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The combination of an ageing population, increasing prevalence of preventable noncommunicable diseases and a decline in physical activity with age emphasizes the need for investment in physical activity programs and services for older people. This study aimed to add to the initial evidence on the effectiveness of the Move for Life (MFL) intervention by examining its effects on psychosocial health outcomes and determinants of physical activity. MFL is an intervention that aims to augment existing community-based public physical activity programs for middle-aged and older adults in Ireland with strategies derived from behavioural theory and support from peer leaders. A 3-arm cluster randomised feasibility trial compared MFL intervention, usual provision (UP) and waiting list control (CON) groups at baseline (T0), post-intervention (T1, at 8-, 10- or 12-weeks) and 6-month follow up after baseline (T2). Psychosocial health and determinants of physical activity were assessed at each occasion by validated self-report measures. Linear or generalized linear mixed models were fitted to estimate group differences over time. Of 733 recruited individuals, 601 (mean age: 63.06 ± 8.1 years, 80.4% female) met study inclusion criteria. Significant advantages were found in the MFL group relative to UP in ratings of self-efficacy to overcome barriers to physical activity participation, subjective norms for and attitudes towards participation in physical activity (ps < .05). Subsequent analyses accounting for implementation fidelity revealed additional advantages for the ‘high fidelity’ MFL group relative to other groups, notably regarding loneliness and relatedness to others, perceived behavioural control, attitudes toward and intentions to participate in physical activity (ps < .05). The pattern of results shows the potential of MFL to impact positively the psychosocial health of inactive adults aged 50 + years and change psychosocial determinants of physical activity, particularly when implemented as intended. The results suggest as well that existing physical activity programs may have unexpected psychosocial consequences.

Insulin activates insulin receptors (InsRs) in the hypothalamus to signal satiety after a meal. However, the rising incidence of obesity, which results in chronically elevated insulin levels, implies that insulin may also act in brain centres that regulate motivation and reward. We report here that insulin can amplify action potential-dependent dopamine (DA) release in the nucleus accumbens (NAc) and caudate–putamen through an indirect mechanism that involves striatal cholinergic interneurons that express InsRs. Furthermore, two different chronic diet manipulations in rats, food restriction (FR) and an obesogenic (OB) diet, oppositely alter the sensitivity of striatal DA release to insulin, with enhanced responsiveness in FR, but loss of responsiveness in OB. Behavioural studies show that intact insulin levels in the NAc shell are necessary for acquisition of preference for the flavour of a paired glucose solution. Together, these data imply that striatal insulin signalling enhances DA release to influence food choices. Insulin signals satiety after a meal; however, the rising incidence of obesity and chronic insulin elevation suggests that insulin may also signal reward. Here, Stouffer et al . show that insulin amplifies dopamine release in rodent striatum depending on diet, and that striatal insulin can influence food choice.

Background Global levels of adolescents’ physical inactivity are cause for concern, despite the well-documented health benefits of physical activity (PA). Addressing the messaging of PA is one approach to improve PA knowledge. While increased knowledge does not necessarily lead to behavior change, physically active students have better knowledge of the health benefits of PA. Recently, researchers have highlighted the need for an effective communication strategy for PA messages. This review aimed to summarize the state of the available evidence about the operationalization of communicating PA messages, the evaluation, and effectiveness of PA messages. Methods The Levac six steps and Joanna Briggs Institute methodological guidance for scoping reviews were followed. Five databases were searched up until April 8th 2024. Both title and abstract and full-text screening were piloted whereby 10% of the total articles were double-screened and the remainder were completed by CG. Data were extracted and a data-based convergent synthesis design was used following qualitative synthesis methods. Finally, a consultation with key stakeholders was held to confirm the findings concerning practical relevance. Results A total of 19,412 articles were identified from searches, 94 full texts were included in the final analysis, corresponding to 80 individual studies. The evidence confirms that there are many factors to consider when communicating PA messages and evaluating their effectiveness. Inconsistencies exist regarding the timing and frequency of message delivery and the evaluation of effective communication. When communicating PA with adolescents, messages commonly focus on the benefits of PA and strategies to overcome barriers and are commonly delivered in the school setting by researchers or school stakeholders i.e. teachers, peers. Messages should be concise, positively framed, support adolescent autonomy, and utilize different messaging platforms and techniques to avoid staleness. Conclusions There is a lack of a standardized approach to communicating PA messages with adolescents making evaluation and comparison challenging. Future research should focus on developing guidance to facilitate the effective communication of PA messages with adolescents.

ObjectivesCOVID-19 restrictions reduced adolescents’ opportunities for physical activity (PA). The purpose of this study was to examine how adolescent PA changed during school closures, to identify the key barriers and facilitators for these changes during lockdown and to use this information to understand how to manage future crises’ situations positively to prevent physical inactivity.MethodsIrish adolescents (N=1214; ages 12–18 years) participated in an online cross-sectional study during April 2020, including items on PA level, changes in PA and reasons for change in an open-ended format. Numeric analyses were through multiple binary logistic regressions, stratified by changes in PA during lockdown and inductive analysis of open coding of text responses.ResultsAdolescents reported they did less PA (50%), no change (30%) or did more PA during lockdown (20%). Adolescents who did less PA were more likely to be overweight (OR=1.8, CI=1.2–2.7) or obese (OR=2.2, CI=1.2–4.0) and less likely to have strong prior PA habits (OR=0.4, CI=0.2–0.6). The most cited barriers to PA were coronavirus, club training cancelled and time. Strong associations for doing more PA included participation in strengthening exercises at least three times in the past 7 days (OR=1.7, CI=1.3–2.4); facilitators were more time, coronavirus and no school.ConclusionCOVID-19 restrictions were both a barrier to and an opportunity for PA. Parents, schools, public health, communities and industries must collaborate to prevent physical inactivity at times of crisis, especially for vulnerable groups.

Electronic health (eHealth) and mobile health (mHealth) approaches to address low physical activity levels, sedentary behavior, and unhealthy diets have received significant research attention. However, attempts to systematically map the entirety of the research field are lacking. This gap can be filled with a bibliometric study, where publication-specific data such as citations, journals, authors, and keywords are used to provide a systematic overview of a specific field. Such analyses will help researchers better position their work. The objective of this review was to use bibliometric data to provide an overview of the eHealth and mHealth research field related to physical activity, sedentary behavior, and diet. The Web of Science (WoS) Core Collection was searched to retrieve all existing and highly cited (as defined by WoS) physical activity, sedentary behavior, and diet related eHealth and mHealth research papers published in English between January 1, 2000 and December 31, 2016. Retrieved titles were screened for eligibility, using the abstract and full-text where needed. We described publication trends over time, which included journals, authors, and countries of eligible papers, as well as their keywords and subject categories. Citations of eligible papers were compared with those expected based on published data. Additionally, we described highly-cited papers of the field (ie, top ranked 1%). The search identified 4805 hits, of which 1712 (including 42 highly-cited papers) were included in the analyses. Publication output increased on an average of 26% per year since 2000, with 49.00% (839/1712) of papers being published between 2014 and 2016. Overall and throughout the years, eHealth and mHealth papers related to physical activity, sedentary behavior, and diet received more citations than expected compared with papers in the same WoS subject categories. The Journal of Medical Internet Research published most papers in the field (9.58%, 164/1712). Most papers originated from high-income countries (96.90%, 1659/1717), in particular the United States (48.83%, 836/1712). Most papers were trials and studied physical activity. Beginning in 2013, research on Generation 2 technologies (eg, smartphones, wearables) sharply increased, while research on Generation 1 (eg, text messages) technologies increased at a reduced pace. Reviews accounted for 20 of the 42 highly-cited papers (n=19 systematic reviews). Social media, smartphone apps, and wearable activity trackers used to encourage physical activity, less sedentary behavior, and/or healthy eating were the focus of 14 highly-cited papers. This study highlighted the rapid growth of the eHealth and mHealth physical activity, sedentary behavior, and diet research field, emphasized the sizeable contribution of research from high-income countries, and pointed to the increased research interest in Generation 2 technologies. It is expected that the field will grow and diversify further and that reviews and research on most recent technologies will continue to strongly impact the field.

Background As physical activity is important for health and well-being, it is essential to monitor population prevalence of physical activity. Surveillance is dependent on the use of valid and reliable measurement tools. The PACE+ questionnaire is used globally in youth and has acceptable reliability; however it has not been validated in a European sample. The purpose of this study is to validate this instrument in a sample of 10–18 year old Irish youth. Methods Participants ( n  = 419, 45.7 % male) completed the PACE+ two-item questionnaire and were asked to wear an Actigraph accelerometer for eight consecutive days. Freedson cut-points were used to estimate moderate to vigorous physical activity from accelerometer counts. Analyses compared self-report and accelerometry data in participants with (1) ≥5 and (2) seven valid accelerometer days. Calculations were performed for the whole sample, and were stratified by sex and school level (primary; post-primary). Results Spearman correlations between self-reported physical activity levels and accelerometry derived minutes of moderate-to-vigorous physical activity per day were small ( r  = 0.27; seven valid days) to moderate ( r  = 0.34; ≥5 valid days). Higher correlations were found in older participants (post-primary r  = 0.39; primary r  = 0.24) and females ( r  = 0.39; males r  = 0.27) using ≥5 valid days. The agreement level was high (68–96 %). The accuracy of classifying those not meeting the guidelines (specificity) was moderate to high (59–100 %). Conclusions The PACE+ self-report instrument has acceptable validity for assessing non-achievement of the adolescent physical activity recommendations. The validity is higher in females and increases with age. The continued use of the tool is recommended and will allow for comparability between studies, tracking of physical activity over time including trends in youth population prevalence.

Background Communication campaigns within multi-component school-based interventions could improve knowledge and awareness about physical activity (PA) behavior. Guidance to implement such communication campaigns is lacking. This paper presents the co-creation and evaluation processes that led to the development of the COMMUNICATE toolkit, which supports implementers to communicate PA messages. Methods Students and teachers from secondary schools enrolled in the Active School Flag (ASF) program were invited to participate. To provide a nuanced perspective on the communication of PA, ASF program implementers (i.e., coordinating teacher and adolescent peer leaders) and receivers (i.e., staff and students not involved in ASF delivery), together known as co-creators, engaged in three rounds of co-creation workshops to share ideas, provide feedback, and refine the toolkit. Workshop data were collected via activity recording sheets; written raw materials were photographed and later transcribed verbatim to generate a dataset. Inductive thematic analysis was conducted to organize and describe the toolkit components. A multi-stakeholder research steering group ( n =7) was established to design, facilitate, and evaluate the co-creation process. The toolkit was refined between rounds of workshops. Throughout the co-creation process, the facilitator reflected after each workshop to improve its’ participatory nature. After the final workshop, co-creators completed a process evaluation questionnaire. Additional consultations with experts were held to bridge the gap in expertise. A logic model was developed to understand the theory of change behind the toolkit. Results Eight teachers and 38 students from four ASF schools participated in the co-creation workshops. All 14 aspects of the process evaluation were mainly positive (86.7-100%). Common reasons for negative responses included co-creators not engaging, too much moving around during workshops, teachers’ involvement, and working with strangers. The final version of the toolkit included resources for program implementers to i) raise awareness about PA and the program, ii) plan the promotion of PA, and iii) develop key communication skills. Conclusions The COMMUNICATE toolkit, informed by multi-stakeholder voices, emphasizes a multi-level, multi-stakeholder approach to communicating PA messages with adolescents in schools. It provides tools and resources for program implementers to improve communication efforts. The COMMUNICATE toolkit could be adapted to other peer-led school-based programs.

Background This review of reviews aimed to: (1) summarize the evidence from published reviews on the effectiveness of mass-media campaigns to promote physical activity (PA) or PA-related determinants (intermediate psychological and proximal outcomes) and (2) to identify policy-relevant recommendations related to successful PA campaigns. Methods An extensive literature search was performed on 1 March 2021. Reviews that evaluated the impact of campaigns on distal (e.g. PA) and/or proximal outcomes of PA (awareness, knowledge, etc.) and that targeted the general population or subsets were included. Quality of reviews was assessed using the AMSTAR-2 tool. Policy-relevant recommendations were systematically derived and synthesized and formulated as good practice statements. A protocol was registered beforehand (ID: CRD42021249184). Results A total of 1915 studies were identified, of which 22 reviews were included. The most consistent evidence was found for the effectiveness of mass-media campaigns on proximal outcomes, while the evidence for distal outcomes was mixed. Good practice statements were derived: (1) to achieve behaviour change, mass-media is an important component of larger, multilevel and multicomponent strategies; (2) mass-media strategies should be coordinated and aligned at local- and national-level and be sustained, monitored and resourced at these levels and (3) media should be tailored to reduce socioeconomic inequalities. Conclusions Mass-media can play an important role in the promotion of PA. In general, evidence was more inconsistent for effectiveness on distal outcomes than for proximal outcomes. Policy-relevant recommendations include that mass-media strategies should be resourced, coordinated, aligned, sustained, monitored and evaluated on the local and national level.

Background Current literature reports a gap between development of effective interventions to promote physical activity and the 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 Practitioners, 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 which identified factors related to 1) intervention planning and practical considerations; 2) organisational structures, staffing and resources related to delivery; 3) reflection, evaluation and updating of the intervention; and 4) practical consideration related to scale-up. Furthermore, participants referred to the ongoing commitment, engagement, and support needed throughout the implementation process. Conclusions Future research and practice needs to consider how different factors are experienced at different implementation stages and by the different stakeholder groups involved. The findings highlight multiple inter-related factors that influence the implementation and scale-up of physical activity interventions, but also identifies many strategies that can be utilised to aid future successes.