Increasing Walking in the Hartsfield-Jackson Atlanta International Airport: The Walk to Fly Study.

OBJECTIVES: To test the effectiveness of a point-of-decision intervention to prompt walking, versus motorized transport, in a large metropolitan airport. METHODS: We installed point-of-decision prompt signage at 4 locations in the airport transportation mall at Hartsfield-Jackson Atlanta International Airport (Atlanta, GA) at the connecting corridor between airport concourses. Six ceiling-mounted infrared sensors counted travelers entering and exiting the study location. We collected traveler counts from June 2013 to May 2016 when construction was present and absent (preintervention period: June 2013-September 2014; postintervention period: September 2014-May 2016). We used a model that incorporated weekly walking variation to estimate the intervention effect on walking. RESULTS: There was an 11.0% to 16.7% relative increase in walking in the absence of airport construction where 580 to 810 more travelers per day chose to walk. Through May 2016, travelers completed 390 000 additional walking trips. CONCLUSIONS: The Walk to Fly study demonstrated a significant and sustained increase in the number of airport travelers choosing to walk. Providing signage about options to walk in busy locations where reasonable walking options are available may improve population levels of physical activity and therefore improve public health.

Harmonization of three different accelerometers to classify the 24 h activity cycle.

Increasing interest in measuring key components of the 24 h activity cycle (24-HAC) [sleep, sedentary behavior (SED), light physical activity (LPA), and moderate to vigorous physical activity (MVPA)] has led to a need for better methods. Single wrist-worn accelerometers and different self-report instruments can assess the 24-HAC but may not accurately classify time spent in the different components or be subject to recall errors.Objective. To overcome these limitations, the current study harmonized output from multiple complimentary research grade accelerometers and assessed the feasibility and logistical challenges of this approach.Approach. Participants (n= 108) wore an: (a) ActiGraph GT9X on the wrist, (b) activPAL3 on the thigh, and (c) ActiGraph GT3X+ on the hip for 7-10 d to capture the 24-HAC. Participant compliance with the measurement protocol was compared across devices and an algorithm was developed to harmonize data from the accelerometers. The resulting 24-HAC estimates were described within and across days.Main results. Usable data for each device was obtained from 94.3% to 96.7% of participants and 89.4% provided usable data from all three devices. Compliance with wear instructions ranged from 70.7% of days for the GT3X+ to 93.2% of days for the activPAL3. Harmonized estimates indicated that, on average, university students spent 34% of the 24 h day sleeping, 41% sedentary, 21% in LPA, and 4% in MVPA. These behaviors varied substantially by time of day and day of the week.Significance. It is feasible to use three accelerometers in combination to derive a harmonized estimate the 24-HAC. The use of multiple accelerometers can minimize gaps in 24-HAC data however, factors such as additional research costs, and higher participant and investigator burden, should also be considered.

Dietary intakes differ between LGBTQ + and non-LGBTQ + college students.

Objective: To compare dietary intakes between LGBTQ + and non-LGBTQ + college students. Participants: Participants were LGBTQ+ (n = 92) and non-LGBTQ+ (n = 491) college students. Methods: The 26-item Dietary Screener Questionnaire assessed intakes of added sugars, fiber, whole grains, fruits and vegetables, dairy, and calcium. Percentage of participants meeting Dietary Guidelines for Americans were also computed. Multivariate ANCOVA assessed differences in dietary intake. Chi-square analyses assessed differences in proportions of LGBTQ + and non-LGBTQ + students meeting recommendations. Results: LGBTQ + students reported lower intakes of fiber, whole grains, fruit, and fruits and vegetables both including and excluding French fries (all p < 0.05). Fewer LGBTQ + students met recommendations for fruit (5.7%) compared to their non-LGBTQ + counterparts (14.2%; p = .03). Conclusions: LGBTQ + students report poorer indices of diet quality compared to non-LGBTQ + students. Health promotion programming efforts to improve these outcomes may need to be tailored differently for students who identify as LGBTQ+.

Differences in physical activity and perceived benefits and barriers to physical activity between LGBTQ + and non-LGBTQ + college students.

ObjectiveTo compare physical activity (PA) behaviors and perceived benefits and barriers among lesbian, gay, bisexual, transgender, and queer (LGBTQ+) and non-LGBTQ + college students. Participants: Participants were 406 college students. Methods: Surveys assessed PA behaviors and perceptions of PA among college students. Multivariate ANOVA assessed differences in PA behaviors and perceptions of PA. Results: LGBTQ + students (n = 71) engaged in 17% less aerobic PA and 42% less resistance training than their counterparts (n = 335; both p < .05). LGBTQ + students reported 6.5% lower total Exercise Benefits and Barriers Scale scores and 13.3% higher Barriers Scale scores (both p < .05). Conclusions: LGBTQ + college students are at higher risk of not meeting PA guidelines than non-LGBTQ + students. More perceived barriers and fewer perceived benefits to PA may contribute to this disparity. Identification of LGBTQ+-specific barriers to PA among college students is needed to inform programming to increase PA among this at-risk community.

Physical activity and perceived benefits, but not barriers, to exercise differ by sex and school year among college students.

Objective: To assess whether sex or school year influence physical activity and exercise (PA/EX) behaviors and perceived benefits and barriers of PA/EX among college students. Participants: Participants were 862 (78% female; 20.1 ± 1.4 years) college students. Methods: The International Physical Activity Questionnaire, Exercise Benefits and Barriers Scale, and resistance training (RT) questions were completed online. Results: Factorial ANOVA (sex x year) determined no significant interaction effects of sex and school year in behaviors or perceived benefits and barriers (all p > .05). Males reported higher levels of PA/EX and RT than females (p < .05) with no differences by school year (p = .34). Benefits Scale scores and some of its subscales were higher for males and first-year students compared to females and third- and fourth-year students (all p < .05). Conclusion: PA/EX promotion programs may need to be tailored differently based on sex and school year.

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.

U.S. Adults' Participation in Specific Activities: Behavioral Risk Factor Surveillance System--2011.

BACKGROUND: There is little information on national estimates for participation in types of aerobic activities among U.S. adults. Current estimates are important to develop appropriate and effective interventions to promote physical activity and interpret bias for some activities measured with devices. METHODS: The percentage of adults participating in specific aerobic activities was estimated overall and by demographic subgroups. The 2011 Behavioral Risk Factor Surveillance System respondents (N = 446,216) reported up to 2 aerobic activities they spent the most time doing during the past month. RESULTS: Overall, walking (47%) was the most common activity reported and was reported more by women (54%) than men (41%). Participation in most activities declined with increasing age (P < .006). There were a number of differences in participation between race/ethnic subgroups. Participation increased with more education (P for trend < 0.006) for all activities. Participation in most activities was different (P < .002) across BMI subgroups. CONCLUSIONS: Walking is the most common activity, overall and among most subgroups. Other activity profiles differ by demographic subgroup. Physical activity promotion strategies that focus on identifying and addressing personal and environmental barriers and understanding demographic subgroup differences could lead to more tailored interventions and public health programs.

Estimated energy expenditures for school-based policies and active living.

BACKGROUND: Despite overwhelming evidence of the health benefits of physical activity, most American youth are not meeting the 60 minutes per day recommendation for moderate- to vigorous-intensity physical activity (MVPA). Policy changes have the potential to bring about substantial increases in physical activity in youth, within school and community settings. PURPOSE: The purpose of this study was to quantify the increase in energy expenditure for school-based policies and built environment changes. METHODS: Scientific literature reviews were consulted, and more than 300 published studies (1995-2011) in English were identified based on titles and abstracts. After an initial screening, 85 articles were included. Study quality was assessed, and the impact of various strategies for increasing physical activity in youth was estimated from objective measurements/direct observation. RESULTS: Within school settings, the average minutes of MVPA gained per school day for studies in each intervention category were as follows: mandatory physical education (23 minutes); classroom activity breaks (19 minutes); afterschool activity programs (10 minutes); standardized physical education curricula (6 minutes more than traditional physical education); modified playgrounds (6 minutes); and modified recess (5 minutes more than traditional recess). Within community settings, significant MVPA was associated with active commuting (16 minutes) and park renovations (12 minutes), but proximity to parks had a small effect (1 minute). No conclusions could be drawn regarding joint-use agreements, because of a lack of studies quantifying their impact on energy expenditure. CONCLUSIONS: Of the various policies and built environment changes examined, the largest effects were seen with mandatory physical education, classroom activity breaks, and active commuting to school. Policymakers can use this information along with estimates of the cost, feasibility, and population reach, to identify the best options for increasing physical activity in youth.