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Katie M. Heinrich, Jay Maddock and Adrian Bauman

Background:

Despite clear health benefits of physical activity, previous research has been limited in linking knowledge of physical activity recommendations to actual behavior.

Methods:

Using Expectancy Theory, we examined whether an individual’s health outcome expectancies from physical activity might provide the missing link between knowledge and behavior. With data from a cross-sectional survey, we assessed differences between how much moderate physical activity people thought they needed for health benefits compared with what they thought experts recommended and the relationship of these differences to physical activity behaviors.

Results:

Our hypothesis that people with positive health outcome expectancies would report more minutes of physical activity than those with neutral or negative health outcome expectancies was supported for all self-reported physical activity behaviors (P < .001).

Conclusions:

It appears that the health outcome expectancy of needing more physical activity than recommended by experts is correlated with achieving more physical activity, regardless of type. Future research should address health outcome expectancies as a way to impact physical activity.

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Kelly R. Evenson, Fang Wen, Sarah M. Lee, Katie M. Heinrich and Amy Eyler

Background:

A Healthy People 2010 developmental objective (22-12) was set to increase the proportion of the nation's public and private schools that provide access to their physical activity spaces and facilities for all persons outside of normal school hours. The purpose of this study was to describe the prevalence of indoor and outdoor facilities at schools and the availability of those facilities to the public in 2000 and 2006.

Methods:

In 2000 and 2006, the School Health Policies and Programs Study (SHPPS) was conducted in each state and in randomly selected districts, schools, and classrooms. This analysis focused on the school level questionnaire from a nationally representative sample of public and nonpublic elementary, middle, and high schools (n = 921 in 2000 and n = 984 in 2006).

Results:

No meaningful changes in the prevalence of access to school physical activity facilities were found from 2000 to 2006, for youth or adult community sports teams, classes, or open gym.

Conclusions:

These national data indicate a lack of progress from 2000 and 2006 toward increasing the proportion of the nation's public and private schools that provide access to their physical activity facilities for all persons outside of normal school hours.

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Jay E. Maddock, Bill Reger-Nash, Katie Heinrich, Kevin M. Leyden and Thomas K. Bias

Background:

The U.S. Community Guide to Preventive Services strongly recommends changes in urban design, land use and accessibility to increase physical activity. To achieve these goals, policy change is often needed. This study assessed attitudes of decision makers in Hawaii to determine if physical activity related issues are among their priorities.

Methods:

State and county officials (n = 179) were mailed surveys. Respondents listed the three most important problems (open-ended) in Hawaii and rated the importance of 23 specified problems, of which six directly related to physical activity.

Results:

The survey was completed by 126 (70.4%) respondents. The most frequently mentioned categories for the open-ended questions were affordable housing, environment/sustainability, sprawl/traffic/population growth, and healthcare. Among the closed-ended physical activity related items, increasing traffic was ranked highest (43.9%) and fourth overall. Less than 12% of decision makers rated other physical activity issues as important.

Conclusions:

Future work is needed to increase the visibility and importance of physical activity related issues among policymakers.

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Katie M. Heinrich, Nancee N. Aki, Heidi Hansen-Smith, Mark Fenton and Jay Maddock

Background:

Policy changes were needed to reshape the built environment for active transportation.

Methods:

Using the social ecological model as a framework, the Healthy Hawaii Initiative worked with a contractor to develop a series of meetings, planning sessions, and workshops. Activities spanned 22 months between 2007 and 2009, and involved multiple stakeholders, including educational outreach for legislators and collaborative planning sessions with advocates.

Results:

Ultimately, with the help of the contractor to initiate the process, Complete Streets and Safe Routes to School (SRTS) legislation were introduced January 2009. Advocacy groups monitored bill progress, testified at hearings, and assisted in rewording the bills. The SRTS statute required the Department of Transportation (DOT) to administer the federal SRTS funds and the complete streets law tasked the state and county DOTs to adopt complete streets policies and review existing highway design standards and guidelines. Both bills were signed into law June 2009.

Conclusions:

Focusing efforts at multiple levels of the social ecological model involving champions and key stakeholders led to the successful passage of legislation supporting active transportation. Tracking policy implementation and evaluation over time will help determine actual impact on active transportation behaviors across Hawaii.