Abstract
Faced with the spread of the SARS-CoV-2 virus, regulatory measures aiming to prevent interpersonal contaminations have been undertaken and among these, lockdown. Due to strong restrictions ...out-of-home movements, we hypothesize that overall physical activity will decrease and sedentary behavior increase. This could result in highest exposure to the well-known risk related to insufficient physical activity. To mitigate physical inactivity and sedentary behaviors health-related risks related to children and adolescents lockdown and school closure, Anses (French Agency for Food, Environmental and Occupational Health & Safety) has adapted, within the first days of the public authorities’ prescription, its former benchmarks. This paper supports and comments Anses’ Opinion by raising the questions of whether, why, and how to deal with short- or medium-term lockdown-related physical inactivity and sedentary behavior increases. Short-term and unknown long term-impacts on mental health and well-being, physical fitness and eating behaviors clearly appearing for children and adolescents as being the main issues of concern are highlighted. Targeting the compensations of the physical inactivity increase, the types, frequencies and durations of physical activity, are adapted to restricted environment. Sedentary behavior limitation and frequent interruptions becomes a priority. Overall, considering children and adolescents, the emerging risk justifies proposing specific adaptations and type of activities in order to ensure maintaining health underpinned, at least partly, by physiological equilibrium and physical fitness and avoid the installation of new unhealthy habits or routines that young people could keep after lockdown.
Background Cystic fibrosis (CF) is a genetic disease affecting the respiratory and digestive systems, with recent treatment advances improving life expectancy. However, many people with CF lack ...adequate physical activity (PA). PA can enhance lung function and quality of life, but barriers exist. The Cystic Fibrosis Decisional Balance of Physical Activity questionnaire assesses the decisional balance for PA in adults with CF, but it is not optimal for clinical use. A digital app might overcome this limitation by improving the efficiency of administration, interpretation of results, and communication between patients and health care professionals. Objective This paper presents the development process and reports on the acceptability of a web app designed to measure and monitor the decisional balance for PA in people with CF. Methods This study comprised two stages: (1) the co-design of a digital app and (2) the evaluation of its acceptability among health care professionals and people with CF. A participatory approach engaged stakeholders in the app’s creation. The app’s acceptability, based on factors outlined in the Unified Theory of Acceptance and Use of Technology 2, is vital for its successful adoption. Participants volunteered, gave informed consent, and were aged >18 years and fluent in French. Data collection was performed through qualitative interviews, video presentations, surveys, and individual semistructured interviews, followed by quantitative and qualitative data analyses. Results In total, 11 health care professionals, 6 people with CF, and 5 researchers were involved in the co-design phase. Results of this phase led to the coconstruction of an app named MUCO_BALAD, designed for people with CF aged ≥18 years, health care professionals, and researchers to monitor the decisional balance for PA in people with CF. In the acceptability evaluation phase, the sample included 47 health care professionals, 44 people with CF, and 12 researchers. The analysis revealed that the acceptability measures were positive and that app acceptability did not differ according to user types. Semistructured interviews helped identify positive and negative perceptions of the app and the interface, as well as missing functionalities. Conclusions This study assessed the acceptability of an app and demonstrated promising qualitative and quantitative results. The digital tool for measuring the decisional balance in PA for people with CF is encouraging for health care professionals, people with CF, and researchers, according to the valuable insights gained from this study.
Connected health devices and applications (referred to hereafter as "SDApps" - Smart devices and applications) are being portrayed as a new way for prevention, with the promise of accessibility, ...effectiveness and personalization. Many effectiveness evaluations (experimental designs) with strong internal validity exist. While effectiveness does appear to vary, the mechanisms used by these devices have not yet been thoroughly investigated. This article seeks to unpack this black box, and describes the process of elaboration of an intervention theory for healthy eating and physical activity SDApps. It includes a set of requirements relative to their impact on social health inequalities.
To build this theory, we drew on theory-driven approaches and in particular on the theory of change (ToC) method. To this end, we developed a cumulative and iterative process combining scientific data from the literature with knowledge from experts (researchers and practitioners) and from patients or users. It was a 3-step process, as follows: 1 - identifying the evidence base; 2 - developing the theory through design intervention and creating realistic expectations, including in our case specific work on social health inequalities (SHIs); 3 - modeling process and outcome.
We produced an evidence-based theory according to the ToC model, based on scientific evidence and knowledge from experts and users. It sets out a causal pathway leveraging 11 key mechanisms - theoretical domains - with which 50 behavior change techniques can be used towards 3 ultimate goals: Capacity, Opportunity, Motivation - Behavior (COM-B). Furthermore, the theory specifically integrates requirements relative to the impact on SHIs.
This theory is an aid to SDAapp design and evaluation and it can be used to consider the question of the possible impact of SDApps on the increase in inequalities. Firstly, it enables developers to adopt a more overarching and thorough approach to supporting behavior change, and secondly it encourages comprehensive and contributive evaluations of existing SDApps. Lastly, it allows health inequalities to be fully considered.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Health effects of sedentary behaviors (SB) may vary depending on their characteristics such as type, purpose, duration, and intensity of the behavior. While a growing number of questionnaires assess ...sedentary behaviors, it is unclear which characteristics of SB are measured. The aim of this review was to examine the content of self-report SB questionnaires.
Three databases were searched for sedentary behavior questionnaires published before January 1st, 2016. Based on the inclusion criteria, 82 articles out of 1369 were retrieved for a total of 60 questionnaires. For each questionnaire, the sedentary behavior characteristics identified were reported and analyzed.
Most of the questionnaires assessed the time (n = 60), posture (n = 54), purpose (n = 46) and the types (n = 45) of SB performed. Fewer questionnaires assessed the environment (n = 20) social context (n = 11), status (n = 2), and associated behaviors (n = 2) related to sedentary behaviors. All the questionnaires except two assessed time spent in SB with 17 assessing frequency and 6 assessing breaks in SB. The most frequent characteristics identified in the questionnaires were the categories of sitting (90%), a day (95%), watching television (65%) and using a computer (55%). Many characteristics of SB were not measured.
By knowing the breadth of SB included in questionnaires, this review provides support to shape the design of new questionnaires designed to reduce the gaps in measuring sedentary behaviors.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The Global Physical Activity Questionnaire (GPAQ) has been used to measure physical activity (PA) and sedentary time in France, but no study has assessed its psychometric properties. This study aimed ...to compare the reliability as well as criterion and concurrent validity of the French version of the GPAQ with the French International Physical Activity Questionnaire long form (IPAQ-LF) and use of an accelerometer in a general adult population.
We included 92 participants (students or staff) from the Medicine Campus at the University of Lorraine, Nancy (north-eastern France). The French GPAQ was completed twice, 7 days apart, to study test–retest reliability. The IPAQ-LF was used to assess concurrent validity of the GPAQ, and participants wore an accelerometer (ActiGraph GT3X+) for 7 days to study criterion validity. Reliability as well as concurrent and criterion validity of the GPAQ were tested by the intraclass correlation coefficient (ICC), Spearman correlation coefficient for quantitative variables, and Kappa and Phi coefficients for qualitative variables. Both concurrent and criterion validity of GPAQ were assessed by Bland-Altman plots.
The GPAQ showed poor to good reliability (ICC = 0.37–0.94; Kappa = 0.50–0.62) and concurrent validity (Spearman r = 0.41–0.86), but only poor criterion validity (Spearman r = −0.22–0.42). Limits of agreement for the GPAQ and accelerometer were wide, with differences between 286.5 min/week and 601.3 min/week.
The French version of the GPAQ provides limited but acceptable reliability and validity for the measurement of PA and sedentary time. It may be used for assessing PA and sedentary time in a French adult population.
Elite athletes are continually subjected to a range of constraints specific to high performance, and these can have a negative impact on their health. Although many studies have explored the ...individual factors related to risky behaviours and disorders in elite sport contexts, few have focused on health promotion. Consequently, the interpersonal, institutional, and policy factors of the health-related behaviours of elite athletes are still poorly explored. Based on the socioecological model, this study aimed to identify the factors involved in the health-related lifestyle of elite athletes. Semi-structured interviews were conducted with 45 participants: athletes (N = 32), their coaches (N = 6) and the managers of elite sport centres (N = 7). Both deductive and inductive thematic analyses were performed. Our results highlight the views of the actors. Regarding intrapersonal factors, resilience qualities and health literacy appeared as key factors in influencing the health-related lifestyle of elite athletes. At the interpersonal level, parents and coaches emerged as the main sources of educational support. Regarding institutional factors, the health policies of the elite sport centres were key factors in supporting the athletes’ healthy lifestyle. These results encourage the development of health promotion programs at different levels of intervention.
There are few data on the relationship between health-related quality of life (HRQoL) and leisure time physical activity (LTPA) in the general population. We investigated the relationships of meeting ...public health recommendations (PHR) for moderate and vigorous physical activity with HRQoL in French adult subjects.
LTPA and HRQoL were assessed in 1998 in 2333 men and 3321 women from the SU.VI.MAX. cohort using the French versions of the Modifiable Activity Questionnaire (MAQ) and the SF-36 questionnaire, respectively. Relationship between LTPA and HRQoL was assessed using analysis of variance.
Results from multivariate analysis showed that meeting physical activity recommended levels was associated with higher HRQoL scores (except in Bodily pain dimension for women): differences in mean HRQoL scores between subjects meeting or not PHR ranged from 2.4 (Mental health) to 4.5 (Vitality) and from 2.2 (Bodily pain) to 5.7 (Vitality) for women and men, respectively.
Subjects meeting PHR for physical activity had better HRQoL than those who did not. Our data suggest that 30′ of moderate LTPA per day on a regular basis may be beneficial on HRQoL. Higher intensity LTPA is associated with greater HRQoL. This emphasizes the importance to promote at least moderate physical activity.
Beyond the contribution of sports clubs to physical activity, an important health determinant, sports clubs can embrace the settings-based approach to health promotion, acting as health promoting ...sports clubs (HPSC). Limited research links the HPSC concept with evidence-driven strategies to provide guidance to develop HPSC interventions.
An intervention building a research system of the development of an HPSC intervention will be presented, including seven different studies, from literature review to intervention co-construction and evaluation. The different steps and their results will be presented as lessons learnt for settings-based intervention development.
First, the evidence base showed a poorly defined HPSC concept, but 14 evidence-driven strategies. Second, concept mapping identified 35 sports clubs needs in regard to HPSC. Third, the HPSC model and intervention framework were designed using a participative research approach. Fourth, a measurement tool for HPSC was validated psychometrically. Fifth, capitalization of experience from eight exemplar HPSC projects was realized to test the intervention theory. Sixth, program co-construction was realized by involving sports club actors. Seventh, intervention evaluation was built by the research team.
This HPSC intervention development is an example of building a health promotion program, implicating different types of stakeholders, and provide a HPSC theoretical model, HPSC intervention strategies, a program and toolkit, for sports clubs to implement health promotion and fully endorse their role in the community.
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