Introduction and Objective: Evidence suggests after-school programming is an effective strategy to increase physical activity. However, studies detailing costs and cost utilization of after-school programs are scarce. Reviews of existing literature have mixed reporting on the cost-effectiveness of school-based physical activity interventions. Costs are an essential component of sustainability and scale up of any intervention, especially in resource limited school districts. The main objective of this study is to describe the costs of implementing an after-school physical activity intervention in three diverse, low-resourced, schools.

Methods: We conducted a cost utilization study from an 8.5-month physical activity intervention conducted during the 2021-2022 school year in three diverse, low-resourced, middle schools in the Midwest. Costs were collected from contracts, invoices, payroll, and receipts. Metabolic equivalents were determined using past literature. Costs/MET-hour were calculated for the schools and entire program by dividing costs by total MET-hours engaged in physical activity.

Results: The sample (N=178) was mostly males (52.2%), African American or Black (54.8%) and divided between 6^th, 7^th, and 8^th grades. The number of sessions at each school ranged from 40 to 83, with total number of participants ranging from 580 to 1555. Costs were $2.51/MET-hour, $8.96/MET-hour, and $10.73/MET-hour for the three schools. On average, the intervention had a cost of $4.73/MET-hour.

Conclusions: Cost/MET-hours for the present study are comparable or lower than other school-based physical activity interventions that require additional staff time and programming outside of standard classroom activities. Scale-up of after-school programs may be one way to improve the costs of programs in both schools and districts. Reach seemed to be one of the most significant factors increasing cost utility. It is important for future research to examine factors influencing reach of programming.

Introduction and Objective: Low-contact, scalable physical activity (PA) interventions have shown efficacy in helping Latina women to increase their PA in controlled clinical trials. Nevertheless, there is a paucity of research on the implementation of these interventions in real world settings. We used partner-informed formative research to adapt the Pasos Hacia La Salud (Pasos) web-based intervention for future implementation in a Federally Qualified Health Center (FQHC).

Methods: To identify potential facilitators, barriers, and strategies for implementation, we conducted four focus groups with 17 Latina patients, and 10 semi-structured qualitative interviews with staff and medical personnel at an FQHC in the US-Mexico border region. Data were analyzed using rapid qualitative analysis methods and were collaboratively and jointly coded by at least two members of the team. Matrices were used to summarize results, necessary adaptations were identified, and feasibility was confirmed via member check-in. Data collection and analysis was guided by the Practical, Robust Implementation and Sustainability Model (PRISM).

Results: Facilitators, barriers, and strategies identified via formative research pertained to participant recruitment (e.g., using multiple channels for recruitment, adapting the EHR system for participant referrals), intervention components and characteristics (e.g., incorporating group activities and virtual options for intervention sessions), patients' characteristics (e.g., lack of technology knowledge, which could be addressed via further assistance and training), characteristics of the clinic and the clinic's personnel (e.g., further training needed to better-equip personnel), implementation resources and infrastructure (e.g., leveraging resources such as personnel for intervention delivery), and external factors that may impact implementation (e.g., connecting patients with resources like childcare to address lack of in-home support).

Discussion: Involving key partners through formative research is critical to identifying barriers, facilitators, and related implementation strategies and adaptations for successful implementation of efficacious interventions in real world settings. Implementation of efficacious and scalable interventions in locations with potential for widespread dissemination, such as FQHCs, could lead to greater population-level impact, helping to close health equity gaps.

Introduction and Objective: Improving people’s physical activity (PA) via virtual intervention, including both web-based video sessions and mobile-health PA apps, has become popular in the past decade. Specifically, interventions focusing on improving daily step count provide a convenient and quick feedback loop for the participants, thereby gaining popularity among various PA programs. The aims of this study were to: 1) determine whether virtually delivered PA interventions improve daily step count; 2) provide an effect size estimation of these interventions based upon meta-analysis; 3) examine the factors that might be associated with the effect size of these interventions.

Methods: A structured search in PubMed database was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) to identify eligible studies published between January 2014 and October 2022. Studies were included if they were randomized controlled trials (RCTs) that evaluate the effect of a virtually delivered PA intervention on daily step count among adults; and were excluded if participants were athletes or if the intervention included components with in-person instructional sessions. A meta-analysis was performed in R using meta packages.

Results: Of 765 abstracts, 20 RCTs were included (15 used step-count as primary outcome) (N=2,586). While high heterogeneity was found (I²=99.7%), overall a virtually delivered PA intervention can significantly increase daily steps by 1,422 [803, 2,041] as compared with the control group. Subgroup analysis indicates that interventions specifically targeting 10,000 daily steps increases daily step count by 1,829 [605, 3,053] while interventions without such a target increase 733 [257, 1209] steps. Interventions with reminder phone-calls (1,171 [203, 2,138]) do not seem to have clear advantage on effect size compared with those without reminder calls (1,564 [748, 2,379]). Meta-regression found no significant association between intervention effect size and any of the following covariates: specific intervention target, regular notification, self-adjustable goal, self-report steps, educational session, visible graph for step change and intervention duration.

Conclusions: Virtually delivered PA interventions can significantly increase adults’ daily step count. Interventions targeting 10,000 daily steps appear to have a larger effect size than interventions without such a target, though the difference was not statistically significant.

Introduction and objective

The negative health effects of physical inactivity are well known. Yet, college-aged women are less physical activity than college men. This age range has significant health implications as women begin to establish behaviors they will carry out through the lifespan. This study explores college women’s beliefs and experiences about exercise informed by different framing strategies, and how they may influence exercise engagement.

Methods

Four focus groups were conducted in 2019 with nineteen undergraduate women at a large public Midwestern university. Four differently framed group exercise advertisements were used to prompt focus group discussions on beliefs and intentions to exercise. Transcribed data were analyzed with a thematic content approach.

Findings

Undergraduate female participants described more positive beliefs that influence intention with a well-being framed advertisement. More negative beliefs were described when the advertisement focused on enhancing appearance. Participants of color believed that seeing more representation of diversity in advertisements would make engaging in exercise easier.

Conclusion

Focusing on using framing tactics that positively prompt college women’s beliefs and intentions to engage in movement behaviors will help campus stakeholders create effective messages to improve movement engagement levels for college women. We suggest movement advertisements geared towards college women adhere to their beliefs and include a framing focus of overall well-being with a diverse range of women visually represented. Doing so may positively influence movement behaviors among women and bridge the gap of movement engagement inequality.