Perceptions of Technology Use and Its Effects on Student Writing

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Physical Activity Surveillance Through Smartphone Apps and Wearable Trackers: Examining the UK Potential for Nationally Representative Sampling.

BACKGROUND: Smartphones and wearable activity trackers present opportunities for large-scale physical activity (PA) surveillance that overcome some limitations of questionnaires or researcher-administered devices. However, it remains unknown whether current users of such technologies are representative of the UK population. OBJECTIVE: The objective of this study was to investigate potential sociodemographic biases in individuals using, or with the potential to use, smartphone apps or wearable activity trackers for PA surveillance in the United Kingdom. METHODS: We used data of adults (aged ≥16 years) from two nationally representative surveys. Using the UK-wide 2018 Ofcom Technology Tracker (unweighted N=3688), we derived mutually adjusted odds ratios (ORs; 95% CI) of personal use or household ownership of a smartwatch or fitness tracker and personal use of a smartphone by age, sex, social grade, activity- or work-limiting disability, urban or rural, and home nation. Using the 2016 Health Survey for England (unweighted N=4539), we derived mutually adjusted ORs of the use of wearable trackers or websites or smartphone apps for weight management. The explanatory variables were age, sex, PA, deprivation, and body mass index (BMI). Furthermore, we stratified these analyses by BMI, as these questions were asked in the context of weight management. RESULTS: Smartphone use was the most prevalent of all technology outcomes, with 79.01% (weighted 2085/2639) of the Technology Tracker sample responding affirmatively. All other outcomes were <30% prevalent. Age ≥65 years was the strongest inverse correlate of all outcomes (eg, OR 0.03, 95% CI 0.02-0.05 for smartphone use compared with those aged 16-44 years). In addition, lower social grade and activity- or work-limiting disability were inversely associated with all Technology Tracker outcomes. Physical inactivity and male sex were inversely associated with both outcomes assessed in the Health Survey for England; higher levels of deprivation were only inversely associated with websites or phone apps used for weight management. The conclusions did not differ meaningfully in the BMI-stratified analyses, except for deprivation that showed stronger inverse associations with website or phone app use in the obese. CONCLUSIONS: The sole use of PA data from wearable trackers or smartphone apps for UK national surveillance is premature, as those using these technologies are more active, younger, and more affluent than those who do not

Analysis of Scottish health survey data to inform Scottish physical activity and sedentary behaviour policy and surveillance

In 2011, the United Kingdom (U.K.) physical activity (PA) guidelines were updated. The adult moderate-to-vigorous intensity PA (MVPA) recommendation changed to reflect that different frequency and intensity permutations lead to equivalent health benefits. New recommendations were added for muscle strengthening activities (MSA) and the reduction of sedentary time (ST). Those over 65 years were also recommended to undertake balance and co-ordination activities (BCA). Despite these new additions, Scottish PA policy still concentrated on MVPA, with considerable resources allocated to sport and some exercise activities. Since 2012, the Scottish Health Survey (SHeS) has collected data relating to these new recommendations annually, but few analyses have been undertaken. This thesis contains the most comprehensive analyses of the 2012-15 SHeS PA and ST data to date, and a review into whether the method produces valid and reliable estimates. The aim of this thesis was to inform Scottish PA and sedentary behaviour policy by producing research to support the incorporation of these new recommendations and the promotion of non-sport-related MVPA policies. It also aimed to inform any future developments to PA and ST surveillance in Scotland. The first three studies of this thesis are cross-sectional analyses of the updated recommendations for adults in Scotland. They present prevalence and participation data in specific domains, activities, and behaviours by age and sex. The main findings were that (1) sport was a minority contributor to the total MVPA of adults in Scotland, regardless of sex, age, or activity status (never more than 20%), (2) compliance with the MSA recommendation was approximately half that of the MVPA recommendation (31% of men and 24% of women), and compliance with the BCA recommendation amongst those over 65 years was very low (19% of older men and 12% of older women), and (3) middle-aged adults in work reported a comparable amount of weekday ST to adults over 75 years (7-8 hours per day). The fourth study was a review of the available evidence into whether the PA and ST estimates produced by the 2012-15 SHeS were valid and reliable. The SHeS was found to be fit for purpose, but recommendations were made regarding the analysis and interpretation of the data to minimise areas of concern. These were (1) analyse MVPA data with and without the domain of occupational MVPA, (2) make it clear that only sport and exercise activities can contribute to achieving the MSA and BCA recommendations under the SHeS method, and (3) focus on the comparisons between groups in relation to ST, rather than on the absolute values. The fifth study used the findings from the previous four to inform the design of a prospective cohort study that will investigate the joint effects of MVPA and total ST on all-cause mortality, cardiovascular disease, cancer, and diabetes. This thesis contains the results of the preliminary analyses. This study is designed to inform policy by providing novel information on how the combination of these behaviours affects health outcomes in a representative sample of Scottish adults. There is clear evidence that this work has already informed policy and surveillance. The work on the relative contribution of the domains of MVPA is regularly cited in evidence briefings for the Scottish Government and the Scottish Parliament. This has increased the awareness amongst key policy-makers that sport is not a major contributor to the total MVPA of adults in Scotland. The work on MSA, BCA, and ST was a catalyst for a proposal to include indicators relating to these recommendations on the national PA monitoring framework. The work on MSA and BCA has also been a key reference text in preparation for the next update to the U.K. PA guidelines, stressing the need to consider surveillance at an early stage. In summary, the novel analyses of SHeS data undertaken for this thesis have demonstrably informed PA and sedentary behaviour policy and surveillance in Scotland

The forgotten guidelines: cross-sectional analysis of participation in muscle strengthening and balance & co-ordination activities by adults and older adults in Scotland.

BACKGROUND: In 2011, the UK physical activity guidelines were updated to include recommendations for muscle strengthening and balance & coordination (at least two sessions of relevant activities per week). However, monitoring and policy efforts remain focussed on aerobic activity. This study aimed to assess differences by gender and age in the a) prevalence of muscle strengthening and balance & co-ordination guidelines, and b) participation in guideline-specific activities. METHODS: The sample for the muscle strengthening analyses was 10,488 adult (16-64 years) and 3857 older adult (≥65 years) 2012-2014 Scottish Health Survey respondents. The balance & co-ordination analyses used only the older adult responses. Differences by gender and (where possible) age in guideline prevalence and activity participation were assessed using logistic regression and t-tests. RESULTS: Thirty-one percent of men and 24 % of women met the muscle strengthening guideline, approximately half that of published figures for aerobic physical activity. Nineteen percent of older men and 12 % of older women met the balance & co-ordination guidelines. The oldest age groups were less likely to meet both guidelines compared to the youngest age groups. Differences by gender were only evident for muscle strengthening: more men met the guidelines than women in all age groups, with the largest difference amongst 16-24 year olds (55 % men compared with 40 % women). Participation in relevant activities differed by gender for both guidelines. 'Workout at gym' was the most popular activity to improve muscle strength for men (18 % participated), while swimming was for women (15 % participated). Golf was the most popular activity to improve balance & co-ordination for older men (11 % participated) and aerobics was for older women (6 % participated). Participation decreased in most muscle strengthening activities for both men and women. One exception was golf, where participation levels were as high amongst older men as in younger age groups, although overall levels were low (3 % of all men). CONCLUSIONS: Physical activity policy should aim to increase prevalence of these 'forgotten' guidelines, particularly amongst young women (for muscle strengthening) and older age groups (both guidelines). Gender and age participation differences should be considered when designing population-level interventions

Age-related comparisons by sex in the domains of aerobic physical activity for adults in Scotland.

OBJECTIVE: To investigate the age-related differences in the contributions of the domains of physical activity (PA) for men and women in Scotland who met the current PA guidelines or who were insufficiently active. METHODS: We analysed data from the 2013 Scottish Health Survey (4885 adults (≥ 16 years)). Average weekly minutes of moderate or vigorous PA (MVPA) and the relative contributions to total MVPA were calculated for the domains of: walking, cycling, domestic, leisure, occupational, outdoor, non-team sport, team sport, and exercise & fitness. We performed linear regression analyses to assess differences by 10-year age group, stratified by sex and activity status (1-149 or ≥ 150 min of MVPA per week). These were repeated excluding occupational activity due to concerns with its measurement. RESULTS: For the 64.3% of the sample that met the guidelines, occupational activity was the most prevalent domain accounting for 18-26% of all MVPA for those under 65 years. When excluded, there was no age-related decline in total MVPA (p > 0.05). For the 18.6% of the sample that reported 1-149 min of MVPA per week, domestic activity was the most prevalent domain. Across both sexes and activity statuses, exercise & fitness declined with age and walking was most prevalent in the oldest age group. CONCLUSION: The domains in which adults in Scotland undertake MVPA vary by age group. Policies designed to increase PA should take this into account. Our findings challenge current thinking on age-related changes in activity, with the exclusion of occupational activity mitigating any age-related decline in MVPA.University of Edinburgh College Research Awar

Is occupational physical activity associated with mortality in UK Biobank?

BackgroundCurrent physical activity guidelines do not distinguish between activity accumulated in different behavioural domains but some studies suggest that occupational physical activity (OPA) may not confer health benefits and could even be detrimental. The purpose of this study was to investigate associations between OPA and mortality outcomes.MethodsFrom baseline (2006-2010), 460,901 UK Biobank participants (aged 40-69 years) were followed for a median 12.0 (IQR: 11.3-12.7) years. OPA was categorised by cross-tabulating degree of manual work and walking/standing work amongst those in paid employment (n = 267,765), and combined with categories of occupational status for those not in paid employment (n = 193,136). Cox proportional hazards models were used to estimate sex-stratified hazard ratios (HR) and 95% confidence intervals (CI) for mortality from all causes, CVD, and cancer by occupational group, and for working hours/week and non-occupational physical activity stratified by occupational group. Models included adjustment for age and a range of lifestyle, socio-economic and health-related covariates.ResultsDuring 5,449,989 person-years of follow-up, 28,740 deaths occurred. Compared to those reporting no heavy manual or walking/standing work (e.g. sedentary office workers) and adjusting for covariates, retirement was associated with lower mortality in women (HR = 0.62, CI: 0.53-0.72) and men (HR = 0.80, CI: 0.71-0.90), whereas unemployment was associated with higher mortality in men only (HR = 1.24, CI: 1.07-1.45). Within the working population, there was no evidence of differences in all-cause, CVD or cancer mortality by OPA group when comparing those reporting higher levels of OPA to the lowest OPA reference group for both women and men. Working ConclusionsJobs classified as higher levels of OPA may not be as active as reported, or the types of physical activity performed in those jobs are not health-enhancing. Irrespective of OPA category or employment status, non-occupational physical activity appears to provide health benefits