American Journal of Health Promotion

To identify perceptions of how sociocultural environment enabled and hindered physical activity (PA) participation.

Community-based participatory research.

Two semirural and two urban communities located in Alberta, Canada.

Thirty-five people (74.3% females, 71.4% aged 25–64 years) across the four communities.

PhotoVoice activities occurred over 3 months during the spring of 2009. Participants were asked to document perceived environmental attributes that might foster or inhibit PA in their community. Photographs and narratives were shared in one-on-one interviews. Line-by-line coding of the transcripts was independently conducted by two researchers using an inductive approach. Codes were arranged into themes and subthemes, which were then organized into the Analysis Grid for Environments Linked to Obesity (ANGELO) framework.

Six main themes (accompanied by subthemes) emerged: sociocultural aesthetics, safety, social involvement, PA motivation, cultural ideas of recreation, and car culture. Representative quotes and photographs illustrate enablers and obstacles identified by participants.

This PhotoVoice study revealed how aspects of participants' sociocultural environments shaped their decisions to be physically active. Providing more PA resources is only one step in the promotion of supportive environments. Strategies should also account for the beautification and maintenance of communities, increasing feelings of safety, enhancement of social support among community members, popularization of PA, and mitigating car culture, among others.

There's a lack of evidence on the association between light-intensity physical activity and disability. This study examines the relationships in activity by self-reported physical function in five domains (i.e., activities of daily living [ADL], instrumental ADL, leisure activities, lower extremity, and general activities), and whether this association varies by age.

Cross-sectional.

Data from National Health and Nutrition Examination Survey 2003–2004 and 2005–2006 waves.

Participants included 5700 men and women ages 20 to 85 years.

Difficulty with various activities was measured with the Physical Functioning Questionnaire, accelerometer-measured physical activity, demographics, and self-rated health.

Ordinary least squares regression models were run to examine the relationship between physical function in each domain, light-intensity activity, and the moderating effect of age. Analyses controlled for body mass index, moderate-to-vigorous–intensity activity, self-reported health, accelerometer wear time, and gender.

Little variation was seen in light-intensity physical activity among younger adults regardless of disability status. Older adults reporting difficulty with activities engaged in significantly less light-intensity physical activity compared to those with no disability (271.8 vs. 316.5 minutes). Age significantly moderated the association between light-intensity physical activity and leisure activities (p = .048), and lower extremity mobility (p = .039). Age did not moderate other domains of disability.

Younger age may be protective regarding the influence of disability on light-intensity activity. In addition, disability may be more debilitating for some older individuals. Interventions to increase light-intensity activity should aim to address disability at all ages, with increased attention for older adults.

To examine caregiver and youth attitudes about sports drinks (SDs) and the association of those attitudes with youth SD intake.

Study design was cross-sectional. The online YouthStyles survey was sent to youth (ages 12–17 years) whose caregivers completed the online Summer ConsumerStyles survey for adults.

The 2011 Styles survey data comprised the setting.

The sample was composed of 815 U.S. caregiver-youth dyads.

The outcome variable is youth SD consumption, and exposure variables are youth and caregivers' attitudes that SDs are healthy for children, and caregivers' attitude that children need SDs for hydration. Covariates are youth demographic and physical activity variables.

Multivariable logistic regression was used to estimate adjusted odds ratios (ORs) for youth SD consumption one or more times per week after controlling for covariates.

About one in five youth consumed SDs one or more times per week. Caregiver attitudes about the healthfulness of SDs and children's need of SDs for hydration both significantly differed by race and caregiver education level. The odds of youth SD consumption one or more times per week were significantly higher among youth of caregivers who agreed that SDs are good, healthy drinks for children (OR, 2.72 vs. disagreed) and among youth of caregivers who agreed that children need SDs for hydration (OR, 3.15 vs. disagreed). Youth attitude about SD healthfulness was not associated with intake.

Caregivers, particularly minority and less educated caregivers, may need more education about SD use.

To assess environmental correlates of neighborhood recreational walking.

The study used a cross-sectional survey.

The study was conducted in the local community.

Participants were adults who recently relocated and walk for recreation in their current neighborhood.

The outcome measure was participant-reported neighborhood recreational walking in participants' prior neighborhood. Exposure measures were (1) participant-reported social and environmental characteristics of the prior neighborhood and (2) geographic information system–derived environmental characteristics assessed within a buffer around participant's prior address.

Participants reporting current neighborhood recreational walking (n = 231) were characterized by whether they walked for recreation in their prior neighborhood. Associations between neighborhood characteristics and neighborhood recreational walking were assessed using logistic regression.

Neighborhood recreational walking was associated with perceptions of the presence of recreational facilities (odds ratio [OR] = 2.49, 95% confidence interval [CI] = 1.29–4.84), interesting things to see (OR = 2.82, 95% CI = 1.46–5.45), and others being active (OR = 3.56, 95% CI = 1.80–7.05), and was inversely associated with concerns about crime (OR= .40, 95% CI= .20–.77) and traffic (OR = .43, 95% CI = .22–.87). This behavior was associated with objectively measured presence of walking trails (OR = 3.58, 95% CI = 1.07–4.46), percentage of street length with speed limits ≤25 mph (OR= 1.31 for 10% increase, 95% CI= 1.08–1.61), and percentage of tree canopy coverage (OR= 1.55 for 10% increase, 95% CI = 1.12–2.14).

Recreational walking may be influenced by environmental factors that support a safe, enjoyable, and social experience, attributes that are not necessarily prioritized in transportation walking. Outcome and exposure specificity are important when studying recreational walking.

The aim of the present study was to examine the influence of moderate physical exercise throughout pregnancy on the duration of labor stages.

Study was a randomized controlled trial.

The study took place at Hospital Puerta de Hierro and Hospital Severo Ochoa in Madrid, Spain.

We examined 166 pregnant women (31.6 ± 3.8 years), and all had uncomplicated and singleton gestation. Of these 83 were allocated to the exercise group (EG) and 83 to the control group (CG).

Women from the EG participated in a physical conditioning program throughout pregnancy, which included 55- to 60-minute sessions, 3 days per week.

Pregnancy outcomes were measured: duration of labor stages, gestational age, weight gain, type of delivery, birth weight, birth size, head circumference, Apgar score, pH of umbilical cord.

Student's unpaired t-tests and χ² tests were used; p values of < .05 indicated statistical significance. Cohen's d was used to determine the effect size.

Significant differences were found in the duration of the first stage of labor (EG = 389.6 ± 347.64 minutes vs. CG = 515.72 ± 353.36 minutes; p = .02, effect size Cohen's d = .36). The second and third stages did not differ between the study groups.

A physical exercise program during pregnancy is associated with a shorter first stage of labor. These results may have important relevance to public health.

To assess the relationship between self-reported and objectively measured physical activity (PA) and metabolic syndrome and its risk factors in U.S. adults.

A cross-sectional design was used for this study.

The study was set among a nationally representative sample of U.S. adults.

Adults, ages 20 years and older, from the National Health and Nutrition Examination Survey (NHANES) 2003–2006 (n = 5580) participated in the study.

PA measures included minutes per week of moderate plus vigorous PA estimated by self-report (MVPAsr), total 7-day accelerometry (MVPAa), and accelerometer-based MVPA performed in 10-minute bouts (MVPAb). Risk factors for metabolic syndrome included blood pressure, high-density lipoprotein cholesterol, triglycerides, glucose, and waist circumference.

Odds ratios (ORs) for having metabolic syndrome were calculated for men and women who met the Physical Activity Guidelines for Americans compared to those who did not.

Women who did not meet the PA guidelines had significantly greater odds of having metabolic syndrome according to MVPAsr (OR = 2.20; 95% confidence interval [CI] = 1.65–2.94), MVPAa (OR = 4.40; 95% CI= 2.65–7.31), and MVPAb (OR= 2.91; 95% CI= 1.42–5.96). Men had significantly higher odds of having metabolic syndrome according to MVPAa (OR = 2.57; 95% CI= 1.91–3.45) and MVPAb (OR = 2.83; 95% CI = 1.55–5.17), but not MVPAsr. These ORs remained significant after adjusting for all potential confounders except body mass index, after which only MVPAsr in women and MVPAb in men remained significant.

Individuals who do not meet the PA guidelines exhibited greater odds of having metabolic syndrome. This relationship tended to be stronger for objective PA measures than for self-report.

In the United States, 36% of human papillomavirus (HPV)–related cancers occur among men. HPV vaccination can substantially reduce the risk of HPV infection; however, the vast majority of men are unvaccinated. This study developed and validated transtheoretical model–based measures for HPV vaccination in young adult men.

Cross-sectional measurement development.

Online survey of young adult men.

Three hundred twenty-nine mostly college-attending men, ages 18 to 26.

Stage of change, decisional balance (pros/cons), and self-efficacy.

The sample was randomly split into halves for exploratory principal components analysis (PCA), followed by confirmatory factor analyses (CFA) to test measurement models. Multivariate analyses examined relationships between scales.

For decisional balance, PCA revealed two uncorrelated five-item factors (pros α = .78; cons α = .83). For the self-efficacy scale, PCA revealed a single-factor solution (α = .83). CFA confirmed that the two-factor uncorrelated model for decisional balance and a single-factor model for self-efficacy. Follow-up analyses of variance supported the theoretically predicted relationships between stage of change, pros, and self-efficacy.

This study resulted in reliable and valid measures of pros and self-efficacy for HPV vaccination that can be used in future clinical research.

Local food environments can influence the diet and health of individuals through food availability, proximity to retail stores, pricing, and promotion. This study focused on how small convenience stores, known in New York City as bodegas, influence resident shopping behavior and the food environment.

Using a cross-sectional design, 171 bodegas and 2118 shoppers were sampled.

Small convenience stores in New York City.

Any bodega shopper aged 18+ who purchased food or beverage from a participating store.

Data collection consisted of a store assessment, a health and behavior survey given to exiting customers, and a bag check that recorded product information for all customer purchases.

Descriptive statistics were generated for bodega store characteristics, shopper demographics, and purchase behavior. Multilevel models were used to assess the influence of product availability, placement, and advertising on consumer purchases of sugar-sweetened beverages (SSBs), water, and fruits and vegetables.

Seventy-one percent of participants reported shopping at bodegas five or more times per week, and 35% reported purchasing all or most of their monthly food allotment at bodegas. Model results indicated that lower amounts of available fresh produce were significantly and independently associated with a higher likelihood of SSB purchases. A second, stratified multilevel model showed that the likelihood of purchasing an SSB increased with decreasing varieties of produce when produce was located at the front of the store. No significant effects were found for water placement and beverage advertising.

Small convenience stores in New York City are an easily accessible source of foods and beverages. Bodegas may be suitable for interventions designed to improve food choice and diet.

To investigate consumer understanding and usage of serving size (SS) information on Nutrition Facts (NF) labels.

We analyzed three data sources: (1) U.S. Food and Drug Administration (FDA) Health and Diet Survey (HDS) 1994 (n = 1945), 1995 (n = 1001), and 2008 (n = 2584); (2) National Health and Nutrition Examination Survey (NHANES) 2005–2006 and 2007–2008 (n = 10,750); and (3) 2011 FDA Nutrition Facts Label Experimental Study (NFLES) (n = 9493). Data from FDA are cross-sectional and we focused on usage and meaning of SS.

United States.

Adults (18+ years).

Both HDS and NHANES addressed how often participants used SS information and HDS also asked how SS is determined. Both NHANES and NFLES contained similar questions on the meaning of SS but NFLES also included an open-ended response option.

We included both quantitative and qualitative measures. Questions were analyzed by demographic variables and body mass index with frequencies, cross-tabulations, and χ² statistics reported.

HDS showed that the percentage of consumers who used SS information often or sometimes increased from 54% in 1994 to 64% in 2008. NHANES and NFLES data indicated that a majority of respondents had misinterpreted the meaning of SS. Women and obese individuals were more likely to use SS often or sometimes, but were also more likely to misinterpret the meaning of SS. A small subsample of NFLES participants expressed a distrust of the SS information.

There is a widespread misunderstanding about SS, suggesting the need for clearer NF labels or enhanced education efforts.

To evaluate the effectiveness of FUEL Your Life, a translation of the Diabetes Prevention Program for worksites.

A randomized control group design was conducted in five worksites of a large transportation company. Measures were collected pretest, posttest (6 months), and follow-up (12 months).

Railroad maintenance facilities of Union Pacific Railroad.

Participants consisted of 362 workers (227 treatment, 135 control).

FUEL Your Life was translated from the Diabetes Prevention Program to better fit within the context of the worksite. The primary difference was the use of peer health coaches to provide social support and reinforcement and an occupational nurse to provide lesson content (six sessions of 10 minutes) to participants instead of the lifestyle coaches employed by the Diabetes Prevention Program, resulting in a less structured meeting schedule.

The primary outcomes were weight and body mass index (BMI), with secondary outcomes including eating behaviors, physical activity, and social support.

Latent growth modeling was used to measure changes in the outcomes over time.

Participants in the intervention group maintained weight/BMI (–.1 pounds/–.1 BMI), whereas the control participants gained weight/BMI (+2.6 pounds/+.3 BMI), resulting in a statistically significant difference between groups. Fifty-five percent of intervention participants lost some weight, whereas only 35% of the control group lost weight.

FUEL Your Life, a low intensity intervention, was not effective for promoting weight loss, but was effective for helping workers maintain weight over a 12-month period.

We aimed to understand how employer characteristics relate to the use of incentives to promote participation in wellness programs and to explore the relationship between incentive type and participation rates.

A cross-sectional analysis of nationally representative survey data combined with an administrative business database was employed.

Random sampling of U.S. companies within strata based on industry and number of employees was used to determine a final sample of 3000 companies. Of these, 19% returned completed surveys.

The survey asked about employee participation rate, incentive type, and gender composition of employees. Incentive types included any incentives, high-value rewards, and rewards plus penalties.

Logistic regressions of incentive type on employer characteristics were used to determine what types of employers are more likely to offer which type of incentives. A generalized linear model of participation rate was used to determine the relationship between incentive type and participation.

Employers located in the Northeast were 5 to 10 times more likely to offer incentives. Employers with a large number of employees, particularly female employees, were up to 1.25 times more likely to use penalties. Penalty and high-value incentives were associated with participation rates of 68% and 52%, respectively.

Industry or regional characteristics are likely determinants of incentive use for wellness programs. Penalties appear to be effective, but attention should be paid to what types of employees they affect.