National, regional, and global trends in insufficient physical activity among adults from 2000 to 2022: a pooled analysis of 507 population-based surveys with 5·7 million participants

A Holistic Way to Understand the Determinants of Physical Activity in Urban New South Wales, Australia: A Codesigned Systems Mapping Project

BACKGROUND

To meet the World Health Organization goal of reducing physical inactivity by 15% by 2030, a multisectoral system approach is urgently needed to promote physical activity (PA). We report the process of and findings from a codesigned systems mapping project to present determinants of PA in the context of urban New South Wales, Australia.

METHODS

A participatory conceptual mapping workshop was held in May 2023 with 19 participants working in education, transportation, urban planning, community, health, and sport and recreation. Initial maps were developed and refined using online feedback from the participants. Interviews were conducted with 10 additional policymakers from relevant sectors to further refine the maps.

RESULTS

Two systems maps were cocreated, identifying over 100 variables influencing PA and their interconnections. Five settings emerged from the adults' map-social and community, policy, built environment and transportation, health care, and workplace-and 4 for the young people's map-family, school, transportation, and community and environment. The maps share similarities, such as regarding potential drivers within the transportation, community, and built environment sectors; however, the young people's map has a specific focus on the school setting and the adults' map on workplace and health care settings. Interviews with policymakers provided further unique insights into understanding and intervening in the PA system.

CONCLUSIONS

This codesigned participatory systems mapping process, supplemented by stakeholder interviews, provided a unique opportunity to bring together stakeholders across sectors to understand the complexity within the PA system and begin to identify leverage points for tackling physical inactivity in New South Wales.

"Physical Activity Is Not the Answer to Everything, but It Is to a Lot": Stakeholders' Perceived Determinants of Implementing Physical Activity Interventions for Older Adults

Although many physical activity (PA) interventions for older adults have proven effective in controlled research settings, optimal implementation in real life remains challenging. This study identifies determinants perceived by stakeholders when implementing community-based PA interventions for older adults. We interviewed 31 stakeholders guided by the Consolidated Framework for Implementation Research (CFIR). Results showed that stakeholders are very specific about the role they can play in implementation, making collaboration between stakeholders crucial. Barriers and motivators were identified in the CFIR intervention characteristics domain (relative advantage, complexity and costs, evidence quality and strength, and adaptability and trialability), in the outer setting domain (cosmopolitism, patient needs, and external policy and incentives), in the inner setting domain (implementation climate, relative priority, compatibility and organizational incentives and rewards) and in the individual characteristics domain (knowledge and beliefs, and other personal attributes). An overarching theme was the stakeholders' emphasis on aiming for broad health goals in interventions, as they perceive PA as a means to reach these goals rather than an end in itself. Another overarching theme requiring attention in future implementation efforts is the need to tailor implementation efforts to the specific needs of older adults as the end users of the intervention.

Blended learning in physical education: application and motivation

Background

The aim of the research was to evaluate outdoor aerobic sport activities (OASA) in the physical education (PE) of university students using wearables and their potential to personalize the learning process and enhance motivation.

Methods

In total, 368 university students participated. The OASA structure and the key points of application in PE were described. Descriptive statistics of the training units (n = 3,680) were processed. The students recorded their training data in the Strava app (10 sessions per semester), and the data were shared in the online sport community created on the Strava platform. Motivation was evaluated using a questionnaire. The focus was both on intrinsic motivation and extrinsic "ICT" motivation, based on Strava app features and tools.

Results

The most preferred outdoor aerobic sport activities were running (58%), cycling (13%), and walking (16%). The results provided insight into motivation and performance analysis. Students' motivation to participate in OASA was mainly in health concerns, such as staying in shape (94%), staying healthy (90%), and psychological concerns, such as having fun (88%), improving state of mind (88%), or relieving stress (83%). In achievement concerns, the motivation was a personal challenge (72%), while competing with others was ranked lowest (32%). The Strava app was a motivating tool for students to record, monitor, and analyze their individual activities and feel "connectedness" to the online sport community. 70% of students were motivated by the non-competitive character of PE, which gave them a personalized opportunity to train without being compared to others.

Discussion

The OASA management, with the use of blended learning methods and the Strava app, uses a motivational approach to create, support, and maintain students' healthy habits of physical activity through PE lessons. The need for students to be motivated to exercise can be confirmed in the analysis of the statistical descriptive parameters of running, cycling, and walking. There was a tendency for students to complete only the minimum required distance/time (not more). On the other hand, students enjoyed the training, and 99% of students confirmed that they would enroll again. That fact underlined the importance of motivating students with an effective learning strategy and giving support and guidance.

Associations of physical activity levels with fatigue in people with inflammatory rheumatic diseases in the LIFT trial

Objectives

The overall aim of the current study was to quantify physical activity levels in inflammatory rheumatic diseases (IRDs) and to explore their role in fatigue.

Methods

We conducted a secondary analysis of data from the Lessening the Impact of Fatigue in IRDs (LIFT) trial of the personalized exercise program (PEP) intervention for fatigue. Participants with IRDs were recruited from 2017 to 2019 and the current analysis used fatigue, measured by the Chalder Fatigue Scale (CFS) and the Fatigue Severity Scale (FSS), and accelerometer measured physical activity data collected at baseline and at the 6-month follow-up. Physical activity levels were quantified and associations with fatigue and effects of PEP investigated.

Results

Of the 337 included participants, 195 (68.4%) did not meet the current recommendations for moderate-vigorous physical activity (MVPA). In baseline cross-sectional analysis, many dimensions of physical activity were associated with fatigue. After mutual adjustment, overall physical activity (vector magnitude) was associated with CFS [-0.88 (95% CI -0.12, -1.64)] and distribution of time spent at different activity intensities was associated with FSS [-1.16 (95% CI -2.01, -0.31)]. Relative to usual care, PEP resulted in an increase in upright time, with trends for increases in step count and overall physical activity. People who increased overall physical activity (vector magnitude) more had greater improvements in CFS and FSS, while those who increased step count and MVPA more had greater improvements in FSS.

Conclusion

Increasing physical activity is important for fatigue management in people with IRDs and further work is needed to optimize PEPs to target the symptoms and impact of fatigue.

Trial registration

ClinicalTrials.gov (http://clinicaltrials.gov), NCT03248518.

Xbox Kinect Sports vs. Nintendo Switch Sports and Their Effects on Body Composition and Physical Performance in Older Females: A Randomized Controlled Trial

Background/Objectives: This study aimed to compare the effects of Xbox Kinect Sports (XKS) regarding Nintendo Switch Sports (NSS) and an inactive control group (CG) on body composition (body fat percentage, BFP; and fat-free mass) and physical performance (maximal isometric handgrip strength, MIHS; 30-s chair stand, 30-S; timed up-and-go, TUG; sit-and-reach; and 2-min step) in physically inactive older females. Methods: A randomized controlled trial study was conducted with three parallel groups: XKS (n = 13), NSS (n = 14), and CG (n = 16) considering three weekly 60-min sessions for 12 weeks with pre- and post-assessments. Results: A two-factor mixed analysis of variance (ANOVA) model with repeated measures was performed to measure the time × group effect. Multiple comparisons revealed significant differences in BFP (F(2,18) = 6.12; p = 0.005; ηp2 = 0.226, large effect), 30-S (F(2,18) = 20.7; p = 0.000; ηp2 = 0.496, large effect), TUG (F(2,18) = 10.0; p = 0.000; ηp2 = 0.323, large effect), sit-and-reach (F(2,18) = 37.3; p = 0.000; ηp2 = 0.640, large effect), and 2-min step (F(2,18) = 9.85; p = 0.000; ηp2 = 0.319, large effect) in favor of XKS regarding NSS and CG. The intragroup results only present in XKS a significant decrease in BFP (p = 0.02; d = 0.98) and significant improvements in the 30-S (p = 0.000; d = 1.88), TUG (p < 0.01; d = 2.00), sit-and-reach (p = 0.003; d = 2.58), and 2-min step (p = 0.004; d = 1.05). Conclusions: training using XKS significantly decreases BFP and improves 30-S, TUG, sit-and-reach, and 2-min step in physically inactive older females.

Physical activity policies in Saudi Arabia and Oman: a qualitative study using stakeholder interviews

BACKGROUND

Countries in the Middle East have some of the lowest rates of physical activity and some of the highest rates of obesity in the world. Policies can influence population levels of physical activity. However, there is a dearth of research on physical activity policies in the Gulf region. This qualitative study analyses cross-sectoral barriers and facilitators for the development, implementation and evaluation of physical activity policies in Saudi Arabia and Oman, two of the largest countries in the region.

METHODS

Semi-structured interviews were conducted with 19 senior policymakers from the Ministries of Health, Education, and Sport in Saudi Arabia and Oman, and were examined using thematic analysis.

RESULTS

We identified seven themes related to physical activity policies in Saudi Arabia and Oman: leadership; existing policies; physical activity programs related to policies; private sector policies; challenges; data/monitoring; and future opportunities. Both countries have a central document that guides policy-makers in promoting physical activity, and the available policies in both countries are implemented via multiple programs and initiatives to increase physical activity. Compared with Oman, in Saudi Arabia, programs from the non-profit sector, represented by community groups, play a more significant role in promoting physical activity outside the government framework. The private sector has contributed to promoting physical activity in both countries, but interviewees stated that more financial support is required. Policy limitations differ between Saudi Arabia and Oman: intersectoral collaboration in Oman is limited and mainly based on individuals' own initiative, while the health transformation in Saudi Arabia tends to slow down policy implementation in relevant areas. Physical education in Saudi Arabia and Oman is similar; however, increased support and collaboration between government agencies and the private sector for out-of-school sports academies are needed.

CONCLUSIONS

This study addresses key gaps in analysing physical activity policies in Gulf Cooperation Council countries. Our study highlights the importance of increasing financial support, improving collaboration between governmental agencies and between them and the private sector and consolidating efforts to back physical activity policies and dismantle cross-sectoral barriers in Saudi Arabia and Oman. Educational institutions in Saudi Arabia and Oman play a crucial role in promoting physical activity from early childhood to young adults. Our insights assist policy-makers, public health officials and stakeholders in shaping effective physical activity-promoting policies, programs and interventions to prevent non-communicable diseases. Challenges identified in Saudi Arabia and Oman's policies will inform their future development.