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Gender Gap for Accelerometry-Based Physical Activity Across Different Age Groups in 5 Brazilian Cohort Studies

Luiza I.C. Ricardo, Andrea Wendt, Debora Tornquist, Helen Gonçalves, Fernando Wehrmeister, Bruna Gonçalves C. da Silva, Luciana Tovo-Rodrigues, Iná Santos, Aluisio Barros, Alicia Matijasevich, Pedro C. Hallal, Marlos Domingues, Ulf Ekelund, Renata M. Bielemann, and Inácio Crochemore-Silva

Objectives: This study aims to evaluate the gender inequalities in accelerometer-based physical activity (PA) across different age groups using data from 5 Pelotas (Brazil) cohorts. Methods: The data come from 4 birth cohort studies, covering all live births in the urban area of Pelotas for each respective year (1982, 1993, 2004, and 2015), and the Como vai? cohort study focusing on 60 years and above. Raw accelerometry data were collected on the nondominant wrist using GENEActive/ActiGraph devices and processed with the GGIR package. Overall PA was calculated at ages 1, 2, 4, 6, 11, 15, 18, 23, 30, and 60+ years, while moderate to vigorous PA was calculated from 6 years onward. Absolute (difference) and relative (ratio) gender inequalities were calculated and intersectionality between gender and wealth was also evaluated. Results: The sample sizes per cohort ranged from 965 to 3462 participants. The mean absolute gender gap was 19.3 minutes (95% confidence interval, 12.7–25.9), with the widest gap at 18 years (32.9 min; 95% confidence interval, 30.1–35.7) for moderate to vigorous PA. The highest relative inequality was found in older adults (ratio 2.0; 95% confidence interval, 1.92–2.08). Our intersectionality results showed that the poorest men being the most active group, accumulating around 60 minutes more moderate to vigorous PA per day compared with the wealthiest women at age 18. Conclusions: Men were more physically active than women in all ages evaluated. PA gender inequalities start at an early age and intensify in transition periods of life. Relative inequalities were marked among older adults.

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Supporting People With Musculoskeletal Conditions From Underserved Communities in the United Kingdom to Engage With Physical Activity: A Realist Synthesis and Q-Methodology Study

Alice Berry, Terence Brady, Natasha Bradley, Nicky Harris, Caroline Flurey, Faatihah Niyi-Odumosu, Emma Dures, and Nicola Walsh

Background: In the United Kingdom, 20 million individuals suffer from a musculoskeletal condition, for which physical activity (PA) is a core treatment. Minority ethnic communities experience a disproportionate impact, experiencing higher levels of pain and engaging in less PA. Research has identified various factors that affect their participation in PA, including lack of access to support, limited knowledge of resources, language barriers, fear of racial harassment while exercising, and insufficient communication/information from healthcare professionals. Methods: This project adopted a realist perspective, aiming to understand “what works, in which circumstances, and for whom?” The project had 4 steps: (1) defining review scope with stakeholders; (2) searching and extracting literature, creation of initial program theories; (3) refining/validating initial program theories with stakeholders; and (4) adopting Q-methodology to highlight priority areas. Results: 17 papers were included. Three program theories were identified: (1) Lack of initial access to health service support; (2) Nature of musculoskeletal self-management support—the importance of the therapeutic relationship and value of shared conversations; and (3) Accessible long-term support for PA engagement. The Q-sort exercise highlighted priority areas: (1) complex booking procedures and inadequate translation services, (2) time constraints impact effective patient-centered care, (3) dismissive attitudes/mismatched expectations impact shared decision making, (4) rebuilding trust to strengthen therapeutic relationships, (5) cultural relevance in developing therapeutic relationships, and (6) clinician recommended PA opportunities increase knowledge of PA. Conclusions: Our findings shed light on inequities across the UK’s musculoskeletal pathways, specifically in relation to PA engagement. This points toward priority areas for future research and interventions.

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24-Hour Movement Behaviors of LGBTQA+ Young People: A Systematic Review

Kathryn Fortnum, Sjaan R. Gomersall, Megan H. Ross, James Woodforde, George Thomas, Yu-Shu Wen, Francisco Perales, and Michalis Stylianou

Background: The movement behaviors of LGBTQA+ young people, who encounter specific health, and other, challenges are not well understood. This systematic review examines the 24-hour movement behaviors of LGBTQA+ young people compared with population estimates of meeting the 24-hour movement guidelines. Methods: Seven electronic databases were searched from inception to January 2024. Observational studies published in English and reporting quantitative data for physical activity, sedentary behavior, or sleep duration for LGBTQA+ individuals <24 years old were included. Data were narratively synthesized for children/adolescents (<18 years) and young adults (18–24 years), guided by the Cochrane Synthesis Without Meta-analysis guidelines. Results: Fifty-six studies were included; 46 were of “fair” quality and 37 were conducted in the United States. Physical activity, sedentary behavior, and sleep outcomes were reported in 46, 11, and 14 studies, respectively. Ninety unique LGBTQA+ terms were identified. Based on outcomes reported in ≥1 study, and compared to population estimates, LGBTQA+ young people were less likely to meet aerobic physical activity and strength/resistance training guidelines. LGBTQA+ children/adolescents were less likely to meet the sleep guidelines. Young adults demonstrated similar adherence to sleep guidelines as population estimates. Conclusions: Overall, our results suggest that LGBTQA+ young people have suboptimal 24-hour movement behaviors; in some cases, worse than population estimates. Utilization of more robust measures of exposure and outcome variables is recommended, with a focus on sleep and sedentary behavior.

Free access

Are the Relationships of Physical Activity and Television Viewing Time With Mortality Robust to Confounding? A Study, Utilizing E-Values, From the Melbourne Collaborative Cohort Study

Baldwin Pok Man Kwan, Brigid M. Lynch, Lara Edbrooke, Allison Hodge, and Christopher T.V. Swain

Background: Physical activity and sedentary behavior are associated with health outcomes. However, evidence may be affected by confounding bias. This study aimed to examine the relationships of physical activity and television (TV) viewing time with all-cause, cardiovascular, and cancer mortality in a cohort of Australian adults, and determine the robustness of these relationships to residual and unmeasured confounding. Methods: Data from 27,317 Melbourne Collaborative Cohort Study participants (mean age = 66) were used. Physical activity was assessed using the International Physical Activity Questionnaire—Short Form and categorized as insufficient, sufficient, or more than sufficient. TV viewing time was categorized as low, moderate, or high. Multivariable Cox regression models were used to evaluate associations of interest. E-values were calculated to assess the strength of unmeasured confounders required to negate the observed results. Results: For highest versus lowest physical activity category, the hazard ratio was 0.67 (95% confidence interval, 0.56–0.81) for all-cause mortality; E-values ranged between 1.79 and 2.44. Results were similar for cardiovascular mortality; however, hazard ratios were lower (0.72; 95% confidence interval, 0.51–1.01) and E-values much smaller (1.00–2.12) for cancer mortality. For highest versus lowest TV viewing time category, the hazard ratio was 1.08 (1.01–1.15) for all-cause mortality; E-values ranged between 1.00 and 1.37. Results were similar for cardiovascular and cancer mortality. Conclusions: Physical activity and TV viewing time were associated with mortality. The robustness to unmeasured/residual confounding was moderate for physical activity (all-cause and cardiovascular mortality), but weaker for physical activity (cancer mortality) and TV viewing time in this study of Australian adults.

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Erratum. Are the Relationships of Physical Activity and Television Viewing Time With Mortality Robust to Confounding? A Study, Utilizing E-Values, From the Melbourne Collaborative Cohort Study

Journal of Physical Activity and Health

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Understanding the Relationships Between Physical Activity and Climate Change: An Umbrella Review

Milena Franco Silva, Ana Luiza Favarão Leão, Áine O’Connor, Pedro C Hallal, Ding Ding, Erica Hinckson, Tarik Benmarhnia, and Rodrigo Siqueira Reis

Background: Physical activity is crucial for maintaining health and preventing chronic diseases. However, climate conditions can impact physical activity patterns, and conversely, physical activity can impact climate change. This umbrella review aims to summarize the existing evidence regarding the relationships between physical activity and climate change, as revealed in previous reviews. Methods: Systematic reviews and meta-analyses were analyzed. Searches were conducted across GreenFILE, PubMed, and Web of Science databases for peer-reviewed articles published in English. A 2-stage independent screening process was conducted, and methodological quality was assessed using the JBI framework. Standardized data extraction methods were then applied. Results: Out of 1292 articles retrieved, 7 met all eligibility criteria and were included in the review. Three articles examined physical activity as a primary exposure, 3 focused on the impacts of climate change, and one considered both physical activity and climate change as primary exposures. Conclusions: Findings reveal an interplay between climate change and physical activity. While rising temperatures may prompt outdoor activities up to a certain temperature threshold, air pollution and extreme heat can have harmful effects. Active transportation and improved logistics around large-scale sporting events can mitigate climate change by reducing greenhouse gas emissions, but transportation systems linked to sports venues may increase emissions. Research on the reciprocal relationship between climate change and physical activity domains, and integrating the community into climate discussions, is crucial for equity, especially for marginalized communities. Incorporating climate adaptation and mitigation strategies in physical activity infrastructure to minimize environmental impacts is critical.

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Navigating Physical Activity Promotion and Policy in the Post-COVID-19-Pandemic Era

Justin Richards, Katja Siefken, Michael Pratt, Adrian Bauman, Juliana Mejía-Grueso, Catherine B. Woods, Wanda Wendel-Vos, Erica Hinckson, Deborah Salvo, Pedro C. Hallal, and Andrea Ramírez Varela

Background: There is limited evidence on the priorities and opportunities associated with promoting population physical activity (PA) participation for the post-COVID-19-pandemic future. Purpose: This study assessed government-led PA promotion efforts before and during the COVID-19 pandemic, along with post-COVID-19-pandemic priorities and recommendations. Methods: Two separate cross-sectional surveys conducted in 2023. Survey 1 was targeted at the Global Observatory for Physical Activity (GoPA!) Country Contacts. Survey 2 also included key international informants representing influential stakeholders in PA policy implementation. Results: There were 68 respondents to Survey 1, collectively representing 61 countries. An additional 37 people, including representatives from 14 key international stakeholders responded to Survey 2. Eighty-two percent of countries had national PA policies. COVID-19 widely disrupted PA policy implementation. Less than 40% of countries integrated PA into their COVID-19 response plan and more than 75% reported policies that restricted PA participation. Although most respondents indicated that government PA priorities did not change due to the COVID-19 pandemic, one in five countries reported that cross-sectoral partnership had become more important during this period. Less than a third of postpandemic governments reported as highly engaged despite the widespread proliferation of PA policies and plans prior to the pandemic. There were variations according to country, region, and income. Conclusions: Elevating PA promotion on the public health agenda is crucial for the post-COVID-19-pandemic era. At a policy level, it is critical to focus on adequate resourcing, cross-sectoral partnerships, integrated interventions, and inequities in participation. These factors have become increasingly important in the postpandemic PA policy landscape.

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Striving for Global Consensus: A Systematic Review of Social Return on Investment Applied to Physical Activity and Sport

Inés Nieto, Xián Mayo, Larissa Davies, Lindsey Reece, Ben Strafford, and Alfonso Jimenez

Background: Physical activity and sport (PAS) have been related to health and social benefits, but their monetary value remains unclear. This systematic review on the social return on investment of PAS aimed to find what are the social outcomes measured in previous PAS literature and how are these measured and valued. Methods: A systematic search was conducted on WoS, PubMed, and EconLit. Articles in English, measuring the social value of any type of PAS in monetary terms and utilizing a social return on investment framework, were included. Risk of bias was evaluated using the Drummond checklist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Results: Fifty-five documents (2010–2022), from all continents except America, were included; only 8 were published in peer-reviewed journals, whereas 47 were reports. Most studies evaluated the benefits of specific programs, and 6 measured the engagement in PAS at the population level based on national or community surveys. The social outcomes identified were health (94.5%), crime (50.9%), education (83.6%), subjective well-being (89.1%), social capital (60%), and other (3.6%–23.6%). The valuation methods included willingness to pay, well-being valuation, the cost of an activity that could result in the same outcome, and cost databases associating outcomes with a monetary value. Conclusions: This study updates a previous review and widens the scope by answering the question of how social outcomes are measured and valued in previous PAS literature. Given the heterogeneity found in the application of the method, this review will inform a Delphi study to reach a Global Consensus Statement on the measurement of social value and PAS.

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Associations of Working From Home Frequency With Accelerometer-Measured Physical Activity and Sedentary Behavior in Japanese White-Collar Workers: A Cross-Sectional Analysis of the Meiji Yasuda LifeStyle Study

Naruki Kitano, Yuya Fujii, Aya Wada, Ryoko Kawakami, Kaori Yoshiba, Daisuke Yamaguchi, Yuko Kai, and Takashi Arao

Background: The association of working from home (WFH) with physical activity (PA) and sedentary behavior (SB) has been explored; however, this association during periods without stringent measures to combat coronavirus disease 2019 is undercharacterized. Particularly, few studies have evaluated the potential effect modification on its associations. Therefore, this study aimed to investigate the associations of WFH frequency with accelerometer-measured PA and SB, along with its effect modifiers, among Japanese white-collar workers during the later pandemic period. Methods: A cross-sectional study involving 1133 white-collar workers residing in the Tokyo metropolitan area was conducted between April 2022 and March 2023. WFH frequency was evaluated through a self-report questionnaire, while SB and PA during weekdays were measured using a triaxial accelerometer. Linear regression models adjusting for potential confounders were used to examine the association of WFH frequency with PA and SB. Results: Regardless of activity intensity, individuals who worked at home, even for 1 to 2 days per week, demonstrated lower levels of PA and higher levels of SB as compared with those who did not (P < .05). For example, difference between never and ≥5 days per week WFH was approximately 70 minutes/day for total PA and about 4000 steps/day for step counts. Associations between WFH and decreased PA were more pronounced in workers who were older, female, less educated, in sales and service work, nonregular staff, and precontemplating changes in exercise and eating habits. Conclusions: We report that WFH was associated with decreased PA and increased SB in Japanese white-collar workers with pronounced associated in several subgroups.

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Physical Activity Report Card Indicators and the United Nations Sustainable Development Goals: Insights From Global Matrix 4.0

Diego Augusto Santos Silva, Salomé Aubert, Taru Manyanga, Eun-Young Lee, Deborah Salvo, and Mark S. Tremblay

Background: The World Health Organization recognizes that physical activity (PA) during childhood is crucial for healthy development, aligning well with the achievement of several United Nations (UN) Sustainable Development Goals (SDGs). This study aimed to explore the associations between 10 key indicators of PA for children and adolescents assessed in the Global Matrix 4.0 project, and the UN SDGs. Methods: Data from 57 countries/jurisdictions of the Global Matrix 4.0 project were used. The UN SDG indicators were sourced from the SDG Transformation Center, which publishes each country’s performance on each of the 17 SDGs. Given the robust evidence supporting plausible links between PA and SDGs 3 (good health and well-being), 9 (industry, innovation, and infrastructure), 11 (sustainable cities and communities), 13 (climate action), and 16 (peace, justice, and strong institutions), these SDGs were investigated. Results: Countries/jurisdictions with good and moderate performance in achieving SDG 3, SDG 9, SDG 11, and SDG 16 had higher grades than countries/jurisdictions with fair performance in achieving these SDGs for the following indicators: Organized Sports and PA, Community and Environment, and Government Investments and Strategies. However, countries/jurisdictions with good performance in achieving SDG 13 had lower grades than countries/jurisdictions with fair performance in achieving SDG 13 for the following indicators: Organized Sports and PA, Community and Environment, and Government Investments and Strategies. Conclusions: Organized Sports and PA, Community and Environment, and Government Investments and Strategies were the indicators that demonstrated differences between countries/jurisdictions with good and poor performance in achieving the SDGs.