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Sarah K. Keadle, Eduardo E. Bustamante, and Matthew P. Buman

Over the past 40 years, physical activity (PA) and public health has been established as a field of study. A robust evidence base has emerged demonstrating that participation in recommended amounts of PA results in a wide array of physical and mental health benefits. This led to the establishment of federal and global PA guidelines and surveillance programs. Strong evidence supports the efficacy of individual-level (e.g., goal setting) and environmental (e.g., policies) interventions to promote PA. There has also been progress in establishing a skilled and diverse workforce to execute the work of PA and public health. Looking forward, major challenges include stemming the obesity and chronic disease epidemics, addressing health inequities, and diversifying the workforce. Given the known benefits of PA and the availability of evidence-based interventions, efforts now must focus on implementing this knowledge to improve population health and reduce inequities through PA.

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Eric T. Hyde, John D. Omura, Tiffany J. Chen, David R. Brown, Janet E. Fulton, and Susan A. Carlson

The Physical Activity Guidelines for Americans, second edition recommends that older adults do multicomponent physical activity, which includes balance training in addition to aerobic and muscle-strengthening activities. The authors estimated the prevalence of U.S. older adults (age ≥65 years) who do balance activities and meet the aerobic and muscle-strengthening physical activity guidelines. The authors analyzed data on 1,012 respondents to the 2019 FallStyles survey, a nationwide web-based panel survey. Approximately four in 10 respondents (40.7%) reported doing balance activities on ≥1 day/week, 34.0% on ≥2 days/week, and 25.3% on ≥3 days/week. Prevalence differed by sex, education level, income level, census region, body mass index category, and meeting the aerobic and/or muscle-strengthening guidelines. The combined prevalence of participation in balance activities and meeting aerobic and muscle-strengthening guidelines ranged from 12.0% for ≥3 days/week to 15.8% for ≥1 day/week. Opportunities exist to introduce and increase participation in balance and multicomponent activities by older adults.

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Liam Collins and J. Paige Pope

Older adults spend more time, on average, engaged in sedentary behaviors (SBs) compared with younger cohorts. This is concerning, because prolonged SB is associated with detrimental outcomes. The purpose of this study was to explore the degree to which older adults’ motives to limit their SB were internalized, consistent with self-determination theory. Following the qualitative description approach, seven focus groups (n = 27) of community-dwelling older adults were conducted. Focus groups were transcribed verbatim and coded using a thematic approach. Results revealed some motivation subthemes, which appeared to endorse similar content, varied in the degree to which participants internalized them, differentiating these motives along the self-determination theory motivational continuum. These findings demonstrated that not all motives are equal, highlighting the importance of theory-driven future SB interventions.

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Grace Wei, Jeffrey Farooq, Leslie Castelo-soccio, and Rahul Mhaskar

Background: Physical activity is associated with greater odds of sunburn in adults, increasing harmful sun exposure and skin cancer risk. The authors sought to investigate parallel associations between sunburn and physical activity among US high school students. Methods: The authors examined pooled cross-sectional data from the 2015 and 2017 Youth Risk Behavior Survey. A nationally representative sample of 21,894 US high school students who responded to the sunburn question was included. Results: Prevalence of sunburn was 56.6% between 2015 and 2017. Sunburn prevalence was higher in physically active students (88.3%; 95% confidence interval [CI], 86.7%–90.0%; P < .0001) and student athletes (63.0%; 95% CI, 59.4%–66.7%; P < .0001). Among male students who were vigorously physically active (≥5 d) or on ≥3 teams, the odds of sunburn were 2.33 (95% CI, 1.81–3.00; P < .0001) and 2.52 (95% CI, 1.96–3.23; P < .0001), respectively. Among female students who were vigorously physically active (≥5 d) or on ≥3 teams, the odds of sunburn were 1.65 (95% CI, 1.36–2.02; P < .0001) and 2.92 (95% CI, 2.07–4.13; P < .0001), respectively. Conclusions: Many US high school students are affected by sunburn, and the odds of sunburn are elevated during physical activity and team sports participation. Efforts are needed to improve sun safety regulations, education, and resources for youth during school and physical activity.

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Jonathan P. Davy, Karine Scheuermaier, Laura C. Roden, Candice J. Christie, Alison Bentley, Francesc X. Gomez-Olive, Stella Iacovides, Raphaella Lewis, Gosia Lipinska, Johanna Roche, Andrew Todd, Swantje Zschernack, and Dale E. Rae

Background: The authors assessed the impact of lockdown in response to the COVID-19 pandemic on routine-oriented lifestyle behaviors and symptoms of depression, anxiety, and insomnia in South Africans. Methods: In this observational study, 1048 adults (median age = 27 y; n = 767 females; n = 473 students) responded to an online survey on work, exercise, screen, alcohol, caffeine and sleep behaviors, depression, anxiety, and insomnia before and during lockdown. Comparisons were made between males and females, and students and nonstudents. Results: During lockdown, males reported larger reductions in higher intensity exercise and alcohol use than females, while depressive symptoms increased more among females, more of whom also reported poorer sleep quality. Students demonstrated larger delays in work and sleep timing, greater increases in sitting, screen, sleep duration, napping, depression and insomnia and larger decreases in work hours, exercise time, and sleep regularity compared with nonstudents. Conclusions: Students experienced more changes in their routine-oriented behaviors than nonstudents, coupled with larger increases in depression and insomnia. The dramatic change in their work and sleep timing suggests habitual routines that are at odds with their chronotype, with their sleep changes during lockdown likely reflecting “catch-up” sleep in response to accumulated sleep debt under usual routines.

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Paul Mackie, Gary Crowfoot, Heidi Janssen, Elizabeth Holliday, David Dunstan, and Coralie English

Background: Interrupting prolonged sitting acutely lowers blood pressure in nonstroke populations. However, the dose–response effect in stroke survivors is unknown. The authors investigated different doses of light-intensity standing exercises that interrupt prolonged sitting and reduce blood pressure immediately and over 24 hours in stroke survivors. Methods: Within-participant, laboratory-based, dose escalation trial. Conditions (8 h) were prolonged sitting and 2 experimental conditions of standing exercises with increasing frequency (3 cohorts, 2 × 5 min to 6 × 5 min). The primary outcome is the mean systolic blood pressure. Results: Twenty-nine stroke survivors (aged 66 [12] y) participated. Frequent bouts of standing exercises lowered the mean systolic blood pressure following the 4 × 5-minute (−2.1 mm Hg; 95% confidence interval [CI], −3.6 to −0.6) and 6 × 5-minute conditions (−2.3 mm Hg; 95% CI, −4.2 to −0.5) compared with prolonged sitting. Diastolic blood pressure was lowered following the 6 × 5-minute condition (−1.4 mm Hg; 95% CI, −2.7 to −0.2). The 24-hour systolic blood pressure increased following the 2 × 5-minute condition (6.9 mm Hg; 95% CI, 3.1 to 10.6). Conclusions: Interrupting prolonged sitting with more frequent bouts of standing exercises lowers systolic and diastolic blood pressure in stroke survivors. However, reductions may only be short term, and investigations on sustained effects are warranted.

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Xinge Zhang, Sangho Jee, Jialin Fu, Bowen Wang, Luyang Zhu, Yiming Tu, Lei Cheng, Gaotian Liu, Rui Li, and Justin B. Moore

This study examined the independent associations between psychosocial factors, perceived neighborhood characteristics, and physical activity (PA) in Chinese adolescents. A cross-sectional study using a convenience sample was conducted in fall 2019 at a high school in Wuhan, China. Sociodemographic data, body weight, height, psychosocial factors, perceptions of neighborhood environment, and PA were collected using questionnaires. Hierarchical linear regression analyses were performed in 4 steps, where step 1 included demographic covariates, step 2 added psychosocial factors into the model, step 3 added perceived neighborhood environmental factors, and step 4 added interaction terms between significant psychosocial and environmental factors. A total of 4027 adolescents were included in analysis. The results of the third model indicated that friends’ support (b = 4.58), friends’ norms (b = 7.16), barriers to PA (b = −10.19), autonomous motivation (b = 4.75), self-efficacy (b = 8.86), the presence of shops/stores nearby (b = 5.79), and the availability of PA resources (b = 6.02) were significant predictors (P < .05) of moderate to vigorous PA. None of the interaction terms were significant in the fourth model. Our results suggest that interventions targeting the PA of Chinese adolescents should take into account the attitudes toward PA, perceived barriers to PA, controlled motivation, perceptions of neighborhood PA resource availability, and perceived neighborhood safety to maximize effectiveness.

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Eka Peng Cox, Rebecca Cook, Nicholas O’Dwyer, Cheyne Donges, Helen Parker, Hoi Lun Cheng, Katharine Steinbeck, Janet Franklin, and Helen O’Connor

Background: There is evidence that physical activity (PA), sitting time, and obesity may impact cognition, but few studies have examined this in young women. Methods: Healthy women (18–35 y), without conditions that impair cognition, were recruited for this cross-sectional study. Participants completed anthropometric and validated computerized cognitive assessments (IntegNeuro). Performance on 5 cognitive domains (impulsivity, attention, information processing, memory, and executive function) was reported as z scores. Sitting hours and weekly PA calculated from time in low-, moderate-, and high-intensity activity were obtained via the International Physical Activity Questionnaire. Analysis of variance/analysis of covariance, chi-square, and linear regression were used. Results: 299 (25.9 [5.1] y) women (low PA = 19%; moderate PA = 40%; high PA = 41%) participated. High PA women had lower body mass index (high PA = 26.1 [6.5]; moderate PA = 30.0 [8.7]; low PA = 31.0 [11.1] kg/m2; P < .001) and less sitting time (high PA = 6.6 [3.1]; moderate PA = 7.7 [2.8]; low PA = 9.3 [3.6] hr/weekday; P < .0001). Cognitive function was within normal ranges and did not differ between any PA groups (P = .42). Adjusting for body mass index, C-reactive protein, or sitting hours did not alter results. Weak correlations were found between time in high-intensity activity and impulsivity (b = 0.12, r 2 = .015; P = .04), and between sitting hours and information processing efficiency (b = −0.18, r 2 = .03; P = .002). Valuesare presented as mean (SD). Conclusions: Cognitive function was within the normal range, regardless of PA or sitting time.

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Jodie A. Stearns, Paul J. Veugelers, Tara-Leigh McHugh, Chris Sprysak, and John C. Spence

Background: Potential income disparities were examined in the (1) awareness and uptake of the Children’s Fitness Tax Credit (CFTC), and (2) physical activity (PA) of children from families who did and did not claim the credit in Alberta, Canada in 2012 and 2014. Methods: Secondary analyses of 3 cross-sectional data sets of grade 5 students (10–11 y) were performed, including Alberta Project Promoting healthy Living for Everyone Schools 2012 (N = 1037), and Raising healthy Eating and Active Living Kids Alberta 2012 (N = 2676), and 2014 (N = 3125). Parents reported whether they claimed the CFTC in the previous year, their education and household income, and their child’s gender and PA. Children self-reported their PA from the previous 7 days. In Alberta Project Promoting healthy Living for Everyone Schools, children also wore pedometers. Analyses adjusted for clustering within schools and demographic factors. Results: Higher income families (≥$50,000/y) were more likely to be aware of and to have claimed the CFTC compared with low-income families (<$50,000/y). The CFTC was associated with organized PA with larger associations for higher-income families (odds ratio = 9.03–9.32, Ps < .001) compared with lower-income families (odds ratio = 3.27–4.05, Ps < .01). No associations existed for overall PA or pedometer steps with the CFTC. Conclusions: Income disparities exist in the awareness, uptake, and potential impact of the CFTC. Tax credits are not effective in promoting overall PA.

Open access

Markus Gerber, Christin Lang, Johanna Beckmann, Jan Degen, Rosa du Randt, Stefanie Gall, Kurt Z. Long, Ivan Müller, Madeleine Nienaber, Peter Steinmann, Uwe Pühse, Jürg Utzinger, Siphesihle Nqweniso, and Cheryl Walter

Background: Little is known whether physical activity (PA)-promoting environments are equally accessible to children with divergent socioeconomic status (SES) in low-/middle-income countries. The authors, therefore, examined whether South African children from poorer versus wealthier families living in marginalized communities differed in moderate to vigorous PA and cardiorespiratory fitness. We also tested associations between family car ownership and PA/cardiorespiratory fitness. Methods: Parents/guardians of 908 children (49% girls, mean age = 8.3 [1.4] y) completed a survey on household SES. PA was assessed via 7-day accelerometry, parental and child self-reports, and cardiorespiratory fitness with the 20-m shuttle run test. Results: Based on accelerometry, most children met current moderate to vigorous PA recommendations (≥60 min/d). About 73% of the children did not engage in structured physical education lessons. Whereas children of the lowest SES quintile accumulated higher levels of device-based moderate to vigorous PA, peers from the highest SES quintile engaged in more sedentary behaviors, but self-reported higher engagement in sports, dance, and moving games after school. Families’ car ownership was associated with higher parent/self-reported leisure-time PA. Conclusions: A deeper understanding is needed about why wealthier children are more sedentary, but simultaneously engage in more leisure-time PA. The fact that access to structural physical education is denied to most children is critical and needs to be addressed.