Short Orals: Inequalities in physical activity

Background: Moderate-to-vigorous physical activity (MVPA) promotes health; however, only 43.8% of Hispanic women meet MVPA guidelines compared to 54.7% non-Hispanic white women. Socioecological models postulate that MVPA results from influences internal and external to the individual, but research identifying the behavior change mechanisms (BCM) and socioecological level targets necessary to increase Hispanic women’s MVPA is lacking. Purpose: Synthesize existing literature to determine BCM and socioecological levels that increased Hispanic women’s MVPA. Methods: PubMed, CINAHL, SSCI, Cochrane Library and PsychINFO were searched using ((Hispanic women) OR (Hispanic OR Mexican American OR Latina OR Latinx) AND (female) AND (exercise OR physical activity)) in March 2023. Studies published in peer-reviewed journals in English testing interventions to increase objectively-measured MVPA among healthy Hispanic women were included. Data were extracted and a narrative synthesis was conducted. Results: Thirteen studies met inclusion criteria: 9 unique interventions with 4 studies providing additional findings. The total sample included 2,303 Hispanic women, mean ages ranged 28.4 to 44.6, and all studies were conducted in the United States. Self-efficacy (intrapersonal) and family participation (interpersonal) were the only BCM that mediated MVPA immediately post-intervention and were only tested for mediation in one study each. Fifty percent (n=3) of studies targeting the organizational level and 83.3% (n=5) targeting physical activity access to overcome weather and safety barriers at the neighborhood level significantly improved MVPA post-intervention. Conclusions: Interventions targeting self-efficacy at the intrapersonal, family participation at the interpersonal, and physical activity access at the neighborhood levels increased Hispanic women’s MVPA in the short-term. Interventions targeting the organizational level were not effective for improving MVPA. Practical implications: Future MVPA interventions should be developed targeting the intrapersonal, interpersonal, and neighborhood levels and tested to confirm self-efficacy and family participation mediate Hispanic women’s MVPA and include long-term follow-up analyses. Funding: National Institutes of Health.

BACKGROUND Leisure-time physical activity (LTPA) is recognized for its health benefits, and socioeconomic disparities in LTPA are well-documented. However, the associations between lifecourse socioeconomic position (SEP) and changes in LTPA remain poorly understood. PURPOSE We examined the associations with parental and participant’s own SEP and changes in LTPA among young and early midlife employees. METHODS Survey data from 2908 employees of the City of Helsinki, Finland, aged 19–39 in 2017, were analyzed with a follow-up in 2022, predominantly women (80%). LTPA was quantified in metabolic equivalent task (MET) units, and lifecourse SEP was assessed using parental and participant’s education and occupational class. Linear regression models, adjusted for various demographic and health factors, examined the associations between SEP and changes in LTPA. RESULTS At Phase 1, the lower LTPA group (n=749) averaged 10.4 MET-h/week, with a substantial 19.2 MET-h/week increase in Phase 2. The middle group (n=900) started at 29.3 MET-h/week in Phase 1, with a 9.3 MET-h/week increase. Conversely, the highest MET group (n=1259) reported an average of 79.4 MET-h/week at Phase 1, experiencing a 19.7 MET-h/week decrease in Phase 2. After the analysis, higher parental education was associated to increased LTPA in the middle group after adjusting for age and gender. Participants with higher individual education in the highest MET-group were associated with similar increases in LTPA after full adjustments. CONCLUSIONS Higher parental and individual education were associated with an increase in LTPA among young and early midlife employees over the 5-year follow-up. This association was particularly notable among individuals who were already active at baseline. No associations were observed between initially low LTPA and lifecourse SEP. PRACTICAL IMPLICATIONS These findings emphasize the importance of considering socioeconomic factors in the development and implementation of interventions aimed at promoting physical activity. FUNDING The Ministry of Education and Culture

Background: Previous research consistently shows that having access to resources supporting physical activity encourages physical activity behaviors. However, it remains unclear whether the benefits of these resources vary across communities with different socioeconomic statuses. Purpose: To determine whether neighborhood socioeconomic status (SES) moderates the relationship between access to physical activity-supportive resources and child physical activity in 130 diverse communities across the United States (US). Methods: Data from 4,598 children aged 4-15 were analyzed. More than half of the sample self-identified as Hispanic or Black. Neighborhood SES quartiles were determined using six standardized indicators from the Census. Child access to physical activity-supportive resources at home/yard (e.g., bicycle, active equipment) and in the community/neighborhood (e.g., basketball hoop, playground, tennis court) was self-reported. Total physical activity was measured using the 7-day Physical Activity Behavior Recall instrument. Linear mixed models with robust standard errors were used to analyze the relationship between reported resource access, total physical activity, and the influence of neighborhood SES. Models adjusted for community-level clustering and relevant child- and neighborhood-level covariates. Results: Neighborhood SES moderated the association between reported access to physical activity-supportive resources and total physical activity (p<0.05). Greater access to these resources in the community/neighborhood was linked to higher total physical activity, but only in low SES neighborhoods (p<0.001). Similarly, increased access to resources in the home/yard was associated with higher total physical activity, but only in very low and low SES neighborhoods (p=0.038; p<0.001). Conclusions: Physical activity-supportive resources play a distinct role in promoting physical activity among children living in low-SES communities across the US. Practical implications: The socioeconomic differences observed in the relationship between physical activity-supportive resources emphasize the necessity for targeted policies addressing deprivation in low SES neighborhoods to promote youth physical activity in the US. Funding: National Institutes of Health: R01HL137731, HHSN268201000041C

Background: Populations subject to inequalities, including people experiencing homelessness and addiction are more likely to experience accelerated ageing, frailty and poor outcomes. Targeted physical activity interventions which may delay or reverse frailty are recommended to address their unique needs. Purpose: To explore the feasibility and effectiveness of low-threshold physical activity interventions to target physical function and frailty in this population. Methods: Low-threshold Exercise And Protein supplementation programmes(LEAP I/II) were delivered in day centres in Dublin, Ireland in 2022/2023. The programmes consisted of individual, group and gender-based classes and a weekly ‘Park Walk’. The primary outcome was feasibility measured by recruitment, retention and programme adherence. Secondary outcomes were physical function, frailty and nutritional status, pain and quality of life. A trauma informed approach was utilized. Results: 76 people (mean age 45.8years) participated. Baseline results demonstrated poor physical function and high levels of frailty [16% LEAP-I,11%-LEAP-II (SHARE-Frailty Instrument)]. Higher retention and adherence were observed in subgroups (women, older people, people with stable accommodation and addiction). In regular attenders, changes in effectiveness outcomes of gait speed, lower limb strength, nutritional status, pain and frailty were demonstrated in LEAP-II only (p>0.05). Conclusion: These low-threshold physical activity interventions were safe, feasible, acceptable and effective in some domains indicating proof of concept. Further research evaluating effectiveness and retention-enhancing strategies are warranted. Practical Implications: This research has had immediate impact as it targeted those who are subject to inequality. A follow-up bespoke LEAP-W programme is due to commence for women experiencing homelessness and addiction where high retention and unique needs were identified. Results will enable clinicians to develop tailored interventions and address inequalities in health outcomes. It may influence policy on best practice guidelines in enhance physical activity and health of people with severe and multiple disadvantage. Funding: Trinity College Dublin, Merchants Quay Ireland, Ballyfermot Advance Project

Background: Although intersectoral partnerships are an essential strategy for promoting physical activity at the population level, the integration of equity considerations within their structures and activities remains inadequately understood. Purpose: This study examines how equity and health considerations were addressed in the development and functioning of a regional intersectoral partnership for active living promotion in Montreal, Canada. Methods: As a part of the MUSE (Multisectoral Urban Systems for health and Equity in Canadian cities) research program, we conducted in-depth, semi-structured interviews with stakeholders involved in a regional intersectoral partnership named Montréal Physiquement Active. We recruited participants from various sectors and with different degrees of experience and knowledge of the partnership. Thematic analysis was applied to interview transcripts to extract insights into the conceptualization, challenges, and strategies related to equity and health within the partnership. Results: Findings from nine in-depth interviews indicate that stakeholders perceived equity as a complex component of partnership development and functioning. Partnership stakeholders identified both internal and external equity considerations. Internally, the partnership grappled with how to establish equity between stakeholders with varying degrees of influence. Participatory governance was key in overcoming this challenge. Externally, stakeholders conscientiously sought to address inequalities in access to physical activity and sport opportunities, namely among girls, minoritized groups and families with low incomes. Health, on the other hand, was considered more implicitly as a natural outcome of physical activity and sport. Conclusions: Leadership is critical in fostering an equity-oriented culture within the partnership. Challenges in translating equity and health considerations into practice due to resource limitations and conflicting priorities were addressed with innovative strategies. Practical implications: There are meaningful ways through which intersectoral partnerships can navigate the tension between aspirational goals for equity and the practical realities of implementing collaborative approaches. Funding: CIHR Team Grant Program, Environments and Health (#IP2—150710).

Background: Little is known about sociodemographic differences in early childhood movement behaviours. Purpose: To examine whether meeting the WHO 24-h movement guidelines for yearly years (≥3h total physical activity [TPA], ≥1h moderate- to vigorous-intensity PA, 10–13h sleep, ≤1h screen time, and ≤1h restrained sitting) differed between boys and girls, urban/rural residence, and socioeconomic status (SES) of parents. Methods: Data were collected from 202 3–4-year-old children (56% boys; 49% from urban Helsinki and 51% from rural areas) who participated in the first wave of data collection in the SUNRISE Finland Study in 2022. Children wore ActiGraph accelerometers on their waist for seven days to monitor PA and sleep. Caregivers reported country of origin, work and marital status, personal and household education and income, family assets, type of property, and child’s screen time and restrained sitting. Logistic regression analyses were performed adjusting for child age and sex. Results: Girls were less likely to meet TPA guideline than boys (66% vs. 81% met the guideline, p=0.015). Children were less likely to meet TPA guideline if their parent had high compared to low education (68%;85%, p=0.032) or medium or high compared to low personal income (70%;70%;86%, p=0.022, p=0.034). Children with medium household assets were less likely to meet the restrained sitting guideline compared to low or high assets (59%;77%76%, p=0.040, p=0.026). Fewer children met the screen time (39%;54%, p=0.030) and restrained sitting (64%;77%, p=0.048) guidelines in rural compared to urban areas. Conclusions: Meeting the WHO movement guidelines for early years differs between boys and girls, SES and urban/rural areas. Results from the whole dataset (>1,000 children) will be presented at the conference. Practical implications: Sociodemographic inequalities in early childhood movement behaviours should be addressed in policy decision making and health promotion initiatives. Funding: Ministry of Education and Culture, Vainio and Gyllenberg Foundations.

Background: The occurrence of thefts and robberies in neighborhoods may deter individuals from bicycling and being physically active. Purpose: To describe time series of thefts and robberies of bicycles in the city of São Paulo and the relationships with longitudinal transport bicycling. Methods: ISA, Physical Activity and Environment study (São Paulo, SP, Brazil). Bicycling for transportation was assessed when the participants (n=1,272) answered the study questionnaire in 2014/2015 (baseline) and 2020/2021 (follow-up). Thefts and robberies of bicycles around the participants address (network buffer of 1,500 m) were obtained for the years 2015 to 2019. The time series 2015-2019 of thefts and robberies was analyzed using Prais-Winsten test. The coefficients of the annual trends were used to calculate the average annual percentage change (AAPC) in the time series. Results: Participants (45.0±19.5 yo) were mostly female (58.8%). The yearly prevalence of thefts and robberies of bicycles for each bicycling scenario over time was ‘cycling in both waves’: 2015=11.1%; 2016=22.2%; 2017=44.4%; 2018=55.6%; 2019=55.6%; ‘cycling only at baseline’: 2015=20.7%; 2016=37.7%; 2017=56.6%; 2018=41.5%; 2019=41.5%; ‘cycling only at follow-up’: 2015=10.5%; 2016=36.8%; 2017=52.6%; 2018=44.7%; 2019=50.0%; ‘no cycling’: 2015=19.3%; 2016=32.8%; 2017=51.9%; 2018=50.3%; 2019=44.5%. There was no difference in AAPC between the four bicycling scenarios; however, in all of them AAPC showed a significant upward trend for thefts/robberies: ‘cycling in both’ AAPC=24.5% (95%CI:19.6%_29.7%;p<0.01), ‘cycling only at baseline’ AAPC=36.7% (95%CI:21.6%_53.7%;p=0.003), ‘cycling only at follow-up’ AAPC=28.6% (95%CI:16.9%_41.5%;p=0.004), and ‘no cycling’ AAPC=26.8% (95%CI:24.7%_28.9%;p<0.01). In all regions where participants lived, theft/robbery increased, with the AAPC being higher in the Southern region compared to the Northern region: Midwest AAPC=25.7% (95%CI:17.2%_34.9%;p=0.002); East AAPC=28.0% (95%CI:18.0%_38.9%;p=0.002); South AAPC=38.7% (95%CI:34.1%_43.6%;p<0.01); Southeast AAPC=19.4% (95%CI:2.4%_39.1%;p=0.035); North AAPC=30.5% (95%CI:27.4%_33.7%;p<0.01). Conclusions: An increase in thefts/robberies of bicycles over time was observed, and further investigations are required to assess the impact on bicycling in São Paulo. Funding: CAPES; FAPESP: 2017/17049-3; CNPq: 309301/2020-3.