A life course perspective on determinants of discontinuance of active participation in sports activities.

Physical inactivity remains a global public health challenge today. Determining why people stop regularly participating in sports is significant to develop targeted intervention strategies for sports promotion and healthy living. As sports participation is dynamic throughout life, a life-course perspective is needed to provide a more comprehensive understanding. This study adopts a life-course perspective to explore the determinants of the change from active participation in sports to becoming inactive. Based on online retrospective survey data collected in the Netherlands, a two-level binary logistic regression model is estimated to capture the effects of socio-demographics, sports motivations, life transitions, and neighborhood characteristics on sports dropout over the lifespan. Results show that dropout from sports is age-specific, and that people are less likely to discontinue sports participation when they have health and weight loss goals. Life transitions have different effects. The cessation of living with physically active people appears to be the most important event to make people stop sporting, followed by having a baby, and then owning the first car. Compared with education-related events, work-related events are more likely to cause people to stop sporting. Moreover, the probability of sports discontinuance may increase when residents feel unsafe doing physical activities in their neighborhoods or when the neighborhood has sufficient greenspace for walking. The findings have implications for supporting sports participants to continue exercising by addressing the barriers.

Socio-demographics, neighborhood characteristics, time use, and leisure-time physical activity engagement patterns over the life course.

Physical inactivity remains a major public health challenge today. Understanding the determinants of changes in habitual leisure-time physical activity patterns by type across the life course is important for developing targeted interventions. This study presents a multiple discrete-continuous extreme value model to examine the determinants of habitual participation in and time allocation to multiple leisure-time physical activities over the life course. A comprehensive set of socio-demographics, life transitions, neighborhood characteristics, and time-related factors are considered as determinants of each activity type, including sports, recreational walking, cycling, outdoor playing, and dog walking. Results estimated on retrospective survey data collected in the Netherlands show significant differences in the determinants of the different types of leisure-time physical activity. Social-demographic factors have a strong influence on sports participation, followed by recreational walking, cycling, outdoor playing, and then dog walking. Life transitions have different effects. A change in marital status appears to be the most important life event for sports participation while changing jobs is the most important event for the other two activities. Neighborhood characteristics primarily affect participation in recreational walking, cycling, outdoor playing, and dog walking. As for time-related factors, they mainly impact sports engagement. The findings of this study could help develop effective interventions to promote leisure-time physical activity participation during life transitions and encourage healthy living.

Evaluating the Impact of Adaptive Personalized Goal Setting on Engagement Levels of Government Staff With a Gamified mHealth Tool: Results From a 2-Month Randomized Controlled Trial.

BACKGROUND: Although the health benefits of physical activity are well established, it remains challenging for people to adopt a more active lifestyle. Mobile health (mHealth) interventions can be effective tools to promote physical activity and reduce sedentary behavior. Promising results have been obtained by using gamification techniques as behavior change strategies, especially when they were tailored toward an individual's preferences and goals; yet, it remains unclear how goals could be personalized to effectively promote health behaviors. OBJECTIVE: In this study, we aim to evaluate the impact of personalized goal setting in the context of gamified mHealth interventions. We hypothesize that interventions suggesting health goals that are tailored based on end users' (self-reported) current and desired capabilities will be more engaging than interventions with generic goals. METHODS: The study was designed as a 2-arm randomized intervention trial. Participants were recruited among staff members of 7 governmental organizations. They participated in an 8-week digital health promotion campaign that was especially designed to promote walks, bike rides, and sports sessions. Using an mHealth app, participants could track their performance on two social leaderboards: a leaderboard displaying the individual scores of participants and a leaderboard displaying the average scores per organizational department. The mHealth app also provided a news feed that showed when other participants had scored points. Points could be collected by performing any of the 6 assigned tasks (eg, walk for at least 2000 m). The level of complexity of 3 of these 6 tasks was updated every 2 weeks by changing either the suggested task intensity or the suggested frequency of the task. The 2 intervention arms-with participants randomly assigned-consisted of a personalized treatment that tailored the complexity parameters based on participants' self-reported capabilities and goals and a control treatment where the complexity parameters were set generically based on national guidelines. Measures were collected from the mHealth app as well as from intake and posttest surveys and analyzed using hierarchical linear models. RESULTS: The results indicated that engagement with the program inevitably dropped over time. However, engagement was higher for participants who had set themselves a goal in the intake survey. The impact of personalization was especially observed for frequency parameters because the personalization of sports session frequency did foster higher engagement levels, especially when participants set a goal to improve their capabilities. In addition, the personalization of suggested ride duration had a positive effect on self-perceived biking performance. CONCLUSIONS: Personalization seems particularly promising for promoting the frequency of physical activity (eg, promoting the number of suggested sports sessions per week), as opposed to the intensity of the physical activity (eg, distance or duration). Replications and variations of our study setup are critical for consolidating and explaining (or refuting) these effects. TRIAL REGISTRATION: ClinicalTrials.gov NCT05264155; https://clinicaltrials.gov/ct2/show/NCT05264155.

The Effects of Noise on Cognitive Performance and Helplessness in Childhood: A Review.

Environmental noise affects our daily functioning in many ways, and the cognitive, motivational, and emotional effects of noise are intertwined. Our task performance under noisy conditions depends on our ability to cope with the noise and our cognitive resources. The process of (failed) coping may wear us out cognitively, lead to learned helplessness, and, consequently, alter the motivation to persist in a task. The direct effect of irrelevant sounds on cognitive functioning in children is relatively well-established, however, the research on the framework of learned helplessness is limited when it comes to children. Learned helplessness can give more insight into effects of environmental noise on learning and child development and how the effects of short-term and long-term exposure interact. A systematic literature review is performed to assess to what extent the current evidence addresses the (interaction) effects of the sound environment on cognition and learned helplessness as measured by motivation in children and young adults up to the age of 21. The search resulted in 8 included papers that addressed both cognition and learned helplessness in their research. The included papers study children between 8-13 years old and show evidence for a relation between environmental noise, cognition, and helplessness individually, but none study a possible interaction. Based on the individual study designs, it could be hypothesized that cognitive fatigue may play a role in the interaction. Studies that conducted motivation tasks after cognitive tasks found stronger effects than those that conducted tasks in a random order. More research is needed using the same methods in different age groups to further assess the interaction between cognition and learned helplessness in relation to the sound environment.

Influence of Neighborhood Characteristics on Physical Activity, Health, and Quality of Life of Older Adults: A Path Analysis.

Background: As life expectancy and health expenditure consumed by older people increase, maintaining a better health and quality of life for older adults has become an important social issue. Research indicates that physical activity may help address this challenge. Moreover, it is believed that improved quality of life and health benefits from physical activity can be achieved through interventions in the neighborhood environments. However, existing knowledge has often been based on bivariate relationships between these factors, and few studies have formally examined the extent to which any association between neighborhood environments, health, and quality of life may be mediated by the level of physical activity. This paper aims to investigate the direct and indirect influence of neighborhood characteristics on the health and quality of life of older adults, taking into account physical activity behavior and socio-demographic characteristics in a more comprehensive framework. Methods: Data were collected using a survey among 363 older adults aged 60 years and over in China. A path analysis was used that derives all direct and indirect relationships between the variables. Results: Leisure-time physical activity levels played a mediating role in the relation between social capital and health as well as quality of life. Moreover, the study confirmed direct relationships between neighborhood characteristics such as neighborhood aesthetics and traffic safety and health as well as quality of life. However, the effect of neighborhood characteristics on health and quality of life through transport-related physical activity levels was not found. Conclusions: Leisure-time physical activity instead of transport-related physical activity should be considered a priority when developing interventions aiming to promote healthy aging. Additionally, neighborhood characteristics are important in promoting healthy aging, even though they have no or less impacts on older adults' health and quality of life through physical activity.

Preadolescent Students' Engagement With an mHealth Intervention Fostering Social Comparison for Health Behavior Change: Crossover Experimental Study.

BACKGROUND: Contemporary mobile health (mHealth) interventions use various behavior change techniques to promote healthier lifestyles. Social comparison is one of the techniques that is consensually agreed to be effective in engaging the general population in mHealth interventions. However, it is unclear how this strategy can be best used to engage preadolescents. Nevertheless, this strategy has great potential for this target audience, as they are particularly developing their social skills. OBJECTIVE: This study aims to evaluate how social comparison drives preadolescents' engagement with an mHealth app. METHODS: We designed a 12-week crossover experiment in which we studied 3 approaches to implementing behavior change via social comparison. This study was hosted in a school environment to leverage naturally existing social structures among preadolescents. During the experiment, students and teachers used an mHealth tool that awarded points for performing healthy activities. Participants could read their aggregated scores on a leaderboard and compare their performance with others. In particular, these leaderboards were tweaked to implement 3 approaches of the social comparison technique. The first approach focused on intragroup comparison (ie, students and teachers competing against each other to obtain the most points), whereas the other two approaches focused on intergroup comparison (ie, classes of students and their mentoring teachers collaborating to compete against other classes). Additionally, in the third approach, the performance of teachers was highlighted to further increase students' engagement through teachers' natural exemplary function. To obtain our results, we used linear modeling techniques to analyze the dropout rates and engagement levels for the different approaches. In such analyses, we also considered individual participant traits. RESULTS: Our sample included 313 participants-290 students (92.7%) and 23 teachers (7.3%). It was found that student engagement levels dropped over time and declined during holidays. However, students seemed to monitor the intergroup competitions more closely than the intragroup competitions, as they, on average, checked the mHealth app more often when they were engaged in team-based comparisons. Students, on average, performed the most unique activities when they were engaged in the second intergroup setting, perhaps because their teachers were most active in this setting. Moreover, teachers seemed to play an important role in engaging their students, as their relationship with their students influenced the engagement of the students. CONCLUSIONS: When using social comparison to engage preadolescents with an mHealth tool, an intergroup setting, rather than an intragroup competition, motivated them to engage with the app but did not necessarily motivate them to perform more activities. It seems that the number of unique activities that preadolescents perform depends on the activeness of a role model. Moreover, this effect is amplified by preadolescents' perceptions of closeness to that role model.

Pilot Evaluation of the Impact of Lottery-Based Incentives on Engagement Levels of Male Low SES Vocational Students With an mHealth App.

In general, individuals with lower socioeconomic status (SES) are less physically active and adhere to poorer diets than higher SES individuals. To promote healthier lifestyles in lower SES populations, we hosted a digital health promotion program among male vocational students at a school in The Netherlands. In a pilot study, we evaluated whether this target audience could be engaged with an mHealth app using lottery-based incentives that trigger feelings of anticipated regret. Especially, we studied the social and interpersonal aspects of regret lotteries in a within-subject experimental design. In this design, subjects either participated in a social variant (i.e., with students competing against their peers for a chance at a regret lottery), or an individual variant (i.e., with subjects solely individually engaged in a lottery). Additionally, we studied the impact of different payout schedules in a between-subject experimental design. In this design, participants were assigned to either a short-term, low-value payout schedule, or a long-term, high-value payout schedule. From a population of 72 male students, only half voluntarily participated in our 10-week program. From interviews, we learned that the main reason for neglecting the program was not related to the lottery-based incentives, nor to the prizes that were awarded. Instead, non-enrolled subjects did not join the program, because their peers were not joining. Paradoxically, it was suggested that students withheld their active participation until a larger portion of the sample was actively participating. From the subjects that enrolled in the program (N = 36, males, between 15 and 25 years of age), we found that a large proportion stopped interacting with the program over time (e.g., after roughly 4 weeks). Our results also indicated that students performed significantly more health-related activities when assigned to the social regret lottery, as opposed to the individual variant. This result was supported by interview responses from active participants: They mainly participated to compete against their peers, and not so much for the prizes. Hence, from this study, we obtained initial evidence on the impact of social and competitive aspects in lottery-based incentives to stimulate engagement levels in lower SES students with an mHealth app.

Location Choice in the Context of Older Adults' Leisure-Time Walking.

Leisure-time walking is the most prevalent and preferred form of physical activity of older adults. In order to promote leisure-time walking and enhance the efficiency of using outdoor open spaces, the supply of different types of walking locations should match the needs, interests and preferences of older adults. However, there is limited knowledge on which location types are chosen by which groups of individuals under which conditions. This study therefore examines the effects of socio-demographics, episode participation attributes and neighborhood characteristics on the location choice of older adults for leisure-time walking. A multinomial logit model is estimated based on data collected among 316 respondents aged 60 or older in Dalian, China. The results indicate that older people's location choices for walking are associated with their socio-demographics, episode participation attributes and neighborhood characteristics. Finally, implications of the results for the planning, design and management of open spaces are identified.

Where do People Interact in High-rise Apartment Buildings? Exploring the Influence of Personal and Neighborhood Characteristics.

Early studies conclude that high-rise apartment buildings present challenges for people's quality of life, resulting in social isolation, social annoyance and anonymity for residents. Nevertheless, empirical research into factors supporting social interaction in high-rise apartment buildings is still scarce. This study aims to investigate how often and where people in high-rise neighborhoods interact, and how this is affected by personal and neighborhoods characteristics. A mixture of both quantitative and qualitative methods was used including social interaction diaries and questionnaires among 274 residents, in-depth interviews with 45 residents and objective measurement of the physical environments in four high-rise apartment buildings for low in-income people in Hanoi, Vietnam. Results demonstrate that social interaction is influenced by a number of personal and neighborhood characteristics. Furthermore, most social interactions-also gathering and accompanying playing children-take place in the circulation areas of the apartment buildings. However, the use of these spaces for different purposes of interaction is found to have negative impact on people's privacy, the feeling of safety and cleanliness of the shared spaces. The findings of this study provide information for planners and designers on how to design and improve high-rise apartment buildings that support social interaction.

Loneliness and Life Satisfaction Explained by Public-Space Use and Mobility Patterns.

Previous research has shown that personal, neighborhood, and mobility characteristics could influence life satisfaction and loneliness of people and that exposure to public spaces, such as green spaces, may also affect the extent to which people feel lonely or satisfied with life. However, previous studies mainly focused on one of these effects, resulting in a lack of knowledge about the simultaneous effects of these characteristics on loneliness and life satisfaction. This study therefore aims to gain insights into how public-space use mediates the relations between personal, neighborhood, and mobility characteristics on the one hand and loneliness and life satisfaction on the other hand. Relationships were analyzed using a path analysis approach, based on a sample of 200 residents of three neighborhoods of the Dutch city 's-Hertogenbosch. The results showed that the influence of frequency of public-space use on life satisfaction and loneliness is limited. The effects of personal, neighborhood, and mobility characteristics on frequency of use of public space and on loneliness and life satisfaction were found to be significant. Age and activities of daily living (ADL) are significantly related to each other, and ADL was found to influence recreational and passive space use and loneliness and life satisfaction. Policymakers should, therefore, mainly focus on creating neighborhoods that are highly walkable and accessible, where green spaces and public-transport facilities are present, to promote physical activity among all residents.

Loneliness of Older Adults: Social Network and the Living Environment.

The social participation and integration of older adults are important aspects of healthy aging. However, in general, older adults have smaller social networks than their younger counterparts due to changes in their life cycle stage, such as retirement or age-related losses, along with a declining health and increasing mobility limitations. Consequently, with increasing age, an increasing proportion of older people experience feelings of loneliness and social isolation. Previous studies that have analyzed the relationships between loneliness, social networks, and the living environment have often been based on bivariate relationships or included only a limited number of variables. Therefore, the aim of this study was to analyze multiple relationships in a more comprehensive framework. Data were collected using a survey among 182 adults aged 65 years and over in the Netherlands. A Bayesian belief network (BBN) modeling approach was used that derives all direct and indirect relationships between the variables. The results showed that feelings of loneliness are directly related to satisfaction with one's social network and neighborhood attachment and are indirectly related to perceived safety and satisfaction with local amenities and services. This knowledge is relevant to urban planners and policy makers who focus on creating livable and healthy social neighborhoods for the aging population.

Evaluation of the impact of extrinsic rewards on user engagement in a health promotion context.

Despite the many mHealth solutions available, it remains unclear what their success factors are. Specifically, there has been controversy on the effectiveness of extrinsic rewards. This study evaluates two design elements of an mHealth solution - i.e., social proof and tangible rewards - and their impact on user engagement. During a four-week campaign, a sample of 143 university staff members engaged in a health promotion campaign. Participants were randomly distributed over one of three treatment groups. It was found that the introduction of a sufficiently meaningful, unexpected, and customized extrinsic reward can engage participants significantly more in a health promotion context.

Locations that Support Social Activity Participation of the Aging Population.

Social activities are an important aspect of health and quality of life of the aging population. They are key elements in the prevention of loneliness. In order to create living environments that stimulate older adults to engage in social activities, more insight is needed in the social activity patterns of the aging population. This study therefore analyzes the heterogeneity in older adults' preferences for different social activity location types and the relationship between these preferences and personal and mobility characteristics. This is done using a latent class multinomial logit model based on two-day diary data collected in 2014 in Noord-Limburg in the Netherlands among 213 respondents aged 65 or over. The results show that three latent classes can be identified among the respondents who recorded social activities in the diary: a group that mainly socializes at home, a group that mainly socializes at a community center and a group that is more likely to socialize at public 'third' places. The respondents who did not record any interactions during the two days, are considered as a separate segment. Relationships between segment membership and personal and mobility characteristics were tested using cross-tabulations with chi-square tests and analyses of variance. The results suggest that both personal and mobility characteristics play an important role in social activity patterns of older adults.