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Promotion of Physical Activity for Obesity Prevention in Youth. Russell Pate Arnold School of Public Health University of South Carolina. Societal Trends Influencing Physical Activity. Non-Motorized Transportation.

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promotion of physical activity for obesity prevention in youth

Promotion of Physical Activity forObesity Prevention in Youth

Russell Pate

Arnold School of Public Health

University of South Carolina

slide2
Societal Trends

Influencing Physical Activity

non motorized transportation
Non-Motorized Transportation

Percent of trips walked or biked by 5-15 year olds (McCann 2000)

transportation to school
Transportation to School

How children get to school (US DOT 2000)

transportation to school5
Transportation to School

Percent of children walking and bicycling to school by country (CA Safe Routes to Schools 1996, Dept. of Transport 2001, Gilewe et al. 1998, Carlin et al. 1997)

slide8
Percentage of children ages 3 to 5 who are enrolled in center based childhood care and education programs

ChildStats.gov/ac2002

topics
Topics
  • Feasibility
  • Guidelines / Standards
  • Status
  • Promotion
  • Recommendations
feasibility of
Feasibility Of

Preventing Obesity

By Promoting

Physical Activity in Youth

physical activity and physical fitness in african american girls with and without obesity
Physical Activity and Physical Fitness in African-American Girls With and Without Obesity

Ward et al.

Obesity Research 1997;5:572-577

methods
Methods
  • 150 African American 5th grade students
  • BMI greater than 85th percentile
  • 54 with and 96 without obesity
  • Completed 3 days of physical activity recall
    • 3DPAR
    • Week days
    • After-school time

Ward et al., 1997

participation in physical activity
Participation in Physical Activity

 6 METs

4 METs

Ward et al., 1997

epstein et al health psychology 1995 14 109 115
Epstein et al.

Health Psychology

1995;14:109-115

Effects of Decreasing Sedentary Behavior and Increasing Activity on Weight Changein Obese Children
methods19
Methods
  • Obese children
    • 8-12 years old
    • From 61 families
  • Randomized to treatment groups
    • Increased exercise
    • Decreased sedentary behaviors
    • Both
  • Followed for 1 year

Epstein et al., 1995

percent overweight
Percent Overweight

0

4

8

12

P=.026

Months

hypothetical example
Hypothetical Example
  • Pre-obesity
    • Age = 6 years
    • BMI =16.5 (12 % Fat)
    • Weight =22.7 Kg
  • Obesity
    • Age =12 years
    • BMI =28.7 (35% Fat)
    • Weight =64.5 Kg
hypothetical example22
Hypothetical Example
  • Weight Gain- Age 6-12
  • 41.8 Kg
  • Fat Gain - Age 6-12
  • 20.2 Kg
  • Excess Fat Gain- Age 6-12
  • 13.1 Kg
hypothetical example23
Hypothetical Example
  • 100,870 Total Kcal
  • 16,812 Kcal/Yr
  • 323 Kcal/Wk
  • 46 Kcal/ Day
healthy people 2010 physical activity in children and adolescents
Healthy People 2010Physical Activity in Children and Adolescents
  • 22-6 Moderate physical activity in adolescents       
  • 22-7Vigorous physical activity in adolescents        
  • 22-8Physical education requirement in schools   
  • 22-9Daily physical education in schools 
  • 22-10 Physical activity in physical education class   
  • 22-11Television viewing
healthy people 2010 physical activity in children and adolescents26
Healthy People 2010Physical Activity in Children and Adolescents
  • 22-6 Increase to at least 30% the proportion of young people in grades 9-12 who engage in moderate physical activity for at least 30 minutes on five or more of the previous seven days.
healthy people 2010 physical activity in children and adolescents27
Healthy People 2010Physical Activity in Children and Adolescents
  • 22-7 Increase to at least 85% the proportion of young people in grades 9-12 who engage in vigorous physical activity that promotes the development and maintenance of cardiorespiratory fitness 3 or more days per week for 20 or more minutes per occasion.
san diego consensus physical activity guidelines for adolescents
San Diego ConsensusPhysical Activity Guidelines for Adolescents
  • Guideline 1
    • All adolescents should be physically active daily, or nearly everyday, as part of play, games, sports, and transportation, recreation, physical education, or physical exercise, in the context of family, school, and community activities.
san diego consensus physical activity guidelines for adolescents29
San Diego ConsensusPhysical Activity Guidelines for Adolescents
  • Guideline 2
    • Adolescents should engage in three or more sessions per week of activities that last 20 min or more at a time and that require moderate to vigorous levels of exertion.
health education authority recommendation 1
Health Education Authority Recommendation 1

All children and youth should participate in physical activity that is of at least moderate intensity for an average of one hour per day. While young people should be physically active nearly every day, the amount of physical activity can appropriately vary from day to day in type, setting, intensity, duration, and amount.

health education authority recommendation 2
Health Education Authority Recommendation 2

All children and youth should participate at least twice per week in physical activities that enhance and maintain strength in the musculature of the trunk and upper arm girdle.

slide32
How Active

Are American Kids?

national children and youth fitness study i
National Children and YouthFitness Study I
  • 1985
  • n = 8,000
  • National probability sample
  • Ages 10 - 18
  • Six health-related fitness items
  • Extensive physical activity report
  • Itinerant testers
yrbs 2001
YRBS - 2001
  • 13,627 students completed questionnaires
  • 50 states and the District of Columbia
  • 87 items
  • 7 physical activity items
youth risk behavior surveillance yrbs
Youth Risk Behavior SurveillanceYRBS
  • How many of the past 7 days
    • Exercised or did PA for at least 20 min that made you sweat and breathe hard
    • Participated in PA for at least 30 min that did not make you sweat or breathe hard
    • Do exercise to strengthen or tone your muscles
youth risk behavior surveillance yrbs37
Youth Risk Behavior SurveillanceYRBS
  • On an average school day, how many hours do you watch TV
  • In an average week when in school, on how many days do you go to PE class
  • During an average PE class, how many min do you spend actually exercising or playing sports?
  • During the past 12 months, on how many sports teams did you play
csa monitor
CSA Monitor
  • Computer Science and Applications, Inc.
  • Model 7164
  • Weighs 1.5 oz; 5x5x1.5 cm
  • Measures integrated accelerations in the vertical plane
amherst health and activity study
Amherst Health and Activity Study
  • Subjects were recruited from 7 elementary schools, 1 junior high, and 1 senior high school
  • 38% of the 3648 students enrolled in PE returned consent forms (n=1379)
  • Subjects (n=400) were randomly selected to wear a CSA monitor for 7 days.
  • Subjects were divided into 4 grade groups, A=1-3, B=4-6, C=7-9 and D=grades 10-12.
slide44
Amherst Health & Activity Cut-Points

METs=2.7570+(0.0015Countsmin-1)-(0.0896Age)-(0.000038x[counts  min-1Age])

slide45
250

200

150

Minutes/Day

100

Male

Female

50

0

A

A

B

B

C

C

D

D

Grade Group

Median MVPA Minutes/Day

* males > females (p<0.001)

^ all age groups significantly different (p<0.001)

No significant age*gender interactions

slide46
35

30

25

20

Median number of minutes

15

10

Male

5

Female

0

A

A

B

B

C

C

D

D

Grade Group

Median Vigorous Activity Minutes/Day

* males > females (p<0.001)

^ all age groups significantly different (p<0.001)

No significant age*gender interactions

slide47
8

7

6

5

Minutes/Day

4

3

Male

2

Female

1

0

A

A

B

B

C

C

D

D

Grade Group

Median Very Vigorous Minutes

* males > females (p<0.001)

# all age groups significantly different (p<0.001) except C and D

No significant age*gender interactions

slide48
100

90

80

70

60

Percentage

50

Males

Females

40

30

20

10

0

A

A

B

B

C

C

D

D

Grade Group

Percentage of children meeting HEA

recommendation

slide50
Interventions

To Promote Physical Activity

In Youth

intervention settings
Intervention Settings

School

Home

Community

Healthcare

active winners methods
Active WinnersMethods
  • A community-based physical activity intervention
  • Quasi-experimental
    • 1 Intervention County and 1 Comparison County
  • Subjects were 5th grade students
  • Intervention – after school and summer camps
  • Measures – Students reported after-school activity
    • 3 time points – baseline, during and post-intervention
go for health methods
Go for HealthMethods
  • Two intervention Schools and two control schools
  • Classroom health education
  • Environmental changes
    • School Lunch
    • Vigorous Physical Education
spark methods
SPARKMethods
  • Quasi-Experimental Design
  • 7 schools assigned to 3 conditions
    • Control
    • Trained classroom teacher
    • Physical Education specialist
  • 4th and 5th grade, 955 students
catch methods
CATCHMethods
  • A randomized, controlled field trial
  • 4 field centers
  • 56 Intervention schools, 40 Control schools
  • 3rd to 5th grade, 5106 students
catch vpa of lesson
CATCHVPA-% of Lesson

F=2.35, df=5, 1979, P=.04

dwyer et al 1983 int j epidemiol
Dwyer et al., 1983

Int J Epidemiol

An Investigation of the Effects of Daily Physical Activity on the Health of Primary School Students in South Australia
methods62
Methods
  • 513 10-year olds from 7 primary schools in Adelaide, South Australia
  • 3 classes per school- randomly allocated to:
    • Control - 3 half-hour periods of PE/ week
    • Skill - 1.75 hr/day - skill instructions
    • Fitness - 1.75 hr/day - vigorous PA
  • 14 week program
  • Measurements were made pre and post-intervention

Dwyer et al., 1983

leap methods
LEAPMethods
  • 8th grade girls from 24 high schools
  • 1603 girls, 50% African-American
  • School randomly assigned to control or intervention
  • Physical activity: 3DPAR
    • In 8th grade at baseline
    • In 9th grade during school based intervention
leap intervention components
LEAP Intervention Components
  • Physical Education
  • Other Health Components
    • Health Education
    • Health Environment
    • Health Services
    • Faculty/Staff Wellness
  • Family/Community Environment
leap pe
LEAP PE

Specific Objectives:

  • Develop behavioral skills
  • Enhance physical activity self-efficacy
  • Develop motor skills
  • Provide enjoyable participation in physical activity
  • Implement a personal out-of-school physical activity program
m span methods
M-SPANMethods
  • Environmental, policy, and social marketing intervention on physical activity.
  • 24 middle schools randomly assigned to intervention or control condition.
  • Over 2 years.
  • Designed to increase physical activity in PE classes and through-out the day.
  • Schools had a mean enrollment of 1109 and 44.5% were non-white.

Sallis et al, 2003

moderate to vigorous physical activity
Moderate to Vigorous Physical Activity

P <0.001 for boys

Sallis et al., 2003

slide73
Pate’s Recommendations

For

Increasing Physical

Activity in

Children and Youth

home family
Home/Family
  • Limit electronic entertainment
    • 1 hr/day
  • Protect After-school
    • Active recreation
  • Maximize time outside
  • Provide PA equipment
home family75
Home/Family
  • Be active with kids
  • Help kids find Activities they enjoy
  • Support sports, lessons, clubs
school
School
  • Enhance quality of PE
  • Increase quantity of PE
  • Retain/increase recess
  • Diversify extracurricular opportunities
  • Connect kids to community programs
community
Community
  • Provide comprehensive menu
  • Support school to program to home transition
  • Safe neighborhoods
  • Parks, trails
  • Safe routes to school
healthcare
Healthcare
  • Screen for PA
  • Patient evaluation
  • Referral to Community providers
  • Fund preventive services
public health
Public Health
  • Make PA a priority
  • Build infrastructure
  • Invest in interventions
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