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Khoramrooz M, Zare F, Sadeghian F, Dadgari A, Chaman R, Mirrezaie SM. Socioeconomic inequalities in employees' health-enhancing physical activity: Evidence from the SHAHWAR cohort study in Iran. PLoS One 2023; 18:e0285620. [PMID: 37186583 PMCID: PMC10184902 DOI: 10.1371/journal.pone.0285620] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 04/26/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Increasing level of physical activity (PA) among working population is of particular importance, because of the high return of investment on employees' PA. This study was aimed to investigate socioeconomic inequalities in Health-Enhancing Physical Activity (HEPA) among employees of a Medical Sciences University in Iran. METHODS Data were extracted from the SHAHWAR Cohort study in Iran. Concentration index (C) and Wagstaff decomposition techniques were applied to determine socioeconomic inequality in the study outcomes and its contributors, respectively. RESULTS Nearly half of the university employees (44.6%) had poor HEPA, and employees with high socioeconomic status (SES) suffered more from it (C = 0.109; 95% CI: 0.075, 0.143). Also, we found while poor work-related PA (C = 0.175; 95% CI: 0.142, 0.209) and poor transport-related PA (C = 0.081, 95% CI: 0.047, 0.115) were more concentrated among high-SES employees, low-SES employees more affected by the poor PA at leisure time (C = -0.180; 95% CI: -0.213, -0.146). Shift working, and having higher SES and subjective social status were the main factors that positively contributed to the measured inequality in employees' poor HEPA by 33%, 31.7%, and 29%, respectively, whereas, having a married life had a negative contribution of -39.1%. The measured inequality in poor leisure-time PA was mainly attributable to SES, having a married life, urban residency, and female gender by 58.1%, 32.5%, 28.5%, and -32.6%, respectively. SES, urban residency, shift working, and female gender, with the contributions of 42%, 33.5%, 21.6%, and -17.3%, respectively, were the main contributors of poor work-related PA inequality. Urban residency, having a married life, SES, and subjective social status mainly contributed to the inequality of poor transport-related PA by 82.9%, -58.7%, 36.3%, and 33.5%, respectively, followed by using a personal car (12.3%) and female gender (11.3%). CONCLUSIONS To reduce the measured inequalities in employees' PA, workplace health promotion programs should aim to educate and support male, urban resident, high-SES, high-social-class, and non-shift work employees to increase their PA at workplace, and female, married, rural resident, and low-SES employees to increase their leisure-time PA. Active transportation can be promoted among female, married, urban resident, high-SES, and high-social-class employees and those use a personal car.
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Affiliation(s)
- Maryam Khoramrooz
- Department of Health Management and Economics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Fariba Zare
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Farideh Sadeghian
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ali Dadgari
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
- School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Reza Chaman
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Seyed Mohammad Mirrezaie
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
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James SN, Chiou YJ, Fatih N, Needham LP, Schott JM, Richards M. Timing of physical activity across adulthood on later-life cognition: 30 years follow-up in the 1946 British birth cohort. J Neurol Neurosurg Psychiatry 2023; 94:349-356. [PMID: 36810321 PMCID: PMC10176405 DOI: 10.1136/jnnp-2022-329955] [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: 08/02/2022] [Accepted: 12/16/2022] [Indexed: 02/23/2023]
Abstract
BACKGROUND To assess how timing, frequency and maintenance of being physically active, spanning over 30 years in adulthood, is associated with later-life cognitive function. METHODS Participants (n=1417, 53% female) were from the prospective longitudinal cohort study, 1946 British birth cohort. Participation in leisure time physical activity was reported five times between ages 36 and 69, categorised into: not active (no participation in physical activity/month); moderately active (participated 1-4 times/month); most active (participated 5 or more times/month). Cognition at age 69 was assessed by tests of cognitive state (Addenbrooke's Cognitive Examination-III), verbal memory (word learning test) and processing speed (visual search speed). RESULTS Being physically active, at all assessments in adulthood, was associated with higher cognition at age 69. For cognitive state and verbal memory, the effect sizes were similar across all adult ages, and between those who were moderately and most physically active. The strongest association was between sustained cumulative physical activity and later-life cognitive state, in a dose-response manner. Adjusting for childhood cognition, childhood socioeconomic position and education largely attenuated these associations but results mainly remained significant at the 5% level. CONCLUSIONS Being physically active at any time in adulthood, and to any extent, is linked with higher later-life cognitive state, but lifelong maintenance of physical activity was most optimal. These relationships were partly explained by childhood cognition and education, but independent of cardiovascular and mental health and APOE-E4, suggestive of the importance of education on the lifelong impacts of physical activity.
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Affiliation(s)
- Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Yu-Jie Chiou
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
- Department of Psychiatry, Chang Gung Memorial Hospital Kaohsiung Branch, Kaohsiung, Taiwan
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Nasri Fatih
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Louisa P Needham
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Jonathan M Schott
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
- Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
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Romero-Parra N, Solera-Alfonso A, Bores-García D, Delfa-de-la-Morena JM. Sex and educational level differences in physical activity and motivations to exercise among Spanish children and adolescents. Eur J Pediatr 2023; 182:533-542. [PMID: 36482089 DOI: 10.1007/s00431-022-04742-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 11/08/2022] [Accepted: 11/27/2022] [Indexed: 12/13/2022]
Abstract
Children and adolescents worldwide, especially girls, do not meet moderate to vigorous physical activity (MVPA) guidelines, a situation which is related to obesity and other comorbidities. Sex/gender differences in the practice of MVPA and motivations to engage in physical activity have not been previously examined among Spanish students considering different educational levels. Therefore, the purpose of this study was to explore these differences and analyse if motivations mediate the relationship between educational levels and MVPA in a large sample of students. From different schools in the Madrid region (primary: 11,122; lower secondary: 12,379; upper secondary: 3228) 26,729 students (13,491 boys and 13,238 girls; 9-19 years old) were recruited to participate in this study. The short form of the International Physical Activity Questionnaire and the third version of the Behavioural Regulation in Exercise Questionnaire were used to evaluate, MVPA and motivations to exercise, respectively. Two-way ANCOVA and a mediation analysis were performed. Female students were found to be less active than males (43.4±38.7 and 58.6±45.9 min of MVPA; p < 0.001; ηp2 = 0.023) and showed lower intrinsic (ηp2 = 0.003), and integrated (ηp2 = 0.007) motivations than their male counterparts (p < 0.001). Primary school students were more active than lower and upper secondary students (53.3±44.2, 49.9±42.3 and 48.0±42.8 min of MVPA; p < 0.001; ηp2 = 0.002) and also presented higher intrinsic (ηp2 = 0.011) and integrated (ηp2 = 0.010) motivation than secondary school students (p < 0.001). Conclusion: Among Spanish children and adolescents, females showed lower levels of MVPA and intrinsic and integrated motivation across all the educational levels, and among primary school students in comparison to secondary school. This suggests that inner motivation is more determinant of increased engagement in MVPA and thus, there is need to reinforce it before the transition to secondary school and with special focus on females' preferences. What is Known: •Many children and adolescents worldwide, do not meet physical activity (PA) recommendations. • Within the self-determination theory, autonomous motivation seems to be the main responsible of greater PA levels. What is New: •This study shows for the first time sex and educational level differences in PA levels in a representative sample of Spanish students (9-19 yrs). •Autonomous motivation decreased from primary school onwards and was lower in female students than in their male counterparts.
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Affiliation(s)
- Nuria Romero-Parra
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sports Science, Universidad Politécnica de Madrid (UPM), Madrid, Spain
| | - Adrián Solera-Alfonso
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Daniel Bores-García
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
- Research Group of Humanities and Qualitative Research in Health (Hum & QRinHS), Facultad de CC, De la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - José M Delfa-de-la-Morena
- Department of Physiotherapy, Occupational Therapy, Rehabilitation and Physical Medicine, Faculty of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain.
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Vidmar AP, Cáceres NA, Schneider-Worthington CR, Shirazipour C, Buman MP, de la Haye K, Salvy SJ. Integration of Time-Based Recommendations with Current Pediatric Health Behavior Guidelines: Implications for Obesity Prevention and Treatment in Youth. Curr Obes Rep 2022; 11:236-253. [PMID: 36348216 PMCID: PMC9742346 DOI: 10.1007/s13679-022-00491-z] [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] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW Youth-onset obesity is associated with negative health outcomes across the lifespan including cardiovascular diseases, type 2 diabetes, obstructive sleep apnea, dyslipidemias, asthma, and several cancers. Pediatric health guidelines have traditionally focused on the quality and quantity of dietary intake, physical activity, and sleep. RECENT FINDINGS Emerging evidence suggests that the timing (time of day when behavior occurs) and composition (proportion of time spent allocated to behavior) of food intake, movement (i.e., physical activity, sedentary time), and sleep may independently predict health trajectories and disease risks. Several theoretically driven interventions and conceptual frameworks feature behavior timing and composition (e.g., 24 h movement continuum, circadian science and chronobiology, intermittent fasting regimens, structured day hypothesis). These literatures are, however, disparate, with little crosstalk across disciplines. In this review, we examine dietary, sleep, and movement guidelines and recommendations for youths ages 0-18 in the context of theoretical models and empirical findings in support of time-based approaches. The review aims to inform a unifying framework of health behaviors and guide future research on the integration of time-based recommendations into current quantity and quality-based health guidelines for children and adolescents.
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Affiliation(s)
- Alaina P Vidmar
- Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, 4650 Sunset Boulevard, Mailstop #61, Los Angeles, CA, 90027, USA.
| | - Nenette A Cáceres
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | | | - Celina Shirazipour
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
| | - Matthew P Buman
- College of Health Solutions, Arizona State University, Tempe, USA
| | - Kayla de la Haye
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Sarah-Jeanne Salvy
- Cancer Research Center On Health Equity, Cedars-Sinai Medical Center, West Hollywood, CA, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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5
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Chrismas BCR, Majed L, Al-Mohannadi AS, Sayegh S. Adherence and retention to the self-managed community-based Step Into Health program in Qatar (2012-2019). Front Public Health 2022; 10:927386. [PMID: 36199850 PMCID: PMC9527577 DOI: 10.3389/fpubh.2022.927386] [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: 04/24/2022] [Accepted: 08/15/2022] [Indexed: 01/24/2023] Open
Abstract
Purpose Investigate adherence and retention to the "Step Into Health (SIH)" initiative (www.stepintohealth.qa [website access only available from within the State of Qatar]), a Qatari self-managed community-based health program, from 2012 to 2019. Methods Participants (16,711; 16-80 years; 37% females, 34% Qatari) used a pedometer or smartphone application (app) to measure step count. Absolute adherence (ADH) and retention (RET) were calculated, with ADH (%) the ratio between number of days data and SIH enrollment length (RET). Linear Mixed Models identified differences in ADH between RET groups, main effects (i.e., sex, device, age, BMI, nationality) and interaction effects for ADH (RET entered as a covariate). Results Average ADH and RET to SIH (irrespective of sex, age, device and BMI) was 50% (±31%), and 16% (±20%), respectively, with ADH differing significantly between RET groups (F = 460.2, p < 0.001). RET (as a covariate) revealed a significant main effect for device (F = 12.00, p < 0.001) and age (F = 4.31, p = 0.001) on ADH observed. There was a significant association between RET and sex (p < 0.001), device (p < 0.001), and age groups 16-25 y (p < 0.001), and 26-35 y (p < 0.001). There were no significant main effects for sex or BMI on ADH, and no interaction effects (p ≥ 0.21) observed. Conclusions Follow-up data (e.g., interviews, focus groups, etc.) determining why differences in ADH and RET are observed appears prudent. To convert those that lapsed and/or abandoned SIH/PA into committed long-term PA adherers. This would be a first step to develop targeted public health promotions and initiatives to enhance health outcomes at a population level.
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Affiliation(s)
- Bryna C. R. Chrismas
- Department of Physical Education, College of Education, Qatar University, Doha, Qatar,*Correspondence: Bryna C. R. Chrismas
| | - Lina Majed
- Department of Physical Education, College of Education, Qatar University, Doha, Qatar
| | - Abdulla Saeed Al-Mohannadi
- World Innovation Summit for Health, Qatar Foundation, Doha, Qatar,Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Suzan Sayegh
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
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6
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Delfa-De-La-Morena JM, Bores-García D, Solera-Alfonso A, Romero-Parra N. Barriers to Physical Activity in Spanish Children and Adolescents: Sex and Educational Stage Differences. Front Psychol 2022; 13:910930. [PMID: 35726266 PMCID: PMC9206528 DOI: 10.3389/fpsyg.2022.910930] [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] [Received: 04/01/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
According to worrisome childhood obesity and inadequate physical activity (PA) levels worldwide, especially exacerbated in adolescents girls, this work aimed to identify sex and educational stage differences in barriers to meet PA requirements and international guidelines in Spanish children and adolescents considering the entire educational pathway (primary, secondary, and college). The Short Form of the International PA Questionnaire and the Scale of Perceived Barriers were administered to primary, secondary, and college education students (13,491 boys and 13,238 girls, 9–19 yrs). Two-way ANOVA was performed to analyze barriers to PA according to sex and educational stage with physical status as covariate. Higher disliking and time barriers were reported by females (1.5 ± 1.2 and 3.2 ± 1.5 points) in comparison to males (1.2 ± 1.0 and 2.8 ± 1.4), while primary students showed lower disliking and time (1.2 ± 1.0 and 2.8 ± 1.5) and higher safety (3.1 ± 1.8) constraints in comparison to secondary (1.4 ± 1.1, 3.1 ± 1.4, and 2.8 ± 1.7) and college (1.5 ± 1.2, 3.2 ± 1.5, and 2.8 ± 1.6; p < 0.05 for all comparisons). College females showed higher disliking (1.7 ± 1.2) and time (3.5 ± 1.4) barriers than secondary females (1.5 ± 1.2 and 3.3 ± 1.4; p < 0.05). Sex and educational stage were determinant for time and dislike of PA barriers, which were rated higher by female students in comparison to their male counterparts and from primary education onwards. Altogether this, suggests promotion strategies should carefully consider girls and the step into secondary school.
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Affiliation(s)
- José Manuel Delfa-De-La-Morena
- Department of Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Móstoles, Spain
| | - Daniel Bores-García
- Department of Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Móstoles, Spain.,Research Group of Humanities and Qualitative Research in Health Science, Rey Juan Carlos University, Madrid, Spain
| | - Adrián Solera-Alfonso
- Department of Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Móstoles, Spain
| | - Nuria Romero-Parra
- Department of Physiotherapy, Occupational Therapy, Physical Medicine and Rehabilitation, Rey Juan Carlos University, Móstoles, Spain.,LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sports Science, Universidad Politécnica de Madrid, Madrid, Spain
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7
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Clina JG, Pan Z, Wyatt HR, Peters JC, Hill JO, Sayer RD. Secondary analysis of a university‐based weight loss program in on‐campus versus off‐campus employees. Obes Sci Pract 2022; 8:767-774. [PMID: 36483127 PMCID: PMC9722460 DOI: 10.1002/osp4.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/27/2022] [Accepted: 05/23/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction Many barriers prevent individuals from regularly engaging in physical activity (PA), including lack of time and access to facilities. Providing free gym membership close to one's work may alleviate both time and financial barriers, increase PA, and result in greater weight loss. The purpose of this secondary analysis was to determine if gym usage, self-reported leisure PA, and weight loss differed between participants working on the University of Colorado Anschutz Medical Campus (ON) versus working off-campus (OFF) during a 6-month weight loss trial. Methods 117 adults (ON, n = 62; OFF, n = 55) with overweight or obesity received free gym memberships for the duration of trial. Average gym check ins/week, self-report leisure PA, weight, and fat and lean mass were compared between groups. Results ON reported more check-ins than OFF (ON, 0.93 ± 0.16 times/week; OFF, 0.55 ± 0.10 times/week p = 0.038). Both groups reported increased leisure PA, with ON reporting more leisure PA than OFF at month 4. Both groups had reductions in weight and fat mass, which were similar between groups. Conclusion Gym usage in both groups was low, suggesting that convenient and free gym access only marginally promoted use of provided facilities, likely having little additional impact on PA and weight change. CLINICAL TRIAL REGISTRATION The parent trial was registered at clinicaltrials.gov: NCT02627105.
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Affiliation(s)
- Julianne G. Clina
- Department of Nutrition Sciences University of Alabama at Birmingham Birmingham Alabama USA
| | - Zhaoxing Pan
- Department of Pediatrics Children's Hospital Colorado Research Institute Anschutz Medical Campus Denver Colorado USA
| | - Holly R. Wyatt
- Department of Nutrition Sciences University of Alabama at Birmingham Birmingham Alabama USA
| | - John C. Peters
- University of Colorado Anschutz Health and Wellness Center University of Colorado Anschutz Medical Campus Aurora Colorado USA
| | - James O. Hill
- Department of Nutrition Sciences University of Alabama at Birmingham Birmingham Alabama USA
| | - R. Drew Sayer
- Department of Nutrition Sciences University of Alabama at Birmingham Birmingham Alabama USA
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8
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Porter RR, McClelland P, Ewing A, Sonka V, Trilk JL. Design and implementation of a clinic-to-community, physical activity health promotion model for healthcare providers. Prev Med Rep 2022; 26:101697. [PMID: 35111567 PMCID: PMC8790628 DOI: 10.1016/j.pmedr.2022.101697] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/29/2021] [Accepted: 01/15/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Ryan R. Porter
- Texas Christian University, 2800 S. University Dr, Fort Worth, TX 76129, USA
| | - Patton McClelland
- University of South Carolina School of Medicine Greenville, Greenville, 701 Grove Road, Greenville, SC 29605, USA
| | - Alex Ewing
- Prisma Health, Greenville, 701 Grove Road, Greenville, SC 29605, USA
| | - Victoria Sonka
- Prisma Health, Greenville, 701 Grove Road, Greenville, SC 29605, USA
| | - Jennifer L. Trilk
- University of South Carolina School of Medicine Greenville, Greenville, 701 Grove Road, Greenville, SC 29605, USA
- Corresponding author.
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9
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Moore J, Bartholomae EM, Ward K, Hooshmand S, Kressler J. Three minutes of moderate-intensity stair walking improves glucose and insulin but not insulin sensitivity or total antioxidant capacity. Nutr Metab Cardiovasc Dis 2022; 32:479-486. [PMID: 34896000 DOI: 10.1016/j.numecd.2021.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 10/14/2021] [Accepted: 10/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND AIMS This study examined the effect of moderate intensity stair stepping exercise on the glycemic response, and antioxidant capacity (TAC) during an oral glucose tolerance test (OGTT). METHODS AND RESULTS Thirty participants (women = 12) completed 4 OGTTs during rest or stair walking bouts of 1, 3, and 10 min in a randomized order. Blood was collected at baseline and 30 min during the OGTTs and analyzed for glucose, insulin, TAC, and lactate. Glucose concentrations were decreased following the 10 min (-22.69 (-34.66 to -10.72) mg/dL, p < 0.002) and 3 min (-15.37 (-25.05 to -5.69) mg/dL, p < 0.004) bouts but not the 1 min bout (-6.18 (-19.54 to 7.18) mg/dL, p = 0.352). Insulin concentrations were decreased following the 10 min (-6.11 (-8.86 to -3.36 μIU/dL), p < 0.001) and 3 min (-2.589 (-4.54 to -0.63) μIU/dL, p < 0.012) bouts but not the 1 min bout (-0.37 (-1.87 to 1.13) μIU/dL, p = 0.616). Insulin sensitivity index values showed a significant increase in the 10-min trial (1.81 (0.03-3.58), p < 0.048), but not during the 3 min (0.65 (-0.66 to 1.96) p = 0.317) or 1 min trial (0.13 (-1.58 to 1.84) p = 0.878). There was no omnibus effect for trial in TAC (p = 0.132, η2 = 0.07). There was no interaction between trial and time for blood lactate (p = 0.621, η2 = 0.02). CONCLUSION This study provides evidence bouts as short as 3 min decrease postprandial blood glucose and insulin levels but longer bouts are needed to affect insulin sensitivity.
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Affiliation(s)
- Jeff Moore
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA; The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 West Carson Street, Torrance, CA, 90502, USA.
| | - Eric M Bartholomae
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA; College of Health Solutions, Arizona State University, Phoenix, AZ, 85004, USA
| | - Kathryn Ward
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Shirin Hooshmand
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
| | - Jochen Kressler
- School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, 92182, USA
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10
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Chalabaev A, Sieber S, Sander D, Cullati S, Maltagliati S, Sarrazin P, Boisgontier MP, Cheval B. Early-Life Socioeconomic Circumstances and Physical Activity in Older Age: Women Pay the Price. Psychol Sci 2022; 33:212-223. [PMID: 35112576 PMCID: PMC9096459 DOI: 10.1177/09567976211036061] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Health in older age is shaped by early-life socioeconomic circumstances (SECs) and sex. However, whether and why these factors interact is unclear. We examined a cultural explanation of this interaction by distinguishing cultural and material aspects of SECs in the context of physical activity-a major determinant of health. We used data from 56,331 adults between 50 and 96 years old from the Survey of Health, Ageing and Retirement in Europe (SHARE), a 13-year, large-scale, population-based cohort. Confounder-adjusted logistic linear mixed-effects models showed an association between the cultural aspects of early-life SEC disadvantage and physical activity among women, but it was not consistently observed in men. Furthermore, these associations were compensated for only partially by adult-life socioeconomic trajectories. The material aspects of early-life SECs were not associated with adult-life physical activity. These findings highlight the need to distinguish different aspects of SECs because they may relate to health behaviors in diverse ways.
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Affiliation(s)
- Aïna Chalabaev
- Laboratoire Sport et Environnement
Social (SENS), Université Grenoble Alpes,Aïna Chalabaev, Université Grenoble Alpes,
Laboratoire Sport et Environnement Social (SENS)
| | - Stefan Sieber
- Swiss National Centre of Competence in
Research “LIVES - Overcoming Vulnerability: Life Course Perspectives,” University of
Geneva
| | - David Sander
- Swiss Center for Affective Sciences,
University of Geneva,Laboratory for the Study of Emotion
Elicitation and Expression, Department of Psychology, University of Geneva
| | | | - Silvio Maltagliati
- Laboratoire Sport et Environnement
Social (SENS), Université Grenoble Alpes
| | - Philippe Sarrazin
- Laboratoire Sport et Environnement
Social (SENS), Université Grenoble Alpes
| | - Matthieu P. Boisgontier
- School of Rehabilitation Sciences,
Faculty of Health Sciences, University of Ottawa,Bruyère Research Institute, Ottawa,
Canada
| | - Boris Cheval
- Swiss Center for Affective Sciences,
University of Geneva,Laboratory for the Study of Emotion
Elicitation and Expression, Department of Psychology, University of Geneva
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11
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Abstract
Health disparities by socioeconomic status (SES) have been extensively documented, but less is known about the physical health implications of achieving upward mobility. This article critically reviews the evolving literature in this area, concluding that upward mobility is associated with a trade-off, whereby economic success and positive mental health in adulthood can come at the expense of physical health, a pattern termed skin-deep resilience. We consider explanations for this phenomenon, including prolonged high striving, competing demands between the environments upwardly mobile individuals seek to enter and their environments of origin, cultural mismatches between adaptive strategies from their childhood environments and those that are valued in higher-SES environments, and the sense of alienation, lack of belonging, and discrimination that upwardly mobile individuals face as they move into spaces set up by and for high-SES groups. These stressors are hypothesized to lead to unhealthy behaviors and a dysregulation of biological systems, with implications for cardiometabolic health.
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Affiliation(s)
- Edith Chen
- Institute for Policy Research and Department of Psychology, Northwestern University, Evanston, Illinois 60208, USA;
| | - Gene H Brody
- Center for Family Research, University of Georgia, Athens, Georgia 30602, USA
| | - Gregory E Miller
- Institute for Policy Research and Department of Psychology, Northwestern University, Evanston, Illinois 60208, USA;
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12
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Hesketh K, Jones H, Kinnafick F, Shepherd SO, Wagenmakers AJM, Strauss JA, Cocks M. Home-Based HIIT and Traditional MICT Prescriptions Improve Cardiorespiratory Fitness to a Similar Extent Within an Exercise Referral Scheme for At-Risk Individuals. Front Physiol 2021; 12:750283. [PMID: 34858205 PMCID: PMC8631444 DOI: 10.3389/fphys.2021.750283] [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: 07/30/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022] Open
Abstract
Exercise referral schemes (ERS) are used to promote physical activity within primary care. Traditionally, ERS are conducted in a gym or leisure-center setting, with exercise prescriptions based on moderate-intensity continuous training (MICT). Home-based high-intensity interval training (Home-HIIT) has the potential to reduce perceived barriers to exercise, including lack of time and access to facilities, compared to traditional MICT prescription used with ERS and improve health related outcomes. We hypothesized that Home-HIIT would mediate greater improvement in cardiorespiratory fitness (CRF) by virtue of greater adherence and compliance to the exercise prescription, compared to MICT. Methods: Patients enrolled on an ERS (Liverpool, United Kingdom) were recruited for a pragmatic trial. Participants self-selected either 12 weeks of MICT (45-135 min/week at 50-70% HRmax) or Home-HIIT (4-9 min × 1 min intervals at ≥80% of HRmax, interspersed with 1 min rest). The primary outcome was the change in CRF (VO2 peak) at post-intervention (12 weeks) and follow-up (3-month post intervention), using intention-to-treat analysis. Results: 154 participants (age 48 ± 10y; BMI 30.5 ± 6.1 kg/m2) were recruited between October 2017 and March 2019, 87 (56%) participants chose Home-HIIT and 67 (44%) MICT. VO2 peak increased post-intervention in both groups (MICT 3.9 ± 6.0 ml.kg-1.min-1, Home-HIIT 2.8 ± 4.5 ml.kg-1.min-1, P < 0.001), and was maintained at follow-up (P < 0.001). Fat mass was only reduced post MICT (MICT -1.5 ± 6.3 kg, P < 0.05, Home-HIIT -0.2 ± 2.0 kg, P = 1.00), but the reduction was not maintained at follow-up (MICT -0.6 ± 5.1 kg, Home-HIIT 0.0 ± 2.2 kg, P > 0.05). Adherence to the prescribed programs was similar (MICT 48 ± 35%, Home-HIIT 39 ± 36%, P = 0.77). Conclusion: This is the first study to evaluate the use of Home-HIIT for individuals in a primary care setting. Contrary to our hypothesis, adherence to both exercise prescriptions was poor, and CRF improved to a similar extent in both groups with improvements maintained at 3-month follow-up. We provide evidence that, although not superior, Home-HIIT could be an effective and popular additional exercise choice for patients within primary care based ERS. Clinical Trial Registration: [ClinicalTrials.gov], identifier [NCT04553614].
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Affiliation(s)
- Katie Hesketh
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - Helen Jones
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - Florence Kinnafick
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine, Loughborough University, Loughborough, United Kingdom
| | - Sam O Shepherd
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - Anton J M Wagenmakers
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - Juliette A Strauss
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - Matthew Cocks
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom
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13
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Northcott C, Curtis R, Bogomolova S, Olds T, Vandelanotte C, Plotnikoff R, Maher C. Should Facebook advertisements promoting a physical activity smartphone app be image or video-based, and should they promote benefits of being active or the app attributes? Transl Behav Med 2021; 11:2136-2143. [PMID: 34398963 DOI: 10.1093/tbm/ibab101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Social media provides a convenient platform for health campaigns. However, practitioners designing such campaigns are faced with a number of decisions regarding advertising formats and appeals. This study set out to compare the effectiveness of two advertising formats (image vs. video) and two advertising appeals (benefits of being active vs. app attributes and features) for promoting a physical-activity smartphone app. The advertising experiment was conducted on Facebook and employed a 2 × 2 full-factorial experimental design, examining two advertising formats: image versus video and two advertising appeals: benefit versus attribute. Outcome measures were advertisement cost (number of viewers reached according to the amount spent) and consumer engagement (rates of advertisement click-through and app downloads). Chi-Square analysis revealed that advertisement cost was found to differ according to the type of advertising format used, with image advertisements achieving a greater audience reach than video advertisements (χ 2(1) = 905.292, p < .001). Consumer engagement also differed according to advertising format and appeal: images achieved high rates of advertisement click-through (2.7% vs. 1.9%; χ 2(1) = 196.9, p < .001) and app downloads (0.6% vs. 0.5%; χ 2(1) = 4.0, p = .044) compared with videos. Furthermore, benefit appeal advertisements were more effective than attribute appeals, yielding a greater rate of advertisement click-through (2.8% vs. 1.8%; χ 2(1) = 282.2, p < .001) and app downloads (0.7% vs. 0.4%; χ 2(1) =106.0, p < .001). Overall, image advertisements were seen to be the most cost-effective and engaging. Advertisements employing a benefit appeal achieved greater consumer engagement than and attribute appeal advertisements.
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Affiliation(s)
- Celine Northcott
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Rachel Curtis
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Svetlana Bogomolova
- Ehrenberg-Bass Institute for Marketing Science, UniSA Business, University of South Australia, Adelaide, Australia
| | - Timothy Olds
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, Appleton Institute, Central Queensland University, Rockhampton, Australia
| | - Ronald Plotnikoff
- School of Medicine & Public Health; Faculty of Health and Medicine, Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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14
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Laine JE, Baltar VT, Stringhini S, Gandini M, Chadeau-Hyam M, Kivimaki M, Severi G, Perduca V, Hodge AM, Dugué PA, Giles GG, Milne RL, Barros H, Sacerdote C, Krogh V, Panico S, Tumino R, Goldberg M, Zins M, Delpierre C, Vineis P. Reducing socio-economic inequalities in all-cause mortality: a counterfactual mediation approach. Int J Epidemiol 2021; 49:497-510. [PMID: 31855265 PMCID: PMC7266549 DOI: 10.1093/ije/dyz248] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 11/27/2019] [Indexed: 12/05/2022] Open
Abstract
Background Socio-economic inequalities in mortality are well established, yet the contribution of intermediate risk factors that may underlie these relationships remains unclear. We evaluated the role of multiple modifiable intermediate risk factors underlying socio-economic-associated mortality and quantified the potential impact of reducing early all-cause mortality by hypothetically altering socio-economic risk factors. Methods Data were from seven cohort studies participating in the LIFEPATH Consortium (total n = 179 090). Using both socio-economic position (SEP) (based on occupation) and education, we estimated the natural direct effect on all-cause mortality and the natural indirect effect via the joint mediating role of smoking, alcohol intake, dietary patterns, physical activity, body mass index, hypertension, diabetes and coronary artery disease. Hazard ratios (HRs) were estimated, using counterfactual natural effect models under different hypothetical actions of either lower or higher SEP or education. Results Lower SEP and education were associated with an increase in all-cause mortality within an average follow-up time of 17.5 years. Mortality was reduced via modelled hypothetical actions of increasing SEP or education. Through higher education, the HR was 0.85 [95% confidence interval (CI) 0.84, 0.86] for women and 0.71 (95% CI 0.70, 0.74) for men, compared with lower education. In addition, 34% and 38% of the effect was jointly mediated for women and men, respectively. The benefits from altering SEP were slightly more modest. Conclusions These observational findings support policies to reduce mortality both through improving socio-economic circumstances and increasing education, and by altering intermediaries, such as lifestyle behaviours and morbidities.
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Affiliation(s)
- Jessica E Laine
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Valéria T Baltar
- Department of Epidemiology and Biostatistics, Instituto de Saúde Coletiva, Universidade Federal Fluminense, Rio de Janeiro, Brazil
| | - Silvia Stringhini
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Martina Gandini
- Epidemiology Unit, ASL TO3 Piedmont Region, Grugliasco, Italy
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Gianluca Severi
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP, UMR Inserm 1018) Facultés de Medicine, Université Paris-Saclay, Université Paris-Sud, Saint-Aubin, France
| | - Vittorio Perduca
- Centre de Recherche en Épidémiologie et Santé des Populations (CESP, UMR Inserm 1018) Facultés de Medicine, Université Paris-Saclay, Université Paris-Sud, Saint-Aubin, France
| | - Allison M Hodge
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Pierre-Antoine Dugué
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Roger L Milne
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia.,Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | - Henrique Barros
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal
| | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza-University of Turin and Center for Cancer Prevention, Turin, Italy
| | - Vittorio Krogh
- Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Salvatore Panico
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Rosario Tumino
- Provincial Healthcare Company (ASP) Ragusa, Vittoria, Italy
| | - Marcel Goldberg
- Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France
| | - Marie Zins
- Population-based Epidemiological Cohorts Unit, INSERM UMS 11, Villejuif, France
| | - Cyrille Delpierre
- LEASP, UMR 1027, Inserm-Université Toulouse III Paul Sabatier, Toulouse, France
| | | | - Paolo Vineis
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
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15
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Linder S, Abu-Omar K, Geidl W, Messing S, Sarshar M, Reimers AK, Ziemainz H. Physical inactivity in healthy, obese, and diabetic adults in Germany: An analysis of related socio-demographic variables. PLoS One 2021; 16:e0246634. [PMID: 33561175 PMCID: PMC7872299 DOI: 10.1371/journal.pone.0246634] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 01/25/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Adults with diabetes or obesity are more likely to be physically inactive than healthy adults. Physical activity is essential in the management of both diseases, necessitating targeted interventions in these groups. This study analysed physical inactivity (defined as not taking part in leisure-time physical activity) in over 100,000 adults in Germany considering their body mass index and the presence of diabetes. Furthermore, the relationship between specific socio-demographic factors with physical inactivity was investigated, particularly focussing diabetic and obese people, to refine the identification of risk-groups for targeted interventions on physical activity promotion. METHODS Data from 13 population-based health surveys conducted in Germany from 1997 to 2018 were used. The relevant variables extracted from these datasets were merged and employed in the analyses. We included data from 129,886 individuals in the BMI analyses and 58,311 individuals in the diabetes analyses. Logistic regression analyses were performed to identify the importance of six socio-demographic variables (age, sex/gender, education, income, employment, and migration) for the risk of physical inactivity. RESULTS Obese and diabetic people reported a higher prevalence of physical inactivity than those who were not affected. Logistic regression analyses revealed advanced age, low education level, and low household income as risk factors for physical inactivity in all groups. A two-sided migration background and unemployment also indicated a higher probability of physical inactivity. CONCLUSION Similar socio-demographic barriers appear to be important determinants of physical inactivity, regardless of BMI status or the presence of diabetes. However, physical activity promoting interventions in obese and diabetic adults should consider the specific disease-related characteristics of these groups. A special need for target group specific physical activity programmes in adults from ethnic minorities or of advanced age was further identified.
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Affiliation(s)
- Stephanie Linder
- Division of Physical Activity and Public Health, Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
| | - Karim Abu-Omar
- Division of Physical Activity and Public Health, Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
| | - Wolfgang Geidl
- Division of Exercise and Health, Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
| | - Sven Messing
- Division of Exercise and Health, Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
| | - Mustafa Sarshar
- Division of Health and Physical Activity, Department of Sport Science, Otto-von-Guericke University, Magdeburg, Germany
| | - Anne K. Reimers
- Division of Physical Activity and Public Health, Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
| | - Heiko Ziemainz
- Division of Physical Activity and Public Health, Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Bavaria, Germany
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16
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Nagelhout GE, Abidi L, de Vries H. Reasons for (not) participating in a community-based health promotion program for low-income multi-problem households in the Netherlands: A qualitative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:241-249. [PMID: 32633021 PMCID: PMC7818491 DOI: 10.1111/hsc.13087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 05/23/2020] [Accepted: 06/12/2020] [Indexed: 06/11/2023]
Abstract
People living in low-income multi-problem households may benefit from participation in a community-based health promotion program. Yet, low participation rates are often a problem. It is important to assess reasons for (not) participating to better tailor programs to the needs of this particular at-risk group. Back2Balance is a health promotion program for low-income multi-problem households from Apeldoorn, the Netherlands. We performed qualitative interviews among participants (n = 16) and non-participants (n = 12) of the program and asked them for their reasons for (not) participating in the program. Interview transcripts were thematically analysed using the Framework method. Participants indicated that reasons for participating encompassed intrapersonal motivators (e.g. to become healthier), interpersonal motivators (e.g. participating to get to know new people) and program level motivators (e.g. learning about a healthy lifestyle, and free or very low cost). Participants and non-participants outlined the importance of intrapersonal barriers (e.g. physical health problems), interpersonal barriers (e.g. family circumstances) and program level barriers (e.g. logistic issues, and not understanding or knowing about some part of the program). Concluding, combining health promotion with social interaction motivated participants to participate in the Back2Balance program. Yet, both participants and non-participants experienced many barriers for participation, some of which were related to their multi-problem situation.
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Affiliation(s)
- Gera E. Nagelhout
- Department of Health PromotionMaastricht University (CAPHRI)Maastrichtthe Netherlands
- IVO Research InstituteThe Haguethe Netherlands
| | - Latifa Abidi
- Department of Health PromotionMaastricht University (CAPHRI)Maastrichtthe Netherlands
| | - Hein de Vries
- Department of Health PromotionMaastricht University (CAPHRI)Maastrichtthe Netherlands
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17
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van den Broek T. Early-Life Circumstances, Health Behavior Profiles, and Later-Life Health in Great Britain. J Aging Health 2020; 33:317-330. [PMID: 33345690 PMCID: PMC8120632 DOI: 10.1177/0898264320981233] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objectives: Drawing on UK Household Longitudinal Study data, this study assessed a pathway from early-life disadvantage to suboptimal later-life health via health behavior. Methods: Latent class analysis was used to identify distinct smoking, nutrition, alcohol, and physical activity health behavior profiles. Mediation analyses were performed to assess indirect effects of early-life disadvantage via health behavior on allostatic load, an objective measure of physiological wear and tear. Results: Four health behavior profiles were identified: (1) broadly healthy and high alcohol consumption, (2) low smoking and alcohol consumption, healthy nutrition, and physically inactive, (3) broadly unhealthy and low alcohol consumption, and (4) broadly moderately unhealthy and high alcohol consumption. Having grown up in a higher socioeconomic position family was associated with lower later-life allostatic load. This was partly attributable to health behavioral differences. Discussion: Growing up under disadvantageous socioeconomic circumstances may initiate a chain of risk by predisposing people to health behavior profiles associated with poorer later-life health.
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18
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Moreno-Llamas A, García-Mayor J, De la Cruz-Sánchez E. Physical activity barriers according to social stratification in Europe. Int J Public Health 2020; 65:1477-1484. [PMID: 32989480 PMCID: PMC7521567 DOI: 10.1007/s00038-020-01488-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/31/2020] [Accepted: 09/20/2020] [Indexed: 12/17/2022] Open
Abstract
Objectives To analyse relationships of social stratification on physical activity (PA) prevalence and barriers in the European population. Methods Data were retrieved from Eurobarometer 88.4, a cross-sectional survey conducted in 2017 with 28,031 over 15-year-old inhabitants of the European Union. PA prevalence was calculated along with the probability to be physically inactive by social stratification. Logistic regressions were run in the inactive population to show the social class effect on each barrier adjusted by sociodemographic factors employing a propensity score matched method. Results Low social class presented higher inactivity prevalence (43.11%), whilst the high social class reported the lowest prevalence (23.30%). Also, the low (OR 0.52; 95% CI 0.47–0.58) and middle (OR 0.71; 95% CI 0.64–0.79) social classes were less likely to be active compared to high social class. In the inactive population, the low social class had mostly higher odds to report each barrier. Conclusions Social class is a relevant factor for low PA, with more barriers in the lower social classes. Public health institutions should implement strategies on more influential PA barriers and disadvantaged social groups. Electronic supplementary material The online version of this article (10.1007/s00038-020-01488-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Antonio Moreno-Llamas
- University of Murcia, San Javier Campus, C/Santa Alicia s/n, 30720, Santiago de la Ribera, Murcia, Spain
| | - Jesús García-Mayor
- University of Murcia, San Javier Campus, C/Santa Alicia s/n, 30720, Santiago de la Ribera, Murcia, Spain
| | - Ernesto De la Cruz-Sánchez
- University of Murcia, San Javier Campus, C/Santa Alicia s/n, 30720, Santiago de la Ribera, Murcia, Spain.
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19
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Owen CG, Limb ES, Nightingale CM, Rudnicka AR, Ram B, Shankar A, Cummins S, Lewis D, Clary C, Cooper AR, Page AS, Procter D, Ellaway A, Giles-Corti B, Whincup PH, Cook DG. Active design of built environments for increasing levels of physical activity in adults: the ENABLE London natural experiment study. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Low physical activity is widespread and poses a serious public health challenge both globally and in the UK. The need to increase population levels of physical activity is recognised in current health policy recommendations. There is considerable interest in whether or not the built environment influences health behaviours, particularly physical activity levels, but longitudinal evidence is limited.
Objectives
The effect of moving into East Village (the former London 2012 Olympic and Paralympic Games Athletes’ Village, repurposed on active design principles) on the levels of physical activity and adiposity, as well as other health-related and well-being outcomes among adults, was examined.
Design
The Examining Neighbourhood Activities in Built Environments in London (ENABLE London) study was a longitudinal cohort study based on a natural experiment.
Setting
East Village, London, UK.
Participants
A cohort of 1278 adults (aged ≥ 16 years) and 219 children seeking to move into social, intermediate and market-rent East Village accommodation were recruited in 2013–15 and followed up after 2 years.
Intervention
The East Village neighbourhood, the former London 2012 Olympic and Paralympic Games Athletes’ Village, is a purpose-built, mixed-use residential development specifically designed to encourage healthy active living by improving walkability and access to public transport.
Main outcome measure
Change in objectively measured daily steps from baseline to follow-up.
Methods
Change in environmental exposures associated with physical activity was assessed using Geographic Information System-derived measures. Individual objective measures of physical activity using accelerometry, body mass index and bioelectrical impedance (per cent of fat mass) were obtained, as were perceptions of change in crime and quality of the built environment. We examined changes in levels of physical activity and adiposity using multilevel models adjusting for sex, age group, ethnic group, housing sector (fixed effects) and baseline household (random effect), comparing the change in those who moved to East Village (intervention group) with the change in those who did not move to East Village (control group). Effects of housing sector (i.e. social, intermediate/affordable, market-rent) as an effect modifier were also examined. Qualitative work was carried out to provide contextual information about the perceived effects of moving to East Village.
Results
A total of 877 adults (69%) were followed up after 2 years (mean 24 months, range 19–34 months, postponed from 1 year owing to the delayed opening of East Village), of whom 50% had moved to East Village; insufficient numbers of children moved to East Village to be considered further. In adults, moving to East Village was associated with only a small, non-significant, increase in mean daily steps (154 steps, 95% confidence interval –231 to 539 steps), more so in the intermediate sector (433 steps, 95% confidence interval –175 to 1042 steps) than in the social and market-rent sectors (although differences between housing sectors were not statistically significant), despite sizeable improvements in walkability, access to public transport and neighbourhood perceptions of crime and quality of the built environment. There were no appreciable effects on time spent in moderate to vigorous physical activity or sedentary time, body mass index or percentage fat mass, either overall or by housing sector. Qualitative findings indicated that, although participants enjoyed their new homes, certain design features might actually serve to reduce levels of activity.
Conclusions
Despite strong evidence of large positive changes in neighbourhood perceptions and walkability, there was only weak evidence that moving to East Village was associated with increased physical activity. There was no evidence of an effect on markers of adiposity. Hence, improving the physical activity environment on its own may not be sufficient to increase population physical activity or other health behaviours.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 12. See the NIHR Journals Library website for further project information. This research was also supported by project grants from the Medical Research Council National Prevention Research Initiative (MR/J000345/1).
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Affiliation(s)
- Christopher G Owen
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Elizabeth S Limb
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Claire M Nightingale
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Alicja R Rudnicka
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Bina Ram
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Aparna Shankar
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Steven Cummins
- Population Health Innovation Lab, London School of Hygiene & Tropical Medicine, London, UK
| | - Daniel Lewis
- Population Health Innovation Lab, London School of Hygiene & Tropical Medicine, London, UK
| | - Christelle Clary
- Population Health Innovation Lab, London School of Hygiene & Tropical Medicine, London, UK
| | - Ashley R Cooper
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, Faculty of Social Sciences and Law, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Angie S Page
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, Faculty of Social Sciences and Law, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Duncan Procter
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, Faculty of Social Sciences and Law, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Anne Ellaway
- Medical Research Council and Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Billie Giles-Corti
- National Health and Medical Research Council Centre of Research Excellence in Healthy Liveable Communities, Centre for Urban Research, Royal Melbourne Institute of Technology University, Melbourne, VIC, Australia
| | - Peter H Whincup
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Derek G Cook
- Population Health Research Institute, St George’s, University of London, London, UK
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20
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Vu THL, Bui TTQ, Nguyen TKN, Hoang VM. Adverse influence of multilevel socioeconomic status on physical activity: results from a national survey in Vietnam. BMC Public Health 2020; 20:561. [PMID: 32334560 PMCID: PMC7183671 DOI: 10.1186/s12889-020-08695-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 04/13/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aims to explore associations of individual- and provincial-level socioeconomic status (SES) and the combined interaction among these SES with individual physical activity (PA). METHOD This analyze used data of 3068 Vietnamese people aged 18-65 years from the national representative STEPS survey in 2015 (STEPS2015). The survey collected PA-related data using the Global PA Questionnaire Version 2 and those on provicial-level characteristics from two surveys in 2014, namely the Intercensal Population and Housing Survey (IPHS) and The Vietnam Household Living Standard Survey (VLSS2014). Multilevel linear analyze was performed with individual and provincial characteristics as independent variables and the metabolic equivalent (MET) score - the indicator of individual PA - as the dependent variable. RESULTS Male and female participants with insufficient PA accounted for 20.2 and 35.7%, respectively. Both individual- and provicial-level SES were inversely associated with the individual PA level. As the provincial-level monthly income increased by 1 million Vietnam Dongs, the total PA score of individuals residing in that province reduced by 1900 METS. A buffering effect was reported between provincial and individual SES, as the provincial average income increased, the differences in PA scores between different SES groups decreased. CONCLUSION Our data suggest that Vietnamese individuals in low SES groups tended to be more physically active than those in high SES groups because their PA was largely related to work.
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Affiliation(s)
- Thi Hoang Lan Vu
- Department of Epidemiology, Hanoi University of Public Health, No. 1A Duc Thang Ward, North Tu Liem, Ha Noi, Viet Nam
| | - Thi Tu Quyen Bui
- Department of Biostatistics, Hanoi University of Public Health, No. 1A Duc Thang Ward, North Tu Liem, Ha Noi, Viet Nam.
| | - Thi Kim Ngan Nguyen
- Department of Biostatistics, Hanoi University of Public Health, No. 1A Duc Thang Ward, North Tu Liem, Ha Noi, Viet Nam
| | - Van Minh Hoang
- Hanoi University of Public Health, No. 1A Duc Thang Ward, North Tu Liem, Ha Noi, Viet Nam
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Carter A, Alexander AC. A Qualitative Exploration of Womens’ Experiences Who Belong to a “Fitness Community”. AMERICAN JOURNAL OF HEALTH EDUCATION 2019. [DOI: 10.1080/19325037.2019.1687365] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abdul Rashid NA, Nurjono M, Lee J. Clinical determinants of physical activity and sedentary behaviour in individuals with schizophrenia. Asian J Psychiatr 2019; 46:62-67. [PMID: 31627166 DOI: 10.1016/j.ajp.2019.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/03/2019] [Accepted: 10/03/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Modifiable lifestyle factors such as physical activity (PA) have ameliorative effects on commonly reported health conditions in schizophrenia like cardiovascular diseases and diabetes. Similarly, reduction in sedentary behaviour (SB) promotes better physical health. However, engaging individuals with schizophrenia in PA and less SB can be challenging because of symptoms of schizophrenia. The aims of the present study are (i) to examine the profiles of PA and SB in individuals with schizophrenia; and (ii) to identify their respective clinical determinants. METHOD 157 individuals with schizophrenia were recruited. PA and SB were examined via the Global Physical Activity Questionnaire (GPAQ). Psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS). Potential clinical predictors of PA and SB were identified via univariate regression analyses and subsequently included in the final multiple regression models for PA and SB respectively. RESULTS 63.7% met the WHO PA guidelines. Work-related activity was the largest domain specific contribution towards PA. Mean duration of SB was approximately 9 h and about 57.3% reported at least 8 h or more of SB daily. Positive symptom was associated with engagement in PA and reduced duration of SB. Negative symptom was associated with greater SB. CONCLUSION With emerging evidence of deleterious health effects of SB independent of PA, it is important to monitor SB in individuals with schizophrenia, particularly those presenting with negative symptoms. While the lack of treatment response for negative symptoms remains a challenge, effort should be made to reduce duration of SB.
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Affiliation(s)
| | | | - Jimmy Lee
- Research Division, Institute of Mental Health, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore; North Region & Department of Psychosis, Institute of Mental Health, Singapore.
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Kullman EL, Saylor SM, Little KD. Efficacy of whole-body suspension training on enhancing functional movement abilities following a supervised or home-based training program. J Sports Med Phys Fitness 2019; 60:244-250. [PMID: 31665874 DOI: 10.23736/s0022-4707.19.10066-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The purpose of this study was to determine the effects of suspension training on functional movement and body composition, and to compare the effectiveness of home-based training to supervised training. METHODS Seventeen healthy subjects (8 males, 9 females, age=21.8±3.4 y) with no recent history of resistance training were randomly assigned to a home-based or supervised training group. Subjects performed an 8-week suspension training program consisting of 10 exercises targeting major muscle groups, twice per week for the duration of the study. Pre- and post-intervention testing included body composition using air displacement plethysmography, and a functional movement screen (FMS) to measure functional movement abilities. RESULTS The 8-week training program significantly improved total FMS scores across the whole sample of subjects (Pre=16.4; Post=17.5; P=0.004), with no differences in improvements between groups. When compared separately, only the supervised group significantly improved FMS scores. There was also a significant increase in lean mass across the total sample of subjects (Pre=52.4 kg; Post=53.3 kg; P=0.03) with no differences between groups. But when compared independently, neither group exhibited a significant increase in lean mass. CONCLUSIONS When completed as a whole-body exercise program over an 8-week period, suspension training can improve functional ability and increase lean mass in both a supervised and a home-based setting.
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Affiliation(s)
- Emily L Kullman
- Department of Health and Human Performance, Cleveland State University, Cleveland, OH, USA -
| | - Shelby M Saylor
- Department of Health and Human Performance, Cleveland State University, Cleveland, OH, USA
| | - Kathleen D Little
- Department of Health and Human Performance, Cleveland State University, Cleveland, OH, USA
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Zevallos-Morales A, Luna-Porta L, Medina-Salazar H, Yauri M, Taype-Rondan A. Association between migration and physical activity among medical students from a university located in Lima, Peru. PLoS One 2019; 14:e0212009. [PMID: 30811427 PMCID: PMC6392244 DOI: 10.1371/journal.pone.0212009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 01/22/2019] [Indexed: 12/04/2022] Open
Abstract
Objective To evaluate the association between migration and physical activity among medical students from a university located in Lima, Peru. Methods A cross-sectional study was conducted among second-year medical students from a Peruvian university. Data on moderate- to vigorous-intensity physical activity (MVPA) and migration features were obtained through a self-report questionnaire. To assess the associations of interest, prevalence ratios (PR) along with their 95% confidence intervals (95% CI) were calculated using Poisson regression with robust variances. Results We analyzed data from 312 students (54.5% were women, mean age: 19.0 years, standard deviation: 1.4 years), 90 (28.9%) students performed MVPA for ≥150 minutes/week, 118 (37.8%) performed MVPA for ≤30 minutes/week, and 114 (36.7%) were migrants. Being a migrant was not associated with performing MVPA for ≤30 nor ≥150 minutes/week. However, adjusted analysis showed that the frequency of performing MVPA for ≤30 minutes/week was greater among those who migrated less than five years ago (PR: 1.43; 95% CI: 1.05–1.93) and among those who migrated to continue their studies (PR: 1.44; 95% CI: 1.06–1.94), compared to non-migrants. Conclusion In our population, being a migrant was not associated with physical activity. However, low physical activity was more prevalent among recent migrants and among those who had migrated to study, compared to non-migrants.
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Affiliation(s)
| | - Leslie Luna-Porta
- Universidad de San Martín de Porres, Facultad de Medicina Humana, Lima, Peru
| | | | - María Yauri
- Universidad de San Martín de Porres, Facultad de Medicina Humana, Lima, Peru
| | - Alvaro Taype-Rondan
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
- * E-mail:
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Bartholomae EM, Moore J, Ward K, Kressler J. Sex differences in postprandial glucose response to short bouts of exercise: A randomized controlled trial. J Sci Med Sport 2019; 22:181-185. [DOI: 10.1016/j.jsams.2018.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 07/09/2018] [Accepted: 07/13/2018] [Indexed: 10/28/2022]
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Rodriguez-Hernandez MG, Wadsworth DW. The effect of 2 walking programs on aerobic fitness, body composition, and physical activity in sedentary office employees. PLoS One 2019; 14:e0210447. [PMID: 30695080 PMCID: PMC6350957 DOI: 10.1371/journal.pone.0210447] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 12/21/2018] [Indexed: 01/01/2023] Open
Abstract
Purpose The present study examined changes in body composition, maximum oxygen uptake, and physical activity in sedentary office employees prescribed with two different walking programs during a 10-week intervention. Methods 68 sedentary employees were randomly assigned to one of three groups: multiple bouts of walking (n = 24 (5 male, 19 female) Age = 46±9, BMI = 30.5±5.78 kg/m2), continuous walking (n = 22 (6 male, 16 female) Age = 48±9, BMI = 30.6±6.2 kg/m2) and the control group (n = 22 (5 male, 17 female) Age = 42±10, BMI = 27.5±5.23 kg/m2). Dual-energy X-ray absorptiometry (iDXA) assessed body composition and a Bruce protocol treadmill test assessed aerobic fitness at baseline and week 11. At baseline, week 6 and week 11 a waist worn accelerometer measured physical activity and sedentary behavior. Physical activity was measured throughout the program with a wrist worn accelerometer. Results The results from the mixed-design ANOVA show that fat mass (p < .000) and fat percentage (p < .000) decreased for all three groups as a main effect of time. Sedentary behavior did not change (p>0.05) for all three groups. Moderate intensity physical activity increased significantly from pre-test to week 6 (p<0.05), then decreased from week 6 to post-test (p<0.05), with no significant changes observed from pre-test to post-test (p>0.05) for all groups. No changes in VO2 were observed (p>0.05) for all groups. Conclusions Continuous or intermittent walking activity produce similar benefits on body weight, fat mass and body fat percentage in sedentary employees. Meanwhile, intermittent walking allowed these sedentary employees to increase lean mass and fat free mass. Intermittent walking could provide at least similar benefits on body composition compared to a continuous walking program.
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Affiliation(s)
- Mynor G. Rodriguez-Hernandez
- Education Department, University of Costa Rica, San Ramón, Alajuela, Costa Rica
- School of Kinesiology, Auburn University, Auburn, Alabama, United States of America
- * E-mail: ,
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Bartholomae E, Johnson Z, Moore J, Ward K, Kressler J. Reducing Glycemic Indicators with Moderate Intensity Stepping of Varied, Short Durations in People with Pre-Diabetes. J Sports Sci Med 2018; 17:680-685. [PMID: 30479538 PMCID: PMC6243616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 10/16/2018] [Indexed: 06/09/2023]
Abstract
Investigate the effects of short duration stair climbing/descending at a self-selected pace on post-prandial glucose responses in adults. Thirty participants (10 female) completed 4 oral glucose tolerance tests on separate days. Following glucose consumption, participants underwent seated rest (control) or walked up/down 21 stairs at a self-selected comfortable pace for 10, 3, and 1min in randomized order. Blood glucose was measured by capillary sampling from finger sticks every 15min until values for all trials converged. Area under the curve (AUC) was calculated by trapezoidal rule. In addition, cardiometabolic measurements were taken during stair exercise with a mobile metabolic cart. Results are presented as mean (SD) unless stated otherwise. All stair-climbing trials reduced peak (30min) postprandial blood glucose levels compared to the control [(1 min = 12(31), p = 0.026; 3 min = -15(25), p = 0.003; 10 min = 35(32) mg/dL, p < 0.001]. At 45min, there were significant reductions only for the 3 and 10 min trials [13(29) and 23(31) mg/dL, p = 0.023 and < 0.001 respectively], but not the 1 min trial [6(33) mg/dL, p = 0.317]. There were significant differences in AUC compared to the control only for the 3 and 10min trials [502 (1141) and 866 (1123) mg/dL·min-1, p = 0.023 and < 0.000] but not for the 1min trial [353 (1265) mg/dL·min-1, p = 0.110]. Median (interquartile range) RPEs reported for the 1, 3, and 10min trials were 1.0 (1.5), 2.0(2), and 3.0 (2.0) respectively, while VO2 was n/a, 54(12), and 59(13)% of peak, respectively. Total metabolic cost was 1.4 (0.5), 4.0 (1.0), and 11.9 (2.1) L O2, respectively. A single 1min bout of low-moderate intensity stair stepping can significantly lower peak glucose concentration, with longer bouts being more effective.
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Affiliation(s)
- Eric Bartholomae
- School of Exercise and Nutritional Sciences, San Diego State University. San Diego, CA, USA
- College of Health Solutions, Arizona State University. Tempe, AZ, USA
| | - Zachary Johnson
- School of Exercise and Nutritional Sciences, San Diego State University. San Diego, CA, USA
| | - Jeffery Moore
- School of Exercise and Nutritional Sciences, San Diego State University. San Diego, CA, USA
| | - Kathryn Ward
- School of Exercise and Nutritional Sciences, San Diego State University. San Diego, CA, USA
| | - Jochen Kressler
- School of Exercise and Nutritional Sciences, San Diego State University. San Diego, CA, USA
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Nightingale CM, Rudnicka AR, Ram B, Shankar A, Limb ES, Procter D, Cooper AR, Page AS, Ellaway A, Giles-Corti B, Clary C, Lewis D, Cummins S, Whincup PH, Cook DG, Owen CG. Housing, neighbourhood and sociodemographic associations with adult levels of physical activity and adiposity: baseline findings from the ENABLE London study. BMJ Open 2018; 8:e021257. [PMID: 30121597 PMCID: PMC6104748 DOI: 10.1136/bmjopen-2017-021257] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The neighbourhood environment is increasingly shown to be an important correlate of health. We assessed associations between housing tenure, neighbourhood perceptions, sociodemographic factors and levels of physical activity (PA) and adiposity among adults seeking housing in East Village (formerly London 2012 Olympic/Paralympic Games Athletes' Village). SETTING Cross-sectional analysis of adults seeking social, intermediate and market-rent housing in East Village. PARTICIPANTS 1278 participants took part in the study (58% female). Complete data on adiposity (body mass index (BMI) and fat mass %) were available for 1240 participants (97%); of these, a subset of 1107 participants (89%) met the inclusion criteria for analyses of accelerometer-based measurements of PA. We examined associations between housing sector sought, neighbourhood perceptions (covariates) and PA and adiposity (dependent variables) adjusted for household clustering, sex, age group, ethnic group and limiting long-standing illness. RESULTS Participants seeking social housing had the fewest daily steps (8304, 95% CI 7959 to 8648) and highest BMI (26.0 kg/m2, 95% CI 25.5kg/m2 to 26.5 kg/m2) compared with those seeking intermediate (daily steps 9417, 95% CI 9106 to 9731; BMI 24.8 kg/m2, 95% CI 24.4 kg/m2 to 25.2 kg/m2) or market-rent housing (daily steps 9313, 95% CI 8858 to 9768; BMI 24.6 kg/m2, 95% CI 24.0 kg/m2 to 25.2 kg/m2). Those seeking social housing had lower levels of PA (by 19%-42%) at weekends versus weekdays, compared with other housing groups. Positive perceptions of neighbourhood quality were associated with higher steps and lower BMI, with differences between social and intermediate groups reduced by ~10% following adjustment, equivalent to a reduction of 111 for steps and 0.5 kg/m2 for BMI. CONCLUSIONS The social housing group undertook less PA than other housing sectors, with weekend PA offering the greatest scope for increasing PA and tackling adiposity in this group. Perceptions of neighbourhood quality were associated with PA and adiposity and reduced differences in steps and BMI between housing sectors. Interventions to encourage PA at weekends and improve neighbourhood quality, especially among the most disadvantaged, may provide scope to reduce inequalities in health behaviour.
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Affiliation(s)
- Claire M Nightingale
- Population Health Research Institute, St George's University of London, London, UK
| | - Alicja R Rudnicka
- Population Health Research Institute, St George's University of London, London, UK
| | - Bina Ram
- Population Health Research Institute, St George's University of London, London, UK
| | - Aparna Shankar
- Population Health Research Institute, St George's University of London, London, UK
| | - Elizabeth S Limb
- Population Health Research Institute, St George's University of London, London, UK
| | - Duncan Procter
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Ashley R Cooper
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Angie S Page
- Centre for Exercise, Nutrition and Health Sciences, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK
| | - Anne Ellaway
- MRC/SCO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Billie Giles-Corti
- NHMRC Centre of Research Excellence in Healthy Liveable Communities, RMIT University, Melbourne, Victoria, Australia
| | - Christelle Clary
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Daniel Lewis
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Steven Cummins
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, London, UK
| | - Derek G Cook
- Population Health Research Institute, St George's University of London, London, UK
| | - Christopher G Owen
- Population Health Research Institute, St George's University of London, London, UK
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The contribution of health behaviors to socioeconomic inequalities in health: A systematic review. Prev Med 2018; 113:15-31. [PMID: 29752959 DOI: 10.1016/j.ypmed.2018.05.003] [Citation(s) in RCA: 199] [Impact Index Per Article: 33.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 05/02/2018] [Accepted: 05/05/2018] [Indexed: 12/22/2022]
Abstract
Unhealthy behaviors and their social patterning have been frequently proposed as factors mediating socioeconomic differences in health. However, a clear quantification of the contribution of health behaviors to the socioeconomic gradient in health is lacking. This study systematically reviews the role of health behaviors in explaining socioeconomic inequalities in health. Published studies were identified by a systematic review of PubMed, Embase and Web-of-Science. Four health behaviors were considered: smoking, alcohol consumption, physical activity and diet. We restricted health outcomes to cardiometabolic disorders and mortality. To allow comparison between studies, the contribution of health behaviors, or the part of the socioeconomic gradient in health that is explained by health behaviors, was recalculated in all studies according to the absolute scale difference method. We identified 114 articles on socioeconomic position, health behaviors and cardiometabolic disorders or mortality from electronic databases and articles reference lists. Lower socioeconomic position was associated with an increased risk of all-cause mortality and cardiometabolic disorders, this gradient was explained by health behaviors to varying degrees (minimum contribution -43%; maximum contribution 261%). Health behaviors explained a larger proportion of the SEP-health gradient in studies conducted in North America and Northern Europe, in studies examining all-cause mortality and cardiovascular disease, among men, in younger individuals, and in longitudinal studies, when compared to other settings. Of the four behaviors examined, smoking contributed the most to social inequalities in health, with a median contribution of 19%. Health behaviors contribute to the socioeconomic gradient in cardiometabolic disease and mortality, but this contribution varies according to population and study characteristics. Nevertheless, our results should encourage the implementation of interventions targeting health behaviors, as they may reduce socioeconomic inequalities in health and increase population health.
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Lueck JA. Respecting the 'stages' of depression: Considering depression severity and readiness to seek help. PATIENT EDUCATION AND COUNSELING 2018; 101:1276-1282. [PMID: 29475726 DOI: 10.1016/j.pec.2018.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 02/12/2018] [Accepted: 02/14/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Despite knowing the value of message customization, empirical results have failed to provide clear indicators of what make a depression help-seeking message effective. The present research examines stages of depression in response to a prominent communication strategy, gain versus loss framing, to inform possibilities for effective message customization. METHODS Two experimental studies were conducted with a student (N = 126) and U.S. adult (N = 738) sample that tested the effects of gain versus loss framing at different stages of depression. RESULTS A persuasive gain-frame advantage was found for those with mild and severe depression, whereas a boomerang effect was found for both gain and loss framing among those with moderately severe depression. With regards to intention to seek help, neither gain nor loss framing was found to influence intentions. Stages of depression was a strong predictor, with strongest intentions to seek help observed among those with either minor or severe symptoms of depression. CONCLUSION Effective health messaging must be matched with unique characteristics and needs of individuals at each 'stage' of depression in order to produce favorable outcomes. PRACTICE IMPLICATIONS 'Stages' of depression should be known and carefully assessed before the creation and launch of communication interventions.
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Mawditt C, Sacker A, Britton A, Kelly Y, Cable N. Social influences on health-related behaviour clustering during adulthood in two British birth cohort studies. Prev Med 2018; 110:67-80. [PMID: 29428172 DOI: 10.1016/j.ypmed.2018.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 01/16/2018] [Accepted: 02/05/2018] [Indexed: 11/18/2022]
Abstract
Building upon evidence linking socio-economic position (SEP) in childhood and adulthood with health-related behaviours (HRB) in adulthood, we examined how pre-adolescent SEP predicted membership of three HRB clusters: "Risky", "Moderate Smokers" and "Mainstream" (the latter pattern consisting of more beneficial HRBs), that were detected in our previous work. Data were taken from two British cohorts (born in 1958 and 1970) in pre-adolescence (age 11 and 10, respectively) and adulthood (age 33 and 34). SEP constructs in pre-adolescence and adulthood were derived through Confirmatory Factor Analysis. Conceptualised paths from pre-adolescent SEP to HRB cluster membership via adult SEP in our path models were tested for statistical significance separately by gender and cohort. Adult SEP mediated the path between pre-adolescent SEP and adult HRB clusters. More disadvantaged SEP in pre-adolescence predicted more disadvantaged SEP in adulthood which was associated with membership of the "Risky" and "Moderate Smokers" clusters compared to the "Mainstream" cluster. For example, large positive indirect effects between pre-adolescent SEP and adult HRB via adult SEP were present (coefficient 1958 Women = 0.39; 1970 Women = 0.36, 1958 Men = 0.51; 1970 Men = 0.39; p < 0.01) when comparing "Risky" and "Mainstream" cluster membership. Amongst men we found a small significant direct association (p < 0.001) between pre-adolescent SEP and HRB cluster membership. Our findings suggest that associations between adult SEP and HRBs are not likely to be pre-determined by earlier social circumstances, providing optimism for interventions relevant to reducing social gradients in HRBs. Observing consistent findings across the cohorts implies the social patterning of adult lifestyles may persist across time.
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Affiliation(s)
- Claire Mawditt
- International Centre for Lifecourse Studies in Society and Health, Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Amanda Sacker
- International Centre for Lifecourse Studies in Society and Health, Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Annie Britton
- Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Yvonne Kelly
- International Centre for Lifecourse Studies in Society and Health, Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Noriko Cable
- International Centre for Lifecourse Studies in Society and Health, Research Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
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Lindström M, Rosvall M. Economic stress and low leisure-time physical activity: Two life course hypotheses. SSM Popul Health 2018; 4:358-364. [PMID: 29854921 PMCID: PMC5976861 DOI: 10.1016/j.ssmph.2018.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 04/12/2018] [Accepted: 04/14/2018] [Indexed: 12/24/2022] Open
Abstract
The aim was to investigate associations between economic stress in childhood and adulthood, and low leisure-time physical activity (LTPA) in adulthood from two life course perspectives. The public health survey in Scania in the southernmost part of Sweden in 2012 is a cross-sectional study based on a stratified random sample with 28,029 respondents aged 18-80 (51.7% response rate). Associations between childhood and adult economic stress, and low LTPA were analyzed with logistic regressions. A 14.8% prevalence of men and 13.5% of women had low LTPA (sedentary lifestyle). Low LTPA was associated with higher age, being born abroad, low socioeconomic status, low trust, smoking, poor self-rated health, and economic stress in childhood and adulthood. The odds ratios of low LTPA increased with more accumulated economic stress across the life course in a dose-response relationship. There was no specific critical period (childhood or adulthood), because economic stress in childhood and adulthood were both associated with low LTPA but the associations were attenuated after the introduction of smoking and self-rated health. The accumulation hypothesis was supported because the odds ratios of low LTPA indicated a graded response to life course economic stress. The critical period hypothesis was thus not supported. Economic stress across the life course seems to be associated with low LTPA in adulthood.
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Affiliation(s)
- Martin Lindström
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö, Lund University, S-205 02 Malmö, Sweden
| | - Maria Rosvall
- Social Medicine and Health Policy, Department of Clinical Sciences in Malmö, Lund University, S-205 02 Malmö, Sweden
- Department of Medicine, Gothenburg University, Sweden
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Simons D, De Bourdeaudhuij I, Clarys P, De Cocker K, Vandelanotte C, Deforche B. A Smartphone App to Promote an Active Lifestyle in Lower-Educated Working Young Adults: Development, Usability, Acceptability, and Feasibility Study. JMIR Mhealth Uhealth 2018; 6:e44. [PMID: 29463491 PMCID: PMC5840478 DOI: 10.2196/mhealth.8287] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 11/22/2017] [Accepted: 12/09/2017] [Indexed: 01/08/2023] Open
Abstract
Background Physical activity (PA) levels are problematic in lower-educated working young adults (18-26 years). To promote PA, smartphone apps have great potential, but there is no evidence for their effectiveness in this population. To increase the likelihood that a newly developed app will be effective, formative research and user testing are required. Objective The aim of this study was to describe the development, usability, acceptability, and feasibility of a new theory- and evidence-based smartphone app to promote an active lifestyle in lower-educated working young adults. Methods The new app was developed by applying 4 steps. First, determinants important to promote an active lifestyle in this population were selected. Second, evidence-based behavior change techniques were selected to convert the determinants into practical applications. Third, a new smartphone app was developed. Fourth, volunteers (n=11, both lower and higher educated) tested the app on usability, and lower-educated working young adults (n=16) tested its acceptability and feasibility via (think aloud) interviews, a questionnaire, and Google Analytics. The app was accordingly adapted for the final version. Results A new Android app, Active Coach, was developed that focused on knowledge, attitude, social support, and self-efficacy (based on outcomes from step 1), and that applied self-regulation techniques (based on outcomes from step 2). The app consists of a 9-week program with personal goals, practical tips, and scientific facts to encourage an active lifestyle. To ensure all-day and automatic self-monitoring of the activity behavior, the Active Coach app works in combination with a wearable activity tracker, the Fitbit Charge. Issues detected by the usability test (eg, text errors, wrong messages) were all fixed. The acceptability and feasibility test showed that participants found the app clear, understandable, and motivating, although some aspects needed to be more personal. Conclusions By applying a stepwise, user-centered approach that regularly consulted the target group, the new app is adapted to their specific needs and preferences. The Active Coach app was overall positively evaluated by the lower-educated working young adults at the end of the development process.
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Affiliation(s)
- Dorien Simons
- Health Promotion and Education Unit, Department of Public Health, Ghent University, Ghent, Belgium.,Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Peter Clarys
- Physical Activity, Nutrition and Health Research Unit, Faculty of Physical Education and Physical Therapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Katrien De Cocker
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Physically Active Lifestyles Research Group, Institute for Resilient Regions, University of Southern Queensland, Springfield Central, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, School for Health, Medical and Applied Science, Central Queensland University, Rockhampton, Australia
| | - Benedicte Deforche
- Health Promotion and Education Unit, Department of Public Health, Ghent University, Ghent, Belgium
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Heard EM, Auvaa L, Conway BA. Culture X: addressing barriers to physical activity in Samoa. Health Promot Int 2018; 32:734-742. [PMID: 26825998 DOI: 10.1093/heapro/dav119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
There is an urgent need to address the epidemic rates of non-communicable diseases globally, and the Pacific Island region is of particular concern. Increasing physical activity participation plays an important role in reducing some of the key risk factors for non-communicable diseases including obesity and being overweight. In order to address low levels of physical activity, it is essential to understand the key barriers and facilitating factors experienced by specific population groups. The purpose of this study is to investigate key facilitating factors for participation in a dance aerobic initiative, Culture X, developed in the Pacific Island country, Samoa. The study further aims to understand ways in which the programme assists participants in addressing barriers to physical activity. Face-to-face interviews running from 10 to 20 min were conducted with 28 Culture X participants in order to gain a deep understanding of participants' personal perspectives with regard to barriers and facilitating factors to physical activity. Findings suggest the inclusion of key cultural components (including, traditional dance moves and music, prayer, community orientation and family inclusiveness) were integral for supporting ongoing participation in Culture X. These components further assisted participants in addressing important personal and social barriers to physical activity (including lack of motivation and enjoyment, lack of confidence, time management, family and social commitments and lack of support). This study highlights creative ways that health promotion in the Pacific Island region can encourage physical activity and informs health promotion literature regarding the importance of placing local culture at the heart of behaviour change initiatives.
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Affiliation(s)
- Emma Marie Heard
- School of Nursing and Health Sciences, National University of Samoa, Apia, Samoa
| | - Leveti Auvaa
- School of Nursing and Health Sciences, National University of Samoa, Apia, Samoa
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Barriers to Physical Activity in Low Back Pain Patients following Rehabilitation: A Secondary Analysis of a Randomized Controlled Trial. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6925079. [PMID: 29209630 PMCID: PMC5676355 DOI: 10.1155/2017/6925079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 09/06/2017] [Accepted: 09/13/2017] [Indexed: 12/02/2022]
Abstract
Background Promoting health-enhancing physical activity following rehabilitation is a well-known challenge. This study analysed the barriers to leisure time activity among low back pain patients. Methods A subset of 192 low back pain patients who participated in a randomized controlled trial promoting physical activity was analysed. Physical activity, barriers, and sociodemographic and indication-related variables were assessed by a questionnaire. Differences in barriers between active and inactive participants were tested by Pearson's chi squared test. A logistic regression model was fitted to identify influencing factors on physical activity at six months following rehabilitation. Results Inactive and active participants differed significantly in nine of the 19 barriers assessed. The adjusted regression model showed associations of level of education (OR = 5.366 [1.563; 18.425]; p value = 0.008) and fear of pain (OR = 0.612 [0.421; 0.889]; p value = 0.010) with physical activity. The barriers included in the model failed to show any statistically significant association after adjustment for sociodemographic factors. Conclusions Low back pain patients especially with a low level of education and fear of pain seem to need tailored support in overcoming barriers to physical activity. This study is registered at German Clinical Trials Register (DRKS00004878).
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Nagelhout GE, Hogeling L, Spruijt R, Postma N, de Vries H. Barriers and Facilitators for Health Behavior Change among Adults from Multi-Problem Households: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101229. [PMID: 29036936 PMCID: PMC5664730 DOI: 10.3390/ijerph14101229] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 09/29/2017] [Accepted: 10/11/2017] [Indexed: 01/23/2023]
Abstract
Multi-problem households are households with problems on more than one of the following core problem areas: socio-economic problems, psycho-social problems, and problems related to child care. The aim of this study was to examine barriers and facilitators for health behavior change among adults from multi-problem households, as well as to identify ideas for a health promotion program. A qualitative study involving 25 semi-structured interviews was conducted among Dutch adults who received intensive family home care for multi-problem households. Results were discussed with eight social workers in a focus group interview. Data were analyzed using the Framework Method. The results revealed that the main reason for not engaging in sports were the costs. Physical activity was facilitated by physically active (transport to) work and by dog ownership. Respondents who received a food bank package reported this as a barrier for healthy eating. Those with medical conditions such as diabetes indicated that this motivated them to eat healthily. Smokers and former smokers reported that stress was a major barrier for quitting smoking but that medical conditions could motivate them to quit smoking. A reported reason for not using alcohol was having difficult past experiences such as violence and abuse by alcoholics. Mentioned intervention ideas were: something social, an outdoor sports event, cooking classes, a walking group, and children's activities in nature. Free or cheap activities that include social interaction and reduce stress are in line with the identified barriers and facilitators. Besides these activities, it may be important to influence the target group's environment by educating social workers and ensuring healthier food bank packages.
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Affiliation(s)
- Gera E Nagelhout
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht 6200 MD, The Netherlands.
- Department of Family Medicine, Maastricht University (CAPHRI), Maastricht 6200 MD, The Netherlands.
- IVO Addiction Research Institute, Rotterdam 3021 DM, The Netherlands.
| | - Lette Hogeling
- Chair Group Health & Society, Department of Social Sciences, Wageningen University, Wageningen 6700 EW, The Netherlands.
| | | | | | - Hein de Vries
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht 6200 MD, The Netherlands.
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Sales M, Levinger P, Polman R. Relationships between self perceptions and physical activity behaviour, fear of falling, and physical function among older adults. Eur Rev Aging Phys Act 2017; 14:17. [PMID: 28943974 PMCID: PMC5607601 DOI: 10.1186/s11556-017-0185-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Accepted: 08/31/2017] [Indexed: 11/24/2022] Open
Abstract
Background There has been a lack of research examining the relationship among self-perceptions, behaviour, cognitions and functioning in older adults. This study, therefore, examined the relationship between global and physical self-perceptions, physical activity behaviour, and fear of falling taking into considerations objective measures of physical functioning in community dwelling older adults. Methods/design Sixty-six participants between 60 and 90 years old (71.9 ± 6.6 years; 47 females; 19 males) completed questionnaires assessing physical and global self-description (PSDQ), planned and incidental physical activity behaviour (IPEQ), and falls efficacy (Short FES-I) as well as tests measuring physical functioning. Backwards multiple linear regression modelling was used to assess possible relationships among variables. Results Findings showed that physical self-perceptions (activity, coordination, endurance, flexibility) were associated with self-reported planned and incidental PA whereas sit-to-stand was the only objectively measured physical functioning variable associated with planned PA. Similarly, more falls, global self-esteem, general physical and domain specific physical self-perceptions (flexibility and strength) as well as knee strength were associated with fear of falling. There were also associations between some of the objectively measured physical functioning variables and self-perceptions of the physical self, providing some predictive validity for the PDSQ. Conclusions The findings of this study come to corroborate that the belief system of older adults ideally need to be taken into consideration when designing interventions that aim to enhance PA behaviour or reduce fear of falling. Coupling that with goal-setting, life coaching and behaviour change strategies would also be beneficial to address engagement and adherence to such interventions. Trial registration This trial was retrospectively registered with the Australian New Zealand Clinical Trials Registry - Registry No. ACTRN12614000700639 on the Jul 03rd 2014.
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Affiliation(s)
- Myrla Sales
- Institute of Sport, Exercise & Active Living (ISEAL), College of Sport and Exercise Science, Victoria University, Melbourne, Victoria Australia
| | - Pazit Levinger
- Associate Professor and Group Discipline Leader Exercise Science and Clinical Rehabilitation, Institute of Sport, Exercise & Active Living (ISEAL), College of Sport and Exercise Science, Victoria University, Melbourne, Victoria Australia
| | - Remco Polman
- Professor and Head of School Exercise & Nutrition Sciences, Queensland University of Technology, Kelvin Grove Campus, Brisbane, Australia
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Ray R. Black people don't exercise in my neighborhood: Perceived racial composition and leisure-time physical activity among middle class blacks and whites. SOCIAL SCIENCE RESEARCH 2017; 66:42-57. [PMID: 28705363 DOI: 10.1016/j.ssresearch.2017.03.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Revised: 01/06/2017] [Accepted: 03/28/2017] [Indexed: 06/07/2023]
Abstract
Using a sample of middle class blacks and whites living in urban and suburban areas, this article focuses on how perceptions of the racial composition of neighborhoods influence leisure-time physical activity. Using an ordinal representation of an underlying continuous indication of the perceived percentage of blacks and whites within an egocentric neighborhood, the results show that black men are significantly less likely to be physically active in neighborhoods perceived as predominately white. Alternatively, they are more likely to be physically active in neighborhoods perceived as racially diverse and predominately black. Conversely, for black women, white women, and white men, physical activity increases as the perception of one's neighborhood becomes increasingly white. Black women are significantly less likely to engage in physical activity in neighborhoods perceived as predominately black and urban. Drawing upon the intersectionality framework, I discuss how perceptions of criminalization and safety lead to different levels of leisure-time physical activity for middle class black women and men relative to their white middle class counterparts.
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Affiliation(s)
- Rashawn Ray
- University of Maryland, College Park, United States.
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Evans G, Gleeson H, Gregory K. INTEGRATING SPORT & EXERCISE MEDICINE IN TO A ‘LATE EFFECTS CLINIC’ FOR CHILDHOOD CANCER SURVIVORS: DEVELOPING CARE PATHWAYS TO IMPROVE SERVICE PROVISION. Br J Sports Med 2016. [DOI: 10.1136/bjsports-2016-096900.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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41
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Normansell R, Holmes R, Victor C, Cook DG, Kerry S, Iliffe S, Ussher M, Fox-Rushby J, Whincup P, Harris T. Exploring non-participation in primary care physical activity interventions: PACE-UP trial interview findings. Trials 2016; 17:178. [PMID: 27039181 PMCID: PMC4818945 DOI: 10.1186/s13063-016-1299-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 03/17/2016] [Indexed: 11/10/2022] Open
Abstract
Background Trials in primary care to increase physical activity (PA) typically experience poor recruitment rates and may not recruit those with lower PA levels and who are most in need of the intervention. Despite the well-publicised benefits of physical activity, the majority of adults in the UK remain inactive and, therefore, at greater risk of many health problems. Our aim was to investigate the reasons for non-participation in the PACE-UP trial, which is a primary care pedometer-based walking intervention. This is important for successful recruitment and retention in future PA trials and programmes. Method We conducted semi-structured audio-recorded telephone interviews with 30 participants, aged 45–75 years, purposively sampled from those declining participation in the PACE-UP trial. Recruitment continued until data saturation and a demographically balanced sample was achieved. Interviews were transcribed verbatim, coded and subjected to thematic analysis. Results Interviewees supported walking as suitable exercise for most people in this age group, recognised the importance of this type of research and general practice as an appropriate setting. Key reasons for declining were: the perception of being already ‘too active’; existing medical conditions; work; travel and other commitments. Less frequently cited reasons included reluctance to be randomised, the intervention’s duration, wearing a pedometer, perceived inappropriateness of trial literature and a preference for a different kind of PA or for a group activity. Conclusions Whilst most interviewees perceived themselves to be sufficiently active, an important minority did not participate due to existing medical conditions and other commitments. Recruitment to future PA trials might be improved by tailoring activity to compensate for medical problems, and adapting PA interventions to fit around work and travel commitments. Ensuring that patient-targeted literature is succinct and inclusive and that equipment is user-friendly are also important. Primary care is seen as an appropriate setting for PA trials and programmes. Trial registration ISRCTN98538934.
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Affiliation(s)
- Rebecca Normansell
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 ORE, UK.
| | - Rebecca Holmes
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 ORE, UK
| | - Christina Victor
- Gerontology and Health Services Research Unit, Brunel University, London, UB8 3PH, UK
| | - Derek G Cook
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 ORE, UK
| | - Sally Kerry
- Pragmatic Clinical Trials Unit, Queen Mary University of London, London, E1 2AT, UK
| | - Steve Iliffe
- Research Department of Primary Care and Population Health, University College, London, NW3 2PF, UK
| | - Michael Ussher
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 ORE, UK
| | - Julia Fox-Rushby
- Health Economics Research Group, Brunel University, London, UB8 3PH, UK
| | - Peter Whincup
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 ORE, UK
| | - Tess Harris
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 ORE, UK
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Kure-Biegel N, Schnohr CW, Hindhede AL, Diderichsen F. Risk factors for not completing health interventions and the potential impact on health inequalities between educational groups - a mixed method study from Denmark. Int J Equity Health 2016; 15:54. [PMID: 27029463 PMCID: PMC4815197 DOI: 10.1186/s12939-016-0344-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Accepted: 03/22/2016] [Indexed: 11/12/2022] Open
Abstract
Background Individual-based interventions aim to improve patient self-management of chronic disease and to improve lifestyle among people at high risk, to reduce the prevalence of diseases contributing to health inequality. The present study investigates risk factors for uncompleted health interventions, via a combination of quantitative and qualitative methods. Methods From a health centre in Copenhagen, questionnaire data on educational level, gender, age, and cohabitation status from 104 participants in health interventions were used to examine risks for dropout. Qualitative telephone interviews further investigated risk factors among 17 participants who were registered as uncompleted. Results Our findings show that there is a significantly higher prevalence of uncompleted courses among participants below age 60 (OR 3.38, 95 % CI 1.08; 10.55) and an insignificantly higher prevalence among people with low education (OR 1.82, 95 % CI 0.66; 5.03). Qualitative elaboration of these findings points to low self-control in jobs and a higher degree of comorbidity and treatment of diseases among the lower educated as determinants for not completing, but not lower motivation or less positive attitude toward the intervention itself. Conclusions This study indicates a social difference in dropout, and if dropout is to be prevented, there is a need to acknowledge factors such as organization of the intervention, lack of job flexibility, and comorbidity. If these factors are not addressed, people with low socioeconomic status will most likely have reduced opportunities for making healthy choices, in this case, completing the intervention, and this may increase health inequality.
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Affiliation(s)
- Nanna Kure-Biegel
- Section of Social Medicine, Institute of Public Health, University of Copenhagen, Gothersgade 160, Copenhagen, DK-1014 K, Denmark
| | - Christina Warrer Schnohr
- Section of Social Medicine, Institute of Public Health, University of Copenhagen, Gothersgade 160, Copenhagen, DK-1014 K, Denmark
| | - Anette Lykke Hindhede
- Department of Learning and Philosophy, Aalborg University, A C Meyers Vaenge 15, DK-2450, Copenhagen, SV, Denmark. .,Health Promotion Research, Steno Diabetes Center, Niels Steensens Vej 2, Gentofte, DK-2820, Denmark.
| | - Finn Diderichsen
- Section of Social Medicine, Institute of Public Health, University of Copenhagen, Gothersgade 160, Copenhagen, DK-1014 K, Denmark
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Gharipour M, Sadeghi M, Nouri F, Nezafati P, Qader SS, Taheri M, Maghroun M, Abdalvand A, Soleimani B, Sarrafzadegan N. Socioeconomic determinants and metabolic syndrome: Results from the Isfahan Healthy Heart Program. ACTA BIO-MEDICA : ATENEI PARMENSIS 2016; 87:291-198. [PMID: 28112697 PMCID: PMC10521890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 05/06/2016] [Accepted: 05/06/2016] [Indexed: 06/06/2023]
Abstract
Introduction: The prevalence of metabolic syndrome (MetS) is increasing in Iran. We assessed the relationship between socioeconomic status (SES) and Mets components in the Iranian population. MATERIALS AND METHODS The sample for this study comprised a random cross-section of men and women from two province districts who participated in the Isfahan Healthy Heart Program (IHHP) in 2007. Each participant completed a questionnaire, underwent anthropometric testing and blood pressure measurements, and provided a blood sample. Mets was defined based on ATPIII criteria. Several SES dimensions, such as education, occupation, and number of children, as well as home, car, and personal computer ownership, were assessed to determine the participant's SES. RESULTS A higher-than-average income, car ownership, owning or renting a private home, and having a computer are increasing towards increment in SES. All MetS components were more prevalent in participants defined as having a lower SES, while low HDL levels were more common in participants having an SES II (P>0.001). A multivariate analysis showed that having the lowest SES (I) increased the risk of MetS by 1.72 [1.44-2.07], whereas subjects having an SES III had a 1.23 [1.04-1.47] lower risk for MetS. CONCLUSIONS The relationship between SES and Mets is due largely to behavioural factors, such as practicing unhealthy eating habits. Given the high prevalence of Mets in Iran, we propose that regular health check-ups may be useful in the early detection of the syndrome and, consequently, in the prevention of its effects. In addition, the early detection of MetS may result in the early diagnosis and prevention of cardiovascular diseases.
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McClurkin MA, Yingling LR, Ayers C, Cooper-McCann R, Suresh V, Nothwehr A, Barrington DS, Powell-Wiley TM. Health Insurance Status as a Barrier to Ideal Cardiovascular Health for U.S. Adults: Data from the National Health and Nutrition Examination Survey (NHANES). PLoS One 2015; 10:e0141534. [PMID: 26535890 PMCID: PMC4633202 DOI: 10.1371/journal.pone.0141534] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Accepted: 10/10/2015] [Indexed: 11/24/2022] Open
Abstract
Background Little is known about the association between cardiovascular (CV) health and health insurance status. We hypothesized that U.S. adults without health insurance coverage would have a lower likelihood of ideal cardiovascular health. Methods and Results Using National Health and Nutrition Examination Survey (NHANES) data from 2007–2010, we examined the relationship between health insurance status and ideal CV health in U.S. adults aged ≥19 years and <65 (N = 3304). Ideal CV health was defined by the American Heart Association (AHA) as the absence of clinically manifested CV disease and the simultaneous presence of 6–7 “ideal” CV health factors and behaviors. Logistic regression modeling was used to determine the relationship between health insurance status and the odds of ideal CV health. Of the U.S. adult population, 5.4% attained ideal CV health, and 23.5% were without health insurance coverage. Those without health insurance coverage were more likely to be young (p<0.0001), male (p<0.0001), non-white (p<0.0001), with less than a high school degree (p<0.0001), have a poverty-to-income ratio less than 1 (p<0.0001) and unemployed (p<0.0001) compared to those with coverage. Lack of health insurance coverage was associated with a lower likelihood of ideal CV health; however, this relationship was attenuated by socioeconomic status. Conclusions U.S. adults without health insurance coverage are less likely to have ideal CV health. Population-based strategies and interventions directed at the community-level may be one way to improve overall CV health and reach this at-risk group.
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Affiliation(s)
- Michael A. McClurkin
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Leah Rae Yingling
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Colby Ayers
- Donald W. Reynolds Cardiovascular Clinical Research Center at the University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Rebecca Cooper-McCann
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Visakha Suresh
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Ann Nothwehr
- University of Maryland, College Park, Maryland, United States of America
| | - Debbie S. Barrington
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Tiffany M. Powell-Wiley
- Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
- * E-mail:
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Borodulin K, Sipilä N, Rahkonen O, Leino-Arjas P, Kestilä L, Jousilahti P, Prättälä R. Socio-demographic and behavioral variation in barriers to leisure-time physical activity. Scand J Public Health 2015; 44:62-9. [PMID: 26392420 DOI: 10.1177/1403494815604080] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2015] [Indexed: 11/16/2022]
Abstract
INTRODUCTION We examined the socio-demographic and behavioral determinants of perceived barriers to leisure-time physical activity (LTPA) in a population-based sample of working-aged adults. METHODS Data comprised the National FINRISK 2002 Study, a population-based health examination study. Analyses were restricted to those aged 25-64 years and who perceived that their amount of LTPA did not reach sufficient levels. They reported barriers to LTPA, defined as a lack of time, motivation and lack of companionship to be active with, as well as high expenses. Age, education, household income, employment status, family type, physical activity, smoking and body mass index (BMI) were included as explanatory variables. RESULTS Lack of time was the most frequent barrier. Each barrier was explained by a different set of factors that also varied between genders. The strongest and most systematic associations with the barriers were found for age, employment status and family type. Lack of time was less often reported as a barrier among the unemployed, singles without children and older people. Lacking motivation as a barrier was most common among singles without children. High expenses as a barrier was more often reported by the unemployed, and less often reported in the highest income group. CONCLUSIONS When considering actions to promote LTPA, there is not one single solution, because the perceived barriers vary by population subgroups.
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Affiliation(s)
- Katja Borodulin
- National Institute for Health and Welfare, Helsinki, Finland
| | - Noora Sipilä
- National Institute for Health and Welfare, Helsinki, Finland
| | - Ossi Rahkonen
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Päivi Leino-Arjas
- Finnish Institute of Occupational Health, Helsinki, Finland School of Health Sciences, University of Tampere, Tampere, Finland
| | - Laura Kestilä
- National Institute for Health and Welfare, Helsinki, Finland
| | | | - Ritva Prättälä
- National Institute for Health and Welfare, Helsinki, Finland
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Nunes APDOB, Luiz ODC, Barros MBA, Cesar CLG, Goldbaum M. [Domains of physical activity and education in São Paulo, Brazil: a serial cross-sectional study in 2003 and 2008]. CAD SAUDE PUBLICA 2015; 31:1743-55. [PMID: 26375652 DOI: 10.1590/0102-311x00130814] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This study aimed to estimate the prevalence of physical activity in different domains and the association with schooling, using a serial cross-sectional population-based design comparing data from two editions of a health survey in the city of São Paulo, Brazil. Participation included 1,667 adults in 2003 and 2,086 in 2008. Probabilistic sampling was performed by two-stage clusters. The long version of International Physical Activity Questionnaire (IPAQ) allowed evaluating multiple domains of physical activity. Poisson regression was used. Men were more active in their leisure time and at work and women in the home. Schooling was associated directly with leisure-time activity (2003 and 2008) and inversely with work-related physical activity (2003) for men and for women in housework. The studies showed that Brazilians with less schooling are becoming less active, so that intervention strategies should consider different educational levels. Interventions in the urban space and transportation can increase the opportunities for physical activity and broaden access by the population.
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Affiliation(s)
| | | | | | | | - Moisés Goldbaum
- Faculdade de Medicina, Universidade de São Paulo, São Paulo, BR
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Compernolle S, De Cocker K, Abbott G, Verloigne M, Cardon G, De Bourdeaudhuij I, Ball K. Do sedentary behaviors mediate associations between socio-demographic characteristics and BMI in women living in socio-economically disadvantaged neighborhoods? Int J Behav Nutr Phys Act 2015; 12:48. [PMID: 25884213 PMCID: PMC4395907 DOI: 10.1186/s12966-015-0209-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Accepted: 03/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women living in deprived neighborhoods are a risk group for overweight and obesity, particularly during the childbearing years. Several socio-demographic characteristics may compound this risk, but little is known about why this might be the case. Sedentary behaviors are emerging as a socio-demographically patterned risk factor for obesity. The purpose of the present study was to assess socio-demographic differences in sedentary behaviors, and to examine whether these behaviors could explain the relation between socio-demographic variables and BMI (BMI) in this risk group. METHODS Women aged 18-46 years were recruited from 40 urban and 40 rural deprived neighborhoods in Victoria, Australia. In total, 3879 women reported socio-demographic variables (age, educational level, employment status, marital status, number of children, residential location and country of birth), sedentary behaviors (television time, computer time, total screen time and total sedentary time), physical activity, and height and weight, which were used to calculate BMI. For each socio-demographic variable, four single mediation models were conducted using two-level mixed-models regression analyses. Mediating effects were examined using the MacKinnon product-of-coefficients procedure and the Sobel test. RESULTS All socio-demographic variables were significantly associated with sedentary behaviors. Single mediation analyses revealed that television time (αβ = 0.017, 95% CI = 0.000, 0.030) and total screen time (αβ = 0.006, 95% CI = 0.000, 0.012) mediated 14.1% and 4.9% of the relationship between educational level and BMI, respectively. Total screen time mediated 45.1% of the relationship between employment status and BMI (αβ = -0.020, 95% CI = -0.033, -0.006), and television time mediated 8.2% of the relationship between country of birth and BMI (αβ = -0.008, 95% CI = -0.016, -0.001). CONCLUSION Sedentary behaviors differed depending on socio-demographic characteristics, and partly explained the relationship between socio-demographic factors and BMI in this sample of women. Both television time and total screen time are potential behaviors to target in future programs aimed at reducing socio-demographic disparities in overweight and obesity.
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Affiliation(s)
- Sofie Compernolle
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Katrien De Cocker
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. .,Research Foundation Flanders (FWO), B-1000, Brussels, Belgium.
| | - Gavin Abbott
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia.
| | - Maïté Verloigne
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. .,Research Foundation Flanders (FWO), B-1000, Brussels, Belgium.
| | - Greet Cardon
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Ilse De Bourdeaudhuij
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
| | - Kylie Ball
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia.
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Anderton N, Giri A, Wei G, Marcus RL, Chen X, Bjordahl T, Habib A, Herrera J, Beddhu S. Sedentary Behavior in Individuals With Diabetic Chronic Kidney Disease and Maintenance Hemodialysis. J Ren Nutr 2015; 25:364-70. [PMID: 25753603 DOI: 10.1053/j.jrn.2015.01.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 12/02/2014] [Accepted: 01/02/2015] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The objective of this study was to examine whether more advanced kidney failure is associated with sedentary behavior and whether demographics, comorbidity, nutritional, and inflammatory markers explain this association. DESIGN Observational study. SETTING Outpatients recruited from outpatient clinics and dialysis units. SUBJECTS One hundred sixty patients with chronic kidney disease (CKD) or receiving maintenance hemodialysis (MHD). METHODS Standardized questionnaires including Baecke physical activity questionnaire, standardized anthropometry examination, and blood draw. MAIN OUTCOME MEASURE Sedentary behavior (defined as answering "very often" for "during leisure time I watch television" or answering "never" for "during leisure time I walk") and being physically active (top 25th percentile of the total Baecke score). RESULTS Nineteen percent of CKD and 50% of MHD patients were sedentary (P < .001) and 38.8% of CKD and 11.3% of MHD patients were physically active. In separate multivariable logistic regression models, compared with CKD patients, MHD patients were more sedentary (odds ratio 3.84; 95% confidence interval, 1.18-12.51) and less physically active (odds ratio 0.07; 95% confidence interval 0.01-0.40) independent of demographics, comorbidity, smoking, body size, serum high sensitivity C-reactive protein (hsCRP) and albumin. Congestive heart failure, peripheral vascular disease, and higher body mass index were independently associated with sedentary behavior, whereas younger age, lower body mass index, lower serum hsCRP, and higher serum albumin were associated with being physically active. CONCLUSIONS Sedentary behavior is highly prevalent among diabetic CKD or MHD patients. The strong association of MHD status with sedentary behavior is not explained by demographics, smoking, comorbidity, nutritional, and inflammatory markers. Interventions targeting obesity might improve sedentary behavior and physical activity, whereas interventions targeting inflammation might improve physical activity in these populations.
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Affiliation(s)
- Natalie Anderton
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah; Department of Physical Therapy, University of Utah College of Health, Salt Lake City, Utah
| | - Ajay Giri
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Guo Wei
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Robin L Marcus
- Department of Physical Therapy, University of Utah College of Health, Salt Lake City, Utah
| | - Xiaorui Chen
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Terrence Bjordahl
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Arsalan Habib
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Jenice Herrera
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah
| | - Srinivasan Beddhu
- Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah; Salt Lake City Veterans Affairs Healthcare System, Salt Lake City, Utah.
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Jones A, Paxton RJ. Neighborhood Disadvantage, Physical Activity Barriers, and Physical Activity among African American Breast Cancer Survivors. Prev Med Rep 2015; 2:622-627. [PMID: 26566472 PMCID: PMC4637972 DOI: 10.1016/j.pmedr.2015.07.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND In view of evidence that African American cancer survivors experience the greatest challenges in maintaining adequate levels of physical activity, this cross-section study was designed to determine whether individual and residential environment characteristics are associated with physical activity in this population. METHODS A total of 275 breast cancer survivors completed self-report items measuring sociodemographic variables, physical activity, and select barriers to physical activity in Spring of 2012. Neighborhood disadvantage variables were extracted from national databases. Regression models were computed to assess relationships. RESULTS Traditional correlates of smoking status and the presence of health complications were associated with physical activity. In addition, the relative number of renters versus homeowners in one's neighborhood was associated with lower levels of physical activity in the context of individual level barriers (i.e., interest and space), which were also associated with lower levels of physical activity. DISCUSSION Higher renter rates and individual barriers both contribute to lower levels of physical activity in African American breast cancer survivors. These data suggest that the potential for constant residential turnover (via rentership) and perceived barriers may increase physical inactivity even where facilities may be available.
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Affiliation(s)
- Antwan Jones
- Department of Sociology, The George Washington University
| | - Raheem J Paxton
- Department of Behavioral and Community Health, University of North Texas Health Science Center
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Normansell R, Smith J, Victor C, Cook DG, Kerry S, Iliffe S, Ussher M, Fox-Rushby J, Whincup P, Harris T. Numbers are not the whole story: a qualitative exploration of barriers and facilitators to increased physical activity in a primary care based walking intervention. BMC Public Health 2014; 14:1272. [PMID: 25511452 PMCID: PMC4320609 DOI: 10.1186/1471-2458-14-1272] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 12/11/2014] [Indexed: 11/10/2022] Open
Abstract
Background The majority of mid-life and older adults in the UK are not achieving recommended physical activity levels and inactivity is associated with many health problems. Walking is a safe, appropriate exercise. The PACE-UP trial sought to increase walking through the structured use of a pedometer and handbook, with and without support from a practice nurse trained in behaviour change techniques (BCTs). Understanding barriers and facilitators to engagement with a primary care based physical activity intervention is essential for future trials and programmes. Methods We conducted semi-structured telephone interviews using a topic guide with purposive samples of participants who did and did not increase their walking from both intervention groups. Interviews were audio-recorded, transcribed and coded independently by researchers prior to performing a thematic analysis. Responsiveness to the specific BCTs used was also analysed. Results Forty-three trial participants were interviewed in early 2014. Almost all felt they had benefitted, irrespective of their change in step-count, and that primary care was an appropriate setting. Important facilitators included a desire for a healthy lifestyle, improved physical health, enjoyment of walking in the local environment, having a flexible routine allowing for an increase in walking, appropriate self and external monitoring and support from others. Important barriers included physical health problems, an inflexible routine, work and other commitments, the weather and a mistrust of the monitoring equipment. BCTs that were reported to have the most impact included: providing information about behaviour-health link; prompting self-monitoring and review of goals and outcomes; providing feedback; providing specific information about how to increase walking; planning social support/change; and relapse prevention. Rewards were unhelpful. Conclusions Despite our expectation that there would be a difference between the experiences of those who did and did not objectively increase their walking, we found that most participants considered themselves to have succeeded in the trial and benefitted from taking part. Barriers and facilitators were similar across demographic groups and trial outcomes. Findings indicated several BCTs on which PA trial and programme planners could focus efforts with the expectation of greatest impact as well as strong support for primary care as an appropriate venue. Trial registration ISRCTN98538934.
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Affiliation(s)
| | | | - Christina Victor
- Gerontology and Health Services Research Unit, College of Health and Life Sciences, Brunel University, London UB8 3PH, UK.
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