Policies and opportunities for physical activity in middle school environments

BACKGROUND: This study examined physical activity opportunities and barriers at 36 geographically diverse middle schools participating in the Trial of Activity for Adolescent Girls. METHODS: Principals, physical education and health education department heads, and program leaders were interviewed to assess policies and instructional practices that support physical activity. RESULTS: Schools provided approximately 110 hours per year in physical education instruction. Approximately 20% of students walked or bicycled to school. Eighty-three percent of schools offered interscholastic sports and 69% offered intramural sports. Most schools offered programs for girls, but on average, only 24 girls ( approximately 5%) in the schools attended any programs. Only 25% of schools allowed after school free play. An overall score created to assess school environmental support for physical activity indicated that, on average, schools met 6.7 items of 10 items. Free/reduced lunch program participation versus not (p = .04), perceived priority of physical education instruction over coaching (p = .02), and safety for walking/bicycling to school (p = .02) predicted environmental support score. CONCLUSIONS: Schools have policies and practices that support physical activity, although unfavorable practices exist. Schools must work with community partners and officials to provide environments that optimally support physical activity, especially schools that serve low-income students.     

Trends in prevalence of leisure time physical activity and inactivity: results from Australian National Health Surveys 1989 to 2011

Objective: To examine trends in leisure time physical activity and inactivity in Australians aged 15 years or older from 1989 to 2011. Method: We used data from six Australian National Health Surveys conducted from 1989/90 to 2011/12 in which physical activity was assessed using comparable questions. Analyses examined trends in the prevalence of sufficient physical activity (≥150 minutes/week moderate‐to‐vigorous physical activity) and of inactivity (<30 minutes/week moderate‐to‐vigorous physical activity). Results: The proportion of sufficiently active adults was 39.2% in 1989 and 40.7% in 2011 with an overall declining trend of 0.2% per year (p=0.012). The prevalence of inactivity was 38.7% in 1989 and 37.3% in 2011; the overall time trend by year was stable (OR=0.999, p=0.242). In women, sufficient physical activity decreased by 0.3% per year from 35.5% in 1989 (p=0.025); inactivity increased from 39.5% by 0.3% per year (p=0.004). In men, sufficient physical activity prevalence was 43.1% in 1989 with a steady trend; inactivity decreased from 37.9% by 0.5% per year (p<0.0001). Conclusions: The prevalence of sufficient physical activity remains low and inactivity high. Women appear to be a key target group for intervention. Public health efforts have been ineffective over two decades for improving physical activity among Australian adults. Implications for public health: This research supports calls for a national physical activity action plan given the multitude of benefits from sufficient physical activity. Maintenance of consistent physical activity questions in future National Health Surveys will facilitate long term tracking of physical activity levels in the Australian population.     

A place to play: socioeconomic and spatial factors in children's physical activity

Background and aims:  Concerns about physical inactivity in children and growing levels of obesity are expressed by politicians, health economists and those involved with the health and well-being of children. As this has the potential to be a major health issue, the aim of this investigation was to explore any contributing socioenvironmental considerations.
Methods and results:  Census-matched survey data were analysed from 318 parents of 6- to 7-year-old children, revealing that family socioeconomic status (SES) influenced the places where children engaged in physical activity. Children from low SES backgrounds spent significantly more time playing close to their homes, and their families were less able to afford access to commercial physical-activity facilities, than those from middle and high SES families. Although neighbourhood-based activities are generally associated with more spontaneous free play, such activities may not provide the same opportunities for supervision and physical skill building available through commercial-based activities.
Conclusions:  Given that access to 'enriching' physical-activity spaces may be limited by the capacity to pay, these findings have implications for professionals such as occupational therapists who can take on a role in advocating for equity in access and promotion of a more engaging urban design. Dialogue with urban planners is central to this process.     

Socioeconomic status differences in recreational physical activity levels and real and perceived access to a supportive physical environment

BACKGROUND: Spatial access to recreational facilities and perceptions of the neighborhood environment and physical activity levels were examined by the socioeconomic status of area of residence (SES). METHODS: A cross-sectional survey of adults (18-59 years) (n = 1,803) stratified by SES using a geographic-based index was conducted. RESULTS: Respondents in low SES areas had superior spatial access to many recreational facilities, but were less likely to use them compared with those living in high SES areas. They were more likely to perceive that they had access to sidewalks and shops, but also perceived that their neighborhood was busier with traffic, less attractive, and less supportive of walking. After adjustment, respondents living in low SES areas were 36% less likely to undertake vigorous activity. While they were more likely to walk for transport, this was not statistically significant (OR, 1.27; 95% CI, 0.98-1.64), nor were other SES differences in walking for recreation and walking as recommended. Modifiable environmental factors were associated with walking and vigorous activity, especially perceived access to sidewalks and neighborhood attractiveness. Spatial access to attractive, public open space was associated with walking. CONCLUSIONS: Creating supportive environments--particularly sidewalks in attractive neighborhoods--has the potential to increase walking and vigorous activity.     

Changes in physical activity in pre-schoolers and first-grade children: longitudinal study in the Czech Republic

Background The transition from kindergarten to first year at school is associated with a variety of psychosocial changes in children. The aim of this longitudinal study was to identify the changes in children's physical activity (PA) upon entry to first year at school; and to identify the days of the school week that exhibit low PA. Methods We monitored the PA levels of 176 children twice: initially in kindergarten and again in first‐year classes at school. The age (mean ± standard deviation) of children at kindergarten was 5.7 ± 0.5 years and 6.7 ± 0.5 years at the first year of elementary school. We evaluated PA employing the activity energy expenditure (AEE – kcal/kg/day) from Caltrac accelerometer and daily amount of steps (STEPS) from Yamax pedometer. Participants were monitored over 7 days to include a weekend. Results The mean AEE was 11.5 in pre‐school girls and 12.9 kcal/kg/day in boys; and STEPS were 9923 steps/day in girls and 11 864 in boys on weekdays. At weekends, it was 11.5 kcal/kg/day in girls and 12.7 kcal/kg/day in boys and 10 606 steps/day in girls and 11 182 steps/day in boys. The mean AEE and STEPS in first‐grade girls and boys was 9.9 and 9.8 kcal/kg/day respectively, and 7911 and 8252 steps/day respectively on weekdays, and 8.8 and 9.0 kcal/kg/day and 6872 and 7194 steps/day respectively at weekends. First‐grade school children had significantly lower PA than pre‐school children on weekdays (P < 0.0001) and at weekends (P < 0.0001). Decline in PA on weekdays was during time spent at school (P < 0.0001) and not during after‐school children's leisure time. Conclusion The parts of the week when first‐grade school children show low PA are the times spent in lessons and in after‐school nursery and at weekends. PA needs to be promoted using intervention programmes mainly during the after‐school nursery programmes and at weekends.     

学龄前儿童久坐行为时间与身体活动水平、心理健康状况的关系

目的 分析学龄前儿童久坐行为时间与身体活动水平、心理健康状况的关系,为制定针对学龄前儿童身体活动、心理健康的干预策略提供参考。方法 2019年1—12月选择本地区所辖幼儿园的145名学龄前儿童作为调查对象,用长处和困难问卷(SDQ)(父母版)、三轴加速度计及配套的ActiLife软件对本次全部调查对象开展调查,汇总心理健康状况异常检出率、久坐行为时间与身体活动水平,利用Pearson/Spearman相关分析法分析学龄前儿童久坐行为时间与身体活动水平、心理健康状况的相关性。结果 本地区学龄前儿童久坐行为时间较长(26.49±7.58)min/h,且主要集中在每日12:00-15:59;学龄前儿童身体活动水平总体以低强度身体活动为主,男生中强度身体活动比例最高,女生低强度身体活动比例最高,不同性别身体活动水平比较差异有统计学意义(χ²=10.504,P=0.005);学龄前儿童心理健康状况异常检出率为50.34%(73/145)。相关性分析结果显示:学龄前儿童久坐行为时间与身体活动水平呈负相关(r=-0.418,P＜0.001),与心理健康状况评分呈正相关(r=0.341,P＜0.001)。结论 学龄前儿童久坐行为时间与身体活动水平、心理健康状况关系密切,应通过提高本地区学龄前儿童身体活动水平,缩短久坐行为时间,进而促进心理健康。     

Physical activity energy expenditure in Dutch adolescents: contribution of active transport to school, physical education, and leisure time activities

BACKGROUND: Detailed knowledge about physical activity energy expenditure (PAEE) can guide the development of school interventions aimed at reducing overweight in adolescents. However, relevant components of PAEE have never been objectively quantified in this population. This study investigated the contribution of active transport to and from school, physical education (PE), and leisure time activities to total PAEE during a regular school week in adolescents. METHODS: Seventy‐three adolescents (mean age: 15.7 years) wore an individually calibrated combined heart rate‐acceleration monitor and kept an activity diary during a regular school week. Branched equation modeling was used to calculate PAEE of the specific activity categories, and their relative contribution to total PAEE was determined. RESULTS: Active transport and PE contributed 30.0% and 17.4%, respectively, to school‐related PAEE. Active transport to and from school contributed 15% to total PAEE. Youth with a high physical activity level (PAL) spent 4 hours less in sedentary behavior than subjects with a medium or low PAL (F = 77.415 (2.70), p < .001) and had higher PAEE during leisure time sports (F = 9.135 (2.70), p < .001) and work‐related activities (F = 10.583 (2.70), p < .001) than youth with medium or low PAL values. CONCLUSIONS: Active transport and PE contribute significantly to PAEE during school hours in adolescents. To achieve an increase in total PAEE in the least active group of adolescents, promising strategies might be to reduce inactive behavior, increase participation in leisure time sports, and possibly to replace inactive for active jobs.     

Determinants of leisure time physical activity in rural compared with urban older and ethnically diverse women in the United States

STUDY OBJECTIVE: Determinants of leisure time physical activity (LTPA) in rural middle aged and older women of diverse racial and ethnic groups are not well understood. This study examined: (1) urban-rural differences in LTPA by sociodemographic factors, (2) urban-rural differences in LTPA determinants, and (3) the pattern of relations between LTPA determinants and LTPA. DESIGN: A modified version of the sampling plan of the Behavioral Risk Factor Surveillance Survey (BRFSS) was used. Zip codes were selected with 20% or more of each of the following race/ethnic groups: African American, American Indian/Alaskan Native (AI/AN), and Hispanic. A comparison group of white women were also surveyed using standard BRFSS techniques. PARTICIPANTS: Rural (n=1242) and urban (n=1096) women aged 40 years and older from the US Women's Determinants Study. MAIN RESULTS: Rural women, especially Southern and less educated women, were more sedentary than urban women. Rural women reported more personal barriers to LTPA, cited caregiving duties as their top barrier (compared with lack of time for urban women), and had greater body mass indices. Rural women were less likely to report sidewalks, streetlights, high crime, access to facilities, and frequently seeing others exercise in their neighbourhood. Multivariate correlates of sedentary behaviour in rural women were AI/AN and African American race, older age, less education, lack of enjoyable scenery, not frequently seeing others exercise, greater barriers, and less social support (p<0.05); and in urban women, older age, greater barriers, less social support (p<0.05), and less education (p<0.09). CONCLUSIONS: Rural and urban women seem to face different barriers and enablers to LTPA, and have a different pattern of determinants, thus providing useful information for designing more targeted interventions.     

Educational differences in starting excessive alcohol consumption: explanations from the longitudinal GLOBE study

This paper describes educational differences in starting excessive alcohol consumption during 6 1/2 years of follow-up among 1648 initially alcohol-consuming Dutch adults. The longitudinal GLOBE study provides the unique possibility to study explanations for educational differences due to the collection of extensive baseline information on educational level, alcohol consumption, stressors (tension reduction theory) and vulnerability indicators (differential vulnerability theory) in 1991. Alcohol consumption was again assessed in 1997. We report that lower educated people were almost three times more likely to start excessive alcohol consumption during follow-up compared to the highest educated persons. Both educational differences in exposure to stressors (financial problems) and vulnerability (low social support) contributed to the educational differences in starting excessive alcohol consumption and explained 23% of the educational variation in starting excessive alcohol consumption. Remaining educational differences were however still statistically significant. These results are discussed with regard to implications for interventions and possible additional explanatory mechanisms.     

Sociodemographic and socioeconomic variations in leisure time physical activity in a sample of Hungarian youth

Summary Objectives:  The main goal of the present study is to detect the relationship between youth’s leisure time physical activity and a set of sociodemographic (age, gender, family stucture) and socioeconomic variables (SES and parental schooling). Methods:  Data were collected among Hungarian youth (middle and high school students, N = 1662) aged between 10–20 years using a self-administered questionnaire. Results:  Our findings did not indicate gender differences during the years of middle school, whereas gender differences became significant during the years of high school. In multivariate analyses, parental schooling played a decisive role in youth’s physical activity, wheres SES self-assessment did not remain significant. Conclusion:  These findings provide some useful information on characteristics of the target groups for health education programs. Submitted: 06 December 2007; Revised: 05 May 2008; Accepted: 01 September 2008     

Seasonal variation in household, occupational, and leisure time physical activity: longitudinal analyses from the seasonal variation of blood cholesterol study

The authors examined seasonal variation in physical activity in longitudinal analyses of 580 healthy adults from Worcester, Massachusetts (the Seasonal Variation of Blood Cholesterol Study, 1994-1998). Three 24-hour physical activity recalls administered five times during 12 months of follow-up were used to estimate household, occupational, leisure time, and total physical activity levels in metabolic equivalent (MET)-hours/day. Trigonometric models were used to estimate the peak-to-trough amplitude and phase of the peaks in activity during the year. Total activity increased by 1.4 MET-hours/day (121 kcal/day) in men and 1.0 MET-hours/day (70 kcal/day) in women during the summer in comparison with winter. Moderate intensity nonoccupational activity increased by 2.0-2.4 MET-hours/day in the summer. During the summer, objectively measured mean physical activity increased by 51 minutes/day (95% confidence interval: 20, 82) in men and by 16 minutes/day (95% confidence interval: -12, 45) in women. The authors observed complex patterns of seasonal change that varied in amplitude and phase by type and intensity of activity and by subject characteristics (i.e., age, obesity, and exercise). These findings have important implications for clinical research studies examining the health effects of physical activity and for health promotion efforts designed to increase population levels of physical activity.     

Zinc status and dietary quality of type 2 diabetic patients: implication of physical activity level

The purpose of this study was to analyze the relationships among zinc status, diet quality, glycemic control and self-rated physical activity level of type 2 diabetic patients. Dietary intakes for two non-consecutive days were measured by 24-hour recall method for seventy-six diabetic patients. Fasting blood glucose and HbA1c were measured for the assessment of glycemic control. We evaluated the extent of dietary adequacy by the percentage of subjects with a dietary intake of a nutrient less than the estimated average requirement(EAR), the dietary diversity score(DDS) and the dietary variety score(DVS). Zinc status was assessed from serum levels and urinary excretion. Dietary inadequacy was serious for five nutrients: riboflavin, calcium, thiamin, zinc and vitamin C. Dietary intakes from the meat, fish, and egg food groups and the milk food group were below the recommended level. We found that subjects with high levels of physical activities had significantly higher DVS and serum zinc levels compared to others (p<0.05). Fasting blood glucose levels and HbA1c were not significantly different across self-reported physical activity levels. Therefore, we suggest that maintaining physical activity at or above a moderate level is beneficial to improving dietary quality and zinc status.     

Distinct trajectories of leisure time physical activity and predictors of trajectory class membership: a 22 year cohort study

Background

Policy is frequently identified in the behavioural nutrition and physical activity research literature as a necessary component of effective research and practice. The purpose of this commentary is to promote a dialogue to contribute towards the further development of conceptual understandings and theories of the relationship between policy practice and behavioural research and how these two activities might work synergistically to improve public health outcomes.

Methods

Drawing on policy and public health literature, this commentary presents a a conceptual model of the interaction and mediation between nutrition and physical activity-relevant policy and behavioural nutrition and physical activity research, environments, behaviours and public health implications. The selling of food in school canteens in several Australian states is discussed to illustrate components of the relationship and the interactions among its components.

Results

The model depicts a relationship that is interdependent and cyclic. Policy contributes to the relationship through its role in shaping environmental and personal-cognitive determinants of behaviours and through these determinants it can induce behaviour change. Behavioural research describes behaviours, identifies determinants of behaviour change and therefore helps inform policy development and monitor and evaluate its impact.

Conclusion

The model has implications for guiding behavioural research and policy practice priorities to promote public health outcomes. In particular, we propose that policy practice and behavioural research activities can be strengthened by applying to each other the theories from the scientific disciplines informing these respective activities. Behavioural science theories can be applied to help understand policy-making and assist with disseminating research into policy and practice. In turn, policy science theories can be applied to support the 'institutionalisation' of commitments to ongoing behavioural research.     

The barriers to participation in leisure time physical activities among Iranian women with severe mental illness: A qualitative study

Background and objectivesSedentary behavior and physical inactivity are known risk factors for poor health and increased mortality in patients with severe mental illness. Identifying the barriers to participation in leisure-time physical activities among these patients can be helpful in planning effective interventions aimed at increasing activity level. Prior to the present study, the barriers experienced by female patients in Iran were unknown.Materials and methodsThis was a qualitative study using conventional content analysis. Participants were 32 women with severe mental illness who were hospitalized at women's psychiatric wards of Farabi Teaching Hospital in Kermanshah, Iran, from September 2015 to March 2016. Data were collected through four focus group discussion sessions and were then analyzed.ResultsParticipants had a mean age of 42 (SD = 7.8) and an active diagnosis of schizoaffective disorder (n = 10), schizophrenia (n = 8), a chronic bipolar disorder (n = 8), or major depression disorder (n = 6). Two main barrier categories emerged: Personal experience of disease and Non-supportive context. Within the former, stigma of disease, signs and symptoms of disease, and medication side effects were the constituent subcategories. Non-supportive context subcategories consisted of family, cultural, environmental, and medical staff barriers that influenced non-participation in leisure-time physical activities.ConclusionIranian women with severe mental illness face a number of barriers to participation in leisure-time physical activities including the stigma, symptoms, and treatment of mental illness; and contextual barriers such as family expectations, societal perceptions, environmental factors, and lack of medical staff support. It is recommended that providers consider these factors when developing therapeutic plans for similar patient populations.     

A high level of household physical activity compensates for lack of leisure time physical activity with regard to deficit accumulation: Results from the KORA-Age study

IntroductionAging is associated with increasing loss of physiological resilience and successive accumulation of physiological deficits. This can be measured through a frailty index which sums up symptoms, health conditions and impairments. One possible factor in preventing or delaying deficit accumulation is physical activity. The effect of leisure time physical activity on health is well investigated; however, the effect of household physical activity is less clear. The objective of this cross-sectional study was to examine the association of household physical activity with deficit accumulation while controlling for level of leisure time physical activity.MethodsData originates from the 2008 baseline assessment of the KORA (Cooperative Health Research in the Region of Augsburg)-Age study from Southern Germany. A frailty index of deficit accumulation (Deficit Accumulation Index, DAI) was constructed from 31 age-related health deficits. Physical activity was measured with the Physical Activity Scale for the Elderly (PASE). The association of deficit accumulation and physical activity was analyzed using negative binomial regression analysis.ResultsThe participants' (n = 960, mean age 76 years, 49.0% female) DAI ranged from 0.00 to 0.68. Higher levels of both types of physical activity were statistically significantly associated with less deficit accumulation. Participants in the highest household (leisure time) physical activity quartile had 29% (30%) less deficits than participants in the respective lowest quartiles.ConclusionHigh levels of household physical activity might compensate for low levels of leisure time physical activity in the prevention of deficit accumulation. Further research efforts investigating the temporal sequence of this association are needed.     

Association of leisure time physical activity and sports competition activities with high blood pressure levels: study carried out in a sample of Portuguese children and adolescents

Background A better understanding of the different domains and characteristics of children's and adolescent's physical activity (PA) could be a strategy to clarify the association of this behaviour with the early development of cardiovascular risk factors. Objectives To examine the relationship between leisure time physical activity (LTPA) and sports competition activities (SCA) with high blood pressure (HBP) levels in a sample of children and adolescents from Porto, Portugal. Study design This is a cross‐sectional study, which comprised 503 boys and 572 girls, aged 8–17 years old. LTPA and SCA were assed by self‐reported. Students were assigned as active and non‐active in SCA or LTPA according to their self‐reported participation. Participants were classified as HBP when they are above of the last quartile for systolic and/or diastolic BP adjusted for gender and age. Results Do not be engaged in LTPA (OR: 1.47; 95% CI: 1.12; 1.93) and SCA (OR: 1.36; 95% CI: 1.02; 1.81) was significantly associated with the likelihood of being HBP. However, when cardiorespiratory fitness (CRF) (OR: 1.23; 95% CI: 0.91; 1.67) and body mass index (BMI) (OR: 1.31; 95% CI: 0.98; 1.75) were included on SCA model, the association between SCA with HBP did not showed significant results. Conclusion Children and adolescents who are not engaged in SCA or LTPA are more likely to be classified as having HBP; however, the relationship between SCA and HBP was dependent of CRF and BMI. Further, PA strategies should take these differences on the relationship between HBP, SCA and LTPA.