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Reproductive health is a considerable concern among US female law enforcement officers (LEOs). Miscarriage and preterm birth rates are significantly higher in women firefighters than published US averages. Since law enforcement and firefighting share occupational conditions and practices, adverse birth outcomes were hypothesized to be greater in female law enforcement officers (LEOs) than the US averages. Occupational hazards may place pregnant LEOs at a higher risk for complicated pregnancies and adverse birth outcomes. This study quantified pregnancy outcomes in female LEOs using a cross-sectional survey and compared them to US averages and large prospective studies. The participants (N = 162, 72.2% aged 31–49, 85.2% Caucasian) averaged 2.5 ± 1.4 pregnancies. Stress (59.1%) and shiftwork (59.8%) were the most common reported exposures. Miscarriage and preterm birth rates were 19.1% and 16.4%, respectively. Miscarriages were significantly greater among participants compared to prospective studies [χ2 (1, N = 911,971) = 20.51, p < 0.001]. Female LEOs of childbearing age should receive education about potential reproductive health hazards and take precautions against them. Moreover, policymakers, human resources, and healthcare providers should understand how law enforcement work might affect maternal health. [ABSTRACT FROM AUTHOR]

Obesity, physical activity, and sedentary behavior in childhood are important indicators of present and future health and are associated with school-related outcomes such as academic achievement, behavior, peer relationships, and self-esteem. Using logistic regression models that controlled for gender, age, ethnicity/race, and socioeconomic status, we investigated the likelihood that youth with learning disabilities (LD) and attention-deficit/hyperactivity disorder (ADHD) are obese, physically active, and sedentary using a nationally representative sample of 45,897 youth in the United States from 10 to 17 years of age. Results indicated that youth with comorbid LD/ADHD were significantly more likely than peers without LD or ADHD to be obese; that youth with LD only, ADHD only, and comorbid LD/ADHD were significantly less likely to meet recommended levels of physical activity; and that youth with LD only were significantly more likely to exceed recommended levels of sedentary behavior. Medication status mediated outcomes for youth with ADHD. We offer school-based recommendations for improving health-related outcomes for students with LD and ADHD. [ABSTRACT FROM AUTHOR]

PURPOSE: Improving and sustaining high fitness is important for United States (US) military personnel. Current Army Physical Readiness Training (APRT) has been criticized for subpar fitness preparation; concurrently significant grass roots participation in high intensity functional training (HIFT) programs has occurred. Neither has been tested in a randomized clinical trial (RCT) among military personnel, which was the purpose of this study. METHODS: Data are from protocol adherent participants (N = 59) of a 5-year cluster-RCT among active duty US military personnel. Participants were randomized in small groups to 6- months of training in APRT (n = 26; 38.5% women, 85% Officers, age 33.3 ± 5.3 yrs) or HIFT (n = 33; 21.2% women, 73% Officers, age 34.2 ± 6.6 yrs) 5 days/wk for approximately 60 minute sessions. APRT used the reset phase and the HIFT program was also ramped to increase in exercise complexity and intensity over time. At baseline and 6-months, participants completed fitness tests including the Army Physical Fitness Test (i.e., 2 min of push-ups, 2 min of sit-ups, 2 mile run), 1 rep max (1RM) deadlift, max reps pull-ups, horizontal jump, and timed dummy drag (165-lb). Within-groups analyses were conducted by sex using a single group t-test comparing change scores to no effect. A mixed effect model was conducted for between-group fitness changes. RESULTS: Within-group changes were statistically significant in APRT men for pull-ups (1.9 ± 2.4 reps; t = 2.99, p = .01), 1RM deadlift (23.3 ± 19.9 lbs; t = 4.55, p < .001), and dummy drag (-1.3 ± 2.0 sec, t = -2.6, p = .02); APRT women for sit-ups (7.4 ± 9.8 reps; t = 2.83, p = .04); HIFT men for pull-ups (2.1 ± 1.8 reps; t = 5.85, p < .001), 1RM deadlift (27.2 ± 32.6 lbs; t = 4.17, p < .001), dummy drag (-1.0 ± 2.0 sec; t = -2.49, p = .02), and horizontal jump (13.0 ± 12.1 cm; t = 5.38, p = .001); and HIFT women for 1RM deadlift (20.7 ± 13.7 lbs; t = 4.01, p = .007). No significant between-group differences were found (all p > .05). CONCLUSIONS: Results indicate both exercise programs increased fitness (i.e., upper body muscular endurance, abdominal endurance, and lower body strength and power). Men had more fitness gains, with no differences by treatment group. Despite unique participant challenges of time-consuming War College academics, a concurrent focus on exercise training produced fitness benefits. [ABSTRACT FROM AUTHOR]

Objectives: To compare restaurant marketing by restaurant and neighborhood type. Methods: All restaurants (61=fast food, FF; 72=table service, TS) within an 800-meter radius of 13 public housing developments (HD) and 4 comparison neighborhoods were audited using the Restaurant Assessment Tool©2010. HD neighborhoods were lower income and higher minority than comparison neighborhoods with similar density and street connectivity. Results: Restaurants in HD neighborhoods had fewer healthy en­trées than comparison neighborhoods. FF restaurants had cheaper beverages and more children's meals, supersize drinks, free prize with purchase, super­size items, special characters, and more items geared to driving than TS restaurants. Conclusions: Residents of lower socioeconomic neighborhoods may be differentially exposed to unhealthy food options. [ABSTRACT FROM AUTHOR]

Appropriate and effective physical fitness training is imperative for soldier survival and mission success. The purpose of this study was to determine the effects of Mission Essential Fitness (MEF) circuit-style training program compared to standard Army Physical Readiness Training (APRT) on fitness, physiological, and body composition changes. Active duty Army personnel were randomly assigned to two groups (MEF = 34 or APRT = 33) for 8 weeks of training (15 sessions each). The MEF program included functional movements focused on strength, power, speed, and agility. Fifteen exercises were performed continuously for 60 to 90 seconds for 45 minutes. Baseline and post-test measures included the Army physical fitness test, physiological indicators, body composition, and additional fitness indicators. One-way analysis of covariance models indicated that MEF participants significantly increased their push-ups (p = 0.033), bench press (p = 0.001), and flexibility (p = 0.003) and significantly decreased their 2-mile run (p = 0.003) and step test heart rate (p = 0.004) compared to participants doing APRT. Both groups maintained body composition (p > 0.05) and reported no injuries. The MEF training program safely improved muscular strength and endurance, cardiovascular endurance, and flexibility, supporting functional fitness circuit-style exercise training for military personnel. [ABSTRACT FROM AUTHOR]

Abstract: Background: Public housing facilities play an important role in housing individuals with physical disabilities, including older adults, who are unable to afford private housing. This study assessed general features of physical access in the common use areas of 14 federally subsidized, urban public housing facilities. Methods: Fourteen public housing facilities were assessed by trained field assessors for 6 features of accessibility. Results: Most housing facilities had at least 1 parking space designated with a vertical sign (86%), an entrance that was level or had a ramp (86%), and a 32-inch wide exterior door (71%). Half (50%) had a public restroom designated by signage as accessible, and most of these bathrooms had 32-inch-wide doorways and at least 1 grab bar near the toilet (86%). Most housing managers were able to identify building modifications that had been made to satisfy accessibility regulations. Conclusion: The results suggest that relatively large proportions (14%-29%) of federally funded housing facilities are not complying with federal regulations. Better education and compliance are needed to ensure access for all in public housing facilities. [Copyright &y& Elsevier]

Objective: To examine occupational injuries among career women firefighters (FFs). Methods: A national cross-sectional survey assessed injury prevalence, types, frequencies, and predictors. Results: A total of 3012 women career FFs were enrolled in the study. Almost a third (31.7%) reported at least one occupational injury in the past 12 months. The most common injuries were dislocations, sprains, or strains (59.3%). Racial minority status, self-rated health, body composition, exercise habits, substance use, mental health, and job dissatisfaction were all significant injury correlates. Nearly 43% of injuries resulted in missed workdays. Additionally, 25% reported incurring chronic injuries. Conclusions: Women FFs reported a high prevalence of occupational injury and a significant percentage reported chronic injuries. These data can inform initiatives to curtail injuries in the fire service and better protect women FFs. [ABSTRACT FROM AUTHOR]

Purpose: To assess predictors of stated support for policies promoting physically active transportation.Design: Cross-sectional.Setting: US counties selected on county-level physical activity and obesity health status.Participants: Participants completing random-digit dialed telephone survey (n = 906).Measures: Survey measures assessed stated support for 5 policies to promote physically active transportation, access to active transportation facilities, and time spent in a car. County-level estimates included household car dependence and funding for bicycle-pedestrian projects.Analysis: Multivariable generalized linear mixed models using binary distribution and logit link, accounting for clustering within county.Results: Respondents supported policies for accommodating bicyclists and pedestrians through street improvements (89%), school active transportation programs (75%), employer-funded active commuting incentives (67%), and allocation of public funding (68%) and tax support (56%) for building and maintaining public transit. Residents spending >2 h/d (vs <0.7 hours) in cars were more likely to support street (odds ratio [OR]: 1.87; confidence interval [CI]: 1.09-3.22) and public transit (OR: 1.85; CI: 1.24-2.77) improvements. Residents in counties investing >$1.6 million in bicycle and pedestrian improvements expressed greater support for funding (OR: 1.71; CI: 1.04-2.83) and tax increases (OR: 1.73; CI: 1.08-2.75) for transit improvements compared to those with lower prior investments (<$276 100).Conclusion: Support for policies to enable active transportation is higher where relevant investments in active transportation infrastructure are large (>$1.6 M), public transit is nearby, and respondents drive >2 h/d. [ABSTRACT FROM AUTHOR]

Purpose. This study examined municipal officials' participation in built environment policy initiatives focused on land use design, transportation, and parks and recreation. Design. Web-based cross-sectional survey. Setting. Eighty-three municipalities zuith 50,000 or more residents in eight states. Subjects. Four hundred fifty-three elected and appointed municipal officials. Measures. Outcomes included self-reported participation in land use design, transportation, and parks and recreation policy to increase physical activity. Independent variables included respondent position; perceptions of importance, barriers, and beliefs regarding physical activity and community design and layout; and physical activity partnership participation. Analysis. Multivariable, logistic regression models. Results. Compared to other positions, public health officials had lower participation in land use design (78.3% vs. 29.0%), transportation (78.1% vs. 42.1%), and parks and recreation (67.1% vs. 26.3%) policy. Perceived limited staff was negatively associated with participation in each policy initiative. Perceptions of the extent to which physical activity was considered in community design and physical activity partnership participation were positively associated with participation in each. Perceived lack of collaboration was associated with less land use design and transportation policy participation, and awareness that community design affects physical activity was associated with more participation. Perceived lack of political will was associated with less parks and recreation policy participation. Conclusion. Public health officials are underrepresented in built environment policy initiatives. Improving collaborations may improve municipal officials' policy participation. [ABSTRACT FROM AUTHOR]

Research has suggested that men in relationships are more physically active than men who are single. This study provides a weighted analysis of physical activity by coupling status for men of different sexual orientations. Aggregated data from the United States 2013-2014 National Health Interview Survey were used to conduct multivariate logistic regression analyses. Compared to straight men ( n = 29,926), gay men ( n = 623) were less likely to be in a relationship (AOR 0.32, CI: 0.25-0.41). Coupled gay men did more physical activity than coupled straight men and were 1.62 (CI: 1.05-2.50) times more likely to be active, 1.67 (CI: 1.10-2.51) times more likely to be high active, 1.89 (CI: 1.24-2.89) times more likely to engage in muscle-strengthening activities, and 2.00 (CI: 1.28-3.11) times more likely to meet aerobic and muscle-strengthening recommendations. Coupling facilitates physical activity for men. However, more research is needed to help explore underlying mechanisms for differences by sexuality.

School-based physical education (PE) and physical activity (PA) policies can improve PA levels of students and promote health. Studies of policy implementation, communication, monitoring, enforcement, and evaluation are lacking. To describe how states implement, communicate, monitor, enforce, and evaluate key school-based PE and PA policies, researchers interviewed 24 key informants from state-level organizations in 9 states, including representatives from state departments of health and education, state boards of education, and advocacy/professional organizations. These states educate 27% of the US student population. Key informants described their organizations' roles in addressing 14 school-based PE and PA state laws and regulations identified by the Bridging the Gap research program and the National Cancer Institute's Classification of Laws Associated with School Students (C.L.A.S.S.) system. On average, states had 4 of 14 school-based PE and PA laws and regulations, and more than one-half of respondents reported different policies in practice besides the "on the books" laws. Respondents more often reported roles implementing and communicating policies compared with monitoring, enforcing, and evaluating them. Implementation and communication strategies used included training, technical assistance, and written communication of policy to local education agency administrators and teachers. State-level organizations have varying roles in addressing school-based PE and PA policies. Opportunities exist to focus state-level efforts on compliance with existing laws and regulations and evaluation of their impact.

This manuscript describes the development of the Census of Social Institutions (CSI), a reliable direct observation parcel-level built environment measure. The CSI was used to measure all non-residential parcels (n = 10,842) in 21 one-mile-radius neighborhoods centered around census block groups of varying income and ethnicity in a large metropolitan area. One year test-retest and inter-rater intra-class correlations showed high reliability for major use type and detail code observations. The CSI accurately captured the presence of about 9,500 uses, including 828 multiple major use and 431 mixed major use parcels that would have been missed in standard commercial databases. CSI data can be utilized to determine the health impacts of environmental settings.

Objective: The purpose of this study was to evaluate obesity classifications from body fat percentage (BF%), body mass index (BMI), and waist circumference (WC)., Methods: A total of 451 overweight/obese active duty military personnel completed all three assessments., Results: Most were obese (men, 81%; women, 98%) using National Institutes of Health (NIH) BF% standards (men, >25%; women, >30%). Using the higher World Health Organization (WHO) BF >35% standard, 86% of women were obese. BMI (55.5% and 51.4%) and WC (21.4% and 31.9%) obesity rates were substantially lower for men and women, respectively (p < 0.05). BMI/WC were accurate discriminators for BF% obesity (theta for all comparisons >0.75, p < 0.001). Optimal cutoff points were lower than NIH/WHO standards; WC = 100 cm and BMI = 29 maximized sensitivity and specificity for men, and WC = 79 cm and BMI = 25.5 (NIH) or WC = 83 cm and BMI = 26 (WHO) maximized sensitivity and specificity for women., Conclusions: Both WC and BMI measures had high rates of false negatives compared to BF%. However, at a population level, WC/BMI are useful obesity measures, demonstrating fair-to-high discriminatory power.