American Journal of Health Promotion

To investigate the effects of an 8-week, pedometer-based lifestyle physical activity intervention on physical activity levels.

Participants were 37 college employees who volunteered to participate in the study. The intervention consisted of goal setting, pedometer use, self-monitoring, and weekly e-mail reminders. Physical activity measures (pedometer, survey) were taken at baseline and immediately following the intervention. A t-test for paired samples was used to determine significant changes in measures.

Results indicate a significant increase in average daily steps (p < .01), from 8565 (± 3121) steps at baseline to 10,538 (± 3681) steps after the program. Participants who averaged fewer than 6000 steps and obese participants experienced the greatest increase.

Although preliminary, this study indicates that the minimal contact, self-managed, pedometer-based lifestyle intervention was effective in increasing the daily physical activity of participants. Given the combination of behavioral techniques used, a recommendation for future studies would be to examine the impact of individual behavioral techniques on daily physical activity.

Nutrition education and labeling may help consumers to eat less fat. The purpose of this study is to assess the effect of nutrition education with and without shelf labeling on reduced fat intake in Dutch supermarkets.

The design consisted of a randomized, pretest-posttest, experimental control group design. In total, 2203 clients of 13 supermarkets were included in the sample. Total fat intake of clients and behavioral determinants of eating less fat were measured by a questionnaire. A mixed-effect regression model was used for the analysis.

No significant effects were found for the educational intervention, alone or with the labeling, on total fat intake and the psychosocial determinants of eating less fat.

Nutrition education and labeling of low-fat food products in supermarkets did not prove to be effective strategies. The fact that the supermarket is a highly competitive environment may have accounted for this lack of effect.

To assess workplace tobacco use prevention and cessation policies in manufacturing facilities and explore factors associated with tobacco policies and practices in the tobacco-growing state of Kentucky.

Cross-sectional, descriptive, correlational design.

Telephone survey of Kentucky manufacturing facilities.

A total of 437 human resource managers (77% participation rate).

Telephone interviews by trained local health department staff to assess indoor and outdoor smoking policies, sale of cigarettes on company property, and provision of cessation and prevention programs.

Nearly seven in 10 manufacturing facilities had a written smoking policy, but only 43% banned indoor smoking. About one-fourth of companies reimbursed for cessation treatment and/or provided cessation resources. Companies with unions were more likely than those without unions to provide cessation resources but were also more likely to allow indoor smoking. Although large companies had more than two and a half times the odds as small companies to have a written smoking policy, they were more likely to allow cigarette sales on company property.

Despite the importance of smoke-free policies in the workplace, most manufacturing facilities surveyed allowed indoor smoking and few helped smokers quit. Companies with unions were more likely to cater to their smoking employees. Manufacturing facilities provide an opportunity to protect large numbers of adult workers from the hazards of secondhand smoke and to provide quit assistance for smokers.

This study provides a model to estimate the health-related costs of secondhand smoke exposure at a community level.

Costs of secondhand smoke–related mortality and morbidity were estimated using national attributable risk values for diseases that are causally related to secondhand smoke exposure for adults and children. Estimated costs included ambulatory care costs, hospital inpatient costs, and loss of life costs based on vital statistics, hospital discharge data, and census data.

The model was used to estimate health-related costs estimates of secondhand smoke exposure for Marion County, Indiana. Attributable risk values were applied to the number of deaths and hospital discharges to determine the number of individuals impacted by secondhand smoke exposure.

The overall cost of health care and premature loss of life attributed to secondhand smoke for the study county was estimated to be $53.9 million in 2000—$10.5 million in health care costs and $20.3 million in loss of life for children compared with $6.2 million in health care costs and $16.9 million in loss of life for adults. This amounted to $62.68 per capita.

This method may be replicated in other counties to provide data needed to educate the public and community leaders about the health effects and costs of secondhand smoke exposure.

Ecological models highlight the importance of environmental influences. We examined associations of coastal versus noncoastal location and perceived environmental attributes with neighborhood walking, total walking, and total activity.

Telephone interviews with 800 faculty and general staff of an Australian university.

Men were significantly more likely to walk in their neighborhood if they lived in a coastal location (odds ratio [OR] = 1.66), and they highly rated environmental “aesthetics” (OR = 1.91), “convenience” of facilities (OR = 2.20), and “access” to facilities (OR = 1.98). For women, neighborhood walking was associated with high ratings of “convenience” (OR = 3.78) but was significantly less likely if they had high ratings for “access” (OR = 0.48). For total walking and total physical activity, few significant associations emerged.

Environmental attributes were related to walking in the neighborhood but not to more general activity indices. Understanding gender-specific environmental correlates of physical activity should be a priority.

This study documents the public availability of school physical activity facilities, reasons facilities were not made available to the public, and the barriers and benefits associated with having facilities available.

Cross-sectional.

All schools located in four geographic locations (Washington County, Maryland; northwest suburbs of Minneapolis, Minnesota; Jackson, Mississippi; and Forsyth County, North Carolina).

The survey was completed by 289 school representatives for a response rate of 82.3% (289/351 schools). For the nonrespondents, 61 of 62 schools were visited to obtain information on outdoor facilities.

Information on indoor and outdoor physical activity facilities available to the public was collected for all schools (public, private, and colleges) using a telephone survey. Site visits were made to schools that did not participate in the survey to collect information on outdoor facilities only.

The schools in the four geographic areas owned a wide range and number of physical activity facilities for their students. For the schools, 27% had no indoor facilities and 11% had no outdoor facilities. Private schools and colleges were less likely to have indoor or outdoor facilities compared to public schools. Outdoor facilities were available more often to the public than indoor facilities overall, across sites, and by school type (public, private, college). Among the 313 schools with outdoor facilities, 240 (77%) allowed at least some public use, and among the 210 schools with indoor facilities, 134 (64%) allowed at least some public use. Some reasons that facilities were not made available included: for student use only, supervision and personnel requirements, safety concerns, insurance, liability, and a private or church-owned status. The most common benefits of allowing the public to use the facilities included providing a space to keep youth active and good publicity for the school.

These findings suggest that safety, insurance, and liability concerns are barriers that need to be addressed with schools before indoor and outdoor facilities can be made available to the public. Furthermore, emphasizing the benefits that we found, such as providing a space to keep youth active and good publicity for the school, would also be important.

The purpose of the study was to examine associations between environment and policy factors and physical activity.

A random-digit-dialed, cross-sectional telephone survey was administered.

The setting was a two-county area of eastern South Carolina.

Before weighting, the sample included 1936 adults; 36.9% African-American, 63.1% white, and 60.1% women. The age group distribution was 28.8% 55+ years, 39.3% 35–54 years, and 31.9% 18–34 years of age. The response rate was 62.9%.

Six physical activity questions (2001 Behavioral Risk Factor Surveillance Survey [BRFSS]) were used to create a dichotomous variable, “meets/does not meet recommendation for moderate or vigorous physical activity.” Self-report items assessed knowledge, presence, and use of recreational facilities; presence of environmental and worksite supports; perceived safety; condition of sidewalks; and quality of street lighting

Linear and logistic regression were used to analyze the data. Unadjusted odds for meeting the recommendation were significantly greater for well-maintained sidewalks (OR = 1.90); safe areas for walking/jogging (OR = 1.39); knowledge of routes for bicycling (OR = 1.38) and walking/jogging (OR = 1.32); and worksites with sports teams (OR = 1.53), exercise facilities (OR = 1.33), flexible time for exercise (OR = 1.33), and preventive checkups (OR = 1.26). Among persons who met the recommendation, means were greater for number of known walking/jogging routes (p = .04); number of known bicycling routes (p < .01); number of days per month uses tracks, trails, routes, pathways (p < .01); and number of days per month uses outdoor recreation areas (p < .01).

The results support an association between level of physical activity and environmental and policy factors in two southeastern counties in South Carolina. Limitations of the study include self-reported data and cross-sectional design.

The prevalence of obesity and diabetes continues to increase among employee populations. Although medical costs and the prevalence of diabetes have been studied across increasing body mass index (BMI) categories, little attention has been given to the association of additional health risks within those categories. The purpose of this study was to examine the association of health risk levels on medical charges and prevalence of diabetes across BMI categories within an employee population.

A cross-sectional study design utilized health risk appraisal data (30% response rate) to measure BMI levels, self-reported diabetes status, and selected additional health risks among 38,841 active employees under age 65 of the General Motors Corporation. Associated average annual medical charges from 1996 to 2000 were calculated for defined health risk levels across five BMI categories (<18.5; 18.5–24.9, 25–29.9, 30–34.9, and ≥35).

Higher medical charges were significantly associated with additional health risks (zero risks to four or more risks) across each of the BMI categories: $2689 to $7576 (<18.5); $2655 to $6555 (18.5–24.9); $3239 to $7118 (25–29.9); $3579 to $7758 (30–34.9); and $4151 to $8075 (≥35). Likewise, higher prevalence of diabetes was significantly associated with additional health risks (zero risks to four or more risks) across the BMI categories: 2.6% to 7.0% (<18.5); 1.3% to 2.7% (18.5–24.9); 2.4% to 5.3% (25–29.9); 5.5% to 8.3% (30–34.9); and 7.7% to 15.8% (≥35).

Medical costs and the prevalence of diabetes were lower when the numbers of additional health risks were lower, regardless of the BMI category. Programs to promote weight management have largely been unsuccessful in maintaining long-term weight control. The current results suggest that a strategy focused on reducing health risks within any weight category could provide an alternative strategy to achieve medical cost savings and a lower prevalence of diabetes. The implied benefits of risk reduction within BMI categories would need to be confirmed with a longitudinal study.