TYPE Perspective
PUBLISHED 06 September 2022
DOI 10.3389/fpubh.2022.1002239
SLOfit Lifelong: A model for
OPEN ACCESS leveraging citizen science to
promote and maintain physical
EDITED BY
Radenko M. Matic,
University of Novi Sad, Serbia
REVIEWED BY
Erhan Devrilmez,
fitness and physical literacy
across the lifespan
Karamanoglu Mehmetbey
University, Turkey
Ugur Ödek,
Nevşehir Haci Bektaş Veli
University, Turkey
Gregor Jurak 1 , Shawnda A. Morrison 1*, Maroje Soric1,2 ,
*CORRESPONDENCE
Shawnda A. Morrison Bojan Leskošek1 , Marjeta Kovač1 , Tjaša Ocvirk1 ,
shawnda.morrison@fsp.uni-lj.si
Vedrana Sember1 , Jaka Kramaršič1 , Kaja Meh1 ,
SPECIALTY SECTION
This article was submitted to Žan Luca Potočnik1 , Rok Blagus1,3,4 , Neja Markelj1 ,
Children and Health,
a section of the journal
Petra Golja5 , Vojko Strojnik1 , Vedran Hadžić1 and
Frontiers in Public Health Gregor Starc 1
RECEIVED 24 July 2022 1
Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia, 2 Faculty of Kinesiology, University of
ACCEPTED 12 August 2022
Zagreb, Zagreb, Croatia, 3 Institute for Biostatistics and Medical Informatics, Faculty of Medicine,
PUBLISHED 06 September 2022
University of Ljubljana, Ljubljana, Slovenia, 4 Faculty of Mathematics, Natural Sciences and
CITATION Information Technologies, University of Primorska, Koper, Slovenia, 5 Biotechnical Faculty, University
Jurak G, Morrison SA, Soric M, of Ljubljana, Ljubljana, Slovenia
Leskošek B, Kovač M, Ocvirk T,
Sember V, Kramaršič J, Meh K,
Potočnik ŽL, Blagus R, Markelj N,
Golja P, Strojnik V, Hadžić V and SLOfit Lifelong is a public health initiative which was created to upgrade a
Starc G (2022) SLOfit Lifelong: A model well-established, national physical fitness surveillance system for Slovenian
for leveraging citizen science to
schoolchildren that has been collecting annual fitness and health data for
promote and maintain physical fitness
and physical literacy across the over three decades. The ultimate objective of creating SLOfit Lifelong was to
lifespan. build a modern societal infrastructure with the capacity and ability to detect
Front. Public Health 10:1002239.
doi: 10.3389/fpubh.2022.1002239
future causal associations between childhood physical fitness trends and future
health outcomes based on the lifelong surveillance of one’s own fitness status.
COPYRIGHT
© 2022 Jurak, Morrison, Soric, By instilling citizens with an ambition to test, understand, and follow-up their
Leskošek, Kovač, Ocvirk, Sember, own physical fitness and health status (including related health risk factors),
Kramaršič, Meh, Potočnik, Blagus,
Markelj, Golja, Strojnik, Hadžić and
this initiative provides the technical support and expert feedback needed to
Starc. This is an open-access article engender greater individual control over understanding (and thus modulating),
distributed under the terms of the one’s own physical fitness status as they progress into older adulthood. This
Creative Commons Attribution License
(CC BY). The use, distribution or perspective paper details the extensive approach taken to devise appropriate
reproduction in other forums is fitness test batteries for adults and older adults which can also relate to the
permitted, provided the original
author(s) and the copyright owner(s)
student version of the original SLOfit test database, including establishing
are credited and that the original criterion health risk zones and a public approach to establish this national,
publication in this journal is cited, in citizen-driven health feedback framework. Through its sophisticated online
accordance with accepted academic
practice. No use, distribution or web applications, social media, print media, and outreach workshops, SLOfit
reproduction is permitted which does Lifelong provides the expert support for public health engagement by fostering
not comply with these terms.
positive lifelong physical literacy experiences an individual can enjoy across
their aging journey.
KEYWORDS
aging, exercise monitoring, participatory research, policy making, population health,
surveillance
Frontiers in Public Health 01 frontiersin.org
, Jurak et al. 10.3389/fpubh.2022.1002239
Introduction Helsinki. Participants provided written, informed consent prior
to data collection.
Cardiovascular diseases (CVD) have become the leading
cause of global mortality in the 21st century primarily due to
lifestyle changes, including increased physical inactivity (1, 2). Setting context and population
Recent estimates find the direct health care costs of physical
inactivity in Europe reach upwards of 11.7 billion euros per year, The original SLOfit infrastructure program (herein
with an additional 3.8 billion being lost to poor productivity differentiated as: SLOfit Students) monitors child fitness
(3). Although CVD events occur more frequently during, or through their entire schooling period (27). This includes
after, the fifth decade of life, there is strong evidence that the roughly N = 13,000 graduates per year who are potential
precursors of CVD originate in childhood and adolescence (4, 5) SLOfit Lifelong cohort members. SLOfit Lifelong is designed
and can be tracked into adulthood (6). Amongst the most to be capable of housing their fitness data from childhood to
important modifiable CVD risk factors is physical fitness. Being adulthood, thus “slotting” in existing SLOfit members as they
physically fit means being able to carry out daily tasks with age, in parallel to recruiting new participants.
vigor and alertness (7). Physical fitness refers to a full range of In Slovenia, the physical fitness of children and adolescents is
physical qualities, including cardio-respiratory fitness, muscular monitored by a program originally entitled “Sports Educational
strength, speed of movement, agility, coordination, flexibility, Card”, implemented in 1982 on a sample of Slovenian schools.
and body composition. Having higher childhood fitness provides After 5 years of refinement and pilot testing, the program
lower risk of developing CVD later in life and lower risk of was introduced to all Slovenian primary and secondary school
premature death (8). Increased physical fitness in childhood is curricula in all Slovenian schools (28). “SLOfit Students” is one
associated with positive CVD risk factors (9), improved mental of the oldest and largest child and youth fitness databases in the
health (10), and quality of life (11, 12). world, holding information on more than 40 birth cohorts who
With aging, negative physiological and physical changes can have been followed for ∼13 years. Exact measurement protocols
occur, including sarcopenia (13), progressive muscle mass loss are published in the Sports Educational Card manual (29), a
(14), and declines in muscular strength (15, 16), cardiovascular compulsory tool for every PE teacher freely available on the
function (17), flexibility (18), and balance (19). These can cause SLOfit website (www.slofit.org/ucitelj/administracija). Testing is
functional declines that prevent older people from performing administered by PE teachers trained from the Faculty of Sport,
basic tasks (20–22), affecting mortality rates (23), increasing fall University of Ljubljana, which is the only institution in Slovenia
risk, and leading to higher incidence of hospitalization (24). educating PE teachers in a 5-year specialist program. All
Physical fitness is clearly an important health marker across schools follow identical testing protocols and use standardized
the lifespan (25). The American Heart Association recommends equipment. Results are entered into the “My SLOfit app” where
checking fitness as part of general check-ups (26). Therefore, data is first checked with smart algorithms, analyzed, and made
monitoring physical fitness across the life course is critical not available to all registered users, i.e., parents/guardians control
only to prevent chronic disease, but also to maintain functional access (doctors, coaches, the children themselves).
capacity, identify weaknesses, and addressing them early enough Beginning in 2016, SLOfit researchers developed and
to possibly reverse declines via lifestyle interventions. launched a free-for-use, online application system called “My
The purpose of this paper is to communicate SLOfit” (27). Amongst other features, this application allows
how SLOfit Lifelong was developed, the health data users to store their personal data long after their schooling
it conveys, and how this initiative collaborates with period has ended. The My SLOfit app supports 24-h movement
individuals to provide quality testing and expert behavior data collection and lifestyle habits (e.g., physical
feedback for adults of all ages who wish to better activity, sleep, sedentary time), in addition to direct fitness
understand their body and its functional capacity across testing data. SLOfit Lifelong now has the potential to house novel
their lifetime. data on young people graduating secondary education (18–19 y)
and continue as long as they wish.
Ethics, setting context and
population Key programmatic elements
Ethics statement Medical screening
Any data collected within the context of SLOfit Lifelong We developed a medical screening protocol to mitigate
was approved by the Slovenian National Medical Ethics health-risks associated with fitness testing for adults with
Committee (ID: 0120-468/2021/3), following the Declaration of specific/underlying clinical concerns. SLOfit Lifelong test
Frontiers in Public Health 02 frontiersin.org
