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We strongly believe that diversity, equity, and inclusion in research lead to better science, more innovations and more relevant outcomes that better serve society at large. Historically, scientific research is quite WEIRD, meaning that it is dominated by researchers and study samples from Western, Educated, Industrialized, Rich, and Democratic countries. Such WEIRD research leads to results that better serve a small, privileged group of WEIRD people, widening health inequalities. Research among a selective group with similar backgrounds and perspectives results in bias and hinders innovation. As a result, we end up missing out on the valuable holistic viewpoint that more inclusive research would gain. In this invited commentary based on the International Conference on Ambulatory Monitoring of Physical Activity and Movement (ICAMPAM) 2022 keynote presentation by Prof. ChinAPaw, we discuss the importance of diversity, equity, and inclusion in research and introduce our vision for AWESOME science—All-inclusive, Worldwide ranging, Equitable, Sincere, Open-minded, Mindful of our own implicit bias, and Essential—that is more inclusive and relevant for everyone regardless of who they are and where they live. More diversity, equity, and inclusion make our collective dance toward healthy societies more beautiful and impactful!

There is much evidence showing that physical activity is related to optimal health, including physical and mental function, and quality of life. Additionally, data are accumulating with regard to the detrimental health impacts of sedentary behavior. Much of the evidence related to long-term health outcomes, such as cardiovascular disease and cancer—the two leading causes of death in the United States and worldwide—comes from observational epidemiologic studies and, in particular, prospective cohort studies. Few data on these outcomes are derived from randomized controlled trials, conventionally regarded as the “gold standard” of research designs. Why is there a paucity of data from randomized trials on physical activity or sedentary behavior and long-term health outcomes? A further issue to consider is that prospective cohort studies investigating these outcomes can take a long time to accrue sufficient numbers of endpoints for robust and meaningful findings. This contrasts with the rapid pace at which technology advances. Thus, while the use of devices for measuring physical behaviors has been an important development in large-scale epidemiologic studies over the past decade, cohorts that are now publishing results on health outcomes related to accelerometer-assessed physical activity and sedentary behavior may have been initiated years ago, using “dated” technology. This paper, based on a keynote presentation at 8th International Conference on Ambulatory Monitoring of Physical Activity and Movement 2022, discusses the issues of study design and slow pace of discovery in prospective cohort studies and suggests some possible ways to maximize the utility and comparability of “dated” device data from prospective cohort studies for research investigations using the Women’s Health Study as an example.

The consequences of multiple sclerosis (MS), particularly gait and walking dysfunction, may obfuscate (i.e., make unclear in meaning) the measurement of physical activity using body-worn motion sensors, notably accelerometers. This paper is based on an invited keynote lecture given at the 8th International Conference on Ambulatory Monitoring of Physical Activity and Movement, June 2022, and provides an overview of studies applying accelerometers for the measurement of physical activity behavior in MS. The overview includes initial research uncovering a conundrum with the interpretation of activity counts from accelerometers as a measure of physical activity. It then reviews research on calibration of accelerometer output based on its association with energy expenditure in yielding a biologically based metric for studying physical activity in MS. The paper concludes with other applications and lessons learned for guiding future research on physical activity measurement using accelerometry in MS and other populations with neurological diseases and conditions.

Background: Activity trackers and the Pregnancy Physical Activity Questionnaire (PPAQ) measures physical activity (PA) and sedentary time (SED). However, none of these tools have been validated against a criterion method in pregnancy. We aimed to compare a consumer activity tracker and the Danish version of PPAQ (PPAQ-DK) and to validate them using the doubly labeled water technique (DLW) as criterion method. Methods: A total of 220 healthy pregnant women participated. Total energy expenditure (TEE), PA energy expenditure (PAEE), and PA level were determined at gestational Weeks 28–29 using DLW and a Garmin Vivosport (Garmin, Olathe, KS) activity tracker. In addition, PAEE, moderate-to-vigorous intensity PA, and SED were determined using the activity tracker and PPAQ-DK during all three trimesters. Results: TEE from the activity tracker and DLW correlated (r = .63; p < .001), but the activity tracker overestimated TEE (503 kcal/day). Also, the activity tracker overestimated PAEE (303 kcal/day) and PA level compared with DLW. Likewise, PPAQ-DK overestimated PAEE (1,513 kcal/day) compared with DLW. Compared to PPAQ-DK, the activity tracker reported lower values of PAEE and moderate-to-vigorous intensity PA and higher values of SED during all three trimesters. Conclusions: When compared to DLW, we found better agreement of PAEE estimates from the activity tracker than from PPAQ-DK. TEE from the tracker and DLW correlated moderately well, but this was not the case for PAEE or PA level. The activity tracker measured lower PA and higher SED than PPAQ-DK throughout pregnancy. The consumer activity tracker performed better than the questionnaire, but both significantly overestimated PA compared to DLW.

Adherence to exercise rehabilitation has been shown to be an important factor that may influence successful treatment. In professional athletes, a significant reduction in exercise adherence delays recovery. The aim of this study was to explore barriers to and facilitators of exercise rehabilitation adherence in injured volleyball athletes. Eight professional volleyball athletes were recruited, and qualitative data were collected using semistructured interviews. All athletes had completed their rehabilitation program after they had suffered a musculoskeletal injury. All data were analyzed using thematic analysis after the investigators ensured that saturation had been reached. Pain was identified as a significant barrier to exercise adherence by all athletes. The provision of social support, including mental, practical, and task related, also had a significant positive impact. The athletes’ ability to develop the necessary coping strategies and confidence on performing exercises at home was also mentioned as a factor that affected exercise adherence, although less often.

Background: This study aimed to explore association of self-reported physical activity domains of work, leisure, and transport-related physical activity and body mass index (BMI) in 9388 adult men and women from the Africa-Wits-INDEPTH partnership for Genomic (AWI-Gen) study in Africa. Africa-Wits-INDEPTH partnership for Genomic is a large, population-based cross-sectional cohort with participants from 6 sites from rural and urban areas in 4 sub-Saharan African countries. Methods: A sex-stratified meta-analysis of cross-sectional data from men and women aged 29–82 years was used to assess the association of physical activity with BMI. Results: Overall, meeting physical activity guidelines of at least 150 minutes per week was associated with 0.82 kg/m² lower BMI in men (β = −0.80 kg/m²; 95% confidence interval [CI], −1.14 to −0.47) and 0.68 kg/m² lower BMI in women (β = −0.68 kg/m²; 95% CI, −1.03 to −0.33). Sex and site-specific differences were observed in the associations between physical activity domains and BMI. Among those who met physical activity guidelines, there was an inverse association between transport-related physical activity and BMI in men from Nanoro (Burkina Faso) (β = −0.79 kg/m²; 95% CI, −1.25 to −0.33) as well as work-related physical activity and BMI in Navrongo men (Ghana) (β = −0.76 kg/m²; 95% CI, −1.25 to −0.27) and Nanoro women (β = −0.90 kg/m²; 95% CI, −1.44 to −0.36). Conclusions: Physical activity may be an effective strategy to curb rising obesity in Africa. More studies are needed to assess the impact of sex and geographic location-specific physical activity interventions on obesity.

Background: A low socioeconomic status (SES) presents lower physical activity; however, the relationship between SES and sedentary behavior (SB) remains unclear. We aimed to assess this association of SES with physical activity (PA) and SB. Methods: We employed representative self-reported data of the European Union from the cross-sectional survey Eurobarometer 2017, comprising a final sample of 13,708 citizens (18–64 y old), to assess the association of SES (education, occupation, and economic issues) with PA and sitting time quartiles, and to describe inequalities in vigorous, moderate, and walking activity and sitting time. Results: Multinomial regressions revealed that people from higher SESs were more likely to report higher PA; nonetheless, higher educational attainment and occupations were also associated with higher sitting time but not with lower economic issues. The inequality, shown by Gini coefficients, describes a socioeconomic gradient in vigorous and moderate activity, from higher inequality in lower statuses to lower inequality in higher statuses. The Gini coefficients also indicated higher socioeconomic inequalities in PA than SB. Conclusions: Higher SESs showed paradoxically more PA and SB; however, sitting time presented smaller differences and a more homogeneous distribution across the population.

Purpose: To examine the factor structure and measurement invariance of the Körperkoordinations Test Für Kinder (KTK) and covariates of motor competence in a sample of Iranian children aged 5–14 years. Methods: Participants were children aged 5–14 years (N = 432, 61% boys). Age, sex, and body mass index were collected. Confirmatory factor analysis (CFA) was conducted to investigate the factorial structure of KTK and multigroup CFA carried out to test measurement invariance across sexes and age groups. In addition, we calculated a model with covariates to identify the association between KTK items with age, sex, and body mass index z score. Results: CFA supported the construct validity of a one-factor model with an appropriate fit indices that the four subtests loaded on the same factor namely motor competence. Furthermore, according to the magnitude of changes in root mean square error of approximation and comparative fit index between nested models, the assumption of KTK measurement invariance across age-groups and sex were valid. Finally, adequate fit indices were found for the multigroup CFA path model of KTK with the covariates sex, age, and body mass index z score. Conclusion: The KTK is a valid, reliable, and valuable instrument for assessing motor competence of Iranian children and adolescents.

Background: Understanding how or whether sedentary behavior affects motor competence in young children is important considering that children spend a lot of time sedentary. The aim of this study was to examine whether sedentary behavior predicts motor competence in young children. Methods: A longitudinal study with a total of 372 children aged 3.5 years at baseline and 5 years at follow-up was conducted. Objectively measured activity patterns (i.e., using accelerometers) were conducted in a subsample with 188 children. Sedentary behavior was assessed both objectively and subjectively (parent-reported screen time). Locomotor and object control skill scores were determined using the Test of Gross Motor Development—Second Edition. A multivariable analysis was executed adjusting for potential confounders (such as age, sex, time spent in moderate- to vigorous-intensity physical activity, monitor wear time, body mass index z scores, and maternal education). Results: Sedentary behavior at either time point was not significantly associated with either locomotor or object control skills after adjusting for potential confounders. Discussion: Our results did not support the assumption that sedentary behavior affects motor competence in young children. Regardless, given the lack of consistency in the evidence base, we recommend to parents, educators, and health professionals that sedentary activities should be kept within government recommendations due to potential negative effects on child development.