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Kelly R. Evenson, Brian Neelon, Sarah C. Ball, Amber Vaughn and Dianne S. Ward

Background:

Despite the growing interest in active (ie, nonmotorized) travel to and from school, few studies have explored the measurement properties to assess active travel. We evaluated the criterion validity and test–retest reliability of a questionnaire with a sample of young schoolchildren to assess travel to and from school, including mode, travel companion, and destination after school.

Methods:

To assess test–retest reliability, 54 children age 8 to 11 years completed a travel survey on 2 consecutive school days. To assess criterion validity, 28 children age 8 to 10 years and their parents completed a travel survey on 5 consecutive weekdays.

Results:

test–retest reliability of all questions indicated substantial agreement. The questions on mode of transport, where you will go after school, and how you will get there also displayed substantial agreement between parental and child reports.

Conclusions:

For this population, a questionnaire completed by school-age children to assess travel to and from school, including mode, travel companion, and destination after school, was reliably collected and indicated validity for most items when compared with parental reports.

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Jennifer G. Walker, Kelly R. Evenson, William J. Davis, Philip Bors and Daniel A. Rodríguez

Background:

This comparative case study investigates 2 successful community trail initiatives, using the Active Living By Design (ALBD) Community Action Model as an analytical framework. The model includes 5 strategies: preparation, promotion, programs, policy, and physical projects.

Methods:

Key stakeholders at 2 sites participated in in-depth interviews (N = 14). Data were analyzed for content using Atlas Ti and grouped according to the 5 strategies.

Results:

Preparation: Securing trail resources was challenging, but shared responsibilities facilitated trail development. Promotions: The initiatives demonstrated minimal physical activity encouragement strategies. Programs: Community stakeholders did not coordinate programmatic opportunities for routine physical activity. Policy: Trails’ inclusion in regional greenway master plans contributed to trail funding and development. Policies that were formally institutionalized and enforced led to more consistent trail construction and safer conditions for users. Physical Projects: Consistent standards for wayfinding signage and design safety features enhanced trail usability and safety.

Conclusions:

Communities with different levels of government support contributed unique lessons to inform best practices of trail initiatives. This study revealed a disparity between trail development and use-encouragement strategies, which may limit trails’ impact on physical activity. The ALBD Community Action Model provided a viable framework to structure cross-disciplinary community trail initiatives.

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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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Anna K. Porter, Samantha Schilsky, Kelly R. Evenson, Roberta Florido, Priya Palta, Katelyn M. Holliday and Aaron R. Folsom

Background: This study assessed the independent associations between participation in self-reported sport and exercise activities and incident cardiovascular disease (CVD). Methods: Data were from 13,204 participants in the Atherosclerosis Risk in Communities Study cohort (1987–2015). Baseline sport and exercise activities were assessed via the modified Baecke questionnaire. Incident CVD included coronary heart disease, heart failure, or stroke. Multivariable-adjusted Cox proportional hazard models assessed the association of participation in specific sport and exercise activities at enrollment with risk of CVD. Results: During a median follow-up time of 25.2 years, 30% of the analytic sample (n = 3966) was diagnosed with incident CVD. In fully adjusted models, participation in racquet sports (hazard ratio [HR] 0.75; 95% confidence interval [CI], 0.61–0.93), aerobics (HR 0.75; 95% CI, 0.63–0.88), running (HR 0.68; 95% CI, 0.54–0.85), and walking (HR 0.89; 95% CI, 0.83–0.95) was significantly associated with a lower risk of CVD. There were no significant associations for bicycling, softball/baseball, gymnastics, swimming, basketball, calisthenics exercises, golfing with cart, golfing with walking, bowling, or weight training. Conclusions: Participation in specific sport and exercises may substantially reduce the risk for CVD.

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Stephanie Mazzucca, Derek Hales, Kelly R. Evenson, Alice Ammerman, Deborah F. Tate, Diane C. Berry and Dianne S. Ward

Background: Physical activity has many benefits for young children’s health and overall development, but few studies have investigated how early care and education centers allot time for physical activity, along with measured individual physical activity levels for indoor/outdoor activities during a typical day. Methods: Fifty early care and education centers in central North Carolina participated in 4 full-day observations, and 559 children aged 3–5 years within centers wore accelerometers assessing physical activity during observation days. Observation and physical activity data were linked and analyzed for associations between child activity and type of classroom activity. Results: Children averaged 51 (13) minutes per day of moderate to vigorous physical activity and 99 (18) minutes per day of light physical activity while in child care. Children averaged 6 (10) and 10 (13) minutes per day of observed outdoor and indoor daily teacher-led physical activity, respectively. Outdoor time averaged 67 (49) minutes per day, and physical activity levels were higher during outdoor time than during common indoor activities (center time, circle time, and TV time). Conclusions: Physical activity levels varied between indoor and outdoor class activities. Policy and program-related efforts to increase physical activity in preschoolers should consider these patterns to leverage opportunities to optimize physical activity within early care and education centers.

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Anne Marie Z. Jukic, Kelly R. Evenson, Amy H. Herring, Allen J. Wilcox, Katherine E. Hartmann and Julie L. Daniels

Background:

Correlates of prenatal physical activity can inform interventions, but are not well-understood.

Methods:

Participants in the Pregnancy, Infection, and Nutrition 3 Study were recruited before 20 weeks gestation. Women self-reported frequency, duration, and mode of moderate and vigorous physical activities. We used logistic regression to identify correlates of any physical activity (≥10 minutes/week of any mode), any recreational activity (≥10 minutes/week), and high volume recreational activity (either ≥150 minutes/week of moderate or ≥75 minutes/week of vigorous). Our analysis included 1752 women at 19-weeks gestation and 1722 at 29 weeks.

Results:

Higher education, white race, and enjoyment of physical activity were positively correlated with all 3 outcomes. Any recreational activity was negatively associated with parity, body mass index, and history of miscarriage. The associations of history of miscarriage and body mass index differed at 19 weeks compared with 29 weeks. Single marital status, health professional physical activity advice, and time for activity were associated with high volume recreational activity only.

Conclusions:

Correlates of physical activity differed by mode and volume of activity and by gestational age. This suggests that researchers planning physical activity interventions should consider the mode and amount of activity and the gestational age of the participants.

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Deborah A. Cohen, Claude Setodji, Kelly R. Evenson, Phillip Ward, Sandra Lapham, Amy Hillier and Thomas L. McKenzie

Background:

The Systematic Observation of Play and Recreation in Communities (SOPARC) was designed to estimate the number and characteristics of people using neighborhood parks by assessing them 4 times/day, 7 days/week. We tested whether this schedule was adequate and determined the minimum number of observations necessary to provide a robust estimate of park user characteristics and their physical activity levels.

Methods:

We conducted observations every hour for 14 hours per day during 1 summer and 1 autumn week in 10 urban neighborhood parks: 2 each in Los Angeles, CA; Albuquerque, NM; Columbus, OH; Durham, NC; and Philadelphia, PA. We counted park users by gender, age group, apparent race/ethnicity, and activity level. We used a standardized Cronbach’s alpha and intraclass correlation coefficients to test the reliability of using fewer observations.

Results:

We observed 76,632 individuals, an average of 547/park/day (range 155−786). Interobserver reliability ranged from 0.80 to 0.99. Obtaining a robust estimate of park user characteristics and their physical activity required a schedule of 4 days/week, 4 times/day.

Conclusion:

An abbreviated schedule of SOPARC was sufficient for estimating park use, park user characteristics, and physical activity. Applying these observation methods can augment physical activity surveillance.

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I-Min Lee, Eric J. Shiroma, Kelly R. Evenson, Masamitsu Kamada, Andrea Z. LaCroix and Julie E. Buring

In recent years, it has become feasible to use devices for assessing physical activity and sedentary behavior among large numbers of participants in epidemiologic studies, allowing for more precise assessments of these behaviors and quantification of their associations with health outcomes. Between 2011–2015, the Women’s Health Study (WHS) used the Actigraph GT3X+ device to measure physical activity and sedentary behavior over seven days, during waking hours, among 17,708 women (M age, 72 years) living throughout the United States. Devices were sent to and returned by participants via mail. We describe here the methods used to collect and process the accelerometer data for epidemiologic data analyses. We also provide metrics that describe the quality of the accelerometer data collected, as well as expanded findings regarding previously published associations of physical activity or sedentary behavior with all-cause mortality during an average follow-up of 2.3 years (207 deaths). The WHS is one of the earliest “next generation” epidemiologic studies of physical activity, utilizing wearable devices, in which long-term follow-up of participants for various health outcomes is anticipated. It therefore serves as a useful case study in which to discuss unique challenges and issues faced.

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JoAnn Kuo, Kathryn H. Schmitz, Kelly R. Evenson, Thomas L. McKenzie, Jared B. Jobe, Ariane L. Rung, Joel Gittelsohn and Russell R. Pate

Background:

With limited opportunities for physical activity during school hours, it is important to understand the contexts of physical activities done outside of school time. Given the importance of physical and social aspects of environments, the purpose of this study was to describe where and with whom girls participate in physical activities outside of school.

Methods:

Participants were 1925 sixth-grade girls in the Trial of Activity for Adolescent Girls (TAAG). At baseline, they completed a 3-day physical activity recall (3DPAR), reporting the main activity performed during 30-minute intervals and the physical and social contexts of physical activities.

Results:

The most frequently reported physical activities done outside of school time were house chores, walking (for transportation or exercise), dance, basketball, playing with younger children, and running or jogging. The most common location for these activities was at home or in the neighborhood. With the exception of household chores, these activities were typically done with at least one other person.

Conclusions:

Interventions that promote physical activities that can be done at or around home or developing supportive social networks for physical activity would be consistent with the current physical activity contexts of adolescent girls.

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Amy Eyler, Jamie Chriqui, Jay Maddock, Angie Cradock, Kelly R. Evenson, Jeanette Gustat, Steven Hooker, Rodney Lyn, Michelle Segar, Nancy O’Hara Tompkins and Susan G. Zieff

Background:

In the United States, health promotion efforts often begin with state-level strategic plans. Many states have obesity, nutrition, or other topic-related plans that include physical activity (PA). The purpose of this study was to assess PA content in these state plans and make recommendations for future plan development.

Methods:

Publically available plans were collected in 2010. A content analysis tool was developed based on the United States National PA Plan and included contextual information and plan content. All plans were double coded for reliability and analyzed using SPSS.

Results:

Forty-three states had a statewide plan adopted between 2002 and 2010, none of which focused solely on PA. Over 80% of PA-specific strategies included policy or environmental changes. Most plans also included traditional strategies to increase PA (eg, physical education, worksite). Few plans included a specific focus on land use/community design, parks/recreation, or transportation. Less than one-half of plans included transportation or land use/community design partners in plan development.

Conclusions:

Though the majority of states had a PA-oriented plan, comprehensiveness varied by state. Most plans lacked overarching objectives on the built environment, transportation, and land use/community design. Opportunities exist for plan revision and alignment with the National PA Plan sectors and strategies.