Background

Moving to a different country often leads to changes in a person’s health-related behaviours such as, among others, engagement in moderate-to-vigorous physical activity (MVPA). Italian immigrants in Norway have tripled in the past 15 years, but little is known about their lifestyle and health. The aim of this study was to examine i) the MVPA behaviour, ii) the association of MVPA with self-rated health, and iii) the perceived impact of moving among first-generation Italian immigrants in Norway.

Methods

The data was retrieved from a cross-sectional survey (n= 321) and a set of in-depth interviews (n= 14) conducted within the study Mens Sana in Corpore Sano. Inclusion criteria were: age ≥ 18 years, living in Norway permanently, having lived in Italy at least until age 16 years. The data included information on the participants’ MVPA behaviour (amount, frequency, and mode), self-rated health, and perceived impact of moving on their MVPA behaviour. Additionally, socio-demographic characteristics (sex, age, and educational level) and factors associated with the settlement process (years in Norway, contact with close friends, and national identity) were included as covariates.

Results

Most of the respondents (62%) engaged in MVPA for ≥150 min/week; the mean MVPA frequency was 3.37±2.29 times/week. The most popular modes of MVPA were active transport and physical activity in natural settings. After controlling for multiple covariates, both engaging in MVPA for ≥150 min/week (β= 0.177; p= 0.002) and higher MVPA frequency (β = 0.164; p= 0.005) significantly predicted higher levels of self-rated health. While 15% of respondents perceived that moving to Norway had a negative impact on their MVPA behaviour, 50% perceived a positive impact. From the qualitative analysis, it emerged that proximity to natural environments and Norway’s culture that value outdoor recreations were important elements supporting the participants’ MVPA habits as well as their perceived health.

Conclusions

In spite of the relatively high socio-economic profile of most first-generation Italian immigrants in Norway, yet their MVPA levels is somewhat lower than the Norwegian population’s. The physical and cultural environment in Norway, however, appears to contribute buffering the health challenges among Italian immigrants in Norway.

Background: Studies that have analyzed the association between the different movement behaviors and fundamental movement skills (FMS), have considered it in an independent manner, disregarding the compositional nature of 24-hour movement behaviors (24h MB). The aim of this study was to investigate relationships between the 24h MB and FMS in low-income preschoolers. Methods: Two hundred and four preschoolers of both sexes (4.5±0.8 years old; 101boys) provided objectively assessed physical activity (PA) and sedentary time (ST) data (Actigraph wGT3X), and FMS assessments (TGMD-2). Sleep duration (SD) was reported by parents through interview. Association of daily time composition of movement behaviors with FMS was explored using compositional data analysis (R Core Team, 3.6.1). Results: Our data highlighted that no single movement behaviour significantly predicted locomotor, manipulative, or total motor competence.  When data were considered as a 24h MB composition based on PA, ST and SD, adjusted for age, BMI and sex, the composition significantly predicted locomotor score (P <0.0001; r2 = 0.31), manipulative score (P <0.0001; r2 = 0.19) and total motor competence score (P <0.0001; r2 = 0.35), respectively. Conclusion: Our study suggests that the 24h MB composition is more important for adequate FMS then any individual, movement behavior. This represents an important finding, particularly for creating and optimizing interventions to benefit child health.

Background:

Physical activity is a key determinant for health and considered as an important factor in the prevention of lifestyle related-diseases. All physical activity domains are generally considered to be health enhancing. However, accumulating evidence in recent years suggests that occupational physical activity may not have the same beneficial health effect as leisure time physical activity. Our aim was to assess the association of occupational and leisure time physical activity and all-cause mortality. 

Methods. 

We obtained individual participant data from published and unpublished cohort studies and assessed their risk of bias. We harmonized the data, and used Cox survival regression models to assess the association between occupational and leisure time physical activity with all-cause mortality, in a two-stage individual participant data meta-analysis. Different models were performed to assess the impact of relevant confounders including behavioral, health-related and socio-economic factors. Results of the data were reported with hazard ratios (HRs) and 95% confidence intervals (95% CI). 

Results:

Data from 22 prospective cohort studies showed that male workers with high occupational physical activity had an increased risk of all-cause mortality in comparison with sedentary occupational physical activity (HR: 1.12, 95%CI: 1.03- 1.23). For female workers, no such association was found (HR: 1.01, 95%CI: 0.85-1.19). when comparing high with sedentary occupational physical activity. 

Increasing levels of leisure time physical activity were inversely and dose-dependently associated with a reduced risk of all-cause mortality. For example, high compared with sedentary leisure time physical activity was associated with reduced risks for males (HR: 0.53, 95%CI: 0.36-0.79) and for females (HR: 0.49, 95%CI: 0.31-0.79). 

All associations remained robust when adjusting for additional relevant confounders, leaving one study out analysis, and when assessing the role of bias and reverse causality. 

Conclusion:

We consistently found a reduced risk of all-cause mortality with increasing levels of leisure time physical activity, but not for occupational physical activity. These findings indicate that occupational activity may not be health-enhancing. These findings suggest that occupational physical activity may not be considered a suitable substitute to leisure time physical activity when striving for health enhancement.

Introduction 

In contrast to leisure time physical activity (LTPA), occupational physical activity (OPA) does not have similar beneficial health effects. These differential health effects, also known as the physical activity health paradox, might be explained by dissimilar effects of LTPA and OPA on cardiorespiratory fitness (CRF). This study aims to investigate the association between device-worn measures of physical behaviors during both work and leisure time and CRF among workers with high level of OPA. 

Methods 

Our results are based on a sample of 309 workers employed within the service and production sector from the cross-sectional FEPA (Flemish Employees’ Physical Activity) study. OPA and LTPA were measured using two Axivity AX3 accelerometers, worn on the back and right thigh for 2 to 4 consecutive working days. CRF levels were obtained by the Harvard step test. Compositional multiple linear regression analyses were used to analyze the relations, adjusted for age, sex, education, smoking, BMI, moderate-to vigorous physical activity (MVPA), and physical work demands. 

Results 

During work time, more sedentary behavior (SB) was associated with higher CRF when compared relatively to time spent on other work behaviors, while more SB during leisure time was associated with lower CRF when compared to other leisure time behaviors. Reallocating more time to MVPA from the other behaviors within leisure time was positively associated with CRF, which was not the case for MVPA during work. 

Conclusion 

Our results emphasize the need for taking the domain-specific nature of physical activity into account to understand its relation to CRF. Guidelines usually do not differentiate between OPA and LTPA in their recommendation to participate in at least 150 min of physical activity per week, regardless of the OPA level. Workers already meeting this recommendations through OPA might therefore mistakenly think that they already meet the recommendations on physical activity and think they can spend their leisure time in a sedentary fashion. In reality, these types of workers might benefit from recommendations to take more sitting breaks during their work and to participate in leisure time MVPA to maintain or improve their CRF in order ‘to be fit for the job’.

Background: School recess provides a unique opportunity for children to be active. However, many children perceive smartphones as a key barrier for engaging in physical activity during recess. The aim was to investigate if a ban on smartphone usage during recess changed children's physical activity. Methods: During August-October 2020, children from grades 4-7 (10-14 yrs.) at six Danish schools were banned from using their smartphones during recess for a four-weeks period. Questionnaire and systematic observation (SOPLAY) data were collected from 814 children before intervention (baseline) and 828 during the last week of intervention (follow-up). Results: The mean frequency of physical activity significantly increased from baseline to follow-up (odds ratio = 1.370), as did physical activity on a moderate level (odds ratio = 1.387). Vigorous physical activity significantly decreased (odds ratio = 0.851). The increase in physical activity was found among both schools having outdoor and indoor recess, among both boys and girls and nearly equally among grades 4–7. Notably, we observed a much greater decrease in sedentary behavior and a slightly larger increase in moderate physical activity for girls than for boys and particularly boys decreased in vigorous physical activity. They might have changed their physical activity behavior in follow-up because more girls participated in physical activities, resulting in more children in the same space. Conclusion: This suggests that implementing a ban on smartphone usage during recess would, in line with the HEPA strategy, improve the everyday conditions for health among a broad range of children. To our knowledge, this is the first intervention study investigating if a ban on smartphone usage during recess changed schoolchildren's physical activity behavior. Thus, this study fills an important gap for researchers, school boards, teachers, health professionals, and politicians on how schoolchildren’s physical activity during recess can be positively changed by policy.

Purpose:         

There are enormous economic, human, and environmental costs of inactivity, climate change, air pollution and congestion and active travel can help reduce and prevent these. In England, however, only 26% of all trips are made by walking and only 2% are made by cycling. Walking and cycling contribute just 4% of total distance travelled. ‘Beat the Street’ is a community-wide intervention which aims to increase active travel by turning an area into a 6-week game. Residents earn points and prizes by walking and cycling and tapping a smartcard on RFID readers called ‘Beat Boxes’ placed on lampposts at half-mile intervals. To-date, over 1 million people have taken part in the intervention, however, the impact of the program on adult active travel is yet to be explored.

Methods: 

In Autumn 2019, Beat the Street was delivered throughout the London Borough of Hounslow. Prior, and immediately following the intervention, residents were invited to complete a self-report questionnaire (Sport England Active Lives Survey-SF) to assess changes in physical activity. Time-stamp data generated through Beat Box activity provided an objective measure of intervention engagement and a traffic survey camera was used to measure the number of cars travelling along 1 target road between 1-week pre- and 1-week post-intervention. Data were analysed using a series of ANOVAs and McNemar tests. 

Results:          

28,219 people took part in the six-week game, of which 56% were female. Between pre- and post-intervention there was 7% decrease in adults reporting less than 30mins of activity per week and a 13% rise in adults reporting 150+ mins (n=346, p<0.01). Beat box data ascertained that 25% of total taps at all Beat Boxes were made between 08:00-08:59am and a further 28% were made between 3:00-3:59pm, typical travel to school/work periods. Further, traffic camera data showed that between the week before and week following Beat the Street, 1199 and 705 fewer cars and 130 and 36 fewer vans were observed travelling along Cambridge Road between 07:00-09:30am and 2:00-4:30pm, respectively.

Conclusions:   

These data sources, in combination, suggest gamification may be an encouraging approach to increasing levels of active travel at a community-wide level.

Background: Previous research has shown that school can be an influential context to promote students’ physical activity engagement, physical fitness, and motor competence. The purpose of this study was to investigate the effectiveness of a 5-month-long intervention program that aimed to increase students’ motor competence and physical fitness during school days.

Methods: A quasi-experimental intervention design with pre- and post-tests was implemented. Altogether 325 Finnish Grade 5 (M_age = 11.26, SD = .33) students from five schools participated in the study. At the beginning of the study, students were divided into experimental and control groups on purpose. The intervention consisted of three components: a) weekly 20 minutes sessions of guided training during a regular PE lesson, b) weekly 20 minutes sessions of guided training during recess and c) daily 5 minutes long activity breaks during academic lessons. Intervention activities aimed to increase different elements of physical fitness and motor competence. One week before and one week after the intervention period students’ physical fitness levels were measured by 20-meter shuttle run (cardiorespiratory fitness), curl-up and push-up (muscular fitness) tests, and motor competence by 5-leaps (locomotor skills) and throwing-catching-combination (object control skills) tests.

Results: Repeated measures MANOVA indicated that there was a multivariate interaction effect between experimental and control groups over time (F [5, 222] = 7.52, p=.000, partial η²=.145). Moreover, univariate analysis revealed that students in the experimental group performed significantly better in 20-meter shuttle run test (F [1, 226] = 21,9, p=.000, partial η²=.088), curl-up (F [1, 226] = 4,9, p=.028, partial η²=.021), push-up (F [1, 226] = 15,5, p=.000, partial η²=.064) and throwing-catching-combination (F [1, 226] = 4,0, p=.046, partial η²=.017). There were no differences between experimental and control groups in 5-leaps test (F [1, 226] = 0.003 p=.958, partial η²=.000).

Conclusions: The intervention program appeared to be effective in increasing students’ cardiorespiratory fitness, muscular fitness, and object control skills. This indicates that guided school-based physical activity programs can be influential in promoting physical fitness and motor competence among school children.

Background:

Published in 2018, the World Health Organisation’s Global Action Plan for Physical Activity (GAPPA) sets out 20 actions across 4 objectives (Active Societies, Active Environments, Active People, Active Systems) to reduce global inactivity by 15% by 2030. GAPPA takes a whole-systems approach (WSA), calling for cross-sectoral collaboration to address physical inactivity levels. This study sought to explore implementation to date, highlighting progress made and areas that require further focus.

Methods:

A desk-based scoping study, using a systematic, but flexible approach, identified sites and personnel implementing GAPPA or a WSA. Methods of collection included a review of existing literature, snowball sampling of key individuals and internet searches. These methods identified a range of academics and practitioners who were subsequently contacted and interviewed on their use of GAPPA to date.

 

Results:

Preliminary findings suggest that GAPPA’s implementation currently varies greatly internationally. Some nations, including Finland and Scotland have embraced a WSA, taking steps to actively map their PA system. Elsewhere, countries such as Ireland and Australia are exploring practical approaches to implementing a WSA. GAPPA was only published in June 2018 and thus, where action is taking place, these countries offer important implementation evidence and opportunities for transferable learning. Regarding GAPPA’s objectives, our review concludes that in nations that have embraced GAPPA, the Active Societies and Active Environments objectives are being actioned or have plans in development for action, while progress towards behaviour and system change objectives (Active People and Active Systems) appear less evident.

 

Conclusions:

There is some promising evidence drawn from GAPPA’s early implementation, although we conclude that if WHO targets are to be reached, wider adoption is needed. It appears that the nations who have best applied GAPPA, are those who arguably have pre-existing cross-sectoral networks in PA and public health. Therefore, perhaps a crucial first step in nationally implementing GAPPA is the establishment of these networks, laying foundations for collaborative action. Furthermore, the generation and dissemination of research by some of the early adopters is crucial to both reinforce knowledge transfer and guide others towards a whole-systems approach.

The World Health Organization recommends active commuting to and from school as a source of physical activity. Worldwide, active commuting, i.e. walking or biking, is determined by various factors including gender, socioeconomic status of families and neighborhoods, the built envormnet, distance to schools, perceived neighborhood safety, life styles, and availability of walkways, biking paths and parks. Previous studies from  Swedish indicate that the proportion of youth being active commuters descres with age, but has also decresed over time.  This study aimed at assessing health and environmental factors associated with modes of transportation to and from school among 333 adolescents aged 16-19 living in a middle-sized city in Sweden.

The present city has 380 kilometer of walking and biking paths that cover the whole city, of which parts are heated in the winter to avoid snow and ice. Still, only 32% of the adolescents were active commuters to and from school.  Active commuting was linked to other healthy behaviours including more frequenct daily consumption of fruits and vegetables and less frequent consumption of junk food. Morover, the presence of  well illuminated walking and biking paths was strongly associated with active commuting, as compared to not having access to less illuminated paths. However, the relation between active commuting and socioeconomic status of the neighborhood was complex and needs to be explored in future larger studies. 

The result will be used to increase awareness  of the health and enviromental benfits of active commuting among adolencnets, schools, and local policy makers.

Background: 

Using Amartya Sen’s capability approach (CA) to conceptualize physical activity (PA) promotion projects has been suggested as a promising alternative to conventional theories, as it focuses on the real opportunities people have to engage in PA rather than on PA behavior alone. The Capital4Health research consortium used the CA to conceptualize and implement PA projects in four different settings across the life-course. The aim of the study was to evaluate the implementation of the CA in these projects and to develop recommendations for the use of the concept in future PA promotion projects.

Methods: Based on an overarching analytical framework, we investigated the utilization of the CA in the individual projects using document analysis, workshops, and group interviews with project teams. Results were used to develop a set of draft principles and recommendations for effectively employing the CA in future projects and as a bridging framework for larger consortia. A participatory process combining elements of action research and Delphi surveys is currently conducted with all members of the Capital4Health consortium to arrive at final set of agreed-upon principles.

Results: Preliminary results show that the use of the CA varied substantially between projects and settings, but that a number of common conclusions can be drawn. A future framework for using capabilities for PA promotion may focus on three areas: (a) Project conceptualization should address both the target group and relevant multipliers. It should also consider both individual PA competences and structural factors. (b) Evaluation should cover both capabilities for PA as well as actual changes in PA levels to assess health impact on multiple levels. (c) The CA may be very useful to research consortia for developing shared goals and evaluation frameworks. This, however, requires a shared knowledge base and agreement about central theoretical concepts. 

Conclusions: The CA constitutes a potentially useful theoretical basis for both individual PA promotion projects and multi-setting research consortia. However, the application of the concept is complex and may vary significantly between settings. The proposed guiding principles may therefore provide a useful aid to future projects wishing to apply this innovative approach.

Background: Workplace physical activity interventions have shown positive outcomes for employee health, productivity and absenteeism (1,2). However, the majority prescribe the duration and/or type of activity to be undertaken. In response to strong public opinion that employers should do more to improve the health of their workforce, Public Health Wales, the public health agency for Wales, developed a 12-month pilot physical activity initiative - Time to Move (TTM). TTM allowed participants to use one hour/week (pro rata) of paid work time for any physical activity. We evaluated TTM to understand its impact and identify learning. 

Methods: Using pre-experimental time series design, data were collected from participating employees: baseline (June-August 2018), mid-initiative (December 2018) and at 12-months (June–August 2019). Using validated scales where possible, questionnaires recorded: physical activity (MET-minutes/week), general health (0, poor–100, good), mental well-being (SWEMWBS), job satisfaction (1, very dissatisfied–5, very satisfied) and demographics. Biometric measures (baseline, 12-months) included Body Mass Index (BMI) and blood pressure. Analyses used descriptive statistics, bivariate analysis and generalized linear modelling. Focus groups explored participants’ perceptions of TTM, analysed thematically. 

Results: 542 participants completed all measures (63.1% of baseline). Compared to baseline, at 12-months 57.7% reported increased physical activity (30.6% decreased; 11.6% no change) with 75.3% meeting UK activity guidelines (58.8% baseline). Those with the lowest levels of physical activity at baseline (n=223) increased their weekly moderate activity by >2.5 hours, whilst those with moderate activity (n=269) increased by 58 minutes/week. A small improvement was reported in mental well-being (mean scores; 22.4 baseline, 23.2 12-months), with participants with low mental well-being at baseline improving the most. Self-reported health and job satisfaction also improved. However, BMI and blood pressure changes were non-meaningful. Employee attitudes to TTM were positive. Organisational support was a motivating factor for participation, with competing demands a barrier. 

Conclusions: The provision of paid time to engage in physical activity can improve employee health and well-being. TTM provides an example of how organisations can promote physical activity and change workplace culture. However, further research should explore the long-term impact of the intervention, including the potential impact of COVID-19-related restrictions.

Background: According to the socio-ecological model, policy is one of the levers to initiate structural and environmental changes to foster health-enhancing physical activity (HEPA) promotion (Golden et al., 2015). However, little is known about local evidence to support governments in their policies to promote HEPA (Bull, 2018). Research on HEPA policies at local level seems particularly remains scant (Noël Racine et al., 2020). This study aims to carry out the collection of comprehensive information on municipal HEPA policies of the French Riviera to provide an overview of the development of these policies on this territory. Methods: Mid-size cities from 2 counties of the French South Region were targeted (n = 17). In each city, a local HEPA policy analysis tool, CAPLA-Santé, was administered to key informants heading the departments of sport, health and social. CAPLA-Santé is a local policy analysis tool adapted from the national HEPA policy analysis tool (HEPA PAT version 2) developed by the World Health Organization. Data were collected through semi-structured interviews and documents analysis. These empirical data were used to make an inductive analysis. Results: A total of 10 mid-size cities were volunteered to participate. Key informants from sport (n = 10), health (n = 5) and social (n = 6) departments were interviewed. Several written HEPA policies were formalized in 6 cities, 4 of them based their policies on scientific evidences or a national policy. These policies (n = 14), were mainly from the sport (n = 8) and the health sectors (n = 4). Some cities had a department head to ensure cross-sectoral collaboration (n = 3). Key informants reported that the support of national policies, the commitment of elected officials and an important local stakeholders’ network could facilitate the HEPA promotion; whereas lack of intersectoral collaboration and resources could be a limitation. Conclusions: The results help to better understand the local HEPA policies, highlighting some barriers, facilitators and perspectives. Using a local HEPA policy analysis tool can provide evidence to support policymakers. These findings could be valuable to scale up the HEPA promotion at the local level.

Background: Workplace based physical activity programs show great potential to improve health and wellbeing to a large part of the population. However, these programs appear to recruit mostly participants who already have an active lifestyle. This study aims to identify barriers and facilitators of inactive desktop workers, and can serve to inform policy makers or physical activity program designers to adapt current program in order to reach more inactive participants.

 

Methods: Desktop workers were voluntarily recruited by use of social media and by direct communication to companies. Inactive participants were included by means of the International Physical Activity Questionnaire (IPAQ). Semi-structured interviews were conducted with 22 desktop workers, being employed in 15 different Belgian companies and being mostly female (n=18). Interviews were transcribed verbatim and analysed using thematic analysis.

 

Results:

Results indicate that interpersonal relationships can be both a potential facilitator (e.g. having a colleague who asks you to join the exercise program) as a barrier (e.g. being scared of negative reactions from colleagues). Furthermore, organisational factors such as a high workload or a perceived lack of time is claimed as an important mediating factor for participation. On the other hand, having permission to exercise during working hours or having a fixed time to exercise said to be an important facilitator. Also environmental factors are important, since not having an on-site  physical activity facility or program is seen as an important barrier. Lastly, also communication from the management being supportive and emphasizing the importance of participating is found to be an important motivator.   

Conclusions: This study shows several specific barriers and facilitators of inactive desktop workers to participate within workplace based physical activity programs. These results can support developers of physical activity programs to create more targeted interventions in order to reach more inactive employees.

Background: It has been suggested that risk behaviours including diet, physical activity (PA), sedentary behaviour (SB), smoking and alcohol consumption cluster among adolescents. Our objective was to investigate clustering of risk behaviours in overweight and obese adolescents from the French PRALIMAP-InèS trial and to identify their socioeconomic correlates.

Methods: Information on diet (fruit, vegetables, sugary products and beverages), PA, SB (week and week-end days), smoking and alcohol consumption (current frequency and intoxication episodes) and socio-demographical data were collected using self-reported questionnaires at the trial inclusion. Behavioural risk factors were entered as categorical variables in a two-step clustering procedure: multiple correspondence analyses followed by a two-way clustering procedure based on hierarchical methods. Associations between cluster membership and socio-economic variables were investigated using multivariable multinomial logistic regression.

Results: A total of 1391 participants were included in analyses and four clusters were identified: (1) “Moderate to high PA, low soft drinkers, low alcohol consumers low SB, non-smokers” (n=543; 39.0%)”, (2) “High SB and low fruits and vegetables consumers” (n=376; 26.8%), (3) “Smokers and alcohol consumers” (n=247; 17.7%) and (4) “High fruits and vegetable consumers, soft drinkers and low PA” (n=229; 16.5%).  Compared to the healthiest cluster (cluster 1), adolescents from cluster 2&3 (unhealthy clusters) were more likely boys, older, attending vocational high school and not living with their two parents. Adolescents from cluster 4 were more socially advantaged (according to the WHO family affluence scale) than those of cluster 1.

Conclusions: Risk behaviour patterns in adolescents were shown to be clustered in both healthier and less healthy ways, with a complex interplay with socio-economic factors. Adapted to cluster Public health interventions may bring some benefits.

Issue. In the province of Gipuzkoa, 34.1% of women and 32.1% of men do not reach the minimum levels of healthy physical activity. On the other hand, there is an important influence of social determinants, the gap on physical activity between the richest 10% and the poorest 10% is 28 points.

Description. Mugiment Gipuzkoa is a multicomponent and multilevel initiative whose objective is the promotion of physical activity in the population. One of the main strategies is the development of a network of physical activity  counseling services (PACS). In this network the autonomous, provincial and local government of different sectors such as health, sports, social services and education are called to act in coordination. The objective of the PACS network, is to cause the change of behavior in the inactive population, but also to reorient the policies of local entities regarding physical activity. The PACS connect sports services to the local services of different sectors, articulating referral protocols.

Results. At the beginning of 2020 Gipuzkoa has 23 PACS in 16 municipalities. In 2018, 16 PACS corresponding to 12 municipalities have been evaluated. 778 people have attended to the services, the user profile is of an adult or aged woman, inactive, who came from the health center or autonomously. Most of them (73%), opted for autonomous physical activity. Pre-post methodology has been inplemented using a sample of 365 participants. Analized  the clinical health history, we observe  a positive trend on BMI, physical activity and less use of health resources at six months.

Lessons. Coordinated action between different levels of the administration and different sectors is key to the accompaniment of local entities when developing policies aimed at the inactive population. In the case of social and educational services, the experience of collaboration is limited, so it is necessary to deepen these sectors.

Main message. The establishment of a network of services for orientation to physical activity can serve to foster the development of effective local policies that focus on  inactive people.

Background: 

Physical inactivity and its consequences is a growing problem. Health enhancing physical activity (HEPA) behavior has previously been linked to the characteristics of the physical surroundings. Active Living (AL) is, in that connection, an international concept developed to integrate HEPA into everyday life.

The city of Odense located on Funen in Denmark has undergone major urban developments throughout the past 10 years – and will continue to do so prospectively. This has resulted in a possibility to create an AL area to be used by various target groups (employees and students at the university, patients and relative at the hospital, athletes participating in sporting activities in different associations etc.). Therefore, the University of Southern Denmark (SDU) is involved in a project aiming at creating a 80-hectare AL area with various activity possibilities for the everyday users.

Methods: 

Citizen Science (CS) has been the bearing principle from the beginning of the project. Rather than developing such an area “behind the desk”, the guiding question throughout the process has been: According to the citizens, what should such area contain of? This has been initiated through expert workshops, student modules in relation to the Sports and Health education at SDU, arranging events together with local media, organizing the Danish Championship in cycle cross, organizing a school festival etc. 

Results:

Using the CS approach, the project has received more than 1.000 inputs and ideas from citizens, associations, students etc. The proposals have formed the basis for the results in a combined PhD project, focusing on AL and principles of landscape architecture. Drawings from this PhD will be presented and principles of Citizen Science will be discussed at the conference.

The next project step is to raise external funding to realize the potential of the area.

Conclusion: 

At this time, the project is still at its initial stage trying to raise funding to initiate and carry out the collected ideas. However, this project is a great example on how a CS approach in developing an urban area by integrating various sectors, hopefully, can improve the final product in terms of usability and sustainability.

In 2008 Community sport coaches (CSC) were introduced in the Netherlands as a policy instrument to motivate inhabitants to become physically active, by connecting the sport sector with other sectors (e.g. health, education). Almost 6000 CSC are currently active throughout 98% of Dutch municipalities. We used Jolley’s model to examine the use of CSC as a complex local sport policy instrument for health enhancement (Jolley, 2014; Van Lindert et al., 2017). The question we aimed to answer was: To which extent is the CSC program used for health enhancement? We will share the impact of this policy program in the Netherlands and discuss the relevance and implications for other countries.

In 2019, we conducted an online questionnaire to examine the health incentives and outcomes (e.g. sectors, target groups, goals) of local CSC programmes among all municipalities implementing CSC (n=347). We also surveyed our CSC (n=100) and CSC employers (n=27) panels about their work on health enhancement.

Findings show that health enhancement is not often an explicit goal of CSC programmes. No national goals of the program address health explicitly and only 27% of municipal goals for CSC are focused on health. Nevertheless, the governmental health department and/or local health parties are often (82%) involved in CSC policy decision making (e.g. by paying part of the finances and/or by employing CSC). This results in a contribution to health enhancement of almost all (98%) local CSC programmes. Findings show that CSC connect the sport sector with the health sector in 96% of the municipalities, coaches/employers have often collaborated with health organisations last year (respectively 81% and 100%) and/or CSC work with inactive and/or overweighed inhabitants (69%)).

CSC are responsible for motivating people to become physically active, and logically this has an impact on health. Despite the lack of explicit goals, local CSC programmes are intertwined with health incentives and outcomes. But often the exact effects on health are unknown. More explicit and specific health goals may increase the impact of sport policy on health enhancement. Facilitators and barriers relevant to further national and international implementation of CSC programmes will be discussed.

Community-based health enhancing physical activity (PA) initiatives often lead to important mental health and wellbeing outcomes beyond improvements in physical activity levels. However, identifying what outcomes to measure and how to measure them is a challenge in community-based work. There is a lack of practical guidance on how to strengthen mental health and wellbeing outcomes within the context of PA initiatives. This symposium will share the work on a project with community based practitioners and mental health/physical activity experts which is being led by the HEPA Europe Working Group on HEPA promotion in socially disadvantaged groups, supported by WHO Europe. The symposium will engage participants in discussions around the following questions: 1. What are the most important mental health and wellbeing outcomes of community-based health enhancing physical activity initiatives in Europe, and how can these best (i.e., adequately, and pragmatically) be assessed for evaluation purposes? 2. What are the needs of practitioners (from physical activity sectors and mental health sectors) working in communities to promote mental health through physical activity?

Organisers: Prof Niamh Murphy (Ireland) and Ass Prof Annemarie Wagemakers (The Netherlands) Discussant:Prof Mark Tully, Professor of Public Health, School of Medicine, Ulster University, Northern Ireland. Chair contact details: Prof Niamh Murphy nmurphy@wit.ie

Issue/problem: Implementation of national systems for patients’ physical activity (PA) assessment and counselling is a cost-effective strategy recommended in the WHO Global Action Plan for PA 2018-2030. Although Primary Health Care (PHC) professionals are recognized as key agents for PA promotion, challenges remain on how to develop feasible and scalable tools to support them in promoting patients’ PA. The Portuguese model could help other countries improve PA assessment and brief counselling in PHC settings. This study aims to describe the tools’ development and usage. Description of the problem: The Portuguese Directorate-General of Health developed two evidence-based digital tools to support PA promotion by healthcare professionals: a) PA brief assessment tool; and b) brief counselling tool. The assessment tool was incorporated within the electronic medical health record software “SClínico” in September 2017. It includes three questions: 1) how many days per week the patient performs any kind of PA (work, commuting or leisure-time); 2) how much time per day; and 3) how many hours per day the patient spends in sedentary behaviours. The PA brief counselling tool is available through the electronic medical prescription software “PEM” since December 2017 and consists of five inter-related self-explanatory guides that can be delivered to patients (printed or by email), according to their motivation and PA levels. They facilitate person-centered and autonomy-supportive PA counselling, targeting specific behaviour change mediators, and using validated techniques. Results: From September 2017 to December 2021, 159,179 patients had their PA assessed (2235 per 100,000 users of the National Health Service) and, from these, 16133 received PA brief counselling guides (177 per 100000 residents in Portugal, ≥15years old), with a six-fold and three-fold increases, respectively, between 2018 and 2019 (previous to the COVID-19 pandemic). Future actions will address cost-effectiveness of this policy. Lessons: The brief assessment and brief counselling tools were well-accepted and are increasingly being used, with potential for generalized adoption within the Portuguese Health Care System. Main messages: Portugal has taken a decisive action to promote PA using PHC as a priority setting. PA tools usage is increasing considerably, highlighting the importance of making available easy-to-use PA promotion tools.

Backgrounds: In the 6-10 year period, physical activity (PA) and motor skills have a positive impact on cognitive development, which in turn act on academic performance. In order to better understand these links, a study was conducted to explore these relationships for disadvantaged children between the ages of 6 and 10. Methods: Children from two primary schools located in a disadvantaged neighbourhood (Tarbes, France) participated in the study. Variables were measured at 5 measurement times over 3 academic school years (2016; 2017; 2018). PA was measured by accelerometry over the whole day and weekend (MVPAF, MVPAWF). Motor skills were also assessed with a shuttle run test (NAV), a standing broad jump test (SBJ) and a tapping test (TT). A cardiorespiratory Shuttle Run test 20m (AR) was also carried out. Attentional capacities were measured with a computer-based Flanker Task: the Total Reaction Rime (RTT) of the correct answers (ms) for each child was collected. Finally, the children's score academic performance in French Language and Mathematics were collected. To study the relationships between the different variables, conditional inference trees including all these variables were performed with R software. Two trees were generated having as target variables respectively French language (FR) and Mathematics (MAT). Results: French language (FR) was predicted first by the age of the children (p<0.001), but as well for the youngest and the oldest chidldren, FR was predicted by performance on the TT (p<0.001) and RTT (p<0.001): the children who perform better on the TT test and have a lower RTT are those who obtain the best results in French language. Mathematics (MAT) was explained by these same variables as for FR (p<0.001). The evaluation of these two conditional inference tree by the Pseudo R-square were respectively 0.13 and 0.11. Discussion: These two conditional inference trees revealed that French language and Mathematics were predicted by attentional capacities (RTT), by motor variables (TT, NAV and SBJ). Finally, these models obtained were non-linear, complex and highlight different profiles of children. Although these relationships are documented in the literature (Diamond, 2002), this study confirms this from a longitudinal perspective, which is rarely used.

Background. The drive for muscularity behaviors are very common in male athletes, especially in male bodybuilders. Studies have shown that drive for muscularity is a risk factor for eating disorders and muscle dysmorphia. Although several psychological variables have been related to drive for muscularity (e.g. body dissatisfaction), little is known about the motivational mechanisms underlying drive for muscularity.This study applied the trans-contextual model of motivation to the drive for muscularity behaviors of male bodybuilders at risk of developing muscle dysmorphia. The relationships between self-determination theory constructs and drive for muscularity behaviors, via the theory of planned behavior variables were examined.

Methods. A total of 175 Swiss male bodybuilders (M_age = 27.34; SDage = 7.53) completed measures on motivation for sport, theory of planned behavior variables, and drive for muscularity behaviors. They practiced bodybuilding from three to 24 hours per week and had done so for 7.19 years on average. A series of path analyses was performed to determine the final model.

Results. The fit indices of the final model were satisfactory: χ2 (11) = 13.81; p = .244; TLI = .98; CFI = .99; RMSEA = .04. The model explained 29% of the variance of drive for muscularity behaviors. The final path analysis supported the motivational sequence, with autonomous motivation for sport showing a positive, significant and indirect association with the drive for muscularity behaviors via perceived behavioral control and intention to gain muscle mass, and controlled motivation for sport showing a positive association with the drive for muscularity behaviors both directly and via attitude and intention to gain muscle mass.

Conclusions. It was concluded that the trans-contextual model of motivation applies only partially to the drive for muscularity behaviors in male bodybuilders. Preventive actions may be important for male bodybuilders, who focus on gaining muscle mass. Specifically, such actions should be directed toward helping them to avoid developing controlled motivation because, although motivation for sport of any kind can be a direct or indirect risk factor for the development of deviant behavior, controlled motivation seems be put them at greater risk.

Interventions promoting physical activity and improved wellbeing delivered through professional football clubs have previously produced favourable changes in health in adult males (Hunt et al., 2014). Walking football has proven a popular variant suitable for older adults and studies have reported positive changes in health outcomes (Arnold et al., (2015); Reddy et al., (2017); McEwan, et al., (2019)). However, studies exploring outcomes following walking football interventions when compared to a control group in an older adult population are scarce. Therefore, the aim of the current study was to explore the effects of a 12-week walking football intervention on cardiovascular disease risk factors and quality of life in an older adult population.

Following ethical approval, participants (n = 23, one female; 68 ± 8 years old), were recruited through the Drink Wise, Age Well scheme; a local Lottery funded organisation and were invited to take part in a 12-week walking football intervention or control group. Intervention group participants (n= 17), were invited to one 60-minute walking football session per week consisting of a warm-up and small-scale competitive games, whereas control group participants (n= 6), continued with their normal habitual lifestyle. Outcomes measured were weight, resting blood pressure, non-fasting blood lipids, six-minute walk distance, and quality of life. Outcomes were assessed at baseline (week-0), midpoint (week-7) and post-intervention (week-13). Sessional RPE was recorded after each session. Preliminary data were analysed using a repeated-measures ANOVA.

Adherence to the 12-week intervention was 83%. Mean (± SD) attendance for sessions was 68 ± 26% (range; 0-92%). Mean rating of perceived exertion was 6.3 ± 1 (range; 2-8). Analysis revealed a significant reduction in total cholesterol (p=0.01) and LDL cholesterol (p=0.19) in the intervention group. However, despite favourable changes in both groups for each variable, no significant difference between groups occurred between baseline, week-7 and post-intervention.

The study outlines the potential for individuals enrolled in a walking football scheme to engage in weekly moderate-to-vigorous PA as well as maintaining and improving a myriad of health outcomes. Engagement in other pre-existing health promotion schemes, such as walking football at other local organisations may have influenced outcome measures.

Background 

If children are encouraged early in childhood to engage in a physically active lifestyle and if they are used to practice physical activity (PA) as children, they are likely to be more active as they grow up (Telama et al., 2014). Nevertheless, in Belgium, only 2% of children 6 to 9 years of age are able to reach PA international recommendations (Wijtzes et al., 2016). Fortunately, holistic school-focused initiatives can raise children’s level of physical activity (Heath et al., 2012). Accordingly, the aim of the study was to scrutinise the influence of an innovative pedagogical approach on self-reported PA and lifestyle habits among elementary school children.  

 

Methods

176 pupils (11-13)  and 5 physical education (PE) teachers were recruited in the area of Liege. Those pupils took part in a 10 weeks intervention including one weekly session of PE. PE lessons are original since they combine High Intensity Interval Training (HIIT), dramatization and health education. Assessments were performed before (T0), during (process analysis) and after the intervention (T1). Childrens’ levels of PA were assessed with the PAQ-C, as their food habits were assessed with the Adolescent food habits Checklist. Children were also invited, before each session, to notify and share their good practices related to the health education activities proposed during the lesson. 

 

Results

Results exposed significant improvements in self-reported PA (3,09 to 3,26 scores; p<0,000). As we sort out results by gender, we noticed higher improvements among girls. In contrast, we observed a slight and non-significant decrease in children’s food habits (13,88 to 13,55 scores; p=0,24). On over 400 good practices collected, half were related to physical activity and hydration. By involving physical and psychosocial objectives, the study is expected to provide a deeper understanding of the impact of this teaching method on children.

 

Conclusion

As Oblomov pedagogy seems to have the potential to generate health basic knowledge as well as pleasure of being physically active, it could be extended to other various settings such as obesity prevention. This method will also be shared with PE teachers in Belgium, as part of the PE curriculum reform in Belgium. 

Issue and problem: In Brazil, 47% of people are insufficiently physically active (Guthold et al, 2018). According to the Global Physical Activity Observatory, 13.2% of deaths in Brazil are caused by inactivity. Besides, Ding et al (2016) estimated the direct health cost attributable to physical inactivity in this country at 1.6 billion US dollars. Rio de Janeiro (RJ) is one of the largest cities in Brazil, with a high mortality rate (54.1%) from non-communicable diseases (NCDs) and substantial health inequalities (SIM/MRJ, 2019). As a large city, it reproduces a worldwide trend, which associates economic growth and urbanization with an unhealthy lifestyle and epidemic levels of obesity and remarkable physical inactivity (WHO, 2014).

Problem description: The multifactorial context above described enables NCDs and challenges health protection systems. For this reason, the Municipal Health Department of RJ implemented since 2009 a Health-Enhancing Physical Activity (HEPA) policy: ‘Programa Academia Carioca’ (PAC). This policy supports regular physical activity free of charge, in Primary Care Health Units (UAP). The Program combines the practice of physical activity associated with various educational and community activities. It includes Physical Education professionals who work in a multidisciplinary way. Therefore, this study aims to evaluate the implementation of this policy.

Results (effects/changes): After 11 years, the PAC has 142,969 participants, 80% of whom have NCDs. Among its participants, blood pressure control was demonstrated in 90% of hypertensive patients; weight loss, and a 60% reduction in cardiovascular risk classification, and suspension of medication in 20% of users. Being part of the PAC resulted in greater use and understanding of the general services of UAP in 86% and 98% of participants, respectively. Detailed results are not available at that time but will be presented at the conference.

Lessons: The PAC showed to be a successful tool to enhance health through physical activity at UAP. The use of trained and specialized professionals plays a fundamental key to develop educational and community actions in vulnerable groups. 

Main messages: The implementation of an ambitious and integrated HEPA policy, considering environmental and health factors, can produce more effective institutional responses to change this epidemiological scenario.

Background:

Portugal has one of the highest rates of physical inactivity in Europe. To raise the profile of physical activity (PA) among adults, the Portuguese National Physical Activity Promotion Program of the Directorate-General of Health developed and implemented a national mass media campaign in 2019 named “Follow the Whistle”. The campaign was based on social marketing principles and behavior change theory, namely the COM-B model, and was developed through formative research. We aim to describe the implementation process and short-term impact evaluation data.

 

Methods:

“Follow the Whistle” was launched in June 2019 and continued for 4 weeks (TV, Radio, Online and Cinema, newspapers, outdoors). Pre (n=878, 57%women) and post (n=1319, 58%women) independent adult population samples were used to assess campaign impact. Participants were recruited through the mailing list of a Portuguese mutual insurance company, a network from across Portugal. The online questionnaire comprised socio-demographic factors, campaign awareness and recall, and psychosocial and behavioral measures linked to the four targets of the COM-B model, including items to assess perceived capability for physical activity(C), perceived opportunity for practice/ ease of integration of PA in daily living(O), motivation for PA practice(M) and behavior(B) assessed with IPAQ and the Activity Choice Index.

 

Results:

Pre-and post-campaign samples were broadly demographically similar. Campaign recall increased significantly from 1% to 24% in prompted tagline recall (1/3 at post-campaign correctly recalled specific campaign images). All the targeted COM-B indicators changed in the expected direction, suggesting increases in perceived capability to engage in PA, perceived daily opportunities for being physically active, and in motivation (considering PA as fun, important, and compatible with other important things in life) (all ps<0.05). Results from PA behavior measures revealed increases only for vigorous activities  (p<0.001).

 

 

Conclusions:

The GAPPA recommends the creation of active societies starting with best-practice community-wide communications campaigns. Although one focus of the “Follow-the whistle”  (i.e. promotion of active transport and incidental everyday forms of physical activity) was not entirely achieved (i.e. changes only in vigorous activities), the initial campaign objectives of increases in awareness, and influencing intermediate outcomes were achieved. Further campaign waves are planned for future years.

Background

Self-management can improve health status and reduce hospitals admissions in patients with chronic obstructive pulmonary disease (COPD). The aim of this mixed-methods study was to evaluate the implementation of the “Living well with COPD” self-management program, a nation-wide effort by the Swiss Lung Associations and the Swiss society of pulmonary medicine.

Methods

For the implementation evaluation we used qualitative (interviews, focus groups) and quantitative (questionnaires, documentation analysis) methods to assess indicators of the outcomes reach, dose, fidelity, acceptability and appropriateness of the program. To evaluate the effectiveness, we assessed exercise capacity (1-minute sit-to-stand test), disease specific quality of life (Chronic Respiratory Questionnaire CRQ), symptoms, health care utilisation and health behaviour including physical activity at baseline and at the end of the program (after 12 months).

Results

Seven Cantonal Lung Associations implemented the program into their services according to plan, conducted it 13 times during 1 year and included in total 122 COPD patients (mean age 69 years, 48% female). The patients’ attendance rate and the coaches’ fidelity to the protocol were high (81% and 94%, respectively). Overall, acceptance and satisfaction of all involved persons (patients, coaches, responsible persons from the Lung Associations) was very high; they particularly acknowledged the meaningfulness of the program. Challenges were sustainable funding, integration of the coaches’ additional workload and uncertainties regarding roles and responsibilities. After 14 month, the patients did not just avoid a decline in exercise capacity and health status but significantly improved in the 1-minute sit-to-stand test (23.9 vs. 27.1 repetitions) and in 3 of 4 CRQ subscales (with 0.2-0.5 units).

Conclusions

The “Living well with COPD” program was successfully implemented despite a tight schedule and showed a remarkably positive impact of the COPD patients’ health status. The insights of this study will support the broader multiplication of the program throughout Switzerland and also serves the international community since it is one of the first nation-wide implementations beyond study settings.

Publicly accessible green open spaces such as parks, playgrounds and urban forests are key environments within urban tissue for promotion of health-enhancing physical activities (HEPA). The association between green open space and physical activity has been a subject of numerous studies, most of them focusing on factors affecting the use of green space for HEPA. However, there are inconsistencies among studies about associations between spatial characteristics of a public open space (e.g. size, distance, safety, quality) and HEPA. This presents a struggle for urban designers and policy makers to develop and implement evidence-based guidelines for designing green open spaces to promote HEPA. Slovenian planning and management plans are no exception to this. In order to effectively overcome this shortfall, we developed an approach and methodology combining current knowledge, planning evaluation and an empirical study.

Accordingly, we conducted a comprehensive analysis of current national legislation and documents related to public health, physical activity promotion and spatial planning. We also carried out workshops, focus groups, and discussions with relevant public health experts, decision makers and planners. To assess the practical relevance of the factors identified by experts and research literature, we tested the proposed approach and guidelines on a pilot study in the municipality of Kočevje, which is the largest Slovenian municipality, characterized by one town (Kočevje) and a number of small villages. Pilot study encompassed analysis of the municipality documents and spatial plans, spatial analyses, a survey among 176 residents of the municipality, and interviews with relevant representatives of local authority.

The analysis of the planning plans showed that there is not one single official document which would stress the importance of green open space for HEPA, either on strategic or implemental level. Furthermore, the pilot study proved great differences between the town and surrounding villages, the town being insufficient in supply of green spaces suitable for walking or cycling, whilst villages were lacking open spaces as a setting where people could engage in physical activity.

Based on the results, we underline the importance of the topic integration into planning documents and propose guidelines to achieve this.

Introduction

Children’s health related behaviors, such as physical activity develop are maintained in the family environment. A large amount of studies examined different family influences on children’s health behaviors. It has been shown that the Family Health Climate (FHC) (Niermann et al., 2015), and parents’ general beliefs and expectations regarding children’s PA are related to children’s behaviour (Fredricks & Eccles, 2004). However, there is a lack of studies that examined changes in these variables over  time and their relation to changes in children’s physical activity. The aim of this study was to investigate a) if FHC and outcome expectations change from first to fourth grade in primary school and b) how they are related to decrease or increase of children’s physical activity.

Methods

380 consulted parents of primary-school age children (46,6 % male) continuously answered questions about their PA-related outcome expectations, FHC (predictor) and daily PA (outcome) of their children over four school years, starting 2014 with first grade (t1), third grade (t2), fourth grade (t3) in Leipzig, Germany. Repeated measures ANOVA were used to analyse changes over time.

Results

Analysis showed no significant difference for FHC (F(1.96, 743.27) = 1.92, p =.15) an for parent’s PA-related outcome expectations (F(1.98, 749.58) = 0.097, p = .91). Children’s daily PA decrease significant over time (t1 to t3) (.04, 95%-CI[0.004, 0.343], p = .043).

Conclusion

The results indicate stability of the FHC and parents’ outcome expectations during primary school. In contrast, physical activity decreases over time, which is in line with previous studies. In further analyses we will examine how FHC and parents’ outcome parents outcome expectations are related to changes in physical activity. In addition, future analyses should be performed gender-specific.

References

Fredricks, J.A.; Eccles, J.S. Parental influences on youth involvement in sports. InDevelopmental Sport andExercise Psychology: A Lifespan Perspective; Weiss, M.R., Ed.; Fitness Information: Morgantown, WV, USA,2004; pp. 145–164.

Niermann, C., Kremers, S., Renner, B., Woll, A. (2015). Family Health Climate and Adolescents`Physical Activity and Healthy Eating: A Cross-Sectional Study with Mother-Father-Adolescent Triads. PLoS ONE 10 (11). 1-18.

Background:  Substantial evidence shows that meeting physical activity guidelines is important for disease prevention, promoting physical and mental health and quality of life. In Ireland, only 38% of older adults are sufficiently active to meet the guidelines. The primary aim of this research was to conduct a feasibility study of the Move for Life intervention to reach and help inactive adults 50+ increase their physical activity.

Methods: Move for Life is a feasibility cluster randomised control trial where the Local Sports Partnerships hubs are the units of randomisation and individuals within the hubs are the units of analysis. The intervention augments regular programme content with behavioural skills, social support and group cohesion strategies, and includes a peer-mentoring component. Over seven hundred (N=733) participants registered to become part of the intervention. Most (98%, n=724) completed baseline measures. Participants were asked to complete self-report process evaluation questionnaires immediately after and 12 weeks after their programme had finished. Interviews were conducted with participants, physical activity instructors and peer mentors. Questionnaire responses across groups were compared with tests of statistical significance. Qualitative data complemented and assisted with interpretation of quantitative findings.

Results: A total of 601 participants met eligibility criteria (average age 63.06 years, range 50-91, 80.4% female). The study retention rate was 63%. Reported compliance rate with intervention strategies was over 75%. The intervention group were more likely to enjoy the programme than usual provision. Intervention participants were more likely to report the programme as interesting and worth the time they invested in it, and to recommend it to a friend than usual provision. They were also more likely to report enjoying learning about different strategies to keep physically active (ORs ranging from 2.56 to 3.76). At 3-month follow up, the intervention group were more likely to be aware of their Local Sports Partnership opportunities and to have contacted their Local Sports Partnership more frequently in comparison to usual provision (all p<.05).

Conclusions: Move for Life is a realistic and promising augmentation to existing physical activity programmes for older adults with potential for adoption and scalability following completion of a full trial.

Problem

Prevalence of adult congenital heart disease (ACHD) is growing.  Exercise is safe and effective at enhancing exercise capacity and quality of life (QOL) for ACHD patients but they are predominately sedentary with reduced exercise capacity and obese compared to peers.  ACHD patients are concerned about their inactivity, however are uncertain of exercise suitability and safety and are unable to access specialist advice or cardiac rehabilitation (CR).   Many ACHD patients are managed in specialist centres covering vast areas meaning classes are inappropriate. 

Acquired heart disease CR is cost-effective, improving QOL, exercise capacity, mortality and morbidity. ACHD patients potentially gain the same benefits.  Remote cardiac rehabilitation (RCR) using technology could be a feasible model providing accessible specialist knowledge and individualised exercise prescription.

Description of the problem

Cardiologists referred sedentary, complex ACHD patients for a 12-week RCR providing individualised exercise prescription, education and motivation via telephone clinics and free apps (PT Momentum, Pacer and Active 10).  Initially, habitual exercise was encouraged, participants were coached to achieve the recommended UK PA guidelines. Self-efficacy for Exercise (SEE) and Satisfaction with Life Score (SWLS) were assessed comparing patients’ responses upon program completion to baseline.

 

1. To determine the feasibility and acceptability of RCR to ACHD patients and quanitfy the impact of RCR on patient's physical activity (PA) and QOL.

2. To discover if technology supported programme can increase the PA level of ACHD patients.

Results

From 23 referrals, 11 completed the program becoming more physically active, fulfilling the guidelines. Improvements were seen in both SEE (mean 30) and SWLS (mean 10). Patients deemed RCR an acceptable service delivery.

Participants (9) responded well to apps. Reasons for not using apps included data capacity (1) or no device (2).  

Lessons

ACHD patients engaged with RCR making it; viable, acceptable and practical solution improving PA levels and QOL.

RCR using app’s is a feasible model however, alternatives are required.

Main Messages

RCR enables ACHD patients to receive specialist knowledge, individualised, accessible and effective exercise prescription improving QOL and PA levels.

RCR potentially leads to substantial cost savings and improvements in morbidity and mortality of ACHD patients.

 

Background

Organisations operating at multiple levels of the physical activity and outdoor recreation ecosystem in Ireland collect data pertaining to recreational trail use, yet despite its potential utility, there is no centralised surveillance system for Irish walking trails. Due to the little effort to collate data, recreational walking trail usage in Ireland during the COVID-19 pandemic is unknown. The aims of this study are twofold. Firstly, this study aims to compare trends in footfall count data on Irish trails prior to, and during, the period following the outbreak of COVID-19. Secondly, this study aims to triangulate findings from footfall count data with openly available mobility data. 

 

Methods

This descriptive study analysed changes in footfall counts gathered from passive infrared sensors on 33 of Ireland’s walking trails between January 2019 and December 2020. The relationship between Google Community Mobility Report (GCMR) data and footfall counts was analysed to corroborate trends in footfall data.

 

Results

Overall, total footfall increased by 6% (p = 0.024) between 2019 and 2020 on trails included in this analysis. Notably, mean trail usage was between 26% and 47% higher (p = 0.002) in October–December 2020 than during the same period in 2019. On average, trails <2km from an urban area had higher footfall during all periods of movement restrictions. 

 

Conclusions

The conclusions of this study are twofold. Firstly, recreational walking trail use increased during the COVID-19 pandemic, especially on trails closer to urban areas. The increase reported here poses questions relating to the potential positive legacy which the pandemic period may have had on recreational trail use. Secondly, combining multiple data sources can provide trail managers with more detailed representations of trail usage. However, there are currently little efforts to harmonise data. Future research should examine the multi-level determinants of trail use to inform context specific trail promotion campaigns. Furthermore, investigating novel ways to coordinate heterogeneous datasets pertaining to recreational walking may prove fruitful for the fields of outdoor recreation and physical activity research.

The World Health Organization and the Norwegian Directorate of Health recommends that older adults over 65 years with poor mobility should perform physical activity to enhance balance and prevent falls on 3 or more days per week. Norway has one of the highest hip fracture incidence rates in the world. Falls and hip fractures among elderly is a public health problem.

For around 10 years we have the knowledge that systematic exercise and well-designed exercise programs can reduce the rate of falls among older people living at home. The aim with this work was to develop an e-learning program to increase the knowledge about strength and balance exercises among people working at fitness centers, senior centers and nursing homes. The developing process of the e-learning program was a collaboration between the Norwegian Directorate of Health, the Norwegian University of Science and Technology and experts on e-learning. Three resource groups were also involved. The e-learning was developed from January until November 2019.

The e-learning programs BASIS is for free and available at www.basis-fallforebygging.no. Over 1200 people completed the course within the first months after release. BASIS comes in three versions and contains six modules. After completing the course, you get access to a hundred warming up, strength, balance and cool down exercises. The exercises are graded based on the functional capacity of the elderly. You can design your own programs or choose between fixed programs. The e-learning was announced and updated in 2020. Experiences will be presented. 

BASIS can be an effective way to spread knowledge about exercise as well as fall prevention. The e-learning can be one important piece in the broader work to increase knowledge, change practice, prevent falls and increase the physical function in elderly people. While some organizations are changing practice fast, in many organizations changing practice seems to take longer time. The e-learning must be followed up with a change of culture, routines and practices at fitness centers, senior centers and nursing homes.

BASIS can increase knowledge about how to facilitate exercise to increase physical function in elderly at fitness centers, senior centers and nursing homes.

Background

The Global Matrix of report card grades on physical activity serves as a public health awareness tool by summarising the status of child and youth physical activity prevalence and action. Since schools and the wider community and environment are critical influences on the physical activity levels of children and youth, this research sought to examine the factors considered when assigning these grades across included European countries. Specifically, we sought to: (1) provide a detailed examination of the evidence informing these indicators across participating European Global Matrix 3.0 countries; (2) explore the comparability of the grades for these two indicators across Europe; (3) detail any limitations or issues with the methods used to assign grades; and (4) provide suggestions on how future grading of the indicators could be improved. 

Methods

Key documents relating to the European countries involved in the 2018 Global Matrix 3.0 were collated. This inlcuded the long and short forms of the report card for each country as well as the scientific paper.  A template was developed and used to capture information on: the grade assigned for each indicator; details of the data used to assign the grade, the source of the data; indication of the quality of the data and any reported challenges or issues in assigning the grade for both the ‘School’ and ‘Community and Environment’ indicators.

Results

Seventeen of the 20 European Report Card countries (85%) had a grade for schools, and 15 countries (75%) had a grade for community and environment. All countries considered between one and five factors when assigning the grade for these indicators. There were wide disparities in the number and sources of evidence used to assign the grades for both indicators, limiting the comparability of the evidence between different countries. 

Conclusions

To enable comparability, the authors recommend moving towards an agreed standardised set of metrics for grading each indicator. Furthermore, it would be useful to develop and share common tools, methods and instruments in order to collect data in a uniform way across countries. Such action will ultimately make the Global Matrix a more robust tool for future use.

Background

According to a socio-ecological perspective, the neighbourhood environment plays a critical role in promoting physical activity across all population groups. A comprehensive assessment of environmental characteristics is a prerequisite to the planning, implementation and evaluation of physical activity interventions. This work aims to identify existing audit tools for the assessment of physical activity related environmental features in order to evaluate a) their applicability in the European context and b) their relevance in the urban and rural context.

Methods

Within the research project EUBeKo[1] we searched relevant websites (e. g. Active Living Research) and scientific databases (e. g. PubMed) in order to identify existing audit instruments. We then developed a categorization system for the integration of the topics and items retrieved from the identified tools. To reveal context-relevant strengths and weaknesses, we critically inspected the instruments with the support of the current scientific evidence and literature regarding eligibility to the European context and rural/urban applicability.

Results

We identified 29 audit tools focusing on different topics and features influencing physical activity (e. g. infrastructure, barriers). Some also include aspects of the social environment (e. g. presence of people) or the subjective perception (e. g. walkability, aesthetics). We found that numerous tools contain aspects of the socio-ecological environment reflected on the item level that do not conform with European environmental characteristics (e. g. street signage, types of destinations). Furthermore, we identified an unequal distribution with few tools being developed explicitly for the rural context (n = 3).

Conclusions

It is challenging to rate the applicability and relevance of audit tools. We were able to develop a comprehensive categorization system that can assist researchers and practitioners in the selection of a suitable set of items for an optimized assessment of European physical activity environments. In addition, our work points out the need for an instrument reflecting urban and specifically rural peculiarities of the European context.

Background: Adequate nutrition and regular physical activity (PA) are key elements in healthy aging. In France, behavioural interventions promoting healthy eating and PA in older adults consist mainly in collective workshops organised by pension and health insurance funds. After analyzing pre-existing workshops, we designed the co-constructed project ALAPAGE to improve these workshops and assess their impact on diet and PA.

Methods: ALAPAGE is a cluster randomized controlled trial; 60 collective workshops in southeastern France will be randomized in a 2:1 (intervention/control) ratio. We will recruit 900 autonomous older adults (≥ 60 years) living at home and will make specific efforts to recruit socially isolated and/or economically vulnerable people. In the intervention group, collective workshop period will include 7 sessions (1 session/week): 1 introductory, 4 diet and 2 PA (to teach principles of functional dual-task exercise focused on strength, flexibility and physical functioning). During the following 3-months, participants will be recommended to perform exercises as often as possible and will participate in post-workshop activities. The control group will first participate to other types of workshops and then to a diet and PA workshop (waiting-list design).

Results: The dietary practices (using experimental economics), physical activity (battery of field test and habitual PA), quality of life, and cost-effectiveness will be assessed at the first and last session, and 3 months later.

Conclusion: Results will guide decision-makers to organize actions and their dissemination. Transferability to other regions will be facilitated by the fact that key stakeholders involved in ALAPAGE belong to structured national networks.

Background

According to the German prevention law (§ 20a SGB V) of 2016, statutory health insurances are legally bound to integrate sustainable setting-based health promotion in their activities. This includes the development of sustainable concepts for community-based physical activity promotion (cbPAP) with a focus on socially disadvantaged individuals (SDI) (e.g. individuals with low income, low social status) to improve health equity. The aim of the systematic review with a narrative synthesis is to identify context-specific factors for the sustainable implementation of cbPAP and further, to inform the project KOMBINE (German acronym for “Community-Based PA Promotion to Implement National Recommendations”) for a scientific and practice-based implementation of the National Recommendations for Physical Activity and Physical Activity Promotion in communities.

Methods

A systematic review with narrative synthesis was conducted. The search was carried out in the databases PubMed, Scopus, CINAHL, PsycINFO/SportDiscus, and WebofScience. Searches were limited to only include studies published up until 04/2020, in English and German. Altogether, qualitative, quantitative, "mixed-method" studies, reports and reviews were considered. Articles referring to factors of sustainable implementation of community-based physical activity promotion with a whole-system approach were included. Although this was not an inclusion criterion, articles addressing accessibility for SDI were specifically taken into account. The framework by Schell et al. (2013) was used for data extraction and analysis, while the four main elements from Popay et al. (2006) were applied in the narrative synthesis process. 

Results

29 studies (13 qualitative, 1 quantitative, 9 "mixed-method" studies, 3 reviews, 3 reports) were included in the review. 137 references to sustainability factors were identified. According to the framework by Schell et al. (2013), factors were most frequently reported in domains of organizational levels (21), partnerships (18) and financial stability (16). Additional factors in the domains of accessibilities for SDI (11), infrastructure (7), participation (9), and cultural context (10) were identified by the authors. The relationship between the factors and the context of the programs are considered as well. 

Conclusions

The identified factors for sustainability should be systematically addressed at an early stage in the conception of cbPAP measures for SDI to ensure sustainability after implementation.

With a rapidly ageing society, healthy ageing has become a key challenge for older adults. Engagement in physical activity, and particularly walking, is a key strategy that contributes to healthy ageing. The present study aimed to evaluate the efficacy of a group walking program for older adults that incorporates the 5R Shared Leadership Program (5R^S), compared to a regular group walking program. By implementing a structure of shared leadership and strengthening peer leaders’ identity leadership, 5R^S has in other contexts been associated with greater performance and well-being.

Our cluster randomised controlled trial included 19 older adult walking groups (i.e., the clusters; N = 503; M_age = 69.23 years, SD = 6.68), which all participated in a 12-week structured group walking program. Nine of these walking groups (n = 304) were randomly assigned to the intervention condition and received additionally the 5R^S program.

Results revealed that 5R^S was successful in strengthening the identity leadership qualities of the appointed peer leaders. Moreover, multilevel regressions showed that 5R^S succeeded in increasing group cohesion and walking activity to a greater extent than a regular group walking program, while participants’ group identification and well-being increased to a similar extent in both conditions. Furthermore, structural equation modelling revealed that group identification mediated the impact of peer leaders’ identity leadership on group cohesion and well-being (but not walking activity). We can conclude that by harnessing the capacity of the group and its peer leaders, 5R^S constitutes a promising intervention to engage older adults in physical activity.

Background: 
Health promotion projects commonly measure health outcomes and behavior to provide proof of effectiveness. An alternative concept that focuses on the real opportunities a person can choose from to influence their health is Amartya Sen’s capability approach. Numerous tools have been developed to measure capability change in general, but it remains unclear which ones can be applied specifically to physical activity (PA).We therefore conducted a systematic review to identify appropriate tools to measure capabilities for physical activity and health and provide information on their quality.

Methods: 
The review included a total of 6,850 articles published between 2000 and June 2019 that were identified via searches on PubMed, EbscoHost, and ProQuest. Screenings of titles/abstracts and full texts were conducted independently by two researchers using Endnote X9 and Microsoft Excel. Identified tools are currently being analyzed regarding their indicators, evaluation methods, quality, and the extent to which they address capabilities for physical activity. 

Results: 
The screening resulted in a total of 49 articles included in the analysis. Preliminary results show a diverse use of methods for measuring capabilities for healthy lifestyles. Preliminary results show that three categories of instruments can be identified: (a) Five studies employed secondary data analysis of specific datasets to extrapolate capabilities for healthy living; (b) five articles dealt with measuring capabilities using qualitative approaches (interviews, video recordings); (c) 39 articles reported on a total of 10 different questionnaires to measure capabilities. We identified only one instrument (employing both a questionnaire and qualitative measures) that explicitly measured capabilities for PA, albeit only for a specific target group. 

Conclusions: 
The identified articles show that capabilities for healthy lifestyles are mostly measured by questionnaire. Available tools are mostly target group- and setting-specific. Currently, there is a dearth of tools that explicitly cover capabilities for PA, especially across settings or target groups. Therefore, more research is needed to work towards the development of universally applicable tools to measure PA capability.

Background: If boys and girls are known to have different levels of quality of life (HRQoL), less is known about behavioural factors such as physical activity (PA), sedentary behaviour (SB) that can explain it. We aimed to analyse the mediation effect of PA and SB on the association of sex and HRQoL among adolescents.

Methods: 2448 adolescents (1378, 56.3% of Girls) from the PRALIMAP trial with 2-year follow-up were included. HRQoL (physical, mental, social and general dimension scores; range 0-100), PA (walking, moderate vigorous and total) and SB (sitting time) were assessed using the Duke Health profile and the IPAQ questionnaires, respectively. The 2-year mean PA and SB were calculated and categorized into high or low PA (≥ 1hour/day) or SB (2 hours/day out of school).  We conducted a mediation analysis to investigate the causal mechanism of gender (reference=Girls) on HRQoL through PA and SB by estimating total effect (TE), natural direct effect (NDE), natural indirect effects (NIE) as well as proportion mediated (PM: proportion of sex-HRQoL relationship mediated by PA or SB).

Results: The direct relationship of gender and HRQoL (NDE) was significant whatever the HRQoL dimension. When using vigorous PA as mediator, PM was estimated at 13.7% (TE:11.0 [9.5 to 12.5]; NIE:1.5[0.9 to 2.1]), 19.4% (TE: 12.3 [10.6 to 14.1]; NIE: 2.4 [1.6 to 3.1]), 70.0% (TE:4.6 [3.1 to 6.2] ; NIE: 3.3 [2.5 to 4.0])  and 25.6% (TE: 9.3 [8.1 to 10.5]; NIE:2.4 [1.8 to 2.9]) for physical, mental, social and general HRQoL, respectively. Similar but less important mediation effect was observed for moderate and walking PA. For Total PA, PM was estimated 7.0%, 8.7%, 47.4% and 14.7% for physical, mental, social and general HRQoL while  for SB, the mediation was inverse and less important (PM:  -1.5%, -1.4%, -2.0% and -1.5% for physical, mental, social and general HRQoL respectively).

Conclusion: HRQoL is significantly higher in boys compared to girls among adolescents and this difference is shown to be partially mediated by differences in PA practice, especially vigorous PA. Additionally to the impact of adolescent PA in preventing non-communicable diseases in adulthood, it can also enhance their well-being. 

Background: Citizens who contribute as volunteers and peer mentors within a community are important assets that can be mobilised to improve health and wellbeing. In order to optimise the contribution of peer-volunteers to active ageing initiatives, we need to understand their experiences and identify ways to support them in preparing for the role and overcoming potential challenges.

Aim: This study synthesises the perspectives of a range of stakeholders involved in peer volunteering active ageing initiatives implemented in UK and provides an in-depth account of how such initiatives can effectively mobilise individuals as community assets. It draws on the experience of all actors involved in such initiatives, ranging from volunteers, recipients of volunteering actions, volunteer managers and volunteering service providers.

Methods: This evidence synthesis used qualitative data from (a) three studies focusing on the development (phase 1), feasibility trial evaluation (phase 2) and community roll-out (phase 3) of ACE (Active, Connected, Engaged), a peer volunteering active ageing intervention, alongside (b) the experiences of third sector organisations in providing peer volunteering programmes. Ten managers, 22 volunteers and 20 ACE participants were interviewed. Interviews were audio-recorded, transcribed verbatim and analysed using framework analysis.

Results: Seven main themes including 33 higher and 22 lower order themes were identified: Motives; Benefits; Characteristics of peer volunteers; Challenges; Training needs; Recruitment; Successful strategies for maintenance.

Altruism, changes in life circumstances, opportunities to reconnect with the community and personal fulfilment were the main reasons for volunteering. Volunteering was described as being personally rewarding, an avenue to acquire new skills and knowledge, and increased social connections and physical activity. Effective volunteers are committed, reliable, have a good sense of humour, good interpersonal skills and are able to relate to the participants. When pairing volunteers with participants, clarity of role, level of time commitment, shared interests and geographical proximity are worth considering.

Conclusions: Successful implementation of peer-volunteering initiatives requires the use of appropriate recruitment routes, easy joining procedures, provision of ongoing support, good communication across all stakeholders, feedback and recognition of effort and a dedicated team to build resilience and provide volunteers with administrative support.

Background: While urban built environments might promote active ageing, an infrequently studied question is how the neighbourhood walkability modulates physical activity changes during a physical activity intervention program in older adults. We assessed the influence of objectively assessed neighbourhood walkability on the change in physical activity during the intervention program used in the ongoing PREvención con DIeta MEDiterránea (PREDIMED)-Plus trial. PREDIMED-Plus is a parallel-group, randomized trial which tested the effect of an intensive lifestyle intervention on cardiovascular disease prevention, in overweight and obese participants with the metabolic syndrome.

Method: The present study involved 228 PREDIMED-Plus senior participants aged between 55 to 75, recruited in Palma de Mallorca (Spain). Overweight/obese older adults with metabolic syndrome were randomized to an intensive weight-loss lifestyle intervention or a control group (106 intervention group and 122 control group). A home neighborhood environment walkability index (residential density, land use mix, intersections density) was calculated using geographic information systems (1km sausage-network buffer). Physical activity was assessed using accelerometer for seven days, and a REGICOR validated physical activity questionnaire, at baseline and 2 follow-up visits (six-months and one-year later). Generalized Additive Mixed Models (GAMMs) were fitted to estimate the association between the neighbourhood walkability index and changes in physical activity during follow-up.

 

Results: Higher neighbourhood walkability (1 z-score increment) was associated with moderate-to-vigorous accelerometer assessed physical activity duration, (ß = 3,44; 95% CI = 0.52;6.36 minutes per day). When analyses were stratified by intervention arm, the association was only observed in the intervention group (ß = 6.357; 95% CI = 2.07;10.64 minutes per day) (p for interaction = 0.055). There were no statistically significant associations between neighbourhood walkability and self-reported physical activity nor brisk walking duration.

 

Conclusions: The results indicate that the walkability of the neighbourhood could support a physical activity intervention, helping to maintain or increase older adults’ objectively measured physical activity. This research may modify evidence on whether environmental factors modify habits acquisition during physical activity intervention programs.

Background: Physical activity is associated with improved psychological well-being and lower levels of cardio metabolic risk factors, diabetes, obesity among children and adolescent.  The purpose of the study was 1- to examine gender, type of day, and age grade differences in objectively PA; 2- to examine the attainment of recommended physical activity guidelines; 3-to examine the association between PA levels and BMI z-score among children and adolescents in Morocco.

Method: 172 Moroccan children/adolescents (mean age = 10.92 ± 1.55 years, mean BMI z-score = -0.16 ± 1.33; 19.2 % overweight) were recruited for this study and wore a tri-axial accelerometer (GT3X+) for 7 consecutive days.   Two-way analysis of covariance was used to examine gender and age grade differences in physical activity level separately for weekdays and weekends, adjusted for body mass index for age (BMI z-score) and wear time.  Logistic regression analyses were conducted to examine independent relationships between attainments of physical activity guidelines and gender. Pearson correlation was used to assess the association between physical activity levels and BMI z-score.

Results: In both weekends and weekday, children spent more time in Light physical activity than adolescents (p < 0.001), boys were more engaged in moderate activity (p < 0.001) and vigorous (p < 0.001) activity and took more steps than girls. Boys were eight time more likely to meet the recommendation for at least 60 min of moderate to vigorous physical activity per day than girls (OR: 8.569; 95% [CI]: 4.23–17.32), p < 0.001. Among adolescent, moderate to vigorous PA were inversely correlated with BMI z-score (r= -0,213; p= 0.04).

Conclusion:  The findings can shed light on the need of urgent scaling up of implementation of known effective policies and programmes for adolescents and girls to increase their involvement in PA.

Acknowledgements: This study was performed with the support of the International Atomic Energy Agency (CRP E4.30.24; RAF 6042).

Background: Older age is often associated with functional, social, and mental health problems, leading to major financial burdens on the health care sector, as the number of older adults (65+ years) is expected to increase to 22% by the year 2050. Using neighbourhood open spaces (NOS) for physical activity and social interaction may be an easy way for older adults to uphold healthy and active ageing. However, little is known about older adults’ use of

NOS. The purpose of this study was to assess factors promoting or inhibiting older adults’ use of NOS in a deprived neighbourhood before and after an environmental intervention creating or improving facilities for older adults within NOS.

Methods: A convergent mixed methods approach was used to assess outcomes of a participatory research intervention. Observations using the System for Observing Play and Recreation in Communities were conducted to observe older adults living in a deprived neighbourhood, and their use of 13 NOS in spring 2017 (baseline) and spring 2018 (follow-up). Semi-structures interviews with ten older adults were held in spring 2018 to identify barriers and facilitators for using NOS.

Results: The intervention resulted in the construction of two pavilions and renovated benches, including raised flower beds and small bench-tables. An increase of 44% more older adults was observed at follow-up using the NOS with the renovated benches. No use of the two pavilions was observed. The interviews identified six important factors for older adults’ use of NOS: weather, support for social caretakers, support for resourceful volunteers, organized activities, social interaction, and sense of ownership.

Conclusions: Social interaction is a key factor for older adults’ use of NOS and should be prioritized by health promoters in combination with age-friendly facilities and organizational support. Daily social interaction may be easier to promote in close distance NOS, whereas NOS further away may rely on organizational support, such as social caretakers and volunteers.

Background: Family-based interventions may be a promising solution to increase children’s physical activity, but there is a lack of knowledge on how to facilitate such interventions, specifically in socioeconomically disadvantaged areas. The aim of this study was to explore participants’ and leader’s experiences of the content and delivery of the family-based programme A Healthy Generation.

Method: A Healthy Generation is a health-promoting programme, for families with children in grade 2 (8-9 years) including siblings. Intervention components are: activity sessions, , parental support groups, healthy meals and health information. The programme is delivered twice a week for one school year in collaboration with local municipalities, health coordinators and a variation of invited sport organisations in socioeconomically disadvantaged areas. Data was collected through participant observations during activity sessions, interviews with leaders (n=11), and four focus groups with parents (n=27) who had participated in the programme. Data was transcribed verbatim and analysed using content analysis.

Findings: Leaders’ and participants’ experienced the programme to have an appealing “Family-concept for joy, activity and integration”. The variation of activities provided opportunities and challenges to new interests, and the family approach were perceived as valuable for parental engagement and integration. To be “A suitable programme for all participants”, activities directed to whole families needed to be simple and fun to keep all participants engaged, but also provide a progression for learning. Free and locally situated activities, meals and equipment for whole families facilitated participation, whereas lack of time and socio-cultural differences were barriers. The programme delivery consisted of “A fruitful leadership collaboration” where health coordinators played an important role as coordinators of a heterogeneous group, so the invited leaders could focus on the content of their sport. They also provided participants with continuity and important reminders for participation during and in-between activity sessions.

Conclusions: Participants’ and leaders’ experiences of a family-based health promoting programme give insight to the importance of local involvement, collaborative leadership and a well-adjusted family programme for health promotion. The study also draws attention to opportunities and barriers for increased integration through health promotion aimed at families in socioeconomically disadvantaged areas.

Intro

Physical activity for adolescents with disabilities (AWD) are reported to have even greater health benefits than for adolescents without disabilities (AWoD). The settings for organised physical activity opportunities can include physical education, extra-curricular activities and community sport. Few studies have reported whether there are differences in participation in these settings between AWD and AWoD. The purpose of this study was to report differences in participation in organised physical activity between AWD and AWoD in Ireland.

Methods

Data, were disaggregated by disabilities, from the Irish children sport participation and physical activity 2018 study; a national representative self-report survey. Adolescents selected sports and physical activities they took part in the last 12 months in physical education, extra-curricular activities, and community sports. The child functioning module was completed with data coded according to the Washington group on disability statistics criteria. Data were stratified by gender and school level, with average scores of the number of activities analysed by T-Tests with Hedge’s g, and no participation by Chi-square test of independence.

Results

The weighted sample included 6646 adolescents (53% female, 68% secondary level), of which 16% reported disabilities. Specific difficulties were sensory (4%), physical (1%), cognitive (7%), and behavioural (9%). More AWD reported they did not do any organised physical activities in all three settings (physical education, p = 0.029, extra-curriculum, p = <.001, community sport p = <.001) than AWoD. Adolescents with behavioural disabilities reported fewer types of physical education activities (males primary, p = .014, g =.31; secondary, p = .008, g = .24) and community sports (male primary, p = <.001, g = .49; female secondary, p = .027, g = .14) than adolescents without behavioural disabilities.

Conclusions

Adolescents with behavioural difficulties were the largest disability group and reported fewer number of organised physical activities than AWoD, reinforcing action are needed to increase perceived choice of activities. An alarming number of AWD reported no organised physical activities in all three settings. More thorough studies are required to investigate these reasons, and to provide support across settings, whereby differences in participation between adolescents with and without disabilities are not so profound.

Background: Insufficient attention to the inherent complexity of health ecosystems, through policy intervention, has precluded the development of sustainable and equitable solutions for health enhancing physical activity. While complexity and systems-thinking is becoming increasingly prevalent in policy discourse, little research has examined the implications of these approaches for developing national-level physical activity policies. Our project was the first to engage physical activity policy-makers, from across different sectors, in a discussion about their understanding of complexity and its effects on their efforts to influence systemic change.

Methods: Ten national-level United Kingdom physical activity policy-makers were recruited through a purposive sampling strategy. Data was collected using semi-structured interviews. The data set was rigorously analysed using a thematic analysis.

Results: All participants were bound by a collective culture of passion (theme 1) and enterprise in developing policy solutions for physical inactivity. However, making sense of the issue’s complexity was not always easy. Our study revealed problems (theme 2) in that policy-makers were uncertain in their attempts to define complexity and its perceived implications for their work. Similarities drawn between physical inactivity and other public health issues resulted in policy-makers disassociating themselves from it, leaving them somewhat unable to identify their role and responsibility, and that of others, in addressing the problem. Pathways forward (theme 3) included leadership and other mechanisms to connect the system in effective advocacy, support and collaboration for physical activity promotion and policy implementation. Here connections were made to the ecological and technological developments that societies face.

Conclusions: Our project advances knowledge on complexity and physical activity policy with critical implications for policy-making and broader decision-making for promoting health enhancing physical activity. The findings suggest that, in order to achieve reasonable and sustainable goals, it is important to embrace interconnectedness and create a shared platform for policy-makers to convene and reconcile their views and roles. Particular attention to identifying and operationalising leadership, policy levers and implementation factors in local systems is warranted. Focus needs to be placed on mechanisms that contribute to system cohesion, support the diffusion of best practice and knowledge exchange, and facilitate multi-sectoral policy-making.

Background: Longitudinal studies demonstrate that physical activity (PA) declines on average from adolescence to early adulthood. However, some subgroups of adolescents increase activity while others decrease or maintain high or low activity. Determinants of change or maintenance of (in)activity may differ between subgroups and are valuable information for targeted health promotion. The purpose of this study was to identify PA patterns from adolescence to early adulthood, and also to explore how different activity domains and sedentary behaviour (SB) are associated with PA patterns.

Methods: The data of this observational cohort study (collected in 2013/2014 and 2017/2018) consisted of 254 Finns at age 15 and 19 participating the Health Promoting Sports Club study. K-means cluster analysis for longitudinal data was performed to identify participant clusters (patterns) based on their accelerometry-measured moderate-to-vigorous PA (MVPA).  Associations of sports club participation (SC), active commuting (AC), and SB with PA patterns were examined by logistic regression analysis.

Results: (preliminary) Five MVPA patterns were identified: inactivity maintainers (n=71), activity maintainers (n=70), decreasers from moderate (to low) PA (n=61), decreasers from high (to moderate) PA (n=32), and increasers (n=20).

At age 15, SC participation (41–97%) and AC (47–75%) were common in all the patterns. By age 19, clear dropout from these activities was prevalent (SC participation mean 32%, AC 31–63%).

Maintained SC participation was associated with a higher likelihood of belonging to the decreasers from high PA (OR=11.2, CI=1.4-90.0) and to the combined group of increasers and activity maintainers (OR=3.6, CI=1.8-7.4); also with a lower likelihood of being an inactivity maintainer (OR=0.1, CI=0.02-0.2). Dropout from SC was related to a higher likelihood of being a decreaser from high PA (OR=10.9, CI=1.3-90.7). Maintenance/adoption of AC was associated with a lower likelihood of being an inactivity maintainer (OR=0.3, CI=0.1-0.7). Decreased SB was related to a higher likelihood of belonging to the activity maintainers and increasers (OR=0.96, CI=0.93–0.98).

Conclusions:

PA patterns diverge greatly over the transition to adulthood. Changes in SC participation, AC, and SB show different associations with diverging PA patterns. Hence, tailored PA promotion is recommended.

 

Background: Global research shows a strong link between physical activity and risk of developing non-communicable diseases. To increase physical activity levels, governments must design and implement a comprehensive set of policy actions across a range of areas. To aid governments in this process, the MOVING benchmarking tool was developed to assess the strength of policies across three domains that make up a comprehensive approach to physical activity policy. 

Methods: The MOVING benchmarking tool, which was developed using a consultative process that reviewed evidence on physical activity policy design and existing benchmarking tools, built on the policy areas of the MOVING framework. It values the strength of policy design, based on evidence-informed and aspirational attributes of effective policy-making that impacts health-related behaviours, with a focus on adolescents. The tool was applied to a set of physical activity policies from five countries: Netherlands, Norway, Poland, Portugal and UK. These countries were selected based on their participation in the EU-funded CO-CREATE project, which focuses on prevention of overweight and obesity among adolescents.  Relevant physical activity policies in each participating country were identified based on a comprehensive scan, with a set methodology.

Results: The MOVING benchmarks assessed the strengths and weaknesses in the design of policies across the policy areas of the MOVING policy framework. They produced an overall assessment of policy environments for physical activity across the five countries, as well as an assessment of each individual policy area within the framework, such as walking and cycling infrastructure and active transport. Further, by allowing a fast assessment of many physical activity policies, the benchmarking tool enabled an analysis of the interplay of single policies and drawing conclusions about the overall policy environment in the five countries. 

Conclusion:  The MOVING benchmarking tools can identify gaps and assess the strength of actions taken by national governments to promote physical activity, and can be used by policymakers, researchers and civil society to inform advocacy for and design of policies. The scores generated by the benchmarking tool will be amalgamated into an overall policy index for 27 European countries.

Issue/problem: Since 2016, French doctors are allowed to prescribe adapted physical activity (APA) to patients with long-term illness (ALD) through the “sport sur ordonnance” program. Despite the goal of promoting physical activity in ALD patients, health authority recent reports unanimously highlight organisational and funding difficulties. Whereas most of the funding effort is based on national or mutual insurance companies, our intervention proposes to fix the organisational difficulties. We provided an optimized care pathway coordinated by an APA professional and an innovative online platform to ease medical prescription, patients access and follow-up to APA.
Problem description: Three main problems have been identified: Diagnostic heterogeneity, APA accessibility and Program evaluation. To fix these issues, the proposed intervention firstly included an initial evaluation based on a standardized diagnostic. Secondly, we evaluated APA structures following functional specifications and referenced those succeeding the criteria to ensure an optimized patients’ orientation toward an adapted care service. Finally, pre- and post-care bio-psycho-social tests were mandatory. Interviews and evaluation data were stored via questionnaires on our securized platform for further analyses. 
Results: 2200 patients benefited from our program, and 116 yet finished the whole 2-years program. Patients description: 64 yo, 66% women, 35% cancer, 14% diabetes, 11% heart failure and 9% mental illnesses. 96% declared being motivated to maintain their physical activity after the program and reported a 4.8/5 in rating their APA care. Significant pre-post enhancements suggest that our program succeed in promoting and facilitating regular APA practice in ALD patients.
Lessons: The ecosystem built around insurance companies (APA professionals, doctors and patients) provides an appropriate response to the health policy dedicating to promote a regular APA practice for ALD patients. However, the expected efficiency depends on a structured, organized and innovative system. Firstly, evaluating the medicoeconomic impact is necessary to ensure the sustainability of this national policy. Systematically measuring the pre- and post-care intervention should allow reaching this objective. Secondly, we learned that the necessary next steps will rely on time saving and quality increase. We propose automatized detailed and patient specific APA prescription following HAS guidelines and automatized orientation toward the most adapted APA professional.

Background:

Physical fitness outcomes are considered major health biomarkers to assess and monitor exercise-based interventions across the lifespan. Recent studies provide evidence that many adult and childhood chronic diseases should have their origins in gestational or fetal life. To date, a few pioneering studies have showed associations between prenatal predictors and selected physical fitness tests (strength and cardiorespiratory). Nevertheless, there is a lack of knowledge about the influence of prenatal factors on childhood performance on a comprehensive fitness test battery including speed and coordination. The innovative purpose of the current study is to analyse the relative weight of prenatal predictors on schoolchildren’s physical fitness outcomes.

Methods: We obtain data from1188 children (571 girls) aged 6-11 years and 1020 adolescents (495 girls) aged 12-17 years. Prenatal predictors (gestational anemia, gestational diabetes and length of gestation) were self-reported from offspring’s mothers. The ALPHA fitness test battery for youth was used to assess offspring´s physical fitness (muscular strength, motor fitness and cardiorespiratory fitness). Regression analysis were performed to predict the different physical fitness outcomes.

Results: The main findings of the present study indicate that the presence of gestational anemia significantly predicted lower scores of lower-body explosive muscular strength (standing long jump) and motor fitness (4x10-m shuttle run) and predicted moderately lower scores of upper-body isometric muscular strength (handgrip strength test). (p<.005; p<.008; p<.075 respectively). Moreover, gestational anemia better predicted lower scores of muscular strength and motor fitness in children than in adolescents (standing long jump, handgrip strength test, 4x10-m shuttle run) (p<.001; p<.051; p<0.18, respectively). While gestational age and length of gestation (<34- ≥42 weeks) predict better cardiorespiratory fitness (20 m shuttle-run test) (p<.023; p<.023 respectively) and motor fitness (4x10 m shuttle; moderately for length of gestation). (p<.020; p< 0.55 respectively).

Conclusion: This evidence suggests that preventive strategies by health-care institutions, policy makers and technicians must be two-fold: a) to effectively reduce gestational anemia in order to prevent offspring´s predisposition to low levels of physical fitness, and b) to intervene with toddlers and children at risk to provide tailored physical activity programs and regular physical fitness evaluation.

Background: There has been an increasing focus on the importance of national policy to address population levels of physical inactivity. It has been suggested that the four ‘cornerstones’ of policy comprise: 1) national guidelines on physical activity levels; 2) setting population goals and targets; 3) surveillance or health monitoring systems; and 4) public education. The aim of the current paper was to analyse the policy actions which have addressed each of these elements for children and youth in England and to identify areas of progress and remaining challenges.

Methods: A literature search was undertaken to identify past and present documents relevant to physical activity policy for children and youth in England. Each document was analysed to identify content relevant to the four ‘cornerstones’ of policy.

Results: Physical activity guidelines for children and youth have been in place since 1998 and reviewed periodically to ensure they reflect the latest scientific evidence. The setting of physical activity targets has focused on the provision of opportunities for physical activity, particularly through physical education (PE) in schools, rather than in relation to the proportion of children meeting recommended physical activity levels. There has been much surveillance of children’s physical activity but this has been undertaken infrequently over time, by a wide range of organisations, and with varying inclusion of different domains of activity such as school PE, leisure time activity and active travel. There has only been one campaign in England targeted at children and their intermediaries (Change4Life), which was an obesity campaign focussing on dietary behaviour in combination with physical activity. Most recently an infographic supporting the physical activity guidelines for children and young people was developed, but details of its dissemination and usage are unknown.

Conclusions: There have been many developments in physical activity policy in England targeted at children and youth. The area of greatest progress is national physical activity guidelines. Establishing prevalence targets, streamlining surveillance systems, and investing in public education would strengthen national policy efforts to reduce physical inactivity.

Introduction: There is a growing interest in workplace interventions to reduce sedentary behaviour. Professional males are most at risk of prolonged sedentary behaviour, are considered difficult to reach in terms of recruitment to studies, and may require targeted health promotion interventions. Research on the views of senior managers and executives as well as employees in a professional setting in relatively underdeveloped. Studies have shown that a ‘one size fits all’ approach is not suitable in behaviour change interventions. The aim of this study was to qualitatively explore professional male workers’ facilitators and barriers to reducing workplace sedentary behaviour and their views on suggested intervention strategies to ensure relevance and practicality of the intervention in each specific context.

Methods: Three semi-structured focus groups and one interview were conducted with a purposive sample of 25 professional men (15 employees and 10 senior managers). The men were recruited using convenience sampling from two professional worksites in Dublin, Ireland. Transcripts were analysed using thematic analysis.

Results: The men identified a range of intrapersonal, interpersonal and organisational barriers and facilitators to reducing workplace sedentary behaviour. Perceived facilitators included individual motivation, the formation of new habits likely through small changes, management buy-in and support and organisational culture. Perceived barriers included the primacy of work, job requirements of being desk-bound, and management expectations. Views of suggested strategies for a novel multicomponent intervention to target the determinants of sedentary behaviour as informed by the socio-ecological model were positive overall.

Conclusions: The needs, preferences and opinions of professional men to participate in a workplace intervention to reduce sedentary behaviour should be taken into consideration prior to implementation in a workplace setting. This is important to ensure relevance and the practicality of intervention strategies in the particular settings.

Introduction: Regular physical activity (PA) is associated to a decrease in morbidity and mortality and to a better quality of life. The environment has been shown as an important factor in the adoption of an active lifestyle, especially among the elderly, since it may be the difference between a dependent or independent living and a better health status. Thus, the purpose of this study was to analyze the relation between the PA level and the environment perception of the elderly from a city in southern Brazil. Methods: Three neighborhoods of the city of Santa Maria, RS – Brazil were drawn to be part of the investigation, with low, medium and high socioeconomic levels. The sample had 202 subjects. An adapted version of the International Physical Activity Questionnaire for the Brazilian elderly (Mazo & Benedetti, 2010) was used to evaluate PA level and a Portuguese version of the Neighborhood Environmental Walkability Scale (Salvador et al, 2009) to evaluate environment perception. The statistical analyses were done by relative and absolute frequencies and logistic regression. Results: The prevalence of adequate PA levels was inferior to 30% in the three studied neighborhoods and the average of minutes spent with PA per week was 63.14 (±115.15). From the 41 variables considered in the environment perception, four had a p<0.20 being selected for the multiple logistic regression model. The presences of fair and pedestrian crosswalks near home were the most influent factors on PA: the presence of fair increases 3.3 times the chance of the elderly being physically active and the crosswalks increase 2.7 times that chance. Conclusion: A low prevalence of physically active elderly was observed in Santa Maria, which was also shown in other studies with similar samples.The variables that most positively influenced the older adults’ PA levels were the presence of fair and pedestrian crosswalks, showing the importance of the creation and maintenance of environments that facilitate PA, as well as public policies that promote healthy and safe environments. 

Background: Schools are ideally placed to provide children and adolescents with multiple opportunities to be or learn to be physically active. However, key reviews have reported that interventions to date have largely failed to have any long-term impact on overall physical activity levels. In this position paper, greater attention to key issues is needed to realise the full potential of schools and ideal physical activity for health promotion setting. Methods: This study draws on multi-author expertise to develop a position paper to advance opinion on school-based programmes. Collaborative conceptual thinking was established through various tools such as literature review, evidence synthesis and online and in person meetings. Results/Discussion: The adoption of a systems approach is valuable for understanding the complexities of the school setting and to support the implementation of whole-of-school initiatives. Furthermore, we contend that the full range of physical, cognitive, emotional and social benefits that physical activity provides should be considered, rather than a narrow focus solely on physical activity levels.  Interdisciplinary research questions are most useful in exploring and evaluating whole-of-school approaches.   Informed by process, impact and outcome evaluation and implementation science, both qualitative and quantitative research methodologies and a move beyond traditional research design are needed to advance our knowledge of what works, for whom and in what context. Case studies from several European countries will be presented to illustrate examples of systems approaches in action. This includes examples at multiple levels firstly, a national approach including a Physical Education curriculum reformation (Portugal), a regional approach such as a county council partnership with a University to support physical activity promotion (France) and a local approach at the school level i.e. a whole-of-school physical activity programme (Spain and Ireland). Conclusion: From authors expertise and reflection, this paper makes recommendations on the nature of the evidence required to bridge the implementation gap, sustain and scale-up innovative approaches to whole-of-school programmes.

Background: Nutritional behaviours such as diet, physical activity (PA) and sedentary behaviour (SB) are interdependent and are likely to change in different way during a public health intervention. This study aimed to 1) identify cross-sectional nutritional profiles and their 2-year longitudinal transition among French school-aged adolescents, 2) identify factors associated with these profiles and transition.

Methods: Adolescents from the 2-year school-based PRALIMAP (PRomotion de l’ALIMentation et de l’Activité Physique) intervention were included. Nutritional behaviours (diet, PA and SB) were assessed by self-administered questionnaire at the beginning (T0) and end (T2) of the study. Nutritional profiles were identified at T0 using latent class analysis, and their transition from T0 to T2 using latent transition analysis. Logistic regression models were computed to identify associated factors such as sex, weight status, age, socioeconomic status and a PRALIMAP intervention.

Results: Among the 2390 adolescents included (mean ± SD age=15.1 ± 0.6 years), 5 nutritional profiles were evidenced at T0 and labelled as “healthy”(12.2%), “excessive diet” (16.0%), “physically inactive” (26.1%), “restrictive diet” (23.5%), and “unhealthy” (22.2%). Compared to “physically inactive” profile, adolescents from the “healthy” ones were less likely to be girls (OR=0.21; p<.0001), and socially advantaged (OR=0.87; p=.0002). “Unhealthy” profile adolescents were less likely to be overweight/obese (OR=0.48; p<.0001) and more likely to be older (OR=3.67; p<.0001). At T2, proportion of adolescents increased in “healthy” (+4.6%), “unhealthy” (+2.8%) profiles, and decreased in “excessive diet” (-1.2%), “physically inactive” (-3.2%), “restrictive diet” (-3.03%) profiles. Compared to the control group, adolescents from the intervention group were more likely to remain in “healthy” (OR=1.3), and to switch from “excessive eater” (OR=1.1) and “physically inactive” (OR=2.6) to “healthy“. Sustainability of “healthy” profile increased with socioeconomic status.

Conclusions: The results of this study confirm the variety of behavioural profiles in nutrition with significant social differences. It also demonstrated the effectiveness of the intervention in changing behaviours favourably.  Public health focusing on nutritional changes may be more effective it taking in to account the social status of adolescents.

Backgrounds: Sedentary time (ST) is considered as a major public health concern. Children are particularly vulnerable as their ST increase with age. Therefore, school-based interventions aimed to reduce and prevent children ST are burgeoning. Previously a review found that school-based interventions proposing multiples components which include standing desks appeared to be more effective compared to uni-component studies (Hegarty et al., 2016). However, this result only depended on 11 records published before 2016 and must be verified since the growing number of school-based interventions are proposed.

Objective: To continue the evaluation of the effectiveness of school-based interventions published since the previous review (2016).

Methods: A total of 4 databases were examined: PubMed-Medline, PsycINFO, ScienceDirect and Google Scholar. The search was conducted using keywords in English, the main ones being: 1) "Sedentary Time" 2) "Intervention" 3) "Child", 4) "School". Records published between August 2016 and August 2019 with objective measure of ST were analysed. Data were collected and compiled by an author according to PRISMA criteria.  

Results: 14 studies were included: 9 studies were multi-components (64%) and 5 were uni-component (36%). The method of measurement used in all studies was accelerometry. Environmental and organizational changes were the most used components. Among fourteen, nine studies reported significant results on post-intervention: respectively, with three being uni-component and six being multi-components. The long-term effect remain undetermined.

Conclusion: Uni component studies used only environmental reorganization which reduces ST in the short term. This finding had already been supported in previous interventions studies using standing desks that had been identified by the last systematic review (Aminian et al., 2015; Clemes et al., 2016). The uni- and multi-components studies do not differ clearly in the results obtained. However, multi-components interventions seem to be the more promising strategy to reduce ST and to develop healthy habits at long term. Interventions with follow-up measures at long term are required.

Background: Sheds for Life (SFL) is a ten-week health and wellbeing programme delivered in the community setting of Men’s Sheds in Ireland that uses gender-sensitive approaches to engage typically hard-to-reach men (‘Shedders’) with health. SFL consists of a health check, core modules of physical activity (consisting of a walking programme or chair-based exercises for older adults), mental wellbeing, healthy eating and other elective wellbeing components. SFL is implemented across two phases with four regions per phase. The purpose of the research is to evaluate SFL using an implementation science approach to assess programme impact and implementation effectiveness with a view to enhancing its sustainability and scalability while also informing gender-sensitive strategies that engage hard-to-reach men with health and wellbeing.

Methods: This study is a hybrid typology “effectiveness-implementation” design. A community-based participatory research, and mixed methods approach has been adopted to measure the effects of the SFL intervention on Shedders across implementation phases and identify and monitor implementation barriers and facilitators that can inform future sustainability and scale-up of SFL. Central to effective implementation of SFL is a partnership approach between the Irish Men’s Sheds Association (IMSA) and other health-related partner organisations (POs). This research engages key stakeholders (at individual (Shedder), provider (POs) and organisational (IMSA) levels) and prioritises implementation outcomes. Purposive sampling is used to recruit a diverse sample of participants (Shedders n=420 and SFL providers n=20).

Results: Findings from phase 1 will inform phase 2 implementation. Preliminary physical activity outcome results from phase one across four regions (baseline to ten weeks) suggest days active per week increased from 3.07 to 4.32 days (P =.00) days walking increased from 4.29 to 5.28 days (P=.00) minutes walking per day increased from 33.31 to 38.15 (P=.005)

Conclusions: Preliminary findings highlight the potential of the SFL initiative to address the increasing calls for gender-specific health promotion programmes that target lifestyle and health behaviour change in men. Shed settings are unique and effective in attracting men from more marginalised male subpopulations, reaching men who would typically not engage with health services.

This study is funded by the Irish Research Council (ID: EBPPG/2018/256)

Background

Physical activity (PA) programmes targeting older adults often report relatively low attendance rates which limits impact. Research into barriers and enablers of PA adherence is often qualitative and rarely tests outcomes against objectively monitored adherence to assess whether what people say is actually reflected in what they do. This study adopts a rare, mixed methods, longitudinal perspective identifying subjective and objective predictors of and associations with adherence to REtirement in ACTion (REACT), a 12-month physical activity intervention for frail or pre-frail older adults.

Methods

Semi-structured interviews conducted at six (n=17) and 12 months (n=10) explored barriers and enablers to adherence. Thematic analysis led to ten adherence related research hypotheses. These were tested by examining correlations between REACT programme attendance and physical function (Short Physical Performance Battery), self-rated physical function (mobility assessment tool-short form (MAT-sf)), dominant hand grip strength assessed by digital dynamometer, Ageing Well profile (social scale), process evaluation data at baseline (n=411) and six-months (n=348) and open-ended participant feedback at six-months (n=307). Each participant response was scored -1) for a negative comment, 1 for positive or zero for no comment or balancing negative and positive comments.  

Results

Higher adherence correlated with younger age (r=-0.162, p<0.001), better physical function, both objectively measured (r=0.118, p<0.05) and self-rated (r=0.134, p<0.01), greater grip strength (r=0.118, p<0.05) and having less social contact (r=-0.134, p<0.01), at baseline. It also correlated with an improvement in objectively measured physical function between baseline and six months (r=0.200, p<0.001). At 6-months enjoyment of the programme (r=0.263, p<0.001), specifically enjoyment of muscle-strengthening exercises (r=0.142, p<0.027), perception of positive social interactions (from questionnaire data (r=0.212, p<0.001) and open-ended feedback (r=0.157, p<0.01)) and perceptions of an autonomy-supportive teaching style (r=0.213, p<0.001) all correlated with higher adherence.

Conclusions

PA programmes for older adults should encourage the development of social connections and group cohesion but should take a flexible approach to avoid negatively affecting adherence amongst those with pre-existing high levels of social contact. Building confidence in PA and physical function as these improve during the programme, promoting enjoyment and utilising an autonomy-supportive leader teaching style are important in order to support adherence.

Background: Interventions promoting healthy behaviors such as physical activity are effective to prevent overweight and obesity among adolescents. Following such interventions, body satisfaction change could be discrepant with weight change (e.g. less body satisfaction while having lost weight), and decrease sustainability of behaviors in the long-term. This study aimed to describe the discrepancy between body satisfaction change and weight change among adolescents following a 2-year school-based intervention, and to identify associated sociodemographic factors.

Methods: Adolescents from the 2-year school-based “Promotion de l’Alimentation et de l’Activité Physique” study conducted in northeastern France from 2006 to 2009 were included. Body satisfaction change was assessed using a self-administered questionnaire at the end of the study. Weight change was measured by the difference of body mass index z-score at end and start of the study. Discrepancy between body satisfaction change and weight change was described with cross-tabulations and weighted Cohen’s kappa. Sociodemographic factors associated with discrepancy were determined by multivariate logistic regression models.

Results: Among the 3279 adolescents included (mean ± standard deviation age= 15.2±0.6 years), the proportion of discrepancy between body satisfaction change and weight change was 74.8% (pessimism= 41.6%; optimism= 33.2%). The weighted Cohen’s kappa indicated high discrepancy (κ= 0.09; 95% confidence interval [0.07; 0.11]). The likelihood of discrepancy, especially pessimism was higher in boys than in girls (odds ratio= 1.44, 95% confidence interval [1.19; 1.74], p= .0002), and higher in adolescents with high socioeconomic status than in those with low socioeconomic status (odds ratio= 1.82; 95% confidence interval [1.20; 2.74], p= .004)

Conclusions: Discrepancy between body satisfaction change and weight change was high among school-aged adolescents with increased likelihood for boys and adolescents with high socioeconomic status. Body satisfaction change should be considered in overweight and obesity prevention interventions alongside body weight change, and could be used as an indicator of long-term behavior maintenance.

Background: Regularly observed and sufficient physical activity (PA) of young people depends on the creation of conditions for success in the preferred PA. Therefore, we consider the diagnostics of PA preferences to be an irreplaceable part of PA diagnostics.

The aim of this study is thus to (a) detect the state and trends in the preferences of individually oriented PA of young people in different education and sports environments in the context of weekly PA; (b) to detect the associations among developing preferences of track and field and the fulfilment of recommendations within a weekly PA.

Methods: In the research conducted from 2007 to 2017 participated in total 16116 participants aged from 14 to 26. We have realized a sports preferences questionnaire and weekly PA questionnaire IPAQ-long in order to detect the preferences in the individually oriented types of PA.

Results: The biggest long-term stability among the Czech and Polish boys and the Czech girls showed swimming and cycling and among Polish girls swimming and skating. The most significant increase of preferences was detected in track and field, especially among the Czech girls and boys. The girls and boys who prefer track and field meet weekly PA recommendations significantly more than those who do not prefer it. Both Czech and Polish boys and girls showed that those who prefer athletic/running activities fulfil significantly more recommendations to a weekly PA; specifically at least 5 times a week for a minimum of  60 minutes of MVPA and simultaneously at least 3 times a week for a minimum of 20 minutes of vigorous PA. Preferences of athletic/running activities also increase the chance of fulfilment of above-mentioned recommendations to a weekly PA with both girls (OR=1.801, CI=1.571-2.065) and boys (OR=1.655, CI=1.437-1.905). These preferences are also important predictors for fulfilment of PA recommendations.

Conclusions: The knowledge of trends in preferred types of PA has a predictive meaning for supporting physically active lifestyle of young people and for creation of optimal conditions to pursue popular types of PA.

Background: In 2019, the German Multiple Sclerosis (MS) Society was certified as a provider for “Funktionstraining” (FT). FT is an exercise training program developed for people with disabilities or people at risk of disability, takes place weekly and is led by a qualified FT-therapist. It is prescribed by a physician (between 12 and 24 months) and is part of outpatient medical rehabilitation. Due to the COVID-19 pandemic, the tele-rehabilitation concept “Funktionstraining-online” (FT-online) was developed for pwMS. This study examines the FT-online from a participants’ point of view within an online survey.

Methods: We developed an online questionnaire that included data of sample characteristics, participants’ experiences with FT-online in terms of usability and training content. Further, the survey captured the quality of FT-online and the FT-therapist and compared carefully FT-online with face-to-face training. The standardised questionnaires Self-Efficacy Scale – Short Form (ASKU), the Multiple Sclerosis Questionnaire for Physiotherapists MSQPT and the Fatigue-Questionnaire (WeiMuS) were included. The 103 interviewed people with MS (pwMS) participated in FT-online at least for three months.

Results: Data analyses are in process. The response rate was 75% (n=78). The analysed sample is 53.4±8.1 years old with a disease duration of 18±8.7 years (male=7, female=71). Preliminary results in the ASKU certify a low self-efficacy in the sample (2.25 ±0.67). Qualitative results show the advantages for FT-online in the independence of mobility and infrastructure, flexibility, compatibility within job and family, group feeling in times of social distancing and an increase in quality of life. The disadvantages described by the sample are mainly technical problems and lack of socialising. 35% (n=27) participants experienced both: FT-online and face-to-face. 44.4% (n=12) of this sample prefer FT-online, 33.3% (n=9) prefer the face-to-face training course and 22.2% (n=6) rate both kinds of training equal.

Conclusions: The implementation of FT-online was an important step to ensure the exercise-related physical activity in pwMS during the COVID-19 pandemic. The descriptive analyses show high potential for FT-online training in pwMS. We are aware of the bias in current data, because of the pandemic situation both the free choice of FT-offers and the pandemic circumstances held influence in study outcomes. First results lead to the conclusion that FT-online may be beneficial for a broad range of persons with neurologic diseases, movement disorders and fatigue episodes and should be considered for future medical rehabilitation.

Background: Insufficient physical activity (PA) is an important risk factor for overweight and obesity among adolescents, both causes of cardiovascular diseases. Sport is the largest contributor to achieving the World Health Organization (WHO) PA levels guidelines. However, few studies have investigated temporal trends in weekly sport participation in relation to adolescents’ weight status. The main objective of this study was to compare sport participation to weight status and investigate their relationship over time.

Methods: Two data collections were conducted during spring 2015 (n=1019) and 2019 (n=1112) in 30 French high schools. Adolescents reported their age, sex, height, weight, parents’ socioeconomic status (SES) and hours of sport per week. Body mass index was calculated and classified into three categories (normal weight, overweight, obese) according to the International Obesity Task Force. Three sports groups were created according to WHO PA guidelines: no sport (NS), sport less than 7 hours a week (7-) and sport more than or equal to 7 hours a week (7+). Binary logistic regressions adjusted for age, sex and SES were performed to evaluate sport participation, weight status and their relationship over time.

Results: Between 2015 and 2019, prevalence of overweight and obesity increased from 9.1% to 14.1%, with this increase greater among low-SES girls. We observed an increase in both the proportion of adolescents playing 7+ hours of sport (8.0% to 12.3%) and those not playing sport (34.2% to 35.9%). These changes varied according to adolescents’ SES. In 2019, low-SES adolescents were 1.5 times less likely to play sport (95% CI:1.17-1.99) while no change was observed among high-SES adolescents. Finally, 7+ adolescents were no more likely to be overweight or obese in 2019 compared to 2015. Contrarily, NS and 7- adolescents were 1.7 and 1.8 times more likely respectively to be overweight or obese in 2019 compared to 2015.

Conclusion: These results confirm the adequacy of WHO PA recommendations to counter the rise of overweight and obesity, and show that enough hours of sport participation alone could help stabilize overweight and obesity prevalence, without controlling for other forms of PA.

Background: Public policy is increasingly recognized as an important component of physical activity (PA) promotion, as policy actions to address lifestyle behaviours have the potential to influence the health and well-being of an entire population. However, our knowledge about the current status, implementation and effectiveness of PA policies in individual countries is still very limited, and there is consequently no clear guidance on which policies governments should preferably use in different settings or under various preconditions. In order to improve the evidence-base, we conducted a detailed assessment of existing PA policies in four EU Member States using WHO’s HEPA Policy Audit Tool (PAT) in the context of the Policy Evaluation Network (PEN).

Methods: We employed a six-step process to administer the HEPA PAT Version 2 in Ireland, the Netherlands, Germany, and Poland. This involved identifying stakeholders, pre-filling parts of the tool using existing survey data and desk-research, approaching select institutions to verify details, and obtaining expert opinion via workshops, interviews, and/or questionnaires. Based on the four completed PATs, we performed a comparative analysis to identify similarities and differences between countries and with previous studies using the tool.

Results: In all four countries, the health and sport sector were found to be most active in PA promotion, followed by education, transport, and environment/urban planning. All countries have national systems to monitor population PA levels, and three out of four already have national PA recommendations. The study also showed that policy context (e.g. ministry portfolios, importance of subnational governments) varies substantially between countries. This influences policy implementation and made it necessary to employ a bespoke approach in each country to obtain the required information. 

Conclusions: Our findings largely confirm results of previous studies using the PAT in other countries. They also indicate that using the tool in combination with other policy monitoring tools, e.g. the EU Monitoring Framework for HEPA across Sectors, may provide added value and help countries monitor policy progress more consistently. Our experience also confirms some known limitations of the PAT, e.g. regarding subnational policies and a high level of dependence on cooperation from key policy actors.  

Background: The Daily Mile is a school-based physical activity intervention that aims to improve children’s aerobic fitness levels. It encompasses a 15-minute run for the whole class on or around the school grounds at least three times per week. The Daily Mile is an easy and accessible intervention, but the downside is a low threshold to stop or skip a session. Therefore, we aimed to determine 1) the effects of performing The Daily Mile for 12 weeks on the aerobic fitness levels of Dutch primary school children and 2)  if additional personal support for teachers impacted the effectiveness of The Daily Mile.

Methods: We conducted a controlled trial in grades 5 through 8 of nine primary schools across the Netherlands. Schools were allocated to control, intervention (12 weeks The Daily Mile) or intervention-plus (12 weeks The Daily Mile and additional support) group. Children completed the shuttle-run test (SRT) at baseline and follow-up, 12 weeks apart. We analyzed the data using multi-level linear regression models clustered within individuals and by classes and schools. All models were adjusted for sex and age.

Results: We collected complete data sets for 536 children (mean age 10.0 years). The participation rate of classes in the intervention group was 87.8% and in the intervention-plus group 89.7%. After correcting for age and sex, the adjusted model showed a significant intervention effect on SRT-score after 12 weeks for both the intervention group (1.1 stages; 95% CI 0.75, 1.47) and the intervention-plus group (0.6 stages; 95% CI 0.32, 0.89), when compared to the control group.

Conclusion: Performing The Daily Mile at least three times per week for a 12 week period can be effective in increasing the aerobic fitness levels of primary school children. Additional personal support for teachers did not improve the effectiveness of the intervention on aerobic fitness within this time frame. This may be due to the high implementation rates in both the intervention group and the intervention-plus group. Possibly additional personal support might become beneficial for maintenance on the longer term.

Background: The rise in childhood overweight and obesity worldwide demands effective health promotion and obesity prevention programmes, especially targeting socially disadvantaged areas. The aim of this study is to examine the effectiveness of a revised parental support programme, promoting physical activity and a healthy diet, and on preventing overweight and obesity among children in disadvantaged areas.

Methods: The effectiveness of this programme will be compared to standard school routines in a parallel group cluster randomised controlled trial. The 6-month programme included: 1) A health information brochure; 2) School nurses conducting motivational interviewing with parents; 3) Classroom activities and home assignments for children; 4) A self-test for type-2 diabetes risk for parents. Seventeen schools were enrolled including 352 six-year-old children (155 intervention/197 control). Physical activity and sedentary time were measured by accelerometry. Dietary intake was assessed by a newly developed mobile phone-based photo method. Weight and height were measured by trained researchers. All outcomes were measured at baseline and at 6 and 18 months post baseline. Parental level of education was self-reported, and the highest level achieved by either parent was used as an indicator of socioeconomic position (SEP). A mixed-effect regression analysis will be performed to evaluate the effectiveness of the programme.
Results: After the intervention, when adjusting for sex and parental education, the intervention group showed 6.4 mins more moderate to vigorous physical activity (MVPA) during weekdays than the control group (p = 0.03). No significant effect on MVPA was detected during weekends (p = 0.47). Further, no significant effect was detected on time spent sedentary during weekdays (p = 0.12) nor during weekends (p = 0.78).

According to IOTF classifications, 9.6% of the children had obesity, 16.4% overweight, 4.4% underweight and 69.6% normal weight. Results on changes in BMI, and dietary intake at 6 months will be presented.
Conclusions: The results from the evaluation of this parental support programme will add to the knowledge and advance intervention and implementation research in the Swedish/Nordic context relating to prevention of overweight and obesity in childhood.

 

 

Background: Physical activity is essential for public health. Newer device-based measures can identify different activity behaviors, which is useful to focus future health promotion initiatives. The objectives of this study were to describe time spend cycling, running, walking, standing, sitting, and lying during a regular day using accelerometers, and to describe differences between age-groups and gender. 

 

Methods: In the Moving Denmark study a representative sample of 400.000 Danes were invited to a national survey. A subsample of 1525 respondents gave consent to wear an accelerometer (Axivity AX3 attached to the right thigh; 24 h/day, 7 consecutive days) of which 930 fulfilled the inclusion criteria (min. 3 valid weekdays and 1 valid weekend day with data). Daily time spent biking, running, walking, standing, sitting, and lying were derived using the method proposed by Skotte et al. (2014) using 1-s epochs, and differences between age-groups (15-25, 26-45, 46-65, +66 y/o) and gender were investigated using Kruskal-Wallis rank sum test. 

 

Results: Among those cycling (39.2%) and those running (67.9%), the mean time per day was 8.4 minutes for cycling and 2.8 minutes for running. The mean time walking, standing, sitting, and lying was 93.5, 183.2, 572.1, and 542.2 min/day, respectively. No significant difference was observed between age groups on biking, but time spend biking was highest among men. Average time spend running and walking was highest among the youngest participants (15-25 y/o), but with no differences observed on gender. No difference between age groups were found for standing, but the average time spend standing was significantly higher for women compared to men. Average sitting time was significantly higher among the older participants (+66 y/o), whereas time spend lying was highest among the youngest participants, but with no differences observed on gender.  

 

Conclusions: The study show that at least 67.9% of the sample are active through either biking, running, or both, but also that the average daily minutes are limited. Men accumulate in average more minutes of biking, and women more minutes of standing. The younger participants had more minutes of walking, running, and lying, while the older participants more often were sitting. 

 

Introduction: Total self-reported sitting time is associated with higher risk for cardiometabolic disease and mortality, while breaks in prolonged sitting has positive cardiometabolic effects. However, less is known about the associations of domain specific sitting and breaks at work and self-rated global health, likewise if physical activity could influence the associations.

Methods: 36,120 adults (42% women) from the Swedish working population who participated in a nationwide occupational health service screening 2014 -2018 were included in this cross-sectional study. Sitting duration and frequency of breaking sitting time at work, self-rated global health, exercise, leisure time sitting, diet, smoking and stress were self-reported. Cardiorespiratory fitness was estimated by a submaximal cycle test and BMI assessed through physical examination. Occupation was classified to requiring university competence or not. Logistic regression modelling assess OR (95% CI) associated between poor global health and decreased levels of workplace sitting and increased breaks in workplace sitting.

Results: Having poor perceived global health was associated with increasing levels of workplace sitting, OR 0.65 (0.57-0.74) for sitting 75% of the time vs. sitting almost all time. Association were found between having poor perceived global health and lower frequency of breaking up workplace sitting every 30 minutes, in people sitting more than half of their working time, OR 0.60 (0.51-0.69) for occasionally vs. seldom breaking up sitting. The association were affected by sex, type of work, exercise habits, and sitting during leisure time. When sitting almost all the time OR for poor global health was 0.48 (0.39-0.60) for regular exerciser vs. no regular exercise. Within the no regular exercise group the OR 0.75 (0.63-0.89) for having poor global health was lower if not sitting almost all the time.

Conclusion: Sitting almost all the time at work and not taking breaks, are associated with increased risk for perceived poor global health. The associations are affected by sex, type of job, exercise habits and sitting during leisure time. People who have to sit almost all their time at work, should be recommended to exercise on regular weekly bases and/or decrease their leisure time sitting to reduce the risk for poor health.

Background: This paper outlines a mixed methods research study conducted at three independent boarding schools (a uniquely Danish type of residential setting for young people between the ages of 14 to 18) that all focus on sport and physical activity. In total independent boarding schools attracts more than 30.000 students per year, which makes it a very popular choice for young people. Interestingly, this particular type of schools have not been researched much.

This study aims to provide an insight into the special qualities of Danish independent boarding schools and explore how a focus on sport and physical activity in relation to personal development of young people plays a role at three of these schools.

Methods: The analyses are based on an online survey distributed to 1020 students at the participating schools in March 2019. In total, 865 students answered the survey. The purpose of the survey was to collect quantitative data on background issues, the students’ motives for choosing independent boarding school life and to gain an insight into what the students’ perceived as the special qualities of living on such a school – typically for one year. The quantitative findings are enriched by empirical findings and conclusions from qualitative data generated via six MSc theses.

Results: The survey results show that students to a great extent choose an independent boarding school based on the sports program (73%), facilities (69%) and sport performance levels (51%). The students point out getting new friends (92%), being a part of a community (92%), learning to collaborate (91%) and solving conflicts (88%) as some of the special qualities of life at independent boarding schools. The qualitative analyses reveals that sense of community, social interaction with fellow students and the relationship between teachers and students are perceived as the main qualities of this type of school life. Furthermore, the analyses points out that sport and physical activity can both hinder and promote qualities as the ones mentioned.

Conclusion: The study contributes to new and important insights into a popular and unique type of school in Denmark, but more research is undoubtedly needed.

The burden of non communicable diseases is a rising global problem and the increasing inactivity seen all over the world is extremely costly to societies (Ding et al., 2016). A recent Danish evaluation on physical activity (PA) showed that a considerable number of Danish children and adolescents do not meet national PA recommendations (The Ministry of Health, 2019). Viewing this problem through a life course perspective points to the solution of making sustainable behavioural changes with children (Frohlich & Potvin, 2008). Across the life span, there is clear evidence of the health-enhancing benefits of PA (Lee et al 2012). However, at the same time, ample empirical evidence supports that extrinsic motives for participating in PA, such as increasing health, are insufficient when long term participation is the goal. This means that prevention and health promotion interventions should not blindly target the factors and behaviours that predict adult health, such as PA, but move towards intervening on the ‘so-called’ causes of the causes such as factors enabling a physical active lifestyle throughout life. Physical literacy (PL) is a comprehensive multidimensional concept that has been identified as a ‘cause of the causes’. PL consists of dimensions that lay the foundation for an individual’s capacity and tendency for engaging in physical activities throughout life (Whitehead, 2001). In this symposium, we aim to present four research and interventions projects from the education, sport and public health sectors that have emerged in the last couple of years, and through the presentation of these projects, how we in Denmark have established a PL ecosystem between research and practice - and how our national collaboration, PL-net, has contributed to this. Program: 1) Introduction to the symposium 2) Physical literacy, physical activity and wellbeing in Danish children 3) The Child-COOP Denmark study: Using physical literacy to guide and evaluate a systemic approach to health promotion 4) Staying active together in sports - the Importance of and how to promote the emotional domain of Physical literacy 5) 3PL: Promoting pupils' physical literacy - A pilot study testing feasibility and acceptability of the Y-PATH intervention in a Danish school setting. 6) The symposium will be ended by a panel debate where it also will be possible for the participants to ask questions.

Prof. Peter Bentsen Center for Clinical Research and Prevention peter.bentsen@regionh.dk & Postdoc Peter Elsborg Center for Clinical Research and Prevention peter.elsborg@regionh.dk

Introduction: Research increases our understanding on the efficacy of exercise and physical activity on older adults’ health and well-being. However, the scientific output is relevant in clinical settings only and cannot be easily implemented in real-life setting. Consequently, the public health impact of the research output fails to be scaled-up for audiences and target groups at large. We therefore need more evidence on theory-to-practice approaches, in which physical activity interventions pay more attention to practical implementation.

Aim: The aim of this symposium is to describe successful examples on active ageing from research-to-practice. Examples are from 4 countries where different approaches are being used to improve adoption, implementation and maintenance physical activity among older people. Relevant scientific frameworks like RE-AIM and implementation science are utilized.

Organizer and Chair: Katja Borodulin, Age Institute, Helsinki, Finland, katja.borodulin@ikainstituutti.fi Discussant: Jannique van Uffelen, Department of Movement Sciences at KU Leuven, Leuven, Belgium, Jannique.Vanuffelen@kuleuven.be.

Goals:

1. Describe the progress of developing and monitoring global physical activity policy from the 1990s through the release and implementation of Global Action Plan for Physical Activity-GAPPA;
2. Present findings of a systematic review of instruments for physical activity policy analysis;
3. Describe the methods and progress after 1-year implementation of the Global Observatory for Physical Activity-GoPA! physical activity policy inventory;
4. Present the preliminary findings and lessons learned after 1-year implementation of the Global Observatory for Physical Activity-GoPA! physical activity policy inventory.

Abstract

Issue/problem: Physical inactivity is one of the most important factors contributing to global morbidity and mortality, but despite both importance and the recent launch of a WHO action plan, public health policy around physical activity remains poorly developed and monitored.

Description of the problem: Physical inactivity accounts for as many as 5 million deaths per year globally but has yet to be addressed effectively by most governments or the World Health Organization(WHO). Many efforts led by WHO, national governments, networks, and academics from the 1990s to the present have tried to turn physical activity into a public health priority. Since its launch in 2015, the Global Observatory for Physical Activity-GoPA! has monitored the progress of national physical activity surveillance, policy and research. The GoPA! Policy Inventory created in 2017, contributes to physical activity policy monitoring and aims to collect data worldwide.

Results: In this symposium we will address several key questions about physical activity policy by examining different initiatives such as GAPPA and the experience of monitoring policy globally with the GoPA! policy inventory. We will examine whether it is feasible to track physical activity policy at the global and country levels, if the existence of “good” physical activity policy is associated with less physical inactivity and how policy indicators may be used for advocacy and guidance in the coming years.

Lessons: Findings show that PA policy monitoring has and still varies substantially by geographic area and country income group. Effectiveness and implementation of PA policies remains challenging worldwide. PA policy indicators can enhance understanding of the links between policy and population levels of PA.

Main messages: GoPA! is committed to continue improving PA policy monitoring for informing and encouraging policy to address physical inactivity worldwide.

 

Agenda and Presenters

Introduction: Michael Pratt (10-minutes)

Talk 1: Developing and monitoring physical activity policy: 1990 to today – Michael Pratt (15-minutes)

Talk 2: Instruments for the analysis of national-level physical activity and sedentary behaviour policies: a systematic review – Željko Pedišić (15-minutes)

Talk 3: The GoPA! Policy Inventory: Progress and methods - Andrea Ramirez (15-minutes)

Talk 4: The GoPA! Policy Inventory: preliminary findings and lessons learned – Bojana Klepac (15-minutes)

Q&A from the audience

Conclusion by discussant Adrian Bauman (20-minutes)

Organizer Andrea Ramirez Varela, MD, MPH, Ph.D. Assistant professor School of Medicine, Universidad de los Andes, Colombia Steering Committee Member and Coordinator - Global Observatory for Physical Activity (GoPA!) aravamd@gmail.com Discussant: Adrian Bauman, MB BS MPH PhD FACSM FAFPHM FAHMS Emeritus Professor Professor of Public Health, Sydney School of Public Health University of Sydney Country Contact and Steering Committee Member - Global Observatory for Physical Activity (GoPA!) adrian.bauman@sydney.edu.au Chair: Michael Pratt, MD, MSPE, MPH Professor and Director, Institute for Public Health and MPH Program Department of Family Medicine and Public Health University of California San Diego School of Medicine Chair, Global Observatory for Physical Activity (GoPA!) mipratt@ucsd.edu

Background: Physical activity (PA) is associated with reduced risk of many noncommunicable diseases while a high volume of sedentary behavior (SB) is also considered to increase the risk of these diseases. Accurate measurement of both PA and SB is crucial for estimating these risk factors, and accelerometers together with standardized questionnaires are suggested a feasible way to measure these behaviors. However, collecting raw acceleration data of PA, SB and sleep in a standardized and similar way on a large scale has not been done before. In the European Union Physical Activity and Sport Monitoring System project (EUPASMOS), this has been done for the first time in 18 EU Member States.

Organizer: -Tommi Vasankari, Prof., MD, PhD, UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland (contact person fot this sympisium) Chairs: -Tommi Vasankari, Prof., MD, PhD, UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland -Paulo Rocha, PhD, Portuguese Institute for Sport and Youth, Lisbon, Portugal. Presenters: -Ellen de Hollander, National Institute for Public Health and the Environment, Centre for Nutrition, Prevention and Health Services, PO Box 1, 3720, BA Bilthoven, the Netherlands -Maarten Schipper, , National Institute for Public Health and the Environment, Centre for Nutrition, Prevention and Health Services, PO Box 1, 3720, BA Bilthoven, the Netherlands -Henri Vähä-Ypyä, UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland. -Pauliina Husu, UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500 Tampere, Finland Discussant: -If the symposium is accepted by organizers, we hope that a senior discussant or two will be nominated by organizers and contact person from the senior researchers that are going to take part to HEPA Europe 2020 conference (like Adrian Bauman, Pekka Oja, etc.).

Background:

Regular physical activity is associated with physiological and mental health benefits for adolescents including improved fitness and cardiometabolic health, increased muscle and bone strength and reduced risk of obesity. Despite this, globally, many adolescents (81%) fail to meet physical activity guidelines. Physical activity levels decline as children move into adolescence and through to adulthood and may affect the likelihood of developing chronic health conditions. It is recognised that parental support and friendship networks play an important role in attenuating declines in physical activity during adolescence and it is vital that we develop effective interventions to help adolescents stay active.

 

Aim:

This symposium will engage policymakers, professionals, scientists and stakeholders to discuss research projects on Engaging peers, parents and pupils to increase physical activity among adolescents. The goals of this symposium are to highlight the challenges and ongoing work to address sub-optimal levels of physical activity in this population and disseminate the results of novel physical activity interventions to develop knowledge and understanding. This symposium will share experiences, learning and best practice in Patient and Public Involvement (PPI), transitioning from formative research to feasibility testing and upscaling interventions and it will also allow for debate and to identify gaps and priority areas for physical activity among adolescents.

 

Symposia presentations:

 1.    Putting young people at the heart of physical activity research design: The Walking In ScHools (WISH) Study (Dr Maria O’Kane, Ulster University)

This presentation will outline the importance of youth PPI and demonstrate how PPI can be embedded within research design using the WISH Study Youth Advisory Group as a case study.

2.    GAP: The Girls Active Project (Sara McQuinn, Dublin City University)

This presentation will discuss the barriers and facilitators for physical activity in adolescents and outline how the behaviour change wheel provided a framework for developing the Girls Active Project.

3.    Supporting our lifelong engagement: mothers and teens exercising (SOLE MATES); from formative research to feasibility testing (Dr Elaine Murtagh, Mary Immaculate College)

Dr Murtagh will discuss the value of formative research in developing interventions and present findings from a novel mother-daughter multi-component physical activity programme.

4.    Exploring correlates of adolescent boys’ muscular fitness: a mixed-methods formative study (Ashley Cox, Edge Hill University)

This presentation will describe a mixed-methods formative study conducted to inform the development of a school-based intervention to promote muscular fitness among adolescent boys.

5.    The Walking In ScHools (WISH) Study: Development and evaluation of a peer-led school-based walking intervention in adolescent girls from pilot to fully-powered trial (Dr Angela Carlin, Ulster University)

Dr Carlin will describe how the WISH pilot study guided the development of a full trial to evaluate the effects of a peer-led walking intervention on increasing physical activity in adolescent girls. 

Organiser: Dr Maria O’Kane, Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, Ulster University, m.okane@ulster.ac.uk, +44 28 7167 5519 Discussant: Prof Marie Murphy, Centre for Exercise Medicine, Physical Activity and Health, Sports and Exercise Sciences Research Institute, Ulster University, mh.murphy@ulster.ac.uk, +44 28 9036 6669 Chair: Prof Alison Gallagher, Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, am.gallagher@ulster.ac.uk, +44 28 7012 3178

The symposium present last findings on health promotion interventions in sports clubs. After a short introduction about the health promoting sports clubs (HPSC), five presentations (France, Sweden, Ireland, Finland and Netherlands) will reflect upon how sports clubs can be health promoting: in theory, from youth perspectives, by increasing physical activity level as outcome or enhancing sustainability of interventions, before opening the discussion with academic experts. Presentation 1 describes an iterative international process, implicating three groups (French sport students, French and Swedish experts) to create an intervention theory, based on the HPSC model. Presentation 2 focuses on a cross-sectional study investigating 123 Swedish youth’s representation of sports clubs’ role towards health promotion, identifying social dimension, environment, coaches, amount and ambition of practice as key factors. Presentation 3 is a longitudinal study among 366 adolescents, followed from age 15 to age 19, questioning the participation to organised sport practice and their orientation (leisure or competitive). Results have shown that by the age of 19, 33% of boys and 43% of girls have dropped out of organised sport, where 45% of boys and 26% of girls continued participation. Adolescents with a competitive goal orientation were more likely to continue participation. Presentation 4 is a longitudinal study among 131 youth measuring objective physical activity before and in the middle of a sport season. Principal results showed a significant change across time point, as well as differences between gender (a decrease in moderate to vigorous physical activity during games for boys and an increase for girls). Presentation 5 examined factors that influenced the sustainability of 14 Dutch sporting program aimed at increasing physical activity among inactive people 6.5 years after their implementation. Interviews with representatives of Dutch National Sports Federations and sports clubs helped to identify facilitating and impeding factors, like program adaptation, evaluation, financing and factors related to human resources. Question and Answer will be organised around the key ingredients and challenges facing the development of HPSC interventions, such as implementation of theoretical background, sport participants need consideration, complexity of outcomes evaluation of HPSC and program sustainability.

This symposium is organised by the health promoting sports clubs (former sports clubs for health) working group, led by Aurélie Van Hoye and Susanna Geidne. The presenters are Stacey Johnson, Susanna Geidne, Katja Rinta-Antila, Kevin Gavin and Linda Ooms. The discussants are Sami Kokko and Jan Seghers. Aurélie Van Hoye contact information are : Aurélie Van Hoye Maître de Conférences Faculté du Sport - U.F.R. STAPS Université de Lorraine 30 rue du Jardin Botanique CS 30156 54600 Villers-lès-Nancy Tel: 0033 (0)3 72 74 67 42 Portable: 0033 (0)6 71 08 08 76 https://www.researchgate.net/profile/Aurelie_Van_Hoye email: aurelie.van-hoye@univ-lorraine.fr

A central problem of current efforts to promote health and physical activity (PA) is that many successful projects remain stuck in the demonstration phase and are not implemented successfully at scale. The use of participatory and/or co-creation approaches has been suggested to avoid this “pilot project trap” and better adapt interventions to target group needs and setting specificities.

This symposium intends to introduce to an international audience a particular participatory concept that has become increasingly popular in PA promotion in Germany in recent years: The Cooperative Planning approach has been successfully used in sport facility planning, local and regional PA policy development, and various settings of PA promotion (incl. kindergartens, schools, vocational training, and communities). The workshop will shed light on the theoretical background and methodology of Cooperative Planning as well as its specific application in select settings.  

The first presentation will introduce the concept of Cooperative Planning, outline potential areas of application, and compare it with other popular participatory and co-creation approaches in PA promotion. Following this, we will provide evidence from ongoing projects employing the approach to promote PA in kindergartens (Presentation 2) and in the community setting (Presentation 3). Presentation 4 will introduce an example from the retirement home setting and also highlight ways of combining Cooperative Planning with other approaches such as photovoice and participatory evaluation. The final presentation will provide an outlook on the future extension of the concept by introducing the idea of the Practice Dive, which may be used to further optimize knowledge co-creation between researchers and practitioners. 

A closer look at the Cooperative Planning approach is both timely and relevant for an international audience for a number of reasons: Conceptually, Cooperative Planning is a theory-based framework that combines ideas ofparticipation and co-creation for PA into an innovative whole-of-system approach. From a practical PA promotion perspective, it transcends many existing techniques by focusing both on engaging multipliers and members of the target group, and by involving all of them in the decisive intervention development process (e.g. rather than only via opinion polls or focus groups). This symposium will allow us to combine evidence from four different projects, highlighting both the specificities of working in different settings as well as different aspects and possible extensions of the Cooperative Planning approach. 

Presentation 1: The cooperative planning approach in physical activity promotion: Theoretical foundation, classification and key elements (P. Gelius, R. Sommer, S. Ferschl, M. Till, A. Frahsa, K. Abu-Omar) Presentation 2: Cooperative planning with coaching elements in childcare centres: a qualitative investigation of childcare directors’ perspectives (C. Müller, H. Hassel) Presentation 3: Implementation of Community-Based Physical Activity Promotion Focusing on Individuals with Social Disadvantages, Developed Using a Participatory Approach (J. Semrau, N. Helsper, S. Kohler, L. Dippon, K. Abu-Omar, K. Pfeifer, A. Rütten) Presentation 4: Participatory physical activity promotion in senior residencies (D. Altmeier, A. Thiel, A. Frahsa) Presentation 5: Extending co-creation in physical activity and health promotion: The Practice Dive approach (J. Popp, J. Carl, E. Grüne, K. Pfeifer) Symposium organizer/chair: Dr. Peter Gelius Department of Sport Science and Sport FAU Erlangen-Nürnberg Gebbertstr. 123b 91058 Erlangen, GERMANY e-mail: peter.gelius@fau.de Discussant: PD Dr. Karim Abu-Omar Department of Sport Science and Sport FAU Erlangen-Nürnberg Gebbertstr. 123b 91058 Erlangen, GERMANY e-mail: karim.abu-omar@fau.de

The UN Sustainable Development Goals’ (https://sustainabledevelopment.un.org/) and the Global Action Plan on Physical Activity (https://www.who.int/ncds/prevention/physical-activity/gappa) highlight the need to move beyond individual behaviour change to broader policy and system approaches, focusing not only on health but also on sustainability. Recently policy responses to the epidemics of physical inactivity and sedentary behaviour have grown. The Global Observatory for Physical Activity (GoPA) reports that by 2013, 139 countries were members of its physical activity advocacy alliance and 26.6% of these countries had already published a stand-alone physical activity plan. The ‘Policy Evaluation Network’ is a multi-disciplinary European research network aimed at understanding the impact of public policy for promoting healthy lifestyles in an effort to prevent non-communicable disease. To understand the progress governments are making in creating healthy policy environments, the benchmarking of best practice has proven effective for advancing the food policy agenda; however its usefulness for physical activity requires evaluation. Individual country results promote mutual learning between countries. This symposium will take a deep look at public policy in physical activity. It will summarise evidence from systematic literature reviews and present a tool for benchmarking progress. It will also discuss the potential next steps for addressing the inactivity, obesity and climate challenges through policy solutions in a systematic way. The Chair will give an overview of context within which this symposium takes place e.g. GAPPA, Policy developments etc. They will also explain the symposium’s purpose and objectives, introduce the speakers and direct questions. Symposium Objectives: 1. To review evidence for the contribution of transport, sport and mass media policy to the promotion of physical activity. 2. To show how evidence generate in each of these reviews contributed to the development of the physical activity environment policy index (PA-EPI). 3. To discuss the next steps for addressing inactivity by using policy intervention as a tool to catalyse change. Abstract 1: Which transport policies increase physical activity of the whole of society? A Systematic Review. Abstract 2: The impact of mass-media campaigns on physical activity: a review of reviews through a policy lens. Abstract 3: Evidence of the impact of Sport Policies on physical activity and sport participation: A Systematic Mixed Studies Review. Abstract 4: The development of the Physical Activity Environment Policy Index (PA-EPI): a tool for monitoring and benchmarking government policies and actions to improve physical activity. The Discussant summarizes the presentations and provides insights on the specific topic area, generating an interactive discussion with the audience for at least 15 minutes, moderated by the Chair. (15 minutes) Conclusions: Some discussion of the possible contribution to, or implications for, the advancement of HEPA related goals.

Organizer: Prof. Catherine Woods, Catherine.Woods@ul.ie, Physical Activity for Health Research Cluster, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick. Discussant: Dr. Jeroen Lakerveld, Amsterdam UMC, VU University Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health research institute, De Boelelaan 1089a, Amsterdam, the Netherlands. Chair: Dr. Peter Gelius, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.

As a major risk for non-communicable diseases (NCDs), one of the most prominent challenges in public health is physical inactivity. The purpose of this symposium is to provide an overview about the burden of physical inactivity over the course of life. The World Health Organization coordinates three key surveillance initiatives that collect nationally representative data on physical activity prevalence and related behaviours that enable inter-country comparisons. Disbursed over five presentations, this session facilitate the discussion of the results from three surveillance initiatives as well as good practices examples of moving from data collection to policy action.

The WHO/European Childhood Obesity Surveillance Initiative (COSI) is the largest such survey in the world. This initiative, which was founded in 2007, collects nationally representative data from over 40 countries in the WHO European Region. The COSI survey collects valuable information about childhood physical activity (PA) patterns among children ages six to nine years. The information is collected by parent report and includes information such as the child’s participation in extracurricular PA, membership in sports clubs and active transport to school. An overview of results from the most recent round of COSI will be presented focusing on prevalence estimates for a wide range of PA indicators, and highlighting important differences between countries. There will also be a focus on important socioeconomic differences in physical activity levels among children and a discussion of how the relationship between socioeconomic variables and PA levels among children may vary between countries.

Monitoring physical activity during adolescence is important as there is evidence as this period is crucial to establishing life-long PA habits. The Health Behaviour in School-aged Children (HBSC) survey has been a pioneer cross-national study for over 30 years and is established in 49 countries. Recent trends in PA and sedentary behaviour of boys and girls, aged 11, 13 and 15 years will be discussed including the alarming decline in PA levels through adolescence across Europe. As a fundamental prerequisite for healthy growth and establishing healthy behaviour lifestyles for later life, focused efforts are required to reverse the current trend. There is need for a multisectorial approach, across countries and with stakeholders to enable a lifestyle that incorporates regular PA.

The state of prevalence of physical inactivity in adulthood, results of the WHO’s STEPwise approach to surveillance (STEPS) in Europe will be presented. This flexible instrument uses three different steps in order to obtain valuable data on the established risk factors that determine major NCDs burden among adults.

João Breda; Head of the WHO European Office for NCDs, 9 Leontyevsky pereulok 125009; Russia; e- mail: rodriguesdasilvabred@who.int; phone: +7 4957872108 Julianne Williams; Technical Officer; World Health Organization Office for NCDs, 9 Leontyevsky pereulok 125009; Russia; e- mail: williamsj@who.int; phone: +7 4957872108 Ana Rito; Principal Investigator – Portugal, National Institute of Health Dr. Ricardo Jorge, Food and Nutrition Department, Lisboa, Portugal, ana.rito@insa.min-saude.pt Martin Weber; Program Manager, Child and Adolescent Health; WHO Regional Office for Europe, Marmorvej 51, 2100, Denmark; e- mail: weberm@euro.who.int; phone: +45 45 33 70 00 Ivo Rakovac; Programme Manager – NCD Surveillance, World Health Organization Office for NCDs, 9 Leontyevsky pereulok 125009; Russia; e- mail: rakovaci@who.int ; phone: +7 4957872108 Stephen Whiting; Technical Officer; World Health Organization Office for NCDs, 9 Leontyevsky pereulok 125009; Russia; e- mail: whitings@who.int; phone: +7 4957872108

Issue/problem:

Mental ill health affects approximately 1 in 4 people at some point in their lives (Rosenbaum et al., 2015). In the EU, it is estimated that metal disorders affect more than a third of the population each year, with anxiety and depression being the most common disorders (World Health Organisation, 2015).

Physical activity has an established evidence base for the treatment, maintenance and promotion of mental health problems (Rosenbaum et al., 2015; Firth et al., 2016), and an international consensus statement supports its use in both clinical and population-based settings (Rosenbaum et al., 2018). However, practical guidelines for health professionals and exercise practitioners are scarce in the available literature.

Description of the problem:

SPHERE (Sport Healing Rehabilitation; 2019-2020 http://www.ecos-europe.com/sphere/erasmus-project/) is a collaborative project with partners from psychiatry, academia, physical activity promotion, and third sector sports organisations, from seven EU countries. To support the use of physical activity for mental health promotion, a critical review of evidence was conduct and guidelines for practice were developed. Furthermore, using an online survey, an online map presenting examples of physical activity programmes for mental health rehabilitation from across the EU was created. 

Results (effects/changes):

This presentation will outline the developed guidelines for physical activity use to promote mental health. Guidelines include 17 recommendations relating to physiological, psychological and social dimensions of mental health rehabilitation. The project includes  case studies from England, Italy, Croatia and Germany which will be briefly presented with an in-depth case study of the Finland based pilot project presented to demonstrate how guidelines have been used for the development of an evidence based physical activity intervention. The symposium will demonstrate practical, evidence based guidelines for use for practioners and evaluators which can be used to support this growing health concern in the EU.

Lessons:

To support mental health rehabilitation using physical activity, guidelines for practice must be flexible to allow for individual differences and preferences, settings (clinical or community), and facility and equipment availability.

Main messages:

Physical activity is widely understood to have an important role in the lives of people with mental health problems for both the promotion and maintenance of mental health and for other co-morbidities such as obesity, inactivity and coronary vascular disease risk. These guidelines and examples of case studies from across the EU provide practical and pragmatic recommendations that can be used to inform the provision of physical activity for people with mental health problems.

Chair: Diane, Crone; Professor; Cardiff Metropolitan University, Cyncoed Campus, Cardiff, CF23 6XD, dmcrone@cardiffmet.ac.uk; +44(0)2920417092. Discussant/presenters: 1. Diane Crone, Professor; Cardiff Metropolitan University, Cyncoed Campus, Cardiff, CF23 6XD, dmcrone@cardiffmet.ac.uk; +44(0)2920417092. 2. Fernando, Cross; Research Associate, Technical University Munich, Georg-Brauchle-Ring 60/62 D-80992 München, fernando.cross@tum.de, +49 89 289-24553. 3. Sampsa, Kivisto; Physical Activity Lead, Finish Sport Federation, Tampere, Finland.

Policymakers often lack the evidence to drive change and improve the lives of citizens through physical activity. This symposium will discuss how two unique global programs, ‘Active Citizens Worldwide’ (ACW) and ‘Sport Impacts: Children’ (SIC), have bridged the gap between academia and policymakers. Combining advanced data analytics, the latest in health, social and economic research and global benchmarking these programs have delivered unique insights on the drivers and outcomes of physical activity.

ACW is a city-based programme formed through a collaboration of 4 cities: London, Stockholm, Singapore and Auckland. The project uses advanced analytics on large datasets covering entire cities to inform policymakers’ efforts to enhance participation levels, and to calculate the monetary and non-monetary value that sport and physical activity has on society. Previously unrelated datasets have been integrated to provide completely new analytical insights on the true drivers of the complex physical activity system including facility access, and mindsets and motivations.This is combined with systematic modelling of the broad range of outputs and outcomes of physical activity including health, social, and economic benefits.This standardisation in modelling approach and analysis has enabled multiple cities to compare, benchmark and learn from each other. ACW ultimately enables cities to understand what is working and what is not in their city, and thereby design policies with the best chance of improving their city’s health, wealth and wellbeing.

Using a similar approach, the SIC initiative is a unique cross-sectorial collaboration between top national sports bodies, charities and academics in England. Through this partnership each organisation shared national participation, workforce and facility databases as well as recent primary research, which was analysed and modelled to give a holistic overview of the drivers and outcomes of childhood participation in sport. This analysis shows that the access to and benefits of sport and physical activity is not equal between different demographic groups. Preliminary findings have also indicated which type of sports and activities contribute the most value to children and their communities. This has led to the creation of a strong evidence base of the social and economic impact of childhood physical activity and sport in England, which is already being used by sport bodies and policymakers to re-evaluate their approaches to childhood participation.

These programs illustrate how a collaborative approach using data and analytics has connected research with policy and practice and lead to substantial impacts in countries around the world.

Organizer and speaker: Elena Portas, Senior Health Specialist, Portas Consulting 44 Southampton Buildings, Holborn, London, WC2A 1AP England ep@portasconsulting.com +44 7772 185067 Chair: Charlie Cowen, Partner Portas Consulting 44 Southampton Buildings, Holborn, London, WC2A 1AP England ccowen@portasconsulting.com +44 7384 119228 Speaker: Chris Scott, London Sport House of Sport, 190 Great Dover St, London SE1 4YB England chris.scott@londonsport.co.uk +44 7498 753851 Speaker: Lottie Birdsall-Strong, The Football Association England Wembley Stadium, 1 New Union Square, London HA9 0WS England Lottie.strong@thefa.com +44 7816 219303

There are more than 60 million sports club members in the EU, which makes sports clubs an organizational settings with a huge potential for health promotion. The Sports Club for Health (SCforH) initiative started in 2008, to assist sports clubs in promoting health-enhancing physical activity. In support of this endeavour, SCforH guidelines were issued in 2011 and updated in 2017. The SCforH initiative has been supported by three large European Union grants and included partner organisations from 18 countries. In 2013, the Council of the European Union proposed the national implementation of SCforH guidelines as one of the 23 indicators for evaluation of HEPA levels and policies in the European Union member states. Recently, the European Commission recognised the SCforH initiative as a “success story” and an example of good practice. The aim of this symposium is to summarize recent evidence relevant to the promotion of health-enhancing physical activity through sports clubs in the EU and to discuss about future directions and challenges for EU public health efforts in this area. The symposium will include five 10-minute presentations on: [i] the findings of an updated systematic review on health benefits of different sport disciplines; [ii] Hungarian implementation of a SCforH intervention; [iii] the effectiveness of a coordinated action between the healthcare sector and local sports clubs to promote physical activity; [iv]; tracking participants in Jackpot.fit program—an Austrian sport promotion initiative; and [v] the development of a SCforH online learning tool. The symposium program will also include: Introduction by Chair (5 minutes), 25 minutes of Q&A, and conclusion by Discussant (10 minutes).

Organisers: Title: Associate Professor First name: Zeljko Last name: Pedisic Institution: Institute for Health and Sport, Victoria University Address: PO Box 14428, Melbourne, Victoria Postal code: 8001 Country: Australia Email: zeljko.pedisic@vu.edu.au Title: Professor First name: Sylvia Last name: Titze Institution: University of Graz, Institute of Sport Science Address: Mozartgasse 14, Graz Postal code: 8010 Country: Austria Email: sylvia.titze@uni-graz.at Chair: Title: Associate Professor First name: Zeljko Last name: Pedisic Institution: Institute for Health and Sport, Victoria University Address: PO Box 14428, Melbourne, Victoria Postal code: 8001 Country: Australia Discussant: Title: Dr First name: Karen Last name: Milton Institution: Norwich Medical School, University of East Anglia Address: Norwich Postal code: NR4 7TJ Country: United Kingdom Email: k.milton@uea.ac.uk

Background: “Sit less–move more” has been a common advice to improve health of adults. Research indicates that this advice might be health enhancing among adults with sedentary occupations but not among adults with physically active occupations such as cleaners. This may be explained by the considerable differences in 24-h physical behaviors between adults in sedentary and physically active occupations. To provide a scientific approach and encourage research on 24-h physical behaviors and health for those in physically active occupations, we recently proposed the “Sweet-Spot Hypothesis.” The hypothesis postulated that the “Sweet-Spot” of 24-h physical behaviors for better health differs between adults, depending on their occupation. 

Methods: To exemplify such hypothesis, we tested the cross-sectional association between 24-hour time composition of physical behaviors measured using thigh-based accelerometry and self-rated health among adults engaged in white-collar (n=136), manufacturing (n=481) and cleaning (n=130) occupations. 

Results: We found that the sweet spot of 24-h physical behaviors for better health was far from “sit less-move more” zone among adults with physically active occupations. Specifically, among white-collar workers, 24-h physical behavior distribution associated with the best 5% of self-rated health comprised about 30% of the day spent on sedentary behavior, 45% spent actively, and 25% spent on sleep. However, among cleaners, this distribution was about 50% spent sedentary, 15% spent actively, and 35% on sleep and in manufacturing sector, this distribution was about 35% spent sedentary, 35% spent actively, and 30% spent on sleep. 

Conclusion: The advice “sit less–move more” may not bring adults in physically active occupations toward their “Sweet-Spot” of 24-h physical behaviors for better health. To promote health for all and reduce social gradient, we see a great need for empirically testing the “Sweet-Spot Hypothesis” with high-quality data and strong study design. We hope that the proposal of testing “Sweet-Spot Hypothesis” will encourage discussion, debates, and empirical research to expand our collective knowledge about the healthy “24-h physical behavior balance” for all.

There is strong and consistent evidence that leisure-time physical activity (LTPA) improves cardiovascular health and reduces the risk of all-cause and cardiovascular mortality. Less is known about health effects of occupational physical activity (OPA), and results are not in favor of a beneficial effect on cardiovascular health. Several large-scale prospective studies have found that high occupational physical activity (OPA) is associated with detrimental or no effects on cardiovascular health and mortality. These contrasting associations with cardiovascular morbidity and mortality for LTPA and OPA have coined “The Physical activity health paradox”. Although the underlying physiological mechanisms are not established, a theoretical framework was proposed by Holtermann and colleagues (2018). This framework suggests that due to the nature of OPA (i.e. low intensity, long duration, constrained postures, and limited recovery), it may not result in healthy adaptation to the same extent as LTPA, or even lead to unhealthy responses, such as elevated 24-hour heart rate and blood pressure and increased inflammation. Drawing on theoretical models and empirical findings, the aim is to summarize the literature regarding potential physiological mediators of the physical activity health paradox. This also includes a brief summary of our own research based on accelerometer measurements of physical activity with cardiovascular regulation assessed by heart rate and blood pressure in workers with low occupational class and manual work.

Background: Frailty is a common and clinically significant multi-dimensional syndrome associated with adverse health outcomes such as hospitalisation, disability, and mortality among older adults. Physical activity interventions have been shown to be effective in the prevention and treatment of functional decline and frailty, with strength training protocols reporting improvements in mobility, balance, preservation of muscle function and independence. Due to the trial’s exploratory and feasibility design a small sample was used to investigate the acceptability and practicality in long term care. This includes addressing the HEPA priority of improving the health and well-being of people with chronic conditions and/or frailty.

Methods: Eleven older adults (aged >65 years) were randomised to the intervention or wait-list control. A 6-week strength training protocol for 35 mins 3x/week used resistance machines, specially designed for older adults, in a residential care home. Mixed methods were used to assess the feasibility and acceptability of the intervention and research measures and indicate meaningful differences in outcomes. Feasibility was measured through adherence statistics and focus groups/interviews with staff and participants. Pre- and post-intervention levels are given as descriptive statistics for physiological, psychosocial, cognitive, and functional measures. Intervention effect is illustrated through mean difference (95% Confidence Intervals) pre- to post-intervention in the intervention group.

 Results: Intervention group (n=6) adherence was 98.9%. Interviews revealed participants and staff found the measures and intervention acceptable, practicable and beneficial. Mean differences pre- to post-intervention indicated meaningful clinical difference in measures of strength, functional capacity and frailty. Psychosocial variables (stress, depression, social support), immunological measures, cognition and Activities of Daily Living Scores did not show meaningful change.

Conclusion: A strength training intervention protocol for frail care home residents was beneficial, with findings supporting a future randomised controlled trial. High adherence and clinically meaningful differences for frailty and physical function support the use of such interventions to improve multi-dimensional health, maintain functional capacity and independence, and enhance social participation in frail older adults. This study and further research may help inform practical physical activity initiatives for frail older adults, and support strategies prioritising health and well-being, and the prevention of functional decline and frailty.

Background: Global research shows a strong link between physical activity and risk of developing non-communicable diseases. To increase physical activity levels, governments must design and implement a comprehensive set of policy actions across a range of areas. To aid governments in this process, the MOVING benchmarking tool was developed to assess the design and strength of countries’ policies in promoting physical activity, as well as gaps in policy action. 

Methods: The MOVING benchmarking tool was developed using a consultative process that reviewed evidence on physical activity policy design, existing benchmarking tools and built on the policy areas of the MOVING framework. The tool values the strength of policy design based on policy attributes that are evidence-based and aspirational – regardless of whether any countries have implemented them. The tool was applied to a set of physical activity policies from five countries participating in “CO-CREATE”, a European Commission-funded project: Netherlands, Norway, Poland, Portugal and UK. Physical activity policies that are currently implemented in these countries were identified based on a comprehensive country scan, with a set methodology. A set of policies from each country corresponding to benchmarks on access to quality public open space and green spaces and community and mass participation initiatives were analysed.  The policies were assessed by applying the benchmark corresponding to the relevant policy area

Results: The benchmarking tools easily identified the strengths and weaknesses in the design of each policy. Thus, the benchmarking tool identified where there was scope for improvement in specific policy area for each country, such as walking and cycling infrastructure and active transport. It also allowed comparisons between countries for specific policy areas. Further, by allowing a fast assessment of many physical activity policies, the benchmarking tool enabled an analysis of the interplay of single policies and draw conclusions about the overall policy environment in the selected countries. 

Conclusion:  The MOVING benchmarking tool can inform the development and implementation of policies which promote physical activity. It can be used by government policy-makers, researchers and civil society organisations to identify areas of physical activity policy that require government action. The scores generated by the benchmarking tool will be amalgamated into an overall policy index for 27 European countries.

Background

Systems approaches have been used in recent years in addressing complex public health problems such as obesity and physical inactivity. Depicting these ‘wicked’ problems through systems maps has helped system actors better understand the entire systems in which these problems exist. Like physical activity (PA) promotion, there are multiple sectors and organisations who have a stake in the promotion of walking. However, their efforts are seldom combined, and stakeholders often work in conceptual silos when tackling the same problem. Walking has been described as a ‘best buy’ for public health (Bull and Hardman, 2018). However, walking promotion requires efforts across the entire ecosystem if population-level PA goals are to be reached. The purpose of this study is to generate a systems map of the factors that influence walking in Cork.

Methods

Participants of the workshops all work in Cork, Ireland. Participants remotely attended two online Zoom workshops to develop the systems map. The Australian Systems Map for Physical Activity (Bellew et al., 2020) was used as a framework in the development of the map. Semi-structured interviews (n=5) were used to supplement the online workshops. A third online workshop is planned for October 2020 to discuss identified interventions. 

Outcomes

The systems map provided stakeholders with a new perspective on the complexities of the system and provided a platform to network with organisations outside of their sectors. Semi-structured interviews helped identify barriers and facilitators to working collaboratively and explored the political and commercial environment of the system. Furthermore, 19 potential interventions were identified from the workshop discussions. A selection of these will be discussed in detail in a third workshop in October 2020.

Conclusions

The systems map alone will not increase walking levels across the entire system. However, it will provide stakeholders with a common visual language of the structure of the system. Thus, enabling them to identify where they sit within the system and potential leverage points they can influence. Furthermore, understanding the entire ecosystem of walking in Cork through a systems map may prove useful in other contexts when approaching the complex problem of population-level walking promotion.

Background: Among adolescents there is a notable decline in physical activity (PA) levels from childhood, more notable among females than males. Visibility is regularly a cornerstone of strategy to promote engagement with women’s sport particularly around stimulating and sustaining female participation in sport and PA. This includes leveraging sporting role models (SRM) to develop participation in sport and PA. The purpose of this research is to locate and describe the features and impact of SRM led interventions on female participation in sport and PA. Methods: APA PsychInfo, PudMed, and Sport Discus databases was used to identify SRM led interventions. In sum, 7,169 papers were identified with 360 duplicates. A further 5,122 were removed from title screen, 1,666 from abstract screening, 21 from full text review with two studies included in the final review. Results: Two SRM led interventions were included in the final review and were deemed as ‘fair’ quality using Black and Downs Checklist. The first study1 aimed to improve attendance in PE, behaviour and attitude towards PA through a 12-week school based intervention. Schools were funded to complete a novel sport rolled out by teachers (group 1), with a second group having an additional visit from an elite ‘athlete mentor’ (group 2). The study found 98% of students enjoyed the athlete visits and found them beneficial however there was no additional impact on PE attendance and attitudes to PA linked to athlete visits. The second study2 involved school students visiting a local professional football club and meeting professional football players through video messages and letters over a four-month school period. The intervention group showed a significant increase in self-efficacy towards PA compared to the control group. Conclusion: There is limited, if any, evidence to support SRM led interventions to promote participation in sport or PA. Studies considered in this review are poorly designed and evaluated and lack theoretical frameworks. There is scope to undertake a broader review of grey literature due to the scarcity of published evidence despite anecdotal support and implementation of SRM interventions throughout the sport sector. 1 ARMOUR, K. & DUNCOMBE, R. 2012. Changing lives? Critical evaluation of a school-based athlete role model intervention. Sport, Education and Society, 17, 381-403. 2 DUBUY, V., DE COCKER, K., DE BOURDEAUDHUIJ, I., MAES, L., SEGHERS, J., LEFEVRE, J., DE MARTELAER, K., BROOKE, H. & CARDON, G. 2014. Evaluation of a real world intervention using professional football players to promote a healthy diet and physical activity in children and adolescents from a lower socio-economic background: a controlled pretest-posttest design. BMC Public Health, 14, 1-9.

Background: The intricacies of cross sector partnerships regarding what may help and what may hinder collaboration and partnerships in the short- or long-term remain largely unknown. The 2018 Global Action Plan for Physical Activity promotes whole-system collaborative approaches and our review contributes to our understanding of the management of cross-sector partnerships and collaborations promoting physical activity.

Methods: We searched Medline, Embase, PsychINFO, ProQuest Central, SCOPUS and SPORTDiscus to identify published records dating from 1986 to August 2021. Public health interventions using a partnership approach were included, if at least two partners were not from the same sector and their shared goal was to promote or increase population-level physical activity. Eligibility also required records to include information about the context and the barriers and/or facilitators of the partners of the reported cross-sector partnerships. The CASP checklist and the ROBINS-I tool were used to appraise the included records and thematic analysis to summarise and synthesise the findings. Due to the small number of eligible quantitative studies, the study focused on qualitative findings relating to the parameters set out for this systematic review.

Results: The study included records (n = 32) that described public health interventions or programs aiming to promote physical activity, community sport or active living through cross-sector partnerhips, as part of qualitative (n = 19), quantitative (n = 1) or mixed methods (n = 12) research. The review identified barriers, facilitators and recommendations to overcome common challenges in relation to four broad themes: approaching and selecting partners, funding, building capacity and taking joint action.

Conclusion: Partners are often urged to collaborate under the limits of time and resources. Agreeing on expectations, gaining momentum and establishing trust requires time and resources early on, before any intervention output can be evidenced. Therefore, investment in the early stages may remove key barriers of partnerships and accelerate joint leadership. Boundary spanners linking sectors, translating differences and consolidating common ground can facilitate whole-systems approaches.

Background:

With the first initiatives dating back to the 1990s, the past two decades have seen a rapid increase in the use of exercise referral schemes (ERS) worldwide. Despite the accumulating evidence on their effectiveness, there are currently no international guidelines available to inform the design of such interventions. The key elements and processes employed vary both within and between countries. This systematic review aims to address this frequently overlooked topic by identifying elements that are predominant in international ERS.

Methods:

Scientific databases (PubMed, Scopus) and grey literature sources were systematically searched. In order to collect the information relevant for understanding and visualizing all ERS models, a broad spectrum of document types was considered eligible for inclusion, i.e. randomized controlled or pragmatic trials, cohort studies, case-control studies, case series, case reports, qualitative studies, economic evaluations, mixed designs, policy documents, and official governmental reports. We extracted data on scheme components, contents, and main actors involved in scheme delivery. Cross-functional flowcharts were employed to facilitate comparison between different ERS designs: Firstly, the collected data were visualized in flowcharts indicating the pathway a patient follows from beginning to end of an individual ERS. Secondly, elements that appeared more frequently across all included ERS were identified.

Results:

Preliminary results identified 18 models of ERS that were eligible for data analysis, including Green Prescription (New Zealand), Hreyfiseðill (Iceland), National Exercise Referral Scheme (Wales). Program designs ranged from short advice by a primary healthcare professional to physical activity prescription and/or further referral to affiliated health professionals. The prevailing actors involved in scheme delivery were physicians, nurses, physiotherapists, training experts, physical activity providers, and coordinators. Seven predominant elements emerged from the comparison between ERS designs: assessment, counselling, individualized physical activity recommendations, written prescription, behavior change techniques, support person, and follow-up.

Conclusions:

To the best of our knowledge, this is the first study that takes a closer look at the design characteristics of ERS across the world. Our preliminary results indicate that there are seven key elements. The contribution of these elements on the effectiveness of ERS needs to be explored in future research.

Background

The effectiveness of technology-based physical activity interventions (TbPAI) has recently been shown for obese women (Cotie et al., 2018). However, the acceptability of TbPAI has often been considered through the measure of satisfaction, and not through the theoretical concepts of acceptability. To our knowledge, TbPAI acceptability has never been explored in bariatric surgery. The purpose of this study was to explore in-depth the facilitators of and barriers to TbPAI acceptability according to the theoretical concepts of the UTAUT2 model (Venkatesh et al., 2012).

Methods

Twenty-six women with a mean age of 32.9 (SD=5.5) and a BMI of 30.1 (SD=6.5) were interviewed at least 6 months after bariatric surgery. Participants were selected in a panel of obese women who completed measures of acceptability (Hayotte et al., 2020) for each TbPAI, and expressed preference in using at least one of the technologies (10 active video games, 10 mobile application, 6 videoconferencing). Interviews were audio-recorded, transcribed verbatim, and analysed using thematic content analysis. Ethical approval was gained by local committee, and informed consent were obtained from the participants before data collection.

Results

Autonomy, monitoring and feedback were identified as facilitators of mobile application acceptability. Lack of external regulation was perceived as a barrier. Regarding the acceptability of active video games, the playful dimension was perceived as a facilitator, despite several participants showing resistance to any game experience. For videoconferencing, individualization of practice was perceived as a facilitator, whereas appointment constraints were seen as a barrier.

Conclusions

These preliminary results highlighted areas to be considered for the dissemination of these TbPAI in a healthcare setting. These results will also help to better individualize TbPAI counselling according to the barriers and facilitators identified.

Elderly’s sustainable engagement in an active lifestyle is a complex phenomenon, implying a plurality of physical, psychological and environmental barriers and facilitators. One of the key factors limiting physical activity (PA) in rural area is the lack of accessibility to PA offers. The use of videoconferencing is a promising solution in terms of acceptability and efficiency to promote PA. However, the acceptability (initial stage of the technology adoption process) of the videoconferencing is still underexplored, as well as its role in promoting PA in rural areas. The purpose of this study was to explore, through the perceptions of the elderly and policymakers, the mechanisms of acceptability of the development of PA interventions using videoconferencing for elderly living in rural areas.

Elderly (n=10) and policymakers (n=12) from 11 different rural town of the South of France participated in the study. Semi-structured individual interviews were conducted, where a video presentation of PA interventions using videoconferencing was played as support. The interview guide assessed the acceptability of this type of intervention through the following themes: (1) perceptions of benefits, (2) barriers, and (3) intentions of use.

Preliminary results showed shared perceptions between elderly and policymakers for barriers (e.g., lack of real social ties, lack of technological equipment) and benefits (e.g., breaking loneliness, overcome weather conditions). However, intentions of use are heterogeneous according to individual characteristics (e.g., "young" elderly between 60 to 65 years are more favourable to the use of technologies) and the specificity of towns (e.g., in the smallest towns with less than 500 people, elderly are less inclined to change their habits).

This study showed that the development of videoconferencing PA intervention could be accepted by elderly living in rural areas, taking into account some conditions (e.g., offer as punctual and non-regular use, set up individual support for the use of technology). Additional quantitative studies should be conducted for a more comprehensive understanding of the factors influencing the videoconferencing PA intervention acceptability in rural areas.

Background: Since youth’s participation rates in sport drop throughout adolescence, approaches to engage and retain this age group in physical activities are needed. Peers are highly influential on youth’s behaviour, and peer education is widely used for youth health promotion purposes to harness this peer influence. Peer education builds on the rationale that youth who share characteristics that identify them as peers will have increased credibility, identification, and role modelling in their interactions. However, it is often unclear how the rationales of peer education are activated in peer-led programmes. We therefore asked: How can peer leaders be supported in activating their ‘peerness’ in health promotion programmes?

Methods: The study was conducted in a non-profit organisation, GAME, where youth (age 16-25) are trained to lead street sport activities for younger children (age 8-15) in low resource neighbourhoods. The youth leaders were often locals and thus shared a peer relation with the participating children based on age and growing up in the same community. The empirical material consisted of learning objectives for GAME’s peer leader training programme and field notes from observations (approximately 54 hours) of the peer leader training. To explore educational content that can support the rationales of peer education, the qualitative analysis drew on contemporary interpretations of two forms of knowledge;techne (practical knowledge) and phronesis (practical wisdom), originally proposed by Aristotle.

Results: Techne was supported in training activities that prepared peer leaders for making decisions related to the implementation of street sport activities while taking contextual factors (e.g. the weather or the participants’ experience) into consideration. Phronesis was supported in training activities that encouraged peer leaders to reflect on their position and leadership approach and to support positive social relations among the participants. Training that supported phronesis encouraged experience-based critical reflection and decision-making rather than providing a recipe of how to act. 

Conclusion: Supporting phronesis in peer leader training will encourage peer leaders to use their peerness actively. To meet the rationales of peer education, peer leaders’ practical wisdom should be acknowledged as a key component in peer leadership and this should be reflected in peer leader training.

Sport New Zealand conducts continuous physical activity and sport "Active NZ" surveys, conducted since 2017; these survey around 20,000 representatively sampled adults annually (response rate 29-32%, data weighted to NZ Census population). There has been international interest in "single item" physical activity questions to estimate and monitor physical activity levels. Validated questions for adults have asked about the number of days in the past week people were active for >=30 mins for leisure or transport (SI-days). The Active NZ surveys also ask IPAQ-long form questions and a new single item question on the number of hours people were active in sport/recreation in the past 7 days (SI-hours). The public health problem is that the validated SI-days question cannot directly estimate the WHO recommended threshold of 150+ mins of PA/week. This study describes the prevalence of these questions, and examines the relationships between SI-days, SI-hours and IPAQ-long form [using 600 total PA met-mins as the threshold approximating 150 mins of moderate PA, and also using the leisure time domain only in IPAQ).

Methods: analyses were descriptive, and inter-method comparisons using Spearman's correlations, and the best fit with the PA thresholds were estimated using Area under the ROC curve (AUC) and Youden's Index.

Results: IPAQ and SI-days were  only collected mid 2019 to early 2020 (n=15044). SI-days showed a mean of 3.2 days (sd=2.2), SI-hours 5.3 (sd=6.2), and SI-hours 150 mins+ was reported by 60.6%. 88.2% reached the IPAQ-total met threshold, and 41.4% met the IPAQ leisure only threshold. Correlations between SI measures and IPAQ were 0.22 for IPAQ-total, and ~ 0.45 for IPAQ-leisure. SI-days and SI-hours were correlated rho=0.51. ROC curve analyses showed AUC values with IPAQ measures were between 0.63 to 0.76, but the SI-days showed a good AUC of 0.82 (0.81-0.83) with the SI-hours 150 mins threshold. Youdens index suggested the best fit was at 3+ days/week were most likely to meet the SI-hours threshold.

Discussion: These data show SI questions reflect health enhancing thresholds well, and that those reporting >3 SI days showed  best fit with the 150mins threshold based on SI hours, indicating good surveillance utility.

Background: In 2019, the UK prominently placed the strength recommendations on their Chief Medical Officers’ Physical Activity Guidelines infographic. The purpose of this study was to offer a nuanced description of older adults’ awareness, understanding, and participation in activities that meet the strength component, as well as their perceived barriers to strength training participation. 

Methods: Older adults living in the UK (n=15, 70±3.3 years) volunteered to participate in one 30-minute, semi-structured, one-on-one interview on Zoom with the lead author. Advertisements were placed in ageing charity newsletters. People who identified as 65 years old or over and living in the UK were asked to respond via email if interested. 

Results:

Awareness

None of our participants were aware of the strength recommendations. 

‘I honestly can’t say that I ever recall seeing that.’ 

Understanding and Action 

Walking was the most common modality for participants who believed they were meeting the strength guidelines. 

‘I think I’m more than meeting them because... I do masses of walking...’ 

Suggestions for Improvement 

Adding more detail to the guidelines and separating the guidelines based on ability, rather than chronological age, was suggested. 

‘It’s a bit subjective as to what counts as building strength.’ 

Barriers to Strength Training 

Barriers included misconceptions about strength training in later life, 

‘You know, you always know, don’t overload yourself...I never push it.’ 

and a lack of options for older adults who are not quite ready for classes for the oldest old, 

‘There’s a big cohort of us that are what you might call young old and the provision for us who are fit and active 

is sadly missing...the classes that are on are always for the older old’ 

Conclusion: Our participants reported an unawareness of the strength guidelines. Adherence reporting to the strength guidelines should be interpreted with abundance of caution, as older adults are largely unaware of what activities fulfill this requirement. Researchers & practitioners can influence the many barriers to strength training participation primarily with dissemination of accurate information and providing age & ability-appropriate strength prescription.

Regular physical activity (PA) in youth has mental and social health outcomes (Ekelund, 2016; Biddle, 2019). Available data also suggest that the level of PA in youth predicts PA in adulthood (Telama, 2014; Varma, 2017). However, international studies (Aubert et al, 2018) have shown that the majority of young people do not achieve the PA levels recommended for health benefits (Guthold, 2020). However, despite policy intentions to develop sports infrastructure (Deguilhem, 2016; Esteban, 2016), a decrease in the overall level of physical inactivity will not be achieved by 2025 (Guthold, 2020). It seems to be a gap between the willingness of public services and the concrete actions of citizens. One of the commonly recognized obstacles to PA is the lack of time (Embersin, 2007). Thus, based on Elias' temporal model (1997) we propose to move beyond the linear view of time (chronos) to a perspective of timely time (kairos). Adopting an ecological perspective on human development, postulating that multiple determinants impact on our choices of physical activity (Bauman, 2012), we qualify and quantify the social times conducive to physical activity and inactivity. Using objective measurements of PA by accelerometry (ActiGraph GT3X) and a measure of social time by digital daily diary, we identify three profiles of adolescents whose perceptions of time vary according to their level of PA. Adolescents with an active profile (>3000 METs per week) practice PA within the framework of school and out-of-school by optimizing active transports, whereas those with a low activity profile (600<PA<3000 METs per week) are mainly involved in school PA. Finally, adolescents with an inactive profile (PA<600 METs per week) only practice during compulsory physical education lessons and no social time records intense PA. As the only social time conducive to PA captured by all adolescents, the physical education lesson does not seem to be able, in its current form, to reduce inequalities in access to daily PA opportunities. There is scope for research into the organization of a school ecology (Waters, 2013; Turcotte, 2018) conducive to health education through PA.

Background

Care–physical activity (care–PA) initiatives are being implemented in the Netherlands to stimulate the health of citizens with a low socioeconomic status (SES), with the aim of reducing health inequality and healthcare utilisation. A two-year care–PA initiative specifically developed for citizens with a low SES, X-Fittt 2.0, was offered free of charge to participants, and included 12 weeks of intensive guidance and sports sessions, and 21 months of aftercare. As the impact of care–PA initiatives on healthcare utilisation has not yet been studied, our research question was: “What is the impact of participation in a care–PA initiative on the healthcare utilisation of citizens with a low SES?”.

Methods

We studied the healthcare utilisation of 44 former participants of X-Fittt 2.0, focussing on general practitioner care, pharmaceutical care, hospital care, paramedical care, medical aids and mental healthcare. We compared utilisation intensity (number of healthcare claims) during the two years before participation in X-Fittt 2.0 (period 1) with utilisation intensity during the two years after initial participation (period 2) using paired t-tests.

Results

As expected, utilisation intensity increased significantly for paramedical care for non-chronic disorders after participation. No differences in utilisation intensity were observed for the other healthcare categories. Furthermore, although it was not the core focus of this study, our results show that people with a low SES tend to have higher healthcare utilisation than those with a higher SES.

Conclusions

This exploratory study, which is unique for its use of healthcare claims data for participants of a care–PA initiative, shows a statistically significant increase in utilisation intensity for paramedical care (supplementary healthcare insurance for non-chronic conditions) in period 2 compared with period 1, as expected. This increase is likely caused by a greater utilisation intensity for physiotherapy, which covers respectively 95% and 92% of the paramedical healthcare claims of the supplementary healthcare insurance in periods 1 and 2. The design of our study can be used as a template for future research that aims to study health care utilisation over a longer time period. The results of this and future studies can be used to improve health policies.

Background

The involvement of local governments in physical activity (PA) promotion represents a key factor to drive change at grassroots level, based on identified specific needs and solutions, tailored to each local context (needs, resources, etc.). The aim of LoGoPAS, Erasmus + Sport co-financed project (2020-2021), is to assess, promote and support local governments’ involvement in PA (policy) promotion.

 

Methods

A mixed methods approach has been put in place (including thematic document analysis of grey literature, semi-structured stakeholder interviews, group consensus methodologies) to explore and analyze the current legally binding and voluntary activities of local goverments in PA (policy) promotion. The study is being conducted at local level in Finland, France, Germany, Japan and Romania. Already validated instruments to evaluate local PA policy, such as L-PAT (Local Policy Audit Tool), Capla SANTE or TEAviisari will be used to harmonize data collected from each partner country, at local level.  

 

Results

Locally collected data from partner countries reveal significant differences in the organization and delivery of PA related policies with more regulations and structures in the western countries (e.g. Germany or Finland) and more opportunistic and mixed approach (related to the purpose of the PA related projects) in Romania. Also, the currently available instruments for evaluation of local PA policies (those used for data harmonization in our project - see methods section) can benefit from additions in order to capture the complexities of the engagement of local governments in PA promotion.  

Conclusion

Although the roles of local governments in PA promotion has been widely acknowledged (e.g. by WHO or the European Comission), there are currently few hands-on instruments for policy-makers and other actors at local level to advance PA promotion agenda and activities. Approaches tailored to local contexts may help engage local governments, while international networking may foster the exchange of experiences and help optimize interventions.

objective

Workers with high occupational physical activity (OPA) experience higher risk of cardiovascular diseases (CVD) than sedentary workers. In an ageing workforce, greater proportions will be expected to have CVD, and pre-existing CVD are shown to increase vulnerability to exposure of high OPA. However, most of the epidemiological evidence is derived from male cohorts, excluding those with pre-existing CVD, and using clinically manifest disease outcomes that are prone to healthy worker selection bias. To address these limitations and to highlight whether pre-existing CVD indicate vulnerability, this study investigated the effects of OPA on pre-clinical asymptomatic progression of carotid artery intima-media thickness (IMT) among women. 

 

methods

Women participants (N= 905) of the population-based Kuopio Ischemic Heart Disease Study (KIHD) with data on OPA and IMT were included. Linear mixed models, stratified by pre-existing CVD, estimated the association between OPA and the IMT progression from baseline (1998-2001) through 8-years of follow-up.

 

results                                        

Non-stratified analysis showed the greatest 8-year IMT progressions by exposure to light standing or moderately heavy active work (both 0.13 mm). Stratified analysis on within group changes and total level of IMT showed exposure to light standing and moderately heavy active work to give the greatest 8-year IMT progressions, especially pronounced among normotensives and those with pre-existing stenosis or ischemic heart disease (IHD). Women with pre-existing CVD ended up with the greatest total IMT levels (sum of baseline and estimated 8-year IMT change), in spite of less 8-year IMT change than among women with out pre-existing CVD. This may be explained by their initial high IMT level, combined with a celling effect of the change. 

 

conclusion

Exposure to light standing work and moderately heavy active work was associated with accellerated progression of IMT, especially pronounced among normotensives or workers with pre-existing stenosis or IHD. The majority of the reported 8-year IMT progressions are at a clinically relevant magnitude of 0.1 mm, which associates with an 11% increased risk of acute myocardial infarction.

Background: Walkability is a new definition in sport and health science in Hungary. In our study the walkability was measured by NEWS-Hungarian questionnaire first time in Hungary and our research aim was to compare neighbourhood walkability to physical activity level.

Methods: The study comprised 593 participating adults (248 males and 345 females).  The data was collected during February-May 2019 using quota sampling by age and gender representing the Hungarian adult (18+) population. The physical activity was measured by RM 42 hip-worn triaxial accelerometer for 7 consecutive days using vigorous, moderate to vigorous activities and daily steps scores. The walkability was measured by walking and cycling facilities subscale (10 questions) of NEWS-Hungarian questionnaire. The subscale measured the environment’s possibilities and quality for walking and cycling. Data were presented as mean ± standard deviation, Spearman’s rank correlation was used to analyse data using SPSS 24. program, where level of significance was set at p<0.05.

Results: The mean age of the participants was 44.41±18.64 and their average number of daily steps was 7308.47±6993.86. 69.05% was lived in cities and 30.05% in rural areas. The respondent’s opinion about the walking and cycling around their place of living was measured by a 4 point scale (1 = strongly disagree and 4 = strongly agree), where we found 2.76±2.8 mean scores. The walkability score was showed significant but weak correlation with accelerometer-measured vigorous PA (R=0.124, p=0.004). But the accelerometer-based number of steps was not showed correlation with walkability (R=0.058, p=0.184).

Conclusions: According to our results the built environment, especially walking and cycling places had significant but weak effect on physical activity patters. The participants were somewhat satisfied with walking and cycling possibilities of their built environment but this was not affected directly the time spent physically active. This study used first time the NEWS-Hungarian walkability scale to have a better understanding of the country specific details and compared them with PA level of the population further analysis needed.

Introduction: Physical activity (PA) as health promotion tool is not one without adverse effects and adolescents with nonfatal physical activity-related injuries (PARI) may experience serious health consequences for the rest of their lives. 

Methods: As a part of the pilot study of the Health Behaviour in School-aged Children Study conducted in October and November 2021 in Slovakia, we surveyed 119 adolescents (53 girls; average age 12,6±2,0) for moderate-to-vigorous physical activity (MVPA), medically attended injuries (MAI), physical activity-related injuries in sports clubs (PARISC), physical activity-related injuries in leisure-time (PARILT) and physical activity-related injuries in schools (PARIS) and we measured their cardiorespiratory fitness (using 20-metre shuttle run) and their body composition (using InBody 230).  

Results: Out of 119 adolescents, 50 (42%) were attending sports clubs of which 27 (54%) had one or more PARI in sports clubs’ activities in previous year, 50 adolescents (42%) had PARI in leisure activities and 15 (12,6%) in school activities. PARISC led to an average of 10 missed days from school or leisure-time activities. PARILT led to 7,2 missed days and PARIS led to 6,2 missed days. Spearman’s correlations (n = 50 for PARISC and n= 119 for PARILT and PARIS) revealed associations between MAI and PARISC, PARILT and PARIS, but not between MVPA or 20-metre shuttle run laps and PARISC, PARILT and PARIS. Not surprisingly, percentage of body fat was negatively associated with the number of 20-metre shuttle run laps. In addition, results of crude linear regression models showed that frequency of MVPA was not associated with frequencies of PARISC (B coefficients (B)/95% CI: 0,03/-0,11-0,18), PARILT (B/95% CI: 0,04/-0,05-0,13) or PARIS (B/95% CI: -0,02/-0,07-0,02) among Slovak adolescents in our pilot study.

Conclusions: Estimating the burden of PARI is important in advocating the need of directing sufficient resources to PARI prevention along with the PA promotion. Improvement and understanding of factors associated with PARI might be helpful in PARI prevention. In addition, it might, among other factors, play a role in promotion of active lifestyle in adolescence.

Conclusions: The collaboration between professionals to refer and guide inactive people with a chronic disease from the healthcare setting to physical activities can be improved by responding to the barriers that are indicated by this study. This study contributes to improving health-enhancing physical activity in an inactive target group and decreasing the prevalence of physical inactivity.

Background: A gender-based disparity in physical activity, where girls are less physically active than boys, is a persistent finding in the literature. Participation in organised sport plays a significant role for adolescents’ physical activity habitsand provides an important means to achieve the recommended amount of daily physical activity. Nevertheless, participation in sport decreases with age, and to a higher degree among girls. Moreover, girls living in low socio-economic status neighbourhoods are even less represented in organised sport. This upholds a social inequality as a range of physical, mental and social benefits are associated with regular participation in sport. Empowering girls as experts on their own needs and preferences toward sport is critical. The aim of this qualitative study was to examine the experiences and perceived barriers to sports participation among adolescent girls living in low socio-economic status neighbourhoods.

 

Methods: During July-October 2021 eleven semi-structured focus groups were carried out with adolescent girls (10-16 years) who were not engaged in organised sport. The participating girls (n = 44) were recruited through purposive sampling via four Danish schools placed in areas with high deprivation. A thematic analysis was conducted from verbatim transcripts using NVivo. 

 

Results: Six themes were identified; 1) Competing priorities, 2) Social aspects of sports participation, 3) Perceived lack of sporting abilities, 4) Feeling discomfort, 5) Gender stereotypes and 6) Physical Education as introduction to sport. Even though there were many similarities among the girls’ perceived barriers to sports participation, the data showed variations in the way these barriers were experienced.

 

Conclusions: The results provide insight into barriers to sports participation among adolescent girls living in low socio-economic status neighbourhoods. The findings correspond with other studies among adolescent girls in general. However, the findings among this underrepresented group will be useful to shed light on how interventions should be designed to promote sports participation among adolescent girls living in low socio-economic status neighbourhoods. As this is perceived as a hard-to-reach group, the findings will be a contribution to the field and are highly needed to illuminate the different perspectives on gender-based disparities that exist in relation to sports participation.

Issue/problem: Physical activity (PA) can prevent falls, a leading cause of death globally. Alternative delivery channels may increase the “reach” of interventions into older adult populations in areas which lack trained instructors. Using technology is one alternative to traditional, face-to-face group classes where instructors and participants are in the same room. We delivered a PA program via the Internet for older adults in rural West Virginia (USA). This alternative could help other countries reach more older adults and reduce falls.

Description of the problem: Tai Ji Quan: Moving for Better Balance^® (TJQMBB) is an evidence-based intervention for older adults that reduces falls. Adults, ≥ 55 years, attended free, 1-hour tele-TJQMBB sessions, twice weekly, for 16 weeks at 5 remote community sites (3 urban, 2 rural). Trained instructors (new to TJQMBB) led 6 classes from a classroom for participants at remote sites. Instructors/sites used minicomputer, web camera, microphone, and television(s) for live, 2-way verbal/audio exchange. A CPR-certified person was present with participants. This project identified barriers to implementing tele-TJQMBB. Data on barriers were collected from instructors’ class logs and summarized.

Results: Fifty-two adults (81% female, mean age 70) attended 23 (median) of 32 sessions. Barriers that caused session cancelations included: participant vacations/unavailability (n=7), inclement weather (n=4), technical issues (n=2), no CPR person (n=1), classroom not available (n=1), site closed for state holiday (n=1), competing event at site (n=1), and ill instructor (n=1). Technical barriers during sessions included interruptions/lack of audio, video freezing, and Wi-Fi/Internet connectivity problems. Two participants did not like videoconferencing. 

Lessons: Tele-TJQMBB may be easier to teach with instructors who have already taught the program in-person. Selecting instructors/sites that are comfortable with technology may reduce technological barriers. Some older adults may still prefer face-to-face classes. Most cancelations were due to reasons normally encountered in face-to-face classes. Use of technology added new barriers that will need addressed for future classes.

Main messages: Technology reached older adults in areas with no instructors. We think that this is the first time a live, evidence-based, group PA intervention was delivered using this method which could be a model for reaching older adults globally. 

 

Background: Physical activity promotes the better physical and emotional well-being of children. A high percentage of Chilean children do not reach the minimum daily time expected of physical activity. Parents and educators of preschoolers are fundamental to the development of activities that involve movement. This study aimed to examine the relationship between the weekly time that Chilean preschoolers include physical activity in their plays and children's development. Also, compare child development between preschoolers who engaged in physical activity play with or without caregivers' presence. Methods: The sample consisted of 54 preschoolers aged 34.7-65.9 months (mean 52.0±10.2). The parents completed: a) Ages and Stages Questionnaire Third Edition to measure communication, motor, solving-problem, and personal-social development, and Ages and Stages Questionnaire Socioemotional to measure the socio-emotional development of children and their areas (self-regulation, compliance, autonomy, adaptive functioning (physiological needs), affection, social communication, and interaction; b) an ad-hoc questionnaire to register the time that children dedicate weekly to physical activity on their play, and if their children engaged in play that included physical activity with their caregivers or not. Results: Pearson coefficient showed that preschoolers' time spent weekly on plays that included physical activity was moderate and significant (p<0.05) when related to social communication's, adaptive-functioning's, personal-social's, and communication's development. T Student for independent samples revealed that Self-regulation (t=-2.09; p<0.05) and adaptive-functioning's development (t=-2.99; p<0.01) were better in preschoolers engaged in play that included physical activity with their caregivers than those who did not play with them. A multivariate regression analysis indicated that preschoolers' adaptive-functioning could be predicted by a combination of higher time dedicated weekly to physical activity on their play and children playing with their caregivers. Conclusions: These findings suggest that physical activity in preschoolers could benefit their physiological needs. Thus, it is necessary to promote strategies that include the family and increase physical activity time on children's plays.

Introduction: Physical activity (PA) as health promotion tool is not one without adverse effects and adolescents with nonfatal physical activity-related injuries (PARI) may experience serious health consequences for the rest of their lives. 

Purpose: The aim of this study was to assess the associations between physical activity-related injuries in adolescents in various settings and moderate-to-vigorous physical activity, medically attended injuries, cardiorespiratory fitness and body composition.

Methods: As a part of the pilot study of the Health Behaviour in School-aged Children Study conducted in October and November 2021 in Slovakia, we surveyed 119 adolescents (53 girls; average age 12,6±2,0) for frequency ofmoderate-to-vigorous physical activity (MVPA), frequency of medically attended injuries (MAI), frequencies of physical activity-related injuries in sports clubs (PARISC), physical activity-related injuries in leisure-time (PARILT) and physical activity-related injuries in schools (PARIS) and we measured their cardiorespiratory fitness (using 20-metre shuttle run) and their body composition (using InBody 230).  

Results: Out of 119 adolescents, 50 (42%) were attending sports clubs of which 27 (54%) had one or more PARI in sports clubs’ activities in previous year, 50 adolescents (42%) had PARI in leisure activities and 15 (12,6%) in school activities. PARISC led to an average of 10 missed days from school or leisure-time activities. PARILT led to 7,2 missed days and PARIS led to 6,2 missed days. Spearman’s correlations (n = 50 for PARISC and n= 119 for PARILT and PARIS) revealed associations between MAI and PARISC, PARILT and PARIS, but not between MVPA or 20-metre shuttle run laps and PARISC, PARILT and PARIS. Not surprisingly, percentage of body fat was negatively associated with the number of 20-metre shuttle run laps. In addition, results of crude linear regression models showed that frequency of MVPA was not associated with frequencies of PARISC (B coefficients (B)/95% CI: 0,03/-0,11-0,18), PARILT (B/95% CI: 0,04/-0,05-0,13) or PARIS (B/95% CI: -0,02/-0,07-0,02) among Slovak adolescents in our pilot study.

Conclusions: Estimating the burden of PARI is important in advocating the need of directing sufficient resources to PARI prevention along with the PA promotion. Improvement and understanding of factors associated with PARI might be helpful in PARI prevention. In addition, it might, among other factors, play a role in promotion of active lifestyle in adolescence.

Objetives: to determine whether or not, and, what extent the association between sedentary time, moderate to vogorous physical activity and self-care disability. 

Design: Cross-sectional

Participants: 122 (84 females, mean age 85 years old) older adults. 

Methods: Sedentary time was measured with accelerometers. Self-care disability was assessed with th barthel index. A multivariate regression model was used to ascertain the effects of the interaction between sedentary time and moderate to vigorous physical activity on the disability of participants. The Jhonson-Nyeman model was used to estimate the exact mvpa thresfold from which the effect of sedentary time on disability ceased to be significant.

Results: We found a significant effect of sedentary time on self care disability (p<0.5). The results also indicated that mvpa moderates the relationship between self-care disability satatus and sedentary time. 51 min/day of mvpa would neglect the sedentary time effects on self care disability.

Conclusions: The negative effects of sedentary time on self care disability can be offset with 51 min/day of mvpa. 

Low cardiorespiratory fitness (CRF) is associated with higher blood pressure and risk of incident hypertension. However, existing literature has mainly investigated CRF at baseline. For HEPA initiatives, it is important to know how change in CRF in midlife associate with incident hypertension, and whether this varies between sexes, age and baseline CRF.

91,728 individuals (20-79 years, 48% women, free from hypertension at baseline) from the Swedish workforce who had completed two health profile assessments in a nationwide occupational health service screening between 1986 and 2019 were included. CRF (assessed as VO₂max) was estimated using a submaximal cycle test. Change in CRF between the two tests was expressed as % change in absolute CRF (L∙min^-1) per year and categorized as “maintainers” (-1% to 1% change/year), “decreases” (≥-1% change/year) or “increasers” (≥1% change/year). Incident hypertension was defined as having a blood pressure >140/90 mmHg or diagnosed with hypertension at the second test. Binary logistic regression was used to assess OR (95% CI) for hypertension at the second test between maintainers, decreases and increasers. All analyses were adjusted for sex, age, heart medication, time between tests, education, and change in other lifestyle variables between the two tests (stress, diet, exercise, smoking).

Compared to maintainers (set as reference), OR for decreases was 1.27 (1.18-1.38) and increasers OR 0.99 (0.89-1.09). Isolating midlife participants (40-60 years), OR for decreasers was 1.47 (1.30-1.66) and increasers OR 0.75 (0.64-0.86). Looking at sex differences, male decreasers had OR 1.24 (1.12-1.36) and female decreasers OR 1.36 (1.20-1.56), compared to maintainers, while OR for male and female increasers was 0.93 (0.83-1.03) and 0.97 (0.83-1.13). For participants with low CRF at baseline (<32∙kg^-1∙min^-1), OR for decreasers was 1.70 (1.51-1.92) and increasers 1.32 (1.18-1.49). Corresponding ORs in those with high CRF at baseline were 0.90 (0.80-1.02) and 0.43 (0.26-0.71).

Decrease in CRF with >1% per year associated with significant higher risk for incident hypertension, while maintaining or increasing CRF had similar risk associations. This was seen in both men and women, different age-groups and baseline level of CRF. Health enhancing promotion strategies to maintain or increase CRF level is highly clinically relevant.

Background: The covid-19 pandemic has had a large impact on the daily lives of adolescents, even in Sweden where the restrictions were relatively mild. The aim of this study was to examine if there had been a change in mental health outcomes and if these changes were related to changes in physical activity patterns before and during the pandemic.  

Methods: In this longitudinal study, data were collected in the autumn 2019 and in follow-up measurements in the spring 2021. Physical activity and sedentary time were measured for seven consecutive days by accelerometry (Actigraph). The mental health outcomes, health-related quality of life (HRQoL) and psychosomatic health were measured with questionnaires (KIDSCREEN-10 and PSP). ANCOVA analyses were applied to estimate the associations between change in physical activity patterns and mental health outcomes.

Results: In total, 585 boys (45%) and girls (55%), aged 13-14 years (baseline) from 34 schools around Stockholm, were included in the study. Between 2019-2021 there was a decrease in HRQoL (p=<0.001) and increase in psychosomatic problems (p=<0.001) among both boys and girls. There was a significant positive relationship between change in MVPA and change in HRQoL (β=0.02, CI: 0.00, 0.05).

Conclusions: The results suggest that the COVID-19 pandemic has impaired the mental health of Swedish adolescents but increased physical activity was related to positive changes in the mental health outcome HRQoL. 

 

Funding: The Public Health Authority and Skandia

One neighborhood in Groningen, the Netherlands, is a neighborhood housing about 12,000 citizens with on average a low-SES background, showing a less healthy and active lifestyle. In the past, initiatives have been undertaken to promote active lifestyle by implementing outdoor facilities stimulating physical activity. However, use of facilities was poor due to lack of citizen involvement. Aim of this project was to engage citizens in the overall process of capturing, plan making and prototyping of concepts for an exercise-friendly physical and social environment.

From January 2020 - May 2022 a Living Lab was run following the “Our Voice” citizen science method. Participatory citizen science was applied in which a community of stakeholders (public/private parties) and citizens was built. The community addressed the problem by creating more insight in promoting/degrading features in the neighborhood concerning an active lifestyle. Citizens (n=40) used the Stanford Neighborhood Discovery Tool, which allowed for systematic observations of the physical environment. Additionally, emergent research walks gave extra information on neighborhood barriers/facilitators next to Discovery Tool data. Collected data allowed citizens to brainstorm on possible solutions in sessions facilitated by the researchers. Solutions were presented to local government and further developed for implementation and realization.

Use of the Discovery Tool created an overview of the neighborhood. Based on positive/negative features, new ideas were generated for improving exercise-friendliness. One example was a walking route along art objects in the neighborhood. Furthermore, a citizens work group was formed which discussed this route, and other ideas and prototypes, with local government. This group was also involved in realization of prototypes.

Our project resulted in a citizen science approach which can be transferred to other neighborhoods. Use of Discovery Tool showed many benefits for neighborhood plan making. Early and continuous involvement of citizens will lead to more sustainable engagement and is a powerful method to create engagement around societal problems and social innovation in the field of Health Enhancing Physical Activity.

A transferable method for neighborhood development based on citizen science was developed. Key feature in our method was integration of design thinking, citizen engagement, and use of digital tools.

It is widely known that people from a low-SES background show a less healthy and active lifestyle. One neighborhood in Groningen, the Netherlands, is a neighborhood housing about 12,000 citizens with on average a low-SES background. In the past, initiatives have been undertaken to promote an active lifestyle by implementing outdoor facilities stimulating physical activity. However, use of these facilities was poor due to lack of citizen involvement. Aim of this project was to engage citizens in the overall process of capturing, plan making and prototyping of concepts for an exercise-friendly physical and social environment.

In the period from January-November 2020 a Living Lab was set up following the “Our Voice” citizen science method. Participatory citizen science was applied in which a community of stakeholders (public and private parties) and citizens was set up. This composes the first step of design thinking: empathizing. The community addressed the aforementioned problem by creating more insight in promoting or degrading features in the neighborhood concerning an active lifestyle (design thinking step 2: defining). For this, citizens made use of the Stanford Neighborhood Discovery Tool. Due to local COVID-19 restrictions, citizens did not collect data individually but were accompanied by a researcher during research walks. The Tool allowed for systematic observations of the physical environment. Additionally, the emergent research walks  gave additional information on neighborhood barriers and facilitators next to Discovery Tool data.

Use of the Discovery Tool created an overview of the neighborhood. Based on positive and negative features, new ideas were generated for improving exercise-friendliness (design thinking steps 3 and 4: ideating and prototyping). Furthermore, a work group of citizens was formed which discussed their prototypes with the local government and will be involved in carrying out the ideas.

Our project resulted in a citizen science approach which can be transferred to other neighborhoods. Use of the Discovery Tool showed many benefits for plan making for the neighborhood. Early and continuous involvement of citizens will lead to more sustainable engagement and is a powerful method to create engagement around societal problems and social innovation in the field of Health Enhancing Physical Activity.

Background: Conducting everyday activities out-of-home may accumulate a large share of older adults’ daily physical, especially if active transportation is used. Environmental features in home neighborhood may motivate for higher physical activity, but the role of features around destinations is less known. Our goal was to study 1) clustering of older adults’ reported activity destinations, and 2) whether transport mode to a destination was associated with characteristics of destination clusters.

Methods: Data comprise AGNES study participants (901 community-dwelling people aged 75-85 years living in city of Jyväskylä, Finland; 57% women) combined with geospatial data. Using digital mapping, participants located frequently used destinations for shopping, services, and social and spiritual activities on a map, and reported transport mode (active/passive) for each. Geographic information system was used to define distance from home to each destination, to identify spatially clustered destination areas, and to assess destination areas’ characteristics (urban location, intersection density, nature versatility, and the proportion of reported social/spiritual destinations of all destinations in the area). Based on their characteristics, destination areas were hierarchically categorized to area types. In mixed model, active transportation (vs. passive) was regressed for area type and adjusted for distance, car use possibility, walking difficulty in 2km, age, sex, and MMSE score.

Results: Of reported destinations within 2km from home (1278 destinations for 642 participants), 81% clustered spatially in 23 destination areas and 19% remained separate. Hierarchical clustering resulted three area types: 1) city centre (versatile activities and nature), 2) less serviced areas (versatile activities and less nature), 3) shopping areas (shopping/service activities and less nature). The proportion of destinations visited using active transportation was 63% in city centre, 68% in less serviced areas, 69% in shopping areas, and 56% for separate destinations outside the areas. Based on mixed model results, the odds for active transport use were higher when destinations located in city centre (OR=4.8, 95%CI 1.3–17.0) or in shopping areas (OR=11.9, 95%CI 2.6–55.6) compared to visiting locations outside spatially clustered destination areas.

Conclusions: Majority of older adults’ activity destinations locate as spatially clustered. Varied destinations close to one another may promote active transport.

Background: The physical activity pattern of the population, as well as the tasks of different occupational groups, have changed over the past decades. Hence, studies within and between different occupational groups, and not just between white and blue collar workers, are central for current risk group analyses. The aim was to study clustering of unhealthy lifestyle factors in different occupational groups in a large sample of men and women from the Swedish working population.

Methods: 72,855 individuals aged 18-75 years (41% women) from the Swedish working population who participated in a nationwide occupational health service screening between 2014-2019 were included in this cross-sectional descriptive study. Nine different occupational groups were identified based on the International Standard Classification of Occupation 2008. Exercise, diet, smoking habits and perceived health were self-reported. Cardiorespiratory fitness was estimated using a submaximal cycle test. Blood pressure and BMI was assessed through physical examination. Logistic regression modelling assessed OR (95%CI) for clustering of unhealthy lifestyle factors, defined as ≥3 of the following; low exercise, poor diet, daily smoking, poor perceived health, low fitness, high blood pressure and high BMI in the different occupational groups.

 

Results: The OR (95% CI) for clustering of unhealthy lifestyle factors were, compared to managers that served as reference, 1.00 (0.89-1.11) for professionals, 1.25 (1.11-1.39) for associate professionals, 1.93 (1.71-2.18) for clerical support workers, 2.40 (2.14-2.70) for service and sales workers, 1.63 (1.29-2.05) for agricultural, forestry and fishery workers, 2.23 (1.99-2.49) for craft and related trades workers, 2.52 (2.25-2.83) for plant and machine operators, and assemblers, and 2.62 (2.26-3.05) for elementary occupations. Comparing occupational groups within “service and sales workers” and “plant and machine operators, and assemblers”, revealed significantly higher OR for professionals in care workers (OR2.92 (2.55-3.34)) and in drivers (OR 3.32(2.86-3.87)) compared to each of the main occupational groups.

 

Conclusion: There were large variations in clustering of unhealthy lifestyle-related factors between as well as within different white and blue collar occupations. This study suggest that targeted measures of health promotion are foremost needed in blue collar occupations, however with some white collar sub-occupations being at similar need as blue collar occupations.

In recent years, we have got more information on physical activity and motor skills of preschool-aged children in Finland. However, national monitoring system for this age groups is still lacking in Finland like in many other European countries too. This presentation describes the process and recent results of an on-going research and development project JOYPAM – monitoring the joy of motion, physical activity and motor skills for pre-school-aged children. Aim of the project is to co-create, test and recommend a national level monitoring system by the end of 2020.

Background

The extent to which people are physically inactive is dependent upon social gradients. Numerous studies have proven that individuals with social disadvantages are not active enough. Parallel to this, several researchers have raised concerns that public health interventions may increase inequalities in the population. However, little is known about the success of community-based physical activity promotion among individuals with social disadvantages. Hence, our goal was to identify the characteristics of successful interventions within this field.

Methods

From March 2015 to March 2019, a search for systematic reviews dealing with community-based physical activity promotion was carried out using the databases PubMed, Scopus, PsycInfo/SPORTDiscus (via Ebscohost), ERIC and IBSS (via ProQuest). Only articles written in English or German were included. Studies without information about socially disadvantaged groups or physical activity promotion in low and middle-income countries were excluded. Checking of the reference lists of included reviews completed the research. Two authors independently conducted the screening, selection and data extraction. Results were synthesized narratively.

Results

In the first step, a total of 2,610 articles were identified. After the screening, 20 publications could be considered, while only six involved individuals with social disadvantages. In particular, these articles described environmental interventions, tailoring, and involvement of the target group, as effective among individuals with social disadvantages. In addition, strategies for gaining political support, intersectionality strategies, and the creation of access routes to reach individuals with social disadvantages were specified as requirements for effectiveness.

Conclusion

The current state of research concerning physical activity interventions in a community setting for individuals with social disadvantages is very limited. Because the target group is so broad, the evidence of successful approaches is heterogeneous. In order to assess the characteristics of physical activity promotion interventions, additional studies that focus on various groups of people with social disadvantages in real-world community settings are needed.

Background

Sick leave due to musculoskeletal pain is common in the workforce. Time use in physical behaviors at work such as sitting, standing, low- (LIPA) and moderate-to-vigorous physical activity (MVPA) may impact on sick leave due to pain. However, studies addressing this relationship using technical measures of physical behaviors are scarce. The aim was to investigate the association between time-use compositions of physical behavior at work and sick leave trajectories due to musculoskeletal pain over one year.

Methods

We analyzed data of 981 workers in a Danish cohort (DPHACTO 2012-2014). We assessed physical behaviors at work at baseline using thigh-worn accelerometers, and classified behaviors at work as sitting, standing, LIPA, and MVPA. Over 1 year follow-up, workers reported sick leave days due to musculoskeletal pain using text messages at 4-week intervals (14 waves). We used Latent class growth analysis to distinguish sub-groups with different trajectories of sick leave. We analyzed associations between time-use in physical behaviors and sick leave trajectories using multinomial regression analysis with adjustment for age, gender, BMI, smoking, and accelerometry-measured physical activity during leisure. Compositional data analysis was used to account for the co-dependency of different behaviors.

Results

We identified four distinct trajectories of sick leave due to pain over one year as follows: no sick days (prevalence 76%), few days-increasing trajectory (19%), some days-decreasing trajectory (3%), and some days-increasing trajectory (2%). Spending more time in sitting relative to the other behaviors was negatively associated with few days-increasing trajectory of sick leave (p<0.001), while time in LIPA was positively associated with some days-increasing trajectory of sick leave (p=0.001). Reallocating 60 min/day from sitting to other behaviors at work predicted a 22% increased likelihood of few days-increasing trajectory of sick-leave. In contrast, reallocating 30 min/day from LIPA to other behaviors at work predicted a 57% decreased likelihood for some days-increasing trajectory.

Conclusion

We found that compositions with more sitting relative to the other behaviors had lower odds for the trajectory with increasing sick leave due to pain, while compositions with more LIPA had higher odds.  This may have implications for prevention of pain-related sick leave in workers.

Background: Temperament refers to innate differences between individuals, is partly genetically determined, relatively stable across lifespan and expressed through behaviors such as physical activity and sedentary behavior. These two behaviors are known as major determinants of health. Therefore, measuring physical activity and sedentary behaviors temperaments appears to be of interest but no existing questionnaires allow for it among French adults. This study aimed to create and validate a questionnaire to measure physical activity and sedentary behavior temperaments among French adults.

Methods: The questionnaire was created by the Delphi method. Based on an existing questionnaire on eating temperament, 31 experts in physical activity, health psychology and public health were asked to formulate equivalent items to measure physical activity and sedentary behavior temperaments. The test of the psychometric qualities of the questionnaire and its validation will be carried out on three samples of north-eastern French adults: one of 500 to explore internal validity, one of 100 for external validity, and one of 60 for test-retest reliability (4-week interval). Internal validity will be investigated by exploratory and confirmatory factor analyses, and external validity and test-retest reliability with correlation analyses.

Results: The Delphi method results in a questionnaire of 40 items on physical activity and sedentary behavior temperaments. The test of the psychometric qualities of the questionnaire and its validation are in progress and will be carried out for the congress.

Conclusions: The validation of this questionnaire and its use in practice would help to guide changes in the management of physical activity and sedentary behavior as part of health promotion approach.

Background: Regular physical activity (PA) has been found to be important for cardiovascular health and longevity. However, notable proportion of adult population does not meet the national PA recommendations. Active transport is one domain of physical activity, that could be a time-efficient way to increase PA and reach the national recommendations. Additionally, it could have a positive effect to body composition.

Methods: Based on longitudinal cohort study, active commuting modes and objectively measured PA were used to determine the influence of commuting mode to steps, aerobic steps, BMI and waist circumference. Linear regression models were fitted to test the associations between the change groups of commuting mode and the longitudinal changes of the response variables.

Results: When compared to passive commuters, participants with public transport (P=0.09) and walking (P<0.001-0.021) showed higher amounts of steps and aerobic during summertime and wintertime. Cyclers showed higher amounts of steps and aerobic steps only in wintertime (p=0.001-0.002). Passive commuters had higher BMI than walkers (P=0.05) and cyclers (P=0.023) in summertime. Also, cyclers had lower waist circumference than passive commuters (P=0.016-0.02). Among those who remained persistently active, number of steps did not change. When compared to persistently active, among those who changed from active to passive commuting, steps (-900 - -885) and aerobic steps (-500) declined (P=0.010-0.036) while among those who changed from passive to active commuting steps (+900-1000) and aerobic steps (+650-750) increased (P=0.023-0.011).

Conclusions: Commuting actively to work and changing passive mode to active mode has a positive effect to number of daily steps and aerobic steps. Since the active commuting is part of the daily routine, promoting active commuting could be one of the key factors tackling the obesity and insufficient PA among adults. Continuity of active commuting seemed to be effective way to maintain body weight in balance over the years.

Background: Physical activity during the day is composed of different domains, specifically work related, transportation, and recreation, physical activity. We aimed at studying the correlation between energy expenditure and the corresponding metabolic equivalent of task and sleep in the context of type of physical activity, general level of activity as to be low, moderate and vigorous and the intensity of activity either moderate or vigorous physical activity.

Methodology: A cross-sectional study, participants were n= 273 enrolled from al-Neelain university faculty of medicine between January and April 2021 we used the global physical activity questionnaire to measure standard metabolic equivalent of task (MET) for participants for  vigorous and moderate work MET, Transportation MET, Vigorous and moderate lesiure MET, and sedentary time.  we used Pittsburgh sleep quality index to assess different components of sleep (subjective sleep quality, sleep latency, habitual sleep efficiency, sleep duration, sleep disturbances, use of medications, daytime dysfunction) and sleep quality.

Results : Mean of Total-MET was (3533.36min/week) predominantly moderated work-MET (33%). Poor sleepers prevalence was high (62%). Moreover there was significant difference between good and poor sleepers in moderate work MET mean (876.36,1334.2 min/week) (p<0.01).respectively. There was significant positive correlations between moderate work MET and roughly all sleep components rho=(0.196, 0.182, 0.132, 0.149)(p<0.01, p<0.01, p<0.05, p<0.05)respectively and sleep quality rho=(. 211)(p<0.001). Vigorous-lesiure MET positively correlated with sleep latency rho=(0. 134)(p<0.01). Total MET correlated with sleep latency, use of medications, and sleep quality in general. (0.134,  0.124, 0.133) (p<0.05). 

Conclusion: Our results show that poor sleep quality is primarily influenced by the type and intensity of physical activity. Eliciting a dose-response effect of different domains, being  deleterious for work related physical activity as work MET is of too low intensity or too long duration for maintaining or improving cardiorespiratory fitness and cardiovascular health subsequently imposing its deleterious effect. So  in order to improve quality of life for university students, special strategies and policies that leverage ‘good sleep’ quality are warranted by limiting work related physical activity and adding on well structured early morning exercises for University students thus improving cardiorespiratory fitness and subsequently sleep. 

Background: There is strong evidence showing that sedentary behaviour (SB) increase the risk to develop several chronic diseases and to premature death (Chau et al., 2015). A dose response relation is observed with a more marked risk when people spend more than 7 hours / day in sitting position (Ekelund et al., 2019). The study INCA 3 on the lifestyle habits of French population indicated that 40 % of people between 18 and 79 years had a high risk for health conditions with more than 7 hours of daily SB (ANSES, 2017). The economic consequences of this risk have never been evaluated. The aim of this study was to estimate the economic burden of SB-related diseases in France.

 

Methods: From meta-analysis or large cohorts based on individual SB time, we identified relative risk (RR) to develop cardiovascular disease (CVD), colon cancer, breast cancer and all-causes premature death after co-variables adjustments including physical activity. From RR and prevalence of SB time in France, a population attributable fraction approach was used to estimate the yearly number of cases for each disease. Data from the national health insurance were used to calculate the annual average costs per case for each disease. Then, disease-specific and total health-care costs attributable to prolonged SB time were calculated. Indirect costs for private sector and households were calculated in a second stage.

 

Results: In France, 66 528 premature deaths / year appear related to a daily SB time ≥ 8,6 hours Each year prolonged SB cost 559 millions € for the national health insurance, including 359 millions € for CVD (≥ 10 hours of daily SB), 170 millions € for breast cancer (≥ 6 hours of daily SB), and 31 millions € for colon cancer (≥ 5 hours of TV / day).

 

Conclusions: These preliminary results showed that many deaths could be avoided by reducing  prolonged SB prevalence in France. Moreover, direct health-care costs attributable to SB related diseases represent a high economic burden for the French health system. To address this issue, strong responses should be implemented to tackle SB, complementary to physical activity promotion.

Background:

Sports programs are recognised as a promising way to contribute to the personal development of socially vulnerable adults. However, it remains unknown which elements of sports programs are critical for social inclusion and personal development to occur. Knowledge on these critical elements is needed to improve sports programs and to maximize positive outcomes.

 

Methods:

Data were collected and analyzed using concept mapping (CM), which is a standardized systematic tool to visualize relations between different concepts by collecting and sorting ideas in groups and ranking them in terms of importance (1-5 Likert-scale). A total of 14 sports coaches, 5 program coordinators, 8 social workers and 5 advisors partook in our CM study, making up four groups of informants. Data among participants of the sports programs have been collected in a separate study.

 

Results:

Altogether, sports coaches provided 152 elements, program coordinators provided 81 elements, social workers provided 115 elements, and the advisors provided 95 elements that they deemed critical for positive outcomes of sports programs serving socially vulnerable adults. Both overlapping and unique elements were provided. The role of the sports coach had the highest average importance score (>4.00) and was equally important for all four groups. Elements related to facilities of the sports activity, such as accessible and diverse activities appeared to be more important for social workers and advisors than for program coordinators and sports coaches. In fact, elements related to facilities of the sports program had the lowest importance score among program coordinators and sports coaches. Elements related to external partners involved in the sport program (e.g., clear agreements with partners, continuous funding) showed to be important to program coordinators and advisors, but less important to the sports coaches. Social workers did not mention elements related to external partners. All four groups deemed elements related to the personal development of the participant, such as working towards a goal and intrinsic motivation important. 

 

Conclusions: 

Training the sports coaches properly and keeping involved care workers in close contact enables participants to achieve better positive outcomes. Sports programs should be experienced as a safe and positive learning environment participants should be encouraged to work on their personal goals without forcing them. For the continuity of a sports program, collaboration with municipalities and social care organizations are essential.

Background: Poor mental health among youth is a public health concern. As half of the mental disorders occur before or during adolescence it is important to investigate how modifiable lifestyle factors are associated with mental health in this population. The association between physical activity patterns and mental health has been studied before but most studies rely on self-reported physical activity. This study aimed to investigate the associations between device-measured physical activity patterns, sports participation, screen time, and mental health in Swedish adolescents.

 

Methods: Cross-sectional data were collected from 1139 adolescents aged 13-14 in 2019. Data on physical activity patterns were collected using accelerometers for one week. Screen time and sports participation were self-reported by the students. Anxiety and health-related quality of life were assessed using a short version of the Spence Children’s Anxiety Scale and Kidscreen-10.

 

Results: A positive association between time spent in moderate-to-vigorous-physical activity during the whole week and health-related quality of life was found (B=0.03, CI: 0.01, 0.05 and B=0.04, CI: 0.02, 0.07), whereas sedentary time during the whole week (B=-0.02, CI: -0.03, -0.01 and B=-0.02, CI: -0.03, -0.01) and high screen time on weekdays (B=-3.50, CI: -4.79, -2.22 and B=-1.54, CI: -2.66 -0.41) were associated with low health-related quality of life in girls and boys respectively. Although the effect sizes generally were small, the largest effect sizes were observed between the high/low MVPA group in boys (Cohen’s d -0.51) and high/low screen time group on weekdays in girls (Cohen’s d 0.59). With regards to anxiety, high moderate-to-vigorous-physical activity during leisure time on weekdays was associated with low anxiety scores in girls (B=-0.09, CI: -0.13, -0.05) and boys (B=-0.4, CI: -0.07, -0.01). Gender differences were observed, boys participating in organized sports had lower anxiety (B= -1.81 CI: -3.49, -0.13) whereas girls who reported high screen time on weekdays had high anxiety (B=4.06, CI: 1.94, 6.18).

Conclusions: Our results could create a paradigm for future studies to decide which types of PA patterns and time domains to target in intervention studies with the aim to improve mental health among adolescents.

Background: The Short Questionnaire to Assess Health Enhancing Physical Activity (SQUASH) is a widely used questionnaire, and used for monitoring prevalence rates of physical activity(PA) in the Netherlands. To provide a standardized protocol for data processing and analysis of the SQUASH, an analysis guide was published in 2004. However, since then, the compendium of Metabolic Equivalent (MET) values of PA has been updated, and new PA guidelines have been developed. The new PA guidelines differ from the old ones in terms of the appropriate amount of active time (150 minutes/week versus 5 days/week 30 minutes), decrease in cut-off point for moderate intensity (adults 18-54 years of age) and adding a bone- and muscle strengthening component. Therefore, the protocol for data processing and analysis of the SQUASH needs to be updated. In this study, results from the old and new protocol demonstrate the differences in adherence rates between the two sets of guidelines in the Netherlands for the adult population.

Method: Data of a nationally representative sample of 6942 participants aged 18 years and older were used to calculate adherence to the old and the new PA guidelines by using the original and the updated protocol. In the new protocol, the MET-values of the activities including sports were adjusted according to the 2011 Compendium. Moderate intense activity was defined as ≥3.0 MET irrespective of age and the bone and muscle strengthening component was added.

Results: Adherence to the old Dutch PA guidelines is 48.1% among adults aged 18-54 years, and 74.4% among adults 55 years and older. For the new PA guidelines the adherence is 48.4% and 38.1% respectively. The large difference for adults 55 years and older is due to changes in the cut-off values for moderate-to-vigorous intensity PA and the addition of bone and muscle strengthening exercises.

Conclusions: The updated protocol for data processing and analysis of the SQUASH describes the steps to calculate the new PA guidelines in a structured way and gives researchers the opportunity to work with the data from the SQUASH in a uniform way. The SPSS syntax for data processing is available at: www.sportenbewegenincijfers.nl/methoden.

Background: Evidence suggest that greenspace use can be associated with children’s physical, mental, social health, and well-being (Tillmann et al., 2018, Mygind et al., 2019, Mygind et al., 2021). Greenspace can facilitate a wide range of low-cost activities and the availability of greenspace is frequently linked to increased levels of recreational physical activity. Accordingly, contemporary children’s declining greenspace use prompts a need to understand the factors that affect frequency of use.

Methods: Aiming to determine to what extent demographic, environmental and social factors predict greenspace use for school-aged (6-15-year-old) children in Denmark, a national online survey was distributed to parents of 10.000 0-15-year-old children. From a total of 4772 responses a sub-sample of 3171 responses from parents of school-aged children was included in the analysis for this study. The aim was addressed by answering the following research questions: 1) How often do Danish children use greenspaces? 2) What demographic differences in greenspace use are present? 3) How do social and environmental factors predict greenspace use?

Results: Responses from the 3171 parents showed that 49.5% of the children used greenspace almost every day during the summer season. Multivariate binary logistic regression analysis showed that the number of types of greenspaces within walking or cycling distance from home was a strong predictor for daily use. Social factors (parental concern and encouragement) also predicted use, but less so. Geography and child age were the only demographic predictors for using greenspace almost every day. 

Conclusions: Findings from the present study suggest that providing opportunity for choosing between various types of greenspaces within walking or cycling distance might be an effective way to stimulate children’s use of greenspace. Also, increased parental awareness of their role in children’s outdoor spatial behaviours might further greenspace use among children.

Virtual communities are emerging in many aspects of health activities and widespread in health management. Online health communities offer a virtual system where people with common interest, specific health needs can exchange information and experiences with other people with the same condition as well as getting support from peer and professionals. The objective of this study is to develop an ICT platform enhancing community resident participation involving in the chronic disease prevention and physical activities.  The aim of this platform is to promote physical activity of community residents for health promotion and disease prevention goal attainment. Health promotion goals for enhancing physical activity were set by health care professionals based on scientific evidence. Instead of individual plan to set the goal by themselves, the platform offered them tailored goal with their conditions and then suggested them to participate in group shared their physical activity goals. The platform encouraged the active participation of community residents though adherence physical activity of health communities in which they were members.The ICT platform provides a place where community residents with chronic conditions or even healthy people who want to promote their health be able to find an appropriate group for together prevent disease and enhancing physical activity. The platform in the study allowed community residents to develop their own communities and invite other members to participate with them. This online community intended to empower community residents to increase their involvement in their self-management and pushing the active participation in phycial activities. Function such as reminder of activity participating was added. Future study will be conducted to evaluate changes in health promotion self-efficacy, health goal fulfillment, health-related quality of life, and shared decision-making after using the Health Community Platform among community residents. Extensive research initiatives are needed to determine the impact of virtual health communities on patient outcome, the overall process as well as quality and access of care. 

Background: The continued prevalence of positive samples to banned performance-enhancing drugs confirms the importance to maintain the anti-doping efforts. Though the role of socio-cognitive variables in doping attitudes is well identified (e.g., Ntoumanis et al., 2014), the role of implicit processes remains sparsely studied in sports’ doping, especially in high level cyclists. While the potential of traditional computer-IAT has been developed to capture individuals’ non conscious attitudes toward doping (Brand et al., 2014ab; Schindler et al., 2015), paper-and-pen IAT offers unquestionably ease-of-administration prospects (Chan and al., 2017). The aim of this study is to develop a French paper-and-pen IAT as an alternative method to measure implicit attitudes toward doping.

 

Method: Based on the Paper-and-Pen IAT of Chan and al. (2017), the French validation of the tool will strictly follow validation procedure (Vallerand, 1989; Boateng et al., 2018), consisting in translation and adaptation, dimensionality, reliability and construct validity tests. A sample of 160 volunteer, sports university students and high level cyclists, all French-spoken, have taken part to this study. Statistical measures of score-D comparisons between paper-and-pen and computerized IAT, as well as t-test scores and correlation coefficients will attest the reliability of the tool (Lucidi et al., 2006).

 

Results: We expect to highlight a link between paper-and-pen IAT and the computerized corollary in the field of sports doping. We expect that the IAT will be able to distinguish between users of banned performance-enhancing drugs from non users according to their scores. Results will be available in April.

 

Conclusion: This study aimed at verifying the reliability and efficiency of the paper-and-pen IAT as an alternative method to measure athletes’ attitudes toward doping. Paper-and-pen IATs are less-costly, more convenient and efficient to run, and offer greater flexibility in terms of study design and data-collection. Consequently, future research might benefit from using IAT to measure underlying doping mechanisms. A better understanding of these processes might lead to strategies for enhancing anti-doping prevention programs.

Despite the accumulation of scientific evidence supporting the benefits of physical activity, the general population remains insufficiently active and this situation is even worsened for some specific populations such as obese people (Barker et al., 2019). It is therefore becoming urgent to develop interventions that can effectively change individuals’ behavior. In this context, "e-health" interventions and gamification appear to be a particularly promising avenue to improve physical activity and reduce attrition rates of current programs.

This study protocol aims to present a randomized, two-arm intervention design that will examine the efficacy of a digital intervention based on play and teamwork for an obese sample. Fifty patients will be recruited at the hospital of Clermont-Ferrand, France and randomized into two groups: the experimental group will receive digital supervised sessions of PA in videoconference and a gamification of PA through a mobile app and will be compared to an active control group representing the traditional care program (supervised physical activity three times per week during three months). Informed by the tenets of the social identity approach and built around behavior change techniques, implemented via the principles of gamification, this three-month intervention has the objective to improve physical activity adherence. Objective and self-reported PA, quality of live, physical condition and psychological variables like motivation or perceived discrimination will be assessed before, at the end of the intervention and then at the issue of a 6-month follow up in order to evaluate the long-term effect of the intervention. We make the assumption that the intervention will be efficient by the development of an intrinsic motivation through the process of gamification on the one hand. On the other hand, through the in-group collaboration with other people who share the same stigmatized criteria that will help participants to overcome weight stigmas, acting generally as physical activity barriers.

This poster presentation will introduce the conception of the intervention, the experimental design and proposed evaluation of the trial. If the effectiveness of this intervention is confirmed, its implementation in the health circuit could reduce the costs and constraints associated to face-to-face support.

Objectives. This study aimed to explore the impact of short-term exercise of varying intensity on traditional cardiometabolic disease (CMD) risk factors. Study Design. One hundred-and-nine children (11.07 ± 0.81 y) were conveniently assigned to 5-weeks of either: moderate intensity continuous training (MICT; n = 29) set at 65% – 70% of maximum heart rate (MHR); high intensity interval training (HIIT; n = 29; > 80% MHR); combined training (HIIT + MICT; n = 27); or no training (CT; n = 24).Data Analysis.A two-way analysis of variance (group x time) was used to evaluate the effects of training on all traditional CMD risk parameters. Effect sizes (ES) were calculated to assess the magnitude of difference. Results. MICT, HIIT and HIIT + MICT significantly improved resting heart rate (ES = -0.39; ES = -1.05; ES = -1.05; p < 0.0001), fasting glucose (ES = -0.63; ES = -0.90; ES = -0.13; p = 0.0004), peak oxygen consumption (ES = 0.53; ES = 0.88; ES = 0.46; p < 0.0001) and c-reactive protein (ES = -0.18; ES = -1.04; ES = -0.54; p = 0.0016), respectively. The HIIT + MICT group significantly reducedwaist circumference(-5.37%; p < 0.0001) and waist-to-hip ratio (-2.47%; p < 0.0002) compared with the MICT (6.99%; 6.33%) and HIIT (-0.50%; -1.27%) groups, respectively. Conclusion.The findings from this study indicate that short-term HIIT and MICT interventions are both effective for improving cardiometabolic health in children. HIIT + MICT may provide superior reductions in central obesity indicators. 

 

Background

Independent boarding schools are a unique Danish type of residential setting for young people between the ages of 14 to 18. Distinguishing independent boarding schools from Danish public schools is, the independent boarding schools’ distinct obligation to promote the “personal development” of the students. Approximately half of the 242 Danish independent boarding schools have an explicit focus on sport and physical activity (PA). Thus, it is interesting to investigate if sports-based independent boarding schools offer an arena with particularly good opportunities to work with the personal development of young people?

 

Methods: In March 2019 a survey was distributed to 1020 students at three participating sports-based independent boarding schools. This survey has since been developed further and in March 2022, it will be distributed nationwide to approximately 120 schools, with the scope of reaching approximately 18.000 students. To gain insights in regard to the aim of the study, the survey will collect quantitative data on sociodemographics of the students, motives for choosing independent boarding school life, the students’ perception of the pedagogical practice in sports and PA lessons, the students’ perceived personal development, and the students' well-being.

 

Results and conclusion:  The study will take place in March 2022 and thus data and conclusions will be presented at the conference.

Introduction

Normal aging is associated with progressive functional loss in many cognitive domains, including working memory, attention (van Raalten et al., 2008) and executive functions (Nyberg et al., 2008), responsible for the control of behavioral activities (Miller & Cohen, 2001). Research aim was to evaluate postural control and executive function during dual tasking in physically active and inactive old adults.

Methods

Participants were 42 older healthy human males and females (Mean age: 70.17±6.08 years). Posturography method with a single piezoelectric force plate was used to measure postural sway activity. For the evaluation of cognitive functions, we used Word Memory task with ten audio-recorded words (Lithuanian nouns) in each trial, and the Mathematical Processing Task, where negative or positive one-digit integer-numbers (10 in total) were presented in each trial at 2-second intervals. Physical activity of participants was evaluated according to WHO recommendations.

Results

The study showed that there was a strong correlation between physically active time spent and balance behavior. The balance of physically active older people was statistically significantly more stable when they performed cognitive tasks than that of those who were physically inactive. Dual-task interferences on postural sway were evident in both Word Memory task and the Mathematical Processing Task conditions. Dual-task effect on Mathematical Processing Task and Word Memory task was not statistically different.

Discussion

Taken together, we suggest that physical activity improves proprioceptive control which also improves balance control. In dual tasking, more attention is required in cognitive tasking, so better proprioception allows for better balance control with fewer attention resources. However, it is also evident that participants can reduce sway activity and increase balance stability by increasing attentional control.

References

van Raalten, T.R., Ramsey, N.F., Jansma, J.M., Jager, G., & Kahn, R.S.(2008). Automatization and working memory capacity in schizophrenia. Schizophrenia Research, 100(1-3), 161-171.

Miller, E. K., & Cohen, J.D. (2001). An integrative theory of prefrontal cortex function. Annual Review of Neuroscience, 24, 167–202.

Nyberg, E.D., Nyberg, L., Bäckman, L., & Neely, A.S. (2008). Plasticity of executive functioning in young and older adults: immediate training gains, transfer, and long-term maintenance. Psychology and Aging, 23(4), 720-730.

Objective The physical activity health paradox, describing contrasting long-term effects of domain-specific physical activity on health, states occupational physical activity (OPA) to be hazardous and leisure time physical activity (LTPA) to be beneficial for health. Yet, the acute effects of OPA and LTPA on cardiovascular risk factors are sparsely investigated. The aim of this study was to investigate the acute effects on ambulatory blood pressure (ABP) from steps per hour during work and leisure time among cleaners in Denmark.

Methods Data were obtained from a cluster randomized worksite intervention among 91 cleaners in Denmark. Data included a questionnaire, objective physical measurements of weight, height, BMI, ABP and steps per hour. The latter was measured during work and leisure time within a maximum of four continuous days. A preliminary linear regression analysis was conducted as a mixed model including random intercept and slope, allowing for both within- and between-participant variability. The analysis was adjusted for sex, age, job seniority, medication use, smoking, self-reported fitness and BMI. Changes in ABP (mmHg) were estimated per 100 steps/hour. 

                                                               

Results Mean steps/hour were 1333.4 (SD ± 404.1) during work and 530.8 (SD ± 234.1) during leisure time. The resting ABP was systolic 122.4 mmHg (SD ± 20.5) and diastolic 80.7 mmHg (SD ± 12.8). In total, 15.4 % of the population were hypertensive (≥140/≥90 mmHg, or using anti-hypertensives). The ABP did not seem to differ from exposure to steps taken during work (systolic -0.44 mmHg, 95 % CI: -1.07-0.20, diastolic 0.04 mmHg, 95 % CI, -0.43-0.36) and leisure (systolic -0.42 mmHg, 95 % CI, -1.54-0.70, diastolic 0.30 mmHg, 95 % CI, -0.49-1.08). Either did the amount of steps taken seem to affect the ABP during work or leisure.

 

Conclusion Our findings show no significant association between steps per hour and ABP, and no contrasting effects between work and leisure time. These acute mechanisms fostering the divergent results need to be further investigated to improve the understanding of the physical activity health paradox.

Background: There is strong evidence of the multiple benefits of physical activity on health in primary, secondary and tertiary prevention (WHO, 2020). However, economic evaluations are still needed to estimate direct and indirect costs that could be saved from various Health-Enhancing Physical Activity (HEPA) promotion strategies (Ding et al., 2020). Moreover, these savings might be influenced by specificities of the national health system. The aim of this study is to explore the economic impact of HEPA from different settings in France. 

 

Methods: A systematic scoping review of grey and scientific literature was conducted. Relevant articles were identified through searching from PubMed, ScienceDirect, SportDiscus databases and from google. Searches were conducted in English and French between January 2000 and December 2020. A data extraction template was used to collect, organize and summarize data regarding the following variables: aim of the study, study population, study settings, methods, and main results. 

 

Results: A total of 17 studies were included from the grey literature (n = 10) and the scientific peer-reviewed literature (n= 7). Data from each variables of interest were heterogeneous, making comparisons difficult. Studies were categorized in 5 types : studies aiming to estimate the cost of physical inactivity or the cost that could be saved from HEPA promotion in general population (n = 8) ;  studies aiming to evaluate the medico-economic impact of a physical activity adapted program (n = 5) ; studies aiming to assess the economic benefit of active travel in a city (n = 3) ; study aiming to estimate the economic impact of physical activity from a company and its employee’s perspectives (n = 1). Whatever the methods, the study population or the study setting, several tens of millions of euros to several billions of euros could be saved each year by investing in HEPA promotion.

 

Conclusions: HEPA promotion can lead to substantial saving. Methods should be standardized to more precisely estimate its extent in different settings in France. This could help policy-makers in their decision to invest in HEPA promotion, especially in phases of epidemics, where sedentarity and physical inactivity account for major health risks.

Background

Although exercise training is an important component of pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD), a majority of COPD patients fails to maintain training after PR. This study aimed to evaluate the effectiveness and implementation of a 12-months home-based, minimal equipment strength exercise programme.

 

Methods

Parallel arm, multicentre study across four Swiss PR clinics, random allocation of COPD patients (1:1 ratio) into intervention (IG) or control group (CG, usual care). Primary outcome was change in dyspnoea (Chronic Respiratory Questionnaire, CRQ) from baseline to 12-months, secondary outcomes change in exercise capacity (1-minute-sit-to-stand-test [1-min-STST], 6-minute-walk-test [6MWT]), health-related quality of life, exacerbations and symptoms. Main effectiveness analyses were based on the intention-to-treat approach and adjusted linear regression models were used. To assess the implementation outcomes dose, reach, fidelity, adherence, acceptability and appropriateness, we conducted interviews with patients, coaches and stakeholder and analysed reports, diaries and notes.

 

Results

123 patients (IG: 61, CG: 62) were randomised, 61 females, mean (SD) age 66.8 (8.1) years, and 104 participants completed 12-months follow-up (IG: 53, CG: 51). Of 53 IG participants, 37 (70%) conducted the training until study end. We found no difference in change of CRQ dyspnoea over 12 months (adjusted mean difference 0.28, 95% CI -0.23-0.80, p=0.27). We found moderate evidence for a difference in 1-min-STST repetitions favouring the IG (adjusted mean difference 2.6 (95% CI 0.22-5.03, p=0.033) but no evidence for an effect in other outcomes.

All involved groups perceived the strength-training exercises as appropriate, efficient for COPD patients and relevant to maintain improvements after PR. The patients’ most important facilitators for long-term motivation were self-perceived improvement in strength, supervision by a coach and integration of the training in daily routine. Based on these insights, we redesigned and reworded the training material and introduced three new exercises.

 

Conclusions

The exercise program had no effect on dyspnoea but improved 1-min-STST performance and patient-perceived fitness. The results from the insights of the involved persons enabled us to optimize the program for sustainable further use in clinical and other settings and inform the future design of patient-centred home-based exercise programs in COPD.

 

A global target of the WHO is to reduce physical inactivity in all adults and adolescents by approximately fifteen percent by 2030. Social media could have an impact in this effort because of its enormous reach, potentially addressing underserved populations in need for PA interventions. To date, characteristics and effectiveness of social media-based interventions for the promotion of PA are not well understood.                                                                                                      

This scoping review provides a broad overview of existing social media-based interventions and systematically maps the evidence regarding their effectiveness for PA promotion and other health outcomes.

Scopus and Medline were searched for the terms “physical activity”, “social media” and key social media platforms. Following the PRISMA guidelines for scoping reviews (PRISMA-ScR), two reviewers independently screened abstracts and full texts for eligibility. Any discrepancies were resolved by a third reviewer. All records referring to interventions delivered via any type of social media or at least incorporated one social media component of either pre-existing or study-specific platforms and addressed PA as primary outcome were included. Results were summarized following the objectives of this review. In addition, evidence on use, acceptability, and usability of interventions was mapped.

In total, 12.321 publications were identified and 53 met the inclusion criteria. The use of Facebook was most prevalent in interventions to promote PA, followed by the incorporation of study-specific platforms alone or in combination with Facebook. Occasionally utilized applications included Twitter, Pokémon Go, and YouTube. More than one third of the studies revealed positive effects regarding the promotion of PA. Additional evidence emerged in this scoping review demonstrating that social media-based interventions have a positive impact on other physical dimensions of health (e.g. weight or blood pressure).  Due to the great heterogeneity in the assessment of acceptability, use, and usability across the different publications, results cannot be pooled. However, the use of Facebook as a motivator for PA was rated positively across six of the included studies.  

Social media seems to be a promising tool for increasing PA at the population level. Future studies should take the abundance of platforms into account and select social media interventions meeting the requirements, preferences, and needs of varying target populations.

Background: As a major public health concern, there is a high association between aging and obesity, nutritional deficiencies and physical (in)activity. Thus, diseases related to cartilage are on the list of main concerns of the WHO, assuming the prevention of degeneration of articular cartilage as an important issue for which there are few effective solutions. It is imperative to find preventive strategies that can reduce the incidence of chronic osteoarthritis.

Methods: Eleven women (58.1±3.3 years-old) diagnosed with knee osteoarthritis (KOA) enrolled in tri-weekly aquatic fitness 45’ sessions, for 12 weeks. Taking advantage of the physical properties of the water for increasing the load, a gradual use of the extension of the levers was defined. The warm-up focused on body alignment, joint mobility and breathing. The fundamental part was based on exercises that combine the cardiorespiratory component with the strength component, promoting a superior range of motion. At the end of each session there was a progressive decrease in load, alternating body segments. Before and after the 12 weeks they performed the Senior Fitness Test, hand-grip strength and body measures. All participants were volunteer, informed consent was obtained and all procedures were in accordance to Helsinki Declaration. Sessions were instructed by a CSCS®.

Results: Significant and meaningful improvements were observed in lower body strength (p<0.001; d=1.10), lower body flexibility (p<0.001; d=2.88), aerobic endurance (p<0.001; d=0.95), dynamic balance (p<0.001; d=1.22) and hand grip strength (p<0.001; d=1.56). Significant, but moderate improvements were observed in body mass (p=0.034; d=0.56) and waist circumference (p=0.041; d=0.66).

Conclusions: Aquatic fitness induced extensive benefits in women conditioning, suggesting that this activity is able to promote an increase in life quality, even if KOA is diagnosed. This program aims to be a tool for implementing healthy behaviour, based on a physical exercise program to people with KOA. With a demographic trend towards an aging population, today society has dragged itself into a vicious cycle to the proven relationship between OA and obesity, and the increasing prevalence of both. To contribute to solving these problems, it is mandatory to have interdisciplinary perspectives that promote a motivating and lasting activity.

Background: Despite the crucial role of regular physical activity (PA) for preventing chronic non-communicable diseases, fewer than half of older adults in Germany engage in the recommended levels.

Objective: The aim of this study was to compare acceptance and effectiveness of two interventions for PA promotion among initially inactive community-dwelling adults aged 60 years and above in a nine-month randomized trial with a cross-over design.

Methods: Participants were recruited offline and randomized to (a) a print-based intervention (PRINT n=113) and (b) a web-based intervention (WEB, n=129). Thirty percent (n=38) of those in group (b) received a PA tracker in addition to WEB (WEB+, (c)). All intervention groups were offered ten weekly face-to-face group sessions led by trained student assistants. Afterwards, participants could choose to stay in their group or cross over to one of the other groups. Group sessions were continued monthly for another six months. Three-dimensional accelerometers to assess PA at baseline (T0), three-months (T1) and nine-months (T2) were employed. Intervention acceptance was assessed via self-administered paper-based questionnaires. Linear mixed models were used to calculate differences in moderate-to-vigorous PA (MVPA) between time points and intervention groups.

Results: Of the initially recruited n=242 participants, n=91 (37.6 %) were randomized to the WEB group, n=38 (15.7%) to WEB+ and n=113 (46.7%) to PRINT and n=195 participants completed T1. Only n=1 moved from WEB to PRINT and n=15 from PRINT to WEB (WEB-WEB: n=103, PRINT-PRINT: n=76), when offered to cross over at T1. One-hundred and sixty participants completed T2. MVPA in min per day increased between baseline and T1, but these within-group changes in time disappeared after adjusting for covariates. MVPA decreased by 9 min/ day between baseline and T2 (β_time = -9.37, 95% CI: [-18.58; -0.16]), regardless of intervention group (WEB vs. PRINT: β_group*time = -3.76, 95% CI: [-13.33; 5.82], WEB+ vs. PRINT: β_group*time = 1.40, 95% CI: [-11.04; 13.83]). Intervention acceptance was generally high.

Conclusions: Despite high levels of acceptance of web- and print-based interventions for PA promotion and little movement between groups at T1, when given the choice, participation was not associated with increases in PA over time.

Background: Incorporating age-friendly elements across urban environments can promote active and healthy ageing by facilitating opportunities to improve health and well-being among older residents. However, developing inclusive and supportive age-friendly environments remains a key gap for governance and public policy. Community-engaged citizen science recognises older adults as key stakeholders in designing and implementing age-friendly initiatives. The aim of this study was to employ the Our Voice citizen science for healthy equity framework to engage older adults and community stakeholders to: a) identify local urban characteristics that influence active and healthy ageing, and b) co-produce recommendations to develop actionable urban changes.

Methods: Older adults (n= 17; Mean age= 72(7.5 SD); 11 women) and community stakeholders (n= 23; 14 women) in urban planning and ageing-well services were recruited from Birmingham, UK. Six online discussion groups (n= 16 older adults, 11 stakeholders), 12 Discovery Tool walks (n= 14 older adults), 3 in-person discussions (n= 12 older adults), 2 online individual discussions (n= 2 older adults) and 2 workshop events (n= 15 older adults, 17 stakeholders) were conducted. Audio transcripts and co-produced data were member checked and thematically analysed to identify urban barrier and facilitator themes and co-produce recommendations.

Results: A range of interconnected urban features were identified as influential of active and healthy ageing, including presence or absence of community facilities, suitable outdoor spaces, and the impact of Covid-19. Six collective and 12 individual recommendations were co-produced proposing feasible ways to enhance urban environments. These included public toilets schemes, maintenance of green and public spaces, car parking enforcement, provision of local information, and integrating communities across all ages. 

Conclusion: Employing citizen science developed a network of older adults and stakeholders that shared local knowledge and experiences to co-produce a strong vision for shaping urban environments in Birmingham. This approach facilitated older adults to: drive research processes and solution-building; identify local urban influences; and advocate these findings to a network of actors who can disseminate and activate change in urban domains. To enhance citizen science further, increased time and resources to embed older adults into scientific processes, including data analysis and interpretation, is required.

Background:

The impact of the physical environment on physical activity is not equal for all citizens. According to the socioecological theory, moderators of the association can for example be income, education, age, ethnicity and gender. These moderating conditions are important for practice in order to plan and initiate the best solutions for different population groups.

Methods:

Based on a systematic review process 1464 studies were screened. After title, abstract and full text reading 41 studies remained and constitute the basis for this presentation.

Results:

Citizens with different sociodemographic backgrounds are often geographically divided within cities. Looking at the overall characteristics of urban areas, studies show that citizens with lower incomes and shorter education often live in areas with higher population density and generally shorter distances to daily destinations. Conversely, citizens with higher incomes and longer education often have better access to trails, sidewalks and sports facilities. Several of the included studies find that access to facilities is inferior for low-income citizens, but other studies indicate that social and personal factors also play a role in the use of the areas. Adding to this, some evidence possits a lower adoption of for example new bike trails for citizens with shorter education. This leads many of the studies to recommend holistic efforts where improvements in the built environment are initiated simultaneously with other types of efforts that strengthen information, skills and motivation for physical activity. For example, combine cheaper or free access to sports facilities or gyms with marketing and beginners’ courses. Another important finding from the equity review is a focus on safety from crime and traffic, which more often is a problem in low income areas, and at the same time a larger perceived barrier for women and elderly people.    

Conclusion:

The interplay between sociodemographic characteristic and the physical environment is complex, but the review points to some important findings.

 

Physical inactivity is a worldwide public challenge and a leading risk factor for overweight and obesity. Despite the well-recognized benefits of physical activity (PA), only 29% of European youth meet recommended guidelines of at least 60 minutes of daily moderate-to-vigorous PA. The school setting provides an ideal environment to promote healthy lifestyles among young people as initiatives can target all students and the whole school community. The main goal of the EUMOVE project is to design and implement a comprehensive set of strategies and resources to enable the educational community to promote healthy lifestyles in order to reduce risk factors for non-communicable diseases.

EUMOVE project (https://eumoveproject.eu/) is a 3-year project delivered by a collaboration between academic and non-governmental institutions from Spain, Portugal, France, Italy, and the United Kingdom. The direct beneficiaries of the project will include school leaders, teachers, and parents, and indirect beneficiaries will be primary and secondary students. EUMOVE project will develop a set of strategies and resources such as Physically Active Lessons Toolkit, Real Time Active Breaks Platform, Active School Commuting Toolkit, Learning Units about healthy lifestyles promotion, School Leaders toolkit, Parents Toolkit about promoting healthy lifestyles, and Mobile phone APP. Project dissemination will be implemented across each partner region and includes: Online dissemination through a learning platform, scientific events aimed at teachers and researchers, workshops with teachers including training on how to use the teaching resources, and Workshops with parents providing recommendations for promoting healthy lifestyle in their children.

Thus, the EUMOVE project offers evidence-based and innovative resources to be applied by the educational community in the real-world setting to promote PA levels, appropriate diet and sleep habits, and reduce sedentary time amongst children and adolescents across a number of European countries.

Background: For the past decade, community-based programmes have been a popular strategy for physical activity promotion. The implementation of these programmes is a complex process, characterized by (a) objectives that vary locally, (b) adaptions to the programme over time in response to a community’s shifting needs, challenges and opportunities, (c) emergent outcomes, and (d) non-linear causality. This poses several challenges for evaluation, as commonly used evaluation designs mainly focus on predetermined programme components and outcomes. Such a traditional evaluation approach may overlook necessary but unanticipated programme developments or outcomes and provide limited opportunity to learn from these. The aim of this study was to develop a novel evaluation approach that considers the complexity perspective, in order to evaluate a large community-based programme for children’s physical activity and health promotion in the Netherlands.

Methods: An exploratory review of theoretical and methodological literature regarding community-based health promotion, complexity theory, developmental evaluation and theory based evaluation was conducted. Based on this review a novel evaluation approach was developed.

Results: The developed evaluation framework focusses on elements of the complex and adaptive implementation process of community-based health promotion. These include the local programme theory, implementation, adaption, the influence of context and feedback loops, and intended as well as emergent and unintended outcomes. By studying each of these elements in practice using innovative qualitative methods, including Ripple Effects Mapping and the Critical Event Card tool, principles that guide effective health promotion across community contexts can be extracted. Practice-based knowledge can subsequently be validated in other contexts. 

Conclusions: The proposed evaluation approach aims to inform both research and practice (local and national programme planners and policy makers), by considering the implementation of community-based programmes as a complex process in evaluation. Using this evaluation approach will provide insight in how community-based health promotion programmes impact communities, and which mechanisms underly success or failure. The proposed evaluation approach may be relevant for other physical activity promotion programmes or policies. Since considering complexity in evaluation is a relatively new challenge in public health, we believe it is essential to share and deliberate on innovative evaluation approaches and methods.

Background: The acquisition of health promotion (HP) skills and knowledge is essential for interventions development [1,2]. Considering the increasing recognition of the potential of HP in sports clubs (SC) [3] and the number of HP interventions [4,5], the development of training to optimize their implementation is important. To this end, the MOOC (Massive Open Online Course) PROSCeSS (PROmotion de la Santé dans les Clubs de SportS) was developed. The objective of this work was to evaluate the learning process of the MOOC, its acceptability and its effectiveness on the HP knowledge and on the abilities to implement the learning.

Method: Questionnaires were sent to participants before and after the training between November and February 2022. The RE-AIM model, measuring reach (affected audience) of the training, effectiveness (knowledge gained), adoption (motivations to participate in the course), implementation (use of learning), and maintenance (long-term use of learning) was used to structure the study. Descriptive and multivariate statistics were performed using SPSS 23.0 software.

Preliminary Results: Of the 2000 learners, 21% completed the pre-MOOC questionnaire and 5% completed the post-MOOC questionnaire. Among non-exclusive categories, 32% of learners were SC coaches, 26% were managers, 43% were practitioners (on average for 10 years) and 46% were HP or sport professionals. A paired sample t-test showed an 11% increase in the post-MOOC knowledge questionnaire score compared to the pre-MOOC questionnaire, as well as a 10% increase in confidence in implementing HP actions. 48% of learners were "completely satisfied" with the MOOC and 47% "quite satisfied". The strategies of participatory approach, communication and objective were considered as the most important and feasible while the lack of time, financial and human resources were considered the main barriers to learning’s implementation.

Conclusion: SC actors seem to be interested in HP and want to be trained. This MOOC appears to be an effective solution for acquiring knowledge in HP. The results provide indications for the development of strategic tools and inform on strategies recognized as effective and feasible to implement HP projects and face the problems encountered by the SC.

Background Adolescents tend to be less physically active and thus become more vulnerable to health risks. Engaging adolescents becoming agents of their active lifestyle could potentially catalyze the impact of interventions. Therefore, the effects of an asset-based physical activity promotion intervention on the physical activity behavior and physical fitness of pre-vocational students was evaluated, taking into account the extent to which the students were involved in the design and implementation of the interventions. Methods This randomized controlled trial included 2286 prevocational students divided between an intervention and control group. Innovative triple-i interactive research methods were used to develop and implement tailor-made interventions in co-creation with students and teachers. Self- reported physical activity behavior and direct assessments of physical fitness levels were determined on baseline and two annual follow-ups. Student involvement was determined by validated questionnaires. Generalized estimating equations were performed to determine intervention effects over time. Sensitivity analyses were conducted to evaluate the effects of the extent of student involvement. Results No intervention effects were found for total physical activity level, screen time, active transport and sports activities (CI includes zero; P>0.05). Positive effects of the intervention were found for the long jump (β=3.44; CI=1.29:5.58; P=0.01), the handgrip strength (β=0.55; CI=0.02:1,08; P=0.04), the shuttle run test (β=0.28; CI=0.02:0.54; P=0.03) and the sum of skinfolds (β=-0.08; CI=-0.11:-0.06; P=0.01). Subgroup analyses on the extent of student involvement showed mixed results. Students at intervention schools where students involvement was more successful showed no alterations in physical activity levels and higher scores on shuttle run scores (β=0.58;CI=0.29:0.87; P=0.00) compared to controls. Students at intervention schools that were less involved, showed higher scores on long jump (β=7.77; CI=4.78:10.76; P=0.00), grip strength (β=1.34; CI=0.61:2.06; P=0.00), and sum of skinfolds (β=-0.15; CI=-0.19:-0.10; P=0.00). Conclusions The participatory physical activity intervention in this study does not change physical activity level but does improve some elements of physical fitness. The research methods used in this study offers a protocol to align intervention plans to the students’ assets by co-creation which is feasible to use in the school context.

Background: The built environment is one of the main places where residents engage in their physical activity. Therefore, it is important to identify the track most frequently used by the population. This was done by designing a mobile application that charts the track that residents take when practicing their sports and sends them to a specially designed data hall to arrange and classify information. Since there are no tracks dedicated to exercising in the Jijel city, Algeria; the study aimed to identify the most frequently used tracks, as well as identify the points that constitute an obstacle in those tracks.

Methods: During April-May 2021, 107 people (76 men, 31 women) from city of Jijel (Algeria) participated in the study (Purposive Sample). Participants were provided with a mobile application (APK file) linked to a database that collects and arranges data and mapped with ArcGIS software. The experiment lasted for 30 consecutive days. Where the application was programmed to start automatically at 06:00 am to 09.00 am. The application maps participants' track, and identifying places where deceleration occurs.

Results: Around eighty-two percent (82.2%) chose three main tracks, two coastal tracks (A,B), and a mountain track (C), These are the paths that have been analysed and studied.  A total of 2552 hours of data were collected, with an average of 29 hours per person. In the three tracks, there were 18 sub-tracks (less than 10 meters), These sub-paths are distributed as (A:06, B:09, C:03).  The coastal tracks (A,B) witnessed a noticeable slowdown in movement speed.  This slowdown is related to the presence of obstacles such as unpaved roads, congested traffic points and narrow pedestrian paths, which witness congestion in the morning. The mountain track (C) considered the least slowed path due to the absence of traffic congestion.

Conclusions: The tracks and the three lanes must be rehabilitated in a way that allows residents to engage in physical activity in a smooth and safe manner. Some changes have been suggested in the lanes and marked with signs dedicated, with a recommendation to intervene at 43 obstacles.

Background:  Falls are a major cause of mortality and morbidity in older adults worldwide, yet those who are more physically active have a lower risk of falling.  There is little information on which participants are most likely to complete falls prevention exercise programmes and increase their levels of physical activity (PA).  This study aims to identify factors associated with completion of, and PA levels, at the end of the Falls Management Exercise (FaME) falls prevention exercise programme, a programme designed to increase balance and functional capacity, increase bone and muscle mass and reduce fear of falling.

Methods: 356 community-dwelling adults provided routine data.  Characteristics of participants were compared at baseline.  Comparison of activity levels between completers and non-completers were carried out, and a regression analysis performed to identify factors associated with programme completion and achievement of 150 minutes of moderate to vigorous physical activity (MVPA) per week. 

Results:  143 participants completed the FaME programme.  This group was significantly younger (range 50-96; mean=75.3, SD=8.1 in completers vs. mean=77.8, SD=8.3 in non-completers) and had significantly lower scores on the FRAT (median=1, IQR=0-2 in completers vs. median=2, IQR=1-3 in non-completers) and FES-I risk assessments (median=10, IQR=7-13 in completers vs. median=11, IQR=8-16 in non-completers) at baseline, and a significantly higher level of physical activity (PA) per week (median=673 minutes, IQR=252-1252 in completers vs. median=558, IQR=120-1127 in non-completers).  Completers significantly increased their total minutes of PA per week, and the converse was true for non-completers.   Multivariate regression analyses showed that FRAT score was significantly associated with completion of FaME, and 180 degree turn and FES-I score were significantly associated with achieving the recommended 150 minutes of MVPA per week.

Conclusions:  This study has shown that a significant increase in PA levels is only demonstrated in those who complete the FaME programme.  Scores from selected functional measures and risk assessments are associated with FaME completion and achievement of 150 minutes of MVPA.  This information can be used to provide targeted support to improve completion rates and physical activity levels of participants. 

Background

Children and adolescents with cerebral palsy (CP) are a vulnerable group who find it challenging to meet current physical activity guidelines, which predispose them to the negative health implications associated with low levels of physical activity and high levels of sedentary time. For these reasons, a key role for many clinicians, parents, and other practitioners is to encourage and facilitate an increase in habitual physical activity and reduce the amount of time spent sedentary, in order to optimize long-term health outcomes. 

In Denmark, there is a strong tradition of practicing habitual exercise at leisure activities (83% of children and adolescents). When participating in leisure activities these children are being physically active as well as experiencing being a part of a community. Children and adolescents living with CP are often not able to participate in regular leisure activities, which excludes them from the active and social life that’s happening there. This study focuses on parents of children with GMFCS I-II, who, due to their good walking abilities, may be more likely to be able to participate in regular leisure activities. 

This study aims to explore the daily life and challenges described by parents in their pursuit of supporting their children with CP living a physically active life. This knowledge can be used by parents, clinicians, coaches, teachers, and other practitioners to guide families living with CP towards a more physically active lifestyle and possibly optimize long-term physical and social health outcomes for children and adolescents with CP.

 

Methods

Eleven parents of children with CP (n=7) (GMFCS I-II) aged 7-15 years participated in seven semi-structured interviews. Thematical analysis was performed to understand the data material. 

 

Results and conclusions

The main challenge described by parents was formulated as “Falling between two stools” referring to the experience of their child being “too good” for adapted leisure activities, but at the same time wanting to participate in regular leisure activities, but performing a little too poorly, to feel included. It was found that a reigning performance culture in regular leisure activities was perceived as a barrier for the participation of these children.

Background: Sedentary time (sitting) has been associated with adverse cardio-metabolic consequences. The general recommendation is to interrupt long periods of sitting. In order to successfully develop interventions and policies to decrease sedentary behaviour, high-risk groups as well as the context of sitting should be identified. The aim of this study was to investigate sedentary behaviour among (subgroups of) the Dutch population and to identify in which domains most sedentary time was spent.

Methods: Data from the 2017 Dutch national Health Interview Survey was used, which includes a nationally representative sample of 8,441 Dutch citizens aged 4 years and older. Sedentary time on an average day was assessed using an adjusted version of the Marshall questionnaire. Sitting domains were defined as: 1) traveling, 2) at work, 3) at school or studying 4) watching television, 5) using a computer/smartphone at home, and 6) otherwise. Total sedentary time was analysed stratified by age, sex and level of education with ANOVA and Bonferroni correction.

Results: On average the Dutch population accumulates 9,0 hours/day of sedentary time. Overall, participants accumulated most sedentary time while watching television (2.2 hours/day) followed by sitting at work and other activities (both 1.7 hour/day). Significant differences (p<0.001) were found by sex, age group and level of education. Men reported slightly more sedentary hours than women (9.2 vs. 8.8 hours/day). With respect to age groups, adolescents (12-17 years old) reported the highest, whereas children (4-11 years old) reported the lowest sedentary hours (10.1 vs. 7.3 hours/day). Finally, sedentary hours were high for higher educated people (9.7 vs. 8.2 hours/day in lower educated people). Adolescents accumulated most sedentary time at school or during studying (4.0 hours/day), higher educated people accumulated most sedentary time at work (3.4 hours/day).

Conclusions: Our study showed that in general Dutch people spend a lot of time sedentarily, especially adolescents and higher educated people. Most sedentary times was spent while watching television, at school or during studying, and at work. Therefore interventions aiming to decrease sedentary behaviour in the home environment, the occupational as well as the educational setting are of importance to implement.

Background There is an emerging body of knowledge regarding benefits of outdoor activity on well-being, restoration and mood enhancement. This pre-post study explored psychological outcomes in groups carrying out exercise classes in outdoor and indoor settings. An aim looks to environment in group classes for physical activity programs for population health. Research Questions: (1) What are the psychological outcomes after a green exercise session (2) Is there a difference in psychological scores between indoor and outdoor exercise programs? Methods Two groups of subjects undertaking similar exercises for one hour, in two settings: a fitness studio (N=19) and a city park (N=15), subjects completed the Subjective Exercise Experience Scale (SEES) prior to and post classes. Paired t-tests for dependent groups identified differences in the three categories of SEES, computed by IMB SPSS Statistics 20. Results Exercise in each group improved scores of psychological well-being. Independent samples t-test showed the outdoor group reported higher psychological well-being markers in the pre-survey. Statistically significant difference for “awful” with indoor (M=2.8421, SD=1.64192) and outdoor (M=1.7333, SD=.96115); conditions t(32)=2.32, p=.027. Paired samples t-test showed weak statistical significance for improved values for psychological well-being (M=5.36, SD=1.24) and decreased values for psychological distress (M=1.08, SD=1.87) in the indoor group pre to post. There were no statistically significant differences between pre and post survey data, the outdoor environment did not garner higher response scores than the indoor group. Limitations included relatively small sample size, difference in age between outdoor and studio participants, as well as a hot summer in Germany, which may have impacted the perceived well-being scores. Conclusions Exercise is beneficial to psychological well-being, regardless of environment. The study did not provide evidence that green exercises elicited greater psychological responses, likely due to study limitations. The outdoor cohort, 50-70 years of age, demonstrated a heightened interest in outdoor programs. Indoor exercise classes should be encouraged as it decreases distress. Green exercise could foster anticipation of a more positive experience yet weather could impact mood outcomes. Intensity, hydration and shade should be prioritized. Future green exercise studies should include objective measures such as age and weather conditions.

Background. Older adults often fail to reach the recommended amount of physical activity to prevent the age-related decline in metabolic, cardiorespiratory, and muscular function. Effective home-based physical training programs could neutralize barriers preventing older adults from being active, and administration/supervision through videoconference may be an optimal solution. The present randomized controlled trial aimed to test the non-inferiority of training program administered through videoconference against the same program administered face-to-face in healthy older adults. 

Methods. Participants were randomized in a no-training control group (n=13), a face-to-face training group (n=15), and a videoconference training group (n=13). The intervention groups completed the same home-based, structured, progressive and combined training program for 16 weeks, 1-hour twice a week. Pre-intervention and post-intervention evaluations included body composition, cardiorespiratory fitness and muscle function measures. The non-inferiority margin was calculated by comparing the face-to-face training group to the no-training control group.

Results. Non-inferiority of videoconferencing against face-to-face training was observed for changes in body weight (p<.01), fat mass (p=.015), maximal aerobic power (p=.013), maximal heart rate (p=.034), maximal oxygen consumption (p<.01), knee extension strength (p=.044) and lower limb power (p=.019), but not for muscle mass (p=.067), handgrip strength (p=.171), trunk extension strength (p=.241) and knee flexion strength (p=.462).

Conclusion. A training program administered through videoconferencing was not inferior to the same program administered face-to-face for reducing body weight and fat mass, and for improving maximal aerobic power and oxygen consumption as well as lower limb power and knee extension strength in healthy elderly subjects.  However, videoconferencing training was not as effective as face-to-face training for improving handgrip, trunk extension and knee flexion isometric strength, possibly because of a higher motivation related to the physical presence of the trainer in the face-to-face training group.

INTRODUCTION One scope of the Active and Healthy Ageing framework is to increase awareness on elderly-related topics. The year 2020 has seen an upheaval across the world caused by the COVID-19 emergence, even higher to older persons.

METHODS In Italy, data gathered by the PASSI d’Argento behavioural surveillance system on general population aged 65+ in the timeframe 2016-2019 describe health conditions, lifestyles and care needs for elderly.

RESULTS Basing on physical activity recommended by the WHO globally, 33% of non-physically impaired older persons reaches out those levels, 27%  are partially active, 40% is sedentary. 9% fell down within 30 days prior the interview, accessing hospital was necessary in 19% of cases; 64% of falling occurred at home, 20% outdoor. 61% refers at least one infrastructural housing issue, 15% perceive higher neighbourhood insecurity. 35% reported difficulties in accessing essential services, especially to local health premises and for necessities. About 19% lives socially isolated, 21% had not any contact (neither by phone) with anyone in a typical week, 71% do not attend collective meetings, such as at a club or church. Nearby 1 out of 3 (29%) represents an asset to the own family/community: 19% looks after cohabiting people, 14% relatives or friends not living together with, 6% engage in volunteering. Participation in training courses or social events (trips/stays organised) regards little more than 2 over65 out of 10: 5% partakes in learning courses, 23% enjoyed those latest occasions. Such low social connectedness is observed even among «younger elderly» (aged 65-74). Nearly 19% referred frailty impacting on their own families mainly, 94% of frail elderly is given help from relatives, 20% from professional caregivers, 12% from acquaintances. All these factors suffer from socio-economic and territorial differences. Among elderly reporting many economic difficulties, social isolation is 31%, frailty 28%, difficult access to services 58%, falling 15%, with a geographic gradient at the expense of the Southern Regions.

CONCLUSIONS COVID-19 is a clear threat to older persons: in Italy, monitoring ageing dimensions under the pandemic scenario represents even a greater opportunity to have scientific data which describe the impact of health emergency on elderly.

Background

During the COVID-19 pandemic, many white-collar workers were requested to exclusively work from home (WFH), which may have affected their sedentary behavior. In Sweden, having less severe restrictions than many other countries, workers were allowed to alternate between WFH and work at the office (WAO), so called hybrid work. Understanding how hybrid work influences total sedentary behavior and its temporal distribution is an important issue for future health promotion. This study aimed to investigate to what extent office workers changed their temporal pattern of sedentary behavior during days WFH compared to WAO, considering age and gender as potential moderators.

Methods

Data were collected from May to December 2020 in office workers (n=199). Their mean age was 42 (SD 10) years and 55% were women. Physical behaviors were measured using a thigh-worn accelerometer (AxivityAX3) for seven consecutive days. A diary identified working hours, time-in-bed and days WFH or WAO. Time-use was classified as short (0-5 min), moderate (5-30 min) and long bouts (>30 min) of sedentary behavior (SB), non-SB, and time-in-bed during workdays (WAO and WFH) and non-workdays. We used Compositional data analysis to express data as 24-hour compositions and linear mixed models to estimate difference in 24-hour compositions between day types (within worker), including age and gender as covariates and moderators.

Results

We found that workdays (WFH and WAO) were associated with proportionally less time-in-bed relative to time awake, more time SB relative to non-SB, and more time in longer relative to shorter sedentary bouts, compared to non-workdays (all p<0.001). WFH was associated with more time-in-bed relative to awake and more SB relative to non-SB than WAO (p<0.05), but the differences for sedentary bouts were not significant. Younger workers and women had more SB, and women accumulated more time than men in longer relative to shorter bouts of SB. However, age and gender did not affect differences between day types.

Conclusions

Working from home influenced 24-hour time-use in office workers by increasing sedentary behavior in total, while its temporal pattern was unchanged. Results contribute to evidence that can support organizational policies on hybrid work.

Background:

Fibromyalgia is characterized by stiffness and widespread pain which cause a negative impact on health-related quality of life and activities of daily living. In this regard, these activities are usually presented as dual-task situations (execution of two tasks simultaneously). Some physical fitness tests have been used under dual-task condition in order to evaluate physical fitness under a more ecological approach. It is hypothesized that physical fitness test could provide more information than physical fitness test under single-task condition. Therefore, the aim of the present study was to explore the relationship between 10m walking test performance under both single and dual- task conditions and the fear of falling and the intensity of pain in women with fibromyalgia.

Methods:

A total of 38 women (55.65 [9.28] years-old) participated in the study. Participants performed the 10-m walking test where they have to walk on a 10 meters straight-line as fast as they can. Moreover, the fear of falling and the intensity of pain were measured by a visual analogue scale (0-100).

Results:

Furthermore, the performance of 10-m walking test correlated positively with the fear of falling in both under single (rho= 0.550; p-value:< 0.001) and dual-task conditions (rho= 0.483; p-value: 0.002). However, the performance of 10m walking test only positively correlated with pain under dual-task condition (rho= 0.341; p-value: 0.031). In single task condition did not significantly correlate (rho= 0.252; p-value: 0.116).

Conclusions:

The performance of 10m walking test under single and dual-task conditions are correlated with the fear of falling. However, the pain intensity only significant correlated with 10m walking test performance under dual-task condition. This could indicate that pain intensity has more influence than the fear of falling on decreasing the performance of a daily living activity such as walking. However, further studies under dual-task paradigm are needed to confirm this hypothesis.

Background/Objectives: About 1,000,000 new cases of cancer in Adolescent and Young Adults (AYAs) are diagnosed annually worldwide. . While their long term survival is about 80%, they are six times more likely to develop a second primary cancer (SPC) compared to their peers. This risk is multifactorial and depends on the type of first cancer, treatment received and prevalence of risk factors. PREVAPAJA aimed to implement a clinical program based on physical activity (PA) and cancer prevention recommendations for AYAs with cancer at Centre Léon Bérard-AYAs Department.

Methods: The study was conducted at Leon Berard Comprehensive Cancer Centre among patients aged 15-25 years. AYAs attended PA sessions during the active treatment period and were individually informed on SPC risk prevention. PA, sedentary, anthropometrics, quality of life and fatigue were assessed at baseline (T1) and at the end of treatment (T2). PA level and intention of changes in health behaviors were assessed by phone 1 year after T1.

Results: 68 AYAs (median age=19 years) were enrolled in 2016-2017). The results showed an improvement in PA level during and at distance of the intervention, with also a reduction of sitting time. Fatigue decreased between T1 and T2 (=<0.003) and overall quality of life improved significantly between T1 and T2 (p<0.001).

Conclusions: This study showed the feasibility of implementing a clinical program based on PA intervention and cancer prevention recommendations for AYAs with cancer. It responded to AYAs’ needs for support and discussions regarding PA recommendations and ways to prevent SPC. Beneficial outcomes of this program should encourage to systematically proposing PA intervention in combination with information exchanges with AYAs with cancer.

Issue/problem: To minimize public health risks and promote HEPA among citizens, an integrated approach between public health experts and spatial planning is much needed. However, cross-sectoral cooperation is very demanding and needs harmonization of concepts and professional terms to reach mutual understanding.

Description of the problem: In 2017 the Urban Planning Institute of the Republic of Slovenia launched the programme entitled Expert Basis for Spatial Planning of Green Areas, aimed at HEPA promotion for citizens. It was co-financed by the Ministry of Health and based on the objectives in the National Programme on Nutrition and Health Enhancing Physical Activity 2015-2025 and the Strategy of the Government of the Republic of Slovenia for Children and Youth Environmental Health 2012-2020. Its purpose is to expertly support the planning and development of towns/settlements in Slovenia for better quality of life and direct it for active and healthy lifestyles of citizens of all ages and social groups. To properly address all relevant issues, cooperation with the National Institute of Public Health was established.

Results (effects/changes): The programme contained multidisciplinary collaboration in a form of consultation workshops and an expert review of the programme publication named Going Out for Health: A green space planning manual to promote physical activity and a healthy lifestyle. The emphasis was on supporting spatial planning issues on quality of green spaces with basic objectives of public health perspectives. The guide is the first example of linking public health promotion approaches and quality aspects of green space planning and design in Slovenia. It contains general guidelines for the planning of green areas aimed at promoting HEPA, expert materials to support municipalities in devising relevant approaches, and decision-making in order to provide useful and attractive green areas.

Lessons: The aspects of green area spatial planning aimed at promoting HEPA are diverse and closely interconnected. The programme and its manual reflect a good cooperation example between spatial planning and public health experts.

Main messages: A good collaboration between urban planners and public health professionals is crucial to prepare useful guidelines for spatial planners and municipality decision-makers on green space planning for HEPA promotion.

Background:

Primary school physical education (PE) is critical for the development of skills that are essential for lifelong participation in physical activity (PA). Despite this, PE provision in Irish schools is inconsistent, while just 17% of Irish children currently achieve the recommended 60 minutes of daily PA. PE exposes children to regular, developmentally appropriate PA and teachers are essential in ensuring high quality PE is provided. This study aims to examine the perceptions and practises related to PE amongst Irish primary school teachers.

Methods: 

A survey was developed and validated using a modified Delphi technique and included 57 questions to examine Irish primary school teachers current teaching practices and supports needed to enhance their PE provision. A link to the survey was emailed to all Irish primary schools and shared on social media. SPSS version 27 was used for data analysis.

Results: 

Of the 473 respondents, 84.4% were female, 15.2% male and 0.4% didn’t say (median age=34 (IQR=12)). Respondents indicated PE is timetabled (90.7%) and taught weekly (97%) in most schools. Time allocated for PE is used for other subjects in 35.9% of cases. Respectively, 40.8% and 52.4% of respondents indicated they never plan for or reflect on their teaching of PE. Just 57.1% of respondents indicated sufficient facilities, while 46.3% believe their equipment is insufficient. Approximately half (45.5%) have undertaken continuous professional development, citing a lack of courses offered, time and other priorities as barriers to undertaking additional training. Teachers cited their own lack of competence and confidence to teach PE as reasons why they would welcome engagement from a specialist PE teacher for certain strands (32.3%) or as a general support in PE (24.1%).

Conclusion: 

Although the vast majority of primary school teachers deliver PE on a weekly basis, these findings suggest teachers require additional supports to assist in their provision of PE. Novel approaches, such as the engagement of specialist PE teachers to support delivery in primary schools, are required to improve PE for Irish youths.

Introduction

The disease profile of low- to middle-income countries is moving towards one seen in Westernised countries, where deaths are mainly attributed to chronic diseases. Children develop risk factors at a young age predisposing them to noncommunicable diseases in adulthood. Most of the risk factors are preventable through healthy lifestyles. Results from South Africa (SA) show that many children, particularly from marginalized communities, do not achieve the minimal requirements of physical activity (PA). Thus, more emphasis needs to be placed on primary prevention strategies, such as incorporating health promotion interventions within established educational and workplace structures. Primary schools present unique opportunities for holistic prevention interventions.

Methods

Using an ecosystem approach, an interprofessional team of PA researchers, public health specialists and digital innovators, together with partners from the ministry of education and ministry of health in SA, was set up to map and tackle the role of physical education (PE) in the SA school system. Experts identified actionable changes at the school, teacher and policy levels. First, a comprehensive health intervention was developed and implemented in primary schools in low resourced settings in the Eastern Cape of SA. The intervention was followed to learn and adapt. Finally, changes in the educational system will be scaled-up and sustained through governmental institutionalization.

Results

In 1994 PE lost its stand-alone subject status and became part of Life Orientation. Ever since, non-specialist teachers lack the confidence and understanding to adequately teach the subject. The interdisciplinary team developed “the KaziBantu model (Healthy Schools for Healthy Communities)”, to promote PA and healthy lifestyles in public primary schools through two complementary programs: KaziKidz, a PE toolkit for schoolchildren, and KaziHealth, a workplace health intervention program for teachers. Furthermore, Short Learning Programs have been developed for continued professional development of life orientation teachers, thereby introducing lasting changes within the educational system.

Discussion/Conclusion

PE and health literacy are oftentimes neglected in the SA curriculum, especially in marginalized areas. System-wide changes initiated and sustained through local ownership are critical to ensure long-lasting impact. Our multilateral intervention aimed to achieve this to offer children and teachers a quality education.

Background: Children and adolescents’ engagement in physical activity has decreased in most Western countries across the previous three decades. Therefore, increasing number of researchers are investigating antecedents of physical activity engagement in childhood and adolescence. This longitudinal study investigated if cardiorespiratory fitness measured at Grade 5 explained objectively measured moderate-to-vigorous physical activity (MVPA) at grade 7.

Methods: The sample of the study included 169 (62 boys and 107 girls, M age = 11.27, SD = .32 at the beginning of the study) Finnish PE students. Cardiorespiratory fitness was measured by 20 meters shuttle run test and MVPA by Actigraph wGT3X+ accelerometers. Sex, BMI and MVPA score at Grade 5 were used as covariates in the analysis. Hierarchical multiple regression analysis was conducted as follows: (a) sex, BMI and MVPA score at Grade 5 were set as covariates on the first step of the analysis; (b) cardiorespiratory fitness measured at Grade 5 was set as independent variable on the second step of the analysis; c) MVPA measured at Grade 7 was set as dependent variable on the third step of the analysis.

Results: Regression analysis demonstrated that sex, BMI and MVPA at Grade 5 were significant variables (R² = 0.235; F = 16.925; p = 0.000) predicting variance in MVPA score at Grade 7. More specifically, results indicated that BMI (β = 0.161; P < 0.026) and MVPA at Grade 5 (β = 0.397; P < 0.000) were significant predictors of MVPA score at Grade 7, whereas sex (β = 0.023; P < 0.738) was not. Subsequently, cardiorespiratory fitness measured at Grade 5 improved predictive strength of the model for MVPA at Grade 7 (R² = 0.284; R² change = 0.049; F = 16.250; P < 0.001). Results showed that cardiorespiratory fitness at Grade 5 (β = 0.264, P < 0.001) was a significant predictor of MVPA at Grade 7.  

Conclusions: Results of this study demonstrated that cardiorespiratory fitness is an important antecedent of MVPA from childhood to adolescence. However, the portion cardiorespiratory fitness predicted MVPA was relatively low. Intensive physical activities within elementary school years are strongly encouraged.

Background: The recent COVID-19 pandemic showed us that the use of digital health technologies could contribute and make health systems and services more effective. People worldwide use digital health solutions to protect their health and promote well-being. WHO recognizes digital health as key to realizing better access to health for people and an important part of the future of health. The aim of the survey is to study medical students attitude towards m-Health applications installed on their devices, assess their usage, and identify their relation to students sport habits. The research as well focused on medical students intention to apply m-Health apps into their clinical practice in order to improve the quality of services provided to patients. 

Methods: In order to achieve the purpose of the study, an anonymous web based questionnaire was used among first year medical students in Medical University –Sofia in Bulgaria, and all the students participated voluntarily. Both the attitudes of the students towards m-Health application, and how sports habits are related with them were measured with closed questions. The study was conducted during January and February 2021. We used a descriptive statistical method to analyze the data. 

Results: Completed questionnaires were received from 133 students. Although the majority of the students (67%) have a positive attitude towards m-Health applications, only half of them (47%) believe that m-Health applications have affected (better and much better) their health-promoting behavior. Data about the use of m-Health applications into their future clinical practice shows that medical students will recommend these applications to their patients (60%), but less than half of them (39%) feel confident with the protection of their patients’ personal data. 

Conclusions: The study was conducted to explore medical students’ opinion about m-Health applications and the related health-promoting behavior. The results shows that although they are keen in using, and recommending m-Health applications, they still do not trust the treatment of the personal data. It is thus recommended that more efforts should be in the direction of m-Health applications trustworthiness development. Great acknowledge, and guidelines in this area are important to ensure the wider use of m-Health applications.

Background: A substantial body of research have shown that parents' behaviours are closely linked to children's behaviours. Although some studies have reported positive association between parents' and youths' physical activity, especially in same‐sex (father–son; mother–daughter), further studies are required to strengthen these preliminary findings. The main objective of this study was to examine the relationship between fathers' and mothers' physical activity and mode of commuting and sons' and daughters' physical activity and mode of commuting.

Methods: This cross-sectional study included 1,372 participants, 686 parents (43.4±6.5 years; mothers: 52.8%) and 439 children (age: 9.7±1.7 years; girls: 65.1%) and 246 adolescents (14±1.7 years; girls: 68.3%). Each participant completed a self-report questionnaire on physical activity (Parents: IPAQ; Children: YAP) and commuting patterns (PACO: Pedalea y Anda al Cole). The parents completed and signed an informed consent on the characteristics of the study, which was approved by the corresponding ethics committee. Descriptive statistics (mean, standard deviation, and frequency distribution) and chi-square test (p<0.05) were used to examine this association. Odds ratio (OR) and confidence interval 95% (CI) were used to determine the degree of association.

Results: Most of the sample did not meet Physical activity recommendations, particularly adolescents and parents (children: 46.4%; adolescents: 6.5%; and parents: 7.2%). Less than one third of the sample commute to school/work actively (children: 31.6%; adolescents: 31.0%; and parents: 31.6%). Only the fathers' physical activity was positively associated with their female children´s physical activity (OR= 2,477, 95%CI: 1,144-5,362). A positive association between fathers' active commuting to work and their children' commuting to school was only found in girls (Girls OR= 2,890, 95%CI: 1,336-6,251), but this relationship was not found in boys’ children and adolescents. And another association was found between mothers´active commuting to work and their children´s commuting (Girls OR= 3,242, 95%CI: 1,343-7,828; Boys OR= 6,381, 95%CI: 2,530-16,091), but not with adolescents. 

Conclusions: Parent’s physical activity and active commuting to work are closely linked to their children's physical activity and active commuting to school, especially in girls. This study emphasizes the importance to involve parents in school-based interventions to create a positive ripple effect in Physical activity-related behaviours.

Physical activity (PA) is an important factor contributing to general health. PA declines rapidly during tween years (9-12 years) when children’s social world changes. During tween years, children’s self-consciousness develops and their focus on social status, friendships, and appearance increase. It is therefore important to consider how to motivate tween’s to be physically active. School playgrounds can contribute substantially to children’s PA and are considered key contexts for children to be physically and socially active. Despite the potential of school playgrounds, little is known about how to motivate tweens to use school playgrounds. 

Use of motivational theories in health research has increased rapidly in the last 20 years and the Self-Determination Theory has been used to conceptualize and analyze motivation. Using the three basic psychological needs (autonomy, competence, and relatedness) proposed by the Self-Determination Theory, this qualitative study aimed to investigate how school playgrounds can support tweens to enhance their autonomous motivation for PA on school playgrounds. We interviewed 56 tweens in focus group go-along interviews in their school playground. 

We found that playgrounds could support each of the three basic psychological needs. School playgrounds supported the need for autonomy when the tweens could freely choose from different play equipment pieces. Furthermore, playgrounds should provide enough space to avoid noisy areas and congestion. To support competence, playgrounds should facilitate challenges at different levels, enabling the tweens to practice and experience task mastery. These challenges should contain an element of risk where the tweens can experience a high degree of competence. Finally, playgrounds provide a unique possibility for making and strengthening social bonds. To support relatedness, playgrounds should include areas to hang out and talk with friends of a similar age. This research highlighted the importance of incorporating tweens’ perspectives in playground design to attract and retain them in play and PA in school playgrounds. 

Background: Physical activity (PA) in Czech children is insufficient. In the last two decades, the prevalence of physical inactivity and excessive time spent in sedentary activities has increased (Gába et al. 2019). The determinants of PA are complex and wide-ranging: individual, socio-demographic, interpersonal, environmental. Motor skill acquisition in early childhood may be an important prerequisite for child PA participation and engagement in PA later in life (Loprinzi et al. 2012).

The aim of this study was to estimate motor competence (MC) level in a Czech school children, identify children with motor impairments and analyze the possible causes.

Methods: The research sample was made from Czech school children (n = 195, 110 girls, and 85 boys) of average age 11.96±1.96 years. To estimate an MC, we used the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, a complete form. We evaluated total motor composite (TMC) and four subcategories: fine manual control, manual coordination, body coordination, and strength and agility. 

Results: Our TMC results correspond to a secular reduction in MC. The results show that the group’s MC is in the lower part of the average level (TMC standard score 45.4±11.7). The overall percentage of children whose TMC is above the 15^th percentile is 64.6 %. Conversely, 35.4 % of children do not meet the criterion in TMC.

On average, the weakest performance was recorded in the area of fine manual control (standard score 38.2±11.6). More in-depth analysis showed that the weakest subcomponent of fine manual control was fine motor precision (scale score 9.3±5.8) and fine motor integration (scale score 10.7±6.1).

Conclusion: 24 children (12.3 %) had well-below average results (TMC≤ 5^th percentile). These children are highly likely to develop a developmental coordination disorder. It is a significantly higher result than in the literature reported around 5 – 6 % in school-age children.

69 children (35.4 %) had below-average result of TMC (TMC ≤ 15^th percentile). The poor results in the fine manual control without the accompanying other motor components point to a low exercise experience rather than a neurodevelopmental disorder.

Background: An appropriate level of physical activity (PA) is important for both physical and mental health and has also been suggested as a protective element against COVID-19. However, even before the outbreak of the COVID-19 pandemic, there were already a high number of physically inactive people in Austria. Due to ongoing pandemic-related social restrictions, not only a further increase of inactivity is suspected, but also the promotion of PA is currently a major challenge. Therefore, the project "MOVEluencer" which has been running since July 2021, follows a multidimensional PA promotion approach that is less affected by the presence of any social restrictions. Methods: The project was realized in six rural communities in Styria (a province of Austria), which were selected based on inequality factors related to health and PA. The target groups are physically inactive residents, particularly families and elderly. Overall, the project measures are based on a participatory approach and are implemented in three sections (phase 1 -3). Results: Phase 1 (July - December 2021) represented an analysis phase in which a photo-challenge was conducted. The aim of the challenge was to identify resources and opportunities for improving active mobility and PA in the communities based on photos taken by residents. Sixty-seven people (43% female) participated in the challenge and submitted a total of 268 photos which were disseminated via the project-specific social media channels. Moreover, in phase 1 working groups represented by members from the project target groups were established. Phase 2 is currently being implemented (since January 2022). One measure is to recruit and train walking buddies to provide regular walks and simple strength exercises along the walking-way. A further measure represents outdoor-educational events, following an interactive learning approach to improve the populations awareness of active mobility and PA in general. During these events, simple tests that assess components of health-related fitness are also offered. Phase 3 will implement target group-specific PA programs currently being developed in the working groups. Conclusion: Promotion of PA remains significant, especially during a pandemic and in rural communities, as awareness of the benefits of PA in this setting is still low.

The World Health Organization (WHO) acknowledges the importance of preschool children taking part in comprehensive physical activities supporting, among other things, their motor development, and competencies. A growing number of children attend early childhood education and care (ECEC), and expectations that this will support the development and learning of the youngest children are high. ECEC are governed by different policies embodied in both laws and curricula, and the framework of a curriculum plays a key role in ensuring the quality of ECEC services. The documents represent the content society wants the ECEC institutions to disseminate, and set out the values, objectives, and content of the work of pre-school teachers and serve as a point of reference for ECEC teachers and schools.

Aim

The purpose of this study was to examine the values of movement and physical activity (MoPA) using government policy documents ECEC from Denmark, Finland, Iceland, Norway, and Sweden.

Method

This descriptive, comparative study was designed based on curriculum theory and used word count and content analyses to examine values of MoPA and to identify similarities and differences in the ECEC policies of Nordic countries.  

Results

Seven terms were identified as MoPA related; body, motor, move, physical activity, physical education, coordination, idrott/liikunta. These terms occurred in various content contexts: development, environment, expression, health and well-being, learning and play, albeit sparsely and were referred to as both a goal in itself and as a mean of achieving other goals (e.g., learning or development in another area). Formulations dedicated to MoPA as a goal were present in the Danish and Finnish curricula and, to some extent, also in the Norwegian, while the Icelandic and Swedish curricula mentioned MoPA only as a mean. Findings indicated that MoPA, which are important for children’s development, health, and well-being, is a low-priority value, to varying degrees, in the ECEC policies enacted by the Nordic countries. Thus, the guidance provided to educators and stakeholders therein is inexplicit. The low priority of the MoPA domain in the ECEC policies might negatively affect the possibility for young children to be physically active in preschools.

Background: Health systems play a fundamental and recognized role in promoting physical activity, particularly in the context of primary health care. eHealth is a broad concept that incorporates any area that combines healthcare and technology. This concept is often associated with improvements in process efficiency and cost reduction. Still, high occurrence of physical inactivity demonstrate the importance of developing new eHealth approaches for a more effective actuation. The aim of this work was to develop a new methodology to increase physical activity level, at primary health care.

Methods: A mobile application with web platform was developed to: physical activity prescription and monitoring; registration of biomedical variables, sending messages to users, managing physical activity events at the initiative of users (social network). The application was explained to the medical doctors and data from a case-study was accessed (56 years-old male, Caucasian, single, nuclear family, upper middle class). History of physical inactivity, obesity, hypertension, dyslipidemia and depressive disorder (sertraline 50mg and mexazolam 1mg therapy), body composition, physical and CRP fitness were assessed. International physical activity and Self-perceived quality of life assessment questionnaires were also used.

Results: It was possible to understand that just by talking was not enough to engage the patient on a more active lifestyle. After several failed attempts on counseling for lifestyle changing, patient was referred for using the developed app. Physical exercise tailored plan was prescribed using the Movida.cronos. This tool opened the possibility of assessing patient performance and adherence to the prescribed program (>90%). It allowed a narrow informative channel between the patient and the medical doctor. In three months, the patient reduced form obesity to overweight (-3.4%), decrease his waist circumference (-6.3%), fat mass (-1.8%) and arterial mean pressure (-5.1%); with an associated increase on step test performance.

Conclusions: This case study demonstrate the potential use of eHealth technology, particularly in primary care. Movida.Cronos allowed the prescription and monitoring of performance and adherence levels to the prescribed exercise program. It brings novel perspectives on prescription and remote monitoring of physical exercise, leading to an increased adherence.

Background

An analysis of currently existing partnerships and cross-country collaboration for physical activity (PA) promotion is valuable for understanding how such partnerships operate, and how they impact national PA promotion efforts. This study aimed to outline the structure of the European Union’s (EU) National Physical Activity Focal Point Network, to evaluate its outputs and benefits, and to describe its potential and challenges.

Methods

We employed a mixed methods approach with three components: (1) document analysis of network meeting reports, (2) semi-structured interviews with key officials who were involved in establishing the network, and (3) an online evaluation survey with the national PA Focal Points. 

Results

The PA Focal Point Network was founded in 2014, and its main task is to coordinate the collection of information for the EU’s HEPA Monitoring Framework. Each of the EU Member States nominated a representative to the network. Focal Points usually meet twice a year to discuss issues related to the HEPA Monitoring Framework and to share best practices and plan activities for the promotion of PA within the EU. The results of the evaluation survey show that participation in the network helped members to specify goals for PA promotion, gain knowledge, and identify opportunities to promote PA in their country. From the perspective of the Focal Points, most helpful outputs of the Network activity are the country factsheets on physical activity, the connections within the Network and the opportunity to share their experience with colleagues during meetings and group discussions.

Conclusions

The study shows that the PA Focal Point Network may serve as an example of successful cross-country collaboration in PA promotion. The network has supported the monitoring of the implementation of the EU Council Recommendation on HEPA across sectors in particular and of PA promotion in the EU in general. It also had positive effects on national PA promotion efforts and on cooperation between countries. All in all, the PA Focal Point Network can serve as an example for other world regions or policy areas that set up similar networks.

Issue: Population level changes in physical activity (PA) may benefit from policy intervention. In response to the UN Sustainable Development Goals, Wales introduced legislation (the Well-being of Future Generations (Wales) Act 2015) to holistically improve health and well-being, including the translation of national policy into practice. This audit provides a case study approach that could be replicated by researchers in other countries to appraise the role of PA actions in national and sub-national policies. 

Description: An audit of policies published by national and sub-national public bodies between 2015 and 2020 was conducted. The list of identified policies was reviewed by an external panel to act as a “critical friend” to verify its inclusiveness. Content of the policies were extracted and synthesised to determine: (i) how many policies included a PA action; (ii) what the drivers of those policies were; (iii) the content of the PA actions; and (iv) how the PA actions aligned with the Well-being of Future Generations (Wales) Act 2015. 

Results: A final list of 73 policies was obtained. Only 16 national-level documents had a PA action, which had been published by 4/13 public bodies (who are bound by the Act). Of the 19 sub-national well-being policies, 15 included PA actions. Most policies were considered reactive and varied in terms of the clarity and specificity of the actions, the assignment roles/responsibilities, and the setting of targets; all overarching principles which can be used to strengthen national and sub-national policy in the future. The most common theme of action across the national-level documents was the broad action of PA promotion, which was identified in nine of the 16 documents. The actions within the national-level documents were reflected in the sub-national well-being plans. 

Lessons: This research used a novel approach to assess alignment of policies related to PA and the Sustainable Development Goals (SDGs) in Wales. It provides an overview of the current status of policy related to PA in Wales, which can be used in manifestos and frameworks to shape the subsequent actions of public bodies. 

Main messages: This case study provides a valuable example of how to utilise PA to address broader health and wellbeing agendas, and specifically the SDGs. It also demonstrates an approach to achieving stronger connections between national and sub-national policy to support the translation of policies into practice. 

Background. The neighborhood environment may enhance or restrict older people’s opportunities to participate in leisure activities, and thus impact quality of life. Walkability depicts the environment's suitability for walking to different destinations. Little is known concerning about the relation between environment walkability and participation in leisure activities. Our purpose was to study whether neighborhood’s objective and perceived walkability were related to participation in various leisure activities outside the home.

Methods. Cross-sectional data of LISPE consisted of 848 community-dwelling people aged 75–90 living in the municipalities of Jyväskylä and Muurame, Finland. Participants’ home addresses were geocoded, and walkability index (mixed land-use, street connectivity, and population density) was calculated using geographic information system and categorized into tertiles. From a checklist, participants chose all infrastructure-based facilitators present in their neighborhood, which draw them to outdoor mobility (e.g., good lighting, services close); the sum of these was used as an indicator of perceived walkability. Participation in leisure activities outside the home was self-reported based on frequency and classified as participation (yes/no) in group activities (≥1x/week), physical activity (≥1x/week), and non-group cultural and other activities (≥1x/month). For each leisure activity type, logistic regression models were conducted for walkability index and perceived walkability separately. Analyses were adjusted age, sex, years of education, weekly car use, walking difficulties, and number of chronic conditions.

Results. Logistic regression showed that the older people who lived in areas with high walkability index were more likely to participate in cultural and other activities activity at least once a month (OR=1.64, 95% Cl=1.14–2.36) and less likely to participate in physical activity at least once a week (OR=0.61, 95% Cl=0.39–0.94, fully adjusted model) than older people living in areas with low walkability index. Older people reporting higher perceived walkability participated more often in physical activity than those who reported lower walkability (OR=1.14, 95% Cl=1.05–1.23).  

Conclusions. Living in the area of high walkability enhanced participation in cultural activities and decreased participation in physical activity. However, higher perceived walkability may motivate older people to be physically active. Environment which offers good infrastructure for outdoor mobility provides opportunities to participate in specific leisure activities.

Issue. In view of the multiple benefits, the integration of physical activity into the health care pathway of people with chronic diseases is a major issue. In Nice, nearly a third of the population is over 60 years old and more than 60,000 people are in long-term illness. In view of this, the City of Nice has decided to set up a physical activity prescription device named Nice Acti’Santé to support people in Nice with a chronic illness who want to make physical activity part of their life.

Description of the problem. The main objective of the device is to encourage people with a chronic disease to engage in a physical activity appropriate to their health. A medico-active process has been implemented to meet this objective: (a) the doctor guides his patient toward the Nice Acti’Santé platform, (b) the platform team makes a free checkup of the patient and guides him toward a partner sports club, (c) the doctor validates the patient's orientation, prescribes the physical activity and signs the certificate, (d) the partner sports club takes charge of the patient and the plateform team sets up a follow-up, (e) after 4 months, the platform team makes a new checkup of the patient and guides him toward an autonomous practice and, (f) the doctor validates the new patient's orientation and signs the certificate.

Results. Preliminary results show that 1 out of 2 patients is registered in a partner sports club after being taken charge on the platform. Most patients are aware of the platform through media or communication supports, and few are oriented by their doctor. 

Lessons. The platform (a) acts in complementarity with the doctor who can count on a quality device with qualified staff to take charge of his patient, (b) guides the patient toward a physical activity adapted to health and taking account his capacities and needs and, (c) helps partner club sports to recruit participants.

Main messages. Nice Acti’Santé is an effective link between health and sport professionals / Nice Acti’Santé is an innovative and local device to serve the most vulnerable people in Nice.

Background: The use of large-scale pooled analyses and data sharing is a potential source to generate evidence to address complex scientific challenges and develop strategies to promote healthy ageing. However, the success of such analyses depends on robust measurements of musculoskeletal (MSK) health in ageing. Simple tests indicative of MSK health and suitable for use with older people are required. This study aims to assess the discriminatory ability of a combination of routine physical function tests and novel measures, notably muscle mechanical properties and ultrasound imaging of thigh composition (relative contribution of muscle and subcutaneous adipose tissue) to classify healthy individuals according to their age and gender.

Methods: This cross-sectional study included 138 community-dwelling, self-reported healthy males and females (65 young, mean age±SD = 25.7±4.8 years; 73 older, 74.9±5.9 years). Handgrip strength; quadriceps strength; respiratory peak flow; timed up and go; stair climbing; anterior thigh tissue thickness (using ultrasound imaging), muscle mechanical properties (stiffness, tone and elasticity; Myoton technology); and self-reported health related quality of life (SF36) were assessed. Stepwise linear discriminant analysis was used to classify cases based on criterion variable derived from the known effects of age on physical function.

Results: Combining conventional physical function tests with novel measures, revealed two discriminant functions which significantly (Wilks’s λ=0.05, 0.34; p<0.001) classified 89% of grouped cases with 11% error rate using leave-one-out cross-validation. Seven variables associated with grip strength, peak flow, timed up and go, anterior thigh thickness, and muscle mechanical properties demonstrated high discriminant ability (p<0.05 correlation with discriminant functions) to classify healthy people.

Conclusions: The present study provides reference data for comparison with clinical populations and a comprehensive battery of non-invasive dry biomarkers with high discriminant ability indicative of musculoskeletal health. The most sensitive novel biomarkers require no volition, highlighting potentially useful tests for screening and monitoring effects of interventions on MSK health for vulnerable older people with pain or cognitive impairment. Older misclassified cases who appeared younger than predicted support the need for studies of older people with different habitual activity levels, to provide relevant reference values for assessment, so rehabilitation goals are targeted appropriately.  

Background: Physical activity contributes to the prevention of chronic illness as well as promotion of physical and mental health, but most adults remain inactive.  Chronic illness affects mainly middle aged and older adults, and very little objectively measured data on physical activity behaviours and associated health outcomes of this population is published. The aims of this study are to: 1. Objectively measure physical behaviour outcomes of adults participating in the Move for Life study; 2. Develop distinct activity profiles based on six behaviour variables; 3. Investigate whether health outcomes differ across the activity profiles.

Methods: Participants were Irish adults aged 50 years and older. Using the activPAL, objectively measured data were collected on average daily: light intensity physical activity (hours); moderate to vigorous intensity physical activity (minutes); step count; time in bed (hours); standing time (hours); and waking sedentary time (hours). Data were obtained on chronic illness and health service utilisation. Validated questionnaires were used to collect data on wellbeing, loneliness and social isolation. Hierarchical cluster analysis using squared Euclidian distance was used to cluster behaviours based on similarity, using SPSS version 26. Regression models explored associations between health outcomes and activity profiles, adjusted for age and sex.

Results: Data from 485 participants were analysed, and four activity profiles were identified: sedentary (n=50, 10.3% of total), low active (n= 295 ,60.8%), moderate active (111, 22.9%) and higher active (n=29, 6%). We will present the differences across the activity profiles for chronic illnesses, multi-morbidity, health service utilisation and validated health tools, comparing to data from the Irish Longitudinal Study on Ageing (TILDA) and the English Longitudinal Study on Ageing (ELSA).

Conclusions: the use of physical activity behaviour clusters may identify people with multi-morbidity and higher utilisation of health services. These findings could be factored into the development of future targeted physical activity interventions.