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This study examined the effects of a combined virtual-reality- and gym-based physical activity (PA) program on PA levels, motor skills, and social skills of children with a developmental disability (DD). Twenty-five children with DD were randomly assigned to experimental and control groups. The intervention was conducted for 60 min, two times a week, for 12 weeks. Pre- and postintervention assessments encompassing PA levels measured via Gravity Estimator of Normal Everyday Activity, motor skills evaluated using the Test of Gross Motor Development-Third Edition, and social skills gauged via the Social Skills Rating System-Parent were conducted. Additionally, a follow-up assessment was administered to the experimental group 12 weeks postintervention. The findings unequivocally demonstrate that the combined virtual-reality- and gym-based PA program yielded significant enhancements in PA levels, motor skills, and social skills among children with DD in the experimental group. Notably, these improvements were sustained 12 weeks after the intervention. These findings may help professionals develop and implement better PA programs for children with DD. [ABSTRACT FROM AUTHOR]

Background: Bicycling is a healthy form of physical activity that can be performed by most adults as part of leisure-time (LT) activity. However, little is known about LT bicycling behaviors, especially in the rural areas of the United States. This study sought to contrast the prevalence and factors associated with LT bicycling in populations living in urban settings with those living in rural settings. Methods: The 2019 Behavior Risk Factor Survey, which contains information regarding LT physical activity behaviors among adults (N = 396,261) in the United States, was used to determine the prevalence, demographic profile, and likelihood of meeting the physical activity guidelines of LT bicyclists. The 2013 National Center for Health Statistics Urban/Rural Classification Scheme was used to classify respondents living in rural and urban settings. Results: Among US adults, 3.8% (95% CI, 3.7–3.9) reported LT bicycling activity, the sixth most common physical activity. Adults living in urban counties compared with rural counties had a greater prevalence of LT bicycling (3.9% vs 2.3%, respectively), with adults living in rural counties having a 34% lower probability of LT bicycling. Rural bicycling prevalence rates were lower across all demographics. Urban bicyclists, compared with rural bicyclists, cycled more months of the year. Overall, 85.5% of all bicyclists met the aerobic physical guidelines, with no differences between urban and rural bicyclists. Conclusions: Bicycling remains an important LT physical activity among adults in the United States. However, a rural–urban difference in the prevalence does exist for LT bicycling. The reasons for this disparity warrant further investigation. [ABSTRACT FROM AUTHOR]

Background: Despite the existence of physical activity policies across many countries, insufficient physical activity remains a major global public health problem. Physical inactivity is an emergent feature of complex systems; it results from a wide range of factors at multiple levels that interact to influence behavior. Traditional approaches to public policy often fail within complex systems, largely due to unpredictability in how the system will respond. Adaptive policies, which are designed to allow for uncertainty about future system behavior and to change over time, may offer a promising solution. In this paper, we introduce the concept of adaptive policies and illustrate how this innovative approach to policy making may be beneficial for reducing physical inactivity. Design: Drawing on existing literature and guiding principles for policy making, we provide 3 examples to illustrate how the concept of adaptive policies can be applied to address physical inactivity. Discussion: The examples illustrate how changes to the way policies and interventions are developed, implemented, and evaluated could help to overcome some of the limitations in existing practices. A key challenge will be engaging policymakers to take a broader perspective of the physical activity system, develop policies that are designed to be adaptable across a range of different future scenarios, and embrace uncertainty and long-term adaptability. Conclusion: Adaptive policies may support decision makers globally to achieve the widespread and sustained changes necessary to increase population levels of physical activity. [ABSTRACT FROM AUTHOR]

Increasing physical activity (PA) and/or decreasing sedentary behaviors is important in the delay and prevention of long-term conditions. PA can help maintain function and independence and decrease the need for hospitalization/institutionalization. Activity rates often decline in later life resulting in a need for interventions that encourage uptake and adherence through the use of Behavior Change Techniques (BCTs). We conducted a systematic review of the evidence for interventions that included BCTs in community-dwelling adults with a mean age of 50–70. The review followed PRISMA guidelines. The interventions were psychosocial, nonpharmacological, and noninvasive interventions utilizing components based on BCTs that evaluated change in PA and/or sedentary behavior. Intervention Component Analysis (ICA) was used to synthesize effectiveness of intervention components. Twelve randomized controlled trials were included in this review. The mean sample age was 50–64. Thirteen BCTs were used across all studies, and the most commonly used techniques were goals and planning, feedback and monitoring, and natural consequences. Seven intervention components linked with BCTs were found: personalized goal setting, tailored feedback from facilitators, on-site and postintervention support, education materials and resources, reinforcing change on behavior and attitudes, self-reported monitoring, and social connectedness. All components, except for social connectedness, were associated with improved health behavior and PA levels. The interventions that use BCTs have incorporated strategies that reinforce change in behavior and attitudes toward PA. [ABSTRACT FROM AUTHOR]

Research indicates a positive relationship between physical literacy and healthy aging; however, there is no consensus on the components required to become a physically literate adult. The objective of this study was to understand how physical literacy for adults with chronic conditions is characterized from the perspective of healthcare professionals. Physiotherapy leaders and physical literacy researchers within North America were invited to an online consensus panel and presented with questions related to physical literacy and rehabilitation. A nominal group technique was used for idea generation, clarification, and ranking. Confidence and safety with movements, motivation and commitment to physical activity, the ability to self-monitor changes in function, and understanding the benefits of physical activity were key components when defining physical literacy. There is a need to reconceptualize physical literacy to include the rehabilitation needs of adults living with chronic conditions, and to design programs that promote physical literacy to enhance function and mobility. [ABSTRACT FROM AUTHOR]

Over the last 4 decades, physical activity researchers have invested heavily in determining "what works" to promote healthy behaviors in schools. Single and multicomponent school-based interventions that target physical education, active transportation, and/or classroom activity breaks effectively increased physical activity among children and youth. Yet, few of these interventions are ever scaled-up and implemented under real-world conditions and in diverse populations. To achieve population-level health benefits, there is a need to design school-based health-promoting interventions for scalability and to consider key aspects of the scale-up process. In this opinion piece, we aim to identify challenges and advance knowledge and action toward scaling-up school-based physical activity interventions. We highlight the key roles of planning for scale-up at the outset, scale-up pathways, trust among partners and program support, program adaptation, evaluation of scale-up, and barriers and facilitators to scaling-up. We draw upon our experience scaling-up effective school-based interventions and provide a solid foundation from which others can work toward bridging the implementation-to-scale-up gap. [ABSTRACT FROM AUTHOR]

This study evaluated physical activity interventions designed for individuals with visual impairments and sought to guide health intervention scientists aiming to promote physical activity in this demographic. We delved into the specifics of participants' visual impairments, intervention features, accommodation approaches, and replicability prospects. The search spanned four databases, namely PubMed, CINAHL, SportDiscus, and Scopus, providing a wide scope and diversity of potential studies. There were no restrictions on publication years. We reviewed 13 studies, totaling 15 interventions. A consensus on visual-impairment definitions remains elusive, and the intervention dosages displayed variability. Notably, 66.7% (n = 7) integrated behavior-change techniques to amplify physical activity levels. Multiple studies employed audio descriptions as an accommodation method. While most studies provided adequate information for potential replication, detailed study protocols were frequently absent. It is essential for developed interventions to be persistently evaluated and fine-tuned to optimize results. [ABSTRACT FROM AUTHOR]

Dementia-friendly communities (DFCs) are a policy-endorsed approach to community engagement in England that promotes social inclusion to enable people affected by dementia to live well. Research suggests that physical activity is beneficial in encouraging social connection and improving health. A mixed method sequential study design in England involving a national survey (n = 31) and semistructured interviews (n = 65) in three DFCs was carried out. The aim was to understand how DFCs enable people affected by dementia to participate in physical activities. An evaluation framework for DFCs was used to organize and interpret the data, and analysis was informed by the inclusive (social) citizen lens. Findings showed that DFCs offered a range of adapted dementia-inclusive and dementia-specific activities; however, people were not routinely offered information at time of diagnosis. Local authorities (councils) were key to enable access to information and infrastructure change to support sustainable inclusion within their local community. [ABSTRACT FROM AUTHOR]

Background: Women with higher body mass index report low rates of and face unique barriers to exercise. Increasing exercise participation can improve mental and physical health independent of weight loss; however, most exercise programs targeting this population focus predominately on losing weight. This paper aims to describe the development of Fit&Fab, a community-based exercise intervention focused on increasing exercise participation and enjoyment for women with obesity. Methods: In partnership with the YMCA, we recruited women ages 35–64 years (body mass index ≥ 30) to participate in 4 focus groups to understand exercise preferences. Formative work was used to identify theory constructs and associated intervention components. Women from the focus groups were recruited for a community advisory board that finalized the intervention design, recruitment, and evaluation plan. Results: Focus groups participants (N = 29) preferred to exercise without men and wanted a cohort-style class that included women of similar exercise levels and body types, incorporated social support, fun activities, and broke exercise into smaller bouts. They wanted a supportive instructor who was fit but understood weight-related challenges. The community advisory board and research team used focus group findings to inform design of the final intervention including group exercise classes, psychosocial support sessions, personalized training, exercise tracking, outcome monitoring, and rewards. Conclusions: Our findings emphasize the need to focus on exercise enjoyment and benefits other than losing weight to improve exercise participation among women with higher body mass index. In addition to having outcomes other than weight loss, exercise interventions with this population should also consider group composition, instructor, and class format. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this systematic review is to reveal the social, personal, and contextual factors that influence physical activity (PA) in children and adolescents during and after cancer treatment. Method: SPORTDiscus, Cochrane, Web of Science, PubMed, and FIS Education electronic database were systematically searched. Results: The 13 included studies show that social support (parents, siblings, and friends) in particular is rated as important by cancer survivors; for example, doing PA together. Depending on the treatment status and state of health, particularities arise. During the acute treatment phase, parents issued more prohibitions regarding PA than after treatment. The state of health and concern about infections are described as inhibiting factors. Not all hospitals generally offer special exercise programs for cancer patients, and in some cases, only sporadic exercise sessions were conducted by specialized staff. In addition, the hospital atmosphere, such as cramped rooms, tends to be associated with demotivating effects. Conclusions: Both inhibiting and promoting factors in the area of social, personal, and contextual factors could be identified. The most fundamental factor for PA is the physical condition. Social factors, such as parents or friends, often have a motivating effect and can promote PA. Inhibiting factors are mainly context-related, such as an environment unsuitable for PA. Although the review highlights interesting aspects, further treatment-related and longitudinal studies could provide deeper insights. [ABSTRACT FROM AUTHOR]

Evidence is sparse on how community-based health-promoting programs can be culturally adapted for racially minoritized, immigrant older adult populations. Choose to Move (CTM) is an evidence-based health-promoting program that enhances physical activity and mobility and diminished social isolation and loneliness in older adults in British Columbia, Canada. However, racially minoritized older adults were not reached in initial offerings. We purposively sampled CTM delivery staff (n = 8) from three not-for-profit organizations, in Metro Vancouver, British Columbia, that serve Chinese older adults. We used semistructured interviews, ethnographic observations, and meeting minutes to understand delivery staff's perspectives on factors that influence CTM adaptations for Chinese older adults. Deductive framework analysis guided by an adaptation framework, Framework for Reporting Adaptations and Modifications-Enhanced, found three dominant cultural- and immigration-related factors influenced CTM adaptations for Chinese older adults: (a) prioritizations, (b) familiarity, and (c) literacy. Findings may influence future program development and delivery to meet the needs of racially minoritized older adult populations. [ABSTRACT FROM AUTHOR]

Many studies have shown that personalized exergames have a positive effect on promoting regular and proper exercise. However, there is no consensus on the design characteristics and evaluation of exergames. This systematic review of published research literature aimed to explore the general characteristics, personalization characteristics, and evaluation of personalized exergames for middle-aged and older people. We screened published studies in the Web of Science, Scopus, PubMed, ACM, and IEEE Xplore databases, extracted data, and performed a thematic analysis according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. Three main themes and nine subthemes were generated from 24 included papers. Moreover, a personalization model (FACTS) and evaluation system (PMSS) of exergames were developed. Personalized exergames had potential positive effects on motivating middle-aged and older people to exercise and improve their health, particularly physical, mental, and social health. However, more fine-grained studies on personalized exergames are necessary in the future. [ABSTRACT FROM AUTHOR]

The article discusses the importance of physical activity promotion by health professionals in increasing population physical activity levels. It highlights the World Health Organization's Global Action Plan on Physical Activity and the International Society for Physical Activity and Health's Eight investments that work for physical activity as key strategies. The article emphasizes the need to strengthen the training of health professionals to increase their knowledge and skills for promoting physical activity. It also provides physical activity guidelines for different populations and discusses the effectiveness of physical activity advice in various healthcare settings. The article proposes a continuum of physical activity advice that can be tailored to different time constraints and settings. Overall, the article emphasizes the role of all health professionals in promoting physical activity and the potential impact on population health. [Extracted from the article]

Youth with intellectual disabilities engage in low levels of physical activity (PA). An aim of this family-based weight-loss behavioral intervention (FBBI) trial was to increase and sustain PA in these youth. Accelerometry data were available from 21 individuals with intellectual disabilities, age 14–22 years. Each completed the 6-month FBBI, after which 10 completed a 6-month maintenance intervention (FBBI-M), and 11 received no further intervention (FBBI-C). Twenty participated in a further 6-month follow-up. Accelerometry data were analyzed using linear mixed models. During FBBI, mean (SE) moderate to vigorous PA increased by 4.1 (2.5) min/day and light PA by 24.2 (13.5) min/day. Mean (SE) difference in moderate to vigorous PA between participants in FBBI-M and FBBI-C at 18 months was 14.0 (5.1) min/day (p =.005); mean (SE) difference in light PA was 47.4 (27.4) min/day (p =.08). Increasing PA through behavioral intervention is possible in youth with intellectual disabilities. [ABSTRACT FROM AUTHOR]

Objectives: To assess the effect of Community Water Fluoridation (CWF) in the prevalence of dental caries and dental fluorosis in 12-year-old children living in Israel. Considering that CWF is important in the prevention of dental caries. Between 2002 and 2014, the water in communities of at least 5,000 individuals was fluoridated. In 2014, CWF in Israel stopped. Method and materials: Data on 12-year-old children from all areas in Israel from the national cross-sectional epidemiological survey conducted in 2011 to 2012 were stratified by city water fluoridation and by city and school socioeconomic status. Two dependent variables were defined: (1) DMFT index of caries experience in the permanent dentition; (2) dental fluorosis in central incisors using the Thylstrup-Fejerskov classification of fluorosis. Results: Data from 2,181 12-year-olds were analyzed. The average DMFT was 1.17 ± 1.72, and 49% were caries-free. Based on DMFT, the caries experience was significantly higher in nonfluoridated cities (1.38 vs 0.98 in fluoridated cities) and there were more caries-free children in fluoridated cities (56.4% vs 40.6% in nonfluoridated). DMFT was higher in cities with lower socioeconomic status than high socioeconomic status (1.29 vs 1.05, respectively, P < .001) and there were fewer caries-free children in low socioeconomic status cities (44.5% vs 53.0% in high socioeconomic status cities, P < .0001). Almost all the 10.3% of children with signs of fluorosis (scoring at least 1 in the Thylstrup-Fejerskov index), had questionable to mild fluorosis (9.3%). Conclusions: CWF is a cheap, simple method of dental health protection that reaches all socioeconomic levels, and cessation of water fluoridation reduced the health of Israel's children. Clinical significance: Water fluoridation provides substantial caries prevention, by reaching a substantial number of people. The relevance of this work is for policymakers to consider CWF as clinically proven method for reducing health inequalities. [ABSTRACT FROM AUTHOR]

Background: Investigating the effects of breaking up sedentary behavior with short bouts of Yoga and Tai-Chi on glycemic control, concentration, and well-being in healthy individuals. Methods: In this randomized balanced incomplete block study, 15 adults (age = 26 [2.50] y, 8 females) completed 2 of 3 protocols: uninterrupted sitting (Control), sitting interrupted with 3 minutes of Yoga every 30 minutes, or with 3 minutes of Tai-Chi every 30 minutes. Protocols lasted 7.5 hours and included a standardized diet. Glucose was measured every 30 minutes with a glucometer (Abbott FreeStyle Libre). Concentration and well-being were recorded with self-reported ecological momentary assessment. Area under the curve was calculated for glucose data. Statistical analyses were performed as a hierarchical repeated-measures model. Results: Glucose area under the curve for the Yoga intervention (34.55 [3.12] mmol/L) was significantly lower than the Control (38.14 [3.18] mmol/L; P <.05). There was a trend toward lower glucose in the Tai-Chi group compared with the Control, but no significant differences were found (AUCTai-Chi = 36.64 [3.11] mmol/L; P =.57). Mean concentration in all groups decreased throughout the day, with the largest decrease in the Control. Well-being for the Yoga and Control groups decreased but increased with Tai-Chi. Concentration and well-being responses were not statistically significant between intervention groups. Conclusions: Breaking up sedentary behavior using 3-minute bouts of Yoga significantly lowers blood glucose in healthy individuals without compromising concentration or well-being. Tai-Chi did not provide the same significant effect on glucose levels but allowed better maintenance of concentration and well-being. These interventions provide effective ways to combat the deleterious effects of prolonged sedentary time while maintaining concentration and well-being. [ABSTRACT FROM AUTHOR]

Background: Studying effective interventions already operating at scale is critical to improving physical activity intervention research translation. The free, weekly, timed 5-km run or walk parkrun represents a unique opportunity to examine successful organic dissemination. We conducted an ecological analysis to identify patterns of growth in Australian parkrun participation and their correlates from 2011 to 2020. Method: Outcome variables were (1) weekly counts of walkers/runners and (2) monthly number of new parkrun registrants. We used latent class analysis to characterize growth trajectories followed by logistic regression on class membership. Covariates included parkrun course characteristics (eg, surface type and route), site-level aggregate participant profile (eg, proportion women and mean age), and surrounding area characteristics (eg, population density and physical activity norm). Results: Three hundred and sixty-three parkruns were included (n = 8,388,695 participation instances). Sixty-nine percent followed a low-growth and 31% a high-growth participation pattern. High growth was associated with greater participation by women, concrete/bitumen surface type, lower area socioeconomic status, and greater volunteer heterogeneity. Odds of being in the slow-growth class were higher if the course contained >1 km of repetition, higher average age of participants, better average parkrun performance, and higher running group membership. Two patterns of new registration were identified: high start followed by steep decline; and low start, slow decline with similar correlates to participation. Conclusions: Parkruns with a less competitive social milieu may have more rapid dissemination. As a free and regular event, parkruns in low socioeconomic areas have the potential to improve the activity levels of those with fewer resources. [ABSTRACT FROM AUTHOR]

Only a minority of Americans adequately engage in activities experts recommend to curb preventable diseases, such as the consumption of healthful foods and regular physical exercise. This poses a challenge for policy makers and social marketers alike, given the substantial impact descriptive norms have on behaviors in the health domain. The authors propose a new way to address this challenge by identifying what they call the "uptrend effect." This effect encourages descriptively nonnormative, healthy behaviors through uptrend messaging that makes salient actual increased engagement in those behaviors over time without referencing an objective descriptive norm. Across seven experimental studies, including studies conducted in the field and measuring real behaviors, this research demonstrates that uptrend messaging leads recipients to infer greater descriptive normativity for the target behavior, which subsequently improves engagement. The authors identify theoretically and practically relevant boundary conditions, showing that the uptrend effect is attenuated when the growth in a behavior is driven by a dissimilar group or when the message explicitly states a descriptive norm. They also demonstrate that uptrend messaging outperforms other norm-based approaches. The theory and findings of this research inform scholars, policy makers, and marketers by providing actionable and easy-to-implement techniques to encourage behaviors that improve consumer quality of life. [ABSTRACT FROM AUTHOR]

Purpose: School recess provides a valuable opportunity for children's daily moderate- to vigorous-intensity physical activity (MVPA). This study aimed to quantify MVPA during school recess in a representative sample of Scottish children and examine whether recess MVPA varied by gender, socioeconomic status, season, urban/rural residency, and recess length. Method: Five-day accelerometry MVPA data were analyzed from 773 children (53.9% girls, 46.1% boys, 10- to 11-y-olds) from 471 schools. Binary logistic regression explored associations between meeting/not meeting the recommendation to spend 40% of recess time in MVPA and the aforementioned risk factors. Descriptive recess data were also analyzed. Results: Participants spent an average of 3.2 minutes (SD 2.1) in MVPA during recess. Girls engaged in 2.5 minutes (SD 1.7) of MVPA compared with 4.0 minutes (SD 2.2) for boys. Only 6% of children met the recess MVPA recommendation. The odds of girls (odds ratio 0.09; 95% confidence interval, 0.04–0.25) meeting the recommendation was lower (P <.001) compared with boys. No statistically significant differences were observed in meeting the recommendation for the other risk factors. Conclusion: Levels of MVPA during school recess are very low in Scottish children, and interventions aimed at increasing MVPA during recess are needed. [ABSTRACT FROM AUTHOR]

This research aims to identify ageist content concerning older adults within local government physical activity policy. Policies are not passive texts; they can comprise hidden or disputed connotations. To identify ageism, the study utilizes a critical discourse analysis approach to analyze physical activity policy documents (n = 61) from 16 local government areas in Victoria, Australia, and the perceptions of local government employees trusted with developing these policies, which were gathered during semistructured interviews (n = 11). Results from the critical discourse analysis indicate that local government policies are imbued with ageism, leading to the construction and perpetuation of various stereotypes of older adults. The discourse analysis points to potentially ageist descriptions including older adults being vulnerable, incapable, and a financial burden. Nonetheless, older adults were also revealed to be significant contributors to the community including in paid employment, caregiving roles, and volunteering. [ABSTRACT FROM AUTHOR]

We aimed to examine exercise intensity among older adults participating from home in remotely delivered EnhanceFitness (Tele-EF). Exercise intensity was assessed through Fitbit-measured heart rate and the Borg 10-point rating of perceived exertion over 1 week of a 16-week exercise program. Outcomes included mean minutes spent at or above the heart rate reserve calculated threshold for moderate intensity and mean rating of perceived exertion. Pearson and Spearman rank correlations were used to examine associations between baseline characteristics with exercise intensity. During the 60-min classes, the 55 participants achieved moderate intensity for a mean of 21.0 min (SD = 13.5) and had a mean rating of perceived exertion of 4.9 (SD = 1.2). There were no significant associations between baseline characteristics and exercise intensity. Older adults can achieve sustained moderate-intensity exercise during Tele-EF supervised classes. Baseline physical function, physical activity, and other health characteristics did not limit ability to exercise at a moderate intensity, though further investigation is warranted. [ABSTRACT FROM AUTHOR]

To support older adults during the first wave of COVID-19, we rapidly adapted our effective health-promoting intervention (Choose to Move [CTM]) for virtual delivery in British Columbia, Canada. The intervention was delivered (April–October 2020) to 33 groups of older adults ("programs") who were a convenience sample (had previously completed CTM in person; n = 153; 86% female; 73 [6] years). We compared implementation outcomes (recruitment, dose received, retention, and completion of virtual data collection) to predetermined feasibility targets. We assessed mobility, physical activity, and social health outcomes pre- and postintervention (3 months) with validated surveys. We met most (dose received, retention, and virtual data collection), but not all (recruitment), feasibility targets. Approximately two thirds of older adults maintained or improved mobility, physical activity, and social health outcomes at 3 months. It was feasible to implement and evaluate CTM virtually. In future, virtual CTM could help us reach homebound older adults and/or serve as support during public health emergencies. [ABSTRACT FROM AUTHOR]

Background: Few programs assess for outcomes once translated into practice. The Physical Activity for Lifelong Success program was developed as a center-based public health intervention and shown to improve walking speed and distance among older adults with type 2 diabetes. We adapted the program for community-based delivery by lay leaders to physically inactive older adults. Methods: We followed the Replicating Effective Programs framework to identify community stakeholders, adapt, implement, and evaluate fidelity of delivery in community settings, and plan for maintenance and evolution. Sixteen community sites enrolled 184 adults (mean age 73.5 y, 85% female, 93% White) in 21 workshops. Baseline and postworkshop measures assessed participants' health-related quality of life, physical function, and physical fitness. Data were analyzed using Fisher exact tests, Student t test, and paired linear regression with fixed effects. Results: Fidelity testing indicated leader training was sufficient to maintain key elements with delivery. Data from 122 participants showed improvements in chair stands (P <.001), arm curls (P <.001), 2-minute step test (P <.001), sit-and-reach (P =.001), 8-foot up-and-go (P <.001), and 10-m walk (P <.001). Conclusions: Adaptation of Physical Activity for Lifelong Success for implementation by community organizations for physically inactive older adults demonstrates that fidelity and effectiveness can be maintained after program translation. [ABSTRACT FROM AUTHOR]

Background: Influences on physical activity and sedentary behavior may differ for migrants moving from their country of origin to a new country. This study aimed to explore the range of contextual factors that influence physical activity and sedentary behavior among Indian migrants, making comparisons with India. Methods: Semistructured interviews were conducted with 21 Indian migrants (10 men and 11 women) aged between 18 and 65 years living in Melbourne, Australia. Data were analyzed thematically, coded inductively, and managed with NVivo. Results: Participants perceived a lack of social connection as a key barrier to physical activity participation. Group-based physical activity fostered social connections. Cultural associations were sites to engage in cultural physical activity and integrate with other Indians. Australia's physical contexts (eg, availability of facilities and built environment) facilitated physical activity behavior. Workplace environments (eg, the nature of the job) prompted sedentary behavior. Other contextual shifts with migration related to activities of daily living (eg, shifts in transport [walking] behavior in India to a greater reliance on cars in Australia) and migrant-friendly health communication (messaging from Australian health/allied health practitioners). Conclusions: Sociocultural contexts remain key influences on migrant physical activity participation. Prioritizing integrated approaches and engaging insider codesign are important in tailoring and promoting migrant physical activity and limiting sedentary behavior. [ABSTRACT FROM AUTHOR]

What motivates consumers to avoid unhealthy behaviors (e.g. consuming sugar, energy drinks, and fast food)? Traditional interventions and lay intuition suggest that to motivate themselves, consumers can consider the negative long-term health consequences of their decisions. Yet, consumers still struggle to avoid unhealthy behaviors. Seven experiments (N  =   4,021) offer a different approach. We find that considering short-term costs of unhealthy behaviors (e.g. irritability or indigestion after eating sugar) better curbs these behaviors than considering long-term costs or no costs. We theorize that short-term costs are more effective at reducing unhealthy behavior because they are more strongly associated with the act of consumption, both in terms of immediate timing and perceived likelihood of costs occurring. As such, short-term costs are better at undermining the reason for consuming unhealthily: anticipated enjoyment of the consumption experience. We test this process by (a) demonstrating mediation via increased association strength and subsequent decreased anticipated enjoyment, (b) manipulating the association strength between consumption and costs (i.e. same cost realized sooner vs. later), and (c) demonstrating moderation via consumers' goal for eating unhealthily. These results identify a powerful but underutilized self-regulation strategy—emphasizing short-term costs of unhealthy consumption—with implications for consumers and marketers. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine children's, camp counselors', and activity leaders' perceptions toward the effects of a 4-week teaching personal and social responsibility model-based summer learning and enrichment program and its ability to reduce bullying behaviors among school-age children. Method: Data collection included semistructured interviews with 30 children and eight camp staff. Child participants completed the following pre- and postsurveys: Personal and Social Responsibility Questionnaire and the Illinois Bullying Scale. In addition, daily observations over a 4-week period were recorded in a field notes log. Survey data were analyzed using descriptive statistics and bivariate correlations, and all observational and interview data were coded using inductive and deductive techniques. Results: The results indicated that the implementation of teaching personal and social responsibility model was perceived to be associated with reduction in the bullying. Conclusion: Findings from the present study suggested teaching personal and social responsibility facilitated social and emotional learning and improved children's personal and social responsibility. [ABSTRACT FROM AUTHOR]

Background: Staff play a critical role in promoting positive youth development in out-of-school-time programs, yet little is known about best-practices for preparing staff to work with youth and meet their needs. The present study seeks to understand the impact of a basic psychological needs training on the staff's ability to deliver needs-supportive instruction to youth during a summer wellness program. Methods: A quasi-experimental, qualitative design using interviews, observations, and journals was employed to compare the intervention staff (n = 9; M = 21.5) with a comparison group who did not receive the training (n = 8; M = 21.10). Results: Results indicated that the intervention enhanced the staff's understandings of basic psychological needs and empowered them to be more responsive to youth misbehavior, while educating youth about the importance of appropriate behavior. Conclusions: In order to prepare staff to meet the psychological needs of youth and protect themselves against exhaustion and burnout, future research should examine adequate dosage and content of staff training. [ABSTRACT FROM AUTHOR]

Parents of children and youth with disabilities (CYD) have expressed unique physical activity (PA) information needs. Community-based organizations (CBOs) require assistance to meet these needs. Guided by the Appraisal of Guidelines, Research and Evaluation II, this project established evidence-informed recommendations for developing PA information targeting families of CYD. This process involved a systematic scoping review to inform draft recommendations (k = 23), which were revised via a consensus meeting with researchers, knowledge users from CBOs, and families of CYD. Broader consultation with CBO knowledge users informed the final recommendations (k = 5) that fit within the following categories: (a) language and definitions, (b) program information, (c) benefits of PA, (d) barriers to PA, and (e) PA ideas and self-regulation tools. CBOs are encouraged to consider these recommendations when developing PA information for families of CYD. Future research will focus on the development of knowledge products to disseminate the recommendations to CBOs and support implementation. [ABSTRACT FROM AUTHOR]

Identifying factors that influence physical activity (PA) among individuals with Down syndrome is essential for PA promotion. Insight can be gained from guardians and health professionals. The purpose of this study was to explore the perspectives of guardians and health professionals on facilitators and barriers of PA in individuals with Down syndrome. Interviews were conducted with 11 guardians (five mothers, four fathers, and two legal guardians) and 11 professionals (four PA specialists, three physical therapists, and four occupational therapists). Grounded theory was applied. Barriers and facilitators fit the levels of the ecological model of health behavior: (a) intrapersonal (perceived rewards), (b) interpersonal (interaction), (c) community (availability of programs), (d) organizational (school systems), and (e) policy (education). Guardians and professionals agreed on the importance of enjoyment, interaction, and programs to promote PA. Differences between groups were identified at the organizational and policy levels. PA in persons with Down syndrome is influenced by interactions between individual and environmental factors. [ABSTRACT FROM AUTHOR]

Context: Early physical activity (PA) after concussion may promote symptom resolution. Prior studies have investigated exercise frequency/duration, yet precise PA intensity or volume required for optimal recovery requires further investigation. moderate to vigorous physical activity (MVPA) is beneficial for physical health. We investigated whether sedentary time, light activity time, MVPA time, or activity frequency in the weeks following concussion are associated with time to symptom resolution among adolescents. Design: Prospective cohort study. Methods: Adolescents 10–18 years of age were tested ≤14 days of concussion and followed until symptom resolution. At the initial visit, participants rated symptom severity and were provided wrist-worn activity trackers to monitor PA for the following week. PA behavior was categorized each day based on heart rate: sedentary (resting), light PA (50%–69% age-predicted max heart rate), and MVPA (70%–100% age-predicted max heart rate). Symptom resolution was defined as the date when participants reported cessation of concussion-like symptoms. Patients were not given specific PA instructions, though some may have received instructions from their physician. Results: Fifty-four participants were included in the study (54% female; mean age = 15.0 [1.8] y; initially assessed 7.5 [3.2] d after concussion). Female athletes recorded more sedentary time (900 [46] vs 738 [185] min/d; P =.01; Cohen d = 0.72), and less time in light PA (194.7 [64.5] vs 224 [55] min/d; P =.08; Cohen d = 0.48) and MVPA (23 [17] vs 38 [31] min/d; P =.04; Cohen d = 0.58) than male athletes. After adjusting for sedentary time, hours per day with >250 steps, sex, and initial symptom severity, more MVPA time was associated with faster symptom resolution time (hazard ratio = 1.016; 95% confidence interval, 1.001–1.032; P =.04). Conclusion: Our findings offer preliminary insight into how varying PA intensities affect concussion recovery, as MVPA may be a higher intensity than what is typically prescribed in concussion care. [ABSTRACT FROM AUTHOR]

External connectivity refers to the service opportunities provided by community open spaces that are influenced by the factors such as traffic distance, road conditions, residence patterns, and population distribution. It is an important factor in determining access to community open spaces. This has important implications for promoting walking behavior and community physical activity among aging urban populations. Using the accessibility evaluation method, we proposed an external connectivity of the community open spaces model from the community perspective and conducted an empirical study using the Overseas Chinese Town community in Shenzhen as an example. External connectivity of the community open spaces can be used to evaluate the efficiency of community open spaces, serving as a reference for open space optimization. Moreover, it has applicable value in promoting physical activity and healthy aging among older adults. [ABSTRACT FROM AUTHOR]

Background: Disaster responders are exposed to several physical and mental health risks. This study aimed to describe self-care strategies used by disaster responders after the earthquake in Syria and eastern Turkey in February 2023. Methods: A study specific web-based questionnaire survey was used to collect quantitative and qualitative data according to a convergent mixed methods approach. Data from 252 disaster responders responding to the earthquakes in Turkey and Syria were analyzed using both descriptive and analytical statistics and summative content analysis of free-text answers. Data were collected in March to July, 2023. Results: The most used self-care strategies included resting, social support from colleagues in the field, extra intake of food or drink, and intake of medicines. The recovery strategies varied due to previous disaster response experience, indicating that supportive self-care strategies can be developed or learned. Conclusion: Given the extreme conditions and limited possibilities of external support, sufficient self-care is an essential competence among disaster responders. Self-care strategies can be both external processed such as intake of medicines, social support from others, and internal processes such as personal reflection. Providing oneself with self-care activities seems to be a skill developed with increasing experience supported by pre-deployment training. Therefore, to enhance resilience, self-care strategies should be encompassed in pre-disaster response training. [ABSTRACT FROM AUTHOR]

Purpose: Therapeutic group interventions are commonly provided in acquired brain injury (ABI) inpatient rehabilitation settings, but little is known about the extent of therapeutic groups run for community-dwellers with ABI. This paper seeks to review current literature concerning the nature of therapeutic groups run for community-dwellers with ABI and the involvement of occupational therapists. Materials & Methods: A scoping review was conducted with systematic searching of relevant databases guided by Arksey and O'Malley's framework. Studies were included if they reported on therapeutic groups for community-dwellers with ABI. Articles were collated and summarised with key findings presented in narrative form with accompanying tables. Results: Seventy articles met inclusion. Groups are used as therapeutic change agents for community-dwellers with ABI and target a diverse range of participation barriers. Participants valued group programs that established safe environments, a sense of belonging, growth opportunities and social connections. Group accessibility needs to be improved, with better funding avenues available for service providers, as well as greater consumer involvement in group design and facilitation. Conclusions: Groups are a valuable therapeutic modality supporting community-dwellers with ABI. Further research is warranted into the use of groups by occupational therapists working with community-dwellers with ABI. IMPLICATIONS FOR REHABILITATION: Therapeutic groups can support the development of social connections, community participation and help community-dwellers with ABI re-establish a positive self-identity. Conducting groups in community settings and involving consumers in group design and facilitation may enhance the group experience for participants. Occupational Therapists should be involved in the design and delivery of occupation-based and participation focused group-based programs. [ABSTRACT FROM AUTHOR]

Background: Spending on preventive care in low- and middle-income countries (LMICs), including Indonesia, is much lower than spending on curative care. There has been a pressing need to develop a clear pathway to increase spending on preventive care. This study aimed to assess the current financing landscape for health promotion and disease prevention in Indonesia and, subsequently, to develop a framework and recommendations for future health promotion financing in the country. Methods: We adopted a mixed-method approach to gather information from all relevant stakeholders from December 2022 to June 2023. For the qualitative approach, we conducted (a) in-depth interviews (IDIs) and (b) focus group discussions (FGDs) with government officials at national and district levels, academics, professional organizations, healthcare workers in primary healthcare centres (PHCs), community health volunteers, non governmental organizations and private companies. For the quantitative approach, we applied a national online survey to healthcare workers involved in health promotion in PHCs. IDIs and FGDs were conducted with purposefully selected resource persons at the national level, five selected districts across Indonesia, and within 15 primary health offices and their communities. All qualitative data were recorded, transcribed, coded, interpreted, and then triangulated with national survey findings to develop the financing framework. Results: We identified gaps between the theory and practice of health promotion and disease prevention. These included the limited scope of health promotion initiatives, lack of direction and coordination between ministries, agencies and government levels, limited availability and capacity of health promoters, various yet uncoordinated funding resources and inflexibility in using the funds. To bridge the gap, the framework we developed suggests strengthening the legal and regulatory basis, strategically prioritizing financing arrangements, promoting evidence-based health promotion activities, developing the capacity of health promoters, enhancing the health financing information system and improving monitoring and evaluation. Conclusions: Identified gaps and challenges in health promotion and disease prevention initiatives inform the development of our framework for future health promotion financing. This framework assists the national government in organizing national health promotion financing strategies and potentially serves as a valuable model for other LMICs. [ABSTRACT FROM AUTHOR]

Background: The benefits of healthy eating are well known, yet adolescent diet is often poor. School based interventions offer a promising option to promote healthy eating, however, evidence is unclear. Aim: This umbrella review synthesised the current evidence on school-based interventions for healthy eating in adolescents (10–19 years old). Methods: Using Joanna Briggs Institute (JBI) umbrella review guidelines, a systematic search was conducted on 11 electronic databases (PubMed, CINHAL, EMBASE, Science Direct, PsycINFO, MEDLINE, Scopus, ERIC, Web of Science, Cochrane Register of Systemic Review and JBI Evidence Synthesis) to identify reviews published between January 2000 and December 2023. Methodological quality was assessed using JBI critical appraisal tool. A narrative synthesis was conducted informed by the World Health Organisation's Health Promoting School (HPS) framework that categorises school-based interventions into three components i.e., health education, school environment changes, and family and community involvement. Results: Seventeen reviews were identified (including 347 unique primary studies) that were published between 2008 and 2023. 87% of the reviews were based on interventions in high- income countries, limiting applicability to low- and middle-income countries. Fourteen reviews were rated as high, two as moderate, and one was rated as low methodological quality. Evidence from 71% of the reviews (n = 14 reviews, 13 = high methodological quality) found that multi-component interventions (i.e., interventions incorporating more than two components of the HPS framework) improved adolescents' knowledge and behaviour concerning healthy eating. At the individual level, tech-driven healthy eating curricula effectively improved eating behaviours of adolescents. These individual-level interventions proved to be more effective and sustainable when supported by system-level changes, such as modifying school environments including increased availability of healthy foods and involving parents to promote healthy eating for adolescents. However, limited evidence from only three reviews suggests mixed feasibility for technology-based interventions and lower feasibility for multi-component interventions. The lack of information on stakeholder involvement in intervention design is another critical evidence gap. Conclusion: School-based multi-component healthy eating interventions that combine individual-level interventions with system-level changes are effective in promoting healthy eating behaviours among adolescents. Future reviews should assess the effectiveness of participatory approaches in intervention design, feasibility and scale-up studies, and analysing evidence from low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Biomarkers for predicting Alzheimer's disease (AD) are advancing and their implementation in various healthcare systems is imminent. There is a need for ethical standards addressing information needs, socio-ethical concerns, and expectations of healthy and at-risk persons. We present an ethical approach that integrates different existing ethical frameworks and discussion of our empirical, cross-cultural findings in a multi-layered perspective by addressing three levels. The micro-level focuses on the communication between counseling professionals, persons at risk or in an early stage of dementia, and family members. The meso-level addresses interprofessional cooperation and exchange as a key element for best person-centered care. The macro-level considers public health promotion, the media, and public-funded research. This approach allows to address key ethical concepts including beneficence, non-maleficence, autonomy, informational self-determination, empowerment, and justice. Our contribution specifically examines the ethical challenges associated with AD prediction by means of biomarkers, based on insights from a German-Israeli comparison, and promotes a transdisciplinary discussion across different healthcare contexts. We propose a reflection on three levels to go beyond the clinical counseling context and to consider the rapidly evolving field of biomarkers in the coming years. Our ethical-practical recommendations should not be considered final, but rather procedural and will require continuous adaptation regarding culturally varying practices, new algorithms, meta-analyses, and re-evaluation of established recommendations. [ABSTRACT FROM AUTHOR]

Introduction: Hepatitis B is a significant public health concern and a leading cause of liver cancer across the world. In Australia, hepatitis B is largely endemic in migrant communities, particularly amongst the Chinese and Vietnamese communities. Negative attitudes towards hepatitis B can be a major barrier to hepatitis B testing and linkage to care. This mixed-methods research explores the attitudes and beliefs, including stigma, about hepatitis B among students of Vietnamese and Chinese background in Australia. Students were chosen as participants as there is little research examining hepatitis B among university students in Australia and they provide a point of entry to communities with high prevalence of hepatitis B, that otherwise may be hard to access. Methods: Online surveys were distributed in Chinese, Vietnamese, and English via social media and completed by 112 students of Chinese and 95 students of Vietnamese backgrounds. In-depth interviews were also conducted with 13 Vietnamese and 10 Chinese participants to further explore the survey results. Results: Survey findings suggest that students have varied attitudes towards people living with hepatitis B. Around half of the participants reported they would behave negatively towards other people with hepatitis B and that they would expect to experience stigma or discrimination if they had hepatitis B. While over 70% in both samples reported that people who have hepatitis B should not be isolated by family and friends, 47.6% of the Chinese sample and 28.3% of the Vietnamese sample reported they would avoid close contact with someone with hepatitis B. The qualitative data expands on the quantitative data. Four key themes were identified: (1) Caution not discrimination (2) Hepatitis B as a sign of immoral behaviour (3) Discriminatory behaviour based on perceived effects of hepatitis B and (4) Shifting attitudes. Conclusion: This research provides insights that could inform culturally sensitive health promotion programs to address negative attitudes towards hepatitis B among the broader Chinese and Vietnamese communities living in Australia. [ABSTRACT FROM AUTHOR]

In recent years, the internalisation of education in China has led to an increase in the prevalence of a highly competitive, test-focused approach to learning. This has had a detrimental impact on the physical health and wellbeing of children and adolescents in China, resulting in a concerning lack of physical literacy among junior high school students. Accordingly, the objective of this study is to construct an evaluation index system for physical literacy in junior high school students with Chinese characteristics, quantify the relative importance of each domain, and provide a framework for students to assess and self-evaluate the sustainable development of their physical literacy. The indicator system was modelled on CAPL-2, and valid indicators were extracted from the literature. A pre-selected indicator system for physical literacy in junior high school students was constructed through three rounds of Delphi expert questionnaire surveys (48 questionnaires were distributed in total). A total of 16 experts participated in all three rounds of the surveys until a consensus was reached on the indicators, resulting in the establishment of a hierarchical analysis-based theoretical model. This was developed using the experts' opinions and determined the items to be subdomains and weights. The AHP was employed to ascertain the relative importance of the subdomains and items within the assessment system. The index weight scores of the Chinese junior high school students' physical literacy assessment index system are aligned with the core tenet of the physical literacy concept, comprising four primary indicators, eight secondary indicators, and 26 tertiary indicators. The weights of the physical literacy evaluation indexes for junior high school students in China were calculated using the AHP to establish a progressive hierarchical model and the consistency test. The primary indicators were found to be in the following order of importance: Physical Competence (29.82%) > Motivation and Confidence (29.64%) > Knowledge and Understanding (20.27%) = Daily Behavior (20.27%). The system is an effective means of evaluating the impact of physical activity and health promotion among junior high school students, and it effectively addresses the needs of this age group in these areas. It provides a comprehensive assessment of the effects of physical activity and health promotion among junior high school students, and it offers a scientific foundation for the development of precise and individualized physical activity and health promotion programs. [ABSTRACT FROM AUTHOR]

Background: The ageing population, coupled with the desire to age-in-place, highlight the need for programs that target health promotion as a means of maintaining functional ability, autonomy, and independence among community-dwelling older adults. This paper describes the development of the VIeSA intervention, which aimed to model a healthy ageing trajectory, including the identification of the necessary tools and methods, that would allow people older people, in partnership with health and social care professionals, to define personal health-related goals and the actions to achieve them. A key element of the intervention development was the creation of a support tool intended to assist this process. Methods: The UK Medical Research Council (MRC) guidance on developing and evaluating complex interventions was applied in the development of the intervention and of the support tool. A participatory approach was selected, with stakeholders engaged on different occasions to allow the refinement of the intervention and of the support tool. Following the steps and suggested actions in the MRC development phase, the development process was conducted by identifying (1) the evidence base and (2) the theoretical framework and (3) by modelling the process and outcomes of the intervention. Results: Following a literature review on effective interventions for functional ability, draft 1 of the support tool was designed. Focus groups with stakeholders provided feedback on this draft allowing for its refinement in terms of content, language use, and structure (draft 2). A review of the approaches for health promotion delivery led to further additions to the tool (draft 3) and informed the content of the training of health and social care professionals. After their training, professionals provided feedback on the acceptability, appropriateness, and feasibility of different elements of the intervention. Results suggested that no further major refinement to the intervention or support tool was necessary. Conclusions: The design and development of the VIeSA intervention using the MRC guidance allowed for a clarity of direction, an optimised content in terms of usefulness and accessibility for all concerned stakeholders, and greater opportunities for its implementation and uptake. [ABSTRACT FROM AUTHOR]

Background: Meta-analyses of randomized trials suggest that health checks and health promotion interventions targeting behavior change in primary care do not prevent cardiovascular morbidity and mortality in the general population. However, whether such interventions are more effective in high-risk populations, such as people living in low socioeconomic settings, remains unclear, as they have been poorly represented in previous trials. Therefore, we aim to evaluate the effectiveness, cost-effectiveness, and implementation of systematic screening followed by an individually oriented, lifestyle-focused, health dialogue intervention for prevention of type 2 diabetes and cardiovascular disease, as compared to opportunistic screening, in primary care in socioeconomically disadvantaged areas. Methods: Using an overall pragmatic approach and a cluster-randomized design with two arms, we aim to enroll 3000 participants aged 50–59 years from 30 primary care centers (PCCs) with an above-average level of Care Need Index in Stockholm Region, Sweden. PCCs will be randomized (1:1) either to a health dialogue intervention, which includes inviting enlisted patients to a systematic screening of risk factors followed by an individually oriented lifestyle-focused health dialogue, or to opportunistic screening, which includes screening patients for a smaller set of risk factors during an appointment at their PCC taking place for other reasons. The main outcome will be change in systolic blood pressure during 6- and 12-month follow-ups. Additional short-term outcomes will be changes in other biological risk factors, health-related quality-of-life, and lifestyle habits, as well as process and implementation outcomes, and unintended side effects. The long-term effect on type 2 diabetes and cardiovascular disease incidence and mortality will be examined using regional and nationwide registers. Changes in systolic blood pressure and other health outcomes will be analyzed using mixed-effect generalized linear modeling and mixed-effect Cox regression to capture variability between and within PCCs. A health economic evaluation will assess resource use and costs in the short- and long-term. Discussion: This trial of lifestyle-focused health dialogues and opportunistic screening in primary care in socioeconomically disadvantaged areas in the largest region of Sweden has the potential to yield valuable insights that could support evidence-based policymaking. Trial registration: ClinicalTrials.gov (NCT06067178). Prospectively registered September 27, 2023. [ABSTRACT FROM AUTHOR]

Background: Many parturients have poor self-care ability, strong dependence on others, and lack mother-infant related nursing skills and health care knowledge. Due to their lack of pregnancy experience, many primiparas lack the relevant skills and knowledge, which can affect maternal and infant health and maternal quality of life. Purpose: The study aimed to investigate the effects of the PRECEDE-PROCEDE model on self-care ability and quality of life among primipara during puerperium. Methods: This quasi-clinical study selected eligible primaparas from those who gave birth at a Grade A hospital in Hengyang, China between April and July 2019. Eighty puerperium primiparas were divided into a control group receiving standard care and an intervention group following the PRECEDE-PROCEDE model. Comparison of self-care ability and quality of life scores was conducted between the two groups pre-intervention, at 3 weeks, and at 6 weeks postpartum. Statistical analysis using SPSS 18.0 included mean and standard deviation for measurement data, and frequency and constituent ratio for counting data. Tests such as t-test, Chi-squared test, rank-sum test, and repeated measure analysis of variance were applied. Findings: The control group's self-care ability scores were (150.8 ± 9.9), (150.9 ± 9.3), and (152.0 ± 10.2) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. For the intervention group, the corresponding scores were (151.1 ± 15.1), (157.8 ± 8.5), and (162.4 ± 7.2). Quality of life scores for the control group were (54.7 ± 8.6), (54.8 ± 7.7), and (55.1 ± 7.7) before intervention, at 3 weeks postpartum, and at 6 weeks postpartum, respectively. At the same time points, while the intervention group saw increases from (55.6 ± 7.6) to (59.2 ± 5.9) and (61.0 ± 5.3). There were statistically significant differences in the time effect and inter-group effect of the total score of self-care ability during puerperium, total score of quality of life, and the score of each dimension between the two groups (P < 0.05), and we also found an interaction effect between grouping and time factors (P < 0.05). After intervention, the incidence of common puerperium health problems except neonatal constipation and diarrhea in the intervention group was lower than that in the control group (P < 0.05). Conclusion: PRECEDE-PROCEDE model may improve self-care ability, reduce the occurrence of common health problems, and improve the quality of life of primiparas during puerperium. [ABSTRACT FROM AUTHOR]

Background: Physical health (PH), including muscle strength, endurance, and the ability to perform daily physical tasks, gradually declines with increasing age, leading to disability and an increased disease burden. Both the urban community environment (UCE) and physical activity (PA) were linked to PH. Methods: A total of 625 participants aged 55 years and older from Haidian and Chaoyang Districts in Beijing, China, were included in the study from September to December 2023.PH was assessed by a combined score of four tests, including BMI, chronic disease, depression and self-rated health.The Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A), Center for Epidemiological Survey-Depression Scale (CES-D), Physical Activity Scale for Elderly (PASE) and Social Support Rate Score (SSRS) were collected. The analysis was carried out with SPSS v.20 and Amos 24, and the results were validated via structural equation modeling (SEM). Results: The urban community environment was positively associated with the health level of older adults. Specifically, the standardized path coefficients indicate that the influence of the built environment (0.72–0.88) was greater than that of the social environment (0.43–0.55) and personal attributes (0.22–0.37) on older adults' health. Physical activity demonstrated both a mediating effect and an indirect effect, highlighting its significant value as a mediating variable. Conclusions: The urban community environment has a positive impact on promoting the physical health of older adults, with the influence of the built environment being greater than that of the social environment and personal attributes on their physical health. Physical activity acts as a mediator between the urban community environment and the physical health of older adults. [ABSTRACT FROM AUTHOR]

Background: The University of California's Diabetes Prevention Program (UC DPP) Initiative was implemented systemwide to address diabetes and obesity risk on all 10 campuses. As little is known about implementing lifestyle change programs in university settings, we examined implementation partners' (i.e., UC DPP leaders and campus leads) perceptions of factors influencing program success on UC campuses. Methods: We conducted qualitative interviews with UC DPP leaders and campus leads to examine challenges and opportunities with university-based DPP delivery models. Interviews were recorded, professionally transcribed, and reviewed in detail by the research team. Transcripts were analyzed using rapid qualitative analysis (RQA). The study was approved by the UCLA Institutional Review Board. All implementation partners provided verbal informed consent. Results: Twenty-six implementation partners (8 UC DPP leaders and 18 campus leads) completed interviews in 2021. Seven themes were identified as critical for implementation, including (1) marketing and recruitment (i.e., market and recruit broadly through established channels as well as target at-risk populations); (2) enrollment (i.e., offer the program during convenient times and let participants know what to expect); (3) use an adaptable, evidence-based program; (4) secure funding for the program, participants, lifestyle coaches, and space; (5) hire experienced and dedicated staff and lifestyle coaches; (6) ensure leadership support; and (7) utilize campus linkages and resources. Perceptions of challenges faced with respect to these themes are also described. Conclusions: This is one of the first studies to examine the challenges and opportunities of delivering an intensive lifestyle change program across 10 university sites. Understanding factors that enhance success of university-based diabetes prevention programs can facilitate UC DPP efforts and help inform delivery strategies of health and wellness programs across other university settings more broadly. [ABSTRACT FROM AUTHOR]

Safety net organizations in rural regions face structural barriers to providing services. Organizations that serve rural Latino communities may face additional barriers related to restrictive immigration policies and anti‐immigrant climates. This study examines the impacts of restrictive immigration policies on safety net organizations that provide critical services to Latinos in rural areas to elucidate the mechanisms by which immigration policies influence Latino health. We conducted a qualitative analysis of 20 in‐depth interviews with safety net organizations providing legal, nutritional, healthcare, labor, educational, and advocacy services to Latinos in rural California. Rural Latino‐serving safety net organizations face immigration‐related funding restrictions and anti‐immigrant climates. Under restrictive immigration policies, rural safety net organizations are forced to extend beyond their organizational missions to circumvent immigration‐related funding restrictions and address anti‐immigrant climates to deliver their services. Staff working in these organizations are at the frontlines of anti‐immigrant climates and experienced an emotional toll from their work. States should address anti‐immigrant climates and increase funding to support organizations who serve Latinos in rural regions. To ensure that rural safety net organizations meet their mission, immigration‐related eligibility requirements from safety net services should be removed. In addition, funders should allocate resources towards mental health services to address the impacts of anti‐immigrant climates on staff who serve in rural Latino communities. [ABSTRACT FROM AUTHOR]

In 2022, South Africa (SA) had the second-highest HIV incidence rate among adolescents worldwide. This study's participants were boys living in SA aged 15–19 years old, in a current dating or sexual relationship, and diagnosed with HIV before the age of 10. Despite the launch of campaigns to spread awareness of Undetectable equals Untransmittable (U = U), our findings showed that a significant number of adolescents living with HIV do not demonstrate an understanding of the concept. This highlights the importance of integrating U = U messaging in ongoing conversations with healthcare workers given the potential positive impact on adolescent wellbeing, transmission risk perception, and safer sexual practices. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to investigate the effectiveness of a supervised physical training program with controlled cadence on functional fitness parameters, quality of life perception, and physical activity level in older adults. Methods: Sixty physically independent older adults were randomly divided into three groups: Supervised Training (ST, n = 20), Unsupervised Training (UT, n = 20), and a Control Group (C, n = 20). The ST and UT groups participated in a 12-week program, performing exercises three times a week for 30 min. The ST group had structured weekly sessions consisting of a 5-minute warm-up (walking at 60% of max heart rate), 20 sets of 30 s at a moderate pace controlled by a metronome with 30 s of passive recovery, and a 5-minute cool-down on non-consecutive days. The UT group trained spontaneously using senior gym equipment, including elliptical machines, rowing machines, air skiers, and leg press machines. The control group maintained their usual daily routines throughout the study. Parameters evaluated included body mass, body mass index (BMI), muscle thickness (biceps brachii, triceps brachii, and vastus lateralis), and functional capacity tests (walking 10m [W10 m], rising from a sitting position [RSP], rising from the prone position [RVDP], sitting and rising from a chair and moving around the house [SRCW]). Quality of life was assessed across physical, psychological, environmental, and social domains, and physical activity levels were also measured. Results: No significant changes (p > 0.05) in body mass, BMI, or muscle thickness were observed between groups before and after the intervention. However, significant time effects in functional fitness tests were found only in the ST group for W10m (p = 0.0469), RVDP (p < 0.0004), RSP (p < 0.0001), and SRCW (p < 0.0001). Quality of life improved significantly over time in the ST and UT groups across all domains (p < 0.0001). Both ST and UT groups also showed significant increases in weekly physical activity time (p > 0.0001). Conclusion: 12 weeks of training improved quality of life perception and physical activity levels in older adults. [ABSTRACT FROM AUTHOR]

Purpose: To explore the attitudes and experiences of clinicians and individuals with chronic stroke on the use of shared decision-making (SDM) during upper extremity rehabilitation to improve daily arm use in the home environment. Specifically, we aimed to describe clinician and client perspectives regarding the facilitators and barriers to using SDM within the context of a self-directed upper extremity intervention for individuals living in the community with chronic stroke. Methods: Data were collected within the context of an interventional study examining the feasibility of the Use My Arm-Remote intervention. Focus group interviews were conducted with the clinicians (n = 3) providing the intervention and individual semi-structured interviews with the participants (n = 15) of the study. All interview data were collected after the end of the intervention period. Data were analyzed using thematic analysis. Results: The following themes were identified: (1) Equal partnership; (2) Enhancing clinician confidence; and (3) This is different. Facilitators and barriers were identified within each theme. Key facilitators for clinicians were competence with SDM and patient characteristics; while facilitators for patients were open and trusting relationships with clinicians and personalized experience. Key barriers to SDM for clinicians were lack of expertise in SDM and participant buy in; while patients identified a lack of foundational knowledge of stroke rehabilitation as a potential barrier. Conclusions: Key barriers were analyzed using the consolidated framework for advancing implementation science to interpret results and identify strategies for enhancing the implementation of SDM in a virtual setting. The CFIR-ERIC tool highlighted the need for targeted educational meetings and materials to address the training and educational needs of both clinicians and patients for future iterations of this intervention. [ABSTRACT FROM AUTHOR]

Purpose: Taxes on unhealthy foods can help improve population health in the United Kingdom (UK), but the health effects of food substitutions resulting from these taxes are often unclear. We investigated the potential impacts of a salt and sugar tax on hypothetical intra-category food substitutions, cost, body-mass index (BMI), and environmental footprints. Methods: Purchase panel data from Kantar (2017) were used to determine the most popular foods high in salt or sugar within eight 'salt-intensive'/'sugar-intensive' food categories. Within food categories, the most popular lower salt (≤ 1.5 g salt/100 g product) and lower sugar (≤ 22.5 g sugar/100 g product) substitutes were also identified. Hypothetical swaps between high salt/sugar foods and lower salt/sugar substitutes were explored, focusing on changes to cost, caloric intake and BMI, and environmental impacts in the UK population. Results: The suggested intra-category substitutions were largely like-for-like and did not accrue an added overall cost to consumers. The substitutions reduced calorie intake by about 200 kcal/day and lowered the prevalence of overweight and obesity in the UK from approximately 60–65% to about 40–45%. The proposed food substitutions led to a total reduction of -2.7Mt of greenhouse gases, ∼ -500.000 ha of land, -0.5km3 of blue water, -12km3 of scarcity weighted water, ∼ -12.000t of phosphorus, and nearly − 14.000t of sulphur dioxide over one year for the UK population due to reductions in calorie intake. Conclusion: Food substitutions following a tax on salt and sugar could lead to significant benefits for health and the environment, without necessarily resulting in major changes to people's expenditure on familiar salty and sugary snacks. [ABSTRACT FROM AUTHOR]

Background: Many refugee women and women seeking asylum arrive in high-income countries with unmet preventive sexual and reproductive health (SRH) care needs. Primary healthcare providers (HCPs) are usually refugee and asylum seekers' first point of care. This study aimed to identify HCP characteristics associated with initiating conversations and discussing SRH opportunistically during other health interactions. Methods: An anonymous online survey was distributed nationally to representatives of health professional organisations and Primary Health Networks. Hierarchical logistic regression analysed factors including HCP demographics, knowledge and awareness, perceived need for training and professional experience with refugee women were included in the models. Results: Among 163 HCPs, those initiating conversations ranged from 27.3% (contraceptive care) to 35.2% (cervical screening). Opportunistic discussions ranged from 26.9% (breast screening) to 40.3% (contraceptive care). Positively associated factors included offering care to refugee women or women seeking asylum at least once every 2 months 7.64 (95% CI 2.41;24.22, P < 0.001); 2.82 (95% CI 1.07;740, P < 0.05), working part-time 8.01 (95% CI 2.34;27.86, P < 0.001); 2.43 (95% CI 1.02;5.76, P < 0.05) and having over 10 years of practice in Australia 2.20 (95% CI 0.71;6.87, P < 0.001); 0.40 (95% CI 1.66;0.95, P < 0.05). Barriers identified by HCPs included women's cultural beliefs (76%), lack of SRH knowledge (72.4%), religious beliefs (67.5%) and limited English-language skills (54.6%). Conclusions: Direct professional experience, frequency of service provision, years of practice, and part time work positively influence HCPs' SRH care practices. Enhancing bilingual health worker programs, outreach, education, and support for SRH and cultural competency training are essential to improving the preventive SRH care of refugee women and women seeking asylum. Primary healthcare providers are usually refugee and asylum seekers' first point of care in resettlement countries. Findings indicate direct professional experience characteristics influence healthcare providers' knowledge and beliefs regarding refugee women's sexual and reproductive health. Clinical practice changes and cultural competency training are needed to improve the preventive sexual and reproductive health care of refugee women and women seeking asylum. [ABSTRACT FROM AUTHOR]