Workplace Physical Activity Within the Gulf Cooperation Council Region: A Scoping Review

Objectives: To identify and examine available literature addressing physical activity (PA) and sedentary behavior (SB) in the workplace in the Gulf Cooperation Council (GCC) region. Design: Scoping Review Method: Academic and gray literature databases were searched for studies published prior to April 2021. Only studies conducted in the GCC region, available in Arabic or English, and addressing workplace PA were included. Results: Ten studies were identified; seven intervention studies, a cross-sectional study, a peer-reviewed brief report, and a 5-year strategy document. For the interventional studies, duration ranged from 3–26 weeks. Interventions delivered varied and included those focusing on multiple behaviour (diet and physical activity), walking challenges, and supervised exercise in paid time. Most included behavior change strategies like prompts, incentives, and education. PA was only measured in four intervention studies with most reporting no significant changes. The one study that reported significant changes from a national workplace walking challenge had a less robust study design and methods making these results difficult to interpret. Studies were hampered by poor study design and reporting of research and intervention details. Two studies reported hot weather and lack of time as barriers to workplace-PA in the GCC region. Conclusions: Literature on workplace PA and SB interventions in the GCC region is limited. Well-designed studies using standardised measures are required to assess PA interventions in GCC workplaces. Further, higher quality research is required to assess motivators and barriers to workplace PA in the GCC to develop sustainable workplace PA interventions

Development, feasibility, acceptability and potential effectiveness of a healthy lifestyle programme delivered in churches in urban and rural South Africa

Rising levels of obesity in South Africa require innovation in community-level lifestyle change programmes. Our aim was to co-develop Impilo neZenkolo (‘Health through Faith’), a healthy lifestyle programme for low-income, black South Africans delivered through churches, and evaluate its feasibility, acceptability and potential effectiveness. In the first phase we developed programme materials with church members. In the second phase we trained lay leaders to deliver the programme and assessed feasibility, acceptability (observation, focus groups and interviews) and potential effectiveness (pre and post measurement of weight, hip and waist circumferences, blood pressure, self-reported physical activity, dietary habits, health status, self-esteem, psychological distress). The study was conducted in four churches in urban and rural South Africa. The development workshops led to increased focus on positive benefits of participation, widening inclusion criteria to all adults and greater emphasis on Christian ethos. Challenges to feasibility included: recruitment of churches; scheduling of programme sessions (leading to one church not delivering the programme); attendance at the programme (63% attended more than half of the 12 weekly sessions); and poor programme fidelity (in particular in teaching behaviour change techniques). Aspects of the programme were acceptable, particularly the way in which the programme was aligned with a Christian ethos. There was some indication that amongst the 42/68 (62%) for whom we were obtained pre- and post-programme measurements the programme has potential to support weight loss. We conclude that a healthy lifestyle programme for low-income, black South Africans, delivered through churches, may be viable with extensive re-development of delivery strategies. These include finding external funding for the programme, endorsement from national level denominational organisations and the professionalization of programme leadership, including paid rather than volunteer leaders to ensure sufficient time can be spent in training

Measuring Productivity, Perceived Stress and Work Engagement of a Nationally Delivered Workplace Step Count Challenge

Workplace step count challenges show promise with regard to increasing physical activity, with walking linked to many positive physical and mental health benefits. Few studies have investigated their effects on work-related outcomes. The aim of this study was to describe (1) the process of collecting work-related outcomes as part of a real-world workplace intervention, the Step Count Challenge, and (2) report step counts and work-related outcomes (productivity, perceived stress and work engagement) during the Step Count Challenge. This pre-post study was conducted as part of a four-week 2018 National Step Count Challenge (SCC) in Scotland, UK. A survey was administered to collect self-reported steps, productivity (HWQ), perceived stress (Cohen Perceived Stress Scale) and work engagement (UWES) on the week prior to the intervention starting (baseline), week 1 and week 4. Process data such as recruitment and response rates were monitored throughout. Of 2042 employees who signed up to the SCC, baseline data were reported for 246 (12% of total; mean age 42.5 years, 83% female). Process data suggest low uptake to the study and poor compliance between surveys time points. Preliminary data suggest positive changes in step counts (3374 steps/day by week 4), stress and productivity. No changes in work engagement were found. The findings highlight the need to integrate research more effectively into real-world interventions, including a true baseline period. The Step Count Challenge may have positive change on some work-related outcomes warranting further investigation into how robust research designs can be delivered without negatively influencing real-world interventions

A systematic evaluation of physical activity and diet policies in Scotland : results from the 2021 Active Healthy Kids Report Card

Background: Policymaking regarding physical activity (PA) and diet plays an important role in childhood health promotion. This study provides a detailed examination of Scottish government and policy for child and adolescent PA and diet and discusses strengths and areas for improvement. Methods: Scottish policy documents (n = 18 [PA]; n = 10 [diet])—published in 2011–20—were reviewed for grading using an adapted version of the Health-Enhancing Physical Activity Policy Audit Tool Version 2. Results: There is clear evidence of leadership and commitment to improving PA and diet and tackling obesity in children and adolescents. The allocation of funds and resources for policy implementation has increased substantially over the past decade. Progress through early key stages of public policymaking—policy agenda and formation—has improved. However, there is limited information on later key stages, including policy monitoring and evaluation. Conclusions: Childhood PA and diet are a clear priority in Scotland, and PA and diet policies clearly support the desire to achieve other goals, including reducing inequalities and increasing active travel in Scotland. Nonetheless, future policies should be further strengthened through clear(er) plans of implementation, and monitoring and evaluation to support their societal impact

Evaluation of physical activity policies in Scotland : results from the 2021 Active Healthy Kids Scotland Report Card

Purpose: The benefits of physical activity (PA) are well-established for children and adolescents, and policy making regarding PA plays an important role in increasing PA. As part of the Active Healthy Kids Global Alliance initiative, the 2021 Active Healthy Kids Scotland Report Card summarised the status of PA and health in Scottish children and adolescents prior to the COVID-19 pandemic—reporting on a range of indicators (Bardid et al., 2022). This study provides a detailed examination of the evidence informing the Government and Policy indicator. Methods: Current Scottish PA policy documents (n=18) published in 2011-2020—not including responses to COVID-19—were reviewed for grading. The grade was determined using an adapted version of the Policy Audit Tool Version 2 (Ward et al., 2021). Key criteria in the scoring rubric include number and breadth of policies, identified funding, identifiable reporting structures, and monitoring and evaluation plan. Results: A C- grade was assigned to the Government and Policy indicator. There is clear evidence of leadership and commitment to increasing levels of PA and providing PA opportunities for children and youth. The allocation of funds and resources for implementation of policy has increased substantially since the publication of previous report cards. Progress through the key stages of public policymaking—policy agenda and formation—has improved. However, some policy documents do not identify accountable organisations, whilst others do not include details regarding reporting structures. Moreover, many policy documents do not provide information on monitoring and evaluation of policies. Conclusions: Scotland has many creditable policies at national level. There appears to be good links between the government and organisations accountable for implementation. Child and adolescent PA is clearly a priority in Scotland; it is not only an outcome, but also a means to achieve other goals (e.g., active travel to take climate action). However, current policies provide limited information on how delivery of proposed actions will be monitored and evaluated in practice. Future policies should therefore include more information on monitoring, evaluation, and reporting of delivery of actions, in order to better understand and support policy implementation and its impact on PA in children and adolescents

A systematic evaluation of physical activity and diet policies in Scotland: Results from the 2021 Active Healthy Kids Report Card

Background Policymaking regarding physical activity (PA) and diet plays an important role in childhood health promotion. This study provides a detailed examination of Scottish government and policy for child and adolescent PA and diet and discusses strengths and areas for improvement. Methods Scottish policy documents (n = 18 [PA]; n = 10 [diet])—published in 2011–20—were reviewed for grading using an adapted version of the Health-Enhancing Physical Activity Policy Audit Tool Version 2. Results There is clear evidence of leadership and commitment to improving PA and diet and tackling obesity in children and adolescents. The allocation of funds and resources for policy implementation has increased substantially over the past decade. Progress through early key stages of public policymaking—policy agenda and formation—has improved. However, there is limited information on later key stages, including policy monitoring and evaluation. Conclusions Childhood PA and diet are a clear priority in Scotland, and PA and diet policies clearly support the desire to achieve other goals, including reducing inequalities and increasing active travel in Scotland. Nonetheless, future policies should be further strengthened through clear(er) plans of implementation, and monitoring and evaluation to support their societal impact

Screen Time and Sleep of Rural and Urban South African Preschool Children

This study aimed to investigate the extent to which preschool children meet guidelines for screen time (< 1 h/day) and sleep (10–13 h/24-h) and explored home factors that affect these behaviors. Parents of preschoolers across income settings in South Africa (urban high-income n = 27, urban low-income n = 96 and rural low-income n = 142) completed a questionnaire. Urban high-income children had higher rates of exceeding screen time guidelines (67.0%) than children from urban low-income (26.0%) and rural low-income (3.5%) settings. Most children (81.0%) met sleep guidelines on weekdays and on weekends (75.0%). More urban high-income children met the sleep guideline, in comparison to both low-income settings. Fewer urban high-income parents (50.0%) thought that screen time would not affect their preschooler’s health, compared to urban low-income (90.4%) and rural low-income (81.7%) parents. Weeknight bedtime was positively correlated with both weekday screen time (p = 0.001) and weekday TV time (p = 0.005), indicating that more time on screens correlated with later bedtimes. Meeting screen time and sleep guidelines differs across income settings, but it is evident that parents of preschoolers across all income settings would benefit from greater awareness about guidelines

Sleep and BMI in South African urban and rural, high and low-income preschool children

Abstract Background The extent to which income setting or rural and urban environments modify the association between sleep and obesity in young children is unclear. The aims of this cross-sectional observational study were to (i) describe and compare sleep in South African preschool children from rural low-income (RL), urban low-income (UL) and urban high-income (UH) settings; and (ii) test for associations between sleep parameters and body mass index (BMI). Methods Participants were preschoolers (5.2 ± 0.7y, 49.5% boys) from RL (n = 111), UL (n = 65) and UH (n = 22) settings. Height and weight were measured. Sleep, sedentary behaviour and physical activity were assessed using accelerometery. Results UL children had higher BMI z-scores (median: 0.39; interquartile range: − 0.27, 0.99) than the UH (− 0.38; − 0.88, 0.11) and RL (− 0.08; − 0.83, 0.53) children (p = 0.001). The UL children had later bedtimes (p < 0.001) and wake-up times (p < 0.001) and shorter 24 h (p < 0.001) and nocturnal (p < 0.001) sleep durations than the RL and UH children. After adjusting for age, sex, setting, SB and PA, for every hour less sleep obtained (24 h and nocturnal), children were 2.28 (95% CI: 1.28–4.35) and 2.22 (95% CI: 1.27–3.85) more likely, respectively, to belong to a higher BMI z-score quartile. Conclusions Shorter sleep is associated with a higher BMI z-score in South African preschoolers, despite high levels of PA, with UL children appearing to be particularly vulnerable

Steps that count: Pedometer-measured physical activity, self-reported physical activity and current physical guidelines ‒ how do they relate?

Background. The association between self-perceived and actual physical activity, with particular reference to physical activity guidelines, may be an important factor in determining the extent of uptake of and compliance with physical activity.Objectives. To examine the association between self-perceived and actual physical activity in relation to physical activity guidelines, with reference to volume, intensity and duration of steps/day, and to establish the level of agreement between pedometer-measured and selfreported ambulatory physical activity, in relation to current guidelines.Methods. A convenience sample of adults (N=312; mean (standard deviation) age 37 (9) years), wore a pedometer (minimum 3 consecutive days) and completed a questionnaire that included information on physical activity patterns. Analyses of covariance, adjusted for age and gender, compared volume- and intensity-based steps according to meeting/not meeting guidelines (self-reported). The extent of agreement between self-reported and pedometer-measured physical activity was also determined.Results. Average (SD) steps/day were 6 574 (3 541). Of a total of 312 participants’ self-reported data, those meeting guidelines (n=63) accumulated significantly more steps/day than those not meeting guidelines (8 753 (4 251) v. 6 022 (3 114) total steps/day and 1 772 (2 020) v. 421 (1 140) aerobic steps/day, respectively; p&lt;0.0001). More than half of the group who self-reported meeting the guidelines did not meet guidelines as per pedometer data.Conclusion. The use of pedometers as an alternative and/or adjunct to self-reported measures is an area for consideration. Steps/day recommendations that consider intensity-based steps may provide significant effects in improving fitness and health

Self-Reported Physical Activity in Middle-Aged and Older Adults in Rural South Africa: Levels and Correlates

Little is known about physical activity (PA) levels and correlates in adults from rural settings in South Africa, where a rapid increase in the number of older people and marked disparities in wealth are evident, particularly between those living in rural and urban areas. This paper describes levels of self-reported PA in rural South African men and women and examines factors associated with meeting PA guidelines. Global Physical Activity Questionnaire (GPAQ) data from the Health and Aging in Africa: Longitudinal studies of INDEPTH communities (HAALSI) survey of 5059 adults aged over 40 years were assessed. Logistic regression analyses were used to assess socio-demographic, functional and cognitive capacity, and chronic disease measures associated with PA. In addition, 75.4% (n = 3421) of the participants with valid GPAQ data (n = 4538 of 5059) met the PA guidelines. Factors associated with not the meeting PA guidelines were being male, over the age of 80 years, being in a higher wealth category, obesity, and poorer functional capacity. These findings highlight worthwhile targets for future interventions to maintain or improve PA levels in this population and suggest that intervening earlier within this age range (from 40 years) may be crucial to prevent the ‘spiral of decline’ that characterizes the frailty syndrome