Does the National Fitness Policy Promote National Health?—An Empirical Study from China

Assessing the efficiency of China's national fitness public services: a super-efficiency DEA-Malmquist-Tobit approach

Introduction

As the Chinese government places an increasing emphasis on public fitness services, there has been a concomitant growth in public demand for greater fiscal expenditure in this area. However, in light of the constrained growth in government financial resources, it is of paramount importance to allocate these resources in a rational manner in order to effectively address the public's fitness and health needs. This study aims to evaluate the efficiency of public expenditure on national fitness services across China, thereby providing valuable insights for policymakers to optimize resource allocation and improve service efficiency.

Methods

The study employs a super-efficiency Data Envelopment Analysis (DEA) model, in conjunction with the Malmquist Index and Tobit regression model, to assess the efficiency of fiscal spending on fitness services in 31 Chinese provinces from 2017 to 2020. The analysis employs both static and dynamic approaches to present an objective view of the development of public fitness service levels across different regions and to empirically identify the key factors influencing fiscal spending efficiency.

Results

The findings indicate substantial regional variations in the efficiency of fiscal expenditure on public fitness services. While some provinces demonstrate high efficiency in the use of public funds, others exhibit notable inefficiencies, particularly in areas with lower levels of economic development and population density. The findings underscore the existence of redundant expenditure and the varying effectiveness of resource utilization across provinces.

Discussion

The study recommends that future strategies prioritize the scientific planning of fiscal inputs into public fitness services, the precise optimization of expenditure structures, the exploration of collaborative supply mechanisms, the expansion of demand-driven feedback channels, the integration of technological innovations, and the acceleration of digitalization in public fitness services.

Physical activity trajectories and their associations with health outcomes in older adults with mild cognitive impairment or dementia: a national cohort study

BACKGROUND

Physical activity (PA) is a promising non-pharmacological intervention for this population. However, few studies have investigated their PA trajectories, influencing factors, and their relationship with health outcomes.

AIMS

The aim was to identify latent trajectories in PA and their determinants in older adults with mild cognitive impairment (MCI) or dementia, as well as to assess the associations between PA trajectories and health outcomes based on the capability-opportunity-motivation behavior model.

METHODS

This is a cohort study. Data were obtained from a national cohort study and included participants aged 60 years and older with MCI or dementia. PA trajectories were identified using group-based trajectory modelling. Multinomial logistic regression was conducted to identify the predictors of PA trajectories. Linear regression models were used to assess the associations between PA trajectories and health outcomes. This study adhered to the STROBE checklist for reporting.

RESULTS

Three distinct PA trajectories were identified: high-decreasing and rebound class (9.34%), moderate-decreasing class (10.31%), and low-increasing class (80.34%). The logistic regression showed that age, sex, education level, body mass index, residence, depressive symptoms, mobility activities of daily life score, frequency of social activities score were PA predictors. Adjusting for sociodemographic variables, only the high-decreasing and rebound class remained significantly associated with worse self-rated health.

DISCUSSION

This study revealed three PA trajectories among older adults with MCI/dementia. Besides sociodemographic variables, addressing physical function and mental health, providing social support are vital for promoting PA in this population.

Analysis of national physical activity and sedentary behaviour policies in China

PURPOSE

The aims of this study were to advance knowledge on physical activity (PA) and sedentary behaviour (SB) policies in China and to highlight related gaps and opportunities in the Chinese policy landscape.

METHODS

Literature and web-based searches were performed to identify national PA and SB policies in China. We assessed which of the 17 elements of the Health-Enhancing Physical Activity Policy Audit Tool (HEPA PAT, version 2) are included in each of the policy documents and whether and how they address the 'cornerstones' of PA and SB policy: PA and SB guidelines, targets, surveillance and monitoring, and public education programmes.

RESULTS

We found 60 national PA and SB policies, of which 54 focused on PA only and 6 focused on both PA and SB. There was a rapid increase in the number of policies issued between 2002 and 2021. In totality, the policies include all 17 key elements for a successful national policy approach to PA promotion according to the HEPA PAT. The policies reflect engagement from a range of sectors and encompass PA targets, recommendations for PA and SB, mandates and recommendations for school-related PA, plans for public education on PA, and plans for surveillance and monitoring of PA and SB.

CONCLUSION

Our findings demonstrate that there has been increasing focus on PA and SB policies in China, which reflects efforts by policymakers to address the health burden of insufficient PA and excessive SB. More emphasis may be placed on SB in Chinese policy, particularly in terms of setting specific targets for population SB. Policymakers and other relevant public health stakeholders in China could also consider developing or adopting the 24-hour movement guidelines, in accordance with recent trends in several other countries. Collaboration and involvement of different sectors in the development and implementation of Chinese PA and SB policies should continue to be facilitated as part of a whole-of-system approach to health promotion.

Alleviating Doctors' Emotional Exhaustion through Sports Involvement during the COVID-19 Pandemic: The Mediating Roles of Regulatory Emotional Self-Efficacy and Perceived Stress

This study aims to understand the state of emotional exhaustion of Chinese doctors during the COVID-19 pandemic, and explore the role of sports involvement in enhancing doctors' regulatory emotional self-efficacy, reducing stress perception, and alleviating emotional exhaustion. Finally, report the existing problems and make recommendations to the government and hospitals. The researchers constructed a cross-sectional questionnaire survey to collect data. From March to April 2022, using the snowball and convenience sampling methods, a total of 413 valid questionnaires were collected from 13 hospitals in Hunan Province. AMOS 23.0 was used to construct a structural equation model (SEM) with the bootstrapping approach to verify the proposed hypotheses. Doctors with more sports involvement exhibited higher levels of regulatory emotional self-efficacy and lesser perceived stress. Doctors who exhibited higher regulatory emotional self-efficacy had lesser perceived stress. The relationship between sports involvement and emotional exhaustion was mediated by perceived stress and/or regulatory emotional self-efficacy. Therefore, the government and hospitals should strengthen the depth and intensity of implementing the "National Fitness Program" at the hospital level, instead of just holding short-term activities with a small number of participants, but to cover all medical staff with fitness opportunities.