When American Adults Do Move, How Do They Do So? Trends in Physical Activity Intensity, Type, and Modality: 1988-2017.

BACKGROUND: Few Americans accumulate enough physical activity (PA) to realize its benefits. Understanding how and why individuals use their discretionary time for different forms of PA could help identify and rectify issues that drive individuals away from certain physical activities, and leverage successful strategies to increase participation in others. METHODS: The authors analyzed approximately 30 years of changes in PA behavior by intensity, type, and mode, using data from the Behavioral Risk Factor Surveillance System. RESULTS: Since 1988, the proportions of adults most frequently engaging in exercise, sport, or lifestyle physical activity have changed noticeably. The most apparent changes from 1988 to 2017 were the proportions most frequently engaging in Exercise and Sport. In addition, the proportion of time reportedly spent in vigorous-intensity PA decreased over time, particularly among male respondents. Moreover, the proportion of Americans reporting an "Other" PA mode increased substantially, suggesting a growing need for a greater variety of easily accessible options for adult PA. CONCLUSIONS: Over time, a smaller proportion of American adults reported participating in sport and exercise modalities and reported engaging more frequently in low-intensity physical activities.

Adult outdoor group sport play during a pandemic: Feasibility, acceptability, and program adherence results from a study of modifications to mitigate COVID-19 risk.

The purpose of this study was to investigate the feasibility, acceptability, and short-term adherence to an adult outdoor group sport play program designed to maximize enjoyment that was modified to incorporate COVID-19 risk mitigation strategies. We enrolled 17 healthy, but sedentary, central Pennsylvania adults (mean age = 31.6 ± 7.3) without obesity via mail advertisements to participate in four, 60-minute sessions of instructor-led modified sport games (e.g., handball, Ultimate Frisbee, soccer) over a two-week period in October 2020. Durign recrutiment and the study period, there were approximately 1000-2000 new cases of COVID-19 daily in central Pennsylvania . The overall adherence rate to the sessions was 91%, and no participants reported new or existing COVID-19 symptoms or diagnoses during the two-week study period or 10-days following the final session. Despite enforcing mandatory COVID-19 safety measures (e.g., universal masking, social distancing), the participants reported enjoying the program and feeling socially connected with one another, while perceiving the program to be safe. Additionally, all participants expressed a desire to participate again, if the program were offered in the future. These results suggest that an outdoor group sport play program for adults can be feasible, acceptable, and well-adhered to despite enforcing mandatory COVID-19 safety precautions. Physical activity programs similar to the one presented here may provide an easily-adaptable approach to outdoor physical activity during the current and potential future pandemics that have viral transmission characteristics similar to COVID-19.

Comparative effectiveness of an adult social physical play versus traditional group exercise program for adherence and fitness: Protocol for a randomized-controlled trial.

Despite the myriad benefits associated with regular physical activity (PA), few American adults accrue sufficient weekly PA. Although "lack of time" is often cited as a correlate of physical inactivity, a growing body of evidence suggests that, perhaps more importantly, people allocate their leisure-time to activities they find more enjoyable than PA. These findings underscore the need to devise physical activities that will be chosen over other enjoyable, but less healthy, behavioral alternatives. As a first step in this direction, we designed a group social PA play program for adults, known as PlayFit. The overarching philosophy of PlayFit is that fun and enjoyment are among the most important influences on PA adherence. In PlayFit, traditional sport games are modified to fulfill basic psychological needs, in a non-competitive, and non-contact environment. We will randomize 280 sedentary adults 18-50 years of age to 12-months of PlayFit or traditional group exercise, matching the groups on intensity, frequency, and duration. The primary outcomes include cardiorespiratory fitness (VO2peak), group adherence, and group enjoyment. We hypothesize that, at 6 months, cardiorespiratory fitness will have increased to the same extent in both groups, but at 12 months, only those randomized to PlayFit will have maintained their fitness through better adherence than Group Exercise - and this outcome will be mediated by enjoyment of the assigned group. Findings from this study could provide evidence that a focus on providing fun and enjoyable PA experiences for adults may be a viable route toward improving PA adherence. A simple, inexpensive PA intervention, such as PlayFit, may represent one such approach to do so.

Feasibility and impact of a 1-minute daily functional exercise regimen prescribed to older adults by their primary care physician.

Despite the inverse relationship between physical activity (PA) and physical function, few older adults achieve PA recommendations. In response to observations that "lack of time" underlies reduced PA among older adults, recent work suggests even short bouts of PA can improve health and fitness. In addition, because they are frequently visited by older adults, an important conduit for PA promotion could be the primary care physician (PCP). However, most PCPs receive little training related to PA, rendering it difficult for them to offer meaningful counseling. Therefore, we explored the feasibility and impact of a PCP-prescribed one-minute daily functional exercise program, consisting of 30 s each of bodyweight push-ups and squats, among 24 patients 60 years of age or older. 42% of patients who were contacted started the exercise prescription and, over 24-weeks, completed approximately 114 sessions, while 75% completed at least half of the possible daily exercise sessions. As a group, the patients demonstrated increases in both maximal push-up and squat performance, though these increases plateaued following week-12. These preliminary results suggest that a PCP prescription of one-minute of daily functional exercise among older adult patients was feasible, acceptable, and effective for improving functional physical fitness. Given these findings, formal controlled research with recruitment from multiple clinics, random assignment to treatment conditions, and blinded assessments of objective functional physical performance should be pursued.

Adults Want to Play Too: Feasibility of an Adult Physical Activity Program Designed to Maximize Enjoyment.

BACKGROUND: Few adults in the United States obtain sufficient physical activity (PA) despite knowledge of the associated health benefits. The current feasibility study examined the feasibility of a novel modified sports intervention designed to promote enjoyment and sustained PA in sedentary adults. METHODS: The US adults (N = 22, mean age 39.2 y, male/female percentage 54.5/45.5) in Central Pennsylvania participated in the PlayFit sports program for 60-minute sessions, 2 to 3 times per week, over the course of 10 weeks and 24 game sessions; completing 198 person sessions collectively. Primary outcomes were PA (accelerometry) and intervention satisfaction. RESULTS: Percentage of time in moderate to vigorous activity ranged from 35.0% (volleyball) to 91.2% (ultimate frisbee). Percentage of time spent in vigorous activity ranged from 0.0% (volleyball) to 29.5% (team handball). Satisfaction, based on a 10-point scale with 10 being the most satisfied, ranged from 7.7 (kickball) to 8.7 (floor hockey and soccer). On average, all sports were rated highly, with the majority rated >8.5 and one rated <8.0. Percentage of time spent in the moderate to vigorous range was lower in men than in women (73.2% vs 80.0%, P = .01), but did not differ by age or body mass index. CONCLUSIONS: PlayFit is a promising first step in exploring the potential of modified sports programs to enhance population PA levels.

Online Positive Affect Journaling in the Improvement of Mental Distress and Well-Being in General Medical Patients With Elevated Anxiety Symptoms: A Preliminary Randomized Controlled Trial.

BACKGROUND: Positive affect journaling (PAJ), an emotion-focused self-regulation intervention, has been associated with positive outcomes among medical populations. It may be adapted for Web-based dissemination to address a need for scalable, evidence-based psychosocial interventions among distressed patients with medical conditions. OBJECTIVE: This study aimed to examine the impact of a 12-week Web-based PAJ intervention on psychological distress and quality of life in general medical patients. METHODS: A total of 70 adults with various medical conditions and elevated anxiety symptoms were recruited from local clinics and randomly assigned to a Web-based PAJ intervention (n=35) or usual care (n=35). The intervention group completed 15-min Web-based PAJ sessions on 3 days each week for 12 weeks. At baseline and the end of months 1 through 3, surveys of psychological, interpersonal, and physical well-being were completed. RESULTS: Patients evidenced moderate sustained adherence to Web-based intervention. PAJ was associated with decreased mental distress and increased well-being relative to baseline. PAJ was also associated with less depressive symptoms and anxiety after 1 month and greater resilience after the first and second month, relative to usual care. CONCLUSIONS: Web-based PAJ may serve as an effective intervention for mitigating mental distress, increasing well-being, and enhancing physical functioning among medical populations. PAJ may be integrated into routine medical care to improve quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT01873599; https://clinicaltrials.gov/ct2/show/NCT01873599 (Archived by WebCite at http://www.webcitation.org/73ZGFzD2Z).

Interest Among Primary Care Patients in Group Problem-Solving Gameplay for Mental Health.

Mental health programs to improve problem-solving skills and reduce stress through social gameplay can improve psychiatric outcomes, but little is known about whether adult patients are interested in using them. Primary care patients (n = 467) completed a cross-sectional survey to assess interest in using 2 types of group programs for mental health. A significantly greater percentage (23.7%) of patients expressed interest in a gameplay-based program than in interpersonal therapy (17.6%) (P < .001). Lonely patients and younger patients were more likely to report interest in gameplay. Results suggest that diverse patient populations are interested in using gameplay programs for mental health.

Communication and social interaction anxiety enhance interleukin-1 beta and cortisol reactivity during high-stakes public speaking.

BACKGROUND: Worry or fear related to speaking in front of others, or more broadly, communicating and interacting with others, is common. At elevated levels, however, it may contribute to heightened stress reactivity during acute speaking challenges. The purpose of this study was to examine multi-system physiological stress reactivity in the context of high-stakes public speaking while considering the impact of hypothesized individual difference risk factors. METHODS: University student participants (n = 95) delivering speeches as a heavily-weighted component of their final grade had saliva samples collected immediately prior to speaking, immediately after, and 20 min after speech completion. Saliva samples were assayed for alpha amylase (sAA), cortisol, and interleukin-1 beta (IL-1ß). Self-reported communication anxiety, social interaction anxiety, rejection sensitivity, and sex were assessed as risk factors for heightened stress reactivity. RESULTS: Salivary sAA, cortisol, and IL-1ß significantly changed following speech delivery. Multivariate analyses demonstrated that elevated levels of self-reported communication anxiety and social interaction anxiety were independently associated with increased cortisol and IL-1ß responses and combined to enhance HPA axis and inflammatory cytokine activity further (i.e., cortisol and IL-1ß AUCI). Sex and rejection sensitivity were unrelated to physiological stress reactivity. CONCLUSIONS: These findings suggest that individuals with elevated communication and interaction fears may be at increased risk of heightened neuroendocrine and inflammatory responses following exposure to acute social stressors. Both types of anxiety may combine to increase physiological reactivity further, with unknown, though likely insalubrious, health consequences over time.

Why just exercise if you can play? Interest in a modified sports program to enhance physical activity among primary care patients.

Fewer adults meet guidelines for aerobic physical activity, and many report a lack of enjoyment as a barrier. This survey was designed to determine the interest of primary care patients in participating in program designed to maximize enjoyment. Primary care patients (n = 540) in Central Pennsylvania reported their interest in participating in a "a regular fitness program where people your own age played games, such as softball, floor hockey and soccer, that were made to be easier to play and less competitive." Mean age was 58.4 years (SD = 16.5, range = 18-98). More than one-third (37.0%), including 59.6% of those under age 50, were interested in the modified sports fitness program. After adjusting for confounders, patients under age 40 were 5.9 (95% CI: 2.6-13.9) times as interested (v. age > 70) and non-white patients were 3.4 (95% CI: 1.3-8.5) times interested. Female patients and those with hypertension, high cholesterol or obesity were equally interested. A fitness program that consists of modified sports may be of interest to most primary care patients under age 50. Patients' initial interest appears high enough to warrant further development and testing.

Common oxytocin receptor gene variant interacts with rejection sensitivity to influence cortisol reactivity during negative evaluation.

The study tested the hypothesis that variation in the oxytocin receptor gene (OXTR rs53576) and self-report of rejection sensitivity are associated with adrenocortical reactivity to social stress. Participants (N=94; 36.17% male; Mage=20.18yrs; 62.8% Caucasian) completed a writing task on a salient problem in society, provided self-report via questionnaire of rejection sensitivity, and were then informed that a committee of peers would evaluate their written comments. Participants received either scripted praise or criticism as a way to induce social evaluative threat. Saliva was collected before and after the stress task and assayed for cortisol. Results revealed that cortisol levels increased in participants with moderate levels of social rejection sensitivity-inferred by rs53576 genotype and reported rejection sensitivity-while cortisol levels decreased in participants with high and low levels of social rejection sensitivity. Our findings suggest a curvilinear relationship between social rejection sensitivity and cortisol reactivity in the context of social rejection, warranting further consideration in future studies.

The father-daughter dance: the relationship between father-daughter relationship quality and daughters' stress response.

The goal of the study was to determine whether father-daughter relationship quality is related to activity of the hypothalamic-pituitary-adrenal (HPA) axis (salivary cortisol) and autonomic nervous system (salivary alpha-amylase, sAA) in late adolescence-emerging adulthood during peer interactions. In the 1st study, reported father-daughter relationships characterized by rejection, chaos, and coercion had lower morning cortisol levels and were temperamentally more sensitive to emotional changes. In the 2nd study, young women who reported father-daughter relationships characterized by warmth, autonomy, support, and structure had lower pretask cortisol levels, and they had attenuated cortisol responses to problem discussion with a friend. In contrast, those who reported father-daughter relationships characterized by rejection, chaos, and coercion had higher pretask cortisol levels, had elevated cortisol in response to problem discussion with a friend, and were more likely to self-disclose about psychosocial stressors. No differences were observed between reported father-daughter relationship quality and sAA levels or task-related reactivity. The findings suggest that father-daughter interactions potentially influence both social cognition and HPA reactivity to developmentally salient stressors in young women.