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Workplace Health Assessments and Long-Term Cardiovascular Risk: A Propensity Score-Matched Emulated Target Trial in 2,091,425 Swedish Workers
Full text linkPurpose: To investigate the long-term association between participation in workplace health assessments and the risk of cardiovascular disease (CVD), using data from a nationwide programme offered through occupational health services in Sweden. Although health assessments are commonly included in workplace health promotion initiatives, the long-term effects of workplace health assessments on chronic disease risk remain largely unexplored.
Methods: A total of 418,285 individuals (45% women, mean age 43, standard deviation 11, yrs.) that participated in an occupational health profile assessment (HPA) from 1995 until 2021 were included. A propensity score-matched emulated target trial approach was used with a 1:4 match to controls (n = 1,673,140) from the general working population by sex, age, and calendar year at HPA and educational level. Cut-off of follow-up time at a maximum of five years, end of study, or CVD event or death. CVD incidence (ICD 10-codes I21, I25, I46, I63, I64, I65, I66), co-morbidity, and sociodemographic information were ascertained through national registers.
Results: There were 2,920 (0.7%) CVD events among HPA participants and 14,010 (0.8%) among controls during follow-up. Hazard ratios (HR, 95% confidence interval) for CVD events were significantly lower for HPA participants compared to controls in Model 1 (adjusted for period effect using birth cohorts); 0.83 (0.80–0.86), Model 2 (adjustment for sex, age, comorbidity, and prior CVD event); 0.85 (0.82–0.88), and Model 3 (additional adjustment for income and occupation); 0.90 (0.86–0.93). Women, younger age-groups, and individuals who participated in repeated HPAs during follow-up had a significantly lower CVD risk compared to their counterparts.
Conclusion: Participation in workplace health assessments was associated with a significantly lower long-term risk of CVD, particularly among women, younger individuals, and those undergoing repeated assessments. While causal conclusions cannot be established, these findings suggest that participation in health assessments in occupational settings may predict a lower risk of future CVD. Integrating repeated assessments into workplace health strategies may strengthen preventive efforts and promote sustained employee health and wellbeing.
Support/Funding Source: The Swedish Research Council for Health, Working Life, and Welfare (Grant No. 2023-01126)
Association Between Physicians’ Engagement in Health-Promoting Physical Activity and Their Counselling Practices on Physical Activity
Full text linkPurpose: This study aimed to explore the relationship between physicians’ personal engagement in health-promoting physical activity (PA) and their practices in counselling patients about PA.
Methods: A quantitative research design was employed, involving 202 physicians who completed an online survey. The Health and Exercise subscale of the Lifestyle and Habits Questionnaire-Brief (6 items) was used to assess participants’ PA-related health behaviours. Responses were rated on a five-point Likert scale (1 = never, 5 = very often), with higher scores indicating more favourable health-promoting behaviour. Physicians’ frequency of counselling patients on PA was measured using a five-item scale adapted from validated PA promotion questionnaires, also rated on a five-point Likert scale. Data were analysed using IBM SPSS Statistics version 29 software.
Results: Of the participants, 44.1% were categorised in the Middle range of health-promoting PA engagement, while 26.7% and 29.2% fell into the Bottom and Top ranges, respectively. A higher proportion of females were in the Middle range (51.6%), while more males were in the Bottom range (41.3%) (p < 0.001). Physicians most frequently asked patients about their PA (mean (M) = 3.28, standard deviation (SD) = 1.20) and advised them to explore the health benefits of PA (M = 3.22, SD = 1.16), though these actions were generally infrequent. Follow-up on patients’ PA progress was the least common behaviour (M = 2.53, SD = 1.32). A statistically significant relationship was found between physicians’ own PA-related health behaviours and the frequency of their PA counselling.
Conclusion: Physicians’ personal engagement in physical activity significantly influences their clinical counselling practices. Continuous development of PA-related competencies may enhance future patient-centred care and promote more frequent and effective PA counselling in clinical settings
Impact of Service Quality on Fitness Club Client Loyalty
Full text linkPurpose: The primary purpose of this study is to evaluate the impact of service quality on the loyalty of fitness club clients. The research addresses the question: ‘what is the impact of service quality on fitness club client loyalty?’.
Methods: This quantitative study employed a methodology involving the analysis of scientific literature, a survey, and statistical analysis to assess the relationship between service quality and customer loyalty in Lithuanian fitness clubs.
Results: The study found that service quality is a dynamic and subjective phenomenon formed by comparing consumer expectations with their experiences. Loyalty in the context of fitness clubs is manifested through repeated memberships, recommendations to others, and remaining faithful despite competitive alternatives. Research indicates a strong link between service quality and customer loyalty, where high-quality services foster satisfaction, trust, and commitment. The results of this study revealed that while customer expectations often exceed their actual experiences, all dimensions of service quality are significantly related to loyalty, with price, fitness programmes, and equipment having the strongest impact.
Conclusion: This research contributes to the understanding of the key service quality dimensions that influence customer loyalty in the fitness club sector in Lithuania. The findings offer practical implications for fitness club managers seeking to enhance customer retention and loyalty by focusing on improving service quality, particularly in the areas of pricing, programme offerings, and facility equipment
Physical Activity in Policy Context: Insights From the German GoPA! Country Card
Full text linkPurpose: This study examines the potential of the updated GoPA! (Global Observatory for Physical Activity) Country Card to increase the visibility of physical activity promotion and to inform strategic policy development in Germany.
Method: The research provides a critical analysis of the updated Germany Country Card, developed in collaboration with academic institutions, the German Ministry of Health and the German Public Health Institute (Robert Koch Institute). It explores how GoPA! functions as both an international benchmarking tool and a national self-assessment instrument. The focus lies on the Card’s capacity to highlight progress, identify policy gaps, and stimulate political engagement.
Results: The updated GoPA! profile for Germany shows positive developments, such as the establishment of national health goals and a growing body of scientific research on physical activity. These elements reflect a rising awareness of physical activity as a health issue. However, the profile also exposes key policy deficits. Germany lacks a standalone national action plan for physical activity and does not yet operate a permanent, well-funded surveillance system. Moreover, responsibilities for promoting physical activity remain dispersed across multiple sectors and administrative levels, often hindering a coherent and unified approach. The GoPA! Country Card makes these strengths and weaknesses visible in an internationally comparable format, creating a foundation for evidence-informed dialogue.
Conclusion: The GoPA! Country Card is more than a descriptive monitoring tool – it is a strategic resource for policymaking. By making data, policies, and research outputs visible, it supports evidence-based communication with both policymakers and the scientific community. This visibility can help identify neglected areas, foster intersectoral coordination, and strengthen political commitment. To fully harness its potential, the Card must not remain a static report but should be actively used to inform and align national strategies. Positioning physical activity promotion as a central, rather than peripheral, health policy concern is crucial. The updated GoPA! profile offers a timely opportunity to transform visibility into action, and to embed physical activity more firmly within Germany’s health policy agenda
S01-4: The Evaluation of a Nationwide Implementation of the “Living Well With COPD” Self-Management Programme in Switzerland in Persons With COPD
Full text linkIntroduction: Following its initial pilot implementation in 2017, the “Living well with COPD” self-management programme has been scaled nationwide by the Swiss Lung Associations since 2019. The aim of this mixed-methods study was to evaluate the real-world effectiveness and the experience of new coaches with the programme until February 2025.
Method: The programme incorporates six weekly group modules provided by a coach, followed by four phone-calls. It aims to support patients in managing their disease and adopting healthy lifestyle behaviours, including increasing physical activity. To evaluate the effectiveness, we assessed disease specific quality of life (Chronic Respiratory Questionnaire, CRQ), exercise capacity (1-min sit-to-stand test, 1-min STS), symptoms (COPD Assessment Test, CAT), number of exacerbations (<1 year), and change in smoking behaviour from baseline to programme end (after 14 months). We conducted personal interviews to assess the coaches’ experience with specific programme elements.
Results: Twelve Cantonal Lung Associations included in total 446 persons with COPD (mean age 68 years, 56% female), 290 patients completed follow-up assessments. The patients showed statistically significant improvements in the CRQ subscales fatigue (p = 0.005), mastery (p = 0.001), 1-min STS (p < 0.001), and CAT (p = 0.03), but no change in the other scales was observed. Fifteen persons stopped smoking (p = 0.01). Eleven coaches (82% female) were interviewed (mean duration interviews: 56 minutes). They assessed that the modules in general covered the most relevant topics, but suggested to consider additionally nutrition, incontinence, depression, and palliative care. They highly appreciated the Action Plan to improve physical activity, but for some coaches the implementation remained challenging, especially due to the different activity levels of the patients. In about half of the patients, the motivation to be more physically active improved over time. The coaches attributed the reasons to a better understanding of the relevance of physical activity and the ability to set realistic activity goals.
Conclusions: The “Living well with COPD” programme was successfully implemented nationwide in real-world settings and showed a positive impact on health status. While the significance of incorporating physical activity into patient education was unequivocal to the coaches, more comprehensive training on how to address this topic is warranted.
Support/Funding Source: This study was funded by the foundation Health Promotion Switzerland.
Keywords: Self-management programme, physical activity action plan, COPD, implementation evaluation, patient educatio
S07-3: Holistic Promotion of Physical Activity Based on Physical Literacy: Results and Implications of the PLACE Intervention
Full text linkPurpose: Although the concept of physical literacy (PL) combines physical, cognitive, and affective aspects into a holistic perspective for promoting active lifestyles and has gained increasing importance internationally, PL-based interventions and practical findings are still in their infancy in Germany. The goal of the present study was to evaluate the main phase of an extracurricular PL intervention (PLACE study) to promote health-enhancing physical activity in eight to ten-year-old children in different districts of Bremen, Germany (Pöppel et al., 2024).
Methods: We used an explanatory sequential mixed-methods design, built on five core dimensions derived from the inter-/national discussion on criteria for quality experiences in students (e.g. Ní Chróinín et al., 2018), which were assessed by comparing the intervention with regular physical education (PE). In group interviews with 40 children, we started with nonverbal reactions to quantitatively assess individual judgements along the five criteria, followed by qualitative statements to elicit verbal explanations to children’s decisions. The collected data were analysed using binomial tests and supplemented with qualitative findings.
Results: The children reported no differences between the PL intervention and compulsory PE for the dimensions ‘social interaction’, ‘improvement of motor skills’, and ‘teaching and classroom management’ (z ≤ 1.67, p ≥. 095). However, the PL intervention was superior in the dimensions ‘cognitive activation’ (z = 3.68, p <. 001) and ‘affective approach to sport’ (z = 2.47, p = .014). Taking into account the qualitative data, the quantitative results can be explained by more in-depth reflection phases (‘cognitive activation’) and a mix of teaching elements (‘affective approach to sport’). In almost all dimensions, the principle of ‘voice and choice’ was perceived as very beneficial.
Conclusion: The findings highlighted co-design and respect for individuality as supportive conditions for extracurricular interventions to promote PL-based child-centred physical activity and healthy, active lifestyles.
Funding/Support Source: Foundation “Stiftung Aktion Hilfe für Kinder”
S08-2: Monitoring Physical Activity Policies at the Subnational Level: A Review of Existing Tools
Full text linkPurpose: The subnational level plays a key role in physical activity (PA) promotion, e.g. by developing policies across different sectors and/or by implementing national PA policies. However, research on PA policy monitoring focuses mainly on the national level; to close this gap, new monitoring tools have been developed that are specifically designed for the local or regional level. This study aimed to identify and examine existing PA policy monitoring tools for the subnational level and to determine their key elements.
Methods: As PA policy monitoring tools developed by governments are not necessarily described in scientific studies, a systematic grey literature review was conducted. Steps included: (1) reference screening of existing reviews, (2) grey literature search in the data bases OpenGrey and Startpage, and (3) expert consultation. Tools were included if they were focused on the subnational level and PA policies. Key characteristics of the tools were extracted and analysed systematically (e.g. scope, data sources, scale, method of data collection, number of items, content).
Results: This review identified 17 tools that monitor, assess, or benchmark PA policies at sub-national level. Preliminary results indicate that nine of these tools were developed by researchers, while eight can be described as government-driven. The methodology of data collection differs; while the majority of tools are based on surveys, some utilise desk-research in combination with expert consultation. Most tools were tested in a single country. Moreover, the number of indicators varied widely, from as few as eight to over 280.
Conclusion: The review identified a considerable variation in methodological approaches for subnational PA policy monitoring, from in-depth qualitative case studies to large scale nationwide surveys that take place on a regular basis. As many tools were developed in a specific national context, their transferability to other countries is often unclear.
Support/Funding Source: This is part of the project IMPAQT, which is funded from Ireland, Health Research Board; Poland, National Centre for Research and Development; Germany, Federal Ministry of Education and Research; The Netherlands, The Netherlands Organisation for Health Research and Development; Romania, Executive Agency for Higher Education, Research, Development and Innovation Funding; Lithuania, Research Council of Lithuania, under the umbrella of the Partnership Fostering a European Research Area for Health (ERA4Health) (GA N° 101095426 of the EU Horizon Europe Research and Innovation Programme)
S08-4: The Prevention Survey (TPS – De Preventiepeiling): A Comprehensive Survey of Preventive Health Policies Beyond Physical Activity in Flanders
Full text linkPurpose: The primary purpose of the prevention survey (TPS) is to monitor and enhance preventive health policies across various sectors in Flanders and Brussels, including schools, enterprises, local governments, childcare facilities, and healthcare institutions. This project is innovative in its comprehensive approach, utilising a triennial survey to gather data on a wide range of preventive health measures, not just focused on physical activity and sedentary behaviour, but also on nutrition, mental wellbeing, dental health, fall prevention, smoking, alcohol and drug use.
Project or Policy Description. Development: TPS was developed by Flanders Institute of Healthy Living (NGO) in collaboration with key partners. This project is both research and practice-based, designed to evaluate and enhance preventive health policies across various settings. This was funded by the Flemish Department of Health.
Implementation: The implementation involves distributing an online detailed questionnaire to various organisations to evaluate their preventive health policies on multiple themes. The data collection is carried out every three years to track progress and identify areas for improvement.
Evaluation: The collected data are analysed to provide insights into the effectiveness of current health policies and practices. Within each health theme, the set of questions is based on several criteria for a qualitative preventive health policy. These quality criteria summarise the initiatives, measures, and facilities that constitute a qualitative preventive policy for the respective theme. The results are shared with: (1) participating organisations to help them enhance their preventive health strategies, and (2) partners in the preventive health sector and stakeholders to give them insights and inspiration for future interventions.
Dissemination: The findings from TPS are disseminated through public reports and workshops. The results are also used to inform regional health policies and support the scaling up of successful interventions.
Conclusions: TPS contributes significantly to the field of preventive health by providing valuable data that informs policymaking and practice. The project’s comprehensive approach and regular data collection offer critical insights for improving health promotion strategies and addressing health disparities across various sectors
S14-1: Building an All-Island Interdisciplinary Consortium for Research on Women in Sport, Exercise, Physical Activity, and Health
Full text linkPurpose: Outlining the development of an all island consortium for research on women in sport, physical activity, exercise, and health can provide a template for other countries to replicate our approach, which ultimately aims to conduct higher quality interdisciplinary research and to prioritise dissemination to influence policy and practice related to girls and women’s engagement in sport, physical activity, and exercise.
Project or Policy Description: Work towards developing this consortium commenced in late 2019, with purposeful activity delayed until 2022 for several reasons, including COVID-19. Representatives from higher education institutes (HEIs) across the island of Ireland convened to confirm the need and enthusiasm for this unique approach to sport and exercise science research. In turn, a survey was carried out on the people and projects of women in sport across the island and two focus groups/workshops were delivered with support from Sport Ireland. At this point a leadership group was established in January 2024 to oversee the formalisation of the consortium. Representatives from across the disciplines of sport and exercise science and from HEIs across the island met monthly to debate and finalise the mission, vision, values, and operating format of the consortium. The consortium, titled ‘míde’ launched in January 2025 at an event, which was endorsed and supported by almost 200 attendees from across research, policy, and practice. Scaling up plans for míde are working well, with several ongoing projects and funding successes to date.
Conclusions: The mission for míde is to advance interdisciplinary and impactful research about women in sport, exercise, physical activity, and health across the lifespan, generating insights that shape and inform policy, enhance practice, and foster inclusivity and equality for women and girls
S14-3: Ensuring the Voices of Adolescents are Heard in the Planning, Implementation, and Evaluation of School-Based Physical Activity Interventions
Full text linkPurpose: Public involvement in the design and conduct of research can improve research integrity, quality, and relevance. Despite growing calls for the involvement of young people in decision-making and the recognition of schools as an important setting for implementing physical activity interventions, conducting public involvement in this setting presents unique challenges and there is minimal knowledge on how public involvement is facilitated in studies involving children and young people due to sub-optimal reporting.
This presentation will emphasise the importance of public involvement in research and outline examples from two studies conducted in Northern Ireland, the Walking In ScHools (WISH) study and the Youth-Physical Activity Towards Health in Northern Ireland (Y-PATH NI) study.
Methods: Youth Advisory Groups (YAG) were set up across both studies to involve adolescents in the delivery, implementation, and dissemination of school-based physical activity (WISH) and physical education (Y-PATH NI) interventions targeted at adolescents. Across both studies, pupils aged 12–14 years were invited to attend YAG meetings, hosted by the research team. Participative methods were used to inform recruitment strategies, data collection methods, intervention materials, and dissemination.
Results: Across the WISH study, pupils attended three YAG meetings (n = 51 pupils from n = 8 schools), while the Y-PATH NI intervention was informed by two YAG meetings (n = 38 pupils from n = 5 schools). Pupils reported enjoying the YAG meetings, felt that their feedback was valued, and considered the meetings a good way to get young people involved in research. The YAG advised on specific issues and informed several key decisions in both studies. There were many examples of the impact of involvement, including low attrition rates and high levels of pupil engagement with data collection.
Conclusion: The case studies presented outline how public involvement can be conducted in the school setting. Based on our experiences to date, we plan to establish a Patient and Public Involvement panel in each participating school to further amplify the voice of adolescents in the planning, design, and conduct of school-based interventions, and ensure interventions are context-specific. These panels will advise on issues specific to their school environment, with the aim of enhancing implementation and adherence to the intervention