Taking Steps to a Healthier Nation: Increasing Physical Activity through Walking
Janet L. Collins and Janet E. Fulton
Physical Activity Surveillance: Providing Public Health Data for Decision Makers
Deborah A. Galuska and Janet E. Fulton
Staying on Task: Challenges of Global Physical Activity Surveillance
Michael Pratt and Janet E. Fulton
Walking and the Perception of Neighborhood Attributes Among U.S. Adults—2012
Prabasaj Paul, Susan A. Carlson, and Janet E. Fulton
The association between walking and environmental attributes depends on walking purpose. This study, based on a large survey of U.S. adults, examined the association between perceived neighborhood safety and built environment attributes, and walking for transportation and leisure.
Data were obtained on transportation and leisure-time walking, perceived neighborhood safety and built environment attributes, and demographic characteristics from the summer wave of the 2012 ConsumerStyles survey of 3951 U.S. adults. Associations were examined by demographic characteristics.
Seventy-five percent of respondents reported walking for either transportation (54%) or leisure (56%) in the past week, 59% reported no safety concern, and 36% reported absence of any built environment attribute of walkability nearby. Respondents with more education, and those who lived in metropolitan areas were more likely to report built environment attributes supportive of walking. All built environment attributes examined, as well as safety concern due to speeding vehicles, were associated with walking after adjustment for demographic characteristics.
Walking, particularly for transportation, is associated with many built environment attributes among U.S. adults. These attributes may be important to consider when designing and modifying the built environment of communities, especially those which are less walkable.
Healthy People 2010 Objectives for Physical Activity, Physical Education, and Television Viewing Among Adolescents: National Trends From the Youth Risk Behavior Surveillance System, 1999−2007
Richard Lowry, Sarah M. Lee, Janet E. Fulton, and Laura Kann
To help inform policies and programs, a need exists to understand the extent to which Healthy People 2010 objectives for physical activity, physical education (PE), and television (TV) viewing among adolescents are being achieved.
As part of the Youth Risk Behavior Surveillance System, 5 national school-based surveys were conducted biennially from 1999 through 2007. Each survey used a 3-stage cross-sectional sample of students in grades 9 to 12 and provided self-reported data from approximately 14,000 students. Logistic regression models that controlled for sex, race/ethnicity, and grade were used to analyze secular trends.
During 1999 to 2007, prevalence estimates for regular participation in moderate and vigorous physical activity, participation in daily PE classes, and being physically active in PE classes did not change significantly among female, male, white, black, or Hispanic students. In contrast, the prevalence of TV viewing for 2 or fewer hours on a school day increased significantly among female, male, white, black, and Hispanic students and among students in every grade except 12th grade.
Among US adolescents, no significant progress has been made toward increasing participation in physical activity or school PE classes; however, improvements have been made in reducing TV viewing time.
Park Access among School-Age Youth in the United States
Carmen D. Harris, Prabasaj Paul, Xingyou Zhang, and Janet E. Fulton
Fewer than 30% of U.S. youth meet the recommendation to be active > 60 minutes/day. Access to parks may encourage higher levels of physical activity.
To examine differences in park access among U.S. school-age youth, by demographic characteristics and urbanicity of block group.
Park data from 2012 were obtained from TomTom, Incorporated. Population data were obtained from the 2010 U.S. Census and American Community Survey 2006–2010. Using a park access score for each block group based on the number of national, state or local parks within one-half mile, we examined park access among youth by majority race/ethnicity, median household income, median education, and urbanicity of block groups.
Overall, 61.3% of school-age youth had park access—64.3% in urban, 36.5% in large rural, 37.8% in small rural, and 35.8% in isolated block groups. Park access was higher among youth in block groups with higher median household income and higher median education.
Urban youth are more likely to have park access. However, park access also varies by race/ethnicity, median education, and median household. Considering both the demographics and urbanicity may lead to better characterization of park access and its association with physical activity among youth.
Knowledge of the Adult and Youth 2008 Physical Activity Guidelines for Americans
Eric T. Hyde, John D. Omura, Kathleen B. Watson, Janet E. Fulton, and Susan A. Carlson
Background: To estimate the proportion of adults’ and parents’ knowledge of the adult aerobic and youth physical activity guidelines, respectively, in the United States. Methods: Data were analyzed from a national sample of adults in the 2017 ConsumerStyles survey. Prevalence of knowledge of the adult aerobic guideline (ie, 150 min/wk of moderate-intensity activity) was estimated among all respondents (n = 3910) and of the youth guideline (ie, 60 min/d of physical activity on 7 d/wk) among parents (n = 1288). Odds ratios were estimated using logistic regression models adjusting for demographic characteristics. Results: Overall, 2.5% (95% confidence interval, 2.0–3.1) of adults and 23.0% (95% confidence interval, 20.5–25.7) of parents were knowledgeable of the adult aerobic and youth guidelines, respectively. After adjustment, odds of knowledge of the adult guideline differed significantly by sex and physical activity level, whereas knowledge of the youth guideline differed by parental education level. Conclusions: Despite the release of the 2008 Physical Activity Guidelines for Americans nearly a decade ago, most US adults and parents lack knowledge of the adult aerobic and youth physical activity guidelines. Effective communication strategies may help raise awareness of current and future editions of national guidelines for physical activity.
Understanding the Demographic Differences in Neighborhood Walking Supports
Susan A. Carlson, Kathleen B. Watson, Prabasaj Paul, Thomas L. Schmid, and Janet E. Fulton
Information about how presence and usefulness of neighborhood supports for walking differs by demographic characteristics can help guide community strategies to promote walking.
Reported presence and usefulness of neighborhood supports (shops, transit stops, sidewalks, parks, interesting things to look at, well-lit at night, low crime rate, and cars following speed limit) were examined in 3973 U.S. adults who completed the 2014 SummerStyles survey.
Percentage reporting neighborhood supports as present ranged from 25.3% (SE = 0.8) for interesting things to 55.8% (SE = 1.0) for low crime rate. Percentage who reported a support as useful ranged from 24.6% (SE = 1.4) for transit stops to 79.0% (SE = 1.1) for sidewalks among those with the support. This percentage ranged from 13.4% (SE = 0.8) for transit stops to 52.8% (SE = 1.1) for shops among those without the support. One or more demographic differences were observed for the presence of each support, and the presence of all supports differed by education and metro status. Demographic patterns were less clear when examining usefulness and patterns often differed by support type and presence.
Presence and usefulness of neighborhood supports for walking can differ by type and demographic characteristics. Recognizing these difference can help communities plan and implement strategies to promote walking.
Trends in Meeting the Physical Activity Guidelines: Muscle-Strengthening Alone and Combined With Aerobic Activity, United States, 1998–2018
Eric T. Hyde, Geoffrey P. Whitfield, John D. Omura, Janet E. Fulton, and Susan A. Carlson
Background: The National Health Interview Survey is unique among US federal surveillance systems with over 20 years of consistent assessment of muscle-strengthening and aerobic activity. The authors examined trends in the prevalence of US adults who met the muscle-strengthening (2 or more days per week) and the combined muscle-strengthening and aerobic physical activity (at least 150 min/wk of moderate-intensity equivalent activity) guidelines from 1998 to 2018. Methods: The 1998–2018 National Health Interview Survey data were analyzed. Age-adjusted prevalence of meeting the muscle-strengthening and combined aerobic and muscle-strengthening guidelines by selected respondent characteristics were estimated for each year and linear and higher-order trends were assessed. Results: From 1998 to 2018, prevalence of meeting the muscle-strengthening guideline increased from 17.7% to 27.6%, and meeting the combined aerobic and muscle-strengthening guidelines increased from 14.4% to 24.0%. All subgroups demonstrated significant increases in meeting both guideline measures over this period although trends varied across the 21 years; increasing trends were more commonly sustained in the second decade of monitoring. Conclusions: Although increasing trends in prevalence of meeting the muscle-strengthening and combined guidelines are encouraging, current prevalence estimates remain low. Opportunities exist for the continued promotion of muscle-strengthening activity using evidence-based approaches.
Differences in Physical Activity Prevalence and Trends From 3 U.S. Surveillance Systems: NHIS, NHANES, and BRFSS
Susan A. Carlson, Dianna Densmore, Janet E. Fulton, Michelle M. Yore, and Harold W. Kohl III
Three U.S. surveillance systems—National Health Interview Survey (NHIS), National Health and Nutrition Examination Survey (NHANES), and Behavioral Risk Factor Surveillance System (BRFSS)—estimate physical activity prevalence.
Survey differences were examined qualitatively. Prevalence estimates by sex, age, and race/ethnicity were assessed for comparable survey periods. Trends were examined from NHIS 1998 to 2007, NHANES 1999 to 2006, and BRFSS 2001 to 2007.
Age-adjusted prevalence estimates appeared most similar for NHIS 2005 (physically active: 30.2%, inactive: 40.7%) and NHANES 2005 to 2006 (physically active: 33.5%, inactive: 32.4%). In BRFSS 2005, prevalence of being physically active was 48.3% and inactive was 13.9%. Across all systems, men were more likely to be active than women; non-Hispanic whites were most likely to be active; as age increased, overall prevalence of being active decreased. Prevalence of being active exhibited a significant increasing trend only in BRFSS 2001 to 2007 (P < .001), while prevalence of being inactive decreased significantly in NHANES 1999 to 2006 (P < .001) and BRFSS 2001 to 2007 (P < .001).
Different ways of assessing physical activity in surveillance systems result in different prevalence estimates. Before comparing estimates from different systems, all aspects of data collection and data analysis should be examined to determine if comparisons are appropriate.