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Abstract Introduction Compensatory behavior of physical activity (PA) based on the ActivityStat hypothesis in adolescents is scarcely investigated, and existing studies showed inconclusive results. Understanding the compensatory behavior in a holistic way is important as this can help to improve intervention outcomes and thus, increase the PA levels in adolescents. Thus, the aim of the present study is to investigate the occurrence, direction, timeframe, and ratio of habitual activity compensation in adolescents. Furthermore, we want to identify the awareness of compensation and factors that influence compensatory behavior. Methods The present qualitative study used a mixed methods crossover analysis design. Participants (N = 15, 8 boys and 7 girls) were adolescents aged 11–15 years (mean age 13.04 ± 1.28). They provided a habitual weekly schedule with habitual/regular activities and their intensity. Participants then kept an activity diary over one week to capture their actual behavior. After that, data were compared and deviations > ±20% were considered as compensation opportunities. On this basis, deviations were descriptively analyzed for compensatory behavior and were coded as positive and negative compensatory behavior. Further, for each compensation, the ratio of compensation (MET-minutes of the compensating activity/MET-minutes of the activity that was compensated) was calculated. Additionally, interviews were conducted to explore perceptions and influencing factors for (no) compensation. Results Overall, 198 compensation opportunities were identified with deviations greater ± 20%. Of these, 109 opportunities were compensated overall (69 within-day, 40 between-day). Negative compensation took place in 57 opportunities and 52 opportunities were compensated positively. Most of the deviations were overcompensated (compensation/deviation > 100%). About half of the adolescents (N = 8) were not aware about their compensatory behavior, and only one boy was aware of all his compensatory behavior. The most mentioned influence for positive compensation were social support by friends and good weather. As influencing factors for negative compensation, tiredness as well as no need for movement were mentioned predominantly. No negative compensation occurred because adolescents wanted to stick to their routines or participated in hedonistic activities. Discussion Summarizing the findings, the present study delivered new insights into the field of compensatory behavior in adolescents. Nevertheless, compensatory behavior was not consistently observed regarding the occurrence of compensation, direction, timeframe and ratio. However, social support appears to be an important factor to compensate positively or to avoid a negative compensatory behavior. Further, it seems to be helpful to support individuals in their search for hedonistic activities as well as in the establishment of routines.

Abstract Physical activity has numerous health benefits for people with physical disabilities. Nevertheless, activity levels are often below recommended levels. To promote physical activity among children and adolescents who use a wheelchair as their primary source of mobility, this systematic review explores the physical activity patterns of this group. A systematic search of PubMed, Sports Medicine & Education Index, Web of Science, and SPORTDiscus was performed, included articles were synthesized in terms of duration, intensity, and settings in which physical activity occurred, as well as the physical activity measurement methods. Nine articles were included. The mean overall physical activity level across the included studies was 98 minutes per day (range: 78–115 minutes per day). Two articles analysed the duration of physical activity at different intensities (very light physical activity, light physical activity (LPA), moderate to vigorous physical activity (MVPA) and intensities near to maximum). Within the included articles, both subjective and objective measurement methods were used. Due to the small number of articles, combined with small sample sizes, there is not enough evidence to answer the research questions sufficiently. Nevertheless, the review provides an overview of actual research and clearly shows that the physical activity values are insufficiently researched. There is a need for further research on the scope, types and settings of physical activity in the target group.

Abstract Background Active travel behavior such as walking and cycling is associated with several health benefits. Especially the family environment seems to be important for active travel in children and adolescents. Currently, little is known regarding travel behavior in leisure time and associations of travel behavior within parent-adolescent dyads. Methods The present analysis is based on the German ARRIVE study (Active tRavel behavioR in the famIly enVironmEnt), which incorporated a large scale, representative cross-sectional online survey including 517 parent–child dyads consisting of adolescents (N = 517; boys = 263, girls = 254) aged 11–15 years and one of their parents (N = 517; fathers = 259, mothers = 258). Based on that survey which took place in June 2021 (during the COVID-19 pandemic), we calculated the prevalence of active travel to four commonly visited destinations (school/work, friends/relatives, shopping stores and recreational activities) using an adapted version of the travel to school questionnaire by Segura-Diaz JM, Rojas-Jimenez A, Barranco-Ruiz Y, Murillo-Pardo B, Saucedo-Araujo RG, Aranda-Balboa MJ, et al. (Int J Environ Res Public Health 17(14), 2020). In addition, we investigated the associations between parents’ and adolescents’ travel behavior using scores for school/work, leisure time (friends/relatives, shopping stores and recreational activities) and overall (school/work and leisure time). Results Across all destinations, prevalence of active travel in adolescents (63.08%) was higher than in parents (29.21%). Active travel to school (47.33%) as well as to work (20.43%) indicated the lowest prevalence. Linear regression models revealed significant associations in overall active travel between mothers and adolescents (girls: β = 0.308, p

IntroductionWhile there are several approaches to collect basic information on physical activity (PA) promotion policies, some governments require more in-depth overviews on the situation in their country. In Germany, the Federal Ministry of Health expressed its interest in collecting detailed data on target group specific PA promotion, as relevant competences are distributed across a wide range of political levels and sectors. This study describes the development of a policy brief on physical activity promotion for children and adolescents in Germany. In particular, it addresses two major gaps in the current literature by systematically assessing good practice examples and “routine practices,” i.e., PA promotion activities already taking place on large scale and regular basis.Materials and methodsBased on relevant national and international guidelines, the TARGET:PA tool was co-produced by researchers and ministry officials. It includes (1) PA recommendations, (2) national prevalence rates, (3) recommendations for PA promotion, and data on national (4) routine practices, (5) good practice projects and (6) policies. Data were collected for children and adolescents in Germany using desk research, semi-structured interviews and secondary data analysis.ResultsA policy brief and scientific background document were developed. Results showed that 46% of the 4–5-year-olds fulfil WHO recommendations but only 15% of the 11–17-year-olds, and that girls are less active than boys. Currently, in Germany no valid data are available on the PA behaviour of children under the age of three. An overview of routine practices for PA promotion for children and adolescents was compiled, and experts were asked to critically assess their effectiveness, reach and durability. Overall, 339 target group specific projects for PA promotion were found, with 22 classified as examples of good practice. National PA policies for children and adolescents were identified across different sectors and settings.ConclusionThe study provides a comprehensive overview of the current status of PA promotion for children and adolescents in Germany. The co-production of the policy brief was a strength of the study, as it allowed researchers to take the needs of ministry officials into account, and as it supported the immediate uptake of results in the policymaking process. Future studies should test the applicability of the TARGET:PA tool to different target groups and countries.

Abstract Background According to the ActivityStat hypothesis more physical activity (PA) in one timespan is compensated by increased sedentary time (ST) in the following timespan and vice versa to maintain an overall stable PA level. Until now, existing literature revealed inconsistent results regarding compensatory behaviour across children and adolescents. Thus, the aim of the present study is (1) to investigate whether ST in the morning is compensated by active behaviour in the afternoon and (2) whether ST during the week is compensated by active behaviour during the weekend in (pre)adolescent girls. Additionally, we aimed to differentiate between positive and negative compensatory behaviour and examine whether it is moderated by socioeconomic status (SES), age or weight status. Methods The participants were 370 sixth grade school girls (mean age 11.6 years) from Munich that participated in the CReActivity study, a school based intervention study aiming to identify the mechanisms of behavioural changes in PA among girls. ST and PA were measured over seven consecutive days using accelerometery. Descriptive determination of compensatory behaviour, as well as Bayesian multivariate multilevel analysis were conducted with data clustered on the individual (ID), class and school level. Results Descriptive analysis revealed rather constant compensatory behaviour of about 60% for after-school days and weekends over all observation points. However, regarding all girls, compensation was predominantly negative. Differentiated analysis indicated that all girls with low ST levels in the morning or on weekdays, compensated for this behaviour with lower PA levels in the afternoon or on weekends. Multilevel covariate analysis indicated great variability between the participants. Furthermore, differences in compensatory behaviour can also be seen on class and school levels. Interestingly, PA compensatory behaviour is not associated with age, weight status or SES. Conclusion Our findings could neither confirm nor reject the ActivityStat Hypothesis. Overall, due to the great variability across the girls, it seems that compensation depends on individual factors. In the future, to prevent negative compensation, school-based interventions that have the potential to provide opportunities to be physically active, should not neglect (pre)adolescents’ leisure time behaviour. Trial Registration DRKS00015723 (date of registration: 2018/10/22 retrospectively registered).

BackgroundIn recent years, there has been a global trend toward an increase in life expectancy and the proportion of elderly people among the population. In this regard, it becomes important to promote active and healthy aging. Physical inactivity and social isolation are both risk factors of many chronic illnesses and highly prevalent in older adults. This challenges communities to develop interventions that reduce these risk factors among elderly populations. The main aims of this study were to summarize community-based interventions that aim to simultaneously promote social participation and physical activity in older adults and to examine their effects.MethodsWe performed a systematic review based on the PRISMA standards. Literature searches were conducted in six scientific databases in July 2021. Articles were included if they had an interventional design, focused on older adults living in the community and measured social participation and physical activity as an outcome. The data were summarized narratively due to the heterogeneity of studies and the variety of outcome measures.ResultsOverall, 46 articles published in English were included. The studies were grouped in (1) interventions with main focus on physical activity promotion; (2) social activities that included a physical activity component; (3) health behavior interventions/ health education interventions; (4) multicomponent interventions; (5) environmental interventions. The majority of the reviewed studies reported positive effects of interventions on physical activity and/or social participation. No study reported negative effects. Analysis of quantitative studies showed that multicomponent interventions have great positive effects on both outcomes. In qualitative studies positive effects were found regardless of intervention type.ConclusionThis review summarizes the evidence about the effects of community-based interventions that aim to promote social participation and physical activity in older adults. Multicomponent interventions seem to be most suitable for simultaneous promotion of physical activity and social participation. However, high variability in measurement methods used to assess both social participation and physical activity in the included studies made it difficult to compare studies and to indicate the most effective.Systematic review registrationwww.crd.york.ac.uk, identifier: PROSPERO [CRD42021268270].

The promotion of physical activity in people from lower social strata is a public health priority. Previous reviews of physical activity interventions among socioeconomically disadvantaged adults have focused on intervention effectiveness without considering their translation into practice. This review utilised the RE-AIM framework (Reach, Efficacy/Effectiveness, Adoption, Implementation, Maintenance) to (1) evaluate the extent to which experimental and non–/quasi-experimental trials of interventions to promote physical activity among socioeconomically disadvantaged adults report on issues of internal and external validity and (2) to provide recommendations for future intervention studies.Four databases were searched through June 2021. We included studies published in English or German since 2000 that tested physical activity interventions for socioeconomically disadvantaged adults. Two researchers coded all studies using a validated RE-AIM data extraction tool with 61 indicators referring to internal and external validity. Binary coding (yes = 1/no = 0) was applied to calculate the number and percentage of studies reporting each of the indicators.We included 39 studies of which 22 were non–/quasi-experimental trials. Indicators of reach were most frequently reported (59.2%), followed by implementation (38.9%) and efficacy/effectiveness (28.9%). Dimensions related to external validity were least frequently reported (adoption: 21.9%, maintenance: 17.8%). Few differences were found between experimental and non–/quasi-experimental trials.Analysis showed overall poor reporting of components related to internal and external validity. We recommend that future research should increase attention on reporting indicators of internal and external validity to facilitate their translation and implementation into real world settings.Trial registration: The review was registered with PROSPERO (CRD42021283688).

Abstract Background Physical activity recommendations are reached by only a small part of the population. A common problem is that research findings on public health-related topics such as physical activity promotion are oftentimes not translated into practice. The involvement of relevant stakeholders, such as change agents (role models, decision-makers, and/or knowledge mediators), is a common strategy to implement physical activity recommendations in specific settings, as they have the necessary knowledge of contextual factors. However, dissemination and implementation of physical activity recommendations are often prevented by focusing exclusively on the health sector and by underestimating the individual perceptions and needs of change agents. Therefore, the purpose of this study was to address the problem of how physical activity recommendations can be translated into practice through comprehensive consideration of the situation and context of change agents from various sectors of society at different administrative levels. This allows for deriving recommendations for action on how a national dissemination strategy of physical activity recommendations should be designed. Methods Qualitative expert interviews were conducted with change agents from different sectors of society and administrative levels in Germany (N = 21). Case selection took place via a sampling plan. The interviews were recorded, transcribed verbatim, and analysed by two trained researchers using qualitative content analysis. Results The change agents’ perceived relevance of physical activity and physical activity promotion and their knowledge of physical activity recommendations varied across different sectors. Nine themes were identified covering the change agents’ needs for the implementation of physical activity recommendations: strengthening of political will and cooperation, availability of public space for physical activity, change in awareness and health education, professional qualification, financial incentives, development of physical activity-promoting programmes and structures, provision of resources, bridging the theory–practice gap, and knowledge of physical activity recommendations. Conclusions This exploratory study contributes to the development of an evidence-based dissemination strategy of physical activity recommendations involving change agents from various sectors. Cross-sectoral needs and obstacles were identified indicating gaps that have to be addressed. Future research should choose practice-oriented approaches to develop dissemination strategies that are adapted to the needs of local contexts.

Active travel in adolescence contributes to improved health outcomes. Self-Determination Theory suggests that motivation and basic psychological needs influence travel behavior. Person-centered approaches can examine interrelationships of these constructs underlying travel behavior. The aim of this study was to investigate (i) which clusters can be identified in adolescents, (ii) whether clusters explain overall active travel behavior, (iii) whether clusters were associated with travel mode to various destinations or distance, and (iv) whether differences across clusters appear regarding sex/gender, age, and weight status. The sample included 517 (263 male, 254 female) adolescents from Germany, aged 11–15. Self-organizing maps analysis identified six clusters from nine input variables: intrinsic motivation, integrated regulation, identified regulation, introjected regulation, external regulation, amotivation, autonomy satisfaction, competence satisfaction, and relatedness satisfaction. The most beneficial cluster regarding active travel demonstrated highest basic psychological needs satisfaction and autonomous motivation with low controlled motivation and amotivation. The most vulnerable cluster was characterized by generally low levels of motivation except for external regulation and amotivation. Clusters were not associated with distance to school, friends/relatives, shopping facilities, or leisure facilities. The findings support the importance of high quality and high quantity of motivation for active travel in adolescents.

IntroductionPhysical inactivity is a major risk factor for a population's health, especially among socially disadvantaged groups. Many health promotion projects focus on increasing physical activity among their respective target groups. However, because they are mostly developed and implemented under laboratory conditions, they fail when being scaled to real-world settings. The community-based participatory research projects BIG and GESTALT have demonstrated their effectiveness regarding the physical activity promotion in real-world settings by employing a participatory method.Material and AnalysisWithin the context of the BIG-5 and GET-10 projects, these previously implemented and tested participatory projects are scaled to 15 additional settings in Bavaria, Germany. By applying an overarching mixed-methods evaluation framework, the aim is to gain insights into a) the recruitment of communities for scale-up; b) the specific results of the projects according to the RE-AIM framework. In the recruitment of communities, standardized information on the first contact, the consultation process, the person in charge, and previously implemented health promotion projects are collected. A systematic web search will complete information on each community and their health promotion activities. Results will be compared with information on those communities most in need, here according to the deprivation index of communities in Bavaria, Germany. The scale-up process and its results will be measured using semi-structured interviews with project coordinators. A standardized questionnaire will be used with the course's participants. Applying the RE-AIM framework, the collected data will be analyzed deductively.DiscussionWe expect the results to be highly relevant for the effective scale-up of any health promotion project. The study will enhance the understanding of how to reach those communities most in need of health promotion projects and will identify the barriers coordinators face in reaching socially disadvantaged groups.ConclusionAlthough participatory projects are often used as individual projects, little is known about the scaling up of participatory health promotion projects. This cross-cutting evaluation of two projects aims at producing data on the barriers and facilitators for the reach of settings most in need, and those success factors for a durable implementation.

Regular physical activity during childhood and adolescence is associated with health benefits. Consequently, numerous health promotion programs for children and adolescents emphasize the enhancement of physical activity. However, the ActivityStat hypothesis states that increases in physical activity in one domain are compensated for by decreasing physical activity in another domain. Currently, little is known about how physical activity varies in children and adolescents within intervals of one day or multiple days. This systematic review provides an overview of studies that analyzed changes in (overall) physical activity, which were assessed with objective measurements, or compensatory mechanisms caused by increases or decreases in physical activity in a specific domain in children and adolescents. A systematic search of electronic databases (PubMed, Scopus, Web of Science, SportDiscus) was performed with a priori defined inclusion criteria. Two independent researchers screened the literature and identified and rated the methodological quality of the studies. A total of 77 peer-reviewed articles were included that analyzed changes in overall physical activity with multiple methodological approaches resulting in compensation or displacement. Of 40,829 participants, 16,265 indicated compensation associated with physical activity. Subgroup analyses separated by study design, participants, measurement instrument, physical activity context, and intervention duration also showed mixed results toward an indication of compensation. Quality assessment of the included studies revealed that they were of high quality (mean = 0.866). This review provides inconclusive results about compensation in relation to physical activity. A trend toward increased compensation in interventional studies and in interventions of longer duration have been observed.

Active commuting (AC) provides numerous health benefits and is one way to improve physical activity in children and adolescents. Boys are more likely to use active transport modes than girls. Girls and boys benefit differently from interventions that promote AC. The aim of this systematic review is to evaluate the effects of interventions on girls and boys and to appraise the extent to which previous studies have taken sex/gender into account. Eleven electronic databases were searched to identify all relevant randomized and non-randomized controlled trials based on a priori defined eligibility criteria. Two independent reviewers screened the literature for eligibility and assessed risk of bias. Semiquantitative analyses were conducted to evaluate the effects of intervention effects by taking sex/gender aspects into account. To evaluate sex/gender considerations in interventional studies, a recently developed sex/gender checklist was applied. Twelve studies were included that examined intervention effects on AC in girls and boys. Three intervention studies showed significant effects in increasing AC, with one study favoring girls, one favoring boys, and another focusing on a single sex/gender (only girls). According to the checklist, the overall sex/gender rating highlighted a lack of information in sex/gender consideration. Studies with and without significant effects indicated no differences in the sex/gender checklist. The results indicate that sex/gender is not considered adequately in primary interventional research on AC. To evaluate the effectiveness of intervention in boys and girls, detailed analyses of sex/gender are required, and better reporting about sex/gender-specific intervention content is necessary. In future health research to promote AC, sex/gender should be systematically taken into account.

Abstract Background Children’s independent mobility (CIM) is an important contributor to physical activity and health in children. However, in the last 20 years CIM has significantly decreased. To develop effective intervention programs to promote CIM, the impact of the environment on CIM must be identified. This review seeks to provide an overview of sex/gender-specific socio-ecological correlates of CIM. Methods A systematic literature search of five databases (PubMed, PsycInfo, Scopus, Medline, Web of Science) was conducted with a priori defined eligibility criteria and identified 1838 potential articles published between January 1990 and November 2017. Two independent reviewers screened the literature and identified and rated methodological quality of the studies. Related factors of CIM were summarized separately for CIM license (parental permission to travel independently) and CIM destination (destinations to which a child travels independently), and separately for boys and girls using a semi-quantitative method. Results Twenty-seven peer-reviewed journal articles were identified which examined the relationship between the social and physical environment and CIM. Only seven studies reported results divided by sex/gender. Most associations between the environment and CIM were found in the expected direction (positive or negative) or not associated at all. The social environment seemed to be more influential for ensuring CIM than the physical environment. Neighborhood safety, fear of crime and stranger, parental support, and perception of traffic were important social environmental factors influencing CIM, while car ownership, distance, and neighborhood design were relevant physical environmental attributes. Few studies examined sex/gender-related environmental correlates of independent mobility, and those findings were inconsistent. Conclusion The findings of this systematic review serve as suggestions for intervention programs to increase CIM and to identify future directions in research. To establish a robust comprehension of the impact of the social and physical environment on CIM, further sex/gender-sensitive studies using comparable measurements for CIM and environmental correlates are needed.

Measures to slow down the spread of coronavirus SARS-CoV-2 have had an impact on the daily life and physical activity (PA) of many people. Nevertheless, in Germany, mitigation policies and incidence values vary widely across the federal states (Länder). Thus, the aim of the present study was to investigate regional differences in PA during the coronavirus pandemic. This study is based on the SPOVID project (Examining physical activity and sports behavior in the face of COVID-19 pandemic: a social inequality perspective) that incorporates a large-scale, representative cross-sectional survey representing the German population (≥14 years). Based on the survey that took place in October 2020 (N = 1477), we investigated the relationships between the COVID-19 incidence values as well as the mitigation policies across the federal states in Germany and changes in PA. Pearson correlations indicated a strong negative relationship between PA change and 7-day incidence values (r = −0.688 **, p = 0.009) and a moderate negative relationship between PA changes and an index of mitigation policies (r = −0.444, p = 0.112). Higher 7-day incidence values and stricter mitigation policies were associated with a stronger decline in PA levels. Therefore, it is important to support people to stay active even if there are restrictions. In particular, in federal states and regions with high incidences and stricter mitigation policies, measures to promote health-enhancing PA are necessary.

Physical activity during early childhood is a prerequisite for healthy development in many cases. The aim of this study was to assess the relationships of social modelling and support from parents, peers, and siblings and domain-specific physical activity participation in a nationwide sample of preschool boys and girls from Germany. 519 preschool children aged 4−6 and one of their parents participated in the ‘MoMo’ Wave 1 Study between 2009 and 2012. Participants and their parents provided self-reported data on social support modelling, and domain-specific physical activity participation (physical activity in sports clubs, physical activity outside of sports clubs, and outdoor play). Parental, peer, and sibling support and modelling were related to domain-specific physical activity: Parental support was particularly relevant for physical activity in sports clubs, and peer support for outdoor play. Parental modelling was only related to physical activity outside of sports clubs: Maternal modelling was a positive correlate in girls and paternal modelling in boys, respectively. Sibling and peer modelling were especially relevant for physical activity in sports clubs. The results were heterogeneous regarding types and providers of support and modelling. Thus, different providers and types of support should be targeted in physical activity promotion programs for preschool children.