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

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Olga Sarmiento, Andrea Torres, Enrique Jacoby, Michael Pratt, Thomas L. Schmid and Gonzalo Stierling

Background:

The Ciclovía-Recreativa is a free, community-based program in which streets are closed temporarily to motorized transport, allowing access to walkers, runners, rollerbladers, and cyclists only. We assessed existing information about the Ciclovía as a public health strategy and proposed next steps for research and public health practice.

Methods:

We conducted a systematic search of peer-reviewed and other literature, which was complemented by expert interviews and consultation.

Results:

We reviewed 38 Ciclovías from 11 countries. Most programs (84.2%) take place in urban settings. The programs range from 18−64 events per year (54 ± 24.6; 52 [mean ± standard deviation; median]) with events lasting from 2−12 hours (6 ± 2.4; 6). The length of the streets ranges from 1−121 km (14.6 ± 22.1; 7), and the estimated number of participants per event ranges from 60-1,000,000 persons (61,203 ± 186,668; 3810). Seventy-one percent of the programs include physical activity classes and in 89% of the Ciclovías, the streets are connected with parks.

Conclusions:

Ciclovías have potential for positive public health outcomes, but evidence on their effectiveness is limited. The different stages of new and established programs offer a unique opportunity for transnational studies aimed at assessing their public health impact.

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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.

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Michael J. Saunders, Rebecca W. Moore, Arie K. Kies, Nicholas D. Luden and Casey A. Pratt

This study examined whether a carbohydrate + casein hydrolysate (CHO+ProH) beverage improved time-trial performance vs. a CHO beverage delivering ~60 g CHO/hr. Markers of muscle disruption and recovery were also assessed. Thirteen male cyclists (VO2peak = 60.8 ± 1.6 ml · kg−1 · min−1) completed 2 computer-simulated 60-km time trials consisting of 3 laps of a 20-km course concluding with a 5-km climb (~5% grade). Participants consumed 200 ml of CHO (6%) or CHO+ProH beverage (6% + 1.8% protein hydrolysate) every 5 km and 500 ml of beverage immediately postexercise. Beverage treatments were administered using a randomly counterbalanced, double-blind design. Plasma creatine phosphokinase (CK) and muscle-soreness ratings were assessed immediately before and 24 hr after cycling. Mean 60-km times were 134.4 ± 4.6 and 135.0 ± 4.0 min for CHO+ProH and CHO beverages, respectively. All time differences between treatments occurred during the final lap, with protein hydrolysate ingestion explaining a significant (p < .05) proportion of betweentrials differences over the final 20 km (44.3 ± 1.6, 45.0 ± 1.6 min) and final 5 km (16.5 ± 0.6, 16.9 ± 0.6 min). Plasma CK levels and muscle-soreness ratings increased significantly after the CHO trial (161 ± 53, 399 ± 175 U/L; 15.8 ± 5.1, 37.6 ± 5.7 mm) but not the CHO+ProH trial (115 ± 21, 262 ± 88 U/L; 20.9 ± 5.3, 32.2 ± 7.1 mm). Late-exercise time-trial performance was enhanced with CHO+ProH beverage ingestion compared with a beverage containing CHO provided at maximal exogenous oxidation rates during exercise. CHO+ProH ingestion also prevented increases in plasma CK and muscle soreness after exercise.

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