BACKGROUND:Engagement in regular physical activity throughout childhood is fundamental to physiological development and prevention of chronic disease. Despite strong evidence supporting its benefits, many young Australians fail to achieve recommended physical activity levels, with rural children and youth in particular experiencing challenges to participation. Understanding the reasons for low participation and identifying strategies to enhance engagement within rural communities is critical to equitable health promotion. This scoping review synthesized current literature to identify barriers and facilitators to physical activity for rural and remote children and youth in Australia. METHODS:This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Reviews guidelines. Four databases were searched to identify peer-reviewed studies examining barriers and facilitators to physical activity among Australian rural children and youth. Narrative synthesis was used to analyze texts, then identified barriers and facilitators were categorized using an adapted socioecological framework. RESULTS:Twenty-one studies met the inclusion criteria. Narrative synthesis revealed 46 barriers and 40 facilitators to physical activity engagement. Findings showcased barriers including accessibility, self-exclusionary behaviors, gender norms, and negative social environments. Facilitators included social support, use of school infrastructure, and positive sporting environments. CONCLUSION:Children and youth in rural areas face multifaceted barriers and facilitators to physical activity, shaped by social and physical environments. While this review provides an emerging understanding of these factors and their practical implications, further research is needed to develop a deeper understanding and to ensure future service provision is tailored to the context of rural children and youth.
BACKGROUND:Autistic adults experience lower levels of physical activity (PA) than nonautistic adults and face health inequities associated with inactivity. While barriers and facilitators to PA have been synthesized for autistic children and youth, comparable evidence focused on autistic adults remains limited. This scoping review synthesized perceived barriers and facilitators to PA participation among autistic adults and mapped these determinants onto the Behavior Change Wheel and Theoretical Domains Framework. METHODS:Five databases (MEDLINE, CINAHL, Scopus, SPORTDiscus, and ProQuest) were searched in December 2023, and the search was updated in December 2025. Eligible studies were English-language empirical quantitative, qualitative, or mixed-methods studies examining perceived barriers and/or facilitators to PA participation among autistic adults and their parents/caregivers. Extracted determinants were charted and mapped to Theoretical Domains Framework domains. RESULTS:Fifteen studies were included. Across studies, 48 barriers and 34 facilitators were identified. Barriers were represented in all Theoretical Domains Framework domains except optimism, whereas facilitators were represented in all domains except knowledge, social/professional role and identity, and optimism. Environmental context and resources and social influences were most prominent. Key barriers included inaccessible or sensory-challenging environments, financial and time constraints, competing sedentary routines, lack of autism-informed support, stigma, and negative PA experiences. Key facilitators included accessible and sensory-friendly settings, social supports, enjoyable and personally meaningful goals, and autonomy-supportive participation. CONCLUSIONS:PA participation among autistic adults is shaped by interactions among capability, opportunity, and motivation. These findings provide a foundation for theory-based, autism-informed, and autonomy-supportive PA interventions.
BACKGROUND:Research on associations between the built environment (BE) and health has expanded globally, but evidence from Gulf Cooperation Council countries remains fragmented. OBJECTIVE:To systematically synthesize and critically appraise evidence on associations between BE attributes and health-related outcomes in Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the UAE. METHODS:Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, Web of Science and Scopus were searched for peer-reviewed studies published between January 2000 and May 2024. Eligible studies quantitatively examined associations between BE attributes and health-related outcomes among Gulf Cooperation Council populations. Two reviewers independently screened studies, extracted data, and assessed methodological quality and risk of bias. Due to heterogeneity in BE measures, health outcomes, and study designs, findings were synthesized narratively. RESULTS:Of 371 records identified, 79 studies met the inclusion criteria. Nearly all were cross-sectional (n = 78), with only one longitudinal study. Evidence supported positive associations between neighborhood accessibility (eg, walking and cycling infrastructure, destination proximity, and public transport access) and land-use characteristics (eg, mixed use and green/open spaces) with physical activity, walkability, and quality of life. Car-oriented urbanization, extreme heat, and sociocultural constraints, particularly gender-related barriers to recreation, emerged as important contextual factors. Evidence linking BE attributes to dietary behaviors, chronic disease outcomes, and mental health was limited and generally of low certainty. CONCLUSION:Accessibility, land use, thermal environment, and urban form appear associated with health-related behaviors and outcomes in the Gulf Cooperation Council. However, methodological limitations constrain causal inference, highlighting the need for longitudinal and policy evaluation studies to inform healthy-city planning in hot-arid environments.
PURPOSE:This study aimed to identify distinct physical activity (PA) trajectories among middle-aged and older adults using group-based trajectory modeling and to examine whether these trajectories were associated with different sarcopenia-related profiles. METHODS:Data were obtained from 2029 individuals aged 40 years and older who participated in the China Health and Retirement Longitudinal Study in 2011, 2013, and 2015. PA was assessed using the International Physical Activity Questionnaire. Sarcopenia-related outcomes included low muscle strength, poor physical performance, low muscle mass, possible sarcopenia, and sarcopenia. RESULTS:Compared with the low-stable group, individuals in the moderate-stable group had lower odds of poor muscle strength (adjusted odds ratio [aOR] = 0.70; 95% CI, 0.52-0.93) and sarcopenia (aOR = 0.58; 95% CI, 0.39-0.88). Individuals in the high-stable group had lower odds of poor muscle strength (aOR = 0.70; 95% CI, 0.51-0.97), poor physical performance (aOR = 0.73; 95% CI, 0.54-0.98), and sarcopenia (aOR = 0.57; 95% CI, 0.36-0.91). Stratified analyses suggested sex- and age-specific association patterns, with significant associations mainly involving muscle strength and muscle mass in men and physical performance and possible sarcopenia in women. Subgroup analyses suggested that these associations differed by sex and were more evident in older age groups. CONCLUSIONS:Distinct PA trajectories were associated with different patterns of sarcopenia-related risk among middle-aged and older adults. These findings suggest that trajectory-based PA assessment may provide additional information beyond single-time PA measures and support more refined muscle health risk stratification.
BACKGROUND:Sport policy focuses on increasing community-level participation numbers and on development and performance at the elite level. There is limited literature on participation trends across demographic subgroups with specific references to sport policy. The study aim was to investigate the latest sport participation trends and discuss them through the lens of sport policy and sport offerings. METHODS:Community-level registered sport participants/players from 10 major sports in Victoria, Australia, were combined to examine broad participation trends. Age-Specific participation rates were calculated for each age cohort, sex, year, and region. RESULTS:Overall participation numbers increased from 749,037 in 2015 (12.6%) to 939,295 in 2023 (14.2%). However, participation increases were not consistent. The largest decline in participation was for those aged 10-11 years, with participation in 2023 (69.7%) 7% points lower than the peak in 2017 (77.3%). Participation was consistently higher in regional compared with metropolitan areas and for males compared with females. CONCLUSION:This study demonstrates that, while overall numbers of participants playing sport have increased, there are inconsistencies across age, sex, and region. We recommend that sport policy and research focus on physical literacy and retention of participants, specifically for children, and the transition of individuals into different sport offerings that match their motivations, needs, and desires. Further, the sex and regional participation disparities require investigation. Without formative action, we are at risk of failing to provide sporting opportunities that are suited to our children and youth, which will impact their health and well-being and the sporting system for both community and elite.
BACKGROUND:The built environment can play an important role in encouraging physical activity (PA). In the United States, zoning policies are a primary lever by which jurisdictions can create built environments that are more conducive to PA. While several studies have shown associations between activity-oriented zoning and PA, they have all relied on self-reported PA data. This cross-sectional study examined associations between activity-oriented zoning and objective measures of walking and biking trips from StreetLight Data, Inc, derived from mobile device location-based services. METHODS:County-aggregated, population-weighted data on exposure to code reform and transit-oriented development zoning and 8 specific activity-oriented zoning provisions (sidewalks, crosswalks, bike-pedestrian connectivity, street connectivity, bike lanes, bike parking, bike-pedestrian trails/paths, and mixed use) as of 2010 were linked to 2019 data on walking and biking trips per 1000 county residents for 154 counties in 35 states and D.C. Multivariable linear regression models were computed with robust standard errors to analyze associations between each of the zoning measures and walking and biking trips, controlling for county-level characteristics. RESULTS:Having 100% (vs 0%) of the county population exposed to transit-oriented development zoning was associated with 145 more average daily walking trips per 1000 county residents. Exposure to zoning provisions for crosswalks, bike-pedestrian connectivity, street connectivity, bike lanes, bike parking, bike-pedestrian trails/paths, mixed use, and transit-oriented development were associated with 15 to 27 more biking trips per 1000 county residents. CONCLUSIONS:Results highlight the potential role of zoning in providing greater opportunities for people to meet PA recommendations by creating opportunities for walking and biking.
BACKGROUND:Safe passage interventions aim to enhance public safety and improve access to community resources, including public parks, in underserved communities. However, no studies have directly compared community- and police-led safety interventions with respect to park-based moderate to vigorous physical activity (MVPA). To address this gap, we compared associations between Community-led Safe Passage Services (SPS) and the Los Angeles Police Department Community Safety Partnership (CSP) program with MVPA in South Los Angeles public parks. METHODS:We conducted structured observations of 3997 park users across 8 SPS and 9 CSP parks in South Los Angeles using the System for Observing Play and Recreation in Communities and the Physical Activity Resource Assessment. We applied t tests, analysis of variance, and hierarchical linear models to examine MVPA across park intervention types. RESULTS:Overall, MVPA was higher in SPS parks (P < .001). Black, male, teen, and adult park users exhibited significantly higher MVPA in SPS parks (P < .001). A hierarchical linear model controlling for sex, age, race, and park conditions indicated that Black park users were significantly less physically active in CSP parks (P = .05). Conversely, Black park users had significantly higher MVPA in SPS parks (P = .034). Intervention type was a stronger predictor of MVPA than park features and amenities, whereas incivilities were negatively associated with MVPA (P < .001). CONCLUSIONS:Community-led safety interventions may promote physical activity among Black park users. These findings suggest that community-led public park safety models are a promising approach for advancing health equity.
INTRODUCTION:Previous studies show rural populations face elevated chronic disease risk and barriers to physical activity (PA). We examined how PA varies across rurality using the Rural Urban Commuting Area (RUCA) 4-category system. METHODS:Accelerometer data from Black participants and White participants in the REasons for Geographic and Racial Differences in Stroke cohort study were analyzed across RUCA classification: isolated, small rural, large rural, and urban. PA was categorized into 3 intensities based on counts per minute (CPM): sedentary behavior (SB, <50 CPM), light-intensity physical activity (LIPA, 50-1064 CPM), and moderate-to-vigorous intensity physical activity (≥1065 CPM). RESULTS:Data were from 7317 participants (age 63.5 [8.5] y, 46% men, 32% Black, 79% urban). Urban participants engaged in the most SB (690.6 [117.6] min/d) and the least LIPA (187.5 [78.1] min/d). Rural residents engaged in significantly more LIPA and less SB than urban residents in fully adjusted models. Moderate-to-vigorous intensity physical activity was low across RUCA groups (mean 13.1 [17.6] min/d). A significant interaction was observed between education and RUCA category for LIPA (P = .03). Individuals in small rural areas with less than a high school education engaged in 46.7 more minutes per day of LIPA than urban residents with a college education (P = .001). CONCLUSIONS:Moderate-to-vigorous intensity physical activity was low across RUCA categories with rural-urban differences in PA driven by LIPA and SB. Educational attainment modified the association between rurality and LIPA, suggesting education may play a role in rural-urban differences in PA. Shared barriers contributing to low moderate-to-vigorous intensity physical activity need further exploration.
BACKGROUND:Recruiting older adults to public health interventions is challenging, and underrepresentation can have important consequences for research outcomes and scalability. This paper reports the process of recruiting participants and the effectiveness of strategies employed in the "Walk with Me" study, a physical activity intervention targeting older adults in areas of socioeconomic disadvantage in Northern Ireland. METHODS:Thirty-eight community organizations and 10 general practices located in areas of socioeconomic disadvantage were involved in recruiting activity over an 18-month period. Recruitment methods included letters from general practices and the distribution of study information through local community organizations. Demographic information about participants and how they heard about the study were collected as part of baseline data collection for the trial. RESULTS:Of the 364 participants recruited, information on recruitment source was available from 355 (124 males, 230 females, and 1 who did not identify as either male or female). Of these, 328 (92.4%) self-reported that they were recruited via a letter from their general practitioner, and 27 (7.6%) reported being recruited from other sources. Postintervention focus groups with 30 participants identified their reasons for participating included a perception that their general practitioner had selected them personally, it provided an opportunity for a health check as access to a general practitioner can be difficult, and they were encouraged to participate by family members. CONCLUSIONS:Recruitment to community-based interventions requires partnerships with general practices to ensure successful completion. Findings provide insight into the recruitment of older adults in a community-based physical activity intervention.
BACKGROUND:Physical inactivity and mental distress were prevalent across African populations during COVID-19. However, limited research has explored the role of sedentary time in shaping mental health outcomes during the pandemic. In this study, sedentary time during COVID-19 and its moderating role in the relationship between COVID-19 symptom burden and mental health outcomes were examined in Botswana, Ghana, Nigeria, and Tanzania. METHODS:Cross-sectional data (April 2020 to November 2022) from 3125 adults (male = 52.3%, Mage = 27.05, SD = 8.91) were analyzed. Participants completed self-report measures of COVID-19 symptoms (eg, persistent cough and unusual fatigue), physical activity and sedentary time (International Physical Activity Questionnaire-Short Form), as well as anxiety (Generalized Anxiety Disorder 7) and depressive symptoms (Patient Health Questionnaire). RESULTS:Median sedentary time per day was lower in Nigeria (median = 120, interquartile range = 150) and Tanzania (median = 120, interquartile range = 180) than in Botswana and Ghana (median = 180, interquartile range = 180). Overall, sedentary time moderated the positive relationship between COVID-19 symptom burden and depressive symptoms (B = 0.60, P = .012), with stronger associations at higher sitting time (simple slope: B = 2.27, P < .001). At the country level, this moderating effect was observed only in Ghana (B = 1.38, P < .001; simple slope: B = 2.40, P < .001). CONCLUSIONS:These findings highlight cross-country variation in sedentary time during the pandemic and suggest that greater sedentary time exacerbated the relationship between COVID-19 symptom burden and depressive symptoms, particularly in Ghana. Context-specific factors and differing pandemic responses may help explain these country-level differences.
BACKGROUND:Physical activity (PA) may help to delay or possibly prevent cognitive decline and dementia. However, few studies have adopted a life-course approach to prospectively examine repeated measures of PA in relation to cognitive decline. METHODS:Framingham Heart Study Offspring and Omni 1 participants without prevalent dementia who had ≥3 self-reported PA measures and ≥2 cognitive domain factor score measures were included (n = 2229). Memory, executive function, and language factor scores were previously derived using bifactor confirmatory factor analysis models. Group-based multitrajectory models characterized PA patterns over the adult life-course (ages 17-96 y). Linear mixed-effects models estimated annual changes in cognitive domain factor scores across PA trajectory groups over the same time period. RESULTS:We identified 4 PA trajectories: (1) stabilizers: decline from early adulthood through midlife and then stable after age 50 (n = 176), (2) decliners: constant decline over adulthood (n = 526), (3) reversers: increase from early adulthood through midlife and then decline after age 70 (n = 1145), and (4) plummeters: slow decline from early adulthood through midlife and then sharp decline after age 75 (n = 382; reference). Compared with the reference group, stabilizers had 0.012 SD/year (95% CI, 0.004-0.02) slower memory decline, 0.012 SD/year (95% CI, 0.005-0.02) slower executive function decline, and 0.015 SD/year (95% CI, 0.007-0.02) slower language decline. Decliners had slower cognitive decline across all domains, and reversers had slower language decline. CONCLUSIONS:Our findings suggest that sustaining PA in mid-to-late life and preventing later life declines may help mitigate cognitive decline with aging.
BACKGROUND:Physical activity participation varies across demographic groups; however, less is known about how intersecting sociodemographic characteristics influence the likelihood of meeting physical activity guidelines in Aotearoa, New Zealand. This study explored the type and number of characteristics most strongly associated with reduced odds of meeting physical activity guidelines in New Zealand. METHODS:The Active New Zealand 2023 adult and young people surveys were used. Sociodemographic characteristics included age, gender, ethnicity, deprivation, and disability. Multivariable logistic regression analyses estimated the odds ratio (OR) and 95% confidence interval (CI) for the association between meeting physical activity guidelines and the number and type of demographic characteristics. RESULTS:Of 5890 young people, the lowest odds of meeting physical activity guidelines were among participants identifying as Asian (OR = 0.48, 95% CI = 0.39-0.59), when holding other characteristics constant. Of 15,836 adults, the lowest odds were among participants with a disability (OR = 0.51, 95% CI = 0.44-0.58). For both samples, the odds of meeting physical activity guidelines lowered for every increment in the number of characteristics. After stratifying by gender, young males had lower odds of meeting physical activity guidelines across each count of characteristics compared with young females (one characteristic: OR = 0.45, 95% CI = 0.36-0.56; 2 characteristics: OR = 0.26, 95% CI = 0.21-0.36; 3 or more characteristics: OR = 0.17, 95% CI = 0.10-0.29). CONCLUSION:The findings from this study highlight the need to account for the intersectionality of individuals' sociodemographic characteristics when designing future physical activity programs.
AIM:The neighborhood influences lifestyle interventions for cancer survivors. We evaluated the moderating role of perceived neighborhood environment on physical activity outcomes of a diet and physical activity intervention tailored to urban Latina breast cancer survivors. METHODS:This secondary data analysis included a subset of Latina breast cancer survivors (n = 86) who participated in ¡Mi Vida Saludable! (n = 167), a randomized trial evaluating eHealth and in-person diet and physical activity interventions. The eHealth component included motivational and informational messaging, and the in-person component included nutrition and physical activity education. We assessed neighborhood aesthetics and walkability perceptions at baseline. Moderate to vigorous physical activity (MVPA) and body mass index were assessed at baseline and 6 and 12 months. Generalized estimating equations estimated intervention effects on MVPA and body mass index. Interaction terms tested whether perceived neighborhood aesthetics and walkability moderated intervention effects. RESULTS:Latinas with lower incomes and less education more commonly reported low perceived neighborhood aesthetics and walkability. Lower perceptions negatively moderated the effects of the eHealth intervention on change in MVPA between baseline and 6 months: 6-month MVPA change from the eHealth intervention was 501 minutes per week lower (95% CI, -837 to -165) comparing low versus high perceived neighborhood aesthetics and 454 minutes per week lower (95% CI, -799 to -109) comparing low versus high perceived neighborhood walkability. Neighborhood perceptions did not moderate effects of the in-person intervention on MVPA or body mass index at any time point. CONCLUSIONS:Among urban Latina breast cancer survivors, poorer neighborhood perceptions were associated with smaller physical activity improvements following an eHealth intervention. Future interventions should account for neighborhood perceptions.
BACKGROUND:Cycling contributes substantially to public health and sustainable mobility. For children and adolescents, safe participation in active transport depends on the acquisition of age-appropriate cycling competences. Schools offer a unique setting to promote cycling skills with broad and equitable reach. This study evaluates bikepool, a large-scale, school-based cycling program implemented across the German federal state of Hesse. METHODS:A mixed-methods evaluation was conducted using a quasi-experimental pre-post design. Cycling competence changes were measured in secondary school students (N = 182) with a standardized skills test developed for this study. Self-reported cycling frequency was assessed via questionnaires in an intervention group (n = 109) and a control group (n = 112). Subgroup analyses examined whether intervention effects differed by initial skill level. RESULTS:Students' safety-related cycling performance improved significantly following participation in the program across most test components. The largest absolute gains were observed among students with the lowest baseline cycling competence. In contrast, participation in the program was not associated with higher self-reported cycling frequency compared with nonparticipating students. CONCLUSIONS:As a large-scale, school-based program, bikepool can significantly improve students' cycling competence across several safety-related cycling tasks. However, competence gains alone did not translate into increased cycling frequency, underscoring the need for multicomponent strategies that include supportive social and environmental conditions. Beyond intervention effects, the study points to blind spots in cycling-related physical activity research, particularly the lack of standardized assessments of cycling competence and limited surveillance of children's ability to participate safely in active mobility.
Physical activity (PA) is vital for health. Yet, participation levels in Saudi Arabia remain among the lowest globally. While Saudi Arabia's southern region has a cooler climate and a natural environment more conducive to activity, surprisingly, rates are lower than in the rest of the country. This area presents distinct cultural, social, and environmental challenges that influence how people engage in PA. This study explored how adults in the southern region of Saudi Arabia make sense of their decisions and experiences regarding PA. Semistructured interviews were conducted with 15 participants from various backgrounds. The interview questions were informed by the social-ecological model, and the data were analyzed inductively to identify themes. Two overarching themes were generated: "Release with Restrictions," which captures the apparently liberating mental and physical aspects of PA, and "PA as Investment," which highlights a strategic approach to decision making regarding engagement in PA. Participants often saw PA as a physical and mental outlet, but their ability to participate was constrained by safety concerns, social norms, and competing demands. Gender-specific barriers were particularly notable, with women facing higher costs, fewer accessible facilities, and stricter cultural expectations. While recent reforms under Saudi Vision 2030 have expanded access to female PE in schools, increased women-only fitness facilities, and improved public spaces for PA, cost-related barriers for women remain a challenge. Environmental issues, such as poor infrastructure and safety risks, further limited PA engagement. Participants also viewed PA as a form of investment in their well-being, driven by both immediate benefits, like stress relief, and longer-term health outcomes. Decisions around PA often reflected a personal cost-benefit analysis, weighing time, money, and opportunity. While recent government initiatives have helped shift norms and improve infrastructure, persistent gender inequities and unequal access highlight the need for inclusive policies and targeted campaigns that promote PA and active transport, especially among women. Systemic change where PA promotion is complemented by addressing gender inequity in access to facilities, greater local investment in safe walking and cycling infrastructure, and monitoring of response to changes in the policy and physical context is needed.
BACKGROUND:Approximately 1 in 5 US children have obesity. Primary care-based screening for healthy lifestyle behaviors is one way to identify children at risk of having obesity and related consequences; however, providers often lack tools to connect patients and families to obesity prevention. Our study sought to identify essential elements of an electronic health record-based screening and community referral system to help pediatric patients meet physical activity and nutrition guidelines. METHODS:Our mixed-methods study was conducted at a large, academic pediatric medical center in a Midwestern, US city. Qualitative data included in-depth interviews with health care workers (n = 17), focus groups with community organizations (n = 15), parents and guardians of pediatric patients (n = 9), and a bioinformatics team (n = 5). Data informed a subsequent survey with health care providers (n = 40). Multiple data collection methods and participant types triangulated findings. RESULTS:Participants indicated that a screening-referral system would need to be trusted, sustainable, and tailored. Screening should be anchored in a nonjudgmental conversation, streamlined and time efficient, and offer options that cater to individual circumstances and needs. Referrals to community resources would need to be sourced from a comprehensive and high-quality database, tailored to individuals' preferences, and kept up to date. CONCLUSIONS:Overall, participants believed a system to facilitate community referrals for physical activity and nutrition would be valuable, and suggested ways to maximize acceptability. Our study explored a way to link pediatric patients to community resources to better meet physical activity and nutrition recommendations and guides future innovations to improve obesity-related lifestyle risk factors.
BACKGROUND:Dual-task training helps improve balance and reduce falls among older adults, but self-administration of such training has yet to be explored. This study investigates the effectiveness of self-administered dual-task (sDT) compared with single-task training for improving balance and reducing falls. METHODS:Participants were 216 community-dwelling adults aged 65 years or over who had experienced at least 1 fall in the previous 6 months. Participants were assigned randomly to the sDT (n = 99) or self-administered single-task training (n = 117) group. Both groups completed 36 training sessions over 12 weeks, including 6 supervised workshops. The primary outcome was frequency of falls, while secondary outcomes included dynamic balance, dual-tasking ability, fear of falls, general health, global cognition, and quality of life. Assessment timelines included baseline, 12 weeks postintervention, and 6-month follow-up. RESULTS:The number of falls decreased in both groups. Compared with the self-administered single-task training group, the sDT group had a significantly lower fall rate (incidence rate ratio: 0.47; 95% CI, 0.34-0.64; P < .001). Immediate between-group effects showed that the sDT group had improved general health and global cognition. Immediate and long-term within-group effects in the sDT group included improved dynamic balance, standard Time Up and Go, and global cognition. No adverse events were recorded. CONCLUSION:Twelve weeks of sDT intervention was found to be safe and effective for reducing falls among at-risk participants. Future studies should evaluate the effects of sDT interventions, including a usual care control group.
BACKGROUND:The effects of physical activity (PA) interventions on blood pressure observed in current randomized controlled trials are mainly derived from older adults with high socioeconomic status (SES). Reliable evidence from low SES populations is scarce. This study aimed to examine the effects of PA intervention on blood pressure in low SES older adults. METHODS:Eight villages from Sichuan, China were randomly assigned in a 1:1 ratio to the intervention or control group. The intervention group received PA intervention, while the control did not. The main outcomes of this secondary analysis were changes in systolic and diastolic blood pressure (DBP) at 24-month follow-up from baseline. In addition, there was a change in mean arterial pressure (MAP) at 24-month follow-up from baseline. RESULTS:Among the 506 older adults, the mean age was 70.89 (SD, 5.67) years, and 281 were women. The mean baseline systolic blood pressure, DBP, and MAP in the intervention group were 134.26 mm Hg, 78.30 mm Hg, and 96.93 mm Hg, respectively. At 24 months, these were 136.44 mm Hg, 78.98 mm Hg, and 97.19 mm Hg respectively. The mean baseline systolic blood pressure, DBP, and MAP in the control group were 133.42 mm Hg, 79.06 mm Hg, and 97.16 mmHg, respectively. At 24 months, these were 133.83 mm Hg, 79.24 mm Hg, and 98.34 mmHg, respectively. No significant between-group differences were found in systolic blood pressure (1.77 mm Hg; P = .37), DBP (0.50 mm Hg; P = .66), and MAP (-0.93 mm Hg; P = .48) at 24 months. The results remained unchanged at 4 weeks, 8 weeks, and 6 months. For 12-month follow-up, there was a significant effect only in DBP (-2.44 mm Hg; P = .03). CONCLUSIONS:Among the low SES older adults, PA intervention did not significantly decrease blood pressure. This null finding suggested that future interventions should be tailored for this population and should consider a longer study period.
