Systematic Review Protocol to Evaluate the Evidence Informing the Physical Activity Guidelines for Americans Midcourse Report: Implementation Strategies for Older Adults.

The Physical Activity Guidelines for Americans (Guidelines) advises older adults to be as active as possible. Yet, despite the well documented benefits of physical activity just 12.8% of those ages 65 and older meet the Guidelines. To address this, the U.S. Department of Health and Human Services (HHS) developed a Midcourse Report focused on effective strategies to improve older adult physical activity behaviors. The first step in this process was a systematic literature review. A literature review team was contracted to examine the evidence on key settings and effective behavioral intervention strategies, as well as effective policy, systems, and environmental (PSE) approaches, to improve physical activity among older adults. The PSE search employed an equity-centered framework adapted to researching PSE approaches for improving physical activity outcomes in older adults. Sixteen thousand eight hundred and eighty-three titles and abstracts were screened, and 734 full articles were reviewed for inclusion. Of those, 64 original research articles were included for the final review to answer two questions, one (plus 5 sub-questions) focused on Settings/Strategies literature (45 studies) and one (plus 2 sub-questions) focused on PSE literature (19 studies). The literature review process identified key settings and evidence-based strategies to support older adults in becoming more physically active, and provides a foundation for the Physical Activity Guidelines for Americans Midcourse Report: Implementation Strategies for Older Adults. More research is needed to address how factors related to equity and psychosocial constructs influence physical activity behaviors among older adults.

Understanding the Impact of Move Your Way Campaign Exposure on Key Physical Activity Outcomes - Results from a Multi-site Pilot Evaluation.

The Move Your Way® campaign was developed to encourage physical activity contemplators to get active. A pilot test of campaign implementation was conducted and evaluated in eight communities between March and October 2020. A web-based, cross-sectional survey of adults collected pilot campaign outcome data after campaign implementation. Differences in outcomes between exposed and unexposed groups across the communities were compared. A total of n = 5,140 responded to the survey. Across eight communities, those who reported campaign exposure had 7.2 (95% CI, 6.1-8.6) greater odds of being aware of the Physical Activity Guidelines for Americans (Guidelines) compared to unexposed respondents. Additionally, they had greater odds of identifying the correct aerobic and muscle-strengthening dosages and had 1.4 (95% CI, 1.1-1.6) greater odds of reporting meeting both the aerobic and muscle-strengthening Guidelines. In this pilot evaluation, reported exposure to Move Your Way is associated with higher odds of being aware of the Guidelines, knowing recommended dosages, likelihood of becoming more active in the future, higher physical activity self-efficacy, making a recent physical activity behavior change, and higher physical activity levels. The Move Your Way campaign can be used in communities to promote physical activity.

Sedentary Behavior and Health: Update from the 2018 Physical Activity Guidelines Advisory Committee.

PURPOSE: To provide an overview of relationships between sedentary behavior and mortality as well as incidence of several noncommunicable diseases and weight status reported in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report (2018 PAGAC Scientific Report), and to update the evidence from recent studies. METHODS: Evidence related to sedentary behavior in the 2018 PAGAC Scientific Report was summarized, and a systematic review was undertaken to identify original studies published between January 2017 and February 2018. RESULTS: The 2018 PAGAC Scientific Report concluded there was strong evidence that high amounts of sedentary behavior increase the risk for all-cause and cardiovascular disease (CVD) mortality and incident CVD and type 2 diabetes. Moderate evidence indicated sedentary behavior is associated with incident endometrial, colon and lung cancer. Limited evidence suggested sedentary behavior is associated with cancer mortality and weight status. There was strong evidence that the hazardous effects of sedentary behavior are more pronounced in physically inactive people. Evidence was insufficient to determine if bout length or breaks in sedentary behavior are associated with health outcomes. The new literature search yielded seven new studies for all-cause mortality, two for CVD mortality, two for cancer mortality, four for type 2 diabetes, one for weight status, and four for cancer; no new studies were identified for CVD incidence. Results of the new studies supported the conclusions in the 2018 PAGAC Scientific Report. CONCLUSIONS: The results of the updated search add further evidence on the association between sedentary behavior and health. Further research is required on how sex, age, race/ethnicity, socioeconomic status, and weight status may modify associations between sedentary behavior and health outcomes.

Physical Activity in Cancer Prevention and Survival: A Systematic Review.

PURPOSE: This article reviews and updates the evidence on the associations between physical activity and risk for cancer, and for mortality in persons with cancer, as presented in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report. METHODS: Systematic reviews of meta-analyses, systematic reviews, and pooled analyses were conducted through December 2016. An updated systematic review of such reports plus original research through February 2018 was conducted. This article also identifies future research needs. RESULTS: In reviewing 45 reports comprising hundreds of epidemiologic studies with several million study participants, the report found strong evidence for an association between highest versus lowest physical activity levels and reduced risks of bladder, breast, colon, endometrial, esophageal adenocarcinoma, renal, and gastric cancers. Relative risk reductions ranged from approximately 10% to 20%. Based on 18 systematic reviews and meta-analyses, the report also found moderate or limited associations between greater amounts of physical activity and decreased all-cause and cancer-specific mortality in individuals with a diagnosis of breast, colorectal, or prostate cancer, with relative risk reductions ranging almost up to 40% to 50%. The updated search, with five meta-analyses and 25 source articles reviewed, confirmed these findings. CONCLUSIONS: Levels of physical activity recommended in the 2018 Guidelines are associated with reduced risk and improved survival for several cancers. More research is needed to determine the associations between physical activity and incidence for less common cancers and associations with survival for other cancers. Future studies of cancer incidence and mortality should consider these associations for population subgroups, to determine dose-response relationships between physical activity and cancer risk and prognosis, and to establish mechanisms to explain these associations.