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Background Education of health professionals is a key element of the wider strategy to increase society's physical activity levels. To date, no study has directly assessed UK medical students’ knowledge of physical activity guidelines or their ability/willingness to prescribe exercise. Methods A questionnaire survey of final year medical students in Scottish Universities was conducted prior to a presentation on the current UK guidelines. Results Completed questionnaires (n=177) represented 37% of the final year cohorts. Physical inactivity was incorrectly perceived to be the least important risk factor to global mortality. 40% stated they were aware of current guidelines, but in a forced choice, 68% were able to correctly identify them for adults. In comparison, 97% correctly identified the UK's alcohol guidelines. 52% stated they felt adequately trained to give physical activity advice to the general public. Conclusions The medical students in this study underestimated the risk of physical inactivity, and did not know the physical activity guidelines as well as other health promotion guidelines. A large proportion remained unconfident about giving physical activity advice. Improved education of this group is required.

With the significant decrease in physical activity rates, the importance of intervention programs in the schools, where children spend a significant part of the day, has become indisputable. The purpose of this review is to systematically examine the possibility of school-based interventions on promoting physical activity and physical fitness as well as preventing obesity. A systematic approach adopting PRISMA statement was implemented in this study. Three different databases (2010–2019) were screened and primary and secondary school-based intervention programs measuring at least one variable of obesity, physical activity, or physical fitness were included. The risk of bias was assessed using the validated quality assessment tool for quantitative studies. Among 395 potentially related studies, 19 studies were found to meet the eligibility criteria. A general look at the studies examined reveals that among the outcomes, of which most (18/19) were examined, a significant improvement was provided in at least one of them. When the program details are examined, it can be said that the success rate of the physical activity-oriented programs is higher in all variables. School-based interventions can have important potential for obesity prevention and promotion of physical activity and fitness if they focus more on the content, quality, duration and priority of the physical activity.

Physical activity (PA) is a cost-effective and non-pharmacological foundation for the prevention and management of chronic and complex diseases. Healthcare professionals could be viable conduits for PA promotion. However, the evidence regarding the effectiveness and benefits of the current forms of PA promotion are inconclusive. Healthcare professionals’ perceptions on key determinants impact on the optimum promotion of PA were explored in this review. Thirty-four (34) studies were identified after systematically searching seven databases for peer-reviewed articles published within the last decade. PA advice or counselling was the most recorded form of PA promotion, limited counselling time was the most reported obstacle while providing incentives was viewed as a key facilitator. There is widespread consensus among healthcare professionals (HCPs) on some aspects of PA promotion. Utilisation of all PA promotional pathways to their full potential could be an essential turning point towards the optimal success of PA promotional goals. Hence, strategies are required to broaden chronic disease treatment methods to include preventive and integrative PA promotion approaches particularly, between frontline HCPs (e.g., GPs) and PA specialists (e.g., EPs). Future studies could explore the functionality of GP to EP referral pathways to determining what currently works and areas requiring further development.

Background Physical activity plays an important role over the life course for non-communicable disease prevention. At an early age, it can support physical, cognitive, and emotional development as well as the establishment of an active lifestyle throughout life. Early childcare centers provide a valuable opportunity in promoting physical activity. Yet, it is unclear, whether and to what extent policy documents such as educational framework plans incorporate physical activity promotion activities and structures in the early childcare setting. We aim to analyze the integration of physical activity in educational framework plans in Germany. Methods Ten criteria were identified based on a policy document on prevention indicators and an analytical framework for effective physical activity policy measures: (1) Physical activity as a topic in the educational framework plan, (2) availability of a pedagogical concept for physical activity, (3) objectives, (4) target groups, (5) timeframe, (6) budget, (7) implementation plan, (8) stakeholder involvement across political sectors, (9) legal status, and (10) policy evaluation. Information on the criteria was obtained from the educational framework plans, further policy documents, and a standardized self-administered questionnaire. Results All educational framework plans addressed physical activity in a subchapter, while none provided a pedagogical concept on its implementation. The objectives focused on competence goals and related policy measures for physical activity promotion. Most of the educational framework plans targeted children up to 6 years and considered different subgroups. While a timeframe and budget were not mentioned, concrete assistance for policy implementation was provided. On average, three sectors were involved in the educational framework plans’ development. The implementation was binding for 12 out of 16 educational framework plans. Half of the educational framework plans were evaluated either internally or externally. Conclusions Educational framework plans describe physical activity promotion for the early childcare setting at a federal state level through their focus on children’s competence development. However, minimum criteria for the implementation and evaluation of PA promotion measures are lacking in educational framework plans. Further research is needed to explore the role of educational framework plans in health promotion, considering the heterogeneity across federal states. Trial registration Not applicable.

Proton Exchange Membrane Water Electrolysis (PEMWE) under acidic conditions outperforms alkaline water electrolysis in terms of less resistance loss, higher current density, and higher produced hydrogen purity, which make it more economical in long-term applications. However, the efficiency of PEMWE is severely limited by the slow kinetics of anodic oxygen evolution reaction (OER), poor catalyst stability, and high cost. Therefore, researchers in the past decade have made great efforts to explore cheap, efficient, and stable electrode materials. Among them, the RuO2 electrocatalyst has been proved to be a major promising alternative to Ir-based catalysts and the most promising OER catalyst owing to its excellent electrocatalytic activity and high pH adaptability. In this review, we elaborate two reaction mechanisms of OER (lattice oxygen mechanism and adsorbate evolution mechanism), comprehensively summarize and discuss the recently reported RuO2-based OER electrocatalysts under acidic conditions, and propose many advanced modification strategies to further improve the activity and stability of RuO2-based electrocatalytic OER. Finally, we provide suggestions for overcoming the challenges faced by RuO2 electrocatalysts in practical applications and make prospects for future research. This review provides perspectives and guidance for the rational design of highly active and stable acidic OER electrocatalysts based on PEMWE.

Background Few whole-school physical activity programmes integrate implementation science frameworks within the design, delivery, and evaluation. As a result, knowledge of the key factors that support implementation at scale is lacking. The Creating Active Schools (CAS) programme was co-designed and is underpinned by the Capability, Opportunity, Motivation and Behaviour (COM-B) model and the Consolidated Framework for Implementation Research (CFIR). The study aims to understand the initial impact and implementation of CAS in Bradford over 9 months using McKay’s et al.’s (2019) implementation evaluation roadmap. Methods Focus groups and interviews were conducted with school staff (n = 30, schools = 25), CAS Champions (n = 9), and the CAS strategic lead (n = 1). Qualitative data were analysed both inductively and deductively. The deductive analysis involved coding data into a priori themes based on McKay et al’s implementation evaluation roadmap, using a codebook approach to thematic analysis. The inductive analysis included producing initial codes and reviewing themes before finalising. Results Identified themes aligned into three categories: (i) key ingredients for successful adoption and implementation of CAS, (ii) CAS implementation: challenges and solutions, and (iv) the perceived effectiveness of CAS at the school level. This included the willingness of schools to adopt and implement whole-school approaches when they are perceived as high quality and aligned with current school values. The programme implementation processes were seen as supportive; schools identified and valued the step-change approach to implementing CAS long-term. Formal and informal communities of practice provided “safe spaces” for cross-school support. Conversely, challenges persisted with gaining broader reach within schools, school staff’s self-competence and shifting school culture around physical activity. This resulted in varied uptake between and within schools. Conclusions This study provides novel insights into the implementation of CAS, with outcomes aligning to the adoption, reach, and sustainability. Successful implementation of CAS was underpinned by determinants including acceptability, intervention complexity, school culture and school stakeholders’ perceived self-efficacy. The combination of McKay’s evaluation roadmap and CFIR establishes a rigorous approach for evaluating activity promotion programmes underpinned by behavioural and implementation science. Resultantly this study offers originality and progression in understanding the implementation and effectiveness of whole-school approaches to physical activity.

Background Few studies have evaluated teacher- and school-level characteristics associated with implementation of recommended physical activity (PA) promoting practices. The purpose of this study is to examine associations between teachers’ PA practices and: [1] teacher-level factors, including their own PA, and [2] school-level factors. Methods This cross-sectional study examined time spent daily in light PA (LPA) and moderate-vigorous PA (MVPA) in association with 7 teacher PA practices among 288 classroom/special area teachers and teaching assistants in 20 urban, suburban and rural schools (recruited through a school wellness trial) in 4 districts. LPA and MVPA was assessed using 24-h ankle accelerometry (up to seven consecutive days). A sum score for teacher PA practices was assessed via survey (7 items; sum score range: 7–35; Cronbach’s alpha = 0.73; higher scores indicate more PA promoting practices). Teacher-level factors included gender, race, self-reported height/weight, years teaching, and education. School-level factors included school type, free-and-reduced-price meal eligibility, student racial/ethnic composition, and urbanicity. Analyses included multilevel regression models, accounting for clustering within schools and adjusting for demographic covariates and school district. Results Teachers were 91% female, 63% elementary, 60% white, mean age 43.2 years ( SD  = 11.3), and 41% obese). Teachers wore accelerometers an average of 5.8 days, spent 399.6 min in LPA ( SD  = 85.0) per day, 24.1 min in MVPA ( SD  = 14.4) per day, and the mean teacher PA practices sum score was 22.4 ( SD  = 5.0). Every 15-min increase in MVPA was related to an increase in teacher PA practices sum score (coeff =1.07; SE  = 0.28; p  < 0.001). Female gender (versus males; coeff = − 1.95; SE  = 0.92, p  = 0.034), an obese weight status (versus non-obese; coeff = − 1.38; SE  = 0.54, p  = 0.010), and teaching in a middle school (versus elementary; coeff = − 3.86; SE  = 0.54, p  < 0.001) were associated with lower teacher PA practices scores. LPA was not associated with teacher PA promoting practices. Conclusions Teachers with higher MVPA, but not higher LPA, and those without obesity were more likely to implement PA promoting practices that could positively impact their students’ PA. Similar to prior studies, these practices were more commonly implemented in elementary schools and by male teachers. Future studies in schools should explore whether improvement of teacher health behaviors subsequently impacts student health behaviors. Trial registration Clinical Trials, NCT03432715 ; Registered on 02/2/2018.

Background Physicians are increasingly being called upon to promote physical activity (PA) among patients. However, a paucity of exercise medicine teaching in the UK undergraduate medical curricula prevents students from acquiring the necessary knowledge and skills to do so. To address this issue, King's College London School of Medicine introduced an exercise medicine strand of teaching. This study evaluated the acceptability of exercise promotion behaviour change lectures and explored the knowledge and attitudes of the students who received it. Methods Students were invited to complete a 6-item online questionnaire prior to and after exercise medicine lectures. The questionnaire assessed beliefs regarding the importance of PA in disease prevention and management, in addition to their confidence in advising patients on PA recommendations. A focus group (n=7) explored students’ attitudes towards and knowledge of PA promotion and exercise prescribing. Results In total, 121 (15%) first-year and second-year MBBS students completed the questionnaire. Students’ beliefs regarding the importance of PA in managing disease and their confidence in PA promotion among patients increased after the teaching (p<0.001). More students were able to correctly identify the Chief Medical Officer recommended adult PA guidelines (p<0.05). Students were enthusiastic about the exercise medicine teaching, strongly supportive of its continued inclusion in the curriculum and advocated its importance for patients and themselves as future doctors. Conclusions Behaviour change teaching successfully improved students’ knowledge of and confidence regarding PA promotion. These improvements are a step forward and may increase the rates and success of physician PA counselling in the future.

Background Movement-based therapists, including physical, exercise, and sport therapists, play a key role in promoting physical activity in individuals with non-communicable diseases. However, no clear consensus exists on effective intervention approaches. This scoping review examines available intervention studies and theoretical works for physical activity promotion in movement-based therapy. Methods In accordance with Colquhoun et al.‘s framework and PRISMA-ScR guidelines, we systematically searched PubMed, Scopus, Web of Science, and PsycINFO until March 31, 2024. Eligible records described physical activity-promoting concepts including interventional studies and theoretical works applicable in movement-based therapies for individuals with non-communicable diseases. Data extraction covered assessment, therapeutic content, didactic-methodological principles, and theoretical underpinnings. Interventions were categorized based on behavior change techniques (BCTs), the behavior change wheel, and a clinical reasoning model for clients behavior change. Network analysis explored relationships between therapeutic content and didactic-methodological principles. Results Fifty-seven records met inclusion criteria; 77% were intervention studies, and 23% were theoretical works. Most concepts originated from orthopedics/rheumatology (23%), neurology (21%), and oncology (9%), while 12% were generic concepts. Across concepts, 66 biopsychosocial assessment instruments and 60 BCTs were applied (Median BCTs per concept: 11.5, range: 4–37). Key didactic-methodological principles included tailoring/individualization ( n  = 47), active participation ( n  = 39), collaborative communication ( n  = 21), and patient self-responsibility and independence ( n  = 14). Least mentioned was facilitating positive movement experiences and enjoyment of physical activity ( n  = 3). Network analysis identified action planning, goal setting, and feedback as central BCTs. Conclusion This review provides an overview of 57 physical activity promotion concepts used in movement-based therapies for individuals with non-communicable diseases. Findings reveal considerable heterogeneity, highlighting diverse strategies used by movement-based therapists to influence physical activity behavior. Trial registration Open Science Framework (OSF), December 23, 2022 (DOI: https://doi.org/10.17605/OSF.IO/AXZSJ ).