Meaningful social interactions and regular physical activity are inversely associated with loneliness. Using a mixed-methods research design employing quantitative and qualitative research approaches, this research aimed to explore loneliness, physical activity, friendship, and experiences relating to the COVID-19 pandemic both prior to and during the pandemic. Quantitative data of (1) n = 363 first-year university students assessed in 2018/2019 and of (2) n = 175 individuals aged 18–29 years assessed in 2020 were gathered using independent self-administered online surveys. In addition, (3) n = 4 students were recruited for semi-structured, qualitative interviews in 2020 during the onset phase of the COVID-19 pandemic. Correlation and regression analyses as well as analyses of variance were conducted. Thematic analysis as a qualitative method was used to explore the role physical activity, friendship, and social interactions played in loneliness, particularly in times of social isolation and social distancing. Results revealed associations of varying strength between physical activity and loneliness in 2018/2019 (r = −0.09, p ≤ 0.05) and 2020 (r = −0.20, p < 0.01). In 2020, n = 73 (41.7%) participants felt that their loneliness had increased since the COVID-19 social and physical distancing guidelines were introduced, but this was not associated with a perceived change in physical activity (r = −0.05, p > 0.05). Analyses of qualitative data revealed three main themes: (1) the lack of deep friendships at university, (2) the positive perceived impact of team sports on feelings of loneliness, and (3) the need for real connection in times of crisis. Thus, with regard to feelings of loneliness during the pandemic, being physically active seems to be a small but potentially relevant factor among young individuals. The qualitative study suggests that first-year university students might buffer the lack of deep friendships and meaningful interactions by building social bonds in team sports. In times of physical distancing, young individuals vulnerable to loneliness may therefore require special support such as doing sports with physical distance and perceiving connected with their team for instance by digital devices and emotional coping.

Background Despite the known health benefits of physical activity (PA), less than half and less than one-third of older adults in Germany reach the PA recommendations for endurance training and strength training, respectively, of the World Health Organization. The aim of this study is to investigate the implementation and effectiveness over the course of 9 months of two interventions (information technology [IT]-based vs print-based) for PA promotion among initially inactive older adults in a randomized, crossover trial. This study is part of a large research consortium (2015-2021) investigating different aspects of PA promotion. The IT-based intervention was previously developed and refined, while the print-based intervention was newly developed during this funding phase. Objective We aim to compare the effectiveness and examine the preferences of study participants regarding both delivery modes. Methods Our target sample size was 390 initially inactive community-dwelling older adults aged ≥60 years at baseline (3-month follow-up [T1]: expected n=300; 9-month follow-up [T2]: expected n=240) who were randomized to one of two interventions for self-monitoring PA: IT-based (50%) or print-based (50%) intervention. In addition, 30% of the IT-based intervention group received a PA tracker. At T1, participants in both groups could choose whether they prefered to keep their assigned intervention or cross over to the other group for the following 6 months (T2). Participants’ intervention preferences at baseline were collected retrospectively to run a post hoc matched-mismatched analysis. During the initial 3-month intervention period, both intervention groups were offered weekly group sessions that were continued monthly between T1 and T2. A self-administered questionnaire and 3D accelerometers were employed to assess changes in PA between baseline, T1, and T2. Adherence to PA recommendations, attendance at group sessions, and acceptance of the interventions were also tracked. Results The funding period started in February 2018 and ends in January 2021. We obtained institutional review board approval for the study from the Medical Association in Bremen on July 3, 2018. Data collection was completed on January 31, 2020, and data cleaning and analysis started in February 2020. We expect to publish the first results by the end of the funding period. Conclusions Strategies to promote active aging are of particular relevance in Germany, as 29% of the population is projected to be ≥65 years old by 2030. Regular PA is a key contributor to healthy aging. This study will provide insights into the acceptance and effectiveness of IT-based vs print-based interventions to promote PA in initially inactive individuals aged ≥60 years. Results obtained in this study will improve the existing evidence base on the effectiveness of community-based PA interventions in Germany and will inform efforts to anchor evidence-based PA interventions in community structures and organizations via an allocation of permanent health insurance funds. Trial Registration German Registry of Clinical Trials DRKS00016073; https://tinyurl.com/y983586m International Registered Report Identifier (IRRID) DERR1-10.2196/15168

Background Fewer than half of older German adults engage in the recommended levels of endurance training. Objective The study aim is to compare the acceptance and effectiveness of two interventions for physical activity (PA) promotion among initially inactive community-dwelling older adults ≥60 years in a 9-month, crossover randomized trial. Methods Participants were recruited in person and randomized to one of the following interventions for self-monitoring PA: a print-based intervention (PRINT: 113/242, 46.7%) or a web-based intervention (WEB: 129/242, 53.3%). Furthermore, 29.5% (38/129) of those in the web-based intervention group received a PA tracker in addition to WEB (WEB+). After randomization, the participants and researchers were not blinded. The participants’ baseline intervention preferences were retrospectively assessed. All the intervention groups were offered 10 weekly face-to-face group sessions. Afterward, participants could choose to stay in their group or cross over to one of the other groups, and group sessions were continued monthly for another 6 months. 3D accelerometers to assess PA and sedentary behavior (SB) at baseline (T0), 3-month follow-up (T1), and 9-month follow-up (T2) were used. Adherence to PA recommendations, attendance of group sessions, and intervention acceptance were assessed using self-administered paper-based questionnaires. Linear mixed models were used to calculate differences in moderate to vigorous PA (MVPA) and SB between time points and intervention groups. Results Of the 242 initially recruited participants, 91 (37.6%) were randomized to the WEB group; 38 (15.7%) to the WEB+ group; and 113 (46.7%) to the PRINT group. Overall, 80.6% (195/242) of the participants completed T1. Only 0.4% (1/242) of the participants changed from the WEB group to the PRINT group and 6.2% (15/242) moved from the PRINT group to the WEB group (WEB-WEB: 103/249, (41.4%); PRINT-PRINT: 76/249, 30.5%) when offered to cross over at T1. Furthermore, 66.1% (160/242) of participants completed T2. MVPA in minutes per day increased between baseline and T1, but these within-group changes disappeared after adjusting for covariates. MVPA decreased by 9 minutes per day between baseline and T2 (βtime=−9.37, 95% CI −18.58 to −0.16), regardless of the intervention group (WEB vs PRINT: βgroup*time=−3.76, 95% CI −13.33 to 5.82, WEB+ vs PRINT: βgroup*time=1.40, 95% CI −11.04 to 13.83). Of the participants, 18.6% (38/204) met the PA recommendations at T0, 16.4% (26/159) at T1, and 20.3% (28/138) at T2. For SB, there were no significant group differences or group-by-time interactions at T1 or T2. Intervention acceptance was generally high. The use of intervention material was high to moderate at T1 and decreased by T2. Conclusions There was little movement between intervention groups at T1 when given the choice, and participation was not associated with increases in PA or decreases in SB over time. Trial Registration German Clinical Trials Register DRKS00016073; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00016073

The results led to the need for a further large study with sufficient statistical power to detect the desired effect size, taking into account potential confounding factors and using validated measures of AS and periodontitis.

Smokers with spondyloarthritis experience worse disease than those who are never smokers. However, this study provides new evidence that, among smokers, smoking cessation is associated with lower disease activity and better physical function and QoL. Clinicians should specifically promote smoking cessation as an adjunct to usual therapy in patients with spondyloarthritis.

Background Web‐based, theory‐driven interventions effectively promote older adults’ physical activity. Social‐cognitive mechanisms of their effect on stage of change need to be further researched. Methods Older adults were randomly allocated to intervention group 1 (10‐week online physical activity program), intervention group 2 (same program plus activity tracker), or delayed intervention control group; n = 351 were analyzed (59.6% of originally allocated individuals). Stages of change for recommended endurance and strength training and social‐cognitive predictors of physical activity were assessed using questionnaires at baseline and follow‐up. Intervention effects and mediation were investigated using mixed‐effects ANOVA and ordinal least squares regression. Results Direct effects on stage of change were found for intervention group 1 regarding endurance training (bintervention group 1 = 0.44, 95% confidence interval [0.15, 0.73]), and both groups regarding strength training (bintervention group 1 = 1.02, [0.71, 1.33], bintervention group 2 = 1.24, [0.92, 1.56]). Social‐cognitive predictor changes in task self‐efficacy, intention, and action planning explained intervention effect on stage of change, but not to the full extent. Conclusions The results indicate significant web‐based intervention effects on physical activity stage, partly mediated by changes in task self‐efficacy, intention, and action planning.

Zusammenfassung Hintergrund Soziale Isolation ist ein Risikofaktor für Einsamkeit und damit für gesundheitliche Beeinträchtigungen. Veränderungen im Zusammenhang mit der Coronapandemie in Deutschland gilt es besser zu verstehen. Fragestellung Ziel der Studie war es, Einsamkeit und assoziierte Faktoren vor und während der Coronapandemie in Deutschland systematisch zu untersuchen. Die Fragestellungen waren: 1. Wie einsam fühlen sich Menschen vor und während der Coronapandemie? 2. Wie viele Menschen fühlen sich seit Beginn der Coronapandemie einsamer? 3. Wie viele Menschen berichten über gesundheitliche Belastungen während der Coronapandemie? Material und Methoden Im Jahr 2019 (vor der Coronapandemie) wurden 1003 und im Jahr 2020 (während der Coronapandemie) 1050 Erwachsene online befragt (51 % Frauen; 18–90 Jahre). Ergebnisse Es fühlten sich 10,8 % vs. 26,6 % der Befragten vor bzw. seit der Coronapandemie mehrfach pro Woche oder täglich einsam. Alleinlebende, Frauen und Jüngere fühlten sich häufiger einsam. Seit der Coronapandemie fühlten sich 30,8 % einsamer, v. a. Jüngere. Von starken gesundheitlichen Belastungen berichteten 18,9 %, dies hing mit jüngerem Alter, verschiedenen Sorgen/Ängsten und Einsamkeit zusammen. Diskussion Die höhere Ausprägung der Einsamkeit und Sorgen während der Coronapandemie sollte bei verhaltensbezogenen Maßnahmen zur Prävention der psychischen und körperlichen Beeinträchtigungen sowie behördlichen Maßnahmen berücksichtigt werden. Jüngere Menschen und Alleinlebende könnten profitieren, indem sie zu gezielten Bewältigungsstrategien (z. B. angemessener Nutzung digitaler Medien) ermutigt werden.

Objective: Selective study dropout limits manifestation and detection of intervention effects and is a major challenge in behavioral intervention studies. Engaging in health-risk behaviors might make individuals especially dropout-vulnerable. Thus, this theory-based study's aim was to identify health-related lifestyle profiles affecting dropout in a web-based physical activity intervention trial targeting older adults. Method: The 12week intervention trial was conducted between 2016 and 2018 in Germany. Baseline lifestyle profiles consisting of self-reported physical activity, sedentary behavior, alcohol consumption, fruit and vegetable intake, nocturnal sleep, and social activity were assessed with questionnaires and investigated in 589 individuals. The risk of study dropout related to health-related lifestyle profile was tested with Poisson regression in 571 individuals (96.9%). Results: Latent profile analysis identified four latent health-related lifestyle profiles: socially inactive (n = 23, 3.9%), slightly unhealthy (n = 449, 75.2%), health-promoting (n = 81, 13.8%), and highly physically active lifestyle (n = 36, 6.1%). Profiles differed significantly by sex, stage of behavior change, and subjective health. Compared with the average of all profiles, statistically significant study dropout adjusted risk ratios (aRR) were 1.91 for the socially inactive lifestyle, and aRR = 0.73 for the slightly unhealthy lifestyle. There were no statistically significant effects for the highly physically active lifestyle (aRR = 0.94) and the healthpromoting lifestyle (aRR = 0.76) on study dropout. Conclusions: This study highlights the relevance of accounting for the correlation between health-related lifestyle profiles and study participation of older adults in physical activity interventions.