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PURPOSE: This study was conducted to provide descriptive data of accelerometer-determined ambulatory physical activity in a sample of free-living college students and to examine college students' ambulatory physical activity patterns. METHODS: All participants (245 females, age = 19.9 +/- 1.6 yr, body mass index (BMI) = 22.9 +/- 3.3 kg x m[-2],209 males, age = 20.2 +/- 2.0 yr, BMI = 25.2 +/- 4.0 kg x m[-2]) wore an accelerometer for seven consecutive days. Accumulated physical activity (ct x d[-1], ct x min[-1] x d[-1], and min x d[-1] spent at different intensities) and minutes per day spent in moderate or vigorous physical activity in sessions of at least 10 min were analyzed to describe the physical activity of the sample and examine physical activity patterns. RESULTS: The entire sample accumulated 362,750.1 +/- 112,824.1 ct x d[-1] (males = 383,787.2 +/- 112,001.3 vs females = 344,804.1 +/- 110,619.5 ct x d[-1], P < 0.01) and 46.7 +/- 18.9 min x d[-1] in moderate physical activity (males = 51.7 +/- 19.8 vs females = 42.5 +/- 17.0 min x d[-1], P < 0.01). They were more active on weekdays than weekend days (P < 0.05), and they spent 13.6 +/- 12.7 min.d (males = 13.2 +/- 12.0 vs females = 13.8 +/- 13.3, P > 0.05) in moderate or vigorous physical activity sessions of at least 10 min. CONCLUSION: Participants in this study accumulated a moderate amount of physical activity on most weekdays. Most participants, however, were not meeting the current moderate physical activity recommendation when moderate or vigorous physical activity sessions of at least 10 min were examined. [ABSTRACT FROM AUTHOR]

Context: The Healthy Diné Nation Act (HDNA) of 2014 included a 2% tax on foods of little-to-no-nutritious value ("junk foods") on the Navajo Nation. The law was the first ever in the United States and any Indigenous nation worldwide with a population at a high risk for common nutrition-related conditions. To date, research on community support for food tax legislation among Indigenous nations is entirely lacking., Objective: To assess the extent of support for the HDNA and factors associated with support including sociodemographic variables, knowledge of the HDNA, nutrition intake, and pricing preferences., Design: Cross-sectional survey., Setting: The Navajo Nation., Participants: A total of 234 Navajo Nation community members across 21 communities., Outcome Measures: The percentage of participants who were supportive of the HDNA., Results: Participants were 97% Navajo, on average middle-aged, 67% reported an income below $25 000 annually, and 69.7% were female. Half of the respondents said they "support" (37.4%) or "strongly support" (13.0%) the tax, while another 35% of people said they were neutral or somewhat supportive; 15% did not support the tax. Participants with higher income ( P = .025) and education ( P = .026) and understanding of the legislation ( P < .001 for "very well" vs "not at all") had increased odds of greater support, as did people who believed that the HDNA would make Navajo people healthier (vs not, P < .001). Age, gender, language, and reported nutrition intake (healthy or unhealthy) were not associated with HDNA support, but participants willing to pay 5% or 12%-15% higher prices for fast food and soda had increased odds of greater support ( P values range from .023 to <.001)., Conclusions: The majority of Navajo community members surveyed were moderately supportive of the Navajo Nation tax on unhealthy foods. Higher income and education and understanding of the law were associated with greater support, but nutrition intake was not., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc.)

Context: To promote the health of the Navajo people, the Navajo Nation passed the Healthy Diné Nation Act (HDNA) in 2014. The HDNA included a 2% tax on "minimal-to-no-nutritional-value" foods and waived 5% sales tax on healthy foods, the first such policy in the United States and any sovereign Tribal nation. Uniquely aligned with Tribal government structures, revenue was directly allocated to 110 small local government entities (Chapters) for self-determined wellness projects., Objective: To characterize HDNA-funded wellness projects, test for variation in project type, and funding amount over time by region and community size., Design: Longitudinal study assessing funded wellness projects from tax inception through 2019., Setting: The Navajo Nation., Participants: One hundred ten Navajo Nation Chapters receiving funding for self-determined wellness projects., Outcome Measures: The categories and specific types of wellness projects and funding over 4 years by region and community size., Results: Of revenue collected in 2015-2018, more than 99.1% was disbursed through 2019 ($4.6 million, $13 385 annually per community) across 1315 wellness projects (12 per community). The built recreational environment category received 38.6% of funds, equipment/supplies 16.5%, instruction 15.7%, food and water initiatives 14.0%, and social events 10.2%. Most common specific projects were walking trails ($648 470), exercise equipment ($585 675), food for events ($288 879), playgrounds ($287 471), and greenhouses ($275 554). Only the proportion allocated to instruction changed significantly over time (increased 2% annually, P = .02). Smaller communities (population <1000) allocated significantly higher proportions to traditional, agricultural, and intergenerational projects and less to the built environment., Conclusions: Through 2019, more than 99% of HDNA revenue was successfully disbursed to 110 rural, Tribal communities. Communities chose projects related to promoting the built recreational environment, agriculture, and fitness/nutrition education, with smaller communities emphasizing cultural and intergenerational projects. These findings can inform other indigenous nations considering similar policies and funding distributions., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc.)

Introduction: Several studies have reported that children gain more weight during the summer season. Despite high obesity rates, little research has included American Indian/Alaskan Native children, and few studies have been longitudinal. This observational study examines seasonal weight variability over 3.5 years among ethnically diverse children, including 2,184 American Indian/Alaskan Native children., Methods: Children's height and weight were measured before and after the summer from 2012-2015 and analyzed in 2019-2020, including children with ≥2 consecutive measurements (N=7,890, mean age=8.4 [SD=2.8] years). Mixed-effects models tested whether the percentage of the 95th BMI percentile and BMI differed by season (summer versus the rest of the year) and ethnicity., Results: American Indian/Alaskan Native (23.7%), Hispanic (19.8%), and Black (17.8%) children had significantly higher baseline obesity rates than White children (7.1%). The percentage of the 95th BMI percentile significantly increased during the summer compared with the percentage during the rest of the year, with the strongest effects for children who were obese (b=2.69, 95% CI=1.35, 4.03, p<0.001) or overweight (b=1.47, 95% CI=0.56, 2.35, p<0.01). In BMI units, summer BMI increase was 0.50 kg/m 2 higher (obese model) and 0.27 kg/m 2 higher (overweight) than that of the rest of the year. Seasonal effects were significantly less pronounced for American Indian/Alaskan Native children than for White children., Conclusions: Children gained significantly more weight during the summer season, with the strongest effects for children who were obese. American Indian/Alaskan Native children had less seasonal variability than White children, but higher overall obesity rates. These data underscore summer as a critical time for obesity prevention among children who are overweight/obese but suggest that seasonal patterns may vary for American Indian/Alaskan Native children., (Copyright © 2021 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Our study summarizes tax revenue and disbursements from the Navajo Nation Healthy Diné Nation Act of 2014, which included a 2% tax on foods of minimal-to-no nutritional value (junk food tax), the first in the United States and in any sovereign tribal nation. Since the tax was implemented in 2015, its gross revenue has been $7.58 million, including $1,887,323 in 2016, the first full year. Revenue decreased in absolute value by 3.2% in 2017, 1.2% in 2018, and 4.6% in 2019, a significant downward trend (P = .02). Revenue allocated for wellness projects averaged $13,171 annually for each local community, with over 99% successfully disbursed and more rural areas generating significantly less revenue. Our results provide context on expected revenue, decreases over time, and feasibility for tribal and rural communities considering similar policies.

Aedes aegypti mosquitoes are primary vectors of dengue, yellow fever, chikungunya and Zika viruses. Ae. aegypti is highly anthropophilic and relies nearly exclusively on human blood meals and habitats for reproduction. Socioeconomic factors may be associated with the spread of Ae. aegypti due to their close relationship with humans. This paper describes and summarizes the published literature on the association between socioeconomic variables and the distribution of Ae. aegypti mosquitoes in the mainland United States. A comprehensive search of PubMed/Medline, Scopus, Web of Science, and EBSCO Academic Search Complete through June 12, 2019 was used to retrieve all articles published in English on the association of socioeconomic factors and the distribution of Ae. aegypti mosquitoes. Additionally, a hand search of mosquito control association websites was conducted in an attempt to identify relevant grey literature. Articles were screened for eligibility using the process described in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Initially, 3,493 articles were identified through the database searches and previously known literature. After checking for duplicates, 2,145 articles remained. 570 additional records were identified through the grey literature search for a total of 2,715 articles. These articles were screened for eligibility using their titles and abstracts, and 2,677 articles were excluded for not meeting the eligibility criteria. Finally, the full text for each of the remaining articles (n=38) was read to determine eligibility. Through this screening process, 11 articles were identified for inclusion in this review. The findings for these 11 studies revealed inconsistent relationships between the studied socioeconomic factors and the distribution and abundance of Ae. aegypti . The findings of this review suggest a gap in the literature and understanding of the association between anthropogenic factors and the distribution of Ae. aegypti that could hinder efforts to implement effective public health prevention and control strategies should a disease outbreak occur., (© 2020 Walter de Gruyter GmbH, Berlin/Boston.)

Background . Colorado passed House Bill 11-1069 in 2011 requiring all public elementary schools to provide students with a minimum of 30 minutes of physical activity (PA) per school day (Physical Activity Expectation in Schools, 2011). The purpose of this article is to describe the results of a 3-year initiative to increase opportunities for PA and to provide recommendations for school health practitioners implementing similar programming. Intervention. In 2014, 13 school districts were funded to increase student PA during school hours and before and after school hours. Intervention activities spanned all components of the Comprehensive School Physical Activity Program framework. An evaluation was conducted to estimate the number of schools providing at least 30 minutes of PA a day. A mixed methods evaluation design was implemented that included tracking the number of minutes of PA provided before, during, and after school and semistructured interviews with school health coordinators. Results. In Year 1, an average of 48 minutes of PA were provided per day. By the end of year 3, the average minutes of PA doubled to 90 minutes per day. Teachers and staff identified professional development and administrator support as key components to incorporating more PA throughout the school day. Conclusions. Health promotion interventions in schools can increase access to PA opportunities for students. Sustainability of PA efforts in schools is dependent on funding to support professional development for teachers and staff and building administrative support for school-based PA.

Background: The purpose of this study was to evaluate an unstructured and a structured program designed to increase physical activity (PA). The unstructured program increased the amount of equipment during recess, whereas the structured program introduced activities to students., Methods: PA was observed using the System for Observing Play and Leisure Activity in Youth (SOPLAY) in two school districts in Colorado. Researchers recorded baseline and follow-up observations for sedentary activity, moderate PA, and vigorous PA, as well as for available equipment for the unstructured program. Observations from schools were aggregated for data analyses at the district level., Results: For the program increasing equipment, moderate PA and vigorous PA increased, while sedentary behavior decreased. For the structured program, moderate PA and vigorous PA did not increase, whereas sedentary behaviors increased following the program., Conclusions: Other variables are likely influencing student PA during recess, such as teachers' interaction with students or the fidelity of the program. Results indicate that funding and implementing a program aimed at increasing PA will not necessarily accomplish that goal, and additional research should be performed to determine the best practice for increasing PA., (© 2019, American School Health Association.)

Introduction: The purpose of this study is to examine the impact of a districtwide food best practices and preparation changes in elementary schools lunches, implemented as part of the LiveWell@School childhood obesity program, funded by LiveWell Colorado/Kaiser Permanente Community Health Initiative., Methods: Longitudinal study examining how school changes in best practices for food preparation impacted the types of side items offered from 2009 to 2015 in elementary school cafeterias in a high-need school district in southern Colorado. Specifically, this study examined changes in side items (fruits, vegetables, potatoes, breads, and desserts). In Phase 1 (2009-2010), baseline data were collected. During Phase 2 (2010-2011), breaded and processed foods (e.g., frozen nuggets, pre-packaged pizza) were removed and school chefs were trained on scratch cooking methods. Phase 3 (2011-2012) saw an increased use of fresh/frozen fruits and vegetables after a new commodity order. During Phase 4 (2013-2015), chef consulting and training took place. The frequency of side offerings was tracked across phases. Analyses were completed in Fall 2016. Because of limited sample sizes, data from Phases 2 to 4 (intervention phases) were combined for potatoes and desserts. Descriptive statistics were calculated. After adjusting for length of time for each phase, Pearson chi-square tests were conducted to examine changes in offerings of side items by phase., Results: Fresh fruit offerings increased and canned fruit decreased in Phases 1-4 (p=0.001). A significant difference was observed for vegetables (p=0.001), with raw and steamed vegetables increasing and canned vegetables decreasing from Phase 1 to 4. Fresh potatoes (low in sodium) increased and fried potatoes (high in sodium) decreased from Phase 1 to Phases 2-4 (p=0.001). Breads were eliminated entirely in Phase 2, and dessert changes were not significant (p=0.927)., Conclusions: This approach to promoting healthier lunch sides is a promising paradigm for improving elementary cafeteria food offerings., Supplement Information: This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is sponsored by Kaiser Permanente, Community Health., (Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Providing opportunities for students to be physically active during the school day leads to increased academic performance, better focus, and fewer behavioral problems. As schools begin to incorporate more physical activity programming into the school day, evaluators need methods to measure how much physical activity students are being offered through this programming. Because classroom-based physical activity is often offered in 3-minute to 5-minute bouts at various times of the day, depending on the teachers' time to incorporate it, it is a challenge to evaluate this activity. This article describes a method to estimate the number of physical activity minutes provided before, during, and after school. The web-based tool can be used to gather data cost-effectively from a large number of schools. Strategies to increase teacher response rates and assess intensity of activity should be explored.

Objectives: This analysis of a large-scale survey of college students from 2003 to 2007 explores relationships between meeting vigorous physical activity (VPA) recommendations and key demographic, lifestyle, and personal characteristics., Methods: Multivariate logistic regression modeling was used to analyze VPA data from the Utah Higher Education Health Behavior Survey, a descriptive cross-sectional survey conducted in 2003 (N = 4574), 2005 (N = 9673) and 2007 (N = 7938)., Results: Factors consistently associated with meeting VPA recommendations included involvement in extracurricular sports, being single, and daily consumption of fruits or vegetables. In contrast, factors such as older age (> 23 years old), having a particularly low (<18.5 kg˙m2) or high BMI (> 34.9 kg˙m2), and being a current smoker were associated with not meeting the VPA recommendation. This corroborates paradoxical findings that binge alcohol consumption correlates with meeting VPA., Conclusions: Findings support the need for targeted interventions among college students to support the establishment of long-term protective behavioral patterns against chronic disease risk throughout the life course.

The purpose of this study was to examine the intensity levels of PA opportunities offered in public school classrooms. Schools (N = 101) in school districts (N = 25) reported PA opportunities offered in classrooms using an online data collection tool over a two-year period (2014-2016). Using a randomized sampling technique, 20-30% of teachers in each school were selected each week to report PA in their classroom. These responses resulted in N = 18,210 usable responses. A researcher determined the intensity of PA opportunities using the 2011 Compendium of Physical Activities as a guideline; two additional researchers confirmed the coded categories. A descriptive analysis of PA opportunities was conducted to describe the proportion of opportunities whose intensity levels were light (LPA), moderate (MPA), vigorous (VPA), sedentary (SED), and those of unknown intensity. Chi-square analyses were utilized to examine differences between proportions of intensity levels offered by semester. Kruskal-Wallace tests were utilized to examine differences in proportion of physical activity opportunity intensity offered by grade level. Most PA opportunities were MPA (58.7%), followed by VPA (17.6%) and LPA (11.5%). Few responses were SED (0.5%), and 11.6% were of indeterminate intensity. A greater proportion of more physically intense activities reported during the fall versus spring semesters (p < 0.0001). Differences in the intensity levels of PA offered by grade also differed, with a trend of decreasing intensity as grade level increased (p < 0.0001). This study provides insight into the PA actually occurring in classrooms; a previously underexplored construct of school-based PA.

Active transportation (AT) may represent an ideal opportunity to accumulate physical activity (PA). Thus, the purpose of this study was to describe the AT profile among students from two Colorado school districts. Students completed a survey on AT resulting in a final dataset (n = 3738) from which descriptive and inferential statics were calculated. Respondents were 11.32 ± 2.82 years of age (Boys = 48.27 %; Girls = 51.73 %). Most students (87.29 %) traveled to or from school via automobile, while 11.17 % walked and 1.53 % biked. Boys rode bicycles to school significantly more (p < 0.0001) than girls, and when walking, accumulated significantly more time (p = 0.02) than females. When examining by grade level significant differences were found for days/week walking (p = 0.0002) to school and biking (p < 0.001) to school. High school students accumulated significantly (p < 0.0001) more time walking to school than middle or elementary school students. Similarly, high school students spent more time biking (p < 0.0001) to school than middle school and elementary school respondents. These findings indicate that travel to school by automobile is still the dominant mode of travel for most public school students. Further, males were generally more likely to obtain extra time in AT. Moreover, older students were more likely to engage in AT, and to spend more time during their AT.

The purpose of the study was to conduct an evaluation of an unstructured afterschool physical activity (PA) programme (Keep it Moving!; KIM) in an ethnically diverse and low socio-economic status (SES) school district. PA of students in 3rd-5th grades (N = 205) at four elementary schools were assessed during spring 2012. An ActiGraph accelerometer was utilised to examine objectively measured time and steps in differing intensity levels. Standard data reduction procedures were used to process collected data and characterise PA. Students averaged approximately 54 min of accelerometer wear-time during the KIM programme, 10.4 ± 6.1 min (19.2%) of which were spent in sedentary behaviour, 28.2 ± 8.3 min (52.1%) in light PA and 15.6 ± 6.6 min (28.7%) in moderate-to-vigorous intensity PA. Within the cadence band of 1-19 steps/min participants accumulated the highest time-derived PA (16.4 ± 6.3 min). In total, children averaged 1811.9 ± 527.5 steps during the entire KIM programme. Results from the programme indicated that elementary-aged students received additional PA through the KIM programme. The mean value of accumulated steps during the afterschool PA programme represented 12-16.5% of the minimum steps/day target (depending upon gender) identified for elementary-aged school children. These data represent unique findings from a high-need population that may be helpful for researchers and practitioners alike.

Purpose: To evaluate the impact of a health-promoting price intervention on food sales and profit., Design: Nonrandomized evaluation study., Setting: Two hospital cafeterias., Participants: Hospital employees (2800) were the priority population., Intervention: During baseline phase, healthy versions of existing unhealthy items were introduced. The intervention phase included marketing and price incentives/disincentives for healthy and unhealthy items, with a 35% price differential., Measures: Average and proportional change in sales and impact on financial outcomes were assessed., Analysis: Two-way factorial analyses of variance and two-proportion Z-score tests were run to assess change in sales. Independent samples t tests were used to test for changes in profit., Results: Significant impact was demonstrated on all burger sales in the desired direction during intervention (P < .001). Most notably, the average weekly turkey burger sales at Penrose Hospital (PH) increased 13-fold (10.85-145.59) and became the majority of the market share (51.8%, P < .001). For salads, significant interaction between phase and food type was found at St. Francis Medical Center (SFMC) (P = .002) but not at PH (P = .304). Healthy PH salads were popular at baseline and intervention, comprising the majority of the market share throughout the entire study (68.4%-70.2%, respectively, P = .238). Cafeteria gross sales and burger profit (P < .001) increased at both cafeterias., Conclusion: Incentivizing consumers through price interventions changed hospital cafeteria food sales in the desired direction while improving the bottom line., (© The Author(s) 2016.)

Background: Afterschool programs are promising arenas to improve youth physical activity (PA) levels. During the school year for 2012-2013, 5 elementary schools from a low-socioeconomic status (SES) school district in southern Colorado participated in evaluation of the afterschool program entitled Keep It Moving! (KIM)., Methods: In this cross-sectional analysis we sought to evaluate the relationships among participant PA, teacher interaction, and lesson context during an unstructured afterschool PA program. Participants were third-fifth grade students enrolled in the KIM program at the 5 participating elementary schools and were assessed utilizing accelerometers and direct observation with the System for Observing Fitness Instruction Time (SOFIT)., Results: Program participants wore the accelerometer 37.1 ± 5.4 min session(-1). Approximately half of the time was spent in light PA (LPA) and 15.7 ± 5.3 min session(-1) in moderate to vigorous PA (MVPA). Game play was positively associated with LPA and negatively associated with MVPA. When teachers did not promote PA with students there was a positive association with sedentary activity (SA) and a negative association with MVPA., Conclusions: Lesson context and teacher interactions may be important factors associated with PA intensity of afterschool PA programming. Future research should address whether structured PA curricula may improve quality of afterschool PA programming., (© 2015, American School Health Association.)

The Better Bites program, a hospital cafeteria nutrition intervention strategy, was developed by combining evidence-based practices with hospital-specific formative research, including key informant interviews, the Nutrition Environment Measures Study in Restaurants, hospital employee surveys, and nutrition services staff surveys. The primary program components are pricing manipulation and marketing to promote delicious, affordable, and healthy foods to hospital employees and other cafeteria patrons. The pricing manipulation component includes decreasing the price of the healthy items and increasing the price of the unhealthy items using a 35% price differential. Point-of-purchase marketing highlights taste, cost, and health benefits of the healthy items. The program aims to increase purchases of healthy foods and decrease purchases of unhealthy foods, while maintaining revenue neutrality. This article addresses the formative research, planning, and development that informed the Better Bites program.

Background: After-school programs may provide valuable opportunities for children to accumulate healthful physical activity (PA). This study assessed the PA of third-, fourth-, and fifth-grade children in the Keep It Moving! (KIM) after-school PA program, which was implemented in an ethnically diverse and low socioeconomic status school district in Colorado Springs, Colorado., Methods: The PA of KIM participating children (N = 116) at 4 elementary schools was objectively assessed using ActiGraph accelerometers and the System for Observing Fitness Instruction Time (SOFIT). Linear mixed-effects models or generalized linear mixed-effects models were used to compare time spent in sedentary (SED) behaviors, light PA (LPA), moderate PA (MPA), vigorous PA (VPA), and moderate-to-vigorous PA (MVPA) between genders and weight status classifications during KIM sessions., Results: Children accumulated 7.6 minutes of SED time, 26.9 minutes of LPA, and 22.2 minutes of MVPA during KIM sessions. Boys accumulated less SED time (p < .05) and LPA (p = .04) than girls, but accumulated more MPA (p = .04), VPA (p = .03), and MVPA (p = .03). Overweight/obese children accumulated more LPA (p = .04) and less VPA (p < .05) than nonoverweight children. SOFIT data indicated that children spent a considerable proportion of KIM sessions being very active (12.4%), walking (36.0%), or standing (40.3%)., Conclusion: The KIM program provides opportunities for disadvantaged children to accumulate substantial amounts of MVPA (>20 minutes per session) in an effort to meet current PA guidelines., (© 2013, American School Health Association.)

The purpose of this study was to examine the levels and correlates of physical activity among a sample of overweight postpartum adolescents. Postpartum adolescents were recruited from a university-based teen mother program and local school districts. Adolescents (N = 21) aged 16 to 19 years, with a child between 6 and 12 months of age, volunteered. Participants wore a pedometer and reported their physical activity for seven consecutive days. Descriptive statistics and relationships between steps/day and self-reported physical activity, demographic, and psychosocial characteristics were calculated. Results indicated that participants were insufficiently active. Self-reported walking and pre-pregnancy BMI were moderately associated with steps/day. The findings of this preliminary study suggest that these postpartum adolescents were insufficiently active to attain substantial health benefits from physical activity. Postpartum adolescents represent an understudied population that may need to be a priority population for physical activity interventions.

Background: The purpose of this study was to compare steps·d-1 between an accelerometer and pedometer in 2 free-living samples., Methods: Data from 2 separate studies were used for this secondary analysis (Sample 1: N = 99, Male: n = 28, 20.9 ± 1.4 yrs, BMI = 27.2 ± 5.0 kg·m-2, Female: n = 71, 20.9 ± 1.7 yrs, BMI = 22.7 ± 3.0 kg·m-2; Sample 2: N = 74, Male: n = 27, 38.0 ± 9.5 yrs, BMI = 25.7 ± 4.5 kg·m-2, Female: n = 47, 38.7 ± 10.1 yrs, BMI = 24.6 ± 4.0 kg·m-2). Both studies used identical procedures and analytical strategies., Results: The mean difference in steps·d-1 for the week was 1643.4 steps·d-1 in Study 1 and 2199.4 steps·d-1 in Study 2. There were strong correlations between accelerometer- and pedometer-determined steps·d-1 in Study 1 (r = .85, P < .01) and Study 2 (r = 0.87, P < .01). Bland-Altman plots indicated agreement without bias between steps recorded from the devices in Study 1 (r = -0.14, P < .17) and Study 2 (r = -0.09, P < .40). Correlations examining the difference between accelerometer-pedometer steps·d-1 and MVPA resulted in small, inverse correlations (range: r = -0.03 to -0.28)., Conclusions: These results indicate agreement between accelerometer- and pedometer-determined steps·d-1; however, measurement bias may still exist because of known sensitivity thresholds between devices.

Background: This study evaluated the effect of elimination and nonelimination games on objectively measured physical activity and psychosocial responses in children., Methods: A total of 29 children in grades 4 to 6 (65.5% male; 10.5 +/- 1.0 years old) wore an accelerometer while participating in 2 elimination and 2 nonelimination games. Activity counts were collected using a 30-second epoch and converted to METs to determine minutes spent in sedentary behavior and light, moderate, vigorous, and moderate-to-vigorous physical activity. Self-efficacy, enjoyment, and peer-victimization were assessed on 4 occasions (before and after 2 elimination and 2 nonelimination games)., Results: Overall, girls spent more time in sedentary behavior compared with boys. Children engaged in significantly more moderate-to-vigorous physical activity during nonelimination games compared with elimination games. Furthermore, children significantly increased self-efficacy after playing both game sessions. A significant interaction between type of game and time of measurement in the prediction of enjoyment showed that enjoyment modestly increased after elimination games and slightly decreased after nonelimination games. There were no differences in peer-victimization., Conclusion: This study provides preliminary evidence that nonelimination games provide more moderate-to-vigorous physical activity compared with elimination games, but elimination games may be more enjoyable.

Background: We synthesized the results of 7 National Park Service pilot interventions designed to increase awareness of the health benefits from participation in recreation at national parks and to increase physical activity by park visitors., Methods: A content analysis was conducted of the final evaluation reports of the 7 participating parks. Pooled data were also analyzed from a standardized trail-intercept survey administered in 3 parks., Results: The theme of new and diverse partnerships was the most common benefit reported across the 7 sites. The 2 parks that focused on youth showed evidence of an increase in awareness of the benefits of physical activity. Many of the other sites found high levels of awareness at baseline (approaching 90%), suggesting little room for improvement. Five of the 7 projects showed evidence of an increase in physical activity that was associated with the intervention activities. Multivariate analyses suggested that the media exposure contributed to a small but significant increase in awareness of the importance of physical activity (6%) and number of active visits (7%)., Conclusions: Enhancements and replication of these programs represents a promising opportunity for improving partnerships between public health and recreation to increase physical activity.

Background: Girl Scouting may offer a viable channel for health promotion and obesity prevention programs. This study evaluated the effectiveness of an intervention program delivered through Girl Scout Junior troops that was designed to foster healthful troop meeting environments and increase obesity prevention behaviors at home., Methods: Seven Girl Scout troops were randomized to intervention (n = 3, with 34 girls) or standard-care control (n = 4, with 42 girls) conditions. Girls ranged in age from 9 to 13 years (mean 10.5 years). Intervention troop leaders were trained to implement policies promoting physical activity (PA) and healthful eating opportunities at troop meetings, and to implement a curriculum promoting obesity-prevention behaviors at home. The primary outcome variable was child body mass index (BMI) z-score. Secondary outcomes included accelerometer-assessed PA levels in troop meetings, direct observations of snack offerings, time spent in physically active meeting content, and leader encouragement of PA and healthful eating., Results: The intervention was delivered with good fidelity, and intervention troops provided greater opportunities for healthful eating and PA (x2 = 210.8, p < .001), relative to control troops. In troop meetings, intervention troop leaders promoted PA (x2 = 23.46, p < .001) and healthful eating (x2 = 18.14, p < .001) more frequently, and discouraged healthful eating and PA less frequently (x2 = 9.63, p = .002) compared to control troop leaders. Most effects of the intervention on individual-level variables of girls and parents were not significantly different from the control condition, including the primary outcome of child BMI z-score (F1, 5 = 0.42, p = .544), parent BMI (F1, 5 = 1.58, p = .264), and related behavioral variables. The notable exception was for objectively assessed troop PA, wherein girls in intervention troops accumulated significantly less sedentary (x2 = 6.3, p = .011), significantly more moderate (x2 = 8.2, p = .004), and more moderate-to-vigorous physical activity, (x2 = 18.4, p < .001), than girls in control troops., Conclusions: Implementing a health promotion curriculum and supporting policies to provide more healthful environments in Girl Scout troop meetings appears feasible on a broader scale. Additional work is needed to bridge health promotion from such settings to other environments if lasting individual-level behavior change and obesity prevention remain targeted outcomes., Trial Registration Number: NCT00949637.

Background: The purpose of this study was to examine whether college students meeting the vigorous physical activity (VPA) recommendation reported less frequent symptoms of depression than those not meeting the recommendation., Methods: A secondary analysis of the Utah Higher Education Health Behavior Survey was conducted. Descriptive statistics and unconditional logistic regressions were calculated., Results: The final sample included 8621 participants (age = 21.34 +/- 2.6 years). There was a difference in the frequency of depressive symptoms and VPA. Those not meeting the VPA recommendation reported having more frequent depressive symptoms than those meeting the VPA recommendation. Results were consistent by gender., Conclusion: In this sample, our data suggest VPA may be associated with a reduction in depressive symptoms. These findings might be indicative of a dose-response relationship between VPA and symptoms of depression in college students.

Background: Work sites offer a productive setting for physical activity (PA) promoting interventions. Still, PA participation remains low. Thus, the purpose of this study was to examine the reasoning behind commonly reported barriers and enabling factors to participation in PA programs in a work-site setting., Methods: Employees from a large city government were recruited to participate in focus groups, stratified by white- and blue-collar occupations. Responses from open-ended questions about factors influencing participation in PA programs were audio recorded and transcribed verbatim. Resulting data were analyzed with open and axial coding., Results: The sample consisted of 60 employees composing 9 focus groups. Although time was the most common barrier between both groups, white-collars workers responded that scheduling and work conflicts were the most common barrier concerning time. Blue-collar workers indicated shift work as their most common barrier. In addition, health was a significant enabling factor for both occupational categories. White-collar workers were much more concerned with appearances and were more highly motivated by weight loss and the hopefulness of quick results than were blue-collar workers., Conclusions: These findings are important in the understanding of PA as it relates to the reasoning behind participation in work-site programs in regard to occupational status.

This study evaluated a competition-based employer-sponsored physical activity program using pedometers. City employees (N approximately 2,600) formed teams in groups of 10 persons (N = 640). The groups competed against each other over a 12-wk. period with the goal of attaining 10,000 steps per day, per person. Only teams with complete data were included in the formal evaluation. A repeated-measures analysis of variance indicated significant differences in team steps by week of the program, with post hoc comparisons indicating significant differences from baseline step counts evident during Weeks 6-8 but not at the end of the program. These data confirm that competition-based physical activity programs using pedometers may not be an effective means of increasing the long-term physical activity of employees.

The purpose of this study was to examine whether young adults changed their physical activity (PA) behavior when wearing motion sensors. PA patterns of 119 young adults (M age = 20.82 years, SD = 1.50, M body mass index = 23.93 kg/m2, SD = 4.05) were assessed during 2 consecutive weeks. In Week 1, participants wore an accelerometer. During Week 2, participants wore an accelerometer and a pedometer Counts/day from the accelerometer were examined over the entire study period. Steps/day from the pedometer were examined during Week 2. Descriptive statistics and two-factor repeated-measures analysis of variance were calculated. There were significant differences in counts/day by study day during both weeks of the study (Week 1, p < .0001; Week 2, p < .0001), and steps/day during Week 2 (p < .0001). However, reactivity was not evident. Subsequent investigation by day of the week revealed these differences were due to changes in participants' PA behavior by weekdays and weekends. With respect to gender, men were more active than women during both weeks of monitoring, but daily PA behavior between the genders followed a similar pattern. In conclusion, reactivity to accelerometers and pedometers was not evident in this sample.

Public health has historically been concerned with eliminating factors associated with disease, disability, and early mortality, whereas leisure studies has emerged from the need to create and manage recreational opportunities and promote leisure activities and experiences. Coincidently, both fields have progressed toward an appreciation of the role of active leisure in enhancing a population's health and well-being. Factors associated with making choices to be physically active in leisure time are complex and multidimensional. This paper provides historical perspectives from public health and leisure studies (i.e., parks and recreation), describes models used to understand physically active leisure from both fields, and suggests direction for future collaborative research between public health and parks, recreation, and leisure researchers.