Meeting Physical Activity Guidelines Research Articles

Associations of Individual and Neighborhood Level Characteristics with Leisure-Time Physical Activity

Although access to transit may affect transport-related physical activity (PA), built environment features such as green space, may differentially influence PA in other domains. The Houston TRAIN Study is a natural experiment assessing the impact of light-rail infrastructure on transit behaviors and PA. PURPOSE: Assess the relations of individual and neighborhood level characteristics with leisure-time PA (LTPA) among TRAIN participants. METHODS: Participants were adults (≥18 years) residing within 3 miles of new light-rail corridors in Houston, TX. LTPA was assessed with the self-administered Modifiable Activity Questionnaire (past week), and weekly met-minutes of LTPA were derived. Individual level sociodemographic characteristics (age, gender, race/ethnicity, education) were also reported. Participant addresses were geocoded and matched to census block groups (neighborhood unit). Neighborhood level sociodemographic (median income, racial distribution) and built environment (park access and tree canopy coverage) variables were constructed using public georeferenced data. Generalized mixed effect regression models were used to estimate the relation of individual and neighborhood factors on meeting PA guidelines with LTPA (≥500 weekly met-minutes). RESULTS: Among 618 participants at baseline, 60% reported meeting PA guidelines with LTPA. At the individual level, Black race was inversely related to meeting guidelines with LTPA (vs. white, OR: 0.4, CI: 0.3-0.7) and having at least some college education was directly related to meeting PA guidelines with LTPA (vs. no college, OR: 1.5, CI: 1.0-2.1). Age and gender were not significantly associated with LTPA. At the neighborhood level, being in the top tertile of neighborhood income (vs. tertile 1, OR: 2.3, CI: 1.4-3.8) was directly associated with meeting guidelines with LTPA. Neighborhood racial distribution, park access and tree canopy coverage were not related to LTPA. CONCLUSIONS: Among TRAIN participants, individual level education and neighborhood level income are independently related to LTPA, suggesting that socioeconomic status is an important multilevel predictor of LTPA for Houston residents. Other factors were not related to LTPA, contrasting with findings from other studies in different settings. Funded by NIH R01 DK101593

Effects of a Group-based Behavioral Physical Activity Intervention in Older Adults

Chronic diseases are highly prevalent among older adults. Despite the known benefits of regular physical activity (PA), particularly for disease prevention and management, a majority of older adults do not meet PA guidelines. There is a need for evidence-based programs that can successfully initiate and maintain PA behaviors. PURPOSE: To examine the effects of a 12-week, group-based, behavioral PA intervention on PA behaviors and weight-loss in older adults. METHODS: Inactive older adults (>50 years) were randomized to a 12-week, group-based, behavioral PA intervention, or to an attention control nutrition intervention. Demographic variables were collected via a survey; objectively measured height and weight were obtained. Participants wore an accelerometer during all waking hours for 7 days on the right hip. Percent of day spent in sedentary, light, and moderate to vigorous PA was calculated. All measures were obtained at baseline and 12-weeks (post intervention). Repeated measures ANOVAs examined changes in weight and PA behaviors over time between groups, controlling for age, gender, and education. RESULTS: Participants (n=50) averaged 64.1+8.4 years of age and had a BMI of 33.3+7.5 kg/m2. A majority were women (72%), married (62%), white (86%), and had at least some college education (86%). Participants spent 62% of the day sedentary, 37% in light PA, and 1% in moderate to vigorous PA. Participants in the PA group had significantly greater increases in moderate to vigorous PA than those in the nutrition group (p=.04). Participants in the nutrition group had significantly greater decreases in time spent sedentary than those in the PA group (p=.03). There was no significant change over time in light PA (p=.29). There was a significant decrease in weight over time among participants from both groups (p=.001). CONCLUSIONS: Findings from our study suggest that group-based behavioral PA interventions may be an effective way to increase moderate to vigorous PA among older adults. Behavioral PA and dietary interventions may also result in weight loss. Given the expected growth in the number of adults 65+ in the U.S., there is a need for interventions that can successfully increase PA and be disseminated widely. Such interventions have the potential to increase independence and longevity across the population.

Parental Factors Associated with Young Children Meeting the Physical Activity Guidelines

Parents may be instrumental in helping their children meet the physical activity (PA) guidelines of ≥ 60 min/d of moderate to vigorous intensity activity, yet there are few studies that have examined this issue. PURPOSE: To examine parental factors associated with young children meeting PA guidelines. We hypothesized that parental attitudes, defined as perceived importance of children being active, parental support of their child’s PA, and self-efficacy (SE) in helping their child get 60 min/d would be associated with the child meeting PA guidelines. Parents’ BMI, race (white/black), income level (<40K/>40K), education (<college/college), marital status (not married/married), and PA level were also examined as correlates. METHODS: A cross-sectional survey was conducted with parents of children aged 4-10 yrs who lived in the Boston area. Parents reported the amount of time their child spent in 20 activities over the past 7 days. Parental importance was assessed with “how important is it to you that your child gets 60 min or more of PA every day?” Parental support was assessed with 5 items about the typical frequency of support (e.g., “how often did you encourage your child to do PA”). Parental SE was assessed by asking parents their confidence in helping their child get 60 min/d in 4 different situations (e.g., “when your child is tired”). Parents’ PA was assessed with 2 questions about how often they did leisure time PA, and moderately active housework or gardening in past 7 days. Multiple logistic regression was used to examine parent variables associated with children meeting PA guidelines, controlling for children’s age and gender. RESULTS: The sample (n=180) was 51% white, not married, and had an income <40K; 57% had <college degree. Most children (77%) met PA guidelines. Parental importance (odds ratio (OR) = 1.63, 95% CI: 1.02, 2.59) and support (OR =1.25; 95% CI: 1.10, 1.42) were positively associated with children meeting PA guidelines. Children of black parents were 70% less likely to meet guidelines than children of white parents (OR= 0.30; 95% CI: 0.10, 0.89). CONCLUSION: Parents’ perceived importance of PA and support appear to play an important role in young children’s PA. Given the racial differences in children’s PA, examination of differences in parental influences on PA by race may be warranted.

Physical Literacy Domain Scores in Canadian Children Meeting and not Meeting Canada’s Physical Activity Guidelines

PURPOSE: To compare differences in physical literacy (PL) domain scores between Canadian children meeting Canada’s physical activity (PA) guidelines and those not meeting the guidelines. METHODS: Children (n = 2,215) aged 8-12 years, with parental consent, from seven Canadian provinces had their PL levels measured by trained research staff using the Canadian Assessment of Physical Literacy (CAPL). The CAPL is valid, reliable, and consists of 4 domains (physical competence; daily behaviour; knowledge and understanding; and motivation and confidence) that provide a composite PL score—scoring was adjusted for age in all domains and for sex in the physical competence domain. Weekly PA levels were measured by pedometers that were worn by participants for a minimum of 3 valid days (≥10 h wear time/day). Children were grouped for analysis based on those meeting Canadian PA guidelines (≥12,000 steps ≥6 days/week) and those not meeting the guidelines. All comparisons were performed using ANCOVAs to control for age, sex and seasonality differences in PA. RESULTS: After controlling for age, sex and seasonality, children meeting PA guidelines had significantly higher physical competence (F = 67.92, p<0.0001) and motivation and confidence (F = 21.01, p<0.0001) domain scores compared to children not meeting the guidelines. No differences were observed in children meeting PA guidelines compared to children not meeting the guidelines for the knowledge and understanding domain (F = 78.21, p = 0.53). CONCLUSION: These results reinforce the importance of Canadian children meeting PA guidelines, as there seem to be favourable associations with physical competence measures and motivation and confidence scores.

Meeting Recommended Levels of Physical Activity and Health-Related Quality of Life in Rural Adults.

BackgroundLittle is known about physical activity (PA) and health-related quality of life (HRQOL) among rural adults. The purpose of this study was to investigate the relationship between meeting recommended levels of PA and HRQOL in a rural adult population.MethodsThis study analyzed data from 6,103 rural adults 18 years of age and older participating in a 2013 survey. Respondents reporting at least 150 minutes a week of moderate-intensity (or moderate-vigorous combination) PA during the past month were categorized as meeting PA guidelines. Five health variables were used to assess HRQOL. A continuous HRQOL ability score was also created using item response theory (IRT).ResultsRural adults who met recommended levels of PA were significantly more likely to report good HRQOL in adjusted models of physical health (OR: 1.99; 95% CI: 1.54–2.56), mental health (OR: 1.96; 95% CI: 1.46–2.64), inactivity health (OR: 2.14; 95% CI: 1.54–2.97), general health (OR: 1.69; 95% CI: 1.35–2.13), and healthy days (OR: 1.98; 95% CI: 1.58–2.47), compared to those who did not meet recommended levels. Furthermore, rural adults meeting recommended levels of PA also had a significantly greater HRQOL ability score (51.7 ± 0.23, Mean ± SE), compared to those not meeting recommended levels (48.4 ± 0.33, p < .001).ConclusionThis study found that meeting recommended levels of PA increases the likelihood of reporting good HRQOL in rural adults. These results should be used to promote the current PA guidelines for improved HRQOL in rural populations.

The relationship of diabetes-related distress and depressive symptoms with physical activity and dietary behaviors in adults with type 2 diabetes: A cross-sectional study

AimsDiabetes-related distress (DD) and depressive symptoms (DS) may influence self-management behaviors in people living with type 2 diabetes (T2D). We examined the association of DD and DS with physical activity (PA) and adherence to recommended dietary behaviors in adults with T2D. MethodsUsing baseline data from 2040 adults with T2D in the Alberta’s Caring for Diabetes (ABCD) cohort study, DD, DS, PA and adherence to dietary behaviors were assessed. A composite variable for presence of DD and DS was computed for analyses. ANOVA and logistic regression tested independent associations of DS and DD with PA and adherence to diet. ResultsParticipants were 64±10.6years, 45% female, 76% with annual household income≤$80,000, and 86% with high school education or more. Those with DD alone were 1.8 times (95% CI 1.1, 2.9) and those with DD and DS combined were 2.0 times (95% CI 1.1, 3.7) more likely not to meet PA guidelines compared to those without DD or DS. The presence of DS alone was not significantly associated with meeting PA guidelines (OR 1.4; 95% CI 0.7, 3.0). Compared to those without DD or DS, patients with DD alone (OR 1.5; 95% CI 1.4, 3.4), DS alone (OR 5.2; 95% CI 2.7, 9.7), or DD and DS combined (OR 2.5; 95% CI 1.6, 3.8) were more likely to have poor adherence to recommended dietary behaviors. ConclusionsGreater distress or depressive symptoms were associated with worse self-management behaviors in adults with T2D. Attention to mental health status may improve participation in PA and adherence to diet recommendations in these patients.

Abstract 11: Neighborhood Social Cohesion and Meeting Physical Activity Guidelines: Does the Association Differ by Race/Ethnicity?

Introduction: Neighborhood social cohesion is associated with physical activity (PA), but prior studies have used local population samples and presented results in aggregate across racial/ethnic groups. Hypothesis: Neighborhood social cohesion is associated with PA in a large, nationally representative dataset and may be modified by race/ethnicity. Methods: Data from the National Health Interview Survey (NHIS) 2013-14 survey waves were combined (n=64,754). NHIS 2013-14 included four questions on neighborhood social cohesion - participants rated agreement/disagreement with the following statements (scale: 1-strongly disagree, 2-disagree, 3-agree, 4-strongly agree): 1) people in this neighborhood help each other out; 2) there are people I can count on in this neighborhood; 3) people in this neighborhood can be trusted; and 4) this is a close-knit neighborhood. A neighborhood cohesion score was constructed by summing the responses to the questions (range: 4 to 16). The primary outcome of meeting aerobic PA guidelines (150 minutes/week of moderate or 75 minutes/week of vigorous PA) was calculated using self-reported moderate or vigorous minutes/week. Multivariable regression models for meeting PA guidelines were run, adjusting for age, race/ethnicity, sex, education, income, nativity (U.S.- or foreign-born), and English proficiency; additional models were run with neighborhood cohesion as a binary variable (above/below median) to assess potential effect modification by race/ethnicity. All data were analyzed using complex survey weighting in STATA 12.1 and SUDAAN 10.0. Results: About half of U.S. adults reported meeting PA guidelines (49.6). Neighborhood social cohesion was fairly high, with a median value of 12 (IQR: 11-15) and was higher in those 65+ years of age, and with higher education, income and length of time living in one’s neighborhood. In adjusted analyses, a one-unit increase in neighborhood social cohesion was associated with an increased odds of meeting PA guidelines (OR:1.04 (1.03, 1.05), p&lt;0.001). Neighborhood social cohesion and PA was associated in whites and Hispanics (OR:1.30 (1.20, 1.42), p&lt;0.001; OR: 1.18 (1.03, 1.34), p&lt;0.001, respectively), and not in blacks or Asian American subgroups (Chinese, Filipino and Asian Indians). Conclusions: Neighborhood social cohesion was associated with meeting PA guidelines in this nationally representative sample of U.S. adults. However this association appears to be driven by whites and Hispanics. While neighborhood characteristics may be an important aspect of public health planning and epidemiologic inquiry, additional studies are needed to further investigate which neighborhood factors affect ability to meet PA guidelines for blacks and Asian Americans.

Combined Associations of Muscle-Strengthening Activities and Accelerometer-Assessed Physical Activity on Multimorbidity: Findings From NHANES.

Physical activity (PA) has previously been demonstrated to be inversely related with multimorbidity (having more than one chronic disease); however, it is unknown whether dual participation in both PA and muscle-strengthening activities (MSA) may further reduce the odds of being multimorbid. Therefore, the purpose of our study was to determine the association between multimorbidity and individuals meeting recommended guidelines for both PA and MSA. Nonexperimental. The 2003-2006 National Health and Nutritional Examination Survey. Four thousand five hundred eighty-seven adults aged ≥20 years. Accelerometry-measured PA, self-reported MSA, and multimorbidity. Data were analyzed using multivariable linear and logistic regression. The odds (95% confidence interval) of being multimorbid for those only meeting MSA guidelines, only meeting PA guidelines, and meeting both PA and MSA guidelines (vs. not meeting either), respectively, were .69 (.48, .98; p = .04), .55 (.44, .70; p < .01), and .38 (.27, .53; p < .01). Our findings demonstrate that individuals meeting recommended guidelines for both MSA and PA were less likely to be multimorbid than individuals participating in one or none of these exercise modalities. Determining effective ways to initiate and maintain concurrent adoption of MSA and PA is needed to provide a cost-effective behavioral alternative for reducing the prevalence of multimorbidity.

Effects of Exergaming on Physical Activity in Overweight Individuals

The majority of patients with overweight and type 2 diabetes show insufficient levels of daily physical activity (PA) and usually are among the least likely to engage in or adhere to any form of generic PA. Active video games (exergames) may be a solution to motivate these individuals to overcome their sedentary lifestyle. This systematic review was conducted to review the current evidence for the effectiveness of exergaming in overweight and type 2 diabetes mellitus and thus to evaluate the suitability of these games to be used as tools for exercise promotion that meet current PA guidelines. We searched electronic bibliographic databases (PubMed, Embase, Web of Science, OpenGrey, and the Cochrane Central Register of Controlled Trials) up to March 2015. Randomized controlled trials (RCT) and cross-sectional studies published in English in a peer-reviewed journal and analyzing the effects of exergames on objectively measured intensity parameters of PA in overweight (body mass index [BMI] ≥25kg/m(2)) adults (mean age ≥18years) with and without type 2 diabetes were included. Study selection, data extraction, and quality assessment were performed independently by two review authors. Primary outcomes included changes in oxygen uptake (VO2), energy expenditure (EE), heart rate (HR), or activity counts. Secondary outcomes were enjoyment of treatment, exercise adherence, ratings of perceived exertion (RPE), changes in body composition, and changes in blood parameters (serum glucose, long-term blood glucose, blood cholesterol, triglycerides, or serum lactate). Of 2845 records, 14 publications (11 studies) met the inclusion criteria. All included studies (ten experimental, cross-sectional laboratory studies and one RCT) were able to show increases in either VO2, EE, HR, or activity counts. However, effects of exergaming in terms of changes in these intensity parameters varied significantly between game modes and consoles as well as because of the vastly differing durations of exergame activity between studies. One of the included studies had a low risk of bias, and three had a high risk of bias; seven studies had an unclear risk of bias as the study description was insufficient. No studies were found investigating the changes in objectively measured PA intensity parameters in patients with type 2 diabetes. This review suggests that exergames are able to increase PA among overweight individuals. However, the inconsistent results and the overall poor or moderate methodological quality do not permit judgment on whether exergames are suitable to meet PA guidelines in this target group. The lack of research regarding the effects of exergames in type 2 diabetes indicates a great need for future research.

Association Between Objectively Measured Physical Activity and Cognitive Function in Older Adults-The Reasons for Geographic and Racial Differences in Stroke Study.

To examine the relationship between objectively measured physical activity (PA) and cognitive function in white and black older adults. Cross-sectional. REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Older adults who provided valid data from accelerometer and cognitive function tests (N=7,098). Accelerometers provided estimates of PA variables for 4 to 7 consecutive days. PA cut-points of 50 counts per minute (cpm) and 1,065cpm were applied to differentiate between being sedentary and light PA and between light and moderate to vigorous PA (MVPA), respectively. Prevalence of cognitive impairment was defined using the Six-Item Screener (<4/6). Letter fluency, animal fluency, word list learning, and Montreal Cognitive Assessment (orientation and recall) were used to assess memory and executive function. Of 7,098 participants (aged 70.1±8.5, 54.2% female, 31.5% black), 359 (5.1%) had impaired cognition within ±12months of PA measurement. The average proportion of time spent in MVPA (MVPA%) was 1.4±1.9%. Participants in the highest quartile of MVPA% (~258.3min/wk) were less likely to be cognitively impaired than those in the lowest quartile (odds ratio=0.65, 95% confidence interval=0.43-0.97). MVPA% was also significantly associated with executive function and memory z-scores (P<.001). Similar analyses of proportion of time spent in light PA (LPA%) and sedentary time (ST%) showed no significant associations with cognitive function. Higher levels of objectively measured MVPA%, rather than LPA% or ST%, were associated with lower prevalence of cognitive impairment and better performance in memory and executive function in aging people. The amount of MVPA associated with lower prevalence of cognitive impairment is consistent with meeting PA guidelines.

Feasibility and Preliminary Efficacy of an Online Intervention to Increase Physical Activity in Nova Scotian Cancer Survivors: A Randomized Controlled Trial.

BackgroundPhysical activity (PA) behavior change interventions among cancer survivors have used face-to-face, telephone, email, and print-based methods. However, computer-tailored, Internet-delivered programs may be a more viable option to achieve PA behavior change.ObjectiveThe objective of this study is to test the feasibility and preliminary efficacy of a Web-based PA behavior change program among cancer survivors.MethodsNova Scotian cancer survivors (N=415) who previously expressed interest in a research study were approached. Interested participants were asked to complete an online assessment of PA and quality of life (QOL) before being randomized to either a theory-based PA behavior change program using the PA tracking website UWALK (UCAN; n=48) or usual care (UC; n=47). After the intervention (9 weeks), participants completed another online assessment of PA and QOL as well as measures to evaluate the program and website. Descriptive analyses from surveys and Web analytic software were used to assess feasibility and mean change scores were used to test efficacy.ResultsOf all contacted survivors, 95 (22.3%, 95/415) completed baseline measures and were randomized with 84 (88%, 84/95) completing the 9-week assessment. The behavior change program and website were rated highly on the satisfaction items. Average logins were 10.3 (1.1 per week) and 26.0% (111/432) of the weekly modules were completed. Most participants (71%, 29/41) indicated they were more aware of their daily PA levels and 68% (28/41) found the site easily navigable. Adjusted group differences in total exercise minutes favored the UCAN group by an increase of 42 minutes (95% CI -65 to 150; P=.44, d=0.17). Results were more pronounced, though still nonsignificant, among those not meeting guidelines at baseline where UCAN increased PA by 52 minutes compared to a decrease of 15 minutes in UC (adjusted between group difference=75, 95% CI -95 to 244; P=.38, d=0.27).ConclusionsWe found that Internet-delivery may be a feasible alternative to more costly methods to promote PA among Nova Scotian cancer survivors. Moreover, there was a trend toward increased PA among those in the UCAN group, especially among those who were not meeting PA guidelines at baseline. Future research should focus on recruiting inactive cancer survivors and engaging them in the website to determine the optimal potential of Web-based interventions for promoting PA in cancer survivors.

How sedentary and physically active are breast cancer survivors, and which population subgroups have higher or lower levels of these behaviors?

Physical activity (PA) and sedentary behavior may influence the physical and mental health of breast cancer survivors; however, few studies have objectively measured these behaviors in this population. We used accelerometers to measure the PA and sedentary time levels of breast cancer survivors and examined the demographic, behavioral, and medical correlates of these behaviors using two complementary approaches. A total of 259 breast cancer survivors wore an accelerometer for 7 days during waking hours and completed a questionnaire. We used linear regression and classification trees to investigate correlates of PA and sedentary time. The breast cancer survivors in this study (mean age = 61 years, mean time since diagnosis = 3 years) were sedentary for a daily average of 8.2 h, in light-intensity PA for 5.8 h and in moderate-to-vigorous intensity PA (MVPA) for 32 min, with 16 % meeting PA guidelines. Participants with high comorbidity were the least likely to be meeting guidelines (0 %), while a subgroup of participants with no/low comorbidity, a university degree, and higher levels of pre-diagnosis MVPA were the most likely to be meeting guidelines (47 %). Older participants (70+ years) were the most likely to have sedentary time levels at least twice as high as activity levels, while participants who were younger than 70 years and not in the lowest category of pre-diagnosis MVPA were the least likely. Interventions to facilitate physical activity and reduce sedentary time among breast cancer survivors should consider comorbidity status and previous PA experience.

Association between physical activity motives and type of physical activity in children

Objectives: Motives for participating in a specific type of physical activity (PA) may differ across PA type in youth. We studied the relationship between PA motives and type of PA engaged in by youth. Design: Cross-sectional analysis using data from the Monitoring Activities of Teenagers to Comprehend their Habits (MATCH) study. Method: Eight hundred and two students age 10–11 years from 17 primary schools in New Brunswick, Canada completed a questionnaire that collected data on type of PA participated in (individual, group-based, organised and non-organised), PA motives (enjoyment, social affiliation, competence, fitness/health, and appearance) and attainment of PA guidelines (60 minutes of moderate-to-vigorous PA (MVPA) per day). The associations between PA motives and PA type and between PA motives and attainment of PA recommendations were assessed in multi-level logistic regression models. Results: Endorsing enjoyment motives was associated with participation in organised PA (odds ratio, 95% confidence interval (CI): 1.54, 1.24–1.91). Competence motives were associated with participation in group-based PA (1.27, 1.11–1.46) and achievement of PA recommendations (1.95, 1.37–2.78). Conclusion: Targeting enjoyment and competence motives may be associated with increased participation in organised and group-based PA as well as with an increased likelihood of meeting PA guidelines in youth.

Prevalence of physical activity in European adults — Compliance with the World Health Organization's physical activity guidelines

BackgroundAdults are recommended to engage in at least 150min/week of moderate-to-vigorous physical activity (PA). PurposeThis study aimed to examine the level of compliance with PA recommendations among European adults. MethodsUsing data from European Social Survey round 6, PA self-report data was collected from 52,936 European adults from 29 countries in 2012. Meeting PA guidelines was assessed using World Health Organization criteria. Results61.47% (60.77% male, 62.05% female) of European adults reported to be engaged in moderate to vigorous PA at least 30min on 5 or more days per week. The likelihood of achieving the PA recommended levels was higher among respondents older than 18–24. For those aged 45–64years the likelihood increased 65% (OR=1.65, 95% CI: 1.51–1.82, p<0.001) and 112% (OR=2.12, 95% CI: 1.94–2.32, p<0.001) for males and females, respectively. Those who were high school graduates were more likely to report achieving the recommended PA levels than those with less than high school education (males: OR=1.19, 95% CI: 1.12–1.27, p<0.001; females: OR=1.13, 95% CI: 1.06–1.20, p<0.001). ConclusionAlthough about 60% of European adults reported achieving the recommended levels of PA, there is much room for improvement among European adults, particularly among relatively inactive subgroups.

Objectively Measured School Day Physical Activity Among Elementary Students in the United States and Finland.

Schools are in a unique position to ensure that all students meet the current physical activity (PA) recommendations. This study aimed to examine 1st to 3rd grade elementary students' accelerometer measured school day PA in the United States (U.S.) and Finland. The sample consisted of 200 students (107 girls, 93 boys; ages 6 to 8) and their school day PA was monitored with hip-worn ActiGraph GT3X+ accelerometers across a 5-day school week and the thresholds 100 and 2296 count per minute were used to separate sedentary time, light PA, and moderate-to-vigorous PA (MVPA). On an average school day, students were engaged in MVPA for 20.0 min in the U.S. and 24.1 min in Finland. Students' school-day MVPA was 9 to 16 minutes higher during physical education (PE) days compared with non-PE days (U.S: 25.8 vs. 16.6 min/day; Finland: 36.3 vs. 20.1 min/day). Girls had less MVPA and more sedentary time compared with boys in both samples. This study highlights both the role of PE and other school day physical activities in meeting PA guidelines. Policy measures are needed to change the structure of the school day and enhance PA to ensure that students meet the PA recommendations.

Abstract B27: Overweight/obesity and physical activity rates in an ethnically diverse sample of breast cancer survivors

Abstract Background: High body mass index (BMI) is linked to poorer survival after breast cancer diagnosis. Physical activity (PA) could moderate this association. Objectives/Hypothesis: Prevalence of high BMI (overweight/obesity) and level of PA were evaluated in a statewide sample of women within 18 months of breast cancer diagnosis. Methods: In an ongoing study, 73 women (35 EA and 38 AA) were identified through the SC Central Cancer Registry, and were interviewed to obtain their self-reported body weight, height, PA and other data. Results: Age: Age ranged from 26 to 90 years (mean 61 years, SD 13.0), with AAs 2.1 years younger than EAs (p=0.49). Education: 62% had more than a high school (HS) diploma (58% of AAs and 66% of EAs, p=0.49). BMI: 77% were overweight/obese; 42% of AAs and 31% of EAs were overweight, 45% of AAs and 34% of EAs were obese (p=0.03). PA: 23% reported no PA (29% of AAs and 17% of EAs, p=0.23). Only 38% met CDC PA guidelines of at least 150 min/week of moderate PA (29% of AAs and 47% of EAs; p=0.11). PA and BMI: PA &amp;lt;90 min/week was associated with 4-fold higher risk of overweight/ obesity (p=0.023). No significant associations were seen by race. PA and Education: No significant association was observed between &amp;gt;HS education and meeting PA guidelines (p=0.15), or between &amp;gt;HS education and greater PA per week (p=0.57). Education and BMI: No significant association was seen (p=0.77). Conclusions: Prevalence of overweight/obesity was high, especially among AAs. Future Recommendations: It is imperative to identify strategies to reduce obesity/overweight in BRCA survivors. Citation Format: Joan E. Cunningham, Colleen E. Bauza, Erika T. Brown, Alberg J. Anthony, Emily Kistner-Griffin, Ida J. Spruill, Debbie C. Bryant, Nestor F. Esnaola, Melanie S. Jefferson, Keith Whitfield, Rita M. Kramer, Susan Bolick, Deborah Hurley, Catishia Mosley, Tonya R. Hazelton, Vivian J. Bea, Dana R. Burshell, Kendrea D. Knight, Marvella E. Ford. Overweight/obesity and physical activity rates in an ethnically diverse sample of breast cancer survivors. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B27.

Breaking-up sedentary time is associated with impairment in activities of daily living

Identifying modifiable behaviors associated with prevention of activities of daily living (ADL) impairments is vital to implement preventive strategies for independent living in elderly. We aimed to examine the associations between objectively measured breaks in sedentary time with ADL impairments and physical independence. Cross-sectional assessments were carried out in 371 participants (131 male) aged 65–103years from the Portuguese surveillance system of physical activity. Physical activity (PA) and sedentary time (ST) were assessed with accelerometry, and ADL impairments and physical independence with the self-reported 12-item composite physical function scale. Using ROC analyses a cut-off of 7 hourly breaks in sedentary time was identified which maximized the sensitivity and specificity in diagnosing physical dependence. Logistic regression analysis demonstrated that, independently of moderate-to-vigorous PA (MVPA), participants performing ≤7 hourly breaks in sedentary time had 2 to 7 fold increased odds for impairment in 10 of the 12 ADL. When stratifying ADL into basic, instrumental and advanced ADL we verified that less than 7 hourly breaks in sedentary time was associated with a 2 to 5 fold increased odds for impairments and physical dependence, independent of MVPA. No associations were observed between meeting PA guidelines and basic, instrumental, and advanced ADL impairment although time in MVPA was lower in participants showing impairments. In conclusion, the frequency of breaks in sedentary time in older ages is independently associated with lower risk for ADL impairments and physical dependence. Our findings support interventions to encourage older adults to increase overall PA by interrupting sedentary time.

A self-regulation-based intervention to increase physical activity in cancer patients

The study examined whether a behavior-change intervention focusing on self-regulatory strategies and emphasizing role model support increases physical activity (PA) among insufficiently active (not meeting PA guidelines of 150 min/week) cancer patients. Ambulatory cancer patients [N = 72; 54% female; M = 56 years, SD = 12.34; most with breast or colon cancer (34, 15%)] were enrolled in the MOTIVACTION-study, a 4-week intervention (1-hr counseling, followed by weekly phone calls), with pretest (T1), posttest (T2) and a 10-week follow-up (T3). Participants were randomized to either an exercise or to a stress management intervention (active control). The exercise intervention emphasized self-regulatory strategies (e.g. action- and coping planning and self-monitoring); patients were also encouraged to contact a physically active same-sex role model as a potential exercise partner. The active control condition consisted of coping and relaxation techniques. Sixty-seven patients remained in the study and completed the SQUASH assessment of PA and a measure of perceived stress. PA was validated by Actigraph accelerometry. At T2, 46% of the patients in the exercise group and 19% of stress management patients increased their activity levels to meet PA guidelines (>150 min/week; χ2(1) = 5.51, p = .019). At T3, participants in the exercise intervention maintained their exercise level (46%), but also 31% of the stress management patients met the guidelines. All patients reported reductions in perceived stress. Additional analyses comparing patients in the exercise group by role model contact (63% realized contact) revealed that those who had contact with their role model were significantly more likely to adhere to the recommended guidelines (T2:50%; T3:64%) compared to those who did not have contact with a role model (T2:39%; T3:15%), suggesting the potential of mobilizing role model support to facilitate PA. In sum, cancer patients may not only benefit from an exercise intervention emphasizing self-regulation, but also from stress management, regarding both reducing stress and increasing PA.

Gender Differences in Physical Activity Levels of Older People With Type 2 Diabetes Mellitus.

Physical activity (PA) is important in managing Type 2 Diabetes Mellitus (T2DM). This study aimed to determine 1) the number of daily steps taken by older people with T2DM, 2) if T2DM is associated with taking fewer steps per day and less likelihood of meeting PA guidelines, and 3) whether these associations are modified by age or gender. PA was obtained by pedometer from 2 cohorts of older adults with and without T2DM. Multivariable regression was used to determine associations between T2DM, mean steps per day and meeting a guideline equivalent (7 100 steps per day). There were 293 participants with T2DM (mean age 67.6 ± 6.8 years) and 336 without T2DM (mean age 72.1 ± 7.1 years). In women, T2DM was associated with fewer mean steps per day (β = -1306.4; 95% CI -2052.5, -560.3; P = .001) and not meeting the PA guidelines (OR 0.51; 95% CI 0.28, 0.92; P = .03). Associations were not significant in men (P > .05). Only 29.7% of those with T2DM and 33.3% of those without T2DM met PA guidelines. Greater focus is needed on how to maintain and increase PA in older age with particular focus on women with T2DM.

Correlates of Physical Activity among Blacks and Whites with Arthritis.

To evaluate the correlates of physical activity (PA) participation among white and black individuals with diagnosed arthritis. This study used a cross-sectional design, grounded in the Social Ecological Model. Participants (N = 205) completed a survey regarding PA participation and potential correlates of PA. Bivariate and multivariate analyses were used to examine the correlates of PA. Nearly 30% of the population met the current guidelines for aerobic PA. A greater proportion of Whites (35.3%) than Blacks (20.9%) met current guidelines (χ(2) = 4.98, p = .03). In bivariate analyses, ethnicity, income, body mass index, self-efficacy for exercise, exercise outcome expectations, physical function, physician advice to exercise, and perceived safety from neighborhood crime and traffic were associated with meeting PA guidelines (p < .05). In regression analyses adjusted for socio-demographic characteristics, exercise self-efficacy and physician's advice to exercise were the only significant predictors of PA (p < .05). This finding was confirmed with stepwise forward regression. PA interventions for people with arthritis should focus on enhancing self-efficacy for exercise and include strategies to optimize communication about PA by healthcare providers.