Journal of physical activity & health最新文献

Background: Ensuring a livable and healthy built environment that addresses challenges of climate change and the pandemic of noncommunicable diseases should include creating an environment support of physical activity. This study aims to build local evidence on improving the residential areas by assessing the built environment of 4 residential areas in Oman.

Methods: This study uses the Microscale Audit of Pedestrian Streetscapes-Mini, a 15-item tool with 4 subscales (destinations and land use, aesthetics, pedestrian infrastructure, and crossings/traffic safety), to conduct environmental audits of 4 areas in Barka and Nizwa, Oman. In each neighborhood, two 1-km long routes that crossed the diameter of the area, and passed by, or led to one or more group of amenities were selected. Each route was scored independently by 2 raters and showed good interrater agreement.

Results: The overall score was poor walkability across the 4 neighborhoods (mean = 0.18; range: 0.14 and 0.20) where scores >0.80 are considered excellent for walkability. Aesthetics was the only subscale with a good quality score (0.64) compared with the others (pedestrian infrastructure: 0.19, crossings/traffic safety: 0.06, and destination and land use: 0.06).

Conclusions: This study demonstrated the utility of the Microscale Audit of Pedestrian Streetscapes-Mini tool for cities of the Gulf Cooperation Council. The low scores point to the urgent need to identify cost-effective adaptations of the built environment that could substantially increase physical activity outcomes of the population. Further regionally relevant research can help identify specific design elements needed for more walker friendly neighborhoods.

Objective: To determine the disparities in length of live and age-specific probabilities of death of US Olympians by sex, performance level, and age at debut at the Olympics.

Methods: We apply parametric models of mortality to estimate probabilities of death by age. The best performing model (Gompertz model) is then used to calculate life tables for subpopulations of Olympians. The life table functions are then used to decompose the differences in life expectancies by age.

Results: Olympians live longer than the general population but are a diverse population in terms of survival. Gender gap in survival is substantially smaller in Olympians than in general population. Medalists have a shorter lifespan than nonmedalists. Olympians debuting at extremely young ages (<22) have a survival disadvantage compared with Olympians debuting at older ages. The differences between general population and Olympians are widening in younger cohorts.

Conclusion: US Olympians outlive the general population, but they constitute diverse group in terms of survival by sex, age at debut, and performance level. Studying and monitoring health disparities within the Olympic population is crucial for informing policies and regulations in sports organizations.

Background: Understanding socioeconomic and gender inequalities in physical inactivity during adolescence is a relevant public health issue to promote health in adult life. The aim of this qualitative study is to identify the factors that determine physical activity inequalities in adolescents.

Methods: We selected 2 educational centers in each of the 3 socioeconomic status areas-low, middle, and high-in the city of Madrid. We conducted a total of 18 semistructured interviews and 12 focus groups involving students, parents, teachers, and school principals. We followed the interpretative/constructivist paradigm within a case study design and grounded theory for the data analysis with the usage of ATLAS.ti 23 software.

Results: Results included 4 main themes: (1) access to off-school structured physical activities; (2) physical activity restrictions due to socioeconomic status; (3) unacknowledged privilege in upper socioeconomic status adolescents; and (4) gender physical activity inequalities.

Conclusion: Improving the health of adolescents and future adults through increased physical activity requires equity and gender perspectives.

Background: Type 2 diabetes is a major cause of illness and disability and physical activity reduces these risks. The SMART Health study aim was to compare the efficacy of a multicomponent intervention to promote aerobic physical activity and resistance training in schoolteachers at risk of or diagnosed with type 2 diabetes, with and without a technology-based behavior change package.

Methods: We randomized participants (N = 104) into 3 groups: "wait-list" control group, 5 face-to-face visits with a psychologist and exercise specialist (SH group), or 5 face-to-face visits over a 3-month period with a psychologist and exercise specialist, plus a technology-based behavior change package for an additional 6 months (SH+ group). Physical activity was the primary outcome (daily steps measured by pedometers). Systolic and diastolic blood pressure, waist circumference, body mass index, fasting blood glucose, glycosylated hemoglobin, plasma lipids, self-reported resistance training, anxiety and depression were also assessed at 3 and 9 months (primary time point). Linear mixed models were used to assess the intervention efficacy of SH and SH+ compared with wait-list control.

Results: There were no significant group-by-time effects for steps in the SH or SH+ groups compared to the wait-list control group. Self-reported participation in monthly minutes of resistance training significantly increased at 3-month postbaseline in both groups (SH: 136 min, P < .01, d = 0.33 and SH+: 145 min P < .001, d = 0.4) versus the control group. The improvements were maintained for the SH group at 9 months. There was also a meaningful effect (P < .06, d = -0.23) for reducing anxiety for SH group at 9 months.

Conclusions: SMART Health was a feasible, multicomponent intervention, which increased self-reported resistance training but no other secondary outcomes.

Background: With physical activity levels in children and youth decreasing as their obesity rates rise, collaborations between public health and school health professionals for physical activity interventions are recommended. Physical activity interventions at the school site and those with community involvement in program planning have demonstrated positive outcomes.

Methods: As schools are a vital part of community physical activity promotion for students, public health and school health partners in one state created a brain energizers/movement integration website to support 2 components of a comprehensive school physical activity program: "Physical activity integrated into the school day" and "Staff involvement." This study presents a process evaluation and level of utilization assessment of a public health, web-based resource for physical activity promotion in the elementary school for students aged 6-12 years. Web links were sent to all members of a statewide school nurse association, and 269 school nursing staff responded to an online survey evaluating the website.

Results: About 40% of respondents used and shared the site with other teachers/staff at their schools, and the activities and videos were stated as the greatest benefits.

Conclusions: Public health and education sectors can collaborate within comprehensive school physical activity programs to provide movement integration resources for students to meet physical activity goals. School nurses can encourage physical activity during the school day and staff involvement by promoting both the health promotion and educational benefits of movement integration and physically active learning.

Background: Nonalcoholic fatty liver disease (NAFLD) is a global health concern, and despite its high prevalence, lifestyle modifications such as exercise play a pivotal role in resolving this condition. This study aims to identify factors associated with NAFLD resolution, with a focus on the role of exercise, in different age groups.

Methods: Longitudinal data from Korean military officers, during the period 2019-2021, were obtained from the National Health Information Database. NAFLD was defined as a hepatic steatosis index ≥36, and NAFLD resolution was defined as individuals achieving hepatic steatosis index <36 in the subsequent year of diagnosis. Information on alcohol consumption, exercise frequency, and family history of diabetes was collected through self-reported questionnaires.

Results: The analysis included a total of 163,728 individuals, with a mean age of 36.87, predominantly male (91.62%). The prevalence of NAFLD was 27.04%. Favorable factors for NAFLD resolution encompassed moderate-intensity exercise for more than 180 minutes per week, vigorous-intensity exercise for more than 90 minutes per week, female sex, age, and resistance exercise for more than 3 days per week. Hypertension, family history of diabetes, and smoking were identified as factors against NAFLD resolution. The exercise requirements for NAFLD resolution varied among age groups, with those <30 years old requiring more than 180 minutes per week of moderate- or vigorous-intensity exercise and those >50 years old needing only 90 minutes per week of such exercise.

Conclusion: The exercise requirements for NAFLD resolution exhibit age-related differences. Individualized guidance for NAFLD management should consider these variations and be tailored to specific age groups.

Background: Outdoor physical activity (PA) is an important component of overall health; however, it is difficult to measure. Passively collected smartphone location data like Google Location History (GLH) present an opportunity to address this issue.

Objectives: To evaluate the use of GLH data for measuring outdoor PA.

Methods: We collected GLH data for 357 individuals from the Washington State Twin Registry. We first summarized GLH measurements relevant to outdoor PA. Next, we compared accelerometer measurements to GLH classified PA for a subset of 25 participants who completed 2 weeks of global positioning system and accelerometer monitoring. Finally, we examined the association between GLH measured walking and obesity.

Results: Participants provided a mean (SD) average 52 (18.8) months of GLH time-activity data, which included a mean (SD) average of 2421 (1632) trips per participant. GLH measurements were classified as the following: 79,994 unique walking trips (11.6% of all trips), 564,558 (81.8%) trips in a passenger vehicle, 11,974 cycling trips (1.7%), and 890 running trips (0.1%). Sixty-two percent of these trips had location accuracy >80%. In the accelerometry evaluation, GLH walking trips had a corresponding mean vector magnitude of 3150 counts per minute, compared with 489 counts per minute for vehicle trips. In adjusted cross-sectional analyses, we observed an inverse association between both walking minutes and trips per month and the odds of being obese (odds ratio = 0.78; 95% CI, 0.60-0.96, and odds ratio = 0.91; 95% CI, 0.82-0.98, respectively).

Conclusions: GLH data provide a novel method for measuring long-term, retrospective outdoor PA that can provide new opportunities for PA research.

Background: Physical inactivity is a significant health risk factor linked to chronic diseases and premature death. To address this, initiatives like Exercise is Medicine® aim to promote physical activity in health care systems. However, integrating physical activity counseling into clinical practice faces barriers such as limited reimbursement. Understanding billing practices and reimbursement rates for physical activity counseling is crucial for its integration into health care.

Methods: This study used 12 months of billing data from a large midwestern US hospital. Variables included charges, charge amounts, primary payors, reimbursement rates, and denial rates associated with International Classification of Diseases-10 diagnosis codes, and Evaluation and Management billing codes for physical activity counseling. Logistic regression analysis identified factors associated with denial rates.

Results: Over 12 months, 19,366 lifestyle-related charges were submitted, totaling $7,842,845. Of these, 5.28% were denied, amounting to $414,446. The most common International Classification of Diseases-10 codes were "obesity" (38.8%) and "sedentary lifestyle" (32.6%), while the most common Evaluation and Management codes were for established outpatient office visits. Charges were mainly submitted to employer-paid insurance (43.5%), Medicaid (22.2%), and Medicare (21.9%). Higher odds of denial were associated with newer patients, shorter visit lengths, and the sedentary lifestyle code.

Conclusion: This study provides novel data on the use, reimbursement, and denial rates of physical activity counseling billing codes in a large health care system. Physical activity counseling-related charges are rarely denied by third-party payors. Further research is needed to determine if these findings are generalizable to other US health care systems.

Background: To analyze global trends in the noncommunicable diseases (NCDs) burden attributable to low physical activity, considering the impacts of population aging and growth.

Method: Based on the Global Burden Disease 2019 Study, the NCDs-related death and disability-adjusted life years attributable to low physical activity (defined as <3000 metabolic equivalent-min/wk) were obtained from 2010 to 2019. The average annual percent change was calculated using the joinpoint analysis. Decomposition analysis was applied to assess the separated contributions of 3 components (population aging, population growth, and death change due to all other factors) on the overall change in NCDs death attributed to low physical activity.

Results: From 2010 to 2019, the average annual percent change of age-standardized rates of NCDs due to low physical activity was -0.09% for death and -0.06% for disability-adjusted life years. However, the global absolute number of deaths from NCDs attributable to low physical activity increased from 672,215 to 831,502, and disability-adjusted life years rose from 12,813,793 to 15,747,938. This rise was largely driven by population aging and growth, contributing to a 13.0% and 14.7% increase, respectively. The most significant impact of population aging on NCD deaths was observed in high-middle socio-demographic index countries (17.6%), whereas population growth had the greatest effect in low socio-demographic index countries (24.3%).

Conclusions: The reduction in NCDs death rates attributed to low physical activity is insufficient to counteract the effects of population aging and growth. Targeted interventions for physical activity promotion should focus on the older population with special attention to diseases most sensitive to physical inactivity.

Background: Physical activity is crucial for maintaining health and preventing chronic diseases. However, climate conditions can impact physical activity patterns, and conversely, physical activity can impact climate change. This umbrella review aims to summarize the existing evidence regarding the relationships between physical activity and climate change, as revealed in previous reviews.

Methods: Systematic reviews and meta-analyses were analyzed. Searches were conducted across GreenFILE, PubMed, and Web of Science databases for peer-reviewed articles published in English. A 2-stage independent screening process was conducted, and methodological quality was assessed using the JBI framework. Standardized data extraction methods were then applied.

Results: Out of 1292 articles retrieved, 7 met all eligibility criteria and were included in the review. Three articles examined physical activity as a primary exposure, 3 focused on the impacts of climate change, and one considered both physical activity and climate change as primary exposures.

Conclusions: Findings reveal an interplay between climate change and physical activity. While rising temperatures may prompt outdoor activities up to a certain temperature threshold, air pollution and extreme heat can have harmful effects. Active transportation and improved logistics around large-scale sporting events can mitigate climate change by reducing greenhouse gas emissions, but transportation systems linked to sports venues may increase emissions. Research on the reciprocal relationship between climate change and physical activity domains, and integrating the community into climate discussions, is crucial for equity, especially for marginalized communities. Incorporating climate adaptation and mitigation strategies in physical activity infrastructure to minimize environmental impacts is critical.