Responses to the Physical Activity Guidelines and Dissemination Strategies for Behavior Change in a Representative Sample of US Adults

Author(s):  
Malorie Polster ◽  
Erin E. Dooley ◽  
Kate Olscamp ◽  
Katrina L. Piercy ◽  
April Oh

Background: Dissemination of the Physical Activity Guidelines for Americans (Guidelines) is needed, but how individuals respond to the Guidelines is not well understood. This surveillance study describes US adults’ reported responses to and information sources for hearing about the Guidelines and explores relationships between how respondents heard about the Guidelines and their reported response(s). Methods: Data were analyzed from the population-based 2019 Health Information National Trends Survey 5 Cycle 3. Population-weighted proportions of response were calculated. Among those who had heard about the Guidelines, binary logistic regressions examined associations between the reported response(s) and the information source and number of sources reported. Results: The analytical sample included 5047 adults. Nearly 65% of US adults reported hearing about the Guidelines, and 29% reported a behavioral response (eg, increased physical activity). Hearing about the Guidelines through health professionals (adjusted odds ratio = 2.30, 95% confidence interval, 1.45–3.65) or social media (adjusted odds ratio = 1.89, 95% confidence interval, 1.20–2.96) (vs other sources) was associated with reporting increasing physical activity. Hearing from multiple sources (vs one source) was associated with reporting increasing physical activity (adjusted odds ratio = 1.97, 95% confidence interval, 1.18–3.31). Conclusion: Findings suggest dissemination of the Guidelines across multiple channels may promote greater changes in physical activity.

2019 ◽  
Vol 15 ◽  
pp. 174550651987118 ◽  
Author(s):  
Laura P Abell ◽  
Kelly A Tanase ◽  
Madison L Gilmore ◽  
Anna E Winnicki ◽  
Victor L Holmes ◽  
...  

Objectives: While physical activity is important for health, many women do not meet recommended levels, particularly mothers. The purpose of this study was to assess whether physical activity levels differ by number of children at home in women aged 25–44 in the general US population. Methods: This cross-sectional analysis used 2017 Behavioral Risk Factor Surveillance System data for females aged 25–44 (N = 6266) from California, Colorado, New York, Texas, and Utah. Ordered logistic regression analysis assessed the relationship between physical activity levels and number of children at home while controlling for state and demographic, socioeconomic, and health-related factors. Results: About half of participants reported “inactive” or “insufficiently active” physical activity levels and about two-thirds reported having one or more children at home. The results of adjusted analysis indicated that physical activity level was significantly related to having one child (adjusted odds ratio = 0.75, 95% confidence interval = 0.63, 0.89), two children (adjusted odds ratio = 0.79; 95% confidence interval = 0.67, 0.93), and three or more children (adjusted odds ratio = 0.80, 95% confidence interval = 0.67, 0.94) at home. Conclusion: Overall, physical activity levels were significantly related to presence of children at home for women aged 25–44, but increasing number of children at home did not impact effect size. For women aged 25–44 in a primary care setting, a moderate prevalence of inactive or insufficiently active physical activity may be expected. Providers should address physical activity with all patients in this target population during well-visits, but particularly for women with children at home; educate patients about the health benefits of regular physical activity; and provide resources that will help them integrate physical activity into their daily lifestyles.


2020 ◽  
pp. 096914132095345
Author(s):  
Patrick Brzoska ◽  
Tugba Aksakal ◽  
Yüce Yilmaz-Aslan

Objective: Regular pap smears are effective in reducing cervical cancer incidence and mortality. Migrant women have been reported to utilize cervical cancer screening less often than non-migrant women. However, inconsistent results, e.g. from Germany, have also been reported. This study examines disparities in the use of annual pap smears among 20–69 year old migrant and non-migrant women in neighboring Austria. Method: Data from a nationwide population-based survey of 7633 women is used of whom 504 (6.6%) were migrants from European Union countries and 251 (3.3%) were migrants from non-European Union countries. Logistic regression analysis was conducted to account for socio economic and health differences between the three population groups. Results: The study shows that as compared to the non-migrant women, migrant women from European Union and non-European Union countries were at lower odds of having received a pap smear in the last 12 months (adjusted odds ratio  = 0.80, 95% confidence interval = 0.66–0.96 and adjusted odds ratio = 0.74, 95%-confidence interval = 0.57–0.97, respectively). Disparities were similar with respect to utilization in the last 36 months (adjusted odds ratio = 0.60, 95% confidence interval = 0.46–0.77 and adjusted odds ratio = 0.58, 95% confidence interval = 0.40–0.82, respectively). Conclusions: The findings are in agreement with research from the majority of other countries. They suggest barriers that migrants encounter in the health system and highlight the need for diversity-sensitive health care strategies.


2021 ◽  
Author(s):  
Yoshan Moodley ◽  
Kobus Herbst ◽  
Frank Tanser

Study question: What is the relationship between interpregnancy interval (IPI) and pregnancy loss in a a rural sub-Saharan African (SSA) setting? Summary answer: IPIs >60 months, but not <6 months, were associated with a higher odds of pregnancy loss in our SSA setting. What is known already: IPIs >60 months are detrimental to both fetal and maternal health, while contradictory findings exist for IPIs <6 months. No studies have investigated the relationship between IPI and pregnancy loss in SSA settings, despite high pregnancy loss rates and exponential population growth in the SSA region. Study design, size, duration: Population-based cohort involving 8940 women aged 16-35 years who reported two consecutive singleton pregnancies between 2000 and 2017. Participants/materials, setting, methods: Study participants were from the uMkhanyakude District in KwaZulu-Natal, South Africa. We obtained data on pregnancy-related characteristics and other variables relevant to pregnancy loss from regular surveys conducted by the Africa Health Research Institute (AHRI) as part of its demographic and health surveillance platform. IPI was determined as the time in months between the end of the first pregnancy and the start of the second pregnancy. Pregnancy loss was defined as either miscarriage or stillbirth. We used an adjusted logistic regression model to investigate the relationship between IPI and pregnancy loss. Main results and the role of chance: IPIs >60 months were associated with an almost three-fold higher odds of pregnancy loss (Adjusted Odds Ratio: 2.64, 95% Confidence Interval:1.71-4.09) when compared with IPIs of 6-60 months. IPIs <6 months conferred a similar odds of pregnancy loss when compared with IPIs of 6-60 months (Adjusted Odds Ratio: 0.82, 95% Confidence Interval: 0.35-1.91). Limitations, reasons for caution: Possible recall bias around some of the pregnancy-related data. Inability to adjust our multivariate statistical analysis for certain sexually transmitted diseases which are known risk factors for pregnancy loss. Wider implications of the findings : Family planning services in SSA should consider discouraging IPIs >60 months. Although IPIs <6 months had no impact on pregnancy loss, these should also be discouraged in SSA, given the potential socioeconomic consequences for the already vulnerable women of this region.


2016 ◽  
Vol 44 (3) ◽  
pp. 370-375 ◽  
Author(s):  
Lindsey Turner ◽  
Frank J. Chaloupka

The integration of physical activity into elementary school classrooms, through brief activity breaks (ABs) and lessons that incorporate movement into instruction as active lessons (ALs), are key parts of school physical activity programming and can improve children’s health and academic outcomes. With nationally representative survey data from 640 public elementary schools in the United States, we examined the use of these practices and the extent of implementation within classrooms. ALs were used in 71.7% of schools, and ABs were used in 75.6% of schools. In multivariate models, ALs were significantly less likely to be used in majority-Latino schools (adjusted odds ratio = 0.48, 95% confidence interval [0.25, 0.93], p < .05) than in predominantly White schools. ABs were significantly less likely to be used in lower socioeconomic schools (adjusted odds ratio = 0.57, 95% confidence interval [0.34, 0.95], p < .05) than in higher socioeconomic schools. At schools where ABs were ever used, they were used by 45.6% of teachers, but fewer teachers used them at larger schools (β = −.08, p < .01) and at lower socioeconomic schools (β = −.09, p < .05). The reach of ALs and ABs is modest and classroom-level implementation is quite low. Additional dissemination and support is warranted to improve the reach and implementation of these strategies in elementary schools. Such efforts could improve the school-day experience in ways that benefit millions of young children.


Author(s):  
Kristen Lyall ◽  
Gayle C Windham ◽  
Nathaniel W Snyder ◽  
Rostislav Kuskovsky ◽  
Peining Xu ◽  
...  

Abstract Polyunsaturated fatty acids (PUFAs) are critical for brain development and have been linked with neurodevelopmental outcomes. We conducted a population-based case-control study in California to examine the association between PUFAs measured in midpregnancy serum samples and autism spectrum disorder (ASD) in offspring. ASD cases (n = 499) were identified through the California Department of Developmental Services and matched to live-birth population controls (n = 502) on birth month, year (2010 or 2011), and sex. Logistic regression models were used to examine crude and adjusted associations. In secondary analyses, we examined ASD with and without co-occurring intellectual disability (ID; n = 67 and n = 432, respectively) and effect modification by sex and ethnicity. No clear patterns emerged, though there was a modest inverse association with the top quartile of linoleic acid level (highest quartile vs. lowest: adjusted odds ratio = 0.74, 95% confidence interval: 0.49, 1.11; P for trend = 0.10). Lower levels of total and ω-3 PUFAs were associated with ASD with ID (lowest decile of total PUFAs vs. deciles 4–7: adjusted odds ratio = 2.78, 95% confidence interval: 1.13, 6.82) but not ASD without ID. We did not observe evidence of effect modification by the factors examined. These findings do not suggest a strong association between midpregnancy PUFA levels and ASD. In further work, researchers should consider associations with ASD with ID and in other time windows.


Author(s):  
Coral L. Hanson ◽  
Paul Kelly ◽  
Lis Neubeck ◽  
Jordan Bell ◽  
Holly Gibb ◽  
...  

Background: Physical activity (PA) levels vary across specific population groups, contributing to health inequalities. Little is known about how local authority leisure centers contribute to population PA and whether this differs by age, sex, or socioeconomic group. Methods: The authors calculated weekly leisure center–based moderate/vigorous PA for 20,904 registered adult users of local authority leisure facilities in Northumberland, United Kingdom, between July 2018 and June 2019, using administrative data. The authors categorized activity levels (<30, 30–149, and ≥150 min/wk) and used ordinal regression to examine predictors for activity category achieved. Results: Registered users were mainly female (58.7%), younger (23.9% of users aged 18–29 y vs 10.1% of those aged 70+ y), and from the 2 most affluent socioeconomic quintiles (53.7%). Median weekly moderate/vigorous leisure center–based activity was 55 minutes per week (interquartile range: 30–99). Being female (odds ratio: 2.09; 95% confidence interval, 1.95–2.35), older (odds ratio: 1.14; 95% confidence interval, 1.11–1.16), and using a large facility (odds ratio: 1.21; 95% confidence interval, 1.03–1.42) were positive predictors of leisure center–based PA. Conclusion: Older adults and females were more likely to be active and achieve the recommended PA levels through usage of the centers. Widespread use of this novel measure of leisure center–based activity would improve the understanding of how local authority leisure centers can address physical inactivity and its associated inequalities.


Author(s):  
Qiao Qin ◽  
Fangfang Fan ◽  
Jia Jia ◽  
Yan Zhang ◽  
Bo Zheng

Abstract Purpose An increase in arterial stiffness is associated with rapid renal function decline (RFD) in patients with chronic kidney disease (CKD). The aim of this study was to investigate whether the radial augmentation index (rAI), a surrogate marker of arterial stiffness, affects RFD in individuals without CKD. Methods A total of 3165 Chinese participants from an atherosclerosis cohort with estimated glomerular filtration rates (eGFR) of ≥ 60 mL/min/1.73 m2 were included in this study. The baseline rAI normalized to a heart rate of 75 beats/min (rAIp75) was obtained using an arterial applanation tonometry probe. The eGFRs at both baseline and follow-up were calculated using the equation derived from the Chronic Kidney Disease Epidemiology Collaboration. The association of the rAIp75 with RFD (defined as a drop in the eGFR category accompanied by a ≥ 25% drop in eGFR from baseline or a sustained decline in eGFR of > 5 mL/min/1.73 m2/year) was evaluated using the multivariate regression model. Results During the 2.35-year follow-up, the incidence of RFD was 7.30%. The rAIp75 had no statistically independent association with RFD after adjustment for possible confounders (adjusted odds ratio = 1.12, 95% confidence interval: 0.99–1.27, p = 0.074). When stratified according to sex, the rAIp75 was significantly associated with RFD in women, but not in men (adjusted odds ratio and 95% confidence interval: 1.23[1.06–1.43], p = 0.007 for women, 0.94[0.76–1.16], p = 0.542 for men; p for interaction = 0.038). Conclusion The rAI might help screen for those at high risk of early rapid RFD in women without CKD.


2021 ◽  
Vol 9 ◽  
pp. 205031212110245
Author(s):  
Getu Mosisa ◽  
Bikila Regassa ◽  
Bayise Biru

Introduction: Hypertension remains an emerging public health problem globally, particularly in developing countries. Age, income level, obesity, alcohol consumption, smoking, vegetables and fruit consumption, physical activity and chat chewing were some risk factors of hypertension. However, there are limited data on the epidemiology of hypertension in Ethiopia. This study aimed to assess Epidemiology of Hypertension among the community of selected towns of Wollega zones. Methods: A community-based cross-sectional study was conducted from 1 to 30 June 2019 in selected towns of Wollega zones. A multistage sampling technique was used to select 840 study participants. Data were collected using the WHO STEP wise approach. The data were coded and entered into EpiData 3, and exported to SPSS version 20.0 for analysis. Bivariate and multivariable logistic regression analyses were conducted. Statistical significance was declared at p-value < 0.05. Results: The study included a total of 838 respondents with a response rate of 99.7%. The prevalence of hypertension was found to be 189 (22.6%) (95% confidence interval = 19.9%–25.2%). Of this, 108 (12.9%) and 81 (9.7%) of female and male were hypertensive, respectively. Age groups of 30–44 years (adjusted odds ratio = 2.65 (1.43, 4.89)), 45–59 years (adjusted odds ratio = 3.55 (1.79, 7.04)), above 60 years (adjusted odds ratio = 2.97 (1.43, 6.18)), having history of alcohol consumption (adjusted odds ratio = 4.29 (2.4, 7.66)), involving in vigorous physical activity (adjusted odds ratio = 0.096 (0.028, 0.33)), not walking to and from the work (adjusted odds ratio = 13.12 (8.34, 20.67)), being overweight (adjusted odds ratio = 1.98 (1.21, 3.25)), inadequate fruits serving per day (adjusted odds ratio = 2.93 (1.75, 4.88)) were significantly associated with hypertension. Conclusion: The prevalence of hypertension was found to be high in the study area. Older age, alcohol consumption, not engaging in vigorous activity, physical inactivity, being overweight and inadequate intake of fruits were found to be risk factors for hypertension. Therefore, health care providers should provide extensive health education and promotion on recommended lifestyle modification to tackle the burden of hypertension.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara C. Auld ◽  
Hardy Kornfeld ◽  
Pholo Maenetje ◽  
Mandla Mlotshwa ◽  
William Chase ◽  
...  

Abstract Background While tuberculosis is considered a risk factor for chronic obstructive pulmonary disease, a restrictive pattern of pulmonary impairment may actually be more common among tuberculosis survivors. We aimed to determine the nature of pulmonary impairment before and after treatment among people with HIV and tuberculosis and identify risk factors for long-term impairment. Methods In this prospective cohort study conducted in South Africa, we enrolled adults newly diagnosed with HIV and tuberculosis who were initiating antiretroviral therapy and tuberculosis treatment. We measured lung function and symptoms at baseline, 6, and 12 months. We compared participants with and without pulmonary impairment and constructed logistic regression models to identify characteristics associated with pulmonary impairment. Results Among 134 participants with a median CD4 count of 110 cells/μl, 112 (83%) completed baseline spirometry at which time 32 (29%) had restriction, 13 (12%) had obstruction, and 9 (7%) had a mixed pattern. Lung function was dynamic over time and 30 (33%) participants had impaired lung function at 12 months. Baseline restriction was associated with greater symptoms and with long-term pulmonary impairment (adjusted odds ratio 5.44, 95% confidence interval 1.16–25.45), while baseline obstruction was not (adjusted odds ratio 1.95, 95% confidence interval 0.28–13.78). Conclusions In this cohort of people with HIV and tuberculosis, restriction was the most common, symptomatic, and persistent pattern of pulmonary impairment. These data can help to raise awareness among clinicians about the heterogeneity of post-tuberculosis pulmonary impairment, and highlight the need for further research into mediators of lung injury in this vulnerable population.


2021 ◽  
pp. 0310057X2198971
Author(s):  
M Atif Mohd Slim ◽  
Hamish M Lala ◽  
Nicholas Barnes ◽  
Robert A Martynoga

Māori are the indigenous people of New Zealand, and suffer disparate health outcomes compared to non-Māori. Waikato District Health Board provides level III intensive care unit services to New Zealand’s Midland region. In 2016, our institution formalised a corporate strategy to eliminate health inequities for Māori. Our study aimed to describe Māori health outcomes in our intensive care unit and identify inequities. We performed a retrospective audit of prospectively entered data in the Australian and New Zealand Intensive Care Society database for all general intensive care unit admissions over 15 years of age to Waikato Hospital from 2014 to 2018 ( n = 3009). Primary outcomes were in–intensive care unit and in-hospital mortality. The secondary outcome was one-year mortality. In our study, Māori were over-represented relative to the general population. Compared to non-Māori, Māori patients were younger (51 versus 61 years, P < 0.001), and were more likely to reside outside of the Waikato region (37.2% versus 28.0%, P < 0.001) and in areas of higher deprivation ( P < 0.001). Māori had higher admission rates for trauma and sepsis ( P < 0.001 overall) and required more renal replacement therapy ( P < 0.001). There was no difference in crude and adjusted mortality in–intensive care unit (16.8% versus 16.5%, P = 0.853; adjusted odds ratio 0.98 (95% confidence interval 0.68 to 1.40)) or in-hospital (23.7% versus 25.7%, P = 0.269; adjusted odds ratio 0.84 (95% confidence interval 0.60 to 1.18)). One-year mortality was similar (26.1% versus 27.1%, P=0.6823). Our study found significant ethnic inequity in the intensive care unit for Māori, who require more renal replacement therapy and are over-represented in admissions, especially for trauma and sepsis. These findings suggest upstream factors increasing Māori risk for critical illness. There was no difference in mortality outcomes.


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