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  • Author: Kelly R. Evenson x
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Kelly R. Evenson and Jorge Mota

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Kelly R. Evenson and Sara B. Satinsky

Background:

National plans are increasingly common but infrequently evaluated. The 2010 United States National Physical Activity Plan (NPAP) provided strategies to increase population levels of physical activity. This paper describes (i) the initial accomplishments of the NPAP sector teams, and (ii) results from a process evaluation to determine how the sectors operated, their cross-sector collaboration, challenges encountered, and positive experiences.

Methods:

During 2011, a quarterly reporting system was developed to capture sector-level activities. A year-end interview derived more detailed information. Interviews with 12 sector leads were recorded, transcribed verbatim, and analyzed for common themes.

Results:

The 6 sectors worked on goals from the implementation plan that focused broadly on education, promotion, intervention, policy, collaboration, and evaluation. Through year-end interviews, themes were generated around operations, goal setting, and cross-sector collaboration. Challenges to the NPAP work included lack of funding and time, the need for marketing and promotion, and organizational support. Positive experiences included collaboration, efficiency of work, enhanced community dynamic, and accomplishments toward NPAP goals.

Conclusions:

These initial results on the NPAP sector teams can be used as a baseline assessment for future monitoring. The lessons learned may be useful to other practitioners developing evaluations around state- or national-level plans.

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Kelly R. Evenson, Amy H. Herring and Fang Wen

Background:

Few studies measure physical activity objectively or at multiple time points during postpartum. We describe physical activity at 3- and 12-months postpartum among a cohort of women using both self-reported and objective measures.

Methods:

In total, 181 women completed the 3-month postpartum measures, and 204 women completed the 12-month postpartum measures. Participants wore an ActiGraph accelerometer for 1 week and completed in-home interviews that included questions on physical activity. A cohort of 80 women participated at both time points. Poisson regression models were used to determine whether physical activity differed over time for the cohort.

Results:

For the cohort, average counts/minute were 364 at 3-months post-partum and 394 at 12-months postpartum. At both time periods for the cohort, vigorous activity averaged 1 to 3 minutes/day, and moderate activity averaged 16 minutes/day. Sedentary time averaged 9.3 hours at 3-months postpartum and 8.8 hours at 12-months postpartum, out of a 19-hour day. Average counts/minute increased and sedentary behavior declined from 3- to 12-months postpartum.

Conclusion:

Interventions are needed to help women integrate more moderate to vigorous physical activity and to capitalize on the improvements in sedentary behavior that occur during postpartum.

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Kelly R. Evenson, Kimberly B. Morland, Fang Wen and Kathleen Scanlin

This study describes moderate to vigorous physical activity (MVPA) and sedentary behavior among New York City (NYC) residents 60 years and older and compared with national United States’ estimates. Adults aged 60 or older living in NYC (n = 760) were compared with similar aged adults from the National Health and Nutrition Examination Survey (NHANES; n = 2,451 adults). Both groups wore an ActiGraph accelerometer for one week. The NYC sample recorded 13.2, 23.8, and 37.8 mean min/day of MVPA and the NHANES sample recorded 10.6, 21.1, and 39.3, depending on the definition. Sedentary behavior averaged 9.6 hr/day for the NYC sample and 9.3 hr/day for the NHANES sample. The NYC sample spent a longer proportion of time in sedentary behavior and light activities, but more time in MVPA than the NHANES sample. Urbanicity may explain some of the differences between the two samples.

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Catherine J. Vladutiu, Kelly R. Evenson and Stephen W. Marshall

Background:

Although physical activity can provide health benefits to pregnant women, population-based research on the circumstances surrounding injuries from physical activity during pregnancy is lacking.

Methods:

Physical activity and subsequent injuries among a cohort of 1469 pregnant women in North Carolina were examined prospectively from the third phase of the Pregnancy, Infection, and Nutrition Study between 2001 and 2005. Chi-square analyses were used to compare distributions of maternal characteristics among women who sustained injuries from physical activity and women who reported no injuries during pregnancy. Injury incidence rates were calculated.

Results:

Few pregnant women (N = 34) reported a physical activity-related injury during pregnancy. The rates of physical activity-related and exercise-related injuries during pregnancy were 3.2 per 1000 physical activity hours and 4.1 per 1000 exercise hours, respectively. The most common types of injuries were bruises or scrapes (55%). Among all injuries, 33% resulted from exercise and 67% resulted from nonexercise physical activities. Sixty-four percent of all injuries were due to falls.

Conclusions:

The incidence of injury from physical activity was low during pregnancy. Women should continue to be encouraged to maintain involvement in physical activity during pregnancy, while being aware of the potential for injury, particularly falls, from these activities.

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Kelly R. Evenson, Joan M. Dorn, Ricky Camplain, Russell R. Pate and David R. Brown

Background:

From 1995–2013, an 8-day Physical Activity and Public Health Course for Researchers has been offered yearly in the United States.

Methods:

In 2013, an evaluation quantified time that fellows spent in different course offerings, surveyed fellows on course impact, documented grant funding, and identified fellow participation on leading physical activity-related journals.

Results:

The number of fellows that attended the course ranged from 20 per year to 35 per year. Fellows who participated in the web survey (n = 322) agreed that the course: met their expectations (99%), had a positive impact on the physical activity research or practice work they did (98%), and helped increase their professional networking in the field (93%). Following the course, 73% of fellows had further contact with course faculty and 71% had further contact with other fellows. From the National Institutes of Health, 117 grants were awarded to 82 fellows (21% of eligible fellows). Out of 14 journals reviewed, 11 had at least 1 fellow on their staff as editor, associate editor, or editorial board member.

Conclusion:

The Physical Activity and Public Health Course for Researchers helps address a training need by providing instruction and building capacity in the US and abroad for conducting research on physical activity and public health.

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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, Semra A. Aytur, Sara B. Satinsky, Zachary Y. Kerr and Daniel A. Rodríguez

Background:

We surveyed North Carolina (NC) municipalities to document the presence of municipal walking- and bicycling-related projects, programs, and policies; to describe whether prevalence of these elements differed if recommended in a plan; and to characterize differences between urban and rural municipalities.

Methods:

We surveyed all municipalities with ≥ 5000 persons (n = 121) and sampled municipalities with < 5000 persons (216/420), with a response rate of 54% (183/337). Responses were weighted to account for the sampling design.

Results:

From a list provided, staff reported on their municipality’s use of walking- and bicycling-related elements (8 infrastructure projects, 9 programs, and 14 policies). The most commonly reported were projects on sidewalks (53%), streetscape improvements (51%), bicycle/walking paths (40%); programs for cultural/recreational/health (25%), general promotional activities (24%), Safe Routes to School (24%), and law enforcement (24%); and policies on maintenance (64%), new facility construction (57%), and restricted automobile speed or access (45%). Nearly all projects, programs, or policies reported were more likely if included in a plan and more prevalent in urban than rural municipalities.

Conclusion:

These results provide cross-sectional support that plans facilitate the implementation of walking and bicycling elements, and that rural municipalities plan and implement these elements less often than urban municipalities.

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Marit L. Bovbjerg, Anna Maria Siega-Riz, Kelly R. Evenson and William Goodnight

Background:

Previous studies report conflicting results regarding a possible association between maternal physical activity (PA) and cesarean delivery.

Methods:

Seven-day PA recalls were collected by telephone from pregnant women (n = 1205) from North Carolina, without prior cesarean, during 2 time windows: 17 to 22 weeks and 27 to 30 weeks completed gestation. PA was treated as a continuous, nonlinear variable in binomial regressions (log-link function); models controlled for primiparity, maternal contraindications to exercise, preeclampsia, pregravid BMI, and percent poverty. We examined both total PA and moderate-tovigorous PA (MVPA) at each time. Outcomes data came from medical records.

Results:

The dose-response curves between PA or MVPA and cesarean risk at 17 to 22 weeks followed an inverse J-shape, but at 27 to 30 weeks the curves reversed and were J-shaped. However, only (total) PA at 27 to 30 weeks was strongly associated with cesarean risk; this association was attenuated when women reporting large volumes of PA (> 97.5 percentile) were excluded.

Conclusion:

We did not find evidence of an association between physical activity and cesarean birth. We did, however, find evidence that associations between PA and risk of cesarean may be nonlinear and dependent on gestational age at time of exposure, limiting the accuracy of analyses that collapse maternal PA into categories.

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Aileen P. McGinn, Kelly R. Evenson, Amy H. Herring, Sara L. Huston and Daniel A. Rodriguez

Background:

Crime is one aspect of the environment that can act as a barrier to physical activity. The goals of this study were to (1) compare measures of perceived crime with observed crime and (2) examine the association between the independent and combined effects of objective and perceived crime on physical activity.

Methods:

Perceived crime and physical activity were assessed in 1659 persons via telephone survey. Crime was objectively measured in a subset of 303 survey participants.

Results:

For all types of crime, there was low agreement between objective and perceived measures. Both perceived and objectively measured crime were independently associated with leisure activities.

Conclusions:

This study suggests that perceptions and objective measures of crime are both important correlates of leisure physical activity. Evaluating both measures is necessary when examining the relationship between crime and physical activity to develop interventions that will most influence leisure physical activity levels.