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Samantha M. Ross, Ellen Smit, Joonkoo Yun, Kathleen Bogart, Bridget Hatfield, and Samuel W. Logan

Background: Children and adolescents with disabilities often report low levels of physical activity (PA). Estimating the magnitude of PA disparities has been previously challenged by underreporting and variability in subsampling of disability. Using the National Survey of Children’s Health, this study estimated the population-level PA disparities experienced and the association between disability status and PA engagement. Methods: Weighted prevalence of PA engagement (National Physical Activity Guidelines for Americans (2nd edition) and sports participation) was compared across disability groups for children (n = 20,867, 6–11 y) and adolescents (n = 28,651, 12–17 y) and found to be 12%. Age-stratified multivariable logistic regressions estimated the likelihood of PA engagement as a function of disability status and type, after adjusting for child and household factors. Results: Children, but not adolescents, with disabilities had significantly lower odds of being sufficiently active compared with peers without disabilities (adjusted odds ratio = 0.75; 95% confidence interval, 0.60–0.94). Across age groups, the lowest prevalence rates were observed among those experiencing function and mobility disabilities. Children and adolescents were significantly less likely to participate in sports compared with peers. Conclusion: Children with function and mobility disabilities were identified as priority subpopulations least likely to be sufficiently active. The disparity in sports participation highlights a critical intervention point for increasing PA among children with disabilities.

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Samantha M. Ross, Ellen Smit, Joonkoo Yun, Kathleen R. Bogart, Bridget E. Hatfield, and Samuel W. Logan

A secondary data analysis of 33,093 children and adolescents age 6–17 years (12% with disabilities) from a 2016–2017 National Survey of Children’s Health nonrepresentative sample aimed to identify (a) unique clusters of sociodemographic characteristics and (b) the relative importance of disability status in predicting participation in daily physical activity (PA) and sports. Exploratory classification tree analyses identified hierarchical predictors of daily PA and sport participation separately. Disability status was not a primary predictor of daily PA. Instead, it emerged in the fifth level after age, sex, body mass index, and income, highlighting the dynamic intersection of disability with sociodemographic factors influencing PA levels. In comparison, disability status was a second-level predictor for sport participation, suggesting that unique factors influencing PA level are likely experienced by disabled children and adolescents. The authors employ an intersectionality lens to critically discuss implications for research in adapted PA.

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Paul D. Loprinzi, Bradley J. Cardinal, Carlos J. Crespo, Gary R. Brodowicz, Ross E. Andersen, and Ellen Smit

Background:

The exclusion of participants with invalid accelerometry data (IAD) may lead to biased results and/or lack of generalizability in large population studies. The purpose of this study was to investigate whether demographic, behavioral, and biological differences occur between those with IAD and valid accelerometry data (VAD) among adults using a representative sample of the civilian noninstitutionalized U.S. population.

Methods:

Ambulatory participants from NHANES (2003−2004) who were 20−85 years of age were included in the current study and wore an ActiGraph 7164 accelerometer for 7 days. A “valid person” was defined as those with 4 or more days of at least 10+ hrs of monitoring per day. Among adults (20−85 yrs), 3088 participants provided VAD and 987 provided IAD. Demographic, behavioral, and biological information were obtained from the household interview or from data obtained in a mobile examination center.

Results:

Differences were observed in age, BMI, ethnicity, education, smoking status, marital status, use of street drugs, current health status, HDL-cholesterol, C-reactive protein, self-reported vigorous physical activity, and plasma glucose levels between those with VAD and IAD.

Conclusions:

Investigators should take into consideration the potential cut-off bias in interpreting results based on data that excludes IAD participants.

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Carlos J. Crespo, Mario R. Garcia-Palmieri, Ellen Smit, I-Min Lee, Daniel McGee, Paola Muti, Nayda R. Figueroa Valle, Farah A. Ramirez-Marrero, Jo L. Freudenheim, and Paul Sorlie

Studies on the association between physical activity and fatal prostate cancer have produced inconclusive results. The Puerto Rico Heart Health Program was a cohort study of a randomly selected sample of 9824 men age 35 to 79 years at baseline who were followed for mortality until 2002. Multiple examinations collected information on lifestyle, diet, body composition, exercise, urban-rural residence, and smoking habits. Physical activity status was measured using the Framingham Physical Activity Index, an assessment of occupational, leisure-time, and other physical activities measured as usual activity over the course of a 24-hour day. Physical activity was strati-fed into quartiles. Multivariate logistic regression analysis was used to assess the association of physical activity with prostate cancer mortality. Other covariates included age, education, urban-rural residence, smoking, and body mass index. Compared with the lowest level of physical activity (Q1), the risk of prostate cancer mortality was OR = 0.99 (95% CI = 0.64–1.55) for Q2, OR = 1.34 (95% CI = 0.88–2.05) for Q3, and OR = 1.19 (95% CI = 0.75–1.90) for Q4. Further analyses by age group, overweight status, or vigorous physical activity also did not show a significant association between physical activity and prostate cancer mortality. Physical activity did not predict prostate cancer mortality in this group of Puerto Rican men.