Conference Agenda

Background: Regular physical activity (PA) improves quality of life for people living with cancer. However, survivors struggle to engage in sufficient PA, highlighting the need for accessible community-based health-enhancing physical activity (HEPA) support. Community cancer support centres represent promising settings for delivering such services, yet implementing programmes in real-world contexts remains a challenge. This study aims to identify context-specific determinants and feasible implementation strategies for community-based PA services for people living with and beyond cancer in Ireland.

Methods:
This formative qualitative study included semi-structured focus groups with cancer support centre staff (service providers) and people living with and beyond cancer (service users), alongside an interview with a national-level decision maker. Consultations were audio-recorded and transcribed verbatim. Analysis combined deductive coding using constructs from the Consolidated Framework for Implementation Research (CFIR) Addendum with inductive thematic analysis. Determinants were mapped to implementation strategies from the Expert Recommendations for Implementing Change (ERIC) taxonomy using the CFIR-ERIC Matching Tool.

Results: Determinants were identified across all five CFIR domains. Key barriers included a cultural 'mind yourself' attitude discouraging PA, inconsistent referral pathways, and lack of specialised staff in centres. Facilitators included strong deliverer commitment to improving current services, high survivor demand, and existing funding. Relevant ERIC strategies included educational outreach, inter-organisational alliance building, promoting adaptability, and accessing new funding.

Conclusions: By integrating stakeholder perspectives with theory-informed analysis, this study identifies specific implementation strategies that will increase the uptake of HEPA interventions supporting PA participation among cancer survivors within their local environments.

Funding source: Research Ireland

Purpose:
Physical activity benefits mental and physical health, yet its integration into psychiatric care remains limited. This study identifies key facilitators and barriers affecting physical activity policy implementation in Flemish Psychiatric Hospitals (PH) and Psychiatric Care Homes (PCH), and translates these into policy recommendations.

Methods:
A qualitative descriptive design was used. In-depth interviews were conducted with managers from 12 purposively selected PH and PCH in Flanders (Nov 2025–Jan 2026). Data were analyzed thematically using MAXQDA.

Results:
Four themes emerged. Organizations apply a broad lifestyle-oriented vision of physical activity, but levels of formalization vary. Barriers occur at societal, staff, resource, network, organizational, governmental and patient levels. Facilitators at the same levels show opportunities that often counter these barriers. Good practices include varied activities, playful or competitive elements, individualized support, low-threshold access and voluntary participation. These insights informed recommendations for clearer guidelines, stronger financial support, enhanced collaboration, platforms for sharing good practices, attention to lifestyle factors and stigma reduction.

Conclusions:
Physical activity is acknowledged but unevenly implemented. Strengthened policy frameworks and multidisciplinary collaboration are needed to improve implementation.

Support/Funding Source: This study is part of a two-year project, Step by Step: for more physical activity in psychiatric care, funded by the King Baudouin Foundation, Mulders-Moonens Fund (024-J15812960-0022188).

Purpose: To generate a Narrative review of evidence for green space as low-cost interventions at the population level for health enhancing physical activity (HEPA) in low-resourced urban environments, with consideration for the health equity effects and implementation for poor populations.

Methods: A narrative review was conducted using PubMed, Scopus, and Web of Science (2000–2025). Of 4,156 records identified, 2,847 remained after duplicate removal. Following abstract screening, 198 full-text articles were assessed, and 92 studies met inclusion criteria related to physical activity outcomes, psychosocial health indicators, implementation strategies, and equity outcomes of green infrastructure interventions.

Results: In the included research, better access to urban green areas was consistently linked to increased levels of physical activity and enhanced psychosocial well-being. In lower-income communities, park rehabilitation and accessibility improvements were linked to estimated increases in community-based physical activity between 18% and 35%, as well as decreases in reported stress and higher community participation. Positive benefits varied by sex and socioeconomic position, and females and youngsters from extremely deprived households showed less improvement. Similarly, when green spaces were accessible and safe, more women and members of underrepresented ethnic groups participated in nature-based physical exercise. Increased implementation and better health equity results were observed for interventions employing participatory planning, community participation and cross-sector collaboration among urban planning, transportation and public health sectors.

Conclusion: Strategic investment in green infrastructure can promote HEPA in low-resource urban settings, but requires political commitment and community engagement.

Support/Funding Source: No external funding was received for this study.

SmartCHANGE, funded through the Horizon Europe programme (2023–2027), develops AI‑based digital tools to support healthier habits in young children. This presentation focuses on the HappyPlant mobile app used in Finnish schools and describes both its feasibility and young people’s experiences of using it. The app utilizes behavioural change theories and includes gamification elements and health related tasks based on one's own goals and AI-risk prediction models and has been co‑created with researchers, developers, school nurses and pupils to ensure suitability.

Methods: The non‑randomised controlled design includes 8 nurses and 100 pupils (50 intervention; 50 control) in grades 5 and 8. Pupils use the gamified version of the HappyPlant together with activity trackers for 3 months, while school nurses use an AI-based web tool to assess risk, monitor progress, and provide tailored support. Control group uses the same app, but without gamification or goal setting, presenting only activity tracker values.

Results: Feasibility data will be collected through pupil surveys and semi‑structured focus groups. The results presented at the conference will describe pupils’ experiences with the HappyPlant app, factors influencing engagement, and the implications of school policies such as restrictions on mobile‑phone use during the school day.

Conclusion: SmartCHANGE contributes to practice and policy by offering scalable, school‑compatible AI-based digital health tools to support children’s daily health behaviours and strengthen evidence on digital behaviour change tools.

Keywords: physical activity promotion; behaviour change; digital health; school‑based health promotion; feasibility.

This study aims to examine whether municipal health interventions may be advantageously relocated to natural outdoor environments and how participants experience engaging in such programs. The examination builds on the hypothesis that spending time outdoors increases physical activity and contributes to improved mental health.

This presentation reports findings from three nature-based interventions implemented across two Danish municipalities. The interventions targeted three distinct groups: Adolescents experiencing reduced mental health, adults experiencing reduced mental health, and adults living with diabetes. Each intervention relocated activities, such as mindfulness, physical activity, and patient education, into natural environments.

The impact of the nature-based interventions was investigated using the RE-AIM framework. Participant interviews, observation and participant reflection forms were analysed using thematic analysis.

Preliminary findings indicate that the interventions enhanced participants’ mental health. Participants reported experiencing a sense of community, increased physical activity, and improved feelings of mastery, all of which were supported by the motivating qualities of the natural environment. Adolescents were particularly motivated by physically and mentally challenging activities, whereas adults were primarily motivated by the sense of calm and restoration offered by the natural surroundings.

The preliminary results support the recommendation to relocate municipal health interventions into natural environments, however further research is needed, including larger sample sizes, mixed methods designs, and investigations of the organisational and economic implications.

This study, funded by 15. Juni Fonden and NordeaFonden, provides key insights into integrating green spaces and 24‑hour movement behaviours to prevent non‑communicable diseases and improve mental health in municipal health interventions.

Purpose

Waist circumference (WC), cardiorespiratory fitness (CRF), and physical activity (PA) are interrelated determinants of cardiometabolic health. Because WC, CRF, and PA may influence one another bidirectionally, each can act both as a confounder and a mediator. It remains unclear whether peak PA intensities accumulated over different time durations show distinct associations with WC when accounting for CRF.

Methods
A total of 3475 adults (mean age 51±13 years; 60% women) participated in the cross-sectional population-based FINFIT17- and FINFIT21-studies and wore hip‑mounted accelerometers for one week. CRF was estimated with a 6‑minute walk test, and WC was measured with standardized procedures. Accelerometer data were processed using MAD-metrics and mean daily peak intensities were derived for 1‑, 3‑, 6‑, 10‑, 30‑, and 120‑minute durations. Age‑ and sex‑adjusted and age‑, sex‑, and CRF‑adjusted partial correlations were calculated between WC and each intensity measure.

Results
All age‑ and sex‑adjusted partial correlations showed statistically significant inverse associations with WC (p<0.001), the strongest one for the 3‑minute duration (r=−0.305). After adjusting for CRF, associations were markedly attenuated. The strongest remaining inverse correlation was observed for the 30‑minute duration (r =−0.062; p<0.001), with significant associations (p<0.05) persisting for the all over 3‑minute durations.

Conclusions

Peak daily activity intensities across both short and long durations were inversely associated with WC across the study group. Adjustment for CRF substantially attenuated the associations, shifting the strongest association towards longer durations. These findings suggest that longer activity bouts may provide additional benefits for central adiposity in some contexts.

Schools have been identified as key settings for health promotion, but school-based physical activity initiatives have rarely had a sustained impact. Interventions have been criticized for focusing on individual behavior rather than considering the context in which people live their lives. With a focus on contextual potential for integrating physical activity, outdoor education has been identified as a promising approach. However, outdoor education requires pedagogical expertise and does not primarily emphasize physical activity. Research remains limited on approaches that use outdoor settings as learning contexts without expecting the environment to be used as a means of teaching. To address these challenges, the Walking School initiative was developed and implemented. Grounded in settings-based Health Promotion, the initiative integrated education outdoors while walking to promote sustainable movement as part of everyday school culture. This article examines teaching practice when teaching takes place outdoors while walking.

A mixed-methods participatory design involved six intervention classes, eight control classes (12–16 years old), and nine teachers, representing six subjects. The intervention comprised weekly curriculum-based outdoor walking lessons co-developed by researchers, teachers, and students. Data included surveys, interviews, and observations.

Preliminary findings suggest that teacher-led structure determines whether outdoor lessons resemble a lesson or merely a walk. Content is of limited complexity, and activities include discussions, worksheets, and podcasts. The outdoor environment is not integrated into teaching content, and the absence of classroom boundaries and close teacher–student proximity is perceived to encourage distractions. These findings inform efforts on how to integrate health-enhancing physical activity in schools.