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Sandy J. Slater, Anmol Sanghera, Yadira Herrera and Jamie F. Chriqui

Background: Head Start serves over 1 million diverse low-income preschool children and is an ideal setting for developing and implementing obesity prevention efforts, which is expected to have positive impacts on behavior as youth age. This study examined how regional- and state-level Head Start offices have supported implementation of the recently updated physical activity (PA) requirement within the teaching and learning environment Head Start Program Performance Standard (1302.31). Methods: Key informant telephone interviews were conducted with 8 regional- and 36 state-level Head Start representatives. Interviews were recorded and professionally transcribed. Data were coded and analyzed using constant comparative methods in ATLAS.ti (version 8). Audit trails were maintained, and disagreements in codes were discussed and resolved among coders. Results: The following 3 overarching themes emerged: communication, resources and technical assistance, and challenges. Results showed variation in respondent knowledge regarding the Standards. Although regional contacts provide technical assistance, state-level contacts have many information sharing strategies for programs. Implementation challenges included the need for frequent professional development opportunities given staff turnover and low PA competency, and additional PA curricula. Conclusion: Findings can help identify existing or potential strategies that could be adopted more widely or developed to assist Head Start programs incorporate PA into daily activities.

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Ryoko Kawakami, Yuko Gando, Kiminori Kato, Susumu S. Sawada, Haruki Momma, Motohiko Miyachi, I-Min Lee, Steven N. Blair, Minoru Tashiro, Chika Horikawa, Yasuhiro Matsubayashi, Takaho Yamada, Kazuya Fujihara and Hirohito Sone

Background: To examine the association between muscular and performance fitness (MPF) and the incidence of glaucoma. Methods: A total of 27,051 glaucoma-free participants aged 20–87 years underwent physical fitness tests between April 2001 and March 2002. The MPF index was calculated using an age- and sex-specific summed z-score from grip strength, vertical jump, single-leg balance, forward bending, and whole-body reaction time. The participants were divided into quartiles according to the MPF index and each physical fitness test. Participants were followed up for the development of glaucoma, which was defined based on physician-diagnosed glaucoma at an annual health examination between April 2002 and March 2008. Hazard ratios for the incidence of glaucoma were estimated using Cox proportional hazards models. Results: During follow-up, 303 participants developed glaucoma. Compared with the lowest MPF index group, hazard ratio (95% confidence interval) of developing glaucoma was 0.64 (0.46–0.89) for the highest MPF index group (P for trend = .001). Vertical jump and whole-body reaction time were associated with incident glaucoma (P for trend = .01 and <.001, respectively). There were no associations between the other physical fitness tests and the incidence of glaucoma. Conclusion: Higher MPF is associated with lower incidence of glaucoma.

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Roman P. Kuster, Daniel Baumgartner, Maria Hagströmer and Wilhelmus J.A. Grooten

Background: Sedentary behavior (SB) is associated with several chronic diseases and office workers especially are at increased risk. SB is defined by a sitting or reclined body posture with an energy expenditure of ≤1.5 metabolic equivalents. However, current objective methods to measure SB are not consistent with its definition. There is no consensus on which sensor placement and type should be used. Aim: To compare the accuracy of newly developed artificial intelligence models for 15 sensor placements in combination with four signal types (accelerometer only/plus gyroscope and/or magnetometer) to detect posture and physical in-/activity during desk-based activities. Method: Signal features for the model development were extracted from sensor raw data of 30 office workers performing 10 desk-based tasks, each lasting 5 min. Direct observation (posture) and indirect calorimetry (in-/activity) served as the reference criteria. The best classification model for each sensor was identified and compared among the sensor placements, both using Friedman and post hoc Wilcoxon tests (p ≤ .05). Results: Posture was most accurately measured with a lower body sensor, while in-/activity was most accurately measured with an upper body or waist sensor. The inclusion of additional signal types improved the posture classification for some placements, while the acceleration signal already contained the relevant signal information for the in-/activity classification. Overall, the thigh accelerometer most accurately classified desk-based SB. Conclusion: This study favors, in line with previous work, the measurement of SB with a thigh-worn accelerometer and adds the information that this sensor is also accurate in measuring physical in-/activity while sitting and standing.

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Justin B. Hollander, Ann Sussman, Peter Lowitt, Neil Angus and Minyu Situ

Background: Understanding more about the unseen side of our responses to visual stimuli offers a powerful new tool for transportation planning. Traditional transportation planning tends to focus on the mobility of vehicles rather than on opportunities to encourage sustainable transport modes, like walking. Methods: Using eye-tracking emulation software, this study measured the unconscious visual responses people have to designs and layouts in new built environments, focusing on what makes streets most walkable. Results: The study found key differences between the way the brain takes in conventional automobile-oriented residential developments versus new urbanist layouts, with the former lacking key fixation points. Conclusion: The study’s discoveries significantly explain why new urbanist layouts promote walking effortlessly and conventional automobile-oriented residential developments cannot.

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Rodrigo Sudatti Delevatti, Ana Carolina Kanitz, Cláudia Gomes Bracht, Salime Donida Chedid Lisboa, Elisa Corrêa Marson, Thaís Reichert, Vitória Bones and Luiz Fernando Martins Kruel

Background: There are a lack of clinical trials with suitable methodological quality that compare aquatic exercise training types in type 2 diabetes (T2D) treatment. This study aimed to compare the effects of aerobic and combined aquatic training on cardiorespiratory outcomes in patients with T2D. Methods: Untrained patients with T2D were randomized to receive an aerobic aquatic training, a combined aquatic training, or a procedure control in 3 weekly sessions for 15 weeks. The sessions were 50 minutes long. The intensities were from 85% to 100% of heart rate of anaerobic threshold and at maximal velocity for aerobic and resistance parts, respectively. Resting heart rate, peak oxygen uptake (VO2peak), and oxygen uptake corresponding to second ventilatory threshold and its relation with VO2peak were evaluated. Results: Participants were 59.0 (8.2) years old and 51% women. Intervention groups increased in VO2peak (aerobic aquatic training group: 4.48 mL·kg−1·min−1, P = .004; combined aquatic training group: 5.27 mL·kg−1·min−1; P = .006) and oxygen uptake corresponding to second ventilatory threshold, whereas the control group presented an increase in oxygen uptake corresponding to second ventilatory threshold and minimal change in VO2peak. Conclusions: Aerobic and combined aquatic exercise interventions improve the cardiorespiratory fitness of patients with T2D.

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Lewis Keane, Emma Sherry, Nico Schulenkorf, Joel Negin, Ding Ding, Adrian Bauman, Edward Jegasothy and Justin Richards

Background: The purpose of this paper was to identify personal, social, and environmental mediators of recreational physical activity (PA) in a 6-month netball-based intervention for women and girls in Tonga. Methods: Tonga Netball’s “low-engagement village program” was implemented in 10 villages and aimed to increase the recreational PA levels in women and girls through a comprehensive, structured community-level netball program addressing key barriers to participation. In a mixed-methods approach, these mediating barriers were identified through qualitative interviews based on the socioecological model. Quantitative measures for mediators and recreational PA were then developed, and data from 301 women and girls were collected. Standard mediation analyses methods were then applied. Results: Program participation appeared to significantly increase PA levels. Statistically significant personal mediators were body issues, preferring competitions, and clothing. Social mediators were support from sports council, community leaders, friends, and church. Environmental mediators were travel time and access to balls, bibs, and umpires. Conclusion: A comprehensive community-level program addressing key participation barriers can increase recreational PA among women and girls in Tonga. Triangulating these results with mediation analyses of variables on the causal pathway can strengthen our understanding of causation and inform funding prioritization for critical program components in similar contexts.

Open access

Nicole K. Nathan, Rachel L. Sutherland, Kirsty Hope, Nicole J. McCarthy, Matthew Pettett, Ben Elton, Rebecca Jackson, Stewart G. Trost, Christophe Lecathelinais, Kathryn Reilly, John H. Wiggers, Alix Hall, Karen Gillham, Vanessa Herrmann and Luke Wolfenden

Aim: To assess the impact of a multistrategy intervention designed to improve teachers’ implementation of a school physical activity (PA) policy on student PA levels. Methods: A cluster-randomized controlled trial was conducted in 12 elementary schools. Policy implementation required schools to deliver 150 minutes of organized PA for students each week via physical education, sport, or class-based activities such as energizers. Schools received implementation support designed using the theoretical domains framework to help them implement the current policy. Results: A total of 1,502 children in kindergarten to grade 6 participated. At follow-up compared with control, students attending intervention schools had, measured via accelerometer, significantly greater increases in school day counts per minute (97.5; 95% confidence interval [CI], 64.5 to 130.4; P < .001) and moderate to vigorous physical activity (MVPA) (3.0; 95% CI, 2.2–3.8, P < .001) and a greater decrease in sedentary time (−2.1; 95% CI, −3.9 to −0.4, P = .02) per school day. Teachers in intervention schools delivered significantly more minutes (36.6 min) of PA to their students at follow-up (95% CI, 2.7–70.5, P = .04). Conclusions: Supporting teachers to implement a PA policy improves student PA. Additional strategies may be needed to support teachers to implement activities that result in larger gains in student MVPA.

Open access

Abby Haynes, Catherine Sherrington, Geraldine Wallbank, David Lester, Allison Tong, Dafna Merom, Chris Rissel and Anne Tiedemann

The Coaching for Healthy Ageing trial evaluated the impact on physical activity (PA) and falls based on a year-long intervention in which participants aged 60+ receive a home visit, regular health coaching by physiotherapists, and a free activity monitor. This interview study describes the participants’ experiences of the intervention and ideas for improvement. The authors sampled purposively for maximum variation in experiences. The data were analyzed thematically by two researchers. Most of the 32 participants reported that the intervention increased PA levels, embedded activities, and generated positivity about PA. They were motivated by quantified PA feedback, self-directed goals, and person-centered coaching. Social connectivity motivated some, but the intervention did not support this well. The intervention structure allowed participants to trial and embed activities. Autonomy and relatedness were emphasized and should be included in future program theory. The authors identified synergistic effects, likely “essential ingredients,” and potential areas for improving this and similar interventions.

Open access

Nicole McCarthy, Kirsty Hope, Rachel Sutherland, Elizabeth Campbell, Rebecca Hodder, Luke Wolfenden and Nicole Nathan

Background: To determine Australian primary school principals’, teachers’, and parents’ attitudes to changing school uniform policies to allow students to wear sports uniforms every day and to assess associations between participant characteristics and their attitudes. A secondary aim was to identify principals’ and teachers’ perceived barriers to uniform changes. Methods: Cross-sectional surveys of principals, teachers, and parents of children in grades 2 to 3 (age 7–10 y) from 62 Australian primary schools (Oct 2017–Mar 2018) were undertaken. Mixed logistic regression analyses assessed the associations between participant characteristics and attitudes toward uniform changes. Results: In total, 73% of the principals (38/52) who responded reported that their school only allowed children to wear a sports uniform on sports days. Overall, 38% of the principals (18/47), 63% of the teachers (334/579), and 78% of the parents (965/1231) reported they would support a policy that allowed children to wear daily sports uniforms. The most commonly reported barrier was the perception that sports uniforms were not appropriate for formal occasions. Conclusions: Although the majority of the principals were not supportive of a change to a daily sports uniform, the majority of the teachers and parents were. Strategies to improve principal support may be required if broader adoption of physical activity–supporting uniforms is to be achieved.

Open access

Soultana Macridis, Christine Cameron, Jean-Philippe Chaput, Tala Chulak-Bozzer, Patricia Clark, Margie H. Davenport, Guy Faulkner, Jonathon Fowles, Lucie Lévesque, Michelle M. Porter, Ryan E. Rhodes, Robert Ross, Elaine Shelton, John C. Spence, Leigh M. Vanderloo and Nora Johnston

Background: The ParticipACTION Report Card on Physical Activity for Adults is a knowledge exchange tool representing a synthesis of the literature and data available at the national level. The purpose of this paper is to summarize the results of the inaugural 2019 edition. Methods: Thirteen physical activity indicators, grouped into 4 categories, were graded by a committee of experts using a process that was informed by the best available evidence. Sources included national surveys, peer-reviewed literature, and gray literature such as government and nongovernment reports and online content. Results: Grades were assigned to Daily Behaviors (overall physical activity: D; daily movement: C; moderate to vigorous physical activity: F; muscle and bone strength: INC; balance: INC; sedentary behavior: INC; sleep: B−), Individual Characteristics (intentions: B+), Settings and Sources of Influence (social support: INC; workplace: INC; community and environment: B−; health and primary care settings: C−), and Strategies and Investments (government: B−). Conclusions: Generally, lower grades were given to behavior-related indicators (eg, overall physical activity) and better grades for indicators related to investments, community supports, and strategies and policies. Research gaps and future recommendations and directions are identified for each indicator to support future practice, policy, and research directions.