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Michelle L. Granner and Patricia A. Sharpe

Background:

Promotion of physical activity is a public health priority, and environmental factors influence physical activity behavior. Valid and reliable automated measurement tools of physical activity for assessment and evaluation within public settings are needed.

Methods:

Searches of the research literature and governmental reports from physical activity, transportation, and recreation fields were conducted to identify methods of automated counting and validation studies. The article provides a summary of (a) current methods and uses of automated counters, (b) information about validity and reliability where available, (c) strengths and limitations of each method, and (d) measurement issues.

Results:

Existing automated counting technology has strengths and limitations. Infrared sensors have been the most commonly used type of monitor and can mark date and time of passage, but are vulnerable to errors due to environmental conditions; cannot detect more than one person passing at a time; cannot identify mode of activity or distinguish among individuals; and lack consistent and adequate reliability for use in open spaces. Seismic devices and inductive loops may be useful for specific applications. More information is needed concerning the validity and reliability of infrared sensors, seismic devices, and inductive loops for confined areas. Computer imaging systems hold potential to address some of the limitations of other automated counters and for applications in both confined and open areas, but validation research is in the initial stages.

Conclusions:

Although automated monitoring is a promising method for measurement of physical activity, more research is necessary to determine the acceptable parameters of performance for each type of automated monitor and for which applications each is best suited.

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Sara Wilcox, Patricia A. Sharpe, Brent Hutto and Michelle L. Granner

Background:

Self-efficacy is a consistent correlate of physical activity, but most self-efficacy measures have not been validated in diverse populations. This study examined the construct, criterion-related, and convergent validity and internal consistency of the Self-Efficacy for Exercise Questionnaire.

Methods:

African American and Caucasian adults (N = 1919) from two adjacent counties in South Carolina were identified through a list-assisted random digit-dialed telephone survey. Psychometric properties of the measure were assessed by gender, race, age, education, and body weight subgroups.

Results:

Across all subgroups, a single-factor solution explained 93 to 98% of the common variance in an exploratory factor analysis, and all 14 items had factor loadings exceeding 0.40. Higher exercise self-efficacy was significantly associated with greater physical activity, younger age, male gender, higher education, and lower body weight, as predicted. Internal consistency was high for all subgroups (α = 0.90 to 0.94).

Conclusion:

The Self-Efficacy for Exercise Questionnaire appears to be a valid and reliable measure for use with diverse populations.

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Sara Wilcox, Melinda Forthofer, Patricia A. Sharpe and Brent Hutto

Background:

Walking interventions delivered by lay leaders have been shown to be effective. Knowing the characteristics of individuals who volunteer to be group leaders in walking programs could facilitate more efficient and effective recruitment and training.

Methods:

Walking group leaders were recruited into a community-based program and formed walking groups from existing social networks. Leaders and members completed a survey, participated in physical measurements, and wore an accelerometer. Regression models (adjusting for group clustering and covariates) tested psychosocial and behavioral differences between leaders and members.

Results:

The sample included 296 adults (86% women, 66% African American). Leaders (n = 60) were similar to members (n = 236) with respect to most sociodemographic and health characteristics, but were significantly older and more likely to report arthritis and high cholesterol (P-values < .05). Although leaders and members were similar in sedentary behavior and physical activity, leaders reported higher levels of exercise self-regulation, self-efficacy, and social support (P-values < .01). Leaders also reported greater use of outdoor trails (P = .005) and other outdoor recreation areas (P = .003) for physical activity than members.

Conclusion:

Although walking group leaders were no more active than members, leaders did display psychosocial characteristics and behaviors consistent with a greater readiness for change.

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Sara Wilcox, Cheryl Der Ananian, Patricia A. Sharpe, Jennifer Robbins and Theresa Brady

Background:

Physical activity (PA) is important for arthritis self-management. A better understanding of the PA correlates in persons with arthritis will help inform interventions.

Methods:

Computer searches were conducted on PubMed, PsychInfo, Current Contents, and Cinahl databases. Reference lists of extracted articles were also searched. Thirty-six studies published between 1976 and February 2004 met inclusion criteria.

Results:

PA correlates are presented for sociodemographic, psychological, health-related, social, and environmental categories. Self-efficacy, perceived benefits and barriers, mental well-being, prior PA, and pain received the most consistent support as PA correlates, whereas sociodemographic, social, and environmental variables were the least studied. Too few studies were conducted to allow comparisons across arthritis type or study design.

Conclusions:

We recommend that additional qualitative research be conducted to understand factors influencing PA in persons with arthritis. Prospective studies, particularly in the context of a PA program or intervention, would also be useful to better understand how barriers and enablers change over time.

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Michelle L. Granner, Patricia A. Sharpe, Brent Hutto, Sara Wilcox and Cheryl L. Addy

Background:

Few studies have explored associations of individual, social, and environmental factors with physical activity and walking behavior.

Methods:

A random-digit-dial questionnaire, which included selected individual, social, and environmental variables, was administered to 2025 adults, age 18 y and older, in two adjacent counties in a southeastern state. Logistic regressions were conducted adjusting for age, race, sex, education, and employment.

Results:

In multivariate models, somewhat different variables were associated with physical activity versus regular walking. Self-efficacy (OR = 19.19), having an exercise partner (OR = 1.47), recreation facilities (OR = 1.54), and safety of trails from crime (OR = 0.72) were associated with physical activity level; while self-efficacy (OR = 4.22), known walking routes (OR = 1.54), recreation facilities (OR = 1.57-1.59), and safety of trails from crime (OR = 0.69) were associated with regular walking behavior.

Conclusions:

Physical activity and walking behaviors were associated with similar variables in this study.

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Brent Hutto, Patricia A. Sharpe, Michelle L. Granner, Cheryl L. Addy and Steven Hooker

Background:

Question order might affect self-reported regular physical activity (PA) measured with items from the Behavioral Risk Factor Surveillance System (BRFSS) PA module.

Methods:

A telephone survey was conducted using 2 forms (N = 1004, N = 212) with varying PA question order. The standard form presented moderate-PA, vigorous-PA, and walking questions, in that order, whereas the alternate form presented walking questions, followed by moderate-PA, and then vigorous-PA questions. Weighted, adjusted rates of vigorous PA, walking, meeting the Centers for Disease Control and Prevention (CDC) recommendation for moderate or vigorous PA, and moderate PA from each form were compared.

Results:

Vigorous PA and walking were similar regardless of question order. Meeting the CDC recommendation for moderate or vigorous PA was reported less often with the alternate form among 18- to 34-year-olds. Less moderate PA was reported with the alternate form overall and among 18- to 34-year-olds, women, whites, and those with a high school education or less.

Conclusion:

Estimating PA and walking across sociodemographic strata with differing patterns of PA requires asking moderate-PA and vigorous-PA questions before walking questions. Asking walking questions first might lead to bias, especially for moderate PA. Walking, added to a survey with BRFSS moderate and vigorous PA items, should be placed after moderate and vigorous PA. Walking questions first may cause bias, especially for moderate PA.

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Melinda Forthofer, Sara Wilcox, Deborah Kinnard, Brent Hutto and Patricia A. Sharpe

Background: Social network–driven approaches have promise for promoting physical activity in community settings. Yet, there have been few direct investigations of such interventions. This study tested the effectiveness of a social network–driven, group-based walking intervention in a medically underserved community. Methods: This study used a quasi-experimental pretest–posttest design with 3 measurement time points to examine the effectiveness of Sumter County on the Move! in communities in Sumter County, SC. A total of 293 individuals participated in 59 walking groups formed from existing social networks. Participants were 86% females, 67% black, and 31% white, with a mean age of 49.5 years. Measures included perceptions of the walking groups; psychosocial factors such as self-regulation, self-efficacy, and social support; and both self-reported and objectively measured physical activity. Results: The intervention produced significant increases in goal setting and social support for physical activity from multiple sources, and these intervention effects were sustained through the final measurement point 6 months after completion of the intervention. Nonetheless, few of the desired changes in physical activity were observed. Conclusion: Our mixed results underscore the importance of future research to better understand the dose and duration of intervention implementation required to effect and sustain behavior change.

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Patricia A. Sharpe, Sara Wilcox, Laura J. Rooney, Donna Strong, Rosie Hopkins-Campbell, Jean Butel, Barbara Ainsworth and Deborah Parra-Medina

Background:

Objective measurement of physical activity with accelerometers is a challenging task in community-based intervention research. Challenges include distribution of and orientation to monitors, nonwear, incorrect placement, and loss of equipment. Data collection among participants from disadvantaged populations may be further hindered by factors such as transportation challenges, competing responsibilities, and cultural considerations.

Methods:

Research staff distributed accelerometers and provided an orientation that was tailored to the population group. General adherence strategies such as follow-up calls, daily diaries, verbal and written instructions, and incentives were accompanied by population-specific strategies such as assisting with transportation, reducing obstacles to wearing the accelerometer, tailoring the message to the participant population, and creating a nonjudgmental environment.

Results:

Sixty women asked to wear the Actigraph GT1M returned the accelerometer, and 57 of them provided sufficient data for analysis (at least 10 hours a day for a minimum of 4 days) resulting in 95% adherence to the protocol. Participants wore the accelerometers for an average of 5.98 days and 13.15 hours per day.

Conclusions:

The high accelerometer monitoring adherence among this group of economically disadvantaged women demonstrates that collection of high-quality, objective physical activity data from disadvantaged populations in field-based research is possible.