Exploring the Feasibility, Acceptability, and Potential Benefits of the Mom Movement Intervention (MOMmi).

OBJECTIVE: To explore the feasibility, acceptability, and potential benefits associated with a mind-body intervention and varied delivery styles among women during the postpartum period. DESIGN: Mixed-methods feasibility study. SETTING: Fraser Valley, British Columbia, Canada. PARTICIPANTS: Forty-three women (93% White), with an average age of 32.1 (SD = 2.9) years, who had given birth within the last 6 months. METHODS: Participants were randomized to three physical activity groups. Validated questionnaires were administered before and after the 12-week intervention. Attendance and feasibility metrics and qualitative semistructured interviews were conducted to assess the intervention. RESULTS: The intervention and trial were partially feasible, and retention to the intervention was high; however, adherence as assessed by attendance was lower than expected. There was high acceptability among those in the group-based, in-person intervention. There was moderate acceptability among those in the individual, home-based asynchronous program. CONCLUSION: Findings highlight the necessity of better understanding what is desired by this population or simply providing more options to participants so that we can tailor physical activity to their needs and provide the necessary support.

Psychological and physiological effects of an acute bout of yoga before a simulated academic exam in university students.

Objective: Test anxiety is common among nursing students. Yoga is one form of physical activity which may be beneficial for pretest anxiety. Participants: Thirteen undergraduate students (85% nursing majors, 15% awaiting program entry, 20 ± 4.9 years of age) completed the crossover design study. Methods: Participants completed a yoga or control intervention (independent quiet study) on opposing testing days. At three time points, participants provided ratings of anxiety (visual analog scales), saliva samples for cortisol and alpha amylase, and seated heart rate variability (HRV, time and frequency domains) was recorded. Results: Yoga prior to a simulated exam had a positive impact on subjective measures of stress but did not positively impact cortisol or HRV compared to the control condition. Conclusions: There may be benefits to participating in 30 min of moderate intensity yoga for reduced perception of stress before a scholarly examination. Further research regarding the impacts of acute yoga on physiological measures of HRV and/or cortisol are warranted.

Participant Bias in Community-Based Physical Activity Research: A Consistent Limitation?

Physical activity is a beneficial, yet complex, health behavior. To ensure more people experience the benefits of physical activity, we develop and test interventions to promote physical activity and its associated benefits. Nevertheless, we continue to see certain groups of people who choose not to, or are unable to, take part in research, resulting in "recruitment bias." In fact, we (and others) are seemingly missing large segments of people and are doing little to promote physical activity research to equity-deserving populations. So, how can we better address recruitment bias in the physical activity research we conduct? Based on our experience, we have identified 5 broad, interrelated, and applicable strategies to enhance recruitment and engagement within physical activity interventions: (1) gain trust, (2) increase community support and participation, (3) consider alternative approaches and designs, (4) rethink recruitment strategies, and (5) incentivize participants. While we recognize there is still a long way to go, and there are broader community and societal issues underlying recruitment to research, we hope this commentary prompts researchers to consider what they can do to try to address the ever-present limitation of "recruitment bias" and support greater participation among equity-deserving groups.

Describing and exploring physical activity experiences among adults with cancer during the COVID-19 pandemic: a mixed-methods survey study.

Understanding if (and how) adults with cancer perceived their physical activity (PA) levels have changed (or not) since the COVID-19 pandemic and why this may have occurred is important. Given current gaps in knowledge, the purpose of this study was to explore PA experiences among adults with cancer amidst the COVID-19 pandemic. Individuals were eligible if they were currently ≥19 years of age, had been diagnosed with cancer ≥18 years of age, and were living in Canada. 113 adults affected by cancer (Mage = 61.9 ± 12.7 years; 68% female) completed the survey which asked closed- and open-ended questions about PA levels and PA engagement experiences. Most participants (n = 76, 67.3%) were not meeting PA guidelines, and reported engaging in, on average, 89.2 ± 138.2 minutes per week of moderate-to-vigorous PA. Participants indicated their PA declined (n = 55, 38.7%), did not change (n = 40, 35.4%), or increased (n = 18, 15.9%) since the start of the pandemic. Participants described their changed PA as due to public health restrictions, lowered motivation during the pandemic, or cancer- and treatment-related effects. For those engaging in similar or greater PA, online home-based and outdoor PA were shared as main forms of PA. Findings suggest PA behavior change support and ongoing access to online, home-based and outdoor PA options will be required as pandemic restrictions ease in this population.

Describing Supportive Care Programming Access and Comfort Gathering through the COVID-19 Pandemic: An Observational Mixed Methods Study with Adults Affected by Cancer.

Supportive care programming helps many adults affected by cancer manage concerns related to their disease. Public health restrictions imposed by the COVID-19 pandemic have undoubtedly changed the nature of supportive care programming delivery. Yet, access to supportive care programming and comfort gathering through the pandemic are unknown. As a first step towards informing ongoing supportive care programming for adults affected by cancer, this observational, mixed methods study described supportive care programming access through the COVID-19 pandemic and comfort returning to in-person supportive care programming as restrictions eased. Adults affected by cancer (n = 113; mean age = 61.9 ± 12.7 years; 68% female) completed an online survey, and descriptive statistics were computed. A purposeful sample of survey participants (n = 12; mean age = 58.0 ± 14.5 years; 58% female) was subsequently recruited to complete semi-structured interviews. Interviews were analyzed using reflexive thematic analysis. Less than half (41.6%) of the survey sample reported accessing supportive care programming during the pandemic, and of those who had accessed supportive care programming, most (65.6%) perceived similar or greater access than pre-pandemic. During interviews, participants described the ways online delivery enhanced their access and reduced barriers to supportive care programming. However, physical activity programming was described as challenging to navigate online. With restrictions easing, most of the survey sample (56.6%) reported being apprehensive about returning to in-person supportive care programming and identified the protocols that would make them feel safe to gather. During interviews, participants recounted struggling to balance their need for social connection with their health and safety. This study provides evidence to inform supportive care programming for adults affected by cancer through the COVID-19 pandemic. Findings suggest online delivery can enhance access to some types of supportive care programming for some adults affected by cancer, and that efforts are needed to ensure all adults affected by cancer feel comfortable gathering in-person.

Moms on the move: A qualitative exploration of a postpartum group exercise program on physical activity behaviour at three distinct time points.

PURPOSE: Physical activity (PA) after the birth of a child is associated with improved physical and mental health benefits. The aim of the study was to explore new mothers' experiences of PA before and after participation in a group-based PA program for new mothers. The study has three research questions: how new mothers felt; 1) about PA after the birth of their child 2) about engaging in a group-based PA program and 3) after the program ended about ongoing PA engagement. METHODS: We conducted an 8-week bi-weekly PA program for postpartum women. To understand the experience of postpartum women engaging in a group-based PA program we conducted one-on-one semi-structured interviews before, after, and at 6-month follow-up. RESULTS: Of the n = 21 participants in the Moms on the Move study; n = 17 completed pre interviews.s. One primary theme emerged from pre-program interviews where mothers shared how they were lost as to where to start PA. Post-program interviews produced two primary themes; engaging in PA helped mothers, and mothers learned to rethink PA. CONCLUSIONS: Postpartum women who participated in this group-based PA program had positive benefits to their mental and physical health and were able to alter their PA behaviour.

Does Higher Self-Reported Cardiorespiratory Fitness Reduce the Odds of Hospitalization From COVID-19?

BACKGROUND: Regular physical activity and higher cardiorespiratory (CR) fitness enhance immune function, possibly reducing coronavirus disease 2019 (COVID-19) infection severity. The aim was to assess the association between physical activity and self-reported CR fitness on COVID-19 infection characteristics. METHODS: Participants formerly testing positive for COVID-19 completed an online questionnaire measuring COVID-19 infection characteristics and complications, self-reported CR fitness level, physical activity, and sociodemographic and health-related characteristics. Self-reported CR fitness was determined as the pace to cover 4.8 km without becoming overly fatigued (with slow walking, brisk walking, jogging, and running corresponding to low, moderate, good, and excellent levels of fitness, respectively). RESULTS: A total of 263 individuals completed the survey. Compared with the lowest level of self-reported CR fitness, the odds of hospitalization significantly decreased by 64% (odds ratio = 0.36; 95% confidence interval, 0.13-0.98; P = .04) in individuals reporting the ability to maintain a brisk walk. In individuals reporting the ability to maintain a jogging pace, the further reduction in hospitalization was not significant (odds ratio = 0.22; 95% confidence interval, 0.05-1.04; P = .05). For COVID-19 symptom severity and number, there were no significant associations with self-reported CR fitness or physical activity levels. CONCLUSIONS: For individuals with low self-reported CR fitness, improving CR fitness represents a strategy to reduce the risk of hospitalization from COVID-19.

Active by nature: exploring cancer survivors' exercise barriers, facilitators, preferences, and psychosocial benefits of engaging in outdoor physical activity.

INTRODUCTION: Large numbers of cancer survivors struggle with mental health after cancer diagnosis. Cancer survivors are encouraged to engage in physical activity in order to improve physical and mental health. Additional benefits to physical activity engagement in natural environments have been reported but this has not been explored in cancer survivors. METHODS: Study participants had to be over the age of 19, a Canadian resident, and have had a cancer diagnosis. Recruitment to complete an online survey occurred through social media and snowball sampling. The data collected included physical activity participation, preferences and location, barriers and facilitators of engagement in outdoor physical activity, nature-related questions, and measures of psychosocial health. The sample was split by the number of outdoor physical activity minutes (> 150 min per week). Correlations were computed to examine the role of outdoor physical activity minutes on measured psychosocial health outcomes. RESULTS: One hundred and fourteen (N = 114) cancer survivors completed the online questionnaire. More than half of the respondents indicated that an outdoor environment was central to their physical activity of choice with walking identified as the most common outdoor physical activity. Group support was the main expected facilitator of success in an outdoor walking program. Outdoor active participants were significantly more motivated and confident to be physically active and reported significantly more benefit and enjoyment in being physically active than outdoor inactive participants. Minutes of outdoor physical activity was significantly correlated with subjective happiness, nature relatedness, and higher quality of life. No significant correlations were found between minutes of outdoor physical activity and generalized anxiety. CONCLUSION: While future research is needed to further explore the role of nature in cancer survivor psychosocial health, we believe that our data suggests preference and benefit for outdoor physical activity in cancer survivors.

The Evaluation of a Health-Based Education and Behavioral Change Retreat on Quality of Life, Physical Activity and Psychosocial Health in Adult Cancer Survivors: An Exploratory Analysis.

Knights Cabin Cancer retreats may represent an ideal opportunity and environment to fill the gap in health education and behavioral change. It is unknown, however, whether the program improves quality of life, physical activity, and psychosocial health. Cancer survivors who enrolled in a retreat completed online questionnaires prior to and 3 months post to assess health-related quality of life, physical activity, and psychosocial variables; perceived stress, depression, and self-esteem. Paired t tests were utilized to compare changes pre and 3 months post the retreat. The majority of the 51 cancer survivors were female with a mean age of 53. The mental component summary of health-related quality of life (p < 0.016) and physical activity score (p = 0.048) was significantly improved at follow-up, while the physical component summary of health-related quality of life was not (p = 0.139). In addition, participants showed an improvement in psychosocial variables of self-esteem (p = 0.016) and depression (p = 0.016) after 3 months but did not show a significant improvement in perceived stress (p = 0.054). Improvements were seen following a Knights Cabin Cancer retreat in mental health-related quality of life and physical activity as well as some psychosocial variables. Further research is needed to evaluate the individual program components and the sustainability of the program in the community.

The Impact of COVID-19 on Women's Physical Activity Behavior and Mental Well-Being.

BACKGROUND: A global pandemic caused by COVID-19 resulted in restrictions to daily living for Canadians, including social distancing and closure of recreation facilities and provincial parks. METHODS: The objective of this study was to assess whether sex differences exist in physical activity and well-being since COVID-19 and to explore how barriers or facilitators to physical activity may explain these differences. Chi-square tests, independent t-tests and one-way ANOVAs were conducted to evaluate data provided by 1098 Canadians-215 men and 871 women. RESULTS: Women were significantly less physically active than men and reported more barriers and fewer facilitators to physical activity and experienced significantly more generalized anxiety than men. Women who were engaged in less physical activity due to COVID-19 reported significantly lower mental health scores, lower social, emotional and psychological well-being, and significantly higher generalized anxiety, while women who engaged in more physical activity had improved mental health scores. CONCLUSIONS: Given the challenges that women uniquely face due to restrictions, it is imperative to advocate and provide environmental opportunity and support for physical activity to reduce the mental duress women may be experiencing. Specific physical activity programming that is inclusive of lifestyle physical activity and can engage children is encouraged.

Does body size impact muscle recruitment during law enforcement physical control simulator use?

This study examined muscle activation during the 'push-pull' component of law enforcement physical abilities testing and assessed activation differences based on sex, height, and body mass index. Fifty participants (40 male) completed the 'push-pull' task while surface electromyograms were recorded from ten upper and lower extremity muscles, and six trunk muscles. Muscle activation was amplitude-normalized to maximum voluntary isometric contraction and compared between sexes and tertiles of height and body mass index (BMI). Women had significantly higher activation of anterior deltoid and pectoralis major on the pull, and posterior deltoid and triceps on the push. Significant differences largely remained after controlling for body size in regression analyses. The lowest tertile of height had significantly higher triceps activity on the push. The highest tertile of BMI had significantly higher rectus abdominus and external obliques activity on the pull, and external obliques activation on the push. Practitioner summary: Muscle activation during the 'push-pull' component of law enforcement standardised testing was examined, including differences based on sex, height, and BMI. Minimal differences existed between sexes (females had higher deltoid, pectoralis major, triceps activity), height (shorter people had higher triceps activity) and BMI tertiles (larger people had more abdominal activity). Abbreviations: ANOVA: analysis of variance; BMI: body mass index; COPAT: correctional officer's physical abilities test; EMG: electromyogram; IMU: inertial measurement unit; MVIC: maximum voluntary isometric contraction; PARE: physical abilities requirement evaluation; PCS: physical control simulator; POPAT: police officer's physical abilities test; RMS: root mean square.

The Impact of COVID-19 on Physical Activity Behavior and Well-Being of Canadians.

A global pandemic caused by the novel coronavirus (COVID-19) resulted in restrictions to daily living for Canadians, including social distancing and closure of city and provincial recreation facilities, national parks and playgrounds. The objective of this study was to assess how these preemptive measures impacted physical activity behaviour and well-being of Canadians. An online survey was utilized to measure participant physical activity behavior, nature exposure, well-being and anxiety levels. Results indicate that while 40.5% of inactive individuals became less active, only 22.4% of active individuals became less active. Comparatively, 33% of inactive individuals became more active while 40.3% of active individuals became more active. There were significant differences in well-being outcomes in the inactive population between those who were more active, the same or less active (p < 0.001) but this was not seen in the active population. Inactive participants who spent more time engaged in outdoor physical activity had lower anxiety than those who spent less time in outdoor physical activity. Public health measures differentially affected Canadians who were active and inactive and physical activity was strongly associated with well-being outcomes in inactive individuals. This suggests that health promoting measures directed towards inactive individuals may be essential to improving well-being.

Letter to the Editor: The development of knights cabin cancer retreats: a community program to engage cancer survivors' proactive health behaviors

Purpose: Cancer survivors often lack the knowledge and skills to return to positive health behaviors following a cancer diagnosis. The use of retreats may be an ideal environment for cancer survivors to learn about health behaviours while receiving social support from other survivors. Methods: Knights Cabin Cancer Retreats was created as a charitable organization in 2014 and is at no cost to participants or their supporters. Elements of the retreat include guided hikes, yoga, classes on nutrition, stress, mindfulness and sleep management techniques, all with a focus on the evidence based theories of behavioral change. Results: Ten retreats have been hosted across Canada to date with 137 cancer survivors and their supporters. Survivors reported that their top learning outcomes from the retreat were physical activity/nutrition and behavioral change/habit development. Conclusion: Knight's Cabin Cancer retreats are unique in their programming with a format of health education that allows for emotional support and engagement with other cancer survivors in a therapeutically natural environment.

The predictive relationship between baseline insulin and glucose with subclinical carotid atherosclerosis after 5 years in a multi-ethnic cohort.

BACKGROUND AND AIMS: We aimed at exploring the relationship between baseline insulin and glucose and the progression of carotid atherosclerosis in a multi-ethnic cohort. METHODS: Males and females (n = 797) of European, Chinese, South Asian and Aboriginal origin were assessed as part of the Multicultural Community Health Assessment Trial (MCHAT) study for socio-demographics, smoking status, fasting insulin and glucose at baseline. IMT, plaque area and total area were assessed after 5 years. RESULTS: A total of 545 participants returned after 5 years for a follow-up assessment. Average age of the study participants was 47.5 (SD 8.9) years. At baseline, the median and interquartile range for insulin was 62.0 (49.5) pmol/L, and glucose was 5.2 (0.60) mmol/L. Baseline glucose and insulin predicted the 5-year progression of atherosclerosis in our models, after adjusting for covariates. We found significant insulin-ethnicity interactions in the IMT model (p = 0.044) with the slope of the relationship showing that for every percentage change in insulin the Europeans experienced 7.3% more increase in IMT at 5 years than the Aboriginals. In the plaque area and total area models, there were significant glucose-ethnicity interactions (p = 0.009 and p=0.016 respectively), with the slope showing a 101% and 121% increase for plaque area and total area, respectively, in Europeans, at 5 years per percent change in glucose at baseline. Logistic regression found a significant glucose-ethnicity interaction with the presence of plaques (OR = 0.31, p = 0.03) such that compared to the Europeans, the South Asians had a lower odds of developing plaque presence. Similarly, we found glucose-ethnicity interactions in the logistic regression when comparing the Chinese to the Europeans (OR = 0.2, p=0.005), with the Chinese being less likely to develop plaque presence. CONCLUSIONS: Ethnicity modifies the predictive relationship between insulin and glucose with sub-clinical indicators of carotid atherosclerosis but not consistently so.

Association between exercise-induced change in body composition and change in cardiometabolic risk factors in postmenopausal South Asian women.

The South Asian population suffers from a high prevalence of type 2 diabetes and cardiovascular disease (CVD). A unique obesity phenotype of elevated visceral adipose tissue (VAT) is associated with CVD risk among South Asians. Exercise-induced reduction in VAT and body fat is an effective mechanism to improve cardiometabolic risk factors but this has not been shown in South Asians. Whether exercise-induced changes in measurements such as waist circumference (WC) are independently related to changes in cardiometabolic risk factors in South Asians is unknown. Multi-slice computed tomography scanning was used to assess VAT, cardiometabolic risk factors through a fasting blood sample, and body fat using dual-energy X-ray absorptiometry. Forty- nine postmenopausal South Asian women who participated in two 12-week aerobic exercise programs were included. Bivariate correlations were used to assess associations between change in cardiometabolic risk factors and change in body composition. Regression analyses were conducted with change in glucose, insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) as dependent variables and change in body composition as independent variables of interest. There were significant associations between changes in fasting insulin, glucose, and HOMA-IR with change in VAT. The association between change in VAT and these cardiometabolic risk factors was independent of change in other body composition variables of interest. South Asian women should be encouraged to engage in aerobic activity to reduce their risk of type 2 diabetes and CVD, and physicians should be aware of improvements in glucose regulation with exercise training not observed through reductions in WC.

Effectiveness of Exercise on Visceral Adipose Tissue in Older South Asian Women.

INTRODUCTION: Individuals of South Asian (SA) origin have a greater risk for type 2 diabetes and cardiovascular disease than other ethnic populations. This increased risk is in part explained by the unique obesity phenotype of elevated visceral adipose tissue (VAT) among this population. Aerobic exercise in Europeans is effective at reducing VAT, but this has not been studied in SA, who have some of the lowest levels of physical activity in the world. Therefore, the purpose of this study was to determine whether exercise can reduce VAT given the unique obesity phenotype and associated disease risk in the SA population. METHODS: A total of 75 physically inactive, postmenopausal SA women were randomized to either culturally based (Bhangra dance), standard (gym-based), or control (nonexercise) program for 12-wk. The primary outcome was change in VAT. RESULTS: The average attendance in the culturally based and standard program was 78% ± 33% and 67% ± 25%, respectively. After an intention-to-treat analysis, VAT was not significantly reduced in culturally based (-60 cm, 95% confidence interval [CI] = -172 to 54, P = 0.300) or standard (-98 cm, 95% CI = -216 to 21, P = 0.106) exercise compared with control after adjustment for baseline physical activity and age. In those participants who attended more than two-thirds of the exercise classes, VAT was significantly reduced compared with control (-109 cm, 95% CI = -204 to -13, P = 0.026). CONCLUSION: In intention-to-treat analysis VAT was not significantly reduced after 12 wk of either standard or culturally based exercise. However, attendance in both standard and culturally based exercise was high, and VAT was significantly reduced among SA women who adhered to these programs.

The association between acculturation and dietary patterns of South Asian immigrants.

Dietary acculturation, specifically the adoption of western dietary habits, may result in adverse health effects such as obesity and type 2 diabetes. Therefore, it is necessary to explore the role of acculturation in dietary patterns as well as awareness and knowledge of healthy nutrition among South Asian immigrants. This is an especially important population to target as South Asians have higher prevalence rates of type 2 diabetes and cardiovascular disease, which may be magnified with immigration. The current investigation is a sub-study of the Multi-Cultural Community Health Assessment Trial (M-CHAT). There were 207 participants of South Asian origin included in the initial study, 129 were born outside of Canada and had immigrated after the age of 18. The length of residence in Canada was used as a marker for acculturation. A questionnaire addressing perceived changes in dietary patterns, food preparation, and nutrition knowledge and awareness since immigration was used to assess dietary practices. The association between length of residence and variables related to perceived changes in dietary patterns was explored with Spearman correlation and significant associations were subsequently analyzed with ordinal logistic regression analysis adjusted for age, sex, education and body mass index. South Asian immigrants in Canada reported a variety of positive dietary practices, including an increased consumption of fruits and vegetables and an improvement in food preparation (including an increase in grilling and a decrease in deep frying when cooking). However, there was a reported increase in the consumption of convenience foods, sugar-sweetened beverages, red meat and in dining out. South Asian immigrants in Canada reported a variety of positive dietary practices including an improvement in food preparation. Future health promotion strategies should encourage cultural sensitivity in efforts to reduce the consumption of sugar-sweetened beverage, convenience foods and to encourage eating at home rather than dining out.

The association between "hypertriglyceridemic waist" and sub-clinical atherosclerosis in a multiethnic population: a cross-sectional study.

BACKGROUND: "Hypertriglyceridemic waist" (HTGW) phenotype, an inexpensive early screening tool for detection of individuals at risk for type 2 diabetes and cardiovascular disease was found to be associated with subclinical atherosclerosis in various patient populations such as those with diabetes mellitus, chronic kidney disease, and those infected with human immunodeficiency virus. However, less is known regarding an association between HTGW and subclinical atherosclerosis in the apparently healthy, multiethnic population. Therefore, the aim of the study was to explore the association between HTGW and sub-clinical atherosclerosis in an apparently healthy, multiethnic population; and to investigate whether the effect of HTGW on sub-clinical atherosclerosis persists over and above the traditional atherosclerosis risk factors. METHODS: We studied 809 individuals of Aboriginal, Chinese, European and South Asian origin who were assessed for indices of sub-clinical atherosclerosis (intima-media thickness (IMT), total area and presence of carotid plaques), socio-demographic and lifestyle characteristics, anthropometrics, lipids, glucose, blood pressure, and family history of cardiovascular disease. RESULTS: We found that, compared to individuals without HTGW and after adjusting for age, ethnicity, smoking, and physical activity; men and women with HTGW had a significantly higher: IMT (men: B (95%CI = 0.084 (0.037, 1.133), p < 0.001; women: B (95%CI) = 0.041 (0.006, 0.077), p = 0.020); and total area (men: B (95%CI = 0.202 (0.058, 0.366), p = 0.005; women: B (95%CI) = 0.115 (0.006, 0.235), p = 0.037). The association between HTGW waist and presence of plaques was significant for men (OR (95%CI) = 1.904 (1.040, 3.486), p = 0.037 vs. men without HTGW), but not for women (p = 0.284). Once analyses were adjusted for additional, traditional risk factors for atherosclerosis, the effect of HTGW on sub-clinical atherosclerosis was no longer significant. CONCLUSIONS: In conclusion, HTGW may serve as an early marker of subclinical atherosclerosis in men and women, irrespective of ethnicity. However, once individuals are assessed for all traditional risk factors for atherosclerosis, the additional assessment for HTGW is not warranted.