The Alberta moving beyond breast cancer (AMBER) cohort study: a prospective study of physical activity and health-related fitness in breast cancer survivors Action Schools! BC: a school-based physical activity intervention designed to decrease cardiovascular disease risk factors in children. Feasibility of a telephone and web-based physical activity intervention for women shift workers Perceived barriers and enablers to participation in a community-tailored physical activity program with Indigenous Australians in a regional and rural setting: a qualitative study Personal, social, and environmental correlates of physical activity in adults living in rural south-west England: a cross-sectional analysis The economic burden of physical inactivity in Canada. Weight status, physical activity, and fitness among third-grade rural children. Stores Healthy Options Project in Remote Indigenous Communities (SHOP@RIC): a protocol of a randomised trial promoting healthy food and beverage purchases through price discounts and in-store nutrition education The 'Women's Lifestyle Study', 2-year randomized controlled trial of physical activity counselling in primary health care: rationale and study design What are the most effective behaviour change techniques to promote physical activity and/or reduce sedentary behaviour in inactive adults? A systematic review protocol The effect of ongoing feedback on physical activity levels following an exercise intervention in older adults: a randomised controlled trial protocol Physical activity for the prevention and treatment of major chronic disease: an overview of systematic reviews The Colon Health and Life-Long Exercise Change trial: a randomized trial of the National Cancer Institute of Canada Clinical Trials Group Effects of a Whatsapp-delivered physical activity intervention to enhance health-related physical fitness components and cardiovascular disease risk factors in older adults. Health Opportunities with Physical Exercise (HOPE): social contextual interventions to reduce sedentary behavior in urban settings. Improving health-related fitness in children: the fit-4-Fun randomized controlled trial study protocol Exercise and well-being: a review of mental and physical health benefits associated with physical activity The effect of a multi-disciplinary obesity intervention compared to usual practice in those ready to make lifestyle changes: design and rationale of Whanau Pakari Aerobic fitness and physical activity levels of children born prematurely following randomization to postnatal dexamethasone. Improving physical fitness and emotional well-being in adolescents of low socioeconomic status in Chile: results of a school-based controlled trial. Enhancing exercise tolerance and physical activity in COPD with combined pharmacological and non-pharmacological interventions: PHYSACTO randomised, placebo-controlled study design Dance for health: improving fitness in African American and Hispanic adolescents. VIP in construction: systematic development and evaluation of a multifaceted health programme aiming to improve physical activity levels and dietary patterns among construction workers
Background Limited research has examined the association between physical activity , health-related fitness , and disease outcomes in breast cancer survivors . Here , we present the rationale and design of the Alberta Moving Beyond Breast Cancer ( AMBER ) Study , a prospect i ve cohort study design ed specifically to examine the role of physical activity and health-related fitness in breast cancer survivorship from the time of diagnosis and for the balance of life . The AMBER Study will examine the role of physical activity and health-related fitness in facilitating treatment completion , alleviating treatment side effects , hastening recovery after treatments , improving long term quality of life , and reducing the risks of disease recurrence , other chronic diseases , and premature death . Methods / Design The AMBER Study will enroll 1500 newly diagnosed , incident , stage I-IIIc breast cancer survivors in Alberta , Canada over a 5 year period . Assessment s will be made at baseline ( within 90 days of surgery ) , 1 year , and 3 years consisting of objective and self-reported measurements of physical activity , health-related fitness , blood collection , lymphedema , patient-reported outcomes , and determinants of physical activity . A final assessment at 5 years will measure patient-reported data only . The cohort members will be followed for an additional 5 years for disease outcomes . Discussion The AMBER cohort will answer key questions related to physical activity and health-related fitness in breast cancer survivors including : ( 1 ) the independent and interactive associations of physical activity and health-related fitness with disease outcomes ( e.g. , recurrence , breast cancer-specific mortality , overall survival ) , treatment completion rates , symptoms and side effects ( e.g. , pain , lymphedema , fatigue , neuropathy ) , quality of life , and psychosocial functioning ( e.g. , anxiety , depression , self-esteem , happiness ) , ( 2 ) the determinants of physical activity and health-related fitness including demographic , medical , social cognitive , and environmental variables , ( 3 ) the mediators of any observed associations between physical activity , health-related fitness , and health outcomes including biological , functional , and psychosocial , and ( 4 ) the moderators of any observed associations including demographic , medical , and biological/disease factors . Taken together , these data will provide a comprehensive inquiry into the outcomes , determinants , mechanisms , and moderators of physical activity and health-related fitness in breast cancer survivors OBJECTIVE Our primary objective was to determine whether a novel ' active school ' model -- Action Schools ! BC -- improved the cardiovascular disease ( CVD ) risk profile in elementary-school children . Our secondary objective was to determine the percentage of children with elevated CVD risk factors . METHODS We undertook a cluster-r and omized controlled school-based trial with 8 elementary schools across 1 school year , in British Columbia , Canada , beginning in 2003 . Boys and girls ( n=268 , age 9 - 11 years ) were r and omly assigned ( by school ) to usual practice ( UP , 2 schools ) or intervention ( INT , 6 schools ) groups . We assessed change between groups in cardiovascular fitness ( 20-m Shuttle Run ) , blood pressure ( BP ) , and body mass index ( BMI , wt/ht(2 ) ) . We evaluated total cholesterol ( TC ) , total : high-density cholesterol ( TC : HDL-C ) , low-density lipoprotein , apolipoprotein B , C-reactive protein and fibrinogen on a subset of volunteers ( n=77 ) . RESULTS INT children had a 20 % greater increase in fitness and a 5.7 % smaller increase in BP compared with children attending UP schools ( P<0.05 ) . Forty five percent of children had at least one elevated risk factor ( fitness , BP or BMI ) at baseline . There were no significant differences between groups for change in BMI or in any of the blood variables . CONCLUSION Action Schools ! BC was an effective school-based physical activity model for improving the CVD risk profile of elementary-school children . Our multi-component intervention exposed children to fitness enhancing physical activity . It may be important for education stakeholders to adequately re source the delivery of the active school models if cardiovascular health benefits are to be achieved on a population basis INTRODUCTION Shift work ( an occupation requiring work between 2200 and 0500H ) comprises approximately 20 % of the workforce in Europe and North America [ 1 ] . This is likely to increase , with many shift workers ( SWs ) in emergency services , retail , hospitality , healthcare , transportation and manufacturing [ 2 ] . SWs are at increased risk for negative health outcomes , including cancer and other chronic diseases [ 3 , 4 ] . Biological changes from poor lifestyle habits related to shift work ( e.g. low physical activity ( PA ) , poor nutrition , obesity ) are thought to contribute to this risk ; these factors are also amenable to lifestyle intervention [ 5 ] . PA in particular , reduces cancer risk [ 6 ] , and has many positive physical and psychological benefits [ 7 ] . It is a simple , cost-effective strategy that may be implemented by individual workers or within workplaces to mitigate risk . Unfortunately , SWs are unlikely to engage in regular PA [ 8 ] . In Canada , only 15.9 % of SWsmeet the PA guidelines and have lower levels of aerobic fitness than those of day workers [ 9 ] . Few behavioural interventions improving health outcomes in SWs have been published [ 10 ] . In a targeted PA intervention , nurses r and omised to 4 months of supervised PA  improved aerobic fitness , muscular strength , fatigue and musculoskeletal symptoms . However , authors reported low adherence and large loss to follow-up , perhaps due to the supervised scheduled sessions [ 11 , 12 ] . Sustained behaviour change is a challenge and requires targeted efforts to encourage individuals to reach an adequate dose of PA to change health outcomes [ 13 ] . Due to irregular schedules and time constraints , SWs may be less likely to adhere to a traditional supervised PA intervention with face-to-face behavioural support [ 12 ] . Women SWs cite work schedule interference and lack of time as PA barriers and report scheduling flexibility as the most important in PA [ 14 ] . This highlights the need for a creative and innovative programming to promote PA in SWs . Distance-based interventions , in which individuals exercise independent of study staff or participants , may include telephone counselling and website or smart phone app-based technology . These interventions are highly flexible and may help overcome barriers related to timing and scheduling that are important for SWs . In a review of telephone-based PA interventions , 14 of 17 found evidence for behaviour change [ 15 ] . These may be a way to implement scalable , individuallytailored interventions in SWs . The primary objective of this study was to test the feasibility of a distance-based PA intervention in women SWs . Feasibility studies are important for establishing effective processes and underst and ing re sources required before attempting a r and omised controlled trial ( RCT ) , in order to put forward interventions that are most likely to be efficacious [ 16 ] . As this work was funded by a grant to examine the role of lifestyle in reducing breast cancer risk in SWs , only women were included . A secondary objective was to conduct a preliminary evaluation of intervention efficacy , to estimate effect size for future studies Background Aboriginal and Torres Strait Isl and er people have higher rates of chronic disease and a lower life expectancy than non-Indigenous Australians . In non-urban areas these health disparities are even larger . The aim of this qualitative study was to explore perceived barriers and enablers to attending an eight-week physical activity program in a rural and regional setting which aim ed to improve health outcomes , but had a low attendance rate . Methods Thirty-four Indigenous Australians participated in the intervention from the rural ( n = 12 ) and the regional ( n = 22 ) community .  Qualitative semi-structured individual interviews were conducted at the follow-up health assessment s with 12 participants . A thematic network analysis was undertaken to examine the barriers and enablers to participation in the program . Results Overall , there were positive attitudes to , and high levels of motivation towards , the physical activity program . Enablers to participation were the inclusion of family members , no financial cost and a good relationship with the principal investigator , which was strengthened by the community-based participatory approach to the program design . Barriers to program attendance were mostly beyond the control of the individuals , such as ‘ sorry business ’ , needing to travel away from the community and lack of community infrastructure . Conclusions More consideration is needed prior to implementation of programs to underst and how community-specific barriers and enablers will affect attendance to the program . Trial registration ACTRN12616000497404 . Registered 18 April 2016 Background Despite the health risks , physical inactivity is common . Identifying the correlates of physical activity to inform the design of interventions to reduce the disease burden associated with physical inactivity is a public health imperative . Rural adults have a unique set of characteristics influencing their activity behaviour , and are typically understudied , especially in Engl and . The aim of this study was to identify the personal , social , and environmental correlates of physical activity in adults living in rural villages . Methods The study used baseline data from 2415 adults ( response rate : 37.7 % ) participating in the first time period of a stepped-wedge cluster r and omised trial , conducted in 128 rural villages from south-west Engl and . Data collected included demographic characteristics , social factors , perception of the local environment , village level factors ( percentage male , mean age , population density , Index of Multiple Deprivation , and sport market segmentation ) , and physical activity behaviour . R and om effects ( “ multilevel ” ) logistic regression models were fitted to the binary outcome whether individuals met physical activity guidelines , and r and om effects linear regression models were fitted to the continuous outcome MET-minutes per week leisure time physical activity , using the personal , social , environmental , and village-level factors as predictors . Results The following factors both increased the odds of meeting the recommended activity guidelines and were associated with more leisure-time physical activity : being male ( p = 0.002 ) , in good health ( p < 0.001 ) , greater commitment to being more active ( p = 0.002 ) , favourable activity social norms ( p = 0.004 ) , greater physical activity habit ( p < 0.001 ) , and recent use of recreational facilities ( p = 0.01 ) . In addition , there was evidence ( p < 0.05 ) that younger age , lower body mass index , having a physical occupation , dog ownership , inconvenience of public transport , and using recreational facilities outside the local village were associated with greater reported leisure-time physical activity . None of the village-level factors were associated with physical activity . Conclusions This study adds to the current literature on the correlates of physical activity behaviour by focusing on a population exposed to unique environmental conditions . It highlights potentially important correlates of physical activity that could be the focus of interventions targeting rural population s , and demonstrates the need to examine rural adults separately from their urban counterparts BACKGROUND About two-thirds of Canadians are physically inactive . As a risk factor for several chronic diseases , physical inactivity can potentially be a substantial public health burden . We estimated the direct health care costs attributable to  physical inactivity  in Canada , the number of lives lost prematurely each year that are attributable to a sedentary lifestyle and the effect that a reduction of 10 % in inactivity levels ( a Canadian objective for 2003 ) could have on reducing direct health care costs . METHODS We calculated summary relative risk ( RR ) estimates from prospect i ve longitudinal studies of the effects of physical inactivity on coronary artery disease , stroke , colon cancer , breast cancer , type 2 diabetes mellitus and osteoporosis . We then computed the population -attributable fraction ( PAF ) for each illness from the summary RR and the prevalence of physical inactivity ( i.e. , 62 % ) and applied the PAF to the total direct health care expenditures for 1999 and to the number of deaths in 1995 associated with each disease to determine the health care costs and lives lost prematurely that were directly attributable to physical inactivity . RESULTS About $ 2.1 billion , or 2.5 % of the total direct health care costs in Canada , were attributable to physical inactivity in 1999 . A sensitivity analysis ( simultaneously varying each of the health care costs and PAF by + /- 20 % ) indicated that the costs could be as low as $ 1.4 billion and as high as $ 3.1 billion . About 21,000 lives were lost prematurely in 1995 because of inactivity . A 10 % reduction in the prevalence of physical inactivity has the potential to reduce direct health care expenditures by $ 150 million a year . INTERPRETATION Physical inactivity represents an important public health burden in Canada . Even modest reductions in inactivity levels could result in substantial cost savings BACKGROUND Rural children are at a particular high risk for obesity . Given the importance of exercise in obesity and chronic disease prevention , this study evaluated the level and relationship between physical activity and fitness in a sample of rural third grade rs . The second purpose of the study was to determine potential differences in physical activity and fitness level by weight status in this sample . METHODS Twelve schools participating in a multidisciplinary research project were r and omly selected for the study . Body mass index-for-age percentile , the modified Self-administered Physical Activity Checklist  , and the FITNESSGRAM battery tests were utilized to determine children 's weight status , physical activity , and fitness level , respectively . RESULTS Thirty-eight percent of the 237 participating children ( 9.2 ± 0.4 years ) were overweight or obese . Nearly 15 % were extremely obese . Children spent 91.8 ± 83.8 and 32.2 ± 47.7 minutes in moderate- and vigorous-intensity activities . Obese children spent less time in moderate-intensity activity ( p < .01 ) and combined moderate- and vigorous-intensity activity more than other children ( p < .05 ) . Forty-three percent of all children failed to meet the fitness st and ard for muscular strength and 36 % failed to meet it for flexibility . CONCLUSIONS Rural children in this sample had higher rates of obesity compared to the national average ; they had poor fitness and 30 % failed to meet the minimum physical activity recommendations on the previous day . Future interventions should focus on increasing physical activity , especially of moderate-intensity , and improving physical fitness in order to reduce obesity and decrease the risk of future chronic diseases in this high-risk population Background Indigenous Australians suffer a disproportionate burden of preventable chronic disease compared to their non-Indigenous counterparts – much of it diet-related . Increasing fruit and vegetable intakes and reducing sugar-sweetened soft-drink consumption can reduce the risk of preventable chronic disease . There is evidence from some general population studies that subsidising healthier foods can modify dietary behaviour . There is little such evidence relating specifically to socio-economically disadvantaged population s , even though dietary behaviour in such population s is arguably more likely to be susceptible to such interventions .This study aims to assess the impact and cost-effectiveness of a price discount intervention with or without an in-store nutrition education intervention on purchases of fruit , vegetables , water and diet soft-drinks among remote Indigenous communities . Methods / Design We will utilise a r and omised multiple baseline ( stepped wedge ) design involving 20 communities in remote Indigenous Australia . The study will be conducted in partnership with two store associations and twenty Indigenous store boards . Communities will be r and omised to either i ) a 20 % price discount on fruit , vegetables , water and diet soft-drinks ; or ii ) a combined price discount and in-store nutrition education strategy . These interventions will be initiated , at one of five possible time-points , spaced two-months apart . Weekly point-of-sale data will be collected from each community store before , during , and for six months after the six-month intervention period to measure impact on purchasing of discounted food and drinks . Data on physical , social and economic factors influencing weekly store sales will be collected in order to identify important covariates . Intervention fidelity and mediators of behaviour change will also be assessed . Discussion This study will provide original evidence on the effectiveness and cost-effectiveness of price discounts with or without an in-store nutrition education intervention on food and drink purchasing among a socio-economically disadvantaged population in a real-life setting .Trial registration Australian New Zeal and Clinical Trials Registry : Background Physical inactivity is an independent risk factor for diabetes and heart disease . There is evidence that increasing physical activity can reduce the risk of developing these chronic diseases , but less evidence about effective ways to increase adherence to physical activity . Interventions are therefore needed that produce sustained increases in adherence to physical activity , are cost-effective and improve clinical endpoints . Methods The Women 's Lifestyle Study is a two year r and omized controlled trial involving a nurse-led intervention to increase physical activity in 40–74 year old physically inactive women recruited from primary care . Baseline measures were assessed in a face-to-face interview with a primary care nurse . The intervention involved delivery of a ' Lifestyle script ' by a primary care nurse followed by telephone counselling for nine months and a face-to-face nurse visit at six months . Outcome measurements are assessed at 12 and 24 months . The primary outcome is physical activity measured using a vali date d physical activity question naire . Secondary outcomes include blood pressure , weight , waist circumference , physical fitness ( step test ) , serum HbA1c , fasting glucose , lipids , insulin , and quality of life ( SF36 ) . Costs were measured prospect ively to allow a subsequent cost-effectiveness evaluation if the trial is positive . Discussion Due to report in 2008 , the Women 's Lifestyle Study tests the effectiveness of an enhanced low-cost , evidence -based intervention in increasing physical activity , and improving cardiovascular and diabetes risk indicators over two years . If successful in demonstrating improvements in health outcomes , this r and omized controlled trial will be the first to demonstrate long-term cardiovascular and diabetes risk health benefit , in addition to improvements in physical activity , from a sustainable physical activity intervention based in primary care . Trial Registration Australian Clinical Trials Registry ( ACTR ) , ACTRN012605000490673 Introduction Large proportions of the population are not meeting recommended levels of physical activity and have increasingly sedentary lifestyles . Low levels of physical activity are predictive of poor health outcomes and time spent sedentary is related to a host of risk factors independently of physical activity levels . Building an evidence base of the best approaches to intervene in the lifestyles of inactive individuals is crucial in preventing long-term disease , disability and higher mortality rates . Methods and analysis Systematic search es will be conducted on all relevant data bases ( eg , PubMed , Scopus , CINAHL , PsycINFO ) . Studies will be included if they assess interventions aim ed at changing physical activity or sedentary behaviour levels in adults ( over 18 ) who are inactive and do not suffer from chronic conditions . Studies must also be r and omised controlled trials ( RCTs ) , have a primary outcome of physical activity or sedentary behaviour , and measure outcomes at least 6 months after intervention completion . Studies will be coded using the Behaviour Change Technique ( BCT ) taxonomy v1 and Template for Intervention Description and Replication ( TIDieR ) guidelines . 2 review ers will independently screen full-text articles and extract data on study characteristics , participants , BCTs , intervention features and outcome measures . Study quality will also be assessed independently by 2 review ers using the Cochrane risk of bias tool . A meta- analysis will be considered if there is sufficient homogeneity across outcomes . GRADE criteria will be used to assess quality of evidence . Dissemination This will be the first review to systematic ally appraise interventions aim ed at changing the physical activity or sedentary behaviour of inactive individuals using RCT design s with a 6-month follow-up post-intervention . This review will better inform intervention design ers targeting inactive population s and inform the design of a future complex intervention . Review registration number This protocol was registered with the International Prospect i ve Register of Systematic Review s ( PROSPERO ) on 17 October 2014 ( registration number : CRD42014014321 ) Background Physical inactivity ranks as a major contributing factor in the development and progression of chronic disease . Lifestyle interventions reduce the progression of chronic disease , however , compliance decreases over time and health effects only persist as long as the new lifestyle is maintained . Telephone counselling ( TC ) is an effective way to provide individuals with ongoing support to maintain lifestyle changes . Remote physical activity monitoring and feedback ( RAMF ) via interactive technologies such as activity trackers and smartphones may be a cost-effective alternative to TC , however , this comparison has not been made . This study , therefore , aims to determine the effect of ongoing feedback ( TC vs. RAMF ) on the maintenance of physical activity following a 12-week individualised lifestyle program , and the effect of this on health risk factors and health services usage . Methods and design A r and omised controlled trial with a parallel groups design . A total of 150 adults ( ≥60 years ) who participate in a 12-week face-to-face individualised lifestyle program will be r and omised to twelve months of RAMF ( n = 50 ) , TC ( n = 50 ) , or usual care ( n = 50 ) . Participants r and omised to RAMF will use a smartphone activity tracker app , synced to a wrist worn activity tracker , to provide them with automated feedback regarding compliance to prescribed activity targets . Telephone counselling involves a follow-up phone call every fortnight for the first three months and a monthly call for the remaining nine months of the follow-up period . The primary outcome measures are physical activity compliance ( accelerometry and Active Australia survey ) . Secondary outcome measures include cardiorespiratory fitness , muscle strength , dynamic balance , quality of life , blood pressure , body composition , and health services usage . Measures will be made before and after the individualised lifestyle program , and at three , six and twelve months during the intervention . Discussion The results of this study will help to determine the efficacy of RAMF devices on compliance to prescribed physical activity compared to the current gold st and ard of TC . If the remote monitoring proves effective , it may provide a cost efficient alternative method of assisting maintenance of behaviour change from lifestyle interventions .Trial registration ACTRN12615001104549 . Retrospectively Registered 20/10/2015 Background The evidence that higher levels of physical activity and /or lower levels of physical inactivity are associated with beneficial health-related outcomes stems mainly from observational studies . Findings from these studies often differ from r and omised controlled trials and systematic review s currently demonstrate mixed results , due partly to heterogeneity in physical activity interventions , method ologies used and population s studied . As a result , translation into clinical practice has been difficult . It is therefore essential that an overview is carried out to compare and contrast systematic review s , and to identify those physical activity interventions that are the most effective in preventing and /or treating major chronic disease . This protocol has been registered on PROSPERO 2013 : CRD42013003523 . Methods We will carry out an overview of Cochrane systematic review s. We will search the Cochrane Data base of Systematic Review s for systematic review s of r and omised controlled trials that have a primary focus on disease-related outcomes . We will restrict review s to those in selected major chronic diseases . Two authors will independently screen search outputs , select studies , extract data and assess the quality of included review s using the assessment of multiple systematic review s tool ; all discrepancies will be resolved by discussing and reaching a consensus , or by arbitration with a third author . The data extraction form will summarise key information from each review , including details of the population ( s ) ( for example , disease condition ) , the context ( for example , prevention , treatment or management ) , the participants , the intervention(s ) , the comparison(s ) and the outcomes . The primary outcomes of interest are the prevention of chronic disease and /or improved outcomes , in the treatment or management of chronic disease . These outcomes will be summarised and presented for individual chronic diseases ( for example , any change in blood pressure in hypertension or glucose control in diabetes ) . Secondary outcomes of interest are to describe the structure and delivery of physical activity interventions  across chronic disease conditions and adverse events associated with physical activity . Discussion We anticipate that our results could inform research ers , guideline groups and policymakers of the most efficacious physical activity interventions in preventing and /or managing major chronic disease BACKGROUND Observational studies indicate that physical activity ( PA ) is strongly associated with improved disease outcomes in colon cancer survivors , but a r and omized controlled trial is needed to determine whether the association is causal and whether new policies to promote exercise are justified . PURPOSE The co.21 Colon Health and Life-Long Exercise Change ( challenge ) trial undertaken by the National Cancer Institute of Canada Clinical Trials Group ( NCIC CTG ) is design ed to determine the effects of a structured pa intervention on outcomes for survivors of high-risk stage II or III colon cancer who have completed adjuvant therapy within the previous 2 - 6 months . METHODS Trial participants ( n = 962 ) will be stratified by centre , disease stage , body mass index , and performance status , and will be r and omly assigned to a structured pa intervention or to general health education material s. The pa intervention will consist of a behavioural support program and supervised pa sessions delivered over a 3-year period , beginning with regular face-to-face sessions and tapering to less frequent face-to-face or telephone sessions . The primary endpoint is disease-free survival . Important secondary endpoints include multiple patient-reported outcomes , objective physical functioning , biologic correlative markers , and an economic analysis . SUMMARY Cancer survivors and cancer care professionals are interested in the potential role of PA to improve multiple disease-related outcomes , but a r and omized controlled trial is needed to provide compelling evidence to justify changes in health care policies and practice BACKGROUND This pilot study evaluated the feasibility and preliminary effectiveness of a 10-week WhatsApp-based intervention aim ed at enhancing health-related physical fitness components and cardiovascular disease ( CVD ) risk factors compared with a face-to-face condition . METHODS Participants ( N.=32 ) were assigned to one of three groups : training group ( N.=16 ) , mobile group ( N.=7 ) and control group ( N.=9 ) . Training group and mobile group performed the same training program , based on strength training with elastics b and s and aerobic exercise , during 10 weeks ; only the delivery mode differed . RESULTS The mobile group increased h and grip strength , aerobic capacity and decreased systolic blood pressure and heart rate after exercise though there were no significant differences respect to control group . The training group decreased significantly systolic blood pressure ( P=0.038 ) , diastolic blood pressure ( P=0.005 ) , mean arterial pressure ( P=0.006 ) and heart rate after exercise ( P=0.002 ) , respect to control group . CONCLUSIONS Comparison between training and mobile group showed that WhatsApp-based physical activity intervention was less effective than face-to-face condition . The results indicate that the use of an online social network produced slight changes in some health-related physical fitness components and CVD risk factors Physical activity interventions targeting social and physical environments of the urban poor hold promise in improving health outcomes in underserved communities . This study r and omly assigned overweight , sedentary , economically disadvantaged adults to one of three intervention conditions at The Hope and Healing Center , a large inner-city health facility providing numerous options for exercise . Within the tenets of Social Action Theory , the Health Opportunities with Physical Exercise ( HOPE ) trial will test the efficacy of two behavior change models , social support and patient-provider interaction , to increase physical activity . In addition to a st and ard care condition , in which patients have open access to Hope and Healing physical activity programming , patients were assigned to one of two behavior change interventions . Those assigned to patient-peer receive face-to-face , systematic and scheduled encouragement from study -trained ' peer ' interventionists at the facility . Patients assigned to patient-provider receive face-to-face , systematic and scheduled encouragement provided by study -trained ' provider ' interventionists also at the facility . The primary outcomes of change in exercise behavior will be documented by self-reported physical activity and confirmed by fitness testing at baseline , 6 , 12 and 24 months during the 1 year of active intervention and 1 year of relapse prevention follow-up . Intervention conditions will be compared on psychosocial mediators including motivational appraisal s , ratings of social support , rapport , problem solving and self-efficacy for overcoming barriers to increased physical activity . Novel aspects of this intervention include : ( 1 ) delivery of socially based physical activity interventions to an economically disadvantaged urban population , ( 2 ) reduction of environmental barriers to be physically active and ( 3 ) emphasis on social interactions influencing health habit change . Results of this study have the potential to identify mechanisms of behavior change that could be adopted by physical activity interventions aim ed at reducing sedentary behavior and health disparities in high-risk , underserved population Background Declining levels of physical fitness in children are linked to an increased risk of developing poor physical and mental health .  Physical activity programs for children that involve regular high intensity physical activity , along with muscle and bone strengthening activities , have been identified by the World Health Organisation as a key strategy to reduce the escalating burden of ill health caused by non-communicable diseases . This paper reports the rationale and methods for a school-based intervention design ed to improve physical fitness and physical activity levels of Grade s 5 and 6 primary school children . Methods / Design Fit-4-Fun is an 8-week multi-component school-based health-related fitness education intervention and will be evaluated using a group r and omized controlled trial . Primary schools from the Hunter Region in NSW , Australia , will be invited to participate in the program in 2011 with a target sample size of 128 primary schools children ( age 10 - 13 ) . The Fit-4-Fun program is theoretically grounded and will be implemented applying the Health Promoting Schools framework . Students will participate in weekly curriculum-based health and physical education lessons , daily break-time physical activities during recess and lunch , and will complete an 8-week ( 3 × per week ) home activity program with their parents and /or family members . A battery of six health-related fitness assessment s , four days of pedometery-assessed physical activity and a question naire , will be administered at baseline , immediate post-intervention ( 2-months ) and at 6-months ( from baseline ) to determine intervention effects . Details of the method ological aspects of recruitment , inclusion criteria , r and omization , intervention program , assessment s , process evaluation and statistical analyses are described . Discussion The Fit-4-Fun program is an innovative school-based intervention targeting fitness improvements in primary school children . The program will involve a range of evidence -based behaviour change strategies to promote and support physical activity of adequate intensity , duration and type , needed to improve health-related fitness . Trial Registration NoAustralia and New Zeal and Clinical Trials Register ( ANZCTR ) : Purpose of review This review highlights recent work evaluating the relationship between exercise , physical activity and physical and mental health . Both cross-sectional and longitudinal studies , as well as r and omized clinical trials , are included . Special attention is given to physical conditions , including obesity , cancer , cardiovascular disease and sexual dysfunction . Furthermore , studies relating physical activity to depression and other mood states are review ed . The studies include diverse ethnic population s , including men and women , as well as several age groups ( e.g. adolescents , middle-aged and older adults ) . Recent findings Results of the studies continue to support a growing literature suggesting that exercise , physical activity and physical-activity interventions have beneficial effects across several physical and mental-health outcomes . Generally , participants engaging in regular physical activity display more desirable health outcomes across a variety of physical conditions . Similarly , participants in r and omized clinical trials of physical-activity interventions show better health outcomes , including better general and health-related quality of life , better functional capacity and better mood states . Summary The studies have several implication s for clinical practice and research . Most work suggests that exercise and physical activity are associated with better quality of life and health outcomes . Therefore , assessment and promotion of exercise and physical activity may be beneficial in achieving desired benefits across several population s. Several limitations were noted , particularly in research involving r and omized clinical trials . These trials tend to involve limited sample sizes with short follow-up periods , thus limiting the clinical implication s of the benefits associated with physical activity . Abbreviations CAD : coronary artery disease ; COPD : chronic obstructive pulmonary disease ; CRP : cardiac rehabilitation program ; CVD : cardiovascular disease ; GMCB : group-mediated cognitive – behavioural ; HRQOL : health-related quality of life Background Child obesity internationally has been identified as one of the major threats to future population health . Indigenous people and those from lower socio-economic background s are over-represented in obesity statistics . There is a need for evidence of effect of interventions for child obesity with long-term follow-up . Whether engaging with those that are more motivated to make lifestyle changes is a useful strategy has not been fully explored . We hypothesise that in obese/overweight children , assessed as psychologically “ ready for change ” , delivery of a 12-month multi-disciplinary intervention programme results in a significant reduction in body mass index st and ard deviation score . Methods / Design Whanau Pakari is an unblinded r and omised controlled clinical trial comparing a 12 month intervention programme with st and ard practice , with 6 monthly assessment s for 2 years , conducted in Taranaki , New Zeal and ( a region where 15.8 % of the population are indigenous ) . It specifically targets indigenous people and those in more deprived households . Obese/overweight children and adolescents aged 5–16 years are eligible . Exclusion criteria are medical/psychological conditions leading to inability to undertake physical activity/participate in group sessions ; those not “ ready ” to make lifestyle changes ; and those without a committed family member . Assessment s of health parameters , dietary history , physical activity and overall health-related quality of life/psychological functioning are completed in the participant ’s home .  Fasting blood tests are obtained at baseline , 12 and 24 months . The primary outcome is body mass index st and ard deviation score . Secondary outcomes include quality of life , dietary behaviour and physical activity , cardiovascular and metabolic profile ( blood pressure , resting heart rate , waist circumference ) , glycaemic control ( fasting glucose and glycated Haemoglobin ) , fasting insulin , and lipids . A general linear mixed model will be used to assess change from baseline using the 6 , 12 , 18 and 24 month measures , adjusting for age , gender , socioeconomic status and ethnicity , and whether at the contemplative or preparation/action stages of readiness for change . Discussion This trial will inform the development of management programmes for obese children and adolescents that are appropriate for indigenous population s. It will investigate whether those at the preparation/action stage of “ readiness ” to make lifestyle changes are more successful in making changes than those who are contemplative . Trial registration Australian New Zeal and Clinical Trials Registry (ANZCTR):12611000862943 . ( Date registered 15/08/2011 ) OBJECTIVE To investigate the effects of postnatal dexamethasone treatment on aerobic fitness and physical activity levels in school-aged children born with very low birth weight ( VLBW ) . STUDY DESIGN This was a follow-up study of 65 VLBW infants who participated in a r and omized controlled trial of dexamethasone ( DEX ) to reduce ventilator dependency .  Aerobic fitness was determined from peak oxygen uptake ( VO(2peak ) ) with a cycle ergometer . Habitual physical activity was assessed by question naire . RESULTS A trend for a treatment with an interaction between treatment and of diagnosis of chronic lung disease ( CLD ) was found , with the children in the placebo group with CLD having the lowest VO(2peak ) ( P = .09 ) . Reduced fitness was seen in 53 % of the group treated with DEX and 48 % of the group given placebo . No between-group differences in physical activity were seen . Parental reports suggested that nearly two-thirds of the children participated in < 1 hour per week of vigorous physical activity , which was explained in part by decreased large airway function ( r = 0.30 ; P = .03 ) . CONCLUSIONS We found no adverse effect of postnatal DEX on aerobic fitness or habitual physical activity at school age . However , the reduced fitness and physical activity levels emphasize the need for closer follow-up and early interventions promoting physical activity to reduce the risk of chronic disease in this at-risk population Regular physical activity is associated with a reduced risk of all-cause mortality , and mortality due to cardiovascular disease and cancer . Among adolescents , physical activity is associated with benefits in the prevention and control of emotional distress , and improvement of self-esteem . Countries in transitional epidemiological scenarios , such as Chile , need to develop effective strategies to improve physical activity as a way to face the epidemic of chronic diseases . The objective of this study was to evaluate the effects of a school-based physical activity program on physical fitness and mental health status of adolescents living in a low socioeconomic status area in Santiago , Chile . A quasi-experimental design was used to evaluate the effects of the program over one academic year . The study included 198 students aged 15 years old . Two ninth grade classes were r and omly selected as the  intervention group , with two classes of the same grade as controls . A social planning approach was used to develop the intervention . The program was design ed and implemented based on student preferences , teachers ' expertise and local re sources . Changes in physiological and mental health status were assessed . After the intervention , maximum oxygen capacity achieved a significant increase of 8.5 % in the intervention versus 1.8 % in the control group ( p < 0.0001 ) . Speed and jump performance scores improved significantly more in the intervention versus the control group ( p > 0.01 ) . Anxiety score decreased 13.7 % in the intervention group versus 2.8 % in the control group ( p < 0.01 ) , and self-esteem score increased 2.3 % in the intervention group and decreased 0.1 % in the control group after the end of the program ( p < 0.0001 ) . No significant change was observed in the depressive score . Student participation and compliance with the program was > 80 % . To conclude , a school-based program to improve physical activity in adolescents of low socioeconomic status , obtained a high level of participation and achieved significant benefits in terms of physical fitness and mental health status Introduction Chronic obstructive pulmonary disease ( COPD ) is associated with exercise limitation and physical inactivity , which are believed to have significant long-term negative health consequences for patients . While a number of COPD treatments and exercise training programmes increase exercise capacity , there is limited evidence for their effects on physical activity levels , with no clear association between exercise capacity and physical activity in clinical trials . Physical activity depends on a number of behaviour , environmental and physiological factors . We describe the design of the PHYSACTO trial , which is investigating the effects of bronchodilators , either alone or with exercise training , in combination with a st and ardised behaviour-change self-management programme , on exercise capacity and physical activity in patients with COPD . It is hypothesised that bronchodilators in conjunction with a behaviour-change self-management programme will improve physical activity and that this effect will be amplified by the addition of exercise training . Methods and analysis Patients are being recruited from 34 sites in Australia , New Zeal and , the USA , Canada and Europe . Patients receiving a multicomponent intervention design ed to support behaviour change related to physical activity are r and omised to four treatment arms : placebo , tiotropium , tiotropium+olo date rol , and tiotropium+olo date rol+exercise training . The primary outcome is improvement in exercise capacity after 8 weeks , measured by endurance time during a shuttle walk test . The secondary outcome is improvement in physical activity , including objective accelerometer assessment and patient-reported functioning using the Functional Performance Inventory — Short Form and the novel hybrid PROactive instrument . Additionally , the influence of moderating variables ( ie , factors influencing a patient 's choice to be physically active ) on increases in physical activity is also explored . Ethics and dissemination The study has been approved by the relevant Institutional Review Boards , Independent Ethics Committee and Competent Authority according to national and international regulations . The findings of the trial will be disseminated through relevant peer- review ed journals and international conference presentations . Trial registration number NCT02085161 Cardiovascular disease begins early in life but might be prevented or delayed by primary prevention programs design ed for children and adolescents .  Regular physical activity is an important part of primary prevention programs , and school physical education programs have potential for the promotion of regular physical activity . Cardiovascular disease is the major cause of death among Hispanics and African Americans in the United States . Low levels of fitness and increased body mass index are common in African American and Hispanic adolescents . Increased physical activity and the adoption of healthy eating habits would increase fitness and reduce body mass index among these adolescents . The purpose of the study was to undertake a small-scale controlled trial to determine if Dance for Health , an intervention program design ed to provide an enjoyable aerobic program for African American and Hispanic adolescents , has a significant effect on improving aerobic capacity , helping students maintain or decrease weight , and on improving attitudes toward physical activity and physical fitness . In the first year of the program ( 1990 - 91 ) , approximately 110 boys and girls ages 10 - 13 years participated in an aerobic dance pilot program three times per week for 12 weeks . Dance for Health was revised and continued in the 1992 - 93 school year with seventh grade students and an added culturally sensitive health curriculum . Forty-three students were r and omized to Dance for  Health and 38 to  usual physical activity . Those in the intervention class received a health education curriculum twice a week and a dance oriented physical education class three times a week . The usual physical activity consisted mostly of playground activities . Students in the intervention had a significantly greater lowering in body mass index and resting heart rate than students in regular physical activity Background The prevalence of both overweight and musculoskeletal disorders ( MSD ) in the construction industry is high . Many interventions in the occupational setting aim at the prevention and reduction of these health problems , but it is still unclear how these programmes should be design ed . To determine the effectiveness of interventions on these health outcomes r and omised controlled trials ( RCTs ) are needed . The aim of this study is to systematic ally develop a tailored intervention for prevention and reduction of overweight and MSD among construction workers and to describe the evaluation study regarding its (cost-)effectiveness . Methods / Design The Intervention Mapping ( IM ) protocol was applied to develop and implement a tailored programme aim ed at the prevention and reduction of overweight and MSD . The ( cost- ) effectiveness of the intervention programme will be evaluated using an RCT . Furthermore , a process evaluation will be conducted . The research population will consist of blue collar workers of a large construction company in the Netherl and s . InterventionThe intervention programme will be aim ed at improving ( vigorous ) physical activity levels and healthy dietary behaviour and will consist of tailored information , face-to-face and telephone counselling , training instruction ( a fitness " card " to be used for exercises ) , and material s design ed for the intervention ( overview of the company health promoting facilities , waist circumference measuring tape , pedometer , BMI card , calorie guide , recipes , and knowledge test).Main study parameters/endpointsThe intervention effect on body weight and waist circumference ( primary outcome measures ) , as well as on lifestyle behaviour , MSD , fitness , CVD risk indicators , and work-related outcomes ( i.e. productivity , sick leave ) ( secondary outcome measures ) will be assessed . Discussion The development of the VIP in construction intervention led to a health programme tailored to the needs of construction workers . This programme , if proven effective , can be directly implemented . Trial registration Netherl and s Trial Register ( NTR ) :
There is limited evidence and a lack of robust interventions that examine the impacts of  physical activity on health and fitness status in the Canadian Indigenous population .
Vali date d , culturally relevant tools for measuring physical activity may aid in program evaluation and focused educational material s could better support population health initiatives .
The Indigenous population of Canada faces an increased burden of chronic disease , leading to decreased life expectancy .
Physical activity is an important health behaviour that improves chronic disease risk factors and physical fitness .
The objective of this systematic review was to evaluate physical activity interventions in the Indigenous population in Canada to determine effects on physical activity rates , physical fitness , and health outcomes .