Health-Related Quality of Life, Self-Efficacy and Enjoyment Keep the Socially Vulnerable Physically Active in Community-Based Physical Activity Programs: A Sequential Cohort Study

Abstract

Physical inactivity is most commonly found in socially vulnerable groups. Dutch policies target these groups through community-based health-enhancing physical activity (CBHEPA) programs. As robust evidence on the effectiveness of this approach is limited, this study investigated whether CBHEPA programs contribute to an increase in and the maintenance of physical activity in socially vulnerable groups. In four successive cohorts, starting at a six-month interval, 268 participants from 19 groups were monitored for twelve months in seven CBHEPA programs. Data collection was based on repeated questionnaires. Socio-economic indicators, program participation and coping ability were measured at baseline. Physical activity, health-related quality of life and on-going program participation were measured three times. Self-efficacy and enjoyment were measured at baseline and at twelve months. Statistical analyses were based on a quasi-RCT design (independent t-tests), a comparison of participants and dropouts (Mann-Whitney test), and multilevel modelling to assess change in individual physical activity, including group level characteristics. Participants of CBHEPA programs are socially vulnerable in terms of low education (48.6%), low income (52.4%), non-Dutch origin (64.6%) and health-related quality of life outcomes. Physical activity levels were not below the Dutch average. No increase in physical activity levels over time was observed. The multilevel models showed significant positive associations between health-related quality of life, self-efficacy and enjoyment, and leisure-time physical activity over time. Short CBHEPA programs (10–13 weeks) with multiple trainers and gender-homogeneous groups were associated with lower physical activity levels over time. At twelve months, dropouts' leisure-time physical activity levels were significantly lower compared to continuing participants, as were health-related quality of life, self-efficacy and enjoyment outcomes. BMI and care consumption scored significantly higher among dropouts. In conclusion, Dutch CBHEPA programs reach socially vulnerable, but not necessarily inactive, groups in terms of socio-economic and health-related quality of life outcomes. Our findings suggest that CBHEPA programs particularly contribute to physical activity maintenance in socially vulnerable groups, rather than to an increase in physical activity behaviour over time.

Characteristics of physical activity in patients with critical limb ischemia

“…In our study, however, no significant association was observed between the average number of steps walked and the lower-limb muscle strength among CLI patients. Moreover, it is generally considered that the amount of physical activity and health-related QOL are strongly correlated with each other 11 ) and that the higher the sense of well-being, the more they are involved in physical activity 12 ) , but no correlation was observed between the number of steps walked and health-related QOL in our study. Patients with CLI need non-weight bearing exercise during the treatment of wound to reduce the burden to the wounded area, which consequently imposes restrictions on their walking.…”

The role of physical activity enjoyment on the acute mood experience of exercise among smokers with elevated depressive symptoms

“…Indeed, data non-specific to smokers indicate that self-reported physical activity enjoyment is cross-sectionally positively correlated with level of physical activity engagement (Cleland et al, 2010; Hagberg et al, 2009; Rech et al, 2014; Salmon et al, 2003; Umeda et al, 2014) and prospectively associated with greater exercise program adherence and long-term maintenance of physical activity (Crain et al, 2010; Dishman et al, 2014; Herens et al, 2016; Lewis et al, 2016; Williams et al, 2006). Self-report of physical activity enjoyment also predicts acute increases in positive mood and decreases in negative mood from pre- to post- exercise (Miller et al, 2005; Motl et al, 2000) and mediates the exercise-mood relationship (Miller et al, 2005; Motl et al, 2000).…”

A Conceptual Guideline to Age-Friendly Outdoor Space Development in China: How Do Chinese Seniors Use the Urban Comprehensive Park? A Focus on Time, Place, and Activities

“…An engagement in moderate physical activities is proven to be the key element of achieving a healthy and active lifestyle which is promoted by active aging [4,5]. The benefits of physical activities include the enhancement of body balance, strength, and mental health [6][7][8]. The physical activities discussed in this paper include active activities and passive activities.…”