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Andreas Heissel, Anou Pietrek, Michael A. Rapp, Stephan Heinzel and Geoffrey Williams

incentives undermines autonomy and motivation and is to be avoided ( Ryan & Deci, 2017 ). In the context of health care counseling, need support is seen as a core ingredient in the relationship between the health care provider and patient, supporting inner motivational resources and the autonomous self

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Hongjun Yu and Andiara Schwingel

As life expectancy increases, population aging has become an important focus of global health. Aging is associated with increased burden of chronic diseases and increased health care costs. This is an important challenge to global economic stability in the 21st century ( Prince et al., 2015 ). Both

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René Revis Shingles

Cultural competence is considered a foundational behavior of professional practice that “should be incorporated into instruction” ( National Athletic Trainers’ Association, 2011 , p. 3). Health care professionals are expected to demonstrate knowledge, skills, and abilities to understand customs

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Francini Vilela Novais, Eduardo J. Simoes, Chester Schmaltz and Luiz R. Ramos

It is imperative that actions are developed to promote a more active lifestyle for older individuals. Toward this end, primary health care (PHC) centers ought to take a central position in promoting physical activity. However, fewer than 40% of the basic health units in Brazil have developed programs

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Peter W. Grandjean, Burritt W. Hess, Nicholas Schwedock, Jackson O. Griggs and Paul M. Gordon

Kinesiology programs are well positioned to create and develop partnerships within the university, with local health care providers, and with the community to integrate and enhance the activities of professional training, community service, public health outreach, and collaborative research. Partnerships with medical and health care organizations may be structured to fulfill accreditation standards and the objectives of the “Exercise is Medicine®” initiative to improve public health through primary prevention. Barriers of scale, location, time, human resources, and funding can be overcome so all stakeholder benefits are much greater than the costs.

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Michelle Y. Martin, M. Paige Powell, Claire Peel, Sha Zhu and Richard Allman

This study examined whether leisure-time physical activity (LTPA) was associated with health-care utilization in a racially diverse sample of rural and urban older adults. Community-dwelling adults (N = 1,000, 75.32 ± 6.72 years old) self-reported participating in LTPA and their use of the health-care system (physician visits, number and length of hospitalizations, and emergency-room visits). After controlling for variables associated with health and health-care utilization, older adults who reported lower levels of LTPA also reported a greater number of nights in the hospital in the preceding year. There was no support, however, for a relationship between LTPA and the other indicators of health-care utilization. Our findings suggest that being physically active might translate to a quicker recovery for older adults who are hospitalized. Being physically active might not only have health benefits for older persons but also lead to lower health-care costs.

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Ítalo R. Lemes, Rômulo A. Fernandes, Bruna C. Turi-Lynch, Jamile S. Codogno, Luana C. de Morais, Kelly A.K. Koyama and Henrique L. Monteiro

.4, €1.9, and €4.8 million in Germany, Spain, and Italy, respectively. In addition, this estimate is expected to rise by 59%, 179%, and 157% by 2020. 12 Although there are few studies investigating health care expenditures directly related to MetS, several studies have investigated the economic burden

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Tatiana Andreyeva and Roland Sturm

Background:

Physical activity has clear health benefits but there remains uncertainty about how it affects health care costs.

Objective:

To examine how physical activity is associated with changes in health expenditure for a national sample age 54 to 69 y, and estimate how this association varies across people with different chronic diseases and health behaviors.

Methods:

Data were from the Health and Retirement Study, a national longitudinal survey of late middle age Americans.

Results:

Correcting for baseline differences in active and inactive groups, physical activity was associated with reduced health care costs of about 7% over 2 y (or $483 annually).

Conclusions:

Regular physical activity in late middle age may lower health expenditure over time, and the effect is likely to be more pronounced for the obese, smokers, and individuals with some baseline health problems. While substantially large for the health care system, our estimates are much smaller than health-unadjusted comparisons or cross-sectional effects.

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Priscila M. Nakamura, Camila B. Papini, Inaian P. Teixeira, Alberto Chiyoda, Eliete Luciano, Kelly Lynn Cordeira and Eduardo Kokubun

Background:

Interventions in primary health care settings have been effective in increasing physical fitness. In 2001, the Programa de Exercício Físico em Unidades de Saúde (Physical Exercise in Health Primary Care Program—PEHPCP) was launched in Rio Claro City, Brazil. The intervention consisted of biweekly, 60-minute group sessions in all primary health care settings in the city. This study evaluated the effect of PEHPCP on physical fitness and on the aging process after a decade of ongoing implementation.

Methods:

There were 409 women (50 ± 26 y old) and 31 men (64 ± 10 y old) who were eligible for this study. Every 4 months, participants completed the American Alliance for Health, Physical Education, Recreation and Dance standardized tests.

Results:

Program participation was associated with a reduced effect, compared with baseline, of the natural decline of physical fitness caused by aging, as represented by changes in the following measures: coordination test time, −0.44 seconds; agility and dynamic balance test time; −1.81 seconds; aerobic capacity test time, 3.57 seconds; and muscle strength exercises, +0.60 repetitions. No significant effect on flexibility was found.

Conclusions:

The PEHPCP showed potential in improving muscle strength, coordination, aerobic capacity, and agility and dynamic balance in participants and in maintaining flexibility in participants.

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Lena Viktoria Kallings, Matti E. Leijon, Jan Kowalski, Mai-Lis Hellénius and Agneta Ståhle

Background:

Physical activity on prescription, as a method for increasing physical activity, has attracted attention in recent years. However, few studies have examined adherence as a primary outcome variable. The aim of this article was to examine self-reported adherence to individualized prescribed physical activity in a routine primary health care setting.

Methods:

Patients receiving an individualized physical activity on prescription (FaR) for prevention or treatment of disease were recruited from 13 Swedish primary health care units. Self-reported adherence, physical activity level, readiness to change to a more physically active lifestyle, and well-being were measured with questions at baseline and after 6 months in 240 patients (mean age 51, range 12 to 80, 75% women).

Results:

At the 6-month follow-up a majority (65%) of the patients reported adherence to the prescription. Partial adherence was reported by 19% and nonadherence by 16%. There was a relationship between adherence and well-being and stages of action or maintenance.

Conclusions:

The results demonstrate that adherence to physical activity on prescription is as good as adherence to other treatments for chronic diseases. This is significant because even a small increase in physical activity is important both on an individual level and for public health.