Contextual and individual predictors of physical activity: Interactions between environmental factors and health cognitions

Effects of customer relationship management (CRM) strategies and socio-cognitive constructs on the physical activity of individuals with arthritis over time

BACKGROUND

Regular physical activity is important for arthritis self-management and could be promoted through tailoring community leisure and fitness centers' customer-relationship management (CRM) strategies.

OBJECTIVES

This study investigates the influence of two CRM strategies on individuals with arthritis reaching or maintaining two moderate-to-vigorous physical activity (MVPA) thresholds (≥150 and ≥45 minutes/week) from baseline-to-12 months and 12-to-24 months as well as mean changes in total minutes/week of MVPA. It also explores time-dependent variations in the influence of socio-cognitive variables on MVPA outcomes.

METHODS

Survey data from 374 participants with arthritis in a two-year randomized controlled trial (control versus two CRM strategies: IncentiveOnly and Incentive+Support) were used. Participants reported measures of physical activity participation, socio-cognitive decision-making, mental and physical wellbeing, friendship, community connectedness, sense of trust in others, and demographics.

FINDINGS/DISCUSSION

Receiving the Incentive+Support CRM strategy (versus control) increased participants' likelihood of reaching/maintaining both physical activity thresholds from 12-to-24 months (≥150 MVPA minutes/week, p < .001; ≥45 MVPA minutes/week, p < .032) but not from baseline-to-12 months. However, receiving the IncentiveOnly CRM strategy (versus control) did not predict reaching/maintaining these thresholds. Importantly, socio-cognitive decision-making variables' influence on reaching/maintaining these MVPA thresholds varied over time, suggesting CRM strategies may require further tailoring based on time-specific profiles. Perhaps because of new facility induced excitement, the mean change in total MVPA minutes/week for the control group significantly increased (26.8 minute/week, p = .014, 95% CI [5.5, 48.0]) from baseline-to-12 months, but subsequently declined by 11.4 minute/week from 12-to-24 months (p = .296, 95% CI [-32.7, 9.9]). Mean changes in total MVPA minutes/week were non-significant for those receiving IncentiveOnly content but significant for those receiving Incentive+Support content: baseline-to-12 months (38.2 minute/week increase, p = .023, 95% CI [4.9, 71.4]) and baseline-to-24-months (45.9 minute/week increase, p = .007, 95% CI [12.7, 79.1]).

Individual and country-level factors associated with self-reported and accelerometer-based physical activity in old age: a cross-national analysis of European countries

This study aimed to investigate associations between individual-level (personality traits, quality of life) and country-level (gross domestic product per capita, number of policies and action plans for physical activity) factors with self-reported and accelerometer-based physical activity and cross-level interactions among European countries. Based on the Survey of Health, Ageing and Retirement in Europe (SHARE) from 2019-2020, self-reported physical activity (N = 46,617 from 27 countries) and accelerometer-based average acceleration and intensity gradient (N = 855 from 10 countries) were analyzed. Mixed-model regressions with two levels (individuals nested within countries) were used for analyses. Between countries differences accounted for relatively small portions of the variability in self-reported physical activity (intraclass correlation, ICC = 7.5%), average acceleration (ICC = 3.5%), and intensity gradient (ICC = 1.9%). There were more associations between individual- and country-level factors and self-reported physical activity than with accelerometer-based physical activity. The association between individual-level variables and accelerometer-based physical activity did not differ between countries. Cross-level interactions suggested that associations between some personality traits and self-reported physical activity were stronger in countries with lower GDP. Both individual- and country-level factors are related to participation in more intensive physical activities. Adults with less resilient personality traits living in countries with lower resources are at the highest risk for physical inactivity.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10433-022-00737-8.

Intra-individual trajectories of subjectively prioritizing health over other life domains

Subjectively prioritizing health over other life domains is an indicator of health motivation and is associated with higher levels of health behaviors and more effective health behavior self-regulation. However, little is known about when individuals prioritize health over other life domains and which factors predict prioritizing health. Here, we examine 3644 older adults in Germany (mean age 60.79) over a period of 6-9 years from DEAS, a population-representative survey. Latent growth curves were estimated to examine individual change in prioritizing health. Socio-structural (gender, educational attainment) and indicators of health status (baseline status and change in [a] number of illnesses, [b] functional health, and [c] self-rated health) were tested as predictors of changes in health prioritization. Participants prioritized health over other life domains, and this increased over time. Women and those with worse health status (lower functional and lower self-rated health) prioritized health more than men and those with better health status, respectively. Lower educational attainment was associated with higher increases in prioritizing health, and interactions between educational status and health indicators show that increases are larger in those with worse health and lower educational attainment. This indicates individual differences in the degree and the changes of prioritizing health.

Twelve-month findings of the MOVE Frankston randomised controlled trial of interventions to increase recreation facility usage and physical activity among adults

Substantial cross-sectional evidence and limited longitudinal research indicates that the availability of recreational facilities (e.g., parks, fitness centres) is associated with physical activity participation. However, few intervention trials have investigated how recreational infrastructure can be used to reduce inactivity levels in communities. The MOVE Frankston study aimed to assess the impact of low intensity strategies to promote use of a multi-purpose leisure and aquatic centre in a socioeconomically diverse, metropolitan community. This randomised controlled trial of two years’ duration compared public awareness raising (control condition) with two interventions: mailed information about the centre and a free entry pass (I-O); and this minimal intervention supplemented by customer relations management support through telephone contact, mailed promotional materials and additional incentives (I+S). Participants (n = 1320) were inactive adults living in the City of Frankston, Melbourne Australia. There were 928 people (70.3%) followed up at 12 months (61.2% female, 52% ≥55 yrs). Compared with controls, attendance at the Centre once or more was higher in both the I-O (OR 1.79, 95% CI 1.28–2.50) and I+S groups (OR 1.46, 95% CI 1.03–2.07). The proportion of people using the centre weekly did not differ by group. The odds of being in contemplation or preparation to use the Centre were higher in both the I-O (OR 1.76, 95% CI 1.28–2.42) and I+S groups (OR 1.48, 95% CI 1.07–2.06). Total physical activity and related social and cognitive factors did not differ between the groups. The findings show that the low intensity promotional strategies prompted occasional attendance and increased readiness to use this recreational facility, a level of behaviour change unlikely to reduce non-communicable disease risk. It is recommended that more frequent customer relations contact, and involvement of healthcare providers, be tested as strategies to encourage inactive adults to take up physical activity opportunities at recreational facilities of this type.

Individual socioeconomic and neighborhood factors predict changes in sports activity during the transition to retirement

Background

There are substantial socioeconomic status (SES) differences in sports activity (SA) during the transition to retirement. In line with social-ecological models, the aim of this longitudinal study was to examine the association of perceptions of social and physical neighborhood factors with changes in SA across the retirement transition and to examine potential interactions with SES factors.

Methods

Data from 6 waves of the German Ageing Survey (DEAS) provided 710 participants (at baseline: mean age 61.1, 52.9% of men) who retired between baseline (1996, 2002, 2008, 2011) and their 6-year follow-up assessment. Associations between changes in SA (increases and decreases compared to retaining) and individual SES and neighborhood factors were estimated using multinomial logistic regression analysis.

Results

Increases were observed in 18.45% of participants, decreases in 10%. Occupational prestige was a risk factor for decreases, education a resource for increases in SA. Interactions between household income and several neighborhood factors were observed.

Conclusions

In line with social-ecological models, individual, neighborhood factors and interacting associations were found. In particular safety perceptions could be a resource for promotion SA in older adults who experience disadvantage.

Applying Social Cognition Models to Explain Walking Duration in Older Adults: The Role of Intrinsic Motivation

This study examined the applicability of the health action process approach (HAPA) to walking duration in older adults and the added value of extending the HAPA by intrinsic motivation. Self-reports from older adults (N = 309; Mage = 78.7, 70-95 years) regarding activity-related intrinsic motivation and HAPA variables were collected at the baseline of a fall prevention intervention study. Walking duration at ≥3 metabolic equivalents of task was measured for 7 days via body-worn accelerometers. Two structural equation models with walking duration as a manifest outcome were specified. In both models, the model fit was acceptable, but intention and planning were not associated with walking duration. Intrinsic motivation was significantly related to most HAPA variables and walking duration. Variance explained for walking duration was R2 = .14 in the HAPA and R2 = .17 in the extended model. For explaining older adults' walking duration, intrinsic motivation, but not HAPA-based intention and planning, seemed to be important.

Work and sport: relationships between specific job stressors and sports participation

This study examines the relationships between different job stressors and sports participation. Based on a large-scale representative sample (N = 1935), the paper tested if the number of different job stressors encountered in a job is related to sports participation. Moreover, we examined the relative impact of different stressors on sport participation. As predicted, the number of stressors encountered at work is negatively associated with leisure-time sports participation. When testing the relative effects of different job stressors, intense physical labour, shift and night work, and job insecurity (i.e. having a fixed-term contract or fearing unemployment) are negatively related to sports participation, whereas hazardous exposure (i.e. noise), bad working atmosphere, and long working hours are not related to sports participation. Hence, the total number of job stressors, but also the specificity of job stressors, should be taken into account by professionals in the fields of health research and physical activity promotion. Practioner summary: In a large-scale representative sample, we examined if different adverse job conditions are negatively related to sports participation. We found that the number of different job stressors was negatively related to sports participation. In particular, intense physical labour, shift and night work as well as job insecurity had an impact.

Socioeconomic status and change in sports activity among middle-aged and older men and women: evidence from the German Ageing Survey

BACKGROUND

Sports activity (SA) behavior is unequally distributed across socioeconomic status (SES) groups. However, little is known about the impact of SES on change in SA over time.

METHODS

Based on data from the German Ageing Survey, we examined the role of objective (education, occupational prestige, household equivalent income, composite SES-index) and subjective (self-rated standard of living) SES indicators on negative and positive changes in SA during a follow-up of 6 years among adults aged 40+ years using logistic regression analysis.

RESULTS

Among active individuals at baseline, 32.1% of males and 24.8% of females experienced a negative change in SA. Among inactive individuals, 25.8 and 29.9% experienced a positive change. In the multivariate analysis, males and females with low SES were about twice as likely to experience a negative change and half as likely to experience a positive change. These patterns were observed regardless which SES indicator was examined.

CONCLUSIONS

This study provides comprehensive evidence for socioeconomic inequalities in negative and positive changes in SA behavior among middle-aged and older adults in Germany. To reduce socioeconomic inequalities, future SA interventions should address the mechanisms leading to differential probabilities of change in SA behavior by SES.

A longitudinal study examining uptake of new recreation infrastructure by inactive adults

BACKGROUND

The built environment is reported to influence physical activity in populations, but longitudinal evidence about the impact of building new physical activity infrastructure is limited. This study aimed to prospectively investigate the uptake and usage of the newly established Peninsula Aquatic and Recreation Centre (PARC), a large multi-purpose recreation facility in Melbourne, Australia.

METHODS

Physically inactive adults (n = 549) from the City of Frankston were recruited before the opening of PARC and followed up 12 months later to measure frequency of attendance at the Centre, and the purposes and barriers to use. Multivariable methods were used to identity the demographic, cognitive and social predictors of attendance, and the relationship between PARC use and improvements in leisure-time physical activity.

RESULTS

Over 12 months 8.7% of the sampled residents used PARC once per month or more, 17.5% attended less than once per month, and 73.8% did not use the Centre. Lap swimming was the dominant purpose for attendance, and the major barriers were cost of transport and cost of entry. Independent predictors of usage were being female, having children, living within 5 km of the Centre, and expressing strong intentions for use prior to its opening. Use of PARC was not associated with progression to a higher level of total leisure-time physical activity.

CONCLUSIONS

While installation of multi-purpose aquatic and recreation facilities may be considered an investment towards physical activity in populations, regular use by inactive people is likely to be low. Strategies to reduce barriers, including cost and transport, and to motivate use should be trialled in order to improve the public health impacts of this form of infrastructure.

Socioeconomic Status Moderates the Effects of Health Cognitions on Health Behaviors within Participants: Two Multibehavior Studies

Background

Socioeconomic differences in health-related behaviors are a major cause of health inequalities. However, the mechanisms (mediation/moderation) by which socioeconomic status (SES) affects health behavior are a topic of ongoing debate.

Purpose

Current research on SES as moderator of the health cognitions–health behavior relation is inconsistent. Previous studies are limited by diverse operationalizations of SES and health behaviors, demographically narrow samples, and between-person designs addressing within-person processes. This paper presents two studies addressing these shortcomings in a within-person multibehavior framework using hierarchical linear models.

Methods

Two online studies, one cross-sectional and one 4 week longitudinal, assessed 1,005 (Study 1; Amazon MTurk; USA only) and 1,273 participants (Study 2; Prolific; international). Self-reports of multiple SES indicators (education, income, occupation status; ZIP code in Study 1), health cognitions (from the theory of planned behavior), and measures of six health behaviors were taken. Multilevel models with cross-level interactions tested whether the within-person relationships between health cognitions and behaviors differed by between-person SES.

Results

Education significantly moderated intention-behavior and attitude-behavior relationships in both studies, with more educated individuals showing stronger positive relationships. In addition, ZIP-level SES (Study 1) moderated attitude-behavior effects such that these relationships were stronger in participants living in areas with higher SES.

Conclusions

Education appears to be an important resource for the translation of intentions and attitudes into behavior. Other SES indicators showed less consistent effects. This has implications for interventions aiming at increasing intentions to change health behaviors, as some interventions might inadvertently increase health inequalities.

Determinants of Obesity in Two Urban Communities: Perceptions and Community-Driven Solutions

Objective

In the search of solutions to the rising rates of obesity, community perspectives are important because they highlight areas of need and help determine the level of community support for potential interventions. This study aimed to identify community perceptions of factors associated with obesity in two urban municipalities - one racially mixed and one predominantly African American - and to explore community-driven solutions to the problem of obesity.

Methods

The study used Photovoice methodology to understand what community members perceived as obesity-promoting factors in their residential environments.

Results

A total of 96 photographs of factors relevant to obesity were discussed. Most commonly depicted were restaurants, grocery stores, fast food, and fitness centers. In 10 race-stratified focus groups, participants made 592 comments on 12 themes, the most common being restaurants, physical activity, food stores, and proposed solutions. The top three themes - restaurants, physical activity, and food stores - accounted for 58% of all barriers to healthy weight. Proposed solutions ranged from personal efforts and peer support, to educating adults and children, to community action.

Conclusions

Interventions addressing the immediate food and physical activity environment - restaurants, grocery stores, and resources for physical activity - may have high likelihood of success as they align with community needs and understanding of priorities. Health education and promotion programs that increase food-related knowledge and skills are also needed and likely to receive strong community support.

Physical Activity Behavior and Competing Activities: Interrelations in 55- to 70-Year-Old Germans

In this study, we draw attention to time-competing activities and psychological variables as impeding or enabling factors of physical activity behavior in 55- to 70-year-old Germans. Cross-sectional data was used (n = 4,891). Results indicate that paid work has a negative relationship with sufficient physical activity. Persons who provide nursing care seem to be motivated to achieve sufficient physical activity behavior, but do not meet established recommendations. Active citizenship positively relates to higher physical activity levels. The investment of energy in life domains and a distinct internal locus of control characterize motivated underachievers. Those sufficiently physically active show higher values in conscientiousness. This suggests that time-consuming and strongly externally determined activities like nursing care and paid work hinder a sufficient level of physical activity, even if the motivation is existent. Active citizenship and physical activity seem to be linked processes.

Smoking and sedentary behavior changes from adolescence to emerging adulthood: A multilevel modeling perspective

The present research investigated a) the effects of psychological (e.g., depressive symptoms, delinquency) and neighborhood socioeconomic environmental factors (e.g., education, poverty, proportion of racial/ethnic minorities) on changes in smoking and sedentary behaviors from adolescence to emerging adulthood and b) whether there were any cross-level interactions based on socio-ecological models. A series of multilevel analyses (level-1: individual-level; level-2: neighborhood-level) were conducted with the National Longitudinal Study of Adolescent Health (Add Health) wave I (1995) and wave III (2001) data among about 10,000 US adolescents. Adolescents' delinquency (but not depressive symptoms) predicted emerging adults' progression to daily smokers. Adolescents living in neighborhoods with more Hispanics reported being less likely to initiate smoking and progress to daily smoking during emerging adulthood. Adolescents living in neighborhoods with lower education levels reported more sedentary behaviors during emerging adulthood. However, there were no cross-level interactions between individual-level psychological factors and neighborhood-level environmental factors. Supporting the notion of socio-ecological models, not only psychological factors but also neighborhood environments warrant research attention to explain changes in risky health behaviors from adolescence to emerging adulthood. Theory-based research with appropriate characteristics across multiple levels is required to better understand emerging adults' risky health behaviors.

Is the intention-behaviour gap greater amongst the more deprived? A meta-analysis of five studies on physical activity, diet, and medication adherence in smoking cessation

Objectives

Unhealthy behaviour is more common amongst the deprived, thereby contributing to health inequalities. The evidence that the gap between intention and behaviour is greater amongst the more deprived is limited and inconsistent. We tested this hypothesis using objective and self‐report measures of three behaviours, both individual‐ and area‐level indices of socio‐economic status, and pooling data from five studies.

Design

Secondary data analysis.

Methods

Multiple linear regressions and meta‐analyses of data on physical activity, diet, and medication adherence in smoking cessation from 2,511 participants.

Results

Across five studies, we found no evidence for an interaction between deprivation and intention in predicting objective or self‐report measures of behaviour. Using objectively measured behaviour and area‐level deprivation, meta‐analyses suggested that the gap between self‐efficacy and behaviour was greater amongst the more deprived (B = .17 [95% CI = 0.02, 0.31]).

Conclusions

We find no compelling evidence to support the hypothesis that the intention–behaviour gap is greater amongst the more deprived.

The MOVE study: a study protocol for a randomised controlled trial assessing interventions to maximise attendance at physical activity facilities

BACKGROUND

Physical activity is associated with a host of health benefits, yet many individuals do not perform sufficient physical activity to realise these benefits. One approach to rectifying this situation is through modifying the built environment to make it more conducive to physical activity, such as by building walking tracks or recreational physical activity facilities. Often, however, modifications to the built environment are not connected to efforts aimed at encouraging their use. The purpose of the Monitoring and Observing the Value of Exercise (MOVE) study is to evaluate the effectiveness of two interventions designed to encourage the ongoing use of a new, multi-purpose, community-based physical activity facility.

METHODS/DESIGN

A two-year, randomised controlled trial with yearly survey points (baseline, 12 months follow-up, 24 months follow-up) will be conducted among 1,300 physically inactive adult participants aged 18-70 years. Participants will be randomly assigned to one of three groups: control, intervention 1 (attendance incentives), or intervention 2 (attendance incentives and tailored support following a model based on customer relationship management). Primary outcome measures will include facility usage, physical activity participation, mental and physical wellbeing, community connectedness, social capital, friendship, and social support. Secondary outcome measures will include stages of change for facility usage and social cognitive decision-making variables.

DISCUSSION

This study will assess whether customer relationship management systems, a tool commonly used in commercial marketing settings, can encourage the ongoing use of a physical activity facility. Findings may also indicate the population segments among which the use of such systems are most effective, as well as their cost-effectiveness.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry: ACTRN12615000012572 (registered 9 January 2015).

A systematic review of interventions to promote physical activity in the preschool setting

PURPOSE

Conduct a systematic review of school-based interventions to promote physical activity in preschoolers.

DESIGN AND METHODS

A systematic search of literature between 2002 and 2014 in nine electronic databases and reference lists was conducted using the terms physical activity combined with environment, children, or interventions.

RESULTS

Fourteen articles were identified. Interventions were environmental, cognitive/behavioral, or a combination. Positive interventions involving preschool children included manipulation of the playground with the number of children playing at one time, markings, or equipment, and goal setting and reinforcement.

PRACTICE IMPLICATIONS

More research is needed to determine interventions to promote physical activity in preschool children.