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Leijon M, Algotson A, Bernhardsson S, Ekholm D, Ersberg L, Höök MJS, Klüft C, Müssener U, Garås ES, Nilsen P. Generation Pep - study protocol for an intersectoral community-wide physical activity and healthy eating habits initiative for children and young people in Sweden. Front Public Health 2024; 12:1299099. [PMID: 38435288 PMCID: PMC10904517 DOI: 10.3389/fpubh.2024.1299099] [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: 10/18/2023] [Accepted: 01/29/2024] [Indexed: 03/05/2024] Open
Abstract
Background There is overwhelming evidence for the preventive effects of regular physical activity and healthy eating habits on the risk for developing a non-communicable disease (NCD). Increasing attention has been paid to community-wide approaches in the battle against NCDs. Communities can create supportive policies, modify physical environments, and foster local stakeholder engagement through intersectoral collaboration to encourage communities to support healthy lifestyles. The Pep initiative is based on intersectoral community-wide collaboration among Sweden's municipalities. Primary targets are municipality professionals who work with children and young people as well as parents of children <18 years. The goal is to spread knowledge and create commitment to children's and young people's health with a special focus on physical activity and healthy eating habits to facilitate and support a healthy lifestyle. The overarching aim of the research project described in this study protocol is to investigate factors that influence the implementation of the Pep initiative in Sweden, to inform tailored implementation strategies addressing the needs and local prerequisites of the different municipalities. Methods The project includes a qualitative and a quantitative study and is framed by a theoretical model involving four complementary forms of knowledge, explicitly recognized in the Pep initiative: knowledge about the issue; knowledge about interventions; knowledge about the context; and knowledge about implementation. Study 1 is a focus group study exploring barriers and facilitators for implementing the Pep initiative. The study will be carried out in six municipalities, selected purposively to provide wide variation in municipality characteristics, including population size and geographical location. Data will be analyzed using thematic analysis. Study 2 is a cross-sectional web-based survey investigating the implementability of the Pep initiative in Sweden's 290 municipalities. Conditions for implementing different areas of the Pep initiative will be examined in terms of the acceptability, appropriateness, and feasibility, three predictors of implementation success. Data will be analyzed using non-parametric statistics. Discussion The findings of the two studies will increase understanding of the prerequisites for implementing the Pep initiative in Swedish municipalities, which will provide valuable input into how implementation of the Pep initiative can best be facilitated in the different municipality settings.
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Affiliation(s)
- Matti Leijon
- Generation Pep, Stockholm, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Albin Algotson
- Department of Management and Engineering, Faculty of Science and Engineering, Linköping University, Linköping, Sweden
| | - Susanne Bernhardsson
- Region Västra Götaland, Research, Education, Development, and Innovation Primary Health Care, Gothenburg, Sweden
- Department of Health and Rehabilitation, Unit of Physiotherapy, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - David Ekholm
- Department of Culture and Society, Linköping University, Linköping, Sweden
| | | | | | - Carolina Klüft
- Generation Pep, Stockholm, Sweden
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ulrika Müssener
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | | | - Per Nilsen
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Ioannou E, Chen HL, Bromley V, Fosker S, Ali K, Fernando A, Mensah E, Fowler-Davis S. The key values and factors identified by older adults to promote physical activity and reduce sedentary behaviour using co-production approaches: a scoping review. BMC Geriatr 2023; 23:371. [PMID: 37328734 PMCID: PMC10276377 DOI: 10.1186/s12877-023-04005-x] [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: 10/28/2022] [Accepted: 04/26/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Inactivity and sedentary behaviour in older adults adversely impacts physical function, reduces social networks, and could contribute to population healthcare costs. To encourage and support the planning and uptake of physical activity by older adults, it is important to understand what physical activity means to older adults. Therefore, the aim of this scoping review was to collate what older adults have self-identified as the key factors for sustaining and increasing their physical activities. METHODS Arksey and O'Malley's Scoping Review framework was used to guide the review process. SCOPUS, ASSIA, PsychINFO and MEDLINE databases were searched. Studies were eligible for inclusion if they were peer-reviewed, the target population were older adults (aged 55 and above), co-production related research approaches were explicitly stated in the methods and there was a focus on design of physical activity interventions or products to support or enhance physical activity. Assets and values important for physical activity were first extracted from included studies and were subsequently thematically analysed. Themes are presented to provide an overview of the literature synthesis. RESULTS Sixteen papers were included in the analysis. Data from these papers were gathered via designing interventions or services (n = 8), products (n = 2), 'exergames' (n = 2) or mobile applications (n = 4). Outcomes were varied but common themes emerged across papers. Overarching themes identified by older adults were associated with a desire to increase activity when it was accessible, motivational, and safe. In addition, older adults want to enjoy their activities, want independence and representation, want to stay connected with families and friends, be outdoors, familiarity, activities to be tailored and resulting in measurable/observed progress. CONCLUSIONS Population demographics, personal attributes, and life experiences all affect preferences for physical activity. However, the key factors identified by older adults for increasing physical activity were common-even in separate co-production contexts. To promote physical activities in older adults, activities must fundamentally feel safe, provide a sense of social connectedness, be enjoyable and be accessible in terms of cost and ability.
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Affiliation(s)
- Elysa Ioannou
- Sport and Physical Activity Research Centre (SPARC), Sheffield Hallam University, Sheffield, UK
| | - Henglien Lisa Chen
- University of Sussex (Social Work and Social Care), Brighton and Hove, UK
| | - Vicky Bromley
- University of Sussex (Social Work and Social Care), Brighton and Hove, UK
| | - Sam Fosker
- Royal London Hospital, London; Founder, Cush Health, London, UK
| | - Khalid Ali
- Brighton and Sussex Medical School, Brighton and Hove, UK
| | - Avanka Fernando
- University of Sussex (Social Work and Social Care), Brighton and Hove, UK
| | - Ekow Mensah
- University Hospitals NHS Trust, Nottingham, UK
| | - Sally Fowler-Davis
- Advanced Wellbeing Research Centre (AWRC), Sheffield Hallam University, Sheffield, UK.
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Lunetto M, Castro O, Gericke C, Hale J. Barriers and enablers to local active travel during COVID-19: A case study of Streetspace interventions in two London boroughs. Wellcome Open Res 2023; 8:177. [PMID: 37663794 PMCID: PMC10468679 DOI: 10.12688/wellcomeopenres.19164.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2023] [Indexed: 09/05/2023] Open
Abstract
Background: During the coronavirus disease 2019 (COVID-19) pandemic, UK local authorities increased emergency active travel interventions. This study aimed to understand what aspects of temporary Streetspace for London schemes represent barriers or enablers to walking and cycling for short local journeys. Methods: Focusing on two Inner London boroughs, we conducted 21 semi-structured stakeholder interviews and sampled 885 public comments about Streetspace schemes. We triangulated the data in a thematic analysis to identify barriers and enablers, which were categorised using the Capability, Opportunity, Motivation, Behaviour (COM-B) model. Results: Opportunity and motivation factors were reflected in the barriers (accessibility and integration of the schemes; controversy, dissatisfaction, and doubt) and enablers (new routes and spaces; sustainability and health beliefs) and mixed themes (changes to traffic and appeal of the area; feelings of safety). Capability was not reflected in the main themes. Conclusions: Although aspects of Streetspace schemes were seen to enable active travel, our findings suggest that additional processes to address the acceptability, fairness, and unintended consequences of emergency interventions will be important to their long-term success for health and sustainability.
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Affiliation(s)
- Maria Lunetto
- Centre for Behaviour Change, University College London, London, England, WC1E 6AE, UK
| | - Oscar Castro
- Centre for Behaviour Change, University College London, London, England, WC1E 6AE, UK
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise, National University of Singapore University Town, 138602, Singapore
| | - Chiara Gericke
- Centre for Behaviour Change, University College London, London, England, WC1E 6AE, UK
| | - Joanna Hale
- Centre for Behaviour Change, University College London, London, England, WC1E 6AE, UK
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Al Halabi A, Habas E, Farfar KL, Ghazouani H, Alfitori G, Abdulla MA, Borham AM, Khan FY. Time Spent on Medical Round Activities, Distance Walked, and Time-Motion in the General Medicine Department at Hamad General Hospital in Qatar. Cureus 2023; 15:e37935. [PMID: 37220459 PMCID: PMC10200253 DOI: 10.7759/cureus.37935] [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] [Accepted: 04/21/2023] [Indexed: 05/25/2023] Open
Abstract
Background The daily morning round is a routine activity performed by medical teams. During the morning round, updates on the patient's clinical condition, new laboratory results, and other test results are reviewed and discussed between team members, the patient, and at times the family. Completing these tasks takes time. The design of the patient location differs between hospitals, and significant distance between patients can considerably affect round times. This study assesses physicians' time spent on clinical activities, the distance traveled, and the time they spend walking between patients during daily morning rounds to identify better reorganization methods to reduce wasted time. Methodology The survey was self-administered and had no intervention needing ethical approval. The research team's leader engaged two observers (a general practitioner from another department and a general internal medicine department case manager) to collect the data. The general practitioner was a medical graduate doctor, while the bed manager was not a medical college graduate. They observed 10 rounds over 10 non-consecutive days from July 1 to July 30, 2022. They recorded daily activities during the daily morning round, including time spent with patients, family conversations, bedside education, medication, social issues, and the time and distance required to move from patient to patient and from one location to location. The informal conversations about age, work history, and other small talk were recorded and converted into quantitative data. In each round, records were given to a statistician for rechecking. Subsequently, the records were imported into a Microsoft Excel spreadsheet for further statistical analysis. For continuous variables, the data were summarized as mean, median, and standard deviation. For categorical variables, the data were summarized as counts or proportions. Results On average, the duration of the daily morning round was 161.7 ± 17.3 minutes. The average number of patients seen by the general internal medicine round team was 14. The median patient encounter time per patient was 14 minutes (11-19 minutes), with an average of 12 minutes. An average of 8.6 employees participated in the 10-day rounds. The physician spent 41.2% of the time in direct contact with the patient during the morning round, 11.4% in maintaining electronic medical records, and 18.20% in bedside teaching. Additionally, 7.1% of the round time was spent because of interruptions by clinical and non-clinical staff other than team members or family members who were not in the room. Furthermore, a team member walked an average of 763 ± 54.5 m (667-872 m) per round, costing 35.7 minutes (22.1%) of the total round time. Conclusions The daily morning round time was significantly longer compared with the reported round times. Relocating patient beds to a common location reduced the rounding time by 22.30%. Disruption, teaching, and medical instruction must also be considered and shortened to reduce the morning round time.
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Affiliation(s)
- Anas Al Halabi
- Quality and Patient Safety, Hamad Medical Corporation, Doha, QAT
| | | | | | - Hafedh Ghazouani
- Quality and Patient Safety, Hamad Medical Corporation, Doha, QAT
| | | | - Moza A Abdulla
- Quality and Patient Safety, Hamad Medical Corporation, Doha, QAT
| | | | - Fahmi Y Khan
- Internal Medicine, Hamad General Hospital, Doha, QAT
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Durão S, Burns J, Schmidt BM, Tumusiime D, Hohlfeld A, Pfadenhauer L, Ongolo-Zogo C, Rehfuess E, Kredo T. Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review. BMC Public Health 2023; 23:112. [PMID: 36647042 PMCID: PMC9841711 DOI: 10.1186/s12889-022-14841-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/08/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity at a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity. METHODS We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction. RESULTS We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence). CONCLUSIONS Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings. TRIAL REGISTRATION PROSPERO 2018 CRD42018093429.
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Affiliation(s)
- Solange Durão
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa.
| | - Jacob Burns
- grid.5252.00000 0004 1936 973XInstitute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany ,Pettenkofer School of Public Health, Munich, Germany
| | - Bey-Marrié Schmidt
- grid.415021.30000 0000 9155 0024Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa ,grid.8974.20000 0001 2156 8226School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - David Tumusiime
- grid.10818.300000 0004 0620 2260College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Ameer Hohlfeld
- grid.415021.30000 0000 9155 0024Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Lisa Pfadenhauer
- grid.5252.00000 0004 1936 973XInstitute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany ,Pettenkofer School of Public Health, Munich, Germany
| | - Clémence Ongolo-Zogo
- grid.17063.330000 0001 2157 2938Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Eva Rehfuess
- grid.5252.00000 0004 1936 973XInstitute for Medical Information Processing, Biometry and Epidemiology, Pettenkofer School of Public Health, LMU Munich, Munich, Germany ,Pettenkofer School of Public Health, Munich, Germany
| | - Tamara Kredo
- grid.415021.30000 0000 9155 0024Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
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den Braver NR, Garcia Bengoechea E, Messing S, Kelly L, Schoonmade LJ, Volf K, Zukowska J, Gelius P, Forberger S, Woods CB, Lakerveld J. The impact of mass-media campaigns on physical activity: a review of reviews through a policy lens. Eur J Public Health 2022; 32:iv71-iv83. [PMID: 36444108 PMCID: PMC9706123 DOI: 10.1093/eurpub/ckac085] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND This review of reviews aimed to: (1) summarize the evidence from published reviews on the effectiveness of mass-media campaigns to promote physical activity (PA) or PA-related determinants (intermediate psychological and proximal outcomes) and (2) to identify policy-relevant recommendations related to successful PA campaigns. METHODS An extensive literature search was performed on 1 March 2021. Reviews that evaluated the impact of campaigns on distal (e.g. PA) and/or proximal outcomes of PA (awareness, knowledge, etc.) and that targeted the general population or subsets were included. Quality of reviews was assessed using the AMSTAR-2 tool. Policy-relevant recommendations were systematically derived and synthesized and formulated as good practice statements. A protocol was registered beforehand (ID: CRD42021249184). RESULTS A total of 1915 studies were identified, of which 22 reviews were included. The most consistent evidence was found for the effectiveness of mass-media campaigns on proximal outcomes, while the evidence for distal outcomes was mixed. Good practice statements were derived: (1) to achieve behaviour change, mass-media is an important component of larger, multilevel and multicomponent strategies; (2) mass-media strategies should be coordinated and aligned at local- and national-level and be sustained, monitored and resourced at these levels and (3) media should be tailored to reduce socioeconomic inequalities. CONCLUSIONS Mass-media can play an important role in the promotion of PA. In general, evidence was more inconsistent for effectiveness on distal outcomes than for proximal outcomes. Policy-relevant recommendations include that mass-media strategies should be resourced, coordinated, aligned, sustained, monitored and evaluated on the local and national level.
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Affiliation(s)
- Nicolette R den Braver
- Correspondence: Nicolette R. den Braver, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institutes, Amsterdam University Medical Centres, De Boelelaan 1089a, 1081HV Amsterdam, The Netherlands, Tel: +31 20 44 430 80, e-mail:
| | - Enrique Garcia Bengoechea
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland,Research and Innovation Unit, Sport Ireland, Ireland
| | - Sven Messing
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Liam Kelly
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Linda J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kevin Volf
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Joanna Zukowska
- Faculty of Civil and Environmental Engineering, Gdansk University of Technology, Gdansk, Poland
| | - Peter Gelius
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sarah Forberger
- Leibniz Institute for Prevention Research and Epidemiology—BIPS, Bremen, Germany
| | - Catherine B Woods
- Department of Physical Education and Sport Sciences, Physical Activity for Health Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - J Lakerveld
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institutes, Amsterdam University Medical Centres, Amsterdam, The Netherlands,Upstream Team, Amsterdam, The Netherlands
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Warner A, Vanicek N, Benson A, Myers T, Abt G. Agreement and relationship between measures of absolute and relative intensity during walking: A systematic review with meta-regression. PLoS One 2022; 17:e0277031. [PMID: 36327341 PMCID: PMC9632890 DOI: 10.1371/journal.pone.0277031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION A metabolic equivalent (MET) is one of the most common methods used to objectively quantify physical activity intensity. Although the MET provides an 'objective' measure, it does not account for inter-individual differences in cardiorespiratory fitness. In contrast, 'relative' measures of physical activity intensity, such as heart rate reserve (HRR), do account for cardiorespiratory fitness. The purpose of this systematic review with meta-regression was to compare measures of absolute and relative physical activity intensity collected during walking. METHODS A systematic search of four databases (SPORTDiscus, Medline, Academic Search Premier and CINAHL) was completed. Keyword searches were: (i) step* OR walk* OR strid* OR "physical activity"; (ii) absolute OR "absolute intensity" OR mets OR metabolic equivalent OR actigraph* OR acceleromet*; (iii) relative OR "relative intensity" OR "heart rate" OR "heart rate reserve" OR "VO2 reserve" OR VO2* OR "VO2 uptake" OR HRmax* OR metmax. Categories (i) to (iii) were combined using 'AND;' with studies related to running excluded. A Bayesian regression was conducted to quantify the relationship between METs and %HRR, with Bayesian logistic regression conducted to examine the classification agreement between methods. A modified Downs and Black scale incorporating 13 questions relative to cross-sectional study design was used to assess quality and risk of bias in all included studies. RESULTS A total of 15 papers were included in the systematic review. A comparison of means between absolute (METs) and relative (%HRR, %HRmax, %VO2R, %VO2max, HRindex) values in 8 studies identified agreement in how intensity was classified (light, moderate or vigorous) in 60% of the trials. We received raw data from three authors, incorporating 3 studies and 290 participants. A Bayesian random intercept logistic regression was conducted to examine the agreement between relative and absolute intensity, showing agreement in 43% of all trials. Two studies had identical relative variables (%HRR) totalling 240 participants included in the Bayesian random intercept regression. The best performing model was a log-log regression, which showed that for every 1% increase in METs, %HRR increased by 1.12% (95% CI: 1.10-1.14). Specifically, the model predicts at the lower bound of absolute moderate intensity (3 METs), %HRR was estimated to be 33% (95%CI: 18-57) and at vigorous intensity (6 METs) %HRR was estimated to be 71% (38-100). CONCLUSION This study highlights the discrepancies between absolute and relative measures of physical activity intensity during walking with large disagreement observed between methods and large variation in %HRR at a given MET. Consequently, health professionals should be aware of this lack of agreement between absolute and relative measures. Moreover, if we are to move towards a more individualised approach to exercise prescription and monitoring as advocated, relative intensity could be more highly prioritised.
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Affiliation(s)
- Ashley Warner
- Department of Sport, Health and Exercise Science, University of Hull, Hull, United Kingdom
| | - Natalie Vanicek
- Department of Sport, Health and Exercise Science, University of Hull, Hull, United Kingdom
| | - Amanda Benson
- School of Health Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Tony Myers
- Department of Sport and Health, Newman University, Birmingham, United Kingdom
| | - Grant Abt
- Department of Sport, Health and Exercise Science, University of Hull, Hull, United Kingdom
- * E-mail:
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Jabardo-Camprubí G, Bort-Roig J, Donat-Roca R, Milà-Villarroel R, Sitjà-Rabert M, McKenna J, Puig-Ribera A. A socio-ecological approach to reduce the physical activity drop-out ratio in primary care-based patients with type 2 diabetes: the SENWI study protocol for a randomized control trial. Trials 2022; 23:842. [PMID: 36192800 PMCID: PMC9531392 DOI: 10.1186/s13063-022-06742-7] [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] [Received: 06/17/2022] [Accepted: 09/13/2022] [Indexed: 12/02/2022] Open
Abstract
Background Physical activity (PA) is a key behaviour for patients with type 2 diabetes (T2DM). However, healthcare professionals’ (HCP) recommendations (walking advice), which are short-term and individually focused, did not reduce the PA drop-out ratio in the long run. Using a socio-ecological model approach may contribute to reducing patient dropout and improving adherence to PA. The aim of this study is threefold: first, to evaluate the effectiveness of a theory-driven Nordic walking intervention using a socio-ecological approach with T2DM patients in Spain; second, to explore the feasibility on the PA adherence process in T2DM patients while participating in the SENWI programme; and third, to understand the HCPs’ opinion regarding its applicability within the Spanish healthcare system. Methods A three-arm randomized control trial (n = 48 each group) will assess the efficacy of two primary care-based PA interventions (Nordic walking vs. Nordic walking plus socio-ecological approach; two sessions per week for twelve weeks) compared to a control group (usual HCPs’ walking advice on PA). Inclusion criteria will include physically inactive patients with T2DM, older than 40 years and without health contraindications to do PA. PA levels and drop-out ratio, quality of life and metabolic and health outcomes will be assessed at baseline, post-intervention and at 9- and 21-month follow-ups. The effect of the different interventions will be assessed by a two-factor analysis of variance: treatment group vs time. Also, a two-factor ANOVA test will be performed with linear mixed models for repeated measures. A qualitative analysis using focus groups will explore the reasons for the (in)effectiveness of the new PA interventions. Qualitative outcomes will be assessed at post-intervention using thematic analysis. Discussion Compared with the general PA walking advice and Nordic walking prescriptions, integrating a socio-ecological approach into Spanish primary care visits could be an effective way to reduce the PA drop-out ratio and increase PA levels in patients with T2DM. Such interventions are necessary to understand the role that multiple socio-complex process in day-to-day PA behaviour has in patients with T2DM in the Spanish context. Trial registration ClinicalTrials.gov NCT05159089. Physical Activity Drop-out Ratio in Patients’ Living with Type 2 Diabetes. Prospectively registered on 15 December 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06742-7.
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Affiliation(s)
- Guillem Jabardo-Camprubí
- Sports and Physical Activity Research Group, Centre for Health and Social Research, University of Vic-Central University of Catalonia, Sagrada Familia 7, Barcelona, VIC, Spain.
| | - Judit Bort-Roig
- Sports and Physical Activity Research Group, Centre for Health and Social Research, University of Vic-Central University of Catalonia, Sagrada Familia 7, Barcelona, VIC, Spain
| | - Rafel Donat-Roca
- School of Health Science UManresa, Sport Exercise and Human Movement (SEaMH), University of Vic-Central University of Catalonia, Av. Universitaria 4-6, Manresa, Spain
| | - Raimon Milà-Villarroel
- School of Health Science Blanquerna, Ramon Llull University, Padilla, 326-332, Barcelona, Spain
| | - Mercè Sitjà-Rabert
- School of Health Science Blanquerna, Global Research on Wellbeing (GRoW) Research Group, Ramon Llull University, Padilla, 326-332, Barcelona, Spain
| | - Jim McKenna
- School of Sport, Leeds Becket University, Leeds, LS1 3HE, Leeds, England
| | - Anna Puig-Ribera
- Sports and Physical Activity Research Group, Centre for Health and Social Research, University of Vic-Central University of Catalonia, Sagrada Familia 7, Barcelona, VIC, Spain
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Barriers and Motivators to Physical Activity Prior to Starting a Community-Based Walking Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010659. [PMID: 34682405 PMCID: PMC8535237 DOI: 10.3390/ijerph182010659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 10/07/2021] [Accepted: 10/11/2021] [Indexed: 11/17/2022]
Abstract
Despite the clear benefits of an active lifestyle, most American adults fail to meet physical activity (PA) guidelines. Because of its safety and ease, walking is a promising population-level strategy to increase PA. There is a need to further understand why adults do and do not participate in walking. This study provides a broader understanding of barriers and motivators of walking prior to starting a walking program. Four years of baseline data from a community-based walking program were analyzed (n = 1491). Descriptive statistics summarized participant characteristics, barriers, reinforcements, and current PA. Chi-square tests were used to assess differences in the barrier and reinforcement responses between participant’s PA level and age categories. Open-ended responses were analyzed using thematic analysis. On average, participants were white (96%), middle-aged (52 ± 13 years old) females (92%). Poor weather and time were frequently reported barriers to walking. Open-ended responses (n = 141) identified additional barriers of lack of motivation (n = 37), joint issues (n = 29), fatigue (n = 24), safety or lack of environmental supports (n = 17), family or work demands (n = 15), and lacking a walking partner (n = 9). Good weather, health, and weight loss were frequently reported motivators. Additional motivators (n = 282) identified included stress relief and mental health (n = 82), social time (n = 70), dog care (n = 41), other health benefits (n = 38), connect with nature (n = 19), enjoyment (14), occupation (n = 11), and environmental and community supports (n = 6). Findings highlight the importance of understanding participant barriers and motivators for PA before starting a program. Future research should examine how reported barriers and motivators are related to program completion and adherence. Tailoring community-based programs to address specific barriers and motivators may enable more participants to effectively change and maintain PA.
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Saito Y, Tanaka A, Tajima T, Ito T, Aihara Y, Nakano K, Kamada M, Inoue S, Miyachi M, Lee IM, Oguma Y. A community-wide intervention to promote physical activity: A five-year quasi-experimental study. Prev Med 2021; 150:106708. [PMID: 34197869 DOI: 10.1016/j.ypmed.2021.106708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 06/14/2021] [Accepted: 06/23/2021] [Indexed: 01/21/2023]
Abstract
Evidence on the effects of a community-wide intervention (CWI) on population-level physical activity (PA), especially in the long term, is limited. Therefore, we evaluated the five-year effect of CWI on promoting PA through information dissemination, education, and community support primarily targeting older adults, by incorporating Japanese guidelines, in Fujisawa City, from 2013. To assess the effect of the whole-city intervention, we distributed questionnaires in 2013, 2015, and 2018 to three independent random samples of 3,000 community-dwelling adults (aged ≥ 20 years) using a quasi-experimental study design. Three separate samples responded to the survey (41% at baseline, 46% at the two-year mark, and 48% at the five-year follow-up). The primary outcome was change in PA participation. At the five-year follow-up, PA (median: 120 minutes/day) was significantly higher than at baseline (86 minutes/day) and the two-year follow-up (90 minutes/day). The results of the multivariate analysis indicated that PA among older adults-the primary target population of the CWI-increased significantly at the five-year follow-up, compared to those aged 20-64 (mean difference of change between groups: 14.7 minutes/day, P= 0.029). Among older adults, PA was significantly lower in those with poorer perceived economic status than in their more well-off counterparts at the two-year follow-up (P= 0.003); however, there was no significant difference at the five-year follow-up (P= 1.000). There was a positive interaction between group and period (mean difference of change between groups: 40.9 minutes/day, P= 0.001). In conclusion, the five-year CWI targeting older adults, incorporating national guidelines, improved population-level PA.
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Affiliation(s)
- Yoshinobu Saito
- Sports Medicine Research Center, Keio University, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa 223-8521, Japan; Center for Innovation Policy, Kanagawa University of Human Services, Research Gate Building TONOMACHI 2-A, 3-25-10 Tonomachi, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-0821, Japan
| | - Ayumi Tanaka
- Division of Health Promotion, Fujisawa City Health and Medical Foundation, 5527-1 Oba, Fujisawa, Kanagawa 251-0861, Japan
| | - Takayuki Tajima
- Sports Medicine Research Center, Keio University, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa 223-8521, Japan; Department of Physical Therapy, Graduate School of Health Sciences, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa, Tokyo 116-8551, Japan
| | - Tomoya Ito
- Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa, Kanagawa 252-0883, Japan
| | - Yoko Aihara
- Health Promotion Division, Health and Welfare Department, Fujisawa City, 2131-1 Kugenuma, Fujisawa, Kanagawa 251-0022, Japan
| | - Kaoko Nakano
- Health Promotion Division, Health and Welfare Department, Fujisawa City, 2131-1 Kugenuma, Fujisawa, Kanagawa 251-0022, Japan
| | - Masamitsu Kamada
- Department of Health Education and Health Sociology, School of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University 6-1-1, Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Motohiko Miyachi
- Department of Physical Activity Research, National Institute of Health and Nutrition, NIBIOHN, 1-23-1 Toyama, Shinjuku-ku, Tokyo 162-8636, Japan
| | - I-Min Lee
- Division of Preventive Medicine, Brigham & Women's Hospital, Harvard Medical School, 900 Commonwealth Ave East, Boston, MA 02215, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
| | - Yuko Oguma
- Sports Medicine Research Center, Keio University, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa 223-8521, Japan; Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa, Kanagawa 252-0883, Japan.
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Developing System-Oriented Interventions and Policies to Reduce Car Dependency for Improved Population Health in Belfast: Study Protocol. SYSTEMS 2021. [DOI: 10.3390/systems9030062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Reducing car dependency requires orchestrated multi-sectoral, multi-policy action in a complex landscape. Thus, development of proposed interventions to reduce car dependency should be informed by systems thinking, complexity science, and socio-technical transition theory. We aim to co-design sustainable systems-oriented intervention approaches to reduce car dependency in Belfast. The study includes seven integrated tasks—1: Map stakeholders and partnerships influencing car dependency using stakeholder network analysis; 2: A review of systematic reviews regarding interventions to reduce car dependency; 3: Map-related policies via analysis of policy documents and semi-structured interviews; 4: A participatory group model building workshop to co-produce a shared understanding of the complex system perpetuating car dependency and a transition vision; 5: Using Discrete Choice Experiments, survey road users to evaluate the importance of transport infrastructure attributes on car dependency and on alternative modes of travel; 6: Citizen juries will ‘sense-check’ possible actions; and, 7: Stakeholders will interpret the findings, plan orchestrated multi-sectoral action, and agree on ways to sustain collaborations towards the common vision of reducing car dependency. We expect to attain a systemic view of the car dependency issue, potential intervention approaches to reduce it, and a framework for their integration through the co-ordination of stakeholder actions.
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Johansson MS, Søgaard K, Prescott E, Marott JL, Schnohr P, Holtermann A, Korshøj M. Can we walk away from cardiovascular disease risk or do we have to 'huff and puff'? A cross-sectional compositional accelerometer data analysis among adults and older adults in the Copenhagen City Heart Study. Int J Behav Nutr Phys Act 2020; 17:84. [PMID: 32631371 PMCID: PMC7336624 DOI: 10.1186/s12966-020-00985-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 06/17/2020] [Indexed: 01/13/2023] Open
Abstract
Background It is unclear whether walking can decrease cardiovascular disease (CVD) risk or if high intensity physical activity (HIPA) is needed, and whether the association is modified by age. We investigated how sedentary behaviour, walking, and HIPA, were associated with systolic blood pressure (SBP), waist circumference (WC), and low-density lipoprotein cholesterol (LDL-C) among adults and older adults in a general population sample using compositional data analysis. Specifically, the measure of association was quantified by reallocating time between sedentary behaviour and 1) walking, and 2) HIPA. Methods Cross-sectional data from the fifth examination of the Copenhagen City Heart Study was used. Using the software Acti4, we estimated daily time spent in physical behaviours from accelerometer data worn 24 h/day for 7 days (i.e., right frontal thigh and iliac crest; median wear time: 6 days, 23.8 h/day). SBP, WC, and LDL-C were measured during a physical examination. Inclusion criteria were ≥ 5 days with ≥16 h of accelerometer recordings per day, and no use of antihypertensives, diuretics or cholesterol lowering medicine. The 24-h physical behaviour composition consisted of sedentary behaviour, standing, moving, walking, HIPA (i.e., sum of climbing stairs, running, cycling, and rowing), and time in bed. We used fitted values from linear regression models to predict the difference in outcome given the investigated time reallocations relative to the group-specific mean composition. Results Among 1053 eligible participants, we found an interaction between the physical behaviour composition and age. Age-stratified analyses (i.e., </≥65 years; 773 adults, 280 older adults) indicated that less sedentary behaviour and more walking was associated with lower SBP among older adults only. For less sedentary behaviour and more HIPA, the results i) indicated an association with a lower SBP irrespective of age, ii) showed an association with a smaller WC among adults, and iii) showed an association with a lower LDL-C in both age groups. Conclusions Less sedentary behaviour and more walking seems to be associated with lower CVD risk among older adults, while HIPA types are associated with lower risk among adults. Therefore, to reduce CVD risk, the modifying effect of age should be considered in future physical activity-promoting initiatives.
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Affiliation(s)
- Melker Staffan Johansson
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark. .,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Eva Prescott
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, Hovedvejen indg. 5, st., 2000, Frederiksberg, Denmark.,Department of Cardiology, Bispebjerg University Hospital, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark
| | - Jacob Louis Marott
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, Hovedvejen indg. 5, st., 2000, Frederiksberg, Denmark
| | - Peter Schnohr
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, Hovedvejen indg. 5, st., 2000, Frederiksberg, Denmark
| | - Andreas Holtermann
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Mette Korshøj
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
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Nobles J, Thomas C, Banks Gross Z, Hamilton M, Trinder-Widdess Z, Speed C, Gibson A, Davies R, Farr M, Jago R, Foster C, Redwood S. "Let's Talk about Physical Activity": Understanding the Preferences of Under-Served Communities when Messaging Physical Activity Guidelines to the Public. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082782. [PMID: 32316591 PMCID: PMC7215851 DOI: 10.3390/ijerph17082782] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 04/07/2020] [Accepted: 04/09/2020] [Indexed: 11/16/2022]
Abstract
Despite many countries having physical activity guidelines, there have been few concerted efforts to mobilize this information to the public. The aim of this study was to understand the preferences of under-served community groups about how the benefits of physical activity, and associated guidelines, can be better communicated to the public. Participatory workshops, co-developed between researchers, a local charity, and a community artist, were used to gather data from four groups in Bristol, UK: young people (n = 17); adults (n = 11); older adults (n = 5); and Somali women (n = 15). Workshop content was structured around the study aims. The community artist and/or the local charity delivered the workshops, with researchers gathering data via observation, photos, and audio-recordings, which were analysed using the framework method. All four groups noted that the benefits of physical activity should be included within any communications efforts, though not restricted to health-related benefits. Language used should be simple and jargon-free; terms such as "sedentary", "vigorous" and "intensity" were deemed inaccessible, however all groups liked the message "some is good, more is better". Views about preferred mechanisms, and messenger, for delivering physical activity messages varied both between, and within, groups. Recommendations for those working in physical activity communications, research, and policy are provided.
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Affiliation(s)
- James Nobles
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol National Health Service Foundation Trust, Bristol BS1 3NU, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK
- Correspondence:
| | - Clare Thomas
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol National Health Service Foundation Trust, Bristol BS1 3NU, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK
| | | | | | - Zoe Trinder-Widdess
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol National Health Service Foundation Trust, Bristol BS1 3NU, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK
| | - Christopher Speed
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TH, UK
| | - Andy Gibson
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol National Health Service Foundation Trust, Bristol BS1 3NU, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK
- Department of Health and Social Sciences, Faculty of Health and Applied Sciences, University of the West of England, Bristol BS16 1QY, UK
| | - Rosie Davies
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol National Health Service Foundation Trust, Bristol BS1 3NU, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK
- Department of Health and Social Sciences, Faculty of Health and Applied Sciences, University of the West of England, Bristol BS16 1QY, UK
| | - Michelle Farr
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol National Health Service Foundation Trust, Bristol BS1 3NU, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK
| | - Russell Jago
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol National Health Service Foundation Trust, Bristol BS1 3NU, UK
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TH, UK
| | - Charlie Foster
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TH, UK
| | - Sabi Redwood
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol National Health Service Foundation Trust, Bristol BS1 3NU, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 1TH, UK
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Irvine KN, Marselle MR, Melrose A, Warber SL. Group Outdoor Health Walks Using Activity Trackers: Measurement and Implementation Insight from a Mixed Methods Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072515. [PMID: 32272603 PMCID: PMC7177624 DOI: 10.3390/ijerph17072515] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/30/2020] [Accepted: 04/01/2020] [Indexed: 11/16/2022]
Abstract
Outdoor walking groups are nature-based interventions (NBIs) that promote health and wellbeing by modifying individual behaviour. The challenges of such NBIs include the motivation of inactive adults to participate and measurement issues. This feasibility study investigates a 12-week group outdoor health walk (GOHW) incorporating activity trackers and use of a holistic health and wellbeing measure, the Self-sasessment of Change (SAC) scale. A mixed methods design explored participant recruitment and retention, programme delivery, and measures of physical activity and health and wellbeing. Walker data included: pre-post questionnaires, daily step counts, and interviews. Programme delivery information included: weekly checklists, staff reflections, stakeholder meeting minutes, and a report. Thirteen adults (age 63–81, 76% female) joined and completed the activity tracker GOHW. Activity trackers motivated walkers to join and be more active but complicated programme delivery. Activity trackers allowed the quantification of physical activity and the SAC health and wellbeing measure was easy to use. By week 12, all participants met national physical activity guidelines. Clinically relevant changes on the SAC scale included: sleeping well, experiencing vibrant senses, and feeling energised, focused, joyful, calm and whole. Results illustrate the feasibility of using activity trackers to motivate engagement in and provide a measure of physical activity from GOHWs. The SAC scale offers a promising measure for nature–health research. A conceptual model is provided for the development of future large-scale studies of NBIs, such as group outdoor health walks.
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Affiliation(s)
- Katherine N. Irvine
- Social, Economic and Geographical Sciences, James Hutton Institute, Craigiebuckler, Aberdeen AB14 8QH, UK
- Correspondence: ; Tel.: +44-(0)1224-395-397
| | - Melissa R. Marselle
- Helmholtz Center for Environmental Research-UFZ, Department of Ecosystem Services, Permoserstr 15, 04318 Leipzig, Germany;
- German Centre for Integrative Biodiversity Research (iDiv) Halle-Jena-Leipzig, Deutscher Platz 5e 04103 Leipzig, Germany
| | - Alan Melrose
- Alan Melrose Consultancy Ltd., 1 Balnastraid Cottages, Dinnet, Aboyne AB34 5NE, UK;
| | - Sara L. Warber
- Department of Family Medicine, University of Michigan Medical School, 1018 Fuller St, Ann Arbor, MI 48104-1213, USA;
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro TR1 3HD, UK
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15
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Yao J, Tan CS, Chen C, Tan J, Lim N, Müller-Riemenschneider F. Bright spots, physical activity investments that work: National Steps Challenge, Singapore: a nationwide mHealth physical activity programme. Br J Sports Med 2019; 54:1047-1048. [DOI: 10.1136/bjsports-2019-101662] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2019] [Indexed: 11/03/2022]
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Johansson MS, Korshøj M, Schnohr P, Marott JL, Prescott EIB, Søgaard K, Holtermann A. Time spent cycling, walking, running, standing and sedentary: a cross-sectional analysis of accelerometer-data from 1670 adults in the Copenhagen City Heart Study : Physical behaviours among 1670 Copenhageners. BMC Public Health 2019; 19:1370. [PMID: 31651272 PMCID: PMC6814105 DOI: 10.1186/s12889-019-7679-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 09/23/2019] [Indexed: 01/31/2023] Open
Abstract
Background Information about how much time adults spend cycling, walking and running can be used for planning and evaluating initiatives for active, healthy societies. The objectives of this study were to describe how much time adult Copenhageners cycle, walk, run, stand and spend sedentary using accelerometers, and to describe differences between population groups. Methods In the fifth examination of the Copenhagen City Heart Study, 2335 individuals gave consent to wear accelerometers (skin-attached; right thigh and iliac crest; 24 h/day, 7 consecutive days) of which 1670 fulfilled our inclusion criteria (≥16 h/day for ≥5 days; median wear time: 23.8 h/day). Daily time spent cycling, walking, running, standing and sedentary was derived from accelerometer-based data using the Acti4 software, and differences between sex, age groups, level of education and BMI were investigated using Kruskal-Wallis rank sum tests. Results Among those cycling (61%), the median cycling time was 8.3 min/day. The median time walking, running, standing and sedentary was 82.6, 0.1, 182.5 and 579.1 min/day, respectively. About 88% walked fast (i.e., ≥100 steps/min) ≥30 min/day. The shortest duration and lowest prevalence of cycling, walking and running were found among older individuals, those with a low level of education, and individuals being overweight or obese. Conclusions We found a long duration and high prevalence of cycling and walking, but also that many adult Copenhageners spent much time sedentary. Population groups with low participation in physical activities such as cycling and walking should be targeted in future initiatives towards an active, healthy society.
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Affiliation(s)
- Melker Staffan Johansson
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark. .,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark.
| | - Mette Korshøj
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Peter Schnohr
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, Hovedvejen indg. 5, st, 2000, Frederiksberg, Denmark
| | - Jacob Louis Marott
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, Hovedvejen indg. 5, st, 2000, Frederiksberg, Denmark
| | - Eva Irene Bossano Prescott
- The Copenhagen City Heart Study, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, Hovedvejen indg. 5, st, 2000, Frederiksberg, Denmark.,Department of Cardiology, Bispebjerg and Frederiksberg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Andreas Holtermann
- Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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Zaragoza Casterad J, Sevil-Serrano J, Bois JE, Generelo E, Lhuisset L, Aibar-Solana A. Centre for the Promotion of Physical Activity and Health (CAPAS-City): A Pyrenean Cross-Cultural Structure to Lead the Way in the Design, Implementation, and Evaluation of Multilevel Physical Activity Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193631. [PMID: 31569673 PMCID: PMC6801737 DOI: 10.3390/ijerph16193631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 11/22/2022]
Abstract
This study describes a Pyrenean cross-cultural structure called Centre for the Promotion of Physical Activity and Health (CAPAS-City) that was created to promote physical activity (PA) in Huesca (Spain) and Tarbes (France). The main aim of this centre is to lead the way in the design, implementation, and evaluation of multilevel PA interventions to improve their efficacy and sustainability inside the city. CAPAS-City responds to the main challenges related to multilevel PA interventions, through six guiding principles: (1) promoting sustainability, (2) playing a leadership role, (3) promoting multisectoral partnerships, (4) using evidence-based strategies, (5) promoting integrated knowledge translation, and (6) using a participatory research approach. Five multilevel PA interventions were designed in both cities by CAPAS-City with these principles in mind. Through the example of the Annual MOT Test adapted to bikes, we also illustrate one practical application of the use of these principles, following the Social-Ecological approach, in which the main agents of influence are involved at different levels to encourage cycling. According to the promising results found in this study, CAPAS-City appears to be a structure that is able to respond to the main needs and challenges of multilevel interventions to increase PA levels in the whole population of both cities.
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Affiliation(s)
- Javier Zaragoza Casterad
- Department of Didactics of the Musical, Plastic and Corporal Expression, Faculty of Social Sciences and Humanities, University of Zaragoza, 22003 Huesca, Spain.
| | - Javier Sevil-Serrano
- Department of Didactics of the Musical, Plastic and Corporal Expression, Faculty of Health and Sport Sciences, University of Zaragoza, 22001 Huesca, Spain.
| | - Julien E Bois
- University of Pau & Countries of Adour, e2s UPPA, MEPS, Tarbes, France Quartier Bastillac, 65000 Tarbes, France.
| | - Eduardo Generelo
- Department of Didactics of the Musical, Plastic and Corporal Expression, Faculty of Social Sciences and Humanities, University of Zaragoza, 22003 Huesca, Spain.
| | - Léna Lhuisset
- University of Pau & Countries of Adour, e2s UPPA, MEPS, Tarbes, France Quartier Bastillac, 65000 Tarbes, France.
| | - Alberto Aibar-Solana
- Department of Didactics of the Musical, Plastic and Corporal Expression, Faculty of Social Sciences and Humanities, University of Zaragoza, 22003 Huesca, Spain.
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Aittasalo M, Tiilikainen J, Tokola K, Suni J, Sievänen H, Vähä-Ypyä H, Vasankari T, Seimelä T, Metsäpuro P, Foster C, Titze S. Socio-Ecological Natural Experiment with Randomized Controlled Trial to Promote Active Commuting to Work: Process Evaluation, Behavioral Impacts, and Changes in the Use and Quality of Walking and Cycling Paths. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091661. [PMID: 31086071 PMCID: PMC6540220 DOI: 10.3390/ijerph16091661] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Revised: 05/08/2019] [Accepted: 05/09/2019] [Indexed: 11/16/2022]
Abstract
Active commuting to work (ACW) has beneficial effects on health, traffic, and climate. However, more robust evidence is needed on how to promote ACW. This paper reports the findings of a multilevel natural experiment with a randomized controlled trial in 16 Finnish workplaces. In Phase 1, 11 workplaces (1823 employees) from Area 1 were exposed to environmental improvements in walking and cycling paths. In Phase 2, five more workplaces (826 employees) were recruited from Area 2 and all workplaces were randomized into experimental group (EXP) promoting ACW with social and behavioral strategies and comparison group (COM) participating only in data collection. Process and impact evaluation with questionnaires, travel diaries, accelerometers, traffic calculations, and auditing were conducted. Statistics included Wilcoxon Signed Ranks Test, Mann-Whitney U-test, and after-before differences with 95% confidence intervals (95% CI). After Phase 1, positive change was seen in the self-reported number of days, which the employees intended to cycle part of their journey to work in the following week (p = 0.001). After Phase 2, intervention effect was observed in the proportion of employees, who reported willingness to increase walking (8.7%; 95% CI 1.8 to 15.6) and cycling (5.5%; 2.2 to 8.8) and opportunity to cycle part of their journey to work (5.9%; 2.1 to 9.7). To conclude, the intervention facilitated employees’ motivation for ACW, which is the first step towards behavior change.
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Affiliation(s)
- Minna Aittasalo
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Johanna Tiilikainen
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Kari Tokola
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Jaana Suni
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Harri Sievänen
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Henri Vähä-Ypyä
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, P.O. Box 30, 33501 Tampere, Finland.
| | - Timo Seimelä
- Department of Transport and Streets, City of Tampere, Frenckellinaukio 2, PL 487, 33101 Tampere, Finland.
| | - Pasi Metsäpuro
- Department of Mobility and Transport, WSP Finland Ltd., Kelloportinkatu 1 D, 33100 Tampere, Finland.
| | - Charlie Foster
- Centre for Exercise Nutrition and Health Sciences, School for Policy Studies, Faculty of Social Sciences and Law, University of Bristol, 8 Priory Road, Bristol BS81TZ, UK.
| | - Sylvia Titze
- Institute of Sport Science, University of Graz, Mozartgasse 14, 8010 Graz, Austria.
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White RL, Parker PD, Lubans DR, MacMillan F, Olson R, Astell-Burt T, Lonsdale C. Domain-specific physical activity and affective wellbeing among adolescents: an observational study of the moderating roles of autonomous and controlled motivation. Int J Behav Nutr Phys Act 2018; 15:87. [PMID: 30200980 PMCID: PMC6131748 DOI: 10.1186/s12966-018-0722-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 09/03/2018] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Abundant evidence demonstrates a relationship between physical activity and mental wellbeing. However, the strength of the relationship is not consistent. Factors contributing to variation in the strength of association are not well understood and, therefore, it remains difficult to optimize physical activity to ensure the strongest possible relationship with mental health. Self-determination theory suggests that more autonomously motivated behaviors lead to better mental health outcomes, when compared to more controlled behaviors. Therefore, we examined whether autonomous and controlled motivation moderated the relationships between physical activity and affective wellbeing within two domains (i.e., leisure-time and active travel). METHODS Between February and April 2014, adolescents (N = 1632, M age = 12.94 years, SD = 0.54, 55% male) wore an accelerometer across seven-days and completed self-report measures of leisure-time physical activity and active travel. They also completed two measures of motivation (towards leisure-time physical activity and active travel) and an affective wellbeing measure. RESULTS Structural equation modeling revealed that greater self-reported leisure-time physical activity was associated with greater positive affect (β = .29) and less negative affect (β = -.19) and that motivation did not moderate these relationships. Self-reported active travel had no linear relationship with affective wellbeing, and motivation did not moderate these relationships. Accelerometer-measured leisure-time physical activity had no relationship with positive affect but, had a weak inverse association with negative affect (β = -.09), and neither relationship was moderated by motivation. Accelerometer-measured active travel had no association with positive affect; however, autonomous motivation significantly moderated this association such that active travel had a positive association with positive affect when autonomous motivation was high (β = .09), but a negative association when autonomous motivation was low (β = -.07). Accelerometer-measured active travel had no association with negative affect. Despite some significant moderation effects, motivation did not consistently moderate the relationship between all physical activity variables (leisure-time and active travel, and self-report and accelerometer) and affective outcomes. CONCLUSIONS Tailoring physical activity interventions and guidelines to prioritize leisure-time ahead of other life domains could benefit wellbeing. Promoting autonomous participation in active travel may also be associated with increased wellbeing among adolescents.
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Affiliation(s)
- Rhiannon Lee White
- School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
- Institute for Positive Psychology and Education, Australian Catholic University, PO Box 968, North Sydney, NSW 2059 Australia
| | - Philip D. Parker
- Institute for Positive Psychology and Education, Australian Catholic University, PO Box 968, North Sydney, NSW 2059 Australia
| | - David R. Lubans
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, NSW 2308 Australia
| | - Freya MacMillan
- School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia
| | - Rebecca Olson
- School of Social Science, The University of Queensland, QLD, St. Lucia, 4072 Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, University of Wollongong, Northfields Avenue, Wollongong, NSW 2522 Australia
- Menzies Centre for Health Policy, University of Sydney, Camperdown, NSW 2006 Australia
- School of Public Health, Peking Union Medical College, Tsinghua University and Chinese Academy of Medical Sciences, Beijing, 100006 China
| | - Chris Lonsdale
- Institute for Positive Psychology and Education, Australian Catholic University, PO Box 968, North Sydney, NSW 2059 Australia
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Stamatakis E, Hamer M, Murphy MH. What Hippocrates called ‘Man’s best medicine’: walking is humanity’s path to a better world. Br J Sports Med 2018; 52:753-754. [DOI: 10.1136/bjsports-2018-099371] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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