Kelly Cornett, Katherine Bray-Simons, Heather M. Devlin, Sunil Iyengar, Patricia Moore Shaffer and Janet E. Fulton
Artur Direito, Joseph J. Murphy, Matthew Mclaughlin, Jacqueline Mair, Kelly Mackenzie, Masamitsu Kamada, Rachel Sutherland, Shannon Montgomery, Trevor Shilton and on behalf of the ISPAH Early Career Network
Increasing population levels of physical activity (PA) can assist in achieving the United Nations sustainable development goals, benefiting multiple sectors and contributing to global prosperity. Practices and policies to increase PA levels exist at the subnational, national, and international levels. In 2018, the World Health Organization launched the first Global Action Plan on Physical Activity (GAPPA). The GAPPA provides guidance through a framework of effective and feasible policy actions for increasing PA, and requires engagement and advocacy from a wide spectrum of stakeholders for successful implementation of the proposed actions. Early career professionals, including researchers, practitioners, and policymakers, can play a major role with helping “all people being regularly active” by contributing to 4 overarching areas: (1) generation—of evidence, (2) dissemination—of key messages and evidence, (3) implementation—of the evidence-based actions proposed in the GAPPA, and (4) contributing to advocacy for robust national action plans on PA. The contribution of early career professionals can be achieved through 5 pathways: (1) research, (2) workplace/practice, (3) business, (4) policy, and (5) professional and public opinion. Recommendations of how early career professionals can contribute to the generation, dissemination, and implementation of the evidence and actions proposed by the GAPPA are provided.
Jordan Andre Martenstyn, Lauren Powell, Natasha Nassar, Mark Hamer and Emmanuel Stamatakis
Background: Previous epidemiological studies examining the association between physical activity (PA) and mortality risk have measured absolute PA intensity using standard resting metabolic rate reference values that fail to consider individual differences. This study compared the risk of all-cause and cardiovascular mortality between absolute and corrected estimates of PA volume. Methods: 49,982 adults aged ≥40 years who participated in the Health Survey for England and Scottish Health Survey in 1994–2008 were included in our study. PA was classified as absolute or corrected metabolic equivalent (MET)-hours per week, taking participant’s weight, height, age, and sex into account. Cox regression models were used to examine the association between absolute and corrected PA volumes and all-cause and cardiovascular mortality. Results: The authors found no difference in the association between levels of PA and risk of all-cause and cardiovascular mortality for absolute and corrected MET-hours per week, although there was a consistent decrease in mortality risk with increasing PA. There was no difference in mortality when analyses were stratified by sex, age, and body mass index. Conclusions: The association between PA volume and risk of mortality was similar regardless of whether PA volume was estimated using absolute or corrected METs. There is no empirical justification against the use of absolute METs to estimate PA volume from questionnaires.
Jeanette Gustat, Christopher E. Anderson, Keelia O’Malley, Tian Hu, Rachel G. Tabak, Karin Valentine Goins, Cheryl Valko, Jill S. Litt and Amy A. Eyler
Background: To assess how perceptions of the community built environment influence support for community policies that promote physical activity (PA). Methods: A national cross-sectional survey assessed perceptions of the local built environment and support of community policies, including school and workplace policies, promoting PA. A random digit–dialed telephone survey was conducted in US counties selected on Behavioral Risk Factor Surveillance System data for high or low prevalence of obesity and inactivity. A total of 1208 subjects were interviewed, 642 from high-prevalence counties and 566 from low-prevalence counties. Analyses were stratified by county prevalence of obesity and inactivity (high or low). Linear models adjusted for covariates were constructed to assess the influence of built environment perceptions on policy support. Results: Perception of more destinations near the residence was associated with increased support for community policies that promote PA, including tax increases in low-prevalence (obesity and inactivity) counties (P < .01). Positive perception of the workplace environment was associated (P < .001) with increased support for workplace policies among those in high-, but not low-, prevalence counties. Conclusions: Support for community policies promoting PA varies by perception of the built environment, which has implications for policy change.
Tracy Nau, Karen Lee, Ben J. Smith, William Bellew, Lindsey Reece, Peter Gelius, Harry Rutter and Adrian Bauman
Background: The value of a systems thinking approach to tackling population physical inactivity is increasingly recognized. This study used conceptual systems thinking to develop a cognitive map for physical activity (PA) influences and intervention points, which informed a standardized approach to the coding and notation of PA-related policies in Australia. Methods: Policies were identified through desktop searches and input from 33 nominated government representatives attending 2 national PA policy workshops. Documents were audited using predefined criteria spanning policy development, strategic approaches to PA, implementation processes, and evaluation. Data were analyzed using descriptive statistics. Results: The audit included 110 policies, mainly led by the health or planning/infrastructure sectors (n = 54, 49%). Most policies purporting to promote PA did so as a cobenefit of another objective that was not focused on PA (n = 63, 57%). An intention to monitor progress was indicated in most (n = 94, 85%); however, fewer than half (n = 52, 47%) contained evaluable goals/actions relevant to PA. Descriptions of resourcing/funding arrangements were generally absent or lacked specific commitment (n = 67, 61%). Conclusions: This study describes current PA-relevant policy in Australia and identifies opportunities for improving coordination, implementation, and evaluation to strengthen a whole-of-system and cross-agency approach to increasing population PA.
Nicolas Hobson, Sherry L. Dupuis, Lora M. Giangregorio and Laura E. Middleton
Persons with mild cognitive impairment (MCI) and early dementia are often physically inactive, despite associated benefits. This study explored the barriers, facilitators, and preferences for exercise among persons living with MCI/early dementia. The authors conducted 2 focus groups among persons living with MCI/early dementia (n = 4, 6 participants) and 2 focus groups among care partners (n = 3, 4 participants). The transcripts were analyzed using thematic analysis, guided by the social-ecological model. Three themes emerged, reinforcing motivation to exercise, managing changes to cognitive and physical health, and variable perceptions of dementia, each with influences from individual, care partner, and community levels. Low intrinsic motivation, poor physical/cognitive health, and stigma restricted the exercise among persons living with MCI/early dementia. The care partners motivated their partners and provided company and transportation to exercise. People with MCI/early dementia also indicated poor access to exercise providers and exercise opportunities that met their needs and preferences was a barrier to exercise participation. Knowledge translation research should develop exercise interventions at the individual, social, and community levels.
Mohammad Siahpush, Trish D. Levan, Minh N. Nguyen, Brandon L. Grimm, Athena K. Ramos, Tzeyu L. Michaud and Patrik L. Johansson
Background: The mortality benefits of meeting the US federal guidelines for physical activity, which includes recommendations for both aerobic and muscle-strengthening activities, have never been examined among smokers. Our aim was to investigate the association between reporting to meet the guidelines and all-cause, cancer, cardiovascular disease, and respiratory disease mortality among smokers. Methods: We pooled data from the 1998–2009 National Health Interview Survey, which were linked to records in the National Death Index (n = 68,706). Hazard ratios (HR) were computed to estimate the effect of meeting the physical activity guidelines on mortality. Results: Smokers who reported meeting the guidelines for physical activity had 29% lower risk of all-cause mortality (HR: 0.71; 95% confidence interval [CI], 0.62–0.81), 46% lower risk of mortality from cardiovascular disease (HR: 0.54; 95% CI, 0.39–0.76), and 26% lower risk of mortality from cancer (HR: 0.74; 95% CI, 0.59–0.93), compared with those who reported meeting neither the aerobic nor the muscle-strengthening recommendations of the guidelines. Meeting the aerobic recommendation of the guidelines was associated with a 42% decline in that risk (HR: 0.58; 95% CI, 0.44–0.77). Conclusion: Smokers who adhere to physical activity guidelines show a significant reduction in mortality.
Christina M. Patch, Caterina G. Roman, Terry L. Conway, Ralph B. Taylor, Kavita A. Gavand, Brian E. Saelens, Marc A. Adams, Kelli L. Cain, Jessa K. Engelberg, Lauren Mayes, Scott C. Roesch and James F. Sallis
Background: A common hypothesis is that crime is a major barrier to physical activity, but research does not consistently support this assumption. This article advances research on crime-related safety and physical activity by developing a multilevel conceptual framework and reliable measures applicable across age groups. Methods: Criminologists and physical activity researchers collaborated to develop a conceptual framework. Survey development involved qualitative data collection and resulted in 155 items and 26 scales. Intraclass correlation coefficients (ICCs) were computed to assess test–retest reliability in a subsample of participants (N = 176). Analyses were conducted separately by age groups. Results: Test–retest reliability for most scales (63 of 104 ICCs across 4 age groups) was “excellent” or “good” (ICC ≥ .60) and only 18 ICCs were “poor” (ICC < .40). Reliability varied by age group. Adolescents (aged 12–17 y) had ICCs above the .40 threshold for 21 of 26 scales (81%). Young adults (aged 18–39 y) and middle-aged adults (aged 40–65 y) had ICCs above .40 for 24 (92%) and 23 (88%) scales, respectively. Older adults (aged 66 y and older) had ICCs above .40 for 18 of 26 scales (69%). Conclusions: The conceptual framework and reliable measures can be used to clarify the inconclusive relationships between crime-related safety and physical activity.
Angela Maria Hoyos-Quintero and Herney Andrés García-Perdomo
Objective: To evaluate the relationship between biologico-demographical, sociocultural, and environmental factors and the performance of physical activity in early childhood. Methodology: A systematic search was carried out of the databases MEDLINE, EMBASE, CENTRAL, and LILACS, as well as Google Scholar, Open Grey, ClinicalTrials.gov, DARE, PROSPERO, Health Technology Assessment, and the World Health Organization International Clinical Trials Registry Platform, from their first records to June 2018. The selection criteria were previously defined with respect to population age and article theme. No meta-analyses were carried out due to the heterogeneity of the studies. Results: The percentage of moderate to vigorous physical activity runs between 3% and 47%. Environmental and sociocultural factors were identified as exerting a greater influence on children’s physical activity in early childhood, with the environmental factors being, according to almost all the study authors, the greater of the two. Conclusions: According to the studies included in this research project, the factors identified as associated with moderate to vigorous physical activity are environmental (play in open spaces) and sociocultural (the role of the family and the physical activity of the mother). The evidence is not strong enough to conclude that biologico-demographic factors are significantly influential in the physical activity at this age.
Ítalo R. Lemes, Rômulo A. Fernandes, Bruna C. Turi-Lynch, Jamile S. Codogno, Luana C. de Morais, Kelly A.K. Koyama and Henrique L. Monteiro
Background: Metabolic syndrome (MetS) is a combination of risk factors for cardiovascular disease and type 2 diabetes mellitus. The prevalence of MetS worldwide is increasing. There is no study investigating the economic burden of MetS, especially in developing countries, on medication-related expenditure. The aim of this study was to investigate the association of medication-related expenditures with MetS and to explore how physical activity (PA) may influence this association. Methods: A total of 620 participants, 50 years or older, randomly selected in the city of Bauru, Brazil. Participants were followed from 2010 to 2014, and data on health care expenditure were collected annually. PA questionnaire was applied at baseline, 2 (2012), and 4 (2014) years later. Results: Mean age was 64.7 (95% confidence interval, 64.1–65.3). MetS was associated with higher medication expenditure related to diseases of the circulatory (P <.01) and endocrine (P <.01) systems. MetS explained 17.2% of medication-related expenditures, whereas PA slightly attenuated this association, explaining 1.1% of all health care costs. Conclusion: This study demonstrates that MetS has a significant burden on health care expenditures among adults, whereas PA seems to affect this phenomenon significantly, but in low magnitude.