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Topical Collection Information

Dear Colleagues,

We are organizing a Topic Collection on Physical Activity and Public Health in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph.

There is compelling evidence for the importance of regular physical activity in attaining and maintaining a wide range of health outcomes across the lifespan. Active lifestyles are important for disease prevention as well as disease management and rehabilitation. Accordingly, understanding the associations of physical activity with health, as well the psychological, social, and environmental factors that shape physical activity behaviours, are urgent public health priorities. To advance our understanding and consequently develop more effective physical activity promotion, researchers in this field are continually seeking to develop improved methods of measuring physical activity and analysing raw data.

This Collection welcomes contributions across the broad field of physical activity and public health, including (but not limited to) the following topics:

  • Determinants/correlates of physical activity, as a global measure or in specific contexts such as leisure, occupation, active transport, organized sport.
  • Physical activity and disease prevention
  • Physical activity outcomes in clinical populations, including, for example, cancer survivorship and cardiac rehabilitation
  • Physical activity and mental health
  • Physical activity and cognition
  • Physical activity in ageing populations
  • Physical activity and educational attainment in children
  • Physical activity measurement: challenges and recent advances
  • Physical activity prescription for health

We will welcome contributions that: focus on children or adults; report quantitative or qualitative studies; and use cross-sectional, experimental, or cohort designs.

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the collection website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Physical activity
  • Public health
  • Adults
  • Older adults
  • Children
  • Mental health
  • Cognition
  • Correlates
  • Determinants
  • Leisure
  • Active transport
  • Sport
  • Rehabilitation
  • Measurement
  • Exercise

Published Papers (65 papers)

2023

Jump to: 2022, 2021, 2020, 2019, 2018

13 pages, 622 KiB  
Article
The Association between Adult Sport, Fitness, and Recreational Physical Activity and Number and Age of Children Present in the Household: A Secondary Analysis Using NHANES
by Jerraco L. Johnson, Ailton Coleman, Jamila L. Kwarteng, Ahondju U. Holmes, Dulcie Kermah, Marino A. Bruce and Bettina M. Beech
Int. J. Environ. Res. Public Health 2023, 20(11), 5942; https://doi.org/10.3390/ijerph20115942 - 24 May 2023
Viewed by 4065
Abstract
Only one in three adults in the United States meets the weekly recommendation for physical activity (PA). The presence of children in the home may restrict adult PA. The purpose of this study was to examine the association between adult moderate and vigorous [...] Read more.
Only one in three adults in the United States meets the weekly recommendation for physical activity (PA). The presence of children in the home may restrict adult PA. The purpose of this study was to examine the association between adult moderate and vigorous sport, fitness, and recreational physical activities and the number and age (0–5 and 6–17) of children in their household. Secondary data were drawn from the National Health and Nutrition Examination Survey (NHANES) from 2007–2016. Adults with complete survey data for self-reported moderate (MPA) and vigorous physical activities (VPA), number of children in the home, and other sociodemographic variables were included. The final sample included 2034 adults from 22–65 years of age. Analyses included ANOVAs and separate multivariable regression analyses to determine if the number of children in the household aged 0–5 and 6–17 were significant predictors of weekly moderate-to-vigorous physical activity (MVPA) after controlling for covariates. For MPA, no differences were found between adult PA regardless of the number and age of children in the home. For VPA, adults with two or more children aged 0–5 reported 80 fewer minutes of weekly VPA (p < 0.05) compared to those with no children or just one child in this age group after controlling for all covariates. Finally, adults with three or more children in the household aged 6–17 reported fifty fewer minutes of weekly VPA (p < 0.05) compared to those with no children, one, or just two in the household. These findings highlight a need to support the vigorous PA behaviors of this population, as the majority of the family-based PA intervention studies to date have primarily focused on family dyads. Full article
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2022

Jump to: 2023, 2021, 2020, 2019, 2018

9 pages, 621 KiB  
Article
30 Year Trends of Reduced Physical Fitness in Undergraduate Students Studying Human Movement
by Myles W. O’Brien, Madeline E. Shivgulam, William R. Wojcik, Brittany A. Barron, Roxanne E. Seaman and Jonathon R. Fowles
Int. J. Environ. Res. Public Health 2022, 19(21), 14099; https://doi.org/10.3390/ijerph192114099 - 28 Oct 2022
Cited by 1 | Viewed by 1300
Abstract
The physical fitness of Canadian adults has decreased over the past 30 years, while sedentary time has increased. However, it is unknown if university students studying human movement exhibit similar population declines. Physical fitness (i.e., anthropometrics, musculoskeletal fitness, and aerobic fitness) and habitual [...] Read more.
The physical fitness of Canadian adults has decreased over the past 30 years, while sedentary time has increased. However, it is unknown if university students studying human movement exhibit similar population declines. Physical fitness (i.e., anthropometrics, musculoskeletal fitness, and aerobic fitness) and habitual activity (e.g., physical activity, stationary time, etc.) was measured in a cohort of kinesiology students (Post30; 2010–2016; n = 129 males, 224 females) using standardized fitness testing and accelerometry, respectively. Physical fitness was compared to data collected on a cohort of students from the same institution and program, 30 years prior (i.e., Pre, 1984–1987, n = 103 males, 73 females). Post30 had greater waist circumference (males: 83.6 ± 9.1 cm vs. 77.8 ± 8.3 cm, females: 77.1 ± 9.7 cm vs. 70.3 ± 5.2 cm, both p < 0.001) and lower estimated maximal aerobic fitness (males: 55 ± 11 vs. 63 ± 7, females: 45 ± 10 vs. 50 ± 7 mLO2/kg/min, both, p < 0.001). Compared to Pre, male Post30 vertical jump (53.6 ± 10.2 vs. 57.0 ± 8.4 cm, p = 0.04) and female Post30 broad jump (178.7 ± 22.1 vs. 186.0 ± 15.5 cm, p < 0.001) were lower. A subsample (n = 65) of Post30 whose habitual activity was assessed, met the aerobic portion of Canadian physical activity guidelines (~400 min/week), but spent excessive amounts of time stationary (10.7 h/day). Current kinesiology students may not be immune to population decreases in physical fitness. Relative to previous group of students interested in movement, fitness was lower in our sample, potentially attributed to excessive stationary time. Regular assessment of physical fitness in kinesiology curriculums may be valuable to understand these declining trends in undergraduate students that mimic population declines in fitness. Full article
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10 pages, 711 KiB  
Article
The Influence of Motivators and Barriers to Exercise on Attaining Physical Activity and Sedentary Time Guidelines among Canadian Undergraduate Students
by Liam P. Pellerine, Nick W. Bray, Jonathon R. Fowles, Joyla A. Furlano, Anisa Morava, Taniya S. Nagpal and Myles W. O’Brien
Int. J. Environ. Res. Public Health 2022, 19(19), 12225; https://doi.org/10.3390/ijerph191912225 - 27 Sep 2022
Cited by 6 | Viewed by 2490
Abstract
Canadian 24 h movement guidelines recommend engaging in >150 min/week of moderate–vigorous-intensity physical activity and ≤8 h/day of sedentary time. Half of Canadian post-secondary students do not meet physical activity or sedentary time guidelines. This pan-Canadian study aimed to (1) identify commonly cited [...] Read more.
Canadian 24 h movement guidelines recommend engaging in >150 min/week of moderate–vigorous-intensity physical activity and ≤8 h/day of sedentary time. Half of Canadian post-secondary students do not meet physical activity or sedentary time guidelines. This pan-Canadian study aimed to (1) identify commonly cited motivators/barriers to exercise, and (2) determine which motivators/barriers were most influential for attaining physical and sedentary activity guidelines. A total of 341 respondents (279 females, 23 ± 4 years old, 53% met activity guidelines, 49% met sedentary guidelines) completed an online survey regarding undergraduate student lifestyle behaviours. Improved physical health (74% of respondents), mental health (67%), physical appearance (60%), and athletic performance (28%) were the most common motivators to exercise. The most common barriers were school obligations (68%), time commitments (58%), job obligations (32%), and lack of available fitness classes (26%). Students citing improved athletic performance (odds ratio (OR) = 1.94, p = 0.02) were more likely to adhere to activity guidelines, while those who selected physical health (OR = 0.56, p = 0.03) and physical appearance (OR = 0.46, p = 0.001) as motivators were less likely to meet activity guidelines. Students who cited school obligations as a barrier were less likely (OR = 0.59, p = 0.03) to meet sedentary guidelines. The motivators and barriers identified provide a foundation for university-led initiatives aimed at promoting physical activity and reducing sedentary time among undergraduate students. Strategies that positively re-frame students’ physical health and appearance-based motivations for exercise may be particularly useful in helping more students achieve national activity recommendations. Full article
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10 pages, 972 KiB  
Article
Health Care Providers’ Perspectives on Promoting Physical Activity and Exercise in Health Care
by Liam P. Pellerine, Myles W. O’Brien, Chris A. Shields, Sandra J. Crowell, Robert Strang and Jonathon R. Fowles
Int. J. Environ. Res. Public Health 2022, 19(15), 9466; https://doi.org/10.3390/ijerph19159466 - 02 Aug 2022
Cited by 6 | Viewed by 2197
Abstract
Health care providers (HCPs) are entrusted with providing credible health-related information to their patients/clients. Patients/clients who receive physical activity and exercise (PAE) advice from an HCP typically increase their PAE level. However, most HCPs infrequently discuss PAE or prescribe PAE, due to the [...] Read more.
Health care providers (HCPs) are entrusted with providing credible health-related information to their patients/clients. Patients/clients who receive physical activity and exercise (PAE) advice from an HCP typically increase their PAE level. However, most HCPs infrequently discuss PAE or prescribe PAE, due to the many challenges (e.g., time, low confidence) they face during regular patient care. The purpose of this study was to ascertain HCPs’ perspectives of what could be done to promote PAE in health care. HCPs (n = 341) across Nova Scotia completed an online self-reflection survey regarding their current PAE practices and ideas to promote PAE. The sample consisted of 114 physicians, 114 exercise professionals, 65 dietitians, and 48 nurses. Quantitative textual analysis (frequency of theme ÷ number of respondents) was performed to identify common themes to promote PAE in health care. In the pooled sample, the primary theme cited was to increase the availability of community programs (24.1% of respondents), followed by more educational opportunities for providers (22.5%), greater promotion of PAE from HCPs (17.1%), reducing financial barriers experienced by patients/clients (16.3%), and increasing availability of qualified exercise professionals (15.0%). Altogether, increased PAE education and greater availability of affordable community PAE programs incorporating qualified exercise professionals, would reduce barriers preventing routine PAE promotion and support the promotion of PAE in Nova Scotia. Full article
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9 pages, 321 KiB  
Article
Bibliometric Analysis of Literature on Physical Activity and COVID-19
by Apichai Wattanapisit, Manas Kotepui, Sanhapan Wattanapisit and Noah Crampton
Int. J. Environ. Res. Public Health 2022, 19(12), 7116; https://doi.org/10.3390/ijerph19127116 - 10 Jun 2022
Cited by 6 | Viewed by 1819
Abstract
The coronavirus disease 2019 (COVID-19) pandemic induced a sudden surge in COVID-19 related publications. This bibliometric analysis aimed to analyze literature on physical activity and COVID-19 published in the PubMed database. The search terms ((physical activity [MeSH Terms] OR physical inactivity [MeSH Terms]) [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic induced a sudden surge in COVID-19 related publications. This bibliometric analysis aimed to analyze literature on physical activity and COVID-19 published in the PubMed database. The search terms ((physical activity [MeSH Terms] OR physical inactivity [MeSH Terms]) AND COVID-19 [MeSH Terms]) were applied to obtain publications from the inception of PubMed to February 2022. The analyses included the year of publication, type of publication, and origin of publication by country, region, and country income. The research areas were analyzed for research articles and systematic reviews. Of 1268 articles, 143 articles were excluded, and 1125 articles were analyzed. A total of 709 articles (63.02%) were published in 2021. A majority of publications were research articles (n = 678, 60.27%). The USA (n = 176, 15.64%), countries in the European Region (n = 496, 44.09%), and high-income countries (n = 861, 76.53%) were dominant publishing countries. Of 699 research articles and systematic reviews, surveillance and trends of physical activity were the main research area, followed by health outcomes, and correlates and determinants of physical activity. There is a wide gap in publication productivity in the field of physical activity and health during the pandemic among different countries’ economic statuses. Full article

2021

Jump to: 2023, 2022, 2020, 2019, 2018

16 pages, 2227 KiB  
Article
Differences in Park Walking, Comparing the Physically Inactive and Active Groups: Data from mHealth Monitoring System in Seoul
by Youngjun Park, Sunjae Lee and Sohyun Park
Int. J. Environ. Res. Public Health 2022, 19(1), 395; https://doi.org/10.3390/ijerph19010395 - 30 Dec 2021
Cited by 2 | Viewed by 1453
Abstract
Despite the overall increase in physical activities and park uses, the discrepancies between physically inactive and active people have increasing widened in recent times. This paper aims to empirically measure the differences in walking activity in urban parks between the physically inactive and [...] Read more.
Despite the overall increase in physical activities and park uses, the discrepancies between physically inactive and active people have increasing widened in recent times. This paper aims to empirically measure the differences in walking activity in urban parks between the physically inactive and active. As for the dataset, 22,744 peoples’ 550,234 walking bouts were collected from the mHealth system of the Seoul government, using the smartphone healthcare app, WalkOn, from September to November 2019, in Seocho-gu district, Seoul, Korea. We classified the physically inactive and active sample groups, based on their regular walking (≥150 min of moderate-to-vigorous walking activity a week), and analyzed their park walking activities. We found that while there was no significant difference in walking measures of non-park walking between the sample groups, the difference did exist in park walking. The park walking average in the physically active group had more steps (p = 0.021), longer time (p = 0.008), and higher intensity (p < 0.001) of walking than that in the inactive group. Each park also revealed differences in its on-site park walking quantity and quality, based on which we could draw the list of ‘well-walked parks’, which held more bouts and more moderate-to-vigorous physical activities (MVPAs) than other parks in Seocho-gu district. This paper addresses how park walking of physically inactive and active people is associated with multiple differences in everyday urban walking. Full article
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11 pages, 615 KiB  
Article
Do Framed Mental Health Messages on Social Media Influence University Students’ Motivation for Physical Activity?
by Georgia Gilbert, Chloë Williamson, Justin Richards, Taya Annabelle Collyer and Paul Kelly
Int. J. Environ. Res. Public Health 2021, 18(16), 8671; https://doi.org/10.3390/ijerph18168671 - 17 Aug 2021
Cited by 6 | Viewed by 4034
Abstract
Message framing has been used as a strategy for promoting physical activity (PA) in university students, but the effectiveness of gain-framed (GF), or loss-framed (LF) messages is variable. This study aims to investigate the effects on motivation and PA behaviour of framed messaging [...] Read more.
Message framing has been used as a strategy for promoting physical activity (PA) in university students, but the effectiveness of gain-framed (GF), or loss-framed (LF) messages is variable. This study aims to investigate the effects on motivation and PA behaviour of framed messaging on social media in university students. Gain- and loss-framed messages communicated the mental health outcomes of PA. A three-arm feasibility study (n = 148) collected pre-post intervention online questionnaire responses to assess motivation for PA, exercise, active travel, and PA levels, in response to the messaging intervention on Facebook. Both GF and LF messages effectively increased average motivation for PA in comparison to controls (GF by 0.3 (on a 7-point Likert scale), 9% [95% CI: 3–17%], p = 0.007, LF by 0.3, 10% [CI: 3–18%], p = 0.005). Average motivation for exercise increased in comparison to controls (GF by 0.6, 16% [95% CI: 6–26%], p = 0.001, LF by 0.5, 14.6% [95% CI: 5–26%], p < 0.001). Average motivation for active travel increased in comparison to controls (GF by 0.7, 18% [95% CI: 8–29%], p < 0.001, LF by 0.6, 19% [95% CI: 8–30%], p < 0.001). No meaningful differences between GF or LF messages were observed. Framed messages regarding mental health outcomes of PA delivered via social media could be effective for increasing PA motivation in university students. However, based on our results there is no gain- or loss-framed advantage. Full article
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12 pages, 731 KiB  
Article
Parental Mental Well-Being and Frequency of Adult-Child Nature Visits: The Mediating Roles of Parents’ Perceived Barriers
by Jasmine Gustafsson, Ann Ojala, Pauliina Hiltunen, Elina Engberg, Annika Wiklund-Engblom, Nea Törnwall, Eva Roos and Carola Ray
Int. J. Environ. Res. Public Health 2021, 18(13), 6814; https://doi.org/10.3390/ijerph18136814 - 25 Jun 2021
Cited by 2 | Viewed by 3212
Abstract
Regular access to green space has been shown to provide several health benefits for children. However, children today spend less time outdoors. Thus, it has become important to understand what drives and limits children’s activities in nature. Based on a Finnish online survey [...] Read more.
Regular access to green space has been shown to provide several health benefits for children. However, children today spend less time outdoors. Thus, it has become important to understand what drives and limits children’s activities in nature. Based on a Finnish online survey of 1463 parents of children aged 2–7 conducted in 2019, the current study examined parents’ perceived barriers to visiting nature with their children. It also examined how parental mental well-being is related to families’ frequency of nature visits, and whether this association is mediated by different categories of parents’ perceived barriers. Eleven out of 12 barriers were largely perceived by parents as reasons that did not prevent them from visiting nature with their children. Next, factor analysis indicated a three-factor solution to the barriers. The results of a multiple mediation analysis showed that better parental mental well-being was associated with more frequent adult-child nature visits, and this relationship was partially mediated by a “lack of competence and logistics” and a “lack of time and interest”, but not by “insecurity and fear”. The results indicated that parents with poor mental well-being were more likely to perceive barriers to visiting nature, which in turn appeared to be related to a higher likelihood of having children who visited nature less frequently. Full article
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16 pages, 4897 KiB  
Review
Training Healthcare Professionals on How to Promote Physical Activity in the UK: A Scoping Review of Current Trends and Future Opportunities
by Jake Netherway, Brett Smith and Javier Monforte
Int. J. Environ. Res. Public Health 2021, 18(13), 6701; https://doi.org/10.3390/ijerph18136701 - 22 Jun 2021
Cited by 8 | Viewed by 3665
Abstract
What physical activity (PA) training do current and future healthcare professionals (HCPs) receive in the UK? How is PA training delivered to them? The present scoping review looks at existing evidence to respond these questions. Seven databases were searched: Medline, SportDISCUS, PsycINFO, EMBASE, [...] Read more.
What physical activity (PA) training do current and future healthcare professionals (HCPs) receive in the UK? How is PA training delivered to them? The present scoping review looks at existing evidence to respond these questions. Seven databases were searched: Medline, SportDISCUS, PsycINFO, EMBASE, CINAHL, Cochrane Review Database, and Web of Science. Grey literature sources and key stakeholders were consulted. Studies were screened for inclusion, data were extracted and charted, and findings were synthesised according to the two research questions. Of the 3535 identified studies, 25 were included. The results show that no standardised approach was used to deliver PA promotion in HCPs training. PA training content was chiefly underpinned by an epidemiological approach. Online delivery of content predominated in continuing professional development training, whereas in undergraduate healthcare curriculum, delivery strategies varied. Overall, the process of embedding PA in HCPs’ curriculum and culture is ongoing. In addition to highlighting what is present within healthcare education, this study identifies further opportunities. Potential avenues include extending PA promotion into other workforces, including social workers. Full article
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11 pages, 1084 KiB  
Article
The Impact of Post-COVID-19 Syndrome on Self-Reported Physical Activity
by Jeannet M. Delbressine, Felipe V. C. Machado, Yvonne M. J. Goërtz, Maarten Van Herck, Roy Meys, Sarah Houben-Wilke, Chris Burtin, Frits M. E. Franssen, Yvonne Spies, Herman Vijlbrief, Alex J. van ’t Hul, Daisy J. A. Janssen, Martijn A. Spruit and Anouk W. Vaes
Int. J. Environ. Res. Public Health 2021, 18(11), 6017; https://doi.org/10.3390/ijerph18116017 - 03 Jun 2021
Cited by 57 | Viewed by 8405
Abstract
Background: A subgroup of patients recovering from COVID-19 experience persistent symptoms, decreased quality of life, increased dependency on others for personal care and impaired performance of activities of daily living. However, the long-term effects of COVID-19 on physical activity (PA) in this subgroup [...] Read more.
Background: A subgroup of patients recovering from COVID-19 experience persistent symptoms, decreased quality of life, increased dependency on others for personal care and impaired performance of activities of daily living. However, the long-term effects of COVID-19 on physical activity (PA) in this subgroup of patients with persistent symptoms remain unclear. Methods: Demographics, self-reported average time spent walking per week, as well as participation in activities pre-COVID-19 and after three and six months of follow-up were assessed in members of online long-COVID-19 peer support groups. Results: Two hundred thirty-nine patients with a confirmed COVID-19 diagnosis were included (83% women, median (IQR) age: 50 (39–56) years). Patients reported a significantly decreased weekly walking time after three months of follow-up (three months: 60 (15–120) min. vs. pre-COVID-19: 120 (60–240) min./week; p < 0.05). Six months after the onset of symptoms walking time was still significantly lower compared to pre-COVID-19 but significantly increased compared to three months of follow-up (three months: 60 (15–120) min. vs. six months: 90 (30–150) min.; p < 0.05). Conclusions: Patients who experience persistent symptoms after COVID-19 may still demonstrate a significantly decreased walking time six months after the onset of symptoms. More research is needed to investigate long-term consequences and possible treatment options to guide patients during the recovery fromCOVID-19. Full article
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15 pages, 361 KiB  
Article
Impact of the COVID-19 Pandemic on Physical Activity and Sedentary Behaviour: A Qualitative Study in a Canadian City
by Jennie A. Petersen, Calli Naish, Dalia Ghoneim, Jason L. Cabaj, Patricia K. Doyle-Baker and Gavin R. McCormack
Int. J. Environ. Res. Public Health 2021, 18(9), 4441; https://doi.org/10.3390/ijerph18094441 - 22 Apr 2021
Cited by 26 | Viewed by 9759
Abstract
Public health measures introduced to combat the COVID-19 pandemic have impacted the physical activity, health, and well-being of millions of people. This grounded theory study explored how the COVID-19 pandemic has affected physical activity and perceptions of health among adults in a Canadian [...] Read more.
Public health measures introduced to combat the COVID-19 pandemic have impacted the physical activity, health, and well-being of millions of people. This grounded theory study explored how the COVID-19 pandemic has affected physical activity and perceptions of health among adults in a Canadian city (Calgary). Twelve adults (50% females; 20–70 years) were interviewed between June and October (2020) via telephone or videoconferencing. Using a maximum variation strategy, participants with a range of sociodemographic characteristics, physical activity levels, and perceptions of seriousness and anxiety related to COVID-19 were selected. Semi-structured interviews captured participant perceptions of how their physical activity and perceptions of health changed during the pandemic. Using thematic analysis, four themes were identified: (1) Disruption to Daily Routines, (2) Changes in Physical Activity, (3) Balancing Health, and (4) Family Life. Participants experienced different degrees of disruption in their daily routines and physical activity based on their individual circumstances (e.g., pre-pandemic physical activity, family life, and access to resources). Although participants faced challenges in modifying their daily routines and physical activity, many adapted. Some participants reported enhanced feelings of well-being. Public health strategies that encourage physical activity and promote health should be supported as they are needed during pandemics, such as COVID-19. Full article
5 pages, 1247 KiB  
Brief Report
Leisure-Time Physical Activity before and during Pregnancy Is Associated with Improved Insulin Resistance in Late Pregnancy
by Chenxi Cai, Zhengxiao Zhang, Samantha Mcdonald, Cody Strom, Rachel J. Skow, Linda E. May, Craig D. Steinback and Margie H. Davenport
Int. J. Environ. Res. Public Health 2021, 18(9), 4413; https://doi.org/10.3390/ijerph18094413 - 21 Apr 2021
Cited by 5 | Viewed by 2182
Abstract
A total of 83 third trimester pregnant women were recruited to examine the role of pre-pregnancy versus late-pregnancy physical activity on maternal insulin resistance. Principal component analysis plots demonstrated a distinction between the high and low Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) [...] Read more.
A total of 83 third trimester pregnant women were recruited to examine the role of pre-pregnancy versus late-pregnancy physical activity on maternal insulin resistance. Principal component analysis plots demonstrated a distinction between the high and low Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) groups. The variation was driven primarily by exercise prior to and during pregnancy. Specifically, higher levels of physical activity prior to pregnancy was associated with a lower HOMA-IR and is not modified by other variables. Women who were active prior to pregnancy were more active during pregnancy. These results suggest that being active before pregnancy may be a good strategy for mitigating the risk of insulin resistance during late pregnancy. Full article
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9 pages, 398 KiB  
Article
A 20-Year Follow-Up Study of Objectively Measured Physical Activity
by Anders Raustorp and Andreas Fröberg
Int. J. Environ. Res. Public Health 2021, 18(6), 3076; https://doi.org/10.3390/ijerph18063076 - 17 Mar 2021
Cited by 2 | Viewed by 1595
Abstract
Background: The objectives of this study were to explore the effect of time, long-term tracking, and the proportion of objectively measured physical activity (PA) from early adolescence to the mid-thirties. Methods: PA was measured as mean steps per day (SPD) with pedometers during [...] Read more.
Background: The objectives of this study were to explore the effect of time, long-term tracking, and the proportion of objectively measured physical activity (PA) from early adolescence to the mid-thirties. Methods: PA was measured as mean steps per day (SPD) with pedometers during 2000 (T1), 2003 (T2), 2005 (T3), 2010 (T4), 2016 (T5) and 2020 (T6). Data from 64 participants (n = 32 males) were analysed from their early adolescence (T1) to their mid-thirties (T6). Results: SPD decreased in the total sample and among males and females (all, p < 0.001). Males took more mean SPD than females during T1 (p = 0.002), whereas females took more mean SPD during T2 (p = 0.009) and T6 (p = 0.008). Males’ mean SPD tracked between T1 and T2 (p = 0.021), T2 and T3 (p = 0.030), T3 and T4 (p = 0.015) and T4 and T5 (p = 0.003). Females’ mean SPD tracked between T3 and T4 (p = 0.024) and T5 and T6 (p < 0.001). In the total sample, more mean SPD were found on weekdays compared to weekend days at T3 (p = 0.017) and T5 (p < 0.001). Conclusions: SPD decreased between T1 and T6. Mean SPD tracked low-to-moderate in the short time span. From late adolescence to the mid-thirties, more mean SPD was observed during weekdays compared to weekend days. Full article
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11 pages, 559 KiB  
Article
Physical Activity during the First COVID-19-Related Lockdown in Italy
by Eszter Füzéki, Jan Schröder, Nicolò Carraro, Laura Merlo, Rüdiger Reer, David A. Groneberg and Winfried Banzer
Int. J. Environ. Res. Public Health 2021, 18(5), 2511; https://doi.org/10.3390/ijerph18052511 - 03 Mar 2021
Cited by 18 | Viewed by 2886
Abstract
The spread of the COVID-19 virus was met by a strict lockdown in many countries around the world, with the closure of all physical activity (PA) facilities and limitations on moving around freely. The aim of the present online survey was to assess [...] Read more.
The spread of the COVID-19 virus was met by a strict lockdown in many countries around the world, with the closure of all physical activity (PA) facilities and limitations on moving around freely. The aim of the present online survey was to assess the effect of lockdown on physical activity in Italy. Physical activity was assessed using the European Health Interview Survey questionnaire. A total of 1500 datasets were analyzed. Differences between conditions were tested with a chi2-based (χ2) test for categorical variables, and with the Student’s t-test for paired data. A fixed effects binary logistic regression analysis was conducted to identify relevant predictor variables to explain the compliance with World Health Organisation (WHO) recommendations. We found a substantial decline in all physical activity measures. Mean differences in walking and cycling metabolic equivalent of task minutes per week (METmin/week), respectively, were 344.4 (95% confidence interval (95% CI): 306.6–382.2; p < 0.001) and 148.5 (95% CI: 123.6–173.5; p < 0.001). Time spent in leisure time decreased from 160.8 to 112.6 min/week (mean difference 48.2; 95% CI: 40.4–56.0; p < 0.001). Compliance with WHO recommendations decreased from 34.9% to 24.6% (chi2 (1, 3000) = 38.306, p < 0.001, V = 0.11). Logistic regression showed a reduced chance (OR 0.640, 95% CI: 0.484–0.845; p = 0.001) to comply with WHO PA recommendations under lockdown conditions. Measures to promote physical activity should be intensified to limit detrimental health effects. Full article
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13 pages, 1073 KiB  
Article
Neighborhood Environmental Factors and Physical Activity Status among Rural Older Adults in Japan
by Kenta Okuyama, Takafumi Abe, Xinjun Li, Yuta Toyama, Kristina Sundquist and Toru Nabika
Int. J. Environ. Res. Public Health 2021, 18(4), 1450; https://doi.org/10.3390/ijerph18041450 - 04 Feb 2021
Cited by 4 | Viewed by 2300
Abstract
(1) Background: Although several neighborhood environmental factors have been identified to be associated with older adults’ physical activity, little research has been done in rural areas where the population is aging. This study aimed to investigate neighborhood environmental factors and the longitudinal change [...] Read more.
(1) Background: Although several neighborhood environmental factors have been identified to be associated with older adults’ physical activity, little research has been done in rural areas where the population is aging. This study aimed to investigate neighborhood environmental factors and the longitudinal change of physical activity status among rural older adults in Japan. (2) Methods: The study included 2211 older adults, aged over 60 years, residing in three municipalities in Shimane prefecture and participating at least twice in annual health checkups between 2010 and 2019. Physical activity was identified based on self-report. Hilliness, bus stop density, intersection density, residential density, and distance to a community center were calculated for each subject. Hazard ratios for the incidence of physical inactivity were estimated using Cox proportional hazards models. (3) Results: We found that 994 (45%) of the study subjects became physically inactive during the follow-up. Those living far from a community center had a lower risk of becoming physically inactive compared to those living close to a community center. When the analysis was stratified by residential municipality, this association remained in Ohnan town. Those living in hilly areas had a higher risk of becoming physically inactive in Okinoshima town. (4) Conclusions: The impact of neighborhood environmental factors on older adults’ physical activity status might differ by region possibly due to different terrain and local lifestyles. Full article
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11 pages, 321 KiB  
Article
Student-Led Motivational Interviewing for Physical Activity Promotion among Rural Adults: A Feasibility and Acceptability Trial
by Jenelle Dziano, Emma Milanese, Svetlana Bogomolova and James Dollman
Int. J. Environ. Res. Public Health 2021, 18(3), 1308; https://doi.org/10.3390/ijerph18031308 - 01 Feb 2021
Cited by 2 | Viewed by 3158
Abstract
In many countries, rural residents have lower life expectancies and poorer health outcomes than urban residents. Adults living in rural Australia have lower physical activity levels than major city counterparts, contributing to this observed health disparity. As physical activity interventions in rural populations [...] Read more.
In many countries, rural residents have lower life expectancies and poorer health outcomes than urban residents. Adults living in rural Australia have lower physical activity levels than major city counterparts, contributing to this observed health disparity. As physical activity interventions in rural populations have shown minimal success, there is an urgent need for innovative and affordable interventions that facilitate active lifestyles in this vulnerable population. This study assessed the feasibility of physical activity-focused motivational interviewing, delivered by university health sciences undergraduates in a rural Australian region. “Health age” was assessed at baseline (n = 62) from physiological and behavioral measures, immediately followed by the motivational interview, with health age again assessed at 8 weeks follow-up. Mixed methods using a questionnaire (n = 41 at both time points) and one-on-one interview (n = 8) identified aspects of intervention acceptability and feasibility. A large majority rated the motivational interview as meaningful (98%), empathetic (96%), autonomy-focused (88%), and likely to lead to sustained behavior change (98%). Interviews highlighted several potential attitudinal and structural factors that might influence long-term behavior change. Further development of this strategy in rural regions will depend on a deeper understanding of individuals’ and communities’ awareness, attitudes, and beliefs in relation to active lifestyles. Full article
14 pages, 390 KiB  
Article
Home-Based Stair Climbing as an Intervention for Disease Risk in Adult Females; A Controlled Study
by Elpida Michael, Michael J. White and Frank F. Eves
Int. J. Environ. Res. Public Health 2021, 18(2), 603; https://doi.org/10.3390/ijerph18020603 - 12 Jan 2021
Cited by 12 | Viewed by 4658
Abstract
Cardiovascular disease and the metabolic syndrome are major contributors to health care expenditure. Increased physical activity reduces disease risk. The study compared effects of walking up and down stairs at home with continuous, gym-based stair climbing on the disease risk factors of aerobic [...] Read more.
Cardiovascular disease and the metabolic syndrome are major contributors to health care expenditure. Increased physical activity reduces disease risk. The study compared effects of walking up and down stairs at home with continuous, gym-based stair climbing on the disease risk factors of aerobic fitness, serum lipids, body composition, fasting blood glucose, and resting cardiovascular variables. Sedentary women (31.7 ± 1.4 years) were randomly assigned to home-based (n = 26) or gym-based (n = 24) climbing for five days.week−1 over an eight-week period. Each ascent required a 32.8-m climb, with home-based climbing matching the vertical displacement in the gym. Participants progressed from two ascents.day−1 to five ascents.day−1 in weeks 7 and 8. Relative to controls, stair climbing improved aerobic fitness (V˙O2max +1.63 mL.min−1.kg−1, 95% CI = 1.21–2.05), body composition (weight −0.99 kg, 95% CI = 1.38–0.60), and serum lipids (LDL cholesterol −0.20 mmol.L−1, 95% CI = 0.09–0.31; triglycerides −0.21 mmol.L−1, 95% CI = 0.15–0.27), with similar risk reductions for home and gym-based groups. Only the home-based protocol reduced fasting blood glucose. Discussion focuses on stair climbing bouts as time-efficient exercise and the potential benefits of a home-based intervention. Stair use at home offers a low-cost intervention for disease risk reduction to public health. Full article

2020

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15 pages, 1083 KiB  
Article
What Keeps Them Physically Active? Predicting Physical Activity, Motor Competence, Health-Related Fitness, and Perceived Competence in Irish Adolescents after the Transition from Primary to Second-Level School
by Una Britton, Johann Issartel, Jennifer Symonds and Sarahjane Belton
Int. J. Environ. Res. Public Health 2020, 17(8), 2874; https://doi.org/10.3390/ijerph17082874 - 21 Apr 2020
Cited by 28 | Viewed by 4332
Abstract
Physical activity (PA) decreases with age. The school transition is noted for significant changes in PA behaviour. Motor competence (MC), health-related fitness (HRF), and perceived competence (PC) are generally positively associated with PA. The aim of this study was to examine longitudinal cross-lagged [...] Read more.
Physical activity (PA) decreases with age. The school transition is noted for significant changes in PA behaviour. Motor competence (MC), health-related fitness (HRF), and perceived competence (PC) are generally positively associated with PA. The aim of this study was to examine longitudinal cross-lagged relationships between PA, MC, HRF, and PC across the school transition from final year of primary school to first year of second-level school in Irish youth. PA (accelerometery), object-control and locomotor MC (TGMD-III), PC (perceived athletic competence subscale of the Self-Perception Profile for Adolescents), and HRF (20 m shuttle run, horizontal jump, vertical jump, push-ups, curl-ups) were measured in final year of primary school (6th class) and first year of second-level school (1st year). In the sixth class, 261 participants (53% female; mean age 12.22 ± 0.48 years) were tested. In first year, 291 participants (48% female; mean age: 13.20 ± 0.39 years) were tested. In total, 220 participants were involved in the study at both timepoints. Cross-lagged regression in AMOS23, using full information maximum likelihood estimation, was conducted to test reciprocal and predictive pathways between variables. The full cross-lagged model showed acceptable fit (χ2 = 69.12, df = 8, p < 0.01, NFI = 0.93, CFI = 0.94). HRF was the strongest predictor of future PA (β = 0.353), and also predicted PC (β = 0.336) and MC (β = 0.163). Object-control MC predicted future PA (β = 0.192). Reciprocal relationships existed between object-control MC and PA, and between object-control MC and PC. HRF was the strongest predictor of PA. Object-control MC also predicted PA. PA promotion strategies should target the development of HRF and object-control MC in primary school to reduce the decline in PA frequently observed after the school transition. Full article
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10 pages, 354 KiB  
Article
Prevalence and Factors Associated with Thinness in Rural Polish Children
by Agnieszka Suder, Paweł Jagielski, Beata Piórecka, Małgorzata Płonka, Karol Makiel, Matylda Siwek, Iwona Wronka and Mariusz Janusz
Int. J. Environ. Res. Public Health 2020, 17(7), 2368; https://doi.org/10.3390/ijerph17072368 - 31 Mar 2020
Cited by 6 | Viewed by 2515
Abstract
A lot of attention has been focused on obesity, however, the other extreme—thinness—may lead to inhibition of physical and intellectual development. The aim was to assess the prevalence of thinness and determine the associated factors in children from rural populations. We used data [...] Read more.
A lot of attention has been focused on obesity, however, the other extreme—thinness—may lead to inhibition of physical and intellectual development. The aim was to assess the prevalence of thinness and determine the associated factors in children from rural populations. We used data from the cross-sectional sample of 3048 children, examined in schools from a district in southern Poland. The sample included 89% of the district departments, and included a proportion of rural and small town populations—a representative one for the region. Thinness was determined based on the criteria proposed by Cole and Lobstein. Biological, sociodemographic and lifestyle factors were analysed. The odds ratio (OR) and 95% confidence interval (CI) were calculated using logistic regression analysis. The prevalence of thinness was 11.5% in boys and 13.5% in girls. In the younger group, it was similar in boys and girls at 11.8%; whereas in the older group, it was 11.1% and 14.5%, respectively. The prevalence of thinness Grade 3 in girls was two times higher than in boys. The increased index of leisure time physical activity was connected with thinness in prepubertal boys. The mechanism determining the development of thinness is very complex and further exploration of this trend is recommended. Full article
14 pages, 322 KiB  
Article
Dog Ownership and Walking: Perceived and Audited Walkability and Activity Correlates
by Barbara B. Brown and Wyatt A. Jensen
Int. J. Environ. Res. Public Health 2020, 17(4), 1385; https://doi.org/10.3390/ijerph17041385 - 21 Feb 2020
Cited by 14 | Viewed by 3209
Abstract
Few studies assess dog ownership and walking with both self-reported or perceived and audited or objective walkability and physical activity measures. Across two years, we examined both types of walkability and activity measures for residents living within 2km of a “complete street”—one renovated [...] Read more.
Few studies assess dog ownership and walking with both self-reported or perceived and audited or objective walkability and physical activity measures. Across two years, we examined both types of walkability and activity measures for residents living within 2km of a “complete street”—one renovated with light rails, bike lanes, and sidewalks. Audited walkability (Irvine–Minnesota Inventory) was more consistently related to dog ownership and walking groups than perceived walkability (Neighborhood Environment Walkability Scale—Abbreviated). Self-reported leisure walking was much higher (289–383 min per week) among dog walkers than among other groups (100–270 min per week), despite no difference in accelerometer-measured light or moderate-to-vigorous physical activity (MVPA). Furthermore, the most powerful difference between groups involved single-family detached home residence, which was much lower among non-dog-owners (44%) than among non-dog-walkers or dog walkers (81% and 70%, respectively). Given discrepancies across walkability and activity measures, we recommend future use of walkability audits and objectively measured physical activity over the current emphasis on self-report measures. We also urge greater attention to increased densities of housing, which may negatively affect dog ownership levels unless compensating supports for dog ownership and walking are created by public health messaging, dog-friendly policies, and dog-friendly housing and community design. Full article
15 pages, 502 KiB  
Article
How Health Promoters Can Assess Capacity Building Processes in Setting-Based Approaches—Development and Testing of a Monitoring Instrument
by Alexandra Sauter, Verena Lindacher, Jana Rueter, Janina Curbach and Julika Loss
Int. J. Environ. Res. Public Health 2020, 17(2), 407; https://doi.org/10.3390/ijerph17020407 - 08 Jan 2020
Cited by 7 | Viewed by 2860
Abstract
Background: Health promoters often use stakeholder groups to jointly plan and implement local interventions. Stakeholder groups should take over responsibility to later run the health promotion program independently. Monitoring this process of capacity building can help health promoters improve the quality of [...] Read more.
Background: Health promoters often use stakeholder groups to jointly plan and implement local interventions. Stakeholder groups should take over responsibility to later run the health promotion program independently. Monitoring this process of capacity building can help health promoters improve the quality of the process. Instruments for the systematic assessment of capacity building among stakeholder groups are scarce. The goal of this study was to develop, and pilot test a generic assessment instrument for setting-based capacity building. Methods: We drafted a semi-standardized monitoring instrument to be used in stakeholder groups in various settings. This “EVA-protocol” (short for evaluation protocol) was based on capacity building domains e.g., leadership, resource mobilization. It was pilot implemented in a research network on increasing an active lifestyle in various settings. The respective health promoters documented 78 meetings of 15 different stakeholder groups. We performed feedback interviews and member checking among the facilitating health promoters, asking for comprehensibility, length, usability and perceived benefits of the instrument. Findings: Data collected in the “EVA-protocol” helped the facilitating health promoters understand the development of competences and capacities in the stakeholder groups and identify factors that favor or hinder the capacity building process. The instrument was rated as user friendly, but it was remarked that it is best filled out by two persons and reflected upon by those to offer the greatest benefit. Not all projects could afford this procedure due to lack of time/staff resources. Conclusions: The drafted instrument can serve as quality management tool for health promoters who facilitate participatory stakeholder groups in different settings and intend to build capacities for sustainable health promotion structures. Full article
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2019

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11 pages, 285 KiB  
Article
Changes in Physical Activity Behaviour and Psychosocial Correlates Unique to the Transition from Primary to Secondary Schooling in Adolescent Females: A Longitudinal Cohort Study
by Kate Ridley and James Dollman
Int. J. Environ. Res. Public Health 2019, 16(24), 4959; https://doi.org/10.3390/ijerph16244959 - 06 Dec 2019
Cited by 5 | Viewed by 2694
Abstract
Few studies have investigated physical activity changes over the transition from primary to secondary school. This study assessed change in physical activity and the psychosocial correlates across 12 months in two cohorts of adolescent girls, who were either in primary school in year [...] Read more.
Few studies have investigated physical activity changes over the transition from primary to secondary school. This study assessed change in physical activity and the psychosocial correlates across 12 months in two cohorts of adolescent girls, who were either in primary school in year 1, moving to secondary school in year 2 (Transition cohort) or an older cohort (Secondary cohort) who remained in early secondary school. Female adolescents (n = 191; 38% response rate) in South Australia self-reported physical activity and psychosocial correlates of physical activity. Changes between baseline and 12-month follow-up were assessed using paired t-tests. Multiple regression modelling identified psychosocial predictors of physical activity change. Physical activity declined in the transition but not the secondary cohort. The decline was most pronounced during school break times. Independent predictors of physical activity change were: change in enjoyment in the transition cohort; and changes in enjoyment, perceived outcomes, and friend encouragement in the secondary cohort. Transitioning from primary to secondary school is a critical period during which physical activity typically declines, particularly among females. Effective physical activity promotion in this vulnerable group will depend on a deeper understanding of the sociocultural, curricular and environmental influences on physical activity that are unique to each school context. Full article
21 pages, 413 KiB  
Article
Associations between the Home Physical Environment and Children’s Home-Based Physical Activity and Sitting
by Michael P. Sheldrick, Clover Maitland, Kelly A. Mackintosh, Michael Rosenberg, Lucy J. Griffiths, Richard Fry and Gareth Stratton
Int. J. Environ. Res. Public Health 2019, 16(21), 4178; https://doi.org/10.3390/ijerph16214178 - 29 Oct 2019
Cited by 21 | Viewed by 5421
Abstract
It is important to understand the correlates of children’s physical activity (PA) and sitting at home, where children spend significant time. The home social environment has an important influence; however, much less is known about the home physical environment. Therefore, the study aimed [...] Read more.
It is important to understand the correlates of children’s physical activity (PA) and sitting at home, where children spend significant time. The home social environment has an important influence; however, much less is known about the home physical environment. Therefore, the study aimed to assess relationships between the physical environment and children’s sitting and PA at home. In total, 235 child-parent dyads were included in the analyses. Children spent 67% of their time at home sitting. Linear regression analyses examined associations between physical home environmental factors obtained via an audit and children’s (55% girl, 10.2 ± 0.7) objective PA and sitting at home. Following adjustment for socio-demographics and social environmental factors, an open plan living area (OPLA), musical instrument accessibility and availability, and perceived house size were negatively and positively associated, whereas media equipment accessibility and availability was positively and negatively associated with sitting and standing, respectively. Additionally, an OPLA was positively associated with total and moderate-to-vigorous PA. Furthermore, sitting breaks were positively associated with objective garden size and negatively associated with digital TV. The physical home environment may have an important influence on children’s sitting, standing and PA at home; therefore, interventions that target this environment are needed. Full article
12 pages, 4145 KiB  
Article
Enjoyment and Intensity of Physical Activity in Immersive Virtual Reality Performed on Innovative Training Devices in Compliance with Recommendations for Health
by Małgorzata Dębska, Jacek Polechoński, Arkadiusz Mynarski and Piotr Polechoński
Int. J. Environ. Res. Public Health 2019, 16(19), 3673; https://doi.org/10.3390/ijerph16193673 - 30 Sep 2019
Cited by 58 | Viewed by 5410
Abstract
The aim of the study is to assess the enjoyment and intensity of physical exercise while practicing physical activity (PA) in immersive virtual reality (IVR) using innovative training devices (omni-directional Omni treadmill and Icaros Pro flight simulator). The study also contains the results [...] Read more.
The aim of the study is to assess the enjoyment and intensity of physical exercise while practicing physical activity (PA) in immersive virtual reality (IVR) using innovative training devices (omni-directional Omni treadmill and Icaros Pro flight simulator). The study also contains the results of subjective research on the usefulness of such a form of PA in the opinion of users. In total, 61 adults (10 women and 51 men) took part in the study. To assess the enjoyment level (EL) Interest/Enjoyment subscale of Intrinsic Motivation Inventory (IMI) was used. Exercise intensity was assessed during 10-min sessions of active video games (AVGs) in IVR based on heart rate (HR). The average enjoyment level during physical exercise in IVR on the tested training devices was high (Omni 5.74 points, Icaros 5.60 points on a 1–7 Likert scale) and differed significantly in favor of PA on Omni. In the opinion of the majority of participants, AVGs in IVR on the tested devices constitute a sufficiently useful form of PA to meet the needs of leisure time activities, and they can even replace some forms of physical effort performed in a classic way. The intensity of PA during games on training devices was at the level recommended for health benefits for 80.55% (Omni) and 50.77% (Icaros Pro) of its duration. Based on the conducted research, it can be assumed that AVGs in IVR using a multi-directional treadmill and a flight simulator can be an effective tool for increasing participation in health-oriented PA. Full article
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17 pages, 723 KiB  
Article
Equity-Specific Effects of Interventions to Promote Physical Activity among Middle-Aged and Older Adults: Development of a Collaborative Equity-Specific Re-Analysis Strategy
by Gesa Czwikla, Filip Boen, Derek G. Cook, Johan de Jong, Tess Harris, Lisa K. Hilz, Steve Iliffe, Richard Morris, Saskia Muellmann, Denise A. Peels, Claudia R. Pischke, Benjamin Schüz, Martin Stevens, Frank J. van Lenthe, Julie Vanderlinden and Gabriele Bolte
Int. J. Environ. Res. Public Health 2019, 16(17), 3195; https://doi.org/10.3390/ijerph16173195 - 01 Sep 2019
Cited by 7 | Viewed by 3361
Abstract
Reducing social inequalities in physical activity (PA) has become a priority for public health. However, evidence concerning the impact of interventions on inequalities in PA is scarce. This study aims to develop and test the application of a strategy for re-analyzing equity-specific effects [...] Read more.
Reducing social inequalities in physical activity (PA) has become a priority for public health. However, evidence concerning the impact of interventions on inequalities in PA is scarce. This study aims to develop and test the application of a strategy for re-analyzing equity-specific effects of existing PA intervention studies in middle-aged and older adults, as part of an international interdisciplinary collaboration. This article aims to describe (1) the establishment and characteristics of the collaboration; and (2) the jointly developed equity-specific re-analysis strategy as a first result of the collaboration. To develop the strategy, a collaboration based on a convenience sample of eight published studies of individual-level PA interventions among the general population of adults aged ≥45 years was initiated (UK, n = 3; The Netherlands, n = 3; Belgium, n = 1; Germany, n = 1). Researchers from these studies participated in a workshop and subsequent e-mail correspondence. The developed strategy will be used to investigate social inequalities in intervention adherence, dropout, and efficacy. This will allow for a comprehensive assessment of social inequalities within intervention benefits. The application of the strategy within and beyond the collaboration will help to extend the limited evidence regarding the effects of interventions on social inequalities in PA among middle-aged and older adults. Full article
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15 pages, 970 KiB  
Article
Calibration of Self-Reported Time Spent Sitting, Standing and Walking among Office Workers: A Compositional Data Analysis
by David M. Hallman, Svend Erik Mathiassen, Allard J. van der Beek, Jennie A. Jackson and Pieter Coenen
Int. J. Environ. Res. Public Health 2019, 16(17), 3111; https://doi.org/10.3390/ijerph16173111 - 27 Aug 2019
Cited by 17 | Viewed by 3742
Abstract
We developed and evaluated calibration models predicting objectively measured sitting, standing and walking time from self-reported data using a compositional data analysis (CoDA) approach. A total of 98 office workers (48 women) at the Swedish Transport Administration participated. At baseline and three-months follow-up, [...] Read more.
We developed and evaluated calibration models predicting objectively measured sitting, standing and walking time from self-reported data using a compositional data analysis (CoDA) approach. A total of 98 office workers (48 women) at the Swedish Transport Administration participated. At baseline and three-months follow-up, time spent sitting, standing and walking at work was assessed for five working days using a thigh-worn accelerometer (Actigraph), as well as by self-report (IPAQ). Individual compositions of time spent in the three behaviors were expressed by isometric log-ratios (ILR). Calibration models predicting objectively measured ILRs from self-reported ILRs were constructed using baseline data, and then validated using follow-up data. Un-calibrated self-reports were inaccurate; root-mean-square (RMS) errors of ILRs for sitting, standing and walking were 1.21, 1.24 and 1.03, respectively. Calibration reduced these errors to 36% (sitting), 40% (standing), and 24% (walking) of those prior to calibration. Calibration models remained effective for follow-up data, reducing RMS errors to 33% (sitting), 51% (standing), and 31% (walking). Thus, compositional calibration models were effective in reducing errors in self-reported physical behaviors during office work. Calibration of self-reports may present a cost-effective method for obtaining physical behavior data with satisfying accuracy in large-scale cohort and intervention studies. Full article
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22 pages, 39407 KiB  
Article
Comfort and Time-Based Walkability Index Design: A GIS-Based Proposal
by Tarek Al Shammas and Francisco Escobar
Int. J. Environ. Res. Public Health 2019, 16(16), 2850; https://doi.org/10.3390/ijerph16162850 - 09 Aug 2019
Cited by 28 | Viewed by 5707
Abstract
Encouraging people to walk as a means of transport throughout their daily lives has obvious benefits for the environment, the economy, and personal health. Specific features of the built environment have a significant influence on encouraging or discouraging walking. By identifying and quantifying [...] Read more.
Encouraging people to walk as a means of transport throughout their daily lives has obvious benefits for the environment, the economy, and personal health. Specific features of the built environment have a significant influence on encouraging or discouraging walking. By identifying and quantifying these features we can design Walkability Indices (WI). The WI in the literature do not take factors related to comfort such as noise pollution and shade/sun conditions into account. Given the importance of these factors in walking, we decided to include them in our design of a new geographic information system (GIS)-based WI. The relative weight of each factor was determined by consulting experts. The proposed WI, computed for the entire city of Madrid, Spain, uses sections of the sidewalk as the spatial unit. The properties of this WI (based on secondary sources, spatially detailed, dynamic, weighted, and including comfort-related factors) fill a gap in previous WI proposals. Full article
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11 pages, 309 KiB  
Article
Popularity and Friendships and Their Relationship to Physical Activity Before and After Transition to a Higher School Grade
by Kenda C. Swanson, Alberto Nettel-Aguirre and Gavin R. McCormack
Int. J. Environ. Res. Public Health 2019, 16(15), 2782; https://doi.org/10.3390/ijerph16152782 - 03 Aug 2019
Cited by 4 | Viewed by 2899
Abstract
Background This study investigated the relationships between children’s friendship ties and their physical activity (PA) both before and after their transition to a new school year. Methods In 2011–2012, children in grades 5–8 attending a Canadian urban middle-school completed web-based health and friendship [...] Read more.
Background This study investigated the relationships between children’s friendship ties and their physical activity (PA) both before and after their transition to a new school year. Methods In 2011–2012, children in grades 5–8 attending a Canadian urban middle-school completed web-based health and friendship surveys two times before (“pre-transition”) and three times after (“post-transition”) they moved up in school grade. Cross-sectional associations between an average daily frequency of ≥60 min/day of moderate-to-vigorous intensity PA (MVPA) and characteristics of children’s friendships were estimated for pre-transition (n = 191) and post-transition (n = 255) data. Sociodemographic-adjusted linear regression (β) estimated associations between a child’s MVPA and friendship characteristics. Results We found positive associations between a child’s MVPA and the average MVPA of their friends at post-transition only (β = 0.61, 95% CI 0.10 to 1.13) and the number of sent friendships at pre-transition (β = 0.03, 95% CI 0.01 to 0.05) and post-transition (β = 0.02, 95% CI 0.01 to 0.04). A statistically significant interaction between popularity and friends’ average PA at pre-transition was also found. Conclusions The PA of friends and the number of school friends that a child identified are positively associated with MVPA. The estimated associations between MVPA and aspects of children’s friendships are similar for boys and girls. Full article
15 pages, 922 KiB  
Article
Familial Environment and Overweight/Obese Adolescents’ Physical Activity
by Nicole S. Carbert, Mariana Brussoni, Josie Geller and Louise C. Mâsse
Int. J. Environ. Res. Public Health 2019, 16(14), 2558; https://doi.org/10.3390/ijerph16142558 - 17 Jul 2019
Cited by 11 | Viewed by 3752
Abstract
(1) Background: Family environments can impact obesity risk among adolescents. Little is known about the mechanisms by which parents can influence obesity-related adolescent health behaviours and specifically how parenting practices (e.g., rules or routines) and/or their own health behaviours relate to their adolescent’s [...] Read more.
(1) Background: Family environments can impact obesity risk among adolescents. Little is known about the mechanisms by which parents can influence obesity-related adolescent health behaviours and specifically how parenting practices (e.g., rules or routines) and/or their own health behaviours relate to their adolescent’s behaviours. The primary aim of the study explored, in a sample of overweight/obese adolescents, how parenting practices and/or parental modeling of physical activity (PA) behaviours relate to adolescents’ PA while examining the moderating role of parenting styles and family functioning. (2) Methods: A total of 172 parent-adolescent dyads completed surveys about their PA and wore an accelerometer for eight days to objectively measure PA. Parents completed questionnaires about their family functioning, parenting practices, and styles (authoritative and permissive). Path analysis was used for the analyses. (3) Results: More healthful PA parenting practices and parental modeling of PA were both associated with higher levels of adolescents’ self-reported moderate-vigorous physical activity (MVPA). For accelerometer PA, more healthful PA parenting practices were associated with adolescents’ increased MVPA when parents used a more permissive parenting style. (4) Conclusions: This study suggests that parenting practices and parental modeling play a role in adolescent’s PA. The family’s emotional/relational context also warrants consideration since parenting style moderated these effects. This study emphasizes the importance of incorporating parenting styles into current familial interventions to improve their efficacy. Full article
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10 pages, 478 KiB  
Article
Longer, More Active Commute, but Still not Very Active: Five-Year Physical Activity and Travel Behavior Change in a University Population
by Lina Engelen, Erika Bohn-Goldbaum, Melanie Crane, Martin Mackey and Chris Rissel
Int. J. Environ. Res. Public Health 2019, 16(13), 2420; https://doi.org/10.3390/ijerph16132420 - 08 Jul 2019
Cited by 4 | Viewed by 3164
Abstract
Active travel can support the achievement of recommended levels of physical activity. Monitoring travel behavior of university students and staff provides a useful insight into patterns of regional travel and population level changes in physical activity. This study sought to evaluate current travel [...] Read more.
Active travel can support the achievement of recommended levels of physical activity. Monitoring travel behavior of university students and staff provides a useful insight into patterns of regional travel and population level changes in physical activity. This study sought to evaluate current travel and physical activity behaviors in a university population and to determine whether these changed over time. An online survey of travel behavior and physical activity was conducted at the University of Sydney, Australia. The survey was actively promoted for three weeks prior to the release of the survey among staff and students, which asked about travel behavior on a specific day in September 2017. The survey questions were the same as those used in a similar online survey conducted across the University in 2012. In total, 4359 People completed the survey, representing 10.8% of staff and 4.1% of students. Approximately two thirds of survey respondents were students, in both the 2012 and 2017 surveys. Compared with 2012, there was an increase in active travel to the University in 2017 from increased walking and train travel. Compared to 2012, in 2017 there was an increase in average minutes walked by about nine minutes, and less time spent sitting. Trip lengths increased, with 68% of trips taking longer than 30 min in 2017. The amount of time spent in low–moderate levels physical activity increased between 2012 and 2017, potentially related to active travel behavior. Citywide changes towards a system-wide transport fare structure was the biggest change in the transport environment between the two surveys and may have contributed to increased train travel. Full article
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11 pages, 503 KiB  
Article
Influence of Physical Education Teachers on Motivation, Embarrassment and the Intention of Being Physically Active During Adolescence
by Rubén Trigueros, José M. Aguilar-Parra, Adolfo J. Cangas, Remedios López-Liria and Joaquín F. Álvarez
Int. J. Environ. Res. Public Health 2019, 16(13), 2295; https://doi.org/10.3390/ijerph16132295 - 28 Jun 2019
Cited by 36 | Viewed by 6184
Abstract
According to a WHO report (2018), more than 80% of adolescents do not do enough physical activity. Physical Education (PE) classes should be aimed at solving this problem. The present study aims to analyze the influence teachers have on motivation, embarrassment and intention [...] Read more.
According to a WHO report (2018), more than 80% of adolescents do not do enough physical activity. Physical Education (PE) classes should be aimed at solving this problem. The present study aims to analyze the influence teachers have on motivation, embarrassment and intention to be physically active among their students. A total of 604 secondary school students participated in the study. Various statistical analyses were carried out to explain the causal relationships between the variables. The results revealed a positive relation between the autonomy support and the satisfaction of basic psychological needs (BPN), and a negative relation with the frustration of BPN. In contrast, perceived control revealed a positive relation with frustration of BPN, and a negative relation with the satisfaction of BPN. Satisfaction of BPN was negatively related to embarrassment and positively related to self-determined motivation. On the other hand, frustration of BPN was positively related to embarrassment and negatively with self-determined motivation. Embarrassment was negatively related to self-determined motivation, and the latter was positively related to intention to be physically active. Indeed, the study demonstrates the influence and the importance of PE teachers and of the motivational and emotional processes of adolescents during PE classes and the role they play in acquiring the habits of an active lifestyle. Full article
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18 pages, 509 KiB  
Article
Do Differences in Social Environments Explain Gender Differences in Recreational Walking across Neighbourhoods?
by Fatima Ghani, Jerome N Rachele, Venurs HY Loh, Simon Washington and Gavin Turrell
Int. J. Environ. Res. Public Health 2019, 16(11), 1980; https://doi.org/10.3390/ijerph16111980 - 04 Jun 2019
Cited by 5 | Viewed by 4512
Abstract
Within a city, gender differences in walking for recreation (WfR) vary significantly across neighbourhoods, although the reasons remain unknown. This cross-sectional study investigated the contribution of the social environment (SE) to explaining such variation, using 2009 data from the How Areas in Brisbane [...] Read more.
Within a city, gender differences in walking for recreation (WfR) vary significantly across neighbourhoods, although the reasons remain unknown. This cross-sectional study investigated the contribution of the social environment (SE) to explaining such variation, using 2009 data from the How Areas in Brisbane Influence healTh and AcTivity (HABITAT) study, including 7866 residents aged 42–67 years within 200 neighbourhoods in Brisbane, Australia (72.6% response rate). The analytical sample comprised 200 neighbourhoods and 6643 participants (mean 33 per neighbourhood, range 8–99, 95% CI 30.6–35.8). Self-reported weekly minutes of WfR were categorised into 0 and 1–840 mins. The SE was conceptualised through neighbourhood-level perceptions of social cohesion, incivilities and safety from crime. Analyses included multilevel binomial logistic regression with gender as main predictor, adjusting for age, socioeconomic position, residential self-selection and neighbourhood disadvantage. On average, women walked more for recreation than men prior to adjustment for covariates. Gender differences in WfR varied significantly across neighbourhoods, and the magnitude of the variation for women was twice that of men. The SE did not explain neighbourhood differences in the gender–WfR relationship, nor the between-neighbourhood variation in WfR for men or women. Neighbourhood-level factors seem to influence the WfR of men and women differently, with women being more sensitive to their environment, although Brisbane’s SE did not seem such a factor. Full article
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14 pages, 2306 KiB  
Article
Validation of the Block Walk Method for Assessing Physical Activity occurring on Sidewalks/Streets
by Richard R. Suminski, Gregory M. Dominick and Eric Plautz
Int. J. Environ. Res. Public Health 2019, 16(11), 1927; https://doi.org/10.3390/ijerph16111927 - 31 May 2019
Cited by 8 | Viewed by 3120
Abstract
The block walk method (BWM) is one of the more common approaches for assessing physical activity (PA) performed on sidewalks/streets; however, it is non-technical, labor-intensive, and lacks validation. This study aimed to validate the BWM and examine the potential for using a wearable [...] Read more.
The block walk method (BWM) is one of the more common approaches for assessing physical activity (PA) performed on sidewalks/streets; however, it is non-technical, labor-intensive, and lacks validation. This study aimed to validate the BWM and examine the potential for using a wearable video device (WVD) to assess PA occurring on sidewalks/streets. Trained observers (one wearing and one not wearing the WVD) walked together and performed the BWM according to a previously developed protocol along routes in low, medium, and high walkable areas. Two experts then reviewed the videos. A total of 1150 (traditional) and 1087 (video review) individuals were observed during 900 min of observation. When larger numbers of individuals were observed, the traditional method overestimated the overall number of people as well as those walking and sitting/standing, while underestimating the number of runners. Valid estimates of PA occurring on sidewalks/streets can be obtained by the traditional BWM in low and medium walkability areas and/or with non-common activities (cycling); however, its validity is questionable when sidewalks/streets use volume is high. The use of WVDs in PA assessment has the potential to establish new levels of accuracy, reduce resource requirements, and open up the possibility for retrospective analysis. Full article
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18 pages, 976 KiB  
Article
Socio-Ecological Natural Experiment with Randomized Controlled Trial to Promote Active Commuting to Work: Process Evaluation, Behavioral Impacts, and Changes in the Use and Quality of Walking and Cycling Paths
by Minna Aittasalo, Johanna Tiilikainen, Kari Tokola, Jaana Suni, Harri Sievänen, Henri Vähä-Ypyä, Tommi Vasankari, Timo Seimelä, Pasi Metsäpuro, Charlie Foster and Sylvia Titze
Int. J. Environ. Res. Public Health 2019, 16(9), 1661; https://doi.org/10.3390/ijerph16091661 - 13 May 2019
Cited by 14 | Viewed by 4513
Abstract
Active commuting to work (ACW) has beneficial effects on health, traffic, and climate. However, more robust evidence is needed on how to promote ACW. This paper reports the findings of a multilevel natural experiment with a randomized controlled trial in 16 Finnish workplaces. [...] Read more.
Active commuting to work (ACW) has beneficial effects on health, traffic, and climate. However, more robust evidence is needed on how to promote ACW. This paper reports the findings of a multilevel natural experiment with a randomized controlled trial in 16 Finnish workplaces. In Phase 1, 11 workplaces (1823 employees) from Area 1 were exposed to environmental improvements in walking and cycling paths. In Phase 2, five more workplaces (826 employees) were recruited from Area 2 and all workplaces were randomized into experimental group (EXP) promoting ACW with social and behavioral strategies and comparison group (COM) participating only in data collection. Process and impact evaluation with questionnaires, travel diaries, accelerometers, traffic calculations, and auditing were conducted. Statistics included Wilcoxon Signed Ranks Test, Mann-Whitney U-test, and after-before differences with 95% confidence intervals (95% CI). After Phase 1, positive change was seen in the self-reported number of days, which the employees intended to cycle part of their journey to work in the following week (p = 0.001). After Phase 2, intervention effect was observed in the proportion of employees, who reported willingness to increase walking (8.7%; 95% CI 1.8 to 15.6) and cycling (5.5%; 2.2 to 8.8) and opportunity to cycle part of their journey to work (5.9%; 2.1 to 9.7). To conclude, the intervention facilitated employees’ motivation for ACW, which is the first step towards behavior change. Full article
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11 pages, 903 KiB  
Article
Cardiorespiratory Fitness without Exercise Testing Can Predict All-Cause Mortality Risk in a Representative Sample of Korean Older Adults
by Moongu Song, Inhwan Lee and Hyunsik Kang
Int. J. Environ. Res. Public Health 2019, 16(9), 1633; https://doi.org/10.3390/ijerph16091633 - 10 May 2019
Cited by 9 | Viewed by 3032
Abstract
This study examined the association between cardiorespiratory fitness (CRF) without exercise testing and all-cause mortality in Korean older adults. The present study was carried out using data from the 2008 and 2011 Living Profiles of Older People Survey. A total of 14,122 participants [...] Read more.
This study examined the association between cardiorespiratory fitness (CRF) without exercise testing and all-cause mortality in Korean older adults. The present study was carried out using data from the 2008 and 2011 Living Profiles of Older People Survey. A total of 14,122 participants aged 60 years and older (57% women) completed the 2008 baseline and 2011 follow-up assessments (i.e., socioeconomic status, health behaviors and conditions, and prevalence of chronic diseases), and they were included for the final analyses. CRF was estimated (eCRF) with sex-specific algorithms and classified as lower (lowest 25%), middle (middle 50%), and upper (highest 25%). Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) across eCRF categories. In total, multivariable-adjusted HRs and 95% CIs were 1 for the upper eCRF group (referent), 1.059 (0.814~1.378) for the middle eCRF group, and 1.714 (1.304~2.253) for the lower eCRF group. In men, multivariable-adjusted HRs and 95% CIs were 1 for the upper eCRF group (referent), 1.011 (0.716~1.427) for the middle eCRF group, and 1.566 (1.098~2.234) for the lower eCRF group. In women, multivariable-adjusted HRs and 95% CIs were 1 for the upper eCRF group (referent), 1.064 (0.707~1.602) for the middle eCRF group, and 1.599 (1.032~2.478) for the lower eCRF group. The current findings suggest that eCRF may have an independent predictor of all-cause mortality, underscoring the importance of promoting physical activity to maintain a healthful level of CRF in Korean geriatric population. Full article
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26 pages, 1657 KiB  
Review
The Effects of Green Exercise on Physical and Mental Wellbeing: A Systematic Review
by Ian Lahart, Patricia Darcy, Christopher Gidlow and Giovanna Calogiuri
Int. J. Environ. Res. Public Health 2019, 16(8), 1352; https://doi.org/10.3390/ijerph16081352 - 15 Apr 2019
Cited by 165 | Viewed by 29005
Abstract
We aimed to examine the evidence for the proposed additive effect of exercise in the presence of nature (green exercise) by systematically reviewing studies that investigated the effects of outdoor or virtual green exercise compared with indoor exercise. Our review updates an earlier [...] Read more.
We aimed to examine the evidence for the proposed additive effect of exercise in the presence of nature (green exercise) by systematically reviewing studies that investigated the effects of outdoor or virtual green exercise compared with indoor exercise. Our review updates an earlier review, whose searches were conducted in April 2010. Trials were eligible if: (a) participants in an outdoor or virtual exercise condition were exposed to views of nature (green exercise); (b) green exercise was compared with indoor exercise with no exposure to nature; (c) included an outcome related to physical or mental health; (d) used comparative or crossover trial design. We searched the following databases from 1st January 2010 to 28th June 2018: PubMed, CENTRAL, EMBASE, PsycINFO, GreenFile, and Sports DISCUS. We assessed risk of bias using the Cochrane “risk of bias” tool. Where possible we conducted a meta-analysis using the inverse variance random-effects method, and where this approach was not possible we presented the results qualitatively and in harvest plots. We identified 28 eligible trials. In a meta-analysis of just three longitudinal trials, the only statistical finding was slightly lower post-intervention perceived exertion with green versus indoor exercise (mean difference: −1.02; 95% confidence intervals: −1.88, −0.16). Compared with indoor exercise, acute bouts of outdoor green exercise may favorably influence affective valence and enjoyment, but not emotion, perceived exertion, exercise intensity, and biological markers. No other consistent statistical differences were observed, apart from a higher enjoyment of outdoor green versus virtual green exercise. We found a high risk of bias across trials and an overall low quality of evidence. In conclusion, there was limited evidence to support the view that green exercise offers superior benefits to exercise without exposure to nature. The low quality of evidence prohibits clear interpretation of trial findings. Future robust and rigorously designed trials are needed to evaluate the effects of long-term and multiple-bout exposure to nature during exercise compared with exercise indoors. Full article
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9 pages, 289 KiB  
Article
Smartphone Use and Physical Activity among College Students in Health Science-Related Majors in the United States and Thailand
by Nattika Penglee, Richard W. Christiana, Rebecca A. Battista and Ed Rosenberg
Int. J. Environ. Res. Public Health 2019, 16(8), 1315; https://doi.org/10.3390/ijerph16081315 - 12 Apr 2019
Cited by 25 | Viewed by 5672
Abstract
Smartphone use among college students is prevalent across the world. Recently, research has begun to investigate the relationship between smartphone use and physical activity. This study examined the amount of time spent using a smartphone and the physical activity (PA) levels among college [...] Read more.
Smartphone use among college students is prevalent across the world. Recently, research has begun to investigate the relationship between smartphone use and physical activity. This study examined the amount of time spent using a smartphone and the physical activity (PA) levels among college students majoring in health science-related disciplines in the United States (US) and Thailand. Using convenience sampling, college students in the US (n = 242) and Thailand (n = 194) completed an online survey, in Fall 2016, assessing smartphone usage and PA. Data were analyzed using chi-square tests and two-way ANOVA (p < 0.05). US students reported more days per week ( U = 15,150.0 , p = 0.00 , r = 0.33 ) and greater duration of PA ( U = 11,234.0 , p = 0.00 , r = 0.33 ) than Thai students while Thai students used smartphones more per day than US students ( U = 13,137.5 , p = 0.00 , r = 0.40 ). No difference existed for years of smartphone use ( U = 22,207.0 , p = 0.27 ). Greater smartphone use per day inversely related to days per week of engaging in PA among Thai students ( X 2 ( 3 ) = 10.55 , p = 0.01 , ε 2 = 0.06 ), but not among US students ( X 2 ( 3 ) = 2.39 , p = 0.50 ). The high smartphone use among college students, especially in Thailand, may be a barrier to PA as well as a strategy for PA promotion in higher education settings. Research should examine the best techniques for smartphone application development to promote PA in college settings. Full article
11 pages, 718 KiB  
Article
The Potential of Specialized Media in Public Health: Analysis of Health-Related Content in Sports Newspapers
by Antonio Lopez-Villegas and Daniel Catalan-Matamoros
Int. J. Environ. Res. Public Health 2019, 16(7), 1202; https://doi.org/10.3390/ijerph16071202 - 03 Apr 2019
Cited by 1 | Viewed by 2872
Abstract
Sports-specialized newspapers are one of the print media with the highest number of readers in Spain. However, little is known about the health coverage in this type of print press. The aim of the study was to analyze any health-related material in sports [...] Read more.
Sports-specialized newspapers are one of the print media with the highest number of readers in Spain. However, little is known about the health coverage in this type of print press. The aim of the study was to analyze any health-related material in sports newspaper coverage and describe the main characteristics. This is an observational and cross-sectional study, performed in relation to the three most read daily Spanish sports newspapers (MARCA, AS, SPORT). A descriptive analysis was conducted to assess the health-related materials selected after a careful search over a period of 30 days. During this time, a total of 815 units of analysis were identified. On average, 14.79% (n = 645 pages) of the full content (n = 4362) included health-related material. The Liga BBVA section was the most frequent to contain health-related content by a significant margin (p = 0.01). The main covered topics were injuries to soccer players (52%), doping (21%), and other diseases in athletes or their relatives (8.6%) with no significant differences (p = 0.10). Photographs (87.4%) were the most frequent visual material used in the health content, followed by infographics (12.6%). Press releases were the most frequent source of information (58%). Spanish sports newspapers include a high proportion of health-related material, especially in terms of providing detailed descriptions of athletes’ sport injuries, mainly related to soccer. Full article
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11 pages, 287 KiB  
Article
Experiences with Participation in a Supervised Group-Based Outdoor Cycling Programme for People with Mental Illness: A Focus Group Study
by Helle Schnor, Stina Linderoth and Julie Midtgaard
Int. J. Environ. Res. Public Health 2019, 16(4), 528; https://doi.org/10.3390/ijerph16040528 - 13 Feb 2019
Cited by 3 | Viewed by 3738
Abstract
Epidemiological evidence suggests that physical exercise, notably popular sports, is associated with reduced, mental health burden. This study explored participation in a supervised, group-based, outdoor cycling programme (10 × 10 km rides over a five-month period) for people with mental illness. We conducted [...] Read more.
Epidemiological evidence suggests that physical exercise, notably popular sports, is associated with reduced, mental health burden. This study explored participation in a supervised, group-based, outdoor cycling programme (10 × 10 km rides over a five-month period) for people with mental illness. We conducted two rounds of three audio-taped focus groups with people with mental illness (n = 25, mean age = 40 years) that focused on previous physical activity and motivation for enrolment (baseline), and on programme evaluation, including subjective wellbeing (after 10 weeks). Transcribed verbatim, the group discussions were analysed using systematic text condensation, which identified 12 categories and four themes: 1) Reinvigoration, (2) motivation through equal status, (3) group commitment without focus on illness, and (4) the value of cycling. Of particular interest was the potential for outdoor cycling to support unique non-stigmatising therapeutic relationships in a non-patient environment, outdoor sensory experiences, e.g., fresh air, wind, and rain, and feelings of personal mastery, equal status, solidarity, community, and healing. This study indicated that outdoor cycling performed in groups supervised by healthcare staff may support exercise self-efficacy and empower people with mental illness, potentially promoting long-term physical activity and participation. Future interventional studies examining the effectiveness of outdoor cycling complementary to conventional community mental healthcare services are warranted. Full article
22 pages, 366 KiB  
Article
Recognition of Barriers to Physical Activity Promotion in Immigrant Children in Spain: A Qualitative Case Study
by Romain Marconnot, Antonio Luís Marín-Rojas, Jose Manuel Delfa-de-la-Morena, Jorge Pérez-Corrales, Javier Gueita-Rodríguez, Cesar Fernández-de-las-Peñas and Domingo Palacios-Ceña
Int. J. Environ. Res. Public Health 2019, 16(3), 431; https://doi.org/10.3390/ijerph16030431 - 02 Feb 2019
Cited by 11 | Viewed by 4131
Abstract
Physical activity facilitates the acquisition of healthy habits from childhood to adulthood. Differences exist regarding the performance of physical activity among immigrant children compared to native Spanish children. The purpose of the study was to describe the barriers that exist for the promotion [...] Read more.
Physical activity facilitates the acquisition of healthy habits from childhood to adulthood. Differences exist regarding the performance of physical activity among immigrant children compared to native Spanish children. The purpose of the study was to describe the barriers that exist for the promotion of physical activity. A qualitative case-study approach was implemented. Parents of immigrant children, teachers, a school principal, and priests were included, using purposeful sampling. Data were collected from 25 participants, via unstructured and semi-structured interviews, focus groups, and researchers’ field notes. A thematic analysis was performed and ecological levels were identified. Our findings revealed the following barriers to performing physical activity: (a) the meaning of physical activity, (b) gender inequalities, (c) academic burden, (d) lack of social contact, (e) expenses and family economy, (f) lack of infrastructure and natural surroundings, (g) time constraints, (h) fear and insecurity, and (i) the reason for immigrating. These results may be used to revise the school curriculum, promoting equal opportunities for physical activity and encouraging family participation. Additionally, urban design policies should be encouraged to facilitate access to open spaces for recreation within cities. Full article
17 pages, 3474 KiB  
Article
Equity Impact Assessment of Interventions to Promote Physical Activity among Older Adults: A Logic Model Framework
by Gesa Lehne, Claudia Voelcker-Rehage, Jochen Meyer, Karin Bammann, Dirk Gansefort, Tanja Brüchert and Gabriele Bolte
Int. J. Environ. Res. Public Health 2019, 16(3), 420; https://doi.org/10.3390/ijerph16030420 - 01 Feb 2019
Cited by 9 | Viewed by 13424
Abstract
Reducing social inequalities in health and health determinants, including physical activity (PA), is a major challenge for public health. PA-promoting interventions are increasingly implemented. Little is known, however, about the impact of these interventions on social inequalities. For prioritizing interventions most likely to [...] Read more.
Reducing social inequalities in health and health determinants, including physical activity (PA), is a major challenge for public health. PA-promoting interventions are increasingly implemented. Little is known, however, about the impact of these interventions on social inequalities. For prioritizing interventions most likely to be effective in reducing inequalities, studies of PA interventions need to conduct equity impact assessments. The aim of this article is to describe the development of a logic model framework for equity impact assessments of interventions to promote PA. The framework was developed within the prevention research network AEQUIPA—Physical activity and health equity: primary prevention for healthy ageing, informed by an equity-focused systematic review, expert interviews, exploratory literature searches, and joint discussions within the network. The framework comprises a general equity-focused logic model to be adapted to specific interventions. The intervention-specific equity-focused logic models illustrate the key elements relevant for assessing social inequalities in study participation, compliance with and acceptance of interventions, as well as the efficacy of interventions. Future work within AEQUIPA will reveal which key elements are most critical for the interventions’ equity impacts. Equity impact assessments are beneficial for prioritizing interventions most likely to be effective in reducing health inequalities. Full article
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16 pages, 1642 KiB  
Article
The Role of Anthropogenic Elements in the Environment for Affective States and Cortisol Concentration in Mountain Hiking—A Crossover Trial
by Martin Niedermeier, Carina Grafetstätter, Martin Kopp, Daniela Huber, Michaela Mayr, Christina Pichler and Arnulf Hartl
Int. J. Environ. Res. Public Health 2019, 16(2), 290; https://doi.org/10.3390/ijerph16020290 - 21 Jan 2019
Cited by 16 | Viewed by 4466
Abstract
Green exercise might have positive effects on health and affective states. Little is known about the ideal characteristics of the natural environment, where exercise is conducted in. Thus, the primary aim of the present study was to investigate the effects of anthropogenic elements [...] Read more.
Green exercise might have positive effects on health and affective states. Little is known about the ideal characteristics of the natural environment, where exercise is conducted in. Thus, the primary aim of the present study was to investigate the effects of anthropogenic elements on acute stress-related physiological responses and affective states in green exercise. Using a crossover field study design, 52 healthy participants were exposed to two different mountain hiking conditions: An environment with less anthropogenic elements and an environment with more anthropogenic elements. Pre and post conditions, affective states and salivary cortisol concentration were measured. Repeated measures ANOVAs were used to analyze if pre-post changes differed between the conditions. Pre-post changes in affective states and salivary cortisol concentration did not significantly differ, partial η² < 0.06. Positive affective states showed significantly higher values post compared to pre-condition, partial η² > 0.13. The present results indicate that anthropogenic elements have a minor role in the influence on affective states and salivary cortisol concentration during mountain hiking. It is concluded that a single bout of mountain hiking independent of anthropogenic elements in the environment is effective in influencing affective states positively. Full article
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14 pages, 1913 KiB  
Article
Active School Transportation in Winter Conditions: Biking Together Is Warmer
by Anna-Karin Lindqvist, Marie Löf, Anna Ek and Stina Rutberg
Int. J. Environ. Res. Public Health 2019, 16(2), 234; https://doi.org/10.3390/ijerph16020234 - 15 Jan 2019
Cited by 13 | Viewed by 5410
Abstract
There has been a decline in children’s use of active school transportation (AST) while there is also limited research concerning AST in winter conditions. This study aimed to explore the prerequisites and experiences of schoolchildren and parents participating in an empowerment- and gamification-inspired [...] Read more.
There has been a decline in children’s use of active school transportation (AST) while there is also limited research concerning AST in winter conditions. This study aimed to explore the prerequisites and experiences of schoolchildren and parents participating in an empowerment- and gamification-inspired intervention to promote students’ AST in winter conditions. Methods: Thirty-five students, who were aged 12–13 years, and 34 parents from the north of Sweden participated in the study. Data were collected using photovoice and open questions in a questionnaire and analyzed using qualitative content analysis. Results: The results show that involvement and togetherness motivated the students to use AST. In addition, during the project, the parents changed to have more positive attitudes towards their children’s use of AST. The students reported that using AST during wintertime is strenuous but rewarding and imparts a sense of pride. Conclusion: Interventions for increasing students’ AST in winter conditions should focus on the motivational aspects for both children and parents. For overcoming parental hesitation with regards to AST during winter, addressing their concerns and empowering the students are key factors. To increase the use of AST all year around, targeting the challenges perceived during the winter is especially beneficial. Full article
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15 pages, 1015 KiB  
Article
Action 3:30R: Results of a Cluster Randomised Feasibility Study of a Revised Teaching Assistant-Led Extracurricular Physical Activity Intervention for 8 to 10 Year Olds
by Russell Jago, Byron Tibbitts, Emily Sanderson, Emma L. Bird, Alice Porter, Chris Metcalfe, Jane E. Powell, Darren Gillett and Simon J. Sebire
Int. J. Environ. Res. Public Health 2019, 16(1), 131; https://doi.org/10.3390/ijerph16010131 - 06 Jan 2019
Cited by 10 | Viewed by 6184
Abstract
Many children are not sufficiently physically active. We conducted a cluster-randomised feasibility trial of a revised after-school physical activity (PA) programme delivered by trained teaching assistants (TAs) to assess the potential evidence of promise for increasing moderate-to-vigorous physical activity (MVPA). Participants (n [...] Read more.
Many children are not sufficiently physically active. We conducted a cluster-randomised feasibility trial of a revised after-school physical activity (PA) programme delivered by trained teaching assistants (TAs) to assess the potential evidence of promise for increasing moderate-to-vigorous physical activity (MVPA). Participants (n = 335) aged 8–10 years were recruited from 12 primary schools in South West England. Six schools were randomised to receive the intervention and six acted as non-intervention controls. In intervention schools, TAs were trained to deliver an after-school programme for 15 weeks. The difference in mean accelerometer-assessed MVPA between intervention and control schools was assessed at follow-up (T1). The cost of programme delivery was estimated. Two schools did not deliver the intervention, meaning four intervention and six control schools were analysed at T1. There was no evidence for a difference in MVPA at T1 between intervention and control groups. Programme delivery cost was estimated at £2.06 per pupil per session. Existing provision in the 12 schools cost £5.91 per pupil per session. Action 3:30 was feasible to deliver and considerably cheaper than existing after-school provision. No difference in weekday MVPA was observed at T1 between the two groups, thus progression to a full trial is not warranted. Full article
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2018

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9 pages, 280 KiB  
Article
The Relationships between Park Quality, Park Usage, and Levels of Physical Activity in Low-Income, African American Neighborhoods
by Megan Knapp, Jeanette Gustat, Revonda Darensbourg, Leann Myers and Carolyn Johnson
Int. J. Environ. Res. Public Health 2019, 16(1), 85; https://doi.org/10.3390/ijerph16010085 - 30 Dec 2018
Cited by 38 | Viewed by 5164
Abstract
Parks can be an important, low-cost neighborhood resource to increase physical activity and reduce overweight and obesity. The quality of parks, however, may impact use. This study used observational data to examine the relationships between park quality, park usage and levels of physical [...] Read more.
Parks can be an important, low-cost neighborhood resource to increase physical activity and reduce overweight and obesity. The quality of parks, however, may impact use. This study used observational data to examine the relationships between park quality, park usage and levels of physical activity among users in 31 parks within low-income, African American neighborhoods. Relationships between park use and park characteristics (signs of disorder, attractiveness, and number of activity settings) varied by gender and user activity level. No variables of interest were significant for overall number of male users; whereas, disorder and attractiveness were significant for overall number of female users. Parks with signs of disorder were associated with 49% fewer female users (IRR = 0.51, 95% CI = (0.34–0.77)) and attractive parks with 146% more female users (IRR = 2.46, 95% CI = (1.39–4.33)). Similar significant relationships were found among active but not sedentary female users. Communities may consider increasing park maintenance and addressing attractiveness in existing parks as a relatively low-cost environmental strategy to encourage park use, increase physical activity, and reduce the burden of obesity, especially among women in low-income, African-American communities. Full article
13 pages, 303 KiB  
Article
Perceived Facilitators and Barriers in Response to a Walking Intervention in Rural Cancer Survivors: A Qualitative Exploration
by Lauren J. Frensham, Gaynor Parfitt, Rebecca Stanley and James Dollman
Int. J. Environ. Res. Public Health 2018, 15(12), 2824; https://doi.org/10.3390/ijerph15122824 - 11 Dec 2018
Cited by 7 | Viewed by 2981
Abstract
Physical activity has numerous associated benefits for cancer survivors. Compared to their urban counterparts, rural and remote Australians experience a health disadvantage, including poorer survival rate after the diagnosis of cancer. The purpose of this qualitative study was to (a) investigate factors that [...] Read more.
Physical activity has numerous associated benefits for cancer survivors. Compared to their urban counterparts, rural and remote Australians experience a health disadvantage, including poorer survival rate after the diagnosis of cancer. The purpose of this qualitative study was to (a) investigate factors that motivated or inhibited walking in rural participants during a 12-week intervention and (b) to investigate factors that motivated or inhibited physical activity behavior change three months post-intervention. Ten cancer survivors living in rural areas of South Australia participated in a 12-week computer-delivered walking-based intervention during which they reported daily steps, daily affect, and ratings of perceived exertion. Based on this information, individualized daily step goals were sent to them to increase walking. Following the intervention, participants engaged in face-to-face semi-structured interviews. Interviews were recorded, transcribed and coded using thematic analysis. Participants identified a range of physical, psychological, social, environmental, and organizational motivators and barriers. Participants appreciated the monitoring and support from the research team, but some voiced a need for better transition to post-program and many desired ongoing support to maintain their motivation. Future studies should incorporate strategies to help walking behavior to become more intrinsically motivated and therefore sustained. Full article
21 pages, 715 KiB  
Article
Untapped Resources: 10- to 13-Year-Old Primary Schoolchildren’s Views on Additional Physical Activity in the School Setting: A Focus Group Study
by Vera Van den Berg, Eline E. Vos, Renate H. M. De Groot, Amika S. Singh and Mai J. M. Chinapaw
Int. J. Environ. Res. Public Health 2018, 15(12), 2713; https://doi.org/10.3390/ijerph15122713 - 01 Dec 2018
Cited by 10 | Viewed by 6903
Abstract
Schools are considered ideal venues to promote physical activity (PA) in children. However, a knowledge gap exists on how to adequately integrate PA into the school day and in particular, on the preferences of children regarding additional PA in school. Therefore, the aim [...] Read more.
Schools are considered ideal venues to promote physical activity (PA) in children. However, a knowledge gap exists on how to adequately integrate PA into the school day and in particular, on the preferences of children regarding additional PA in school. Therefore, the aim of our qualitative study was to gain comprehensive insight into 10–13-year-old primary schoolchildren’s perspectives on how to increase PA in the school setting. We conducted nine focus groups (32 girls and 20 boys) with children attending the final two grades of primary school in the Netherlands. We used inductive thematic analysis to analyze the data. The results showed that children were enthusiastic about additional PA in school. Children suggested various ways to increase PA, including more time for PA in the existing curriculum, e.g., physical education (PE), recess, and occasional activities, such as field trips or sports days; school playground adaptation; improving the content of PE; and implementing short PA breaks and physically active academic lessons. Children emphasized variation and being given a voice in their PA participation as a prerequisite to keep PA enjoyable and interesting in the long term. Finally, children mentioned the role of the teacher and making efforts to accommodate all children and their different preferences as important. Children have concrete ideas, acknowledging the challenges that accompany integrating additional PA in school. We therefore recommend actively involving children in efforts to increase school-based PA and to make “additional PA in school” a shared project of teachers and students. Full article
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14 pages, 682 KiB  
Article
Changes in Metabolic Syndrome Severity Following Individualized Versus Standardized Exercise Prescription: A Feasibility Study
by Ryan M. Weatherwax, Joyce S. Ramos, Nigel K. Harris, Andrew E. Kilding and Lance C. Dalleck
Int. J. Environ. Res. Public Health 2018, 15(11), 2594; https://doi.org/10.3390/ijerph15112594 - 20 Nov 2018
Cited by 11 | Viewed by 4271
Abstract
This study sought to investigate the efficacy of standardized versus individualized exercise intensity prescription on metabolic syndrome (MetS) severity following a 12-week exercise intervention. A total of 38 experimental participants (47.8 ± 12.2 yr, 170.7 ± 8.0 cm, 82.6 ± 18.7 kg, 26.9 [...] Read more.
This study sought to investigate the efficacy of standardized versus individualized exercise intensity prescription on metabolic syndrome (MetS) severity following a 12-week exercise intervention. A total of 38 experimental participants (47.8 ± 12.2 yr, 170.7 ± 8.0 cm, 82.6 ± 18.7 kg, 26.9 ± 6.7 mL·k−1·min−1) were randomized to one of two exercise interventions (exercise intensity prescribed using heart rate reserve or ventilatory threshold). Following the 12-week intervention, MetS z-score was significantly improved for the standardized (−2.0 ± 3.1 to −2.8 ± 2.8 [p = 0.01]) and individualized (−3.3 ± 2.3 to −3.9 ± 2.2 [p = 0.04]) groups. When separating participants based on prevalence of MetS at baseline and MetS z-score responsiveness, there were six and three participants in the standardized and individualized groups, respectively, with three or more MetS risk factors. Of the six participants in the standardized group, 83% (5/6) of the participants were considered responders, whereas 100% (3/3) of the individualized participants were responders. Furthermore, only 17% (1/6) of the participants with MetS at baseline in the standardized group no longer had symptoms of MetS following the intervention. In the individualized group, 67% (2/3) of participants with baseline MetS were not considered to have MetS at week 12. These findings suggest that an individualized approach to the exercise intensity prescription may ameliorate the severity of MetS. Full article
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16 pages, 905 KiB  
Article
Effects of an Empowerment-Based Health-Promotion School Intervention on Physical Activity and Sedentary Time among Adolescents in a Multicultural Area
by Andreas Fröberg, Linus Jonsson, Christina Berg, Eva-Carin Lindgren, Peter Korp, Magnus Lindwall, Anders Raustorp and Christel Larsson
Int. J. Environ. Res. Public Health 2018, 15(11), 2542; https://doi.org/10.3390/ijerph15112542 - 13 Nov 2018
Cited by 8 | Viewed by 4663
Abstract
Physical activity (PA) decreases with age, and interventions are needed to promote PA during adolescence, especially, among those in low-socioeconomic status (SES) areas. The aim of this study was to investigate whether a two-year, empowerment-based health-promotion school intervention had any effects on changes [...] Read more.
Physical activity (PA) decreases with age, and interventions are needed to promote PA during adolescence, especially, among those in low-socioeconomic status (SES) areas. The aim of this study was to investigate whether a two-year, empowerment-based health-promotion school intervention had any effects on changes in (a) moderate-to-vigorous PA (MVPA), (b) sedentary time (SED), (c) exercise training (ET) frequency, and (d) ET duration, among adolescents. Participants (aged 12–13 years at baseline) from one intervention school and two control schools, were recruited from a multicultural area of Sweden, characterized by low-SES. During the course of the two-year intervention, a total of 135 participants (43% boys) were included in the study. The intervention was developed and implemented as a result of cooperation and shared decision-making among the researchers and the participants. MVPA and SED were measured with accelerometers, and ET frequency and duration was self-reported at the beginning of the seventh, eighth, and ninth grade, respectively. There were no significant effects of the two-year, empowerment-based health-promotion school intervention on changes in the accelerometer-measured MVPA and SED, or the self-reported ET frequency and duration, among the adolescents. Overall, the intervention was unsuccessful at promoting PA and reducing SED. Several possible explanations for the intervention’s lack of effects are discussed. Full article
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9 pages, 277 KiB  
Article
Prevalence of Total Physical Activity, Muscle-Strengthening Activities, and Excessive TV Viewing among Older Adults; and Their Association with Sociodemographic Factors
by Chien-Yu Lin, Jong-Hwan Park, Ming-Chun Hsueh, Wen-Jung Sun and Yung Liao
Int. J. Environ. Res. Public Health 2018, 15(11), 2499; https://doi.org/10.3390/ijerph15112499 - 08 Nov 2018
Cited by 10 | Viewed by 3205
Abstract
The study aimed to describe the prevalence of meeting moderate-to-vigorous-intensity physical activity (MVPA), muscle-strengthening (MS) activities, and television (TV) viewing guidelines, and their association with sociodemographic factors. Data from older adults aged 65 or above were sampled by age and sex to the [...] Read more.
The study aimed to describe the prevalence of meeting moderate-to-vigorous-intensity physical activity (MVPA), muscle-strengthening (MS) activities, and television (TV) viewing guidelines, and their association with sociodemographic factors. Data from older adults aged 65 or above were sampled by age and sex to the population aged 65+ years for each area in Taiwan and collected through telephone interviews. The prevalence of meeting MVPA and MS activities, MVPA and MS activities guidelines, and excessive TV viewing were calculated. We also investigated their associations with sociodemographic variables using logistic regression analyses. A total of 1068 older adults (response rate: 32.5%) participated in the present study. 79.4% met the MVPA guidelines (150 min weekly), 25.3% met the MS guidelines (twice a week), 22.4% met both MVPA and MS guidelines, and 53.1% engaged in excessive TV viewing (more than or equal to two hours per day). Overall, in old age, low educational level was associated with lower odds of meeting MVPA and MS activities, and both the MVPA and MS activity guidelines; while living alone and having no full-time job had higher odds of excessive TV viewing. A large number of older adults do not meet the MS recommendations, but are engaged in excessive TV viewing. Our findings may be important for public health interventions to promote MS and avoid excessive TV viewing, especially for at-risk subgroups. Full article
11 pages, 411 KiB  
Article
Investigating Motor Competence in Association with Sedentary Behavior and Physical Activity in 7- to 11-Year-Old Children
by Anoek M. Adank, Dave H. H. Van Kann, Joris J. A. A. Hoeboer, Sanne I. de Vries, Stef P. J. Kremers and Steven B. Vos
Int. J. Environ. Res. Public Health 2018, 15(11), 2470; https://doi.org/10.3390/ijerph15112470 - 05 Nov 2018
Cited by 25 | Viewed by 4658
Abstract
Children’s motor competence (MC) has declined in the past decades, while sedentary behavior (SB) has increased. This study examined the association between MC and physical activity (PA) levels among primary schoolchildren. Demographics, body height and weight, MC (Athletic Skills Track), and PA levels [...] Read more.
Children’s motor competence (MC) has declined in the past decades, while sedentary behavior (SB) has increased. This study examined the association between MC and physical activity (PA) levels among primary schoolchildren. Demographics, body height and weight, MC (Athletic Skills Track), and PA levels (ActiGraph, GT3X+) were assessed among 595 children (291 boys, mean age = 9.1 years, SD = 1.1). MC was standardized into five categories: from very low to very high. PA levels were classified into SB, light PA (LPA), and moderate-to-vigorous PA (MVPA). Mixed-model analyses were conducted with PA levels as dependent variables and MC as the independent variable, while adjusting for age, gender, and body mass index (BMI) z-score on the individual level. A negative association between MC and SB and a positive association between MC and MVPA were found. The strength of both associations increased as children expressed lower or higher levels of MC. MC is an important correlate of both SB and MVPA, particularly for children with very high or low MC. Developing and improving children’s MC may contribute to spending less time in SB and more time in MVPA, particularly for high-risk groups, i.e., children with low MC. Moreover, addressing MC development and PA promotion simultaneously might create positive feedback loops for both children’s MC and PA levels. Full article
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11 pages, 959 KiB  
Article
Step Rate Thresholds Associated with Moderate and Vigorous Physical Activity in Adults
by Myles W. O’Brien, Matthew J. Kivell, William R. Wojcik, Ghislain D’Entremont, Derek S. Kimmerly and Jonathon R. Fowles
Int. J. Environ. Res. Public Health 2018, 15(11), 2454; https://doi.org/10.3390/ijerph15112454 - 03 Nov 2018
Cited by 42 | Viewed by 4491
Abstract
Adults are recommended to engage in 150 min of moderate (MPA) to vigorous (VPA) aerobic physical activity per week, with the public health message of obtaining 3000 steps in 30 min. There is a paucity of research on step rate thresholds that correspond [...] Read more.
Adults are recommended to engage in 150 min of moderate (MPA) to vigorous (VPA) aerobic physical activity per week, with the public health message of obtaining 3000 steps in 30 min. There is a paucity of research on step rate thresholds that correspond to absolute MVPA (moderate = 3 METs, vigorous = 6 METs) with no research evaluating adult relative MVPA (moderate = 40% VO2max, vigorous = 60% VO2max). Anthropometric differences also influence intensity-related step rate thresholds. The purpose of this study was to identify step rates across a range of walking intensities so that mathematical models incorporating anthropometric factors could be used to identify individualized MVPA step rate thresholds. Forty-three adults (25♀; age = 39.4 ± 15.2 years) completed a staged treadmill walking protocol with pedometers and indirect calorimetry: six-minutes at 2.4, 3.2, 4.0, 5.6, 6.4, 7.2 km/h. Mathematical modelling revealed absolute and relative MPA step rate thresholds of ~100 steps/minute (spm) and ~125 spm, respectively. VPA corresponded to step rates of ~133 spm and ~139 spm for absolute and relative thresholds respectively. The current public message of 3000 steps in 30 min is valid for absolute MPA. However, VPA is achieved at higher thresholds than previously reported, more than 130 spm for healthy adults. Full article
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11 pages, 1097 KiB  
Article
The Effect of Detraining after a Period of Training on Cardiometabolic Health in Previously Sedentary Individuals
by Paul B. Nolan, Shawn M. Keeling, Chantelle A. Robitaille, Christina A. Buchanan and Lance C. Dalleck
Int. J. Environ. Res. Public Health 2018, 15(10), 2303; https://doi.org/10.3390/ijerph15102303 - 19 Oct 2018
Cited by 25 | Viewed by 6601
Abstract
The purpose of this study was to quantify the time-magnitude changes in cardiometabolic health outcomes that occur with cessation of regular exercise training. All participants (n = 22) performed baseline testing, completed a 13-week exercise program, and completed post-program testing. Upon completion [...] Read more.
The purpose of this study was to quantify the time-magnitude changes in cardiometabolic health outcomes that occur with cessation of regular exercise training. All participants (n = 22) performed baseline testing, completed a 13-week exercise program, and completed post-program testing. Upon completion of the 13-week exercise program, participants were randomized to one of the following two treatment groups: (1) the treatment group that continued their exercise for 4 weeks (TRAIN); or (2) the treatment group that discontinued exercise (DETRAIN). Changes from baseline to 13 weeks in both the TRAIN and DETRAIN treatment groups for maximal oxygen consumption (VO2max), body fat percentage, mean arterial pressure, high-density lipoprotein (HDL) cholesterol, and triglycerides were significantly favourable (p < 0.05). VO2max, body fat percentage, and favourable cardiometabolic health adaptations continued to improve (p < 0.05) with an additional one month of exercise training. Upon cessation of exercise, all measures of VO2max and body fat percentage, along with mean arterial pressure, HDL cholesterol, and triglycerides significantly worsened (p < 0.05) in the DETRAIN treatment group. Favourable training adaptations were further enhanced with an additional month of continued exercise training, and cessation of regular exercise rapidly abolished all training adaptations within one month. These novel findings underscore the importance of sustained and uninterrupted exercise training. Full article
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17 pages, 860 KiB  
Article
Effect of a 12-Week Online Walking Intervention on Health and Quality of Life in Cancer Survivors: A Quasi-Randomized Controlled Trial
by Lauren J. Frensham, Gaynor Parfitt and James Dollman
Int. J. Environ. Res. Public Health 2018, 15(10), 2081; https://doi.org/10.3390/ijerph15102081 - 21 Sep 2018
Cited by 31 | Viewed by 7734
Abstract
Cancer survivors are at an increased risk of experiencing physical and psychological ill-effects following cancer treatment. Rural cancer survivors are at a greater risk of future health problems following a cancer diagnosis compared to their urban counterparts. Physical activity has been targeted as [...] Read more.
Cancer survivors are at an increased risk of experiencing physical and psychological ill-effects following cancer treatment. Rural cancer survivors are at a greater risk of future health problems following a cancer diagnosis compared to their urban counterparts. Physical activity has been targeted as a health promotion priority in cancer survivors. Research indicates that a large portion of cancer survivors do not meet physical activity recommendations. The purpose of this quasi-randomized controlled trial was to test the effectiveness of an online 12-week walking intervention designed for cancer survivors, and to explore its impact on physical health indicators and quality of life outcomes. Steps Toward Improving Diet and Exercise among cancer survivors (STRIDE) is an online resource designed according to Social Cognitive Theory and Self Determination Theory, based on individualized step goal setting. Measures of physiology, physical fitness, and quality of life were taken at the baseline, post-intervention, and three-month follow-up in an Intervention group (n = 46) and active Control group (n = 45). The Control group was provided with a pedometer but did not have access to the online program. Three-factor repeated measures ANOVAs indicated that there were improvements in physical fitness (p < 0.01), systolic blood pressure (p < 0.01), diastolic blood pressure (p < 0.01), waist girth (p < 0.01), mental health (p < 0.05), social functioning (p < 0.01), and general health (p < 0.01), but an increase in bodily pain (p < 0.01), from the baseline to week 12 and the three-month follow-up, irrespective of group allocation. Pedometer interventions, delivered with or without online support and step goal setting, show promise for improving the overall health of cancer survivors, at least in the short term. Full article
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12 pages, 447 KiB  
Article
A Cross Sectional Examination of the Relation Between Depression and Frequency of Leisure Time Physical Exercise among the Elderly in Jinan, China
by Shukang Wang, Wei Ma, Shu-Mei Wang and Xiangren Yi
Int. J. Environ. Res. Public Health 2018, 15(9), 2041; https://doi.org/10.3390/ijerph15092041 - 18 Sep 2018
Cited by 17 | Viewed by 4910
Abstract
Depression has become a major global public health problem. Many studies have shown the positive effects of physical exercise on depression. However, few studies have examined the relationship between frequency of leisure time physical exercise and depression without considering the time and intensity [...] Read more.
Depression has become a major global public health problem. Many studies have shown the positive effects of physical exercise on depression. However, few studies have examined the relationship between frequency of leisure time physical exercise and depression without considering the time and intensity of exercise among middle-aged and elderly people of urban communities in northern China. We conducted a cross-sectional survey that included 1604 participants among urban residents aged 50 years or older in China to evaluate how the frequency of physical exercise was related to depression. Our study showed that the prevalence of depression in the urban community of Jinan is 16.52%. For physical exercise, the odds ratios (ORs) and 95% confidence intervals (CIs) for 1~2 times per week, 3~4 times per week and ≥5 times per week were 1.137 (0.661, 1.953), 0.516 (0.304, 0.875) and 0.548 (0.392, 0.768) respectively, with adjustment for age, gender, marital status, BMI, hypertension, previously diagnosed type 2 diabetes, triglyceride, total cholesterol, soy food intake, milk food intake, vegetable and fruit intake and meat intake. We concluded that physically exercising three times a week is associated with a low prevalence of depression. Full article
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15 pages, 466 KiB  
Article
Associations of Physical Activity and Sedentary Time in Primary School Children with Their Parental Behaviors and Supports
by Chiaki Tanaka, Masayuki Okuda, Maki Tanaka, Shigeru Inoue and Shigeho Tanaka
Int. J. Environ. Res. Public Health 2018, 15(9), 1995; https://doi.org/10.3390/ijerph15091995 - 13 Sep 2018
Cited by 15 | Viewed by 4034
Abstract
Background: The associations of objectively evaluated moderate-to-vigorous physical activity (MVPA) and sedentary time between primary school children and their fathers or mothers have not been fully understood. Therefore, we tested the associations in children. Methods: The participants were first to sixth grade [...] Read more.
Background: The associations of objectively evaluated moderate-to-vigorous physical activity (MVPA) and sedentary time between primary school children and their fathers or mothers have not been fully understood. Therefore, we tested the associations in children. Methods: The participants were first to sixth grade boys (n = 166, 9.4 ± 1.6 years) and girls (n = 202, 9.4 ± 1.6 years) and their parents (fathers, n = 123 and mothers, n = 321). MVPA and sedentary time were measured using triaxial accelerometry. The relationship between parental support which was assessed by self-reported questionnaire and children’s MVPA was also examined. Results: MVPA in the children was positively correlated with maternal MVPA after adjustment for the children’s gender, grade, body mass index z-score, paternal or maternal age, and school (p < 0.001). However, paternal or maternal sedentary time and paternal MVPA showed no significant association with sedentary time or MVPA in children. On the other hand, the percentage of MVPA in children who spent more time with their mothers on weekends was significantly lower than those who spent less time (p = 0.034). Children whose mothers watched their sports events had a significantly higher percentage of MVPA than those whose mothers did not watch these events (p = 0.008). There were no associations between children’s MVPA and paternal support. Conclusions: The findings of this study demonstrate the significance of maternal MVPA and support. Full article
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13 pages, 737 KiB  
Article
Does Physical Fitness Affect Academic Achievement among Japanese Adolescents? A Hybrid Approach for Decomposing Within-Person and Between-Persons Effects
by Akira Kyan, Minoru Takakura and Masaya Miyagi
Int. J. Environ. Res. Public Health 2018, 15(9), 1901; https://doi.org/10.3390/ijerph15091901 - 01 Sep 2018
Cited by 11 | Viewed by 8100
Abstract
Positive association between physical fitness and academic achievement in adolescents has been suggested yet the causal effect of physical fitness on academic achievement remains unclear. This study examined if longitudinal changes in physical fitness were associated with changes in academic achievement among junior [...] Read more.
Positive association between physical fitness and academic achievement in adolescents has been suggested yet the causal effect of physical fitness on academic achievement remains unclear. This study examined if longitudinal changes in physical fitness were associated with changes in academic achievement among junior high school students. Analyses were based on a two-year with three time-point data of 567 students (aged 12–13 years old at the baseline-point; 303 boys) who entered in five Japanese junior high schools in 2015. Academic achievement was evaluated using the student’s overall grade point average. Comprehensive physical fitness score was summed up from eight fitness tests: 50-m sprint, standing broad jump, repeated side-steps, sit and reach, sit-ups, hand-grip strength, handball throw, and 20-m shuttle run or endurance run. The hybrid regression model was applied to examine the impact of change in physical fitness on change in academic achievement using multiple imputation to account for non-response at follow-up. The changes in fitness score within-person and the differences in average of fitness score of three-time points between-person were associated with change in overall grade point average for boys. No significant association between fitness score and overall grade point average was observed in girls. Opportunities for increased physical fitness may be important to support academic achievement, particularly in junior high school boys. Full article
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12 pages, 1393 KiB  
Article
A Daily Cup of Tea or Coffee May Keep You Moving: Association between Tea and Coffee Consumption and Physical Activity
by Luciana Torquati, Geeske Peeters, Wendy J. Brown and Tina L. Skinner
Int. J. Environ. Res. Public Health 2018, 15(9), 1812; https://doi.org/10.3390/ijerph15091812 - 22 Aug 2018
Cited by 13 | Viewed by 8209
Abstract
Physical activity (PA) is an independent predictor of mortality and frailty in middle-aged women, but fatigue remains a major barrier in this group. While caffeine intake has been associated with reduced exertion and perceived fatigue, it is not well understood whether consumption of [...] Read more.
Physical activity (PA) is an independent predictor of mortality and frailty in middle-aged women, but fatigue remains a major barrier in this group. While caffeine intake has been associated with reduced exertion and perceived fatigue, it is not well understood whether consumption of naturally caffeinated drinks is associated with physical activity. The aim of this study was to determine whether habitual consumption of coffee and tea is associated with participation in physical activity. Women (n = 7580) from the Australian Longitudinal Study on Women’s Health were included in this investigation. Participants reported average tea and coffee intake over the last 12 months and usual PA. Logistic regression models were adjusted for relevant health and lifestyle confounders, and Sobel test was used for mediation analysis. Participants who consumed 1–2 cups of coffee/day were 17% more likely to meet the recommended 500 metabolic equivalent (MET).min/week than women who had <1 cup/day (odds ratio (OR) 1.17, 95% confidence interval (CI) 1.04–1.32). Participants who reported drinking either 1–2 cups or >3 cups/day of tea were 13–26% more likely to meet 500 MET.min/week than those who had <1 cup/day (OR 1.26, 95% CI 1.08–1.46 and OR 1.13, 95% CI 1.01–1.26, respectively). Tiredness and energy mediated associations between intake of coffee (fully) and tea (partially) and PA. Middle-aged women who drink 1–2 cups of coffee or >1 cup of tea/day are more likely to meet the moderate-to-vigorous PA guidelines than those who drink <1 cup/day. Future research is warranted to investigate causality and effects of specific coffee and tea amounts. Full article
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17 pages, 1701 KiB  
Review
Moderators of School-Based Physical Activity Interventions on Cardiorespiratory Endurance in Primary School-Aged Children: A Meta-Regression
by Ryan D. Burns, Timothy A. Brusseau and You Fu
Int. J. Environ. Res. Public Health 2018, 15(8), 1764; https://doi.org/10.3390/ijerph15081764 - 16 Aug 2018
Cited by 10 | Viewed by 4781
Abstract
The purpose of this study was to examine potential moderators of school-based physical activity interventions on cariorespiratory endurance in primary school-aged children using meta-regression. An Internet search with several databases was employed, extracting school-based pediatric physical activity intervention studies published within the past [...] Read more.
The purpose of this study was to examine potential moderators of school-based physical activity interventions on cariorespiratory endurance in primary school-aged children using meta-regression. An Internet search with several databases was employed, extracting school-based pediatric physical activity intervention studies published within the past 30 years. Studies were included if there was a control or comparison group, if the study sample included primary school-aged children, if the targeted outcome of cardiorespiratory endurance was objectively assessed, if the intervention was at least partially school-based, and if the effect estimate’s variability was reported. An inverse-variance random effects meta-regression was employed using the primary predictors of component number (single component or multi-component) and intervention length using 20 extracted studies with 23 total effects. The overall pooled effect on cardiorespiratory endurance was statistically significant (Hedges’ g = 0.30, 95% C.I.: 0.19–0.40; p < 0.001). Using random effects meta-regression, neither component number (b = −0.09, 95% C.I.: −0.40–0.23; p = 0.560) or intervention length (b = 0.001, 95% C.I.: −0.002–0.004; p = 0.427) yielded a significant modifying effect on cardiorespiratory endurance. School-based physical activity interventions have a significant pooled effect on cardiorespiratory endurance in primary school-aged children. Component number and intervention length does not modify this effect, suggesting other sources for between-study heterogeneity. Full article
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12 pages, 305 KiB  
Article
Youth and Adult Visitation and Physical Activity Intensity at Rural and Urban Parks
by James N. Roemmich, LuAnn Johnson, Grace Oberg, Joley E. Beeler and Kelsey E. Ufholz
Int. J. Environ. Res. Public Health 2018, 15(8), 1760; https://doi.org/10.3390/ijerph15081760 - 16 Aug 2018
Cited by 20 | Viewed by 4913
Abstract
Less physical activity among rural residents may contribute to rural-urban health disparities. Parks can be ideal community resources for promoting physical activity. This study compared park visitation and activity intensity at 15 urban and 15 rural parks matched for acreage and amenities. Parks [...] Read more.
Less physical activity among rural residents may contribute to rural-urban health disparities. Parks can be ideal community resources for promoting physical activity. This study compared park visitation and activity intensity at 15 urban and 15 rural parks matched for acreage and amenities. Parks were observed in the morning, afternoon, and evening on 4 days to determine number of visitors, activity intensity, and amenity use. A total of 5486 visitors were observed with no differences in percentages of males (55.5% vs. 53.9%) and females (44.5% vs. 46.1%) or percentages of weekday (82.4% vs. 81.9%) and weekend (17.6% vs. 18.1%) visitors. The probability of visitors sitting was greater and in moderate intensity activity lower at rural parks. A greater proportion of children (25.0% vs. 14.5%) in rural parks, and teens in urban parks (8.0% vs. 69.6%), were observed on sport fields. A greater proportion of adults in urban areas (12.5% vs. 46.0%) were observed spectating sports. Greater proportions of rural children (10.9% vs. 3.5%), teens (34.1% vs. 12.4%), and adults (38.9% vs. 10.1%) were observed using shelters. Thus, when similar amenities are available, rural and urban parks are used differently, especially by youth. The urban park study results cannot be wholly applied to rural parks. Full article
28 pages, 945 KiB  
Review
Relationships between Motor Proficiency and Academic Performance in Mathematics and Reading in School-Aged Children and Adolescents: A Systematic Review
by Kirstin Macdonald, Nikki Milne, Robin Orr and Rodney Pope
Int. J. Environ. Res. Public Health 2018, 15(8), 1603; https://doi.org/10.3390/ijerph15081603 - 28 Jul 2018
Cited by 62 | Viewed by 9831
Abstract
Positive associations exist between physical activity, cognition, and academic performance in children and adolescents. Further research is required to examine which factors underpin the relationships between physical activity and academic performance. This systematic review aimed to identify, critically appraise, and synthesize findings of [...] Read more.
Positive associations exist between physical activity, cognition, and academic performance in children and adolescents. Further research is required to examine which factors underpin the relationships between physical activity and academic performance. This systematic review aimed to identify, critically appraise, and synthesize findings of studies examining relationships between motor proficiency and academic performance in mathematics and reading in typically developing school-aged children and adolescents. A systematic search of electronic databases was performed to identify relevant studies. Fifty-five eligible articles were critically appraised and key data was extracted and synthesized. Findings support associations between several components of motor proficiency and academic performance in mathematics and reading. There was evidence that fine motor proficiency was significantly and positively associated with academic performance in mathematics and reading, particularly during the early years of school. Significant positive associations were also evident between academic performance and components of gross motor proficiency, specifically speed and agility, upper-limb coordination, and total gross motor scores. Preliminary evidence from a small number of experimental studies suggests motor skill interventions in primary school settings may have a positive impact on academic performance in mathematics and/or reading. Future research should include more robust study designs to explore more extensively the impact of motor skill interventions on academic performance. Full article
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12 pages, 828 KiB  
Article
Walking and Walkability in Pre-Set and Self-Defined Neighborhoods: A Mental Mapping Study in Older Adults
by Malte Bödeker
Int. J. Environ. Res. Public Health 2018, 15(7), 1363; https://doi.org/10.3390/ijerph15071363 - 28 Jun 2018
Cited by 16 | Viewed by 6104
Abstract
Neighborhood walkability contributes to older adults’ walking. However, associations vary depending on the neighborhood definition applied as well as between objective and perceived walkability measures. Therefore, this study aimed to comparatively assess walkability indices for commonly used pedestrian network buffers and perceived neighborhood [...] Read more.
Neighborhood walkability contributes to older adults’ walking. However, associations vary depending on the neighborhood definition applied as well as between objective and perceived walkability measures. Therefore, this study aimed to comparatively assess walkability indices for commonly used pedestrian network buffers and perceived neighborhood areas. A total of 97 adults aged ≥65 years answered a written physical activity questionnaire and 69 respondents participated in face-to-face interviews that involved mental mapping, i.e., to draw perceived neighborhood delineations on paper maps. Hierarchical regression analyses were used to compare the contribution of walkability indices for pre-set buffers and self-defined neighborhoods to older adults’ walking after adjusting for covariates. Results show that older adults’ self-defined neighborhoods are significantly larger, less home-centered, and more walkable than commonly used buffers. Furthermore, the variance accounted for in neighborhood walking increased from 35.9% to 40.4% (ΔR2 = 0.046; p = 0.029), when the walkability index was calculated for self-defined neighborhoods rather than pre-set buffers. Therefore, the study supports that geometric differences between pre-set buffers and older adults’ spatial ideas of perceived neighborhoods have a significant influence on estimated walkability effects and that exposure areas should be matched with the spatial dimension of outcome variables in future research. Full article
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12 pages, 719 KiB  
Article
Temporal Trends in Sports Participation among Adolescents between 2001 and 2015: A French School- and Territory-Based Study
by Maxime Luiggi, Maxime Travert and Jean Griffet
Int. J. Environ. Res. Public Health 2018, 15(7), 1335; https://doi.org/10.3390/ijerph15071335 - 26 Jun 2018
Cited by 10 | Viewed by 6697
Abstract
Improving adolescents’ levels of sport and physical activity (PA) is an official public health issue. French national government plans were launched in 2001, 2006, and 2011 to improve the participation levels of citizens. These plans should be monitored. To date, information on temporal [...] Read more.
Improving adolescents’ levels of sport and physical activity (PA) is an official public health issue. French national government plans were launched in 2001, 2006, and 2011 to improve the participation levels of citizens. These plans should be monitored. To date, information on temporal trends in sports has come from the national population. However, no data are available to measure temporal trends in different territories across the country. Our study aimed to measure these trends among a representative sample of adolescent students of the third biggest French region (Bouches-du-Rhône), but also one of the poorest, between 2001 and 2015. Three surveys were conducted in 2001, 2008, and 2015 in high schools (n = 3218). Logistic regressions adjusted for age were used to determine the impact of socioeconomic status (SES) on sports participation and to measure the changes in sport participation rates. Participation declined among all subgroups of adolescents: from 79.0% to 65.8%. The greatest decrease was observed for boys with a high SES, whilst the lowest was for the high-SES girls. We observed that SES inequalities in access to sport increased among the girls, whilst they reduced among the boys. National government plans seem to have had limited success in this territory. Next to national studies, there is a need to develop territory specific studies which could show important disparities across the national territory. Full article
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14 pages, 1208 KiB  
Article
Resident Perceptions of Neighborhood Conditions, Food Access, Transportation Usage, and Obesity in a Rapidly Changing Central City
by Rayman Mohamed
Int. J. Environ. Res. Public Health 2018, 15(6), 1201; https://doi.org/10.3390/ijerph15061201 - 07 Jun 2018
Cited by 2 | Viewed by 3382
Abstract
There is a lack of research on obesity that uses primary data and fine-grained information on neighborhoods. I use primary data for 367 participants in Detroit to examine neighborhood predictors of obesity. These data were supplemented with public data. I considered multilevel and [...] Read more.
There is a lack of research on obesity that uses primary data and fine-grained information on neighborhoods. I use primary data for 367 participants in Detroit to examine neighborhood predictors of obesity. These data were supplemented with public data. I considered multilevel and spatial modeling, but the data lent itself best to ordinary least squares (OLS) regressions. I find that socioeconomic factors, the built environment, transportation usage, and perceptions of neighborhoods are important predictors of obesity. Importantly, litter is associated with higher levels of obesity. Planners can take measures to reduce litter and collaborate with other policy-makers to encourage less driving, though drawing direct lines of causality is complicated. Full article
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15 pages, 318 KiB  
Article
A Cross-Sectional Examination of Physical Activity Levels and Their Socio-Demographic Determinants in Southern Tanzania
by Beverly Msambichaka, Ramadhani Abdul, Salim Abdulla, Paul Klatser, Marcel Tanner, Ramaiya Kaushik, Bettina Bringolf-Isler, Eveline Geubbels and Ikenna C. Eze
Int. J. Environ. Res. Public Health 2018, 15(6), 1054; https://doi.org/10.3390/ijerph15061054 - 23 May 2018
Cited by 7 | Viewed by 3845
Abstract
Physical activity is essential for healthy aging. Evidence suggests that vigorous-intensity physical activity (VPA) may be more beneficial than moderate-intensity physical activity (MPA). We examined physical activity levels (MPA, VPA and total physical activity), and their socio-demographic determinants in 2311 participants (15–93 years; [...] Read more.
Physical activity is essential for healthy aging. Evidence suggests that vigorous-intensity physical activity (VPA) may be more beneficial than moderate-intensity physical activity (MPA). We examined physical activity levels (MPA, VPA and total physical activity), and their socio-demographic determinants in 2311 participants (15–93 years; 68% women) of the MZIMA Open Community Cohort, who had complete relevant data. Physical activity levels were estimated in minutes per week across three domains—work, leisure and transport. We created three outcome variables: low MPA (<150 min per week of MPA), low VPA (<75 min per week of VPA) and insufficient physical activity (IPA: <150 min per week of total physical activity) and applied sample-weighted multivariable logistic regression to assess associations with potential socio-demographic determinants. Prevalence of IPA, low MPA and low VPA were 25%, 26% and 65% respectively. IPA and low MPA were correlated (Spearman R = 0.98; p < 0.001). Work, leisure and transport contributed 54%, 25% and 21% to total physical activity respectively. IPA and low VPA were significantly associated with female sex, lower education, non-manual occupation and frequent fruit consumption. We observed significant differences by sex (Pheterogeneity < 0.001), on the associations between education and IPA, and between age, occupation and low VPA. In conclusion, low levels of VPA, which were more pronounced in women, support the monitoring and promotion of VPA alongside overall physical activity. Leisure-related activities should also be promoted towards gains in vigorous-intensity and total physical activity in this setting. Full article
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