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Laurel A. Borowski and Heather R. Bowles

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Louise C. Mâsse and Judith E. de Niet

Background:

Over the years, self-report measures of physical activity (PA) have been employed in applications for which their use was not supported by the validity evidence.

Methods:

To address this concern this paper 1) provided an overview of the sources of validity evidence that can be assessed with self-report measures of PA, 2) discussed the validity evidence needed to support the use of self-report in certain applications, and 3) conducted a case review of the 7-day PA Recall (7-d PAR).

Results:

This paper discussed 5 sources of validity evidence, those based on: test content; response processes; behavioral stability; relations with other variables; and sensitivity to change. The evidence needed to use self-report measures of PA in epidemiological, surveillance, and intervention studies was presented. These concepts were applied to a case review of the 7-d PAR. The review highlighted the utility of the 7-d PAR to produce valid rankings. Initial support, albeit weaker, for using the 7-d PAR to detect relative change in PA behavior was found.

Conclusion:

Overall, self-report measures can validly rank PA behavior but they cannot adequately quantify PA. There is a need to improve the accuracy of self-report measures of PA to provide unbiased estimates of PA.

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Barbara Sternfeld and Lisa Goldman-Rosas

Context:

Numerous instruments to measure self-reported physical activity (PA) exist, but there is little guidance for determining the most appropriate choice.

Objective:

To provide a systematic framework for researchers and practitioners to select a self-reported PA instrument.

Process:

The framework consists of 2 components: a series of questions and a database of instruments. The questions encourage users to think critically about their specific needs and to appreciate the strengths and limitations of the available options. Instruments for the database were identified through existing literature and expert opinion.

Findings:

Ten questions, ranging from study aim and study design to target population and logistical consideration, guide the researcher or practitioner in defining the criteria for an appropriate PA instruments for a given situation. No one question on its own determines the optimal choice, but taken together, they narrow the potential field. The database currently includes 38 different self-reported PA instruments, characterized by 18 different parameters.

Conclusions:

The series of questions presented here, in conjunction with a searchable database of self-report PA instruments, provides a needed step toward the development of guiding principles and good practices for researchers and practitioners to follow in making an informed selection of a self-reported PA instrument.

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Ana Henderson and Christine R. Fry

Background:

Improving parks in low income and minority neighborhoods may be a key way to increase physical activity and decrease overweight and obesity prevalence among children at the greatest risk. To advocate effectively for improved recreation infrastructure, public health advocates must understand the legal and policy landscape in which public recreation decisions are made.

Methods:

In this descriptive legal analysis, we reviewed federal, state, and local laws to determine the authority of each level of government over parks. We then examined current practices and state laws regarding park administration in urban California and rural Texas.

Results:

We identified several themes through the analysis: (1) multiple levels of governments are often involved in parks offerings in a municipality, (2) state laws governing parks vary, (3) local authority may vary substantially within a state, and (4) state law may offer greater authority than local jurisdictions use.

Conclusions:

Public health advocates who want to improve parks need to (1) think strategically about which levels of government to engage; (2) identify parks law and funding from all levels of government, including those not typically associated with local parks; and (3) partner with advocates with similar interests, including those from active living and school communities.

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Ugo Lachapelle, Larry Frank, Brian E. Saelens, James F. Sallis and Terry L. Conway

Background:

Most public transit users walk to and from transit. We analyzed the relationship between transit commuting and objectively measured physical activity.

Methods:

Adults aged 20 to 65 working outside the home (n = 1237) were randomly selected from neighborhoods in Seattle and Baltimore regions. Neighborhoods had high or low median income and high or low mean walkability. Mean daily minutes of accelerometer-measured moderate-intensity physical activity (MPA) were regressed on frequency of commuting by transit and neighborhood walkability, adjusting for demographic factors and enjoyment of physical activity. Interaction terms and stratification were used to assess moderating effect of walkability on the relation between transit commuting and MPA. Associations between transit commuting and self-reported days walked to destinations near home and work were assessed using Chi Square tests.

Results:

Regardless of neighborhood walkability, those commuting by transit accumulated more MPA (approximately 5 to 10 minutes) and walked more to services and destinations near home and near the workplace than transit nonusers. Enjoyment of physical activity was not associated with more transit commute, nor did it confound the relationships between MPA and commuting.

Conclusion:

Investments in infrastructure and service to promote commuting by transit could contribute to increased physical activity and improved health.

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Katie M. Heinrich, Nancee N. Aki, Heidi Hansen-Smith, Mark Fenton and Jay Maddock

Background:

Policy changes were needed to reshape the built environment for active transportation.

Methods:

Using the social ecological model as a framework, the Healthy Hawaii Initiative worked with a contractor to develop a series of meetings, planning sessions, and workshops. Activities spanned 22 months between 2007 and 2009, and involved multiple stakeholders, including educational outreach for legislators and collaborative planning sessions with advocates.

Results:

Ultimately, with the help of the contractor to initiate the process, Complete Streets and Safe Routes to School (SRTS) legislation were introduced January 2009. Advocacy groups monitored bill progress, testified at hearings, and assisted in rewording the bills. The SRTS statute required the Department of Transportation (DOT) to administer the federal SRTS funds and the complete streets law tasked the state and county DOTs to adopt complete streets policies and review existing highway design standards and guidelines. Both bills were signed into law June 2009.

Conclusions:

Focusing efforts at multiple levels of the social ecological model involving champions and key stakeholders led to the successful passage of legislation supporting active transportation. Tracking policy implementation and evaluation over time will help determine actual impact on active transportation behaviors across Hawaii.

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Xuemei Zhu, Chanam Lee, Oi-Man Kwok and James W. Varni

Background:

A growing number of studies have examined correlates of walking-to/from-school behaviors. However, the potential differences across neighborhoods have been understudied. To address this knowledge gap, this study compared 4 elementary school settings (low-income inner-city; mid- to low-income, urban with and without freeway in attendance area; and high-income suburban) in Austin, Texas.

Methods:

Parental surveys (n = 680, response rate = 25%) were analyzed using binary logistic regressions to identify correlates of walking to/from school for each setting. Five focus groups were conducted with 15 parents and analyzed using content analysis to supplement the survey results.

Results:

Parents’ personal barrier was the only consistently significant variable across 4 settings (OR = 0.113−0.463, P < .05). Parental education showed contrasting results between the suburban setting (OR = 3.895, P < .01) and the urban setting with freeway presence (OR = 0.568, P < .05). Personal attitude and walking habit had lower explanatory power in lower-income settings than in the higher-income site. But sociodemographic, physical environment, and safety conditions had greater explanatory power in lower-income settings. Freeway barrier was significant in the inner-city setting (OR = 0.029, P < .05) and the urban setting with freeway presence (OR = 0.142, P < .05).

Conclusions:

Significant differences in correlates of walking-to/from-school behaviors were found across the 4 elementary school settings, suggesting the importance of context-sensitive approaches in future research and practice.

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Thomas Gotschi

Background:

Promoting bicycling has great potential to increase overall physical activity; however, significant uncertainty exists with regard to the amount and effectiveness of investment needed for infrastructure. The objective of this study is to assess how costs of Portland’s past and planned investments in bicycling relate to health and other benefits.

Methods:

Costs of investment plans are compared with 2 types of monetized health benefits, health care cost savings and value of statistical life savings. Levels of bicycling are estimated using past trends, future mode share goals, and a traffic demand model.

Results:

By 2040, investments in the range of $138 to $605 million will result in health care cost savings of $388 to $594 million, fuel savings of $143 to $218 million, and savings in value of statistical lives of $7 to $12 billion. The benefit-cost ratios for health care and fuel savings are between 3.8 and 1.2 to 1, and an order of magnitude larger when value of statistical lives is used.

Conclusions:

This first of its kind cost-benefit analysis of investments in bicycling in a US city shows that such efforts are cost-effective, even when only a limited selection of benefits is considered.

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Mindy Fullilove, Chanam Lee and James F. Sallis

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Erin K. Sharpe, Scott Forrester and James Mandigo

Background:

This paper evaluates the impact of a large-scale, community agency-driven initiative to increase physical activity (PA) in after-school programs in Ontario. In 2008, the YMCA and Boys and Girls Club (BGC) introduced CATCH Kids Club (CKC) into 330 after-school program sites.

Methods:

This study assessed the impact of the intervention on the quality and quantity of PA using a pretest/posttest quasi-experimental research design with a comparison non-CKC group. Data were collected at baseline (September 2008) and postintervention (May/June 2009) using the System for Observing Fitness Instruction Time (SOFIT).

Results:

Nearly all sites, with the exception of the BGC baseline program (a sports program) achieved greater than 50% of time spent in MVPA. Significant differences were not found between levels of MVPA at CKC and comparison sites (59.3% vs. 64.2%), or at CKC sites at baseline versus postintervention (59.3% vs. 52.1%). BGC sites had significantly higher levels MVPA in CKC programs than in sports programs (70.8% vs. 35.2%). In postimplementation interviews, leaders reported general support but some mixed reactions related to how the program was received by participants.

Conclusions:

This paper offers support for PA programs that focus on inclusivity and enjoyment and emphasize the important role of staff competency.