Self-reported Physical Activity Behaviors Research Articles

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

INTRODUCTION & 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<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<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<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.

Modifiable Physical Factors That Influence Physical Function for People Receiving Peritoneal Dialysis

People receiving peritoneal dialysis experience physical function decline, impairing their ability to complete everyday activities, leading to poorer quality of life. Physical factors, including cardiorespiratory fitness, muscle strength, physical activity, and sedentary behavior are associated with physical function. However, little is known about this relationship, or temporal changes of these factors in this cohort. This study aimed to explore modifiable physical factors that are associated with physical function, identify which factor has the strongest influence, and explore temporal changes. Adults receiving peritoneal dialysis underwent objective and self-reported physical function, cardiorespiratory fitness, muscle strength, physical activity and sedentary behavior assessments 3 times over a 12-month observation period (at baseline, 6 months, and 12 months). Eighty-two participants underwent assessments. All modifiable physical factors were predominantly moderate to strongly associated with physical function at baseline. Cardiorespiratory fitness had the strongest and most consistent influence with every meter conferring a 0.08-unit (P< 0.01) and 0.01-unit (P< 0.05) increase in self-report and objective physical function score, respectively. Temporal changes were observed for modifiable physical factors with significant mean changes in cardiorespiratory fitness (-9.8%), quadricep strength (-5%), moderate-to-vigorous (-25.9%) and total (-16.2%) physical activity, and sedentary behavior (+7.1%). The results of this study indicate that cardiorespiratory fitness could be routinely monitored to detect risk of physical function decline and targeted through intervention to enhance physical function for people receiving peritoneal dialysis. Nevertheless, all factors should be considered when designing interventions to mitigate temporal changes and induce the numerous health benefits offered by being physically active.

Associations of accelerometry-measured and self-reported physical activity and sedentary behavior with skeletal muscle energetics: The Study of Muscle, Mobility and Aging (SOMMA)

BackgroundSkeletal muscle energetics decline with age, and physical activity (PA) has been shown to offset these declines in older adults. Yet, many studies reporting these effects were based on self-reported PA or structured exercise interventions. Therefore, we examined the associations of accelerometry-measured and self-reported PA and sedentary behavior (SB) with skeletal muscle energetics and explored the extent to which PA and sedentary behavior would attenuate the associations of age with muscle energetics. MethodsAs part of the Study of Muscle, Mobility and Aging, enrolled older adults (n = 879), 810 (age = 76 ± 5 years old, mean ± SD; 58% women) had maximal muscle oxidative capacity measured ex vivo via high-resolution respirometry of permeabilized myofibers (maximal oxidative phosphorylation (maxOXPHOS)) and in vivo by 31phosphorus magnetic resonance spectroscopy (maximal adenosine triphosphate (ATPmax)). Accelerometry-measured sedentary behavior, light activity, and moderate-to-vigorous PA (MVPA) were assessed using a wrist-worn ActiGraph GT9X over 7 days. Self-reported sedentary behavior, MVPA, and all PA were assessed with the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire. Linear regression models with progressive covariate adjustments evaluated the associations of sedentary behavior and PA with muscle energetics, as well as the attenuation of the age/muscle energetics association by MVPA and sedentary behavior. As a sensitivity analysis, we also examined activPAL-measured daily step count and time spent in sedentary behavior and their associations with muscle energetics. ResultsEvery 30 min/day more of ActiGraph-measured MVPA was associated with 0.65 pmol/(s × mg) higher maxOXPHOS and 0.012 mM/s higher ATPmax after adjusting for age, site/technician, and sex (p < 0.05). Light activity was not associated with maxOXPHOS or ATPmax. Meanwhile, every 30 min/day spent in ActiGraph-measured sedentary behavior was associated with 0.39 pmol/s × mg lower maxOXPHOS and 0.006 mM/s lower ATPmax (p < 0.05). Only associations with ATPmax held after further adjusting for socioeconomic status, body mass index, lifestyle factors, and multimorbidity. CHAMPS MVPA and all PA yielded similar associations with maxOXPHOS and ATPmax (p < 0.05), but sedentary behavior did not. Higher activPAL step count was associated with higher maxOXHPOS and ATPmax (p < 0.05), but time spent in sedentary behavior was not. Additionally, age was significantly associated with muscle energetics for men only (p < 0.05); adjusting for time spent in ActiGraph-measured MVPA attenuated the age association with ATPmax by 58% in men. ConclusionMore time spent in accelerometry-measured or self-reported daily PA, especially MVPA, was associated with higher skeletal muscle energetics. Interventions aimed specifically at increasing higher intensity activity might offer potential therapeutic interventions to slow age-related decline in muscle energetics. Our work also emphasizes the importance of taking PA into consideration when evaluating associations related to skeletal muscle energetics.

Self-determined motivation and physical activity in patients with rheumatoid arthritis: a cross-sectional study

Objective To identify factors associated with two self-reported measures of physical activity (PA) in patients with rheumatoid arthritis (RA). Method Hospital outpatients with RA from central Norway filled in questionnaires about symptoms, psychological factors, and PA. Outcomes were two alternative self-reported measures of PA: (i) fulfilling the aerobic PA recommendations of ≥ 150 min/week at moderate intensity or ≥ 75 min/week at vigorous intensity; or (ii) being in the PA maintenance stage of the Stages of Exercise Behaviour Change framework. Logistic regression was applied to identify factors associated with PA. Step 1 included the independent variables sex, age, and smoking habits. Step 2a added self-reported function, joint pain during the past 6 months, and fatigue to Step 1. Step 2b added Exercise Self-Efficacy and the Relative Autonomy Index (RAI), calculated from the Behavioural Regulation in Exercise Questionnaire-2, to Step 1. Step 3 included all the mentioned independent variables. Steps 1–3 were analysed for each PA measure. Results In total, 227 patients participated. The RAI had a statistically significant positive association with being physically active according to both PA definitions. Joint pain had a significant negative association with meeting the aerobic PA recommendations but was not associated with being in the PA maintenance stage. Conclusion The degree of self-determined motivation was the most consistent variable associated with self-reported PA behaviour. Joint pain was associated with one of the two PA measures. Motivation and joint pain may be useful targets for intervention in clinical practice to improve PA engagement among patients with RA.

Exploring change in self-reported physical activity behaviors during the coronavirus disease 2019 lockdown compared with prelockdown: A cross-sectional survey of physically active adults in Saudi Arabia

Background: The World Health Organization announced coronavirus disease 2019 (COVID-19) was a global pandemic in March 2020. Like other countries around the world, the Saudi Arabian Government imposed measures to control the spread of the virus, including lockdowns and limits on people’s physical activity (PA). Aim: The study aimed to explore changes in self-reported PA behavior during the COVID-19 lockdown compared with prelockdown among physically active adults in Saudi Arabia, and understand the barriers for those who performed less or no PA during lockdown. Design: A cross-sectional survey. Materials and Methods: This study included 213 physically active adults (aged 18–64 years) living in Saudi Arabia, the majority of whom were male (65.70%; n = 140). The researcher distributed an online version of the international PA questionnaire (short form) through social media platforms between November 5, 2021, and December 15, 2021. Results: The study’s results showed: (1) 40.8% (n = 87) of study participants did not perform any PA during lockdown; (2) there was a significant reduction in the frequency of all PA intensity (vigorous, moderate, and a combination of both) during lockdown compared with before; (3) there was a significant reduction in the duration of all PA intensity except for vigorous PA intensity during lockdown compared with before; (4) almost 70% (n = 148) of participants did not meet the international recommendation for PA during lockdown; and (5) the lack of appropriate equipment/space and closed sports infrastructure were the most significant barriers that led to participants performing less or no PA during lockdown. Conclusion: The COVID-19 lockdown negatively impacted the PA behaviors of physically active adults in Saudi Arabia, while the majority of participants (70%) did not meet the international recommendation for PA during lockdown.

Agreement between Accelerometer-Assessed and Self-Reported Physical Activity and Sedentary Behavior in Female Breast Cancer Survivors.

An accurate quantitative assessment of physical activity and sedentary lifestyles enables a better understanding of their relationship with the health records of cancer survivors. The objective of this study was to compare the subjective and objective methods of physical activity measurement in female breast cancer survivors. Materials and methods: In total, 135 female breast cancer survivors at the Holycross Cancer Center, Kielce, Poland, were included in this study. A shortened version of the International Physical Activity Questionnaire (IPAQ) was used to subjectively assess the participants' physical activity (PA), and an ActiGraph GT3X-BT accelerometer was used for an objective assessment. In total, 75% of the studied women did not report any vigorous PA, irrespective of the measurement method. The average values of moderate PA and moderate-to-vigorous PA (MVPA) measured with IPAQ compared with the accelerometer were sevenfold and tenfold higher, respectively. Conversely, the sedentary behavior values measured with the accelerometer were almost three times higher than those measured with IPAQ. The PA and sedentary behavior measurements were significantly different. Irrespective of PA intensity, the accelerometer-based measurements produced significantly lower results than IPAQ, while higher results were observed for sedentary behavior. The measurement differences between these two methods increased as the average differences grew. Regardless of the measurement method, a negative association was observed between moderate PA with general adiposity and adipose tissue distribution, whereas sedentary behavior demonstrated an opposite trend. This indicates the detrimental role of obesity in limiting PA.

Rural African American Women With Severe Obesity: A Cross-Sectional Analysis of Lifestyle Behaviors and Psychosocial Characteristics.

To examine differences in lifestyle behavioral and psychosocial factors between rural African American women with Class 3 obesity and those with overweight, and Class 1-2 obesity. Cross-sectional study. Rural Southeastern United States. Participants included 289 African American women with a mean age of 56years, 66% with a high school education or less, and a mean body mass index (BMI) of 38.6kg/m2; 35% (n = 102) were classified with Class 3 obesity. We objectively measured height, weight, and physical activity steps/day. Self-reported dietary and physical activity behaviors, general health-related quality of life, mental health, and social support were measured with validated surveys. Chi-Square analysis for categorical variables and analysis of variance (ANOVA) - via multiple linear regression - for continuous variables. There were no significant demographic differences between BMI groups, except for age, where women with Class 3 obesity were on average younger (51 vs 58y, P < .001). Although dietary behaviors did not differ significantly between groups, we observed significant group differences in self-reported and objective measures of physical activity. The age-adjusted difference in means for self-reported total physical activity minutes/wk. was 91 minutes, with women categorized with Class 3 obesity reporting significantly fewer weekly minutes than those with overweight/Class 1-2 obesity (64.3 vs 156.4min/wk. respectively, P < .01). Among psychosocial variables, only in the physical component scores of health-related quality of life did we find significant group differences - lower physical well-being among women with Class 3 obesity compared to those with overweight/Class 1-2 obesity (P = .02). For African American women with Class 3 obesity living in rural setting, these findings suggest behavioral weight loss interventions may need to target physical activity strategies that address physical, psychosocial, and environmental barriers.

Is exposure to pharmaceutical direct-to-consumer advertising for heart disease and diabetes associated with physical activity and dietary behavior?

ContextScholars have suggested that direct-to-consumer advertising (DTCA) of prescription drugs may discourage or encourage changes in lifestyle to improve health. The current paper informs this debate by examining associations between estimated exposure to DTCA for drugs focused on heart disease/cholesterol and diabetes and self-reported exercise and consumption of a variety of unhealthy foods (candy, sugary drinks, alcohol, and fast food). MethodsWe estimated exposure to DTCA by combining data from Kantar Media Intelligence (Kantar) on televised pharmaceutical DTCA airings in the U.S. from January 2003 to August 2016 (n = 7,696,851 airings) with thirteen years of data from the Simmons National Consumer Survey (Simmons), a mailed survey on television viewing patterns. We estimated associations between exposure to advertising (both overall and for advertisements with specific content) and self-reported physical activity and dietary behavior using Simmons data from January 2004 to December 2016 (n = 288,483 respondents from n = 157,621 unique households in the U.S.). Our analysis controls for many potential confounders including respondent demographics, temporal trends, and program placement to account for purposeful ad targeting to higher-risk adults. FindingsHigher estimated exposure to DTCA for heart disease and diabetes drugs were not consistently associated with meaningful differences in the frequency of engaging in regular physical activity. Greater estimated exposure to DTCA for both diseases were, linked to small but consistently higher volume of consumption of candy, sugar-sweetened beverages, alcohol, and fast food. Specific DTCA message content about diet and exercise explained very little of the observed association between overall DTCA exposure volume and study outcomes. ConclusionsMany Americans were regularly exposed to pharmaceutical DTCA for heart disease and diabetes from 2003 to 2016. Widespread exposure to such DTCA is associated with higher levels (though small in magnitude) of consuming alcohol, fast food, candy, and sugar-sweetened beverages.

Sarcopenia parameters in active older adults – an eight-year longitudinal study

BackgroudSarcopenia is a common skeletal muscle syndrome that is common in older adults but can be mitigated by adequate and regular physical activity. The development and severity of sarcopenia is favored by several factors, the most influential of which are a sedentary lifestyle and physical inactivity. The aim of this observational longitudinal cohort study was to evaluate changes in sarcopenia parameters, based on the EWGSOP2 definition in a population of active older adults after eight years. It was hypothesized that selected active older adults would perform better on sarcopenia tests than the average population.MethodsThe 52 active older adults (22 men and 30 women, mean age: 68.4 ± 5.6 years at the time of their first evaluation) participated in the study at two time points eight-years apart. Three sarcopenia parameters were assessed at both time points: Muscle strength (handgrip test), skeletal muscle mass index, and physical performance (gait speed), these parameters were used to diagnose sarcop0enia according to the EWGSOP2 definition. Additional motor tests were also performed at follow-up measurements to assess participants’ overall fitness. Participants self-reported physical activity and sedentary behavior using General Physical Activity Questionnaire at baseline and at follow-up measurements.ResultsIn the first measurements we did not detect signs of sarcopenia in any individual, but after 8 years, we detected signs of sarcopenia in 7 participants. After eight years, we detected decline in ; muscle strength (-10.2%; p < .001), muscle mass index (-5.4%; p < .001), and physical performance measured with gait speed (-28.6%; p < .001). Similarly, self-reported physical activity and sedentary behavior declined, too (-25.0%; p = .030 and − 48.5%; p < .001, respectively).ConclusionsDespite expected lower scores on tests of sarcopenia parameters due to age-related decline, participants performed better on motor tests than reported in similar studies. Nevertheless, the prevalence of sarcopenia was consistent with most of the published literature.Trial registrationThe clinical trial protocol was registered on ClinicalTrials.gov, identifier: NCT04899531.

A prospective study of the impact of COVID-19-related restrictions on activities and mobility upon physical activity, travel behaviour and attitudes

Background and aimsPublic health measures adopted to contain the spread of COVID-19 included restrictions on activities and mobility as people were asked to stay at home and schools moved to online learning. This may have increased risk of non-communicable disease by limiting recreational and transport-related physical activity. Building on an existing study, we assessed changes in self-reported and device-measured physical activity and travel behaviour before, during and after the peak of local COVID-19 outbreak and restrictions (March–July 2020). We examined beliefs in effectiveness of strategies to increase active and public transport after restrictions were reduced. MethodsA longitudinal study of adult infrequent bus users (average ≤ 2 trips per week; n = 70; 67% women) in Hobart, Australia. One-week assessment periods at four separate timepoints (before, during, 0–3 months after, and 3–6 months after the peak restrictions period) involved wearing an accelerometer, daily transport diaries, online surveys and tracking bus smartcard boardings. ResultsPhysical activity (especially among older participants), bus use and private motor vehicle use declined significantly during or 0–3 months after the peak restrictions period and returned to pre-restrictions levels by 3–6 months after the peak restrictions period, except bus use which remained significantly lower. Retrospective surveys overstated declines in bus use and active transport and self-reports understated declines in physical activity. Social distancing and improving service efficiency and frequency were seen as effective strategies for increasing bus use after restrictions but belief in effectiveness of distancing decreased over time. ConclusionsWhen restrictions on mobility are increased, supportive health promotion measures are needed to prevent declines in physical activity, particularly for older adults. Public transport systems need capacity to implement temporary distancing measures to prevent communicable disease transmission. Providing convenient, flexible, and efficient options for public transport may help to replenish public transport use after restrictions are reduced.

Association Between Adolescent Self-Reported Physical Activity Behaviors and Feeling Close to People at School During the COVID-19 Pandemic.

The disruption of school operations and routines caused by the COVID-19 pandemic affected students' physical and emotional well-being. Providing physical activity opportunities in schools can encourage students to positively engage with each other. Using a nationally representative sample of U.S. high school students from the Adolescent Behaviors and Experiences Survey (January to June 2021), we examined the association between physical activity behaviors and feeling close to people at school using sex-stratified and race/ethnicity-stratified multiple linear regressions models. Participating in team sports, being more physically active, and attending physical education (PE) during an average week were all associated with higher levels of feeling close to people at school, with variation by sex and race/ethnicity. These associations were also significant when the physical activity behavior variables were categorized to reflect national recommendations. Daily physical activity (i.e., ≥60 minutes all 7 days), daily PE (i.e., attended all 5 days), and the number of Comprehensive School Physical Activity Program (CSPAP) components implemented were associated with higher levels of feeling close to people at school. These findings suggest that opportunities for physical activity before, during, and after school are associated with increased levels of feeling close to people at school during crises like COVID-19.

Self-reported physical activity behaviors of childhood cancer survivors: comparison to a general adolescent population in Korea

Adequate physical activity (PA) can significantly contribute to the prevention of undesirable health outcomes in childhood cancer survivors (CCS). This study aimed to identify the patterns of PA and related factors in Korean CCS. Study subjects were 184 adolescents selected from an ongoing cohort study of Korean CCS and 1,840 sex- and school grade-matched controls randomly selected from the participants of the 2019 Korea Youth Risk Behavior Web-based Survey. Information on PA and sedentary behaviors was collected by self-administered questionnaire. We estimated body mass index (BMI)-adjusted odds ratio (OR) and 95% confidence interval (CI) for the advisable healthy behaviors of CCS compared with healthy controls using conditional logistic regression analysis. In addition, the associations of advisable healthy behaviors of CCS with sociodemographic and clinical factors were estimated using multiple logistic regression analysis. CCS were less likely to be physically active than controls, but this finding was evident only in males. The ORs (95% CIs) for regular exercise, moderate intensity PA, vigorous intensity PA, and walking were 0.42 (0.27-0.65), 0.39 (0.24-0.63), 0.53 (0.33-0.84), and 0.64 (0.42-0.98), respectively, in male CCS compared with same-sex controls. Compared with same-sex controls, male CCS were 4.60 times and female survivors were 15.19 times more likely to sleep longer than 8h a day. Among CCS, males were 2.92 times and 3.07 times more likely to perform moderate intensity PA and muscle-strengthening exercise, respectively, than female. Higher BMI (OR: 1.16), highest family income (OR: 3.98), and a caregiver who performed regular exercise (OR: 2.08) were positively associated with vigorous intensity PA of CCS. With increasing time after treatment completion, the probability of engaging in sedentary activity for less than 6h per day decreased (OR = 0.89, 95% CI 0.79-1.00). Korean adolescent CCS were physically inactive compared with control adolescents. Several sociodemographic factors such as sex, family income, caregiver PA, and obesity level were associated with PA behaviors of CCS. Strategic effort would be needed to increase physical activity of childhood cancer survivors in adolescent period with consideration of various sociodemographic factors found in this study.

Commuting to University: Self-Reported and Device-Measured Physical Activity and Sedentary Behaviour

Background: Active commuting could provide an opportunity to counteract unhealthy behaviours, such as insufficient levels of Physical Activity (PA) and sedentary behaviour, which are major health problems in the university population. The aims of this study were to describe and compare self-reported and device-measured in commuting behaviours, PA, and sedentary behaviour in both trips (to and from university) by mode of commuting per weekday, and to identify associations between self-reported and device-measured of commuting behaviours, PA, and sedentary behaviour. Methods: After inclusion criteria, a total of 63 students (65.1% women) from a public university in Cádiz, Spain, participated in this study. Self-reported and device-measured information was used. Results: Commuting time, distance, and speed were lower in active commuters than public and private commuters in both trips (to and from university) (all, p &lt; 0.001). Commuting energy expenditure per min was higher in active commuters than public and private commuters (all, p &lt; 0.001). Active commuters presented significant differences (p &lt; 0.05) with public and private commuters in all PA levels and sedentary behaviour in both trips (to and from university). Conclusions: Active commuting involved the highest levels of energy expenditure per min and could contribute 44% of the weekly PA recommendation for health benefits in university students.

Patterns of physical activity and sedentary behavior before and during pregnancy and cardiometabolic outcomes

ObjectiveTo assess how physical activity and sedentary behavior change from pre-pregnancy to pregnancy, and if pre-pregnancy and pregnancy physical activity and sedentary behavior are related to gestational weight gain, blood pressure, or blood glucose across pregnancy. DesignSecondary analysis of two prospective cohort studies. SettingPrenatal research centers in Pittsburgh, PA and Iowa City, IA. ParticipantsPregnant individuals (n=131), 18-45 years old, of any BMI, with no medical condition limiting physical activity or use of hypertension/diabetes medications. MethodsParticipants self-reported physical activity and sedentary behavior pre-pregnancy and in each trimester using validated questionnaires. Blood pressure, blood glucose, and weight were obtained from study visits and/or electronic medical records. Multivariable regression examined associations between pre-pregnancy, trimester-specific, and changes in physical activity and sedentary behavior with weight gain and blood pressure outcomes in each trimester, and blood glucose in the second trimester. ResultsCompared to pre-pregnancy, physical activity was lower in each trimester, and sedentary behavior was higher in each trimester (p<0.05). Increasing physical activity from pre-pregnancy levels was associated with lower first trimester SBP (p<0.05). Unexpectedly, higher pre-pregnancy physical activity was associated with higher SBP in the first trimester (p=0.02) and higher weight gain in the third trimester (p=0.02). Higher and increasing sedentary behavior was associated with greater weight gain in the third trimester (p=0.03). ConclusionFuture research should investigate the opportune time (before or during pregnancy) to deliver behavior modification interventions that could prevent excessive gestational weight gain or elevated blood pressure to improve maternal health outcomes.

Effectiveness of an 8-Week Physical Activity Intervention Involving Wearable Activity Trackers and an eHealth App: Mixed Methods Study.

BackgroundHealth-promotion interventions incorporating wearable technology or eHealth apps can encourage participants to self-monitor and modify their physical activity and sedentary behavior. In 2020, a Calgary (Alberta, Canada) recreational facility developed and implemented a health-promotion intervention (Vivo Play Scientist program) that provided a commercially available wearable activity tracker and a customized eHealth dashboard to participants free of cost.ObjectiveThe aim of this study was to independently evaluate the effectiveness of the Vivo Play Scientist program for modifying physical activity and sedentary behavior during the initial 8 weeks of the piloted intervention.MethodsOur concurrent mixed methods study included a single-arm repeated-measures quasiexperiment and semistructured interviews. Among the 318 eligible participants (≥18 years of age) registered for the program, 87 completed three self-administered online surveys (baseline, T0; 4 weeks, T1; and 8 weeks, T2). The survey captured physical activity, sedentary behavior, use of wearable technology and eHealth apps, and sociodemographic characteristics. Twenty-three participants were recruited using maximal-variation sampling and completed telephone-administered semistructured interviews regarding their program experiences. Self-reported physical activity and sedentary behavior outcomes were statistically compared among the three time points using Friedman tests. Thematic analysis was used to analyze the interview data.ResultsThe mean age of participants was 39.8 (SD 7.4) years and 75% (65/87) were women. Approximately half of all participants had previously used wearable technology (40/87, 46%) or an eHealth app (43/87, 49%) prior to the intervention. On average, participants reported wearing the activity tracker (Garmin Vivofit4) for 6.4 (SD 1.7) days in the past week at T1 and for 6.0 (SD 2.2) days in the past week at T2. On average, participants reported using the dashboard for 1.6 (SD 2.1) days in the past week at T1 and for 1.0 (SD 1.8) day in the past week at T2. The mean time spent walking at 8 weeks was significantly higher compared with that at baseline (T0 180.34 vs T2 253.79 minutes/week, P=.005), with no significant differences for other physical activity outcomes. Compared to that at baseline, the mean time spent sitting was significantly lower at 4 weeks (T0 334.26 vs T1 260.46 minutes/day, P<.001) and 8 weeks (T0 334.26 vs T2 267.13 minutes/day, P<.001). Significant differences in physical activity and sitting between time points were found among subgroups based on the household composition, history of wearable technology use, and history of eHealth app use. Participants described how wearing the Vivofit4 device was beneficial in helping them to modify physical activity and sedentary behavior. The social support, as a result of multiple members of the same household participating in the program, motivated changes in physical activity. Participants experienced improvements in their mental, physical, and social health.ConclusionsProviding individuals with free-of-cost commercially available wearable technology and an eHealth app has the potential to support increases in physical activity and reduce sedentary behavior in the short term, even under COVID-19 public health restrictions.

A Hybrid Implementation-Effectiveness Study of a Community Health Worker-Delivered Intervention to Reduce Cardiovascular Disease Risk in a Rural, Underserved Non-Hispanic Black Population: The CHANGE Study.

PurposeTo evaluate the implementation and effectiveness of the Carolina Heart Alliance Networking for Greater Equity (CHANGE) Program, an adapted evidence-based cardiovascular disease risk reduction intervention delivered by Community Health Workers (CHW) to rural adults.DesignHybrid implementation-effectiveness study with a pre–post design.SettingNorth Carolina Federally Qualified Health Center and local health department in a rural, medically underserved area.SampleParticipants (n = 255) included 87% Non-Hispanic Black with a mean age of 57 years; 84% had diagnosed hypertension, 55% had diabetes, and 65% had hypercholesterolemia.InterventionA CHW-delivered, low-intensity, 4-month behavioral lifestyle intervention promoting a southern-style Mediterranean dietary pattern and physical activity.MeasuresWe measured number and representativeness of participants reached and retained, intervention delivery fidelity, weight, blood pressure, and self-reported dietary and physical activity behaviors.AnalysisPre–post changes at 4 months were analyzed using paired t-tests.ResultsStudy participants completed 90% of planned intervention contacts; 87% were retained. Intervention delivery fidelity measures showed participants receiving a mean of 3.5 counseling visits, 2.7 booster calls, and on average completing 1.7 modules, setting 1.8 goals, and receiving 1.3 referrals per visit. There were significant mean reductions in systolic (−2.5 mmHg, P < .05) and diastolic blood pressure (−2.1 mmHg, P < .01); the proportion of participants with systolic blood pressure <130 increased by 7 % points (P = .05), and diastolic pressure <80 by 9 percentage points (P < .01). Dietary behaviors improved significantly with average weekly servings of nuts increased by .5 serving (P < .0001), and fruits and vegetables by .8 daily serving (P < .0001). Physical activity also increased on average by 45 min./week (P < .001). Weight did not change significantly.ConclusionsThe CHANGE program showed both implementation and program effectiveness and adds to the evidence supporting CHW-delivered lifestyle interventions to reduce CVD risk among rural, Non-Hispanic Black, and medically underserved populations.

Genome-wide Association Study of Liking for Several Types of Physical Activity in the UK Biobank and Two Replication Cohorts.

A lack of physical activity (PA) is one of the most pressing health issues today. Our individual propensity for PA is influenced by genetic factors. Stated liking of different PA types may help capture additional and informative dimensions of PA behavior genetics. In over 157,000 individuals from the UK Biobank, we performed genome-wide association studies of five items assessing the liking of different PA types, plus an additional derived trait of overall PA-liking. We attempted to replicate significant associations in the Netherlands Twin Register (NTR) and TwinsUK. Additionally, polygenic scores (PGS) were trained in the UK Biobank for each PA-liking item and for self-reported PA behavior, and tested for association with PA in the NTR. We identified a total of 19 unique significant loci across all five PA-liking items and the overall PA-liking trait, and these showed strong directional consistency in the replication cohorts. Four of these loci were previously identified for PA behavior, including CADM2 , which was associated with three PA-liking items. The PA-liking items were genetically correlated with self-reported ( rg = 0.38-0.80) and accelerometer ( rg = 0.26-0.49) PA measures, and with a wide range of health-related traits. Each PA-liking PGS significantly predicted the same PA-liking item in NTR. The PGS of liking for going to the gym predicted PA behavior in the NTR ( r2 = 0.40%) nearly as well as a PGS based on self-reported PA behavior ( r2 = 0.42%). Combining the two PGS into a single model increased the r2 to 0.59%, suggesting that PA-liking captures distinct and relevant dimensions of PA behavior. We have identified the first loci associated with PA-liking and extended our understanding of the genetic basis of PA behavior.

Abstract MP27: Associations Of Accelerometer-measured Physical Activity And Sedentary Behavior With Incident Ischemic Stroke: The Women’s Health Study (WHS)

Introduction: Higher self-reported physical activity and lower sedentary behavior (SB) are associated with lower incidence of ischemic stroke (IS). Objective measurement by accelerometer allows for novel, in-depth examination of these relationships with IS. Objective: Assess the association of accelerometer-measured physical activity and SB with IS. Methods: We included 16,031 women adherent with accelerometer wear (≥ 10 hours/day for 4 days) from the WHS cohort (2011-2015) with no prior cardiovascular disease [age 71.4 (SD 5.6) years, BMI 26.2 (SD 5.0), and 67% hypertensive]. ActiGraph GT3X+ accelerometers measured total volume of physical activity (average vector magnitude [VM]/min), mins spent in light-high (LHPA) and moderate-to-vigorous (MVPA) intensity physical activity, and SB. We categorized all metrics as quartiles and residualized to account for accelerometer wear time. We produced adjusted hazard ratios (HR) and 95% confidence intervals (CI) that independently relate physical activity and SB with IS using Cox proportional hazards models. Sensitivity analyses excluded events in the first year and those with poor self rated health to assess reverse causality. Results: Over a mean of 7.1 (SD 1.6) years of follow-up, 181 IS were observed (30 in first year). Greater total volume of physical activity and more minutes spent in MPVA were associated with lower hazards of ischemic stroke (quartile 4 vs. ref: VM/min HR=0.51, 95% CI: 0.32, 0.82, MVPA HR=0.42, 95% CI: 0.26, 0.67). Minutes spent in LHPA were not associated with IS. Less time spent in SB was associated with lower hazards of IS, but was not statistically significant (Table). Results were robust when adjusted for clinical covariates. Exclusions for reverse causality did not alter inferences made and decreased precision. Conclusion: Greater total volume of physical activity and more minutes spent in MVPA were associated with lower occurrence of IS in this cohort. Less time spent in SB appeared to be protective against IS, but requires further investigation.

Prevalence and trends in Australian adolescents\u2019 adherence to 24-hour movement guidelines: findings from a repeated national cross-sectional survey

Background24-hour movement guidelines recommend a healthy balance of high levels of physical activity, low levels of sedentary behaviour and appropriate sleep duration each day. At present, surveillance data on how Australian adolescents are performing against these guidelines are lacking. This study aims to describe the extent to which Australian secondary school students are adhering to the physical activity, sedentary recreational screen time and sleep duration recommendations outlined in the national 24-hour movement guidelines for children and young people. It also examines whether there are socio-demographic differences in levels of compliance and if there have been significant changes in these behaviours over time.MethodsA repeated national cross-sectional survey of students in grades 8 to 11 (ages 12-17 years) was conducted in 2009-2010 (n=13,790), 2012-2013 (n=10,309) and 2018 (n=9,102). Students’ self-reported physical activity, screen time and sleep behaviours were assessed using validated instruments administered in schools via a web-based questionnaire.ResultsIn 2018, around one in four students (26%) did not meet any of the 24-hour movement guidelines, while only 2% of students met all three. Adherence to the sleep duration recommendation was highest (67%), with substantially smaller proportions of students meeting the physical activity (16%) and screen time (10%) recommendations. Differences in adherence by sex, grade level and socio-economic area were apparent. Students’ compliance with the screen time recommendation has declined over time, from 19% in 2009-2010 to 10% in 2018. However, there has been no significant change in the proportion meeting the physical activity (15% in 2009-2010 cf. 16% in 2018) and sleep duration (69% in 2009-2010 cf. 67% in 2018) recommendations. Compliance with all three guidelines has remained very low (<3%) across each survey round.ConclusionsThere is considerable scope to improve Australian adolescents’ physical activity and sedentary behaviours in line with the national 24-hour movement guidelines. Policy proposals and environmental interventions, particularly those focused on replacing sedentary screen time with physical activity (e.g. promotion of active commuting to/from school), are needed to better support Australian adolescents in meeting the 24-hour movement guidelines.

The impact of a community-based intervention on weight, weight-related behaviours and health-related quality of life in primary school children in Victoria, Australia, according to socio-economic position

BackgroundApproximately a quarter of Australian children are classified as overweight or obese. In high-income countries, childhood obesity follows a socio-economic gradient, with greater prevalence amongst the most socio-economically disadvantaged children. Community-based interventions (CBI), particularly those using a systems approach, have been shown to be effective on weight and weight-related behaviours. They are also thought to have an equitable impacts, however there is limited evidence of their effectiveness in achieving this goal.MethodsSecondary analysis was conducted on data collected from primary school children (aged 6–13 years) residing in ten communities (five intervention, five control) involved in the Whole of Systems Trial of Prevention Strategies for Childhood Obesity (WHO STOPS) cluster randomised trial in Victoria, Australia. Outcomes included Body Mass Index z-score (BMI-z) derived from measured height and weight, self-reported physical activity and dietary behaviours and health related quality of life (HRQoL). Repeat cross-sectional data from 2015 (n = 1790) and 2019 (n = 2137) were analysed, stratified by high or low socio-economic position (SEP). Multilevel linear models and generalised estimating equations were fitted to assess whether SEP modified the intervention effect on the outcomes.ResultsThere were no overall changes in BMI-z for either SEP strata. For behavioural outcomes, the intervention resulted in a 22.5% (95% CI 5.1, 39.9) point greater improvement in high-SEP compared to low-SEP intervention schools for meeting physical activity guidelines. There were also positive dietary intervention effects for high SEP students, reducing takeaway and packaged snack consumption, although there was no significant difference in effect between high and low SEP students. There were positive intervention effects for HRQoL, whereby scores declined in control communities with no change in intervention communities, and this did not differ by SEP.ConclusionThe WHO STOPS intervention had differential effects on several weight-related behaviours according to SEP, including physical activity. Similar impacts on HRQoL outcomes were found between high and low SEP groups. Importantly, the trial evaluation was not powered to detect subgroup differences. Future evaluations of CBIs should be designed with an equity lens, to understand if and how these types of interventions can benefit all community members, regardless of their social and economic resources.