Medicine and Health Sciences Commons^™

Preventing Cardiovascular Disease In Kentucky: Epidemiology, Trends, And Strategies For The Future, Sarah Sartini Rugg, Alison L. Bailey, Steven R. Browning

Internal Medicine Faculty Publications

Cardiovascular disease (CVD) is the leading cause of death in the United States despite dramatic improvements in the treatment of heart disease in recent years. Kentucky leads the nation in the prevalence of several individual risk factors for cardiovascular disease, the prevalence of multiple risk factors, and in cardiovascular mortality. While trends in the prevalence of some of these cardiac risk factors have shown improvement, others have remained unchanged or have worsened. The increased prevalence of obesity and diabetes, especially among young persons, is one of the most worrisome trends. The prevalence of smoking in Kentucky remains high, and has …

Physical Activity And Prostate Cancer Mortality In Puerto Rican Men, Carlos J. Crespo, Mario R. Garcia-Palmieri, Ellen Smit, I-Min Lee, Daniel Lee Mcgee, Paola Muti, Nayda R. Figueroa Valle, Farah A. Ramirez-Marrero, Jo L. Freudenheim, Paul Sorlie

Community Health Faculty Publications and Presentations

Studies on the association between physical activity and fatal prostate cancer have produced inconclusive results. The Puerto Rico Heart Health Program was a cohort study of a randomly selected sample of 9824 men age 35 to 79 years at baseline who were followed for mortality until 2002. Multiple examinations collected information on lifestyle, diet, body composition, exercise, urban-rural residence, and smoking habits. Physical activity status was measured using the Framingham Physical Activity Index, an assessment of occupational, leisure-time, and other physical activities measured as usual activity over the course of a 24-hour day. Physical activity was strati- fied into quartiles. …

Objectively Assessed Associations Between Physical Activity And Body Composition In Middle-School Girls: The Trial Of Activity For Adolescent Girls, June Stevens, David M. Murray, Chris C. Baggett, John P. Elder, Timothy G. Lohman, Leslie A. Lytle, Russell R. Pate, Charlotte A. Pratt, Margarita S. Treuth, Larry S. Webber, Deborah Rohm Young

Faculty Publications

Declining levels of physical activity probably contribute to the increasing prevalence of overweight in US youth. In this study, the authors examined cross-sectional and longitudinal associations between physical activity and body composition in sixth- and eighth-grade girls. In 2003, girls were recruited from six US states as part of the Trial of Activity for Adolescent Girls. Physical activity was measured using 6 days of accelerometry, and percentage of body fat was calculated using an age- and ethnicity-specific prediction equation. Sixth-grade girls with an average of 12.8 minutes of moderate-to-vigorous physical activity (MVPA) per day (15th percentile) were 2.3 times (95% …

Perceived Individual, Social, And Environmental Factors For Physical Activity And Walking, Michelle L. Granner, Patricia A. Sharpe, Brent E. Hutto, Sarah Wilcox, Cheryl L. Addy

Faculty Publications

Background: Few studies have explored associations of individual, social, and environmental factors with physical and walking behavior. Methods: A random-digit-dial questionnaire, which included selected individual, social, and environmental variables, was administered to 2025 adults, age 18 y and older, in two adjacent counties in a southeastern state. Logistic regressions were conducted adjusting for age, race, sex, education, and employment. Results: In multivariate models, somewhat different variables were associated with physical activity versus regular walking. Self-efficacy (OR = 19.19), having an exercise partner (OR = 1.47), recreation facilities (OR = 1.54), and safety of trails from crime (OR = 0.72) were …

Exercise And Cardiovascular Events - Placing The Risks Into Perspective: A Scientific Statement From The American Heart Association Council On Nutrition, Physical Activity, And Metabolism And The Council On Clinical Cardiology, Paul D. Thompson, Barry A. Franklin, Gary J. Balady, Steven N. Blair, Domenico Corrado, N. A. Mark Estes Iii, Janet E. Fulton, Neil F. Gordon, William L. Haskell, Mark S. Link, Barry J. Maron, Murray A. Mittleman, Antonio Pelliccia, Nanette K. Wenger, Stefan N. Willich, Fernando Costa

Faculty Publications

Habitual physical activity reduces coronary heart disease events, but vigorous activity can also acutely and transiently increase the risk of sudden cardiac death and acute myocardial infarction in susceptible persons. This scientific statement discusses the potential cardiovascular complications of exercise, their pathological substrate, and their incidence and suggests strategies to reduce these complications. Exercise-associated acute cardiac events generally occur in individuals with structural cardiac disease. Hereditary or congenital cardiovascular abnormalities are predominantly responsible for cardiac events among young individuals, whereas atherosclerotic disease is primarily responsible for these events in adults. The absolute rate of exercise-related sudden cardiac death varies with …

Frekuensi Keteraturan Senam Dan Penurunan Tekanan Darah Anggota Klub Jantung Sehat Pondalisa, Jakarta Tahun 2000 - 2005, Retno Asti Werdhani

Kesmas

Prevalensi hipertensi di Indonesia meningkat bersamaan dengan meningkatnya usia. Untuk itu, upaya pencegahan hipertensi dan komplikasinya perlu dilakukan sejak dini jauh sebelum usia lanjut. Olahraga khususnya jenis aerobik diketahui dapat mengendalikan tekanan darah. Penelitian ini bertujuan mengetahui hubungan frekuensi dan keteraturan senam terhadap penurunan tekanan darah pada peserta program latihan. Desain studi yang digunakan adalah kohort retrospektif dengan metoda analisis Cox Regression. Penelitian dilakukan terhadap sumber data sekunder 132 anggota KJS Pondalisa yang merupakan salah satu sarana olahraga masyarakat, selama periode satu tahun keanggotaan. Hasil penelitian memperlihatkan bahwa tidak ada anggota yang melakukan senam 3xper minggu sesuai program dengan keteraturan …

Promoting Physical Activity In Children And Youth: A Leadership Role For Schools: A Scientific Statement From The American Heart Association Council On Nutrition, Physical Activity, And Metabolism (Physical Activity Committee) In Collaboration With The Councils On Cardiovascular Disease In The Young And Cardiovascular Nursing, Russell R. Pate, Michael G. Davis, Thomas N. Robinson, Elaine J. Stone, Thomas L. Mckenzie, Judith C. Young

Faculty Publications

No abstract provided.

Knowledge And Perceived Ambiguity Of Physical Activity Recommendations And Physical Activity In Men And Women In The United States, Laura G. Kiken

Theses and Dissertations

Background: The majority of Americans - especially women - do not meet physical activity recommendations. Having physical activity goals has been associated with physical activity participation, and physical activity recommendations set by public health experts can be viewed as externally set goals. However, past research has shown that goals that are specific rather than ambiguous are more likely to be achieved, and variations in recommendations over time and across sources may have created perceived goal ambiguity.Objectives: This study aimed to (1) examine the extent of physical activity recommendation knowledge among adults in the United States, (2) quantify perceptions of the …

The Relationship Between Leisure-Time Physical Activity And The Metabolic Syndrome: An Examination Of Nhanes Iii, 1988-1994, Katrina D. Dubose, Cheryl L. Addy, Barbara E. Ainsworth, Gregory A. Hand, J. Larry Durstine

Faculty Publications

No abstract provided.

Revised Adult Treatment Panel Iii Guidelines And Cardiovascular Disease Mortality In Men Attending A Preventive Medical Clinic, Chris I. Ardern, Peter T. Katzmarzyk, Ian Janssen, Timothy S. Church, Steven N. Blair

Faculty Publications

Background - National Cholesterol Education Program Adult Treatment Panel III guidelines recommended therapeutic lifestyle changes (TLC) and drug therapy to reduce cardiovascular disease (CVD) risk. These guidelines have been revised recently (ATP III-R); however, the risk of CVD mortality within each intervention window and the effects of cardiorespiratory fitness (CRF) and metabolic syndrome on CVD mortality within the framework of the guidelines are unknown.

Methods and Results - Risk factor and CRF data from 19,125 men (aged 20 to 79 years) who attended a preventive medical clinic between 1979 and 1995 were used. Mortality follow-up was completed until December 31, …

Cardiorespiratory Fitness Is Inversely Associated With The Incidence Of Metabolic Syndrome: A Prospective Study Of Men And Women, Michael J. Lamonte, Carolyn E. Barlow, Radim Jurca, James B. Kampert, Timothy S. Church, Steven N. Blair

Faculty Publications

Background - Few studies have reported the relationship between cardiorespiratory fitness and metabolic syndrome incidence, particularly in women.

Methods and Results - We prospectively studied 9007 men (mean±SD, age, 44±9 years; body mass index, 25±3 kg/m²) and 1491 women (age, 44±9 years; body mass index, 22±2 kg/m²) who were free of metabolic syndrome and for whom measures of waist girth, resting blood pressure, fasting lipids, and glucose were taken during baseline and follow-up examinations. Baseline cardiorespiratory fitness was quantified as duration of a maximal treadmill test. Metabolic syndrome was defined with NCEP ATP-III criteria. During a …

Scale Development For Perceived School Climate For Girls’ Physical Activity, Amanda Birnbaum, Kelly R. Evenson, Robert W. Motl, Rod K. Dishman, Carolyn C. Voorhees, James F. Sallis, John P. Elder, Marsha Dowda

Department of Public Health Scholarship and Creative Works

Objectives: To test an original scale assessing perceived school climate for girls' physical activity in middle school girls. Methods: Confirmatory factor analysis (CFA) and structural equation modeling (SEM). Results: CFA retained 5 of 14 original items. A model with 2 correlated factors, perceptions about teachers' and boys' behaviors, respectively, fit the data well in both sixth and eighth-graders. SEM detected a positive, significant direct association of the teacher factor, but not the boy factor, with girls' self-reported physical activity. Conclusions: School climate for girls' physical activity is a measurable construct, and preliminary evidence suggests a relationship with physical activity.

Scale Development For Perceived School Climate For Girls’ Physical Activity, Amanda Birnbaum, Kelly R. Evenson, Robert W. Motl, Rod K. Dishman, Carolyn C. Voorhees, James F. Sallis, John P. Elder, Marsha Dowda

Department of Public Health Scholarship and Creative Works

Objectives: To test an original scale assessing perceived school climate for girls' physical activity in middle school girls. Methods: Confirmatory factor analysis (CFA) and structural equation modeling (SEM). Results: CFA retained 5 of 14 original items. A model with 2 correlated factors, perceptions about teachers' and boys' behaviors, respectively, fit the data well in both sixth and eighth-graders. SEM detected a positive, significant direct association of the teacher factor, but not the boy factor, with girls' self-reported physical activity. Conclusions:School climate for girls' physical activity is a measurable construct, and preliminary evidence suggests a relationship with physical activity.

Correlates Of Physical Activity In Persons With Arthritis: Review And Recommendations, Sarah Wilcox, Cheryl Der Ananian, Patricia A. Sharpe, Jennifer Robbins, Theresa Brady

Faculty Publications

Background: Physical activity (PA) is important for arthritis self-management. A better understanding of the PA correlates in persons with arthritis will help inform interventions. Methods: Computer searches were conducted on PubMed, PsychInfo, Current Contents, and Cinahl databases. Reference lists of extracted articles were also searched. Thirty-six studies published between 1976 and February 2004 met inclusion criteria. Results: PA correlates are presented for sociodemographic, psychological, health-related, social, and environmental categories. Self-efficacy, perceived benefits and barriers, mental well-being, prior PA, and pain received the most consistent support as PA correlates, whereas sociodemographic, social, and environmental variables were the least studied. Too few …

Visit Satisfaction And The Use Of Tailored Health Behavior Communications In Primary Care, Chris N. Sciamanna, Scott P. Novak, Thomas K. Houston, Robert Gramling, Bess H. Marcus

College of Population Health Faculty Papers

BACKGROUND: Though studies suggest that computer-tailored health communications can help patients improve health behaviors, their effect on patient satisfaction, when used in health care settings, has yet to be examined. METHODS: A computer application was developed to provide tailored, printed feedback for patients and physicians about two of the most common adverse health behaviors seen in primary care, smoking and physical inactivity. Ten primary care providers and 150 of their patients were recruited to use the program in the office before their visit. After the visit, patients completed a self-report survey that addressed demographics, computer use history, satisfaction with the …

Using Media Messaging To Promote Healthful Eating And Physical Activity Among Urban Youth, B.J. Carter, Amanda Birnbaum, Lisa Hark, Brian Vickery, Charles Potter, Michael P. Osborne

Department of Public Health Scholarship and Creative Works

National trends show consistent increases, as well as racial and ethnic dis- parities, in the prevalence of overweight children and adolescents. Such disparity is evident regarding behaviors such as a poor diet and a lack of physical activity and in the prevalence and outcomes of associated health problems. It has been suggested that grounding interventions in cultural traditions and norms are critical for preventing obesity among ethnic and racial minority youth; however, with some notable exceptions, few community interventions have used this approach. Moreover, urban minority youth may face additional barriers to healthful eating and physical activity behaviors, such as …

The Effect Of Social Desirability And Social Approval On Self-Reports Of Physical Activity, Swann A. Adams, Charles E. Matthews, Cara B. Ebbeling, Charity G. Moore, Joan E. Cunningham, Jeanette Fulton, James R. Hébert

Faculty Publications

The purpose of this investigation was to examine social desirability and social approval as sources of error in three self-reported physical activity assessments using objective measures of physical activity as reference measures. In 1997, women (n = 81) living in Worcester, Massachusetts, completed doubly labeled water measurements and wore an activity monitor for 14 days. They also completed seven interviewer-administered 24-hour physical activity recalls (PARs) and two different self-administered 7-day PARs. Measures of the personality traits “social desirability” and “social approval” were regressed on 1) the difference between physical activity energy expenditure estimated from doubly labeled water and each …

Prevalence Of Obesity And Lack Of Physical Activity Among Kentucky Adolescents, Hatim A. Omar, Kristin Rager

Pediatrics Faculty Publications

Lack of physical activity and overweight status continues to be a significant health problem in the United States. To assess the actual prevalence of these problems, we reviewed data from the School-based Health Promotion Centers in one middle school, and one High school in central Kentucky. A total of 232 6th graders and 607 9th graders were included. A total of 92% of 6th graders and 45% of 9th graders reported complete lack of regular exercise. 37% of 9th graders and 59% of 6th graders had inappropriate nutrition, 47% of 9th graders and 33% of 6th graders had Body Mass …

Comparison Of Two Approaches To Structured Physical Activity Surveys Of Adolescents, Robert G. Mcmurray, Kimberly B. Ring, Margarita S. Treuth, Gregory J. Welk, Russell R. Pate, Kathryn H. Schmitz, Julie L. Pickrel, Vivian Gonzalez, Maria João C. A. Almeida, Deborah Rohm Young, James F. Sallis

Faculty Publications

Purpose - To compare the test-retest reliability, convergent validity, and overall feasibility/usability of activity-based (AB) and time-based (TB) approaches for obtaining self-reported moderate-to-vigorous physical activity (MVPA) from adolescents.

Methods - Adolescents (206 females and 114 males) completed two 3-d physical activity recalls using the AB and TB surveys, which contained identical lists of physical activities. The participants wore an MTI Actigraph^® accelerometer for the same period.

Results - The TB instrument took about 3 min longer to complete (P=0.022). Overall 2-d test-retest correlations for MVPA were similar for the two surveys (r=0.676 and 0.667), but the girls …

Clinical Implications Of Obesity With Specific Focus On Cardiovascular Disease: A Statement For Professionals From The American Heart Association Council On Nutrition, Physical Activity, And Metabolism, Samuel Klein, Lora E. Burke, George A. Bray, Steven N. Blair, David B. Allison, Xavier Pi-Sunyer, Yuling Hong, Robert H. Eckel

Faculty Publications

Obesity adversely affects cardiac function, increases the risk factors for coronary heart disease, and is an independent risk factor for cardiovascular disease. The risk of developing coronary heart disease is directly related to the concomitant burden of obesity-related risk factors. Modest weight loss can improve diastolic function and affect the entire cluster of coronary heart disease risk factors simultaneously. This statement from the American Heart Association Council on Nutrition, Physical Activity, and Metabolism reviews the relationship between obesity and the cardiovascular system, evaluates the effect of weight loss on coronary heart disease risk factors and coronary heart disease, and provides …

Prevention Conference Vii - Obesity, A Worldwide Epidemic Related To Heart Disease And Stroke: Executive Summary, Robert H. Eckel, David A. York, Stephan Rössner, Van Hubbard, Ian Caterson, Sachiko T. St. Jeor, Laura L. Hayman, Rebecca M. Mullis, Steven N. Blair

Faculty Publications

No abstract provided.

Lower Extremity Muscle Strength And Risk Of Self-Reported Hip Or Knee Osteoarthritis, Jennifer M. Hootman, Shannon J. Fitzgerald, Carol A. Macera, Steven N. Blair

Faculty Publications

Purpose: The purpose of this study was to investigate the gender-specific longitudinal association between quadriceps strength and self-reported, physician-diagnosed hip or knee osteoarthritis (OA).

Methods: Subjects were 3081 community-dwelling adults who were free of OA, joint symptoms and injuries, completed a maximum treadmill exercise test, had isokinetic knee extension and flexion and isotonic leg press strength measurements taken at baseline and returned at least one written follow-up survey. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals.

Results: Women with moderate or high isokinetic quadriceps strength had a significantly reduced risk (55% to 64%) of hip …

Monitoring Physical Activity: Uses And Measurement Issues With Automated Counters, Michelle L. Granner, Patricia A. Sharpe

Faculty Publications

Background: Promotion of physical activity is a public health priority, and environmental factors influence physical activity behavior. Valid and reliable automated measurement tools of physical activity for assessment and evaluation within public settings are needed. Methods: Searches of the research literature and governmental reports from physical activity, transportation, and recreation fields were conducted to identify methods of automated counting and validation studies. The article provides a summary of (a) current methods and uses of automated counters, (b) information about validity and reliability where available, (c) strengths and limitations of each methods, and (d) measurement issues. Results: Existing automated counting technology …

Public Posting As A Strategy To Increase Walking: A Worksite Intervention, Rayleen Earney, Timothy J. Bungum

Environmental & Occupational Health Faculty Publications

Because most American adults do not meet recommended physical activity guidelines, the need for new and innovative strategies is apparent. The current study employed public posting in an attempt to increase walking behavior in a worksite setting. Pedometer generated data was publicly posted in a prominent location in the worksite. In our study that utilized a pre-experimental design, we found that walking steps were statistically higher during the intervention and in a post intervention period as compared to the baseline data. We conclude that the public posting of physical activity data has the potential to increase walking behavior.

Exercise And Physical Activity In The Prevention And Treatment Of Atherosclerotic Cardiovascular Disease: A Statement From The Council On Clinical Cardiology (Subcommittee On Exercise, Rehabilitation, And Prevention) And The Council On Nutrition, Physical Activity, And Metabolism (Subcommittee On Physical Activity), Paul D. Thompson, David Buchner, Ileana L. Piña, Gary J. Balady, Mark A. Williams, Bess H. Marcus, Kathy Berra, Steven N. Blair, Fernando Costa, Barry Franklin, Gerald F. Fletcher, Neil F. Gordon, Russell R. Pate, Beatriz L. Rodriguez, Antronette K. Yancey, Nanette K. Wenger

Faculty Publications

No abstract provided.

Moderate Intensity Exercise Training Improves Cardiorespiratory Fitness In Women, J. David Branch, Russell R. Pate, Sharon P. Bourque

Faculty Publications

Among women, there is an increased prevalence of sedentary lifestyle and less participation in physical activity at levels recommended by the Surgeon General. As a result, women have been identified as a target group in public health initiatives to increase physical activity. The health-related benefits of habitual, moderate intensity physical activity are well documented in the epidemiological literature, but less is known about the effect of such physical activity on cardiorespiratory fitness. Our hypothesis was that moderate and vigorous exercise training regimens of similar estimated energy expenditure would result in similar changes in cardiorespiratory fitness. Eighteen sedentary premenopausal women with …

Statement On Exercise: Benefits And Recommendations For Physical Activity Programs For All Americans - A Statement For Health Professionals By The Committee On Exercise And Cardiac Rehabilitation Of The Council On Clinical Cardiology, American Heart Association, Gerald F. Fletcher, Steven N. Blair, James Blumenthal, Carl Caspersen, Bernard Chaitman, Stephen Epstein, Harold Falls, Erika S. Sivarajan Froelicher, Victor F. Froelicher, Ileana L. Piña

Faculty Publications

No abstract provided.

The Psychological Effects Of Exercise, Judith Rodin, Thomas G. Plante

Psychology

Thousands of businesses in the United States have implemented programs to promote physical fitness among their employees (Falkenberg, 1987). The programs range from company-paid memberships at private health and fitness clubs to complete work site fitness facilities. These programs have been developed not only to improve and maintain employee health but also to promote psychological well-being and productivity and to reduce absenteeism, insurance claims, and stress. Recent research focusing on the use of employee fitness programs to improve work-related behaviors suggests that these programs may improve absenteeism, job satisfaction, tenure. and health care costs, especially among female employees (Baun, Bernacki, …

Does Weight Loss Cause The Exercise-Induced Increase In Plasma High Density Lipoproteins?, Paul T. Williams, Peter D. Wood, Ronald M. Krauss, William L. Haskell, Karen M. Vranizan, Steven N. Blair, Richard Terry, John W. Farquhar

Faculty Publications

Studies showing an increase in plasma concentration of high density lipoprotein cholesterol (HDL-C) with moderate exercise have usually rejected the role of body weight change in the HDL-C raising process, ostensibly because the amount of weight lost has been negligible. To investigate HDL-C changes more thoroughly, we followed initially sedentary middle-aged men randomly assigned to either a moderate running (N=36) or a sedentary control (N=28) group for one year. Among runners, one-year changes in plasma HDL-C concentrations correlated strongly with their body weight changes (r = -0.53, P < 0.001). Curve-fitting procedures and regression analysis suggested that processes associated with weight change produce much of the plasma HDL-C changes induced by moderate exercise and that changes in HDL-C concentration predominantly reflect changes in the reputedly anti-atherogenic HDL2 sub-component. Further, the interaction between weight change and plasma HDL-C concentration was significantly different (P