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  • Author: Elisabeth Winkler x
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Hiroko Shimura, Elisabeth Winkler and Neville Owen

Background:

We examined associations of individual, psychosocial and environmental characteristics with 4-year changes in walking among middle-to-older aged adults; few such studies have employed prospective designs.

Methods:

Walking for transport and walking for recreation were assessed during 2003–2004 (baseline) and 2007–2008 (follow-up) among 445 adults aged 50–65 years residing in Adelaide, Australia. Logistic regression analyses examined predictors of being in the highest quintile of decline in walking (21.4 minutes/day or more reduction in walking for transport; 18.6 minutes/day or more reduction in walking for recreation).

Results:

Declines in walking for transport were related to higher level of walking at baseline, low perceived benefits of activity, low family social support, a medium level of social interaction, low sense of community, and higher neighborhood walkability. Declines in walking for recreation were related to higher level of walking at baseline, low self-efficacy for activity, low family social support, and a medium level of available walking facilities.

Conclusions:

Declines in middle-to-older aged adults’ walking for transport and walking for recreation have differing personal, psychosocial and built-environment correlates, for which particular preventive strategies may be developed. Targeted campaigns, community-based programs, and environmental and policy initiatives can be informed by these findings.

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Hiroko Shimura, Takemi Sugiyama, Elisabeth Winkler and Neville Owen

Background:

Neighborhood walkability shows significant positive relationship with residents’ walking for transport in cross-sectional studies. We examined prospective relationships of neighborhood walkability with the change in walking behaviors over 4 years among middle-to-older aged adults (50–65 years) residing in Adelaide, Australia.

Methods:

A baseline survey was conducted during 2003–2004, and a follow-up survey during 2007–2008. Walking for transport and walking for recreation were assessed at both times among 504 adults aged 50–65 years living in objectively determined high- and low-walkable neighborhoods. Multilevel linear regression analyses examined the associations of neighborhood walkability with changes over 4 years in walking for transport and walking for recreation.

Results:

On average, participants decreased their time spent in walking for transport (–4.1 min/day) and for recreation (–3.7 min/day) between the baseline and 4-year follow-up. However, those living in high-walkable neighborhoods showed significantly smaller reduction (adjusted mean change: –1.1 min/day) in their time spent in walking for transport than did those living in low-walkable neighborhoods (–6.7 min/day). No such statistically-significant differences were found with the changes in walking for recreation.

Conclusions:

High-walkable neighborhoods may help middle-to-older aged adults to maintain their walking for transport.

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Winnie Y.H. Lee, Bronwyn K. Clark, Elisabeth Winkler, Elizabeth G. Eakin and Marina M. Reeves

Background:

This study evaluated the responsiveness to change in physical activity of 2 self-report measures and an accelerometer in the context of a weight loss intervention trial.

Methods:

302 participants (aged 20 to 75 years) with type 2 diabetes were randomized into telephone counseling (n = 151) or usual care (n = 151) groups. Physical activity (minutes/week) was assessed at baseline and 6-months using the Active Australia Survey (AAS), the United States National Health Interview Survey (USNHIS) walking for exercise items, and accelerometer (Actigraph GT1M; ≥1952 counts/minute). Responsiveness to change was calculated as responsiveness index (RI), Cohen’s d (postscores) and Cohen’s d (change-scores).

Results:

All instruments showed significant improvement in the intervention group (P < .001) and no significant change for usual care (P > .05). Accelerometer consistently ranked as the most responsive instrument while the least responsive was the USHNIS (responsiveness index) or AAS (Cohen’s d). RIs for AAS, USNHIS and accelerometer did not differ significantly and were, respectively: 0.45 (95% CI: 0.26–0.65); 0.38 (95% CI: 0.20–0.56); and, 0.49 (95% CI: 0.23–0.74).

Conclusions:

Accelerometer tended to have the highest responsiveness but differences were small and not statistically significant. Consideration of factors, such as validity, feasibility and cost, in addition to responsiveness, is important for instrument selection in future trials

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Marina M. Reeves, Alison L. Marshall, Neville Owen, Elisabeth A.H. Winkler and Elizabeth G. Eakin

Background:

We compared the responsiveness to change (prepost intervention) of 3 commonly-used self-report measures of physical activity.

Methods:

In a cluster-randomized trial of a telephone-delivered intervention with primary care patients, physical activity was assessed at baseline and 4 months (n = 381) using the 31-item CHAMPS questionnaire; the 6-item Active Australia Questionnaire (AAQ); and, 2 walking for exercise items from the US National Health Interview Survey (USNHIS). Responsiveness to change was calculated for frequency (sessions/week) and duration (MET·minutes/week) of walking and moderate-to-vigorous intensity physical activity.

Results:

The greatest responsiveness for walking frequency was found with the USNHIS (0.45, 95% CI: 0.19, 0.72) and AAQ (0.43, 95% CI: 0.19, 0.67), and for walking duration with the USNHIS (0.27, 95%CI 0.13, 0.41) and CHAMPS (0.24, 95% CI: 0.12, 0.36). For moderate-to-vigorous activity, responsiveness for frequency was slightly higher for the AAQ (0.50, 95% CI: 0.30, 0.69); for duration it was slightly higher for CHAMPS (0.32, 95% CI: 0.17, 0.47).

Conclusions:

In broad-reach trials, brief self-report measures (USNHIS and AAQ) are useful for their comparability to population physical activity estimates and low respondent burden. These measures can be used without a loss in responsiveness to change relative to a more detailed self-report measure (CHAMPS).

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Bronwyn K. Clark, Nyssa T. Hadgraft, Takemi Sugiyama and Elisabeth A. Winkler

The office is a key setting for intervening to reduce sitting, therefore office-specific activity measures are needed to evaluate interventions. We tested whether valid measures of office time and office-specific activities could be obtained using Bluetooth sensing with a variety of sampling intervals, receiver wear positions, and beacon placements. Workers from one building (n = 29, 72% female, age 23–68 years) wore, for one workday, the activPAL3 on the thigh (measured sitting, standing and stepping) and the Bluetooth-enabled ActiGraph Link on the wrist and thigh. Location (office/not) was estimated by Bluetooth signal presence/absence at two beacons in the wearer’s office (desk, wall), with chest-worn video cameras as the criterion. Accuracy in location classification was assessed and compared across 60-s, 30-s, and 10-s sampling intervals. The validity of Bluetooth-derived measures of total time in the office and in office-specific activities was assessed. For both the wrist and thigh-worn Link, with various beacon placements, accurate classification of location (office/not) was obtained, with a significant (p < .05) but trivial difference in accuracy across sampling interval options (F scores all ≈ .98). With the 60-s sampling interval, mean absolute percent error was very small for office time and office sitting time (<5%), but higher for infrequent activities: standing (17%–23%), incidental stepping (30%–49%), and purposeful walking (57%–86%). The ActiGraph Link can be used to validly measure office time and office location of activity with a 60-s Bluetooth setting. Higher resolution improves accuracy but not to a meaningful degree.