Physical Activity Perceptions and Influences among Older Adults in Rural Nova Scotia

Work, travel, or leisure: comparing domain-specific physical activity patterns based on rural-urban location in Canada

BACKGROUND

Physical activity occurs across various domains including leisure/recreation, for transportation, or for work or household reasons. Rural and urban active living environments are characterized by different opportunities for physical activity within each domain which may translate into different patterns of behavior. The aim of this study was to compare rural-urban differences in physical activity across different domains, and explore interactions between sociodemographic factors, physical activity domains, and rurality.

METHODS

We used self-reported data collected across three physical activity domains (active transportation, recreation, occupational/household) and relevant sociodemographic variables from the Canadian Community Health Survey. Adjusting for sociodemographic factors, we did two separate cross-sectional analyses: 1) binary logistic regression to determine the odds of reporting any activity in each domain, and 2) ordinary least squares regression using the sub-samples reporting > 0 min per week of activity to compare how much activity was reported in each domain.

RESULTS

Our final survey weighted sample of Canadian adults (mean age 47.4 years) was n = 25,669,018 (unweighted n = 47,266). Rural residents were less likely to report any active transportation (OR = 0.59, 95% CI [0.51, 0.67], p < .0001). For recreational physical activity, rural males had lower odds (OR = 0.75, 95% CI [0.67, 0.83], p < .0001) and rural females had higher odds (OR = 1.19, 95% CI [1.08, 1.30], p = .0002) of reporting any participation compared to urban residents. Rural males (OR = 1.90, 95% CI [1.74, 2.07], p < .0001) and females (OR = 1.33, 95% CI [1.21, 1.46], p < .0001) had higher odds of reporting any occupational or household physical activity.

CONCLUSIONS

Urban residents tend to participate in more active transportation, while rural residents participate in more occupational or household physical activity. Location-based differences in physical activity are best understood by examining multiple domains and must include appropriate sociodemographic interactions, such as income and sex/gender.

Investigating sedentariness and health status of primary school teachers in Ghana

OBJECTIVE

Physical inactivity is linked to chronic illnesses and disabilities among workers, especially those in high demanding jobs like teachers. Despite the global prominence of sedentary behavior research, studies drawing the relationships between physical inactivity and multimorbidity among working teacher populations in low-and middle-countries remain untapped. This study assessed the sedentariness and health status of primary school teachers in Cape Coast Metropolis in Ghana.

METHOD

This cross-sectional survey employed 1109 primary school teachers from the Cape Coast Metropolis in the Central Region of Ghana, targeting the entire population.

RESULTS

Generally, the teachers were highly sedentary and reported poor health status. Other results showed no difference in sedentariness across gender, (n = 1107, t= -0.32, p > 0.05). However, female teachers suffer more pain and discomfort, (n = 1103.51), t = - 3.07, p < 0.05), anxiety and depression, (n = 1099.56), t = - 2.85, p < 0.000), and poor health status (n = 1107), t = 2.14, p < 0.05), than their male counterparts. Also, pain and discomfort, anxiety and depression, health status and years of work significantly predicted sedentariness among the teachers, F (4, 1104) = 5.966, p = 0.00, R = 0.145, R2 = 0.029, adjusted R2 = 0.018.

CONCLUSION

The findings suggest that individualized or personalized interventions are urgently needed to promote regular physical activity to improve the health status and reduce associated complications on the health and well-being, especially among the female primary school teachers. Given the health risks of sedentary lifestyle, behavioral interventions at the person-level (i.e., individualized- routine weekly physical activity programs) and built environmental restructuring (e.g., creation of walkways to encourage regular walking) could be done to improve physical activity behavior among teachers within the Cape Coast Metropolis, and perhaps beyond.

Physical Activity Among Older Women Living in Rural Areas in Canada: A Scoping Review

Although there is strong evidence linking physical activity in older age with wellbeing and health benefits, these relationships tend to be under-researched in a rural context. A scoping review was conducted to identify what is known about physical activity among older women living in rural Canada. The search strategy was intentionally broad, with eight databases, academic journals, and websites scanned for research and grey literature related to Canada, in English, from 2000 to 2022. 33 studies, reviews, and reports were included in the final selection. These articles indicate that physical activity among older women living in rural Canada is influenced by a multitude of layers, contexts, conditions, and environments, with outcomes dependent on a mixture of personal, relational, community, societal, and governmental factors. In general, the women are committed to creating and maintaining an active lifestyle, and supporting their local rural community to enable these activities. While the social environment can proscribe physical activity through ageist attitudes and restrictive socio-cultural norms, social support from family and community members mitigates against these constraints. Rural infrastructure, geography, climate (seasons and weather), as well as transportation and policy issues may also impede the physical activity opportunities of the women. Some of the problems related to sustaining and resourcing recreational activity in rural communities are partly addressed through the implications presented in the articles. Among others, these suggestions relate to leadership and learning opportunities, public engagement, and the partnership working involved in supporting physical activity in rural areas. However, further research is long overdue.

Likelihood of meeting physical activity guidelines in rural and urban adults: cross-sectional analysis of the Canadian Community Health Survey

OBJECTIVES

The goal of this study was to compare the odds of meeting physical activity (PA) guidelines among adults living in rural and urban areas of Canada.

METHODS

Data from the 2017 cycle of the Canadian Community Health Survey were analyzed using binomial logistic regression with a sample of 47,266 adults representing a survey-weighted total of 25,669,018. The odds of meeting PA guidelines were determined based on self-reported moderate-to-vigorous PA (<150 min per week or ≥150 min per week). Communities were categorized as urban or rural based on population size and density. Individual-level correlates included in the model were self-identified sex, age, body mass index, highest level of education, household income, perceived health, and sense of belonging to community.

RESULTS

Approximately 56.6% of rural and 59.3% of urban adults reported meeting recommended PA levels when location was examined as a sole predictor. The best-fit model adjusted for all individual-level factors showed a significant sex × location interaction. Males in rural communities were more likely to report meeting PA guidelines (odds = 0.90 or 47.4%) than males in urban areas (odds = 0.78 or 43.8%), whereas females living in rural communities (odds = 0.58 or 36.7%) were less likely to report meeting PA guidelines than females in urban areas (odds = 0.65 or 39.4%).

CONCLUSION

The association between rural-urban residence and meeting PA guidelines appears to be contingent on self-identified sex differences. Future work should explore how gender- and location-related variables interact to influence self-reported PA engagement.

'If I Had Someone Looking Over My Shoulder…': Exploration of Advice Received and Factors Influencing Physical Activity Among Non-metropolitan Cancer Survivors

BACKGROUND

There are significant geographic inequalities in cancer survival with poorer survival rates in non-metropolitan areas compared to major cities. Physical activity (PA) can reduce cancer recurrence and prevent cardiovascular disease. However, few survivors participate in sufficient PA and the prevalence of inactivity is significantly higher in non-metropolitan survivors. The study investigated non-metropolitan survivors' recollections regarding PA advice received following cessation of active treatment, their knowledge of PA guidelines, and the factors that impact on PA behaviour change.

METHOD

Sixteen individuals (14 women and 2 men) with breast (n = 8), endometrial (n = 4) or colorectal cancer (n = 4), with a mean age of 60 years (SD = 12) completed semi-structured interviews as part of a larger study to examine the acceptability and utility of wearable trackers to increase PA. Interviews explored survivors' recollections regarding the advice they received concerning PA following active treatment, knowledge of PA guidelines for cancer survivors and the influences on PA behaviour change. Interview transcripts were analysed using thematic analysis.

RESULTS

Four main themes emerged: (i) insufficient knowledge of guidelines, (ii) support from the treating oncology team, (iii) external accountability, and (iv) barriers to PA.

CONCLUSIONS

Survivors' knowledge of PA guidelines was limited and they did not often recall their oncologists making specific recommendations concerning PA. Survivors' referred to the desire for accountability and monitoring in order to successfully change PA. Lack of motivation was the main barrier to PA participation. Other barriers included age, health status, and lack of facilities or exercise programs.

Physical Activity Attitudes, Preferences, and Experiences of Regionally-Based Australia Adults Aged 65 Years and Older

An understanding of physical activity attitudes, preferences, and experiences in older adults is important for informing interventions. Focus groups were conducted with 46 regionally-based Australian adults aged 65 years and older, who were not currently meeting activity recommendations. Content analysis revealed that participants mainly engaged in incidental activities such as gardening and household chores rather than planned exercise; however, leisure-time walking was also mentioned frequently. Although participants valued the physical and mental health benefits of physical activity, they reported being restricted by poor physical health, extreme weather, and fear of injury. Participants were interested in exercise groups and physical activity programs tailored to their existing physical health. The majority of participants reported preferring to be active with others. The findings from this study are useful in for informing future interventions specifically tailored to the needs of older adults in Australia.

A life fulfilled: positively influencing physical activity in older adults - a systematic review and meta-ethnography

BACKGROUND

Increasing physical activity in older adults remains a key public health priority in countries with a high burden of non-communicable disease, yet current interventions have failed to substantially increase population uptake with UK data suggesting that only half of 65-74 year olds report meeting recommended levels. The aim of this study was to conduct a systematic and inductive qualitative synthesis of the large body of qualitative research describing what influences physical activity at this age, and older adults' experiences of physical activity.

METHODS

A qualitative meta-ethnography was chosen as the study design as this inductive approach can provide novel insights and generate new theory about physical activity and ageing. Papers were identified by searching electronic databases and key citations. Peer-reviewed primary qualitative studies and systematic reviews were included if they met the following inclusion criteria: community-dwelling participants aged 60 years or older or in the retirement transition period; reporting on leisure-time physical activity; utilising a rigorous qualitative methodology. A line of argument approach was employed to generate a theory about how older adults think and feel about physical activity.

RESULTS

Thirty-nine papers met the inclusion criteria and were synthesised. The emergent theory suggested transition to older age can challenge people's sense of self and their role in life. Physical activity can help in regaining feelings of purpose, of being needed in collective group activity, and by creating habitual routine and structure to the day. In overcoming real and perceived barriers, and by taking up or sustaining physical activities, older adults can further build self-esteem all of which contributes to a fulfilling older age.

CONCLUSION

Current failures to increase population levels of physical activity in older adults may be explained by an approach overly focused on the health benefits of activity. Insights from this study suggest we need to reframe our approach to consider the wider set of goals and aspirations which are of greater personal importance to older adults, and future interventions should focus on how physical activity can contribute to life satisfaction, sense of purpose, and sense of role fulfilment in older age.

TRIAL REGISTRATION

Registered prospectively on PROSPERO on 29th March 2013: CRD42013003796 .