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BACKGROUND: People at high risk of severe illness from COVID-19 have experienced greater restrictions during the pandemic, yet there is a paucity of research exploring their lived experience. OBJECTIVES: This study explored the impact of COVID-19 on people identified as at high risk of severe illness by UK Government, and in particular, the impact of the first lockdown on access to healthcare, medications and use of technological platforms. METHODS: 1038 UK adults who identified as at high risk of severe illness from COVID-19 in line with UK Government guidance or self-identified with acute or other chronic health conditions, completed the Awareness, Attitudes and Actions survey which explored the impact of COVID-19 on access to healthcare, management of long-term health condition, mental health, and health behaviours. RESULTS: Most participants reported feelings of vulnerability, anxiety and isolation, noticed that other people changed their behaviour towards them including a feeling of being stigmatised by people not categorised as high risk. Participants described the largely negative impact that the COVID-19 lockdown had on to health-related behaviours and access to healthcare, which had resulted in large declines in mental health and wellbeing. Participants also indicated disappointment at the UK Governments response and handling of the COVID-19 lockdown. IMPLICATIONS: This study provides novel evidence of the lived experience of the first COVID-19 lockdown for people identified as at high risk of severe illness. In the context of behavioural health interventions, the ubiquity of digital technologies and their adoption into day-to-day life translates into greater potential reach than traditional interventions, and consequently, greater potential for positive public health impact. Findings should be considered by policymakers and healthcare professionals to support people now and as we transition through the recovery phase with a particular emphasis on supportin

OBJECTIVE: News media play a role in politics through the portrayal of policies, influencing public and policymaker perceptions of appropriate solutions. This study explored the portrayal of sugar and sugar-sweetened beverage (SSB) taxes in UK national newspapers. Findings aid understanding of the role newspapers play in shaping understanding and acceptance of policies such as the UK Soft Drink Industry Levy (SDIL). DESIGN: Articles discussing sugar or SSB taxes published in six UK national newspapers between 1 April 2016 and 1 May 2019 were retrieved from the LexisNexis database. Articles were thematically analysed to reveal policy portrayal. SETTING/PARTICIPANTS: Analysis of UK newspaper articles. RESULTS: Two hundred and eighty-six articles were assessed. Sugar and SSB taxes were discussed across the sample period but publication peaked at SDIL announcement and introduction. Themes were split according to support for or opposition to taxation. Supportive messaging consistently highlighted the negative impacts of sugar on health and the need for complex actions to reduce sugar consumption. Opposing messages emphasised individual responsibility for health and the unfairness of taxation both for organisations and the public. CONCLUSIONS: Sugar and SSB taxes received considerable media attention between 2016 and 2019. All newspapers covered arguments in support of and opposition to taxation. Health impacts of excess sugar and the role of the soft drink industry in reducing sugar consumption were prevalent themes, suggesting a joined-up health advocacy approach. Industry arguments were more varied, suggesting a less collaborative argument. Further research should investigate how other media channels portray taxes such as the SDIL.

Objective: The National Child Measurement Programme (NCMP) is a mandatory initiative delivered in England to children in reception and year 6. To date, no research has explored the methods used to deliver the NCMP by Local Government Authorities (LGA) across England. Design: An online survey was administered between February 2018 and May 2018 to explore the delivery of the NCMP across the 152 LGAs in England and disseminated using non-probability convenience sampling. Setting: LGAs received an anonymous link to the survey. Participants: A total of 92 LGAs participated in the survey. Results: Most LGAs who responded provide result feedback (86%), a proactive follow-up (71%) and referrals to services (80%). Additionally, 65% of the authorities tailor Public Health England specimen result letters to suit their needs, and 84% provide attachments alongside. Out of 71% of LGAs who provide proactive follow-up, 19 (29%) provide the proactive follow-up only to upper weight categories, and only 4 (6 %) include Healthy Weight category with other categories in proactive follow-up. Regarding the service availability for children, out of 80% of LGAs who indicated that services are available, 32 (43%) targeted solely upper weight categories while the other 42 (57%) offered services across all weight categories. Finally, most LGAs (88%) commission providers to manage various parts of the NCMP. Conclusions: The results show that LGAs in England localise the NCMP. Further guidance regarding standards of best practice would help LGAs to find the most suitable localisation out of various options that exist across other LGAs.

Over time, there has been a steady increase of workplace health promotion programs that aim to promote employees’ health and fitness. Previous research has focused on such program’s effectiveness, cost-savings, and barriers to engaging in workplace health promotion. The present research focuses on a downside of workplace health promotion programs that to date has not been examined before, namely the possibility that they, due to a focus on individual responsibility for one’s health, inadvertently facilitate stigmatization and discrimination of people with overweight in the workplace.

Objective: The objective was to examine differences in physical activity, sitting time and perceptions of physical activity and health between Pokémon Go users and nonusers at baseline (launch of the application in the United Kingdom) and 3-month follow-up. Materials and Methods: The self-administered, short version of the 7-day recall, International Physical Activity Questionnaire, was adapted to develop the “Physical Activity and Pokémon Go questionnaire,” which was distributed using social media. Four weeks after the launch of the application, 461 participants (n = 193 male, n = 265 female, n = 3 transgender) had completed the questionnaire. At 3-month follow-up, 127 participants repeated the questionnaire. Results: At baseline, mixed models analysis of variance (ANOVA) revealed main effects for Pokémon Go users versus nonusers in the amount of days of vigorous physical activity, moderate physical activity, and walking (All P < 0.01). Users reported that they undertook less days of vigorous physical activity than nonusers, but more days of moderate physical activity and walking. There were no differences in body mass index, minutes of vigorous or moderate physical activity, and walking, or sitting on weekdays (All P > 0.05). Repeated measures ANOVA identified increased sitting on weekdays (P < 0.05), but maintained vigorous, moderate and walking physical activity behaviors in users who remained users. Conclusion: Pokémon Go use can increase the frequency of days of physical activity benefitting health. Users at both time points maintained their physical activity behaviour, but increased sitting time on weekdays, highlighting that another intervention to prevent sitting is needed.

Weight stigma typically focuses on suggestions that people with overweight and obesity are incompetent and immoral. Integrating so far unconnected lines of research, the current research presents two studies that examine the motivational relevance of these aspects of weight stigma. Specifically, we tested the proposition that people with overweight and obesity respond differently to the public viewing them as incompetent compared to immoral, as these aspects of weight stigma differ in reparability. We expect that threats to competence are more acceptable and thus related to a constructive response that is more effective in losing weight in the long-run. By contrast, we propose that threats to morality elicit an acute urge to defend one’s moral image, thereby prompting responses that are more visible to the social environment, but potentially less effective for losing weight. Study 1 experimentally compared exposure to weight stigma focused on morality vs. weight stigma focused on competence in a sample of adults with overweight and obesity (N = 122; MBMI = 31.89, SDBMI = 4.39). We found that when exposed to weight stigma focused on morality, people with overweight and obesity respond by defending their moral image but that this is less effective for encouraging weight loss, whilst exposure to weight stigma focused on competence led to an increased likelihood of engagement in weight loss behaviors. Complementing and extending the findings, Study 2 (N = 348, MBMI = 26.78, SDBMI = 6.78) tested the notion that internalized weight bias predominantly revolves around moral concerns, and thus will lead to less self-determined behavioral regulation. We found strong support for the moral core of weight bias internalization. In line with our predictions, greater weight bias internalization was associated less self-determined and more other-determined regulation of dieting and exercising. This suggests that weight bias internalization operates as a facilitator of maladaptive be

Objective Three dimensional (3D) surface imaging is a viable alternative to traditional body morphology measures, but the feasibility of using this technique with people with obesity has not been fully established. Therefore, the aim of this study was to investigate the validity, repeatability and acceptability of a consumer depth camera 3D surface imaging system in imaging people with obesity. Methods The concurrent validity of the depth camera based system was investigated by comparing measures of mid-trunk volume to a gold-standard. The repeatability and acceptability of the depth camera system was assessed in people with obesity at a clinic. Results There was evidence of a fixed systematic difference between the depth camera system and the gold standard but excellent correlation between volume estimates (r2 = 0.997), with little evidence of proportional bias. The depth camera system was highly repeatable – low typical error (0.192 L), high intraclass correlation coefficient (>0.999) and low technical error of measurement (0.64%). Depth camera based 3D surface imaging was also acceptable to people with obesity. Conclusion It is feasible (valid, repeatable and acceptable) to use a low cost, flexible 3D surface imaging system to monitor the body size and shape of people with obesity in a clinical setting.

The aim of this study was to qualitatively examine weight stigma in individuals who exercise frequently. In total, six focus groups, comprising 30 participants aged 18-25 years, were conducted using convenience sampling. All participants were frequent exercisers. Five themes emerged in the data with participants discussing bullying, the consequences of obesity, causes of obesity, lack of willpower and interventions to reduce obesity. This study is the first qualitative examination of weight stigmatisation in frequent exercisers, where the beliefs reported by focus group participants suggest that frequent exercisers stigmatise, discriminate and dehumanise obese people. Future research to examine the impact of weight stigma on exercise motivation and behaviour of obese people appears warranted.

This chapter introduces you to, and defines, physical activity and sedentary behaviour. It highlights the low levels of the population meeting the recommendations of physical activity in the UK. Thus, interventions are needed to increase physical activity levels. Using a lifespan approach, we introduce you to key interventions. Case studies highlight the key components of these interventions as well as what community sports managers need to consider when developing their own approaches through the highlighting good practice.

This aim of this paper was to explore commonalities between HIV/AIDS related conditions, obesity and other disabling impairments as health-related barriers that limit opportunity and advancement in society and the workplace. Taking a number of examples from original fieldwork and European Union and United Kingdom law, we posit that ‘disability discrimination’ under European Union law remains an indefinite, imprecise and incomplete area that requires greater alignment with the social model of disability. The principle attributes of societal discrimination towards people living with HIV and obese people are that these conditions are perceived to be primarily or in some instances, solely caused by controllable factors related often to behaviours and lifestyle choices. Strong beliefs that these conditions are controllable, is perceived as a justification and in some instances encouragement for the creation of stigma and discriminative behaviours that are unjust and uninformed. The structure of the paper is as follows. First, this paper postulates how and why stigma exists towards both individuals with disabilities and also obese individuals and people living with HIV; second, reviews the legal framework on disability discrimination in both United Kingdom and European Union courts that are directly relevant to the concepts of obesity and HIV-AIDS; third, presents critical thoughts as to the extent to which emerging decisions of the Court of Justice of the European Union concerning obesity and HIV-AIDS accord with the social model of disability; and fourth, offers an analysis of the implications of the United Kingdom and European framework and suggests possible interventions in this area.

OBJECTIVE: Current UK workplace health promotion guidance recommends that employers minimize sedentary behaviors, but understanding the issues relating to prolonged workplace sitting has received little empirical attention. This study aimed to explore employees' perceptions of sitting time. METHODS: Participants at a small to medium-sized UK company were invited to join one of five focus groups. A framework analysis approach was used. RESULTS: Self-reported mean estimate of occupational sitting time was 6.4 hours/day with a mean estimate of leisure time sitting 6.5 hours/nonwork days. The study highlighted employees' lack of appreciation of the health risks associated with sedentary behavior. CONCLUSION: This study has highlighted that in addition to personal determinants, the workplace environment and organizational culture have a key role in supporting employees' potential adoption of healthier sitting behavior in the workplace.

Amateur players far outnumbered professional athletes, but they are often under shadowed in literatures. Unlike professional athletes, amateur players may not possess the resources, knowledge or guidance in treating sports injuries. Soccer is one of the popular sports with fewer literatures addressing amateur players. Quantitative method was used for data collection and analysis. The practical contribution of this study lies in terms of the exploring of risks factors leading to lower limb injuries, most common type and area of injuries faced by amateur soccer players in contrast with professional players. Preventive measures were also discussed. The implications of these findings are valuable to coaches, physical therapists and governments for understanding amateur players and arouse public awareness on health and safety.

Objective: The purpose of this study was to investigate the validity and reliability of the Timed Up and Go Test (TUG) among normal 3-5 years old preschool children in Hong Kong. Methods: Cross-sectional design was applied to this study. Sixty (30 female, 30 male) preschool children aged from 3 to 5 years old (mean age=4.22 ± 0.85) from local normal preschool was recruited using convenient sampling to perform three dynamic balance tests: Timed Up and Go Test (TUG), Star Excursion Balance Test (SEBT) and the Pediatric Balance Scale Test (PBS). A simple self-administrative questionnaire survey was also conducted with their parents. Results: Positive correlation (r=0.74, p<0.05) was found between TUG results obtained at two time points when assessing the test-retest reliability. Moderated negative correlations were found between TUG and SEBT or PBS, which indicated children with longer reaching distance or higher PBS score tend to use shorter time to complete TUG. Conclusion: TUG was a valid and reliable tool for assessing dynamic balance of preschool children aged between 3 and 5 years old. This can also be used for screening or early detection of developmental coordination disorder (DCD) for children aged 6 years old or younger.

domains. The aim of this study was to identify the potential dropout reasons of school athletes and to examine if their perception of dropout was affected by the previous dropout experience. There were 50 subjects who were divided into two groups based on their previous dropout experience (Dropout Group=22, No Dropout Group=28). They filled a questionnaire about potential dropout reasons of the current sport. Coach and teammates were two predominated reasons of dropout; Influence of parent and training seemed to affect the termination of the sport to a lesser extent. Moreover, the perception of social value and lost focus were significantly different between two groups. Character of coach and teammates affect the engagement of training in school athletes. However, the parental influence had less influence than expected. Training intensity played little role as the dropout reason. Previous experience of dropout had an impact of potential dropout reasons on their current sport training.

Objective: The purpose of this study was to examine the test-retest reliability and the criterion validity of a curlup test (CUT) as a measure of core stability, core endurance and dynamic stability in kindergarten children. CUT performance was also compared to half hold lying test (HHLT) and walking time on course (WTC) among without obstacle, with low obstacle and high obstacle measures of core stability, core endurance and dynamic stability. Methods: To estimate reliability, 33 males and 27 female kindergarten children (M aged=4.5 years old) performed the CUT on 2 different days. In the validity phase of the study, scores of all participants were obtained on three field test measures of core stability, core endurance and dynamic stability (CUT, HHLT and WTC). Results: Results indicate that the MCU test has no significant correlation on intra-class test-retest reliability (R=0.13, p>0.01). The criterion validity of the CUT for kindergarten children has is comparable to that of the HHLT(r=0.98, p<0.01) and WTC without obstacle(r=0.96, p<0.01), with low obstacle (r=0.96, p<0.01) and with high obstacle (r=0.98, p<0.01). Result indicates that the CUT test cannot produces reasonably accurate and stable measures of core stability, core endurance and dynamic stability. Conclusion: These preliminary findings provide evidences into the CUT test cannot produces reasonably accurate and stable measures of core stability, core endurance and dynamic stability for kindergarten children.

© 2016, © Emerald Group Publishing Limited. Purpose – The purpose of this paper is to highlight and encourage consideration of the ethical and in some instances legal implications of managerial change in the English Premier League (EPL) which often gets overlooked and sidestepped by clubs. Design/methodology/approach – Extant literature relating to managerial change is identified and discussed to provide the foundations of the discussion of whether managerial change in the EPL which is primarily focused on performance outcome, is neglecting ethical and legal issues. Findings – The loophole that exists in the Employment Rights Act (1996) allows clubs to instantly dismiss a manager and consequently not see out their notice period as agreed in their contract or the statutory notice period. Whilst legally clubs are at will to act in this manner, the instability of EPL management evident today appears to have taken away the rights of an employee. Research limitations/implications – Greater consideration of the current managerial change practices in EPL from an ethical and legal perspective appears warranted. The incomparable rights that a player and a manger have relating to their tenure at a club seem somewhat unfair. Originality/value – Presents thought-provoking information relating to managerial change in the EPL which appears to have been overlooked in the literature to date which primarily focuses on the impact of change on performance.

AIMS: Alongside the increasing prevalence of chronic health conditions such as cardiovascular disease and diabetes has been an increase in interventions to reverse these ill-health trends. The aim of this study was to examine the longitudinal impact of the Sheffield Hallam University Staff Wellness Service on health indicators over a five-year period. METHODS: The Sheffield Hallam Staff Wellness Service was advertised to university employees. Of 2651 employees who have attended the service, 427 respondents (male = 162, female = 265) aged 49.86 ± 12.26 years attended for five years (4 years follow-up). Each year, participants were assessed on a range of health measures (i.e. cardio-respiratory fitness, body mass index, blood pressure, total cholesterol, high-density lipoproteins, lung function and percentage body fat). Participants also received lifestyle advice (based on motivational interviewing) as part of the intervention to either improve, or in some cases maintain, their current health behaviours (e.g. increased physical activity and diet change). RESULTS: The wellness service improved staff health for those with an 'at risk' health profile from baseline. These improvements were maintained in subsequent follow-up assessments. Improvement from baseline to 1-year follow-up was observed for all health indicators as was the maintenance of this improvement in years 2, 3 and 4. CONCLUSIONS: The service demonstrates that a university-based wellness service using a combination of motivational interviewing and health screening to elicit behaviour change (and subsequent improvements in health-related outcomes) was successful in improving the health of employees with an 'at risk' profile.

BACKGROUND: To date research examining the benefits of menu labelling in the UK is sparse. The aim of the present study was to examine the impact of menu labelling in a UK obese population. METHODS: Using a repeated measures design, 61 patients at a tier 3 weight management service completed four questionnaires to assess their food choice (control) and behaviour change when presented with 3 menu labelling formats (calorie content; nutrient content; and energy expenditure). RESULTS: All three forms of labelling increased participants weight control concerns compared to the control condition. There was a significant difference in content of food ordered in the three menu labelling formats compared to the control condition. The calorie condition had the largest percentage decrease in calories selected followed by energy expenditure and nutrient content. However, no difference was observed between the three conditions in the desire for menu labelling in restaurants to be introduced in the UK. CONCLUSIONS: The findings suggest that menu labelling should be enforced in the UK as it is both beneficial to promoting healthy eating and in demand. This study is the first to examine menu labelling in a UK obese population using energy expenditure equivalents to provide nutritional information.

Obesity is a major medical health challenge; however, the associated stigma represents a harmful and obstructive obstacle to treatment. The study purpose was to explore the portrayal of obesity in UK national newspapers. A purposive sample of 312 editions (weekday: n = 208; weekend: n = 104) from six newspapers (3 broadsheet; 3 tabloid) was analyzed. All text related to obesity was content analyzed. In total 349 articles were analyzed. Weight stigmatization and the portrayal of overweight and obesity as a moral digression were evident. Findings demonstrate that UK national newspapers attribute obesity to controllable causes. Caricatured portrayals of overweight and obesity was evident and may play a pivotal role in the formation and maintenance of anti-obesity attitudes.

Obesity discrimination in employment and recruitment has become a topic of focus for research examination with increasing reports of discrimination by colleagues and managers. Whilst a limited number of legal cases have emerged, disability law is consulted in line with the expectation of anti-discriminatory practices at work. In line with disability law, whether obesity is defined as a disability or not has an impact on the outcome of a court ruling. Ambiguity when defining obesity through either the medical or social model means there are many questions that remain unanswered which might lead to inconsistency in court rulings.

© Emerald Group Publishing Limited.Purpose – The purpose of this paper is to examine the competitive balance of the UEFA Champions League group stages. There are numerous financial and commercial benefits to clubs that participate in this competition. The current paper examines whether the seeding system operated by UEFA is hindering some lower ranked teams from qualification and, thus, the associated benefits. Design/methodology/approach – Data were collected for all UEFA Champions League group stages between1999/2000 and 2013/2014. Data analysis techniques included Herfindahl-Hirschman Index to examine competitive balance and one-way ANOVAs to examine the impact of the current seeding system on club performance. Findings – The findings suggest that there are flaws in the ranking and seeding system used by UEFA, as results show that the competition is competitively imbalanced at the group stage. Additionally, clubs that are continually placed in the highest seeding pot historically tend to accumulate more points and finish in a higher position in the group, thereby giving them a better opportunity to progress further in the competition. Research limitations/implications – The study has implications for both the clubs competing in the Champions League, who will be affected by the seeding system, and UEFA themselves when considering the sporting integrity of their flagship competition. Originality/value – To the authors’ knowledge, this is the first paper of its kind to examine competitive balance in this competition, and the paper contributes new knowledge that extends the research undertaken in the field previously.

Background: Anti-fat attitudes may lead to stigmatisation of and lowered self-esteem in obese people. Examining anti-fat attitudes is warranted given that there is an association with anti-fat behaviours. Previous studies, mainly outside the UK, have demonstrated that anti-fat attitudes are increasing over time. Methods: The study was cross-sectional with a sample of 2380 participants (74.2 % female; aged 18–65 years). In an online survey participants reported demographic characteristics and completed a range of implicit and explicit measures of obesity related attitudes. Results: Perceptions of obesity were more negative than reported in previously. Main effects indicated more negative perceptions in males, younger respondents and more frequent exercisers. Attitudes about obesity differed in relation to weight category, and in general were more positive in obese than non-obese respondents. Conclusions: This is the first study to demonstrate anti-fat attitudes across different sections of the UK population. As such, this study provides the first indication of the prevalence of anti-fat attitudes in UK adults. Interventions to modify these attitudes could target specific groups of individuals with more negative perceptions as identified here. Future work would be useful that increases understanding of both implicit and explicit attitudes towards obesity.

This study examined the effect of anti-fat attitude counter-conditioning using positive images of obese individuals participants completed implicit and explicit measures of attitudes towards fatness on three occasions: no intervention; following exposure to positive images of obese members of the general public; and to images of obese celebrities. Contrary to expectations, positive images of obese individuals did not result in more positive attitudes towards fatness as expected and, in some cases, indices of these attitudes worsened. Results suggest that attitudes towards obesity and fatness may be somewhat robust and resistant to change, possibly suggesting a central and not peripheral processing route for their formation.