Physical activity interventions with healthy minority adults: meta-analysis of behavior and health outcomes

This meta-analysis is a systematic compilation of research focusing on various exercise interventions and their impact on the health and behavior outcomes of healthy African American, Hispanic, Native American, and Native Hawaiian adults. Comprehensive searching located published and unpublished studies. Random-effects analyses synthesized data to calculate effect sizes (ES) as a standardized mean difference (d) and variability measures. Data were synthesized across 21,151 subjects in 100 eligible samples. Supervised exercise significantly improved fitness (ES=.571-.584). Interventions designed to motivate minority adults to increase physical activity changed subsequent physical activity behavior (ES=.172-.312) and anthropometric outcomes (ES=.070-.124). Some ES should be interpreted in the context of limited statistical power and heterogeneity. Attempts to match intervention content and delivery with minority populations were inconsistently reported. Healthy minority adults experienced health improvements following supervised exercise. Interventions designed to motivate subjects to increase physical activity have limited magnitude heterogeneous effects.     

Neighborhood walkability and health outcomes among older adults: The mediating role of physical activity

We examined the mediating role of physical activity on the relationships of walkability with Flemish older adults' health outcomes. In low income neighborhoods, residents of high walkable neighborhoods had a 1.5 kg/m² lower BMI than low walkable residents. Of this difference 0.3 kg/m² (19%) and 0.2 kg/m² (12%) were explained through walking for transport and MVPA, respectively. Similar findings were observed for waist circumference. Walkability did not relate to functional performance or quality of life. Walkable neighborhoods may benefit older adults’ health, especially in low income neighborhoods. More research in other contexts is warranted to confirm current findings.     

Interventions to promote physical activity among young and adolescent girls: a systematic review

A narrative systematic review was conducted to describe the available evidence from physical activity (PA) interventions that targeted girls aged 5-18 years and to determine their effectiveness and key characteristics of success. Systematic literature searches were conducted using four databases: PubMed, Web of Science, PsychInfo and SPORTDiscus and by examining the reference lists of included articles and published relevant reviews, to identify studies published in English from 2000 to July 2010. Randomized controlled trials or quasi-experimental designs with pre-test and post-test behavioral outcome data (objective or self-report measure) were included. Methodological quality was assessed using a checklist and conclusions were made concerning effectiveness. A total of 29 articles were reviewed, describing the evaluation of 21 interventions. Ten studies reported a favorable intervention effect upon PA outcomes, seven of which were rated as having a high methodological quality. Multi-component school-based interventions that also offer a physical education that address the unique needs of girls seemed to be the most effective. Although family support is revealed as ineffective, peer strategies showed promising evidence. The review finishes highlighting possible intervention strategies and reporting areas where further investigation is required.     

Interventions for promoting physical activity among European teenagers: a systematic review

Background  

People with a low socioeconomic status (SES) are more likely to be physically inactive than their higher status counterparts, however, the mechanisms underlying this socioeconomic gradient in physical inactivity remain largely unknown. Our aims were (1) to investigate socioeconomic differences in recreational walking among older adults and (2) to examine to what extent neighbourhood perceptions and individual cognitions regarding regular physical activity can explain these differences.     

Active transportation as a way to increase physical activity among children

Background This study examines how active transportation could help increase the daily physical activity volume of school‐aged children. Methods Using data from the 2003 Origin‐Destination Survey carried out among 5% of the 3.5 million residents of the Greater Montreal Area, we determined the proportion of short motorized trips made daily by children 5–14 years old (16 837 children sampled) and estimated the number of steps these trips would account for if they were travelled by foot, taking into account variables such as age, sex and height of children. Modal choice and trip purpose were also examined. Results In 2003, 31.2% of the daily trips made by children aged 5–14 years in the Greater Montreal Area were 1 km or less (0.6 mile). Of these, 33.0% were motorized trips. Overall, 13.1% of the children in the area had ‘steps in reserve’, an average of 2238 steps per child per day. If they were performed, these steps would account for 16.6% of the daily recommended volume of physical activity for children. Conclusion Replacing short motorized trips with walking could increase the physical activity level of children and contribute to meet the recommended guidelines, as long as these walking trips add to their daily physical activity volume. It could also reduce their dependence towards adults for moving around.     

Maintaining physical activity among older adults: six-month outcomes of the Keep Active Minnesota randomized controlled trial

OBJECTIVE: We evaluate the 6-month efficacy of Keep Active Minnesota, a phone- and mail-based physical activity maintenance intervention designed for use with adults age 50 to 70 years who have increased their physical activity within the past year. METHOD: Participants (N=1049) recruited in 2004 and 2005 from one large managed-care organization in Minnesota were randomly assigned to either treatment (N=523) or usual care (N=526) with physical activity assessed using the Community Healthy Activities Model Program for Seniors questionnaire, and expressed as kcal/week expenditures. RESULTS: Total physical activity at baseline was similar for treatment and usual care participants (p<0.44) as was moderate/vigorous physical activity (p<0.21). Maintenance of physical activity was higher among treatment participants whose mean 6-month change in total kcal/week energy expenditure was -91, compared to -683 for usual care participants (p<0.002). Mean 6-month change in kcal/week expenditure in moderate or vigorous activities was -49 for treatment participants, compared to -612 for usual care participants (p<0.001). CONCLUSIONS: This phone- and mail-based physical activity maintenance intervention is efficacious at maintaining physical activity at 6 months.     

Interventions for promoting physical activity among European teenagers: a systematic review

Background  

Although physical activity is considered to yield substantial health benefits, the level of physical activity among European teenagers is not sufficient. Adolescence is characterized by a decline in physical activity level. Many studies investigated the effectiveness of interventions promoting physical activity among young people, but none dealt with the available evidence specific for Europe. This review was conducted to summarize the effectiveness of interventions to promote physical activity among European teenagers.     

VERB - a social marketing campaign to increase physical activity among youth

The VERB campaign is a multiethnic media campaign with a goal to increase and maintain physical activity among tweens, or children aged nine to 13 years. Parents, especially mothers aged 29 to 46, and other sources of influence on tweens (e.g., teachers, youth program leaders) are the secondary audiences of the VERB initiative. VERB applies sophisticated commercial marketing techniques to address the public health problem of sedentary lifestyles of American children, using the social marketing principles of product, price, place, and promotion. In this paper, we describe how these four principles were applied to formulate the strategies and tactics of the VERB campaign, and we provide examples of the multimedia materials (e.g., posters, print advertising, television, radio spots) that were created.     

Twenty-year trends in physical activity among Canadian adults

OBJECTIVE: Physical inactivity is associated with increased risk of mortality and chronic diseases, yet trend information is lacking in most countries. This investigation examines physical activity levels of Canadian adults aged 18 years and older. METHODS: Data were collected in six national surveys between 1981 and 2000. Sample sizes ranged from 2,500 to 18,000. Prevalences were tested using Chi-square and Student's t-tests. Socio-demographic correlates were examined using odds ratios adjusted for age, sex, education and income. RESULTS: Physical activity increased in the 1980s and 1990s among men and women and for all age, education and income groups (p<0.01). Although education differentials narrowed over the period, age differentials widened and income differentials emerged. DISCUSSION: The positive trend in Canada is consistent with Finland, but contrary to recent trends for Australia, England and the United States. Despite increases, sedentary living remains a public health issue particularly among women, older adults and lower income groups.     

Identification of correlates of physical activity among Latino adults

127 Latino adults responded to a survey concerning physical activity. Respondents over-represented well educated and middle class Latinos. Subjects reported a mean of 48 minutes/week of walking for exercise. This sample reported less than two episodes per week of vigorous physical activity, again below the recommended 3/wk needed to insure cardiovascular fitness. We expect more representative samples to engage in less physical activity. Stepwise multiple regression analyses were conducted using 24 variables based on Social Learning Theory. A multiple R of 0.66 accounted for over 27% of the variance in walking for exercise (p<0.001). Older adults, those with a history of childhood injury, and those who reported friend support were more likely to walk for exercise. Respondents who participated in physical activity during childhood and adolescence (including formal physical education in school) and, paradoxically, those who had models for exercise in childhood were less likely to walk for exercise. A multiple R of 0.75 accounted for 43% of the variance in vigorous physical activity and reached significance (p<0.001). Self-efficacy, friends' support, childhood physical activity, and eating a heart healthy diet were positively related to vigorous activity. These results suggest that different correlates influence walking versus vigorous activity, and that correlates of physical activity are different for Latinos compared to Anglos. The findings emphasize the need for larger scale investigations of the determinants of activity within the Latino population.M. Hovell, E. Barrington, M. Hackley, J. Elder, F. Castro, Kristin Kilbourne; Division of Health Promotion, Graduate School of Public Health, San Diego State University, San Diego, CA 92182, J. Sallis; Department of Psychology, San Diego State University, San Diego, CA 92182, R. Hofstetter; Department of Political Science, San Diego State University, San Diego, CA 92182.This research was supported by grants to Drs. Hovell and Sallis: ASPH/CDC Cooperative Agreement Contract; NHLBI (40575).     

Quality of life and physical activity among adults: population-based study in Brazilian adults

Objective

To analyze the association between leisure-time physical activity (PA) (walking, moderate- and vigorous-intensity activities) and transport (active commuting) with quality of life (QoL) domains (physical, social relations, environmental and psychological).

Methods

Participants were 1,461 adults (18?C65?years) living in the city of Curitiba, Brazil. QoL was assessed using the abbreviated WHOQoL questionnaire and PA through the IPAQ long version. Multiple linear regression models were used to analyze the relationship between PA types (walking, moderate and vigorous) and domains (leisure and transport) with QoL domains.

Results

Walking for leisure was positively associated with social relations (???=?1.5; P?=?0.011) and environment (???=?3.3; P?=?0.015) domains among men and with physical (???=?3.2; P?=?0.04), environment (???=?4.1; P?=?0.011) and psychological (???=?3.2; P?=?0.009) domains among women. Moderate intensity PA was associated with all but the physical QoL domain among women. Among men, this association was observed only between insufficient levels of PA and the physical domain of QoL (???=?3.0; P?=?0.016). Vigorous PA was associated with social relations (???=?3.4;?P?=?0.034)?and psychological (???=?4.2; P?=?0.009) QoL domains. Transport PA was only associated with the physical QoL domain in men (???=?3.1; P?=?0.042).

Conclusion

There is a positive relationship between PA and QoL, though this association varies according to the type and intensity of PA and differs across QoL domains. Unlike transport PA, leisure-time PA shows consistent association with QoL.     

Predictors of physical activity stage of change among adults with physical disabilities

PURPOSE: To use the Transtheoretical Model (TTM) constructs to examine the most important physical activity stage of change predictors for mostly inactive adults with physical disabilities. METHODS: A cross-sectional survey completed on the Internet. One hundred fifty-one individuals with physical disabilities (50% response rate) completed the survey questionnaires. Self-report standardized measures were used. RESULTS: A direct discriminant function analysis revealed that the most important stage of change predictors were the behavioral (r2 = .88) and cognitive (r2 = .50) processes of change, followed by self-efficacy (r2 = .33) and decisional balance (r2 = .13). The most accurate stages in prediction were the contemplation (76.3%), preparation (58.3%), and precontemplation (40%) stages, whereas the least accurate stages were the action (0.0%) and maintenance (8.3%) stages. CONCLUSION: Health promoters and educators may use strategies from the TTM to develop theory-driven physical activity motivational programs for the posited populace. Considering the cross-sectional design, study replication is warranted.     

Relationships of physical activity with dietary behaviors among adults

BACKGROUND: Physical activity and diet are important influences on health, but few data are available about the relationship between these two factors. The purpose of this study was to examine relationships between physical activity and dietary quality and to identify determinants of the combination of sedentary behavior and suboptimal diet. METHODS: The design of this study was cross-sectional. The setting was a large managed-care organization and the participants were 1,322 racially diverse men and women ages 25-91 years. We categorized subjects' physical activity into vigorous, moderate, and sedentary based on answers to two validated interviewer-administered questions about intensity and duration of specified activities. Dietary assessment was by means of a validated short food frequency questionnaire. We defined suboptimal diet as consuming unhealthful quantities of at least two of the following five food groups: fruits, vegetables, whole grain foods, whole-fat dairy foods, and red and processed meats. RESULTS: Seven hundred fifty-four (57%) subjects were sedentary and 617 (47%) consumed a suboptimal diet. Using multiple linear regression, we found that sedentary individuals consumed smaller amounts of foods and nutrients considered to be healthful, such as fruits and vegetables, fiber, calcium, folate, and vitamins A, C, and E, than more active participants. For nutrients considered to be harmful, such as saturated fat, trans fat, and dietary cholesterol, the association with physical activity was inverse. In multiple logistic regression analyses, the strongest sociodemographic correlates of the joint presence of inactivity and poor diet were less education [odds ratio for 1-year decrease 1.14 (95% confidence interval 1.06, 1.22)], nonwhite race [1.48 (1.05, 2.07)], and nonmarried status [1.49 (1.06, 2.10)]. CONCLUSIONS: Physical activity and diet quality are correlated behaviors. Suboptimal diet and sedentary behavior tend to cluster in individuals who are less educated, not married, and of nonwhite race. Programs that target diet and activity together, informed by their joint determinants, may attain enhanced outcomes.