Physical activity attitudes, intentions and behaviour among 18-25 year olds: a mixed method study

Determinants and Factors of Physical Activity After Oncology Treatments (DEFACTO) in Metropolitan France: Protocol of a Mixed Methods Study and Intervention

BACKGROUND

While the scientific community widely recognizes the benefits of physical activity (PA) in oncology supportive care, cancer survivors who have undergone chemo- or radio-immunotherapy treatments struggle to meet PA recommendations. This underscores the importance of identifying factors influencing active lifestyle adoption and maintenance and proposing a multilevel model (micro-, meso-, and macrolevel) to better understand facilitators and barriers. Currently, no socioecological model explains an active lifestyle in the posttreatment phase of breast, colorectal, prostate, and lung cancers.

OBJECTIVE

The objective is to identify factors influencing an active lifestyle in cancer survivorship and assess the feasibility of an individualized program targeting an active lifestyle. The objectives will be addressed in 3 stages. Stage 1 aims to elucidate factors associated with the active lifestyle of cancer survivors. Stage 2 involves developing an explanatory model based on previously identified factors to create a tailored health education program for an active lifestyle after oncology treatments. Stage 3 aims to evaluate the feasibility and potential effects of this personalized health education program after its national implementation.

METHODS

First, the exploration of factors influencing PA (stage 1) will be based on a mixed methods approach, using an explanatory sequential design and multilevel analysis. The quantitative phase involves completing a questionnaire from a socioecological perspective. Subsequently, a subset of respondents will engage in semistructured interviews to aid in interpreting the quantitative results. This phase aims to construct a model of the factors influencing an active lifestyle and develop an individualized 12-week program based on our earlier findings (stage 2). In stage 3, we will implement our multicenter, multimodal program for 150 physically inactive and sedentary cancer survivors across metropolitan France. Program feasibility will be evaluated. Measured PA level by connected device and multidimensional variables such as declared PA and sedentary behaviors, PA readiness, motivation, PA preferences, PA knowledge and skills, and barriers and facilitators will be assessed before and during the program and 52 weeks afterward.

RESULTS

The institutional review board approved the mixed methods study (phase 1) in April 2020, and the intervention (phase 3) was approved in March 2022. Recruitment and data collection commenced in April 2022, with intervention implementation concluded in May 2023. Data collection and full analysis are expected to be finalized by July 2024.

CONCLUSIONS

The Determinants and Factors of Physical Activity After Oncology Treatments (DEFACTO) study seeks to enhance our understanding, within our socioecological model, of factors influencing an active lifestyle among cancer survivors and to assess whether a tailored intervention based on this model can support an active lifestyle.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05354882; https://www.clinicaltrials.gov/study/NCT05354882.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/52274.

Gender-Based Heat Map Images of Campus Walking Settings: A Reflection of Lived Experience

Fear of crime can influence our view of and experience with the world around us. This can be problematic for individuals seeking physical activity, including from walk commuting. Prior work shows fear is especially evident among women, who report fear of rape and sexual abuse by men as a primary concern. We present the results of a cross-sectional survey (n = 571) where participants were shown images from college campus (n = 4 campuses) depicting different lighting (daytime, nighttime), and entrapment levels (high, low; i.e., able to easily escape if needed, with high entrapment being difficult and low being easy), and using the Qualtrics heat map tool, selected features that stood out to them most. Data were segregated by gender and analyzed to determine similarity of heat maps for the same base image. Heat map images were analyzed using canonical correlation (Rc) to determine the relationship between the two groups; dispersion testing to decipher spatial uniformity within the images; the Structural Similarity Index (SSIM) to characterize the nature of image patterns differences; and, the Breslow-Day Test to specify pattern locations within images. Several heat map images are also presented in the results. Overall, female and male participants appear to "see" different things when imagining walk-commuting (as seen by poor Rc values) and the nature of what they were looking at were different (as seen by poor SSIM values). Female participants tended to focus on areas outside the walking path, such as bushes and dark areas, whereas men's focus was on the path ahead [χ2(1) = 4.29, p = 0.04]. Furthermore, women were more likely to select areas outside the walking path during high entrapment settings [χ2(1) = 15.49, p < 0.001] and at nighttime [χ2(1) = 4.98, p = 0.02]. Our study demonstrates point-of-view differences in female-male walking space assessments. Viewing walking safety through the lens of lived experience could be productive for holistic community walking safety.

The health perception of urban green spaces and its emotional impact on young adults: an empirical study from three cities in China

Introduction

Exposure to green space can bring many benefits to physical and mental health, but in China, the attractiveness of green space to youth groups seems to be not significant. The question of how to encourage young people to go out of the house to better perceive green space, enjoy nature, and promote physical and mental health is on our minds.

Methods

This study combines young people's green space perception, green space use, and purpose of visit to explore its impact on the emotional health of youth groups, combined with the PANAS psychological data scale, an online questionnaire survey of 426 residents (18-35  years old) in three Chinese cities, and was used to construct a multiple regression model and AMOS structural equations.

Results and discussion

The results of the study showed that, firstly, environmental attractiveness, environmental odor, and number of facilities were the key factors influencing adolescents' landscape perception evaluation, while activity space, environmental odor, and environmental attractiveness had a greater impact on adolescents' emotional well-being. Second, among adolescents' visit purposes, socializing and fitness were more likely to help them generate positive emotions while resting and viewing activities were effective in helping them alleviate negative emotions. In addition, in terms of usage, residents who took public transportation as well as those who arrived on foot were the most emotionally healthy. The findings of this paper provide insights for public policymakers, urban planners, and landscape architects to better encourage youth participation in green spaces when they are installed.

The role of psychosocial factors in the decision to enroll in physical education courses at the state college level

OBJECTIVE

Physical education (PE) courses may provide young adults with opportunities to become active, however, enrollment in college PE courses remains low.

PARTICIPANTS

This study examined psychosocial factors related to PE enrollment in a sample of 177 college students (29.4% completed a PE course).

METHODS

Participants completed an online survey that inquired about demographic information, college PE enrollment, exercise self-efficacy, and several open-ended questions regarding their enrollment decisions.

RESULTS

There were no differences in self-efficacy scores between PE completers and non-completers. PE completers had more positive previous experiences with PE (43.7% vs 19.3%, p < .01) while non-completers had more negative PE experiences (33% vs 12.5%, p = .03). PE completers felt that self-improvement (51.5% vs 21.3%, p < .01) was most important regarding decisions to enroll in a PE course, while non-completers were concerned with PE courses counting toward their degree (29.2% vs 9.1%, p = .02).

CONCLUSIONS

These findings can help inform those involved in teaching and administration of PE courses at the state college level. Future research should further investigate how past PE experiences shape students' feelings toward PE.

Effect of a Multifaceted Intervention on Children's Body Image and the Mediating Role of Body Image in Changes in Adiposity Indicators

Besides genetic factors and energy-related behaviors, psycho-cultural factors are also important in obesity etiology. Previous studies have suggested that improving body image might be an effective method for managing body weight. Thus, this study aimed to evaluate the effects of a multifaceted intervention on the body image of children and explore whether body image played a mediating role in changes in adiposity indicators. This study was embedded in a cluster randomized controlled trial, involving 1287 children from 24 primary schools in three cities in China (Beijing, Changzhi and Urumqi). The 9-month multifaceted intervention on childhood obesity included five components (three targeted children and two targeted environments), and randomization was performed by an independent person who was blinded to the schools. Two indicators (body size perception and body size expectation) were chosen to characterize body image and were measured by Ma figural stimuli at baseline and the end of the trial. Changes in body image indicators were classified as conducive to weight loss or not. Other anthropometric measures and self-reported behaviors were also collected at both time points. Generalized linear mixed models were used in the analyses. Compared to the controls (n = 648), the proportion of body size perception conducive to weight loss increased in the intervention group (n = 639), with an odds ratio of 2.42 (95%CI: 1.70~3.45, p < 0.001). The proportion of body size expectation conducive to weight loss also increased more in the intervention group than in the controls (OR = 1.74, 95%CI: 1.14~2.66, p = 0.010). In children whose baseline nutritional status was "normal weight with higher BMI" or "overweight/obese", the improvements in body size perception and body size expectation partly mediated the association between the intervention and changes in BMI, BMI Z score, waist circumference and body fat percentage (p < 0.05). This multifaceted study effectively improved the body image of children, which, in turn, led to beneficial changes in adiposity indicators. For the first time, body size perception and body size expectation have been confirmed to be important factors associated with the beneficial effect of a childhood obesity intervention, suggesting that body image components should be generalized in the future.

Age-dependent changes in the risk of weight gain in Chinese adults: results from the Kailuan cohort study

OBJECTIVES

Over the past decades, China has seen a dramatic epidemic of overweight and obesity. However, the optimal period for interventions to prevent overweight/obesity in adulthood remains unclear, and little is known regarding the joint effect of sociodemographic factors on weight gain. We aimed to investigate the associations of weight gain with sociodemographic factors, including age, sex, educational level, and income.

STUDY DESIGN

This was a longitudinal cohort study.

METHODS

This study included 121,865 participants aged 18-74 years from the Kailuan study who attended health examinations over the period 2006-2019. Multivariate logistic regression and restricted cubic spline were used to evaluate the associations of sociodemographic factors with body mass index (BMI) category transitions over two, six, and 10 years.

RESULTS

In the analysis of 10-year BMI changes, the youngest age group had the highest risks of shifting to higher BMI categories, with odds ratio of 2.42 (95% confidence interval 2.12-2.77) for a transition from underweight or normal weight to overweight or obesity and 2.85 (95% confidence interval 2.17-3.75) for a transition from overweight to obesity. Compared with baseline age, education level was less related to these changes, whereas gender and income were not significantly associated with these transitions. Restricted cubic spline analyses suggested reverse J-shaped associations of age with these transitions.

CONCLUSIONS

The risk of weight gain in Chinese adults is age dependent, and clear public healthcare messaging is needed for young adults who are at the highest risk of weight gain.

The Criteria to Identify Pornography That Can Support Healthy Sexual Development for Young Adults: Results of an International Delphi Panel

Pornography is not homogenous. There is a paucity of research that offers guidance to young adults and adult stakeholders interested in navigating the available range of pornography to find materials that support healthy sexual development for young adults. Drawing on the expertise of a Delphi Panel of experts from a range of relevant areas this article offers six criteria for assessing whether pornography can support healthy sexual development: includes a variety of sexual practices; includes a variety of body types, genders and races; shows negotiation of consent on screen; is known to be ethically produced; focuses on pleasure for all participants; shows safe sex. The article identifies four pornographic websites that may meet these criteria: Sex School, Make Love Not Porn, PinkLabel.TV and Lust Cinema.

Psychological Correlates of Perceived Physical Activity Engagement During the COVID-19 Pandemic Among Previously Active Individuals

The COVID-19 pandemic altered daily life in the United States and disrupted how people engage in routine health behaviors, such as physical activity (PA). This study investigates factors that may have helped people sustain recommended levels of moderate to vigorous PA (MVPA) during this time. Using a cross-sectional design, we recruited from Amazon's Mechanical Turk in April/May 2020 a sample of individuals who reported that they had met recommended PA guidelines (≥ 150 weekly MVPA minutes; N = 397) prior to structural changes brought about by COVID-19. We assessed via self-report whether these individuals were meeting recommended levels of MVPA during the COVID-19 pandemic, their intrinsic motivation and identified regulation for exercise, exercise self-efficacy, perceived disruption to their exercise routine, and access to resources for PA. Higher identified regulation, self-efficacy, access to PA resources, and lower perceived disruption were associated with meeting PA guidelines during COVID-19. These findings provide insight into factors that may be important for continued engagement in MVPA when one experiences major disruptions to their exercise routine.Supplemental data for this article is available online at https://doi.org/10.1080/08964289.2021.1929811 .

Under pressure to exercise: a cross-sectional study of characteristics and predictors of compulsive exercise in early adolescents

BACKGROUND

To investigate the frequency of compulsive exercise among early adolescents, and determine the associated impact of sex, physical activity level, exercise habits, motivational regulation, dieting behaviour and health-related quality of life (HRQoL) on compulsive exercise.

METHODS

Cross-sectional design with 8th grade adolescents (n = 572, mean ± SD age 13.9 ± 0.3 yrs). Outcome assessment was compulsive exercise (Compulsive Exercise Test, CET). Total CET score ≥ 15 was defined as clinical CET score. Further assessment included exercise motivation (Behavioural Regulation of Exercise Questionnaire-2), HRQoL (KIDSCREEN 27), accelerometer-assessed physical activity and Andersen test for cardiorespiratory fitness. Exercise obsession was defined as clinical CET score and < 60 min/day with moderate-to-vigorous objectively assessed physical activity.

RESULTS

Small sex differences were found for CET total score. Seven percent of the adolescents were classified with clinical CET score, and four percent with exercise obsession. Adolescents with clinical CET score had higher body mass index, more weight loss attempts, and lower physical fitness compared to adolescents with non-clinical CET score. Being a boy, higher scores on introjected motivational regulation and HRQOL subscale parent relation and autonomy, use of exercise monitoring tool, and number of weight loss attempt the past 12 months explained 39% of the total CET score variance. Physical activity level did not predict compulsive exercise.

CONCLUSIONS

Compulsive exercise in early adolescents was predicted by exercise motivation, exercise habit, and dieting, but not physical activity level. This implicates a distinction of obsessive cognitions about physical activity from performed physical activity in adolescents, and that such cognitions must be addressed in future initiatives that aim to improve adolescents' general physical activity level, health, and wellbeing. Trial registration ClinicalTrials.gov: NCT03906851. Although there is a huge concern about adolescents being insufficiently physically active, there are also adolescents who struggle with issues of compulsive exercise. The issues of compulsive exercise have been rarely studied in adolescents. We therefore aimed to describe compulsive exercise and factors that were associated with and could explain presence of compulsive exercise. A total of 572 8th graders (age 13.9 ± 0.3 yrs) responded to this study. We found that the score on compulsive exercise was higher in boys than in girls, and that adolescents with high score on compulsive exercise had higher body mass index, more weight loss attempts, and lower physical fitness compared to adolescents with low score on compulsive exercise. Also, we found that exercise obsessions, i.e., thinking of exercise without actually exercising, was present in four percent of the respondents. Being a boy, attempting weight loss, exercising to avoid shame/guilt, and exercising for the perceived value of exercise predicted compulsive exercise. Awareness of the compulsive exercise and exercise obsessions is important in public health initiatives that aim to increase adolescents' physical activity level.

Design and validation of theory-based perceptions concerning the physical literacy questionnaire for pregnant women (P2LQ-PW)

Background

There is evidence that physical literacy plays an essential role in understanding the importance of maintaining appropriate physical activity and thereby preventing illnesses during pregnancy. The present study aimed to design and validate a physical literacy questionnaire focused on pregnant women.

Methods

In this exploratory psychometric study, theory-based perceptions concerning the physical literacy questionnaire for pregnant women were designed. Face-to-face interviews were conducted to develop the initial items. The findings from the interviews were merged with the literature review. The content, construct, and face validity was assessed by the participation of midwives, health educationists, and pregnant women. The content validity ratio, content validity index, and impact score of the items were calculated. The construct validity of the questionnaire was calculated through confirmatory and exploratory factor analysis. The reliability of the questionnaire was calculated by the standard error of measurement, intra-class correlation coefficient, composite reliability, and Cronbach’s alpha.

Results

The highest score was seen in the knowledge subscale and the value of Cronbach’s alpha for the subscales was 0.89 to 0.97, and the value of ICC was 0.76 to 0.89. The correlation according to the opinion of experts was satisfactory in all items of the questionnaire. The minimum loading factor for varimax rotation in the knowledge subscale was 0.41, the attitude was 0.56, the nurture factor was 0.38, and enabling factor was 0.27. The compatibility of the model among the constructs was confirmed by the normed chi-square (χ²/ df) < 5.0, comparative fit index ≥0.90, Tucker-Lewis index ≥0.9, and root mean square error of approximation < 0.08.

Conclusion

The physical literacy questionnaire for pregnant women is the first tool based on the PEN-3 model that other researchers can use to collect data and conduct educational interventions to change physical literacy behavior among Persian women during pregnancy.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-14204-7.

Implementing population-wide mass media campaigns: Key drivers to meet global recommendations on fruit and vegetable consumption

While the influence of implementation of mass media and community-based campaigns has been evident elsewhere, this information has been notably absent in Thailand. This study aimed to investigate the association between implementation of mass media campaigns (MMC) and community-based campaigns (CBC) for increased fruit and vegetable (FV) consumption to meet the global recommended level in the Thai population. The sample was obtained from a nationally-representative, longitudinal household survey of the Thai population, Round1 (2018) and Round2 (2019). The study applied a multi-stage sampling design to obtain a sample of persons age 15 years or older. Face-to-face interviews were conducted with 3,010 respondents who successfully participated in both Round1 and Round2 surveys. Information on FV consumption, exposure to Government MMC, ThaiHealth MMC including social marketing (MMSMC) and CBC, and sociodemographic characteristics were collected. Binary logistic regression analysis was used to investigate the association between implementation of those campaigns and increased FV consumption compared to the recommended level. Of the total respondents, only 11.3% had higher FV consumption and also met the minimum requirement. Respondents who lived in rural areas, were farmers, and grew FV at home had the highest probability of increased FV consumption. Exposure to the MMC and CBC was also associated with an increase in FV consumption. Above all, those who had exposure to the MMSMC, who reported either having high level of perception (OR = 1.832, 95% CI 1.259–2.666) or ever heard or seen (OR = 1.770, 95% CI 1.264–2.479) or heard and seen (OR = 1.698, 95% CI 1.131–2.550) campaign information were more likely to have a substantial increase in FV consumption and meeting/exceeding the recommended level than those who were not exposed to these campaigns. Other associated factors include education, occupation and physical activity. Implementation of MMSMC can help the population meet the global recommended level of FV consumption. This study presents its novelty since it was the first to highlight influence of mass media campaigns on increased FV consumption in Asian population. This was also the first study that used data from a population-based longitudinal study. The study suggested that MMC and CBC should also be promoted together with support systems to increase their intensity to a level that can increase population FV consumption to meet the recommended level. Sociodemographic characteristics should be taken into account, and targeted media is needed to effectively reach specific sub-groups of the population.

Physical exercise and its associated factors among Ethiopian pregnant women: a cross-sectional study based on the theory of planned behavior

Introduction

Women in Ethiopia prefer sedentary behavior and are physically inactive during pregnancy; this increases the risks of pregnancy-related complications. Therefore, this study aimed to assess physical exercise and its associated factors among pregnant women attending Antenatal Care at Debermarkose Referral Hospital, Northwest Ethiopia: using the theory of planned behavior.

Methods

An institution-based cross-sectional study was conducted from 23rd February to 10th June, 2020. A systematic random sampling technique was used to select 333 study participants. Data were collected with face-to-face interviews using a pretested structured questionnaire. Epi-info and STATA version 14.0 were used for data entry and analysis respectively. Multivariable linear regression analysis was done to identify the association between dependent and independent factors, and p < 0.05 was used as a cutoff to determine statistical significance at multivariable logistics regressions.

Result

A total of 333 pregnant women were participated in this study with response rate of 98%. The proportion of variance (R²) in intention accounted for the factors was 0.79. The magnitude of intention to do physical exercise during the current pregnancy was 3.8 ± 2. primary level of education (β = 0.43; 95% CI 0.25, 0.61), 2nd trimester gestational age (β = 0.19; 95% CI 0.04, 0.33), 3rd trimester gestational age (β = 0.17; 95% CI 0.02, 0.32), Attitude (β = 0.34; 95% CI 0.19, 0.49), subjective norm (β = 0.12; 95% CI 0.01, 0.23) and perceived behavioral control (β = 0.45; 95% CI 0.33, 0.57) were significantly associated with pregnant womens’ intention to do physical exercise during pregnancy period.

Conclusion and recommendations

This study provided that the theory of planned behavior could be successfully applied to identify the factors related to the intention to do physical exercise during pregnancy The program designers who work on pregnancy better consider providing Information education and communication to change the attitude, work on influencing significant individuals and barriers and enabling factors.

Patterns and Associations of Physical Activity, Screen Time, Sleep, and Dietary Habits among Saudi Females Participating in Fitness Centers

This study was designed to investigate the level and associations of physical activity, sedentary behavior, sleep, and dietary habits among Saudi women attending fitness centers in Riyadh. A descriptive cross-sectional study was carried out from 12 fitness centers in Riyadh, Saudi Arabia. A total of 460 participants answered a two-part survey self-administered questionnaire, which included information about the demographic characteristics and lifestyle. The analysis found significant differences between the two groups in terms of age, weight, BMI, and combined prevalence of being overweight and obese. Compared with less active females, high active females showed significantly more favorable dietary habits (p < 0.05). Significantly higher values were observed for the total physical activity energy expenditure in METs-min/week (p = 0.028). Moreover, females with high screen time (>3 h per day) were younger, less active, slept longer, and had higher intakes of fast foods and chocolates/candy intake (p = 0.001). Overall, the participants were highly active, exceeding the recommended physical activity needed to enhance health. The analysis also showed sufficient sleep duration (>7 h/night) was significantly associated with the diet and nutrition of the participants. Health education programs are needed to reduce the risks of sedentary behavior, sleep problems, and dietary habits.

Physical activity intention and attendance behaviour in Finnish youth with cerebral palsy - results from a physical activity intervention: an application of the theory of planned behaviour

Physical activity is associated with better health in individuals with cerebral palsy (CP). Numerous physical activity interventions have been designed to promote physical activity among youth with CP. No previous studies have explored the factors contributing to the intention to participate and predicting attendance behaviour for these interventions. Using theory of planned behaviour (TPB), this study explored the prediction of physical activity intention and attendance behaviour in a physical activity intervention aiming to promote physical activity in a sample of young individuals with CP. Males with CP aged 9–21 years were asked to complete measures of attitude, subjective norms, perceived behavioural control and, intentions towards a physical activity intervention. Participants had no cognitive impairments to understand and follow instructions, were categorised into Gross Motor Function Classification System I–III, did not receive any specific lower limbs’ medical treatment, or did not participate in a strength training program for lower limbs within 6 months before the study. Subjective norms were found to be the only significant predictor of intention, accounting for 83% of variance in intention. Intention and perceived behaviour control were found to be a nonsignificant predictor of attendance behaviour in youth with CP. The results show that TPB is a relevant tool in the prediction of intention towards a physical activity intervention in Finnish youth with CP.

Training During the COVID-19 Lockdown: Knowledge, Beliefs, and Practices of 12,526 Athletes from 142 Countries and Six Continents

Objective

Our objective was to explore the training-related knowledge, beliefs, and practices of athletes and the influence of lockdowns in response to the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Methods

Athletes (n = 12,526, comprising 13% world class, 21% international, 36% national, 24% state, and 6% recreational) completed an online survey that was available from 17 May to 5 July 2020 and explored their training behaviors (training knowledge, beliefs/attitudes, and practices), including specific questions on their training intensity, frequency, and session duration before and during lockdown (March–June 2020).

Results

Overall, 85% of athletes wanted to “maintain training,” and 79% disagreed with the statement that it is “okay to not train during lockdown,” with a greater prevalence for both in higher-level athletes. In total, 60% of athletes considered “coaching by correspondence (remote coaching)” to be sufficient (highest amongst world-class athletes). During lockdown, < 40% were able to maintain sport-specific training (e.g., long endurance [39%], interval training [35%], weightlifting [33%], plyometric exercise [30%]) at pre-lockdown levels (higher among world-class, international, and national athletes), with most (83%) training for “general fitness and health maintenance” during lockdown. Athletes trained alone (80%) and focused on bodyweight (65%) and cardiovascular (59%) exercise/training during lockdown. Compared with before lockdown, most athletes reported reduced training frequency (from between five and seven sessions per week to four or fewer), shorter training sessions (from ≥ 60 to < 60 min), and lower sport-specific intensity (~ 38% reduction), irrespective of athlete classification.

Conclusions

COVID-19-related lockdowns saw marked reductions in athletic training specificity, intensity, frequency, and duration, with notable within-sample differences (by athlete classification). Higher classification athletes had the strongest desire to “maintain” training and the greatest opposition to “not training” during lockdowns. These higher classification athletes retained training specificity to a greater degree than others, probably because of preferential access to limited training resources. More higher classification athletes considered “coaching by correspondence” as sufficient than did lower classification athletes. These lockdown-mediated changes in training were not conducive to maintenance or progression of athletes’ physical capacities and were also likely detrimental to athletes’ mental health. These data can be used by policy makers, athletes, and their multidisciplinary teams to modulate their practice, with a degree of individualization, in the current and continued pandemic-related scenario. Furthermore, the data may drive training-related educational resources for athletes and their multidisciplinary teams. Such upskilling would provide athletes with evidence to inform their training modifications in response to germane situations (e.g., COVID related, injury, and illness).

Supplementary Information

The online version contains supplementary material available at 10.1007/s40279-021-01573-z.

Motives and Barriers Related to Physical Activity and Sport across Social Backgrounds: Implications for Health Promotion

Studies have found physical inactivity to be a significant health risk factor and have demonstrated how physical inactivity behaviour varies according to social background. As a result, differences according to social background must be considered when examining motives and barriers related to physical activity and sport. This scoping review examines motives and barriers related to physical activity and sport among people with different social backgrounds, including age, socioeconomic status, gender, ethnic minority background and disability status. A systematic literature search was performed in four scientific databases and yielded 2935 articles of which 58 articles met the inclusion criteria. We identified common motives for physical activity and sport as health benefits, well-being, enjoyment, social interaction, and social support; common barriers as time restrictions, fatigue and lack of energy, financial restrictions, health-related restrictions, low motivation, and shortage of facilities. We also identified several motives and barriers that were specific to or more pronounced among people with different social backgrounds. The knowledge about motives and barriers related to physical activity and sport provided in this article can inform health promotion initiatives that seek to improve public health both in general and when specifically targeting groups of people with different social backgrounds.

Theory of Planned Behavior and Perceived Role Model as Predictors of Nutrition and Physical Activity Behaviors Among College Students in Health-Related Disciplines

Physical activity (PA) and nutrition behaviors among college students in health-related disciplines are understudied. We used theory of planned behavior (TPB) and role model beliefs (RMB) to predict PA and eating behaviors of college students in health-related programs (nurses, physical education, exercise science, and athletic training). A 26-item survey was administered among the participants. Independent variables included TPB constructs and RMB measured on a 5-point scale. PA was measured by multiplicative scores of students' number of days by the amount of time spent exercising per week. Nutrition behavior was measured using fruits (2½ c-eq/day), vegetables (2½ c-eq/day), dairy (2 c-eq/day), grains (6 oz-eq/day), and proteins (5½ oz-eq/day). Multiple regression analyses were used to predict PA and nutrition behaviors. A total of 271 college health majors (mean age 22.5 ± 4.6 years) participated in the study. The majority (56.8%) of students did not meet the weekly PA guidelines and 43.2% did not meet the recommended dietary guidelines for daily servings of food groups combined. Regression analyses showed that outcome evaluation, behavioral belief, and RMB, were significantly related with student's PA behavior and they accounted for 34%, 8%, and 1% of the variance, respectively (total R² = 44.7). Outcome evaluation and behavioral beliefs were significantly related with nutritional behavior and they accounted for 13.3%, and 5.3% of the variance respectively (total R² = 18.6). TPB (outcome evaluation, behavioral belief) and RMB could be used to guide programs in promoting PA and nutrition behavior among college health majors.

A cross-sectional study of physical activity behaviour and associations with wellbeing during the UK coronavirus lockdown

This study assessed physical activity (PA) and wellbeing during lockdown. UK adults reported their PA in the previous week, perception of PA importance (more, less, same) and wellbeing, depression, anxiety and stress. One-way ANOVA compared PA and wellbeing by PA importance. The 'less' importance group did less PA than the 'more' and 'same' (p < 0.05) importance group; and scored worse on all wellbeing measures than the 'same' importance group (p < 0.01). They also had worse wellbeing, depression and anxiety than the 'more' importance group (p < 0.05). Strategies to overcome the impact of the pandemic should aim to increase PA.

Reductions in Cardiopulmonary Disease Risk Following Calisthenic Concurrent Aerobic and Resistance Training in Young Adults in a Low Resource Setting

Background: Studies have demonstrated that young adults, especially in low- to middle-income countries, are increasingly susceptible to unfavorable alterations in body composition during their transition from adolescence to adulthood. This places young adults at an increased risk for numerous chronic diseases, such as cardiovascular, and/or pulmonary diseases. Objectives: This study aimed to determine if concurrent aerobic and resistance calisthenic training could reduce cardiopulmonary disease risk in young adults in a low resource setting. Methods: Thirty young adult males were randomly assigned to either a six-week non-exercising control group (NON) or concurrent aerobic or resistance training group (CON) that engaged in three, non-consecutive, 60-minute exercise sessions using a combination of 4 - 5 progressive resistance training exercises for two sets of 15 - 20 repetitions and 30 minutes of aerobic exercises at a rating of perceived exertion of 9 - 15. This study assessed anthropometry (body mass, stature, body mass index waist-to-hip ratio, waist-to-stature ratio, sum of skinfolds, percentage body fat, fat mass, fat free mass and conicity index) and lung function (forced vital capacity (FVC), forced expired volume in one second (FEV1), forced expiratory volume in one second/forced vital capacity ratio (FEV1/FVC), peak expiratory flow (PEF), maximal expiratory flow at 75% (MEF75%), maximal expiratory flow at 50% (MEF50%) and maximal expiratory flow at 25 (MEF25%). Results: Concurrent training resulted in significant (P ≤ 0.05) improvements in waist-to-hip ratio (0.94 ± 0.04 to 0.92 ± 0.05; P = 0.042), fat free mass (57.46 ± 9.16 to 58.21 ± 8.65 kg; P = 0.018), percentage body fat (14.56 ± 5.96 to 13.24 ± 5.77%, P = 0.006), fat mass (10.22 ± 5.31 to 9.29 ± 5.17 kg; P = 0.008), sum of skinfolds (96.22 ± 35.64 to 87.67 ± 32.15 mm; P = 0.004), PEF (5.06 ± 2.04 to 6.57 ± 2.51 L; P = 0.018), MEF75% (4.78 ± 2.01 to 6.24 ± 1.99 L.sec-1; P = 0.026), MEF50% (4.08 ± 1.20 to 5.24 ± 1.44 L.sec-1; P = 0.043) and MEF25% (2.66 ± 0.63 to 3.31 ± 1.87 L.sec-1; P = 0.038). Conclusions: The findings support the feasibility and efficacy of a simple and inexpensive concurrent aerobic and resistance training program to simultaneously improve body composition and lung function in an attempt to curb the increasing incidence of overweight/obesity and associated lung dysfunction in young adults in a low resource setting.

Overweight/obesity among 15- to 24-year-old women in Ghana: 21-year trend, future projections and socio-demographic correlates

Although developing countries are experiencing some of the fastest rises in the prevalence of adult overweight and obesity, little is known about the pace of the problem among young people in transition from adolescence to adulthood. This study examined the trend and associated socio-demographic predictors of overweight/obesity (BMI ≥25kg/m2) from 1993 to 2014 among women aged 15-24 years in Ghana and projected the future prevalence from 2019 to 2040. Descriptive statistics, the arithmetic linear change model, and binary logistic regression were applied to data on women aged 15-24 years from five nationally representative Ghana Demographic and Health Surveys conducted in 1993 (N=488), 1998 (N=517), 2003 (N=1832), 2008 (N=1693) and 2014 (N=1491). Overall, overweight/obesity among women aged 15-24 years almost tripled between the 1993 (6.8%; 95% CI=4.9-9.3) and 2014 (19.5%; 95% CI=17.3-21.2) surveys. Based on the arithmetic linear change model, overweight/obesity is projected to increase linearly to over 35% among the 15-24 year cohort of women by 2040. Age, educational level, wealth status, occupation, type of locality, ethnicity, frequency of viewing TV per week, parity and contraceptive use were found to be significant predictors of overweight/obesity among this sub-group of women. The trend of overweight/obesity demonstrated in this group of women could potentially provide momentum for further increases in the prevalence of overweight/obesity and associated health outcomes in the coming years in Ghana. This underscores the need for urgent national-level public health intervention efforts to curtail the problem.

A systematic review of physical activity, sedentary behavior, and substance use in adolescents and emerging adults

The transition from adolescence into emerging adulthood is marked by changes in both physical activity and substance use. This systematic review characterized associations between movement behaviors (physical activity, sedentary behavior) and frequently used substances (alcohol, cannabis) among adolescents and emerging adults to inform lifestyle interventions that target multiple behavior change outcomes. This systematic review was guided by PRISMA. Electronic databases of PubMed, PsycINFO, and Web of Science were searched from inception through June 25, 2019. The search was designed to identify empirical studies reporting an association between physical activity or sedentary behavior and alcohol or cannabis, with search criteria determining eligibility based on several sampling characteristics (e.g., participants under 25 years of age). After identifying and screening 5,610 studies, data were extracted from 97 studies. Physical activity was positively associated with alcohol use among emerging adults, but the literature was mixed among adolescents. Sedentary behavior was positively associated with alcohol and cannabis use among adolescents, but evidence was limited among emerging adults. Self-report measures were used in all but one study to assess these behaviors. Physical activity is linked to greater alcohol use among emerging adults. Whereas existing studies demonstrate that sedentary behavior might serve as a risk marker for alcohol and cannabis use among adolescents, additional primary research is needed to explore these associations in emerging adults. Future work should also use device-based measures to account for timing of and contextual features surrounding activity and substance use in these populations.

Physical Activity in the Daily Life of Adolescents: Factors Affecting Healthy Choices from a Discrete Choice Experiment

Physical activity improves peoples’ well-being and can help in preventing weight gain, obesity, and related non-communicable diseases. Promoting healthy behaviors in the daily travels and transport choices of adolescents is very important in early establishing healthy habits that imply routine physical activity. For designing and developing effective strategies, it is relevant to study adolescents’ preferences for physical activity and what factors in the social and environmental contexts affect their preferences. The paper investigates these aspects by means of a discrete choice experiment, using data from more than 4300 16–17 year-old adolescents in Italy. The results show that adolescents generally prefer walking for long time alone. However, females prefer cycling, while adolescents from lower educated families prefer motorized means of transport. Environmental factors affect the adolescents’ preferences: living nearby a green area is associated with more active and healthier choices in their short daily travels. Conversely, adolescents living closer to an industrial or high traffic area prefer to use motorized vehicles. Such findings have been discussed and policy implications presented, in order to support policymakers in designing cross-sectoral policies to promote healthy choices related to physical activity in adolescence.

Physical activity in physiotherapy students: Levels of physical activity and perceived benefits and barriers to exercise

Background

Physiotherapists have been identified as key role players in health promotion, prevention and treatment of non-communicable diseases.

Objectives

The aim of this study is to describe the perceived benefits and barriers to exercise and their association with levels of physical activity (PA) in physiotherapy students attending university in the Western Cape province of South Africa.

Method

This study follows a quantitative, cross-sectional, survey design. Two hundred and ninety-six participants were recruited from three universities in the Western Cape. Participants completed a demographic questionnaire (DQ), Exercise Benefits and Barriers Scale (EBBS) and the International Physical Activity Questionnaire (IPAQ).

Results

Female students accounted for 83% of the sample. Out of the 296 participants, 58% lived off-campus and 65% were involved in sporting activities six hours per week. The median score on the EBBS was 136 (54-167) for all years. Responses with the highest agreement for perceived benefits were associated with physical performance. Alternatively, responses with the highest agreement for perceived barriers were associated with physical exertion. Only 37.5% students engaged in high PA.

Conclusion

Undergraduate physiotherapy students in the Western Cape across all three universities do not engage in adequate PA. In this group of students, benefits associated with high PA related to physical performance and barriers associated with low levels of PA related to physical exertion.

Clinical implications

Physiotherapists who do not practise what they preach are not effective role models and may not be effective in obtaining behaviour change through PA-related health promotion.

Engagement with a Web-Based Health Promotion Intervention among Vocational School Students: A Secondary User and Usage Analysis

Engagement with web-based interventions is both generally low and typically declining. Visits and revisits remain a challenge. Based on log data of a web-based cluster randomized controlled trial conducted in vocational schools, the present secondary analysis aimed to identify influencing factors on initially logging in to a health promotion platform among young adults and to examine the engagement over the course of an eight-week intervention. Data of 336 students (62.2% female, age span 18–25) from two intervention arms (web-based intervention and web-based intervention with an additional initial face-to-face contact) was included. Binary logistic regression and log-data visualization were performed. An additional initial face-to-face contact (odds ratio (OR) = 2.971, p = 0.005), female sex (OR = 2.237, p = 0.046) and the health-related skill “dealing with health information” (OR = 2.179, p = 0.030) significantly increased the likelihood of initially logging in. Other variables showed no influence. 16.6% of all potential users logged in at least once, of which 57.4% revisited the platform. Most logins were tracked at the beginning of the intervention and repeated engagement was low. To increase the engagement with web-based interventions, health-related skills should be fostered. In addition, a strategy could be to interlink comparable interventions in vocational schools more regularly with everyday teaching through multi-component interventions.

Self-reported physical activity status among adolescents in Debre Birhan town, Ethiopia: Cross-sectional study

BACKGROUND

Regular physical activity reduces the risk of ischaemic heart disease, stroke, diabetes, and breast and colon cancer. But, adolescents are insufficiently physically active. Therefore, this study was aimed to assess self- reported physical activity status and associated factors among adolescents in Debre Birhan town, Ethiopia.

METHODS

School based cross-sectional study was conducted from April 20 to May 10/2019 in Debre Berhan town Secondary schools. Multi-stage sampling technique was used to select 580 study participants from three secondary schools. Physical activity was assessed using questions adopted from recreation, sport, and leisure-time physical activity assessment section of international physical activity questionnaire (IPAQ). Adolescents who have done moderate to vigorous exercise for 60 minutes per day for at least three days in the last seven days were categorized as physically active. Descriptive statistics, bivariable and multivariable logistic regression analysis was done. Probability value less than 0.05 was used as a cut of point to determined statistically significant association.

RESULT

A total of 580 students participated in this study. Less than 1 in 5 (17.2%, 95% confidence interval (CI) = 14.13%-20.27%) students were physically active. Male student (Adjusted odds ratio (AOR): 2.63, 95%CI = 1.5-4.59), age less than or equal to 16 (AOR: 2.04, 95% CI = 1.12-3.71) and access to sports center (gymnasium) (AOR: 2.09, 95% CI = 1.12-3.89 were positively associated with physical activity.

CONCLUSION

Physical activity status was very low. Therefore, the local, regional and national administrators in collaboration with sport and health offices administrators should make facilities accessible.

Magnitude of sedentary behavior and associated factors among secondary school adolescents in Debre Berhan town, Ethiopia

BACKGROUND

Sedentary life style is becoming increasingly common in this industrial age due to changes on the way people manufacture, transport and communicate. Sedentary lifestyle is associated with chronic diseases (diabetes, cardiovascular disease, and cancer), depression, obesity and premature mortality. The objective of this study was to assess the magnitude and associated factors of sedentary behavior.

METHODS

School based cross sectional study was conducted among 580 students from April 20 to May 10, 2019 in secondary schools in Debre Berhan City Administration. Sedentary behavior was measured using time spent on four activities (watching TV/Video, listening to music, surfing internet and playing games). Adolescents are considered sedentary if they spend two or more hours in one or all listed activities per day. Data was entered to Epidata version 4.2.2.1 and exported to SPSS version 20 for analysis.

RESULT

A total of 580 (44.3% male and 55.7% female) students participated in this study. The magnitude of sedentary behavior (≥2 h per day) was 65.5% (95% CI = 61.32% - 69.08). Family monthly income greater than 8000 birr (AOR: 6.42, 95%CI = 2.18-18.78), maternal education (AOR: 5.12, 95%CI = 1.09-23.83), access to TV (AOR: 4.87, 95%CI = 1.99-11.87), access to mobile internet (AOR: 2.37, 95% CI = 1.14-4.93) and utilization of social media (AOR: 2.98, 95%CI = 1.43-6.17) were positively associated with adolescent sedentary behavior.

CONCLUSION

The prevalence of sedentary behavior was high among adolescents of Debre Berhan town. Therefore, schools in the town should work towards creating awareness on the wise use of screen based entertainments.

Short-Term Psychological and Physiological Effects of Varying the Volume of High-Intensity Interval Training in Healthy Men

We assessed the short-term effects of varying the volume of high-intensity interval training (HIIT) on psychological and physiological responses of 23 healthy adult males ( M = 21 years; M peak oxygen uptake [VO2peak] = 47.2 ml·kg−1·min−1). Participants were randomly assigned to low- and very-low-volume HIIT groups and engaged in nine supervised exercise sessions over three weeks. The low-volume HIIT group performed 8-12 60-second work bouts on a cycle ergometer at the peak power output achieved during the incremental test, interspersed by 75 seconds of low-intensity active recovery. The very-low-volume HIIT performed 4-6 work bouts with the same intensity, duration, and rest intervals. During training, participants’ ratings of perceived exertion (Borg Category Ratio-10 scale) and their affective responses (Feeling Scale −5/+5) during the last 15 seconds of each work bout were recorded. Physiological data were VO2peak, endurance, and anaerobic performance before and after the intervention. Throughout training, participants in the very-low-volume group (relative to the low-volume group) reported lower ratings of perceived exertion in Week 1 ( M = 4.1 vs. M = 6.3; p < .01) and Week 3 ( M = 4.0 vs. M = 6.2; p < .01), and higher affective response in these same two weeks (Week 1: M = 1.9 vs. M = 0.3; p = .04; Week 3: M = 2.1 vs. M = 0.9; p = .06). Regarding physical fitness, Wingate peak power increased significantly after training in the very-low-volume HIIT group ( M = 1,049 W vs. M = 1,222 W; p < .05), but not in the low-volume HIIT group ( M = 1,050 W vs. M = 1,076 W). No significant change was found after training in physiological variables of peak power output, VO2peak, and endurance performance. In summary, in this short-term training period, the very-low-volume HIIT enhanced anaerobic capacity and was perceived as less strenuous and more pleasurable than low-volume HIIT.

Incidence of childhood overweight and obesity and its association with weight-related attitudes and behaviors in China: a national longitudinal study

BACKGROUND

Childhood obesity is a major public health challenge. We aimed to investigate the incidence of overweight/obesity among Chinese children; and prospectively examine the associations of weight-change intention with risk of overweight/obesity and behavioral changes in initially normal-weight children.

METHODS

A national sample of 21,796 children aged 6-17 years were investigated in September 2013 and followed up nine months later, of which 19,887 (91%) were normal weight and 1909 (9%) were underweight at baseline. Weight and height were objectively measured. Weight perception, weight-change intention, weight control practices, weight-related behaviors, and demographic information were obtained by questionnaires.

RESULTS

Among children with underweight or normal-weight, the cumulative incidence of overweight/obesity was 2.77% (95% CI 2.55-2.99). Among normal-weight children, those who overestimated their weight had higher baseline BMI z-scores and an increased relative risk (RR) of overweight/obesity (RR 1.51, 95% CI 1.15-1.99). Children who misperceived themselves as underweight or overweight had stronger weight-change intention than their counterparts. However, children with weight-change intention did not develop greater changes in dietary intakes, physical activities, or sedentary behaviors than those without intention. There was no significant association between weight-change intention and incidence after adjusting for BMI z-scores at baseline. Self-reported improving diet, increasing physical activity, and dieting were associated with certain actual behavioral improvements and smaller increase in BMI z-score, but not associated with decreased risk of overweight/obesity.

CONCLUSION

The 9-months cumulative incidence of overweight/obesity was 2.77% among Chinese children. Weight-change intention was not associated with incidence of overweight/obesity in normal-weight children, regardless of their weight perception. More importantly, children's weight-change intention was insufficient in achieving desirable behavioral changes. Future overweight and obesity prevention programs should directly target on promoting children's actual behavioral changes.

Overweight adolescents' brain response to sweetened beverages mirrors addiction pathways

Many adolescents struggle with overweight/obesity, which exponentially increases in the transition to adulthood. Overweight/obesity places youth at risk for serious health conditions, including type 2 diabetes. In adults, neural substrates implicated in addiction (e.g., orbitofrontal cortex (OFC), striatum, amygdala, and ventral tegmental area) have been found to be relevant to risk for overweight/obesity. In this study, we examined three hypotheses to disentangle the potential overlap between addiction and overweight/obesity processing by examining (1) brain response to high vs. low calorie beverages, (2) the strength of correspondence between biometrics, including body mass index (BMI) and insulin resistance, and brain response and (3) the relationship between a measure of food addiction and brain response using an established fMRI gustatory cue exposure task with a sample of overweight/obese youth (M age = 16.46; M BMI = 33.1). Greater BOLD response was observed across the OFC, inferior frontal gyrus (IFG), nucleus accumbens, right amygdala, and additional frontoparietal and temporal regions in neural processing of high vs. low calorie beverages. Further, BMI scores positively correlated with BOLD activation in the high calorie > low calorie contrast in the right postcentral gyrus and central operculum. Insulin resistance positively correlated with BOLD activation across the bilateral middle/superior temporal gyrus, left OFC, and superior parietal lobe. No relationships were observed between measures of food addiction and brain response. These findings support the activation of parallel addiction-related neural pathways in adolescents' high calorie processing, while also suggesting the importance of refining conceptual and neurocognitive models to fit this developmental period.

Gaming behaviour with Pokémon GO and physical activity: A preliminary study with medical students in Thailand

Pokémon GO becomes the most rapidly downloaded mobile application in history. This study aimed to determine the physical activity of medical students, who played Pokémon GO, and the change in their use of Pokémon GO and physical activity over time. An observational study was conducted. Physical activity was measured by using self-administered questionnaires at baseline (phase 0), 1 month (phase 1) and 3 months (phase 2) post-Pokémon GO download. The changes in physical activity (phase 0 to 1 and phase 1 to 2) were analysed using Wilcoxon Signed Ranked test. The trend (3-point analysis) of physical activity from phase 0, 1 to 2 were analysed using Friedman’s test. The relationship between physical activity and time spent gaming was analysed by using Spearman’s rank correlation. Twenty-six participants (mean age 22.04±1.70 years) participated in the study. There was no statistically significant change in physical activity during the three-month period (p = 0.45). Only 11 participants (42.3%) were still playing Pokémon GO 3 months after download. The key reasons for playing game were ‘have fun’ and ‘pass time/boredom’. The most common commuting mode to play the game was walking; some drove a car or motorcycle while playing the game. There was no correlation between physical activity and time spent gaming. This study highlights how the lack of sustainability of the game and the motivation behind using Pokémon GO as a game rather than a physical activity app may have undermined the potential of using the game to improve physical activity. Further studies need to explore the reasons for the lack of sustainability and how to combine fun with behavioural change.

Are young adults appreciating the health promotion messages on diet and exercise?

Aim

This study aims to determine if current health promotion messages relating to diet and physical activity are sufficiently targeted towards young adults. In addition, we examine what elements of these messages might be improved to ensure they encourage improved diet and exercise behaviours within this underserved group.

Subject and methods

Using qualitative methods, five focus group discussions (FGDs) and two semi-structured in-depth interviews were conducted among 19 young adults in Aberdeen City. An appropriate topic guide was developed for this purpose. After obtaining consent, all FGDs and interviews were audio-recorded and transcribed verbatim. A thematic analysis was conducted that allowed for emerging themes to be identified from the data. Links between themes were established and key quotes identified.

Results

Five major themes emerged: (1) exposure to health messages over time; (2) chains of healthy or unhealthy behaviours; (3) perceptions and attitudes towards health messages; (4) facilitators and barriers; (5) improving the usability of health messages.

Conclusions

The results demonstrate that young adults did not find current health promotion messages engaging. These messages did not support them in overcoming their perceived barriers, nor were they suitably formatted or located for them. There were suggestions from young adults on how to improve these messages including using social media, presenting messages in more usable forms, and working with larger corporations to make these messages more effective. Tailoring these messages specifically for young adults could improve their diet and exercise behaviours, thereby helping to reduce future obesity levels and co-morbidities within Scotland.

Electronic supplementary material

The online version of this article (10.1007/s10389-018-0905-9) contains supplementary material, which is available to authorized users.

Idealised media images: The effect of fitspiration imagery on body satisfaction and exercise behaviour

Recent studies have documented a shift in the cultural ideal of physical attractiveness, with women subscribing to a visibly toned ideal that emphasises health and fitness. The present study experimentally investigated the impact of athletic and muscular fitness-idealised images compared to traditional thin ideal images on women's body dissatisfaction and exercise behaviour, under the framework of Social Comparison Theory. Participants were 106 female undergraduate students randomly assigned to view one of three sets of images (thin ideal, athletic ideal, or muscular ideal) followed by a bout of exercise. Acute exposure to athletic ideal and thin ideal images led to increased body dissatisfaction, but exposure to muscular ideal images did not. Relative to thin ideal images, fitness-idealised images did not motivate participants to engage in higher levels of exercise suggesting that this type of fitness inspiration might not motivate actual exercise behaviour.

Correlates of sedentary behaviour in adults: a systematic review

OBJECTIVE

The objective of this study was to systematically review evidence to identify intrapersonal, social environmental, physical environmental and policy correlates of sedentary behaviour (SB) among adults.

METHODS

Six databases were searched to identify studies that reported on intrapersonal, social, physical environmental and/or policy correlates of SB across domains (i.e. occupational, leisure and transportation) in adults (mean ≥ 18 years old). Subgroup differences (sex, age, disease status, publication status and date, weekdays vs. weekend) were examined. Risk of bias was assessed, and a qualitative synthesis completed.

PROSPERO

CRD42014009814 RESULTS: Searching identified 22,779 articles; 257 were used in the analysis. Most studies used self-reported SB and were cross-sectional. The most studied domain of SB and correlate was leisure and intrapersonal, respectively. Consistent evidence found positive relationships between full-time employment and higher transportation and lower leisure SB; higher income/socioeconomic status and greater transportation and occupation SB; living in more urban areas and greater sitting time and total SB; ownership of televisions and greater leisure SB; and, active workstations and lower occupational SB.

CONCLUSIONS

The review identifies the need for longitudinal studies, as well as further research on factors in the physical, social and policy environments. The review also recognizes the need to standardize methodology for collecting, defining and reporting SB and correlates.

Tracing How Normative Messages May Influence Physical Activity Intention

Normative messages have been shown to increase intention to do physical activity. We traced how "positive" and "negative" normative messages influenced physical activity intention by comparing constructs of the model of goal-directed behavior with descriptive norms (MGDB + DNs) across control and treatment groups in an experiment. For this purpose, 16-24-year-old respondents (n = 1,200) in Bulgaria, Croatia, and Romania were asked about their age, sex, and levels of physical activity before being exposed to positive and negative normative messages and completing a questionnaire with MGDB + DNs scales. Different MGDB + DNs constructs were influenced by the normative messages: compared with the control, the negative message group showed stronger attitudes (p = .003) and the positive message group showed higher positive anticipated emotions (p = .005). The positive message's effect is consistent with the literature on conformity to social norms. The negative message's effect lends itself to interpretations based on social identity and deviance regulation theories.

Psychosocial and environmental correlates of active and passive transport behaviors in college educated and non-college educated working young adults

Background

This study aimed to examine potential differences in walking, cycling, public transport and passive transport (car/moped/motorcycle) to work and to other destinations between college and non-college educated working young adults. Secondly, we aimed to investigate which psychosocial and environmental factors are associated with the four transport modes and whether these associations differ between college and non-college educated working young adults.

Methods

In this cross-sectional study, 224 working young adults completed an online questionnaire assessing socio-demographic variables (8 items), psychosocial variables (6 items), environmental variables (10 items) and transport mode (4 types) and duration to work/other destinations. Zero-inflated negative binomial regression models were performed in R.

Results

A trend (p<0.10) indicated that more college educated compared to non-college educated young adults participated in cycling and public transport. However, another trend indicated that cycle time and public transport trips were longer and passive transport trips were shorter in non-college compared to college educated working young adults. In all working young adults, high self-efficacy towards active transport, and high perceived benefits and low perceived barriers towards active and public transport were related to more active and public transport. High social support/norm/modeling towards active, public and passive transport was related to more active, public and passive transport. High neighborhood walkability was related to more walking and less passive transport. Only in non-college educated working young adults, feeling safe from traffic and crime in their neighborhood was related to more active and public transport and less passive transport.

Conclusions

Educational levels should be taken into account when promoting healthy transport behaviors in working young adults. Among non-college educated working young adults, focus should be on increasing active and public transport participation and on increasing neighborhood safety to increase active and public transport use. Among college educated working young adults, more minutes of active transport should be encouraged.

Are parents' motivations to exercise and intention to engage in regular family-based activity associated with both adult and child physical activity?

BACKGROUND/AIM

To examine the associations between parents' motivation to exercise and intention to engage in family-based activity with their own and their child's physical activity.

METHODS

Cross-sectional data from 1067 parent-child pairs (76.1% mother-child); children were aged 5-6 years. Parents reported their exercise motivation (ie, intrinsic motivation, identified regulation, introjected regulation, external regulation and amotivation) as described in self-determination theory and their intention to engage in family-based activity. Parents' and children's mean minutes of moderate-to-vigorous-intensity physical activity (MVPA) and mean counts per minute were derived from ActiGraph accelerometers worn for 3 to 5 days (including a mixture of weekdays and weekend days). Multivariable linear regression models, adjusted for parent sex, number of children, indices of multiple deprivation and clustering of children in schools were used to examine associations (total of 24 associations tested).

RESULTS

In fully adjusted models, each unit increase in identified regulation was associated with a 6.08 (95% CI 3.27 to 8.89, p<0.001) min-per-day increase in parents' MVPA. Parents' external regulation was associated with children performing 2.93 (95% CI -5.83 to -0.03, p=0.05) fewer minutes of MVPA per day and a 29.3 (95% CI -53.8 to -4.7, p=0.02) accelerometer count-per-minute reduction. There was no evidence of association for the other 21 associations tested.

CONCLUSIONS

Future family-based physical activity interventions may benefit from helping parents identify personal value in exercise while avoiding the use of external control or coercion to motivate behaviour.

Adapting evidence-based behavioral weight loss programs for emerging adults: A pilot randomized controlled trial

Emerging adults are at high risk of obesity but behavioral weight loss programs do not meet their needs. Emerging adults ( N = 52, age = 22.3 ± 2 years, body mass index = 34.2 ± 5.5 kg/m², 46.2% non-Hispanic White) were randomly assigned to one of three behavioral weight loss programs adapted based on formative work: face-to-face behavioral weight loss, web-based behavioral weight loss, or web plus optional community sessions (Hybrid). Assessments occurred at 0 and 3 months. Engagement and self-monitoring were highest in Hybrid. Intent-to-treat weight losses were -2.8 ± 2.9 percent in face-to-face behavioral weight loss, -2.2 ± 4.5 percent in web-based behavioral weight loss, and 4.8 ± 4.9 percent in Hybrid. Percent achieving ⩾5 percent weight loss was highest in Hybrid (63%). Findings suggest potential for adapted behavioral weight loss to promote engagement and weight loss in emerging adults.

'Now I care': a qualitative study of how overweight adolescents managed their weight in the transition to adulthood

OBJECTIVES

A qualitative study of recalled experiences of early adolescent overweight/obesity revealed low levels of weight-related concern. This further analysis aimed to explore weight-related concern and weight-loss efforts as participants transitioned into adulthood.

DESIGN, PARTICIPANTS AND METHODS

Participants were 35 young adults from a population-based cohort study who had body mass index (BMI) >95th centile between ages 11 and 15 and participated in semistructured interviews aged 24. At age 24, they were categorised as: 'slimmers' (N=13) who had lower BMI Z-scores at 24 than their adolescent peak and were not obese (BMI<30 kg/m²); 'relapsers' (N=8, of whom 2 were morbidly obese (BMI>35 kg/m²) at age 24); 'stable' (N=3, of whom 1 morbidly obese); and 'gainers' (N=11, of whom 5 morbidly obese). Themes were identified and coded using NVivo qualitative data analysis software, blind to participants' current weight status.

RESULTS

Contrasting with the lack of concern recalled in respect of earlier adolescence, weight-related concerns and/or desire to lose weight generally increased around the time of school leaving and almost all participants described some form of exercise (formal/informal) and dietary weight-control strategies. Among 'slimmers', there was some (subtle) evidence of more consistent use of exercise, self-monitoring of diet and exercise and of lifestyle changes becoming habitual and/or part of identity. Few participants had accessed professional support. Diet clubs seemed to have been used most by 'gainers', some only recently. Labour-market and housing transitions were strong influences, described as facilitating weight losses by some, but increases by others. For some participants, it appeared that weight loss was simply a by-product of these transitions.

CONCLUSIONS

In contrast to earlier adolescence, even the heaviest participants tended to show actual weight loss action or preparation for action. The transition to adulthood could thus be a key life stage for interventions.

Smoking Cessation in Pulmonary Care Subjects: A Mixed Methods Analysis of Treatment-Seeking Participation and Preferences

BACKGROUND

African-American smokers experience disproportionate COPD morbidity. As a front-line COPD behavioral management strategy, smoking cessation is less prevalent among African-American smokers. Identifying barriers and predictors to smoking cessation in this population is important to bridging this disparity.

METHODS

In this study, the predictors of enrollment and attendance to a 3-session urban hospital smoking cessation program were examined. A retrospective chart review was conducted for all pulmonary clinic patients who smoked and were referred to the cessation program between June 2013 and May 2014. Demographic, smoking behavior, cardiopulmonary, and health status variables were extracted (N = 253). Second, a qualitative assessment of the beliefs and barriers for smoking cessation and physical activity were examined in a sub-sample of the population (n = 41).

RESULTS

One-hundred forty-seven of the pulmonary subjects (58%) enrolled in the cessation program, and 40 attended all sessions (16% of the total sample). Participants with COPD (odds ratio = 4.65, P = .030), or had a mother who had cancer (odds ratio = 4.49, P = .027), were more likely to attend the program. Qualitatively, pulmonary care patients who wanted to quit smoking and be more physically active cited: strong beliefs about the inability to engage in these behaviors, belief that quitting and increased activity might exacerbate poor health, and an inability to obtain pharmacotherapy as barriers to adopting these behaviors.

CONCLUSIONS

Smoking cessation program attendance in this sample of mostly African-American smokers was poor. Increased knowledge about cessation benefits and access to full-course pharmacotherapy, particularly in those without a COPD diagnosis and who do not have a maternal history of cancer, may be high-priority targets to promote cessation program uptake in this population. Increased knowledge and access to safe forms of physical activity may also be beneficial.

A mixed methods approach to improving recruitment and engagement of emerging adults in behavioural weight loss programs

Objective

Emerging adults ages 18–25 are at high risk for obesity, but are markedly underrepresented in behavioural weight loss (BWL) programs and experience lower engagement and retention relative to older adults.

Purpose

To utilize a mixed methods approach to inform future efforts to effectively recruit and engage this high‐risk population in BWL programs.

Methods

We used a convergent parallel design in which quantitative and qualitative data were given equal priority. Study 1 (N = 137, age = 21.8 + 2.2, BMI = 30.1 + 4.7) was a quantitative survey, conducted online to reduce known barriers and minimize bias. Study 2 (N = 7 groups, age = 22.3 + 2.2, BMI = 31.5 + 4.6) was a qualitative study, consisting of in person focus groups to gain greater depth and identify contextual factors unable to be captured in Study 1.

Results

Weight loss was of interest, but weight itself was not a central motivation; an emphasis on overall lifestyle, self‐improvement and fitness emerged as driving factors. Key barriers were time, motivation and money. Recruitment processes should be primarily online with messages tailored specifically to motivations and preferences of this age group. Preferences for a program were reduced intensity and brief, hybrid format with some in‐person contact, individual level coaching, experiential learning and peer support. Key methods of promoting engagement and retention were autonomy and choice, money and creating an optimal default.

Conclusions

An individually tailored lifestyle intervention that addresses a spectrum of health behaviours, promotes autonomy and emphasizes activity and fitness may facilitate recruitment and engagement in this population better than traditional BWL protocols.

Applying the Model of Goal-Directed Behavior, Including Descriptive Norms, to Physical Activity Intentions: A Contribution to Improving the Theory of Planned Behavior

The theory of planned behavior (TPB) has received its fair share of criticism lately, including calls for it to retire. We contribute to improving the theory by testing extensions such as the model of goal-directed behavior (MGDB, which adds desire and anticipated positive and negative emotions) applied to physical activity (PA) intention. We also test the inclusion of a descriptive norms construct as an addition to the subjective norms construct, also applied to PA, resulting in two additional models: TPB including descriptive norms (TPB + DN) and MGDB including descriptive norms (MGDB + DN). The study is based on an online survey of 400 young adult Internet users, previously enrolled in a subject pool. Confirmatory factor analysis (CFA) showed that TPB and TPB + DN were not fit for purpose, while MGDB and MGDB + DN were. Structural equation modelling (SEM) conducted on MGDB and MGDB + DN showed that the inclusion of descriptive norms took over the significance of injunctive norms, and increased the model's account of total variance in intention to be physically active.

Mirror, Mirror by the Stairs: The Impact of Mirror Exposure on Stair versus Elevator Use in College Students

Previous research has indicated that self-awareness-inducing mirrors can successfully incite behaviors that align with one's personal values, such as helping others. Other research has found a large discrepancy between the high percentage of young adults who report valuing the healthfulness of physical activity (PA) and the low percentage who actually meet PA participation standards. However, few studies have examined how mirror exposure and both perceived and actual body size influence highly valued PA participation among college students. The present study assessed stair versus elevator use on a western college campus and hypothesized that mirror exposure would increase the more personally healthy transportation method of stair use. In accordance with previous research, it was also hypothesized that males and those with a lower body mass index (BMI) would be more likely to take the stairs, and that body size distorting mirrors would impact the stair-elevator decision. One hundred sixty-seven students (51% male) enrolled in an introductory psychology course were recruited to take a survey about their "transportation choices" at an indoor campus parking garage. Participants were individually exposed to either no mirror, a standard full-length mirror, or a full-length mirror manipulated to make the reflected body size appear either slightly thinner or slightly wider than normal before being asked to go to the fourth floor of the garage for a survey. Participants' choice of floor-climbing method (stairs or elevator) was recorded, and they were administered an Internet-based survey assessing demographic information, BMI, self-awareness, perceived body size, and other variables likely to be associated with stair use. Results from logistic regression analyses revealed that participants who were not exposed to a mirror [odds ratios (OR) = 0.37, 95% CI: 0.14-0.96], males (OR = 0.33, 95% CI: 0.13-0.85), those with lower BMI (OR = 0.84, 95% CI: 0.71-0.99), those with higher exercise participation (OR = 1.09, 95% CI: 1.02-1.18), and those engaging in more unhealthy weight-control behaviors (OR = 1.55, 95% CI: 1.14-2.11) showed increased odds of taking the stairs. Implications and future directions are discussed.

Obesity Among Young Adults in Developing Countries: A Systematic Overview

This article discusses the overweight/obesity situation among young adults in developing countries. For this target population, obesity prevalence ranges from 2.3 to 12 %, and overweight is 28.8 %, mostly affecting females. Weight is now increasing during this life stage of transition at a higher rate, 1 kg/year, than in developed countries. Maternal factors and early childhood socioeconomic status are associated with BMI in young adults along with changing environmental and behavioural factors in some low and middle income countries, brought about by demographic and socioeconomic transitions. Young adults with 'normal weight' obesity need identification using other convenient low cost measures (skin folds or waist circumference) along with BMI. Obesity prevention or management interventions were not identified, but clearly needed to help stem the obesity pandemic. Young people generally give little priority to their future health, so such interventions need to be conducted at some optimal age, be innovative, country specific and culturally acceptable.

Adolescent Physical Education Class Participation as a Predictor for Adult Physical Activity

BACKGROUND

The aim of this study was to determine whether engagement in more physical education (PE) classes during one high school year is associated with change in physical activity (PA) from adolescence to young adulthood.

METHODS

Data were from 1774 participants in Waves 2 (high school, 1996) and 4 (young adulthood, 2008) of the National Longitudinal Study of Adolescent to Adult Health. The predictor was number of PE classes/week in high school (daily, some, or none). The outcome was change in moderate-to-vigorous physical activity (ΔMVPA) over the 12-year period. ΔMVPA was based on differences in MVPA scores derived at each wave from responses to a physical activity behavior recall (range, -9 to 9 scale score or -15 to 15 MVPA episodes/week). Multivariable generalized linear models examined the association between PE participation and ΔMVPA, adjusting for sociodemographics, weight status, and school clustering.

RESULTS

In high school, 34.7% participated in daily PE, whereas 50.1% participated in none. Participation in more PE classes was associated with greater MVPA in high school (mean MVPAW2none = 3.11, standard deviation [SD] = 1.99; mean MVPAW2some = 3.70, SD = 2.00; mean MVPAW2daily = 4.31, SD = 1.95; p < 0.0001). Overall, MVPA decreased over the 12 years (median ΔMVPA = -1.0, or 1-2 MVPA episodes/week). MVPA decreased more for males (median ΔMVPAmale = -1.0, interquartile range [IQR] = -3.0 ± 1.0; median ΔMVPAfemale = 0.0, IQR = -2.0 ± 2.0; p < 0.0001) and those who had participated in some/daily PE (median ΔMVPAsome = -1.0, IQR = -3.0 ± 1.0; median ΔMVPAdaily = -1.0, IQR = -3.0 ± 1.0) than those not in PE (median ΔMVPAnone = 0.0, IQR = -2.0 ± 2.0; p < 0.0001). The relationship between PE and ΔMVPA was maintained in multivariable analyses (βsome = -0.58, standard error [SE] = 0.18; p = 0.002; βdaily = -0.93, SE = 0.16; p < 0.001).

CONCLUSIONS

High school PE participation did not prevent declining PA from adolescence to young adulthood.

Transition von der Kindheit in das Erwachsenenalter bei chronischen Krankheiten

Dank des medizinischen Fortschritts erleben zunehmend mehr Kinder mit chronischen Erkrankungen das Erwachsenenalter. Patienten mit angeborenen Stoffwechselkrankheiten stellen nur eine, jedoch in ihrer Größe und Problematik besondere Gruppe heranwachsender Patienten dar. Allerdings fehlen vielfach begleitende Strukturen im Gesundheitssystem, um eine erfolgreiche Transition zu ermöglichen. Dies kann zu erheblicher Beeinträchtigung der Gesundheit der Betroffenen führen. Der Artikel beschreibt den Transitionsprozess des gesunden Adoleszenten zum jungen Erwachsenen sowie die Schwierigkeiten dieses Prozesses für chronisch kranke junge Menschen mit erhöhtem Bedarf an Gesundheitsbetreuung, die zusätzlich den Übergang aus der pädiatrischen Medizin in die Erwachsenenmedizin zu bewältigen haben.

Young adult males' motivators and perceived barriers towards eating healthily and being active: a qualitative study

BACKGROUND

There is a lack of understanding of young men's perspectives in obesity-related research. This study aims to: (1) identify young men's perceived motivators and barriers in adopting healthy eating and physical activity behaviours, and (2) explore any differences in responses by weight status categories.

METHODS

Ten focus groups (32-63 minutes; 3-9 participants per group) were conducted with 61 young men (BMI: 25.3 ± 5.1 kg/m(2), aged: 18-25 years) from the Hunter region, New South Wales, Australia. There were 35 (57.4 %) healthy weight men and 26 (42.6 %) overweight/ obese men. Three groups were with healthy weight participants, three with overweight/obese participants and four with mixed-BMI participants. Sessions were audio-recorded and transcribed. Data analysis was conducted by an independent researcher using NVIVO10.

RESULTS

Motivators for healthy eating grouped into four themes: physical health (e.g. to live longer), sport or performance (e.g. to support their sporting goals), physical appearance (e.g. sexual attractiveness) and social influences (e.g. societal expectations to eat healthy), while key motivators for physical activity were: physical appearance (e.g. sexual attractiveness), social inclusion (e.g. making friends), physical and mental health (e.g. relieve stress) and improvements for sport or performance (e.g. improve fitness). Themes for key barriers to eating healthy were: intrinsic (e.g. perceived effort to adopt healthy eating), logistic (e.g. cost), and social factors (e.g. peer influence), while busy lifestyles (e.g. lack of time), logistic (e.g. cost), cognitive-emotional (e.g. feelings of inferiority) and social factors (e.g. family upbringing) were key barriers for physical activity. Responses varied little by BMI status.

CONCLUSION

This research emphasises the importance of consulting young men when developing healthy lifestyle programs that aim to promote healthy eating and physical activity in young men. Future research is needed to identify the most effective ways to address their motivators and barriers in intervention research.

Psychosocial moderators of associations between life events and changes in physical activity after leaving high school

OBJECTIVES

To examine 1) associations between life events and changes in leisure-time physical activity (LTPA) in school leavers and 2) whether these associations are moderated by psychosocial factors.

METHODS

Final year students (n=440) from high schools in rural Western Australia completed annual telephone interviews on three occasions; baseline (T1), one-year follow-up (T2; n=440) and two-year follow-up (T3; n=374). LTPA was measured using the Minnesota Leisure-time Physical Activity Questionnaire. Life events included moving out of home, working full-time and studying full-time. Psychosocial factors included enjoyment, self-efficacy, outcome expectations, club membership, and support from family and friends. Mixed linear regression models examined the effect of life events on changes in LTPA from T1 to T2 and T1 to T3.

RESULTS

A decline in LTPA across all time points was observed. Those who continued full-time education had a smaller LTPA decline than those who did not. Those who were not a member of a sporting club at T1 had greater LTPA decline if they worked full-time at T2.

CONCLUSIONS

There is a need for interventions to prevent declines in LTPA among school leavers, especially those who do not enter tertiary education. Encouraging sporting club membership during high school might be important.