Potential causal associations between leisure sedentary behaviors, physical activity, sleep traits, and myopia: a Mendelian randomization study

BACKGROUND

Myopia is the most prevalent refractive error and a growing global health concern that significantly affects visual function. Researchers have recently emphasized considerably on the influence of lifestyle on myopia incidence and development. This study investigates the relationship between leisure sedentary behaviors (LSB)/physical activity (PA)/sleep traits and myopia.

METHODS

LSB, PA, and sleep trait-associated genetic variants were used as instrument variables in a Mendelian randomization (MR) study to examine their causal effects on myopia. Summary genome-wide association studies (GWASs) statistical data for LSB and PA were obtained from UK Biobank, and the data of sleep traits was obtained from UK Biobank, UK Biobank and 23andMe, and FinnGen. We used summary statistics data for myopia from MRC IEU. The MR analyses was performed using the inverse variance-weighted (IVW), MR-Egger, weighted median, and MR Pleiotropy RESidual Sum and Outlier methods.

RESULTS

Computer use was genetically predicted to increase the myopia risk [IVW odds ratio (OR) = 1.057; 95% confidence interval (CI), 1.038-1.078; P = 7.04 × 10- 9]. The self-reported moderate-to-vigorous physical activity (MVPA) (IVW OR = 0.962; 95% CI, 0.932-0.993; P = 1.57 × 10- 2) and television watching (IVW OR = 0.973; 95% CI, 0.961-0.985, P = 1.93 × 10- 5) were significantly associated with a lower myopia risk. However, genetically predicted sleep traits or accelerometer-measured physical activity had no significant associations with myopia.

CONCLUSION

Our results indicated that computer use is a risk factor for myopia, whereas television watching and MVPA may protect against myopia. These findings shed new light on possible strategies for reducing the prevalence of myopia.

Checklist for Habitual Physical Activity (CHaPA) for adults 75 years and older: tool development and content and face validation

BACKGROUND

Physical activity significantly contributes to older adults' physical and mental health, suggesting that physical activity could enhance healthy life expectancy. Despite its importance for adults aged 75 and older, activity levels among a large proportion of individuals aged 75 and older in Japan do not meet the recommended levels of physical activity, indicating a need for specific strategies tailored to this age group. This study aimed to develop a screening tool that measures daily activities promoting physical activity among older adults and assessed its content and face validity.

METHODS

In Stage 1, we derived constructs pertinent to physical activity from previous literature and formulated an item list based on a prior qualitative study we undertook in Japan that evaluated daily behaviours facilitating physical activity among older adults. During Stage 2, we assessed the content and face validity of the list utilising the Nominal Group Technique (NGT), involving eight experts. The content validity was confirmed through two scoring evaluation rounds, while the face validity was verified through the NGT discussion, focusing on the comprehensibility and appropriateness of the tool.

RESULTS

We created a tool with 22 items consisting of three constructs. The NGT participants modified eight of these items for the final assessment, resulting in a finalised tool comprising 22 items that satisfied the adaptation criteria. The content validity of these items was affirmed by median adequacy (>5.0 points) and interquartile range (<1.0 points). The NGT discussion consensus also confirmed satisfactory face validity.

CONCLUSION

The newly developed tool, Checklist for Habitual Physical Activity (CHaPA) for adults 75 years and older, is a valid screening tool to assess the daily behaviours that facilitate physical activity. This self-administered instrument aims to assist older adults who need to start and maintain physical activity daily. Before its widespread public deployment, further investigation of the tool's validity and reliability is necessary.

Exercise behaviors and resource use among graduate students at a Canadian university: A cross-sectional study

OBJECTIVE

Participation in regular exercise among post-secondary students is often low. Our cross-sectional study aimed to assess exercise levels, perceived barriers/motivators to exercise, and knowledge and use of exercise resources in graduate students.

PARTICIPANTS

We recruited graduate students across various disciplines at a large Canadian university.

METHODS

Participants (n = 540) completed an anonymous mixed methods online survey.

RESULTS

Approximately 11% of participants reported not participating in any form of weekly exercise, and only 9.4% met the Canadian Physical Activity Guidelines. The most common barrier and motivator to exercise was time commitment and improving physical health, respectively. Some participants were aware of available exercise services but most did not use them. Suggestions for improving services included having graduate-dedicated exercise space and resources.

CONCLUSIONS

Low exercise participation among graduate students may be due to a lack of education of available resources or a lack of existing resources that meet their specific needs.

Tools to guide clinical discussions on physical activity, sedentary behaviour, and/or sleep for health promotion between primary care providers and adults accessing care: a scoping review

BACKGROUND

Health care providers have reported low knowledge, skill, and confidence for discussing movement behaviours (i.e., physical activity, sedentary behaviour, and sleep), which may be improved with the use of tools to guide movement behaviour discussions in their practice. Past reviews have examined the psychometric properties, scoring, and behavioural outcomes of physical activity discussion tools. However, the features, perceptions, and effectiveness of discussion tools for physical activity, sedentary behaviour, and/or sleep have not yet been synthesized. The aim of this review was to report and appraise tools for movement behaviour discussions between health care providers and adults 18 + years in a primary care context within Canada or analogous countries.

METHODS

An integrated knowledge translation approach guided this review, whereby a working group of experts in medicine, knowledge translation, communications, kinesiology, and health promotion was engaged from research question formation to interpretation of findings. Three search approaches were used (i.e., peer-reviewed, grey literature, and forward searches) to identify studies reporting on perceptions and/or effectiveness of tools for physical activity, sedentary behaviour, and/or sleep. The quality of included studies was assessed using the Mixed Methods Appraisal Tool.

RESULTS

In total, 135 studies reporting on 61 tools (i.e., 51 on physical activity, one on sleep, and nine combining two movement behaviours) met inclusion criteria. Included tools served the purposes of assessment (n = 57), counselling (n = 50), prescription (n = 18), and/or referral (n = 12) of one or more movement behaviour. Most tools were used or intended for use by physicians, followed by nurses/nurse practitioners (n = 11), and adults accessing care (n = 10). Most tools were also used or intended to be used with adults without chronic conditions aged 18-64 years (n = 34), followed by adults with chronic conditions (n = 18). The quality of the 116 studies that evaluated tool effectiveness varied.

CONCLUSIONS

Many tools were positively perceived and were deemed effective at enhancing knowledge of, confidence for, ability in, and frequency of movement behaviour discussions. Future tools should guide discussions of all movement behaviours in an integrated manner in line with the 24-Hour Movement Guidelines. Practically, this review offers seven evidence-based recommendations that may guide future tool development and implementation.

The Effectiveness of an Online Learning Strategy on Changing Physical Activity Counseling Practice in Nurses

BACKGROUND

Nurses may be well poised for providing physical activity guidance and support to patients.

PURPOSE

The purposes of this study were to examine the effectiveness of a concise, evidence based online learning modules strategy (OLMS) for improving nurses' physical activity counselling.

METHODS

68 nurses were randomly assigned to either an OLMS group or control group. The OLMS group completed a series of six online learning modules aimed at improving physical activity counselling practice.

RESULTS

The OLMS group, compared to the control group, showed a trend for improvement in Physical Activity Counselling Practice (p = .063) after controlling for baseline values, and significant improvement in (a) Self-efficacy for Physical Activity Counselling (p = .001), (b) Knowledge of Physical Activity Guidelines, (p = .031), and (c) Perceived Benefits of Physical Activity Counselling (p = .014) over the course of the intervention. No significant change was found for Barriers for Providing Physical Activity Counselling (p > .05).

CONCLUSIONS

The OLMS tested may be an effective means for improving self-efficacy, knowledge, and perceived benefits of physical activity counselling, suggesting the utility of online learning strategies for improving nurses' physical activity counselling practice. Given barriers to providing physical activity counselling were not affected by the intervention, future interventions and policy change could target these barriers specifically in order to give nurses more tools and time for reaching patients and addressing physical activity counselling in practice.

Movement guidelines for young children: Engaging stakeholders to design dissemination strategies in the Hong Kong early childhood education context

Background

Early childhood is a critical period during which patterns of movement behaviors are formed. The World Health Organization had endorsed guidelines for physical activity, sedentary behavior and sleep over a 24-h time period, which had been adopted by the Center for Health Protection of Hong Kong. This paper reports on stakeholder engagements that were conducted to inform the design of strategies to disseminate the guidelines in early childhood education (ECE) settings.

Methods

Using a mixed-methods study design, we sought to (a) assess the stakeholders' levels of awareness and knowledge of the Hong Kong movement guidelines for young children and (b) identify the factors that influence the uptake of the said guidelines. We conducted an online survey of early childhood education teachers (N =314), twelve focus groups involving teachers (N = 18) and parents (N = 18), and individual interviews of key informants (N = 7) and domestic workers who provide care for preschool-aged children (N = 7). Descriptive statistics were used for the quantitative data, and thematic analysis was performed on the qualitative data using an inductive and semantic approach following a realist framework.

Findings

Our findings show that teachers were aware of the movement guidelines for young children, but their knowledge of the specific guidelines was deficient; parents and domestic workers had limited awareness and knowledge of the guidelines. Uptake of the movement guidelines is enabled by parent engagement, activities in the ECE centers, home-school cooperation, and community activities for children. The challenges include the time poverty of parents, local curriculum requirements, limited physical spaces, social values, and pandemic-related restrictions.

Conclusion

We recommend that dissemination strategies in the ECE context should deliver knowledge content and support stakeholders in mitigating the challenges associated with time, space, and social conditions.

Levels and patterns of physical activity and sedentary behavior in adults with and without visual impairment

BACKGROUND

Limited data are available on objectively measured physical activity (PA) and sedentary behavior (SB) among adults with and without visual impairment (VI).

OBJECTIVE

To compare PA and SB levels and patterns in adults with and without VI and to examine how these differ based on sex and day of the week.

METHODS

Thirty-two participants with VI and 32 participants without VI participated in this cross-sectional study. PA and SB were assessed using GT3X ActiGraph accelerometers during waking hours for 7 days, and variables were examined in terms of disability group, sex, and day of the week. Nonparametric Mann-Whitney U test and Wilcoxon signed-rank test were used, and significance was set at p < 0.05.

RESULTS

PA did not differ in terms of sex or day of the week in participants with VI. The PA of participants without VI was significantly higher for men than it was for women and was significantly higher during weekdays than on weekend days. Total sedentary time and the duration of SB breaks were significantly longer for female participants with VI than for those without VI. The number of sedentary bouts lasting ≥10 min during weekend days was significantly higher for participants with VI than for those without VI.

CONCLUSIONS

Most adults with and without VI did not meet the recommended levels of daily PA and spend a large portion of the day being sedentary. Interventions to enhance PA and reduce sedentary time in adults with and without VI are required.

Potential value of home square-stepping exercises for inactive older adults: an exploratory case study

Background

Most older adults do not engage in regular physical activity. However, more research on options to partake in regular exercise in this population by reducing barriers and enhancing enablers while still reaching benefits is needed.

Methods

Using embedded mixed methods, 10 inactive older adults over the age of 65 completed a 3-week square-stepping exercise intervention to help overcome the initial barriers and activate initial enablers to perform regular exercise. Physical activity level was tracked at home with a pedometer using median steps/day over seven days for pre-post measure. Aerobic intensity while doing square-stepping exercises was quantified via a heart rate monitor in a supervised session. Each participant had an interview asking about barriers and enablers to regular exercise and if the intervention could modify any. Based on initial physical activity a framework matrix was used to pull potential barriers to compare, contrast, and search for patterns between participants with lower and higher initial physical activity levels.

Results

The 3-week square-stepping exercise intervention helped participants overcome barriers such as being uncomfortable in a fitness facility and body image and activate enablers such as the use of home equipment and convenience. The median total steps/day increased by 12% (p = 0.02), and a moderate-intensity level was reached by 80% of the sample participants when performing the square stepping exercise during a supervised session. Common barriers such as having a suitable program, hard to keep the intensity were reported by participants regardless of the initial physical activity level.

Conclusion

Regardless of initial physical activity level, inactive older adults can increase physical activity level at the recommended intensity and overcome common barriers to exercise when performing square-stepping exercises, especially for those intimidated by a fitness facility setting and those concerned with their body image. A longer intervention including more participants using the square-stepping exercises is required to understand if square-stepping exercises can increase the proportion of older adults exercising regularly.

Supplementary information

The online version contains supplementary material available at 10.1186/s12877-021-02712-x.

Sociodemographic Factors Associated With Meeting the Canadian 24-Hour Movement Guidelines Among Adults: Findings From the Canadian Health Measures Survey

Background: This study examined associations between sociodemographic factors and meeting versus not meeting the new Canadian 24-Hour Movement Guidelines recommendations. Methods: The study is based on 7651 respondents aged 18–79 years from the 2007 to 2013 Canadian Health Measures Survey, a nationally representative, cross-sectional survey. Sociodemographic factors included age, sex, household education, household income, race, having a chronic condition, smoking status, alcohol consumption, and body mass index. Participants were classified as meeting or not meeting each of the time-specific recommendations for moderate to vigorous physical activity, sedentary behavior, and sleep duration. Results: Being an adult aged 18–64 years, normal weight, nonsmoker, and not having a chronic condition were associated with meeting the integrated guidelines. Being aged 18–64 years, male, normal weight, nonsmoker, not having a chronic condition, having a higher household education, and higher household income were associated with meeting the moderate to vigorous physical activity recommendation; being aged 18–64 years was associated with meeting the sedentary behavior recommendation; and being white, not having a chronic condition, and having a higher household income were associated with meeting the sleep duration recommendation. Conclusions: Few Canadian adults met the 2020 Canadian 24-Hour Movement Guidelines, and disparities across sociodemographic factors exist. Implementation strategies and dissemination approaches to encourage uptake and adoption are necessary.

[Dissemination of National Physical Activity Recommendations: Participatory Development of Dissemination Strategies in Germany]

BACKGROUND

In 2016, the first evidence-based National Recommendations for Physical Activity and Physical Activity Promotion were published in Germany. These recommendations are primarily intended for experts, decision makers and stakeholders.

OBJECTIVES

This study aims to describe the development of dissemination strategies for these recommendations.

PROCESS

To facilitate the co-production of knowledge between practitioners, decision makers, and researchers, a participatory approach was applied. This approach involved the development of target group-specific strategies for disseminating the recommendations. This was achieved in two workshops and one working group phase; 92 professionals and decision makers participated in the process.

RESULTS

The working groups developed specific dissemination strategies that were grouped into the following strategy types: (1) inform multipliers, (2) activate multipliers, (3) use existing and develop new networks, (4) initiate policy change.

CONCLUSION

The participatory approach adopted in this project was successful in developing dissemination strategies and is unique from an international perspective. To improve the evaluation of such co-production processes, future research should determine and operationalize appropriate indicators.

Is knowledge of screen time guidelines associated with stages of behavior change for television viewing among adolescents?

It is unknown whether knowledge of guidelines for television (TV) viewing translate into behavior change for TV time among adolescents. The purpose of the present study is to verify whether knowledge of TV recommendations (spending <2 hr/day watching TV) is associated with the stages of behavior change related to TV viewing among adolescents. Schoolchildren (11-16 years) from six schools were recruited. Their knowledge of TV guidelines (correct [<2 hr/day], overestimated [<1 hr/day or never watch TV], underestimated [<3hr/day or watch TV whenever they wanted], and do not know [response option]) and stages of behavior change related to TV (precontemplation, contemplation, preparation, action, and maintenance) were assessed by a questionnaire. Multinomial logistic regression was used to test the association between knowledge and stages of behavior change. A total of 792 adolescents (53% girls) participated, of whom 45% were in the precontemplation stage, while 35% underestimated and 18% did not know the TV guidelines. Those who overestimated the guidelines had higher odds of being in the maintenance stage than did those who knew the recommendations correctly (odds ratio [OR] 2.06), while those who underestimated the guidelines had lower odds of being in the maintenance (OR 0.22) and any other stage compared to those who were aware of the recommendations (the precontemplation stage was the reference). Underestimating the guidelines was associated with being in the precontemplation stage, while overestimating them was associated with the maintenance stage. Interventions should test whether increasing knowledge can help shifting those in the precontemplation and contemplation toward action and maintenance.

Knowledge translation of the Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older: a collaborative movement guideline knowledge translation process

Establishing a step-by-step process that provides practitioners with a blueprint for translating movement guidelines into action stands to optimize the investment in guideline development, improve guideline promotion and uptake, and ultimately enhance population health. The purpose of this paper is to describe how the Knowledge-to-Action framework and integrated knowledge translation were operationalized to systematically inform our knowledge translation (KT) efforts for the Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older. In October 2018, the need for a KT Process, operating in tandem with the Guideline Development Process, led to the establishment of a KT team with a specific structure and terms of reference. The KT team collaboratively agreed on decision-making principles prior to selecting target audiences to focus their efforts. We undertook formative research to assess the local context and determinants of guideline dissemination and implementation efforts among target audiences. Plans for the subsequent steps and research are outlined. We highlight recommendations and lessons learned for applying the process in other settings. Novelty We outline a collaborative and systematic process and research program for the knowledge translation of movement guidelines. This paper provides an innovative and replicable blueprint to optimize future movement guideline knowledge translation efforts.

Public health communication and education to promote more physical activity and less sedentary behaviour: Development and formative evaluation of the 'physical activity triangle'

OBJECTIVE

Communication and education about health behaviours to the general population is essential in public health promotion. This paper describes the process and outcome of developing a new health education model (infographic) for physical activity (PA) and sedentary behaviour used in Flanders (Belgium).

METHODS

The Flanders Institute for Healthy Living, expertise centre for public health, coordinated a process, including the evaluation of its previous education model among citizens; reviewing existing models from other countries; expert panel meetings (n = 3); and a formative evaluation (34 focus groups) among citizen with various profiles.

RESULTS

The previous model was difficult to understand and not motivating. Foreign models (n = 18) were mostly expert-based (72 %), but not evaluated among citizens. Based on expert meetings, the new model includes a daily and weekly variety of activities at different volumes and intensities, sitting (interruptions), and physical and mental health benefits of PA. Based on the focus groups, no quantitative PA recommendations were integrated, and specific symbols, colours, and heart icons were crucial to illustrate different PA behaviours, volumes and intensities.

PRACTICE IMPLICATIONS

Involving several key stakeholders, especially sedentary/inactive and vulnerable citizens, is suggested when developing a health model. Citizens preferred non-quantitative PA messages and quantitative messages around sitting interruptions.

Optimal messaging of the Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years and older

The Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years and older (“Guidelines”) integrate recommendations for physical activity, sedentary, and sleep behaviours. Given the novelty of these integrated Guidelines, it was important to consider messaging strategies that would be most effective in reaching Canadian adults. The purpose of this study was to examine optimal messaging of the Guidelines as it pertains to communication channels and messages. Representative samples of Guideline end-users (N = 1017) and stakeholders (N = 877) each completed a cross-sectional survey. Descriptive statistics were calculated along with tests of statistical significance. Inductive content analysis was used to code stakeholders’ comments (i.e., suggestions, concerns) on a draft version of the Guidelines. Most end-users had recently referred to online medical resources; family, friends, and co-workers; and physicians as communication channels for information regarding the movement behaviours. End-users and stakeholders felt that generic messages would foster self-efficacy to meet the Guidelines. Stakeholders highlighted a variety of considerations to ensure the Guidelines are inclusive towards diverse groups within the Canadian population. Findings will inform Guideline messaging.

Novelty Most end-users referred to online medical resources; family, friends, and co-workers; and physicians as communication channels. End-users and stakeholders indicated that generic messages would foster self-efficacy to meet the Guidelines. Stakeholders expressed concerns about the inclusivity of the Guidelines for diverse socioeconomic groups.

"Let's Talk about Physical Activity": Understanding the Preferences of Under-Served Communities when Messaging Physical Activity Guidelines to the Public

Despite many countries having physical activity guidelines, there have been few concerted efforts to mobilize this information to the public. The aim of this study was to understand the preferences of under-served community groups about how the benefits of physical activity, and associated guidelines, can be better communicated to the public. Participatory workshops, co-developed between researchers, a local charity, and a community artist, were used to gather data from four groups in Bristol, UK: young people (n = 17); adults (n = 11); older adults (n = 5); and Somali women (n = 15). Workshop content was structured around the study aims. The community artist and/or the local charity delivered the workshops, with researchers gathering data via observation, photos, and audio-recordings, which were analysed using the framework method. All four groups noted that the benefits of physical activity should be included within any communications efforts, though not restricted to health-related benefits. Language used should be simple and jargon-free; terms such as "sedentary", "vigorous" and "intensity" were deemed inaccessible, however all groups liked the message "some is good, more is better". Views about preferred mechanisms, and messenger, for delivering physical activity messages varied both between, and within, groups. Recommendations for those working in physical activity communications, research, and policy are provided.

Multidimensional motivation for exercise: A latent profile and transition analysis

OBJECTIVES

To: a) identify motivational profiles for exercise, using Self-Determination Theory as a theoretical framework, among a sample of parents of UK primary school children; b) explore the movement between motivational profiles over a five year period; and c) examine differences across these profiles in terms of gender, physical activity and BMI.

DESIGN

Data were from the B-Proact1v cohort.

METHODS

2555 parents of British primary school children participated across three phases when the child was aged 5-6, 8-9, and 10-11. Parents completed a multidimensional measure of motivation for exercise and wore an ActiGraph GT3X + accelerometer for five days in each phase. Latent profile and transition analyses were conducted using a three-step approach in MPlus.

RESULTS

Six profiles were identified, comprising different combinations of motivation types. Between each timepoint, moving between profiles was more likely than remaining in the same one. People with a more autonomous profile at a previous timepoint were unlikely to move to more controlled or amotivated profiles. At all three timepoints, more autonomous profiles were associated with higher levels of MVPA and lower BMI.

CONCLUSIONS

The results show that people's motivation for exercise can be described in coherent and consistent profiles which are made up of multiple and simultaneous types of motivation. More autonomous motivation profiles were more enduring over time, indicating that promoting more autonomous motivational profiles may be central to facilitating longer-term physical activity engagement.

Awareness and Knowledge of Physical Activity Recommendations in Young Adult Men

Background: There are only a few studies that have assessed awareness and knowledge regarding aerobic type of physical activity (PA) guidelines recommendations, while no previous studies have examined muscular type of activity recommendation guidelines. The aim was to assess knowledge and awareness and study the associations with demographic variables and physical activity and fitness. Methods: Participants were 776 young (age 26 ± 7 years) men. Awareness and knowledge of PA recommendation guidelines were assessed by prompted questionnaires together with demographic variables and physical activity. In addition, physical fitness was measured. Results: Forty percent of the participants reported being aware of the physical activity recommendation. Moreover, 7% correctly identified the recommendations for moderate aerobic physical activity and 25% for muscular type of activity. In addition, 4% correctly identified both aerobic and muscular activity recommendations. Being aware of the PA recommendations was associated with being married or partnered, having higher education level and being more physically active during leisure-time (p < 0.05). Individuals with no awareness of the recommendations had lower results in cardiorespiratory and muscular fitness compared to those being aware (p < 0.05). Being married or partnered was positively associated with the knowledge of the muscular activity recommendations (p < 0.05). Moreover, the individuals with correct knowledge of the PA recommendations had higher levels of muscular fitness (p < 0.05). Conclusion: A low number of individuals are aware or know the physical activity recommendations among young adult men. Therefore, more vigorous attempts to promote physical activity recommendations are needed.

Knowledge of the Adult and Youth 2008 Physical Activity Guidelines for Americans

BACKGROUND

To estimate the proportion of adults' and parents' knowledge of the adult aerobic and youth physical activity guidelines, respectively, in the United States.

METHODS

Data were analyzed from a national sample of adults in the 2017 ConsumerStyles survey. Prevalence of knowledge of the adult aerobic guideline (ie, 150 min/wk of moderate-intensity activity) was estimated among all respondents (n = 3910) and of the youth guideline (ie, 60 min/d of physical activity on 7 d/wk) among parents (n = 1288). Odds ratios were estimated using logistic regression models adjusting for demographic characteristics.

RESULTS

Overall, 2.5% (95% confidence interval, 2.0-3.1) of adults and 23.0% (95% confidence interval, 20.5-25.7) of parents were knowledgeable of the adult aerobic and youth guidelines, respectively. After adjustment, odds of knowledge of the adult guideline differed significantly by sex and physical activity level, whereas knowledge of the youth guideline differed by parental education level.

CONCLUSIONS

Despite the release of the 2008 Physical Activity Guidelines for Americans nearly a decade ago, most US adults and parents lack knowledge of the adult aerobic and youth physical activity guidelines. Effective communication strategies may help raise awareness of current and future editions of national guidelines for physical activity.

Enhancing health care professionals' and trainees' knowledge of physical activity guidelines for adults with and without SCI

Background: Health care providers (HCPs) are preferred sources of physical activity (PA) information; however, minimal research has explored HCPs' knowledge of spinal cord injury (SCI) PA guidelines, and no research has examined HCP trainees' PA guideline knowledge. Objective: The current study explored HCPs' and trainees' initial knowledge of PA guidelines for both adults with SCI and the general population, and the utility of an event-based intervention for improving this knowledge. Methods: Participants (HCPs n = 129; trainees n = 573) reported guideline knowledge for both sets of guidelines (SCI and general population) immediately after, one-month, and six-months following the intervention. Frequencies determined guideline knowledge at each timepoint, while chi-squared tests examined differences in knowledge of both guidelines, as well as knowledge differences in the short- and long-term. Results: Results demonstrated that HCPs and trainees lack knowledge of PA guidelines, particularly guidelines for adults with SCI. The results further suggest that a single event-based intervention is not effective for improving long-term guideline knowledge. Conclusion: Suggestions are made for future research with the aim of improving interventions that target HCP and HCP trainees' long-term guideline knowledge for adults with SCI and the general population.

Citizen Science to Communicate about Public Health Messages: The Reach of a Playful Online Survey on Sitting Time and Physical Activity

There is a lack of research on how to communicate public health guidelines. Citizen science (CS) has been an effective way to involve the public in research. This study analyses the reach of a well-established CS experiment, launched during an annual national science event, to understand if it could be used as communication strategy for public health issues. A short playful online survey contained tailored health-related messages associated to an "animal totem" profile, based on the combination of sitting and physical activity levels (koala: high sitting, low activity; gorilla: high sitting, high activity; zebra: low sitting, low activity; bee: low sitting, high activity). Tweets, radio interviews, radio and online advertisements, press articles, and a press conference were used to promote the CS experiment. Google Analytics and Facebook Graph API (application programming interface) (use and spread of experiment) and descriptive statistics (attributes of adults completing the experiment) were used. A total of 6,246 adults completed the experiment, with a peak of views (n = 5,103) and completions (n = 1,209) a couple of days before the event. Completers were mostly female (65.8%), on average 37.5 years old, and had a healthy body mass index (23.8 kg/m²). Nearly half (46.4%) had the most beneficial profile ("bee"), 26.5% had the least healthy profile ("koala"). CS as part of a national science event is a good platform for health communication as 1 in 1,000 Flemish adults were reached. However, those completing the experiment were not representative of the general Flemish adult population and reported to be more physically active. Abbreviations: API: application programming interface; BMI: body mass index; CVD: cardiovascular disease; METs: metabolic equivalents.

Association between sleep problems and health-related quality of life in Canadian adults with chronic diseases

OBJECTIVES

This study aimed to explore the association between sleep problems and health-related quality of life (HRQoL) in Canadian adults with chronic diseases, and whether mental illness can mediate the association.

METHODS

Data were drawn from the Canadian Community Health Survey, 2015. A total of 10,900 participants aged ≥18 years and diagnosed with chronic diseases were enrolled in this study.

RESULTS

Of these participants, 23.6% (95% CI 22.1, 25.2) suffered from severe impairment of HRQoL. Extreme sleep durations, including both short (<5, 5 to <6, and 6 to <7 h) and long (9 to <10, and ≥10 h) sleep durations, were significantly associated with severe impairment of HRQoL (compared to 7 to <8 h). Insomnia was also independently associated with severe impairment of HRQoL when compared to those without insomnia. In the mediation analyses, mental illness was shown to partly mediate the associations of extreme sleep durations and insomnia with severe impairment of HRQoL.

CONCLUSIONS

In conclusion, both extreme sleep durations and insomnia were independently associated with severe impairment of HRQoL in adults with chronic diseases, and mental illness partly mediated the association.

Estimates of the current and future burden of cancer attributable to sedentary behavior in Canada

Leisure-time sedentary behavior is an emerging modifiable risk factor for cancer. We estimated the proportion of cancers attributed to leisure-time sedentary behavior as a separate risk factor from physical activity in Canada for 2015. We projected numbers of future avoidable cancers by 2042 using various assumed levels of reduced leisure-time sedentary behavior in the population. We calculated population attributable risks (PAR) for associated cancers and all-cancers associated with leisure-time sedentary behavior. Our analysis used pooled data on leisure-time sedentary behavior from the Canadian Community Health Survey (CCHS), and incident cancer data from the Canadian Cancer Registry (CCR). Survey respondents were categorized into three levels of leisure-time sedentary behavior, "<3 h/day", "≥3-<6 h/day", and "≥6 h/day". Estimates for the future burden of leisure-time sedentary behavior were calculated using the potential impact fractions framework (PIF) and counterfactual scenarios, from 10% to 50% decreases in leisure-time sedentary behavior. The estimated prevalence of leisure-time sedentary behavior at the highest level (≥6 h/day) in Canada during the 2000s was 9.9% among both sexes combined across age-groups. The total attributable burden due to leisure-time sedentary behavior was estimated to be 10.3% for associated cancers and 6.5% for all-cancers in 2015. A 50% reduction in leisure-time sedentary behavior across the Canadian population could avoid 4054 cancers by 2042. We estimated that over 3000 cancer cases in Canada were attributable to leisure-time sedentary behavior in 2015, and that that 4054 incident cancer cases could be prevented by 2042 with meaningful reductions in leisure-time sedentary behavior.

Visual impairment and objectively measured physical activity and sedentary behaviour in US adolescents and adults: a cross-sectional study

OBJECTIVES

To compare levels of physical activity and sedentary time in a representative sample of US adolescents and adults with and without visual impairment.

DESIGN

Cross-sectional analyses were carried out using data from the National Health and Nutrition Examination Survey.

PARTICIPANTS

The study population consisted of 6001 participants (adolescents n=1766, adults n=4235). The present analysis aggregated data from 2003 to 2004 and 2005-2006.

MEASURES

Objective physical activity and sedentary behaviour assessment was conducted over 7 days. Distance visual acuity was measured for each eye in all participants 12 years and older. Participants' vision was categorised as: normal vision, uncorrected refractive error, non-refractive visual impairment. We estimated the sex-specific linear associations between presenting vision and objectively measured physical activity and sedentary patterns using adjusted generalised linear models in adolescents and adults.

RESULTS AND CONCLUSIONS

Adolescents with uncorrected refractive error and non-refractive visual impairment did not accumulate higher levels of sedentary time or lower levels of moderate-to-vigorous physical activity (MVPA) compared with those with normal vision. We observed no association between vision status and accelerometer measured MVPA in adults aged 20-49 years. We observed more time spent sedentary among females 20-49 years old with non-refractive visual impairment compared with those presenting normal vision (mean difference 329.8 min/week, 95% CI: 12.5 to 647.0). Adults 50 years and older with non-refractive visual impairment appeared to accumulate less lifestyle physical activity, particularly in women (mean difference -82.8 min/week, 95% CI: -147.8 to -17.8). Adult women with non-refractive visual impairment have lower levels of lifestyle physical activity and higher levels of sedentary time than those with normal vision. Taken together, these findings highlight the need for interventions to promote physical activity and reduce sedentary time in adult populations with visual impairment, specifically adult women.

A Multi-Week Assessment of a Mobile Exergame Intervention in an Elementary School

BACKGROUND

Exergaming is potentially useful to promote physical activity in children; however, long-term effectiveness is unclear. MobileKids Monster Manor (MKMM) is a mobile exergame developed with the help of young advisors. The game wirelessly transmits physical activity data from an accelerometer to a mobile device. Players' steps are redeemed for in-game rewards, for example, new characters.

OBJECTIVE

First, to evaluate whether increased physical activity previously observed in a 1-week intervention is sustained over a 2-week intervention and 1-week follow-up, and second, to compare impact in schools within different socioeconomic environments.

METHODS

Thirty-seven elementary school students participated in a 4-week randomized controlled study (1-week baseline; 2-week intervention [with only the Game group receiving MKMM]; and 1-week follow-up). All participants wore a Tractivity^® accelerometer throughout. Linear mixed models were applied to assess sustainability; a second 42-children-based dataset and age-/sex-adjusted linear regression models were used to compare effect across socioeconomic environments.

RESULTS

In the first week of intervention, the Game group compared to the Control group showed a greater increase in physical activity (of 1,758 steps/day [95% confidence interval, CI = 133-3,385] and 31 active minutes/day [95% CI = 4-59]), relative to baseline (13,986 steps/day; 231 active minutes/day). However, this was not sustained in the second intervention week or follow-up. The school within a lower socioeconomic status environment showed lower baseline activity and the 1-week intervention resulted in a greater increase relative to baseline (3,633 steps/day more [95% CI = 1,281-5,985]).

CONCLUSION

MKMM could be a useful short-term physical activity promotion tool; however, effectiveness may decrease as novelty diminishes.

Health and broader community benefit of parkrun-An exploratory qualitative study

ISSUE ADDRESSED

parkrun is a free, weekly, timed, international mass community 5-km walk/run event. Unlike other paid events, parkrun attracts populations harder to engage in physical activity (PA) (eg, women, those with overweight/obesity or illness/injury/disability). This exploratory qualitative study investigated the individual, social and environmental factors associated with parkrun's broad appeal in Australia.

METHODS

Tasmanian parkrunners who completed a quantitative survey (2016) were purposively recruited for a 2017 interview study. Semistructured interviews focused on reasons for parkrun participation. Data saturation was achieved by the tenth interview. Data were analysed thematically.

RESULTS

Four themes emerged: (a) participation facilitators and barriers; (b) PA gain and broader community benefit; (c) social connections/networks; and (d) organisational issues. Appealing characteristics of parkrun included strong social support, performance gain opportunities, socialising, inclusivity (eg, all ages/abilities), sense of community, positive atmosphere and accessibility (eg, no cost and convenience). Some participants reported that parkrun had stimulated gains in their total PA (not always limited to walking/running) and that parkrun may also result in other community benefits (eg, supporting local businesses, fee-based running club/event participation and "parkrun tourism"). Most participants first attended parkrun because of encouragement from their social networks, and participants subsequently encouraged others to attend. Participants found parkrun events well organised, but identified some potential threats (eg, local politics).

CONCLUSIONS

Social factors appeared critical in driving initial and ongoing parkrun participation. parkrun may lead to wider community benefits beyond that gained through increased individual PA. These findings highlight the "success factors" driving parkrun participation and provide insights for other community-based PA promotion activities.

Health benefits of physical activity: a systematic review of current systematic reviews

PURPOSE OF REVIEW

The health benefits of physical activity and exercise are clear; virtually everyone can benefit from becoming more physically active. Most international guidelines recommend a goal of 150 min/week of moderate-to-vigorous intensity physical activity. Many agencies have translated these recommendations to indicate that this volume of activity is the minimum required for health benefits. However, recent evidence has challenged this threshold-centered messaging as it may not be evidence-based and may create an unnecessary barrier to those who might benefit greatly from simply becoming more active. This systematic review evaluates recent systematic reviews that have examined the relationship between physical activity and health status.

RECENT FINDINGS

Systematic reviews and/or meta-analyses (based largely on epidemiological studies consisting of large cohorts) have demonstrated a dose-response relationship between physical activity and premature mortality and the primary and secondary prevention of several chronic medical conditions. The relationships between physical activity and health outcomes are generally curvilinear such that marked health benefits are observed with relatively minor volumes of physical activity.

SUMMARY

These findings challenge current threshold-based messaging related to physical activity and health. They emphasize that clinically relevant health benefits can be accrued by simply becoming more physically active. VIDEO ABSTRACT: http://links.lww.com/HCO/A42.

‘It makes your life worthwhile. It gives you a purpose in living’: mobility experiences among active older adults with low income

The World Health Organization claims that mobility is vital to healthy ageing and is the best guarantee of older adults being able to cope and remain in their homes and communities. Mobility enables older adults to maintain their physical health, independence and participation in society. In general, mobility is examined objectively, from a quantitative perspective where mobility is measured as physical movement (e.g.physical activity) and/or travel behaviour (e.g.trips, modes and distances). The predominant focus on the functional aspects of mobility tends to overlook the subjective (e.g.perceptions, attitudes and motivations) and temporal dimensions of older adults’ mobility experiences. Using a constructivist grounded theory methodology, we conducted 24 in-depth interviews with six highly active community-dwelling older adults with low income, aged 65 or over, over a period of four years. Our analysis identified the following themes: maintaining a sense of self, being resourceful, openness to engagement, engaging in superficial contact, experiencing social capital, accessing transportation, leaving the immediate neighbourhood and facing affordability. Findings illustrate that intrapersonal factors, in addition to environmental (built, social and cultural) and temporal-level factors, play a crucial role in mobility. In the future, this gained knowledge can be incorporated into approaches to study the multiple interrelated factors and their interrelations that influence older adults’ mobility.

Development of a physical literacy model for older adults - a consensus process by the collaborative working group on physical literacy for older Canadians

BACKGROUND

Arguably the uptake and usability of the physical activity (PA) guidelines for older adults has not been effective with only 12% of this population meeting the minimum guidelines to maintain health. Health promoters must consider innovative ways to increase PA adoption and long-term sustainability. Physical literacy (PL) is emerging as a promising strategy to increase lifelong PA participation in younger age-groups, yet there is relatively little evidence of PL being used to support older adults in achieving the PA guidelines.

METHODS

An iterative and mixed-methods consensus development process was utilized over a series of six informed processes and meetings to develop a model of physical literacy for adults aged 65 years and older.

RESULTS

A multi-disciplinary collaborative working group (n = 9) from diverse practice settings across Canada, and representative and reflective of the full range of key elements of PL, was assembled. Three consensus meetings and two Delphi surveys, using an international cohort of 65 expert researchers, practitioners, non-government organizations and older adults, was conducted. 45% responded on the first round and consensus was achieved; however, we elected to run a second survey to support our results. With 79% response rate, there was consensus to support the new PL model for older adults.

CONCLUSION

Older adults are a unique group who have yet to be exposed to PL as a means to promote long-term PA participation. This new PL model uses an ecological approach to integrate PL into the lifestyles of most older adults. Understanding the interactions between components and elements that facilitate PL will ultimately provide a new and effective tool to target PA promotion and adherence for all older Canadians.

Sedentary time in older men and women: an international consensus statement and research priorities

Sedentary time is a modifiable determinant of poor health, and in older adults, reducing sedentary time may be an important first step in adopting and maintaining a more active lifestyle. The primary purpose of this consensus statement is to provide an integrated perspective on current knowledge and expert opinion pertaining to sedentary behaviour in older adults on the topics of measurement, associations with health outcomes, and interventions. A secondary yet equally important purpose is to suggest priorities for future research and knowledge translation based on gaps identified. A five-step Delphi consensus process was used. Experts in the area of sedentary behaviour and older adults (n=15) participated in three surveys, an in-person consensus meeting, and a validation process. The surveys specifically probed measurement, health outcomes, interventions, and research priorities. The meeting was informed by a literature review and conference symposium, and it was used to create statements on each of the areas addressed in this document. Knowledge users (n=3) also participated in the consensus meeting. Statements were then sent to the experts for validation. It was agreed that self-report tools need to be developed for understanding the context in which sedentary time is accumulated. For health outcomes, it was agreed that the focus of sedentary time research in older adults needs to include geriatric-relevant health outcomes, that there is insufficient evidence to quantify the dose–response relationship, that there is a lack of evidence on sedentary time from older adults in assisted facilities, and that evidence on the association between sedentary time and sleep is lacking. For interventions, research is needed to assess the impact that reducing sedentary time, or breaking up prolonged bouts of sedentary time has on geriatric-relevant health outcomes. Research priorities listed for each of these areas should be considered by researchers and funding agencies.

This consensus statement has been endorsed by the following societies: Academy of Geriatric Physical Therapy, Exercise & Sports Science Australia, Canadian Centre for Activity and Aging, Society of Behavioral Medicine, and the National Centre for Sport and Exercise Medicine.

Increasing Canadian paediatricians' awareness and use of the new Canadian Physical Activity and Sedentary Behaviour Guidelines for ages 0 to 17 years

Objective

To examine changes in the awareness, use, feasibility, and barriers associated with the Canadian Physical Activity and Sedentary Behaviour Guidelines for Children and Youth ages 0-17 years in a sample of Canadian paediatricians, and to assess tools/resources developed by the Canadian Paediatric Society (CPS).

Methods

Practicing paediatricians who were members of the CPS were invited to complete an on-line survey in February 2013. In response to survey findings, the CPS developed and promoted tools/resources to increase and improve paediatricians' counselling of the guidelines. The CPS membership was surveyed again in September-October 2014. Findings are based on responses from 331 and 217 (23% and 16% participation rate) Canadian paediatricians who completed the survey in 2013 and 2014, respectively.

Results

No significant differences were observed for awareness, use, or feasibility associated with the physical activity or sedentary behaviour guidelines between 2013 and 2014. However, a lack of knowledge/training was reported as a barrier sometimes/often/always by paediatricians significantly less in 2014 (14%) compared to 2013 (32%). Insufficient motivation/lack of support from parents/caregivers/youth was also reported as a barrier less frequently in 2014 (64%) compared to 2013 (75%) but it was borderline non-significant (P=0.05). Only 9% of paediatricians were unaware of the new CPS tools/resources.

Conclusions

The new tools/resources developed by the CPS appeared to reduce some barriers experienced by paediatricians in counselling families about the guidelines. However, this did not appear to translate into greater awareness or use of the guidelines. Continued tool/resource development and training initiatives may be required.

HealtheSteps™ Study Protocol: a pragmatic randomized controlled trial promoting active living and healthy lifestyles in at-risk Canadian adults delivered in primary care and community-based clinics

BACKGROUND

Physical inactivity is one of the leading causes of chronic disease in Canadian adults. With less than 50% of Canadian adults reaching the recommended amount of daily physical activity, there is an urgent need for effective programs targeting this risk factor. HealtheSteps™ is a healthy lifestyle prescription program, developed from an extensive research base to address risk factors for chronic disease such as physical inactivity, sedentary behaviour and poor eating habits. HealtheSteps™ participants are provided with in-person lifestyle coaching and access to eHealth technologies delivered in community-based primary care clinics and health care organizations.

METHOD/DESIGN

To determine the effectiveness of Healthesteps™, we will conduct a 6-month pragmatic randomized controlled trial with integrated process and economic evaluations of HealtheSteps™ in 5 clinic settings in Southwestern Ontario. 110 participants will be individually randomized (1:1; stratified by site) to either the intervention (HealtheSteps™ program) or comparator (Wait-list control). There are 3 phases of the HealtheSteps™ program, lasting 6 months each. The active phase consists of bi-monthly in-person coaching with access to a full suite of eHealth technology supports. During the maintenance phase I, the in-person coaching will be removed, but participants will still have access to the full suite of eHealth technology supports. In the final stage, maintenance phase II, access to the full suite of eHealth technology supports is removed and participants only have access to publicly available resources and tools.

DISCUSSION

This trial aims to determine the effectiveness of the program in increasing physical activity levels and improving other health behaviours and indicators, the acceptability of the HealtheSteps™ program, and the direct cost for each person participating in the program as well as the costs associated with delivering the program at the different community sites. These results will inform future optimization and scaling up of the program into additional community-based primary care sites.

TRIAL REGISTRATION

NCT02413385 (Clinicaltrials.gov). Date Registered: April 6, 2015.

The Canadian 24-Hour Movement Guidelines for Children and Youth: Implications for practitioners, professionals, and organizations

The new Canadian 24-Hour Movement Guidelines for Children and Youth emphasize the integration of all movement behaviours that occur over a whole day (i.e., light, moderate, and vigorous physical activity, sedentary behaviour, and sleep). These guidelines shift the paradigm away from considering each behaviour in isolation. This concept of the "whole day matters" not only calls for a change in thinking about movement but also for redevelopment of dissemination and implementation practice. Past guideline launch activities largely have aimed to create awareness through passive dissemination strategies (e.g., Website posts, distribution of print resources). For the integrated guidelines to have public health impact, we must move beyond dissemination and raising of awareness to implementation and behaviour change. Shifting this focus requires new, innovative approaches to intervention, including interdisciplinary collaboration, policy change, and refocused service provision. The purpose of this paper is to identify practitioners, professionals, and organizations with potential to disseminate and/or implement the guidelines, discuss possible implementation strategies for each of these groups, and describe the few resources being developed and those needed to support dissemination and implementation efforts. This discussion makes readily apparent the need for a well-funded, comprehensive, long-term dissemination, implementation, and evaluation plan to ensure uptake and activation of the guidelines.

Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep

Leaders from the Canadian Society for Exercise Physiology convened representatives of national organizations, content experts, methodologists, stakeholders, and end-users who followed rigorous and transparent guideline development procedures to create the Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep. These novel guidelines for children and youth aged 5-17 years respect the natural and intuitive integration of movement behaviours across the whole day (24-h period). The development process was guided by the Appraisal of Guidelines for Research Evaluation (AGREE) II instrument and systematic reviews of evidence informing the guidelines were assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Four systematic reviews (physical activity, sedentary behaviour, sleep, integrated behaviours) examining the relationships between and among movement behaviours and several health indicators were completed and interpreted by expert consensus. Complementary compositional analyses were performed using Canadian Health Measures Survey data to examine the relationships between movement behaviours and health indicators. A stakeholder survey was employed (n = 590) and 28 focus groups/stakeholder interviews (n = 104) were completed to gather feedback on draft guidelines. Following an introductory preamble, the guidelines provide evidence-informed recommendations for a healthy day (24 h), comprising a combination of sleep, sedentary behaviours, light-, moderate-, and vigorous-intensity physical activity. Proactive dissemination, promotion, implementation, and evaluation plans have been prepared in an effort to optimize uptake and activation of the new guidelines. Future research should consider the integrated relationships among movement behaviours, and similar integrated guidelines for other age groups should be developed.

Using concept mapping in the development of the EU-PAD framework (EUropean-Physical Activity Determinants across the life course): a DEDIPAC-study

Background

A large proportion of European children, adults and older adults do not engage in sufficient physical activity (PA). Understanding individual and contextual factors associated with PA behaviours is essential for the identification and implementation of effective preventative environments, policies, and programmes that can promote an active lifestyle across life course and can potentially improve health. The current paper intends to provide 1) a multi-disciplinary, Pan-European and life course view of key determinants of PA behaviours and 2) a proposal of how these factors may cluster.

Methods

After gathering a list of 183 potential PA behaviours-associated factors and a consensus meeting to unify/consolidate terminology, a concept mapping software was used to collate European experts’ views of 106 identified factors for youth (<19 years), adults (19–64 years), and older adults (≥65 years). The analysis evaluated common trends in the clustering of factors and the ratings of the distinct factors’ expected modifiability and population-level impact on PA behaviours across the life course. Priority for research was also assessed for each cluster.

Results

The concept mapping resulted in six distinct clusters, broadly merged in two themes: 1) the ‘Person’, which included clusters ‘Intra-Personal Context and Wellbeing’ and ‘Family and Social Economic Status’ (42 % of all factors) and 2) the ‘Society’, which included the remaining four clusters ‘Policy and Provision’, ‘Cultural Context and Media’, ‘Social Support and Modelling’, and ‘Supportive Environment’ (58 % of all factors). Overall, 25 factors were rated as the most impactful on PA behaviours across the life course and being the most modifiable. They were mostly situated in the ‘Intra-Personal Context and Wellbeing’ cluster. Furthermore, 16 of them were rated as top priority for research.

Conclusions

The current framework provides a preliminary overview of factors which may account for PA behaviour across the life course and are most relevant to the European community. These insights could potentially be a foundation for future Pan-European research on how these factors might interact with each other, and assist policy makers to identify appropriate interventions to maximize PA behaviours and thus the health of European citizens.

Exercise as Medicine: Key Concepts in Discussing Physical Activity with Patients who have Type 2 Diabetes

People with type 2 diabetes stand to benefit substantially from being physically active. Practice guidelines consistently recommend that people with diabetes obtain at least 150 minutes of moderate to vigorous aerobic exercise per week. Although the message of 150 minutes per week is important, there are several other key messages regarding physical activity that may not be communicated as often or as clearly. This article gives an overview of the importance of resistance training, the dose-response relationship between physical activity and health outcomes, and the emerging evidence concerning the role of sedentary behavior in people with type 2 diabetes. This article provides valuable content for healthcare providers that will help to inform their discussions about physical activity with patients who have type 2 diabetes.

Canadian physical activity guidelines for adults: are Canadians aware?

The present study evaluated awareness of the Canadian Society for Exercise Physiology’s 2011 Canadian Physical Activity Guidelines for Adults and assessed correlates. Reported awareness of the physical activity (PA) guidelines was 12.9% (204/1586) of the total sample surveyed. More than half (55%) self-reported meeting PA guidelines of ≥ 150 min of moderate to vigorous PA per week. Awareness of PA guidelines was significantly related to participants’ level of PA (χ2 (1) = 30.63, p < 0.001, φ = –0.14), but not to any demographic variables.

Adherence to Canadian physical activity and sedentary behaviour guidelines among children 2 to 13 years of age

Active living is relevant for healthy child development and disease prevention. In 2011-2012 new Canadian Physical Activity and Sedentary Behaviour Guidelines were developed for children under four and 5-17 years of age. This cross-sectional study assessed children's adherence to the national guidelines, using a large sample of Alberta children ages 2-4 and 5-13 years in 2013. The proportions of children achieving the average daily duration of physical activity and screen time recommended were determined, and child and parental predictors of non-achievement were identified. Participants were 631 parent and child dyads. Data were collected by parental reports of physical activity and screen time during weekdays, and analysed using univariate and multivariate techniques (p < 0.05). Logistic regression models were used to examine factors associated with children's non-achievement of physical activity and screen time recommendations while adjusting for covariates. Sixty-two percent of children aged 2-4 and 26% of children aged 5-13 did not meet physical activity time recommendations, and 64% of children aged 2-4 and 23% of children aged 5-13 exceeded the maximum screen time recommendation. Several associations between parental age and education with non-achievement were observed but associations were not consistent across age groups or behaviours. Among preschoolers, those with middle-age parents were more likely to not achieve physical activity recommendations. Evidence of high non-achievement of the recommendations among children 2-4 years highlights the need for increased programming targeting preschool children. Further research is required to identify modifiable risk factors that may inform future health promotion efforts.

Canadian 24-Hour Movement Guidelines for Children and Youth: Exploring the perceptions of stakeholders regarding their acceptability, barriers to uptake, and dissemination

Engaging stakeholders in the development of guidelines and plans for implementation is vital. The purpose of this study was to examine stakeholders’ (parents, teachers, exercise professionals, paediatricians, and youth) perceptions of the Canadian 24-Hour Movement Behaviour Guidelines for Children and Youth (“Movement Guidelines”). Stakeholders (n = 104) engaged in semi-structured focus groups or interviews to discuss the perceived acceptability of the guidelines, potential barriers to implementation, and preferred methods and messengers of dissemination. A thematic analysis was conducted. Overall, there was consistent support across all stakeholder groups, with the exception of youth participants, for the Movement Guidelines. Stakeholders identified a range of barriers to the uptake of the guidelines including concerns with accurately defining key terms such as “recreational” screen time; everyday challenges such as financial and time constraints; and the possibility of the Movement Guidelines becoming just another source of stress and guilt for already busy and overwhelmed parents. Participants identified a range of recommended methods and messengers for future dissemination. School and medical settings were the most commonly recommended settings through which dissemination efforts should be delivered. Overall, participants representing a range of stakeholder groups were receptive to the new Movement Guidelines and endorsed their value. In complementing the Movement Guidelines, messaging and resources will need to be developed that address common concerns participants had regarding their dissemination and implementation.

The effectiveness of workplace interventions to increase physical activity and decrease sedentary behaviour in adults: protocol for a systematic review

BACKGROUND

A physically active lifestyle plays a preventative role in the development of various chronic diseases and mental health conditions. Unfortunately, few adults achieve the minimum amount of physical activity and spend excessive time sitting. Developing targeted interventions to increase active living among adults is an important endeavour for public health. One plausible context to reach adults is the workplace. This systematic review aims to review the effectiveness of workplace interventions on increasing physical activity and decreasing sedentary behaviour in the workplace.

METHODS

An advisory group of practitioners will work in collaboration with the research team to inform the systematic review and knowledge mobilization. Fifteen electronic databases will be searched to identify studies examining the effectiveness of workplace interventions on physical activity and sedentary behaviour. All experimental designs and observational studies (non-experimental intervention studies) meeting the study criteria will be included. Studies examining generally healthy, employed, adult participants will be included for the review. Interventions will focus on increasing physical activity and/or decreasing sedentary behaviour from the individual to policy level. The primary outcome variables will be reported or observed physical activity and/or sedentary behaviour in the workplace. Secondary outcomes will include variables ranging from return on investment to quality of life. Study quality will be assessed for risk of bias following the protocol identified in the Cochrane Handbook for Systematic Reviews of Interventions and supplemented by the guidelines developed by the Cochrane Effective Practice and Organisation of Care group, using RevMan. The quality of the evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation approach. Meta-analyses, forest plots, and harvest plots will be used where appropriate to assess the direction, size, and consistency of the intervention effect across the studies using similar intervention strategies. Follow-up knowledge mobilization activities and products will be developed to support the use of this knowledge in practice.

DISCUSSION

This protocol paper describes a systematic review assessing the effectiveness of various types of workplace interventions on increasing physical activity and decreasing sedentary behaviour at work. Collaborating with an advisory group of potential knowledge users throughout the process postulates a greater use and reach of the information gained from this systematic review by knowledge users.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42015019398.