ACHPER Healthy Lifestyles Journal – 1



James F. Sallis, Ph.D., Director

alr@projects.sdsu.edu

Carmen L. Cutter, MPH, Deputy Director

ccutter@projects.sdsu.edu

Introduction to the Active Living Research Reference List

for January-December 2006

The following pages are citations of studies of the relationships between the environment, physical activity, and obesity published January-December 2006.  The searches were conducted with several databases and were designed to represent the multiple disciplines in Active Living Research. We found 301 references in 2006 published in 122 different journals. In 2004 we found 101 references and 160 in 2005, although our search terms have expanded, this still reflects how our field is growing. Some citations do not include a journal issue or page numbers; these are articles that are available online ahead of print publication.

We have improved upon our search terms and hope that this list is inclusive. Please send us relevant citations we have missed.

We will continue to publish twice yearly literature updates as the literature is expanding so rapidly. The mid-year update will be online only and will be emailed to everyone on the ALR email list. The abstracts for the current 2006 update and the 2004-2005 abstracts can be found at: .

Papers that specifically report environmental correlates of physical activity behavior or obesity will be included in the ALR literature database. This database includes study methods, measurement details and relevant results. We hope to make this available online in the near future. You can review the online prototype at the conference by visiting the ALR Literature Database booth, located next to Registration. We are keen to hear how you would use such a service in your work.

If you have questions or comments please contact Chad Spoon at cspoon@projects.sdsu.edu.

Sincerely,

Jacqueline Kerr, PhD, Dori Rosenberg, MPH, Holly Forman

& The Active Living Research Staff

2006 Search Terms

|Physical Activity/Obesity terms (abstract only) |Environment terms (title or abstract) |

|non motorized OR NMT OR multimodal transportation OR active |environment OR environments OR environmental OR sprawl OR neighbourhood*|

|transport* OR driving OR active living OR inactivity OR inactive |OR neighborhood* OR recreation* OR metropolitan OR rural OR urban* OR |

|OR fit OR fitness OR body mass index OR BMI OR car OR cars OR |pedestrian OR pedestrians OR equipment OR geograph* OR aesthet* OR |

|automobile OR leisure OR television OR TV OR obese OR obesity OR |convenient OR convenience OR urban form OR destination* OR trail OR |

|weight OR overweight OR journey OR travel* OR walk OR walking OR |trails OR park OR parks OR path OR paths OR distance* OR density OR |

|cycle OR cycling OR bike OR bikers OR biking OR bicycle OR |access* OR planning OR location* OR feature* OR polic* OR facility OR |

|bicycling OR sedentary OR commuter* OR commuting OR exercise OR |facilities OR crime OR architecture OR building* OR transit OR street* |

|exercising OR exerciser* OR physical activity OR physically |OR stair* OR playground OR playgrounds OR urban design OR neighborhood |

|active OR play OR playground* OR playing OR vehicle OR obesogenic|development OR neighbourhood development OR smart growth OR outdoor OR |

| |indoor OR connectivity OR new urbanism OR healthy places OR healthy |

| |communities OR greenway OR greenways OR rail-trail OR home OR school OR |

| |schools OR land use OR safe OR safety OR route OR routes OR workplace OR|

| |community OR communities OR attractive* OR green space* OR public space*|

| |OR open space* OR place OR places OR site OR sites OR siting OR greenery|

| |OR amenity OR amenities OR attribute* OR walkable OR walkability OR |

| |residential OR residence OR sidewalks OR availability |

Databases used in the literature searches included Pub Med, ISI Web of Science, and other non-indexed journals.

For more specific information please contact Chad Spoon at cspoon@projects.sdsu.edu.

Journal Counts

Adolescence- 1

American Journal of Clinical Nutrition- 3

American Journal of Community Psychology- 1

American Journal of Epidemiology- 1

American Journal of Health Behavior- 1

American Journal of Health Promotion- 9

American Journal of Preventive Medicine- 20

American Journal of Public Health- 1

Annals of Behavioral Medicine- 1

Annual Review of Public Health- 1

Applied Psychology-An International Review- 1

Archives of Disease in Childhood- 1

Archives of Internal Medicine- 1

Archives of Pediatrics and Adolescent Medicine- 5

Asia Pacific Journal of Clinical Nutrition- 1

Australasian Journal on Ageing- 1

Australian and New Zealand Journal of Public Health- 2

Behavioral Interventions- 1

BMC Public Health- 2

British Journal of Health Psychology- 1

British Journal of Nutrition- 3

CA: A Cancer Journal for Clinicians- 1

Canadian Journal of Physiology and Pharmacology- 1

Canadian Journal of Public Health- 3

Circulation- 1

Cities- 1

Contemporary Clinical Trials- 1

Diabetes and Metabolism- 1

Diabetes Care- 1

Disability and Rehabilitation- 1

Eastern Mediterranean Health Journal- 1

Environment and Behavior- 3

Environment and Planning A- 1

Environment and Planning B-Planning and Design- 1

Environmental Health- 1

Environmental Politics- 1

Ethnicity and Disease- 1

European Journal of Clinical Nutrition- 1

European Journal of Public Health- 2

Evaluation and Program Planning- 2

Exercise and Sport Sciences Reviews- 1

Future of Children- 4

Geriatrics and Gerontology Journals- 1

Geografiska Annaler Series B-Human Geography- 1

Growth and Change- 1

Health and Place- 10

Health Education and Behavior- 1

Health Education Research- 7

Health Promotion Journal of Australia- 2

International Journal of Behavioral Nutrition and Physical Activity- 6

International Journal of Circumpolar Health- 1

International Journal of Epidemiology- 1

International Journal of Health Geographics- 1

International Journal of Obesity- 7

Journal of Adolescent Health- 6

Journal of Advanced Nursing- 1

Journal of Aging and Physical Activity- 5

Journal of Cardiovascular Nursing- 1

Journal of Child Health Care- 1

Journal of Community Health- 4

Journal of Environmental Management- 1

Journal of Environmental Psychology- 1

Journal of Epidemiology and Community Health- 2

Journal of International Medical Research- 1

Journal of Leisure Research- 4

Journal of Nutrition Education and Behavior- 2

Journal of Pediatric Psychology- 1

Journal of Pediatrics- 1

Journal of Physical Activity and Health- 27

Journal of Planning Education and Research- 1

Journal of Public Health- 3

Journal of Public Health Management and Practice-1

Journal of Rural Health- 1

Journal of School Health- 1

Journal of Science and Medicine in Sport- 9

Journal of the American Dietetic Association- 2

Journal of the American Geriatrics Society- 1

Journal of the American Planning Association- 5

Journal of the Royal Society for the Promotion of Health- 1

Journal of the Royal Society of Medicine- 1

Journal of Transport Economics and Policy- 1

Journal of Transport Geography- 4

Journal of Urban Health-Bulletin of the New York Academy of Medicine- 1

Journal of Women’s Health- 1

Journal of Youth and Adolescence-1

Maternal and Child Nutrition- 1

Mayo Clinic Proceedings-1

Medical Journal of Australia-1

Medicine and Science in Sports and Exercise- 6

Morbidity and Mortality Weekly Report- 1

Nursing Research- 1

Obesity- 5

Obesity Reviews- 1

Pan American Journal of Public Health- 1

Patient Education and Counseling- 1

Pediatric Exercise Science- 1

Pediatrics- 7

Perceptual and Motor Skills- 1

Policy brief (UCLA Center for Health Policy Research)- 1

Preventing Chronic Disease- 7

Preventive Medicine- 10

Promotional Education- 1

Psychological Science- 1

Psychology In The Schools- 1

Public Health- 2

Public Health Nutrition- 2

Qualitative Health Research- 1

Research Quarterly For Exercise and Sport- 4

Social Policy and Administration- 1

Social Science and Medicine- 5

Sport Education and Society- 1

Sports Medicine- 1

Topics in Stroke Rehabilitation- 1

Transport Policy- 4

Transport Reviews- 1

Transportation Research Part A-Policy and Practice- 2

Transportation Research Part B-Methodological- 1

Transportation Research Part D-Transport and Environment- 1

Urban Studies- 1

Women and Health- 4

Citations

A. Alexander, P. Bergman, M. Hagstromer and M. Sjostrom (2006). IPAQ Environmental Module; Reliability Testing. Journal of Public Health; 14: 76-80.

Abstract The physical environment has emerged as a potential correlate to physical activity, and altering the environment could be one way to increase physical activity on a population level. The aim of the present study was to assess the test–retest reliability of the Swedish version of an environmental instrument developed for population-based studies. The study population was recruited from a larger study performed at the same time. A random sample of Swedish adults, age 18–74, was invited to participate in the reliability testing of 17 questions regarding the local physical environment. The questions addressed variables such as presence of sidewalks, bike paths and recreational facilities as well as questions regarding aesthetic, social and safety attributes. A total of 98 subjects completed the test and retest questionnaires. Overall percent agreement ranged from 55.1–92.9%. Intraclass correlation (ICC) for the total sample ranged from 0.36–0.98. The questions regarding motorized vehicles produced the highest total reliability score (ICC=0.98) and the question regarding safety from crime during the day produced the lowest (ICC=0.36). Small differences were seen between men and women for a few variables, but no apparent pattern was identified. The test–retest of the Swedish version of the environmental module resulted in substantial agreement for most variables. The instrument showed an acceptable reliability and can therefore be used in future studies regarding local environmental attributes and physical activity in Sweden.

P. M. Anderson and K. F. Butcher (2006). Childhood obesity: Trends and potential causes. Future Of Children; 16: 19-45.

The increase in childhood obesity over the past several decades, together with the associated health problems and costs, is raising grave concern among health care professionals, policy experts, children's advocates, and parents. Patricia Anderson and Kristin Butcher document trends in children's obesity and examine the possible underlying causes of the obesity epidemic. They begin by reviewing research on energy intake, energy expenditure, and "energy balance," noting that children who eat more " empty calories" and expend fewer calories through physical activity are more likely to be obese than other children. Next they ask what has changed in children's environment over the past three decades to upset this energy balance equation. In particular, they examine changes in the food market, in the built environment, in schools and child care settings, and in the role of parents-paying attention to the timing of these changes. Among the changes that affect children's energy intake are the increasing availability of energy-dense, high-calorie foods and drinks through schools. Changes in the family, particularly an increase in dual-career or single-parent working families, may also have increased demand for food away from home or pre-prepared foods. A host of factors have also contributed to reductions in energy expenditure. In particular, children today seem less likely to walk to school and to be traveling more in cars than they were during the early 1970s, perhaps because of changes in the built environment. Finally, children spend more time viewing television and using computers. Anderson and Butcher find no one factor that has led to increases in children's obesity. Rather, many complementary changes have simultaneously increased children's energy intake and decreased their energy expenditure. The challenge in formulating policies to address children's obesity is to learn how best to change the environment that affects children's energy balance.

T. Andreyeva and R. Sturm (2006). Physical Activity and Changes in Health Care Costs in Late Middle Age. Journal of Physical Activity & Health; 3: S6-S19.

Background: Physical activity has clear health benefits but there remains uncertainty about how it affects health care costs. Objective: To examine how physical activity is associated with changes in health expenditure for a national sample age 54 to 69 y, and estimate how this association varies across people with different chronic diseases and health behaviors. Methods: Data were from the Health and Retirement Study, a national longitudinal survey of late middle age Americans. Results: Correcting for baseline differences in active and inactive groups, physical activity was associated with reduced health care costs of about 7% over 2 y (or $483 annually). Conclusions: Regular physical activity in late middle age may lower health expenditure over time, and the effect is likely to be more pronounced for the obese, smokers, and individuals with some baseline health problems. While substantially large for the health care system, our estimates are much smaller than health-unadjusted comparisons or cross-sectional effects.

G. Antonini, M. Bierlaire and M. Weber (2006). Discrete choice models of pedestrian walking behavior. Transportation Research Part B-Methodological; 40: 667-687.

We propose a discrete choice framework for pedestrian dynamics, modelling short term behavior of individuals as a response to the presence of other pedestrians. We use a dynamic and individual-based spatial discretization, representing the physical space. We develop a model predicting where the next step of a walking pedestrian will be, at a given point in time. The use of the discrete choice framework is justified by its flexibility, the capacity to deal with individuals and the compatibility with agent-based simulation. The model is calibrated using data from actual pedestrian movements, manually taken from video sequences. We present two different formulations: a cross-nested logit and a mixed nested logit. In order to verify the quality of the calibrated model, we have designed and developed a pedestrians simulator. (c) 2005 Elsevier Ltd. All rights reserved.

T. A. Arcury, B. M. Snively, R. A. Bell, S. L. Smith, J. M. Stafford, L. K. Wetmore-Arkader and S. A. Quandt (2006). Physical activity among rural older adults with diabetes. Journal Of Rural Health; 22: 164-168.

Purpose: This analysis describes physical activity levels and factors associated with physical activity in an ethnically diverse (African American, Native American, white) sample of rural older adults with diabetes. Method: Data were collected using a population-based, cross-sectional stratified random sample survey of 701 coommunity-dwelling elders with diabetes completed in 2 rural North Carolina counties. Outcome measures were as follows:first, physical activity in the past year, and second, days physically active in the prior week (0-7). Potential correlates included personal and health characteristics and were evaluated for statistical significance using logistic regression models. Findings: About half (52.5%) of the participants stated that they had engaged in physical activity in the past year. Among those, 42.5% stated that they had no days with at least 30 minutes of continuous physical activity in the prior week, while 21.5% reported daily physical activity. Common activities were walking and housework. Correlates of physical activity in the past year and days active in the prior week included measures of physical health and mobility. Conclusions: Physical activity in this ethnically diverse sample of rural elders with diabetes is limited. Effort must be invested to increase physical activity in these groups.

A. Astrup, M. W. L. Bovy, K. Nackenhorst and A. E. Popova (2006). Food for thought or thought for food? A stakeholder dialogue around the role of the snacking industry in addressing the obesity epidemic. Obesity Reviews; 7: 303-312.

The current obesity epidemic is generally considered multi-causal. Certain foods, including snacks such as potato chips, and their marketing are often highlighted as needing particular attention. This forces potato chip producers to take position on their role and responsibility. Based on expert interviews and a literature review, a systems analysis approach is presented that distinguishes between basic physiology, self-control and what we call jam transmitters, signals and pressures from the environment that hinder or frustrate self-control. Examples of the latter are commercial push and seduction, obesogenic cultures, obesogenic physical environment, socioeconomic factors, genes, hormones and instincts. Solution of the epidemic demands an approach that involves all factors and all related actors. As for the snacking industry, the comprehensive responses are: to introduce specific diet products; to improve the nutritional quality of its products; the latter combined with supporting and engaging in healthy lifestyle marketing; to practice responsible targeting of marketing; and to limit the promotion of unhealthy consumption patterns.

H. Badland and G. Schofield (2006). Understanding the relationship between town size and physical activity levels: A population study. Health & Place; 12: 538-546.

Little is known about the relationship between town size and physical activity levels. A representative population sample survey was used to identify activity and environmental barrier differences between residents in diverse town sizes (n = 7916). Binary logistic regression analysis identified residents in large cities (> 100 000 people) were 15% less likely to be sedentary for overall activity classifications in comparison to small town dwellers (< 1000 people) (OR = 0.85; 95%Cl = 0.74-0.99). Barriers to physical activity participation differed by town size; smaller town residents reported a higher prevalence of infrastructural barriers, whereas larger city residents cited personal constraints. Community physical activity interventions should address issues associated with town size. (c) 2005 Elsevier Ltd. All rights reserved.

H. Badland and G. Schofield (2006). Test-retest reliability of a survey to measure transport-related physical activity in adults. Research Quarterly For Exercise And Sport; 77: 386-390.

K. Ball (2006). People, places. and other people? Integrating understanding of intrapersonal, social and environmental determinants of physical activity. Journal of Science and Medicine in Sport;

"People or places: what should be the target?" was the provocative title of a keynote session at the fifth Australian National Physical Activity Conference held in Melbourne in 2005. This paper will argue that in fact there need not be major conflict between these views, and that couching recent debate about physical activity promotion as a polarised choice between these presents a false dichotomy. To illustrate this, the paper will consider several problems with singular approaches to understanding and promoting physical activity, and will then describe emerging empirical evidence on the nexus between people and places. To balance an increasing emphasis in the scientific literature on physical environmental determinants of physical activity, the role of intrapersonal and social factors will also be revisited. It is concluded that growing evidence supporting the multiple domains of influence on physical activity justifies calls for multi-disciplinary and multi-sectoral partnerships and approaches to the promotion of active lifestyles.

K. Ball and D. Crawford (2006). Socio-economic factors in obesity: a case of slim chance in a fat world? Asia Pacific Journal of Clinical Nutrition; 15 Suppl: 15-20.

The global obesity pandemic has been well-documented and widely discussed by the public, the media, health officials, the food industry and academic researchers. While the problem is widely recognised, the potential solutions are far less clear. There is only limited evidence to guide decisions as to how best to manage obesity in individuals and in populations. While widely viewed as a clinical and public health problem in developed countries, it is now clear that many developing countries also have to grapple with this problem or face the crippling healthcare costs resulting from obesity-related morbidity. There is also abundant evidence that obesity is socio-economically distributed. In developed countries persons of lower socio-economic position are more likely to be affected, while in developing countries, it is often those of higher socio-economic position who are overweight or obese. The aim of this paper is to briefly review the evidence that links socio-economic position and obesity, to discuss what is known about underlying mechanisms, and to consider the role of social, physical, policy and cultural environments in explaining the relationships between socio-economic position and obesity. We introduce the concept of 'resilience' as a potential theoretical construct to guide research efforts aimed at understanding how some socio-economically disadvantaged individuals manage to avoid obesity. We conclude by considering an agenda to guide future research and programs focused on understanding and reducing obesity among those of low socio-economic position.

K. Ball and D. Crawford (2006). An investigation of psychological, social and environmental correlates of obesity and weight gain in young women. International Journal of Obesity; 30: 1240-1249.

Objectives: This study explored the biological, psychological, social and environmental correlates of young women's current weight and retrospective 2-year weight change. Methods: A total of 790 young women (mean age 26.8 years), sampled from the Australian Longitudinal Study on Women's Health, provided self-reported data on their height and weight, sociodemographics and a range of biological, psychological, social and environmental variables. Results: Several variables from all domains (biological, psychological, social support and environmental) were correlated with higher body mass index, and less strongly greater 2-year weight change. Key correlates included the tendency to never put on weight, no matter what; self-efficacy for avoiding weight gain, and for healthy eating; attention paid to weight; family support and friends' support/sabotage of physical activity/healthy eating; and perceived difficulty of taking the stairs rather than the elevator as part of the daily routine. Conclusions: Intervention strategies aimed at reducing weight gain and obesity may need to focus on social and environmental, as well as psychological factors; however, further research is necessary to confirm these findings given that a number of hypothesized associations were not observed.

K. Ball, J. Salmon, B. Giles-Corti and D. Crawford (2006). How can socio-economic differences in physical activity among women be explained? A qualitative study. Women & Health; 43: 93-113.

This qualitative study investigated why women of low socio-economic status (SES) are less physically active than women of higher-SES. Semi-structured interviews were conducted with 19 high-, 19 mid- and 18 low-SES women. A social-ecological framework, taking into account intrapersonal, social and environmental level influences, was adopted to guide the development of interview questions and interpretation of data. Thematic analysis identified a number of key influences on physical activity that varied by SES. These included negative early life/family physical activity experiences (a consistent theme among those of low-/mid-SES); participation in a wider range of physical activities in leisure time (high-SES); greater priority given to television viewing (low-SES); lack of time due to work commitments (low-SES); lack of time due to family commitments (high-SES); and neighbourhood-level barriers (low-SES). Financial costs were not perceived as a key barrier by women in any SES group. Public health strategies aimed at reducing SES inequalities in physical activity might focus on overcoming negative early experiences/attitudes to physical activity, reducing television viewing and promoting a wider variety of different types of physical activity, and addressing neighbourhood safety and other barriers to physically active lifestyles in socio-economically disadvantaged areas.

T. A. Barnett, J. O'Loughlin, L. Gauvin, G. Paradis and J. Hanley (2006). Opportunities for student physical activity in elementary schools: A cross-sectional survey of frequency and correlates. Health Education & Behavior; 33: 215-232.

The objectives of this study were to describe opportunities for student physical activity (PA) in elementary schools and to identify factors in the school environment associated with higher PA opportunity. Self-report questionnaires were completed by school principals and physical education teachers in 277 schools (88% response) in metropolitan Montreal. Correlates of opportunity were identified using ordinal logistic regression. There was substantial variation in PA opportunities between schools. Higher opportunity was associated with role modeling of PA by school principals, their interest in increasing PA through links to the municipality, adequate financial and human resources, access to school sports facilities, adequate space for storing student sports equipment, and suburban location. There is both the need and the potential for intervention to increase PA opportunities in elementary schools. Addressing barriers related to resources and access to sports facilities may help reduce disparities between schools in opportunities for students to engage in PA.

A. Bedimo-Rung, J. Gustat, B. J. Tompkins, J. Rice and J. Thomson (2006). Development of a Direct Observation Instrument to Measure Environmental Characteristics of Parks for Physical Activity. Journal of Physical Activity & Health; 3: S176-S189.

Background: The study’s purpose is to describe the development and evaluate the reliability (inter-observer agreement) and validity (rater agreement with a gold standard) of a direct observation instrument to assess park characteristics that may be related to physical activity. Methods. A direct observation instrument of 181 items was developed based on a conceptual model consisting of the following domains: features, condition, access, esthetics, and safety. Fifteen pairs of observers were trained and sent to two parks simultaneously to assess two Target Areas each. Results: Overall domain reliability was 86.9%, and overall geographic area reliability was 87.5%. Overall domain validity was 78.7% and overall geographic area validity was 81.5%. Conclusions: Inter-rater reliability and validity were generally good, although validity was slightly lower than reliability. Objective items showed the highest reliability and validity. Items that are time-sensitive may need to be measured on multiple occasions, while items asking for subjective responses may require more supervised practice.

E. S. Belansky, C. Romaniello, C. Morin, T. Uyeki, R. L. Sawyer, S. Scarbro, G. W. Auld, L. Crane, K. Reynolds, R. F. Hamman and J. A. Marshall (2006). Adapting and implementing a long-term nutrition and physical activity curriculum to a rural, low-income, biethnic community. Journal of Nutrition Education and Behavior; 38: 106-13.

This study adapted an urban-based school nutrition program for delivery in a rural community. Specific aims were to adapt the curriculum; expand it to include physical activity; determine effectiveness on students' attitudes, knowledge, and self-efficacy; and assess teachers' impressions. Three cohorts were established: 173 students taught by a resource teacher, 170 students taught by classroom teachers, and 187 students who did not receive the curriculum. Pre- and posttest surveys measured outcomes, and classroom teachers were observed and interviewed. The curriculum was shown to be effective in enhancing student outcomes for both the resource teacher and classroom teacher cohorts. Teachers reported that lessons needed to be simplified and that children enjoyed them. Findings support the transferability of an urban-based nutrition curriculum to a rural community and the need for students to receive health education annually.

G. G. Bennett, K. Y. Wolin, E. Puleo and K. M. Emmons (2006). Pedometer-determined physical activity among multiethnic low-income housing residents. Medicine And Science In Sports And Exercise; 38: 768-773.

Purpose: We sought to characterize pedometer-determined physical activity among a predominantly racial and ethnic minority sample of adults residing in low-income housing. Methods: Data were collected from 433 participants at baseline in a randomized colon cancer prevention intervention trial conducted within low-income housing communities. Using random effects models to control for clustering within housing sites, we examined variation in daily steps by several sociodemographic characteristics. Results: Participants recorded a mean of 5326 (+/- 3871 SD) daily steps over a 5-d sampling period. Significantly lower levels of pedometer-determined physical activity were found among older-aged participants (P < 0.0001), women (P = 0.02), those who were overweight and obese (P = 0.03), those reporting no weekly exercise (P = 0.04), as well as among nonworking individuals (P < 0.0001). No significant differences were found by education or income. In multivariable analyses, age, gender, body mass index, and employment status remained significantly associated with steps. Conclusions: These findings suggest a high prevalence of physical inactivity among low-income housing residents. These data, derived from a well-characterized sample, provide useful estimates for the investigation of pedometers as measures of total accumulated physical activity among lower-income, racial and ethnic minority populations.

G. G. Bennett, K. Y. Wolin, K. Viswanath, S. Askew, E. Puleo and K. M. Emmons (2006). Television viewing and pedometer-determined physical activity among multiethnic residents of low-income housing. American Journal of Preventive Medicine; 96: 1681-5.

OBJECTIVES: We evaluated the association between television viewing and pedometer-determined physical activity among predominantly racial/ethnic minority residents of low-income housing in metropolitan Boston in 2005. METHODS: We used mixed models to analyze the association between reported hours of television viewing and pedometer-determined steps per day among 486 adults. We also examined whether television viewing was associated with the achievement of 10000 steps per day. RESULTS: There was a mean 3.6 hours of average daily television watching. In multivariable analyses, each hour of television viewing on an average day was associated with 144 (95% confidence interval [CI]= -276, -12) fewer steps per day and a decreased likelihood of accumulating 10,000 steps per day (odds ratio [OR]=0.84; 95% CI=0.71, 0.99). Weekday and weekend television viewing were each also associated with fewer steps per day. CONCLUSIONS: Average daily television viewing was associated with reductions in total pedometer-determined physical activity levels (approximately 520 steps per day) in this lower-income sample. As part of a comprehensive physical activity promotion plan, recommendations to reduce television viewing should be made.

E. M. Berke, R. T. Ackermann, E. H. Lin, P. H. Diehr, M. L. Maciejewski, B. Williams, M. B. Patrick and J. P. LoGerfo (2006). Distance as a barrier to using a fitness-program benefit for managed Medicare enrollees. Journal of Aging and Physical Activity; 14: 313-24.

This study evaluated the effect of distance on the likelihood of initiating and maintaining regular use of a fitness-program benefit in a population of managed Medicare seniors. We studied 8,162 participants and nonparticipants in a managed-care fitness-program benefit: a structured group exercise program or an unstructured health-club membership. Participants in both programs lived significantly closer to facilities than nonparticipants did (structured, p or = 200,000) U.S. cities. BMI was measured on 72% and self-reported on 28%. Perception of neighborhood safety was assessed with the Neighborhood Environment for Children Rating Scales. The collective efficacy measure was adapted from the Project on Human Development in Chicago Neighborhoods. RESULTS: Thirty percent of the women were married, 38% lived below the U.S. poverty threshold, and 66% reported no education beyond high school. Approximately one-half of the women were non-Hispanic black, and one-fourth were Hispanic (any race). After adjustment for sociodemographic factors (household income, education, race/ethnicity, age, and marital status), smoking, depression, and television time, the prevalence of obesity (BMI > or = 30 kg/m2) increased across tertiles of neighborhood safety from safest to least safe (37% vs. 41% vs. 46%, p = 0.004) but did not differ across tertiles of collective efficacy from highest to lowest (41% vs. 40% vs. 42%, p = 0.67). DISCUSSION: In a national sample of women with young children, obesity was more prevalent among those who perceived their neighborhoods to be unsafe.

M. M. Bylina, T. C. Hu, T. J. Conway, J. Perrin, J. L. E. Houser, J. Hurst and C. C. Cox (2006). Comparison of exercise attitudes and behaviors of urban older adults with AARP's national sample results. Journal Of Aging And Physical Activity; 14: 41-58.

This study assessed perceptions about exercise among a convenience sample of low-income, urban, older adult patients at a publicly operated ambulatory primary-care clinic, and results were then compared with the findings of a national study. Although it was expected that the predominantly minority and economically disadvantaged participants in this study would trail significantly behind their White counterparts in their perceptions and behavior regarding exercise, findings demonstrated otherwise. Specifically, when physicians encourage moderate exercise, when patients believe that they can overcome barriers to exercise, and when the environment supports moderate exercise through the availability of community exercise classes, inequities in health behaviors can be reduced. Interventions designed to increase exercise for this population should be developed with an understanding of the many barriers that they will have to overcome, a focus on building confidence, and communicating the many benefits of this behavior.

X. Y. Cao, P. L. Mokhtarian and S. L. Handy (2006). Neighborhood design and vehicle type choice: Evidence from Northern California. Transportation Research Part D-Transport And Environment; 11: 133-145.

Previous studies have found that suburban development is associated with the unbalanced choice of light duty trucks. The specific aspects of the built environment that influence vehicle choice, however, have not been well-established. Further, these studies have not shed much light on the underlying direction of causality: whether neighborhood designs themselves, as opposed to preferences for neighborhood characteristics or attitudes towards travel, more strongly influence individuals' decisions regarding vehicle type. Using a sample from Northern California, this study investigated the relationship between neighborhood design and vehicle type choice, controlling for residential self-selection. Correlation analyses showed that neighborhood design has a strong association with vehicle type choice. Specifically, traditional neighborhood designs are correlated with the choice of passenger cars, while suburban designs are associated with the choice of light duty trucks. The nested logit model suggests that sociodemographic and attitudinal factors play an important role, and that an outdoor spaciousness measure (based on perceptions of yard sizes and off-street parking availability) and commute distance also impact vehicle type choice after controlling for those other influences. This study, therefore, supports the premise that land use policies have at least some potential to reduce the choice of light duty trucks, thereby reducing emissions. (c) 2005 Elsevier Ltd. All rights reserved.

M. Caraher, J. Landon and K. Dalmeny (2006). Television advertising and children: lessons from policy development. Public Health Nutrition; 9: 596-605.

AIM: To conduct a policy review of the regulations related to food advertising on television aimed at children. DESIGN: The study consisted of documentary analysis of relevant legislation and policy documents related to children's advertising from both industry and non-governmental organisations at a global level and in 20 countries. This was supported with semi-structured telephone interviews with individuals from 11 countries. RESULTS: The initial findings resulted in a listing of regulatory impacts from which we developed a taxonomy of regulatory schemes. There was a tension between the development of legislation to cover this area and the use of voluntary agreements and codes. This tension represents a food industry/civic society split. The food and advertising industries are still engaged in a process of denying the impact of advertising on food choice and children as well as commissioning their own research. Outright bans are unusual, with most countries addressing the situation through voluntary agreements and self-regulation. We found a deep division over the way forward and the role and place of legislation. Policy-makers expressed concerns that national legislation was increasingly less relevant in dealing with broadcast media transmitted from outside national boundaries and therefore not subject to the receiving countries' laws but to the laws of the country from which they were transmitted. CONCLUSIONS: The options for the regulation of advertising targeted at children range from (1) a complete ban on advertising as in the case of Sweden, through (2) partial restrictions on advertising by type of food, target group or limits on the amount of advertisements or times shown, to (3) continuation of self-regulation by the advertising and food industries. There is a global dimension to regulation that needs to be built in, as national frontiers are no barriers to broadcast media and public health nutrition needs to ensure that its concerns are heard and addressed.

P. H. Casey, P. M. Simpson, J. M. Gossett, M. L. Bogle, C. M. Champagne, C. Connell, D. Harsha, B. McCabe-Sellers, J. M. Robbins, J. E. Stuff and J. Weber (2006). The association of child and household food insecurity with childhood overweight status. Pediatrics; 118: e1406-13.

CONTEXT: The prevalence of childhood overweight status is increasing. Some have suggested that childhood overweight is associated with food insecurity, defined as limited or uncertain access to enough nutritious food. OBJECTIVES: The purpose of this work was to assess the association of household and child food insecurity with childhood overweight status. METHODS: The National Health and Nutrition Examination Survey 1999-2002 uses a stratified multistaged probability sample and collects a broad array of data from a nationally representative sample of US citizens. All children 3 to 17 years old in this sample are included in these analyses. We measured BMI categorized as at risk for overweight or greater (> or = 85%) or overweight (> or = 95%) and household and child food security/insecurity using the US Food Security Scale. RESULTS: When compared with children from food-secure households, children from food-insecure households were more likely to demonstrate significant associations with being at risk for overweight or greater in the following demographic categories: 12 to 17 years, girls, white, and in households with income < 100% and > 4 times the federal poverty level. Household food insecurity is associated with child overweight status in children aged 12 to 17, girls, and children who live in households with incomes > 4 times the federal poverty level. Child food insecurity demonstrated the same associations with being at risk for overweight or greater, as did household food insecurity, but associations were also seen in 3- to 5-year-old children, boys, and Mexican American children. Child food insecurity is significantly associated with child overweight status for children aged 12 to 17, girls, white children, and children in families with income < or = 100% poverty level. Controlling for ethnicity, gender, age, and family poverty index level, childhood food insecurity is associated with a child being at risk for overweight status or greater, but not overweight status. CONCLUSIONS: Household and child food insecurity are associated with being at risk for overweight and overweight status among many demographic categories of children. Child food insecurity is independently associated with being at risk for overweight status or greater while controlling for important demographic variables. Future longitudinal research is required to determine whether food insecurity is causally related to child overweight status.

J. Cawley (2006). Markets and childhood obesity policy. Future Of Children; 16: 69-88.

In examining the childhood obesity epidemic from the perspective of economics, John Cawley looks at both possible causes and possible policy solutions that work through markets. The operation of markets, says Cawley, has contributed to the recent increase in childhood overweight in three main ways. First, the real price of food fell. In particular, energy-dense foods, such as those containing fats and sugars, became relatively cheaper than less energy-dense foods, such as fresh fruits and vegetables. Second, rising wages increased the "opportunity costs" of food preparation for college graduates, encouraging them to spend less time preparing meals. Third, technological changes created incentives to use prepackaged food rather than to prepare foods. Several economic rationales justify government intervention in markets to address these problems. First, because free markets generally under-provide information, the government may intervene to provide consumers with nutrition information they need. Second, because society bears the soaring costs of obesity, the government may intervene to lower the costs to taxpayers. Third, because children are not what economists call "rational consumers"-they cannot evaluate information critically and weigh the future consequences of their actions-the government may step in to help them make better choices. The government can easily disseminate information to consumers directly, but formulating policies to address the other two rationales is more difficult. In the absence of ideal policies to combat obesity, the government must turn to "second-best" policies. For example, it could protect children from advertisements for "junk food." It could implement taxes and subsidies that discourage the consumption of unhealthful foods or encourage physical activity. It could require schools to remove vending machines for soda and candy. From the economic perspective, policymakers should evaluate these options on the basis of cost-effectiveness studies. Researchers, however, have as yet undertaken few such studies of obesity-related policy options. Such analyses, once available, will help policymakers achieve the greatest benefit from a fixed budget.

E. Cerin, B. E. Saelens, J. F. Sallis and L. D. Frank (2006). Neighborhood Environment Walkability Scale: validity and development of a short form. Medicine and Science in Sports and Exercise; 38: 1682-91.

PURPOSE: The aim of this study was to examine the factorial and criterion validity of the Neighborhood Environment Walkability Scale (NEWS) and to develop an abbreviated version (NEWS-A). METHODS: A stratified two-stage cluster sample design was used to recruit 1286 adults. The sample was drawn from residential addresses within eight high- and eight low-walkable neighborhoods matched for socioeconomic status. Subjects completed the NEWS and reported weekly minutes of walking for transport and recreation using items from the International Physical Activity Questionnaire. RESULTS: Multilevel confirmatory factor analysis was used to develop measurement models of the NEWS and NEWS-A. Six individual-level and five blockgroup-level factors were identified. Factors/scales gauging presence of diversity of destinations, residential density, walking infrastructure, aesthetics, traffic safety, and crime were positively related to walking for transport. Aesthetics, mixed destinations, and residential density were associated with walking for recreation. CONCLUSIONS: The NEWS and NEWS-A possess adequate levels of factorial and criterion validity. Alternative methods of scoring for different purposes are presented.

C. B. Chan, D. A. Ryan and C. Tudor-Locke (2006). Relationship between objective measures of physical activity and weather: a longitudinal study. International Journal of Behavioral Nutrition and Physical Activity; 3: 21. BACKGROUND: The weather may be a barrier to physical activity but objective assessment of this hypothesis is lacking. Therefore we evaluated the effect of temperature, rain or snow, and wind speed on the daily physical activity of adults. METHODS: This report contains data from 25 males (BMI (mean +/- SD): 28.7 +/- 3.83 kg/m2) and 177 females (BMI: 29.2 +/- 5.92 kg/m2) enrolled in an intervention to increase physical activity. Steps/day of the participants was measured by pedometer. Weather data were obtained from Environment Canada. A total of 8,125 observations were included in a mixed linear model analysis. RESULTS: Significant weather related variables (at the 5% level) impacting steps/day included: seasonal effects related to the interaction between weekday and month; mean temperature, total rainfall, interactions between gender, BMI and total snow, interactions between maximum wind speed and BMI, and the amount of snow on the ground. The estimated magnitudes for the various effects were modest, ranging from ~1% to ~20%. Thus for an average individual taking ~10,000 steps/day, weather-dependent changes in physical activity could reach 2,000 steps/day. CONCLUSION: We conclude that weather had modest effects on physical activity of participants in an intervention to increase their activity. It should be stressed that these effects may be different for less or more motivated people. With this in mind, we suggest that the effect of weather on physical activity in the general population needs to be objectively assessed to better understand the barrier it poses, especially as it relates to outdoor recreation or work activities.

W. Charoentrakulpeeti, E. Sajor and W. Zimmermann (2006). Middle-class travel patterns, predispositions and attitudes, and present-day transport policy in Bangkok, Thailand. Transport Reviews; 26: 693-712.

Middle-class expansion and new consumption patterns have increasingly become an important focus of studies of the development and change in newly industrialized and middle-income-developing East and South East Asian countries. However, there is still a dearth of studies in the literature particularly focusing on middle-class travel patterns, predispositions and transport policy preferences. Nor have the implications of these factors on current transport and land development policy been examined. The present exploratory study addresses this gap by examining three cases in Bangkok, Thailand, which in recent decades witnessed dramatic middle-class expansion, an increase in private motor vehicle population, and spatial diffusion of middle-class residences into lower-density zones in the suburbs. By mainly employing a survey method of data-gathering and quantitative research analysis, the paper discusses the following findings: (1) that middle-class travel behaviour is characterized by a high dependence on private motor vehicle travel and 'inward commuting'; (2) that middle-class preferences for transport mode and attitudes about remedial policy options are generally protective of their members' car-dependence and ownership; and (3) that present policy measures of the Thai government on Bangkok transport perfectly fit and support exclusively middle- and upper-class predispositions and stakes in mobility. These findings in a developing country city basically follow a similar profile to be found in middle-class-dominant transport patterns and urban form in a number of North American cities. This paper further argues that in a developing country city such as Bangkok, where marked social differentiation and the combined population of poor and low-income classes still comprise almost half of the urban social landscape despite an expanding middle-class, an adequate and good public transport system that also meets the former's need for efficient mobility is an imperative.

D. Chenoweth and J. Leutzinger (2006). The Economic Cost of Physical Inactivity and Excess Weight in American Adults. Journal of Physical Activity & Health; 3: 148-163.

Background: Physical inactivity and excess weight in American adults have reached epidemic levels. This article describes how cost data from previously conducted analyses in several states were used to quantify the costs of physical inactivity and excess weight among American adults. Methods: Medical and workers' compensation cost data on selected medical conditions were obtained from various health plans and state agencies in seven states. Productivity loss norms were obtained from published studies. Results: The estimated financial burden which includes direct medical care, workers' compensation, and productivity loss costs among the seven states is $93.32 billion for physical inactivity and $94.33 billion for excess weight. The estimated nationwide cost of these risk factors is approximately $507 billion with projected costs exceeding $708 billion in 2008. Projected cost-savings of $31 billion per year could be realized with a 5% drop in these risk factors. Conclusion: The cost of physical inactivity and excess weight among American adults is significant. More research on best-of-class interventions to curtail the high prevalence of these risk factors is needed.

O. D. Christenson, R. B. Zabriskie, D. L. Eggett and P. A. Freeman (2006). Family acculturation, family leisure involvement, and family functioning among Mexican-Americans. Journal Of Leisure Research; 38: 475-495.

The purpose of this study was to examine the relationship between acculturation and family leisure involvement and aspects of family functioning (cohesion and adaptability) from Mexican-American parent, youth, and family perspectives. Acculturation was measured using the Bidimensional Acculturation Scale for Hispanics (BAS), family leisure involvement was measured using the Family Leisure Activity Profile (FLAP), and family functioning was measured using the Family Adaptability and Cohesion Evaluation Scales (FACES II). The sample was obtained from communities in Texas and Utah and consisted of 74 Mexican-American families, including a parent and child from each family. After adjusting for sociodemographic variables, the independent variables were found to help discriminate levels of acculturation for parents, youth, and families. Recommendations are given for commercial and community recreation programs targeting Mexican-American families, in addition to implications for further research.

A. D. Christodoulos, A. D. Flouris and S. P. Tokmakidis (2006). Obesity and physical fitness of pre-adolescent children during the academic year and the summer period: effects of organized physical activity. Journal of Child Health Care; 10: 199-212.

This study examined obesity and parameters of physical fitness in 178 elementary schoolchildren during an academic year as well as after the summer holidays. Results showed significant physical fitness improvements during the school year, with little or no changes in the summer holidays. Children who reported less than 30 minutes of daily participation in physical activity demonstrated lower prevalence rates for overweight and obesity as well as superior fitness performance. The detrimental effect of the summer break on the progress of physical fitness was less in children who did participate in physical activity than in those who did not. Longitudinal modelling using generalized estimating equations demonstrated that physical activity is a major contributing factor for obesity over time, masking the singular effect of various fitness parameters. It is concluded that pre-adolescent children advance in physical fitness mainly during the school year, with physical activity being a beneficial countermeasure for the development of obesity.

D. P. Cliff, A. Wilson, A. D. Okely, K. J. Mickle and J. R. Steele (2006). Feasibility of SHARK: A physical activity skill-development program for overweight and obese children. Journal of Science and Medicine in Sport;

This study aimed to assess the feasibility of a community-based physical activity motor development program, called SHARK, among overweight and obese children. Thirteen overweight or obese children aged 8-12 years were recruited to the 10-week program from the Illawarra region of NSW, Australia. Measures at baseline, post-treatment and 9-month follow-up included BMI, motor development, perceived competence, objectively measured physical activity and performance of an activity of daily living. At post-treatment and follow-up motor development, perceived athletic competence and perceived global self-worth had significantly increased. Although recorded minutes in moderate-to-vigorous activity significantly declined at post-treatment and follow-up, activity daily counts did not. The results indicate that community-based activity programs designed to improve the motor development and perceived competence of overweight and obese children are feasible and may have important and sustainable benefits. However, a larger sample size and a comparison group are required to determine whether this approach can impact on activity levels and weight status.

D. P. Coe, J. M. Pivarnik, C. J. Womack, M. J. Reeves and R. M. Malina (2006). Effect of physical education and activity levels on academic achievement in children. Medicine and Science in Sports and Exercise; 38: 1515-9.

PURPOSE: This study was conducted to determine the effect of physical education class enrollment and physical activity on academic achievement in middle school children. METHODS: Participants were 214 sixth-grade students randomly assigned to physical education during either first or second semesters. Moderate and vigorous physical activity (MVPA) (number of 30-min time blocks) outside of school was assessed using the 3-d physical activity recall (3DPAR). The 3DPAR time blocks were converted to ordinal data with scores of 1 (no activity), 2 (some activity), or 3 (activity meeting Healthy People 2010 guidelines). Academic achievement was assessed using grades from four core academic classes and standardized test scores (Terra Nova percentiles). RESULTS: Grades were similar regardless of whether students were enrolled in physical education during first or second semesters. Physical education classes averaged only 19 min of MVPA. Students who either performed some or met Healthy People 2010 guidelines for vigorous activity had significantly higher grades (P < 0.05) than students who performed no vigorous activity in both semesters. Moderate physical activity did not affect grades. Standardized test scores were not significantly related to physical education class enrollment or physical activity levels. CONCLUSION: Although academic achievement was not significantly related to physical education enrollment, higher grades were associated with vigorous physical activity, particularly activity meeting recommended Healthy People 2010 levels.

D. A. Cohen, J. S. Ashwood, M. M. Scott, A. Overton, K. R. Evenson, L. K. Staten, D. Porter, T. L. McKenzie and D. Catellier (2006). Public parks and physical activity among adolescent girls. Pediatrics; 118: e1381-9.

OBJECTIVES: Physical activity may be constrained or facilitated by local environments. The availability of neighborhood facilities for physical activity may be particularly relevant for youth, who are unable to drive and whose activity is often limited to the immediate distance they are able to walk or bicycle. Several studies have shown that proximity to recreational facilities and parks is one of the most important predictors of physical activity. Because the United States already has an extensive infrastructure of parks, with 70% of adults indicating that they live within walking distance of a park or playground, parks may be a potential venue for increasing physical activity. This might be particularly important for adolescent girls, whose physical activity levels decline substantially as they go through puberty. The goal of this study was to examine the association between park proximity, park type, and park features and physical activity in adolescent girls. PATIENTS AND METHODS: This was a cross-sectional study using baseline data from the Trial of Activity for Adolescent Girls. It included 1556 grade 6 girls who were randomly selected from 6 middle schools in each of the following 6 field site areas: Washington, DC, and Baltimore, Maryland; Columbia, South Carolina; Minneapolis, Minnesota; New Orleans, Louisiana; Tucson, Arizona; and San Diego, California. Girls wore accelerometers for 6 days to measure metabolic equivalent-weighted moderate-to-vigorous physical activity, a measure accounting for the volume and intensity of activity. Metabolic equivalent-weighted moderate-to-vigorous physical activity was calculated for the hours outside of school time using 2 different cutpoints, activity levels > or = 3.0 metabolic equivalents and > or = 4.6 metabolic equivalents, the latter indicating activity at the intensity of a brisk walk or higher. We mapped all of the parks within 1 mile of each girl's home. Trained staff used a checklist to document the presence of facilities and amenities at each park, including passive amenities, such as drinking fountains, restrooms, and areas with shade, as well as active amenities like basketball courts, multipurpose fields, playgrounds, and tennis courts. RESULTS: Mean nonschool metabolic equivalent-weighted moderate/vigorous physical activity, using the 4.6 metabolic equivalent cutoff, was 611.1 minutes (range: 49.7-4718.6 metabolic equivalent minutes per 6 days) and 1704.8 metabolic equivalent minutes per 6 days (range: 276.2-5792.6 metabolic equivalent minutes per 6 days) when using the 3.0 metabolic equivalent cutpoint. Many girls had multiple parks within a 1-mile radius of their homes: 57% had > or = 1 type of park, the majority being neighborhood or community parks; 42% had between 1 and 3 parks, 37% had > or = 4 parks, and 14% had > or = 8 parks. The type, number, and specific parks features were associated with girls' nonschool metabolic equivalent-weighted moderate/vigorous physical activity. At the 4.6 metabolic equivalent cutpoint, higher levels of nonschool metabolic equivalent-weighted moderate/vigorous physical activity were associated with both neighborhood and community parks (22 metabolic equivalent minutes) and miniparks (40 metabolic equivalent minutes). Each park, regardless of type, in the half-mile around each girl's home was associated with an increase in nonschool metabolic equivalent-weighted moderate/vigorous physical activity by 2.8% or 17.2 nonschool minutes of metabolic equivalent-weighted moderate/vigorous physical activity per 6 days. Beyond a half-mile, each park increased nonschool metabolic equivalent-weighted moderate/vigorous physical activity by 1.1% or 6.7 metabolic equivalent minutes per 6 days. For the average girl with 3.5 parks within a 1-mile radius of home, the presence of parks accounted for 36.5 extra nonschool metabolic equivalent minutes per 6 days, approximately 6% of total nonschool metabolic equivalent-weighted moderate/vigorous physical activity. Using the 3.0 metabolic equivalent cutpoint, this sums to an additional 68 metabolic equivalent minutes of nonschool metabolic equivalent-weighted moderate/vigorous physical activity over 6 days, or 4% of the total. The most common amenities in the parks were playgrounds, multipurpose fields, and picnic areas. Slightly more than one third of girls lived within a half-mile of a park with a basketball court, and > 20% had access to walking paths and tennis courts in their local park. Higher levels of nonschool metabolic equivalent-weighted moderate/vigorous physical activity per 6 days were associated with walking paths (13 metabolic equivalent minutes), running tracks (82 metabolic equivalent minutes), playgrounds (28 metabolic equivalent minutes), and basketball courts (30 metabolic equivalent minutes). Parks with streetlights and floodlights were also associated with an increase of 18 and 22 minutes of nonschool metabolic equivalent-weighted moderate/vigorous physical activity, respectively. With the 3.0 metabolic equivalent cutoff for metabolic equivalent-weighted moderate/vigorous physical activity, additional nonschool metabolic equivalent minutes more than doubled when girls had miniparks (92 metabolic equivalent minutes), natural resource areas (36 metabolic equivalent minutes), walking paths (59 metabolic equivalent minutes), and running tracks (208 metabolic equivalent minutes) within a half-mile of their homes. Skateboard areas and special-use parks were negatively associated with nonschool metabolic equivalent-weighted moderate/vigorous physical activity in adolescent girls. CONCLUSIONS: Adolescent girls who live near more parks, particularly near those with amenities that are conducive to walking and with active features, engage in more nonschool metabolic equivalent-weighted moderate/vigorous physical activity than those with fewer parks. Whether this is because of actual use of the parks or neighborhood choice could not be determined. Although the magnitude of the association between parks and additional minutes of metabolic equivalent-weighted moderate/vigorous physical activity was small for an individual, amounting to an average of 4%-6% of a girl's total nonschool metabolic equivalent-weighted moderate/vigorous physical activity, it is likely to have a large population-level association. Because of the potential population level impact, the use of parks to promote physical activity should be further studied.

D. A. Cohen, S. Ashwood, M. Scott, A. AOverton, K. R. Evenson, C. C. Voorhees, A. Bedimo-Rung and T. L. McKenzie (2006). Proximity to School and Physical Activity Among Middle School Girls: The Trial of Activity for Adolescent Girls Study. Journal of Physical Activity & Health; 3: S129-S138.

Background: Proximity to routine destinations is an important correlate of physical activity. We examined the association between distance from school and physical activity in adolescent girls. Methods: We mapped the addresses of 1554 sixth grade girls who participated in the Trial of Activity for Adolescent Girls (TAAG) Study and calculated the shortest distance from home to school along the street network. Using a hierarchical design we examined the association between METweighted moderate to vigorous physical activity (MW- MVPA) and distance to

school, while controlling for potential confounders. Results: Distance to school was inversely associated with weekday MW- MVPA for middle school girls. For every mile the girls lived from their schools, they engaged in an average of 13 fewer MET- weighted minutes per week. Conclusions: Distance to school is inversely associated with MW-MVPA. The most adversely affected girls lived more than 5 miles from school. Time spent commuting could explain reduced time for physical activity.

D. A. Cohen, B. K. Finch, A. Bower and N. Sastry (2006). Collective efficacy and obesity: The potential influence of social factors on health. Social Science & Medicine; 62: 769-778.

Social determinants have been identified as a fundamental cause of health and disease in most industrialized countries. However, much less is known about which characteristics of communities may lead to disparities in health outcomes. Collective efficacy-the willingness of community members to look out for each other and intervene when trouble arises-is a social factor shown to be associated with outcomes related to obesity, including premature mortality and cardiovascular disease. The objective of this study is to determine whether neighborhood collective efficacy is associated with individual measures of body mass index (BMI) in adolescents. We use a multi-level, cross-sectional survey in Los Angeles County, involving 807 adolescents in 684 households in 65 neighborhoods in addition to a sample of 3000 adult respondents. The main outcomes measures are BMI, at risk of overweight, and overweight status. Using a two-level model, we find significant relationships between collective efficacy and all three outcomes, net of levels of neighborhood disadvantage. The associations between BMI and collective efficacy could potentially be explained by several factors, including a metabolic pathway, neighborhood differences in the physical and social environments, or a combination of these two. If group-level collective efficacy is indeed important in the regulation of individual-level net energy balance, it suggests that future interventions to control weight by addressing the social environment at the community level may be promising. (c) 2005 Elsevier Ltd. All rights reserved.

R. Cole, E. Leslie, A. Bauman, M. Donald and N. Owen (2006). Socio-Demographic Variations in Walking for Transport and for Recreation or Exercise Among Adult Australians. Journal of Physical Activity & Health; 3: 164-178.

Background: Walking is integral to strategies to promote physical activity. We identified socio-demographic variations in walking for transport, and for recreation or exercise. Methods: Representative population data (n = 3392) from Australia were collected using computer assisted telephone interviewing, to examine adults’ participation in moderate- or brisk-paced walking for transport and walking for recreation or exercise; walking “sufficient” to meet the current public health guideline (> 150 min/wk); and, the contributions of total walking to meeting the guideline for total physical activity. Results: Rates of sufficient walking for transport (10% for men, 9% for women) were lower than those for walking for recreation or exercise (14% for both genders). Few socio-demographic differences emerged. Men over age 60 y were significantly less likely (OR = 0.40) to walk for transport; men age 45 to 59 y were more likely (OR = 1.56) to walk for recreation or exercise. Walking contributed more toward meeting the current public health guideline among women (15% to 21%) than among men (6% to 8%). Conclusions: There is potential for socially equitable increases in participation, through a focus on both walking for transport and on walking for recreation or exercise; attention to gender differences would be helpful.

S. M. Connor (2006). Food-related advertising on preschool television: building brand recognition in young viewers. Pediatrics; 118: 1478-85.

OBJECTIVES: This study used content analysis to explore how much and what type of advertising is present in television programming aimed at toddlers and preschool-aged children and what methods of persuasion are being used to sell products and to promote brands to the youngest viewers. METHODS: Four randomly selected, 4-hour blocks (9 am to 1 pm) were recorded in spring 2005 from each of 3 stations airing programming aimed specifically at toddlers and preschool-aged children (Public Broadcasting Service, Disney, and Nickelodeon). All content that aired in the spaces between programs was examined. Data recorded for food-related advertisements included the primary appeals used to promote products or brands, whether advertisements were aimed at children or adults, whether advertisements used primarily animation or live action, whether advertisements showed food, and whether licensed characters were used. RESULTS: In 96 half-hour blocks of preschool programming, the 3 stations had a total of 130 food-related advertisements (1.354 food advertisements per half-hour). More than one half of all food advertisements (76 of 130 advertisements) were aimed specifically at children, and the majority of those were for fast food chains (50 advertisements) or sweetened cereals (18 advertisements). The primary advertising appeals used associated products with fun and happiness and/or with excitement and energy. Fast food advertisements in particular seemed to focus on building brand recognition and positive associations, through the use of licensed characters, logos, and slogans. CONCLUSIONS: The majority of child-oriented food advertisements viewed seemed to take a branding approach, focusing on creating lifelong customers rather than generating immediate sales. Promotional spots on advertisement-supported (Nickelodeon) and sponsor-supported (Public Broadcasting Service and Disney) networks took similar approaches and used similar appeals, seeming to promote the equation that food equals fun and happiness.

F. Contaldo and F. Pasanisi (2006). High-protein diet, obesity, and the environment. American Journal of Clinical Nutrition; 83: 387; author reply 387-8.

A. Crossman, D. Anne Sullivan and M. Benin (2006). The family environment and American adolescents' risk of obesity as young adults. Social Science & Medicine;

In this article, the effects of the family environment and adolescents' behaviors while in school grades 7 through 12 on their weight status 6 years later are examined using data from the United States National Longitudinal Study of Adolescent Health. Ordinal regression models of 6378 adolescents reveal that their family environments exert an influence on their weight that lasts into young adulthood. Parental obesity puts both males and females at greater risk for being overweight or obese as young adults, as does already having excessive weight in adolescence. The findings also reveal significant gender differences in the intergenerational transmission of body weight within families. Higher parental educational attainment, a stronger perception that parents care about them, and a higher self-esteem reduce female adolescents' risk for excessive weight as young adults, while being African American or Native American increases it. In contrast, only a perception that their parents are trying to control their diets and a higher degree of closeness with a parent put male adolescents at greater risk for excessive weight as young adults. Adolescents' participation in physical activities does not predict subsequent weight for either males or females, although the amount of time spent in sedentary activities does for females, but not males. The only adolescent behavior examined that influenced male weight in young adulthood was eating breakfast.

S. Cummins and S. Macintyre (2006). Food environments and obesity--neighbourhood or nation? International Journal of Epidemiology; 35: 100-4.

H. Cutt, B. Giles-Corti, M. Knuiman and V. Burke (2007). Dog ownership, health and physical activity: A critical review of the literature. Health & Place; 13: 261-272.

This review examines the association between dog ownership and adult physical activity levels. While there is evidence to suggest that dog ownership produces considerable health benefit and provides an important form of social support that encourages dog owners to walk, there is limited evidence on the physical environmental and policy-related factors that affect dog owners walking with their dog. With the high level of dog ownership in many industrialized countries, further exploration of the relationship between dog ownership and physical activity levels may be important for preventing declining levels of physical activity and the associated detrimental health effects. (c) 2006 Elsevier Ltd. All rights reserved.

K. K. Davison and C. T. Lawson (2006). Do attributes of the physical environment influence children's physical activity? A review of the literature. International Journal of Behavioral Nutrition and Physical Activity; 3: 19.

ABSTRACT: BACKGROUND: Many youth today are physically inactive. Recent attention linking the physical or built environment to physical activity in adults suggests an investigation into the relationship between the built environment and physical activity in children could guide appropriate intervention strategies. Method: Thirty three quantitative studies that assessed associations between the physical environment (perceived or objectively measured) and physical activity among children (ages 3 to 18-years) and fulfilled selection criteria were reviewed. Findings were categorized and discussed according to three dimensions of the physical environment including recreational infrastructure, transport infrastructure, and local conditions. Results: Findings across the various studies showed that children's participation in physical activity is positively associated with publicly provided recreational infrastructure (access to recreational facilities and schools) and transport infrastructure (presence of sidewalks and controlled intersections, access to destinations and public transportation). At the same time, transport infrastructure (number of roads to cross and traffic density/speed) and local conditions (crime, area deprivation) are negatively associated with children's participation in physical activity. Conclusions: Results highlight links between the physical environment and children's physical activity. Additional research using a transdisciplinary approach and assessing moderating and mediating variables is necessary to appropriately inform policy efforts.

K. K. Davison and D. L. Schmalz (2006). Youth at risk of physical inactivity may benefit more from activity-related support than youth not at risk. International Journal of Behavioral Nutrition and Physical Activity; 3: 5.

BACKGROUND: This study examines whether associations between activity-related support and adolescents' physical activity differ for adolescents at high versus low risk of physical inactivity. METHODS: Participants included 202 middle-school-aged girls (N = 92) and boys (N = 110). Physical activity was assessed using three self-report questionnaires. Activity-related support from mothers, fathers, siblings, and peers was assessed using the Activity Support Scale. Perceived sport competence was assessed using the Physical Activity Self Description Questionnaire. Participants' height and weight were measured and used to calculate their age- and sex-adjusted Body Mass Index percentile. Participants were classified as being at high risk for physical inactivity if they fulfilled two of the following three criteria: (1) overweight; (2) female; or (3) having low perceived sport competence. RESULTS: Activity-related support from all sources was associated with higher levels of physical activity among adolescents. A stronger association between activity support and physical activity was found for adolescents at high risk for physical inactivity in comparison to adolescents at low risk. CONCLUSIONS: Findings from this study suggest that the activity-related support from family and friends may be an effective tool in promoting physical activity among youth at risk of physical inactivity.

K. Day, M. G. Boarnet, M. Alfonzo and A. Forsyth (2006). The Irvine-Minnesota Inventory to Measure Built Environments: Development. American Journal of Preventive Medicine; 30: 144-152.

BACKGROUND: Researchers and policymakers increasingly identify active living-including walking and bicycling for travel and recreation-as a potential strategy to increase rates of physical activity in the United States. Understanding the impact of the built environment on physical activity levels requires reliable methods to measure potentially relevant built environment features. This paper presents an audit tool-the Irvine Minnesota Inventory-that was designed to measure a wide range of built environment features that are potentially linked to active living, especially walking. METHODS: The inventory was created through a literature review, focus group interviews, a panel of experts, and field testing in 27 settings. The inventory was developed in 2003-2004. RESULTS: The Irvine Minnesota Inventory includes 162 items, organized into four domains: accessibility (62 items), pleasurability (56 items), perceived safety from traffic (31 items), and perceived safety from crime (15 items). (Some items are in multiple domains.) The inventory includes both a paper version and a version in Microsoft Access, to allow data to be input directly into the computer. CONCLUSIONS: Limitations of methods used to develop the inventory are discussed. Strategies are offered for using the Irvine Minnesota Inventory to systematically and reliably measure characteristics of the built environment that are potentially linked to active living.

G. J. de Bruijn, S. P. J. Kremers, G. Lensvelt-Mulders, H. de Vries, W. van Mechelen and J. Brug (2006). Modeling individual and physical environmental factors with adolescent physical activity. American Journal of Preventive Medicine; 30: 507-512.

Background: Recent calls have been made to consider both environmental factors and individual-level factors in the explanation of physical activity (PA). The present study tested a conceptual model that integrated past PA, relevant environmental-level and individual-level factors and their associations with adolescent PA, using the tenets of the Theory of Planned Behavior (TPB). Methods: Data were gathered in an adolescent sample (n=221; 60% girls) using questionnaires. PA was assessed in May 2003 and November 2003. Theory, of Planned Behavior cognitions regarding PA and the environmental factors under study were assessed in November 2003. Confirmatory factor analyses and path analyses were performed using AMOS software. Results: The initial structural model did not provide an acceptable fit to the data. Including a direct path from past PA to current PA significantly improved model fit to an acceptable fit. Including a direct path from past PA to environmental perceptions did not significantly improve model fit. Including a direct path from the environmental variables to current PA did not significantly improve model fit. Current PA was most strongly influenced by past PA, while environmental aesthetics and distance to PA opportunities were indirectly related to adolescents' intention to be physically active. Significant standardized path coefficients ranged from 0.14 to 0.34 and explained 17% variance in current PA. Conclusions: Combining past PA, Theory of Planned Behavior cognitions, and environmental factors increased our understanding of their relative influences on adolescent PA. Implications for future research on physical activity are discussed.

J. de Jong, K. A. Lemmink, M. Stevens, M. H. de Greef, P. Rispens, A. C. King and T. Mulder (2006). Six-month effects of the Groningen active living model (GALM) on physical activity, health and fitness outcomes in sedentary and underactive older adults aged 55-65. Patient Education and Counseling; 62: 132-41.

OBJECTIVE: To determine the effects on energy expenditure, health and fitness outcomes in sedentary older adults aged 55-65 after 6-month participation in the GALM program. METHODS: In three Dutch communities, subjects from matched neighbourhoods were assigned to an intervention (n = 79) or a waiting-list control group (n = 102). The GALM program consisted of fifteen 60 min sessions once a week emphasising moderate-intensity recreational sports activities. RESULTS: The intervention group showed significant increases in energy expenditure for recreational sports activities, other leisure-time physical activity, health indicators, and perceived and performance-based fitness. Contrary to our expectations, the same increases were found for the control group. Consequently, only significant between-group differences, favouring the intervention group, were obtained for sleep, diastolic blood pressure, perceived fitness score and grip strength. CONCLUSION: The increases in energy expenditure for physical activity from the GALM program, especially for the more intensive recreational sports activities, look promising and are in line with the expected amounts necessary to improve health. Further research is needed to evaluate long-term effects of participation in the GALM program. PRACTICE IMPLICATIONS: These results underline that GALM can be considered successful in stimulating leisure-time physical activity and improving health and fitness in older adults.

J. Delva, P. M. O'Malley and L. D. Johnston (2006). Racial/ethnic and socioeconomic status differences in overweight and health-related behaviors among American students: national trends 1986-2003. Journal of Adolescent Health; 39: 536-45.

PURPOSE: This article reports long-term trends by race/ethnicity and socioeconomic status (SES) in the percent of American students who are overweight and who engage in three health-related behaviors hypothesized to be associated with overweight. METHODS: Data are from the Monitoring the Future annual surveys, using nationally representative samples of eighth, 10th, and 12th grade students. Participants include 62,156 eighth and 64,899 10th graders who completed the 1993-2003 surveys and 35,107 12th graders who completed the questionnaire form containing the measures pertaining to this study in the 1986-2003 surveys. Trends are presented separately by gender and grade level for different racial/ethnic and SES subgroups, in: (a) percent overweight (body mass index > or = 85th percentile), (b) percent who always or almost always eat breakfast, (c) percent who regularly exercise vigorously, and (d) average hours of weekday television viewing. RESULTS: The prevalence of overweight and of engaging in less healthy behaviors is considerably greater among youth from racial/ethnic minority backgrounds, of lower socioeconomic status, and in higher grades. Trends in overweight and these behaviors are found to vary substantially by gender, racial/ethnic group, socioeconomic status, and grade level. CONCLUSIONS: The study findings show well-established and persistent differences in the percent of racial/ethnic minority and low SES youth who are overweight and whose dietary and exercise habits are less healthy. Documentation of these problems may lead to research and policy agendas that will contribute both to our understanding and to the reduction of these important health disparities.

A. L. Diamant, S. H. Babey, T. A. Hastert and E. R. Brown (2006). Less than one-quarter of California adults walk regularly. Policy brief (UCLA Center for Health Policy Research); 1-12.

This policy brief presents information about the walking habits of California adults based on data from the 2003 California Health Interview Survey (CHIS 2003). We examine the prevalence of regular walking and no walking by socio-demographic and neighborhood characteristics. Regular walking is defined as walking on at least five separate occasions for a combined total of at least 150 minutes in the previous seven days. This definition is based on the recommendation that adults engage in moderate physical activity for at least 30 minutes on five or more days of the week. Occasional walking is defined as walking at least once for 10 or more minutes in the previous seven days. No walking is defined as not walking at least once for 10 or more minutes in the previous seven days.

C. Dunn, C. Thomas, D. Ward, L. Pegram, K. Webber and C. Cullitan (2006). Design and implementation of a nutrition and physical activity curriculum for child care settings. Preventing Chronic Disease; 3: A58.

BACKGROUND: Childhood overweight continues to increase in the United States. Children should begin establishing healthy eating and physical activity behaviors at a young age. CONTEXT: Many children spend a large part of their day in child care settings, whether in preschools or home day care settings. Child care providers in these settings have an opportunity to establish and reinforce habits that promote good health. However, the providers need training and creative educational materials to teach children about healthy eating and physical activity. Color Me Healthy is an educational program focusing on nutrition and physical activity that was developed for children aged 4 and 5 years by three of the authors (C.D., C.T., and L.P.). METHODS: In 2001 and 2002, the program was implemented in 47 North Carolina counties and the North Carolina Cherokee reservation. In December 2001, we used an information-dissemination model called Train the Trainer during a session to teach county teams comprising local public health professionals and cooperative extension employees how to teach child care providers in their communities to use the curriculum. The child care providers were then trained between March and August 2002. Follow-up evaluation forms were given to trained child care providers 8 weeks after the training. CONSEQUENCES: Of the providers who completed the evaluations (n = 486), 92.0% indicated that using the Color Me Healthy curriculum increased the physical activity of their students, and 91.8% indicated that it increased the children's knowledge about movement. In addition, 93.0% of providers also indicated that using Color Me Healthy had increased the children's knowledge about healthy eating. INTERPRETATION: Child care providers need educational materials on healthy eating and physical activity and should be trained to use them. The Train the Trainer model is an effective way to teach public health professionals to train child care providers on the Color Me Healthy curriculum materials about healthy eating and physical activity.

G. F. Dunton and M. Schneider (2006). Reliability and Validity of a Scale to Measure Self-Efficacy to Overcome Barriers to Walking for Transportation. Journal of Physical Activity & Health; 3: 48-58.

Background: Walking short distances provides a convenient opportunity to attain the health benefits of moderate-intensity physical activity. The present study tested the reliability and validity of an instrument designed to assess self-efficacy to overcome barriers to walking for transportation. Methods: A sample of 305 undergraduates, ages 18 to 46 y (mean = 20.6 y) (70.3% female), completed self-efficacy measures for travel-related walking and for vigorous exercise. Minutes of moderate- and vigorous-intensity physical activity were assessed using a MTI accelerometer (n = 85). Results: Overall, subjects reported low levels of self-efficacy to overcome barriers to walking for transportation. The eight-item walking for transportation self-efficacy scale demonstrated good reliability, discriminant validity, and expected relations to physical activity criteria. Conclusion: The conceptual distinction between self-efficacy for travel-related walking and self-efficacy for vigorous exercise may have important implications for interventions seeking to promote moderate-intensity physical activity through walking for transportation.

J. J. M. Dwyer, K. R. Allison, E. R. Goldenberg, A. J. Fein, K. K. Yoshida and M. A. Boutilier (2006). Adolescent girls' perceived barriers to participation in physical activity. Adolescence; 41: 75-89.

Research shows a decline in physical activity levels during adolescence, particularly among girls. This study explored perceived barriers to participation in moderate and vigorous physical activity among adolescent girls who live in a large ethnoracially and socioeconomically diverse city. A total of 73 adolescent girls in Toronto participated in 1 of 7 focus group sessions which were audio-taped and-transcribed verbatim, and qualitative software was used to facilitate data analysis. A constant comparison approach was used to inductively develop themes. Participants' perceived barriers to participating in physical activity included: lack of time; involvement in technology-related activities; influence of peers, parents and teachers; concern about safety; inaccessibility of facilities and cost of using them; competition; and body-centered issues. The results suggest that strategies to address specific intrapersonal, social-environmental, and physical-environmental barriers to physical activity participation should be used in physical activity promotion programs for adolescent girls.

J. J. M. Dwyer, K. R. Allison, K. N. LeMoine, E. M. Adlaf, J. Goodman, G. E. J. Faulkner and D. C. Lysy (2006). A provincial study of opportunities for school-based physical activity in secondary schools. Journal of Adolescent Health; 39: 80-86.

Purpose: Adolescents spend considerable time at school and thus it is important to understand their opportunities for school-based physical activity. This study surveyed Ontario secondary schools to identify the range of structured opportunities and their engagement by students. Methods: A questionnaire was mailed to key informants in 600 randomly selected secondary schools in Ontario, for which 474 respondents (79%) returned completed questionnaires. Results: Curriculum-based physical education (PE) classes in grade nine were reported to be offered in all schools and these classes in grades 10, 11 and 12 were offered in almost all schools. Student enrollment in PE decreased from grades 9 to 12 (97.9%, 49.6%, 43.3% and 35.9%, respectively). Respondents reported that funding, timetable, facilities and resources made it somewhat difficult to implement the health and physical education curriculum in their schools. About two-thirds (65.5%) of the schools had an intramural program and 15.0% of students participated in it, whereas 97.2% of the schools had an inter-school sports program and 25.0% of students participated in it. Supervision issues made it difficult to provide intramural programs and funding made it difficult to provide inter-school sports programs. Conclusions: Although provision of physical activity opportunities in Ontario appears satisfactory, actual engagement by students is low. The results suggest that strategies to increase student participation in PE, intramural programs, and inter-school sports programs need further consideration. (c) 2006 Society for Adolescent Medicine. All rights reserved.

C. J. Dye and S. Wilcox (2006). Beliefs of low-income and rural older women regarding physical activity: You have to want to make your life better. Women & Health; 43: 115-134.

This study elicited perceptions about physical activity in 28 older rural and low-income women (27 were Caucasian) in four focus groups to identify factors that affected their physical activity levels. This population is greatly understudied and underserved. Overall, themes that surfaced across the groups were consistent with social cognitive theory. Prominent themes included outcome expectations about both physical and mental benefits; beliefs about the sources of motivation to be physically active, including both internal sources and external sources; barriers to being active; and the types of social environments important for physical activity. These findings provide useful information regarding the types of physical activity programs preferred by rural, low-income older women and ways to build self-efficacy and social support among members of this population group with regard to increasing physical activity.

A. Ellaway, A. Kirk, S. Macintyre and N. Mutrie (2006). Nowhere to play? The relationship between the location of outdoor play areas and deprivation in Glasgow. Health Place;

Childhood obesity is rising and this rise has been linked to a decrease in physical activity. Access to appropriate facilities for physical activity is a key determinant of participation. This paper investigates the provision of outdoor play areas for children in relation to area deprivation in Glasgow, Scotland. Analysis of the distribution of outdoor play areas showed significantly higher mean number of play areas per 1000 child population in more deprived areas. However, despite the apparent advantage of deprived areas in terms of actual number of play areas, the quality of play areas in different types of areas may warrant further exploration.

L. H. Epstein, S. Raja, S. S. Gold, R. A. Paluch, Y. Pak and J. N. Roemmich (2006). Reducing sedentary behavior: The relationship between park area and the physical activity of youth. Psychological Science; 17: 654-659.

This study was designed to determine whether the characteristics of the neighborhood environment are related to the substitution of physical activity for sedentary behavior among youth. Fifty-eight 8- to 15-year-old youth were studied in a within-subjects crossover design with three phases: baseline, increased sedentary behavior, and decreased sedentary behavior. The relations between changes in physical activity and design, diversity, and density attributes of the neighborhood environment were determined using random coefficient models. Compared with girls, boys showed greater increases in physical activity when sedentary behaviors were reduced and greater decreases in physical activity when sedentary behaviors were increased. Greater access to parks was associated with greater physical activity when sedentary behaviors were reduced.

W. D. Evans, J. M. Renaud, E. Finkelstein, D. B. Kamerow and D. S. Brown (2006). Changing perceptions of the childhood obesity epidemic. American Journal of Health Behavior; 30: 167-176.

Objectives: To examine changes in public attitudes about childhood obesity and support for prevention. Methods: RTI surveyed US households (N = 1047 and N = 1139) about perceived severity, causes, and support for specific obesity interventions. Logistic regressions examined differences in obesity attitudes and support for prevention. Results: Perceived health threat of childhood obesity increased between the 2 surveys. Support increased for interventions such as regulation of restaurant portions and fast food advertising. Logistic regressions revealed differences among sociodemographic groups. Conclusions: Public support for childhood obesity prevention is increasing. Policy makers can use these findings to develop appropriate prevention strategies.

R. Ewing, R. C. Brownson and D. Berrigan (2006). Relationship between urban sprawl and weight of United States youth. American Journal Of Preventive Medicine; 31: 464-474.

Among United States youth there is an obesity epidemic with potential life-long health implications. To date, relationships between the built environment and body mass index (BMI) have not been evaluated for youth, and have not been evaluated longitudinally. Objectives: To determine if urban sprawl is associated with BMI for U.S. youth. Methods: Using data from the 1997 National Longitudinal Survey of Youth (NLSY97), both cross-sectional and longitudinal analyses were conducted. Hierarchical modeling was used to relate characteristics of individuals, households, and places to BMI. Individual and household data were extracted from the NLSY97. The independent variable of interest was the county sprawl index, which was derived with principal components analyses from census and other data. Results: In a cross-sectional analysis, the likelihood of U.S. adolescents (aged 12-17 years) being overweight or at risk of over-weight (>= 85th percentile relative to the Centers for Disease Control growth charts) was associated with county sprawl (p=0.022). In another cross-sectional analysis, after controlling for sociodemographic and behavioral covariates, the likelihood of young adults (aged 18-23 years) being obese was also associated with county sprawl (p=0.048). By contrast, in longitudinal analyses, BMI growth curves for individual youth over the 7 years of NLSY97, and BMI changes for individual youth who moved between counties, were not related to county sprawl (although coefficient signs were as expected). Conclusions: Cross-sectional analyses suggest that urban form is associated with being overweight among U.S. youth. The strength of these relationships proved comparable to those previously reported for adults. Longitudinal analyses show no such relationship. It is unclear why these approaches give different results, but sample sizes, latent effects, and confounders may contribute. (Am J Prev Med 2006;31(6):464-474) (c) 2006 American journal of Preventive Medicine

R. Ewing, S. Handy, R. C. Brownson, O. Clemente and E. Winston (2006). Identifying and Measuring Urban Design Qualities Related to Walkability. Journal of Physical Activity & Health; 3: S223-S240.

Background: In active living research, measures used to characterize the built environment have been mostly gross qualities such as neighborhood density and park access. This project has developed operational definitions and measurement protocols for subtler urban design qualities believed to be related to walkability. Methods: Methods included: 1) recruiting an expert panel; 2) shooting video clips of streetscapes; 3) rating urban design qualities of streetscapes by the expert panel; 4) measuring physical features of streetscapes from the video clips; 5) testing inter-rater reliability of physical measurements and urban design quality ratings; 6) statistically analyzing relationships between physical features and urban design quality ratings, 7) selecting of qualities for operationalization, and 8) developing of operational definitions and measurement protocols for urban design qualities based on statistical relationships. Results: Operational definitions and measurement

protocols were developed for five of nine urban design qualities: imageability, visual enclosure, human scale, transparency, and complexity. Conclusions: A field survey instrument has been developed, tested in the field, and further refined for use in active living research.

M. Exworthy and S. Peckham (2006). Access, choice and travel: Implications for health policy. Social Policy & Administration; 40: 267-287.

The UK National Health Service is introducing policies offering patients a choice of the hospital where they would like to be treated. 'Patient choice' policies form part of a wider debate about the access to health care and the interaction between providers (including information, provision, performance and reputation) and patients (including knowledge, resources and willingness to travel). As the hospital of 'choice' might not necessarily be the 'local' provider, such policy developments are predicated on an assumption that some patients will be willing to travel further. This will, in turn, affect patients' access to services. In general, use of services decreases with distance but this is dependent on accessibility to services, the organization of those services, the socio-economic characteristics of the patient, perceptions of the provider and the condition for which they are to be treated. This article reviews the evidence on patients' willingness to travel in terms of access to health care and assesses the emerging implications of and for current UK policy on patient choice.

S. L. Ferney and A. L. Marshall (2006). Website physical activity interventions: preferences of potential users. Health Education Research; 21: 560-6.

Information and communication technologies (particularly websites and e-mail) have the potential to deliver health behavior change programs to large numbers of adults at low cost. Controlled trials using these new media to promote physical activity have produced mixed results. User-centered development methods can assist in understanding the preferences of potential participants for website functions and content, and may lead to more effective programs. Eight focus group discussions were conducted with 40 adults after they had accessed a previously trialed physical activity website. The discussions were audio taped, transcribed and interpreted using a themed analysis method. Four key themes emerged: structure, interactivity, environmental context and content. Preferences were expressed for websites that include simple interactive features, together with information on local community activity opportunities. Particular suggestions included online community notice boards, personalized progress charts, e-mail access to expert advice and access to information on specific local physical activity facilities and services. Website physical activity interventions could usefully include personally relevant interactive and environmentally focused features and services identified through a user-centered development process.

P. Filion, K. McSpurren and B. Appleby (2006). Wasted density? The impact of Toronto's residential-density-distribution policies on public-transit use and walking. Environment And Planning A; 38: 1367-1392.

Although the Toronto metropolitan region performs well relative to its North American counterparts in terms of density and public-transit use, it does not derive as much walking and public-transit patronage benefit from its high-residential-density areas as it could. The impact of residential density on journey patterns is limited by an imperfect juxtaposition of density and public-transit service peaks. Another impediment is the difficulty of associating density with other variables needed for it to translate into increased walking and public-transit modal shares. We attribute this situation to insufficient planning capacity owing in large part to generalized neighbourhood opposition to high-density residential developments and disagreement between levels of government. In this paper we both narrate events of relevance to the distribution of high residential density over the last five decades and analyze present relationships between high-density areas and journey patterns. We conclude by discussing the possibility of achieving rcsidential-density layouts and distributions that are more conducive to walking and public-transit use than the tower-in-the-park model and the scattering of high-density pockets, both of which predominate in Toronto.

N. Fitzgerald, D. Himmelgreen, G. Damio, S. Segura-Perez, Y. K. Peng and R. Perez-Escamilla (2006). Acculturation, socioeconomic status, obesity and lifestyle factors among low-income Puerto Rican women in Connecticut, US, 1998-1999. Pan American Journal Of Public Health; 19: 306-313.

Objectives. To examine the associations of socioeconomic status and acculturation with obesity and lifestyle characteristics that may be risk factors for diabetes and cardiovascular disease among low-income Puerto Rican women. Methods. This cross-sectional study was conducted between 1998 and 1999 by interviewing a convenience sample of 200 low-income Puerto Rican female caretakers of young children in Hartford, Connecticut, United States of America. Various recruitment methods were used to ensure adequate representation of the target community. The associations of obesity (body mass index >= 30.0) and lifestyle factors (physical activity, cigarette smoking, alcohol consumption, food intake) with socioeconomic status (education, employment, car ownership), acculturation, age, and marital status were examined with Spearman rho, chi-squared, and Mann-Whitney U tests and logistic regression analyses. Results. Mean age was 29 years. Obesity (40%), physical inactivity (47%), and cigarette smoking (32%) were common. Less acculturated participants were 57% less likely to smoke and 54% less likely to be obese than their more acculturated counterparts. Lower socioeconomic status (not finishing high school or not owning a car) was associated with a higher likelihood of obesity, but unemployed (vs. employed) women were less likely to be obese (P < 0.05). Women who did not own a car consumed meat, eggs and fish less often than those who owned a car. Smokers were more likely to have an unhealthy food intake pattern than nonsmokers. Conclusions. The associations of acculturation and socioeconomic status with some lifestyle characteristics suggest the need for culturally appropriate programs to promote healthy lifestyle behaviors in this low-income community.

J. Fleury and S. M. Lee (2006). The social ecological model and physical activity in African American women. American Journal Of Community Psychology; 37: 129-140.

Little is known about the social and contextual correlates (e. g., social norms, environment, social networks, and organizational support) influencing the adoption and maintenance of regular physical activity among minority and underserved populations. The purpose of this review was to apply the social ecological model to better understand physical activity among African American women. A review of the literature pertaining to correlates of physical activity among African American women was conducted and applied to a social ecological perspective. Understanding and addressing social and contextual correlates of physical activity behavior among African American women are necessary to establish comprehensive programs, particularly within community settings. The social ecological model provides a strong theoretical basis to guide physical activity intervention in this population.

J. A. Flohr, M. K. Todd and C. Tudor-Locke (2006). Pedometer-assessed physical activity in young adolescents. Research Quarterly for Exercise and Sport; 77: 309-15.

The purpose of this study was to evaluate the physical activity (PA) patterns of children. Forty-four 7th-grade students (19 boys, 25 girls) recorded pedometer data for 2 consecutive weeks. Separate 2 x 3 repeated measures analyses of variance were used to examine differences in total steps/day between boys and girls and between after-school activity participants and nonparticipants. The relative contribution of physical education (PE) and after-school activity (ASA) to weekday steps/day was evaluated as a proportion, for example (steps taken in PE class/total daily steps taken on a PE class day) * 100. The total sample mean was 11,392 steps/day, SD = 4112; for boys, M = 12,490 steps/day, SD=3910, versus girls, M = 10,557 steps/day, SD=4142; F=(1, 42) 4.365, p =.043. The sample population averaged 2046 steps, SD=945, during PE class; boys=2379 steps, SD=1115, versus girls=1782, SD=703; t (42) = 2.15, p =.038, d =.65, which represented 18% of the total steps/day on PE days. In comparison, the participants accumulated an average of 5366 steps, SD=2590; ASA for boys=5897 steps/day, SD=2738, versus girls=4963 steps/day, SD=2450; t (42) = 1.190, p =.241, d =.36), representing 46% of the steps/day on all weekdays and 47% of the total on PE days. Expressed as a rate, the sample population took 45.5 steps/min (SD=21) during PE class and 13.1 steps/min (SD = 4.7) in ASA on all weekdays. The relative stability of day-to-day behavior in youth is a preliminary finding but noteworthy. Although the absolute contribution ofPE class to daily PA was less than ASA (i.e., 18 vs. 47%, respectively), the importance of the condensed contribution in class was evident when these two activities were expressed as rates (i.e., steps/min). These data indicate that youth involved in ASA accumulated a greater number of steps on all days, weekend days, and health education days when compared to youth not involved in ASA.

A. Forsyth, K. H. Schmitz, M. Oakes, J. Zimmerman and J. Koepp (2006). Standards for Environmental Measurement Using GIS: Toward a Protocol for Protocols. Journal of Physical Activity & Health; 3: S241-S257.

Background: Interdisciplinary research regarding how the built environment influences physical activity has recently increased. Many research projects conducted jointly by public health and environmental design professionals are using geographic information systems (GIS) to objectively measure the built environment. Numerous methodological issues remain, however, and environmental measurements have not been well documented with accepted, common definitions of valid, reliable variables. Methods: This paper proposes how to create and document standardized definitions for measures of environmental variables using GIS with the ultimate goal of developing reliable, valid measures. Inherent problems with software and data that hamper environmental measurement can be offset by protocols combining clear conceptual bases with detailed measurement instructions. Results: Examples demonstrate how protocols can more clearly translate concepts into specific measurement. Conclusions: This paper provides a model for developing protocols to allow high quality comparative research on relationships between the environment and physical activity and other outcomes of public health interest.

L. D. Frank, J. F. Sallis, T. L. Conway, J. E. Chapman, B. E. Saelens and W. Bachman (2006). Many pathways from land use to health - Associations between neighborhood walkability and active transportation, body mass index, and air quality. Journal Of The American Planning Association; 72: 75-87.

The literature shows single-use, low-density land development and disconnected street networks to be positively associated with auto dependence and negatively associated with walking and transit use. These factors in turn appear to affect health by influencing physical activity, obesity, and emissions of air pollutants. We evaluated the association between a single index of walkability that incorporated land use mix, street connectivity, net residential density, and retail floor area ratios, with health-related outcomes in King County, Washington. We found a 5% increase in walkability to be associated with a per capita 32.1% increase in time spent in physically active travel, a 0.23-point reduction in body mass index, 6.5% fewer vehicle miles traveled, 5.6% fewer grams of oxides of nitrogen (NOx) emitted, and 5.5% fewer grams of volatile organic compounds (VOC) emitted. These results connect development patterns with factors that affect several prevalent chronic diseases.

E. Freiberger and H. B. Menz (2006). Characteristics of falls in physically active community-dwelling older people: Findings from the "Standfest im Alter" study. Geriatrics & Gerontology Journals; 39: 261-267.

BACKGROUND: Falls are common in physically active older people due to their increased exposure to hazardous situations. However, most studies of the characteristics and circumstances of falls are based on frail older people. OBJECTIVE: To describe the location, time, cause, injuries and medical treatment associated with falls in a physically active group of older people. METHODS: Prospective falls data over a 12-month period were obtained from 293 people (163 men and 130 women) aged between 70 and 90 years who took part in the "Standfest im Alter" study, a randomized controlled trial conducted in Erlagen, Germany. RESULTS: During the study period, there were 322 falls. 122 participants (42%) fell at least once and 62 (21%) fell on multiple occasions. The typical fall occurred outside the home during leisure activities, at midday or in the afternoon and did not result in injury or admission to hospital. There were no differences in the rate of falls according to gender; however, fall location, time of fall, fall injury and visits to the doctor after the fall were all influenced by gender. CONCLUSIONS: The results of this study provide useful insights into the characteristics and circumstances of falls in physically active older people living in the community, which may assist with the development of future falls prevention activities.

H. Frumkin (2006). The measure of place. American Journal of Preventive Medicine; 31: 530-2.

S. Gable, Y. Chang and J. L. Krull (2007). Television watching and frequency of family meals are predictive of overweight onset and persistence in a national sample of school-aged children. Journal Of The American Dietetic Association; 107: 53-61.

Objective To identify eating and activity factors associated with school-aged children's onset of overweight and persistent overweight. Design Data were gathered at four time points between kindergarten entry and spring of third grade. Children were directly weighed and measured and categorized as not overweight (= 95th percentile body mass index); parents were interviewed by telephone or in person. Subjects/setting Subjects were participants in the Early Childhood Longitudinal Study-Kindergarten Cohort, a nationally representative sample of children who entered kindergarten during 1998-1999. Children who weighed = 0.82), as was recall of transport-related walking trips outside the neighborhood (ICC 0.84). Reliability for duration of recreational walking outside the neighborhood was fair to good (ICC = 0.55). The reliability of indices of total physical activity based on MET min/week (ICC = 0.82) and MET min/week dichotomized to 'sufficient' physical activity for health (kappa = 0.67) were both acceptable. Conclusions. The Neighborhood Physical Activity Questionnaire (NPAQ) is sufficiently reliable for studies examining environmental correlates of walking within the neighborhood. (c) 2006 Elsevier Inc. All rights reserved.

G. Giuliano and J. Dargay (2006). Car ownership, travel and land use: a comparison of the US and Great Britain. Transportation Research Part A-Policy And Practice; 40: 106-124.

This paper conducts an international comparative analysis of relationships between car ownership, daily travel and urban form. Using travel diary data for the US and Great Britain, we estimate models of car ownership and daily travel distance. Both a structural model with daily travel conditional upon car ownership and a reduced form model for daily travel, excluding car ownership, are estimated. Model results are similar, and show that differences in travel are explained by (1) differences in demographics between the two countries; (2) lower household income in Great Britain; (3) country specific differences in costs of car ownership and use, transport supply and other factors we have not been able to control. We find that metropolitan size affects travel only in the largest metropolitan areas of the US. Daily travel distance is inversely related to local population density, but the effect is much stronger for the US than Great Britain. We conclude that higher transport costs in Great Britain promote economizing behavior, which in turns leads to more consumption of local goods and services and more use of alternative transport modes. (c) 2005 Elsevier Ltd. All rights reserved.

T. A. Glass, M. D. Rasmussen and B. S. Schwartz (2006). Neighborhoods and obesity in older adults - The Baltimore Memory Study. American Journal Of Preventive Medicine; 31: 455-463.

Background: Obesity has reached epidemic proportions. Although its causes are not well understood, its increasing prevalence is not likely to be due to genetic factors or underlying biology. This has led to interest in the role of environmental factors, although few Studies have focused on the role of the social environment. This study investigated whether neighborhood psychosocial hazards independent of individual risk factors were associated with increased odds of obesity. Methods: Baseline data were analyzed in 2005 from a cohort study of 1140 randomly selected community-dwelling men and women aged 50 to 70 years from 65 contiguous neighborhoods in Baltimore MD. Body mass index (BMI in kilograms/meters squared) was calculated from measured height and weight at. baseline (2001-2002). People with a BMI of 30 and higher were considered obese. Multilevel logistic regression was used to examine associations between a 12-item scale of neighborhood psychosocial hazards and the odds of obesity. Results: Thirty-eight percent of the cohort were obese. Residents of neighborhoods in the highest quartile of the Neighborhood Psychosocial Hazards scale were nearly twice as likely to be obese compared to residents in the least-hazardous neighborhoods (53% vs 27%). After adjustment for age, gender, race/ethnicity, education, household wealth, alcohol consumption, tobacco use, self-reported physical activity, and dietary intake, living in more hazardous neighborhoods was associated with a graded increase in the odds of obesity. This association was partially mediated by physical activity. Conclusions: Even after controlling for a large set of demographic, behavioral, and socioeconomic individual-level risk factors, living in a neighborhood with greater psychosocial hazards was independently associated with obesity. (Am J Prev Med 2006;31(6):455-463) (c) 2006 American journal of Preventive Medicine

M. Golan, V. Kaufman and D. R. Shahar (2006). Childhood obesity treatment: targeting parents exclusively v. parents and children. British Journal Of Nutrition; 95: 1008-1015.

There is a consensus that interventions to prevent and treat childhood obesity should involve the family; however, the extent of the child's involvement has received little attention. The goal of the present study was to evaluate the relative efficacy of treating childhood obesity via a family-based health-centred intervention, targeting parents alone v. parents and obese children together. Thirty-two families with obese children of 6-11 years of age were randomised into groups, in which participants were provided for 6 months a comprehensive educational and behavioural programme for a healthy lifestyle. These groups differed in their main agent of change: parents-only v. the parents and the obese child. In both groups, parents were encouraged to foster authoritative parenting styles (parents are both firm and supportive; assume a leadership role in the environmental change with appropriate granting of child's autonomy). Only the intervention aimed at parents-only resulted in a significant reduction in the percentage overweight at the end of the programme (P=0.02) as well as at the 1-year follow-up meeting. The differences between groups at both times were significant (P < 0.05). A greater reduction in food stimuli in the home (P < 0.05) was noted in the parents-only group. In both groups, the parents' weight status did not change. Regression analysis shows that the level of attendance in sessions explained 28 % of the variability in the children's weight status change, the treatment group explained another 10 %, and the improvement in the obesogenic load explained 11 % of the variability. These results suggest that omitting the obese child from active participation in the health-centred programme may be beneficial for weight loss and for the promotion of a healthy lifestyle among obese children.

P. Gordon-Larsen, M. C. Nelson, P. Page and B. M. Popkin (2006). Inequality in the built environment underlies key health disparities in physical activity and obesity. Pediatrics; 117: 417-24.

CONTEXT: Environmental factors are suggested to play a major role in physical activity (PA) and other obesity-related behaviors, yet there is no national research on the relationship between disparity in access to recreational facilities and additional impact on PA and overweight patterns in US adolescents. OBJECTIVE: In a nationally representative cohort, we sought to assess the geographic and social distribution of PA facilities and how disparity in access might underlie population-level PA and overweight patterns. DESIGN, SETTING, AND PARTICIPANTS: Residential locations of US adolescents in wave I (1994-1995) of the National Longitudinal Study of Adolescent Health (N = 20745) were geocoded, and a 8.05-km buffer around each residence was drawn (N = 42857 census-block groups [19% of US block groups]). PA facilities, measured by national databases and satellite data, were linked with Geographic Information Systems technology to each respondent. Logistic-regression analyses tested the relationship of PA-related facilities with block-group socioeconomic status (SES) (at the community level) and the subsequent association of facilities with overweight and PA (at the individual level), controlling for population density. MAIN OUTCOME MEASURES: Outcome measures were overweight (BMI > or = 95th percentile of the Centers for Disease Control and Prevention/National Center for Health Statistics growth curves) and achievement of > or = 5 bouts per week of moderate-vigorous PA. RESULTS: Higher-SES block groups had a significantly greater relative odds of having 1 or more facilities. Low-SES and high-minority block groups were less likely to have facilities. Relative to zero facilities per block group, an increasing number of facilities was associated with decreased overweight and increased relative odds of achieving > or = 5 bouts per week of moderate-vigorous PA. CONCLUSIONS: Lower-SES and high-minority block groups had reduced access to facilities, which in turn was associated with decreased PA and increased overweight. Inequality in availability of PA facilities may contribute to ethnic and SES disparities in PA and overweight patterns.

A. Gorin, H. Raynor, K. Chula-Maguire and R. Wing (2006). Decreasing household television time: A pilot study of a combined behavioral and environmental intervention. Behavioral Interventions; 21: 273-280.

Excessive TV viewing is associated with weight gain across the lifespan; thus developing strategies to decrease household viewing time may be an effective obesity prevention approach. This pilot study (n = 6 families) examined the feasibility and short-term impact of a 2-pronged environmental plus behavioral approach designed to reduce TV time in the entire family. The environmental manipulation involved placing TV Allowances (programmed to turn off power after family members had watched 75% of their baseline hours) on all TVs in the home. A kit with behavioral strategies for reducing TV time was also sent to the home each week and family members self-monitored viewing time. Viewing was objectively assessed with the TV Allowances at baseline and at 8 weeks. A significant decrease in objectively measured TV viewing hours was observed, t(5) = 3.1, p = 0.03, 29.8 +/- 10.3 versus 14.9 +/- 6.0 h (equivalent of decreasing from 7.5 to 3.7 h per day). Fifty percent of families reduced their viewing time by >= 50%. The acceptability of the intervention was high, with 100% of families reporting they would recommend the TV Allowances to others. Further research is needed to test the long-term efficacy of the program and its impact on weight. Copyright (c) 2006 John Wiley & Sons, Ltd.

N. C. Gyurcsik, K. S. Spink, S. R. Bray, K. Chad and M. Kwan (2006). An ecologically based examination of barriers to physical activity in students from grade seven through first-year university. Journal of Adolescent Health; 38: 704-11.

PURPOSE: The first purpose was to identify barriers to physical activity that students in grade seven through first-year university experienced. A second purpose was to classify barriers using an ecological framework and to examine the pattern of barrier categories (i.e., intrapersonal, interpersonal, institutional, community, public policy, and physical environmental) and specific barrier types as grade increased. The use of an ecological model addressed limitations in prior research revolving around the identification of salient barriers in a manner that makes the design of effective interventions difficult. METHODS: Participants in grades 7-8 (n = 35), 9-10 (n = 67), 11-12 (n = 80), and the freshmen year of university (n = 109) listed barriers to physical activity on an open-ended measure. RESULTS: Findings revealed a trend for the average number of barriers reported per student to increase as grade in school increased. First-year university students reported significantly more barriers than all other grade groupings. The frequency of barriers reported within the ecological categories was dependent on the specific grade groupings. Further, within each ecological category, distinct barriers were reported across the different grade groupings. CONCLUSIONS: Findings highlight the utility of using an ecological model to categorize barriers, rather than simply classifying barriers as internal or external to an individual, as done in prior research. Understanding the pattern of ecologically based barrier categories and specific types of barriers will help to inform the content of future research and interventions designed to alleviate salient barriers to physical activity.

L. Haerens, B. Deforche, L. Maes, G. Cardon, V. Stevens and I. De Bourdeaudhuij (2006). Evaluation of a 2-year physical activity and healthy eating intervention in middle school children. Health Education Research; 21: 911-921.

The aim of the present study was to evaluate the effects of a middle school physical activity and healthy eating intervention, including an environmental and computer-tailored component, and to investigate the effects of parental involvement. A random sample of 15 schools with seventh and eight graders was randomly assigned to one of three conditions: (i) intervention with parental involvement, (ii) intervention alone and (iii) control group. In 10 schools, an intervention, combining environmental changes with computer-tailored feedback, was implemented over 2 school years. In five intervention schools, increased parental support was added. Physical activity was measured with questionnaires in the total sample and with accelerometers in a sub-sample of children. Fat intake, fruit, water and soft drink consumption were measured using food-frequency questionnaires. Results showed significant positive intervention effects on physical activity in both genders and on fat intake in girls. Parental involvement did not increase intervention effects. It can be concluded that physical activity and eating behaviours of middle school children can be improved by school-based strategies combining environmental and personal interventions. The use of personalized computer-tailored interventions seems to be a promising tool for targeting adolescents but needs to be further explored.

L. Haerens, B. Deforche, L. Maes, V. Stevens, G. Cardon and I. De Bourdeaudhuij (2006). Body mass effects of a physical activity and healthy food intervention in middle schools. Obesity; 14: 847-854.

Objective: To evaluate the effects of a 2-year middle school physical activity and healthy food intervention, including an environmental and computer-tailored component on BMI and BMI z-score in boys and girls. Research Methods and Procedures: A random sample of 15 schools with seventh and eighth graders was randomly assigned to three conditions: an intervention with parental support group, an intervention-alone group, and a control group. Weight and height were measured at the beginning and end of each school year to assess BMI and BMI z-score. A physical activity and healthy food program was implemented over 2 school years. Results: In girls, BMI and BMI z-score increased significantly less in the intervention with parental support group compared with the control group (p < 0.05) or the intervention-alone group (p = 0.05). In boys, no significant positive intervention effects were found. Discussion: This was the first study evaluating the effectiveness of an intervention combining environmental changes with personal computer-tailored feedback on BMI and BMI z-score in middle school children. After 2 school years, BMI and BMI z-score changed in a more positive direction in girls as a result of the intervention with parental support.

S. A. Ham and J. Epping (2006). Dog walking and physical activity in the United States. Preventing Chronic Disease; 3: A47.

INTRODUCTION: Dog walking is a purposeful physical activity that may have health benefits for humans and canines. A descriptive epidemiology of the contribution of dog walking to physically active lifestyles among dog walkers in the United States has not been previously reported. METHODS: Data on youth and adults who reported walking for pet care trips (N = 1282) on the National Household Travel Survey 2001 were analyzed for number of trips, proportion walking a dog for at least 10 minutes on one trip, and accumulation of 30 minutes or more in 1 day of walks lasting at least 10 minutes. RESULTS: In 1 day, 58.9% of dog walkers took two or more walks, 80.2% took at least one walk of 10 minutes or more, and 42.3% accumulated 30 minutes or more from walks lasting at least 10 minutes each. There were no significant differences by sex, family income, or categories of urbanization. CONCLUSION: Walking a dog may contribute to a physically active lifestyle and should be promoted as a strategy that fits within the framework set forth by the Task Force on Community Preventive Services for Physical Activity.

J. Hammel, R. Jones, A. Gossett and E. Morgan (2006). Examining barriers and supports to community living and participation after a stroke from a participatory action research approach. Topics in Stroke Rehabilitation; 13: 43-58.

This participatory action research study focused on identifying community participation goals, barriers, and supports/strategies in partnership with people who have experienced a stroke. Goals demonstrate that participation is more than activity performance in context; instead, it relates to "being a part of" the community and having access to participation opportunities and supports. Results of community site audits from the first 20 participants document environmental (physical, cognitive, social) and system level barriers, as well as effective strategies for promoting participation via environmental modification and systems level changes. A consumer-directed, Web-based tool for documenting participation barriers and sharing strategies is discussed.

S. Handy, X. Y. Cao and P. L. Mokhtarian (2006). Self-selection in the relationship between the built environment and walking - Empirical evidence from northern California. Journal Of The American Planning Association; 72: 55-74.

Available evidence establishes correlations between the built environment and walking, but not a causal relationship, leading researchers to debate whether '' self-selection '' explains the observed correlations: do residents who prefer to walk choose to live in more walkable neighborhoods? Using data from a survey of residents of eight neighborhoods in Northern California, this article presents new evidence on the possibility of a causal relationship between the built environment and walking behavior. This work improves on most previous studies by incorporating travel attitudes and neighborhood preferences into the analysis of walking behavior, and by using a quasi-longitudinal design to test the relationship between changes in the built environment and changes in walking. Both analyses show that the built environment has an impact on walking behavior even after accounting for attitudes and preferences.

C. Hannon, A. Cradock, S. L. Gortmaker, J. Wiecha, A. El Ayadi, L. Keefe and A. Harris (2006). Play Across Boston: a community initiative to reduce disparities in access to after-school physical activity programs for inner-city youths. Preventing Chronic Disease; 3: A100.

BACKGROUND: In 1999, the Centers for Disease Control and Prevention (CDC) funded Play Across Boston to address disparities in access to physical activity facilities and programs for Boston, Mass, inner-city youths. CONTEXT: Local stakeholders worked with the Harvard School of Public Health Prevention Research Center and Northeastern University's Center for the Study of Sport in Society to improve opportunities for youth physical activity through censuses of facilities and programs and dissemination of results. METHODS: Play Across Boston staff conducted a facility census among 230 public recreational complexes and a program census of 86% of 274 physical activity programs for Boston inner-city youths aged 5 to 18 years during nonschool hours for the 1999 to 2000 school year and summer of 2000. Comparison data were collected from three suburban communities: one low income, one medium income, and one high income. CONSEQUENCES: Although Boston has a substantial sports and recreational infrastructure, the ratio of youths to facilities in inner-city Boston was twice the ratio found in the medium- and high-income suburban comparison communities. The low-income suburban comparison community had the highest number of youths per recreational facility with 137 youths per facility, followed by Boston with 117 youths per facility. The ratio of youths to facilities differed among Boston neighborhoods. Boston youths participated less in school-year physical activities than youths in medium- and high-income communities, and less advantaged Boston neighborhoods had lower levels of participation than more advantaged Boston neighborhoods. Girls participated less than boys. INTERPRETATION: Play Across Boston successfully developed and implemented a rigorous needs assessment with local relevance and important implications for public health research on physical activity and the environment. Boston Mayor Thomas M. Menino called the Play Across Boston report a "playbook" for future sports and recreation planning by the city of Boston and its community partners.

S. Hanson (2006). Active Living Research in Light of the TRB/IOM Report. Journal of Physical Activity & Health; 3: S258-S266.

Most of the papers in this issue speak, one way or another, to the question of how physical activity is, or might be, related to the built environment. This question was at the heart of a recent National Research Council (NRC)a study, which culminated in the report, Does the Built Environment Influence Physical Activity? Examining the Evidence.1 The study was motivated by deep concern, especially within the public health community, about the lack of sufficient participation in physical activity among Americans and by curiosity about the extent to which changes to the built environment might help to increase levels of activity. The NRC study highlighted the pressing need for research along several lines if the built environment-physical activity relationship is to be understood sufficiently well to know if and how changes in the built environment might effect large-enough changes in population-level physical activity to be worth the cost of making such changes. My goals in this brief commentary are first, to provide an overview of the NRC study and its recommendations and second, to assess the ways in which the papers in this issue help to close the research gaps that the NRC study identified.

M. Harrison, C. F. Burns, M. McGuinness, J. Heslin and N. M. Murphy (2006). Influence of a health education intervention on physical activity and screen time in primary school children: 'Switch Off-Get Active'. Journal of Science and Medicine in Sport;

Low levels of physical activity coupled with high levels of television viewing have been linked with obesity in children. The objective of this study was to assess the efficacy of 'Switch Off-Get Active', a 16-week controlled health education intervention, in increasing physical activity and reducing screen time and BMI in primary school children. A secondary objective was to compare children with high and low screen time. Participants were 312 children aged 10.2+/-0.7 years, attending nine schools in areas of social disadvantage. The 10-lesson, teacher-led intervention, conducted in spring 2003, emphasised self-monitoring, budgeting of time and selective viewing. Differences, adjusted for baseline values by ANCOVA, existed between intervention and control children at follow-up for self-reported physical activity (intervention +0.84 30min blocks/day, 95%CI 0.11-1.57, p 6 METs). Sociodemographic and environmental information was recorded on self-administered questionnaires. Hierarchical multiple logistic models were developed based on a conceptual framework of factors related to physical activity. Results: Overall, girls were twice as likely to be inactive. Adolescents aged 14 yr were 30% less likely to be inactive compared with those younger than 13 yr (95% CI: 0.5-0.9). Paternal education was inversely associated with inactivity (OR: 0.6, 95% CI: 0.4-0.9). Adolescents living in neighborhoods without sidewalks were 1.3 times more likely to be inactive (95% CI: 1.0-1.6). At the school level, lack of extracurricular exercise (OR: 1.3, 95% CI: 1.1-1.6) and fewer sports meetings (OR: 2.0, 95% CI: 1.4-2.9) were associated with physical inactivity. Difficult access to community recreational facilities (moderate OR: 1.4, 95% CI: 1.0-1.9; difficult OR: 1.7, 95% CI: 1.2-2.4) and concerns about safety in the neighborhood (OR: 2.1, 95% CI: 1.1-4.1) were associated with inactivity. There were some differences associated with physical inactivity between boys and girls. Conclusion: Strategies to promote physical activity in Chinese adolescents should integrate associated factors at household, school, and community levels and address the important gender differences in factors associated with physical inactivity in youth.

J. J. Librett, M. M. Yore and T. L. Schmid (2006). Characteristics of physical activity levels among trail users in a US national sample. American Journal Of Preventive Medicine; 31: 399-405.

Background: The Task Force on Community Preventive Services strongly recommends environmental interventions that include enhanced access to opportunities for physical activity, such as walking and cycling trails. Although accumulating evidence indicates that trails can be effective in increasing physical activity, little is known about trail users. Methods: Cross-sectional analysis of a national sample of 3717 adults from the HealthStyles and ConsumerStyles surveys using logistic regression to determine physical activity patterns and sociodemographic correlates related to trail use, and to identify support regarding trail development policies. Results: Almost 13% (12.7%) of the sample reported using trails at least once a month and 24.3% at least once a week. People who reported using trails at least once a week were twice as likely than people who reported rarely or never using trails to meet physical activity recommendations (odds ratio = 2.3, 95% confidence interval = 1.9-2.8). Nearly half (43.6%) of the non-trail users supported expanded public spaces for people to exercise, and 36.4% of the non-trail users reported that they would be willing to pay more taxes to build more parks and trails in their community. Conclusions: Community trails facilitate physical activity, and almost half of frequent trail users report that access to trails and other green space is important in choosing a place to live. These results support the need for prospective research on whether newly built trails promote physical activity in previously inactive people.

J. J. Librett, M. M. Yore, T. L. Schmid and H. W. Kohl, 3rd (2006). Are self-reported physical activity levels associated with perceived desirability of activity-friendly communities? Health Place;

People living in activity-friendly communities (AFCs) are more active but the self-selection influence is unknown. From 4856 respondents we explored mediating variables with expressed desire to live in AFCs. Association with desire to live in AFCs included ages 18-24 years (odds ratio [OR]=1.9), African American (OR=1.9) or Hispanic (OR=1.5), and believing AFCs would support activity-based transportation (OR=2.4). Regular physical activity (PA) was marginally associated with desire to live in AFCs (OR=1.3). These findings suggest that PA may be a significant factor in communities of this style. Strategies for social marketing along with changes to the built environment to increase PA levels are discussed.

N. Limtanakool, M. Dijst and T. Schwanen (2006). The influence of socioeconomic characteristics, land use and travel time considerations on mode choice for medium- and longer-distance trips. Journal Of Transport Geography; 14: 327-341.

This paper contributes to the limited number of investigations into the influence of the spatial configuration of land use and transport systems on mode choice for medium- and longer-distance travel (defined here as home-based trips of 50 km and over in the Netherlands. We have employed data from the 1998 Netherlands National Travel Survey to address the question as to how socioeconomic factors, land use attributes, and travel time affect mode choice for medium- and longer-distance travel, and how their role varies across trip purposes: commuting, business, and leisure. The empirical analysis indicates that land use attributes and travel time considerations are important in explaining the variation in mode choice for medium- and longer-distance travel when controlling for the socioeconomic characteristics of travellers. (c) 2005 Elsevier Ltd. All rights reserved.

G. Lindsey, Y. Han, J. Wilson and J. Yang (2006). Neighborhood Correlates of Urban Trail Use. Journal of Physical Activity & Health; 3: S139-S157.

Purpose: To model urban trail traffic as a function of neighborhood characteristics and other factors including weather and day of week. Methods: We used infrared monitors to measure traffic at 30 locations on five trails for periods ranging from 12 months to more than 4 y. We measured neighborhood characteristics using geographic information systems, satellite imagery, and US Census and other secondary data. We used multiple regression techniques to model daily traffic. Results: The statistical model explains approximately 80% of the variation in trail traffic. Trail traffic correlates positively and significantly with income, neighborhood population density, education, percent of neighborhood in commercial use, vegetative health, area of land in parking, and mean length of street segments in access networks. Trail traffic correlates negatively and significantly with the percentage of neighborhood residents in age groups greater than 64 and less than 5. Conclusions: Trail traffic is significantly correlated with neighborhood characteristics. Health officials can use these findings to influence the design and location of trails and to maximize opportunities for increases in physical activity.

J. Loomis (2006). A comparison of the effect of multiple destination trips on recreation benefits as estimated by travel cost and contingent valuation methods. Journal Of Leisure Research; 38: 46-60.

This paper investigates the empirical magnitude of multiple destination/ purpose trip bias in the Travel Cost Method (TCM), and the performance of all empirical solution for that method. For the study area, we find that ignoring the multiple destination/ purpose trip distinction does result in a substantial difference in per trip values for the TCM. However, based on a comparison with Contingent Valuation Method derived values for these two trip types, an empirical correction to the Travel Cost Method appears to adequately differentiate the values of single and multiple destination trips. If the multiple destination trip distinction is ignored in estimation it Substantially underestimates recreation benefits derived from the Travel Cost Method in Our case Study.

R. Lopez (2006). Black-White residential segregation and physical activity. Ethnicity & Disease; 16: 495-502.

This multilevel study explores the potential relationship between Black-White residential segregation and physical activity. It combines data on physical activity from the 2001 Behavioral Risk Factor Surveillance System (BRFSS), a national telephone survey of adults overseen by the Centers for Disease Control and Prevention (CDC), with a measure of racial segregation. Using hierarchical linear modeling, it controlled for age, sex, Black race, Hispanic ethnicity, education, income, and amount of urban sprawl. For each one-point increase in the Black-White Dissimilarity Index (on a 0-100 scale), the modeled risk of being physically inactive increased by.7% (odds ratio [OR]=1.007, 95% confidence interval [CI]=1.003, 1.011). The relationship between segregation and physical activity was similar for Blacks and Whites, though not statistically significant for the Black-only analysis. This finding may imply that the pathway between segregation and ill health includes physical inactivity.

R. P. Lopez and H. P. Hynes (2006). Obesity, physical activity, and the urban environment: public health research needs. Environmental Health; 5: 25.

Persistent trends in overweight and obesity have resulted in a rapid research effort focused on built environment, physical activity, and overweight. Much of the focus of this research has been on the design and form of suburbs. It suggests that several features of the suburban built environment such as low densities, poor street connectivity and the lack of sidewalks are associated with decreased physical activity and an increased risk of being overweight. But compared to suburban residents, inner city populations have higher rates of obesity and inactivity despite living in neighborhoods that are dense, have excellent street connectivity and who's streets are almost universally lined with sidewalks. We suggest that the reasons for this apparent paradox are rooted in the complex interaction of land use, infrastructure and social factors affecting inner city populations. Sometimes seemingly similar features are the result of very different processes, necessitating different policy responses to meet these challenges. For example, in suburbs, lower densities can result from government decision making that leads to restrictive zoning and land use issues. In the inner city, densities may be lowered because of abandonment and disinvestment. In the suburbs, changes in land use regulations could result in a healthier built environment. In inner cities, increasing densities will depend on reversing economic trends and investment decisions that have systematically resulted in distressed housing, abandoned buildings and vacant lots.These varying issues need to be further studied in the context of the totality of urban environments, incorporating what has been learned from other disciplines, such as economics and sociology, as well as highlighting some of the more successful inner city policy interventions, which may provide examples for communities working to improve their health. Certain disparities among urban and suburban populations in obesity and overweight, physical activity and research focus have emerged that are timely to address. Comparable research on the relationship of built environment and health is needed for urban, especially inner city, neighborhoods.

J. Lopez-Zetina, H. Lee and R. Friis (2006). The link between obesity and the built environment. Evidence from an ecological analysis of obesity and vehicle miles of travel in California. Health & Place; 12: 656-664.

Aims: Obesity and physical inactivity are known to be risk factors for many chronic diseases including hypertension, coronary artery disease, diabetes, and cancer. We sought to explore the association between an indicator of transportation data (Vehicle Miles of Travel, VMT) at the county level as it relates to obesity and physical inactivity in California. Methods: Data from the California Health Interview Survey 2001 (CHIS 2001), the US 2000 Census, and the California Department of Transportation were merged to examine ecological correlations between vehicle miles of travel, population density, commute time, and county indicators of obesity and physical inactivity. Obesity was measured by body mass index (BMI). Physical inactivity was based on self-reported behaviors including walking, bicycling, and moderate to vigorous activity. The unit of analysis was the county. Thirty-three counties in California with population size greater than 100,000 persons per county were retained in the analyses. Results: CHIS 2001 statewide obesity prevalence ranged from 11.2% to 28.5% by county. Physical inactivity ranged from 13.4% to 35.7%. Daily vehicle miles of travel ranged from 3.3 million to 183.8 million per county. By rank bivariate correlation, obesity and physical inactivity were significantly associated (p < 0.01). Furthermore, by rank analysis of variance, the highest mean rank obesity was associated with the highest rank of VMT (p < 0.01). Similar rank patterns were observed between obesity and physical inactivity and commute time. Associations between VMT and physical inactivity were examined but failed to reach statistical significance. Conclusion: This analysis adds to the growing evidence supporting the association between VMT (a measure of automobile transportation) and obesity. An urban design characterized by over dependence on motorized transportation may be related to adverse health effects. (c) 2005 Elsevier Ltd. All rights reserved.

J. C. Lucove, S. L. Huston and K. R. Evenson (2007). Workers' perceptions about worksite policies and environments and their association with leisure-time physical activity. American Journal of Health Promotion; 21: 196-200.

PURPOSE: To estimate the employed population's exposure to perceived worksite policies and environments hypothesized to promote physical activity and to determine their relationship to leisure-time physical activity. DESIGN: Cross-sectional, random-digit-dial telephone survey. SETTING: Community. SUBJECTS: Employed adults (n = 987) in six North Carolina counties. MEASURES: Outcomes included any leisure-time physical activity, recommended physical activity, and work-break physical activity. Perceived worksite policies and environments included on-site fitness facility at work, safe place to walk outside work, paid time for activity, subsidized health-club membership, and flexible work schedule. ANALYSIS: Descriptive statistics were used to describe the study population and exposure to perceived worksite policies and environments. Multivariable logistic regression was used to evaluate relationships between perceived worksite policies and environments and physical activity, controlling for age, race, sex, educational status, disability, and general health status. RESULTS: Various supportive worksite policies and environments were reported by 15% to 56% of employed participants. Associations between perceived worksite policies and environments and physical activity were strongest for having paid time for non-work-related physical activity, an on-site fitness facility at work, and subsidies for health clubs. Recommended activity was not associated with perceived worksite policies and environments. CONCLUSION: Worksite policies and environments are promising factors for future study in physical activity promotion. Studies should evaluate these relationships in other populations and explore measurement error in self-reported worksite policies and environments.

J. C. Lumeng, D. Appugliese, H. J. Cabral, R. H. Bradley and B. Zuckerman (2006). Neighborhood safety and overweight status in children. Archives of Pediatrics & Adolescent Medicine; 160: 25-31.

OBJECTIVE: To determine if there is a relationship between parental perception of neighborhood safety and overweight at the age of 7 years. DESIGN: Cross-sectional analysis of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development. SETTING: Ten urban and rural US sites. PARTICIPANTS: A total of 768 children selected via conditional random sampling with complete data at follow-up. MAIN OUTCOME MEASURES: Parents reported demographics and perception of neighborhood safety by standardized questionnaire. Child overweight status was defined as a body mass index greater than or equal to the 95th percentile for age and sex from measured anthropometrics at the age of 7 years. The base model included relationship of the safety reporter to the child, sex, and baseline body mass index z score at the age of 4.5 years. Covariates tested included maternal marital status, education, and depressive symptoms; child race/ethnicity; participation in structured after-school activities; Home Observation for Measurement of the Environment total score; and neighborhood social cohesiveness. RESULTS: The sample was 85% white, and 10% of the children were overweight. Neighborhood safety ratings in the lowest quartile were independently associated with a higher risk of overweight at the age of 7 years compared with safety ratings in the highest quartile (adjusted odds ratio, 4.43; 95% confidence interval, 2.03-9.65). None of the candidate covariates altered the relationship between perception of neighborhood safety and child overweight status. CONCLUSIONS: Perception of the neighborhood as less safe was independently associated with an increased risk of overweight at the age of 7 years. Public health efforts may benefit from policies directed toward improving both actual and perceived neighborhood safety.

J. Maddock (2006). Evaluation of community-based physical activity programs. Evaluation And Program Planning; 29: 240-241.

The rate of obesity has been rapidly increasing in many countries. Lack of physical activity is a key component to this increase. Changes in the structure and walkability of cities and towns and increased automation in the work and home environments have led to declining rates of daily energy expenditure. Recently, many states and countries have turned to social-ecological approaches, intervening at the environmental, social and individual level to combat the decline in energy expenditure. While these efforts hold much promise for increasing the levels of physical activity, they present unique challenges to evaluators. Many of these interventions involve a wide variety of channels including mass media, Internet, community events and school-based programs often occurring simultaneously. The size of these programs is also large encompassing cities, states and even nations making finding equivalent comparison groups difficult. With these challenges and the political and social pressures to demonstrate results from these programs, strong process, outcome and impact evaluations are needed. (c) 2006 Elsevier Ltd. All rights reserved.

D. M. Matheson, T. N. Robinson, A. Varady and J. D. Killen (2006). Do Mexican-American mothers' food-related parenting practices influence their children's weight and dietary intake? Journal Of The American Dietetic Association; 106: 1861-1865.

Food-related parenting attitudes are thought to influence children's dietary intake and weight. The objective of this study was to examine the associations between mothers' reports of food-related parenting and children's dietary intake and body mass index (BMI). A sample of 108 Mexican-American fifth-grade children and their mothers were surveyed. Children's height, weight, and three 24-hour dietary recalls were collected. Mothers reported household food insecurity status and food-related parenting attitudes. Correlational analyses were calculated among dietary intake variables, children's BMI percentiles, and food-parenting behaviors. Mothers' pressure on their children to eat was inversely correlated with children's BMI. In food-insecure families, attitudes toward making healthful foods available were inversely associated with children's daily energy intake and BMI. In contrast, in food-secure families, attitudes about making healthful foods available were positively associated with children's fruit intake and percentage energy from fat, and parental modeling of healthful food behaviors was inversely associated with the energy density. In our sample of Mexican-American families, mothers' food-related parenting was associated with their children's weight and dietary intake. These associations differed in food-secure and food-insecure households. Overall, pressure to eat was highly associated with children's weight, but the temporal nature of these relationships cannot be discerned.

E. Matthies, C. A. Klockner and C. L. Preissner (2006). Applying a modified moral decision making model to change habitual car use: How can commitment be effective? Applied Psychology-An International Review; 55: 91-106.

A theory-driven intervention was carried out to initiate the try-out of a new travel mode behavior (try out taking public transport instead of car) in a sample of habitual car users (N = 297). A modified moral decision making model based on the theory of Schwartz and Howard (1981) served as background for the design of an intervention combining a habit-defrosting technique (temporary gift of a free ticket) with a norm-focused technique (plea for commitment). The sample consisted of 297 German citizens with good car access and living in areas with a convenient supply of public transportation. Participants were randomly assigned to four groups (commitment preceded by a free ticket, commitment only, free ticket only, and control) and had to report their travel mode choice for a particular, regular trip (e.g. trip to work) for a period of 8 weeks and a 2-week follow-up period. Additionally, model variables (personal norm to reduce car use, social norm, perceived behavioral costs, and habit) were recorded every 2 weeks. Although overall effects of the interventions were small, results indicate that a moral motivation is a relevant predictor for travel mode choices and can be stabilised by a commitment intervention preceded by a temporary change of the situation.

T. M. McCambridge, D. T. Bernhardt, J. S. Brenner, J. A. Congeni, J. E. Gomez, A. J. M. Gregory, D. B. Gregory, B. A. Griesemer, F. E. Reed, S. G. Rice, E. W. Small, P. R. Stricker, B. L. Frankowski, R. S. Gereige, L. M. Grant, D. Hyman, H. Magalnick, C. J. Mears, G. J. Monteverdi, R. D. Murray, G. P. Evan, M. M. Roland and T. L. Young (2006). Active healthy living: Prevention of childhood obesity through increased physical activity. Pediatrics; 117: 1834-1842.

The current epidemic of inactivity and the associated epidemic of obesity are being driven by multiple factors (societal, technologic, industrial, commercial, financial) and must be addressed likewise on several fronts. Foremost among these are the expansion of school physical education, dissuading children from pursuing sedentary activities, providing suitable role models for physical activity, and making activity-promoting changes in the environment. This statement outlines ways that pediatric health care providers and public health officials can encourage, monitor, and advocate for increased physical activity for children and teenagers.

B. McCann (2006). Making Physical Activity Research Relevant to Policy Makers. Journal of Physical Activity & Health; 3: S267-S272.

C. M. McDonald, T. Karamlou, J. G. Wengle, J. Gibson and B. W. McCrindle (2006). Nutrition and exercise environment available to outpatients, visitors, and staff in Children's hospitals in Canada and the United States. Archives of Pediatrics & Adolescent Medicine; 160: 900-5.

BACKGROUND: Children's hospitals should advocate for children's health by modeling optimum health environments. OBJECTIVES: To determine whether children's hospitals provide optimum health environments and to identify associated factors. DESIGN: Telephone survey. SETTING: Canadian and US hospitals with accredited pediatric residency programs. PARTICIPANTS: Food services directors or administrative dietitians. MAIN OUTCOME MEASURES: Health environment grades as determined for 4 domains quantifying (1) the amount of less nutritious food sold at cafeterias (cafeteria grade), (2) the presence of fast food outlets (outlet grade), (3) the amount of nutritious food alternatives available (healthful alternative grade), and (4) the presence of patient obesity or employee exercise programs (program grade). RESULTS: The overall response rate was 87%. Compared with Canadian hospitals, US hospitals had more food outlets (89% vs 50%) and more snack/beverage vending machines (median, 16 vs 12) (P =.001 for both), despite equivalent consumer numbers. External companies managed more outlets at US vs Canadian hospitals (65% vs 14%; P =.01), and, generally, US hospitals recuperated more revenue from their outlets. Worst cafeteria grade was associated with US hospital location (odds ratio [OR], 8.9; 95% confidence interval [CI], 1.6-50; P =.01) and lower healthful alternative grade (OR, 0.016; 95% CI, 0.002-0.15; P= 5 trips, 37%) was associated with child's level of independence and the perceived benefits of active commuting. Behaviour change in this setting requires multi-level strategies. (c) 2005 Elsevier Ltd. All rights reserved.

Y. Michael, T. Beard, D. S. Choi, S. Farquhar and N. Carlson (2006). Measuring the influence of built neighborhood environments on walking in older adults. Journal Of Aging And Physical Activity; 14: 302-312.

There is a need for greater understanding of how perceptions and objective measures of the physical environment influence physical activity among seniors. The goal of this study was to examine the degree of association between perceived and objective characteristics of the neighborhood environment and the relation of each type of measurement to neighborhood walking in older adults. Data on self-reported frequency of walking in the neighborhood and perceived measures of neighborhood environment from 105 older adults were linked to objective measures assessed by geographic information systems and an audit instrument. Perceived and objective measurements of the built environment exhibited a low degree of agreement (kappas: = 10 years as adolescents (mean age 16.5 +/- 1.7 years; N = 5524) were followed into adulthood (mean = 22.4 +/- 1.8 years; N = 4368), self-reporting PA, sedentary behavior, and dietary characteristics. Adult BMI and adolescent z scores were derived from measured height and weight. Results: Compared with those living together, twins living apart exhibited greater discordance in change in BMI, PA, and fast food intake from adolescence to adulthood. Adolescent household environments accounted for 8% to 10% of variation in adolescent fast food intake and sedentary behaviors and 50% of variation in adolescent overweight. Adolescent household effects on PA were substantially greater in young adulthood (accounting for 50% of variation) vs. adolescence. Young adult fast food intake was significantly affected by young adult household environment, accounting for 12% of variation. Discussion: These findings highlight important environmental influences on BMI, PA, and fast food intake during the transition to adulthood. Household and physical environments play an important role in establishing long-term behavior patterns.

M. C. Nelson, P. Gordon-Larsen, Y. Song and B. M. Popkin (2006). Built and social environments associations with adolescent overweight and activity. American Journal of Preventive Medicine; 31: 109-17.

BACKGROUND: Little is known about the patterning of neighborhood characteristics, beyond the basic urban, rural, suburban trichotomy, and its impact on physical activity (PA) and overweight. METHODS: Nationally representative data (National Longitudinal Study of Adolescent Health, 1994-1995, n = 20,745) were collected. Weight, height, PA, and sedentary behavior were self-reported. Using diverse measures of the participants' residential neighborhoods (e.g., socioeconomic status, crime, road type, street connectivity, PA recreation facilities), cluster analyses identified homogeneous groups of adolescents sharing neighborhood characteristics. Poisson regression predicted relative risk (RR) of being physically active (five or more bouts/week of moderate to vigorous PA) and overweight (body mass index equal or greater than the 95th percentile, Centers for Disease Control and Prevention/National Center for Health Statistics growth curves). RESULTS: Six robust neighborhood patterns were identified: (1) rural working class; (2) exurban; (3) newer suburban; (4) upper-middle class, older suburban; (5) mixed-race urban; and (6) low-socioeconomic-status (SES) inner-city areas. Compared to adolescents living in newer suburbs, those in rural working-class (adjusted RR[ARR] = 1.38, 95% confidence interval [CI] = 1.13-1.69), exurban (ARR = 1.30, CI = 1.04-1.64), and mixed-race urban (ARR = 1.31, CI = 1.05-1.64) neighborhoods were more likely to be overweight, independent of individual SES, age, and race/ethnicity. Adolescents living in older suburban areas were more likely to be physically active than residents of newer suburbs (ARR = 1.11, CI = 1.04-1.18). Those living in low-SES inner-city neighborhoods were more likely to be active, though not significantly so, compared to mixed-race urban residents (ARR = 1.09, CI = 1.00-1.18). CONCLUSIONS: These findings demonstrate disadvantageous associations between specific rural and urban environments and behavior, illustrating important effects of the neighborhood on health and the inherent complexity of assessing residential landscapes across the United States. Simple classical urban-suburban-rural measures mask these important complexities.

T. L. Nielsen, K. Wraae, K. Brixen, A. P. Hermann, M. Andersen and C. Hagen (2006). Prevalence of overweight, obesity and physical inactivity in 20- to 29-year-old, Danish men. Relation to sociodemography, physical dysfunction and low socioeconomic status: the Odense Androgen Study. International Journal Of Obesity; 30: 805-815.

Objective: To assess the prevalence of overweight, obesity and physical inactivity in 20- to 29-year-old men and to analyze whether sociodemography, physical dysfunction and low socioeconomic status are independent correlates of obesity and physical inactivity. Design: Population-based, cross-sectional study. Subjects: Seven hundred and eighty-three Caucasian, Danish men, aged 20- 29 years recruited from 2042 respondents in a questionnaire survey of 3000 men, randomly drawn from the Danish Civil Registration System. Methods: Questionnaire, interview and physical examination. Results: The 783 included men and the 2042 questionnaire respondents matched the background population demographically. The 783 men matched the questionnaire respondents as regards BMI, physical activity, chronic disease, medication, smoking, sociodemography and socioeconomic status. The prevalence of overweight and obesity was 31.7 and 7.9%, respectively (World Health Organization criteria). Using waist circumference (WC) cutoffs of 94 and 102 cm, the prevalence was 16.2 and 10.6%, respectively; 24.4% were physically inactive. BMI and WC increased significantly from age 20 to 29 years. Physical activity decreased significantly with age and correlated inversely with WC, but not with BMI. Occupation, geography, partner status, fatherhood and tobacco exposure were independently related with obesity and physical inactivity. Obesity was also related to musculoskeletal complaints, whereas chronic diseases and low educational level were associated with physical inactivity. Age was not independently related with either outcome. Conclusion: In affluent societies, sociodemographic changes may partly explain the age-related decrease in physical activity and the parallel increase in WC and BMI.

G. J. Norman, S. K. Nutter, S. Ryan, J. F. Sallis, K. J. Calfas and K. Patrick (2006). Community Design and Access to Recreational Facilities as Correlates of Adolescent Physical Activity and Body-Mass Index. Journal of Physical Activity & Health; 3: S118-S128.

Background: Neighborhood-level environmental features have been associated with adult physical activity and weight status, but this link has not been established for adolescents. Methods: Community design and access to recreational facilities variables were derived using geographic information systems (GIS) for 799 adolescents (age 11 to 15 y, mean = 12.8 y, 53% girls, 43% ethnic minority). Environment variables were calculated for a 1-mile buffer around each participant’s residence. Accelerometers measured min/d of physical activity. Results: Number of nearby recreation facilities and number of nearby parks correlated positively with girls’ physical activity, and intersection density inversely related to girls’ physical activity. Retail floor area ratio correlated positively with boys’ physical activity. No community design or access to recreation variables were related to BMI-percentile. Conclusions: There was limited evidence that both community design and access to recreation facilities variables were associated with adolescent physical activity, but additional built environment variables need to be studied that have particular relevance for youth.

J. A. O'Dea and R. Wilson (2006). Socio-cognitive and nutritional factors associated with body mass index in children and adolescents: possibilities for childhood obesity prevention. Health Education Research; 21: 796-805.

A large national study of schoolchildren aged 6-18 years was conducted to assess nutritional and socio-cognitive factors associated with body mass index (BMI). A questionnaire was used to assess nutritional quality of breakfast, importance of physical activity and food variety score, among 4441 students from randomly selected schools in all states and territories of Australia between September and December 2000. Height and weight were measured. Nutritional knowledge, dietary self-efficacy and dietary locus of control were also assessed among adolescents. School socio-economic status (SES) was derived from parental income. The factors were modelled using multiple linear regression to determine significant predictors of BMI. Dietary self-efficacy, nutritional quality of breakfast and SES were found to be the principal predictors of BMI in addition to the expected biological factors of age, gender and height. Furthermore, low SES was found to contribute to high BMI, mediated by the low nutritional quality of breakfast. Food variety was positively associated with high BMI and this was mediated by dietary self-efficacy. Nutrition knowledge and dietary locus of control were not associated with BMI. These results suggest that breakfast programmes for low-income children may be an effective measure in the prevention of childhood obesity.

M. O'Dougherty, M. Story and L. Lytle (2006). Food choices of young African-American and Latino adolescents: where do parents fit in? Journal of the American Dietetic Association; 106: 1846-50.

To gain insight into parents' perceptions of the food preferences of their young adolescents, and their negotiating and decision-making strategies around food purchasing and meals, four focus groups were held with 32 African-American parents and three focus groups with 14 Spanish-dominant, first-generation immigrant Latina mothers. Most participants were of low socioeconomic status and were single parents. Many African-American parents emphasized children's growing appetites and preferences for fast food. Many reported making weekday dinner decisions jointly with the child or allowing the child to eat a lunch-like alternative, and allowing serve-yourself meals on weekends. A few prepared traditional ethnic foods. Latina parents reported that their children liked ethnic foods and fast/junk foods. They emphasized buying foods their children wanted, making no eating restrictions, and preparing traditional ethnic dinners without alternatives. African-American and Latina parents displayed concern over whether to place restrictions on young adolescents' eating. Further research is needed on the ways in which socioeconomic inequalities compound barriers to healthful eating, with particular attention to low income and immigrant populations.

D. Ogilvie, R. Mitchell, N. Mutrie, M. Petticrew and S. Platt (2006). Evaluating Health Effects of Transport Interventions: Methodologic Case Study. American Journal of Preventive Medicine; 31: 118-126.

BACKGROUND: There is little evidence about the effects of environmental interventions on population levels of physical activity. Major transport projects may promote or discourage physical activity in the form of walking and cycling, but researching the health effects of such "natural experiments" in transport policy or infrastructure is challenging. METHODS: Case study of attempts in 2004-2005 to evaluate the effects of two major transport projects in Scotland: an urban congestion charging scheme in Edinburgh, and a new urban motorway (freeway) in Glasgow. RESULTS: These interventions are typical of many major transport projects. They are unique to their context. They cannot easily be separated from the other components of the wider policies within which they occur. When, where, and how they are implemented are political decisions over which researchers have no control. Baseline data collection required for longitudinal studies may need to be planned before the intervention is certain to take place. There is no simple way of defining a population or area exposed to the intervention or of defining control groups. Changes in quantitative measures of health-related behavior may be difficult to detect. CONCLUSIONS: Major transport projects have clear potential to influence population health, but it is difficult to define the interventions, categorize exposure, or measure outcomes in ways that are likely to be seen as credible in the field of public health intervention research. A final study design is proposed in which multiple methods and spatial levels of analysis are combined in a longitudinal quasi-experimental study.

T. Osuji, S. Lovegreen, M. Elliott and R. C. Brownson (2006). Barriers to physical activity among women in the rural midwest. Women & Health; 44: 41-55.

Physical activity is an important factor in chronic disease control and prevention. Yet women and rural residents consistently report lower rates of physical activity than their male and urban/suburban counterparts. The objective of this study was to assess the relationship between personal, social, and environmental barriers and meeting moderate physical activity recommendations in a sample of rural women. Data were obtained from a telephone survey of 2,510 residents of rural southeastern Missouri, Tennessee, and Arkansas. After adjusting for age and income, women who identified personal barriers, such as lack of time, no motivation, disinterest in exercise, and having no one to exercise with,were less likely to meet physical activity recommendations. There was evidence of a dose-response relationship between the number of barriers identified and meeting moderate physical activity recommendations among women with higher incomes and women with lower incomes; however, this relationship was most striking among women with annual household incomes of $25,000 or more. These findings may be used to tailor physical activity interventions to women in rural communities.

C. W. Outley and A. Taddese (2006). A content analysis of health and physical activity messages marketed to African American children during after-school television programming. Archives of Pediatrics & Adolescent Medicine; 160: 432-5.

OBJECTIVE: To examine the number of food advertisements African American children are exposed to during children's television programming aired on predominantly African American and general television stations. DESIGN: A content analysis was conducted to identify and analyze the health-related content (HRC) and physical activity-related content (PARC) of food advertisements shown during children's television programming. SETTING: Three sets of television advertisements from 3 stations (Black Entertainment Television, The WB [Warner Bros], and Disney Channel) served as the sample during a 1-week period in July 2005 (July 11-15), from 3 pm to 9 pm. RESULTS: In total, 1098 advertisements were recorded, with 256 food and beverage commercials used for this study. Results indicate that 36.3% of all commercials were based on fast food restaurants, 31.3% were for drinks, 16.8% were for candy, 13.7% were for cereals, and 2.0% were for snacks (percentages do not total 100 because of rounding). Compared with The WB and Disney Channel, Black Entertainment Television had significantly (P=.001) more food and beverage advertisements. Few HRC or PARC advertisements were shown. Of 256 food and beverage commercials, only 8.2% contained HRC and 9.4% had PARC. Also, the HRC and PARC scenes contained messages that were implied vs explicitly talking about the health or physical benefits of the product. CONCLUSIONS: African American children are overexposed to numerous types of food and beverage advertisements. These advertisements do not provide an adequate level of positive HRC and PARC messages. Consequently, the messages that are portrayed may undermine efforts to teach African American children about the importance of healthy living and physical activity.

C. Padez (2006). Trends in overweight and obesity in Portuguese conscripts from 1986 to 2000 in relation to place of residence and educational level. Public Health; 120: 946-52.

OBJECTIVE: The aim of this study was to analyse changes in the prevalence of overweight and obesity between 1986 and 2000 in Portuguese conscripts, and to examine the role of place of residence and educational level. STUDY DESIGN: Cross-sectional study. METHODS: Data sets from the cross-sectional annual surveys of all 18-year-old Portuguese males born between 1966 and 1981 and examined between 1986 and 2000 (850 081 subjects) were used in this study. Height and weight were measured and body mass index was calculated. Data on educational level (4, 6, 9, 11 and 12+ years) and residence (urban, semi-urban and rural) were collected. RESULTS: The prevalence of overweight increased from 10.5% in 1986 to 21.3% in 2000, and the prevalence of obesity increased from 0.9% to 4.2% in the same period (P ................
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