bluuebunny/crossref_metadata_2025 huggingface dataset:
174 A qualitative exploration of the influence of formal and informal care practices on physical activity in care home residents
Authors: Wylie Gavin , Kroll Thilo , Witham Miles , Morris Jacqui
Published: September 2024

Background

Physical activity (PA) levels among older people who live in care homes are low, with residents estimated to spend 70 - 80% of their waking time inactive. Low PA in care homes reduces independence, function, and quality of life. Influences on PA behaviour stem partly from residents’ reduced intrinsic physiological capacity. However, influences on PA behaviour are also context-specific, and staff practices related to the organisational and cultural environments of care homes are critical in how (or if) care home residents engage in PA.

Objective

To explore the role and perceptions of staff in the promotion of PA in care home residents.

Methods

A focused ethnographic study in five care homes for older people comprised 54 hours of non-participant observation and 15 in-depth interviews with care home care workers. Observations of PA behaviours focused on key moments and the daily routines of the care homes. Interviews were informed by observations and sought explanations for observed behaviour. All data were analysed using thematic analysis informed by a social-ecological perspective.

Results

The findings show how care workers perceptions of roles, identity, and sense of purpose regarding PA facilitation led to a continuum of formal and informal practices. Opportunities for PA appeared to be constrained or facilitated by care workers conceptualisations of the nature and purpose of care that stemmed from: (i) beliefs around how (or if) carers could facilitate PA opportunities within the constraints of the care routine; (ii) carers’ notions of identity and the purpose of their role; (iii) the boundaries of care work; (iv) formal practices in PA; (v) carers’ knowledge and understanding of PA.

Conclusions

Care staff are the most appropriate people to sustain facilitation of PA on a regular basis, however, this is contingent on addressing detailed individual, interpersonal, organisational, and physical environmental influences on PA. The findings are placed in the context of a social-ecological model that can be used to support the development of interventions to increase PA in care homes. These findings provide evidence to support potential transformation of care worker roles to emphasise PA facilitation as a key part of the role.
197 Association between physical activity and chronic diseases in the adult population in Slovenia
Authors: Brovč Monika , Kukec Andreja , Pustivšek Suzana , Vračko Pia
Published: September 2024

Purpose

The purpose of this study was to examine the results of the latest European health interview survey (EHIS 2019) to analyze the prevalence of non-communicable diseases (NCDs) and the association between them and physical activity (PA) in adults in Slovenia, and to determine the role of socio-economic and other factors. The main hypothesis was that people who achieve the World Health Organization’s recommended physical activity have less diseases than those who do not. The innovative approach was the use of multivariate analysis to examine the correlations between different factors.

Methods

Data from the EHIS 2019 survey was used. It is a cross-sectional study of a representative sample of adults aged 15 and over, conducted periodically in EU member states. 9900 adults participated in the Slovenian study. Chi-square test was used to assess the statistical difference between the observed outcomes and explanatory variables and binary logistic regression to assess the interdependence of all selected variables.

Results

People who met PA recommendations had a lower prevalence of NCDs compared to those who did not (36.3% vs. 50.7%, p < 0.001), as well as those who met the muscle strengthening recommendations (32.2% vs. 40.7%, p < 0.001). The higher percentages of individuals meeting the recommendations were among women, younger age groups, single individuals, those who didn’t have NCDs, those sitting less than 4 hours per day, and those with a normal body mass index. In multivariate analysis, there was a significant difference between those achieving the recommended PA and those who did not; the latter had an approximately 1.4-fold higher odds ratio of having at least one NCD (p < 0.001). People who sit for 12 hours or more per day had approximately 1.8-fold higher odds ratio of having an NCD (p = 0.019).

Conclusions

Based on the results of the study, it would be useful to emphasize the importance of physical inactivity and prolonged sitting for health and to strengthen public health programmes to promote PA and reduce sitting time.

Support/Funding Source

This study didn’t receive funding.
127 Barriers, Facilitators and Opportunities to Promote Walking in Middle and Older-Aged Adults
Authors: O’Meara Alison , Kilbride Heather , Grace James , Maye Laura , Holloway Paul , Mingham Rosane , Chan Jason , Trace Anna O’Reilly , Setti Annalisa
Published: September 2024

Purpose

Physical activity is a key factor in preventing dementia (Livingston et al., 2020) and reducing the risk of other non-communicable diseases (Ding et al., 2016). Almost 50% of middle-aged Irish people do not meet the recommended guidelines for physical activity; people still use functional walking limitedly and the car is a preferred means of transport (Healthy Ireland, 2019; National Household Travel Survey, 2022). The aim of this study was to capture perceptions of the barriers, facilitators and potential solutions to promote walking across different stakeholders, aiming to increase walking in middle-older age.

Methods

Perceptions were gathered across five distinct stakeholder groups (Walkers, Academics, Healthcare Professionals, Policy Makers, Charity/Community Groups) via recorded, semi-structured interviews (n = 42) and focus groups (n = 3).

Results

Results were analysed using thematic analysis. Stakeholders indicated that any intervention aimed to promote walking needs to be tailored to specific groups; any tool used (technology-based or not) needs to account for a spectrum of needs and motivations. Recreational and functional walking are perceived differently; functional walking, coinciding with city walking, is perceived as a loss of time by middle-aged people, older adults are more positive, although barriers are present. Recreational walking is perceived as health enhancing by all stakeholders, but with negative environmental impact by policy makers and advocates aiming at reducing carbon emissions. All stakeholders are open to technological solutions to address the issue of increasing health-enhancing and community-beneficial walking, but interactive solutions are needed.

Conclusions

This study provides valuable insights into the key barriers and facilitators to walking amongst middle-aged and older adults, which can help to inform tailored solutions that aim to promote walking. The findings also bear relevance to policy makers aiming to promote more sustainable communities, as they shed light on when, where and for whom walking is beneficial, and how people feel about the type of environment they walk in.

Support/Funding Source

This project is funded through the Science Foundation Ireland National Challenge Fund.
192 Behavioural and observational analysis of ‘Be Active with Arthritis’ exercise programme to promote and maintain physical activity (PA) in people with arthritis
Authors: Stephenson Aoife , Harris Maia , Khalid Rameen , Hurley-Osing Deirdre , French David , McDonough Suzanne
Published: September 2024

Purpose

The Irish Society of Chartered Physiotherapists (ISCP) and Arthritis Ireland (AI) developed ‘Be Active with Arthritis’ (BAWA), a physiotherapy-led, group-based exercise programme to promote PA in people with arthritis. Participant feedback suggests BAWA participants initially become more active, but many reduce PA levels after programme completion. This may be explained by the absence of behaviour change techniques (BCTs) supporting PA maintenance.

The study objectives are:

1. Identify core BCTs recommended in BAWA training materials and distinguish between those used for supporting in-class exercise versus those supporting day-to-day PA maintenance.

2. Complete an observational analysis of BAWA delivery to explore which BCTs are used to support PA maintenance.

Methods

Training materials for the delivering therapists were reviewed for the presence of core BCTs. The core BCTs linked to PA in-class and PA maintenance were identified. Team members attended and audio-recorded BAWA classes; recordings were analysed for the presence of core BCTs (in-class and maintenance).

Results

Twenty-three core PA in-class BCTs (23/93), and 11 core PA maintenance BCTs were identified in the training materials. Researchers observed 13 BAWA classes from four programme blocks; led by three different therapists, at three separate locations. Seven of the 11 core maintenance BCTs (64%) were identified at least once from the recordings. The most frequently used were: “Generalisation of target behaviour”, “Credible source” and “Body changes”. An additional seven BCTs were identified in the recordings and documented as potentially pertinent to PA maintenance. The most frequently used additional BCTs were “Behavioural practice/rehearsal” and “Habit formation”.

Conclusions

The inclusion of BCTs into the training material was low. There was limited prevalence of BCTs previously thought to be linked to PA maintenance. The observed absence of BCTs such as “Self-monitoring of behaviour” in daily life using devices such as smartwatches was notable. Future development of a maintenance intervention for people living with arthritis should adopt evidence based BCTs and involve people with arthritis in making judgements on acceptability.

Support/funding source

HRCI/HRB in collaboration with AI, HRCI-HRB-2022-010.
52 Co-development of the Physical Literacy Consensus Statement for England
Authors: Foweather Lawrence , Duncan Mike , Essiet Inimfon , Hurter Liezel , Bingham Daniel , Morris Jade , Daly-Smith Andy , Roberts Will , Lewis Kiara , Goss Hannah , O’Brien Wesley , Shearer Cara , Barnett Lisa
Published: September 2024

Purpose

Physical literacy has gained considerable traction across physical activity, sport, health, and education sectors, leading to an abundance of definitions and interpretations worldwide. However, implementing and advocating for physical literacy becomes challenging when the concept holds different meanings for different individuals and organisations. ‘Uniting’ perspectives on the concept could catalyse efforts to adopt, support and promote physical literacy in practice. This study aimed to develop a physical literacy consensus statement for England that was accessible for those working in research, policy, and practice.

Methods

Phase one included a review of the evidence, a first national stakeholder consultation, and focus groups with children and young people. Phase two included a modified-Delphi methodology and co-development of the draft statement with an expert panel of sixty researchers and stakeholders from around fifty organisations. Phase three included a second national consultation on the draft statement. Phase four involved further co-development and an online survey with the expert panel to revise the statement.

Results

Consensus was established on a definition: Physical literacy is our relationship with movement and physical activity throughout life. The statement also included five key messages encompassing (1) Understanding physical literacy, (2) Why physical literacy matters, (3) Supporting physical literacy, (4) Our experiences affect our physical literacy, and (5) Physical literacy is personal.

Conclusion

The consensus statement is for sector professionals and practitioners and provides a shared understanding of what physical literacy, why it is important and how it can be supported. By understanding, supporting, and adapting to the diverse needs and preferences of everyone, practitioners can play a pivotal role in enhancing physical literacy - an intrinsic driver for engagement in movement and physical activity behaviours. Future research should evaluate the implementation and the impact of the consensus statement.

Funding

The National Lottery and Sport England
81 Correction of bias in self-reported 24-hour movement behaviours: How well can the bias be removed?
Authors: Kastelic Kaja , Rakić Marija , Šuc Anja , Šarabon Nejc
Published: September 2024

Background

Measurement of self-reported 24-hour movement behaviours (i.e. physical activity, sedentary behaviour, and sleep) is important for research, policy, and practice. However, studies showed that self-reported estimates are substantially biased, and that bias usually differs by individual’s characteristics (e.g. age, sex, body mass index). This study aimed to calibrate a recently developed questionnaire for the assessment of moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behaviour (SB), and sleep; and to explore how well can the bias be removed.

Methods

We pooled micro-level data from previous validation studies of the Daily Activity Behaviours Questionnaire (DABQ). A total of 268 participants (143 females; age range between 15 and 81 years) provided self-reported (DABQ) and device-measured (accelerometer activPAL) estimates of 24-hour movement behaviours, and their socio-demographic information. We used a set of multiple linear regression models to develop calibration equations based on 70% of the sample (e.g. dependent variable: device-measured SB; independent variables: self-reported SB, MVPA, and sleep, age, sex, body mass index) and conducted cross-validation on the remaining 30% of the sample.

Results

Self-reported MVPA, LPA, SB, and sleep explained 22%, 18%, 24%, and 41% of the variance of device-measured MVPA, LPA, SB, and sleep, respectively. When adding age, sex, body mass index, and other two self-reported movement behaviours to the model, explained variance improved to 31%, 36%, 37%, and 42%, respectively. Non-calibrated self-reported estimates on SB (-110 min/day, 95% CI: -147, -74) and MVPA (-31 min/day, 95% CI: -39, -23) showed underestimation, LPA (136 min/day, 95% CI: 100, 172) overestimation, and sleep time no significant difference (5 min/day, 95% CI: -6, 16). However, we observed no significant difference (± 2 min/day) between calibrated self-reported and device-measured movement behaviours, with substantially narrower limits of agreement.

Conclusion

Our results showed that calibrated DABQ provide comparably accurate group-level estimates of 24-hour movement behaviours than accelerometer activPAL. Questionnaire calibration is a relatively simple method to improve the validity of self-reported estimates that have been underutilized in physical activity research to date. Improved validity of calibrated self-reported estimates on 24-hour movement behaviours may benefit epidemiological research, population surveillance systems, and individual-level assessments in practice.
100 DEFRAIL: The Development of a Patient-centred, Theory-informed, Expert-guided Diet and Exercise for Frailty Intervention
Authors: Fagan Sarah , Cooke John , Mulcahy Ríona , Bambrick Padraig , Harrison Michael , Mulhare Brian , Kehoe Bróna
Published: September 2024

Purpose

Combined exercise and dietary interventions have been shown to benefit older adults with frailty, with significant promise in transitioning between frailty states. However, there is limited availability of such interventions, partly due to a lack of capacity in healthcare. While community-based programmes offer a plausible solution, often intervention settings do not reflect the transfer of research to practical ‘real world’ programmes and there is a paucity of research investigating ‘true’ community-based programmes. With older adults citing numerous barriers to adherence, the purpose of this study was to describe the development of DEFRAIL (Diet and Exercise for Frailty), a patient-centred, evidenced-based behaviour change intervention.

Methods

The research is guided by the Medical Research Council’s Framework for the Development, Evaluation, and Implementation of Complex Interventions. Four key steps contributed to the intervention development. 1) A review of the literature identified the evidence for intervention delivery models. 2) Interviews with older adults with frailty (n = 13) explored attitudes and preferences for exercise and protein supplementation. 3) A behaviour change analysis was performed using the COM-B Model to identify behaviour change techniques (BCTs) to embed in the intervention. 4) An expert panel of healthcare professionals, academics and potential implementers (n = 18) was consulted, via a DELPHI process to obtain consensus on the final structure of the intervention.

Results

There is a lack of detail on intervention delivery models in the literature. Settings varied for ‘community’ interventions from universities, research centres, gym and home-based programmes. Three key themes were identified from the interviews with older adults: impact of physical limitations, impact of knowledge, impact of medical professionals, which influenced capability, opportunity, and motivation in regards to the behaviours. Modifiable barriers identified, informed the selection of intervention functions and BCTs, which were translated into actionable intervention components. The expert panel agreed the final components of the intervention.

Conclusion

Developing interventions underpinned by evidence, theory and with input from end-users and experts will enhance the potential for positive behaviour change, promoting adherence to the intervention and hence, increase its potential effectiveness.

Support/Funding Source

This study is funded by the Irish Research Council enterprise partner scholarship with industry partner Tírlan.
166 Do Local Sports Partnerships’ physical activity programs for middle-aged adults and older adults in Ireland work?
Authors: Bengoechea Enrique Garcia , Woods Catherine
Published: September 2024

Purpose

To strengthen the practice-based evidence needed to complement the more traditional evidence-based practice, pragmatic, yet robust, evaluations of real-world programs are necessary. This study sought to add to the existing evidence for the effectiveness of physical activity (PA) programs for middle-aged and older adults offered by public Local Sports Partnerships (LSP) in Ireland.

Methods

Using a cluster randomised control trial, we collected and analysed data from 463 individuals aged 50+ years, who participated in the Move for Life (MFL) study. Outcomes were self-reported compliance with PA guidelines (PAGL); accelerometer-based moderate-to-vigorous intensity PA (MVPA), light intensity PA (LiPA), standing time and sedentary time; body composition, physical function and psychological wellbeing. LSP programs included Bike for Life, Women on Wheels, Go for Life Games, Get Ireland Walking and Men on the Move. Mixed effects regression models to assess Group x Time interactions over a 6-month period, while accounting for repeated measurements, relevant confounders in a social ecological framework and the effects of the MFL intervention against a control group.

Results

When combining the two cycling programs, positive effects on meeting PAGL for all programs (all p<.05) was found. Considering accelerometer-based PA, evidence emerged for positive program effects on MVPA (Bike for Life + Women on Wheels, Get Ireland Walking), LiPA (Bike for Life, Go for Life), and sedentary time (Bike for Life + Women on Wheels, Go for Life) (all p<.05). No evidence of program effects on body composition (BMI, waist circumference) was found. Regarding physical function, while there were no significant differences between groups for Timed Up and Go; participants in Bike for Life + Women on Wheels and Get Ireland Walking outperformed their control group counterparts in the Six-Minute Walk Test (p<.01). Lastly, Men on the Move was the only program where we observed a positive trend over time in wellbeing scores compared to control participants (p=.087).

Conclusions

Despite sample size limitations, the results show the effectiveness of LSP programs, notably in terms of energy expenditure outcomes, while highlighting areas for improvement regarding outcomes related to body composition, physical function and, particularly, psychological wellbeing.

Funding Source

Grant HaPAI/2017/CW
67 Does the volume or intensity of steps matter more on maximal oxygen consumption?
Authors: Vähä-Ypyä Henri , Husu Pauliina , Tokola Kari , Sievänen Harri , Vasankari Tommi
Published: September 2024

Purpose

Both high step count and high intensity of steps are associated with better health outcomes. This study investigates how many daily steps or running steps are associated with higher maximal oxygen consumption (VO2max).

Methods

The dataset was derived from 2135 female and 1439 male participants, aged 20-69 years, who took part in the FinFit2017- and FinFit2021population studies. Their VO2max was predicted using the 6-minute walking test, while daily step and running step counts were measured using accelerometers (UKK RM42). The female and male participants were categorized into ten groups based on VO2max deciles, weighed by age. Receiver operating characteristic (ROC) curves were used to determine the cut-points for the number of steps and running steps that were associated with a specified decile. The optimal cut-point was the point minimizing the Euclidean distance between the ROC curve and the (0,1) point.

Results

The area under curve (AUC) for steps decreased from 0.739 to 0.642 in females and from 0.709 to 0.597 in males as the VO2max decile increased. At the lowest decile, the optimal cut-point was 6033 steps per day for females and 5474 steps per day for males. The step cut-point plateaued at the VO2max level of 30 ml/kg/min for females and at the VO2max level of 35 ml/kg/min for males.

The AUC and cut-points for the running steps showed an upward trend with increasing VO2max. AUC values ranged from 0.686 to 0.788 for females and from 0.701 to 0.768 for males. The cut-points at the highest decile were 234 running steps per day for females and 238 for males.

Conclusions

In this cross-sectional sample of working-aged adults, a greater number of daily steps was associated with higher VO2max up to 7000 steps per day, whereas the running steps did not show a plateau effect. Consequently, our results suggest that individuals with lower levels of physical activity can benefit from increasing their overall physical activity volume. On the other hand, those having higher volumes of physical activity may benefit more by increasing the intensity of their physical activity.

Support/Funding Source

Finnish Ministry of Education and Culture
50 Exercise groups implemented by municipalities promote older adults’ physical functioning
Authors: Saloranta Eerika , Urtamo Annele , Rappe Erja , Jyväkorpi Satu , Kalmari Pirjo , Ylitörmänen Tuija , Öhman Hanna , Borodulin Katja
Published: September 2024

Purpose

The implementation and outcomes of physical activity promotion programmes are less studied. This study examines whether physical exercise groups implemented by municipalities are feasible and promote physical functioning among community-dwelling older adults in real-life settings.

Methods

Five municipalities participating in the Strength in Old Age Programme organised guided exercise groups for older adults in Finland. Voluntary participants (mean age 79.6 years (SD 4.2), 74% women) were recruited into strength-balance groups (n = 117) and other exercise groups (n = 34). The strength-balance groups had gym and balance training twice a week. The other groups had chair and balance exercise or senior dance once a week plus home exercise once a week. Short Physical Performance Battery (SPPB) was conducted before and after an 8–12-week exercise period by local exercise instructors. Statistical analyses included changes in SPPB scores and chair stand time within and between exercise groups (t-test) and in subgroup comparisons (baseline SPPB scores <10 points vs. ≥10 points, ANOVA, Dunnett T3).

Results

All exercise groups were implemented as planned, including the SPPB tests by local exercise instructors. Average attendance rate to guided exercise sessions was 91%. Both exercise groups showed significant improvement in the SPPB scores (strength-balance groups: from 9.8 to 11.0 points, p < 0.001; other groups: from 10.4 to 11.2 points, p < 0.001) and chair stand time (strength-balance groups: from 13.7 to 10.9 seconds (s), p < 0.001; other groups: from 12.3 to 10.9 s, p < 0.001). The strength-balance groups had a greater reduction in the chair stand time compared to the other groups (mean change -2.8 s vs. -1.5 s, p < 0.041). The subgroup analyses showed that participants with lower SPPB baseline scores had a greater improvement in the SPPB scores (F(3,147)=34.61, p < 0.001) and chair stand time (F(3,147)=18.30, p < 0.001) compared to the participants with better baseline functioning.

Conclusions

Municipalities can implement physical exercise groups and mobility tests successfully and promote older adults’ physical functioning in real-life settings. Baseline testing is recommended to identify the target groups that might benefit from training the most.

Funding Source

Juho Vainio Foundation, Päivikki and Sakari Sohlberg Foundation
65 Exploring the experience of beach access in people living with a disability - a mixed methods study
Authors: Czencz James , McKenzie Georgia
Published: September 2024

Introduction

Access to blue spaces and opportunities to be active in the community are important to adults living with a disability. Beach access days are inclusive events that promote physical accessibility and social inclusion. This study aimed to explore the experiences of adults living with a disability attending a beach access day in South West Victoria.

Methods

Employing a mixed-methods research design, five participants (Mean Age: 53.5 years, Male: 4) completed a validated beach accessibility survey tool comprising likert scale and short answer questions regarding barriers, facilitators, and experiences of beach access. Recruitment occurred following the beach access day, with survey links disseminated via email from registration data to eleven attendees. Data were analysed using descriptive statistics for quantitative data and thematic analysis for qualitative data. Participants were offered access to the preliminary study results for feedback.

Results

Based on prelimanary findings, participating in a beach access day event positively impacted the attitudes of individuals with disabilities towards beach access. The qualitative data revealed three themes: 1. Socialisation and recreation - the need to socialise and engage in physical activity within the community; 2. Health and well-being - participants perceived improved accessibility as beneficial to their health; 3. Connection with identity - the beach is not just a place but a part of who they identify as. The quantitative survey data also identified barriers to beach access, including personal health issues, fatigue, difficulty moving on sand, and lack of transfer equipment. However, the study also found that certain facilitators, such as more accessible parking and toilets, transfer equipment like hoists, and physical assistance with beach activities, could help improve beach access for individuals with disabilities.

Conclusion

The study highlights the need to make beaches accessible, and improving access can promote positive outcomes and the desire to participate more often. Inclusive events like beach access days have the potential to improve the health and well-being of people living with a disability and promote more inclusive and disability-aware societies. Communities should invest in such initiatives to make blue space environments more accessible and inclusive for individuals of all abilities.
17 Exploring the feasibility of an mHealth application to enhance physical activity in community-dwelling older adults
Authors: Daniels Kim , Robijns Jolien , Vonck Sharona , Spooren Annemie , Hansen Dominique , Bonnechère Bruno
Published: September 2024

Background

Advancements in smartphone technology have paved the way for innovative interventions aimed at promoting physical activity (PA) and have led to the development of an mHealth app called MIA. The primary objective of this feasibility study is to comprehensively investigate the potential of the MIA app in effectively promoting PA and fostering sustained, healthy behaviors among its users.

Methods

A diverse sample of 30 participants aged 65 or older, free of severe illness from the community was recruited. Baseline data was collected on demographics, assessed PA (IPAQ SF), measured PA enjoyment (PACES), and evaluated digital health readiness (DHRQ). Participants used the app while providing real-time feedback via a “think-aloud” protocol. A five-week usage period followed, with post-period PACES assessment and usability measures (SUS, UEQ, NPS, CSAT). We analyzed the app usage patterns with Power BI and gathered qualitative data through five focus groups. Both qualitative and quantitative analyses were employed, assessing clinical relevance alongside statistical significance, and descriptive statistics to summarize results were used.

Results

The study included 30 participants, averaging 69.9±5.3 years old, with 17 females (56.7%) and 13 males (43.3%), primarily having completed higher education (50%) and displaying strong digital literacy skills (average 59.6±8.8). Regarding PA, 10% were inactive, 40% minimally active, and 50% vigorously active, indicating a highly active sample. Usability and acceptance were positive, with an SUS score of 77.41, CSAT score of 86.6%, and 87% expressing satisfaction. Power BI data showed participants engaged in an average of three workouts per week and read one to two articles weekly.

Focus groups supported quantitative findings, suggesting improvements like more motivational tips, app usage tutorials, clearer instructions for workout videos, expanded community activities, a reader tracker, enriched learning modules, and enhanced progression tracking.

Discussion and conclusion

The Mia app shows feasibility in usage, acceptability, demand, and practicality, prompting further impact assessments. Positive feedback highlights the need for user-tailored improvements before clinical trials. However, limitations include a non-representative, digitally literate sample, potential bias from self-reported PA measures, and lack of blinding. Future research should explore less tech-savvy older adults’ perceptions, gauging accessibility and appeal to a broader audience.
66 Facilitating Health in Schools: The Role of Implementers in the Generation Healthy Kids Program
Authors: Skovgaard Thomas , Nielsen Jonas Vestergaard
Published: September 2024

Purpose

This study investigates the role of local implementation teams in Generation Healthy Kids (GHK), an ongoing multi-component, school-based intervention promoting healthy weight, health, and wellbeing among Danish children aged 6–11.

Methods

The study is one segment of a larger cluster-randomized trial assessing the GHK intervention’s effectiveness and implementation. Semi-structured interviews have been conducted with members of implementation teams, or implementation leads, at the twelve schools randomly assigned to intervention. Interviews were designed to delve into key implementation responsibilities and to identify key challenges and facilitators when promoting the four fundamental intervention components on: diet, physical activity, screen media use, and sleep habits.

Results

With data collection concluding in May 2024, preliminary analyses suggest that successful implementation hinges on securing adequate support and the right competencies among staff members interacting directly with the primary target group, tailoring the program to fit diverse school contexts, and ensuring effective internal and external coordination. Strategic promotion of the intervention among stakeholders is also anticipated to be a critical factor.

Conclusions

The anticipated findings will shed light on organizational and structural elements influencing the effectiveness of multi-layered, school-based health interventions. Implementers – meaning professional personnel at the forefront of execution - emerge as key figures for how well an innovation like GHK is developed and realized. The efficiency of this group is, however, contingent on adequate work infrastructures - including well-organized task arrangements, adequate staffing and support, proactive leadership by school principals, and clear role definitions. The insights gained from this study will inform the design and support of health promotion strategies in schools, with potential implications for policy and practice in child health and wellbeing.

Funding Source

The study is supported via funding from an overall GHK-grant provided by the Novo Nordisk Foundation.
77 How do we include low SES girls in sport? A qualitative study on girls’ perceived barriers to sports participation
Authors: Ljungmann Cecilie Karen , Christensen Julie Hellesøe , Johnsen Helene Rald , Klinker Charlotte , Pawlowski Charlotte
Published: September 2024

Purpose

Girls are more likely to drop out of sport during adolescence than boys, in particular girls from low SES neighbourhoods. It is important to listening to these girls to get knowledge to do inclusive actions to increase low SES girls in sport. However, no studies have investigated barriers to sports participation among girls from low SES neighbourhoods. The aim of the study was to investigate perceived barriers to sports participation among adolescent girls from low SES neighbourhoods.

Methods

Eleven focus groups were conducted in five low SES neighbourhoods in Denmark from July-October 2021, involving in total 44 adolescent girls from Grade 6-9 (aged 10-16 years) who were not engaged in organised sports. Ten girls had Danish ethnic origin. Thirty-four girls had other ethnic minority background (i.e., from Afghanistan, Iraq, Lebanon, Morocco, Palestine, Somalia, Syria, or Turkey). A thematic analysis was used to analyse the girls’ perceptions managed in NVivo 12.

Results

The girls prioritised homework, household duties, and socialising with friends over sports. Also, the girls refrained from participating in sport due to fear of not fitting in because of ethnic background and reluctance to participate alone. Moreover, feelings of inadequacy in sporting abilities, bodily discomfort, and negative body image were perceived as barriers. Finally, gender stereotypes, depicting sports as unsuitable for girls, along with negative attitudes from boys, further discouraged the girls’ engagement.

Conclusions

The findings illustrate that barriers to sports participation among this group of girls are complex and call for multifaceted actions to address the disparities such as offering programs that are more flexible may be fruitful to address these girls’ concerns about educational commitments. A less competitive environment with more emphasis on fun, enjoyment, and inclusion, may address the feeling of lacking sporting abilities. Also, peer-leaders or a buddy system may increase a sense of belonging. These findings will be useful in order to shed light on how interventions could be designed and implemented to include low SES girls in sports communities.

Support/Funding Source

The study was supported by the Novo Nordisk Foundation [grant number NNF20SH00].
104 Impact of a School-Based Physical Activity Intervention program on Physical Activity Levels, Sleep Patterns, Aerobic Fitness, and Motor Competence
Authors: Costa Júlio A , Vale Susana , Cordovil Rita , Rodrigues Luís P , Cardoso Vasco , Proença Rui , Costa Manuel , Neto Carlos , Brito João , Guilherme José , Seabra André
Published: September 2024

Introduction

The “Super Quinas” project evaluated the effectiveness of an intervention program to improve PA, aerobic fitness, sleep, and motor competence on children in primary school.

Methods

This pilot project was conducted in 44 schools across the country (i.e., in Portugal), and involved over 1600 school-age children (6 to 10 years old). All 1600 children completed the MC assessment (MCA) in the PRE test in the 1st week and the POST test in the 12th week. Additionally, a sub-group of 38 children underwent more specific tests (i.e., PA, sleep, body composition and aerobic fitness) for a detailed analysis of the impact of this intervention project. The experimental group (n = 19) enrolled in a 12-week intervention program (one more extra-curricular activity class of 60 min per week) compared to the CG (n = 19), all aged 9–10 years. PA and sleep were measured by accelerometry, and aerobic fitness was measured by Children’s Yo-Yo test (YYIR1C) during the 1st week (PRE), the 6th week (DUR), and the 12th week (POST) of the intervention program. MC in PRE and POST intervention was also assessed by the MC Assessment (MCA) instrument. Heart rate (HR, assessed using HR monitors), and enjoyment level were recorded during all intervention program classes.

Results

Comparing the EG and CG in DUR and POST, the EG spent ∼18min and ∼34min more time in moderate to vigorous PA (MVPA) per day (p < 0.001); had ∼44min and ∼203min less sedentary time per day (p < 0.001); performed more 44 and 128m in YYIR1C compared to CG (p < 0.001) and slept more 17 and 114min per night (p < 0.001). In POST MC was significantly better (27%) in the EG compared to CG (p < 0.001). The %HRmax during the extra-curricular classes ranged between 65 and 81% (i.e., light to moderate intensities), and the enjoyment between fun and great fun.

Conclusion

Our findings suggest that adding one more extra-curricular activity class of 60 min per week for 12 weeks effectively increased the levels of PA, aerobic fitness, sleep duration, and MC in children aged 9–10 years.
103 Implementation of a physical activity referral scheme in the German healthcare system: A qualitative analysis of implementation success
Authors: Klamroth Sarah , Lorenz Eva , Naber Inga , Mino Eriselda , Weissenfels Anja , Gelius Peter , Abu-Omar Karim , Geidl Wolfgang , Pfeifer Klaus
Published: September 2024

Purpose

The BewegtVersorgt project is the first study to implement a physical activity referral scheme (PARS) in the German healthcare system. The PARS aims to increase physical activity (PA) levels among persons with non-communicable diseases and includes a brief PA advice by physicians and an individualized PA promotion by physical therapists or sports therapists (PARS group). In a pragmatic cluster-randomized controlled trial, the PARS group is compared to a group receiving PA advice only (PAA). Based on the RE-AIM framework, this qualitative study evaluates specific dimensions of implementation success of the PARS, all from health professionals’ perspective.

Methods

We conducted semi-structured interviews (n = 13) with physicians and medical assistants from eight (out of 17) medical practices and with five therapists (out of 14 therapy practices). Following the principles of intensity case sampling, the practices were purposefully selected based on the number of participants treated and dropped-out. The interview transcripts were analyzed using thematic analysis, combining deductive and inductive category building.

Results

Most health professionals report that they would already address PA promotion in some way and see this as part of their job, but in different roles. The majority of interviewees believes that both intervention types (PARS, PAA) have added value for the participants but the individual approach in the PARS group was seen as more advantageous by physicians (adoption). While most of the physicians did not use techniques of motivational interviewing (MI) for PA advice, therapists largely delivered the individualized PA promotion as intended and integrated MI. Both, therapists and physicians faced barriers with integrating the process into everyday practice and during intervention delivery (implementation). Most interviewees advocate a sustainable implementation of the program, taking into account adjustments to the intervention concept as well as structural and system-related changes (maintenance).

Conclusions

Given the intervention adjustments and barriers faced with the implementation in routine care, implementation success was only partially achieved. These results, in combination with the evaluation of all dimensions of implementation success, will help to adapt the PARS to be more suitable for integration into the German healthcare system.

Funding Source

Funded by the German Federal Ministry of Health.
62 More than a kickaround: A health impact assessment, over a twelve-month period, of Football Cooperative: A Men’s Community-based Social Initiative of Physical Activity
Authors: Daly Steve , Carroll Paula , Egan Tom , Harrison Michael , Richardson Noel
Published: September 2024

Purpose

It is well established that men suffer lower life expectancy and quality of life. Recognising the importance of gender-specific strategies in addressing men’s health, considerable evidence supports the notion that a substantial portion of male life expectancy and morbidity can be influenced by modifiable factors. Therefore, it is vital to create and expand impactful health interventions tailored for men, enhancing overall population health. This study evaluates the health impact of the participants in Football Cooperative (FC), a community-based physical activity and social initiative designed and used by men.

Methods

Outcomes were measured for participants at four time points (baseline, three, six and twelve months) using both objective and subjective measures. Anthropometric measures included: a) height (cm), b) weight (Kg) (from which, body mass index (BMI) was calculated (Kg/m2)) and c) waist circumference (WC). Aerobic fitness was assessed using the Yo-Yo Intermittent Recovery test level 1. The self-reported data in the survey had a mix of demographic and psychological measures. These included, cardiovascular risk factors, UCLA loneliness scale and Rosenberg self-esteem scale.

Results

With a mean age of 38 years (SD ± 7 years) n = 107 participants provided data. The average BMI went from 27.2 at baseline (B) to 26.2 at twelve months (12M). Average weight, decreased 87.4kg (B) to 84.3kg (12M) and WC decreased by 4.5%, from 97.1cm (B) to 92.7 (12M). In the self-report survey there were improvements in mental health, at three months (3M) 50% of participants reported improvements, increasing to 95% at 12M. Likewise, improvements in Social Health at 33% (3M) increased to 72% (12M). Participants reported decreased alcohol consumption and increased fruit and vegetable consumption. There was an increase in injuries sustained from 48% (3M) to 66% (12M). Stratifying by attendance, low attendees had less benefit than high (23% low to 67% high in physical benefit).

Conclusion

The Football Cooperative initiative provided improvements in the health of the participants, which increased over time. It can be argued that engaging men in ongoing activity will benefit many health aspects over the lifetime.

Funding Source

This PhD has been funded by the South East Research Development Fund [WD SERD_2020_54_WSCH, €90,000].
95 Parental education, physical activity, sedentary behavior and Family Health Climate of children in primary-school age: A mediation analysis
Authors: Ziegeldorf Alexandra , Hottenrott Nina , Moritz Johanna , Wagner Petra , Wulff Hagen
Published: September 2024

Purpose

Parents’ level of education (ED) is an important factor influencing children’s physical ac-tivity (PA) and sedentary behaviour (SED). In this context, family factors, such as the physical activity related family health climate (FHCPA), are relevant (Niermann et al., 2015). However, the effect of FHCPA on the interaction between parental ED and chil-dren’s PA and SED has not been investigated yet. In this analysis, the mediating effect of the FHCPA on the relation between ED and objectively measured PA-parameters was examined.

Methods

For this analysis, data from 94 children (51.1% female, Mean age = 9,0 (±1)) and their parents from the collaborative research project “Familie+” (Baseline) have been used. Questionnaires were used to assess parental ED and FHCPA. Children’s moderate-to-vigorous physical activity (MVPA) and SED were measured using accelerometers (GT3X+ und wGT3X+). Bivariate correlations were conducted to investigate associations between parental ED and MVPA/SED/FHCPA. Mediation analyses were used to investigate the role of FHCPA in the link between maternal and paternal ED and children’s MVPA/SED.

Results

Between maternal ED and FHCPA there was a small correlation for the total sample (ρ=.318, p<.001) and a medium correlation for girls only (ρ=.570, p<.001). Mediation analyses showed no significant mediation effect. However, there was a significant direct association considering FHCPA in the relation between higher maternal ED and SED in girls compared to lower ED.

Conclusion

Future research should examine more complex models to develop and sharpen further theoretical frameworks in order to be able to derive better recommendations through health prevention programs, especially for mothers and girls.

Support/Funding Source

The data originate from a collaborative research project (‘Familie+ - Gesundes Zusam-menleben in Familie und Schule’/‘Family+ - Living healthily together in family and school’) which was funded by the German Federal Ministry of Health.

References:

Niermann et al. (2015). Family Health Climate and Adolescents `Physical Activity and Healthy Eating: A Cross-Sectional Study with Mother-Father-Adolescent Triads. PLoS ONE 10 (11). 1-18.