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Brown RD, Pepper GV. The Uncontrollable Mortality Risk Hypothesis: Theoretical foundations and implications for public health. Evol Med Public Health 2024; 12:86-96. [PMID: 38807860 PMCID: PMC11132133 DOI: 10.1093/emph/eoae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 04/26/2024] [Indexed: 05/30/2024] Open
Abstract
The 'Uncontrollable Mortality Risk Hypothesis' employs a behavioural ecological model of human health behaviours to explain the presence of social gradients in health. It states that those who are more likely to die due to factors beyond their control should be less motivated to invest in preventative health behaviours. We outline the theoretical assumptions of the hypothesis and stress the importance of incorporating evolutionary perspectives into public health. We explain how measuring perceived uncontrollable mortality risk can contribute towards understanding socioeconomic disparities in preventative health behaviours. We emphasize the importance of addressing structural inequalities in risk exposure, and argue that public health interventions should consider the relationship between overall levels of mortality risk and health behaviours across domains. We suggest that measuring perceptions of uncontrollable mortality risk can capture the unanticipated health benefits of structural risk interventions, as well as help to assess the appropriateness of different intervention approaches.
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Affiliation(s)
- Richard D Brown
- Psychology Department, Northumbria University, Newcastle, UK
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2
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Goon S, Slotnick M, Leung CW. Associations Between Subjective Social Status and Health Behaviors Among College Students. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2024; 56:184-192. [PMID: 38244011 DOI: 10.1016/j.jneb.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 12/04/2023] [Accepted: 12/05/2023] [Indexed: 01/22/2024]
Abstract
OBJECTIVE Examine the associations between subjective social status (SSS), diet, and health outcomes in college students. METHODS Cross-sectional study of 841 students enrolled at a large Midwestern university. Subjective social status within the US, as well as within the university, was measured using the MacArthur Scale of SSS. Outcomes included dietary intake (assessed using the Dietary Screening Questionnaire), body mass index, sleep, physical activity, alcohol use, and vaping behavior. Generalized linear models adjusting for students' sociodemographic characteristics were used to assess associations between SSS and outcomes of interest. RESULTS Higher SSS-US was associated with 4%, 3%, and 1% higher intake of fruits, whole grains, and fiber, respectively (P < 0.05). Higher SSS-US and SSS-university rankings were both significantly associated with lower body mass index and better sleep duration (P < 0.05). Higher SSS-university rankings were also associated with more days of physical activity and alcohol consumption (P < 0.05). CONCLUSIONS AND IMPLICATIONS In this exploratory study, higher SSS, apart from alcohol intake, was associated with more favorable health outcomes. More research is needed to consider additional psychological and biological mediators and dynamic aspects of SSS, examine potential interactions between SSS and racial and ethnic identities, and explore potential mechanisms underlying the observed associations.
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Affiliation(s)
- Shatabdi Goon
- Allegheny County Health Department, Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Melissa Slotnick
- Department of Nutritional Sciences, School of Public Health, University of Michigan, MI
| | - Cindy W Leung
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
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Kheirmandparizi M, Gouin JP, Bouchaud CC, Kebbe M, Bergeron C, Madani Civi R, Rhodes RE, Farnesi BC, Bouguila N, Conklin AI, Lear SA, Cohen TR. Perceptions of self-monitoring dietary intake according to a plate-based approach: A qualitative study. PLoS One 2023; 18:e0294652. [PMID: 38015899 PMCID: PMC10683993 DOI: 10.1371/journal.pone.0294652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/05/2023] [Indexed: 11/30/2023] Open
Abstract
Dietary self-monitoring is a behaviour change technique used to help elicit and sustain dietary changes over time. Current dietary self-monitoring tools focus primarily on itemizing foods and counting calories, which can be complex, time-intensive, and dependent on health literacy. Further, there are no dietary self-monitoring tools that conform to the plate-based approach of the 2019 Canada Food Guide (CFG), wherein the recommended proportions of three food groups are visually represented on a plate without specifying daily servings or portion sizes. This paper explored the perceptions of end-users (i.e., general public) and Registered Dietitians of iCANPlateTM-a dietary self-monitoring mobile application resembling the CFG. Qualitative data were collected through virtual focus groups. Focus group questions were based on the Capability, Opportunity, Motivation-Behaviour (COM-B) theoretical framework to explore perceptions of using the CFG and currently available dietary self-monitoring tools. The prototype iCANPlateTM (version 0.1) was presented to gain feedback on perceived barriers and facilitators of its use. Focus group discussions were audio recorded and verbatim transcribed. Trained researchers used thematic analysis to code and analyze the transcripts independently. Seven focus groups were conducted with Registered Dietitians (n = 44) and nine focus groups with members from the general public (n = 52). During the focus groups, participants mainly discussed the capabilities and opportunities required to use the current iteration of iCANPlateTM. Participants liked the simplicity of the application and its capacity to foster self-awareness of dietary behaviours rather than weight control or calorie counting. However, concerns were raised regarding iCANPlateTM's potential to improve adherence to dietary self-monitoring due to specific characteristics (i.e., insufficient classifications, difficulty in conceptualizing proportions, and lack of inclusivity). Overall, participants liked the simplicity of iCANPlateTM and its ability to promote self-awareness of dietary intakes, primarily through visual representation of foods on a plate as opposed to reliance on numerical values or serving sizes, were benefits of using the app. Findings from this study will be used to further develop the app with the goal of increasing adherence to plate-based dietary approaches.
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Affiliation(s)
- Maryam Kheirmandparizi
- Faculty of Land and Food Systems, Food, Nutrition and Health, the University of British Columbia, Vancouver, British Columbia, Canada
| | - Jean-Philippe Gouin
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | | | - Maryam Kebbe
- Faculty of Kinesiology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Coralie Bergeron
- Faculty of Land and Food Systems, Food, Nutrition and Health, the University of British Columbia, Vancouver, British Columbia, Canada
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
| | - Rana Madani Civi
- Faculty of Land and Food Systems, Food, Nutrition and Health, the University of British Columbia, Vancouver, British Columbia, Canada
| | - Ryan E. Rhodes
- School of Exercise Science, Physical & Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Biagina-Carla Farnesi
- Division of Adolescent Medicine, Montreal Children’s Hospital, Westmount, Quebec, Canada
| | - Nizar Bouguila
- Concordia Institute for Information Systems Engineering, Engineering, Computer Science and Visual Arts Integrated Complex, Concordia University, Montreal, Quebec, Canada
| | - Annalijn I. Conklin
- Faculty of Pharmaceutical Sciences, the University of British Columbia, Vancouver, British Columbia, Canada
| | - Scott A. Lear
- Faculty of Health Sciences, Burnaby and Division of Cardiology, Providence Health Care, Simon Fraser University, Vancouver, BC, Canada
| | - Tamara R. Cohen
- Faculty of Land and Food Systems, Food, Nutrition and Health, the University of British Columbia, Vancouver, British Columbia, Canada
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
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Gautam N, Dessie G, Rahman MM, Khanam R. Socioeconomic status and health behavior in children and adolescents: a systematic literature review. Front Public Health 2023; 11:1228632. [PMID: 37915814 PMCID: PMC10616829 DOI: 10.3389/fpubh.2023.1228632] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 09/25/2023] [Indexed: 11/03/2023] Open
Abstract
Socioeconomic status affects individuals' health behaviors and contributes to a complex relationship between health and development. Due to this complexity, the relationship between SES and health behaviors is not yet fully understood. This literature review, therefore, aims to assess the association between socioeconomic status and health behaviors in childhood and adolescence. Preferred Reporting for Systematic Review and Meta-Analysis protocol guidelines were used to conduct a systematic literature review. The electronic online databases EBSCO Host, PubMed, Web of Science, and Science Direct were utilized to systematically search published articles. The Joanna Briggs Institute's critical appeal tool was used to assess the quality of included studies. Eligibility criteria such as study context, study participants, study setting, outcome measures, and key findings were used to identify relevant literature that measured the association between socioeconomic status and health behaviors. Out of 2,391 studies, only 46 met the final eligibility criteria and were assessed in this study. Our review found that children and adolescents with low socioeconomic status face an elevated risk of unhealthy behaviors (e.g., early initiation of smoking, high-energy-dense food, low physical activity, and involvement in drug abuse), in contrast to their counterparts. Conversely, children and adolescents from higher socioeconomic backgrounds exhibit a higher prevalence of health-promoting behaviors, such as increased consumption of fruit and vegetables, dairy products, regular breakfast, adherence to a nutritious diet, and engagement in an active lifestyle. The findings of this study underscore the necessity of implementing specific intervention measures aimed at providing assistance to families from disadvantaged socioeconomic backgrounds to mitigate the substantial disparities in health behavior outcomes in children and adolescents.
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Affiliation(s)
- Nirmal Gautam
- School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Getenet Dessie
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Mohammad Mafizur Rahman
- School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Rasheda Khanam
- School of Business, Faculty of Business, Education, Law and Arts, University of Southern Queensland, Toowoomba, QLD, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD, Australia
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Sedlačík M, Lacinová V, Hasilová K. Assessment of physical activity among adolescents: a guide to the literature. Front Psychol 2023; 14:1232382. [PMID: 37484102 PMCID: PMC10359975 DOI: 10.3389/fpsyg.2023.1232382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 06/27/2023] [Indexed: 07/25/2023] Open
Abstract
Purpose The aim of this article is to systematically review articles and annual reports concerning young peoples' physical activity (PA) and linking this to considerations of the state and national defense. Method A systematic search of the literature included an analysis of publications accessible in global databases and other available books, student papers, and projects. The articles and reports were categorized based on year of publication, methods used, age of respondents, sample size, country, and digital object identifier (DOI). Results The result of this search is an overview of the extent and manner in which the worldwide scientific community is addressing the current situation and the long-term development of the physical fitness of adolescents. This publication also maps to what extent professional publications and articles are addressing PA from the perspective of the needs of armies and armed forces of various countries around the world. Conclusions The article provides a systematic overview of methods used to measure PA, and an overview of articles dealing with assessing PA. The examined articles indicate that from the perspective of not only national defense, but also health and overall quality of life, in particular, we need initiatives to encourage and motivate young people to increase their everyday PA. The research therefore also includes an overview of factors that may considerably influence PA. The results ascertained in this publication will be used, i.a. for investigating a longitudinal defense research project of the Ministry of Defense of the Czech Republic in which the authors are participating.
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Bergen T, Kim AHM, Mizdrak A, Signal L, Kira G, Richards J. Determinants of Future Physical Activity Participation in New Zealand Adolescents across Sociodemographic Groups: A Descriptive Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6001. [PMID: 37297605 PMCID: PMC10252680 DOI: 10.3390/ijerph20116001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023]
Abstract
This cross-sectional study aimed to explore various determinants of future physical activity (PA) participation in adolescents across sociodemographic groups. Sociodemographic characteristics (age, gender, ethnicity, deprivation status, physical disability status) were assessed in a national sample (n = 6906) of adolescents (12-17 years old) between 2017 and 2020 in New Zealand. The determinants of future PA participation chosen for analysis included current indicators of PA participation (i.e., total time, number of types, number of settings). We also examined widely recognised modifiable intrapersonal (i.e., physical literacy) and interpersonal (i.e., social support) determinants of current and future PA behaviour, along with indicators of PA availability issues. Older adolescents scored worse across all determinants of future PA than younger adolescents, with a key transition point appearing at 14-15 years of age. Māori and Pacific ethnicities scored best across each determinant category on average, with Asian populations scoring the worst. Gender diverse adolescents scored substantially worse than male and female adolescents across every determinant. Physically disabled adolescents scored worse than non-disabled across all determinants. Adolescents from medium and high deprivation neighbourhoods scored similarly across most determinants of future PA participation and both tended to score worse than people from low deprivation neighbourhoods. A particular focus on the improvement of future PA determinants is warranted within adolescents who are older, Asian, gender diverse, physically disabled, and from medium to high deprivation neighbourhoods. Future investigation should prioritise the longitudinal tracking of PA behaviours over time and develop interventions that affect multiple future PA determinants across a range of sociodemographic backgrounds.
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Affiliation(s)
- Tom Bergen
- Department of Public Health, University of Otago, Wellington 6242, New Zealand; (A.M.); (L.S.)
- Sport New Zealand Ihi Aotearoa, Wellington 6011, New Zealand;
| | - Alice Hyun Min Kim
- Biostatistics Group, Dean’s Department, University of Otago, Wellington 6242, New Zealand;
| | - Anja Mizdrak
- Department of Public Health, University of Otago, Wellington 6242, New Zealand; (A.M.); (L.S.)
| | - Louise Signal
- Department of Public Health, University of Otago, Wellington 6242, New Zealand; (A.M.); (L.S.)
| | - Geoff Kira
- Te Hau Kori, Faculty of Health, Victoria University of Wellington Te Herenga Waka, Wellington 6012, New Zealand;
| | - Justin Richards
- Sport New Zealand Ihi Aotearoa, Wellington 6011, New Zealand;
- Te Hau Kori, Faculty of Health, Victoria University of Wellington Te Herenga Waka, Wellington 6012, New Zealand;
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Sulz LD, Gleddie DL, Kinsella C, Humbert ML. The health and educational impact of removing financial constraints for school sport. EUROPEAN PHYSICAL EDUCATION REVIEW 2023; 29:3-21. [PMID: 36620347 PMCID: PMC9810829 DOI: 10.1177/1356336x221104909] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Financial barriers often restrict sport participation among children from low-income families. Schools are thought to offer equitable access to programming, including school sport participation. However, pay-to-play school sport models can inhibit participation among students from low-income households. Recognizing the potential benefits of school sport and realizing the financial barriers to participation, the purpose of this study was to understand the extent to which school sport promotes educational experiences and holistic well-being of Canadian youth from low-income families. A case study was conducted with stakeholders who were supported by funding from a non-profit organization to help cover the costs of school sport registration fees. Data were collected from in-depth interviews with low-income students and their parents, teacher-coaches and school administrators. Three overarching themes were representative of the experiences of school sport participation among low-income students: (1) healthy student-athletes, (2) developing student-athletes in school, for life, and (3) supporting student-athletes as a community. The participants perceived that school sport participation offered holistic health benefits, and developed skills and behaviours that support positive educational experiences and foster life skills. Further, our results highlighted the importance of the school community in supporting low-income students to participate in school sport teams and the need to reframe school sport to better support low-income families.
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Affiliation(s)
- Lauren Denise Sulz
- Lauren Denise Sulz, Faculty of Education,
University of Alberta, Edmonton, Alberta, Canada.
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Salmensalo M, Ruotsalainen H, Hylkilä K, Kääriäinen M, Konttila J, Männistö M, Männikkö N. Associations between digital gaming behavior and physical activity among Finnish vocational students. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01788-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Abstract
Digital gaming is considered to be a major sedentary lifestyle among youth. The time spent on digital gaming may also affect the physical behavior of young adults.
Objective
This study aimed to investigate the associations between various characteristics of digital gaming behavior (i.e., gaming time, device, and game type) and participation in physical activity among Finnish vocational students.
Materials and methods
The research employed a cross-sectional survey design. The analyzed sample consisted of 773 students (455 males, 318 females) from eight vocational school units in Northern Finland who regularly played digital games. Data were collected via an online self-reported questionnaire, which included questions concerning average weekly time spent on digital gaming, preferred device, favorite types of games, and physical activity.
Results
The students spent an average of two hours each day playing digital games. Males preferred to play using personal computers (PCs), whereas mobile gaming was more popular among females. Shooter (42.4%) and entertainment (64.2%) games were the most popular game types among males and females, respectively. The results revealed that male gender and PC gaming were both positively related to physical inactivity among vocational school students. A preference toward sport games was inversely related with physical inactivity.
Conclusion
The presented findings can be utilized to develop interventions that target the prevention of sedentary behavior among vocational students. Further longitudinal studies will be required to reliably assess the relationship between digital gaming and physical activity.
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Pereira S, Reyes AC, Chaves R, Santos C, Vasconcelos O, Tani G, Katzmarzyk PT, Baxter-Jones A, Maia J. Correlates of the Physical Activity Decline during Childhood. Med Sci Sports Exerc 2022; 54:2129-2137. [PMID: 35941524 PMCID: PMC9669110 DOI: 10.1249/mss.0000000000003013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to describe longitudinal trends in children's moderate-to-vigorous physical activity (MVPA) and to investigate associations with individual, familial, and school characteristics. METHODS A sample of 341 Portuguese children age 5-10 yr (173 girls) from six age cohorts was followed over 3 yr using a mixed-longitudinal design. Physical activity, body mass index (BMI), gross motor coordination, and musculoskeletal fitness were assessed annually. Information on socioeconomic status and school characteristics was collected and analyzed with mixed models. RESULTS MVPA shows a similar declining trend in both sexes, but on average, boys exceeded the World Health Organization recommendations of 60 min·d -1 . The best model showed that boys spend, on average, more time in MVPA than girls. Children with lower BMI are less prone to the decline in MVPA, whereas higher levels of musculoskeletal fitness were associated with lower declines in MVPA. Of all school characteristics, only playground dimension was related to MVPA decreasing trajectories. CONCLUSIONS MVPA systematically declines from 5 to 10 yr of age in both boys and girls, but boys remained more active than girls across the age range. The best predictors of MVPA decline are sex, BMI, musculoskeletal fitness, and school playground dimension.
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Affiliation(s)
- Sara Pereira
- CIFI2D, Faculty of Sport, University of Porto, Porto, PORTUGAL
- CIDEFES, Faculty of Physical Education and Sports, Lusófona University, Lisboa, PORTUGAL
| | - Ana Carolina Reyes
- Faculty of Education and Sport, University of Cape Verde, Mindelo, CAPE VERDE
| | - Raquel Chaves
- Department of Physical Education, Federal University of Technology-Paraná, Curitiba, Paraná, BRAZIL
| | - Carla Santos
- CIFI2D, Faculty of Sport, University of Porto, Porto, PORTUGAL
| | | | - Go Tani
- School of Physical Education and Sports, University of São Paulo, São Paulo, BRAZIL
| | - Peter T. Katzmarzyk
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA
| | - Adam Baxter-Jones
- College of Kinesiology, University of Saskatchewan, Saskatoon, CANADA
| | - José Maia
- CIFI2D, Faculty of Sport, University of Porto, Porto, PORTUGAL
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Wilson K, Schmidt A, Hess A, Vanos J, Ross A. Shifts in Self-Reported Physical Activity, Sedentary Behavior, and Play Among Lower-Socioeconomic Children During the COVID-19 Pandemic: A Repeated Cross-Sectional Study. Am J Health Promot 2022; 36:1335-1338. [PMID: 35582730 PMCID: PMC9125129 DOI: 10.1177/08901171221091234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
PURPOSE The lack of in-person schooling and participation in structured recreation activities during the COVID-19 pandemic may have altered children's movement behaviors. This study assessed changes in children's self-reported in school and out of school physical activity, sedentary behavior, and play before and during the pandemic. DESIGN A repeated cross-sectional online survey was administered in February 2020 (pre-pandemic, in-person) and 2021 (during pandemic, remote). SETTING Children attended an urban public school district in Phoenix (AZ) serving a low-income population. SUBJECTS Students in grades 4-8 completed the survey in 2020 (n = 253, 62% response rate) and 2021 (n = 261, 77% response rate). MEASURES The survey included items from the Youth Activity Profile and three additional questions about play. ANALYSIS Differences in mean scores and mean scores by gender were analyzed using one-way and two-way ANOVAs. RESULTS Students reported less physical activity during remote recess in 2021 (M = 3.42, SD = .80 v. M = 2.99, SD = .86, p < .05). Physical activity outside of school decreased during the pandemic (M = 2.76, SD = 1.26 v. M = 2.53, SD = 1.18, p < .05). Most students (55%) reported playing less during the pandemic, but playing in new ways (67%). CONCLUSION Children may benefit from interventions to counter reduced movement experienced during the pandemic, particularly in under-resourced areas.
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Affiliation(s)
- Kylie Wilson
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
| | - Annette Schmidt
- Mary Lou Fulton Teachers College, Arizona State University, Phoenix, AZ, USA
| | - Aaron Hess
- College of Integrative Sciences and Arts, Arizona State University, Phoenix, AZ, USA
| | - Jennifer Vanos
- School of Sustainability, Arizona State University, Phoenix, AZ, USA
| | - Allison Ross
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA
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Ke Y, Shi L, Peng L, Chen S, Hong J, Liu Y. Associations between socioeconomic status and physical activity: A cross-sectional analysis of Chinese children and adolescents. Front Psychol 2022; 13:904506. [PMID: 36118481 PMCID: PMC9477139 DOI: 10.3389/fpsyg.2022.904506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesAlthough socioeconomic status (SES) has been shown to be an important determinant of physical activity (PA) in adults, the association in children and adolescents remains less consistent based on evidence from western developed countries. The purpose of this study, therefore, is to investigate associations between SES and PA among Chinese children and adolescents.MethodsA cross-sectional study was conducted with a self-reported questionnaire in China. The multi-stage stratified cluster sampling method was used, and 2,955 children and adolescents (8–17 years old, 53.4% girls) were enrolled in this study. SES was assessed by measuring parental education levels, perceived family wealth, and Family Affluence Scale II (FAS II). PA was assessed by reliable and valid items from the Health Behavior School-aged Children Surveillance questionnaires. Descriptive statistics were used to report sample characteristics, including demographic characteristics, levels of PA, and SES. The Chi-square test was applied to analyze the differences of PA in gender and school period. Binary logistic regression was used to analyze the association between SES and PA among children and adolescents.ResultsOverall, 10.4% of children and adolescents accumulated moderate-to-vigorous physical activity (MVPA) at least 60 min per day. Boys were more physically active than girls (14.1% vs. 7.2%, p < 0.001). Higher socioeconomic status was positively associated with higher physical activity levels among children and adolescents, especially using FAS and mother education level as SES measures. The association between SES and PA varied by gender and grade group, and the effects of SES are also different on weekdays and weekends.ConclusionThis study found socioeconomic disparities in PA among Chinese children and adolescents, and showed the importance of targeting children and adolescents with low SES intervention priority. Based on these research findings, it is suggested that SES, especially for FAS and mother education level, should be considered when designing and implementing the promotion of regular PA in children and adolescents. Health policymakers may use this information to develop interventions to reduce health inequalities among children and adolescents in the future.
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Affiliation(s)
- Youzhi Ke
- School of Physical Education, Shanghai University of Sport, Shanghai, China
| | - Lijuan Shi
- Department of Comprehensive Education and Preschool Education, Shanghai Teacher Training Center, Shanghai, China
| | - Lingqun Peng
- School of Physical Education, Shanghai University of Electric Power, Shanghai, China
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Jintao Hong
- Shanghai Research Institute of Sports Science, Shanghai, China
| | - Yang Liu
- School of Physical Education, Shanghai University of Sport, Shanghai, China
- Shanghai Research Center for Physical Fitness and Health of Children and Adolescents, Shanghai, China
- *Correspondence: Yang Liu,
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Yuan S, Gu Q, Lei Y, Shen J, Niu Q. Can Physical Exercise Promote the Development of Teenagers' Non-Cognitive Ability?-Evidence from China Education Panel Survey (2014-2015). CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9091283. [PMID: 36138592 PMCID: PMC9497572 DOI: 10.3390/children9091283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/16/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022]
Abstract
Background: With the development of educational philosophy, physical exercise is considered to be an important factor in the development of individual cognitive abilities in adolescents. However, the effects of physical exercise on non-cognitive abilities in adolescents remain inadequate. Objective: This study examined the effect of physical exercise on non-cognitive ability and further examined the differences in this effect in different groups. Methods: Survey data on non-cognitive ability, physical exercise and covariates were collected in the China Education Panel Survey (2014−2015) from a nationally representative sample of adolescents (n = 7904) in the eighth (follow-up) grade. Results: The results show that, after controlling for the influence of other factors, physical exercise has a promoting effect on six non-cognitive abilities—social behavior (p < 0.001), communication ability (p < 0.01), perseverance (p < 0.05), school adaptation (p < 0.001), educational expectation (p < 0.01) and creative thinking (p < 0.01)—and there is no significant effect on emotional control (p > 0.05). Furthermore, the development of non-cognitive ability in physical exercise shows certain group differences. Conclusions: There are gender differences in the performance of non-cognitive ability. Girls perform better than boys in non-cognitive ability. Physical exercise is an important means to develop non-cognitive ability, which indicates that non-cognitive ability has plasticity in adolescence. Future intervention may improve the non-cognitive ability of Chinese adolescents by increasing physical exercise.
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Affiliation(s)
- Shiwei Yuan
- Wuxi Higher Health Vocational Technology School, Wuxi 214000, China
| | - Qian Gu
- School of Physical Education, Shandong University, Jinan 250100, China
- Correspondence:
| | - Yuanyuan Lei
- Physical Education College, Hebei Normal University, Shijiazhuang 050000, China
| | - Jinbo Shen
- Taiyuan Institute of Technology, Taiyuan 030008, China
| | - Qian Niu
- Taiyuan Institute of Technology, Taiyuan 030008, China
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Differences and Associations between Physical Activity Motives and Types of Physical Activity among Adolescent Boys and Girls. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6305204. [PMID: 35686232 PMCID: PMC9173893 DOI: 10.1155/2022/6305204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/06/2022] [Indexed: 12/14/2022]
Abstract
Interventions aimed at motivation for physical activity (PA) are mostly beneficial, but the effects on preventing the decrease in PA are not entirely clear, especially in girls. The main aim of this study was to identify the differences and associations between PA motives and types of PA in boys and girls and between low and high motivated boys and girls. Another aim is to identify the types of motivation and PA that increase the likelihood of achieving PA recommendations and to propose ways of increasing PA among low motivated adolescents. The research carried out before the COVID-19 pandemic (2010–2019) and involved 2,149 Czech and 1,927 Polish adolescents aged 15–19 years. The International Physical Activity Questionnaire-Long Form was used to identify the level of PA types, while PA motivation was examined through the Motives for Physical Activities Measure-Revised. During the ten years, a decline was observed in enjoyment, fitness, and social motives. An increase in appearance motives was observed in girls, while no significant changes were seen in boys. Boys showed a higher motivation for PA than girls in enjoyment, competence, fitness, and social motives, while girls were high motivated in appearance motives. The greatest statistically significant differences between low and high motivated individuals were found in the associations between recreation/vigorous PA and between all types of motivation in boys and girls in both countries. The strongest associations in both genders were observed between enjoyment/competence motives and recreation/vigorous PA. Respecting and using the associations between the types of PA motives and types of PA in low and high motivated boys and girls can support feelings of PA enjoyment, increase PA, support the achievement of PA recommendations, and positively affect adolescents' healthy lifestyles.
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14
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Liu J, Zeng M, Wang D, Zhang Y, Shang B, Ma X. Applying Social Cognitive Theory in Predicting Physical Activity Among Chinese Adolescents: A Cross-Sectional Study With Multigroup Structural Equation Model. Front Psychol 2022; 12:695241. [PMID: 35370866 PMCID: PMC8965556 DOI: 10.3389/fpsyg.2021.695241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 12/27/2021] [Indexed: 11/26/2022] Open
Abstract
This cross-sectional study aimed to assess the applicability of social cognitive determinants among the Chinese adolescents and examine whether the predictability of the social cognitive theory (SCT) model on physical activity (PA) differs across gender (boys and girls) and urbanization (urban and suburban). A total of 3,000 Chinese adolescents ranging between the ages of 12-15 years were randomly selected to complete a set of questionnaires. Structural equation modeling (SEM) was applied to investigate the relationships between social cognitive variables and PA in the urbanization and gender subgroups. The overall model explained 38.9% of the variance in PA. Fit indices indicated that the structural model of SCT was good: root mean square error of approximation (RMSEA) = 0.047, (root mean square residual) RMR = 0.028, goodness of fit index (GFI) = 0.974, adjusted goodness of fit index (AGFI) = 0.960, Tucker-Lewis coefficient (TLI) = 0.971, and comparative fit index (CFI) = 0.978. Regarding the subgroup analysis, social support (critical ratios [CRs] = 2.118; p < 0.001) had a more substantial impact on the PA of adolescents in suburban areas than that in urban areas, whereas self-regulation (CRs = -2.896, p < 0.001) had a more substantial impact on the PA of adolescents in urban areas than in suburban areas. The results indicate that the SCT model predicts the PA of Chinese adolescents substantially. An SCT model could apply over a range of subgroups to predict the PA behavior and should be considered comprehensively when designing interventions. These findings would benefit PA among the Chinese adolescents, especially across genders and urbanization.
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Affiliation(s)
- Jianxiu Liu
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Muchuan Zeng
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Dizhi Wang
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Yao Zhang
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
| | - Borui Shang
- Department of Kinesiology, Hebei Institute of Physical Education, Shijiazhuang, China
- Department of Social Sciences, Hebei Sport University, Shijiazhuang, China
| | - Xindong Ma
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China
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15
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Jago R, Tibbitts B, Willis K, Sanderson E, Kandiyali R, Reid T, MacNeill S, Kipping R, Campbell R, Sebire SJ, Hollingworth W. Peer-led physical activity intervention for girls aged 13 to 14 years: PLAN-A cluster RCT. PUBLIC HEALTH RESEARCH 2022. [DOI: 10.3310/zjqw2587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Increasing physical activity among girls is a public health priority. Peers play a central role in influencing adolescent behaviour. Peer-led interventions may increase physical activity in adolescent girls, and a feasibility trial had shown that PLAN-A (Peer-led physical Activity iNtervention for Adolescent girls) had evidence of promise to increase physical activity in adolescent girls.
Objective
The objective was to test whether or not PLAN-A can increase adolescent girls’ physical activity, relative to usual practice, and be cost-effective.
Design
This was a two-arm, cluster-randomised controlled trial, including an economic evaluation and a process evaluation.
Participants
State-funded secondary schools in the UK with girls in Year 9 (aged 13–14 years) participated in the trial. All Year 9 girls in participating schools were eligible.
Randomisation
Schools were the unit of allocation. They were randomised by an independent statistician, who was blinded to school identities, to the control or intervention arm, stratified by region and the England Index of Multiple Deprivation score.
Intervention
The intervention comprised peer nomination (i.e. identification of influential girls), train the trainers (i.e. training the instructors who delivered the intervention), peer supporter training (i.e. training the peer-nominated girls in techniques and strategies underpinned by motivational theory to support peer physical activity increases) and a 10-week diffusion period.
Outcomes
The primary outcome was accelerometer-assessed mean weekday minutes of moderate to vigorous physical activity among Year 9 girls. The follow-up measures were conducted 5–6 months after the 10-week intervention, when the girls were in Year 10 (which was also 12 months after the baseline measures). Analysis used a multivariable, mixed-effects, linear regression model on an intention-to-treat basis. Secondary outcomes included weekend moderate to vigorous physical activity, and weekday and weekend sedentary time. Intervention delivery costs were calculated for the economic evaluation.
Results
A total of 33 schools were approached; 20 schools and 1558 pupils consented. Pupils in the intervention arm had higher Index of Multiple Deprivation scores than pupils in the control arm. The numbers randomised were as follows: 10 schools (n = 758 pupils) were randomised to the intervention arm and 10 schools (n = 800 pupils) were randomised to the control arm. For analysis, a total of 1219 pupils provided valid weekday accelerometer data at both time points (intervention, n = 602; control, n = 617). The mean weekday moderate to vigorous physical activity was similar between groups at follow-up. The central estimate of time spent engaging in moderate to vigorous physical activity was 2.84 minutes lower in the intervention arm than in the control arm, after adjustment for baseline mean weekday moderate to vigorous physical activity, the number of valid days of data and the stratification variables; however, this difference was not statistically significant (95% confidence interval –5.94 to 0.25; p = 0.071). There were no between-arm differences in the secondary outcomes. The intervention costs ranged from £20.85 to £48.86 per pupil, with an average cost of £31.16.
Harms
None.
Limitations
The trial was limited to south-west England.
Conclusions
There was no evidence that PLAN-A increased physical activity in Year 9 girls compared with usual practice and, consequently, it was not cost-effective.
Future work
Future work should evaluate the utility of whole-school approaches to promote physical activity in schools.
Trial registration
This trial is registered as ISRCTN14539759.
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. 10, No. 6. See the NIHR Journals Library website for further project information. This trial was designed and delivered in collaboration with the Bristol Randomised Trials Collaboration (BRTC), a United Kingdom Clinical Research Commission (UKCRC)-registered Clinical Trials Unit that, as part of the Bristol Trials Centre, is in receipt of NIHR Clinical Trials Unit support funding. The sponsor of this trial was University of Bristol, Research and Enterprise Development www.bristol.ac.uk/red/. The costs of delivering the intervention were funded by Sport England.
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Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- National Institute for Health Research Applied Research Collaboration West at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Byron Tibbitts
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Kathryn Willis
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Emily Sanderson
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Bristol, UK
| | - Rebecca Kandiyali
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Tom Reid
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Stephanie MacNeill
- School of Social and Community Medicine, University of Bristol, Bristol, UK
- Bristol Randomised Trials Collaboration, Bristol Trials Centre, University of Bristol, Bristol, UK
| | - Ruth Kipping
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Rona Campbell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Simon J Sebire
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
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16
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Nagata JM, Ganson KT, Iyer P, Chu J, Baker FC, Gabriel KP, Garber AK, Murray SB, Bibbins-Domingo K. Sociodemographic Correlates of Contemporary Screen Time Use among 9- and 10-Year-Old Children. J Pediatr 2022; 240:213-220.e2. [PMID: 34481807 PMCID: PMC9107378 DOI: 10.1016/j.jpeds.2021.08.077] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/20/2021] [Accepted: 08/26/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To determine sociodemographic correlates of contemporary screen time use among a diverse population-based sample of 9- and 10-year-old children. STUDY DESIGN In 2021, we analyzed cross-sectional baseline (2016-2018) data from the Adolescent Brain Cognitive Development study (n = 10 755). Multiple linear regression analyses were conducted to estimate associations between sociodemographic factors (sex, race/ethnicity, country of birth, household income, parental education) and 6 contemporary forms of screen time (television, videos [eg, YouTube], video games, social networking, texting, and video chat). RESULTS On average, children reported 3.99 hours of screen time per day across 6 modalities, with the most time spent watching/streaming television shows/movies (1.31 hours), playing video games (1.06 hours), and watching/streaming videos (1.05 hours). On average, Black children reported 1.58 more hours of screen time per day and Asian children reported 0.35 less hours of screen time per day compared with White children (mean 3.46 hours per day), and these trends persisted across most modalities. Boys reported higher overall screen time (0.75 hours more) than girls, which was primarily attributed to video games and videos. Girls reported more time texting, social networking, and video chatting than boys. Higher income was associated with lower screen time usage across all modalities except video chat. However, in high-income households, Latinx children reported 0.65 more hours of screen time per day than White children. CONCLUSIONS Given the sociodemographic differences in child screen use, guideline implementation strategies can focus on key populations, encourage targeted counseling by pediatricians, and adapt Family Media Use Plans for diverse backgrounds.
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Affiliation(s)
- Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Puja Iyer
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Jonathan Chu
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, California, USA,Department of Physiology, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andrea K. Garber
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA
| | - Stuart B. Murray
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, California, USA
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
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17
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Jensen CT, Heinze C, Andersen PK, Bauman A, Klinker CD. Mental health and physical activity in vocational education and training schools students: a population-based survey. Eur J Public Health 2021; 32:233-238. [PMID: 34904167 PMCID: PMC8975539 DOI: 10.1093/eurpub/ckab202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background The prevalence of young people not adhering to the World Health Organization (WHO) physical activity guidelines is high, especially among students in vocational education and training, compared to fellow peers. Also, low levels of mental health have been found in this group, however, to a lesser degree than peers in general education. As positive mental health aspects have more generally been found to be associated with increased likelihood of physical activity in young people, this study examined the association between mental health and physical activity among Danish students in vocational education and training. Methods Students in vocational education and training (N = 5277, mean age 24.3 years, range 15.8–64.0 years) responded to a national representative survey assessing four aspects of mental health (well-being, self-efficacy, self-esteem and life satisfaction) and physical activity. Physical activity was dichotomized as adherence to the WHO minimum guidelines or not. Logistic regression was used to examine if each mental health aspect was associated with physical activity in crude and adjusted models. Results A positive dose–response association was found between all aspects of mental health and adherence to WHO physical activity guidelines. However, the association between self-esteem and physical activity was modified by gender, with a dose–response relationship found only among males. Conclusions Higher levels of positive mental health were associated with better odds of achieving WHO physical activity guidelines in a dose–response-manner. Prospective studies are needed to further elucidate the causal relationship between mental health and physical activity. Future interventions must pay attention to differential gender effects.
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Affiliation(s)
- Christine Tøfting Jensen
- Health Promotion Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Clara Heinze
- Health Promotion Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Per Kragh Andersen
- Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Adrian Bauman
- Prevention Research Collaboration, School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Charlotte Demant Klinker
- Health Promotion Research, Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Herlev, Denmark
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18
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Ng K, Koski P, Lyyra N, Palomaki S, Mononen K, Blomqvist M, Vasankari T, Kokko S. Finnish late adolescents' physical activity during COVID-19 spring 2020 lockdown. BMC Public Health 2021; 21:2197. [PMID: 34852807 PMCID: PMC8635322 DOI: 10.1186/s12889-021-12263-w] [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: 07/11/2021] [Accepted: 11/11/2021] [Indexed: 11/17/2022] Open
Abstract
Background Physical activity (PA) is recognised as one of the leading and effective strategies to prevent non-communicable diseases that boosts the immune system to fight against diseases. Closures of schools, sport clubs and facilities because of COVID-19 reduced the opportunities to participate in PA. We aimed to examine physical activity levels of late adolescents, the contexts to be physical active and its changes during the spring 2020 lockdown. Methods A national representative sample of late adolescents in general upper secondary school (n = 2408, females = 64%, mean age = 17.2y, SD = 0.63) completed self-report online surveys on PA behaviours between March and June 2020. Multinominal logistic regression analyses were performed to identify correlates with PA, and decision tree analyses to ascertain the perceived changes on PA during lockdown based on sport club aspirations and levels of PA. Results Among the late adolescents, the distribution of PA frequency was 23% (0-2 days/week), 35% (3-4 days/week), 30% (5–6 days/week) and 12% (7 days/week), and differences between males and females were not statistically significant. Participation in both indoor and outdoor PA were 50 times more likely to report daily PA (OR = 54.28, CI = 15.16–194.37) than non-participation. A quarter of late adolescents were not part of a sports club, yet their PA levels increased. Although sports club members generally perceived they did less PA during lockdown, over a third of sport club members with competitive aspirations reported daily PA. Conclusions Overall, most late adolescents reported their PA levels decreased during lockdown. Findings from this study continue to demonstrate factors associated with PA in the context of the COVID-19 lockdown. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12263-w.
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Affiliation(s)
- Kwok Ng
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland. .,Physical Activity for Health Research Cluster, Department of Physical Education and Sport Sciences, University of Limerick, Limerick, Ireland.
| | - Pasi Koski
- Department of Teacher Education, University of Turku, Rauma, Finland
| | - Nelli Lyyra
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Sanna Palomaki
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Kaisu Mononen
- KIHU Research Institute of Olympic Sports, Jyvaskyla, Finland
| | - Minna Blomqvist
- KIHU Research Institute of Olympic Sports, Jyvaskyla, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
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19
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Pelletier CA, White N, Duchesne A, Sluggett L. Barriers to physical activity for adults in rural and urban Canada: A cross-sectional comparison. SSM Popul Health 2021; 16:100964. [PMID: 34841038 PMCID: PMC8606540 DOI: 10.1016/j.ssmph.2021.100964] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/21/2021] [Accepted: 11/09/2021] [Indexed: 12/04/2022] Open
Abstract
Background Individual differences in physical activity behavior are associated with a collection of individual and environmental factors manifesting as barriers to participation. Understanding how barriers to physical activity differ based on sociodemographic characteristics can support identification and elimination of health inequities. Objectives To compare the odds of reporting individual and environmental barriers to physical activity in rural and urban adults, and explore interactions between rural-urban location and sociodemographic factors to characterize patterns in barriers to physical activity. Design Cross-sectional. Methods We analyzed the 2017 Canadian Community Health Survey Barriers to Physical Activity Rapid Response, with a final weighted sample of 24,499,462 (unweighted n=21,967). The likelihood of reporting each barrier domain based on rural-urban location was examined using binary logistic regression following a model-fitting approach with sociodemographic characteristics as covariates or interaction terms. Results Adjusting for sociodemographic factors, rural residents showed 85% higher odds of reporting at least one social or built environmental barrier (OR=1.85 [1.66, 2.07]). Compared to urban residents, rural residents showed significantly higher odds of reporting barriers to facility access (OR=4.15 [3.58, 4.83]) and a lack of social support to be active (OR=1.17 [1.04, 1.32]). Urban residents reported lower preference for physical activity, lower enjoyment of physical activity and lower confidence in their ability to regularly engage in physical activity. Interactions between socioeconomic status and location were identified related to enjoyment and confidence to be active. There was no effect of location on predicting the odds of reporting an individual resource-related variable (e.g., time, energy). Conclusions Despite being more likely than urban residents to prefer and enjoy physical activity, rural residents have fewer opportunities and receive less social support to be active. It is important to consider geographic location when characterizing barriers to physical activity and in the development of context-specific health promotion strategies. Rural residents have a higher odds of reporting social or built environmental barriers to physical activity. The most common environmental barrier for rural residents was lack of access to free or low-cost facilities. Urban residents reported a lower preference and enjoyment of physical activity. There was no rural-urban location-based difference in barriers related to time or costs to be active. It is important to consider geographic location and sex when characterising barriers to physical activity.
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Affiliation(s)
- Chelsea A Pelletier
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, V2N 4Z9, Canada
| | - Nicole White
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, V2N 4Z9, Canada.,Department of Psychology, University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, V2N 4Z9, Canada
| | - Annie Duchesne
- Department of Psychology, University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, V2N 4Z9, Canada
| | - Larine Sluggett
- University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, V2N 4Z9, Canada
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20
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Shahu A, Okunrintemi V, Tibuakuu M, Khan SU, Gulati M, Marvel F, Blumenthal RS, Michos ED. Income disparity and utilization of cardiovascular preventive care services among U.S. adults. Am J Prev Cardiol 2021; 8:100286. [PMID: 34816144 PMCID: PMC8593567 DOI: 10.1016/j.ajpc.2021.100286] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/25/2021] [Accepted: 10/29/2021] [Indexed: 12/01/2022] Open
Abstract
Low income individuals are less likely to receive smoking cessation counseling. Low income individuals are less likely to have their blood pressure checked. Low income individuals are less likely to be receive exercise counseling. Low income individuals are less likely to receive dietary counseling. Low income individuals are less likely to have their cholesterol levels checked.
Objective : Associations between income disparity and utilization of cardiovascular disease (CVD) preventive care services, such as receipt of lifestyle advice and screening for CVD risk factors in populations with and without CVD, are not well understood. The purpose of this study was to evaluate associations between income and utilization of CVD-preventive services among U.S. adults. Methods : We included adults ≥18 years with and without CVD from the 2006 to 2015 Medical Expenditure Panel Survey. We categorized participants as high-income (>400% of federal poverty level [FPL]), middle income (200–400% of FPL), low-income (125–200% of FPL) and very low (VL)-income (<125% of FPL). We used logistic regression to compare the likelihood of receiving CVD-preventive services by income strata, adjusting for sociodemographic factors and comorbidities. Results : The study included 185,081 participants (representing 194.6 million U.S. adults) without CVD, and 32,862 participants (representing 37 million U.S. adults) with CVD. VL-income adults without CVD were less likely than high-income adults to have blood pressure measured within past 2 years [odds ratio [OR] 0.41 (95% confidence interval [CI] 0.37–0.45)] or cholesterol levels checked within past 5 years [0.36 (0.33–0.38)] or receive counseling about diet modifications [0.77 (0.74–0.81)], exercise [0.81 (0.77–0.85)], or smoking cessation [0.71 (0.63–0.79)] within past year. VL-income adults with CVD were also less likely to have blood pressure [0.32 (0.22–0.46)] or cholesterol [0.33 (0.26–0.42)] checked and receive counseling about exercise [0.84 (0.76–0.93)] or smoking cessation [0.78 (0.61–0.99)]. Additional subgroup analyses restricted to participants who had seen a healthcare provider within the preceding 12 months, as well as secondary analyses stratified by sex, race and ethnicity, showed similar disparities between high-income and VL-income participants. Conclusions : VL-income adults were less likely to be screened for CVD risk factors or receive CVD-prevention counseling than high-income adults, regardless of CVD status. More work must be done to reduce disparities in access to and utilization of CVD-preventive services among adults in different income groups.
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Affiliation(s)
- Andi Shahu
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT.,Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD
| | - Victor Okunrintemi
- Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX
| | - Martin Tibuakuu
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD
| | - Safi U Khan
- Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX
| | - Martha Gulati
- Division of Cardiology, University of Arizona College of Medicine, Phoenix, AZ
| | - Francoise Marvel
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD
| | - Roger S Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD
| | - Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, MD
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21
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Do Crowding-Out Effects Explain the Low Effect of a Health Promotion Intervention among Young People at a Vocational School? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111127. [PMID: 34769645 PMCID: PMC8583595 DOI: 10.3390/ijerph182111127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/15/2021] [Indexed: 11/17/2022]
Abstract
In recent years, school-based interventions have increasingly been used as a strategy to promote good eating habits and physical activity among young people at school. However, little is known about the effect that this kind of public involvement has on the overall behavior of young people. Economists refer to the existence of a crowding-out effect when public sector engagement in influencing behavior is counteracted by behaviors at the individual level. The aim of this study was to investigate the effects of a health promotion intervention program among young people at a vocational school on the overall behavior of the students and consider whether a crowding-out effect existed when it came to health behavior. This study used data from the Gearing up the Body (GUB) intervention that was carried out at the vocational school of Uddannelsescenter Holstebro, Denmark. The study included 130 students from two vocational programs. Answers were collected from survey questions in three waves. Our results showed that intervening in the school setting had the intended impact on physical activity but an unintended impact on eating behavior. In the GUB study, we found signs of countervailing behaviors in and out of school that need to be further explored.
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22
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Cragun D, Beckstead J, Farmer M, Hooker G, Dean M, Matloff E, Reid S, Tezak A, Weidner A, Whisenant JG, Pal T. IMProving care After inherited Cancer Testing (IMPACT) study: protocol of a randomized trial evaluating the efficacy of two interventions designed to improve cancer risk management and family communication of genetic test results. BMC Cancer 2021; 21:1099. [PMID: 34645413 PMCID: PMC8513202 DOI: 10.1186/s12885-021-08822-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/01/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Implementing genetic testing for inherited cancer predisposition into routine clinical care offers a tremendous opportunity for cancer prevention and early detection. However, genetic testing itself does not improve outcomes; rather, outcomes depend on implemented follow-up care. The IMPACT study is a hybrid type I randomized effectiveness-implementation trial to simultaneously evaluate the effectiveness of two interventions for individuals with inherited cancer predisposition focused on: 1) increasing family communication (FC) of genetic test results; and 2) improving engagement with guideline-based cancer risk management (CRM). METHODS This prospective study will recruit a racially, geographically, and socioeconomically diverse population of individuals with a documented pathogenic/likely pathogenic (P/LP) variant in an inherited cancer gene. Eligible participants will be asked to complete an initial trial survey and randomly assigned to one of three arms: A) GeneSHARE, a website designed to increase FC of genetic test results; B) My Gene Counsel's Living Lab Report, a digital tool designed to improve understanding of genetic test results and next steps, including CRM guidelines; or C) a control arm in which participants continue receiving standard care. Follow-up surveys will be conducted at 1, 3, and 12 months following randomization. These surveys include single-item measures, scales, and indices related to: 1) FC and CRM behaviors and behavioral factors following the COM-B theoretical framework (i.e., capability, opportunity, and motivation); 2) implementation outcomes (i.e., acceptability, appropriateness, exposure, and reach); and 3) other contextual factors (i.e., sociodemographic and clinical factors, and uncertainty, distress, and positive aspects of genetic test results). The primary outcomes are an increase in FC of genetic test results (Arm A) and improved engagement with guideline-based CRM without overtreatment or undertreatment (Arm B) by the 12-month follow-up survey. DISCUSSION Our interventions are designed to shift the paradigm by which individuals with P/LP variants in inherited cancer genes are provided with information to enhance FC of genetic test results and engagement with guideline-based CRM. The information gathered through evaluating the effectiveness and implementation of these real-world approaches is needed to modify and scale up adaptive, stepped interventions that have the potential to maximize FC and CRM. TRIAL REGISTRATION This study is registered at Clinicaltrials.gov (NCT04763915, date registered: February 21, 2021). PROTOCOL VERSION September 17th, 2021 Amendment Number 04.
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Affiliation(s)
- Deborah Cragun
- College of Public Health, University of South Florida, 13201 Bruce B Downs Boulevard, IDRB 304, Tampa, FL, 33612, USA
| | - Jason Beckstead
- College of Public Health, University of South Florida, 13201 Bruce B Downs Boulevard, IDRB 304, Tampa, FL, 33612, USA
| | - Meagan Farmer
- My Gene Counsel, PO Box 612, Branford, CT, 06405, USA
| | - Gillian Hooker
- Vanderbilt University Medical Center, 1500 21st Avenue South, Suite 2810, Nashville, TN, 37212, USA
| | - Marleah Dean
- Department of Communication, University of South Florida, 4202 East Fowler Avenue, CIS 3043, Tampa, FL, 33620, USA
- Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, FL, 33612, USA
| | - Ellen Matloff
- My Gene Counsel, PO Box 612, Branford, CT, 06405, USA
| | - Sonya Reid
- Vanderbilt University Medical Center, 1500 21st Avenue South, Suite 2810, Nashville, TN, 37212, USA
| | - Ann Tezak
- Vanderbilt University Medical Center, 1500 21st Avenue South, Suite 2810, Nashville, TN, 37212, USA
| | - Anne Weidner
- Vanderbilt University Medical Center, 1500 21st Avenue South, Suite 2810, Nashville, TN, 37212, USA
| | - Jennifer G Whisenant
- Vanderbilt University Medical Center, 1500 21st Avenue South, Suite 2810, Nashville, TN, 37212, USA
| | - Tuya Pal
- Vanderbilt University Medical Center, 1500 21st Avenue South, Suite 2810, Nashville, TN, 37212, USA.
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Bledniak E, Aleksonis HA, King TZ. The role of tax-filing status in uncovering socioeconomic and physical activity differences in college-aged students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021:1-10. [PMID: 34242550 DOI: 10.1080/07448481.2021.1942889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 05/10/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
This study examined relationships among multifaceted measures of socioeconomic status (SES) and physical activity (PA) in undergraduates. Participants were classified into dependent and independent tax filers to encapsulate the atypical divide in financial responsibility. Participants: 366 diverse American undergraduates. Methods: Participants completed an online survey including three SES metrics and the International Physical Activity Questionnaire. Results: Participants engaged in the same amount of total PA, albeit different proportions depending on SES measure and PA type. Independent tax filers engaged in more occupational PA than dependent tax filers, regardless of SES. Students with low SES engaged in less leisure-time PA than students with high SES. Conclusion: Household Material Hardship and SES proxy measures should be considered in the context of tax filing status among undergraduates. Greater precision with multifactorial SES measures will assist in providing the nuanced context when optimizing interventions and reducing barriers to increase PA in young adults.
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Affiliation(s)
- Ewelina Bledniak
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Holly A Aleksonis
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Tricia Z King
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
- Neuroscience Institute, Georgia State University, Atlanta, Georgia, USA
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24
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Gupta RD, Chakraborty PA, Hossain MB. Association of household wealth and education level with hypertension and diabetes among adults in Bangladesh: a propensity score-based analysis. Trop Med Int Health 2021; 26:1047-1056. [PMID: 33991034 DOI: 10.1111/tmi.13625] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the association of household wealth and education level with hypertension and diabetes in Bangladesh using propensity score (PS) analyses. METHODS A nationally representative sample of the Bangladesh Demographic and Health Survey 2017-18 was analysed to explore the research question. A weighted sample of 11 320 individuals was considered. Hypertension and diabetes were the outcomes of interest, and household wealth status (non-poor and poor) and education level (secondary/higher education and no secondary/higher education) were the exposure variables of interest. A person was defined as hypertensive if their average blood pressure was ≥140/90 mmHg or self-reported history of taking antihypertensive medications. Individuals were classified as diabetic if they had a Fasting Blood Glucose level of ≥7 mmol/l or reported taking prescribed medication for reducing high blood glucose or diabetes. We used the 1:1 nearest neighbour PS matching without replacement and PS weighting approaches to assess the association between the exposures and the outcome variables. RESULTS Wealth status was significantly associated with diabetes but not with hypertension, while education status was significantly associated with neither diabetes nor hypertension. We also observed a significant interaction effect between household wealth status and education level with diabetes. The odds of diabetes were approximately 60% higher among adults from non-poor households and those without secondary/higher education. CONCLUSION Diabetes prevention and control programs should focus on non-poor individuals, while hypertension prevention programs should target populations irrespective of educational attainment and wealth status.
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Affiliation(s)
- Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | | | - Md Belal Hossain
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,Biomedical Research Foundation, Dhaka, Bangladesh
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Heino MTJ, Knittle K, Noone C, Hasselman F, Hankonen N. Studying Behaviour Change Mechanisms under Complexity. Behav Sci (Basel) 2021; 11:77. [PMID: 34068961 PMCID: PMC8156531 DOI: 10.3390/bs11050077] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/22/2021] [Accepted: 04/28/2021] [Indexed: 01/13/2023] Open
Abstract
Understanding the mechanisms underlying the effects of behaviour change interventions is vital for accumulating valid scientific evidence, and useful to informing practice and policy-making across multiple domains. Traditional approaches to such evaluations have applied study designs and statistical models, which implicitly assume that change is linear, constant and caused by independent influences on behaviour (such as behaviour change techniques). This article illustrates limitations of these standard tools, and considers the benefits of adopting a complex adaptive systems approach to behaviour change research. It (1) outlines the complexity of behaviours and behaviour change interventions; (2) introduces readers to some key features of complex systems and how these relate to human behaviour change; and (3) provides suggestions for how researchers can better account for implications of complexity in analysing change mechanisms. We focus on three common features of complex systems (i.e., interconnectedness, non-ergodicity and non-linearity), and introduce Recurrence Analysis, a method for non-linear time series analysis which is able to quantify complex dynamics. The supplemental website provides exemplifying code and data for practical analysis applications. The complex adaptive systems approach can complement traditional investigations by opening up novel avenues for understanding and theorising about the dynamics of behaviour change.
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Affiliation(s)
- Matti T. J. Heino
- Faculty of Social Sciences, University of Helsinki, P.O. Box 54, 00014 Helsinki, Finland; (M.T.J.H.); (K.K.)
| | - Keegan Knittle
- Faculty of Social Sciences, University of Helsinki, P.O. Box 54, 00014 Helsinki, Finland; (M.T.J.H.); (K.K.)
| | - Chris Noone
- School of Psychology, National University of Ireland, H91 TK33 Galway, Ireland;
| | - Fred Hasselman
- Behavioural Science Institute, Radboud University Nijmegen, Postbus 9104, 500 HE Nijmegen, The Netherlands;
| | - Nelli Hankonen
- Faculty of Social Sciences, University of Helsinki, P.O. Box 54, 00014 Helsinki, Finland; (M.T.J.H.); (K.K.)
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A cross-sectional analysis of associations between lifestyle advice and behavior changes in patients with hypertension or diabetes: NHANES 2015-2018. Prev Med 2021; 145:106426. [PMID: 33450214 DOI: 10.1016/j.ypmed.2021.106426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 11/22/2022]
Abstract
Clinicians supporting patients in lifestyle behavior change is an important strategy to help reduce chronic disease burden. Using National Health and Nutrition Examination Survey (NHANES) data from 2015 to 2018, this study assessed rates of and associations between patient-reported receipt of lifestyle behavior change advice and corresponding self-reported behavior change for four different lifestyle behaviors: 1) weight loss, 2) increase physical activity, 3) reduce sodium, and 4) reduce fat and calories. Adult survey respondents with hypertension and/or diabetes (n = 4716) who received lifestyle advice ranged from 43% to 58%, with the most common recommendation being to increase physical activity. Between 61% and 73% of respondents reported currently modifying health behaviors, with the greatest number reporting weight loss. Multiple logistic regression models were used to test associations for each lifestyle behavior advice-behavior change pair, adjusting for demographic characteristics. Compared to those who received no advice, respondents who received advice had significantly higher odds of reporting losing weight (aOR: 1.93; 95% CI: 1.51, 2.48); increasing physical activity (aOR 2.02; 95% CI: 1.73, 2.37); reducing dietary sodium (aOR 4.95; 95% CI: 3.93, 6.25); and reducing intake of fat/cal (aOR 3.57; 95% CI: 2.86, 4.45). This study utilized population level data to lend further evidence that provider advice about lifestyle behaviors for patients who have hypertension or diabetes may influence patient behavior. However, prevalence of advice is low, and differences in rates of behavior change exist across socioeconomic status and race/ethnicity, indicating a need to further research how providers might better support patients with varying social needs.
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Activity-Inactivity Patterns, Screen Time, and Physical Activity: The Association with Overweight, Central Obesity and Muscle Strength in Polish Teenagers. Report from the ABC of Healthy Eating Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217842. [PMID: 33114707 PMCID: PMC7662883 DOI: 10.3390/ijerph17217842] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 12/15/2022]
Abstract
Today, the time spent actively is increasingly being replaced by screen-based media, although in some teenagers, a high level of physical activity (PA) and longer time spent in front of a screen (screen time, ST) may coexist as a mixed behavioral pattern. This study aimed to examine the association of the pattern created as activity (low/high ST with high PA) and inactivity patterns (low/high ST with low PA) with overweight, central obesity, and muscle strength in Polish teenagers taking into consideration socioeconomic and demographic factors. Cross-sectional data were collected from elementary school children (n = 1567), aged 11–13 years. Height, weight, waist circumference, and handgrip strength were measured. Body mass index (BMI) was calculated as the overweight measure, and the waist-to-height ratio (WHtR) was calculated as the central obesity measure. Data on ST, PA, socioeconomic status, demographics, and nutrition knowledge were collected by a questionnaire. Activity–inactivity patterns were defined by an a priori approach. Multivariate logistic regression modelling was applied. The most active pattern (lowST-highPA) was found in 17% of the total sample. Teenagers with the most inactive pattern (highST-lowPA) had over four times higher chance of general overweight. No association between WHtR ≥0.5 and highST-highPA pattern was found. Higher muscle strength (>1 SD) was associated only with high physical activity. Urban residence or lower socioeconomic status increased adherence to the most inactive pattern. From a public health perspective, implementing interventions promoting active patterns in 11–13-year-old teenagers is important for obesity prevention and enhanced physical fitness, especially in girls, teenagers living in urban areas, and from families with lower socio-economic status.
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28
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Hankonen N, Absetz P, Araújo-Soares V. Changing activity behaviours in vocational school students: the stepwise development and optimised content of the 'let's move it' intervention. Health Psychol Behav Med 2020; 8:440-460. [PMID: 34040880 PMCID: PMC8114352 DOI: 10.1080/21642850.2020.1813036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/11/2020] [Indexed: 11/17/2022] Open
Abstract
Background: School-based interventions that increase physical activity (PA) in a sustainable way are lacking. Systematic and participatory, theory and evidence-based intervention development may enhance the effectiveness of complex behavioural interventions in the long term. However, detailed descriptions of the intervention development process are rarely openly published, hindering transparency and progress in the field. Aims: To illustrate a stepwise process to develop intervention targeting PA and sedentary behaviour (SB) among older adolescents, and to describe the final, optimised version of the intervention, detailing content of sessions by theoretical determinants and techniques. Methods: Two established intervention development frameworks (Intervention Mapping and Behaviour Change Wheel) were integrated, leading to a comprehensive evidence and theory-based process. It was informed by empirical studies, literature reviews, expert and stakeholder consultation, including scenario evaluation and component pre-testing. In all steps, contextual fit and potential for sustainability were ensured by stakeholder engagement. Results: As a large majority of youth opposed decreasing screen time, increasing PA and decreasing SB were defined as target behaviours, with peers and the school context including classroom practices as key social environments in influencing youth PA (problem specification, step 1). Behavioural diagnosis (step 2) identified a variety of determinants in the domains of capability (e.g. self-regulation skills), motivation (e.g. outcome expectations) and environmental opportunities. These were organised into an intervention theory integrating several formal theories, including Self-Determination Theory. Theory-aligned principles guided material design (Step 3). Feasibility RCT allowed optimisation into a final intervention protocol (step 4). Conclusions: Intervention elements target students directly, and indirectly by changing teacher behaviour and the school and wider environment. A systematic development and optimisation led to a high potential for sustainability. The detailed intervention content, with specification of the hypothesised mechanisms, allows for other researchers to replicate, adapt or refine parts or the whole intervention, considering specific target groups and (sub-)cultures.
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Affiliation(s)
- Nelli Hankonen
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Pilvikki Absetz
- Department of Public Health and Clinical Nutrition, University of Eastern Finland, Joensuu, Finland
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29
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Cairncross C, Obolonkin V, Coppinger T, Rush E. Cardiorespiratory effects of project energize: a whole-of region primary school nutrition and physical activity programme in New Zealand in 2011 and 2015. BMC Sports Sci Med Rehabil 2020; 12:58. [PMID: 32963789 PMCID: PMC7499903 DOI: 10.1186/s13102-020-00200-0] [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: 05/06/2020] [Accepted: 08/20/2020] [Indexed: 11/25/2022]
Abstract
Background Since 2004, Sport Waikato has delivered Project Energize, a through-school nutrition and physical activity program to primary schools in the Waikato. As part of the program’s continued assessment and quality control, the programme was evaluated in 2011 and 2015. This paper’s aim was to compare the cardiorespiratory fitness (time to run 550 m (T550)) levels of children participating in Project Energize in 2011 and 2015. Methods In the 2011 evaluation of Project Energize, gender specific- T550-for-age Z scores (T550AZ) were derived from the T550 of 4832 Waikato children (2527 girls; 2305 boys; 36% Māori) aged between 6 and 12 years. In 2015, T550 was measured for 4798 (2361 girls; 2437 boys; 32% Māori) children, representative of age, gender and school socioeconomic status (SES). The T550AZ for every child in the 2015 study and 2011 evaluation were derived and differences in T550 between 2015 and 2011 by gender, SES and age were determined using independent t-tests. Multiple regression analysis predicted T550 Z score and run time, using year of measurement, gender, ethnicity, age and school SES. Results With and without adjustment, children in 2015 ran 550 m faster than in 2011 (adjusted Z score 0.06, time 11 s). Specifically, girls ran at a similar speed in 2015 as 2011 but boys were faster than in 2011 (Z score comparison P < 0.001, mean difference 0.18 95%CI 0.12, 0.25). Regression analysis showed time taken to run 550 m was 11 s less in 2015 compared with 2011. Boys ran it 13 s faster than girls (Z score 0.07) and for each 1 year age increase, children were 8 s slower (Z score 0.006). For each 10% decrease in SES, children were 3 s slower (Z score 0.004) and Māori children were 5 s slower than Non-Māori children (Z score 0.15). Conclusions The findings from this study support the continuation of the delivery of Project Energize in the Waikato region of New Zealand, as cardiorespiratory fitness scores in 2015, compared to 2011, were improved, particularly for lower SES schools and for Māori children. Ethnically diverse populations, schools with higher deprivation and girls, continue to warrant further attention to help achieve equity.
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Affiliation(s)
- Carolyn Cairncross
- School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Victor Obolonkin
- School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
| | - Tara Coppinger
- Department of Sport, Leisure & Childhood Studies, Cork Institute of Technology, Cork, Ireland
| | - Elaine Rush
- School of Sport and Recreation, Auckland University of Technology, Auckland, New Zealand
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30
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Szczuka Z, Banik A, Abraham C, Kulis E, Luszczynska A. Associations between self-efficacy and sedentary behaviour: a meta-analysis. Psychol Health 2020; 36:271-289. [PMID: 32597242 DOI: 10.1080/08870446.2020.1784419] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Objective: The study sought to synthesize research on the relationship between time spent engaged in sedentary behaviours (SB) and self-efficacy. Analyses investigated whether such associations are moderated by age, conceptualization of self-efficacy, conceptualization of SB, and/or SB measurement.Design and Main Outcome Measures: The review was registered with PROSPERO (no. CRD42018086899). Studies including associations between self-efficacy and SB were identified through a systematic search of six databases. Inclusion criteria were met by k = 26 original studies.Results: A random effect meta-analysis showed that higher levels of self-efficacy were associated with lower levels of SB (r = -.158, 95% CI [-.220, -.094]). Moderator analyses indicated that associations between self-efficacy and SB may be similar in strength across age groups, the conceptualizations of self-efficacy or SB and SB measurements.Conclusion: The findings provide preliminary guidance for future interventions targeting reduction of SB, although more longitudinal research is needed to draw causal inferences.
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Affiliation(s)
- Zofia Szczuka
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Anna Banik
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Charles Abraham
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Ewa Kulis
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Aleksandra Luszczynska
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.,Trauma, Health, & Hazards Center, University of Colorado at Colorado Springs, Colorado Springs, CO, USA
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31
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Keyworth C, Epton T, Goldthorpe J, Calam R, Armitage CJ. Acceptability, reliability, and validity of a brief measure of capabilities, opportunities, and motivations ("COM-B"). Br J Health Psychol 2020; 25:474-501. [PMID: 32314500 DOI: 10.1111/bjhp.12417] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/23/2020] [Indexed: 11/30/2022]
Abstract
Objectives The Capabilities, Opportunities, Motivations, Behaviour (COM-B) model is being used extensively to inform intervention design, but there is no standard measure with which to test the predictive validity of COM or to assess the impact of interventions on COM. We describe the development, reliability, validity, and acceptability of a generic 6-item self-evaluation COM questionnaire. Design and methods The questionnaire was formulated by behaviour change experts. Acceptability was tested in two independent samples of health care professionals (N = 13 and N = 85, respectively) and a sample of people with low socio-economic status (N = 214). Acceptability (missing data analyses and user feedback), reliability (test-retest reliability and Bland-Altman plots) and validity (floor and ceiling effects, Pearson's correlation coefficient [r], exploratory factor analysis [EFA], and confirmatory factor analysis [CFA] were tested using a national survey of 1,387 health care professionals. Results The questionnaire demonstrated acceptability (missing data for individual items: 5.9-7.7% at baseline and 18.1-32.5% at follow-up), reliability (ICCs .554-.833), and validity (floor effects 0.6-5.5% and ceiling effects 4.1-22.9%; pairwise correlations rs significantly <1.0). The regression models accounted for between 21 and 47% of the variance in behaviour. CFA (three-factor model) demonstrated a good model fit, (χ2 [6] = 7.34, p = .29, RMSEA = .02, CFI = .99, TLI = .99, BIC = 13,510.420, AIC = 13,428.067). Conclusions The novel six-item questionnaire shows evidence of acceptability, validity, and reliability for self-evaluating capabilities, opportunities, and motivations. Future research should aim to use this tool in different populations to obtain further support for its reliability and validity. Statement of contribution What is already known on the subject? The Capability, Opportunity, Motivation (COM), Behaviour (-B) model is being used extensively to inform intervention design. The lack of an accepted universal measure hinders progress in behaviour change. What does this study add? There is evidence of acceptability, validity, and reliability for self-evaluating COM. Our measure may be sufficiently generic for any behaviour or population, although this requires further testing.
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Affiliation(s)
- Chris Keyworth
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Centre for Health Psychology, School of Health Sciences, The University of Manchester, UK
| | - Tracy Epton
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Centre for Health Psychology, School of Health Sciences, The University of Manchester, UK
| | - Joanna Goldthorpe
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Centre for Health Psychology, School of Health Sciences, The University of Manchester, UK
| | - Rachel Calam
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Centre for Health Psychology, School of Health Sciences, The University of Manchester, UK
| | - Christopher J Armitage
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, Manchester Centre for Health Psychology, School of Health Sciences, The University of Manchester, UK.,Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, UK
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Wang Z, Qin Z, He J, Ma Y, Ye Q, Xiong Y, Xu F. The association between residential density and physical activity among urban adults in regional China. BMC Public Health 2019; 19:1279. [PMID: 31590643 PMCID: PMC6781297 DOI: 10.1186/s12889-019-7593-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 09/04/2019] [Indexed: 02/04/2023] Open
Abstract
Background Studies from Western countries reported a positive relationship between residential density (RD) and physical activity (PA) among adults. There was no such study from China, a rapidly-urbanizing country in the world. This study aimed to investigate the RD-PA association among urban adults in China. Methods A multistage sampling approach was used to randomly select participants (aged 35–74 years old) in urban areas of Nanjing in 2017. The outcome variable was PA (dichotomized into “sufficient” or “insufficient”), while the independent variable was RD (tertiled into three sub-groups). Odds ratios (OR) and 95% confidence interval (CI) were computed to examine the RD-PA association using mixed-effects logistic regression models with adjustment for age, sex, nationality, marriage, educational attainment, employment status, body weight status, green space and neighborhood-level clustering effects. Results Of the 1568 eligible participants, 1551 were interviewed (response rate = 98.9%), with the mean age (standard deviation) of 54.7 (11.1) years old, and 46% of men. After adjustment for potential confounders and community-level clustering effects, participants lived in communities with higher (OR = 0.31, 95% CI = 0.21, 0.47) and middle (OR = 0.70, 95% CI = 0.50, 0.99) residential density were significantly less likely to achieve sufficient physical activity relative to their counterparts lived in the lower densed communities. Similar negative RD-PA association was examined for men or women, separately. The difference in the ORs between the middle and higher RD tertiles was also statistically significant (P < 0.01). Conclusions A negatively gradient RD-PA association, independent of body weight status and green space, was observed among urban adults in regional China. It has public health implications for China to help residents’ promote and maintain physical activity through planning and constructing PA−/health-friendly built environment in future.
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Affiliation(s)
- Zhiyong Wang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Zhenzhen Qin
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Jing He
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Yuyang Ma
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qing Ye
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Yaqing Xiong
- Geriatric Hospital of Nanjing Medical University, 30 Rd. Luojia, Nanjing, 210024, People's Republic of China.
| | - Fei Xu
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China.,School of Public Health, Nanjing Medical University, Nanjing, China.,Faculty of Geo-Information Science and Earth Observation, University of Twente, Enschede, The Netherlands.,International Initiative on Spatial Lifecourse Epidemiology, Enschede, The Netherlands
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Virtanen JI, Muikku T, Similä T, Cinar AB, Pohjola V. Physical activity, BMI and oral health behaviour among adolescents: Finnish School Health Promotion Study. Eur J Public Health 2019; 29:296-302. [PMID: 30252075 DOI: 10.1093/eurpub/cky193] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To assess associations between oral health behaviour and physical activity and related factors among adolescents. METHODS The study population (n = 76 529) consisted of a representative sample of 16- to 18-year-old Finnish adolescents (boys: 37 211, girls: 39 318). An anonymous, confidential and voluntary classroom-administered questionnaire included questions about tooth brushing frequency, physical activity, BMI and eating habits. Moderate-to-vigorous physical activity (MVPA) was used to assess the adolescents' physical activity. The chi-square test and multiple binary logistic regression were used for statistical analyses. Adjusted odds ratios (OR) and their 95% confidence intervals (CI) were calculated for MVPA, BMI, breakfast, smoking and socioeconomic factors as parents' education and school type. RESULTS The prevalence of twice daily tooth brushing was highest among adolescents reporting 4 hours or more of MVPA (51-77%). Obese and smoking adolescents exercised less often than normal weighted and non-smokers. Girls brushed their teeth twice daily significantly more often than boys (P < 0.001), and high-school students brushed their teeth significantly more often than vocational school students (P < 0.001). Logistic regression models showed that obesity (OR = 2.14, 95% CI 1.92-2.37) and irregular breakfast eating (OR = 2.35, 95% CI 2.19-2.52) among boys, and obesity (OR = 2.81, 95% CI 2.48-3.17), physical inactivity (OR = 1.89, 95% CI 1.78-2.00) and irregular breakfast eating (OR = 1.91, 95% CI 1.79-2.04) among girls were strong predictors for poor tooth brushing. CONCLUSIONS Physically active adolescents had better oral health behaviour than less active adolescents. Obesity and smoking were associated with infrequent tooth brushing.
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Affiliation(s)
- Jorma I Virtanen
- Department of Community Dentistry, Faculty of Medicine, University of Turku, Turku, Finland.,Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Tuija Muikku
- Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Toni Similä
- Medical Research Center, Oulu University Hospital, Oulu, Finland.,Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Ayse B Cinar
- Dental Health Services Research Unit, Dundee Dental School and Hospital, University of Dundee, Dundee, UK
| | - Vesa Pohjola
- Medical Research Center, Oulu University Hospital, Oulu, Finland.,Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
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Heino MTJ, Knittle K, Fried E, Sund R, Haukkala A, Borodulin K, Uutela A, Araujo-Soares V, Vasankari T, Hankonen N. Visualisation and network analysis of physical activity and its determinants: Demonstrating opportunities in analysing baseline associations in the Let's Move It trial. Health Psychol Behav Med 2019; 7:269-289. [PMID: 34040851 PMCID: PMC8114395 DOI: 10.1080/21642850.2019.1646136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/16/2019] [Indexed: 01/07/2023] Open
Abstract
Background: Visualisations and readily-accessible web-based supplementary files can improve data reporting and transparency. In this paper, we make use of recent developments in software and psychological network analysis to describe the baseline cohort of a trial testing the Let's Move It intervention, which aimed to increase physical activity (PA) and reduce sedentary behaviours (SB) among vocational school students. Methods: At baseline, 1166 adolescents, distributed across 6 school clusters and four educational tracks, completed measures of PA and SB, theoretical predictors of these behaviours, and body composition. Within a comprehensive website supplement, which includes all code and analyses, data were tabulated and visualised, and network analyses explored relations between predictor variables and outcomes. Results: Average daily moderate-to-vigorous PA was 65 min (CI95: 57min-73 min), and SB 8h44 min (CI95: 8h04min-9h24 min), with 25.8 (CI95: 23.5-28.0) interruptions to sitting. Cluster randomisation appeared to result in balanced distributions for baseline characteristics between intervention and control groups, but differences emerged across the four educational tracks. Self-reported behaviour change technique (BCT) use was low for many but not all techniques. A network analysis revealed direct relationships between PA and behavioural experiments, planning and autonomous motivation, and several BCTs were connected to PA via autonomous motivation. Visualisation uncovered a case of Simpson's paradox. Conclusions: Data-visualisation and data exploration techniques (e.g. network analysis) can help reveal the dynamics involved in complex multi-causal systems - a challenging task with traditional data presentations. The benefits of presenting complex data visually should encourage researchers to publish extensive analyses and descriptions as website supplements, which would increase the speed and quality of scientific communication, as well as help to address the crisis of reduced confidence in research findings. We hope that this example will serve as a template for other investigators to improve upon in the future.
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Affiliation(s)
| | - Keegan Knittle
- Faculty of Social Sciences, University of HelsinkiHelsinki, Finland
| | - Eiko Fried
- Department of Clinical Psychology, Leiden University, Leiden, The Netherlands
| | - Reijo Sund
- Faculty of Health Sciences, University of Eastern FinlandKuopio, Finland
| | - Ari Haukkala
- Faculty of Social Sciences, University of HelsinkiHelsinki, Finland
| | - Katja Borodulin
- Faculty of Social Sciences, University of HelsinkiHelsinki, Finland
| | - Antti Uutela
- Faculty of Social Sciences, University of HelsinkiHelsinki, Finland
| | - Vera Araujo-Soares
- Institute of Health and Society, Medical Faculty, Newcastle University, Newcastle upon Tyne, UK
| | | | - Nelli Hankonen
- Faculty of Social Sciences, University of HelsinkiHelsinki, Finland
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35
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Vasquez G, Salinas J, Molokwu J, Shokar G, Flores-Luevano S, Alomari A, Shokar NK. Physical Activity in Older Mexican Americans Living in Two Cities on the U.S.-Mexico Border. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091820. [PMID: 30142906 PMCID: PMC6163189 DOI: 10.3390/ijerph15091820] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/17/2018] [Accepted: 08/21/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND There is limited information on physical activity in marginalized older populations like that on the U.S.-Mexico border. This study aims to understand physical activity engagement among older Hispanics residing in two U.S.-Mexico Border counties. METHODS The International Physical Activity Questionnaire (IPAQ) was used to measure physical activity in El Paso and Cameron County, Texas. Physical activity levels were reported for vigorous, moderate, and walking met/mins. Adjusted and unadjusted modeling was conducted to determine county differences and sociodemographic covariates. RESULTS There were 784 participants and 92.9% were less than 65 years of age. El Paso participants reported a significantly greater natural log met/mins of vigorous (β = 1.34, p = 0.000) and walking (β = 0.331, p = 0.006). Significant sociodemographic covariates in El Paso for vigorous met/mins were gender (females β = -1.20, p = 0.003), having a regular doctor (β = -0.779, p = 0.029), and acculturation (β = 0.513, p = 0.019). Significant associations in Cameron County were having a regular doctor (β = -1.03, p = 0.000) and fair/poor health status (β = -0.475, p = 0.001). CONCLUSION Level of physical activity may differ in older Hispanics by urban context on the U.S.-Mexico border. Future physical activity programs to promote physical activity should take context into consideration.
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Affiliation(s)
- Gerardo Vasquez
- Department of Family Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA.
| | - Jennifer Salinas
- Department of Family Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA.
| | - Jennifer Molokwu
- Department of Family Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA.
| | - Gurjeet Shokar
- Department of Family Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA.
| | | | - Adam Alomari
- Department of Family Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA.
| | - Navkiran K Shokar
- Department of Family Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, TX 79905, USA.
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36
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Araújo-Soares V, Hankonen N, Presseau J, Rodrigues A, Sniehotta FF. Developing Behavior Change Interventions for Self-Management in Chronic Illness: An Integrative Overview. EUROPEAN PSYCHOLOGIST 2018; 24:7-25. [PMID: 31496632 PMCID: PMC6727632 DOI: 10.1027/1016-9040/a000330] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 02/21/2018] [Accepted: 04/19/2018] [Indexed: 12/24/2022]
Abstract
More people than ever are living longer with chronic conditions such as obesity, type 2 diabetes, and heart disease. Behavior change for effective self-management can improve health outcomes and quality of life in people living with such chronic illnesses. The science of developing behavior change interventions with impact for patients aims to optimize the reach, effectiveness, adoption, implementation, and maintenance of interventions and rigorous evaluation of outcomes and processes of behavior change. The development of new services and technologies offers opportunities to enhance the scope of delivery of interventions to support behavior change and self-management at scale. Herein, we review key contemporary approaches to intervention development, provide a critical overview, and integrate these approaches into a pragmatic, user-friendly framework to rigorously guide decision-making in behavior change intervention development. Moreover, we highlight novel emerging methods for rapid and agile intervention development. On-going progress in the science of intervention development is needed to remain in step with such new developments and to continue to leverage behavioral science's capacity to contribute to optimizing interventions, modify behavior, and facilitate self-management in individuals living with chronic illness.
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Affiliation(s)
- Vera Araújo-Soares
- Institute of Health & Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,School of Psychology, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Nelli Hankonen
- Faculty of Social Sciences, University of Tampere, Finland
| | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Canada.,School of Psychology, University of Ottawa, Canada
| | - Angela Rodrigues
- Institute of Health & Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Fuse. The UK Clinical Research Collaboration Centre for Translational Research in Public Health
| | - Falko F Sniehotta
- Institute of Health & Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Fuse. The UK Clinical Research Collaboration Centre for Translational Research in Public Health
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37
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Knittle K, Nurmi J, Crutzen R, Hankonen N, Beattie M, Dombrowski SU. How can interventions increase motivation for physical activity? A systematic review and meta-analysis. Health Psychol Rev 2018; 12:211-230. [DOI: 10.1080/17437199.2018.1435299] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Keegan Knittle
- Department of Social Research – Social Psychology, University of Helsinki, Helsinki, Finland
| | - Johanna Nurmi
- Department of Social Research – Social Psychology, University of Helsinki, Helsinki, Finland
- Behavioural Science Group, Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Rik Crutzen
- Department of Health Promotion, Maastricht University/CAPHRI, Maastricht, Netherlands
| | - Nelli Hankonen
- Department of Social Research – Social Psychology, University of Helsinki, Helsinki, Finland
- Faculty of Social Sciences, University of Tampere/Linna, Tampere, Finland
| | - Marguerite Beattie
- Department of Social Research – Social Psychology, University of Helsinki, Helsinki, Finland
| | - Stephan U Dombrowski
- Faculty of Natural Sciences, Division of Psychology, University of Stirling, Stirling, UK
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