Posters 3

The benefits of an active lifestyle are recognized, even among a population suffering from chronic pain. However, it can be difficult to stay motivated to be active when pain is a major part of your daily life. The Versant AKOR project involves pairing people living with chronic pain with adventurers crossing Canada north of the 60th parallel. During the six-month expedition, participants must cover together, but remotely, the same number of kilometers as the adventurers. The participants of the 2021 research project found and maintained an active lifestyle eight months after the end of the adventure. The 2nd research project, Versant AKOR 2024, will provide a better understanding of how the motivation of participants in physical activity is transformed through this intervention model aimed at establishing a breeding ground for the development of social affiliation and the vicarious experience. Drawing on the theory of self-determination (Ryan and Deci), we are interested in the types of motivation and the impact of such a project on the adoption of an active lifestyle and on the reassessment of the place occupied by pain in life some participants. Data collection will be carried out from May to October 2024. It will consist of repeated data collection, individual interviews, as well as observation of group meetings. The presentation will focus on the protocol and preliminary results, as well as the similar research project which will begin in October in Lorient in Brittany, which is the result of a collaboration between the University of Sherbrooke and the Mobile pain unit (GH South Brittany). This study will provide relevant information on the development of a new mode of intervention based on social affiliation and thus contribute to the accessibility of an active lifestyle for all.

Background: We developed the Smart Heart prototype as a complete remote heart health monitoring and automated feedback delivery system. It uses sensing technology, combined with AI for early detection of heart failure deterioration, prompt action by end-users, and prevent heart failure-related hospitalisations by improving self-care activities, including physical activity. Purpose: To describe the preliminary effects of Smart Heart on physical activity, sedentary behaviours, and self-care activities Methods: Multi-site, single arm pilot study comprising 20 adults with heart failure. Participants accessed the Smart Heart System for 8-weeks. Outcomes were assessed at baseline and post-intervention. Physical activity and sedentary time were assessed using the Samsung Galaxy Watch Pro 5, self-care activities were assessed using the Self-Care of Heart Failure Index (SCHFI). Daily weights, symptoms, and BP were assessed via the Smart Heart platform. Results: Participants spent long periods of time being sedentary with intermittent bouts of activity performed at a light intensity. Activity levels were associated with metrics of self-care. Conclusions: This novel Smart Heart ecosystem offers a complete remote heart health monitoring and automated feedback delivery system to support people to modify sedentary time, physical activity and self-care activities, which are critical for the health and well-being of people living with heart failure. Practical implications: Study findings will inform a future Type 2 hybrid randomised controlled trial. The co-designed intervention will also provide unique insights into the use of wearable technologies and how to integrate these data. Funding: National Medical Health Research Council, GNT2004316

Background: Self-management of heart failure typically includes reducing sedentary time, increasing physical activity, self-weighing, and taking medication. Understanding how people with heart failure manage their condition is crucial for refining future interventions, however traditionally these activities have been assessed using self-report methods. Wearable cameras offer a unique and objective tool to capture the lived experiences and daily activities of people with heart failure. Purpose: We aimed to determine the potential utility of wearable cameras to better understand activities of daily living in people living with heart failure. Methods: We analysed wearable camera image data (>2M images) obtained from 30 people living with heart failure. Images were processed using the E-Myscéal system with customized search terms for seven activities of daily living (physical activity, screen time, gardening, shopping, drinking, eating, taking medication). The utility of the system for capturing specific activities was evaluated using sensitivity analysis. Daily activity image data were analysed using descriptive statistics. Differences in recorded activities were also captured for 10 participants that were readmitted to hospital for heart failure. Results: The E-Myscéal system demonstrated heightened sensitivity towards specific search terms. Overall, large numbers of images were found for screen time compared to physical activities (including shopping and gardening. More activities were recorded before midday compared with afternoons. Changes in the participants’ daily activities were also observed before and after their hospitalization. Conclusions: Wearable cameras can capture valuable data on daily physical activities of people living with heart failure to develop personalized interventions. A flexible interrogation system is crucial for efficient analysis of the huge volume of data produced by lifelogging devices. Practical implications: These data can inform personalised interventions. The E-Myscéal system is a practical tool to interrogate these types of data. Funding: Heart Foundation Vanguard Grant #101348.

Background: Physical activity improves quality of life in women with breast cancer. It is essential to implement strategies to encourage healthier habits in the continuum of cancer, especially during survival. Purpose: This study aims to present the impact and current logic model resulting from the implementation of 300 multicomponent physical exercise sessions for Brazilian women who are breast cancer survivors. Methods: Since 2013, the Cancer Institute, Sports Practice Center and University of São Paulo have implemented the Remama Program, which aims to improve the quality of life through canoeing training and has a university extension arm. In 2017, the University began developing research with this population. By 2020, owing to the COVID-19 pandemic and sanitary restrictions, researchers identified the need to offer an alternative way to exercise and counteract increased sedentary time and its consequent adverse effects on the health of these women (n=56). The ONcoFITT Program emerged offering virtual classes with multicomponent exercises through physical teleconditioning. Results: ONcoFITT’s logic model comprises: a) classes twice a week for one hour a day (n=300), b) activities based on functional capabilities, c) specific cognition activities, self-massage and meditation, d) monitoring adhesion (35%), adherence (26%) and subjective perception of effort (average 6 to 8), e) quarterly virtual physical assessment (n=12), f) monthly thematic actions and social networks (n=47). Management occurs by a multidisciplinary team and the Program aims to maintain and/or improve body strength and flexibility, and social support. Conclusions: ONcoFITT and Remama together form a hybrid Program that promotes positive impacts on the health of women breast cancer survivors, guided by a robust logic model according to their needs. Practical implications: Offer free and accessible sessions and qualified guidance on adopting healthy lifestyles for women after breast cancer. Funding: Coordination of Superior Level Staff Improvement. Keywords: Women; Oncology; Physical activity.

Research Abstracts Background: BNOTM is one of the features in the BruHealth Mobile app in Brunei Darussalam that tracks steps and offers the option to sync with wearables. Purpose: To understand the characteristics of individuals who engage with the Steps Challenge, including age, gender, nationality, district and recorded medical history of cancer, heart diseases, diabetes mellitus, cerebrovascular diseases, hypertensive diseases and dyslipidemia within the mobile app in December 2022. Methods: The study involved 191,137 participants, with data collected from the mobile app that linked to the national electronic health records. Logistic regression was used to analyze the relationship between characteristics and the steps user engagement using R studio. Results: Among the mobile app participants, 33.3% were identified as steps users. Bruneian Citizens (OR = 3.73, 95% CI: 3.60–3.87) and women (OR = 1.70, 95% CI: 1.67–1.74) were more inclined to engage in BNOTM steps. Individuals aged 20-49 years exhibited greater engagement compared to those aged 12-19 years, although participation decreased beyond 50 years. Conversely, individuals with cancer, heart diseases, diabetes mellitus, cerebrovascular diseases, hypertensive diseases and dyslipidemia were less likely to participate in BNOTM steps. These findings are all statistically significant (p<0.005). Conclusions: The study indicates there is significant interest in using mobile apps for promoting physical activity, with a third of participants engaging in steps challenge. Demographic factors like citizenship, gender and age influence participation with citizens, women and those aged 20-49 showing higher engagement. However, individuals with chronic conditions participate less. Practical implications: While mobile phone apps effectively promote physical activity, interventions need to be tailored to demographics. Efforts to improve engagement, especially among older individuals and those with chronic diseases, are essential. Funding: This study received no specific grant from any funding agency.

The Multifunctional Gymnastics Program of the Social Service of Commerce of São Paulo promotes access to its gyms with a proposal to develop physical capacities and motor skills in an integral way for students with different physical conditions over the age of 12. The physical sports activity programs aim to encourage the regular practice of physical activity in a democratic way, providing access in different regions of the state and creating opportunities for workers, their families and also benefiting populations with lower economic conditions. A little over a year ago, access was created so that users can freely visit 13 units in the São Paulo metropolitan region, so that they can optimize their time, get to know new possibilities for practice and also carry out activities near their home or work while maintaining regular exercise and using an exercise app. The unit in this survey has 1603 students, 744 of whom are elderly, and 76% of whom are female, which indicates that we offer opportunities for female care and empowerment through our activities We observed that with this access our maximum attendance per hour rose from 67 people to 98 individuals, and the evening hours saw an increase in people doing activity after work, but there was still no increase in the average number of workouts per week. The use of the app, which allows educators at all units to guide students and prescribe exercises, was well accepted by the students and demonstrates that new technologies increase access to regular physical activity.In addition, proposals for new collective training models have also led to more students from other units coming to our space.We conclude that the creation of strategies involving technology, access and diversity of activities significantly encourages attendance and permanence in our program.

Background: Peer support-based interventions are a common strategy for promoting health-related behavioral changes. With digital technology advancements, interventions using digital technology may be acceptable to older adults. Here, we evaluated the effects of implementing a digital peer-supported application (DPSA) on total physical activity (TPA) and frequency of going out (FG) among older adults using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Purpose: To evaluate and report on a DPSA intervention for older adults using the RE-AIM framework. Methods: This study was an industry-government-academia collaborative intervention between the local government, an application-development company, and a university in Fujisawa, Japan, targeting older adults who were not receiving long-term care assistance. The 3-month intervention was categorized into two terms. We assessed the reach, implementation, and maintenance information provided by the government and the company. Furthermore, we evaluated its effectiveness by adopting a pretest-posttest within-participants design, with TPA and FG using questionnaires as the primary outcome (no adoption setting). Results: The overall Reach to the population was 5.2 per 10,000. The participants’ mean age was 78.4 (standard deviation, 5.9) years, and 31 (75.6%) were females. Regarding Implementation, the intervention adherence rate was 77.3%. No significant difference was found in TPA (p=0.176) regarding Effectiveness; however, a significant increase was found in exercise time (p=0.005). A significant increase was observed in FG (p<0.001), while Maintenance is still being tracked. Conclusions: The DPSA intervention, aimed at increasing TPA and FG, showed no difference in TPA but increased exercise time and FG. Improving interventions through this study and implementing effective interventions for older adults is necessary. Practical implications: We plan to organize projects by evaluating the present intervention using the RE-AIM framework and implementing further projects in the following year. Funding: This study was financially supported by the Elderly Support Division of the Fujisawa City government.

Background: Sweat analysis has gained increasing attention due to its constitution with diverse biomolecules, offering a non-invasive alternative to invasive procedures such as blood sampling or cerebrospinal fluid (CSF) collection. This method offers a more accessible and convenient approach to monitoring physiological responses. Tryptophan is an essential amino acid that undergoes catabolism through the kynurenine pathway to generate various metabolites. These metabolites play important roles in regulating mood, energy levels, and overall well-being, and their concentrations in sweat may reflect physiological responses to exercise and metabolic activity. However, the change in metabolite concentrations, particularly in sweat, remains limited. Purpose: This study aims to develop a method for sweat collection and analysis using High-Performance Liquid Chromatography (HPLC) to investigate the sweat content of tryptophan (TRP) and its metabolites in older adults. Method: The HPLC conditions were optimized with standard TRP and metabolite solutions. Sweat samples from ninety adults (45-90 years old) were collected, and the TRP and its metabolites were analyzed using HPLC coupled with UV-vis and fluorescence detectors. Results: The optimized conditions have a retention time of under 10 minutes and linear responses of R2 > 0.99. TRP and its metabolites from sweat were detectable in the concentrations range of 130-8,000 fmol/ µg sodium, 25-200 fmol/ µg sodium, and 0.5-70 pmol/µg sodium for TRP, kynurenine, and 3-hydroxy anthranilic acid, respectively. Notably, TRP decreased, while kynurenine, increased with age. Conclusion: The HPLC technique provides a simple, fast, and sensitive method for quantifying sweat content. Incorporating tryptophan metabolite analysis into the sweat profile may facilitate the development of personalized exercise to motivate physical performance in older populations. Practical implications: Implementation of this method has the potential to promote physical activity among older adults, resulting in healthier aging and improved overall well-being. Funding: Mahidol University

Context: In April 2022, the COVID-19 epidemic disrupted the healthcare offer: many patients with chronic diseases had to interrupt thier rehabilitation. It is in this context that the Telerehabilitation Program was born in the center Pole Saint Helier, by offering patients with chronic disabilities remote interdisciplinary monitoring. Objet: After 2 years of application, the goal is to measure the effects of this remote care for the patient. Method: A questionnaire measuring satisfaction, the intensity of rehabilitation and the possibility of transposing the contributions into daily life after treatment, has been completed by patients for 2 years, as well as scales specific to the pathology (E-MIF, OSWESTRY…). Results: We note a high satisfaction rate on the part of patients, a real rehabilitative impact, motivation to continue self-rehabilitation and ease of transposition into the patient environment. The analysis of the proposed scales also shows the relevance of this type of care on quality of life. (functional abilities, fatigue) Conclusion: Born during the health crisis, Telerehabilitation Program has found its place in addition to the day hospital. Practical implications: The Telerehabilitation Program is a new intensive therapeutic approach which promotes transposition into daily life due to its anchoring in the patient’s environment. Particularly suitable when access to care is difficult (paramedical desert, young child, impossible work stoppage). It also offers a complementary solution to the care pathway for chronic patients.

Background: Physical inactivity and diabetes have increased in the Brazilian population, while their economic burden is still unclear. Purpose: To analyze the association between healthcare costs and the combination of physical inactivity and type 2 diabetes in Brazilian adults. Methods: A cohort study, in which 771 adults were tracked from 2010 to 2020. Physical activity was assessed through face-to-face interviews using the Baecke questionnaire (physical inactivity was defined as a score <P75th), while diabetes was assessed through medical records. Healthcare costs (US$) were determined by expenditures paid by the Brazilian National Health Service, accessed by medical records, and expressed as median and interquartile range values. Comparisons between groups were analyzed using the Kruskal-Wallis test (p-value <5%). Results: The median of healthcare costs accumulated from 2010 to 2020 by adults classified as Active + Non-diabetic was US$ 279.42 [287.61], while adults classified as inactive or diabetic accumulated US$ 227.80 [349.10], and adults classified as inactive + diabetic accumulated US$ 547.20 [976.20] (Kruskal-Wallis test, p-value= 0,001). Conclusions: The combination of physical inactivity and diabetes seems to significantly increase healthcare costs in Brazil. Practical implications: The combination of physical inactivity and diabetes increases primary healthcare costs among Brazilian adults by about 95%. The elimination and/or mitigation of at least one of these variables would lead to a significant economic relief to the Brazilian National Health Service. Funding: FAPESP

Background: Despite numerous health benefits and extensive promotion efforts, 35% of Australian adults did not meet the WHO physical activity (PA) guidelines in 2022. To meet the WHO goal of reducing physical inactivity by 15% by 2030, a multi-sectoral system approach is urgently needed. Purpose: We report the process and findings from a co-designed systems mapping project to present environmental, social, and policy determinants of PA for children and adults in the context of urban New South Wales (NSW), Australia. Methods: A qualitative participatory group concept mapping workshop was held in May 2023 with 19 researchers and stakeholders working in education, transportation, urban planning, community, health, and sport and recreation. Initial maps were developed and refined using further online feedback from the participants. Interviews were conducted with additional policy makers from relevant sectors to further refine the maps. Results: Two systems maps were co-created, identifying over 100 variables influencing PA and their interconnections. Five domains emerged from the adults’ map – social and community, policy, built environment and transportation, healthcare, and workplace; four for the children’s map – family, school, transportation, and community and environment. The maps share similarities such as regarding potential drivers within the transportation, community and built environment sectors; however, the children’s map has an additional focus on the school setting and the adults’ map on workplace and healthcare settings. Interviews with policy makers provided further unique insights into understanding and intervening in the PA system for children and adults. Conclusions: This co-designed participatory systems mapping process, supplemented by stakeholders interviews, provided a unique opportunity to bring together stakeholders across sectors to understand the complexity within the PA system and begin to identify leverage points for tackling the systemic drivers of physical inactivity in NSW. Funding: Australia National Health and Medical Research Council, NSW Ministry of Health

Background: Limited understanding exists regarding evidence-based policies within local government (LG) promoting environments supportive of physical activity (PA). Purpose: To determine the presence of LG policies and broadly assess their alignment with evidence-based recommendations for promoting activity-supportive environments. Methods: Australian councils (n=250) with cities or towns exceeding 10,000 residents were sent a survey investigating governance, transport, urban planning, liveability and other PA-related policies. Participants responded (yes/no) to indicate policy presence and had the option of providing additional comments. The survey aimed to identify the presence of policies supportive of activity-friendly environments. Data analysis comparing responses to evidence-based recommendations revealed their broad alignment with the evidence-base. Results: Fifty-seven responses were received from 52 councils (20.8%) across six Australian states. Most prioritised health, wellbeing or active communities (96.5%). Social inclusion was also a common policy focus (68.4%). However, few prioritised health impact assessments for urban planning (17.5%) and transport (14%) projects, or low-cost PA programs (21.1%). Creating liveable communities (84.2%) and ensuring access to parks (82.5%) were strong focus areas, but only half prioritised access to daily destinations and dwelling densities (56.1%). Key related concepts such as ‘20-minute neighbourhoods’ (22.8%) were also less prominent. Most prioritised walking (87.7%) and cycling (70.2%), but only half prioritised provision of cycling (56.1%) and walking (49.1%) infrastructure. Public transport (28.1%) and access requirements (22.8%), and walking (21.8%) and cycling (15.8%) participation targets were less common, and only one had public transport usage targets. Conclusions: Many councils prioritised healthy and active communities and had adopted high-level policies broadly aligned with evidence-based recommendations. However, the lack of more nuanced, evidence-based policies may impede progress towards achieving these aspirations. Future research is required to examine council policies more closely. Practical implications: Australian councils need to comprehensively adopt evidence-based policies to support active communities. Funding: This research received no funding.

Background: One promising method of addressing inequalities in physical activity (PA) participation globally is prescription-based-PA whereby healthcare providers (HCPs) write movement recommendations tailored to patient’s needs to complete independently. Despite success in Nordic countries, this model is underutilized in North America. Prescription-to-Get-Active (RxTGA), a not-for-profit organization based in Alberta, Canada bridges the gap between the healthcare system and fitness industry by brokering PA prescriptions written by HCPs to patients who do not meet national movement guidelines. To date, few studies have assessed prescription PA involvement experiences from HCP and recipient perspectives: an important consideration given the model’s potential for impacting health positively. Purpose: The purpose is to assess RxTGA involvement experiences by: 1) Examining barriers and facilitators to having conversations about and writing PA prescriptions quantitatively among RxTGA-affiliated HCPs; and 2) Exploring barriers and facilitators to obtaining, redeeming, and engaging in prescription-based PA qualitatively among RxTGA recipients. Methods: Using a case-study design, two groups are being recruited: 84 HCPs to complete a series of validated surveys; and 20 prescription recipients to engage in a one-on-one-semi-structured interview. HCP data are being analyzed using descriptive statistics and correlations between demographic and dependent variables. Inductive and deductive approaches are being applied to analyze recipient interview data. Results: Data collection is ongoing (June 2024 completion). It is expected that traditional engagement barriers and facilitators will be identified for both groups (e.g., time, resources, accessibility, knowledge) in addition to pandemic-specific nuances. Conclusions: It is anticipated that this Canadian study will reveal unique experiences specific to RxTGA involvement that will be transferable to enable ongoing development in the PA-prescription arena. Practical Implications: Better understanding of barriers and facilitators to involvement in PA prescription is needed to optimize engagement and reduce inactivity, thereby impacting individual, local, and global PA rates and health positively. Funding: Prescription-to-Get-Active, Alberta, Canada

The organization Montréal-Métropole en santé (MMS) brings together over 300 stakeholders dedicated to promoting active living and sustainable eating practices on the island of Montreal. However, assessing the outcomes of their joint actions is challenging due to the complexity of this intersectoral partnership. To address this difficulty, this project aimed to design, implement, and evaluate an evaluation capacity building program within MMS. A development committee, composed of both researchers and MMS members, was formed to assess the current evaluation capacities within MMS and guide the implementation of activities aimed at enhancing evaluation knowledge and skills within the organization. The committee first examined MMS’s evaluation capacities by adapting the following instrument to the MMS context: Grille d’analyse des capacités en évaluation des organismes communautaires québécois (Buetti, Bourgeois & Savard, 2019). Subsequently, this adapted instrument enabled the committee to identify strengths and weaknesses in evaluation practices within MMS that should be prioritized for fostering a stronger evaluation culture within the organization. The three priorities agreed for strengthening correspond to the following components of the instrument: (1) organizational resources; (2) planning and evaluation activities; (3) organizational decision-making. Additionally, through this identification, the committee designed and guided three workshops dedicated to building evaluation skills related to each of the three defined priorities. The workshops specifically focused on: (1) indicator selection and tool development; (2) preparation for analysis; (3) analysis of new data. Ultimately, this project contributed to a better understanding of the collective impact of MMS networks, facilitating collaboration between MMS stakeholders to effectively promote healthy lifestyles in the Montreal metropolis. Funding for this project was provided by the Mitacs program and the partner organization, MMS.

Background: Efforts such as Health-for-All Policies acknowledge that including health in policies improves public health and has co-benefits. Transport policy is an opportunity to include promote public health. However, the specific policy dynamics that lead to policy enactment and those that precede these decisions are not well understood. Purpose: We aimed to identify the dynamics and factors involved in decision making, using the case of 20 miles per hour (mph) speed limits, and the role of dynamics and factors as being facilitative and/or obstructive. Methods: In this qualitative study, 13 semi-structured interviews were carried out among 5 policy makers, 5 researchers and 3 advocates from UK, Switzerland, Spain, Ireland and Austria in cities that successfully implemented 20mph limits. Data was coded in MAXQDA according to barriers and facilitators of policy dynamics. We created a causal loop diagram (CLD) to identify reinforcing and balancing feedback loops in order to understand policy dynamics of successful policy enactment. Results: Data saturation was reached after 9 interviews. The CLD provided insight in balancing dynamics including measurement and evaluation and political leadership. For example, a balancing feedback loop around measurement and evaluation suggested that data collection and evaluation during incremental policy implementation might decrease the fear of unwanted outcomes among opposition groups, which in turn could decrease the policy makers’ fear of the public’s reaction and has the potential to increase the political leadership to implement these policies. Moreover, reinforcing feedback loops were identified around public acceptance and topic normalization. Conclusions: These insights help to understand the dynamics underlying successful policy enactment and to identify key stakeholder groups to enhance policy enactment. Policy implications: Incremental policy implementation could lead to higher public acceptance, reducing policy makers fear and potentially increase their leadership to implement policies. Funding: Vital Cities and Citizens Initiative of Erasmus University Rotterdam

Background: Professional sport clubs and organisations (PSCOs) have been identified as effective settings for health promotion (HP), however, their role within local health and wellbeing (H&W) systems as physical activity (PA) and wider HP providers is unclear. Purpose: Our research sought to explore the views of key stakeholders within the local H&W system of Bristol (United Kingdom) on the role of PSCOs within the system, the challenges of collaboration within the system, and how future partnerships could be improved locally. Methods: To address our aims, semi-structured interviews were conducted with 17 stakeholders from private, public, and charitable organisations who operate within Bristol’s H&W system. Results: Stakeholders perceived PSCOs as organisations that are often embedded within communities and therefore have significant presence and reach within their localities. Moreover, the unique access to assets, such as stadia and tickets, alongside specialist sport coaches, place PSCOs as an attractive partner within local systems, particularly for PA promotion. However, stakeholders reported concerns over the genuineness of PSCOs’ HP activities and their current approach to collaborative working. Stakeholders highlighted a lack of effective collaboration currently existing amongst organisations striving to promote PA locally and suggested a need to better understand organisations’ roles and for greater multisectoral partnership locally. Conclusions: PSCOs were considered unique and valuable organisations, however, clearer communication of their intentions and objectives is required. Organisations operating in local H&W systems should identify key partners and opportunities allowing collaboration to meet shared locality ambitions. Practical implications: PSCOs should consider approaches to better communicate their organisational intentions and structure, alongside collaborating with system partners to fund and deliver local PA and wider health promoting initiatives. Moreover, evaluations of local system approaches to health and PA promotion should be embedded in practice. Funding: This research was funded by the Bristol Sport Foundation.