Lack of knowledge of physical activity guidelines: can physical activity promotion campaigns do better?

Objectives To identify the prevalence of knowledge of the current UK physical activity guidelines which were introduced in 2011 and prior physical activity guidelines (30 min on 5 days each week) within two large samples of UK adult's. To investigate whether knowledge of physical activity guidelines differs according to demographics such as ethnicity, age, education and employment status. Design Descriptive cross-sectional study comparing two distinctive adult samples. Setting National survey and online-administered survey conducted in England. Participants The 2007 Health Survey for England provides data on knowledge of physical activity guidelines from 2860 UK adults (56% women, 89% white, 63% under 45 years old). In 2013, an online survey was disseminated and data were collected from 1797 UK adults on knowledge of the most recent physical activity guidelines. The 2013 sample was 70% women, 92% white and 57% under 45 years old. All adults in both samples were >18 years old and without illnesses/disorders likely to restrict physical activity. Main outcomes Knowledge of physical activity guidelines in 2007 and 2013. Demographic correlates of knowledge of moderate-to-vigorous physical activity guidelines. Results 18% of the 2013 sample accurately recalled the current physical activity guidelines compared with 11% of the 2007 sample who accurately recalled the previous guidelines. The differences in knowledge of physical activity guidelines existed for marital status, gender, age, education and employment status within both 2007 and 2013 samples (p<0.05). Men with lower education and employment status (unemployed including student and retired) and older adults were less likely to know physical activity guidelines (p<0.05). Knowledge of physical activity guidelines remained higher in the 2013 sample after controlling for demographic differences (p<0.05). Conclusions Disadvantaged population groups are less knowledgeable about physical activity guidelines. Although knowledge of physical activity guidelines appears to have increased in recent years demographic disparities are still evident. Efforts are needed to promote health information among these groups

Teacher perceptions on the delivery and implementation of movement integration strategies: the CLASS PAL (Physically Active Learning) Programme

Children sit for extended periods in the school classroom. Movement integration (MI) methods (e.g. active breaks, physically active lessons) could be used to break/reduce sitting time and improve classroom behaviour and engagement. Limited evidence is available on teacher perceptions of what influences the implementation of MI. Interviewed primary school teachers reported factors perceived to influence implementation at a variety of levels including individual (e.g. teacher and pupil characteristics, time, behavioural management) and school (e.g. whole school approach; and external to school expectations). In addition suggestions for increasing adoption and implementation of MI (e.g. communicating MI initiatives to schools) were identified

Awareness of moderate-to-vigorous physical activity: Can information on guidelines prevent overestimation?

BACKGROUND: Mass-media campaigns such as Change4Life use messaging to promote physical activity guidelines. Raising knowledge of MVPA guidelines within UK adults is a main goal of current mass media campaigns aimed at increasing engagement in MVPA. As this may help to inform accurate perceptions of adults’ own MVPA level it is an important area of investigation. Subjective norms, health status and normal walking intensity may also influence adult’s awareness of their own MVPA behaviour. The aim of this study was to examine the hypothesis that greater knowledge of MVPA guidelines, supportive subjective norms, lower self-reported health status and intensity of typical walking pace are associated with accurate awareness of MVPA engagement within a sample of UK adults. METHODS: A cross-sectional study of UK adults was conducted. UK adults who subscribed to the National Academic Mailing List Service (JISCMail) were sent an invitation to complete an online survey. 1,724 UK adults completed the online survey which included items on minutes spent in MVPA, awareness of MVPA using constructs highlighted by the precaution adoption process model, subjective norms, knowledge of guidelines, health status and demographics. RESULTS: The sample was 70% female, 57% aged under 45, 93% White and 69% in full-time employment. 62% reported their health to be above average, while 62% demonstrated accurate awareness of their own physical activity level, only 18% correctly reported the MVPA guidelines and 51% reported high subjective norms towards MVPA. Logistic regression analyses identified high subjective norms (OR = 1.84, CI: 1.29, 2.63, p = .001), average or below average health status (OR = .71, CI: .53 .97, p = .001), and a self-reported regular walking pace of moderate-to-vigorous (OR = 1.31, CI: 1.05, 1.63, p = .02) to be associated with accurate MVPA awareness. Knowledge of MVPA guidelines was not associated with MVPA awareness. CONCLUSIONS: Mass media campaigns, such as Change4Life, inform the general public of MVPA guidelines. Campaign messages may be more influential targeting subjective norms instead of knowledge of guidelines, thereby raising awareness of personal MVPA behaviour amongst inactive adults and increasing motivation to engage in more MVPA

Metadata correction: Brain activation in response to personalized behavioral and physiological feedback from self-monitoring technology: pilot study

[This corrects the article DOI: 10.2196/jmir.8890.]

Brain activation in response to personalized behavioral and physiological feedback from self-monitoring technology: pilot study

Background: The recent surge in commercially available wearable technology has allowed real-time self-monitoring of behavior (eg, physical activity) and physiology (eg, glucose levels). However, there is limited neuroimaging work (ie, functional magnetic resonance imaging [fMRI]) to identify how people’s brains respond to receiving this personalized health feedback and how this impacts subsequent behavior. Objective: Identify regions of the brain activated and examine associations between activation and behavior. Methods: This was a pilot study to assess physical activity, sedentary time, and glucose levels over 14 days in 33 adults (aged 30 to 60 years). Extracted accelerometry, inclinometry, and interstitial glucose data informed the construction of personalized feedback messages (eg, average number of steps per day). These messages were subsequently presented visually to participants during fMRI. Participant physical activity levels and sedentary time were assessed again for 8 days following exposure to this personalized feedback. Results: Independent tests identified significant activations within the prefrontal cortex in response to glucose feedback compared with behavioral feedback (P<.001). Reductions in mean sedentary time (589.0 vs 560.0 minutes per day, P=.014) were observed. Activation in the subgyral area had a moderate correlation with minutes of moderate-to-vigorous physical activity (r=0.392, P=.043). Conclusion: Presenting personalized glucose feedback resulted in significantly more brain activation when compared with behavior. Participants reduced time spent sedentary at follow-up. Research on deploying behavioral and physiological feedback warrants further investigation

Small-sided soccer in school reduces postprandial lipaemia in adolescent boys

Purpose: While laboratory based moderate- to high-intensity exercise reduces postprandial lipaemia in adolescents this exercise differs to the free-living physical activities in which young people typically engage. This study compared the effect of free-living afterschool soccer activity and treadmill exercise on in-school postprandial lipaemia in adolescent boys. Methods: Fifteen boys (12.6 (0.5) years) completed three, 2-day experimental trials. On Day 1, participants either: rested (CON); exercised for 48 min on a treadmill at 60% peak V[Combining Dot Above]O2 (TM); played 48 min of 5-a-side soccer (SOC). On Day 2, participants attended school where a capillary blood sample determined fasting triacylglycerol ([TAG]) and glucose ([glucose]) concentrations. Participants then consumed a standardised breakfast (0 h) and lunch (4.5 h) and blood samples were taken postprandially at 2.5, 5.0 and 7.0 h. Results: Reductions in fasting [TAG] were small-moderate after TM (-16%, 95% CI = -27 to -2%, ES = 0.46), but large after SOC (-30%, 95% CI = -40 to -20%, ES = 1.00) compared with CON; the concentration was also lower in SOC compared with TM (-18%, 95% CI = -29 to -5%, ES = 0.53). Based on ratios of geometric means, the area under the TAG versus time curve was 18% lower after TM (95% CI = -29 to -5%, ES = 0.51) and 25% lower after SOC (95% CI = -35 to -13%, ES = 0.76,) compared with CON. In contrast, SOC and TM were not significantly different (-9%, 95% CI = -21 to 5%, ES = 0.25). Conclusion: Compared with duration-matched inactivity (CON), after-school small sided soccer (SOC) and treadmill exercise (TM) resulted in a similar, moderate reduction of postprandial lipaemia in adolescent boys

Measurement invariance of TGMD-3 in children with and without mental and behavioral disorders

This study evaluated whether the Test of Gross Motor Development 3 (TGMD-3) is a reliable tool to compare children with and without mental and behavioural disorders across gross motor skill domains. A total of 1075 children (aged 3-11 years), 98 with mental and behavioural disorders and 977 without (typically developing), were included in the analyses. The TGMD-3 evaluates fundamental gross motor skills of children across two domains: locomotor skills and ball skills. Two independent testers simultaneously observed children’s performances (agreement over 95%). Each child completed one practice and then two formal trials. Scores were recorded only during the two formal trials. Multigroup Confirmatory Factor Analysis tested the assumption of TGMD-3 measurement invariance across disability groups. According to the magnitude of changes in Root Mean Square Error of Approximation and Comparative Fit Index between nested models, the assumption of measurement invariance across groups was valid. Loadings of the manifest indicators on locomotor and ball skills were significant (p < .001) in both groups. Item Response Theory analysis showed good reliability results across locomotor and the ball skills full latent traits. The present study confirmed the factorial structure of TGMD-3 and demonstrated its feasibility across normally developing children and children with mental and behavioural disorders. These findings provide new opportunities for understanding the effect of specific intervention strategies on this population

A digital lifestyle behaviour change intervention for the prevention of type 2 diabetes: a qualitative study exploring intuitive engagement with real-time glucose and physical activity feedback.

Background Mobile health technologies have advanced to now allow monitoring of the acute physiological responses to lifestyle behaviours. Our aim was to explore how people engaged with real-time feedback on their physical activity and glucose levels over several weeks. Methods Semi-structured interviews with 26 participants (61.5% female, 56.6 years) at moderate-to-high risk of developing type 2 diabetes were conducted. Interviews were completed after participants took part in an intervention comprising a flash glucose monitor (Freestyle Libre) and a physical activity monitor (Fitbit Charge 2). Purposive sampling ensured representation of ages, genders and group allocations. Results Inductive thematic analysis revealed how individuals intuitively used, interpreted and acted on feedback from wearable technologies. Six key themes emerged: triggers of engagement with the technologies, links between behaviour and health, lack of confidence, changes to movement behaviours, changes to diet and barriers to lifestyle behaviour change. Conclusions Our findings demonstrate that accessing behavioural and physiological feedback can increase self-awareness of how lifestyle impacts short-term health. Some participants noticed a link between the feedback presented by the two devices and changed their behaviour but many did not. Training and educational support, as well as efforts to optimize how feedback is presented to users, are needed to sustain engagement and behaviour change. Extensions of this work to involve people with diabetes are also warranted to explore whether behavioural and physiological feedback in parallel can encourage better diabetes self-management

Physical activity guidelines and cardiovascular risk in children: a cross-sectional analysis to determine whether 60 minutes is enough

Background Physical activity reduces cardiovascular mortality and morbidity. The World Health Organisation (WHO) recommends children engage in 60 min daily moderate-to-vigorous physical activity (MVPA). The effect of compliance with this recommendation on childhood cardiovascular risk has not been empirically tested. To evaluate whether achieving recommendations results in reduced composite-cardiovascular risk score (CCVR) in children, and to examine if vigorous PA (VPA) has independent risk-reduction effects. Methods PA was measured using accelerometry in 182 children (9–11 years). Subjects were grouped according to achievement of 60 min daily MVPA (active) or not (inactive). CCVR was calculated (sum of z-scores: DXA body fat %, blood pressure, VO2peak, flow mediated dilation, left ventricular diastolic function; CVR score ≥1SD indicated ‘higher risk’). The cohort was further split into quintiles for VPA and odds ratios (OR) calculated for each quintile. Results Active children (92 (53 boys)) undertook more MVPA (38 ± 11 min, P  0.05). CCVR in the lowest VPA quintile was significantly greater than the highest quintile (3.9 ± 0.6, P < 0.05), and the OR was 4.7 times higher. Conclusion Achievement of current guidelines has positive effects on body composition and cardiorespiratory fitness, but not CCVR. Vigorous physical activity appears to have beneficial effects on CVD risk, independent of moderate PA, implying a more prescriptive approach may be needed for future VPA guidelines

Cross-Sectional Associations of Reallocating Time Between Sedentary and Active Behaviours on Cardiometabolic Risk Factors in Young People: An International Children's Accelerometry Database (ICAD) Analysis.

INTRODUCTION: Sedentary time and time spent in various intensity-specific physical activity are co-dependent, and increasing time spent in one behaviour requires decreased time in another. OBJECTIVE: The aim of the present study was to examine the theoretical associations with reallocating time between categories of intensities and cardiometabolic risk factors in a large and heterogeneous sample of children and adolescents. METHODS: We analysed pooled data from 13 studies comprising 18,200 children and adolescents aged 4-18 years from the International Children's Accelerometry Database (ICAD). Waist-mounted accelerometers measured sedentary time, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA). Cardiometabolic risk factors included waist circumference (WC), systolic blood pressure (SBP), fasting high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), triglycerides, insulin, and glucose. Associations of reallocating time between the various intensity categories with cardiometabolic risk factors were explored using isotemporal substitution modelling. RESULTS: Replacing 10 min of sedentary time with 10 min of MVPA showed favourable associations with WC, SBP, LDL-C, insulin, triglycerides, and glucose; the greatest magnitude was observed for insulin (reduction of 2-4%), WC (reduction of 0.5-1%), and triglycerides (1-2%). In addition, replacing 10 min of sedentary time with an equal amount of LPA showed beneficial associations with WC, although only in adolescents. CONCLUSIONS: Replacing sedentary time and/or LPA with MVPA in children and adolescents is favourably associated with most markers of cardiometabolic risk. Efforts aimed at replacing sedentary time with active behaviours, particularly those of at least moderate intensity, appear to be an effective strategy to reduce cardiometabolic risk in young people