Media Consumption, Stress and Wellbeing of Video Game and eSports Players in Germany: The eSports Study 2020.

The popularity of video gaming and eSports is increasing rapidly. However, most research focuses on the economical features and psychological consequences of gaming and only little is known about the health behavior of the players. Therefore, this study is a follow-up of the eSports Study 2019 and further investigates the health and health behavior of video game and eSports players in Germany. This cross-sectional study, conducted between April and September 2019, includes 1038 players (91.2% male; 23.0 ± 5.4 years; body mass index: 24.8 ± 5.0 kg/m2) who provided data regarding their health status, physical activity, sleep, media consumption, stress and wellbeing via a web-based survey. Descriptive statistics were performed on all questions. Linear regressions were used to examine the relation between media consumption, wellbeing and stress. Almost all respondents classified their health status as "good" or better (92.5%). The average sedentary and physical activity time was 7.2 ± 3.5 h/day and 8.8 ± 10.7 h/week, respectively. Respondents slept for 7.5 ± 1.3 h/night on weekdays and for 8.5 ± 1.5 h/night on weekends, but many were "sometimes" or more frequently overtired (53.1%). Daily duration of playing video games (230.4 ± 159.3 min/day) and watching livestreams and videos with (102.6 ± 101.7 min/day) and without gaming content (72.9 ± 88.5 min/day) were much higher than watching regular television (18.9 ± 49.1 min/day) or reading analog media (32.1 ± 53.5 min/day). In terms of stress and wellbeing, most players reported low stress levels (13.8 ± 5.7) and reached a moderate average score of 60.1 ± 16.4 out of 100 points in the WHO-5 Well-Being Index. Linear regressions revealed no relevant significant associations. The results indicate good subjective health and health behavior of the target group. However, the high amounts of screen-based media-consumption, as well as the moderate stress and wellbeing levels show potential for improvement. In addition, the target group consumed high amounts of digital media in reference to gaming, while traditional media consumption was distinctly low. Consequently, media campaigns that address health promotion in this target group should use the platforms of digital media instead.

Questionnaire choice affects the prevalence of recommended physical activity: an online survey comparing four measuring instruments within the same sample.

BACKGROUND: Since prevalence estimates of recommended physical activity (PA) considerably vary between different surveys, prevalence might be crucially affected by the choice of measuring instrument. The aim of the present study is to compare the results of four PA questionnaires regarding the current moderate- and vigorous-intensity aerobic PA (MVPA) recommendations of the World Health Organization. METHODS: Within an online survey, participants answered the German Health Interview and Examination Survey for Adults (DEGS), the European Health Interview Survey PA Questionnaire (EHIS), the Eurobarometer (EURO), and a single-item measure (SIM). Weekly volume of MVPA was compared via a Friedman test and the prevalence of participants achieving the WHO's MVPA recommendation via Cochran's Q. Agreement between all questionnaire pairs was evaluated via Kappa statistics. RESULTS: One hundred seventy-six participants were included in the analyses (70.5% female, mean age: 33.1 years (SD=12.2)). Between the four questionnaires, the weekly volume of MVPA statistically significant differed (SIM: MED=90.0 (MIN=0.0, MAX=210.0), DEGS: MED=120.0 (MIN=0.0, MAX=420.0), EHIS: MED=24.0 (MIN=0.0, MAX=1395.0), EURO: MED=51.0 (MIN=0.0, MAX=2430.0), p<.001, all pairwise comparisons p<.01), as well as the prevalence of participants achieving the MVPA recommendations (SIM 31.3% (95% CI 24.5-38.7), DEGS 43.2% (95% CI 35.8-50.8), EHIS 67.0% (95% CI 59.6-73.9), EURO 87.5% (95% CI 81.7-92.0), p<.001), except between SIM and DEGS (p=.067). Agreement was weak between all questionnaire pairs (all κ< 0.60). CONCLUSIONS: Questionnaire choice crucially affects the resulting MVPA data and hence the prevalence of achieving recommended PA levels within the same sample. Therefore, for PA surveillance, standardised survey and analysis methods and efforts to harmonise monitoring systems are needed, since whether recommended levels of PA are achieved should not be determined by the choice of one measuring instrument or another.

Associations between health-related skills and young adults' work ability within a structural health literacy model.

Young adults have a high societal relevance but are still an under-represented target group in health promotion. Health literacy is widely acknowledged as one of the strongest predictors and key determinant of health, so its influence on work ability is of great interest. The purpose of the study was to examine the associations between health-related skills and work ability within the structural model of health literacy of Lenartz, Soellner and colleagues, which explains health behaviour and health through the indirect and direct influence of six 'advanced skills' ('self-perception', 'proactive approach to health', 'dealing with health information', 'self-control', 'self-regulation' and 'communication and cooperation'). The cross-sectional study was based on baseline data of a health literacy promotion intervention (495 vocational school students, 59.0% female, age span 18-25 years). Structural equation modelling with partial least squares was used to examine the associations between the six constructs of the model and the Work Ability Index (WAI). Mean WAI score was 39.7 ± 4.5 (51.1% categorized 'moderate'/'poor'). Five out of six constructs of the model showed a statistically significant indirect or direct effect, respectively, on work ability. The model explained 24.8% of the WAI score variance. Our findings show associations between the health literacy model and the work ability among young employees. In view of demographic change, it is crucial to develop and analyse target group-specific health literacy interventions. The model offers new facets in the modelling of health literacy.

Demographics and Health Behavior of Video Game and eSports Players in Germany: The eSports Study 2019.

The number of video game and eSports players is steadily rising. Since little is known about their health behavior to date, the present study examines the demographics and health behavior of video game and eSports players. In this cross-sectional study, data on demographics, health status, physical activity, nutrition, sleep, and video game usage were assessed via a web-based survey of n = 1066 players (91.9% male; 22.9 ± 5.9 years; body mass index (BMI): 24.6 ± 4.8 kg/m²) in Germany in 2018. The majority of respondents (95%) reported a good to excellent health status. Two thirds (66.9%) engaged in moderate to vigorous physical activity for more than 2.5 h/week. The average duration of sitting and sleep time was 7.7 ± 3.6 h/day and 7.1 ± 1.3 h/day, respectively. Mean fruit and vegetable consumption was 2.7 ± 1.8 portions/day. Video games were played for 24.4 ± 15.9 h/week on average. Partial Spearman correlations revealed poor positive associations of video game play time to sedentary behavior (rho = 0.15; p < 0.01) and BMI (rho = 0.11; p < 0.01), as well as a poor negative association to self-reported health status (rho = -0.14; p < 0.01). These results indicate the good subjective health of this target group. Nevertheless, the high amount of video game play time and its poor negative association to health status indicate a need for specific health promotion strategies for this target group.

Health coaching for promoting physical activity in low back pain patients: a secondary analysis on the usage and acceptance.

BACKGROUND: Multicomponent interventions combined with health coaching are widely recommended to improve a healthy lifestyle. The aim of the present study was to analyse the usage and acceptance of a multicomponent intervention (telephone, web and face-to-face coaching) for low back pain patients, and thereby gain an understanding of why this intervention was not as effective as expected. METHODS: A secondary analysis of a randomised controlled trial, aimed at promoting physical activity, was conducted. It was a cross-sectional study based on data of a multicomponent intervention group (baseline = 201 participants). For evaluating the usage and acceptance, descriptive statistics were applied. RESULTS: Over half (n = 118) of the patients participated at least once in the telephone coaching. Approximately half of the participants (44 of 90) rated the telephone coaching as "good".34 of 92 (37%) participants reported of visiting the web-platform. The web-platform was comprehensible for nearly one-quarter (n = 8 of 33) and very useful for one participant.The face-to-face-contact was rated highly (range: 79.4-88.2 out of 100). CONCLUSION: Usage of the telephone coaching approach was moderate with even fewer participants visiting the web-platform. In addition, these approaches were not rated as very useful. The acceptance of the face-to-face contact was high.Since the usage and acceptance could influence the effectiveness, utilisation and acceptance studies might help to explain the reason for non-effective lifestyle interventions. Therefore, more studies analysing the usage and acceptance are needed. To improve the usage and acceptance, a stronger participatory orientation in the design of interventions and the integration of face-to-face contact could be helpful.

Show cards of the Global Physical Activity Questionnaire (GPAQ) - do they impact validity? A crossover study.

BACKGROUND: The Global Physical Activity Questionnaire (GPAQ) is applied internationally as a tool to assess the level of physical activity. The GPAQ was designed as an interview, including the use of show cards, which visualise activities of moderate and intensive physical activity and support the distinction between these intensities. The self-administered version of the GPAQ is used in the application-oriented research for reasons of economy and practicality. However, the use of show cards often remains unknown. The aim of the present study was to examine differences in validity between two self-administered versions of the GPAQ with and without show cards. METHODS: In this crossover study, two groups (n = 54; 57.4% female; 28.3 ± 12.2 years) received the GPAQ with or without show cards after 7 days and the respective other version after additional 7 days. For validation, all participants wore an accelerometer (ActiGraph GT3X+) on all 14 days. Differences between GPAQ versions and accelerometer data were compared by Wilcoxon signed rank test. Additionally, Spearman analyses and Bland-Altman plots were calculated. RESULTS: No statistically significant difference between the GPAQ versions could be found in regard to the accuracy of physical activity assessment (p > 0.05). Both GPAQ versions show similar correlation coefficients for vigorous physical activity (rho = 0.31-0.42) and sedentary behaviour (rho = 0.29-0.32). No statistically significant correlation was found for physical activity of moderate intensity. The Bland-Altman plots support these results, as both GPAQ versions have the same trends in terms of overestimation and underestimation of physical activity. CONCLUSION: The use of show cards had no significant impact on questionnaire validity. Therefore, both GPAQ versions can be applied interchangeably. Nevertheless the exact description of application of the GPAQ is desirable in terms of reproducibility and transparent scientific research.

Influence of Health Literacy on the Physical Activity of Working Adults: A Cross-Sectional Analysis of the TRISEARCH Trial.

Studies show that high health literacy (HL) can support the promotion and maintenance of healthy behavior such as physical activity (PA). However, most studies rely on subjective data. The aim of the present study is to investigate the relationship between HL and PA, not only with subjectively but also with objectively measured PA data. The present study is a pooled analysis of baseline data from the research association TRISEARCH (2015-2018), which focused on the HL of working adults. HL was measured by Lenartz' questionnaire, and PA by the Global Physical Activity Questionnaire (GPAQ; n = 1056). A subsample (n = 124) also received accelerometers (Actigraph GT3X+) to provide more objective PA data. Partial correlations and regression models were used to investigate the relationship between HL and questionnaire- and accelerometer-derived PA. Very low and medium partial correlations could be found for HL subscales and daily PA by questionnaire (r = -0.06, p < 0.05) and accelerometer (r = 0.26, p < 0.01). No subscale of HL made a significant contribution to the amount of daily PA (all p > 0.05). Not all subscales of HL seem to have an influence on the occurrence of healthy behavior, such as PA. This should be considered when HL-based interventions are designed. Further investigation of the relationship between HL and PA is needed. Objective assessments of both HL and PA can provide additional information for this task.

Expectations Regarding Workplace Health Coaching: A Qualitative Study With Stakeholders.

The integration of health coaching in workplace interventions has increased over the past several years. However, the tasks and the qualifications of the coaches have not been clearly defined. The objective of this qualitative study was to assess workplace stakeholders' expectations regarding a health coach. Systematic field notes of 11 meetings and 14 semi-structured interviews with stakeholders of a workplace intervention, including employees, company doctors, and representatives of health insurances, were analyzed according to the structured content analysis. Stakeholders reported that the main aspect of a health coach's work should be the motivation of clients (workers) to achieve their internally developed goals. Regarding the coach's competencies, personal, methodological, and social skills were desired. They also expected that the health coach use a range of different approaches to develop contacts and, in terms of content, focus on physical activity. These findings provide a step toward establishing criteria for professional health coaching and an evidence-based curriculum for coach training.

Effectiveness Studies in Health Promotion: A Review of the Methodological Quality of Studies Reporting Significant Effects on Physical Activity in Working Age Adults.

The methodology of intervention studies on physical activity (PA) promotion is of great importance regarding evidence development in complex interventions. The aim of this review was to provide an overview of the methodological quality of those studies which reported statistically significant effects of interventions promoting PA. PUBMED was searched for reviews on PA promotion to identify studies reporting effective interventions with participants of working age (16⁻67 years). Selected reviews were screened and data from primary studies with effective interventions were extracted to assess methodological quality. Forty-six reviews with 600 primary studies were identified, of which 33 met the inclusion criteria. Twenty-one studies were conducted as randomized controlled trials, 13 included an intervention control group, 25 measured PA by questionnaire, and 13 included objective measurements. Information on used statistics was often scarce, and long-term follow-up measurements were frequently missing. The overall methodological quality was moderate for randomized studies and low for non-randomized studies; information on methods and results was often lacking. To overcome these methodological issues, standardized guidelines for reporting study results should be considered, not only when publishing results but also when designing studies. This review provides a solid foundation for the development of practical advice for planning application-oriented studies in PA promotion.

Impact of different recruitment strategies on accelerometry adherence and resulting physical activity data: A secondary analysis.

Strategies for increasing adherence to physical activity assessments are often linked to extra financial or personal effort. This paper aims to investigate the influence of the recruitment strategy on participants' adherence to accelerometry and resulting PA data. Data were used from two previous studies conducted in 2013 and 2016 in Cologne, Germany, differing in recruitment strategy (N = 103, 40.8% male, mean age 20.9 ±â€¯3.7 years, mean BMI 23.7 ±â€¯4.1 kg/m2). In the passive recruitment (PR) group, vocational students took part in the accelerometry (ActiGraph GT3X+) in line with the main study unless they denied participation. In the active recruitment (AR) group, vocational students were invited to actively volunteer for the accelerometry. Impact of recruitment strategy on adherence and PA data was examined by regression analysis. Average adherence to the accelerometry was 66.7% (AR) and 74.0% (PR). No statistically significant influence of recruitment strategy on adherence and resulting PA was found (all p > 0.05). The difference in recruitment strategy did not affect adherence to accelerometry. The data imply that AR may be applicable. Future studies using larger sample sizes and diverse populations should further investigate these trends.

Influencing Factors on the Overestimation of Self-Reported Physical Activity: A Cross-Sectional Analysis of Low Back Pain Patients and Healthy Controls.

Introduction. The aim of the present study was to determine the closeness of agreement between a self-reported and an objective measure of physical activity in low back pain patients and healthy controls. Beyond, influencing factors on overestimation were identified. Methods. 27 low back pain patients and 53 healthy controls wore an accelerometer (objective measure) for seven consecutive days and answered a questionnaire on physical activity (self-report) over the same period of time. Differences between self-reported and objective data were tested by Wilcoxon test. Bland-Altman analysis was conducted for describing the closeness of agreement. Linear regression models were calculated to identify the influence of age, sex, and body mass index on the overestimation by self-report. Results. Participants overestimated self-reported moderate activity in average by 42 min/day (p = 0.003) and vigorous activity by 39 min/day (p < 0.001). Self-reported sedentary time was underestimated by 122 min/day (p < 0.001). No individual-related variables influenced the overestimation of physical activity. Low back pain patients were more likely to underestimate sedentary time compared to healthy controls. Discussion. In rehabilitation and health promotion, the application-oriented measurement of physical activity remains a challenge. The present results contradict other studies that had identified an influence of age, sex, and body mass index on the overestimation of physical activity.