A university campus physical activity program

Issue addressed: The transition from youth to adulthood is associated with significant decreases in leisure time physical activity. University campuses are settings in which young adults' physical activity may be influenced.

Methods: Following a survey of students at two urban university campuses, a physical activity program was implemented at one campus over 8 weeks. A follow up survey was then conducted at both campuses. Physical activity was assessed by deriving leisure time participation categories from self reported activity in the last 2 weeks.

Results: Following the campus based programs, students at the intervention campus were significantly more likely to be sufficiently active for long term health benefits than were those at the comparison campus (P<0.001) due to an increase in the proportion of vigorously active students.

Conclusions: Providing programs and opportunities to be physically active in university campuses may help to promote physical activity in young adults.

So what?: Settings based approaches to promoting physical activity in young adults may be pursued at university campuses where facilities and infrastructure exist to support such strategies.

Assessing volume of accelerometry data for reliability in preschool children

Purpose: This study examines what volume of accelerometry data (h·d-1) is required to reliably estimate preschool children’s physical activity and whether it is necessary to include weekday and weekend data.

Methods: Accelerometry data from 493 to 799 (depending on wear time) preschool children from the Melbourne-based Healthy Active Preschool Years study were used. The percentage of wear time each child spent in total (light–vigorous) physical activity was the main outcome. Hourly increments of daily data were analyzed. t-tests, controlling for age and clustering by center of recruitment, assessed the differences between weekday and weekend physical activity. Intraclass correlation coefficients estimated reliability for an individual day. Spearman–Brown prophecy formula estimated the number of days required to reach reliability estimates of 0.7, 0.8, and 0.9.

Results: The children spent a significantly greater percentage of time being physically active on weekend compared with weekdays regardless of the minimum number of hours included (t = 12.49–16.76, P < 0.001 for all). The number of days required to reach each of the predetermined reliability estimates increased as the number of hours of data per day decreased. For instance, 2.7–2.8 d of data were required to reach a reliability estimate of 0.7 with 10 or more hours of data per day; 3.3–3.4 d were required to meet the same reliability estimate for days with 7 h of data.

Conclusions: Future studies should ensure they include the minimum amount of data (hours per day and number of days) as identified in this study to meet at least a 0.7 reliability level and should report the level of reliability for their study. In addition to weekdays, at least one weekend day should be included in analyses to reliably estimate physical activity levels for preschool children.

Patterns of physical activity and sedentary behaviour in preschool children

Background
Little is known about patterns of sedentary behavior (SB) and physical activity among preschoolers. Therefore, in this observational study patterns of SB and moderate-to-vigorous physical activity (MVPA) were examined in detail throughout the week in preschool-aged boys and girls.

Methods
A sample of 703 Melbourne preschool children (387 boys; 4.6 ± 0.7 y) were included in data analysis. SB and MVPA data were collected using accelerometry over an eight-day period. Percentage of time per hour in SB and in MVPA between 08:00 h and 20:00 h was calculated. Multi-level logistic regression models were created to examine the hour-by-hour variability in SB and MVPA for boys and girls across weekdays and weekend days. Odds ratios (OR) were calculated to interpret differences in hour-by-hour SB and MVPA levels between boys and girls, and between weekdays and weekend days.

Results
The highest SB levels co-occurred with the lowest MVPA levels from the morning till the early afternoon on weekdays, and during the morning and around midday on weekends. Besides, participation in SB was the lowest and participation in MVPA was the highest from the mid afternoon till the evening on weekdays and weekend days. The variability across the hours in SB and, especially, in MVPA was rather small throughout weekdays and weekends. These patterns were found in both boys and girls. During some hours, girls were found to be more likely than boys to demonstrate higher SB levels (OR from 1.08 to 1.16; all p < 0.05) and lower MVPA levels (OR from 0.75 to 0.88; all p < 0.05), but differences were small. During weekends, hour-by-hour SB levels were more likely to be lower (OR from 0.74 to 0.98; all p < 0.05) and hour-by-hour MVPA levels were more likely to be higher (OR from 1.15 to 1.50; all p < 0.05), than during weekdays, in boys and girls.

Conclusion
Entire weekdays, especially from the morning till the early afternoon, and entire weekend days are opportunities to reduce SB and to promote MVPA in preschool-aged boys and girls. Particularly weekdays hold the greatest promise for improving SB and MVPA. No particular time of the week was found where one sex should be targeted.

School and individual-level characteristics are associated with children's moderate to vigorous intensity physical activity during school recess

Objective: The objective of this study was to identify school environmental characteristics associated with moderate to vigorous physical activity during school recess, including morning and lunch breaks.

Methods: Accelerometry data, child-level characteristics and school physical activity, policy and socio-cultural data were collected from 408 sixth grade children (mean age 11 years) attending 27 metropolitan primary schools in Perth, Western Australia. Hierarchical modelling identified key characteristics associated with children's recess moderate to vigorous physical activity (RMVPA).

Results: Nearly 40% of variability in children's RMVPA was explained by school environment and individual characteristics identified in this study. Children's higher daily RMVPA was associated with newer schools, schools with a higher number of grassed surfaces per child and fewer shaded grassed surfaces, and the physical education coordinator meeting Australian physical activity guidelines.

Conclusions: Characteristics of the school physical and social environments are strongly correlated with children's MPVA during recess.

Cross-sectional and longitudinal associations between parenting style and adolescent girls' physical activity

Background Understanding the influences on physical activity is crucial, particularly among important target groups such as adolescent girls. This study describes cross-sectional and longitudinal associations between parenting style and girls’ participation in organized sport, walking/cycling trips and objectively assessed moderate to vigorous physical activity (MVPA).

Methods Data were collected from adolescent girls (n=222) and their parents in 2004 and again in 2006. Parents self-reported their demographic characteristics and parenting style. Girls self-reported their organized sport participation and weekly walking/cycling trips, while MVPA was assessed using accelerometers. Linear regression and interaction analyses were performed. Interactions between socio-demographic factors and parenting style with organized sport, walking/cycling trips and MVPA are presented.

Results There were cross-sectional associations between authoritative (B=−0.45, p=0.042) and indulgent (B=−0.56, p=0.002) parenting and the number of walking/cycling trips, and authoritarian (B=0.27, p=0.033) parenting and frequency of organized sport. Significant interactions included those between: family status, authoritative parenting and daily (p=0.048) and week day (p=0.013) MVPA; education, indulgent parenting and MVPA on weekend days (p=0.006); and, employment, authoritarian parenting and duration and frequency of organized sport (p=0.004), highlighting the complexity of these relationships. Longitudinal analyses revealed significant decreases in organized sport and MVPA, significant increases in walking/cycling trips and no significant associations between parenting and physical activity.

Conclusion Parenting styles appear to influence walking and cycling trips among adolescent girls, though not physical activity within other domains. Socio-demographic characteristics interact with the relationships between parenting and physical activity. While these findings can inform the development of family-based interventions to improve child and adolescent health, the direction of the observed associations and the number of associations approaching significance suggest the need to further explore this area.

Differences between 9-11 year old British Pakistani and White British girls in physical activity and behavior during school recess

Background School recess provides an important opportunity for children to engage in physical activity. Previous studies indicate that children and adults of South Asian origin are less active than other ethnic groups in the United Kingdom, but have not investigated whether activity differs within the shared school environment. The aim of this study was to test the hypothesis that British Pakistani girls aged 9–11 years are less active during recess than White British girls.

Methods In Study One, the proportion of recess spent by 137 White British (N = 70) and British Pakistani (N = 67) girls in sedentary behavior, moderate-to-vigorous activity (MVPA) and vigorous activity (VPA) was determined using accelerometry. In Study Two, 86 White British (N = 48) and British Pakistani (N = 38) girls were observed on the playground using the System for Observing Children’s Activity and Relationships during Play (SOCARP). Accelerometry data were collected during observations to allow identification of activities contributing to objectively measured physical activity.

Results Accelerometry data indicated that British Pakistani girls spent 2.2% (95% CI: 0.2, 4.3) less of their total recess time in MVPA and 1.3% (95% CI: 0.2, 2.4) less in VPA than White British girls. Direct observation showed that British Pakistani girls spent 12.0% (95% CI: 2.9, 21.1) less playground time being very active, and 12.3% (95% CI: 1.7, 23.0) less time playing games. Time spent being very active according to direct observation data correlated significantly with accelerometer-assessed time spent in MVPA and VPA, and time spent playing games correlated significantly with accelerometer-assessed time spent in VPA, suggesting that differences in behavior observed in Study Two may have contributed to the differences in time spent in MVPA and VPA in Study One.

Conclusions British Pakistani girls were less active than White British girls during school recess. Recess has been identified as a potentially important target for the delivery of physical activity interventions; such interventions should consider ways in which the activity levels of British Pakistani girls could be increased.

Effectiveness of interventions to promote physical activity among socioeconomically disadvantaged women : a systematic review and meta-analysis

Physical activity is important for preventing weight gain and obesity, but women experiencing socioeconomic disadvantage are at high risk of inactivity. This study aimed to determine the effectiveness of interventions to increase physical activity among women experiencing disadvantage, and the intervention factors (i.e. physical activity measure, delivery mode, delivery channel, setting, duration, use of theory, behavioural techniques, participant age, risk of bias) associated with effectiveness. We conducted a meta-analysis of controlled trials using random-effects models and meta-regression. Seven databases were searched for trials among healthy women (18–64 years), which included a physical activity intervention, any control group, and statistical analyses of a physical activity outcome at baseline and post-intervention. Nineteen studies were included (n = 6,339). Because of substantial statistical heterogeneity (χ2 = 53.61, df = 18, P < 0.0001, I2 = 66%), an overall pooled effect is not reported. In subgroup analyses, between-group differences were evident for delivery mode, which modestly reduced heterogeneity (to 54%). Studies with a group delivery component had a standardized mean difference of 0.38 greater than either individual or community-based delivery. Programs with a group delivery mode significantly increase physical activity among women experiencing disadvantage, and group delivery should be considered an essential element of physical activity promotion programs targeting this population group.

Change in active travel and changes in recreational and total physical activity in adults : longitudinal findings from the iConnect study

Background : To better understand the health benefits of promoting active travel, it is important to understand the relationship between a change in active travel and changes in recreational and total physical activity.

Methods : These analyses, carried out in April 2012, use longitudinal data from 1628 adult respondents (mean age 54 years; 47% male) in the UK-based iConnect study. Travel and recreational physical activity were measured using detailed seven-day recall instruments. Adjusted linear regression models were fitted with change in active travel defined as ‘decreased’ (<−15 min/week), ‘maintained’ (±15 min/week) or ‘increased’ (>15 min/week) as the primary exposure variable and changes in (a) recreational and (b) total physical activity (min/week) as the primary outcome variables.

Results : Active travel increased in 32% (n=529), was maintained in 33% (n=534) and decreased in 35% (n=565) of respondents. Recreational physical activity decreased in all groups but this decrease was not greater in those whose active travel increased. Conversely, changes in active travel were associated with commensurate changes in total physical activity. Compared with those whose active travel remained unchanged, total physical activity decreased by 176.9 min/week in those whose active travel had decreased (adjusted regression coefficient −154.9, 95% CI −195.3 to −114.5) and was 112.2 min/week greater among those whose active travel had increased (adjusted regression coefficient 135.1, 95% CI 94.3 to 175.9).

Conclusion : An increase in active travel was associated with a commensurate increase in total physical activity and not a decrease in recreational physical activity.

Adolescents' perception of the relationship between movement skills, physical activity and sport

Movement skill competence is important to organised youth physical activity participation, but it is unclear how adolescents view this relationship. The primary aim of this study was to explore adolescents’ perception of the relationship between movement skills, physical activity and sport, and whether their perceptions differed according to extent of participation in organised physical activities. We recruited 33 (17 male) Grade 11 and 12 students (aged 16 to 18) from two secondary schools in Australia. Focus groups were allocated according to whether or not students participated in organised physical activity, where ‘organised activity’ was defined as activity which involved regular classes, training or competition, was reasonably structured or formal, or had a teacher, instructor or coach. There were three all-male ‘organised’ groups, one mixed-gender ‘organised’ group and one all-female ‘not-organised’ group. Students were asked about their attitudes towards physical activity and sport, the relationship between childhood skill proficiency and later physical activity and their perceptions of the appropriate time taken to learn movement skills. Group discussions lasted for approximately 50 minutes, were recorded and were then transcribed verbatim. Transcripts were read using a constant comparison method, in which quotes were continually compared to other quotes. A thematic analysis was conducted in which the transcripts were analysed inductively. Participation in organised sport had no bearing on opinions regarding whether lack of childhood skill development would negatively impact latter participation. It did, however, subtly influence opinions regarding whether skill could be successfully acquired later in life. When asked whether not having well-developed skills as a child would negatively impact on participation in sport/physical activity later in life, the response was mixed, but this was not related to their involvement in organised sport or activities. Students who believed early skill proficiency related to subsequent activity thought this was due to skill ability and motivation. An alternate view was that subsequent activity did not need to be based on skill proficiency; also, one’s environment might change, resulting in differing opportunities/constraints. Students felt skills could be learnt at any time in life (dependent on motivation), but that learning skills at a younger age would be easier and that skills learnt later would not be as developed. Fear of failure was identified as a barrier to learning when older. We conclude that motivation towards participation in sport and physical activity is affected by adolescents’ perception of their own movement skill ability. Therefore, developing children’s actual and perceived movement skills may help to increase adolescent physical activity. Since those with intrinsic achievement orientations were not as inclined towards organised activity, we may also need to provide physical activity options that resonate with intrinsic achievement motivations.

Advancing science and policy through a coordinated international study of physical activity and built environments: IPEN Adult methods

Background: National and international strategies to increase physical activity emphasize environmental and policy changes that can have widespread and long-lasting impact. Evidence from multiple countries using comparable methods is required to strengthen the evidence base for such initiatives. Because some environment and policy changes could have generalizable effects and others may depend on each country’s context, only international studies using comparable methods can identify the relevant differences. Methods: Currently 12 countries are participating in the International Physical Activity and the Environment Network (IPEN) study. The IPEN Adult study design involves recruiting adult participants from neighborhoods with wide variations in environmental walkability attributes and socioeconomic status (SES). Results: Eleven of twelve countries are providing accelerometer data and 11 are providing GIS data. Current projections indicate that 14,119 participants will provide survey data on built environments and physical activity and 7145 are likely to provide objective data on both the independent and dependent variables. Though studies are highly comparable, some adaptations are required based on the local context. Conclusions: This study was designed to inform evidence-based international and country-specific physical activity policies and interventions to help prevent obesity and other chronic diseases that are high in developed countries and growing rapidly in developing countries.

Light-intensity physical activity and cardiometabolic biomarkers in US adolescents

Physical activity for cancer survivors : a meta-analysis of randomised controlled trials

Objective To systematically evaluate the effects of physical activity in adult patients after completion of main treatment related to cancer. Design Meta-analysis of randomised controlled trials with data extraction and quality assessment performed independently by two researchers. Data sources Pubmed, CINAHL, and Google Scholar from the earliest possible year to September 2011. References from meta-analyses and reviews. Study selection Randomised controlled trials that assessed the effects of physical activity in adults who had completed their main cancer treatment, except hormonal treatment. Results There were 34 randomised controlled trials, of which 22 (65%) focused on patients with breast cancer, and 48 outcomes in our meta-analysis. Twenty two studies assessed aerobic exercise, and four also included resistance or strength training. The median duration of physical activity was 13 weeks (range 3-60 weeks). Most control groups were considered sedentary or were assigned no exercise. Based on studies on patients with breast cancer, physical activity was associated with improvements in insulin-like growth factor-I, bench press, leg press, fatigue, depression, and quality of life. When we combined studies on different types of cancer, we found significant improvements in body mass index (BMI), body weight, peak oxygen consumption, peak power output, distance walked in six minutes, right handgrip strength, and quality of life. Sources of study heterogeneity included age, study quality, study size, and type and duration of physical activity. Publication bias did not alter our conclusions. Conclusions Physical activity has positive effects on physiology, body composition, physical functions, psychological outcomes, and quality of life in patients after treatment for breast cancer. When patients with cancer other than breast cancer were also included, physical activity was associated with reduced BMI and body weight, increased peak oxygen consumption and peak power output, and improved quality of life.

Active commuting to school and association with physical activity and adiposity among US youth

Background: Walking or bicycling to school (ie, active commuting) has shown promise for improving physical activity and preventing obesity in youth. Our objectives were to examine, among US youth, whether active commuting was inversely associated with adiposity and positively associated with moderate-to-vigorous physical activity (MVPA). We also examined whether MVPA mediated the relationships between active commuting and adiposity.

Methods: Using data of participants aged 12 to 19 years from the US National Health and Nutrition Examination Survey 2003 to 2004 (n = 789 unweighted), we constructed multiple linear regression models that controlled for dietary energy intake and sociodemographics. The main exposure variable was active commuting. The outcomes were BMI z-score, waist circumference, skinfolds and objectively measured MVPA. The product-of-coefficients method was used to test for mediation.

Results: Active commuting was inversely associated with BMI z-score (β = –0.07, P = .046) and skinfolds (β = –0.06, P = .029), and positively associated with overall daily (β = 0.12, P = .024) and before- and after-school (β = 0.20, P < .001) MVPA. Greater before- and after-school MVPA explained part of the relationship between active commuting and waist circumference (Sobel z = –1.98, P = .048).

Conclusions: Active commuting was associated with greater MVPA and lower measures of adiposity among US youth. Before- and after-school MVPA mediated the relationships between active commuting and waist circumference.

A commentary on current practice in mediating variable analyses in behavioural nutrition and physical activity

Objective : To critique current practice in, and provide recommendations for, mediating variable analyses (MVA) of nutrition and physical activity behaviour change.

Strategy : Theory-based behavioural nutrition and physical activity interventions aim at changing mediating variables that are hypothesized to be responsible for changes in the outcome of interest. MVA are useful because they help to identify the most promising theoretical approaches, mediators and intervention components for behaviour change. However, the current literature suggests that MVA are often inappropriately conducted, poorly understood and inadequately presented. Main problems encountered in the published literature are explained and suggestions for overcoming weaknesses of current practice are proposed.

Conclusion : The use of the most appropriate, currently available methods of MVA, and a correct, comprehensive presentation and interpretation of their findings, is of paramount importance for understanding how obesity can be treated and prevented.

Knowledge, attitudes and practices of clinicians in promoting physical activity to prostate cancer survivors

Objectives: