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Gregory W. Heath

Background:

Regular physical activity has been demonstrated to protect against coronary heart disease, Type 2 diabetes mellitus, selected cancers, hypertension, obesity, and other chronic conditions. Therefore, the public health significance of promoting physical activity and preventing inactivity has become a well-established agenda for public health agencies at all levels.

Methods:

A secondary search of the literature, focusing on existing evidence reviews, was conducted to identify effective or promising public health physical activity interventions. Further examination of published evidence-based programs also was carried out to supplement the known evidence base. Intervention strategies were selected using criteria prescribed by each of the systematic reviews to yield categories of intervention effectiveness.

Key recommendations:

The selected physical activity interventions conformed to the domains identified by The Guide to Community Preventive Services. Recommended evidenced-based strategies from within the domain of informational approaches include 2 exemplary community-wide campaigns; mass media campaigns, represented by VERB; and an emerging practice of delivery of short physical activity messages at key community sites. Exemplary representative behavioral/social interventions include social support through organized walking clubs/partners within communities. Exemplary environmental/policy approaches include creating/enhancing access to places for physical activity with informational outreach activities and the emerging strategy of community-wide policies and planning.

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Gregory W. Heath and John Bilderback

Background: There is a paucity of studies, especially among diverse populations, demonstrating the effects of policy and environmental interventions to increase regular physical activity. The Grow Healthy Together Chattanooga project provided the opportunity to assess the impact of physical activity policy and environmental interventions on the physical activity among predominately African American children living in the inner city. Methods: Using the System for Observing Physical Activity and Recreation in Communities (SOPARC), the authors examined the physical activity of children along urban pedestrian/bike routes/trails and recreational park areas within the boundaries of the Grow Healthy Together Chattanooga communities. SOPARC data were collected at baseline (fall 2010/spring 2011) and repeated (spring 2014) in each community. Results: The SOPARC assessments yielded a total of 692 child/youth observations in 2010 and 806 observations in 2014. Children/youth observed in 2014 were greater than 2 times the odds of engaging in moderate/vigorous physical activity compared with their 2010 counterparts (odds ratio  = 2.75, 95% confidence interval, 1.43–5.32). Conclusions: The present findings support the hypothesis that policy and environmental interventions can contribute to increased physical activity levels among children/youth over ∼3-year period. These results provide evidence that improved access to “urban” pedestrian/bicycle routes/trails appears to translate into increased opportunities for physical activity among inner city children/youth.

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Gregory W. Heath and David W. Brown

Background:

Since overweight (25 ≤ BMI < 30) and obesity (BMI ≥ 30 Kg/m2) are associated with poor health-related quality of life (HRQOL) and regular physical activity is associated with higher levels of HRQOL, the authors examined the relationship between physical activity and HRQOL among overweight and obese adults (age ≥ 18 years) residing in the United States.

Methods:

Using the 2005 BRFSS survey, they examined the independent relationship between recommended physical activity and measures of HRQOL developed by the Centers for Disease Control and Prevention among 283,562 adults age 18 years or older with overweight or obesity. Measures of physical activity, height, weight, and HRQOL were self-reported. Multivariable logistic regression was used to obtain odds ratios and 95% confidence intervals adjusted for age, race/ethnicity, sex, education, smoking status, chronic disease, and body-mass index.

Results:

The proportion of adults with overweight and obesity who attained recommended levels of physical activity had higher levels of HRQOL than physically inactive adults for all age, racial/ethnic, and sex groups. After multi-variable adjustment, overweight and obese adults who met the recommended level of physical activity had higher levels of HRQOL than physically inactive adults across all age strata.

Conclusions:

These results highlight the HRQOL role that physical activity can have among overweight and obese persons despite their excess body weight.

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David W. Brown, David R. Brown, Gregory W. Heath, David G. Moriarty, Lina Balluz and Wayne H. Giles

Background:

Hypertension (HTN), which affects more than 65 million Americans, is associated with poor health-related quality of life (HRQOL). Regular physical activity (PA) has been shown to reduce blood pressure and is associated with higher levels of HRQOL.

Methods:

Using self-reports from 60,321 hypertensive adults age 18 y or older who participated in the 2003 Behavioral Risk Factor Surveillance Survey, we examined the independent relationship between engaging in recommended levels of moderate or vigorous PA and four measures of HRQOL developed by the Centers for Disease Control and Prevention.

Results:

For all age and racial/ethnic groups and both sexes, the proportion of hypertensive adults with 14 or more unhealthy days (physical or mental) in the past month was significantly lower among those who attained recommended levels of PA than among physically inactive adults.

Conclusions:

Participation in regular PA is one of several lifestyle strategies available to control and prevent HTN. These results suggest that PA is associated with higher levels of HRQOL among adults with HTN and highlight the importance of health programs that promote participation in regular PA.

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Gregory W. Heath, Ross C. Brownson, Judy Kruger, Rebecca Miles, Kenneth E. Powell, Leigh T. Ramsey and the Task Force on Community Preventive Services

Background:

Although a number of environmental and policy interventions to promote physical activity are being widely used, there is sparse systematic information on the most effective approaches to guide population-wide interventions.

Methods:

We reviewed studies that addressed the following environmental and policy strategies to promote physical activity: community-scale urban design and land use policies and practices to increase physical activity; street-scale urban design and land use policies to increase physical activity; and transportation and travel policies and practices. These systematic reviews were based on the methods of the independent Task Force on Community Preventive Services. Exposure variables were classified according to the types of infrastructures/policies present in each study. Measures of physical activity behavior were used to assess effectiveness.

Results:

Two interventions were effective in promoting physical activity (community-scale and street-scale urban design and land use policies and practices). Additional information about applicability, other effects, and barriers to implementation are provided for these interventions. Evidence is insufficient to assess transportation policy and practices to promote physical activity.

Conclusions:

Because community- and street-scale urban design and land-use policies and practices met the Community Guide criteria for being effective physical activity interventions, implementing these policies and practices at the community-level should be a priority of public health practitioners and community decision makers.