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Michael Pratt and Janet E. Fulton

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Thomas L. Schmid, Michael Pratt and Lindsay Witmer

Background:

Although policy approaches are traditionally an important element of public health efforts to address major health problems, public health policy around physical activity remains poorly defined and developed.

Methods:

After extensive literature searches and reviews of policy frameworks developed for other public health issues such as tobacco control and injury prevention, the Centers for Disease Control and Prevention hosted a series of workshops and discussions on physical activity policy.

Results:

A simple model describing relationships among policy, the environment, behavior, and health was developed, a framework for organizing and conceptualizing policy interventions was described, and priorities for public health efforts to promote physical activity were proposed.

Conclusions:

An expanded focus on physical activity policy interventions is warranted, and such efforts can complement physical activity promotion efforts at other levels. The addition of researchers with expertise in the policy sciences will enhance the work of existing multidisciplinary teams.

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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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Amy Eyler, Ross Brownson, Tom Schmid and Michael Pratt

With increasing evidence of the detrimental effects of physical inactivity, there is interest in enhancing research on policies that may influence physical activity in communities. Given the potential policy impact, a framework that organized and conceptualized policy interventions and priorities for public health efforts to promote physical activity was developed. In addition, the Physical Activity Policy Research Network (PAPRN) was formed as a way to operationalize the contents of the framework. Recommendations for future work in this area include enhancing transdisciplinary collaborations, raising the priority of policy evaluation, studying policies at all levels, and emphasizing dissemination of findings.

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Daniel Benjamin Bornstein, Russell R. Pate and Michael Pratt

Background:

Architects of the United States national physical activity plan can benefit from a thorough understanding of national physical activity plans from other nations. The purpose of this paper was to search for and analyze comprehensive national physical activity plan documents that can best inform the development of the U.S. plan.

Methods:

Electronic databases were searched for national physical activity plan documents, yielding 252 documents from 56 countries. After eliminating documents that were not written in English, did not address physical activity primarily, and did not meet our definition of a national physical activity plan, we were left with physical activity plans from 6 countries—Australia, United Kingdom, Scotland, Sweden, Northern Ireland, and Norway.

Key recommendations:

Architects of the U.S. plan can learn as much from what was present in many documents as from what was absent. Examples of recommended components of national plans have been identified and highlighted for each of the 6 countries. Missing from all but 1 national plan document was a detailed process for accountability. Providing a clear path and detailed process of accountability will assist greatly in measuring short- and long-term success of the U.S. plan.

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Russell R. Pate, Jennifer L. Gay, David R. Brown and Michael Pratt

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Pedro C. Hallal, Diana C. Parra, Mario R. Azevedo, Michael Pratt and Ross C. Brownson

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Deborah Salvo, Rodrigo S. Reis, Adriano A.F. Hino, Pedro C. Hallal and Michael Pratt

Background:

There is little understanding about which sets of environmental features could simultaneously predict intensity-specific leisure-time physical activity (LTPA) among Brazilians. The objectives were to identify the environmental correlates for intensity-specific LTPA, and to build the best-fit linear models to predict intensity-specific LTPA among adults of Curitiba, Brazil.

Methods:

Cross sectional study in Curitiba, Brazil (2009, n = 1461). The International Physical Activity Questionnaire and Abbreviated Neighborhood Environment Assessment Scale were used. Ninety-two perceived environment variables were categorized in 10 domains. LTPA was classified as walking for leisure (LWLK), moderate-intensity leisure-time PA (MLPA), vigorous-intensity leisure-time PA (VLPA), and moderate-to-vigorous intensity leisure-time PA (MVLPA). Best fitting linear predictive models were built.

Results:

Forty environmental variables were correlated to at least 1 LTPA outcome. The variability explained by the 4 best-fit models ranged from 17% (MLPA) to 46% (MVLPA). All models contained recreation areas and aesthetics variables; none included residential density predictors. At least 1 neighborhood satisfaction variable was present in each of the intensity-specific models, but not for overall MVLPA.

Conclusions:

This study demonstrates the simultaneous effect of sets of perceived environmental features on intensity-specific LTPA among Brazilian adults. The differences found compared with high-income countries suggest caution in generalizing results across settings.

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Luisa Aires, Michael Pratt, Felipe Lobelo, Rute Marina Santos, Maria Paula Santos and Jorge Mota

Background:

The objective of this study was to analyze associations of cardiorespiratory fitness (CRF) with physical activity, time spent watching television and using computer, mode of commuting to school (CS), and adiposity, by gender.

Methods:

Participants were 1708 students (53.8% girls), aged 11 to 19 years. CRF was evaluated with a 20-meter shuttle-run test using VO2max by previously published equation. Maturation stages determined by Tanner’s criteria, body mass index, and skinfolds were measured, and a questionnaire used to assess socioeconomic status, PA, television and computer time, and mode of CS. We conducted a regression analysis using CRF as the dependent variable.

Results:

CRF was independent and positively associated with physical activity [β = 0.338 (95% CI = 0.119; 0.188); P < .001] and with maturation [β = −0.876 (95% CI = 0.666; 1.087); P < .001]; independent and negatively associated with television time [β = −0.003 (95% CI = −0.005; −0.002); P < .001] and adiposity [β = −0.068 (95% CI = −0.076; −0.060); P < .001]. CRF was positively associated with CS [β = 0.337; (95% CI = 0.014; 0.741); P = .014]. No associations were found for computer time.

Conclusions:

These findings suggest that increasing overall physical activity levels through interventions in different domains such as active CS, reducing sedentary activities, such as television time, might be effective strategies for improving CRF in youth.

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Jesus Soares, Eduardo J. Simões, Luiz Roberto Ramos, Michael Pratt and Ross C. Brownson

Background:

We used data from a random telephone survey of 2045 adults in Recife, Brazil to investigate the associations of health-related quality of life (HRQoL) with selected factors.

Methods:

We generated odds ratios of 4 HRQoL measures (perception of overall health, mentally unhealthy days, physically unhealthy days, and physically and mentally unhealthy days impeding usual activities) by levels of environmental factors (number of destinations, neighborhood aesthetics, neighborhood crime safety, neighborhood traffic interference, and neighborhood walkability), physical activity behavior, and participation in the Academia da Cidade Program (ACP).

Results:

Perception of overall health was associated with age, gender, education, body mass index (BMI) level, chronic disease, and having heard or seen an ACP activity. Mentally unhealthy days were associated with age, sex, BMI level, neighborhood aesthetics, and neighborhood crime safety. Physically unhealthy days were associated with age, sex, chronic diseases, leisure time physical activity, and neighborhood crime safety, and neighborhood traffic interference. Physically and mentally unhealthy days impeding usual activities were associated with chronic disease neighborhood crime safety, and traffic interference.

Conclusions:

The associations of HRQoL with environmental factors and health promoting programs may have public health policy implications and highlight the need for additional research into HRQoL in Brazil.