Healthy Life Centres: a 3-month behaviour change programme’s impact on participants’ physical activity levels, aerobic fitness and obesity: an observational study

ObjectivesIndividuals with low socioeconomic status and multimorbidity tend to have lower physical activity (PA) levels than the general population. Primary care is an important setting for reaching high-risk individuals to support behaviour change. This study aimed to investigate the impact of behaviour change interventions delivered by Norwegian Healthy Life Centres (HLCs) on participants’ PA levels, aerobic fitness and obesity, and furthermore to investigate possible predictors of change.DesignAn observational study with a pre–post design and a 3-month follow-up.SettingThirty-two HLCs in Norway were included.ParticipantsA total of 713 participants (72% of the participants included at baseline), 71% women, with a mean age of 51 (18–87 years) and body mass index (BMI) of 32 (SD 7) met to follow-up.InterventionIndividual consultations and tailored individual and group-based exercise and courses organised by the HLCs and cooperating providers.Outcome measuresThe primary outcome was time spent in moderate to vigorous PA (MVPA, min/day) (ActiGraph GT3X+ accelerometer). The secondary outcomes were light PA (LPA, min/day), number of steps per day, time spent sedentary (SED, min/day), aerobic fitness (submaximal treadmill test, min), BMI (kg/m2) and waist circumference (WC, cm).ResultsThere was no change in MVPA (B 1.4, 95% CI −0.4 to 3.1) after 3 months. The participants had improved LPA (4.0, 95% CI 0.5 to 7.5), increased number of steps (362, 95% CI 172 to 552), reduced SED (−5.6, 95% CI −9.8 to –1.3), improved fitness (0.8, 95% CI 0.6 to 1.0), reduced BMI (−0.2, 95% CI −0.1 to –0.3) and reduced WC (−1.7, 95% CI −2.0 to –1.3). Positive predictors of change were number of exercise sessions completed per week, duration of adherence to HLC offers and participation in exercise organised by HLC.ConclusionParticipation in the HLC interventions had small positive impacts on participants’ PA levels, aerobic fitness and obesity. Further research to develop effective behaviour change programmes targeting individuals with complex health challenges is needed.Trial registration numberNCT03026296.

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Exploring the impact of the ‘new’ ParticipACTION: overview and introduction of the special issue

Health Promotion and Chronic Disease Prevention in Canada ◽

10.24095/hpcdp.38.4.01 ◽

2018 ◽

Vol 38 (4) ◽

pp. 153-161 ◽

Cited By ~ 3

Author(s):

Guy Faulkner ◽

Lira Yun ◽

Mark S. Tremblay ◽

John C. Spence

Keyword(s):

Physical Activity ◽

Physical Activity Promotion ◽

Population Based ◽

Organizational Level ◽

Activity Levels ◽

Marketing Organization ◽

Individual Level ◽

Activity Promotion ◽

The Impact

ParticipACTION is the Canadian physical activity communications and social marketing organization first launched in the fall of 1971 and then ceased operations in 2001. ParticipACTION was relaunched in 2007. Framed as a public health natural experiment, evidence was collected from a population-based survey of knowledge, awareness, understanding of physical activity, and physical activity levels among Canadians (individual level), and key informant surveys and interviews examining capacity, readiness and advocacy for physical activity promotion among physical activity organizations (organizational level). The purpose of this paper is to first provide an overview of some of the major initiatives undertaken by the ‘new’ ParticipACTION that may have contributed to any changes at these individual or organizational levels. Second, the paper sets the stage for the three empirical papers in this special series reporting follow-up results.

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Levels and Changes of Physical Activity in Adolescents during the COVID-19 Pandemic: Contextualizing Urban vs. Rural Living Environment

Applied Sciences ◽

10.3390/app10113997 ◽

2020 ◽

Vol 10 (11) ◽

pp. 3997 ◽

Cited By ~ 6

Author(s):

Natasa Zenic ◽

Redha Taiar ◽

Barbara Gilic ◽

Mateo Blazevic ◽

Dora Maric ◽

...

Keyword(s):

Physical Activity ◽

Rural Areas ◽

Urban Adolescents ◽

Living Environment ◽

Activity Levels ◽

Social Distancing ◽

Rural Living ◽

Urban Rural ◽

The Impact

The COVID-19 pandemic and the social distancing implemented shortly after influence physical activity levels (PALs). The purpose of this investigation was to evaluate the changes in PAL and factors associated with PALs among Croatian adolescents while considering the impact of community (urban vs. rural living environment). The sample included 823 adolescents (mean age: 16.5 ± 2.1 years) who were tested on baseline (from October 2019 to March 2020; before COVID-19 pandemic in Croatia) and follow-up (in April 2020; during the COVID-19 pandemic and imposed rules of social distancing). Baseline testing included anthropometrics, physical fitness status, and evaluation of PALs, while follow-up included only PALs (evaluated by a standardized questionnaire through an internet application). The results showed a significant influence of the living environment on the decrease of PAL, with a larger decrease in urban adolescents. Logistic regression showed a higher likelihood for normal PALs at baseline in adolescents who had better fitness status, with no strong confounding effect of the urban/rural environment. The fitness status of urban adolescents predicted their PALs at follow-up. The differences between urban and rural adolescents with regard to the established changes in PALs and relationships between the predictors and PALs are explained by the characteristics of the living communities (lack of organized sports in rural areas), and the level of social distancing in the studied period and region/country.

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Effect of Statewide Lockdown in Response to COVID-19 Pandemic on Physical Activity Levels of Hemodialysis Patients

Blood Purification ◽

10.1159/000514935 ◽

2021 ◽

pp. 1-8

Author(s):

Maggie Han ◽

Priscila Preciado ◽

Ohnmar Thwin ◽

Xia Tao ◽

Leticia M. Tapia-Silva ◽

...

Keyword(s):

Physical Activity ◽

New York ◽

New York City ◽

New York State ◽

Hemodialysis Patients ◽

Activity Levels ◽

Physical Activity Levels ◽

National Emergency ◽

The Impact

Background/Objectives: On March 22, 2020, a statewide stay-at-home order for nonessential tasks was implemented in New York State. We aimed to determine the impact of the lockdown on physical activity levels (PAL) in hemodialysis patients. Methods: Starting in May 2018, we are conducting an observational study with a 1-year follow-up on PAL in patients from 4 hemodialysis clinics in New York City. Patients active in the study as of March 22, 2020, were included. PAL was defined by steps taken per day measured by a wrist-based monitoring device (Fitbit Charge 2). Average steps/day were calculated for January 1 to February 13, 2020, and then weekly from February 14 to June 30. Results: 42 patients were included. Their mean age was 55 years, 79% were males, and 69% were African Americans. Between January 1 and February 13, 2020, patients took on average 5,963 (95% CI 4,909–7,017) steps/day. In the week prior to the mandated lockdown, when a national emergency was declared, and in the week of the shutdown, the average number of daily steps had decreased by 868 steps/day (95% CI 213–1,722) and 1,222 steps/day (95% CI 668–2300), respectively. Six patients were diagnosed with COVID-19 during the study period. Five of them exhibited significantly higher PAL in the 2 weeks prior to showing COVID-19 symptoms compared to COVID-19 negative patients. Conclusion: Lockdown measures were associated with a significant decrease in PAL in hemodialysis patients. Patients who contracted COVID-19 had higher PAL during the incubation period. Methods to increase PAL while allowing for social distancing should be explored and implemented.

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The Impact of Isolation Measures Due to COVID-19 on Energy Intake and Physical Activity Levels in Australian University Students

Nutrients ◽

10.3390/nu12061865 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1865 ◽

Cited By ~ 10

Author(s):

Linda A. Gallo ◽

Tania F. Gallo ◽

Sophia L. Young ◽

Karen M. Moritz ◽

Lisa K. Akison

Keyword(s):

Physical Activity ◽

Energy Intake ◽

Activity Levels ◽

Physical Isolation ◽

Home Based ◽

Physical Activity Levels ◽

Reduced Physical Activity ◽

The Impact

The coronavirus disease 2019 (COVID-19) pandemic resulted in physical isolation measures in many parts of the world. In Australia, nationwide restrictions included staying at home, unless seeking medical care, providing care, purchasing food, undertaking exercise, or attending work in an essential service. All undergraduate university classes transitioned to online, mostly home-based learning. We, therefore, examined the effect of isolation measures during the early phase of the COVID-19 pandemic in Australia (March/April) on diet (24-h recall) and physical activity (Active Australia Survey) patterns in third-year biomedical students. Findings were compared with students enrolled in the same course in the previous two years. In females, but not males, energy intake was ~20% greater during the pandemic, and snacking frequency and energy density of consumed snacks also increased compared with 2018 and 2019. Physical activity was impacted for both sexes during the pandemic with ~30% fewer students achieving “sufficient” levels of activity, defined by at least 150 min over at least five sessions, compared with the previous two years. In a follow-up study six to eight weeks later (14–18% response rate), during gradual easing of nationwide restrictions albeit continued gym closures and online learning, higher energy intake in females and reduced physical activity levels in both sexes persisted. These data demonstrate the health impacts of isolation measures, with the potential to affect long-term diet and activity behaviours.

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The Impact of Scholastic Factors on Physical Activity Levels during the COVID-19 Lockdown: A Prospective Study on Adolescents from Bosnia and Herzegovina

Children ◽

10.3390/children8100877 ◽

2021 ◽

Vol 8 (10) ◽

pp. 877

Author(s):

Damir Sekulic ◽

Daria Ostojic ◽

Andrew Decelis ◽

‪José Castro-Piñero ◽

Tatjana Jezdimirovic ◽

...

Keyword(s):

Physical Activity ◽

Grade Point Average ◽

Bosnia And Herzegovina ◽

Sport Participation ◽

Activity Levels ◽

Grade Point ◽

Physical Activity Levels ◽

A Prospective Study ◽

The Impact

Scholastic factors (academic achievement) are hypothesized to be important determinants of health-related behaviors in adolescents, but there is a lack of knowledge on their influence on physical activity levels (PAL), especially considering the COVID-19 pandemic and the imposed lockdown. This study aimed to investigate the associations between scholastic factors and PAL before and during the pandemic lockdown. The participants were adolescents form Bosnia and Herzegovina (n = 525, 46% females), who were observed prospectively at the baseline (before the pandemic lockdown) and during the lockdown in 2020 (follow-up). The scholastic factors (grade point average, behavioral grade, school absences, unexcused absences) were evidenced at the baseline (predictors). The outcome (PAL) was evaluated using the Physical Activity Questionnaire for Adolescents at the baseline and the follow-up. Gender, age, parental/familial conflict, and sport participation were observed as confounders. No significant influence of the predictors on PAL were evidenced at the baseline or at the follow-up. The scholastic variables were significantly associated with the changes of PAL which occurred due to pandemic lockdown, with a lower risk for negative changes in PAL among adolescents who were better in school (OR = 0.56, 95%CI: 0.34–0.81, and OR = 0.66, 95%CI: 0.34–0.97, for the grade point average and behavioral grade, respectively). Students who do well in school are probably more aware of the health benefits of proper PAL, and therefore are devoted to the maintenance of their PAL even during the home-confinement of lockdown. Public health authorities should focus more on helping adolescents to understand the importance and benefits of proper PAL throughout the school system.

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Integrating Motivational Interviewing into Clinical Care to Increase Physical Activity Levels in Women with Gestational Diabetes

10.21203/rs.3.rs-61688/v1 ◽

2020 ◽

Author(s):

Ralph Smith ◽

Ashley Ridout ◽

Angus Livingstone ◽

N. Wango ◽

Yvonne Kenworthy ◽

...

Keyword(s):

Physical Activity ◽

Glycaemic Control ◽

Gestational Diabetes ◽

Motivational Interviewing ◽

Clinical Pathway ◽

Moderate Intensity ◽

Activity Levels ◽

Physical Activity Levels ◽

The Impact

Abstract Background: Regular physical activity (PA) improves glycaemic control in women diagnosed with Gestational Diabetes (GDM). However, PA advice competes with other components of care, with many women forgoing the benefits of regular PA. Motivational interviewing (MI) is an effective technique for increasing individual PA levels. A clinical pathway was developed integrating MI on PA into the routine care. This report evaluates the impact of MIs on self-reported PA levels.Methods: Women attending a single centre NHS GDM clinic were invited to engage in an individual PA-focused MI session, delivered by a trained midwife. This included goal setting and activity planning. All women had a confirmed diagnosis of GDM based on a 75g oral glucose tolerance test using the International association of diabetes and pregnancy study group diagnostic thresholds. A modified version of the exercise vital sign was used to evaluate self-reported aerobic PA levels at baseline and two-week telephone follow-up. PA levels were coded into three categories: i) red (<30mins moderate intensity PA (MIPA)/week), ii) amber (30-150mins MIPA/week) and iii) green (150mins MIPA/week). Women with contraindications to PA were excluded. The main outcome was the difference PA levels from baseline to two weeks. The Pearson’s Chi-squared test was used to evaluate statistical difference in self-reported PA levels from baseline to follow-up.Results: Complete follow-up data was obtained from 62 women. Mean gestation was 27+5/40 weeks (9-36+4/40), mean age 31.7y (21-43y) and mean BMI 29.9kg/m2 (18.3-48.2 kg/m2). At baseline, 19 (30.6%) were coded red (<30mins MIPA/week); 26 (41.9%) amber (30-150mins MIPA/week); and 17 (27.4%) green (150mins MIPA/week). Self-reported physical activity levels of these women at two-week follow-up revealed only 3 (4.8%) women coded red, 24 (38.7%) amber and 35 (56.5%) green. This demonstrates a significant association for increased PA levels after MI at two-week follow-up (p=0.0001).Conclusion: This new clinical pathway provides encouraging results, showing that self-reported PA increased significantly at two-week follow-up. Further work is now required to examine the impact on glycaemic control, maternal and fetal outcomes, and maintenance of PA levels. This model of care should be integrated into other high-risk patient groups.

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A Scoping Review of Exercise Referral Schemes Involving Qualified Exercise Professionals in Primary Health Care

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2020-1070 ◽

2021 ◽

Author(s):

Myles W. O'Brien ◽

Nick W. Bray ◽

Matthew J. Kivell ◽

Jonathon R Fowles

Keyword(s):

Physical Activity ◽

Aerobic Fitness ◽

Scoping Review ◽

Healthcare Providers ◽

Activity Level ◽

Activity Levels ◽

Physical Activity Counselling ◽

Supervised Exercise ◽

The Impact ◽

Exercise Referral

Qualified exercise professionals (QEPs) have the training, knowledge, and scope of practice to effectively provide physical activity counselling, prescribe exercise, and deliver exercise programming to patients with or without chronic diseases. Healthcare providers identify an interest in referring patients to QEPs; however, the impact of exercise referral schemes (ERS) involving QEPs on patients’ physical health is unclear. A scoping review regarding the available evidence of ERS involving healthcare provider referrals to QEPs was performed. A literature search was conducted in six databases (initially: n=6011 articles), yielding n=23 articles examining QEP delivered physical activity counselling (n=7), QEP supervised exercise training (n=4), or some combination (n=12). Although studies were heterogeneous in methods, procedures, and populations, ERSs increased patients’ subjective physical activity levels. Few studies incorporated objective physical activity measures (n=5/23), and almost half measured aerobic fitness (n=11/23). ERS involving a QEP that includes activity counselling and/or exercise programming/training report favourable impacts on patients’ subjectively measured physical activity and objectively measured aerobic fitness. Based on the existing literature on the topic, this scoping review provides recommendations for designing and/or evaluating ERS with QEPs that include: objective measures, long-term follow-up, QEP qualifications, and the cost-effectiveness of ERS. Novelty: • ERS involving QEPs report increased patients’ perceived physical activity level and may improve patients’ cardiorespiratory fitness. • Promoting the collaboration of QEPs with other healthcare providers can enhance patients’ physical fitness and health. • This scoping review provides recommendations for the design and evaluation of ERS involving QEPs.

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Cognitive Impairment and Physical Activity in Old Age: The Impact on All-Cause Mortality in a 15-Year Follow-Up of the Bambuí Cohort Study of Aging

SSRN Electronic Journal ◽

10.2139/ssrn.3557992 ◽

2020 ◽

Author(s):

Erico Castro-Costa ◽

Jerson Laks ◽

Cecilia Godoi Campos ◽

Josélia OA Firmo ◽

Maria Fernanda Lima-Costa ◽

...

Keyword(s):

Physical Activity ◽

Cohort Study ◽

Cognitive Impairment ◽

Old Age ◽

All Cause Mortality ◽

The Impact

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POS1234 IMPACT OF THE CHANGE IN ADMINISTRATION ROUTE OF TOCILIZUMAB AND ABATACEPT, DUE TO THE COVID-19 LOCKDOWN ON DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3126 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 900.1-900

Author(s):

L. Diebold ◽

T. Wirth ◽

V. Pradel ◽

N. Balandraud ◽

E. Fockens ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Physical Activity ◽

Disease Activity ◽

Univariate Analysis ◽

Route Of Administration ◽

Anxiety And Depression ◽

Administration Route ◽

Factors Associated ◽

The Impact

Background:Among therapeutics used to treat rheumatoid arthritis (RA), Tocilizumab (TCZ) and Abatacept (ABA) are both biologic agents that can be delivered subcutaneously (SC) or intravenously (IV). During the first COVID-19 lockdown in France, all patients treated with IV TCZ or IV ABA were offered the option to switch to SC administration.Objectives:The primary aim was to assess the impact of changing the route of administration on the disease activity. The second aim was to assess whether the return to IV route at the patient’s request was associated with disease activity variation, flares, anxiety, depression and low physical activity during the lockdown.Methods:We conducted a prospective monocentric observational study. Eligibility criteria: Adult ≥ 18 years old, RA treated with IV TCZ or IV ABA with a stable dose ≥3 months, change in administration route (from IV to SC) between March 16, 2020, and April 17, 2020. The following data were collected at baseline and 6 months later (M6): demographics, RA characteristics, treatment, history of previous SC treatment, disease activity (DAS28), self-administered questionnaires on flares, RA life repercussions, physical activity, anxiety and depression (FLARE, RAID, Ricci &Gagnon, HAD).The primary outcome was the proportion of patients with a DAS28 variation>1.2 at M6. Analyses: Chi2-test for quantitative variables and Mann-Whitney test for qualitative variables. Factors associated with return to IV route identification was performed with univariate and multivariate analysis.Results:Among the 84 patients who were offered to switch their treatment route of administration, 13 refused to change their treatment. Among the 71 who switched (48 TCZ, 23 ABA), 58 had a M6 follow-up visit (13 lost of follow-up) and DAS28 was available for 49 patients at M6. Main baseline characteristics: female 81%, mean age 62.7, mean disease duration: 16.0, ACPA positive: 72.4%, mean DAS28: 2.01, previously treated with SC TCZ or ABA: 17%.At M6, the mean DAS28 variation was 0.18 ± 0.15. Ten (12.2%) patients had a DAS28 worsening>1.2 (ABA: 5/17 [29.4%] and TCZ: 5/32 [15.6%], p= 0.152) and 19 patients (32.8%) had a DAS28 worsening>0.6 (ABA: 11/17 [64.7%] and TCZ: 8/32 [25.0%], p= 0.007).At M6, 41 patients (77.4%) were back to IV route (26 TCZ, 15 ABA) at their request. The proportion of patients with a DAS28 worsening>1.2 and>0.6 in the groups return to IV versus SC maintenance were 22.5%, 42.5% versus 11.1% and 22.2% (p=0.4), respectively. The univariate analysis identified the following factors associated with the return to IV route: HAD depression score (12 vs 41, p=0.009), HAS anxiety score (12 vs 41, p=0.047) and corticosteroid use (70% vs 100%, p=0.021), in the SC maintenance vs return to IV, respectively.Conclusion:The change of administration route of TCZ and ABA during the first COVID-19 lockdown was infrequently associated with a worsening of RA disease. However, the great majority of the patients (77.4%) request to return to IV route, even without disease activity worsening. This nocebo effect was associated with higher anxiety and depression scores.Disclosure of Interests:None declared

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Later sleep timing predicts accelerated summer weight gain among elementary school children: a prospective observational study

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-021-01165-0 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Jennette P. Moreno ◽

Javad Razjouyan ◽

Houston Lester ◽

Hafza Dadabhoy ◽

Mona Amirmazaheri ◽

...

Keyword(s):

Physical Activity ◽

Observational Study ◽

Sleep Duration ◽

Obesity Prevention ◽

Prospective Observational Study ◽

Light Exposure ◽

Activity Level ◽

Activity Levels ◽

School Year ◽

Children’S Sleep

Abstract Objectives and background Social demands of the school-year and summer environment may affect children’s sleep patterns and circadian rhythms during these periods. The current study examined differences in children’s sleep and circadian-related behaviors during the school-year and summer and explored the association between sleep and circadian parameters and change in body mass index (BMI) during these time periods. Methods This was a prospective observational study with 119 children ages 5 to 8 years with three sequential BMI assessments: early school-year (fall), late school-year (spring), and beginning of the following school-year in Houston, Texas, USA. Sleep midpoint, sleep duration, variability of sleep midpoint, physical activity, and light exposure were estimated using wrist-worn accelerometry during the school-year (fall) and summer. To examine the effect of sleep parameters, physical activity level, and light exposure on change in BMI, growth curve modeling was conducted controlling for age, race, sex, and chronotype. Results Children’s sleep midpoint shifted later by an average of 1.5 h during summer compared to the school-year. After controlling for covariates, later sleep midpoints predicted larger increases in BMI during summer, (γ = .0004, p = .03), but not during the school-year. Sleep duration, sleep midpoint variability, physical activity levels, and sedentary behavior were not associated with change in BMI during the school-year or summer. Females tended to increase their BMI at a faster rate during summer compared to males, γ = .06, p = .049. Greater amounts of outdoor light exposure (γ = −.01, p = .02) predicted smaller increases in school-year BMI. Conclusions Obesity prevention interventions may need to target different behaviors depending on whether children are in or out of school. Promotion of outdoor time during the school-year and earlier sleep times during the summer may be effective obesity prevention strategies during these respective times.

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