The impact of retirement on physical activity

Most adults do not achieve the levels of physical activity currently recommended for a healthy lifestyle. Population surveys suggest that there is a linear decline of activity levels with age, yet physical activity has many health benefits for older adults. If these are to be more widely adopted among older people, health policy and promotion require an understanding of the factors that influence decreasing activity with age. This study examined the patterns of physical activity of 699 participants in the West of Scotland Twenty-07 Study who were aged 60 years when interviewed in 1991 and followed up four to five years later. It examined the factors that influenced whether or not the subjects achieved currently recommended levels of activity, by applying random effects models with a seasonal adjustment. It was found that higher levels of physical activity associated with a healthier lifestyle, and that socio-economic factors played a minor role in determining the level of physical activity. A substantial amount of physical activity occurred at work but was lost by those who had retired, for while those who were not working were more physically active at home or at leisure than those in work, the majority of the sample did too little physical activity outside work to compensate for the loss of work-based activity. One conclusion is that health promotion initiatives that encourage people to become more physically active should be targeted at those who are about to retire

Using Organisational Cultural Theory to understand workplace interventions to reduce sedentary time

Sedentary behaviour has been shown to have a negative impact on health. As such, prolonged sitting in the workplace is being increasingly seen as a public health problem. Multi-component interventions to reduce sedentary time at work are being used as a way of addressing the different environmental, personal and organisational influences on sedentary behaviour. The role of the organisational context on behaviour has rarely been explored in depth or theorised in the sedentary workplace behaviour literature yet a rich body of theory and evidence exists outside the field. The current article applies an organisational cultural framework for exploring how organisational factors and dynamics impact on sedentary behaviour in the workplace. Empirical data are taken from a qualitative study of office workers’ responses to a ‘sit less’ initiative. Thirteen in-depth interviews and documentary analysis were conducted to help elucidate the ways in which organisational assumptions, strategy, structures, activities, operations, actions and norms combine to constrain reduced sitting time at work. The article offers a theoretical approach to understanding how organisational culture can influence interventions aimed at encouraging people to sit less in the workplace. It also offers an opportunity to consider how intervention design can better account for the ‘whole systems’ of an organisation and how ‘sit less’ initiatives can be positioned within them

Evaluating health effects of transport interventions: methodologic case study

Background: There is little evidence about the effects of environmental interventions on population levels of physical activity. Major transport projects may promote or discourage physical activity in the form of walking and cycling, but researching the health effects of such “natural experiments” in transport policy or infrastructure is challenging. Methods: Case study of attempts in 2004–2005 to evaluate the effects of two major transport projects in Scotland: an urban congestion charging scheme in Edinburgh, and a new urban motorway (freeway) in Glasgow. Results: These interventions are typical of many major transport projects. They are unique to their context. They cannot easily be separated from the other components of the wider policies within which they occur. When, where, and how they are implemented are political decisions over which researchers have no control. Baseline data collection required for longitudinal studies may need to be planned before the intervention is certain to take place. There is no simple way of defining a population or area exposed to the intervention or of defining control groups. Changes in quantitative measures of health-related behavior may be difficult to detect. Conclusions: Major transport projects have clear potential to influence population health, but it is difficult to define the interventions, categorize exposure, or measure outcomes in ways that are likely to be seen as credible in the field of public health intervention research. A final study design is proposed in which multiple methods and spatial levels of analysis are combined in a longitudinal quasi-experimental study

Perceived characteristics of the environment associated with active travel: development and testing of a new scale

Background Environmental characteristics may be associated with patterns of physical activity. However, the development of instruments to measure perceived characteristics of the local environment is still at a comparatively early stage, and published instruments are not necessarily suitable for application in all settings. We therefore developed and established the test-retest reliability of a new scale for use in a study of the correlates of active travel and overall physical activity in deprived urban neighbourhoods in Glasgow, Scotland. Methods We developed and piloted a 14-item scale based on seven constructs identified from the literature (aesthetics, green space, access to amenities, convenience of routes, traffic, road safety and personal safety). We administered the scale to all participants in a random postal survey (n = 1322) and readministered the scale to a subset of original respondents (n = 125) six months later. We used principal components analysis and Varimax rotation to identify three principal components (factors) and derived summary scores for subscales based on these factors. We examined the internal consistency of these subscales using Cronbach's alpha and examined the test-retest reliability of the individual items, the subscale summary scores and an overall summary neighbourhood score using a combination of correlation coefficients and Cohen's kappa with and without weighting. Results Public transport and proximity to shops were the items most likely to be rated positively, whereas traffic volume, traffic noise and road safety for cyclists were most likely to be rated negatively. Three principal components – 'safe and pleasant surroundings', 'low traffic' and 'convenience for walking' – together explained 45% of the total variance. The test-retest reliability of individual items was comparable with that of items in other published scales (intraclass correlation coefficients (ICCs) 0.34–0.70; weighted Cohen's kappa 0.24–0.59). The overall summary neighbourhood score had acceptable internal consistency (Cronbach's alpha 0.72) and test-retest reliability (ICC 0.73). Conclusion This new scale contributes to the development of a growing set of tools for investigating the role of perceived environmental characteristics in explaining or mediating patterns of active travel and physical activity

Recruiting hard-to-reach populations to physical activity studies : evidence and experiences

Most researchers who are conducting research with a public health focus face difficulties in recruiting the segments of the population that they really want to reach. This symposium presented evidence and experiences on recruiting participants to physical activity research, including both epidemiological and intervention based studies. Results from a systematic review of recruitment strategies suggested that we know little about how best to recruit and highlighted the need for researchers to report this in more detail, including metrics of reach into the target population such as number, proportion, and representativeness of participants. Specific strategies used to optimise responses to a population-based mail survey were presented such as study promotion, survey design, multiple mailings, and personal engagement. Finally, using place based recruiting via schools or places of worship to target ethnic minority youth were discussed. Overall the symposium presenters suggested that we need to learn more about how best to recruit participants, in particular those typically under-represented, and that researchers need to apportion a similar amount of planning effort to their recruitment strategies as they do the their research design. Finally we made a plea for researchers to report their recruitment processes in detail

Do pedometers motivate people to walk more?

Physical activity confers many important health benefits. The 'active living message' recommends that adults should accumulate 30 ruin of moderate-intensity physical activity (e.g. brisk walking) on most--preferably all--days of the week, but the populations of most developed countries are not meeting this target. Walking is one mode of activity that most people can do without skills, equipment, facilities or extra expense and walking has less bias in terms of age, sex and social class than facility-based exercise. Thus we need to investigate interventions that promote walking

Where is the Theoretical Basis for Understanding and Measuring the Environment for Physical Activity?

Researchers are beginning to explore environmental correlates to further the field of physical activity research. Before interventions and experimental investigations can be undertaken, it is necessary to identify specific environmental features that are consistent correlates of physical activity. There has been a plethora of research measuring such cross-sectional associations since this field came to the fore in 2003. This paper posits that it is time for researchers to evaluate the state of knowledge, and suggests that future developments in this field focus on the theoretical bases for (i) measurement of the environment and (ii) understanding the links between perceptions of the environment and behaviour through psychological theories of cognition. Key theories considered include social ecology and the theory of planned behaviour. It is suggested that with a continued absence of a common conceptual framework, vocabulary and measurement tools the majority of studies may remain at a correlates stage. In highlighting issues with current methodologies, this commentary encourages more grounded theoretical approaches to the study of the environment and physical activity

Effect of exercise referral schemes in primary care on physical activity and improving health outcomes: Systematic review and meta-analysis

This is an open access article - Copyright @ 2011 BMJObjective: To assess the impact of exercise referral schemes on physical activity and health outcomes. Design: Systematic review and meta-analysis. Data sources Medline, Embase, PsycINFO, Cochrane Library, ISI Web of Science, SPORTDiscus, and ongoing trial registries up to October 2009. We also checked study references. Study selection Design: randomised controlled trials or non-randomised controlled (cluster or individual) studies published in peer review journals. Population: sedentary individuals with or without medical diagnosis. Exercise referral schemes defined as: clear referrals by primary care professionals to third party service providers to increase physical activity or exercise, physical activity or exercise programmes tailored to individuals, and initial assessment and monitoring throughout programmes. Comparators: usual care, no intervention, or alternative exercise referral schemes. Results Eight randomised controlled trials met the inclusion criteria, comparing exercise referral schemes with usual care (six trials), alternative physical activity intervention (two), and an exercise referral scheme plus a self determination theory intervention (one). Compared with usual care, follow-up data for exercise referral schemes showed an increased number of participants who achieved 90-150 minutes of physical activity of at least moderate intensity per week (pooled relative risk 1.16, 95% confidence intervals 1.03 to 1.30) and a reduced level of depression (pooled standardised mean difference −0.82, −1.28 to −0.35). Evidence of a between group difference in physical activity of moderate or vigorous intensity or in other health outcomes was inconsistent at follow-up. We did not find any difference in outcomes between exercise referral schemes and the other two comparator groups. None of the included trials separately reported outcomes in individuals with specific medical diagnoses. Substantial heterogeneity in the quality and nature of the exercise referral schemes across studies might have contributed to the inconsistency in outcome findings. Conclusions Considerable uncertainty remains as to the effectiveness of exercise referral schemes for increasing physical activity, fitness, or health indicators, or whether they are an efficient use of resources for sedentary people with or without a medical diagnosis.This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme (project number 08/72/01) (www.hta.ac.uk/)