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Sarah M. Lee, Howell Wechsler and Allison Balling

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Richard Lowry, Sarah M. Lee, Janet E. Fulton and Laura Kann

Background:

To help inform policies and programs, a need exists to understand the extent to which Healthy People 2010 objectives for physical activity, physical education (PE), and television (TV) viewing among adolescents are being achieved.

Methods:

As part of the Youth Risk Behavior Surveillance System, 5 national school-based surveys were conducted biennially from 1999 through 2007. Each survey used a 3-stage cross-sectional sample of students in grades 9 to 12 and provided self-reported data from approximately 14,000 students. Logistic regression models that controlled for sex, race/ethnicity, and grade were used to analyze secular trends.

Results:

During 1999 to 2007, prevalence estimates for regular participation in moderate and vigorous physical activity, participation in daily PE classes, and being physically active in PE classes did not change significantly among female, male, white, black, or Hispanic students. In contrast, the prevalence of TV viewing for 2 or fewer hours on a school day increased significantly among female, male, white, black, and Hispanic students and among students in every grade except 12th grade.

Conclusions:

Among US adolescents, no significant progress has been made toward increasing participation in physical activity or school PE classes; however, improvements have been made in reducing TV viewing time.

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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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Richard Lowry, Sarah M. Lee, Deborah A. Galuska, Janet E. Fulton, Lisa C. Barrios and Laura Kann

Background:

Few studies have focused on the relationship between physical activity-related (PA) injury and overweight among youth.

Methods:

We analyzed data from the 2001 and 2003 Youth Risk Behavior Surveys (n = 28,815). Logistic regression was used to examine the independent effects of BMI and frequency of participation in vigorous activity, moderate activity, strengthening exercises, physical education (PE) classes, and team sports on the likelihood of PA injury.

Results:

Approximately 14% of females and 19% of males reported seeing a doctor or nurse during the previous 30 d for an injury that happened while exercising or playing sports. PA injury was associated with participation in team sports, strengthening exercises, and (among females) vigorous physical activity. Controlling for type and frequency of physical activity, injury was not associated with being overweight (BMI ≥ 95th percentile).

Conclusions:

Moderate physical activity and school PE classes may provide relatively low-risk alternatives for overweight youth who need to increase their physical activity.

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MinKyoung Song, Dianna D. Carroll, Sarah M. Lee and Janet E. Fulton

Background:

The 2008 Physical Activity Guidelines recommend youth participate in a variety of physical activities; however, few nationally representative studies describe the types and variety of youth activity. This study assessed the most frequently reported types and variety of activities among U.S. high school students, and examined the association between variety and meeting the 2008 Guidelines for aerobic activity (aerobic guideline).

Methods:

We analyzed data on 8628 U.S. high school students in grades 9–12 from the 2010 National Youth Physical Activity and Nutrition Survey. Types of physical activity were assessed by identifying which activities each student reported in the past 7 days. Variety was assessed by the total number of different activities each student reported. Percentage (95% CI) of students who reported engaging in each activity was assessed. Logistic regression was used to examine the association between variety and meeting the aerobic guideline.

Results:

Walking was the most frequently reported activity among U.S. high school students. On average, students reported participating in 6 different activities. Variety was positively associated with meeting the aerobic guideline.

Conclusions:

These findings support encouraging youth to participate in many physical activities and may be useful for developing interventions that focus on the most prevalent activities.

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Shannon L. Michael, Edward Coffield, Sarah M. Lee and Janet E. Fulton

Background:

Federal guidelines state that youth should participate in a variety of physical activity (PA) they find enjoyable. Little is known, however, about how variety and enjoyment are associated with PA participation among adolescents.

Methods:

Data came from the 2010 National Youth Physical Activity and Nutrition Survey, a nationally representative survey of adolescents. Path analysis was used to examine the association of a variety of self-reported PA, defined as the number of activities and activity types (ie, team sports/weightlifting, individual activities, and other competitive/recreational sports), on self-reported PA enjoyment and participation. The analysis also examined whether enjoyment mediates the association between a variety of PA and participation. Separate models were estimated for boys and girls.

Results:

Number of activities was associated with increased PA enjoyment and participation. For boys and girls, team sports/weightlifting was associated with increased participation, and individual activities were indirectly associated with increased participation through enjoyment. For boys, team sports/weightlifting was indirectly related with participation.

Conclusions:

These findings suggest that participation in a variety of PA is associated with increased PA enjoyment and participation. Providing opportunities for adolescents to engage in a variety of activities might help them identify PA they enjoy and facilitate lifelong PA habits.

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Zewditu Demissie, Richard Lowry, Danice K. Eaton, Marci F. Hertz and Sarah M. Lee

Background:

This study investigated associations of violence-related behaviors with physical activity (PA)-related behaviors among U.S. high school students.

Methods:

Data from the 2009 national Youth Risk Behavior Survey, a cross-sectional survey of a nationally representative sample of 9th–12th grade students, were analyzed. Sex-stratified, adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were estimated for associations between violence-related behaviors and being physically active for ≥ 60 minutes daily, sports participation, TV watching for ≥ 3 hours/day, and video game/computer use for ≥ 3 hours/day.

Results:

Among male students, at-school bullying victimization was negatively associated with daily PA (aOR: 0.72; 95% CI: 0.58–0.87) and sports participation; skipping school because of safety concerns was positively associated with video game/computer use (1.42; 1.01–2.00); and physical fighting was positively associated with daily PA. Among female students, atschool bullying victimization and skipping school because of safety concerns were both positively associated with video game/computer use (1.46; 1.19–1.79 and 1.60; 1.09–2.34, respectively), and physical fighting at school was negatively associated with sports participation and positively associated with TV watching.

Conclusions:

Bullying victimization emerged as a potentially important risk factor for insufficient PA. Schools should consider the role of violence in initiatives designed to promote PA.

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Sarah M. Lee, Allison Nihiser, Darcy Strouse, Barnali Das, Shannon Michael and Marian Huhman

Background:

Co-physical activity (between parents and children), as an outcome variable, and its correlates have not been examined previously. The purpose of this study was to investigate correlates of co-physical activity among a nationally representative sample of 9- to 13-year-old children and their parents.

Methods:

Data were from the 2004 Youth Media Campaign Longitudinal Survey, a national survey of 5177 child-parent dyads. Parents of 9- to 13-year-old children were asked to report co-physical activity. Parents and children responded to a series of sociodemographic, behavioral, and psychosocial measures. Co-physical activity was treated as a dichotomous variable (ie, some or none). Logistic regression was used to assess associations of correlates directly and possible interactions between correlates.

Results:

More than three-quarters of parents reported co-physical activity at least 1 day in the prior week. Age, race/ethnicity, sports team participation, eating meals together, parental confidence to influence the child’s organized activity, and the child’s perception of parental support were significantly associated with co-physical activity.

Conclusion:

The majority of respondents reported participating in co-physical activity, and multiple sociodemographic, behavioral, and psychosocial correlates were significantly associated with co-physical activity. This study provides insight for physical activity interventions that might involve parents.

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Marian Huhman, Richard Lowry, Sarah M. Lee, Janet E. Fulton, Susan A. Carlson and Carrie D. Patnode

Background:

We examined trends of physical activity and screen time among nationally representative samples of children aged 9–13 years to explore whether children overall are becoming less physically active and less likely to be in compliance with screen time recommendations.

Methods:

We analyzed Youth Media Campaign Longitudinal Survey data for trends and demographic patterns of free time and organized physical activity, and hours and minutes of watching television and playing video or computer games. Child-parent dyads for 2002 (N = 3114), 2004 (N = 5177), and 2006 (N = 1200) were analyzed.

Results:

On the day before the interview, and for free time physical activity in the past week, children reported a significant increase in physical activity from 2002–2006. Screen time levels were stable overall; 76.4% of children met the recommendations of 2 hours or less of daily screen time.

Conclusion:

Levels of physical activity among U.S. children aged 9–13 years were stable, or levels slightly improved from 2002–2006. Except for some subgroup differences, trends for compliance with screen time recommendations were also stable from 2002–2006 for U.S. children aged 9–13 years.

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Mindy Millard-Stafford, Jeffrey S. Becasen, Michael W. Beets, Allison J. Nihiser, Sarah M. Lee and Janet E. Fulton

A systematic review of literature was conducted to examine the association between changes in health-related fitness (e.g., aerobic capacity and muscular strength/endurance) and chronic disease risk factors in overweight and/or obese youth. Studies published from 2000–2010 were included if the physical activity intervention was a randomized controlled trial and reported changes in fitness and health outcomes by direction and significance (p < .05) of the effect. Aerobic capacity improved in 91% and muscular fitness improved in 82% of measures reported. Nearly all studies (32 of 33) reported improvement in at least one fitness test. Changes in outcomes related to adiposity, cardiovascular, musculoskeletal, metabolic, and mental/emotional health improved in 60%, 32%, 53%, 41%, and 33% of comparisons studied, respectively. In conclusion, overweight and obese youth can improve physical fitness across a variety of test measures. When fitness improves, beneficial health effects are observed in some, but not all chronic disease risk factors.