Lucas J. Carr

Validation of Walk Score for estimating access to walkable amenities

Background Proximity to walkable destinations or amenities is thought to influence physical activity behaviour. Previous efforts attempting to calculate neighbourhood walkability have relied on self-report or time-intensive and costly measures. Walk Score is a novel and publicly available website that estimates neighbourhood walkability based on proximity to 13 amenity categories (eg, grocery stores, coffee shops, restaurants, bars, movie theatres, schools, parks, libraries, book stores, fitness centres, drug stores, hardware stores, clothing/music stores). Objective The purpose of this study is to test the validity and reliability of Walk Score for estimating access to objectively measured walkable amenities. Methods Walk Scores of 379 residential/non-residential addresses in Rhode Island were manually calculated. Geographic information systems (GIS) was used to objectively measure 4194 walkable amenities in the 13 Walk Score categories. GIS data were aggregated from publicly available data sources. Sums of amenities within each category were matched to address data, and Pearson correlations were calculated between the category sums and address Walk Scores. Results Significant correlations were identified between Walk Score and all categories of aggregated walkable destinations within a 1-mile buffer of the 379 residential and non-residential addresses. Test–retest reliability correlation coefficients for a subsample of 100 addresses were 1.0. Conclusion These results support Walk Score as a reliable and valid measure of estimating access to walkable amenities. Walk Score may be a convenient and inexpensive option for researchers interested in exploring the relationship between access to walkable amenities and health behaviours such as physical activity.

Walk score™ as a global estimate of neighborhood walkability.

BACKGROUND Walk Score recently has been demonstrated as a valid and reliable tool for estimating access to nearby facilities, a critical component of the physical activity environment. It has not yet been determined whether Walk Score relates to other critical components of the physical activity environment, including street connectivity, access to public transit, residential density, and crime. PURPOSE The aim of this study was to explore the relationship between Walk Score and objective/subjective measures of the physical activity environment. METHODS Walk Scores were calculated for residential addresses of 296 participants of two RCTs (2006-2009). Street connectivity, residential density, access to public transit provisions, and crime were objectively measured (GIS) and cross-referenced with Walk Scores and participants perceptions of the environment (e.g., perceived crime, access to physical activity facilities, perceived neighborhood walkability). Pairwise Pearson correlations were calculated in March 2010 to compare Walk Score to subjective/objective measures of neighborhood walkability. RESULTS Significant positive correlations were identified between Walk Score and several objective (e.g., street connectivity, residential density and access to public transit provisions) and subjective (e.g., summed score of the physical activity environment) measures of the physical activity environment. However, positive correlations also were observed between Walk Score and crime. CONCLUSIONS Collectively, these findings support Walk Score as a free, easy-to-use, and quick proxy of neighborhood density and access to nearby amenities. However, positive associations between Walk Score and reported crime highlight a limitation of Walk Score and warrant caution of its use.

Accuracy of Intensity and Inclinometer Output of Three Activity Monitors for Identification of Sedentary Behavior and Light-Intensity Activity

Purpose. To examine the accuracy of intensity and inclinometer output of three physical activity monitors during various sedentary and light-intensity activities. Methods. Thirty-six participants wore three physical activity monitors (ActiGraph GT1M, ActiGraph GT3X+, and StepWatch) while completing sedentary (lying, sitting watching television, sitting using computer, and standing still) light (walking 1.0 mph, pedaling 7.0 mph, pedaling 15.0 mph) intensity activities under controlled settings. Accuracy for correctly categorizing intensity was assessed for each monitor and threshold. Accuracy of the GT3X+ inclinometer function (GT3X+Incl) for correctly identifying anatomical position was also assessed. Percentage agreement between direct observation and the monitor recorded time spent in sedentary behavior and light intensity was examined. Results. All monitors using all thresholds accurately identified over 80% of sedentary behaviors and 60% of light-intensity walking time based on intensity output. The StepWatch was the most accurate in detecting pedaling time but unable to detect pedal workload. The GT3X+Incl accurately identified anatomical position during 70% of all activities but demonstrated limitations in discriminating between activities of differing intensity. Conclusions. Our findings suggest that all three monitors accurately measure most sedentary and light-intensity activities although choice of monitors should be based on study-specific needs.

Multicomponent intervention to reduce daily sedentary time: a randomised controlled trial

Objectives To test the efficacy of a multicomponent technology intervention for reducing daily sedentary time and improving cardiometabolic disease risk among sedentary, overweight university employees. Design Blinded, randomised controlled trial. Setting A large south-eastern university in the USA. Participants 49 middle-aged, primarily female, sedentary and overweight adults working in sedentary jobs enrolled in the study. A total of 40 participants completed the study. Interventions Participants were randomised to either: (1) an intervention group (N=23; 47.6+9.9 years; 94.1% female; 33.2+4.5 kg/m2); (2) or wait-list control group (N=17; 42.6+8.9 years; 86.9% female; 31.7+4.9 kg/m2). The intervention group received a theory-based, internet-delivered programme, a portable pedal machine at work and a pedometer for 12 weeks. The wait-list control group maintained their behaviours for 12 weeks. Outcome measures Primary (sedentary and physical activity behaviour measured objectively through StepWatch) and secondary (heart rate, blood pressure, height, weight, waist circumference, per cent body fat, cardiorespiratory fitness, fasting lipids) outcomes were measured at baseline and postintervention (12 weeks). Exploratory outcomes including intervention compliance and process evaluation measures were also assessed postintervention. Results Compared to controls, the intervention group reduced daily sedentary time (mean change (95%CI): −58.7 min/day (−118.4 to 0.99; p<0.01)) after adjusting for baseline values and monitor wear time. Intervention participants logged on to the website 71.3% of all intervention days, used the pedal machine 37.7% of all working intervention days and pedalled an average of 31.1 min/day. Conclusions These findings suggest that the intervention was engaging and resulted in reductions in daily sedentary time among full-time sedentary employees. These findings hold public health significance due to the growing number of sedentary jobs and the potential of these technologies in large-scale worksite programmes. Trial Registration ClinicalTrials.gov #NCT01371084.

Feasibility of a portable pedal exercise machine for reducing sedentary time in the workplace

Background Sedentary time is independently associated with an increased risk of metabolic disease. Worksite interventions designed to decrease sedentary time may serve to improve employee health. Objective The purpose of this study is to test the feasibility and use of a pedal exercise machine for reducing workplace sedentary time. Methods Eighteen full-time employees (mean age+SD 40.2+10.7 years; 88% female) working in sedentary occupations were recruited for participation. Demographic and anthropometric data were collected at baseline and 4 weeks. Participants were provided access to a pedal exercise machine for 4 weeks at work. Use of the device was measured objectively by exercise tracking software, which monitors pedal activity and provides the user real-time feedback (eg, speed, time, distance, calories). At 4 weeks, participants completed a feasibility questionnaire. Results Participants reported sitting 83% of their working days. Participants used the pedal machines an average of 12.2+6.6 out of a possible 20 working days and pedalled an average of 23.4+20.4 min each day used. Feasibility data indicate that participants found the machines feasible for use at work. Participants also reported sedentary time at work decreased due to the machine. Discussion Findings from this study suggest that this pedal machine may be a feasible tool for reducing sedentary time while at work. These findings hold public health significance due to the growing number of sedentary jobs in the USA and the potential of the device for use in large-scale worksite health programmes.

Acceptability and effects of a seated active workstation during sedentary work

Purpose – The purpose of this paper is to test the user acceptability (Phase 1) and effects (Phase 2) of completing sedentary work while using a seated active workstation. Design/methodology/approach – In Phase 1, 45 sedentary employees completed an acceptability questionnaire immediately after performing sedentary work tasks (typing, mousing) while using the seated active workstation for 30 minutes. In Phase 2, the paper tested the differential effects of completing sedentary work tasks at two different workstations (sedentary workstation vs seated active workstation) on physiological (energy expenditure, muscle activity, heart rate, blood pressure), cognitive (learning, memory, attention) and work performance (typing and mousing ability) outcomes among 18 sedentary employees. Findings – In Phase 1, 96 percent of participants reported they would use the seated active workstation “daily” if provided access in their office. In Phase 2, working while using the seated active workstation increased energy expe...

Associations between Body Mass Index, Shopping Behaviors, Amenity Density, and Characteristics of the Neighborhood Food Environment among Female Adult Supplemental Nutrition Assistance Program (SNAP) Participants in Eastern North Carolina

We examined associations between body mass index (BMI) and the food environment among adult female Supplemental Nutrition Assistance Program (SNAP) participants (N = 197) in eastern North Carolina. Food venue proximity to residential addresses was calculated using a geographic information system. Walk Score was used as a measure of amenity density. Correlation and linear regression analyses were used to examine associations between BMI and distance to and use of food venues, and residential amenity density. Frequency of supercenter use was significantly inversely associated with distance to supercenters. Walk Score was significantly inversely associated with BMI. BMI was not associated with distance to or use of any particular food venue. Future studies should examine specific health-promoting elements of amenity-dense neighborhoods accessible to limited-income populations.

Total Worker Health Intervention Increases Activity of Sedentary Workers

INTRODUCTION Office employees are exposed to hazardous levels of sedentary work. Interventions that integrate health promotion and health protection elements are needed to advance the health of sedentary workers. This study tested an integrated intervention on occupational sedentary/physical activity behaviors, cardiometabolic disease biomarkers, musculoskeletal discomfort, and work productivity. DESIGN Two-group, RCT. Data were collected between January and August 2014. SETTING/PARTICIPANTS Overweight/obese adults working in sedentary desk jobs were randomized to: (1) a health protection-only group (HPO, n=27); or (2) an integrated health protection/health promotion group (HP/HP, n=27). INTERVENTION HPO participants received an ergonomic workstation optimization intervention and three e-mails/week promoting rest breaks and posture variation. HP/HP participants received the HPO intervention plus access to a seated activity permissive workstation. MAIN OUTCOME MEASURES Occupational sedentary and physical activity behaviors (primary outcomes), cardiometabolic health outcomes, musculoskeletal discomfort, and work productivity (secondary outcomes) were measured at baseline and post-intervention (16 weeks). RESULTS The HP/HP group increased occupational light intensity physical activity over the HPO group and used the activity permissive workstations 50 minutes/work day. Significant associations were observed between activity permissive workstation adherence and improvements in several cardiometabolic biomarkers (weight, total fat mass, resting heart rate, body fat percentage) and work productivity outcomes (concentration at work, days missed because of health problems). CONCLUSIONS The HP/HP group increased occupational physical activity and greater activity permissive workstation adherence was associated with improved health and work productivity outcomes. These findings are important for employers interested in advancing the well-being of sedentary office workers. TRIAL REGISTRATION This study is registered at www.clinicaltrials.gov NCT02071420.

The Role of Resistance Training in the Prevention and Treatment of Chronic Disease

Recent research suggests that resistance training (RT) in adults has the potential to prevent, treat, and possibly even reverse the impact of several chronic diseases. A properly designed progressive program can have profound effects on the musculoskeletal system, resulting in enhanced physical and mental health. In this review, the authors summarize recent research detailing the numerous benefits gained from participating in an RT program in those with or at risk for chronic disease. This includes increases in muscle mass and strength; enhanced physical function; reduced risks for osteoporosis and cardiovascular and metabolic diseases; improved management of cancer, neuromuscular disorders, HIV, and chronic obstructive pulmonary disease; and reductions in negative mood states. Given these benefits, numerous national organizations, including the committee commissioned to create the National Physical Activity Guidelines for Americans, have endorsed the participation in RT as a necessary component of maintaining health. Fortunately, the most current estimates show that a growing number of individuals are participating in RT, but these national estimates still fall below the goal of 30% set by Healthy People 2010. Future research will therefore need to focus on increasing the adoption and adherence of RT, as it carries the potential to dramatically affect public health.

Search query data to monitor interest in behavior change: application for public health.

There is a need for effective interventions and policies that target the leading preventable causes of death in the U.S. (e.g., smoking, overweight/obesity, physical inactivity). Such efforts could be aided by the use of publicly available, real-time search query data that illustrate times and locations of high and low public interest in behaviors related to preventable causes of death. Objectives This study explored patterns of search query activity for the terms ‘weight’, ‘diet’, ‘fitness’, and ‘smoking’ using Google Insights for Search. Methods Search activity for ‘weight’, ‘diet’, ‘fitness’, and ‘smoking’ conducted within the United States via Google between January 4th, 2004 (first date data was available) and November 28th, 2011 (date of data download and analysis) were analyzed. Using a generalized linear model, we explored the effects of time (month) on mean relative search volume for all four terms. Results Models suggest a significant effect of month on mean search volume for all four terms. Search activity for all four terms was highest in January with observable declines throughout the remainder of the year. Conclusions These findings demonstrate discernable temporal patterns of search activity for four areas of behavior change. These findings could be used to inform the timing, location and messaging of interventions, campaigns and policies targeting these behaviors.