International Journal of Behavioral Nutrition and Physical Activity最新文献

Background: Given the therapeutic potential of Approach-Avoidance interventions (AAIs) in the alcohol domain, research has increasingly applied them to the food domain. In AAIs, harmful stimuli are avoided while healthy ones are approached, for example by respectively moving a phone away from or towards oneself.

Methods: We administered a phone-based AAI six times over two weeks to 156 participants in a pre-registered randomized-controlled trial to reduce intake of six "decrease-foods" and increase intake of six "increase-foods", selected according to each participant's individual dietary goals. The control group received a placebo task in which all stimuli were equally often approached and avoided. Food craving and intake were the outcomes, measured daily during the training period, four days before and after, and once during a follow-up one month after training. Per-food approach bias was recorded before and after training, and at follow-up.

Results: Compared to placebo, active training reduced the level of decrease-food craving (b = -0.19; 95% HDI [-0.31, -0.05]) without affecting how often craving occurred. Restrained eaters (b = -0.19; 95% HDI [-0.36, -0.03]) and those with low past dietary success (b = 0.13; 95% HDI [0.03, 0.24]) showed the strongest craving strength reduction. Active training also reduced approach bias for decrease-foods, albeit with weaker evidence (b = -38.10; 89% HDI [-73.82, -0.39]). We found no intervention effects on increase-foods on any outcome. There were no interpretable training effects for food intake and no changes were maintained at follow-up.

Conclusions: A multisession mobile AAI reduced craving intensity for foods that participants wanted to eat less of in the 4 days after the end of the intervention period with reductions bouncing back at 4-week follow-up. It remains to future research how this can be sustained long-term and effectively translated into reduced food intake.

Trial registration: This study was registered in the German Clinical Trials Register, ID DRKS00030780.

Purpose: Physical activity is beneficial across the lifespan, but most Americans do not meet physical activity guidelines. Multiple sources exist that identify opportunities to address gaps in physical activity research knowledge and implementation. Several of these opportunities have important considerations for populations experiencing health inequities. The goal of this study was to identify, synthesize, and categorize opportunities for research (i.e., systematic investigations to develop generalizable knowledge) into a conceptual framework to advance physical activity research in a cohesive and efficient manner.

Methods: The National Collaborative on Childhood Obesity Research convened subject matter experts to conduct five qualitative document analysis steps: (1) identify sources published by United States government, intergovernmental, or national non-profit organizations related to physical activity, (2) review sources to extract research opportunities, (3) code the opportunities by variables (translational research phase, social ecological level, setting, and priority population) determined by the expert group, (4) synthesize data on similar opportunities, and (5) review crosstabulation data to examine coding patterns and develop a framework.

Results: Opportunities (n = 385) were extracted from sources (n = 11) and combined into condensed opportunity statements (n = 87). Most called for effectiveness research (n = 44, 51%) or dissemination and implementation science research (n = 14, 16%). 38% were related to policy, systems, and environmental interventions (n = 33), and 70% mentioned community settings (n = 61). Additionally, 76% did not include health equity considerations (n = 66), and 75% mentioned no specific population or populations across the lifespan (n = 65). The resultant Physical Activity Research Opportunities (PARO) framework details opportunities by translational research phase (methods/measures development, etiology, efficacy, effectiveness, dissemination and implementation, and surveillance) and social ecological level (individual or interpersonal, policy/systems/environmental, and crosscutting), including health equity considerations.

Conclusions: The resultant PARO framework highlights gaps in current evidence and reveals opportunities for physical activity funders, researchers, policymakers, and practitioners to strategically advance their work. There are prospects for designing efficacy and effectiveness trials with an eye toward dissemination and implementation, developing strategies for improving dissemination and implementation, and using community- and practitioner-engaged approaches across translational research phases to advance health equity. Health equity can also be addressed by tailoring interventions, enhancing reach to priority populations, and improving social determinants of health.

Background: Hypertension remains a major public health challenge in China. Leisure-time physical activity (LTPA) is critical for hypertension control. Yet its social network determinants, particularly key role models, are understudied in China's familial-centric cultural context.

Methods: This sequential mixed-methods study integrated quantitative surveys with qualitative interviews among hypertensive patients in Yichang, China. A total of 2639 patients were selected from 18 primary healthcare institutions using multi-stage random sampling method. Totally, 10,550 social relationships were nominated. Quantitative data on LTPA was measured by the International Physical Activity Questionnaire Long Form, and social network characteristics (size, density, LTPA aggregation, LTPA heterogeneity, and LTPA status of specific members) was gathered through the name generator method. Generalized additive mixed models assessed nonlinear associations between social network characteristics and LTPA levels (individual-level, n = 2639); mixed-effects logistic regression analyzed member-patient LTPA linkages (relationship-level, n = 10,550). Qualitative data (n = 37) via interviews underwent grounded theory coding to contextualize mechanisms.

Results: Among participants, 70.56% engaged in light intensity LTPA (L-LTPA), whereas 34.82% achieved ≥ 150 minutes/week moderate-to-vigorous intensity LTPA (MV-LTPA). Nonlinear thresholds were identified: smaller networks (≤ 4 members) with higher kinship density (≥ 65%) significantly increased MV-LTPA adherence (P < 0.001). Network-level LTPA aggregation demonstrated linearly positive with MV-LTPA (P < 0.001) but triphasic associations (i.e., increase then decrease to steady) with L-LTPA (P = 0.006). Critically, having a physically active spouse was the strongest predictor of MV-LTPA adherence (OR = 1.967, 95% CI: 1.571-2.463, P < 0.001). Qualitative themes revealed that kinship networks fostered LTPA through shared norms and social support.

Conclusions: Social networks represent modifiable factors that influence LTPA behaviors. Integrating network-driven strategies into hypertension management and prioritizing spouses as "exercise advocates" could promote LTPA for middle-aged and elderly hypertensive patients in China. This study advances cross-cultural behavioral theory and offers actionable solutions for pragmatic solutions for global hypertension management in aging populations under similar social context.

Objective: This study reviewed (1) the effects of physical enrichment of (pre-)school playgrounds on children's and adolescents' movement behaviours and their cognitive, psychological, and social development, and (2) how enrichment characteristics influenced these outcomes.

Methods: A systematic review with meta-analysis was conducted following the PRISMA guidelines. We searched 7 databases (SPORTDiscus, CINAHL, MEDLINE, APA PsycINFO, Cochrane Library, Web of Science, and Scopus) and two reviewers independently screened studies for eligibility. Effect sizes of interventions were calculated using standardized mean differences (Hedges' g) and tested using random-effects models. Meta-regression was used to explore heterogeneous findings. Narrative syntheses were conducted when meta-analysis was not possible.

Results: Twenty-eight studies and 19,753 participants were included. Three studies had low risk of bias, 11 studies had high risk of bias, while 14 studies had some concerns. The meta-analyses for movement behaviours showed significant increases in vigorous physical activity (VPA, n = 7 studies, g = 0.17, 95% Confidence Interval (CI): 0.06, 0.27), moderate-to-vigorous physical activity (MVPA, n = 17, g = 0.17, CI: 0.03, 0.30), and steps per minute (n = 3, g = 0.81, CI: 0.03, 1.59) for enrichment interventions relative to control conditions. The results for MVPA had large heterogeneity and were only significant short-term. Line markings alone or in combination with physical structures (e.g., climbing walls) increased MVPA, while involving end-users decreased MVPA. Line markings alone or in combination with physical structures or equipment increased VPA. There was no effect of enrichment for sedentary behaviour, low or moderate intensity physical activity. The results for cognitive (attention restoration and executive functioning), psychological (wellbeing and quality of life), and social (interactions, orientations, and bullying) development were mixed.

Conclusion: Our findings show that studies on physical enrichment had low methodological quality and findings had high heterogeneity. Line markings in isolation or combined with other enrichment strategies might increase levels of VPA and MVPA in children and adolescents. Evidence on cognitive, psychological and social development is inconclusive due to few and weak studies for these outcomes. We provide future directions for research and practice by drawing from the environmental enrichment paradigm.

Trial registration: PROSPERO registration number CRD42022364392.

Background: Adolescent mental health has emerged as a critical public health issue, with increasing prevalence of anxiety and depression. Physical activity (PA) is known to offer numerous health benefits, but its relationship with adolescent mental health is less clear and the optimal intensity and duration remain debated.

Methods: This prospective cohort study analyzed data from 6,991 adolescents in Jiangsu, China. Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ), and PA was categorized as moderate-intensity PA (MPA) or vigorous-intensity PA (VPA) based on self-reported activity levels. The study examined the cross-sectional and longitudinal associations between PA and mental health, adjusting for various confounding factors.

Results: Among the cohort (mean age, 12.71 ± 2.12 years; 53.6% male), 1,265 participants (18.1%) had mental health issues at baseline. Cross-sectional analyses revealed a significant negative non-linear dose-response association between levels of MPA and VPA and the prevalence of mental health problems in adolescents (P = 0.001), after adjusting for potential confounding factors such as age, gender, nationality, and family structure. Specifically, adolescents who engaged in 30-59 min of MPA daily exhibited a 56.4% reduction in the odds ratios of mental health issues (OR = 0.436, 95% CI: 0.327-0.581, P < 0.001). Similarly, those who participated in up to 29 min of VPA daily had 49.2% lower odds ratios (OR = 0.508, 95% CI: 0.415-0.622, P < 0.001). Longitudinal analyses confirmed that MPA and VPA were significantly negatively associated with the incidence of subsequent mental health problems. In particular, adolescents who engaged in 30-59 min of MPA daily (OR = 0.548, 95% CI: 0.411-0.729, P < 0.001) and up to 29 min of VPA daily (OR = 0.583, 95% CI: 0.474-0.716, P < 0.001) demonstrated the strongest protective effects. Sensitivity analyses and subgroup analyses also confirmed the robustness of these results.

Conclusions: Significant positive associations exist between moderate PA and improved adolescent mental health outcomes. The better effects are observed with 30-59 min of MPA or ≤ 29 min of VPA daily. Exceeding these durations may not yield additional benefits. When promoting PA among adolescents, focus should be placed on selecting appropriate activity types and scientifically managing activity duration.