Virtual Workshops as an Effective and Engaging Policy Implementation Strategy: Lessons From the National Youth Sports Strategy.

BACKGROUND.: Implementation is an important piece of effective policymaking, but connecting local organizations with federal policy can be challenging. A virtual workshop structure can help engage implementation partners, especially when in-person events are not possible. The workshops described here leveraged virtual outreach and facilitation methods to foster community engagement, forge connections, and build relationships at the regional, state, and local levels. METHODS.: This article focuses on five virtual workshops. The planning phase consisted of selecting the geographic scope of each workshop, developing outreach and facilitation materials, and supporting event logistics. The execution and summary phase included tailoring materials, hosting the events, and producing follow-up materials. Networking, resource sharing, collaboration, and active facilitation were employed to promote engagement. RESULTS.: Registration for the virtual workshops included 223 individuals representing organizations in 28 states. Participants shared 133 resources. In a post-event evaluation, 93% of respondents indicated they could identify at least one new resource to support their efforts to increase youth sports participation in their community, and 94% indicated they plan to follow up and explore potential partnerships/collaborations with others they met or heard from at the workshop. Networking and resource sharing were identified as the most useful aspects of the workshops. CONCLUSIONS.: With careful planning and collaboration, virtual workshops represent a useful community engagement mechanism to bring policy into practice. Creating events focused on the participant experience supports health promotion professionals, engages communities, and takes a policy off the page and out to the people.

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 Contemplators' Knowledge and Awareness of the Physical Activity Guidelines.

BACKGROUND: The Office of Disease Prevention and Health Promotion completed research to understand factors that could encourage Americans to follow the Physical Activity Guidelines for Americans, second edition, released in 2018. This study describes survey research assessing demographic characteristics that might be related to knowledge and awareness of the guidelines. METHODS: An online survey of 2050 adult physical activity contemplators assessed knowledge of physical activity, awareness of the guidelines, and knowledge of dosage recommendations. Univariate and bivariate analyses were performed, and demographic differences in knowledge and awareness were analyzed using Pearson chi-square tests and Fisher exact tests. RESULTS: Respondents had medium to high knowledge of physical activity, although knowledge varied significantly by socioeconomic factors. Knowledge of dosage recommendations was very low, with 2% and 3% of respondents correctly identifying recommended moderate- and vigorous-intensity doses, respectively. Only 22% were aware of the guidelines; awareness was greater among those with a higher education or income and those without a disability. CONCLUSIONS: These findings guided the development of the Office of Disease Prevention and Health Promotion's Move Your Way campaign and reinforced the need to raise awareness of the guidelines and promote behavior change among physical activity contemplators-particularly those from lower socioeconomic groups.

Benefits of Physical Activity during Pregnancy and Postpartum: An Umbrella Review.

PURPOSE: This study aimed to summarize the evidence from the 2018 Physical Activity Guidelines Advisory Committee Scientific Report, including new evidence from an updated search of the effects of physical activity on maternal health during pregnancy and postpartum. METHODS: An initial search was undertaken to identify systematic reviews and meta-analyses published between 2006 and 2016. An updated search then identified additional systematic reviews and meta-analyses published between January 2017 and February 2018. The searches were conducted in PubMed®, CINAHL, and Cochrane Library and supplemented through hand searches of reference lists of included articles and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS: The original and updated searches yielded a total of 76 systematic reviews and meta-analyses. Strong evidence demonstrated that moderate-intensity physical activity reduced the risk of excessive gestational weight gain, gestational diabetes, and symptoms of postpartum depression. Limited evidence suggested an inverse relationship between physical activity and risk of preeclampsia, gestational hypertension, and antenatal anxiety and depressive symptomology. Insufficient evidence was available to determine the effect of physical activity on postpartum weight loss, postpartum anxiety, and affect during both pregnancy and postpartum. For all health outcomes, there was insufficient evidence to determine whether the relationships varied by age, race/ethnicity, socioeconomic status, or prepregnancy weight status. CONCLUSIONS: The gestational period is an opportunity to promote positive health behaviors that can have both short- and long-term benefits for the mother. Given the low prevalence of physical activity in young women in general, and the high prevalence of obesity and cardiometabolic diseases among the U.S. population, the public health importance of increasing physical activity in women of childbearing age before, during, and after pregnancy is substantial.

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.

Physical Activity, Injurious Falls, and Physical Function in Aging: An Umbrella Review.

PURPOSE: To review and update the evidence of the relationship between physical activity, risk of fall-related injury, and physical function in community-dwelling older people that was presented in the 2018 Physical Activity Guidelines Advisory Committee Scientific Report (PAGAC Report). METHODS: Duplicate independent screenings of 1415 systematic reviews and meta-analyses published between 2006 and 2016 identified from PubMed®, Cochrane Library, and CINAHL databases yielded 111 articles used for the PAGAC Report. The PAGAC Aging Subcommittee members graded scientific evidence strength based upon a five-criteria rubric and assigned one of four grades: strong, moderate, limited, or not assignable. An updated search of 368 articles published between January 2017 and March 2018 yielded 35 additional pertinent articles. RESULTS: Strong evidence demonstrated that physical activity reduced the risk of fall-related injuries by 32% to 40%, including severe falls requiring medical care or hospitalization. Strong evidence also supported that physical activity improved physical function and reduced the risk of age-related loss of physical function in an inverse graded manner among the general aging population, and improved physical function in older people with frailty and with Parkinson's disease. Aerobic, muscle-strengthening, and/or multicomponent physical activity programs elicited the largest improvements in physical function in these same populations. Moderate evidence indicated that for older adults who sustained a hip fracture or stroke, extended exercise programs and mobility-oriented physical activity improved physical function. CONCLUSIONS: Regular physical activity effectively helps older adults improve or delay the loss of physical function and mobility while reducing the risk of fall-related injuries. These important public health benefits underscore the importance of physical activity among older adults, especially those living with declining physical function and chronic health conditions.

Umbrella and Systematic Review Methodology to Support the 2018 Physical Activity Guidelines Advisory Committee.

INTRODUCTION: In 2016, the 2018 Physical Activity Guidelines Advisory Committee, a group of experts in exercise science and health, began an extensive review of the literature to inform the second edition of the Physical Activity Guidelines for Americans. METHODS: The purpose of this paper is to describe the evidence-based methodology used to review, evaluate, and synthesize published, peer-reviewed physical activity research. The protocol-driven methodology was designed to maximize transparency, minimize bias, and ensure relevant, timely, and high-quality systematic reviews. Training protocols, quality control procedures, search strategies, assessment instruments, abstraction guides and forms, and reporting templates were developed. RESULTS: A systematic approach was used to select the evidence for the 2018 Physical Activity Guidelines Advisory Committee Scientific Report that included umbrella reviews and systematic reviews. Within 16 months, 38 searches were conducted; and 20,838 titles, 4913 abstracts, and 2139 full texts were triaged. Of those, 1130 articles were abstracted to answer 38 research questions. CONCLUSIONS: To inform population-based physical activity guidelines, this systematic process facilitated a vast review of the literature on physical activity and health in a short period of time. This flexible, yet rigorous and transparent process included a clear and detailed methodology with a focus on training and quality control.

Can E-Gaming Be Useful for Achieving Recommended Levels of Moderate- to Vigorous-Intensity Physical Activity in Inner-City Children?

OBJECTIVE: The purpose of this study was to compare the energy expenditure of a tailored, interactive genre of e-gaming ("Winds of Orbis: An Active Adventure"; Entertainment Technology Center, Carnegie Mellon, Pittsburgh, PA) ( www.activeadventuregame.com ) with that of a tethered videogame ("Dance Dance Revolution" [DDR]; Konami Digital Entertainment, El Segundo, CA) and with traditional physical education (PE) activities in meeting recommended levels of moderate- to vigorous-intensity physical activity (MVPA). SUBJECTS AND METHODS: Schoolchildren (n=104) in grades 3-8 from inner-city Washington, DC completed three randomly ordered 20-minute bouts of DDR, "Orbis," and PE. Energy expenditure was measured using accelerometry. RESULTS: Overall, energy expenditure was significantly greater from PE compared with "Orbis" and DDR (P<0.01). Among girls (n=58) and children with obesity (n=49), however, energy expenditure from "Orbis" and PE was similar, and both resulted in higher energy expenditure compared with DDR (P<0.01). After adjustment for sex, grade, and body mass index, we observed that among children in grades 3-5 energy expenditure from all three activities was sufficient to meet recommended intensity criteria for vigorous activity (>6 metabolic equivalents). Among children in grades 6-8, however, these vigorous-intensity criteria were met only by boys and only with PE activities. CONCLUSIONS: In the school setting, traditional PE activities continue to work well for some children in meeting MVPA recommendations. Among special subgroups, however, e-gaming may provide a useful supplement to PE in increasing activity levels during the school day and beyond.

Activity patterns and perceptions about active transport to school.

OBJECTIVES: To document physical activity patterns and perceptions about active transport to school. METHODS: Children's activity was measured. Children and parents were surveyed about active transport to school. RESULTS: Children were most active after (465 ± 20 cpm) and least active before (379 ± 18 cpm) and during school (351 ± 13 cpm). Weight was not related to activity. Boys were more confident than girls, whereas parents felt more confident than children did about active transport. CONCLUSIONS: Active transport programs will likely have a greater impact on before-school activity than after school. Perceptions concerning active transport should be assessed, and parent/child discrepancies rectified prior to program implementation.