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1.
J Phys Act Health ; 16(8): 618-622, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-31319401

RESUMO

BACKGROUND: To estimate the proportion of adults' and parents' knowledge of the adult aerobic and youth physical activity guidelines, respectively, in the United States. METHODS: Data were analyzed from a national sample of adults in the 2017 ConsumerStyles survey. Prevalence of knowledge of the adult aerobic guideline (ie, 150 min/wk of moderate-intensity activity) was estimated among all respondents (n = 3910) and of the youth guideline (ie, 60 min/d of physical activity on 7 d/wk) among parents (n = 1288). Odds ratios were estimated using logistic regression models adjusting for demographic characteristics. RESULTS: Overall, 2.5% (95% confidence interval, 2.0-3.1) of adults and 23.0% (95% confidence interval, 20.5-25.7) of parents were knowledgeable of the adult aerobic and youth guidelines, respectively. After adjustment, odds of knowledge of the adult guideline differed significantly by sex and physical activity level, whereas knowledge of the youth guideline differed by parental education level. CONCLUSIONS: Despite the release of the 2008 Physical Activity Guidelines for Americans nearly a decade ago, most US adults and parents lack knowledge of the adult aerobic and youth physical activity guidelines. Effective communication strategies may help raise awareness of current and future editions of national guidelines for physical activity.

2.
Prev Chronic Dis ; 16: E66, 2019 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-31146804

RESUMO

INTRODUCTION: Cardiovascular disease (CVD) is the leading cause of death in the United States, and increasing physical activity can help prevent and manage disease. Walking is an easy way for most adults to be more active and may help people at risk for CVD avoid inactivity, increase their physical activity levels, and improve their cardiovascular health. To guide efforts that promote walking for CVD prevention and management, we estimated the prevalence of walking among US adults by CVD risk status. METHODS: Nationally representative data on walking from participants (N = 29,742) in the 2015 National Health Interview Survey Cancer Control Supplement were analyzed. We estimated prevalence of walking (ie, any, transportation, and leisure) overall and by CVD status. We defined CVD status as either not having CVD and not at risk for CVD; being at risk for CVD (overweight or having obesity plus 1 or more additional risk factors); or having CVD. We defined additional risk factors as diabetes, high cholesterol, or hypertension. Odds ratios were estimated by using logistic regression models adjusted for respondent characteristics. RESULTS: Prevalence of any walking decreased with increasing CVD risk (no CVD/not at risk, 66.6%; at risk: overweight or has obesity with 1 risk factor, 63.0%; with 2 risk factors, 59.5%; with 3 risk factors, 53.6%; has CVD, 50.2%). After adjusting for respondent characteristics, the odds of any walking and leisure walking decreased with increasing CVD risk. However, CVD risk was not associated with walking for transportation. CONCLUSIONS: Promoting walking may be a way to help adults avoid inactivity and encourage an active lifestyle for CVD prevention and management.

3.
Am J Health Promot ; 33(8): 1134-1143, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31195803

RESUMO

PURPOSE: Step It Up! The Surgeon General's Call to Action to Promote Walking and Walkable Communities (Call to Action) presents goals and supporting strategies to promote walking. We assessed the presence and prioritization of 4 community supports for walking related to the goals of the Call to Action from the perspective of US adults. DESIGN: Cross-sectional web-based survey. SETTING: US adults. PARTICIPANTS: A total of 4043 respondents. MEASURES: SummerStyles 2016 survey assessing the reported presence and prioritization of 4 community supports for walking. ANALYSIS: Estimated prevalence of the presence of supports overall and by demographic characteristics, and prevalence and adjusted prevalence ratios of their prioritization. RESULTS: The most commonly reported community supports for walking were access to walkable locations (46.5%) and safe streets (29.2%), followed by walking groups (12.9%) and promotional campaigns (9.6%). Access to walkable locations (60.0%) and safe streets (50.6%) were most often prioritized by respondents, followed by promotional campaigns (23.6%) and walking groups (18.8%). Many differences in prioritization by demographic characteristics remained significant after adjusting for presence and other demographic characteristics, such as increased prioritization of all supports with older age groups. CONCLUSIONS: Presence and prioritization of community supports for walking varied widely by type of support and by demographic characteristics. Opportunities exist to improve access and public sentiment related to these supports to promote walking in the United States.

4.
MMWR Morb Mortal Wkly Rep ; 68(23): 513-518, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31194722

RESUMO

Since the release of the 2008 Physical Activity Guidelines for Americans (https://health.gov/paguidelines/2008/pdf/paguide.pdf), the age-adjusted percentage of adults meeting the combined aerobic and muscle-strengthening guidelines increased from 18.2% to 24.3% in 2017 (1). Trends in urban and rural areas, across demographic subgroups, and among subgroups within urban and rural areas have not been reported. CDC analyzed 2008-2017 National Health Interview Survey (NHIS) data to examine trends in the age-standardized prevalence of meeting physical activity guidelines among adults aged ≥18 years living in urban and rural areas. Among urban and rural residents, prevalence increased from 19.4% to 25.3% and from 13.3% to 19.6%, respectively. Nationally, all demographic subgroups and regions experienced increases over this period; increases for several groups were not consistent year-to-year. Among urban residents, the prevalence was higher during 2016-2017 than during 2008-2009 for all demographic subgroups and regions. During the same period, prevalence was higher across all rural-dwelling subgroups except Hispanics, adults with a college education, and those living in the South U.S. Census region. Urban and rural communities can implement evidence-based approaches, including improved community design, improved access to indoor and outdoor recreation facilities, social support programs, and community-wide campaigns to make physical activity the safe and easy choice for persons of all ages and abilities (2-4). Incorporating culturally appropriate strategies into local programs might help address differences across subgroups.


Assuntos
Exercício , Fidelidade a Diretrizes/tendências , Guias como Assunto , População Rural/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos , Adulto Jovem
5.
MMWR Morb Mortal Wkly Rep ; 68(17): 381-387, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31048678

RESUMO

An estimated 54.4 million (approximately one in four) U.S. adults have doctor-diagnosed arthritis (arthritis) (1). Severe joint pain and physical inactivity are common among adults with arthritis and are linked to adverse mental and physical health effects and limitations (2,3). CDC analyzed 2017 Behavioral Risk Factor Surveillance System (BRFSS) data to estimate current state-specific prevalence of arthritis and, among adults with arthritis, the prevalences of severe joint pain and physical inactivity. In 2017, the median age-standardized state prevalence of arthritis among adults aged ≥18 years was 22.8% (range = 15.7% [District of Columbia] to 34.6% [West Virginia]) and was generally highest in Appalachia and Lower Mississippi Valley regions.* Among adults with arthritis, age-standardized, state-specific prevalences of both severe joint pain (median = 30.3%; range = 20.8% [Colorado] to 45.2% [Mississippi]) and physical inactivity (median = 33.7%; range = 23.2% [Colorado] to 44.4% [Kentucky]) were highest in southeastern states. Physical inactivity prevalence among those with severe joint pain (47.0%) was higher than that among those with moderate (31.8%) or no/mild joint pain (22.6%). Self-management strategies such as maintaining a healthy weight or being physically active can reduce arthritis pain and prevent or delay arthritis-related disability. Evidence-based physical activity and self-management education programs are available that can improve quality of life among adults with arthritis.


Assuntos
Artralgia/epidemiologia , Artrite/epidemiologia , Comportamento Sedentário , Índice de Gravidade de Doença , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Adulto Jovem
6.
Prev Med ; 123: 101-108, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30878571

RESUMO

Built environments that provide activity-friendly routes (e.g., sidewalks) to everyday destinations (e.g., shops) can increase physical activity. Surveillance of supports and destinations is important, and identifying which are associated with walking could prioritize surveillance questions. Our purpose was to identify the significant associations between supports and destinations with walking among a nationally-representative sample of urban- and rural-dwelling adults. Participants in the 2015 National Health Interview Survey, Cancer Control Supplement (n = 29,925) reported the near-home presence of walkable supports (roads, sidewalks, paths, or trails; sidewalks on most streets), destinations (shops; transit; movies, libraries, or churches; relaxing places), and past-week walking for leisure or transportation. We used stepwise logistic regression to quantify associations between supports and destinations and walking, including by urban/rural residence. We calculated the prevalence of walking across counts of reported elements by urban/rural residence. Among all participants, roads, sidewalks, paths, or trails and relaxing destinations were associated with leisure walking. Among urban residents, sidewalks on most streets and all four destination types were associated with transportation walking; among rural residents, roads, sidewalks, paths, or trails; movies, libraries, or churches; and relaxing destinations were associated with transportation walking. Walking was more common when more environmental elements were reported. To improve efficiency, communities may match surveillance priorities to behavioral priorities (i.e., leisure versus transportation walking) and environmental context (i.e., urban/rural areas). Surveillance of environments supporting leisure walking might focus on recreation-oriented spaces. Surveillance of environments supporting transportation walking might differ for urban and rural areas, and assessing destinations may be particularly important.

7.
JAMA Netw Open ; 2(3): e190355, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30848809

RESUMO

Importance: Although the benefits of leisure-time physical activity (LTPA) in middle age are established, the health effects of long-term participation and changes in LTPA between adolescence and middle age have not been documented. Objective: To determine whether an association exists between LTPA life course patterns and mortality. Design, Setting, and Participants: This prospective cohort study used data from the National Institutes of Health-AARP (formerly American Association of Retired Persons) Diet and Health Study established in 1995 to 1996. Data analysis was conducted from March 2017 through February 2018. Data were analyzed for 315 059 adult AARP members living in 6 states, namely, California, Florida, Louisiana, New Jersey, North Carolina, or Pennsylvania, or 2 metropolitan areas, Atlanta, Georgia, or Detroit, Michigan. Exposures: Self-reported LTPA (hours per week) at the baseline interview for ages grouped as 15 to 18, 19 to 29, 35 to 39, and 40 to 61 years. Main Outcomes and Measures: All-cause, cardiovascular disease (CVD)-related, and cancer-related mortality records available through December 31, 2011. Results: Of 315 059 participants, 183 451 (58.2%) were men, and the participants were 50 to 71 years of age at enrollment. Ten LTPA trajectories (categorized as maintaining, increasing, and decreasing LTPA across time) were identified, and 71 377 deaths due to all causes, 22 219 deaths due to CVD, and 16 388 deaths due to cancer occurred. Compared with participants who were consistently inactive throughout adulthood, participants who maintained the highest amount of LTPA in each age period were at lower risks for all-cause, CVD-related, and cancer-related mortality. For example, compared with participants who were consistently inactive, maintaining higher amounts of LTPA was associated with lower all-cause (hazard ratio [HR], 0.64; 95% CI, 0.60-0.68), CVD-related (HR, 0.58; 95% CI, 0.53-0.64), and cancer-related (HR, 0.86; 95% CI, 0.77-0.97) mortality. Adults who were less active throughout most of the adult life course but increased LTPA in later adulthood (40-61 years of age) also had lower risk for all-cause (HR, 0.65; 95% CI, 0.62-0.68), CVD-related (HR, 0.57; 95% CI, 0.53-0.61), and cancer-related (HR, 0.84; 95% CI, 0.77-0.92) mortality. Conclusions and Relevance: Maintaining higher LTPA levels and increasing LTPA in later adulthood were associated with comparable low risk of mortality, suggesting that midlife is not too late to start physical activity. Inactive adults may be encouraged to be more active, whereas young adults who are already active may strive to maintain their activity level as they get older.

8.
Prev Med ; 119: 100-107, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30594537

RESUMO

Recent studies of middle age and older adults with, or at risk for, arthritis demonstrate that engaging in physical activities like walking - even at levels below the current aerobic physical activity guideline of ≥150 min of moderate-intensity activity - can protect against onset of functional limitations. Using a large nationally representative sample of US adults ≥18 years with arthritis, we investigated whether, among those not meeting the aerobic activity guideline, walking ≥10 min/week vs. <10 min/week reduced the risk of six outcomes (fair/poor health and five physical limitations) over 2 years. We conducted a prospective cohort study among adults with arthritis in the 2010 National Health Interview Survey who participated in the 2011-2012 Medical Expenditure Panel Survey (n = 1426). Among adults not meeting the guideline, we examined the effect of walking on risk of developing each of six outcomes using hazard ratios (HRs) estimated from multivariable Cox regression models. Among adults with arthritis not meeting the guideline, compared to walking <10 min/week, walking ≥10 min/week was associated with a statistically significant decreased risk for all five limitations: walking three blocks (HR: 0.3 [95% CI = 0.2-0.6]), climbing 10 stairs (HR: 0.5 [95% CI = 0.3-0.8]), stooping/kneeling (HR: 0.4 [95% CI = 0.2-0.8]), reaching overhead (HR: 0.5[95% CI = 0.5-0.8]), and grasping (HR: 0.4 [95% CI = 0.2-0.7]). The decrease in risk was not significant for fair/poor health. Even limited walking may prevent the onset of physical limitations among adults with arthritis of all ages not meeting the aerobic activity guideline.

10.
JAMA ; 320(19): 2020-2028, 2018 11 20.
Artigo em Inglês | MEDLINE | ID: mdl-30418471

RESUMO

Importance: Approximately 80% of US adults and adolescents are insufficiently active. Physical activity fosters normal growth and development and can make people feel, function, and sleep better and reduce risk of many chronic diseases. Objective: To summarize key guidelines in the Physical Activity Guidelines for Americans, 2nd edition (PAG). Process and Evidence Synthesis: The 2018 Physical Activity Guidelines Advisory Committee conducted a systematic review of the science supporting physical activity and health. The committee addressed 38 questions and 104 subquestions and graded the evidence based on consistency and quality of the research. Evidence graded as strong or moderate was the basis of the key guidelines. The Department of Health and Human Services (HHS) based the PAG on the 2018 Physical Activity Guidelines Advisory Committee Scientific Report. Recommendations: The PAG provides information and guidance on the types and amounts of physical activity to improve a variety of health outcomes for multiple population groups. Preschool-aged children (3 through 5 years) should be physically active throughout the day to enhance growth and development. Children and adolescents aged 6 through 17 years should do 60 minutes or more of moderate-to-vigorous physical activity daily. Adults should do at least 150 minutes to 300 minutes a week of moderate-intensity, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous-intensity aerobic activity. They should also do muscle-strengthening activities on 2 or more days a week. Older adults should do multicomponent physical activity that includes balance training as well as aerobic and muscle-strengthening activities. Pregnant and postpartum women should do at least 150 minutes of moderate-intensity aerobic activity a week. Adults with chronic conditions or disabilities, who are able, should follow the key guidelines for adults and do both aerobic and muscle-strengthening activities. Recommendations emphasize that moving more and sitting less will benefit nearly everyone. Individuals performing the least physical activity benefit most by even modest increases in moderate-to-vigorous physical activity. Additional benefits occur with more physical activity. Both aerobic and muscle-strengthening physical activity are beneficial. Conclusions and Relevance: The Physical Activity Guidelines for Americans, 2nd edition, provides information and guidance on the types and amounts of physical activity that provide substantial health benefits. Health professionals and policy makers should facilitate awareness of the guidelines and promote the health benefits of physical activity and support efforts to implement programs, practices, and policies to facilitate increased physical activity and to improve the health of the US population.

11.
Prev Med ; 118: 191-195, 2018 Oct 25.
Artigo em Inglês | MEDLINE | ID: mdl-30416098

RESUMO

Children and adolescents can engage in an active lifestyle by walking to school; however, several barriers may limit this behavior. This study estimates the prevalence of walking to school and related barriers as reported by U.S. parents. Data from the 2017 SummerStyles, a Web-based survey conducted on a nationwide sample of U.S. adults, were analyzed in 2017. Parents of children aged 5-18 years (n = 1137) were asked whether their youngest child walked to or from school during a usual school week and what barriers make this difficult. Frequencies are presented overall and by parent characteristics. About 1 in 6 parents (16.5%) reported their youngest child walks to or from school at least once during a usual week. Prevalence differed by parental race/ethnicity, marital status, region, and distance from school. The most common barrier was living too far away (51.3%), followed by traffic-related danger (46.2%), weather (16.6%), "other" barrier (14.7%), crime (11.3%), and school policy (4.7%). The frequency at which parents reported certain barriers varied by their child's walking status, distance to school, age of youngest child, race/ethnicity, education level, household income, and metropolitan statistical area status. However, the relative ranking of barriers did not differ by these characteristics. Prevalence of walking to school is low in the U.S., and living too far away and traffic-related danger are common barriers reported by parents. Implementing Safe Routes to School programs and other initiatives that utilize strategies to overcome locally-relevant barriers could help increase the prevalence of children walking to school.

13.
Artigo em Inglês | MEDLINE | ID: mdl-30346654

RESUMO

BACKGROUND: Walking is a joint-friendly activity for adults with arthritis. OBJECTIVES: to estimate, among adults with arthritis, the 1) prevalence of leisure and transportation walking overall, by arthritis status, and by sociodemographic and health characteristics, 2) number of total minutes walking per week in each domain, and 3) distributions of walking bout length in minutes METHODS: Data were from the 2010 National Health Interview Survey. Prevalence estimates (% and 95% confidence intervals (CI)) of leisure and transportation walking in the past 7 days and walking bout time in minutes were calculated, as were multivariable (MV) Poisson regression models, accounting for the complex sample design. RESULTS: Prevalence of leisure walking was 45.9% (95% CI=44.2-47.6) for those with arthritis vs 51.9% (95% CI 50.9-52.9) for those without. Transportation walking prevalence was 23.0% (95% CI=21.7-24.4) for those with arthritis vs. 32.0% (95% CI=31.0-33.0) for those without. Total minutes of leisure walking per week did not differ by arthritis status (77.3 vs. 78.3, p=0.62), while minutes of transportation walking did (49.8 vs. 58.1, p=0.03). Most common walking bout length differed between leisure (26-40 minutes) and transportation (10-15 minute) walking but not by arthritis status. In separate adjusted MV models, obesity was consistently negatively associated with both walking outcomes, and being physically active was positively associated; lower extremity joint pain was not associated. CONCLUSIONS: Leisure and transportation walking could be adopted by large proportions of adults with arthritis by adding short bouts. Existing evidence-based programs can help increase physical activity. This article is protected by copyright. All rights reserved.

14.
Am J Prev Med ; 55(6): 887-895, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30344032

RESUMO

INTRODUCTION: Walking can serve many purposes, such as transportation (to get some place) or leisure (for fun, relaxation, or exercise); therefore, it provides many opportunities for people to be physically active. This study examines geographic and urban-rural differences in walking in the U.S. METHODS: Adult respondents (aged ≥18 years) to the 2015 National Health Interview Survey reported participation in and time spent (minutes per week) walking for transportation and leisure in the past week. In 2017, prevalence and time spent walking (among walkers) for any, leisure, and transportation walking were estimated by nine expanded regions and urban-rural designation. RESULTS: Prevalence of any walking ranged from 50.8% (East South Central) to 72.4% (Pacific); for leisure walking 43.9% (East South Central) to 60.6% (Pacific); and transportation walking 17.8% (East South Central) to 43.5% (New England). Among walkers, mean minutes spent walking per week ranged from 77.4 (East South Central) to 101.6 (Pacific); for leisure walking 70.5 (West South Central) to 85.9 (Mountain); and for transportation walking 47.4 (East South Central) to 66.4 (Middle Atlantic). Overall, there were urban-rural differences in prevalence of walking; however, differences depended on walking purpose and expanded region. Time spent walking was similar in urban and rural areas. CONCLUSIONS: Regional differences in walking prevalence and time spent walking exist. Urban-rural differences in prevalence of walking differ based on region and purpose; however, rural areas had a lower prevalence of walking than urban areas regardless of purpose in southern regions. Opportunities exist to improve walking, particularly among southern regions with a focus on rural areas.

15.
Prev Chronic Dis ; 15: E107, 2018 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-30171679

RESUMO

Implementing community design strategies can offer benefits related to walkability; however, they may also come with trade-offs to other community needs and desires. We examined public sentiment for 2 trade-offs among 2014 SummerStyles survey respondents (n = 3,995). About 33% of adults reported strongly favoring safer street design even if driving is slower; only 19% reported strongly favoring community design with walkable destinations even if homes are closer together. Walking frequency was positively associated with strongly favoring trade-offs, while differences by other demographic characteristics depended on the trade-off. Addressing public sentiment for potential trade-offs may be important when promoting walkable design strategies.

16.
Am J Prev Med ; 55(4): 533-540, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30139708

RESUMO

INTRODUCTION: Promotion of walking is a promising strategy for increasing physical activity levels in the U.S. The proportion of adults who report walking for either transportation or leisure has increased in recent years, but evidence on trends in walking for specific purposes is limited. METHODS: The 2005, 2010, and 2015 National Health Interview Survey assessed self-reported participation in and volume (minutes/week) of walking for transportation and leisure in the past week among adults aged ≥18 years. Linear and quadratic trends in the prevalence and mean volume of walking for each purpose were evaluated using logistic and linear regression. Analyses were performed in 2017. RESULTS: The prevalence of transportation walking increased from 28.4% (2005) to 31.7% (2015) (linear trend: p<0.05). Leisure walking prevalence increased from 42.1% (2005) to 52.1% (2015), but the increased stalled from 2010 to 2015 with only a 2.3 percentage point increase (linear and quadratic trends: p<0.05). Across purposes, the mean walking volume decreased from 2005 to 2015, with no significant changes between 2010 and 2015 (linear and quadratic trends: p<0.05). The proportion of adults who walked for both transportation and leisure in the past week increased steadily (linear trend: p<0.05), and this group reported the greatest total volume of walking. CONCLUSIONS: Although the prevalence of self-reported transportation and leisure walking increased during the last decade, the time spent walking decreased. Strategies that encourage walking for multiple purposes may present an opportunity for increasing both participation in walking and the amount of time spent walking.

17.
Prev Med ; 115: 39-46, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30099046

RESUMO

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.

18.
Am J Health Promot ; : 890117118784226, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29962209

RESUMO

PURPOSE: The US Preventive Services Task Force recommends that adults at risk for cardiovascular disease (CVD) be offered or referred to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention. We assessed primary care providers' (PCPs) awareness of local physical activity-related behavioral counseling services, whether this awareness was associated with referring eligible patients, and the types and locations of services to which they referred. DESIGN: Cross-sectional survey. SETTING: Primary care providers practicing in the United States. SUBJECTS: 1256 respondents. MEASURES: DocStyles 2016 survey assessing PCPs' awareness of and referral to physical activity-related behavioral counseling services. ANALYSIS: Calculated prevalence and adjusted odds ratios (aORs). RESULTS: Overall, 49.9% of PCPs were aware of local services. Only 12.6% referred many or most of their at-risk patients and referral was associated with awareness of local services (aOR = 2.81, [95% confidence interval: 1.85-4.25]). Among those referring patients, services ranged from a health-care worker within their practice or group (25.4%) to an organized program in a medical facility (41.2%). Primary care providers most often referred to services located outside their practice or group (58.1%). CONCLUSION: About half of PCPs were aware of local behavioral counseling services, and referral was associated with awareness. Establishing local resources and improving PCPs' awareness of them, especially using community-clinical linkages, may help promote physical activity among adults at risk for CVD.

19.
Am J Public Health ; 108(8): 1055-1058, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29927647

RESUMO

OBJECTIVES: To determine the prevalence of community and street-scale design features that promote walking across the US Virgin Islands (USVI). METHODS: In May 2016, the USVI Department of Health, with technical assistance from the Centers for Disease Control and Prevention, conducted a territory-wide audit with a validated tool. We selected street segments (n = 1114) via a 2-stage sampling method, and estimates were weighted to be representative of publicly accessible street length. RESULTS: Overall, 10.7% of the street length contained a transit stop, 11.3% had sidewalks, 21.7% had at least 1 destination (e.g., stores, restaurants), 27.4% had a traffic calming feature (e.g., speed humps), and 53.2% had at least some street lighting. Several features were less prevalent on residential streets compared with commercial streets, including transit stops, sidewalks, destinations, and street lighting (P < .01). CONCLUSIONS: Across the USVI, community and street-scale features supportive of walking were uncommon. Improving community and street-scale design in the USVI, particularly in residential areas, could increase physical activity by enhancing walkability and therefore improve public health. These data can be used to inform community planning in the USVI.

20.
Prev Med ; 114: 57-63, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29894716

RESUMO

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 ≥18 years) 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.

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