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Prabasaj Paul, Susan A. Carlson, and Janet E. Fulton

Background:

The association between walking and environmental attributes depends on walking purpose. This study, based on a large survey of U.S. adults, examined the association between perceived neighborhood safety and built environment attributes, and walking for transportation and leisure.

Methods:

Data were obtained on transportation and leisure-time walking, perceived neighborhood safety and built environment attributes, and demographic characteristics from the summer wave of the 2012 ConsumerStyles survey of 3951 U.S. adults. Associations were examined by demographic characteristics.

Results:

Seventy-five percent of respondents reported walking for either transportation (54%) or leisure (56%) in the past week, 59% reported no safety concern, and 36% reported absence of any built environment attribute of walkability nearby. Respondents with more education, and those who lived in metropolitan areas were more likely to report built environment attributes supportive of walking. All built environment attributes examined, as well as safety concern due to speeding vehicles, were associated with walking after adjustment for demographic characteristics.

Conclusion:

Walking, particularly for transportation, is associated with many built environment attributes among U.S. adults. These attributes may be important to consider when designing and modifying the built environment of communities, especially those which are less walkable.

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Geoffrey P. Whitfield, Eric T. Hyde, and Susan A. Carlson

Background: Adults should perform ≥150 minutes per week of moderate-intensity equivalent physical activity for substantial health benefits and >300 minutes per week for additional benefits. The authors analyzed 21 years of National Health Interview Survey data to better understand trends in aerobic physical activity participation among US adults. Methods: The authors estimated the annual prevalence (1998–2018) of self-reported leisure-time physical inactivity, insufficient activity, meeting only the minimal aerobic guideline, and meeting the high aerobic guideline overall and by selected characteristics. Prevalence differences between 1998 and 2018 were compared across subgroups and periods of significant change were identified using JoinPoint regression. Results: The prevalence of inactivity decreased from 40.5% (1998) to 25.6% (2018) while the prevalence of meeting the high aerobic guideline increased from 26.0% to 37.4%. Increases in meeting the high guideline were similar across age groups, racial/ethnic groups, levels of education, and Census regions. Increases in insufficient activity and meeting the minimal guideline were statistically significant but of relatively small magnitude. Conclusions: The prevalence of inactivity decreased and meeting the high aerobic guideline increased overall and for all subgroups from 1998 to 2018. Physical activity promotion strategies may aim to continue these trends while also narrowing persistent disparities in participation across subgroups.

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Fleetwood Loustalot, Susan A. Carlson, Janet E. Fulton, Judy Kruger, Deborah A. Galuska, and Felipe Lobelo

Background:

Accurate surveillance data on physical activity prevalence is important for U.S. states and territories as they develop programs and interventions to increase physical activity participation.

Methods:

Using 2007 data from the Behavioral Risk Factor Surveillance System, we estimated the percentage of U.S. adults in each U.S. state and territory who met minimum aerobic activity criteria using the 2008 Physical Activity Guidelines for Americans (2008 Guidelines) and the Healthy People 2010 criteria for physical activity. SUDAAN was used to calculate prevalence estimates and 95% confidence intervals.

Results:

The estimated prevalence of recommended aerobic activity in U.S. states and territories ranged from 44.5% to 73.3% according to 2008 Guidelines and from 30.8% to 60.0% according to Healthy People 2010 criteria. Absolute percent differences in prevalence among U.S. states and territories ranged from 11.7% to 19.1%, and relative percent differences ranged from 20.8% to 44.6%.

Conclusions:

In all U.S. states and territories, a larger proportion of U.S. adults met minimum aerobic activity criteria in the 2008 Guidelines than met corresponding criteria in Healthy People 2010. This difference, however, does not reflect an actual change in the amount of aerobic activity, but a change to the criteria for meeting 2008 Guidelines.

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Susan A. Carlson, Judy Kruger, Harold W. Kohl III, and David M. Buchner

Background:

Falls are a major health problem for older adults. The purpose of this study is to examine the cross-sectional association between non-occupational physical activity and falls and fall-related injuries in US adults age 65 y or older.

Methods:

Respondents age 65 y or older were selected from the 2003 Behavioral Risk Factor Surveillance System (n = 47,619).

Results:

The age-adjusted incidence of falls was significantly higher among inactive respondents (16.3%, 95% CI: 15.2–17.6) than insufficiently active (12.3%, 95% CI: 11.4–13.2) or active (12.6%, 95% CI: 11.6–13.7) respondents. After controlling for sex, age, education, and body-mass index, active and insufficiently active respondents were significantly less likely to have fallen and were significantly less likely to have had a fall-related injury than their inactive peers.

Conclusion:

These results show that active and insufficiently active older adults experience a lower incidence of falls than their inactive peers.

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Shifan Dai, Dianna D. Carroll, Kathleen B. Watson, Prabasaj Paul, Susan A. Carlson, and Janet E. Fulton

Background:

Information on specific types of physical activities in which US adults participate is important for community and program development to promote physical activity.

Methods:

Prevalence of participation and average time spent for 33 leisuretime aerobic activities and 10 activity categories were calculated using self-reported data from 22,545 participants aged ≥ 18 years in the National Health and Nutrition Examination Survey 1999–2006.

Results:

Overall, 38% of US adults reported no leisure-time physical activities, and 43% reported 1 or 2 activities in the past 30 days. Walking was the most frequently reported activity for both men (29%) and women (38%). Among walkers, the average time spent walking was 198 minutes/week for men and 152 minutes/week for women. The most reported activities for men after walking were bicycling and yard work, and for women were aerobics and dance. For most activity categories, participation was lower among adults aged ≥ 65 years than among younger adults, and among Mexican Americans and non-Hispanic blacks than among non-Hispanic whites. Participation in most categories increased with increasing educational attainment.

Conclusions:

Participation in physical activity differs by types of activities and demographic characteristics. Physical activity promotion programs should take these differences into account when developing intervention strategies.

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Kathleen Bachtel Watson, Shifan Dai, Prabasaj Paul, Susan A. Carlson, Dianna D. Carroll, and Janet Fulton

Background:

Previous studies have examined participation in specific leisure-time physical activities (PA) among US adults. The purpose of this study was to identify specific activities that contribute substantially to total volume of leisure-time PA in US adults.

Methods:

Proportion of total volume of leisure-time PA moderate-equivalent minutes attributable to 9 specific types of activities was estimated using self-reported data from 21,685 adult participants (≥ 18 years) in the National Health and Nutrition Examination Survey 1999–2006.

Results:

Overall, walking (28%), sports (22%), and dancing (9%) contributed most to PA volume. Attributable proportion was higher among men than women for sports (30% vs. 11%) and higher among women than men for walking (36% vs. 23%), dancing (16% vs. 4%), and conditioning exercises (10% vs. 5%). The proportion was lower for walking, but higher for sports, among active adults than those insufficiently active and increased with age for walking. Compared with other racial/ethnic groups, the proportion was lower for sports among non-Hispanic white men and for dancing among non-Hispanic white women.

Conclusions:

Walking, sports, and dance account for the most activity time among US adults overall, yet some demographic variations exist. Strategies for PA promotion should be tailored to differences across population subgroups.

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Prabasaj Paul, Susan A. Carlson, Dianna D. Carroll, David Berrigan, and Janet E. Fulton

Background:

Walking, the most commonly reported physical activity among U.S. adults, is undertaken in various domains, including transportation and leisure.

Methods:

This study examined prevalence, bout length, and mean amount of walking in the last week for transportation and leisure, by selected characteristics. Self-reported data from the 2010 National Health Interview Survey (N = 24,017) were analyzed.

Results:

Prevalence of transportation walking was 29.4% (95% CI: 28.6%–30.3%) and of leisure walking was 50.0% (95% CI: 49.1%–51.0%). Prevalence of transportation walking was higher among men; prevalence of leisure walking was higher among women. Most (52.4%) transportation walking bouts were 10 to 15 minutes; leisure walking bouts were distributed more evenly (28.0%, 10–15 minutes; 17.1%, 41–60 minutes). Mean time spent in transportation walking was higher among men, decreased with increasing BMI, and varied by race/ethnicity and region of residence. Mean time spent leisure walking increased with increasing age and with decreasing BMI.

Conclusion:

Demographic correlates and patterns of walking differ by domain. Interventions focusing on either leisure or transportation walking should consider correlates for the specific walking domain. Assessing prevalence, bout length, and mean time of walking for transportation and leisure separately allows for more comprehensive surveillance of walking.

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Susan A. Carlson, Kathleen B. Watson, Prabasaj Paul, Thomas L. Schmid, and Janet E. Fulton

Background:

Information about how presence and usefulness of neighborhood supports for walking differs by demographic characteristics can help guide community strategies to promote walking.

Methods:

Reported presence and usefulness of neighborhood supports (shops, transit stops, sidewalks, parks, interesting things to look at, well-lit at night, low crime rate, and cars following speed limit) were examined in 3973 U.S. adults who completed the 2014 SummerStyles survey.

Results:

Percentage reporting neighborhood supports as present ranged from 25.3% (SE = 0.8) for interesting things to 55.8% (SE = 1.0) for low crime rate. Percentage who reported a support as useful ranged from 24.6% (SE = 1.4) for transit stops to 79.0% (SE = 1.1) for sidewalks among those with the support. This percentage ranged from 13.4% (SE = 0.8) for transit stops to 52.8% (SE = 1.1) for shops among those without the support. One or more demographic differences were observed for the presence of each support, and the presence of all supports differed by education and metro status. Demographic patterns were less clear when examining usefulness and patterns often differed by support type and presence.

Conclusions:

Presence and usefulness of neighborhood supports for walking can differ by type and demographic characteristics. Recognizing these difference can help communities plan and implement strategies to promote walking.

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Kathleen B. Watson, Susan A. Carlson, Tiffany Humbert-Rico, Dianna D. Carroll, and Janet E. Fulton

Background:

Less than one-third of U.S. adults walk for transportation. Public health strategies to increase transportation walking would benefit from knowing what adults think is a reasonable distance to walk. Our purpose was to determine 1) what adults think is a reasonable distance and amount of time to walk and 2) whether there were differences in minutes spent transportation walking by what adults think is reasonable.

Methods:

Analyses used a cross-sectional nationwide adult sample (n = 3653) participating in the 2010 Summer ConsumerStyles mail survey.

Results:

Most adults (> 90%) think transportation walking is reasonable. However, less than half (43%) think walking a mile or more or for 20 minutes or more is reasonable. What adults think is reasonable is similar across most demographic subgroups, except for older adults (≥ 65 years) who think shorter distances and times are reasonable. Trend analysis that adjust for demographic characteristics indicates adults who think longer distances and times are reasonable walk more.

Conclusions:

Walking for short distances is acceptable to most U.S. adults. Public health programs designed to encourage longer distance trips may wish to improve supports for transportation walking to make walking longer distances seem easier and more acceptable to most U.S. adults.

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Kathleen B. Watson, Ginny M. Frederick, Carmen D. Harris, Susan A. Carlson, and Janet E. Fulton

Background:

There is little information on national estimates for participation in types of aerobic activities among U.S. adults. Current estimates are important to develop appropriate and effective interventions to promote physical activity and interpret bias for some activities measured with devices.

Methods:

The percentage of adults participating in specific aerobic activities was estimated overall and by demographic subgroups. The 2011 Behavioral Risk Factor Surveillance System respondents (N = 446,216) reported up to 2 aerobic activities they spent the most time doing during the past month.

Results:

Overall, walking (47%) was the most common activity reported and was reported more by women (54%) than men (41%). Participation in most activities declined with increasing age (P < .006). There were a number of differences in participation between race/ethnic subgroups. Participation increased with more education (P for trend < 0.006) for all activities. Participation in most activities was different (P < .002) across BMI subgroups.

Conclusions:

Walking is the most common activity, overall and among most subgroups. Other activity profiles differ by demographic subgroup. Physical activity promotion strategies that focus on identifying and addressing personal and environmental barriers and understanding demographic subgroup differences could lead to more tailored interventions and public health programs.