Prabasaj Paul

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.

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.

Adults Eligible for Cardiovascular Disease Prevention Counseling and Participation in Aerobic Physical Activity - United States, 2013.

Cardiovascular disease (CVD) is the leading cause of death in the United States, and physical inactivity is a major risk factor (1). Health care professionals have a role in counseling patients about physical activity for CVD prevention. In August 2014, the U.S. Preventive Services Task Force (USPSTF) recommended that adults who are overweight or obese and have additional CVD risk factors be offered or referred to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention. Although the USPSTF recommendation does not specify an amount of physical activity, the 2008 Physical Activity Guidelines for Americans state that for substantial health benefits adults should achieve ≥150 minutes per week of moderate-intensity aerobic physical activity or ≥75 minutes per week of vigorous-intensity aerobic activity, or an equivalent combination of moderate- and vigorous-intensity aerobic physical activity. To assess the proportion of adults eligible for intensive behavioral counseling and not meeting the aerobic physical activity guideline, CDC analyzed data from the 2013 Behavioral Risk Factor Surveillance System (BRFSS). This analysis indicated that 36.8% of adults were eligible for intensive behavioral counseling for CVD prevention. Among U.S. states and the District of Columbia (DC), the prevalence of eligible adults ranged from 29.0% to 44.6%. Nationwide, 19.9% of all adults were eligible and did not meet the aerobic physical activity guideline. These data can inform the planning and implementation of health care interventions for CVD prevention that are based on physical activity.

Shared use agreements between municipalities and public schools in the United States, 2014

Shared use agreements allow public use of school facilities during non-school hours. Such agreements can cover outdoor facilities alone or may be more comprehensive by also including indoor facilities. Our aim was to: 1) estimate the prevalence of shared use agreements and facility types covered among U.S. municipalities and 2) identify differences in prevalence by municipality characteristics. The 2014 National Survey of Community-based Policy and Environmental Supports for Healthy Eating and Active Living is a representative survey of US municipalities (n=2029). Data were analyzed using survey weights to create national estimates. Logistic and multinomial regression models determined odds ratios adjusting for municipality characteristics. Among 1930 municipalities with a school, 41.6% had a shared use agreement as reported by a local official, 45.6% did not, and 12.8% did not know. Significant differences in prevalence existed by population size, rural/urban status, poverty prevalence, median education level, and census region; however, after adjustment for other municipality characteristics significant differences remained only by population size, median education level, and census region. Among municipalities with a shared use agreement, 59.6% covered both outdoor and indoor facilities, 5.5% covered indoor facilities only, and 34.9% covered outdoor facilities only. Opportunities exist to expand the use of shared use agreements particularly in municipalities with small populations, lower education levels, and in the South, and to promote more comprehensive shared use agreements that include both indoor and outdoor facilities.

Walking and the Perception of Neighborhood Attributes Among U.S. Adults—2012

BACKGROUND The association between walking and environmental attributes depends on walking purpose. This study, based on a large survey of U.S. adults, examined the association between perceived neighborhood safety and built environment attributes, and walking for transportation and leisure. METHODS Data were obtained on transportation and leisure-time walking, perceived neighborhood safety and built environment attributes, and demographic characteristics from the summer wave of the 2012 ConsumerStyles survey of 3951 U.S. adults. Associations were examined by demographic characteristics. RESULTS Seventy-five percent of respondents reported walking for either transportation (54%) or leisure (56%) in the past week, 59% reported no safety concern, and 36% reported absence of any built environment attribute of walkability nearby. Respondents with more education, and those who lived in metropolitan areas were more likely to report built environment attributes supportive of walking. All built environment attributes examined, as well as safety concern due to speeding vehicles, were associated with walking after adjustment for demographic characteristics. CONCLUSION Walking, particularly for transportation, is associated with many built environment attributes among U.S. adults. These attributes may be important to consider when designing and modifying the built environment of communities, especially those which are less walkable.

National physical activity surveillance: Users of wearable activity monitors as a potential data source

The objective of this study was to assess usage patterns of wearable activity monitors among US adults and how user characteristics might influence physical activity estimates from this type of sample. We analyzed data on 3367 respondents to the 2015 HealthStyles survey, an annual consumer mail panel survey conducted on a nationwide sample. Approximately 1 in 8 respondents (12.5%) reported currently using a wearable activity monitor. Current use varied by sex, age, and education level. Use increased with physical activity level from 4.3% for inactive adults to 17.4% for active adults. Overall, 49.9% of all adults met the aerobic physical activity guideline, while this prevalence was 69.5% among current activity monitor users. Our findings suggest that current users of wearable activity monitors are not representative of the overall US population. Estimates of physical activity levels using data from wearable activity monitors users may be an overestimate and therefore data from users alone may have a limited role in physical activity surveillance.

The attributable proportion of specific leisure-time physical activities to total leisure activity volume among US adults, National Health and Nutrition Examination Survey 1999-2006

BACKGROUND Previous studies have examined participation in specific leisure-time physical activities (PA) among US adults. The purpose of this study was to identify specific activities that contribute substantially to total volume of leisure-time PA in US adults. METHODS Proportion of total volume of leisure-time PA moderate-equivalent minutes attributable to 9 specific types of activities was estimated using self-reported data from 21,685 adult participants (≥ 18 years) in the National Health and Nutrition Examination Survey 1999-2006. RESULTS Overall, walking (28%), sports (22%), and dancing (9%) contributed most to PA volume. Attributable proportion was higher among men than women for sports (30% vs. 11%) and higher among women than men for walking (36% vs. 23%), dancing (16% vs. 4%), and conditioning exercises (10% vs. 5%). The proportion was lower for walking, but higher for sports, among active adults than those insufficiently active and increased with age for walking. Compared with other racial/ethnic groups, the proportion was lower for sports among non-Hispanic white men and for dancing among non-Hispanic white women. CONCLUSIONS Walking, sports, and dance account for the most activity time among US adults overall, yet some demographic variations exist. Strategies for PA promotion should be tailored to differences across population subgroups.

How reported usefulness modifies the association between neighborhood supports and walking behavior

Neighborhood supports have been associated with walking, but this association may be modified by reports about the usefulness of these supports for promoting walking. This study examined the association between reported presence of neighborhood supports and walking and whether usefulness modified this association in a nationwide sample of U.S. adults. Measures of reported presence and use or potential use (i.e., usefulness) of neighborhood supports (shops within walking distance, transit stops, sidewalks, parks, interesting things to look at, well-lit at night, low crime rate, and cars following speed limit) were examined in 3973 adults who completed the 2014 SummerStyles survey. Multinomial regression models were used to examine the association between presence of supports with walking frequency (frequently, sometimes, rarely (referent)) and the role usefulness had on this association. The interaction term between reported presence and usefulness was significant for all supports (p<0.05). For adults who reported a support as useful, a positive association between presence of the support and walking frequency was observed for all supports. For adults who did not report a support as useful, the association between presence of the support and walking frequency was null for most supports and negative for sidewalks, well-lit at night, and low crime rate. The association between presence of neighborhood supports and walking is modified by reported usefulness of the support. Tailoring initiatives to meet a communitys supply of and affinity for neighborhood supports may help initiatives designed to promote walking and walkable communities succeed.

Developing Point-of-Decision Prompts to Encourage Airport Walking: The Walk to Fly Study.

BACKGROUND Point-of-decision prompts may be appropriate to promote walking, instead of using a mechanized mode of transport, such as a train, in airports. To our knowledge, no current studies describe the development of messages for prompts in this setting. METHODS In-person interviews were conducted with 150 randomly selected airport travelers who rode the train to their departure gate. Travelers reported various reasons for riding the train to their gate. They were asked about messages that would encourage them to walk. Exploratory factor analysis was conducted for reasons for riding the train. Confirmatory factor analysis was conducted for messages to encourage walking to the departure gate. RESULTS Travelers reported not knowing walking was an option (23.8%), seeing others riding the train (14.4%), and being afraid of getting lost (9.2%) as reasons for riding the train. Many indicated that directional signs and prompts promoting walking as exercise would encourage them to walk instead of riding the train. CONCLUSIONS Some reasons for riding the train in an airport may be modifiable by installing point-of-decision prompts. Providing directional signs to travelers may prompt them to walk to their gate instead of riding the train. Similar prompts may also be considered in other community settings.

Park Access Among School-Age Youth in the United States.

BACKGROUND Fewer than 30% of U.S. youth meet the recommendation to be active ≥ 60 minutes/day. Access to parks may encourage higher levels of physical activity. PURPOSE To examine differences in park access among U.S. school-age youth, by demographic characteristics and urbanicity of block group. METHODS Park data from 2012 were obtained from TomTom, Incorporated. Population data were obtained from the 2010 U.S. Census and American Community Survey 2006-2010. Using a park access score for each block group based on the number of national, state or local parks within one-half mile, we examined park access among youth by majority race/ethnicity, median household income, median education, and urbanicity of block groups. RESULTS Overall, 61.3% of school-age youth had park access--64.3% in urban, 36.5% in large rural, 37.8% in small rural, and 35.8% in isolated block groups. Park access was higher among youth in block groups with higher median household income and higher median education. CONCLUSION Urban youth are more likely to have park access. However, park access also varies by race/ethnicity, median education, and median household. Considering both the demographics and urbanicity may lead to better characterization of park access and its association with physical activity among youth.