Research Methods in Physical Activity and Health Physical activity is vital for good health It has an established strong evidence base for its positive effects on functional capacity, reducing the risk of many chronic diseases, and promoting physical, mental and social well-being Furthermore, these benefits are evident across a diversity of ages, groups and populations The need for these benefits in current societies means that exercise practitioners, professional bodies, institutions, health authorities and governments require high quality evidence to establish appropriate exercise guidelines, implementation strategies and effective exercise prescription at individual, group and population levels Research Methods in Physical Activity and Health is the first book to comprehensively present the issues associated with physical activity and health research and outline methods available along with considerations of the issues associated with these methods and working with particular groups The book outlines the historical and scientific context of physical activity and health research before working through the full research process, from generating literature reviews and devising a research proposal, through selecting a research methodology and quantifying physical activity and outcome measures, to disseminating findings Including a full section on conducting research studies with special populations, the book includes chapters on: • • • • • • Observational and cross-sectional studies; Interviews, questionnaires and focus groups; Qualitative and quantitative research methods; Epidemiological research methods; Physical activity interventions and sedentary behaviour; and Working with children, older people, indigenous groups, LGBTI groups, and those physical and mental health issues Research Methods in Physical Activity and Health is the only book to approach the full range of physical activity research methods from a health perspective It is essential reading for any undergraduate student conducting a research project or taking applied research modules in physical activity and health, graduate students of epidemiology, public health, exercise psychology or exercise physiology with a physical activity and health focus, or practicing researchers in the area Stephen R Bird is a Research Group Leader at RMIT University, Australia He has over 30 years of experience working in the University and Hospital sectors in the field of Health and Exercise He has authored five books in the field, as well as numerous book chapters and over 100 articles on the subject He is an active member of numerous professional associations, including being a former Chair of the Physiology Section of the British Association of Sport and Exercise Sciences His current research interests include physical activity for older people, the prevention of chronic diseases, and the use of exercise in rehabilitation programs Research Methods in Physical Activity and Health Edited by Stephen R Bird First published 2019 by Routledge Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 52 Vanderbilt Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2019 selection and editorial matter, Stephen R Bird; individual chapters, the contributors The right of Stephen R Bird to be identified as the authors of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988 All rights reserved No part of this book may be reprinted or reproduced or utilised in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data Names: Bird, Stephen R., 1959– editor Title: Research methods in physical activity and health / edited by Stephen R Bird Description: Abingdon, Oxon ; New York, NY : Routledge, 2018 | Includes bibliographical references and index Identifiers: LCCN 2018037817 | ISBN 9781138067677 (hardback) | ISBN 9781138067684 (pbk.) | ISBN 9781315158501 (ebk.) Subjects: LCSH: Exercise—Health aspects—Research—Methodology | Health behavior—Research—Methodology | Physical fitness—Research—Methodology Classification: LCC RA781 R366 2018 | DDC 613.7072—dc23 LC record available at https://lccn.loc.gov/2018037817 ISBN: 978-1-138-06767-7 (hbk) ISBN: 978-1-138-06768-4 (pbk) ISBN: 978-1-315-15850-1 (ebk) Typeset in NewBaskerville by Apex CoVantage, LLC Contents List of figuresviii List of tablesx List of boxesxii List of contributorsxiii Why research into health and physical activity? STEPHEN R BIRD The historical and current context for research into health and physical activity STEPHEN R BIRD AND DAVID R BROOM Health concepts 13 DAVID R BROOM Nurture vs nature: the genetics and epigenetics of exercise 21 MACSUE JACQUES, SHANIE LANDEN, SARAH VOISIN, SÉVERINE LAMON AND NIR EYNON Systematically searching and reviewing the literature 28 NIRAV MANIAR, KATHRYN DUNCAN AND DAVID OPAR Producing the research proposal 45 MARIE MURPHY AND CATHERINE WOODS Ethical issues in health and physical activity research 57 VALERIE COX Observational (cross-sectional and longitudinal) studies 74 CHRISTOPHER S OWENS, DIANE CRONE, CHRISTOPHER GIDLOW AND DAVID V.B JAMES Interviews and focus groups DIANE CRONE AND LORENA LOZANO-SUFRATEGUI 80 vi Contents 10 Questionnaires 93 PHILIP HURST AND STEPHEN R BIRD 11 Notes and tips on surveys 102 PHILIP HURST AND STEPHEN R BIRD 12 Qualitative research in physical activity and health 109 BRETT SMITH AND CASSANDRA PHOENIX 13 Intervention studies, training studies and determining the acute responses to bouts of exercise 117 STEPHEN R BIRD AND CATHERINE WOODS 14 An introduction to research methods in the epidemiology of health and physical activity 134 TRINE MOHOLDT AND BJARNE M NES 15 Research into sedentary behaviour 147 NICOLA D RIDGERS AND SIMONE J.J.M VERSWIJVEREN 16 Ensuring quality data: validity, reliability and error 157 DAMIAN A COLEMAN AND JONATHAN D WILES 17 Quantitative data analyses 168 R.C RICHARD DAVISON AND PAUL M SMITH 18 Measurement of physical behaviours in free-living populations 184 ALAN E DONNELLY AND KIERAN P DOWD 19 Measurements of physical health and functional capacity 194 BRETT GORDON, ANTHONY SHIELD, ISAAC SELVA RAJ, AND NOEL LYTHGO 20 Physical activity and the ‘feel-good’ effect: challenges in researching the pleasure and displeasure people feel when they exercise 210 PANTELEIMON EKKEKAKIS, MATTHEW A LADWIG AND MARK E HARTMAN 21 Studying the risks of exercise and its negative impacts 230 ANDY SMITH AND NATHALIE NORET 22 Research studies with children 238 MICHAEL J DUNCAN AND KEITH TOLFREY 23 Research studies with older people JANE SIMS AND HARRIET RADERMACHER 247 Contents vii 24 Working with Indigenous and other cultural groups 266 AUNTY KERRIE DOYLE AND ELIZABETH PRESSICK 25 Research methods in physical activity and health: sexual orientation and gender identity 278 DAMON KENDRICK 26 Conducting physical activity research within chronic disease populations 288 BRIGID M LYNCH, LUCY HACKSHAW-MCGEAGH AND JULIAN SACRE 27 Research studies with populations with mental health issues 300 ANDY SMITH AND NATHALIE NORET 28 Research studies in populations with physical disabilities 309 CHRISTOF A LEICHT, BARRY MASON AND JAN W VAN DER SCHEER 29 Using health equity to guide future physical activity research involving people living with serious mental illness 317 PAUL GORCZYNSKI, SHANAYA RATHOD AND KASS GIBSON 30 Disseminating the research findings 324 ASHLEIGH MORELAND AND JOSHUA DENHAM 31 Translating research findings into community interventions Considerations for design and implementation: a case-based approach 330 ANDREW D WILLIAMS, LUCY K BYRNE, LINDSEY B STRIETER, GREIG WATSON, AND ROSS ARENA Index340 Figures 5.1 The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram 6.1 Example of a Gantt chart for an 18-month project 7.1 Studies must be ethical, scientifically sound and safe 7.2 Key information needed on a participant information sheet 7.3 Good research design seeks to maximize benefits and minimize risks 7.4 Some examples of types of risks in physical activity research 9.1 Timelining graph with photographs 13.1 Possible design for an acute study (cross-over design) 13.2 Possible design for an intervention or training study – Randomized Controlled Trial (RCT) 13.3 Example of a CONSORT diagram for a walking programme × 30 minutes per week 14.1 Simplified study design classification Qualitative studies, systematic reviews and meta-analyses are not included 14.2 Prospective cohort studies 14.3 Retrospective cohort studies 14.4 Example of confounding Smoking (Z ) is independently associated with both physical inactivity (X ) and coronary heart disease (Y ) An observed association between physical inactivity and coronary heart disease could therefore be confounded by smoking 14.5 Number of articles retained in Pubmed when using ‘Sedentary behaviour’ as search term 15.1 The active couch potato and inactive non-sedentary phenomena 16.1 The relationship between two methods of heart rate assessment 17.1 Normal distribution curve 17.2 Examples of correlations coefficients depicting: panel A – a strong, positive relationship; panel B – a moderate, positive relationship; panel C – no relationship; and panel D a strong, negative relationship 17.3 Forest plot of the Odds Ratio of individuals with low physical activity developing high blood pressure 18.1 The application of intensity thresholds to accelerometer data 20.1 The circumplex model of core affect, defined by the orthogonal and bipolar dimensions of valence and activation 29 54 58 61 65 66 89 119 121 124 135 137 137 142 144 152 164 172 174 183 188 221 Figures ix 20.2 Assessing affective constructs only once before and once after the exercise bout may lead to the impression that participants moved from the pre-exercise to a more positive post-exercise rating via a path of continuous improvement over time 222 20.3 Juxtaposing two self-report instruments that are similarly oriented and use fully or partially overlapping numerical rating scales may lead to artificial ‘variance transfer’ from one to the other This type of common method bias can obfuscate substantive differences between the constructs being assessed by the two measurement instruments224 20.4 A three-domain typology of exercise intensity that takes into account important metabolic landmarks, such as the ventilatory threshold and the maximal lactate steady-state, can standardize exercise intensity across individuals more effectively than percentages of maximal exercise capacity 225 20.5 Affective responses to the same exercise stimulus may vary between individuals not only in terms of magnitude but also in terms of direction 226 22.1 Proposed protocol to maximize provision of data in accelerometerbased physical activity research with children and adolescents, taken from McCann et al (2016) 244 24.1 Cyclic nature of the Dilly Bag Model, describing the links to the values of this research 269 26.1 Phases across the chronic disease trajectory at which physical activity can be studied 289 28.1 Bespoke treadmill developed to accommodate wheelchair athletes with a sliding safety rail (left) and an attachable handrail for ambulant runners or cyclists (right) 312 28.2 A single (top) and dual-roller (bottom) ergometer which enable sprinting performance to be assessed in individuals’ own wheelchairs 313 28.3 A manual wheelchair user performing exercise on an arm crank ergometer314 334 Andrew D Williams et al S2S involved the delivery of evidence-based individualized exercise programmes to participants within a group setting by Accredited Exercise Physiologists over a 12-week period and was accompanied by home-based exercise programmes for clients to complete in their own time.29,30 Participants were also provided with the opportunity to attend optional additional sessions focused on improving their health and wellbeing and assisting self-management (e.g the benefits of physical activity, diet and nutrition, management or prevention of chronic conditions and falls prevention) Over the life of the project at least 1,573 individuals enrolled and received exercise prescription and more than 1,115 completed the S2S programme although data quality issues from those enrolled in regional locations prevents exact numbers being available Multiple outcomes related to physical activity adherence and health risk factors were assessed as part of the Strength Strength programme [unpublished data] Improvements in physical activity participation were observed by participants during the 12-week intervention and a limited evaluation of the outcomes that was performed revealed mean improvements in shuttle and six-minute walk test distance, in functional strength measures and reductions in waist circumference and resting blood pressure in those with higher levels on entry into the programme suggesting reduced risk of comorbidities The proportion of participants continuing to undertake their home-based programme following completion of the S2S programme was 65% at months, 56% at months and 52% at 12 months indicating that the approach was successful in educating and motivating many participants to be more physically active A comprehensive health economics assessment of the programme was not performed as part of the analysis of the programme due to timeframes required for the delivery of the report and issues associated with participant identifiers Active Launceston case study The Active Launceston health promotion initiative involved a partnership between the Tasmanian State Government, Launceston City Council, University of Tasmania, as well as local businesses, community groups and not-for-profit organizations An outline of the project direction and its preliminary outcomes have been described elsewhere.31 Briefly, Active Launceston was underpinned by the Ottawa Charter for Health Promotion focusing primarily on the fifth action area which was to reorient (health) services towards a prevention focus.32 It ran in the city of Launceston, a city of approximately 100,000 residents, between 2008 and 2015 and aimed to fill an identified gap in lack of coordination in the community for physical activities.33 The initiative included a suite of physical activity programmes designed to accommodate people of all ages, interests and abilities, an extensive marketing campaign, input from health and industry professionals, and advocacy for environmental and policy change The Active Launceston programme adopted a community-engagement, population-based approach with a goal to mobilize community members to increase their voluntary participation in physical activity by:34 filling gaps in provision, reducing barriers and targeting those with the highest need A stated aim was to fill identified gaps in physical activity provision in the community and to develop capacity within the community to ensure sustainable participation in physical activity Over its lifespan Active Launceston programmes attracted 11,887 attendees who attended a total of 30,342 sessions amounting to over 38,000 hours of physical activity Semi-regular evaluations of both process and impact of the intervention using Translating research findings 335 mixed methods design (combination of qualitative and quantitative evaluation) were performed in 2008, 2012 and again in 2015 The process evaluation was conducted through use of focus group, stakeholder interviews and a cross-sectional serial online survey It identified that participants believed the programmes provided personal benefits through improved health, personal development and social connectedness Facilitators of participation included free and accessible programmes as well catering for people with different abilities and specific needs in non-threatening environments The impact evaluation involved assessments of community-wide engagement in physical activity measured using telephone surveys of approximately 900 residents of Launceston in 2008, 2012 and again in 2015 Results of the surveys indicated gradual increases in the proportion of the population who achieved sufficient activity for health (defined as 150 or more per week) over the years, with a significantly higher proportion achieving sufficient activity levels in 2015 compared to 2008 (p < 0.01) Awareness of the Active Launceston programme almost doubled from 31.9% to 61.5% over the same timeframe and the proportion of those interviewed who were sufficiently active for health was higher in those aware of Active Launceston (57.5%) than those who were not (44%) in the 2015 survey A retrospective cost-benefit analysis on the programme conducted by the Menzies Institute for Medical Research at the University of Tasmania [unpublished data] estimated a good return on investment Using an estimated return on investment of 1.61 (based on a meta-analysis of 51 studies35) and a total investment of $1.9 million from 2008 to 2015, the cost to deliver Active Launceston was $160 per participant, and the estimated economic benefit and return of Active Launceston was $416 and $257 per participant respectively The outcomes of this project indicate that inter-sectoral partnerships to increase population-wide physical activity levels using multi-strategy and wide-scale interventions can be effective in encouraging individuals to increase physical activity levels and may then lead to improved health outcomes and generate a positive return on investment for funding bodies Key learnings Multiple important learnings are revealed through the implementation and evaluation of physical activity interventions that operate in community settings, including those summarized above Importantly these programmes can successfully increase physical activity levels of participants and reduce health risk factors during the intervention period,11 and potentially for many years following the cessation of the intervention,36 although further evaluation of a range of programme types and foci are required to confirm these results These programmes can also provide less tangible or measurable benefits through increasing social capital and health literacy for participants.31 Often there is an assumption that because benefits of an intervention such as exercise have been shown in rigorously controlled laboratory-based studies, these benefits will transfer to community- or population-based interventions However as the scale of any study is increased, the complexities involved in designing, implementing and evaluating the intervention also increase.37 The randomized controlled trial is considered the pinnacle of study design.38 However, it is often not possible to evaluate community physical activity programmes with this type of design given the diversity of settings and complexity of interventions Alternative designs don’t provide the 336 Andrew D Williams et al same evidence of programme effectiveness but are more feasible in many situations,38 where balancing of the optimal evaluation design against what is achievable in practice is required None of the case studies in this chapter used a randomized controlled intervention, as this was not feasible at the time However their success can possibly be attributed to considering multiple aspects of the ecological framework,7,8 adopting numerous strategies to increase physical activity, developing partnerships and incorporating specific evaluation as part of the design process Despite their successes, the two Tasmanian case studies described in this chapter relied on substantial public and philanthropic funding for their development and operation, which while significant, was not sufficient to fund randomized controlled trials or to fully evaluate outcomes The failure to fully evaluate these programmes represents a missed opportunity given the limited funding available for these types of initiatives A problem with preventive health initiatives is that the investment required for the initiative may precede the return on that investment by many years.39 The benefits can often be quite difficult to quantify as they may result not only in reduced or delayed acute healthcare and disability costs, but also increased work productivity and the building of social capital A world-class study conducted by researchers at the University of Queensland and Deakin University in Australia used economic modelling to quantify the benefits of 150 different health interventions, of which 123 were preventive.40 The study found that if the Australian government were to implement the top 20 health interventions it would cost Australia $4.6 billion over 30 years However, this expense would be offset by predicted cost savings of $11 billion over the same timeframe due to reduced acute care costs and increased productivity Such a programme which included interventions across taxation, regulation, health promotion and clinical intervention was predicted to pay for itself within 10 years and result in 1 million additional years of healthy life across the Australian population.40 The sustainability of initiatives is important as health and productivity benefits from community initiatives require time to become apparent A weakness in the implementation of both the S2S and Active Launceston initiatives was to achieve sustainability of the programmes As follow-up assessments were not planned, it is unclear whether participants of the programmes continue to maintain improvements in activity and health measures independent of the programme Although in its early stages, the Health and Wellness Academy initiative has taken an approach likely to lead to ongoing sustainability through training future teachers how to deliver the programme This approach ensures that subject to time being available within the curriculum the programme can be delivered in schools by these mentors independent of the ongoing status of HWA Educating communities and participants should be a key element of community health programmes as this education helps to empower individuals to increase responsibility for their own health.41 Methods of providing this education can vary and while widely distributed messages through advertising or social media can initiate awareness and interest in health, more targeted/individualized education, as is delivered in both the HWA and S2S programmes, delivered to smaller groups of participants or individuals are likely to have longer-term benefits in empowering those who receive it Initiatives that not overtly plan to achieve project sustainability in their target population or are dependent on the resources such as staffing, volunteers, facilities, equipment and materials they provide are less likely to lead to sustainable outcomes in the long term To assist with exercise adherence and therefore sustainability of outcomes S2S implemented home-based exercise programmes and low-cost resources such as elastic bands to enable participants to exercise independently Translating research findings 337 The long-term sustainability of community interventions may also be influenced by involving a range of stakeholders in partnership Active Launceston effectively utilized partnerships to sustain the initiative for nine years During this time ongoing funding was received from a number of partners including federal, state and local government as well as the university sector and industry Changes to government policy in 2016 resulted in state government funding being withdrawn which caused the initiative to reduce its offerings Although a retrospective cost-benefit analysis was performed, prospective analyses of the potential economic benefits were considered but not implemented Due to the weaknesses of retrospective compared to prospective economic analyses it is more difficult to ascertain the true economic benefits arising from Active Launceston than if prospective economic analyses were performed A higher degree of certainty of reported economic benefits would have helped to justify the expenditure of public funding as an ongoing expense As part of the S2S initiative, a limited economic evaluation, that compared the cost of setting up and delivering the programme with the estimated savings from a reduction in falls causing injury within 12 months of programme completion, was conducted The analysis projected a small positive monetary saving of ~AU$70,000 from the programme Given the benefits observed in a range of health risk factors and the ongoing compliance with home-based exercise by half of participants it is possible that these savings would continue into the future Conclusion Physical inactivity is an increasing problem globally However overcoming the increasing problem of physical inactivity is complicated due to the numerous issues involved in getting people to be more physically active Initiatives involving multiple strategies to encourage increased activity levels and empower participants are more likely to be effective Planning and incorporating evaluation strategies into initiatives is essential to inform wider policy To maximize likelihood of positive outcomes and inform stakeholders, future community-based physical activity initiatives should: Investigate opportunities to share knowledge and resources between stakeholders Address all relevant aspects of the ecological framework to the target population in the design of the initiative • Adopt multiple strategies to encourage participation within the target community and to educate and empower participants to sustain habitual physical activity • Embed evaluation processes including cost-benefit assessments into the initiative (see Nutbeam and Bauman,38 for planning evaluations) • • References Lear SA, Hu W, Rangarajan S, Gasevic D, Leong D, et al The effect of physical activity on mortality and cardiovascular disease in 130000 people from 17 high-income, middleincome, and low-income countries: the PURE study Lancet 2017; 390(10113):2643–54 Tucker SJ, Carr LJ Translating physical activity evidence to hospital settings: a call for culture change Clin Nurse Spec 2016; 30(4):208–15 Hallal PC, Andersen LB, Bull FC, Guthold R, Haskell W, Ekelund U Global physical activity levels: surveillance progress, pitfalls, and prospects Lancet 2012; 380(9838):247–57 World Health Organization Physical inactivity: a global public health problem 2014 Available from: 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15(3):259–67 Index Note: Page numbers in italics refer to figures; bold numbers refer to tables absolute risk (AR), defined 17 accelerometers/accelerometry: for chronic disease population 296 – 7; to measure physical behaviour 149 – 50, 188, 188 – 9; for older population 257 accuracy of measurement technique 185 – 6 ACTIVATE Trial 297 active couch potato phenomenon 151 – 2, 152 Active Launceston health promotion initiative 334 – 5, 336, 337 activPAL (activity monitor) 150, 190 acute study: defined 118; designing 118 – 19, 119; recruitment for 122 – 3; trials in 124 – 5 adherence, assessment of 130 adolescents see children, research with adverse incidents, reporting 131 affective responses to exercise: analogue samples and 215 – 16; data analysis of 226, 226; effect size and 223; history of research on 212 – 15; measurement of 217 – 20; overview 210 – 11, 226 – 7; research dilemma in 211 – 12; sample size and 216 – 7; standardization of intensity and 223 – 5, 225; timing of measurement of 220 – 3, 222; see also negative impacts of exercise aged care facilities, research in 260 – 1 ageing population see older people, research with allocation of participants to groups 126 alternative hypothesis (H1) 177 analogue research 215 – 16 analytic epidemiology 134, 135 animals, research with 71 – 2, 304 arm crank ergometry 312 – 3, 314 assessment: of accuracy of measurement technique 185 – 6; of adherence or compliance 130; of reliability 161 – 2, 165, 165 – 6; of validity 161 – 5, 163, 164 associations: assessing 173, 174 – 5, 176; interpreting 139 attrition 76 audience: for articles 324; for research proposals 46, 48 audit of services 71 Australia, Indigenous peoples of 266, 333; see also Indigenist research Australian Institute of Aboriginal and Torres Strait Islander Studies (AIATSIS) 267 – 8 authorship of journal articles 326 – 7 autonomic dysreflexia 311 autophotography 111 – 12 background of proposed study 46, 51 balance and mobility measures 200 banned activities 68 – 9 bell-shaped curve 170, 172 between-participants design 179 between-subjects group design 179 bias: common method 223, 224; controlling for 142 – 3; in epidemiological research 139 – 41; falseness of research findings and 211; meta-bias 41; minimizing 179; recall 111, 141; selection 141, 215 – 16 bias assessment of systematic literature review 38 – 9 blind data collection 127 – 8 blood lipids 196 – 7 blood pressure 194 – 5 body composition 197 body fat norms and transgendered or intersex athletes 284 – 5 Boolean operators 34, 34 – 5 budget for and cost of proposed study 49, 54 bullying: homophobic and transphobic 281 – 2; in school sport 232 burden: of disease 288; participant 290 – 1; response 103 cameras, wearable 191 cancer 288 cardiopulmonary exercise testing 296 cardiovascular disease Index 341 carers, involving in research 293 case studies: with chronic disease population 297; of community interventions 331 – 7; of focus groups and interviews 87 – 90; of physical activity promotion in aged care facility 260 – 1; of sedentary behaviour 151 – 3, 152 causal relationships: in epidemiological research 139, 140; in observational studies 75, 76; reverse causation 143 CBPAR (community based participatory action research) 110 central tendency, measures of 170, 171 CHAMPS (Community Health Activities Model Program for Seniors) Questionnaire 255 – 6, 260 children, research with: ethical issues in 238 – 9; informed consent for 239 – 40; overview 238; physical activity monitoring issues and 243, 244, 245; recruitment and retention issues in 241, 241 – 2; safeguarding issues in 240; study logistics and 242 – 3 chronic disease population, research with: ACTIVATE Trial 297; checklist for 297 – 8; data collection and 295 – 7; ethical issues in 289 – 92; practical issues in 292 – 3; recruitment for 293 – 5 chronic diseases: ageing of society and 1 – 2; increase in prevalence of 1, 298; overview 288; phases of trajectory of 289; prevention of 288 – 9; sedentary behaviour and 143; see also chronic disease population, research with CI (confidence interval) 172 – 3 CINAHL 31 circumplex 220, 221 cisgender, defined 278 clean data 157 – 9 clinical health measures: blood lipids 196 – 7; blood pressure 194 – 5; body composition 197; endothelial dysfunction 196; glycaemic control and insulin sensitivity 197 – 8; heart rate 195 clinics, recruitment from 295 cluster sampling 105 coding in thematic analysis 113 coefficient of determination 173 coercion of participants 69 Cohen’s d 180 – 1 cohort study 136, 137 college-student samples 215 colorectal cancer 289 combined sensors 190 commercial interests, disclosure of 69 common method biases 223, 224 community based participatory action research (CBPAR) 110 Community Health Activities Model Program for Seniors (CHAMPS) Questionnaire 255 – 6, 260 community interventions: Active Launceston health promotion 334 – 5; evaluation of 335 – 6; overview 331 – 2; recommendations for 337; Strength Strength 333 – 4; sustainability of 336 – 7; University of Illinois at Chicago Health and Wellness Academy 332 – 3 comorbidity 301 complex polygenic traits 22 – 3 compliance, assessment of 130 compulsion to participate 63 concept tables 32, 32 – 3, 34, 35 – 6 conceptual models for constructs 219 – 20 condition of participants, controlling for 129 – 30 conferences, presentations at 327 confidence in evidence 41 confidence interval (CI) 172 – 3 confidentiality 64 – 5, 290 conflation of mental illness types 301 confounding 141, 142, 142 – 3 consent forms 61 – 2; see also informed consent consent to publish 63 – 4 Consolidated Standards of reporting Trials (CONSORT) statement 123, 124 construct validity 95, 160 – 1 content validity 94 – 5, 161 continuous variable 138 control groups in intervention and training studies 121, 125 – 6 controlling: for bias and confounding 142 – 3; for condition of participants 129 – 30; for testing environment 130 convenience sampling 105 convergent validity 95 core affect: content domain of 220, 221; defined 218 coronary heart disease correlational study 136 correlation coefficients, interpreting 173, 174 – 5 covert observations 68 criterion validity 95, 161, 176, 185 critical thinking, need for 214 – 15 Cronbach’s alpha 96 cross-cultural research, protocols of 272, 274 cross-over design 118 – 19, 119 cross-sectional observational studies 74 – 8 cross-sectional surveys 136 cultural groups see Indigenist research cultural humility 272 342 Index Dadirri model 268 – 9 data analysis: in acute, intervention, or training studies 130 – 1; for affective responses to exercise 226, 226; in epidemiological research 138 – 9; in qualitative research 112 – 14; see also quantitative data analyses databases: electronic, of literature 31 – 2; filters for searches of 37 – 8 data collection: blind and double-blind 127 – 8; from chronic disease population 295 – 7; clean data 157 – 9; in epidemiological research 138; monitoring 293; in qualitative research 111 – 12; for systematic literature review 38 data management for systematic literature review 38 data protection 64 – 5 data synthesis for systematic literature review 40 – 1 deception in research 67 – 8, 123, 290 descriptive epidemiology 134, 135, 136 descriptive statistics: confidence interval and standard error of mean 172 – 3; measures of central tendency and variability 170, 171; overview 169 – 70; testing for normality of data 170 – 2 descriptive synthesis 40 design of research studies see research designs diastolic blood pressure (DBP) 194 – 5 dichotomous variable 138 differential misclassification 139 – 41 digital qualitative methods 112 direct measurement instruments for older people 256 – 7 disabilities, people with: assessment of physical capacity of 310; equipment and technology for 311 – 13, 312; exercise risks and contraindications for 310 – 11; physical activity guidelines for 309 – 10 disclosure: of commercial interests 69; of identifiable information 64 – 5 discrete variable 138 discriminant validity 95 dissemination of research findings 50, 55, 324 – 8 DNA methylation and exercise 24 dose response 143 double-blind data collection 127 – 8 double-blind research design 180 doubly labelled water technique 186, 256 ecological validity 159 Education Resources Information Center (ERIC) 32 effect modification 142 effect size: affective responses to exercise and 223; in quantitative data analysis 180 – 1 eligibility criteria for systematic literature review 30 – 1, 38 Embase 31 emotions, defined 219 EndNote software 38 endothelial dysfunction 196 enjoyment, as priority in work with children 242 epidemiological research: bias in 139 – 41; confounding in 141, 142, 142 – 3; controlling for bias and confounding in 142 – 3; criteria for causality in 139, 140; data analysis in 138 – 9; data collection in 138; design of 134, 135, 136; on dose response 143; effect modification in 142; interpretation of association in 139; measures of physical activity in 138; on sedentary behaviour 143, 144, 145 epidemiology, defined 15 epigenetic modifications: DNA methylation 24; histone modification 24 – 5; overview 23 – 4 epistemological constructionism 109 – 10 ergometers, single and dual-roller 312, 313 ERIC (Education Resources Information Center) 32 ethical approval process 57, 58, 59 – 60, 292 ethical issues: animals, work with, and 71 – 2, 304; children, work with, and 238 – 9; for chronic disease population 289 – 92; compulsion 63; confidentiality and data protection 64 – 5, 290; consent forms 61 – 2; consent to publish 63 – 4; covert observations 68; deception 67 – 8, 123, 290; existing data/sample use 71; Gatekeeper permission 63; history of 57 – 8; illegal and banned activities 68 – 9, 233 – 5; incentives, coercion, interests and influence 69 – 70; in Indigenist research 267 – 8; negative impacts of exercise studies and 232; participant information sheets 60 – 1, 61, 62; providing participants with results 70 – 1; questionnaires and 97 – 8; in recruitment 60; reporting 59; in research proposals 50, 53; risks 65, 65 – 7; social determinants of health 321; SOGI and 279, 280; sources of information on 72; surveys and 106 – 7; types of 58 – 9; vulnerable groups 70; withdrawal of consent 62 – 3, 98, 234; see also informed consent ethics review committees 59 ethnography 87 exclusion criteria 120, 122, 122 exercise: in buffering impact of negative and violent experiences 305 – 6; defined 14 – 15; genetics and epigenetics of 21 – 5; Index 343 high-intensity interval training 10, 215, 222 – 3; histone modification and 24 – 5; older people and 249, 249 – 51, 251 – 2, 258 – 9; people with disabilities and 309 – 11; standardizing intensity of 223 – 5, 225; see also affective responses to exercise; negative impacts of exercise; physical activity exercise capacity, testing 295 – 6 ‘exercise pill,’ search for 3 – 4 existing data/sample, use of 71 experimental designs see randomized controlled trial (RCT) design; research designs experimental hypothesis (H1) 177 exposure variable 134 external validity 160, 180 face validity 95 false findings 211 familiarization sessions 129 ‘feel-good’ effect 211; see also affective responses to exercise filters for database searches 37 – 8 fitness devices, wearable 190, 257, 297 flexibility measures 200 flow-mediated dilation 196 focus groups: case study of project using 87 – 90; conducting 85 – 6; defined 80 – 1; designing 83 – 4; preparation for 84 – 5; quality criteria for 86 – 7; uses of 81, 82, 83 forest plots 181 – 2, 183 frequency scales 97 functional fitness 199 – 200 funding applications, research proposals for 48 – 56 funding for community interventions 336 gait 199 Gantt charts 50, 54 Gatekeeper permission 63 gender, defined 278 General Data Protection Regulation 64 generalizability: from adults to older adults 255; limitations on 131; of qualitative research 114; selection bias and 141 Genome Wide Association Studies (GWAS) 22 – 3 geriatric syndromes 247 Global Positioning System (GPS) 191 glycaemic control and insulin sensitivity 197 – 8 Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach 41 group interviews see focus groups group means 226 groups: allocation of participants to 126; control, in intervention and training studies 125 – 6; ‘hard-to-reach’ 87 – 8, 90; risk of contamination between 127; support, recruitment from 294; vulnerable, research with 70, 106 – 7, 317, 321; see also focus groups Guttman and Rasch scale 97 GWAS (Genome Wide Association Studies) 22 – 3 ‘hard-to-reach’ groups 87 – 8, 90 Harvard Alumni Health Study 134 ‘Hawthorne effect’ 94, 127 health, defined 13 health disparities of SSAGD people 283 health equity perspective 319, 320 – 1 healthy worker effect 141 heart rate 195 heart rate monitors 189 heritability, defined 21 high-intensity interval training 10, 215, 222 – 3 histone modification and exercise 24 – 5 historical context of physical activity 6 – 7 homophobia 281 – 2, 282 – 3 homosexuality, decriminalization of, in Australia 280, 281 hormone levels and transgendered or intersex athletes 284 hospitals, recruitment from 294 – 5 Human Research Ethics Committee (HREC) 279, 284 HWA (University of Illinois at Chicago Health and Wellness Academy) 332 – 3, 336 hypokinetic diseases, increase in prevalence of hypotheses: developing 177 – 8; of proposed studies 47, 51; testing 176 – 7; Type I and Type II errors of 178 illegal activities 68 – 9, 233 – 5 ‘inactivity epidemic’ 10 – 11 incentives for participants in research 69 incidence, defined 16 – 17 incidental and planned exercise tool (IPEQ) 256 inclusion criteria 120, 122, 122 independent measures design 179 Indigenist research: checklist for 273, 275; core values of 268; ethical issues in 267 – 8; methodologies of 268 – 9, 270 – 1, 272; overview 266 – 7, 275; protocols of crosscultural research 272, 274 Indigenous knowledge 267, 267 indirect calorimetry 186 indirect measurement instruments for older people 255 – 6 informal dissemination of findings 328 information bias 139 – 41 344 Index informed consent: children, work with, and 239 – 40; chronic disease and 291; mental illness and 303; overview 60; questionnaires and 98 Integrated Research Application System (IRAS) 60 intensity of exercise: older people and 258 – 9; standardizing 223 – 5, 225 inter-class correlation 173, 176 interdisciplinary approaches 302 – 3 internal validity 160, 179 – 80 International Physical Activity Questionnaire (IPAQ) 255 International Society for the Advancement of Kinanthropometry 158 interquartile range 170, 171 inter-rater reliability 114 intersex 278, 285 intersex athletes 284 – 6 interval data 169 intervention study: control group for 121, 125 – 6; defined 118; designing 119 – 20; recruitment for 122 – 3 interviews: case study of project using 87 – 90; conducting 85 – 6; defined 80 – 1; designing 83 – 4, 84; preparation for 84 – 5; in qualitative research 111; quality criteria for 86 – 7; uses of 81, 82, 83 INVOLVE 49, 243 journals, publishing in 324 – 7 knowledge, Indigenous 267, 267 knowledge-based questions 97 Kolmogorov-Smirnov test 170 language barriers 290 legal issues: illegal and banned activities, research on 68 – 9, 233 – 5; negative impacts of exercise research 232; SOGI and 279 – 81 liability insurance 67 life history approach 89 Life in Motion (LIM) programme 260 – 1 LIFE-P study 260 light physical activity (LPA) 147 Likert-type scales 96 limitations: on generalizability 131; of metaanalysis 182; of proposed study 47 – 8; of qualitative research 111 literature review of exercise and mental illness 304 – 5; see also systematic literature review longitudinal observational studies 74 – 8 loss to follow-up bias 141 Male-to-Female transgendered athletes 284 malpractice, deliberate scientific 59 matching groups 126 mean 170, 171 measurement: accuracy of 185 – 6; of affective responses to exercise 217 – 20; of clinical health 194 – 8; of physical behaviours 138, 186 – 91, 188, 255 – 8; repeating 128 – 9; of sedentary behaviour 148 – 50; of strength and functional capacity 198 – 201 media: dissemination of findings via 328; misinformation from 11; negative impacts of exercise and 233; recruitment via 295 median 170, 171 Medical Subject Headings (MeSH) 35, 35 – 6 Medline 31, 37 memory distortion 111 mental health population, research with: examples of 303 – 5; future directions for 305 – 6; methodological issues and 300 – 3; overview 300; see also serious mental illness, people with meta-analysis 40, 181 – 3, 183, 304 meta-bias 41 metabolic equivalent tasks (METs) 147, 185, 258 – 9 metabolic measurement 186 meta-synthesis 41 methodological practices, entrenched 211 – 12, 214 – 15 methods of proposed study 47, 51 – 2 metrics, publication 325 – 6, 326 misconduct, reporting 59 mode 170, 171 moderate-to-vigorous physical activity (MVPA) 147, 184, 317 monitoring physical activity of children and adolescents 243, 244, 245 mood, defined 219 multichotomuous variable 138 muscle strength measurement 198 – 9 NAILSMA (North Australian Indigenous Land and Sea Management Alliance) checklist 273, 275 narrative literature review 28 – 9 narrative synthesis 40 ‘nature’ vs ‘nurture’ 21 – 5 nayri kata model 269 negative impacts of exercise: ethical and legal issues and 232; importance of study of 230 – 1; as ‘looking for trouble’ 231 – 2; media and 233; outliers and 232 – 3; research questions on 235 – 6; scenarios for 233 – 5 neuroscience 302 nominal data 168 nominal variable 138 non-differential misclassification 139 non-random sampling 105 Index 345 non-responders 131 normality of data 170 – 2, 172 North Australian Indigenous Land and Sea Management Alliance (NAILSMA) checklist 273, 275 nucleosome repositioning 24 null hypothesis (H0) 47, 177 – 8 numerical data, types of 168 – 9 objectives of proposed study 46 – 7, 51 observational studies 74 – 8 odds ratio (OR): defined 18 – 19; in metaanalysis 182, 183 older people: contextual influences on physical activity of 252 – 4; physical activity recommendations for 249, 249 – 51, 251 – 2; population description 248; prevalence rates for physical activity for 248 – 9 older people, research with: case study of 260 – 1; combining indirect and direct measures in 258; future directions for 259 – 60; measurement issues and 255 – 8; output of physical activity of 258 – 9; overview 247, 261; Strength Strength 333 – 4 online questionnaire administration 99 – 100 ontology 109 open access journals 325 ordinal data 169 outcome measures: for acute, intervention, or training studies 128 – 9; measurement for physical behaviours and 184; for proposed study 52 – 3 outcome reporting bias 41 outcome variable 134 outliers, studying 232 – 3 Out on the Fields Study 282, 282 – 3 paediatric population see children, research with palawa people 269 paradigms 214 parental informed consent 239 – 40 participant information sheets 60 – 1, 61, 62, 239 – 40 participants: allocation of, to groups 126; coercion of 69; condition of, controlling for 129 – 30; incentives for 69; protection of 233, 239, 240; providing results to 70 – 1, 131 – 2, 327 – 8; sources of support for 234; see also recruitment; specific populations participation in physical activity, factors affecting 330 – 1 partners, involving in research 293 patient and public involvement in research 48 – 9, 243, 292 patient support groups, recruitment from 294 Pearson Product Moment correlation coefficient 173 pedometers/pedometry 187, 257 – 8 performance norms for transgendered or intersex athletes 285 – 6 pharmacology 301 phenotypes, defined 21 photo-elicitation, participant-generated 89, 89 photovoice 111 – 2 phrase searching 34, 34 physical activity: benefits of 2, 7 – 9, 247, 288 – 9; defined 14, 184, 248; guidelines on, as research-based 2 – 3; importance of 4, 6; participation in 117; recommendations for 249, 249 – 51, 251 – 2, 309 – 10; reduction in 1, 7; see also exercise physical behaviours: accuracy of measurement technique for 185 – 6; defined 184; measurement of 185, 186 – 91, 188 physical capacity, determining 310 physical disabilities see disabilities, people with physical inactivity: defined 15, 148; as risk factor for morbidity and premature mortality 330 piloting questionnaires 97 Pitts-McClure hypothesis 212 – 13 placebos 67, 127 political influence on research 69 – 70 population attributable risk (PAR), defined 18 population-based interventions see community interventions portable gas analysis systems 186 Positive and Negative Affect Schedule (PANAS) 219 – 20 postural measurement 190 poverty and mental illness 301 precision in search structure 33 presentations at scientific conferences or seminars 327 prevalence, defined 16 prevention of chronic diseases 288 – 9 PRISMA Checklist for systematic literature review 29 – 30 PRISMA flow diagram 29, 38 Prisons or Probation Trusts, research with 60 process evaluation 130 pro-exercise bias 211 Profile of Mood States (POMS) 213, 217 – 18, 220 prospective cohort study 136, 137 protection of participants 233, 239, 240 proximity searching 34 PsycINFO 31 public and patient involvement in research 48 – 9, 243, 292 publication bias 41 346 Index publication of results 63 – 4, 324 – 7 public domain, data in 64 public health, defined PubReMiner 36 purposive sampling 105 qualitative research: approaches to 110; data analysis in 112 – 14; data collection in 111 – 12; defined 109; generalizability of 114; inter-rater reliability in 114; validity of 114 – 15 quality assessment of systematic literature review 38 – 9 quantitative data analyses: descriptive statistics 170 – 3, 171, 172; determining associations 173, 174 – 5, 176; effect size 180 – 1; interventions and hypothesis testing 176 – 8; meta-analysis 40, 181 – 3, 183, 304; overview 168; statistical power 178 – 9; types of numerical data 168 – 9 quantitative research designs 178 – 80 questionnaires: administering 99 – 100; defined 93; designing 94 – 7; in epidemiological research 138; ethical considerations for 106 – 7; for physical behaviours 187; recruitment of participants for 97 – 8; social desirability and 98 – 9; use of 93 – 4 randomized controlled trial (RCT) design: ACTIVATE Trial 297; community interventions and 335 – 6; dropouts from 304; as gold standard 9; for intervention or training research 121; for quantitative research 179 random sampling 104 – 5 range 170, 171 ratio data 169 rationale for research 289 – 90 recall bias 111, 141 recording interviews and focus groups 85 recruitment: for acute, intervention, or training studies 122 – 3; of children 241, 241 – 2; of chronic disease population 293 – 5; ethical issues in 60; for questionnaires 97 – 8; for surveys 104 – 5 references for proposed study 48, 55 – 6 registries, recruitment from 294 relative intensity of physical exercise 258 – 9 relative risk (RR), defined 17 relativist approach 87, 114 – 15 reliability: assessment of 161 – 2, 165, 165 – 6; defined 185; example of 159; of qualitative research 114; of questionnaires 96 repeated measures design 180, 257 repeating measurements 128 – 9 reporting: adverse incidents 131; misconduct and ethical concerns 59; see also dissemination of research findings reputational risk 66 – 7 research designs: importance of 4; for observational studies 74 – 8; for proposed studies 47, 51 – 2, 52 – 3; for quantitative research 178 – 80; see also randomized controlled trial (RCT) design research into health and physical activity: current context for 9 – 11; historical context for 6 – 7; purpose of 1 – 5 research proposals: audience for 46; components of 46 – 8; defined 45; ethical issues and 50, 53; for funding applications 48 – 56; purpose of 45 – 6 research questions: for negative impacts of exercise 231 – 2, 235––236; for research proposals 47 research team 49, 53 – 4 response burden 103 response rates: to questionnaires 99 – 100; to surveys 106 results: dissemination of 50, 55, 324 – 8; false 211; providing to participants 70 – 1, 131 – 2; questioning previous 211 – 12; of surveys 107 retention of children and adolescents 241, 241, 242 retrospective cohort study 136, 137 reverse causation 143 review of literature see systematic literature review risk: of contamination between groups 127; of exercise 310 – 1; minimizing 65, 65 – 6; questionnaires and 97 – 8; types of 66, 66 – 7 same sex attracted and gender diverse (SSAGD) 279 – 81, 280; see also sexual orientation and gender identity samples: analogue 215 – 16; college-student 215; existing, use of 71; for surveys 103 – 4 sample size: in research on affective responses to exercise 216 – 17; statistical significance and 180 – 1; for surveys 105 – 6 sampling: non-random 105; random 104 – 5; signal 222 – 3 Schizophrenia Commission (UK) 319, 321 school-based wellness programmes 332 school sport, bullying in 232 scientific journals, publishing in 324 – 7 scientific malpractice 59 scientific method 7 – 8 scoping literature review 29 Scopus 32 search strategy for systematic literature review 32, 32 – 8, 34, 35 – 6, 37 secondary data and consent 71 secondary ignorance 212 sedentary, defined 147 sedentary behaviour: case studies of 151 – 3, 152; defined 15, 148, 185; epidemiological Index 347 research on 143, 144, 145; health and 2, 151; increase in 7; measurement of 148 – 50; prevalence of 150 – 1 sedentary occupations 1, selection bias 141, 215 – 16 self-report measures: of affective responses to exercise 213, 217 – 20; for chronic disease population 296; juxtaposing 223, 224; for older people 256; of physical behaviours 186 – 7; of sedentary behaviour 148 – 9 seminars, presentations at 327 semi-structured interviews 80, 111 sensitivity, defined 185 sensitivity in search structure 33 serious mental illness, people with: benefits of physical activity for 317 – 18; defined 317; ethical issues and 321; health equity perspective and 320 – 1; physical inactivity of 318 – 19; social determinants of health and 319; see also mental health population, research with sex, defined 278 sexuality, defined 278 sexual orientation and gender identity (SOGI): acronyms for 278 – 9; equality and freedom based on 278; ethical issues and 279, 280; gender issues and 283 – 4; health disparities and 283; hormone levels and 284; legal issues and 279 – 81; percentage fat norms and 284 – 5; social issues and 281 – 2; terms for 279 Shapiro-Wilk test 170 signal sampling 222 – 3 simple random sampling 104 single-blind research design 180 single group, repeated measures design 180 skewness scores 170 smartphones 190 snowball sampling 105 social desirability: in epidemiological research 141; questionnaires and 98 – 9; surveys and 106 social determinants of health 319 – 22 social media, sharing research findings on 328 socioeconomic status and health behaviours 319 SOGI see sexual orientation and gender identity split-half reliability 96 SPORTDiscus 31 SSAGD (same sex attracted and gender diverse) 279 – 81, 280; see also sexual orientation and gender identity standard deviation 170, 171 standard error of estimate 176 standard error of mean (SEM) 172 – 3 standing time 185 State-Trait Anxiety Inventory (STAI) 213, 217 – 18, 220 statistical power 178 – 9 stigma of mental illness 300 stratified sampling 104 – 5 Strength Strength (S2S) programme 333 – 4, 336 – 7 strength and functional capacity measures 198 – 201 STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) statement 107 support groups, recruitment from 294 surveys: cross-sectional 304; defined 102; designing 102 – 3; recruitment of participants for 104 – 5; sample for 103 – 4; sample size for 105 – 6 sustainability of community interventions 336 – 7 systematic error 179 systematic literature review: completion of 41 – 2; confidence in evidence of 41; data items, outcomes and prioritization for 38; data management, selection process and data collection process for 38; data synthesis for 40 – 1; defined 28; eligibility criteria for 30 – 1, 38; information sources for 31 – 2; PRISMA Checklist for 29, 29 – 30; quality and risk of bias, assessment of 38 – 9; rationale and objectives for 30; search strategy for 32, 32 – 8, 34, 35 – 6, 37 systolic blood pressure (SBP) 194 – 5 techniques, practice of 158 technology, wearable see fitness devices, wearable testing: exercise capacity 295 – 6; hypotheses 176 – 8; for normality of data 170 – 2 testing environment, controlling for 130 test-retest reliability 96 text mining tools 36 thematic analysis 86, 112 – 14 Thurstone scale 97 timelines of proposed study 49 – 50, 54, 89 timelining 89 time to consider participation 291 title of research proposal 46, 50 training study: control group for 121, 125 – 6; defined 118; designing 119 – 20; recruitment for 122 – 3 transcribing interviews and focus groups 86 transgendered, defined 278 transgendered athletes 284 – 6 treadmills, bespoke 311, 312 truncation 33, 34 Type I errors 178 Type II errors 178 typical error 166 348 Index University of Illinois at Chicago Health and Wellness Academy (HWA) 332 – 3, 336 validity: assessment of 161 – 5, 163, 164; criterion 95, 161, 176, 185; example of 159; external 160, 180; internal 160, 179 – 80; of measurement tools for older people 255; of qualitative research 114 – 15; of questionnaires 94 – 5; of self-report measures 187; types of 159 – 61 values: importance of, in research and sport 231; of Indigenist research 268; yerin dilly bag model and 269, 269, 270 – 1, 272 variability, measures of 170, 171 variables 134, 138 variance transfer 223, 224 variation in measurements 128 – 9 vulnerable groups, research with 70, 106 – 7, 317; see also specific groups, such as children wait-list control groups 126 ‘wash-out’ period 118 Web of Science Core Collection 32 wheelchairs 311, 312 whole-room calorimetry 186 wildcards 33 withdrawal of consent 62 – 3, 98, 234 Yale MeSH Analyzer 36 yarning 268 yerin dilly bag model 269, 269, 270 – 1, 272 ... prevent health problems from happening or reoccurring by developing policy, implementing interventions, administering services and conducting research Achieving and maintaining good health is... PHILIP HURST AND STEPHEN R BIRD 12 Qualitative research in physical activity and health 109 BRETT SMITH AND CASSANDRA PHOENIX 13 Intervention studies, training studies and determining the acute... group and population levels Research Methods in Physical Activity and Health is the first book to comprehensively present the issues associated with physical activity and health research and outline