Health care providers (HCPs) are entrusted with providing credible health-related information to their patients/clients. Patients/clients who receive physical activity and exercise (PAE) advice from an HCP typically increase their PAE level. However, most HCPs infrequently discuss PAE or prescribe PAE, due to the many challenges (e.g., time, low confidence) they face during regular patient care. The purpose of this study was to ascertain HCPs’ perspectives of what could be done to promote PAE in health care. HCPs (n = 341) across Nova Scotia completed an online self-reflection survey regarding their current PAE practices and ideas to promote PAE. The sample consisted of 114 physicians, 114 exercise professionals, 65 dietitians, and 48 nurses. Quantitative textual analysis (frequency of theme ÷ number of respondents) was performed to identify common themes to promote PAE in health care. In the pooled sample, the primary theme cited was to increase the availability of community programs (24.1% of respondents), followed by more educational opportunities for providers (22.5%), greater promotion of PAE from HCPs (17.1%), reducing financial barriers experienced by patients/clients (16.3%), and increasing availability of qualified exercise professionals (15.0%). Altogether, increased PAE education and greater availability of affordable community PAE programs incorporating qualified exercise professionals, would reduce barriers preventing routine PAE promotion and support the promotion of PAE in Nova Scotia.

Canadian 24 h movement guidelines recommend engaging in >150 min/week of moderate–vigorous-intensity physical activity and ≤8 h/day of sedentary time. Half of Canadian post-secondary students do not meet physical activity or sedentary time guidelines. This pan-Canadian study aimed to (1) identify commonly cited motivators/barriers to exercise, and (2) determine which motivators/barriers were most influential for attaining physical and sedentary activity guidelines. A total of 341 respondents (279 females, 23 ± 4 years old, 53% met activity guidelines, 49% met sedentary guidelines) completed an online survey regarding undergraduate student lifestyle behaviours. Improved physical health (74% of respondents), mental health (67%), physical appearance (60%), and athletic performance (28%) were the most common motivators to exercise. The most common barriers were school obligations (68%), time commitments (58%), job obligations (32%), and lack of available fitness classes (26%). Students citing improved athletic performance (odds ratio (OR) = 1.94, p = 0.02) were more likely to adhere to activity guidelines, while those who selected physical health (OR = 0.56, p = 0.03) and physical appearance (OR = 0.46, p = 0.001) as motivators were less likely to meet activity guidelines. Students who cited school obligations as a barrier were less likely (OR = 0.59, p = 0.03) to meet sedentary guidelines. The motivators and barriers identified provide a foundation for university-led initiatives aimed at promoting physical activity and reducing sedentary time among undergraduate students. Strategies that positively re-frame students’ physical health and appearance-based motivations for exercise may be particularly useful in helping more students achieve national activity recommendations.

How to statistically assess the validity of activity monitors?The interpretation of study outcomes relies heavily on the results of statistical tests implemented that compare the device of interest to a criterion measure. While simple correlations are typically implemented to determine if the values observed between the comparator-criterion are associated with each other, the determination of validity from correlations alone is insufficient (1). The interpretation of results, and thus conclusions drawn, may vary depending on the specific statistical tests implemented. This poses an issue when guidelines suggest divergent statistical tests be utilized. This point is particularly evident with current guidelines, as the Towards Intelligent Health and Well-Being Network of Physical Activity Assessment (INTERLIVE) group recommends Bland-Altman analyses (i.e., fixed/proportional biases) and mean absolute percent error

The Physical Activity Vital Sign (PAVS) is a two-question assessment used to estimate habitual moderate to vigorous aerobic physical activity (MVPA). Previous studies have shown active adults cannot estimate the physical activity intensity properly. The initial purpose was to investigate the criterion validity of the PAVS for quantifying habitual MVPA in young adults meeting weekly MVPA guidelines (n = 140; 21 ± 3 years). A previously validated PiezoRx waist-worn accelerometer served as the criterion measure (wear time, 6.7 ± 0.6 days). All participants completed the PAVS once before wearing the PiezoRx. Standardized activity monitor validation procedures were followed. The PAVS (201 ± 142 min/week) underestimated (p < .001) MVPA compared to the PiezoRx (381 ± 155 min/week). To correct for this large error, the sample was divided into calibration model development (n = 70; 21 ± 3 years) and criterion validation (n = 70; 21 ± 3 years) groups. The PAVS score, age, gender, and body mass index outcomes from the development group were used to construct a multiple linear regression model-based calibrated PAVS (cPAVS) equation. In the validation group, the cPAVS was similar (p = .113; 352 ± 23 min/week) compared to accelerometry. Equivalence testing demonstrated the cPAVS, but not the PAVS, was equivalent to the PiezoRx. Despite achieving most statistical criteria, the PAVS and cPAVS still had high degrees of variability, preventing their use on an individual level. Alternative strategies are needed for the PAVS in an active young adult population. These results caution using the PAVS in active young adults and identify a case where obvious variabilities in accuracy conflict with statistically congruent results.

Wearable activity monitors provide objective estimates of time in different physical activity intensities. Each continuous stepping period is described by its length and a corresponding single intensity (in metabolic equivalents of task [METs]), creating square wave–shaped signals. We argue that physiological responses do not resemble square waves, with the purpose of this technical report to challenge this idea and use experimental data as a proof of concept and direct potential solutions to better characterize activity intensity. Healthy adults (n = 43, 19♀; 23 ± 5 years) completed 6-min treadmill stages (five walking and five jogging/running) where oxygen consumption (3.5 ml O2·kg−1·min−1 = 1 MET) was recorded throughout and following the cessation of stepping. The time to steady state was ∼1–1.5 min, and time back to baseline following exercise was ∼1–2 min, with faster stepping stages generally exhibiting longer durations. Instead of square waves, the duration intensity signal reflected a trapezoid shape for each stage. The METs per minute during the rise to steady state (upstroke slopes; average: 1.7–6.3 METs/min for slow walking to running) may be used to better characterize activity intensity for shorter activity bouts where steady state is not achieved (within ∼90 s). While treating each activity bout as a single intensity is a much simpler analytical procedure, characterizing each bout in a continuous manner may better reflect the true physiological responses to movement. The information provided herein may be used to improve the characterization of activity intensity, definition of bout breaks, and act as a starting point for researchers and software developers interested in using wearables to measure activity intensity.