Understanding health inequalities is essential for improving social justice. Intersectionality refers to a theoretical framework for studying the intersection of multiple social categorizations that create unique experiences and related social inequalities. Currently, the majority of the intersectional studies in the physical activity field have a qualitative design; thus, there is a need for quantitative intersectional studies. This commentary aims to explore primary obstacles impeding intersectional quantitative research and provide recommendations for overcoming these obstacles in physical activity research. In the commentary, we discuss that the lack of accessibility of large-scale and diverse data sets, and suboptimal social categorizations and intersectionality-related questions may contribute to the scarcity of intersectional quantitative research in the field. To facilitate intersectional quantitative analyses, we advocate for making large-scale data sets accessible for intersectional secondary analyses, diverse sampling, standardizing questions and categories related to intersectionality, promoting inclusive research designs and methods, and using the appropriate questions and social categorization that reflect the distinct experiences of each subgroup. By addressing these challenges, researchers may gain new insights into health disparities, making physical activity research more inclusive and contributing to more equitable health outcomes.
Browse
Challenges and Future Directions for Promoting Intersectional Quantitative Studies in Physical Activity Research
Mari Sone, Teatske M. Altenburg, and Mai J.M. ChinAPaw
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
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.
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.
Achieving Advocacy Success—The International Society for Physical Activity and Health’s Long-Term Strategy to Advance Physical Activity as a Priority in Global Health Policy
Trevor Shilton and Karen Milton
Background: In 2011, physical inactivity was described as the Cinderella risk factor for noncommunicable diseases. This metaphor was used to highlight the disjunct between the advancing evidence on physical inactivity as a risk factor for ill health, its high prevalence, and the paucity of global policy response or priority afforded to physical activity. This paper describes the strategic actions of the International Society for Physical Activity and Health (ISPAH) to raise the profile of physical activity as a global public health priority. Methods: From 2008, ISPAH coordinated a long-term advocacy strategy to advance the status of physical activity and promote its presence as a priority within global health policy. The society employed an advocacy mix that reflected contemporary advocacy theory and models. Results: Through 6 advocacy deliverables, aligned to the global calendar of United Nations and World Health Organization policy developments, ISPAH seized the opportunity to advance physical activity policy and strategies to inform global noncommunicable disease action planning and align with the Sustainable Development Goals. ISPAH’s successful execution of global advocacy for physical activity highlights the importance of leadership, clear objectives, progressive action, timeliness, partnerships, and persistence. Conclusion: As a result of strategic global advocacy since 2008, the field in 2024 is better positioned in relation to global professional mobilization, policy, and technical support for physical activity. However, despite impressive progress across more than 12 years, and the innovation of the Global Action Plan on Physical Activity, the work of global advocacy for physical activity is far from complete.
Dose–Response Relationships of Moderate to Vigorous Physical Activity and Sedentary Time With Renal Function Indices in Adolescents With Reduced Renal Function: A Cross-Sectional Study
Zisai Wang, Qiuwei Tian, Yujie Xu, Marady Hun, Lin Hu, Mingyi Zhao, and Qingnan He
Background: This study aimed to explore the associations between moderate to vigorous physical activity (MVPA) and sedentary time with renal function indices in adolescents with kidney disease. Methods: A cross-sectional study was conducted on 719 adolescents (median age 15 y, 40.6% female) with kidney disease from the National Health and Nutrition Examination Survey 2007–2016. The exposures were MVPA time and sedentary time. Renal metabolic parameters included serum uric acid (SUA), creatinine, blood urea nitrogen, the estimated glomerular filtration rate (eGFR), and the albumin creatinine ratio. Weighted multivariate regression analysis was used to estimate associations between exposures and outcomes. Results: After stratifying MVPA time, the regression effect values β (95% CI) for MVPA on SUA (Q2: −0.22 [−0.41 to −0.03]; Q3: −0.32 [−0.53 to −0.11]) and creatinine (Q2: −0.08 [−0.15 to −0.01]; Q3: −0.04 [−0.11 to 0.03]) gradually decreased with increasing MVPA time. In males (−0.76 [−1.19 to −0.32]), MVPA time was significantly associated with lower SUA levels compared with females (−0.14 [−0.38 to 0.10]). Notably, female adolescents who had an MVPA time exceeding 420 minutes exhibited lower albumin creatinine ratio (−75.37 [−146.63 to −4.11]). In addition, both recreational MVPA time (−0.26 [−0.45 to −0.06]) and sedentary time (−3.15 [−5.83 to −0.46]) were negatively associated with eGFR. Conclusions: Our study found an association between MVPA and lower levels of SUA in male adolescents with kidney disease and albuminuria in female adolescents with kidney disease. In addition, MVPA was also negatively associated with creatinine and eGFR, whereas sedentary time was only associated with eGFR. Further studies are needed to confirm these findings.
Effects of Physical Activity Interventions on Physical Self-Perception in College Students: A Systematic Review and Meta-Analysis
Zhiling Yang, Zhiying Yang, Wengling Ou, Qing Zeng, and Jiafu Huang
Background: Although the physical activities have demonstrated efficacy in improving physical self-perception, the findings of available studies in college students were conflicting. This review aimed to examine the effects of physical activity interventions on physical self-perception in college students. Methods: Web of Science, PubMed, Cochrane Library, EBSCOhost, Embase, Scopus, CNKI, WanFang, and Chinese Technical Periodicals were searched from inception to April 2024. Studies were included if they were randomized controlled trials (RCTs) or non-RCTs (non-RCTs) that examined the effects of physical activity interventions on college students’ physical self-perception. Random-effects models were used in meta-analyses to synthesize effect sizes. Results: Forty studies (17 RCTs and 23 non-RCTs) with 4955 participants were included in this meta-analysis. Overall, physical activity interventions had small to moderate significant effect on physical self-worth (standardized mean difference [SMD] = 0.44, P < .00001), perceived sports competence (SMD = 0.60, P < .00001), perceived physical condition (SMD = 0.45, P < .00001), perceived physical strength (SMD = 0.53, P < .00001), and perceived body attractiveness (SMD = 0.54, P < .00001). Significant differences were observed in study design (P = .031–.039), intervention type (P = .003–.031), and intervention duration (P = .002–.036) for some aspects of physical self-perception, such as perceived physical strength and perceived body attractiveness. Conclusions: Physical activity interventions have beneficial effects on physical self-perception in college students, especially those conducted for 12 weeks, 3 times or more per week, lasting 90 minutes or more per session. Large, high-quality RCTs are required to further confirm these findings.
Exploring the Interplay Between Climate Change, 24-Hour Movement Behavior, and Health: A Systematic Review
Eun-Young Lee, Seiyeong Park, Yeong-Bae Kim, Mikyung Lee, Heejun Lim, Amanda Ross-White, Ian Janssen, John C. Spence, and Mark S. Tremblay
Background: Given the emergence of climate change and health risks, this review examined potential relationships between varying indicators of climate change, movement behaviors (ie, physical activity [PA], sedentary behavior, and sleep), and health. Methods: Seven databases were searched in March 2020, April 2023, and April 2024. To be included, studies must have examined indicators of climate change and at least one of the movement behaviors as either an exposure or a third variable (ie, mediator/moderator), and a measure of health as outcome. Evidence was summarized by the role (mediator/moderator) that either climate change or movement behavior(s) has with health measures. Relationships and directionality of each association, as well as the strength and certainty of evidence were synthesized. Results: A total of 79 studies were eligible, representing 6,671,791 participants and 3137 counties from 25 countries (40% low- and middle-income countries). Of 98 observations from 17 studies that examined PA as a mediator, 34.7% indicated that PA mediated the relationship between climate change and health measure such that indicators of adverse climate change were associated with lower PA, and worse health outcome. Of 274 observations made from 46 studies, 28% showed that PA favorably modified the negative association between climate change and health outcome. Evidence was largely lacking and inconclusive for sedentary behavior and sleep, as well as climate change indicators as an intermediatory variable. Conclusions: PA may mitigate the adverse impact of climate change on health. Further evidence is needed to integrate PA into climate change mitigation, adaptation, and resilience strategies.
The Effects of Sport Participation for Adults With Physical or Intellectual Disability: A Scoping Review
Leanne Hassett, Anne M. Moseley, Marnee J. McKay, Jenni Cole, Sakina Chagpar, Minke P.J. Geerts, Wing S. Kwok, Connie Jensen, Catherine Sherrington, and Nora Shields
Background: Adults with physical or intellectual disability are less active than those without disability. Objective: To review literature regarding sport participation in adults with physical or intellectual disability. Specifically, to examine characteristics of available studies including participants, interventions, outcomes, and impact. Methods: A scoping review was completed. Searches of 6 databases and a trial registry plus citation tracking were undertaken. Two independent reviewers screened items for eligibility and extracted data about the studies, participants, interventions, and outcomes. A single reviewer extracted data to quantify impacts of sport participation, classified as favorable, insignificant, or unfavorable. Results: 164 studies involving 11,642 participants were included. Most studies (128/164) used a cross-sectional design. Most participants were men (81%) with physical disability (135/164), and spinal cord injury was the most prevalent underlying health condition (54%). Most studies evaluated a mix of sports (83/164) in a disability-specific context (159/164), with basketball or wheelchair basketball being the most common individual sport (28/164). Physical impairment was the most frequently reported outcome domain (85/334 results). Sports participation impact was classified as 55% favorable, 42% insignificant, and 3% unfavorable. Conclusions: There were many favorable and few unfavorable outcomes for participation in sport for adults with physical or intellectual disability. More research is needed to address the evidence gaps of gender, health condition, and type of sport, and to use more rigorous research designs to evaluate the effects of sport participation. While new evidence is generated, we suggest adults with physical or intellectual disability be encouraged to engage in sport. Registration: PROSPERO registration number CRD42018104379.