Search

Background: Few mobile health resistance-based physical activity interventions have targeted community-dwelling adults. "Ecofit" is a multicomponent intervention that promotes resistance and aerobic activities using smartphone technology, outdoor gyms, and social support. This study evaluated process evaluation outcomes of the ecofit randomized controlled trial: (1) the acceptability and usability of the ecofit smartphone app and app user workouts; (2) perceptions of factors influencing outdoor gym use; and (3) the fidelity, reach, recruitment, and dose received of the ecofit program., Methods: Process data were collected through program evaluation surveys at 3 months, and app usage data were collected via the intervention platform for up to 3 months. Data were analyzed using descriptive statistics., Results: The survey was completed by 57% (n = 69) of eligible participants. The majority (93%) believed the app provided them with sufficient information to perform muscle-strengthening activities. Approximately half (51%) agreed that the goal-setting function encouraged them to complete their workouts, and 42% agreed that the self-assessment helped them monitor progress. "Proximity" to outdoor gyms emerged as the most important factor for choosing locations to workout (mean = 5.5, SD = 1.1). Participants logged a median of 5.5 (interquartile range = 19) workouts and 1 (interquartile range = 1) upper- and lower-body muscular fitness self-assessment., Conclusions: The ecofit app provided participants with sufficient skills to perform unsupervised resistance training exercises using mobile health. Only half of the participants regarded self-assessments and goal setting as useful, suggesting a need for modifications to how these are implemented. Mobile health remains a promising delivery platform to promote unsupervised resistance training, although more research is needed to improve uptake.

Introduction: In Australia, 45% of adults meet the aerobic recommendations, and only 9%-30% meet the resistance training guidelines. Given the lack of at-scale community-based interventions promoting resistance training, the aim of this study was to assess the impact of an innovative mHealth intervention on upper- and lower-body muscular fitness, cardiorespiratory fitness, physical activity, and social-cognitive mediators among a sample of community-dwelling adults., Study Design: Researchers evaluated the community-based ecofit intervention using a cluster RCT from September 2019 to March 2022 in 2 regional municipalities of New South Wales, Australia., Setting/participants: Researchers recruited a sample of 245 participants (72% female, aged 53.4±13.9 years) who were randomized to the ecofit intervention group (n=122) or waitlist control (n=123) group., Intervention: The intervention group received access to a smartphone application with standardized workouts tailored to 12 outdoor gym locations and an introductory session. Participants were encouraged to perform at least 2 ecofit workouts per week., Main Outcome Measures: Primary and secondary outcomes were assessed at baseline, 3 months, and 9 months. The coprimary muscular fitness outcomes were evaluated using the 90-degree push-up and the 60-second sit-to-stand test. Intervention effects were estimated using linear mixed models accounting for group-level clustering (participants could enroll in groups of up to 4). Statistical analysis was conducted in April 2022., Results: Statistically significant improvements were observed in upper (1.4 repetitions, 95% CI=0.3, 2.6, p=0.018) and lower (2.6 repetitions, 95% CI=0.4, 4.8, p=0.020) body muscular fitness at 9 months but not at 3 months. Increases in self-reported resistance training, resistance training self-efficacy, and implementation intention for resistance training were statistically significant at 3 and 9 months., Conclusions: This study has shown that a mHealth intervention promoting resistance training using the built environment can improve muscular fitness, physical activity behavior, and related cognitions in a community sample of adults., Trial Registration: This trial was preregistered with the Australian and New Zealand Clinical Trial Registry (ACTRN12619000868189)., (Copyright © 2023 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Aims: This study aimed to describe the prevalence and socio-demographic and lifestyle-related correlates of muscle-strengthening activity (MSA; strength/resistance training, sit-ups/push-ups, etc.) among a large sample of European adolescents., Methods: Data were drawn from the European Health Interview Survey Wave 2 (2013-2014), including 8818 adolescents (15-17 years) from 28 European countries. Self-reported MSA was assessed using a previously validated survey item. Population-weighted prevalence ratios were calculated for (a) 'none' (0 days/week), (b) 'insufficient MSA' (1-2 days/week) or (c) 'sufficient MSA' (⩾3 days/week). Generalised linear models using Poisson regression with robust error variance were used to calculate the prevalence ratios for adolescents reporting sufficient MSA by socio-demographic/lifestyle characteristics and by European region., Results: Overall, 19.4% (95% confidence interval (CI) 18.3-20.7) reported sufficient (⩾3 days/week) MSA and 57.9% (95% CI 56.4-59.6) reported none. Females, adolescents from Southern and Eastern European regions, those not meeting the aerobic guideline and adolescents classified as overweight were significantly associated with a lower likelihood of reporting sufficient MSA, independent of other characteristics., Conclusions: The majority of European adolescents do not meet the MSA guidelines. Future large-scale MSA public-health interventions should target female and currently inactive adolescents, as well as those from Southern and Eastern European regions.

Background: Physical activity guidelines recommend young people engage in regular muscle-strengthening activities (e.g., resistance training [RT]). However, few school-based physical activity interventions have been delivered at-scale or promoted RT. The aim of this study was to evaluate the reach, effectiveness, adoption, implementation and maintenance of the Resistance Training for Teens (RT for Teens) program., Methods: Data were collected between August 2015 and October 2020. RE-AIM was operationalized as: (i) Reach: number and characteristics of students estimated to be exposed to the program; (ii) Effectiveness: impact of the program on student-level outcomes measured in a subsample of 750 students from 17 schools; (iii) Adoption: number and representativeness of schools with one or more teachers trained to deliver the program; (iv) Implementation: extent to which the program was delivered as intended; and (v) Maintenance: extent to which the program was sustained in schools., Results: The estimated program reach was ~ 10,000 students, out of a total student population of ~ 200,000 (~ 5%). Students were from diverse socioeconomic and ethnic backgrounds. Improvements in muscular fitness, RT self-efficacy, perceived cardiorespiratory fitness and flexibility, and participation in muscle-strengthening physical activities were documented. A total of 30 workshops were delivered, involving 468 teachers from 249 schools from diverse geographical regions. Implementation varied considerably, with teachers adapting the program to suit the context of their school and student cohorts. However, RT skill development and the promotion of muscular fitness were the session components delivered most during sessions. Teachers' adherence to the SAAFE (Supportive, Active, Autonomous, Fair and Enjoyable) teaching principles was high. Approximately 30% of teachers (144/476) registered to use the RT for Teens app. At the school-level, 37% (93/249) of schools had at least one registered user (teacher and/or student). A total of 2,336 workouts and 3,116 fitness tests were completed by registered users. Of the 249 schools represented, 51 (20.5%) sent an additional (previously untrained) teacher to a second workshop., Conclusions: The RT for Teens program had broad reach and adoption. However, intervention delivery varied considerably across schools and additional support strategies are required to optimize intervention implementation and maintain program delivery over time. Future studies will benefit from the utilization of accepted frameworks, recommendations and guidelines for implementation research., Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN12621000352808), retrospectively registered 1 st February 2021., (© 2021. The Author(s).)

Objective: Muscle-strengthening exercise (use of weight machines, free weights, push-ups, sit-ups), has multiple independent health benefits, and is a component of the Global physical activity guidelines. However, there is currently a lack of multi-country muscle-strengthening exercise prevalence studies. This study describes the prevalence and correlates of muscle-strengthening exercise across multiple European countries., Methods: Data were drawn from the European Health Interview Survey Wave 2 (2013-14), which included nationally representative samples (n = 3,774-24,016) from 28 European countries. Muscle-strengthening exercise was assessed using the European Health Interview Survey Physical Activity Questionnaire. Population-weighted proportions were calculated for (1) "insufficient" (0-1 days/week) or (2) "sufficient" muscle-strengthening exercise (≥2 days/week). Prevalence ratios were calculated using multivariate Poisson regression for those reporting sufficient muscle-strengthening by country and by sociodemographic/lifestyle characteristics (sex, age, education, income, self-rated health etc.)., Results: Data were available for 280,605 European adults aged ≥18 years. Overall, 17.3% (95% CI = 17.1%-17.5%) reported sufficient muscle-strengthening exercise (≥2 days/week). Muscle-strengthening exercise was geographically patterned with the lowest prevalence reported in South-eastern European countries (Romania, Malta and Cyprus: range: 0.7%-7.4%), and the highest prevalence in the Nordic countries (Iceland, Sweden, and Denmark: range: 34.1%-51.6%). Older age, insufficient aerobic activity, poorer self-rated health, lower income/education, being female, and being overweight/obese were significantly associated with lower likelihood of reporting sufficient muscle-strengthening exercise, independently of other characteristics., Conclusions: Most European adults do not report sufficient muscle-strengthening exercise, and prevalence estimates varied considerably across countries. Low participation in muscle-strengthening exercise is widespread across Europe, and warrants public health attention., Competing Interests: The authors have declared that no competing interests exist.

The aim of this study is to examine the prevalence and correlates of adolescents' resistance training (RT) skill competence. Participants were 548 adolescents (14.1 ± 0.5 years) from 16 schools in New South Wales, Australia. RT skills were assessed using the Resistance Training Skills Battery. Demographics, BMI, muscular fitness, perceived strength, RT self-efficacy, and motivation for RT were also assessed. The proportion demonstrating "competence" and "near competence" in each of the six RT skills were calculated and sex differences explored. Associations between the combined RT skill score and potential correlates were examined using multi-level linear mixed models. Overall, the prevalence of competence was low (range = 3.3% to 27.9%). Females outperformed males on the squat, lunge and overhead press, whereas males performed better on the push-up (p < .05). Significant associations were seen for a number of correlates, which largely differed by sex. Muscular fitness was moderately and positively associated with RT skills among both males (β = 0.34, 95%CIs = 0.23 to 0.46) and females (β = 0.36, 95%CIs = 0.23 to 0.48). Our findings support a link between RT skills and muscular fitness. Other associations were statistically significant but small in magnitude, and should therefore be interpreted cautiously.

Purpose: Guidelines recommend that young people engage in muscle-strengthening activities on at least 3 d·wk. The purpose of this study was to examine the effect of a school-based intervention focused on resistance training (RT) for adolescents., Methods: The "Resistance Training for Teens" intervention was evaluated using a cluster-randomized, controlled trial with 607 adolescents (50.1% girls; 14.1 ± 0.5 yr) from 16 secondary schools. Teachers were trained to deliver the intervention, which included the following: (i) an interactive student seminar; (ii) a structured physical activity program, focused on RT; (iii) lunchtime fitness sessions; and (iv) Web-based smartphone apps. The primary outcome was muscular fitness (MF) and secondary outcomes included body mass index, RT skill competency, flexibility, physical activity, self-efficacy, and motivation. Assessments were conducted at baseline, 6 months (postprogram; primary end point), and 12 months (follow-up). Outcomes were assessed using linear mixed models, with three potential moderators tested using interaction terms (and subgroup analyses where appropriate)., Results: For the primary outcome (MF), a group-time effect was observed at 6 months for the upper body (2.0 repetitions; 95% confidence interval (CI), 0.8-3.2), but not the lower body (-1.4 cm; 95% CI, -4.7-1.9). At 6 months, there were intervention effects for RT skill competency and self-efficacy, but no other secondary outcomes. Effects for upper body MF and RT skill competency were sustained at 12 months. Despite overall no effect for body mass index, there was a group-time effect at 12 months among students who were overweight/obese at baseline (-0.55 kg·m; 95% CI, -1.01 to -0.08)., Conclusions: The school-based RT intervention resulted in immediate and sustained improvements in upper body MF and RT skill competency, demonstrating an effective and scalable approach to delivering RT within secondary schools.

The purpose of this study was to examine the mediating effect of resistance training skill competency on percentage of body fat, muscular fitness and physical activity among a sample of adolescent boys participating in a school-based obesity prevention intervention. Participants were 361 adolescent boys taking part in the Active Teen Leaders Avoiding Screen-time (ATLAS) cluster randomised controlled trial: a school-based program targeting the health behaviours of economically disadvantaged adolescent males considered "at-risk" of obesity. Body fat percentage (bioelectrical impedance), muscular fitness (hand grip dynamometry and push-ups), physical activity (accelerometry) and resistance training skill competency were assessed at baseline and post-intervention (i.e., 8 months). Three separate multi-level mediation models were analysed to investigate the potential mediating effects of resistance training skill competency on each of the study outcomes using a product-of-coefficients test. Analyses followed the intention-to-treat principle. The intervention had a significant impact on the resistance training skill competency of the boys, and improvements in skill competency significantly mediated the effect of the intervention on percentage of body fat and the combined muscular fitness score. No significant mediated effects were found for physical activity. Improving resistance training skill competency may be an effective strategy for achieving improvements in body composition and muscular fitness in adolescent boys.

Objectives: The study aim was to assess rater agreement of the Resistance Training Skills Battery (RTSB) for adolescents. The RTSB provides an assessment of resistance training skill competency and includes six exercises. The RTSB can be used to assess performance and progress in adolescent resistance training programmes and to provide associated feedback to participants. Individual skill scores are based on the number of performance criteria successfully demonstrated and an overall resistance training skill quotient (RTSQ) is created by summing the six skill scores., Design/methods: The eight raters had varying experience in movement skill assessment and resistance training and completed a 2-3h training session in how to assess resistance training performance using the RTSB. The raters then completed an assessment on six skills for 12 adolescents (mean age=15.1 years, SD=1.0, six male and six female) in a randomised order., Results: Agreement between seven of the eight raters was high (20 of the 21 pairwise correlations were greater than 0.7 and 13 of the 21 were greater than 0.8). Correlations between the eighth rater and each of the other seven raters were generally lower (0.45-0.78). Most variation in the assigned RTSB scores (67%) was between cases, a relatively small amount of the variation (10%) was between raters and the remainder (23%) was between periods within raters. The between-raters coefficient of variation was approximately 5%., Conclusions: The RTSB can be used reliably by those with experience in movement skill assessment and resistance training to assess the resistance skill of adolescents., (Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.)

The aim of this study was to describe the development and assess test-retest reliability and construct validity of the Resistance Training Skills Battery (RTSB) for adolescents. The RTSB provides an assessment of resistance training skill competency and includes 6 exercises (i.e., body weight squat, push-up, lunge, suspended row, standing overhead press, and front support with chest touches). Scoring for each skill is based on the number of performance criteria successfully demonstrated. An overall resistance training skill quotient (RTSQ) is created by adding participants' scores for the 6 skills. Participants (44 boys and 19 girls, mean age = 14.5 ± 1.2 years) completed the RTSB on 2 occasions separated by 7 days. Participants also completed the following fitness tests, which were used to create a muscular fitness score (MFS): handgrip strength, timed push-up, and standing long jump tests. Intraclass correlation (ICC), paired samples t-tests, and typical error were used to assess test-retest reliability. To assess construct validity, gender and RTSQ were entered into a regression model predicting MFS. The rank order repeatability of the RTSQ was high (ICC = 0.88). The model explained 39% of the variance in MFS (p ≤ 0.001) and RTSQ (r = 0.40, p ≤ 0.001) was a significant predictor. This study has demonstrated the construct validity and test-retest reliability of the RTSB in a sample of adolescents. The RTSB can reliably rank participants in regards to their resistance training competency and has the necessary sensitivity to detect small changes in resistance training skill proficiency.

Background: The COVID-19 global pandemic greatly impacted lifestyles and physical activity routines. This study explored how the COVID-19 pandemic impacted participant experience and motivation in ecofit, a large, community-based, multicomponent intervention that supports aerobic and resistance-based physical activity using publicly available, outdoor exercise facilities and smartphone technology. Methods: Fifteen participants from the intervention arm of the study were interviewed. Audiotaped telephone interviews were transcribed verbatim and analyzed by a researcher uninvolved in the intervention. Through an inductive thematic approach, data were coded and organized into themes. The quantitative measure of participant smartphone application engagement was used as a classification during analysis. Results: Several themes representing participants' experience of the COVID-19 pandemic in their engagement with ecofit, overall physical activity levels, motivation to exercise, and perception and usage of outdoor gym facilities were identified. Conclusion: The impact of the COVID-19 pandemic on clinical trials is beginning to emerge. Although the present study showed a mixed impact of the pandemic on participation in the ecofit program, the overall implications for the intervention are yet to be determined. Interestingly, although a large review found a negative impact of COVID-19 on physical activity, this sample reported an overall increase. [ABSTRACT FROM AUTHOR]

Objectives: While outdoor gyms are being rapidly installed around the globe, little is known about their implications on physical activity, and fitness and other health-related outcomes. The primary objective of this systematic review was to examine the effects of outdoor gyms on physical activity, fitness and other health-related outcomes. Secondary objectives were to describe outdoor gym characteristics, user characteristics, and outdoor gym usage.Design: Systematic review.Methods: Peer-reviewed papers published in English were obtained through online database searches of the following databases; EBSCO, SPORTdiscus, Medline, PsycINFO, Web of Science, Scopus and Informit. Searches covered the periods from database inception to January 2019. Studies that reported on the efficacy of outdoor gym use for physical activity, health-related outcomes or descriptive aspects of outdoor gyms and their users were eligible for inclusion.Results: There was some support that outdoor gyms may improve physical activity, fitness and other health-related outcomes, however few experimental studies have been conducted. There was no consistency between outdoor gyms in terms types and number of installed equipment for each facility. Further, this review found discrepancies of whom were the most likely users of outdoor gyms and when they were mainly used.Conclusions: This review contributes to the limited evidence on the impact and characteristics of outdoor gyms on physical activity and fitness and health-related outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Secondary schools have the potential to promote health-related fitness (HRF) and physical activity within and outside school hours. As such, schools are often chosen as the setting to implement child and adolescent physical activity programs. School-based programs often utilise teachers as delivery agents, but few studies examine effects on teacher-level outcomes. Purpose: The primary aim of this study was to determine the impact of teacher training embedded within a physical activity intervention on teacher-level outcomes. The secondary aim of this study was to evaluate process data, including implementation, satisfaction and fidelity. Methods: Resistance Training for Teens (RT for Teens) was evaluated using a cluster randomised controlled trial in 16 secondary schools. Teachers (N = 44; 48% female/52% male; mean ± SD years teaching experience = 10.6 ± 8.0) from 16 secondary schools were assessed at baseline. Intervention group teachers (i.e. from eight schools) delivered a structured school-based physical activity program over 10-weeks. Teacher outcomes included confidence to teach health-related fitness (HRF) activities, perceived barriers to teaching HRF activities, and perceived fitness. Detailed process evaluation data were also collected. Assessments were conducted at baseline and 6-months (post-program), and outcomes were assessed using repeated measures analysis of variance. Results: There was a positive group-by-time effect for the confidence composite score (p = .010, partial eta squared = 0.29), but no effects for the two (contextual, interpersonal) barrier composite scores. Also, there was a significant effect for perceived 'general fitness' (p = 0.044, partial eta squared = 0.13), but not for specific fitness subdomains. Teachers were highly satisfied with both the training and the program, believing it was beneficial for students. Resource usage and adherence to the SAAFE (Supportive, Active, Autonomous, Fair, Enjoyable) delivery principles was high. Conclusion: RT for Teens improved teachers' confidence and perceived fitness. These findings highlight the potential for high-quality teacher training and program delivery to positively influence teacher-level outcomes. This may provide support for the use of teacher professional development to improve HRF-related pedagogy. [ABSTRACT FROM AUTHOR]

Abstract Objective To examine the impact of a school-based physical activity intervention on adolescents' self-esteem and subjective well-being, and to explore moderators and mediators of intervention effects. Methods Resistance Training for Teens was evaluated using a cluster RCT in 16 schools located in New South Wales, Australia. Adolescents (N = 508; 14.1 ± 0.5 years; 49.6% female) completed measures of global self-esteem, subjective well-being, and hypothesized mediators (i.e., perceived fitness, resistance training self-efficacy, and autonomous motivation) at baseline (April–June, 2015) and post-intervention (October–December). The school-based physical activity program was delivered by teachers over 10-weeks via Physical Education, co-curricular school sport, or an elective subject known as Physical Activity and Sport Studies, and involved once-weekly fitness sessions and additional lunch-time sessions. Intervention effects and moderator analyses were tested using multi-level linear regression analyses with interaction terms. Multi-level mediation analyses were used to explore potential mediators of changes in well-being outcomes. Results Intervention effects for self-esteem (β = 0.05, p =.194) and wellbeing (β = 0.03, p =.509) were not statistically significant. Moderator analyses showed effects for self-esteem were greater for the overweight/obese subgroup (p =.069 for interaction), and resistance training self-efficacy was a significant mediator of changes in self-esteem (product-of-coefficients [AB] = 0.021, SE = 0.010, 95% CIs = 0.002 to 0.040). No other significant indirect effects were observed. Conclusion Overall, Resistance Training for Teens did not improve adolescents' self-esteem or subjective well-being. However, our mediation findings lend support to resistance training self-efficacy as a mechanism explaining the positive effect of resistance training on self-esteem. Highlights • School-based physical activity interventions can positively influence youth well-being. • No intervention effects were observed for self-esteem or subjective well-being. • Changes in resistance training self-efficacy mediated changes in self-esteem. [ABSTRACT FROM AUTHOR]

Objective The present study examined the effect of a school-based multicomponent physical activity intervention on aggression in adolescent males from low-income areas, and explored potential mediators of change in aggression. Methods Participants were adolescent males ( N  = 361; 12.7 ± 0.5 years) enrolled in the ‘Active Teen Leaders Avoiding Screen-time’ cluster RCT. Self-report measures for aggression, perceived strength and recreational screen-time were collected at baseline and 8-months. The effect of the intervention on aggression was tested using multi-level linear regression and potential mediators (i.e., screen-time and perceived strength) were explored using a product-of-coefficients test. Results There was no significant intervention effects for aggression (C [SE] = -0.038 [0.044], p  = .384) or perceived strength (A [SE] = -0.0 [0.0], p  = .884). However, a statistically significant effect was found for screen-time (A [SE] = -0.160 [0.04], p = <0.01). Changes in screen-time significantly mediated changes in aggression at post-test (AB [SE] = -0.021 [0.009], 95% CI = -0.042 to -0.005). Conclusion Limiting recreational screen-time may help to reduce aggression in adolescent boys. Interventions targeting adolescents' recreational screen-time should examine their ‘flow-on’ effects on externalising behaviours in adolescent populations. [ABSTRACT FROM AUTHOR]

Background: Obesity prevention interventions targeting 'at-risk' adolescents are urgently needed. The aim of this study is to evaluate the sustained impact of the 'Active Teen Leaders Avoiding Screen-time' (ATLAS) obesity prevention program. Methods: Cluster RCT in 14 secondary schools in low-income communities of New South Wales, Australia. Participants were 361 adolescent boys (aged 12-14 years) 'at risk' of obesity. The intervention was based on Self-Determination Theory and Social Cognitive Theory and involved: professional development, fitness equipment for schools, teacher-delivered physical activity sessions, lunch-time activity sessions, researcher-led seminars, a smartphone application, and parental strategies. Assessments for the primary (body mass index [BMI], waist circumference) and secondary outcomes were conducted at baseline, 8- (post-intervention) and 18-months (follow-up). Analyses followed the intention-to-treat principle using linear mixed models. Results: After 18-months, there were no intervention effects for BMI or waist circumference. Sustained effects were found for screen-time, resistance training skill competency, and motivational regulations for school sport. Conclusions: There were no clinically meaningful intervention effects for the adiposity outcomes. However, the intervention resulted in sustained effects for secondary outcomes. Interventions that more intensively target the home environment, as well as other socio-ecological determinants of obesity may be needed to prevent unhealthy weight gain in adolescents from low-income communities. [ABSTRACT FROM AUTHOR]

A correction to the article "Evaluating the Reach, Effectiveness, Adoption, Implementation and Maintenance of the Resistance Training for Teens Program" in the November 30, 2021 issue is presented.

We aimed to explore associations between guideline-concordant muscle-strengthening activity (MSA) and demographic, biological, psychosocial, and behavioral factors among Australian adolescents. We used baseline data from the 'Resistance Training for Teens' cluster randomized controlled trial (collected April–June 2015). Adolescents (n = 602, mean age = 14.1 ± 0.5 years, 50% female) from 16 schools in New South Wales, Australia self-reported their sex, primary language spoken at home, postal code (for socioeconomic status), resistance training (RT) self-efficacy, motivation for RT, perceived strength, moderate-to-vigorous physical activity (MVPA), screen-time, and sleep. Participants also completed tests of height, weight, cardiorespiratory and muscular fitness, flexibility, and RT skills. MSA was self-reported and participants were dichotomized as 'meeting' (3–7 days) or 'not meeting' (0–2 days) the MSA guideline. Binary logistic regression with odds ratios (OR) was used to determine associations with adolescents' MSA. Analyses for each variable group explained a small-to-moderate proportion of the variance in MSA. Sex, muscular fitness, RT self-efficacy, perceived strength, and total MVPA emerged as statistically significant factors. However, only RT self-efficacy (OR = 2.48 [1.37 to 4.50]) and total MVPA (OR = 1.48 [1.22 to 1.79]) were associated with guideline-concordant MSA in the full model, which explained 52% of the variance. Our study adds to the limited understanding of adolescents' MSA behavior. RT self-efficacy and total MVPA were independently associated with guideline-concordant MSA among Australian adolescents. The findings have implications for the design and delivery of future interventions targeting adolescents' MSA behavior. • One in three adolescents met the WHO muscle-strengthening activity (MSA) guideline. • One in four adolescents reported completing no MSA at all. • Males were more likely than females to meet the MSA guideline. • Resistance training self-efficacy and overall physical activity were independently related to guideline-concordant MSA. [ABSTRACT FROM AUTHOR]

Exercise in natural environments can improve cognition, positive affect, and reduce psychological stress. However, it remains unclear whether these benefits are subject to a gradient effect, whereby more natural features confer greater cognitive and psychological benefits. This study examined the influence of the exercise environment (i.e., the degree of nature) on cognition, and psychological outcomes in a sample of adolescents (n = 90; mean age = 14.3 ±.05 years). Four groups were randomised to one of the following experimental conditions: a non-exercise indoor control, indoor exercise, park exercise, and exercise in a nature reserve. Participants' self-reported their stress, affect, and vitality and completed two measures of cognition ('Rapid Visual Information Processing' and 'Spatial Working Memory') immediately before and ~6 min after exercise. All exercise conditions participated in a group-based circuit lasting ~20 min, which included a mixture of aerobic and body-weight resistance activities. Linear mixed models were used to examine changes within and between groups. The indoor group increased sustained attention accuracy compared to the park group. There were no between-group differences in working memory. The indoor and nature groups increased cognitive arousal compared to control. The park group improved in state-level vitality compared to control. The mixed-results of this research do not support our 'nature gradient' hypothesis, whereby cognitive and psychological outcomes would improve in accordance with the degree of nature present in the exercise environment. • Improvements in sustained attention accuracy favoured indoor over park exercise. • Park exercise resulted in improvements in state-level vitality. • No evidence that exercise environment influences working memory. • No conclusive nature gradient effects on cognitive and psychological outcomes. [ABSTRACT FROM AUTHOR]

The risk and prevalence of Type 2 Diabetes (T2D) has dramatically increased over the past decade. The aim of this study was to develop, implement and evaluate a physical activity intervention to improve aerobic and muscular fitness among adults at risk of, or diagnosed with T2D. A 20-week, assessor blinded, parallel-group randomized controlled trial (RCT) was conducted at the University of Newcastle (June-December 2015). Adults were randomized to the intervention (n=42) or wait-list control group (n=42). The theory-based intervention included: Phase 1 (weeks 1-10) integrated group sessions (outdoor physical activity and cognitive mentoring), and the eCoFit smartphone application (app). Phase 2 (weeks 11-20) only included the eCoFit app. Participants were assessed at baseline, 10weeks and 20weeks. Linear mixed models (intention-to-treat) were used to determine group-by-time interactions at 10weeks (primary time-point) and 20weeks for the primary outcomes. Several secondary outcomes were also assessed. After 10weeks, significant group-by-time effects were observed for aerobic fitness (4.5mL/kg/min; 95% CI [1.3, 7.7], d=0.68) and muscular fitness (lower body) (3.4 reps, 95% CI [2.7, 4.2], d=1.45). Intervention effects for secondary outcomes included significant increased physical activity (1330steps/week), improved upper body muscular fitness (5 reps; arm-curl test), improved functionality (-1.8s; timed-up and go test) reduced waist circumference (2.8cm) and systolic blood pressure (-10.4mmHg). After 20weeks, significant effects were observed for lower body muscular fitness and health outcomes. eCoFit is an innovative lifestyle intervention which integrates smartphone technology, social support, and the outdoor environment to improve aerobic and muscular fitness. [ABSTRACT FROM AUTHOR]