# Oral exam prep
# Notes
## 1. Physical Activity Guidelines
**Where they came from:**Guidelines come from the WHO and national health bodies, based on decades of research showing physical activity prevents disease and improves long-term health.
**Prescriptions:**
* Adults: **150 min moderate** or **75 min vigorous** activity weekly
* **Strength training**: at least **2 days/week**
* Older adults: include **balance training**
**Why:** Supports cardiovascular health, muscle and bone health, mental health, independence, and reduces risk of chronic disease.
***
## 2. Device-Based Measurement
**What it is:** Using objective tools to quantify PA instead of relying on self-reports.
**Examples:**
* Accelerometers
* Pedometers
* Heart-rate monitors
* GPS devices
* Multi-sensor wearables
**Strengths:**
* Objective → no recall bias
* Captures intensity, frequency, duration
* Useful for population surveillance
**Weaknesses:**
* Expensive
* Participant burden
* Doesn’t capture context
* Data processing is complex
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## 3. Good Sources of PA & Health Information in Ireland
* Healthy Ireland (policy + guidelines)
* HSE website (public health guidance)
* Sport Ireland (programmes, participation data)
* CSO (population & health stats)
* Healthy Ireland Survey (annual PA data)
* Public Health Agency NI (if NI context needed)
* WHO Europe (international guidance)
***
## 4. Measuring PA & PA-Related Outcomes
**PA Measures:**
* Device-based: accelerometers, pedometers
* Self-report: IPAQ, GPAQ, travel surveys
* Fitness tests: VO2max, step tests
**PA-Related Outcomes:**
* Sedentary time
* Strength (handgrip, sit-to-stand)
* Balance
* Anthropometrics (BMI, WC)
* Clinical markers (BP, glucose, lipids)
* Psychosocial outcomes (motivation, QoL)
**Key message:** Use multiple methods because PA is multi-dimensional.
***
## 5. Evaluating PA in Ireland
* Healthy Ireland Survey (IPAQ-SF)
* CSPPA Study (children & adolescents)
* Sport Ireland reports
* NPAP monitoring (National Physical Activity Plan indicators)
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## 6. Men on the Move (MOM)
**What it is:**A community-based PA programme targeting physically inactive middle-aged men, delivered via Sport Ireland and Local Sports Partnerships.
**Core Components:**
* Group sessions (2×/week)
* Aerobic + strength training
* Behaviour change support (goal setting, social support)
* Designed for men who typically avoid structured programmes
**Why it works:**
* Male-friendly environment
* Strong social support
* Accessible and low cost
* Gradual progression keeps men engaged
**Evidence:**
* ↑ Fitness
* ↑ PA levels
* ↓ Weight & waist circumference
* High retention
* Good acceptability
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## 7. Study Designs in PA Research
**Observational:**
* **Cross-sectional:** Snapshot in time, shows associations only.
* **Prospective/Longitudinal:** Follow people over time; stronger for causality.
**Experimental:**
* **RCTs:** Random allocation to intervention/control. Gold standard for causality (e.g., lifestyle vs. metformin for diabetes prevention).
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## 8. Relative Risk (RR)
* RR compares disease risk between groups.
* Example: inactive 4% vs. active 2% → RR = 2.0 (inactive = double risk).
* RR flipped: active RR = 0.5 (half risk).
* **Confidence intervals:** If CI crosses 1.0 → uncertain effect.
***
## 9. Systems Approach to Physical Activity
* PA is shaped by the **whole system**, not just individual choices.
* Influencing sectors: transport, schools, workplaces, health services, community organisations, policy.
* These sectors must collaborate, not operate separately.
* Focus: change environments and structures so activity becomes easy and normal.
* Small programmes alone cannot shift population activity levels.
**Example:**Men on the Move acts as a systems approach by combining community delivery, group support, social connection, and accessible structures.
***
## 10. Older Adults Staying Active in a Digital World (Webinar)
**Are web/phone interventions viable?** Yes.
**Why they work:**
* High digital use among older adults (60–80%)
* COVID showed strong engagement
* Removes barriers: travel, mobility issues, weather
* Home-based strength/balance is feasible
* Live sessions maintain structure, social contact, and accountability
**Challenges:**
* Low confidence with platforms (Zoom/Teams)
* Tech frustrations (sound/camera issues)
* Lower motivation without in-person supervision
* Harder to monitor safety (falls, conditions)
* Device/internet costs
* Harder to teach strength/balance online
**Bottom line:**Effective if tech support is strong, sessions are simple and safe, and social interaction is built in. Hybrid models are ideal.
***
## 11. Prompting Clients for Moderate Pace
Methods:
* % max HR: **64–79%**
* Walking pace (mile/km time)
* RPE
* Talk test
* Step count
* Time to cover distance
**Importance:** Helps people understand what “moderate” actually feels like.
***
## 12. Accelerometry
**What it measures:**
* Body accelerations
* Frequency, duration, intensity
* Often tri-axial (movement in all directions)
**Advantages:**
* Real-time concurrent measurement
* Detailed intensity/frequency/duration
* Stores weeks of data
* Low burden
* Relatively cheap
**Disadvantages:**
* Misses certain activities (cycling, stair climbing, load carrying)
* Poor capture of upper-body movement when worn on hip
* Data cleaning and analysis are time-consuming
***
## 13. Formative Evaluation
Occurs during planning/pre-implementation.
Includes:
* **Problem definition:** norms, behaviours, needs assessment
* **Solution generation:** evidence review, theory, practitioner input
* **Logic model:** map inputs → actions → outputs → outcomes
* **Pilot testing:** observe or run mini trials
***
## 14. Implementation (All Content in One Place)
Implementation = putting a proven program into real-world practice.
Key points:
* Bridges the gap between **research evidence** and **daily practice**
* Fidelity is critical → deliver as designed
* Without good implementation, even excellent interventions fail
* Deals with real-world barriers: staffing, resources, local culture
***
## 15. Scale-Up (All Content in One Place)
Scale-up = expanding a successful program from small pilot → regional → national.
**Why it matters:**
* Small pilots help almost no one unless expanded
* Maximises population health impact
* Ensures programmes survive beyond initial funding
**Requirements:**
* Fidelity + flexibility
* Workforce training
* Sustainable funding
* Monitoring & evaluation
* Strong partnerships (HSE, Sport Ireland, communities)
**Barriers:**
* Cost
* Lack of staff
* Low political priority
* Inequalities in access
***
## 16. RE-AIM Framework (For Implementation & Scale-Up)
**Purpose:** Evaluate how well interventions work in real-world settings.
**Components:**
* **Reach:** Who participates? Who is left out?
* **Effectiveness:** What benefits occur? Any harms?
* **Adoption:** Which settings/organisations take it up?
* **Implementation:** Was it delivered with fidelity? At what cost?
* **Maintenance:** Does it last over time? Individual + organisational.
**Why it matters:**RE-AIM helps ensure PA programmes don’t just work in theory – they work for real people, in real settings, and keep working long-term.
## <u>Potential questions:</u>
**✅ FORMATIVE EVALUATION / NEEDS ASSESSMENT**
**1. What is a formative evaluation?**It’s early-stage evaluation used to shape and improve a programme before it’s fully launched.
**2. What is a needs assessment?**It identifies the problem, who is affected, and what risks the programme must target.
**3. Why is a needs assessment important?**It ensures the programme addresses a real need instead of guessing.
**4. How does a needs assessment guide planning?**It tells you which behaviours, risk factors, and populations to focus on.
**5. What data is used in needs assessments?**Surveys, interviews, epidemiological data, and health records.
**6. How does it differ from summative evaluation?**Formative = planning; summative = measuring results at the end.
**7. What happens if you skip a needs assessment?**You risk designing a useless or ineffective programme.
**8. How do you identify modifiable risks?**By analysing data on behaviours and health patterns.
**9. Why understand the target group?**It makes the programme relevant and doable.
**10. What tools help in needs assessment?**Surveys, focus groups, literature reviews, clinical data.
**✅ SYSTEMS / PARTNERSHIP APPROACH**
**11. What is a systems approach?**It looks at how different sectors interact to influence health. (Health, education, transport, government)
**12. What is a partnership approach?**Multiple organisations working together to deliver a programme.
**13. Why are partnerships important?**They increase reach, resources, and sustainability.
**14. Who are typical stakeholders?**Healthcare services, community groups, employers, policymakers.
**15. How do partnerships improve participation?**They offer more access points and community trust.
**16. How do partnerships improve sustainability?**Resources and responsibilities are shared long-term.
**17. What challenges can arise?**Communication issues and conflicting priorities.
**18. What role do healthcare providers play?**Screening, referrals, and monitoring.
**19. Why is cross-sector collaboration needed?**Health problems have multiple causes, so multiple sectors must respond.
**20. Why involve the community?**It boosts engagement and makes the programme culturally relevant.
**✅ SMART OBJECTIVES**
**21. What does SMART mean?**Specific, Measurable, Achievable, Relevant, Time-bound.
**22. Why are SMART objectives important?**They give clear targets and make evaluation easier.
**23. Difference between SMART a...
