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Yves Vanden Auweele, Filip Boen, Wanda Schapendonk and Karen Dornez

This study evaluated the impact of two simple interventions aimed at promoting stair use among female employees at a five-floor worksite. The first intervention involved a “health” sign that linked stair use to health and fitness; it was placed at the junction between the staircase and the elevator. The second intervention involved an additional e-mail sent a week later by the worksite’s doctor, pointing out the health benefits of regular stair use. Stair use increased significantly from 69% at baseline to 77% in the week after the first intervention, 2 (1) = 12.97, p < .001. Moreover, compared with the first intervention, stair use increased significantly to 85% in the week after the second intervention, 2 (1) = 15.58, p < .001. However, stair use decreased to 67% in a follow-up one month after the sign was removed, and was not significantly different from baseline, 2 (1) = 0.41, p = .52. These results suggest that simple and inexpensive interventions such as a health sign in combination with an e-mail sent by the worksite’s doctor can encourage female employees to use the stairs. However, it appears that sustained effort is needed to consolidate these effects.

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Jay E. Maddock, Bill Reger-Nash, Katie Heinrich, Kevin M. Leyden and Thomas K. Bias

Background:

The U.S. Community Guide to Preventive Services strongly recommends changes in urban design, land use and accessibility to increase physical activity. To achieve these goals, policy change is often needed. This study assessed attitudes of decision makers in Hawaii to determine if physical activity related issues are among their priorities.

Methods:

State and county officials (n = 179) were mailed surveys. Respondents listed the three most important problems (open-ended) in Hawaii and rated the importance of 23 specified problems, of which six directly related to physical activity.

Results:

The survey was completed by 126 (70.4%) respondents. The most frequently mentioned categories for the open-ended questions were affordable housing, environment/sustainability, sprawl/traffic/population growth, and healthcare. Among the closed-ended physical activity related items, increasing traffic was ranked highest (43.9%) and fourth overall. Less than 12% of decision makers rated other physical activity issues as important.

Conclusions:

Future work is needed to increase the visibility and importance of physical activity related issues among policymakers.

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Meghan Baruth and Sara Wilcox

Background:

Understanding who is most and least likely to remain active after the completion of physical activity (PA) interventions can assist in developing more targeted and effective programs to enhance prolonged behavior change. The purpose of this study was to examine predictors of meeting PA recommendations 6 months postintervention in participants enrolled in Active for Life.

Methods:

Participants from 2 behavioral PA programs [158 Active Choices (AC); 1025 Active Living Every Day (ALED)] completed surveys 6 months after completion of the active intervention. Analyses examined predictors of meeting PA recommendations at follow-up.

Results:

The following were significant predictors: In ALED: self-report health status, satisfaction with body function, and self-efficacy at baseline; PA status at posttest; changes in self-efficacy, perceived stress, and satisfaction with body function and appearance from baseline to posttest. In AC: PA status at posttest.

Conclusions:

The ultimate goal of health promotion programs is to teach the behavioral skills necessary to sustain behavior change once an active intervention is complete. The findings from this study suggest that predicting PA behavior after cessation of PA interventions may not be straightforward, and predictor variables may operate differently in different intervention approaches.

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Cora Lynn Craig

Background:

Low levels of physical activity (PA) and fitness have long been a government concern in Canada; however, more than half of adults are inactive. This article examines factors influencing policy development and implementation using Canadian PA policy as a case study.

Methods:

Current and historical PA policy documents were amassed from a literature review, audit of government and non government websites and from requests to government officials in each jurisdiction directly responsible for PA. These were analyzed to determine policy content, results, barriers, and success factors.

Results:

The national focus for PA policy in Canada has devolved to a multilevel system that meets most established criteria for successful strategies. Earlier PA targets have been met; however, the prevalence of PA decreased from 2005 to 2007. Annual per capita savings in health care associated with achieving the earlier target is estimated at $6.15 per capita, yet a fraction of that is directed to promoting PA.

Conclusion:

Evidenced-based strategies that address multiple policy agendas using sector-specific approaches are needed. Sustained high-level commitment is required; advocacy grounded in metrics and science is needed to increase the profile of the issue and increase the commitments to PA policies in Canada and internationally.

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Nicholas Gilson, Wendy J. Brown, Guy Faulkner, Jim McKenna, Marie Murphy, Andy Pringle, Karin Proper, Anna Puig-Ribera and Aphroditi Stathi

Background:

This paper aimed to use the Delphi technique to develop a consensus framework for a multinational, workplace walking intervention.

Methods:

Ideas were gathered and ranked from eight recognized and emerging experts in the fields of physical activity and health, from universities in Australia, Canada, England, the Netherlands, Northern Ireland, and Spain. Members of the panel were asked to consider the key characteristics of a successful campus walking intervention. Consensus was reached by an inductive, content analytic approach, conducted through an anonymous, three-round, e-mail process.

Results:

The resulting framework consisted of three interlinking themes defined as “design, implementation, and evaluation.” Top-ranked subitems in these themes included the need to generate research capacity (design), to respond to group needs through different walking approaches (implementation), and to undertake physical activity assessment (evaluation). Themes were set within an underpinning domain, referred to as the “institution” and sites are currently engaging with subitems in this domain, to provide sustainable interventions that refect the practicalities of local contexts and needs.

Conclusions:

Findings provide a unique framework for designing, implementing, and evaluating walking projects in universities and highlight the value of adopting the Delphi technique for planning international, multisite health initiatives.

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Kate Heelan, H. Jason Combs, Bryce M. Abbey, Paul Burger and Todd Bartee

Background:

The decline in active commuting to and from school in the United States is, in part, due to urban design standards and public policies that promote automobile travel and discourage pedestrian activity.

Purpose:

The current investigation examines active commuting at neighborhood schools and how it is altered by distance to school, student age and its potential impact on Body Mass Index.

Methods:

Demographic and transportation datasets were obtained for 5367 elementary students (K−5th grade) and middle school students (6th−8th grade) in 2 Midwestern communities.

Results:

4379 (81.6%) students were successfully geocoded and 21.9% actively commute to school at least half of the time meeting the Healthy People 2010 objective 22−14. Of those students who could potentially actively commute to school (0.5 mile for grades K−5 and 1 mile for grades 6−8) 36.6% are passive commuters. No significant negative associations were found between BMI z-score or BMI percentile with accumulation of activity through active commuting (frequency × distance) for elementary (r = −0.04, P = .27) or middle school students (r = .027, P = .56).

Conclusion:

Many elementary students living within 0.3−0.4 miles are being driven to school. Promoting pedestrian-friendly communities and making healthy and sustainable transportation choices should be priorities for community leaders and school administrators.

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Marj Moodie, Michelle M. Haby, Boyd Swinburn and Robert Carter

Background:

To assess from a societal perspective the cost-effectiveness of a school program to increase active transport in 10- to 11-year-old Australian children as an obesity prevention measure.

Methods:

The TravelSMART Schools Curriculum program was modeled nationally for 2001 in terms of its impact on Body Mass Index (BMI) and Disability-Adjusted Life Years (DALYs) measured against current practice. Cost offsets and DALY benefits were modeled until the eligible cohort reached age 100 or died. The intervention was qualitatively assessed against second stage filter criteria (‘equity,’ ‘strength of evidence,’ ‘acceptability to stakeholders,’ ‘feasibility of implementation,’ ‘sustainability,’ and ‘side-effects’) given their potential impact on funding decisions.

Results:

The modeled intervention reached 267,700 children and cost $AUD13.3M (95% uncertainty interval [UI] $6.9M; $22.8M) per year. It resulted in an incremental saving of 890 (95%UI −540; 2,900) BMI units, which translated to 95 (95% UI −40; 230) DALYs and a net cost per DALY saved of $AUD117,000 (95% UI dominated; $1.06M).

Conclusions:

The intervention was not cost-effective as an obesity prevention measure under base-run modeling assumptions. The attribution of some costs to nonobesity objectives would be justified given the program’s multiple benefits. Cost-effectiveness would be further improved by considering the wider school community impacts.

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Jaakko Kaprio and Seppo Sarna

Occupational disability was investigated in former Finnish athletes in the Olympic Games, World or European championships, or intercountry competitions during 1920–1965 (N = 2,402 men) for eight selected sports. The referents were 1,712 men selected from the Finnish conscription register, matched on age and area of residence and classified as completely healthy. The first outcome measure was the length of working life based on the age when the subject was granted a disability pension, or age at death before age 65. The Kaplan-Meier estimate of mean working life expectancy was 61.4 years for endurance sport athletes, 60.0 years for team games athletes, and 59.2 years for power sport competitors, compared with 57.6 years for the reference group. Decreased coronary artery disease and cerebrovascular and respiratory morbidity were observed for all athletes when compared with the referent group. It was concluded that sustained and vigorous physical activity during early adulthood may extend the occupationally active life span and defer the onset of disability before retirement age.

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Fiona Iredale, Frank Bell and Myra Nimmo

Fourteen sedentary 50- to 55-year-old men were exercised to exhaustion using an incremental treadmill protocol. Mean (±SEM) peak oxygen uptake (V̇O2peak) was 40.5 ± 1.19 ml · kg1 · min−1, and maximum heart rate was 161 ± 4 beats · min−1. Blood lactate concentration was measured regularly to identify the lactate threshold (oxygen consumption at which blood lactate concentration begins to systematically increase). Threshold occurred at 84 ± 2% of V̇O2peak. The absolute lactate value at threshold was 2.9 ± 0.2 mmol · L−1. On a separate occasion, 6 subjects exercised continuously just below their individual lactate thresholds for 25 min without significantly raising their blood lactate levels from the 10th minute to the 25th. The absolute blood lactate level over the last 20 min of the steady-state test averaged 3.7 ± 1.2 mmol · L−1. This value is higher than that elicited at the threshold in the incremental test because of the differing nature of the protocols. It was concluded that although the lactate threshold occurs at a high percentage of V̇O2peak, subjects are still able to sustain exercise at that intensity for 25 min.

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Rebecca F. Wiener, Sabrina L. Thurman and Daniela Corbetta

We used eye tracking to investigate where infants and adults directed their gaze on a scene right before reaching. Infants aged 5, 7, 9, and 11 months old and adults looked at a human hand holding an object out of reach for 5 s, then the hand moved the object toward the participant for reaching. We analyzed which part of the scene (the object, the hand, or elsewhere) infants and adults attended the most during those 5 s before reaching. Findings revealed that adults’ visual fixations were majorly focused on the object to reach. Young infants’ looking patterns were more widely distributed between the hand holding the object, the object, and other nonrelevant areas on the scene. Despite distributed looking on the scene, infants increased their amount of time looking at the object between 5 and 11 months. Nine- and 11-month-olds showed overall accumulated looking durations comparable to adults’ for most of the objects; however, 9-month-olds differed in their rate of gaze transition between scene areas. From the age of 5 months old, infants are able to sustain their gaze to the pertinent scene area when the scene contains a central object on which they will later be able to act.