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Ann E. Vandenberg, Rebecca H. Hunter, Lynda A. Anderson, Lucinda L. Bryant, Steven P. Hooker and William A. Satariano

Background:

Research on walking and walkability has yet to focus on wayfinding, the interactive, problem-solving process by which people use environmental information to locate themselves and navigate through various settings.

Methods:

We reviewed the literature on outdoor pedestrian-oriented wayfinding to examine its relationship to walking and walkability, 2 areas of importance to physical activity promotion.

Results:

Our findings document that wayfinding is cognitively demanding and can compete with other functions, including walking itself. Moreover, features of the environment can either facilitate or impede wayfinding, just as environmental features can influence walking.

Conclusions:

Although there is still much to be learned about wayfinding and walking behaviors, our review helps frame the issues and lays out the importance of this area of research and practice.

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Susan Henderson, Robin Tanner, Norma Klanderman, Abby Mattera, Lindsey Martin Webb and John Steward

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Laura A. Esparza, Katherine S. Velasquez and Annette M. Zaharoff

Background:

Physical inactivity and related health consequences are serious public health threats. Effective strategies to facilitate and support active-living opportunities must be implemented at national, state, and local levels. San Antonio, Texas, health department officials launched the Active Living Council of San Antonio (ALCSA) to engage the community in developing a 3- to 5-year plan to promote active living.

Methods:

A steering committee set preliminary ALCSA aims and established a multisector membership structure modeled after the US National Physical Activity Plan (NPAP). ALCSA adopted governance standards, increased knowledge of physical activity and health, and engaged in an 18-month collaborative master plan writing process.

Results:

ALCSA selected overarching strategies and evidence-based strategies for each societal sector and adapted strategies to the local context, including tactics, measures of success, and timelines. Community and expert engagement led to a localized plan reflecting national recommendations, the Active Living Plan for a Healthier San Antonio.

Conclusion:

Multisector collaborations among governmental agencies and community organizations, which were successfully developed in this case to produce the first-ever local adaptation of the NPAP, require clearly defined expectations. Lessons learned in ALCSA’s organizational and plan development can serve as a model for future community-driven efforts to increase active living.

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Lira Yun, Elaine M. Ori, Younghan Lee, Allison Sivak and Tanya R. Berry

Background:

Mass media campaign is an integral tool to influence physical activity participant behaviors. The purpose of the systematic review was to identify the effectiveness of mass media campaigns in promoting physical activity.

Methods:

Literature update from January 2010 to September 2016 was conducted in 13 databases. Full text articles of 128 were screened, and 23 articles (18 campaigns) were selected from the initial 1692 articles.

Results:

All campaigns involved mass media advertisements to promote physical activity to general individuals (n = 2), adults (8), children (4), older adults (2), and parents of children (n = 2). The campaign evaluation designs included clustered RCT (2), cohort (3), quasi-experimental (9), and cross-sectional (9). Eight articles demonstrated significant campaign impact on proximal, 6 on intermediate, 5 on distal outcomes, and 6 on distal change based on either proximal or intermediate outcome.

Conclusion:

The current review assessed the outcome evaluation of mass media physical activity campaigns that varied in their respective scope, target population and outcomes measured to identify individual changes at proximal, intermediate, and distal level. Results from formative and process evaluation as well as dose-response and cost-effective analysis are suggested to provide valuable evidence for campaign stakeholders and planners.

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Francini Vilela Novais, Eduardo J. Simoes, Chester Schmaltz and Luiz R. Ramos

Background: Physical activity promotion within primary health care is in the spotlight. However, few studies have evaluated the long-term effectiveness of possible interventions. This study aimed to compare the effectiveness of 3 primary health care interventions in increasing leisure-time physical activity among older Brazilians. Methods: Experimental study with 142 older residents of an ongoing urban cohort in São Paulo (Brazil). Participants were randomized into 3 groups: minimal intervention group, physician-based counseling group, and individual counseling and referral for physical activity programs group (CRG). We used the long version of the International Physical Activity Questionnaire to assess leisure-time physical activity at baseline, 4 years after baseline without any intervention, 3 months after intervention, and 6 months after intervention. Statistical analysis included repeated analysis of variance. Results: At baseline, 31% of the individuals were active, and this figure remained stable for a period of 4 years. Three months after the interventions, there was a significant increase in leisure-time physical activity for CRG compared with the minimal intervention (P < .001) and physician-based counseling (P < .02) groups, and these differences persisted after 6 months (P < .001 and P < .05, respectively). Conclusion: Results indicate that interventions with CRG are effective in producing sustained changes in physical activity among older Brazilians.

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Jennifer L. Gay, Sara W. Robb, Kelsey M. Benson and Alice White

Background:

The Social Vulnerability Index (SVI), a publicly available dataset, is used in emergency preparedness to identify communities in greatest need of resources. The SVI includes multiple socioeconomic, demographic, and geographic indicators that also are associated with physical fitness and physical activity. This study examined the utility of using the SVI to explain variation in youth fitness, including aerobic capacity and body mass index.

Methods:

FITNESSGRAM data from 2,126 Georgia schools were matched at the census tract level with SVI themes of socioeconomic, household composition, minority status and language, and housing and transportation. Multivariate multiple regression models were used to test whether SVI factors explained fitness outcomes, controlling for grade level (ie, elementary, middle, high school) and stratified by gender.

Results:

SVI themes explained the most variation in aerobic fitness and body mass index for both boys and girls (R 2 values 11.5% to 26.6%). Socioeconomic, Minority Status and Language, and Housing and Transportation themes were salient predictors of fitness outcomes.

Conclusions:

Youth fitness in Georgia was related to socioeconomic, demographic, and geographic themes. The SVI may be a useful needs assessment tool for health officials and researchers examining multilevel influences on health behaviors or identifying communities for prevention efforts.

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Alex Antonio Florindo, Evelyn Fabiana Costa, Thiago Herick Sa, Taynã Ishii dos Santos, Marília Velardi and Douglas Roque Andrade

Background:

The aim of this study was to describe a methodology for training to provide counseling on physical activity among community health workers working within primary healthcare in Brazil.

Methods:

This was an intervention study conducted with 65 community health workers in the Ermelino Matarazzo district in the São Paulo, Brazil (30 in intervention group). The intervention group received a course of 12 hours (with 4 meetings of 3 hours each in 1 month) that aimed to improve their knowledge and be autonomous with regard to promoting physical activity. For data analysis, focus groups and questionnaires on knowledge and perceptions regarding physical activity were used.

Results:

The average attendance for the 4 meetings was 29 workers (93% of total). There was an improvement in knowledge on physical activity recommendations in comparison with the control (P = .03), and qualitative results revealed that the professionals appreciated the learned content, valued its application based on knowledge construction and felt secure about promoting physical activity. This was seen through high adherence levels and construction collective of proposal for home visits for physical activity promotion.

Conclusion:

The training was effective in improving knowledge and attitudes toward counseling on physical activity among community health workers.

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Gregory W. Heath and John Bilderback

Background: There is a paucity of studies, especially among diverse populations, demonstrating the effects of policy and environmental interventions to increase regular physical activity. The Grow Healthy Together Chattanooga project provided the opportunity to assess the impact of physical activity policy and environmental interventions on the physical activity among predominately African American children living in the inner city. Methods: Using the System for Observing Physical Activity and Recreation in Communities (SOPARC), the authors examined the physical activity of children along urban pedestrian/bike routes/trails and recreational park areas within the boundaries of the Grow Healthy Together Chattanooga communities. SOPARC data were collected at baseline (fall 2010/spring 2011) and repeated (spring 2014) in each community. Results: The SOPARC assessments yielded a total of 692 child/youth observations in 2010 and 806 observations in 2014. Children/youth observed in 2014 were greater than 2 times the odds of engaging in moderate/vigorous physical activity compared with their 2010 counterparts (odds ratio  = 2.75, 95% confidence interval, 1.43–5.32). Conclusions: The present findings support the hypothesis that policy and environmental interventions can contribute to increased physical activity levels among children/youth over ∼3-year period. These results provide evidence that improved access to “urban” pedestrian/bicycle routes/trails appears to translate into increased opportunities for physical activity among inner city children/youth.

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Alan G. Knuth, Deborah C. Malta, Danielle K. Cruz, Adriana M. Castro, Janaína Fagundes, Luciana M. Sardinha, Cristiane Scolari Gosch, Eduardo J. Simões and Pedro C. Hallal

Background:

Based on the Brazilian National Health Promotion Policy (PNPS), the Ministry of Health (MoH) started stimulating and funding physical activity interventions in 2005, leading to the establishment of a countrywide network. The aim of the present article is to geographically describe this network (2005−2008) and to present structure and process evaluation indicators of interventions funded in 2006 and 2007.

Methods:

In 2005, the 27 state capitals received funding for carrying out physical activity-related interventions. From 2006 onwards, public calls for proposals were announced, and cities were selected through a competitive basis. Coordinators of interventions in cities who got funding in 2006 and 2007 answered to survey questions on structure and process aspects of the interventions.

Results:

The network currently comprises 469 projects, out of which over 60% are carried out in small cities (<30,000 inhabitants). The most frequently used public spaces for the interventions are squares and indoor sports courts. The main physical activity-related topic of the PNPS prioritized in the projects is healthy diet. The main partnerships developed are between City's Health and Education Secretariats.

Conclusion:

Expanding the network to 1000 cities by 2010 and continuing the evaluation efforts are the next goals of the Brazilian MoH.