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Background: Reducing inequalities in physical activity (PA) and PA-associated health outcomes is a priority for public health. Interventions to promote PA may reduce inequalities, but may also unintentionally increase them. Thus, there is a need to analyze equity-specific intervention effects. However, the potential for analyzing equity-specific effects of PA interventions has not yet been sufficiently exploited. The aim of this study was to set out a novel equity-specific re-analysis strategy tried out in an international interdisciplinary collaboration., Methods: The re-analysis strategy comprised harmonizing choice and definition of outcomes, exposures, socio-demographic indicators, and statistical analysis strategies across studies, as well as synthesizing results. It was applied in a collaboration of a convenience sample of eight European PA intervention studies in adults aged ≥45 years. Weekly minutes of moderate-to-vigorous PA was harmonized as outcome. Any versus no intervention was harmonized as exposure. Gender, education, income, area deprivation, and marital status were harmonized as socio-demographic indicators. Interactions between the intervention and socio-demographic indicators on moderate-to-vigorous PA were analyzed using multivariable linear regression and random-effects meta-analysis., Results: The collaborative experience shows that the novel re-analysis strategy can be applied to investigate equity-specific effects of existing PA interventions. Across our convenience sample of studies, no consistent pattern of equity-specific intervention effects was found. Pooled estimates suggested that intervention effects did not differ by gender, education, income, area deprivation, and marital status., Conclusions: To exploit the potential for equity-specific effect analysis, we encourage future studies to apply the strategy to representative samples of existing study data. Ensuring sufficient representation of 'hard to reach' groups such as the most disadvantaged in study samples is of particular importance. This will help to extend the limited evidence required for the design and prioritization of future interventions that are most likely to reduce health inequalities.

Reducing social inequalities in physical activity (PA) has become a priority for public health. However, evidence concerning the impact of interventions on inequalities in PA is scarce. This study aims to develop and test the application of a strategy for re-analyzing equity-specific effects of existing PA intervention studies in middle-aged and older adults, as part of an international interdisciplinary collaboration. This article aims to describe (1) the establishment and characteristics of the collaboration; and (2) the jointly developed equity-specific re-analysis strategy as a first result of the collaboration. To develop the strategy, a collaboration based on a convenience sample of eight published studies of individual-level PA interventions among the general population of adults aged ≥45 years was initiated (UK, n = 3; The Netherlands, n = 3; Belgium, n = 1; Germany, n = 1). Researchers from these studies participated in a workshop and subsequent e-mail correspondence. The developed strategy will be used to investigate social inequalities in intervention adherence, dropout, and efficacy. This will allow for a comprehensive assessment of social inequalities within intervention benefits. The application of the strategy within and beyond the collaboration will help to extend the limited evidence regarding the effects of interventions on social inequalities in PA among middle-aged and older adults.

Based on the principles of the Social Identity Approach (SIA), the present experiment aimed to examine the impact of communicating descriptive age norms on older adults' autonomous motivation to exercise. Under the cover of a marketing study, older adults (n = 120; age = 65-70 years) participated in a newly created exercise activity, 'Pattern Stepping'. This activity was framed as an activity that was descriptively normative either for older adults, for younger adults, for both groups, or for none. Repeated measures ANOVAs revealed that participants felt greater satisfaction of their basic psychological needs and were more autonomously motivated to exercise if Pattern Stepping was framed as an activity popular among the young, rather than among older adults. These findings suggest that framing an exercise as descriptively normative for the elderly can thwart older adults' autonomous motivation if they do not identify as an older adult., (© The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Excessive uninterrupted sitting, also known as sedentary behavior, has been detrimentally associated with several health outcomes. However, the general population is often unaware of these health risks. Mobile phone technology offers great potential to increase awareness and to initiate behavior change. This study examined the short-term effects of stAPP, a smartphone-based intervention, on prolonged sitting behavior. Fifty-eight participants were randomly assigned to an intervention group (IG, n = 31) or a control group (CG, n = 27). After 1 week of baseline assessment, the IG received stAPP (i.e. smartphone, smartphone app and corresponding motion sensor) and used it during the following week. CG participants were monitored during 2 weeks without receiving stAPP. Total daily sitting time and prolonged sitting bouts (>30 min bouts of sitting) were objectively assessed using activPAL3 inclinometers. Although no significant changes emerged in the CG in any of the sitting parameters, total sitting time (on weekdays; p = 0.032), number of prolonged sitting bouts (>30 min of sitting) [both on week- (p < 0.001) and weekend days (p = 0.008)] and average duration of prolonged sitting bouts [both on week- (p = 0.004) and weekend days (p = 0.029)] decreased significantly in the IG. The stAPP smartphone-based intervention constitutes a promising intervention tool to interrupt and reduce prolonged sitting behavior. Further long-term studies on a larger scale are needed to further explore the effectiveness of a smartphone-based intervention aimed at reducing prolonged sitting behavior.

Background: This follow-up study investigated the year-round effects of a four-week randomized controlled trial using different types of feedback on employees' physical activity, including a need-supportive coach intervention., Methods: Participants (n = 227) were randomly assigned to a Minimal Intervention Group (MIG; no feedback), a Pedometer Group (PG; feedback on daily steps only), a Display Group (DG; feedback on daily steps, on daily moderate-to-vigorous physical activity [MVPA] and on total energy expenditure [EE]), or a Coaching Group (CoachG; same as DG with need supportive coaching). Daily physical activity level (PAL; Metabolic Equivalent of Task [MET]), number of daily steps, daily minutes of moderate to vigorous physical activity (MVPA), active daily EE (EE > 3 METs) and total daily EE were measured at five time points: before the start of the 4-week intervention, one week after the intervention, and 3, 6, and 12 months after the intervention., Results: For minutes of MVPA, MIG showed higher mean change scores compared with the DG. For steps and daily minutes of MVPA, significantly lower mean change scores emerged for MIG compared with the PG. Participants of the CoachG showed significantly higher change scores in PAL, steps, minutes of MVPA, active EE, total EE compared with the MIG. As hypothesized, participants of the CoachG had significantly higher mean change scores in PAL and total EE compared with groups that only received feedback. However, no significant differences were found for steps, minutes of MVPA and active EE between CoachG and PG., Conclusions: Receiving additional need-supportive coaching resulted in a higher PAL and active EE compared with measurement (display) feedback only. These findings suggest to combine feedback on physical activity with personal coaching in order to facilitate long-term behavioral change. When it comes to increasing steps, minutes of MVPA or active EE, a pedometer constitutes a sufficient tool., Trial Registration: Clinical Trails.gov NCT01432327 . Date registered: 12 September 2011.

Purpose: To evaluate the impact of footprints on stair climbing in different settings., Design: Interrupted time-series design., Setting: A company (stair/elevator choice) and a mall (stair/escalator choice)., Participants: Employees (n = 5676) and visitors of the mall (n = 12 623)., Intervention: An intervention comprising 3 consecutive phases was implemented-(1) footprints leading to the stairs were stuck on the floor, (2) a health message referring to the footprints was introduced, and (3) passersby were congratulated for their increased stair use., Measures: Stair climbing was observed before (ie, baseline), during, and 6 to 13 weeks after (ie, follow-up) the intervention., Analysis: Proportions of stair climbers were compared using χ 2 analyses., Results: The footprints resulted in a closely significant increase in stair climbing in the company (from 27.7% at baseline to 31.2% in phase 1). However, they did not produce any effect in the mall. Introducing a health message yielded an additional 12.4% increase in stair climbing in the company and a significant 11.4% increase in the mall (22.3% in phase 2). Congratulating people did not further increase stair climbing. At follow-up, the proportions of stair climbers dropped but still exceeded baseline., Conclusion: Footprints tend to increase stair climbing in a worksite setting with a stair/escalator choice but not in a public setting with a stair/elevator choice. Adding a meaningful message seems essential to obtain stronger and longer term effects.

Background: To examine which school- and home-based factors at age 11 to 12 (6th grade, elementary school) predict physical activity (PA) and sedentary behavior (SB) at age 13 to 14 (8th grade, secondary school)., Methods: Data at both time points were collected from 472 children (mean age baseline = 10.97, SD age = 0.41) and their parents. Children and parents completed self-reported questionnaires. Children's height and weight were measured and children wore a pedometer for 7 days., Results: Hierarchical regression analyses revealed that predominantly boys (β = -.11), children with higher levels of pedometer-determined PA (β = .44) and more parental logistic support (β = .11) at age 11 to 12 displayed higher levels of pedometer-determined PA at age 13 to 14 (R2 = 39.1%). Similar results emerged for self-reported moderate-to-vigorous PA (R2 = 36.7%). Finally, lower levels of screen-based SB at age 13 to 14 (R2 = 32.5%) were most strongly related to lower levels of screen-based SB (β = .41), a medium/high socioeconomic status (β = -.18), and higher levels of parental PA explicit modeling (β = -.18) at age 11 to 12., Conclusions: Children's PA/SB and the supportive role of parents at age 11 to 12 are strong predictors of PA and screen-based SB at age 13 to 14.

Background: This study evaluated the long-term effectiveness of multiple physical activity counseling strategies on subjective health among older adults., Methods: Sedentary older adults (n = 442) were randomized to 3 programs: (1) a one-contact referral to locally organized physical activities, (2) a one-contact provision of a walking program, (3) a 10-week multiple-contact physical activity coaching based on the Self-Determination Theory. Self-reports on well-being, trait anxiety and physical activity were completed at baseline (pretest), and 10 weeks after (10-week follow-up), 1 year after (1-year follow-up) and 2 years after (2-year follow-up) pretests., Results: All 3 programs yielded improvements in well-being and trait anxiety from pretest to 10-week follow-up and to 1-year follow-up. From pretest to 2-year follow-up, no changes emerged in well-being whereas trait anxiety increased significantly. Changes over time in well-being and anxiety were not significantly different between the programs. Changes in physical activity contributed significantly to the prediction of changes in well-being and trait anxiety., Conclusions: The findings demonstrate the year-round effectiveness of physical activity counseling on subjective health among older adults, irrespective of counseling strategy. However, a relapse to baseline level occurred 2 years after the intervention. Physical activity appears to be an important determinant of older adults' well-being.

This study compared the long-term effectiveness of three physical activity counseling strategies among sedentary older adults: a 1-contact referral (REFER), a 1-contact individualized walking program (WALK), and multiple-contact, individually tailored, and need-supportive coaching based on the self-determination theory (COACH). Participants (n = 442) completed measurements before (pretest), immediately after (posttest), and 1 yr after (follow-up test) a 10-wk intervention. Linear mixed models demonstrated significant time-by-condition interaction effects from pre- to posttest. More specifically, WALK and COACH yielded larger increases in daily steps and self-reported physical activity than REFER. Similarly, self-reported physical activity increased more from pre- to follow-up test in WALK and COACH compared with REFER. Autonomous motivation mediated the effect of perceived need-support on physical activity, irrespective of counseling strategy. These results demonstrate the long-term effectiveness of both a 1-contact individualized walking program and a more time-consuming, need-supportive coaching, especially in comparison with a standard referral to local opportunities.

This study examined the long-term and mediation effects of a need-supportive coaching programme on physical activity. Sedentary employees (n = 92) of the university of Leuven received 4 months of physical activity coaching, based on the self-determination theory, by coaches with a bachelor's degree in kinesiology who are specializing in health-related physical activity (n = 30). The programme consisted of a limited number of individual contact moments (i.e. an intake session, three follow-up contacts and an out-take session), either face-to-face, by phone or by e-mail. Self-reported physical activity, social support, self-efficacy and autonomous motivation were assessed in the coaching group (n = 92) and a control group (n = 34) at three moments: before the intervention (i.e. pre-test), after the intervention (i.e. post-test) and 1 year after pre-test measurements (i.e. follow-up test). Results revealed significant 3 (time) × 2 (groups) interaction effects on strenuous and total physical activity. Moreover, whereas the control group remained stable from pre- to post-test, the coaching group increased significantly in moderate, strenuous and total physical activity. Additionally, the coaching group increased significantly in mild, moderate, strenuous and total physical activity from pre- to follow-up tests, whereas the control group did not change. Bootstrapping analyses indicated that self-efficacy and autonomous motivation significantly mediated the intervention effect on physical activity from pre- to post-test, while social support significantly mediated the long-term effect. This study provides evidence for the long-term effectiveness of a need-supportive physical activity programme that might be efficient at the community level.

This study evaluated "Every Step Counts!"- a 10-wk, structured walking intervention in a community-based senior organization - on promoting physical activity participation, fitness, and well-being among older adults (age ≥ 55 yr). The intervention prescribed pedometer-defined walks in weekly walking schedules. These were fitness-tailored and structured in walking load (intensity/volume) according to the principles of training progression. This intervention was offered as a social activity at meeting points of a community-based senior organization. Twenty-nine meeting points (n = 432) constituted the intervention condition. Ten meeting points (n = 148) formed the wait-list control condition. Measurements were organized at intervention start (pretest) and end (posttest). Intention-to-treat linear mixed models showed small positive intervention effects on physical activity, fitness, and aspects of well-being. These results confirm the effectiveness of structured walking interventions with systematic training progression and underscore the value of community-based senior organizations as intervention settings for older adults.

The aim of this study was to test the impact of a simple health-promotion sign on stair use in three community settings in Flanders, Belgium. A health sign was placed at the junction between the stairs and an escalator in a shopping mall and two train stations. Observations took place on four days: baseline, first intervention, post-intervention and second intervention. In the second station, a second post-intervention phase was added. In total, 1437 choices of shoppers were registered in the mall, while 2869 and 2025 choices of commuters were recorded in the two stations, respectively. Despite the different baselines of stair use, the introduction of the health sign in the first intervention phase resulted in a significant increase in all three settings: 10.0% increase in the mall, 8.6% in the first station and 18.0% in the second station. In the second station, the increase during the second intervention exceeded that of the first intervention. Moreover, in this station stair use in the second post-intervention phase was significantly higher than at baseline. An inexpensive health-promoting sign has a substantial effect on the proportion of stair users among shoppers and commuters. Preliminary evidence was found that repeated exposure to a health sign might have a longer term effect on stair use.

Background: With a rapidly ageing society, healthy ageing has become a key challenge. Engagement in physical activity, and particularly walking, is a key strategy that contributes to healthy ageing amongst older adults. The purpose of the present study was to evaluate the efficacy of a group walking program for older adults that incorporates the 5R Shared Leadership Program (5RS). By implementing a structure of shared leadership and strengthening peer leaders' identity leadership, 5RS aims to cultivate a shared social identity amongst participants, which has in other contexts been associated with greater performance and well-being. Methods: A cluster randomised controlled trial was conducted to test the efficacy of the 5RS group walking program on group identification, group cohesion, walking activity, and well-being, compared to a regular group walking program for older adults. Nineteen older adult walking groups (i.e., the clusters; N = 503; Mage = 69.23 years, SD = 6.68) all participated in a 12-week structured group walking program. Nine walking groups (n = 304) were randomly assigned to the intervention in which participants received the 5RS program in addition to regular group walking. Results: 5RS was successful in strengthening the identity leadership qualities of the appointed peer leaders. Multilevel regressions showed that 5RS succeeded in increasing group cohesion and walking activity to a greater extent than a regular group walking program, while participants' group identification and well-being increased to a similar extent in both conditions. Furthermore, structural equation modelling revealed that group identification mediated the impact of peer leaders' identity leadership on group cohesion and well-being (but not walking activity). Conclusion: By harnessing the capacity of the group and its peer leaders, the 5RS program offers a promising intervention to engage older adults in physical activity. Trial registration: The study was retrospectively registered as clinical trial on 9 September 2021 (NCT05038423). [ABSTRACT FROM AUTHOR]

Background: Follow-up support increases the effectiveness of physical activity interventions. This study evaluates the effectiveness of 2 support modes on physical activity and mental health. Methods: University employees were randomly assigned to a coaching program with 4 face-to-face (N = 33) or telephone-based (N = 33) support contacts. Both programs included an initial face-to-face intake session and an informational brochure. Physical activity, trait anxiety, self-efficacy, and social support were measured by self-report before and after the interventions that lasted 3 months. Results: Both groups increased leisure-time physical activity, self-efficacy, and social support and decreased sitting time and trait anxiety. The only significant time by group interaction was found for active transportation. More specifically, participants in the face-to-face group reported a significant increase in their active transportation from pretest to posttest, whereas participants in the telephone group reported no significant change. Conclusions: Both face-to-face support and telephone support proved to be effective in increasing the physical activity level and mental health of university employees. [ABSTRACT FROM AUTHOR]

This study evaluated the impact of two simple interventions aimed at promoting stair use among female employees at a five-floor worksite. The first intervention involved a "health" sign that linked stair use to health and fitness; it was placed at the junction between the staircase and the elevator. The second intervention involved an additional e-mail sent a week later by the worksite's doctor, pointing out the health benefits of regular stair use. Stair use increased significantly from 69% at baseline to 77% in the week after the first intervention, c2 (1) = 12.97, p < .001. Moreover, compared with the first intervention, stair use increased significantly to 85% in the week after the second intervention, c2 (1) = 15.58, p < .001. However, stair use decreased to 67% in a follow-up one month after the sign was removed, and was not significantly different from baseline, c2 (1) = 0.41, p = .52. These results suggest that simple and inexpensive interventions such as a health sign in combination with an e-mail sent by the worksite's doctor can encourage female employees to use the stairs. However, it appears that sustained effort is needed to consolidate these effects. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: To examine the psychological effects of a minimal-contact physical activity intervention that was integrated in the existing structures of a women''s organization and to detect possible mechanisms that might mediate these effects. Methods: Members (n =108) of four units of a women''s organization participated in a 6-month intervention that included one group meeting, a self-help booklet and five monthly reminder letters. Two other units (n =110) served as control group. Primary outcomes were psychological well-being, physical well-being and trait anxiety, which were assessed by self-report questionnaires before and after the intervention. Results: There was a significant time by group interaction for psychological well-being and trait anxiety. The control group reported significantly less psychological well-being at posttest, while there was no change in the intervention group. For trait anxiety, there was a significant decrease in the intervention group and no change in the control group. No significant results were found for physical well-being. The effects of the intervention on psychological well-being and trait anxiety were partly mediated by changes in perceived benefits and barriers of physical activity and by changes in self-efficacy, but not by changes in physical activity. Conclusions: The present intervention may have been effective in countering the seasonal decrease in psychological well-being during winter, and in decreasing trait anxiety. These effects were partly mediated by changes in perceived benefits and barriers of physical activity and by changes in self-efficacy. The minimal-contact hours and the use of existing structures are important strengths for later implementation. [Copyright &y& Elsevier]