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  • Author: Thomas L. Schmid x
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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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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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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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Anne Vernez Moudon, Chanam Lee, Allen D. Cheadle, Cheza Garvin, Donna Johnson, Thomas L. Schmid, Robert D. Weathers and Lin Lin

Background:

The concept of walkable neighborhoods is increasingly important in physical activity research and intervention. However, limited theoretical understanding and measurable definitions remain a challenge.

Methods:

This paper reviews theories defining neighborhoods and offers an empirical approach to identify measurable attributes and thresholds of walkable neighborhoods. Bivariate and multivariate analyses are used for self-reported socio-demographic background, neighborhood walking behavior and perception, and objective measures of environments.

Results:

Environmental attributes positively associated with walking sufficiently to meet health recommendations included higher residential density and smaller street-blocks around home, and shorter distances to food and daily retail facilities from home. Threshold distances for eating/drinking establishments and grocery stores were 860 and 1445 feet.

Conclusions:

Results questioned theoretical constructs of neighborhoods centered on recreation and educational uses. They pointed to finer mixes of uses than those characterizing suburban neighborhoods, and small spatial units of analysis and intervention to capture and promote neighborhood walkability.

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Susan A. Carlson, Roxanna Guide, Thomas L. Schmid, Latetia V. Moore, Danielle T. Barradas and Janet E. Fulton

Background:

Street-scale urban design policies are recommended to increase physical activity in communities. Our purpose was to examine U.S. public support for local street-scale urban design features and policies.

Methods:

Analysis is based on a cross-sectional national sample of adults (n = 4682) participating in the 2006 HealthStyles mail survey.

Results:

About 57% of adults rated local street-scale urban design as highly important in determining the amount of physical activity they obtain. Adjusted odds of rating neighborhood features as having high importance were higher in people aged ≥65 years versus those <65 and minority racial/ethnic groups versus non-Hispanic whites. Two-thirds of adults were willing to take civic action to support local street-scale urban design policy. Adjusted odds of being willing to take any action versus none was higher in non-Hispanic blacks and Hispanics versus non-Hispanic whites, was higher in those with household incomes ≥$60,000 versus ≤$15,000 per year, and increased as education and perceived importance of neighborhood features increased.

Conclusions:

There are high levels of public support for local street-scale urban design policies; however, demographic differences exist in the level of support. These differences are important considerations for policymakers and for those designing community programs targeting street-scale urban design features and policies.

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Olga L. Sarmiento, Thomas L. Schmid, Diana C. Parra, Adriana Díaz-del-Castillo, Luis Fernando Gómez, Michael Pratt, Enrique Jacoby, José D. Pinzón and John Duperly

Background:

Studies assessing the association between health-related quality of life (HR-QOL) with physical activity (PA) and built environment (BE) characteristics are limited.

Methods:

A cross-sectional study was conducted among 1,334 adults from Bogotá, to assess the associations between HR-QOL with PA and BE characteristics. HR-QOL was measured using the World Health Organization and the Centers for Disease Control and Prevention instruments. PA was measured using the International PA Questionnaire. BE characteristics included the dimensions of density, diversity, design, and access to mass-transit. Analysis included multilevel modeling.

Results:

Adults who reported meeting PA recommendations and participating in the Ciclovía were more likely to have a high mean score of HR-QOL and were more likely to perceive their health status as good/excellent. Adults who reported biking for transportation were more likely to have a high mean score of HR-QOL. Regarding BE characteristics, land-use heterogeneity was associated with HR-QOL, perceived good health status and being positive about the future. Park density was associated with HR-QOL, perceived health status good/excellent and being positive about the future. Mass-transit stations availability was negatively associated with HR-QOL.

Conclusion:

This study provides preliminary evidence that HR-QOL is associated with PA and BE characteristics among adults in an urban setting of the developing world.

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Isabela C. Ribeiro, Andrea Torres, Diana C. Parra, Rodrigo Reis, Christine Hoehner, Thomas L. Schmid, Michael Pratt, Luiz R. Ramos, Eduardo J. Simões and Ross C. Brownson

Background:

The Guide for Useful Interventions for Activity in Brazil and Latin America (GUIA), a systematic review of community-based physical activity (PA) interventions in Latin American literature, selected the CuritibAtiva program for a comprehensive evaluation. We describe the process of developing logic models (LM) of PA community interventions from Curitiba, Brazil, and discuss influential factors.

Methods:

The year-long process included engaging stakeholders involved in the promotion of PA in Curitiba, working with stakeholders to describe the programs and their goals, and developing LMs for the 2 main secretaries promoting PA in the city.

Results & Conclusions:

As a result of stakeholder interviews and discussion and the development of the LMs, local officials are coordinating programming efforts and considering ways the programs can be more complementary. The process has prompted program managers to identify overlapping programs, refine program goals, and identify gaps in programming. It also helped to frame evaluation questions, identify data sources, describe realistic outcomes, and reinforce the importance of intersectoral alliances for public health impact. Developing LMs proved to be feasible in the Latin American context, therefore adaptable and useful for other PA promotion programs in the region.

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Ross C. Brownson, Cheryl M. Kelly, Amy A. Eyler, Cheryl Carnoske, Lisa Grost, Susan L. Handy, Jay E. Maddock, Delores Pluto, Brian A. Ritacco, James F. Sallis and Thomas L. Schmid

Background:

Environmental and policy approaches are promising strategies to raise population-wide rates of physical activity; yet, little attention has been paid to the development and prioritization of a research agenda on these topics that will have relevance for both researchers and practitioners.

Methods:

Using input from hundreds of researchers and practitioners, a research agenda was developed for promoting physical activity through environmental and policy interventions. Concept mapping was used to develop the agenda.

Results:

Among those who brainstormed ideas, 42% were researchers and 33% were practitioners. The data formed a concept map with 9 distinct clusters. Based on ratings by both researchers and practitioners, the policy research cluster on city planning and design emerged as the most important, with economic evaluation second.

Conclusions:

Our research agenda sets the stage for new inquiries to better understand the environmental and policy influences on physical activity.

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Luis F. Gomez, Olga L. Sarmiento, Diana C. Parra, Thomas L. Schmid, Michael Pratt, Enrique Jacoby, Andrea Neiman, Robert Cervero, Janeth Mosquera, Candance Rutt, Mauricio Ardila and José D. Pinzón

Background:

Even though there is increasing evidence that the built environment (BE) has an influence on leisure-time physical activity (LTPA), little is known about this relationship in developing countries. The objective of this study was to assess the associations between objective built environment characteristics and LTPA.

Methods:

A cross-sectional multilevel study was conducted in 27 neighborhoods in which 1315 adults aged 18−65 years were surveyed. An adapted version of the IPAQ (long version) was used to assess LTPA. Objective BE characteristics were obtained using Geographic Information Systems. Associations were assessed using multilevel polytomous logistic regression.

Results:

Compared with inactive people, those who resided in neighborhoods with the highest tertile dedicated to parks (7.4% to 25.2%) were more likely to be regularly active (POR = 2.05, 95% CI = 1.13−3.72; P = 0.021). Those who resided in neighborhoods with presence of TransMilenio stations (mass public transportation system) were more likely to be irregularly active (POR = 1.27, 95% CI = 1.07−1.50, P = 0.009) as compared with inactive people.

Conclusions:

These findings showed that park density and availability of TransMilenio stations at neighborhood level are positively associated with LTPA. Public health efforts to address physical inactivity should consider the potential influences of urban planning and mass public transportation systems on health.