Physical Violence During Pregnancy: Maternal Complications and Birth Outcomes

Objective: To assess the association between physical violence during the 12 months before delivery and maternal complications and birth outcomes. Methods: We used population-based data from 6143 women who delivered live-born infants between 1993 and 1995 in South Carolina. Data on women\u27s physical violence during pregnancy were based on self-reports of partner-inflicted physical hurt and being involved in a physical fight. Outcome data included maternal antenatal hospitalizations, labor and delivery complications, low birth weights, and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the associations between physical violence, maternal morbidity, and birth outcomes. Results: The prevalence of physical violence was 11.1%. Among women who experienced physical violence, 54% reported having been involved in physical fights only and 46% had been hurt by husbands or partners. In the latter group, 70% also reported having been involved in fighting. Compared with those not reporting physical violence, women who did were more likely to deliver by cesarean and be hospitalized before delivery for maternal complications such as kidney infection, premature labor, and trauma due to falls or blows to the abdomen. Conclusion: Physical violence during the 12 months before delivery is common and is associated with adverse maternal conditions. The findings support the need for research on how to screen for physical violence early in pregnancy and to prevent its consequences

Perceived Individual, Social, and Environmental Factors for Physical Activity and Walking

Background: Few studies have explored associations of individual, social, and environmental factors with physical and walking behavior. Methods: A random-digit-dial questionnaire, which included selected individual, social, and environmental variables, was administered to 2025 adults, age 18 y and older, in two adjacent counties in a southeastern state. Logistic regressions were conducted adjusting for age, race, sex, education, and employment. Results: In multivariate models, somewhat different variables were associated with physical activity versus regular walking. Self-efficacy (OR = 19.19), having an exercise partner (OR = 1.47), recreation facilities (OR = 1.54), and safety of trails from crime (OR = 0.72) were associated with physical activity level; while self-efficacy (OR = 4.22), known walking routes (OR = 1.54), recreation facilities (OR = 1.57-1.59), and safety of trails from crime (OR = 0.69) were associated with regular walking behavior. Conclusions: Physical activity and walking behaviors were associated with similar variables in this study

The Effect of Question Order on Reporting Physical Activity and Walking Behavior

Background: Question order might affect self-reported regular physical activity (PA) measured with items from the Behavioral Risk Factor Surveillance System (BRFSS) PA module. Methods: A telephone survey was conducted using 2 forms (N = 1004, N = 212) with varying PA question order. The standard form presented moderate-PA, vigorous-PA, and walking questions, in that order, whereas the alternate form presented walking questions, followed by moderate-PA, and then vigorous-PA questions. Weighted, adjusted rates of vigorous PA, walking, meeting the Centers for Disease Control and Prevention (CDC) recommendation for moderate or vigorous PA, and moderate PA from each form were compared. Results: Vigorous PA and walking were similar regardless of question order. Meeting the CDC recommendation for moderate or vigorous PA was reported less often with the alternate form among 18- to 34-year-olds. Less moderate PA was reported with the alternate form overall and among 18- to 34-year-olds, women, whites, and those with a high school education or less. Conclusion: Estimating PA and walking across sociodemographic strata with differing patterns of PA requires asking moderate-PA and vigorous-PA questions before walking questions. Asking walking questions first might lead to bias, especially for moderate PA. Walking, added to a survey with BRFSS moderate and vigorous PA items, should be placed after moderate and vigorous PA. Walking questions first may cause bias, especially for moderate PA

Social and Environmental Factors Associated with Preschoolers' Non-sedentary Physical Activity

The two-fold purpose of the investigation was (1) to describe with direct observation data the physical activity behaviors and the accompanying social and environmental events of those behaviors for children in preschools; and (2) to determine which contextual conditions were predictors of moderate-to-vigorous physical activity (MVPA) and non-sedentary physical activity (i.e., light activity + MVPA) for 3-, 4-, and 5-year-old children during their outdoor play. The results indicate that preschoolers' physical activity is characterized as sedentary in nature throughout their preschool day (i.e., 89% sedentary, 8% light activity, 3% MVPA). During outdoor play periods, when children are most likely to be physically active, some contextual and social circumstances better predict their physical activity. Implications for policymakers, practitioners, and researchers are discussed. Originally published Child Development, Vol. 80, No. 1, Jan/Feb 200

Study of Health and Activity in Preschool Environments (SHAPES): Study Protocol for a Randomized Trial Evaluating a Multi-Component Physical Activity Intervention in Preschool Children

Background: Physical inactivity is a recognized public health concern. Inadequate proportions of children in the U.S, including those of preschool age, are meeting physical activity recommendations. In response to low numbers of preschool children attaining appropriate physical activity levels, combined with the large number of young children who attend preschool, researchers have identified the need to devise interventions to increase physical activity at preschools. However, few multi-component interventions to increase physical activity in preschool children exist. The aims of this study were to observe the effects of a multi-component intervention on physical activity, sedentary behavior, and physical activity energy expenditure in 3-5 year-old children; identify factors that associate with change in those variables; and evaluate the process of implementing the multi-component intervention. The purpose of this manuscript is to describe the study design and intervention protocol. Methods/design: The overall design of the Study of Health and Activity in Preschool Environments (SHAPES) was a two-year randomized trial (nested cohort design), with two conditions, two measurement occasions, and preschool serving as the unit of analysis. Sixteen schools (eight intervention and eight control) were enrolled. The intervention protocol was based on the social ecological model and included four main components: (a) indoor physical activity (“move inside”), (b) recess (“move outside”), (c) daily lessons (“move to learn”), and (d) social environment. Components were implemented using teacher and administrator trainings and workshops, site support visits, newsletters, and self-monitoring methods. Outcomes included accelerometer assessment of physical activity, sedentary behavior, and physical activity energy expenditure; weight status; and demographic factors; family/home social and physical environment; and parental characteristics. An extensive process evaluation battery was also used to monitor dose delivered by interventionists, completeness of intervention component delivery by teachers, and fidelity of teachers’ implementation. Discussion: The study will address important gaps relative to increasing physical activity in preschool children. Few studies to date have incorporated a multi-component approach, rigorous measurement protocol, and thorough evaluation of intervention implementation. Trial registration: NCT0188532

Long-Term Effects of a Physical Activity Intervention in High School Girls

Background - Physical activity decreases during childhood and adolescence, and physical activity levels are significantly lower in females than males, particularly during adolescence. Schools are attractive settings in which to implement interventions designed to promote physical activity in girls and young women, but few studies have tested the sustained effects of such interventions. Design - Cross-sectional. Data were collected in 2002-2003 and analyzed in 2006-2007. Setting/Participants - 1594 adolescent girls in 22 high schools. Intervention - The intervention, Lifestyle Education for Activity Program (LEAP), was designed to increase physical activity in 9th grade girls through two channels: changes in institutional practices and changes in the school environment. This study (LEAP 2) examined the extent to which effects of the intervention were maintained when the girls were in 12th grade. Main Outcome Measures - Number of 30-minute blocks per day of vigorous physical activity. Results - Girls in the intervention schools that most fully implemented and maintained the intervention were more likely than girls in the other schools to participate in an average of one or more blocks of vigorous physical activity per day (p=0.04; OR=1.49; 95% CI=1.01, 2.20). Conclusions - A comprehensive physical activity intervention that is fully implemented and maintained can increase participation in vigorous physical activity by high school girls

Imputation of Missing Data When Measuring Physical Activity by Accelerometry

We consider the issue of summarizing accelerometer activity count data accumulated over multiple days when the time interval in which the monitor is worn is not uniform for every subject on every day. The fact that counts are not being recorded during periods in which the monitor is not worn means that many common estimators of daily physical activity are biased downward

Results of the Active by Choice Today (ACT) Randomized Trial for Increasing Physical Activity in Low-Income and Minority Adolescents

Objective - This study reports the results of the Active by Choice Today (ACT) trial for increasing moderate-to-vigorous physical activity (MVPA) in low-income and minority adolescents. Design - The ACT program was a randomized controlled school-based trial testing the efficacy of a motivational plus behavioral skills intervention on increasing MVPA in underserved adolescents. Twenty-four middle schools were matched on school size, percentage minorities, percentage free or reduced lunch, and urban or rural setting before randomization. A total of 1,563 6th grade students (mean age, 11.3 years, 73% African American, 71% free or reduced lunch, 55% female) participated in either a 17-week (over one academic year) intervention or comparison after-school program. Main Outcome Measure - The primary outcome measure was MVPA based on 7-day accelerometry estimates at 2-weeks postintervention and an intermediate outcome was MVPA at midintervention. Results - At midintervention students in the intervention condition engaged in 4.87 greater minutes of MVPA per day (95% CI: 1.18 to 8.57) than control students. Students in intervention schools engaged in 9.11 min (95% CI: 5.73 to 12.48) more of MVPA per day than those in control schools during the program time periods; indicating a 27 min per week increase in MVPA. No significant effect of the ACT intervention was found outside of school times or for MVPA at 2-weeks postintervention. Conclusions - Motivational and behavioral skills programs are effective at increasing MVPA in low-income and minority adolescents during program hours, but further research is needed to address home barriers to youth MVPA

Correlates of physical activity among U.S. Young adults, 18 to 30 years of age, from NHANES III

Young adults are often in periods of transition, and lifestyle changes such as a decline in physical activity can occur during this period. The purpose of this study was to determine the relationships between demographic, biologic, lifestyle, social support index, environmental factors, and physical activity in young adults. The participants were 4,152 young adults from 18 to 30 years of age enrolled in the Third National Health and Nutrition Examination Survey (NHANES III). A moderate to vigorous physical activity (MVPA) score was calculated from responses to nine activities and up to four activities not previously listed. Multiple regression analyses were used to assess the relationship between MVPA and independent variables separately for men and women. Non-Hispanic Blacks were more active than non-Hispanic White or Mexican American men, whereas, among women, non-Hispanic Whites were more active. Education, social support index, and trying to lose weight were positively associated with MVPA, whereas being married was inversely related in both men and women. Among women, those who were unemployed, in better health, had smaller families, had lower body mass indexes (BMIs), and were not from the South had higher MVPA. Men who were in school during the past 12 months were more active than those who were not in school. The results from this study suggest that demographic and social factors are important determinants of physical activity in young adults and should be considered when planning interventions