Joey Murphy

Physical activity (PA) is political and has enemies. This article lays out the common understanding of enemies of physical activities, offers some critiques, and provides ways forward to improve our ability to address the harms caused by them. Knowing the enemy is vital to improving public health. An enemy is an actor that is actively or passively opposed to policies that would increase population-level PA. Examples of our enemies include the housing, transport, fuel, and car manufacturing industries when they actively or passively oppose policies that would increase population-level PA. Understanding the enemies of PA is neglected in the literature and in our advocacy efforts, to the detriment of PA policy action. To inform policy action on PA, we need to know who the enemies are, how they operate, and how they exert their power. Increasing population-level PA will not be solved by embracing apolitical actions targeting individuals, but by confronting the inherent politicalness of PA policy action to impact the population. Identifying and understanding the enemies of PA will be an important contribution to building the commercial determinants of PA and to strengthening our coalitions to advocate for a new, healthier political direction.

Most research focuses on the relationship of individual movement behaviours, neglecting how different compositions throughout the day associate with cardiometabolic health outcomes. The aim of this study was to explore the optimal awake movement behaviour composition associated with predicted cardiometabolic health outcomes in youth. The study included participants (N = 1,310 participants; 11.1 ± 2.5 [range = 7.98-17.1 years]; 55.9% female; 100% European) from the International Children's Accelerometry Database. Accelerometer measured sedentary behaviour (SB), light-(LPA) and moderate-to-vigorous physical activity (MVPA) defined the awake movement behaviour composition. Four cardiometabolic health outcomes (lipid profile, blood pressure, glucose metabolism, and body mass) were assessed through nine parameters. These were regressed against the awake movement behaviour composition, adjusting for relevant covariates to estimate the optimal awake movement behaviour composition for each predicted cardiometabolic health outcome (i.e. "Goldilocks Day"). The final models found a significant relationship between the awake movement behaviour composition and cardiometabolic health outcome, excluding lipid profile indicators. For indicators of glucose metabolism, blood pressure and body mass, the Goldilocks Day consisted of less SB (-12 to -39 min), LPA (-8 to -32 min) and more MVPA (+44 to 47 min) when compared to the sample mean. These findings concur with current guidelines that more MVPA and less SB are better, but the optimal time youth should spend in each behaviour depends on the health outcome of interest. This indicates that one size does not fit all when making recommendations for multiple cardiometabolic health outcomes.

Charitable arms of professional sports clubs and organizations (PSCOs) offer a range of health promotion (HP) programmes within communities, yet little is known about their role within approaches to HP, particularly from the view of key intersectoral partners. Our study explored the perceptions of the role of PSCOs within local approaches to HP from the perspective of multisectoral stakeholders in a southwest region of England. A qualitative single case study approach was implemented, undertaking semi-structured interviews (n = 23) with intersectoral stakeholders spanning the sport, public, voluntary, and health sectors. Findings suggest PSCOs were viewed as important organizations for provision of local HP due to their unique assets, such as stadia, branding, coaching staff and their presence within communities. However, their aims and objectives were unclear to stakeholders and often perceived as motivated by ‘brand drivers’ of the elite club, despite holding independent charitable status. Moreover, stakeholders were generally unaware of evaluation materials created by PSCOs and favoured the development of a co-produced evaluation framework for PSCOs. In conclusion, PSCOs should utilize existing community forums, networks, and working groups to better communicate organizational structure, aims, and provision amongst prospective partners. Better understanding of PSCOs structures and aims would support understanding of organizational readiness and requirements for future collaboration in intersectoral approaches to local HP. Moreover, local policymakers should consider how mutually beneficial partnerships with PSCOs could be formed, and how the unique assets, and reach, of PSCOs can be best utilized within intersectoral approaches to local HP.

Professional sports clubs and organisations (PSCOs) have been identified as effective organisations for health promotion (HP); however, their position and connectivity within local HP systems is largely unknown. Our research aimed to explore (i) who identifies PSCOs as a key partner within the delivery of local HP projects, (ii) who they collaborate with, and (iii) their perceived importance by network members. A social network analysis survey was completed by eighteen stakeholders within a South West region of England. Few organisations identified PSCOs as a key partner; however, influential organisations, such as the local authority, reported ties to them. Generally, PSCOs were not identified by network stakeholders as key organisations in the dissemination of HP knowledge or resources, such as project delivery or staffing. Limited relationships with voluntary and health sector organisations existed, and fostering such multisectoral relationships should be a priority for PSCOs in the future. PSCOs were not clearly integrated within the local HP system sampled and are siloed within their local HP activities and delivery. Future research and practice should explore how PSCOs’ assets could be best utilised with local HP and contribute towards local and national health priorities.

This is a state-of-the-art review of historical developments, current approaches and recommended future directions in physical activity (PA) research, practice and policy. Since the early epidemiological studies in the 1950s, PA research has developed from within a biomedical paradigm. There is now a strong evidence base linking PA with positive health outcomes. PA is currently understood as a multi-sector issue, requiring a multi-sector solution (e.g. transport, urban design, sport), resulting in multiple individual and societal benefits (e.g. addresses multiple Sustainable Development Goals), however, there is a disconnect between interventions, policy and practice. This may be due to limited cross-sector collaboration between, and within, the public and private sectors. Furthermore, the mix of policy instruments employed by governments to implement PA policy to date has been dominated by soft (e.g. communication) rather than hard options (e.g. fiscal). To progress in PA promotion, we need to move beyond health outcome and intervention evidence generation (e.g. focus on testing efficacy in highly controlled settings), to more complex, real world, politically informed, multi-sector, scale-up and policies, while concurrently collecting data to evaluate such efforts (e.g. natural experiments and evaluations of the policy process). PA programs may benefit from greater incorporation of public policy considerations, so that proposed interventions and policies are designed with potential political constraints in mind. We conclude by providing a call to action to advance the understanding of the role of politics in PA, in order to develop politically informed action on PA.

Background: Identifying factors related to physical activity in university students can aid the development of health promotion interventions, but there is limited research regarding the influence of university environments. This study examined the relationship between level of provision for university environments that aim to promote physical activity and self-reported physical activity patterns of students. Methods: An environmental audit tool was completed by universities (n = 28) on the island of Ireland to acquire information about physical activity opportunities, resources, and supports offered. Students (N = 6951; 50.7% male; 21.51 [5.55] y) completed an online survey, providing responses about their active transport and recreational physical activity behaviors. Binary logistic regressions were used to examine the associations between environmental factors that support physical activity and clustered physical activity patterns, while controlling for gender, age, and university size. Results: Universities with a high provision for organizational structures and internal partnerships, indoor facilities, and sport clubs increase the odds of their students having more active physical activity patterns. Increased provision of investment and personnel was seen to have a mixed relationship with students’ physical activity engagement, highlighting the need to understand where resources are needed and not just increase them. Conclusions: It is important for universities to have adequate organizational structures with internal partnerships to understand how resources can be maximized to support physical activity engagement across the whole student population. University campuses hold the potential for increasing student engagement in physical activity, and these findings can help inform campus-wide initiatives that foster active student populations for improving overall long-term health.

Purpose: Current literature reports a gap between development of effective interventions to promote physical activity and their systematic uptake into real-world settings. Factors relating to implementation and scale-up of physical activity interventions have been examined, however the perspectives of multiple stakeholders from different domains are not well researched. The purpose of this study was to examine the perceived factors related to physical activity intervention implementation and scale-up in different domains from different stakeholders on the island of Ireland. Methods: Intervention providers, coordinators, researchers, funders and policy makers in Ireland were invited to take part in a semi-structured interview exploring factors related to the implementation and scale-up of eleven different physical activity interventions. A thematic analysis was conducted to identify factors related to the implementation and scale-up of the included interventions. The data collection and analysis were guided by the Consolidated Framework for Implementation Research. Results: Thirty-eight participants took part in the interviews (11 providers, 11 coordinators, 6 researchers, 6 policy makers and 4 funders) exploring factors related to physical activity intervention implementation and scale-up. Themes identified related to intervention 1) planning (e.g. intervention development and practical considerations); 2) delivery (e.g. organisational structures, staffing and delivery resources); 3) reflection, evaluation and updating of the intervention; and 4) scale-up (e.g. ensuring fidelity and scale-up considerations). Furthermore, participants referred to the ongoing commitment, engagement, and support needed from relevant stakeholders, communities and researchers throughout the implementation process. Conclusions: This research highlights multiple factors, that are inter-related, and influence the implementation of PA interventions, but also identifies many strategies that can be utilised to enable greater likelihood of success. Future research and practice needs to consider how different factors are experienced at different implementation stages and by the different stakeholder groups involved. As one participant noted, “The intervention doesn’t go into an ideal world, it goes out into a pragmatic world”, highlighting the need to understand what implementation strategies work for who and in what contexts. Funding Source: This work was funded by the Health Research Board (HRB APA-2017–030).

Background: Self-reported physical activity (PA) questionnaires have traditionally been used for PA surveillance in children and adolescents, especially in free-living conditions. Objective measures are more accurate at measuring PA, but high cost often creates a barrier for their use in low- and middle-income settings. The advent of smartphone technology has greatly influenced mobile health and has offered new opportunities in health research, including PA surveillance. Objective: This review aimed to systematically explore the use of smartphone technology for PA surveillance in children and adolescents, specifically focusing on the use of smartphone apps. Methods: A literature search was conducted using 5 databases (PubMed, Scopus, CINAHL, MEDLINE, and Web of Science) and Google Scholar to identify articles relevant to the topic that were published from 2008 to 2023. Articles were included if they included children and adolescents within the age range of 5 to 18 years; used smartphone technology as PA surveillance; had PA behavioral outcomes such as energy expenditure, step count, and PA levels; were written in English; and were published between 2008 and 2023. Results: We identified and analyzed 8 studies (5 cross-sectional studies and 3 cohort studies). All participants were aged 12-18 years, and all studies were conducted in high-income countries only. Participants were recruited from schools, primary care facilities, and voluntarily. Five studies used mobile apps specifically and purposely developed for the study, whereas 3 studies used mobile apps downloadable from the Apple App Store and Android Play Store. PA surveillance using these apps was conducted from 24 hours to 4 weeks. Conclusions: Evidence of PA surveillance using smartphone technology in children and adolescents was insufficient, which demonstrated the knowledge gap. Additional research is needed to further study the feasibility and validity of smartphone apps for PA surveillance among children and adolescents, especially in low- and middle-income countries.

Background: There is limited understanding of the challenges experienced and supports required to aid effective advocacy of the Global Action Plan on Physical Activity (GAPPA). The purpose of this study was to assess the challenges experienced and supports needed to advocate for the GAPPA across countries of different income levels. Methods: Stakeholders working in an area related to the promotion of physical activity were invited to complete an online survey. The survey assessed current awareness and engagement with the GAPPA, factors related to advocacy, and the perceived challenges and supports related to advocacy for implementation of the GAPPA. Closed questions were analyzed in SPSS, with a Pearson’s chi-square test used to assess differences between country income level. Open questions were analyzed using inductive thematic analysis. Results: Participants (n = 518) from 81 countries completed the survey. Significant differences were observed between country income level for awareness of the GAPPA and perceived country engagement with the GAPPA. Challenges related to advocacy included a lack of support and engagement, resources, priority, awareness, advocacy education and training, accessibility, and local application. Supports needed for future advocacy included guidance and support, cooperation and alliance, advocacy education and training, and advocacy resources. Conclusions: Although stakeholders from different country income levels experience similar advocacy challenges and required supports, how countries experience these can be distinct. This research has highlighted some specific ways in which those involved in the promotion of physical activity can be supported to scale up advocacy for the GAPPA. When implementing such supports, consideration of regional, geographic, and cultural barriers and opportunities is important to ensure they are effective and equitable.