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Waaler PN, Bongo LA, Rolandsen C, Lorem GF. An individually adjusted approach for communicating epidemiological results on health and lifestyle to patients. Sci Rep 2024; 14:3199. [PMID: 38331938 PMCID: PMC10853548 DOI: 10.1038/s41598-024-53275-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/30/2024] [Indexed: 02/10/2024] Open
Abstract
If scientific research on modifiable risk factors was more accessible to the general population there is a potential to prevent disease and promote health. Mobile applications can automatically combine individual characteristics and statistical models of health to present scientific information as individually tailored visuals, and thus there is untapped potential in incorporating scientific research into apps aimed at promoting healthier lifestyles. As a proof-of-concept, we develop a statistical model of the relationship between Self-rated-health (SRH) and lifestyle-related factors, and a simple app for conveying its effects through a visualisation that sets the individual as the frame of reference. Using data from the 6th (n = 12 981, 53.4% women and 46.6% men) and 7th (n = 21 083, 52.5% women and 47.5% men) iteration of the Tromsø population survey, we fitted a mixed effects linear regression model that models mean SRH as a function of self-reported intensity and frequency of physical activity (PA), BMI, mental health symptoms (HSCL-10), smoking, support from friends, and HbA1c ≥ 6.5%. We adjusted for socioeconomic and demographic factors and comorbidity. We designed a simple proof-of-concept app to register relevant user information, and use the SRH-model to translate the present status of the user into suggestions for lifestyle changes along with predicted health effects. SRH was strongly related to modifiable health factors. The strongest modifiable predictors of SRH were mental health symptoms and PA. The mean adjusted difference in SRH between those with 10-HSCL index = 1.85 (threshold for mental distress) and HSCL-10 = 1 was 0.59 (CI 0.61-0.57). Vigorous physical activity (exercising to exhaustion ≥ 4 days/week relative to sedentary) was associated with an increase on the SRH scale of 0.64 (CI 0.56-0.73). Physical activity intensity and frequency interacted positively, with large PA-volume (frequency ⨯ intensity) being particularly predictive of high SRH. Incorporating statistical models of health into lifestyle apps have great potential for effectively communicating complex health research to a general audience. Such an approach could improve lifestyle apps by helping to make the recommendations more scientifically rigorous and personalised, and offer a more comprehensive overview of lifestyle factors and their importance.
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Affiliation(s)
- Per Niklas Waaler
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lars Ailo Bongo
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
| | - Christina Rolandsen
- Department of Computer Science, UiT The Arctic University of Norway, Tromsø, Norway
- Deloitte AS, Oslo, Norway
| | - Geir F Lorem
- Department of Psychology, UiT The Arctic University of Norway, Tromsø, Norway.
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2
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Frontera-Escudero I, Bartolomei JA, Rodríguez-Putnam A, Claudio L. Sociodemographic and health risk factors associated with health-related quality of life among adults living in Puerto Rico in 2019: a cross-sectional study. BMC Public Health 2023; 23:2150. [PMID: 37924064 PMCID: PMC10623836 DOI: 10.1186/s12889-023-17115-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/31/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Puerto Rico, a US territory, faces numerous challenges adversely affecting public health, including poverty, a fragile healthcare system, inadequate infrastructure, a debt crisis, and vulnerability to climate change-related natural disasters. The impact of these factors on the Health-Related Quality of Life (HRQoL) measure has not been comprehensively evaluated. Only two studies have assessed HRQoL, with the latest conducted in 2011, prior to recent events that could affect public health. This study aimed to assess the HRQoL and associated sociodemographic and health risk factors among adults living in Puerto Rico in 2019. METHODS Prevalence and 95% confidence intervals were used to describe HRQoL and its associations with sociodemographic and health-related variables among adults living in Puerto Rico who answered the Behavioral Risk Factor Surveillance System (BRFSS) survey (n = 4,944) in 2019. Multivariable logistic regression models were developed to identify which of these variables were more likely to be associated with each of the four core HRQoL questions (HRQoL-4), expressed as prevalence odds ratios with 95% confidence intervals adjusted for potential confounders. RESULTS Through a comprehensive multivariable analysis, we uncovered significant risk factors - increasing number of chronic conditions, advanced age, and low income - associated with poor HRQoL among adults living in Puerto Rico. Specifically, our findings suggest that individuals with an increasing number of chronic conditions were more likely to report poor HRQoL across all 4 domains. As the number of reported chronic conditions increases by one, the odds of reporting having: fair/poor general health increased by a factor of 2.24 (POR: 2.24, 95% CI: 2.08-2.41), physical health impairment increased by a factor of 1.93 (POR: 1.93, 95% CI: 1.78-2.08), mental health impairment increased by a factor of 1.90 (POR: 1.90, 95% CI: 1.78-2.02) and activity limitation increased by a factor of 1.27 ( POR: 1.27, 95% CI: 1.13-1.42). Advancing age was associated with all domains of poor HRQoL, except for the mental health domain for which we observed higher rates of poor HRQoL among the younger population (POR: 4.76, 95% CI: 2.4-9.1). CONCLUSION This paper shows that the prevalence of poor HRQoL has not improved compared to the only previous study of HRQoL of Puerto Rico in the last decade. We also found that poor HRQoL is associated with having multiple chronic conditions in adults living in Puerto Rico. This may be a consequence of a decline in health services after natural disasters and socioeconomic downturns on the island. The study emphasizes the need for targeted interventions and ongoing monitoring of the population's HRQoL over time to reach vulnerable subgroups, especially those with chronic conditions, advanced age, and low income, in order to reduce health disparities in Puerto Rico.
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Affiliation(s)
- Irene Frontera-Escudero
- Department of Environmental Medicine and Public Health, Division of International Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | | | - Alejandro Rodríguez-Putnam
- Department of Health Services Administration, Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Luz Claudio
- Department of Environmental Medicine and Public Health, Division of International Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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3
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Kraft P, Kraft B. Exploring the relationship between multiple dimensions of subjective socioeconomic status and self-reported physical and mental health: the mediating role of affect. Front Public Health 2023; 11:1138367. [PMID: 37575108 PMCID: PMC10416252 DOI: 10.3389/fpubh.2023.1138367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 07/17/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction This study aimed to investigate the predictive effects of two types of subjective socioeconomic status on self-reported physical and mental health. Specifically, we examined the MacArthur Scale (MacArthur) which measures perceived socioeconomic rank in the society and a novel scale called ComSim, which assessed how participants compared themselves socioeconomically to others coming from a similar socioeconomic background. We also considered the influence of income, education, and personal relative deprivation (PRD) in these analyses. Additionally, we explored whether these effects were mediated through negative and positive affect. Methods The data were collected through a cross-sectional, two-wave survey of 294 women and 294 men, with a mean age 41.6 years. Participants were recruited via an online platform. Results The results from multivariate regression models revealed that socioeconomic status measured with both the MacArthur Scale and ComSim significantly predicted both self-reported health measures, whereas income and education did not predict any of these measures in the full multivariate models. PRD only predicted self-reported mental health. Mediation analyses showed that negative and positive affect mediated the relationships between socioeconomic status measured by ComSim and self-reported health measures. Discussion These findings are discussed in the context of the similarity hypothesis of social comparison theory. The results underscore the importance of considering multiple dimensions when examining socioeconomic health disparities.
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Affiliation(s)
- Pål Kraft
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Department of Psychology, Oslo New University College, Oslo, Norway
| | - Brage Kraft
- Division of Psychiatry, Diakonhjemmet Hospital, Oslo, Norway
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4
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Hung ST, Cheng YC, Wu CC, Su CH. Examining Physical Wellness as the Fundamental Element for Achieving Holistic Well-Being in Older Persons: Review of Literature and Practical Application in Daily Life. J Multidiscip Healthc 2023; 16:1889-1904. [PMID: 37435298 PMCID: PMC10329914 DOI: 10.2147/jmdh.s419306] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 06/29/2023] [Indexed: 07/13/2023] Open
Abstract
This review examines the impact of physical activity, nutrition, and sleep evaluations on the physical wellness (PW) and overall well-being of older individuals. A comprehensive search was conducted in databases like PubMed, Google Scholar, and EBSCO Information Services. The search spanned from January 2000 to December 2022, resulting in 19,400 articles, out of which 98 review articles met the inclusion criteria. Through the analysis of these articles, key characteristics of the literature were summarized, and opportunities to enhance the practical application of physical activity (PA), nutrition, and sleep evaluations in the daily lives of older persons were identified. Regular physical activity is crucial for older persons to maintain their physical, mental, and emotional well-being and prevent age-related health issues. Older persons have specific nutritional needs, including increased protein, vitamin D, calcium, and vitamin B12 intake. Poor sleep quality in older persons is associated with negative health outcomes such as cognitive decline, physical disability, and mortality. This review emphasizes the significance of considering physical wellness as a fundamental element for achieving holistic well-being in older persons and highlights the importance of physical activity, nutrition, and sleep evaluations in improving their overall health and well-being. By understanding and implementing these findings, we can enhance the quality of life and promote healthy aging in older persons.
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Affiliation(s)
- Sheng-Te Hung
- Graduate Institute of Sports Coaching Science, College of Kinesiology and Health, Chinese Culture University, Taipei, 111396, Taiwan
| | - Yi-Chen Cheng
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, 111396, Taiwan
| | - Chieh-Chen Wu
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, 111396, Taiwan
| | - Chun-Hsien Su
- Graduate Institute of Sports Coaching Science, College of Kinesiology and Health, Chinese Culture University, Taipei, 111396, Taiwan
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, 111396, Taiwan
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Hoekstra J, Lenssen ES, Wong A, Loef B, Herber GCM, Boshuizen HC, Strak M, Verschuren WMM, Janssen NAH. Predicting self-perceived general health status using machine learning: an external exposome study. BMC Public Health 2023; 23:1027. [PMID: 37259056 DOI: 10.1186/s12889-023-15962-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 05/23/2023] [Indexed: 06/02/2023] Open
Abstract
BACKGROUND Self-perceived general health (SPGH) is a general health indicator commonly used in epidemiological research and is associated with a wide range of exposures from different domains. However, most studies on SPGH only investigated a limited set of exposures and did not take the entire external exposome into account. We aimed to develop predictive models for SPGH based on exposome datasets using machine learning techniques and identify the most important predictors of poor SPGH status. METHODS Random forest (RF) was used on two datasets based on personal characteristics from the 2012 and 2016 editions of the Dutch national health survey, enriched with environmental and neighborhood characteristics. Model performance was determined using the area under the curve (AUC) score. The most important predictors were identified using a variable importance procedure and individual effects of exposures using partial dependence and accumulated local effect plots. The final 2012 dataset contained information on 199,840 individuals and 81 variables, whereas the final 2016 dataset had 244,557 individuals with 91 variables. RESULTS Our RF models had overall good predictive performance (2012: AUC = 0.864 (CI: 0.852-0.876); 2016: AUC = 0.890 (CI: 0.883-0.896)) and the most important predictors were "Control of own life", "Physical activity", "Loneliness" and "Making ends meet". Subjects who felt insufficiently in control of their own life, scored high on the De Jong-Gierveld loneliness scale or had difficulty in making ends meet were more likely to have poor SPGH status, whereas increased physical activity per week reduced the probability of poor SPGH. We observed associations between some neighborhood and environmental characteristics, but these variables did not contribute to the overall predictive strength of the models. CONCLUSIONS This study identified that within an external exposome dataset, the most important predictors for SPGH status are related to mental wellbeing, physical exercise, loneliness, and financial status.
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Affiliation(s)
- Jurriaan Hoekstra
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.
| | - Esther S Lenssen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Albert Wong
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Bette Loef
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Gerrie-Cor M Herber
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Hendriek C Boshuizen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Wageningen University & Research, Wageningen, The Netherlands
| | - Maciek Strak
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - W M Monique Verschuren
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Nicole A H Janssen
- National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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6
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Sassine AJ, Rabbitt MP, Coleman-Jensen A, Moshfegh AJ, Sahyoun NR. Development and Validation of a Physical Food Security Tool for Older Adults. J Nutr 2023; 153:1273-1282. [PMID: 36868513 DOI: 10.1016/j.tjnut.2023.02.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/17/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Current measures of food insecurity focus on economic access to food, but not on the physical aspect of food insecurity that captures the inability to access food or prepare meals. This is particularly relevant among the older adult population who are at a high risk of functional impairments. OBJECTIVES To develop a short-form physical food security (PFS) tool among older adults using statistical methods based on the Item Response Theory (Rasch) model. METHODS Pooled data from adults aged ≥60 y of the NHANES (2013-2018) (n = 5892) were used. The PFS tool was derived from the physical limitation questions included in the physical functioning questionnaire of NHANES. Item severity parameters, fit and reliability statistics, and residual correlation between items were estimated using the Rasch model. The construct validity of the tool was assessed by examining associations with the Healthy Eating Index (HEI)-2015 scores, self-reported health, self-reported diet quality, and economic food insecurity, using weighted multivariable linear regression analysis, controlling for potential confounders. RESULTS A 6-item scale was developed, which had adequate fit statistics and high reliability (0.62). It was categorized based on raw score severity into high, marginal, low, and very low PFS. Very low PFS was associated with respondent's self-reported poor health (OR = 23.8; 95% CI: 15.3, 36.9; P < 0.0001), self-reported poor diet (OR = 3.9; 95% CI: 2.8, 5.5; P < 0.0001), low and very low economic food security (OR = 6.08; 95% CI: 4.23, 8.76; P < 0.0001), and with lower mean HEI-2015 index score, in comparison to older adults with high PFS (54.5 compared with 57.5, P = 0.022). CONCLUSIONS The proposed 6-item PFS scale captures a new dimension of food insecurity that can inform on how older adults experience food insecurity. The tool will require further testing and evaluation in larger and different contexts to demonstrate its external validity.
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Affiliation(s)
- AnnieBelle J Sassine
- Department of Nutrition and Food Science, University of Maryland, College Park; MD United States
| | | | | | - Alanna J Moshfegh
- Beltsville Human Nutrition Research Center, Agricultural Research Service, United States Department of Agriculture
| | - Nadine R Sahyoun
- Department of Nutrition and Food Science, University of Maryland, College Park; MD United States.
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7
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Cunha ACD, Santos Neto ETD, Salaroli LB. Self-assessment of the health status and leisure activities of individuals on haemodialysis. Sci Rep 2022; 12:20344. [PMID: 36437346 PMCID: PMC9701773 DOI: 10.1038/s41598-022-23955-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 11/08/2022] [Indexed: 11/28/2022] Open
Abstract
Self-assessment of health status is an important marker of social and health aspects. Haemodialysis is an option for renal replacement therapy that alters daily life and impacts social participation and the performance of tasks that give the subject a socially accepted role. In this scenario, leisure activities have the potential to generate well-being and are associated with several aspects of daily life, but few studies have analysed their relationship with the self-assessment of health status. This is a cross-sectional, census study with 1024 individuals from haemodialysis units of a Southeast Brazilian region, with the application of a questionnaire in 2019. We calculated the difference between the proportions of self-assessment of health status (positive and negative) and the two logistic regression models. The chances of individuals on haemodialysis negatively evaluating their health increase when they do not perform artistic leisure activities (OR 2.15; 95% CI 1.35-3.43), physical and sports activities (OR 3.20; 95% CI 1.86-5.52), intellectual (OR 2.21; 95% CI 1.44-3.41), manuals (OR 1.82; 95% CI 1.22-2.72), social (OR 2.74; 95% CI 1.74-4.31), tourist (OR 2.08; 95% CI 1.37-3.17) and idleness and contemplative (OR 1.92; 95% CI 1.29-2.85). Negative health self-assessment is associated with not practicing artistic, manual, physical and sporting, social, intellectual, tourist, and contemplative leisure activities, which have the function of providing social participation and giving meaning to life.
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Affiliation(s)
- Alexandre Cardoso da Cunha
- grid.412371.20000 0001 2167 4168Occupational Therapy Department, Federal University of Espírito Santo, Vitória, Espírito Santo Brazil
| | - Edson Theodoro dos Santos Neto
- grid.412371.20000 0001 2167 4168Department of Social Medicine, Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória, Espírito Santo Brazil
| | - Luciane Bresciani Salaroli
- grid.412371.20000 0001 2167 4168Integrated Health Education Department, Graduate Program in Collective Health, Federal University of Espírito Santo, Vitória, Espírito Santo Brazil
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8
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Szychowska A, Drygas W. Physical activity as a determinant of successful aging: a narrative review article. Aging Clin Exp Res 2022; 34:1209-1214. [PMID: 34873677 PMCID: PMC9151514 DOI: 10.1007/s40520-021-02037-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/18/2021] [Indexed: 02/06/2023]
Abstract
Population of older people in many countries is constantly growing, therefore the subject of successful aging has become important and a priority for public health policy-makers. A person who is successfully aging has low risk of chronic disease and disability, high physical function, good mental health and social engagement in older age. Lifestyle factors, such as diet and exercise, have been identified as determinants of successful aging. The aim of this narrative review is to compile the evidence from big cohort studies on the overall health of older people. Their results indicate that regular physical activity increases the chances of successful aging in older people, but only after reaching a sufficient threshold. Physical activity lowers the risk of many chronic diseases and cognitive decline commonly associated with older age, promotes social engagement and improves self-estimated well-being.
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Affiliation(s)
| | - Wojciech Drygas
- Department of Preventive Medicine, Medical University of Lodz, Łódź, Poland
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9
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Cross TJ, Isautier JMJ, Morris SJ, Johnson BD, Wheatley-Guy CM, Taylor BJ. The Influence of Social Distancing Behaviors and Psychosocial Factors on Physical Activity During the COVID-19 Pandemic: Cross-sectional Survey Study. JMIR Public Health Surveill 2021; 7:e31278. [PMID: 34509976 PMCID: PMC8477911 DOI: 10.2196/31278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/16/2021] [Accepted: 08/16/2021] [Indexed: 12/26/2022] Open
Abstract
Background The COVID-19 pandemic has arguably facilitated a shift toward increased sedentariness and reduced physical activity. Moreover, there is mounting evidence that mental health has also declined during the pandemic. However, it remains unknown to what extent social distancing (SD) behaviors and mental health have affected the physical activity levels of the general population. Objective The purpose of this study was to determine the influence of SD behaviors and prevailing mental health on the odds of being physically active during the early COVID-19 pandemic response. Methods A total of 4819 adults (2474/4819, 51.3%, female) from the US population with a median age of 46 (IQR 35-59) completed an online survey during the early pandemic response (April-June 2020). The survey included questions on adherence to 11 SD behaviors, and validated questionnaires which assessed self-reported physical activity, depression, anxiety, and mental well-being. Respondents were categorized into 2 physical activity groups: inactive (0-599 metabolic equivalent of task [MET]-minutes/week) and active (≥600 MET-minutes/week). A logistic generalized additive model (GAM) was used to determine which SD factors and mental health outcomes were associated with physical activity level. Results The GAM analysis revealed that wearing a facemask in public (odds ratio [OR] 1.46, 95% CI 1.14-1.79; P=.003), limiting the use of public transport (OR 1.47, 95% CI 1.19-1.83; P=.001), and restricting travel outside the house (OR 1.56, 95% CI 1.19-2.05; P=.002) were SD behaviors associated with higher odds of being more physically active. Conversely, avoiding physical activity outside the house was associated with higher odds of being inactive (OR 0.52, 95% CI 0.46-0.63; P<.001). Leaving the house more frequently, and a higher mental well-being were associated with increasing odds of being physically active (P<.001). Engaging with a moderate number of SD behaviors (3-7 total) was positively associated with physical activity, whereas a very high SD vigilance (ie, engaging with ≥10 total behaviors) decreased the odds of being active during the early pandemic response. Conclusions Based on the findings of our study, we suggest that future public health messaging of SD guidelines should include (1) a clear portrayal of the benefits of regular exercise on mental health; and (2) a specific focus on how to be physically active outdoors in a COVID-safe manner.
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Affiliation(s)
- Troy J Cross
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States
| | - Jennifer M J Isautier
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia.,Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States
| | - Sarah J Morris
- Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Bruce D Johnson
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, United States
| | | | - Bryan J Taylor
- Department of Cardiovascular Diseases, Mayo Clinic, Jacksonville, FL, United States
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10
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Yang Y, Dixon-Suen SC, Dugué PA, Hodge AM, Lynch BM, English DR. Physical activity and sedentary behaviour over adulthood in relation to all-cause and cause-specific mortality: a systematic review of analytic strategies and study findings. Int J Epidemiol 2021; 51:641-667. [PMID: 34480556 DOI: 10.1093/ije/dyab181] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Questions remain about the effect on mortality of physical activity and sedentary behaviour over time. We summarized the evidence from studies that assessed exposure from multiple time points and critiqued the analytic approaches used. METHODS A search was performed on MEDLINE, Embase, Emcare, Scopus and Web of Science up to January 2021 for studies of repeatedly assessed physical activity or sedentary behaviour in relation to all-cause or cause-specific mortality. Relative risks from individual studies were extracted. Each study was assessed for risk of bias from multiple domains. RESULTS We identified 64 eligible studies (57 on physical activity, 6 on sedentary behaviour, 1 on both). Cox regression with a time-fixed exposure history (n = 45) or time-varying covariates (n = 13) were the most frequently used methods. Only four studies used g-methods, which are designed to adjust for time-varying confounding. Risk of bias arose primarily from inadequate adjustment for time-varying confounders, participant selection, exposure classification and changes from measured exposure. Despite heterogeneity in methods, most studies found that being consistently or increasingly active over adulthood was associated with lower all-cause and cardiovascular-disease mortality compared with being always inactive. Few studies examined physical-activity changes and cancer mortality or effects of sedentary-behaviour changes on mortality outcomes. CONCLUSIONS Accumulating more evidence using longitudinal data while addressing the methodological challenges would provide greater insight into the health effects of initiating or maintaining a more active and less sedentary lifestyle.
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Affiliation(s)
- Yi Yang
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia
| | - Suzanne C Dixon-Suen
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Pierre-Antoine Dugué
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia
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11
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Opdal IM, Larsen LS, Hopstock LA, Schirmer H, Lorem GF. Correction to: A prospective study on the effect of self-reported health and leisure time physical activity on mortality among an ageing population: results from the Tromsø study. BMC Public Health 2021; 21:900. [PMID: 33980190 PMCID: PMC8114684 DOI: 10.1186/s12889-021-10840-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Ida Marie Opdal
- Department of Psychology, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway.
| | - Lill Sverresdatter Larsen
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Laila Arnesdatter Hopstock
- Department of Community Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Clinical Medicine, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway.,Department of Cardiology, Akershus University Hospital, Lørenskog, Norway.,Department of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Geir Fagerjord Lorem
- Department of Psychology, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
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