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Sedentary Time, Sleep, and Physical Activity: A Structural Equation Model of Health-Related Quality of Life in Saudi Children and Young People
Get PDFPurpose: Health-related quality of life (HRQoL) is shaped by behavioural, physiological, and contextual factors. In Saudi Arabia, socio-cultural norms and environmental factors may uniquely shape how children and young people (CYP) engage in physical activity (PA) and experience its impact. This study aimed to 1) explore associations between PA, sedentary time (ST), sleep, and HRQoL; 2) examine whether body size and physical fitness mediate the PA–HRQoL relationship; and 3) assess the influence of biological maturity on these variables.
Methods: A sample of 404 Saudi CYP (202 males; 12.2 ± 2.4 years) wore wrist-mounted accelerometers (Axivity AX3) for seven consecutive days to assess PA, ST, and sleep. Physical fitness was estimated via the 20 m shuttle run test, and body size via body mass index and waist circumference. HRQoL was measured using the validated Arabic KIDSCREEN-27. Age-to-peak-height-velocity served as a marker of biological maturity. Partial Least Squares Structural Equation Modelling (PLS-SEM) with 5,000-sample bootstrapping tested hypothesised associations.
Results: ST was negatively associated with PA (β = –1.02, p < 0.001) and sleep (β = –0.53, p < 0.001). Shorter sleep duration was also associated with lower PA (β = –0.61, p < 0.001). PA was associated with lower body size (β = –0.20, p = 0.003), which predicted reduced fitness (β = –0.30, p < 0.001) and lower physical wellbeing (HRQoL subscale; β = –0.28, p < 0.001). No direct PA–HRQoL link was observed. Physical fitness was not significantly associated with HRQoL (β = 0.065, p = 0.150). A significant indirect association between PA and HRQoL emerged through body size alone. Maturity was negatively associated with PA (β = –0.14, p < 0.001) and physical fitness (β = –0.19, p = 0.002) but not body size (β = –0.085, p = 0.202).
Conclusion: Findings highlight intermediary pathways linking ST, sleep, and PA with HRQoL in Saudi CYP. The absence of a direct PA–HRQoL association reinforces body size as a key mediator. Greater biological maturity may be associated with lower PA and fitness, possibly due to psychosocial or behavioural factors. These results emphasise the importance of culturally tailored, age-sensitive interventions to support PA and wellbeing. Longitudinal research is warranted to clarify these relationships and inform evidence-based strategies to improve quality of life among children and young people.
Support/Funding Source: This is supported by the University of Tabuk, the Saudi Arabian Cultural Bureau in London, and Swansea University
The Associations Between Leisure-Time Physical Activity and Psychological Distress: Moderation by Age in Two Cohorts
Get PDFPurpose: Higher levels of physical activity are associated with better mental health. However, there is mixed evidence on the role of age in moderating this association. The present study investigates how age moderates the prospective associations between different intensities of leisure-time physical activity (LTPA) and psychological distress.
Methods: The study was conducted on survey data from 2017 and 2022 from two different cohorts of the Finnish Helsinki Health Study: the working age employees’ and the ageing employees’ cohort (n = 8,307). The working age employees were between 19 and 39 years old and the ageing employees between 55 and 75 years old at baseline. LTPA was measured as metabolic equivalent hours (MET-hours) across three intensity levels (light, moderate, vigorous) in 2017. Psychological distress in 2022 was measured using the emotional wellbeing subscale from the RAND-36 questionnaire. General linear models were used to examine whether age moderates the association of light, moderate, and vigorous LTPA with psychological distress. The models were adjusted for baseline psychological distress and covariates, including sociodemographic factors and health related behaviour.
Results: The working age employees and the ageing employees averaged 61.4 and 30.6 MET-hours of total LTPA per week, respectively. The working age employees reported, on average, slightly more psychological distress compared to the ageing employees. Higher moderate LTPA was associated with less psychological distress, β = –0.04, t = –3.0, p < .01. Similarly, higher vigorous LTPA was associated with less psychological distress, β = –0.03, t = –3.1, p < .01. However, only the association between moderate LTPA and psychological distress was moderated by age, β = –0.002, t = –3.6, p < .001, such that the association between higher moderate LTPA and less psychological distress became stronger with increasing age.
Conclusion: Moderate and vigorous LTPA appear beneficial for managing psychological distress, with the benefits of moderate activity potentially increasing with age. Therefore, age should be considered when designing physical activity interventions aimed at supporting mental health.
Support/Funding Source: Ministry of Education and Culture, the Juho Vainio Foundation, and The Research Council of Finland (330527)
The Relationship Between Injury and Motivation in Pickleball Players
Get PDFPurpose: Although the health benefits of physical activity across all ages are well-established, 27.5% of the world’s population does not achieve recommended physical activity levels. Psychological and motivational characteristics driving participation in physical activity are studied; however, less is known about barriers such as injuries. Pickleball is the fastest-growing sport in the US, played by people of all ages, in which injuries are increasing. Despite research on motivational drives and pickleball health benefits, little is known about players’ injuries and how they relate to those limits. This study aims to define the relationship between motivation and injury, how it varies across ages, and how players experience and recover from injury.
Methods: This study used a self-reported methodology in which 472 pickleball players completed an online survey posted on Prolific. The survey included the ENJOY Scale, a motivational scale of five factors, and items querying physical injury type and status. Differences in motivation levels and injury status across interest groups were analysed using ANOVAs and qualitative analyses.
Results: Results reveal that injured pickleball players have higher levels in each ENJOY dimension (Pleasure, Relatedness, Competence, Improvement, and Engagement) than those who are not. According to that, most of the injured sample reported continuing to play despite the pain and not reducing the frequency, thereby enhancing the risk of getting severe injuries due to misuse. Moreover, the most common strategies for injury recovery that pickleball players use are: body supports covering the lower part; seeking the care of medical and health experts; using professional equipment and practicing physical activity off the court.
Conclusion: These findings shed light on a fast-growing sport mostly played by amateurs across all ages, where motivational drivers relate to injury risk in line with the literature on sports. Showing how enjoyment leads players to ignore pain, this study contributes to understanding factors that enable and limit health-enhancing physical activity. These results help professionals to design targeted interventions that promote healthy and safe participation in pickleball, considering both positive and negative aspects.
Support/Funding Source: Embry-Riddle Aeronautical University, Daytona Beach Campus, Florida, US
Unravelling Inactivity: Understanding Groups in The Netherlands Who Do Not or Insufficiently Engage in Physical Activity
Get PDFPurpose: In 2023, 45% of the Dutch population met the Dutch Physical Activity (PA) guidelines. The Dutch government aims to increase this to 75% in 2040. The guidelines consist of two components: PA-minutes of at least moderate intensity spread throughout the week, and bone/muscle-strengthening activities. In order to effectively address individuals who do not meet the guidelines, this group first needs to be identified further. The aim of the current study is to define and describe ‘inactive’ and ‘insufficiently active’ groups. This information can help policymakers in designing targeted PA strategies.
Methods: Data of the Dutch Health Survey/Lifestyle Monitor (Statistics Netherlands (CBS)/RIVM) from 2023 was used (n = 9,033). Individuals who do not reach ≥30 minutes of at least light intensity PA (metabolic equivalent (MET) ≥1.6) per week (adults, age ≥18) or per day (children, age 4–17) are considered ‘inactive’. The group that does not match the ‘inactive’ criteria, nor complies to the PA guidelines, is labelled ‘insufficiently active’. Demographic and health characteristics of both groups were studied. The ‘insufficiently active’ group was examined further by looking at duration, frequency, and nature of reported PA. Specifically the spreading of PA throughout the week was studied, maintaining a conservative threshold of seven moments per week.
Results: In 2023, 1.6% of the Dutch population (age ≥4) was inactive and 53.3% classified as insufficiently active. Both groups showed overrepresentation of people with disabilities/chronic illnesses or poor perceived health. The ‘insufficiently active’ individuals showed a lot of variation in PA behaviour. Some already reach sufficient PA minutes, but at too low an intensity and/or insufficiently spread these throughout the week. By engaging in PA a little more often (1–2 additional moments per week), the proportion of the Dutch adult population meeting the guidelines could increase from 44.0% to 56.0%.
Conclusion: The current results show characteristics of the inactive and insufficiently active groups, and provide new building blocks for PA policy. By adding a few weekly PA moments, the percentage of Dutch adults meeting the guidelines could increase drastically.
Support/Funding Source: This research was funded by the Ministry of Health, Welfare and Sport of The Netherlands
Association Between Device-Measured Moderate-to-Vigorous Physical Activity and Perceived Work Ability Among Finnish Adult Population in 2017 and 2023
Get PDFPurpose: To examine associations between device-measured moderate-to-vigorous physical activity (MVPA) and perceived work ability among Finnish adult population in 2017 and 2023.
Methods: We used cross-sectional population health examination survey on physical activity, sub-sample data restricted to under 68-year-old participants of FinHealth 2017 (n = 668) and Healthy Finland 2023 (n = 642). Accelerometer data were analysed to quantify MVPA (ActiGraph GT9X Link). Analysis included participants (43% men), who wore the device 24 hours on three or more days. MVPA information was extracted from 60-second epoch data to ENMOs. We classified MVPA into three groups: less than 30 min per day, 30–90 min per day, and over 90 min per day. Self-reported estimates of current work ability in relation to the person’s lifetime best on a scale from zero to ten (0–10) were dichotomised into good (8–10) and limited (0–7). IBM SPSS Statistics 29 software were used for the logistic regression analyses.
Results: In 2017, 22% of the working aged sample had limited work ability whereas in 2023, 24% had limited work ability. In 2017, 14% had less than 30 min per day MVPA, 53% 30–90 min per day, and 33% more than 90 min per day. In 2023, the figures were similar, i.e. 15%, 55%, and 30%, respectively. The MVPA associations with perceived work ability showed somewhat different in 2017 and 2023. Compared with the most active group, in 2017 the least active group (odds ratio (OR) 2.1; 95% confidence interval (CI) = 1.1–4.0) but not the intermediate activity group (OR 1.4; 95% CI = 0.9–2.3) had a higher likelihood of limited work ability when adjusting for sex, age, education, smoking, and body mass index. Whereas in 2023, both the least active (OR 3.9; 95% CI = 1.9–7.9) and the intermediate (OR 2.1; 95% CI = 1.2–3.6) groups had a higher likelihood of limited work ability.
Conclusion: Lower levels of MVPA associated with a higher likelihood of limited work ability and associations were stronger in 2023 than in 2017. Promoting MVPA may prove useful in maintaining population work ability.
Support/Funding Source: Juho Vainio foundation (Grant #202400184)
Physical Function Among Older Recreational Orienteers: A Comparative Study With the General Population
Get PDFPurpose: Orienteering is a popular activity among older adults in Sweden, but little is known about the physical characteristics and health outcomes of this group compared to the general older population. This study aimed to: 1) describe the physical function of older orienteers, and 2) compare their physical function to that of age-matched active men and women from the general population.
Methods: Men and women aged 65 years and older who participate in recreational orienteering at least once a year were invited to participate. Data were collected in the field. Physical function was assessed using four measures: balance (total ascents on the preferable leg during 60 seconds), grip strength, coordination/motor skills (Timed Up and Go [TUG]), and functional leg strength (number of sit-to-stand during 30 seconds). For comparison, individual data from 1,407 community-dwelling physically active older adults were used. Total description of the comparative population was conducted. Linear regression analyses, adjusted for age, were used for comparisons between the two populations.
Results: A total of 287 individuals participated (37% women), aged 65 to 91 years, median age of 75 years. Median balance score was 1 ascent (interquartile range (IQR): 1.0–2.0 women, 1.0–3.0 men). Median grip strength was for left and right: 228/250 N (IQR: 211–254/221–278) in women, and 380/402 N (IQR: 325.5–420.8/356–445.3) in men. Median TUG was 5.47 s (IQR: 5.0–6.1 women, 5.0–6.3 men). Median sit-to-stand transitions were 20 (IQR: 16–24) in women and 19 (IQR: 16–22.25) in men. Compared to active community-dwelling older adults, both male and female orienteers performed significantly better regarding balance ascents (+1.1 ascents less for both men and women), TUG time (–1 seconds in women and –0.9 seconds in men), and sit-to-stand transitions (+4.8 in women and +4.0 in men) (all p < 0.01). No significant differences were found for grip strength (p-range = 0.190 to 0.739).
Conclusion: Older male and female recreational orienteers demonstrated significantly better performance in several indicators of physical function compared to active non-orienteer peers. Since orienteering naturally challenges balance, leg strength, and coordination/motor skill, these findings suggest that orienteering may be a beneficial form of physical activity for maintaining functional capacity in later life.
Support/Funding Source: Dr. Margaretha Nilsson’s Foundation for Medical Research
S03-3: Local Community Engagement Mechanisms in Five Countries (Denmark, France, Italy, Malta, and Spain) in the Placemaking & Sport Project
Get PDFPurpose: The EU funded Placemaking & Sport project enabled sport organisations to rethink their sport and physical activity offers through placemaking and local community involvement. The project encouraged sport organisations and towns in Denmark, France, Spain, Malta, and Italy to explore new ways of engaging communities in an active lifestyle to bring public space to life.
Project Description. Development and Implementation: Coordinated by ISCA, the project paired grassroots organisations with city representatives – Azur Sport Santé and the City of Nice (France), UISP and UISP Matera (Italy), MOVE Malta and Sport Malta (Malta), DGI and the City of Copenhagen (Denmark), DES and City of Valencia (Spain). The project showcased how, by engaging the local communities’ needs, movement can thrive in unexpected spaces, promoting healthier and more connected cities.
After 18 months of experimentation in diverse cities across Europe, various placemaking methodologies were piloted with the focus on engaging local citizens in decision-making and together transforming spaces into active thriving public places. This included teenagers in Italy, elderly in Denmark, schools, sport and nature organisations in Malta, neighbourhood associations in Spain, and street art associations & museums in France.
Through physical activity and play, but also sharing memories, rekindling childhood connections to parks and squares, inventing games, and telling stories, the transformative power of placemaking in creating more vibrant and inclusive communities was showcased.
Dissemination: The dissemination efforts were focusing on the storytelling of the local activities that were amplified through podcasts and videos. A follow-up initiative in France has already been funded to continue developing their pilot. The learning materials and resources are collected on https://placemaking.isca.org to further build capacities of the sector.
Conclusions: With urban areas facing a shortage of sport facilities, the project demonstrated how squares and parks could serve as accessible venues for physical activity. It sought to reshape the perception of where and how people move while keeping the community at the centre of it through diverse engagement activities. It promoted flexible, inclusive spaces that encourage walking, socialising, and informal recreation ensuring that movement becomes a natural part of everyday life for people of all ages and abilities.
Keywords: Participation, placemaking, physical activity, sport, urban developmen
S07: Health Promotion in the Physical Education Setting
Get PDFThis symposium explores the promotion of health-enhancing physical activity (HEPA) through innovative practice and research initiatives situated in physical education (PE) contexts across different European countries. With a shared aim of advancing physical literacy (PL), upskilling PE teachers, and enhancing student engagement, the symposium features one EU-funded policy/practice project and three research-oriented studies addressing diverse educational stages and methodological approaches:
· The first presentation introduces ePhyLi, an Erasmus+ Sport funded project designed to enhance university students’ knowledge and understanding of PL, equipping future PE teachers to become advocates of meaningful, healthy, active lifestyles. Implemented across the EU and supported by EUPEA, the project has developed multilingual digital tools, including an e-book, a mobile application, and a gamified e-learning platform, currently undergoing pilot testing to assess educational impact, usability, and user experience.
· The second presentation reports on a Romanian study evaluating the effectiveness of Kahoot! platform for enhancing PE lessons aimed at improving fifth-grade students’ theoretical knowledge and understanding of PL. Employing an experimental design, the study revealed significant learning gains in the experimental group, reinforcing the potential of digital gamification elements to enhance engagement and learning in PE and Health classes.
· Our third presentation reports on the PLACE intervention, an extracurricular programme in Germany designed to promote children’s HEPA through a PL framework. Using a mixed-methods design, the study compared the intervention with regular PE across five dimensions of quality experiences. Findings revealed that PLACE was particularly effective in enhancing children’s cognitive activation and affective engagement in sport, underscoring the importance of co-design and respect for individuality in fostering PL-based, child-centred active lifestyles.
· Finally, a study from Latvia examines the relationship between students’ physical fitness levels and their engagement in PE and Health classes across age groups. Drawing on data from fitness assessments, surveys, and pedagogical observations, the findings demonstrate that students with higher physical fitness levels exhibit increased engagement, highlighting the need for more inclusive and differentiated pedagogical approaches for developing PL.
Together, the four contributions underscore the importance of effective high-quality pre- and in-service training, innovative pedagogies, and inclusive practices in nurturing engagement in lifelong HEPA. The symposium demonstrates how digital innovation, collective approaches, and differentiated instruction can empower educators and learners collectively, contributing to developing PL and broader public health goals in and through PE.
Keywords: Physical education, physical literacy, digital tools, health; professional developmen
S10: Lessons From Developing or Updating National Physical Activity Recommendations in Switzerland, Germany, and Hungary: Processes and Challenges
Get PDFInsufficient physical activity (PA) is a growing global health problem: nearly one-third (31%) of adults worldwide did not meet recommended PA levels in 2022, compared with 23% in the year 2000.
WHO has provided recommendations for both individual-level PA (Guidelines on PA and sedentary behaviour) and PA promotion (Global Action Plan for PA). Their importance for the national level is manifold: They set targets for PA practice within different population sub-groups, provide monitoring indicators, and assist stakeholders from policy and practice in promoting PA within the population. However, the adoption of WHO’s recommendations at national level varies between countries and over time, depending on a variety of factors such as overall country capacity, current population PA levels, and the status of national PA strategy deployment. This symposium presents the development or update of national PA recommendations in three European countries that are in various stages of their national PA policy cycle: Switzerland, Germany, and Hungary.
The symposium will start with Switzerland, focusing on the experience and challenges of updating the national PA recommendations based on the WHO PA guidelines. The second and third presentations will introduce the update of the German recommendations for PA and PA promotion, looking at: (1) the integration of different settings, health equity, and planetary health, and (2) ways to better include qualitative aspects of PA, like exercise in green spaces or activities with meaningful others. The final presentation will showcase the importance of using the Hungarian PA recommendations for the monitoring of the national Active Lifestyle Strategy.
The presentations will be followed by a moderated discussion of topics such as: (1) links between updates of WHO and national PA recommendations, (2) the implementation of national PA recommendations and policies, or (3) the limits of PA recommendations in positively impacting population-level PA
S10-4: PA Recommendations and Their Future Monitoring in the Hungarian Active Lifestyle Strategy
Get PDFPurpose: The purpose of the National Active Lifestyle Strategy is to raise proportion of physically active people in Hungary. It also sets goals to reduce the time spent sitting, and, following the World Health Organization (WHO) recommendations, to achieve a minimum of 150–300 minutes of moderate-intensity physical activity (PA) per week for adults, and a minimum of 60 minutes of moderate-vigorous PA per day for children.
Policy Description: In order to support evidence-based policy making, the Active Lifestyle Survey was conducted at the turn of 2023–24 on a national representative sample of the adult population, which will be one of the main monitoring tools in the future.
The Strategy endorses the WHO PA recommendations and sets the goal of reducing the percentage of adults never practising sports by 15% by the year 2035. The baseline value for monitoring has been set by the 2023/2024 Active Lifestyle Survey, which found that 55% of the Hungarian adult population never practice sport.
Besides the Active Lifestyle Survey, which will be the main monitoring tool of the Strategy, and which focuses on the characteristics, motivations, and perceived barriers to PA, the data sources used for reporting PA prevalence for the WHO-EU PA country factsheets, notably the European Health Interview Survey for adults and the Health-Behaviour Survey of Children, remain as main data sources in the near future.
Dissemination and communication of the Strategy is already ongoing. Monitoring activities will be coordinated and handled in an integrated way, trying to create synergies among the already existing data sources and the newly established Active Lifestyle Survey, which is planned to be repeated every four years.
Monitoring of the Strategy needs to be harmonised, using also the existing monitoring tools that are parallelly in place. The Active Lifestyle Survey will be the basic reference to monitor the success of the Strategy, while the activities and data reported in the framework of the EU-WHO HEPA Focal Network will be an integral part of the monitoring measures as well