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  • Author: Deanna M. Hoelscher x
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Andrew E. Springer, Deanna M. Hoelscher and Steven H. Kelder

Background:

Geographic differences in the prevalence of physical activity (PA) have been found among adults in the US; similar studies have not been conducted among adolescents.

Methods:

Using nationally representative cross-sectional data from the CDC’s 2003 Youth Risk Behavior Survey, we estimated the prevalence of PA and sedentary behaviors by metropolitan status and geographic region.

Results:

The prevalence of PA was lowest and prevalence of sedentary behavior highest for urban students. Students from the South reported the lowest prevalence of PA and the highest prevalence of TV watching, while students from the West generally reported the highest PA prevalence and lowest sedentary behavior prevalence. Prevalence differences ranged from < 1.0% to > 15%, with most differences falling between 5% and 10%.

Conclusions:

Findings mirror regional variations previously observed in adult PA. We need to understand factors that contribute to lower PA in youth living in the South and in urban settings.

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Leigh Ann Ganzar, Nalini Ranjit, Debra Saxton and Deanna M. Hoelscher

Background: Few studies have examined school physical activity policies to assess dose–response on student outcomes. The purpose of this study was to evaluate the association between health-promoting physical activity policies in elementary schools and physical activity behavior. Methods: In this cross-sectional study, physical activity was assessed using self-report measures in fourth-grade students in Texas (N = 1958, x = 9.66 y) from the School Physical Activity and Nutrition (SPAN) survey. School policies were assessed using the number of health-promoting policies in place taken from the SPAN School Health Survey with principals and their proxies. Multiple linear regressions adjusted for student- and school-level confounders and school clustering were performed. Results: School physical activity policies were significantly associated with student-level physical activity behavior (P < .05), even after controlling for the student- and school-level confounding variables. The interactions between physical activity policy-by-economic disadvantage (P < .01) and between physical activity policy-by-geographic strata (P < .01) were both significant, with stronger direct effects of policies on student physical activity for economically disadvantaged schools and major urban schools. Conclusion: Results from this study provide evidence for the importance of school-based health policies and practices in potentially reducing health disparities, especially in low-income and urban schools.

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Chanam Lee, Hyung Jin Kim, Diane M. Dowdy, Deanna M. Hoelscher and Marcia G. Ory

Background:

Several environmental audit instruments have been developed for assessing streets, parks and trails, but none for schools. This paper introduces a school audit tool that includes 3 subcomponents: 1) street audit, 2) school site audit, and 3) map audit. It presents the conceptual basis and the development process of this instrument, and the methods and results of the reliability assessments.

Methods:

Reliability tests were conducted by 2 trained auditors on 12 study schools (high-low income and urban-suburban-rural settings). Kappa statistics (categorical, factual items) and ICC (Likert-scale, perceptual items) were used to assess a) interrater, b) test-retest, and c) peak vs. off-peak hour reliability tests.

Results:

For the interrater reliability test, the average Kappa was 0.839 and the ICC was 0.602. For the test-retest reliability, the average Kappa was 0.903 and the ICC was 0.774. The peak–off peak reliability was 0.801. Rural schools showed the most consistent results in the peak–off peak and test-retest assessments. For interrater tests, urban schools showed the highest ICC, and rural schools showed the highest Kappa.

Conclusions:

Most items achieved moderate to high levels of reliabilities in all study schools. With proper training, this audit can be used to assess school environments reliably for research, outreach, and policy-support purposes.

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Deanna M. Hoelscher, Andrew Springer, Tiffni H. Menendez, Peter W. Cribb and Steven H. Kelder

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Casey P. Durand, Kelley K. Pettee Gabriel, Deanna M. Hoelscher and Harold W. Kohl III

Background:

The potential for adults to accrue significant physical activity through public transit use is a topic of interest. However, there are no data on analogous questions among children. The goal of this analysis was to quantify patterns of transit use and correlates of transit-related physical activity among children aged 5 to 17 years.

Methods:

Data for this cross-sectional study came from the 2012 California Household Travel Survey. Probit regressions modeled the probability of transit use; negative binomial regressions modeled minutes/day in transit-related active travel.

Results:

Public transit use accounted for 3% of trips in California in 2012. Older Hispanic youth and those residing in areas with greater housing density and county size had a higher probability of transit use. Driver licensure, home ownership, household income, and vehicles in household were negatively correlated with public transit use. Race/ethnicity, income, and transit type were correlated with time spent in active travel to/from transit.

Conclusions:

Given its importance as a source of physical activity for some children, researchers should consider assessment of public transit-related activity in physical activity measurement instruments. Efforts to encourage active travel should consider how to incorporate transit-related activity, both from a measurement perspective and as an intervention strategy.

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Katherine A. Skala, Andrew E. Springer, Shreela V. Sharma, Deanna M. Hoelscher and Steven H. Kelder

Background:

Physical education (PE) classes provide opportunities for children to be active. This study examined the associations between specific environmental characteristics (teacher characteristics; class size, duration and location; and lesson context) and elementary school-aged children’s moderate-to-vigorous activity (MVPA) during PE.

Methods:

Environmental characteristics and student activity levels were measured in 211 third-, fourth-, and fifth-grade PE classes in 74 Texas public schools using SOFIT direct observation.

Results:

Students engaged in less than half their PE class time in MVPA (38%), while approximately 25% of class time was spent in classroom management. Percent time in MVPA was significantly higher in outdoor classes compared with indoors (41.4% vs. 36.1%, P = .037). Larger (P = .044) and longer (P = .001) classes were negatively associated with percentage of MVPA and positively correlated with time spent in management (P < .001).

Conclusions:

Findings suggest that children’s activity may be influenced by environmental factors such as class size, location, and lesson contexts. These findings hold important policy implications for PE class organization and the need for strategies that maximize children’s MVPA. Further research is needed to test the causal association of these factors with student MVPA.

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Deanna M. Hoelscher, Cristina Barroso, Andrew Springer, Brian Castrucci and Steven H. Kelder

Background:

Few studies have compared physical activity (PA) and sedentary activity (SA) by grade and ethnicity, specifically including elementary school students. A cross-sectional probability-based design was used to provide data by ethnicity (African American, Hispanic, and White/Other), gender, and grade (4th, 8th, and 11th) from 2000 to 2002.

Methods:

Two validated questionnaires (elementary and secondary) assessed self-reported PA and SA. Point-prevalence estimates and 95% confidence intervals were computed.

Results:

Over 70% of students reported vigorous PA on ≥3 days/week, but <50% participated in daily physical education. A significant percentage (30% to 50%) of students reported ≥3 hours per day in SA. Fourth-grade boys and girls reported equal PA; however, 8th and 11th grade girls reported lowered vigorous PA. African American 8th- and 11th-grade boys reported the highest PA, but African American children also reported the highest prevalence of SA.

Conclusions:

Findings from this study highlight the disparities in physical and sedentary activities by gender, grade, and race/ethnicity, and the need to address these differences with programs and policy. In general, grade level and gender differences were more striking and consistent than racial/ethnic differences.

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Nicole E. Nicksic, Meliha Salahuddin, Nancy F. Butte and Deanna M. Hoelscher

Background: A growing body of research has examined the relationship between perceived neighborhood safety and parental encouragement for child physical activity (PA), yet these potential predictors have not been studied together to predict child outdoor PA. The purpose of this study is to examine these predictors and parent- and child-reported child outdoor PA. Methods: The Texas Childhood Obesity Research Demonstration study collected data from fifth-grade students attending 31 elementary schools across Austin and Houston and their parents (N = 748 parent–child dyads). Mixed-effects linear and logistic regressions stratified by gender and adjusted for sociodemographic covariates assessed associations among parental-perceived neighborhood safety, parental encouragement for child’s outdoor PA, and parent- and child-reported child’s outdoor PA. Results: Parental-perceived neighborhood safety was significantly associated with encouraging outdoor PA (P = .01) and child-reported child’s outdoor PA in boys, but not in girls. Significant associations were found between parental encouragement and child-reported outdoor PA for girls (P < .05) and parent-reported outdoor PA (P < .01) for boys and girls. Conclusions: Parent encouragement of PA and neighborhood safety are potential predictors of child outdoor PA and could be targeted in youth PA interventions.

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Shreela V. Sharma, Deanna M. Hoelscher, Steven H. Kelder, Pamela M. Diamond, R. Sue Day and Albert C. Hergenroeder

Background:

The purpose of this study was to identify pathways used by psychosocial factors to influence physical activity and bone health in middle-school girls.

Methods:

Baseline data from the Incorporating More Physical Activity and Calcium in Teens (IMPACT) study collected in 2001 to 2003 were used. IMPACT was a 1 1/2 years nutrition and physical activity intervention study designed to improve bone density in 717 middle-school girls in Texas. Structural Equations Modeling was used to examine the interrelationships and identify the direct and indirect pathways used by various psychosocial and environmental factors to influence physical activity and bone health.

Results:

Results show that physical activity self-efficacy and social support (friend, family engagement, and encouragement in physical activity) had a significant direct and indirect influence on physical activity with participation in sports teams as the mediator. Participation in sports teams had a direct effect on both physical activity (β= 0.20, P < .05) and bone health and (β=0.13, P < .05).

Conclusion:

The current study identified several direct and indirect pathways that psychosocial factors use to influence physical activity and bone health among adolescent girls. These findings are critical for the development of effective interventions for promoting bone health in this population.

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Meliha Salahuddin, Eileen Nehme, Nalini Ranjit, Young-Jae Kim, Abiodun O. Oluyomi, Diane Dowdy, Chanam Lee, Marcia Ory and Deanna M. Hoelscher

Background:

The role of parents’ perceptions of the neighborhood environment in determining children’s active commuting to and from school (ACS) is understudied. This study examined the association between parents’ perceptions of neighborhood social cohesion, perceived neighborhood safety, and their children’s ACS.

Methods:

This cross-sectional analysis (n = 857 from 81 elementary schools in Texas) examined baseline data from the Texas Childhood Obesity Prevention Policy Evaluation project. Participants had a mean age of 9.6 (0.6) years, and 50% were girls. Mixed effects logistic regression models were used to assess gender-stratified associations between parent’s perceived social cohesion and children’s ACS and their perception of neighborhood safety.

Results:

A positive significant association was observed between levels of perceived social cohesion and children’s ACS for boys (P = 0.047); however, an inverse significant association was observed among girls (P = 0.033). Parents of boys living in neighborhoods with medium to high social cohesion were more likely to perceive their neighborhood as safe compared with parents living in neighborhoods with low social cohesion, though nonsignificant. Perceived neighborhood safety for walking and biking was associated with greater ACS among boys (P = 0.003).

Conclusions:

Our study findings indicate that both social and physical environments are important factors in determining ACS among boys.