Dianna D. Carroll

Meeting the 2008 Physical Activity Guidelines for Americans Among U.S. Youth

BACKGROUND Participation in physical activity brings health benefits for adolescents. However, limited data are available on the percentage of U.S. adolescents who engage in levels of aerobic and muscle-strengthening activities recommended in the 2008 Physical Activity Guidelines for Americans (2008 Guidelines). PURPOSE To examine the prevalence at which U.S. adolescents aged 12-17 years meet the 2008 Guidelines, and whether demographic and BMI variables influence that prevalence. METHODS Using data from an interviewer-administered self-report questionnaire in the 1999-2006 National Health and Nutrition Examination Survey (analyzed in 2011), estimates were made of the percentage of adolescents who engaged in recommended levels of aerobic and muscle-strengthening activities (≥60 minutes of aerobic activity/day and participation in muscle-strengthening activities ≥3 days/week). RESULTS Among 6547 U.S. adolescents aged 12-17 years, 16.3% (95% CI=14.9%, 17.9%) met both aerobic and muscle-strengthening guidelines; 14.7% (13.3%, 16.2%) met the aerobic guideline only, 21.3% (19.4%, 23.3%) met the muscle-strengthening guideline only, and 47.8% (45.4%, 50.1%) met neither guideline. Adjusted for covariates, odds of meeting either the aerobic or muscle-strengthening guideline only or both guidelines versus meeting neither guideline were (p<0.05) higher among boys than girls. The odds of meeting the aerobic guideline only were higher among underweight/normal-weight adolescents than among obese adolescents. No clear pattern was observed by family groups according to poverty-to-income ratio. CONCLUSIONS Less than 20% of adolescents reported engaging in recommended levels of both aerobic and muscle-strengthening activities.

Awareness and knowledge of the 2008 Physical Activity Guidelines for Americans.

BACKGROUND To estimate the proportion of U.S. adults aware and knowledgeable of the 2008 Physical Activity Guidelines for Americans. METHODS Analysis is based on a cross-sectional national sample of adults in the 2009 (n = 4281) HealthStyles survey. We estimated the prevalence of adults who reported awareness of government physical activity guidelines and who were knowledgeable of the currently recommended moderate-intensity physical activity guideline (ie, 150 minutes per week) from the 2008 Guidelines. RESULTS In 2009, the percent of adults who reported being aware of government physical activity (PA) guidelines was 36.1%. The percent of adults knowledgeable of the moderate-intensity physical activity guideline was less than 1% (0.56%). CONCLUSIONS Most U.S. adults lack sufficient awareness and knowledge of the 2008 Guidelines, putting them at risk for failure to meet them. The nation needs more effective communication strategies to translate and disseminate PA guidelines.

Obesity, Physical Activity, and Depressive Symptoms in a Cohort of Adults Aged 51 to 61:

Objective: To determine associations between changes in obesity and vigorous physical activity (PA) status and depressive symptoms in a cohort aged 51 to 61 years at baseline. Method: Two waves (1992, 1998) of Health and Retirement Study data were used to divide participants into four obesity and four vigorous PA status categories based on change in or maintenance of their 1992 status in 1998. Depressive symptoms were defined as the upper quintile score (women ≥ 4, men ≥ 3) on the eight-item Center for Epidemiologic Studies—Depression Scale. Logistic regression determined adjusted odds ratios for depressive symptoms associated with obesity and vigorous PA status. Results: Among men, no significant associations were found. Among women, decreasing from high vigorous PA status and maintenance of obese status were independently associated with increased odds for depressive symptoms in 1998. Discussion: The findings illustrate the importance of examining gender differences in studies of risk factors for depression.

Walking for Transportation and Leisure among U.S. Adults—National Health Interview Survey 2010

BACKGROUND Walking, the most commonly reported physical activity among U.S. adults, is undertaken in various domains, including transportation and leisure. METHODS This study examined prevalence, bout length, and mean amount of walking in the last week for transportation and leisure, by selected characteristics. Self-reported data from the 2010 National Health Interview Survey (N = 24,017) were analyzed. RESULTS Prevalence of transportation walking was 29.4% (95% CI: 28.6%-30.3%) and of leisure walking was 50.0% (95% CI: 49.1%-51.0%). Prevalence of transportation walking was higher among men; prevalence of leisure walking was higher among women. Most (52.4%) transportation walking bouts were 10 to 15 minutes; leisure walking bouts were distributed more evenly (28.0%, 10-15 minutes; 17.1%, 41-60 minutes). Mean time spent in transportation walking was higher among men, decreased with increasing BMI, and varied by race/ethnicity and region of residence. Mean time spent leisure walking increased with increasing age and with decreasing BMI. CONCLUSION Demographic correlates and patterns of walking differ by domain. Interventions focusing on either leisure or transportation walking should consider correlates for the specific walking domain. Assessing prevalence, bout length, and mean time of walking for transportation and leisure separately allows for more comprehensive surveillance of walking.

Physical Activity Measures in the Healthy Communities Study

The risk of obesity is reduced when youth engage in recommended levels of physical activity (PA). For that reason, public health organizations in the U.S. have encouraged communities to implement programs and policies designed to increase PA in youth, and many communities have taken on that challenge. However, the long-term effects of those programs and policies on obesity are largely unknown. The Healthy Communities Study is a large-scale observational study of U.S. communities that is examining the characteristics of programs and policies designed to promote healthy behaviors (e.g., increase PA and improve diet) and determining their association with obesity-related outcomes. The purpose of this paper is to describe the methods used to measure PA in children and the personal and community factors that may influence it. The study used both self-reported and objective measures of PA, and measured personal, family, and home influences on PA via three constructs: (1) PA self-schema; (2) parental support; and (3) parental rules regarding PA. Neighborhood and community factors related to PA were assessed using three measures: (1) child perceptions of the neighborhood environment; (2) availability of PA equipment; and (3) attributes of the childs street segment via direct observation. School influences on childrens PA were assessed via three constructs: (1) school PA policies; (2) child perceptions of the school PA environment; and (3) school outdoor PA environment. These measures will enable examination of the associations between characteristics of community PA programs and policies and obesity-related outcomes in children and youth.

Participation in Types of Physical Activities Among US Adults—National Health and Nutrition Examination Survey 1999–2006

BACKGROUND Information on specific types of physical activities in which US adults participate is important for community and program development to promote physical activity. METHODS Prevalence of participation and average time spent for 33 leisure-time aerobic activities and 10 activity categories were calculated using self-reported data from 22,545 participants aged ≥ 18 years in the National Health and Nutrition Examination Survey 1999-2006. RESULTS Overall, 38% of US adults reported no leisure-time physical activities, and 43% reported 1 or 2 activities in the past 30 days. Walking was the most frequently reported activity for both men (29%) and women (38%). Among walkers, the average time spent walking was 198 minutes/week for men and 152 minutes/week for women. The most reported activities for men after walking were bicycling and yard work, and for women were aerobics and dance. For most activity categories, participation was lower among adults aged ≥ 65 years than among younger adults, and among Mexican Americans and non-Hispanic blacks than among non-Hispanic whites. Participation in most categories increased with increasing educational attainment. CONCLUSIONS Participation in physical activity differs by types of activities and demographic characteristics. Physical activity promotion programs should take these differences into account when developing intervention strategies.

Physical Activities of U.S. High School Students—2010 National Youth Physical Activity and Nutrition Survey

BACKGROUND The 2008 Physical Activity Guidelines recommend youth participate in a variety of physical activities; however, few nationally representative studies describe the types and variety of youth activity. This study assessed the most frequently reported types and variety of activities among U.S. high school students, and examined the association between variety and meeting the 2008 Guidelines for aerobic activity (aerobic guideline). METHODS We analyzed data on 8628 U.S. high school students in grades 9-12 from the 2010 National Youth Physical Activity and Nutrition Survey. Types of physical activity were assessed by identifying which activities each student reported in the past 7 days. Variety was assessed by the total number of different activities each student reported. Percentage (95% CI) of students who reported engaging in each activity was assessed. Logistic regression was used to examine the association between variety and meeting the aerobic guideline. RESULTS Walking was the most frequently reported activity among U.S. high school students. On average, students reported participating in 6 different activities. Variety was positively associated with meeting the aerobic guideline. CONCLUSIONS These findings support encouraging youth to participate in many physical activities and may be useful for developing interventions that focus on the most prevalent activities.

Awareness and knowledge of the youth 2008 Physical Activity Guidelines for Americans.

BACKGROUND To measure parental awareness of government physical activity guidelines and knowledge of the amount of physical activity recommended for youth (ie, 60 minutes per day, 7 days per week) as specified in the 2008 Physical Activity Guidelines for Americans. METHODS A cross-sectional national sample of adults responded to physical activity guideline questions added to the HealthStyles survey in 2009 (n = 1552). The prevalence of parents aware of government physical activity guidelines and knowledgeable of the youth physical activity guideline, specifically, was estimated overall and by parental demographic characteristics (sex, education, income level, race/ethnicity, age group, marital status) and body mass index. RESULTS In 2009, 34.8% of parents reported being aware of physical activity guidelines, and 9.7% were knowledgeable of the amount of physical activity recommended for youth. CONCLUSIONS Many parents lack awareness and knowledge of the youth physical activity guidelines. The low prevalence estimates suggest the 2008 Physical Activity Guidelines for Americans has not been effectively disseminated. These results may also indicate a need for effective communication strategies to educate and inform parents, an important influencer of childrens health behaviors.

Adults with One or More Functional Disabilities — United States, 2011–2014

Nearly 40 million persons in the United States have a disability, as defined by responses to six questions recommended by the U.S. Department of Health and Human Services as the national standard for identifying disabilities in population-based health surveys (1). Although these questions have been used to estimate prevalence of functional disabilities overall, as well as types of functional disabilities (disability type), no study has yet investigated the characteristics of U.S. adults by number of disability types. Knowing the characteristics of persons living with multiple disability types is important for understanding the overall functional status of these persons. CDC analyzed data from the family component of the National Health Interview Survey (NHIS) for the years 2011-2014 to estimate the percentage of adults aged 18-64 years with one, two, three, or four or more disability types, by selected demographic and socioeconomic characteristics. Overall, 22.6 million (11.9%) working-age adults were found to have any disability, and in this population, most (12.8 million) persons had only one disability type. A generally consistent pattern between increasing indicators of low socioeconomic status and the number of disability types was observed. Understanding the demographic and socioeconomic characteristics of working-age adults with disabilities, including those with multiple disability types, might help to further the inclusion of persons with disabilities in public health programs and policies.

Walking for Transportation: What Do U.S. Adults Think Is a Reasonable Distance and Time?

BACKGROUND Less than one-third of U.S. adults walk for transportation. Public health strategies to increase transportation walking would benefit from knowing what adults think is a reasonable distance to walk. Our purpose was to determine 1) what adults think is a reasonable distance and amount of time to walk and 2) whether there were differences in minutes spent transportation walking by what adults think is reasonable. METHODS Analyses used a cross-sectional nationwide adult sample (n = 3653) participating in the 2010 Summer ConsumerStyles mail survey. RESULTS Most adults (> 90%) think transportation walking is reasonable. However, less than half (43%) think walking a mile or more or for 20 minutes or more is reasonable. What adults think is reasonable is similar across most demographic subgroups, except for older adults (≥ 65 years) who think shorter distances and times are reasonable. Trend analysis that adjust for demographic characteristics indicates adults who think longer distances and times are reasonable walk more. CONCLUSIONS Walking for short distances is acceptable to most U.S. adults. Public health programs designed to encourage longer distance trips may wish to improve supports for transportation walking to make walking longer distances seem easier and more acceptable to most U.S. adults.