Abstract

Introduction: The American Heart Association’s Life’s Simple 7 and Physical Activity Guidelines for Americans both recommend that US adults get at least 150 minutes of moderate-intensity exercise each week for ideal cardiovascular health. Objective: To evaluate psychological, personal, medical and sociodemographic factors that may impact an individual’s ability to achieve the recommended >=150 weekly minutes of moderate-intensity exercise. Methods: Cross-sectional data from the 2019 Health Information National Trends Survey (HINTS 5, Cycle 3) were evaluated. There were 5,438 responses in the full HINTS 5, cycle 3 dataset; 3,919 remained after eliminating respondents who did not have complete data for all variables of interest. The primary outcome was weekly minutes of moderate-intensity exercise, which was dichotomized into <150 vs. >= 150 weekly minutes. Sociodemographic factors included age, gender, race/ethnicity, education, and feelings about household income. Medical condition factors included a history of conditions such as diabetes, high blood pressure, and cancer. Psychological distress was measured by the Patient Health Questionnaire-4. Other factors of interest included the extent to which people enjoyed exercising, knowledge of government recommendations for physical activity, knowledge about the benefits of exercise, motivations for exercising, and the perceived link between obesity and risk of developing cancer. Descriptive and inferential statistical methods were calculated using SAS version 9.4. A multivariate model was built using backward elimination starting with all the factors that were univariately significant with p<0.05 and dropping one factor at a time until the remaining factors were all significant with p<0.05. Results are presented as odds ratio and 95% confidence interval [CI]. Results: In the multivariate model, the odds of getting >=150 weekly minutes of moderate-intensity exercise were 13.7 [CI: 7.51, 24.9] times higher for respondents who enjoyed exercising ‘a lot’ and 4.0 [CI: 2.2, 7.4] times higher for those who enjoy ‘it some’, compared to those who did not enjoy it at all. Males were 1.83 [CI: 1.38, 2.43] times more likely to get >=150 weekly minutes of moderate-intensity exercise than females. Respondents without high blood pressure were 1.69 [CI: 1.20, 2.38] times more likely to get >=150 minutes of weekly exercise than those with high blood pressure. Conclusion: Limitations include that we do not know the specific types of moderate-intensity exercise respondents engaged in (e.g., walking, swimming) or how they conceptualized enjoying exercise. Our results suggest that we should examine how to help people identify enjoyable options for exercising. Future studies should also further explore gender differences in physical activity and how to engage individuals with high blood pressure to increase their physical activity levels.

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