Psychological determinants of physical activity across the life course: A "DEterminants of DIet and Physical ACtivity" (DEDIPAC) umbrella systematic literature review

A Comprehensive Planning Framework for Designing Effective Physical Activity Interventions in Youth

BACKGROUND

Effective physical activity (PA) interventions are needed to counter the insufficient and declining levels of PA in youth. These require an updated, comprehensive planning framework that consolidates recent decades of progress in promoting PA in young children, children, and adolescents. Effective PA interventions require program planning and conceptual model development that target a coordinated and multilevel set of age-specific PA determinants. Accordingly, this paper presents a comprehensive planning framework that researchers can use to design intervention research to promote PA in youth.

METHODS

The first author conducted targeted searches through Google Scholar to compile PA models/frameworks/guides applicable to youth, a comprehensive set of PA determinants, and determinant-linked strategies to promote PA focusing on review articles. The information was summarized in tables, synthesized, and used to create a planning framework, all of which were reviewed by coauthors.

RESULTS

The APPLE Framework for Planning PA Opportunities for Youth (APPLE = Age, PA focus, Place and time, Leverage relevant influences and strategies, and ensure Enjoyable PA opportunities) incorporated all core elements from targeted reviews to create a comprehensive planning framework. The APPLE Planning Framework has a set of questions/prompts that guide the intervention planning process and conceptual model templates to organize planning efforts for designing intervention research.

CONCLUSIONS

The APPLE Framework for Planning PA Opportunities for Youth will enable researchers to develop comprehensive conceptual models to guide the design of PA interventions for youth. Future research should refine the model and its components to enable PA intervention research in youth to move forward.

Determinants of Engagement in Leisure-Time Physical Activity and Club Sports among University Students: A Large-Scale Study

Various socio-demographic, environmental, and lifestyle-related factors have been reported to be associated with physical activity (PA) habits. However, there exist insufficient data comparing different forms of engagement in PA, sports, and exercise. This study aimed to investigate potential factors associated with the engagement in leisure-time PA (LPA) and club sports (CSs) in a large sample of college/university students. This Austria-wide study followed a cross-sectional design with a final sample of 4508 participants (mean age: 24.9 years; 65.9% female) from 52 Austrian colleges/universities. A standardized survey was used to collect data on demographics, anthropometric characteristics, and a wide range of health-related lifestyle factors, including patterns of PA and underlying motivations for PA engagement as well as details of dietary habits, sleep routines, smoking, and alcohol consumption. Descriptive statistics, chi-squared, logistic regression, and MANCOVA were used for data analysis. Across the entire sample, 85.7% of participants reported regular participation in LPA, including 22.5% who were active members of sports clubs. Of the 36 potential motives listed in the questionnaire, "maintaining physical health", "feeling good", and "refreshing the mind" were the most commonly reported factors motivating students to engage in either LPA or CSs. Ten socio-demographic, dietary, or lifestyle factors were identified as predictors of CSs participation (p < 0.01), whereas only two variables (specifically sleep-related factors) were identified as predictors of LPA participation (p < 0.001). These findings emphasize the importance of considering the type of PA and sport participation and the associated determinants when designing tailored strategies to promote an active lifestyle.

DE-PASS best evidence statement (BESt): determinants of adolescents' device-based physical activity and sedentary behaviour in settings: a systematic review and meta-analysis

BACKGROUND

Although physical activity (PA) is associated with significant health benefits, only a small percentage of adolescents meet recommended PA levels. This systematic review with meta-analysis explored the modifiable determinants of adolescents' device-based PA and/or sedentary behaviour (SB), evaluated in previous interventions and examined the associations between PA/SB and these determinants in settings.

METHODS

A search was conducted on five electronic databases, including papers published from January 2010 to July 2023. Randomized Controlled Trials (RCTs) or Controlled Trials (CTs) measuring adolescents' device-based PA/SB and their modifiable determinants at least at two time points: pre- and post-intervention were considered eligible. PA/SB and determinants were the main outcomes. Modifiable determinants were classified after data extraction adopting the social-ecological perspective. Robust Bayesian meta-analyses (RoBMA) were performed per each study setting. Outcomes identified in only one study were presented narratively. The risk of bias for each study and the certainty of the evidence for each meta-analysis were evaluated. The publication bias was also checked.

PROSPERO ID

CRD42021282874.

RESULTS

Fourteen RCTs (eight in school, three in school and family, and one in the family setting) and one CT (in the school setting) were included. Fifty-four modifiable determinants were identified and were combined into 33 broader determinants (21 individual-psychological, four individual-behavioural, seven interpersonal, and one institutional). RoBMAs revealed none or negligible pooled intervention effects on PA/SB or determinants in all settings. The certainty of the evidence of the impact of interventions on outcomes ranged from very low to low. Narratively, intervention effects in favour of the experimental group were detected in school setting for the determinants: knowledge of the environment for practicing PA, d = 1.84, 95%CI (1.48, 2.20), behaviour change techniques, d = 0.90, 95%CI (0.09, 1.70), choice provided, d = 0.70, 95%CI (0.36, 1.03), but no corresponding effects on PA or SB were found.

CONCLUSIONS

Weak to minimal evidence regarding the associations between the identified modifiable determinants and adolescents' device-based PA/SB in settings were found, probably due to intervention ineffectiveness. Well-designed and well-implemented multicomponent interventions should further explore the variety of modifiable determinants of adolescents' PA/SB, including policy and environmental variables.

Impact of a Nyakaza Move-for-Health Intervention Programme among Adolescents in a Resource-Constrained South African Community

Adolescents in resource-constrained environments face increasing sedentary lifestyles and obesity rates, necessitating effective interventions for promoting physical activity and combating non-communicable diseases. This study evaluates the impact of a 12 week Nyakaza Move-for-Health intervention on physical activity, anthropometry, cardiorespiratory fitness, and behaviour change among adolescents in KwaZulu-Natal, South Africa. One hundred twenty-eight adolescents participated, with assessments including self-reported physical activity, anthropometric indices, and cardiorespiratory fitness measures. The intervention significantly increased physical activity levels. The treatment group's mean score was 2.2 (0.4) at baseline and 2.6 (0.4) (F (14, 79) = 4.884, p = <0.001, η2 = 0.156) at the endline. The body mass index decreased (mean = 22.4 (4.6) at baseline and 21.9 (4.2) at endline; p = 0.025, partial eta squared = 0.025, η2 = 0.004). The intervention programme significantly affected the WHR (mean = 0.80 (0.10) at baseline and 0.76 (0.9) at endline; p < 0.001, partial eta squared = 0.327, η2 = 0.100) and the predicted maximal oxygen uptake (VO2 max) for the treatment group (mean = 42.4 (8.7) at baseline and mean = 43.6 (8.7) at endline; p < 0.711, partial eta squared = 0.017, η2 = 0.033). Focus group discussions indicated shifts in knowledge, attitudes, and motivation towards physical activity. Power analysis revealed strong observed power (PA: 0.983, BMI: 0.098, WHR: 0.887), indicating the robustness of the intervention's effects. These findings underscore the effectiveness of the intervention in improving physical health outcomes. It is recommended that longitudinal studies be conducted to assess the long-term sustainability and impact of such interventions on adolescents' health outcomes, thereby informing the development of comprehensive public health policies and programmes to promote physical activity and combat non-communicable diseases in similar settings.

The Development and Validation of the Health Belief Model for Shift Workers (HBM-SW) Scale

OBJECTIVE

Shift work is associated with circadian misalignment, sleep loss, and suboptimal health behaviors, which may contribute to longer term negative health outcomes. To inform future interventions for shift workers, the present study aimed to develop and evaluate the Health Belief Model for Shift Workers (HBM-SW) scale.

METHODS

The HBM-SW development involved a seven-step process, including a literature review, expert panel analysis, cognitive interviews with shift workers, and a trial with a pilot sample of shift workers (n = 153). Utilizing exploratory factor analysis for factor identification and item reduction, the developed scale loaded on seven factors in line with the theoretical framework of the Health Belief Model: Perceived Threat, Perceived Severity, Perceived Benefits, Perceived Barriers, Cues to Action, Self-efficacy, and Health Motivation. Validation of the scale was conducted utilizing Pittsburgh Sleep Quality Index, International Physical Activity Questionnaire, and Food Frequency Questionnaire.

RESULTS

The pilot sample had an average age of 34.0 (18.0) years, was majority female (54.2%), with an average of 8.0 (11.0) years shift work experience. The HBM-SW showed good - excellent (α = 0.74-0.93) internal consistency and moderate - good (ICC = 0.64-0.89) test re-test reliability. Using health behavior outcome measures, the HBM-SW scale showed meaningful correlations with sleep quality, sleep duration, diet quality and leisure time physical activity, and acceptable validity and reliability. Further testing should be conducted in a larger sample to facilitate confirmatory factor analysis.

CONCLUSIONS

The developed Health Belief Model for Shift Workers scale is likely beneficial for use in future studies of interventions for shift workers.

Change in general and domain-specific physical activity during the transition from primary to secondary education: a systematic review

BACKGROUND

Knowledge of changes in the domains of physical activity (PA) during the transition period from primary to secondary education and the factors associated with these changes, are prerequisites for the design of effective PA promotion strategies. Therefore, the first aim of this study was to systematically review changes in general, leisure-time, school, transport, work, and home PA across the transition from primary to secondary education. The second aim was to systematically review the individual, social, and physical environmental factors that were associated with these changes.

METHODS

Records published up until September 2023 were retrieved from five electronic databases. We included longitudinal and cross-sectional studies that investigated general or domain-specific PA from 2 years before to 2 years after the transition from primary to secondary education. Information on source, study characteristics, sample characteristics, PA, and factors were extracted from the papers included. We reported the direction of change in general and domain-specific PA and the direction of association of the factors with change in general and domain-specific PA.

RESULTS

Forty-eight papers were included in the study. The evidence on changes in PA and associated factors was greatest for general PA. A limited number of the studies investigated the separate domains of leisure-time, school, and transport. Most studies on general and school PA reported a decline in PA, but there were no consistent results for the domains of leisure-time and transport. With respect to the associated factors, evidence was predominantly found for individual factors and to a lesser degree for physical environmental and social environmental factors. None of the factors were consistently associated with changes in general or domain-specific PA during the school transition.

CONCLUSIONS

For the design of targeted PA promotion strategies, further studies are warranted to explore changes in the specific domains of PA across the transition from primary to secondary education, especially in the domains of leisure-time, transport, home, and work PA. In addition, the interactions between factors at different socioecological levels to influence changes in PA need to be addressed more in the future.

TRIAL REGISTRATION

PROSPERO CRD42020190204.

Judo for older adults: the coaches' knowledge and needs of education

This study aimed to explore the views of judo coaches on their perceived knowledge (PK) and needs for education (NE) for training older practitioners. In total, 470 international (Europe = 48%, Americas = 22%, Africa = 23%, Asia = 5% and Oceania = 2%) judo coaches (IJF: level 1 = 55,3%, level 2 = 33%; judo black belt: 3,4 ± 1,7 dan; F = 15%; university education: 68% >BA) responded an online survey encompassing demographic information and 35 items relevant to training older adults (Aging process; Safety and First Aid; Organization & Environment; Physiology and Fitness; Psychology & Mental Health; Teaching & Training) to be rated on a 7-point Likert scale for PK and NE. Non parametric statistics (p > 0.05) was applied to ascertain differences and relationships between PK and NE, respectively. A bivariate go-zone plot was used to highlight items with the lowest PK and the highest NE mean values. The coaches reported high PK (4.5 ± 0.3 pt) and NE (4.7 ± 0.1 pt) values, with significant higher PK values emerging for high education levels and judo experience. In considering their unique needs and special role, the judo coaches presented valuable insights to develop a sustainable educational curriculum tailored to train older judo practitioners.

Children's active school transportation: an international scoping review of psychosocial factors

BACKGROUND

Over the last decades, the prevalence of AST has decreased significantly. Barriers to active school transport (AST) have been extensively examined in the literature, while psychosocial factors that facilitate AST have received less attention. To our best knowledge, there are currently no reviews on this subject. Therefore, the objective of this review was to scope the literature and identify published research about psychosocial factors related to AST.

METHODS

Systematic searches conducted in PubMed, Web of Science, TRID, Scopus, and ERIC resulted in a total of 1933 publications, and 77 of them were considered eligible for this review.

RESULTS

The results of the included articles were categorised into four psychosocial factors: confidence in ability, attitudes, social support, and social norms, which were all generally positively related to AST, with a few exceptions.

CONCLUSION

The findings of this review indicate that these psychosocial factors may be important to consider when developing interventions and highlight that both children and parents should be involved in the process. This knowledge can serve as a valuable guide for developing interventions to promote AST. However, the evidence base supporting these psychosocial factors requires further investigation to fully understand how and when to incorporate them to maximise AST efficacy.

Martial arts, combat sports, and mental health in adults: A systematic review

Martial arts (MA) and combat sports (CS) are physical activities that may be associated with health-related outcomes. The aim of this systematic review was to synthesize and evaluate the available evidence on the relationship between MA and CS training and mental health of adult practitioners (≥18 years). CochraneLibrary, EBSCOhost, Web-of-Science, and Scopus databases were searched up to September 2022 for measures of self-related constructs, ill-being and well-being, cognition and brain structure/function, in adult MA/CS practitioners. Seventy cross-sectional and two longitudinal studies were retained and submitted to risk of bias assessments through an adapted version of the Cochrane Collaboration's Tool. Associations between MA/CS practice and self-related constructs were inconclusive for both consistency and strength of evidence. Limited evidence of significant associations emerged for sub-domains of ill-being (i.e., externalizing and internalizing emotion regulation), and well-being. In regard to cognitive and brain structural/functional variables, evidence of positive association with MA/CS practice was consistent with respect to perceptual and inhibition abilities but limited with respect to attention and memory. Evidence on negative associations of boxing with changes of brain structure integrity due to concussions was also inconclusive. Functional imaging techniques could shed light onto brain activation mechanisms underlying complex cognitive performance. In relation to moderators, mixed results were found for activity exposure, expertise, level of competitive engagement (which often covary with the length of training) and sex and type of MA/CS. The MA/CS' multifaceted nature may produce different, sometimes conflicting outcomes on mental health. Studies on MA/CS represent a flourishing research area needing extensive improvement in theoretical and practical approaches.

Evaluation of the gamified application KIJANI to promote physical activity in children and adolescents: A multimethod study

Objective

Digital approaches have the potential to make activity promotion attractive and age-appropriate for children and adolescents. KIJANI is a mobile application aiming to increase physical activity (PA) in youth via gamification and augmented reality. This study investigates the user experience with KIJANI through a multimethod approach.

Approaches

KIJANI is based on the concept that virtual coins can be earned through PA, for example, in the form of collected step counts. With these coins, blocks can be bought, which can be used to create virtual buildings and landscapes and integrate these into the player's real-world environment via augmented reality. To evaluate the user experience, participants played KIJANI in groups of three for 25 min. Afterwards KIJANI was evaluated qualitatively with one-on-one semi-structured interviews as well as quantitatively with standardized questionnaires.

Results

Overall, 22 participants (12.6 ± 1.7 years, 6 girls) were included in the study. The overall game concept and realization were well received by the target group. Study participants did have various and creative ideas for the further development of KIJANI. The majority (n = 16) thought that using KIJANI would increase their PA level. User experience based on the UEQ scale was (mean ± SD): attractiveness (1.78 ± 1.82), perspicuity (2.15 ± 0.680), efficiency (0.67 ± 1.25), dependability, (1.21 ± 0.93), stimulation (1.24 ± 1.78), and novelty (1.27 ± 1.34).

Conclusion

With these insights, a further step has been taken in the participatory development of KIJANI. Apps like KIJANI appear to be suitable for PA promotion in children and adolescents.

What are the correlates of intention to be physically active in Brazilian adolescents? A network analysis

OBJECTIVE

The current study aimed to explore the association of individual characteristics, social and environmental factors - school and region - in the intention to be physically active in Brazilian adolescents.

METHODS

This is a cross sectional study based on the third edition of the National School Health Survey. The study included a total of 53,937 adolescents. To assess the intention to be physically active, only who engaged in less than 300 min of physical activity per week were included. Participants were asked: "If you had the opportunity to practice physical activity most days of the week, what would your attitude be?" Individual characteristics, physical activity domains, social factors, school, and regional environments were used as exposures. Network analysis was utilized to evaluate the associations.

RESULTS

We observed that boys had higher intentions to be physically active compared to their peers, as did adolescents who perceived themselves as fat. In addition, students from private schools show a higher intention to regularly engage in physical activities, and in general, private schools offer more extracurricular physical activities.

CONCLUSION

In conclusion, individual factors such as sex and body image perception, and environmental factors such as school administrative dependency and availability of extracurricular activities had a significant contribution to the intention to be physically active among Brazilian adolescents.

Impact of COVID-19 on the capacity to self-manage health and chronic conditions

Objective

To investigate well-being, lifestyle behaviors, self-management capacity and healthcare utilization among adults with chronic conditions at the outbreak of the COVID-19 pandemic.

Methods

Data was collected from two interviewer-administered telephone surveys conducted between March 27 - May 22, 2020. Participants were patients at Chicago-area clinics. Self-report and validated measures were used for study-related outcomes.

Results

A total of 553 participants (age range 23-88) completed data collection at both timepoints. One in five (20.7%) participants experienced stress due to the coronavirus most or all the time and rates of negative well-being were high (WHO-5 Index mean = 58.7%). Almost a quarter (22.3%) engaged in hazardous drinking and 79.7% reported insufficient physical activity. Nearly one in four participants (23.7%) avoided seeking medical care due to worry about COVID-19. In multivariable analyses, greater COVID-19 related stress was associated with less physical activity, lower self-efficacy, greater difficulty managing health and medications, and delays in seeking medical care due to the coronavirus.

Conclusions

Mental well-being, lifestyle behaviors, self-management capacity, and healthcare utilization were impacted in the months following the COVID outbreak.

Innovation

These findings suggest health systems should implement proactive measures for detecting and treating emotional and behavioral COVID-related concerns.

Determinants of physical activity in community-dwelling older adults: an umbrella review

INTRODUCTION

Physical activity (PA) is critical for disease prevention and maintaining functional ability with aging. Despite this, as many as 50% of older adults in populations worldwide are considered insufficiently active. There is a recognized need to mobilize policies targeted toward modifiable determinants of healthy aging like PA. This umbrella review aimed to summarize the evidence for determinants of PA in community-dwelling older adults.

METHODS

A research librarian searched six databases. Systematic and scoping reviews were included if they investigated community-dwelling people with a mean age of 60 + years and examined a relationship between a determinant and any type of PA. Two independent reviewers screened and extracted data from all reviews. JBI methodology and Critical Appraisal Checklist for Systematic Reviews and Research Syntheses were followed and information on the quality of the evidence was extracted.

RESULTS

From 17,277 records screened,11 reviews representing > 300 unique primary papers were ultimately included. Only 6% of studies included in all reviews had longitudinal designs. Included studies used a large variety of PA measures, with 76% using only self-report, 15% using only direct measures (e.g., accelerometry), 3% using both types, and 6% with no outcome measure reported. Only four reviews provided a definition of PA and there was substantial inconsistency in the way PA was categorised. Community level influences, which only included the physical environment, were the most commonly assessed (6/11) with more than 70% of the summarized relationships demonstrating null associations. Three out of four reviews reported a positive relationship between walkability and PA in general community-dwelling older adults. There was also evidence supporting relationships between presence of social support for PA, younger age, and men having higher PA from a single systematic review. None of the included reviews assessed the quality of evidence but over 60% performed a risk of bias assessment.

CONCLUSIONS

Walkability, age, gender, and social support for PA were the most supported PA determinants identified. Further research should focus on interpersonal and intrapersonal influences and incorporate direct measures of PA with clear operational definitions. There is a need for longitudinal study designs to further understand determinants of PA behaviour trajectories.

Does the Installation or the Improvement of Existing Outdoor Parks Increase Physical Activity Levels? A Systematic Review

Investment in outdoor parks is proposed as a promising large-scale strategy to promote physical activity (PA). This study aimed to systematically review the impact of park renovations or installing new ones in increasing PA. Searches were conducted using predefined terms in three databases (PubMed, Scopus, and Web of Science) in March 2022. Studies examining the effectiveness of park renovations or developing new ones in increasing PA and having control or comparison were eligible for inclusion. Study quality was assessed using the Quality Assessment Tool for Quantitative Studies. Data were extracted from the included records using a predefined extraction table. The database search yielded 959 records, and 26 were included. For park renovations (n = 17), 11 (65%) studies presented findings supporting a positive effect on PA. The other six (35%) studies found no PA benefits when compared to control or pre-renovations/improvement levels. Regarding new installations (n = 9), five (56%) studies presented improvements in PA, and four (44%) did not. A promising positive impact of park renovations and new installations on park use and PA was observed. The review findings reflect the need to understand the context, daily routines, and interests of the surrounding population before renovating or installing new outdoor parks.

Longitudinal Changes in Moderate to Vigorous Physical Activity in Community-Dwelling Older Men and Women: A 2-Year Prospective Cohort Study in Japan

BACKGROUND

To examine longitudinal changes in accelerometer-measured moderate to vigorous physical activity (MVPA) and associated factors of changes in MVPA among community-dwelling older Japanese men and women over 2 years of follow-up.

METHODS

In total, 601 participants (72.2 [5.4] y, 40.6% men) were included. MVPA was assessed at baseline (2011) and follow-up (2013) using triaxial accelerometers. Sex-stratified multiple linear regression models were used to identify associated factors of changes in MVPA.

RESULTS

On average, a significant decrease in MVPA over 2 years was observed only in women (P < .001). Higher baseline MVPA levels and older age were significantly associated with a decrease in MVPA over 2 years in both men and women. Men who were currently drinking (vs no) and had faster maximum gait speed showed statistically significant increases in MVPA. Women who had very poor/poor economic status (vs fair/good) and were socially isolated (vs no) showed statistically significant increases in MVPA over 2 years, while those who had fear of falling (vs no) and poor/fair self-rated health (vs good/very good) showed statistically significant decreases in MVPA over 2 years.

CONCLUSIONS

Our findings showed different associated factors of changes in MVPA by sex, suggesting the importance of accounting for sex differences in terms of developing specific intervention strategies for promoting MVPA among older men and women.

Sense of control and likelihood of prescription drug misuse 10-years later among middle-aged and older adults

Objectives: Sense of control (i.e. one's beliefs about their ability to influence life circumstances) has been linked to various psychological outcomes. However, it is unknown if sense of control is protective against prescription drug misuse (PDM). The present study sought to evaluate if sense of control is associated with reduced odds of PDM 9 to 10 years later among a sample of middle-aged and older adults.Methods: Data were evaluated from participants (M = 54 years, SD = 10.86; N = 2,108) of the second and third waves of the Midlife in the United States study. Logistic regression models were used to assess whether baseline sense of control (Wave 2) predicted odds of PDM 9 to 10 years later (Wave 3).Results: Findings revealed that greater sense of control at baseline was related to reduced odds of subsequent PDM (OR = 0.78; 95% CI: 0.64, 0.95), adjusting for baseline PDM, sociodemographic characteristics, health behaviors, psychological factors, number of prescription medications, and health. When assessing the subscales of sense of control separately, constraints (OR = 1.19; 95% CI: 1.00, 1.42), but not mastery (OR = 0.96; 95% CI: 0.80, 1.12), was predictive of odds of subsequent PDM. Further, being female was associated with greater odds of PDM (OR = 1.46; 95% CI: 1.02, 2.09), but did not moderate the association between sense of control and PDM.Conclusions: Sense of control may be a novel and viable target for interventions (e.g. using mobile phone apps) aimed at mitigating prescription drug misuse.

Adolescent determinants of life-course leisure-time vigorous physical activity trajectories: a 27-Year longitudinal study

BACKGROUND

Adolescence is regarded as formative years for building the foundations for life-long health and well-being, and adolescent determinants of physical activity (PA) development is particularly interesting. Novel approaches for the study of PA development, such as group-based trajectory modelling, opens for the possibility of identifying different patterns in the relationship among several known determinants of PA. This study aimed to explore how demographic, psychological and social factors in early adolescence determine membership in four distinct leisure-time vigorous physical activity (LVPA) trajectories from 13 to 40 years.

METHODS

This study is based on data from the Norwegian Longitudinal Health Behaviour Study, following a cohort born in 1977 from Western Norway. Four trajectories identified using latent class growth analysis, based on self-reposted LVPA (n = 1103, 45.5% women) measured ten times from age 13 to age 40 and 17 different adolescent determinants, were used in a multivariate multinomial logistic regression.

RESULTS

We found that gender (male), VPA intentions the next year and athletic identity associated with belonging to the two trajectories reporting the highest levels of LVPA in adolescence, while VPA intentions in ten years were associated with belonging to the active trajectory compared to the decreasingly active and low active trajectories Enjoyment increased the odds of belonging to the increasingly and decreasingly active trajectories compared to the low active trajectory. In addition, two of the social determinants, mother's PA and emotional support from father, were associated with belonging to the increasingly active trajectory when compared to the low active trajectory. Higher family income increased the odds of belonging to the increasingly active compared to the decreasingly active trajectory.

CONCLUSIONS

Both demographic, psychological, and social factors were identified as determinants of LVPA trajectory membership, and the findings support previous research related to the importance of intentions, but also indicate that enjoyment, role modelling and emotional support in PA can be of great importance to LVPA promotion among adolescents.

Testing conditionality with Bourdieu's capital theory: How economic, social, and embodied cultural capital are associated with diet and physical activity in the Netherlands

Although Bourdieu's capital theory emphasized that economic, social, and embodied cultural capital interact to shape health behavior, existing empirical research mainly considered separate associations of the three forms of capital. Our aim was to investigate if and how economic, social, and embodied cultural capital are conditional on each other in their associations with adults' diet and physical activity. Cross-sectional, self-reported data from the 2014 GLOBE survey of 2812 adults aged between 25 and 75 years residing in Eindhoven, the Netherlands were used. Step-wise multiple logistic regression models included economic, social, and embodied cultural capital and adjustment for potential confounders. The models estimated odds ratios of main effects and two-way interactions of the forms of capital with fruit consumption, vegetable consumption, sports participation, and leisure time walking or cycling. In the main effects models, embodied cultural capital was consistently positively associated with all outcomes. Social capital was positively associated with sports participation, fruit consumption, and vegetable consumption, and economic capital was positively associated with sports participation and vegetable consumption. In the two-way interaction models, having specific higher levels of both economic and social capital strengthened their positive association with sports participation. No other combinations of capital were conditional on each other. Economic and social capital were conditional on each other in their association with sports participation, so interventions that provide both economic and social support may be especially effective for increasing this type of physical activity. As its association was strong with all outcomes but not conditional on other forms of capital, embodied cultural capital may operate distinctly from economic and social resources. Policy that takes differences in embodied cultural capital into account or changes to the environment that dampen the importance of embodied cultural resources for health behavior may help improve both diet and physical activity.

Assessment of the Impact of Increased Physical Activity on Body Mass and Adipose Tissue Reduction in Overweight and Obese Children

(1) Background: Within the last 30 years, growing rates of child overweight and obesity have been observed as a very concerning phenomenon in most countries worldwide. The research aim was to assess what effect increased physical activity has on reducing body mass and adipose tissue in children between 10 and 11 years of age as well as to answer the question of whether physical activity could be considered as a factor in preventing child overweight and obesity when maintaining their existing diet and lifestyle. (2) Material and methods: There were 419 sports class primary school pupils in the experimental group who, in addition to four obligatory weekly physical education hours, attended six training hours. The control group comprised 485 children from parallel non-sports classes. In all pupils, height and weight measurements as well as physical fitness measurements were taken twice, at the beginning and end of the school year. Cole's method was used to assess the children's normal body weight. With the help of this method, children with excessive body weight were selected from the entire study group (N = 904), who additionally had skinfolds and adipose tissue measured using the BIA electrical bioimpedance method. The obtained results were interpreted using the variance analysis for repeated measurements and LSD test. (3) Results: The number of children with excessive body mass after 10 months of increased physical activity decreased (in the case of overweight: p = 0.0014, obesity: p = 0.0022), as did their skinfolds (p ≤ 0.001) and body fat (p ≤ 0.001), while their physical fitness considerably improved compared to the control group. (4) Conclusions: The introduction of increased physical activity in the experimental group children when maintaining their existing diet and lifestyle contributed to reducing their obesity and overweight and, at the same time, proved to be an effective factor in the process of decreasing their excessive body mass.

Digital Health Nudging to increase physical activity in pediatric patients with congenital heart disease: A randomized controlled trial

BACKGROUND

Digital nudging is a modern e-health approach to increase physical activity (PA) in younger age groups. As activity promotion is particularly important in adolescents with congenital heart disease (CHD) this randomized-controlled trail examines if Digital Health Nudging via daily smartphone messages increases PA, activity-related self-efficacy (ArSE) and health-related quality of life (HrQoL) in adolescents with CHD.

METHODS

From May 2021 to April 2022, 97 patients (15.1 ± 2.0 years, 50% girls) with moderate or severe CHD were randomly allocated 1:1 to intervention (IG) or control group (CG). Daily PA was objectively assessed in minutes of moderate-to-vigorous PA (MVPA) by the wearable "Garmin Vivofit jr. 2" over the entire study period. The IG received daily smartphone messages based on Bandura's social cognitive theory on the subject of PA over a period of 12-weeks.

RESULTS

According to the linear mixed model, the change of MVPA over the study period did not significantly differ between IG and CG when taking baseline MVPA into account (b = 0.136, 95%-CI [-0.355; 0.627], P = .587). Activity level was comparably high and showed only minor variability in both groups with 73.7 [62.3; 78.8] min/day in IG and 78.4 [66.6; 93.9] min/d in CG throughout the whole 12-weeks. Emotional well-being significantly increased over the study period in the IG (IG: Δ1.60 [-0.2; 6.3] vs CG: Δ0.0 [-12.5; 6.3], P = .043), but not total HrQoL (P = .518) and ArSE (P = .305).

CONCLUSIONS

12-weeks, of Digital Health Nudging did not increase PA, but improved feelings of emotional well-being in adolescents with CHD.

TRIAL REGISTRATION

Clinical Trials Identifier NCT04933786.

Risks and Benefits of Judo Training for Middle-Aged and Older People: A Systematic Review

This systematic overview aimed to review studies investigating the benefits and risks of judo training in older people, and to explore practical methodological applications (Registration ID: CRD42021274825). Searches of EBSCOhost, ISI-WoS, and Scopus databases, with no time restriction up to December 2022, resulted in 23 records meeting the inclusion criteria. A quality assessment was performed through the following tools: ROBINS-I for 10 experimental studies, NIH for 7 observational studies, and AGREE-II for 6 methodological studies. A serious risk of bias emerged for 70% of the experimental studies, whereas 100% of the observational and 67% of the methodological studies presented a “fair” quality. When involving 1392 participants (63 ± 12 years; females: 47%), the studies investigated novice (n = 13), amateur/intermediate (n = 4), expert (n = 4), and unknown (n = 3) level judoka by means of device-based, self-reported, and visual evaluation measures. Mean training encompassed 2 ± 1 sessions. week−1 of 61 ± 17 min for 7 ± 6 months. In relation to judo training exposure and outcomes, three main themes emerged: (i) health (56% of studies; e.g., bones, anthropometry, quality of life); (ii) functional fitness (43%; e.g., balance, strength, walking speed); and iii) psychosocial aspects (43%; e.g., fear of falling, cognition, self-efficacy). Although the included studies presented relevant methodological weaknesses, the data support the positive effects of judo training with advancing age. Future research is needed to help coaches plan judo programs for older people.

Portuguese Physical Literacy Assessment Questionnaire (PPLA-Q) for Adolescents: Validity and Reliability of the Psychological and Social Modules using Mokken Scale Analysis

We examined the construct validity and reliability of the previously developed Psychological and Social modules of the Portuguese Physical Literacy Assessment Questionnaire (PPLA-Q) using Mokken Scale Analysis in a sample of 508 Portuguese adolescents in public schools in Lisbon. We used a retest subsample (n = 73) to calculate the Intraclass Correlation Coefficient. Eight PPLA-Q scales can be interpreted as moderate-to-strong Mokken scales (H = .47-.66) with good total-score reliability (ρ = .83-.94), and moderate-to-excellent test-retest reliability (ICC_95%CI = .51-.95); four scales had an interpretable invariant item ordering. All but the Physical Regulation scale functioned similarly across sex. Scale-scores correlated as expected, with low-to-moderate correlations across domains supporting convergent and discriminant validity. These results support the construct validity and reliability of the PPLA-Q to assess the psychological and social domains of physical literacy in Portuguese adolescents (15-18 years) enrolled in physical education.

Within-Person Temporal Associations Among Self-Reported Physical Activity, Sleep, and Well-Being in College Students

OBJECTIVE

A holistic understanding of the naturalistic dynamics among physical activity, sleep, emotions, and purpose in life as part of a system reflecting wellness is key to promoting well-being. The main aim of this study was to examine the day-to-day dynamics within this wellness system.

METHODS

Using self-reported emotions (happiness, sadness, anger, anxiousness) and physical activity periods collected twice per day, and daily reports of sleep and purpose in life via smartphone experience sampling, more than 28 days as college students ( n = 226 young adults; mean [standard deviation] = 20.2 [1.7] years) went about their daily lives, we examined day-to-day temporal and contemporaneous dynamics using multilevel vector autoregressive models that consider the network of wellness together.

RESULTS

Network analyses revealed that higher physical activity on a given day predicted an increase of happiness the next day. Higher sleep quality on a given night predicted a decrease in negative emotions the next day, and higher purpose in life predicted decreased negative emotions up to 2 days later. Nodes with the highest centrality were sadness, anxiety, and happiness in the temporal network and purpose in life, anxiety, and anger in the contemporaneous network.

CONCLUSIONS

Although the effects of sleep and physical activity on emotions and purpose in life may be shorter term, a sense of purpose in life is a critical component of wellness that can have slightly longer effects, bleeding into the next few days. High-arousal emotions and purpose in life are central to motivating people into action, which can lead to behavior change.

"How we do it": A qualitative study of strategies for adopting an exercise routine while living with type 1 diabetes

Introduction

For people living with type 1 diabetes (T1D) the challenge of increasing daily physical activity (PA) is compounded by the increased risks of hypoglycemia and glucose variability. Little information exists on the lived experience of overcoming these barriers and adopting and maintaining an active lifestyle while living with T1D.

Research Design and Methods

We conducted a patient-led qualitative study consisting of semi-structured interviews or focus groups with 22 individuals at least 16 years old living with T1D. We used existing patient co-researcher networks and snowball sampling to obtain a sample of individuals who reported being regularly physically active and had been diagnosed with T1D for at least one year. We used an interpretive description analysis to generate themes and strategies associated with maintaining an active lifestyle while living with T1D. We involved patient co-researchers in study design, data collection, and interpretation.

Results

14 self-identified women and 8 self-identified men (ages 19-62, median age 32 years) completed the study, led by either a researcher, or a patient co-researcher and research assistant regarding their strategies for maintaining an active lifestyle. We identified five themes that facilitate regular sustained PA: (1) Structure and organization are important to adopt safe PA in daily life "I can't do spontaneous exercise. I actually need a couple hours of warning minimum"; (2) Trial and error to learn how their body responds to PA and food "Once you put the time and effort into learning, you will have greater success"; (3) Psychosocial aspects of PA "…because it's not just your body, it's your soul, it's your mind that exercise is for"; (4) Diabetes technology and (5) Education and peer support. Strategies to overcome barriers included (1) Technology; (2) Integrating psychosocial facilitators; (3) Insulin and carbohydrate adjustments; and (4) Planning for exercise.

Conclusions

Living an active lifestyle with T1D is facilitated by dedicated structure and organization of routines, accepting the need for trial and error to understand the personalized glycemic responses to PA and careful use of food to prevent hypoglycemia. These themes could inform clinical practice guidelines or future trials that include PA interventions.

Genetic Pathways Underlying Individual Differences in Regular Physical Activity

Twin and family studies show a strong contribution of genetic factors to physical activity (PA) assessed by either self-report or accelerometers. PA heritability is around 43% across the lifespan. Genome-wide association studies have implied biological pathways related to exercise ability and enjoyment. A polygenic score based on genetic variants influencing PA could help improve the success of intervention programs.

Promoting Physical Activity Habits after Completing Secondary School: Does the Age Matter?

Physical inactivity is one of the most important problems in our society, especially during adolescence. During this stage of schooling, students practice physical activity in physical education classes, but after they finish school, many of them stop practicing it. This research aims to determine which variables predict the intention to practice physical activity after finishing secondary school and to discover the effect that age during adolescence has on these predictive variables. A questionnaire was administered to a sample of secondary school students. The results show that physical exercise identity influences the three antecedents of this theory, while the attitude towards the behaviour (β = 0.13; p < 0.05), perceived behavioural control (β = 0.46; p < 0.05), and physical self-concept (β = 0.41; p < 0.05), have a statistically significant influence on the intention to be physically active. Moreover, when the age is lower, is more important to develop a positive perceived behavioural control and physical exercise identity. Moreover, for younger male adolescents instead of the physical exercise itself, identity seems more important in developing a positive attitude towards behaviour. Likewise, in young female adolescents a low level of support from their close environment (subjective norm) leads to dropping out. The research concludes with the importance of including these variables in physical education classes to promote physical activity practice after completion of secondary school. Some practical implications are presented.

DE-PASS Best Evidence Statement (BESt): modifiable determinants of physical activity and sedentary behaviour in children and adolescents aged 5-19 years-a protocol for systematic review and meta-analysis

INTRODUCTION

Physical activity among children and adolescents remains insufficient, despite the substantial efforts made by researchers and policymakers. Identifying and furthering our understanding of potential modifiable determinants of physical activity behaviour (PAB) and sedentary behaviour (SB) is crucial for the development of interventions that promote a shift from SB to PAB. The current protocol details the process through which a series of systematic literature reviews and meta-analyses (MAs) will be conducted to produce a best-evidence statement (BESt) and inform policymakers. The overall aim is to identify modifiable determinants that are associated with changes in PAB and SB in children and adolescents (aged 5-19 years) and to quantify their effect on, or association with, PAB/SB.

METHODS AND ANALYSIS

A search will be performed in MEDLINE, SportDiscus, Web of Science, PsychINFO and Cochrane Central Register of Controlled Trials. Randomised controlled trials (RCTs) and controlled trials (CTs) that investigate the effect of interventions on PAB/SB and longitudinal studies that investigate the associations between modifiable determinants and PAB/SB at multiple time points will be sought. Risk of bias assessments will be performed using adapted versions of Cochrane's RoB V.2.0 and ROBINS-I tools for RCTs and CTs, respectively, and an adapted version of the National Institute of Health's tool for longitudinal studies. Data will be synthesised narratively and, where possible, MAs will be performed using frequentist and Bayesian statistics. Modifiable determinants will be discussed considering the settings in which they were investigated and the PAB/SB measurement methods used.

ETHICS AND DISSEMINATION

No ethical approval is needed as no primary data will be collected. The findings will be disseminated in peer-reviewed publications and academic conferences where possible. The BESt will also be shared with policy makers within the DE-PASS consortium in the first instance.

SYSTEMATIC REVIEW REGISTRATION

CRD42021282874.

Psychometric testing of the Maltese versions of the Exercise Benefits/Barriers Scale and Exercise Motivation Inventory – 2

Background

Consideration of psychological factors towards exercise participation is important, especially when placed within a cultural context.

Objective

The aim of this study was to translate the Exercise Benefits/Barriers Scale and Exercise Motivation Inventory-2 to Maltese and undertake psychometric testing.

Methods

Maltese-speaking participants (n = 170) aged 18 to 69 years were recruited. 72% completed both questionnaires twice within an 8-to 48-hour period. Reliability was calculated using the Spearman correlation, intraclass correlation coefficient, and Bland–Altman plots. Convergent construct validity was tested using Spearman correlation between theoretical variables.

Results

In total 155 participants completed the questionnaires at both time points. The test/re-test reliability of the two questionnaires was >0.7 for all analyses. Correlations for validity were statistically significant (p < 0.05).

Conclusion

The translated tools have similar psychometric properties to the original version; the authors recommend that health care professionals and physical activity practitioners use these tools when examining population-level physical activity behaviour among Maltese-speaking individuals.

Percepção de barreiras para prática de atividade física em estudantes do curso de educação física

Objetivo: identificar a percepção dos estudantes do curso de educação física, sobre as principais barreiras para prática de atividade física e sua relação com variáveis sociodemográficas. Metodologia: estudo transversal realizado com 1.369 estudantes (876 do sexo masculino; média de idade 24,7±6,5) do curso de educação física de dois centros urbanos do Ceará, Brasil. Foram coletadas informações sociodemográficas, prática de atividade física (sim ou não) e barreiras percebidas. O teste do Qui-quadrado foi utilizado para associação das variáveis sociodemográficas com as principais barreiras percebidas entre os estudantes que reportaram não praticar atividade física, adotando-se p≤0,05. Resultados: do total, 13,4%, (182 estudantes) não praticavam atividade física. As principais barreiras percebidas para a prática de atividade física foram, tempo dedicado aos estudos (53,5%), jornada de trabalho extensa (49,2%), tarefas domésticas (38,1%), falta de recursos financeiros (36,0%) e compromissos familiares (33,9%). As principais barreiras percebidas estiveram associadas ao trabalho, sendo o tempo dedicado aos estudos (p=0,034) e a jornada de estudos extensa (p=0,001) mais prevalentes entre os estudantes trabalhadores, enquanto que a falta de recursos financeiros (p=0,032) e os compromissos familiares (p=0,014) nos desempregados. Conclusão: o tempo dedicado aos estudos foi a principal barreira percebida. Entre as principais barreiras apenas a tarefa doméstica não esteve associada ao trabalho. Observou-se ainda que as principais barreiras percebidas são de cunho social.

Investigating psychological variables for technologies promoting physical activity

Background

Many technological interventions designed to promote physical activity (PA) have limited efficacy and appear to lack important factors that could increase engagement. This may be due to a discrepancy between research conducted in this space, and software designers' and developers' use of this research to inform new digital applications.

Objectives

This study aimed to identify (1) what are the variables that act as barriers and facilitators to PA and (2) which PA variables are currently considered in the design of technologies promoting PA including psychological, physical, and personal/contextual ones which are critical in promoting PA. We emphasize psychological variables in this work because of their sparse and often simplistic integration in digital applications for PA.

Methods

We conducted two systematized reviews on PA variables, using PsycInfo and Association for Computing Machinery Digital Libraries for objectives 1 and 2.

Results

We identified 38 PA variables (mostly psychological ones) including barriers/facilitators in the literature. 17 of those variables were considered when developing digital applications for PA. Only few studies evaluate PA levels in relation to these variables. The same barriers are reported for all weight groups, though some barriers are stronger in people with obesity.

Conclusions

We identify PA variables and illustrate the lack of consideration of these in the design of PA technologies. Digital applications to promote PA may have limited efficacy if they do not address variables acting as facilitators or barriers to participation in PA, and that are important to people representing a range of body weight characteristics.

Proposal of a Comprehensive and Multi-Component Approach to Promote Physical Activity among Japanese Office Workers: A Qualitative Focus Group Interview Study

Office workers spend up to two-thirds of their working hours sitting and are less physically active than other occupational groups. It is necessary to develop an effective approach to promote physical activity among office workers. We conducted a focus group interview with seven Japanese office workers to investigate the current status (topic 1) of, and their opinions on (topic 2), physical activity promotion programs in their workplace. Data were analyzed using qualitative data analysis. We classified the data from topic 1 into individual, socio-cultural, physical, and organizational environments. Most participants indicated that they spent a lot of time sitting and needed programs for a wide range of corresponding employee demands. We classified the data from topic 2 into capability, opportunity, and motivation. Most participants indicated that they wanted evidence-based information, a standing desk, and a conducive workplace environment to enhance physical activity. Thus, we proposed a comprehensive and multi-component approach comprising individual (information delivery), socio-cultural environment (team building, supportive atmosphere), physical environment (standing desk, use of poster), and organizational (incentive, encouraging message from an executive, workplace policy) strategies. Future studies should evaluate the effectiveness of this proposal.

Environmental Physical Activity Cues and Children's Active vs. Sedentary Recreation

Physical activity (PA) benefits health, and intensive environmental modifications can increase children’s PA. Research has not yet addressed if subtle environmental cues, such as posters depicting PA, increase child PA. In the current study, it was hypothesized that children exposed to active posters (vs. nature posters) would spend a larger proportion of free play time engaging with active toys (relative to sedentary toys). Participants were randomly assigned to one of two conditions in which posters on a laboratory wall depicted 1. People being active, or 2. Nature scenes. Children aged 5–10 years (N = 175) could play with up to eight toys (four active, four sedentary) while parents completed study-related surveys. The proportion of playtime that was active was compared between groups. Poster type did not have a significant effect on proportion of active playtime. Previous environmental interventions that increase children’s PA have done so through enhancing access to active opportunities, rather than via signage. It is possible that poster interventions such as this may not influence children’s PA, or perhaps other types of cues would have been more effective. Future research should investigate subtle environmental cues that match both the target audience and the accessible PA options (e.g., posters depicting children playing with available active toys) and explore other low-investment environmental modifications to boost children’s PA.

Age and Sex-Related Associations between Marital Status, Physical Activity and TV Time

Marital status mediates an association between physical activity (PA) and TV time with health outcomes. However, population-based studies have revealed that the health effect of marriage or divorce is age-dependent and differs between women and men. The study aimed to identify the age and sex-related associations between marital status with PA and TV time. We used data from Vigitel, an annual telephone survey started in 2006 in Brazil. We applied a complex sample logistic regression model to estimate the odds for PA and TV time comparing marital statuses according to age and sex subgroups, independent of obesity, hypertension, diabetes, self-assessed poor health, and smoking. Our sample included 561,837 individuals from 18 to 99 years, with a TV time > 3 h/day (prevalence = 25.2%) and PA > 150 min/week (prevalence = 35%). Later, we divided our sample in seven age groups by marital status and sex. Compared to single individuals, married men and women were less likely to watch TV more than 3 h/day in participants >30 years old. When compared to single, married participants were less likely to do more than 150 min of PA/week at younger age groups. Married women older than 40 years were more likely to do more than 150 min of PA/week than the single ones, while there were no differences among married men by age group. In conclusion, our study suggests that the investments in public policies to encourage the practice of PA and reduction of TV time could be based on the marital status, sex, and age, prioritizing less active groups.

Mental health and physical activity in vocational education and training schools students: a population-based survey

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.

Supporting Physical Activity in Patients and Populations During Life Events and Transitions: A Scientific Statement From the American Heart Association

Achieving recommended levels of physical activity is important for optimal cardiovascular health and can help reduce cardiovascular disease risk. Emerging evidence suggests that physical activity fluctuates throughout the life course. Some life events and transitions are associated with reductions in physical activity and, potentially, increases in sedentary behavior. The aim of this scientific statement is to first provide an overview of the evidence suggesting changes in physical activity and sedentary behavior across life events and transitions. A second aim is to provide guidance for health care professionals or public health workers to identify changes and promote physical activity during life events and transitions. We offer a novel synthesis of existing data, including evidence suggesting that some subgroups are more likely to change physical activity behaviors in response to life events and transitions. We also review the evidence that sedentary behavior changes across life events and transitions. Tools for health care professionals to assess physical activity using simple questions or wearable devices are described. We provide strategies for health care professionals to express compassion as they ask about life transitions and initiate conversations about physical activity. Last, resources for life phase-specific, tailored physical activity support are included. Future research needs include a better characterization of physical activity and sedentary behavior across life events and transitions in higher-risk subgroups. Development and testing of interventions designed specifically to combat declines in physical activity or increases in sedentary behavior during life events and transitions is needed to establish or maintain healthy levels of these cardiovascular health-promoting behaviors.

Portuguese Physical Literacy Assessment Questionnaire (PPLA-Q) for adolescents (15-18 years) from grades 10-12: development, content validation and pilot testing

Background

The Portuguese Physical Literacy Assessment (PPLA) is a novel tool to assess high-school students’ (grade 10–12; 15–18 years) Physical Literacy (PL) in Physical Education (PE); inspired by the four domains of the Australian Physical Literacy Framework (APLF), and the Portuguese PE syllabus. This paper describes the development, content validation, and pilot testing of the PPLA-Questionnaire (PPLA-Q), one of two instruments in the PPLA, comprised of modules to assess the psychological, social, and part of the cognitive domain of PL.

Methods

Development was supported by previous work, analysis of the APLF, and literature review. We iteratively gathered evidence on content validity through two rounds of qualitative and quantitative expert validation (n = 11); three rounds of cognitive interviews with high-school students (n = 12); and multiple instances of expert advisor input. A pilot study in two grade 10 classes (n = 41) assessed feasibility, preliminary reliability, item difficulty and discrimination.

Results

Initial versions of the PPLA-Q gathered evidence in favor of adequate content validity at item level: most items had an Item-Content Validity Index ≥.78 and Cohen’s κ ≥ .76. At module-level, S-CVI/Ave and UA were .87/.60, .98/.93 and .96/.84 for the cognitive, psychological, and social modules, respectively. Through the pilot study, we found evidence for feasibility, preliminary subscale and item reliability, difficulty, and discrimination. Items were reviewed through qualitative methods until saturation. Current PPLA-Q consists of 3 modules: cognitive (knowledge test with 10 items), psychological (46 Likert-type items) and social (43 Likert-type items).

Conclusion

Results of this study provide evidence for content validity, feasibility within PE setting and preliminary reliability of the PPLA-Q as an instrument to assess the psychological, social, and part of the cognitive domain of PL in grade 10 to 12 adolescents. Further validation and development are needed to establish construct validity and reliability, and study PPLA-Q’s integration with the PPLA-Observation (an instrument in development to assess the remaining domains of PL) within the PPLA framework.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12230-5.

Psychosocial Health and Physical Activity in People With Major Depression in the Context of COVID-19

Introduction: Major depression is a psychiatric disease associated with physical inactivity, which in turn affects mental and physical health. A randomized controlled trial is being implemented to facilitate physical activity in people with major depression. In March 2020, Swiss state authorities temporarily legislated a lockdown to contain the Coronavirus disease-19 (COVID-19), which influenced health, behavior and research. The aim of this study was to find out whether data gathered before and during/after the lockdown among in-patients with major depression differ with regard to psychosocial health, physical activity and related attitudes and to establish whether baseline data have been affected by the lockdown. Methods: This is a cross-sectional analysis within a randomized controlled trial. Physically inactive, adult in-patients diagnosed with major depression were recruited from four Swiss psychiatric clinics between January 2019 and December 2020. Psychosocial health was measured with questionnaires pertaining to stress, sleep and health-related quality of life. Physical activity was measured with the Simple Physical Activity Questionnaire. Explicit attitudes were measured with seven questionnaires pertaining to physical activity-related motivation and volition. Implicit attitudes toward physical activity were captured with a single target implicit association test. Results: The sample consisted of 165 participants (n = 119 before lockdown, n = 46 during/after lockdown). No statistically significant differences were found between in-patients with major depression assessed before and during/after the COVID-19 lockdown with regard to psychosocial health (stress, p = 0.51; sleep, p = 0.70; physical component of health-related quality of life, p = 0.55; mental component of health-related quality of life, p = 0.64), self-reported physical activity (p = 0.16) and explicit as well as implicit attitudes toward physical activity (p = 0.94). Hence, the COVID-19-induced lockdown seems not to have led to group differences. Conclusion: Baseline data gathered in in-patients suffering from major depression who are physically inactive upon admission to in-patient treatment in Switzerland seem to be unaffected by the COVID-19-induced lockdown. To assess changes in said population regarding psychosocial health and physical activity patterns over time, longitudinal data are needed.

Determinants of physical activity in older adults: an umbrella review protocol

OBJECTIVE

The aim of this review is to summarize the evidence for determinants of physical activity in older adults.

INTRODUCTION

Physical activity is an important predictor of multi-morbidity, falls, and cognitive decline in older adulthood. Understanding what influences older adults' physical activity behavior is an important first step for guiding effective interventions for promoting physical activity in this population.

INCLUSION CRITERIA

This umbrella review will include systematic reviews (including scoping reviews) reporting on the relationship between determinants (also referred to as correlates or factors), measured by either self-report or direct measurement, and physical activity in adults ≥60 years.

METHODS

A systematic search of six databases will be completed in MEDLINE, Embase, CINAHL, Cochrane Library, PsycINFO, and AgeLine. Two independent reviewers will screen titles, abstracts, and full-text articles, and perform data extraction and quality assessment. Evidence for determinants of physical activity will be synthesized using the socio-ecological model. If possible, evidence will be compared by study design, type of physical activity, outcome measure used, setting, and sex.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020159332.

Caffeine intake reduces sedentary time and increases physical activity predisposition in obese police officers

Sedentary time is associated with increased obesity in police officers. Caffeine intake may reduce sedentary time but it has not been extensively investigated. In the present study, the effect of caffeine ingestion on sedentary time was investigated in obese police officers. Fourteen obese police officers ingested either 5 mg/kg of caffeine or cellulose (placebo) for six days. Information on inactivity time, time spent with physical activities, self-reported perception of tiredness, and physical activity disposition was obtained daily during the intervention period. Sedentary and physical activity times were divided into two intraday periods (T₁: 08:00 am-02:00 pm and T₂: 02:00 pm-08:00 pm). Caffeine intake decreased the sedentary time in both T₁ (79.2±2.2%) and T₂ (79.1±2.5%), when compared with T₂ of the placebo condition (81.1±3.6%, P<0.05). Caffeine intake also increased the time spent on light physical activities in T₁ and T₂ (17±2 and 18±2%), when compared with T₂ of the placebo condition (16±3%, P<0.05). In addition, sedentary time increased and light physical activity time decreased from T₁ to T₂ in the placebo (P<0.001) but not in the caffeine condition (P=0.81). Caffeine intake had no effect on tiredness (P>0.05), but it increased the self-reported physical activity disposition compared to the placebo condition (4.5±2.7 vs 3.2±2.3 units, P<0.05). Caffeine intake reduced the sedentary time and increased the time spent on light physical activities of obese police officers, which seems to be related to a higher disposition for the practice of physical activity.

Psychosocial Characteristics, Perceived Neighborhood Environment, and Physical Activity Among Chinese Adolescents

This study examined the independent associations between psychosocial factors, perceived neighborhood characteristics, and physical activity (PA) in Chinese adolescents. A cross-sectional study using a convenience sample was conducted in fall 2019 at a high school in Wuhan, China. Sociodemographic data, body weight, height, psychosocial factors, perceptions of neighborhood environment, and PA were collected using questionnaires. Hierarchical linear regression analyses were performed in 4 steps, where step 1 included demographic covariates, step 2 added psychosocial factors into the model, step 3 added perceived neighborhood environmental factors, and step 4 added interaction terms between significant psychosocial and environmental factors. A total of 4027 adolescents were included in analysis. The results of the third model indicated that friends' support (b = 4.58), friends' norms (b = 7.16), barriers to PA (b = -10.19), autonomous motivation (b = 4.75), self-efficacy (b = 8.86), the presence of shops/stores nearby (b = 5.79), and the availability of PA resources (b = 6.02) were significant predictors (P < .05) of moderate to vigorous PA. None of the interaction terms were significant in the fourth model. Our results suggest that interventions targeting the PA of Chinese adolescents should take into account the attitudes toward PA, perceived barriers to PA, controlled motivation, perceptions of neighborhood PA resource availability, and perceived neighborhood safety to maximize effectiveness.

Establishing the relevance of psychological determinants regarding physical activity in people with overweight and obesity

To identify the most relevant determinants involved in Physical Activity (PA) changes in the EVIDENT 3 study population, measured by the International PA Questionnaire (IPAQ) and the Actigraph GT3X accelerometer.

METHOD

Exploratory study. Data used were collected from EVIDENT 3 study (N = 650). Items to measure psychological determinants were chosen from the baseline questionnaires. PA minutes/week were assessed by an accelerometer and IPAQ. The sample was analyzed by the control group (CG), the intervention group (IG) and Body Mass Index, using Confidence Interval-Based Estimation of Relevance (CIBER) analyses.

RESULTS

486 participants, (IG: n = 251, CG: n = 235) were included. IG shows a positive association between PA assessed by accelerometer and self-efficacy. In IG, the overweight sample shows a positive association between PA assessed by accelerometer and motivation and self-efficacy. PA assessed by accelerometer obtained a higher explained variance (R2 ) in IG, both people with overweight (.10 - .55) and obesity (.03 - .19). In CG, IPAQ reached better results in people with overweight (.12 - .49).

CONCLUSIONS

Motivation and self-efficacy showed as relevant in increasing PA minutes/week, but only in the people with overweight in IG. There might be other factors not analyzed that could improve the low R2 obtained.

Are Self-Efficacy and Perceived Environmental Characteristics Determinants of Decline in Physical Activity Time?

CONTEXT

This study analyzed whether self-efficacy (SE) and perceived environmental characteristics (EC) are determinants of the decline in physical activity (PA) time in adolescents.

METHODS

This used longitudinal observational approach, with 4 years of data collection, involving 355 adolescents (57.7% girls and 42.3% boys), average age of 11.8 years (0.1 y), from João Pessoa, Paraiba, Brazil. SE and EC were measured by scales and PA by a questionnaire. Ordinal logistic regression was used to associate SE and EC with a decline in PA.

RESULTS

There was a linear trend toward a decrease in average PA duration (58.3 [13.7] min/wk/y) and a rise in average access to places for PA (point per year) (0.6 [0.1]), urban safety (0.2 [0.1]), and traffic safety scores (0.5 [0.1]). The results of multivariable analysis indicated that SE and EC were not associated with the decline in PA.

CONCLUSION

There was a decline in PA time, and SE and perceived EC were not determinants of this decline.

Changes in physical activity levels, eating habits and psychological well-being during the Italian COVID-19 pandemic lockdown: Impact of socio-demographic factors on the Florentine academic population

The confinement and lockdown imposed by the COVID-19 pandemic have produced restrictions in the lifestyle of Italian citizens with variations in their psychological well-being. The aim of the study was to identify changes and relationship with socio-demographic parameters. An online survey was administered to 1383 subjects (1007 females and 307 males) working in the University of Florence, Italy. Three validated questionnaires were used for the survey: the Global Physical Activity Questionnaire, the Med Diet Score and the Psychological General Well-Being Index-A. All the subjects were asked to complete the questionnaires twice, in order to attain a picture of the habits before and a later time point during confinement. Our results show that work-related physical activity was decreased, along with an increase in sedentary behaviour (from 07:22±03:20 to 08:49±03:41 h:min; p<0.001, ES = 0.38), whereas recreational physical activity was increased (vigorous exercise varied from 568.5 ± 838.6 to 833.7 ± 1263.0 METs; p<0.002, ES = 0.25). Eating habits changed according to the place where meals were eaten, with an increased habit for breakfast and snacks and a slight increase in alcohol consumption. Psychological well-being decreased (Index from 21.4±3.9 to 18.0±5.3; p<0.001, ES = 0.723), especially in terms of vitality and positive thinking. The socio-demographic variables affecting these variations were mostly represented by age, gender and working conditions: young age and self-employment conditions can be considered factors for the changes in daily habits induced by confinement that may affect psychological well-being.

Motivation for Physical Activity: Validation of the Dutch Version of the Physical Activity and Leisure Motivation Scale (PALMS)

Understanding motivation for exercise can be helpful in improving levels of physical activity. The Physical Activity and Leisure Motivation Scale (PALMS) measures distinct goal-oriented motivations. In this study selected measurement properties of the Dutch version (PALMS-D) are determined. Forward-backward translation was used for cross-cultural adaptation. Construct validity of the PALMS-D was assessed in five subsamples completing the PALMS-D and the Behavioral Regulation in Exercise Questionnaire (BREQ-3). The study population consisted of five samples recruited from different populations; samples consisted of runners, hockey players, soccer players, participants in medical fitness, and a sedentary group of young adults with low activity. A total of 733 participants completed the questionnaire: 562 athletes and 171 non-athletes. Exploratory for Analysis confirmed the original eight factors. Internal consistency of the subscales was high, except for Others’ expectations. The a priori determined hypotheses related to differences between athletes participating in different sports were confirmed, as well as the hypothesis related to differences between amateur athletes, patients in medical fitness, and non-active participants. It was concluded that the Dutch version of the PALMS is an acceptable questionnaire with which to evaluate the individual motivation of athletes in the Netherlands, and discriminates between different leisure athletes, patients in medical fitness, and non-active youths.

Adolescents' Perspectives on the Barriers and Facilitators of Physical Activity: An Updated Systematic Review of Qualitative Studies

Listening to adolescents' voices has been important to promote meaningful physical activity (PA) opportunities. Therefore, an updated systematic review of the available qualitative literature on adolescents' perspectives on the barriers and facilitators of PA was conducted, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies published between 2014 (date of the last systematic review) and 2020 were searched in the Web of Science, EBSCO, and SCOPUS databases. Based on the inclusion criteria applied, 30 out of 8069 studies were included in the review. A thematic analysis was used to inductively and deductively analyze the perspectives of ~1250 adolescents (13-18 years). The studies took place in 13 countries from different continents. The main PA barriers and facilitators of PA were presented and discussed around five higher-order themes: (1) Individual factors (e.g., psychological-motivation, self-efficacy; cognitive-knowledge, understanding; physical-motor skills); (2) social and relational factors (family, friends, significant others); (3) PA nature factors (fun, school-based PA and physical education); (4) life factors (time and competing activities; life-course); and (5) sociocultural and environmental factors (e.g., availability/access to PA facilities, programs; urban/rural zones). By transnationally framing adolescents' voices, this study provides updated evidence and discusses innovative implications for developing tailored interventions and pedagogical strategies aimed at promoting active and healthy lifestyles.

Indices of Cardiovascular Health, Body Composition and Aerobic Endurance in Young Women; Differential Effects of Two Endurance-Based Training Modalities

Endurance training (ET) has multiple beneficial effects on cardiovascular health (CVH), but there is an evident lack of knowledge on differential effects of various types of ET on indices of CVH in women. The aim of this study was to analyse the effectiveness of two different types of ET on changes in indicators of CVH in apparently healthy adult women. The sample included 58 women (24 ± 3 years; height: 165 ± 6 cm, mass: 66.7 ± 7.2 kg, BMI: 24.3 ± 2.5 kg/m², at baseline) divided into one control non-exercising group (n = 19), and two exercising experimental groups (EE). The first EE participated in choreographed aerobic-endurance training (CAT; n = 19), while the second participated in treadmill-based endurance exercise (TEE; n = 20) during the experimental protocol (8 weeks, 24 training sessions). The testing included pre- and post-exercise protocols and measures of anthropometric/body composition indices, lipid panel, and endurance capacity. Two-way analysis of variance for repeated measurements with consecutive post hoc analysis was applied to the “group” and “measurement” variables. The main significant ANOVA effects found for measurement, and “Group x Measurement” interaction (p < 0.05) were found for all variables but body height. The EE induced positive changes in lipid panel variables, anthropometric/body-build status, and endurance capacity. However, TEE improved endurance capacity to a greater extent than CAT. The results suggest that that the optimal exercise intensity and self-chosen type of physical-activity may result in positive effects on indices of CVH, even in women of young age and good health status.

Determinants of Weight-Related Behaviors in Male Saudi University Students: A Qualitative Approach Using Focus Group Discussions

Obesity is a serious public health concern in the Gulf States. Students are exposed to many unhealthy weight-related behaviors due to college life. However, research that gives insight into regional and culture-specific aspects and determinants of weight-related behaviors in students is lacking. The purpose of this study was to explore the potential determinants of weight change, eating behaviors, physical activity, sedentary behaviors, and sleep behaviors in Saudi university students. Five semi-structured focus group discussions guided by Social Cognitive Theory were conducted, consisting of 33 male university students 20 to 22 years old. The data were transcribed, coded, and organized according to themes. The students reported weight gain due to personal, social, and environmental factors related to university lifestyle, such as unhealthy eating behaviors, low physical activity, high sedentary behaviors, and inadequate sleep. Both eating behaviors and physical activity shared similar personal aspects found in other studies, such as knowledge, stress, lack of time, and lack of motivation. However, there were some unique social and environmental factors in the region, such as the social norms, cultural aspects, weather conditions, passive transport dependency, and khat consumption, compared with studies worldwide. Such differences are key factors to developing effective interventions in the future.

Keep on running - a randomized controlled trial to test a digital evidence-based intervention for sustained adoption of recreational running: rationale, design and pilot feasibility study

BACKGROUND

This paper describes the rationale, intervention development, study design and results from the pilot feasibility study of the Keep On Running (KOR) trial. KOR aims to test a web-based brief theory-based intervention, targeting maintenance of recreational running behavior over time (i.e. relapse preventing).

METHODS

Intervention development was based both on Self-Determination Theory and on Self-Regulation Theory. As part of it, a pilot study was implemented (n=18) to measure intervention adherence and participant satisfaction in order to establish the feasibility and acceptability of the intervention toolkit. Furthermore, this pilot study was also used to test the feasibility and acceptability of the questionnaires selected to be part of the later RCT.

RESULTS

Pilot intervention acceptability was good, but overall adherence was low. Features such as feedback and social sharing should be added to the toolkit. The main trial should lessen questionnaire length and include data from usual monitoring gadgets and apps (APIs). The protocol of the RCT was adjusted to test the efficacy of the refined final version of the intervention, and the RCT that will test it, contributing to the understanding of recreational running sustainability, allowing the optimization of future interventions aimed at physical activity promotion.

Health-Promoting Lifestyle and Its Predictors in Adolescent Survivors of Childhood Cancer

Background: Cancer survivors are at increased risk of long-term adverse effects related to the disease or treatment. Thus, it is important for cancer survivors to adopt a health-promoting lifestyle (HPL). This study aims to: (1) describe health behavior self-efficacy (HBSE) and HPL of adolescent survivors of childhood cancer, (2) examine the relationships between HBSE, HPL, and various demographic factors, and (3) identify determinants of HPL among adolescent survivors of childhood cancer. Method: A descriptive cross-sectional study was conducted with adolescent survivors of childhood cancer, ranged in age from 11 to 19 years (n = 82). Participants were recruited from pediatric oncology follow-up clinics at two medical centers in southern Taiwan. Data for each participant were collected from questionnaires assessing HBSE and HPL. Results: Only 61% of the adolescent survivors were considered as normal weight. The exercise was the lowest scoring HBSE subscale. Factors associated with better HPL included: education level, HBSE, well-being, and a healthy diet. Specifically, survivors diagnosed with cancer during adolescence exhibited significantly greater self-efficacy with stress management (F = 3.20, p = .04) compared with those diagnosed at pre-school ages. HBSE scores for well-being and a healthy diet were significant predictors of HPL, accounting for 43.8% of the total variance observed. Discussion: Our findings suggest that the age of diagnosis of childhood cancer significantly modulates the frequency of health-promoting behaviors of adolescent survivors. Thus, interventions designed to enhance adolescents' well-being and the management of a healthy diet may enhance HPL in survivors of childhood cancer.

Understanding Vocational Students' Motivation for Dietary and Physical Activity Behaviors

Unhealthy eating behaviors and low levels of physical activity are major problems in adolescents and young adults in vocational education. To develop effective intervention programs, more research is needed to understand how different types of motivation contribute to health behaviors. In the present study, Self-Determination Theory is used to examine how motivation contributes to dietary and physical activity behaviors in vocational students. This cross-sectional study included 809 students (mean age 17.8 ± 1.9 years) attending vocational education in the Netherlands. Linear multilevel regression analyses were used to investigate the association between types of motivation and dietary and physical activity behaviors. Amotivation was negatively associated with breakfast frequency and positively associated with diet soda consumption and high-calorie between-meal snacks. A positive association was found between autonomous motivation and water intake, breakfast frequency, fruit intake, and moderate-to-vigorous physical activity. Autonomous motivation was negatively associated with the consumption of unhealthy products. Controlled motivation was not associated with physical activity or dietary behaviors. Different types of motivation seem to explain either healthy or unhealthy dietary behaviors in vocational students. Autonomous motivation, in particular, was shown to be associated with healthy behaviors and could therefore be a valuable intervention target.