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Background: The last decade has seen a dramatic shift toward the study of fitness surveillance, thanks in part to the emergence of mobile health (mHealth) apps that allow users to track their health through a variety of data-driven insights. This study examines the adoption trends and community mediation of the mobile fitness application ‘FanFit’, a platform aimed at promoting physical activity among sports fans by creating a fitness app branded to their favourite team for health promotion. Objective: Our study looked at the impact of a specially designed mobile app (FanFit) as a digital health intervention for initiating and maintaining physical activity as part of football club membership. Our analysis indicates that app users will adopt healthier behaviours as a result of the app’s sense of fan community and behaviour change. Methods: The findings reported here are based on an implementation of the FanFit app and, in particular, on those who participated in a more in-depth study (n = 30). These participants were Rangers FC supporters with a mix of genders (n = 19 males and n = 11 females). Focus groups and interviews were conducted with participants to ascertain users’ perspectives on the most effective methods for nudging users toward adopting and maintaining a pattern of fitness behaviours. Results: The findings show that the user community was interested in fitness and wanted to live a ‘healthy lifestyle,’ which was augmented and fuelled by the app’s competitive architecture design. Furthermore, the data reveal a new fan-health discourse about a person’s developing wants, talents, and identities as embodied beings. Conclusions: We have developed and presented valid links between the use of sports club apps and health programmes. The app could be useful for sports programmes and club providers looking for mHealth applications that provide community support through fan discourse with opportunities for both male and female fans.

Participation in university is highly unequal across socio-economic lines globally (UNESCO, 2017). This has led many governments and admission officers to introduce preferential college admissions for disadvantaged students. This report studies the impacts that preferential admissions can have on the higher-education admission, enrolment and retention of disadvantaged students. We answer these research questions in the context of a programme called PACE (Programa de Acompañamiento y Acceso Efectivo a la Educación Superior, Programme for the Support and Effective Access to Higher Education) in Chile. PACE targets disadvantaged high schools and guarantees admission to a selective university for students who graduate in the top 15% of their school, waiving the requirement to obtain a sufficiently high score on the standardised entrance exam. Similar programmes, known as percentage plans, have been used in other countries (e.g., California, Florida and Texas have state-wide percentage plans). Specifically, this report evaluates the impacts of the PACE programme on higher-education admissions and on higher-education enrolment of the disadvantaged students targeted by the programme, up to four years after the end of secondary education. To identify policy impacts, we exploit the randomized expansion of PACE that occurred in 2016. Our main findings are the following. [...]

Although the public transport (PT) commute can form a substantial part of the working day, there is a significant gap in our understanding of how it influences health of those who engage in it. The purpose of this systematic review was to therefore generate evidence from 1972 about the extent to which the PT commute (involving train, bus, subway, tram, or metro) impacts on the mental health, physical health and well-being of the working people. We identified 47 studies in English worldwide involving an empirical quantitative focus which met the inclusion criteria. Of these, 23 studies involved over 500 participants. Although initial multi-modal comparisons showed impact on sickness rate, self-rated health complaints, perceived stress level and reduction in sleep, a more homogeneous analysis of rail commuters showed elevation in salivary cortisol, perceived stress, and affective reactions to crowding. Findings also revealed a bias towards use of endogenous self-report measures. On this basis, we argue that it would be of benefit to test theoretical models to account for more objective measures of job and commuting stress. Recommendations were made for flexible working agendas.

Aims: E-cigarettes have been advocated as an effective smoking cessation intervention, with evidence indicating that they are substantially less harmful than conventional cigarettes. As a result, a pilot to encourage people to swap from conventional cigarettes to e-cigarettes was conducted in 2018 in a socially deprived area in the North West of England. This evaluation highlights the key findings from the pilot. Methods: An analysis of secondary data at 4 weeks ( n = 1022) was undertaken to predict those who used solely used e-cigarettes (i.e. had quit tobacco, as confirmed by a carbon monoxide test, CO < 10 ppm) from baseline characteristics, using chi-square tests and logistic regression. Baseline data were demographics, smoking levels and service provider type. Results: Of the 1022 participants who engaged with the pilot 614 were still engaged at 4 weeks, of whom 62% had quit; quitting was more likely in younger participants (aged 18–24) and less likely in those who were sick and disabled. Of those who still smoked tobacco at week 4 ( n = 226), smoking had reduced from a baseline of 19.1 cigarettes/day to 8.7. Overall, 37% (381) of those initially enrolled were confirmed to be using an e-cigarette on its own at follow-up. Successful quit was associated with occupation (unemployed, 33% vs intermediate, 47%, p = .023) and residing in the less deprived quintiles of deprivation (50% vs 34% in the most deprived quintile, p = .016). Conclusions: Making the conservative assumption that all those not in contact at 4 weeks were still smoking tobacco, for every five people entering the scheme, three people stayed on the programme and reduced their cigarette smoking and one person cut out tobacco altogether. E-cigarettes appear to be an effective nicotine replacement therapy; however, further research is required to determine whether e-cigarette users are more likely to reduce their overall nicotine consumption in the longer term.

The growth of smartphone ownership by fans around the world has continued to increase. Meanwhile, we are seeing a rise in dangerous levels of obesity, diabetes and heart disease. The most at-risk, hard-to-reach groups are often synonymous with football fans (middle aged and older males). For this population group there are also high rates of smartphone ownership – 91% of 35–54 year olds and 51% of 55–64 year olds in the UK in 2018 – providing opportunity for engagement in digital health-related projects. This chapter explores how fans can be engaged in physical activity through their support of sport teams and use of smartphones, introducing a case study of Fan Fit – a smartphone application designed to be an official sports club app, which also includes fitness tracking elements for fan engagement. Fan Fit aims to build a community of participation, and increase interaction and physical activity levels. We present the background and evidence base for Fan Fit, its implementation and the use of action research to develop and test the app. We present key learnings to develop further insight to football clubs who may wish to adopt a similar project or approach.

BACKGROUND As breast cancer survival rates improve and structural health resources are increasingly being stretched, health providers require people living with and beyond breast cancer (LwBBC) to self-manage aspects of their care. OBJECTIVE This study aimed to explore how women use and experience social media to self-manage their psychosocial needs and support self-management across the breast cancer continuum. METHODS The experiences of 21 women (age range 27-64 years) were explored using an in-depth qualitative approach. The women varied in the duration of their experiences of LwBBC, which facilitated insights into how they evolve and change their self-management strategies over time. Semistructured interviews were analyzed inductively using a thematic analysis, a polytextual analysis, and voice-centered relational methods. RESULTS The use of multiple social media platforms, such as YouTube, Facebook, WhatsApp, and Twitter, enabled women to self-manage aspects of their care by satisfying needs for timely, relevant, and appropriate support, by navigating identities disrupted by diagnosis and treatment and by allowing them to (re)gain a sense of control. Women described extending their everyday use of multiple platforms to self-manage their care. However, women experienced social media as both empowering and dislocating, as their engagement was impacted by their everyday experiences of LwBBC. CONCLUSIONS Health care professionals (HCPs) need to be more aware, and open to the possibilities, of women using multiple social media resources as self-management tools. It is important for HCPs to initiate value-free discussions and create the space necessary for women to share how social media resources support a tailored and timely self-managed approach to their unique psychosocial needs.

Purpose\ud Musculoskeletal disorders (MSDs) in the adult population have increased over the past ten years. Evidence suggest that this is due to the rapid development and usage of computer technology and personal electronic devices (PEDs). Research has identified risk factors associated with musculoskeletal (MSK) pain as: duration of use, type of device used, and positions people are using them in. \ud Similarly, children’s usage of PEDs has rapidly increased. With this growth comes a need to understand the potential link between PED use and MSK pain in children. There is a dearth of evidence related to risk factors linked to children’s use of PEDs and any relationship between this usage and MSK pain. It is important to explore and identify these risk factors.\ud \ud Methods\ud A systematic review was conducted to explore the link between children’s MSK pain and their PEDs usage. The aim was to appraise the current research exploring whether there is an association between children’s (aged 3-17 years) MSK pain and their usage of PEDs, as well as to identify any potential risk factors. \ud Electronic searches of EBSCO (CINAHL, SPORT Discus with Full Text), Ovid Online (Amed and MEDLINE), and PubMed Central were conducted for cross-sectional, observational or experimental studies. An integrative narrative synthesis process was followed, and the quality of the papers were reported on using the standard quality assessment criteria for evaluation primary research papers from a variety of fields. \ud \ud Results\ud N=12,671 articles were screened, n=43 studies eligible for inclusion. Of those 43 studies n=35 were cross-sectional, seven cohort studies and one was a test-re-test. N=27 of the cross-sectional studies used subjective measurement, such as questionnaires (Nordic Muscular Questionnaire, the most commonly used) and the pain visual analogue scale, seven used both subjective and objective measures (i.e. questionnaires, 3D posture analysis, and EMG) and eight used only objective measures. \ud The quality of the articles ranged from 0.95 to 0.28, more than 50% of the papers being under 0.50. No papers were excluded based on quality.\ud The current evidence base suggests limited evidence of a link between PED usage and MSK pain in children. However, potential risk factors themes were found; type of device, length of time, and positions adopted when using the device. \ud \ud Conclusions\ud The review concluded that due to the low quality of papers, predominance of subjective outcome measures used and the lack of longitudinal studies that the identified risk factors could not be conclusively demonstrated as being linked to the impact of PED usage on MSK pain. More research is needed, utilising either cohort or longitudinal designs, using both objective and subjective outcome measures which will provide a greater understanding.\ud \ud Implications\ud \ud The results from the systematic review highlight the gap in knowledge and the need for further research. Also highlighted the need to move away from a reliance on subjective measures, and lab-based research to the integration of objective measures within free living environments. Strengthening and developing the evidence base to ensure high quality preventative interventions can be designed to help reduce the impact of the identified risk factors.