bluuebunny/crossref_metadata_2025_split huggingface dataset:
170 Collective creativity; promoting physical activity. Outlining a Co-design process for the development of Digital Physical Activity promotion initiatives for Autistic Adults
Authors: Rodgers Gary , Sweeney Mary Rose , Staines Anthony , Morgulec-Adamowicz Natalia , Ogonowska-Słodownik Anna , Van Biesen Debbie , Healy Sean 
Published: September 2024

Abstract

Purpose
Autistic students at higher education institutions in Ireland have reported feelings of isolation, depression, and disengagement, all of which contribute to health disparities in this population. It is critical to address these issues, given the recent significant increase in the number of Autistic youths enrolling in higher education. To inform the development of acceptable and effective physical activity promotion programmes, we utilized a co-design process with the aim of co-creating a digital health intervention to promote physical activity among Autistic university students.

Methods
A co-design process [Design Thinking] was utilized for the development of the intervention. First, to empathize with participants, semi-structured interviews were held with Autistic adults. Interviews were recorded, transcribed verbatim, and analysed via reflexive thematic analysis. Actionable intervention targets were defined, and potential solutions ideated. The findings from the interviews informed the exploration and refinement of intervention ideas during co-design workshops. Workshops featured a multidisciplinary development team, including Autistic adults and experts in technology, physical activity promotion, and digital health.

Results
Three central themes were developed during analysis of the interview data: (1) “Psychological Factors” describing participants’ experiences and needs relating to routines, motivation, and self-consciousness/anxiety; (2), “E-Health Ideas and Needs” encapsulated the participants’ preferences and suggestions for digital health intervention components; and (3) “Supportive Spaces” encompassing the participants’ preferences relating to physical and social environments for physical activity. Individual interviews findings informed the ideation of digital health solutions for refinement in co-design workshops; these included interventions focusing on enhancing e-communication about physical activity opportunities on campus, the use of AI Chatbots for physical activity promotion; and the use of online social support groups.

Conclusions
Findings suggest Autistic adults face a variety of interrelated barriers to physical activity. The co-design process enabled the collective design of digital health interventions with the potential to overcome these barriers and support Autistic students to enjoy and more active, engaged University experience.

Support/Funding Source
Erasmus+ Sport grant
41 Creating public value through large-scale schoolwide events: Danish School Olympics in Billund Municipality
Authors: Nielsen Jonas Vestergaard , Breum Lars 
Published: September 2024

Abstract

Purpose
Through activities adapted to engage children in class-based competitions at both local and national levels, the Danish School Olympics (DSO) have established a significant sport event for Danish schoolchildren. In 2020, Billund Municipality initiated a collaboration with the DSO as the host of the national finals until 2024. A direct wish from the municipality was to help create community-based events that give children the opportunity to experience the joy of movement and sports. On a strategic level, the municipality also aimed to utilize the collaboration to strengthen local sports associations and their collaboration with the local schools, as well as engaging initiatives that could qualify the physical education in schools.

Methods
Based on the Consolidated Framework for Implementation Research (CFIR), an extensive evaluation was undertaken to illuminate the effects of the collaboration between DSO and the municipality. Four key perspectives were evaluated: 1) the children, 2) the sports associations, 3) the schools and 4) municipal policies. Distributed across the four main themes, data collection included interviews with: children who participated in DSO events; school principals and physical education teachers; representatives from the sport associations; and municipal project managers and politicians.

Results
The interviews show that the collaboration has supported the development of the already established sports associations in Billund municipality and improved the collaboration between municipality and the volunteers. Hosting the DSO finals has provided valuable experiences for the municipality, showcasing the potential for future events and has laid the foundation for further strategic development of the sport and health field. Schools and teachers find value in the concept, and the children feel that DSO operates on their terms, has strengthened the class community, and introduced them to new activities and sports.

Conclusions
The partnership between Billund Municipality and DSO has positively influenced community engagement in sports. The interest in organizing such events is linked to the added value that Billund Municipality experiences for its citizens and associations. However, integrating these experiences into municipal initiatives requires ongoing efforts to maximize their impact effectively.

Funding
The evaluation was funded by the Danish School Olympics and the Municipality of Billund
171 Decline in adherence to Physical Activity Guidelines among the Dutch population
Authors: Schurink Tessa , van den Berg Saskia 
Published: September 2024

Abstract

Purpose
In the Netherlands, the number of people who meet the Physical Activity Guidelines in 2022 has dropped dramatically to a level lower than in 2019. In order to get more insight in this decline, we compared PA behavior in 2022 (after the coronavirus pandemic) with 2019 (before the pandemic).

Methods
For this study the 2019 and 2022 data collection of the Health Survey/Lifestyle Monitor (Statistics Netherlands (CBS) in collaboration with National Institute for Public Health and the Environment (RIVM)) was used. This is an annual survey including a random sample of the Dutch population (N ± 10,000). Physical activity was measured with the Short Questionnaire to Assess Health Enhancing Physical Activity (SQUASH). Specifically, time spend on walking and biking to work/school and in leisure time, playing sports, household activities, activities at work or school, gardening and, for children, playing outside and physical education was asked.

Results
In 2022, 44% of the Dutch population 4 years and older was sufficiently physically active compared to 49% in 2019. The decline was highest among young adults aged 18–29 (9.2 percent point), adolescents aged 12–17 (7.5 percent point), people who do paid work (6.4 percent point) and people educated to a higher level (7.5 percent point). All of these groups cycled less in their leisure time (-27, -51, -25 and -22 minutes per week, respectively), although for young adults this difference was not statistically significant. Adolescents also cycled less time to school (-48 minutes per week), but the mean number of days they cycled to school remained the same (4 days a week). In addition, young adults walked less, particularly in their leisure time (-39 minutes per week).

Conclusions
The decline in adherence to the Physical Activity Guidelines is mainly related to a decline in cycling time and, for young adults, a decline in walking time. Especially among adolescents the decrease in the number of minutes cycling between 2019 and 2022 is striking. However, in both 2019 and 2022, they cycled on average 4 days a week to school. A possible explanation for this is the increased use of electric bicycles.
63 General practitioners’ experience, attitudes and needs on providing advice on physical activity to people with chronic ischemic heart disease - A qualitative study (OptiCor study)
Authors: Prinz Alicia , Leve Verena , Gummersbach Elisabeth , Wilm Stefan , Hoppe Sabrina , Vogl Franziska , Kirchhof Ursula , Neuhaus Anja , Kastaun Sabrina 
Published: September 2024

Abstract

Purpose
The German treatment guideline “chronic ischemic/coronary heart disease (IHD)” recommends that general practitioners (GPs) deliver advice on physical activity (PA) to IHD patients. However, the provision of PA advice is inadequately implemented in general practice in Germany. One reason is the lack of medical training in providing PA advice effectively and efficiently. International guidelines recommend such training for GPs. This study aims to explore needs, experiences, and attitudes including barriers and facilitators of GPs towards the routine delivery of PA advice to IHD patients, in order to adequately inform a customised development of such a training.

Methods
Over a period of four months (March – June 2023), 12 face-to-face problem centred interviews (n = 12; 5/12 females, age range: 35-73 years) and six focus group discussions (n = 37; 13/37 females, age range: 36-70 years) with GPs were conducted. Interview and discussion guides were developed and pilot tested by the multi-professional study team. Data were collected in an iterative process. Purposive sampling and techniques of maximal structural variation were applied (e.g., with regard to professional experience, interest in PA). Audio-recorded data were transcribed verbatim and analysed using a content structuring procedure (deductive and inductive approach). GPs were involved throughout the entire research process, e.g., in multi-professional analysis groups.

Results
Whereas GPs are mostly aware of the health benefits of PA for IHD patients, PA advice is not routinely provided. Conversations on PA tend to be unstructured and advice is often addressed more generally than customised to the patients’ needs and preferences. Priority is given to other lifestyle issues, such as smoking. The effectiveness of PA advice is perceived as less effective but time consuming. GPs mention frustration in this context. They express a need for communication strategies (structure and tools) to motivate patients to PA that can be integrated into everyday GP care.

Conclusion
The results provide relevant insights into the everyday practice of GPs, information on GPs’ needs and requirements and can thus contribute to a target group-specific development of a GP training on PA advice for patients with IHD in the OptiCor study.

Funding
German Ministry of Education and Research (01GY2103).
203 Healthcare professional and commissioners’ perspectives on the factors facilitating and hindering the implementation of digital tools for self-management of long-term conditions within UK healthcare pathways
Authors: Gavin James , Clarkson Paul , Muckelt Paul , Eckford Rachael , Sadler Euan , McDonough Suzanne , Barker Mary 
Published: September 2024

Abstract

Purpose
Physical activity is important in the self-management of long-term conditions (LTCs). However, implementing physical activity into clinical practice is challenging, due to complex barriers including access to programmes, time pressures, and transport costs, for people with comorbidities, managing multiple responsibilities. Various digital tools exist to overcome these barriers and support wide-scale implementation to help people stay physically active.
We explored the needs and preferences of healthcare professionals and commissioners, regarding the use of digital tools to support people with LTCs to self-manage using physical activity. This included barriers and facilitators to implementing digital tools to support people with LTCs in NHS settings.

Methods
Semi-structured interviews were conducted (April 2021 to January 2022) in Wessex, southern England, UK. Purposive sampling was used to recruit general practitioners and healthcare professionals, whereas convenience sampling was used to recruit commissioners (n = 15). Transcripts were coded to develop conceptual themes allowing comparisons between and among perspectives, with the Normalisation Process Theory used to aid interpretation.

Results
Results showed that most digital tools supporting physical activity for LTCs, are not well implemented clinically. Current digital tools were seen to lack condition-specificity, functionality, evidence-base, and voluntary sector involvement. Healthcare professionals and commissioners would not engage, unless digital tools were integrated into health service IT systems and professional networks, or adaptable according to the digital literacy of service users, and staff. For example, being technologically (easy to use) and culturally accessible (societal wide) to individuals. COVID-19 positively changed professional’s attitudes towards digital tools, in terms of being viable, feasible and critical options. Implementation was also influenced by endorsement and trustworthiness (i.e., security and evidence-based).

Conclusion
Our findings highlight that consideration must be given to ensuring that digital tools are accessible to both healthcare professionals and patients, have functionality, and are adaptable to specific LTCs. To promote clinical engagement, digital tools must be evidence-based, endorsed by professional networks, and integrated into existing health systems. Digital literacy of patients and professionals is also crucial for cross-service implementation.
101 Identity leadership in Zumba classes: Does it matter to create a a sense of ‘us’ in temporary exercise groups?
Authors: Boen Filip , Bonte Louis , Brabant Quentin , Könecke Thomas , Figgins Sean , Fransen Katrien 
Published: September 2024

Abstract

Inspired by the social identity approach, recent work has emphasized the importance of identity leadership in temporary exercise groups to boost participation and performance. According to this social identity approach, effective identity leaders are those who can encourage their followers to think, feel, and act as part of the group rather than as individuals. To achieve this, identity leaders should be perceived as prototypical for the group (i.e., being one of “us”), as advancers of the group (i.e., acting for “us”), as group entrepreneurs (i.e., crafting a sense of “us”), and as group impresarios (i.e., making “us” matter).
However, while group exercise leaders usually receive extensive training in physiological and biomechanical movement principles, they are often less educated on how to effectively engage a group of exercisers as a cohesive unit. This seems nevertheless very relevant, considering that many of these exercise groups are temporary, with members meeting only a limited number of times and often not knowing each other (well). Moreover, the composition of these exercise groups can change during the course of the classes: new members can attend, while older members attend irregularly or drop-out, which poses an additional challenge to create a sense of ‘us’.
In a cross-sectional study, we therefore aimed to explore the relations between the perceived identity leadership of instructors of such group exercises classes and relevant outcomes. To this end, we surveyed 458 participants of Zumba classes in a university setting. More specifically, these participants rated their (experienced) instructors in terms of identity leadership and completed additional measures of their identification with the Zumba class, of different forms of motivation to participate, of their self-reported effort, and of their intention to attend to next sessions. The results revealed that the perceived identity leadership of the instructors was quite high, and was positively related to the identification with the Zumba class. In addition, identity leadership was positively related to both self-related effort during the class and the intention to attend the next class. These findings underline the relevance to further develop and train the identity leadership of group exercise leaders.
212 Multi-trajectory analysis of changes in physical activity, BMI and cardiorespiratory fitness in adolescence
Authors: Kolunsarka Iiris , Beets Michael , Huhtiniemi Mikko , Jaakkola Timo 
Published: September 2024

Abstract

Purpose
Over the past four decades, the worldwide prevalence of obesity has nearly tripled, with childhood obesity being now more common than ever. Furthermore, children and adolescents with overweight or obesity are at a higher risk of retaining this condition into adulthood (Lobstein et al., 2015). Previous studies have shown that larger increase in body mass index (BMI) during adolescence is associated with less improvements in cardiorespiratory fitness (CRF) and steeper decline in moderate to vigorous physical activity (MVPA) (Kolunsarka et al., 2021). However, the trajectories of these three variables during adolescence are diverse. Therefore, this study aimed to identify and investigate adolescents with similar concurrent changes in MVPA, CRF and BMI throughout adolescence.

Methods
In this four-year longitudinal study (2017-2021), device-measured MVPA, BMI and CRF data were collected annually from 1157 participants (Mage = 11.37 ± 0.37). A multivariate trajectory analysis was used to identify adolescents who share similar BMI, MVPA and CRF trajectories over four years.

Results
Three distinct groups were identified and labelled according to BMI trajectories. The ‘persistently normal’ group (86%) exhibited the highest baseline levels of CRF and MVPA, with significant increases in CRF and a concurrent decrease in MVPA. Conversely, the ‘improving from high’ group (5%) demonstrated a significant increase in CRF and a non-significant (p = 0.07) increase in MVPA. In contrast, the ‘progressing to very high’ group (9%) showed no significant changes in either MVPA or CRF.

Conclusion
These findings underscore the critical importance of early identification and targeted interventions to mitigate the risk of accelerated weight gain, insufficient physical activity and declining fitness during adolescence.

Funding Source
This study was funded by the Strategic Research Council within the Academy of Finland within the project SchoolWell, and the Finnish Ministry of Education and Culture.
References:
Lobstein T, Jackson-Leach R, Moodie ML, et al. (2015). Child and adolescent obesity: part of a bigger picture. The Lancet, 385(9986), 2510–2520.
Kolunsarka, I., Gråstén, A., Huhtiniemi, M. & Jaakkola, T. (2021). Development of Children’s Actual and Perceived Motor Competence, Cardiorespiratory Fitness, Physical Activity, and BMI. Med Sci Sports Exerc, 53(12), 2653–2660.
182 The Impact of Physical Activity on Obesity and NCD Outcomes: Insights from Kenyan Panel Data
Authors: Mainaa Cecilia 
Published: September 2024

Abstract

Physical activity (PA) levels and sedentary behaviors are recognized as important modifiable risk factors for overweight, obesity, and non-communicable diseases (NCDs). However, there is a scarcity of evidence regarding the effects of different types of physical activities and sedentary time on these health outcomes in Sub-Saharan Africa. Employing a three-stage cluster sample design to gather panel data from 166 adults in Kenya, this study aims to investigate the empirical association between work-related PA, leisure PA, transport-related PA, and sedentary time with weight and the likelihood of an NCD outcome (either high blood pressure, diabetes, heart attack, or stroke). The main research questions are 1) what is the impact of work, leisure and transport-related PA on BMI? 2) to what extent does an increase in sedentary time contribute to a higher BMI? 3) what is the impact of work, leisure and transport-related physical activities on NCD outcomes? And finally, 4) to what extent does increased sedentary time contribute to a higher probability of an NCD outcome? The use of panel data from 2015 and 2022, allows us to account for time-invariant unobserved heterogeneity; additionally, findings were supported through robustness checks using entropy balancing.
Our results confirm a declining trend in PA levels and an increase in daily sedentary time, coupled with an overall increase in average BMI and incidences of NCDs. Using panel fixed effects, we find an increase of one metabolic equivalent (MET) hour per week in vigorous work activity is linked to a 0.025% reduction in BMI. Similarly, a comparable increase in leisure-related physical activity is associated with a BMI decrease of 0.16%, while an equivalent increase in transport-related activity results in a BMI reduction of 0.052%. We also find that work-related PA leads to a decrease in the probability of an NCD outcome, while sedentary time is positively associated with the probability of developing an NCD. Policies need to aim at promoting physical activity in the workplace and providing infrastructure that supports leisure and transport-related physical activities. Addressing these factors can play a crucial role in reducing the prevalence of obesity and NCDs among adults in Kenya.
124 Using Co-Design Methods to Develop a Theory and Evidence-Based Mother-Daughter mHealth Intervention Prototype Targeting Physical Activity in Pre-Teen Girls
Authors: Matthews James , Brennan Carol , O’Donoghue Grainne , Keogh Alison , Rhodes Ryan 
Published: September 2024

Abstract

Purpose
Pre-teen girls of lower socio-economic position are at increased risk of physical inactivity. Parental support, particularly mothers, is positively correlated with girls’ physical activity levels. Consequently, family-based interventions are recognised as a promising approach to improve young people’s physical activity. However, the effects of these interventions on girls’ physical activity are often inconsistent, with calls for more rigorous, theory based and co-designed family-based interventions to promote physical activity in this cohort. Therefore, the aim of this study was to use co-design methods to develop a theory and evidence- based mother daughter mHealth intervention prototype targeting physical activity in pre-teen girls.

Method
The intervention prototype was developed in accordance with the UK Medical Research Council framework, the Behaviour Change Wheel, the Theoretical Domains Framework, and the Behaviour Change Techniques Taxonomy V1. The co-design process incorporated three phases, (i) behavioural analysis, (ii) the selection of intervention components, and (iii) refinement of the intervention prototype. Across these phases, there were workshops with pre-teen girls (n = 10); mothers of pre-teen girls (n = 9), and primary school teachers (n = 6), with further input from an expert advisory group.

Results
This three-phase co-design process resulted in the development of a theory-based intervention which targeted two behaviours, (i) mothers’ engagement in a range of supportive behaviours for their daughters’ physical activity, and (ii) daughters’ physical activity behaviour. Formative research identified eleven theoretical domains to be targeted as part of the intervention (e.g., knowledge, skills, and beliefs about capabilities). These were to be targeted by six intervention functions (e.g., education, persuasion, modelling), and 28 behaviours change techniques (e.g., goal setting, self-monitoring). The co-design process resulted in a mobile app being chosen as the mode of delivery for the intervention.

Conclusion
This paper offers a rich description of using co-design methods to develop a mother-daughter mHealth intervention prototype, that is ready for feasibility and acceptability testing. The use of theoretical frameworks in the co-design process provided a robust and transparent foundation on which to develop the prototype, enabling the evaluation of potential pathways for behaviour change.