Parental practices encouraging and discouraging physical activity in Hong Kong Chinese preschoolers

Background: Regular participation in physical activity (PA) can help reduce the risk of overweight/obesity. Parental practices related to PA are modifiable determinants of preschoolers' PA that are still not well understood, especially in non-Western cultures. This qualitative explorative study aimed to identify parental practices encouraging or discouraging PA in Hong Kong preschoolers. Methods: Nominal Group Technique (NGT) sessions (n = 45; 6 to 9/group), complemented by a focus group (n = 6) and individual interviews (n = 12), were conducted with primary caregivers (mainly parents) of Hong Kong preschoolers to investigate what parents do to encourage (4 groups) and discourage (2 groups) PA in children. The groups were stratified by low and high neighborhood socioeconomic status. Results: Participants generated 21 and 16 items describing practices encouraging and discouraging preschoolers' PA, respectively. Parental provision of instrumental, motivational, and conditional support were thought to encourage child's PA, while parental safety concerns, focus on academic achievement, lack of time and resources, and promotion of sedentary behaviors were thought to discourage child's PA. Conclusions: Several parental practices that were deemed to encourage or discourage Hong Kong preschoolers' PA were identified. These can assist with development of a culturally sensitive scale of PA parenting practices and inform future quantitative research.

Responsiveness to psychological stress and food intake : the influence of adiposity in men and physical activity in women

Hyperactivity of the stress pathways can cause diseases. This research concludes that levels of adiposity and physical activity status does not influence physiological responsiveness to psychological stress. Nevertheless, stress pathway activity in response to food intake can be influenced by increased adiposity but not by increased levels of physical activity.

Environmental barriers and enablers to physical activity participation among rural adults: A qualitative study

Issue addressed Social-ecological models of health behaviour acknowledge environmental influences, but research examining how the environment shapes physical activity in rural settings is limited. This study aimed to explore the environmental factors that act as barriers or facilitators to physical activity participation among rural adults. Methods Forty-nine adults from three regions of rural Tasmania, Australia, participated in semi-structured interviews that explored features of the environment that supported or hindered physical activity. Interviews were digitally recorded, transcribed verbatim and analysed thematically. Results Four key themes emerged: functionality, diversity, spaces and places for all and realistic expectations. 'Functionality' included connectivity with other destinations, distance, safety, continuity, supporting infrastructure and surfacing. While there was limited 'diversity' of structured activities and recreational facilities, the importance of easy and convenient access to a natural environment that accommodated physical activity was highlighted. 'Spaces and places for all' highlighted the importance of shared-use areas, particularly those that were family-and dog-friendly. Despite desires for more physical activity opportunities, many participants had 'realistic expectations' of what was feasible in rural settings. Conclusions Functionality, diversity, spaces and places for all and realistic expectations were identified as considerations important for physical activity among rural adults. Further research using quantitative approaches in larger samples is needed to confirm these findings. So what? Urban-centric views of environmental influences on physical activity are unlikely to be entirely appropriate for rural areas. Evidence-based recommendations are provided for creating new or modifying existing infrastructure to support active living in rural settings.

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.

Associations between physical activity, television viewing and postnatal depressive symptoms amongst healthy primiparous mothers

Background: Postnatal depression is a serious illness in new mothers. In the general population, physical activity (PA) has been found to reduce the risk of depression, whilst sedentary behaviour (SB; in particular television viewing) has been linked to higher levels of depressive symptoms, yet little is known regarding associations between PA, SB and postnatal depression. This study aimed to investigate associations between PA, television viewing and postnatal depressive symptoms in healthy primiparous mothers.. Methods: Cross-sectional survey data were provided by 406 first-time mothers (approximately 3-months postpartum) enrolled in the Melbourne InFANT Extend trial (2012/2013). Women self-reported PA (time spent walking for leisure and transport, and other moderate and vigorous PA), television viewing, and depressive symptoms (CES-D 10). Random intercept linear models examined associations between PA, television viewing and depressive symptoms. Results: In crude models total PA was inversely associated with risk of postnatal depressive symptoms (B = -0.122; 95% CI = -0.24, -0.01). In models adjusted for key sociodemographic and behavioural covariates the association did not remain statistically significant. No other associations between PA, television viewing and postnatal depressive symptoms were evident.. Conclusions: Postnatal depressive symptoms may not be related to PA and television viewing in the same way that these behaviours predict depressive symptoms in the general population. Further investigation of the specific domains of PA, as well as different types/contexts of SB and their respective associations with postnatal depressive symptoms is warranted in order to better inform development of targeted interventions aimed at enhancing postnatal mental health..

Maternal dietary intake and physical activity habits during the postpartum period: associations with clinician advice in a sample of Australian first time mothers

BACKGROUND: Numerous health benefits are associated with achieving optimal diet and physical activity behaviours during and after pregnancy. Understanding predictors of these behaviours is an important public health consideration, yet little is known regarding associations between clinician advice and diet and physical activity behaviours in postpartum women. The aims of this study were to compare the frequency of dietary and physical activity advice provided by clinicians during and after pregnancy and assess if this advice is associated with postpartum diet and physical activity behaviours.

METHODS: First time mothers (n = 448) enrolled in the Melbourne InFANT Extend trial completed the Cancer Council of Australia's Food Frequency Questionnaire when they were three to four months postpartum, which assessed usual fruit and vegetable intake (serves/day). Total physical activity time, time spent walking and time in both moderate and vigorous activity for the previous week (min/week) were assessed using the Active Australia Survey. Advice received during and following pregnancy were assessed by separate survey items, which asked whether a healthcare practitioner had discussed eating a healthy diet and being physically active. Linear and logistic regression assessed associations of advice with dietary intake and physical activity.

RESULTS: In total, 8.6 % of women met guidelines for combined fruit and vegetable intake. Overall, mean total physical activity time was 350.9 ± 281.1 min/week. Time spent walking (251.97 ± 196.78 min/week), was greater than time spent in moderate (36.68 ± 88.58 min/week) or vigorous activity (61.74 ± 109.96 min/week) and 63.2 % of women were meeting physical activity recommendations. The majority of women reported they received advice regarding healthy eating (87.1 %) and physical activity (82.8 %) during pregnancy. Fewer women reported receiving healthy eating (47.5 %) and physical activity (51.9 %) advice by three months postpartum. There was no significant association found between provision of dietary and/or physical activity advice, and mother's dietary intakes or physical activity levels.

CONCLUSIONS: Healthy diet and physical activity advice was received less after pregnancy than during pregnancy yet no association between receipt of advice and behaviour was observed. More intensive approaches than provision of advice may be required to promote healthy diet and physical activity behaviours in new mothers.

Smartphone apps to improve fitness and increase physical activity among young people: protocol of the Apps for IMproving FITness (AIMFIT) randomized controlled trial

BACKGROUND: Physical activity is a modifiable behavior related to many preventable non-communicable diseases. There is an age-related decline in physical activity levels in young people, which tracks into adulthood. Common interactive technologies such as smartphones, particularly employing immersive features, may enhance the appeal and delivery of interventions to increase levels of physical activity in young people. The primary aim of the Apps for IMproving FITness (AIMFIT) trial is to evaluate the effectiveness of two popular "off-the-shelf" smartphone apps for improving cardiorespiratory fitness in young people.

METHODS/DESIGN: A three-arm, parallel, randomized controlled trial will be conducted in Auckland, New Zealand. Fifty-one eligible young people aged 14-17 years will be randomized to one of three conditions: 1) use of an immersive smartphone app, 2) use of a non-immersive app, or 3) usual behavior (control). Both smartphone apps consist of an eight-week training program designed to improve fitness and ability to run 5 km, however, the immersive app features a game-themed design and adds a narrative. Data are collected at baseline and 8 weeks. The primary outcome is cardiorespiratory fitness, assessed as time to complete the one mile run/walk test at 8 weeks. Secondary outcomes are physical activity levels, self-efficacy, enjoyment, psychological need satisfaction, and acceptability and usability of the apps. Analysis using intention to treat principles will be performed using regression models.

DISCUSSION: Despite the proliferation of commercially available smartphone applications, there is a dearth of empirical evidence to support their effectiveness on the targeted health behavior. This pragmatic study will determine the effectiveness of two popular "off-the-shelf" apps as a stand-alone instrument for improving fitness and physical activity among young people. Adherence to app use will not be closely controlled; however, random allocation of participants, a heterogeneous group, and data analysis using intention to treat principles provide internal and external validity to the study. The primary outcome will be objectively assessed with a valid and reliable field-based test, as well as the secondary outcome of physical activity, via accelerometry. If effective, such applications could be used alongside existing interventions to promote fitness and physical activity in this population. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12613001030763. Registered 16 September 2013.

The efficacy of a clinician referral and 12 week physical activity program among men living with prostate cancer: a multicentre cluster randomised controlled trial

BACKGROUND : The purpose of this study was to determine the efficacy of a clinician referral and exercise program in improving exercise levels and quality of life for men with prostate cancer.

METHODS : This was a multicenter cluster randomized controlled trial in Melbourne, Australia comprising 15 clinicians: 8 clinicians were randomized to refer eligible participants (n = 54) to a 12-week exercise program comprising 2 supervised gym sessions and 1 home-based session per week, and 7 clinicians were randomized to follow usual care (n = 93). The primary outcome was self-reported physical activity; the secondary outcomes were quality of life, anxiety, and symptoms of depression.

RESULTS : A significant intervention effect was observed for vigorous-intensity exercise (effect size: Cohen's d, 0.46; 95% confidence interval [CI], 0.09-0.82; P = .010) but not for combined moderate and vigorous exercise levels (effect size: d, 0.08; 95% CI, −0.28 to 0.45; P = .48). Significant intervention effects were also observed for meeting exercise guidelines (≥150 min/wk; odds ratio, 3.9; 95% CI, 1.9-7.8; P = .002); positive intervention effects were observed in the intervention group for cognitive functioning (effect size: d, 0.34; 95% CI, −0.02 to 0.70; P = .06) and depression symptoms (effect size: d, −0.35; 95% CI, −0.71 to 0.02; P = .06). Eighty percent of participants reported that the clinician's referral influenced their decision to participate in the exercise program.

CONCLUSIONS : The clinician referral and 12-week exercise program significantly improved vigorous exercise levels and had a positive impact on mental health outcomes for men living with prostate cancer. Further research is needed to determine the sustainability of the exercise program and its generalizability to other cancer populations.

Physical activity, screen-based behaviours and obesity among Fijian adolescents

 This PhD investigated obesity and mental health issues. Physical activity, screen-based behaviour (including e-gaming) measures don’t seem to be closely linked to BMI-z or psychosocial outcomes in Fijian adolescents. Expectations of the BMI-z impact of PA programs should be low and control on violent e-gaming through licensing agreements is suggested.