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Pawel Zembura, Aleksandra Goldys and Hanna Nalecz

Background:

Poland’s 2016 Report Card on Physical Activity for Children and Youth is the first assessment of child and youth physical activity (PA) in Poland using the Active Healthy Kids Global Alliance grading system. The main goal was to summarize and describe the current state of child and youth PA to increase awareness and surveillance.

Methods:

The systematic methodology that underpins the Active Healthy Kids Canada Report Card was adapted and applied to the Polish report card. The best available data were consolidated, reviewed by a group of experts, and used to assign the letter grades to 9 core PA indicators on a scale ranging from A (highest) to F (lowest).

Results:

The 9 indicators were graded as such: 1) Overall Physical Activity (D), 2) Organized Sport Participation (C), 3) Active Play (INC), 4) Active Transportation (C), 5) Sedentary Behaviors (D), 6) Family and Peers (C), 7) School (B), 8) Community and the Built Environment (C), and 9) Government Strategies and Investments (C).

Conclusions:

The final grades show a strong role of school in providing PA for children and youth in Poland. However, promotion of school-based sport participation appears to be insufficient by itself to sustainably promote PA in this group.

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Suzie Mudge, Denise Taylor, Oliver Chang and Rosita Wong

Background:

Activity Monitors give an objective measure of usual walking performance. This study aimed to examine the test-retest reliability of the StepWatch Activity Monitor outputs (mean steps/day; peak activity index; sustained activity indices of 1, 5, 20, 30, 60 minutes; steps at high, medium, and low stepping rates).

Methods:

Thirty healthy adults age 18 to 49 years wore the StepWatch for 2 3-day periods at least 1 week apart.

Results:

The intraclass correlation coefficients of the StepWatch outputs ranged from 0.44 to 0.91 over 3 days. The coefficient of variation ranged from 3.0% to 51.3% over the monitoring periods, with higher variation shown for shorter monitoring periods. The most reliable 5 outputs had 95% limits of agreement between 3-day periods that were less than 40%. These were mean steps/day (±39.1%), highest step rate in 1 (±17.3%) and 5 (±37.4%) minutes, peak activity index (±25.6%), and percentage of inactive time (±9.52%).

Conclusions:

Mean steps/day, highest step rate in 1 and 5 minutes, peak activity index, and percentage of inactive time have good test-retest reliability over a 3-day monitoring period, with lower reliability shown by the other StepWatch outputs. Monitoring over 1 or 2 days is less reliable.

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Marj Moodie, Michelle M. Haby, Boyd Swinburn and Robert Carter

Background:

To assess from a societal perspective the cost-effectiveness of a school program to increase active transport in 10- to 11-year-old Australian children as an obesity prevention measure.

Methods:

The TravelSMART Schools Curriculum program was modeled nationally for 2001 in terms of its impact on Body Mass Index (BMI) and Disability-Adjusted Life Years (DALYs) measured against current practice. Cost offsets and DALY benefits were modeled until the eligible cohort reached age 100 or died. The intervention was qualitatively assessed against second stage filter criteria (‘equity,’ ‘strength of evidence,’ ‘acceptability to stakeholders,’ ‘feasibility of implementation,’ ‘sustainability,’ and ‘side-effects’) given their potential impact on funding decisions.

Results:

The modeled intervention reached 267,700 children and cost $AUD13.3M (95% uncertainty interval [UI] $6.9M; $22.8M) per year. It resulted in an incremental saving of 890 (95%UI −540; 2,900) BMI units, which translated to 95 (95% UI −40; 230) DALYs and a net cost per DALY saved of $AUD117,000 (95% UI dominated; $1.06M).

Conclusions:

The intervention was not cost-effective as an obesity prevention measure under base-run modeling assumptions. The attribution of some costs to nonobesity objectives would be justified given the program’s multiple benefits. Cost-effectiveness would be further improved by considering the wider school community impacts.

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Jeanne M. Gabriele, Diane L. Gill and Claire E. Adams

Background:

Several theories and models have been proposed to explain decisions in changing and adopting behavior but few address the intricacies of behavioral maintenance. The current study assesses the utility of the Investment Model, which identifies satisfaction, investments, and involvement alternatives as predictors of commitment and continued behavior, in predicting physical activity behavior.

Methods:

Participants (N = 267) completed questionnaires about physical activity and commitment. Structural equation modeling assessed relationships among 2 types of exercise commitment (want to or enthusiastic commitment, have to or obligatory commitment), 3 commitment determinants (satisfaction, investments, and alternatives), and physical activity (minutes of physical activity, stage of behavior change).

Results:

Want to commitment, but not have to commitment, was related to stage of exercise behavior change and time spent in physical activity. Satisfaction and investments were positively related to want to commitment; whereas, satisfaction, investments, and alternatives were positively related to have to commitment. The model explained 68% and 23% of the variance in time spent in physical activity and stage of behavior change, respectively.

Conclusions:

This study provides support for the application of the Investment Model to physical activity and suggests that want to commitment may be important for explaining and predicting sustained physical activity behavior.

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Nicholas Gilson, Wendy J. Brown, Guy Faulkner, Jim McKenna, Marie Murphy, Andy Pringle, Karin Proper, Anna Puig-Ribera and Aphroditi Stathi

Background:

This paper aimed to use the Delphi technique to develop a consensus framework for a multinational, workplace walking intervention.

Methods:

Ideas were gathered and ranked from eight recognized and emerging experts in the fields of physical activity and health, from universities in Australia, Canada, England, the Netherlands, Northern Ireland, and Spain. Members of the panel were asked to consider the key characteristics of a successful campus walking intervention. Consensus was reached by an inductive, content analytic approach, conducted through an anonymous, three-round, e-mail process.

Results:

The resulting framework consisted of three interlinking themes defined as “design, implementation, and evaluation.” Top-ranked subitems in these themes included the need to generate research capacity (design), to respond to group needs through different walking approaches (implementation), and to undertake physical activity assessment (evaluation). Themes were set within an underpinning domain, referred to as the “institution” and sites are currently engaging with subitems in this domain, to provide sustainable interventions that refect the practicalities of local contexts and needs.

Conclusions:

Findings provide a unique framework for designing, implementing, and evaluating walking projects in universities and highlight the value of adopting the Delphi technique for planning international, multisite health initiatives.

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Lena Fleig, Megan M. McAllister, Penny Brasher, Wendy L. Cook, Pierre Guy, Joseph H. Puyat, Karim M. Khan, Heather A. McKay and Maureen C. Ashe

Objectives:

To characterize patterns of sedentary behavior and physical activity in older adults recovering from hip fracture and to determine characteristics associated with activity.

Methods:

Community-dwelling, Canadian adults (65 years+) who sustained hip fracture wore an accelerometer at the waist for seven days and provided information on quality of life, falls self-efficacy, cognitive functioning, and mobility.

Results:

There were 53 older adults (mean age [SD] 79.5 [7.8] years) enrolled in the study; 49 had valid data and demonstrated high levels of sedentary time (median [p10, p90] 591.3 [482.2, 707.2] minutes/day), low levels of light activity (186.6 [72.6, 293.7]), and MVPA (2 [0.1, 27.6]), as well as few daily steps (2467.7 [617.1, 6820.4]). Regression analyses showed that age, gender, gait speed, and time since fracture were associated with outcomes.

Conclusions:

Older adults have long periods of sedentary time with minimal activity. Results are a call to action to encourage people to sit less and move more.

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Meghan Baruth and Sara Wilcox

Background:

Understanding who is most and least likely to remain active after the completion of physical activity (PA) interventions can assist in developing more targeted and effective programs to enhance prolonged behavior change. The purpose of this study was to examine predictors of meeting PA recommendations 6 months postintervention in participants enrolled in Active for Life.

Methods:

Participants from 2 behavioral PA programs [158 Active Choices (AC); 1025 Active Living Every Day (ALED)] completed surveys 6 months after completion of the active intervention. Analyses examined predictors of meeting PA recommendations at follow-up.

Results:

The following were significant predictors: In ALED: self-report health status, satisfaction with body function, and self-efficacy at baseline; PA status at posttest; changes in self-efficacy, perceived stress, and satisfaction with body function and appearance from baseline to posttest. In AC: PA status at posttest.

Conclusions:

The ultimate goal of health promotion programs is to teach the behavioral skills necessary to sustain behavior change once an active intervention is complete. The findings from this study suggest that predicting PA behavior after cessation of PA interventions may not be straightforward, and predictor variables may operate differently in different intervention approaches.

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Mitch J. Duncan, Hannah M. Badland and William Kerry Mummery

Background:

The aim of this study was to examine the relationship between occupational category and 3 health-related behaviors: participation in leisure-time physical activity, active transport (AT) and occupational sitting in a sample of employed Australian adults.

Methods:

A random, cross-sectional sample of 592 adults aged 18 to 71 years completed a telephone survey in October/November 2006. Reported occupations were categorized as professional (n = 332, 56.1%), white-collar (n = 181, 30.6%), and blue-collar (n = 79, 13.3%). Relationships between occupational category and AT, sufficient physical activity and occupational sitting were examined using logistic regression.

Results:

White-collar employees (OR = 0.36, 95% CI 0.14−0.95) were less likely to engage in AT and more likely to engage in occupational sitting (OR = 3.10, 95% CI 1.63−5.92) when compared with blue-collar workers. Professionals (OR = 3.04, 95% CI 1.94−4.76) were also more likely to engage in occupational sitting compared with blue-collar workers. No relationship was observed between occupational category and engagement in sufficient physical activity.

Conclusions:

No association between occupational category and sufficient physical activity levels was observed, although white-collar and professionals were likely to engage in high levels of occupational sitting. Innovative and sustainable strategies are required to reduce occupational sitting to improve health.

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Glen Nielsen, Rachael Taylor, Sheila Williams and Jim Mann

Background:

To investigate whether the number of permanent playground facilities in schools influences objectively measured physical activity.

Methods:

Physical activity was measured using Actical accelerometers over 2 to 5 days in 417 children (5–12 years) from 7 schools. The number of permanent play facilities likely to encourage physical activity in individuals or groups of children (eg, adventure playgrounds, swings, trees, playground markings, courts, sandpits) were counted on 2 occasions in each school. The surface area of each playground (m2) was also measured.

Results:

The number of permanent play facilities in schools ranged from 14 to 35 and was positively associated with all measures of activity. For each additional play facility, average accelerometry counts were 3.8% (P < .001) higher at school and 2.7% (P < .001) higher overall. Each additional play facility was also associated with 2.3% (P = .001) or 4 minutes more moderate/vigorous activity during school hours and 3.4% (P < .001) more (9 minutes) over the course of the day. School playground area did not affect activity independent of the number of permanent play facilities. Findings were consistent across age and sex groups.

Conclusion:

Increasing the number of permanent play facilities at schools may offer a cost-effective and sustainable option for increasing physical activity in young children.

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Jason Duvall

Background:

This study investigated the effectiveness of enhanced cognitive awareness as a means of encouraging outdoor walking. An intervention using engagement-based strategies was compared with a more traditional walking intervention focused on developing and committing to a personalized walking schedule.

Methods:

117 adults were randomly assigned to 1 of 2 treatments—Standard Care (schedule setting, commitment) or Engagement (awareness plans)—and asked to take at least 3, 30 minute outdoor walks each week for 2 weeks. During the study period, self-report and objective measures were used to collect data on walking behavior.

Results:

Individuals in both treatment conditions reported significant increases (P < .05) in walking behavior. Participants in both treatments failed to sustain these increases at a follow-up measure 4 weeks later. However, the Engagement condition was particularly effective for those individuals who had less prior experience maintaining a walking routine.

Conclusion:

Overall, the findings suggest it may be beneficial to incorporate engagement-based strategies into existing walking interventions. Results of this study also raise the possibility that efforts to encourage cognitive awareness may make the outdoor walking experience more interesting and enjoyable.