Measuring physical activity-related environmental factors: reliability and predictive validity of the European environmental questionnaire ALPHA

BACKGROUND: A questionnaire to assess physical activity related environmental factors in the European population (a 49-item and an 11-item version) was created as part of the framework of the EU-funded project "Instruments for Assessing Levels of PHysical Activity and fitness (ALPHA)". This paper reports on the development and assessment of the questionnaire's test-retest stability, predictive validity, and applicability to European adults. METHODS: The first pilot test was conducted in Belgium, France and the UK. In total 190 adults completed both forms of the ALPHA questionnaire twice with a one-week interval. Physical activity was concurrently measured (i) by administration of the long version of the International Physical Activity Questionnaire (IPAQ) by interview and (ii) by accelerometry (Actigraph device). After adaptations, the second field test took place in Belgium, the UK and Austria; 166 adults completed the adapted questionnaire at two time points, with minimum one-week interval. In both field studies intraclass correlation coefficients (ICC) and proportion of agreement were computed to assess the stability of the two test scores. Predictive validity was examined in the first field test by correlating the results of the questionnaires with physical activity data from accelerometry and long IPAQ-last 7 days. RESULTS: The reliability scores of the ALPHA questionnaire were moderate-to good in the first field testing (ICC range 0.66 - 0.86) and good in the second field testing (ICC range 0.71 - 0.87). The proportion of agreement for the ALPHA short increased significantly from the first (range 50 - 83%) to the second field testing (range 85 - 95%). Environmental scales from both versions of the ALPHA questionnaire were significantly associated with self-reported minutes of transport-related walking, and objectively measured low intensity physical activity levels, particularly in women. Both versions were easily administered with an average completion time of six minutes for the 49-item version and less than two minutes for the short version. CONCLUSION: The ALPHA questionnaire is an instrument to measure environmental perceptions in relation to physical activity. It appears to have good reliability and predictive validity. The questionnaire is now available to other researchers to investigate its usefulness and applicability across Europe

Health benefits of different sports:A systematic review and meta-analysis of longitudinal and intervention studies Including 2.6 million adult participants

Background Several reviews have examined the health benefits of participation in specific sports, such as baseball,cricket, cross-country skiing, cycling, downhill skiing, football, golf, judo, rugby, running and swimming. However, newprimary studies on the topic have recently been published, and the respective meta-analytic evidence needs to beupdated.Objectives To systematically review, summarise and appraise evidence on physical health benefits of participationin different recreational sports.Methods Searches for journal articles were conducted in PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, SportsMedicine & Education Index and Web of Science. We included longitudinal and intervention studies investigatingphysical health outcomes associated with participation in a given sport among generally healthy adultswithout disability.Results A total of 136 papers from 76 studies conducted among 2.6 million participants were included in the review.Our meta-analyses of available evidence found that: (1) cycling reduces the risk of coronary heart disease by 16%(pooled hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.80, 0.89), all-cause mortality by 21% (HR = 0.79; 95% CI:0.73, 0.84), cancer mortality by 10% (HR = 0.90; 95% CI: 0.85, 0.96) and cardiovascular mortality by 20% (HR = 0.80; 95%CI: 0.74, 0.86); (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure,cardiovascular function at rest, cardiorespiratory fitness and bone strength (p < 0.050); (3) handball has favourableeffects on body composition and cardiorespiratory fitness (p < 0.050); (4) running reduces the risk of all-causemortality by 23% (HR = 0.77; 95% CI: 0.70, 0.85), cancer mortality by 20% (HR = 0.80; 95% CI: 0.72, 0.89) and cardiovascularmortality by 27% (HR = 0.73; 95% CI: 0.57, 0.94) and improves body composition, cardiovascular function at restand cardiorespiratory fitness (p < 0.010); and (5) swimming reduces the risk of all-cause mortality by 24% (HR = 0.76;95% CI: 0.63, 0.92) and improves body composition and blood lipids (p < 0.010).ConclusionsA range of physical health benefits are associated with participation in recreational cycling, football, handball, running and swimming. More studies are needed to enable meta-analyses of health benefits of participation in other sports.PROSPERO registration number CRD42021234839

Associations of specific types of sports and exercise with all-cause and cardiovascular-disease mortality:A cohort study of 80,306 British adults

Background/Aim Evidence for the long-term health effects of specific sport disciplines is scarce. Therefore, we examined the associations of six different types of sport/exercise with all-cause and cardiovascular disease (CVD) mortality risk in a large pooled Scottish and English population-based cohort. Methods Cox proportional hazards regression was used to investigate the associations between each exposure and all-cause and CVD mortality with adjustment for potential confounders in 80 306 individuals (54% women; mean±SD age: 52±14 years). Results Significant reductions in all-cause mortality were observed for participation in cycling (HR=0.85, 95% CI 0.76 to 0.95), swimming (HR=0.72, 95% CI 0.65 to 0.80), racquet sports (HR=0.53, 95% CI 0.40 to 0.69) and aerobics (HR=0.73, 95% CI 0.63 to 0.85). No significant associations were found for participation in football and running. A significant reduction in CVD mortality was observed for participation in swimming (HR=0.59, 95% CI 0.46 to 0.75), racquet sports (HR=0.44, 95% CI 0.24 to 0.83) and aerobics (HR=0.64, 95% CI 0.45 to 0.92), but there were no significant associations for cycling, running and football. Variable dose–response patterns between the exposure and the outcomes were found across the sport disciplines. Conclusions These findings demonstrate that participation in specific sports may have significant benefits for public health. Future research should aim to further strengthen the sport-specific epidemiological evidence base and understanding of how to promote greater sports participation

Status and Trends of Physical Activity Surveillance, Policy, and Research in 164 Countries: Findings From the Global Observatory for Physical Activity—GoPA! 2015 and 2020 Surveys

Background: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. Methods: We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. Results: The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world’s population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world’s population live in countries where PA promotion capacity should be significantly improved. Conclusion: Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion

The Toronto Charter for Physical Activity (Die Toronto-Charta fur Bewegung)

The World Health Organization and other international health promotion organisations and agencies have recognised physical inactivity as a major health risk factor. However, physical inactivity still receives less attention than other risk factors for non-communicable diseases (e.g. tobacco use, unhealthy diets and overweight). Therefore, in 2009 the Council for Global Advocacy for Physical Activity (GAPA) of the International Society for Physical Activity and Health (ISPAH) initiated the development of the first Charter for Physical Activity as a global call for action. The Charter was presented at the International Congress on Physical Activity and Public Health in Toronto, Canada, in May 2010. A strategic implementation of the Charter fosters intersectoral collaboration and can significantly contribute to increasing the prevalence of a population-wide active lifestyle

Objectively measured walkability and active transport and weight-related outcomes in adults: a systematic review

The aim of this study was to investigate which GIS-based measures of walkability (density, land-use mix, connectivity and walkability indexes) in urban and suburban neighbourhoods are used in research and which of them are consistently associated with walking and cycling for transport, overall active transportation and weight-related measures in adults. A systematic review of English publications using PubMed, Science Direct, Active Living Research Literature Database, the Transportation Research Information Service and reference lists was conducted. The search terms utilised were synonyms for GIS in combination with synonyms for the outcomes. Thirty-four publications based on 19 different studies were eligible. Walkability measures such as gross population density, intersection density and walkability indexes most consistently correlated with measures of physical activity for transport. Results on weight-related measures were inconsistent. More research is needed to determine whether walkability is an appropriate measure for predicting weight-related measures and overall active transportation. As most of the consistent correlates, gross population density, intersection density and the walkability indexes have the potential to be used in planning and monitoring

Epidemiology of cycling for exercise, recreation or sport in Australia and its contribution to health-enhancing physical activity

Objectives - To provide population estimates and explore trends for recreational cycling by subgroups, and to understand the contribution of recreational cycling to meeting the physical activity guidelines among Australian adults. Design - Repeated cross sectional population surveys. Methods - Data from the Exercise, Recreational and Sport Survey (ERASS) for the years 2001–2009 were used. Approximately 13,000 Australian adults (≥15 years) were interviewed each year across all seasons. Data include frequency of cycling during the previous 12 months and average duration of a cycling session, asked since 2005. Three thresholds for meeting the physical activity guidelines were considered using the separate categories: achieving >150 min, >300 min, and 5 sessions of 30 min cycling per week. Results - The pooled prevalence of recreational cycling was 10%. Employed middle-aged men with tertiary education reported the highest prevalence of recreational cycling. An increase in cycling was observed over time, mainly attributed to an increase in “irregular” cycling (<1/week). Among all cyclists a third met the physical activity guidelines of 150 min/week, and less than 20% met the guidelines of 300 min/week or 5 sessions of 30 min/week, respectively. Although a small group, almost two thirds of those participating in organised or partly organised recreational cycling met the guidelines. Conclusions - Recreational cycling is a plausible way to accumulate sufficient health-enhancing physical activity. The majority of recreational cyclists do not cycle in organised rides. Targeted efforts are needed to exploit the full potential of recreational cycling for public health

A European perspective on GIS-based walkability and active modes of transport

BACKGROUND: The association between GIS-based walkability and walking for transport is considered to be well established in USA and in Australia. Research on the association between walkability and cycling for transport in European cities is lacking. The aim of this study was to test the predictive validity of established walkability measures and to explore alternative walkability measures associated with walking and cycling for transport in a European context. METHODS: Outcome data were derived from the representative cross-sectional survey (n = 843) 'Radfreundliche Stadt' of adults in the city of Graz (Austria). GIS-based walkability was measured using both established measures (e.g. gross population density, household unit density, entropy index, three-way intersection density, IPEN walkability index) and alternative measures (e.g. proportion of mixed land use, four-way intersection density, Graz walkability index). ANCOVAs were conducted to examine the adjusted association between walkability measures and outcomes. RESULTS: Household unit density, proportion of mixed land use, three-way intersection density and IPEN walkability index were positively associated with walking for transport, but the other measures were not. All walkability measures were positively associated with cycling for transport. CONCLUSION: The established walkability measures were applicable to a European city such as Graz. The alternative walkability measures performed well in a European context. Due to measurement issues the association between these walkability measures and walking for transport needs to be investigated further