i) Exergame concepts were effective in increasing both participants’ learning enjoyment and PA level, (ii) The addition of exergame was successful in promoting higher engagement between participants and educators, (iii) A lot of participants reported higher motivation to learn course contents and (iv) Perceived exergame as an opportunity to sharpen their thinking skills through challenges presented in exergame. Overall, the findings contribute to our understanding of how pedagogical strategies such as exergame can be adopted in and out of the classroom to promote desirable learning experiences and academic outcomes.

'Weekend warrior' and regularly active physical activity patterns confer similar cardiovascular and mortality benefits: a systematic meta-analysis.

It is well documented that physical activity (PA) is associated with a lower risk of non-communicable diseases including cardiovascular disease (CVD) as well as mortality.1–3 Previous PA guidelines as well as recent guidelines by the World Health Organization have recommended that all adults should aim for 150–300 min of moderate intensity PA per week or 75–150 min of vigorous intensity PA per week or an equivalent combination of moderate-intensity and vigorous-intensity PA per week.4 Evidence suggests these levels provide substantial health benefits in most people.2 Despite guideline recommendations and population-wide strategies to promote PA levels, most populations do not adhere to PA recommendations. A major reason for the low levels of adherence is the lack of time. The balance between frequency, duration, and intensity, which are components of PA, plays an important part in the protective effects of PA. To derive maximal benefits from PA, an appropriate intensity, frequency, and duration, which comprise the volume is essential. However, emerging evidence suggests that the intensity of PA may be more important than the quantity (frequency or duration).5 It is uncertain if the majority of PA concentrated into a few days confers similar cardiovascular benefits as that spread over more days. Following the seminal study by Lee et al.,6 a few recent reports have evaluated whether guideline recommended PA patterns concentrated in one or two sessions per week (commonly called the ‘weekend warrior’ pattern) or patterns spread over multiple sessions per week (i.e. regularly active pattern) may differ with respect to cardiovascular outcomes and mortality. Some studies have reported similar benefits,7 whereas other reports suggest that regularly active PA patterns confer more benefits than weekend warrior PA patterns.6,8 Given the sparseness and inconsistency of the data, there is a need to systematically synthesize the existing evidence. Furthermore, given the relatively low sample size of some of these previous studies, pooling the overall evidence will provide adequate power to reveal any true associations. In this context, we aimed to assess and compare the associations of weekend warrior and regularly active PA patterns vs. inactive PA patterns with the risk of adverse cardiovascular outcomes using a systematic review and meta-analysis of all published observational cohort studies conducted on the topic.

The Use of Wearable Activity Trackers in Schools to Promote Child and Adolescent Physical Activity: A Descriptive Content Analysis of School Staff's Perspectives.

The school environment is an ideal setting for promoting physical activity (PA). Wearable activity trackers (wearables) have previously been implemented, in research, as intervention tools within the school-environment. However, the large-scale use and acceptance of wearables, in schools, is unknown. This study distributed a cross-sectional survey to school staff to investigate the prevalence of child and adolescent wearable use in schools, including when and how they are used, and school staff's willingness to use them in the future (as implemented by school staff). This survey consisted of between 13 and 22 items, including closed-ended and open-ended questions. Closed-ended responses were displayed descriptively (wearable prevalence and characteristics), and open-ended qualitative responses were categorised using descriptive content analysis (how wearables are used). 1087 school staff provided valid responses. Of those, 896 (82.4%) had never used a wearable as a teaching or support tool for their students, and 120 (11%) currently used- and 71 (6.5%) had previously used- a wearable as a teaching or support tool for their students. When wearables were used, school staff implemented their use regularly and during physical education lessons or throughout the entire school day. Wearables were used to monitor or increase student's PA levels, or for student and staff educational purposes (e.g., academic learning, movement breaks). Most school staff were willing to use a wearable as a teaching or support tool to promote student's PA, and/or learning about PA, in the future. This study is the first study to explore the widescale use and acceptance of children and adolescents using wearables in the school-setting. Findings may inform the development of future school-based interventions and public health initiatives for physical activity promotion, using wearables.

P01-16 EUMOVE Project: an Erasmus+ Project for the promotion of healthy lifestyles among children and adolescents

Physical inactivity is a worldwide public challenge and a leading risk factor for overweight and obesity. Despite the well-recognized benefits of physical activity (PA), only 29% of European youth meet recommended guidelines of at least 60 minutes of daily moderate-to-vigorous PA. The school setting provides an ideal environment to promote healthy lifestyles among young people as initiatives can target all students and the whole school community. The main goal of the EUMOVE project is to design and implement a comprehensive set of strategies and resources to enable the educational community to promote healthy lifestyles in order to reduce risk factors for non-communicable diseases.EUMOVE project (https://eumoveproject.eu/) is a 3-year project delivered by a collaboration between academic and non-governmental institutions from Spain, Portugal, France, Italy, and the United Kingdom. The direct beneficiaries of the project will include school leaders, teachers, and parents, and indirect beneficiaries will be primary and secondary students. EUMOVE project will develop a set of strategies and resources such as Physically Active Lessons Toolkit, Real Time Active Breaks Platform, Active School Commuting Toolkit, Learning Units about healthy lifestyles promotion, School Leaders toolkit, Parents Toolkit about promoting healthy lifestyles, and Mobile phone APP. Project dissemination will be implemented across each partner region and includes: Online dissemination through a learning platform, scientific events aimed at teachers and researchers, workshops with teachers including training on how to use the teaching resources, and Workshops with parents providing recommendations for promoting healthy lifestyle in their children.Thus, the EUMOVE project offers evidence-based and innovative resources to be applied by the educational community in the real-world setting to promote PA levels, appropriate diet and sleep habits, and reduce sedentary time amongst children and adolescents across a number of European countries.

Effectiveness and implementation success of a co-produced physical activity referral scheme in Germany: study protocol of a pragmatic cluster randomised trial

BackgroundWhile effective physical activity referral schemes (PARSs) and related structures for promoting physical activity (PA) already exist in several countries, in Germany, PARSs have not yet been implemented systematically and nationwide. Through a co-production approach with relevant actors in the German healthcare system, a PARS was developed, and an implementation plan was created (e.g. financing). This study protocol aims to evaluate the developed PARS for people with non-communicable diseases (NCDs) in Germany regarding its potential effectiveness and implementation success.MethodsTo evaluate the effectiveness and implementation success of the PARS, we will apply a pragmatic cluster-randomised controlled trial (cRCT) in Hybrid II design by comparing two intervention groups (PARS vs PA advice [PAA]). The trial will take place in the Nürnberg metropolitan region, with 24 physician practices recruiting 567 people with NCDs. Both groups will receive brief PA advice from a physician to initially increase the participants’ motivation to change their activity level. Subsequently, the PARS group will be given individualised support from an exercise professional to increase their PA levels and be transferred to local exercise opportunities. In contrast, participants in the PAA group will receive only the brief PA advice as well as information and an overview of regional PA offerings to become more active at their own initiative. After 12 and 24 weeks, changes in moderate to vigorous PA and in physical activity-related health competence (movement competence, control competence, self-regulation competence) will be measured as primary outcomes. Secondary outcomes will include changes in quality of life. To measure implementation success, we refer to the RE-AIM framework and draw on patient documentation, interviews, focus groups and surveys of the participating actors (physicians, exercise professionals).DiscussionThrough a between-group comparison, we will investigate whether additional individual support by an exercise professional compared to brief PA advice alone leads to higher PA levels in people with NCDs. The acceptance and feasibility of both interventions in routine care in the German healthcare system will also be evaluated.Trial registrationClinicalTrials.gov, NCT04947787. Registered 01 June 2021.

Investigating psychological variables for technologies promoting physical activity.

BackgroundMany technological interventions designed to promote physical activity (PA) have limited efficacy and appear to lack important factors that could increase engagement. This may be due to a discrepancy between research conducted in this space, and software designers’ and developers’ use of this research to inform new digital applications.ObjectivesThis study aimed to identify (1) what are the variables that act as barriers and facilitators to PA and (2) which PA variables are currently considered in the design of technologies promoting PA including psychological, physical, and personal/contextual ones which are critical in promoting PA. We emphasize psychological variables in this work because of their sparse and often simplistic integration in digital applications for PA.MethodsWe conducted two systematized reviews on PA variables, using PsycInfo and Association for Computing Machinery Digital Libraries for objectives 1 and 2.ResultsWe identified 38 PA variables (mostly psychological ones) including barriers/facilitators in the literature. 17 of those variables were considered when developing digital applications for PA. Only few studies evaluate PA levels in relation to these variables. The same barriers are reported for all weight groups, though some barriers are stronger in people with obesity.ConclusionsWe identify PA variables and illustrate the lack of consideration of these in the design of PA technologies. Digital applications to promote PA may have limited efficacy if they do not address variables acting as facilitators or barriers to participation in PA, and that are important to people representing a range of body weight characteristics.

Abstract P069: Temporal Patterns Of Adherence To The Physical Activity Goal In A Mobile Health Weight-loss Trial

Background: Wearable trackers such as Fitbit may promote physical activity (PA) levels recommended by the US Physical Activity Guidelines. However, there is a lack of evidence on the associations between long-term wearable tracker use and temporal patterns of PA levels. Therefore, we aimed to identify distinct trajectories of the adherence to PA goals using group-based trajectory modeling in a year-long mobile health weight-loss trial. Method: PA data were collected within the SMARTER weight-loss trial that recruited adults (i.e., age ≥18 years) from 2018 to 2020 from southwest PA, USA. Healthy adults with body mass index between 27-43 kg/m 2 were randomized to either self-monitoring with daily personalized feedback messages (SM+FB, n=251) or self-monitoring only (SM, n=251) and followed for 52 weeks. Adherence to weekly PA goals, the primary outcome of this analysis, was computed as the percentage of fairly active and very active total minutes per week measured by Fitbit Charge 2™ relative to the minimum PA goal of 150 minutes/week recommended for all study participants. We used group-based trajectory modeling to identify distinct temporal patterns of adherence to weekly PA goals. Results: The sample (N = 502) was mostly female (n=399, 79%), white (n=423, 82%) with a mean age of 45.0 ± 14.4 years. Among the models considered, the five-group trajectory model for adherence to weekly PA goals was selected based on the best data fit: low adherence with a linear decline (n=80, 16.0%; b[intercept] ± SE: 73.18 ± 5.03, p&lt;.0001; b[linear] ± SE: -6.37±.28, p&lt;.0001); low initial adherence with nonlinear increase (n=194, 38.7%; b[intercept] ± SE: 93.48 ± 3.63, p&lt;.0001; b[linear] ± SE: .49 ± .31, p=.108;b[quadratic] ± SE: -.03±.01, p&lt;.0001); moderate initial adherence with linear decline (n=145, 28.8%, b[intercept] ± SE: 230.53 ±2.83, p&lt;.0001; b[linear] ± SE: -.40±.09, p&lt;.0001), moderate initial adherence with nonlinear decline (n=39, 7.8%, b[intercept] ± SE: 216.99 ± 18.72, p&lt;.0001; b[linear] ± SE: 0.25 ± 7.46, p=.974; b[quadratic] ± SE: -1.57 ± .93, p=.090; b[cubic] ± SE: .12 ± .05, p=.010; b[quartic] ± SE: -.004 ± .001, p=.010; b[quantic] ± SE: .00003±.00001, p&lt;.0001), and high initial adherence with nonlinear decline (n=44, 8.8%; b[intercept] ± SE: 379.46 ± 9.84, p&lt;.0001; b[linear] ± SE: 2.37 ± 1.59, p=.138; b[quadratic] ± SE: .10 ± .07, p=.171; b[cubic] ± SE: -.003±.001, p=.003). Conclusions: We identified five distinct trajectories for long-term adherence to the PA goal over 52 weeks. More research is needed to determine additional means of supporting PA in individuals with low and declining adherence trajectories.

The Effects of mHealth-Based Gamification Interventions on Participation in Physical Activity: Systematic Review.

BackgroundIt is well known that regular physical exercise has associated benefits; yet, participation remains suboptimal. Mobile health (mHealth) has become an indispensable medium to deliver behavior change interventions, and there is a growing interest in the gamification apps in mHealth to promote physical activity (PA) participation. Gamification could use game design elements (such as points, leaderboards, and progress bars), and it has the potential to increase motivation for PA and engagement. However, mHealth-based gamification interventions are still emerging, and little is known about the application status and efficacy of such interventions.ObjectiveThis systematic review aims to investigate gamification apps in mHealth for improving PA levels and simultaneously summarize the impact of gamification interventions on PA participation.MethodsWe searched PubMed, Scopus, Web of Science, Embase, CINAHL (EBSCO host), and IEEE Xplore from inception to December 20, 2020. Original empirical research exploring the effects of gamification interventions on PA participation was included. The papers described at least one outcome regarding exercise or PA participation, which could be subjective self-report or objective indicator measurement. Of note, we excluded studies about serious games or full-fledged games.ResultsOf 2944 studies identified from the database search, 50 (1.69%) were included, and the information was synthesized. The review revealed that gamification of PA had been applied to various population groups and broadly distributed among young people but less distributed among older adults and patients with a disease. Most of the studies (30/50, 60%) combined gamification with wearable devices to improve PA behavior change, and 50% (25/50) of the studies used theories or principles for designing gamified PA interventions. The most frequently used game elements were goal-setting, followed by progress bars, rewards, points, and feedback. This review demonstrated that gamification interventions could increase PA participation; however, the results were mixed, and modest changes were attained, which could be attributed to the heterogeneity across studies.ConclusionsOverall, this study provides an overview of the existing empirical research in PA gamification interventions and provides evidence for the efficacy of gamification in enhancing PA participation. High-quality empirical studies are needed in the future to assess the efficacy of a combination of gamification and wearable activity devices to promote PA, and further exploration is needed to investigate the optimal implementation of these features of game elements and theories to enhance PA participation.

Usage of Digital Health Tools and Perception of mHealth Intervention for Physical Activity and Sleep in Black Women.

Black women of reproductive age are disproportionately affected by chronic health conditions and related disease risk factors such as physical inactivity and obesity. Health promotion studies need to focus on this population since optimizing preconception health will lead to improvement of both birth outcomes and the woman’s long-term health. mHealth interventions that utilize wearable sensors to provide personalized and timely feedback can be used to promote physical activity (PA). This study aimed to examine Black women’s wearable sensor usage and their perceptions about future mHealth interventions that target PA and sleep. Our analysis included 497 Black women (aged 18–47 years) who completed a cross-sectional online survey. Ninety-two percent of participants did not meet the recommended level of PA, and 32.3% reported poor sleep quality. More participants indicated interest in a remote PA program (77%) than an in-person one (73%). More than half of participants indicated interest in receiving personalized feedback messages based on wearable trackers about PA (58.1%) and sleep (63.5%). This perceived acceptability of remote intervention and wearable-based feedback messages did not differ by socioeconomic status. Remotely delivered mHealth interventions that utilize wearables can be a viable behavioral change strategy to promote PA and sleep quality in Black women.

High fitness levels attenuate the increased risk of heart failure due to low socioeconomic status: A cohort study

High fitness levels attenuate the increased risk of heart failure due to low socioeconomic status: A cohort study

Cooperative planning in childcare centers to improve physical activity: a qualitative investigation of directors' perspectives.

SummaryInterventions to promote physical activity (PA) in childcare centers have been shown to increase children’s PA levels; moreover, a growing number of evidence-based best practice guidelines exist for this setting. However, there is a lack of knowledge on the facilitators of and barriers to the successful implementation of PA guidelines and interventions. We used Cooperative Planning to improve capabilities for PA in childcare centers. This qualitative study aimed to explore childcare center directors’ views on the Cooperative Planning process and identify the facilitators of and barriers to its implementation. We conducted guided semi-structured interviews with the directors of nine childcare centers after completion of the 12-month Cooperative Planning process. The interviews were recorded, transcribed and analyzed using qualitative content analysis with inductive category development. Facilitators and barriers were systematized according to the Consolidated Framework for Implementation Research (CFIR). Cooperative Planning was regarded as being helpful for structuring the process and involving all team members. Several facilitators within the CFIR domains inner setting (structural characteristics, networks and communications, implementation climate), outer setting (support from parents and provider), characteristics of individuals (intrinsic motivation of the staff) and process (individual drivers) were identified. The reported barriers included structural characteristics (e.g. lack of time), networks and communications (e.g. team conflicts) and characteristics of individuals (e.g. lack of willingness to accept change). Several contextual and interpersonal factors seem to influence the extent to which a Cooperative Planning process can be implemented by a childcare center’s team. Future research is needed to evaluate the strategies needed to overcome the identified barriers.

Do Framed Mental Health Messages on Social Media Influence University Students' Motivation for Physical Activity?

Message framing has been used as a strategy for promoting physical activity (PA) in university students, but the effectiveness of gain-framed (GF), or loss-framed (LF) messages is variable. This study aims to investigate the effects on motivation and PA behaviour of framed messaging on social media in university students. Gain- and loss-framed messages communicated the mental health outcomes of PA. A three-arm feasibility study (n = 148) collected pre-post intervention online questionnaire responses to assess motivation for PA, exercise, active travel, and PA levels, in response to the messaging intervention on Facebook. Both GF and LF messages effectively increased average motivation for PA in comparison to controls (GF by 0.3 (on a 7-point Likert scale), 9% [95% CI: 3–17%], p = 0.007, LF by 0.3, 10% [CI: 3–18%], p = 0.005). Average motivation for exercise increased in comparison to controls (GF by 0.6, 16% [95% CI: 6–26%], p = 0.001, LF by 0.5, 14.6% [95% CI: 5–26%], p < 0.001). Average motivation for active travel increased in comparison to controls (GF by 0.7, 18% [95% CI: 8–29%], p < 0.001, LF by 0.6, 19% [95% CI: 8–30%], p < 0.001). No meaningful differences between GF or LF messages were observed. Framed messages regarding mental health outcomes of PA delivered via social media could be effective for increasing PA motivation in university students. However, based on our results there is no gain- or loss-framed advantage.