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Shaima Alothman, Jeffrey C. Hoover, Mohammed M. Alshehri, Aqeel M. Alenazi, Jo Wick, Joseph LeMaster, Jason Rucker and Patricia M. Kluding

Background: To investigate how changes in sedentary behavior relate to health outcomes, it is important to establish the test–retest reliability of activity monitors in measuring habitual sedentary behavior in people with type 2 diabetes (T2D) as a prerequisite for interpreting this information. Thus, the authors’ objective was to examine the test–retest reliability of a common activity monitor (activPAL) in measuring sedentary behavior and physical activity in people with T2D. Methods: Sedentary-time, standing-time, stepping-time, step-count, and sit-to-stand transitions were obtained from two 7-day assessment periods separated by at least 1 week. Test–retest reliability was determined with the intraclass correlation coefficient (ICC) to compare sedentary and activity measures between the 2 time points. Results: A total of 30 participants with self-reported T2D completed the study (age 65 [6] y, 63% women, body mass index 33.3 [5] kg/m2). High test–retest reliability was found for sedentary-time (ICC = .79; 95% confidence interval [CI], .61–.89) and standing-time (ICC = .74; 95% CI, .53–.87). Very high test–retest reliability was found for stepping-time (ICC = .90; 95% CI, .81–.95), step-count (ICC = .91; 95% CI, .83–.96), and sit-to-stand transitions (ICC = .90; 95% CI, .79–.95). Conclusion: The activPAL device showed high to very high test–retest reliability in measuring all tested activity categories in people with T2D.

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Jane Jie Yu, Chia-Liang Tsai, Chien-Yu Pan, Ru Li and Cindy Hui-Ping Sit

Background: To examine the relationship between physical activity (PA) and inhibition in boys and girls with motor impairments compared with children with typical development. Methods: The participants were 58 (26 motor impairments and 32 typical development) children aged 7–12 years who met the inclusion criteria. PA was assessed using accelerometers for 7 consecutive days. The time spent in PA of different intensity levels (light, moderate, and vigorous) were analyzed for weekdays and weekends. Using a visuospatial attention paradigm, inhibition was evaluated by the difference in reaction time between invalid and valid cue conditions. Generalized linear mixed models were used to determine the associations of inhibition with PA and motor ability by sex. Results: Boys and children with typical development had shorter reaction times in inhibition than girls (P < .001) and children with motor impairments (P < .05), respectively. Motor ability (b = 189.98) and vigorous PA on weekdays (b = −43.18) were significant predictors of inhibition in girls only. Conclusions: The results indicate a positive relationship between vigorous PA (on weekdays) and inhibition in children (girls), moderated by sex and motor ability. Effective interventions that promote vigorous PA for children both in and out of school should be designed to foster their executive function development.

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Isao Saito, Koutatsu Maruyama, Tadahiro Kato, Yasunori Takata, Kiyohide Tomooka, Ryoichi Kawamura, Yuichi Uesugi, Yoshihiko Naito, Haruhiko Osawa and Takeshi Tanigawa

Background: Autonomic activity is possibly influenced by physical activity (PA). However, it remains unclear whether this association is modified by insulin resistance. Methods: This population-based study between 2009 and 2012 included 2016 men and women aged 30–79 years. The PA was assessed using a validated questionnaire based on sleep, occupation, transportation, household characteristics, and leisure-time PA. Heart rate (HR) and heart rate variability (HRV) in the sitting position were determined from 5-minute recordings of pulse waves detected by a fingertip sensor. The HRV was calculated as frequency (standard deviation of normal-to-normal [NN] intervals [SDNN]), root mean square of successive differences (RMSSD), and percentage differences between normal NN intervals >50 milliseconds [pNN50]) and time domains. Insulin resistance was evaluated using the homeostasis model assessment index (HOMA-IR). Results: HR, RMSSD, and pNN50 were related to the total and moderate/vigorous PA tertiles in models that included HOMA-IR. The partial regression coefficient of total PA per 1-SD increase was .05 (P = .019) for log-transformed RMSSD and 1.86 (P = .001) for pNN50. No interactive associations were observed between PA and HOMA-IR. Conclusions: Low total PA was associated with increased HR and low levels of RMSSD and pNN50, reflecting parasympathetic modulation that was not modified by insulin resistance.

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Werner de Andrade Müller, Grégore Iven Mielke, Inácio Crochemore M. da Silva, Mariangela F. Silveira and Marlos Rodrigues Domingues

Background: Physical activity (PA) during pregnancy is associated with several benefits in maternal and child outcomes, and its relationship with preterm birth is still conflicting. This study aims to examine the associations between PA during pregnancy and occurrence of preterm birth. Methods: PA was assessed by questionnaire (for each trimester) and accelerometry (second trimester) in women enrolled in a birth cohort study that started during pregnancy and included births that occurred between January 1 and December 31, 2015. Gestational age was based on the last menstrual period and ultrasonography. All deliveries before 37 weeks of gestation were considered preterm births. A Poisson regression model was used to measure associations controlling for potential confounders. Results: PA information was available for 4163 women and 13.8% of births were preterm. A total of 15.8% of women were engaged in PA during pregnancy. Multivariate analysis showed that only PA performed in the third trimester of pregnancy (prevalence ratio = 0.58; 95% confidence interval, 0.36–0.96) was associated with the outcome. Conclusions: PA performed in the third trimester of pregnancy was associated with a protection to preterm birth. Pregnant women should be counseled to engage in PA to lower the risk of premature delivery.

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Janine V. Olthuis, Margo C. Watt, Christopher E. J. DeWolfe, Emma Connell, Emily N. Wright and Laura Sevigny

Women, relative to men, are at particularly high risk for anxiety and depression, perhaps in part due to their heightened levels of anxiety sensitivity (AS). Physical activity (PA) is an accessible mental health intervention that may be particularly beneficial for women. Using a within-subjects pre-post mixed methods design, this study tested the acceptability, appropriateness, feasibility, and evidence-base of a community-based PA intervention for AS among women at high risk for anxiety and depression. Participants were 45 women with high AS who completed an 8-week group PA intervention. Data were collected via self-report questionnaires, interviews, and recruitment, participation, and retention rates. Results suggest the intervention is acceptable, appropriate, and feasible. Interviews reveal high intervention satisfaction and perceived benefits beyond AS reduction. There was a relatively high attrition rate that suggests room for improvement. The intervention significantly reduced AS, as well as panic, social anxiety, generalized anxiety, and depression symptoms. In the context of the preliminary nature of this study, results suggest the use of community-delivered, group-based PA as a mental health intervention strategy for women is worth further exploration. There is potential for collaboration between the health system, PA delivery professionals, and community organizations to improve access to care.

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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.

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Jennifer R. Pharr, Mary Angela M. Terencio and Timothy Bungum

Background: People who are physically active enjoy a multitude of health benefits across their lifespan compared with people who are not physically active. However, little research has sought to determine whether those who meet the physical activity (PA) guidelines also engage in other healthy behaviors. The purpose of this study was to compare healthy behaviors of people who met the PA guidelines set forth by the U.S. Department of Health and Human Services to those who did not meet the guidelines. Methods: This was a cross-sectional study using data from the Behavioral Risk Factor Surveillance System survey conducted in 2017. Descriptive statistical analyses were performed using chi-square tests. Odds and adjusted odds ratios were calculated using multiple logistic regressions. Results: Those who met the PA guidelines were more likely to get a flu shot, have a medical checkup, take human immunodeficiency virus tests, wear seatbelts, and binge drink more frequently, compared with those who did not meet the guidelines. This group is also less likely to be smokers and be overweight or obese in comparison to their inactive counterparts. Conclusion: The positive association between PA and other healthy behaviors represents synergistic health activities, with healthy behaviors supporting others.

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Alanna Weisberg, Alexandre Monte Campelo, Tanzeel Bhaidani and Larry Katz

Traditional physical activity tracking tools, such as self-report questionnaires, are inherently subjective and vulnerable to bias. Physical activity tracking technology, such as activity tracking wristbands, is becoming more reliable and readily available. As such, researchers are employing these objective measurement tools in both observational- and intervention-based studies. There remains a gap in the literature on how to properly select activity tracking wristbands for research, specifically for the older adult population. This paper outlines considerations for choosing the most appropriate wrist-worn wearable device for use in research with older adults. Device features, outcome measures, population, and methodological considerations are explored.

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Janet Lok Chun Lee and Rainbow Tin Hung Ho

In response to demographic changes in recent years, an increasing number of parks have established exercise spaces for older adults. However, limited research has been conducted to investigate how older adults utilize, experience, and perceive these spaces. This study aims to explore their experiences of using these spaces and their perspectives on these spaces by using a qualitative descriptive research design. In-depth interviews were conducted with 32 users in three Hong Kong parks with low, medium, and high area-based socioeconomic statuses. The findings highlight that exercise spaces in parks can cultivate a positive environment allowing older adults with varying physical abilities and health statuses to remain active together as well as to support each other socially and emotionally in a natural outdoor setting. The participants’ perspectives on the exercise space discussed in this study suggest that future plans for constructing such spaces in parks might benefit from a co-design approach.

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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.