The International Journal Of Behavioral Nutrition And Physical Activity[JOURNAL]
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200 papers
Development of the Canadian Eating Practices Screener for Adolescents to assess eating practices based on Canada's Food Guide 2019 recommendations.
Jacob R, Any M, Desgreniers V … +7 more , Bessette G, Al Kazzi R, Martin AE, Tugault-Lafleur C, Hernandez K, St-Pierre S, Haines J
Int J Behav Nutr Phys Act · 2025 Dec · PMID 41402790 · Full text
BACKGROUND: In addition to guidance on food choices, the Canada’s Food Guide 2019 (CFG-2019) provides recommendations to support healthy eating habits. A brief self-administered eating practices questionnaire informed by...
BACKGROUND: In addition to guidance on food choices, the Canada’s Food Guide 2019 (CFG-2019) provides recommendations to support healthy eating habits. A brief self-administered eating practices questionnaire informed by CFG-2019 recommendations was recently developed and validated among adults, but no such measure is available for adolescents. The objective of this study was to develop and assess the content validity of a self-administered screener to measure eating practices based on CFG-2019 recommendations among English- and French-speaking adolescents aged 10 to 17 years. METHODS: Following a literature review of existing measures and the identification of guiding principles for questionnaire development, a 26-item draft screener was created. The content validity of the draft screener was assessed by an expert panel with expertise in nutrition, eating behaviours, public health and/or questionnaire validation (English n = 13, French n = 7) and through two rounds of cognitive interviews with adolescents (English n = 18, French n = 13). RESULTS: The number of items was reduced from 26 to 12 following review by the expert panel, and further reduced to 11 after the cognitive interviews with adolescents. Minor wording changes were made to improve clarity of a few items. CONCLUSIONS: This study resulted in the development of the 11-item Canadian Eating Practices Screener for Adolescents/Questionnaire court canadien sur les pratiques alimentaires des adolescents designed for use among adolescents aged 10 to 17 years. Further work is needed to test the screener for construct validity and reliability. After which, this measure can be used for research and nutrition surveillance of eating practices among adolescents living in Canada.
Effectiveness and equity impacts of traffic restriction schemes outside schools: a controlled natural experimental study.
Patterson R, Carey EG, Garrott K … +8 more , Huang Y, Ogilvie D, Hadfield-Hill S, Cope A, Davis A, van Sluijs E, Panter J, CROSS study team
Int J Behav Nutr Phys Act · 2025 Dec · PMID 41398292 · Full text
BACKGROUND: Active travel (such as walking, cycling and scooting) has a range of benefits for human and planetary health, whereas driving children to school contributes substantially to motor vehicle traffic at peak time...
BACKGROUND: Active travel (such as walking, cycling and scooting) has a range of benefits for human and planetary health, whereas driving children to school contributes substantially to motor vehicle traffic at peak times. Local governments have collaborated with schools to implement traffic restriction schemes, in which motor vehicle access around schools is restricted at drop-off and pick-up times. We examined the impacts of these schemes on how children travel to school, and how these differed between socio-economic groups, in England and Scotland. METHODS: In this controlled before-and-after natural experimental study, we used data collected by primary schools on children’s mode of travel to school between 2012 and 2023. We matched each intervention school to two control schools based on area-level deprivation, urban–rural status, school size, baseline prevalence of active travel to school, and geographical region. We used fixed-effects regression models to conduct difference-in-difference analyses of the percentage of pupils using active modes of transport and private motor vehicles, adjusting for potential confounding factors. We examined absolute and relative differences and differential effects by stratifying analyses by geographical region, method of enforcement, area-level deprivation, and urban–rural status. RESULTS: We used data from 498 schools (166 intervention and 332 control) at which on average 70% of children travelled to school by active modes at baseline, with no significant difference between intervention and selected control schools (p = 0.79). The proportion of pupils in intervention schools travelling by active modes increased by 5.9 absolute percentage points (95% CI: 2.5 to 9.1), and the proportion travelling by private motor vehicle decreased by 5.3 points (2.5 to 8.2), relative to control schools. The results for relative changes were similar, the patterns were consistent between jurisdictions and no differences were seen in other stratified analyses. CONCLUSION: We found that after primary schools implemented schemes, a greater proportion of children walked, cycled or scooted to school and a smaller proportion were driven. These findings suggest that wider roll-out of these schemes might contribute to promoting active travel in children, and perhaps, to improving health. Improving the availability, quality and consistency of routinely collected data on travel to school would facilitate future research into these schemes.
Optimising 24-Hour movement behaviours in preschoolers through parenting practices: an evidence-based intervention study.
Decraene M, Miatke A, Dumuid D … +5 more , Cardon G, Verloigne M, De Bruyne R, Verbestel V, De Craemer M
Int J Behav Nutr Phys Act · 2025 Dec · PMID 41388547 · Full text
BACKGROUND: Establishing healthy 24-hour movement behaviours early in life is crucial for long-term health. However, few preschoolers comply with the 24-hour movement behaviour guidelines. Given the pivotal role of paren...
BACKGROUND: Establishing healthy 24-hour movement behaviours early in life is crucial for long-term health. However, few preschoolers comply with the 24-hour movement behaviour guidelines. Given the pivotal role of parents in shaping children's health habits, interventions targeting parenting practices may optimise these behaviours in preschoolers. This study evaluates the effectiveness of the 'Move ARound And Get Active' (MARGA) intervention in improving preschoolers' 24-hour movement behaviour composition, guideline compliance, and parents' parenting practices. METHODS: A two-armed, non-equivalent pretest-post-test control group design was conducted in Belgium. The MARGA intervention, co-created with parents, incorporated seven interactive sessions over 11 weeks, focussing on parenting practices conceptualised within the Self-Determination Theory and behaviour change methods such as planning and goal setting. Participants included preschoolers (2.5-6 years) and one parent per child (n = 141; 49 intervention, 92 control). The primary outcomes were changes in preschoolers' 24-hour movement behaviour composition and guideline compliance measured using accelerometers and proxy-reported diary. Secondary outcomes included changes in proxy-reported parents' parenting practices. Both intention-to-treat (ITT) and per-protocol (PP) analyses were performed. In addition, intervention implementation was investigated. RESULTS: The intervention showed no significant impact on the overall 24-hour movement behaviour composition, nor on 24 h-movement behaviour guideline compliance. However, favourable intervention effects were observed for screen time guideline compliance (ITT: d = 1.5, p = 0.04, PP: d = 8.6, p = < 0.001) and combinations of screen time and physical activity (ITT: d = 1.2, p = 0.05, PP: d = 1.7, p = 0.04) or sleep (PP: d = 1.7, p = 0.05) guideline compliance. Parenting practices also improved in parents from the intervention condition compared to parents from the control condition, including setting screen time rules (ITT: d = 0.79, p = 0.01, PP: d = 1.1, p = 0.001), providing choices within sleep routines (ITT: d = 0.63, p = 0.04, PP: d = 0.68, p = 0.05), parent and preschooler performing physical activity together (PP: d = 0.76, p = 0.03) and explaining screen time rules (PP: d = 0.68, p = 0.05). Implementation scores indicated moderate engagement, with attendance rates averaging 49.7%. CONCLUSIONS: The intervention showed modest improvements in preschoolers' 24-hour movement behaviours and parenting practices. Extended follow-up observations might be required to capture changes in preschoolers' 24-hour movement behaviours, especially considering that the intervention targets preschoolers indirectly by first aiming to influence parents' parenting practices. TRIAL REGISTRATION: ClinicalTrials.gov (ID NCT06171191).
Creating healthy habits for Maryland preschoolers (CHAMP): a cluster-randomized controlled trial among childcare centers.
Kowalski AJ, Armstrong B, Trude ACB … +7 more , Arbaiza R, Czinn A, Bellows LL, Johnson SL, Wang Y, Hager ER, Black MM
Int J Behav Nutr Phys Act · 2025 Dec · PMID 41372951 · Full text
BACKGROUND: Risks for chronic health problems are embedded in preschoolers' dietary and physical activity habits. Childcare centers are a potential venue to establish healthy habits. We hypothesized that health-promoting...
BACKGROUND: Risks for chronic health problems are embedded in preschoolers' dietary and physical activity habits. Childcare centers are a potential venue to establish healthy habits. We hypothesized that health-promoting center plus parent interventions would improve preschoolers' dietary and physical activity outcomes, including body weight, over control. METHODS: We made local modifications to the 30-week Food Friends curriculum to develop a center intervention, Creating Healthy Habits Among Maryland Preschoolers (CHAMP), and a parent website (CHAMP+), aligned with the CHAMP intervention. The CHAMP intervention included a manual, web-based lessons plans, handouts, resources, and program materials implemented by CHAMP-trained staff. We evaluated effectiveness in a 3-arm cluster randomized controlled trial. Childcare centers serving low-income communities were recruited (2017-2020) from 10 counties and randomized to center (CHAMP), center plus parent (CHAMP+), or Control arms. Willingness-to-try-new-food, fruit and vegetable (FV) preference, motor competence (Test of Gross Motor Development-2), moderate-vigorous-physical-activity (MVPA, 7-day accelerometry), and anthropometry (BMI z-scores) were measured at baseline/endline (6 months post-baseline) by assessors masked to intervention status. Linear mixed models examined differences in changes among arms. Center baseline nutrition/physical activity environmental quality (Environment and Policy Assessment and Observation) was examined as moderating intervention effects. RESULTS: Fifty-six centers were randomized (CHAMP = 21, CHAMP+ = 20, Control = 20); 855 children. Centers were diverse by location, race, and income; children were mean age 48.44 (SD 7.50) months, 54% male; 26% experienced overweight/obesity. Analyses adjusted for baseline differences in child age, race, and ethnicity. The intervention improved motor competence (gross motor quotient: pooled CHAMP/CHAMP+ vs. Control 5.67 [95% CI: 0.60, 10.75]; locomotor score: pooled CHAMP/CHAMP+ vs. Control 1.74 [95% CI: 0.43, 3.05]) and reduced BMIz (pooled CHAMP/CHAMP+ vs. Control (-0.08 [95% CI: -0.15, 0.00]); with no intervention effects on willingness-to-try-new-foods, FV preference, or MVPA and no impact enhancement by the parent intervention (CHAMP+). Moderation analyses showed stronger increases in willingness-to-try-new-foods and MVPA in centers with higher quality nutrition/physical activity environments. CONCLUSIONS: Childcare center interventions can improve motor competence and reduce BMIz among preschoolers. Higher quality nutrition/physical activity environment can increase the impact of interventions on children's dietary behaviors and physical activity, contributing to healthy habits. TRIAL REGISTRATION: NCT03111264.
Exercise empowerment: a scoping review of randomized controlled trials and quasi-experimental physical activity interventions.
Streetman AE, Walden RL, Orr CJ … +1 more , Heerman WJ
Int J Behav Nutr Phys Act · 2025 Dec · PMID 41366451 · Full text
BACKGROUND: Physical inactivity is a leading contributor to chronic disease and premature mortality across the globe. Traditional physical activity interventions often promote physical activity initiation but have limite...
BACKGROUND: Physical inactivity is a leading contributor to chronic disease and premature mortality across the globe. Traditional physical activity interventions often promote physical activity initiation but have limited long-term effectiveness. Empowerment has been recognized as a potentially powerful tool in health behavior change, but it is unclear how empowerment is operationalized in physical activity interventions. One current gap in the literature is the role of empowerment in physical activity interventions. Therefore, this review aims to determine how exercise empowerment is defined, measured, and theoretically framed in randomized controlled trials and quasi-experiments across various populations. We are also interested in understanding the strategies for facilitating empowerment, whether empowering interventions increase physical activity, and if physical activity outcomes are assessed. METHODS: A scoping review adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews was conducted across five electronic databases (PubMed, Embase, PsycINFO, Web of Science, Cochrane Library, CINAHL). Inclusion criteria included adults and children, participation in a physical activity intervention, and an empowerment strategy. Exclusion criteria included qualitative studies, studies published before 1994, and studies not in English. RESULTS: Forty papers were included in this scoping review, but no interventions explicitly defined exercise empowerment. Empowerment was not directly measured in any of the included interventions. Empowerment theory or a derivative informed nine (22.5%) of the included articles, while six (15%) lacked theoretical underpinnings. Most interventions (55%) utilized an educational approach. Physical activity was measured subjectively in 27 (67.5%) interventions. Physical activity increased in most studies (n = 29; 72.5%). CONCLUSIONS: This review highlights the disconnect between the multidimensional framework of empowerment theory and interventions designed to empower participants. We identified several opportunities to increase intervention effectiveness, including developing and applying a consensus definition of exercise empowerment that creates better alignment with empowerment theory. Exercise empowerment should be defined as the perceived confidence and control over exercise choices that lead to sustained exercise and a sense of fulfillment. It can be experienced both individually and collectively. The process of building exercise empowerment depends on developing personal confidence and control over exercise choices, engaging with supportive social networks to initiate and sustain exercise, and utilizing available community-based exercise resources.
Evaluating the impact of park renovation on park-based physical activity: a natural experiment in Belgium with two years of follow-up.
Van Puyvelde A, Van Cauwenberg J, Veitch J … +4 more , Timperio A, Van Dyck D, Poppe L, Deforche B
Int J Behav Nutr Phys Act · 2025 Dec · PMID 41350875 · Full text
BACKGROUND: Parks are valuable resources to promote physical activity (PA) among all ages. However, studies investigating the longer-term effect of park renewal on park-based PA are scarce and have not been conducted in...
BACKGROUND: Parks are valuable resources to promote physical activity (PA) among all ages. However, studies investigating the longer-term effect of park renewal on park-based PA are scarce and have not been conducted in Europe. This study builds upon prior research investigating the immediate effects of a total park renewal in Belgium on park-based PA. Specifically, it examines the overall and age-specific effects of the renewal one year and two years after its completion, providing insights into the longer-term impact on park-based PA. METHODS: A natural experiment was conducted by observing the behaviour of the park visitors in two urban public parks (i.e., intervention and control park). The intervention involved extensive park renewal, including increased size, adding outdoor fitness equipment, a multi-use sports cage, six playgrounds targeting children of different ages, various benches, wheelchair-accessible picnic tables, wide concrete pathways, and removal of low vegetation. Observations were performed before, immediately after, and one and two years after the renewal using the System for Observing Play and Recreation in Communities. The number of visitors observed sedentary, walking or vigorously active were recorded according to age group and mean PA intensity levels were calculated. General(ized) linear models were fitted to assess the effect of the renewal on visitors’ PA in the park. RESULTS: Overall, an increase was observed in the total number of visitors engaged in sedentary and vigorous activities one and two years after the renewal. However, no evidence for effects were found for the total number of visitors observed walking or for the mean PA intensity levels of the visitors. There were some age-specific differences: the number of adults and older adults observed sedentary increased, whereas no such effect was found for children or adolescents. Positive effects were observed for the number of adolescents, adults and older adults observed walking. Additionally, the number of children, adolescents and older adults engaging in vigorous PA increased in the intervention park compared to the control park. CONCLUSION: Extensive urban park renewal can increase both sedentary and active visitor numbers one and two years post-renewal, although effects vary across age groups.
Temporal trends of no moderate to vigorous physical activity in adolescents: a 16-year trend analysis of 115,926 participants.
Chen S, Brown D, Pfledderer CD … +2 more , Huang WY, Tremblay MS
Int J Behav Nutr Phys Act · 2025 Dec · PMID 41345642 · Full text
BACKGROUND: Engaging in no moderate-to-vigorous physical activity (MVPA) has been recognized as an important indicator in physical activity (PA) surveillance, as any engagement in MVPA confers health benefits compared to...
BACKGROUND: Engaging in no moderate-to-vigorous physical activity (MVPA) has been recognized as an important indicator in physical activity (PA) surveillance, as any engagement in MVPA confers health benefits compared to none. Studying the prevalence of no MVPA can provide valuable insights into physical inactivity patterns and inform public health intervention efforts. While some cross-sectional studies have examined this issue, no research has analysed year-to-year trends. Therefore, the aim of this study was to assess trends of no MVPA among adolescents and key subgroups using a nationally representative US sample. METHODS: Data from 2005 to 2021 cycles of the Youth Risk Behavior Surveillance System were used, with 115,926 US adolescents aged 14-17 years included (female: unweighted sample size = 58,582, 50.5%; weighted%=49.4%). Participants self-reported their demographic (sex, age, race/ethnicity, body mass index) and behavioural information (days of ≥ 60 min of MVPA over the past week, and recreational screen time). No MVPA was operationalized as reporting 0 days of ≥ 60 min of MVPA. Trend analysis was performed to assess temporal variations from 2005 to 2021 using a series of binary logistic regression models after controlling for demographic and screen time related variables. RESULTS: Declining trends in no MVPA were observed among adolescents from 2005 (weighted: 24.3%) to 2021 (weighted: 15.5%). After stratifying by sex, age, race/ethnicity, body mass index and recreational screen time, similar downward trends were shown across all adolescent subgroups consistently (p for trend < 0.001). Girls, older adolescents, those who identified as non-White, adolescents with excess weight, and those engaging in more than 2 h of recreational screen time per day tended to report no MVPA at higher rates (all p < 0.001) compared to their counterparts. CONCLUSIONS: No MVPA has declined among the US adolescents, especially after 2009. Notably, sociodemographic disparities were observed in no MVPA among different population subgroups. PA promotion strategies targeting girls and older adolescents should be prioritized to further reduce the prevalence of no MVPA.
Effects of the '10,000 Steps Duesseldorf' intervention promoting physical activity in community-dwelling adults: results of a nonrandomized controlled trial.
Matos Fialho PM, Schmitz E, Vomhof M … +6 more , Icks A, Lang A, Kuss O, Cardon G, Weyers S, Pischke CR
Int J Behav Nutr Phys Act · 2025 Dec · PMID 41339900 · Full text
BACKGROUND: Despite approximately half of the German general population not meeting the physical activity (PA)-guidelines of the World Health Organization with further decreases noted during the pandemic, population-base...
BACKGROUND: Despite approximately half of the German general population not meeting the physical activity (PA)-guidelines of the World Health Organization with further decreases noted during the pandemic, population-based intervention strategies to tackle this public health problem remain sparse. This study aimed to replicate the successfully delivered “10,000 Steps Ghent” intervention and research trial conducted in Belgium, two research questions were examined: (1) Do individuals located in the city that a complex PA intervention is implemented in (Duesseldorf) engage in more PA compared to individuals located in the control city (Wuppertal) after one year? (2) Is the proportion of those reaching 10,000 steps/day higher in the intervention than in the control city after the intervention? METHODS: A nonrandomized controlled intervention trial was conducted among residents of two German cities. The 12-month intervention ‘10,000 Steps Duesseldorf’ was designed as a multicomponent intervention targeting different socioecological levels: at the intrapersonal level, a website allowed participants to self-monitor their steps; at the organizational level, workplaces and community groups were engaged through step count competitions; and at the community and policy levels, a city-wide media campaign to increase awareness regarding PA benefits was rolled out and street signage indicating walking routes were posted in different city district of Duesseldorf. To investigate intervention effects, PA was assessed via pedometers in two representative samples of adults aged 25–75 years from Duesseldorf (intervention) and Wuppertal (control). Measurements were taken at baseline (April 2021-March 2022) and again one year later (May–November 2023) and the same participants recorded their steps over a 7-day period at both time points. Baseline differences in socio-demographic and health-related variables between intervention and control were adjusted for in a propensity score model with matching weights. RESULTS: 627 adults completed baseline and 553 the follow-up assessment (60% female, 60% intervention across both timepoints and cities). The results of the propensity score analyses revealed that intervention participants walked an average of 462 steps per day more (95% confidence interval: -146 to 1070) than controls at follow-up. However, the proportion of residents reaching 10,000 steps/day was comparable between intervention and control (Duesseldorf: 26.4%, Wuppertal: 25.6%) after the intervention (odds ratio 1.04, 95% confidence interval: 0.41 to 2.66). CONCLUSIONS: Although the increase in step count detected in our study was promising, further intervention efforts and accompanying research are needed to meet the minimally relevant intervention effect of 1000 steps that was set in the original Ghent study. TRIAL REGISTRATION: German Clinical Trials Register DRKS00024873 (Date of registration: April 21st, 2021; URL: https://drks.de/search/de/trial/DRKS00024873 ).
The great live and move challenge and the promotion of physical activity in children: results from a two-school-year cluster-randomized trial.
Gourlan M, Lambert C, Fregeac B … +6 more , Mora L, Jeanleboeuf F, Minotte A, Coste O, Pereira B, Cousson-Gélie F
Int J Behav Nutr Phys Act · 2025 Dec · PMID 41327252 · Full text
BACKGROUND: Population surveys indicate that a large proportion of children worldwide do not meet the recommended 60 min of moderate-to-vigorous physical activity (PA) daily. This study aimed to assess the impact of the...
BACKGROUND: Population surveys indicate that a large proportion of children worldwide do not meet the recommended 60 min of moderate-to-vigorous physical activity (PA) daily. This study aimed to assess the impact of the Great Live and Move Challenge (GLMC), a theory of planned behavior (TPB)-based intervention, on PA and TPB variables in French primary school children over two school years. Secondary objectives included assessing whether TPB variables mediated the GLMC's impact on PA and whether the GLMC impacted the strength of the link between TPB variables. METHODS: A cluster-randomized controlled trial was conducted over 16 months. One hundred primary schools were randomized into an intervention or control group. A total of 2723 children aged 7-11 years (mean age: 9.1; 49.7% boys) were included (n intervention = 1420, n control = 1303). The GLMC, based on TPB, comprised a motivational phase (targeting attitudes, subjective norms, and perceived behavioral control) and a volitional phase (notably focusing on the intentions-PA link). The intervention involved teachers, parents, and community stakeholders. The primary outcome was the change in the proportion of children meeting PA guidelines after 16 months. Secondary outcomes included changes in mean daily PA and TPB variables. Assessments occurred at baseline, 4, 12, and 16 months. Data were analyzed using mixed models and path analyses. RESULTS: The "time × group" interaction indicated that, compared with the control group, the intervention group had a significantly higher proportion of children meeting international PA guidelines after 16 months (OR = 3.38, 95% CI = 2.50 to 4.56, P < 0.001). TPB variables did not significantly mediate the impact of the GLMC on mean daily PA at 16 months. The path coefficient between intentions and mean daily PA was significantly higher in the intervention group than in the control group at 4 (CR = 2.45; β = 0.22 vs. 0.13) and 16 months (CR = 2.87; β = 0.24 vs. 0.14). CONCLUSIONS: The GLMC increased the proportion of children meeting PA guidelines over 16 months, and may help bridge the intentions-PA gap. The absence of mediation by TPB variables highlights the need to investigate other psychosocial mechanisms to better understand how the GLMC promotes PA in children. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN) Registry: 61,116,221 (retrospectively registered).
Changing patterns and associated factors of exercise participation and physical activity levels among middle-aged and older adults from 2011-2020 in China.
Hua N, Zhang X, Wu F … +3 more , Yang Y, Zhang Q, Chen J
Int J Behav Nutr Phys Act · 2025 Nov · PMID 41318633 · Full text
BACKGROUND: Physical inactivity remains a global concern. Understanding population-level physical activity (PA) trends is essential for evidence-based policy-making. METHODS: Repeated cross-sectional analysis was conduct...
BACKGROUND: Physical inactivity remains a global concern. Understanding population-level physical activity (PA) trends is essential for evidence-based policy-making. METHODS: Repeated cross-sectional analysis was conducted using the five waves (2011-2020) of data from the China Health and Retirement Longitudinal Study. PA was assessed by the International Physical Activity Questionnaire. PA sources (job demands, entertainment, exercise, and others) were assessed since 2013. Age- and sex-standardized prevalence was calculated. Log-binomial regression was performed to explore associated factors. RESULTS: Among Chinese adults ≥ 45 years, weekly exercise participation nearly doubled from 22.6% (2013) to 43.9% (2020). Job-related PA declined but remained the major source of moderate-to-vigorous PA. Insufficient PA prevalence demonstrated slight fluctuations, bottoming at 19.6% in 2018 between 2011 (23.9%) and 2020 (22.2%), with significant reductions in adults ≥ 75 years (-12.7%), females (-5.8%), urban residents (-5.5%), hypertension (-4.1%) or diabetes (-9.7%) groups. By 2020, insufficient PA was more prevalent among adults ≥ 75 years (41%, PR: 2.06, 95% CI: 1.65 to 2.57), individuals with low socioeconomic status (SES) (PR: 1.41, 95% CI: 1.26 to 1.59), rural residents (PR: 1.13, 95% CI: 1.01 to 1.26), and individuals with dyslipidemia (PR:1.12, 95% CI: 1.00 to 1.24). CONCLUSION: Our study provides national updated evidence showing exercise participation doubled among middle and older Chinese, yet insufficient PA remained stable over the past decade, which is likely attributable to reductions in job-related PA. In the context of rapid lifestyle and societal changes, future policies and intervention programs need to co-target exercise and varied PA domains and prioritize high-risk populations, including advanced age seniors, rural residents, and low SES groups, to alleviate inequities.
Effectiveness of a smartphone-delivered Approach-Avoidance intervention in dietary behavior - a randomized controlled trial.
Aulbach MB, Roettger M, van Alebeek H … +3 more , Kahveci S, Schmidt J, Blechert J
Int J Behav Nutr Phys Act · 2025 Nov · PMID 41316308 · Full text
BACKGROUND: Given the therapeutic potential of Approach-Avoidance interventions (AAIs) in the alcohol domain, research has increasingly applied them to the food domain. In AAIs, harmful stimuli are avoided while healthy...
BACKGROUND: Given the therapeutic potential of Approach-Avoidance interventions (AAIs) in the alcohol domain, research has increasingly applied them to the food domain. In AAIs, harmful stimuli are avoided while healthy ones are approached, for example by respectively moving a phone away from or towards oneself. METHODS: We administered a phone-based AAI six times over two weeks to 156 participants in a pre-registered randomized-controlled trial to reduce intake of six "decrease-foods" and increase intake of six "increase-foods", selected according to each participant's individual dietary goals. The control group received a placebo task in which all stimuli were equally often approached and avoided. Food craving and intake were the outcomes, measured daily during the training period, four days before and after, and once during a follow-up one month after training. Per-food approach bias was recorded before and after training, and at follow-up. RESULTS: Compared to placebo, active training reduced the level of decrease-food craving (b = -0.19; 95% HDI [-0.31, -0.05]) without affecting how often craving occurred. Restrained eaters (b = -0.19; 95% HDI [-0.36, -0.03]) and those with low past dietary success (b = 0.13; 95% HDI [0.03, 0.24]) showed the strongest craving strength reduction. Active training also reduced approach bias for decrease-foods, albeit with weaker evidence (b = -38.10; 89% HDI [-73.82, -0.39]). We found no intervention effects on increase-foods on any outcome. There were no interpretable training effects for food intake and no changes were maintained at follow-up. CONCLUSIONS: A multisession mobile AAI reduced craving intensity for foods that participants wanted to eat less of in the 4 days after the end of the intervention period with reductions bouncing back at 4-week follow-up. It remains to future research how this can be sustained long-term and effectively translated into reduced food intake. TRIAL REGISTRATION: This study was registered in the German Clinical Trials Register, ID DRKS00030780.
Development of the Physical Activity Research Opportunities (PARO) framework.
Balis LE, Hatfield DP, Din M … +4 more , Lima-Dos-Santos SP, Stott G, Sharfman A, Brown DR
Int J Behav Nutr Phys Act · 2025 Nov · PMID 41299681 · Full text
PURPOSE: Physical activity is beneficial across the lifespan, but most Americans do not meet physical activity guidelines. Multiple sources exist that identify opportunities to address gaps in physical activity research...
PURPOSE: Physical activity is beneficial across the lifespan, but most Americans do not meet physical activity guidelines. Multiple sources exist that identify opportunities to address gaps in physical activity research knowledge and implementation. Several of these opportunities have important considerations for populations experiencing health inequities. The goal of this study was to identify, synthesize, and categorize opportunities for research (i.e., systematic investigations to develop generalizable knowledge) into a conceptual framework to advance physical activity research in a cohesive and efficient manner. METHODS: The National Collaborative on Childhood Obesity Research convened subject matter experts to conduct five qualitative document analysis steps: (1) identify sources published by United States government, intergovernmental, or national non-profit organizations related to physical activity, (2) review sources to extract research opportunities, (3) code the opportunities by variables (translational research phase, social ecological level, setting, and priority population) determined by the expert group, (4) synthesize data on similar opportunities, and (5) review crosstabulation data to examine coding patterns and develop a framework. RESULTS: Opportunities (n = 385) were extracted from sources (n = 11) and combined into condensed opportunity statements (n = 87). Most called for effectiveness research (n = 44, 51%) or dissemination and implementation science research (n = 14, 16%). 38% were related to policy, systems, and environmental interventions (n = 33), and 70% mentioned community settings (n = 61). Additionally, 76% did not include health equity considerations (n = 66), and 75% mentioned no specific population or populations across the lifespan (n = 65). The resultant Physical Activity Research Opportunities (PARO) framework details opportunities by translational research phase (methods/measures development, etiology, efficacy, effectiveness, dissemination and implementation, and surveillance) and social ecological level (individual or interpersonal, policy/systems/environmental, and crosscutting), including health equity considerations. CONCLUSIONS: The resultant PARO framework highlights gaps in current evidence and reveals opportunities for physical activity funders, researchers, policymakers, and practitioners to strategically advance their work. There are prospects for designing efficacy and effectiveness trials with an eye toward dissemination and implementation, developing strategies for improving dissemination and implementation, and using community- and practitioner-engaged approaches across translational research phases to advance health equity. Health equity can also be addressed by tailoring interventions, enhancing reach to priority populations, and improving social determinants of health.
The right dose of data: balancing reliability and participant burden in a validated daily measure of food parenting practices.
De-Jongh González O, Mâsse LC
Int J Behav Nutr Phys Act · 2025 Nov · PMID 41299663 · Full text
BACKGROUND: Intensive longitudinal methods are increasingly used to capture daily fluctuations in food parenting practices (FPP), but reliable tools for daily assessment are limited. Most studies rely on a fixed recall p...
BACKGROUND: Intensive longitudinal methods are increasingly used to capture daily fluctuations in food parenting practices (FPP), but reliable tools for daily assessment are limited. Most studies rely on a fixed recall period for all FPP constructs; yet, the reliability of such approach remains unclear as some FPP may fluctuate more than others. Identifying the minimum number of measurement days needed can improve the feasibility and quality of daily FPP research. This Daily Diary study aimed to: 1) assess the test–retest reliability of daily FPP measures among mothers and fathers over a 14-day period; 2) estimate the minimum number of days needed to achieve adequate reliability; and 3) validate these reliability estimates using a second 14-day period. METHODS: A total of 315 parents (aged 40 ± 5 years; 60% mothers) of children aged 2.5–6 years completed 28 daily assessments across two 14-day periods, three months apart, yielding 8820 observations. Seven FPP constructs were assessed daily using 13 binary items, and evidence of validity was obtained with a Confirmatory Factor Analysis (CFA). Intraclass correlation coefficients (ICCs) were calculated from mixed-effect models using data from the first 14-day period. The Spearman-Brown formula estimated the minimum number of days needed for ICC ≥ 0.70. These minimum-day estimates were validated using the second 14-day period, drawing random sets of consecutive and non-consecutive days. RESULTS: ICCs in the first period ranged from 0.80–0.97. Required days for acceptable reliability varied by FPP construct: Coercive control (1 day); Autonomy support, Child involvement, and Meal routines (5–6 days); and Rules and limits, Nondirective support, and Healthy opportunities (8–9 days). Compared to fathers, mothers required fewer days to reliably assess Rules and Limits, Healthy Opportunities, Autonomy and Nondirective Support. Validation in the second period showed ICCs ≥ 0.70 except for Healthy opportunities, Nondirective support, and Child involvement, which had borderline ICCs (0.63–0.68) in some subgroups and sampling approaches. CONCLUSIONS: This study provides a valid and reliable instrument to measure FPP in Daily Diary protocols. Although 14 days of data collection ensures high reliability, many FPP constructs can be assessed reliably with fewer days. To reduce participant burden, researchers may tailor diary duration based on the specific construct and caregiver sex.
The influence of social network structures on leisure-time physical activity in hypertensive patients: a mixed-methods study in China.
Shen B, Pei C, Guan T … +7 more , He Y, He Z, Li H, Lu X, Yang L, Zhao J, Liu Y
Int J Behav Nutr Phys Act · 2025 Nov · PMID 41287083 · Full text
BACKGROUND: Hypertension remains a major public health challenge in China. Leisure-time physical activity (LTPA) is critical for hypertension control. Yet its social network determinants, particularly key role models, ar...
BACKGROUND: Hypertension remains a major public health challenge in China. Leisure-time physical activity (LTPA) is critical for hypertension control. Yet its social network determinants, particularly key role models, are understudied in China's familial-centric cultural context. METHODS: This sequential mixed-methods study integrated quantitative surveys with qualitative interviews among hypertensive patients in Yichang, China. A total of 2639 patients were selected from 18 primary healthcare institutions using multi-stage random sampling method. Totally, 10,550 social relationships were nominated. Quantitative data on LTPA was measured by the International Physical Activity Questionnaire Long Form, and social network characteristics (size, density, LTPA aggregation, LTPA heterogeneity, and LTPA status of specific members) was gathered through the name generator method. Generalized additive mixed models assessed nonlinear associations between social network characteristics and LTPA levels (individual-level, n = 2639); mixed-effects logistic regression analyzed member-patient LTPA linkages (relationship-level, n = 10,550). Qualitative data (n = 37) via interviews underwent grounded theory coding to contextualize mechanisms. RESULTS: Among participants, 70.56% engaged in light intensity LTPA (L-LTPA), whereas 34.82% achieved ≥ 150 minutes/week moderate-to-vigorous intensity LTPA (MV-LTPA). Nonlinear thresholds were identified: smaller networks (≤ 4 members) with higher kinship density (≥ 65%) significantly increased MV-LTPA adherence (P < 0.001). Network-level LTPA aggregation demonstrated linearly positive with MV-LTPA (P < 0.001) but triphasic associations (i.e., increase then decrease to steady) with L-LTPA (P = 0.006). Critically, having a physically active spouse was the strongest predictor of MV-LTPA adherence (OR = 1.967, 95% CI: 1.571-2.463, P < 0.001). Qualitative themes revealed that kinship networks fostered LTPA through shared norms and social support. CONCLUSIONS: Social networks represent modifiable factors that influence LTPA behaviors. Integrating network-driven strategies into hypertension management and prioritizing spouses as "exercise advocates" could promote LTPA for middle-aged and elderly hypertensive patients in China. This study advances cross-cultural behavioral theory and offers actionable solutions for pragmatic solutions for global hypertension management in aging populations under similar social context.
Association between outdoor physical activity and positive mental health in adolescence: estimating the mediation effect of autonomy, competence and relatedness.
Drapeau C, Lenze L, Montiel C … +3 more , Gallant F, Bélanger M, Doré I
Int J Behav Nutr Phys Act · 2025 Nov · PMID 41286859 · Full text
BACKGROUND: Both nature and physical activity practice have been identified as positive contributors to mental health and well-being. Engaging in outdoor physical activity (OPA) likely combines these benefits. However, t...
BACKGROUND: Both nature and physical activity practice have been identified as positive contributors to mental health and well-being. Engaging in outdoor physical activity (OPA) likely combines these benefits. However, the mechanisms through which these associations operate remain unknown. Since OPA can promote the satisfaction of the basic psychological needs of autonomy, competence and relatedness and basic psychological needs are associated with positive mental health, they could represent a mediator in the OPA-positive mental health association. The aims of this study are to 1) estimate the association between OPA and positive mental health in adolescents and 2) examine whether satisfaction of autonomy, competence and relatedness mediate this relationship. METHODS: Data from the MATCH longitudinal study were used to examine these objectives in young (14–15 years), middle-age (15–16 years) and older (16–17 years) adolescents. OPA and satisfaction of the basic psychological needs of autonomy, competence and relatedness were self-reported three times per year. Positive mental health was self-reported once per year. Linear and logistic regression models (objective 1) and mediation analyses based on counterfactual definitions of natural direct (NDE) and natural indirect (NIE) effects (objective 2) were performed, adjusting for age, gender, puberty stage, and neighborhood income. RESULTS: No association was found between OPA frequency and positive mental health in young adolescents (OR [95% CI] = 1.10 [0.69, 1.75]); however, a positive association is observed in middle-age (OR [95% CI] = 1.99 [1.11, 3.57]) and older (OR [95% CI] = 3.40 [1.25, 10.09]) adolescents. Mediation analyses suggest that only relatedness may mediate the OPA-positive mental health association among middle-age adolescents. CONCLUSIONS: Results indicate that OPA may relate differently to positive mental health across adolescence and that underpinning mechanisms need to be further investigated.
How can physical enrichment of school playgrounds improve movement behaviours and developmental outcomes in children and adolescents? A systematic review with meta-analysis.
Oppici L, Aadland KN, Aadland E … +2 more , Li M, Rudd JR
Int J Behav Nutr Phys Act · 2025 Nov · PMID 41275283 · Full text
OBJECTIVE: This study reviewed (1) the effects of physical enrichment of (pre-)school playgrounds on children's and adolescents' movement behaviours and their cognitive, psychological, and social development, and (2) how...
OBJECTIVE: This study reviewed (1) the effects of physical enrichment of (pre-)school playgrounds on children's and adolescents' movement behaviours and their cognitive, psychological, and social development, and (2) how enrichment characteristics influenced these outcomes. METHODS: A systematic review with meta-analysis was conducted following the PRISMA guidelines. We searched 7 databases (SPORTDiscus, CINAHL, MEDLINE, APA PsycINFO, Cochrane Library, Web of Science, and Scopus) and two reviewers independently screened studies for eligibility. Effect sizes of interventions were calculated using standardized mean differences (Hedges' g) and tested using random-effects models. Meta-regression was used to explore heterogeneous findings. Narrative syntheses were conducted when meta-analysis was not possible. RESULTS: Twenty-eight studies and 19,753 participants were included. Three studies had low risk of bias, 11 studies had high risk of bias, while 14 studies had some concerns. The meta-analyses for movement behaviours showed significant increases in vigorous physical activity (VPA, n = 7 studies, g = 0.17, 95% Confidence Interval (CI): 0.06, 0.27), moderate-to-vigorous physical activity (MVPA, n = 17, g = 0.17, CI: 0.03, 0.30), and steps per minute (n = 3, g = 0.81, CI: 0.03, 1.59) for enrichment interventions relative to control conditions. The results for MVPA had large heterogeneity and were only significant short-term. Line markings alone or in combination with physical structures (e.g., climbing walls) increased MVPA, while involving end-users decreased MVPA. Line markings alone or in combination with physical structures or equipment increased VPA. There was no effect of enrichment for sedentary behaviour, low or moderate intensity physical activity. The results for cognitive (attention restoration and executive functioning), psychological (wellbeing and quality of life), and social (interactions, orientations, and bullying) development were mixed. CONCLUSION: Our findings show that studies on physical enrichment had low methodological quality and findings had high heterogeneity. Line markings in isolation or combined with other enrichment strategies might increase levels of VPA and MVPA in children and adolescents. Evidence on cognitive, psychological and social development is inconclusive due to few and weak studies for these outcomes. We provide future directions for research and practice by drawing from the environmental enrichment paradigm. TRIAL REGISTRATION: PROSPERO registration number CRD42022364392.
Digital assessment of real-world walking in people with impaired mobility: How many hours and days are needed?
Buekers J, Chernova J, Koch S … +23 more , Marchena J, Lemos J, Becker C, Bonci T, Braun J, Brittain G, Buckley E, Caulfield B, Del Din S, Demeyer H, Frei A, Gazit E, Hausdorff JM, Ionescu A, Jansen CP, Klenk J, Long M, Sharrack B, Singleton D, Troosters T, Yarnall AJ, Rochester L, Garcia-Aymerich J
Int J Behav Nutr Phys Act · 2025 Nov · PMID 41272787 · Full text
BACKGROUND: Impaired mobility increases falls and mortality risk. However, guidelines to reliably assess real-world walking activity and gait remain undefined. We aimed to (i) determine the minimum daily wear time during...
BACKGROUND: Impaired mobility increases falls and mortality risk. However, guidelines to reliably assess real-world walking activity and gait remain undefined. We aimed to (i) determine the minimum daily wear time during waking hours (7:00–22:00) for a valid measurement day, (ii) identify the minimum number of valid days, and (iii) weekend days, to reliably assess weekly walking activity and gait parameters, and (iv) provide recommendations for reliable real-world walking assessments. METHODS: Participants with chronic obstructive pulmonary disease (n = 565), multiple sclerosis (n = 558), Parkinson’s disease (n = 543) or proximal femoral fracture (n = 487) from 10 countries were asked to wear a single wearable device on the lower back, 24 h/day for seven days, resulting in 13,191 measurement days. The Mobilise-D processing pipeline was used to obtain 24 daily walking activity and gait parameters. Minimum daily wear time was determined as the highest wear time category that did not statistically change parameter values. Intraclass correlation coefficients ≥ 0.80 determined the minimum number of valid measurement and weekend days. RESULTS: The minimum daily wear time varied between “no requirement” (13% of parameter-condition combinations) and > 14 h (19%), with higher requirements for walking activity than gait parameters. The minimum number of days ranged from 1 (17%) to > 7 days (6%), and was higher for parameters that are yet to be clinically validated. There was no evidence of a weekend nor health condition effect on parameter reliability. CONCLUSIONS: For studies involving multiple walking activity and gait parameters or health conditions, expert consensus recommends a minimum of > 12 h of daily wear time across ≥ 3 days. For studies that involve specific parameters or health conditions, individual recommendations are provided within the manuscript.
Primary school-based food environment intervention increases diet diversity: Project Daire, a cluster randomized controlled trial.
Olgacher D, Wallace C, Brennan SF … +9 more , Lavelle F, Moore SE, McKinley MC, McCole P, Hunter RF, Dunne L, Cardwell CR, McCarthy D, Woodside JV
Int J Behav Nutr Phys Act · 2025 Nov · PMID 41272727 · Full text
BACKGROUND: This study explored the effects of Project Daire, a school-based food intervention, on secondary dietary outcomes Diet Diversity Score (DDS) and Diet Quality Score (DQS), among 6–7 and 10-11-year-old children...
BACKGROUND: This study explored the effects of Project Daire, a school-based food intervention, on secondary dietary outcomes Diet Diversity Score (DDS) and Diet Quality Score (DQS), among 6–7 and 10-11-year-old children. METHODS: A randomised-controlled, factorial design trial was conducted in 15 Northern Ireland primary schools across four intervention arms: Nourish, Engage, Nourish and Engage, and Control (Delayed). Nourish modified the school food environment and increased exposure to local foods, while Engage delivered educational activities on nutrition, food, and agriculture. Food consumption data were collected at baseline and at up to a 6-month follow-up. DDS and DQS (at home, at school and/or total) were determined based on the UK Eatwell Guide. RESULTS: A total of 445 children aged 6–7 and 458 aged 10–11 completed the trial. Among the 10-11-year-olds who received the Nourish intervention, significant increases were observed in the school DDS (adjusted mean difference = 2.79, 95% CI: 1.44–4.14; p < 0.001) and total DDS (adjusted mean difference = 1.55, 95% CI: 0.65–2.44; p = 0.001) compared to their counterparts who did not receive it. No such changes were observed in the DDS of 6-7-year-olds in the Nourish group, nor in either age group receiving the Engage intervention. The DQS of both age groups remained unchanged across all intervention groups. CONCLUSIONS: The Nourish intervention was associated with improved dietary diversity among older children through modifications to the whole-school environment. However, the absence of measurable effects on diet quality highlights the need for future iterations of Project Daire to incorporate additional strategies. These should include targeted approaches to improve diet quality, foster active parental engagement, utilize validated dietary assessment tools, and ensure sustained implementation. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04277312.
Non-linear dose-response association between physical activity and mental health in adolescents: a prospective cohort study based on SEARCH.
Zhang Y, Wang Z, Zhang R … +4 more , Wang Y, Yang J, Wang F, Liu Z
Int J Behav Nutr Phys Act · 2025 Nov · PMID 41267100 · Full text
BACKGROUND: Adolescent mental health has emerged as a critical public health issue, with increasing prevalence of anxiety and depression. Physical activity (PA) is known to offer numerous health benefits, but its relatio...
BACKGROUND: Adolescent mental health has emerged as a critical public health issue, with increasing prevalence of anxiety and depression. Physical activity (PA) is known to offer numerous health benefits, but its relationship with adolescent mental health is less clear and the optimal intensity and duration remain debated. METHODS: This prospective cohort study analyzed data from 6,991 adolescents in Jiangsu, China. Mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ), and PA was categorized as moderate-intensity PA (MPA) or vigorous-intensity PA (VPA) based on self-reported activity levels. The study examined the cross-sectional and longitudinal associations between PA and mental health, adjusting for various confounding factors. RESULTS: Among the cohort (mean age, 12.71 ± 2.12 years; 53.6% male), 1,265 participants (18.1%) had mental health issues at baseline. Cross-sectional analyses revealed a significant negative non-linear dose-response association between levels of MPA and VPA and the prevalence of mental health problems in adolescents (P = 0.001), after adjusting for potential confounding factors such as age, gender, nationality, and family structure. Specifically, adolescents who engaged in 30-59 min of MPA daily exhibited a 56.4% reduction in the odds ratios of mental health issues (OR = 0.436, 95% CI: 0.327-0.581, P < 0.001). Similarly, those who participated in up to 29 min of VPA daily had 49.2% lower odds ratios (OR = 0.508, 95% CI: 0.415-0.622, P < 0.001). Longitudinal analyses confirmed that MPA and VPA were significantly negatively associated with the incidence of subsequent mental health problems. In particular, adolescents who engaged in 30-59 min of MPA daily (OR = 0.548, 95% CI: 0.411-0.729, P < 0.001) and up to 29 min of VPA daily (OR = 0.583, 95% CI: 0.474-0.716, P < 0.001) demonstrated the strongest protective effects. Sensitivity analyses and subgroup analyses also confirmed the robustness of these results. CONCLUSIONS: Significant positive associations exist between moderate PA and improved adolescent mental health outcomes. The better effects are observed with 30-59 min of MPA or ≤ 29 min of VPA daily. Exceeding these durations may not yield additional benefits. When promoting PA among adolescents, focus should be placed on selecting appropriate activity types and scientifically managing activity duration.
Correction to: 2025 position statement on active outdoor play.
Lee EY, de Lannoy L, Kim YB … +14 more , Rathod A, James ME, Lopes O, Nasrallah B, Thankarajah A, Adjei-Boadi D, de Barros MIA, Duncan S, Miller RM, Mygind L, Vanderloo LM, Wang PY, Tremblay MS, AOP10 Steering Committee Group
Int J Behav Nutr Phys Act · 2025 Nov · PMID 41267054 · Full text
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