The Australian Longitudinal Study on Women’s Health (ALSWH) commenced in Australia in 1996 when researchers recruited approximately 40,000 women in three birth cohorts: 1973–1978, 1946–1951, and 1921–1926. Since then participants have completed surveys on a wide range of health issues, at approximately three-year intervals. This overview describes changes in physical activity (PA) over time in the mid-age and older ALSWH cohorts, and summarizes the findings of studies published to date on the determinants of PA, and its associated health outcomes in Australian women. The ALSWH data show a significant increase in PA during mid-age, and a rapid decline in activity levels when women are in their 80s. The study has demonstrated the importance of life stages and key life events as determinants of activity, the additional benefits of vigorous activity for mid-age women, and the health benefits of ‘only walking’ for older women. ALSWH researchers have also drawn attention to the benefits of activity in terms of a wide range of physical and mental health outcomes, as well as overall vitality and well-being. The data indicate that maintaining a high level of PA throughout mid and older age will not only reduce the risk of premature death, but also significantly extend the number of years of healthy life.
Wendy J. Brown and Toby Pavey
Wendy J. Brown and Yvette D. Miller
National physical activity data suggest that there is a considerable difference in physical activity levels of US and Australian adults. Although different surveys (Active Australia and BRFSS) are used, the questions are similar. Different protocols, however, are used to estimate “activity” from the data collected. The primary aim of this study was to assess whether the 2 approaches to the management of PA data could explain some of the difference in prevalence estimates derived from the two national surveys.
Secondary data analysis of the most recent AA survey (N = 2987).
15% of the sample was defined as “active” using Australian criteria but as “inactive” using the BRFSS protocol, even though weekly energy expenditure was commensurate with meeting current guidelines. Younger respondents (age < 45 y) were more likely to be “misclassified” using the BRFSS criteria.
The prevalence of activity in Australia and the US appears to be more similar than we had previously thought.
Kristiann C. Heesch, Jannique van Uffelen and Wendy J. Brown
The aim of this study was to examine older adults’ understanding and interpretation of a validated questionnaire for physical activity surveillance, the Active Australia Survey (AAS). To address this aim, cognitive interviewing techniques were used during face-to-face semistructured interviews with 44 adults age 65–89 years. Qualitative data analysis revealed that participants were confused with questionnaire phrasing, misunderstood the scope of activities to include in answers, and misunderstood the time frame of activities to report. They also struggled to accurately estimate the frequency and duration of their activities. Our findings suggest that AAS questions may be interpreted differently by older adults than intended by survey developers. Findings also suggest that older adults use a range of methods for calculating PA frequency and duration. The issues revealed in this study may be useful for adapting AAS for use in older community-dwelling adults.
Wendy J. Brown, Kerry Mummery, Elizabeth Eakin and Grant Schofield
To describe the effectiveness of a multi-strategy physical activity (PA) intervention.
Self-report data from random samples were collected prior to and following intervention. Social marketing, healthcare provider, and environmental strategies were concurrently implemented with a central coordinating theme of “10,000 Steps Rockhampton.”
There was evidence of significant project reach and awareness. The downward trend in PA seen in the comparison community (48.3% to 41.9% “active”) was not evident in Rockhampton. Women were the “early adopters” in this project; with an increase of 5% (95% CI: –0.6, 10.6) in the percent categorized as “active” (compared with decreases among women in the comparison community and among men in both communities).
High levels of project awareness, combined with modest increases in activity levels in women, demonstrate initial project effects. Longer term interventions, focusing on sustainable individual, social, and environmental change strategies are needed to maintain and improve this result.
Toby G. Pavey, Nicola W. Burton and Wendy J Brown
There is growing evidence that regular physical activity (PA) reduces the risk of poor mental health. Less research has focused on the relationship between PA and positive wellbeing. The study aims were to assess the prospective associations between PA and optimism, in both young and mid-aged women.
9688 young women (born 1973–1978) completed self-report surveys in 2000 (age 22 to 27), 2003, 2006, and 2009; and 11,226 mid-aged women (born 1946–1951) completed surveys in 2001 (age 50–55) 2004, 2007, and 2010, as part of the Australian Longitudinal Study on Women’s Health. Generalized estimating equation models (with 3-year time lag) were used to examine the relationship between PA and optimism in both cohorts.
In both cohorts, women reporting higher levels of PA had greater odds of reporting higher optimism over the 9-year period, (young, OR = 5.04, 95% CI: 3.85–6.59; mid-age, OR = 5.77, 95% CI: 4.76–7.00) than women who reported no PA. Odds were attenuated in adjusted models, with depression accounting for a large amount of this attenuation (young, OR = 2.00, 95% CI: 1.57–2.55; mid-age, OR = 1.64 95% CI: 1.38–1.94).
Physical activity can promote optimism in young and mid-aged women over time, even after accounting for the negative effects of other psychosocial indicators such as depression.
Gemma Cathrine Ryde, Helen Elizabeth Brown, Nicholas David Gilson and Wendy J. Brown
Prolonged occupational sitting is related to poor health outcomes. Detailed data on sitting time at desks are required to understand and effectively influence occupational sitting habits.
Full-time office employees were recruited (n = 105; mean age 40.9 ± 11.5 years; BMI 26.1 ± 3.9, 65% women). Sitting at the desk and in other work contexts was measured using a sitting pad and ActivPAL for an entire working week. Employees used a diary to record work hours. Time spent at work, sitting at work and at the desk; number of sit to stand transitions at the desk; and number of bouts of continuous sitting at the desk < 20 and > 60 minutes, were calculated.
Average time spent at work was 8.7 ± 0.8 hours/day with 67% spent sitting at the desk (5.8 ± 1.2 hours/day), and 4% in other workplace settings. On average, employees got up from their desks 3 times/hour (29 ± 13/day). Sitting for more than 60 consecutive minutes occurred infrequently (0.69 ± 0.62 times/day), with most sit to stands (80%; 23 ± 14) occurring before 20 minutes of continual sitting.
The findings provide highly detailed insights into desk-based sitting habits, highlighting large proportions of time spent sitting at desks, but with frequent interruptions.
Sarah J. Fraser, Justin J. Chapman, Wendy J. Brown, Harvey A. Whiteford and Nicola W. Burton
The aim of this study was to assess the feasibility of using questionnaires and accelerometers to measure physical activity and sedentary behavior among inpatient adults with mental illness.
Participants completed a physical activity and sitting time questionnaire and wore an accelerometer for 7 consecutive days. Feasibility was assessed in terms of participant engagement, self-reported ease/difficulty of completing study components, extreme self-report data values and adherence to accelerometer wear time criteria. Ease/difficulty ratings were examined by level of distress.
177 inpatients were invited to the study, 101 completed the questionnaires and 36 provided valid accelerometry data. Participants found it more difficult to complete sitting time and physical activity questionnaires than to wear the accelerometer during waking hours (z = 3.787, P < .001; z = 2.824, P = .005 respectively). No significant differences were found in ease/difficulty ratings by level of distress for any of the study components. Extreme values for self-reported sitting time were identified in 27% of participants.
Inpatient adults with mental illness can engage with self-report and objective methods of measuring physical activity and sedentary behavior. They were initially less willing to participate in objective measurement, which may however be more feasible than self-report measures.
Nurdiana Zainol Abidin, Wendy J. Brown, Bronwyn Clark, Ahmad Munir Che Muhamed and Rabindarjeet Singh
We evaluated feasibility of physical activity measurement by accelerometry among older Malay adults living in semi-rural areas in Malaysia. Results showed that 95% of 146 participants (aged [SD] 67.6 [6.4] years) were compliant in wearing the accelerometer for at least five days. Fifteen participants were asked for re-wear the accelerometer because they did not have enough valid days during the first assessment. Participants wore the accelerometer an average of 15.3 hr in a 24-hr day, with 6.5 (1.2) valid wear days. No significant difference in valid wear day and time was found between men and women. Participants who are single provide more valid wear days compared with married participants (p < .05), and participants with higher levels of education provide longer periods of accelerometer wearing hours (p < .01). Eighty-seven percent of participants reported ‘no issues’ with wearing the meter. This study suggests that accelerometry is a feasible method to assess the physical activity level among older Malay adults living in semi-rural areas.
Sjaan R. Gomersall, Toby G. Pavey, Bronwyn K. Clark, Adib Jasman and Wendy J. Brown
Sedentary behavior is continuing to emerge as an important target for health promotion. The purpose of this study was to determine the validity of a self-report use of time recall tool, the Multimedia Activity Recall for Children and Adults (MARCA) in estimating time spent sitting/lying, compared with a device-based measure.
Fifty-eight participants (48% female, [mean ± standard deviation] 28 ± 7.4 years of age, 23.9 ± 3.05 kg/m2) wore an activPAL device for 24-h and the following day completed the MARCA. Pearson correlation coefficients (r) were used to analyze convergent validity of the adult MARCA compared with activPAL estimates of total sitting/lying time. Agreement was examined using Bland-Altman plots.
According to activPAL estimates, participants spent 10.4 hr/day [standard deviation (SD) = 2.06] sitting or lying down while awake. The correlation between MARCA and activPAL estimates of total sit/lie time was r = .77 (95% confidence interval = 0.64–0.86; P < .001). Bland-Altman analyses revealed a mean bias of +0.59 hr/day with moderately wide limits of agreement (–2.35 hr to +3.53 hr/day).
This study found a moderate to strong agreement between the adult MARCA and the activPAL, suggesting that the MARCA is an appropriate tool for the measurement of time spent sitting or lying down in an adult population.
Venurs H.Y. Loh, Jerome N. Rachele, Wendy J. Brown, Fatima Ghani and Gavin Turrell
Background: Residents of more socioeconomically disadvantaged neighborhoods are more likely to report poorer physical function, although the reasons for this remain unknown. It is possible that neighborhood-level perceptions of safety from crime contribute to this relationship through its association with walking for recreation. Methods: Data were obtained from the fourth wave (collected in 2013) of the HABITAT (How Areas in Brisbane Influence HealTh and AcTivity) multilevel longitudinal study of middle- to older-aged adults (46–74 y) residing in 200 neighborhoods in Brisbane, Australia. The data were analyzed separately for men (n = 2190) and women (n = 2977) using multilevel models. Results: Residents of the most disadvantaged neighborhoods had poorer physical function, perceived their neighborhoods to be less safe from crime, and do less walking for recreation. These factors accounted for differences in physical function between disadvantaged and advantaged neighborhoods (24% for men and 25% for women). Conclusion: This study highlights the importance of contextual characteristics, through their associations with behaviors, that can have in explaining the relationship between neighborhood disadvantage and physical function. Interventions aimed at improving neighborhood safety integrated with supportive environments for physical activity may have positive impact on physical function among all socioeconomic groups.