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.

A cluster-randomized controlled trial to reduce sedentary behavior and promote physical activity and health of 8-9 year olds : the transform-us! study

Background: Physical activity (PA) is associated with positive cardio-metabolic health and emerging evidence suggests sedentary behavior (SB) may be detrimental to children’s health independent of PA. The primary aim of the Transform-Us! study is to determine whether an 18-month, behavioral and environmental intervention in the school and family settings results in higher levels of PA and lower rates of SB among 8-9 year old children compared with usual practice (post-intervention and 12-months follow-up). The secondary aims are to determine the independent and combined effects of PA and SB on children’s cardio-metabolic health risk factors; identify the factors that mediate the success of the intervention; and determine whether the intervention is cost-effective.
Methods/design: A four-arm cluster-randomized controlled trial (RCT) with a 2 × 2 factorial design, with schools as the unit of randomization. Twenty schools will be allocated to one of four intervention groups, sedentary behavior (SB-I), physical activity (PA-I), combined SB and PA (SB+PA-I) or current practice control (C), which will be evaluated among approximately 600 children aged 8-9 years in school year 3 living in Melbourne, Australia. All children in year 3 at intervention schools in 2010 (8-9 years) will receive the intervention over an 18-month period with a maintenance ‘booster’ delivered in 2012 and children at all schools will be invited to participate in the evaluation assessments. To maximize the sample and to capture new students arriving at intervention and control schools, recruitment will be on-going up to the post-intervention time point. Primary outcomes are time spent sitting and in PA assessed via accelerometers and inclinometers and survey.
Discussion: To our knowledge, Transform-Us! is the first RCT to examine the effectiveness of intervention strategies for reducing children’s overall sedentary time, promoting PA and optimizing health outcomes. The integration of consistent strategies and messages to children from teachers and parents in both school and family settings is a critical component of this study, and if shown to be effective, may have a significant impact on educational policies as well as on pedagogical and parenting practices.

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.

Patterns of time use among regional and rural adolescent girls: associations with correlates of physical activity and health-related quality of life

OBJECTIVES: To describe patterns of time use among regional and rural adolescent girls and compare identified clusters with respect to correlates of physical activity (PA) and health-related quality of life (HRQoL).

DESIGN: Cross-sectional PA and lifestyle survey.

METHODS: Data were from Year 7-9 adolescent girls (aged 12-15 years) from 16 schools involved in a cluster-randomised trial in regional and rural Victoria, Australia (n=494). Time use data were collected using 24-h Previous Day Physical Activity Recall (PDPAR-24) questionnaire, collapsed into 17 categories of time use. Differences between time use clusters with regard to demographics, correlates of PA and HRQoL measured using PedsQL 4.0 Generic Core Scales, were investigated.

RESULTS: Two time use clusters were identified and were associated with correlates of PA and HRQoL. Girls who spent significantly more time in teams sports, non-team sports, school classes, watching TV and sleeping had higher levels of positively aligned PA correlates (e.g. self-efficacy, perceived sports competence) and HRQoL than girls characterised with high levels of computer use and video gaming. CONCLUSIONS: These findings highlight how different activity patterns of regional and rural girls affect HRQoL and can inform future intervention strategies to improve PA levels and HRQoL. Clusters characterised by low levels of PA and high computer use and video gaming require targeted interventions to address barriers to their participation.

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.

A comparison of subjective and objective measures of physical activity and fitness in identifying associations with cardiometabolic risk factors

Purpose
To compare the ability of alternative measures of physical activity and fitness to quantify associations with health outcomes.

Methods
Associations between a range of subjective and objective physical activity and fitness measures and cardiometabolic risk factors were examined using data from 1,631 Australians aged 26–36 years. Anthropometry, fitness, blood pressure, and fasting blood glucose, insulin, and lipids were measured at study clinics. Participants completed the International Physical Activity Questionnaire (IPAQ) and 7-day pedometer diaries; they also reported sedentary behavior (sitting, television viewing).

Results
In men and women, associations were strongest for fitness, with those in the highest (vs. lowest) fitness quarter having a 75% to 80% lower prevalence of two or more primary risk factors (waist circumference, high-density lipoprotein cholesterol, and insulin resistance). In men, a 60% to 70% reduced prevalence of two or more risk factors was observed across extreme quarters of IPAQ leisure, IPAQ vigorous, sitting duration, and pedometer measures. Similar reductions in prevalence were observed only across extreme quarters of pedometer activity and television viewing in women.

Conclusions
Associations between alternative measures and cardiometabolic risk were relatively independent, suggesting that a range of physical activity and fitness measures may be needed to most accurately quantify associations between physical activity and health.

Effects of a holistic health program on women's physical activity and mental and spiritual health

Intervention studies aimed at promoting increased physical activity have been trialled in many different settings including primary care, worksites and the community. Churches are also potential settings for physical activity promotion. However, little is known about the effectiveness of this setting for promoting physical activity, particularly in Australia. The purpose of this study was to evaluate the effectiveness of a mind, body and spiritually based health promotion program in increasing physical activity and promoting mental and spiritual health. Nineteen women completed the 8-week intervention, and 30 women in a non-health related 8-week program at the same church comprised a comparison group. Pre- and post-program surveys assessed outcome measures. Between-group differences over time were examined using one-way MANOVA's. Physical activity was higher in the intervention group than the comparison group. In contrast to the comparison group, both mental health (depression symptoms) and spiritual health improved significantly more among intervention participants. The data highlight the potential for a church-based setting and holistic approach to health promotion as a successful means of increasing physical activity and promoting mental and spiritual health among Australian women.

Understanding and influencing physical activity to improve health outcomes

Participation in physical activity is associated with significant benefits to health. We provide an overview of research relevant to understanding and influencing health-enhancing physical activity in adults. We describe a behavioural epidemiology framework that is designed to integrate the range of studies in the field; give brief examples of studies on the relationships between physical activity and health outcomes; and, we consider descriptive studies of adult populations on levels of participation. We describe research findings on the correlates of physical activity participation; describe ecological models of health behaviour that may be used in understanding and influencing physical activity; and, we review research findings on how environmental attributes can influence adults’ physical activity, particularly walking. There is considerable potential to use evidence-based approaches to increase the physical activity levels of whole populations, particularly through a focus on developing the attributes of community environments that can promote walking.

Occupational and non-occupational physical activity and the social determinants of physical activity : results from the Health Survey for England

Background: This article aims to examine the relative contribution of occupational activity to English adults’ meeting of government recommendations for physical activity (PA).

Methods: Data were extracted from a cross-sectional survey of householders in the UK via the Health Survey for England.¹ In total, 14,018 adult participants were included in the analysis. Multivariate logistic regression was used to examine the odds of achieving PA recommendations with and without including occupational activity and to examine the contribution of gender and social and demographic characteristics.

Results: When occupational PA was included, 36% of men and 25% of women were active at the recommended level. Once occupational PA was removed, these proportions were 23% and 19%, respectively. These results were socially patterned, most notably by age and gender.

Conclusions: Occupational PA provides a substantial contribution to those meeting the government target for PA.

Youth physical activity and sedentary time and associations with cardiometabolic health

In recent years, there has been increasing interest in the effects of sedentary behaviour on children’s health, defined as sitting behaviours that require low levels of energy expenditure (≤1.5 METs).¹ There is some evidence that sedentary behaviours may be detrimental to children’s health, though the majority of associations observed are derived from cross-sectional studies examining television viewing and adiposity.² This study adds to the literature by examining cross-sectional and prospective associations between objectively measured moderate- to vigorous physical activity (MVPA) and sedentary time, and cardiometabolic risk factors in youth aged 4–18 years.

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.