Promote Physical Activity Recommendations Research Articles

An umbrella review of systematic reviews on interventions of physical activity before pregnancy, during pregnancy, andpostpartum to control and/or reduce weight gain.

The increasing prevalence of overweight and obesity worldwide represents a (chronic) complex public health problem. This is also seen among women of childbearing age despite increased efforts to promote physical activity (PA) interventions. Excessive gestational weight gain (GWG) is associated with negative health outcomes for both mothers and offspring. To summarize current systematic reviews (SRs) on PA interventions during pregnancy and postpartum to prevent excessive GWG and identify the most effective approaches. A literature search was conducted on major electronic databases (MEDLINE/Pubmed, Cochrane, Web of Science, Epistemonikos) from inception to March 2023. This study included SRs and meta-analyses of studies involving women aged 18 years or older from diverse ethnic backgrounds, who were either in the preconception period, pregnant, or within 1 year postpartum and who had no contraindications for exercise. Women with chronic diseases, such as pre-existing diabetes (type 1 or type 2) were excluded. Two reviewers extracted data from selected studies assessing the impact of PA in preconception, pregnancy, and postpartum. Methodologic quality was assessed with the AMSTAR-2 tool. A narrative summary of results addresses relationships between PA and weight before, during, and after pregnancy, informing future research priorities for preventing excessive weight gain. This study is registered on PROSPERO (CRD420233946666). Out of 892 identified articles, 25 studies were included after removing duplicates, unrelated titles, and screening titles and abstracts for eligibility. The results demonstrate that PA can help prevent excessive GWG and postpartum weight retention. Structured and supervised moderate-intensity exercise, at least twice a week, and each session lasting a minimum of 35 min seems to provide the greatest benefits. Women who comply with the PA program and recommendations are more likely to achieve adequate GWG and return to their pre-pregnancy body mass index after delivery. Further research is warranted to explore how preconception PA influences pregnancy and postpartum outcomes given the absence of identified preconception-focused interventions.

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.

Healthcare providers' promotion of physical activity among child and adolescent cancer survivors: strategies and challenges.

PurposeThis study aims to investigate how healthcare providers (HCPs) promote physical activity (PA) to child and adolescent cancer survivors.MethodsSemi-structured interviews were conducted with HCPs (n = 16; women n = 12; men n = 4) who provide care for cancer survivor youth (age 3 to 18). Participants represented 7 professions, including child life specialists, oncologists, nurse practitioners, physical therapists, and social workers. A reflexive thematic analysis was conducted to explore the techniques that HCPs use to promote PA for this patient population and ways PA promotion can improve.ResultsHCPs use five strategies to promote PA to cancer survivor youth: (1) broadening the definition of PA, (2) tailoring PA recommendations, (3) including families, (4) connecting patients to programming, and (5) promoting patient motivation.ConclusionsThis research highlights techniques that HCPs use to promote PA to young cancer survivors and reveals the need for additional ways to support HCPs to improve PA promotion for child and adolescent cancer survivors. While HCPs emphasized the importance of PA for this patient population, they navigate barriers that limit the quality of PA discussions.Implications for cancer survivorsFurther research should explore interventions to improve PA promotion and PA participation among child and adolescent cancer survivors. By understanding the perspectives of HCPs, patients, and their families, PA promotion strategies can be improved, and more programs that support both patients and practitioners may be developed.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11764-022-01218-8.

Church Contextual Factors Associated With Latinx Physical Activity and Park Use.

Churches can be important settings for promoting physical activity (PA) among Latinx populations. Little is known about what factors across the church context-social, organizational, and physical (outdoor spaces)-are associated with Latinx PA to inform faith-based PA interventions. This study investigated associations of church contextual factors with Latinx PA. We used cross-sectional data from a Latinx adult sample recruited from 6 churches that each had a nearby park in Los Angeles, California (n = 373). Linear or logistic regression models examined associations of church PA social support, PA social norms, perceived quality and concerns about the park near one's church, and church PA programming with 4 outcomes: accelerometer-based moderate-to-vigorous PA (MVPA) and self-reported adherence to PA recommendations, use of the park near one's church, and park-based PA. Park quality and concerns were positively associated with using the park near one's church. Church PA programming was positively associated with park-based PA. None of the factors were related to accelerometer-based MVPA or meeting PA recommendations. Findings suggest targeting church PA programming and nearby parks may be key to improving Latinx park use. Church and local parks department partnerships may help enhance park conditions to support churchgoing Latinx PA and health.

Bike-sharing systems: Effects on physical activityin a Spanish municipality

Introduction: Urban mobility (such as walking or biking) and public Bike-Sharing Systems (BSS) have begun to emerge through programs and services that drive change from the strong culture of dependence on motor vehicles in most developed countries. At the international level, the 2030 Agenda of the United Nations (UN) opted to establish objectives for sustainable development, addressing the need to establish changes in urban mobility. The World Health Organization (WHO) has concluded that physical inactivity and being overweight / obesity are the fourth and fifth risk factors for non-communicable diseases in the world, respectively. The objective of this study is to know if a BSS has been able to serve as a means of promoting Physical Activity (PA) in the urban environment. Material and Methods: A quantitative and longitudinal study has been designed with data collection and analysis from July 2009 to January 2012. The sample consisted of a total of 3,268 users and a total of 59998 observations were recorded (Men: n = 42,411; Women: n = 17,587). SPSS 21.0 and ANOVA were used for statistical analysis. Results: Users between the ages of 20 and 44 have spent an average of 30.7 minutes, between 45 and 64 years an average of 36 minutes and between 65 and 79 years an average of 51.1 minutes. Conclusions: The data suggest that the WHO (2010) PA recommendations may be being met. BSS can favor the practice of PA in the urban environment, and thus, be able to promote less polluted and traffic-congested environments. Men from 65 to 79 years old have had the most average minutes of use. The routes that took the most minutes were those that go between the same stations and those that pass between stations on the urban outskirts.

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.

Insufficient physical activity level among Sahrawi adults living in a protracted refugee setting

BackgroundThe Sahrawi people fled their homes in 1975 as the conflict in Western Sahara escalated and settled down near Tindouf, Algeria, where they still live. High prevalence of overweight and obesity and type 2 diabetes had been found in this protracted refugee setting. Scaling up national policy efforts to promote physical activity (PA) is critical to reducing the prevalence of noncommunicable diseases (NCDs) in the near future. One possible barrier to the inclusion of PA in NCD prevention strategies is the lack of research on PA level, which may reduce political support and policy development for PA. Thus, the aim of this study was to investigate the PA level among adults living in Sahrawi refugee camps and socioeconomic factors associated with PA.MethodsA cross-sectional survey was carried out in 2014 in five refugee camps near Tindouf, Algeria. A total of 180 women and 175 men were included. PA was measured using the international physical activity questionnaire short form (IPAQ-SF).ResultsThere was a large amount of variance in reported PA for both genders, ranging from 10 min of total PA per week to above 40 h. Forty-three percent of the participants had a low PA level (defined as not meeting the PA recommendations of 150 min of moderate to vigorous PA per day). The chi-square test of independence showed that males, those aged ≥ 60 years and people with higher education were more likely to be in the low PA level category. No significant relationship was found between PA level and BMI status. Most of the participants thought that engaging in PA would be wise, valuable, right and good but thought to a lesser degree that PA would be easy, comfortable and interesting.ConclusionsAlmost half of the participants were categorised as insufficiently physically active, however, most of the Sahrawi refugees express a positive attitude towards PA. PA is a low-cost approach to reducing deaths and NCDs, government initiatives to increase PA levels in refugee camps are advised.

Beneficial effects of moderate to vigorous physical activity on cardiovascular disease among Chinese adults.

BackgroundIn China, lack of evidence remains a significant challenge for the national initiative to promote physical activity (PA). We aimed to quantify the beneficial effects of meeting or maintaining the recommended PA level [150 minutes per week (min/wk) of moderate PA or 75 min/wk of vigorous PA or an equivalent combination] on incident cardiovascular disease (CVD) among Chinese population.MethodsWe included 100,560 participants without history of CVD from three cohorts in the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for CVD events and its subtypes, including stroke, coronary heart disease, heart failure, and CVD death.ResultsDuring a median follow-up of 7.3 years (range: 6–15 years), 777,163 person-years and 4693 incident CVD events were observed. Compared with participants who were inactive at baseline, the multivariable adjusted HR (95% CI) of developing CVD was 0.74 (0.69–0.79) for those who met recommended moderate to vigorous physical activity (MVPA) level at baseline. Furthermore, the risk of CVD incidence was reduced with increment of MVPA (Ptrend < 0.001), and the HR (95% CI) of highly-active versus inactive category was 0.62 (0.56–0.68). Compared with individuals who were inactive both at the baseline and follow-up, those keeping active over the period of follow-up had a substantial lower risk of incident CVD with the HR (95% CI) of 0.57 (0.43–0.77).ConclusionsThe findings demonstrated that meeting and maintaining the recommended MVPA level could reduce the cardiovascular risk. Wider adoption of the PA recommendations would have considerable health impacts to the Chinese population.

Younger Adolescents' Perceptions of Physical Activity, Exergaming, and Virtual Reality: Qualitative Intervention Development Study.

BackgroundNovel strategies to promote physical activity (PA) in adolescence are required. The vEngage study aims to test whether a virtual reality (VR) exergaming intervention can engage younger adolescents (aged 13 to 15 years) with PA.ObjectiveThis study aimed to gather adolescents’ views of using VR to encourage PA and identify the key features they would like to see in a VR exergaming intervention via interviews.MethodsParticipants were recruited through 2 schools in London, United Kingdom. Semistructured interviews were conducted with adolescents about their views on PA and what might work to increase PA, technology, knowledge and experience of VR, and desired features in a VR exergaming intervention. Data were analyzed using Framework Analysis.ResultsA total of 31 participants aged between 13 and 15 years (58% female, 62% from nonwhite ethnicities) participated in this interview study. The vast majority had no awareness of government PA recommendations but felt they should be more thoroughly informed. All participants were positive about the use of VR in PA promotion. Rewards, increasing challenges, and a social or multiplayer aspect were identified by participants as crucial aspects to include in a VR exercise game. Barriers were related to cost of high-end systems. Being able to exercise at home was very appealing. VR exergaming was viewed as a way to overcome multiple perceived social and cultural barriers to PA, particularly for girls.ConclusionsKey elements that should be incorporated into a VR game for health intervention were identified and described. These also included the use of rewards, novelty and enjoyment in immersive game play, multiplayer options, and real-world elements, as well as continual updates and new challenge levels. The use of VR to promote PA in adolescents is promising, but some barriers were raised.

Promoting physical activity for health. A survey of knowledge, confidence and role-perception in final-year UK physiotherapy students

BACKGROUND: Physical inactivity is the fourth leading cause of global mortality and is a significant independent risk factor for a range of chronic conditions. Advice from a healthcare professional can increase activity levels in adults. Current literature does not identify whether UK physiotherapy undergraduate students are prepared to promote physical activity (PA) for health. PURPOSE: The aim of this study was to determine the knowledge, confidence and role perception of final-year UK Physiotherapy undergraduate students to promote physical activity for health. METHODS: An online cross-sectional survey was used. 19 UK undergraduate Physiotherapy courses participated. Descriptive statistics explored knowledge, confidence and role-perception. Inferential statistics tested the relationships between variables. RESULTS: Response rate was 16.6% (n = 158). The majority of respondents (82% n = 129) had received training in promoting PA for health. 66% (n = 73) of this group correctly specified a duration, frequency and intensity for current UK PA recommendations for 19–64 year olds. Role perception was extremely high (99%) in the surveyed population. Students reported being confident in giving general PA advice (92%, n = 144). Confidence scores were significantly correlated with training in the promotion of PA for health (B = 0.38 p < 0.001). CONCLUSION: Final-year UK Physiotherapy students perceive a professional role in promoting physical activity for health; and demonstrate good but variable knowledge of this subject. Confidence domain scores were best predicted by training in the promotion of PA for health.

Ownership and Use of Commercial Physical Activity Trackers Among Finnish Adolescents: Cross-Sectional Study.

BackgroundMobile phone apps for monitoring and promoting physical activity (PA) are extremely popular among adults. Devices, such as heart rate monitors or sports watches (HRMs/SWs) that work with these apps are at sufficiently low costs to be available through the commercial markets. Studies have reported an increase in PA levels among adults with devices; however, it is unknown whether the phenomena are similar during early adolescence. At a time when adolescents start to develop their own sense of independence and build friendship, the ease of smartphone availability in developed countries needs to be investigated in important health promoting behaviors such as PA.ObjectiveThe objective of this study was to investigate the ownership and usage of PA trackers (apps and HRM/SW) among adolescents in a national representative sample and to examine the association between use of devices and PA levels.MethodsThe Finnish school-aged physical activity (SPA) study consisted of 4575 adolescents, aged 11-, 13-, and 15-years, who took part in a web-based questionnaire during school time about PA behaviors between April and May 2016. Binary logistic regression analyses were used to test the associations between moderate to vigorous physical activity (MVPA) and devices, after controlling for gender, age, disability, and family affluence.ResultsPA tracking devices have been categorized into two types, which are accessible to adolescents: (1) apps and (2) HRM/SW. Half the adolescents (2351/4467; 52.63%) own apps for monitoring PA, yet 16.12% (720/4467) report using apps. Fewer adolescents (782/4413; 17.72%) own HRM/SW and 9.25% (408/4413) use HRM/SW. In this study, users of HRM/SW were 2.09 times (95% CI 1.64-2.67), whereas users of apps were 1.4 times (95% CI 1.15-1.74) more likely to meet PA recommendations of daily MVPA for at least 60 min compared with adolescents without HRM/SW or without apps.ConclusionsTo our knowledge, this is the first study that describes the situation in Finland with adolescents using PA trackers and its association with PA levels. Implications of the use of apps and HRM/SW by adolescents are discussed.

A Physical Activity Intervention for Brazilian Students From Low Human Development Index Areas: A Cluster-Randomized Controlled Trial.

Promoting physical activity (PA) in low- and middle-income countries is an important public health topic as well as a challenge for practice. This study aimed to assess the effect of a school-based intervention on different PA-related variables among students. This cluster-randomized-controlled trial included 548 students in the intervention group and 537 in the control group (11-18 years-old) from 6 schools in neighborhoods with low Human Development Index (0.170-0.491) in Fortaleza, Brazil. The intervention included strategies focused on training teachers, opportunities for PA in the school environment and health education. Variables measured at baseline and again at the 4-months follow-up included the weekly time in different types of moderate-to-vigorous PA (MVPA), preference for PA during leisure-time, PA behavioral change stage and active commuting to school. Generalized linear models and binary logistic regressions were used. An intervention effect was found by increasing the weekly time in MVPA (effect size = 0.17), popular games (effect size = 0.35), and the amount of PA per week (effect size = 0.27) among students (all P < .05). The intervention was effective in promoting improvements in some PA outcomes, but the changes were not sufficient to increase the proportion of those meeting PA recommendations.

Preventing dementia by promoting physical activity and the long-term impact on health and social care expenditures

BackgroundPreventing dementia has been proposed to increase population health as well as reduce the demand for health and social care. Our aim was to evaluate whether preventing dementia by promoting physical activity (PA) a) improves population health or b) reduces expenditure for both health and social care if one takes into account the additional demand in health and social care caused by increased life expectancy. MethodsA simulation model was developed that models the relation between PA, dementia, mortality, and the use of health care and social care in England. With this model, scenarios were evaluated in which different assumptions were made about the increase in PA level in (part of) the population. ResultsLifetime spending on health and social care related to dementia was highest for the physically inactive (£28,100/£28,900 for 40-year-old males/females), but spending on other diseases was highest for those that meet PA recommendations (£55,200/£43,300 for 40-year-old males/females) due to their longer life expectancies. If the English population aged 40–65 were to increase their PA by one level, life expectancy would increase by 0.23years and health and social care expenditures would decrease by £400 per person. ConclusionsPreventing dementia by increasing PA increases life expectancy and can result in decreased spending overall on health and social care, even after additional spending during life years gained has been taken into account. If prevention is targeted at the physically inactive, savings in dementia-related costs outweigh the additional spending in life years gained.

Realising the potential for an Olympic legacy; teaching medical students about sport and exercise medicine and exercise prescribing

BackgroundPhysicians are increasingly being called upon to promote physical activity (PA) among patients. However, a paucity of exercise medicine teaching in the UK undergraduate medical curricula prevents students from acquiring...

Physical activity guidelines and preschooler's obesity status

The benefits of promoting physical activity (PA) in counteracting the high prevalence of childhood obesity have become increasingly important in the past decade. The aim of this study was to examine the association between compliance of daily PA recommendations and the risk of being overweight or obese in preschool-aged children. The sample comprised 607 children aged 4-6 years, recruited from kindergartens located in the metropolitan area of Porto, Portugal. Preschooler's body mass index was classified according to International Obesity Task Force. PA was assessed during 7 consecutive days by accelerometer. Children were classified as meeting or not meeting PA recommendations based on two guidelines: (i) at least 3 h per day of total PA (TPA); and (ii) at least 1 h per day of moderate to vigorous PA (MVPA). The prevalence of overweight and obesity was 23.5 and 10.6% in girls and 17.2 and 8.9% in boys. In all, 90.2 and 97.3% of girls met the ≥ 1 h MVPA and ≥ 3 h TPA recommendations, respectively. In all, 96.2 and 99.4% boys met the ≥ 1 h MVPA and 3 h TPA recommendations, respectively. Boys were significantly more likely to achieve the ≥ 1 h MVPA and ≥ 3 h TPA recommendations than girls (P ≤ 0.001). Not meeting the ≥ 1 h MVPA guideline was associated with obesity status (OR: 3.8; IC: 1.3-10.4), in girls, but not boys. No other statistically significant associations were found. These findings suggest that over 90% of children met the recommended guidelines. There is an association with low levels of MVPA and higher obesity status among preschool girls. Further, longitudinal studies are needed to confirm these data.

The Role of Recreational Spaces in Meeting Physical Activity Recommendations Among Middle School Students

There is growing recognition of the importance of recreational space utilization for promoting physical activity (PA) among youth. A cross-sectional study was conducted with a sample of 926 diverse 6th-8th grade students in Somerville, MA. Participants completed the 2007 Youth Risk Surveillance Survey (YRBS). Chi-square testing and logistical regression modeling were performed to predict meeting national PA recommendations for moderate, vigorous, and 60 minutes or more (60+) PA. The participants reported meeting recommended PA levels for moderate (27%), vigorous (70%) and 60+ (21%) PA. In multivariate analysis, being male and speaking English were significantly associated with meeting all 3 PA recommendations. Recreational spaces significantly associated with meeting PA recommendations included neighborhood parks and walk/bike paths, playing fields and courts, and recreational centers. Recreational space utilization varied by gender, race/ethnicity, and language. Recreational space utilization was an important predictor of meeting PA recommendations among middle school students. Our results showed that PA attainment and recreational space utilization varied by demographic characteristics. The role of each recreational space in predicting PA varied depending on the outcome used. This study demonstrates the potential use of YRBS data to inform resource allocation for PA promotion in diverse communities.

Targeting physical activity promotion in general practice: characteristics of inactive patients and willingness to change.

BackgroundCounselling in routine general practice to promote physical activity (PA) is advocated, but inadequate evidence is available to support this intervention, and its sustainable implementation over time is difficult.ObjectivesTo describe the characteristics of physically inactive adults visiting GPs and the factors associated with their willingness to change PA.MethodsA cross-sectional analysis of 4317 Spanish people aged 20–80 years, selected by systematic sampling among those attending 56 public primary health care practices identified as inactive by their GPs in 2003. PA (7-day PAR), PA stage of change, health-related quality of life (SF-36), cardiovascular risk factors, and social and demographic characteristics were measured. Multivariate mixed effects ordinal logistic models were adjusted to identify factors associated with motivational readiness to change.ResultsAt least 70% (95% CI: 67.6% to 72.8%) of patients assessed by GPs did not achieve minimal PA recommendations. In addition, 85% (95% CI: 83% to 86.3%) had at least an additional cardiovascular risk factor. Only 30% (95% CI: 25.8% to 33.5%) were prepared for or attempting a change. A younger age; retirement or work at home; higher education and social class levels; obesity; and hypertension were associated with a higher motivational readiness to change (p < 0.05).ConclusionThe overburden that would result from counselling such a high proportion of inactive primary care patients justifies a targeted strategy for PA promotion in family practice. Selection of a target population based on readiness to change, the combination of risk factors and socio-demographic characteristics of patients is suggested in order to prioritise promotion efforts.