A Two-Phased Pilot Study Evaluating the Feasibility and Acceptability of the Cognitively Enriched Walking Program "Take a Walk with Your Brain" for Older Adults.

Given the aging population, finding solutions to retain optimal cognitive capacity is a research priority. The potential of physical activity to reduce the risk of cognitive decline and to enhance cognitive functioning is established. Combining physical with cognitive activity has been put forward as a potentially even more effective way to promote healthy cognitive aging. Most studies on combined interventions have however been conducted in laboratory settings. This paper reports on a two-phased pilot study evaluating the acceptability and feasibility of a newly developed real-life cognitively enriched walking program for adults aged 65+ years. In Phase I, the feasibility and enjoyability of the cognitive tasks was evaluated by conducting walk-along interviews with older adults (n = 163). In Phase II, the cognitively enriched walking program was piloted in two groups of older adults (n = 19), and the feasibility and acceptability of the program and cognitive tasks was evaluated by means of questionnaires and focus groups. The cognitive tasks (i.e., median scores of ≥3 on a total of 4 (Phase I) and ≥6 on a total of 10 (Phase II) for most of the tasks) and the cognitively enriched walking program (i.e., median scores of ≥7 on a total of 10) were considered feasible and acceptable. Based on the input of the participants, key considerations for a feasible and acceptable program were defined: participants should be sufficiently challenged cognitively and physically, social interaction is an important motivator, cognitive tasks should make use of stimuli reflecting daily life and be conducted in group, the rationale for the tasks should be explained to participants, the frequency of the group sessions should be maximum 2 times a week, and the program should be supervised by a trained coach. These results warrant future research to establish the effectiveness of this program.

Conceptualization of a cognitively enriched walking program for older adults: a co-design study with experts and end users.

BACKGROUND: Research in controlled laboratory settings shows that physical activity programs enriched with cognitive challenges enhance the benefits of physical activity on cognition in older adults. This translational study aimed to conceptualise a real-life, cognitively enriched walking program for older adults (65+) by investigating (a) which cognitive tasks are most suited for cognitive enrichment of a walking program, and (b) how to embed these tasks in a walking program to become feasible, enjoyable and effective. METHODS: A co-design process was followed with input of 34 academic experts and 535 end users. First, an online, three-rounds Delphi process was used to obtain consensus amongst academic experts on the key characteristics that a real-life cognitively enriched walking program should have. Next, end users provided feedback and suggestions on what the experts concluded, and gave more insight into their preferences and concerns by means of an online/telephone survey. RESULTS: Combined input from experts and end users resulted in a list of recommendations to guide the further development of the cognitively enriched walking program. First, it is important to provide a range of cognitive tasks to choose from. Each of these tasks should (a) provide variation and differentiation, (b) be implemented with increasing levels of difficulty, and (c) be integrated in the walk. Second, divide the walk into three parts: 5-10 min brisk walking, cognitive tasks for most of the walk, and 5-10 min free walking. Finally, the program should strive for a minimal session frequency of twice a week, include competition occasionally and carefully, ensure safety and keep the walks fun. CONCLUSIONS: The co-design process resulted in recommendations to guide the next steps in the program development process. Additional studies will be performed to improve the enjoyability and feasibility, and to assess the effectiveness of the cognitively enriched walking program to improve cognitive functioning and physical activity in older adults (65+).

Marketing Up the Wrong Tree? Organisational Perspectives on Attracting and/or Retaining Older Adults in Sport.

Community sport is seen as a suitable setting for physical activity for different population groups. Older adults (aged 50+ years) are a rapidly growing population group. Physical activity is critical for healthy ageing, however sport participation rates for older adults are very low. The aim of this study was to investigate how sporting organisations perceive sport for older adults. This cross-sectional study surveyed 171 representatives from Australian National and State Sporting Organisations. Descriptive statistics were used to summarise the results and the three sporting organisation categories' (high, medium, and low participation) responses were compared using non-parametric statistics. Contextualised in the perspective of organisational change, a framework for marketing to the ageing consumer was used to interpret the results. Older adults are not a high priority group for most sporting organisations, however the benefits of engaging older adults were recognised, particularly in context of increasing participation numbers. A lack of age-appropriate programmes was perceived to be a major barrier of engaging older adults. This lack of programmes stems from older adults being deemed as a less attractive segment than other age groups for sporting organisations. Modifications that sports felt they could make to attract and/or retain older adults included specific marketing and age appropriate opportunities. There was widespread consensus across sporting organisations, suggesting that perceptions of older adult sport participation were comparable across the sector, such as increasing participation numbers and engaging their older fan base. In the context of attracting, and retaining, older adults in sport clubs, it was concluded that most sporting organisations are not (yet) ready to build "age friendly" sporting environments. There is very limited literature on the organisational perspective of older adults and sport, meaning this study is unique in the field. Although sport policy encourages organisations to grow their participation, most organisations do not actively and strategically engage older adults. This research provides an understanding of why this untapped market is not a priority target and provides comprehensive insights for policy makers to better engage with this population group.

Are Reallocations between Sedentary Behaviour and Physical Activity Associated with Better Sleep in Adults Aged 55+ Years? An Isotemporal Substitution Analysis.

Physical activity has been proposed as an effective alternative treatment option for the increasing occurrence of sleep problems in older adults. Although higher physical activity levels are associated with better sleep, the association between specific physical activity intensities and sedentary behaviour (SB) with sleep remains unclear. This study examines the associations of statistically modelled time reallocations between sedentary time and different physical activity intensities with sleep outcomes using isotemporal substitution analysis. Device-measured physical activity data and both objective and subjective sleep data were collected from 439 adults aged 55+ years. Replacing 30 min of SB with moderate to vigorous intensity physical activity (MVPA) was significantly associated with an increased number of awakenings. Moreover, a reallocation of 30 min between light physical activity (LPA) and MVPA was significantly associated with increased sleep efficiency. Furthermore, reallocating 30 min of SB to LPA showed a significant association with decreased sleep efficiency. There were no significant associations of time reallocations for wake time after sleep onset, length of awakenings, and sleep quality. These results improve our understanding of the interrelationships between different intensities of movement behaviours and several aspects of sleep in older adults.

A focus group study of older adults' perceptions and preferences towards web-based physical activity interventions.

OBJECTIVE: To explore older adults' perceptions and preferences for web-based physical activity interventions. PARTICIPANTS: Adults 65+ years were recruited via telephoning randomly selected households in Central Queensland, Australia. METHODS: Six focus groups were conducted with a total of 46 adults 65+ years. Data were analyzed by qualitative content analysis. RESULTS: This group of older adults liked websites that have links to information and included instructional videos and disliked websites that were hard to navigate. Many participants did not express an initial interest in web-based physical activity programs. The most common reason was that they did not have a computer or adequate internet connection. Some participants said they would be interested if it included a structured exercise program. When asked about preferences for web-based physical activity programs, this group preferred them to be simple and not cluttered, to include personalized advice, to include reminder check-ins and the ability to review goals after illness or injury. The most common preference for personalized advice in web-based interventions was that the information needs to be tailored to their existing injuries and illnesses. CONCLUSION: The findings from this study will inform the design of future web-based interventions specifically tailored to the needs of older people.

A mixed-methods case study exploring the impact of participation in community activity groups for older adults on physical activity, health and wellbeing.

BACKGROUND: Regular physical activity (PA) has many health benefits but declines with age. Community multi-activity groups offering volunteer-led socially-oriented activity programs could provide an opportunity for older people to maintain or increase PA levels and promote their health. The aim of this study was to examine the potential effect of becoming a member of an existing community activity group on PA levels, physical and mental health-related quality of life (HR QoL), comparing any impacts associated with participation in physical activity or social activity programs. METHODS: This mixed-methods case study, combining a longitudinal quantitative-survey with qualitative focus groups to contextualise the survey results, focused on an Australian community organisation called Life Activities Clubs (LACs). LACs provide various physical activities (e.g. walking, cycling, dancing) and social activities (e.g. book groups, dine-outs, craft). Data were collected using a self-report survey administered at baseline, six and twelve-months after joining and group differences between participants of PA programs (PA group) and social programs (social group) were analysed using linear mixed-models. Two focus groups with LAC members were held, one representing each activity type and analysed using content and thematic analysis. RESULTS: 35 people (mean age 67) completed the surveys and 11 people participated in the focus groups. PA levels and physical health-related QoL were maintained over 1 year in the PA group, and declined between baseline and 12-months in the social group. Focus groups suggested social aspects of PA programs increased motivation to maintain regular attendance and do more PA than participants would on their own and that physical activities provided health benefits. Mental HR QoL did not change in either group, focus groups suggested this was because the social aspects of both types of program provide benefits relating to mental health including stress relief, enjoyment and adapting to major life events, to prevent a decline in QoL. CONCLUSIONS: Community PA programs appear to maintain PA levels and physical HR QoL in older adults, and both social and PA programs may maintain mental HR QoL. Incorporating both types of program into one organisation may also encourage less physically active members to try physical activities.

Copenhagen Consensus statement 2019: physical activity and ageing.

From 19th to 22nd November 2018, 26 researchers representing nine countries and a variety of academic disciplines met in Snekkersten, Denmark, to reach evidence-based consensus about physical activity and older adults. It was recognised that the term 'older adults' represents a highly heterogeneous population. It encompasses those that remain highly active and healthy throughout the life-course with a high intrinsic capacity to the very old and frail with low intrinsic capacity. The consensus is drawn from a wide range of research methodologies within epidemiology, medicine, physiology, neuroscience, psychology and sociology, recognising the strength and limitations of each of the methods. Much of the evidence presented in the statements is based on longitudinal associations from observational and randomised controlled intervention studies, as well as quantitative and qualitative social studies in relatively healthy community-dwelling older adults. Nevertheless, we also considered research with frail older adults and those with age-associated neurodegenerative diseases, such as Alzheimer's and Parkinson's disease, and in a few cases molecular and cellular outcome measures from animal studies. The consensus statements distinguish between physical activity and exercise. Physical activity is used as an umbrella term that includes both structured and unstructured forms of leisure, transport, domestic and work-related activities. Physical activity entails body movement that increases energy expenditure relative to rest, and is often characterised in terms of intensity from light, to moderate to vigorous. Exercise is defined as a subset of structured physical activities that are more specifically designed to improve cardiorespiratory fitness, cognitive function, flexibility balance, strength and/or power. This statement presents the consensus on the effects of physical activity on older adults' fitness, health, cognitive functioning, functional capacity, engagement, motivation, psychological well-being and social inclusion. It also covers the consensus on physical activity implementation strategies. While it is recognised that adverse events can occur during exercise, the risk can be minimised by carefully choosing the type of activity undertaken and by consultation with the individual's physician when warranted, for example, when the individual is frail, has a number of co-morbidities, or has exercise-related symptoms, such as chest pain, heart arrhythmia or dizziness. The consensus was obtained through an iterative process that began with the presentation of the state-of-the-science in each domain, followed by group and plenary discussions. Ultimately, the participants reached agreement on the 30-item consensus statements.

Physical Activity Attitudes, Preferences, and Experiences of Regionally-Based Australia Adults Aged 65 Years and Older.

An understanding of physical activity attitudes, preferences, and experiences in older adults is important for informing interventions. Focus groups were conducted with 46 regionally-based Australian adults aged 65 years and older, who were not currently meeting activity recommendations. Content analysis revealed that participants mainly engaged in incidental activities such as gardening and household chores rather than planned exercise; however, leisure-time walking was also mentioned frequently. Although participants valued the physical and mental health benefits of physical activity, they reported being restricted by poor physical health, extreme weather, and fear of injury. Participants were interested in exercise groups and physical activity programs tailored to their existing physical health. The majority of participants reported preferring to be active with others. The findings from this study are useful in for informing future interventions specifically tailored to the needs of older adults in Australia.

Validity of objective methods for measuring sedentary behaviour in older adults: a systematic review.

BACKGROUND: The evidence showing the ill health effects of prolonged sedentary behaviour (SB) is growing. Most studies of SB in older adults have relied on self-report measures of SB. However, SB is difficult for older adults to recall and objective measures that combine accelerometry with inclinometry are now available for more accurately assessing SB. The aim of this systematic review was to assess the validity and reliability of these accelerometers for the assessment of SB in older adults. METHODS: EMBASE, PubMed and EBSCOhost databases were searched for articles published up to December 13, 2017. Articles were eligible if they: a) described reliability, calibration or validation studies of SB measurement in healthy, community-dwelling individuals, b) were published in English, Portuguese or Spanish, and c) were published or in press as journal articles in peer-reviewed journals. RESULTS: The review identified 15 studies in 17 papers. Of the included studies, 11 assessed the ActiGraph accelerometer. Of these, three examined reliability only, seven (in eight papers) examined validity only and one (in two papers) examined both. The strongest evidence from the studies reviewed is from studies that assessed the validity of the ActiGraph. These studies indicate that analysis of the data using 60-s epochs and a vertical magnitude cut-point < 200 cpm or using 30- or 60-s epochs with a machine learning algorithm provides the most valid estimates of SB. Non-wear algorithms of 90+ consecutive zeros is also suggested for the ActiGraph. CONCLUSIONS: Few studies have examined the reliability and validity of accelerometers for measuring SB in older adults. Studies to date suggest that the criteria researchers use for classifying an epoch as sedentary instead of as non-wear time (e.g., the non-wear algorithm used) may need to be different for older adults than for younger adults. The required number of hours and days of wear for valid estimates of SB in older adults was not clear from studies to date. More older-adult-specific validation studies of accelerometers are needed, to inform future guidelines on the appropriate criteria to use for analysis of data from different accelerometer brands. TRIAL REGISTRATION: PROSPERO ID# CRD42017080754 registered December 12, 2017.

A mixed methods case study exploring the impact of membership of a multi-activity, multicentre community group on social wellbeing of older adults.

BACKGROUND: Social wellbeing factors such as loneliness and social support have a major impact on the health of older adults and can contribute to physical and mental wellbeing. However, with increasing age, social contacts and social support typically decrease and levels of loneliness increase. Group social engagement appears to have additional benefits for the health of older adults compared to socialising individually with friends and family, but further research is required to confirm whether group activities can be beneficial for the social wellbeing of older adults. METHODS: This one-year longitudinal mixed methods study investigated the effect of joining a community group, offering a range of social and physical activities, on social wellbeing of adults with a mean age of 70. The study combined a quantitative survey assessing loneliness and social support (n = 28; three time-points, analysed using linear mixed models) and a qualitative focus group study (n = 11, analysed using thematic analysis) of members from Life Activities Clubs Victoria, Australia. RESULTS: There was a significant reduction in loneliness (p = 0.023) and a trend toward an increase in social support (p = 0.056) in the first year after joining. The focus group confirmed these observations and suggested that social support may take longer than 1 year to develop. Focus groups also identified that group membership provided important opportunities for developing new and diverse social connections through shared interest and experience. These connections were key in improving the social wellbeing of members, especially in their sense of feeling supported or connected and less lonely. Participants agreed that increasing connections was especially beneficial following significant life events such as retirement, moving to a new house or partners becoming unwell. CONCLUSIONS: Becoming a member of a community group offering social and physical activities may improve social wellbeing in older adults, especially following significant life events such as retirement or moving-house, where social network changes. These results indicate that ageing policy and strategies would benefit from encouraging long-term participation in social groups to assist in adapting to changes that occur in later life and optimise healthy ageing.

Participant characteristics of users of holistic movement practices in Australia.

OBJECTIVES: The aim of this study was to compare the characteristics of users of holistic movement practices in Australia to people who were physically active but not using holistic movement practices. A second aim was to compare characteristics of users of specific holistic movement practices (yoga/Pilates and t'ai chi/qigong). DESIGN: We performed a secondary data analysis on pooled data of a nationally-representative physical activity survey conducted yearly 2001-2010 (n = 195,926). SETTING: Australia-wide Exercise, Recreation, and Sport Survey (ERASS). MAIN OUTCOME MEASURES: A range of socio-demographic and participation characteristics were documented and compared between users and non-users of holistic movement practices and between yoga/Pilates and t'ai chi/qigong users, employing descriptive statistics, chi square, and multiple logistic regression analyses. RESULTS: Users of holistic movement practices (n = 6826) were significantly more likely than non-users to be female, older, have fewer children at home, and have higher levels of education, socio-economic background, and physical activity involvement (p < 0.001). Yoga/Pilates (n = 5733) and t'ai chi/qigong (n = 947) users were also found to differ on a number of characteristics, including age, sex, socioeconomic background, and marital status. CONCLUSION: As a group, Australian users of holistic movement practices differ on a range of characteristics from those Australians active in other types of physical activities. However, differences between yoga/Pilates and t'ai chi/qigong users suggest these practices attract somewhat different sub-populations. To what extent these differences are due to characteristics inherent to the practices themselves or to differences in delivery-related parameters needs to be examined in future research.

Sport for Adults Aged 50+ Years: Participation Benefits and Barriers.

Despite the health benefits of sport, the proportion of people participating in sport decreases with age. This qualitative study explored the benefits and barriers regarding older adult community sport participation, from the perspective of national sporting organizations, in addition to older adult sport club and nonsport club members, across eight focus group interviews (n = 49). Seven benefits were discussed, primarily social and physical health and intergenerational opportunities. Ten barriers were also discussed, including physical health, time constraints, and lack of appropriate playing opportunities. Ensuring access to activities that can benefit social health is of great importance to older adults. As sport can provide participation opportunities across generations, it can be an ideal physical activity option for this age group. However, a major barrier is that sport policy often prioritizes the participation for younger age groups. Policymakers should include a focus on older adults, to derive social health benefits.

Sitting Time in Adults 65 Years and Over: Behavior, Knowledge, and Intentions to Change.

This study examined sitting time, knowledge, and intentions to change sitting time in older adults. An online survey was completed by 494 Australians aged 65+. Average daily sitting was high (9.0 hr). Daily sitting time was the highest during TV (3.3 hr), computer (2.1 hr), and leisure (1.7 hr). A regression analysis demonstrated that women were more knowledgeable about the health risks of sitting compared to men. The percentage of older adults intending to sit less were the highest for TV (24%), leisure (24%), and computer (19%) sitting time. Regression analyses demonstrated that intentions varied by gender (for TV sitting), education (leisure and work sitting), body mass index (computer, leisure, and transport sitting), and physical activity (TV, computer, and leisure sitting). Interventions should target older adults' TV, computer, and leisure time sitting, with a focus on intentions in older males and older adults with low education, those who are active, and those with a normal weight.

Assessment and monitoring practices of Australian fitness professionals.

OBJECTIVES: Assessment and monitoring of client health and fitness is a key part of fitness professionals' practices. However, little is known about prevalence of this practice. This study describes the assessment/monitoring practices of a large sample of Australian fitness professionals. DESIGN: Cross-sectional. METHODS: In 2014, 1206 fitness professionals completed an online survey. Respondents reported their frequency (4 point-scale: [1] 'never' to [4] 'always') of assessment/monitoring of eight health and fitness constructs (e.g. body composition, aerobic fitness). This was classified as: (i) 'high' ('always' assessing/monitoring ≥5 constructs); (ii) 'medium' (1-4 constructs); (iii) 'low' (0 constructs). Classifications are reported by demographic and fitness industry characteristics. The odds of being classified as a 'high assessor/monitor' according to social ecological correlates were examined using a multiple-factor logistic regression model. RESULTS: Mean age of respondents was 39.3 (±11.6) years and 71.6% were female. A total of 15.8% (95% CI: 13.7%-17.9%) were classified as a 'high' assessor/monitor. Constructs with the largest proportion of being 'always' assessed were body composition (47.7%; 95% CI: 45.0%-50.1%) and aerobic fitness (42.5%; 95% CI: 39.6%-45.3%). Those with the lowest proportion of being 'always' assessed were balance (24.0%; 95% CI: 24.7%-26.5%) and mental health (20.2%; 95% CI: 18.1%-29.6%). A perceived lack of client interest and fitness professionals not considering assessing their responsibility were associated with lower odds of being classified as a 'high assessor/monitor'. CONCLUSIONS: Most fitness professionals do not routinely assess/monitor client fitness and health. Key factors limiting client health assessment and monitoring include a perceived lack of client interest and professionals not considering this their role.

Sport and ageing: a systematic review of the determinants and trends of participation in sport for older adults.

BACKGROUND: The global population is ageing. As ageing is often associated with a decline in health, there is a need to further develop preventative health measures. Physical activity can positively influence older adults' (aged 50 years and older) health. Previous research on the relationship between physical activity and health for older adults has mainly focused on physical activity in general, and not specific types of exercise. Due to the social nature of sport, it may assist in improving physical, mental and social health for older adults. Sport, as a form of physical activity, has not been widely explored as a physical activity opportunity for older adults. This review concurrently explored two research questions: the determinants and the trends of sport participation for community dwelling older adults. METHODS: Two parallel systematic searches of nine electronic databases were conducted in December 2015 for the two research questions. English language quantitative and qualitative studies that provided specific results for community dwelling older adults' sport participation were included and a quality ratings assessment was undertaken. RESULTS: There were 10,171 studies initially identified for the first research question and 1992 studies for the second research question. This culminated in 18 and 8 studies respectively that met the inclusion criteria. The most frequently mentioned determinants of participation were health and using sport to negotiate the ageing process. The most frequently mentioned trends of sport participation were the effect of historical sport participation on current participation, and sport participation across the lifespan. The main themes for both research questions had contrasting results, for example, participation in sport could improve health, but poor health was also a limitation of sport participation. CONCLUSIONS: This review demonstrates that older adults are a heterogeneous age group, and therefore require different strategies than other age groups to successfully participate in sport. It is recommended that the main findings from this review are incorporated into specific strategies to develop age appropriate sporting opportunities for older adults, so that sport can be presented as a viable physical activity option for this age group.

Gender differences in physical activity motivators and context preferences: a population-based study in people in their sixties.

BACKGROUND: Although regular participation in physical activity (PA) has health benefits across the life span, the proportion of people doing sufficient activity for these benefits decreases with age. The aim of this study was to identify motivating factors and context preferences for PA in people in their sixties, and to examine gender differences in these factors. METHODS: Data were used from people aged 60-67 years who responded to a mail survey in Brisbane, Australia, in 2009. Respondents indicated their agreement/disagreement with seven PA motivators and 14 PA context preferences. Data were analyzed using multi-level multinomial logistic regression, adjusted for sociodemographic and health variables, and PA level. RESULTS: Of the 1845 respondents, 59% was female. Based on self-reported PA, one in three respondents (35%) did not meet the PA guidelines of at least 150 min of moderate intensity PA per week. The three leading motivating factors for both women and men were to prevent health problems, to feel good and to lose weight. Women were more likely than men to be motivated by improving appearance (OR 2.93, 95%CI 2.07-4.15), spending time with others (1.76, 1.31-2.37), meeting friends (1.76, 1.31-2.36) or losing weight (1.74, 1.12-2.71). The three leading context preferences for both women and men were for activities close to home, at low cost and that could be done alone. Women were more likely than men to prefer activities that are with people of the same sex (OR 4.67, 95%CI 3.14-6.94), supervised (2.79, 1.94-4.02), with people the same age (2.00, 1.43-2.78) and at a fixed time (1.42, 1.06-1.91). Women were less likely than men to prefer activities that are competitive (OR 0.32, 95%CI 0.22-0.46), are vigorous (0.33, 0.24-0.47), require skill and practice (0.40, 0.29-0.55) and done outdoors (0.51, 0.30-0.86). CONCLUSION: Although there was overlap in motivating factors and context preferences for PA in women and men aged 60-67 years, there were also marked gender differences. These results suggest that PA options for people in their sixties should be tailored to meet gender specific interests in order to promote PA participation in this rapidly growing population group.

Participation trends in holistic movement practices: a 10-year comparison of yoga/Pilates and t'ai chi/qigong use among a national sample of 195,926 Australians.

BACKGROUND: In recent decades, the evidence supporting the physical and mental health benefits of holistic movement practices such as yoga and t'ai chi have become increasingly established. Consequently, investigating the participation prevalence and patterns of these practices is a relevant pursuit in the public health field. Few studies have provided population-level assessment of participation rates, however, and even fewer have focused on patterns over time. The purpose of this study was to examine participation prevalence and trends in yoga/Pilates and t'ai chi/qigong over a ten-year period in a nationally representative sample of Australians aged 15 years and over, with particular attention to sex and age. A secondary purpose was to juxtapose these findings with participation trends in traditional fitness activities over the same period. METHODS: Data comprised modes and types of physical activity, age, and sex variables collected through the Exercise, Recreation and Sport Survey (ERASS), a series of independent cross-sectional Australia-wide surveys conducted yearly between 2001 and 2010. For each year, weighted population estimates were calculated for those participating in yoga/Pilates, t'ai chi/qigong, and fitness activities (e.g. aerobics, calisthenics). Linear regression and multiple logistic regression analyses were used to examine trends in prevalence rates over time and differences among sex and age (15-34; 35-54; 55+ years) groups, respectively. RESULTS: Average prevalence rates between 2001 and 2010 were 3.0% (95% CI 2.9-3.1) for yoga/Pilates, 0.6% (95% CI 0.5-0.6) for t'ai chi/qigong, and 19.2% (95% CI 18.9-19.4) for fitness activities. Across the decade, overall participation rates remained relatively stable for yoga/Pilates and t'ai chi/qigong, while increasing linearly for fitness activities. For both genders and in all three age groups, participation in fitness activities increased, whereas only in the 55+ age group was there a significant increase in yoga/Pilates participation; participation in t'ai chi/qigong declined significantly in the two younger age groups. CONCLUSIONS: Participation rates in yoga/Pilates and t'ai chi/qigong in Australia were low and relatively stable. As fitness activities increased in popularity across the decade, holistic movement practices did not. These findings point to the need to investigate activity-specific barriers and facilitators to participation, including intrapersonal, interpersonal, organisational, and environmental factors.

The association between social support and physical activity in older adults: a systematic review.

BACKGROUND: The promotion of active and healthy ageing is becoming increasingly important as the population ages. Physical activity (PA) significantly reduces all-cause mortality and contributes to the prevention of many chronic illnesses. However, the proportion of people globally who are active enough to gain these health benefits is low and decreases with age. Social support (SS) is a social determinant of health that may improve PA in older adults, but the association has not been systematically reviewed. This review had three aims: 1) Systematically review and summarise studies examining the association between SS, or loneliness, and PA in older adults; 2) clarify if specific types of SS are positively associated with PA; and 3) investigate whether the association between SS and PA differs between PA domains. METHODS: Quantitative studies examining a relationship between SS, or loneliness, and PA levels in healthy, older adults over 60 were identified using MEDLINE, PSYCInfo, SportDiscus, CINAHL and PubMed, and through reference lists of included studies. Quality of these studies was rated. RESULTS: This review included 27 papers, of which 22 were cross sectional studies, three were prospective/longitudinal and two were intervention studies. Overall, the study quality was moderate. Four articles examined the relation of PA with general SS, 17 with SS specific to PA (SSPA), and six with loneliness. The results suggest that there is a positive association between SSPA and PA levels in older adults, especially when it comes from family members. No clear associations were identified between general SS, SSPA from friends, or loneliness and PA levels. When measured separately, leisure time PA (LTPA) was associated with SS in a greater percentage of studies than when a number of PA domains were measured together. CONCLUSIONS: The evidence surrounding the relationship between SS, or loneliness, and PA in older adults suggests that people with greater SS for PA are more likely to do LTPA, especially when the SS comes from family members. However, high variability in measurement methods used to assess both SS and PA in included studies made it difficult to compare studies.

Sources of practice knowledge among Australian fitness trainers.

Few studies have examined the sources of practice knowledge fitness trainers use to inform their training methods and update knowledge. This study aims to describe sources of practice knowledge among Australian fitness trainers. In July 2014, 9100 Australian fitness trainers were invited to complete an online survey. Respondents reported the frequency of use of eight sources of practice knowledge (e.g. fitness magazines, academic texts). In a separate survey, exercise science experts (n = 27) ranked each source as either (1) 'high-quality' or (2) 'low-quality'. Proportions of users of 'high-quality' sources were calculated across demographic (age, sex) and fitness industry-related characteristics (qualification, setting, role). A multivariate logistic regression analysis assessed the odds of being classified as a user of high-quality sources, adjusting for demographic and fitness industry-related factors. Out of 1185 fitness trainers (response rate = 13.0%), aged 17-72 years, 47.6% (95% CI, 44.7-50.4%) were classified as frequent users of high-quality sources of practice knowledge. In the adjusted analysis, compared to trainers aged 17-26 years, those aged ≥61 years (OR, 2.15; 95% CI, 1.05-4.38) and 40-50 years (OR, 1.54; 95% CI, 1.02-2.31) were more likely to be classified as a user of high-quality sources. When compared to trainers working in large centres, those working in outdoor settings (OR, 1.81; 95% CI, 1.23-2.65) and medium centres (OR, 1.59; 95% CI, 1.12-2.29) were more likely to be classified as users of high-quality sources. Our findings suggest that efforts should be made to improve the quality of knowledge acquisition among Australian fitness trainers.

Do physical activity interventions in Indigenous people in Australia and New Zealand improve activity levels and health outcomes? A systematic review.

BACKGROUND: Indigenous Australians and New Zealanders have a significantly shorter life expectancy than non-Indigenous people, mainly due to differences in prevalence of chronic diseases. Physical activity helps in the prevention and management of chronic diseases, however, activity levels are lower in Indigenous than in non-Indigenous people. OBJECTIVE: To synthesise the literature on the effects of physical activity interventions for Indigenous people in Australia and New Zealand on activity levels and health outcomes. METHODS: The Cochrane Library, MEDLINE, SPORTSDiscus and PsycINFO were searched for peer-reviewed articles and grey literature was searched. Interventions targeted Indigenous people in Australia or New Zealand aged 18+ years and their primary or secondary aim was to increase activity levels. Data were extracted by one author and verified by another. Risk of bias was assessed independently by two authors. Data were synthesised narratively. RESULTS: 407 records were screened and 13 studies included. Interventions included individual and group based exercise programs and community lifestyle interventions of four weeks to two years. Six studies assessed physical activity via subjective (n = 4) or objective (n = 2) measures, with significant improvements in one study. Weight and BMI were assessed in all but one study, with significant reductions reported in seven of 12 studies. All five studies that used fitness tests reported improvements, as did four out of eight measuring blood pressure and seven out of nine in clinical markers. CONCLUSIONS: There was no clear evidence for an effect of physical activity interventions on activity levels, however, there were positive effects on activity related fitness and health outcomes. TRIAL REGISTRATION: The review protocol was registered with PROSPERO (registration number: CRD42015016915 ).