Promote Physical Activity Behavior Research Articles

Factors influencing physical activity behavior in older adults with subjective cognitive decline: an empirical study using SEM and fsQCA methods.

Despite the evident potential benefits of engaging in physical activity (PA) for older adults with subjective cognitive decline (SCD), their PA levels remains low. Previous research has predominantly focused on PA behaviors in individuals with dementia/mild cognitive impairment, with limited attention given to those with SCD. Therefore, this study aims to identify key factors influencing PA behavior in older adults with SCD based on the Self-Determination Theory (SDT) and the capability-opportunity-motivation (COM-B) model. Three hundred and three individuals aged 60 and above with SCD participated in this study. A face-to-face structured questionnaire survey was conducted. Data were analyzed using Structural Equation Modeling (SEM) and Fuzzy Set Qualitative Comparative Analysis (fsQCA). SEM results indicate that PA social support primarily influences PA behavior through three indirect pathways: the separate mediating effect of basic psychological needs, the separate mediating effect of motivation, and the chained mediating effect of both. Physical literacy, on the other hand, influences PA behavior through the separate mediating effect of motivation. Necessary conditions analysis by fsQCA reveals that no single factor is necessary for promoting PA behavior in older adults with SCD, while sufficiency analysis identifies four different combinations of factors leading to PA behavior. The model derived from the framework of SDT and the COM-B model effectively explains and predicts the interrelationships among variables. Physical activity behavior in older individuals with SCD is the result of multifactorial synergies.

Assessing the relationship between urban park spatial features and physical activity levels in Residents: A spatial analysis Utilizing drone remote sensing

The park environment is crucial for promoting physical activity (PA). While numerous studies show that park environments influence PA behavior, inconsistencies remain, likely due to varing research methods and parks types. This study employs a fixed spatial grid method to systematically sample four representative parks in Tianjin, China. High-precision orthophoto map (DOM) data from drones provided detailed environmental attributes (like tree canopy area, lawn area, and paved area) and PA characteristics (number of participants, intensity, diversity). The results show: 1) Cluster analysis grouped 1839 park grids into 12 environmental attribute integrations, each correlating with different PA characteristics. “Tree-lined jogging corridors” and “Large sports field areas” exhibit the highest PA intensity, while “Entrance plazas”, “Central plazas,” and “Open sports spaces” have the highest number of participants and PA diversity. 2) Correlation analysis shows that various environmental attributes, including Lawn Area, and Paved Area, are significantly correlated with PA characteristics. 3）Random Forest analysis indicates the key attributes are the paved area for the number of PA participants and PA diversity, and specialized sports facilities area for PA intensity. These findings support urban green space planning and highlight the importance of better park environments for public health.

What Effect Do Goal Setting Interventions Have on Physical Activity and Psychological Outcomes in Insufficiently Active Adults? A Systematic Review and Meta-Analysis.

Goal setting is commonly used for promoting physical activity (PA) among insufficiently active individuals. Previous reviews have analyzed the effects of goal setting on PA, but the purpose of this systematic review was to examine the concurrent effects of goal setting on PA and psychological outcomes in insufficiently active individuals to support interventions aiming to produce sustained PA behavior change. In this review (PROSPERO: CRD42021243970), we identified 13 studies with 1208 insufficiently active adults that reported the effects of goal-setting interventions (range 3-24wk) on both PA and psychological outcomes (eg,self-efficacy, motivation, and affect). We used meta-analysis and narrative synthesis to analyze these effects. All goals used in the included studies were specific goals. Setting specific goals had a large, positive effect on PA (g [standard mean difference] = 1.11 [P < .001]; 95% confidence interval, 0.74-1.47), but only a small, positive effect on the combined psychological outcomes (g [standard mean difference] = 0.25 [P < .001]; 95% CI, 0.10-0.40). Moderator analyses revealed that interventions that did not reward participants had a significantly greater effect on PA than interventions that did provide rewards (g = 1.30 vs 0.60, respectively, P ≤ .003). No other significant moderators were found. Our review offers initial insight into the long-term effects of specific goals on PA and psychological outcomes in insufficiently active adults. Further research that examines the PA and psychological effects of goal-setting interventions and investigates a wider range of goal types could develop a stronger evidence base to inform intervention for insufficiently active individuals.

Exploring the Relationship between Built Environment Attributes and Physical Activity in Lower-Income Aging Adults: Preliminary Insights from a Multi-Level Trial.

The built environment has been linked to physical activity (PA) behaviors, yet there is limited knowledge of this association among lower-income midlife and older adults who are insufficiently active. The present cross-sectional study utilized baseline data collected between October 2017 and November 2019 from a clustered randomized controlled trial to determine how built environment attributes were associated with PA behaviors among midlife and older adults (n = 255) residing in or near affordable housing sites (n = 10). At each site, perceptions of the built environment were collected and scored at the participant level via the abbreviated Neighborhood Environment Walkability Survey (NEWS-A), while objective built environment attributes were measured and scored by trained research staff using the Physical Activity Resource Assessment (PARA). Multiple PA behaviors-walking, total PA, and moderate-to-vigorous PA (MVPA) (min/wk)-were measured using the validated Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. Adjusted linear regression models examined associations between NEWS-A measures and PA behaviors, and site-level correlations between PARA measures and PA behaviors were examined using Spearman's rank correlations. At the participant level, adjusted models revealed that a one point increase in the NEWS-A aesthetics score was associated with a 57.37 min/wk increase in walking (β = 57.37 [95% CI: 20.84, 93.91], p = 0.002), with a similar association observed for street connectivity and MVPA (β = 24.31 min/wk [95% CI: 3.22, 45.41], p = 0.02). At the site level, MVPA was positively correlated with the quality of the features of local, PA-supportive environmental resources (ρ = 0.82, p = 0.004). Findings indicate that participant- and site-level measures of the built environment may play a role in promoting PA behavior among this demographic and similar populations. Results also suggest that improvements in aesthetic attributes and street connectivity, along with enhancing the quality of local, PA-supportive environmental resources, may be effective strategies for promoting physical activity among lower-income midlife and older adults.

EXPLORING PSYCHOLOGICAL NEED SATISFACTION AND MOTIVATION TO EXERCISE AND PHYSICAL ACTIVITY IN AN ARAB CONTEXT

INTRODUCTION &amp; AIMS Promoting physical activity (PA) requires an understanding of PA behavior, its correlates, and its determinants. This study aimed to assess self-reported PA behavior of adults in Qatar and understand the associations between self-determination theory (SDT) based motivational processes and PA behavior. METHODS This cross-sectional study used an anonymous online questionnaire within Qatar comprising demographic questions, the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Behavioral Regulation in Exercise Questionnaire (BREQ-3), and the Psychological Need Satisfaction in Exercise (PNSE) scale. RESULTS Respondents (N = 347; nfemales=246, nmales=101) were 21.6% non-Arab expats, 63.7% Arab expats, and 14.7% Qatari nationals. The prevalence of sufficient PA (minimum of 600 MET·min per week according to the IPAQ-SF criteria) was 66%, while 34% of participants were insufficiently active. Males (x¯ = 1808.16±2517.47 MET·min·wk-1) were significantly more active than females (x¯ = 1049.40±1717.31 MET·min·wk-1; P=0.001), and reported more autonomous forms of regulation (x¯ identified=2.86, x¯ integrated=2.33, x¯ intrinsic=2.64) than females (x¯ identified=2.58, x¯ integrated=2.01, x¯ intrinsic=2.36; P&amp;lt;0.05), as well as higher perceived competence satisfaction (x¯ =3.89) than females (x¯ = 3.49; P=0.025). A bivariate correlation showed that total PA and moderate to vigorous physical activity (MVPA) were positively and significantly (P&amp;lt;0.01) associated with autonomous forms of regulation, namely, identified (rtotal_PA=0.16, rMVPA=0.15) integrated (rtotal_PA=0.26, rMVPA=0.25), and intrinsic (rtotal_PA=0.20, rMVPA=0.18) regulation, as well as perceived competence in exercise (rtotal_PA=0.21, rMVPA=0.18; P&amp;lt;0.01). CONCLUSION The bivariate correlation results were consistent with the theoretical tenets of SDT, supporting the application of SDT to advance the understanding of psychological associations of PA in predominantly Arab populations. The observed gender gap in physical activity levels is consistent with previous research in Arab populations. Future research could target SDT constructs to promote PA behavior in Arab women through culturally sensitive interventions.

Effects of internet-based digital health interventions on the physical activity and quality of life of colorectal cancer survivors: a systematic review and meta-analysis.

The recent trend of Internet-based digital health interventions has driven researchers to implement them to promote physical activity (PA) and improve patients' health outcomes. This systematic review and meta-analysis aim to evaluate the effects of Internet-based digital health interventions on PA and quality of life (QoL) in colorectal cancer (CRC) survivors. We searched for relevant studies investigating the effects of internet-based digital health interventions published until Dec. 2022 in electronic databases (PubMed, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and CEPS) according to PRISMA guidelines. The Joanna Briggs Institute critical appraisal checklist was used to examine the quality of the included studies. We performed thefixedandrandom effectsmodel for meta-analysis. Among 746 identified studies, eight published between 2018 and 2022 were included. These covered 991 internet-based digital health interventions and 875 controls. After 6months of internet-based digital health interventions, CRC survivors' performance in PA (standardized mean difference (SMD) = 0.23, 95% confidence interval [CI] = 0.09-0.38) and QoL (SMD = 0.11, 95% CI = 0.01-0.22) indicators improved significantly. Internet-based digital health improved the PA behaviour and QoL of patients with CRC. Because of differences in intervention outcomes, additional randomized controlled trials are warranted to provide suggestions for clinical practice. Internet-based digital health interventions are promising for promoting PA in CRC survivors.

O.4.2-11 Effects of habit formation interventions on physical activity habit strength: meta-analysis and meta-regression

Abstract Background Interventions aimed at promoting physical activity (PA) behavior through habit formation pathways are gaining popularity, as they differ from conventional interventions that rely on intention pathways. Past research has established a positive correlation between PA habits and behavior. However, the efficacy of current interventions designed to form PA habits and improve PA automaticity is not yet fully ascertained. Additionally, the intervention components that significantly impact the effectiveness of these interventions are yet to be determined. Methods We conducted a search of three databases (PubMed, Embase, and Cochrane Library) from January 2000 to December 2022, with a focus on interventions for developing PA habits. Two independent authors conducted paper selection, quality assessment, data extraction, and coding of behavior change techniques (BCTs). The effect size of interventions was calculated using standardized mean difference. Subgroup analyses were carried out based on follow-up duration, delivery method, sample characteristics, and theory. Furthermore, we employed meta-regression to investigate the association between BCTs and PA habits. Results Ten eligible studies with relatively high quality were included in the final data set. Characteristics of studies varied in intervention sample and delivery way. The habit formation interventions significantly increased PA habit (SMD=0.31, 95% CI 0.14 - 0.48, P&amp;lt;.001) compared to the control groups. Subgroup analysis demonstrated that the duration of follow-up≤12 weeks have a higher effect size on PA habit than the duration &amp;gt; 12 weeks. Meta-regression revealed that problem solving has a significant positive association with effectiveness improvement (β = 0.36, 95% CI 0.17–0.55), while social reward is linked with a reduction in effectiveness (β = -0.40, 95% CI -0.74–0.06). Conclusions Our findings reveal that habit formation interventions are effective in fostering PA habit. Future studies could leverage the insights form this study to optimize the intervention design and achieve better effectiveness.

Relationships between psychosocial well-being and leisure time physical activity among 160.000 young Finnish men: a cross-sectional study during 2015–2021

Evidence on the relationship between psychosocial well-being and physical activity (PA) is insufficient, especially in young adults between 18 and 29 years. Identifying protective factors for psychosocial well-being as well as factors that may promote PA behaviour in this specific age group is crucial.The aim of the present study was to explore the association between self-reported leisure time physical activity (LTPA) and a number of measures of psychosocial well-being in a large sample of Finnish young men. The sample used for this study is based on registers of the Finnish Defence Forces and consist of questionnaire-based data collected from 159,776 young healthy men (18–29 years, mean age 19 years) who started their military service during the period from 2015 to 2021. Sum scores were calculated for self-esteem and prosocial behaviour. Physical activity, number of friends and the relationship with the parents were each measured with a single question. Unadjusted and adjusted (education, financial situation of the family, family structure) logistic regression models were calculated.A multinominal logistic regression analysis showed that a higher level of LTPA was associated with a higher level of both prosocial behaviour (OR 6.12, 95% CI 5.88–6.36) and self-esteem (OR 4.41 95% CI 4.28–4.54). Further, LTPA had a positive relationship with good social relations, both with peers and parents. The odds ratio for participation in any LTPA weekly was higher (OR 2.74; CI 2.27–3.20) among those who had a close and trustworthy relationship with their parents compared to those men with more challenging relationships with their parents (OR 1.77; CI 1.46–2.14). An inactive lifestyle (PA less than once a week) seemed to be most common among men with no friends. About one third (31%) of men with no friends reported to engage in LTPA less than once a week, while only 10% of men with very many good friends reported to engage in similarly inactive LTPA behaviour.LTPA seems to be positively associated with self-esteem, prosocial behaviour and good social relations among young adult men. Actions aimed at promoting LTPA may have a positive impact on psychosocial well-being among young men, or vice versa. The relationship between PA and psychosocial well-being is complex and interrelated.

Developing an ecological approach to physical activity promotion in adults with Cystic fibrosis.

BackgroundThere are few examples of interventions designed to promote physical activity (PA) in adults with Cystic fibrosis (CF). Increasing levels of habitual PA may be more feasible and result in greater compliance than conventional exercise training inventions which give little or no attention to long-term PA behaviour. Despite this there is limited research exploring perceptions of PA among adults with CF. The study aimed to understand the ecological correlates of PA in adults with CF and to involve individuals with CF, their families (where applicable) and clinicians in a formative process to inform the development of an ecological approach to PA promotion in this population.MethodsAn iterative approach was utilised, whereby findings from earlier phases of the research informed subsequent phases. Semi-structured interviews were conducted to explore patients’ perceptions of PA, devised using the PRECEDE component of the PRECEDE-PROCEED model. Followed by, focus groups to discuss the perceived barriers, facilitators and opportunities for PA participation and how this information could inform the development and delivery of a PA intervention. Separate focus groups were conducted with individuals with CF (n = 11) and their families and CF MDT members. Thematic analysis was used to construct themes.ResultsPhysical and mental wellbeing manifested as both barriers and facilitators of PA. CF is characterised by a progressive decline in physical function, which presents as a number of challenging symptoms and set-backs for an individual with CF. PA represents an opportunity for participants to slow the rate of this decline and manage the symptoms associated with the condition. Enjoyment was an important facilitator of PA. Exercise professionals and family reinforce PA behaviour, particularly during adolescence.ConclusionsPA promotion should form part of routine CF care with additional exercise professional support during adolescence.

A Systematic Review on Physical Health Education Interventions for People with Parkinson’s Disease: Content, Impact, and Implementation Considerations Across the Parkinson’s Trajectory

Educational interventions promoting the role of physical activity (PA) aim to address knowledge, poor exercise self-efficacy, and low outcome expectations, which are well-researched barriers to PA participation in healthy and in people with chronic conditions. However, little is known about the effectiveness of educational interventions in addressing these barriers in people with Parkinson's (PwP). To examine the content of education interventions that promote PA behavior in PwP, and to assess their effectiveness on physical and psychosocial outcomes. An electronic search (12/2021) of MEDLINE, EMBASE, CINAHL, PubMed PsycINFO, the Web of Science and the Cochrane Library was conducted from 1990 to 2021. Education interventions, alone or combined with other strategies, promoting PA in PwP were included. Quality was assessed using the Johanna Briggs Institute and National Institute of Health quality assessment tools. A narrative synthesis was performed. Six studies were identified. Five interventions were comprised of education and exercise sessions. Improvement in physical and psychosocial outcomes were suggested but delineating the exact impact of education was impeded due to lack of assessment. Few interventions exist that provide knowledge, and skills promoting PA participation, and fewer are addressed towards newly diagnosed PwP. There is lack of assessment over the effectiveness of education as a tool to facilitate PA participation in PwP. Lack of assessment poses the risk of potentially disregarding effective interventions or adopting ineffective approaches without the evidence. Education interventions can boost PA engagement by increasing factors such as exercise self-efficacy, but further interventions are required to assess this model of relationship.

Middle school students’ attitudes toward physical activity and physical education, intentions, and physical activity behavior

Schools are focusing more on promoting physical activity (PA) before, during, and after the school day, to combat the risk factors associated with sedentary behaviors. Since attitudes impact decisions to be physically active, identifying how PA attitudes relate to established attitudes toward physical education (PE), as well as PA intentions and behaviors are important—and thus the focus of this study. Middle school students ( N = 948; 45% female) completed PA behavior, PA intention, and PA and PE attitude surveys. Findings provided a better understanding of attitude theory with the identification of relationships between PA attitudes and PE attitudes, behavioral intention, and behavior. Multiple regression model results showed significant relationships between positive PA attitudes, negative PA attitudes, and PE attitudes with behavioral intention, and self-reported PA behavior. Differences between positive and negative PA attitudes were identified with positive PA attitudes most predicting intention. The results provide guidance for developing learning experiences aimed at promoting attitudes toward PA.

The Effectiveness of Planning Interventions for Improving Physical Activity in the General Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Planning interventions such as action planning (AP) and coping planning (CP) have been recognized as influential strategies in promoting physical activity (PA), but mixed results of existing evidence have been observed. This study aims to perform a systematical meta-analysis to evaluate the efficacy of planning interventions for improving PA in the general population. Eight databases, including Medline, Embase, PsycINFO, Cochrane Library, Web of Science, ProQuest, CNKI, and Wanfang Data, were searched to locate relevant randomized controlled trials (RCTs) from their inception to 31 December 2021. In total, 41 trials with 5439 samples were included in this systematic review, and 35 trials were used in our meta-analysis. The results showed that PA was better promoted in the planned intervention group compared to the control group (SMD = 0.35, 95% CI = 0.25–0.44, I2 = 61.4%). Based on the subgroup analyses, we found that planning strategies were more effective among patients, males, when adopting AP intervention, when using the face-to-face sessions delivery mode, and when reinforcements were conducted during the follow-up. The findings of this study indicate that planning interventions significantly improved PA behavior, and, in some contexts, the effects performed better. Future research needs to be conducted to explore the underlying mechanisms of planning interventions and validate their effects more extensively.

Inclusion of physical activity in nurse practitioner programs: A national perspective.

Physical activity (PA) provides a multitude of health benefits, creating an avenue for disease prevention and management. Health care providers play a crucial role in helping patients become more active, yet little is known about the preparation of primary care nurse practitioners (NPs) to aid in this effort. To examine the amount and type of PA training offered in primary care NP programs in the United States. A cross-sectional study design was used. Eligible programs' websites were reviewed, and an online survey of program leaders assessed details regarding the inclusion of PA training, barriers, and future plans. Data extracted from 1,067 NP program websites revealed that 81.7% of websites (n = 264) with course descriptions contained one or more general health promotion keywords, whereas only 0.6% (n = 2) included a PA-specific keyword. Two-hundred institutions (53.2%) completed the program leader survey, of which 45.0% reported no inclusion of PA training. Among institutions providing PA training, 82.2% (n = 88) and 55.1% (n = 59) reported the inclusion of aerobic activity and strength training recommendations, respectively. Forty-one institutions (46.1%) felt that their institution prepared students to effectively counsel patients on starting a PA program. Although some NP programs include PA content, most provide no or less-than-adequate PA training. The current state of PA training in NP programs may hinder health promotion and disease prevention efforts. Programs should dedicate sufficient time and attention to preparing future NPs to promote PA behaviors. A multifaceted, multistakeholder approach is needed to facilitate widespread adoption of PA inclusion.

Development and Validation of Physical Activity-Specific Rumination Scale for Children Through UK Children’s Voice

ABSTRACT Many physical activity (PA) interventions implemented to tackle the child obesity epidemic have shown limited effectiveness, possibly due to a lack of consideration of potential stress that accompanies behavior adaptation and the automatic perseverative cognition that exacerbates the stress (namely rumination). Purpose: The main aim of this paper is to develop and validate the PA-specific Rumination Scale for Children (PARSC) that assesses children’s tendencies to engage in repeated negative thoughts about PA (Study 2). Items in the scale were derived from qualitative information about factors that inherently demotivates PA participation (intrinsic barriers) through the lived experience of UK children (Study 1). Methods: For Study 1, pedometry PA data were collected from 143 children (aged 6–10 years). Twenty-one focus groups were formed based on participants’ year group, sex and PA level. For PARSC validation (Study 2), 382 children completed the questionnaire twice. Self-report PA, device-based PA, and avoidant coping were also assessed. Results: Study 1—Four overarching themes identified as intrinsic barriers were lack of competence, fear of negative experiences, external constraints and lacking a sense of purpose. Altogether, 10 higher order and lower order themes were used to construct PARSC items. Study 2—From Rasch analysis, PARSC possessed sound internal validity, internal consistency, and test–retest reliability. Self-report PA and avoidant coping were predictive of PA-specific rumination, but not device-based PA. Conclusion: PARSC is a useful tool to identify children ruminative about PA for whom interventions can be designed, with the intrinsic barriers considered, to promote PA behavior adaptation.

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.

The Effectiveness of Sequentially Delivered Web-Based Interventions on Promoting Physical Activity and Fruit-Vegetable Consumption Among Chinese College Students: Mixed Methods Study.

BackgroundWeb-based interventions for multiple health behavior change (MHBC) appear to be a promising approach to change unhealthy habits. Limited research has tested this assumption in promoting physical activity (PA) and fruit-vegetable consumption (FVC) among Chinese college students. Moreover, the timing of MHBC intervention delivery and the order of components need to be addressed.ObjectiveThis study aims to examine the effectiveness of 2 sequentially delivered 8-week web-based interventions on physical activity, FVC, and health-related outcomes (BMI, depression, and quality of life) and the differences in the intervention effects between the 2 sequential delivery patterns. The study also aims to explore participants’ experiences of participating in the health program.MethodsWe conducted a randomized controlled trial, in which 552 eligible college students (mean 19.99, SD 1.04 years, 322/552, 58.3% female) were randomly assigned to 1 of 3 groups: PA-first group (4 weeks of PA followed by 4 weeks of FVC intervention), FVC-first group (4 weeks of FVC followed by 4 weeks of PA intervention), and a control group (8 weeks of placebo treatment unrelated to PA and FVC). The treatment content of two intervention groups was designed based on the Health Action Process Approach (HAPA) framework. A total of four web-based assessments were conducted: at baseline (T1, n=565), after 4 weeks (T2, after the first behavior intervention, n=486), after 8 weeks (T3, after the second behavior intervention, n=420), and after 12 weeks (T4, 1-month postintervention follow-up, n=348). In addition, after the completion of the entire 8-week intervention, 18 participants (mean 19.56, SD 1.04 years, 10/18, 56% female) who completed the whole program were immediately invited to attend one-to-one and face-to-face semistructured interviews. The entire study was conducted during the fall semester of 2017.ResultsThe quantitative data supported superior effects on physical activity, FVC, and BMI in the 2 sequential intervention groups compared with the control group. There were no significant differences in physical activity, FVC, and health-related outcomes between the 2 intervention groups after 8 weeks. The FVC-first group contributed to more maintenance of FVC compared with the PA-first group after 12 weeks. Four major themes with several subthemes were identified in the qualitative thematic analysis: PA and FVC behavior, health-related outcomes, correlates of behavior change, and contamination detection.ConclusionsThis study provides empirical evidence for the effectiveness of sequentially delivered, web-based MHBC interventions on PA and FVC among Chinese college students. The timing issue of MHBC intervention delivery was preliminarily addressed. Qualitative findings provide an in-depth understanding and supplement the quantitative findings. Overall, this study may contribute considerably to future web-based MHBC interventions.Trial RegistrationClinicalTrials.gov NCT03627949; https://clinicaltrials.gov/ct2/show/NCT03627949International Registered Report Identifier (IRRID)RR2-10.1186/s12889-019-7438-1

Evaluating the Effectiveness of Gamification on Physical Activity: Systematic Review and Meta-analysis of Randomized Controlled Trials.

BackgroundGamification refers to the use of game elements in nongame contexts. The use of gamification to change behaviors and promote physical activity (PA) is a promising avenue for tackling the global physical inactivity pandemic and the current prevalence of chronic diseases. However, there is no evidence of the effectiveness of gamified interventions with the existence of mixed results in the literature.ObjectiveThe aim of this systematic review and meta-analysis is to evaluate the effectiveness of gamified interventions and their health care potential by testing the generalizability and sustainability of their influence on PA and sedentary behavior.MethodsA total of 5 electronic databases (PubMed, Embase, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials) were searched for randomized controlled trials published in English from 2010 to 2020. Eligibility criteria were based on the components of the participants, interventions, comparators, and outcomes framework. Studies were included when they used gamified interventions in daily life with an active or inactive control group and when they assessed a PA or sedentary behavior outcome. We conducted meta-analyses using a random-effects model approach. Sensitivity analyses, influence analyses, and publication bias analyses were performed to examine the robustness of our results.ResultsThe main meta-analysis performed on 16 studies and 2407 participants revealed a small to medium summary effect of gamified interventions on PA behavior (Hedges g=0.42, 95% CI 0.14-0.69). No statistical difference among different subgroups (adults vs adolescents and healthy participants vs adults with chronic diseases) and no interaction effects with moderators such as age, gender, or BMI were found, suggesting good generalizability of gamified interventions to different user populations. The effect was statistically significant when gamified interventions were compared with inactive control groups, such as waiting lists (Hedges g=0.58, 95% CI 0.08-1.07), and active control groups that included a nongamified PA intervention (Hedges g=0.23, 95% CI 0.05-0.41). This suggests that gamified interventions are not only efficient in changing behavior but also more effective compared with other behavioral interventions. The long-term effect (measured with follow-up averaging 14 weeks after the end of the intervention) was weaker, with a very small to small effect (Hedges g=0.15, 95% CI 0.07-0.23).ConclusionsThis meta-analysis confirms that gamified interventions are promising for promoting PA in various populations. Additional analyses revealed that this effect persists after the follow-up period, suggesting that it is not just a novelty effect caused by the playful nature of gamification, and that gamified products appear effective compared with equivalent nongamified PA interventions. Future rigorous trials are required to confirm these findings.

A coaching intervention improves physical activity and sedentary behaviour for non-admitted hospital patients: the Healthy4U-2 randomised controlled trial

Introduction: Non-admitted secondary care hospital clinics are important settings to target high-risk individuals to facilitate changes in physical activity (PA). Patients are likely to accept doctors’ advice and instigate behaviour change contemplation. Surgeons can identify physically inactive patients, and refer them into coaching interventions as a pathway to promote PA behaviour change. The aim of this study was to determine if a PA coaching intervention could result in changes in PA and sedentary behaviours (SB) in physically inactive non-admitted patients referred by consulting hospital surgeons.

Engaging community-dwelling older adults as co-developers in a public outdoor exercise facilities-based physical activity education intervention: A mixed-method participatory study in Hong Kong.

In Hong Kong, an increasing number of outdoor exercise facilities have been established in public open spaces to promote physical activity (PA) in older adults. However, no intervention is dedicated in educating the public on how to make use of these resources to fulfil the PA guidelines based on behavioural change theory. This study has two phases, phase one aims to describe the participatory development of the intervention, and phase two is the evaluation of a public outdoor exercise facilities-based PA education intervention for community-dwelling older adults. A mixed-methods participatory design was used to evaluate the impact of the intervention. PA behaviour was assessed as the fulfilment of the PA recommendations by World Health Organization, and the Rapid Assessment of Physical Activity (RAPA) scale at baseline, immediately, and 3 and 6months post-intervention. Psychosocial constructs and physical assessments were carried out at both pre- and post-intervention. Individual in-depth interviews were conducted at post-intervention. Forty-seven participants were enrolled in the intervention. The average adherence rate was 90.87%. PA significantly increased after the intervention and remained elevated for the following 6months. Post-intervention, the qualitative findings supported the quantitative findings at both the individual and social levels. However, findings regarding the change in participants' usage of environmental resources were divergent. The intervention was well-received by the participating older adults, as reflected by the high adherence rate. Both quantitative and qualitative data demonstrated the overall impacts of the intervention for creating sustainable changes in PA behaviour.

Active and healthy lifestyle in Brazilian Primary Health Care user’s: A pragmatic clinical trial about "VAMOS" behavior change program

This study aimed to investigate the effectiveness and maintenance of the behavior change program "VAMOS", version 2.0, on behavioral and health outcomes in Brazilian users (≥ 18 years) of Primary Health Care (PHC) in Florianópolis, state of Santa Catarina, southern Brazil. A pragmatic clinical trial was carried out between 2016 and 2019 in Basic Health Units, with 265 users allocated in the intervention group (n = 125) and the control group (n = 140). The intervention group participated for three months in the VAMOS to promote physical activity (PA) and a healthy diet. The control group received in a single meeting counseling about the importance of an active and healthy lifestyle. Variables of PA (daily minutes in light PA, moderate-to-vigorous PA, total PA, and sedentary behavior), eating behavior (weekly consumption of fruits, vegetables, and soda drinks), anthropometry (body mass, waist circumference (WC), and body mass index), and quality of life (QOL) (positive or negative perception), were evaluated, through interviews and objective measures, in the pre-intervention, post-intervention, and 12 months after the end of the intervention. The intervention group increased moderate-to-vigorous PA bouts, consumed of vegetables and, QOL, and decreased the consumption of soda drinks and WC (p&lt;0.05). The intervention was sufficient to maintain the achieved benefits of moderate-to-vigorous PA bouts, soda drink consumption, and WC. VAMOS effectively promote an active and healthy lifestyle in PHC users and, its strategies proved to be adequate to maintain the gains acquired. VAMOS is a pioneer and a health innovation.