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Judy Kruger, Sandra A. Ham and Serena Sanker

Background:

Physical inactivity is associated with increased morbidity and mortality. This study provides prevalence estimates of inactivity by select characteristics among older adults.

Methods:

Respondents ≥50 years of age were selected from the 2005 Behavioral Risk Factor Surveillance System (N = 185,702).

Results:

Overall, 30.0% of older adults did not engage in leisure-time physical activity. Within each racial/ethnic group, the prevalence of inactivity was highest among Hispanic men (41.9%) and women (42.4%). Among men with and without disabilities, chronic disease conditions associated with inactivity were angina or coronary artery disease. Among women with disabilities, chronic disease conditions associated with inactivity were stroke and diabetes; among women without disabilities only diabetes was significantly associated with inactivity.

Conclusion:

Regular physical activity is an important means to maintaining independence, because it substantially reduces the risk for developing many diseases; contributes to healthy bones, muscles, and joints; and can reduce the risk for falling. Health care providers are encouraged to discuss concerns regarding physical activity with their patients.

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Judy Kruger, Andrew J. Mowen and John Librett

Background:

The purposes of this study were to review surveillance of recreation and park use to determine adaptations for tracking leisure time physical activity and increasing collaboration to achieve public health goals.

Methods:

Surveillance in public health and parks and recreation and discussions at the 2006 Cooper Institute conference were reviewed.

Results:

This review suggested four actions to improve collaborative surveillance of leisure time physical activity and active park use. The proposals are to incorporate more detailed measures of leisure time physical activity and active park visits into park surveillance; include key park, recreation, and leisure items in public health surveillance; assess active park visits and leisure time physical activity more frequently; and establish public health physical activity objectives for parks and recreation and outdoor recreation participation.

Conclusions:

These proposals can facilitate collaboration between public health and parks and recreation and exploration of active park use and outdoor recreation in relation to health.

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Sandra A. Ham, Judy Kruger and Catrine Tudor-Locke

Background:

Given the evidence that regular physical activity produces substantial health benefits, participation in sports, exercise, and recreation is widely encouraged. The objective of this study was to describe participation in sports, exercise, and recreational physical activities among US adults.

Methods:

Data from 2 national surveys of respondents age 18 years and older were analyzed. Respondents to the American Time Use Survey (ATUS) from 2003 through 2005 (N = 45,246) reported all activities on 1 randomly selected survey day. Respondents to the National Health and Nutrition Examination Survey (NHANES) from 1999 through 2004 (N = 17,061) reported leisure-time physical activities in the 30 days before the interview.

Results:

One-quarter of adults participated in any sport, exercise, or recreational activity on a random day, and 60.9% of adults participated in any leisure-time activity in the previous 30 days. The most common types of activities were walking, gardening and yard work, and other forms of exercise. The sports and recreational activities had typical durations of 1/2 to 3 hours per session, and the exercise activities typically lasted 1 hour or less.

Conclusions:

The prevalence of sports, exercise, and recreational physical activities is generally low among US adults; exercise is the most commonly reported type of activity.

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Latetia V. Moore, Janet Fulton, Judy Kruger and Judith McDivitt

Background:

We estimated percentages of US adults (≥18 years) who knew that prior federal physical activity (PA) guidelines call for a minimum of 30 minutes of moderate-intensity PA most days(≥5)/week using 2003 to 2005 HealthStyles, an annual mail survey.

Methods:

10,117 participants identified “the minimum amount of moderate-intensity PA the government recommends to get overall health benefits.” Response options included 30/≥5, 20/≥3, 30/7, and 60/7 (minutes/days per week), “none of these,” and “don’t know.” The odds of correctly identifying the guideline was modeled by participant sex, age, race/ethnicity, income, education, marital status, body mass index, physical activity level, and survey year using logistic regression.

Results:

25.6% of respondents correctly identified the guideline. Women were 30% more likely to identify the guideline than men (Odds Ratio [95% Confidence Limits] (OR) = 1.28 [1.15, 1.44]). Regular PA was positively associated with identifying the guideline versus inactivity (OR = 2.08 [1.73, 2.50]). Blacks and those earning <$15,000 annually were 24% to 32% less likely to identify the guideline than whites and those earning >$60,000, respectively.

Conclusions:

Most adults did not know the previous moderate-intensity PA recommendation, which indicates a need for effective communication strategies for the new 2008 Physical Activity Guidelines for Adults.

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Susan A. Carlson, Judy Kruger, Harold W. Kohl III and David M. Buchner

Background:

Falls are a major health problem for older adults. The purpose of this study is to examine the cross-sectional association between non-occupational physical activity and falls and fall-related injuries in US adults age 65 y or older.

Methods:

Respondents age 65 y or older were selected from the 2003 Behavioral Risk Factor Surveillance System (n = 47,619).

Results:

The age-adjusted incidence of falls was significantly higher among inactive respondents (16.3%, 95% CI: 15.2–17.6) than insufficiently active (12.3%, 95% CI: 11.4–13.2) or active (12.6%, 95% CI: 11.6–13.7) respondents. After controlling for sex, age, education, and body-mass index, active and insufficiently active respondents were significantly less likely to have fallen and were significantly less likely to have had a fall-related injury than their inactive peers.

Conclusion:

These results show that active and insufficiently active older adults experience a lower incidence of falls than their inactive peers.

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Fleetwood Loustalot, Susan A. Carlson, Janet E. Fulton, Judy Kruger, Deborah A. Galuska and Felipe Lobelo

Background:

Accurate surveillance data on physical activity prevalence is important for U.S. states and territories as they develop programs and interventions to increase physical activity participation.

Methods:

Using 2007 data from the Behavioral Risk Factor Surveillance System, we estimated the percentage of U.S. adults in each U.S. state and territory who met minimum aerobic activity criteria using the 2008 Physical Activity Guidelines for Americans (2008 Guidelines) and the Healthy People 2010 criteria for physical activity. SUDAAN was used to calculate prevalence estimates and 95% confidence intervals.

Results:

The estimated prevalence of recommended aerobic activity in U.S. states and territories ranged from 44.5% to 73.3% according to 2008 Guidelines and from 30.8% to 60.0% according to Healthy People 2010 criteria. Absolute percent differences in prevalence among U.S. states and territories ranged from 11.7% to 19.1%, and relative percent differences ranged from 20.8% to 44.6%.

Conclusions:

In all U.S. states and territories, a larger proportion of U.S. adults met minimum aerobic activity criteria in the 2008 Guidelines than met corresponding criteria in Healthy People 2010. This difference, however, does not reflect an actual change in the amount of aerobic activity, but a change to the criteria for meeting 2008 Guidelines.

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Judy Kruger, Michelle M. Yore, Barbara E. Ainsworth and Caroline A. Macera

Background:

Physical activity (PA) plays a major role in maintaining energy balance. We examined the patterns of occupational activity, strength training, and lifestyle PA (low, medium, high) by sex and race among persons trying to control their weight (lose weight, stay about the same, not trying to lose/not trying to stay about the same).

Methods:

Population data (N = 9258) from a nationwide telephone survey were collected to examine PA patterns. Domains of PA were analyzed by sex and race.

Results:

Of those trying to control their weight, approximately 24.0% engaged in strengthening activities 2 to 3 d/wk. Among those trying to lose weight, 48.2% versus 42.2% of men (White and non-White, respectively) and 40.4% versus 35.1% of women (White and non-White, respectively) reported high volumes of PA.

Conclusions:

PA patterns among persons trying to control their weight vary by sex and race. Adults trying to control their weight are encouraged to increase levels of PA.

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Joseph T. Walker, Andrew J. Mowen, William W. Hendricks, Judy Kruger, James R. Morrow Jr. and Kelly Bricker

Background:

The Physical Activity in Parks Setting (PA-PS) instrument is a series of survey questions designed by a consortium of public health and leisure research scholars to gauge park-based physical activity for use in civilian, noninstitutionalized populations. This paper introduces this self-reported instrument and provides test-retest reliability results.

Methods:

Data to test the instrument reliability were collected during 2 waves in 2008 through the California Outdoor Recreation Opinions and Attitudes Telephone Survey. To conduct test-retest reliability we examined the agreement between 100 randomly reselected respondents from the first wave of respondents (n = 2004) that answered the same survey within 21 to 30 days of the initial administration.

Results:

The reliability of measures that categorized individual park use and visitation with others provided moderate levels of agreement (Kappa = 0.44 to 0.64). Questions about park features, facilities and amenity use, and specific park-based physical activity participation were of fair to substantial agreement (Kappa = 0.21 to 0.90) depending on the item in question.

Conclusion:

The results from these test-retest reliability analyses suggest the PA-PS items were reliable and should be considered in future population surveys that assess park visitation patterns and park-based physical activity levels.

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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.

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Amy Eyler, Tina Lankford, Jamie Chriqui, Kelly R. Evenson, Judy Kruger, Nancy Tompkins, Carolyn Voorhees, Susan Zieff, Semra Aytur and Ross Brownson

Background:

Trails provide opportunities for recreation, transportation and activity. The purpose of this article is to describe state legislation related to community trails, to analyze legislation content, and to evaluate legislation on inclusion of evidence-informed elements.

Methods:

State trail legislation from 2001 to 2008 was identified using online legislative databases. An analysis of evidence-informed elements included in the legislation was conducted. These elements included: funding, liability, accessibility, connectivity, and maintenance.

Results:

Of the total 991 trail bills, 516 (52.0%) were appropriations bills, of which 167 (32.2%) were enacted. We analyzed 475 (48%) nonappropriation trail bills of which 139 (29.3%) were enacted. The percentage of enactment of appropriations bills decreased over time while enactment of nonappropriations trail bills increased. Over half of the nonappropriations trail bills included at least 1 evidence-informed element, most commonly funding. Few bills contained liability, connectivity, accessibility, or maintenance.

Conclusions:

There is opportunity for providing evidence-informed information to policy-makers to potentially influence bill content. The number of bills with a funding element demonstrates that fiscal support for trails is an important policy lever that state legislatures may use to support trails. Lastly, trails should be considered in over-all state-level physical activity legislation to provide opportunities for communities to be active.