Context Matters: Systematic Observation of Place-Based Physical Activity

A systematic observation of moderate-to-vigorous physical activity levels in Australian natural blue space locations

Research has shown that blue space (i.e. water-based environments) can be good for physical and mental health, with one possible reason being that people are physically active when visiting blue space environments. However, little is known about how active people are when visiting blue space. We used the System for Observing Physical Activity and Recreation in Natural Areas to systematically record whether people were active while visiting eight different blue space locations in Australia. We first calculated the proportion of people who were moderately or vigorously active at each location and then conducted a series of linear regression models to determine which demographic and environmental factors predicted higher activity levels. We identified that 44% of people visiting blue space locations were active. However, there were significant interactions between both age and gender, and type of blue space. Males (β = -0.25, p = 0.018) and females (β = -0.26, p ≤ 0.001) were less active at built-up riverfronts than coastal beaches. Females were also less active at inland beaches (β = -0.15, p = 0.013) and watering holes (β = -0.20, p = 0.011) compared with coastal beaches. Children (β = 0.16, p = 0.006) and adolescents, however, were more active at inland beaches (β = 0.32, p ≤ 0.001) than coastal beaches. These results are important to consider when making decisions around access to, and infrastructure within, blue space environments, as different blue space environments influence human behaviour differently for different people.

Using Computer Vision to Annotate Video-Recoded Direct Observation of Physical Behavior

Direct observation is a ground-truth measure for physical behavior, but the high cost limits widespread use. The purpose of this study was to develop and test machine learning methods to recognize aspects of physical behavior and location from videos of human movement: Adults (N = 26, aged 18-59 y) were recorded in their natural environment for two, 2- to 3-h sessions. Trained research assistants annotated videos using commercially available software including the following taxonomies: (1) sedentary versus non-sedentary (two classes); (2) activity type (four classes: sedentary, walking, running, and mixed movement); and (3) activity intensity (four classes: sedentary, light, moderate, and vigorous). Four machine learning approaches were trained and evaluated for each taxonomy. Models were trained on 80% of the videos, validated on 10%, and final accuracy is reported on the remaining 10% of the videos not used in training. Overall accuracy was as follows: 87.4% for Taxonomy 1, 63.1% for Taxonomy 2, and 68.6% for Taxonomy 3. This study shows it is possible to use computer vision to annotate aspects of physical behavior, speeding up the time and reducing labor required for direct observation. Future research should test these machine learning models on larger, independent datasets and take advantage of analysis of video fragments, rather than individual still images.

Patterns of physical activity among nursing home residents before and during the Covid 19 pandemic-a systematic observation

BACKGROUND

The Covid-19 outbreak in spring of 2020 posed an array of challenges for nursing homes, including promoting resident physical activity (PA). Given the diversity of factors affecting resident PA, we explored how activity patterns outside weekly-scheduled structured activities changed during the pandemic and what factors promoted or inhibited PA during the pandemic.

METHODS

We conducted systematic direct observations over 823.5 h in eight nursing homes in Southern Germany in 2020 and 2021.

RESULTS

In 2020, 84.7% of person observation units were classified as sedentary (average activity level: 1.14 MET). In 2021, the percentage increased to 91.6% of observed person units (average activity level: 1.08 MET) (t = 6.947; p = .000). According to tree classification, influencing factors of PA included mealtime and daytime in 2020 and 2021, as well as presence of men residents only in 2020 and guided low threshold activities in 2021.

CONCLUSIONS

Nursing homes constitute highly sedentary places-an issue exacerbated by access restrictions for external activity experts and significant others as well as behavioural restrictions for residents during the Covid-19 pandemic. Staff could not compensate due to existing time restraints and lack of training in PA promotion. Based on our findings, we recommend future studies to develop feasible and resource-low activities to be integrated into the daily routines of nursing homes.

How Much Did Urban Park Use Change under the COVID-19 Pandemic? A Comparative Study of Summertime Park Use in 2019 and 2020 in Edinburgh, Scotland

The importance of urban parks was highlighted during the COVID-19 pandemic, when a number of restrictions on social gatherings were in place and people's movements were often restricted to their local neighbourhood. This study examined the changes in patterns of park use before and during COVID-19 to understand how the pandemic influenced such use. The methods involved behaviour observation and mapping, to offer a comparison of the use of parks in Edinburgh, Scotland, before and in the first year of the COVID-19 pandemic. The findings show an overall increase in use of urban parks during COVID-19, as expected, with significantly higher use in social areas, sports and fitness areas, and playground areas. However, while there was an overall increase in people visiting parks with others during COVID, in woodland areas there was an increase in lone visitors. This study shows the importance of parks for socialisation, exercise and children's play, but also for spending time alone in natural areas during COVID-19. The value of urban parks at a time of social disruption, such as the pandemic, is highlighted, and their role in supporting a variety of urban dwellers' needs points to priorities for future park planning, design and management.

Re-visiting systematic observation: A pedagogical tool to support coach learning and development

Systematic observation has been one of the most employed data collection methods in sport coaching literature. Initial work, originally undertaken in the 1970's, and gaining traction in the 80's and 90's looked to predominately offer descriptions of coaches' behavior. While this research continues to offer a significant contribution to the fields understanding of what coaches do during practice, systematic observation used only in this way has unfulfilled potential. The premise of this paper is to consider systematic observation as a coach development tool—a precedent which has been set in the literature. The arguments made are based on an alternative way of thinking about systematic observation, as a pedagogical tool that supports coaches in better understanding themselves and their pedagogical practice. Principles of dialogic pedagogy are used as the basis of our argument whereby “researchers” and “coaches” work collaboratively to co-construct knowledge and support coach reflection, and ultimately develop coaches' practice.

Increased mask adherence after important politician infected with COVID-19

Objectives

To quantify changes in adherence to mask and distancing guidelines in outdoor settings in Philadelphia, PA before and after President Trump announced he was infected with COVID-19.

Methods

We used Systematic Observation of Masking Adherence and Distancing (SOMAD) to assess mask adherence in parks, playgrounds, and commercial streets in the 10 City Council districts in Philadelphia PA. We compared adherence rates between August and September 2020 and after October 2, 2020.

Results

Disparities in mask adherence existed by age group, gender, and race/ethnicity, with females wearing masks correctly more often than males, seniors having higher mask use than other age groups, and Asians having higher adherence than other race/ethnicities. Correct mask use did not increase after the City released additional mask guidance in September but did after Oct 2. Incorrect mask use also decreased, but the percentage not having masks at all was unchanged.

Conclusions

Vulnerability of leadership appears to influence population behavior. Public health departments likely need more resources to effectively and persuasively communicate critical safety messages related to COVID-19 transmission.

An empirical example of analysis using a two-stage modeling approach: within-subject association of outdoor context and physical activity predicts future daily physical activity levels

People differ from each other to the extent to which momentary factors, such as context, mood, and cognitions, influence momentary health behaviors. However, statistical models to date are limited in their ability to test whether the association between two momentary variables (i.e., subject-level slopes) predicts a subject-level outcome. This study demonstrates a novel two-stage statistical modeling strategy that is capable of testing whether subject-level slopes between two momentary variables predict subject-level outcomes. An empirical case study application is presented to examine whether there are differences in momentary moderate-to-vigorous physical activity (MVPA) levels between the outdoor and indoor context in adults and whether these momentary differences predict mean daily MVPA levels 6 months later. One hundred and eight adults from a multiwave longitudinal study provided 4 days of ecological momentary assessment (during baseline) and accelerometry data (both at baseline and 6 month follow-up). Multilevel data were analyzed using an open-source program (MixWILD) to test whether momentary strength between outdoor context and MVPA during baseline was associated with average daily MVPA levels measured 6 months later. During baseline, momentary MVPA levels were higher in outdoor contexts as compared to indoor contexts (b = 0.07, p < .001). Participants who had more momentary MVPA when outdoors (vs. indoors) during baseline (i.e., a greater subject-level slope) had higher daily MVPA at the 6 month follow-up (b = 0.09, p < .05). This empirical example shows that the subject-level momentary association between specific context (i.e., outdoors) and health behavior (i.e., physical activity) may contribute to overall engagement in that behavior in the future. The demonstrated two-stage modeling approach has extensive applications in behavioral medicine to analyze intensive longitudinal data collected from wearable sensors and mobile devices.

BaSAlt - A mixed-methods study protocol on setting-based physical activity promotion and counseling in nursing homes

Introduction

Physical activity (PA) is a major contributor to healthy aging. However, physical inactivity is prevalent among the elderly in Germany, particularly in institutionalized settings such as nursing homes. This paper aims to describe the study objectives, design, methods, assessment types, collection schedules and considerations for analyzing the data within the BaSAlt study on facilitators and barriers for PA promotion in nursing homes.

Methods

We designed the BaSAlt study as a participatory intervention study with multiple measurement points in six to eight nursing homes with a total of approx. 200 residents using four main modules: (1) setting-level analysis of physical activity patterns, physical activity-related climate and physical activity-related interaction with ‘significant others,’ and organizational facilitators and barriers to physical activity, (2) physical-activity related individual-level analysis of objective and self-reported physical activity and sedentary behavior, a geriatric assessment with established procedures, assessment of people's activity and health biographies (biographical mapping) as well as their motivational, subjective well-being and distress status, and (3) a counseling module that integrates counseling at the setting level as well as individual physical activity counseling for residents. In module (4) evaluation, the effects of integrated counseling with regard to the implementation of PA promotion strategies are analyzed.

Discussion

This study will extend our knowledge of physical activity promotion in German nursing homes. Its findings will inform governmental authorities, care professionals, and academics on how to reach a particular group, characterized by inactivity, multimorbidity, and a high prevalence of dementia, residing in nursing homes, a setting that will gain further relevance in the future.

Systematic observation of mask adherence and distancing (SOMAD): Findings from Philadelphia

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Mask adherence differed by gender, age group, and race/ethnicity.

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Mask adherence also differs by physical activity level, setting, and location.

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High rates of incorrect mask usage (17%) and non-adherence (40% with no mask at all) were observed.

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Mask adherence was lower in higher poverty neighborhoods.

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Maintaining a 6-foot distance was lowest for Hispanics.

Adherence to guidelines for face coverings and physical distancing are critical strategies to stem the COVID-19 pandemic but are not uniformly followed. Understanding factors associated with adherence to mask-wearing and physical distancing may help guide future control efforts. We conducted an observational study using Systematic Observation of Mask Adherence and Distancing (SOMAD) in August 2020 in parks, playgrounds and commercial streets in each of 10 City Council Districts in Philadelphia, PA. Wearing a mask correctly varied by setting with highest adherence in commercial areas and lowest in playgrounds. Almost 17% wore visible masks that did not cover the nose and/or mouth. There were multiple disparities in correct mask use. Females had higher rates than males (unadjusted relative risk = 1.40, p < .0001) and seniors higher than any other age group (unadjusted chi-square p < .0001). Asians wore masks correctly the most often [adjusted log odds ratio (LOR) = 0.53 compared with non-Hispanic white, p = 0.02]. Correct mask-wearing was higher in areas with a higher population density (adjusted LOR = 0.03 per one thousand/square mile, p = 0.02) and lower in higher poverty areas (adjusted LOR = −0.01, p = .03). Disparities in adherence to mask wearing and physical distancing likely reflect differences in perception of risk by gender, age group, and race/ethnicity. While the risk of COVID-19 transmission is lower in outdoor settings, it is unlikely to be zero. The lower rates of mask use by males and minority groups suggest increased efforts are needed to enhance adherence to recommended guidelines.

The school playground environment as a driver of primary school children's physical activity behaviour: A direct observation case study

The school playground can promote PA for large numbers of children. This study identifies areas of the playground that children visited at break-times, the decisions according to gender and the influence of contextual and environmental variables on PA levels. The playground of a culturally diverse primary school was observed during morning break-times and lunchtimes. Counts of sedentary, LPA, and MVPA episodes, and the contexts in which they occurred were recorded using the system for observing play and leisure in youth (SOPLAY). Ball sports areas had higher counts of boys (mean ± SD; 9.9 ± 4.8) compared to girls (2.0 ± 3.5); areas promoting climbing and social interaction had higher counts of girls (7.9 ± 7.2) compared to boys (3.5 ± 2.9). The proportion of MVPA episodes during break-times was 34% ± 26%. Areas of the playground with organised activities had 2.70 (95%CI: 1.87 to 3.91) times higher MVPA counts than areas "not organised". Areas with "supervision" were associated with higher MVPA counts (1.34; 1.18 to 1.53) compared with "not supervised" areas. Organisation and supervision might influence PA choices and PA levels of children in the primary school playground. Further investigation is required to explore different playgrounds settings, and context and gender preferences.

Challenges, opportunities and solutions for local physical activity stakeholders: an implementation case study from a cross-sectoral physical activity network in Northeast England

Background

Increasingly, national policy initiatives and programmes have been developed to increase physical activity (PA). However, challenges in implementing and translating these policies into effective local-level programmes have persisted, and change in population PA levels has been small. This may be due to insufficient attention given to the implementation context, and the limited interactions between local policy-makers, practitioners and researchers. In this paper we use a case study of a cross-sectoral network in Northeast England, to identify the local-level challenges and opportunities for implementing PA policies and programmes, particularly the updated 2019 UK PA guidelines.

Methods

Five focus groups (n = 59) were conducted with practice partners, local policy-makers and researchers during an initial workshop in April 2018. Through facilitated discussion, participants considered regional priorities for research and practice, along with barriers to implementing this agenda and how these may be overcome. During a second workshop in December 2018, overarching findings from workshop one were fedback to a similar group of stakeholders, along with national policy-makers, to stimulate feedback from delegates on experiences that may support the implementation of the UK PA guidelines locally, focusing on specific considerations for research, evidence and knowledge exchange.

Results

In workshop one, three overarching themes were developed to capture local challenges and needs: (i) understanding complexity and context; (ii) addressing the knowledge and skills gap; and (iii) mismatched timescales and practices. In workshop two, participants’ implementation plans encompassed: (i) exploring a systems approach to implementation; (ii) adapting policy to context; and (iii) local prioritising.

Conclusions

Our findings suggest that academics, practitioners and policy-makers understand the complexities of implementing PA strategies, and the challenges of knowledge exchange. The updated UK PA guidelines policy presented an opportunity for multiple agencies to consider context-specific implementation and address enduring tensions between stakeholders. An organically derived implementation plan that prioritises PA, maps links to relevant local policies and supports a context-appropriate communication strategy, within local policy, practice and research networks, will help address these. We present 10 guiding principles to support transferable knowledge exchange activities within networks to facilitate implementation of national PA policy in local contexts.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-09847-3.

Assessing Physical Activity in Temporary Spaces: Application of SOPARC / iSOPARC® for Play Streets

Purpose: The System for Observing Play and Recreation in Communities (SOPARC) is a valid, reliable method for understanding how people engage in physical activity (PA) in various permanent settings (e.g., parks) and contexts. However, its utility, reliability, and validity in temporary spaces has not been examined. Temporary spaces can provide PA opportunities often absent in low-income communities due to inadequate safe permanent PA spaces. Play Streets involve temporary closure of streets or other publicly accessibly spaces (e.g., parking lots, open-fields) to create safe play spaces for a specified time-period. We describe the utility, reliability, and validity of using SOPARC to assess PA in temporary spaces like Play Streets. Method: Trained SOPARC/iSOPARC (iPad App) research staff completed systematic observations during Play Streets occurring in four diverse low-income rural U.S. communities during summer 2017. Results: We successfully used iSOPARC to document PA and how spaces were used at Play Streets (n = 16), confirming its utility, reliability, and validity. Unlike observations of permanent spaces, target areas could not be pre-established since play spaces often changed during set-up, requiring time onsite to identify target areas and boundaries. Play areas frequently appeared and/or disappeared during Play Streets, and this was systematically addressed by using physical target area boundaries instead of activities. Conclusions: Understanding how temporary spaces are used for PA is critical for promoting their use. SOPARC/iSOPARC methods are useful in a Play Streets' context; however, systematic methods and training are needed to address inherent unpredictable and dynamic changes within and across target areas.

Identifying Urban Immigrant Food-Cultivation Practices for Culturally-Tailored Garden-Based Nutrition Programs

Garden-based nutrition programs are used to address food access and nutrition in low-income communities. In urban immigrant communities, food-growing practices may be shaped by environmental and cultural factors, and may not reflect the assumptions behind these curricula. Built-environment research was adapted to develop a protocol for assessing a community's gardening practices. A random sample of census blocks was generated and mapped, observational protocols developed, iteratively tested and refined, then fieldworkers trained and deployed. Daily debriefings were conducted to identify challenges in field implementation. Nearly all (93%) sampled blocks contained evidence of food cultivation. Garden structures, land-use patterns, and plant choices reflected cultural preferences, differing substantively from USDA home gardening curricula. This tool successfully identified food-growing practices within an urban immigrant Asian and Pacific Islander community, and provides a replicable methodology for community assessment. Results support the need to culturally-tailor garden-based nutrition programs for urban immigrant populations.

Assessing Physical Activities Occurring on Sidewalks and Streets: Protocol for a Cross-Sectional Study

Background

A considerable proportion of outdoor physical activity (PA) is done on sidewalks and streets, necessitating the development of a reliable measure of PA performed in these settings. The Block Walk Method (BWM) is one of the more common approaches for this purpose. Although it utilizes reliable observation techniques and displays criterion validity, it remains relatively unchanged since its introduction in 2006. It is a nontechnical, labor-intensive, first generation method. Advancing the BWM would contribute significantly to our understanding of PA behavior.

Objective

This study will develop and test a new BWM that utilizes a wearable video device (WVD) and computer video analysis to assess PAs performed on sidewalks and streets. The specific aims are to improve the BWM by incorporating a WVD (eyeglasses with a high-definition video camera in the frame) into the methodology and advance this WVD-enhanced BWM by applying machine learning and recognition software to automatically extract information on PAs occurring on the sidewalks and streets from the videos.

Methods

Trained observers (1 wearing and 1 not wearing the WVD) will walk together at a set pace along predetermined 1000 ft sidewalk and street observation routes representing low, medium, and high walkable areas. During the walks, the non-WVD observer will use the traditional BWM to record the numbers of individuals standing, sitting, walking, biking, and running in observation fields along the routes. The WVD observer will continuously video the observation fields. Later, 2 investigators will view the videos to determine the number of individuals performing PAs in the observation fields. The video data will then be analyzed automatically using multiple deep convolutional neural networks (CNNs) to determine the number of humans in the observation fields and the type of PAs performed. Bland Altman methods and intraclass correlation coefficients (ICCs) will be used to assess agreement. Potential sources of error such as occlusions (eg, trees) will be assessed using moderator analyses.

Results

Outcomes from this study are pending; however, preliminary studies supporting the research protocol indicate that the BWM is reliable for determining the PA mode (Cramer V=.89; P<.001), the address where the PA occurred (Cohen kappa=.85; P<.001), and the number engaged in an observed PA (ICC=.85; P<.001). The number of individuals seen walking along routes was correlated with several environmental characteristics such as sidewalk quality (r=.39; P=.02) and neighborhood aesthetics (r=.49; P<.001). Furthermore, we have used CNNs to detect cars, bikes, and pedestrians as well as individuals using park facilities.

Conclusions

We expect the new approach will enhance measurement accuracy while reducing the burden of data collection. In the future, the capabilities of the WVD-CNN system will be expanded to allow for the determination of other characteristics captured in videos such as caloric expenditure and environmental conditions.

International Registered Report Identifier (IRRID)

PRR1-10.2196/12976

Validation of the Block Walk Method for Assessing Physical Activity occurring on Sidewalks/Streets

The block walk method (BWM) is one of the more common approaches for assessing physical activity (PA) performed on sidewalks/streets; however, it is non-technical, labor-intensive, and lacks validation. This study aimed to validate the BWM and examine the potential for using a wearable video device (WVD) to assess PA occurring on sidewalks/streets. Trained observers (one wearing and one not wearing the WVD) walked together and performed the BWM according to a previously developed protocol along routes in low, medium, and high walkable areas. Two experts then reviewed the videos. A total of 1150 (traditional) and 1087 (video review) individuals were observed during 900 min of observation. When larger numbers of individuals were observed, the traditional method overestimated the overall number of people as well as those walking and sitting/standing, while underestimating the number of runners. Valid estimates of PA occurring on sidewalks/streets can be obtained by the traditional BWM in low and medium walkability areas and/or with non-common activities (cycling); however, its validity is questionable when sidewalks/streets use volume is high. The use of WVDs in PA assessment has the potential to establish new levels of accuracy, reduce resource requirements, and open up the possibility for retrospective analysis.

Physical Activity of Children with Physical Disabilities: Associations with Environmental and Behavioral Variables at Home and School

The purpose of this study was to examine the physical activity (PA) of children with physical disabilities (PD) and its associated environmental and behavioral factors at home and at school. One hundred and forty-seven Hong Kong children (mean age = 13.5 ± 2.5 years) with PD from three special schools participated. We used BEACHES (Behaviors of Eating and Activity for Children's Health: Evaluation System) to assess their PA and associated variables at home (before dinner) and during four school settings (before classes, recess, lunch breaks, after classes) on four school days. Overall, the children were typically inactive and spent little time in moderate-to-vigorous physical activity (MVPA), range = 6.3% to 17.0% across settings. At home, children were more active when fathers were present (p < 0.001). At school, prompts to be active contributed to their MVPA% before classes (p < 0.01) and during recess and lunch breaks (both p < 0.001). The presence of a child's mother was positively associated with MVPA% before classes (p < 0.001) and the presence of other children was associated with MVPA% during recess and lunch breaks (both p < 0.05). With children with PD accruing small amounts of MVPA in both home and school settings, multifaceted interventions reflecting both contextual and personal factors should be considered in order to increase the health-enhancing PA of this population.

Early Steps in Automated Behavior Mapping via Indoor Sensors

Behavior mapping (BM) is a spatial data collection technique in which the locational and behavioral information of a user is noted on a plan layout of the studied environment. Among many indoor positioning technologies, we chose Wi-Fi, BLE beacon and ultra-wide band (UWB) sensor technologies for their popularity and investigated their applicability in BM. We tested three technologies for error ranges and found an average error of 1.39 m for Wi-Fi in a 36 m² test area (6 m × 6 m), 0.86 m for the BLE beacon in a 37.44 m² test area (9.6 m × 3.9 m) and 0.24 m for ultra-wide band sensors in a 36 m² test area (6 m × 6 m). We simulated the applicability of these error ranges for real-time locations by using a behavioral dataset collected from an active learning classroom. We used two UWB tags simultaneously by incorporating a custom-designed ceiling system in a new 39.76 m² test area (7.35 m × 5.41 m). We considered 26 observation points and collected data for 180 s for each point (total 4680) with an average error of 0.2072 m for 23 points inside the test area. Finally, we demonstrated the use of ultra-wide band sensor technology for BM.

Impacts of a Temporary Urban Pop-Up Park on Physical Activity and Other Individual- and Community-Level Outcomes

Physical inactivity is a known risk factor for obesity and a number of chronic diseases. Modifying the physical features of neighborhoods to provide residents with equitable and convenient access to spaces for physical activity (PA) is a promising strategy for promoting PA. Public urban recreation spaces (e.g., parks) play an important role in promoting PA and are potentially an important neighborhood element for optimizing social capital and liveability in cities. Most studies examining the effects of park availability and use on PA have focused on traditional, permanent parks. The aims of this study were to (1) document patterns of park use and park-based PA at a temporary urban pop-up park implemented in the downtown business district of Los Altos, California during July-August 2013 and May-June 2014, (2) identify factors associated with park-based PA in 2014, and (3) examine the effects of the 2014 pop-up park on additional outcomes of potential benefit for park users and the Los Altos community at large. Park use remained high during most hours of the day in 2013 and 2014. Although the park attracted a multigenerational group of users, children and adolescents were most likely to engage in walking or more vigorous PA at the park. Park presence was significantly associated with potentially beneficial changes in time-allocation patterns among users, including a reduction in screen-time and an increase in overall park-time and time spent outdoors. Park implementation resulted in notable use among people who would otherwise not be spending time at a park (85% of surveyed users would not be spending time at any other park if the pop-up park was not there-2014 data analysis). Our results (significantly higher odds of spending time in downtown Los Altos due to park presence) suggest that urban pop-up parks may also have broader community benefits, such as attracting people to visit downtown business districts. Pending larger, confirmatory studies, our results suggest that temporary urban pop-up parks may contribute to solving the limited access to public physical activity recreation spaces many urban residents face.