Neighborhood characteristics, adherence to walking, and depressive symptoms in midlife African American women. Differential exercise effects on quality of life and health-related quality of life in older adults: a randomized controlled trial A Walking Program for Outpatients in Psychiatric Rehabilitation: Pilot Study Walking football as sustainable exercise for older adults – A pilot investigation Social Rhythm and Mental Health: A Cross-Cultural Comparison Physical activity and mental health outcomes during menopause: A randomized controlled trial Home training with and without additional group training in physically frail old people living at home: effect on health-related quality of life and ambulation Relationship between regular walking, physical activity, and health-related quality of life. "Step by Step". A feasibility study of a lunchtime walking intervention designed to increase walking, improve mental well-being and work performance in sedentary employees: Rationale and study design EFFECTS OF EXERCISE ON MENTAL AND PHYSICAL HEALTH PARAMETERS OF PERSONS WITH SCHIZOPHRENIA Exercise volume and intensity: a dose–response relationship with health benefits The long-term effects of a primary care physical activity intervention on mental health in low-active, community-dwelling older adults Inverse association between physical inactivity and mental health in men and women. Physical activity and mental well-being in older people participating in the Better Ageing Project Views and experiences of behaviour change techniques to encourage walking to work: a qualitative study Improving physical function and blood pressure in older adults through cobblestone mat walking: a randomized trial. Daily physical activity in adults with mild and moderate learning disabilities: is there enough? Effectiveness of Three Different Walking Prescription Durations on Total Physical Activity in Normal- and Overweight Women Exercise and well-being: a review of mental and physical health benefits associated with physical activity Adherence to a home-walking prescription in patients with chronic obstructive pulmonary disease. Older women and physical activity: using the telephone to walk. A Pilot Study Describing Physical Activity in Persons with Schizophrenia Spectrum Disorders (SSDS) after an Exercise Program Experiences of route and task-based walking in a university community: qualitative perspectives in a randomized control trial. Using epidemiological data to model efficiency in reducing the burden of depression* Role of antiretroviral therapy in improving food security among patients initiating HIV treatment and care A progressive postresection walking program significantly improves fatigue and health-related quality of life in pancreas and periampullary cancer patients. Effects of nurse counseling on walking for exercise in elderly primary care patients. Can Exergaming Contribute to Improving Physical Activity Levels and Health Outcomes in Children? An overview of the "Positive Action for Today's Health" (PATH) trial for increasing walking in low income, ethnic minority communities. I-DECIDE: An Online Intervention Drawing on the Psychosocial Readiness Model for Women Experiencing Domestic Violence. Motivational interviewing increases physical activity and self-efficacy in people living in the community after hip fracture: a randomized controlled trial
BACKGROUND African American women have more symptoms of depressed mood than white women . Adverse neighborhood conditions may contribute to these symptoms . Although reductions in depressive symptoms with physical activity have been demonstrated in white adults , little research has examined the mental health benefits of physical activity in African American women . Further , it is unknown whether physical activity can offset the effects of living in disadvantaged neighborhoods on depressive symptoms . The purpose of this study was to examine the relationships among neighborhood characteristics , adherence to a physical activity intervention , and change over time in depressive symptoms in midlife African American women . METHODS Two hundred seventy-eight women participated in a home-based , 24-week moderate-intensity walking intervention . Either a minimal treatment ( MT ) or enhanced treatment ( ET ) version of the intervention was r and omly assigned to one of the two community health centers .  Walking adherence was measured as the percentage of prescribed walks completed . Objective and perceived measures of neighborhood deterioration and crime were included . RESULTS Adjusting for demographics , body mass index ( BMI ) , and depressive symptoms at baseline , walking adherence and objective neighborhood deterioration were associated with significantly lower depressive symptoms , whereas perceived neighborhood deterioration was associated with significantly higher depressive symptoms at 24 weeks . CONCLUSIONS Adherence to walking as well as aspects of the environment may influence depressive symptoms in African American women . In addition to supporting active lifestyles , improving neighborhood conditions may also promote mental health among African American women Abstract Purpose Maintaining quality of life ( QOL ) and physical and mental health status are important outcomes throughout the aging process . Although cross-sectional studies suggest a relationship between global QOL and physical activity , it is unclear whether such a relationship exists as a function of exercise training . Methods We examined the effects of two exercise intervention arms on health-related quality of life ( HRQOL ) and global QOL .  Low-active , older adults ( n = 179 ) were r and omly assigned to either a 12-month aerobic walking group or a strengthening and flexibility group .  HRQOL and QOL were measured at baseline , 6 , and 12 months . Results There was a significant group by time effect on QOL [ F(2,176 ) = 3.11 , p = 0.047 , η2 = 0.03 ] . There was also a significant overall group by time effect for HRQOL [ F(4,174 ) = 2.46 , p = 0.047 , η2 = 0.05 ] , which was explained by the significant group by time interaction for mental health status ( p = 0.041 , η2 = 0.02 ) favoring the walking condition . Further analyses using latent class analysis revealed three classes of individuals with differential patterns of change in QOL and HRQOL across time . These classes reflected no change , declines , and improvements in these constructs across time . Conclusions Walking appears to enhance the mental aspect of HRQOL and global QOL when compared to a non-aerobic intervention . Additionally , the patterns of change in QOL and HRQOL were not linear over time . Our findings are in contrast to previous reports that these outcomes change a little or not at all in r and omized trials The purpose s of this quasi-experimental pilot study were to determine adherence to a 12-week group-based moderate-intensity walking program for sedentary adult out patients with serious and persistent mental illness and to examine change from baseline to after the walking program in health status ( mental and physical health , mood , and psychosocial functioning ) and exercise motivation ( exercise outcomes expectancies , exercise decisional balance ) .  The 15 volunteers in this study were aged 21 to 65 years and enrolled in psychosocial rehabilitation ; they participated in a 12-week walking program meeting three times per week for 1 hr , supplemented with four health information workshops delivered at the beginning of the study . Participants received individual exercise prescriptions determined by preprogram fitness testing and used heart rate monitors during walking sessions .  Thirteen participants ( 87 % ) completed the study and attended 76 % of the walking sessions . Overall , they walked at lower intensity than prescribed , with pulses within target heart rate ranges 35 % of the time during Weeks 1 through 4 , 26 % of the time during Weeks 5 through 8 , and 22 % of the time during Weeks 9 through 12 . However , mood improved ( Profile of Mood States , t = -2.51 , two-tailed , df = 12 , p = .02 ) , as did psychosocial functioning ( Multnomah Community Ability Scale , two-tailed , df = 12 , t = 2.49 , p = .02 ) . The findings indicate a walking group may be feasible for rehabilitation programs . In addition to the known cardiovascular risk-reduction benefits of regular walking , walking may improve mood and psychosocial functioning in adults with serious and persistent mental illness Abstract The health benefits of playing football and the importance of exercise and social contact for healthy ageing are well established , but few older adults in the UK take enough exercise . Football is popular , flexible in format and draws players into engrossing , effortful and social exercise , but the physical dem and s of play at full speed may make it unsustainable for some older adults . Restricted to walking pace , will play still be engaging ? Will health benefits be retained ? Will physical dem and s remain manageable ? This pilot study aims to investigate : ( 1 ) the experience of older adults playing walking football  every week , is it sustainable and rewarding , ( 2 ) the intensity and locomotor pattern of walking football , ( 3 ) the scale and nature of walking football  health benefits and ( 4 ) possible cognitive benefits of playing walking football through measures of processing speed , selective and divided attention and updating and inhibition components of executive function .  ‘ Walking football ’ and ‘ waiting list ’ groups were compared before and after 12 weeks of one-hour per week football . Walking football was found to be engaging , sustainable for older adults and moderately intensive ; however , selective health and cognitive benefits were not found from this brief intervention . Highlights Walking football is a lower impact but authentic form of football that enables older players to extend their active participation . Walking football is enjoyable and moderately dem and ing and may be a sustainable form of exercise for older adults . Health and cognitive benefits to playing walking football were not found Background Social rhythm refers to the regularity with which one engages in social activities throughout the week , and has established links with bipolar disorder , as well as some links with depression and anxiety . The aim of the present study is to examine social rhythm and its relationship to various aspects of health , including physical health , negative mental health , and positive mental health . Method Question naire data were obtained from a large-scale multi-national sample of 8095 representative participants from the U.S. , Russia , and Germany . Results Results indicated that  social rhythm irregularity  is related to increased reporting of health problems , depression , anxiety , and stress . In contrast , greater regularity is related to better overall health state , life satisfaction , and positive mental health . The effects are generally small in size , but hold even when controlling for gender , marital status , education , income , country , and social support . Further , social rhythm means differ across Russia , the U.S. , and Germany . Relationships with mental health are present in all three countries , but differ in magnitude . Conclusions  Social rhythm irregularity  is related to mental health in Russia , the U.S. , and Germany Background : Many women experience detriments in mental health during the menopausal transition . Physical activity may attenuate these adverse outcomes but few studies investigating such effects exist . Purpose : This study examined the effects of a 4-month r and omized controlled exercise trial on mental health outcomes in 164 previously low-active middle-aged women ( M age=49.9 ; SD=3.6 ) . Methods and Results : Participants completed body composition and fitness assessment and a battery of psychological measures at the beginning and end of a 4-month r and omized controlled exercise trial with three arms : walking , yoga , control . The results indicated that walking and yoga were effective in enhancing positive affect and menopause-related QOL and reducing negative affect . Women who experienced decreases in menopausal symptoms across the trial also experienced improvements in all positive mental health and QOL outcomes and reductions in negative mental health outcomes . Whether menopausal symptoms increased or decreased across the trial appeared to be determined in part by whether there were increases or decreases in cardiorespiratory fitness . Conclusions : Physical activity appears to enhance mood and menopause-related QOL during menopause , however , other aspects of mental health may be affected only as a result of reduction in menopausal symptoms . Increasing cardiorespiratory fitness could be one way to reduce menopausal symptoms Objective : To test the effect of two exercise regimes on health-related quality of life ( HRQoL ) and ambulatory capacity . Design : R and omized controlled trial . Subjects : Seventy-seven community-dwelling physically frail people over 75 years of age ( mean=81 , SD=4.5 ) . Interventions : Home training ( HT , N = 38 ) comprised twice daily functional balance and strength exercises and three group meetings . Combined training ( CT , N = 39 ) included group training twice weekly and the same home exercises . Interventions lasted 12 weeks . Physiotherapists ran both programmes . Home exercises were recorded daily . Main measures : HRQoL was assessed by SF-36 , and ambulatory capacity by walking speed and frequency and duration of outdoor walks . Results : Following intervention , CT improved the SF-36 mental health index significantly more than HT ( p = 0.01 ) . The SF-36 physical health index ( p = 0.002 ) and walking speed ( p = 0.02 ) demonstrated improvements , but no group differences . Six months after cessation of intervention there was still overall improvements on the mental health index ( p = 0.032 ) , borderline overall improvements on the physical health index ( p = 0.057 ) , higher weekly number of outdoor walks for the CT group than for the HT group ( p = 0.027 ) and an improved habitual walking speed in the CT group only ( p = 0.022 ) . Conclusions : HT improved HRQoL and walking speed , but additional group training gave larger benefits on mental health . Group training away from home may be beneficial for mental health and ambulatory capacity BACKGROUND The current physical activity ( PA ) and  health-related quality of life ( HRQoL ) literature warrants further investigation with general population sample s. The exploratory-focused purpose of this study was to compare total PA-HRQoL and walking-HRQoL relations , include a measure of general happiness , and to evaluate potential activity-HRQoL demographic moderators . METHODS A r and om sample of 351 adults completed an adapted Godin Leisure Time Question naire , the SF-36 , and the Satisfaction with Life Scale .  RESULTS Partial correlations revealed small-to-moderate associations between walking/total PA and general health , vitality , and social functioning after controlling for key demographics ( P < 0.05 ) . A dependent t-test determined  walking and PA  as equally related to vitality and social functioning . Multiple regression revealed annual income as a moderator of the total PA/walking-social functioning relationship [ F(3,315 ) = 9.71 and F(3,316 ) = 12.03 , P < 0.01 , respectively ] . CONCLUSIONS HRQoL may be considered with walking interventions and annual income . The contribution of PA to overall happiness appears to be minor Background Following an extensive recruitment campaign , a 16-week lunchtime intervention to increase walking was implemented with insufficiently physically active University employees to examine programme feasibility and the effects of the programme in increasing walking behaviour , and in improving well-being and work performance . Methods / design A feasibility study in which participants were r and omised to an immediate treatment or a delayed treatment control ( to start at 10 weeks ) group . For the first ten weeks of the intervention , participants took part in three facilitator-led group walks per week each of thirty minutes duration and were challenged to accumulate another sixty minutes of walking during the weekends . In the second phase of the intervention , the organised group walks ceased to be offered and participants were encouraged to self-organise their walks . Motivational principles were employed using contemporary motivational theory . Outcome measures ( including self-reported walking , step counts , cardiovascular fitness , general and work-related well-being and work performance ) were assessed at baseline , at the end of the 16-week intervention and ( for some ) four months after the end of the intervention . Process and outcome assessment s were also taken throughout , and following , the intervention . Discussion The results of the intervention will determine the feasibility of implementing a lunchtime walking programme to increase walking behaviour , well-being and performance in sedentary employees . If successful , there is scope to implement definitive trials across a range of worksites with the aim of improving both employee and organisational health . Trial registration Current Controlled Trials IS RCT N81504663 Although the benefits of exercise are well documented , few published research studies have examined exercise in persons with schizophrenia . This pilot examined a 16-week walking program for out patients diagnosed with schizophrenia ( N = 10 ) .  Six-minute walking distance , body mass index , percent body fat and severity of psychiatric symptoms were measured . Experimental participants in the walking group experienced significant reductions in body fat ( p = 0.03 ) compared to a control group not participating in the exercises during the same time period . Experimental participants also had greater aerobic fitness , lower body mass indexes , and fewer psychiatric symptoms than controls at the conclusion of the program . Research is needed to identify effective exercise interventions and feasible delivery modalities for persons with schizophrenia in community setting Introduction The health benefits of exercise are well established . However , the relationship between exercise volume and intensity and health benefits remains unclear , particularly the benefits of low-volume and intensity exercise . Purpose The primary purpose of this investigation was , therefore , to examine the dose – response relationship between exercise volume and intensity with derived health benefits including volumes and intensity of activity well below international recommendations . Methods Generally healthy , active participants ( n = 72 ; age = 44 ± 13 years ) were assigned r and omly to control ( n = 10 ) or one of five 13-week exercise programs : ( 1 ) 10-min brisk walking 1 × /week ( n = 10 ) , ( 2 ) 10-min brisk walking 3 × /week ( n = 10 ) , ( 3 ) 30-min brisk walking 3 × /week ( n = 18 ) , ( 4 ) 60-min brisk walking 3 × /week ( n = 10 ) , and ( 5 ) 30-min running 3 × /week ( n = 14 ) , in addition to their regular physical activity . Health measures evaluated pre- and post-training including blood pressure , body composition , fasting lipids and glucose , and maximal aerobic power ( VO2max ) . Results Health improvements were observed among programs at least 30 min in duration , including body composition and VO2max : 30-min walking 28.8–34.5 mL kg−1 min−1 , 60-min walking 25.1–28.9 mL kg−1 min−1 , and 30-min running 32.4–36.4 mL kg−1 min−1 . The greater intensity running program also demonstrated improvements in triglycerides . Conclusion In healthy active individuals , a physical activity program of at least 30 min in duration for three sessions/per week is associated with consistent improvements in health status Objectives : To examine the effect that physical activity delivered via two different versions of the Green Prescription ( a primary care physical activity scripting program ) had on depressive symptomatology and general mental health functioning over a 12-month period in non-depressed , low-active , community-dwelling older adults . Method : Two hundred and twenty-five participants from the Healthy Steps study took part in the present study . Healthy Steps participants were r and omized to receive either the st and ard time-based or a modified pedometer-based Green Prescription .  Depression , mental health functioning and physical activity were measured at baseline , post-intervention ( 3 months post-baseline ) and at the 9-month follow-up period . Results : At post-intervention , a positive association was found between increases in leisure-time physical activity and total walking physical activity and a decrease in depressive symptomatology ( within the non-depressed range of the GDS-15 ) and an increase in perceived mental health functioning , regardless of intervention allocation . These improvements were also evident at the follow-up period for participants in both intervention allocation groups . Conclusion : Our findings suggest that the st and ard time-based Green Prescription and a modified pedometer-based Green Prescription are both effective in maintaining and improving mental health in non-depressed , previously low-active older adults PURPOSE The Aerobics Center Longitudinal Study ( ACLS ) provides the opportunity to evaluate associations between measures of physical activity and mental health in a large and well-characterized population of men and women . METHODS Participants were 5451 men and 1277 women ( 20 - 88 yr ) who completed a maximal fitness treadmill test and self-report measures of habitual physical activity , depressive symptoms ( Center for Epidemiological Studies Scale for Depression ; CES-D ) and emotional well-being ( General Well-Being Schedule ; GWB ) . To evaluate the dose-response gradient of the association , we classified the sample , separately for men and women , into three levels of relative cardiorespiratory ( CR ) fitness ( low , moderate , high ) on the maximal treadmill test , and four levels on a physical activity index of weekly walking , jogging , and running . RESULTS In both men and women , there was a significant inverse grade d dose-response relationship between maximal CR fitness and the CES-D score ( P < 0.0001 ) , and a significant positive grade d dose-response relationship between CR fitness and the GWB score ( P < 0.0001 ) . We also observed dose-response associations between the level of physical activity and both CES-D and GWB scores ( P < 0.0001 ) that peaked at 11 - 19 miles per week . CONCLUSION Among men and women in the ACLS , relative increases in maximal CR fitness and habitual physical activity are cross-sectionally associated with lower depressive symptomatology and greater emotional well-being . Prospect i ve epidemiological studies and controlled clinical trials are needed to identify the minimal and optimal levels of physical activity and CR fitness associated with various mental health benefits in different segments of the general population Increasing evidence suggests that physical activity can prevent some aspects of mental illness in older people such as depression , dementia and Alzheimer ’s disease . Additionally , limited research has shown that engagement in structured exercise can improve aspects of psychological well-being such as mood and self-perceptions in older adults . However , the relationship between incidental daily activity such as walking or time spent sedentary , with psychological well-being has not been investigated . The Better Ageing Project provided an opportunity to assess well-being and quality of life using st and ardised question naires with 176 adults aged 70 and over .  Accelerometry was used to objective ly assess daily energy expended in physical activity at different levels of intensity . In addition , an assessment of the impact of the 12-month Better Ageing structured group exercise programme was assessed through question naires and interviews . Total daily physical activity energy expenditure ( joules/day ) and amount of time spent in activity of at least moderate intensity were weakly related ( r = 0.20–0.28 ) to quality of life , subjective well-being and physical self-perceptions . Time spent sedentary ( min/day ) was weakly and negatively related to several mental health indicators . The quantitative data showed only minor psychological benefits of the exercise intervention . In contrast , interviews with 27 research participants and 4 exercise leaders suggested that important improvements in perceived function and social benefits had been experienced Background High levels of physical inactivity are linked to several chronic diseases including coronary heart disease , type-2 diabetes , obesity , some cancers and poor mental health . Encouraging people to be more active has proven difficult . One way to incorporate physical activity into the daily routine is through the journey to and from work . Although behaviour change techniques ( BCTs ) are considered valuable in promoting behaviour change , there is very little in the published literature about the views and experiences of those encouraged to use them . Methods The Walk to Work study was a feasibility study incorporating an exploratory cluster r and omised controlled trial . The 10-week intervention involved training workplace-based Walk to Work promoters ( volunteers or nominated by participating employers ) to encourage colleagues to increase walking during their daily commute . The intervention used nine specific BCTs : Intention formation , barrier identification , specific goal setting , instruction , general encouragement , self-monitoring of behaviour social support , review of behavioural goals and relapse prevention . Digitally recorded interviews were undertaken with 22 employees , eight of whom were Walk to Work promoters to underst and their views and experiences of using these techniques . The Framework method of data management and constant comparison were used to analyse the data and identify key themes . Results For each individual BCT , there appeared to be people who found it useful in helping them to increase walking to work and others who did not . Following training , the Walk to Work promoters varied in the extent to which they were able to fulfil their role : additional support and encouragement during the 10-week intervention may be required for the promoters to maintain motivation . Wider context ual ( economic climate , unprecedented wet weather ) and organisational ( workload , car parking facilities ) issues were identified that influenced the delivery of , and response to , the intervention . Conclusions Walk to work interventions employing BCTs should include sufficient techniques to enable participants to choose a ‘ package ’ to suit their needs . Additional support at organisational level should also be encouraged , and consideration given to wider context ual factors that impinge on the delivery of , and response to , the intervention . Trial registration IS RCT N72882329 OBJECTIVES To determine the relative effects of cobblestone mat walking , in comparison with regular walking , on physical function and blood pressure in older adults . DESIGN R and omized trial with allocation to cobblestone mat walking or conventional walking . SETTING General community in Eugene , Oregon . PARTICIPANTS One hundred eight physically inactive community-dwelling adults aged 60 to 92 ( mean age+/-st and ard deviation=77.5+/-5.0 ) free of neurological and mobility-limiting orthopedic conditions . INTERVENTION Participants were r and omized to a cobblestone mat walking condition ( n=54 ) or regular walking comparison condition ( n=54 ) and participated in 60-minute group exercise sessions three times per week for 16 consecutive weeks . MEASUREMENTS Primary endpoint measures were balance ( functional reach , static st and ing ) , physical performance ( chair st and s , 50-foot walk , Up and Go ) , and blood pressure ( systolic , diastolic ) . Secondary endpoint measures were Short Form-12 physical and mental health scores and perceptions of health-related benefits from exercise .  RESULTS At the 16-week posttest , differences between the two exercise groups were found for balance measures ( P=.01 ) , chair st and s ( P<.001 ) , 50-foot walk ( P=.01 ) , and blood pressure ( P=.01 ) but not for the Up and Go test ( P=.14 ) . Although significant within-group changes were observed in both groups for the secondary outcome measures , there were no differences between intervention groups . CONCLUSION Cobblestone mat walking improved physical function and reduced blood pressure to a greater extent than conventional walking in older adults . Additional benefits of this walking program included improved health-related quality of life . This new physical activity may provide a therapeutic and health-enhancing exercise alternative for older adults PURPOSE Whilst the health benefits associated with regular physical activity are well known , little objective evidence exists regarding the activity profiles of adults with mild and moderate learning disabilities . The aims of the present study were to establish 7 day physical activity profiles for 24 adults with mild and moderate learning disabilities and to compare them with the general population and current Department of Health recommendations for physical activity . METHOD A descriptive study was used , based on interviews with 24 adults with learning disabilities ( mean age 34 years ) triangulated by daytime and residential care workers . Participants volunteered from two residential homes and one social education centre ( SEC ) in a city in the North of Engl and . RESULTS The physical activity profiles show that the participants led sedentary lifestyles that were more exaggerated than those of the general population . Twenty-two participants ( 93 % ) performed significantly less than the minimum daily levels of physical activity recommended by the Department of Health . CONCLUSIONS Few adults with learning disabilities can choose to walk to work , go for a run or visit the local swimming pool without adequate support . This study suggests that there may not be enough moderate or vigorous physical activity choices available in day and residential care setting s to empower adults with mild and moderate learning disabilities to meet the minimum recommendations of the Department of Health . Hence some people with learning disabilities have no alternatives to a sedentary lifestyle and the health risks associated with physical inactivity Objective : While there is a dose-response relationship between physical activity ( PA ) and health benefit , little is known about the effectiveness of different PA prescriptions on total daily PA . Aim : To test , under real-life conditions and using an objective , non-invasive measurement technique ( accelerometry ) , the effect of prescribing additional physical activity ( walking only ) of different duration s ( 30 , 60 and 90 min/day ) on compliance ( to the activity prescribed ) and compensation ( to total daily PA ) . Participants in each group were prescribed 5 sessions of walking per week over 4 weeks . Methods : 55 normal-weight and overweight women ( mean BMI 25 ± 5 kg/m2 , height 165 ± 1 cm , weight 68 ± 2 kg and mean age 27 ± 1 years ) were r and omly assigned to 3 prescription groups : 30 , 60 or 90 min/day PA . Results : Walking duration result ed in an almost linear increase in the number of steps per day during the prescription period from an average of about 10,000 steps per day for the 30-min prescription to about 14,000 for the 90-min prescription . Compliance was excellent for the 30-min prescription but decreased significantly with 60-min and 90-min prescriptions . In parallel , degree of compensation subsequent to exercise increased progressively as length of prescription increased . Conclusion : A 30-min prescription of extra walking 5 times per week was well tolerated . However , in order to increase total PA  further , much more than 60 min of walking may need to be prescribed in the majority of individuals . While total exercise ‘ volume ' increased with prescriptions longer than 30 min , compliance to the prescription decreased and greater compensation was evident Purpose of review This review highlights recent work evaluating the relationship between exercise , physical activity and physical and mental health . Both cross-sectional and longitudinal studies , as well as r and omized clinical trials , are included . Special attention is given to physical conditions , including obesity , cancer , cardiovascular disease and sexual dysfunction . Furthermore , studies relating physical activity to depression and other mood states are review ed . The studies include diverse ethnic population s , including men and women , as well as several age groups ( e.g. adolescents , middle-aged and older adults ) . Recent findings Results of the studies continue to support a growing literature suggesting that exercise , physical activity and physical-activity interventions have beneficial effects across several physical and mental-health outcomes . Generally , participants engaging in regular physical activity display more desirable health outcomes across a variety of physical conditions . Similarly , participants in r and omized clinical trials of physical-activity interventions show better health outcomes , including better general and health-related quality of life , better functional capacity and better mood states . Summary The studies have several implication s for clinical practice and research . Most work suggests that exercise and physical activity are associated with better quality of life and health outcomes . Therefore , assessment and promotion of exercise and physical activity may be beneficial in achieving desired benefits across several population s. Several limitations were noted , particularly in research involving r and omized clinical trials . These trials tend to involve limited sample sizes with short follow-up periods , thus limiting the clinical implication s of the benefits associated with physical activity . Abbreviations CAD : coronary artery disease ; COPD : chronic obstructive pulmonary disease ; CRP : cardiac rehabilitation program ; CVD : cardiovascular disease ; GMCB : group-mediated cognitive – behavioural ; HRQOL : health-related quality of life BACKGROUND We know little about long-term exercise behavior and adherence in patients with chronic obstructive pulmonary disease ( COPD ) . PURPOSE The study 's purpose was ( 1 ) to describe exercise behavior and adherence to a home-walking exercise prescription over 12 months in a sample of patients with COPD ; and ( 2 ) to vali date categories of exercise adherence over time in this population . DESIGN This was a secondary analysis of a r and omized controlled trial . SUBJECTS A total of 103 participants with COPD who were r and omly assigned to one of three versions of a dyspnea self-management program participated .  MEASURES The components of exercise frequency , duration , and intensity were measured by exercise/dyspnea daily logs , and participants were classified into categories on the basis of their pattern of exercise adherence over the year . RESULTS Participants walked an average of 3 days per week initially , with a decline to 2.5 days per week over the year . On average , participants walked longer than the prescribed duration of 20 minutes per session . Dyspnea intensity at the end of the walk tended to remain stable at a mean level of 4 over the year . Classification by adherence category distinguished differences in 6-minute walk distance , endurance treadmill test time , Short Form-36 physical function , and Short Form-36 mental health , with endurance treadmill test time and physical function improvements mirroring increases in exercise adherence , and mental health highest among occasional lapse and lowest among relapser and recycle categories . CONCLUSIONS This investigation provides a description of long-term exercise behavior and adherence in a sample of patients with COPD . The categories suggest that physical benefits are related to consistent adherence , whereas mental health improvements are related to regular exercise with some flexibility in the schedule . Future research should test interventions to improve exercise adherence in patients with COPD and identify characteristics of patients who are most likely and least likely to adhere over time R egular physical activity has been shown to have beneficial effects on both physical and mental health.i4 The Centers for Disease Control and the American College of Sports Medicine have suggested that adults should accumulate at least 30 minutes of moderate physical activity during the course of most days . * In the elderly population , moderate physical activity , such as walking , is associated with improved health outcomes .*5 Nevertheless , the majority of older people are sedentary . Results from the 1985 National Health Interview Survey show that two-thirds of those ages 65 and over do not exercise regularly.‘j The benefits of physical activity for elderly women include decreased risk of osteoporosis , decreased incidence of depression , and increased functional status.‘~7W’0 Despite these findings , the Behavioral Risk Factor Surveillance System reported that in 1990 , 86.7 % of women surveyed ages 65 and over were sedentary.i ’ Yet , little is known about the determinants of exercise behavior in this population . Interventions to increase physical activity in the elderly include public education campaigns , formal education , and training programs.‘2-‘4 These efforts have been unsuccessful at maintaining the adoption of this behavior.‘2-‘4 Dishman et all3 report that 50 % of those who participate in organized exercise programs such as aerobics classes will drop out during the first 3 - 6 months . An individual ’s knowledge , attitude , and demographics are some factors that research ers have found to influence exercise habits.13 Among elderly women , physical and health problems , time constraints , personal issues such as inclement weather , lack of companionship , safety concerns , and lack of motivation interfere with regular exercise.15 Our objective was to use telecommunications technology to underpin an intervention that would be effective , easy to use , convenient , and inexpensive Despite the well known mental and physical health benefits of exercise , persons with schizophrenia spectrum disorders remain sedentary . While the exercise barriers ( i.e. , lack of motivation , poor concentration , sedative effects of medication , poverty , and lack of access to exercise education/programs ) of persons with SSDs are numerous , lack of motivation is considered foremost among them . Exercise interventions have been shown to improve exercise behavior , but there is a need for longitudinal documentation of physical activity after interventions conclude . This pilot study describes the physical activity level of 22 persons with SSDs 14 to 34 ( mean 22 ) months after the conclusion of an exercise intervention provided in a r and omized controlled trial ( RCT ) . Eighteen months after the RCT , 22 participants wore  pedometers daily for one week without altering their activity .  Experimental participants walked more steps and covered more distance on average than control participants on six of the seven days . This pilot study is among the first to document the physical activity level of persons with SSDs after exercise intervention . While our findings confirm the low activity level of persons with SSDs reported by others , experimental participants demonstrated higher activity levels than controls on most days . Future studies should increase the sample size and recruit participants from multiple sites to enhance power and generalizability BACKGROUND This study explored the experiences of university employees recruited to a 10-week r and omized controlled trial ( n = 64 ) . The trial compared " walking routes " with " walking-while-working " on daily step totals , showing that , compared with controls , interventions result ed in around 1000 extra steps per day . METHODS A sub sample of 15 academic and administrative employees from intervention groups completed interviews at the end of intervention . Interviews were transcribed verbatim and subject to inductive coding within the major themes of benefits /positives and problems/barriers . FINDINGS Both interventions benefited employee health and work productivity but were difficult to implement in the workplace . Involvement in walking routes was challenged by the difficulties of managing time pressures , and individuals assigned to walking-while-working had to deal with local management subcultures favoring physical presence and inactivity . CONCLUSIONS Findings highlight the need for further research , advocate the value of walking at work , and provide insights into the challenges that face staff in workplace interventions BACKGROUND : The Global Burden of Disease study has suggested that mental disorders are the leading cause of disability burden in the world . This study takes the leading cause of mental disorder burden , depression , and trials an approach for defining the present and optimal efficiency of treatment in an Australian setting . AIMS OF THE STUDY : To examine epidemiological and service use data for depression to trial an approach for modelling ( i ) the burden that is currently averted from current care , ( ii ) the burden that is potentially avertable from a hypothetical regime of optimal care , ( iii ) the efficiency or cost-effectiveness of both current and optimal services for depression and ( iv ) the potential of current knowledge for reducing burden due to depression , by applying the WHO five-step method for priorities for investment in health research and development . METHODS : Effectiveness and efficiency were calculated in disability adjusted life years ( DALYs ) averted by adjusting the disability weight for people who received efficacious treatment .  Data on service use and treatment outcome were obtained from a variety of secondary sources , including the Australian National Survey of Mental Health and Wellbeing , and efficacy of individual treatments from published meta-analyses expressed in effect sizes . Direct costs were estimated from published sources . RESULTS : Fifty-five percent of people with depression had had some contact with either primary care or specialist services . Effective coverage of depression was low , with only 32 % of cases receiving efficacious treatment that could have lessened their severity ( averted disability ) . In contrast , a proposed model of optimal care for the population management of depression provided increased treatment contacts and a better outcome . In terms of efficiency , optimal care dominated current care , with more health gain for less expenditure ( 28 632 DALYs were averted at a cost of AUD295 million with optimal care , versus 19 297 DALYs averted at a cost of AUD720 million with current care ) . However , despite the existence of efficacious technologies for treating depression , only 13 % of the burden was averted from present active treatment , primarily because of the low effective coverage . Potentially avertable burden is nearly three times this , if effective treatments can be delivered in appropriate amounts to all those who need it . DISCUSSION : This paper reports a method to calculate the burden currently averted from cross-sectional survey data , and to calculate the burden likely to be averted from an optimal programme estimated from r and omized controlled trial data . The approach taken here makes a number of assumptions : that people are accurate in reporting their service use , that effect sizes are a suitable basis for modelling improvements in disability and that the method used to translate effect sizes to disability weight change is valid . The robustness of these assumptions is discussed . Nonetheless it would appear that while optimal care could do more than present services to reduce the burden of depression , current technologies for treating depression are insufficient . IMPLICATION S FOR HEALTH CARE PROVISION AND USE : There is an urgent need to educate both clinicians ( primary and specialist ) and the general public in the effective treatments that are available for depression . IMPLICATION S FOR HEALTH POLICIES : Over and above implementing treatments of known efficacy , more powerful technologies are needed for the prevention and treatment of depression . IMPLICATION S FOR FURTHER RESEARCH : Modelling burden averted from a variety of secondary sources can introduce bias at many levels . Future research should examine the validity of approaches that model reductions in disability burden . A powerful treatment to relieve depression and prevent relapse is needed Objective : Although the physical health benefits of HIV antiretroviral therapy ( ART ) are well documented , the socioeconomic benefits are still being established . Few studies have examined the effects of ART on food insecurity , although studies suggest there may be a benefit via improved health and ability to work . Design : Twelve-month prospect i ve cohort study of 602 treatment-naive patients initiating clinical care in Ug and a. Methods : Longitudinal multivariate logistic regression was used to investigate the effect of ART on food insecurity compared to HIV care without ART . A staged regression approach was used to explore pathways through which ART may affect food insecurity . Results : Food insecurity decreased significantly for both the ART and non-ART groups over time , with the ART group experiencing greater reductions by the end of the study . ART remained a significant predictor of reduction in food insecurity over time after controlling for baseline differences in the regression model ( odds ratio 0.642 ; P < 0.01 ) . Improvements in work and mental health status were identified as potential pathways through which ART may improve food security . Conclusion : Taken together with the well known benefits of food security on ART adherence , treatment retention and clinical outcomes in re source -poor setting s , our results suggest that a positive feedback loop of improved functioning and productivity could result from the interaction between food security and ART . Policymakers could leverage this positive cycle by strengthening mental health support and promoting sustainable food security interventions as part of HIV treatment programs BACKGROUND As patients with pancreas and periampullary cancer ( PPC ) experience improved survival rates and longevity , the focus shifts toward living life while surviving cancer . Fatigue is the most commonly reported symptom in all cancer patients .  Exercise has been found to effectively decrease fatigue levels and improve physical functioning in cancer patients . STUDY DESIGN One hundred two patients with resected PPC consented to participate in this study and were r and omized to either an intervention group ( IG ) or a usual care group ( UCG ) . Subjects completed visual analog scales , the FACIT-Fatigue Scale and the Short Form-36v2 after surgery and again 3 to 6 months after hospital discharge . RESULTS Patients in the IG and UCG were comparable with regard to demographics , comorbidities , cancer type and staging , type of resection , preoperative fatigue and pain levels , adjuvant therapy , and baseline walking distance . Patients in the IG had significantly improved scores on the FACIT-Fatigue Scale at study completion , improved fatigue and pain scores , as well as overall physical functioning and mental health composite scores . At study completion , participants in the IG were walking twice as far and were significantly more likely to have continued walking or another form of exercise as compared with the UCG . Using hierarchical cluster analysis , 3 mutually exclusive symptom groupings were identified in the cohort . Kaplan-Meier survival analysis did not indicate an overall survival benefit for the IG . CONCLUSIONS This is the first prospect i ve , r and omized controlled trial to report that participation in a home walking program confers a significant benefit in resected PPC patients with regard to fatigue levels , physical functioning , and health-related quality of life Background . Counseling sedentary primary care patients can increase physical activity , but whether this approach will increase exercise and fitness in elderly adults with chronic diseases remains to be determined . Methods . After receiving individualized nurse counseling to begin a program of walking for health , 60- to 80-year-old primary care patients were r and omized to one of three levels of telephone contacts over 10 months : ( i ) 20 nurse-initiated calls , ( ii ) 10 nurse-initiated calls plus 10 motivational calls programmed through an automated phone calling system , or ( iii ) no program-initiated phone contacts .  Self-reported ( diary ) walking adherence was the primary outcome ; other activity , social support , health quality of life , and measured walking performance , mobility , and body mass index and girths were also assessed during the initiation ( months 1 - 6 ) and maintenance ( months 7 - 10 ) phases of the trial . Results . Average adherence for the 181 participants to the goal of walking at least 20 minutes on 3 or more days per week was 44 % for initiation and 42 % for maintenance . Participants receiving the combination of nurse-initiated personal and automated phone calls  walked significantly more frequently than those with no phone contacts . Fitness improved in all three groups ; changes were generally correlated with self-reported walking . Having a companion was associated with more frequent walking . Perceived quality of physical and mental health did not change . Conclusions . Simple and relatively inexpensive nurse contacts can motivate elderly primary care patients to walk for exercise , and this activity is associated with measurable health benefits Physical inactivity among children is a serious public health problem . It has been suggested that high levels of screen time are contributory factors that encourage sedentary lifestyles in young people . As physical inactivity and obesity levels continue to rise in young people , it has been proposed that new-generation active computer- and video-console games ( otherwise known as “ exergaming ” ) may offer the opportunity to contribute to young people 's energy expenditure during their free time . Although studies have produced some encouraging results regarding the energy costs involved in playing active video-console games , the energy costs of playing the authentic versions of activity-based video games are substantially larger , highlighting that active gaming is no substitute for real sports and activities . A small number of exergaming activities engage children in moderate-intensity activity , but most do not . Only 3 very small trials have considered the effects of exergaming on physical activity levels and /or other health outcomes in children . Evidence from these trials has been mixed ; positive trends for improvements in some health outcomes in the intervention groups were noted in 2 trials . No adequately powered r and omized , controlled trial has been published to date , and no trial has assessed the long-term impact of exergaming on children 's health . We now need high- quality r and omized , controlled trials to evaluate the effectiveness and sustainability of exergaming  , as well as its clinical relevance ; until such studies take place , we should remain cautious about its ability to positively affect children 's health BACKGROUND Ethnic minorities and lower-income adults have among the highest rates of obesity and lowest levels of regular physical activity ( PA ) . The Positive Action for Today 's Health ( PATH ) trial compares three communities that are r and omly assigned to different levels of an environmental intervention to improve safety and access for walking in low income communities . DESIGN AND SETTING Three communities matched on census tract information ( crime , PA , ethnic minorities , and income ) were r and omized to receive either : an intervention that combines a police-patrolled-walking program with social marketing strategies to promote PA , a police-patrolled-walking only intervention , or no-walking intervention ( general health education only ) . Measures include PA ( 7-day accelerometer estimates ) , body composition , blood pressure , psychosocial measures , and perceptions of safety and access for PA at baseline , 6 , 12 , 18 , and 24 months . INTERVENTION The police-patrolled walking plus social marketing intervention targets increasing safety ( training community leaders as walking captains , hiring off-duty police officers to patrol the walking trail , and containing stray dogs ) , increasing access for PA ( marking a walking route ) , and utilizes a social marketing campaign that targets psychosocial and environmental mediators for increasing PA . MAIN HYPOTHESES/ OUTCOMES : It is hypothesized that the police-patrolled walking plus social marketing intervention will result in greater increases in moderate-to-vigorous PA as compared to the police-patrolled-walking only or the general health intervention after 12 months and that this effect will be maintained at 18 and 24 months . CONCLUSIONS Implication s of this community-based trial are discussed BACKGROUND Domestic violence ( DV ) perpetrated by men against women is a pervasive global problem with significant physical and emotional consequences . Although some face-to-face interventions in health care setting s have shown promise , there are barriers to disclosure to health care practitioners and women may not be ready to access or accept help , reducing uptake . Similar to the mental health field , interventions from clinical practice can be adapted to be delivered by technology . PURPOSE This article outlines the theoretical and conceptual development of I-DECIDE , an online healthy relationship tool and safety decision aid for women experiencing DV . The article explores the use of the  Psychosocial Readiness Model ( PRM ) as a theoretical framework for the intervention and evaluation . METHODS This is a theoretical article drawing on current theory and literature around health care and online interventions for DV . RESULTS The article argues that the Internet as a method of intervention delivery for DV might overcome many of the barriers present in health care setting s. Using the PRM as a framework for an online DV intervention may help women on a pathway to safety and well-being for themselves and their children . This hypothesis will be tested in a r and omized , controlled trial in 2015/2016 . CONCLUSION This article highlights the importance of using a theoretical model in intervention development and evaluation Objective : To investigate if motivational interviewing improved physical activity , self-efficacy , quality of life , mobility and mental health in people living in the community after hip fracture . Design : Single-blind r and omized controlled trial . Setting : Community . Participants : A total of 30 adults after hip fracture who had been discharged from rehabilitation to independent living in the community and allocated to a control group ( n = 14 ) or an intervention group ( n = 16 ) . Intervention : All participants received usual care . The intervention group also received eight weekly sessions of motivational interviewing as additional input , with the control group having no additional matching input . Main outcomes : The primary outcome was physical activity levels as measured by an accelerometer ( steps taken per day , time spent walking per day , and time spent sitting or lying each day ) . Secondary outcomes included self-efficacy ( confidence about walking and not falling ) , health-related quality of life , mobility and mental health . Results : Relative to usual care , the motivational interviewing group took significantly more steps per day ( mean = 1237 steps , 95 % confidence interval ( CI ) 12 to 2463 ) , walked for longer per day ( mean = 14.4 minutes , 95 % CI 0.6 to 28.8 ) , had improved self-efficacy evidence d by being more confident about walking ( mean = 1.6 units out of 10 , 95 % CI 0.3 to 2.9 ) and not falling ( mean = 1.1 units out of 10 , 95 % CI 0.3 to 1.9 ) and improved health-related quality of life and mental health . Conclusion : This study provides preliminary evidence that motivational interviewing can result in clinical ly meaningful improvements in physical activity and psychosocial outcomes for people recovering from hip fracture
Evidence for anxiety , psychological stress , psychological well-being , subjective well-being and social isolation and loneliness varied in volume and effectiveness , but no harmful effects were identified .
The setting and context of walking seems to be important variables .
Background / objectives Walking has well-established positive relationships with , and effects on , physical health .
In contrast , while poor mental health contributes substantially to global health burden , an overview of the benefits from walking has not previously been published .
We aim ed to scope the literature and present what is known , and highlight what is not known , about walking and mental health .