Week Of Moderate-to-vigorous Physical Activity Research Articles

Development of an accelerometer age- and sex-specific approach based on population-standardized values for physical activity surveillance: A proof of concept

BackgroundA shift from self-reports to wearable sensors for global physical activity (PA) surveillance has been recommended. The conventional use of a generic cut-point to assess moderate-to-vigorous PA (MVPA) is problematic as these cut-points are often derived from non-representative samples under non-ecological laboratory conditions. This study aimed to develop age- and sex-specific (age-sex) cut-points for MVPA based on population-standardized values as a feasible approach to assess the adherence to PA guidelines and to investigate its associations with all-cause mortality. MethodsA total of 7601 participants (20–85+ years) were drawn from the 2003–2004 and 2005–2006 National Health and Nutrition Examination Surveys (NHANES). Minutes per week of MVPA were assessed with a hip-worn accelerometer. Counts per minute (CPM) were used to define an age- and sex-specific target intensity, representing the intensity each person should be able to reach based on their age and sex. Age- and sex-specific MVPA cut-points were defined as any activity above 40% of the target intensity. These population- and free-living-based age-sex specific cut-points overcome many of the limitations of the standard generic cut-point approach. For comparison, we also calculated MVPA with a generic cut-point of 1952 CPM. Both approaches were compared for assessing adherence to PA guidelines and association of MVPA with all-cause mortality (ascertained through December 2015). ResultsBoth approaches indicated that 37% of the sample met the 150+ min/week guideline. The generic cut-point approach showed a trend to inactivity with age, which was less pronounced using the age-sex cut-points. Overall mortality rates were comparable using generic cut-point (hazard ratio (HR) = 0.61, 95% confidence interval (95%CI): 0.50‒0.73) or age-sex cut-points (HR = 0.57, 95%CI: 0.50‒0.66) for the entire sample. The generic cut-point method revealed an age- and sex-related gap in the benefits of achieving 150+ min/week of MVPA, with older adults showing an 18% greater reduction in mortality rates than younger adults, and a larger difference in women than in men. This disparity disappeared when using age-sex-specific cut-points. ConclusionOur findings underscore the value of age-sex cut-points for global PA surveillance. MVPA defined with age-sex thresholds was associated with all-cause mortality and the dose‒response was similar for all ages and sexes. This aligns with the single recommendation of accumulating 150+ min/week MVPA for all adults, irrespective of age and sex. This study serves as a proof of concept to develop this methodology for PA surveillance over more advanced open-source acceleration metrics and other national and international cohorts.

Predictors of Physical Activity One Year After Moderate to Severe Traumatic Brain Injury.

To identify predictors of moderate to vigorous physical activity (MVPA) at 12-months post-moderate-severe traumatic brain injury (TBI). Setting: Four inpatient rehabilitation centers. Individuals enrolled in the TBI Model Systems with moderate to severe TBI, admitted to inpatient rehabilitation, and able to ambulate without physical assistance from another person. Prospective longitudinal cohort study. MVPA was measured by having participants wear an ActiGraph GT3X on their wrist for 7 consecutive days. We used multivariate regression to predict minutes per week of MVPA at 12months after TBI. Three classes of predictors were entered hierarchically-demographic and clinical variables (age, sex, body mass index, education, TBI severity, neighborhood walkability score, and self-reported preinjury physical activity [PA] level), baseline TBI-related comorbid conditions (eg, measures of sleep, pain, mood, fatigue, and cognition), and intention to exercise and exercise self-efficacy assessed approximately 1week after discharge from inpatient rehabilitation. 180 participants (ages 17.7-90.3years) were enrolled, and 102 provided at least 5days of valid accelerometer data at 12months. At 12months, participants recorded an average of 703 (587) minutes per week of MVPA. In univariate and multivariate analyses, age was the only significant predictor of 12-month MVPA (r =-0.52). A sharp decline in MVPA was observed in the tertile of participants who were over the age of 61. Older adults with TBI are at elevated risk of being physically inactive. Assuming PA may enhance health after TBI, older adults are a logical target for prevention or early intervention studies. Studies with longer outcomes are needed to understand the trajectory of PA levels after TBI.

The Temporal Relationship Between Moderate to Vigorous Physical Activity and Secondary Conditions During the First Year After Moderate to Severe Traumatic Brain Injury

ObjectiveTo determine the cross-sectional and temporal relationships between minutes per week of moderate to vigorous physical activity (MVPA) as measured by a wrist-worn accelerometer and secondary conditions in the first year after moderate to severe traumatic brain injury (TBI). DesignProspective longitudinal cohort study. SettingFour inpatient rehabilitation centers. ParticipantsIndividuals (N = 180) with moderate-severe TBI enrolled in the TBI Model Systems Study. InterventionsParticipants wore a wrist accelerometer for 7 days immediately post discharge, and for 7 consecutive days at 6- and 12-months post injury. Main Outcome MeasuresMinutes per week of MVPA from daily averages based on wrist worn accelerometer. Secondary conditions included depression (Patient Health Questionnaire-9), fatigue (PROMIS Fatigue), Pain (Numeric Rating Scale), Sleep (Pittsburgh Sleep Quality Index), and cognition (Brief Test of Adult Cognition by Telephone). ResultsAt baseline, 6 and 12 months, 61%, 70% and 79% of the sample achieved at least 150 minutes per week of MVPA. The correlations between minutes of MVPA between baseline, 6 and 12 months were significant (r = 0.53-0.73), as were secondary conditions over these time points. However, no significant correlations were observed between minutes of MVPA and any secondary outcomes cross-sectionally or longitudinally at any time point. ConclusionsGiven the robust relationships physical activity has with outcomes in the general population, further research is needed to understand the effect of physical activity in individuals with moderate-severe TBI.

Sedentary Behavior and Physical Activity Associated with Psychosocial Outcomes in Adolescents with Type 1 Diabetes.

Adolescents with type 1 diabetes (T1D) are particularly vulnerable to poor psychosocial outcomes-high rates of diabetes distress and poor quality of life are common among this cohort. Previous work in the general population demonstrated positive associations between quality of life and increases in moderate-to-vigorous physical activity (MVPA), as well as decreased sedentary behavior. While survey-based assessments of young adults with T1D observed similar trends, these studies were limited by their use of subjective assessments of MVPA and sedentary behavior. The use of direct activity monitoring is needed to establish the association between psychosocial outcomes and MVPA and sedentary behavior among adolescents with T1D. To explore the association between objectively measured MVPA and sedentary behavior on psychosocial outcomes among adolescents with T1D. The current study is a secondary analysis of baseline data collected for a pilot trial of sleep-promoting intervention for adolescents with T1D. Participants (n = 29, with a mean age of 15.9 ± 1.3 years) completed baseline surveys and wore an actigraph for a week following the baseline visit. We examined minutes per week of MVPA and proportion of awake time spent sedentary in relation to adolescents' diabetes distress, depressive symptoms, and diabetes-related quality of life. Participants engaged in a mean of 19.6 ± 22.4 minutes of MVPA per day and spent 68.6 ± 9.9% of their awake time sedentary. MVPA was associated with lower diabetes distress in unadjusted (-3.6; 95% CI: -6.4 to -0.8) and adjusted (-2.6; 95% CI: -5.0--0.3) analyses. Sedentary time was associated with higher diabetes distress in adjusted (6.3; 95% CI: 1.3-11.2) but not unadjusted (6.0; 95% CI: -5.6-12.6) analyses. In secondary analyses, we did not observe significant associations between quality of life or depressive symptoms with either MVPA or sedentary behavior. Our findings extend previous survey-based work demonstrating an association between decreased diabetes distress with greater weekly MVPA and lower sedentary time. The current study highlights the multifaceted benefits of physical activity in this population and provides preliminary evidence for developing interventions to reduce sedentary time as an alternative method to improve psychosocial outcomes in this at-risk population.

The Independent Walking for Brain Health Intervention for Older Adults: Protocol for a Pilot Randomized Controlled Trial.

Extensive research suggests that physical activity (PA) is important for brain and cognitive health and may help to delay or prevent Alzheimer's disease and related dementias. Most PA interventions designed to improve brain health in older adults have been conducted in laboratory, gym, or group settings that require extensive resources and travel to the study site or group sessions. Research is needed to develop novel interventions that leverage mobile health (mHealth) technologies to help older adults increase their engagement in PA in free-living environments, reducing participant burden and increasing generalizability of research findings. Moreover, promoting engagement in moderate-to-vigorous PA (MVPA) may be most beneficial to brain health; thus, using mHealth to help older adults increase time spent in MVPA in free-living environments may help to offset the burden of Alzheimer's disease and related dementias and improve quality of life in older age. We developed a novel PA intervention that leverages mHealth to help older adults achieve more minutes of MVPA independently. This pilot study was a 12-week randomized controlled trial to investigate the feasibility of providing just-in-time (JIT) feedback about PA intensity during free-living exercise sessions to help older adults meet current PA recommendations (150 minutes per week of MVPA). Participants were eligible if they were cognitively healthy English speakers aged between 65 and 80 years without major cardiovascular, neurologic, or mental health conditions; could ambulate independently; and undergo magnetic resonance imaging. Enrollment occurred from October 2017 to March 2020. Participants randomized to the PA condition received an individualized exercise prescription and an mHealth device that provided heart rate-based JIT feedback on PA intensity, allowing them to adjust their behavior in real time to maintain MVPA during exercise sessions. Participants assigned to the healthy aging education condition received a reading prescription consisting of healthy aging topics and completed weekly quizzes based on the materials. In total, 44 participants were randomized to the intervention. A follow-up manuscript will describe the results of the intervention as well as discuss screening, recruitment, adverse events, and participants' opinions regarding their participation in the intervention. The long-term goal of this intervention is to better understand how MVPA affects brain and cognitive health in the real world and extend laboratory findings to everyday life. This pilot randomized controlled trial was conducted to determine the feasibility of using JIT heart rate zone feedback to help older adults independently increase time spent in MVPA while collecting data on the plausible mechanisms of change (frontal and medial temporal cerebral blood flow and cardiorespiratory fitness) that may affect cognition (memory and executive function) to help refine a planned stage 2 behavioral trial. ClinicalTrials.gov NCT03058146; https://clinicaltrials.gov/ct2/show/NCT03058146. DERR1-10.2196/42980.

Combined Associations of Physical Activity and Particulate Matter With Subsequent Cardiovascular Disease Risk Among 5-Year Cancer Survivors.

BackgroundThe combined associations of physical activity and particulate matter (PM) with subsequent cardiovascular disease (CVD) risk is yet unclear.Methods and ResultsThe study population consisted of 18 846 cancer survivors who survived for at least 5 years after initial cancer diagnosis from the Korean National Health Insurance Service database. Average PM levels for 4 years were determined in administrative district areas, and moderate‐to‐vigorous physical activity (MVPA) information was acquired from health examination questionnaires. A multivariable Cox proportional hazards model was used to evaluate the risk for CVD. Among patients with low PM with particles ≤2.5 µm (PM2.5; (19.8–25.6 μg/m3) exposure, ≥5 times per week of MVPA was associated with lower CVD risk (adjusted hazard ratio [aHR], 0.77; 95% CI, 0.60–0.99) compared with 0 times per week of MVPA. Also, a higher level of MVPA frequency was associated with lower CVD risk (P for trend=0.028) among cancer survivors who were exposed to low PM2.5 levels. In contrast, ≥5 times per week of MVPA among patients with high PM2.5 (25.8–33.8 μg/m3) exposure was not associated with lower CVD risk (aHR, 0.98; 95% CI, 0.79–1.21). Compared with patients with low PM2.5 and MVPA ≥3 times per week, low PM2.5 and MVPA ≤2 times per week (aHR, 1.26; 95% CI, 1.03–1.55), high PM2.5 and MVPA ≥3 times per week (aHR, 1.34; 95% CI, 1.07–1.67), and high PM2.5 and MVPA ≤2 times per week (aHR, 1.38; 95% CI, 1.12–1.70) was associated with higher CVD risk.ConclusionsCancer survivors who engaged in MVPA ≥5 times per week benefited from lower CVD risk upon low PM2.5 exposure. High levels of PM2.5 exposure may attenuate the risk‐reducing effects of MVPA on the risk of CVD.

Physical inactivity and sitting time prevalence and trends in Mexican adults. Results from three national surveys

BackgroundPhysical inactivity and high sitting time are directly related to mortality and morbidity of non-communicable diseases (NCDs). Thus, improved understanding of the prevalence and trends of these behaviors could support the design of policies and interventions for NCDs prevention.ObjectiveTo determine the current prevalence of physical inactivity and high sitting time, to analyze the trends, and to estimate the association of meeting/not meeting physical activity recommendations and low/high sitting time with sociodemographic characteristics and body mass index categories.MethodologyData from the 2018 National Health and Nutrition Survey were used. Moderate-to-vigorous physical activity (MVPA) and sitting minutes per week were calculated using the International Physical Activity Questionnaire short form (IPAQ). In total, 38,033 questionnaires of adults aged 20 to 69-year-old were analyzed. Adults were classified as physically inactive if they achieved less than 150 minutes per week of MVPA and as with high sitting time if they accumulated more than 420 minutes of sitting per day. Health and Nutrition National Surveys (ENSANUT) 2006, 2012 and 2018 were used to estimate the trends.ResultsIn total, 16.5% were classified as physically inactive and 11.3% within the high sitting time category. Both prevalences increased more than 40% during the 12-y period (2006–2018). In 2018, men, younger adults, those living in urban areas, and people within the highest socioeconomical status and educational levels were more likely to not achieve physical activity recommendations and to be classified in the highest sitting time category.ConclusionTo stop current increased trends and achieve global targets, stronger and more concerted efforts to promote physical activity and reduce sitting time are required. Thus, continued surveillance of these behaviors is necessary.

The association of physical activity on homocysteine in pregnant women

Introduction Women with high levels of physical activity have improved pregnancy, labor, and delivery outcomes related to cardiovascular health. Hyperhomocysteinemia, which predicts cardiovascular disease risk, is associated with maternal vascular complications during pregnancy, such as placental abruption and preeclampsia. However, studies are lacking on whether physical activity impacts homocysteine in pregnant women, pointing to a potential mechanism behind the improved cardiovascular health in women who exercise during pregnancy. The purpose of this study was to examine if women with high levels of physical activity have lower levels of homocysteine compared to women with low levels of physical activity. Methods This study was a secondary analysis using data from the 2003 to 2006 National Health and Nutrition Examination Survey. A total of 257 pregnant women were included. Physical activity was assessed objectively over seven days with accelerometers. High and low groups based on moderate-to-vigorous physical activity (MVPA) and steps/day were defined. Homocysteine and related laboratory biomarkers (vitamin B12, folate, pyridoxal 5′-phosphate) were assessed through blood draws. Data assembly was performed using SAS and analysis via SPSS Complex Samples. Results Only an estimated 17.7 ± 4.7% of women met guidelines to achieve at least 150 min per week of MVPA. Plasma homocysteine was not different between pregnant women with high and low levels of moderate-to-vigorous physical activity (4.39 ± 0.21 and 4.44 ± 0.17 µmol/L; p > .05) or between those with high and low levels of steps (3.95 ± 0.26 and 4.62 ± 0.27 µmol/L; p > .05) when the data was split into two quantiles by the median. These results were similar when using log-transformed values for homocysteine to normalize the distribution of data. Pregnant women in the group of the high steps tended to have higher vitamin B12, folate, and pyridoxal 5′-phosphate than those in the group of the low steps. Sensitivity analyses revealed that homocysteine was not different between the upper 25% (4.04 ± 0.22 µmol/L) and lower 25% (4.17 ± 0.26 µmol/L) MVPA (p = .716) but that it was statistically higher in the low (<5000 steps/day) (4.99 ± 0.20 µmol/L) steps/day group compared to high (>7500 steps/day) steps/day (3.99 ± 0.23 µmol/L) (p = .003) after excluding individuals with hypertension and thyroid/kidney issues. Conclusion Maternal steps/day, but not MVPA, appear to be associated with homocysteine (albeit weakly) in the present study after excluding potential factors which impact homocysteine. The volume of physical activity appears to be an important indicator as this difference was not revealed until the physical activity was more distinctly separated.

A longitudinal study on depressive symptoms and physical activity during the Spanish lockdown

Background/Objective: The aim was to evaluate the evolution of depressive symptoms and to explore the influence of physical activity (PA) practice during the home confinement due to the COVID-19 outbreak in Spain. Method: Information was collected from 595 confined participants who reported personal and contextual information, depressive symptoms and PA levels at four time points. Results: The changes in depressive symptoms were analyzed using a linear mixed model with cubic splines. Results showed a significant increase, with a significant rise between T1 and T2 (OR = 2.38, 95% CI = 1.83-3.10). It continued growing until T4 (OR = 2.93, 95% CI = 1.97-4.38). A negative relationship was observed between the increase in depressive symptoms and moderate-to-vigorous physical activity (MVPA) levels, with a significant slope up to 4 hours of MVPA per week (OR = 0.51, 95% CI = 0.29-0.90) that tended to increase until 16 hours per week of MVPA (OR = 0.41, 95% CI = 0.20-0.87). Conclusions: Results from a partition model showed that moderate intensity of PA could be enough to prevent an increase of depressive symptoms during home isolation.

Validation Of Exercise Vital Sign (evs) Questions In A Pediatric Population

PURPOSE: The purpose of this study was to determine which factors were associated with increased weekly moderate to vigorous physical activity (MVPA) measured by Exercise Vital Sign (EVS) questions. METHODS: Patients presenting to a sports medicine clinic between the ages of 5-18 were asked “On average, how many days per week did you participate in MVPA” and “On average, how many minutes per day did you participate in MVPA”. Weekly physical activity, age, sex, BMI percentile, as well as history of asthma, attention deficit hyperactivity disorder, depression and diabetes were recorded. A linear regression analysis was utilized in those who reported any physical activity to determine which factors were associated with increased MVPA. RESULTS: Data were recorded on 14,440 subjects. Average age was 13.91±2.49 years and average BMI percentile was 65.50±27.74 percent. Females made up 54.1%. Asthma was reported by 2340 (16.2%), ADHD was reported by 818 (5.7%), depression was reported by 308 (2.1%), and diabetes was reported by 92 (.6%). Overall, 45.6% of subjects reported 420 minutes or more of weekly MVPA. Those who reported any physical activity (n=13,708) averaged 424.14±287.45 minutes per week of MVPA. Those with a history of depression had almost 60 minutes/week less MVPA when controlling for age, sex, BMI percentile, asthma, ADHD, and diabetes (p>.001). Females reported 45 minutes less MVPA than males when controlling for age, BMI percentile, asthma, ADHD, depression and diabetes (p>.001). Discussion: Physical activity is an important health determinant in childrens’ current and future health. The majority of youth do not meet current physical activity recommendations. Children suffering from depression should be screened for MVPA to encourage meeting physical activity recommendations. As females continue to obtain significantly less MVPA than males, targeted interventions need to be developed for this population. Regular screenings of MVPA levels should be implemented for children to help identifying and counsel those who are insufficiently active.

SELF-REPORTED PHYSICAL ACTIVITY IN SPECIALIZED AND UNSPECIALIZED YOUTH

The benefits of physical activity cross all domains of health. Unfortunately, many children are not meeting the current American College of Sports Medicine recommendations of 60 minutes of moderate to vigorous physical activity (MVPA) 7 days a week. This is especially deleterious since physical activity patterns during childhood may carryover to adulthood. Research has also shown that participating in one sport may increase the risk of injury. The purpose of this study was to examine self-reported exercise levels in children reporting to a tertiary sports medicine clinic over a three year period. Subjects were asked “How many minutes of moderate to vigorous physical activity per day?” and “How many days per week do you participate in moderate to vigorous physical activity”. Minutes per week of MVPA was calculated. Age, sex, and current sports and recreational activities were recorded. There were 7427 unique patients (53% female) with an average age of 13.8±2.6. The average minutes per day of exercise was reported as 85.6±44.4, average days per week was 4.4±1.6 and minutes per week was 410.8±266.9. Females reported less minutes per day (83.5 vs. 87.8, p<.001), less days per week (4.2 vs 4.7, p<.001) and less minutes per week (384.1 vs 440.2, p<.001) than males. On average, females reported 56 minutes less activity per week than their male counterparts. There were 3618 participants who only reported one activity and were categorized as specialized in a single physical activity. Those that specialized in a single activity were significantly older (14.1 vs 13.4, p<.001). There were no significant differences between reported minutes per day between specialized and unspecialized athletes (85.8 vs 85.2, p=.57). Those who specialized in one activity reported more days per week (4.6 vs 4.2. p<.001) and more minutes per week (423.8 vs 397.0, p=.001) than unspecialized athletes. Research has consistently shown that females are less active than males. Those who specialized in one activity participated in more minutes per week of activity, mainly through participating in more days of physical activity. Children should be encouraged to participate in a variety of activities on a daily basis to ensure they receive the benefits of physical activity.

Using Mobile Health Tools to Assess Physical Activity Guideline Adherence and Smoking Urges: Secondary Analysis of mActive-Smoke

BackgroundRates of cigarette smoking are decreasing because of public health initiatives, pharmacological aids, and clinician focus on smoking cessation. However, a sedentary lifestyle increases cardiovascular risk, and therefore, inactive smokers have a particularly enhanced risk of cardiovascular disease.ObjectiveIn this secondary analysis of mActive-Smoke, a 12-week observational study, we investigated adherence to guideline-recommended moderate-to-vigorous physical activity (MVPA) in smokers and its association with the urge to smoke.MethodsWe enrolled 60 active smokers (≥3 cigarettes per day) and recorded continuous step counts with the Fitbit Charge HR. MVPA was defined as a cadence of greater than or equal to 100 steps per minute. Participants were prompted to report instantaneous smoking urges via text message 3 times a day on a Likert scale from 1 to 9. We used a mixed effects linear model for repeated measures, controlling for demographics and baseline activity level, to investigate the association between MVPA and urge.ResultsA total of 53 participants (mean age 40 [SD 12] years, 57% [30/53] women, 49% [26/53] nonwhite, and 38% [20/53] obese) recorded 6 to 12 weeks of data. Data from 3633 person-days were analyzed, with a mean of 69 days per participant. Among all participants, median daily MVPA was 6 min (IQR 2-13), which differed by sex (12 min [IQR 3-20] for men vs 3.5 min [IQR 1-9] for women; P=.004) and BMI (2.5 min [IQR 1-8.3] for obese vs 10 min [IQR 3-15] for nonobese; P=.04). The median total MVPA minutes per week was 80 (IQR 31-162). Only 10% (5/51; 95% CI 4% to 22%) of participants met national guidelines of 150 min per week of MVPA on at least 50% of weeks. Adjusted models showed no association between the number of MVPA minutes per day and mean daily smoking urge (P=.72).ConclusionsThe prevalence of MVPA was low in adult smokers who rarely met national guidelines for MVPA. Given the poor physical activity attainment in smokers, more work is required to enhance physical activity in this population.

Association Between Physical Activity Intervention Website Use and Physical Activity Levels Among Spanish-Speaking Latinas: Randomized Controlled Trial.

BackgroundThe internet’s low cost and potential for high reach makes Web-based channels prime for delivering evidence-based physical activity (PA) interventions. Despite the well-studied success of internet-based PA interventions in primarily non-Hispanic white populations, evidence on Spanish-speaking Latinas’ use of such interventions is lacking. The recent rise in technology use among Latinas in the United States, a population at heightened risk for low PA levels and related conditions, suggests that they may benefit from Web-based PA interventions tailored to their cultural and language preferences.ObjectiveThe goal of the research was to examine participant engagement with various features of an internet-based PA intervention for Latinas and explore how use of these features was differentially associated with adoption and maintenance of PA behavior change.MethodPasos Hacia la Salud tested a Spanish-language, culturally adapted, individually tailored, internet-based PA intervention versus a Spanish language, internet-based, Wellness Contact Control condition for underactive Latinas (N=205, mean age 39.2 [SD 10.5] years, 84% Mexican American). These analyses examined engagement with the website and explored how use was associated with adoption and maintenance of moderate to vigorous physical activity (MVPA) behavior.ResultsOverall, participants logged on to the website an average of 22 times (SD 28) over 12 months, with intervention participants logging on significantly more than controls (29 vs 14.7, P<.001). On average, participants spent more time on the website at months 1, 4, and 6 compared to all other months, with maximum use at month 4. Both log-ins and time spent on the website were significantly related to intervention success (achieving higher mean minutes of MVPA per week at follow-up: b=.48, SE 0.20, P=.02 for objectively measured MVPA and b=.74, SE 0.34, P=.03 for self-reported MVPA at 12 months, controlling for baseline). Furthermore, those meeting guidelines by the Centers for Disease Control and Prevention for PA at 12 months (≥150 minutes per week of MVPA) logged on significantly more than those not meeting guidelines (35 vs 20 over 12 months, P=.002). Among participants in the intervention arm, goal-setting features, personal PA reports, and PA tips were the most used portions of the website. Higher use of these features was associated with greater success in the program (significantly more minutes of self-reported MVPA at 12 months controlling for baseline). Specifically, one additional use of these features per month over 12 months translated into an additional 34 minutes per week of MVPA (goals feature), 12 minutes per week (PA tips), and 42 minutes per week (PA reports).ConclusionsThese results demonstrate that greater use of a tailored, Web-based PA intervention, particularly certain features on the site, was significantly related to increased PA levels in Latinas.Trial RegistrationClinicalTrials.gov NCT01834287; https://clinicaltrials.gov/ct2/show/NCT01834287

Self-Reported Physical Activity Level in Student Athletes at Preparticipation Physical Evaluations.

Quantify physical activity in healthy student athletes. Cross-sectional survey. Five Central Ohio schools during mass preparticipation physicals. Three hundred sixty-five children between the ages 10 and 18 years. Days per week of moderate to vigorous physical activity (MVPA), minutes per day of MVPA, and number of activities. Minutes per week of MVPA. One hundred eighty high school and 177 middle school subjects responded to the survey. There were 198 male and 162 female respondents. Mean age recorded 14.2 ± 1.7 years. There were no differences in activity volume based on sex. Mean minutes per week of MVPA reported 316.0 ± 231.0. High school subjects reported fewer activities than middle school cohort 2.7 ± 1.2 versus 3.2 ± 1.5 (P < 0.05). Only 7% of respondents reported exercising 60 minutes daily. Twenty-seven percent of respondents met minutes per week (420 minutes of MVPA) by training in large volumes on fewer days. Surprisingly, this physically active population did not meet the national standards of daily MVPA. In addition, middle school athletes reported more variety of activities compared with high school athletes surveyed which reached statistical significance. Screening for daily physical activity is important in the athletic population because young athletes may not meet daily MVPA recommendations.

Social support and physical activity change in Latinas: Results from the Seamos Saludables trial.

Family responsibilities and poor social support are barriers to physical activity among Latinas. This study evaluated the effects of a home- and print-based intervention on social support, moderating effects of familial ties on support and moderate-to-vigorous physical activity (MVPA), and mediating effects of support on MVPA. Participants were randomized to receive through the mail either individually tailored physical activity intervention or general wellness print materials. Familial ties and social support were assessed by marital and child status and the social support for physical activity measure, respectively. MVPA was measured using the 7-day Physical Activity Recall Interview and accelerometer. Assessments were conducted at baseline, 6 months posttreatment, and 12 months follow-up. Participants (n = 266; 40.6 ± 9.9 years old) were mostly immigrant and Spanish-speaking Latinas. The intervention group achieved greater increases in family and friend support compared to the wellness control group from baseline to posttreatment and follow-up (p < .05). Intervention changes in support did not depend on marital or child status. The intervention also increased minutes per week of MVPA more than the wellness control (p < .05) and the effect did not depend on marital or child status. There were significant indirect effects of treatment, indicating the intervention achieved greater increases in MVPA by increasing family (ab = 5.21, SE = 2.94, 95% confidence interval [CI] = 0.91-14.11) and friend (ab = 6.83, SE = 5.15, 95% CI = 0.16-20.56) support. The intervention improved and sustained support from family and friends and MVPA irrespective of familial ties. Social support mediated increases in MVPA. (PsycINFO Database Record

Motives for Participation in Physical Activity and Observance of Physical Activity Recommendations among Adults with Type 2 Diabetes.

Drawing on self-determination theory, this study examined how motivation to engage in physical activity (PA) influences the observance of PA recommendations by adults with type 2 diabetes. This study used a cross-sectional design. In total, 365 adults with type 2 diabetes (181 men and 184 women, mean age = 60.39 years; SD=6.47) completed a questionnaire assessing their motivations and behaviours regarding PA. PA behaviour was assessed by means of the weekly practice of moderate-to-vigorous PA (MVPA) during leisure time. A symptom checklist was also used to assess diabetes-related symptoms experienced over the past month. Results of a hierarchic binary logistic regression revealed that participants accumulating at least 150 minutes per week of MVPA during their leisure time were more likely to display higher scores on intrinsic and identified motives, whereas participants not accumulating 150 minutes per week of MVPA during their leisure time were more likely to present higher scores on external regulation and amotivation. In addition, results of a multivariate analysis of covariance (MANCOVA) showed that participants accumulating at least 150 minutes per week of MVPA during their leisure time experienced less fatigue and fewer hyperglycemic symptoms. These findings suggest that adults who observe PA recommendations for type 2 diabetes possess higher levels of autonomous motives to practise PA. Results further highlight the importance of motives for engaging in PA by adults with type 2 diabetes in terms of the positive relationship between observing PA recommendations and experiencing less fatigue and fewer hyperglycemic symptoms.

Abstract MP13: Perceived Environmental Supports and Barriers are Associated with Physical Activity Behaviors During Pregnancy

Background: In the absence of contraindications, current guidelines recommend ≥ 150 minutes/week of moderate-intensity aerobic activity for women during pregnancy for the prevention of excess weight gain, metabolic abnormalities (e.g., gestational diabetes), and the general health of both mother and offspring. In the U.S., approximately 20% of pregnant women meet this recommendation. The perceived quality of the built environment may play an important role in supporting or hindering active living during pregnancy. Thus, this study examined the association of environmental supports for physical activity (PA) with PA behaviors in a population of pregnant women. Methods: The study included 155 pregnant women in the Ohio State University Wexner Medical Center that self-reported PA behaviors during the third trimester (27+ weeks). Participants also rated 26 perceived environmental supports and barriers for PA in four domains: outdoor recreation supports, access to a safe walking environment, neighborhood and community supports, and public recreation facilities; the total environmental quality score ranged from 0 (worst) to 26 (best). Logistic regression was used to examine the association of the total and subscale scores with achievement of ≥150 minutes of moderate-to-vigorous physical activity (MVPA) during the pregnancy, maintenance of pre-pregnancy PA level, and change in moderate PA from the 1st through 3rd trimester. Results: The study included women between the ages of 20-46 years that were between 27-40 weeks pregnant. The mean age was 32 years (SD=4.3 years). Fifty percent of the study population reported achieving ≥150 minutes per week of MVPA. Women with access to a safe walking environment were more likely to maintain or increase their PA during pregnancy [adjusted OR (aOR) per 1-point increase in PA score = 1.61, 95% CI: 1.14-2.28, p&lt;0.01]; a safe walking environment was characterized by perceptions of physically active neighbors, lack of concern about unattended pets, safe and well-maintained sidewalks, and adequate street lighting. Participants that reported better access to public recreational facilities were also more likely to maintain or increase moderate PA levels throughout their pregnancy (aOR = 1.24, 95% CI: 1.05 - 1.47, p&lt;0.05). Conclusions: Perceived access to a safe environment and neighborhood public recreation facilities are strongly associated with achievement and maintenance of recommended PA throughout pregnancy. Interventions at the individual-level have been shown to promote PA during pregnancy. Combining these efforts with community-level interventions that enhance the built environment to include access to safe outdoor space for leisure and recreational facilities may also positively impact the metabolic health of expectant mothers.

Comparison of Self-Reported and Accelerometer-Assessed Physical Activity in Older Women

BackgroundSelf-reported physical activity measures continue to be validated against accelerometers; however, the absence of standardized, accelerometer moderate-to-vigorous physical activity (MVPA) definitions has made comparisons across studies difficult. Furthermore, recent accelerometer models assess accelerations in three axes, instead of only the vertical axis, but validation studies have yet to take incorporate triaxial data.MethodsParticipants (n = 10 115) from the Women’s Health Study wore a hip-worn accelerometer (ActiGraph GT3X+) for seven days during waking hours (2011–2014). Women then completed a physical activity questionnaire. We compared self-reported with accelerometer-assessed MVPA, using four established cutpoints for MVPA: three using only vertical axis data (760, 1041 and 1952 counts per minute (cpm)) and one using triaxial data (2690 cpm).ResultsAccording to self-reported physical activity, 66.6% of women met the US federal physical activity guidelines, engaging in ≥150 minutes per week of MVPA. The percent of women who met guidelines varied widely depending on the accelerometer MVPA definition (760 cpm: 50.0%, 1041 cpm: 33.0%, 1952 cpm: 13.4%, and 2690 cpm: 19.3%).ConclusionsTriaxial count data do not substantially reduce the difference between self-reported and accelerometer-assessed MVPA.

Demographic and Clinical Determinants of Moderate to Vigorous Physical Activity During Home-Based Cardiac Rehabilitation

Little is known concerning moderate to vigorous physical activity (MVPA) levels in patients attending home-based cardiac rehabilitation (CR) programs and whether demographic/clinical characteristics moderate these levels. Patients (N = 280, 77 female) who were referred to home-based CR, mainly because of myocardial infarction (34%), coronary artery bypass graft (17%), and percutaneous coronary intervention/ stent/atherectomy (32%), completed a questionnaire assessing demographic and clinical characteristics as well as MVPA, measured at the beginning and end of a 3-month home-based CR program. Charts were reviewed for blood work, blood pressure, stress tests, and diagnosis. Patients averaged 88.5 minutes per week of MVPA before starting home-based CR, which increased to 191.1 minutes during the program. Multiple regression analyses showed that patients who were male (beta = -.11), did not have metabolic syndrome (beta = -.14), and were meeting the MVPA guideline before starting home-based CR (beta = .25) engaged in significantly more MVPA during home-based CR than their counterparts. Furthermore, the increase in MVPA was significantly larger for males (beta = -.20), patients without metabolic syndrome (beta = -.13), and patients who did not meet the MVPA guideline at baseline (beta = -.29) than their counterparts. The MVPA levels of patients attending home-based CR tend to vary depending on gender, whether or not metabolic syndrome was present, and prior MVPA levels, suggesting the need to potentially target these particular groups in future behavioral interventions aimed at increasing MVPA.

Socioeconomic Effects on Meeting Physical Activity Guidelines

This study examined the relationship between age and gender with physical activity (PA) and how meeting of PA guidelines (PAGL) is related to socioeconomic status (SES) and sedentary behaviors (SB). Data were collected from 11-, 13-, and 15-yr-old students in 32 countries participating in the Health Behaviour in School-aged Children (HBSC) survey 2001/2002. A self-completed questionnaire assessed weekly moderate-to-vigorous physical activity (MVPA) and SB for the past 7 d and MVPA for a typical week. SES was assessed using the Family Affluence Scale (FAS). None of the countries averaged enough MVPA to meet PAGL. The pattern of MVPA across age and gender was consistent among all countries. In all countries, older children were less active when compared with the youngest children; girls were significantly less active than boys were (mean hours per week of MVPA 3.52 +/- 1.88 vs 4.13 +/- 1.95) and were more likely to not meet the PAGL. SES was significantly associated with the amount of reported MVPA. SES and PAGL were not significantly related in seven countries, and a significant decrease in the influence of age was observed in these countries compared with other countries. Levels of MVPA during adolescence showed consistent patterns across countries in relation to age, gender, and social class. The limited effect of age on PA in countries where the influence of social class was less strong suggests the possibility of a moderating effect of context in the development of habits acquired during childhood.