https://hdl.handle.net/20.500.12412/2476 2026-07-06T23:40:38Z https://hdl.handle.net/20.500.12412/7328 Validation of the 15-Item and 5-Item Versions of the Perceived Physical Literacy Instrument for Spanish Adolescents Aged 11–18: A Study Using the Original 18-Item Version Romero-Macarrilla, José Antonio; Bauer, Robert; Fernández-Sánchez, Javier; Fernández-Sánchez, Eva; González-Gutiérrez, Iván; Adsuar, José Carmelo; Pastor-Cisneros, Raquel; Mendoza Muñoz, María; Carlos Vivas, Jorge; Collado-Mateo, Daniel Background: Physical literacy is a multidimensional construct encompassing physical competence, confidence, motivation, knowledge, and lifelong engagement in physical activity. The Perceived Physical Literacy Instrument (PPLI) has been widely used internationally; however, previous adolescent validations have been based on a reduced 9-item version originally developed for teachers. This study aims to evaluate the validity and test–retest reliability of a Spanish adaptation of the original 18-item PPLI in Spanish adolescents aged 11–18 years. Methods: A multi-phase validation study was conducted with 869 Spanish adolescents (421 females). The procedure included: (1) translation and cultural adaptation, (2) Exploratory Factor Analysis (EFA; n = 290), Confirmatory Factor Analysis (CFA; n = 579) and invariance analyses, and (3) test–retest reliability assessment. Results: EFA supported a three-factor solution comprising 15 items. CFA showed standardized factor loadings ranging from 0.62 to 0.89, indicating that the latent constructs were adequately represented. Although the 15-item model showed acceptable fit, a 5-item unidimensional short form was developed due to limitations in the three-dimensional models. This short form demonstrated good model fit (scaled RMSEA = 0.073; scaled CFI = 0.992; SRMR = 0.026), adequate convergent validity (AVE = 0.558), high reliability (. = 0.821), moderate test–retest stability (ICC = 0.69), and full configural, metric, and scalar longitudinal invariance. Conclusions: The 15-, 9-, and 5-item versions of the PPLI are valid and reliable options. The 15-item version allows comprehensive assessment and domain-level interpretation. The 9-item version facilitates comparability with previous international research. The 5-item version may be useful in contexts with time constraints but may not be the preferred choice for comprehensive assessment of physical literacy in clinical or detailed pedagogical diagnostic settings. 2026-04-09T00:00:00Z https://hdl.handle.net/20.500.12412/7327 Lower body muscular strength as a predictor of health indicators in youth population: A systematic review and meta-analysis Moreno-Gonzalez, Laura; Alonso Callejo, Antonio; Felipe, José Luis; Manzano-Carrasco, Samuel; Gallardo, Leonor; García Unanue, Jorge Muscular strength in the lower body during childhood and adolescence is crucial for determining various health indicators. While previous reviews have examined the benefits of health-related muscular fitness (MF) in youth, this study aims to analyse a specific indicator of muscular fitness, focusing on current evidence regarding lower- limb muscular strength and power tests as predictors of health parameters in children and adolescents. A sys tematic search was conducted in Web of Science, MEDLINE (PubMed), and Scopus databases up to December 2023. Observational studies were considered if they quantitatively assessed the association between lower body muscular strength and health outcome variables. Meta-analyses were performed to determine the pooled stan dardized coefficients. Age was evaluated as a potential moderating factor. Twenty-four studies (n = 121 306) were included, covering outcomes like adiposity, cardiometabolic risk, bone health, and inflammatory bio markers. Meta-analyses of 11 studies revealed pooled standardized coefficients; statistical significance was determined for p < 0.001. Lower body strength/power was negatively associated with multiple adiposity in dicators: waist circumference (r = 0.27), body fat percentage (r = 0.31), sum of skinfolds (r = 0.31). Additionally, significant negative correlations were observed with insulin resistance (r = 0.20), and car diometabolic risk index (r = 0.27). Associations with systolic (r = 0.14) and diastolic (r = 0.07) blood pressure, and bone mineral density of the femoral neck (r = 0.12) were weaker. Lower body muscular strength predicts health outcomes like obesity and cardiometabolic diseases. Although no direct link to bone mass was found, lean mass influenced by muscle is essential for bone health. Further research is needed to clarify these relationships and guide interventions, supporting guidelines promoting muscle-strengthening activities in youth. 2026-05-01T00:00:00Z https://hdl.handle.net/20.500.12412/7326 Informational and structural barriers to exercise oncology care in Spain: development of the MOVE - Onco questionnaire and preliminary findings Martínez-Sánchez, Almudena; Mendoza Muñoz, María; Dominguez-Muñoz, Francisco J.; Guerrero-Torrico, Candela; Gusi, Narcis; Subburaj, Jeyanthi; Villafaina, Santos Purpose Exercise is recommended as a core component of supportive cancer care; however, its implementation remains inconsistent. Beyond individual motivation, social and healthcare system factors may shape access to structured exercise programs. This study aimed to develop and content-validate the Motivators, Obstacles, Values, and Exercise in Oncology (MOVE-Onco) questionnaire and to provide preliminary evidence on informational and structural barriers to exercise among oncology patients in Spain. Methods A multi-phase study was conducted including: (1) qualitative item generation through patient interviews and cognitive debriefing; (2) a two-round Delphi process with a multidisciplinary expert panel (N = 16) using a = 75% consensus criterion; and (3) a pilot cross-sectional application in 53 oncology patients to assess internal consistency and describe perceived barriers, facilitators, knowledge, and preferences. Results Content validity was achieved with = 75% expert agreement in the final Delphi round. Internal consistency was excellent for the Barriers scale (a = 0.91) and good for the Facilitators scale (a = 0.85). Although most participants believed exercise improves health outcomes (98.1%) and expressed interest in structured programs (86.9%), 67.9% reported not receiving professional exercise guidance and 94.3% were unaware of specialized oncology exercise resources. Informational barriers were more frequently endorsed than physical or psychological limitations in this pilot sample. Conclusions The MOVE-Onco questionnaire demonstrates preliminary content validity and internal consistency in a Spanish oncology context. Pilot findings suggest that limited professional guidance and low awareness of available resources, rather than lack of patient motivation, may constitute key barriers to exercise engagement. These results highlight potential structural gaps in supportive cancer care delivery. However, these findings should be interpreted cautiously and require confirmation in larger studies. 2026-05-16T00:00:00Z https://hdl.handle.net/20.500.12412/7325 Exploratory assessment of the correlates of lifestyle medicine among Spanish university students: UNILIFE-M study Mendoza Muñoz, María; Manzano-Carrasco, Samuel; Montenegro-Espinosa, José Adrián; Quiroz-Cárdenas, Fiorella; Yañéz-Sepúlveda, Rodrigo; Olivares-Arancibia, Jorge; Keon Yon, Dong; Barreto Schuch, Felipe; Galán-López, Pablo; López-Gil, José Francisco Background University students are at a key life stage in their lives for the development of health-related behaviors, yet few studies have explored their overall lifestyle using multidimensional tools. The present exploratory study aimed to assess lifestyle through the Short Multidimensional Inventory Lifestyle Evaluation for University Students (U-SMILE) and to determine its sociodemographic and health correlates in a sample of Spanish university students. Methods This cross-sectional analysis was based on baseline data collected at Universidad Loyola Andalucía (Spain) as part of the UNIversity students’ LIFEstyle behaviors and Mental health (UNILIFE-M) multicenter project during the 2024 academic year. A total of 671 first-year students (median age = 18 years, 50.1% female) completed validated self-report questionnaires assessing lifestyle behaviors, sociodemographic variables, body mass index (BMI), and diagnosed health conditions. Lifestyle was evaluated using the U-SMILE. Descriptive statistics and robust linear models were applied to identify associated factors. Results The median overall U-SMILE score was 69.0 points (interquartile range [IQR] = 64–73). Older students (> 18 years old) presented lower scores (unstandardized beta coefficient [B] = -1.59; p = 0.006), as did those enrolled in non-health science degrees (B = -1.47; p = 0.005), single students (B =-1.40; p = 0.013), and those with a mental disorder (B = -2.79; p = 0.001). Heterosexual students scored higher than non-heterosexual peers (B = 2.49; p = 0.007), and students with normal weight showed better results than underweight participants (B = 2.08; p = 0.020). Domainspecific analyses revealed that males scored higher in physical activity, sleep, and social support, whereas females performed better in stress management. Students residing outside university accommodation generally achieved higher domain scores. Conclusions These exploratory findings suggest that lifestyle, as measured by the U-SMILE, is associated with several sociodemographic and health-related characteristics in Spanish university students. Lower scores were associated with older age, enrolment in non-health science degrees, underweight status, non-heterosexual orientation, single marital status, and the presence of a diagnosed mental disorder. Sex, BMI status, accommodation, and employment status were associated with specific lifestyle domains. 2026-05-01T00:00:00Z