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Dino MJS, Dion KW, Abadir PM, Budhathoki C, Huang CM, Padula WV, Himmelfarb CRD, Davidson PM. The impact of a mixed reality technology-driven health enhancing physical activity program among community-dwelling older adults: a study protocol. Front Public Health 2024; 12:1383407. [PMID: 38807990 PMCID: PMC11130374 DOI: 10.3389/fpubh.2024.1383407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 04/25/2024] [Indexed: 05/30/2024] Open
Abstract
Background Physical inactivity and a sedentary lifestyle among community-dwelling older adults poses a greater risk for progressive physical and cognitive decline. Mixed reality technology-driven health enhancing physical activities such as the use of virtual coaches provide an emerging and promising solution to support healthy lifestyle, but the impact has not been clearly understood. Methods and analysis An observational explanatory sequential mixed-method research design was conceptualized to examine the potential impact of a user-preferred mixed reality technology-driven health enhancing physical activity program directed toward purposively selected community-dwelling older adults in two senior centers in the Philippines. Quantitative components of the study will be done through a discreet choice experiment and a quasi-experimental study. A total of 128, or 64 older adults in each center, will be recruited via posters at community senior centers who will undergo additional screening or health records review by a certified gerontologist to ensure safety and proper fit. Treatments (live coaching with video-based exercise and mixed reality technology-driven exercise) will be assigned to each of the two senior center sites for the quasi-experiment. The participants from the experimental group shall be involved in the discreet choice experiment, modeling, and usability evaluations. Finally, a qualitative sample of participants (n = 6) as key informants shall be obtained from the experimental group using purposive selection. Discussion This study protocol will examine the health impact of a promising mixed reality program in health promotion among older adults. The study utilizes a human-centered mixed method research design in technology development and evaluation in the context of developing nations.Clinical trial registration: ClinicalTrials.gov, identifier NCT06136468.
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Affiliation(s)
- Michael Joseph S. Dino
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Research, Development, and Innovation Center, Our Lady of Fatima University, Valenzuela, Philippines
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN, United States
| | - Kenneth W. Dion
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN, United States
| | - Peter M. Abadir
- School of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Chakra Budhathoki
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN, United States
| | - Chien-Ming Huang
- Department of Computer Science, Johns Hopkins University, Baltimore, MD, United States
| | - William V. Padula
- Department of Pharmaceutical and Health Economics, University of Southern California School of Pharmacy, Los Angeles, CA, United States
| | - Cheryl R. Dennison Himmelfarb
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN, United States
| | - Patricia M. Davidson
- School of Nursing, Johns Hopkins University, Baltimore, MD, United States
- Sigma Theta Tau, International Honor Society in Nursing, Indianapolis, IN, United States
- Office of the Vice Chancellor and President, University of Wollongong, Wollongong, NSW, Australia
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Resendiz E, Ramírez-Varela A, Mejía-Grueso J, Moon J, Mitáš J, Brownson RC, Salvo D, Pratt M. Breaking Barriers: An Innovative Tool to Assess the National and City-Level Physical Activity Policy Development to Practice Disconnect. J Phys Act Health 2024; 21:425-433. [PMID: 38242113 DOI: 10.1123/jpah.2023-0471] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/21/2023] [Accepted: 12/12/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Population-level physical activity increases are improbable without intersectoral collaboration across government levels and sectors to develop and implement physical activity promotion policies. This study aims to provide information about the development of the Interaction between National and Local Government Levels in Development and Implementation of Physical Activity Policies Tool (INTEGRATE PA-Pol). A framework was created to examine the development and implementation of national and subnational physical activity policies and the (mis)alignment between government levels. METHODS The work was conducted in 3 phases: (1) a scoping review was carried out to identify local government physical activity promotion policies and instruments for assessing them, (2) an expert group designed 6 questionnaires, and (3) cognitive response testing was employed for validity testing and item modification with a panel of research and policy experts. RESULTS The INTEGRATE PA-Pol Tool consists of 6 questionnaires assessing how national and subnational governments collaborate to develop and implement physical activity promotion policies. CONCLUSION This tool can assist in better understanding the development and implementation of a public policy monitoring system that will allow for benchmarking and priority setting to comprehend how physical activity promotion policies are designed and executed.
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Affiliation(s)
- Eugen Resendiz
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | | | | | - Jane Moon
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
| | - Josef Mitáš
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czech Republic
| | - Ross C Brownson
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Deborah Salvo
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX, USA
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, MO, USA
| | - Michael Pratt
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA
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Berntzen BJ, Tolvanen A, Kujala UM, Silventoinen K, Vuoksimaa E, Kaprio J, Aaltonen S. Longitudinal leisure-time physical activity profiles throughout adulthood and related characteristics: a 36-year follow-up study of the older Finnish Twin Cohort. Int J Behav Nutr Phys Act 2024; 21:47. [PMID: 38671483 PMCID: PMC11046842 DOI: 10.1186/s12966-024-01600-y] [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: 12/11/2023] [Accepted: 04/19/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Personalized interventions aiming to increase physical activity in individuals are effective. However, from a public health perspective, it would be important to stimulate physical activity in larger groups of people who share the vulnerability to be physically inactive throughout adulthood. To find these high-risk groups, we identified 36-year leisure-time physical activity profiles from young adulthood to late midlife in females and males. Moreover, we uncovered which anthropometric-, demographic-, lifestyle-, and health-related characteristics were associated with these physical activity profiles. METHODS We included 2,778 females and 1,938 males from the population-based older Finnish Twin Cohort Study, who responded to health and behavior surveys at the mean ages of 24, 30, 40 and 60. Latent profile analysis was used to identify longitudinal leisure-time physical activity profiles. RESULTS We found five longitudinal leisure-time physical activity profiles for both females and males. Females' profiles were: 1) Low increasing moderate (29%), 2) Moderate stable (23%), 3) Very low increasing low (20%), 4) Low stable (20%) and 5) High increasing high (9%). Males' profiles were: 1) Low increasing moderate (29%), 2) Low stable very low (26%), 3) Moderate decreasing low (21%), 4) High fluctuating high (17%) and 5) Very low stable (8%). In both females and males, lower leisure-time physical activity profiles were associated with lower education, higher body mass index, smoking, poorer perceived health, higher sedentary time, high blood pressure, and a higher risk for type 2 diabetes. Furthermore, lower leisure-time physical activity was linked to a higher risk of depression in females. CONCLUSIONS We found several longitudinal leisure-time physical activity profiles with unique changes in both sexes. Fewer profiles in females than in males remained or became low physically active during the 36-year follow-up. We observed that lower education, higher body mass index, and more smoking already in young adulthood were associated with low leisure-time physical activity profiles. However, the fact that several longitudinal profiles demonstrated a change in their physical activity behavior over time implies the potential for public health interventions to improve leisure-time physical activity levels.
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Affiliation(s)
- Bram J Berntzen
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland
| | - Asko Tolvanen
- Methodology Centre for Human Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35, FI-40014, Jyväskylä, Finland
| | - Karri Silventoinen
- Helsinki Institute for Demography and Population Health, University of Helsinki, P.O. Box 42, FI-00014, Helsinki, Finland
| | - Eero Vuoksimaa
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland
| | - Sari Aaltonen
- Institute for Molecular Medicine Finland FIMM, University of Helsinki, P.O. Box 20, FI-00014, Helsinki, Finland.
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Gómez-Redondo P, Valenzuela PL, Martínez-de-Quel Ó, Sánchez-Martín C, Cerezo-Arroyo M, Moreno-Manzanaro D, Alegre LM, Guadalupe-Grau A, Ara I, Mañas A. The role of supervision and motivation during exercise on physical and mental health in older adults: a study protocol for a randomized controlled trial (PRO-Training project). BMC Geriatr 2024; 24:274. [PMID: 38509514 PMCID: PMC10953175 DOI: 10.1186/s12877-024-04868-8] [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: 12/18/2023] [Accepted: 03/04/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Although supervised exercise is frequently recommended for older adults, its superiority over unsupervised exercise remains uncertain. Furthermore, whether motivational techniques could help to enhance the effectiveness of the latter remains to be elucidated. The present randomized controlled trial aims to determine the role of supervision and motivational strategies on the safety, adherence, efficacy, and cost-effectiveness of different exercise programs for improving physical and mental health in older adults. METHODS Participants (n = 120, aged 60-75 years) will be randomly allocated into five groups: 1-Control (CON), 2-Supervised exercise without motivational intervention (SUP), 3- Supervised exercise with motivational intervention (SUP +), 4- Unsupervised exercise without motivational intervention (UNSUP) and 5- Unsupervised exercise with motivational intervention (UNSUP +). Over 24 weeks, all exercise groups will participate in a multicomponent exercise program three times/week (performed in group classes at a center for SUP and SUP + , or home without supervision but with the help of a mobile app for UNSUP and UNSUP +), while the CON group will maintain their usual lifestyle. The motivational intervention (for SUP + and UNSUP + groups) will be based on the self-determination theory, including strategies such as phone calls, interactive workshops, motivational messages, informative infographics and videos. Primary outcomes will include safety, adherence, costs, and lower-body muscular function using a leg press machine. Secondary outcomes will include upper-body muscular function, physical and cardiorespiratory function, blood pressure and heart rate, body composition, health-related quality of life, cognitive performance, anxiety, depression, physical activity levels, sleep and sedentarism, biochemical markers, motivators and barriers to exercise. Assessments will be conducted at baseline, mid-intervention (i.e., week 13), at the end of the intervention (i.e., week 25), and 24 weeks later (i.e., week 49). DISCUSSION The findings of this trial might provide valuable insights into the role of supervision and motivational strategies on the effectiveness of exercise programs for older adults. Additionally, the study could contribute to developing cost-effective interventions, supporting the design of future public policies for healthy aging. TRIAL REGISTRATION NCT05619250. Registered 16 November 2022.
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Affiliation(s)
- Paola Gómez-Redondo
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Pedro L Valenzuela
- Physical Activity and Health Research Group (PaHerg), Research Institute of Hospital, 12 de Octubre (imas12), Madrid, Spain
- Department of Systems Biology, University of Alcalá, Madrid, Spain
| | - Óscar Martínez-de-Quel
- Didactics of Languages, Arts and Physical Education Department, Faculty of Education, Complutense University of Madrid, 28040, Madrid, Spain
- Faculty of Sciences for Physical Activity and Sport (INEF), Polytechnic University of Madrid, 28040, Madrid, Spain
| | - Coral Sánchez-Martín
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Mónica Cerezo-Arroyo
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - David Moreno-Manzanaro
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Luis M Alegre
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Amelia Guadalupe-Grau
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain
| | - Asier Mañas
- GENUD Toledo Research Group, Faculty of Sports Sciences, University of Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain.
- CIBER of Frailty and Healthy Aging, Instituto de Salud Carlos III, Madrid, Spain.
- Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), Junta de Comunidades de Castilla-La Mancha (JCCM), Toledo, Spain.
- Didactics of Languages, Arts and Physical Education Department, Faculty of Education, Complutense University of Madrid, 28040, Madrid, Spain.
- Center UCM-ISCIII for Human Evolution and Behavior, 28029, Madrid, Spain.
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Miki T, Nohara M, Nomura K. Effectiveness of mHealth interventions to promote physical activity and reduce sedentary behaviours on work-related productivity and performance: a systematic review protocol. BMJ Open 2024; 14:e080240. [PMID: 38443086 PMCID: PMC11146360 DOI: 10.1136/bmjopen-2023-080240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 02/16/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION Technologies such as health and fitness applications (apps) and wearable activity trackers have recently gained popularity and may play a key role in promoting physical activity and reducing sedentary behaviours. Although several systematic reviews have investigated their efficacy in physical activity and sedentary behaviours, few studies have focused on their impact on work-related outcomes among workers. Here, to explore the effects of mHealth interventions designed to encourage physical activity and decrease sedentary behaviours on work-related outcomes, including absenteeism, presenteeism, productivity, work performance and workability among workers, we will conduct a systematic review based on recent articles and an extensive literature search. METHODS AND ANALYSIS The literature search will be performed using PubMed, Web of Science, the Cochrane Library and the Japan Medical Abstracts Society from inception to 23 September 2023. We will select studies that (1) investigated the impact of mHealth interventions to promote physical activity and reduce sedentary behaviours on work-related outcomes such as absenteeism, presenteeism, productivity, work performance and workability; (2) were designed as a randomised controlled trial (RCT) or non-randomised study of interventions (NRSI); (3) were conducted among workers and (4) were published as full-text original articles in Japanese or English. We will assess the review quality with the AMSTAR 2 tool. The risk of bias will be assessed with the RoB tool 2.0 and ROBINS-I. ETHICS AND DISSEMINATION Ethical approval is unnecessary as the study will rely solely on previously published articles. The research results will be submitted for publication in a peer-reviewed scientific journal. TRIAL REGISTRATION NUMBER The study protocol has been registered with the UMIN Clinical Trials Registry (ID=UMIN000052290).
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Affiliation(s)
- Takako Miki
- Division of Public Health, Department of Hygiene and Public Health, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Michiko Nohara
- Division of Public Health, Department of Hygiene and Public Health, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita, Japan
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Shiferaw KB, Yalew ES, Zemed A, Yitayal MM, Belay GJ, Alie M, Kibret AK, Takele MD, Abich Y, Gashaw M. Prevalence of physical inactivity and associated factors among older adults in Gondar town, Northwest Ethiopia: a community-based cross-sectional study. BMC Geriatr 2024; 24:106. [PMID: 38287268 PMCID: PMC10826078 DOI: 10.1186/s12877-024-04701-2] [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: 04/10/2023] [Accepted: 01/11/2024] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Older adults are increasing in number in both developed and developing countries. However, as the world's aging population grows, the burden of diseases among older people also increases. Despite this, co-occurring health problems due to physical inactivity in older adults have become a concern, and physical inactivity can be caused by different conditions. As a result, for older adults to have better health outcomes, early diagnosis of physical activity status and prevention of non-communicable diseases are crucial. There is a lack of data on the prevalence and associated factors of physical inactivity among older adults that is scarce in sub-Saharan Africa, particularly in the study area, Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of physical inactivity among older adults in Gondar town, Northwest Ethiopia, in 2022. METHODS A community-based cross-sectional study was conducted from April 1st to June 30th, 2022, in Gondar town, Northwest Ethiopia. The data was collected by the Global Physical Activity Questionnaire, Volume 2 through face-to-face interviews among 838 participants. Data were entered into Epinfo version 7.1, then exported and analysed using the Statistical Package of Social Science version 25. A binary logistic regression model was performed to identify factors associated with physical inactivity. The result was considered statistically significant based on an adjusted odds ratio of 95% and a p-value less than 0.05. RESULT The prevalence of physical inactivity was 65.6% (95% CI: 62.1-68.9). Being female (AOR: 3.053, 95% CI:1.487-6.267), age group > = 80 (AOR: 4.082, 95% CI:1.234-13.497), primary school level (AOR: 3.020, 95% CI:1.433-6.367), no formal education (AOR: 8.573, 95% CI:2.843-25.847), unemployed (AOR: 10.273, 95% CI:5.628-18.753), and symptoms of depression (AOR: 7.152, 95% CI: 4.786-17.965) were significantly associated with physical inactivity. CONCLUSION Physical inactivity was relatively high among older adults in Gondar town. Being female, older age, having low levels of education, being unemployed, and having depression symptoms were associated with physical inactivity. We suggest promoting the health benefits of physical activity among females by reducing their burden, older age groups, and unemployed older adults, and avoiding depression among individuals.
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Affiliation(s)
- Kassaw Belay Shiferaw
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Ermias Solomon Yalew
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ashenafi Zemed
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melisew Mekie Yitayal
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Jember Belay
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melkamu Alie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemu Kassaw Kibret
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mihret Dejen Takele
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yohannes Abich
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Moges Gashaw
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Bonatesta L, Palermi S, Sirico F, Mancinelli M, Torelli P, Russo E, Annarumma G, Vecchiato M, Fernando F, Gregori G, Niebauer J, Biffi A. Short-term economic evaluation of physical activity-based corporate health programs: a systematic review. J Occup Health 2024; 66:uiae002. [PMID: 38183160 PMCID: PMC10939391 DOI: 10.1093/joccuh/uiae002] [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: 10/22/2023] [Revised: 12/05/2023] [Accepted: 12/27/2023] [Indexed: 01/07/2024] Open
Abstract
OBJECTIVES Corporate health programs (CHPs) aim to improve employees' health through health promotion strategies at the workplace. Physical activity (PA) plays a crucial role in primary prevention, leading many companies to implement PA-based CHPs. However, there is limited examination in the scientific literature on whether PA-based CHPs (PA-CHPs) lead to economic benefits. This systematic review aimed to summarize the available literature on the economic aspects of PA-CHPs. METHODS A systematic review was conducted to identify studies focused on PA-CHPs targeting healthy sedentary workers and reporting at least one economic outcome, such as return on investment (ROI), costs, or sick leave. RESULTS Of 1036 studies identified by our search strategy, 11 studies involving 60 020 participants met the inclusion criteria. The mean (±SD) cost per capita for PA-CHPs was estimated as 359€ (±238€) (95% CI, 357-361€). In 75% of the studies, the net savings generated by PA-CHPs in 12 months were reported, with an average of 1095€ (±865€) (95% CI, 496-1690€). ROI was assessed in 50% of the included studies, with an average of 3.6 (±1.41) (95% CI, 2.19-5.01). CONCLUSIONS In addition to promoting a healthy lifestyle, PA-CHPs have the potential to generate significant economic returns. However, the heterogeneity among the existing studies highlights the need for standardization and accurate reporting of costs in future research.
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Affiliation(s)
- Lorenzo Bonatesta
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, 00187 Rome, Italy
| | - Stefano Palermi
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, 00187 Rome, Italy
- Public Health Department, University of Naples Federico II, 80131 Naples, Italy
| | - Felice Sirico
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, 00187 Rome, Italy
- Public Health Department, University of Naples Federico II, 80131 Naples, Italy
| | - Mario Mancinelli
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, 00187 Rome, Italy
| | - Pierpaolo Torelli
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, 00187 Rome, Italy
| | - Ettore Russo
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, 00187 Rome, Italy
| | - Giada Annarumma
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, 00187 Rome, Italy
| | - Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35128 Padova, Italy
| | - Frederik Fernando
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, 00187 Rome, Italy
| | - Giampietro Gregori
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, 00187 Rome, Italy
| | - Josef Niebauer
- University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Alessandro Biffi
- Med-Ex, Medicine & Exercise, Medical Partner Scuderia Ferrari, 00187 Rome, Italy
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Zangger G, Mortensen SR, Tang LH, Thygesen LC, Skou ST. Association between digital health literacy and physical activity levels among individuals with and without long-term health conditions: Data from a cross-sectional survey of 19,231 individuals. Digit Health 2024; 10:20552076241233158. [PMID: 38410789 PMCID: PMC10896057 DOI: 10.1177/20552076241233158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 02/28/2024] Open
Abstract
Objectives This study explored associations between digital health literacy and physical activity levels and assessed potential interactions of long-term health conditions. Methods A cross-sectional survey was sent to 34,000 inhabitants in Region Zealand, Denmark. The survey included items on physical activity levels and three electronic Health Literacy Questionnaire (eHLQ) scales (1, 4, and 5). Associations were assessed by logistic regression and adjusted for confounders. Results A total of 19,231 participated in the survey. Positive associations were found between higher digital health literacy and being active >30 min./week at moderate-to-vigorous intensity (eHLQ 1: OR 1.24, p < 0.001; eHLQ 4: OR 1.13, p = 0.012; eHLQ 5: OR 1.25, p < 0.001), compliance with the World Health Organization minimum recommendations for physical activity (eHLQ 1: OR 1.33 p < 0.001; eHLQ 4: OR 1.08 p = 0.025; eHLQ 5: OR 1.32, p < 0.001), and self-reported physical active (eHLQ 1: OR 1.50 p < 0.001; eHLQ 4: OR 1.24 p < 0.001; eHLQ 5: OR 1.54 p < 0.001), even when fully adjusted for covariates. No significant interaction was found for long-term health conditions. However, individuals with more long-term health conditions exhibited the lowest digital health literacy scores (9% to 19% scored <2.0). Conclusion A higher digital health literacy is positively associated with higher physical activity levels. This highlights the importance of screening and promoting digital health literacy in managing digital health and digital physical activity interventions. Future research should explore strategies and targeted interventions to enhance digital health literacy and improve health outcomes.
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Affiliation(s)
- Graziella Zangger
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Sofie Rath Mortensen
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Lars Herman Tang
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Søren T. Skou
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Region Zealand, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Nagi MA, Ahmed H, Rezq MAA, Sangroongruangsri S, Chaikledkaew U, Almalki Z, Thavorncharoensap M. Economic costs of obesity: a systematic review. Int J Obes (Lond) 2024; 48:33-43. [PMID: 37884664 DOI: 10.1038/s41366-023-01398-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 09/18/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION Obesity is a growing public health problem leading to substantial economic impact. This study aimed to summarize the economic impact of obesity and to critically analyze the methods used in the cost-of-illness (COI) studies on obesity. METHODS We conducted systematic search in PubMed and Scopus from September 1, 2016, to July 22, 2022. Original COI studies estimating the economic cost of obesity and/or overweight in at least one country, published in English were included. To facilitate the comparison of estimates across countries, we converted the cost estimates of different years to 2022 purchasing power parity (PPP) values using each country's consumer price index (CPI) and PPP conversion rate. RESULTS Nineteen studies were included. All studies employed a prevalence-based approach using Population Attributable Fraction (PAF) methodology. About half of the included studies (53%) were conducted in high-income countries while the others (47%) were conducted in middle-income countries. The economic burden of obesity ranged between PPP 15 million in Brazil to PPP 126 billion in the USA, in the year 2022. Direct medical costs accounted for 0.7% to 17.8% of the health system expenditure. Furthermore, the total costs of obesity ranged from 0.05% to 2.42% of the country's gross domestic product (GDP). Of the seven studies that estimated both direct and indirect costs, indirect costs accounted for the largest portion of five studies. Nevertheless, a variety in methodology across studies was identified. The number of co-morbidities included in the analysis varied across studies. CONCLUSIONS Although there was a variety of methodologies across studies, consistent evidence indicated that the economic burden of obesity was substantial. Obesity prevention and control should be a public health priority, especially among countries with high prevalence of obesity.
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Affiliation(s)
- Mouaddh Abdulmalik Nagi
- Doctor of Philosophy Program in Social, Economic and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
- Faculty of Medical Sciences, Aljanad University for Science and Technology, Taiz, Yemen
| | - Hanan Ahmed
- Faculty of Medical Sciences, Aljanad University for Science and Technology, Taiz, Yemen
- Master of Public Health, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Mustafa Ali Ali Rezq
- Master of Public Health, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Pharmacy, Sana'a University, Sana'a, Yemen
| | - Sermsiri Sangroongruangsri
- Social and Administrative Pharmacy Excellence Research (SAPER) unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Usa Chaikledkaew
- Social and Administrative Pharmacy Excellence Research (SAPER) unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Ziyad Almalki
- Prince Sattam Bin Abdulaziz University, Department of Clinical Pharmacy, Al-Kharj, Riyadh, Saudi Arabia
| | - Montarat Thavorncharoensap
- Social and Administrative Pharmacy Excellence Research (SAPER) unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand.
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Steward IP, Young ES, Dogra SA, Stamp E, Daly-Smith A, Siddique K, Morgan K, Crowther J, Hall J. How to develop young physical activity leaders? A Delphi study. PLoS One 2023; 18:e0286920. [PMID: 37773961 PMCID: PMC10540972 DOI: 10.1371/journal.pone.0286920] [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: 02/10/2023] [Accepted: 05/25/2023] [Indexed: 10/01/2023] Open
Abstract
The International Society for Physical Activity and Health advocates for increased capability of the physical activity workforce as a key ingredient to a system-based approach. Young leader programmes are gaining traction globally as peers are a primary influence on young people and positive role models are important for increasing or maintaining physical activity. Yet, there is limited understanding of 'what works' for training young physical activity leaders. This study aims to develop a consensus on how to identify and support young people to become physical activity leaders. An iterative three-phased mixed methods Delphi consensus approach. A rapid review focused on the feasibility, acceptability and impact of existing young leader physical activity training (phase one); focus groups (n = 3) and interviews (n = 6) with 15 practitioners and young leaders to examine young physical activity leader training needs (phase two); and a three-round questionnaire process (phase three). Stakeholders (n = 43) from across the public, voluntary and education sectors, academics and young leaders completed all questionnaires. A consensus was reached for 75 statements related to: young leader traits prior to and following training, recruitment methods, training content, delivery format and context, relationships, incentives, and skill development. The Delphi process, combining insight from multi-sectoral stakeholders, identified a range of factors that underpin young leader training programmes. These factors should be applied to develop a curriculum and comprehensive training programme to provide young leaders with the required capability to be effective within their roles, and ultimately support an increase in physical activity amongst children and young people.
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Affiliation(s)
- Isobel P Steward
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Emma S Young
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
- Faculties of Life Sciences and Health Studies, University of Bradford, Bradford, United Kingdom
| | - Sufyan Abid Dogra
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Elizabeth Stamp
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Andy Daly-Smith
- Faculties of Life Sciences and Health Studies, University of Bradford, Bradford, United Kingdom
- Centre for Applied Education Research, Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, West Yorkshire, United Kingdom
| | - Kammy Siddique
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Kelly Morgan
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Cardiff, United Kingdom
| | - Jamie Crowther
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
| | - Jennifer Hall
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Bradford, United Kingdom
- Faculties of Life Sciences and Health Studies, University of Bradford, Bradford, United Kingdom
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11
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Dambi JM, Domingue B, Abas M, Chibanda D, Esterhuizen TM. Reliability and validity of the Shona version of the Exercise Benefits and Barriers Scale in Zimbabwean adult people living with HIV/AIDS. Front Psychiatry 2023; 14:1188689. [PMID: 37692308 PMCID: PMC10483228 DOI: 10.3389/fpsyt.2023.1188689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/31/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction Despite the widely known benefits of physical activity (PA), only 25% of people living with HIV (PLHIV) meet the WHO-recommended minimum PA levels. Consequently, it is essential to understand PA barriers and facilitators using objective measures. Although the Exercise Benefits and Barriers Scale (EBBS) is extensively used, its psychometric evidence is fragmented and has not been previously validated in PLHIV. This study aimed to translate and validate the EBBS Shona version in Zimbabwean PLHIV. Methods A cross-sectional study was used to recruit 567 PLHIV from four (4/9) randomly selected polyclinics (primary healthcare facilities) in urban Harare, Zimbabwe. We recruited adult patients (aged ≥18 years) with a confirmed diagnosis of HIV. Participants had to be willing to provide informed consent, not acutely unwell, and proficient in the Shona language. We used a forward-backwards translation method to translate the EBBS from English to Shona, a native Zimbabwean language. After cross-cultural adaptation, we pretested the draft version in 10 PLHIV to assess the face validity, understandability and cultural appropriateness using semi-structured interviews. Thereafter, the EBBS was administered to 567 consecutively-selected PLHIV. Factor analyses were performed for construct validity evaluation. Results Most participants were female (72.5%) and reached secondary/high school (78.8%), with a mean age of 39.9 (SD 12.1) years. The EBBS-Shona version yielded a four-factor solution consisting of three benefits factors and one barrier factor against the originally postulated six-factor structure. The EBBS-Shona yielded α = 0.85 and intraclass correlation coefficient = 0.86, demonstrating excellent reliability. Increased perception of exercise benefits was positively correlated with increased reports of physical activity, higher health-related quality of life and lower psychiatric morbidity; evidence for construct validity. Discussion This study demonstrates the validity and reliability of the EBBS-Shona version in Zimbabwean PLHIV. The EBBS-Shona version can be used for research and clinical purposes to glean data to inform the development, implementation, and evaluation of bespoke PA interventions for PLHIV.
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Affiliation(s)
- Jermaine M. Dambi
- Rehabilitation Sciences Department, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
- Friendship Bench, Harare, Zimbabwe
| | - Ben Domingue
- Graduate School of Education, Stanford University, Stanford, CA, United States
| | - Melanie Abas
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Dixon Chibanda
- Friendship Bench, Harare, Zimbabwe
- Mental Health Unit, Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
- Department of Population Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Tonya M. Esterhuizen
- Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
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12
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Zangger G, Bricca A, Liaghat B, Juhl CB, Mortensen SR, Andersen RM, Damsted C, Hamborg TG, Ried-Larsen M, Tang LH, Thygesen LC, Skou ST. Benefits and Harms of Digital Health Interventions Promoting Physical Activity in People With Chronic Conditions: Systematic Review and Meta-Analysis. J Med Internet Res 2023; 25:e46439. [PMID: 37410534 PMCID: PMC10359919 DOI: 10.2196/46439] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/20/2023] [Accepted: 05/25/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Digital health interventions for managing chronic conditions have great potential. However, the benefits and harms are still unclear. OBJECTIVE This systematic review and meta-analysis aimed to investigate the benefits and harms of digital health interventions in promoting physical activity in people with chronic conditions. METHODS We searched the MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials databases from inception to October 2022. Eligible randomized controlled trials were included if they used a digital component in physical activity promotion in adults with ≥1 of the following conditions: depression or anxiety, ischemic heart disease or heart failure, chronic obstructive pulmonary disease, knee or hip osteoarthritis, hypertension, or type 2 diabetes. The primary outcomes were objectively measured physical activity and physical function (eg, walk or step tests). We used a random effects model (restricted maximum likelihood) for meta-analyses and meta-regression analyses to assess the impact of study-level covariates. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and the certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation. RESULTS Of 14,078 hits, 130 randomized controlled trials were included. Compared with usual care or minimal intervention, digital health interventions increased objectively measured physical activity (end of intervention: standardized mean difference [SMD] 0.29, 95% CI 0.21-0.37; follow-up: SMD 0.17, 95% CI 0.04-0.31) and physical function (end of intervention: SMD 0.36, 95% CI 0.12-0.59; follow-up: SMD 0.29, 95% CI 0.01-0.57). The secondary outcomes also favored the digital health interventions for subjectively measured physical activity and physical function, depression, anxiety, and health-related quality of life at the end of the intervention but only subjectively measured physical activity at follow-up. The risk of nonserious adverse events, but not serious adverse events, was higher in the digital health interventions at the end of the intervention, but no difference was seen at follow-up. CONCLUSIONS Digital health interventions improved physical activity and physical function across various chronic conditions. Effects on depression, anxiety, and health-related quality of life were only observed at the end of the intervention. The risk of nonserious adverse events is present during the intervention, which should be addressed. Future studies should focus on better reporting, comparing the effects of different digital health solutions, and investigating how intervention effects are sustained beyond the end of the intervention. TRIAL REGISTRATION PROSPERO CRD42020189028; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=189028.
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Affiliation(s)
- Graziella Zangger
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Alessio Bricca
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Behnam Liaghat
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Centre for Evidence-Based Orthopedics (CEBO), Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark
| | - Carsten B Juhl
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, University Hospital of Copenhagen, Herlev and Gentofte, Denmark
| | - Sofie Rath Mortensen
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Rune Martens Andersen
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Camma Damsted
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Trine Grønbek Hamborg
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
| | - Mathias Ried-Larsen
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Centre for Physical Activity Research, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Lars Hermann Tang
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Søren T Skou
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospital, Slagelse, Denmark
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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13
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Barbosa A, Brito J, Figueiredo P, Seabra A, Ding D, Mendes R. How much does it cost to implement a community-based walking football programme for patients with type 2 diabetes? BMJ Open Sport Exerc Med 2023; 9:e001549. [PMID: 37304893 PMCID: PMC10254688 DOI: 10.1136/bmjsem-2023-001549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2023] [Indexed: 06/13/2023] Open
Abstract
Objectives The current study analysed the implementation costs of a community-based walking football exercise programme for patients with type 2 diabetes. Methods The direct costs of a community-based walking football programme for middle-aged and older male patients with type 2 diabetes, designed and tested in Porto (Portugal), were calculated from the payer's perspective. One season of this programme consists of three sessions per week (60 min per session) for nine months (October to June). Cost calculations were based on two groups of 20 patients and included the sports infrastructure and equipment, human resources, pre-exercise clinical evaluation, medical equipment, technical training and other consumable costs. An economic depreciation of 1 year using the linear method for sports and electronic materials was considered. Cost analysis dated December 2021 and is expressed in international dollars ($). Results This programme was estimated to have a total implementation cost of $22 923.07; $2547.01/month; $573.08/patient; $106.13/session; $63.68/patient/month and $5.31/patient/session. Conclusion A community-based walking football programme for patients with type 2 diabetes is affordable and can be scaled up by local communities to promote physical activity and manage type 2 diabetes with the involvement of multiple stakeholders such as the football clubs, municipalities and primary healthcare units.
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Affiliation(s)
- Ana Barbosa
- EPIUnit, Universidade do Porto Instituto de Saúde Pública, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal
| | - João Brito
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal
| | - Pedro Figueiredo
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal
- Physical Education Department, College of Education, United Arab Emirates University, Al Ain, Abu Dhabi, UAE
| | - André Seabra
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Universidade do Porto Faculdade de Desporto, Porto, Portugal
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Romeu Mendes
- EPIUnit, Universidade do Porto Instituto de Saúde Pública, Porto, Portugal
- Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal
- ACES Douro I — Marão e Douro Norte, Administração Regional de Saúde do Norte, Vila Real, Portugal
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14
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Duijvestijn M, de Wit GA, van Gils PF, Wendel-Vos GCW. Impact of physical activity on healthcare costs: a systematic review. BMC Health Serv Res 2023; 23:572. [PMID: 37268930 DOI: 10.1186/s12913-023-09556-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/16/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND This systematic review aims to describe the relation between physical inactivity and healthcare costs, by taking into account healthcare costs of physical-inactivity-related diseases (common practice), including physical-activity-related injuries (new) and costs in life-years gained due to avoiding diseases (new), whenever available. Moreover, the association between physical inactivity and healthcare costs may both be negatively and positively impacted by increased physical activity. METHODS A systematic review was conducted, including records reporting on physical (in)activity in relation to healthcare costs for a general population. Studies were required to report sufficient information to calculate the percentage of total healthcare costs potentially attributable to physical inactivity. RESULTS Of the 264 records identified, 25 were included in this review. Included studies showed substantial variation in the assessment methods of physical activity and in type of costs included. Overall, studies showed that physical inactivity is related to higher healthcare costs. Only one study included costs of healthcare resources used in prolonged life when physical-inactivity-related diseases were averted, showing net higher healthcare costs. No study included healthcare costs for physical-activity-related injuries. CONCLUSIONS Physical inactivity is associated with higher healthcare costs in the general population in the short-term. However, in the long-term aversion of diseases related with physical inactivity may increase longevity and, as a consequence, healthcare costs in life-years gained. Future studies should use a broad definition of costs, including costs in life-years gained and costs related to physical-activity-related injuries.
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Affiliation(s)
- Marjolein Duijvestijn
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
| | - G Ardine de Wit
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Paul F van Gils
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - G C Wanda Wendel-Vos
- National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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15
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Li N, Gao Y, Zhang Y, Deng Y. An integrated multi-level analysis reveals learning-memory deficits and synaptic dysfunction in the rat model exposure to austere environment. J Proteomics 2023; 279:104887. [PMID: 36966970 DOI: 10.1016/j.jprot.2023.104887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/15/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023]
Abstract
Austere environment existing in tank, submarine and vessel has many risk factors including high temperature and humidity, confinement, noise, hypoxia, and high level of carbon dioxide, which may cause depression and cognitive impairment. However, the underlying mechanism is not fully understood yet. We attempt to investigate the effects of austere environment (AE) on emotion and cognitive function in a rodent model. After 21 days of AE stress, the rats exhibit depressive-like behavior and cognitive impairment. Compared with control group, the glucose metabolic level of the hippocampus is significantly decreased using whole-brain positron emission tomography (PET) imaging, and the density of dendritic spines of the hippocampus is remarkably reduced in AE group. Then, we employ a label-free quantitative proteomics strategy to investigate the differentially abundant proteins in rats' hippocampus. It is striking that the differentially abundant proteins annotated by KEGG enrich in oxidative phosphorylation pathway, synaptic vesicle cycle pathway and glutamatergic synapses pathway. The synaptic vesicle transport related proteins (Syntaxin-1A, Synaptogyrin-1 and SV-2) are down-regulated, resulting in the accumulation of intracellular glutamate. Furthermore, the concentration of hydrogen peroxide and malondialdehyde is increased while the activity of superoxide dismutase and complex I and IV of mitochondria is decreased, indicating that oxidative damage to hippocampal synapses is associated with the cognitive decline. The results of this study offer direct evidence, for the first time, that austere environment can substantially cause learning and memory deficits and synaptic dysfunction in a rodent model via behavioral assessments, PET imaging, label-free proteomics, and oxidative stress tests. SIGNIFICANCE: The incidence of depression and cognitive decline in military occupations (for example, tanker and submariner) is significantly higher than that of global population. In the present study, we first established novel model to simulate the coexisting risk factors in the austere environment. The results of this study offer the direct evidences, for the first time, that the austere environment can substantially cause learning and memory deficits by altering plasticity of the synaptic transmission in a rodent model via proteomic strategy, PET imaging, oxidative stress and behavioral assessments. These findings provide valuable information to better understand the mechanisms of cognitive impairment.
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Affiliation(s)
- Nuomin Li
- Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China
| | - Yanan Gao
- Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China
| | - Yongqian Zhang
- School of Life Science, Beijing Institute of Technology, Beijing 100081, China.
| | - Yulin Deng
- Institute of Engineering Medicine, Beijing Institute of Technology, Beijing 100081, China; School of Life Science, Beijing Institute of Technology, Beijing 100081, China; Beijing Key Laboratory for Separation and Analysis in Biomedicine and Pharmaceuticals, Beijing Institute of Technology, Beijing 100081, China.
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16
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Brusco NK, Hill KD, Haines T, Dunn J, Panisset MG, Dow B, Batchelor F, Biddle SJH, Duque G, Levinger P. Cost-Effectiveness of the ENJOY Seniors Exercise Park for Older People: A Pre-Post Intervention Study. J Phys Act Health 2023; 20:555-565. [PMID: 37024105 DOI: 10.1123/jpah.2022-0380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND The Exercise interveNtion outdoor proJect in the cOmmunitY (ENJOY) Seniors Exercise Park program uses specialized outdoor equipment and a physical activity program to engage older people in physical activity, with multiple health benefits. We determined the cost-effectiveness of the ENJOY program. METHODS The economic evaluation compared health care utilization costs 6 months prior to and 6 months post ENJOY program participation. Incremental cost-utility analysis for the primary aim (quality of life) and incremental cost-effectiveness analysis for the secondary aim (falls) were used. Analyses took a societal perspective inclusive of Australian government-funded health care and pharmaceuticals in addition to hospitalizations, community-based nursing and allied health, and community services. Productivity costs were also calculated. RESULTS Fifty participants (average age 72.8 y [SD 7.4] and 78.0% [n = 39/50] women) were included. Participation in the ENJOY program reduced health care costs in the 6 months following the program: preintervention, $9764.49 (SD $26,033.35); postintervention, $5179.30 (SD $3826.64); observed postintervention reduction -$4.585.20 (95% confidence interval, -$12,113.99 to $2943.59; P = .227) without compromising quality of life (mean difference [MD] 0.011; 95% confidence interval, -0.034 to 0.056; P = .631) or increasing the likelihood of a fall (-0.5; 95% confidence interval, 0.00 to -0.50; P = .160). The ENJOY intervention is likely cost-effective. CONCLUSIONS Planning for shared community spaces should consider the benefits of a Seniors Exercise Park as part of the built environment.
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Affiliation(s)
- Natasha K Brusco
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, VIC,Australia
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, VIC,Australia
| | - Terry Haines
- School of Primary and Allied Health Care, Monash University, Melbourne, VIC,Australia
| | - Jeremy Dunn
- National Ageing Research Institute, Melbourne, VIC,Australia
| | - Maya G Panisset
- Department of Medicine, University of Melbourne, Melbourne, VIC,Australia
| | - Briony Dow
- National Ageing Research Institute, Melbourne, VIC,Australia
- Centre for Health Policy, University of Melbourne, Melbourne, VIC,Australia
- School of Nursing and Midwifery, Deakin University, Melbourne, VIC,Australia
| | - Frances Batchelor
- National Ageing Research Institute, Melbourne, VIC,Australia
- School of Nursing and Midwifery, Deakin University, Melbourne, VIC,Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, VIC,Australia
| | - Stuart J H Biddle
- Centre for Health Research, University of Southern Queensland, Springfield, QLD,Australia
| | - Gustavo Duque
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, VIC,Australia
| | - Pazit Levinger
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, VIC,Australia
- National Ageing Research Institute, Melbourne, VIC,Australia
- Institute for Health and Sport, Victoria University, Melbourne, VIC,Australia
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17
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KARI JAANAT, NERG IIRO, HUIKARI SANNA, LEINONEN ANNAMAIJU, NURKKALA MARJUKKA, FARRAHI VAHID, KORPELAINEN RAIJA, KORHONEN MARKO. The Individual-Level Productivity Costs of Physical Inactivity. Med Sci Sports Exerc 2023; 55:255-263. [PMID: 36125340 PMCID: PMC9815811 DOI: 10.1249/mss.0000000000003037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE This study estimated the long-term individual-level productivity costs of physical inactivity. METHODS The data were drawn from the Northern Finland Birth Cohort 1966, to which the productivity cost variables (sick leaves and disability pensions) from Finnish registries were linked. Individuals ( N = 6261) were categorized into physical activity groups based on their level of physical activity, which was measured in three ways: 1) self-reported leisure-time moderate- to vigorous-intensity physical activity (MVPA) at 46 yr old, 2) longitudinal self-reported leisure-time MVPA at 31-46 yr old, and 3) accelerometer-measured overall MVPA at 46 yr old. The human capital approach was applied to calculate the observed costs (years 2012-2020) and the expected costs (years 2012-2031). RESULTS The results showed that the average individual-level productivity costs were higher among physically inactive compared with the costs among physically active. The results were consistent regardless of the measurement type of physical activity or the period used. On average, the observed long-term productivity costs among physically inactive individuals were €1900 higher based on self-reported MVPA, €1800 higher based on longitudinal MVPA, and €4300 higher based on accelerometer-measured MVPA compared with the corresponding productivity costs among physically active individuals. The corresponding difference in the expected costs was €2800, €1200, and €8700, respectively. CONCLUSIONS The results provide evidence that productivity costs differ according to an individual's level of physical activity. Therefore, investments in physical activity may decrease not only the direct healthcare costs but also the indirect productivity costs paid by the employee, the employer, and the government.
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Affiliation(s)
- JAANA T. KARI
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyväskylä, FINLAND,Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, FINLAND
| | - IIRO NERG
- Department of Economics, Accounting and Finance, University of Oulu, Oulu, FINLAND
| | - SANNA HUIKARI
- Department of Economics, Accounting and Finance, University of Oulu, Oulu, FINLAND
| | - ANNA-MAIJU LEINONEN
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, FINLAND,Center for Life Course Health Research, University of Oulu, Oulu, FINLAND
| | - MARJUKKA NURKKALA
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, FINLAND,Center for Life Course Health Research, University of Oulu, Oulu, FINLAND
| | - VAHID FARRAHI
- Research Unit of Medical Imaging, Physics, and Technology, University of Oulu, Oulu, FINLAND,Center for Machine Vision and Signal Analysis, University of Oulu, Oulu, FINLAND
| | - RAIJA KORPELAINEN
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation sr., Oulu, FINLAND,Center for Life Course Health Research, University of Oulu, Oulu, FINLAND,Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, FINLAND
| | - MARKO KORHONEN
- Department of Economics, Accounting and Finance, University of Oulu, Oulu, FINLAND
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18
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Incidence and Predictors of Physical Inactivity Among Malaysian Community-Dwelling Older Persons. J Aging Phys Act 2023; 31:105-116. [PMID: 35894915 DOI: 10.1123/japa.2021-0390] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 03/24/2022] [Accepted: 05/24/2022] [Indexed: 02/03/2023]
Abstract
The aim of this study was to determine the incidence of physical inactivity and identify the predictors for low physical activity among community-dwelling older persons living in Malaysia in 3 years follow-up. In this prospective study, physical activity levels were measured using the Physical Activity Scale for the Elderly. The arbitrary cutoff for Physical Activity Scale for the Elderly in this study was ≤70.9 for low and >141 for high physical activity levels. Out of the 955 physically active participants at baseline, 555 of them (mean [SD] age 68.82 [4.92] years) were successfully followed up to 3 years. Cumulative incidence of being physically inactive was 21% with rate of 7 per 100 person-years. It was found that being older (<.001), from Malay ethnic group (<.05), smokers (<.01), having lower gait speed (<.001), and lower cognitive status (<.05) were predictors for physical inactivity among Malaysian community-dwelling older persons in 3 years follow-up. These factors should be taken into consideration when planning for intervention and promotion strategies to increase physical activity levels among Malaysian older persons.
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19
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Górna S, Pazdro-Zastawny K, Basiak-Rasała A, Krajewska J, Kolator M, Cichy I, Rokita A, Zatoński T. Physical activity and sedentary behaviors in Polish children and adolescents. Arch Pediatr 2023; 30:42-47. [PMID: 36481164 DOI: 10.1016/j.arcped.2022.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 06/10/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Participating in physical activity (PA) is essential for children's proper development. Promoting physical activity from early school years is considered a highly important prevention task for good health. The aim of this study was to evaluate the level of PA and sedentary behavior of children and adolescents aged 6-17 years attending primary and junior high schools in Wroclaw, Lower Silesia, Poland. The study assessed the frequency of various forms of PA and sedentary behavior in children and adolescents. The age differences in PA and sedentary behavior in the cohort studied was also analyzed. DESIGN Survey study to assess children's and adolescents' physical activity and sedentary behavior were based on a parent-reported questionnaire. PARTICIPANTS A total of 2913 children and adolescents aged 6-17 years (average age, 11.38 years) from Wroclaw, Poland, who participated in a pro-health campaign "Let's Get the Kids Moving." This project promotes a healthy lifestyle among primary and middle school students. RESULTS The frequency of physical activity significantly decreased as children grew older (p < 0.0001). As many as 18.6% of adolescents 13-17 years old undertook the recommended level of physical activity less than once a week. Time spent in front of the television or computer by pupils in group 3 was longer than in younger children (p < 0.0001). Nearly 19% of adolescents (13-17 years old) spent 5 h or more daily in a sitting position in front of the television or computer on weekends. CONCLUSIONS Polish children and adolescents do not spend the recommended level of time on physical activity and spend excessive time in front of the television and other electronic devices. The level of physical activity decreases as the number of hours spent in a sitting position increases with increasing age. Actions should be taken to avoid the long-term consequences of these behaviors.
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Affiliation(s)
- Sara Górna
- Akademia Wychowania Fizycznego im Eugeniusza Piaseckiego w Poznaniu, Poland
| | - Katarzyna Pazdro-Zastawny
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University: Uniwersytet Medyczny im. Piastow Slaskich we Wroclawiu, Wrocław, Poland.
| | - Alicja Basiak-Rasała
- Department of Social Medicine, Wroclaw Medical University: Uniwersytet Medyczny im. Piastow Slaskich we Wroclawiu, Wrocław, Poland
| | - Joanna Krajewska
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University: Uniwersytet Medyczny im. Piastow Slaskich we Wroclawiu, Wrocław, Poland
| | - Mateusz Kolator
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University: Uniwersytet Medyczny im. Piastow Slaskich we Wroclawiu, Wrocław, Poland
| | - Ireneusz Cichy
- University School of Physical Education in Wrocław: Akademia Wychowania Fizycznego we Wroclawiu, Poland
| | - Andrzej Rokita
- University School of Physical Education in Wrocław: Akademia Wychowania Fizycznego we Wroclawiu, Poland
| | - Tomasz Zatoński
- Department of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University: Uniwersytet Medyczny im. Piastow Slaskich we Wroclawiu, Wrocław, Poland
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20
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Effect of Elite Sport on Physical Activity Practice in the General Population: A Systematic Review. J Phys Act Health 2023; 20:77-93. [PMID: 36513078 DOI: 10.1123/jpah.2022-0123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 10/12/2022] [Accepted: 10/18/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Our study investigated the effect of elite sport on physical activity (PA) practice in the general population. METHODS Structured Boolean searches were conducted across 5 electronic databases (PubMed, JSTOR, Web of Science, SPORTDiscus, and PsycInfo) from January 2000 to August 2021. Peer-reviewed studies in English were included if the effects of hosting elite sport events, elite sport success, and elite sport role modeling on PA/sport practice in the general population were measured. RESULTS We identified 12,563 articles and included 36 articles. Most studies investigated the effect of hosting elite sport events (n = 27), followed by elite sport success (n = 16) and elite sport role modeling (n = 3). Most studies did not observe a positive effect of hosting elite sport events, elite sport success, or elite sport role modeling on PA/sport practice in the general population. No evidence of a lagged effect of elite sport was observed. No evidence of elite sport effects was observed according to age range and geographical scale. CONCLUSION There is no evidence supporting the effect of elite sport in increasing PA or sport participation in the general population. Decision makers and policymakers should be aware of this and invest in strategies such as those recommended by the World Health Organization.
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21
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Akksilp K, Isaranuwatchai W, Teerawattananon Y, Chen C. The association between health costs and physical inactivity; analysis from the Physical Activity at Work study in Thailand. Front Public Health 2023; 11:1037699. [PMID: 36960361 PMCID: PMC10027789 DOI: 10.3389/fpubh.2023.1037699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 02/08/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction Physical inactivity increases the risks of several common yet serious non-communicable diseases, costing a tremendous amount of health expenditure globally. This study aimed to estimate the association between health costs and physical inactivity in Thailand. Methods Data from the Physical Activity at Work cluster randomized controlled trial participants with valid objective physical activity data were extracted. Health costs were collected using the Health and Welfare Survey and the Work Productivity and Activity Impairment Questionnaire and were categorized into past-month outpatient illness, past-year inpatient illness, and past-week presenteeism and absenteeism. Time spent in moderate-to-vigorous physical activity was used to determine the activity level according to the current guideline (i.e., ≥150 minutes moderate-intensity or ≥75 minutes vigorous-intensity equivalent physical activity per week). The primary analysis evaluated the association between direct cost (treatment and travel costs) and societal cost (direct cost plus absenteeism due to the illness) of past-month outpatient illness and physical inactivity using a two-part model. Results In total, 277 participants with a mean age of 38.7 were included. Average direct and societal cost due to past-month outpatient illness were 146 THB (3.99 USD) (SD = 647 THB) and 457 THB (12.5 USD) (SD = 1390 THB), respectively. Compared to active participants, direct and societal cost of past-month outpatient illness were 153 THB (4.18 USD) (95%CI: -54.7 to 360 THB) and 426 THB (11.7 USD) (95%CI: 23.3 to 829 THB) higher in physically inactive individuals, respectively, adjusted for covariates. The additional societal cost of past-month outpatient illness was 145% higher in physically inactive participants compared to active participants. On the other hand, there was no significant association in direct and societal cost of past-year inpatient illness nor past-week indirect costs between physically active and non-active participants. Discussion Results were similar to recent findings in different countries. However, the findings should be generalized with caution due to the small sample size and potential bias from reverse causation. Future research is crucial for clarifying the health costs of physical inactivity in Thailand and other countries.
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Affiliation(s)
- Katika Akksilp
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Health Intervention and Technology Assessment Programme, Ministry of Public Health, Bangkok, Thailand
- *Correspondence: Katika Akksilp
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Programme, Ministry of Public Health, Bangkok, Thailand
| | - Yot Teerawattananon
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Health Intervention and Technology Assessment Programme, Ministry of Public Health, Bangkok, Thailand
| | - Cynthia Chen
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
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22
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Zan H, Shin SH. The positive impact of informal spousal caregiving on the physical activity of older adults. Front Public Health 2022; 10:977846. [PMID: 36589971 PMCID: PMC9800888 DOI: 10.3389/fpubh.2022.977846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Although physical activity (PA) is crucial for health, the literature is mixed about how individuals' PA decisions are affected by their spouses. To fill this gap, we examined the extent to which providing care for one spouse affects the PA of the other spouse among those aged 50 or older in the United States. Methods We analyzed 9,173 older adults living with their spouses or partners from the 2004 to 2016 waves of the Health and Retirement Study. To identify the causal effect of spousal caregiving on the PA of older adults, we estimated individual-fixed effects models using a two-stage least squared instrumental variable approach with spousal falls as our instrument. We also estimated the models by splitting the sample by gender and race/ethnicity to identify heterogeneous impacts of spousal caregiving on PA decisions among subgroups. Results We found that a one percentage point increase in the probability of providing care to spouses led to an increase in the probability of initiating moderate or vigorous PA (MVPA) by 0.34-0.52 percentage points. This effect was salient, especially among female and non-Hispanic white older adults. Discussion Caregiving experience might provide opportunities to learn about caregiving burdens and trigger an emotional response about the salience of an event (i.e., they need care in the future). Older caregivers might start MVPA in an effort to improve or maintain their health and avoid burdening their families for caregiving in the future. This study demonstrated spousal influence on PA. Instead of delivering PA-promotion information (e.g., the harm of sedentary lifestyle and benefits of regular PA) to individuals, risk communication and education efforts on PA promotion might be more effective considering the family context. Family events such as health shocks or the emergence of caregiving needs from family members provide windows of opportunities for intervening. Subgroup differences should also be considered in targeted interventions.
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Affiliation(s)
- Hua Zan
- Center on the Family, University of Hawai'i at Mānoa, Honolulu, HI, United States,*Correspondence: Hua Zan, ✉
| | - Su Hyun Shin
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, United States
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23
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Anindya K, Marthias T, Zulfikar Biruni M, Hage S, Ng N, Laverty AA, McPake B, Millett C, Haregu TN, Hulse ESG, Cao Y, Lee JT. Low physical activity is associated with adverse health outcome and higher costs in Indonesia: A national panel study. Front Cardiovasc Med 2022; 9:972461. [PMID: 36588560 PMCID: PMC9800782 DOI: 10.3389/fcvm.2022.972461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 11/25/2022] [Indexed: 12/23/2022] Open
Abstract
Aims To assess the association between low physical activity, cardiovascular disease (CVD) and risk factors, health service utilization, risk of catastrophic health expenditure, and work productivity in Indonesia. Methods In this population-based, panel data analysis, we used data from two waves of the Indonesian Family Life Survey (IFLS) for 2007/2008 and 2014/2015. Respondents aged 40-80 years who participated in both waves were included in this study (n = 5,936). Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ-SF). Multinomial logistic regression model was used to examine factors associated with physical activity levels (low, moderate, and high). We applied a series of multilevel mixed-effect panel regression to examine the associations between physical activity and outcome variables. Results The prevalence of low physical activity increased from 18.2% in 2007 to 39.6% in 2014. Compared with those with high physical activity, respondents with low physical activity were more likely to have a 10-year high CVD risk (AOR: 2.11, 95% CI: 1.51-2.95), use outpatient care (AOR: 1.26, 95% CI: 1.07-1.96) and inpatient care (AOR 1.45, 95% CI: 1.07-1.96), experience catastrophic health expenditure of 10% of total household expenditure (AOR: 1.66, 95% CI: 1.21-2.28), and have lower labor participation (AOR: 0.24, 95% 0.20-0.28). Conclusions Low physical activity is associated with adverse health outcomes and considerable costs to the health system and wider society. Accelerated implementation of public health policies to reduce physical inactivity is likely to result in substantial population health and economic benefits.
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Affiliation(s)
- Kanya Anindya
- Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia,School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tiara Marthias
- Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia,*Correspondence: Tiara Marthias
| | - Muhammad Zulfikar Biruni
- Directorate of Pharmaceutical Services, Ministry of Health of the Republic of Indonesia, Jakarta, Indonesia
| | - Sophia Hage
- Royal Sports Performance Center, Jakarta, Indonesia,Indonesia Sports Medicine Doctor Association, Jakarta Pusat, Indonesia
| | - Nawi Ng
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anthony A. Laverty
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Barbara McPake
- Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Christopher Millett
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, United Kingdom
| | - Tilahun Nigatu Haregu
- Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Emily S. G. Hulse
- Center for Health Policy, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Yingting Cao
- Non-Communicable Disease Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - John Tayu Lee
- Nossal Institute for Global Health, The University of Melbourne, Melbourne, VIC, Australia,Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom,College of Health and Medicine, Australian National University, Canberra, ACT, Australia
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24
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Xu YY, Xie J, Yin H, Yang FF, Ma CM, Yang BY, Wan R, Guo B, Chen LD, Li SL. The Global Burden of Disease attributable to low physical activity and its trends from 1990 to 2019: An analysis of the Global Burden of Disease study. Front Public Health 2022; 10:1018866. [PMID: 36590002 PMCID: PMC9798308 DOI: 10.3389/fpubh.2022.1018866] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/23/2022] [Indexed: 12/23/2022] Open
Abstract
Introduction Low physical activity (LPA) is associated with several major non-communicable diseases (NCDs) and premature mortality. In this study, we aimed to assess the global burden and trends in disease attributable to LPA (DALPA) from 1990 to 2019. Methods Annual age-standardized disability-adjusted life years (DALYs) and death rates of DALPA [all-cause and five specific causes (ischaemic heart disease, diabetes mellitus, stroke, colon and rectal cancer, and breast cancer)] by sex, age, geographical region and social deprivation index (SDI) score from 1990 to 2019 were available from the Global Burden of Disease (GBD) study 2019. The estimated annual percentage changes (EAPCs) were calculated to quantify the changing trend. A generalized linear model (GLM) was used to explore the relationship between DALYs/death rates of DALPA and sociodemographic factors. Results Globally, in 2019, the age-standardized DALYs and death rates of DALPA were 198.42/100,000 (95% UI: 108.16/100,000-360.32/100,000) and 11.10/100,000 (95% UI: 5.66/100,000-19.51/100,000), respectively. There were 15.74 million (8.51-28.61) DALYs and 0.83 million (0.43-1.47) deaths attributable to LPA. Overall, age-standardized DALYs and death rates presented significant downward trends with EAPCs [-0.68% (95% CI: -0.85- -0.50%) for DALYs and -1.00% (95% CI: -1.13- -0.86%) for deaths] from 1990 to 2019. However, age-standardized DALYs and death rates of diabetes mellitus attributable to LPA were substantially increased [EAPC: 0.76% (95% CI: 0.70-0.82%) for DALYs and 0.33% (95% CI: 0.21-0.51%) for deaths]. In the 15-49 age group, DALPA presented significant upward trends [EAPC: 0.74% (95% CI: 0.58-0.91%) for DALYs and 0.31% (95% CI: 0.1-0.51%) for deaths]. The GLM revealed that higher gross domestic product and current health expenditure (% of GDP) were negatively associated with DALYs and death rates of DALPA. Conclusion Although global age-standardized DALYs and death rates of DALPA presented downward trends, they still cause a heavy burden worldwide. These rates showed upward trends in the diabetic and 15-49 age groups, which need more attention and health interventions.
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Affiliation(s)
- Yuan-Yi Xu
- Department of Rehabilitation and Advancement, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Jin Xie
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China,Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Hao Yin
- Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Fang-Fang Yang
- Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Chun-Ming Ma
- Department of Rehabilitation and Advancement, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Bao-Yi Yang
- Department of Intensive Care Unit, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Rui Wan
- Department of Intensive Care Unit, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Bin Guo
- Department of Outpatient, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Li-Dian Chen
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China,*Correspondence: Li-Dian Chen
| | - Song-Lin Li
- Division of Financial Services, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China,Song-Lin Li
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25
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Petrusevski C, Morgan A, MacDermid J, Wilson M, Richardson J. Framing physical literacy for aging adults: an integrative review. Disabil Rehabil 2022; 44:8149-8160. [PMID: 34913771 DOI: 10.1080/09638288.2021.2012841] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE Physical literacy is an important component for improving functional health for adults. However, little is known how physical literacy can be framed to support the rehabilitation needs of aging adults. METHODS An integrative review was conducted to understand what components are used to frame physical literacy for adults. Electronic databases were searched from 2000-2021 for eligibility criteria including: 1) adults ≥45 years of age, 2) addressed physical literacy OR physical literacy components AND referred to outcomes assessing either mobility, physical function, rehabilitation, health promotion, health prevention, public health, or physical activity. RESULTS A total of 22 articles met the inclusion criteria. The varied methodological quality, including grey literature (50%) to systematic reviews (14%), indicates that physical literacy for adults is a novel topic. When defining physical literacy for adults, 13 new constructs emerged with purposeful activities, knowledge of age-related changes and social interaction as the top three. Physical literacy interventions demonstrated improvements in self-efficacy, physical function, and exercise behaviour. CONCLUSION Findings from the current literature indicate that engagement in purposeful, social, and diverse activities, obtaining knowledge of age-related changes and being able to self-adapt to mobility fluctuations is the foundation to becoming a physically literate adult.Implications for RehabilitationPhysical literacy is emerging as a promising health strategy for adults and older adults.Reconceptualization of the physical literacy construct to include rehabilitation approaches is needed to address the mobility challenges associated with aging.The foundation to becoming a physically literate adult involves monitoring one's ability for movement and having the knowledge to identify and remediate changes in function while engaging in purposeful movements.Physical literacy programs for adults and older adults have potential to positively impact important health outcomes equitably for all individuals.
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Affiliation(s)
| | - Ashley Morgan
- School of Rehabilitation Science, McMaster University, Hamilton, Canada
| | - Joy MacDermid
- School of Rehabilitation Science, McMaster University, Hamilton, Canada.,Department of Health Evidence & Impact, McMaster University, Hamilton, Canada.,Physical Therapy and Surgery, Western University, London, Canada.,Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Canada
| | - Michael Wilson
- Department of Health Evidence & Impact, McMaster University, Hamilton, Canada.,McMaster Health Forum, McMaster University, Hamilton, Canada.,Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, Canada
| | - Julie Richardson
- School of Rehabilitation Science, McMaster University, Hamilton, Canada.,Department of Health Evidence & Impact, McMaster University, Hamilton, Canada
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26
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Wilke J, Rahlf AL, Füzéki E, Groneberg DA, Hespanhol L, Mai P, de Oliveira GM, Robbin J, Tan B, Willwacher S, Hollander K, Pillay JD. Physical Activity During Lockdowns Associated with the COVID-19 Pandemic: A Systematic Review and Multilevel Meta-analysis of 173 Studies with 320,636 Participants. SPORTS MEDICINE - OPEN 2022; 8:125. [PMID: 36219269 PMCID: PMC9551244 DOI: 10.1186/s40798-022-00515-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 09/02/2022] [Indexed: 11/23/2022]
Abstract
Background Many countries have restricted public life in order to contain the spread of the novel coronavirus (SARS-CoV2). As a side effect of related measures, physical activity (PA) levels may have decreased. Objective We aimed (1) to quantify changes in PA and (2) to identify variables potentially predicting PA reductions. Methods A systematic review with random-effects multilevel meta-analysis was performed, pooling the standardized mean differences in PA measures before and during public life restrictions. Results A total of 173 trials with moderate methodological quality (modified Downs and Black checklist) were identified. Compared to pre-pandemic, total PA (SMD − 0.65, 95% CI − 1.10 to − 0.21) and walking (SMD − 0.52, 95% CI − 0.29 to − 0.76) decreased while sedentary behavior increased (SMD 0.91, 95% CI: 0.17 to 1.65). Reductions in PA affected all intensities (light: SMD − 0.35, 95% CI − 0.09 to − 0.61, p = .013; moderate: SMD − 0.33, 95% CI − 0.02 to − 0.6; vigorous: SMD − 0.33, − 0.08 to − 0.58, 95% CI − 0.08 to − 0.58) to a similar degree. Moderator analyses revealed no influence of variables such as sex, age, body mass index, or health status. However, the only continent without a PA reduction was Australia and cross-sectional trials yielded higher effect sizes (p < .05). Conclusion Public life restrictions associated with the COVID-19 pandemic resulted in moderate reductions in PA levels and large increases in sedentary behavior. Health professionals and policy makers should therefore join forces to develop strategies counteracting the adverse effects of inactivity. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-022-00515-x.
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Affiliation(s)
- Jan Wilke
- grid.7839.50000 0004 1936 9721Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Anna Lina Rahlf
- grid.449681.60000 0001 2111 1904Department of Sports Science, Institute of Health, Nutrition and Sports Science, Europa-Universität Flensburg, Flensburg, Germany
| | - Eszter Füzéki
- grid.7839.50000 0004 1936 9721Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - David A. Groneberg
- grid.7839.50000 0004 1936 9721Institute of Occupational, Social and Environmental Medicine, Goethe University Frankfurt, Frankfurt/Main, Germany
| | - Luiz Hespanhol
- grid.412268.b0000 0001 0298 4494Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil ,grid.509540.d0000 0004 6880 3010Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam University Medical Centers – Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Patrick Mai
- grid.27593.3a0000 0001 2244 5164Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany ,grid.440974.a0000 0001 2234 6983Department of Mechanical and Process Engineering, Offenburg University of Applied Sciences, Offenburg, Germany
| | - Gabriela Martins de Oliveira
- grid.412268.b0000 0001 0298 4494Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo (UNICID), São Paulo, Brazil
| | - Johanna Robbin
- grid.440974.a0000 0001 2234 6983Department of Mechanical and Process Engineering, Offenburg University of Applied Sciences, Offenburg, Germany
| | - Benedict Tan
- grid.413815.a0000 0004 0469 9373Department of Sport and Exercise Medicine, Changi General Hospital, Singapore, Singapore
| | - Steffen Willwacher
- grid.440974.a0000 0001 2234 6983Department of Mechanical and Process Engineering, Offenburg University of Applied Sciences, Offenburg, Germany
| | - Karsten Hollander
- grid.461732.5Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Am Kaiserkai 1, 20457 Hamburg, Germany
| | - Julian David Pillay
- grid.412114.30000 0000 9360 9165Department of Basic Medical Sciences, Durban University of Technology, Durban, South Africa
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Morris TP, Burzynska A, Voss M, Fanning J, Salerno EA, Prakash R, Gothe NP, Whitfield-Gabrieli S, Hillman CH, McAuley E, Kramer AF. Brain Structure and Function Predict Adherence to an Exercise Intervention in Older Adults. Med Sci Sports Exerc 2022; 54:1483-1492. [PMID: 35482769 PMCID: PMC9378462 DOI: 10.1249/mss.0000000000002949] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Individual differences in brain structure and function in older adults are potential proxies of brain reserve or maintenance and may provide mechanistic predictions of adherence to exercise. We hypothesized that multimodal neuroimaging features would predict adherence to a 6-month randomized controlled trial of exercise in 131 older adults (age, 65.79 ± 4.65 yr, 63% female), alone and in combination with psychosocial, cognitive, and health measures. METHODS Regularized elastic net regression within a nested cross-validation framework was applied to predict adherence to the intervention in three separate models (brain structure and function only; psychosocial, health, and demographic data only; and a multimodal model). RESULTS Higher cortical thickness in somatosensory and inferior frontal regions and less surface area in primary visual and inferior frontal regions predicted adherence. Higher nodal functional connectivity (degree count) in default, frontoparietal, and attentional networks and less nodal strength in primary visual and temporoparietal networks predicted exercise adherence ( r = 0.24, P = 0.004). Survey and clinical measures of gait and walking self-efficacy, biological sex, and perceived stress also predicted adherence ( r = 0.17, P = 0.056); however, this prediction was not significant when tested against a null test statistic. A combined multimodal model achieved the highest predictive strength ( r = 0.28, P = 0.001). CONCLUSIONS Our results suggest that there is a substantial utility of using brain-based measures in future research into precision and individualized exercise interventions older adults.
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Affiliation(s)
| | - Agnieszka Burzynska
- Department of Human Development and Family Studies,
Colorado State University, Fort Collins, CO
| | - Michelle Voss
- Deptartment of Psychology, University of Iowa, Iowa City,
IA
| | - Jason Fanning
- Department of Health and Exercise Science, Wake Forest
University, Winston-Salem, NC
| | - Elizabeth A. Salerno
- Division of Public Health Sciences, Department of Surgery,
Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Ruchika Prakash
- Department of Psychology, Ohio State University, Columbus,
OH
| | - Neha P. Gothe
- Beckman Institute for Advanced Science and Technology,
University of Illinois at Urbana-Champaign, Urbana, IL
- Department of Kinesiology and Community Health, University
of Illinois at Urbana-Champaign, Urbana, IL
| | - Susan Whitfield-Gabrieli
- Department of Psychology, Northeastern University, Boston,
MA
- McGovern Institute for Brain Research, Department of Brain
and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA
| | - Charles H. Hillman
- Department of Psychology, Northeastern University, Boston,
MA
- Department of Physical Therapy, Movement, and
Rehabilitation Sciences, Northeastern University, Boston, MA
| | - Edward McAuley
- Beckman Institute for Advanced Science and Technology,
University of Illinois at Urbana-Champaign, Urbana, IL
- Department of Kinesiology and Community Health, University
of Illinois at Urbana-Champaign, Urbana, IL
| | - Arthur F. Kramer
- Department of Psychology, Northeastern University, Boston,
MA
- Beckman Institute for Advanced Science and Technology,
University of Illinois at Urbana-Champaign, Urbana, IL
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Ojedoyin OO, Olagbegi OM, Nadasan T, Govender P. Levels and Patterns of Physical Activity and Sedentary Behaviour of Primary School Learners in Lagos State, Nigeria. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10745. [PMID: 36078465 PMCID: PMC9517747 DOI: 10.3390/ijerph191710745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Physical activity (PA) and sedentary behaviour (SB) assessment in children is critical for the prevention of noncommunicable diseases. African studies examining PA and SB of primary school-age children are few. This study investigated PA, SB levels and their correlates among primary school children in Lagos, Nigeria. METHOD In a cross-sectional study of 733 learners, their self-reported PA and SB were assessed using the Children PA Questionnaire (CPAQ) (6-9 years age category) and Youth Activity Profile (YAP) (10-12 years age category) while pedometers were used for objective PA and SB assessment, and socioeconomic status (SES) index were measured using a structured questionnaire. Standardised procedures were used for anthropometric and cardiovascular measures. Results Based on CPAQ, 87.5% and 100% of the learners aged 6-9 years met the recommended PA and SB guidelines, respectively which were lower with pedometers (72.8% and 87.3%). The proportion of boys aged 6-9 years who met the guidelines for PA and SB (using pedometer) was significantly higher than that of the girls(PA: 80.7% vs. 64%, p = 0.018; SB: 94% vs. 80%, p = 0.008). Self-reported PA was positively associated with age (CPAQ: B = 455.39, p < 0.001; YAP: B = 1.638, p = 0.009) and negatively with SES (CPAQ: B = -201.39, p < 0.001; YAP: B = -1.000, p < 0.001). Objective PA was positively associated with waist to hip ratio(WHR) (6-9 years: B = 66090.24, p = 0.032) and negatively with sex (6-9 years: B = -5533.41, p = 0.027) and hip circumference (10-12 years: B = -1269.13, p = 0.017). SB was associated with SES in learners aged 10-12 years (B = -0.282, p = 0.003). CONCLUSION High SES is a major predictor of reduced PA among these cohort of learners.
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Affiliation(s)
- Olusegun Olatunji Ojedoyin
- Discipline of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
- Harvard Medical Rehabilitation Hospital, Ikorodu, Ikorodu P.O. Box 3143, Lagos, Nigeria
| | - Oladapo Michael Olagbegi
- Discipline of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
| | - Thayananthee Nadasan
- Discipline of Physiotherapy, School of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
| | - Pragashnie Govender
- Discipline of Occupational Therapy, School of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa
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29
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Barbosa A, Whiting S, Ding D, Brito J, Mendes R. Economic evaluation of physical activity interventions for type 2 diabetes management: a systematic review. Eur J Public Health 2022; 32:i56-i66. [PMID: 36031821 PMCID: PMC9421413 DOI: 10.1093/eurpub/ckac074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Background Economic evaluation of physical activity interventions has become an important area for policymaking considering the high costs attributable to physical inactivity. However, the evidence for such interventions targeting type 2 diabetes control is scarce. Therefore, the present study aimed to synthesize economic evaluation studies of physical activity interventions for type 2 diabetes management. Methods A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement (PROSPERO reference number CRD42021231021). An electronic search was performed in PubMed, Web of Science, Cochrane Library and NHS Economic Evaluation Database. Studies were eligible if they included: adults with type 2 diabetes; any physical activity intervention in the community settings; an experimental or quasi-experimental design; and a parameter of economic evaluation [cost analysis of interventions, cost-effectiveness analysis (including cost-utility analysis) and cost-benefit analysis] as an outcome. Results Ten studies were included in this review: seven were randomized controlled trials and three were quasi-experimental studies. All studies included direct costs, and four also included indirect costs. Four studies demonstrated that physical activity interventions were cost-saving, six studies showed cost-effectiveness, and two studies reported cost-utility. The estimates varied considerably across the studies with different analytical and methodological approaches. Conclusion Overall, this systematic review found that physical activity interventions are a worth investment for type 2 diabetes management. However, comparability across interventions was limited due to heterogeneity in interventions type, design and delivery, which may explain the differences in the economic measures.
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Affiliation(s)
- Ana Barbosa
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | - Stephen Whiting
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,World Health Organization, Regional Office for Europe, Copenhagen, Denmark
| | - Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Camperdown, Australia
| | - João Brito
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal
| | - Romeu Mendes
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,World Health Organization, Regional Office for Europe, Copenhagen, Denmark.,Portugal Football School, Portuguese Football Federation, Oeiras, Portugal.,ACES Douro I-Marão e Douro Norte, Northern Region Health Administration, Vila Real, Portugal
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30
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Coleman CJ, McDonough DJ, Pope ZC, Pope CA. Dose-response association of aerobic and muscle-strengthening physical activity with mortality: a national cohort study of 416 420 US adults. Br J Sports Med 2022; 56:bjsports-2022-105519. [PMID: 35953241 PMCID: PMC10064988 DOI: 10.1136/bjsports-2022-105519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To investigate the dose-response association of aerobic physical activity (PA) and muscle-strengthening exercise (MSE) with all-cause mortality. METHODS National Health Interview Survey data (1997-2014) were linked to the National Death Index through 2015, which produced a cohort of 416 420 US adults. Cox proportional-hazard models were used to estimate HRs and 95% CIs for the associations of moderate aerobic PA (MPA), vigorous aerobic PA (VPA) and MSE with mortality risk. Models controlled for age, sex, race-ethnicity, income, education, marital status, survey year, smoking status, body mass index and chronic conditions. RESULTS Relative to those who engaged in no aerobic PA, substantial mortality risk reduction was associated with 1 hour/week of aerobic PA (HR: 0.85, 95% CI: 0.83 to 0.86) and levelled off at 3 hours/week of aerobic PA (0.73, 0.71 to 0.75). Similar results were observed for men and women and for individuals younger and older than 60 years. MSE conferred additional mortality risk reduction at 1 time/week (0.89, 0.81 to 0.97) and appeared no longer beneficial at 7 times/week (0.99, 0.94 to 1.04). CONCLUSION The minimum effective dose of aerobic PA for significant mortality risk reduction was 1 hour/week of MPA or VPA, with additional mortality risk reduction observed up to 3 hours/week. For older adults, only small decreases in mortality risk were observed beyond this duration. Completing MSE in combination with aerobic PA conferred additional mortality risk reduction, with a minimum effective dose of 1-2 times/week.
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Affiliation(s)
- Carver J Coleman
- Department of Economics, Brigham Young University, Provo, Utah, USA
| | - Daniel J McDonough
- University of Minnesota Twin Cities, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, Minnesota, USA
| | - Zachary C Pope
- Well Living Lab, Rochester, Minnesota, USA
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - C Arden Pope
- Department of Economics, Brigham Young University, Provo, Utah, USA
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31
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Physical activity telephone coaching intervention for insufficiently physically active ambulatory hospital patients: Economic evaluation of the Healthy 4U-2 randomised controlled trial. PLoS One 2022; 17:e0270211. [PMID: 35737687 PMCID: PMC9223391 DOI: 10.1371/journal.pone.0270211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/02/2022] [Indexed: 11/19/2022] Open
Abstract
The Healthy 4U-2 randomised controlled trial demonstrated that a physical activity (PA) telephone coaching intervention was effective for improving objectively-measured PA and health-related outcomes. The current study reports on an economic evaluation performed alongside the trial to determine whether this effective intervention is also cost-effective from a healthcare funder perspective. Participants (N = 120) were insufficiently physically active adults recruited from an ambulatory care clinic in a public hospital in regional Australia. The primary outcome was change in moderate-to-vigorous physical activity (MVPA) measured using accelerometers. Changes in quality-adjusted life-years (QALYs) were derived from the 12-Item Short Form Health Survey Questionnaire (SF-12). Incremental cost-effectiveness ratios (ICERs) were calculated for each outcome. Uncertainty of cost-effectiveness results were estimated using non-parametric bootstrapping techniques and sensitivity analyses. The mean intervention cost was $132 per person. The control group incurred higher overall costs compared to intervention ($2,465 vs. $1,743, respectively). Relative to control, the intervention resulted in incremental improvements in MVPA and QALYs and was deemed cost-effective. Probabilistic sensitivity analysis indicated that compared to control, the intervention would be cost-effective for improving MVPA and QALYs at very low willingness to pay thresholds. Sensitivity analyses indicated that results were robust to varied assumptions. This study shows that PA telephone coaching was a low-cost strategy for increasing MVPA and QALYs in insufficiently active ambulatory hospital patients. Findings of health benefits and overall cost-savings are uncommon and PA telephone coaching offers a potentially cost-effective investment to produce important public health outcomes.
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MacLeod KE, Ye Z, Donald B, Wang G. A Literature Review of Productivity Loss Associated with Hypertension in the United States. Popul Health Manag 2022; 25:297-308. [PMID: 35119298 PMCID: PMC9536345 DOI: 10.1089/pop.2021.0201] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
A literature review of peer-reviewed articles published 2000-2019 was conducted to determine the types and extent of hypertension-associated productivity loss among adults in the United States. All monetary outcomes were standardized to 2019 $ by using the Employment Cost Index. Twenty-seven articles met the inclusion criteria. Nearly half of the articles (12 articles) presented monetary outcomes of productivity loss. Absenteeism (14 articles) and presenteeism (8 articles) were most frequently assessed. Annual absenteeism was estimated to cost more than $11 billion, nationally controlling for sociodemographic characteristics. The annual additional costs per person were estimated at $63 for short-term disability, $72-$330 for absenteeism, and $53-$156 for presenteeism, controlling for participant characteristics; and may be as high as $2362 for absenteeism and presenteeism when considered in combination. The annual additional time loss per person was estimated as 1.3 days for absenteeism, controlling for common hypertension comorbidities, including stroke and diabetes; and 15.6 days for work and home productivity loss combined, controlling for sociodemographic characteristics. The loss from absenteeism alone might be more than 20% of the total medical expenditure of hypertension. Although the differences in estimation methods and study populations make it challenging to synthesize the costs across the studies, this review provides detailed information on the various types of productivity loss. In addition, the ways in which methods could be standardized for future research are discussed. Accounting for the costs from productivity loss can help public health officials, health insurers, employers, and researchers better understand the economic burden of hypertension.
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Affiliation(s)
- Kara E. MacLeod
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia, USA
- ASRT, Inc., Atlanta, Georgia, USA
| | - Zhiqiu Ye
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia, USA
| | - Bruce Donald
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia, USA
- ASRT, Inc., Atlanta, Georgia, USA
| | - Guijing Wang
- Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia, USA
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Kolu P, Kari JT, Raitanen J, Sievänen H, Tokola K, Havas E, Pehkonen J, Tammelin TH, Pahkala K, Hutri-Kähönen N, Raitakari OT, Vasankari T. Economic burden of low physical activity and high sedentary behaviour in Finland. J Epidemiol Community Health 2022; 76:677-684. [PMID: 35473717 PMCID: PMC9209672 DOI: 10.1136/jech-2021-217998] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 04/05/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Low physical activity and high sedentary behaviour are unquestionably relevant for public health while also increasing direct and indirect costs. METHODS The authors examined the direct and indirect costs attributable to low physical activity and high sedentary behaviour in Finland in 2017. Costs related to major non-communicable diseases drawn from Finnish registries covered direct costs (outpatient visits, days of inpatient care, medication and institutional eldercare) and indirect costs (sickness-related absences, disability pensions, unemployment benefits, all-cause mortality and losses of income tax revenue). Prevalences of low physical activity and high sedentary behaviour (≥8 hours per 16 waking hours) were based on self-reports among adolescents or accelerometer data among adults and the elderly from three Finnish population studies: FINFIT 2017, Health 2011 and the Cardiovascular Risk in Young Finns Study. Cost calculations used adjusted population attributable fractions (PAF) and regression models. Total annual costs were obtained by multiplying PAF by the total costs of the given disease. RESULTS The total costs of low physical activity in Finland in 2017 came to approximately €3.2 billion, of which direct costs accounted for €683 million and indirect ones for €2.5 billion. Costs attributable to high sedentary behaviour totalled roughly €1.5 billion. CONCLUSION The findings suggest that low physical activity and high sedentary behaviour levels create substantial societal costs. Therefore, actions intended to increase physical activity and reduce excessive sedentary behaviour throughout life may yield not only better health but also considerable savings to society.
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Affiliation(s)
- Päivi Kolu
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyvaskyla, Finland
| | - Jaana T Kari
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Jani Raitanen
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyvaskyla, Finland.,Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Harri Sievänen
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyvaskyla, Finland
| | - Kari Tokola
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyvaskyla, Finland
| | - Eino Havas
- JAMK University of Applied Sciences, LIKES, Jyvaskyla, Finland
| | - Jaakko Pehkonen
- UKK Institute for Health Promotion Research, Tampere, Finland
| | | | - Katja Pahkala
- Research Centre for Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Paavo Nurmi Centre, Unit of Health and Physical Activity, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
| | - Nina Hutri-Kähönen
- Tampere Centre for Skills Training and Simulation, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli T Raitakari
- Research Centre for Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Tommi Vasankari
- Jyväskylä University School of Business and Economics, University of Jyväskylä, Jyvaskyla, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
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Nguyen P, Le LKD, Ananthapavan J, Gao L, Dunstan DW, Moodie M. Economics of sedentary behaviour: A systematic review of cost of illness, cost-effectiveness, and return on investment studies. Prev Med 2022; 156:106964. [PMID: 35085596 DOI: 10.1016/j.ypmed.2022.106964] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/20/2021] [Accepted: 01/15/2022] [Indexed: 10/19/2022]
Abstract
AIMS METHODS: RESULTS: We identified nine articles (conducted in Australia (n = 5), Europe (n = 3) and China (n = 1)); three reported healthcare costs associated with excessive sedentary time, whilst six were economic evaluations of interventions targeting sedentary behaviour. Healthcare costs associated with excessive sedentary time as reported in cost of illness studies were substantial; however, none explored non-health sector costs. In contrast, all full economics evaluations adopted a societal perspective; however, costs included differed depending on the intervention context. One sedentary behaviour intervention in children was cost-saving. The five interventions targeting occupational sitting time of adults in office workplaces were cost-effective. Physical environmental changes such as sit-stand desks, active workstations etc., were the key cost driver. CONCLUSIONS Sedentary behaviour is likely associated with excess healthcare costs, although future research should also explore costs across other sectors. Cost-effectiveness evidence of sedentary behaviour reduction interventions in workplaces is limited but consistent. Key gaps relate to the economic credentials of interventions targeting children, and modelling of long-term health benefits of interventions.
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Affiliation(s)
- Phuong Nguyen
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia; Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia.
| | - Long Khanh-Dao Le
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Jaithri Ananthapavan
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia; Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - Lan Gao
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia; School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, Australia
| | - David W Dunstan
- Baker Heart and Diabetes Institute, Melbourne, Australia; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Marj Moodie
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia; Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
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35
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YAKAL S, ERTUNA A, TAHIRBEGOLLI B, BAYRAKTAR B. Cost analysis of sports injuries diagnosis in a university hospital sports medicine department. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.20.04473-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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36
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Morris TP, Kucyi A, Anteraper SA, Geddes MR, Nieto-Castañon A, Burzynska A, Gothe NP, Fanning J, Salerno EA, Whitfield-Gabrieli S, Hillman CH, McAuley E, Kramer AF. Resting state functional connectivity provides mechanistic predictions of future changes in sedentary behavior. Sci Rep 2022; 12:940. [PMID: 35042916 PMCID: PMC8766514 DOI: 10.1038/s41598-021-04738-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 12/28/2021] [Indexed: 12/11/2022] Open
Abstract
Sedentary behaviors are increasing at the cost of millions of dollars spent in health care and productivity losses due to physical inactivity-related deaths worldwide. Understanding the mechanistic predictors of sedentary behaviors will improve future intervention development and precision medicine approaches. It has been posited that humans have an innate attraction towards effort minimization and that inhibitory control is required to overcome this prepotent disposition. Consequently, we hypothesized that individual differences in the functional connectivity of brain regions implicated in inhibitory control and physical effort decision making at the beginning of an exercise intervention in older adults would predict the change in time spent sedentary over the course of that intervention. In 143 healthy, low-active older adults participating in a 6-month aerobic exercise intervention (with three conditions: walking, dance, stretching), we aimed to use baseline neuroimaging (resting state functional connectivity of two a priori defined seed regions), and baseline accelerometer measures of time spent sedentary to predict future pre-post changes in objectively measured time spent sedentary in daily life over the 6-month intervention. Our results demonstrated that functional connectivity between (1) the anterior cingulate cortex and the supplementary motor area and (2) the right anterior insula and the left temporoparietal/temporooccipital junction, predicted changes in time spent sedentary in the walking group. Functional connectivity of these brain regions did not predict changes in time spent sedentary in the dance nor stretch and tone conditions, but baseline time spent sedentary was predictive in these conditions. Our results add important knowledge toward understanding mechanistic associations underlying complex out-of-session sedentary behaviors within a walking intervention setting in older adults.
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Affiliation(s)
- Timothy P Morris
- Department of Psychology, Northeastern University, 435 ISEC, 360 Huntington Avenue, Boston, 02115, USA.
| | - Aaron Kucyi
- Department of Psychology, Northeastern University, 435 ISEC, 360 Huntington Avenue, Boston, 02115, USA
| | - Sheeba Arnold Anteraper
- Department of Psychology, Northeastern University, 435 ISEC, 360 Huntington Avenue, Boston, 02115, USA
| | - Maiya Rachel Geddes
- Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Canada
- Brigham and Women's Hospital, Harvard Medical School, Cambridge, USA
| | - Alfonso Nieto-Castañon
- Department of Psychology, Northeastern University, 435 ISEC, 360 Huntington Avenue, Boston, 02115, USA
| | - Agnieszka Burzynska
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, USA
| | - Neha P Gothe
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana Champaign, Urbana, USA
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jason Fanning
- Department of Health and Exercise Sciences, Wake Forrest University, Winston-Salem, NC, USA
| | - Elizabeth A Salerno
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Susan Whitfield-Gabrieli
- Department of Psychology, Northeastern University, 435 ISEC, 360 Huntington Avenue, Boston, 02115, USA
- McGovern Institute for Brain Research, Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Charles H Hillman
- Department of Psychology, Northeastern University, 435 ISEC, 360 Huntington Avenue, Boston, 02115, USA
- Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - Edward McAuley
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana Champaign, Urbana, USA
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Arthur F Kramer
- Department of Psychology, Northeastern University, 435 ISEC, 360 Huntington Avenue, Boston, 02115, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana Champaign, Urbana, USA
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Reece LJ, Owen K, Graney M, Jackson C, Shields M, Turner G, Wellington C. Barriers to initiating and maintaining participation in parkrun. BMC Public Health 2022; 22:83. [PMID: 35027014 PMCID: PMC8759213 DOI: 10.1186/s12889-022-12546-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 01/04/2022] [Indexed: 11/10/2022] Open
Abstract
AbstractInterventions that increase population physical activity are required to promote health and wellbeing. parkrun delivers community-based, 5 km events worldwide yet 43% who register never participate in a parkrun event. This research had two objectives; i) explore the demographics of people who register for parkrun in United Kingdom, Australia, Ireland, and don’t initiate or maintain participation ii) understand the barriers to participating in parkrun amongst these people. Mandatory data at parkrun registration provided demographic characteristics of parkrun registrants. A bespoke online survey distributed across the three countries captured the reasons for not participating or only participating once. Of 680,255 parkrun registrants between 2017 and 19, 293,542 (43%) did not participate in any parkrun events and 147,148 (22%) only participated in one parkrun event. Females, 16–34 years and physically inactive were more likely to not participate or not return to parkrun. Inconvenient start time was the most frequently reported barrier to participating, with females more likely than males to report the psychological barrier of feeling too unfit to participate. Co-creating strategies with and for people living with a chronic disease, women, young adults, and physically inactive people, could increase physical activity participation within parkrun.
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Pereira MG, Voltarelli VA, Tobias GC, de Souza L, Borges GS, Paixão AO, de Almeida NR, Bowen TS, Demasi M, Miyabara EH, Brum PC. Aerobic Exercise Training and In Vivo Akt Activation Counteract Cancer Cachexia by Inducing a Hypertrophic Profile through eIF-2α Modulation. Cancers (Basel) 2021; 14:cancers14010028. [PMID: 35008195 PMCID: PMC8750332 DOI: 10.3390/cancers14010028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/14/2021] [Accepted: 12/17/2021] [Indexed: 01/15/2023] Open
Abstract
Simple Summary Chronic disease-related muscle atrophy is a serious public health problem since it reduces mobility and contributes to increases in hospitalization costs. Unfortunately, there is no approved treatment for muscle wasting at present. Thus, an understanding of the mechanisms underlying the control of muscle mass and function under chronic diseases can pave the way for the discovery of innovative therapeutic strategies to counteract muscle wasting. Since numerous types of cancer induce cachexia, which has no cure nor an effective treatment, the main proposal here was to study the effects of AET in cancer cachexia, and to investigate, through in vivo manipulation of the Akt/mTORC1 pathway, whether the cachectic muscle still presents conditions to respond adaptively to hypertrophic stimuli. Our results could provide a basis for innovative research lines to better understand muscle plasticity and to investigate potential therapeutic approaches necessary to prevent muscle loss. Abstract Cancer cachexia is a multifactorial and devastating syndrome characterized by severe skeletal muscle mass loss and dysfunction. As cachexia still has neither a cure nor an effective treatment, better understanding of skeletal muscle plasticity in the context of cancer is of great importance. Although aerobic exercise training (AET) has been shown as an important complementary therapy for chronic diseases and associated comorbidities, the impact of AET on skeletal muscle mass maintenance during cancer progression has not been well documented yet. Here, we show that previous AET induced a protective mechanism against tumor-induced muscle wasting by modulating the Akt/mTORC1 signaling and eukaryotic initiation factors, specifically eIF2-α. Thereafter, it was determined whether the in vivo Akt activation would induce a hypertrophic profile in cachectic muscles. As observed for the first time, Akt-induced hypertrophy was able and sufficient to either prevent or revert cancer cachexia by modulating both Akt/mTORC1 pathway and the eIF-2α activation, and induced a better muscle functionality. These findings provide evidence that skeletal muscle tissue still preserves hypertrophic potential to be stimulated by either AET or gene therapy to counteract cancer cachexia.
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Affiliation(s)
- Marcelo G. Pereira
- School of Physical Education and Sport, University of Sao Paulo, Sao Paulo 05508030, Brazil; (V.A.V.); (G.C.T.); (L.d.S.); (G.S.B.); (A.O.P.); (N.R.d.A.)
- Leeds School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK;
- Correspondence: (M.G.P.); (P.C.B.)
| | - Vanessa A. Voltarelli
- School of Physical Education and Sport, University of Sao Paulo, Sao Paulo 05508030, Brazil; (V.A.V.); (G.C.T.); (L.d.S.); (G.S.B.); (A.O.P.); (N.R.d.A.)
- Sirio-Libanes Hospital, Sao Paulo 01308050, Brazil
- Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
| | - Gabriel C. Tobias
- School of Physical Education and Sport, University of Sao Paulo, Sao Paulo 05508030, Brazil; (V.A.V.); (G.C.T.); (L.d.S.); (G.S.B.); (A.O.P.); (N.R.d.A.)
- Children’s Cancer and Blood Foundation Laboratories, Departments of Pediatrics, and Cell and Developmental Biology, Drukier Institute for Children’s Health, Meyer Cancer Center, Weill Cornell Medicine, New York, NY 10021, USA
| | - Lara de Souza
- School of Physical Education and Sport, University of Sao Paulo, Sao Paulo 05508030, Brazil; (V.A.V.); (G.C.T.); (L.d.S.); (G.S.B.); (A.O.P.); (N.R.d.A.)
| | - Gabriela S. Borges
- School of Physical Education and Sport, University of Sao Paulo, Sao Paulo 05508030, Brazil; (V.A.V.); (G.C.T.); (L.d.S.); (G.S.B.); (A.O.P.); (N.R.d.A.)
| | - Ailma O. Paixão
- School of Physical Education and Sport, University of Sao Paulo, Sao Paulo 05508030, Brazil; (V.A.V.); (G.C.T.); (L.d.S.); (G.S.B.); (A.O.P.); (N.R.d.A.)
| | - Ney R. de Almeida
- School of Physical Education and Sport, University of Sao Paulo, Sao Paulo 05508030, Brazil; (V.A.V.); (G.C.T.); (L.d.S.); (G.S.B.); (A.O.P.); (N.R.d.A.)
| | - Thomas Scott Bowen
- Leeds School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds LS2 9JT, UK;
| | - Marilene Demasi
- Biochemistry and Biophysics Laboratory, Butantan Institute, Sao Paulo 05503900, Brazil;
| | - Elen H. Miyabara
- Department of Anatomy, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo 05508000, Brazil;
| | - Patricia C. Brum
- School of Physical Education and Sport, University of Sao Paulo, Sao Paulo 05508030, Brazil; (V.A.V.); (G.C.T.); (L.d.S.); (G.S.B.); (A.O.P.); (N.R.d.A.)
- Correspondence: (M.G.P.); (P.C.B.)
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Reis BM, da Silva JB, Rocha APR, Liebano RE, Driusso P. Intravaginal electrical stimulation associated with pelvic floor muscle training for women with stress urinary incontinence: study protocol for a randomized controlled trial with economic evaluation. Trials 2021; 22:823. [PMID: 34801063 PMCID: PMC8606065 DOI: 10.1186/s13063-021-05781-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 11/01/2021] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Pelvic floor muscle training (PFMT) exercises and neuromuscular electrical stimulation (NMES) are described as conservative interventions to prevent or treat female stress urinary incontinence (SUI). However, it has not been described yet the effect of PFMT associated to intravaginal NMES which evaluated the cost-effectiveness and cost-utility of treating. AIMS To evaluate the effects of intravaginal NMES associated with the PFMT protocol on urinary loss and quality of life in women with SUI and to evaluate the cost-effectiveness and cost-utility and pelvic floor muscle in women with SUI. METHODS Randomized controlled trial study with economic evaluation. Inclusion criteria are woman (biological), aged ≥ 18 years old and with a report of SUI ≥ once/week. Exclusion criteria are presence of vaginal or urinary infection, virginity, being in the gestational or puerperium period, or neurological disease. Participants will undergo physical therapy assessment and intervention: anamnesis, pelvic floor muscle assessment by vaginal palpation and manometry (PeritronTM), questionnaires (Short-Form 6 Dimensions-Brazil (SF-6D), King's Health Questionnaire (KHQ) and King´s Health Questionnaire for Scoring Algorithm), health costs, and voiding diary. Participants will be randomly allocated into 3 groups: CG (control group), IG 1 (intervention group 1, PFMT), and IG2 (intervention group 2, PFMT + NMES). The statistical analysis will be performed by intention to treat, and multivariate analysis of mixed effects will be used to compare outcomes. Effect size measurements will be calculated and will be provided by Cohen's d test. A significance level of 5% will be adopted. Additionally, the incremental cost-effectiveness and incremental cost-utility ratios will be used. DISCUSSION This protocol can corroborate with the literature in order to identify the effect of techniques, based on the possibility of confirming the hypothesis that the NMES associated with PFMT performed concurrently will be the best treatment option; considering the effectiveness, cost-effectiveness, and cost-utility analysis, it will be used as an option for optimization of the treatment of SUI. TRIAL REGISTRATION Brazilian Registry of Clinical Trials (ReBEC) ID: RBR-6gtzg4 . Registered on September 3, 2019.
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Affiliation(s)
- Bianca Manzan Reis
- Women’s Health Research Laboratory, Physical Therapy Post-Graduate Program, Federal University of São Carlos, Rod. Washington Luis, km 235, CEP, São Carlos, SP 13565-905 Brazil
| | - Jordana Barbosa da Silva
- Women’s Health Research Laboratory, Physical Therapy Post-Graduate Program, Federal University of São Carlos, Rod. Washington Luis, km 235, CEP, São Carlos, SP 13565-905 Brazil
| | - Ana Paula Rodrigues Rocha
- Women’s Health Research Laboratory, Physical Therapy Post-Graduate Program, Federal University of São Carlos, Rod. Washington Luis, km 235, CEP, São Carlos, SP 13565-905 Brazil
| | - Richard Eloin Liebano
- Physioterapeutics Resources Laboratory, Physical Therapy Post-Graduate Program, Federal University of São Carlos, São Carlos, SP Brazil
| | - Patricia Driusso
- Women’s Health Research Laboratory, Physical Therapy Post-Graduate Program, Federal University of São Carlos, Rod. Washington Luis, km 235, CEP, São Carlos, SP 13565-905 Brazil
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Humanistic and socioeconomic burden of COPD patients and their caregivers in Malaysia. Sci Rep 2021; 11:22598. [PMID: 34799609 PMCID: PMC8604899 DOI: 10.1038/s41598-021-01551-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 10/28/2021] [Indexed: 11/25/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is associated with substantial humanistic and socioeconomic burden on patients and their caregivers. COPD is expected to be 7th leading cause of disease burden till 2030. The objective of the current study was to assess the humanistic and socioeconomic burden of COPD patients and their caregivers in Malaysia. The burden includes the cost of management of COPD, QOL of COPD patients and their caregivers, work productivity and activity impairment of COPD patients and their caregivers due to COPD. One hundred and fifty COPD patients and their caregivers from the chest clinic of Penang Hospital were included in the study from August 2018 to August 2019. Caregiving cost was estimated using the replacement cost approach, while humanistic and social burden was assessed with the help of health status questionnaires. Overall, 64.66% and 7.1% of COPD patients reported to depend on informal caregivers and professional caregivers respectively. COPD patients reported dyspnoea score as 2.31 (1.31), EQ-5D-5L utility index 0.57 (0.23), CCI 2.3 (1.4), SGRQ-C 49.23 (18.61), productivity loss 31.87% and activity impairment 17.42%. Caregivers reported dyspnoea score as 0.72 (0.14), EQ-5D-5L utility index 0.57 (0.23), productivity loss 7.19% and social activity limitation as 21.63% due to taking care of COPD patients. In addition to the huge direct cost of management, COPD is also associated with substantial burden on society in terms of compromised quality of life, reduced efficiency at the workplace, activity impairment and caregiver burden.
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Lera-Lopez F, Marco R. Physical activity disparities across Europe: clustering European regions by health-related physical activity levels. Health Promot Int 2021; 37:6389713. [PMID: 34634808 PMCID: PMC9053455 DOI: 10.1093/heapro/daab157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In the context of stagnating global levels of physical activity (PA), this study examines the geographical segmentation of PA at the regional level (196 regions) in Europe. Cluster analysis and multinomial logistic regression are applied. Cluster analysis provides a taxonomy of four differentiated groups according to the health-related PA levels of the European regions. This taxonomy shows that there are significant regional disparities among European countries in terms of the regional PA level. The cluster profiles in terms of regional socioeconomic characteristics are described for each group, emphasizing the regional characteristics associated with PA. Regional economic variables, tertiary education and social Internet use are significant variables for characterizing the types of regions. The results emphasize the relevance of a European regional approach for reducing inter-regional PA disparities and improving health through PA in Europe. Practical implications of this research are based on regional European coordination, such as collaborative models of sport infrastructure use, co-financing of inter-regional facilities, mutual physical educational scholar programs and promotion of common inter-regional sport competitions and sporting events. Finally, formal schemes for exchanging of best regional practices to promote health-enhancing PA might increase the perception and the role of PA at the regional level in the European society.
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Affiliation(s)
- Fernando Lera-Lopez
- Department of Economics, Public University of Navarra, Campus Arrosadía s/n, 31006 Pamplona, Spain
| | - Rocio Marco
- Department of Applied Economy, Universidad Autónoma de Madrid, Ciudad universitaria de Cantoblanco, Francisco Tomás y Valiente Road, number 5, 28049 Madrid, Spain
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Malone SK, Patterson F, Grunin L, Melkus GD, Riegel B, Punjabi N, Yu G, Urbanek J, Crainiceanu C, Pack A. Habitual physical activity patterns in a nationally representative sample of U.S. adults. Transl Behav Med 2021; 11:332-341. [PMID: 31985811 DOI: 10.1093/tbm/ibaa002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Physical inactivity is a leading determinant of noncommunicable diseases. Yet, many adults remain physically inactive. Physical activity guidelines do not account for the multidimensionality of physical activity, such as the type or variety of physical activity behaviors. This study identified patterns of physical activity across multiple dimensions (e.g., frequency, duration, and variety) using a nationally representative sample of adults. Sociodemographic characteristics, health behaviors, and clinical characteristics associated with each physical activity pattern were defined. Multivariate finite mixture modeling was used to identify patterns of physical activity among 2003-2004 and 2005-2006 adult National Health and Nutrition Examination Survey participants. Chi-square tests were used to identify sociodemographic differences within each physical activity cluster and test associations between the physical activity clusters with health behaviors and clinical characteristics. Five clusters of physical activity patterns were identified: (a) low frequency, short duration (n = 730, 13%); (b) low frequency, long duration (n = 392, 7%); (c) daily frequency, short duration (n = 3,011, 55%); (d) daily frequency, long duration (n = 373, 7%); and (e) high frequency, average duration (n = 964, 18%). Walking was the most common form of activity; highly active adults engaged in more varied types of activity. High-activity clusters were comprised of a greater proportion of younger, White, nonsmoking adult men reporting moderate alcohol use without mobility problems or chronic health conditions. Active females engaged in frequent short bouts of activity. Data-driven approaches are useful for identifying clusters of physical activity that encompass multiple dimensions of activity. These activity clusters vary across sociodemographic and clinical subgroups.
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Affiliation(s)
- Susan K Malone
- Rory Myers College of Nursing, New York University, New York, NY, USA
| | - Freda Patterson
- Department of Behavioral Health and Nutrition, College of Health Sciences, University of Delaware, Newark, DE, USA
| | - Laura Grunin
- Rory Myers College of Nursing, New York University, New York, NY, USA
| | - Gail D Melkus
- Rory Myers College of Nursing, New York University, New York, NY, USA
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Naresh Punjabi
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Gary Yu
- Rory Myers College of Nursing, New York University, New York, NY, USA
| | - Jacek Urbanek
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Ciprian Crainiceanu
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Allan Pack
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Butts JF, Schmitz KH, Onks C, Silvis M. Implementing a Physical Activity Consultation Clinic during a Global Pandemic. Curr Sports Med Rep 2021; 20:389-394. [PMID: 34357884 DOI: 10.1249/jsr.0000000000000866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Ten percent of all premature deaths and 117 billion dollars in annual health care costs are attributable to physical inactivity in America. The positive impact exercise can have on overall health is irrefutable. While it is the responsibility of health care providers to assess and counsel for exercise, there are logistical, structural, and educational barriers preventing this counseling. A physical activity consultation clinic led by primary care sports medicine physicians would allow for focused exercise counseling by appropriately trained providers to motivated patients. While previously there have been many institutional and logistical barriers to establishing such a clinic, the COVID-19 pandemic has created a window of opportunity for doing so within a large academic medical center. This article reviews the importance of exercise on overall health, outlines the barriers for establishing a clinical experience dedicated to counseling for physical activity, and details how overcoming those barriers was facilitated by the COVID-19 pandemic.
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Affiliation(s)
- Jessica F Butts
- Departments of Family & Community Medicine, and Orthopedics & Rehabilitation, Penn State Milton S. Hershey Medical Center, Hershey, PA
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Rodrigues JC, Avila MA, Driusso P. Transcutaneous electrical nerve stimulation for women with primary dysmenorrhea: Study protocol for a randomized controlled clinical trial with economic evaluation. PLoS One 2021; 16:e0250111. [PMID: 34014922 PMCID: PMC8136645 DOI: 10.1371/journal.pone.0250111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 03/29/2021] [Indexed: 12/02/2022] Open
Abstract
Primary dysmenorrhea (PD) is a common gynecological disorder characterized by cramping pain in the lower abdomen during menstruation, in the absence of identifiable pathology. While Transcutaneous Electrical Nerve Stimulation (TENS) is used to promote PD pain relief, there is still a need to understand the parameters and cost-effectiveness of this intervention. As such, this study aims to disclose a study that will evaluate the effectiveness and cost-effectiveness of TENS on pain intensity in women with PD. This is a protocol for an assessor-blinded randomized controlled trial that includes 174 women with PD, >18 years old, with menstrual pain greater than or equal to four points in the Numerical Rating Scale. Participants will be randomized into three groups (active TENS, placebo TENS, and educational booklet). Participants allocated to the active TENS group will receive electrical stimulation (F = 100 Hz, pulse duration = 200 μs, for 30 min). In contrast, the placebo TENS group will receive placebo stimulation (same parameters, but for only 30 s, and then the current will be ramped off over a 15-s time frame) for three consecutive months during menstruation. Participants allocated to the educational booklet group will receive instructions about health promotion and education actions related to PD. A blinded assessor will evaluate the pain intensity (Numerical Rating Scale), presenteeism (Stanford Presenteeism Scale), Health-Related Quality of Life (Short-Form 6 dimensions and SF-36), and health costs of menstrual pain. This is the first study to propose a health economic evaluation while assessing the benefits of using TENS to treat PD symptoms. It is hypothesized that active TENS will be more effective than placebo TENS or the educational booklet in improving clinical outcomes in the short-, medium- and long-term. The study will also provide information about the cost-effectiveness of TENS, which can be used by policy makers to improve PD care in public and private health systems.
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Affiliation(s)
- Jéssica Cordeiro Rodrigues
- Women’s Health Research Laboratory (LAMU), Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Mariana Arias Avila
- Laboratory of Research on Electrophysical Agents (LAREF), Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil
| | - Patricia Driusso
- Women’s Health Research Laboratory (LAMU), Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil
- * E-mail:
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Motivation for Physical Activity: Validation of the Dutch Version of the Physical Activity and Leisure Motivation Scale (PALMS). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105328. [PMID: 34067770 PMCID: PMC8156727 DOI: 10.3390/ijerph18105328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/13/2021] [Accepted: 05/14/2021] [Indexed: 01/04/2023]
Abstract
Understanding motivation for exercise can be helpful in improving levels of physical activity. The Physical Activity and Leisure Motivation Scale (PALMS) measures distinct goal-oriented motivations. In this study selected measurement properties of the Dutch version (PALMS-D) are determined. Forward-backward translation was used for cross-cultural adaptation. Construct validity of the PALMS-D was assessed in five subsamples completing the PALMS-D and the Behavioral Regulation in Exercise Questionnaire (BREQ-3). The study population consisted of five samples recruited from different populations; samples consisted of runners, hockey players, soccer players, participants in medical fitness, and a sedentary group of young adults with low activity. A total of 733 participants completed the questionnaire: 562 athletes and 171 non-athletes. Exploratory for Analysis confirmed the original eight factors. Internal consistency of the subscales was high, except for Others’ expectations. The a priori determined hypotheses related to differences between athletes participating in different sports were confirmed, as well as the hypothesis related to differences between amateur athletes, patients in medical fitness, and non-active participants. It was concluded that the Dutch version of the PALMS is an acceptable questionnaire with which to evaluate the individual motivation of athletes in the Netherlands, and discriminates between different leisure athletes, patients in medical fitness, and non-active youths.
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Mattli R, Farcher R, Syleouni ME, Wieser S, Probst-Hensch N, Schmidt-Trucksäss A, Schwenkglenks M. Physical Activity Interventions for Primary Prevention in Adults: A Systematic Review of Randomized Controlled Trial-Based Economic Evaluations. Sports Med 2021; 50:731-750. [PMID: 31755043 DOI: 10.1007/s40279-019-01233-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Physical inactivity is a worldwide pandemic associated with major chronic diseases. Given limited resources, policy makers are in need of physical activity interventions that provide best value for money. OBJECTIVE To summarize evidence from RCT-based economic evaluations of primary prevention physical activity interventions in adult populations outside the workplace setting. DESIGN Systematic review of health economic evaluations. Incremental cost-effectiveness ratios (ICERs) in US$ per MET-hour gained were estimated on the basis of mean differences in intervention costs and standardized effects between intervention and control groups. DATA SOURCES Identification of relevant studies via systematic searches in electronic databases (MEDLINE, Embase and NHSEED). ELIGIBILITY CRITERIA Cost-effectiveness analyses in which all data (except unit costs) came from one RCT investigating physical activity interventions for primary prevention or health promotion in an adult population in high-income countries. RESULTS In twelve eligible studies, 22 interventions were investigated. Interventions were based on advice, goal setting and follow-up support, exercise classes, financial incentives or teaching on behavioral change. The ICER varied widely among the interventions and four interventions showed an ICER below the applied benchmark of US$0.44 to US$0.63 per MET-hour gained. These four interventions were based on individualized advice via print or web. CONCLUSION We found evidence from RCTs indicating cost-effectiveness of some physical activity interventions for primary prevention in adults. However, the majority of interventions assessed would not be cost-effective according to the benchmark applied. Furthermore, our study showed that trial-based evidence on cost-effectiveness of physical activity interventions is scarce. Therefore, we recommend that future studies investigating the efficacy or effectiveness of such interventions consider costs as an additional outcome and assess cost-effectiveness.
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Affiliation(s)
- Renato Mattli
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland. .,Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Gertrudstrasse 15, 8401, Winterthur, Switzerland.
| | - Renato Farcher
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Gertrudstrasse 15, 8401, Winterthur, Switzerland
| | - Maria-Eleni Syleouni
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Gertrudstrasse 15, 8401, Winterthur, Switzerland
| | - Simon Wieser
- Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Gertrudstrasse 15, 8401, Winterthur, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, Switzerland.,University of Basel, Petersplatz 1, 4001, Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Mittlere Allee 18, 4052, Basel, Switzerland
| | - Matthias Schwenkglenks
- Institute of Pharmaceutical Medicine (ECPM), University of Basel, Klingelbergstrasse 61, 4056, Basel, Switzerland
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Mizdrak A, Ding D, Cleghorn C, Blakely T, Richards J. Hitting the Target but Missing the Point? Modelling Health and Economic Impacts of Different Approaches to Meeting the Global Action Plan for Physical Activity Target. Sports Med 2021; 51:815-823. [PMID: 33433862 PMCID: PMC7981302 DOI: 10.1007/s40279-020-01398-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND The World Health Organization launched the Global Action Plan for Physical Activity (GAPPA) in 2018, which set a global target of a 15% relative reduction in the prevalence of physical inactivity by 2030. This target, however, could be acheived in various ways. METHODS We use an established multi-state life table model to estimate the health and economic gains that would accrue over the lifetime of the 2011 New Zealand population if the GAPPA target was met under two different approaches: (1) an equal shift approach where physical activity increases by the same absolute amount for everyone; (2) a proportional shift approach where physical activity increases proportionally to current activity levels. FINDINGS An equal shift approach to meeting the GAPPA target would result in 197,000 health-adjusted life-years (HALYs) gained (95% uncertainty interval (UI) 152,000-246,000) and healthcare system cost savings of US$1.57b (95%UI $1.16b-$2.03b; 0% discount rate). A proportional shift to the GAPPA target would result in 158,000 HALYs (95%UI 127,000-194,000) and US$1.29billion (95%UI $0.99b-$1.64b) savings to the healthcare system. INTERPRETATION Achieving the GAPPA target would result in large health gains and savings to the healthcare system. However, not all population approaches to increasing physical activity are equal-some population shifts bring greater health benefits. Our results demonstrate the need to consider the entire population physical activity distribution in addition to evaluating progress towards a target.
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Affiliation(s)
- Anja Mizdrak
- Department of Public Health, University of Otago (Wellington), 23 Mein Street, Newtown, Wellington, New Zealand.
| | - Ding Ding
- Prevention Research Collaboration, Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - Christine Cleghorn
- Department of Public Health, University of Otago (Wellington), 23 Mein Street, Newtown, Wellington, New Zealand
| | - Tony Blakely
- Department of Public Health, University of Otago (Wellington), 23 Mein Street, Newtown, Wellington, New Zealand
- Population Interventions, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Justin Richards
- Faculty of Health, Victoria University Wellington, Wellington, New Zealand
- Sport New Zealand, Wellington, New Zealand
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Hafner M, Yerushalmi E, Stepanek M, Phillips W, Pollard J, Deshpande A, Whitmore M, Millard F, Subel S, van Stolk C. Estimating the global economic benefits of physically active populations over 30 years (2020-2050). Br J Sports Med 2021; 54:1482-1487. [PMID: 33239354 PMCID: PMC7719903 DOI: 10.1136/bjsports-2020-102590] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 01/15/2023]
Abstract
Objectives We assess the potential benefits of increased physical activity for the global economy for 23 countries and the rest of the world from 2020 to 2050. The main factors taken into account in the economic assessment are excess mortality and lower productivity. Methods This study links three methodologies. First, we estimate the association between physical inactivity and workplace productivity using multivariable regression models with proprietary data on 120 143 individuals in the UK and six Asian countries (Australia, Malaysia, Hong Kong, Thailand, Singapore and Sri Lanka). Second, we analyse the association between physical activity and mortality risk through a meta-regression analysis with data from 74 prior studies with global coverage. Finally, the estimated effects are combined in a computable general equilibrium macroeconomic model to project the economic benefits of physical activity over time. Results Doing at least 150 min of moderate-intensity physical activity per week, as per lower limit of the range recommended by the 2020 WHO guidelines, would lead to an increase in global gross domestic product (GDP) of 0.15%–0.24% per year by 2050, worth up to US$314–446 billion per year and US$6.0–8.6 trillion cumulatively over the 30-year projection horizon (in 2019 prices). The results vary by country due to differences in baseline levels of physical activity and GDP per capita. Conclusions Increasing physical activity in the population would lead to reduction in working-age mortality and morbidity and an increase in productivity, particularly through lower presenteeism, leading to substantial economic gains for the global economy.
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Affiliation(s)
| | - Erez Yerushalmi
- Birmingham City Business School, Birmingham City University, Birmingham, Birmingham, UK
| | - Martin Stepanek
- Charles University, Institute of Economic Studies, Praha, Praha, Czech Republic.,Vitality Corporate Services Limited, London, London, UK
| | | | - Jack Pollard
- Health Economics Research Centre, University of Oxford, Oxford, UK
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Coughlan D, Saint-Maurice PF, Carlson SA, Fulton J, Matthews CE. Leisure time physical activity throughout adulthood is associated with lower medicare costs: evidence from the linked NIH-AARP diet and health study cohort. BMJ Open Sport Exerc Med 2021; 7:e001038. [PMID: 33768963 PMCID: PMC7938970 DOI: 10.1136/bmjsem-2021-001038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 01/12/2023] Open
Abstract
Background There is limited information about the association between long-term leisure time physical activity (LTPA) participation and healthcare costs. The purpose of this study was to investigate the association between LTPA over adulthood with later life healthcare costs in the USA. Methods Using Medicare claims data (between 1999 and 2008) linked to the National Institutes of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study, we examined associations between nine trajectories of physical activity participation throughout adulthood with Medicare costs. Results Compared with adults who were consistently inactive from adolescence into middle age, average annual healthcare costs were significantly lower for maintainers, adults who maintained moderate (–US$1350 (95% CI: –US$2009 to –US$690) or −15.9% (95% CI: −23.6% to −8.1%)) or high physical activity levels (–US$1200 (95% CI: –US$1777 to –US$622) or −14.1% (95% CI: −20.9% to −7.3%)) and increasers, adults who increased physical activity levels in early adulthood (–US$1874 (95% CI: US$2691 to –US$1057) or −22.0% (95% CI: −31.6% to −12.4%)) or in middle age (–US$824 (95% CI: –US$1580 to –US$69 or −9.7% (95% CI −18.6% to −0.8%)). For the four trajectories where physical activity decreased, the only significant difference was for adults who increased physical activity levels during early adulthood with a decline in middle age (–US$861 (95% CI:–US$1678 to –US$45) or −10.1% (95% CI: −19.7% to −0.5%)). Conclusion Our analyses suggest the healthcare cost burden in later life could be reduced through promotion efforts supporting physical activity participation throughout adulthood.
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Affiliation(s)
- Diarmuid Coughlan
- Health Economics Group, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Surveillance Research Program, Division of Cancer Control & Population Sciences, National Cancer Institute, Bethesda, Maryland, USA
| | - Pedro F Saint-Maurice
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Susan A Carlson
- Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Janet Fulton
- Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Charles E Matthews
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
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50
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Ur Rehman A, Hassali MAA, Muhammad SA, Shakeel S, Chin OS, Ali IABH, Muneswarao J, Hussain R. Economic Burden of Chronic Obstructive Pulmonary Disease Patients in Malaysia: A Longitudinal Study. PHARMACOECONOMICS - OPEN 2021; 5:35-44. [PMID: 32291727 PMCID: PMC7895885 DOI: 10.1007/s41669-020-00214-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) requires long-term pharmacological and non-pharmacological management that encompasses continuous economic burden on patients and society, and also results in productivity losses due to compromised quality of life. Among working-age patients, COPD is the 11th leading cause of work productivity loss. OBJECTIVE The aim of this study was to assess the economic burden of COPD in Malaysia, including direct costs for the management of COPD and indirect costs due to productivity losses for COPD patients. METHODOLOGY Overall, 150 patients with an established diagnosis of COPD were followed-up for a period of 1 year from August 2018 to August 2019. An activity-based costing, 'bottom-up' approach was used to calculate direct costs, while indirect costs of patients were assessed using the Work Productivity and Activity Impairment Questionnaire. RESULTS The mean annual per-patient direct cost for the management of COPD was calculated as US$506.92. The mean annual costs per patient in the management phase, emergency department visits, and hospital admissions were reported as US$395.65, US$86.4, and US$297.79, respectively; 31.66% of COPD patients visited the emergency department and 42.47% of COPD patients were admitted to the hospital due to exacerbation. The annual mean indirect cost per patient was calculated as US$1699.76. Productivity losses at the workplace were reported as 31.87% and activity limitations were reported as 17.42%. CONCLUSION Drugs and consumables costs were the main cost-driving factors in the management of COPD. The higher ratio of indirect cost to direct medical costs shows that therapeutic interventions aimed to prevent work productivity losses may reduce the economic burden of COPD.
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Affiliation(s)
- Anees Ur Rehman
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia.
- Faculty of Pharmacy, Bahauddin Zakariya University Multan, Punjab, Pakistan.
| | - Mohamed Azmi Ahmad Hassali
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia
| | | | - Sadia Shakeel
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia
| | - Ong Siew Chin
- Department of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia
| | | | - Jaya Muneswarao
- Department of Clinical Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia
| | - Rabia Hussain
- Department of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, University Sains Malaysia, Penang, Malaysia
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