Health behaviours associated with video gaming in adolescent men: a cross-sectional population-based MOPO study.

BACKGROUND: Playing video games, a form of sedentary behaviour, is associated with poor well-being and increased risk of morbidity due to chronic disease. However, the association between health behaviours and video gaming is poorly understood. The purpose of this population-based study was to reveal the differences in dietary habits and physical activity for adolescent men with high amount of video games on weekdays, as compared to their peers who play less often. METHODS: Seven hundred ninety-six adolescent men (age: mean = 17.8, SD = 0.6) attended compulsory conscription for military service in 2013 and completed a questionnaire regarding the amount and frequency of their video gaming. They also participated in a medical examination and underwent physiological measurements. The participants who played video games more than 3 h/d on weekdays were compared with those who played 3h/d or less. The association between health behaviours and the amount of playing video gaming was analysed using multivariable logistic regression analysis. RESULTS: 24.1% (n = 192) of the participants reported video gaming in excess of 3 h/d. This group had higher incidence of having low physical fitness, having poor eating habits, and being obese. No differences were found in smoking or alcohol drinking habits. Other factors, including low leisure-time physical activity (OR = 1.94; 95% CI, 1.29-2.91), low consumption of vegetables and fruits (OR = 0.83; 95% CI, 0.72-0.97), high consumption of sweetened soft drinks (OR = 1.28; 95% CI, 1.06-1.55) and high amount of sitting time (OR = 1.40; 95% CI, 1.28-1.52), explained one-fourth of the difference. CONCLUSION: In this population-based study, adolescent men who played video games a lot on weekdays had lower physical fitness, were more often obese, and had poorer dietary habits, as compared to their peers who played less often. Because playing video games typically adds to a person's total sedentary time, this activity may be associated with adverse health outcomes at a very young age- especially in combination with poor health behaviours. The results of this study can be utilized to promote health interventions targeted at adolescent men so as to raise their awareness of the disadvantages of excessive video gaming.

Screening everyday health information literacy among four populations.

BACKGROUND: People face varying obstacles when interacting with health information in their everyday lives. OBJECTIVES: This study aims to examine the applicability of a multidimensional Everyday Health Information Literacy (EHIL) screening tool in detecting people with challenges in accessing, understanding, evaluating and using health information in everyday situations. METHODS: Previously collected EHIL screening tool data from Finnish upper secondary school students (n = 217), Finnish young men (n = 1450), Finnish adults with an increased risk for metabolic syndrome (n = 559) and Namibian university students (n = 271) were reanalysed to examine the factorial structure of the tool and to compare the groups. Statistical analyses included exploratory factor analyses, calculation of mean factor scores and one-way analysis of variance. RESULTS: A three factor structure ('awareness', 'access', 'assessment') for the screening tool was supported based on the Finnish samples. However, the Namibian data did not follow a similar structure. Significant differences in groupwise factor scores were discovered. DISCUSSION: The findings suggest that the multidimensional EHIL screening tool can be used in pointing out areas where individuals or groups may need support. CONCLUSION: The tool may be useful to health information and library services workers when counselling or educating the public.

Disordered eating behavior, health and motives to exercise in young men: cross-sectional population-based MOPO study.

BACKGROUND: Being overweight is an increasing problem among young people, among whom disordered eating behavior is linked with weight problems as well as unhealthy weight control. The aim of the present study was to investigate whether health factors and motives to exercise differ in young men by the type of disordered eating behavior. METHODS: The population-based, cross-sectional MOPO study consisted of 2,096 young Finnish men (mean age 17.9, SD 0.7) attending compulsory call-ups for military service in the Oulu area in 2010, 2011, and 2013. They responded to a questionnaire that included two subscales of the Eating Disorder Inventory-3 indicating drive for thinness and bulimic behavior and questions on health, physical activity, and motives to exercise. The association between disordered eating behavior and related factors was analyzed by binary logistic regression. RESULTS: Altogether, 6.9 % (n = 145) of the men had symptoms of disordered eating, i.e., 5.4 % had a drive for thinness (n = 114) and 3.7 % had bulimic behavior (n = 77). Drive for thinness was associated with a perception of being overweight (OR 3.7; 95 % CI 2.2-6.1), poor self-rated health (2.3; 1.2-4.4), more leisure sitting time (1.1; 1.0-1.2), and body-related exercise motives (body acceptance: 3.0; 1.7-5.2; weight loss: 2.5; 1.4-4.4). Bulimic behavior was positively associated with poor self-rated health (2.6; 1.1-5.8) and several motives to exercise, i.e., due to another person's suggestion (2.8; 1.6-4.8), competitive sports (2.1; 1.2-3.7), body acceptance (2.1; 1.1-3.9), and weight loss (1.9; 1.1-3.3), but inversely associated with health/fitness-related exercise motives (health promotion: 0.3; 0.1-0.5; muscular strength or physical performance: 0.5; 0.2-0.9). CONCLUSIONS: In young men, disordered eating behavior was associated with being overweight, having poor self-rated health, and having a greater amount of leisure sitting time as well as non-health-related motives to exercise. In order to recognize those at risk for disordered eating behavior, evaluating these factors could be beneficial.

Profiles of sedentary and non-sedentary young men - a population-based MOPO study.

BACKGROUND: Sedentary behavior is associated with poor well-being in youth with adverse trajectories spanning to adulthood. Still, its determinants are poorly known. Our aim was to profile sedentary and non-sedentary young men and to clarify their differences in a population-based setting. METHODS: A total of 616 men (mean age 17.9, SD 0.6) attending compulsory conscription for military service completed a questionnaire on health, health behavior, socioeconomic situation and media use. They underwent a physical (body composition, muscle and aerobic fitness) and medical examination. Profiles were formed by principal component analysis (PCA). RESULTS: A total of 30.1 % men were sedentary (daily leisure-time sitting ≥5 h) and 28.9 % non-sedentary (sitting ≤2 h). The sedentary men had more body fat, more depressive symptoms, but lower fitness and life satisfaction than non-sedentary men. However, according to PCA, profiles of unhealthy eating, life-dissatisfaction, and gaming were detected both among sedentary and non-sedentary men, as well as high self-rated PA and motives to exercise. CONCLUSION: Determinants of sedentary and non-sedentary lifestyles were multiple and partially overlapping. Recognizing individual patterns and underlying factors of the sedentary lifestyle is essential for tailored health promotion and interventions.

Individual factors affecting preferences for feedback message tactics in the contexts of physical activity.

Tailored feedback on personal physical activity behavior has been used to inform individuals and promote physical activity among different populations. This study aimed to increase the understanding of factors associated with young men's preferences for feedback message tactics in the context of physical activity and exercise. How preferences vary was analyzed in terms of the self-reported physical activity, stage of exercise behavior change, exercise self-efficacy, objectively measured physical health status, and sociodemographic characteristics of young Finnish men. Population-based survey data, including physiological measurements (n = 525), were collected at the Finnish Defence Forces' call-ups in the city of Oulu, Finland, in September 2011. The results indicate that the stage of exercise behavior change, exercise self-efficacy, physical health status, and educational level are associated with a preference for normative and ipsative comparison. Multivariate logistic regression models show that an advanced stage of exercise behavior change and education in the academic track of an upper secondary school are independent predictors of preferring ipsative and normative physical activity feedback among young men. The study provides new insights into how the stage of behavior change influences health information behavior and is in line with studies emphasizing social factors--including education--as being important in shaping health-related behavior. These factors could form the basis for tailoring information when designing health promotion.

Gamified physical activation of young men--a Multidisciplinary Population-Based Randomized Controlled Trial (MOPO study).

BACKGROUND: Inactive and unhealthy lifestyles are common among adolescent men. The planned intervention examines the effectiveness of an interactive, gamified activation method, based on tailored health information, peer networks and participation, on physical activity, health and wellbeing in young men. We hypothesize that following the intervention the physical activation group will have an improved physical activity, as well as self-determined and measured health compared with the controls. METHODS/DESIGN: Conscription-aged men (18 years) attending compulsory annual call-ups for military service in the city of Oulu in Finland (n = 1500) will be randomized to a 6-months intervention (n = 640) or a control group (n = 640) during the fall 2013. A questionnaire on health, health behaviour, diet and wellbeing is administered in the beginning and end of the intervention. In addition, anthropometric measures (height, weight and waist circumference), body composition, grip strength, heart rate variability and aerobic fitness will be measured. The activation group utilizes an online gamified activation method in combination with communal youth services, objective physical activity measurement, social networking, tailored health information and exercise programs according to baseline activity level and the readiness of changes of each individual. Daily physical activity of the participants is monitored in both the activation and control groups. The activation service rewards improvements in physical activity or reductions in sedentary behaviour. The performance and completion of the military service of the participants will also be followed. DISCUSSION: The study will provide new information of physical activity, health and health behaviour of young men. Furthermore, a novel model including methods for increasing physical activity among young people is developed and its effects tested through an intervention. This unique gamified service for activating young men can provide a translational model for community use. It can also be utilized as such or tailored to other selected populations or age groups. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01376986.

More Physical Activity, More Work Engagement? A Northern Finland Birth Cohort 1966 Study.

OBJECTIVE: To examine the role of physical activity (PA) and sedentary behavior (SED) for work engagement. METHODS: We used data from Northern Finland Birth Cohort 1966 Study ( n = 3046 to 4356) to analyze self-reported weekly leisure-time physical activity (LTPA), daily leisure-time sitting time (LTST) and work engagement. PA and SED 24-hour were also measured with accelerometer for 14 days. The data were analyzed using linear regression analyses. RESULTS: High self-reported LTPA and sports participation were associated with higher work engagement and its subdimensions. High self-reported ST was associated with lower work engagement, vigor, and absorption. Accelerometer-measured light PA was associated with higher work engagement and vigor, and accelerometermeasured steps were linked to higher vigor. Accelerometer-measured SED was associated with lower work engagement, vigor, and dedication. CONCLUSIONS: Self-reported and accelerometer-measured PA and SED may play a role in people's work engagement.

Parental Factors Related to Physical Activity among Adolescent Men Living in Built and Natural Environment: A Population-Based MOPO Study.

Introduction: Physical inactivity is a global concern, especially among adolescent men. Little research has been done on the association between parental factors and young adults' physical activity in the context of residential environment. We aimed to reveal what parental factors are associated with physical activity among adolescent men living in built and natural environments. Methods: A population-based sample of 1,904 men (mean age = 17.9, SD = 0.7 years) completed a questionnaire regarding physical activity, parental factors, and lifestyle in Northern Finland in 2012 and 2013. Geographical information system methods and dominant land-use type were used to define the residential environment in a 1-kilometer radius buffer zone surrounding each participant's home address. If the residential area included more artificial surfaces, it was defined as a built environment, and areas including more nature were defined as natural environments. Results: According to multivariable analyses, a mother's physical activity (OR = 1.9; 95% CI: 1.3-2.8) was positively associated with the physical activity of adolescent men living in built environments, and the father's physical activity was positively associated with the physical activity of adolescent men living in natural environments (2.8; 1.7-4.8). Self-rated health (built 5.9 [4.0-8.7]; natural 5.2 [3.0-9.0]) was positively associated with physical activity level. Those with symptoms of depression were more likely to be physically inactive (built 0.5 [0.3-0.8]; natural 0.3 [0.1-0.6]). Adolescent men were equally physically active regardless of the living environment. Conclusions: The level of physical activity of parents, self-rated health, and depressive symptoms should be considered when designing physical activity promotions for adolescent men according to their residential environments.

Satellite Imaging-Based Residential Greenness and Accelerometry Measured Physical Activity at Midlife-Population-Based Northern Finland Birth Cohort 1966 Study.

BACKGROUND: Recently, the importance of light physical activity (LPA) for health has been emphasized, and residential greenness has been positively linked to the level of LPA and a variety of positive health outcomes. However, people spend less time in green environments because of urbanization and modern sedentary leisure activities. AIMS: In this population-based study, we investigated the association between objectively measured residential greenness and accelerometry measured physical activity (PA), with a special interest in LPA and gender differences. METHODS: The study was based on the Northern Finland Birth Cohort 1966 (5433 members). Participants filled in a postal questionnaire and underwent clinical examinations and wore a continuous measurement of PA with wrist-worn Polar Active Activity Monitor accelerometers for two weeks. The volume of PA (metabolic equivalent of task or MET) was used to describe the participant's total daily activity (light: 2-3.49 MET; moderate: 3.5-4.99 MET; vigorous: 5-7.99 MET; very vigorous: ≥8 MET). A geographic information system (GIS) was used to assess the features of each individual's residential environment. The normalized difference vegetation index (NDVI) was used for the objective quantification of residential greenness. Multiple linear regression and a generalized additive model (GAM) were used to analyze the association between residential greenness and the amount of PA at different intensity levels. RESULTS: Residential greenness (NDVI) was independently associated with LPA (unadjusted ß = 174; CI = 140, 209) and moderate physical activity (MPA) (unadjusted ß = 75; CI = 48, 101). In the adjusted model, residential greenness was positively and significantly associated with LPA (adjusted ß = 70; CI = 26, 114). In men, residential greenness was positively and significantly associated with LPA (unadjusted ß = 224; CI = 173, 275), MPA (unadjusted ß = 75; CI = 48, 101), and moderate to vigorous physical activity (MVPA) (unadjusted ß = 89; CI = 25, 152). In women, residential greenness was positively related to LPA (unadjusted ß = 142; CI = 96, 188) and inversely associated with MPA (unadjusted ß = -22; CI = -36, -8), vigorous/very vigorous physical activity (VPA/VVPA) (unadjusted ß = -49; CI = -84, -14), and MVPA (unadjusted ß = -71; CI = -113, -29). In the final adjusted models, residential greenness was significantly associated only with the amount of LPA in men (adjusted ß = 140; CI = 75, 204). CONCLUSIONS: Residential greenness was positively associated with LPA in both genders, but the association remained significant after adjustments only in men. Residential greenness may provide a supportive environment for promoting LPA.

Individual and environmental factors associated with green exercise in urban and suburban areas.

In this study, we mainly aimed to explore the associations of personal and socio-demographic factors, and the supply of green areas and built sports facilities with green exercise (GE). We also compared the residents of the core urban area and suburban areas according to the level of leisure time physical activity (LTPA) they had. A population-based sample of 3730 adults (aged 25-101 y) from Finland, filled out a questionnaire in 2015. Variables describing the supply of green areas and built sports facilities were objectively calculated. The green areas were classified into small (<25 ha), middle-sized (25-150 ha) and large (>150 ha) areas to reflect their qualities for GE. The data analysis methods included multinomial logistic regression, t-, and Chi Square tests. Our results indicate that having a short distance to at least a middle-sized green area and high nature relatedness are important for participation in GE, both in core urban and suburban areas. More factors were found to be related to GE in the suburban areas compared to core urban areas and among the low LTPA compared to the high LTPA group.

Physical activity is associated with cardiac autonomic function in adolescent men.

INTRODUCTION: Moderate to vigorous physical activity (MVPA) has been shown to be associated with autonomic regulation of the heart measured with heart rate variability (HRV). Only a limited amount of studies have examined this relationship among adolescents, and the effects of increasing PA on HRV is not well established. The aim of this study was to investigate how overall self-reported PA associates with HRV in a large population of adolescent men. METHODS: The study was part of the Finnish MOPO study consisting of 3629 young men (mean age 18, SD 1 years) enrolled for military call-ups in 2009-2013. Overall PA, including both the intensity and frequency of habitual exercise, was assessed by a questionnaire and the respondents categorized into four groups of PA (low, moderate, high and top). Short-term HRV, physical performance and body composition were measured. RESULTS: HRV, as indicated by mean ln rMSSD, increased according the PA categories as follows: low (3.65 ms (SD 0.7), p<0.001 vs. other groups), moderate (3.78 ms (0.6) p<0.001), high (3.85 ms (0.6) p<0.001) and top activity (3.93 ms (0.6) p<0.001) According to the multivariable linear regression analysis, a significant positive relationship (ß = 0.129, p<0.05) was observed between self-reported PA and ln rMSSD independent of body mass index, waist circumference and fat percentage. CONCLUSIONS: Physical activity was positively associated with cardiac autonomic regulation, in adolescent men. A linear increase in HRV according to PA was observed, suggesting that even slight increments in PA might be beneficial for cardiac autonomic regulation The results emphasize the importance of physical activity in improving cardiac health in young people.

Physical Activity, Residential Environment, and Nature Relatedness in Young Men-A Population-Based MOPO Study.

Background: In general, nature relatedness is positively associated with physical activity, health, and subjective well-being. However, increased residence in urban areas, and the decrease in natural spaces, may affect the younger generation most adversely. The associated environmental changes can increase youths' risk of spending most of their time indoors, and weaken their nature relatedness, making them less likely to enjoy nature's health benefits. This is a serious public health issue, since inadequate physical activity, combined with minimum time spent in green space, can affect health across the whole lifespan. Thus, to develop effective interventions for physical activation and promote health and well-being among young men, further knowledge of the determinants of their nature relatedness is necessary. Aims: To explore factors related to nature relatedness, including physical activity, physical activity with parents, and residential environment. Methods: The study population consisted of all 914 young men (mean-17.8 years; SD-0.5) who participated in mandatory call-ups for military service and completed the study questionnaire in 2013. The questionnaire inquired about their nature relatedness, demographic characteristics, socioeconomic status, physical activity, health, and subjective well-being. A geographic information system (GIS) was used to assess the features of their residential environments. Multivariable linear regression was used to analyze the data. Results: Physical activity (p = 0.021) and physical activity with parents at primary school age (p = 0.007), and currently (p = 0.001) as well as good self-rated health (p = 0.001), and father's higher socioeconomic status (p = 0.041), were positively connected to nature relatedness. Conclusions: Physical activity in general, physical activity with parents, and nature relatedness were positively related. This knowledge can be utilized in promoting physical activity and health among young men.

Feasibility of Gamified Mobile Service Aimed at Physical Activation in Young Men: Population-Based Randomized Controlled Study (MOPO).

BACKGROUND: The majority of young people do not meet the recommendations on physical activity for health. New innovative ways to motivate young people to adopt a physically active lifestyle are needed. OBJECTIVE: The study aimed to study the feasibility of an automated, gamified, tailored Web-based mobile service aimed at physical and social activation among young men. METHODS: A population-based sample of 496 young men (mean age 17.8 years [standard deviation 0.6]) participated in a 6-month randomized controlled trial (MOPO study). Participants were randomized to an intervention (n=250) and a control group (n=246). The intervention group was given a wrist-worn physical activity monitor (Polar Active) with physical activity feedback and access to a gamified Web-based mobile service, providing fitness guidelines, tailored health information, advice of youth services, social networking, and feedback on physical activity. Through the trial, the physical activity of the men in the control group was measured continuously with an otherwise similar monitor but providing only the time of day and no feedback. The primary outcome was the feasibility of the service based on log data and questionnaires. Among completers, we also analyzed the change in anthropometry and fitness between baseline and 6 months and the change over time in weekly time spent in moderate to vigorous physical activity. RESULTS: Mobile service users considered the various functionalities related to physical activity important. However, compliance of the service was limited, with 161 (64.4%, 161/250) participants visiting the service, 118 (47.2%, 118/250) logging in more than once, and 41 (16.4%, 41/250) more than 5 times. Baseline sedentary time was higher in those who uploaded physical activity data until the end of the trial (P=.02). A total of 187 (74.8%, 187/250) participants in the intervention and 167 (67.9%, 167/246) in the control group participated in the final measurements. There were no differences in the change in anthropometry and fitness from baseline between the groups, whereas waist circumference was reduced in the most inactive men within the intervention group (P=.01). Among completers with valid physical activity data (n=167), there was a borderline difference in the change in mean daily time spent in moderate to vigorous physical activity between the groups (11.9 min vs -9.1 min, P=.055, linear mixed model). Within the intervention group (n=87), baseline vigorous physical activity was inversely associated with change in moderate to vigorous physical activity during the trial (R=-.382, P=.01). CONCLUSIONS: The various functionalities related to physical activity of the gamified tailored mobile service were considered important. However, the compliance was limited. Within the current setup, the mobile service had no effect on anthropometry or fitness, except reduced waist circumference in the most inactive men. Among completers with valid physical activity data, the trial had a borderline positive effect on moderate to vigorous physical activity. Further development is needed to improve the feasibility and adherence of an integrated multifunctional service. TRIAL REGISTRATION: Clinicaltrials.gov NCT01376986; http://clinicaltrials.gov/ct2/show/NCT01376986 (Archived by WebCite at http://www.webcitation.org/6tjdmIroA).

Effect of wrist-worn activity monitor feedback on physical activity behavior: A randomized controlled trial in Finnish young men.

UNLABELLED: The purpose of this study is to evaluate whether the use of an activity monitor providing feedback has an effect on physical activity (PA) in young men. A population-based sample of 276 conscription-aged (mean = 17.9, SD = 0.7 years) men participated in a 3-month randomized controlled trial in Oulu in 2012. Participants were randomized to an intervention group (INT, N = 137) and a control group (CON, N = 139). INT received a wrist-worn monitor (Polar Active) showing daily activity, and CON received identical monitors without feedback. Main outcome was the change from baseline in objectively measured weekly time spent in moderate-to-vigorous PA (MVPA) and sedentary activity (SED), as assessed by generalized estimation equations (GEE). Other lifestyle factors were assessed by a questionnaire at baseline and at 3 months. Weekly physical activity data (≥ 4 days with ≥ 8 h each) were obtained from 72 (53%) and 90 (65%) men in the INT and CON, respectively. Based on GEE, time spent in MVPA increased (p = 0.012) and SED decreased (p = 0.032) in the INT compared with the CON. During the first 7 weeks, the INT spent on average 1 h less sedentary than the CON (t-test, p < 0.05). During the first week, the INT showed 12 minutes more MVPA compared to the CON (t-test, p = 0.034). Based on questionnaire data, the proportion of the most sedentary men decreased in the INT (Wilcoxon test, 28% vs. 10%, p = 0.029), with no change in the CON (20% vs. 19%, p = 0.546). To conclude, a wrist-worn activity monitor providing feedback had a short-term positive effect on PA and SED in young men. TRIAL REGISTRATION: This is a pilot study for a larger randomized controlled trial registered to the clinical trials register NCT01376986.