The impact of sport and active recreation injuries on physical activity levels at 12 months post-injury

The aim of this study was to evaluate the impact of serious sport and active recreation injury on 12-month physical activity levels. Adults admitted to hospital with sport and active recreation-related injuries, and captured by the Victorian Orthopaedic Trauma Outcomes Registry were recruited to the study. Changes between preinjury and 12 month post-injury physical activity was assessed using the short International Physical Activity Questionnaire (IPAQ). Independent demographic, injury, and hospital variables were assessed for associations with changes in physical activity levels, using multivariate linear regression. A total of 324 patients were recruited, of which 98% were followed up at 12 months. Mean short IPAQ scores decreased from 7650 METS (95% CI: 7180, 8120) preinjury to 3880 METS; (95% CI: 3530, 4250) post-injury, independent of functional recovery. Education level and occupation group were the only variables independently associated with changes in physical activity levels post-injury. These results highlighted that sport and active recreation injuries lead to significant reductions in physical activity levels. Hence, the prevention of sport and active recreation injuries is important when considering promotion of activity at a population level.

Statistical approaches to testing the relationships of the built environment with resident-level physical activity behavior and health outcomes in cross-sectional studies with cluster sampling

To achieve valid conclusions, studies exploring associations of the built environment with residents' physical activity and health-related outcomes need to employ statistical approaches accounting for clustered data. This article discusses the following main statistical approaches: analysis of covariance, regression models with robust standard errors, generalized estimating equations, and multilevel generalized linear models. The choice of a statistical method depends on the characteristics of the study and research questions. While the first three approaches are employed to account for clustering in the data, multilevel models can also help unravel more substantive issues within a social ecological theoretical framework of health behavior.

Physical activity, activity change, and their correlates in a population-based sample of colorectal cancer survivors

Background: Physical activity can provide benefits to cancer survivors, including reduced symptoms and treatment side effects, improved overall quality of life, and decreased risk of other chronic diseases.

Purpose: The aim of the study was to describe physical activity before and after diagnosis of colorectal cancer and to examine the associations with sociodemographic and disease-related variables.

Methods: Telephone interviews were conducted with 1,996 colorectal cancer survivors recruited through a cancer registry.

Results: In comparison to prediagnosis activity levels, there were 21% fewer participants meeting the physical activity and health guideline (150 min of moderate-intensity physical activity per week) postdiagnosis. Meeting the guideline postdiagnosis was associated with being male, living outside of the state capital city, having a higher education, having a healthy body mass index, not smoking, having had surgery only, and no reported fatigue. Attributes associated with a decrease in physical activity following diagnosis were being female, living within the state capital city, having a lower level of education, having a stoma, having adjuvant therapy, and experiencing fatigue.

Conclusions: There is considerable scope for targeted interventions to increase the physical activity of colorectal cancer survivors, particularly for those groups that we have identified as being less active and/or have reduced their activity.

Associations between behavior regulation, competence, physical activity, and health for adolescent females

This study investigated the association between the different types of behavior regulation and competence on sport and physical activity (PA) and perceived health, and the influence of school year level (ie, year 7 and year 11) and setting (ie, metropolitan and rural) on these relationships.

Park proximity, quality and recreational physical activity among mid-older aged adults: moderating effects of individual factors and area of residence

The transition from active employment to retirement is a potentially critical period for promoting maintenance or development of recreational physical activity in older age. Park proximity and quality might be important correlates of recreational physical activity in this age group. However, research on park-physical activity relationships among mid-older aged adults is limited and inconclusive. Furthermore, while knowledge of individual moderators of park-physical activity relationships is crucial for tailoring interventions, this knowledge is also limited. We investigated relationships between perceived park proximity, park quality and recreational physical activity among mid-older aged adults. Additionally, we examined the potential moderating effects of gender, education level, retirement status, functional limitations and area of residence on these relationships.

Traversing myths and mountains: addressing socioeconomic inequities in the promotion of nutrition and physical activity behaviours

BACKGROUND: In developed countries, individuals experiencing socioeconomic disadvantage - whether a low education level, low income, low-status occupation, or living in a socioeconomically disadvantaged neighbourhood - are less likely than those more advantaged to engage in eating and physical activity behaviours conducive to optimal health. These socioeconomic inequities in nutrition and physical activity (and some sedentary) behaviours are graded, persistent, and evident across multiple populations and studies. They are concerning in that they mirror socioeconomic inequities in obesity and in health outcomes. Yet there remains a dearth of evidence of the most effective means of addressing these inequities. People experiencing disadvantage face multiple challenges to healthy behaviours that can appear insurmountable. With increasing recognition of the role of underlying structural and societal factors as determinants of nutrition and physical activity behaviours and inequities in these behaviours, and the limited success of behaviour change approaches in addressing these inequities, we might wonder whether there remains a role for behavioural scientists to tackle these challenges. DISCUSSION: This debate piece argues that behavioural scientists can play an important role in addressing socioeconomic inequities in nutrition, physical activity and sedentary behaviours, and that this will involve challenging myths and taking on new perspectives. There are successful models for doing so from which we can learn. Addressing socioeconomic inequities in eating, physical activity and sedentary behaviours is challenging. However, successful examples demonstrate that overcoming such challenges is possible, and provide guidance for doing so. Given the disproportionate burden of ill health carried by people experiencing socioeconomic disadvantage, all our nutrition and physical activity interventions, programs and policies should be designed to reach and positively impact these individuals at greatest need.

Moderating effects of age, gender and education on the associations of perceived neighborhood environment attributes with accelerometer-based physical activity: the IPEN adult study

The study's purpose was to examine age, gender, and education as potential moderators of the associations of perceived neighborhood environment variables with accelerometer-based moderate-to-vigorous physical activity (MVPA). Data were from 7273 adults from 16 sites (11 countries) that were part of a coordinated multi-country cross-sectional study. Age moderated the associations of perceived crime safety, and perceiving no major physical barriers to walking, with MVPA: positive associations were only found in older adults. Perceived land use mix-access was linearly (positive) associated with MVPA in men, and curvilinearly in women. Perceived crime safety was related to MVPA only in women. No moderating relationships were found for education. Overall the associations of adults' perceptions of environmental attributes with MVPA were largely independent of the socio-demographic factors examined. These findings are encouraging, suggesting that efforts to optimize the perceived built and social environment may act in a socially-equitable manner to facilitate MVPA.

Association between maternal education and objectively measured physical activity and sedentary time in adolescents

BACKGROUND: Investigating socioeconomic variation in physical activity (PA) and sedentary time is important as it may represent a pathway by which socioeconomic position (SEP) leads to ill health. Findings on the association between children's SEP and objectively assessed PA and/or sedentary time are mixed, and few studies have included international samples.

OBJECTIVE: Examine the associations between maternal education and adolescent's objectively assessed PA and sedentary time.

METHODS: This is an observational study of 12 770 adolescents (10-18 years) pooled from 10 studies from Europe, Australia, Brazil and the USA. Original PA data were collected between 1997 and 2009. The associations between maternal education and accelerometer variables were examined using robust multivariable regression, adjusted for a priori confounders (ie, body mass index, monitor wear time, season, age and sex) and regression coefficients combined across studies using random effects meta-analyses. Analyses were conducted in March 2014.

RESULTS: Adolescents of university educated mothers spent more time sedentary (9.5 min/day, p=0.005) and less time in light activity (10 min/day, p<0.001) compared with adolescents of high school educated mothers. Pooled analysis across two studies from Brazil and Portugal (analysed separately because of the different coding of maternal education) showed that children of higher educated mothers (tertiary vs primary/secondary) spent less time in moderate to vigorous PA (MVPA) (6.6 min/day, p=0.001) and in light PA (39.2 min/day: p<0.001), and more time sedentary (45.9 min/day, p<0.001).

CONCLUSIONS: Across a number of international samples, adolescents of mothers with lower education may not be at a disadvantage in terms of overall objectively measured PA.

Characteristics of teacher training in school-based physical education interventions to improve fundamental movement skills and/or physical activity: a systematic review

BACKGROUND: Fundamental movement skill (FMS) competence is positively associated with physical activity (PA). However, levels of both FMS and PA are lower than expected. Current reviews of interventions to improve FMS and PA have shown that many school-based programs have achieved positive outcomes, yet the maintenance of these interventions is variable. Teachers play a central role in the success and longevity of school-based interventions. Despite the importance of teacher engagement, research into the nature and quality of teacher training in school-based PA and FMS interventions has received little attention.

OBJECTIVE: The aim of this systematic review was to investigate the type and quantity of teacher training in school-based physical education PA and/or FMS interventions, and to identify what role teacher training had on the intervention outcome.

METHODS: A systematic search of eight electronic databases was conducted. Publication date restrictions were not implemented in any database, and the last search was performed on 1 March 2015. School physical education-based interventions facilitated by a school teacher, and that included a quantitative assessment of FMS competence and/or PA levels were included in the review.

RESULTS: The search identified 39 articles. Eleven of the studies measured FMS, 25 studies measured PA and three measured both FMS and PA. Nine of the studies did not report on any aspect of the teacher training conducted. Of the 30 studies that reported on teacher training, 25 reported statistically significant intervention results for FMS and/or PA. It appears that teacher training programs: are ≥ 1 day; provide comprehensive subject and pedagogy content; are framed by a theory or model; provide follow-up or ongoing support; and measure teacher satisfaction of the training, are more effective at improving student outcomes in FMS and/or PA. However, the provision of information regarding the characteristics of the teacher training was largely inadequate. Therefore, it was difficult to ascertain which teacher training characteristics were most important in relation to intervention effectiveness.

CONCLUSION: It is clear that whilst teachers are capable of making substantial improvements in student outcomes in PA and FMS, the findings of this review suggest the teacher training component of school-based PA and/or FMS interventions is not only under-reported but is under-studied, and, perhaps as a result, the value of teacher training is not widely understood. What remains unclear, due to poor reporting, is what role teacher training is having on these outcomes.

Scaling-up an efficacious school-based physical activity intervention: study protocol for the 'Internet-based professional learning to help teachers support activity in youth' (iPLAY) cluster randomized controlled trial and scale-up implementation evaluat

BACKGROUND: Despite the health benefits of regular physical activity, most children are insufficiently active. Schools are ideally placed to promote physical activity; however, many do not provide children with sufficient in-school activity or ensure they have the skills and motivation to be active beyond the school setting. The aim of this project is to modify, scale up and evaluate the effectiveness of an intervention previously shown to be efficacious in improving children's physical activity, fundamental movement skills and cardiorespiratory fitness. The 'Internet-based Professional Learning to help teachers support Activity in Youth' (iPLAY) study will focus largely on online delivery to enhance translational capacity.

METHODS/DESIGN: The intervention will be implemented at school and teacher levels, and will include six components: (i) quality physical education and school sport, (ii) classroom movement breaks, (iii) physically active homework, (iv) active playgrounds, (v) community physical activity links and (vi) parent/caregiver engagement. Experienced physical education teachers will deliver professional learning workshops and follow-up, individualized mentoring to primary teachers (i.e., Kindergarten - Year 6). These activities will be supported by online learning and resources. Teachers will then deliver the iPLAY intervention components in their schools. We will evaluate iPLAY in two complementary studies in primary schools across New South Wales (NSW), Australia. A cluster randomized controlled trial (RCT), involving a representative sample of 20 schools within NSW (1:1 allocation at the school level to intervention and attention control conditions), will assess effectiveness and cost-effectiveness at 12 and 24 months. Students' cardiorespiratory fitness will be the primary outcome in this trial. Key secondary outcomes will include students' moderate-to-vigorous physical activity (via accelerometers), fundamental movement skill proficiency, enjoyment of physical education and sport, cognitive control, performance on standardized tests of numeracy and literacy, and cost-effectiveness. A scale-up implementation study guided by the RE-AIM framework will evaluate the reach, effectiveness, adoption, implementation, and maintenance of the intervention when delivered in 160 primary schools in urban and regional areas of NSW.

DISCUSSION: This project will provide the evidence and a framework for government to guide physical activity promotion throughout NSW primary schools and a potential model for adoption in other states and countries.

Playing their part: the role of physical activity and sport in sustaining the health and well being of small rural communities

It is widely recognised that the health of rural Australians is poor in comparison with their urban counterparts. Similarly, the role played by physical activity in maintaining health has been well researched and is well documented. However, little appears to have been published in recent years about the links between physical activity and health in rural communities. The objective of this article was to begin to address that gap. To achieve this, the article drew on research conducted in two small rural communities in Victoria Australia, and highlighted the role that physical activity and sport played in sustaining the health and wellbeing of individuals and communities in rural areas. Taking the World Health Organisation's definition of health (a state of complete physical, mental and social well-being and not merely the absence of disease) as its measure, the paper highlighted the many ways in which physical activity and sport in rural communities contribute to physical health, mental wellbeing and social cohesiveness. Based this finding, the authors suggest that physical activity and sport make a significant contribution to the health and wellbeing of rural people and their communities and suggest that further research is necessary to better define this apparent contribution.

Changes to (primary) school recess and their effect on children's physical activity: an Australian perspective

Headlines greet us on almost a daily basis lamenting the declining health of Australian children. They are said to be inactive, unfit, overweight and lacking in fundamental motor skills. It is a disturbing picture. Calls have gone out to parents to encourage their children to be more active and for schools to counter these problems by allocating more time to sport and physical education however, in both instances, there are particular problems to be addressed. One aspect of schooling that is rarely considered in discussions about how to increase children's activity levels is recess. This article examines the problems facing physical education and offers some suggestions as to how schools might preserve and promote physical activity during recess breaks.

Too hot to trot? exploring potential links between climate change, physical activity and health

Based on an analysis of existing literature, this paper explores the links between climate change, physical activity and health. It highlights the importance of physical activity for health, explores current understandings of factors influencing participation in sport and physical activity, and develops some hypotheses about the ways in which climate change may impact on the factors influencing physical activity and thereby on the level of participation in physical activity. The paper argues that climate change has the potential to be a barrier to participation in physical activity, particularly in areas where temperatures are already relatively high, and that a reduction in physical activity across the population is likely to have detrimental health impacts. The need for research to clarify the nature and extent of the threat posed to physical activity participation is highlighted, as is the need to take into account the direct and indirect costs of any changes or reductions in physical activity in any assessment of the costs of climate change and/or its mitigation.

Children's perceptions of their home and neighborhood environments, and their association with objectively measured physical activity: A qualitative and quantitative study

Environmental factors may have an important influence on children’s physical activity, yet children’s perspectives of their home and neighborhood environments have not been widely assessed. The aim of this study was to investigate children’s perceptions of their environments, and to examine associations between these perceptions and objectively measured physical activity. The sample consisted of 147, 10-year-old Australian children, who drew maps of their home and neighborhood environments. A subsample of children photographed places and things in these environments that were important to them. The maps were analyzed for themes, and for the frequency with which particular objects and locations appeared. Physical activity was objectively measured using accelerometers. Six themes emerged from the qualitative analysis of the maps and photographs: the family home; opportunities for physical activity and sedentary pursuits; food items and locations; green space and outside areas; the school and opportunities for social interaction. Of the 11 variables established from these themes, one home and two neighborhood factors were associated with children’s physical activity. These findings contribute to a broader understanding of children’s perceptions of their environment, and highlight the potential importance of the home and neighborhood environments for promoting physical activity behavior.

Physical activity, emotional stress, sleep disturbances, and daily fluctuations in chronic fatigue symptomatology

The current study explored the relationships between physical and emotional stress and the symptomatology of chronic fatigue syndrome (CFS). Fifty-four CFS patients were studied using a longitudinal design. A self-report format was used to collect daily measures of major physical (sleep disturbance and physical activity) and emotional (subjective emotional stress level) stressors, as well as measures of levels of fatigue and secondary symptoms. The variables accounted for a moderate variance at the individual and occasion levels. Sleep disturbance and emotional stress were found to be positively associated with levels of fatigue and symptomatology, whereas physical activity was found to have a negative relationship with fatigue only. The severity of fatigue and symptoms were found to fluctuate daily in relation with the variables, indicating the complex nature of the associations.