Over the past 40 years, physical activity (PA) and public health has been established as a field of study. A robust evidence base has emerged demonstrating that participation in recommended amounts of PA results in a wide array of physical and mental health benefits. This led to the establishment of federal and global PA guidelines and surveillance programs. Strong evidence supports the efficacy of individual-level (e.g., goal setting) and environmental (e.g., policies) interventions to promote PA. There has also been progress in establishing a skilled and diverse workforce to execute the work of PA and public health. Looking forward, major challenges include stemming the obesity and chronic disease epidemics, addressing health inequities, and diversifying the workforce. Given the known benefits of PA and the availability of evidence-based interventions, efforts now must focus on implementing this knowledge to improve population health and reduce inequities through PA.
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Physical Activity and Public Health: Four Decades of Progress
Sarah K. Keadle, Eduardo E. Bustamante, and Matthew P. Buman
Preventing Suicide and Promoting Mental Health Among Student-Athletes From Diverse Backgrounds
Karrie L. Hamstra-Wright, John E. Coumbe-Lilley, and Eduardo E. Bustamante
Suicide and contributing mental health conditions in athletes are shared concerns within health care and society at large. This commentary focuses on suicide risk among athletes and the role of sports medicine professionals in preventing suicide and promoting mental health. In this commentary, we draw on the scientific literature and our clinical experiences to pose and answer these questions: Does suicide risk among athletes vary by sociodemographic factors (eg, sex, gender, race/ethnicity, family income, sexual orientation) or if injured? Do sociodemographic differences influence access to and benefits from services among athletes? How do I know my athletes are at risk for suicide? What do I do if one of my athletes shares with me that they have considered suicide? Within our commentary, we review the current literature and clinical practices regarding these questions and close with actionable suggestions and recommendations for future directions.
Active or Sedentary? Objectively Measured Physical Activity of Latinos and Implications for Intervention
David X. Marquez, Eduardo E. Bustamante, Edward McAuley, and Dawn E. Roberts
Background:
Latinos have the lowest leisure-time physical activity (LTPA) rates. However, measurement of only LTPA might underestimate total physical activity. This study compares the objective physical activity of Latinos reporting high or low levels of LTPA and also compares gender differences.
Methods:
Data were obtained from 148 Latinos (n = 83 women, n = 65 men). Freedson cut points were employed to determine daily minutes of activity.
Results:
Latinos reporting high LTPA engaged in more daily minutes of vigorous and very vigorous activity than Latinos reporting low LTPA (P values < .05). There was no difference in daily minutes of moderate-intensity activity (P = .12), with both groups of Latinos meeting Centers for Disease Control and Prevention/American College of Sports Medicine guidelines. Men engaged in more daily minutes of moderate activity than women (P < .01).
Conclusions:
Many Latinos met physical activity guidelines even when reporting low levels of LTPA. Future studies should determine whether equivalent health benefits are achieved by meeting guidelines through LTPA and non-LTPA.
Physical Activity of Urban Community-Dwelling Older Latino Adults
David X. Marquez, Ruby Hoyem, Louis Fogg, Eduardo E. Bustamante, Beth Staffileno, and JoEllen Wilbur
Background:
To date, little is known about the physical activity (PA) levels and commonly reported modes of PA of older Latinos, and this information is critical to developing interventions for this population. The purpose of the current study was to examine PA assessed by self-report and accelerometer and to assess the influence of acculturation, gender, and age on the PA of urban community-dwelling older Latino adults.
Methods:
Participants were self-identified Latinos, primarily women (73%), and individuals aged 50 to 59 (31%), 60 to 69 (30%), and 70+ (39%). PA was measured with an accelerometer and the Community Healthy Activity Model Program for Seniors (CHAMPS) PA questionnaire.
Results:
Men reported engaging in, and objectively participated in, significantly more minutes of moderate/vigorous PA than women, but women reported greater light intensity household PA. Latinos aged 50 to 59 engaged in significantly more accelerometer-assessed PA than Latinos aged 60 to 69 and 70+, respectively. The majority of participants did not meet the PA Guidelines for Americans. No differences in PA were demonstrated by acculturation level. Older Latino men and women reported walking and dancing as modes of leisure PA.
Conclusions:
These findings suggest PA interventions should be targeted toward older Latinos, taking into account gender and age.
Independent Associations of Organized Physical Activity and Weight Status with Children’s Cognitive Functioning: A Matched-Pairs Design
Catherine L. Davis, Joseph P. Tkacz, Phillip D. Tomporowski, and Eduardo E. Bustamante
Purpose:
This study tested whether participation in organized physical activity (active vs. inactive) or weight status (normal weight vs. overweight or obese) independently relate to children’s cognition, using a matched-pairs design.
Design and Methods:
Normal weight, active children (8–11 yrs, 5th-75th percentile BMI) were recruited from extracurricular physical activity programs while normal weight inactive (5th-75th percentile BMI) and overweight inactive children (BMI ≥85th percentile) were recruited from local Augusta, Georgia area schools. Measures included the Cognitive Assessment System, anthropometrics, and parent- and self-report of physical activity. Paired t tests compared cognition scores between matched groups of normal weight active vs. normal weight inactive (N = 24 pairs), normal weight inactive vs. overweight inactive (N = 21 pairs), and normal weight active vs. overweight inactive children (N = 16 pairs). Children in each comparison were matched for race, gender, age, and socioeconomic status.
Results:
Normal weight active children had higher Planning (M± SD = 109 ± 11 vs. 100 ± 11, p = .011) and Attention scores (108 ± 11 vs. 100 ± 11, p = .013) than overweight inactive children. Normal weight inactive children had higher Attention scores than overweight inactive children (105 ± 13 vs. 93 ± 12, p = .008). When compared with normal weight inactive children, normal weight active children had higher Planning (113 ± 10 vs. 102 ± 13, p = .008) and marginally higher Attention scores (111 ± 11 vs. 104 ± 12, p = .06).
Conclusion:
Findings suggest independent associations of children’s weight status with selective attention, and physical activity with higher-order processes of executive function.
Exercise and Academic Performance Among Children With Attention-Deficit Hyperactivity Disorder and Disruptive Behavior Disorders: A Randomized Controlled Trial
Jared D. Ramer, María E. Santiago-Rodríguez, Catherine L. Davis, David X. Marquez, Stacy L. Frazier, and Eduardo E. Bustamante
Purpose: To examine effects of a 10-week after-school physical activity (PA) program on academic performance of 6- to 12-year-old African American children with behavior problems. Methods: Participants were randomized to PA (n = 19) or sedentary attention control (n = 16) programs. Academic records, curriculum-based measures, and classroom observations were obtained at baseline, postintervention, and/or follow-up. Mixed models tested group × time interactions on academic records and curriculum-based measures. One-way analysis of variance or Kruskal–Wallis tested for differences in postintervention classroom observations. Results: Intent-to-treat analyses demonstrated a moderate effect within groups from baseline to postintervention on disciplinary referrals (PA: d = −0.47; attention control: d = −0.36) and a null moderate effect on academic assessments (PA: d = 0.11 to 0.36; attention control: d = 0.05 to 0.40). No significant group × time interactions emerged on direct academic assessments (all Ps ≥ .05, d = −0.23 to 0.26) or academic records (all Ps ≥ .05, d = −0.28 to 0.16). Classroom observations revealed that intervention participants were off-task due to moving at twice the rate of comparative classmates (F = 15.74, P < .001) and were off-task due to talking 33% more often (F = 1.39, P = .257). Conclusion: Academic outcome improvements were small within and between groups and did not sustain at follow-up. Academic benefits of after-school PA programs for children with attention-deficit hyperactivity disorder and/or disruptive behavior disorders were smaller than neurobiological, behavioral, and cognitive outcomes as previously reported.
Engagement in Sedentary and Physically Active After-School Programs Among African American Children with ADHD and Disruptive Behavior Disorders
Jared D. Ramer, María Enid Santiago-Rodriguez, Dana B. Rusch, Tara G. Mehta, Grace E. Cua, Stacy L. Frazier, Marc S. Atkins, Karrie L. Hamstra-Wright, and Eduardo E. Bustamante
Context: Sport and physical activity (PA) programs are an important developmental resource for youth with Attention Deficit Hyperactivity Disorder (ADHD) and Disruptive Behavior Disorders. The purpose of this study is to assess sport participation rates, PA participation, and after-school supervision rates among African American children with ADHD and/or Disruptive Behavior Disorders. Design: In this cross-sectional study, parents of African American children with elevated symptoms of ADHD, oppositional defiant disorder, and/or conduct disorder (N = 175, 6- to 12-y-old, 31% female) reported after-school program participation over the past year. Methods: Logistic regression analyses tested relationships between ADHD symptoms, oppositional defiant disorder symptoms, and conduct disorder symptoms, likelihood of regular participation (≥2 d/wk) in sport, PA, and sedentary after-school programs, and likelihood of being supervised and unsupervised after school. All regressions controlled for age, sex, income, and medication status. Sample participation rates were descriptively compared with participation rates of same-aged peers regionally, and nationally, reported in 3 national surveys. Results: Parents in the local sample reported higher rates of sedentary after-school program participation (54%) but lower rates of PA program participation (31%), and sport participation (12%) compared with same-aged peers. The local sample was less likely to be unsupervised after-school compared with same-aged peers with only 27% of parents reporting that their child was unsupervised ≥ 2 days per week. Children endorsing oppositional defiant disorder (odds ratio = 2.05; P < .05) and conduct disorder (odds ratio = 5.74; P < .05) were more likely to be unsupervised more frequently after-school as compared with those not meeting endorsement. Conclusions: Given demonstrated benefits of youth sport programming and observed inequities in participation, there is a need to develop support models that connect parents, coaches, and social services agencies to facilitate inclusion. Sports medicine professionals are uniquely positioned to contribute to these efforts, as they are often key opinion leaders in both the youth sport and health care contexts.
