Background: Identifying factors influencing the implementation of evidence-based environmental recommendations to promote physical activity in childcare services is required to develop effective implementation strategies. This systematic review aimed to: (1) identify barriers and facilitators reported by center-based childcare services impacting the implementation of environmental recommendations to increase physical activity among children, (2) synthesize these factors according to the 14 domains of the “Theoretical Domains Framework,” and (3) report any associations between service or provider characteristics and the reported implementation of such recommendations. Methods: Electronic searches were conducted in 6 scientific databases (eg, MEDLINE) and Google Scholar to identify studies reporting data from childcare staff or other stakeholders responsible for childcare operations. Included studies were based on childcare settings and published in English. From 2164 identified citations, 19 articles met the inclusion criteria (11 qualitative, 4 quantitative, and 4 mixed methods). Results: Across all articles, the majority of factors impacting implementation fell into the “environmental context and resources” domain (eg, time, equipment, and space; n = 19) and the “social influences” domain (eg, support from parents, colleagues, supervisors; n = 11). Conclusion: The current review provides guidance to improve the implementation of environmental recommendations in childcare services by addressing environmental, resource, and social barriers.
Lubna Abdul Razak, Tara Clinton-McHarg, Jannah Jones, Sze Lin Yoong, Alice Grady, Meghan Finch, Kirsty Seward, Edouard Tursan d’Espaignet, Rimante Ronto, Ben Elton and Luke Wolfenden
Nicolas Hobson, Sherry L. Dupuis, Lora M. Giangregorio and Laura E. Middleton
Persons with mild cognitive impairment (MCI) and early dementia are often physically inactive, despite associated benefits. This study explored the barriers, facilitators, and preferences for exercise among persons living with MCI/early dementia. The authors conducted 2 focus groups among persons living with MCI/early dementia (n = 4, 6 participants) and 2 focus groups among care partners (n = 3, 4 participants). The transcripts were analyzed using thematic analysis, guided by the social-ecological model. Three themes emerged, reinforcing motivation to exercise, managing changes to cognitive and physical health, and variable perceptions of dementia, each with influences from individual, care partner, and community levels. Low intrinsic motivation, poor physical/cognitive health, and stigma restricted the exercise among persons living with MCI/early dementia. The care partners motivated their partners and provided company and transportation to exercise. People with MCI/early dementia also indicated poor access to exercise providers and exercise opportunities that met their needs and preferences was a barrier to exercise participation. Knowledge translation research should develop exercise interventions at the individual, social, and community levels.
Miguel A. Sanchez-Lastra, Vicente de Dios Álvarez and Carlos Ayán Pérez
Background: The promotion of physical activity among imprisoned people is a public health strategy that could help to improve the health status of this collective. This systematic review is aimed at reviewing the scientific evidence regarding the effects of exercise training programs performed by inmates. Methods: A systematic search for randomized controlled trials aimed at identifying the characteristics and effects of prison-based exercise training programs on imprisoned people was carried through MEDLINE, SPORTDiscus, and Scopus. Results: A total of 11 randomized controlled studies were selected, and the methodological quality of these was acceptable according to the Downs and Black scale. The proposed interventions were mainly based on the performance of aerobic or combined exercise training programs. Generally, the participants were healthy men who were imprisoned for at least 2 months and up to 15 years. Ten out of the 11 studies reported significant changes on physical and mental health–related variables, after the intervention took place. Conclusion: These findings suggest that prison-based exercise programs constitute a feasible and useful strategy for improving the physical and mental health status of prisoners.
Robert J. Brychta, Vaka Rögnvaldsdóttir, Sigríður L. Guðmundsdóttir, Rúna Stefánsdóttir, Soffia M. Hrafnkelsdóttir, Sunna Gestsdóttir, Sigurbjörn A. Arngrímsson, Kong Y. Chen and Erlingur Jóhannsson
Introduction: Sleep is often quantified using self-report or actigraphy. Self-report is practical and less technically challenging, but prone to bias. We sought to determine whether these methods have comparable sensitivity to measure longitudinal changes in adolescent bedtimes. Methods: We measured one week of free-living sleep with wrist actigraphy and usual bedtime on school nights and non-school nights with self-report questionnaire in 144 students at 15 y and 17 y. Results: Self-reported and actigraphy-measured bedtimes were correlated with one another at 15 y and 17 y (p < .001), but reported bedtime was consistently earlier (>30 minutes, p < .001) and with wide inter-method confidence intervals (> ±106 minutes). Mean inter-method discrepancy did not differ on school nights at 15 y and 17 y but was greater at 17 y on non-school nights (p = .002). Inter-method discrepancy at 15 y was not correlated to that at 17 y. Mean change in self-reported school night bedtime from 15 y to 17 y did not differ from that by actigraphy, but self-reported bedtime changed less on non-school nights (p = .002). Two-year changes in self-reported bedtime did not correlate with changes measured by actigraphy. Conclusions: Although methods were correlated, consistently earlier self-reported bedtime suggests report-bias. More varied non-school night bedtimes challenge the accuracy of self-report and actigraphy, reducing sensitivity to change. On school nights, the methods did not differ in group-level sensitivity to changes in bedtime. However, lack of correlation between bedtime changes by each method suggests sensitivity to individual-level change was different. Methodological differences in sensitivity to individual- and group-level change should be considered in longitudinal studies of adolescent sleep patterns.
Xiaolin Yang, Irinja Lounassalo, Anna Kankaanpää, Mirja Hirvensalo, Suvi P. Rovio, Asko Tolvanen, Stuart J.H. Biddle, Harri Helajärvi, Sanna H. Palomäki, Kasper Salin, Nina Hutri-Kähönen, Olli T. Raitakari and Tuija H. Tammelin
Background: The purpose of this study was to examine trajectories of leisure-time physical activity (LTPA) and television-viewing (TV) time and their associations in adults over 10 years. Methods: The sample comprised 2934 participants (men, 46.0%) aged 24–39 years in 2001 and they were followed up for 10 years. LTPA and TV time were assessed using self-report questionnaires in 2001, 2007, and 2011. Longitudinal LTPA and TV-time trajectories and their interactions were analyzed with mixture modeling. Results: Three LTPA (persistently highly active, 15.8%; persistently moderately active, 60.8%; and persistently low active, 23.5%) and 4 TV time (consistently low, 38.6%; consistently moderate, 48.2%; consistently high, 11.7%; and consistently very high, 1.5%) trajectory classes were identified. Persistently highly active women had a lower probability of consistently high TV time than persistently low-active women (P = .02), whereas men who were persistently highly active had a higher probability of consistently moderate TV time and a lower probability of consistently low TV time than their persistently low-active counterparts (P = .03 and P = .01, respectively). Conclusions: Maintaining high LTPA levels were accompanied by less TV over time in women, but not in men. The associations were partially explained by education, body mass index, and smoking.
Peng Zhang, Jung Eun Lee, David F. Stodden and Zan Gao
Background: The objective was to examine changes of children’s time spent in sedentary, light physical activity, moderate to vigorous physical activity (MVPA), and estimated energy expenditure (EE) rates during weekdays and weekends across 3 years. Methods: An initial sample of 261 children’s (mean age = 7.81 y) 5-day physical activity and EE were assessed annually via accelerometry across 3 years using repeated-measures multivariate analysis of variance. The outcome variables were time spent in sedentary, light physical activity, MVPA, and kilocalories per day for weekdays and weekends. Results: A significant decrease in MVPA and EE occurred during weekdays across the 3 years (P = .01). Only the second-year data demonstrated an increase (+2.49 min) in weekend MVPA (P = .04). Children’s sedentary time during weekdays increased significantly in years 1 and 2 (P = .01), yet significantly decreased in the third year (−44.31 min). Children’s sedentary time during weekends significantly decreased in the first year (−27.31 min), but increased in the following 2 years (P = .01). Children’s light physical activity demonstrated a statistically significant increase in year 2 (+3.75 min) during weekdays (P = .05). Conclusions: Children’s MVPA and EE generally declined during weekdays but were maintained during weekends across a 3-year time span. Children may benefit most from weekday intervention strategies.
Nathan H. Parker, Rebecca E. Lee, Daniel P. O’Connor, An Ngo-Huang, Maria Q.B. Petzel, Keri Schadler, Xuemei Wang, Lianchun Xiao, David Fogelman, Richard Simpson, Jason B. Fleming, Jeffrey E. Lee, Ching-Wei D. Tzeng, Sunil K. Sahai, Karen Basen-Engquist and Matthew H.G. Katz
Background: Physical activity and exercise appear to benefit patients receiving preoperative treatment for cancer. Supports and barriers must be considered to increase compliance with home-based exercise prescriptions in this setting. Such influences have not been previously examined. Methods: The authors used quantitative and qualitative methods to examine potential physical activity influences among patients who were prescribed home-based aerobic and strengthening exercises concurrent with preoperative chemotherapy or chemoradiation for pancreatic cancer. Physical activity was measured using exercise logs and accelerometers. Social support for exercise and perceived neighborhood walkability were measured using validated surveys. Relationships between influences and physical activity were evaluated using linear regression analyses and qualitative interviews. Results: Fifty patients received treatment for a mean of 16 (9) weeks prior to planned surgical resection. Social support from friends and neighborhood esthetics were positively associated with physical activity (P < .05). In interviews, patients confirmed the importance of these influences and cited encouragement from health care providers and desire to complete and recover from treatment as additional motivators. Conclusions: Interpersonal and environmental motivators of exercise and physical activity must be considered in the design of future home-based exercise interventions designed for patients receiving preoperative therapy for cancer.
Élvio R. Gouveia, Andreas Ihle, Bruna R. Gouveia, Matthias Kliegel, Adilson Marques and Duarte L. Freitas
Objective: To investigate the relations of balance to muscle mass (MM) and muscle strength (MS), depending on age and physical activity, which is of particular importance to functional independence in older people. Methods: This cross-sectional study included 802 volunteers (69.82 ± 5.60 years). The Fullerton Advanced Balance scale was used to assess balance and a composite score, including arm curl and chair stand tests for assessing MS. MM was estimated by dual-energy X-ray absorptiometry and physical activity by questionnaire. Results: Greater MM (r = .26, p < .001) and MS (r = .53, p < .001) were positively correlated to balance. The old-old adults and less active individuals attained lower balance. Notably, moderation and subsequent simple slope analyses revealed that the relations of balance, MM, and MS were larger in less active and the old-old adults. Conclusions: The old-old and less active adults were more prone to muscle weakness and balance impairments. Tailored interventions should particularly consider these vulnerable groups.
Matti Hyvärinen, Sarianna Sipilä, Janne Kulmala, Harto Hakonen, Tuija H. Tammelin, Urho M. Kujala, Vuokko Kovanen and Eija K. Laakkonen
Purpose: To investigate the validity and test–retest reliability of a single seven-level scale physical activity assessment question (SR-PA L7) and its three-level categorization (SR-PA C3). Methods: The associations of SR-PA L7 and C3 with accelerometer-measured leisure-time physical activity (ACC-LTPA) and with the results of four different physical performance tests (6-min walk [n = 733], knee extension [n = 695], vertical jump [n = 731], and grip force [n = 780]) were investigated among women aged 47–55 years participating in the Estrogenic Regulation of Muscle Apoptosis study (n = 795). The reliability was studied using Spearman correlations with 4-month test–retest period (n = 152). Results: SR-PA L7 and C3 had low correlations with ACC-LTPA (r s = .105–.337). SR-PA L7, SR-PA C3, and ACC-LTPA explained comparable but small amount of variance of the physical performance test results. The reliability analysis provided moderate agreement (r s = .707 and .622 for SR-PA L7 and C3, respectively). Conclusions: SR-PA L7 and C3 demonstrated limited validity and reasonable repeatability.