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Ian Cook, Marianne Alberts, and Estelle V. Lambert

Background:

We describe the effect of 2 different accelerometer cut-points on physical activity (PA) patterns in rural and urban black South African women.

Methods:

Hip-mounted uni-axial accelerometers were worn for 6 to 7 days by rural (n = 272) and urban (n = 16) participants. Twenty-hour (4 AM to 12 AM) PA counts (cts) and volumes (min·day−1) were extracted: sedentary (SED, <100 cts·min−1), light (100–759 cts·min−1), moderate-1 (MOD1, 760–1951 cts·min−1), moderate-2 to vigorous (MOD2VG, ≥1952 cts·min−1), and bouts ≥10 min for ≥760 cts·min−1 (MOD1VGbt) and ≥1952 cts·min−1 (MOD2VGbt).

Results:

Valid data were obtained from 263 rural women and 16 urban women. Total counts and average counts were higher (+80,399 cts·day−1, +98 cts·min−1.day−1) (P < .01), SED lower (−61 min·day−1, P = .0042), MOD1 higher (+65 min·day−1, P < .0001), and MOD1VGbt higher (+19 min·day−1, P = .0179) in rural women compared with urban women. Estimated adherence (≥30 min·day−1 for 5 days·wk−1) was 1.4-fold higher in rural women than urban women for MOD-1VGbt, but 3.3-fold higher in urban women than rural women for MOD2VGbt.

Conclusions:

Rural women accumulate greater amounts of PA than urban women within a particular count band. Depending on which moderate PA cut-point was used to estimate PA public health adherence, rural women could be classified as less physically active than urban women.

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Catherine E. Draper, Tracy L. Kolbe-Alexander, and Estelle V. Lambert

Background:

The Community Health Intervention Programmes (CHIPs) is a physical activity-based health promotion program operating in disadvantaged communities in the Western Cape, South Africa with primary school learners, adults and senior adults. Program growth, anecdotal evidence and experience of those involved suggest the program has been positively received by communities. The aim of this study was to conduct a qualitative, retrospective process evaluation concerning both factors associated with successful implementation of the programs, and implementation challenges.

Methods:

‘Success’ was defined in consultation with CHIPs staff and stakeholders. Data were gathered through naturalistic observation, structured interviews and focus groups (n = 104), and open-ended questionnaires (n = 81). The sample included CHIPs staff and stakeholders, program members and leaders.

Results:

Factors contributing to the program’s success include: focus on combining social development and exercise science, community development model, scientifically sound program content, appropriate activities, intrapersonal and interpersonal factors, program leadership, encouraging staff, and various contextual factors.

Conclusions:

The findings confirm that CHIPs presents a model of sustainable implementation of physical activity in disadvantaged communities, and that it positively impacts the quality of life, perceptions of the role of physical activity in health, and personal responsibility for health of those involved in its programs.

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Tracy L. Kolbe-Alexander, Estelle V. Lambert, Judith Biletnikoff Harkins, and Ulf Ekelund

The aim of this study was to assess the validity and reliability of the Yale Physical Activity Survey (YPAS) and the short version of the International Physical Activity Questionnaire (IPAQ) in older South African adults. The YPAS includes measures of weekly energy expenditure (EE) for housework, yard work, caregiving, exercise, and recreation. The IPAQ measures total time and EE during vigorous and moderate activity, walking, and sitting. The instruments were administered twice for test–retest reliability (men, n = 52, 68 ± 5.4 years, and women, n = 70, 66 ± 5.8 years). Data for criterion validity were obtained from accelerometers. YPAS reliability ranged from r = .44 to.80 for men and r = .59 to .99 for women (p < .0001). IPAQ reliability was lower for men (r = .29 to .76) than for women (r = .46 to .77). Criterion validity of the YPAS was .31 to .54 for men and .26 to .29 for women. The YPAS and short IPAQ had comparable results for reliability and criterion validity.

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Julian D. Pillay, Tracy L. Kolbe-Alexander, Karin I. Proper, Willem van Mechelen, and Estelle V. Lambert

Background:

Brisk walking is recommended as a form of health-enhancing physical activity. This study determines the steps/minute rate corresponding to self-paced brisk walking (SPBW); a predicted steps/minute rate for moderate physical activity (MPA) and a comparison of the 2 findings.

Methods:

A convenience sample (N = 58: 34 men, 24 women, 31.7 ± 7.7yrs), wearing pedometers and a heart rate (HR) monitor, performed SPBW for 10 minutes and 5 indoor sessions, regulated by a metronome (ranging from 60–120 steps/minute). Using steps/minute and HR data of the trials, a steps/minute rate for MPA was predicted. Adjustments were subsequently made for aerobic fitness (using maximal oxygen uptake (VO2max) estimates), age, and sex as possible contributors to stepping rate differences.

Results:

Average steps/minute rate for SPBW was 118 ± 9 (116 ± 9; 121 ± 8 for men/women, respectively; P = .022); predicted steps/minute rate for MPA was 122 ± 37 (127 ± 36; 116 ± 39 for men/women, respectively; P < .99) and was similar to steps/minute rate of SPBW (P = .452), even after adjusting for age, sex, and aerobic fitness.

Conclusion:

Steps/minute rates of SPBW correlates closely with targeted HR for MPA, independent of aerobic fitness; predicted steps/minute rate for MPA relates closely to steps/minute rates of SPBW. Findings support current PA messages that use the term brisk walking as a reference for MPA.

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Pasmore Malambo, Andre P. Kengne, Estelle V. Lambert, Anniza De Villiers, and Thandi Puoane

Background: To investigate the mediation effects of physical activity (PA) on the relationship between the perceived neighborhood aesthetic environment and overweight/obesity in free-living South Africans. Methods: A cross-sectional study of 671 adults aged ≥ 35 years was analyzed. PA was assessed using the validated International Physical Activity Questionnaire. Perceived neighborhood aesthetics was assessed using the Neighborhood Environment Walkability Scale Questionnaire. Results: Of 671 participants, 76.0% were women, 34.1% aged 45–54 years, and 69.2% were overweight or obese. In adjusted logistic regression models, overweight/obesity was significantly associated with neighborhood aesthetics [odds ratio (OR) = 0.68; 95% confidence interval (CI), 0.50–0.93] and PA (OR = 0.65; 95% CI, 0.65–0.90). In expanded multivariable models, overweight/obesity was associated with age 45–55 years (OR = 1.59; 95% CI, 1.05–2.40), female gender (OR = 6.24; 95% CI, 3.95–9.86), tertiary education (OR = 4.05; 95% CI, 1.19–13.86), and urban residence (OR = 2.46; 95% CI, 1.66–3.65). Conclusion: Aesthetics was positively associated with PA; both aesthetics and PA were negatively associated with overweight and obesity. There was no evidence to support a significant mediating effect of PA on the relationship between aesthetics and overweight/obesity. Future studies should consider objective assessment of aesthetics and PA. In addition, future studies should consider using longitudinal design to evaluate food-related environments, which are related to overweight or obesity.

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Catherine Draper, Susan Basset, Anniza de Villiers, Estelle V. Lambert, and the HAKSA Writing Group

Background:

There is current concern for the health and well-being of children and youth in South Africa, including habits of physical activity (PA) and sedentary behavior. The 2014 Healthy Active Kids South Africa Report Card evaluates the current activity status of children and youth.

Methods:

The Research Working Group was comprised of 23 experts in physical education, nutrition, sport science, public health and journalism. The search was based on a systematic review of peer-reviewed literature (previous 5 years), dissertations, and nonpeer-reviewed reports (‘gray’ literature) dealing with the PA and nutritional status of South African children and youth 6−18 years of age. Key indicators were identified and data extracted. Grades for each indicator were discussed and assigned.

Results:

Overall PA levels received a D grade, as roughly 50% or more of children and youth were not meeting recommended levels. Organized sports participation fared better with a C, and government policies were promising, receiving a B. Screen time and sedentary behavior were a major concern and received a grade of F. Under- and over-weight were highlighted, but overweight is on the rise and this indicator was assigned a D grade. Most of the other indicators in South Africa remained the same or became worse so that grades declined from C- to D. In particular, sedentary behavior, soft-drink and fast food consumption, and an ineffectual regulatory environment to control advertising to children were a concern. There is need to engage parents and communities for advocacy and social mobilization.

Open access

Monika Uys, Susan Bassett, Catherine E. Draper, Lisa Micklesfield, Andries Monyeki, Anniza de Villiers, Estelle V. Lambert, and the HAKSA 2016 Writing Group

Background:

We present results of the 2016 Healthy Active Kids South Africa (HAKSA) Report Card on the current status of physical activity (PA) and nutrition in South African youth. The context in which we interpret the findings is that participation in PA is a fundamental human right, along with the right to “attainment of the highest standard of health.”

Methods:

The HAKSA 2016 Writing Group was comprised of 33 authorities in physical education, exercise science, nutrition, public health, and journalism. The search strategy was based on peer-reviewed manuscripts, dissertations, and ‘gray’ literature. The core PA indicators are Overall Physical Activity Level; Organized Sport Participation; Active and Outdoor Play; Active Transportation; Sedentary Behaviors; Family and Peer Influences; School; Community and the Built Environment; and National Government Policy, Strategies, and Investment. In addition, we reported on Physical Fitness and Motor Proficiency separately. We also reported on nutrition indicators including Overweight and Under-nutrition along with certain key behaviors such as Fruit and Vegetable Intake, and policies and programs including School Nutrition Programs and Tuck Shops. Data were extracted and grades assigned after consensus was reached. Grades were assigned to each indicator ranging from an A, succeeding with a large majority of children and youth (81% to 100%); B, succeeding with well over half of children and youth (61% to 80%); C, succeeding with about half of children and youth (41% to 60%); D, succeeding with less than half but some children and youth (21% to 40%); and F, succeeding with very few children and youth (0% to 20%); INC is inconclusive.

Results:

Overall PA levels received a C grade, as we are succeeding with more than 50% of children meeting recommendations. Organized Sports Participation also received a C, and Government Policies remain promising, receiving a B. Screen time and sedentary behavior were a major concern. Under- and over-weight were highlighted and, as overweight is on the rise, received a D grade.

Conclusions:

In particular, issues of food security, obesogenic environments, and access to activity-supportive environments should guide social mobilization downstream and policy upstream. There is an urgent need for practice-based evidence based on evaluation of existing, scaled up interventions.

Open access

Catherine E. Draper, Simone A. Tomaz, Susan H. Bassett, Cora Burnett, Candice J. Christie, Colleen Cozett, Monique de Milander, Soezin Krog, Andries Monyeki, Niri Naidoo, Rowena Naidoo, Alessandra Prioreschi, Cheryl Walter, Estelle Watson, and Estelle V. Lambert

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Tiago V. Barreira, Stephanie T. Broyles, Catrine Tudor-Locke, Jean-Philippe Chaput, Mikael Fogelholm, Gang Hu, Rebecca Kuriyan, Estelle V. Lambert, Carol A. Maher, José A. Maia, Timothy Olds, Vincent Onywera, Olga L. Sarmiento, Martyn Standage, Mark S. Tremblay, Peter T. Katzmarzyk, and for the ISCOLE Research Group

Background: To determine if children’s moderate to vigorous physical activity (MVPA) and sedentary time varied across levels of household income in countries at different levels of Human Development Index (HDI), consistent with the theory of epidemiological transition. Methods: Data from 6548 children (55% girls) aged 9–11 years from 12 countries at different HDI levels are used in this analysis to assess MVPA and sedentary time (measured using ActiGraph accelerometers) across levels of household income. Least-square means are estimated separately for boys and girls at the estimated 10th, 50th, and 90th percentiles of HDI for the sample. Results: For boys, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (both P < .002). For girls, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (all P < .01) and positively related with income at the 90th percentile (P = .04). Sedentary time is positively associated with income at the 10th percentile of HDI for boys (P = .03), but not for girls. Conclusions: Results support the possibility of an epidemiological transition in physical activity, with lower levels of MVPA observed at opposite levels of income depending on the HDI percentile. This phenomenon was not observed for sedentary time.

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Catherine E. Draper, Simone A. Tomaz, Linda Biersteker, Caylee J. Cook, Jacqui Couper, Monique de Milander, Kamesh Flynn, Sonja Giese, Soezin Krog, Estelle V. Lambert, Tamarin Liebenberg, Cyndi Mendoza, Terri Nunes, Anita Pienaar, Alessandra Priorieschi, Dale E. Rae, Nafeesa Rahbeeni, John J. Reilly, Louis Reynolds, Marie-Louise Samuels, Ricardo Siljeur, Jody Urion, Mariza van Wyk, and Anthony D. Okely

Background: In December 2018, the South African 24-hour movement guidelines for birth to 5 years were released. This article describes the process used to develop these guidelines. Methods: The Grading of Recommendations Assessment, Development, and Evaluation-ADOLOPMENT approach was followed, with some pragmatic adaptions, using the Australian guidelines for the early years as a starting point. A consensus panel, including stakeholders in early childhood development and academics, was formed to assist with the development process. Results: At a face-to-face meeting of the panel, global and local literatures were considered. Following this meeting, a first draft of the guidelines (including a preamble) was formulated. Further reviews of these drafts by the panel were done via e-mail, and a working draft was sent out for stakeholder consultation. The guidelines and preamble were amended based on stakeholder input, and an infographic was designed. Practical “tips” documents were also developed for caregivers of birth to 5-year-olds and early childhood development practitioners. The guidelines (and accompanying documents) were released at a launch event and disseminated through various media channels. Conclusions: These are the first movement guidelines for South African and the first such guidelines for this age group from a low- and middle-income country.