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Rod K. Dishman and Claudio Nigg

Background:

Measuring the way people vary across time in meeting recommended levels of physical activity is a prerequisite to quantifying exposure in outcome studies or identifying determinants of sufficient physical activity. The study determined whether distinct patterns of change in sufficient physical activity could be identified in a population.

Methods:

A cohort (N = 497) from a random, multiethnic sample of adults living in Hawaii was assessed every 6 months for 2 years beginning spring 2004. Latent transition analysis classified people as sufficiently or insufficiently active each time.

Results:

In the total cohort, odds that people would move from insufficient to sufficient activity (45% to 59%) at each 6-month transition were higher than odds they would move from sufficient to insufficient activity (8% to 13%). However, those odds, as well as types and amounts of physical activity, differed widely among and within 3 of 4 transition classes that represented 21% of the cohort.

Conclusions:

Point-prevalence of sufficient physical activity in the total cohort was similar to contemporary U.S. estimates. However, physical activity varied between and within subgroups of the cohort. Further research is needed using self-report and objective measures to determine patterns of change in sufficient physical activity in other representative cohorts.

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Sasha A. Fleary, Robin Mehl and Claudio Nigg

Background: Health behaviors in childhood and adolescence are implicated in health behaviors and chronic disease risk in adulthood for the majority of the US population. However, little is known about these relationships in Hawaiian youth. This study investigated the extent to which childhood physical activity (PA) and fruit and vegetable consumption behaviors predicted later behaviors across a 10-year period in Hawaiian youth. Methods: Three cohorts of fourth- to sixth-grade students who participated in an elementary after-school program (Fun 5) provided baseline data (Y1—data collected between 2003 and 2007), 5-year (Y5—data collected between 2008 and 2012), and 10-year (Y10—data collected between 2013 and 2017) follow-up surveys. Demographic, PA, and fruit and vegetable consumption measures were completed at all 3 time points. Bivariate and multiple regressions were computed in 2018. Results: Y1 and Y5 behavior predicted PA in young adulthood. For fruit and vegetable consumption, Y1 behavior predicted Y5 behavior but not Y10 behavior, and Y5 behavior predicted Y10 behaviors. Conclusions: Similar to mainland US youth, it is important to address PA and nutrition early in the life span for Hawaiian youth to increase long-term preventive health behaviors and reduce long-term chronic disease risk.

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Peter Anthamatten, Lois Brink, Beverly Kingston, Eve Kutchman, Sarah Lampe and Claudio Nigg

Background:

Careful research that elucidates how behavior relates to design in the context of elementary school grounds can serve to guide cost-efficient design with the goal of encouraging physical activity (PA). This work explores patterns in children’s PA behavior within playground spaces with the specific goal of guiding healthy playground design.

Methods:

Data on children’s utilization and PA behavior in 6 playgrounds divided into 106 observation zones were collected in 2005 and 2006 at Denver elementary school playgrounds using the System for Observing Play and Leisure Activity in Youth. Analyses of variance and t tests determined whether there were differences in utilization and behavior patterns across observations zones and between genders.

Results:

This study provides evidence that children prefer to use certain types of playground zones and that they are more likely to practice moderate-to-vigorous physical activity (MVPA) in some zones. The authors observed statistically significant differences between genders. Boys were more likely to engage in MVPA in zones without equipment, girls were more likely to use zones with equipment.

Conclusions:

This work suggests that the inclusion or omission of specific playground features may have an impact on the way that children use the spaces.

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Astrid Steinbrecher, Eva Erber, Andrew Grandinetti, Claudio Nigg, Laurence N. Kolonel and Gertraud Maskarinec

Background:

Physical inactivity is an established risk factor for diabetes; however, little is known about this association across ethnic groups with different diabetes risk. Therefore, we evaluated the association between physical activity and diabetes and potential effect modification by ethnicity in the Hawaii component of the Multiethnic Cohort.

Methods:

Participants, aged 45 to 75 years, were enrolled by completing a questionnaire on demographics, diet, and self-reported weekly hours of strenuous sports, vigorous work, and moderate activity. Among the 74,913 participants (39% Caucasian, 14% Native Hawaiian, 47% Japanese American), 8561 incident diabetes cases were identified by self-report, a medication questionnaire, and through health plan linkages. Cox regression was applied to estimate hazard ratios (HR) and 95% confidence intervals (95%CI) while adjusting for known confounders.

Results:

Engaging in strenuous sports was inversely related to diabetes risk with HRs (4+ hours/week vs. never) of 0.67 (95%CI: 0.57–0.79) in women and 0.80 (95%CI: 0.72–0.88) in men. In stratified analyses, the inverse association was consistent across ethnic groups. The inverse association of vigorous work with diabetes was limited to men, while beneficial effects of moderate activity were observed only in Caucasians.

Conclusions:

These findings support a role of high-intensity physical activity and ethnic-specific guidelines in diabetes prevention.

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Faith D. Lees, Phillip G. Clark, Claudio R. Nigg and Phillip Newman

Longer life expectancy, rapid population growth, and low exercise-participation rates of adults 65 and older justify the need for better understanding of older adults’ exercise behavior. The objectives of this focus-group study were to determine barriers to the exercise behavior of older adults. Six focus groups, three with exercisers and three with nonexercisers, were conducted at various sites throughout Rhode Island. The majority (n = 57) of the 66 individuals who participated were women, and all stated that they were 65 and older. Results from the focus-group data identified 13 barriers to exercise behavior. The most significant barriers mentioned by nonexercisers were fear of falling, inertia, and negative affect. Exercisers identified inertia, time constraints, and physical ailments as being the most significant barriers to exercise. Implications from these focus-group data can be useful in the development of exercise interventions for older adults, which could increase exercise participation.