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Tung HH, Kuo CY, Lee PL, Chang CW, Chou KH, Lin CP, Chen LK. Efficacy of Digital Dance on Brain Imagery, Cognition, and Health: Randomized Controlled Trial. J Med Internet Res 2024; 26:e57694. [PMID: 39078687 PMCID: PMC11322681 DOI: 10.2196/57694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 05/13/2024] [Accepted: 07/05/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Multidomain interventions have demonstrable benefits for promoting healthy aging, but self-empowerment strategies to sustain long-term gains remain elusive. OBJECTIVE This study evaluated the effects of digital somatosensory dance game participation on brain imagery changes as primary outcomes and other physical and mental health measures as secondary outcomes related to healthy aging. METHODS Between August 31, 2020, and June 27, 2021, this randomized controlled trial recruited 60 eligible participants older than 55 years with no recent engagement in digital dance games. A computer-generated randomization sequence was used to allocate participants 1:1, without stratification, to an intervention group (n=30) who underwent digital somatosensory dance game training or a control group (n=30). An anonymized code masked the intervention allocations from the investigators, and individuals who assigned the interventions were not involved in analyzing the study data. The intervention entailed two 30-minute dance game sessions per week for 6 months, and the control group received healthy aging education. Primary outcomes were brain imagery changes. All variables were measured at baseline and the 6-month follow-up, and intervention effects were estimated using t tests with intention-to-treat analyses. RESULTS Compared with the control group, intervention participants had significantly different brain imagery in the gray matter volume (GMV) of the left putamen (estimate 0.016, 95% CI 0.008 to 0.024; P<.001), GMV of the left pallidum (estimate 0.02, 95% CI 0.006 to 0.034; P=.004), and fractional amplitude of low frequency fluctuations of the left pallidum (estimate 0.262, 95% CI 0.084 to 0.439; P=.004). Additionally, the intervention group had different imagery in the cerebellum VI GMV (estimate 0.011, 95% CI 0.003 to 0.02; P=.01). The intervention group also had improved total Montreal Cognitive Assessment scores (estimate 1.2, 95% CI 0.27 to -2.13; P<.01), quality of life (estimate 7.08, 95% CI 2.35 to 11.82; P=.004), and time spent sitting on weekdays (estimate -1.96, 95% CI -3.33 to -0.60; P=.005). Furthermore, dance performance was significantly associated with cognitive performance (P=.003), health status (P=.14), resilience (P=.007), and demoralization (P<.001). CONCLUSIONS Digital somatosensory dance game participation for 6 months was associated with brain imagery changes in multiple regions involving somatosensory, motor, visual, and attention functions, which were consistent with phenotypic improvements associated with healthy aging. TRIAL REGISTRATION ClinicalTrials.gov NCT05411042; https://clinicaltrials.gov/study/NCT05411042.
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Affiliation(s)
- Heng-Hsin Tung
- Department of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chen-Yuan Kuo
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Pei-Lin Lee
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Wen Chang
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kun-Hsien Chou
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Education and Research, Taipei City Hospital, Taipei, Taiwan
| | - Liang-Kung Chen
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
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Cheng J, Wu Y, Wang X, Yu H. Objectively measured the impact of ambient air pollution on physical activity for older adults. BMC Public Health 2024; 24:821. [PMID: 38491436 PMCID: PMC10941607 DOI: 10.1186/s12889-024-18279-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/05/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Air pollution poses a significant health risk to the human population, especially for vulnerable groups such as the elderly, potentially discouraging their engagement in physical activity. However, there is a lack of sufficient objective and longitudinal data in current research on how air pollution affects physical activity among older adults. With these gaps, we aimed to explore the relationship between air pollution and objective measurement-based physical activity among older adults by engaging in a longitudinal study design. METHODS A total of 184 older adults were recruited from three cities with varying levels of air quality. Mean daily minutes of physical activity were measured with 7 consecutive days of accelerometer monitoring (ActiGraph GT3X-BT). Corresponding air pollution data including daily PM2.5 (µg/m3), PM10 (µg/m3) and air quality index (AQI) were sourced from the China National Environmental Monitoring Centre at monitor locations close to older adults' addresses. Associations between air quality and physical activity were estimated using a fixed effect model, adjusting for average daytime temperature, rain, age and weight. RESULTS AQI and PM2.5 were observed to exhibit significant, inverse, and linear associations with mean daily walk steps, minutes of light physical activity (LPA), moderate physical activity (MPA) and moderate-to-vigorous physical activity (MVPA) in the single variable models. A one-level increase in AQI corresponded to a decline in 550.04 steps (95% [CI] = -858.97, -241.10; p < 0.001), 10.43 min (95% [CI] = -17.07, -3.79; p < 0.001), 4.03 min (95% [CI] = -7.48, -0.59; p < 0.001) and 4.16 min (95% [CI] = -7.77, -0.56; p < 0.001) in daily walking steps, LPA, MPA, and MVPA, respectively. A one-level increase in PM2.5 correlated with a decline in daily walk steps, LPA, MPA and MVPA by 361.85 steps (95% [CI] = -516.53, -207.16; p < 0.001), 8.97 min (95% [CI] = -12.28, -5.66; p < 0.001), 3.73 min (95% [CI] = -5.46, -2.01; p < 0.001,) and 3.79 min (95% [CI] = -5.59, -1.98; p < 0.001), respectively. However, PM10 displayed a significant negative association exclusively with LPA, with one-level increase in PM10 resulting in a 3.7-minute reduction in LPA (95% [CI] = -6.81, -0.59, p < 0.05). CONCLUSION Air pollution demonstrates an inverse association with physical activity levels among older adults, potentially discouraging their engagement in physical activity. Different air quality indicators may exert varying impacts on physical activity. Future studies are warranted to enhance policy interventions aimed at reducing air pollution and promoting physical activity.
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Affiliation(s)
- Jiali Cheng
- Faculty of Public Physical Education, Hebei Normal University, 050024, Shijiazhuang, China
| | - Yin Wu
- The Experimental High School Attached to Beijing Normal University, 100032, Beijing, China
| | - Xiaoxin Wang
- Department of Physical Education, Tsinghua University, Tsinghua Yuan Str, 100084, Beijing, China
| | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Tsinghua Yuan Str, 100084, Beijing, China.
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Tcymbal A, Messing S, Mait R, Perez RG, Akter T, Rakovac I, Gelius P, Abu-Omar K. Validity, reliability, and readability of single-item and short physical activity questionnaires for use in surveillance: A systematic review. PLoS One 2024; 19:e0300003. [PMID: 38470871 PMCID: PMC10931432 DOI: 10.1371/journal.pone.0300003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/19/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Accurate and fast measurement of physical activity is important for surveillance. Even though many physical activity questionnaires (PAQ) are currently used in research, it is unclear which of them is the most reliable, valid, and easy to use. This systematic review aimed to identify existing brief PAQs, describe and compare their measurement properties, and assess their level of readability. METHODS We performed a systematic review based on the PRISMA statement. Literature searches were conducted in six scientific databases. Articles were included if they evaluated validity and/or reliability of brief (i.e., with a maximum of three questions) physical activity or exercise questionnaires intended for healthy adults. Due to the heterogeneity of studies, data were summarized narratively. The level of readability was calculated according to the Flesch-Kincaid formula. RESULTS In total, 35 articles published in English or Spanish were included, evaluating 32 distinct brief PAQs. The studies indicated moderate to good levels of reliability for the PAQs. However, the majority of results showed weak validity when validated against device-based measurements and demonstrated weak to moderate validity when validated against other PAQs. Most of the assessed PAQs met the criterion of being "short," allowing respondents to complete them in less than one minute either by themselves or with an interviewer. However, only 17 questionnaires had a readability level that indicates that the PAQ is easy to understand for the majority of the population. CONCLUSIONS This review identified a variety of brief PAQs, but most of them were evaluated in only a single study. Validity and reliability of short and long questionnaires are found to be at a comparable level, short PAQs can be recommended for use in surveillance systems. However, the methods used to assess measurement properties varied widely across studies, limiting the comparability between different PAQs and making it challenging to identify a single tool as the most suitable. None of the evaluated brief PAQs allowed for the measurement of whether a person fulfills current WHO physical activity guidelines. Future development or adaptation of PAQs should prioritize readability as an important factor to enhance their usability.
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Affiliation(s)
- Antonina Tcymbal
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Rachel Mait
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Roberto Galindo Perez
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Taiyeba Akter
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Ivo Rakovac
- World Health Organization Regional Office for Europe, Copenhagen, Denmark
| | - Peter Gelius
- Institute of Sport Sciences, Université de Lausanne, Lausanne, Switzerland
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Bauman AE, Richards JA. Understanding of the Single-Item Physical Activity Question for Population Surveillance. J Phys Act Health 2022; 19:681-686. [PMID: 36126942 DOI: 10.1123/jpah.2022-0369] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Sport New Zealand conducts continuous representative "Active NZ" surveys. Between 2019 and 2020 (n = 13,887), these surveys asked International Physical Activity Questionnaire (IPAQ)-long-form questions, the single-item days (SI-days) per week question, and 1 question on hours per week (single-item hours [SI-hours] per week). This study examines relationships between the established SI-days question and meeting physical activity (PA) guidelines (150 min moderate-to-vigorous physical activity per week from SI-hours question and IPAQ). METHODS Analyses were descriptive, and the best fit between SI-days and the PA thresholds was estimated using area under the receiver operator characteristic curves and Youden index. RESULTS Using SI-hours, 60.6% achieved 150+ minutes; 85.2% reported the IPAQ-total minimum threshold, and 40.8% met the IPAQ-leisure time PA-only threshold. Receiver operator characteristic analyses showed area under the curve values with IPAQ between 0.63 and 0.76, but the SI-days showed a very good area under the curve of 0.82 (0.81-0.83) with the SI-hours 150-minute threshold. Youden index suggested the best fit was at 3+ days per week for maximizing Sensitivity and Specificity to meet IPAQ or SI-hours-defined PA guidelines. DISCUSSION The SI-days per week question reflects achieving PA guidelines, and the best fit was with the SI-hours per week question. This provides surveillance-relevant concurrent validity for the SI-days measure, but the cut point for broadly meeting guidelines appears to be at least 3 days per week, not 5 days per week as previously thought.
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Affiliation(s)
- Adrian E Bauman
- School of Public Health, Sydney University, Camperdown, NSW,Australia
| | - Justin A Richards
- Te Hau Kori, Victoria University of Wellington (Te Herenga Waka), Wellington,New Zealand
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Characterisation of Temporal Patterns in Step Count Behaviour from Smartphone App Data: An Unsupervised Machine Learning Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111476. [PMID: 34769991 PMCID: PMC8583116 DOI: 10.3390/ijerph182111476] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/23/2021] [Accepted: 10/25/2021] [Indexed: 12/23/2022]
Abstract
The increasing ubiquity of smartphone data, with greater spatial and temporal coverage than achieved by traditional study designs, have the potential to provide insight into habitual physical activity patterns. This study implements and evaluates the utility of both K-means clustering and agglomerative hierarchical clustering methods in identifying weekly and yearlong physical activity behaviour trends. Characterising the demographics and choice of activity type within the identified clusters of behaviour. Across all seven clusters of seasonal activity behaviour identified, daylight saving was shown to play a key role in influencing behaviour, with increased activity in summer months. Investigation into weekly behaviours identified six clusters with varied roles, of weekday versus weekend, on the likelihood of meeting physical activity guidelines. Preferred type of physical activity likewise varied between clusters, with gender and age strongly associated with cluster membership. Key relationships are identified between weekly clusters and seasonal activity behaviour clusters, demonstrating how short-term behaviours contribute to longer-term activity patterns. Utilising unsupervised machine learning, this study demonstrates how the volume and richness of secondary app data can allow us to move away from aggregate measures of physical activity to better understand temporal variations in habitual physical activity behaviour.
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O’Halloran P, Kingsley M, Nicholson M, Staley K, Randle E, Wright A, Bauman A. Responsiveness of the single item measure to detect change in physical activity. PLoS One 2020; 15:e0234420. [PMID: 32584830 PMCID: PMC7316312 DOI: 10.1371/journal.pone.0234420] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/26/2020] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The objective of this study was to evaluate the responsiveness of the single item measure (SIM) to detect change in PA when compared to hip-worn accelerometry. A secondary aim was to provide further data on validity of the measure at a single time point. METHODS Validity of the SIM to determine the number of days of ≥30 minutes of accelerometer-derived moderate-to-vigorous physical activity (MVPA) was assessed in 120 participants (78% female, 19% male, 3% other; age: 46 ± 11 years). Analysis of change was based on change in the number of days that participants completed ≥30 minutes of MVPA determined by the SIM and accelerometry over two 7-day periods in 90 participants (age: 47±11 years). Accelerometer data were analysed as total minutes of MVPA per day (MVPA-total) and as sustained bouts of 10 minutes or more of MVPA (MVPA-bouts). Validity of the SIM to detect change in MVPA, using accelerometer data as the reference measurement, was examined through Spearman's correlation and agreement in classification of change between SIM and accelerometry. Responsiveness to change was assessed by standardised response means and Cohen's d. RESULTS Standardised response means for PA change were moderate for the SIM (0.77), MVPA-total (0.57) and MVPA-bouts (0.79). The correlation for change in number of days ≥30 minutes MVPA between the SIM and accelerometry were small to moderate (MVPA-total: r = 0.36 and MVP-bouts: r = 0.40). The SIM displayed moderate accuracy (60%-63%), using accelerometer data as the reference measurement, in detecting increases in days ≥30 minutes of MVPA. CONCLUSION The SIM is a potentially useful assessment tool for evaluating change in MVPA, particularly when device-based measures or longer self-report measures are not feasible.
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Affiliation(s)
- Paul O’Halloran
- School of Psychology and Public Health, La Trobe University Bundoora Australia, Bundoora, Australia
- Centre for Sport and Social Impact, La Trobe University Bundoora Australia, Bundoora, Australia
| | - Michael Kingsley
- Centre for Sport and Social Impact, La Trobe University Bundoora Australia, Bundoora, Australia
- Holsworth Research Initiative, La Trobe University Bendigo Australia, Bendigo, Australia
- Department of Exercise Science, University of Auckland, Auckland, New Zealand
| | - Matthew Nicholson
- Centre for Sport and Social Impact, La Trobe University Bundoora Australia, Bundoora, Australia
| | - Kiera Staley
- Centre for Sport and Social Impact, La Trobe University Bundoora Australia, Bundoora, Australia
| | - Erica Randle
- Centre for Sport and Social Impact, La Trobe University Bundoora Australia, Bundoora, Australia
| | - Annemarie Wright
- Victorian Health Promotion Foundation (VicHealth), Carlton, Australia
- The University of Melbourne (Honorary), Parkville, Australia
| | - Adrian Bauman
- School of Public Health Sydney University Australia, Sydney, Australia
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Mainsbridge CP, Cooley D, Dawkins S, de Salas K, Tong J, Schmidt MW, Pedersen SJ. Taking a Stand for Office-Based Workers' Mental Health: The Return of the Microbreak. Front Public Health 2020; 8:215. [PMID: 32596199 PMCID: PMC7300182 DOI: 10.3389/fpubh.2020.00215] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 05/11/2020] [Indexed: 01/13/2023] Open
Abstract
There is evidence that movement-based microbreaks can improve the cardiovascular health of desk-based employees, but their effect on mood states is yet to be investigated. As daily work tasks can potentially result in the loss of physical and psychological resources, the objective of this study was to measure the effect of movement microbreaks during formal work time on mood states. In a randomized-controlled pilot study with repeated measures (baseline, post-test, washout) of self-reported job stress and mood states (fatigue and vigor), police officers (N = 43) were exposed to movement microbreaks during work hours. A multivariate significant difference between groups was noted after the intervention period. Further analysis revealed that the experimental group reported a latent reduction in job-related stress after the 3-months washout period. Although the study was conducted with a small sample, our preliminary findings suggest that interrupting sedentary work with movement microbreaks may have beneficial effects on employee mental health. The implications of movement microbreaks for mitigating work-related stress of first responders, including police, is discussed, along with directives for future research.
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Affiliation(s)
| | - Dean Cooley
- School of Education, Ballarat, VIC, Australia
| | - Sarah Dawkins
- Tasmanian School of Business and Economics, Hobart, TAS, Australia
| | - Kristy de Salas
- School of Technology, Environments, and Design, Hobart, TAS, Australia
| | - Jiajin Tong
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, Beijing, China
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Assessing the Measurement Properties of the Fitbit Zip® Among Adults Living With HIV. J Phys Act Health 2020; 17:293-305. [PMID: 31958771 DOI: 10.1123/jpah.2019-0242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 11/12/2019] [Accepted: 12/05/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To assess the criterion and construct validity of the Fitbit Zip® to measure physical activity among adults living with HIV. METHODS Participants were video recorded completing 2 walk tests while wearing the Fitbit Zip® and completed 3 self-reported physical activity questionnaires 1 week later. The authors calculated intraclass correlation coefficients (ICCs) to determine agreement between the number of steps taken and distance walked (Fitbit Zip®) with the visual count of number of steps taken and actual distance walked (walk tests). The authors tested 15 a priori hypotheses about predicted associations between questionnaire scores and physical activity measured by the Fitbit Zip®. RESULTS Among the 34 participants, there was "excellent" agreement between the number of steps taken measured by the Fitbit Zip® and visually counted number of steps taken (ICC = .99) and number of steps taken at slow (ICC = .75), moderate (ICC = .85), and fast (ICC = .78) walking speeds. There was "poor" agreement between the Fitbit Zip® recorded distance and actual determined distance walked (ICC = .20). Three (20%) construct validity hypotheses were confirmed. CONCLUSIONS The Fitbit Zip® demonstrated criterion validity for its ability to measure number of steps taken but not distance walked, and did not demonstrate construct validity for measuring physical activity among adults with HIV.
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Hwa Hsu C, Tung HH, Clinciu DL, Chen LK, Yin WH, Iqbal U, Wang TJ. Physical activity: A primary health quality determinant among community-dwelling geriatric women in Taiwan. Int J Qual Health Care 2017; 29:792-796. [DOI: 10.1093/intqhc/mzx101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 08/03/2017] [Indexed: 01/10/2023] Open
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Social identity, perceived urban neighborhood quality, and physical inactivity: A comparison study of China, Taiwan, and South Korea. Health Place 2016; 41:1-10. [PMID: 27372259 DOI: 10.1016/j.healthplace.2016.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 06/04/2016] [Accepted: 06/07/2016] [Indexed: 02/08/2023]
Abstract
UNLABELLED Asian countries are currently witnessing unprecedented increase in physical inactivity and subsequent negative health outcomes; however, few cross-country studies documenting this trend exist. This paper presents the findings of a nationally representative sample, based on the East Asian Social Survey in 2011. The study sought to examine the association of social identity factors, such as objective socio-economic position, perceived social status and neighborhood quality with physical inactivity, while controlling for psychosocial and physical health. A sample of 5222 adults living in urban areas across China, Taiwan, and South Korea were surveyed. METHODS Multivariate nested logistic regressions were constructed. RESULTS Perceived social status was positively associated with physical activity. Gender difference in physical activity was significant, and this difference widened as educational levels increased. Class division in physical activity was also found. Perceived physical and social features of neighborhood such as suitability for walking and jogging, air quality, and help from neighbors were to different degrees associated with physical inactivity. CONCLUSION Gender, marital status, education and perceived social status were common factors associated with physical inactivity in East Asian countries. Perceived urban neighborhood quality is particularly important for Chinese people to stay physically active. Cultural-behavioral norms for physical activity associated with gender and social status call for more studies on cultural perspective for health behaviors in cross-cultural contexts.
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