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Open access

Michael Pratt, Andrea Ramirez Varela, Harold W. (Bill) Kohl III, Bojana Klepac Pogrmilovic, Željko Pedišić, and James F. Sallis

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Zoe Yu Shiu, Kim Delbaere, and Kimberley S. van Schooten

Concerns about falling (CAF) affect daily life activities in older people; however, it is unclear whether gender moderates this relationship. The authors investigated the cross-sectional relationship between CAF and objectively measured physical activity (PA) and gait quality in 503 community-dwelling older men and women. About 448 people (age = 76.2 [SD 7.9] years, 296 females) contributed sufficient data on movement intensity, activity duration (bouts of walking, sitting, and standing), number of transitions between activities (sit-to-stand and sit-to-walk), number of steps and gait quality, quantified as walking speed, and sample entropy. Associations with the Iconographical Falls Efficacy Scale were tested. The authors found no significant moderation by gender. However, women participated in less PA than men and showed a more irregular walking pattern. Higher levels of CAF led to lower PA and poorer gait quality. Our findings suggest that prevention of CAF-related PA avoidance may be particularly important for women, who are less active and at higher risk of falls.

Open access

Heather A. McKay, Lindsay Nettlefold, Joanie Sims-Gould, Heather M. Macdonald, Karim M. Khan, and Adrian Bauman

Background: Choose to Move is one of few scaled-up health-promoting interventions for older adults. The authors evaluated whether Choose to Move participants maintained their intervention-related gains in physical activity (PA), mobility, and social connectedness 12 months after the intervention ended. Methods: The authors assessed PA, mobility, loneliness, social isolation, and muscle strength via questionnaire and objective measures in 235 older adults at 0 months (baseline), 6 months (end of intervention), and 18 months (12-months postintervention). The authors fitted linear mixed models to examine the change in each outcome from 6 to 18 months (primary objective) and 0 to 18 months (secondary objective) and reported by age group (60–74 and ≥75 y). Results: In younger participants, PA decreased between 6 and 18 months, but remained significantly higher than at baseline. Intervention-related benefits in loneliness, social isolation, mobility, and muscle strength were maintained between 6 and 18 months in the younger participants. Older participants maintained their intervention benefits in loneliness, mobility, and muscle strength. When compared with baseline values, PA levels in older participants were unchanged, whereas social isolation increased. Conclusions: Older adults maintained some, but not all, health benefits of Choose to Move 12 months after the intervention ended. Long-term commitments are needed to deliver effective health-promoting interventions for older adults if benefits are to be maintained.

Open access

Philippa J.A. Nicolson, Maria T. Sanchez-Santos, Julie Bruce, Shona Kirtley, Lesley Ward, Esther Williamson, and Sarah E. Lamb

Mobility is essential to maintaining independence for older adults. This systematic review aimed to summarize evidence about self-reported risk factors for self-reported mobility decline; and to provide an overview of published prognostic models for self-reported mobility decline among community-dwelling older adults. Databases were searched from inception to June 2, 2020. Studies were screened by two independent reviewers who extracted data and assessed study quality. Sixty-one studies (45,187 participants) were included, providing information on 107 risk factors. High-quality evidence and moderate/large effect sizes for the association with mobility decline were found for older age beyond 75 years, the presence of widespread pain, and mobility modifications. Moderate–high quality evidence and small effect sizes were found for a further 21 factors. Three model development studies demonstrated acceptable model performance, limited by high risk of bias. These findings should be considered in intervention development, and in developing a prediction instrument for practical application.

Open access

Gregory J. Welk, Pedro F. Saint-Maurice, Philip M. Dixon, Paul R. Hibbing, Yang Bai, Gabriella M. McLoughlin, and Michael Pereira da Silva

A balance between the feasibility and validity of measures is an important consideration for physical activity (PA) research—particularly in school-based research with youth. The present study extends previously tested calibration methods to develop and test new equations for an online version of the youth activity profile (YAP) tool, a self-report tool designed for school applications. Data were collected across different regions and seasons to develop more robust, generalizable equations. The study involved a total of 717 youth from 33 schools (374 elementary [ages 9–11 years], 224 middle [ages 11–14 years], and 119 high school [ages 14–18 years]) in two different states in the United States. Participants wore a Sensewear monitor for a full week and then completed the online YAP at school to report PA and sedentary behaviors in school and at home. Accelerometer data were processed using an R-based segmentation program to compute PA and sedentary behavior levels. Quantile regression models were used with half of the sample to develop item-specific YAP calibration equations, and these were cross validated with the remaining half of the sample. Computed values of mean absolute percentage error ranged from 15 to 25% with slightly lower error observed for the middle school sample. The new equations had improved precision compared with the previous versions when tested on the same sample. The online version of the YAP provides an efficient and effective way to capture school level estimates of PA and sedentary behaviors in youth.

Open access

Andrew P. Kingsnorth, Mhairi Patience, Elena Moltchanova, Dale W. Esliger, Nicola J. Paine, and Matthew Hobbs

The response to COVID-19 resulted in behavioral restrictions to tackle the spread of infection. Initial data indicates that step counts were impacted by lockdown restrictions; however, there is little evidence regarding changes of light and moderate to vigorous physical activity (MVPA) behavioral intensities. In this study, participants were asked to provide longitudinal wearable data from Fitbit devices over a period of 30 weeks, from December 2019 to June 2020. Self-assessed key worker status was captured, along with wearable estimates of steps, light activity, and MVPA. Bayesian change point analyses of data from 97 individuals found that there was a sharp decrease of 1,473 steps (95% credible interval [CI] [−2,218, −709]) and light activity minutes (41.9; 95% CI [−54.3, −29.3]), but an increase in MVPA minutes (11.7; 95% CI [2.9, 19.4]) in the mean weekly totals for nonkey workers. For the key workers, the total number of steps (207; 95% CI [−788, 1,456]) and MVPA minutes increased (20.5; 95% CI [12.6, 28.3]) but light activity decreased by an average of 46.9 min (95% CI [−61.2, −31.8]). Interestingly, the change in steps was commensurate with that observed during Christmas (1,458; 95% CI [−2,286, −554]) for nonkey workers and behavioral changes occurred at different time points and rates depending on key worker status. Results indicate that there were clear behavioral modifications before and during the initial COVID-19 lockdown period, and future research should assess whether any behavioral modifications were sustained over time.

Open access

Pedro F. Saint-Maurice, David Berrigan, Geoffrey P. Whitfield, Kathleen B. Watson, Shreya Patel, Erikka Loftfield, Joshua N. Sampson, Janet E. Fulton, and Charles E. Matthews

Background: Surveillance of domain-specific physical activity in the United States is lacking. Thus, the authors describe domain-specific moderate to vigorous physical activity (MVPA) in a nationwide sample of US adults. Methods: Participants from the AmeriSpeak panel (n = 2649; 20–75 y; 50% female) completed the Activities Completed Over Time in 24-Hours previous-day recall. The authors estimated average MVPA duration (in hours per day) overall and in major life domains by sex, age, race/ethnicity, and education. They also described the most commonly reported MVPAs and timing of MVPA during the day. Results: Across all life domains, participants reported an average of 2.5 hours per day in MVPA. Most MVPA was accumulated during work (50% of total, 1.2 h/d) and household activities (28%, 0.7 h/d) with less MVPA reported in leisure time (15%, 0.4 h/d). Time reported in MVPA varied by sex, and race/ethnicity (P < .05). Walking at work and for exercise, childcare, and walking for transportation were the most commonly reported domain-specific MVPAs. A greater proportion of MVPA took place in the morning (∼06:00 h) and evening (∼18:00 h). Conclusions: Work and household activities accounted for 78% of overall MVPA reported, while leisure-time MVPA accounted for only 15% of the total. Encouraging MVPA during leisure time and transportation remain important targets for promoting MVPA in US adults.

Open access

Tiffany J. Chen, Kathleen B. Watson, Shannon L. Michael, Jessica J. Minnaert, Janet E. Fulton, and Susan A. Carlson

Background: Healthy People 2030 includes objectives to increase meeting the aerobic physical activity guideline for ages 6–13 years (of ages 6–17 y, monitored by National Survey of Children’s Health [NSCH]) and grades 9 to 12 (mostly aged 14–18+ y, monitored by Youth Risk Behavior Survey [YRBS]). This study compares methodologies, prevalence, and patterns of meeting the guideline, particularly for overlapping ages 14–17 years. Methods: Nationally representative surveys, 2016–2017 NSCH (adult proxy report, 6–17 y) and 2015 and 2017 YRBS (self-report, grades 9–12), assess meeting the guideline of ≥60 minutes of daily moderate to vigorous physical activity. Prevalence and odds ratios were estimated by age group and demographics. Results: For youth aged 14–17 years, 17.4% (95% confidence interval [CI], 16.1–18.7; NSCH) and 27.0% (95% CI, 25.6–28.5; YRBS) met the guideline. 25.9% (95% CI, 24.8–27.2) aged 6–13 years (NSCH) and 26.6% (95% CI, 25.3–28.0) in grades 9 to 12 (YRBS) met the guideline. Across surveys, fewer females (P < .001) and Asian youth (P < .001 except among NSCH 14–17 y) met the guideline. Conclusions: Neither methodology nor estimates for meeting the aerobic guideline are similar across surveys, so age continuity between juxtaposed estimates should not be assumed by magnitude nor age for separate Healthy People 2030 youth physical activity objectives.