What Hippocrates called “Man’s best medicine”: walking is humanity’s path to a better world

What Hippocrates called “Man’s best medicine”: walking is humanity’s path to a better worl

The effects of different patterns of brisk walking on aspects of fitness, cardiovascular risk and psychological well-being

The use of a pattern of accumulated bouts of exercise has become enshrined in recent public health recommendations. Although there is epidemiological evidence to support this, the experimental evidence for such recommendations is limited. The four studies described in this thesis investigated the effects of different patterns of exercise on fitness, cardiovascular risk and selected psychological parameters. [Continues.

Student activity and sport study Ireland: protocol for a Web-based survey and environmental audit tool for assessing the impact of multiple factors on university students’ physical activity

Background: Increasing proportions of the global population transition through a university setting, a setting associated with engagement in behaviors that diminish health such as high levels of physical inactivity. Increasing physical activity (PA) is a key element of health promotion strategies in many countries, but a better understanding of students’ PA and how it is associated with personal, behavioral, and environmental factors is needed. Studies provide protocols to collect information regarding these factors separately; however, none have developed a validated systematic approach to gather information pertaining to all across a whole country. Objective: The purpose of this project is to examine students’ physical activity and how it is associated with personal, behavioral, and environmental factors. Methods: Student Activity and Sport Study Ireland (SASSI) is a university-based cross-sectional study that was carried out across the island of Ireland in 2014. A novel and comprehensive Web-based environmental audit tool (EAT) gathered information pertaining to the environment provided by universities for physical activity. A Web-based student survey (SS) collected information about physical activity beliefs, attitudes, motivations, and behaviors of students. The audit tool and SS were developed through rigorous consultation processes involving international experts. An institutional champion volunteered at each university to recruit, administer, and ensure the completion of both assessments. Results: Data collection was undertaken between May and December 2014. A total of 80% (33/41) of universities completed the EAT, whereas 88.31% (8122/9197) of students (49.10% [3966/8122] male; mean 23.17 [SD 6.75], years) completed the SS sufficiently. Studies are currently underway with the data collected using this protocol. Conclusions: SASSI provides a novel and comprehensive protocol for systematically assessing the PA of students and the related personal, behavioral, and actual environmental factors. The strengths of the SASSI study are presented and include high response rates and a unique dataset that can provide information to relevant stakeholders and policy makers, along with aiding the development of university environments and interventions that promote PA involvement. The weaknesses of the protocol are recognized with suggestions given to overcome them in future research. This protocol is applicable for other countries and has great potential to create harmonization of data, which would allow for direct comparisons across nations

Outdoor walking speeds of apparently healthy adults: A systematic review and meta‑analysis

Background Walking outdoors can be used by many individuals to meet public health guidelines for moderate-to-vigorous intensity physical activity. The speed at which adults walk may be a proxy for intensity. Traditional estimates of indoor walking speed are unlikely to reflect self-selected usual or other instructed paces of outdoor walking speed. Objective To inform estimates of pace-based walking speed of apparently healthy adults in outdoor settings. Methods We searched four electronic databases for articles published in English between January 1970 and March 2019. Studies that reported walking speed (m/s), cadence (steps/min), or intensity(mL/kg/min) of ambulatory, apparently healthy, and community-dwelling adults (> 18 years) were included. Walking speed categories were defined according to the description provided in each study. Meta-analysis was used to synthesise speed, cadence, and intensity data by slow, usual, medium, fast, and maximal pace (where reported). Results Thirty-five studies, representing 14,015 participants (6808 women, 5135 men, and 2072 sex not specified), were identified. The mean (95% CI) walking speed for slow, usual, medium, fast, and maximal pace was 0.82 (0.77–0.86), 1.31 (1.27–1.35), 1.47 (1.44–1.49), 1.72 (1.64–1.81), and 1.62 (1.45–1.79) m/s, respectively. Mean cadence (95% CI) for usual and fast paces were 116.65 (114.95–118.35) and 126.75 (121.87–131.63) steps/min, respectively. The mean oxygen consumption (95% CI) for the usual and medium paces was 11.97 (11.69–12.25) and 13.34 (12.94–13.73) mL/kg/min, respectively. Conclusion These findings provide greater clarity with regard to how various indicators of enacted walking pace, speed, and intensity overlap and how each can be best communicated in the real-world setting to optimise health-related outcomes. Pace-based instructions can be used to support walking in outdoor settings within public health guidelines

Prevalence and correlates of physical inactivity in community-dwelling older adults in Ireland

The public health challenges associated with rapid population ageing are likely to be exacerbated by poor physical activity levels. The purpose of this study was to identify correlates of physical inactivity in a population-representative sample of older adults in Ireland. This paper reports a secondary analysis of data from 4892 adults aged 60+ from the Irish Longitudinal Study on Ageing (TILDA). TILDA includes an assessment of the mental and physical health, and social and financial circumstances of participants assessed in a home interview and self-completion questionnaire. Chi squared statistics and forced entry logistic regression were used to identify factors associated with physical inactivity. Females were over twice as likely to be inactive as their male counterparts (Odds Ratio 2.2). Increasing old age was associated with inactivity among males and females. Those who reported above secondary level education, no reported falls in the last year and no fear of falling were less likely to be physically inactive. While older adults who noted poor/fair self-reported health, that they did not look after grandchildren, did not own a car or did not attend a course were also more likely to be inactive than those who reported positively for these items. Gender displayed a strong but often contrasting influence on factors that affect physical activity among older adults. Among females, living alone or in a rural area, retirement, fair/poor emotional health and activity being limited by illness were all significantly associated with inactivity. While cohabiting, being employed and residing in an urban area were related to low levels of activity in males. Our findings identify specific groups of the older Irish population who may be at particular risk of physical inactivity and thereby the associated physiological and psychological hazards. These results can support the development of tailored interventions to promote healthy ageing

The influence of role models on the sedentary behaviour patterns of primary school-aged children and associations with psychosocial aspects of health

Background: High levels of sedentary behaviour(SB)are associated with poor health outcomes in children,but the effects on mental health are less clear.This study explored the relationship between SB and psychosocial aspects of health in children, and what influence key role models, including parents and schoolteachers, have on the SB levels of children. Methods: Physical activity (PA) and SB were measured using accelerometery in 101 children, 113 parents and 9 teachers. Children were aged 9 or 10 years old and in fourth grade. Child psychosocial outcomes were assessed using the Rosenberg Self-Esteem Scale and the Strengths and Difficulties Questionnaire. Results: Children engaged in a high volume of SB (9.6 h/day) but interrupted SB often. They accumulated less than 11,000 steps per day, and thus, many may not meet the recommended daily levels of PA. No associations were found between child SB and teacher SB during the school day or child SB and parent SB during the after-school period. No association was found between SB and self-esteem, although children with a higher body mass index had a higher number of emotional and behavioural difficulties. SB was linked to that of parents and teachers, or that SB was associated with self-esteem or behavioural problems, school children were highly sedentary and insufficiently physically active. Therefore, there is a need to explore school practices and curriculum delivery methods,as well as school and home environments,to reduce the volume of SB children engage in

Identification of health-related behavioural clusters and their association with demographic characteristics in Irish university students

Background: Students engage in risky health-related behaviours that influence their current and future health status. Health-related behaviours cluster among adults and differently based on sub-populations characteristics but research is lacking for university populations. Examining the clustering of health- related behaviours can inform our initiatives and strategies, while examining cluster members’ characteristics can help target those who can prosper most from health promotion efforts. This study examines the clustering of health-related behaviours in Irish university students, and investigates the relationship with students’ sex, age, field of study and accommodation type. Methods: An online survey was completed by 5672 Irish university students (51.3% male; 21.60 ± 5.65 years) during 2014. Two-step cluster analysis was used to understand how health-related behaviours (physical activity, smoking, alcohol intake, drug use and dietary habits) cluster among male and female students. Binary logistic regressions were conducted to examine the likelihood of students falling into certain clusters based on their characteristics. Results: Five cluster groups were identified in males and four in females. A quarter of males were categorised as ideal healthy with older students and those from certain fields of study having a higher likelihood of being classified in a low physical activity and poor diet (OR = 1.06–2.89), alcohol consumption (OR = 1.03–3.04), or smoking and drug use (OR = 1.06–2.73) cluster. Forty-five percent of females were categorised as ideal healthy with older females more likely to be in a low active and smoking cluster (OR = 1.03), and less likely to be in a convenience food cluster (OR = 0.96). Females from certain fields of study were also more likely to be classified in these clusters (OR = 1.59–1.76). Students living away from their family home had in increased likelihood of being in a cluster related to a higher frequency of alcohol consumption (OR = 1.72–3.05). Conclusion: Health-related behaviours cluster among this population and need to be taken into account when designing multi-health interventions and policies. These findings can be used to target student groups at risk, leading to more efficient and successful health promotion efforts. The addition of modules providing information regarding health-related behaviours are advised in all fields of study

Active students are healthier and happier than their inactive peers: the results of a large representative cross-sectional study of university students in Ireland

Background: Time spent in university represents a period of transition and may be an appropriate time to promote physical activity among young adults. The aim of this study was to assess participation of university students in sport and physical activity in Ireland and to explore the association between physical activity and perceptions of overall health, mental health, and happiness. Methods: The Student Activity and Sport Study Ireland was a cross-sectional online survey among a representative sample (n = 8122) of university students in Ireland. Binary logistic regressions were performed to examine associations between self-reported physical activity and gender (predictor variables) and individual perceptions of overall health, mental health, and happiness (binary outcomes). Results: Only 64.3% of respondents met the recommended level of 150 minutes of moderate to vigorous physical activity per week with males significantly more active than females (72.1% vs 57.8% meeting guidelines). Those meeting physical activity guidelines were more likely to report greater overall health and higher mental health and happiness scores compared with their inactive peers. Conclusions: Active students enjoy better health (overall and mental) and are happier than their inactive peers. This provides a clear rationale for providing students with opportunities to be active at university. The data provide a baseline to monitor changes in physical activity patterns

Barriers and facilitators to implementing community-based physical activity interventions: a qualitative systematic review

Background: Over the past decade several physical activity (PA) interventions have been shown to be efficacious in a controlled research setting, however there is a continued lack of evidence for how to successfully implement these PA interventions in real-world settings such as the community. This review aims to explore the barriers and facilitators that affect the implementation of community-based PA interventions and make recommendations to improve implementation from the included studies. Methods: A systematic literature search of EBSCOhost, Scopus, PUBMED and Web of Science was conducted to identify articles that reported qualitative data on the implementation factors of community-based interventions where PA was a primary outcome. Data were extracted using the Consolidated Framework for Implementation Research (CFIR) as a guide. Implementation factors and recommendations were then mapped onto the 5 domains of the CFIR and synthesised thematically. Results: From 495 articles, a total of 13 eligible studies were identified, with 6 studies using a mixed methods approach, and 7 reporting qualitative methods only. There were 82 implementation factors identified, including 37 barriers and 45 facilitators, and a further 26 recommendations from the papers across all 5 domains of the CFIR. More barriers than facilitators were identified within the CFIR domain inner setting, in contrast to all other domains where facilitator numbers outweighed barriers. Conclusions: This review identified many facilitators and barriers of implementing physical activity interventions in the community. A key finding of this review was the impact of implementation strategies on successful implementation of community PA interventions. From the evidence, it was clear that many barriers to implementation could have been negated or reduced by an implementation plan in which several strategies are embedded. The findings of this review also suggest more attention to individual’ skills and involvement is needed to improve self-efficacy and knowledge. The role of individuals across all organisational levels, from providers to leaders, can impact on the implementation of an intervention and its succes

Factors related to the implementation and scale-up of physical activity interventions in Ireland: a qualitative study with policy makers, funders, researchers and practitioners

Background Current literature reports a gap between development of efective interventions to promote physical activity and the systematic uptake into real-world settings. Factors relating to implementation and scale-up of physical activity interventions have been examined, however the perspectives of multiple stakeholders from diferent domains are not well researched. The purpose of this study was to examine the perceived factors related to physical activity intervention implementation and scale-up in diferent domains from diferent stakeholders on the island of Ireland.Methods Practitioners, researchers, funders and policy makers in Ireland were invited to take part in a semi-structured interview exploring factors related to the implementation and scale-up of eleven diferent physical activity interventions. A thematic analysis was conducted to identify factors related to the implementation and scale-up of the included interventions. The data collection and analysis were guided by the Consolidated Framework for Implementation Research.Results Thirty-eight participants took part in the interviews which identifed factors related to 1) intervention planning and practical considerations; 2) organisational structures, stafng and resources related to delivery; 3) refection, evaluation and updating of the intervention; and 4) practical consideration related to scale-up. Furthermore, participants referred to the ongoing commitment, engagement, and support needed throughout the implementation process.Conclusions Future research and practice needs to consider how diferent factors are experienced at diferent implementation stages and by the diferent stakeholder groups involved. The fndings highlight multiple inter-related factors that infuence the implementation and scale-up of physical activity interventions, but also identifes many strategies that can be utilised to aid future successes.</p