The World Health Organization (WHO) Global Action Plan on Physical Activity recommends adopting a systems approach to implementing and tailoring actions according to local contexts. We held group ...model-building workshops with key stakeholders in the Caribbean region to develop a causal loop diagram to describe the system driving the increasing physical inactivity in the region and envision the most effective ways of intervening in that system to encourage and promote physical activity. We used the causal loop diagram to inform how the WHO Global Action Plan on Physical Activity might be adapted to a local context. Although the WHO recommendations aligned well with our causal loop diagram, the diagram also illustrates the importance of local context in determining how interventions should be coordinated and implemented. Some interventions included creating safe physical activity spaces for both sexes, tackling negative attitudes to physical activity in certain contexts, including in schools and workplaces, and improving infrastructure for active transport. The causal loop diagram may also help understand how policies may be undermined or supported by key actors or where policies should be coordinated. We demonstrate how, in a region with a high level of physical inactivity and low resources, applying systems thinking with relevant stakeholders can help the targeted adaptation of global recommendations to local contexts.
Background: Adolescents who perceive themselves as overweight are at risk of future weight gain and increased risk of type 2 diabetes, hypertension, and poor mental health. Perceived weight may ...influence weight related behaviors (e.g., physical activity), but less is known about the relationship between adolescents' perceived weight and both perceived health and desire to exercise. We explored the association between perceived weight, perceived health, and desire to exercise in adolescents. Methods: Cross-sectional data from adolescents, ages 12-17 years, were drawn from the Family Life, Activity, Sun, Health, and Eating study (2014). Perceived weight status (1-item; very underweight to very overweight), perceived health status (1-item; poor to excellent), and desire to exercise (1-item; strongly disagree to strongly agree) were self-reported. Ordinal logistic regression models tested associations between perceived weight and both perceived health and desire to exercise controlling for age, sex, race/ethnicity, and food insecurity. Results: Of the sample (n = 1407; mean age = 14; 51% female; 64% White), most adolescents perceived their weight to be just right (61%), and their health to be excellent (42%). Adolescents who perceived themselves as slightly or very overweight, compared to just right, had 4.5 (95% CI 3.5, 5.8) and 37.7 (95% CI 22.5, 63.2) higher odds, respectively, of perceiving themselves in worse health. Adolescents who perceived themselves as slightly or very underweight, compared to just right, had 2.94 (95% CI 0.1, 0.8) and 1.41 (95% CI 0.5, 1.0) lower odds of a greater desire to exercise. Perceptions of being slightly or very overweight were not associated with desire to exercise (p = 0.9 and 0.4, respectively). Conclusions: Current findings highlight that higher perceived weight in adolescents is negatively associated with perceived health, but not necessarily desire to exercise. Future research should explore the relationship between weight perception and other motivators of physical activity.
BackgroundSince 2018 NHS Ayrshire and Arran (NHSA&A) has offered a specialist nurse-led hypertrophic cardiomyopathy (HCM) clinic, providing assessment and education to those with clinically stable ...HCM, and those genetically at risk of HCM. Though there is growing evidence on the safety of exercise in this population, an HCM diagnosis often leads to concern around the risk of physical activity and exercise participation.1 2AimsThis study aimed to explore perceptions of physical activity and exercise in those with established HCM.MethodsA physiotherapist conducted telephone interviews with six NHSA&A HCM clinic attendees. All had been diagnosed with HCM several years prior to the clinic being established. None had ever accessed a cardiovascular prevention and rehabilitation programme (CVPRP) or specialist exercise professional. Interviews were semi-structured and focused on ‘Given your HCM diagnosis, what are your thoughts on physical activity and exercise?’ with additional prompts used to guide discussions. All were audio-recorded, and took 20-30 minutes. Qualitative data generated were transcribed and thematically analysed.ResultsOf the six (mean age 62.7 SD10.17 years, 3 female/3 male; average time since diagnosis 11.2 SD 5.26 years), five reported being physically active and recognising the health benefits of this. Only one participant regularly engaged in structured exercise. Much of the discussions focused upon physical, psychological and social limitations to being active, with psychological limitations most prevalent and underpinning all interviews (figure 1). Participants highlighted how they valued the nurse-led HCM clinic support, and how this had been lacking in the period immediately following their diagnosis. Abstract 10 Figure 1Participants’ physical, psychological and social limitations to being activeFigure omitted. See PDFConclusionFollowing HCM diagnosis, there is a need for early reassurance and clear individualised physical activity advice. Expansion of the nurse-led clinic service to enable access to an individually-tailored multidisciplinary CVPRP may reduce physical, psychological and social barriers to safely and effectively facilitate long-term structured exercise participation in this population.
AbstractObjectiveTo estimate the effect of a moderate to high intensity aerobic and strength exercise training programme on cognitive impairment and other outcomes in people with mild to moderate ...dementia.DesignMulticentre, pragmatic, investigator masked, randomised controlled trial.SettingNational Health Service primary care, community and memory services, dementia research registers, and voluntary sector providers in 15 English regions.Participants494 people with dementia: 329 were assigned to an aerobic and strength exercise programme and 165 were assigned to usual care. Random allocation was 2:1 in favour of the exercise arm.InterventionsUsual care plus four months of supervised exercise and support for ongoing physical activity, or usual care only. Interventions were delivered in community gym facilities and NHS premises.Main outcome measuresThe primary outcome was score on the Alzheimer’s disease assessment scale-cognitive subscale (ADAS-cog) at 12 months. Secondary outcomes included activities of daily living, neuropsychiatric symptoms, health related quality of life, and carer quality of life and burden. Physical fitness (including the six minute walk test) was measured in the exercise arm during the intervention.ResultsThe average age of participants was 77 (SD 7.9) years and 301/494 (61%) were men. By 12 months the mean ADAS-cog score had increased to 25.2 (SD 12.3) in the exercise arm and 23.8 (SD 10.4) in the usual care arm (adjusted between group difference −1.4, 95% confidence interval −2.6 to −0.2, P=0.03). This indicates greater cognitive impairment in the exercise group, although the average difference is small and clinical relevance uncertain. No differences were found in secondary outcomes or preplanned subgroup analyses by dementia type (Alzheimer’s disease or other), severity of cognitive impairment, sex, and mobility. Compliance with exercise was good. Over 65% of participants (214/329) attended more than three quarters of scheduled sessions. Six minute walking distance improved over six weeks (mean change 18.1 m, 95% confidence interval 11.6 m to 24.6 m).ConclusionA moderate to high intensity aerobic and strength exercise training programme does not slow cognitive impairment in people with mild to moderate dementia. The exercise training programme improved physical fitness, but there were no noticeable improvements in other clinical outcomes.Trial registrationCurrent Controlled Trials ISRCTN10416500.
Fit for Consumption Smith Maguire, Jennifer
2008, 20070906, 2007, 2007-09-06, 20070101
eBook
This is the first text to offer a comprehensive socio-cultural and historical analysis of the current fitness culture.
Fitness today is not simply about health clubs and exercise classes, or measures ...of body mass index and cardiovascular endurance. Fit for Consumption conceptualizes fitness as a field within which individuals and institutions may negotiate - if not altogether reconcile - the competing and often conflicting social demands made on the individual body that characterize our current era.
Intended for researchers and senior undergraduate and postgraduate students of sport, leisure, cultural studies and the body, this book utilizes the US fitness field as a case study through which to explore the place of the body in contemporary consumer culture. Combining observations in health clubs, interviews with fitness producers and consumers, and a discourse analysis of a wide variety of fitness texts, this book provides an empirically grounded examination of one of the pressing theoretical questions of our time: how individuals learn to fit into consumer culture and the service economy and how our bodies and selves become ‘fit for consumption.'
1. Making Sense of Fitness 2. The Roots of Fitness: Physical Culture and Physical Capital 3. Health Clubs: The Stratification of Fitness Sites 4. Fitness Media: An Education in the Fitness Lifestyle 5. Personal Trainers: In the Service of Fitness 6. Lessons from the Fitness Field
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