New Canadian Physical Activity Guidelines

The Canadian Society for Exercise Physiology (CSEP), in cooperation with ParticipACTION and other stakeholders, and with support from the Public Health Agency of Canada (PHAC), has developed the new Canadian Physical Activity Guidelines for Children (aged 5–11 years), Youth (aged 12–17 years), Adults (aged 18–64 years), and Older Adults (aged ≥65 years). The new guidelines include a preamble to provide context and specific guidelines for each age group. The entire guideline development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument, which is the international standard for clinical practice guideline development. Thus, the guidelines have gone through a rigorous and transparent developmental process; we based the recommendations herein on evidence from 3 systematic reviews, and the final guidelines benefitted from an extensive online and in-person consultation process with hundreds of stakeholders and key informants, both domestic and international. Since 2006, the products of our efforts resulted in the completion of 21 peer-reviewed journal articles (including 5 systematic reviews) that collectively guided this work. The process that Canadian researchers undertook to update the national physical activity guidelines represents the most current synthesis, interpretation, and application of the scientific evidence to date.

Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey

Background

Healthy childhood development is fostered through sufficient physical activity (PA; including time outdoors), limiting sedentary behaviours (SB), and adequate sleep; collectively known as movement behaviours. Though the COVID-19 virus outbreak has changed the daily lives of children and youth, it is unknown to what extent related restrictions may compromise the ability to play and meet movement behaviour recommendations. This secondary data analysis examined the immediate impacts of COVID-19 restrictions on movement and play behaviours in children and youth.

Methods

A national sample of Canadian parents (n = 1472) of children (5–11 years) or youth (12–17 years) (54% girls) completed an online survey that assessed immediate changes in child movement and play behaviours during the COVID-19 outbreak. Behaviours included PA and play, SB, and sleep. Family demographics and parental factors that may influence movement behaviours were assessed. Correlations between behaviours and demographic and parental factors were determined. For open-ended questions, word frequency distributions were reported.

Results

Only 4.8% (2.8% girls, 6.5% boys) of children and 0.6% (0.8% girls, 0.5% boys) of youth were meeting combined movement behaviour guidelines during COVID-19 restrictions. Children and youth had lower PA levels, less outside time, higher SB (including leisure screen time), and more sleep during the outbreak. Parental encouragement and support, parental engagement in PA, and family dog ownership were positively associated with healthy movement behaviours. Although families spent less time in PA and more time in SB, several parents reported adopting new hobbies or accessing new resources.

Conclusions

This study provides evidence of immediate collateral consequences of the COVID-19 outbreak, demonstrating an adverse impact on the movement and play behaviours of Canadian children and youth. These findings can guide efforts to preserve and promote child health during the COVID-19 outbreak and crisis recovery period, and to inform strategies to mitigate potential harm during future pandemics.

Parental correlates of physical activity in children and early adolescents

This article is intended to unite the existing research on parental influences on children's physical activity behaviours in order to establish direction for future research and improve existing child physical activity intervention programmes. A comprehensive, 34-study review of parental correlates of child physical activity was conducted and six variables were examined. There were significant correlations found between parental support and child physical activity level. Results for an association between parental and child physical activity levels, however, were mixed. There were not enough studies to draw conclusions about single-parent families, family socioeconomic status and ethnicity. Finally, there were some weak inter- and intra-generational sex correlations, but these results were mostly inconclusive. Possible mechanisms, including parental support, modelling, shared activities, societal differences by generation, minority groups and genetics are discussed, and recommendations are made on translating experimental results into tangible intervention efforts essential for disease prevention through increased physical activity.

Physical activity: Health impact, prevalence, correlates and interventions

OBJECTIVE

To provide a broad overview of the state of physical activity (PA) research in the form of (1) definitions of PA, (2) health benefits, (3) prevalence, (4) correlates and (5) interventions.

DESIGN

A high-level overview of published reviews of the literature.

RESULTS

Regular PA is an effective primary and secondary preventative strategy against at least 25 chronic medical conditions with risk reduction typically in the 20-30% range. While approximately 75% of adults meet recommended PA guidelines, the prevalence is slightly lower for women compared to men, and considerably lower for youth, older adults and those in higher income countries. Motivation, self-efficacy and self-regulation remain consistent correlates of PA. Interventions show PA changes in the small effect size range for adults and youth but the heterogeneity is considerable across studies. Only a few (aggregate of behavioural regulation strategies, supervision, high frequency of contact) reliable moderators of intervention success were identified across study quality, sample characteristics, theory/behaviour change techniques and delivery modes/settings.

CONCLUSION

PA research should continue to examine the mechanisms causing health outcomes, the dose that can lead to clinically relevant changes in health status, the scope and validity of PA surveillance and innovative behaviour change techniques, while improving the reach and duration of PA interventions.

How big is the physical activity intention-behaviour gap? A meta-analysis using the action control framework

OBJECTIVES

The physical activity (PA) intention-behaviour gap is a topic of considerable contemporary research, given that most of our models used to understand physical activity suggest that intention is the proximal antecedent of behavioural enactment. The purpose of this study was to quantify the intention-PA gap at public health guidelines with a meta-analysis of the action control framework.

DESIGN

Systematic review and meta-analysis.

METHODS

Literature searches were conducted in July 2012 among five key search engines. This search yielded a total of 2,865 potentially relevant records; of these, 10 studies fulfilled the full eligibility criteria (N = 3,899).

RESULTS

Random-effects meta-analysis procedures with correction for sampling bias were employed in the analysis for estimates of non-intenders who subsequently did not engage in physical activity (21%), non-intenders who subsequently performed physical activity (2%), intenders who were not successful at following through with their PA (36%), and successful intenders (42%). The overall intention-PA gap was 46%.

CONCLUSION

These results emphasize the weakness in early intention models for understanding PA and suggest this would be a problem during intervention. Contemporary research that is validating and exploring additional constructs (e.g., self-regulation, automaticity) that augment intention or improving the measurement of motivation seems warranted.

STATEMENT OF CONTRIBUTION

What is already known on this subject? Intention is considered the proximal antecedent of behaviour in many popular models. Intention is also an established correlate of physical activity behaviour, yet discordance is considerable in experimental research. What does this study add? This meta-analysis of studies that have assessed concordance/discordance of physical activity intention and behaviour at public health guidelines shows the intention-behaviour gap at 48% and the discordance is from intenders who do not act. The results demonstrate that discordance is not just from extreme levels of intention or behaviour (e.g., intend to exercise six times but only exercise five), but from levels that are relevant to health promotion.

Personality correlates of physical activity: a review and meta-analysis

This review aimed to combine the literature on major personality traits and physical activity alongside providing some meta-analytic summaries of the findings. Overall, 33 studies containing 35 independent samples, ranging from 1969 to 2006, met the inclusion criteria. Extraversion (r = 0.23), neuroticism (r = -0.11) and conscientiousness (r = 0.20) were identified as correlates of physical activity using random effects meta-analytic procedures correcting for sampling bias and attenuation of measurement error. The five-factor model traits of openness to experience/intellect and agreeableness, as well as Eysenck's psychoticism trait, were not associated with physical activity. Potential moderators of personality and physical activity relationships such as sex, age, culture/country, design and instrumentation were inconclusive given the small number of studies. Still, the existing evidence was suggestive that personality and physical activity relationships are relatively invariant to these factors. Studies examining personality and different physical activity modes suggested differences by traits such as extraversion, but more research is needed to make any conclusions. Future research using multivariate analyses, personality-channelled physical activity interventions, longitudinal designs and objective physical activity measurement is recommended.

Parental correlates in child and adolescent physical activity: a meta-analysis

OBJECTIVE

Physical activity (PA) has a profound impact on health and development in children. Parental behaviors (i.e., modeling and support) represent an obvious important factor in child PA. The purpose of this paper was to provide a comprehensive meta-analysis that overcomes the limitations of prior narrative reviews and quantitative reviews with small samples.

METHODS

Ten major databases were used in the literature search. One-hundred and fifteen studies passed the eligibility criteria. Both fixed and random effects models with correction for sampling and measurement error were examined in the analysis. Moderator analyses investigating the effects of child's developmental age, study design, parental gender, measurement of child PA, and quality rating were performed.

RESULTS

Based on the random effects model, the results showed that parental modeling was weakly associated with child PA (summary r = .16, 95% CI .09-.24) and none of the proposed moderators were significant. Separate analyses examining the moderating effects of parental gender and boys' PA found that that father-son PA modeling (r = .29, 95% CI .21-.36) was significantly higher compared to mother-son PA (r = .19, 95% CI .14-.23; p < .05). However, parental gender did not moderate the relationship between parental modeling and girls' PA (p > .05). The random effects model indicated an overall moderate effect size for the parental support and child PA relationship (summary r = .38, 95% CI .30-.46). Here, the only significant moderating variable was the measurement of child PA (objective: r = .20, 95% CI .13-.26; reported: r = .46, 95% CI .37-.55; p < .01).

CONCLUSIONS

Parental support and modeling relate to child PA, yet our results revealed a significant degree of heterogeneity among the studies that could not be explained well by our proposed moderators.

Factors associated with exercise adherence among older adults. An individual perspective

This paper reviews the literature concerning factors at the individual level associated with regular exercise among older adults. Twenty-seven cross-sectional and 14 prospective/longitudinal studies met the inclusion criteria of a mean participant age of 65 years or older. The findings are summarised by demographics, exercise experience, exercise knowledge, physiological factors, psychological factors, activity preferences and perceived social influences. In general, education and exercise history correlate positively with regular exercise, while perceived physical frailty and poor health may provide the greatest barrier to exercise adoption and adherence in the elderly. Social-cognitive theories identify several constructs that correlate with the regular exercise behaviour of older adults, such as exercise attitude, perceived behavioural control/self-efficacy, perceived social support and perceived benefits/barriers to continued activity. As well, stage modelling may provide additional information about the readiness for regular exercise behaviour among older adults. However, relatively few studies among older adults exist compared with middle-aged and younger adults. Further, the majority of current research consists of cross-sectional designs or short prospective exercise trials among motivated volunteers that may lack external validity. Future research utilising longitudinal and prospective designs with representative samples of older adults will provide a better understanding of significant causal associations between individual factors and regular exercise behaviour.

A birth of inactivity? A review of physical activity and parenthood

OBJECTIVE

To review the existing research on physical activity and parenthood in order to establish direction for future research.

METHOD

Articles were limited to English peer-reviewed journals, published from 1989 to 2007. Major findings from 25 independent samples were summarized based on common subtopics of: physical activity of parents compared to non-parents, physical activity barriers, employment and marital status, number of children, and theory-based work applied to parents.

RESULTS

Parenthood and physical activity involvement showed a negative relationship (meta-analytic d=0.41 to 0.48, correcting for sampling error) when compared to non-parents. Mothers were generally less active than fathers. Associations were found between specific barriers and parental physical activity, but the relationship between physical activity and marital/employment status as well as number/age of children was inconsistent. Finally, the use of theoretical models applied to understanding early family development and physical activity has been limited.

CONCLUSIONS

Parents with dependent children are clearly more inactive than non-parents and the topic has received disproportionably scant research considering the size of the effect. Current research has largely been focused on mothers, and has relied heavily on cross-sectional designs and self-report measures. Future work should focus on longitudinal designs across family development, gender and role interactions, and include social ecological frameworks and objective physical activity measurement.

The group psychotherapy and home-based physical exercise (group-hope) trial in cancer survivors: physical fitness and quality of life outcomes

Physical exercise has been shown to enhance quality of life (QOL) in cancer survivors using pretest-posttest designs and compared to usual care (i.e. no intervention). In the present study, we conducted a randomized controlled trial to determine if exercise could improve QOL in cancer survivors beyond the known benefits of group psychotherapy (GP). We matched 22 GP classes (N=108) on content and then randomly assigned 11 (n=48) to GP alone and 11 (n=60) to GP plus home-based, moderate-intensity exercise (GP+EX). Participants completed a physical fitness test and QOL measures (e.g. Functional Assessment of Cancer Therapy scales) at the beginning and end of GP classes (about 10 weeks). We had excellent recruitment (81%), retention (89%), and adherence (84%) rates and a modest contamination (22%) rate. Using intention-to-treat repeated measures analyses of variance, we found significant Time by Condition interactions for functional well-being, fatigue, and sum of skinfolds. We also found borderline significant interactions for physical well-being, satisfaction with life, and flexibility. All interactions favored the GP+EX condition. We conclude that a home-based, moderate intensity exercise program may im-prove QOL in cancer survivors beyond the benefits of GP, particularly in relation to physical and functional well-being.

Sedentary behaviour and health in adults: an overview of systematic reviews

The purpose of this overview of systematic reviews was to determine the relationship between different types and patterns of sedentary behaviour and selected health outcomes in adults and older adults. Five electronic databases were last searched in May, 2019, with a 10-year search limit. Included reviews met the a priori population (community-dwelling adults aged 18 years and older), intervention/exposure/comparator (various types and/or patterns of sedentary behaviour), and outcomes criteria. Eighteen systematic reviews were included in the evidence synthesis. High levels of sedentary behaviour are unfavourably associated with cognitive function, depression, function and disability, physical activity levels, and physical health-related quality of life in adults. Reducing or breaking up sedentary behaviour may benefit body composition and markers of cardiometabolic risk. Total sedentary behaviour and TV viewing were most consistently associated with unfavourable health outcomes, while computer and Internet use may be favourably associated with cognitive function for older adults. The quality of evidence within individual reviews (as assessed by review authors) varied from low to high, while the certainty of evidence was low to very low. These findings have important public health implications, suggesting that adults should avoid high levels of sedentary behaviour and break-up periods of prolonged sitting. (PROSPERO registration nos.: CRD42019123121 and CRD42019127157.) Novelty High levels of sedentary behaviour are unfavourably associated with important health outcomes in adults. Reducing or breaking up sedentary behaviour may benefit body composition and markers of cardiometabolic risk. Computer and Internet use may be favourably associated with cognitive function in older adults.

Investigating multiple components of attitude, subjective norm, and perceived control: an examination of the theory of planned behaviour in the exercise domain

The presence of two subcomponents within each theory of planned behaviour (TPB) concept of attitude (affective and instrumental), subjective norm (injunctive and descriptive), and PBC (self-efficacy and controllability) has been widely supported. However, research has not examined whether the commonality of variance between these components (i.e. a general factor) or the specificity of variance within the subcomponents influences intention and behaviour. Therefore, the purpose of this study was to examine the optimal conceptualization of either two subcomponents or a general common factor for each TPB concept within an omnibus model. Further, to test whether conceptualizations may differ by population even within the same behavioural domain, we examined these research questions with 300 undergraduates (M age = 20) and 272 cancer survivors (M age = 61) for exercise behaviour. Results identified that a general subjective norm factor was an optimal predictive conceptualization over two separate injunctive and descriptive norm components. In contrast, a specific self-efficacy component, and not controllability or a general factor of PBC, predicted intention optimally for both samples. Finally, optimal models of attitude differed between the populations, with a general factor best predicting intention for undergraduates but only affective attitude influencing intention for cancer survivors. The findings of these studies underscore the possibility for optimal tailored interventions based on population and behaviour. Finally, a discussion of the theoretical ambiguity of the PBC concept led to suggestions for future research and possible re-conceptualization.

Mediators of physical activity behaviour change among adult non-clinical populations: a review update

BACKGROUND

An understanding of the determinants of physical activity through mediators of behaviour change is important in order to evaluate the efficacy of interventions. Prior reviews on this topic noted that few studies employed mediator analyses in experimental physical activity trials; the purpose of this review is to update these prior reviews in order to evaluate the state of our present understanding of interventions that include proposed mediators of behaviour change.

METHODS

Literature was identified through electronic database (e.g., MEDLINE, psychINFO) searching. Studies were eligible if they described a published experimental or quasi-experimental trial examining the effect of an intervention on physical activity behaviour and mediator change in non-clinical adult populations. Quality of included studies was assessed and the analyses examined the symmetry between mediators and behaviour change.

RESULTS

Twenty seven unique trials passed the eligibility criteria and 22 were included in the analysis with scores of moderate or higher quality. Half of the studies reviewed failed to show an intervention effect on PA. The remaining studies showed evidence that the intervention affected changes in the proposed mediators, but tests of mediated effect were performed in only six of these 11 cases and demonstrated mixed outcomes. Differences by theory were not discernable at this time, but self-regulation constructs had the most evidence for mediation.

CONCLUSION

Published literature employing mediators of change analyses in experimental designs is still relatively elusive since the time of prior reviews; however, the general null findings of changes in mediating constructs from these interventions are a more timely concern. Changes in self-regulation constructs may have the most effect on changes in PA while self-efficacy and outcome expectation type constructs have negligible but limited findings. Innovation and increased fidelity of interventions is needed and should be a priority for future research.

Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep

The Canadian Society for Exercise Physiology assembled a Consensus Panel representing national organizations, content experts, methodologists, stakeholders, and end-users and followed an established guideline development procedure to create the Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These guidelines underscore the importance of movement behaviours across the whole 24-h day. The development process followed the strategy outlined in the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. A large body of evidence was used to inform the guidelines including 2 de novo systematic reviews and 4 overviews of reviews examining the relationships among movement behaviours (physical activity, sedentary behaviour, sleep, and all behaviours together) and several health outcomes. Draft guideline recommendations were discussed at a 4-day in-person Consensus Panel meeting. Feedback from stakeholders was obtained by survey (n = 877) and the draft guidelines were revised accordingly. The final guidelines provide evidence-based recommendations for a healthy day (24-h), comprising a combination of sleep, sedentary behaviours, and light-intensity and moderate-to-vigorous-intensity physical activity. Dissemination and implementation efforts with corresponding evaluation plans are in place to help ensure that guideline awareness and use are optimized.

Novelty First ever 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older with consideration of a balanced approach to physical activity, sedentary behaviour, and sleep Finalizes the suite of 24-Hour Movement Guidelines for Canadians across the lifespan

Experimental evidence for the intention-behavior relationship in the physical activity domain: a meta-analysis

OBJECTIVE

Most contemporary theories of physical activity include an intention construct as the proximal determinant of behavior. Support of this premise has been found through correlational research. The purpose of this paper was to appraise the experimental evidence for the intention-behavior relationship through meta-analysis.

METHODS

Studies were eligible if they included: (1) random assignment of participants to intervention/no intervention groups; (2) an intervention that produced a significant difference in intention between groups; and (3) a measure of behavior was taken after the intention measure. Literature searches were concluded in December 2010 among five key search engines.

RESULTS

This search yielded a total of 1,033 potentially relevant records; of these, 11 passed the eligibility criteria. Random effects meta-analysis procedures with correction for sampling bias were employed in the analysis. The sample-weighted average effect size derived from these studies was d+ = .45 (95% CI .30 to .60) for intention, yet d+ = .15 (95% CI .06 to .23) for behavior.

CONCLUSIONS

These results demonstrate a weak relationship between intention and behavior that may be below meaningful/practical value. We suggest that prior evidence was probably biased by the limits of correlation coefficients in passive designs. It is recommended that contemporary research apply models featuring intention-behavior mediators or action control variables in order to account for this intention-behavior gap.

Development of a consensus statement on the role of the family in the physical activity, sedentary, and sleep behaviours of children and youth

BACKGROUND

Children and youth who meet the physical activity, sedentary, and sleep behaviour recommendations in the Canadian 24-Hour Movement Guidelines are more likely to have desirable physical and psychosocial health outcomes. Yet, few children and youth actually meet the recommendations. The family is a key source of influence that can affect lifestyle behaviours. The purpose of this paper is to describe the process used to develop the Consensus Statement on the Role of the Family in the Physical Activity, Sedentary, and Sleep Behaviours of Children and Youth (0-17 years) and present, explain, substantiate, and discuss the final Consensus Statement.

METHODS

The development of the Consensus Statement included the establishment of a multidisciplinary Expert Panel, completion of six reviews (three literature, two scoping, one systematic review of reviews), custom data analyses of Statistics Canada's Canadian Health Measures Survey, integration of related research identified by Expert Panel members, a stakeholder consultation, establishment of consensus, and the development of a media, public relations, communications and launch plan.

RESULTS

Evidence from the literature reviews provided substantial support for the importance of family on children's movement behaviours and highlighted the importance of inclusion of the entire family system as a source of influence and promotion of healthy child and youth movement behaviours. The Expert Panel incorporated the collective evidence from all reviews, the custom analyses, other related research identified, and stakeholder survey feedback, to develop a conceptual model and arrive at the Consensus Statement: Families can support children and youth in achieving healthy physical activity, sedentary and sleep behaviours by encouraging, facilitating, modelling, setting expectations and engaging in healthy movement behaviours with them. Other sources of influence are important (e.g., child care, school, health care, community, governments) and can support families in this pursuit.

CONCLUSION

Family is important for the support and promotion of healthy movement behaviours of children and youth. This Consensus Statement serves as a comprehensive, credible, and current synopsis of related evidence, recommendations, and resources for multiple stakeholders.

Personality and perceived stress during COVID-19 pandemic: Testing the mediating role of perceived threat and efficacy

Prolonged stress is associated with poor physical and mental health outcomes. Understanding the mediators between personality and stress is critical for developing effective stress management interventions during a pandemic. Our study explored whether perceptions of threat from COVID-19 and efficacy to follow government recommendations for preventing COVID-19 would mediate the relationships between personality traits (e.g., neuroticism, conscientiousness-goal-striving, extroversion-activity and sociability) and perceived stress. In an online survey of a representative sample of Canadian adults (n = 1055), we found that higher neuroticism and extroversion were associated with higher levels of stress during the pandemic and a greater increase in stress levels compared to levels before the pandemic. Perceived threat and efficacy significantly mediated the relationship between neuroticism and stress, which suggested that individuals with higher neuroticism experienced higher levels of stress due to higher levels of perceived threat and lower levels of efficacy. Perceived threat did not mediate the relationship between extroverts and stress, which suggested that the source of stress may stem from elsewhere (e.g., inability to socialize). Our findings highlighted that personality traits could be an important factor in identifying stress-prone individuals during a pandemic and that stress management interventions need to be personality specific.

Prediction of leisure-time walking: an integration of social cognitive, perceived environmental, and personality factors

Background

Walking is the primary focus of population-based physical activity initiatives but a theoretical understanding of this behaviour is still elusive. The purpose of this study was to integrate personality, the perceived environment, and planning into a theory of planned behaviour (TPB) framework to predict leisure-time walking.

Methods

Participants were a random sample (N = 358) of Canadian adults who completed measures of the TPB, planning, perceived neighbourhood environment, and personality at Time 1 and self-reported walking behaviour two months later.

Results

Analyses using structural equation modelling provided evidence that leisure-time walking is largely predicted by intention (standardized effect = .42) with an additional independent contribution from proximity to neighbourhood retail shops (standardized effect = .18). Intention, in turn, was predicted by attitudes toward walking and perceived behavioural control. Effects of perceived neighbourhood aesthetics and walking infrastructure on walking were mediated through attitudes and intention. Moderated regression analysis showed that the intention-walking relationship was moderated by conscientiousness and proximity to neighbourhood recreation facilities but not planning.

Conclusion

Overall, walking behaviour is theoretically complex but may best be addressed at a population level by facilitating strong intentions in a receptive environment even though individual differences may persist.

The confounded self-efficacy construct: conceptual analysis and recommendations for future research

Self-efficacy is central to health behaviour theories due to its robust predictive capabilities. In this paper, we present and review evidence for a self-efficacy-as-motivation argument in which standard self-efficacy questionnaires - i.e., ratings of whether participants 'can do' the target behaviour - reflect motivation rather than perceived capability. The potential implication is that associations between self-efficacy ratings (particularly those that employ a 'can do' operationalisation) and health-related behaviours simply indicate that people are likely to do what they are motivated to do. There is some empirical evidence for the self-efficacy-as-motivation argument, with three studies demonstrating causal effects of outcome expectancy on subsequent self-efficacy ratings. Three additional studies show that - consistent with the self-efficacy-as-motivation argument - controlling for motivation by adding the phrase 'if you wanted to' to the end of self-efficacy items decreases associations between self-efficacy ratings and motivation. Likewise, a qualitative study using a thought-listing procedure demonstrates that self-efficacy ratings have motivational antecedents. The available evidence suggests that the self-efficacy-as-motivation argument is viable, although more research is needed. Meanwhile, we recommend that researchers look beyond self-efficacy to identify the many and diverse sources of motivation for health-related behaviours.

Copenhagen Consensus statement 2019: physical activity and ageing

From 19th to 22nd November 2018, 26 researchers representing nine countries and a variety of academic disciplines met in Snekkersten, Denmark, to reach evidence-based consensus about physical activity and older adults. It was recognised that the term ‘older adults’ represents a highly heterogeneous population. It encompasses those that remain highly active and healthy throughout the life-course with a high intrinsic capacity to the very old and frail with low intrinsic capacity. The consensus is drawn from a wide range of research methodologies within epidemiology, medicine, physiology, neuroscience, psychology and sociology, recognising the strength and limitations of each of the methods. Much of the evidence presented in the statements is based on longitudinal associations from observational and randomised controlled intervention studies, as well as quantitative and qualitative social studies in relatively healthy community-dwelling older adults. Nevertheless, we also considered research with frail older adults and those with age-associated neurodegenerative diseases, such as Alzheimer’s and Parkinson’s disease, and in a few cases molecular and cellular outcome measures from animal studies. The consensus statements distinguish between physical activity and exercise. Physical activity is used as an umbrella term that includes both structured and unstructured forms of leisure, transport, domestic and work-related activities. Physical activity entails body movement that increases energy expenditure relative to rest, and is often characterised in terms of intensity from light, to moderate to vigorous. Exercise is defined as a subset of structured physical activities that are more specifically designed to improve cardiorespiratory fitness, cognitive function, flexibility balance, strength and/or power. This statement presents the consensus on the effects of physical activity on older adults’ fitness, health, cognitive functioning, functional capacity, engagement, motivation, psychological well-being and social inclusion. It also covers the consensus on physical activity implementation strategies. While it is recognised that adverse events can occur during exercise, the risk can be minimised by carefully choosing the type of activity undertaken and by consultation with the individual’s physician when warranted, for example, when the individual is frail, has a number of co-morbidities, or has exercise-related symptoms, such as chest pain, heart arrhythmia or dizziness. The consensus was obtained through an iterative process that began with the presentation of the state-of-the-science in each domain, followed by group and plenary discussions. Ultimately, the participants reached agreement on the 30-item consensus statements.

The health benefits of interactive video game exercise

The purpose of this study was to evaluate the effectiveness of interactive video games (combined with stationary cycling) on health-related physical fitness and exercise adherence in comparison with traditional aerobic training (stationary cycling alone). College-aged males were stratified (aerobic fitness and body mass) and then assigned randomly to experimental (n = 7) or control (n = 7) conditions. Program attendance, health-related physical fitness (including maximal aerobic power (VO2 max), body composition, muscular strength, muscular power, and flexibility), and resting blood pressure were measured before and after training (60%–75% heart rate reserve, 3 d/week for 30 min/d for 6 weeks). There was a significant difference in the attendance of the interactive video game and traditional training groups (78% ± 18% vs. 48% ± 29%, respectively). VO2 max was significantly increased after interactive video game (11% ± 5%) but not traditional (3% ± 6%) training. There was a significantly greater reduction in resting systolic blood pressure after interactive video game (132 ± 6 vs. 123 ± 6 mmHg) than traditional (131 ± 7 vs. 128 ± 8 mmHg) training. There were no significant changes in body composition after either training program. Attendance mediated the relationships between condition and changes in health outcomes (including VO2 max, vertical jump, and systolic blood pressure). The present investigation indicates that a training program that links interactive video games to cycle exercise results in greater improvements in health-related physical fitness than that seen after traditional cycle exercise training. It appears that greater attendance, and thus a higher volume of physical activity, is the mechanism for the differences in health-related physical fitness.

Healthy movement behaviours in children and youth during the COVID-19 pandemic: Exploring the role of the neighbourhood environment

This paper explores patterns of increased/ decreased physical activity, sedentary and sleep behaviours among Canadian children and youth aged 5-17 years during the COVID-19 pandemic, and examines how these changes are associated with the built environment near residential locations. A cluster analysis identified two groups who were primarily distinguished by the changes in outdoor activities. Compliance to 24-hour movement guidelines was low among both groups. For children, houses (versus apartments) was correlated with increased outdoor activities; proximity to major roads was a barrier. For youth, low dwelling density, and access to parks in high-density neighbourhoods, increased the odds of increased outdoor activities during the pandemic. Our findings can inform future urban and health crisis planning practices by providing new insights into the desirable public health messaging and characteristics of healthy and resilient communities.