Last data update: Apr 29, 2024. (Total: 46658 publications since 2009)
Records 1-29 (of 29 Records) |
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Meeting the aerobic and muscle-strengthening physical activity guidelines among older US adults, National Health Interview Survey 1998-2018
Hyde ET , Brown DR , Webber BJ , Piercy KL , Omura JD , Rose K , Whitfield GP . J Appl Gerontol 2024 7334648241232930 The Physical Activity Guidelines for Americans, second edition, recommends older adults participate in ≥150 minutes per week of moderate-intensity equivalent aerobic activity and ≥2 days per week of muscle-strengthening activity. We estimated prevalence and trends of meeting the guidelines among US adults aged ≥65 years from 1998 to 2018. Using the 1998-2018 National Health Interview Survey, we estimated the prevalence of meeting aerobic, muscle-strengthening, and combined physical activity guidelines stratified by age group, sex, race and ethnicity, and education level. Within age groups, we calculated prevalence differences by sociodemographic categories. Prevalence of meeting each guideline increased for all age groups and most sociodemographic subgroups. The increased magnitude of meeting the combined guideline from 1998-2000 to 2016-2018 differed across levels of educational attainment for most age groups. Despite increasing over time, the prevalence among older adults of meeting physical activity guidelines remains low (range for combined guideline: 7.2%-17.2%). |
Parks, trails, and greenways for physical activity: A Community Guide systematic economic review
Jacob V , Reynolds JA , Chattopadhyay SK , Hopkins DP , Brown DR , Devlin HM , Barrett A , Berrigan D , Crespo CJ , Heath GW , Brownson RC , Cuellar AE , Clymer JM , Chriqui JF . Am J Prev Med 2024 INTRODUCTION: This systematic economic review examined the cost-benefit and cost-effectiveness of park, trail, and greenway infrastructure interventions to increase physical activity or infrastructure use. METHODS: The search period covered the date of inception of publications databases through February 2022. Inclusion was limited to studies that reported cost-benefit or cost-effectiveness outcomes and were based in the United States and other high-income countries. Analyses were conducted during March 2022 through December 2022. All monetary values reported are in 2021 U.S. dollars. RESULTS: The search yielded 1 study based in the United States and 7 based on other high-income countries, with 1 reporting cost-effectiveness and 7 reporting cost-benefit outcomes. The cost-effectiveness study based in the United Kingdom reported $23,254 per disability-adjusted life year averted. The median benefit to cost ratio was 3.1 (Interquartile Interval: 2.9 to 3.9) based on 7 studies. DISCUSSION: The evidence shows that economic benefits exceed the intervention cost of park, trail, and greenway infrastructure. Given large differences in the size of infrastructure, intervention cost and economic benefits varied substantially across studies. There was insufficient number of studies to determine cost-effectiveness of these interventions. |
Stepping up counseling and referral to effective physical activity interventions for adults with osteoarthritis
Fallon EA , Brown DR , Callahan LF , Foster AL , Kim JS , Lo GH , Piercy KL . J Rheumatol 2023 In "Stepping Forward: A Scoping Review of Physical Activity in Osteoarthritis," White and colleagues(1) aimed to help patients, policymakers, investigators, and healthcare providers (HCPs) better understand how physical activity (PA) is defined and measured, the benefits of PA for knee osteoarthritis (KOA), the potential role of PA in the development and/or progression of KOA, and the PA guidelines for Americans.(2) This correspondence aims to reinforce the importance of PA for adults with arthritis; clarify definitions for "inactive" and "insufficiently active" from the PA guidelines for Americans(2) and supplement White and colleagues' scoping review by (1) highlighting arthritis-appropriate evidence-based interventions (AAEBIs) for PA and self-management education; and (2) providing resources to facilitate HCP screening, counseling, and referral to evidencebased PA interventions for adults with arthritis. |
From practice to publication: The promise of writing workshops
Lavinghouze SR , Kettel Khan L , Auld ME , Sammons Hackett D , Brittain DR , Brown DR , Greaney E , Harris DM , Maynard LM , Onufrak S , Robillard AG , Schwartz R , Siddique S , Youngner CG , Wright LS , O'Toole TP . Health Promot Pract 2022 23 21s-33s Practitioners in health departments, university extension programs, and nonprofit organizations working in public health face varied challenges to publishing in the peer-reviewed literature. These practitioners may lack time, support, skills, and efficacy needed for manuscript submission, which keeps them from sharing their wisdom and experience-based evidence. This exclusion can contribute to literature gaps, a failure of evidence-based practice to inform future research, reduced ability to educate partners, and delays in advancing public health practice. Our article describes the writing workshops offered to Division of Nutrition, Physical Activity, and Obesity (DNPAO), Centers for Disease Control and Prevention (CDC) funded programs in 2021. This project consisted of three 60-minute introductory writing webinars open to all recipients, followed by a Writing for Publications workshop, an 8- to 9-week virtual learning/writing intensive for selected writing team applicants. The Society for Public Health Education staff, consultants, and CDC/DNPAO staff developed, refined, and presented the curriculum. The workshop for public health practitioner writing teams was offered to two cohorts and included extensive coaching and focused on potential submission to a Health Promotion Practice supplement, "Reducing Chronic Disease through Physical Activity and Nutrition: Public Health Practice in the Field" (see Supplemental Material), which was supported by CDC/DNPAO. We describe the webinars, the workshop design, modifications, evaluation methods and results. |
Differences in park plans and policies across U.S. municipalities
Peterson EL , Carlson SA , Ussery EN , Dunn I , Brown DR , Galuska DA . J Park Recreat Admi 2021 39 (4) Park planning documents may be valuable tools in order to promote policies and direct resources toward parks. However, the prevalence of such planning documents and policies specific to parks across municipal characteristics is not well known. This study compares the presence of parks and recreation plans and policies that address park safety and maintenance by municipality characteristics. Na-tionally representative data from the 2014 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living were analyzed (n=2005, response rate: 45%). About 7 out of 10 U.S. municipalities with a population of at least 1,000 reported having a parks and recreation plan. Prevalence of specific park or outdoor recreation policies was 78% for lighting, 85% for patrols by police and security, and 87% for maintenance of green space and equipment. The prevalence of a parks and recreation plan and of specific park or outdoor recreation policies were significantly lower in the smaller communities examined in this study. Most communities with at least 1,000 residents have park planning documents and policies, and opportunities may exist for practitioners to leverage the planning process to better engage residents. Future studies could in-vestigate the role and importance of using planning documents, policies, or bud-get provisions to address park access and quality in less populous municipalities. © 2020 Sagamore-Venture Publishing. |
Human papillomavirus oral-and sero-positivity in fanconi anemia
Sauter SL , Zhang X , Romick-Rosendale L , Wells SI , Myers KC , Brusadelli MG , Poff CB , Brown DR , Panicker G , Unger ER , Mehta PA , Bleesing J , Davies SM , Kovacic MB . Cancers (Basel) 2021 13 (6) 1-18 High-risk human papillomavirus (HPV) is prevalent and known to cause 5% of all cancers worldwide. The rare, cancer prone Fanconi anemia (FA) population is characterized by a predis-position to both head and neck squamous cell carcinomas and gynecological cancers, but the role of HPV in these cancers remains unclear. Prompted by a patient-family advocacy organization, oral HPV and HPV serological studies were simultaneously undertaken. Oral DNA samples from 201 individuals with FA, 303 unaffected family members, and 107 unrelated controls were tested for 37 HPV types. Serum samples from 115 individuals with FA and 55 unrelated controls were tested for antibodies against 9 HPV types. Oral HPV prevalence was higher for individuals with FA (20%) versus their parents (13%; p = 0.07), siblings (8%, p = 0.01), and unrelated controls (6%, p ≤ 0.001). A FA diagnosis increased HPV positivity 4.84-fold (95% CI: 1.96–11.93) in adjusted models compared to unrelated controls. Common risk factors associated with HPV in the general population did not predict oral positivity in FA, unlike unrelated controls. Seropositivity and anti-HPV titers did not significantly differ in FA versus unrelated controls regardless of HPV vaccination status. We conclude that individuals with FA are uniquely susceptible to oral HPV independent of conventional risk factors. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. |
Economics of interventions to increase active travel to school: A Community Guide Systematic Review
Jacob V , Chattopadhyay SK , Reynolds JA , Hopkins DP , Morgan JA , Brown DR , Kochtitzky CS , Cuellar AE , Kumanyika SK . Am J Prev Med 2021 60 (1) e27-e40 CONTEXT: The number of children who bicycle or walk to school has steadily declined in the U.S. and other high-income countries. In response, several countries responded in recent years by funding infrastructure and noninfrastructure programs that improve the safety, convenience, and attractiveness of active travel to school. The objective of this study is to synthesize the economic evidence for the cost and benefit of these programs. EVIDENCE ACQUISITION: Literature from the inception of databases to July 2018 were searched, yielding 9 economic evaluation studies. All analyses were done in September 2018-May 2019. EVIDENCE SYNTHESIS: All the studies reported cost, 6 studies reported cost benefit, and 2 studies reported cost effectiveness. The cost-effectiveness estimates were excluded on the basis of quality assessment. Cost of interventions ranged widely, with higher cost reported for the infrastructure-heavy projects from the U.S. ($91,000-$179,000 per school) and United Kingdom ($227,000-$665,000 per project). Estimates of benefits differed in the inclusion of improved safety for bicyclists and pedestrians, improved health from increased physical activity, and reduced environmental impacts due to less automobile use. The evaluations in the U.S. focused primarily on safety. The overall median benefit‒cost ratio was 4.4:1.0 (IQR=2.2:1-6.0:1, 6 studies). The 2-year benefit-cost ratios for U.S. projects in California and New York City were 1.46:1 and 1.79:1, respectively. CONCLUSIONS: The evidence indicates that interventions that improve infrastructure and enhance the safety and ease of active travel to schools generate societal economic benefits that exceed the societal cost. |
Built Environment Approaches to Increase Physical Activity: A Science Advisory From the American Heart Association
Omura JD , Carlson SA , Brown DR , Hopkins DP , Kraus WE , Staffileno BA , Thomas RJ , Lobelo F , Fulton JE . Circulation 2020 142 (11) e160-e166 Engaging in regular physical activity is one of the most important things people can do to improve their cardiovascular health; however, population levels of physical activity remain low in the United States. Effective population-based approaches implemented in communities can help increase physical activity among all Americans. Evidence suggests that built environment interventions offer one such approach. These interventions aim to create or modify community environmental characteristics to make physical activity easier or more accessible for all people in the places where they live. In 2016, the Community Preventive Services Task Force released a recommendation for built environment approaches to increase physical activity. This recommendation is based on a systematic review of 90 studies (search period, 1980-June 2014) conducted using methods outlined by the Guide to Community Preventive Services. The Community Preventive Services Task Force found sufficient evidence of effectiveness to recommend combined built environment strategies. Specifically, these strategies combine interventions to improve pedestrian or bicycle transportation systems with interventions to improve land use and environmental design. Components of transportation systems can include street pattern design and connectivity, pedestrian infrastructure, bicycle infrastructure, and public transit infrastructure and access. Components of land use and environmental design can include mixed land use, increased residential density, proximity to community or neighborhood destinations, and parks and recreational facility access. Implementing this Community Preventive Services Task Force recommendation in communities across the United States can help promote healthy and active living, increase physical activity, and ultimately improve cardiovascular health. |
Cross-sectional association between physical activity level and subjective cognitive decline among US adults aged 45years, 2015
Omura JD , Brown DR , McGuire LC , Taylor CA , Fulton JE , Carlson SA . Prev Med 2020 141 106279 Subjective cognitive decline (SCD) is the self-reported experience of worsening or more frequent confusion or memory loss within the previous 12 months and can be one of the earliest symptoms of Alzheimer's disease. Regular physical activity can contribute to the primary, secondary, and tertiary prevention of cognitive decline. At the national level, prevalence estimates of SCD by physical activity level in the United States are currently unknown. The purpose of this study is to examine the prevalence of SCD and resulting functional limitations by physical activity level among US adults aged ≥45 years. Data from 33 states and the District of Columbia participating in the 2015 Behavioral Risk Factor Surveillance System (N = 128,925) were analyzed. We estimated the prevalence of SCD (a positive response to a question about worsening or more frequent confusion or memory loss within the previous 12 months) and resulting functional limitations overall and by self-reported physical activity level based on current guidelines (i.e., active, insufficiently active, and inactive). Odds ratios were estimated using logistic regression models adjusting for respondent characteristics. Overall, 11.3% of US adults aged ≥45 years reported SCD. Prevalence of SCD increased as physical activity level decreased (active: 8.8%; insufficiently active: 11.4%; inactive: 15.7%). Among those with SCD, the prevalence of functional limitations also increased as physical activity level decreased (active: 40.5%; insufficiently active: 50.0%; inactive: 57.4%). These differences largely remained after adjusting for respondent characteristics. Findings highlight the potential public health impact nationally of efforts to promote physical activity for cognitive health. |
Prevalence of master plans supportive of active living in US municipalities
Peterson EL , Carlson SA , Schmid TL , Brown DR . Prev Med 2018 115 39-46 Community planning documents can play an important role in promoting the design and maintenance of walkable communities. This study estimates the prevalence among US municipalities of (1) community wide planning documents and (2) inclusion of plan objectives supportive of active living within these documents. Data from the 2014 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living (CBS HEAL), a survey of local officials, were analyzed (n=2005). Prevalence of comprehensive or general plans, 3 specific plan types, and 3 objectives supportive of active living were analyzed using survey weights to create national estimates. Overall, 64% of municipalities had a comprehensive/general plan, 46% had a transportation plan, 48% had a bicycle or pedestrian plan and 76% had a land use plan. Of municipalities with a plan, 78% included at least one of the three objectives measured supportive of active living. Differences in presence of plans and objectives were observed by population size of the municipality, urban status, region, and median education. Helping communities, especially smaller or rural municipalities and those with lower median education levels, create and adopt planning documents supportive of active living may be an important step in creating more walkable communities. |
Racial and ethnic differences in perceived safety barriers to walking, United States National Health Interview Survey - 2015
Whitfield GP , Carlson SA , Ussery EN , Watson KB , Brown DR , Berrigan D , Fulton JE . Prev Med 2018 114 57-63 Barriers to safe walking may prevent people from being physically active, and previous reports have identified differences in barriers to safe walking across racial and ethnic groups. The purpose of this research was to determine the role demographic characteristics play on racial/ethnic differences in perceived barriers to safe walking and determine if racial/ethnic differences vary by urban/rural residence and Census region. Participants in the 2015 National Health Interview Survey Cancer Control Supplement (n=31,433 adults >/=18years) reported perceived barriers to safe walking (traffic, crime, and animals) and demographic characteristics. Urban/rural residence and Census region were based on home addresses. We calculated adjusted prevalence of barriers by race/ethnicity using logistic regression; geographic differences in barriers across racial/ethnic groups were examined via interaction terms. After adjustment for demographic characteristics, non-Hispanic blacks (blacks) and Hispanics reported crime and animals as barriers more frequently than non-Hispanic whites (whites) (crime: blacks, 22.2%; Hispanics, 16.7%; whites, 9.0%; animals: blacks, 18.0%; Hispanics, 12.4%; whites, 8.5%). Racial/ethnic differences in perceived crime as a barrier were more pronounced in the Northeast and Midwest than in the South and West. Urban-dwelling blacks (all regions) and Hispanics (Midwest and South) reported animals as barriers more frequently than whites. Racial/ethnic differences in perceived barriers to safe walking remained after adjusting for demographic characteristics and varied by geographic location. Addressing perceived crime and animals as barriers to walking could help reduce racial/ethnic differences in physical activity, and several barriers may need to be assessed to account for geographic variation. |
Supporting active living through community plans: The association of planning documents with design standards and features
Peterson EL , Carlson SA , Schmid TL , Brown DR , Galuska DA . Am J Health Promot 2018 33 (2) 890117118779011 PURPOSE: The purpose of this study was to examine the association between the presence of supportive community planning documents in US municipalities with design standards and requirements supportive of active living. DESIGN: Cross-sectional study using data from the 2014 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living. SETTING: Nationally representative sample of US municipalities. PARTICIPANTS: Respondents are 2005 local officials. MEASURES: Assessed: (1) The presence of design standards and feature requirements and (2) the association between planning documents and design standards and feature requirements supportive of active living in policies for development. ANALYSIS: Using logistic regression, significant trends were identified in the presence of design standards and feature requirements by plan and number of supportive objectives present. RESULTS: Prevalence of design standards ranged from 19% (developer dedicated right-of-way for bicycle infrastructure development) to 50% (traffic-calming features in areas with high pedestrian and bicycle volume). Features required in policies for development ranged from 14% (short/medium pedestrian-scale block sizes) to 44% (minimum sidewalk widths of 5 feet) of municipalities. As the number of objectives in municipal plans increased, there was a significant and positive trend ( P < .05) in the prevalence of each design standard and requirement. CONCLUSIONS: Municipal planning documents containing objectives supportive of physical activity are associated with design standards and feature requirements supportive of activity-friendly communities. |
Proportion of adults who identified walking as a US Surgeon General priority
Kumar GS , Watson KB , Brown DR , Carlson SA . Prev Chronic Dis 2018 15 E62 In September 2015, Step It Up! The Surgeon General's Call to Action to Promote Walking and Walkable Communities (Call to Action) was released. This descriptive study reports the proportion of adults who responded to the 2016 Summer ConsumerStyles survey (N = 4,114) who identified walking as the activity the US Surgeon General recently promoted in the Call to Action to help Americans be more physically active. Less than half of adults (44%) correctly identified walking. Adults who were aged 18 to 24 years (35%), were male (43%), were non-Hispanic white (42%), or were physically inactive (36%) were less likely to identify walking than their counterparts. This study highlights an opportunity to raise awareness and promote the Call to Action, especially among certain populations. |
Research highlights from the status report for Step It Up! The Surgeon General's Call to Action to Promote Walking and Walkable Communities
Brown DR , Carlson SA , Kumar GS , Fulton JE . J Sport Health Sci 2017 7 (1) 5-6 In September 2015, the Office of the Surgeon General, U.S. Department of Health and Human Services, released Step it up! The surgeon general's call to action to promote walking and walkable communities (Call to Action) to increase walking among people across the USA.1 The Call to Action also recognized that walkable communities can accommodate wheelchair rolling and are inclusive of persons with disabilities. The Status Report for the Call to Action was released in 2017, summarizing the state of walking and walkability in the USA when the Call to Action was released and describing select actions done since to sustain the messages and promote the goals of the Call to Action (Table 1).2 These Research highlights briefly summarize the key findings of the Status Report. |
Achieving equity in physical activity participation: ACSM experience and next steps
Hasson RE , Brown DR , Dorn J , Barkley L , Torgan C , Whitt-Glover M , Ainsworth B , Keith N . Med Sci Sports Exerc 2017 49 (4) 848-858 There is clear and consistent evidence that regular physical activity is an important component of healthy lifestyles and fundamental to promoting health and preventing disease. Despite the known benefits of physical activity participation, many people in the United States remain inactive. More specifically, physical activity behavior is socially patterned with lower participation rates among women; racial/ethnic minorities; sexual minority youth; individuals with less education; persons with physical, mental, and cognitive disabilities; individuals >65 yr of age; and those living in the southeast region of the United States. Many health-related outcomes follow a pattern that is similar to physical activity participation. In response to the problem of inequities in physical activity and overall health in the United States, the American College of Sports Medicine (ACSM) has developed a national roadmap that supports achieving health equity through a physically active lifestyle. The actionable, integrated pathways that provide the foundation of ACSM's roadmap include the following: 1) communication-raising awareness of the issue and magnitude of health inequities and conveying the power of physical activity in promoting health equity; 2) education-developing educational resources to improve cultural competency for health care providers and fitness professionals as well as developing new community-based programs for lay health workers; 3) collaboration-building partnerships and programs that integrate existing infrastructures and leverage institutional knowledge, reach, and voices of public, private, and community organizations; and 4) evaluation-ensuring that ACSM attains measurable progress in reducing physical activity disparities to promote health equity. This article provides a conceptual overview of these four pathways of ACSM's roadmap, an understanding of the challenges and advantages of implementing these components, and the organizational and economic benefits of achieving health equity. |
Prevalence of modifiable cancer risk factors among U.S. adults aged 18-44 years
White MC , Shoemaker ML , Park S , Neff LJ , Carlson SA , Brown DR , Kanny D . Am J Prev Med 2017 53 S14-s20 INTRODUCTION: Carcinogen exposure and unhealthy habits acquired in young adulthood can set the stage for the development of cancer at older ages. This study measured the current prevalence of several cancer risk factors among young adults to assess opportunities to intervene to change the prevalence of these risk factors and potentially reduce cancer incidence. METHODS: Using 2015 National Health Interview Survey data (analyzed in 2016), the prevalence of potential cancer risk factors was estimated among U.S. adults aged 18-44 years, based on responses to questions about diet, physical activity, tobacco product use, alcohol, indoor tanning, sleep, human papillomavirus vaccine receipt, and obesity, stratified by sex, age, and race/ethnicity. RESULTS: The prevalence of some risk factors varied by age and race/ethnicity. Obesity (one in four people) and insufficient sleep (one in three people) were common among men and women. Physical inactivity (one in five men, one in four women); binge drinking (one in four men, one in eight women); cigarette smoking (one in five men, one in seven women); and frequent consumption of red meat (one in four men, one in six women) also were common. More than half of the population of adults aged 18-44 years consumed sugar-sweetened beverages daily and processed meat at least once a week. Most young adults had never had the human papillomavirus vaccine. CONCLUSIONS: Findings can be used to target evidence-based environmental and policy interventions to reduce the prevalence of cancer risk factors among young adults and prevent the development of future cancers. |
Building community: stakeholder perspectives on walking in malls and other venues
Belza B , Miyawaki CE , Allen P , King DK , Marquez DX , Jones DL , Janicek S , Rosenberg D , Brown DR . J Aging Phys Act 2017 25 (4) 1-41 Mall walking has been a popular physical activity for decades. However, little is known about why mall managers support these programs or why adults choose to walk. Our study aim was to describe mall walking programs from the perspective of walkers, managers, and leaders. Twenty-eight walkers, 16 walking program managers, and six walking program leaders from five states participated in a telephone or in-person semi-structured interview (N=50). Interview guides were developed using a social-ecological model. Interviews were recorded, transcribed verbatim, and analyzed thematically. All informants indicated satisfaction with their program and environmental features. Differences in expectations was noted in that walkers wanted a safe, clean, and social place whereas managers and leaders felt a need to provide programmatic features. Given the favorable walking environments in malls, there is an opportunity for public health professionals, health care organizations, and providers of aging services to partner with malls to promote walking. |
Safe, affordable,convenient: Environmental features of malls and other public spaces used by older adults for walking
King DK , Allen P , Jones DL , Marquez DX , Brown DR , Rosenberg D , Janicek S , Allen L , Belza B . J Phys Act Health 2016 13 (3) 289-95 BACKGROUND: Midlife and older adults use shopping malls for walking, but little research has examined mall characteristics that contribute to their walkability. METHODS: We used modified versions of the Centers for Disease Control and Prevention (CDC)-Healthy Aging Research Network (HAN) Environmental Audit and the System for Observing Play and Recreation in Communities (SOPARC) tool to systematically observe 443 walkers in 10 shopping malls. We also observed 87 walkers in 6 community-based nonmall/nongym venues where older adults routinely walked for physical activity. RESULTS: All venues had public transit stops and accessible parking. All malls and 67% of nonmalls had wayfinding aids, and most venues (81%) had an established circuitous walking route and clean, well-maintained public restrooms (94%). All venues had level floor surfaces, and one-half had benches along the walking route. Venues varied in hours of access, programming, tripping hazards, traffic control near entrances, and lighting. CONCLUSIONS: Despite diversity in location, size, and purpose, the mall and nonmall venues audited shared numerous environmental features known to promote walking in older adults and few barriers to walking. Future research should consider programmatic features and outreach strategies to expand the use of malls and other suitable public spaces for walking. |
Evaluation of the Physical Activity and Public Health Course for Practitioners
Evenson KR , Brown DR , Pearce E , Camplain R , Jernigan J , Epping J , Shepard DM , Dorn JM . Res Q Exerc Sport 2016 87 (2) 1-7 PURPOSE: From 1996 to 2013, a 6-day Physical Activity and Public Health Course for Practitioners has been offered yearly in the United States. An evaluation was conducted to assess the impact of the course on building public health capacity for physical activity and on shaping the physical activity and public health careers of fellows since taking the courses. METHOD: An evaluation quantified time that fellows spent in different course offerings and surveyed fellows. RESULTS: From 1996 to 2012, 410 fellows attended the course, and in 2013, 186 participated in the Web-based survey (56% response rate). The number of fellows attending the course ranged from 15 to 33 yearly. From 1996 to 2012, the course averaged 38 hr of instructional time that included topics on interventions and environment/policy work to increase physical activity, program evaluation, public health research, and health disparities. The course included consultations, collaborative work, and field-based experiences. Fellows who participated in the survey agreed that the course had a positive impact on the physical activity research or practice work they did (98%), met their expectations (96%), helped them with research/practice collaborations with other physical activity professionals (96%), assisted them in conducting higher-quality interventions/programs (95%), helped increase their professional networking in the field (93%), and had a positive impact on other work they did (91%). Following the course, 66% and 56% had further contact with faculty and other fellows, respectively. CONCLUSION: The Physical Activity and Public Health Course for Practitioners made important contributions toward building the capacity of physical activity and public health practitioners. |
Mall walking program environments, features, and participants: a scoping review
Farren L , Belza B , Allen P , Brolliar S , Brown DR , Cormier ML , Janicek S , Jones DL , King DK , Marquez DX , Rosenberg DE . Prev Chronic Dis 2015 12 E129 INTRODUCTION: Walking is a preferred and recommended physical activity for middle-aged and older adults, but many barriers exist, including concerns about safety (ie, personal security), falling, and inclement weather. Mall walking programs may overcome these barriers. The purpose of this study was to summarize the evidence on the health-related value of mall walking and mall walking programs. METHODS: We conducted a scoping review of the literature to determine the features, environments, and benefits of mall walking programs using the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance). The inclusion criteria were articles that involved adults aged 45 years or older who walked in indoor or outdoor shopping malls. Exclusion criteria were articles that used malls as laboratory settings or focused on the mechanics of walking. We included published research studies, dissertations, theses, conference abstracts, syntheses, nonresearch articles, theoretical papers, editorials, reports, policy briefs, standards and guidelines, and nonresearch conference abstracts and proposals. Websites and articles written in a language other than English were excluded. RESULTS: We located 254 articles on mall walking; 32 articles met our inclusion criteria. We found that malls provided safe, accessible, and affordable exercise environments for middle-aged and older adults. Programmatic features such as program leaders, blood pressure checks, and warm-up exercises facilitated participation. Individual benefits of mall walking programs included improvements in physical, social, and emotional well-being. Limited transportation to the mall was a barrier to participation. CONCLUSION: We found the potential for mall walking programs to be implemented in various communities as a health promotion measure. However, the research on mall walking programs is limited and has weak study designs. More rigorous research is needed to define best practices for mall walking programs' reach, effectiveness, adoption, implementation, and maintenance. |
Oral human papillomavirus is common in individuals with Fanconi anemia
Sauter SL , Wells SI , Zhang X , Hoskins EE , Davies SM , Myers KC , Mueller R , Panicker G , Unger ER , Sivaprasad U , Brown DR , Mehta PA , Butsch Kovacic M . Cancer Epidemiol Biomarkers Prev 2015 24 (5) 864-72 BACKGROUND: Fanconi Anemia (FA) is a rare genetic disorder resulting in a loss of function of the FA-related DNA repair pathway. Individuals with FA are predisposed to some cancers including oropharyngeal and gynecological cancers with known associations with human papillomavirus (HPV) in the general population. Since individuals with FA respond poorly to chemotherapy and radiation, prevention of cancer is critical. METHODS: To determine if individuals with FA are particularly susceptible to oral HPV infection, we analyzed survey-based risk factor data and tested DNA isolated from oral rinses from 126 individuals with FA and 162 unaffected first-degree family members for 37 HPV types. RESULTS: Fourteen individuals (11.1%) with FA tested positive, significantly more (p=0.003) than family members (2.5%). While HPV prevalence was even higher for sexually active individuals with FA (17.7% vs. 2.4% in family; p=0.003). HPV positivity also tended to be higher in the sexually inactive (8.7% in FA vs. 2.9% in siblings). Indeed, having FA increased HPV positivity 4.9 fold (95%CI: 1.6-15.4) considering age and sexual experience, but did not differ by other potential risk factors. CONCLUSION: Our studies suggest that oral HPV is more common in individuals with FA. It will be essential to continue to explore associations between risk factors and immune dysfunction on HPV incidence and persistence over time. Impact HPV vaccination should be emphasized in those with FA as a first step to prevent oropharyngeal cancers, although additional studies are needed to determine if the level of protection it offers in this population is adequate. |
Cancer prevention and worksite health promotion: time to join forces
Allweiss P , Brown DR , Chosewood LC , Dorn JM , Dube S , Elder R , Holman DM , Hudson HL , Kimsey CD Jr , Lang JE , Lankford TJ , Li C , Muirhead L , Neri A , Plescia M , Rodriguez J , Schill AL , Shoemaker M , Sorensen G , Townsend J , White MC . Prev Chronic Dis 2014 11 E128 The workplace is recognized as a setting that can profoundly influence workers’ health and well-being (1,2). The Centers for Disease Control and Prevention (CDC) workplace health promotion efforts address cancer prevention by focusing on cancer screening programs, community–clinical linkages, and cancer risk factors (eg, tobacco use, physical inactivity) that also influence risk for other chronic diseases (http://www.cdc.gov/workplacehealthpromotion/). Some efforts focus specifically on cancer; some focus on general chronic disease prevention. Additionally, the National Institute for Occupational Safety and Health (NIOSH), part of CDC, provides research and recommendations to address workplace hazards posed by chemicals that may increase cancer risk (http://www.cdc.gov/niosh/topics/cancer/policy.html). | Existing resources can be leveraged to expand the scope of workplace initiatives to address additional cancer risk factors and disparities. Changes to the physical and social characteristics of work environments are likely to have greater impact than health education alone (3). Given the aging US population (which is expected to result in a marked increase in the number of cancer diagnoses over the coming decades) and the prevalence of numerous risk factors among working-aged adults (4,5), a multifaceted approach to cancer prevention in the workplace is timely and needed. In addition, community-based prevention efforts may offer unrealized opportunities to reach vulnerable working populations who are not served by workplace health promotion programs. In this essay, we draw attention to a wide variety of available CDC resources and provide ideas for new efforts to advance primary cancer prevention among working adults. |
Physical activity and health-related quality of life: US adults with and without limitations
Brown DR , Carroll DD , Workman LM , Carlson SA , Brown DW . Qual Life Res 2014 23 (10) 2673-80 PURPOSE: The purpose of this study was to examine the dose-response relationship between physical activity (PA) and health-related quality of life (HRQOL) among adults with and without limitations. METHODS: We dichotomized HRQOL as ≥14 unhealthy (physical or mental) days (past 30 days), or <14 unhealthy days. By using a moderate-intensity minute equivalent, PA categories were as follows: inactive, 10-60, 61-149, 150-300, and >300 min/week. Persons with limitations reported having problems that limited their activities or required use of special equipment. Age-adjusted prevalence estimates and logistic regression analyses were performed with 2009 Behavioral Risk Factor Surveillance System data (n = 357,665), controlling for demographics, BMI, smoking, and heavy alcohol use. RESULTS: For adults without limitations, the odds of ≥14 unhealthy days were lower among adults obtaining any PA (10-60 min/week, AOR = 0.79, 95 % CI 0.70, 0.88), compared with those inactive. A quadratic trend (P < 0.001) indicated enhanced HRQOL with each PA level, but improvements were less marked between lower and upper sufficient PA categories (150-300 and >300 min/week). Because of a significant age interaction, persons with limitations were stratified by age (18-34, 35-64, and 65+ years). Findings for persons aged 35 years or older with limitations were similar to those without limitations. Lower odds of poor HRQOL for persons aged 18-34 years with limitations were associated with recommended levels of PA (150-300 min/week; AOR = 0.61, 95 % CI 0.43, 0.88 and >300 min/week; AOR = 0.58, 95 % CI 0.43, 0.80). CONCLUSIONS: PA is positively associated with HRQOL among persons with and without limitations. |
Vital signs: disability and physical activity - United States, 2009-2012
Carroll DD , Courtney-Long EA , Stevens AC , Sloan ML , Lullo C , Visser SN , Fox MH , Armour BS , Campbell VA , Brown DR , Dorn JM . MMWR Morb Mortal Wkly Rep 2014 63 (18) 407-13 BACKGROUND: Adults with disabilities are less active and have higher rates of chronic disease than the general population. Given the health benefits of physical activity, understanding physical activity, its relationship with chronic disease, and health professional recommendations for physical activity among young to middle-age adults with disabilities could help increase the effectiveness of health promotion efforts. METHODS: Data from the 2009-2012 National Health Interview Survey (NHIS) were used to estimate the prevalence of, and association between, aerobic physical activity (inactive, insufficiently active, or active) and chronic diseases (heart disease, stroke, diabetes, and cancer) among adults aged 18-64 years by disability status and type (hearing, vision, cognitive, and mobility). The prevalence of, and association between, receiving a health professional recommendation for physical activity and level of aerobic physical activity was assessed using 2010 data. RESULTS: Overall, 11.6% of U.S. adults aged 18-64 years reported a disability, with estimates for disability type ranging from 1.7% (vision) to 5.8% (mobility). Compared with adults without disabilities, inactivity was more prevalent among adults with any disability (47.1% versus 26.1%) and for adults with each type of disability. Inactive adults with disabilities were 50% more likely to report one or more chronic diseases than those who were physically active. Approximately 44% of adults with disabilities received a recommendation from a health professional for physical activity in the past 12 months. CONCLUSIONS: Almost half of adults with disabilities are physically inactive and are more likely to have a chronic disease. Among adults with disabilities who visited a health professional in the past 12 months, the majority (56%) did not receive a recommendation for physical activity. IMPLICATIONS FOR PUBLIC HEALTH: These data highlight the need for increased physical activity among persons with disabilities, which might require support across societal sectors, including government and health care. |
Stand-alone mass media campaigns to increase physical activity: updated findings from the Community Preventive Services Task Force
Community Preventive Services Task Force , Brown DR . Am J Prev Med 2012 43 (5) 562-4 SUMMARY: The Community Preventive Services Task Force concludes there is insufficient evidence to determine the effectiveness of stand-alone mass media campaigns to increase physical activity at the population level. Additional research is needed to determine effectiveness. |
Stand-alone mass media campaigns to increase physical activity: a Community Guide updated review
Brown DR , Soares J , Epping JM , Lankford TJ , Wallace JS , Hopkins D , Buchanan LR , Orleans CT , Community Preventive Services Task Force . Am J Prev Med 2012 43 (5) 551-61 CONTEXT: The goal of the systematic review described in this summary was to determine the effectiveness of stand-alone mass media campaigns to increase physical activity at the population level. This systematic review is an update of a Community Guide systematic review and Community Preventive Services Task Force recommendation completed in 2001. EVIDENCE ACQUISITION: Updated searches for literature published from 1980 to 2008 were conducted in 11 databases. Of 267 articles resulting from the literature search, 16 were selected for full abstraction, including the three studies from the original 2001 review. Standard Community Guide methods were used to conduct the systematic evidence review. EVIDENCE SYNTHESIS: Physical activity outcomes were assessed using a variety of self-report measures with duration intervals ranging from 6 weeks to 4 years. Ten studies using comparable outcome measures documented a median absolute increase of 3.4 percentage points (interquartile interval: 2.4 to 4.2 percentage points), and a median relative increase of 6.7% (interquartile interval: 3.0% to 14.1%), in self-reported physical activity levels. The remaining six studies used alternative outcome measures: three evaluated changes in self-reported time spent in physical activity (median relative change, 4.4%; range of values, 3.1%-18.2%); two studies used a single outcome measure and found that participants reported being more active after the campaign than before it; and one study found that a mass media weight-loss program led to a self-reported increase in physical activity. CONCLUSIONS: The findings of this updated systematic review show that intervention effects, based wholly on self-reported measures, were modest and inconsistent. These findings did not lead the Task Force to change its earlier conclusion of insufficient evidence to determine the effectiveness of stand-alone mass media campaigns to increase physical activity. This paper also discusses areas needing future research to strengthen the evidence base. Finally, studies published between 2009 and 2011, after the Task Force finding was reached, and briefly summarized here, are shown to support that finding. |
Effect of exercise on cognitive performance in community-dwelling older adults: review of intervention trials and recommendations for public health practice and research
Snowden M , Steinman L , Mochan K , Grodstein F , Prohaska TR , Thurman DJ , Brown DR , Laditka JN , Soares J , Zweiback DJ , Little D , Anderson LA . J Am Geriatr Soc 2011 59 (4) 704-16 There is evidence from observational studies that increasing physical activity may reduce the risk of cognitive decline in older adults. Exercise intervention trials have found conflicting results. A systematic review of physical activity and exercise intervention trials on cognition in older adults was conducted. Six scientific databases and reference lists of previous reviews were searched. Thirty studies were eligible for inclusion. Articles were grouped into intervention-outcome pairings. Interventions were grouped as cardiorespiratory, strength, and multicomponent exercises. Cognitive outcomes were general cognition, executive function, memory, reaction time, attention, cognitive processing, visuospatial, and language. An eight-member multidisciplinary panel rated the quality and effectiveness of each pairing. Although there were some positive studies, the panel did not find sufficient evidence that physical activity or exercise improved cognition in older adults. Future research should report exercise adherence, use longer study durations, and determine the clinical relevance of measures used. |
Racial/Ethnic differences in perceived access, environmental barriers to use, and use of community parks
Carlson SA , Brooks JD , Brown DR , Buchner DM . Prev Chronic Dis 2010 7 (3) A49 INTRODUCTION: Community parks provide places for people to be physically active. Our objective was to determine how access to, barriers to use of, and use of community parks differ by race/ethnicity. METHODS: Analyses are based on a cross-sectional national sample of adults (N = 5,157) participating in the 2006 HealthStyles mail survey. Community parks were defined as outdoor public areas within 10 miles or a 20-minute drive from where a person lives that include walking/bike paths, nature preserves, playgrounds, beaches, lakes, rivers, or similar places. RESULTS: Overall, 12% of respondents reported not having a community park. Among those with a community park, 14% reported personal safety concerns and 14% reported inadequate or poorly maintained facilities as barriers to park use. Race/ethnicity was not associated with park access; however, Hispanics and non-Hispanic blacks were more likely than non-Hispanic whites to report barriers. Among those with access to a community park, 83% reported any park use in the previous year and, of these, 67% reported an active visit. Odds of any park use did not differ significantly by race/ethnicity. Odds of an active visit were significantly lower in non-Hispanic blacks than whites (odds ratio, 0.67) but did not significantly differ between Hispanics and non-Hispanic whites. CONCLUSION: Parks are valuable community resources to all racial/ethnic groups. To promote and increase community park use, it is important to be aware that parks are used differently by different racial/ethnic groups and that barriers may differentially influence park use. |
Obesity, physical activity, and depressive symptoms in a cohort of adults aged 51 to 61
Carroll DD , Blanck HM , Serdula MK , Brown DR . J Aging Health 2010 22 (3) 384-98 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. |
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