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James F. Sallis and Kevin Patrick

The International Consensus Conference on Physical Activity Guidelines for Adolescents convened to review the effects of physical activity on the health of adolescents, to establish age-appropriate physical activity guidelines, and to consider how these guidelines might be implemented in primary health care settings. Thirty-four invited experts and representatives of scientific, medical, and governmental organizations established two main guidelines. First, all adolescents should be physically active daily or nearly every day as part of their lifestyles. Second, adolescents should engage in three or more sessions per week of activities that last 20 min or more and that require moderate to vigorous levels of exertion. Available data suggest that the vast majority of U.S. adolescents meet the first guideline, but only about two thirds of boys and one half of girls meet the second guideline. Physical activity has important effects on the health of adolescents, and the promotion of regular physical activity should be a priority for physicians and other health professionals.

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Kevin Patrick, Michael Pratt and Robert E. Sallis

Background:

Healthcare professionals are influential sources of health information and guidance for people of all ages. However healthcare providers do not routinely address physical activity (PA). Engaging health professionals in a national plan for physical activity will depend upon whether proven strategies can be found to promote PA within clinical settings.

Methods:

The literature on promoting PA in healthcare settings was reviewed, as were recommendations from healthcare organizations and evidence-gathering entities about whether and how PA should be promoted in healthcare.

Key recommendations:

Evidence is mixed about whether interventions based in healthcare settings and offered by healthcare providers can improve PA behaviors in patients. Brief stand-alone counseling by physicians has not been shown to be efficacious, but office-based screening and advice to be active, followed by telephone or community support for PA has proven effective in creating lasting PA behavior improvement. Healthcare delivery models that optimize the organization of services across clinical and community resources may be very compatible with PA promotion in health care. Because of the importance of PA to health, healthcare providers are encouraged to consider adding PA as a vital sign for each medical visit for individuals aged 6 years and older.

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James F. Sallis, Kevin Patrick and Barbara J. Long

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Maura Reilly, Guadalupe X. Ayala, John P. Elder and Kevin Patrick

Background:

Research suggests that individuals who talk with their physicians about lifestyle behaviors are more physically active. Research on this topic is limited in the U.S. Latino population. This study examines doctor-patient communication from the perspective of enrollees in a physical activity (PA) intervention.

Methods:

Three hundred and eighty-seven Latinos were surveyed at program enrollment. Analysis examined the extent to which physician communication about healthy lifestyles and weight was associated with self-reported PA, including leisure-time PA (LTPA), transportation PA (TPA), and occupational PA (OPA). Physician communication included asking, advising, and assisting.

Results:

Most of the respondents reported no LTPA (46%) and no TPA (60%). The percent reporting no occupational activity, which included housework if a homemaker, was lower at 36%. Greater physician assistance was associated with a greater likelihood of doing any LTPA (P ≤ .05). A similar trend was observed for TPA (P ≤ .10).

Conclusions:

Latinos who reported physician assistance to engage in healthy lifestyle behaviors reported more LTPA. Providers who assist their patients in obtaining resources to support PA have the potential to increase levels of PA.

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Kevin S. Spink, Karen Chad, Nazeem Muhajarine, Louise Humbert, Patrick Odnokon, Catherine Gryba and Kristal Anderson

This study examined the relationship between intrapersonal correlates and being sufficiently active for health benefits in youth and adolescents (12-17 years of age). Participants completed questionnaires that assessed physical activity in the form of energy expenditure and intrapersonal correlates. Being in the sufficiently active group (> 8 kcal per day per kg of body weight) was associated with engaging in a greater array of physical activities, reporting greater levels of health, reporting a better home life, and spending less time in sedentary activities. The results provided preliminary evidence that selected intrapersonal correlates were associated with youth and adolescents who were sufficiently active to attain health benefits.

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Kevin S. Spink, Christopher A. Shields, Karen Chad, Patrick Odnokon, Nazeem Muhajarine and Louise Humbert

The present study examines whether the correlates of physical activity relevant to sufficiently active youth and adolescents differed as a function of type (structured or unstructured) of physical activity. Participants completed measures of physical activity and activity correlates. The most frequently cited correlates were enjoyment, friends’ participation, and friends’ support. Significant differences were found across type of activity for enjoyment, perceived competence, parental support, coaches’ support, and friends’ participation. The results provide insight into the correlates of physical activity in this population and provide preliminary evidence that different correlates may be associated with different activities.

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Gregory J. Norman, Sandra K. Nutter, Sherry Ryan, James F. Sallis, Karen J. Calfas and Kevin Patrick

Background:

Neighborhood-level environmental features have been associated with adult physical activity and weight status, but this link has not been established for adolescents.

Methods:

Community design and access to recreational facilities variables were derived using geographic information systems (GIS) for 799 adolescents (age 11 to 15 y, mean = 12.8 y, 53% girls, 43% ethnic minority). Environment variables were calculated for a 1-mile buffer around each participant’s residence. Accelerometers measured min/d of physical activity.

Results:

Number of nearby recreation facilities and number of nearby parks correlated positively with girls’ physical activity, and intersection density inversely related to girls’ physical activity. Retail floor area ratio correlated positively with boys’ physical activity. No community design or access to recreation variables were related to BMI-percentile.

Conclusions:

There was limited evidence that both community design and access to recreation facilities variables were associated with adolescent physical activity, but additional built environment variables need to be studied that have particular relevance for youth.

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Suzanna M. Martinez, Elva M. Arredondo, Scott Roesch, Kevin Patrick, Guadalupe X. Ayala and John P. Elder

Background:

U.S. Latinos engage in nonleisure-time walking (NLTW) more than other ethno-racial groups. Studies are needed to explore factors associated with NLTW to inform interventions for effective physical activity promotion.

Purpose:

To examine the social-ecological correlates of NLTW among Mexican-origin Latinos.

Methods:

Individual, social, and environmental level factors and PA were assessed in a telephone survey completed by 672 Mexican-origin adults randomly sampled in San Diego County. Data were collected in 2006 and analyzed in 2009.

Results:

Participants were mostly female (71%), with an average age of 39 years. Less than one-third met PA guidelines for NLTW (29%). Structural equation modeling showed that NLTW was positively associated with being female, but negatively associated with living in the U.S. ≥ 12 years, and being U.S.-born.

Conclusions:

In this sample NLTW differed by various indicators of acculturation and gender. These findings might help inform the development of interventions to promote NLTW and thus physical activity in Mexican-origin adults.

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Dori E. Rosenberg, Gregory J. Norman, Nicole Wagner, Kevin Patrick, Karen J. Calfas and James F. Sallis

Background:

Sedentary behavior is related to obesity, but measures of sedentary behaviors are lacking for adults. The purpose of this study was to examine the reliability and validity of the Sedentary Behavior Questionnaire (SBQ) among overweight adults.

Methods:

Participants were 49 adults for the 2 week test-retest reliability study (67% female, 53% white, mean age = 20) and 401 overweight women (mean age = 41, 61% white) and 441 overweight men (mean age = 44, 81% white) for the validity study. The SBQ consisted of reports of time spent in 9 sedentary behaviors. Outcomes for validity included accelerometer measured inactivity, sitting time (International Physical Activity Questionnaire), and BMI. Intraclass correlation coefficients (ICCs) assessed reliability and partial correlations assessed validity.

Results:

ICCs were acceptable for all items and the total scale (range = .51–.93). For men, there were significant relationships of SBQ items with IPAQ sitting time and BMI. For women, there were relationships between the SBQ and accelerometer inactivity minutes, IPAQ sitting time, and BMI.

Conclusions:

The SBQ has acceptable measurement properties for use among overweight adults. Specific measures of sedentary behavior should be included in studies and population surveillance.

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Dori E. Rosenberg, Jacqueline Kerr, James F. Sallis, Gregory J. Norman, Karen Calfas and Kevin Patrick

The authors tested the feasibility and acceptability, and explored the outcomes, of 2 walking interventions based on ecological models among older adults living in retirement communities. An enhanced intervention (EI) was compared with a standard walking intervention (SI) among residents in 4 retirement facilities (N = 87 at baseline; mean age = 84.1 yr). All participants received a walking intervention including pedometers, printed materials, and biweekly group sessions. EI participants also received phone counseling and environmental-awareness components. Measures included pedometer step counts, activities of daily living, environment-related variables, physical function, depression, cognitive function, satisfaction, and adherence. Results indicated improvements among the total sample for step counts, neighborhood barriers, cognitive function, and satisfaction with walking opportunities. Satisfaction and adherence were high. Both walking interventions were feasible to implement among facility-dwelling older adults. Future studies can build on this multilevel approach.