Potential value of home square-stepping exercises for inactive older adults: an exploratory case study

Background Most older adults do not engage in regular physical activity. However, more research on options to partake in regular exercise in this population by reducing barriers and enhancing enablers while still reaching benefits is needed. Methods Using embedded mixed methods, 10 inactive older adults over the age of 65 completed a 3-week square-stepping exercise intervention to help overcome the initial barriers and activate initial enablers to perform regular exercise. Physical activity level was tracked at home with a pedometer using median steps/day over seven days for pre-post measure. Aerobic intensity while doing square-stepping exercises was quantified via a heart rate monitor in a supervised session. Each participant had an interview asking about barriers and enablers to regular exercise and if the intervention could modify any. Based on initial physical activity a framework matrix was used to pull potential barriers to compare, contrast, and search for patterns between participants with lower and higher initial physical activity levels. Results The 3-week square-stepping exercise intervention helped participants overcome barriers such as being uncomfortable in a fitness facility and body image and activate enablers such as the use of home equipment and convenience. The median total steps/day increased by 12% (p = 0.02), and a moderate-intensity level was reached by 80% of the sample participants when performing the square stepping exercise during a supervised session. Common barriers such as having a suitable program, hard to keep the intensity were reported by participants regardless of the initial physical activity level. Conclusion Regardless of initial physical activity level, inactive older adults can increase physical activity level at the recommended intensity and overcome common barriers to exercise when performing square-stepping exercises, especially for those intimidated by a fitness facility setting and those concerned with their body image. A longer intervention including more participants using the square-stepping exercises is required to understand if square-stepping exercises can increase the proportion of older adults exercising regularly.

Fitness Facility Staff Can Be Trained to Deliver a Motivational Interviewing-Informed Diabetes Prevention Program

Background: Training programs must be evaluated to understand whether the training was successful at enabling staff to implement a program with fidelity. This is especially important when the training has been translated to a new context. The aim of this community case study was to evaluate the effectiveness of the in-person Small Steps for Big Changes training for fitness facility staff using the 4-level Kirkpatrick training evaluation model.Methods: Eight staff were trained to deliver the motivational interviewing-informed Small Steps for Big Changes program for individuals at risk of developing type 2 diabetes. Between August 2019 and March 2020, 32 clients enrolled in the program and were allocated to one of the eight staff. The Kirkpatrick 4-level training evaluation model was used to guide this research. Level one assessed staff satisfaction to the training on a 5-point scale. Level two assessed staff program knowledge and motivational interviewing knowledge/skills. Level three assessed staff behaviors by examining their use of motivational interviewing with each client. Level four assessed training outcomes using clients' perceived satisfaction with their staff and basic psychological needs support both on 7-point scales.Results: Staff were satisfied with the training (M = 4.43; SD = 0.45; range = 3.86–4.71). All learning measures demonstrated high post-training scores that were retained at implementation follow-up. Staff used motivational interviewing skills in practice and delivered the program at a client-centered level (≥6; M = 6.34; SD = 0.83; range = 3.75–7.80). Overall, clients perceived staff supported their basic psychological needs (M = 6.55; SD = 0.64; range = 6.17–6.72) and reported high staff satisfaction scores (M = 6.88; SD = 0.33; range = 6–7).Conclusion: The Small Steps for Big Changes training was successful and fitness facility staff delivered a motivational interviewing-informed program. While not all staff operated at a client-centered level, clients perceived their basic psychological needs to be supported. Findings support the training for future scale-up sites. Community fitness staff represent a feasible resource through which to run evidence-based counseling programs.

An outbreak of COVID-19 associated with a fitness centre in Saskatchewan: Lessons for prevention

Background: An outbreak of the coronavirus disease 2019 (COVID-19) occurred in Saskatchewan from September 12 to October 20, 2020. The index event, attendance at a local gym, seeded six additional clusters/outbreaks in multiple settings. These included a high school, a hospital, three workplaces (A, B and C) and several households. The overall cluster comprised 63 cases, 27 gym members and an additional 36 second, third and fourth generation cases. Methods: All outbreak-related, laboratory-confirmed cases of COVID-19 were included in the analysis. Local public health authorities interviewed all cases and contacts and conducted environmental investigations of the fitness facility. We used descriptive epidemiological methods to understand transmission dynamics of the gym-associated cluster using case investigation, contact investigation and laboratory data, including whole genome sequencing. Results: Sequencing data confirmed the unique lineage of cluster-related cases (n=32 sequenced; severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] lineage B.1.1.72). In addition to gym attendance, infectious cases attended high school and were involved in other activities. Despite ongoing transmission in the fitness facility, no secondary cases were identified in the high school where four student belonging to the cluster attended class during their infectious period. Conclusion: We describe an outbreak of COVID-19 where the index case(s) attended a fitness facility, and further spread occurred for 38 days despite active-case finding and isolation of positive cases over this period. Due to gym attendance over time, short-term closing and cleaning may not interrupt chains of transmission. Targeted, preventive public health action in fitness facilities may be warranted. Control measures worked to limit in-school acquisition.

Potential Benefits of a Novel Home-Based Exercise Program for Inactive Older Adults: An Exploratory Case Study

Background This study proposed a 3-week home exercise program using a square-stepping exercise (SSE) to explore if it could address common barriers and enhance enablers of regular exercise among older adults. Methods Using embedded mixed methods, 10 inactive older adults over the age of 65 completed the proposed program in conjunction with follow-up interviews. Participants were deemed inactive if they took less than 10,000 steps/day over one week. Their physical activity was tracked at home with a pedometer. Results Barriers reached during the proposed program were being uncomfortable in a fitness facility and body image. The proposed program enhanced enablers such as the use of home equipment and easy access. The average total steps/day increased by 27% (p=0.02) and moderate-intensity was reached by 80% of participants when performing the SSE. Conclusion The exercise program addressed the common barriers to exercise and could increase the physical activity level of inactive older adults especially for those intimidated by a fitness facility setting and those concerned with their body image.

Sustainability Implementation of UI Green Metric World University Rankings Energy & Climate Change (EC) Indicators: A Case Study of MUET Gymnasium Fitness Facility

Mehran University of Engineering & Technology is a public university established in 1973. Wit seventeen faculties of multi-disciplines and having more than 7,500 students, MUET has made lots of achievements. In 2019, MUET is ranked 271 in the world, 2nd in Pakistan, 1st in Sindh Province, and slotted 275th in terms of Energy and Climate change (EC) indicators implementations on Sustainable development by UI GreenMetric World University Rankings. UI GreenMetric is a sustainability-based ranking whose aim is to provide rankings of universities all over the world based on their efforts for the implementation of pre-define indicator criteria. One of the criteria for this ranking is the Energy and Climate change (EC) indicator which had a most 21 percent weightage. In this review, this paper presents a detailed analysis for the implementation of EC indicators of UI GreenMetric World University Rankings to reduce carbon dioxide footprints and maintain sustainability at MUET gymnasium fitness facility. In this mechanism, an Energy Efficient Flywheel-Based KERS (Kinetic Energy Recovery System) Bicycle Generator is designed and developed. Additionally, a techno-economic (Energy, Cost and Co2 emission saving) beneficial analysis of generators with their usage as a free renewable energy source to overcome luminosity demand of MUET gymnasium fitness facility by an efficient LED lighting system and their relative relation with the EC indicator implementation is also discussed.

Fitness facility staff demonstrate high fidelity when implementing an evidence-based diabetes prevention program

Translating evidence-based diabetes prevention programs into the community is needed to make promising interventions accessible to individuals at-risk of type 2 diabetes. To increase the likelihood of successful translation, implementation evaluations should be conducted to understand program outcomes and provide feedback for future scale-up sites. The purpose of this research was to examine the delivery of, and engagement with, an evidence-based diet and exercise diabetes prevention program when delivered by fitness facility staff within a community organization. Ten staff from a community organization were trained to deliver the diabetes prevention program. Between August 2019–March 2020, 26 clients enrolled in the program and were assigned to one of the ten staff. Three fidelity components were accessed. First, staff completed session-specific fidelity checklists (n = 156). Second, two audio-recorded counseling sessions from all clients underwent an independent coder fidelity check (n = 49). Third, staff recorded client goals on session-specific fidelity checklists and all goals were independently assessed for (a) staff goal-setting fidelity, (b) client intervention receipt, and (c) client goal enactment by two coders (n = 285). Average self-reported fidelity was 90% for all six sessions. Independent coder scores for both counseling sessions were 83% and 81%. Overall staff helped clients create goals in line with program content and had a goal achievement of 78%. The program was implemented with high fidelity by staff at a community organization and clients engaged with the program. Findings increase confidence that program effects are due to the intervention itself and provide feedback to refine implementation strategies to support future scale-up efforts.