New Zealand is currently in the midst of a diabetes epidemic and it has become clear that the increasing prevalence of obesity and a sedentary lifestyle are inextricably linked to this escalating health crisis. Extensive research has long made clear that people of all ages can enhance their health by incorporating moderate levels of physical activity as part of their normal daily routine and physical activity is now recognised as a major therapeutic modality for type 2 diabetes. Despite such evidence, most people in the western world do not engage in sufficient regular physical activity and there remains a paucity of evidence that elucidates effective methods of achieving the required behaviour change over time. This study set out to demonstrate meaningful correlations between the psychosocial constructs optimism, exercise self-efficacy, goal-directness, stage of change, anxiety and depression, the biochemical measures HbA1c and BMI and also the behavioural outcomes of general physical activity and physical exercise participation, all within a newly diagnosed type 2 diabetic population. Participants (n=30, newly diagnosed adults with type 2 diabetes; mean age 61.46 years; BMI 31.43 Kg/m²[range 18.8-50.95 Kg/m²]) were recruited from attendees of the Christchurch Diabetes Centre's education seminars. The recruitment strategy was designed to search out diabetic patients as near as practicable to the point in time when they first became cognisant of their disease state. A battery of instruments was assembled into a researcher-administered retrospective questionnaire and this was completed with all subjects at baseline and again at six month follow-up. Additional data comprised subject's demographics and selected bio-chemical measures (subject height, weight, and blood Haemoglobin A1c). Descriptive, correlational and qualitative statistics were evaluated. The level of physical activity reported was significantly less than is required to facilitate the biochemical and psychological changes that are generally considered necessary to support optimal health. On average, study participants did not perform their planned physical activity tasks as well as they might have, despite being relatively optimistic and goal-directed at baseline. Many participants clearly indicated an inadequate understanding of exercise modalities and the intensity, duration and frequency of physical activity required to support optimal health. Generally, participants tended to overestimate their physical activity levels. Exercise self-efficacy emerged as an especially important psychological construct, and one that appeared to be among those central to the participants' relationships with physical activity and exercise. The study group demonstrated a relatively high prevalence of low level anxiety and depression, and even at these sub-clinical levels, anxiety and depression were significantly inversely related to optimism, goal-directness, goal-attainment, exercise self-efficacy and stage of change. The study findings illuminate the wide contextual variability among patients who are suffering from the same chronic condition. Further, the implications of conducting detailed pre-assessments of patients' personal characteristics and their psychological profiles, in order to guide intervention tailoring, are also outlined and discussed. Areas for future research are highlighted. In conclusion, meso and macro-level policy implications are discussed, with reference to an array of the broader determinants of health.

Fractures are a major public health concern and there is an urgent need to identify high-risk individuals. This study used novel approaches in bone imaging to characterize optimal skeletal development in girls and enhance our understanding of the structural and functional deficits that contribute to skeletal fragility and fracture risk during growth. The findings indicate that fracture in girls is associated with lower trabecular bone density, but not bone macro-architecture at metaphyseal regions of weight-bearing bones, which is consistent with findings reported in children at the distal radius. These findings suggest that lower trabecular density at metaphyseal regions of long bones track throughout the appendicular skeleton and may be an early marker of skeletal fragility.Obese children are overrepresented in childhood fracture cases. Nevertheless, the effects of fat on bone during growth remain unclear. This study showed that skeletal muscle was a stronger determinant of bone parameters in girls than total body adiposity, although fat mass had a persistent, albeit weak association with bone parameters. Furthermore, fatty infiltration of skeletal muscle, which is associated with type 2 diabetes mellitus, was inversely associated with bone strength in girls. These findings are consistent with the proposed functional model of bone development which posits that forces from muscle contractions are the main mechanical challenges to which bones adapt.Physical activity during growth is critical for optimal bone development. The findings from this study support this premise and suggest that regular physical activity enhances bone strength in girls. Nevertheless, for exercise to be accepted as an important public health osteoporosis prevention strategy, lasting adaptations must be shown. Plausible biological explanations have been offered in support of the peri-pubertal years as a "window of opportunity" for maximizing the response to exercise. Findings from this study suggest that a two year school-based high-impact jumping intervention was not an effective means to enhance bone parameters in girls. Controlled dose-response trials will be necessary to test questions regarding the types, bouts, and durations of exercise required to define the "dose" of exercise needed to elicit meaningful skeletal adaptations during growth.

3 pp. / Pedometers are small devices worn at the hip to count the number of steps walked per day. Pedometers gained popularity as a tool for motivating and monitoring physical activity. The purpose of the publication was to provide basic mechanisms and functions of pedometers. Additionally, we provided information of new technology (cell phone and Google Maps) that are emerging as a tool for motivating physical activity.

Over the past several decades abdominal obesity and physical inactivity have increased at an alarming pace. Since both are related to adverse health risk it is important to determine their independent influence. It is well established that cardiorespiratory fitness (CRF, the ability to perform physical activity) and physical activity (PA) are negatively associated with cardiometabolic risk factors (commonly obtained risk factors for disease, e.g: TG, HDL, etc.). In other words, the higher a person’s levels of PA and fitness, the lower that person’s likelihood of developing cardiometabolic risk factors. Abdominal obesity is positively associated with cardiometabolic risk factors which means the more abdominally obese a person is, the more prone that person is to develop cardiometabolic risk factors. However, it is unknown whether PA influences cardiometabolic risk factors independent of fitness level and/or abdominal obesity. My study objective was to examine whether PA is associated with cardiometabolic risk factors independent of cardiorespiratory fitness and/or abdominal obesity in inactive abdominally obese women. The study enrolled 141 inactive abdominally obese women. PA, cardiorespiratory fitness, and cardiometabolic risk profile were measured in all participants. A novel feature of this study was the use of the accelerometer to objectively measure PA and to divide exercise into different levels of intensity, such as: low PA, moderate to vigorous PA (MVPA), etc. My findings revealed that abdominal obesity was positively associated with cardiometabolic risk independent of PA or CRF. I also observed that CRF was inversely related to cardiometabolic risk independent of PA or abdominal obesity. MVPA explained cardiometabolic risk factors by itself, but with insulin resistance measurements (2-hour glucose, and homeostasis model of assessment) this relationship was abolished when abdominal obesity and CRF were also taken into consideration. The findings of this study provide further support for the recommendation that waist circumference and CRF be included as routine measures screening for cardiometabolic risk factors in inactive obese women. Our findings also support the suggestion that even modest amounts of daily MVPA that are below the recommended threshold of 30 minutes/day convey health benefit. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2013-07-23 13:46:57.088

Fizinis aktyvumas vienas iš sveikos gyvensenos ir geros savijautos komponentų, todėl fizinio aktyvumo skatinimas bei tinkama motyvacija turėtų būti neatsiejama moksleivių ugdymo dalimi ne tik mokykloje, tačiau ir namuose. Fizinis aktyvumas ypač naudingas moksleiviško amžiaus vaikams, kuomet dar vystosi organizmas, bei turi teigiamos įtakos vaikų mokymosi efektyvumui. Susiformavę fizinio akyvumo įgūdžiai jauname amžiuje, dažnai išlieka ir vyresniame amžiuje, todėl svarbu fizinio aktyvumo įgūdžius pradėti formuoti kuo anksčiau. Mokinių fiziniam aktyvumui turi įtakos įvairios priežastys – asmenys bendraujantys su vaikais, asmenininiai veiksniai, aplinkos sąlygos. Tyrimo objektas – mokinių fizinis aktyvumas ir jį motyvuojantys veiksniai Baigiamojo darbo tikslas – nustatyti mokinių fizinį aktyvumą motyvuojančius veiksnius. Darbo uždaviniai: 1. Nustatyti 9-10 klasių mokinių fizinį aktyvumą bei jį motyvuojančius veiksnius. 2. Nustatyti 11-12 klasių mokinių fizinį aktyvumą bei jį motyvuojančius veiksnius. 3. Palyginti mokinių fizinį aktyvumą motyvuojančius veiksnius skirtingose amžiaus grupėse. Tyrimo išvados: 1. Tyrimo rezultatai leidžia teigti, kad 9-10 klasių moksleiviai yra fiziškai aktyvūs, 70% mokinių sportuoja nuo 2-3 iki 7 ir daugiau valandų per savaitę ir 80% 9-10 klasių mokinių ne pamokų metu sportuoja, mankštinasi 2-3 ir daugiau kartų per savaitę. 72% laisvalaikį renkasi praleisti užsiimdami fiziškai aktyvia veikla. 60% 9-10 klasių mokinių labiausiai skatina... [toliau žr. visą tekstą] / The object of the research is students’ physical activity and its motivating factors. The aim of the paper is to determine the factors that motivate students’ physical activity. The tasks of the paper are the following: 1. To determine the level of the physical activity of 9-10 graders and to find out what the motivating factors for their physical activity are. 2. To determine the level of the physical activity of 11-12 graders and to find out what the motivating factors for their physical activity are. 3. To compare the factors motivating students’ physical activity in different age groups. Conclusions: 1. According to the results of the analysis, it is possible to assert that the students in 9-10th grade are physically active. 70 per cent of the students participate in sports two to three hours a day and up to seven hours a week. 80 per cent of 9-10th grade students pursue sports as an extra curriculum activity for two to three times a week. 72 per cent choose to take part in physical activity during their free time. 60 per cent of 9-10th grade students are motivated to participate in sports by their parents, friends, classmates, that is to say, people who interact with the students the most. An important variable in terms of 9-10th grader physical activity levels is to do with access to sport facilities, equipment and so on. 48 per cent of 9-10th graders are not motivated by the equipment provided in their schools, nonetheless, the physical activity level of 70 per cent... [to full text]

There has been a growing interest among policymakers in the potential role of physical activity (PA) as a strategy to mitigate the challenges associated with an aging population, specifically the potential pressures on the health care system presented by an increasing need and demand for long term management of chronic health conditions. In this dissertation, the relationship between PA and health service utilization among older adults and the role of PA in reducing health services utilization in this population is examined via two studies. Study 1: The purpose of Study 1 was to examine relationships between LTPA and health services utilization in a nationally representative sample of community-dwelling adults aged 50 years and older. Methods: This study involved a secondary analysis of data from the Cycle 3.1 of the Canadian Community Health Survey. The analysis was restricted to individuals aged 50 years and older, resulting in an unweighted sample of 56,652 adults (48%M; 52%F; mean age 63.5±10.2 years), stratified a priori into three age groups (50 – 64 years, 65 – 79 years, 80 years and older). Self-reported use of general physician (GP) services, specialist physician services and hospital services for the 12-month period prior to the survey were the outcomes of interest. The main independent variable of interest was self-reported LTPA for a 3-month period prior to the survey. A comprehensive set of predisposing, enabling, and health need factors associated with health services utilization were included as control variables in all analyses. Separate multiple logistic and negative binomial regression models were used to assess the association between LTPA and each dichotomous and count-based dependent variable, respectively. Bootstrap re-sampling procedures were applied in all regression analyses. Results In the 50-64 year age group, active individuals were 27% less likely to report any contact with a GP (OR=0.73; p<.001) and had 8% fewer GP consultations (IRR=0.92; p<.01) than their inactive counterparts. Among 65 to 79 year olds, active respondents were 18% less likely than their inactive counterparts to have had an overnight hospitalization in the previous 12 months (OR=0.82, p<.05). Across all age groups, higher levels of non-leisure physical activity was associated with lower health services utilization. Study 2: The purpose of Study 2 was to investigate the effects of a randomized community-based PA intervention (50+ in motion) on participants’ health service utilization and healthcare costs over a 5-year period. Methods: 50+ in motion was a randomized clinical trial comparing the effectiveness of a class-based (CB) and home-based (HB) exercise program for older adults with select chronic health conditions (hypertension, dyslipidemia, type 2 diabetes mellitus, osteoarthritis, overweight or obesity). Of the 172 participants randomized, 59 CB and 69 HB participants granted access to their administrative health data. Data pertaining to GP and specialist physician services utilization and costs as well as hospital services utilization and costs were obtained for all consenting participants from the Saskatchewan Ministry of Health for the year prior to enrolment in the 50+ in motion study through to 48-months post-randomization, for a total of 5-years of data. Independent variables including demographic characteristics, physical activity, sedentary behaviour, cardiovascular endurance, functional fitness, body composition, blood pressure, and self-reported physical and mental health status were collected directly from participants prior to randomization and then annually for 4 years. Longitudinal effects of the 50+ in motion intervention on health services utilization and healthcare costs were assessed using the generalized estimating equation (GEE) approach with covariates selected for inclusion based on methods of purposeful selection. Results: There were no significant differences in health services utilization or health care costs between the CB and HB interventions until the final year of the study when the HB group had 60% more GP visits than the CB group and were 89% less likely than the CB group to be frequent users of specialist services. There were no significant differences between the randomization groups in healthcare costs. Measures of functional fitness emphasizing lower body strength, endurance and power were more consistently associated with lower health services utilization than CV endurance, body composition or physical activity. Sedentary behavior was associated with higher hospital costs, independent of physical activity, functional fitness and health status. Overall Conclusion: Taken together, the two studies in this thesis address a significant gap in the Canadian literature and provide novel insights into the relationships between PA, health and health services utilization in older adults. While further research is needed to improve our understanding of the relationships between physical activity and sedentary behaviour, physical fitness, and health services utilization, the findings presented in this thesis suggest reducing sedentary behaviour and improving functional fitness in older adults may be as important as physical activity, if not more so, in terms of potential impact on health services utilization and health care costs. For health care professionals and policymakers at all levels, the findings highlight the advantages of a multi-pronged, interdisciplinary approach to the development of public health initiatives and interventions focused on increasing PA participation and functional fitness among older adults.

This phenomenological study explored how physical activity is experienced as a means for resilience as well as the defining characteristics and meaning of that experience. Four participants were interviewed, aged 18 to 21 years; all of which were receiving a university education at the time of the interviews. Physical activity has been connected to various physical, intellectual, psychological, and social benefits during adolescence. The participants in this study described their journeys to achieving wellness despite growing up with adversities collectively deemed as adverse. Interpretative phenomenological analysis (IPA) was the methodology utilized to investigate the data generated through several semi-structured in depth interviews with the participants. The analyzed data formed the overarching theme of self development in the face of adversity, which was evident throughout the three superordinate themes: channeling energy, nurturing relationships, and challenging the self. The participants explained their passages through adolescence amidst adversities to be ones full of ups and downs, but ultimately progress towards their current accomplishments, goals, dreams, and personal growth. The themes are discussed within the context of the current literature and then followed by recommendations for future research, considerations for professionals, and a conclusion including words of wisdom from the participants.

The self has been identified as the ?psychological apparatus that allows individuals to think consciously about themselves? (Leary & Price Tangney, 2003, p. 8). Further, the self has been identified as a worthwhile construct of investigation in relation to health behaviour (Contrada & Ashmore, 1999). Two self-related variables that have been useful in the study of health behaviour are <em>identity</em> (e. g. Anderson, Cychosz, & Franke, 1998; Petosa, Suminski & Hortz, 2003; Storer, Cychosz, & Anderson, 1997) and <em>self-efficacy</em> (Maddux, Brawley & Boykin, 1995). Identity Theory posits that individuals regulate their behaviour in a manner that is consistent with their goal identity (Gecas & Burke, 2003). Social Cognitive Theory provides a means of measuring social cognitions that may be important in behavioural regulation relative to identity. Further, self-efficacy beliefs may influence individuals? persistence at aligning their identity and behaviour. Research to date has investigated the link between identity and exercise (e. g. Anderson, Cychosz & Franke, 1998; Petosa, et al. , 2003). Further, researchers are beginning to investigate the link between identity and other health behaviours (e. g. Armitage & Conner, 1999; Kendzierski and Costello, 2004; Storer, Cychosz, & Andersen, 1997). However, research has not utilized the predictive frameworks offered by Identity Theory and Social Cognitive Theory to investigate the relationships between identity, behaviour and behavioural regulation. <br /><br /> Study One investigated the role of identity and self-efficacy beliefs in the maintenance of vigorous physical activity. Results were consistent with both Identity Theory and Social Cognitive Theory. Individuals who strongly identified with the runner identity expressed stronger task and self-regulatory efficacy beliefs. They also exercised more frequently and for longer durations than did those who only moderately identified with running. <br /><br /> Study Two further explored the relationship between exercise identity, exercise behaviour and the self-regulatory processes involved in behavioural regulation. Identity Theory and Social Cognitive Theory were used as guiding frameworks for this investigation. High and moderate exercise identity groups were compared in term of their affective and cognitive reactions to a hypothetical behavioural challenge to exercise identity. Consistent with Identity Theory, results indicated that participants appeared to be regulating their behaviour in a manner that was consistent with their exercise identity. Specifically, in response to the behavioural challenge to identity, high exercise identity participants, in contrast to their moderate counterparts, showed (a) less positive and (b) greater negative affect about the challenge, (c) higher self-regulatory efficacy for future exercise under the same challenging conditions, (d) stronger intentions for this future exercise, as well as for (e) using self-regulatory strategies to manage the challenging conditions and (f) intending to exercise more frequently under those conditions. <br /><br /> Study Three investigated whether identity with <em>healthy eating</em> could also be useful in understanding behaviour and behavioural regulation. Similar to Study Two, extreme healthy-eater identity groups? reactions to a hypothetical behavioural challenge to identity were compared. Results were similar to Study Two. Participants responded in a manner that suggested that they would regulate their future behaviour relative to their healthy-eater identity. In response to the behavioural challenge to identity, individuals who highly identified as healthy-eaters expressed less (a) positive affect, greater (b) negative affect, (c) self-regulatory efficacy for managing their healthy eating in the future challenging weeks, (d) intentions to eat a healthy diet, (e) generated more self-regulatory strategies and had (f) stronger intentions to use those strategies in future weeks under the same challenging conditions than did individuals who moderately identified themselves as healthy-eaters. Further, prospective relationships between healthy-eater identity and social cognitive variables, and healthy eating outcomes were examined. As was found in Study One in the context of exercise, healthy-eater identity and social cognitions predicted healthy eating outcomes. <br /><br /> Taken together, the three studies suggest that identity may be important in understanding health behaviours and the regulation of these behaviours. Also, the present findings support the compatible use of Identity Theory and Social Cognitive Theory in the investigation of identity and health behaviour.

The aim of this study was to assess the physical activity, attitudes towards physical education, and health related fitness at two points, one year apart (Phase One and Phase Two). Three hundred and ninety four secondary school pupils of mixed ethnicities from National Curriculum school years 7, 8 and 9 (mean age ± S.D. = 12.9 ± 0.81 years) participated in phase one of the study. Two hundred and sixty seven pupils (from the original 394 participants) from National Curriculum school years 8, 9 and 10 (mean age ± S.D. = 13.7 ± 0.79 years) took part in phase two one year later. Physical activity was measured using the four by one-day physical activity recall questionnaire (Cale, 1993). Attitude was measured using the Pre-Adolescent Attitude towards Physical Education Questionnaire (PAAPEQ) (Shropshire, 1997). Five components of health related fitness were measured in a randomly selected sub-sample (35%) of the overall sample: body composition (measured using skinfold measures and body mass index); cardiovascular endurance (measured using the twenty metre multistage fitness test, Brewer et al., 1988); flexibility (measured using the sit and reach test); muscular strength (measured using hand grip dynamometry); and muscular endurance (measured using situps). Results of repeated measures ANOVA revealed a significant decrease in energy expenditure between phase one and phase two (p<0.01) and young people’s energy expenditure was higher during weekends (especially Saturdays) than during school days (p<0.01). Young Asians were found to expend less energy than white and black pupils (p<0.01) and boys expended more energy than girls (p<0.01). No main effect according to school year was found (p>0.05) although a significant ‘time’ by ‘days’ of the week interaction was revealed; pupils in Year 8 were more active on school days than those in Years 7 and 9 (p<0.05). Non-parametric analyses conducted on time spent in moderate physical activity (MPA) and vigorous physical activity (VPA) indicated that: MPA and VPA decreased between phases one and two; Asians consistently spent less time in MPA than white and black pupils (p<0.01); boys engaged in more MPA and VPA than girls (p<0.01). However, the difference in mean reported time for boys and girls decreased between phases one and two. Percentages of the whole sample meeting optimal activity guidelines and percentages classified as active or moderately active decreased between measurements for the whole sample. With regard to attitudes towards PE, results from MANOVA revealed a significant ‘school year’ x ‘ethnicity’ x ‘gender’ interaction (p<0.05). Attitudes of black males became more positive with age whereas the attitudes of other groups followed an age related decline. Significant main effects were found according to school year (p<0.01) and ethnicity (p<0.05). Attitude towards PE became less favourable with school year. Asian pupils had more positive overall attitudes than white and black pupils but univariate analysis revealed that Asian pupils had a less positive attitude towards their PE teacher (p<0.05). Furthermore, Pearson’s product moment correlations indicated weak yet significant positive relationships between total attitude towards PE and energy expenditure (p<0.01), time spent in moderate activity (p<0.05) and time spent in vigorous activity (p<0.01). Results of repeated measures ANOVA conducted on health related fitness data revealed that, for all groups, body fat (p<0.05) and muscular endurance (p<0.01) increased between phases one and two. In both phases, significant positive relationships were found between muscular endurance and energy expenditure (p<0.01) and vigorous activity (p<0.05 and p<0.01 for phases one and two respectively). Therefore, young people who were more active had greater levels of muscular endurance. No further consistent findings were made. Findings indicate that generally young people’s physical activity decreases with age and that girls are less active than boys although as young people age the physical activity gap between the genderes narrows. Findings also lend support to the idea that cultural differences may influence physical activity levels and attitudes towards PE. Furthermore, associations between physical activity and attitude towards PE exist and therefore, attitude may be used to predict physical activity behaviour. Ethnicity, age, and attitude towards PE should be considered in the development of future interventions to increase young people’s physical activity levels. However, as the current study did not reveal strong associations between physical activity and health related fitness, further research is required in the area.

Background: This study investigates whether the Theory of Planned Behaviour is a viable model to predict the intentions of care staff to support adults with a learning disability to take part in physical activity. Previous research has suggested that people with a learning disability take part in less physical activity than those without disabilities. Research also shows that people with a learning disability have additional health needs when compared to the general population. Some conditions affecting people with a learning disability may be prevented or alleviated by increased physical activity. People with learning disabilities are sometimes dependent on their care staff to support them to access activities, therefore it is important to include care staff in planning interventions. The principal hypothesis of this research was that the Theory of Planned Behaviour may be a useful model in predicting the intentions of staff to support service users to engage in physical activity. Method: Seventy-eight individuals who were keyworkers for adults with learning disabilities participated in this study. This study is based on the responses of these individuals as recorded on questionnaires at two distinct times. At time one, the respondents completed an adaptation of the International Physical Activity Questionnaire – Short Form (IPAQ-SF), and two questionnaires relating to the Theory of Planned Behaviour. At time two, the respondents completed a follow-up measure of physical activity using the IPAQ-SF. The questionnaires were distributed in a pencil-and-paper format, and were available online. Data were analysed using path analysis, an extension of multiple regression. Results: A number of significant relationships between variables were demonstrated by the data. Perceived behavioural control was a significant predictor both of care staff intention and of the behaviour of the service user. Attitude was also a significant predictor of care staff intention. The data did not support that intention would mediate the relationship between attitude, subjective norm and perceived behavioural control and behaviour. Perceived behavioural control was the most significant predictor of intention and of behaviour. Discussion: Results indicate that people with a learning disability take part in less physical activity than the recommendations for health. Perceived behavioural control was the most predictive variable in this population. The clinical and theoretical implications of this are discussed.