The place of physical activity in the WHO Global Strategy on Diet and Physical Activity

In an effort to reduce the global burden of non-communicable disease, the World Health Organization released a Global Strategy for Diet and Physical Activity in May 2004. This commentary reports on the development of the strategy and its importance specifically for physical activity-related work of NGOs and researchers interested in increasing global physical activity participation. Sparked by its work on global efforts to target non-communicable disease prevention in 2000, the World Health Organization commissioned a global strategy on diet and physical activity. The physical activity interest followed efforts that had led to the initial global "Move for Health Day" in 2002. WHO assembled a reference group for the global strategy, and a regional consultation process with countries was undertaken. Underpinning the responses was the need for more physical activity advocacy; partnerships outside of health including urban planning; development of national activity guidelines; and monitoring of the implementation of the strategy. The consultation process was an important mechanism to confirm the importance and elevate the profile of physical activity within the global strategy. It is suggested that separate implementation strategies for diet and physical activity may be needed to work with partner agencies in disparate sectors (e.g. urban planning for physical activity, agriculture for diet). International professional societies are well situated to make an important contribution to global public health by advocating for the importance of physical activity among risk factors; developing international measures of physical activity and global impacts of inactivity; and developing a global research and intervention agenda

ParticipACTION: Overview and introduction of baseline research on the "new" ParticipACTION

<p>Abstract</p> <p>Background</p> <p>This paper provides a brief overview of the Canadian physical activity communications and social marketing organization "ParticipACTION"; introduces the "new" ParticipACTION; describes the research process leading to the collection of baseline data on the new ParticipACTION; and outlines the accompanying series of papers in the supplement presenting the detailed baseline data.</p> <p>Methods</p> <p>Information on ParticipACTION was gathered from close personal involvement with the organization, from interviews and meetings with key leaders of the organization, from published literature and from ParticipACTION archives. In 2001, after nearly 30 years of operation, ParticipACTION ceased operations because of inadequate funding. In February 2007 the organization was officially resurrected and the launch of the first mass media campaign of the "new" ParticipACTION occurred in October 2007. The six-year absence of ParticipACTION, or any equivalent substitute, provided a unique opportunity to examine the impact of a national physical activity social marketing organization on important individual and organizational level indicators of success. A rapid response research team was established in January 2007 to exploit this natural intervention research opportunity.</p> <p>Results</p> <p>The research team was successful in obtaining funding through the new Canadian Institutes of Health Research Intervention Research (Healthy Living and Chronic Disease Prevention) Funding Program. Data were collected on individuals and organizations prior to the complete implementation of the first mass media campaign of the new ParticipACTION.</p> <p>Conclusion</p> <p>Rapid response research and funding mechanisms facilitated the collection of baseline information on the new ParticipACTION. These data will allow for comprehensive assessments of future initiatives of ParticipACTION.</p

Distinct trajectories of leisure time physical activity and predictors of trajectory class membership: a 22 year cohort study

<p>Abstract</p> <p>Background</p> <p>Prospective studies linking social factors to long term patterns of physical activity are lacking. In this 22 year longitudinal study, we seek to identify long term patterns of involvement in leisure time physical activity (LTPA), and explore socioeconomic and demographic predictors of distinct LTPA trajectories.</p> <p>Methods</p> <p>Among 2102 individuals aged 18–60 years in 1981 who participated in the 1981 Canada Fitness Survey/1988 Campbell's Survey of Well-Being, 1186 (56.4%) completed questionnaires for the 2002/04 follow-up. Complete data on LTPA at all 3 surveys were available for 884 participants. Latent class growth analysis was used to identify major classes of LTPA trajectories; predictors of class membership were identified using polytomous logistic regression.</p> <p>Results</p> <p>Four latent classes were identified: <it>inactive</it>, <it>increasers</it>, <it>active</it>, and <it>decreasers </it>(53%, 26%, 12%, and 9% of participants, respectively). Women, older participants, those with lower household income, and with lower educational attainment, were significantly less likely to follow <it>active </it>(Vs. <it>inactive</it>) trajectories of LTPA. Disadvantaged groups with respect to education and income were also significantly more likely to follow <it>decreasing </it>(Vs. <it>active</it>) trajectories.</p> <p>Conclusion</p> <p>There is a need for continued efforts to increase overall population levels of LTPA, particularly among socially disadvantaged groups with respect to income and education, who are most likely to experience unfavorable trajectories of LTPA.</p

ParticipACTION: A mass media campaign targeting parents of inactive children; knowledge, saliency, and trialing behaviours

<p>Abstract</p> <p>Background</p> <p>In late 2007, Canada's ParticipACTION national physical activity mass media campaign was re-launched, with an initial campaign targeting parents of elementary school-aged children. The campaign informed them about the risks of physical inactivity for children and youth. The purpose of this study was to assess campaign awareness and understanding following the campaign, and to identify whether exposure to this campaign was likely associated with behaviour change.</p> <p>Methods</p> <p>A convenience sample of 1,500 adults was recruited though an existing panel (n = 60,000) of Canadian adults to participate in online surveys. Initial campaign exposure included "prompted" and "unprompted" recall of specific physical activity messages from the 2007 ParticipACTION campaign, knowledge of the benefits of PA, saliency, and initial trial behaviours to help their children become more active.</p> <p>Results</p> <p>One quarter of respondents showed unprompted recall of specific message content from the ParticipACTION campaign, and prompted recall was 57%. Message recall and understanding was associated with knowledge about physical activity, and that in turn was related to high saliency. Saliency was associated with each of the physical activity-related trial behaviours asked.</p> <p>Conclusion</p> <p>Campaign awareness and understanding was high following this ParticipACTION campaign, and was associated with intermediate campaign outcomes, including saliency and trial behaviours. This is relevant to campaign evaluations, as it suggests that an initial focus on influencing awareness and understanding is likely to lead to more substantial change in campaign endpoints.</p

Canadian children's and youth's pedometer-determined steps/day, parent-reported TV watching time, and overweight/obesity: The CANPLAY Surveillance Study

<p>Abstract</p> <p>Background</p> <p>This study examines associations between pedometer-determined steps/day and parent-reported child's Body Mass Index (BMI) and time typically spent watching television between school and dinner.</p> <p>Methods</p> <p>Young people (aged 5-19 years) were recruited through their parents by random digit dialling and mailed a data collection package. Information on height and weight and time spent watching television between school and dinner on a typical school day was collected from parents. In total, 5949 boys and 5709 girls reported daily steps. BMI was categorized as overweight or obese using Cole's cut points. Participants wore pedometers for 7 days and logged daily steps. The odds of being overweight and obese by steps/day and parent-reported time spent television watching were estimated using logistic regression for complex samples.</p> <p>Results</p> <p>Girls had a lower median steps/day (10682 versus 11059 for boys) and also a narrower variation in steps/day (interquartile range, 4410 versus 5309 for boys). 11% of children aged 5-19 years were classified as obese; 17% of boys and girls were overweight. Both boys and girls watched, on average, < 40 minutes of television between school and dinner on school days. Adjusting for child's age and sex and parental education, the odds of a child being obese decreased by 20% for every extra 3000 steps/day and increased by 21% for every 30 minutes of television watching. There was no association of being overweight with steps/day, however the odds of being overweight increased by 8% for every 30 minutes of additional time spent watching television between school and dinner on a typical school day.</p> <p>Discussion</p> <p>Television viewing is the more prominent factor in terms of predicting overweight, and it contributes to obesity, but steps/day attenuates the association between television viewing and obesity, and therefore can be considered protective against obesity. In addition to replacing opportunities for active alternative behaviours, exposure to television might also impact body weight by promoting excess energy intake.</p> <p>Conclusions</p> <p>In this large nationally representative sample, pedometer-determined steps/day was associated with reduced odds of being obese (but not overweight) whereas each parent-reported hour spent watching television between school and dinner increased the odds of both overweight and obesity.</p

The International Prevalence Study on Physical Activity: results from 20 countries

<p>Abstract</p> <p>Background</p> <p>Physical activity (PA) is one of the most important factors for improving population health, but no standardised systems exist for international surveillance. The International Physical Activity Questionnaire (IPAQ) was developed for international surveillance. The purpose of this study was a comparative international study of population physical activity prevalence across 20 countries.</p> <p>Methods</p> <p>Between 2002–2004, a standardised protocol using IPAQ was used to assess PA participation in 20 countries [total N = 52,746, aged 18–65 years]. The median survey response rate was 61%. Physical activity levels were categorised as "low", "moderate" and "high". Age-adjusted prevalence estimates are presented by sex.</p> <p>Results</p> <p>The prevalence of "high PA" varied from 21–63%; in eight countries high PA was reported for over half of the adult population. The prevalence of "low PA" varied from 9% to 43%. Males more frequently reported high PA than females in 17 of 20 countries. The prevalence of low PA ranged from 7–41% among males, and 6–49% among females. Gender differences were noted, especially for younger adults, with males more active than females in most countries. Markedly lower physical activity prevalence (10% difference) with increasing age was noted in 11 of 19 countries for males, but only in three countries for women. The ways populations accumulated PA differed, with some reporting mostly vigorous intensity activities and others mostly walking.</p> <p>Conclusion</p> <p>This study demonstrated the feasibility of international PA surveillance, and showed that IPAQ is an acceptable surveillance instrument, at least within countries. If assessment methods are used consistently over time, trend data will inform countries about the success of their efforts to promote physical activity.</p

ParticipACTION: Baseline assessment of the 'new ParticipACTION': A quantitative survey of Canadian organizational awareness and capacity

ParticipACTION is a Canadian physical activity (PA) communications and social marketing organization that was relaunched in 2007 after a six-year hiatus. This study assesses the baseline awareness and capacity of Canadian organizations that promote physical activity, to adopt, implement and promote ParticipACTION's physical activity campaign. The three objectives were: (1) to determine organizational awareness of both the 'original' and 'new' ParticipACTION; (2) to report baseline levels of three organizational capacity domains (i.e., to adopt, implement and externally promote physical activity initiatives); and, (3) to explore potential differences in those domains based on organizational size, sector and primary mandate. Organizations at local, provincial/territorial, and national levels were sent an invitation via email prior to the official launch of ParticipACTION to complete an on-line survey. The survey assessed their organization's capacity to adopt, implement and externally promote a new physical activity campaign within their organizational mandates. Descriptive statistics were employed to address the first two study objectives. A series of one-way analysis of variance were conducted to examine the third objective. The response rate was 29.7% (268/902). The majority of responding organizations had over 40 employees and had operated for over 10 years. Education was the most common primary mandate, followed by sport and recreation. Organizations were evenly distributed between government and not-for-profits. Approximately 96% of respondents had heard of the 'original' ParticipACTION while 54.6% had heard of the 'new' ParticipACTION (Objective 1). Findings indicate good organizational capacity in Canada to promote physical activity (Objective 2) based on reported means of approximately 4.0 (on 5-point scales) for capacity to adopt, implement, and externally promote new physical activity campaigns. Capacity to adopt new physical activity campaigns differed by organizational sector and mandate, and capacity to implement differed by organizational mandate (Objective 3). At baseline, and without specific details of the campaign, respondents believe they have good capacity to work with ParticipACTION. ParticipACTION may do well to capitalize on the existing strong organizational capacity components of leadership, infrastructure and 'will' of national organizations to facilitate the success of its future campaigns

Non-response bias in physical activity trend estimates

© 2009 Craig et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

How many steps/day are enough? for adults

Physical activity guidelines from around the world are typically expressed in terms of frequency, duration, and intensity parameters. Objective monitoring using pedometers and accelerometers offers a new opportunity to measure and communicate physical activity in terms of steps/day. Various step-based versions or translations of physical activity guidelines are emerging, reflecting public interest in such guidance. However, there appears to be a wide discrepancy in the exact values that are being communicated. It makes sense that step-based recommendations should be harmonious with existing evidence-based public health guidelines that recognize that "some physical activity is better than none" while maintaining a focus on time spent in moderate-to-vigorous physical activity (MVPA). Thus, the purpose of this review was to update our existing knowledge of "How many steps/day are enough?", and to inform step-based recommendations consistent with current physical activity guidelines. Normative data indicate that healthy adults typically take between 4,000 and 18,000 steps/day, and that 10,000 steps/day is reasonable for this population, although there are notable "low active populations." Interventions demonstrate incremental increases on the order of 2,000-2,500 steps/day. The results of seven different controlled studies demonstrate that there is a strong relationship between cadence and intensity. Further, despite some inter-individual variation, 100 steps/minute represents a reasonable floor value indicative of moderate intensity walking. Multiplying this cadence by 30 minutes (i.e., typical of a daily recommendation) produces a minimum of 3,000 steps that is best used as a heuristic (i.e., guiding) value, but these steps must be taken over and above habitual activity levels to be a true expression of free-living steps/day that also includes recommendations for minimal amounts of time in MVPA. Computed steps/day translations of time in MVPA that also include estimates of habitual activity levels equate to 7,100 to 11,000 steps/day. A direct estimate of minimal amounts of MVPA accumulated in the course of objectively monitored free-living behaviour is 7,000-8,000 steps/day. A scale that spans a wide range of incremental increases in steps/day and is congruent with public health recognition that "some physical activity is better than none," yet still incorporates step-based translations of recommended amounts of time in MVPA may be useful in research and practice. The full range of users (researchers to practitioners to the general public) of objective monitoring instruments that provide step-based outputs require good reference data and evidence-based recommendations to be able to design effective health messages congruent with public health physical activity guidelines, guide behaviour change, and ultimately measure, track, and interpret steps/day