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Background: Varying trends in children's and adolescents' physical activity (PA) have been reported during the last 10–20 years. Trends in sedentary behavior (SB) have been studied only rarely. The purpose of the present study was to describe population-based trends in accelerometer-measured PA, standing and SB, among Finnish 7-15-year-old children and adolescents, and to evaluate the potential influence of the COVID-19 pandemic on these behaviors. Method: A cross-sectional population-based Finnish school-aged physical activity Study (FSPA) measured daily steps, vigorous (VPA), moderate (MPA), moderate-to-vigorous (MVPA), light physical activity (LPA), standing, and SB by an accelerometer for seven consecutive days in 2016, 2018, and 2022 (n = 7.080, 57% girls). The data was analyzed by multivariate regression analysis. Results: In 2016, participants took on average 10.305 steps per day, and spent 0:15 (h: min) in VPA, 1:37 in MPA, 1:52 in MVPA, 3:48 in LPA, 0:55 in standing and 7:52 in SB. From 2016 to 2018, daily steps, MPA, LPA, and standing increased [229 steps (95% Confidence Interval, CI 70–387), 0:03 (CI 0:01 − 0:04), 0:11 (CI 0:09 − 0:14), and 0:07 (CI 0:05 − 0:08), respectively], while VPA and SB decreased [0:01 (CI 0:00–0:02) and 0:20 (CI 0:16 − 0:24), respectively]. From 2018 to 2022, daily PA and standing declined [751 steps (CI 562–939), VPA 0:02 (CI 0:01 − 0:03), MPA 0:09 (CI 0:07 − 0:11), MVPA 0:11 (CI 0:09 − 0:14), LPA 0:08 (CI 0:05 − 0:11), and standing 0:01 (CI 0:01 − 0:03)] while SB increased 0:21 (CI 0:16 − 0:25) indicating potential influence of the pandemic. Conclusions: Children and adolescents became physically less active from 2016 to 2022. The potential effects of the COVID-19 were seen as declined PA and increased sedentariness from 2018 to 2022. [ABSTRACT FROM AUTHOR]

Background: Several reviews have examined the health benefits of participation in specific sports, such as baseball, cricket, cross-country skiing, cycling, downhill skiing, football, golf, judo, rugby, running and swimming. However, new primary studies on the topic have recently been published, and the respective meta-analytic evidence needs to be updated. Objectives: To systematically review, summarise and appraise evidence on physical health benefits of participation in different recreational sports. Methods: Searches for journal articles were conducted in PubMed/MEDLINE, Scopus, SpoLit, SPORTDiscus, Sports Medicine & Education Index and Web of Science. We included longitudinal and intervention studies investigating physical health outcomes associated with participation in a given sport among generally healthy adults without disability. Results: A total of 136 papers from 76 studies conducted among 2.6 million participants were included in the review. Our meta-analyses of available evidence found that: (1) cycling reduces the risk of coronary heart disease by 16% (pooled hazard ratio [HR] = 0.84; 95% confidence interval [CI]: 0.80, 0.89), all-cause mortality by 21% (HR = 0.79; 95% CI: 0.73, 0.84), cancer mortality by 10% (HR = 0.90; 95% CI: 0.85, 0.96) and cardiovascular mortality by 20% (HR = 0.80; 95% CI: 0.74, 0.86); (2) football has favourable effects on body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength (p < 0.050); (3) handball has favourable effects on body composition and cardiorespiratory fitness (p < 0.050); (4) running reduces the risk of all-cause mortality by 23% (HR = 0.77; 95% CI: 0.70, 0.85), cancer mortality by 20% (HR = 0.80; 95% CI: 0.72, 0.89) and cardiovascular mortality by 27% (HR = 0.73; 95% CI: 0.57, 0.94) and improves body composition, cardiovascular function at rest and cardiorespiratory fitness (p < 0.010); and (5) swimming reduces the risk of all-cause mortality by 24% (HR = 0.76; 95% CI: 0.63, 0.92) and improves body composition and blood lipids (p < 0.010). Conclusions: A range of physical health benefits are associated with participation in recreational cycling, football, handball, running and swimming. More studies are needed to enable meta-analyses of health benefits of participation in other sports. PROSPERO registration number CRD42021234839. Key Points: We found a reduced risk of all-cause mortality associated with cycling (–21%), running (–23%) and swimming (–24%). Running also improves body composition, cardiovascular function at rest and cardiorespiratory fitness, while swimming also improves body composition and blood lipids. Football improves body composition, blood lipids, fasting blood glucose, blood pressure, cardiovascular function at rest, cardiorespiratory fitness and bone strength, while handball improves body composition and cardiorespiratory fitness. [ABSTRACT FROM AUTHOR]

Background: Few adolescents meet guideline levels of physical activity associated with good health, highlighting the need for intervention. Interventions promoting adolescents' physical activity should be guided by research applying behavioral theory to identify potentially modifiable correlates and associated processes. We applied an integrated social cognition model to identify theory-based constructs and processes that relate to physical activity intentions in a secondary analysis of two samples of Finnish adolescents using a correlational design. Method: Participants in the first sample (n = 455) completed self-report measures of social cognition constructs from theory of planned behavior, habit, self-discipline, and past and current physical activities. Participants in the second sample (n = 3878) completed identical measures plus measures of socio-structural and socio-environmental factors. Participants from the first sample also wore accelerometers for 1 week. Hypothesized model effects were tested using variance-based structural equation modeling in data from the first sample and subsequently confirmed in a pre-registered analysis of data from the second sample. Results: Across both samples, habit, attitude, perceived behavioral control, and self-reported past behavior were associated with physical activity intention. Effects of self-reported past physical activity on intention were partially mediated by social cognition constructs. Effects of accelerometer-based physical activity were small by comparison. Effects of socio-structural and socio-environmental factors on intention in the second sample were partially mediated by the social cognition constructs. Conclusion: Results corroborate beliefs and habit as consistent correlates of adolescents' physical activity intentions and provide preliminary evidence that social cognition constructs account for effects of socio-structural and socio-environmental factors on intentions. [ABSTRACT FROM AUTHOR]

Sixty-two percent of Finnish children and adolescents aged 9–15 participate in sports club activities, yet only one-third of sports participants reach the recommended 60 min of daily moderate-to-vigorous physical activity. The inadequate physical activity of participants underlines the need for physical education among those participating in sports club activities. Sports coaches have significant potential in promoting participants' weekly overall physical activity beyond sports training, given their role of authority. However, coaches in Finland mainly work on a voluntary basis, with varying knowledge and capabilities. The aim of the study was to investigate the physical education orientation and activity of sports coaches, and the associations of these with the moderate-to-vigorous physical activity of young sports participants. Questionnaire data from coaches (n = 26) and young sports participants aged 6–18 (n = 201), and accelerometer data from young sports participants (n = 293) were included in the analysis. The results indicated that even though sports coaches recognized the importance of physical education, they have not fully embraced their role as physical educators and promoters of weekly overall physical activity among young sports participants. The role of families was considered most significant in physical education. Coaches perceived their possibilities to influence the physical activity behavior of the participants as limited. Coaching education and experience had a positive relationship with the coaches' activity in implementing physical education, highlighting the importance of coaching education. The findings suggest that there is a need to increase collaboration with coaches and families to ensure an adequate amount of weekly overall physical activity of children and adolescents. [ABSTRACT FROM AUTHOR]

This study explored sports‐related factors predicting organized sports participation in emerging adulthood. In the Finnish Health Promoting Sports Club (FHPSC) study, 354 sports club participants aged 15 at baseline reported their main sport, onset age, training volume, current competitive level, and future competitive orientation and participated in the follow‐up study at age 19. There were differences in the proportions of maintainers and dropouts in a few sports: football (maintainers 58.6%), and among females, skating (maintainers 60.7%), and swimming (dropouts 80.0%). A binary logistic regression analysis showed that those who had started their main sport by school age (females OR 3.05/95% CI 1.34, 6.98; males OR 3.97/95% CI 1.48, 10.64) and had competed at national top level plus had aimed at success at the adult level competitions in future (females OR 3.42/95% CI 1.16, 10.09; males OR 3.58/95% CI 1.12, 11.41; among females, also had competed at national top level plus had aimed at success at junior level competitions [OR 3.42/95% CI 1.20, 9.78]) were more likely maintainers than dropouts. Early onset in the main sport and competitiveness were related to maintained sports participation while the opposites were related to dropouts in the current organized sports system. [ABSTRACT FROM AUTHOR]

Background Although sports clubs' potential for health promotion is acknowledged, research on whether they promote healthy eating is limited. We aimed to evaluate Finnish youth sports clubs' health promotion orientation, as well as associations between sports clubs' health promotion orientation, coaches' nutritional discussions and sports club participants' (SPs') fruit and/or vegetable consumption. Methods The cross-sectional study included 554 SPs aged 14–16 years, 275 club officials and 311 coaches. Participants replied to questionnaires about sports clubs' health promotion and their own health behaviours, including dietary habits. Health promotion orientation was estimated using a Health Promoting Sports Club (HPSC) index (range 0–22) and nutritional discussions and fruit and/or vegetable consumption as frequencies. A mixed-effects multivariable logistic regression was used to analyse the associations. Results Most sports clubs (69%) had a high health promotion orientation, but the variation between the clubs was wide (HPSC index range 5–21). SPs' daily fruit and/or vegetable consumption was associated with female gender [odds ratio (OR) 3.48, 95% confidence interval (CI) 2.23–5.42, P  < 0.001], better self-rated health (OR 3.26, 95% CI 1.13–9.41, P  = 0.03), higher average school grades (OR 1.67, 95% CI 1.04–2.67, P  = 0.03), and SPs' responses that their coach had often discussed nutrition (OR 2.11, 95% CI 1.41–3.14, P  < 0.001). Conclusion Although sports clubs' orientation towards health promotion was mostly high, it seems not to be enough to promote healthy eating among adolescent participants. Instead, coaches' nutritional discussions were associated with adolescents' fruit and/or vegetable consumption. [ABSTRACT FROM AUTHOR]

Background: The decline in physical activity (PA) during adolescence is well-established. However, while some subgroups of adolescents follow the general pattern of decreased activity, others increase or maintain high or low activity. The correlates and determinants of different PA patterns may vary, offering valuable information for targeted health promotion. This study aimed to examine how psychosocial factors, health behaviours, and PA domains are associated with longitudinal PA patterns from adolescence to young adulthood. Methods: This prospective study encompassed 254 participants measured at mean ages 15 and 19. Device-measured moderate-to-vigorous PA was grouped into five patterns (activity maintainers, inactivity maintainers, decreasers from moderate to low PA, decreasers from high to moderate PA, increasers) via a data-driven method, K-Means for longitudinal data. Multinomial logistic regression was used to analyse the associations between health behaviours, psychosocial factors, PA domains, and different PA patterns. Results: A lack of sports club participation characterised inactivity maintainers throughout adolescence. Difficulties in communicating with one's father at age 15 were associated with higher odds of belonging to inactivity maintainers and to decreasers from moderate to low PA. Lower fruit and vegetable consumption at age 19 was also related to increased odds of belonging to the groups of inactivity maintainers and decreasers from moderate to low PA. Smoking at age 19 was associated with being a decreaser from moderate to low PA. Conclusions: Diverse factors characterise longitudinal PA patterns over the transition to young adulthood. Sports club participation contributes to maintained PA. Moreover, a father-adolescent relationship that supports open communication may be one determinant for sustained PA during adolescence. A healthier diet and non-smoking as a young adult are associated with more favourable PA development. [ABSTRACT FROM AUTHOR]

This study aimed to identify organized sports participation patterns and their prevalence from adolescence to emerging adulthood, and the educational and family-related determinants of the patterns. Adolescents in the Finnish Health Promoting Sports Club (FHPSC) study answered a health behaviour questionnaire and reported on sports club participation at ages 15 and 19 (N = 609). In emerging adulthood, dropouts (total 41.05%; females 43.72%; males 36.56%), maintainers (30.87; 26.44; 38.33), nonparticipants (27.59; 29.32; 24.67), and joiners (0.49; 0.52; 0.44) (p =.024) were identified. A mixed multinomial logistic regression analysis showed, that male gender, as compared to female gender, increased the odds of being a maintainer rather than a nonparticipant or dropout. Among females, high achievement at school and aspiration towards upper secondary school at age 15 increased the odds of being a maintainer at age 19 rather than a nonparticipant. High achievement at school and experiencing a (strong) decrease in parental support for physical activity/sport increased the odds of being a dropout rather than a nonparticipant. Having no experience of a strong decrease in parental support increased the odds of being a maintainer rather than a dropout. Among males, aspiration towards upper secondary school increased the odds of being a maintainer or dropout rather than a nonparticipant. The most common reason for dropping out was study, which was also the most prevalent life status at age 19. The findings highlight a need for more flexible possibilities to combine organized sports participation and school studies, and the importance of parental support for physical activity/sport. [ABSTRACT FROM AUTHOR]

Purpose: To examine the associations between longitudinal physical activity (PA) patterns and the development of cardiometabolic risk factors from adolescence to young adulthood. Methods: This cohort study encompassed 250 participants recruited from sports clubs and schools, and examined at mean age 15 and 19. Device‐measured moderate‐to‐vigorous PA was grouped into five patterns (via a data‐driven method, using inactivity maintainers as a reference). The outcomes were: glucose, insulin, homeostasis model assessment for insulin resistance (HOMA‐IR), total cholesterol, HDL and LDL cholesterol, triglycerides, blood pressure, and body mass index (BMI). Linear growth curve models were applied with adjustment for sex, age, fruit/vegetable consumption, cigarette/snuff use, and change in the device wear‐time. Results: Insulin and BMI increased among decreasers from moderate to low PA (β for insulin 0.23, 95% CI 0.03–0.46; β for BMI 0.90; CI 0.02–1.78). The concentration of HDL cholesterol decreased (β −0.18, CI −0.31 to −0.05) and that of glucose increased (β 0.18, CI 0.02–0.35) among decreasers from high to moderate PA. By contrast, among increasers, blood pressure declined (systolic β −6.43, CI −12.16 to −0.70; diastolic β −6.72, CI −11.03 to −2.41). Conclusions: Already during the transition to young adulthood, changes in PA are associated with changes in cardiometabolic risk factors. Favorable blood pressure changes were found among PA increasers. Unfavorable changes in BMI, insulin, glucose, and HDL cholesterol were found in groups with decreasing PA. The changes were dependent on the baseline PA and the magnitude of the PA decline. [ABSTRACT FROM AUTHOR]

The health promoting sports club describes the development of the settings-based approach in sports clubs. Based on this model, a questionnaire was developed to measure health promotion perceptions in sports clubs (e-PROSCeSS). The objective of this study was to assess the psychometric properties of a French version of the e-PROSCeSS measurement tool. The questionnaire includes three scales measuring stakeholder's perceptions of club (macro), managers (meso) and coaches (micro) activities toward promoting health. Five steps were undertaken to assess perceptions. First, scales were translated into French. Second, each item's content clarity was tested in three populations: managers, coaches, sports participants. Third, descriptive statistics were analyzed for each scale. Fourth, confirmatory factorial analysis was used to select items for each level. Predictive validity found positive relationships between health promotion perceptions and managing/coaching positions, and negative relationships with drop-out intentions. Positive relationships were found between sports participants' perceptions of health promotion and their self-rated performance and quality of life, while negative relationships were detected with drop-out intentions. The French e-PROSCeSS subscales showed good psychometric properties in measuring health determinants at multiple levels. However, the tool did not measure health promotion as an overarching concept that questions its applicability in the sports club setting. [ABSTRACT FROM AUTHOR]

Objectives: This study focused on how adolescents' perceptions of coaches' health promotion activity predict maintained participation and dropout in organized sports in emerging adulthood. In addition, differences in lifestyle habits between maintainers, dropouts, and nonparticipants in organized sports were explored. Materials and Methods: Overall, 616 adolescents reported organized sports participation in the Finnish Health Promoting Sports Club (FHPSC) study at ages 15 and 19. Of these, 323 reported coach's health promotion activity on health topics at the age of 15. An index of a coach's general health promotion activity was formed. At age 19, all study participants reported their lifestyle habits. Results: Among males, those who had perceived coaches' general health promotion activity as frequent were more likely to be maintainers than dropouts (48.6% vs. 20.0%) (p = .002). Among females, there was no significant difference (32.0% vs. 28.4%). Logistic regression analysis adjusted for gender showed that perceiving coach's general health promotion activity as frequent increased the odds of being a maintainer rather than a dropout. Moreover, maintainers had higher odds of having healthy lifestyle habits when compared to nonparticipants (related to physical activity; sleep; fruit and vegetable consumption; and cigarette use) or dropouts (related to physical activity; and cigarette use). In addition, dropouts had higher odds of having healthy lifestyle habits than nonparticipants (related to sleep; and cigarette use). Conclusions: Perceiving coaches' health promotion activity as frequent was related to maintained participation in organized sports among males. Maintainers were more likely to have more healthy lifestyle habits than nonparticipants and dropouts. There is a need to invest in coaches' health promotion activity when it is infrequent. A more detailed understanding is needed of coaches' health promotion activity that supports both maintained participation in sports, especially among females, and healthy lifestyle habits in emerging adulthood. [ABSTRACT FROM AUTHOR]

Background: Regular physical activity and doing well in school are important for growing adolescents. In this study, the associations between physical activity and perceived school performance (PSP) are examined together. Methods: Young adolescents from 42 countries (n = 193,949) in Europe and Canada were examined for associations between self-reported moderate to vigorous physical activity (MVPA) and PSP. Multinominal analyses were conducted with 0 to 2 days of MVPA and below average PSP as reference categories. Adjusted odds ratios and 95% confidence intervals were reported for pooled data and individual countries after controlling for family affluence scale. Results: Girls had better PSP than boys, yet more boys participated in daily MVPA than girls. The associations between PSP and MVPA were inverted U shaped. The strongest association for very good PSP was among young adolescents who reported 5 to 6 days MVPA (odds ratios = 2.3; 95% confidence interval, 2.1–2.4) after controlling for family affluence scale. Conclusions: Young adolescents with average or better PSP took part in at least 3 days of MVPA in a week, suggesting that participating in some MVPA was positively associated with PSP. More days of MVPA in a week, especially for young adolescents with below average PSP, would be beneficial for health and school performance. [ABSTRACT FROM AUTHOR]

Aims: Previous research indicates that foreign-born populations experience more psychological distress than general populations. However, it remains unclear how prevalence varies between regions of origin. The role of socio-demographic and migration-related factors also needs to be further investigated. We aimed to (a) compare the prevalence of psychological distress in foreign-born and general Finnish populations, (b) investigate differences in prevalence between nine regions of origin and (c) examine which socio-demographic and migration-related factors are associated with distress among foreign-born populations. Methods: The study used data from the Survey on Well-Being among Foreign Born Population (FinMonik), a population-based survey (n =6312) of foreign-born populations living in Finland collected between 2018 and 2019 by the Finnish Institute for Health and Welfare. Psychological distress was measured using the Mental Health Inventory-5 (MHI-5), with a cut-off point of 52. Logistic regression was used to adjust analyses by age and sex to determine the prevalence of psychological distress and the associated socio-demographic factors. Results: Psychological distress was more prevalent among those who were foreign born (17.4%) than among the general population (12.9%). Migrants from the Middle East and North Africa had the highest prevalence (29.7%) compared to other regions of origin. Unemployment or economic inactivity, international protection as a reason for migration and beginner-level language proficiency were the main factors increasing the odds for distress among foreign-born populations. Conclusions: Foreign-born populations experience more psychological distress than the general population, but prevalence varies between regions of origin. Future efforts should aim at a better understanding of the mental health risk factors and the development of targeted interventions for these subpopulations. [ABSTRACT FROM AUTHOR]

Summary: A recent literature review indicated that the settings-based approach, as it is applied to sports clubs, is poorly understood and not well implemented. The current study builds on the health promoting sports clubs (HPSC) theoretical model as a basis for a settings-based approach in the sports setting and proposes a logic model to develop and evaluate HPSC in practice. The logic model was established through qualitative, iterative methods in the form of six meetings with eight experts in the field. Qualitative thematic coding was conducted on notes taken and contributions during and between meetings. The results describe a best-practice logic model of HPSC, including inputs, activities, outcomes and impacts at each HPSC level, while case studies illustrate the interactions between levels. Results indicate that a HPSC can have an impact at each level, from individual health to social and community capital. For a sports club, the logic model helps to define how the club's board or management committee can set the conditions for club managers and coaches to support members' health. External stakeholders to clubs are also recognized for their key responsibility in providing different types of resources to support sports clubs to be health promoting. Future research should focus on monitoring and evaluating at each level, including empirical testing system interactions as a whole and interactions across levels. Lay Summary: This article describes a logic model for health promoting sports clubs (HPSC), informed by a settings-based approach. It demonstrates how each of the seven levels of the HPSC model can request resources, implement activities to generate outcomes and impact at their level, as well as how these levels interact. This logic model offers explicit descriptions of the resources needed by stakeholders to develop health promotion (HP) activities. It also highlights the relationships between activities and outcomes, which are often made implicitly by sports club stakeholders, supporting the understanding about how HP can enhance a sports club's core business. This logic model can be used to develop interventions, and to support monitoring and evaluation of processes, activities and results to investigate how sports clubs promote health. [ABSTRACT FROM AUTHOR]

Background The aerobic part of the recently updated physical activity (PA) guidelines for adults recommends at least 150 min of moderate or at least 75 of vigorous-intensity PA or an equivalent combination of both. PA can be accumulated of any bout duration. On an absolute scale, moderate-intensity threshold is 3 metabolic equivalents (METs) and vigorous 6 METs. On a scale relative to individual's personal capacity, moderate-intensity threshold is 40% and vigorous 60% of the oxygen uptake reserve. In this study, the adherence to the new guidelines was evaluated using both absolute and relative thresholds. Methods Totally, 1645 adults aged 20–64 years, participated in this population-based study and their cardiorespiratory fitness (CRF) was estimated with 6-min walking test. The participants with estimated maximal oxygen uptake <7.9 MET were categorized as low CRF group and the others as adequate CRF group. The participants were instructed to wear a triaxial hip-worn accelerometer for 1 week and their adherence to PA guidelines was assessed from the accelerometer data. Results The adequate CRF group had higher adherence to PA guidelines with the absolute thresholds, but the use of relative thresholds inverted the results. The adherence varied from 20% to 99% in the total sample depending on the analysis parameters of accelerometer data. Conclusions The absolute thresholds provide a more appropriate basis to assess the adherence to PA guidelines in population-based samples and interventions. The use of individually determined relative thresholds may be more useful for individual exercise prescriptions in PA counseling. [ABSTRACT FROM AUTHOR]

Background Sports clubs have requested support from national governing authorities to invest in health promotion (HP), by developing policies, guidelines and dedicated funding. This article outlines the development of a national audit tool to review policies development and implementation to support HP in sports clubs. Methods A five-step process was undertaken by an international project team: (i) a rapid literature review to identify items assessing policies in physical activity, HP and sports, (ii) a thematic analysis to categorize items, (iii) a Delphi method to analyze item relevance, country specificity, reformulation, validation and organization, (iv) face validity through an online survey and in-depth interviews with expert representatives on physical activity and sports and (v) audit tool finalization though project team consensus. Results Eight sources were reviewed with 269 items identified. Items were coded into 25 categories with 3 broad themes: policies, actors and settings-based approach. The Delphi study extracted and refined 50 items and categorized them into 10 sections. After revisions from 22 surveys and 8 interviews, consensus was reached by the international project team on 41 items categorized into 11 sections: Role of ministry or department; Policies; Communication; Implementation and Dissemination; Evaluation and Measurement methods; Sub-national-level policies; Funding and Coordination; Participative approach; Actors and Stakeholders; National sporting events; Case studies and Implicated stakeholders. Conclusion To progress HP in the sports club context it is necessary to understand existing national-level policies. This national audit tool will aid in monitoring and assessing national policies for health promoting sports clubs. [ABSTRACT FROM AUTHOR]

A follow‐up data on electrocardiogram (ECG) and blood pressure (BP) changes in adolescent athletes are scarce. We compared ECG and BP between adolescent athletes and nonathletes in a 4‐year follow‐up. A total of 154 youth sports clubs (SC) in Finland and 100 secondary schools for comparison data participated in this observational follow‐up study. Those who maintained or adopted SC participation are referred to as 'Always athletes' (n = 137), those who never participated in SC as 'Never athletes' (n = 108) and those who dropped out ofSC during the follow‐up as 'Changers' (n = 116). The mean age of the participants was 15.5 (0.6) years in all study groups at baseline. Resting ECG including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis and QT interval and BP were measured from all participants at baseline and after follow‐up. 'Always athletes' had lower resting heart rate, more negative T‐wave axis and higher QRS amplitude than 'Never athletes' at baseline and at 4 years (p < 0.05). 'Changers' had lower resting heart rate, more negative T‐wave axis and higher QRS amplitude, systolic BP and pulse pressure than 'Never athletes' at baseline (p < 0.05). None of the observed differences at baseline, were visible at 4 years (p > 0.05) except the difference in T‐wave axis (p = 0.028). The significant group × time interaction between 'Changers' and 'Never athletes' was found for QRS amplitude (p = 0.017). Adolescent athletes have several training‐induced cardiovascular adaptations, which return towards the levels of nonathletes after cessation of regular training. [ABSTRACT FROM AUTHOR]

Background: Finland's 2016 Report Card on Physical Activity for Children and Youth gathers and translates research results and assesses the status and promotion of physical activity (PA) among Finnish children and youth less than 18 years of age. This article summarizes the results and provides grades for 9 indicators. Methods: The working group evaluated the evidence and assigned grades of A (highest, 81% to 100%), B, C, D, or F (lowest, 0% to 20%) for 9 PA indicators using the Active Healthy Kids Canada Report Card development process. Results: The grades varied in Finland as follows: 1) Overall PA/fulfillment of recommendations = D, 2) Organized Sport Participation = C, 3) Active Play = C, 4) Active Transportation = B, 5) Sedentary Behaviors = D, 6) Family and Peers = C, 7) School = B, 8) Community and the Built Environment = B, 9) Government = B. Conclusions: Despite good policies and programs to promote PA in Finland, children and youth overall PA levels are low, whereas their time spent sedentary is high. More effective interventions, operation models, concrete tools as well as environmental solutions are needed to support the work toward more physically active childhood and youth. [ABSTRACT FROM AUTHOR]

Background: Adolescents' physical activity level is a major source of concern. For adolescents with long-term illnesses or disabilities (LTID), being physically active can prevent secondary conditions. This is one of the first studies reporting trends in physical activity of adolescents with LTID in relation to gender, age, and sports club membership. Methods: Data were collected from the Health Behavior in School-aged Children study in Finland during 2002, 2006, 2010, and 2014. In 13- and 15-year-olds (N = 2206), 17.1% reported having LTID. Daily physical activity recall was the dependent variable. Binary logistic regression analysis was conducted separately for sports club members (n = 936) and nonmembers (n = 1270). Results: The proportion of physically active adolescents with LTID in 2014 was higher than in 2002 for girls (15.6% vs 8.7%) and boys (26.6% vs 13.0%). Girl sports club members were 2 limes more likely to be physically active in 2014 than in 2002. The largest trend between 2014 and 2002 was among boy nonmembers (odds ratio: 4.62,95% confidence interval, 2.02-10.58). Conclusions: More adolescents with LTID took part in daily moderate-to-vigorous physical activity in 2014 than in 2002; however, physical activity levels still remain low. Sports club membership was similar to that of the general population. [ABSTRACT FROM AUTHOR]

Background: Longitudinal studies demonstrate an average decline in physical activity (PA) from adolescence to young adulthood. However, while some subgroups of adolescents decrease activity, others increase or maintain high or low activity. Activity domains may differ between subgroups (exhibiting different PA patterns), and they offer valuable information for targeted health promotion. Hence, the aim of this study was to identify PA patterns from adolescence to young adulthood; also to explore the associations of (i) changes in PA domains and in sedentary time, (ii) sociodemographic factors, and (iii) self-rated health with diverging PA patterns. Methods: The observational cohort study data encompassed 254 adolescents at age 15 and age 19. K-means cluster analysis for longitudinal data was performed to identify participant clusters (patterns) based on their accelerometry-measured moderate-to-vigorous PA (MVPA). Logistic regressions were applied in further analysis. Results: Five PA patterns were identified: inactivity maintainers (n = 71), activity maintainers (n = 70), decreasers from moderate (to low) PA (n = 61), decreasers from high (to moderate) PA (n = 32), and increasers (n = 20). At age 15, participation in sports clubs (SC, 41–97%) and active commuting (AC, 47–75%) was common in all the patterns. By age 19, clear dropout from these activities was prevalent (SC participation mean 32%, AC 31–63%). Inactivity maintainers reported the lowest amount of weekly school physical education. Dropout from SC – in contrast to non-participation in SC – was associated with higher odds of being a decreaser from high PA, and with lower odds of being an inactivity maintainer. Maintained SC participation was associated with higher odds of belonging to the decreasers from high PA, and to the combined group of activity maintainers and increasers; also with lower odds of being an inactivity maintainer. Maintenance/adoption of AC was associated with decreased odds of being an inactivity maintainer. Self-reported health at age 19 was associated with the patterns of maintained activity and inactivity. Conclusions: PA patterns diverge over the transition to adulthood. Changes in SC participation and AC show different associations with diverging PA patterns. Hence, tailored PA promotion is recommended. [ABSTRACT FROM AUTHOR]

Background: Studies measuring physical activity (PA) and sedentary behavior on a 24/7 basis are scarce. The present study assessed the feasibility of using an accelerometer at the hip while awake and at the wrist while sleeping to describe 24/7 patterns of physical behavior in working-aged adults by age, sex, and fitness. Methods: The study was based on the FinFit 2017 study where the physical behavior of 20- to 69-year-old Finns was assessed 24/7 by triaxial accelerometer (UKKRM42; UKK Terveyspalvelut Oy, Tampere, Finland). During waking hours, the accelerometer was kept at the right hip and, during time in bed, at the nondominant wrist. PA variables were based on 1-min exponential moving average of mean amplitude deviation of the resultant acceleration signal analyzed in 6-s epochs. The angle for the posture estimation algorithm was used to identify sedentary behavior and standing. Evaluation of time in bed was based on the wrist movement. Fitness was estimated by the 6-min walk test. Results: A total of 2,256 eligible participants (mean age 49.5 years, SD = 13.5, 59% women) wore the accelerometer at the hip 15.7 hr/day (SD = 1.4) and at the wrist 8.3 hr/day (SD = 1.4). Sedentary behavior covered 9 hr 18 min/day (SD = 1.8 hr/day), standing nearly 2 hr/day (SD = 0.9), light PA 3.7 hr/day (SD = 1.3), and moderate to vigorous PA 46 min/day (SD = 26). Participants took 7,451 steps per day (SD = 2,962) on average. Men were most active around noon, while women had activity peaks at noon and at early evening. The low-fit tertile took 1,186 and 1,747 fewer steps per day than the mid- and high-fit tertiles (both p < .001). Conclusions: One triaxial accelerometer with a two wear-site approach provides a feasible method to characterize hour-by-hour patterns of physical behavior among working-aged adults. [ABSTRACT FROM AUTHOR]

Much information is available on electrocardiogram (ECG) and blood pressure (BP) changes in senior athletes. However, corresponding data on adolescent athletes are scarce. To study the differences in resting ECG and BP values among adolescent endurance athletes, nonendurance athletes, and nonathletes. Cross-sectional study. A total of 154 youth sports clubs in Finland and 100 secondary schools for comparison data. We recruited young athletes (n = 410) aged 14 to 16 years in 10 popular sport disciplines, including winter and summer as well as team and individual sports, and categorized them as endurance or nonendurance sports. Comparison data for age-matched, non–sports club participants (n = 164) were collected via secondary schools. Resting ECG, including heart rate, PR interval, QRS duration, QRS axis, QRS amplitude, T axis, and QT interval as well as systolic and diastolic BPs. No differences in any ECG variable of interest were found between the endurance and nonendurance athletes. The PR interval was longer in endurance athletes than in nonathletes (P =.05). The QRS amplitude (P =.03) was higher among nonendurance athletes than among nonathletes. Diastolic BP was lower among endurance (P =.002) and nonendurance (P =.02) athletes than among nonathletes. Endurance athletes (odds ratio [OR] = 2.85; 95% CI = 1.81, 4.50) and nonendurance athletes (OR = 2.19; 95% CI = 1.43, 3.35) were more likely to have sinus bradycardia than were nonathletes. Nonendurance athletes were more likely to have elevated systolic BP than were endurance athletes (OR = 1.70; 95% CI = 1.07, 2.72) and nonathletes (OR = 1.73; 95% CI = 1.04, 2.87). Young athletes had similar ECG and BP findings independent of their sports. Physiological adaptations including sinus bradycardia, higher QRS amplitude, and lower diastolic BP, which are commonly seen in adult athletes, were also present in adolescent athletes. [ABSTRACT FROM AUTHOR]

To determine the prevalence of menstrual dysfunction (MD; ie, oligomenorrhea or amenorrhea) and attitudes toward body weight among athletes and non‐athletes, we studied a cohort of athletes and non‐athletes, in adolescence (14‐16 years) and subsequently in young adulthood (18‐20 years). We further studied the differences between athletes reporting MD and eumenorrheic athletes at both time periods and identified physical and behavioral characteristics that might predict MD in young adulthood. Data were collected using questionnaires, accelerometers, and a pre‐participation screening. In adolescence, the athletes reported current primary amenorrhea more often than the non‐athletes (4.7% vs 0%, P =.03). In young adulthood, athletes reported MD more frequently than non‐athletes (38.7% vs 5.6%, P <.001). Athletes had less desire than non‐athletes to lose weight at both time points, and in adolescence, athletes were more satisfied with their weight. However, about one fifth of the athletes and about 40% of the non‐athletes experienced body weight dissatisfaction at both time points. In adolescence, athletes reporting MD had lower BMI than eumenorrheic athletes. In young adulthood, athletes with MD were more physically active than eumenorrheic athletes. The only longitudinal predictor of MD in young adulthood was MD in adolescence. Our findings indicate that MD is relatively frequent among young Finnish athletes. However, athletes appear to have a smaller tendency to experience body weight dissatisfaction than their non‐athletic peers. MD seems to track from adolescence to adulthood, suggesting that there is a need to focus on possible causes at the earliest feasible phase of an athlete's career. [ABSTRACT FROM AUTHOR]

The Finnish 2014 Report Card on Physical Activity (PA) for Children and Youth is the first assessment of Finland's efforts in promoting and facilitating PA opportunities for children and youth using the Active Healthy Kids Canada grading system. The Report Card relies primarily on research findings from 6 Research Institutes, coordinated by the University of Jyväskylä. The Research Work Group convened to evaluate the aggregated evidence and assign grades for each of the 9 PA indicators, following the Canadian Report Card protocol. Grades from A (highest) to F (lowest) varied in Finland as follows: 1) Overall physical activity—fulfillment of recommendations (D), 2) Organized sport participation (C), 3) Active play (D), 4) Active transportation (B), 5) Sedentary behaviors (D), 6) Family and peers (C), 7) School (B), 8) Community and the built environment (B), and 9) Government (B). This comprehensive summary and assessment of indicators related to PA in Finnish children and youth indicates that Finland still has many challenges to promote a physically active life style for youth. [ABSTRACT FROM AUTHOR]

The objective of this study was to analyze the associations of various individual- and environmental-related factors with subgroups of daily, frequent, moderate and low moderate-to-vigorous physical activity (MVPA) among children and adolescents. Data were obtained from the Finnish School-age Physical Activity (FSPA) study 2016 from 4677 national representative 11-, 13-, and 15-year-old children and adolescents. MVPA and individual- and environmental-related factors were assessed by a questionnaire and analyzed by two-level logistic regression. Seventeen of the twenty-one variables were statistically significantly associated with MVPA. However, only three variables were statistically significant in all MVPA subgroups, whereby self-directed PA at least twice a week, fewer perceived barriers, and higher peer support increased the odds of participating in more MVPA. The results from this study showed essential differences among the MVPA subgroups, also supporting previous findings, whereby various individual- and environmental-based factors are associated with children and adolescents' levels of MVPA. Challenges to designing and implementing effective interventions are based on the need to account for individual differences within the population, as well as the varied connections between PA with different social and physical environments where children and adolescents' PA takes place. PA interventions with various actions at multiple levels are warranted. [ABSTRACT FROM AUTHOR]

Settings-based approaches have become an increasing health promotion focus since the World Health Organization's 1986 Ottawa Charter. While schools, cities, and prisons have implemented this approach, its development within sports environments is recent. Sports are a popular leisure-time activity, requiring validated tools to measure health promotion activity. This study's aim was to develop a measurement tool based on international consensus that measures perceptions of health promotion within sports clubs. It is grounded in the settings-based approach and builds on theory from previous works expanding their context and knowledge. An online, three-round international Delphi study was conducted, inviting experts in sports and health fields to participate in designing the tool. Round 1 created a collaborative list of items; Round 2 validated items based on relevance, importance, and feasibility; and the final round classified items into one determinant category—social, cultural, environmental, or economic. Panelists (69 experts) from 13 countries participated, creating a final list of 62 items at 3 organizational levels; the sports club level included 23 items, the officials level retained 20 items, and the coaching level contained 19 items. This study provides several innovations: (1) applying the settings-based approach to health promotion within sports clubs, (2) defining each club level (sports club, official, coaching) and determinants (social, cultural, environmental, economic) within 3-levels, (3) creating a tool that measures perceptions of health-promotion activities per level and determinant, and (4) obtaining expert consensus on included items. These advancements allow further research on promoting health within sports clubs. [ABSTRACT FROM AUTHOR]

Aims: Insufficient physical activity (PA) is one of the largest public health challenges of our time and requires a multisectoral public-health response. PA recommendations state that all children and adolescents should accumulate at least 60 minutes of moderate-to-vigorous PA (MVPA) daily and carry out vigorous PA (VPA) three times weekly. While participation in sports club activities is known to enhance the probability of reaching the recommended overall PA level, less is known about the contribution of sports club participation to VPA, and few cross-national comparisons have been carried out. The purpose of this paper is to study whether participation in sports club activities is associated with meeting the overall PA and VPA recommendations among children and adolescents across six European countries, namely Belgium (Flanders), Czech Republic, Finland, France, Ireland and Sweden. Methods: Analyses were carried out on existing self-reported national data sets using descriptive statistics and logistic regression. Results: Results indicate that approximately two-thirds of children and adolescents take part in sports club activities in the given countries. Sports club participants were more likely to meet the overall PA recommendations (OR 2.4–6.4) and VPA recommendation (OR 2.8–5.0) than non-participants. Conclusions: The extent to which overall PA and/or VPA is gained through sports club participation versus other settings needs to be further studied. Nonetheless, it can be argued that sports clubs have an important position in PA promotion for younger populations. [ABSTRACT FROM AUTHOR]

Many researchers and authorities have recognized the important role that sports clubs can play in public health. In spite of attempts to create a theoretical framework in the early 2000s, a thorough understanding of sports clubs as a setting for health promotion (HP) is lacking. Despite calls for more effective, sustainable, and theoretically grounded interventions, previous literature reviews have identified no controlled studies assessing HP interventions in sports clubs. This systematic mapping review details how the settings-based approach is applied through HP interventions in sports clubs and highlights facilitators and barriers for sports clubs to become health-promoting settings. In addition, the mapped facilitators and barriers have been used to reformulate previous guidelines of HP in sports clubs. Seven databases were searched for empirical research published between 1986 and 2017. Fifty-eight studies were included, principally coming from Australia and Europe, describing 33 unique interventions, which targeted mostly male participants in team sports. The settings-based approach was not yet applied in sports clubs, as more than half of the interventions implemented in sports club targeted only one level of the socio-ecological model, as well as focused only on study participants rather than the club overall. Based on empirical data, the analysis of facilitators and barriers helped develop revised guidelines for sports clubs to implement settings-based HP. This will be particularly useful when implementing HP initiatives to aid in the development of sports clubs working with a whole setting approach. [ABSTRACT FROM AUTHOR]

Participation in organized sports is a popular and important part of the lives of children and adolescents and is associated with improved psychological and social health, as well as an increased likelihood of meeting physical activity (PA) recommendations. Changes in modern society, including increased car ownership and use of technology and electronic media, have led to an additional focus on the importance of health‐enhancing PA among children and adolescents. The aim of this article was to study the secular changes in self‐reports of participation in organized sports clubs and leisure‐time vigorous physical activity (LVPA), and whether the relationship between participation in organized sports clubs and LVPA has changed from 1985 to 2014. Questionnaire data were collected in two cross‐sectional samples of Finnish and Norwegian 11‐, 13‐ and 15‐year‐olds in 1985/1986 (n = 7137) and 2014 (n = 9218). Overall, participation in organized sports clubs and level of LVPA appears to have changed in the same direction in the two Nordic countries. The proportion of 11‐year‐olds reporting to be participants in organized sports clubs increased from 1985/1986 to 2014. There was an overall increase in self‐reported LVPA. The association between participation in sports clubs and LVPA was stronger in 2014 than in 1985/1986. The findings indicated subgroup differences, in particular with regard to a steeper increase in LVPA and participation in sports clubs among Finnish girls. We suggest that attention should be given to the role of organized sports to better understand secular changes in PA. [ABSTRACT FROM AUTHOR]

The article presents results from Finland's 2018 Report Card on Physical Activity for Children and Youth. It mentions indicators on the basis of which grades are assigned including organized sport participation, active transportation, and sedentary behavior. The report card reveals that governmental support for physical activity (PA) promotion among school-aged children and youth in Finland during past few years has been stronger than ever before.

Background: The purpose of this study was to investigate the prevalence of adolescent physical activity-related injuries in sports club activities, leisure time physical activity and school-based physical activity. The secondary aim was to investigate the differences in the prevalence of physical activity -related injuries between years 2014 and 2016. In addition, we set out to study the associations between age, sex and the frequency of physical activity and injury prevalence.Methods: This cross-sectional study is based on the National Physical Activity Behaviour Study for Children and Adolescents (LIITU in Finnish) conducted in years 2014 and 2016. The subjects completed an online questionnaire in the classroom during school hours. A total of 8406 subjects participated in the current study. Out of these, 49% were boys and 51% were girls. The proportions of 11-, 13-, and 15-year-olds were 35%, 34% and 31%, respectively.Results: In the combined data for 2014 and 2016, injury prevalence was higher in sports club activities (46%, 95% CI 44.8-47.8) than in leisure time PA (30%, 95% CI, 28.5-30.5) or school-based PA (18%, 95% CI, 17.4-19.1). In leisure time PA, the injury prevalence was higher than in school-based PA. In all the three settings, injury prevalence was higher in 2016 than in 2014. Frequency of PA was associated with a higher risk for PA-related injuries in sports clubs and leisure time.Conclusions: With half of the subjects reporting at least one PA-related injury during the past year, results indicate that adolescent PA-related injuries are a large-scale problem. There is a worrisome rise in injury prevalence in recent years. From a public health standpoint, there is an urgent need to invest in injury prevention to reverse this trend. [ABSTRACT FROM AUTHOR]

Aims: The aim of this research was to compare the levels of perceived health literacy among adolescents who do or do not participate in sports club activities. Organized sport club activities reach a high proportion of adolescents, and have the potential to contribute to the development of their health literacy. Methods: The cross-sectional data on health literacy among school children in Finland (aged 13 and 15, n=3852) were measured, as a part of the Health Behaviour in School-Aged Children (HBSC) study, using the Health Literacy for School-aged Children (HLSAC) instrument. Sports club participation and its association with health literacy were examined in relation to age, gender, family affluence, school achievement, and physical activity. The statistical analyses included cross-tabulation and the multilevel mixed-effects logistic regression analyses. Results: Perceived health literacy was higher among adolescents who participated in sports club activities. This conclusion was valid for boys and girls, for both age groups, among those who were physically active 6–7 days a week, had at least moderate school achievement, and those who belonged to the middle or high affluence families. From the health literacy perspective, participation in sports club activities was especially beneficial for those having low or moderate school achievement level. Conclusions: The sports club setting may work towards equalizing health literacy differences related to school achievement. However, the clubs should ensure that access is available to as many adolescents as possible; by this means they may spread beneficial influences, supporting the development of health literacy among broader population groups. [ABSTRACT FROM AUTHOR]

Sufficient and regular physical activity is considered a protective factor, reducing the onset of secondary disability conditions in adolescents with chronic diseases and functional limitations. The aim of this study was to explore whether participation in organized sport may be associated to higher levels of physical activity in adolescents with functional limitations, based on a national representative sample. Data from the Health Behaviour in School-aged Children (HBSC) study collected in Finland from two data collection rounds (2002 and 2010)were conducted and pooled fromadolescents aged between 13 and 15 years old with functional limitations (n = 1041). Differences in self-reported physical activity over the past week and participation in organized sport activity were analysed for each function. Overall, four in ten (n = 413) participated in organized sport and were significantly (p < 0.001) more physically active (mean = 4.92 days, SD= 1.81) than their non-participating (mean = 3.29, SD = 1.86) peers with functional limitations. Despite low population prevalence, adolescents with epilepsy or visual impairments were the least active if they were not participating in organized sport, yet were the most active if they were involved in organized sport. Participating in organized sport appears to be an important factor promoting resources for maintaining recommended levels of physical activity in Finnish adolescents with functional limitations. [ABSTRACT FROM AUTHOR]

There is an increasing amount of evidence suggesting youth sports clubs are an important setting for health promotion. Adolescents in sport club settings can benefit from exposures of positive and negative consequences to health. To better understand the sport club context and coaches' health promotion activity in substance use prevention, this study compares sport club members with non-members aged between 14-16 years old on their experience and use of alcohol, smoking and snuff and coaches' health promotion activity on substances. Methods: Adolescents (n = 671) from sports clubs and from matched schools (n = 1442) were recruited in this study. Multiple binary logistic regressions were performed on substance use. Results: Higher prevalence of substance use was associated with discussions of substances, often held by coaches. Significantly fewer girls who are sport club members had experiences in alcohol, smoking or snuff than their non-member counter-parts, the differences among boys varied by substance. Fewer sport club members experienced smoking than non-members. More boys used snuff than girls. Conclusions: The most salient points for health promotion were that girls who were sport club members used fewer substances and for boys the picture was more complicated. Coaches could be using reactive strategies through informal learning to address substance use in clubs, although more effective training on substance use for coaches is needed. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to examine the rates of sports related injuries in adolescents based on the severity of their long-term illnesses or disabilities (LTID). Few injury prevention strategies in sports and health promotion have explored disaggregation by disability. Methods: Data obtained from the 2014 Finnish Health Behaviour in School-aged Children survey ( n = 3716, mean age = 14.8, SD = 1.03) were grouped into adolescents with and without LTID. A further indicator or severity was determined when adolescents reported their LTID affected their participation (affected LTID). Odds ratio (95% CI) were used to determine the associations between sports related injuries and LTID, daily moderate to vigorous physical activities (MVPA), being a sports club member, physical competence, and family encouragement, after controlling for age, gender and family affluence. Results: One in four adolescents (25%) reported to have LTID and one in eight adolescents (12.5%) reported sports injuries. The odds for adolescents with chronic conditions, functional and learning difficulties was the highest (OR 3.55, CI = 2.3-5.4) for overall injuries, when compared with adolescents without LTID. Adolescents with affected LTID (OR = 2.08, CI = 1.5-2.9) were more likely to report medically attended injuries than adolescents without LTID. Sports-related injuries (OR = 0.33, CI = 0.1-0.8) were lower in adolescents with affected LTID than those without LTID after adjusting for personal and environmental factors. Conclusions: Taking part in sport clubs increases the risk of sports related injuries in adolescents with and without LTID, but not with affected LTID. Few adolescents with affected LTID participate in sports clubs and were less likely to report the most serious type of injury to be from sports. These results could be used for devising sports based injury prevention and health promotion strategies for children with LTID. [ABSTRACT FROM AUTHOR]

Background: Regardless of competitive athletes' body image pressures, only few studies have focused on adolescent sport participants' body image and the findings are inconclusive. Furthermore, the role of competitive goals in sports on adolescents' body size perception has not been studied. We examined the factors associated with adolescents' competitive goals in sports and body size perception, and the associations between adolescents' competitive goals in sports and body size perception.Methods: The cross-sectional study consisted of 475 goal-oriented sports club participants and 936 reference youths (aged 14-16 years). The study questionnaire included multiple choice items on health behaviours, motives to exercise, competitive goals in sports and body size perception. The multinomial logistic regression analysis was used to investigate the associations.Results: Adolescents with competitive goals in sports perceived their body size as about the right size more frequently than reference youths (68% vs 47%, p < 0.001 in girls; 74% vs 61%, p < 0.001 in boys). More than one-fourth of girls with competitive goals in sports perceived themselves as overweight, although only 7% of them were overweight. Adolescents with appearance/weight motives to exercise and poor perceived physical fitness had higher odds of perceived fatness. Additionally, BMI was positively associated with perceived fatness and negatively with perceived thinness. Having competitive goals in sports was not independently associated with perceived fatness or perceived thinness.Conclusions: Adolescents' BMI, appearance/weight motives to exercise, and perceived physical fitness were more strongly associated with body size perception than their competitive goals in sports. However, perceived fatness among girls with competitive goals in sports should be considered in organized sports. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to utilise the collective opinion of a group of Finnish experts to identify the most important learning outcomes of secondary-level school-based health education, in the specific domains of physical activity and nutrition. Design/methodology/approach – The study uses a Delphi survey technique to collect the opinions of a group (panel) of Finnish experts. A list of learning outcomes was compiled via an extensive literature review of documents from all levels of health education (physical activity and nutrition) policy development and implementation. A general inductive analysis method was conducted, resulting in education themes which were then compiled into health literacy-constructed learning outcomes to present to the panel in the two Delphi rounds. Findings – The study question is answered in the form of a ranked list of the 24 most important learning outcomes of physical activity and nutrition education in Finnish schools. The analysis of variance pair-wise comparisons with Bonferroni indicated that six items were statistically possibly more important than the 18 others. The three most important items being: first, understand the importance of a varied and balanced diet; second, the ability to analyse their own lifestyle; third, understand the link between physical activity and health. The study also identified topics/themes which could be either under-represented or over-represented in the current literature and teaching. Originality/value – This study is the only one of its type, and researches an as yet unknown area of health education. The value of this study lies in its role in the further development of school health education, in terms of identifying the “most important” contemporary issues to teach in the classroom, and may also be used as a topic prioritisation and curriculum planning tool. [ABSTRACT FROM AUTHOR]

Finnish sports organisations, local and federal government, and healthcare organisations have widely adopted the World Health Organization and national recommendations for physical activity for different age groups. However, studies have indicated that only 46 % of 3-year-old preschool children, approximately 50 % of primary school students (7-12 years), 10-17 % of secondary school students (13-15 years) and 16 % of Finnish adults (20-54 years) attain those recommendations. In Finland there are 33,620 built sports facilities and over 9000 sport clubs, meaning there are many possibilities for physical activity, yet people are still rather inactive. In this paper we argue that availability of facilities, although an important element, is not enough to promote physical activity. It is possible that the current built physical environmental design does not fulfil people's needs regarding participation in physical activity. More emphasis should be placed on the design and operation of the facilities to develop new affordances for physical activity. [ABSTRACT FROM AUTHOR]

This paper seeks to review the current international health-promoting sports club (HPSC) research, drawing together findings based on case studies from various countries to illustrate the status of HPSCs. In addition, future challenges for HPSC research and implementation are considered. The review includes six case studies from five countries. In summary, there are two major research themes in this area, namely 'research into HPSC activity' and 'research into HPSC networks'. The first theme investigates the extent to which sports clubs and/or national sports organisations invest in health promotion (HP) - both in policy and practice. The latter theme is driven by an intention to widen the scope of HPSCs to reach novel internal actors, like parents, siblings, etc., and/or external non-sporting bodies, like communities, schools, etc. The future challenges for HPSC research require a better understanding of the motives, barriers and capacities of sports clubs and coaches. Sports organisations, clubs and coaches generally support the intent of the HPSC concept, but even with the best evidence- or theory-based HP programmes/guidelines/standards, nothing will happen in practice if the nature and capacities of sports clubs are not better acknowledged. Therefore, a call for embracing implementation science is finally made to enhance implementation. [ABSTRACT FROM AUTHOR]

Sport coaches have paradoxical attitudes towards addressing health promotion as a part of their coaching practice: health is recognized as an important factor, but not greatly invested in. Overall, the extent to which youth sport coaches take health promotion into account has been unclear. Therefore, it is the intention of this study to clarify this situation. The results show that coaches evaluate their own activity on health promotion as being relatively active, whereas young male athletes' evaluations reveal a wide gap in how they perceived the coaches' activity. Young male athletes perceived their coaches as being substantially more passive in comparison to coaches' self-evaluations. This difference may indicate either that coaches' health promotion activity is generally infrequent or that what is done is broadly ineffective. Either way, as the global health-related problems of decreasing physical activity, increasing sedentary lifestyles, and obesity are all issues affecting youths attending sports clubs, arguably there is a need for youth sport coaches to invest more in health promotion activities. However, the coaches need more support from the sports clubs. [ABSTRACT FROM AUTHOR]

The aim was to assess the quality and strength of evidence for the health benefits of specific sport disciplines. Electronic search yielded 2194 records and the selection resulted in 69 eligible studies (47 cross-sectional, 9 cohort, 13 intervention studies). 105 comparisons between participation and non-participation groups in 26 different sport disciplines were reported. Moderately strong evidence showed that both running and football improve aerobic fitness and cardiovascular function at rest, and football reduces adiposity. Conditional evidence showed that running benefits metabolic fitness, adiposity and postural balance, and football improves metabolic fitness, muscular performance, postural balance, and cardiac function. Evidence for health benefits of other sport disciplines was either inconclusive or tenuous. The evidence base for the health benefits of specific sports disciplines is generally compromised by weak study design and quality. Future research should address the health effects of different sport disciplines using rigorous research designs. [ABSTRACT FROM AUTHOR]