Amy A. Eyler

Personal and environmental factors associated with physical inactivity among different racial-ethnic groups of U.S. middle-aged and older-aged women.

Personal, program-based, and environmental barriers to physical activity were explored among a U.S. population-derived sample of 2,912 women 40 years of age and older. Factors significantly associated with inactivity included American Indian ethnicity, older age, less education, lack of energy, lack of hills in ones neighborhood, absence of enjoyable scenery, and infrequent observation of others exercising in ones neighborhood. For all ethnic subgroups, caregiving duties and lacking energy to exercise ranked among the top 4 most frequently reported barriers. Approximately 62% of respondents rated exercise on ones own with instruction as more appealing than undertaking exercise in an instructor-led group, regardless of ethnicity or current physical activity levels. The results underscore the importance of a multifaceted approach to understanding physical activity determinants in this understudied, high-risk population segment.

The epidemiology of walking for physical activity in the United States.

PURPOSE The purpose of this paper was to describe the epidemiology of walking for physical activity among respondents to the U.S. Physical Activity Study. Correlates of walking among people who never walk for physical activity, those who walk regularly, and people who walk occasionally were compared. METHODS Data on walking, personal and environmental correlates, and sociodemographics were collected via telephone using a modified random-digit-dialing technique on a national sample. Three categories were analyzed: Regular walkers were those who met public health recommendations by walking (5x wk-1 and 30 min at a time), occasional walkers were those who walked for physical activity but did not meet this recommendation, and never walkers were those who never walked for physical activity. Multiple logistic regression resulting in odds ratios (OR) and 95% confidence intervals were calculated. RESULTS Thirty-four percent of this population were regular walkers, 45.6% occasional walkers, and 20.7% never walkers. Walkers reported using neighborhood streets, shopping malls, and parks for walking. Regular walkers had more self-confidence and more social support than occasional or never walkers. Occasional and never walkers reported time as a barrier more than regular walkers (OR 1.91 and 2.36). Never walkers were more likely (OR 3.25) to report feeling unhealthy and more likely (OR 4.43) to report lacking energy to exercise. CONCLUSION Our results identify important information that can be used to help guide future interventions that promote walking as a form of physical activity. An ecological approach that combines individual (e.g., self-confidence), interpersonal (e.g., social support), and community aspects (e.g., improve streets for walking) may be the most beneficial.

Measuring the Environment for Friendliness Toward Physical Activity: A Comparison of the Reliability of 3 Questionnaires

OBJECTIVES We tested the reliability of 3 instruments that assessed social and physical environments. METHODS We conducted a test-retest study among US adults (n = 289). We used telephone survey methods to measure suitableness of the perceived (vs objective) environment for recreational physical activity and nonmotorized transportation. RESULTS Most questions in our surveys that attempted to measure specific characteristics of the built environment showed moderate to high reliability. Questions about the social environment showed lower reliability than those that assessed the physical environment. Certain blocks of questions appeared to be selectively more reliable for urban or rural respondents. CONCLUSIONS Despite differences in content and in response formats, all 3 surveys showed evidence of reliability, and most items are now ready for use in research and in public health surveillance.

Environmental, Policy, and Cultural Factors Related to Physical Activity in a Diverse Sample of Women: The Women's Cardiovascular Health Network Project-Summary and Discussion

SUMMARY Ethnic minority and low-income populations have the highest rates of cardiovascular disease and the lowest rates of leisure-time physical activity. Because physical activity reduces the risk of premature death and disability from cardiovascular disease, researching correlates to such activity in these populations is an important aspect of health promotion in the US. To identify environmental, policy, and cultural barriers to physical activity in women, The Womens Cardiovascular Health Network Project conducted focus groups with White, African American, Latina, and American Indian women aged 20–50 years. The focus groups were audiotaped, transcribed, and analyzed with QSR NUD*IST qualitative software using a set of codes developed a priori by the research team. Family priorities were a main barrier to physical activity in all the groups. Having multiple roles as wife, mother, daughter, and as an active community member was mentioned as time-consuming and difficult, leaving little time or energy for exercise. Cultural barriers, which varied among the groups, included acculturation issues, lack of community support, and lack of past experience with exercise. Physical activity interventions suggested involved work programs, family-friendly programs, increased social support, and the availability of safer places to exercise such as parks, well-lit walking trails, and recreation centers. Many of the barriers were common to all groups (e.g., family priority) while some were unique (e.g., lack of community support). Assessing and addressing the issues raised should be considered when planning physical activity interventions for these populations.

Quantitative study of correlates of physical activity in women from diverse racial/ethnic groups: The Women's Cardiovascular Health Network Project--summary and conclusions.

BACKGROUND Physical activity is an important aspect of cardiovascular disease prevention. However, the populations that show high risk of cardiovascular disease also have high rates of physical inactivity. The purpose of this article was to summarize findings from the Women and Physical Activity Survey, part of the Womens Cardiovascular Health Network Project. The goal of the survey was to identify personal, social environmental, cultural, and physical environmental factors that are associated with physical activity status among a diverse group of women. METHODS Seven universities were funded to study factors that influence physical activity among white, African American, Latina, and Native American women residing in rural, suburban, and urban living environments. An ecologic model and qualitative data from these population groups were used to design a quantitative questionnaire. The survey was implemented by telephone and face-to-face interviews in seven sites across the United States. RESULTS Younger age, good general health, and high self-efficacy were the most consistent personal correlates associated with physical activity. Knowing people who exercise and attending religious services were the only social environmental factors with significant associations across population groups. With the exception of safety from crime, no physical environmental factors were consistently related to physical activity. Most groups had intervention suggestions that included access to facilities. CONCLUSION This study identifies pertinent factors related to physical activity in women and addresses the differences in assessment among the groups. Because each group may have unique characteristics, it is important to assess all levels that could influence physical activity such as personal, social, environmental, and policy. The information can then be used to tailor interventions for the various groups.

Quantitative study of correlates of physical activity in women from diverse racial/ethnic groups: Women's Cardiovascular Health Network Project introduction and methodology

BACKGROUND Physical activity is an important aspect of cardiovascular disease prevention. However, data show a high prevalence of physical inactivity among women and ethnic minority and low-income populations. The purpose of this introduction is to describe the Womens Cardiovascular Health Network Project and implementation of the Women and Physical Activity Survey. The goal of the survey was to identify personal, social environmental, and physical environmental factors that are associated with physical activity status among diverse groups of women. METHODS Seven universities were funded to study factors that influence physical activity among African-American, Native American, Latina, and white women residing in rural, suburban, and urban living environments. An ecologic model was used to design a quantitative questionnaire that was implemented by telephone or face-to-face interviews in seven sites across the United States. RESULTS The survey was completed by a total 4122 women, with group totals ranging from 300 to 1000. Results from each site are presented in individual articles in this issue. A summary of results that compare and contrast the groups is presented in an additional report. CONCLUSION This study provides important information on the assessment of physical activity among women. Results can be used to help improve assessments and to develop more effective policies and interventions for unique groups of women.

Personal, social, and environmental correlates of physical activity in rural Midwestern white women.

BACKGROUND Physical activity is a promising component of cardiovascular disease prevention among women. Research in this area is expanding, but much needs to be done to assess subgroups of the population (e.g., people living in rural environments). The study goal was to determine personal, social environmental, and physical environmental correlates of physical activity among rural white women aged 20 to 50 years. METHODS A survey was conducted by using randomly selected numbers in rural areas in Missouri and Illinois. The Women and Physical Activity Survey was administered to assess physical activity status and personal, social environmental, and physical environmental factors. Physical activity status was the dependent variable in analyses comparing inactive women with women who performed any activity and comparing women who met current recommendations for moderate or vigorous physical activity with those women did not meet recommendations. RESULTS Of the 1000 women in the study, 52% met recommendations for physical activity, 40.1% were insufficiently active, and 7.9% were inactive. Younger women (20-29 years) were more likely than the oldest age (40-50 years) category to perform some activity than to be inactive. Women in excellent or very good general health were much more likely to perform some physical activity than to be inactive. Higher income and employment were factors in meeting the recommendations. Attending religious services and a higher social roles score were significant factors. Having street lighting was the only physical environmental factor that emerged as statistically significant. CONCLUSIONS More research is needed on the assessment of important issues regarding physical activity in women. Interventions should use assessment information to tailor programs and to address personal, social environmental, and physical environmental components.

Environmental and policy factors related to physical activity in rural white women.

SUMMARY Physical activity is an important aspect of health promotion and disease prevention. However, women often have lower rates of physical activity than men. The purpose of this study was to identify environmental and policy determinants to physical activity among rural white women. Six focus groups were conducted with women aged 20–50 years who were not currently regular exercisers. Women reported that the social environment had a strong impact on physical activity level. Factors of the social environment included guilt, family responsibility, and social support. Environmental and policy barriers such as lack of access to places to exercise and safety concerns were also discussed. Intervention suggestions included family exercise and work-site programs. Information gained from this study can be used to fuel further research and inform future physical activity interventions.

Test-retest reliability of a questionnaire on physical activity and its correlates among women from diverse racial and ethnic groups.

BACKGROUND A better understanding of physical activity and its correlates is needed, especially among diverse populations of women. The objective of this study was to examine the test-retest reliability of a survey designed to measure physical activity and its correlates among women from diverse racial and ethnic groups. METHODS Test and retest surveys were conducted in person or over the telephone with 344 white, Latina, African-American, and Native American women aged 20 to 50 years living in rural and urban areas of the United States. Reliability of self-reported physical activity and its correlates were determined using intraclass correlation coefficients (ICC) overall and separately by site and race/ethnicity. RESULTS Of the women responding, 45% of the participants met recommendations for physical activity, 40% were insufficiently active, and 15% were inactive. Reliability for the physical activity measure was 0.69 (95% confidence interval [CI], 0.62-0.74), with an ICC of 0.30 to 0.95 across sites. Overall, the seven items on the physical environment had substantial reliability (ICC=0.64-0.91). The sense of community scale (0.79; 95% CI, 0.74-0.83), social issues (0.68; 95% CI, 0.61-0.74), social roles (0.64; 95% CI, 0.56-0.71), and self-efficacy for exercise (0.72; 95% CI, 0.66-0.77) all had acceptable reliability overall and across most sites. CONCLUSIONS This study provides psychometric evidence that the questionnaire on physical activity and its correlates is reliable among diverse women aged 20 to 50 years from various racial and ethnic groups. These results suggest that test-retest reliability is not an obstacle to comparison of associations between physical activity and several hypothesized correlates of activity.

Support for Policy Interventions to Increase Physical Activity in Rural Missouri

Over the past few decades, the health benefits of physical activity have been well documented.~ Physical inactivity is increasingly recognized as a significant risk factor for coronary heart disease. Lack of physical activity also is recognized as a risk factor for a variety of other chronic diseases, including hypertension, noninsulin-dependent diabetes, colon cancer, and osteoporosis? Despite its beneficial effects, most U.S. adults do not participate in regular physical activity. Nearly 30% of adult Americans engage in no leisure-time physical activity. 1