Gender differences in physical activity and its determinants in rural adults in Korea

Predictive factors of students' physical activity in different learning interest phases: A cluster analysis of physical education

INTRODUCTION

This study investigates the relationships among students' perception of the sports environment, expectancy value, achievement goals, physical activity, sports knowledge and skills in physical education (PE) in different learning interest phases.

METHOD

This cross-sectional study used a sample of 4367 Chinese primary and secondary school students enrolled in PE classes, Mage  = 12.1, SD = 2.9, 48.9% males. Validated questionnaires assessed their physical activity, expectancy value, achievement goals, and sports knowledge and skills. Cluster analysis examined four student profiles in relation to their learning interest in PE. For each profile identified, correlation and multiple regression analyses examined the relationships among students' expectancy value, achievement goals, sports knowledge and skills, and physical activity.

RESULTS

Four different student interest profiles were identified, revealing a continuum from the "triggered situational interest" (TSI) to the "well-developed individual interest" (WII) phases. The results confirmed the key role played by students' perception of the family sports environment and sports knowledge and skills in their PE interest in all four phases, while sex, perception of the school and social sports environment, achievement goals and expectancy value had different predictive effects on students' physical activity in different interest phases.

CONCLUSIONS

The findings from this study provide a new lens by which to divide the phases of learning interest in PE. Students' characteristics differed among the four different learning interest phases, and the impacts on physical activity varied. Future research is needed to consider the interest phase of adolescents to make more targeted guidance measures when improving physical activities.

Gender differences in pathways influencing leisure time physical activity: A structural equation analysis

BACKGROUND AND AIMS

Growing interest in exploring pathways that explain the relationship between various influences on physical activity might help in explaining the complexity of this behavior. This study attempts to identify pathways that interact between the physical and social environment and leisure-time physical activity and identify gender differences in these pathways.

METHODS

A survey was conducted in the Kottayam district of Kerala in India from July 2018-December 2019 to examine direct and indirect pathways of various factors that impact leisure-time physical activity. 467 adults in the age group of 18-65 years, was enquired about various individual and environmental factors that affect their physical activity levels. Structural equation modeling was employed to test the relationship among different variables.

RESULTS

The study found that there was a significant indirect effect of intrapersonal and environmental influences in the pathways that affected leisure-time physical activity. Among men, there was a significant association between self-efficacy and motivation and environmental influences (environmental factors, p = 0.019; body-related motivation p = 0.012, motivation for social motives reasons, p = 0.005); however, among women, environmental factors influence only through extrinsic motives related to body image and appearance (environmental factors, p = 0.009, motivation for appearance, p = 0.05).

CONCLUSION

The study concludes that although intrapersonal factors like self-efficacy and extrinsic motives like health and fitness are salient predictors of physical activity, environmental factors play a supportive role in enhancing engagement in leisure time activity. Future interventions should be tailored to meet gender-specific interests to promote regular physical activity among adults.

Determinants of physical activity behaviour change in (online) interventions, and gender-specific differences: a Bayesian network model

BACKGROUND

Physical activity (PA) is known to be beneficial for health, but adherence to international PA guidelines is low across different subpopulations. Interventions have been designed to stimulate PA of different target groups by influencing relevant psycho-social determinants, essentially based on a combination of the Integrated Model for Change, the Theory of Planned Behaviour, its successor the Reasoned Action Approach and the self-determination theory. The current study investigates the pathways through which interventions influence PA. Further, gender differences in pathways of change are studied.

METHODS

An integrated dataset of five different randomised controlled trial intervention studies is analysed by estimating a Bayesian network. The data include measurements, at baseline and at 3, 6 (short-term), and 12 (long-term) months after the baseline, of important socio-cognitive determinants of PA, demographic factors, and PA outcomes. A fragment is extracted from the Bayesian network consisting of paths between the intervention variable, determinants, and short- and long-term PA outcomes. For each relationship between variables, a stability indicator and its mutual information are computed. Such a model is estimated for the full dataset, and in addition such a model is estimated based only on male and female participants' data to investigate gender differences.

RESULTS

The general model (for the full dataset) shows complex paths, indicating that the intervention affects short-term PA via the direct determinants of intention and habit and that self-efficacy, attitude, intrinsic motivation, social influence concepts, planning and commitment have an indirect influence. The model also shows how effects are maintained in the long-term and that previous PA behaviour, intention and attitude pros are direct determinants of long-term PA. The gender-specific models show similarities as well as important differences between the structures of paths for the male- and female subpopulations. For both subpopulations, intention and habit play an important role for short-term effects and maintenance of effects in the long-term. Differences are found in the role of self-efficacy in paths of behaviour change and in the fact that attitude is relevant for males, whereas planning plays a crucial role for females. The average of these differences in subpopulation mechanisms appears to be presented in the general model.

CONCLUSIONS

While previous research provided limited insight into how interventions influence PA through relevant determinants, the Bayesian network analyses show the relevance of determinants mentioned by the theoretical framework. The model clarifies the role that different determinants play, especially in interaction with each other. The Bayesian network provides new knowledge about the complex working mechanism of interventions to change PA by giving an insightful overview of influencing paths. Furthermore, by presenting subpopulation-specific networks, the difference between the influence structure of males and females is illustrated. These new insights can be used to improve interventions in order to enhance their effects. To accomplish this, we have developed a new methodology based on a Bayesian network analysis which may be applicable in various other studies.

The Combined Impact of Chronic Kidney Disease and Diabetes on the Risk of Colorectal Cancer Depends on Sex: A Nationwide Population-Based Study

PURPOSE

Although both chronic kidney disease (CKD) and diabetes mellitus (DM) are considered factors increasing the risk of colorectal cancer (CRC), their impact on CRC is not fully understood. This study was aimed to investigate the impact of CKD, DM, or both diseases on the risk of CRC and to evaluate sex differences therein.

MATERIALS AND METHODS

Using data from the National Health Insurance Service-Health Examination Cohort in Korea, we conducted a 1:2 matched case-control study. The disease groups consisted of CKD-/DM+ (n=17700), CKD+/DM- (n=22643), and CKD+/DM+ groups (n=8506). After 1:2 matching by age, sex, and health examination year and month, the healthy control group consisted of 97698 individuals.

RESULTS

Multivariate Cox regression analysis showed that the CKD-/DM+, CKD+/DM-, and CKD+/DM+ groups were independently associated with an increased incidence of CRC, compared with controls [hazard ratio (HR), 1.34, 1.31, and 1.63, respectively; all p<0.001]. Compared to the controls, adjusted HRs for the cumulative incidence of CRC in the CKD-/DM+, CKD+/DM-, and CKD+/DM+ groups were, respectively, 1.32, 1.26, and 1.43 in male and 1.38, 1.39, and 2.00 in female. The HR for CRC incidence was significantly higher for the CKD+/DM+ group than for the CKD-/DM+ or CKD+/DM- group in female; however, this significant difference was not observed in male.

CONCLUSION

In female, having both CKD and DM significantly increases the risk of CRC, compared with having CKD or DM alone. This study suggests a significant difference in the effect of CKD or DM on the risk of CRC according to sex.

The Association between Energy Balance-Related Behavior and Burn-Out in Adults: A Systematic Review

Although it is believed that physical activity, sedentary, and dietary behavior (i.e., energy balance-related behavior) may decrease the risk of burn-out, the association between both is currently not well understood. Therefore, the aim of this systematic review was to synthesize studies investigating the relationship between energy balance-related behavior and burn-out risk. A systematic literature search was conducted in four databases, resulting in 25 included studies (ten experimental and 15 observational studies). Nine out of ten experimental studies showed that exercise programs were effective in reducing burn-out risk. Fourteen out of fifteen observational studies found a negative association between physical activity and burn-out risk, whereas one study did not find a relation. Two of the 15 observational studies also showed that being more sedentary was associated with a higher burn-out risk, and two other studies found that a healthier diet was related to a lower burn-out risk. No experimental studies were found for the latter two behaviors. It can be concluded that physical activity may be effective in reducing burn-out risk. The few observational studies linking sedentary and dietary behavior with burn-out risk suggest that being more sedentary and eating less healthy are each associated with higher burn-out risk. More high-quality research is needed to unravel the causal relationship between these two behaviors and burn-out risk.

Factors influencing interest in recreational sports participation and its rural-urban disparity

Objectives

Recreational sports are important leisure activities. However, most studies investigating barrier factors and motivation for participation in recreational sports have been limited to specific areas (e.g., a city or school) or demographic groups (e.g., adolescents). Therefore, this study set out to gain a more comprehensive understanding of the behavioral and socioeconomic factors influencing interest in recreational sports participation in Taiwan, as well as to evaluate the effect of any urban-rural divide.

Methods

This study analyzed data collected by the “Taiwan Social Change Survey” (program five, wave 3) “Leisure Life” questionnaire. We used hierarchical linear modeling to assess respondent interest in recreational sports participation and evaluated the influence of behavioral factors, socioeconomic factors, and residence location (urban/rural).

Results

Of the 2,146 participants in this study, 50.3% were male, and the average age was 43.9 years. Location of residence (urban/rural) accounted for 35.3% of the variation in interest in recreational sports participation, while the remaining 64.7% came from the individual level. Participants who lived in rural settings were less interested in recreational sports than their urban counterparts. Gender, educational attainment, participation frequency, health-motivated interest, and appearance-motivated interest were also associated with interest in recreational sports participation.

Conclusions

Different communication strategies may be needed to effectively reach different demographic groups. We suggest that future public health campaigns aiming to increase recreational sports participation include tailored interventions and messages to effectively encourage leisure physical activities among all, regardless of demographic boundaries.

Weight status and associated factors among HIV infected people on antiretroviral therapy in rural Dikgale, Limpopo, South Africa

BACKGROUND

Underweight in human immunodeficiency virus (HIV)-infected people on antiretroviral therapy (ART) complicates the management of HIV infection and contributes to mortality, whereas overweight increases the risk of cardiovascular disease (CVD).

AIM

The study determined weight status and associated factors in people with HIV infection receiving ART.

SETTING

Rural primary health care clinics in Dikgale, Limpopo province, South Africa.

METHODS

A cross-sectional study in which data were collected using the World Health Organization (WHO) stepwise approach to surveillance (STEPS) questionnaire and calculated using WHO analysis programmes guide. Weight and height were measured using standard WHO procedures, and body mass index was calculated as weight (kg)/height (m2). Data on ART duration were extracted from patients' files. CD4 lymphocyte counts and viral load were determined using standard laboratory techniques.

RESULTS

Of the 214 participants, 8.9%, 54.7% and 36.4% were underweight, normal weight and overweight, respectively. Physical activity (OR: 0.99, p = 0.001) and male gender (OR: 0.29, p = 0.04) were negatively associated with overweight. Men who used tobacco were more likely to be underweight than non-tobacco users (OR: 10.87, p = 0.02). Neither ART duration nor viral load or CD4 count was independently associated with underweight or overweight in multivariate analysis.

CONCLUSION

A high proportion of people on ART were overweight and a smaller proportion underweight. There is a need to simultaneously address the two extreme weight problems in this vulnerable population through educating them on benefits of avoiding tobacco, engaging in physical activity and raising awareness of CVD risk.

Practical guidelines for development of web-based interventions

Despite a recent high funding priority on technological aspects of research and a high potential impact of Web-based interventions on health, few guidelines for the development of Web-based interventions are currently available. In this article, we propose practical guidelines for development of Web-based interventions based on an empirical study and an integrative literature review. The empirical study aimed at development of a Web-based physical activity promotion program that was specifically tailored to Korean American midlife women. The literature review included a total of 202 articles that were retrieved through multiple databases. On the basis of the findings of the study and the literature review, we propose directions for development of Web-based interventions in the following steps: (1) meaningfulness and effectiveness, (2) target population, (3) theoretical basis/program theory, (4) focus and objectives, (5) components, (6) technological aspects, and (7) logistics for users. The guidelines could help promote further development of Web-based interventions at this early stage of Web-based interventions in nursing.

Work-site wellness programmes in Sweden: a cross-sectional study of physical activity, self-efficacy, and health

In Sweden, a work-site wellness programme implies reimbursing some of the expenses for health-promoting activities. Although work-site wellness programmes are readily available in Sweden, a large number of employees elect not to participate.

OBJECTIVES

The aim of this study was to investigate the association of physical activity, self-reported general health assessment and self-efficacy with participation in a work-site wellness programme.

STUDY DESIGN

A cross-sectional study design was used.

METHODS

An online questionnaire was distributed to employees of a manufacturing company with 2500 employees in southwest Sweden.

RESULTS

Those who took advantage of the work-site wellness programme assessed their general health as better and had higher assessment of physical activity. The study showed that being enlisted also implies a higher level of physical activity and general health; however, the effect sizes of these correlations were small. Self-efficacy, i.e. perceived behavioural control, was not associated with participation in the work-site wellness programme. However, self-efficacy was correlated with both general health assessment and physical activity. A regression analysis to determine explanatory contributions to the general health assessment score showed no significant contribution from participation in a work-site wellness programme, but was instead explained by perceived behavioural control and physical activity.

CONCLUSIONS

Given the small effect size of the difference in physical activity between participators and non-participators in the work-site wellness programme, it is probable that only a small proportion of participators changed their health-promoting activities as a result of the work-site wellness programme.

Lifestyle behaviors and self-rated health: the living for health program

BACKGROUND

Lack of adherence to dietary and physical activity guidelines has been linked to an increase in chronic diseases in the United States (US). The aim of this study was to assess the association of lifestyle behaviors with self-rated health (SRH).

METHODS

This cross-sectional study used self-reported data from Living for Health Program (N = 1,701) which was conducted from 2008 to 2012 in 190 health fair events in South Florida, US.

RESULTS

Significantly higher percent of females as compared to males were classified as obese (35.4% versus 27.0%), reported poor/fair SRH (23.4% versus 15.0%), and were less physically active (33.9% versus 25.4%). Adjusted logistic regression models indicated that both females and males were more likely to report poor/fair SRH if they consumed ≤2 servings of fruits and vegetables per day (OR = 2.14, 95% CI 1.30-3.54; OR = 2.86, 95% CI 1.12-7.35, resp.) and consumed mostly high fat foods (OR = 1.58, 95% CI 1.03-2.43; OR = 3.37, 95% CI 1.67-2.43, resp.). The association of SRH with less physical activity was only significant in females (OR = 1.66, 95% CI 1.17-2.35).

CONCLUSION

Gender differences in health behaviors should be considered in designing and monitoring lifestyle interventions to prevent cardiovascular diseases.

Patterns and correlates of physical activity among middle-aged employees: a population-based, cross-sectional study

OBJECTIVES

The purpose of this study was to determine the level, pattern and correlates (socio-demographic, lifestyle and work-related) of physical activity among middle-aged employees in Croatia.

MATERIAL AND METHODS

In this cross-sectional study the data were collected using a household interview on a random sample of 766 middle-aged employees (52% female) living in Croatia. The International Physical Activity Questionnaire (IPAQ-long) was used to assess physical activity. An additional questionnaire was used to collect data on socio-demographic, lifestyle and work-related correlates.

RESULTS

The median (95% CI) total physical activity for the whole sample was 78.7 (69.1-88.3) MET-hours/week. Most physical activity was accumulated in the domain of work (26.4 (20.3-32.5) MET-hours/week) or in domestic activities (19.2(17.8-20.7) MET-hours/week), whilst a significantly lower physical activity was found in the transport (3.3 (2.9-3.7) MET-hours/week) and leisure-time domains (6.5 (5.7-7.3) MET-hours/week). The multiple regression analysis showed an inverse relationship between educational level and the size of settlements with the domestic-related and total physical activity (β range: -0.11 to -0.22; p < 0.01). Among lifestyle correlates, only alcohol consumption was positively related to the total physical activity (β = 0.12; p < 0.01), while the perceived level of stress outside work was the only one, which was inversely associated with the work-related (β = -0.09; p < 0.01) and leisure-time physical activity (β = -0.10; p < 0.01).

CONCLUSIONS

Middle-aged employees in Croatia accumulate most of their daily physical activity in the work and domestic domains. Analysis of the relationship between physical activity and potential socio-demographic, lifestyle, and work-related correlates indicated that physical activity promotional activities should be primarily focused on males, employees living in smaller settlements and those with higher educational levels. The correlates of physical activity among middle-aged employees seem to be domain-specific. Therefore, future studies in this area should consider assessing physical activity in each domain separately.

Physical activity in subjects with multiple sclerosis with focus on gender differences: a survey

Background

There is increasing research that examines gender-issues in multiple sclerosis (MS), but little focus has been placed on gender-issues regarding physical activity. The aim of the present study was to describe levels of physical activity, self-efficacy for physical activity, fall-related self-efficacy, social support for physical activity, fatigue levels and the impact of MS on daily life, in addition to investigating gender differences.

Methods

The sample for this cross-sectional cohort study consisted of 287 (84 men; 29.3%) adults with MS recruited from the Swedish Multiple Sclerosis Registry. A questionnaire was sent to the subjects consisting of the self-administrated measurements: Physical Activity Disability Survey – Revised, Exercise Self-Efficacy Scale, Falls- Efficacy Scale (Swedish version), Social Influences on Physical Activity, Fatigue Severity Scale and Multiple Sclerosis Impact Scale. Response rate was 58.2%.

Results

Men were less physically active, had lower self-efficacy for physical activity and lower fall-related self-efficacy than women. This was explained by men being more physically affected by the disease. Men also received less social support for physical activity from family members. The level of fatigue and psychological consequences of the disease were similar between the genders in the total sample, but subgroups of women with moderate MS and relapsing remitting MS experienced more fatigue than men.

Conclusions

Men were less physically active, probably a result of being more physically affected by the disease. Men being more physically affected explained most of the gender differences found in this study. However, the number of men in the subgroup analyses was small and more research is needed. A gender perspective should be considered in strategies for promoting physical activity in subjects with MS, e.g. men may need more support to be physically active.