Motivation Predicts Change in Nurses' Physical Activity Levels During a Web-Based Worksite Intervention: Results From a Randomized Trial.

BACKGROUND: Low physical activity levels can negatively affect the health of nurses. Given the low physical activity levels reported by nurses, there is a clear need for brief and economical interventions designed to increase physical activity levels in this population. We developed a web-based intervention that used motivational strategies to increase nurses' physical activity levels. The intervention provided the nurses with feedback from an activity monitor coupled with a web-based individual, friend, or team physical activity challenge. OBJECTIVE: In this parallel-group randomized trial, we examine whether nurses' motivation at baseline predicted changes in objectively measured physical activity levels during the 6-week intervention. METHODS: The participants were 76 nurses (n=74, 97% female; mean age 46, SD 11 years) randomly assigned to 1 of 3 physical activity challenge conditions: (1) individual, (2) friend, or (3) team. The nurses completed a web-based questionnaire designed to assess motivational regulations for physical activity levels before the intervention and wore a Tractivity activity monitor before and during the 6-week intervention. We analyzed data using multilevel modeling for repeated measures. RESULTS: The nurses' physical activity levels increased (linear estimate=10.30, SE 3.15; P=.001), but the rate of change decreased over time (quadratic estimate=-2.06, SE 0.52; P<.001). External and identified regulations (ß=-2.08 to 11.55; P=.02 to .04), but not intrinsic and introjected regulations (ß=-.91 to 6.29; P=.06 to .36), predicted changes in the nurses' physical activity levels. CONCLUSIONS: Our findings provide evidence that an intervention that incorporates self-monitoring and physical activity challenges can be generally effective in increasing nurses' physical activity levels in the short term. They also suggest that drawing solely on organismic integration theory to predict changes in physical activity levels among the nurses participating in web-based worksite interventions may have been insufficient. Future research should examine additional personal (eg, self-efficacy) and occupational factors (eg, shift length and shift type) that influence physical activity levels to identify potential targets for intervention among nurses. TRIAL REGISTRATION: ClinicalTrials.gov NCT04524572; https://clinicaltrials.gov/ct2/show/NCT04524572.

Establishing modified Canadian Aerobic Fitness Test (mCAFT) cut-points to detect clustered cardiometabolic risk among Canadian children and youth aged 9 to 17 years.

The objective of this study was to establish cut-points to identify potential clustered cardiometabolic risk among children (aged 9-13 years) and youth (aged 14-17 years) using the modified Canadian Aerobic Fitness Test (mCAFT). Nationally representative cross-sectional data were obtained from cycles 1 and 2 (2007-2011) of the Canadian Health Measures Survey. Cardiorespiratory fitness was measured using the mCAFT, which was used to estimate peak oxygen consumption. Clustered cardiometabolic health was identified as the mean of 4 standardized variables: sum of 4 skinfolds; total cholesterol-to-high-density lipoprotein ratio; and systolic and diastolic blood pressure. In total, 2106 (49% female) participants were retained for this analysis. The optimal mCAFT cut-point for males was 49 and 46 mL·kg-1·min-1 among children and youth, respectively. Among females, the mCAFT cut-point was 46 and 37 mL·kg-1·min-1 among children and youth, respectively. In 2016-2017, 83% of females and 71% of males met the new mCAFT cut-points. The mCAFT cut-points can help identify children and youth at potential risk of poor cardiometabolic health in public health surveillance, clinical, and school-based settings. Novelty We developed new mCAFT cut-points to identify potential clustered cardiometabolic risk among Canadian children and youth. These mCAFT cut-points can be used to inform national health surveillance efforts.

Criterion-referenced mCAFT cut-points to identify metabolically healthy cardiorespiratory fitness among adults aged 18-69 years: an analysis of the Canadian Health Measures Survey.

This study aimed to develop and validate health-related criterion-referenced cut-points for the modified Canadian Aerobic Fitness Test (mCAFT), a field-based measure to predict cardiorespiratory fitness among adults (18-69 years). Criterion-referenced mCAFT cut-points were developed using nationally representative data from cycles 1 (2007-2009) and 2 (2009-2011) of the Canadian Health Measures Survey (CHMS). Receiver operating characteristic curves were used to identify age- and sex-specific cut-points for measured waist circumference, blood pressure, and high-density lipoprotein. Cut-points were validated against metabolic syndrome using a fasted subsample (n = 1093) from cycle 5 (2016-2017). For the main analyses, 4967 participants (50% women) were retained. The mCAFT cut-points ranged from 28 to 43 mL·kg-1·min-1 (area under the curve (AUC): 0.60-0.87) among men, and 23 to 37 mL·kg-1·min-1 (AUC: 0.61-0.86) among women. The likelihood of meeting the new mCAFT cut-points decreased with an increase in the presence of metabolic risk factors. In total, 54% (95% confidence interval: 42% to 67%) of Canadian adults met the new mCAFT cut-points in 2016-2017. This study developed and validated the first health-related criterion-referenced mCAFT cut-points for metabolic health among Canadian adults aged 18-69 years. These mCAFT cut-points may be useful in health surveillance, clinical, and public health settings. Novelty We developed and validated new criterion-referenced cut-points for the mCAFT to help identify adults at potential risk of poor metabolic health. These new cut-points could help support national health surveillance efforts.