Background: To meet the World Health Organization goal of reducing physical inactivity by 15% by 2030, a multisectoral system approach is urgently needed to promote physical activity (PA). We report the process of and findings from a codesigned systems mapping project to present determinants of PA in the context of urban New South Wales, Australia. Methods: A participatory conceptual mapping workshop was held in May 2023 with 19 participants working in education, transportation, urban planning, community, health, and sport and recreation. Initial maps were developed and refined using online feedback from the participants. Interviews were conducted with 10 additional policymakers from relevant sectors to further refine the maps. Results: Two systems maps were cocreated, identifying over 100 variables influencing PA and their interconnections. Five settings emerged from the adults’ map—social and community, policy, built environment and transportation, health care, and workplace—and 4 for the young people’s map—family, school, transportation, and community and environment. The maps share similarities, such as regarding potential drivers within the transportation, community, and built environment sectors; however, the young people’s map has a specific focus on the school setting and the adults’ map on workplace and health care settings. Interviews with policymakers provided further unique insights into understanding and intervening in the PA system. Conclusions: This codesigned participatory systems mapping process, supplemented by stakeholder interviews, provided a unique opportunity to bring together stakeholders across sectors to understand the complexity within the PA system and begin to identify leverage points for tackling physical inactivity in New South Wales.
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A Holistic Way to Understand the Determinants of Physical Activity in Urban New South Wales, Australia: A Codesigned Systems Mapping Project
Mengyun Luo, Binh Nguyen, Tracy Nau, Simon K. Chiu, Adrian Bauman, Louise Freebairn, William Bellew, Lucie Rychetnik, David T. Burns, Elizabeth A. Calleja, Lucy Corbett, Jennifer L. Kent, David R. Lubans, Anthony D. Okely, Catherine Sherrington, Anne Tiedemann, and Ding Ding
Navigating Virtual Collisions: Insights Into Perception–Action Differences in Children and Young Adults Using a Head-On Avoidance Task
Megan Hammill, Victoria Rapos, and Michael Cinelli
Children tend to make more last-minute locomotor adjustments than adults when avoiding stationary obstacles. The purpose of this study was to compare avoidance behaviors of middle-aged children (10–12 years old) with young adults during a head-on collision course with an approaching virtual pedestrian. Participants were immersed in a virtual environment and completed a perceptual decision-making task in which they had to respond to the future direction of an approaching virtual pedestrian once they disappeared. Following the perceptual task, participants walked along an 8-m pathway toward a goal, while avoiding a collision with a virtual pedestrian who approached along the midline than veered toward the left, right, or continued walking straight. Results revealed that children were able to correctly predict the future directions of the virtual pedestrian similar to adults, albeit at a slower response time (0.55 s vs. 0.33 s). During the action task, children initiated a deviation in their travel path later (i.e., closer to the virtual pedestrian) compared to adults (1.65 s vs. 1.52 s). Children were also more variable in their onset of deviation and time-to-contact. Although children appear to have developed adult-like perceptual abilities and can avoid an approaching virtual pedestrian, children employ riskier avoidance strategies and are highly variable, suggesting middle-aged children are still fine-tuning their perception-action system.
Community-Based Physical Activity Programs for Blood Pressure Management in African Americans: A Scoping Review
Dennis Miezah, Julie A. Wright, and Laura L. Hayman
Background: Hypertension is a significant risk factor for cardiovascular disease, with a higher prevalence among African Americans (AA) than other racial groups. The impact of community-based interventions on managing blood pressure (BP) in AA communities is not fully understood. The purpose of this review was to synthesize literature on community-based physical activity (PA) programs designed to manage BP in AA populations. Methods: We conducted a scoping review by searching 4 databases (PubMed, CINAHL, MEDLINE, and APA PsycInfo) and reference lists of studies. Search terms included community PA, community-based, hypertension, high BP, AA, Black Americans, PA, and exercise. Inclusion criteria were studies (1) conducted in the United States and (2) published in English language from January 2013 to September 2023, with community-based interventions that included PA for BP management among AA aged ≥18 years. Results: Search results yielded 260 studies, of which 11 met the inclusion criteria. BP decreased over time in studies that incorporated PA, faith-based therapeutic lifestyle changes with nutritional education. The duration of the PA interventions varied, with moderate to vigorous PAs implemented for 12 weeks or longer having a greater impact on BP management. Conclusions: Evidence suggests that community-based PA programs can potentially reduce BP among AA. PA programs incorporating faith-based therapeutic lifestyle change with nutritional education appear to reduce BP. Practitioners should consider multicomponent community-based PA initiatives to improve BP outcomes in AA communities.
Content Validation and Pilot Testing of the Promoting Active Lifestyle Among Children With Disability Questionnaire in Filipino and English
Mary-Grace Kang, Gabriella Isabel Tablante, Kristofferson Mendoza, Aila Nica Bandong, Roselle Guisihan, Audrey Anne Lim, Frances Rom Lunar, Carlos Dominic Olegario, Esmerita Rotor, and Yves Palad
Background: Primary carers, school teachers, and administrators are key influencers in promoting active lifestyle among children with disabilities (CWD). Guided by the Capability, Opportunity, Motivation, Behavior Model, the Promoting Active Lifestyle among CWD (PALS) Questionnaire aims to determine these influencers’ perceptions, capabilities, opportunities, and motivations in active healthy lifestyle promotion. This study evaluated the content validity and feasibility of the PALS Questionnaire in Filipino and English. Methods: Six experts rated the relevance of the items in the Filipino and English versions of the PALS Questionnaire. Item and scale content validity indices and agreement among raters (modified kappa k*) were computed. The questionnaires were revised and pilot tested among 11 participants comprising primary carers, and special education teachers and administrators using 3 methods of administration: online survey, phone interview, and pen-and-paper survey. Results: Scale-level content validity index indicated excellent content validity (0.96–0.97). Item-level content validity index ranged between 0.67 and 1.00. Interrater agreement on the relevance of all items was excellent (k* = .82–1.00), except for the item on teaching assistants (k* = .56). Most participants found the items easy to understand. The average time needed to complete a questionnaire was 30 minutes. The online version of the questionnaire was identified as the most feasible mode of administration. Conclusion: The PALS Questionnaire is a useful instrument for understanding Filipino primary carers’ and educators’ perceptions on promoting CWD’s active healthy lifestyle. Information from the PALS Questionnaire could inform initiatives toward better CWD health and quality of life.
Digest
Kim Gammage, Erica Bennett, Matthew Bird, Jordan Blazo, Alyson Crozier, Alison Ede, Katie Hirsch, Seungmin Lee, Sascha Leisterer, Sean Locke, Eva Pila, and Matthew Stork
Effects of Tai Chi Chuan on Older Adults’ Balance: A Systematic Review With Meta-Analysis
Rafael Bertolini, Rafael Vercelino, Luis Fernando Ferreira, and Luis Henrique Telles da Rosa
Background: Tai Chi Chuan (TCC) is considered a mind and body practice of Chinese origin, considered as an intangible cultural heritage of humanity by UNESCO, and recommended by the World Health Organization as a therapeutic approach to prevent falls. Objective: To assess the effects of TCC on older adult’s balance. Methods: A systematic review of randomized clinical trials was conducted by two independent reviewers using the ROB2 tool to assess the risk of bias under the following databases: PubMed, SCOPUS, Web of Science, PEDro, Embase, Cochrane, CINAHL, and LILACS. A meta-analysis of the selected articles for the dynamic and static balance criteria was conducted in a population of older adults (over 65 years) with publications from 2010 to 2024. Results: Eighteen randomized clinical trials fulfilled the criteria. TCC improves dynamic balance in the timed up and go and gait speeds tests, and static balance in the single-leg test and functional reach test when compared with the control group in the meta-analysis. Adverse events were found in only one study, and the training parameters were heterogeneous. Conclusion: TCC improves older adults with both dynamic and static balance. The results of the parameters indicate a direction in which TCC is prescribed for clinical practice with minimal or no risk of adverse effects.
Gaze Behaviors, Estimated Quiet Eye Characteristics, and Decision Making of Nonexpert Assistant Referees Judging Offside Events in Soccer
Carlos Albaladejo-García, Vicente Luis-del Campo, Jesús Morenas, and Francisco J. Moreno
The study analyzed the gaze behavior and decision-making performance of 20 soccer assistant referees while judging offside events. Specifically, gaze behaviors, gaze entropy, and estimated quiet eye (eQE; defined as the last fixation prior to the attacker’s ball pass) characteristics (i.e., location, onset, offset, and duration) were analyzed in relation to decision-making accuracy. Although a significant number of fixations were observed on the offside line, the highest viewing time corresponded to the ball carrier. The gaze behavior indicated a high distribution of fixations, as evidenced by high stationary gaze entropy (>90%). The assistant referees also distinguished offside from onside positions above chance. However, they displayed nonprolonged eQE on the offside line. As a result, no significant relationships were found between the eQE characteristics and decision-making accuracy. The study concludes that the absence of more functional gaze behaviors, specifically with longer eQE focused on the offside line, impaired the decision-making accuracy of nonexpert assistant referees in soccer.
Predicting Basketball Shot Outcome From Visuomotor Control Data Using Explainable Machine Learning
Nikki Aitcheson-Huehn, Ryan MacPherson, Derek Panchuk, and Adam W. Kiefer
Quiet eye (QE), the visual fixation on a target before initiation of a critical action, is associated with improved performance. While QE is trainable, it is unclear whether QE can directly predict performance, which has implications for training interventions. This study predicted basketball shot outcome (make or miss) from visuomotor control variables using a decision tree classification approach. Twelve basketball athletes completed 200 shots from six on-court locations while wearing mobile eye-tracking glasses. Training and testing data sets were used for modeling eight predictors (shot location, arm extension time, and absolute and relative QE onset, offset, and duration) via standard and conditional inference decision trees and random forests. On average, the trees predicted over 66% of makes and over 50% of misses. The main predictor, relative QE duration, indicated success for durations over 18.4% (range: 14.5%–22.0%). Training to prolong QE duration beyond 18% may enhance shot success.
Device-Based Measurement of Office-Based Physical Activity and Sedentary Time: A Systematic Review
Noah Bongers, Genevieve N. Healy, George Thomas, and Bronwyn K. Clark
Background: The aim of this study was to systematically review the findings for validity, reliability, and acceptability of device-based measures of office-based physical activity and/or sedentary time in an office context to evaluate workplace interventions. Methods: The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Analysis guidelines. Five electronic databases (PubMed, EMBASE, CINAHL, Cochrane, and Web of Science) were searched (inception to December 2023). Keywords included population (e.g., workers), type of measure (e.g., device-based), measurement constructs (e.g., validity), context (e.g., office), and behavior (e.g., sitting). Two authors screened titles, abstracts, and full texts independently with disagreements resolved by a third author. Findings were reported using narrative synthesis, and COnsensus-based standards for the Selection of health status Measurement INstruments was used for quality assessment. Results: In total, 2,299 articles were identified, with 16 articles retained. These reported 21 measurement protocols (nine in free-living settings) assessing eight worn, four remote, and one combined method. Sixteen protocols assessed office sitting, with standing (n = 8), moving (n = 11), postural transitions (n = 7), and location (n = 2) also assessed. Participant sample sizes ranged from one to 42 (median = 13). Criterion validity was assessed in all 21 protocols, with lower limb–worn measures of sitting, and worn and remote measures of location reporting the highest validity/accuracy compared with the ground truth (good to excellent). Only two articles reported acceptability (good acceptability), with none reporting reliability. Conclusions: There is evidence of valid device-based measures of office behavior (particularly sitting and location of workers), but this has largely been obtained in laboratory settings and/or with small samples. Larger studies in more varied free-living settings, potentially using multiples sources of data and assessing acceptability, are required.
Effect of Accelerometer Cut-Points on Preschoolers’ Physical Activity and Sedentary Time: A Systematic Review and Meta-Analysis
Sophie M. Phillips, Kimberly A. Clevenger, Brianne A. Bruijns, Patricia Tucker, Leigh M. Vanderloo, Aidan Loh, Manahil Naveed, and Matthew Bourke
This systematic review and meta-analysis aimed to compare estimated levels of physical activity (PA) and sedentary time (ST) of preschool-aged children (3–5 years old) based on different published accelerometer cut-points used in this age group. Four electronic databases were searched to identify studies estimating levels of PA or ST (ST, light PA [LPA], and moderate to vigorous PA [MVPA]) using multiple accelerometer cut-points, in a sample of preschool-aged children. Data were extracted and risk of bias assessed for all included studies. Random-effects meta-analysis was used to estimate pooled effects for unique combinations of accelerometer cut-points for each outcome. Twenty-four studies, reporting on 18 unique samples, were included. Results demonstrated substantial variability in estimates of PA and ST across different cut-points, with significant differences in estimates of the behaviors between most cut-points. Few cut-points showed similarity; Evenson and Pate were some of the most similar for the assessment of PA and ST of young children. However, when calculating the differences in ST, LPA, and MVPA between the cut-points, the Evenson cut-point estimates approximately 60 min more LPA per day and the Pate 148CPM cut-points estimates 23 and 37 min more ST and MVPA each day, respectively. Given that these were the most similar estimates, this highlights the magnitude of differences between the accelerometer cut-points when estimating preschool-aged children’s movement behavior. This review provides an illustration on the limitations of accelerometer cut-points used to determine PA and ST of preschool-aged children; in that they often produce substantially different estimates. This review provides a compelling rationale as to why further research moving toward alternative data processing methodologies is required, including to identify an optimal approach to estimating movement behavior outcomes in young children that considers congruence with past and future research.