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Background: Obesity is a growing epidemic with non-surgical/non-pharmacological interventions having only nominal and transient effects on excess weight. Those persistent shortcomings are associated with minimal understandings of impacts of treatment-associated changes in psychological variables and their relationships. Women of lower incomes have high rates of obesity and might have increased difficulties accessing evidence-based programs. Methods: Women with obesity of lower- to lower-middle incomes participated in 6-month community-based treatments in the United States emphasizing either self-regulatory skills development (behavioral methods group: n = 63) or typical education in exercise and healthy dietary practices (education group: n = 48). Results: There were significant 6-month improvements in self-regulation, self-efficacy, mood, physical activity/exercise, dietary behaviors, and weight in both groups. All improvements were significantly greater in the behavioral group. Based on the incorporation of multiple behavioral theories, separate multiple regression models were fit for prediction of the weight-loss behavior changes. Stepwise entry of changes in self-regulation, self-efficacy, and mood each significantly contributed to the explained variance in physical activity/exercise change. Change in self-efficacy was most relevant in the prediction of change in dietary behaviors. Change in physical activity/exercise was significantly related to change in dietary behaviors; however, a regression analysis indicated that only physical activity/exercise change was a significant independent contributor to the overall accounted-for variance in lost weight. Conclusion: By incorporating key tenets of social cognitive theory, self-efficacy theory, self-regulation theory, coaction theory, and the mood-behavior model in an additive manner, suggestions and emphases for addressing psychological variables for improved weight-loss behaviors within scalable obesity treatments were advanced. [ABSTRACT FROM AUTHOR]

Abstract Background Women experiencing problematic menopausal symptoms report lower health-related quality of life and greater healthcare use than women without symptoms. Not all women want to or are able to take hormone replacement therapy. Strengthening the evidence for menopause symptom-management options, including physical activity, improves agency for women. Aim This overview assesses effectiveness of physical activity and exercise interventions targeting women experiencing menopause symptoms. Methods Medline, Embase, CINAHL, Scopus, The Cochrane Database of Systematic Reviews and Social Science Citation Index were searched (June 2023) for systematic reviews of physical activity and exercise interventions targeting women experiencing menopause. Reviews were assessed using AMSTAR-2 and a best-evidence approach to synthesis without meta-analysis (SWIM) was adopted. The protocol was registered on PROSPERO (CRD42022298908). Results Seventeen reviews included 80 unique relevant primary studies with 8983 participants. There is evidence showing improvement of physical, urogenital, and total symptoms following yoga interventions. Evidence for vasomotor and psychological symptoms was inconclusive. Findings for aerobic exercise were inconclusive although there were some examples of beneficial effects on total and vasomotor symptoms. Evidence was very limited for other types of physical activity and impact on physical, sexual and urogenital symptoms. Conclusion There is some evidence that yoga, and to lesser extent, aerobic exercise may be beneficial for some menopause symptoms, but there is insufficient evidence to recommend a particular form of exercise. Current reviews categorise women on menopause status; broadening this to include ethnicity, income status, employment and other factors will allow better understanding of context for successful interventions.

Breast Cancer Associated Susceptibility Proteins Type 1/2 (BRCA1/2) promote cellular functioning by modulating NRF2-mediated antioxidant signaling. Redox failure in women with BRCA1/2 insufficiency increases the risk for breast/ovarian/uterine cancers. Risk-reducing salpingo-oophorectomy (RRSO) is a prophylactic surgery of the reproductive organs, which is frequently conducted by the age of 40 to lower the occurrence of cancer in women with BRCA1/2 mutations. However, abrupt estrogen decline following RRSO causes ovarian failure, which implicates various cellular physiological processes, resulting in the increased release of free radicals and subsequent severe onset of menopausal symptoms. Comfort measures (e.g., hormonal replacement therapy (HRT) and mindfulness-based stress reduction (MBSR)) may improve chronological menopause-related quality of life, but their specific effects are not clear in women with gene mutations. Aiming to fill the gap, this study used path analysis to examine the effects of HRT and MBSR on menopausal symptoms among RRSO patients (N = 199, mean age = 50.5 ± 6.7 years). HRT directly alleviated the levels of urogenital symptoms (β = −0.195, p = 0.005), which mediated its indirect significant effects on the somatic–vegetative and psychological symptoms of menopause (β = −0.046, −0.067; both p values = 0.004, respectively), especially in BRCA2 carriers and in women who were currently physically active, premenopausal at the time of RRSO, had a high BMI, and had no history of breast cancer. It increased the severity of urogenital symptoms in women with a history of cancer. MBSR, on the other hand, was associated with indirect increases in the intensity of the somatic–vegetative and psychological symptoms of menopause (β = 0.108, 0.029; p = 0.003, 0.033, respectively). It exerted positive direct effects on different menopausal symptoms in multigroup analysis. The results suggest that young women undergoing recent RRSO may benefit from HRT at an individual level, while their need for extensive measures to optimize their psychological wellbeing is ongoing. The adverse effects of MBSR, which are captured in the present study, imply that MBSR may interfere with redox sensitivity associated with estradiol fluctuations in BRCA1/2 carriers. Investigations are needed to test this hypothesis and elaborate on the underlying mechanisms in these women. [ABSTRACT FROM AUTHOR]

Background: Women experiencing problematic menopausal symptoms report lower health-related quality of life and greater healthcare use than women without symptoms. Not all women want to or are able to take hormone replacement therapy. Strengthening the evidence for menopause symptom-management options, including physical activity, improves agency for women. Aim: This overview assesses effectiveness of physical activity and exercise interventions targeting women experiencing menopause symptoms. Methods: Medline, Embase, CINAHL, Scopus, The Cochrane Database of Systematic Reviews and Social Science Citation Index were searched (June 2023) for systematic reviews of physical activity and exercise interventions targeting women experiencing menopause. Reviews were assessed using AMSTAR-2 and a best-evidence approach to synthesis without meta-analysis (SWIM) was adopted. The protocol was registered on PROSPERO (CRD42022298908). Results: Seventeen reviews included 80 unique relevant primary studies with 8983 participants. There is evidence showing improvement of physical, urogenital, and total symptoms following yoga interventions. Evidence for vasomotor and psychological symptoms was inconclusive. Findings for aerobic exercise were inconclusive although there were some examples of beneficial effects on total and vasomotor symptoms. Evidence was very limited for other types of physical activity and impact on physical, sexual and urogenital symptoms. Conclusion: There is some evidence that yoga, and to lesser extent, aerobic exercise may be beneficial for some menopause symptoms, but there is insufficient evidence to recommend a particular form of exercise. Current reviews categorise women on menopause status; broadening this to include ethnicity, income status, employment and other factors will allow better understanding of context for successful interventions. [ABSTRACT FROM AUTHOR]

Background and Objectives The primary aim of this Stage IB randomized controlled trial (RCT) was to test the preliminary effects of a dual-task exergaming telerehabilitation intervention on cognition and aerobic fitness, compared to aerobic exercise (AEx) only and attention control (stretching) in older adults with subjective cognitive decline. Research Design and Methods This RCT randomized 39 participants on a 2:1:1 allocation ratio to supervised exergame (n  = 20), AEx (n  = 11), and stretching (n  = 8) for 12 weeks. The dual-task exergaming was concurrent moderate-intensity cycling and BrainFitRx cognitive telerehabilitation. Cognition was assessed by NIH Toolbox Cognitive Battery and aerobic fitness by 6-minute walk test (6MWT) and shuttle walk test. Results The participants were 74.6 (7.4) years old and 69% were female. The effect of time was significant, F (1, 23.9) = 13.16, p  = .001, for the Fluid Composite score, and significant within-group changes were seen for the exergame group, t (14.08) = 2.53, p  = .024, d  = 0.33. Between-group changes did not reach significant levels for any cognitive test. Between-group changes for the 6MWT were not significant. Discussion and Implications The exergame participants further improved their fluid cognition, whereas the AEx and stretching groups did not, indicating a potential synergistic effect from AEx and cognitive training. The aerobic fitness changes were similar between the exergame and AEx-only groups, indicating that the feasibility of adding cognitive training to AEx concurrently without sacrificing gains in aerobic fitness from AEx. This study shows the flexibility of exergame delivery and its potentially therapeutic effects in persons at risk for Alzheimer's dementia. Clinical Trial Registration Number NCT04311736 [ABSTRACT FROM AUTHOR]

Just-in-time adaptive interventions (JITAIs) are a novel approach to mobile health (mHealth) interventions, sending contextually tailored behavior change notifications to participants when they are more likely to engage, determined by data from wearable devices. We describe a community participatory approach to JITAI notification development for the myBPmyLife Project, a JITAI focused on decreasing sodium consumption and increasing physical activity to reduce blood pressure. Eighty-six participants were interviewed, 50 at a federally qualified health center (FQHC) and 36 at a university clinic. Participants were asked to provide encouraging physical activity and low-sodium diet notifications and provided feedback on researcher-generated notifications to inform revisions. Participant notifications were thematically analyzed using an inductive approach. Participants noted challenging vocabulary, phrasing, and culturally incongruent suggestions in some of the researcher-generated notifications. Community-generated notifications were more direct, used colloquial language, and contained themes of grace. The FQHC participants' notifications expressed more compassion, religiosity, and addressed health-related social needs. University clinic participants' notifications frequently focused on office environments. In summary, our participatory approach to notification development embedded a distinctive community voice within our notifications. Our approach may be generalizable to other communities and serve as a model to create tailored mHealth notifications to their focus population. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic introduced lifestyle changes that appeared to impact adults' engagement in health-promoting activities. Researchers observed increased stress, sleep problems, and sedentary activity, and decreased physical activity during the pandemic. This secondary analysis examined the frequency that adults engaged in different daily activities and links between activity types, stress, and sleep during the pandemic. Fifty-three adults completed a single online survey in January 2021 where they reported demographics, COVID-19 pandemic experiences, daily activities, stress, and sleep. Sum scores were calculated to indicate total frequency of different activity types. Regressions were used to examine whether the frequency of different activity types predicted sleep duration and stress. There was a trend-level relationship between the frequency of activities done outdoors and stress scores, such that doing outdoor activities more often was linked with less stress (P =.098). Higher income also tended to be linked with more stress (P =.053), as did younger age (P =.028). When restricting the outdoor activity variable to physical outdoor activities only, the relationship with stress became significant (P =.013). These results suggest that engaging in physical activity outdoors may reduce stress during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

• PA alone associates with better physical QOL in early-stage MS. • PA is associated with physical QOL regardless of fatigue and disability status. • PA is not directly associated with mental QOL in early MS. • PA promotion could enhance QOL among persons newly diagnosed with MS. To examine the association between physical activity (PA) and quality of life (QOL) in persons newly diagnosed with multiple sclerosis (MS) who have been under-represented in MS research. Cross-sectional study with secondary data analysis. General community. The study included 152 persons newly diagnosed with MS (ie, diagnosed with MS within the past 2 years) aged 18 and older (N=152). Participants completed the Godin Leisure-Time Exercise Questionnaire to measure PA. QOL, disability status, fatigue, mood, and comorbidity were assessed using the 12-Item Short Form Survey (SF-12), Patient Determined Disease Steps, Hamburg Quality of Life Questionnaire Multiple Sclerosis, and comorbidity questionnaire. The bivariate correlations indicated that PA was significantly and positively associated with the physical component of QOL (ie, SF-12 PCS) (r =0.46). The stepwise multiple linear regression analysis indicated PA as associated with SF-12 PCS (β=0.43, R2 =0.17) when solely included in the model. After controlling for fatigue, mood, disability status, and comorbidity as covariates (R2 =0.63), the association between PA and SF-12 PCS was still statistically significant, but attenuated in magnitude (β=0.11). This study observed that PA was significantly associated with the physical component of QOL in persons newly diagnosed with MS, even after controlling for covariates. The findings underscore the importance of developing behavior change interventions targeting PA while addressing the roles of fatigue and disability status for enhancing the physical component of QOL of this MS subpopulation. [ABSTRACT FROM AUTHOR]

Background Guidelines recommend general practitioners (GPs) take every opportunity to talk to people living with obesity about their weight, and evidence shows even very brief advice is associated with weight loss. However, little is known about what GPs say when giving brief behavioural advice, and if it reflects evidence-based recommendations for people living with obesity. To understand what behavioural advice GPs give, we categorized the content and delivery of GPs' advice during brief interventions. Methods Qualitative content analysis was applied to 159 audio recordings of consultations from the Brief Interventions for Weight Loss (BWeL) trial, where GPs gave brief weight-loss advice to patients with a body mass index ≥30 kg/m2 (or ≥25 kg/m2 if Asian) in 137 UK surgeries. Similar content was grouped into descriptive clusters. Results The results comprised 4 clusters, illuminating different aspects of the advice given: (i) Content of diet and physical activity advice, showing this was highly varied; (ii) Content of "implementation tips" given to support changes, e.g. using smaller plates; (iii) Content of signposting support, either towards further clinician support, or other resources, e.g. information booklets; (iv) Style of advice delivery, showing GPs rarely gave personalized advice, or reasons for their advice. Conclusions and implications Weight-loss advice from GPs to patients with obesity rarely included effective methods, mostly communicating a general "eat less, do more" approach. Advice was mostly generic, and rarely tailored to patients' existing knowledge and behaviours. Effectiveness of brief weight-loss advice could be improved if GPs were given clearer guidance on evidence-based recommendations. [ABSTRACT FROM AUTHOR]

One-third of American children are obese (13.7 million children). Although there are programs and strategies to address this issue, there is limited evidence regarding the role teachers and parents play as role models for healthy behaviors among preschool- aged children. This interventional study examined the impact educating parents and teachers as role models had on preschool-aged children's healthy behaviors (eating and physical activity). Parents and teachers in a public preschool in Newark, New Jersey, were invited to attend. Thirty-seven parents, teachers, and teacher aides representing 37 unduplicated children ages 3 to 5 years participated in the study. More than three-quarters of participants (83.8%, n = 31) were parents, and the remainder were teachers or teacher aides (16.2%, n = 6). The program was structured as a weekly 45-minute session over four weeks. Statistically significant results indicated that children's fruit and vegetable consumption increased by three servings from an average of one to five servings a day. Furthermore, the number of days children shared dinner and breakfast with the family increased from an average of two to five days a week, and children reduced eating takeout food by an average two days a week. There was also a 2-hour decline in the time children spent watching TV or playing video games, from slightly above 3.5 hours on average to 1.5 hours after the intervention. This family-centered/school-focused obesity intervention produced significant improvements in healthy behaviors for both adults and children. Educating parents and teachers to serve as role models for preschool children may contribute to decreasing the childhood obesity epidemic in the United States. [ABSTRACT FROM AUTHOR]

Background: Built environment approaches are recommended to improve population physical activity levels. Implementation strategies are needed to improve uptake, but little is known about effective strategies to translate research to practice in community settings. Purpose: Inform implementation strategies through understanding delivery agents' perceptions of (1) built environment approaches, (2) a toolkit developed to support implementation, and (3) other required implementation strategies. Method: A toolkit was developed to detail the process of partnering to change the built environment and provide examples of built environment approaches (e.g., walking paths, traffic calming). Data were collected through focus groups (N = 3) with Extension Agents (n = 46) in 2020. The semi-structured focus group script was based on the Consolidated Framework for Implementation Research and the Technology Acceptance model. Rapid content analysis techniques and a deductive, grounded theory approach were used to interpret the data. Results. Focus groups generated meaning units coded into themes of perceptions of the intervention (subthemes: barriers, resources needed, and facilitators) and perceptions of the toolkit (subthemes: components to add, positive perceptions, and helpful components). The most common resources needed were coalition guidance and funding. Conclusion: Agents experience barriers and facilitators to implementing built environment approaches and have specific needs for support. Based on the results, we created implementation strategies: (1) Places for Physical Activity toolkit, (2) Coalition Coaching, and (3) Mini-Grants. Future work is needed to investigate the effectiveness of these implementation strategies. [ABSTRACT FROM AUTHOR]

Local district wellness policies are designed to ensure that schools support student health by providing a healthy nutrition environment and opportunities for physical activity. The Kansas State Department of Education (KSDE) developed a 5-year initiative to strengthen wellness policies across their state by offering regional wellness workshops and providing coaches to work with individual districts. KSDE also developed the Wellness Impact Tool (WIT), a self-report measure districts use to document their practices at each school level related to Nutrition, Nutrition Promotion, Physical Activity, and Integrated School-Based Wellness. Kansas districts (N = 286) completed the WIT annually over a 5-year period. The current study evaluates the KSDE wellness initiative by examining the changes in WIT scores over time and by school level, and testing whether greater engagement with wellness supports (i.e., workshops attended and coaching sessions received) predicts higher WIT scores. The findings indicate that district WIT scores increased over the 5-year initiative. Overall, high schools scored higher than elementary or middle schools on Nutrition items, and elementary schools scored higher than other school levels in the domains of Nutrition Promotion, Physical Activity, and Integrated School-Based Wellness. The number of wellness supports utilized by districts each year were significant predictors of subsequent WIT scores. The KSDE's initiative to support Kansas school districts was associated with significant improvements in the quality of wellness practices across the state and provides a model for consideration by other states. [ABSTRACT FROM AUTHOR]

Background Children with overweight and obesity in socially deprived areas (SDAs) are less likely to complete and be compliant to a weight-loss programme. Objectives To identify factors associated with dropout and compliance of a multidisciplinary weight-loss programme in SDA. Methods This prospective longitudinal cohort study included children (6–12 years) with overweight and obesity in a 12-week multidisciplinary intervention living in SDA in Rotterdam, the Netherlands. Potential predictive variables for dropout and compliance included were age, sex, the weight of the child and parents, quality of life, and referral status (self-registration or referral). A Cox proportional hazards model was performed to study the association between dropout and its potential predictive variables, whereas logistic regression analyses were used for the potential predictors for compliance. Results A total of 121 children started the intervention programme. Forty-one (33.9%) children dropped out and 68 (56.2%) were compliant with the intervention. The risk of dropping out of the intervention was significantly lower for a child with overweight parents than for those with parents with normal weight (adjusted hazard ratio [HR] 0.22 [95% confidence interval, CI 0.063–0.75]), and for those with parents with obesity (adjusted HR 0.18 [95% CI 0.060–0.52]). No other potential predictive variables were associated with dropout or compliance. Conclusion Children from SDA participating in a weight-loss programme have a relatively high dropout and a low compliance rate. Parental weight seems to be an important predictor for dropout of children from SDA, where children with normal weight or obese parents have the highest risk of dropout compared with children of overweight parents. [ABSTRACT FROM AUTHOR]

Access to facilities that could promote physical activity (PA) and healthy eating (HE) is limited in rural areas. Shared use agreements with churches may be a promising strategy for enhancing rural community access to facilities. The goals of this qualitative study were to (a) examine rural pastors’ views on the role of faith-based organizations in improving PA and HE in rural communities; (b) describe the availability of church facilities that could be used for PA and HE; (c) understand pastors’ opinions on shared use of church facilities for community health promotion. A purposeful sampling strategy was used to recruit pastors in rural South Carolina. Thirteen United Methodist Church (UMC) pastors (46% female; 54% predominantly African American congregations) participated in phone interviews. Interviews were transcribed and coded using grounded theory and analyzed with NVIVO. Most pastors reported that their churches had a kitchen (88%), classrooms (82%), and open field space (71%). Nine churches (53%) said they had shared use agreements in place although only two agreements (12%) were related to PA promotion and none related to HE activities. Most pastors did not have concerns about shared use, and many believed that sharing the church’s space with the community was an important aspect of outreach. These results demonstrate that rural churches have facilities to support shared use agreements for PA and HE activities and that pastors are open to sharing church space. Future studies should engage rural churches in establishing shared use agreements for health promotion. [ABSTRACT FROM AUTHOR]

"Common-sense" physical activity (PA) interventions for older adults may be more effective if developed in accordance with behavior change theory. One way to achieve this is through retrospectively applying a theoretical behavior change framework to "reverse code" an existing intervention and guide its ongoing development. This study aimed to detail a clear and systematic procedure that applied elements of the Behaviour Change Wheel (BCW) framework to reverse code the Active Ageing Pathway (AAP) intervention. The objectives of the procedure were to characterize the content of the AAP and its links to behavior change theory. The content of the AAP was first deconstructed through the examination of "standard operating procedures" documents, in-person observation, and a series of face-to-face discussions with AAP management. Then, the behavior change techniques (BCT) and BCW intervention functions associated with the AAP's content were identified and coded using the BCT Taxonomy version 1. Forty-one active components were identified within the AAP, which involved numerous professionals, and pertained to a diverse and interlinked range of factors, across various modes of delivery. The components were classified under 20 separate BCT labels, which related to eight of the nine BCW intervention functions. These outcomes were demonstrated to have practical applications for identifying gaps in intervention content as well as for guiding future intervention evaluation. This study supports previous work detailing the usefulness of reverse coding procedures as a tool for developing common-sense interventions, and is the first to do so in the context of a PA intervention for older adults. [ABSTRACT FROM AUTHOR]

The American Academy of Pediatrics recognizes recess as an essential part of overall child development in schools, impacting children's cognitive, socioemotional and physical health and development. However, recess is often removed from the school curriculum in exchange for more classroom activities. The Centers for Disease Control and Prevention (CDC) and SHAPE America developed Strategies for Recess in Schools to promote high-quality recess through specific actions, yet is not known how these are successfully implemented, particularly, in underserved settings. This formative research study examined the implementation of the CDC strategy in an urban, inner-city charter elementary school to identify barriers and facilitators to successful recess implementation from the perspective of various stakeholders. Thirteen in-depth interviews and focus group discussions were conducted with parents, teachers, recess monitors, and school administrators. Interviews were recorded, transcribed, and coded for thematic analysis, supported by group discussion and analytic memos. Results suggested that although stakeholders recognized the importance of recess, the implementation of the CDC strategy was neither uniformly understood nor implemented, suggesting that additional frameworks may be helpful in implementing the CDC strategy in schools in underserved communities. [ABSTRACT FROM AUTHOR]

System for Observing Play and Recreation in Communities (SOPARC) can provide accurate assessment of physical activity; however, the skills, time, and human resources necessary to collect/interpret SOPARC data can be challenging for community organizations. This article describes a more accessible adaptation of SOPARC using video recordings for community organizations to obtain physical activity feedback at Play Streets. Narrated panoramic video scans occurred every 30 minutes at each Play Street using an iPad. Videographers narrated: (1) sex, (2) age group (child, teen, adult, senior), and (3) activity level (sedentary, walking, vigorous) for everyone recorded. SOPARC video scans, in-person iSOPARC observations, and interviews were conducted with Play Streets implementors to determine validity and feasibility. Validity was examined using Lin's concordance correlation coefficient (CCC). In-person and video scans showed near perfect agreement for sedentary individuals (CCC =.95) and substantial agreement for active individuals (CCC =.72). Overall, community partners felt that they "could see how [the scans] could be useful" and "help[ed] see a bit more clearly what's happening." The method described here is a more accessible systematic observation approach to measure physical activity for communities implementing Play Streets. Further, this method can be used without research training while still providing valuable activity feedback. [ABSTRACT FROM AUTHOR]

Background: By chance, one participant of a norm value study concerning the Jenaer-Standing-Stability-Score (JESS-Score) could be measured before and after a lateral ankle sprain (LAS, Grade I). Therefore, a complete comparison of the initial function, the situation after the LAS and even after additional therapy with focus on balance and postural control, was possible.Case Presentation: A 34-year-old woman, working as medical doctor was measured her standing stability by use of the JESS-Score. A few weeks after, she experienced a mild LAS. There was no physical therapy in the first 3 months after the LAS. In the following, the patient received 7 sessions of physical therapy with focus on balance and postural control. The 2 used parts of the stability assessment (JESS-Score: 1-unipedal stance test; 2-target-step-test) changed in the course of time. Before the ankle sprain both tests on balance and postural control reached the standard value and were inconspicuous. There was no medically prescribed therapy due to the LAS, based on the minor complaints. However, after the LAS the number of deviating test items increased and was even 6 weeks and 3 months after the LAS inconsistent. Only after additional physiotherapy, the score result improved to the initial situation again.Conclusions: It is assumable that LAS is associated with postural deterioration. Therefore, the effect of exercises focussing on postural control and balance after lateral ankle sprain, even if only mild, should be investigated. Some items of the JESS-Score seem to be sensitive for evaluating changes concerning the balance ability. [ABSTRACT FROM AUTHOR]

Abstract Background The COVID-19 pandemic presented novel barriers to youth physical activity engagement. Identifying what resources parents and children are interested in receiving can support efforts to mitigate the negative impact of the pandemic on youth physical activity behavior. This study aimed to identify physical activity-related information needs during the COVID-19 pandemic among a nationally representative sample of American parents of children 6–10 years-old and parent-child dyads of children 11–17 years-old. Methods A cross-sectional survey was conducted by a market research company in October–November 2020. Parents and children were asked about their interest in specific types of information about helping their family and themselves, respectively, be active (Yes/No). Weighted percentages were calculated for reported information needs and compared using two-sample test of proportions. Results Final analytic sample was 1000 parents (55.4% female; 74.7% White; 74.0% non-Hispanic); 500 children 11–17 years-old (52.1% male; 77.6% White). Over 40% of participants were interested in information about being active during COVID-19. Parents were more likely to be interested in information if they always (versus never) worked from home [53.3% (95% CI: 43.3–63.0%) versus 22.0% (95% CI: 14.9–31.3%), p

Introduction: The Arthritis Foundation's Walk With Ease (WWE) program has been shown to reduce arthritis symptoms and increase physical performance for up to 1 year. However, research on community-based WWE implementation is limited. The purpose of this study was to examine early implementation at community organizations that received 1-year WWE implementation grants from the Osteoarthritis Action Alliance. Method: Program managers at five Osteoarthritis Action Alliance grantee organizations participated in 45-minute telephone interviews. Interviewees represented organizations with the highest WWE enrollment at 6 months (n = 3, >30% of goal enrollment) and no enrollment at 6 months (n = 2). The Planning for Sustainability framework guided qualitative analysis of factors affecting early implementation. Results: All grantees were confident in WWE's evidence base, thought it a beneficial supplement to other programming, stressed the importance of senior leadership support for WWE, and engaged community partners for marketing support and as walking sites. Implementation experiences unique to low enrollment grantees were (1) recent major structural changes within their organization, (2) difficulties in communicating logistics internally, and (3) difficulties in balancing WWE with other responsibilities. All organizations experienced barriers that required altering their original implementation plans; however, practical solutions like adapting the program to improve flexibility, training organizational staff as leaders, and utilizing community partnerships served to address multiple barriers simultaneously. Discussion: Building organizational capacity by overcoming early barriers is a key element of early implementation. Our findings offer concrete solutions to early WWE implementation barriers and suggest the need for further research on adaptations to improve WWE's flexibility in community organizations. [ABSTRACT FROM AUTHOR]

Background: Only 17% of Latinas meet national physical activity (PA) guidelines for both moderate-to-vigorous aerobic and muscle-strengthening PA. Additional health benefits are derived from the combination of aerobic and muscle-strengthening PA (vs. aerobic alone), yet there is paucity in research on muscle-strengthening activity in Latinas. The aim of this study was to examine changes in muscle-strengthening activity from baseline to 6 and 12 months in Seamos Saludables, a 12-month PA randomized controlled trial for Latinas. Methods: A secondary data analysis was conducted among 131 Latinas ages 18–65 years, who were randomized to either a PA Intervention or a Wellness Control. Self-reported muscle-strengthening exercise was measured at baseline, 6 months, and 12 months via adapted muscle-strengthening questions from the Behavioral Risk Factor Surveillance System. Results: There was a 16-minute/week difference in median minute/week of muscle-strengthening activity between Intervention and Wellness at 6 months (SE = 7.91, p =.04) and 45-minute/week difference at 12 months (SE = 25.80, p =.06) adjusting for baseline. Significantly more PA Intervention participants met muscle-strengthening guidelines of 2 or more days/week at 6 months versus Wellness Control participants (odds ratio [OR] = 4.29, 95% confidence interval [CI] = [1.03, 17.84]). Conclusion: Results from the current study showed that Latinas engaged in muscle-strengthening activity in an intervention that emphasized primarily aerobic PA outcomes, suggesting they may be interested in engaging in muscle-strengthening activities. Future interventions targeting both aerobic and muscle-strengthening activity could achieve greater health improvements and help more Latinas reach the full national PA guidelines. ClinicalTrials.gov Identifier. NCT01583140 [ABSTRACT FROM AUTHOR]

Background. Few studies have examined 24-hour activity and sleep behaviors and their contribution to type 2 diabetes (T2D) in Latino adolescents and young adults with obesity. Aim. This study included quantitative data on T2D risk and 24-hour activity and sleep behaviors and qualitative data on individual, social, and environmental behavioral determinants. Method. A 7 day, 24-hour, wrist-worn accelerometer protocol assessed moderate-to-vigorous physical activity (PA), sedentary behaviors (SB), sleep, and sleep regularity, in adolescents (N = 38; 12–16 years) and young adults (N = 22; 18–22 years). T2D-related outcomes included adiposity (BMI, BF%, waist circumference), fasting, and 2-hour glucose. A subsample of participants (N = 16 adolescents, N = 15 young adults) completed interviews to identify behavioral determinants. Results. High levels of PA were observed among adolescents (M = 103.8 ± 67.5 minutes/day) and young adults (M = 96.8 ± 78.8 minutes/day) as well as high levels of SB across both age groups (≥10 hours/day). Sleep regularity was negatively associated with adiposity (all p s <.05) in both age groups as well as fasting and 2-hour glucose in young adults (all p s <.05). Social support was associated with PA in both age groups as well as SB in younger youth. Auditory noises, lights, and safety inhibited sleep in both age groups. Conclusion. PA is critical for disease reduction, yet reducing SB and improving sleep are also important targets for reducing T2D risk in Hispanic adolescents and young adults. Future health promotion and disease prevention strategies should leverage qualitative findings regarding behavioral determinants. [ABSTRACT FROM AUTHOR]

Background: Multiple studies have shown that physical activity improves cancer survivorship, by decreasing risk of second primary cancers and chronic conditions. However, cancer survivor physical activity levels remain low. General practice presents more opportunities for lifestyle interventions, such as increasing physical activity. We conducted a realist review of physical activity interventions relevant to general practice., Methods: A total of 9728 studies were obtained from a systematic search of the CINAHL, Embase, PsycINFO, PubMed, and SPORTDiscus databases from the inception of the electronic database to 21 June 2024. We focussed on intervention studies that improved physical activity among cancer survivors and were relevant to general practice. Data extraction focussed on: what makes physical activity interventions effective for cancer survivors (what works) and what factors promote physical activity for cancer survivors (for whom it works)., Results: Thirty-seven studies were used to generate themes on the components of physical activity interventions that are likely to work and for whom; these studies facilitated goal setting, action planning, self-monitoring, social support, and shaping of knowledge; through delivering tailored motivational support, evoking a teachable moment, and promoting the use of self-monitoring tools. Interventions that were cost-effective and easily implementable improved sustainability, deployability, and uptake by cancer survivors. Cancer survivor psychological and physical factors, such as baseline motivational levels and post-treatment symptoms, influenced the uptake of physical activity interventions., Conclusion: Our realist review has highlighted opportunities for general practices to promote physical activity among cancer survivors through collaborative goal setting, action planning, self-monitoring, social support, and shaping of knowledge., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Physical activity (PA) is important for managing osteoarthritis (OA), but many patients are inactive. Research is needed on strategies to leverage clinical encounters to engage patients in PA. Guided by the socioecological model of health behavior, this study aimed to engage stakeholders in the process of refining an Osteoarthritis Physical Activity Care Pathway (OA-PCP). Six focus groups and seven individual interviews were conducted with key stakeholders. Focus groups were specific to stakeholder roles and included patients with OA, support partners, and clinic personnel (n = 6 focus groups). Interview participants were local and national PA program representatives (n = 7 interviews). Data were analyzed by thematic analysis. Themes identified in the data included ways the OA-PCP can help patients with OA address challenges to PA engagement, strategies for connecting patients with PA resources, methods for implementing OA-PCP into clinical settings and potential use of PA trackers in the OA-PCP program. Stakeholders' comments were summarized into key recommendations for OA-PCP. Some recommendations reinforced and led to refinements in planned aspects of OA-PCP, including tailoring to individual patients, involvement of a support partner, and addressing pain with PA. Other recommendations resulted in larger changes for OA-PCP, including the addition of three email- or mail-based contacts and not requiring use of a PA tracker. The refined OA-PCP program is being evaluated in an exploratory trial, with the ultimate goal of establishing a PA program for OA that can be successfully implemented in clinical settings. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic presented novel barriers to youth physical activity engagement. Identifying what resources parents and children are interested in receiving can support efforts to mitigate the negative impact of the pandemic on youth physical activity behavior. This study aimed to identify physical activity-related information needs during the COVID-19 pandemic among a nationally representative sample of American parents of children 6-10 years-old and parent-child dyads of children 11-17 years-old.Methods: A cross-sectional survey was conducted by a market research company in October-November 2020. Parents and children were asked about their interest in specific types of information about helping their family and themselves, respectively, be active (Yes/No). Weighted percentages were calculated for reported information needs and compared using two-sample test of proportions.Results: Final analytic sample was 1000 parents (55.4% female; 74.7% White; 74.0% non-Hispanic); 500 children 11-17 years-old (52.1% male; 77.6% White). Over 40% of participants were interested in information about being active during COVID-19. Parents were more likely to be interested in information if they always (versus never) worked from home [53.3% (95% CI: 43.3-63.0%) versus 22.0% (95% CI: 14.9-31.3%), p < 0.001]; had children attending school remotely versus in-person [47.3% (95% CI:40.2-54.5%) versus 27.5% (95% CI: 19.6-37.1%), p < 0.001]; and lived in a big city versus a rural area [66.5% (95% CI:54.5-76.7%) versus 34.1% (95% CI: 22.8-47.6%), p < 0.001]. Children most interested were those who did not have resources for online activity engagement and those worried about their safety or getting infected with COVID-19. Children were also more likely to be interested if their parents worked full-time versus not working [48.6% (95% CI:41.7-55.6%) versus 31.5% (95% CI: 24.1-39.9%), p < 0.001], and lived in a big city versus a rural area [57.2% (95% CI:45.3-68.3%) versus 27.8% (95% CI:17.8-40.7%), p < 0.001].Conclusions: Families are interested in physical activity resources, particularly those whose daily routines and opportunities for physical activity may have been most significantly impacted by the pandemic. This includes parents who always worked from home or whose children attended school remotely. Identifying felt needs is an important step in developing tailored interventions that aim to effectively and sustainably support families in promoting physical activity. [ABSTRACT FROM AUTHOR]

Emerging research identified physical inactivity and weight-related comorbidities as significant risk factors for contracting SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), reinforcing the importance of maintaining regular exercise during the pandemic. Previous scholarship in this area examined the impact of coronavirus disease 2019 (COVID-19) across various populations. Currently, there is limited research examining how these populations engage in and navigate challenges relating to exercise during shelter-in-place mandates and no studies examining the role of social support in promoting exercise during the pandemic. In this study, we examine perceptions of social support during the COVID-19 pandemic among members who belong to a fitness community based in Oakland, California. In-depth interviews (n = 31) were used to understand how the pandemic has affected participants' perceptions of current exercise habits and how understandings of social support facilitate engagement in physical activity. Reported narratives encompassed two primary themes: (1) Facilitators of Social Support and (2) Challenges and Barriers to Social Support. Our findings highlight the importance of social support for reinforcing perceptions of exercise adherence amid challenges experienced by members of a fitness community to remain physically active during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Primary health care has an important role to play in the management of weight and yet discussions of healthy weight management do not occur optimally, indicating a need for simple tools and training in brief weight counselling. The 'FABS' approach (focusing on four topic areas: Food, Activity, Behaviour and Support) was developed to address this.Objectives: To explore the feasibility of the 'FABS' approach within routine general practice consultations and its effectiveness in facilitating healthy weight conversations.Method: The FABS approach was run for a trial period in five New Zealand general practices. The approach entailed staff training, the addition to the practice patient management system of a template outlining potential topics for discussion and a patient handout. GPs were asked to use the approach with any adult patient with a body mass index of over 28 kg/m2. A descriptive analysis of anonymized quantitative practice data was conducted, with limited qualitative data from an online clinician questionnaire and interviews with GPs and patients.Results: Over 4 months, the template was opened 862 times by 27 clinicians in 830 patient consultations. All FABS topics were raised at least once. Physical activity was raised most frequently, followed by two food-related topics. There was variation between practices and between GPs. GPs tended to raise more topics within a single consultation than the training recommended. The limited clinician survey results and patient interviews also indicated positive responses to the approach.Conclusions: It is possible to provide an infrastructure for healthy weight conversation approaches within general practice so that patients receive supportive and consistent messages on a regular basis. General practice is an appropriate setting for this due to the ongoing relationships with patients and team-based approach, but there is a need for effective training and education to ensure appropriate and effectively delivery. [ABSTRACT FROM AUTHOR]

Waka ama is unique as a sport because, as well as the physical benefits for paddlers, it also creates opportunities for participants to experience and connect with the natural environment. This research draws on interviews with waka ama paddlers in Aotearoa New Zealand to illustrate how the well-being of the environment connects to the spiritual, cultural, and physical health of people. Results highlight the multifaceted benefits of participating in waka ama. As well as the physical benefits for paddlers, waka ama also has a strong tikanga, which encourages language revitalization with the use of te reo Māori through karakia, waiata, and the general terms used associated with waka. It also creates opportunities for participants to experience and connect with the natural environment and improve their health. The knowledge gained from participants provide evidence of effective ways to improve health and well-being within communities with a particular focus on waiora, the spiritual connection between hauora and the environment. [ABSTRACT FROM AUTHOR]

Concerns regarding the continued high prevalence of childhood overweight and obesity have created a need for proactive approaches to behavior change. The Family Nutrition and Physical Activity (FNPA) screening tool was developed for research and clinical use to identify home environments and behaviors that could predispose youth to increased weight. FNPA scores have been shown to correlate with body mass index (BMI) percentiles in first-grade students and to predict unique variance in change in BMI percentiles from first to second grade. The FNPA has been used for family behavior counseling and is now a standard component of well-child visits throughout the Geisinger Health System in Pennsylvania. Parents complete the FNPA prior to annual visits, and providers can discuss areas of concern based on screening results. Children of parents who complete the FNPA have shown smaller increases in BMI z-scores over the following year than children of parents who did not complete the FNPA. The FNPA is also used to inform the arrangement of family-centered obesity treatment for children. Recently, the FNPA has undergone a systematic update to ensure its continued relevance and utility. The updated tool is provided, and current and future users can access more information about the tool at myfnpa.org. [ABSTRACT FROM AUTHOR]

The purpose of the Active By Community Design (ABCD) project was to engage residents in the redesign of two public open spaces to increase park visits and park-based physical activity (PBPA). It was anticipated that by adding local preferences to park design considerations along with collected data and available evidence, the study would achieve increased levels of community engagement and subsequent increases in park visits and PBPA. This study summarizes two case studies outlining the community engagement and research translation process. Utilizing a pre–post evaluation design, baseline measures were completed with a series of validated tools for park use and park quality. Baseline data, evidence, community and stakeholder input were synthesized and presented to a "design subcommittee" to translate into "real-world" park redesigns. Park audits, a household survey, and park open days identified the spaces were not designed for the activities residents wanted, while park observations identified usage was low, and those observed were mostly children and adults walking. Park redesigns focused on maximizing access, infrastructure to enable physical activity (PA), PA programs and enhancements to improve aesthetics and safety concerns. The ABCD project successfully demonstrated a process of combining data and community and stakeholder engagement input to translate evidence into the creation of more supportive environments for PA. Stakeholder and resident input to the redesign processes contributed to satisfaction and ownership that residents reported on the redesigned parks, which may increase the likelihood of increased park usage and park-based physical activity. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has disrupted all aspects of life, from health to financial to social. College students in particular have faced difficulties adjusting to an entirely virtual atmosphere, compounding the normal stressors that come with full class loads and transitioning into more independent adult lives. In response to the onset of the COVID-19 crisis, a faculty member at the University of South Florida's College of Public Health designed impromptu, free dance lessons offered through a virtual video platform to the college and broader community. The lessons were offered with the intent of providing a healthy and engaging environment to help students and others in the community cope with lockdown stress, depression, and anxiety throughout spring and summer 2020. This article summarizes the structure of the intervention, lessons learned throughout implementation, and the broader practice potential during the COVID-19 pandemic and beyond. [ABSTRACT FROM AUTHOR]

Among school employees, it has been reported that poor physical and mental health, as well as high stress and large workloads, have resulted in high absenteeism and low retention. The consequences of unhealthy behaviors and stress can extend to students, impacting academic achievement and school costs. Our objective was to examine the impact of school employees’ physical activity (PA), diet quality and perceived occupational stress on cardiometabolic health, and explore how stress may influence the impact of PA and diet on health.In this cross-sectional study, employees from lower-income Massachusetts schools participated in Wellness Assessments (2015–2016), including measured height, weight, and lipids [total (TC), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C)]. Self-administered surveys were used to collect demographic, stress, PA and 24-hour food intake data. Linear regression models were used to examine the relationship among health behaviors (PA and diet), stress and cardiometabolic health. An interaction between stress and health behaviors was also explored.Seventy-four employees (66% teachers) participated. Overweight/obesity (mean BMI: 25.6 kg/m2), high TC and LDL-C were observed in 47%, 4%, and 34%, respectively, and moderate-to-vigorous PA (MVPA) was low (median: 17 min/day). Positive associations were identified between MVPA and cardiometabolic health, but not diet. The effect of MVPA on BMI was modified by stress (p-for-interaction = 0.001), with higher levels of stress associated with a diminished protective association between MVPA and BMI.Higher levels of PA were associated with more favorable cardiometabolic health, with increasing levels of stress minimizing the beneficial effect of PA on BMI.

Study aim: Two thirds of children are not meeting recommended levels of physical activity. A solution to physical inactivity is Comprehensive School Physical Activity Programming (CSPAP). Little is known regarding the impact of a school’s physical activity leader on CSPAP effectiveness. Therefore, this study explored changes in physical activity accumulated during school hours in CSPAP schools being led by the physical education teacher compared to a stand-alone physical activity leader.

Background: Overweight and obesity during childhood consist two of the most important public health issues in the 21st century. Consumption of high-fat processed food has been increased alarmingly.Objective: To examine the association between parental ultra-processed, high-fat products' consumption and childhood overweight/obesity.Methods: A cross-sectional survey, conducted among 422 children, aged 10-12 years, and their parents, during school years 2014-16. Parental and child data were collected through self-administered, anonymous and validated questionnaires. Among others, high-fat ultra-processed food consumption was also recorded. Children's weight status was based on gender- and age-specific tables derived from the International Obesity Task Force body mass index (BMI) cut-offs.Results: The prevalence of obesity in the reference population was 2.9%, whereas the prevalence of overweight was 19.3%. A strong correlation was observed between children's and their parents' BMI status (P < 0.001). Multi-adjusted data analysis revealed no association between parental intake of ultra-processed, high-fat products and children overweight/obesity. Similarly, when the data analysis accounted for family income and physical activity status of the children, the aforementioned results remained insignificant.Conclusion: Despite the fact that parents' specific dietary habits seem not to affect their children's weight status, public health programs should consider parental nutrition education and mobilization as a preventive measure for childhood overweight/obesity. [ABSTRACT FROM AUTHOR]

Background and Purpose. The American Heart Association recommends community-based research on shared use of physical activity (PA) spaces. Pasadena, a community in southeast Houston, Texas with lower socioeconomic status and racial/ethnic diversity, was the setting for our study. Efforts to increase access to PA in Pasadena include building the evidence on PA resources. The purpose of this research was to utilize survey data in a community setting to inform and target efforts around sharing PA spaces. Method. An online survey was administered to K-12 school (n = 25) and park (n = 30) administrators, church leaders (n = 10), community organizations (n = 2), a health care center, and a local business. Results. Park facilities in Pasadena shared by agreement with two high schools and three baseball/softball leagues were ballfields, tennis courts, and jogging paths. No park facilities were shared with faith-based organizations. Four parks communicated daily, and five schools communicated with parks quarterly about providing opportunities for PA. Key facilitators to sharing facilities were building relationships and collaboration, service to the community, and improving health. Key barriers were cost, maintenance, staffing, and prioritizing use with limited time, facilities, and resources. Conclusions. This study is the first of its kind to address shared use at the community level and suggests opportunities to improve communication and partnerships between parks, schools, and churches. This research will inform ongoing efforts to promote access by identifying barriers and motivators among stakeholder groups to help facilitate shared use agreements. [ABSTRACT FROM AUTHOR]

Background: Models of care are needed to address physical activity, nutrition promotion and weight loss in primary care settings, especially with underserved populations who are disproportionately affected by chronic illness. Group medical visits (GMVs) are one approach that can help overcome some of the barriers to behaviour change in underserved populations, including the amount of time required to care for these patients due to socio-economic stressors and psychosocial complexities (1). GMVs have been shown to improve care in coronary artery disease and diabetes, but more evidence is needed in underserved settings.Objective: This project sought to evaluate a GMV incorporating a physical activity component in an underserved patient population, measuring biometric and motivation outcome measures.Methods: This project used a pre-post intervention study design through patient surveys at baseline and 12 weeks. We included validated motivational measures along with self-reported demographic information. A GMV intervention promoting physical activity and nutrition to promote weight loss was delivered by an interdisciplinary primary care team and community partners in a Federally Qualified Health Center in Rochester, NY. The intervention consisted of six, 2-hour sessions that occurred every other week at the clinic site.Results: Participants lost a significant amount of weight and maintained the weight loss at 6 months. In addition, there was a significant improvement in motivation measures.Conclusion: This study provides preliminary evidence that our GMV model can improve weight loss and autonomous motivation in an underserved population. This project has potential for scalability and sustainability. [ABSTRACT FROM AUTHOR]

Objectives: Randomized controlled trials (RCT) often employ multiple recruitment methods to attract participants, however, special care must be taken to be inclusive of under-represented populations. We examine how recruiting from an existing observational study affected the recruitment of African Americans into a RCT that included yoga-based interventions. In particular, we report the recruitment success of The Effects of Health Promoting Programs (HPP) on Cardiovascular Disease Risk (NCT02019953), the first yoga-based clinical trial to focus only on African Americans. Design: To recruit participants, a multifaceted recruitment strategy was implemented exclusively in the Jackson Heart Study (JHS) cohort. The HPP recruited from the JHS cohort using direct mailings, signs and flyers placed around JHS study facilities, and through JHS annual follow-up interviews. Results: Enrollment into HPP was open to all active JHS participants that were eligible to return for the third clinic exam (n = 4644). The target sample size was 375 JHS participants over a 24 month recruitment and enrollment period. From the active members of the JHS cohort, 503 were pre-screened for eligibility in HPP. More than 90% of those pre-screened were provisionally eligible for the study. The enrollment goal of 375 was completed after a 16-month enrollment period with over 25% (n = 97) of the required sample size enrolling during the second month of recruitment. Conclusions: The findings show that participants in observational studies can be successfully recruited into RCT. Observational studies provide researchers with a well-defined population that may be of interest when designing clinical trials. This is particularly useful in the recruitment of a high-risk, traditionally underrepresented populations for non-pharmacological clinical trials where traditional recruitment methods may prolong enrollment periods and extend study budgets. [ABSTRACT FROM AUTHOR]

Health behavior changes often require focusing on factors beyond the individual, particularly in low-income and underresourced areas. The purpose of this article was to assess associations between household structure and adult physical activity levels. Data were collected using Community Assessment for Public Health Emergency Response methodology to administer a household survey (n = 100). Household structure was calculated from summing the number of adults (⩾18 years) and children (<18 years) reported living in the house. Physical activity was measured using the International Physical Activity Questionnaire–Short Form. Adults living in households with two or more adults reported more MET (metabolic equivalent of task) minutes of physical activity per week than adults from households with only one adult. Adults living in households with two or more adults were twice as likely to meet aerobic guidelines for physical activity compared to adults living in households with only adult. Findings suggest the need for developing ecologic approaches in low-income communities to increase social support for physical activity in adults. [ABSTRACT FROM AUTHOR]

Introduction. Despite the known health benefits of biking, within the last year, 46% of college students reported not riding a bike. This trend indicates a need to explore interventions to increase bicycling. The purpose of this study was to examine how a free membership to a citywide bike share system, with a campus docking station, affected bicycling and physical activity. Method. Undergraduate students were recruited from a Midwest University to participate in this research study in spring 2018. Each participant wore an activity-tracking device for 3 weeks and was randomly assigned to either an intervention group (n = 29) or a control group (n = 27). Participants in the intervention group received a free 1-month membership to Kansas City's bike share system, B-cycle. Data on the type of activity (e.g., biking), the frequency, duration, and overall steps were collected. A pre- and posttest survey was developed and distributed to assess perceptions and use of bicycles and the bike share system. T tests were performed to identify differences between the two groups. Results. Data analyses reveal no significant differences in overall steps or increased biking behavior between the two groups. Furthermore, only two of participants who received a free bike share membership redeemed their membership. Among other barriers, risk of overage fees or not wanting to enter credit/debit card information emerged as major themes that deterred participants. Conclusions. Results from this study will inform future interventions to decrease barriers, increase physical activity, and increase the proportions of trips taken by bike among college students. More specifically, alternative payment methods should be explored to decrease the barriers observed. [ABSTRACT FROM AUTHOR]

The purpose was to explore community readiness to adopt physical activity (PA) policies by adapting and pilot testing an online survey (Physical Activity Readiness Survey [PARS]). PARS was adapted from the previously tested Community Readiness Survey-Short. In February/April 2016, key informants (N = 17) involved in PA activities from two rural communities were invited to complete the PARS, representing six dimensions: knowledge, leadership, resources, community climate, existing voluntary PA policies, and political climate. First, participants were asked to respond to a presurvey to screen for overall readiness for up to four evidence-based PA policies. A main survey readiness score (0-6) was determined by averaging the key informants' ratings across items: Raw scores were rescaled to range from 0 to 1, and dimension scores were summed. Participants identified two PA policies in the presurvey: neighborhood availability and point-of-decision prompts. For both policies, political climate had the highest dimension score (1.0) and the knowledge dimension scored lowest (0.05-0.38). Overall readiness scores ranged from 3.19 to 3.62, revealing the preparation stage for both policies. Readiness for the two PA policies were similar, but specific dimension scores varied by policy type and community, reinforcing the need for tailored interventions. [ABSTRACT FROM AUTHOR]

Background. Schools are an important setting for health promotion because they afford children and adolescents numerous opportunities to accumulate the recommended physical activity (PA) minutes and make other health-related decisions, including healthy eating. Unfortunately, there is little evidence of coordinated school-based health interventions in rural Appalachia. The Greenbrier Children's Health Opportunities Involving Coordinated Efforts in Schools Project was a federally funded, 3-year, multicomponent school-based health intervention focused on PA, healthy eating, and weight management. Aims. The purpose of this study was to evaluate the impact of Greenbrier Children's Health Opportunities Involving Coordinated Efforts in Schools on adolescent PA, dietary behaviors, and weight status. Method. Measures of PA, dietary behaviors, and body mass index were collected across 14 data points throughout the intervention (including a baseline in Year 1). Results. Participants included 4,633 randomly selected middle school students (M = 2,289, F = 2,344) across the intervention. Baseline to Year 3 findings revealed a 12.8 percentage point increase in students achieving 60 minutes of daily PA. There were no significant differences in either dietary behavior or body mass index. Discussion. Findings provide evidence of the positive impact comprehensive school-based health interventions can have on middle school student health-related behaviors. Conclusion. Schools remain an ideal setting for health promotion. Initiatives targeting more than one level of influence on health-related behaviors are more likely to succeed. [ABSTRACT FROM AUTHOR]

African American women report low participation in physical activity and are disproportionately burdened by related conditions (obesity, breast, and colon cancer). Physical activity interventions have shown promising results among African American women, but most studies in this area have focused on short-term increases. More enduring changes in health behavior will be needed to eliminate existing health disparities. Thus, the current study examined 12-month physical activity and psychosocial outcomes from a pilot randomized controlled trial (N = 84) of a Home-based Individually tailored Physical activity Print (HIPP) intervention for African American women in the Deep South. Retention was 77.4% at 12 months. HIPP participants increased self-reported moderate-to-vigorous physical activity from 35.1 minutes/week (standard deviation [SD] = 47.8) at baseline to 124 minutes/week (SD = 95.5) at 12 months, compared with the wellness contact control participants who reported increases from 48.2 minutes/week (SD = 51.3) to 102.5 minutes/week (SD = 94.5) over 12 months (between-group p >.05). Results indicate that modest improvements in moderate-to-vigorous physical activity and related psychosocial variables occurred during the active intervention phase (months 0-6) and were sustained during the tapered maintenance period (months 6-12). Low-cost, high-reach, home-based strategies have great potential for supporting sustained participation in physical activity and achieving long-term health benefits among African American women in the Deep South. [ABSTRACT FROM AUTHOR]

While physical activity (PA) is a strong protective factor for adolescents, many youth experience discrimination and intimidation in traditional fitness spaces. This is especially true for youth of color, youth in larger bodies, and transgender youth. This manuscript describes the development of Move and Thrive, an online resource for PA promotion designed specifically for adolescents prioritizing inclusivity and diversity. Working with Community and Youth Advisory Boards, we developed guiding principles of Move and Thrive: to create resources that are 1) youth and community driven; 2) inclusive of diverse representation; 3) body and weight neutral; 4) trauma informed; and 5) accessible. We developed a guide for PA instructors to use trauma informed approaches; avoid mention of weight talk or physical appearance; use gender inclusive language; and offer multiple options to improve accessibility. Specific care was taken to hire instructors diverse in body size, race, ethnicity, and gender identity. The first iteration of Move and Thrive was launched in March 2021, and the current resource contains 72 PA videos. Over the course of 12 months, the site had more than the site had over 9,000 views in over 40 countries, including six continents. Users have reported high levels of satisfaction with Move and Thrive, and physicians have responded enthusiastically to sharing Move and Thrive as a free resource for adolescents. University of Minnesota Move and Thrive Project is currently available on an ad-free YouTube Channel. We believe that Move and Thrive has the potential to reach populations historically excluded from PA resources. [ABSTRACT FROM AUTHOR]

Physical inactivity is a high-priority public health issue in U.S. worksites. There is evidence that physical activity (PA) goal-setting interventions can be effective. Smartphone apps have also been used to deliver accessible and appealing PA interventions. This article describes the use of goal setting and a no-cost PA smartphone app to pilot an 8-week PA intervention, Project Move 2.0, to increase PA among a nonprofit health and social assistance workforce. The community-based partnership identified intervention strategies that addressed moderators for setting PA goals: feedback, goal commitment, situational factors, and ability. The intervention included the use of a no-cost smartphone app for tracking steps/goal setting, an orientation/health education session, weekly text messages, as well as pre- and post-measures for goal setting for PA behaviors and an intervention evaluation questionnaire. There is limited knowledge on the practical aspects of applying goal setting and the use of a no-cost smartphone app to increase employee PA through a workplace PA intervention. Applying goal setting and the use of a no-cost smartphone app shows promise for workplace health promoters to successfully address employee PA.

Background: Physical activity (PA) remains under prescribed by physicians. Motivation and confidence are clear drivers of frequency of promoting PA. Research shows demographic differences in physicians' preventive practices, yet none have included medical students who form habits during training.Objectives: Study objectives were to (i) examine how Canadian medical students' motivation to recommend PA to future patients differs according to six demographic variables (i.e. gender, ethnicity, year of study, university, proposed specialty and academic background) and (ii) examine how Canadian medical students' confidence to recommend PA to future patients differs according to these same demographic variables.Methods: A cross-sectional design was used. First to fourth year medical students from three medical schools responded to an online survey (N = 221).Results: Female participants were more motivated to counsel patients on PA and refer to an exercise specialist compared to males (P < 0.01). Second year students were more motivated to assess a patients' level of PA compared to third and fourth year students (P < 0.01). Students pursuing family medicine were more confident to assess and counsel compared to students pursuing paediatrics (P < 0.01).Conclusion: Given that motivation and confidence have a positive influence on frequency-promoting PA, these results suggest where future efforts should focus, to improve PA promotion in medical practice. Physical inactivity continues to be a major issue worldwide, and medical students as future physicians have a unique opportunity to enhance PA amongst the population. [ABSTRACT FROM AUTHOR]

Background. Regular physical activity is associated with improved physical and psychosocial well-being. Increasing access to physical activity in underresourced communities requires collaborative, community-engaged methods. One such method is community workgroups. Purpose. The purpose of this article is to describe implementation, strengths, challenges, and results of the workgroup approach as applied to increasing access to physical activity, using our recent study as an illustrative example. Method. A 1-day conference was held in April 2017 for community leaders. The first half of the conference focused on disseminating results of a multifaceted community assessment. The second half entailed community workgroups. Workgroups focused on applying community assessment results to develop strategies for increasing access to physical activity, with plans for ongoing workgroup involvement for strategy refinement and implementation. A professional artist documented the workgroup process and recommendations via graphic recording. Results. Sixty-three community leaders attended the conference and participated in the workgroups. Workgroup participants reported that greater macrosystem collaboration was critical for sustainability of physical activity programming and that, particularly in underresourced urban communities, re-imagining existing spaces (rather than building new spaces) may be a promising strategy for increasing access to physical activity. Discussion. Considered collectively, the community workgroup approach provided unique insight and rich data around increasing access to physical activity. It also facilitated stakeholder engagement with and ownership of community health goals. With careful implementation that includes attention to strengths, challenges, and planning for long-term follow-up, the community workgroup approach can be used to develop health promotion strategies in underresourced communities. [ABSTRACT FROM AUTHOR]

Despite state laws requiring concussion education for youth sport stakeholders and a proliferation of educational programs, there has been little demonstrated impact on concussion reporting behaviors. We propose that this is because of four key limitations to existing approaches to concussion education: (1) deliberative decision making by the injured athlete is assumed, (2) interventions are often targeted at individuals rather than social systems, (3) education occurs once during preseason and is forgotten, and (4) dissemination challenges exacerbate health inequalities. Addressing these limitations, we propose a novel theoretic framework that situates individual behavior within a sport system's culture and their broader structural context. Concussion education programs should seek to facilitate safety-supportive interpersonal communication within and between stakeholder groups and influence attributes of groups that drive behavior, including shared values. Addressing the limitations outlined and drawing on the proposed conceptual framework, we describe a novel approach to concussion education: pregame safety huddles. [ABSTRACT FROM AUTHOR]