Do changes to the local street environment alter behaviour and quality of life of older adults? The ‘DIY Streets’ intervention

<p>Background: The burden of ill-health due to inactivity has recently been highlighted. Better studies on environments that support physical activity are called for, including longitudinal studies of environmental interventions. A programme of residential street improvements in the UK (Sustrans ‘DIY Streets’) allowed a rare opportunity for a prospective, longitudinal study of the effect of such changes on older adults’ activities, health and quality of life.</p> <p>Methods: Pre–post, cross-sectional surveys were carried out in locations across England, Wales and Scotland; participants were aged 65+ living in intervention or comparison streets. A questionnaire covered health and quality of life, frequency of outdoor trips, time outdoors in different activities and a 38-item scale on neighbourhood open space. A cohort study explored changes in self-report activity and well-being postintervention. Activity levels were also measured by accelerometer and accompanying diary records.</p> <p>Results: The cross-sectional surveys showed outdoor activity predicted by having a clean, nuisance-free local park, attractive, barrier-free routes to it and other natural environments nearby. Being able to park one's car outside the house also predicted time outdoors. The environmental changes had an impact on perceptions of street walkability and safety at night, but not on overall activity levels, health or quality of life. Participants’ moderate-to-vigorous activity levels rarely met UK health recommendations.</p> <p>Conclusions: Our study contributes to methodology in a longitudinal, pre–post design and points to factors in the built environment that support active ageing. We include an example of knowledge exchange guidance on age-friendly built environments for policy-makers and planners.</p&gt

Validity of the new lifestyles NL-1000 accelerometer for measuring time spent in moderate-to-vigorous physical activity in school settings

Current interest in promoting physical activity in the school environment necessitates an inexpensive, accurate method of measuring physical activity in such settings. Additionally, it is recognized that physical activity must be of at least moderate intensity in order to yield substantial health benefits. The purpose of the study, therefore, was to determine the validity of the New Lifestyles NL-1000 (New Lifestyles, Inc., Lee's Summit, Missouri, USA) accelerometer for measuring moderate-to-vigorous physical activity in school settings, using the Actigraph GT1M (ActiGraph, Pensacola, Florida, USA) as the criterion. Data were collected during a cross-country run (n = 12), physical education (n = 18), and classroom-based physical activities (n = 42). Significant and meaningful intraclass correlations between methods were found, and NL-1000 estimates of moderate-to-vigorous physical activity were not meaningfully different from GT1M-estimated moderate- to-vigorous physical activity. The NL-1000 therefore shows promising validity evidence as an inexpensive, convenient method of measuring moderate-to-vigorous physical activity in school settings

PLAYgrounds: Effect of a PE playground program in primary schools on PA levels during recess in 6 to 12 year old children. Design of a prospective controlled trial

Background The relative number of children meeting the minimal required dose of daily physical activity remains execrably low. It has been estimated that in 2015 one out of five children will be overweight. Therefore, low levels of physical activity during early childhood may compromise the current and future health and well-being of the population, and promoting physical activity in younger children is a major public health priority. This study is to gain insight into effects of a Physical Education based playground program on the PA levels during recess in primary school children aged 6-12. Methods/design The effectiveness of the intervention program will be evaluated using a prospective controlled trial design in which schools will be matched, with a follow-up of one school year. The research population will consist of 6-12 year old primary school children. The intervention program will be aimed at improving physical activity levels and will consist of a multi-component alteration of the schools' playground. In addition, playground usage will be increased through altered time management of recess times, as well as a modification of the Physical Education content. Discussion The effects of the intervention on physical activity levels during recess (primary outcome measure), overall daily physical activity and changes in physical fitness (secondary outcome measures) will be assessed. Results of this study could possibly lead to changes in the current playground system of primary schools and provide structured health promotion for future public health. Trial registration Netherlands Trial Register (NTR): NTR238

REVAMP IT: Utilization of Socioecological Approach to Combat Adolescent Obesity in Knott County, Kentucky

The Kentucky River District Health Department proposes the implementation of REVAMP IT in four selected elementary schools in Knott County, Kentucky to improve subjective attitudes towards various aspects of health knowledge, physical activity, social support, and screen-time, as well as reduce biometrically measured television time and increased step count. REVAMP IT is an evidence-based program that utilizes the socioecological model of Public Health to target aspects of the individual, relational, and community level to facilitate changes from multiple aspects. Screen-time and physical activity goals will be individually set by students, and Knott County Elementary School teachers will be responsible for the development of an in-school curriculum that integrates components from various subjects to promote health education. Families will be approached by volunteers of local non-profit organizations for check-ins via in-home visits or telephone calls to collect data, as well as encourage social support and address concerns or suggestions on a personal level. REVAMP IT aligns with the mission of the Kentucky River District Health Department to protect, maintain, and promote the health of the people of the communities it serves. Short-term goals for REVAMP IT are to achieve biometric goals of screen-time as well as physical activity, and achieve subjective improvement (as measured by pre/post-tests, community forums) towards attitudes to physical activity, nutritional habits, access to facilities, and overall understanding of educational materials. Long-term outcomes of the project are to reduce overall rates of both adolescent and adult obesity in Knott County, as well promotion of a greater sense of community support and involvement, providing parents and students with the knowledge and willingness to participate in taking control of their health. Under the leadership of Jessica Cooper and the full-time Project Director, the Kentucky River District Health Department will pair with community organizations such as the Leslie, Knott, Letcher, Perry County Community Action Council (LKLP) and Knott County Tourism Commission to facilitate a smooth implementation of program components through the utilization of local resources and volunteers. Community leaders as well as representatives from the respective elementary schools include teachers and students will play a critical role in oversight and guidance of REVAMP IT. The results of the project will be shared to the community as well as local health departments with the possibility of seeking additional funding for implementation in other rural, low-income and resource-limited areas in Kentucky

Keeping physically active with rheumatoid arthritis: semi-structured interviews to explore patient perspectives, experiences and strategies

© 2018 Chartered Society of Physiotherapy Background: Regular physical activity is safe and beneficial for people with rheumatoid arthritis (RA) but the majority of people with RA are less active than the general population and have a higher risk of co-morbidities. Exploring strategies used by physically active people with RA could inform effective methods to support those who are less active. Objective: To explore the perspectives, experiences and strategies employed by people with RA who successfully engage with regular physical activity. Design: Individual semi-structured interviews and thematic analysis. Participants: A purposive sample of physically active people with RA. Results: Twelve females and three males participated (mean age 56, range 29 to 80; mean disease duration 13 years, range 10 months to 46 years). Analysis revealed eight constructs clustered into three themes. Theme 1: ‘the individual’ incorporated constructs of symptoms, feelings and role; theme 2: ‘management’ incorporated medical and self-management; theme 3: ‘physical activity’ incorporated constructs of type of physical activity, including barriers or facilitators. Participants reported a long history of physical activity prior to diagnosis and good support networks. All participants recognised that physical activity was key to their RA management, acknowledged the benefits from engaging in physical activity and were able to overcome barriers. Participants had strong beliefs that physical function would decline without regular physical activity. Conclusions: People with RA who successfully maintain physical activity are motivated by a desire to manage symptoms, resist functional decline and maintain health and independence. These findings should be explored with a wider range of people with RA

Primary Care Staff's Views and Experiences Related to Routinely Advising Patients about Physical Activity. A Questionnaire Survey

Background: United Kingdom public health policy has recently re-emphasised the role of primary health care professionals in tackling increasing levels of physical inactivity within the general population. However, little is known about the impact that this has had in practice. This study explores Scottish primary care staff's knowledge, attitudes and experiences associated with advising patients about physical activity during routine consultations. Methods: A cross-sectional questionnaire survey of general practitioners (or family physicians), practice nurses and health visitors based in four health regions was conducted during 2004. The main outcome measures included: i) health professionals' knowledge of the current physical activity recommendations; (ii) practice related to routine physical activity advising; and (iii) associated attitudes. Results: Questionnaires were returned by 757 primary care staff (response rate 54%). Confidence and enthusiasm for giving advice was generally high, but knowledge of current physical activity recommendations was low. In general, respondents indicated that they routinely discuss and advise patients about physical activity regardless of the presenting condition. Health visitors and practice nurses were more likely than general practitioners to offer routine advice. Lack of time and resources were more likely to be reported as barriers to routine advising by general practitioners than other professional groups. However, health visitors and practice nurses were also more likely than general practitioners to believe that patients would follow their physical activity advice giving. Conclusion: If primary health care staff are to be fully motivated and effective in encouraging and supporting the general population to become more physically active, policymakers and health professionals need to engage in efforts to: (1) improve knowledge of current physical activity recommendations and population trends amongst frontline primary care staff; and (2) consider the development of tools to support individual assessment and advice giving to suit individual circumstances. Despite the fact that this study found that system barriers to routine advising were less of a problem than other previous research has indicated, this issue still remains a challenge

Outcomes of implementing the chronic disease self-management program (CDSMP) in the Kurdish community

Background: The incidence of chronic diseases signifies a need to redesign the U.S. healthcare system to better support minority individuals. This project examined the impact of the chronic disease self-management program (CDSMP) workshop in the Kurdish community. The literature shows many positive outcomes of CDSMP workshops, including improvements in physical health, self-efficacy, depression, communication with providers, as well as reduced emergency department visits and hospitalizations. This results in healthcare cost savings for our local communities and our nation. The literature is limited on managing chronic diseases in the Kurdish population, a growing refugee population in the United States and central Virginia region. Furthermore, after speaking with the CDSMP coordinator and reviewing the literature, the CDSMP workshop has not been implemented or evaluated with a Kurdish population. A Logic Model and the PRECEDE-PROCEED model framework were used to implement the CDSMP workshop in the Kurdish community. During the PRECEDE section of this paper, there was a discussion of the social, environmental, epidemiological, administrative, and policy assessment before implementing the CDSMP workshop in the Kurdish population. During the PROCEED section, there was a discussion of the implementation and evaluation of the CDSMP workshop. Methods: A CDSMP workshop was implemented in the Kurdish dialect to a group of female participants living in a Mid-Atlantic state (N=11). Outcome measures included general health, health distress symptoms, physical activities, self-efficacy, social/role activity limitations, and communication with providers. Results: At 6-weeks post-intervention, there was improvement in all outcome measures with significant improvement in self-reported health and health distress symptoms. At 12-weeks post-baseline data collection, all outcome measures continued to show improvement except for self-efficacy and physical activity that demonstrated a fade out effect. Discussions: CDSMP workshops can be modified and successfully implemented in diverse community settings while still maintaining the key components of the program

Communities Across Washington State Commit to Safe, Active Streets for All

SUMMARYFrom 2014 to 2016, the Healthy Eating Active Living (HEAL) program helped 21 cities, 2 counties, and 1 tribe in Washington State, learn how to make their communities safer and more active through better street design. Key partners\u2014led by the Washington State Department of Health (DOH)\u2014included the Washington State Department of Transportation (WSDOT) and Transportation Improvement Board (TIB). The organizations partnered with community leaders, in mostly rural areas, to design strategies that increase access to physical activity.2016640