Significant Increases In Physical Activity Research Articles

Participation in Community-Originated Interventions is Associated with Positive Changes in Weight Status and Health Behaviors in Youth

To assess changes in children's health behaviors and weight status after participation in community-originated interventions. Prospective cohort study following body mass index (BMI) z-score trajectory over time. Schools and community settings in 19 locations in North Carolina. A total of 1144 children, with an average age of 9.5 years, participating in community-originated physical activity and nutrition interventions, such as active recess and healthy cafeteria offerings, and environment and policy changes designed to prevent and reduce the prevalence of childhood obesity. Retention from baseline to final collection was 54%. Measures . Self-reported physical activity and eating behaviors; measured height and weight were collected at baseline and after interventions (average of 20 months). Z-score was compared with expected growth without intervention. Descriptive statistics, χ(2) tests and t-tests, and ANOVA analyses of variance to assess changes in health behaviors and weight status. More than 11% of children improved their weight status, and 86% of children who began at a healthy weight remained there. The average BMI for children who were overweight at enrollment was significantly lower after intervention (1.1 kg/m(2) lower for boys and 0.88 kg/m(2) lower for girls). Overweight and obese children who made improvements in key health behaviors showed greater decreases in BMI z-score than those who did not improve those behaviors (increased fruit [-.2207 vs. -.0793] and vegetable [-.2215 vs. -.0855] intake, and drinking less soda [-.1985 vs. -.0912]). There were no significant increases in physical activity, and changes in physical activity were not related to decreases in BMI z-score in this study. Community-originated interventions to raise awareness about food choices and to change policies and environments may improve BMI z-scores.

Health Promotion in Older Chinese

Aging, in conjunction with decreasing physical activity, is associated with a range of health problems. Simple, low-maintenance, population-based means of promoting activity to counteract the age-associated decline are required. We therefore assessed the effect of pedometry and buddy support to increase physical activity. We undertook a clustered randomized trial (HKCTR-346) of 24 community centers involving 399 older Chinese participants (≥ 60 yr). Centers were randomly allocated to 1) pedometry and buddy, 2) pedometry and no buddy, 3) no pedometry and buddy, and 4) no pedometry and no buddy with a 2 × 2 factorial design. The trial simultaneously tested the individual and combined effects of the interventions. The intervention groups also received monthly organized group activities to provide encouragement and support. Outcome measures were assessed at 6 and 12 months, including physical fitness and activity and cardiovascular disease risk factors (anthropometry and blood pressure). From the 24 centers, 356 volunteers (89.2%) completed the study. Those receiving the interventions had higher mean physical activity levels at 12 months of 1820 (95% confidence interval (CI) = 1360-2290) and 1260 (95% CI = 780-1740) MET·min·wk(-1), respectively relative to the decrease in the control groups. The buddy peer support intervention significantly improved mean aerobic fitness (12% [95% CI = 4%-21%]) and reduced both body fat (-0.6% [95% CI = -1.1% to 0.0%]) and time to complete the 2.5-m get-up-and-go test (-0.27 [95% CI = -0.53 to -0.01] s). No other improvements in the cardiovascular disease risk factors were observed. The combination of motivational tools was no better than the individual interventions. Both motivational interventions increased physical activity levels, and the buddy style improved fitness. These tools could be useful adjuncts in the prevention of obesity and age-related complications.

Changing School Physical Activity: An Examination of Individual School Designed Programs

This study guided by a health ecology conceptual framework evaluated four “bottom-up” Physical Activity (PA) interventions with school personnel planning for their own health ecology with state level support for one year. Students (N = 616) were from four schools in the Southwestern USA in the 3rd-8th grade. Participants had various ethnic backgrounds (e.g., Hispanic 44%, Caucasian 43%) and wore a pedometer for five school days pre/post intervention. Teacher and school level data were also reported by schools. Program components varied across the four intervention sites. Paired samples t test results showed that three of the four intervention schools significantly increased both school day and 24 hr PA. School personnel reported significantly more favorable results at post test for nurse visits, student absences, and classroom teachers’ use of PA breaks. Using a health ecology lens, when schools develop their own PA intervention and have “buy in” from staff, significant increases in PA are attainable.

The Effects of Workplace Physical Activity Interventions in Men

The workplace is cited as a promising setting for physical activity (PA) promotion, but workplace PA interventions tend not to specifically target men. The aim of this article was to review the literature on workplace PA interventions for men and to identify key issues for future intervention development. Articles targeting PA at the workplace were located through a structured database search. Information on intervention strategies and PA outcomes were extracted. Only 13 studies (10.5%) reviewed focused on men, of which 5 showed significant increases in PA. These studies used generic, multicomponent, health promotion strategies with a variety of timeframes, self-report PA measures, and PA outcomes. The systematic review identified that evidence on the effectiveness of workplace PA interventions for men is equivocal and highlighted methodological concerns. Future research should use reliable and valid measures of PA and interventions that focus specifically on men's needs and PA preferences.

Social Cognitive Factors Associated With Physical Activity in Elementary School Girls

To examine social cognitive factors associated with physical activity (PA) among preadolescent girls. Social cognitive theory was used to examine PA in girls (N=90; 71% African American) participating in Girls on the Run. Multiple regressions explored factors associated with PA at posttesting and 3-month follow-up. Significant increases in PA, social influences, and self-efficacy were found, which were sustained at 3-month follow-up. Self-efficacy and social influences had the strongest relations to PA at posttest; self-efficacy remained the strongest predictor of PA at 3-month follow-up. Social support and self-efficacy are important targets of PA interventions in preadolescent girls.

Evaluation of “One Body, One Life”: A Community-Based Family Intervention for the Prevention of Obesity in Children

Service evaluation of a community-based healthy lifestyle programme, designed for families aimed at preventing obesity. Physiological and behaviour measures were recorded at the beginning and end of the programme. Out of a total of 454 participants, 358 (79%) completed. From these completers 293 (64%) were analysed as there was sufficient data. The use of “high visibility recruitment” led to 77% of completers being from Coventry's two most deprived population quintiles. Ethnic minorities were also well represented. There were statistically significant self-reported behaviour changes, with improvements in fruit and vegetables eaten and decrease in consumption of crisps, snacks, and take away foods. There were also significant increases in physical activity. There were small but statistically significant improvements in BMI/BMI percentile for adults and children who started the programme overweight/obese. These results demonstrate the programmes' effectiveness in enabling behaviour change, and attracting participants from deprived communities.

Computer- and web-based interventions to increase preadolescent and adolescent physical activity: a systematic review

This review examined evidence regarding computer- or web-based interventions to increase preadolescent and adolescent physical activity. Today's youth are less active and more overweight than their counterparts from 25 years ago. Overweight youth tend to become overweight adults with weight-related maladies, including type 2 diabetes and cardiovascular problems. Interventions to increase physical activity that reach a large audience are needed. Computer- and web-based physical activity interventions are an appealing means to influence physical activity in preadolescents and adolescents. However, their effectiveness must be determined. The following electronic databases were searched for studies published from 1998 through 2010: CINAHL, PubMed, PsycINFO, Sociological Abstracts, SportDISCUS and Proquest. A systemic review was conducted. Fourteen randomized control trials or quasi-experimental studies were reviewed to: (1) determine the effect of computer- or web-based interventions on increasing physical activity and/or improving body mass index, weight, percent body fat or waist circumference as a result of increasing physical activity; and (2) examine if additional components associated with these interventions increased success. Although most interventions demonstrated statistically significant increases in physical activity or positive health changes related to physical activity, findings were small or short-lived. The value of conducting the interventions at school, using a theory or model as a framework, and supplementing with individual tailoring and parental involvement, is discussed. Computer- and web-based interventions can promote physical activity among preadolescents and adolescents, particularly in schools. However, further efforts are needed to sustain positive changes.

Predictors of physical activity at 1 year in a randomized controlled trial of family members of patients with cardiovascular disease.

Recommendations for physical activity to lower risk of cardiovascular disease (CVD) are widely known but not often followed. The purpose of this study was to determine the demographic, lifestyle, and psychosocial variables that predict improved physical activity among participants in a CVD prevention lifestyle intervention trial. Adult family members (N = 501; 66% female; 36% nonwhite; mean age, 48 years) of cardiac patients were randomized to a 1-year special intervention that received education on physical activity or to a control intervention. Demographics, physical activity, stage of change, and CVD risk factors were measured systematically at baseline and 1 year (94% follow-up). Lipids were analyzed in a core laboratory. Linear regression models were adjusted for confounders. At baseline, 21% of participants reported exercising more than 3 d/wk, which did not differ by group assignment. The special intervention and control intervention experienced significant increases in physical activity at 1 year with mean physical activity days per week in the special intervention significantly greater than the control intervention (2.5 vs 2.0 d/wk, P = .03). Significant predictors of increased physical activity at 1 year were group assignment (P = .03), female sex (P = .04), nonminority status (P <.01), greater readiness to change (P <.01), and baseline measurements of lower body mass index (P <.01) and waist size (P <.01), greater diet adherence (P <.01), higher high-density lipoprotein cholesterol (P <.01), lower high-sensitivity C-reactive protein (P = .02), less depression (P <.01), and higher social support (P = .03). In multiple regression models, group assignment, female, and nonminority status remained independent predictors of higher physical activity levels at 1 year. Several predictors of improved physical activity levels at 1 year were documented among clinical trial participants. Racial/ethnic minorities and men were significantly less likely to make positive changes and may need more targeted efforts to improve physical activity levels.

Encouraging physical activity in pediatric asthma: A case–control study of the wonders of walking (WOW) program

The complex overlap between asthma and obesity may be explained in part by activity avoidance in asthma. We compared responses to a walking intervention between matched groups of children with and without asthma. We expected youth with asthma to have lower baseline and post-intervention activity levels. Psychosocial, demographic, and physiologic correlates of activity were also examined. We compared baseline and post-intervention activity levels among 59 children aged 10-16 with well-controlled asthma and 59 healthy matched controls. Participants completed spirometry, physical examination, anthropometric measurement, and psychosocial questionnaires. INTERVENTION/OUTCOME MEASURE: Participants wore blinded calibrated pedometers for a baseline typical activity week, returning to complete the Wonders of Walking (WOW) intervention, followed by a week of post-intervention pedometer monitoring. Contrary to expectation, no differences between cases (median steps = 6,348/day) and controls (median steps = 6,825/day) in baseline activity were found. Response to the WOW intervention was comparable, with both groups demonstrating an increase of approximately 1,485 steps per day (equivalent to more than 5 additional miles walked during the post-intervention week). Health beliefs did not correlate to activity at baseline or intervention response. No significant associations between activity and asthma control, FEV1, or duration of diagnosis were found. Intervention response was comparable across racial/ethnic groups, children versus adolescents, and between normal weight and overweight youth. Contrary to expectation, we found similar rates of objectively measured physical activity among youth with well-controlled asthma and controls. Importantly, we documented statistically significant increases in physical activity across both groups following a brief, pedometer-based intervention. The intervention was successful even among typically sedentary groups, and represents an effective, safe, and inexpensive walking program.

Physical activity for men receiving androgen deprivation therapy for prostate cancer: benefits from a 16-week intervention

Prostate cancer patients receiving androgen deprivation therapy (ADT) are vulnerable to a number of potentially debilitating side effects, which can significantly impact quality of life. The role of alternate therapies, such as physical activity (PA), in attenuating these side effects is largely understudied for such a large population. Thus, the purpose of this study was to investigate the effects of PA intervention for men receiving ADT on PA behavior, quality of life, and fitness measures. One hundred participants were randomized into an intervention (n = 53) or a wait-list control group (n = 47), with 11 dropping out of the intervention group and 23 dropping out of the wait-list control group prior to post-testing. The intervention consisted of both an individually tailored home-based aerobic and light resistant training program and weekly group sessions. PA, quality of life, fitness, and physiological outcomes were assessed pre and post the 16-week intervention. Significant increases in PA, supported by changes in girth measures and blood pressure, support the beneficial impact of the intervention. Positive trends were also evident for depression and fatigue. However, due to the high dropout rate, these results must be interpreted with caution. PA effectively attenuates many of the side effects of ADT and should be recommended to prostate survivors as an alternate therapy. Determining the maintenance of this behavior change will be important for understanding how the long-term benefits of increased activity levels may alleviate the late effects of ADT.

Implementation of a Faith-Based Physical Activity Intervention: Insights from Church Health Directors

Churches are becoming increasingly popular settings for conducting health promotion programs. Retrospective interviews were conducted with 19 health directors from churches taking part in the evaluation of a large-scale faith-based physical activity initiative. This paper first describes program implementation, church leadership support, and changes in church leadership, and then relates these variables to program outcomes (percentage of participants meeting physical activity recommendations). Finally, barriers and successes to program implementation are reported. The most commonly reported intervention activities implemented by churches were bulletin boards related to healthy eating and physical activity (79%) followed by bulletin inserts (69%), walking programs (58%), chair exercises (48%), praise aerobics (27%), a 10-min exercise CD (26%), and an 8 week behavior change class (26%). Significant increases in physical activity were associated with churches which had ever implemented the behavior change class at the 1-year follow-up. According to health directors, pastors sometimes to often spoke about physical activity and diet from the pulpit but rarely to sometimes took part in program activities. They also reported that pastors spouses' never to rarely spoke about physical activity and diet from the pulpit, and rarely to sometimes took part in program activities. About 68% of the churches had at least one change in pastor over the 3-year study. A majority of these variables, however, were not related to changes in physical activity. Potential reasons for these lack of associations are discussed.

The Effectiveness of a Physical Activity Intervention for Seniors

To determine whether a tailored, 6-month, neighborhood-based, physical activity intervention for people aged 65 to 74 years could increase their total physical activity levels and to identify factors associated with physical activity times. A longitudinal, prospective, intervention study. Perth, Western Australia. A total of 573 older adults, recruited from 30 intervention (n = 260) and 30 control (n = 313) neighborhoods. Initial response rates were 74% (260/352) in the intervention group and 82% (313/382) in the control group, which provided the 573 adults for participation in the study. A total of 413 participants (177 and 236 in the intervention and control groups, respectively) completed the program. A neighborhood-based physical activity intervention. A self-reported questionnaire administered at three time points. Physical activity levels were measured using the International Physical Activity Questionnaire. Personal and demographic information, including perceived financial struggle and proximity to friends, were collected. Descriptive statistics, repeated measures analysis of variance, and generalized estimating equations (GEE). The intervention resulted in a significant increase in total average physical activity times of 2.25 hours per week (p < .001). The GEE analysis confirmed significant increases in physical activity from baseline to midpoint (p = .002) and topostintervention (p = .031). Perception of financial struggle (p = .020) was positively associated with physical activity time spent by participants, whereas having no friends or acquaintances living nearby (p = .037) had a significant negative correlation. The main limitation of this study was the restricted duration of the intervention. The program was successful in increasing weekly mean time for physical activity in seniors and in identifying factors that affect their commitment to physical activities.

Changes in Physical Activity Mirror Changes in Sedentary Time, Particularly Screen Time

Numerous intervention studies have shown increased physical activity (PA) among insufficiently active adults over the short term. Few reports document the impact of increased PA on other daily activities or what happens following the intervention. PURPOSE: To investigate the changes in both PA and sedentary behaviors with two types of intensive PA interventions. METHODS: A 40-day intervention study was designed to increase PA in 438 insufficiently active (<150 min/wk PA) subjects randomly assigned to a pedometer (n=251) or group (n=187) intervention arm who exercised daily. An active control group was also included (n=135). Subjects completed the Active Australia Physical Activity and Sedentary Behaviour Questionnaire pre and post intervention, and at 3 and 6-months follow-up. RESULTS: During the intervention phase there were significant increases in PA for both arms (pre mean (SE) 70 (3) min/wk and 303 (22) and 550 (30) min/wk postintervention in the pedometer and group arms, respectively). Sedentary time decreased significantly in both groups during the intervention (1528 (65) to 1352 (74) min/wk for group and 1494 (57) to 1373 (53) min/wk for pedometer subjects). Within sedentary time there were significant decreases in screen-based leisure time and no changes in reading or driving time. A significant group x intervention decrease in screen time (group > pedometer, p = 0.02) was found. PA patterns decreased and sedentary time gradually increased over the next 6 months. Across the entire study there were significant inverse correlations between changes in PA and changes in screen time (within groups and when combined), but not for other sedentary time (p<0.0001). PA and sedentary behavior patterns for the controls were unchanged across the study. CONCLUSION: Changes in PA mirror changes in screen-based leisure time. Strategies to reduce screen time should be included as part of PA interventions. Supported by the South Australian Department of Health and Australian Research Council.

Using Pedometers to Increase Physical Activity and Improve Health

Without detailed evidence of their effectiveness, pedometers have recently become popular as a tool for motivating physical activity. To evaluate the association of pedometer use with physical activity and health outcomes among outpatient adults. English-language articles from MEDLINE, EMBASE, Sport Discus, PsychINFO, Cochrane Library, Thompson Scientific (formerly known as Thompson ISI), and ERIC (1966-2007); bibliographies of retrieved articles; and conference proceedings. Studies were eligible for inclusion if they reported an assessment of pedometer use among adult outpatients, reported a change in steps per day, and included more than 5 participants. Two investigators independently abstracted data about the intervention; participants; number of steps per day; and presence or absence of obesity, diabetes, hypertension, or hyperlipidemia. Data were pooled using random-effects calculations, and meta-regression was performed. Our searches identified 2246 citations; 26 studies with a total of 2767 participants met inclusion criteria (8 randomized controlled trials [RCTs] and 18 observational studies). The participants' mean (SD) age was 49 (9) years and 85% were women. The mean intervention duration was 18 weeks. In the RCTs, pedometer users significantly increased their physical activity by 2491 steps per day more than control participants (95% confidence interval [CI], 1098-3885 steps per day, P < .001). Among the observational studies, pedometer users significantly increased their physical activity by 2183 steps per day over baseline (95% CI, 1571-2796 steps per day, P < .0001). Overall, pedometer users increased their physical activity by 26.9% over baseline. An important predictor of increased physical activity was having a step goal such as 10,000 steps per day (P = .001). When data from all studies were combined, pedometer users significantly decreased their body mass index by 0.38 (95% CI, 0.05-0.72; P = .03). This decrease was associated with older age (P = .001) and having a step goal (P = .04). Intervention participants significantly decreased their systolic blood pressure by 3.8 mm Hg (95% CI, 1.7-5.9 mm Hg, P < .001). This decrease was associated with greater baseline systolic blood pressure (P = .009) and change in steps per day (P = .08). The results suggest that the use of a pedometer is associated with significant increases in physical activity and significant decreases in body mass index and blood pressure. Whether these changes are durable over the long term is undetermined.

The California active aging community grant program: Translating science Into practice to promote physical activity in older adults

Attempts to study the translation of evidence-based physical activity interventions in community settings are scarce. This project was an investigation of whether 13 diverse local lead agencies could effectively implement a choice-based, telephone-assisted physical activity promotion program for older adults based on intervention models proven efficacious in research settings. At baseline, participants developed their own physical activity programs through an individualized planning session based on preference, health status, readiness to change, and available community resources. Thereafter, participants received regular telephone calls over a 1-year period from a trained staff member or volunteer support buddy. Additional program components consisted of health education workshops, newsletters, and group-based physical activities. Self-report data on caloric expenditure due to all and moderate or greater intensity physical activities were collected from 447 participants (M age = 68 +/- 8.6 years). A significant increase (p < or = .0001) from baseline to midintervention and intervention endpoint was observed for total weekly caloric expenditure (Mdn change = 644-707 kcal/week) and moderate or greater weekly caloric expenditure (Mdn change = 149-265 kcal/week), as well as for weekly physical activity duration and frequency. These changes were observed in participants across all sites. The increases in weekly caloric expenditure were commensurate with findings from several previous randomized clinical trials. The utilization of community agency staff and volunteers receiving basic training to implement essential program components proved feasible. Very favorable levels of program satisfaction expressed by community staff, volunteer support buddies, and participants, combined with the significant increases in physical activity, warrant further dissemination of the intervention model.

Daughters and Mothers Exercising Together (DAMET): A 12-Week Pilot Project Designed to Improve Physical Self-Perception and Increase Recreational Physical Activity

ABSTRACT This paper presents the results of a 12-week single-sex, family-based physical activity intervention grounded in Social Cognitive Theory. Mother/daughter pairs and triads (n = 20) attended physical activity and classroom sessions twice weekly. Physiological data (VO2peak, height, and weight), psychological data (physical self-perception profile subscale scores), information about physical activity participation (PAP, d?wk21) and qualitative impressions (QI) of the program were collected pre-and post-intervention. PAP and QI were also collected 6-months after completing the intervention. Although no significant increases in physical activity were reported, significant improvements in perceived sport competence, physical condition, and strength and muscularity were reported over time. The social cognitive theory, as used to plan this physical activity intervention, offered a promising theoretical perspective for facilitating improved physical self-perception in adolescent girls and their mothers.

Prevention of cardiovascular risk factor elevations in healthy premenopausal women

Abstract Background. A number of factors contribute to increased risk of coronary heart disease (CHD) among postmenopausal women, including atherogenic changes in serum cholesterol profiles, weight gain, and decreases in physical activity during the menopause. To date, no study has attempted to prevent elevations in primary CHD risk factors as women experience menopause. Methods. A sample of 535 healthy premenopausal women, ages 44-50, were recruited for an ongoing B-year randomized prevention trial testing whether increases in low-density lipoprotein cholesterol (LDL-C) and body weight can be prevented during the menopause with a dietary and behavioral intervention. The aim was to reduce total dietary and saturated fat and cholesterol, prevent weight gain, and increase physical activity levels. Changes in CHD risk factors after the first 6 months of treatment were analyzed comparing 253 intervention and 267 assessment-only control participants. Results. The intervention group showed significant reductions in total cholesterol (−0.34 mmol/liter), LDL-C (−0.28 mmol/liter), triglycerides (−0.04 mmol/liter), weight (−4.8 kg), waist-hip ratio (−0.008), systolic blood pressure (−3.5 mm Hg), diastolic blood pressure (−2.2 mm Hg), serum glucose levels (−0.06 mmol/liter), and HDL-C (−0.06 mmol/liter) and significant increases in physical activity (+383 kcal). No significant changes were observed in the control group. Conclusion. Six-month results suggested that participants were receptive to the preventive approach to CHD risk reduction and were successful in making initial positive lifestyle changes. Follow-up data will evaluate long-term adherence to the intervention and the interaction between adherence and physiological changes during menopause.

Prevention of Cardiovascular Risk Factor Elevations in Healthy Premenopausal Women

Background. A number of factors contribute to increased risk of coronary heart disease (CHD) among postmenopausal women, including atherogenic changes in serum cholesterol profiles, weight gain, and decreases in physical activity during the menopause. To date, no study has attempted to prevent elevations in primary CHD risk factors as women experience menopause. Methods. A sample of 535 healthy premenopausal women, ages 44-50, were recruited for an ongoing B-year randomized prevention trial testing whether increases in low-density lipoprotein cholesterol (LDL-C) and body weight can be prevented during the menopause with a dietary and behavioral intervention. The aim was to reduce total dietary and saturated fat and cholesterol, prevent weight gain, and increase physical activity levels. Changes in CHD risk factors after the first 6 months of treatment were analyzed comparing 253 intervention and 267 assessment-only control participants. Results. The intervention group showed significant reductions in total cholesterol (−0.34 mmol/liter), LDL-C (−0.28 mmol/liter), triglycerides (−0.04 mmol/liter), weight (−4.8 kg), waist-hip ratio (−0.008), systolic blood pressure (−3.5 mm Hg), diastolic blood pressure (−2.2 mm Hg), serum glucose levels (−0.06 mmol/liter), and HDL-C (−0.06 mmol/liter) and significant increases in physical activity (+383 kcal). No significant changes were observed in the control group. Conclusion. Six-month results suggested that participants were receptive to the preventive approach to CHD risk reduction and were successful in making initial positive lifestyle changes. Follow-up data will evaluate long-term adherence to the intervention and the interaction between adherence and physiological changes during menopause.