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  • Author: Dori Rosenberg x
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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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Dori E. Rosenberg, Jacqueline Kerr, James F. Sallis, Gregory J. Norman, Karen Calfas and Kevin Patrick

The authors tested the feasibility and acceptability, and explored the outcomes, of 2 walking interventions based on ecological models among older adults living in retirement communities. An enhanced intervention (EI) was compared with a standard walking intervention (SI) among residents in 4 retirement facilities (N = 87 at baseline; mean age = 84.1 yr). All participants received a walking intervention including pedometers, printed materials, and biweekly group sessions. EI participants also received phone counseling and environmental-awareness components. Measures included pedometer step counts, activities of daily living, environment-related variables, physical function, depression, cognitive function, satisfaction, and adherence. Results indicated improvements among the total sample for step counts, neighborhood barriers, cognitive function, and satisfaction with walking opportunities. Satisfaction and adherence were high. Both walking interventions were feasible to implement among facility-dwelling older adults. Future studies can build on this multilevel approach.

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Dori E. Rosenberg, Gregory J. Norman, Nicole Wagner, Kevin Patrick, Karen J. Calfas and James F. Sallis

Background:

Sedentary behavior is related to obesity, but measures of sedentary behaviors are lacking for adults. The purpose of this study was to examine the reliability and validity of the Sedentary Behavior Questionnaire (SBQ) among overweight adults.

Methods:

Participants were 49 adults for the 2 week test-retest reliability study (67% female, 53% white, mean age = 20) and 401 overweight women (mean age = 41, 61% white) and 441 overweight men (mean age = 44, 81% white) for the validity study. The SBQ consisted of reports of time spent in 9 sedentary behaviors. Outcomes for validity included accelerometer measured inactivity, sitting time (International Physical Activity Questionnaire), and BMI. Intraclass correlation coefficients (ICCs) assessed reliability and partial correlations assessed validity.

Results:

ICCs were acceptable for all items and the total scale (range = .51–.93). For men, there were significant relationships of SBQ items with IPAQ sitting time and BMI. For women, there were relationships between the SBQ and accelerometer inactivity minutes, IPAQ sitting time, and BMI.

Conclusions:

The SBQ has acceptable measurement properties for use among overweight adults. Specific measures of sedentary behavior should be included in studies and population surveillance.

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Dori E. Rosenberg, Fiona C. Bull, Alison L. Marshall, James F. Sallis and Adrian E. Bauman

Purpose:

This study explored definitions of sedentary behavior and examined the relationship between sitting time and physical inactivity using the sitting items from the International Physical Activity Questionnaire (IPAQ).

Methods:

Participants (N = 289, 44.6% male, mean age = 35.93) from 3 countries completed self-administered long- and short-IPAQ sitting items. Participants wore accelero-meters; were classified as inactive (no leisure-time activity), insufficiently active, or meeting recommendations; and were classified into tertiles of sitting behavior.

Results:

Reliability of sitting time was acceptable for men and women. Correlations between total sitting and accelerometer counts/min <100 were significant for both long (r = .33) and short (r = .34) forms. There was no agreement between tertiles of sitting and the inactivity category (kappa = .02, P = .68).

Conclusion:

Sedentary behavior should be explicitly measured in population surveillance and research instead of being defined by lack of physical activity.

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Rachel A. Millstein, Katherine D. Hoerster, Dori E. Rosenberg, Karin M. Nelson, Gayle Reiber and Brian E. Saelens

Background:

Sedentary behavior is an increasingly recognized health risk factor, independent of physical activity. Although several correlates of sedentary behavior are known, little research has identified them among U.S. veterans, a population that faces disproportionate chronic disease burden.

Methods:

A survey was mailed to 1997 randomly selected veterans at a large urban Veterans Affairs medical center in 2012 and remailed in 2013 to nonresponders, resulting in a 40% response rate. We examined individual-, social-, and neighborhood-level factors in association with self-reported sitting time. Factors correlated with sitting time at P < .05 were included in a multiple linear regression model.

Results:

In the multivariate model, higher depression (B = 7.8), body mass index (B = 5.1), functional impairment (B = 4.2), and self-rated health (B = 68.5) were significantly associated with higher sitting time, and leisure time physical activity (B = –0.10) and being employed (B = –71.3) were significantly associated with lower sitting time.

Conclusions:

Individual-level, but not social- and neighborhood-level, variables were associated with sitting time in this population. This study identified individual-level targets for reducing sitting time and improving overall health among veterans.

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Simon Marshall, Jacqueline Kerr, Jordan Carlson, Lisa Cadmus-Bertram, Ruth Patterson, Kari Wasilenko, Katie Crist, Dori Rosenberg and Loki Natarajan

The purpose of this study was to compare estimates of sedentary time on weekdays vs. weekend days in older adults and determine if these patterns vary by measurement method. Older adults (N = 230, M = 83.5, SD = 6.5 years) living in retirement communities completed a questionnaire about sedentary behavior and wore an ActiGraph accelerometer for seven days. Participants engaged in 9.4 (SD = 1.5) hr per day of accelerometer-measured sedentary time, but self-reported engaging in 11.4 (SD = 4.9) hr per day. Men and older participants had more accelerometer-measured sedentary time than their counterparts. The difference between accelerometer-measured weekday and weekend sedentary time was nonsignificant. However, participants self-reported 1.1 hr per day more sedentary time on weekdays compared with weekend days. Findings suggest self-reported but not accelerometer-measured sedentary time should be investigated separately for weekdays and weekend days, and that self-reports may overestimate sedentary time in older adults.

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Diane K. King, Peg Allen, Dina L. Jones, David X. Marquez, David R. Brown, Dori Rosenberg, Sarah Janicek, Laila Allen and Basia Belza

Background:

Midlife and older adults use shopping malls for walking, but little research has examined mall characteristics that contribute to their walkability.

Methods:

We used modified versions of the Centers for Disease Control and Prevention (CDC)-Healthy Aging Research Network (HAN) Environmental Audit and the System for Observing Play and Recreation in Communities (SOPARC) tool to systematically observe 443 walkers in 10 shopping malls. We also observed 87 walkers in 6 community-based nonmall/nongym venues where older adults routinely walked for physical activity.

Results:

All venues had public transit stops and accessible parking. All malls and 67% of nonmalls had wayfinding aids, and most venues (81%) had an established circuitous walking route and clean, well-maintained public restrooms (94%). All venues had level floor surfaces, and one-half had benches along the walking route. Venues varied in hours of access, programming, tripping hazards, traffic control near entrances, and lighting.

Conclusions:

Despite diversity in location, size, and purpose, the mall and nonmall venues audited shared numerous environmental features known to promote walking in older adults and few barriers to walking. Future research should consider programmatic features and outreach strategies to expand the use of malls and other suitable public spaces for walking.

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Basia Belza, Christina E. Miyawaki, Peg Allen, Diane K. King, David X. Marquez, Dina L. Jones, Sarah Janicek, Dori Rosenberg and David R. Brown

Mall walking has been a popular physical activity for decades. However, little is known about why mall managers support these programs or why adults choose to walk. Our study aim was to describe mall walking programs from the perspectives of walkers, managers, and leaders. Twenty-eight walkers, 16 walking program managers, and six walking program leaders from five states participated in a telephone or in-person semi-structured interview (N = 50). Interview guides were developed using a social-ecological model. Interviews were recorded, transcribed verbatim, and analyzed thematically. All informants indicated satisfaction with their program and environmental features. Differences in expectations were noted in that walkers wanted a safe, clean, and social place whereas managers and leaders felt a need to provide programmatic features. Given the favorable walking environments in malls, there is an opportunity for public health professionals, health care organizations, and providers of aging services to partner with malls to promote walking.

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Michael J. LaMonte, I-Min Lee, Eileen Rillamas-Sun, John Bellettiere, Kelly R. Evenson, David M. Buchner, Chongzhi Di, Cora E. Lewis, Dori E. Rosenberg, Marcia L. Stefanick and Andrea Z. LaCroix

Background: Limited data are available regarding the correlation between questionnaire and device-measured physical activity (PA) and sedentary behavior (SB) in older women. Methods: We evaluated these correlations in 5,992 women, aged 63 and older, who completed the Women’s Health Initiative (WHI) and Community Healthy Activities Model Program for Seniors (CHAMPS) PA questionnaires and the CARDIA SB questionnaire prior to wearing a hip-worn accelerometer for 7 consecutive days. Accelerometer-measured total, light, and moderate-to-vigorous PA (MVPA), and total SB time were defined according to cutpoints established in a calibration study. Spearman coefficients were used to evaluate correlations between questionnaire and device measures. Results: Mean time spent in PA and SB was lower for questionnaire than accelerometer measures, with variation in means according to age, race/ethnicity, body mass index, and functional status. Overall, correlations between questionnaires and accelerometer measures were moderate for total PA, MVPA, and SB (r ≈ 0.20–0.40). Light intensity PA correlated weakly for WHI (r ≈ 0.01–0.06) and was variable for CHAMPS (r ≈ 0.07–0.22). Conclusion: Questionnaire and accelerometer estimates of total PA, MVPA, and SB have at best moderate correlations in older women and should not be assumed to be measuring the same behaviors or quantity of behavior. Light intensity PA is poorly measured by questionnaire. Because light intensity activities account for the largest proportion of daily activity time in older adults, and likely contribute to its health benefits, further research should investigate how to improve measurement of light intensity PA by questionnaires.