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Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes.An international cross-sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons.In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self-placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self-accomplishment, and life satisfaction, but negatively predicted loneliness and depression.In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health.Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies.

PURPOSE The purpose was to explore the efficacy of a commercial smartwatch with a blood pressure-monitoring feature. DESIGN A randomized controlled trial. METHODS Sixty healthy young adults were recruited. Participants were randomly allocated to wear a commercial smartwatch, one with and one without a blood pressure-monitoring feature for 12 weeks. Data were collected using Omron HEM-907, Inbody 270S, and the International Physical Activity Questionnaire. FINDINGS Results revealed a significant effect and group-by-time interaction on diastolic blood pressure. After 12 weeks in participants who wore a smartwatch with a blood pressure-monitoring feature, the systolic and diastolic blood pressure and resting heart rate had decreased. CONCLUSION Using commercial smartwatches with a blood pressure-monitoring feature is a feasible approach to support self-management, increase awareness, and promote physical activity for health promotion, obesity and chronic disease prevention. CLINICAL RELEVANCE Wearable technologies may be an innovative strategy for preventing high blood pressure by continuous self-monitoring and healthy behavior modifications.

This study aimed to explore the effect on physical activity and sedentary behavior of users of wearable devices, and understand the association between physical activity and behavior. This study conducted a three-arm, randomized controlled trial for 12 weeks. Healthy adults without experience of using a wearable device were recruited and were randomly assigned to a control group with a mobile app and two experimental groups with different smart wearable devices. Data were collected through questionnaires. No significant effect of group, time, or group-by-time interaction among groups for physical activity, sedentary time, or sleep quality was found. Wearing duration significantly positively predicted changes in low-intensity and total physical activity. The number of times the device was checked negatively predicted a change in sedentary time. The behavior of wearable device users is an essential factor for successfully increasing physical activity and decreasing sedentary time.

Objectives Virtual reality (VR) exergames are an innovative approach to promote older adults' mental health. VR exergames are active video games controlled by bodily movements in a safe surrounding with advantages of physical activity engagement and interactions. The purpose of this study was to explore the effectiveness of VR exergames in improving older adults’ cognition and ameliorating depressive outcome by a systematic review, meta-analysis, subgroup analysis, and meta-regression. Design This is a systematic review and meta-analysis. Setting and Participants Adults over 60 years old. Methods Four electronic databases, including PubMed, Embase, Medline, and Cochrane, were searched for related articles. After evaluation, 18 randomized control trials were selected for qualitative and quantitative synthesis. Results The meta-analytical results found moderate effects of VR exergames on overall cognitive function and memory, and a large effect on depressive outcomes in older adults. Commercial VR games had more-significant and larger effects on depressive outcomes than exergames with VR devices. The meta-regression results revealed that the total intervention duration had a significant effect on depressive outcomes. A higher intervention duration had greater effects on depressive outcomes. Conclusions and Implications This meta-analytical study suggests that VR exergames can provide potential positive influences on cognition, memory, and depression in older adult populations. VR exergames could be an interesting strategy for active aging and a good mental health status.

Type 2 diabetes mellitus (T2DM), common in older people, is an important reason for muscle loss in Japanese and Taiwanese populations. However, little is known about the association between lifestyle behaviours and muscle quality. We aimed to compare the lifestyle behaviours of Japanese and Taiwanese older adults with T2DM and to the identify lifestyle factors associated with muscle quality.This cross-sectional study was conducted among community-dwelling individuals with T2DM aged ≥65 years in Taiwan and Japan. Totally, 114 Japanese and 226 Taiwanese participants were enrolled in the study. Outcomes were measured by blood biochemical examinations, body composition analyses and structured self-reported questionnaires to assess lifestyle behaviours and muscle quality. Linear regression models were used to examine the relationship between lifestyle factors and muscle quality using SPSS version 27.0 with a statistical significance level of P 0.05.Japanese subjects were more likely to be smokers and alcohol consumers, and they were less likely to have well-balanced diets and engage in more physical activity as compared to Taiwanese subjects. The muscle quality in the Japanese subjects was significantly poorer than that in the Taiwanese subjects. Physical activity, dietary habits and smoking were associated with muscle quality, after adjusting for age, gender and body mass index.Physical activity of insufficient intensity, unhealthy dietary habits and smoking could be risk factors for poor muscle quality. These findings can contribute to the development of effective strategies to improve muscle quality in community-dwelling older Asian people with T2DM.

Before Erikson proposed the life stages, Confucius concluded an autobiographic review of his entire life in about 500 BC. Confucius’ life stages may be closer to the life experiences of Chinese older adults. Therefore, the purpose of this study was to examine the effect of the life review program on cognitive ability, life satisfaction, meaning of life, and ego integrity. The experiment was based on a single-group time-series design with a four-time test across 21 weeks. The evoking materials were horticultural activities held in seven weekly sessions. The innovative life review program was in accordance with a combination of Confucius’ and Erikson’s life stages. Nine participants completed all sessions. There was a significant positive effect of time on participants’ cognitive ability and meaning of life after the program. A combination of Confucius’ and Erikson’s life stages can be more advantageous for Chinese older adults than only Erikson’s life stage.

Walking and cycling are beneficial for urban adults' health. Transport and recreation are modifiable domains of major physical activity resources. The purposes of this study were to explore associations among psychological and environmental factors, walking and cycling behaviours and quality of life by developing a path model and comparing gender differences.A cross-sectional study.Participants were community-dwelling healthy urban adults aged 20-65 years. Data were collected between September 2019 and June 2020 by self-reported questionnaires, including health beliefs, the neighbourhood environment, walking and cycling behaviours and the World Health Organization Quality-of-Life Scale. An ANCOVA, chi-squared tests, partial least squares-path model and a multi-group analysis were performed for statistical analyses.In total, 1294 valid responses were received, which included 41.27% men and 58.73% women. Men had lower walking behaviours and better self-efficacy than women. The developed path model indicated an acceptable model fit. Significant path coefficients were found among psychological and environmental factors, walking and cycling behaviours and quality of life. The path model between men and women found no significant differences in any path coefficients. Significant path coefficients of environmental factors with cycling behaviour and of walking behaviour with quality of life were found in men but not in women.Improving individuals' health beliefs, self-efficacy and perceived walkability and cyclability is a beneficial strategy for promoting physical activity. Walking and cycling behaviours are recommended to improve the quality of life of urban adult populations.What problem did the study address? A large proportion of urban adult populations still have insufficient physical activity globally. It is essential that implications from an overall perspective of psychological and environmental factors and their interactions be integrated to develop efficient strategies for promoting physical activity and quality of life. What were the main findings? The developed path model with an acceptable model fit found that psychological and environmental factors were important in explaining urban adults' walking and cycling behaviours and quality of life. Differences were not found between men's and women's path models. Where and on whom will the research have impact? Improving urban adults' psychological and environmental factors might be an efficient strategy for promoting sufficient physical activity. Men's low engagement in walking behaviours should garner increased attention. Providing equal opportunities for both genders to engage in walking and cycling behaviours are recommended for health promotion in urban regions.

The impact of meeting leisure time physical activity (LTPA) recommendations and household physical activity (HPA) on all-cause mortality in the Taiwanese population is unclear. We aimed to investigate the relationship between sufficient LTPA and all-cause mortality in middle-aged and older Taiwanese adults and the role of HPA in those with insufficient LTPA.This nationwide prospective cohort study included 4,960 participants aged ≥50 years from the Taiwan Longitudinal Study in Aging (TLSA) survey. Physical activity patterns were assessed in 2003 and then followed up until 2015 for mortality through the National Death Registration Record. Cox proportional hazards regression was conducted to evaluate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality.Of the 4,960 participants, 1712 died of all-cause mortality. Compared to those who had insufficient LTPA, participants who engaged in sufficient LTPA showed a significantly lower risk of all-cause mortality (HR=0.84, 95% CI, 0.73-0.97). For those with insufficient LTPA, HPA also had a significantly reduced risk of all-cause mortality (HR=0.85, 95% CI, 0.75-0.96) among general population. Similar associations were observed in subsequent sensitivity analyses. The subgroup analysis showed that the relationship between HPA and reduced mortality risk was only found in the women with insufficient LTPA group.This study confirmed that sufficient LTPA is associated with a lower risk of all-cause mortality. If sufficient LTPA cannot be performed, additional HPA is related to lower mortality.

IntroductionSeveral studies have suggested that physical activity and sedentary behavior are strongly and independently associated with body composition and obesity. However, few studies have investigated whether substituting sedentary time with moderate-to-vigorous physical activity is associated with body composition in older adults, especially among those older than 75 years.MethodsThis study examined the associations between replacing sedentary time with physical activity and obesity indices in a sample of 199 community-dwelling older Taiwanese adults (52.3% women; 80.6 ± 7.0 years). Physical activity and sedentary behavior were measured using the triaxial accelerometer (GT3X+, ActiGraph). Body composition indices were computed through a bioelectrical impedance analysis of body fat percentage and appendicular skeletal muscle mass index. Waist circumference and body mass index were measured by trained personnel. Isotemporal substitution analyses estimated these associations after adjusting for sociodemographic characteristics and nutritional status.ResultsThe study showed that substituting 30 min of sedentary behavior per day with moderate-to-vigorous physical activity was associated with lower body fat percentage (B = −1.408, 95% CI = −2.55, −0.264), body mass index (B = −0.681, 95% CI = −1.300, −0.061), and waist circumference (B = −2.301, 95% CI = −4.062, −0.539) after adjusting for covariates. Substituting 30 min of light physical activity per day with moderate-to-vigorous physical activity was associated with lower waist circumference (B = −2.230, 95% CI = −4.173, −0.287) after adjusting for covariates. Stratified analyses indicated that associations were stronger in youngest-old older adults, and in older adults with a normal nutritional status (vs. underweight status).DiscussionThese findings confirm the importance of reducing sedentary behavior and increasing moderate-to-vigorous physical activity among older adults to improve their physical health, as well as highlighting the importance of taking into account nutritional status and age group.

Being overweight and obese are major public health challenges worldwide. Smartphone apps are an innovative platform to deliver physical activity modifications for weight management. This study aimed to explore the efficacy of smartphone app-based interventions targeting physical activity for obesity-related outcomes and compare the efficacy among behavioral change techniques.Five online databases were searched for randomized controlled trials in September 30, 2021. Hedges' g was used to compute effect sizes. The random effect models were conducted for all analyses.In total, 12 trials were selected for qualitative and quantitative syntheses. Smartphone app-based interventions exerted small-to-moderate effects on body weight, body mass index, and body fat percentage. The meta-regression found that the older age of participants and a longer duration of the intervention increased the effect. Subgroup analyses found that the interventions were more effective on body weight among participants with a disease or disability, and on body mass index in participants who were obese or overweight. Apps with features such as reminders, self-reporting, and a health coach used as behavioral change techniques were more effective.Smartphone apps are an effective and feasible strategy for physical activity modification using behavioral change techniques. Smartphone app-based interventions can promote physical activity for weight management.

OBJECTIVES Discharge planning is an effective strategy to prevent adverse health events and reduce medical expenditures. The high-risk target populations of discharged elderly patients and important predictors for the occurrence of adverse events are still not clear. Therefore, the purposes of this study were to examine the validity of discharge planning screening tools in sufficiently identifying high-risk adverse events to health after discharge and to compare two screening tools with our study model. DESIGN We conducted a prospective study and recruited elderly patients who had had no hospitalization within 3 months before admission to 13 general wards of a medical center in northern Taiwan from November 2018 to May 2020. METHODS Elderly patients were randomly selected during the study period. Within 24 h of admission, patients were asked to consent to join this study. After the patient was discharged, the patient's health and hospitalization for the next year were tracked by telephone interviews. RESULTS In total, 300 participants were recruited for this study. Incidences of high-risk adverse events within 30 days, 60 days, and 12 months after discharge were 20.3%, 25.7%, and 48.7% respectively. A logistic regression showed that an increased age, physical or mental disabilities or a major illness, a low body-mass index, and having been hospitalized in the past year were significantly related to the occurrence of high-risk events among elderly discharge patients. The pooled sensitivity of the Pra was 52% and the specificity was 72%; the pooled sensitivity of the LACE index was 67% and the specificity was 36%. The predictive model of this study had a higher discriminatory power than the Pra and LACE index for high-risk events after discharge. CONCLUSIONS Elderly patients are more vulnerable to high-risk adverse events after discharge. Both the LACE index and Pra are useful discharge planning screening tools to screen for high-risk adverse events after discharge. Elderly patients need more-active and complete continuity of care plans and discharge planning services to ensure that the overall quality of patient care can be improved and readmissions and mortality reduced. CLINICAL RELEVANCE The findings of this study can provide information for discharge planning managers to identify high-risk elderly patients during hospitalization and promptly offer care education or resources to improve care management.

Aims: Wearable devices are a new strategy for promoting physical activity in a free-living condition that utilizes self-monitoring, self-awareness, and self-determination. The main purpose of this study was to explore health benefits of commercial wearable devices by comparing physical activity, sedentary time, sleep quality, and other health outcomes between individuals who used and those that did not use commercial wearable devices. Methods: The research design was a cross-sectional study using an Internet survey in Taiwan. Self-administered questionnaires included the International Physical Activity Questionnaire–Short Form, Pittsburgh Sleep Quality Index, Health-Promoting Lifestyle Profile, and World Health Organization Quality-of-Life Scale. Results: In total, 781 participants were recruited, including 50% who were users of wearable devices and 50% non-users in the most recent 3 months. Primary outcomes revealed that wearable device users had significantly higher self-reported walking, moderate physical activity, and total physical activity, and significantly lower sedentary time than non-users. Wearable device users had significantly better sleep quality than non-users. Conclusion: Wearable devices inspire users’ motivation, engagement, and interest in physical activity through habit formation. Wearable devices are recommended to increase physical activity and decrease sedentary behavior for promoting good health.

Creating a healthy lifestyle is important across different life stages. Commercial smart wearable devices are an innovative and interesting approach as an early psychological intervention for modifying health-related behaviors. Therefore, the purpose of this study was to explore the effects of smart wearable devices on health-promoting lifestyles and quality of life. The study design was a three-parallel randomized controlled trial with a 3-month intervention. Two commercial smart wearable devices (smartwatches and smart bracelets) with different levels of complicated functions were applied as a psychological intervention in comparison with a smartphone app as the control group. Participants were healthy young adults with a median age of 26 years. Outcome measurements were conducted by self-administered questionnaires. Chi-square tests and ANOVA were performed for testing the difference of participants at baseline, and generalized estimating equations were performed for testing the effect of the intervention. At the beginning, 81 participants were recruited and 73 participants completed the study. Results of a healthy lifestyle demonstrated significant group effects of exercise and a significant effect of the interaction for self-actualization and stress management in the experimental group with a smartwatch (Self-actualization: MD = 0.35[− 0.10,0.80]; Exercise: MD = 0.21[− 0.33 0.75]; Stress management: MD = 0.36[− 0.04,0.76]) by comparing with only using mobile app (Self-actualization: MD = − 0.03[− 0.25,0.18]; Exercise: MD = − 0.12[− 0.38,0.14]; Stress management, MD = − 0.28[− 0.55,0.00]). The significant effect of group-by-time interaction for self-actualization was found in the experimental group with a smart bracelet (MD = 0.05[− 0.30,0.20]) by comparing with the control group. The GEE-adjusted model indicated significant effects of the interaction on the comprehensive, physical, and mental quality of life in the experimental group with the smartwatch (Comprehensive: MD = 0.24[− 0.04,0.52]; Physical: MD = 0.67[0.26,1.09]; Mental: MD = 0.72[0.29,1.16]) by comparing with the control group (Comprehensive: MD = − 1.57[− 2.55, − 0.59]; Physical: MD = 0.25[0.00,0.50]; Mental: MD = 0.08[− 0.11,0.27]). From a psychological perspective, smart wearable devices have potential benefits of shaping a healthy lifestyle and improving the quality of life. Enhancing the utility of commercial well-designed smart wearable devices is an innovative and effective strategy for promoting public health.

Background: Young adults’ physical activity is a foundation of creating future healthy lifestyles. The purpose of this study was to explore differences in physical activity, sedentary behavior, walkability, and health beliefs between young adults with and without cardiometabolic risk factors and the influence of moderate-to-vigorous physical activity.Methods: A cross-sectional study was conducted using a structured questionnaire.Results: Totally, 1149 valid responses were received for a response rate of 86.32%. A significant effect of cardiometabolic risk factors on the physical activity and sedentary time among groups was found. Young adults at high risk had a lower probability of moderate-to-vigorous physical activity than did healthy adults. Individuals who perceived that there were more recreational facilities, higher benefits of exercise, and lower barriers to exercise were more likely to participate in moderate-to-vigorous physical activity.Conclusions: Engaging in physical activity from environment and psychological perspectives is necessary for young adults’ cardiometabolic health promotion.

Older patients often encounter negative health outcomes after discharge from the hospital. The purpose of this study was to explore the effects of discharge planning services and unplanned readmissions on the risk of death within 1 year after discharge in older patients.A prospective observational study was conducted from November 2018 to May 2020. Participants were inpatients aged over 65 years in 13 general wards of a medical center in Taiwan. Data were collected by interviews and patients' medical records, including the offer of discharge planning services, the occurrence of unplanned readmissions, and death which occurred within 1 year after discharge. A proportional hazard regression model with a time-varying covariate was performed for data analysis.In total, 300 patients completed the interview and medical records, and 297 were assessed for eligibility; 42.1% of participants received discharge planning services, 43.4% of participants had an unplanned readmission, and 34 (11.4%) participants died from all causes within 1 year after discharge. After controlling for age, operation, tube use, physical and mental disabilities or major illnesses, body-mass index, incontinence, muscle weakness, malnutrition problems, and length of stay in the hospital, older patients who had received discharge planning services had a significantly lower risk of death within 1 year after discharge (adjusted hazard ratio (aHR)=0.08, p0.001). Older patients who experienced an unplanned readmission had a significantly higher risk of death within 1 year after discharge (aHR=12.78, p = 0.001).After being discharged from the hospital, patients experiencing an unplanned readmission may have an increased chance of death. Therefore, the development of continuous hospital discharge planning services and the achievement of a collaborative partnership are recommended to improve patients' compliance and positive health outcomes after discharge from the hospital.

Background The rising population of older adults is transforming Taiwan society. Although many long-term care facilities now operate for older adults, the transition from the home environment to long-term facilities may cause multiple issues, including relocation stress syndrome, for new residents. Autonomy is a critical element of the human experience. Leisure, as an expression of autonomy, has been shown to enhance self-image and promote feelings of competence and mastery. Purpose The aim of this study was to assess the relationship between participation in leisure activities and adjustment to residential care using the continuity theory. Methods One hundred sixty-three qualified individuals from 11 long-term care institutions were recruited and completed the questionnaire. The sampling criteria for the study were age (55+ years), appropriate cognitive skills, and residency (less than 5 years). Interviews conducted by trained interviewers were used to collect data. Measured outcomes included leisure participation; physical, psychological, and social adjustments; and background information. Cluster analysis, descriptive analysis, multivariate analysis of variance, and least significant difference test were used in analysis. Results Type of admission (voluntary/mandated) and type of leisure participation significantly affected the level of relocation adjustment success. Four leisure behavior categories were identified, including reduced participation, expanded participation, active participation, and continuing participation. The participants in the active and continuing participation categories had significantly higher psychological adjustment than their peers in the reduced participation category. Moreover, the continuing participation category had a significantly better level of social adjustment than their expanded participation category peers. Continuous and active participation categories had a beneficial outcome in relocation adjustment. Conclusions The findings support that, in general, residents of long-term care facilities who participate continuously in leisure activities adjust better psychologically and socially to their new life in these facilities than individuals in the other participation categories. As continuity of participation in leisure activities is important for successful aging, institutions should facilitate the continuing leisure behavior of new residents.

Population aging is an increasing phenomenon in many countries around the world. It has been estimated that more than one quarter of all older adults experience a mental or neurological disorder or disease such as dementia, depression, anxiety, and substance abuse. Reminiscence is a popular treatment for enhancing well-being in older adults. Previous studies have shown that reminiscence therapy improves the cognitive functions, behaviors, and other psychosocial outcomes in older adult patients. The themes and materials that are used in reminiscence treatments for the older adults in Taiwan differ from those used in other countries because of Taiwan's unique historical background and culture.The main purpose of the current study was to review systematically the application and outcomes of reminiscence therapy in Taiwan.The terms "reminiscence," "dementia," "Alzheimer's disease," and "Taiwan" were used in an Integrated Resources Search that was conducted at National Taiwan Normal University. Sixteen articles were systematically reviewed using a synthesis of two matrices of experimental designs and intervention designs.Reminiscence group sizes ranged between 7 and 12 participants, session frequencies were all once a week for periods lasting between 4 and 16 weeks, and session durations ranged from 30 minutes to 2 hours. The memories of the participants were stimulated using materials dating from their youth such as Taiwanese folk songs, toys, photos, radio programs, newspapers, and food and drinks. In terms of research methodology, most of the studies that were reviewed used quasi-experimental designs without random assignment or control group due to sample size. A minority of the reviewed studies applied the randomized controlled treatment method. Only a few of the studies evaluated indicators in pretest, posttest, and follow-up periods. The results of these studies identified several benefits of reminiscence therapy in Taiwanese older adults, including improvements in cognitive function, anxiety, depressive symptoms, self-esteem, life satisfaction, and personal interaction.Reminiscence is a good noninvasive treatment for the prevention and treatment of mental diseases in Taiwanese older adults. Furthermore, reminiscence promotes mental health in older adults. Finally, this study provides recommendations for further study and clinical application of reminiscence therapy in Taiwan.

The aim of this study was to investigate the prevalence of sarcopenia and its associated risk factors among elderly with diabetes in Japan and Taiwan. A cross-sectional study was conducted through convenience sampling. This study was approved by the institutional review boards of Kobe University Graduate School of Health Sciences (No. 543) and Taipei Medical University (No. N201905065). Of the 114 Japanese participants (24.9% females) and 226 Taiwanese participants (75.1% females), the mean age were 73.7±6.9 years and 74.2±6.6 years, respectively. Sarcopenia was found in 10.6% in Japan and 11.1% in Taiwan with no significant difference between both countries. Older age, poor relationships with neighbors, and poor consciousness for health management were significantly associated with sarcopenia in both countries. Additionally, Japanese participants with sarcopenia had significantly longer duration of diabetes, higher level of emotional distress assessed by the Problem Areas In Diabetes (PAID) scale, and lower level of total protein, but no significant differences were shown in Taiwanese participants. Binomial logistic regression analyses were performed to detect risk factors related to sarcopenia. After adjusting for age, sarcopenia was found to be significantly associated with poor consciousness for health management in Japanese participants (OR:0.12 P=0.02) and significantly associated with poor relationships with neighbors and poor consciousness for health management in Taiwanese participants (OR:0.18 P=0.008 and OR:0.45 P=0.04, respectively). These findings are expected to contribute to the development of effective strategies for preventing sarcopenia among elderly with diabetes in Japan and Taiwan.

Engaging in healthy eating and active living is an effective strategy for preventing noncommunicable diseases in older populations. The purposes were to compare the prevalence rates across countries and explore health factors associated with healthy eating and active living. The data were retrieved from a cross-sectional study conducted by the International Social Survey Program (2011 Health and Healthcare), with structured questionnaire surveys in 32 countries. The results showed that 38.42% reported active living and 39.11% reported healthy eating among 11,250 total respondents. Older adults with a long-standing illness or obesity who felt that they were not overcoming problems and had lost confidence were less likely to engage in healthy behavior. Perceived general health had a positive association with the odds of engaging in healthy eating and active living. The international comparisons provide a reference for local governments to decrease health disparities. Inspiring self-awareness about health might encourage older adults to pursue healthy lifestyles.

Wearable technologies represent a novel approach in the prevention of obesity and overweight that encourages users to engage in physical activities aided by technological assistance. This is the first meta-analysis to investigate the effects of wearable technologies as physical activity interventions on weight control. Various electronic databases were searched to select eligible articles, including EBSCO, ScienceDirect, and PubMed, from the first available date to January 9, 2019. All analyses were performed using a random-effects model. Moderator analyses were conducted to investigate differences in the effect size. This meta-analysis of 19 randomized controlled trials indicated that wearable technologies as a physical activity intervention achieved a moderate and significant effect size on body weight and waist circumference and large and significant effect sizes on the body mass index. A subgroup analysis confirmed that wearable technologies were more efficient for weight control in individuals with obesity and chronic diseases. A duration of using wearable technologies for a total of more than or equal to 12 weeks was more effective. Meta-regressions have also revealed that the body weight of individuals who received an additional week of treatment could be reduced by more than 0.37%. Wearable technologies offer innovative platforms of physical activity interventions and an efficient method for weight control.

Physical activity in green and blue spaces provide physical and mental health benefits in populations of all ages. In this study, we explored the effectiveness of longer-term green and blue physical activity of improving the quality of life. Medline, Pubmed, Embase, and Web of Science databases were searched in September 2020. A systematic review and meta-analysis were conducted using a random-effects model. Moderator analyses were performed to investigate differences in effect sizes. In total, eight randomized controlled trials (RCTs) were selected for a qualitative and quantitative synthesis of quality of life outcomes. Results showed significant increased effects of green and blue physical activity interventions on physical and mental health compared to a control group, but an insignificant effect on the general quality of life. A moderator analysis and meta-regression indicated that the mean age of the experimental group had a significant effect on mental health. This first meta-analysis of RCTs found multiple instances of green and blue physical activity being beneficial to physical and mental health. Engaging in physical activity in green and blue spaces is advocated to improve the quality of life of individuals, health practitioners, urban planning, and policymakers.

The non-communicable disease is a serious problem in the world. Prevention emphasized modifiable behavioral and environmental features. Walkable neighborhood increases the level of physical activity and decreases the risk and the mortality of non-communicable diseases. Therefore, the purposes of this study were to understand the walkability and the distribution of the rate of outpatients with hypertension in each administrative region in Taiwan, and to analyze whether the difference of walkability could affect the rate of outpatients with hypertension. All data were retrieved from open government data in Taiwan and analyzed by ANOVA and National Geographic Information System. According to the standard deviation of walkability index, the regions were divided into four levels. The result demonstrated there was a significant difference in the rate of outpatients with hypertension among different regions. The regions with the highest walkability presented the lowest rate of outpatients with hypertension, which was significantly less than the third and the lowest one. In conclusion, the walkability is an important risk factor for hypertension. The walkable neighborhood should be considered of urban planning and sport and health related policies, in order to promote resident’s well-beings in advance. To cite this document: Hsin-Yen Yen and Saeedeh Ching Li, "DIFFERENCES IN WALKABILITY INFLUENCE RESIDENTS’ HYPERTENSION IN TAIWAN: AN ANALYSIS OF OPEN GOVERNMENT DATA", International Journal of Electronic Commerce Studies, Vol.8, No.2, pp.97-107, 2017. Permanent link to this document: http://dx.doi.org/10.7903/ijecs.1516