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Jennifer L. Gay, Harold W. Kohl III, Jennifer J. Salinas, Joseph B. McCormick and Susan P. Fisher-Hoch

Background:

The association between light-intensity activity and cardiovascular disease risk is not well understood. The purpose of this study was to determine the association of light-intensity activity with census-based occupational activity classifications and cardiovascular risk factors among Mexican American adults.

Methods:

118 Mexican American adults (68.6% female) provided cross-sectional accelerometer and biological data. Self-reported occupations were classified by activity level (sedentary, low, moderate). Participants were classified as At-Risk for BMI, glucose, triglycerides, HDL, blood pressure, waist circumference, and percent body fat.

Results:

Participants engaged in > 5 hours of light-intensity activity on average, and those in sedentary occupations engaged in fewer light-intensity activity minutes than low-active or moderately active workers (P < .001). Self-reported occupation explained 14% of the variation in light-intensity activity (P < .001). Participants in moderately active occupations were at increased risk for high %body fat than other workers (P = .01), but no other associations between occupation and cardiovascular risk were detected.

Conclusion:

Early work in physical activity underscored the importance of occupational activity. This study presents evidence of a dose-response association for light-intensity activity by occupational category such that workers in sedentary occupations had less light-intensity activity than employees in more active occupations. Future research on how light-intensity activity derived from occupation may reduce the risk of chronic disease will contribute to improved interventions as light-intensity activity participation may be more feasible than meeting current physical activity guidelines.

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Stella K. Muthuri, Lucy-Joy M. Wachira, Vincent O. Onywera and Mark S. Tremblay

Background:

A physical activity transition to declining activity levels, even among children, now poses a serious public health concern because of its contribution to a rising prevalence of noncommunicable diseases. Childhood physical activity levels are associated with parental perceptions of the neighborhood; however, these relationships have not been explored in sub-Saharan Africa (SSA). The objective was to investigate relationships between parental perceptions of the neighborhood and physical activity indicators among Kenyan children.

Methods:

Data were collected from children 9 to 11 years old in Nairobi as part of the International Study of Childhood Obesity, Lifestyle and Environment. Child physical activity was assessed by accelerometry, and information on obtaining sufficient physical activity, active transport, and parental perceptions of the neighborhood collected using questionnaires.

Results:

Of 563 participating children, 45.7%, 12.6%, and 11.4% used active school transportation, met physical activity guidelines, and were sufficiently active, respectively. Parental perception of positive neighborhood social cohesion, positive environs and connectivity, and negative child safety concerns, were associated with child physical activity outcomes.

Conclusions:

Aspects of parental perceptions of the neighborhood were associated with child physical activity outcomes and should be further explored to appropriately inform policy and practice in curbing declining physical activity levels among children in SSA.

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Darla E. Kendzor, Marlyn Allicock, Michael S. Businelle, Lona F. Sandon, Kelley Pettee Gabriel and Summer G. Frank

Background:

The current study evaluated the feasibility and effectiveness of a diet and physical activity intervention for homeless adults.

Methods:

Shelter residents (N = 32) were randomly assigned to a 4-week diet and physical activity intervention (n = 17) or an assessment-only control group (n = 15). Intervention participants received tailored educational newsletters, pedometers with step goals, and twice daily fruit/vegetable snacks. Key measures included 24-hour dietary recall interviews and accelerometer-measured moderate-to-vigorous intensity physical activity (MVPA).

Results:

At baseline, 68.8% of participants were overweight or obese, 93.8% reported food insecurity, and 43.8% reported activity levels below physical activity guidelines. Baseline dietary recall interviews indicated low fruit/vegetable consumption, and elevated intake of added sugar, saturated fat, and sodium relative to current dietary recommendations. During the 4-week study period, intervention participants engaged in significantly greater accelerometer-measured daily MVPA (P < .001) than controls (median = 60 daily minutes p vs. 41 daily minutes). Between groups differences in fruit/vegetable consumption at the end of treatment did not reach statistical significance. Most participants reported that the intervention was helpful for increasing fruit/vegetable intake and physical activity.

Conclusions:

Findings highlight the potential to improve dietary quality and increase physical activity among sheltered homeless adults.

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Lindsey Cox, Victoria Berends, James F. Sallis, Jessica Marie St. John, Betsy McNeil, Martin Gonzalez and Peggy Agron

Background:

Most youth are not meeting physical activity guidelines, and schools are a key venue for providing physical activity. School districts can provide physical activity opportunities through the adoption, implementation, monitoring, and evaluation of policies. This paper reports results of a 2009 survey of California school governance leaders on the barriers and opportunities to providing school-based physical activity and strategies to promote adoption of evidence-based policies.

Methods:

California school board members (n = 339) completed an 83 item online survey about policy options, perceptions, and barriers to improving physical activity in schools.

Results:

Board members’ highest rated barriers to providing physical activity were budget concerns, limited time in a school day, and competing priorities. The key policy opportunities to increase physical activity were improving the quantity and quality of physical education, integrating physical activity throughout the school day, supporting active transportation to/from school, providing access to physical activity facilities during nonschool hours, and integrating physical activity into before/after school programs.

Conclusions:

Survey findings were used to develop policy resources and trainings for school governance leaders that provide a comprehensive approach to improving physical activity in schools.

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Andrew J. Mowen and Birgitta L. Baker

Background:

The United States’ first National Physical Activity Plan is now under development. This plan follows the release of new physical activity guidelines and seeks to address the nation’s ongoing physical inactivity and obesity crisis. For this plan to be successful, all facets of American culture need to unify behind its recommendations and action steps. Guidance for this plan involves active participation from a variety of sectors, including the park, recreation, fitness, and sport (PRFS) sector.

Purpose:

In this white paper, we discuss the potential of the PRFS sector in addressing America’s physical inactivity. Specifically, we provide a brief description, history, and scope of the PRFS sector; present evidence concerning linkages between this sector and physical activity; and discuss existing challenges and emerging opportunities for promoting physical activity. We conclude by suggesting PRFS recommendations to promote physical activity based on anticipated effectiveness, reach, scope, and sustainability.

Methods:

Academic articles, professional reports, and physical activity plans were reviewed to summarize the evidence concerning PRFS sector strategies for increasing physical activity. Recommendations: Based on our review, we propose several sector-specific proximity, place, program, partnership, promotion, people, policy, and performance indicator recommendations for improving physical activity in the United States.

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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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Stephanie Truelove, Leigh M. Vanderloo and Patricia Tucker

Background:

Many young children are not meeting the Canadian physical activity guidelines. In an effort to change this, the term active play has been used to promote increased physical activity levels. Among young children, physical activity is typically achieved in the form of active play behavior. The current study aimed to review and synthesize the literature to identify key concepts used to define and describe active play among young children. A secondary objective was to explore the various methods adopted for measuring active play.

Methods:

A systematic review was conducted by searching seven online databases for English-language, original research or reports, and were eligible for inclusion if they defined or measured active play among young children (ie, 2 to 6 years).

Results:

Nine studies provided a definition or description of active play, six measured active play, and 13 included both outcomes. While variability in active play definitions did exist, common themes included: increased energy exerted, rough and tumble, gross motor movement, unstructured, freely chosen, and fun. Alternatively, many researchers described active play as physical activity (n = 13) and the majority of studies used a questionnaire (n = 16) to assess active play among young children.

Conclusion:

Much variability in the types of active play, methods of assessing active play, and locations where active play can transpire were noted in this review. As such, an accepted and consistent definition is necessary, which we provide herein.

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Trever J. Ball, Elizabeth A. Joy, Lisa H. Gren, Ruthann Cunningham and Janet M. Shaw

Background:

Few have examined predictive relationships between physical activity (PA) and health using electronic health records (EHRs) of patient-reported PA.

Objective:

Assess initial predictive validity of the Physical Activity “Vital Sign” (PAVS) recorded in EHRs with BMI and disease burden.

Methods:

EHRs were from November 2011 to November 2013 (n = 34,712). Differences in not meeting Physical Activity Guidelines (PAG) were tested using chi-square analysis between being normal weight versus overweight/obese, and scoring below versus above the 50th percentile of the Charlson Comorbidity Index (CCI). Repeated measures logistic regression was used to determine odds of BMI and CCI classifications according to responses to the PAVS as not meeting PAG.

Results:

Patients who did not meet PAG according to the PAVS were more likely than normal weight patients to have a higher BMI (BMI 25.0–29.9, OR = 1.19, P = .001; BMI 30.0–34.9, OR = 1.39, P < .0001; BMI 35.0–39.9, OR = 2.42, P < .0001; BMI ≥ 40, OR = 3.7, P < .0001) and also higher disease burden (above 50th percentile for CCI, OR = 1.8, P < .0001).

Conclusions:

The strong association of the PAVS found with patient BMI and moderately-strong association with disease burden supports initial predictive validity of the PAVS recorded in EHRs. PA recorded in EHRs may be vastly useful for assessing patient disease and cost burdens attributed independently to PA behavior.

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Robert Eley, Robert Bush and Wendy Brown

Background:

Interventions addressing chronic disease through physical activity are hampered by the low evidence base from rural areas. The purpose of the study was to provide information which may contribute to the development of future policy and strategy applicable to rural Queensland.

Methods:

Six diverse rural shires were chosen. A mixed-method design included more than 100 interviews with community representatives; surveys to 3000 community members; audits of facilities, amenities, and other relevant resources in each shire; and detailed observation during repeated site visits.

Results:

Half the respondents failed to meet Australian physical activity guidelines and 1 in 5 reported no activity. Queensland’s rural communities offer good access to a wide variety of structured and nonstructured activities. Some barriers to physical activity (eg, family commitments) are similar to those reported from urban areas; however, others including climate, culture of exercise, and community leadership are unique to the rural environment.

Conclusions:

Unique characteristics of rural environments and populations affect engagement in physical activity. Promotion of healthy lifestyle in rural environments need to be informed by local context and not merely extrapolated from urban situations. Attention must be paid to specific local circumstances which may affect implementation, adoption and participation.

Open access

Peter T. Katzmarzyk, Kara D. Denstel, Kim Beals, Christopher Bolling, Carly Wright, Scott E. Crouter, Thomas L. McKenzie, Russell R. Pate, Brian E. Saelens, Amanda E. Staiano, Heidi I. Stanish and Susan B. Sisson

Background:

The 2016 United States (U.S.) Report Card on Physical Activity for Children and Youth provides a comprehensive evaluation of physical activity levels and factors influencing physical activity among children and youth.

Methods:

The report card includes 10 indicators: Overall Physical Activity, Sedentary Behavior, Active Transportation, Organized Sport Participation, Active Play, Health-related Fitness, Family and Peers, School, Community and the Built Environment, and Government Strategies and Investments. Nationally representative data were used to evaluate the indicators using a standard grading rubric.

Results:

Sufficient data were available to assign grades to 7 of the indicators, and these ranged from B- for Community and the Built Environment to F for Active Transportation. Overall Physical Activity received a grade of D- due to the low prevalence of meeting physical activity guidelines. A grade of D was assigned to Health-related Fitness, reflecting the low prevalence of meeting cardiorespiratory fitness standards. Disparities across age, gender, racial/ethnic and socioeconomic groups were observed for several indicators.

Conclusions:

Continued poor grades suggest that additional work is required to provide opportunities for U.S. children to be physically active. The observed disparities indicate that special attention should be given to girls, minorities, and those from lower socioeconomic groups when implementing intervention strategies.