Development of an Air Pollution Risk Perception Questionnaire for Running Race Runners Based on the Health Belief Model.

An increasing number of individuals participate in running races worldwide; however, running in the presence of air pollution poses health risks to runners. Therefore, developing a valid and reliable instrument is imperative to assess runners' beliefs and perceptions regarding risks and health behaviors. This study developed a comprehensive questionnaire based on the health behavior model and relevant literature. The questionnaire was tested with 310 responses from individuals with running race experiences in Taiwan. Tests of the measurement model were conducted using reliability and confirmatory factor analysis. The results reveal that the questionnaire consists of eight constructs: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, perceived self-efficacy, cues to action, health behavior intention, and awareness of air quality. The 31 items jointly accounted for 72.71% of the observed variance. All eight factors have good internal consistency, convergent, and discriminant validity with acceptable model fit indexes. Additionally, a valid translated English version of the questionnaire is provided for future research, sports agencies, or governments to explore factors that affect, or interact with, risk while running under air pollution conditions to develop management strategies.

Qualitative impact assessment of COVID-19 on the pedagogical, technological and social experiences of higher education students in Taiwan.

COVID-19 has imposed a rippling effect on educational institutions globally, substantially impacting nearly 1.6 billion learners in more than 190 countries. Recognizing Taiwan as an atypicality during this crisis for suffering from a relatively moderate mortality/morbidity compared with the rest of the world, the present paper qualitatively explores the pedagogical, technological and social impact of COVID-19 on higher education students in Taiwan. Employing the focus group discussion methodology, we recruited a cohort of 23 students, comprising of 15 local and 8 international students. Findings show diverse pedagogical experiences in students' instructional modalities. Trending by either discipline of study, students from Science, Technology, Engineering and Mathematics disciplines expressed a greater preference for face-to-face instruction compared to their humanities counterparts. Distance learners reported a decrease in study efficacy and a lack of sense of belongingness to their university. All students demonstrated a high sense of perceived safety and reported minimal changes in their socializing norms during the pandemic. In terms of career planning, local students expressed minimal concerns about potential changes in their careers, versus international students who expressed high degrees of uncertainty, fear and pessimism in the same regard.

Evaluation of the Effectiveness of Outdoor Fitness Equipment Intervention in Achieving Fitness Goals for Seniors.

Despite the popularity of outdoor fitness equipment (OFE) in public spaces with the aim of increasing physical activity (PA), very little research has been conducted to investigate the effectiveness of the equipment's use, especially for achieving the target fitness goal. This study designed an OFE training protocol incorporating four modalities of PA: endurance (air walker and ski machine), resistance (rowing machine and bonny rider), flexibility (arm stretch and shoulder wheel), and balance exercise (waist twister). Seniors who completed the protocol demonstrated that for endurance training, participants were at moderate intensity from heart rate and perceived exertion, while significantly improving cardiac endurance in the two min step test. For resistance/flexibility/balance interventions, only the handgrip strength test, the 30 s chair stand test, the right-hand shoulder flexion test, the right-hand shoulder horizontal abduction test, the single-leg stance test, and the eyes open foam surface clinical test for sensory balance were significant, using a repeated measure analysis of variance. The results demonstrated that older adults aim for the OFE target for specific fitness goals can reach moderate intensity and improve their cardiorespiratory endurance. Yet, results for resistance/flexibility/balance are inconclusive. More studies are needed to carefully assess the effectiveness of using OFE.

Leisure and health benefits associated with acculturation among Western international students living in South Korea.

Purpose: Prior research provides limited information on the roles that leisure can play among Western international students studying in Eastern countries. Exploring this directional difference can provide its implications for Western international student support. Therefore, the purpose of this study is to explore leisure behaviours and leisure benefits associated with acculturation among Western international students residing in South Korea.Method: Using a purposeful criterion sampling strategy, a total of 18 participants (7 males and 11 females) were recruited. This study employed semi-structured in-depth interviews and a content mapping and content mining question strategy was incorporated.Results: The following core themes were associated with the health benefits of leisure activities experienced by international students living in South Korea: (a) promoting mental health, (b) experiencing dynamics of inter-and intra-group friendships, and (c) facilitating acculturation.Conclusions: The findings showed that participants developed friendships with the host individuals and other international students, became well acculturated into a new culture and experienced benefits to their mental health, indicating that leisure participation can be instrumental in improving social and psychological wellbeing.

Accuracy of Optical Heart Rate Sensing Technology in Wearable Fitness Trackers for Young and Older Adults: Validation and Comparison Study.

BACKGROUND: Wearable fitness trackers are devices that can record and enhance physical activity among users. Recently, photoplethysmography (PPG) devices that use optical heart rate sensors to detect heart rate in real time have become popular and help in monitoring and controlling exercise intensity. Although the benefits of using optical heart rate monitors have been highlighted through studies, the accuracy of the readouts these commercial devices generate has not been widely assessed for different age groups, especially for the East Asian population with Fitzpatrick skin type III or IV. OBJECTIVE: This study aimed to examine the accuracy of 2 wearable fitness trackers with PPG to monitor heart rate in real time during moderate exercise in young and older adults. METHODS: A total of 20 young adults and 20 older adults were recruited for this study. All participants were asked to undergo a series of sedentary and moderate physical activities using indoor aerobic exercise equipment. In this study, the Polar H7 chest-strapped heart rate monitor was used as the criterion measure in 2 fitness trackers, namely Xiaomi Mi Band 2 and Garmin Vivosmart HR+. The real-time, second-by-second heart rate data obtained from both devices were recorded using the broadcast heart rate mode. To critically analyze the results, multiple statistical parameters including the mean absolute percentage error (MAPE), Lin concordance correlation coefficient (CCC), intraclass correlation coefficient, the Pearson product moment correlation coefficient, and the Bland-Altman coefficient were determined to examine the performances of the devices. RESULTS: Both test devices exhibited acceptable overall accuracy as heart rate sensors based on several statistical tests. Notably, the MAPE values were below 10% (the designated threshold) in both devices (GarminYoung=3.77%; GarminSenior=4.73%; XiaomiYoung=7.69%; and XiaomiSenior=6.04%). The scores for reliability test of CCC for Garmin were 0.92 (Young) and 0.80 (Senior), whereas those for Xiaomi were 0.76 (Young) and 0.73 (Senior). However, the results obtained using the Bland-Altman analysis indicated that both test optical devices underestimated the average heart rate. More importantly, the study documented some unexpected outlier readings reported by these devices when used on certain participants. CONCLUSIONS: The study reveals that commonly used optical heart rate sensors, such as the ones used herein, generally produce accurate heart rate readings irrespective of the age of the user. However, users should avoid relying entirely on these readings to indicate exercise intensities, as these devices have a tendency to produce erroneous, extreme readings, which might misinterpret the real-time exercise intensity. Future studies should therefore emphasize the occurrence rate of such errors, as this will likely benefit the development of improved models of heart rate sensors.

Outdoor Fitness Equipment Usage Behaviors in Natural Settings.

Outdoor fitness equipment (OFE) areas have become a popular form of built environment infrastructure in public open spaces as a means to improve public health through increased physical activity. However, the benefits of using OFE are not consistent, and several OFE accidents have been reported. In this study, we videotaped how OFE users operate OFE in parks and selected four types of popular OFE (the waist twister, air walker, ski machine, and waist/back massager) for video content analysis. Furthermore, we established coding schemes and compared results with the instructions provided by OFE manufacturers. The results revealed various usage behaviors for the same OFE types. In addition, we observed that a significant portion of user behaviors did not follow manufacturers' instructions, which might pose potential risks or actually cause injuries. Children are especially prone to act improperly. This study provides empirical evidence indicating the existence of potential safety risks due to inappropriate usage behaviors that might lead to accidents and injuries while using OFE. This study provides crucial information that can be used to evaluate the effectiveness of OFE and to develop future park or open space initiatives.

Does the use of outdoor fitness equipment by older adults qualify as moderate to vigorous physical activity?

Despite the rapid worldwide expansion of parks with outdoor fitness equipment (OFE), no objective data regarding the intensity of activity associated with using OFE are available. Hence, this study quantified the energy expenditure and intensity of physical activity by examining four outdoor fitness devices widely used by older adults and provides objective evidence-based intensity references for the Compendium of Physical Activities. Sixteen older adults (mean age: 70.7 ± 5.6 yr) equipped with a portable metabolic system for measuring energy expenditure and activity intensity completed tasks while walking or using four types of OFE. Descriptive statistics and repeated-measures ANOVA with the Bonferroni post hoc test were employed. The energy expenditure and activity intensity for using an air walker at tempos of 80, 100, and 120 bpm were 50.78 ± 14.76 (2.81 ± 0.85), 59.62 ± 14.23 (3.26 ± 0.82), and 65.62 ± 18.27 (3.55 ± 1.02) cal/kg/min (METs), respectively. The induced energy and intensity output values for a ski machine were 54.00 ± 14.31 (3.02 ± 0.87), 68.87 ± 22.74 (3.82 ± 1.35), and 74.55 ± 23.39 (4.05 ± 1.35) cal/kg/min (METs), at 80, 100, and 120 bpm, respectively. The energy output for a waist twister at 60 bpm was 38.43 ± 20.16 cal/kg/min (2.05 ± 1.15 METs), and that for a double arm stretch at 80 bpm was 31.05 ± 12.58 cal/kg/min (1.63 ± 0.70 METs). These findings indicate that activity on the ski machine and air walker could be considered to have moderate intensity, whereas the intensity of activity on the waist twister and double arm stretch was significantly lower than that for walking at either 3.2 km/h or 4 km/h and could be considered only light intensity. The MET values for the OFE were lower than those for similar indoor fitness equipment. The results of this study provide crucial implications for public health practices concerning the development of active living environments.

Who Is Using Outdoor Fitness Equipment and How? The Case of Xihu Park.

Outdoor fitness equipment (OFE) placed in public parks has the potential to encourage physical activity. However, little is known about OFE users and use patterns. This study employed onsite and video observations of OFE usage to describe user characteristics and patterns in Xihu Park. Results indicate that OFE in this park attracted considerable use, particularly in the early morning and late afternoon. During these peak-hour observations, approximately 12 users per hour used the OFE, with the majority being females and seniors. The triple arm stretch and air walker were the most popular stations. However, most OFE users interacted with less than three of the available six OFE stations. Furthermore, users spent an average of less than nine minutes on all OFE stations combined. While OFE equipment was well-used in this urban park, it appears users did not interact with OFE at rates to produce a sufficient bout or level of physical activity during their park visit. Further investigations of OFE are encouraged to determine their health impact.

Association between out-of-home trips and older adults' functional fitness.

AIM: To explore the purposes of older adults' out-of-home trips, and to investigate the association between the frequency of these trips and older adults' functional fitness. METHODS: A total of 412 older adults in Taiwan were recruited from 2009 to 2010. Participants were asked to fill out questionnaires on out-of-home trips, and trained volunteers assessed the functional fitness of respondents using objective measures. Descriptive statistics, univariate analysis, multivariate regression analysis and canonical correlation analysis were then used to analyze the resulting data. RESULTS: Results show that exercise is most frequently the purpose for going out at least once a day, and that parks are the most preferred places to visit. Sex and age are the significant variables explaining variance in older adults' flexibility and physical power, respectively. Canonical correlation analysis showed one significant variate pair (R(2)(c) = 8.80) between the frequency of out-of-home trips (engaging in exercise and participating in religious activities) and fitness measure test scores including the chair stand, arm curl, 2-min step, and 8-foot up-and-go. The relationship did not exist for the back scratch, nor chair sit-and-reach test scores. CONCLUSION: The present study provides empirical and objective evidence on older adults' purposes for taking out-of-home trips, and for the positive association between the frequency of these trips, and the muscular strength and cardiovascular endurance, but not flexibility, of older adults.

Outdoor fitness equipment in parks: a qualitative study from older adults' perceptions.

BACKGROUND: The growing amount of outdoor fitness equipment (OFE) placed in parks in many countries has the intent of encouraging physical activity among aging populations. However, little investigated aspects are the perceptions and experiences of older adults regarding the use of these facilities. Hence, this study seeks senior OFE users' opinions to understand the exact nature of use of these facilities, the perceived health benefits achieved, and equipment's improvements that would further encourage use. METHODS: The study conducts semi-structured interviews with 55 senior OFE users at two parks in Taiwan. RESULTS: Study results suggest that although OFE use is not the main purpose for which seniors visit parks, most seniors perceive the benefit of using OFE in terms of both physical and psychological health, as well as social connection. Respondents also raised issues related to safety, maintenance, and management of OFE. CONCLUSIONS: OFE appears to meet the health needs of seniors, but improved management is necessary to ensure safety. Further research would reveal the actual behavior involving OFE use and use's relationship to the physical activity of seniors.

Relationship between participation in leisure activities and constraints on Taiwanese breastfeeding mothers during leisure activities.

BACKGROUND: Participation in leisure activities strongly associates with health and well-being. Little research has explored the relationship between participation in leisure activities and constraints on breastfeeding mothers during leisure activities. The purposes of this study are: 1) to investigate constraints on breastfeeding mothers during leisure activities and participation in leisure activities; 2) to investigate the differences between preferences for leisure activities and actual participation by breastfeeding mothers; 3) to segment breastfeeding mothers with similar patterns, using a cluster analysis based on the delineated participation in leisure activities and leisure preferences; 4) to explore any differences between clusters of breastfeeding mothers with respect to socio-demographic characteristics, breastfeeding behaviours and leisure constraints. METHODS: This study has a cross-sectional design using an online survey conducted among mothers having breastfeeding experiences of more than four months. The questionnaire includes demographic variables, breastfeeding behaviours, preferences for leisure activities participation, and constraints on leisure activities. Collection of data occurred between March and July 2011, producing 415 valid responses for analysis. RESULTS: For breastfeeding mothers, this study identifies constraints on breastfeeding related to leisure activities in addition to the three traditional factors for constraints in the model. This study demonstrates that reports of constraints related to children, family, and nursing environments are the most frequent. Breastfeeding mothers in Taiwan participate regularly in family activities or activities related to their children. Cluster analysis classified breastfeeding mothers into Action and Contemplation groups, and found that mothers within the latter group participate less in leisure activities and experienced more constraints related to breastfeeding. CONCLUSIONS: Implications provide a developmental design for public health policies for nursing-friendly environments to increase opportunities for breastfeeding mothers to engage in leisure activities and suggest various types of activities to increase participation of that population.