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Cheryl Carnoske, Christine Hoehner, Nicholas Ruthmann, Lawrence Frank, Susan Handy, James Hill, Sherry Ryan, James Sallis, Karen Glanz and Ross Brownson

Background:

Although public support for physical activity-friendly Traditional Neighborhood Developments (TNDs) appears to be growing, information is lacking on private sector perspectives and how economic factors (eg, fuel prices) might influence the development and sale of TNDs.

Methods:

A sample of realtors from the National Association of Realtors (n = 4950) and developers from the National Association of Home Builders (n = 162) were surveyed in early 2009 to assess factors influencing homebuyers' decisions; incentives and barriers to developing TNDs; effects of depressed housing market conditions and financing on sales; trends in buying; and energy considerations (eg, green building).

Results:

Realtors believed that homebuyers continue to rank affordability, safety and school quality higher than TND amenities. Developers reported numerous barriers to TNDs, including the inability to overcome governmental/political hurdles, lack of cooperation between government agencies, and lack of market demand. Yet, realtors believed clients are increasingly influenced by gas and oil prices, and developers reported that clients are looking for energy efficient homes, reduced commute time, and walkable neighborhoods. Respondents reported consumers are more interested in living in a TND than 5 years ago.

Conclusions:

Activity-friendly TNDs appear to be increasing in demand, but developers and realtors reported significant barriers to creating these communities.

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Carole V. Harris, Andrew S. Bradlyn, Nancy O. Tompkins, Melanie B. Purkey, Keri A. Kennedy and George A. Kelley

Background:

The West Virginia Healthy Lifestyles Act contained 5 school-based mandates intended to reduce childhood obesity. These addressed the sale of healthy beverages, physical education time, fitness assessment, health education and assessment, and Body Mass Index measurement. This article describes the processes and methods used to evaluate efforts to implement the legislation.

Methods:

University researchers and state public health and education staff formed the collaborative evaluation team. To assess perceptions and practices, surveys were completed with school personnel (53 superintendents, 586 principals, 398 physical education teachers, 214 nurses) and telephone interviews were conducted with a multistage, stratified sample of 1500 parents and 420 students statewide. Healthcare providers (N = 122) were surveyed regarding current child weight practices and interactions with families. Statewide data reflecting fitness, physical education plans, local wellness policies, and health knowledge were included in the evaluation.

Results:

The evaluation was facilitated by state officials and agencies, resulting in good access to survey groups and high survey response rates for school personnel (57% to 95% response rates); a substantially lower response rate was obtained for healthcare providers (22%).

Conclusions:

Collaborative design and implementation was a key factor in the successful conduct of this obesity policy evaluation.

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Sonja Kahlmeier, Francesca Racioppi, Nick Cavill, Harry Rutter and Pekka Oja

Background:

There is growing interest in “Health in All Policies” approaches, aiming at promoting health through policies which are under the control of nonhealth sectors. While economic appraisal is an established practice in transport planning, health effects are rarely taken into account. An international project was carried out to develop guidance and tools for practitioners for quantifying the health effects of cycling and walking, supporting their full appraisal.

Development Process:

A systematic review of existing approaches was carried out. Then, the products were developed with an international expert panel through an extensive consensus finding process.

Products and Applications:

Methodological guidance was developed which addresses the main challenges practitioners encounter in the quantification of health effects from cycling and walking. A “Health Economic Assessment Tool (HEAT) for cycling” was developed which is being used in several countries.

Conclusions:

There is a need for a more consistent approach to the quantification of health benefits from cycling and walking. This project is providing guidance and an illustrative tool for cycling for practical application. Results show that substantial savings can be expected. Such tools illustrate the importance of considering health in transport policy and infrastructure planning, putting “Health in All Policies” into practice.

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Lawrence Frank, Jacqueline Kerr, Dori Rosenberg and Abby King

Background:

Suburban development patterns may impede physical activity (PA) and mobility and affect healthy aging. This paper investigates the relationships between neighborhood design and walking, driving, PA, and obesity in adults over age 65 years.

Methods:

Data from the SMARTRAQ (Atlanta region) survey provided measures of PA, BMI, SES, and travel patterns. Neighborhood design was measured using a walkability index (residential density, street connectivity, retail density, and land use mix). Chi square and regression was used to evaluate relationships.

Results:

Increased walkability was related with more walking (OR 2.02), less time spent traveling in a car (OR .53), and lower odds of being overweight (OR .68). Those with 1 or no cars were more likely to walk (OR 2.9) and spend less time in cars (OR .53); but also less likely to get recommended levels of PA (OR .55). Visiting a fast food outlet was associated with increased odds of obesity (OR 1.81).

Conclusions:

Policies are needed to bring older Americans closer to shops and services and healthy food outlets as a means of encouraging regular walking and healthy body weight. Incentives to encourage neighborhood grocery stores and affordable housing in central areas along with regulatory reform through zoning can encourage PA and healthy body weight in the elderly.

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Genevieve F. Dunton, Michael Cousineau and Kim D. Reynolds

Background:

Policy strategies aimed at modifying aspects of the social, physical, economic, and educational environments have been proposed as potential solutions to the growing problem of physical inactivity. To develop effective physical activity policies in these and other areas, greater understanding of how and why policies successfully impact behavior change is needed.

Methods:

The current paper proposes a conceptual framework explaining how policy strategies map onto health behavior theoretical variables and processes thought to lead to physical activity change. This framework is used to make hypotheses about the potential effectiveness of different policy strategies.

Results:

Health behavior theories suggest that policies providing information may be particularly useful for individuals who are not yet considering or have only recently begun to consider becoming more physically active. Policies that provide opportunities may be less effective for individuals who do not find physical activity to be inherently fun and interesting. Policies that offer incentives or require the behavior may not be particularly useful at promoting long-term changes in physical activity.

Conclusion:

Exploring possible connections between policy strategies and theoretical constructs can help to clarify how each approach might work and for whom it may be the most appropriate to implement.

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Lesley Steinman, Mark Doescher, David Levinger, Cynthia Perry, Louise Carter, Amy Eyler, Semra Aytur, Angie L.I. Cradock, Kelly R. Evenson, Katie Heinrich, Jacqueline Kerr, Jill Litt, Yucel Severcan and Carolyn Voorhees

Background:

Recent research demonstrates the importance of targeting the built environment to support individual physical activity, particularly for people experiencing health disparities. Master plans to promote biking and/or pedestrians (BPMPs) are a potential method for environmental change. This descriptive study aims to provide a snapshot of plan attributes and better understand demographic, social and transportation characteristics of communities with BPMPs.

Methods:

We collected a census sample of BPMPs from 4 states. Population and commuting data were obtained from national statistics.

Results:

294 master plans were included, with most plans representing municipalities. 62% of plans targeted biking only, one-fifth targeted biking and walking, and 15% targeted walking only. The sampled locations have a similar demographic profile as the overall U.S. for median age and household income, people of color, high school education, and income inequality. The degree of racial diversity of sampled communities is slightly less than the U.S. average and the percentage of people who walk to work were slightly higher.

Conclusions:

Given that communities with master plans have a similar profile as the overall U.S., BPMPs could feasibly be spread to communities throughout the country. Further research is planned to describe BPMPs in detail toward informing future plan development.

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Kelly R. Evenson, Fang Wen, Sarah M. Lee, Katie M. Heinrich and Amy Eyler

Background:

A Healthy People 2010 developmental objective (22-12) was set to increase the proportion of the nation's public and private schools that provide access to their physical activity spaces and facilities for all persons outside of normal school hours. The purpose of this study was to describe the prevalence of indoor and outdoor facilities at schools and the availability of those facilities to the public in 2000 and 2006.

Methods:

In 2000 and 2006, the School Health Policies and Programs Study (SHPPS) was conducted in each state and in randomly selected districts, schools, and classrooms. This analysis focused on the school level questionnaire from a nationally representative sample of public and nonpublic elementary, middle, and high schools (n = 921 in 2000 and n = 984 in 2006).

Results:

No meaningful changes in the prevalence of access to school physical activity facilities were found from 2000 to 2006, for youth or adult community sports teams, classes, or open gym.

Conclusions:

These national data indicate a lack of progress from 2000 and 2006 toward increasing the proportion of the nation's public and private schools that provide access to their physical activity facilities for all persons outside of normal school hours.

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Jimmy Newkirk