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Abigail Sherman Katz and Nicolaas Petrus Pronk

Background:

Physical activity is regarded an important health behavior. Routine doctor visits, dentist visits, and willingness to seek phone advice from a nurse are considered important care-seeking behaviors (ie, behaviors that reflect the way in which people seek and access health care delivery resources available to them). Employers promote physical activity as well as care-seeking behavior to protect and promote health, optimize productivity, and manage health care costs. The purpose of this study was to investigate the association between physical activity and 3 care-seeking behaviors among a sample of 5500 employed adults.

Methods:

Data were obtained from employee health assessments. Logistic regression was used to test the relationship between physical activity and care-seeking behavior.

Results:

Physical activity was positively associated with all 3 measures of care-seeking behavior: doctor visits (P < .001), dentist visits (P < .001), and willingness to seek phone advice from a nurse (P < .05). For individuals reporting chronic conditions, physical activity was negatively associated with doctor visits for the condition (P < .05) and positively associated with self-perceived health (P < .001).

Conclusions:

Physical activity is associated with important care-seeking behaviors for employees with and without chronic conditions.

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Charles H. Tator

There has been a remarkable increase in the past 10 years in the awareness of concussion in the sports and recreation communities. Just as sport participants, their families, coaches, trainers, and sports organizations now know more about concussions, health care professionals are also better prepared to diagnose and manage concussions. As has been stated in the formal articles in this special issue on sport-related concussion, education about concussion is one of the most important aspects of concussion prevention, with the others being data collection, program evaluation, improved engineering, and introduction and enforcement of rules. Unfortunately, the incidence of concussion appears to be rising in many sports and thus, additional sports-specific strategies are required to reduce the incidence, short-term effects, and long term consequences of concussion. Enhanced educational strategies are required to ensure that individual participants, sports organizations, and health care professionals recognize concussions and manage them proficiently according to internationally recognized guidelines. Therefore, this paper serves as a “brief report” on a few important aspects of concussion education and prevention.

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Abhinav Singh and Bharathi Purohit

Background:

Regular physical activity is well recognized as an important lifestyle behavior for the development and maintenance of individual and population health and well-being. This study was conducted to evaluate physical activity, sedentary lifestyle, and obesity among Indian dental health professionals.

Methods:

Global Physical Activity Questionnaire was used to assess physical activity among 324 dental health care professionals. Metabolic equivalents (MET) were used to express the intensity of physical activities. Obesity was recorded corresponding to Body Mass Index. Individuals were considered in high risk group to develop obesity if energy expenditure was < 600 MET min/week.

Results:

Total physical activity measured in mean MET minutes per week was 625.6, 786.3, 296.5, and 296.5 for third year, final year, interns, and faculty, respectively (P ≤ .05). Obesity was observed in 22.4% of third-year students, 16.3% of final-year students, 20.4% of interns, and 40.8% of faculty members (P ≤ .001).

Conclusion:

The sedentary lifestyle of dental health care professionals is a major threat to the present and future health of the professionals by which the entire community could be prone to an epidemic of chronic disease.

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Cecilia Winberg, Gunilla Carlsson, Christina Brogårdh and Jan Lexell

Maintaining regular physical activity (PA) can be challenging for persons with late effects of polio. This qualitative study of ambulatory persons with late effects of polio explored their perceptions of PA, as well as facilitators of and barriers to PA. Semistructured interviews were conducted with 15 persons and analyzed with content analysis using the International Classification of Functioning, Disability and Health (ICF) as a framework. The participants described positive perceptions of PA and its health benefits. PA was used to prevent further decline in functioning, and the type and frequency of activities had changed over time. Past experiences and personal characteristics impacted PA. Support from close relatives, knowledgeable health care professionals, mobility devices, and accessible environments facilitated PA, whereas impairments, inaccessible environments, and cold weather were the main barriers. To perform PA regularly, persons with late effects of polio may benefit from individualized advice based on their disability and personal and environmental factors.

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Rebecca L. Vivrette, Laurence Z. Rubenstein, Jennifer L. Martin, Karen R. Josephson and B. Josea Kramer

Objective:

To determine seniors’ beliefs about falls and design a fall-risk self-assessment and educational materials to promote early identification of evidence-based fall risks and encourage prevention behaviors.

Methods:

Focus groups with community-dwelling seniors, conducted in two phases to identify perceptions about fall risks and risk reduction and to assess face validity of the fall-risk self-assessment and acceptability of educational materials.

Results:

Lay perception of fall risks was in general concordance with evidence-based research. Maintaining independence and positive tone were perceived as key motivators for fall prevention. Seniors intended to use information in the educational tool to stimulate discussions about falls with health care providers.

Implications:

An evidence-based, educational fall-risk self-assessment acceptable to older adults can build on existing lay knowledge about fall risks and perception that falls are a relevant problem and can educate seniors about their specific risks and how to minimize them.

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Ulrika Olsson Möller, Jimmie Kristensson, Patrik Midlöv, Charlotte Ekdahl and Ulf Jakobsson

Objectives:

To investigate the effects of a home-based one-year case management intervention in older people with functional dependency and repeated contact with the health care services on self-reported falls and self-reported injurious falls.

Methods:

The study was a randomized controlled trial with repeated follow-ups. The sample (n = 153) was consecutively and randomly assigned to the intervention group (n = 80, mean age = 81.4 [SD 5.9]) or control group (n = 73, mean age = 81.6 [SD 6.8]). The intervention group received a case management intervention which comprised monthly home visits during 12 months by nurses and physiotherapists employing a multifactorial preventive approach.

Results:

In the intervention group, 96 falls occurred during the intervention period compared with 85 falls in the control group (p = .900). There were 40 and 38 injurious falls (p = .669) in the intervention and control groups, respectively.

Conclusions:

This home-based case management intervention was not able to prevent falls or injurious falls.

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Anna-Karin Welmer, Annika Mörck and Synneve Dahlin-Ivanoff

The aim of this study was to describe experiences of physical activity, perceived meaning, and the importance of and motives and barriers for participation in physical activity in people 80 years of age and older. A qualitative design with focus-group methodology was used. The sample consisted of 20 community-living people age 80–91 yr. Data analyses revealed 4 themes: physical activity as a part of everything else in life, joie de vivre, fear of disease and dependence, and perceptions of frailty. Our results suggest that physical activity was not seen as a separate activity but rather as a part of activities often rated as more important than the physical activity itself. Thus, when designing physical activity interventions for elderly people, health care providers should consider including time for social interaction and possibilities to be outdoors. Moreover, assessment of physical activity levels among elderly people should include the physical activity in everyday activities.

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Catrine Tudor-Locke, Anita M. Myers, C. Shanthi Jacob, Gareth Jones, Darien-Alexis Lazowski and Nancy A. Ecclestone

The Home Support Exercise Program (HSEP) was developed to reach frail community seniors through home support workers (HSWs) rather than more costly health care professionals such as visiting nurses or physical therapists. This article describes the development and formative evaluation of the HSEP prototype, including the training of case managers and HSWs. In the HSEP’s final form, each client is instructed on 10 simple, functional, and progressive exercises and given an illustrated booklet and a short video. Ongoing encouragement is provided by specifically trained HSWs during regular visits (at least once a week). Formative evaluation of the HSEP model was used to examine and resolve implementation and delivery issues. Qualitative data were collected through focus groups or interviews with each stakeholder group—administrators/coordinators, case managers, HSWs, agency supervisors, and clients themselves. Evaluation findings were used to modify training, instructional, and support materials and the exercises.

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Anita L. Stewart, Melanie Grossman, Nathalie Bera, Dawn E. Gillis, Nina Sperber, Martha Castrillo, Leslie Pruitt, Barbara McLellan, Martha Milk, Kate Clayton and Diana Cassady

Diffusing research-based physical activity programs in underserved communities could improve the health of ethnically diverse populations. We utilized a multilevel, community-based approach to determine attitudes, resources, needs, and barriers to physical activity and the potential diffusion of a physical activity promotion program to reach minority and lower-income older adults. Formative research using focus groups and individual interviews elicited feedback from multiple community sectors: community members, task force and coalition members, administrators, service implementers, health care providers, and physical activity instructors. Using qualitative data analysis, 47 transcripts (N = 197) were analyzed. Most sectors identified needs for culturally diverse resources, promotion of existing resources, demonstration of future cost savings, and culturally tailored, proactive outreach. The program was viewed favorably, especially if integrated into existing resources. Linking sectors to connect resources and expertise was considered essential. Complexities of such large-scale collaborations were identified. These results may guide communities interested in diffusing health promotion interventions.

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Michael B. Hudson

It can be challenging deciding how to resolve personal and professional dilemmas, and the dilemmas that athletic trainers and athletic therapists experience are no different, if not more complex, than the dilemmas other health care professionals experience. The moral behaviors individuals demonstrate with these dilemmas come from their experiences; however, moral beliefs may not always coincide with professional obligations and ethics. The purpose of this article is to examine factors that influence decision making for athletic trainers and athletic therapists to identify and describe policies for guiding moral behaviors in the workplace. These key policies include education in ethical decision making, developing a workplace code of conduct, communicating policies regarding professional behaviors, appraising accepted values and behaviors in the workplace, and investigating possible ethical violations and applying appropriate sanctions.