Using a participatory action research approach to explore, understand and evaluate well-being among children living in socially deprived areas in Southern Sweden: a study protocol.

INTRODUCTION: Research suggests that participating in after-school leisure activities has been related to promoting health, well-being and safety among children living in disadvantaged neighbourhoods. The United Nations Child Rights Convention emphasises the inclusion of children in decisions that concern them. However, children seldom are involved in designing implementing and evaluating health promotional environments. The aim of this programme is through a participatory process with children, parents/guardians, and peer-activity leaders explore, measure and evaluate the impact on children's overall well-being related to the social context in an already established health promotion environments in Southern Sweden. METHODS AND ANALYSIS: The project is based on a previously implemented unique community-based participatory research (CBPR) model for equal health in three socially disadvantaged areas in Malmö. All activity house (AAH) is a meeting place for children established in schools but after school time by the culture department of the Malmö municipality. In AAH migrant children participate in need-driven after school activities that they themselves create and develop. To increase participation of the children and ensure that these environments are based on their needs, 30 children (10-12 years), parents/guardians (30), peer-activity leaders (15), and researchers create CBPR teams in the areas and engage in a participatory process. The children reflect, analyse and write about their well-being; identify and discuss key factors in an iterative process, which also includes a strategic group of stakeholders. The children then develop and validate (with 100 other children from AAH) the Socioculturally Aligned Survey Instrument for Children survey inspired by the KIDSSCREEN V.27. The survey tool so developed will further be used to evaluate AAH and will be distributed to all children participating in their activities. ETHICS AND DISSEMINATION: This programme has been approved by the Swedish Ethical Review Authority. The results from this programme will be published as reports and scientific publication.

Leisure Time Physical Activity and Incidence of Arterial Hypertension in ELSA-Brasil Participants. / Atividade Física no Tempo Livre e Incidência de Hipertensão Arterial em Participantes do ELSA-Brasil.

BACKGROUND: Evidence indicates that physical activity (PA) has a protective effect against chronic diseases, including high arterial hypertension (AH). OBJECTIVE: This study investigated, longitudinally, the association between changes in leisure time physical activity (LTPA) and the incidence of hypertension in ELSA-Brasil participants. METHODS: Data from 8,968 participants were analyzed at two different times (2008-2010 and 2012-2014). The International Physical Activity Questionnaire (IPAQ), long version, was used to assess LTPA. The association between LTPA and AH was tested using Poisson regression with relative risk (RR) estimation, with a significance level of 5% and a 95% confidence interval. RESULTS: When the LTPA level variable was categorized as sufficient and insufficient, no statistically significant associations were found between LTPA and AH incidence as a function of changes in PA during follow-up. However, when the LTPA variable was categorized as inactive, little active, active, and very active, a statistically significant association was observed between LTPA and AH in participants classified as very physically active. The risk of AH was reduced by 35% among men RR 0.65 (95% CI 0.50-0.86) and by 66% among women RR 0.34 (95% CI 0.20-0.58) who maintained high levels of LTPA at both moments of follow-up. CONCLUSION: These results suggest that maintaining high levels of PA over time is associated with a lower risk of developing AH, highlighting the importance of PA in preventing this condition, for both men and women.

FUNDAMENTO: Evidências apontam que a atividade física (AF) apresenta efeito protetor para as doenças crônicas, incluindo a hipertensão arterial (HA). OBJETIVO: Este estudo investigou, de forma longitudinal, a associação entre as mudanças na atividade física no tempo livre (AFTL) e a incidência de HA em participantes do ELSA-Brasil. MÉTODOS: Foram analisados dados de 8.968 participantes em dois momentos distintos (2008-2010 e 2012-2014). Foi utilizado o Questionário Internacional de Atividade Física (IPAQ), versão longa, para avaliação da AFTL. A associação entre AFTL e HA foi testada por regressão de Poisson com estimativa do risco relativo (RR), com nível de significância de 5% e intervalo de confiança de 95%. RESULTADOS: Quando a variável nível de AFTL foi categorizada em suficiente e insuficiente, não foram encontradas associações estatisticamente significantes entre AFTL e a incidência HA em função das mudanças na AF durante o seguimento. No entanto, a variável AFTL quando categorizada em inativo, pouco ativo, ativo e muito ativo, observou-se associação estatisticamente significante entre AFTL e HA em participantes classificados como muito ativos fisicamente. O risco de HA foi reduzido em 35% entre homens RR 0,65 (IC 95% 0,50-0,86) e em 66% entre as mulheres RR 0,34 (IC 95% 0,20-0,58) que mantiveram altos níveis de AFTL em ambos os momentos do seguimento. CONCLUSÃO: Esses resultados sugerem que a manutenção de altos níveis de AF ao longo do tempo está associada a um menor risco de desenvolver HA, destacando a importância da AF na prevenção dessa condição, tanto para homens quanto para mulheres.

Leisure television watching exerts a causal effect on gastroesophageal reflux disease: evidence from a two-step mendelian randomization study.

BACKGROUND: Previous studies have shown that physical activity (PA) and leisure sedentary behaviors (LSB, including leisure television watching) are linked to gastroesophageal reflux disease (GERD). However, the associations between PA/LSB and GERD remain controversial. In this study, we aimed to reveal whether these associations reflect causal relationships and reveal the potential mechanisms of these relationships using bidirectional and two-step Mendelian randomization (MR) analyses. METHODS: We obtained genome-wide association study (GWAS) summary statistics for PA/LSB, four common risk factors (including cigarettes smoked per day, alcoholic drinks per week, triglycerides, total cholesterol) and GERD from published GWASs. A bidirectional MR analysis was performed to identify causal relationships between PA/LSB and GERD. Then, a series of sensitivity analyses were performed to verify the robustness of the results. Finally, a mediation analysis via two-step MR was conducted to investigate any effects explained by common risk factors in these relationships. RESULTS: Genetically predicted per 1-SD increase in leisure time television watching significantly increased the risk of GERD in the bidirectional MR analysis (OR = 1.33; 95% CI: 1.14-1.56; P = 2.71 × 10- 4). Sensitivity analyses successfully verified the robustness of the causal relationship. Further mediation analysis showed that this effect was partly mediated by increasing cigarettes smoked per day, with mediated proportions of 18.37% (95% CI: 11.94-39.79%). CONCLUSION: Our findings revealed a causal relationship between leisure television watching and an increased risk of GERD, notably, the causal effect was partially mediated by cigarettes smoked per day. These findings may inform prevention and management strategies directed toward GERD.

Promoting digital inclusion for enhanced resident wellbeing: an examination of aged residential care facility websites.

AIM: Digital inclusion has a positive impact on health and wellbeing through fostering connectivity and access to information. In Aotearoa New Zealand, 4% of older adults live in aged residential care (ARC) facilities and are vulnerable to social isolation. This study explored whether ARC facilities provide opportunities to socially connect online and whether the COVID-19 pandemic affected the provision of these opportunities. METHOD: Information on technology and internet provision from 558 ARC facilities was extracted from facilities' own or related websites in 2019 and 2021. ARC facilities were categorised according to whether they provided digital devices, internet access and internet-based leisure activities, or made no reference to technology. RESULTS: In 2019, 392 (70%) of 558 ARC facilities publicised availability of internet-based technologies for residents; however, only 46 (8%) mentioned providing access to computer devices. In 2021 (during the pandemic), there was a small increase to 421 (76%) and 54 (10%) of facilities respectively. Facilities mentioning internet-based leisure activities were 63 (11%) in 2019 and 55 (10%) in 2021. Those not referring to technology had reduced from 166 (30%) in 2019 to 137 (24%) in 2021. CONCLUSION: Few ARC facilities enabled residents to fully access the digital world, even after periods of isolation due to COVID-19. Aged care providers could be more proactive by providing internet access and digital learning opportunities.

Social participation of women with breast cancer compared to the general population 5 years after primary surgery-what role do medical data and cancer-related complaints play?

PURPOSE: This study analyzes levels of social participation in patients with breast cancer on average 5 years following primary surgery as compared to women in the general population. In addition, the role of breast cancer-related complaints and medical data as possible influencing factors on levels of patients' social participation is investigated. METHODS: A total of n = 454 patients after primary surgery (t0) were recruited for a third follow-up study, and n = 372 completed this survey (t3), corresponding to a response rate of 82.2%. For measuring breast cancer-related complaints, participants completed a written questionnaire. Social participation was measured by a questionnaire on different leisure activities that was taken from the Socio-Economic Panel Study. Medical information was extracted from medical reports at t0. A principal component analysis was carried out to identify different dimensions of social participation. Chi2-tests and logistic regression analyses were applied to analyze social participation as compared to the general population and the role of possible medical and diagnosis-related influencing factors thereby. RESULTS: Compared to the general population, patients show lower levels of social participation in the domains "socio-cultural participation" and "participation in institutions," while no significant differences for "social participation in the private sphere" and "social participation via social media" were found. Psychological symptoms, pain, and a history of mastectomy were most strongly associated with restrictions in social participation. CONCLUSIONS: Our study suggests that social withdrawal may happen due to disease-related symptoms, preventing some breast cancer patients from participating fully in society. Cancer-related follow-ups should address this issue and support patients' reintegration into society through appropriate therapeutic interventions.

Factors Associated With Leisure-Time Bicycling Among Adults in the United States: An Urban-Rural Comparison.

BACKGROUND: Bicycling is a healthy form of physical activity that can be performed by most adults as part of leisure-time (LT) activity. However, little is known about LT bicycling behaviors, especially in the rural areas of the United States. This study sought to contrast the prevalence and factors associated with LT bicycling in populations living in urban settings with those living in rural settings. METHODS: The 2019 Behavior Risk Factor Survey, which contains information regarding LT physical activity behaviors among adults (N = 396,261) in the United States, was used to determine the prevalence, demographic profile, and likelihood of meeting the physical activity guidelines of LT bicyclists. The 2013 National Center for Health Statistics Urban/Rural Classification Scheme was used to classify respondents living in rural and urban settings. RESULTS: Among US adults, 3.8% (95% CI, 3.7-3.9) reported LT bicycling activity, the sixth most common physical activity. Adults living in urban counties compared with rural counties had a greater prevalence of LT bicycling (3.9% vs 2.3%, respectively), with adults living in rural counties having a 34% lower probability of LT bicycling. Rural bicycling prevalence rates were lower across all demographics. Urban bicyclists, compared with rural bicyclists, cycled more months of the year. Overall, 85.5% of all bicyclists met the aerobic physical guidelines, with no differences between urban and rural bicyclists. CONCLUSIONS: Bicycling remains an important LT physical activity among adults in the United States. However, a rural-urban difference in the prevalence does exist for LT bicycling. The reasons for this disparity warrant further investigation.

Leisure Sedentary Behavior, Physical Activities, and Cardiovascular Disease Among Individuals With Metabolic Dysfunction-Associated Fatty Liver Disease.

BACKGROUND: Metabolic dysfunction-associated fatty liver disease is a significant risk factor for cardiovascular disease (CVD). This study assesses the association between leisure-time physical activity, sedentary behavior, and CVD risk among patients with metabolic dysfunction-associated fatty liver disease, considering genetic predisposition to CVD. METHODS: This cohort study included 157 794 participants with metabolic dysfunction-associated fatty liver disease from the UK Biobank who were free of CVD at baseline. The study measured leisure-time sedentary behaviors (watching TV, using a computer, and driving) and physical activities (walking for pleasure, light and heavy do-it-yourself activities, strenuous sports, and other exercises) in terms of frequency and duration over the 4 weeks before assessment. Both a Cox proportional hazard model and an isotemporal substitution model were utilized in the study to assess the association between leisure sedentary behavior, physical activities, and CVD risk. RESULTS: During a median 12.5 years of follow-up, 26 355 CVD cases were reported, including 19 746 coronary heart disease, 4836 stroke, and 7398 heart failure cases. High physical activity levels were linked to a significantly lower risk of CVD (21%), coronary heart disease (20%), stroke (15%), and heart failure (31%). In contrast, individuals with >6.5 h/d of sedentary behavior faced a 16% to 21% higher risk of these conditions compared with those with ≤3.5 h/d. Notably, replacing 30 minutes of inactivity with physical activity reduced CVD risks by 3% to 16%, particularly with strenuous sports. A significant interaction was observed between physical activity, sedentary behavior, and genetic predisposition in relation to stroke risk. CONCLUSIONS: Among patients with metabolic dysfunction-associated fatty liver disease, higher leisure-time physical activity levels correlate with reduced CVD risks, while increased sedentary behavior is linked to higher CVD risks. Replacing sedentary time with physical activity consistently shows benefits in reducing CVD outcomes, irrespective of genetic predisposition.

Awareness, attitudes and perceptions of students towards leisure noise in Durban, South Africa.

BACKGROUND:  Young adults are exposed to high noise levels in leisure venues, which increases their risk of hearing loss, and can affect their quality of life. OBJECTIVES:  The aim of this study was to describe the young adults' awareness, attitudes and perceptions towards leisure noise at a university in South Africa. METHOD:  A descriptive cross-sectional study design with quantitative methods of data was considered for this study. Students from first to fourth years in the Education Department of a local university in Durban, South Africa, who were aged 18 years old - 25 years old were invited to participate in an online survey. RESULTS:  Of the 462 participants, most had a general awareness on noise and hearing loss but lacked knowledge on the negative effect of loud noise, with 95.2% using personal listening devices, followed by visiting restaurants and gyms, and 48.3% being unsure if noise can damage hearing permanently. They were unaware of methods to reduce their exposure to noise. A significant relationship between awareness of noise and attitudes (p = 0.029) indicated that the higher the level of awareness regarding leisure noise, the better their attitude and behaviour, thus the lower the risk of hearing loss. CONCLUSION:  The results highlight the need for implementing the World Health Organization (WHO) noise regulations and providing education for this age group to prevent irreversible hearing loss through exposure to leisure noise.Contribution: A national study is recommended to increase research evidence.

Associations between domains of sedentary behavior, well-being, and quality of life - a cross-sectional study.

The importance of reducing sedentary behavior (SB) in the prevention of mortality and chronic and mental diseases is scientifically well grounded, but SB can be accumulated in diverse domains of life, such as leisure-time SB, transport between home/work/school when sitting (transport-related SB), or in occupational settings such as working or studying (occupational SB), and the associations for each domain of SB with well-being measures and quality of life are still underexplored from a positive perspective. Through a cross-sectional investigation, we collected data from 584 participants who completed a questionnaire throughout November 2021 and with Spearman correlation test, analysed the associations between SB in three different domains with psychological well-being, satisfaction with life, and quality of life. Our results indicated that after adjustment for physical activity, sex, body mass index, smoking history, chronic disease status, financial perception, quality/duration of sleep and university group, in younger adults (18 to 24 years old), leisure-time SB was negatively related to psychological well-being (rho = -0.255; p = 0.008), and in adults (25 to 64 years old), occupational SB was negatively related to satisfaction with life (rho = -0.257; p < .001) and the mental component of quality of life (rho = -0.163; p = 0.027). Our findings highlight the idea that not all SB is built the same and that future strategies to reduce SB from people's lives must target specific domains of SB according to the age group when aiming to improve well-being and quality of life.

Types of leisure-time physical activity participation in childhood and adolescence, and physical activity behaviours and health outcomes in adulthood: a systematic review.

BACKGROUND: Youth leisure-time physical activity participation benefits physical activity habits and health outcomes later in life. However, it is unknown if certain types of leisure-time physical activity contribute to these benefits in different ways; this knowledge could enhance public health efforts. This systematic review aimed to synthesise evidence of the longitudinal associations between childhood and adolescent leisure-time physical activity on adulthood physical activity behaviours and health outcomes. METHODS: A systematic search of the literature was conducted across five databases from inception to July 2022. English, peer-reviewed observational studies with a minimum of two timepoints of data collection were eligible for inclusion. We included studies that investigated the association between participation in leisure-time physical activity types in children and adolescents (i.e., 5-18 years), and physical activity, mental health, or cardiovascular outcomes in adulthood (i.e., ≥ 18 years). RESULTS: Fourteen studies were included in the review, totalling 34,388 observations across five countries. Running in adolescence was associated with increased adulthood physical activity in both sexes, while sports involvement was associated with an increase in physical activity in males only. Adolescent team sports participation was associated with reduced odds of early adulthood depression, with varying findings for anxiety disorders. There was preliminary evidence of minimum threshold requirements for participation in certain activities before associations with future physical activity or health outcome benefits were observed. CONCLUSIONS: Preliminary findings suggest that the lifelong behavioural and health benefits of adolescent participation in leisure-time physical activity appear to be related to the type of activity undertaken, with potential differences between sexes. With the rarity of longitudinal studies spanning from childhood into adulthood, these findings provide important insights for public health strategies to optimise lifelong health and physical activity participation. PROSPERO REGISTRATION: CRD42022347792.

Leisure-time physical activity and the incidence of atrial fibrillation in senior adults: a prospective cohort study.

OBJECTIVE: Whether physical activity could reduce the risk of atrial fibrillation (AF) remains unclear. This study was to investigate the relationship of leisure-time physical activity (LTPA) with AF incidence among Chinese older adults. METHODS: A total of 3253 participants aged ≥60 years from the Guangzhou Heart Study were successfully followed between March 2018 and September 2019. LTPA was assessed using a modified Global Physical Activity Questionnaire. AF was ascertained by 12-lead electrocardiograms, 24-hour single-lead Holter and clinical examination. The Cox proportional hazards model was used to the estimate hazard ratio (HR) and 95% confidence interval (CI) after adjustment for confounders, and the population-attributable fraction (PAF) was estimated. RESULTS: A total of 76 (2.34%) new-onset cases of AF were identified during a median of 31.13 months of follow-up. After adjustment for confounders, subjects who had LTPA at least 10.0 metabolic equivalent (MET)-hours/week had a 55% lower risk of developing AF (HR: 0.45, 95%CI: 0.25-0.81), and at least 20 MET-hours/week reduced the risk by 45% (HR: 0.55, 95%CI: 0.34-0.92). At least 11% (PAF: 11%, 95%CI: 0%-20%) or 14% (PAF: 14%, 95%CI: 0%-26%) of AF cases could be avoided, respectively, if the subjects do LTPA at least 10 MET-hours/week or 20 MET-hours/week. A significant exposure-response trend was also observed between LTPA and AF risk (Plinear-trend = 0.002). For a specific LTPA, doing housework was associated with a 43% reduced risk, while engaging in ball games was associated with an increased risk. CONCLUSION: This prospective cohort study indicated that a higher LTPA volume was associated with a lower AF risk in Chinese older adults.

The causality between leisure sedentary behaviors, physical activity and obstructive sleep apnea: a bidirectional Mendelian randomization study.

Background: Previous observational studies have shown a correlation between leisure sedentary behaviors (LSB) and physical activity (PA) with the incidence of obstructive sleep apnea (OSA). However, the causal associations remain unknown. Therefore, our study used bidirectional two-sample Mendelian randomization (MR) to identify potential causal relationships between LSB/PA and OSA. Methods: We sourced genetic variation data for LSB and PA from the UK Biobank, while data on OSA were collected from the FinnGen study. The primary analysis method employed was the inverse variance weighted (IVW) approach, complemented by the weighted median and MR-Egger methods. For sensitivity analyses, we conducted Cochran's Q test, the MR-Egger intercept test, the MR-PRESSO global test, and the leave-one-out analysis. Results: IVW analyses showed that genetically predicted leisure television watching (odds ratio [OR] = 1.38, 95% confidence interval [CI] = 1.09-1.75, p = 0.007) and computer use (OR = 1.48, 95% CI = 1.15-1.92, p = 0.002) significantly increased the risk of OSA. Conversely, self-reported vigorous physical activity (VPA) (OR = 0.33, 95% CI = 0.11-0.98, p = 0.046) may reduce the risk of OSA. No causal effects on OSA risk were observed for driving or self-reported moderate-to-vigorous physical activity. Furthermore, the reverse MR analysis indicated no significant causal relationship between OSA and any LSB/PA phenotype. Sensitivity tests showed no significant heterogeneity or horizontal pleiotropy. Conclusion: This study suggests that leisurely television watching and computer use are risk factors for OSA, while VPA may be a protective factor. Additionally, OSA does not affect PA or LSB levels. We recommend reducing sedentary activities, particularly television watching and computer use, and prioritizing VPA to reduce the risk of OSA. Further research in diverse populations and settings is needed to validate these findings.

Implementing a free lending of sports and leisure equipment service: a cross-sectional survey exploring user characteristics, utilization patterns, and significance among children and youth.

BACKGROUND: The escalating costs of sports equipment, coupled with socioeconomic disparities, hinder children's participation in physical activities. The Leisure Equipment Library (LEL), a unique service in Sweden, addresses this challenge by providing free equipment lending. This study investigated the significance of providing free lending of sports and recreational equipment for children's and youth's opportunities to engage in physical activities during leisure time. METHOD: Utilizing a cross-sectional survey during the summer-2022 period, the study is based on data from 427 LEL users aged 7 to 25 years. User characteristics (demography, socioeconomic status, physical activity profiles), equipment usage patterns and perceived significance are also analyzed. The findings are discussed using the concept of consumer-brand identification. RESULTS: The results showed that LEL reaches a broad and diverse group of children and young people in terms of gender, age, socioeconomic status, and physical activity profile. The borrowed equipment, primarily used for play and recreation, serves as an essential resource for children and youths and, in particular, for those with low socioeconomic status. LEL is considered highly important by all user groups, with a majority emphasizing its significance in facilitating leisure activities. CONCLUSIONS: The study suggests LEL's success lies in its accessibility and that users identify with the brand of LEL. Users perceive LEL as a service catering to various recreational needs rather than sports, fostering inclusivity. The localization of stores in various types of areas, combined with high-quality products, enable children and young people from different socioeconomic areas to use the service. LEL's success hinges on maintaining a positive brand image and promoting a recreation-oriented identity. Opportunities exist to strengthen emotional bonds with users, enhance branding strategies, and position LEL as a valuable resource for inclusive recreational activities. In conclusion, this study highlights the potential of free lending services, such as LEL, to bridge socioeconomic gaps in the promotion of physical activity among children and young people.

Stimulating leisure-time activities and the risk of dementia: a multi-cohort study.

BACKGROUND: Stimulating activities are associated with a decreased risk of dementia. However, the extent to which this reflects a protective effect of activity or non-participation resulting from dementia is debated. We investigated the association of stimulating leisure-time activity in late adulthood with the risk of dementia across up to two decades' follow-up. METHODS: We used data from five prospective cohort studies from Finland and Sweden. Mental, social, outdoor, consumptive and physical leisure-time activities were self-reported. Incident dementia was ascertained from clinical diagnoses or healthcare and death registers. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: Of the 33 263 dementia-free individuals aged ≥50 years at baseline, 1408 had dementia during a mean follow-up of 7.0 years. Active participation in mental (HR: 0.52, 95% CI: 0.41 to 0.65), social (HR: 0.56 95% CI: 0.46 to 0.72), outdoor (HR: 0.70, 95% CI: 0.58 to 0.85), consumptive (HR: 0.67, 95% CI: 0.53 to 0.94) and physical (HR: 0.62, 95% CI: 0.51 to 0.75) activity, as well as variety (HR: 0.54, 95% CI: 0.43 to 0.68) and the overall frequency of activity (HR: 0.41, 95% CI: 0.34 to 0.49) were associated with a reduced risk of dementia in <10 years' follow-up. In ≥10 years' follow-up all associations attenuated toward the null. CONCLUSION: Stimulating leisure-time activities are associated with a reduced risk of dementia in short-term but not long-term follow-up. These findings may reflect a reduction in leisure-time activity following preclinical dementia or dilution of the association over time.

Crucibles of Craft: Home Workshops and Leisurely Striving in Twentieth-Century U.S. Woodworking Magazines.

With more leisure time in the early to mid-twentieth century, more people in industrialized countries took up hobbies. One hobby-woodworking-became a favorite among men, especially homeowners. Beyond the familiar "do-it-yourselfers" there was an audience eager to learn about woodworking, and magazine publishers encouraged them to acquire new skills and home machinery. American publishers led the way, but workshop converts in English-speaking countries like Canada and the United Kingdom got the magazines and the message. The promise of creative leisure at home did not democratize the hobby. Monthly features and awards praising accomplished amateurs did not challenge social and economic norms but defined leisure success in conventional terms. Those with the income and space to maintain a hobby served as models for others whose circumstances were less ideal. Through its flagship publication, a machine manufacturer often acquiesced to the industrial-era pressures that hobbies sought to alleviate.

Exploring person-specific associations of situational motivation and readiness with leisure-time physical activity effort and experience.

Identifying determinants of leisure-time physical activity (LTPA) often relies on population-level (nomothetic) averages, potentially overlooking person-specific (idiographic) associations. This study uses an idiographic perspective to explore how subjective readiness and motives for LTPA relate to volitional effort (duration, intensity) and affective experience (pleasure, displeasure). We also highlight the potential for different interpretations when data are averaged within individuals and assessed using a variable-centered approach. Participants (N = 22, 25±8 years old, 54.5% women) were asked to continue their regular PA patterns for 10 weeks. Ecological momentary assessment procedures allowed participants to provide pre-activity reports (physical, cognitive, emotional readiness and situational motive for activity) and post-activity reports (activity type, duration, perceived exertion, ratings of affective valence). Spearman rank correlation was implemented to interpret within- and between-person associations. Data visualization approaches were used to showcase person-specific differences in associations. Participants provided 519 reports of LTPA (24±11 events/person), which displayed between- and within-person variety in type, duration, intensity, and affective experience. Exemplar cases highlight discrepancies in interpretation based on level of analysis, such that the nomothetic association (rho = .42, p = .05; 95% CI -.02, .72) between motive to replenish energy and LTPA duration was observed in only one within-person analysis (41% were weak-to-large inverse effects). Alternatively, the negligible nomothetic association (rho = .02, p = .93; 95% CI -.41, .44) between physical readiness and LTPA-related affect did not reflect the 59% of within-person analyses showing moderate-to-large, positive effects. Future research aiming to identify determinants of LTPA effort and experience should integrate contemporary, idiographic analyses in early-stage research for developing person-specific strategies for LTPA promotion.

Leisure-time physical activity as a key protective factor against cognitive decline in older adults: an isotemporal substitution analysis.

This study aimed to test hypothesized effects of replacing sedentary behavior with moderate-to-vigorous physical activity, sleep, and different domains of physical activity by equivalent amounts on suggestive cognitive decline in an older adult population. This was a cross-sectional study including 473 older adults aged ≥ 60 years. Cognitive decline was assessed using the Mini-Mental Health Examination. Physical activity, its different domains and the time of exposure to sedentary behavior were assessed using the International Physical Activity Questionnaire. For data analysis, two isotemporal substitution models were constructed using Poisson regression. The first model tested the effect of sleep time, sedentary behavior, and moderate-to-vigorous physical activity on cognitive decline. The second model was used to determine the effect of physical activity domains (leisure, work, transport, and home), sleep time, and sedentary behavior on cognitive decline. Physical activity during leisure time was protective against cognitive decline among all domains tested, replacing sedentary behavior, sleep, and transport. Conversely, substitution of the leisure domain for sedentary behavior, sleep, and transport was considered a risk factor for cognitive decline. Leisure time proved to be a strong protective factor in reducing the risk of cognitive decline, and it is necessary to encourage and stimulate public policies that include it.

Physical activity as mediator between back pain and disability.

The objective was to explore the mediating role of leisure-time physical activity on the correlation between back pain and disability. A mediation analysis was conducted among the cross-sectional sample of 1330 patients in outpatient clinic. The average age was 47.6 years and 64% were women. For the entire sample, the mediating effect of physical activity remained below 10% of the total effect. The mediating effect was significantly greater among women comparing to men - up to 19.0% [95% confidence interval (CI) 10.4-27.6%] versus 2.3% (95% CI 0.0-6.1%). The effect did not significantly differ based on age, BMI, or educational or professional status. Some insignificant trends, however, could be seen - the effect was possibly stronger among patients with higher educational level and those with higher BMI. The results suggested that while physical activity seems to be a weak mediator, its mediating role might vary across different groups of patients with back pain. This variation should be taken into account when planning rehabilitation measures for people with back pain.

Association between various physical activity domains and overall cancer risk, National Health and Nutrition Examination Survey (NHANES) 2007-2018.

PURPOSE: There are very few studies concurrently evaluating the association between multiple physical activity (PA) domains and cancer prevalence. Therefore, this study aims to fill this gap by investigating the link between multiple PA subdomains [occupational PA (OPA), transportation-related PA (TPA), leisure-time PA (LTPA), and total PA] and the likelihood of cancer. METHOD: The data from National Health and Nutrition Examination Survey (NHANES) 2007-2008, 2009-2010, 2011-2012, 2013-2014, 2015-2016, and 2017-2018 were used in this study. Cancers are the primary outcome variable of interest in this study. PA was self- or proxy-reported using the Global Physical Activity Questionnaire (GPAQ). Multivariable logistic regression models were used, adjusted for covariates. RESULTS: The trend analysis revealed that the prevalence of cancer statistically decreased with the increase in total PA amount. The participants achieving twice the minimum recommended PA guidelines (≥300 minutes) for total PA were 32% [0.68 (0.54, 0.86)] less likely to have cancer. However, significant associations between three PA subdomains (OPA, TPA, and LTPA) and cancers were not found in this study. CONCLUSION: There is no significant association between any of these three single PA subdomains and cancer prevalence other than total PA. Therefore, this study recommends clinical practice should prioritize promoting comprehensive PA that integrates OPA, TPA, and LTPA to achieve at least 150 minutes per week (i.e. per seven days) initially and progressing towards 300 minutes for optimal cancer prevention.