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Psychological and physical activity training for older persons: who does not attend?

BACKGROUND: Interventions to promote successful aging include psychological and physical activity programs. Identification of determinants of attendance of older persons may be useful to develop strategies to improve attendance. For physical activity programs determinants of attendance have been investigated extensively. For psychological programs hardly any knowledge is available. Determinants of attendance at psychological and physical activity programs have never been investigated simultaneously. OBJECTIVE: To identify demographic, physical and psychological determinants of attendance of older subjects following multifaceted psychological training - aimed at promoting active social participation - and physical activity training and to compare the variation of these determinants between the two training programs. METHOD: 118 subjects aged 65-92 years were randomized over psychological and physical activity training. Determinants of attendance were obtained at pretest with questionnaires and performance-based tests. RESULTS: Mean attendance was 62%. Attendance was not related to type of program. Having chronic diseases facilitated attendance in the psychological training group and limited attendance in the physical activity training group. Low and high levels of Activities of Daily Living performance (ADLs) and walking endurance were related to a high attendance in the psychological training group. A low level of activities of daily living (ADL) and a low walking endurance were related to a low attendance in the physical activity training group. For both training groups, persons living with a partner had higher attendance rates than persons living alone, and persons with a low level of anxiety had higher attendance rates than persons with a moderate or a high level of anxiety. CONCLUSION: Psychological training may be more suitable for frail older persons with chronic diseases, low ADL levels and low walking endurance than physical activity training, and may help to prepare such persons for physical activity.

Activities of Daily Living↗

Obesity as compared with physical activity in predicting risk of coronary heart disease in women.

BACKGROUND: The comparative importance of physical inactivity and obesity as predictors of coronary heart disease (CHD) risk remains unsettled. METHODS AND RESULTS: We followed 88 393 women, 34 to 59 years of age, in the Nurses' Health Study from 1980 to 2000. These participants did not have cardiovascular disease and cancer at baseline. We documented 2358 incident major CHD events (including nonfatal myocardial infarction and fatal CHD) during 20 years of follow-up, including 889 cases of fatal CHD and 1469 cases of nonfatal myocardial infarction. In a multivariate model adjusting for cardiovascular risk factors, overweight and obesity were significantly associated with increased risk of CHD, whereas increasing levels of physical activity were associated with a graded reduction in CHD risk (P<0.001). In joint analyses of body mass index (BMI) and physical activity in women who had a healthy weight (BMI, 18.5 to 24.9 kg/m2) and were physically active (exercise > or =3.5 h/wk) as the reference group, the relative risks of CHD were 3.44 (95% confidence interval [CI], 2.81 to 4.21) for women who were obese (BMI > or =30 kg/m2) and sedentary (exercise <1 h/wk), 2.48 (95% CI, 1.84 to 3.34) for women who were active but obese, and 1.48 (95% CI, 1.24 to 1.77) for women who had a healthy weight but were sedentary. In combined analyses of waist-hip ratio and physical activity, both waist-hip ratio and physical activity were significant predictors of CHD, and the highest risk was among women in the lowest category of physical activity and the highest tertile of waist-hip ratio (relative risk=3.03; 95% CI, 1.96 to 4.18). Even a modest weight gain (4 to 10 kg) during adulthood was associated with 27% (95% CI, 12% to 45%) increased risk of CHD compared with women with a stable weight after adjusting for physical activity and other cardiovascular risk factors. CONCLUSIONS: Obesity and physical inactivity independently contribute to the development of CHD in women. These data underscore the importance of both maintaining a healthy weight and regular physical activity in preventing CHD.

Adult↗

Recent sexual abuse, physical abuse, and suicide attempts among male veterans seeking psychiatric treatment.

OBJECTIVES: This study examined the rates of sexual and physical abuse and suicide attempts among male and female patients and focused on the associations between sexual and physical abuse and recent suicide attempts among men. METHODS: Data were examined for a cohort of patients aged 19 years and older who were seeking treatment for substance use disorders, other psychiatric disorders, or both from the Department of Veterans Affairs (VA) between July 1997 and September 1997. Almost all the patients in the sample (more than 99 percent) had a substance use disorder. Patients were interviewed with the Addiction Severity Index about lifetime and recent (past 30 days) sexual and physical abuse and recent suicide attempts. Because of the low prevalence of suicide attempts in the past 30 days and limited representation of female patients in this sample, the data for female patients were used only to conduct descriptive analyses to compare the prevalence of sexual and physical abuse and suicide attempts between genders. RESULTS: The sample comprised 34,245 patients (33,236 males and 1,009 females). Compared with male patients, female patients were ten times as likely to have been sexually abused in the past 30 days and four times as likely to have been physically abused. Among male patients, bivariate analyses showed that those who had been recently sexually or physically abused were more likely than those who had not experienced such abuse to have attempted suicide recently (odds ratios of 4.8 and 3.0, respectively). After controlling for demographic and diagnostic factors, multivariate logistic regression analyses indicated that recent sexual abuse, recent physical abuse, and lifetime sexual abuse were significantly associated with a higher likelihood of a recent suicide attempt among male patients. CONCLUSIONS: Female patients were more likely than their male counterparts to experience sexual and physical abuse. Recent and lifetime history of sexual abuse and recent physical abuse were independent risk factors for recent suicide attempts among men who were seeking treatment. The results suggest that clinicians who identify suicide attempts and suicidal tendencies among male patients should routinely assess for sexual or physical abuse.

Demography↗

Association between physical activity and endogenous fibrinolysis in peripheral arterial disease: a cross-sectional study.

The purpose of this study was to determine whether daily physical activity was independently related to endogenous fibrinolysis in subjects with peripheral arterial disease (PAD). One hundred and six subjects with peripheral arterial disease (PAD) and intermittent claudication were characterized on the activity level of tissue plasminogen activator (tPA, the activator of fibrinolysis), the activity level of plasminogen activator inhibitor (PAI-1, the inhibitor of fibrinolysis), daily physical activity, ambulatory function, and demographic information. Subjects were separated into low (n = 36), moderate (n = 34), and high (n = 36) physical activity tertiles based on a 48-hour monitoring period with use of an accelerometer. The tPA activity of the low physical activity group (1.30 +/- 0.16 IU/mL) was 21% and 19% lower (p<0.05) than that of the moderate (1.65 +/- 0.18 IU/mL) and the high (1.61 +/- 0.15 IU/mL) physical activity groups, respectively. The PAI-1 activity of the low physical activity group (21.41 +/- 1.14 AU/mL) was 15% and 23% higher than that of the moderate (18.61 +/- 1.34 AU/mL) and the high (17.47 +/- 1.14 AU/mL) physical activity groups, respectively. Group differences in tPA activity and PAI-1 activity persisted after our controlling for group differences in measured and self-reported ambulatory measures. Daily physical activity is related to a more favorable endogenous fibrinolytic profile in PAD subjects with intermittent claudication. Subjects who expend fewer than 175 kcal/day in physical activities (approximately 35 minutes) are particularly susceptible to having a prothrombotic state. Subjects should be encouraged to participate in at least 35 minutes of physical activity each day to enhance fibrinolysis.

Aged↗

Can I play too? Physical activity engagement of children with developmental coordination disorders.

BACKGROUND: Children with developmental coordination disorders (DCD) are less physically active and have significantly different patterns of social and physical play than their well-coordinated peers. FACTORS: The impact of motor incoordination on physical activity engagements throughout life is influenced by a multitude of factors. External factors such as the social, cultural and physical environment may act as either supports or barriers to active physical involvement. Individual characteristics including the unique physical and psychological attributes of the child with motor coordination difficulties also impact on engagement in physically active occupations. RESULT: A model is proposed that conceptualizes the multiple dimensions which impinge on the decisions to select, engage and persist in physical activities for children with developmental coordination disorders. PRACTICE IMPLICATIONS: The occupational therapist's role in promoting a balanced and physically active lifestyle is explored. Interventions to increase physical activity participation for children with DCD are dependent on a full understanding of the complex, multi-dimensional correlates of occupational engagement.

Child↗

An analysis of physical guidance as reinforcement for noncompliance.

Physical guidance is a strategy commonly used for noncompliance. In two experiments, we evaluated reinforcing effects of physical guidance. Experiment 1 include three individuals with developmental disabilities who were noncompliant with tasks. Anecdotal observations indicated physical contact was highly reinforcing, and a functional analysis identified attention as a reinforcer for problem behavior. Two conditions compared physical guidance following noncompliance and no physical guidance following noncompliance. Results showed noncompliance increased for all three participants when physical guidance followed noncompliance. The second experiment empirically evaluated the function of noncompliance prior to examining the effect of physical guidance on noncompliance. A functional analysis, conducted with two participants, indicated noncompliance served an escape function for one and an attention function for the other. Comparisons of physical guidance and no physical guidance indicated physical guidance resulted in decreased noncompliance for the participant with an escape function but increased noncompliance for the participant with an attention function.

Activities of Daily Living↗

Development of the Physical Activity Interactive Recall (PAIR) for Aboriginal children.

BACKGROUND: Aboriginal children in Canada are at increased risk for type 2 diabetes. Given that physical inactivity is an important modifiable risk factor for type 2 diabetes, prevention efforts targeting Aboriginal children include interventions to enhance physical activity involvement. These types of interventions require adequate assessment of physical activity patterns to identify determinants, detect trends, and evaluate progress towards intervention goals. The purpose of this study was to develop a culturally appropriate interactive computer program to self-report physical activity for Kanien'kehá:ka (Mohawk) children that could be administered in a group setting. This was an ancillary study of the ongoing Kahnawake Schools Diabetes Prevention Project (KSDPP). METHODS: During Phase I, focus groups were conducted to understand how children describe and graphically depict type, intensity and duration of physical activity. Sixty-six students (40 girls, 26 boys, mean age = 8.8 years, SD = 1.8) from four elementary schools in three eastern Canadian Kanien'kehá:ka communities participated in 15 focus groups. Children were asked to discuss and draw about physical activity. Content analysis of focus groups informed the development of a school-day and non-school-day version of the physical activity interactive recall (PAIR). In Phase II, pilot-tests were conducted in two waves with 17 and 28 children respectively to assess the content validity of PAIR. Observation, videotaping, and interviews were conducted to obtain children's feedback on PAIR content and format. RESULTS: Children's representations of activity type and activity intensity were used to compile a total of 30 different physical activity and 14 non-physical activity response choices with accompanying intensity options. Findings from the pilot tests revealed that Kanien'kehá:ka children between nine and 13 years old could answer PAIR without assistance. Content validity of PAIR was judged to be adequate. PAIR was judged to be comprehensive, acceptable, and enjoyable by the children. CONCLUSIONS: Results indicate that PAIR may be acceptable to children between nine and 13 years old, with most in this age range able to complete PAIR without assistance. The flexibility of its programming makes PAIR an easily adaptable tool to accommodate diverse populations, different seasons, and changing trends in physical activity involvement.

Journal Article↗

Correlates of distances traveled to use recreational facilities for physical activity behaviors.

BACKGROUND: Information regarding how far people are willing to travel to use destinations for different types of recreational physical activity behaviors is limited. This study examines the demographic characteristics, neighborhood opportunity and specific-physical activity behaviors associated with distances traveled to destinations used for recreational physical activity. METHODS: A secondary analysis was undertaken of data (n = 1006) from a survey of Western Australian adults. Road network distances between respondents' homes and 1) formal recreational facilities; 2) beaches and rivers; and 3) parks and ovals used for physical activity were determined. Associations between distances to destinations and demographic characteristics, neighborhood opportunity (number of destinations within 1600 meters of household), and physical activity behaviors were examined. RESULTS: Overall, 56.3% of respondents had used a formal recreational facility, 39.9% a beach or river, and 38.7% a park or oval. The mean distance traveled to all destinations used for physical activity was 5463 +/- 5232 meters (m). Distances traveled to formal recreational facilities, beaches and rivers, and parks and ovals differed depending on the physical activity undertaken. Younger adults traveled further than older adults (7311.8 vs. 6012.6 m, p = 0.03) to use beaches and rivers as did residents of socio-economically disadvantaged areas compared with those in advantaged areas (8118.0 vs. 7311.8 m, p = 0.02). Club members traveled further than non-members to use parks and ovals (4156.3 vs. 3351.6 meters, p = 0.02). The type of physical activity undertaken at a destination and number of neighborhood opportunities were also associated with distance traveled for all destination types. CONCLUSION: The distances adults travel to a recreational facility depends on the demographic characteristics, destination type, physical activity behavior undertaken at that destination, and number of neighborhood opportunities. Knowing how far adults travel to undertake physical activity will assist in designing supportive neighborhoods and designing future ecological research.

Journal Article↗

Youth at risk of physical inactivity may benefit more from activity-related support than youth not at risk.

BACKGROUND: This study examines whether associations between activity-related support and adolescents' physical activity differ for adolescents at high versus low risk of physical inactivity. METHODS: Participants included 202 middle-school-aged girls (N = 92) and boys (N = 110). Physical activity was assessed using three self-report questionnaires. Activity-related support from mothers, fathers, siblings, and peers was assessed using the Activity Support Scale. Perceived sport competence was assessed using the Physical Activity Self Description Questionnaire. Participants' height and weight were measured and used to calculate their age- and sex-adjusted Body Mass Index percentile. Participants were classified as being at high risk for physical inactivity if they fulfilled two of the following three criteria: (1) overweight; (2) female; or (3) having low perceived sport competence. RESULTS: Activity-related support from all sources was associated with higher levels of physical activity among adolescents. A stronger association between activity support and physical activity was found for adolescents at high risk for physical inactivity in comparison to adolescents at low risk. CONCLUSIONS: Findings from this study suggest that the activity-related support from family and friends may be an effective tool in promoting physical activity among youth at risk of physical inactivity.

Journal Article↗

Social cognitive theory and physical activity during breast cancer treatment.

PURPOSE/OBJECTIVES: To measure the association between physical activity and social cognitive theory constructs during breast cancer treatment. DESIGN: Cross-sectional survey. SETTING: Midwestern, academic oncology clinic. SAMPLE: 21 primarily Caucasian (90%) female patients with breast cancer undergoing treatment. 76% were > 50 years old; 76% had stage I or II disease. 17 completed the study. METHODS: Survey (structured interview or self-administration), chart audit, pedometer, and seven-day physical activity recall. MAIN RESEARCH VARIABLES: Steps per day, energy expenditure, self-efficacy, barriers, partners and role models, prior physical activity counseling, physical activity knowledge, pretreatment physical activity, outcome expectations and values, goals, reinforcement management, and emotional well-being. FINDINGS: A higher average of steps per day was significantly associated with having an exercise role model and higher annual income. A higher daily energy expenditure (kilocalories per kilogram body weight per day) was significantly associated with higher barrier self-efficacy, higher task self-efficacy, having an exercise partner, having an exercise role model, higher physical activity enjoyment, and lower negative value score. CONCLUSIONS: Social cognitive theory may provide a useful framework for understanding physical activity among patients with breast cancer during treatment, but correlation strength varies with physical activity measurement type. IMPLICATIONS FOR NURSING: Social cognitive theory and physical activity during breast cancer treatment warrant additional study with larger sample sizes and multivariate analyses. Interventions to increase physical activity among patients with breast cancer may use social cognitive theory and assess theory constructs as potential mediators or moderators in intervention evaluation.

Breast Neoplasms↗

Evidence-based measurement in multiple sclerosis: the psychometric properties of the physical and psychological dimensions of three quality of life rating scales.

The selection of measures of quality of life used in clinical trials of multiple sclerosis (MS) should be evidence-based. Head-to-head comparison of measures facilitates the selection of measures. The aim of the study was to compare the psychometric properties of the physical and psychological dimensions in three measures of quality of life to aid choice of the most appropriate scale for use in clinical trials of MS. One hundred and twenty-one people with MS (rehabilitation = 57; steroids = 64) completed a selection of health measures before and after treatment. The psychometric properties of three measures of physical function (MSIS-29 physical, SF-36 physical functioning, FAMS mobility) and three measures of psychological function (MSIS-29 psychological, SF-36 mental health, FAMS emotional well-being) were compared by examining data quality, scaling assumptions, acceptability, reliability, validity and responsiveness. Physical (0.63-0.71) and psychological (0.70-0.75) scales were substantially correlated indicating they measure related constructs. The MSIS-29 physical and psychological scales satisfied all criteria for internal consistency reliability (physical = 0.91; psychological = 0.89) and validity. The SF-36 physical scale had a notable floor effect (20%). The FAMS mobility scale had lower reliability (alpha = 0.78) compared to other measures. The MSIS-29 physical (effect size = 0.91) and psychological (effect size = 0.62) scales were the most responsive. In these three samples, the MSIS-29 had better measurement properties for combined physical and psychological health than the SF-36 and the FAMS.

Adult↗

Physical and psychiatric comorbidity in general practice.

BACKGROUND: The aim of this study was to determine the association between physical and psychiatric morbidity among general practice patients and to explore the influence of possible intervening variables. METHOD: Physical and psychiatric morbidity in 1620 consecutive patients attending their general practitioner (GP) was assessed using a two-stage design. Ninety-four per cent of the patients (n = 1523) were successfully screened using the General Health Questionnaire (GHQ-12); 428 of the 602 patients (71%) eligible for the second stage were interviewed using the Composite International Diagnostic Instrument adapted for use in primary health care (CIDI-PHC), the Brief Disability Questionnaire (BDQ) and the Groningen Social Disability Schedule (GSDS) to assess psychiatric, physical and social status. Assessments of physical and psychiatric morbidity were also obtained from the patients' GPs. RESULTS: There was a significant association between physical and psychiatric morbidity, although patients with four symptoms or less of physical illness were no more likely to be psychiatric cases than those with none. The association was accounted for by patients at the severe end of the physical continuum with five or more medically explained somatic symptoms: these were twice as likely to be psychiatric cases as those with no such symptoms. Female gender, social disability and physical disability were all significantly more likely to be associated with psychiatric disorder, whether measured by GP or research interview; and these relationships remained after the data were corrected for age differences. CONCLUSIONS: Patients in general practice with moderate to severe physical morbidity are at increased risk of developing psychiatric illness, and when medical illness is present, psychiatric symptoms are more severe. As physical and psychiatric comorbidity is relatively common in general practice, the specific needs of these patients should receive greater attention.

Adult↗

Effects of fatigue on physical activity and function in patients with Parkinson's disease.

OBJECTIVE: To characterize the relationships between symptoms of fatigue, physical activity, physical function, and functional capacity in patients with idiopathic PD. METHODS: Thirty-seven patients with PD underwent evaluation of physical activity, physical function, functional capacity, and fatigue. Physical activity and fatigue were measured by standard questionnaires (Godin Leisure Activity Questionnaire, Yale Physical Activity Questionnaire, and Fatigue Severity Scale); physical function was measured by the Up and Go Test and the Six-Minute Walk; and functional capacity was measured by a maximal oxygen uptake exercise test (VO(2max)). RESULTS: Increased levels of fatigue were associated with decreased levels of leisure physical activity, lower frequency of vigorous physical activity, less time spent moving about performing daily tasks each day, lower diastolic blood pressure and VO(2max), longer Up and Go performance time, and carbidopa-levodopa (CL) use. A multiple regression analysis was performed to determine factors predicting fatigue (Fatigue Severity Scale). The Up and Go Test, Leisure Activity Score, CL use, VO(2max), and diastolic blood pressure were the best predictor variables of fatigue. The Up and Go Test and CL use contributed independently to the model, whereas the other variables appeared to moderate the relationships between these variables. CONCLUSIONS: PD patients with more severe fatigue are more sedentary and have poorer functional capacity and physical function compared with patients with less fatigue.

Adult↗

Physical activity and its determinants in severe chronic obstructive pulmonary disease.

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) have a limited exercise capacity. Surprisingly, little is known about their levels of physical activity practice. We assessed the levels and determinants of physical activity practice in severe COPD patients. METHODS: A cross-sectional systematic sample of 346 COPD patients was recruited during 1 yr in four tertiary hospitals of the Barcelona area of Spain. Patients answered a questionnaire, which included physical activity assessment, and performed spirometric tests and blood gases. RESULTS: Seventy-eight percent of patients walked daily whereas 17% did not practice any physical activity. Median energy expenditure in physical activity was 109 kcal x d(-1) (IQR 24-239). The following factors were independently associated with a lower physical activity level in a logistic regression analysis: female sex (OR 2.92, 95% CI 1.11-7.70), older age (1.04, 1.01-1.07 per year), higher socioeconomic status (2.23, 1.24-4.02), diabetes (2.66, 1.40-5.06), lower physical and mental quality of life (0.93, 0.90-0.96 and 0.96, 0.93-0.98, respectively, per unit), and long-term oxygen therapy (2.07, 1.19-3.60). Neither FEV1, previous COPD admissions, body mass index, nor other treatments were related to physical activity practice. CONCLUSIONS: In conclusion, one third of severe COPD patients in our study reported a level of physical activity lower than the equivalent to walking less than 15 min x d(-1). Apart from sociodemographic variables, comorbidity, health-related quality of life, and long-term oxygen therapy were the only factors independently associated with a low level of physical activity.

Age Factors↗

Population trends in leisure-time physical activity: Minnesota Heart Survey, 1980-2000.

PURPOSE: Twenty-year trends in lifestyle (leisure, household, and transportation related) physical activity and leisure-time physical activity (LTPA) were evaluated in the Minnesota Heart Survey (MHS), a population-based surveillance study to monitor trends in cardiovascular risk factor levels among residents of the Minneapolis-St. Paul metropolitan area. METHODS: The Minnesota LTPA questionnaire was administered to adult participants in one of five cross-sectional MHS surveys conducted in 1980 (N = 1626), 1985 (N = 2292), 1990 (N = 2552), 1995 (N = 2432), and 2000 (N = 3089). Occupational activity was queried in 1980, 1995, and 2000. Age-adjusted, gender-specific geometric means of lifestyle physical activity and LTPA and of light-, moderate-, and vigorous-intensity activities were calculated for each survey. The proportion of adults participating in regular physical activity for 30 and 60 min x d(-1) was reported. RESULTS: Male gender, younger age, higher educational status, and employment were characteristic of greater participation in physical activity. Daily energy expenditure from lifestyle physical activity and LTPA increased between 1980 and 2000 in both genders, and workplace activity decreased. Using direct questions, the prevalence of men and women participating in 30 or more minutes of physical activity at least five times per week ranged from 8 to 12%, with no time trend. Only 1% of participants participated 60 min daily. Overall, BMI was 1-2 kg x m(-2) lower among individuals who participated regularly in physical activity. CONCLUSIONS: Although energy expenditure was lower than national recommendations, greater physical activity was associated with lower body mass. Public health strategies are needed to facilitate participation in physical activity, especially for women, elderly, and less educated individuals.

Adult↗

Psychological determinants of physical activity in Japanese female employees.

To understand how psychological characteristics influence adoption and maintenance of physical activity/exercise, we conducted a cross-sectional study among Japanese employees based upon the idea of stages of behavior modification. The study population consisted of 719 employees (male, 396, female, 323) from five medium-sized manufacturing companies (50-200 employees) in Okayama Prefecture, Japan. The female response rate was 67.5% (n=218), among which 201 eligible female subjects (62.2%) were analyzed. The study questionnaire included demographic characteristics, physical activity/exercise measures, self-efficacy measures, and perceived benefit and barriers scales. Participants were asked to select the items that best described their current physical activity/exercise level from an 8-item questionnaire, and we converted their answers to the 5 stages of change according to a transtheoretical model of behavior change. Perceived benefit and barrier scales were classified into 7 factors (4 benefits and 3 barriers) by factor analyses. The relationship between psychological determinants and the stage of physical activity/exercise was examined by one-way analysis of variance. Only 10% of the subjects had moderate physical activity (in the action and maintenance stages) regularly. We found that self-efficacy, "weight control benefit", "physical barrier" and "time barrier" were psychological determinants of physical activity/exercise stages in female employees, and especially there was a consistent relationship between self-efficacy and the stage of physical activity/exercise. Our data suggest that health education for Japanese female employees requires that health professionals should provide support for strengthening self-efficacy, show practical ways to increase physical activity in daily life, and provide broad and accurate information showing that physical activity/exercise have a good effect on health.

Adult↗

Can school income and racial/ethnic composition explain the racial/ethnic disparity in adolescent physical activity participation?

OBJECTIVE: Our goal was to determine if racial/ethnic disparities in adolescent boys' and girls' physical activity participation exist and persist once the school attended is considered. METHODS: We performed a cross-sectional analysis of 17,007 teens in the National Longitudinal Study of Adolescent Health. Using multivariate linear regression, we examined the association between adolescent self-reported physical activity and individual race/ethnicity stratified by gender, controlling for a wide range of sociodemographic, attitudinal, behavioral, and health factors. We used multilevel analyses to determine if the relationship between race/ethnicity and physical activity varied by the school attended. RESULTS: Participants attended racially segregated schools; approximately 80% of Hispanic and black adolescent boys and girls attended schools with student populations that were <66% white, whereas nearly 40% of the white adolescents attended schools that were >94% white. Black and Hispanic adolescent girls reported lower levels of physical activity than white adolescent girls. There were more similar levels of physical activity reported in adolescent boys, with black boys reporting slightly more activities. Although black and Hispanic adolescent girls were more likely to attend poorer schools with overall lower levels of physical activity in girls; there was no difference within schools between black, white, and Hispanic adolescent girls' physical activity levels. Within the same schools, both black and Hispanic adolescent boys had higher rates of physical activity when compared with white adolescent boys. CONCLUSIONS: In this nationally representative sample, lower physical activity levels in Hispanic and black adolescent girls were largely attributable to the schools they attended. In contrast, black and Hispanic males had higher activity levels than white males when attending the same schools. Future research is needed to determine the mechanisms through which school environments contribute to racial/ethnic disparities in adolescent physical activity and will need to consider gender differences in these racial/ethnic disparities.

Adolescent↗

Prevalence of physical activity among Chinese adults: results from the International Collaborative Study of Cardiovascular Disease in Asia.

OBJECTIVES: Determining physical activity levels in the community provides a context for the development and implementation of programs aimed at increasing these activity levels. Therefore, we assessed overall, work-related, and leisure-time physical activity in a representative sample of Chinese adults, aged 35 to 74 years, using data from the International Collaborative Study of Cardiovascular Disease in Asia. METHODS: Being physically active was defined as participating in 30 or more minutes of moderate or vigorous activity daily. Work-related and leisure-time physical activities were defined as being physically active and participating in any moderate or vigorous activity at work or during leisure time, respectively. RESULTS: In rural and urban China, 78.1% and 21.8% of residents, respectively, were physically active; 75.8% and 16.5%, respectively, participated in work-related activity; and 28.9% and 7.9%, respectively, participated in leisure-time physical activity. In both rural and urban settings, younger adults, men, and southern residents were more likely to be physically active and to participate in work-related and leisure-time physical activity than older adults, women, and northern residents. CONCLUSIONS: Intervention strategies to promote leisure-time physical activity, especially among urban residents, should be considered a major health priority in China.

Adult↗