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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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Catherine J. Vladutiu, Kelly R. Evenson and Stephen W. Marshall

Background:

Although physical activity can provide health benefits to pregnant women, population-based research on the circumstances surrounding injuries from physical activity during pregnancy is lacking.

Methods:

Physical activity and subsequent injuries among a cohort of 1469 pregnant women in North Carolina were examined prospectively from the third phase of the Pregnancy, Infection, and Nutrition Study between 2001 and 2005. Chi-square analyses were used to compare distributions of maternal characteristics among women who sustained injuries from physical activity and women who reported no injuries during pregnancy. Injury incidence rates were calculated.

Results:

Few pregnant women (N = 34) reported a physical activity-related injury during pregnancy. The rates of physical activity-related and exercise-related injuries during pregnancy were 3.2 per 1000 physical activity hours and 4.1 per 1000 exercise hours, respectively. The most common types of injuries were bruises or scrapes (55%). Among all injuries, 33% resulted from exercise and 67% resulted from nonexercise physical activities. Sixty-four percent of all injuries were due to falls.

Conclusions:

The incidence of injury from physical activity was low during pregnancy. Women should continue to be encouraged to maintain involvement in physical activity during pregnancy, while being aware of the potential for injury, particularly falls, from these activities.

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Ryan D. Burns, Timothy A. Brusseau and James C. Hannon

Background:

Optimal levels of moderate-to-vigorous physical activity (MVPA) have been shown to improve health and academic outcomes in youth. Limited research has examined MVPA trajectories throughout a daily middle school physical education (PE) curriculum. The purpose of this study was to examine MVPA trajectories over a daily PE curriculum and the modifying effects of sex, body composition, and cardiorespiratory endurance.

Methods:

One hundred 7th- and 8th-grade students participated in daily PE lessons. There were 66 lessons throughout the semester. MVPA was monitored during each lesson using NL-1000 piezoelectric pedometers. Students were classified into FITNESSGRAM Healthy Fitness Zones using estimated VO2 Max and Body Mass Index (BMI). A population averaged generalized estimating equation was employed to examine MVPA trajectories.

Results:

On average, students’ MVPA decreased over time (β = –0.35, P < .001). Poor student VO2max classification significantly modified the trajectories (β = –0.14, P < .001), however poor BMI classification did not have a modifying effect (β = 0.03, P = .158).

Conclusions:

MVPA decreased in daily PE over time and cardiorespiratory endurance significantly modified the trajectories. The results support that extra efforts have to be made by teachers and students to sustain MVPA behaviors over a semester.

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Catherine E. Draper, Tracy L. Kolbe-Alexander and Estelle V. Lambert

Background:

The Community Health Intervention Programmes (CHIPs) is a physical activity-based health promotion program operating in disadvantaged communities in the Western Cape, South Africa with primary school learners, adults and senior adults. Program growth, anecdotal evidence and experience of those involved suggest the program has been positively received by communities. The aim of this study was to conduct a qualitative, retrospective process evaluation concerning both factors associated with successful implementation of the programs, and implementation challenges.

Methods:

‘Success’ was defined in consultation with CHIPs staff and stakeholders. Data were gathered through naturalistic observation, structured interviews and focus groups (n = 104), and open-ended questionnaires (n = 81). The sample included CHIPs staff and stakeholders, program members and leaders.

Results:

Factors contributing to the program’s success include: focus on combining social development and exercise science, community development model, scientifically sound program content, appropriate activities, intrapersonal and interpersonal factors, program leadership, encouraging staff, and various contextual factors.

Conclusions:

The findings confirm that CHIPs presents a model of sustainable implementation of physical activity in disadvantaged communities, and that it positively impacts the quality of life, perceptions of the role of physical activity in health, and personal responsibility for health of those involved in its programs.

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Markus V. Nahas, Mauro V. G. de Barros, Maria Alice A. de Assis, Pedro C. Hallal, Alex A. Florindo and Lisandra Konrad

Background:

A cross-cultural, randomized study was proposed to observe the effects of a school-based intervention designed to promote physical activity and healthy eating among high school students in 2 cities from different regions in Brazil: Recife and Florianopolis. The objective of this article is to describe the methodology and subjects enrolled in the project.

Methods:

Ten schools from each region were matched and randomized into intervention and control conditions. A questionnaire and anthropometry were used to collect data in the first and last month of the 2006 school year. The sample (n = 2155 at baseline; 55.7% females; 49.1% in the experimental group) included students 15 to 24 years, attending nighttime classes. The intervention focused on simple environmental/organizational changes, diet and physical activity education, and personnel training.

Results:

The central aspects of the intervention have been implemented in all 10 intervention schools. Problems during the intervention included teachers’ strikes in both sites and lack of involvement of the canteen owners in schools.

Conclusions:

The Saude na Boa study provides evidence that public high schools in Brazil represent an important environment for health promotion. Its design and simple measurements increase the chances of it being sustained and disseminated to similar schools in Brazil.

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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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Anthony Barnett, Ester Cerin and Tom Baranowski

Background:

A population level increase in physical activity (PA) is critical to reduce obesity in youth. Video games are highly popular and active video games (AVGs) have the potential to play a role in promoting youth PA.

Method:

Studies on AVG play energy expenditure (EE) and maintenance of play in youth were systematically identified in the published literature and assessed for quality and informational value.

Results:

Nine studies measuring AVG play EE were identified. The meta-analytic estimates of average METs across these studies were 3.1 (95% CI: 2.6, 3.6) to 3.2 (95% CI: 2.7, 3.7). No games elicited an average EE above the 6 MET threshold for vigorous EE. Observed differences between studies were likely due to the different types of games used, rather than age or gender. Four studies related to maintenance of play were identified. Most studies reported AV G use declined over time. Studies were of low-to-medium quality.

Conclusion:

AVGs are capable of generating EE in youth to attain PA guidelines. Few studies have assessed sustainability of AV G play, which appears to diminish after a short period of time for most players. Better-quality future research must address how AV G play could be maintained over longer periods of time.

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Cheryl B. Anderson

One’s athletic identity, developed and maintained by others as well as the self, is likely important in sustaining long-term physical activity over many years. The 21-item Athletic Identity Questionnaire (AIQ) is presented as a multidimensional measure of the components of athletic identity that reflects an attribute all people possess to varying degrees and encompasses exercise, sports, and physical activity. Confirmatory factor analyses in two samples of young adults (n = 446 and 485) supported a first-order model of four correlated factors: athletic appearance; importance of exercise/ sports/ physical activity; competence; and encouragement from others. A latent factor of physical activity with two indicators—stage of exercise behavior and exercise frequency per week—correlated significantly with the four athletic identity factors in both samples (r = 0.57–0.89 in Sample 1, r = 0.56–0.90 in Sample 2), and this 5-factor measurement model also represented an adequate fit. Results provide support for the reliability and validity of the AIQ.

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Mitch J. Duncan, Hannah M. Badland and William Kerry Mummery

Background:

The aim of this study was to examine the relationship between occupational category and 3 health-related behaviors: participation in leisure-time physical activity, active transport (AT) and occupational sitting in a sample of employed Australian adults.

Methods:

A random, cross-sectional sample of 592 adults aged 18 to 71 years completed a telephone survey in October/November 2006. Reported occupations were categorized as professional (n = 332, 56.1%), white-collar (n = 181, 30.6%), and blue-collar (n = 79, 13.3%). Relationships between occupational category and AT, sufficient physical activity and occupational sitting were examined using logistic regression.

Results:

White-collar employees (OR = 0.36, 95% CI 0.14−0.95) were less likely to engage in AT and more likely to engage in occupational sitting (OR = 3.10, 95% CI 1.63−5.92) when compared with blue-collar workers. Professionals (OR = 3.04, 95% CI 1.94−4.76) were also more likely to engage in occupational sitting compared with blue-collar workers. No relationship was observed between occupational category and engagement in sufficient physical activity.

Conclusions:

No association between occupational category and sufficient physical activity levels was observed, although white-collar and professionals were likely to engage in high levels of occupational sitting. Innovative and sustainable strategies are required to reduce occupational sitting to improve health.