Digital Commons Network^™

Greenspace Across The United States: Exploring Equity And Associations With Physical Activity, Obesity, And Health-Related Quality Of Life, Ellen W. Stowe

Theses and Dissertations

Neighborhood greenspace is important for health and well-being but may not be equitably present in neighborhoods across the United States. Also, many adults are physically inactive, have obesity, and report poor health-related quality of life. Greenspace has been tied to these health conditions, but with mixed findings. The purpose of this study was to 1) use an environmental justice perspective to examine variations in 11 measures of greenspace by neighborhood race/ethnicity, income, and rurality in block groups across the contiguous United States and 2) examine 11 greenspace measures in connection to physical activity, obesity, and health-related quality of life in …

Household Food Security, Lifestyle Factors, And Glycemic Control Among Youth And Young Adults With Diabetes, Lauren A. Reid

Theses and Dissertations

The purpose of this study was to assess the associations between household food insecurity (HFI) and glycemic control, physical activity, and diet quality in youth and young adults (YYA) with type 1 diabetes (T1D) and type 2 diabetes (T2D). Among older adults, HFI has been shown to complicate diabetes management due to the essential role of diet in diabetes management and the financial stress associated with HFI. Although HFI is more prevalent among YYA with diabetes than the general population, there are only a handful of studies that have focused on this population and, studies that include YYA with T2D …

Effects Of A Physical Activity Intervention On The Stress Reduction Of Underserved Adolescent Youth, Gwenyth C. Asbury

Senior Theses

Stress levels of American teenagers are rising. Studies show that teens are reporting higher stress levels than what they perceive to be healthy and that these levels are higher than the levels of perceived stress reported by adults (APA, 2013). In addition to reporting unhealthy levels of stress, adolescents are reporting feeling overwhelmed and depressed due to their stress (APA, 2013). These findings are especially true for underserved adolescents who are more likely to have exposure to violence, discrimination, racism and conditions of poverty in addition to experiencing the typical stressors associated with adolescence (American Academy of Child and Adolescent …

Does Marriage, Employment And Having Children Matter? A Secondary Analysis On Physical Activity Levels, Leisure Time Physical Activity, And Social Roles Among Women In The United States, Tramaine Paul Mcmullen

Theses and Dissertations

Background: Social roles, such as being married, employed, or having children, have been shown to have independent negative relationships with moderate to vigorous physical activity (MVPA) levels among women. Increasing the number of women with children that meets physical activity guidelines is critical to reduce chronic disease and early mortality in this population. However, few studies have examined the relationship between holding multiple social roles, MVPA, and leisure-time physical activity (LTPA) among women with children. The study had two aims: 1) to determine the relationship between objectively measured MVPA by social roles and 2) to examine the frequency of specific …

Linking Activity, Nutrition, And Child Health (Launch): Protocol For A Longitudinal Cohort Study Of Children As They Develop From Infancy To Preschool Age, Russell R. Pate, Edward A. Frongillo Jr., Kerry Cordan, Marsha Dowda, Alexander C. Mclain, Myriam E. Torres, William H. Brown, Agnes Bucko, Emily R. Shull

Faculty Publications

Background

Physical activity is known to provide important health benefits in children ages 3 years and above, but little is known about the effects of physical activity on health in very young children under age 3. LAUNCH (Linking Activity, Nutrition, and Child Health) is a study designed to expand the body of knowledge on development of physical activity behavior and associations between physical activity and other health characteristics as children transition from infancy to preschool age.

Methods

Physical activity and sedentary behavior will be measured objectively in young children over a period of 30 months. Each child will complete a …

Associations Among Neighborhood Socioeconomic Deprivation, Physical Activity Facilities, And Physical Activity In Youth During The Transition From Childhood To Adolescence, Morgan N. Clennin, Min Lian, Natalie Colabianchi, Andrew Kaczynski, Marsha Dowda, Russell R. Pate

Faculty Publications

Background: This study aims to examine the longitudinal association of neighborhood socioeconomic deprivation (SED) with physical activity in youth during the transition from elementary to middle school, and to determine if access to physical activity facilities moderates this relationship. Methods: Data were obtained from the Transitions and Activity Changes in Kids (TRACK) study, which was a multilevel, longitudinal study designed to identify the factors that influence changes in physical activity as youth transition from elementary to middle school. The analytic sample for the current study included 660 youth with complete data in grades 5 (baseline) and 7 (follow-up). A repeated …

How Do Neighbourhood Definitions Influence The Associations Between Built Environment And Physical Activity?, Suzanne Mavoa, Nasser Bagheri, Mohammad Javad Koohsari, Andrew T. Kaczynski, Karen E. Lamb, Koichiro Oka, David O'Sullivan, Karen Witten

Faculty Publications

Researchers investigating relationships between the neighbourhood environment and health first need to decide on the spatial extent of the neighbourhood they are interested in. This decision is an important and ongoing methodological challenge since different methods of defining and delineating neighbourhood boundaries can produce different results. This paper explores this issue in the context of a New Zealand-based study of the relationship between the built environment and multiple measures of physical activity. Geographic information systems were used to measure three built environment attributes—dwelling density, street connectivity, and neighbourhood destination accessibility—using seven different neighbourhood definitions (three administrative unit boundaries, and 500, …

How Do Neighbourhood Definitions Influence The Associations Between Built Environment And Physical Activity?, Suzanne Mavoa, Nasser Bagheri, Mohammad Javad Koohsari, Andrew T. Kaczynski, Karen E. Lamb, Koichiro Oka, David O'Sullivan, Karen Witten

Faculty Publications

Researchers investigating relationships between the neighbourhood environment and health first need to decide on the spatial extent of the neighbourhood they are interested in. This decision is an important and ongoing methodological challenge since different methods of defining and delineating neighbourhood boundaries can produce different results. This paper explores this issue in the context of a New Zealand-based study of the relationship between the built environment and multiple measures of physical activity. Geographic information systems were used to measure three built environment attributes—dwelling density, street connectivity, and neighbourhood destination accessibility—using seven different neighbourhood definitions (three administrative unit boundaries, and 500, …

Examining The Relationship Between Park Neighborhoods, Features, Cleanliness, And Condition With Observed Weekday Park Usage And Physical Activity: A Case Study, Kerry Hamilton, Andrew T. Kaczynski, Melissa L. Fair, Lucie Levesque

Faculty Publications

Background. Little research has comprehensively explored how park features, quality indicators, and neighborhood environments are associated with observed park usage and physical activity (PA). This case study examined whether weekday park usage and PA differ by neighborhood type, across numerous categories of park features, and according to park feature condition and cleanliness. Methods. Direct observation was used to capture the number of users and PA levels within 143 park features in 6 parks (3 urban, 3 suburban) over the course of six weeks. Audits of park environments assessed the type, condition, and cleanliness of all features and amenities. …

First Year Physical Activity Findings From Turn Up The Heat (Healthy Eating And Activity Time) In Summer Day Camps, Robert Weaver, Keith Brazendale, Jessica L. Chandler, Gabrielle Turner-Mcgrievy, Justin B. Moore, Jennifer L. Huberty, Dianne S. Ward, Michael W. Beets

Faculty Publications

Background Summer day camps (SDCs) serve 14 million children yearly in the U.S. and aim to provide participating children with 60 minutes of moderate-to-vigorous physical activity (MVPA). This study evaluated an intervention designed to increase the percent of children meeting this MVPA guideline.

Design Two-group, pre-post quasi-experimental.

Setting/Participants Twenty SDCs serving 1,830 children aged 5–12 years were assigned to MVPA intervention (n = 10) or healthy eating attention control (n = 10).

Intervention

The STEPs (Strategies to Enhance Practice) intervention is a capacity-building approach grounded in the Theory of Expanded, Extended and Enhanced Opportunities. Camp leaders and staff receive training …

Food Insecurity And Physical Activity Among U.S. Populations, Quyen G. To

Theses and Dissertations

Objectives: Examine the association between food insecurity (FI) and physical activity (PA) in the U.S. population.

Methods: Accelerometry (PAM) and self-report PA (PAQ) data from NHANES 2003-2006 were used. Those aged less than six years or were older than 65 years, pregnant, with physical limitations, or with family income above 350% of the poverty line were excluded. FI was measured by the USDA Household Food Security Survey Module. Crude and adjusted odd ratios were calculated from logistic regression to identify the association between FI and adherence to the PA recommendation. Crude and adjusted coefficients were calculated from linear regression to …

Impact Of Physical Activity In The Prevention Of Colorectal Cancer, Sarah Ashley Barnes

Theses and Dissertations

This review evaluates the current understanding of research on the impact of physical activity in the prevention of colorectal cancer. Current biological mechanisms implicated in physical activity and colorectal cancer risk reduction are blood glucose regulation, insulin sensitivity, leptin and adiponectin profiles, inflammation as well as secreted protein acidic and rich in cysteine (SPARC), an exercise induced myokine. Recent literature indicates that 30-60 minutes of moderate to vigorous activity a day is effective against colorectal cancer development, and there is convincing evidence of aerobic exercise as differently beneficial in recruiting mechanisms identified as preventative against colorectal cancer. This article provides …

Family-Focused Physical Activity, Diet, And Obesity Interventions In African-American Girls: A Systematic Review, Daheia J. Barr-Anderson, Alexis W. Adams-Wynn, Katherine I. Disantis, Shiriki Kumanyika

Faculty Publications

Obesity interventions that involve family members may be effective with racial/ethnic minority youth. This review assessed the nature and effectiveness of family involvement in obesity interventions among African-American girls aged 5-18 years, a population group with high rates of obesity. Twenty-six databases were searched between January 2011 and March 2012, yielding 27 obesity pilot or full-length prevention or treatment studies with some degree of family involvement and data specific to African-American girls. Interventions varied in type and level of family involvement, cultural adaptation, delivery format, and behavior change intervention strategies; most targeted parent-child dyads. Some similarities in approach based on …

A Randomized Trial Of A Diet And Exercise Intervention For Overweight And Obese Women From Economically Disadvantaged Neighborhoods: Sisters Taking Action For Real Success (Stars), Sarah Wilcox, Patricia A. Sharpe, Deborah Parra-Medina, Michelle L. Granner, Brent E. Hutto

Faculty Publications

Background - Lower socioeconomic status at both the individual and neighborhood level is associated with increased health risks. Weight loss can reduce this risk, but few high quality weight loss studies target this population.

Objectives - STARS tests a culturally-appropriate, group-based behavioral and social support intervention on body weight and waist circumference in women from financially disadvantaged neighborhoods.

Design - A stratified (by BMI) randomized trial. Randomization to group was generated by a random numbers table with allocation concealment by opaque envelopes.

Methods - Participants 25-50 years who had a BMI ≥ 25 kg/m² and a waist circumference ≥ …

Equating Accelerometer Estimates Of Moderate-To-Vigorous Physical Activity: In Search Of The Rosetta Stone, Daniel B. Bornstein, Michael W. Beets, Wonwoo Byun, Gregory J. Welk, Matteo Bottai, Marsha Dowda, Russell R. Pate

Faculty Publications

Purpose - No universally accepted ActiGraph accelerometer cutpoints for quantifying moderate-to-vigorous physical activity (MVPA) exist. Estimates of MVPA from one set of cutpoints cannot be directly compared to MVPA estimates using different cutpoints, even when the same outcome units are reported (MVPA min•d^-1). The purpose of this study was to illustrate the utility of an equating system that translates reported MVPA estimates from one set of cutpoints into another, to better inform public health policy.

Design - Secondary data analysis.

Methods - ActiGraph data from a large preschool project (N=419, 3-6yr-olds, CHAMPS) was used to conduct the analyses. …

Cardiometabolic Results From An Armband-Based Weight Loss Trial, John C. Sieverdes, Xuemei Sui, Gregory A. Hand, Vaughn W. Barry, Sarah Wilcox, Rebecca A. Meriwether, James W. Hardin, Amanda C. Mcclain, Steven N. Blair

Faculty Publications

Purpose: This report examines the blood chemistry and blood pressure (BP) results from the Lifestyle Education for Activity and Nutrition (LEAN) study, a randomized weight loss trial. A primary purpose of the study was to evaluate the effects of real-time self-monitoring of energy balance (using the SenseWear^TM Armband, BodyMedia, Inc Pittsburgh, PA) on these health factors.

Methods: 164 sedentary overweight or obese adults (46.8 ± 10.8 years; BMI 33.3 ± 5.2 kg/m²; 80% women) took part in the 9-month study. Participants were randomized into 4 conditions: a standard care condition with an evidence-based weight loss manual (n …

Changes In Cvd Risk Factors In The Activity Counseling Trial, Meghan Baruth, Sarah Wilcox, James F. Sallis, Abby C. King, Bess H. Marcus, Steven N. Blair

Faculty Publications

Primary care facilities may be a natural setting for delivering interventions that focus on behaviors that improve cardiovascular disease (CVD) risk factors. The purpose of this study was to examine the 24-month effects of the Activity Counseling Trial (ACT) on CVD risk factors, to examine whether changes in CVD risk factors differed according to baseline risk factor status, and to examine whether changes in fitness were associated with changes in CVD risk factors. ACT was a 24-month multicenter randomized controlled trial to increase physical activity. Participants were 874 inactive men and women aged 35-74 years. Participants were randomly assigned to …

Fitness And Adiposity As Predictors Of Functional Limitation In Adults, Andréa L. Maslow, Anna E. Price, Xuemei Sui, Duck-Chul Lee, Ilkka Vuori, Steven N. Blair

Faculty Publications

Background: This study examined the associations of body mass index (BMI), waist circumference (WC), and cardiorespiratory fitness (CRF) with incident functional limitation (IFL) in adults.

Methods: Patients (n = 2400), 30+ years [mean age, 45.2 (SD, 8.3); 12% women], completed a baseline health examination during 1979 to 1995. CRF was quantified by age- and sex-specific thirds for maximal treadmill exercise test duration. Adiposity was assessed by BMI and WC (grouped for analysis according to clinical guidelines). Incident IFL was identified from mail-back surveys during 1995, 1999, and 2004.

Results: After adjusting for potential confounders and either BMI or WC, CRF …

The Relative Influence Of Demographic, Individual, Social, And Environmental Factors On Physical Activity Among Boys And Girls, Carrie D. Patnode, Leslie A. Lytle, Darin J. Erickson, John R. Sirard, Daheia J. Barr-Anderson, Mary Story

Faculty Publications

Background: This study aimed to evaluate the associations of selected demographic, individual, social, and environmental factors with moderate-to-vigorous physical activity (MVPA) in a sample of children and adolescents.

Methods: MVPA was assessed among youth (n = 294) 10-17-years-old using the ActiGraph accelerometer. Youth completed measures of demographic and individual variables related to physical activity (PA), perceived social support by parents and peers, and perceived neighborhood characteristics. Parents completed the long-form of the International Physical Activity Questionnaire. The Physical Activity and Media Inventory was used to measure the home environment and Geographical Information Systems software was used to measure the physical …

Age-Related Changes In Types And Contexts Of Physical Activity In Middle School Girls, Russell R. Pate, James F. Sallis, Dianne S. Ward, June Stevens, Gregory J. Welk, Deborah Rohm Young, Jared B. Jobe, Patricia K. Strikmiller

Faculty Publications

Background - Because girls are less physically active than boys, it is important to understand the types of activities preferred by girls, and changes in those preferences over time, in order to design effective physical activity interventions.

Purpose - To describe developmental trends in participation in specific forms of physical activity in 6th- and 8th-grade girls.

Methods - Data for this study are from the Trial of Activity for Adolescent Girls. Self-reported physical activity, anthropometric, and demographic data were collected from random cross sections of 6th-grade girls in 36 middle schools in six U.S. communities. The same data were collected …

Associations Between Sport And Screen-Entertainment With Mental Health Problems In 5-Year-Old Children, Lucy J. Griffiths, Marsha Dowda, Carol Dezateux, Russell R. Pate

Faculty Publications

Background: Few studies have examined the benefits of regular physical activity, and risks of sedentary behavior, in young children. This study investigated associations between participation in sports and screen-entertainment (as components of physical activity and sedentary behavior), and emotional and behavioral problems in this population.

Methods: Cross-sectional analysis of data from 13470 children (50.9% boys) participating in the nationally representative UK Millennium Cohort Study. Time spent participating in sports clubs outside of school, and using screen-entertainment, was reported by the child's mother at child age 5 years, when mental health was also measured using the Strengths and Difficulties Questionnaire.

Results …

A Cost Analysis Of A Physical Activity Intervention For Older Adults, Erik J. Groessl, Robert M. Kaplan, Steven N. Blair, W. Jack Rejeski, Jeffrey A. Katula, Abby C. King, Roger A. Fielding, Nancy W. Glynn, Marco Pahor

Faculty Publications

We examined the costs of a physical activity (PA) and an educational comparison intervention. 424 older adults at risk for mobility disability were randomly assigned to either condition. The PA program consisted of center-based exercise sessions 3x weekly for 8 weeks, 2x weekly for weeks 9 to 24 and weekly behavioral counseling for 10 weeks. Optional sessions were offered during maintenance weeks (25-52). The comparison intervention consisted of weekly education meetings for 24 weeks, and then monthly for 6 months. Cost analyses were conducted from the "payer's" perspective, with a 1-year time horizon. Intervention costs were estimated by tracking personnel …

Factors Related To Objectively Measured Physical Activity In Preschool Children, Karin A. Pfeiffer, Marsha Dowda, Kerry L. Mciver, Russell R. Pate

Faculty Publications

This study examined correlates of objectively measured physical activity (PA) in a diverse sample of preschool children (age 3-5 years; n=331). Accelerometer min∙hr^-1 of moderate-to-vigorous physical activity (MVPA) and nonsedentary activity (NSA) were the outcome measures. Correlations among potential correlates and PA ranged from r=-0.12-0.26. Correlates in the final MVPA model were age, race, sex, BMI Z score, and parent perception of athletic competence, explaining 37% of the variance. The NSA model included the latter two variables, explaining 35% of the variance. Demographic factors were correlates of PA; parent perceptions of children's competence may be important regarding …

Electronic Media Exposure And Its Association With Activity-Related Outcomes In Female Adolescents: Cross-Sectional And Longitudinal Analyses, Felipe Lobelo, Marsha Dowda, Karin A. Pfeiffer, Russell R. Pate

Faculty Publications

Background: Few investigations have assessed in adolescent girls the cross-sectional and longitudinal associations between elevated exposure to electronic media (EM) and activity-related outcomes such as compliance with physical activity (PA) standards or cardiorespiratory fitness (CRF). Methods: Four-hundred thirty-seven white and African American girls were assessed at the 8th, 9th, and 12th grades. PA and EM (TV/video watching, electronic games, Internet use) were self-reported, and CRF was estimated using a cycle-ergometer test. Hi EM exposure was defined as ≥ four 30-minute blocks/d. Results: 8th-, 9th-, and 12th-grade girls in the Hi EM group showed lower compliance with PA standards and had …

Cardiorespiratory Fitness As A Predictor Of Fatal And Nonfatal Stroke In Asymptomatic Women And Men, Steven P. Hooker, Xuemei Sui, Natalie Colabianchi, John E. Vena, James N. Laditka, Michael J. Lamonte, Steven N. Blair

Faculty Publications

Background and Purpose - Prospective data on the association between cardiorespiratory fitness (CRF) and stroke are largely limited to studies in men or do not separately examine risks for fatal and nonfatal stroke. This study examined the association between CRF and fatal and nonfatal stroke in a large cohort of asymptomatic women and men.

Methods - A total of 46,405 men and 15,282 women without known myocardial infarction or stroke at baseline completed a maximal treadmill exercise test between 1970 and 2001. CRF was grouped as quartiles of the sex-specific distribution of maximal metabolic equivalents achieved. Mortality follow-up was through …

Physical Activity And Neighborhood Resources In High School Girls, Russell R. Pate, Natalie Colabianchi, Dwayne E. Porter, Maria João C. A. Almeida, Felipe Lobelo, Marsha Dowda

Faculty Publications

Background - Physical activity behavior is influenced by a person's physical environment, but few studies have used objective measures to study the influences of the physical environment on physical activity behavior in youth. The purpose of this study was to examine the relationship between selected neighborhood physical activity resources and physical activity levels in high school girls.

Methods - Participants were students in schools that had participated in a large physical activity intervention trial. The 3-Day Physical Activity Recall was completed by 1506 12th-grade girls. Data on physical activity facilities and resources in the participating communities were collected using a …

Physical Activity And Blood Pressure In Childhood: Findings From A Population-Based Study, Sam D. Leary, Andy R. Ness, George Davey Smith, Calum Mattocks, Kevin Deere, Steven N. Blair, Chris J. Riddoch

Faculty Publications

The pathological processes associated with development of cardiovascular disease begin early in life. For example, elevated blood pressure (BP) can be seen in childhood and tracks into adulthood. The relationship between physical activity (PA) and BP in adults is well-established, but findings in children have been inconsistent, with few studies measuring PA mechanically. Children aged 11 to 12 years were recruited from the Avon Longitudinal Study of Parents and Children. 5505 had systolic and diastolic BP measurements, plus valid (at least 10 hours for at least 3 days) accelerometer measures of PA; total PA recorded as average counts per minute …

Use Of Accelerometers In A Large Field-Based Study Of Children: Protocols, Design Issues, And Effects On Precision, Calum Mattocks, Andy R. Ness, Sam D. Leary, Kate Tilling, Steven N. Blair, Julian Shield, Kevin Deere, Joanne Saunders, Joanne Krikby, George Davey Smith, Jonathan Wells, Nicholas Wareham, John J. Reilly, Chris J. Riddoch

Faculty Publications

Background: Objective methods can improve accuracy of physical activity measurement in field studies but uncertainties remain about their use.

Methods: Children age 11 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), were asked to wear a uni-axial accelerometer (MTI Actigraph) for 7 days.

Results: Of 7159 children who attended for assessment, 5595 (78%) provided valid measures. The reliability coefficient for 3 days of recording was .7 and the power to detect a difference of 0.07 SDs (P ≤ .05) was > 90%. Measures tended to be higher on the first day of recording (17 counts/min; 95% CI, …

Associations Among Physical Activity, Health Indicators, And Employment In 12th Grade Girls, Marsha Dowda, Karin A. Pfeiffer, Rod K. Dishman, Russell R. Pate

Faculty Publications

Objectives: This study compared physical activity, sedentary behaviors, and other health indicators between 1381 employed and nonemployed 12th grade girls.

Methods: The girls were from 22 high schools in South Carolina (2002-2003); 56% of the girls were African American, and the mean age was 17.7 (0.6) years. Physical activity and sedentary behaviors were measured using the 3-Day Physical Activity Recall (3DPAR). Fitness, depressive symptoms, and smoking behavior were assessed.

Results: Fifty percent of the girls were employed, and on average, employed girls worked 9.6 30-minute blocks per day. Girls who worked reported significantly (p≤0.001) higher average total metabolic …

Long-Term Effects Of A Physical Activity Intervention In High School Girls, Russell R. Pate, Ruth P. Saunders, Rod K. Dishman, Cheryl L. Addy, Marsha Dowda, Dianne S. Ward

Faculty Publications

Background - Physical activity decreases during childhood and adolescence, and physical activity levels are significantly lower in females than males, particularly during adolescence. Schools are attractive settings in which to implement interventions designed to promote physical activity in girls and young women, but few studies have tested the sustained effects of such interventions.

Design - Cross-sectional. Data were collected in 2002-2003 and analyzed in 2006-2007.

Setting/Participants - 1594 adolescent girls in 22 high schools.

Intervention - The intervention, Lifestyle Education for Activity Program (LEAP), was designed to increase physical activity in 9^th grade girls through two channels: changes in …