Adolescent girls' exposure to physical activity-promoting environments.

OBJECTIVES: To examine self-reported exposure to a physical activity (PA) promoting intervention and changes to school environmental PA factors. METHODS: Randomly selected 8(th) grade girls in year 2 (N = 3469) and year 3 (N = 3462) completed surveys on exposure to the health education, PE components, PA programming, and PA supporting messages. Girls' perceptions of their school-environment and an assessment of school environmental factors by principals in support of PA also were measured. Analysis included generalized linear mixed models with random effects for site and school comparing intervention and control schools. RESULTS: Year 2 intervention girls reported greater exposure to all 4 components of the intervention compared to control school girls. In year 3, differences by treatment disappeared in all but 2 components. CONCLUSIONS: Intervention girls were exposed to TAAG in year 2 with effects diminishing in year 3.

Adoption and implementation of physical activity and dietary counseling by community health center providers and nurses.

BACKGROUND: Primary care providers are expected to provide lifestyle counseling, yet many barriers exist. Few studies report on adoption and implementation in routine practice. This study reports training, adoption, and implementation of an intervention to promote physical activity (PA) and dietary counseling in community health centers. METHODS: Providers (n = 30) and nurses (n = 28) from 9 clinics were invited to participate. Adopters completed CD-ROM training in stage-matched, patient-centered counseling and goal setting. Encounters were audio recorded. A subsample was coded for fidelity. RESULTS: Fifty-seven percent of providers and nurses adopted the program. Provider counseling was seen in 66% and nurse goal setting in 58% of participant (N = 266) encounters, although audio recordings were lower. Duration of provider counseling and nurse goal setting was 4.9 ± 4.5 and 7.3 ± 3.8 minutes, respectively. Most PA (80%) and diet (94%) goals were stage-appropriate. Although most providers discussed at least 1 behavioral topic, some topics (eg, self-efficacy, social support) were rarely covered. CONCLUSIONS: A sizeable percentage of providers and nurses completed training, rated it favorably, and delivered lifestyle counseling, although with variable fidelity. With low implementation cost and limited office time required, this model has the potential to be disseminated to improve counseling rates in primary care.

Black, Hispanic, and white girls' perceptions of environmental and social support and enjoyment of physical activity.

BACKGROUND: This study examines the differences among black, Hispanic, and white adolescent girls in their perceptions surrounding physical activity (PA), including support within the school climate, friend and family social support, and personal enjoyment. METHODS: Participants included 1466 sixth-grade girls from 36 middle schools across the United States. Participants were 20% black, 21% Hispanic, 47% white, and 12% of other or mixed races. Multivariate analyses were performed on each scale, adjusting for body mass index and free and reduced-price lunch status. RESULTS: Results showed racial differences on several variables. Black girls, compared with white girls, perceived significantly lower PA enjoyment (p<.001) and teacher support for PA (p=.004). Hispanic girls experienced less PA enjoyment (p=.003) and perceived less support for PA from boys (p=.001) and their families (p=.008) than white girls. Black girls reported significantly higher levels of physical education (PE) enjoyment than did white girls (p=.003). CONCLUSIONS: Differences in perceived PA support and enjoyment across race raise questions about why these differences exist and how best to address disparities within interventions.

Policies and opportunities for physical activity in middle school environments.

BACKGROUND: This study examined physical activity opportunities and barriers at 36 geographically diverse middle schools participating in the Trial of Activity for Adolescent Girls. METHODS: Principals, physical education and health education department heads, and program leaders were interviewed to assess policies and instructional practices that support physical activity. RESULTS: Schools provided approximately 110 hours per year in physical education instruction. Approximately 20% of students walked or bicycled to school. Eighty-three percent of schools offered interscholastic sports and 69% offered intramural sports. Most schools offered programs for girls, but on average, only 24 girls ( approximately 5%) in the schools attended any programs. Only 25% of schools allowed after school free play. An overall score created to assess school environmental support for physical activity indicated that, on average, schools met 6.7 items of 10 items. Free/reduced lunch program participation versus not (p = .04), perceived priority of physical education instruction over coaching (p = .02), and safety for walking/bicycling to school (p = .02) predicted environmental support score. CONCLUSIONS: Schools have policies and practices that support physical activity, although unfavorable practices exist. Schools must work with community partners and officials to provide environments that optimally support physical activity, especially schools that serve low-income students.

Reliability of pedometer-determined free-living physical activity data in college women.

This study examined stability and reliability of free-living physical activity assessed by pedometer in 69 young female college students (M age = 18.7 years, SD = 1.2, range: 18-25 years; body mass index = 23.2 kg/m2, SD = 0.6) for two complete weeks (Week 1 and Week 2) separated by 12 weeks. During Week 1, participants took an average of 8880 steps/day, SD = 3219, range: 1858-19480; during Week 2 9088 steps/day, SD = 3299, range 1736-16837; t (68) = -.568, p = .572. In both weeks, only Sunday differed significantly (repeated measures analysis of variance; Week 1: p < .0001; Week 2: p < .01) from all other days of the week. The computed intraclass correlation between weeks was moderate (.72). Group mean pedometer-determined physical activity was stable across 2 weeks separated by 12 weeks in this young, healthy sample of women. Individuals within these groups held their rank order to a moderate extent over time. These findings provide important evidence of the reliability of pedometer-determined physical activity data and are of practical importance to study design.

Physical activity correlates in adolescent girls who differ by weight status.

OBJECTIVE: This study compared correlates of physical activity (PA) among African-American and white girls of different weight groups to guide future interventions. RESEARCH METHODS AND PROCEDURES: Participants were 1015 girls (mean age, 14.6 years; 45% African-American) from 12 high schools in South Carolina who served as control subjects for a school-based intervention. Post-intervention measures obtained at the end of ninth grade were used. PA was measured using the Three-Day PA Recall, and a questionnaire measured social-cognitive and environmental variables thought to mediate PA. Height and weight were measured, and BMI was calculated. Girls were stratified by race and categorized into three groups, based on BMI percentiles for girls from CDC growth charts: normal (BMI < 85th percentile), at risk (BMI, 85th to 94th percentile), and overweight (BMI > or = 95th percentile). Girls were further divided into active and low-active groups, based on a vigorous PA standard (average of one or more 30-minute blocks per day per 3-day period). Mixed-model ANOVA was used to compare factors among groups, treating school as a random effect RESULTS: None of the social-cognitive or environmental variables differed by weight status for African-American or white girls. Perceived behavioral control and sports team participation were significantly higher in girls who were more active, regardless of weight or race group. In general, social-cognitive variables seem to be more related to activity in white girls, whereas environmental factors seem more related to activity in African-American girls. DISCUSSION: PA interventions should be tailored to the unique needs of girls based on PA levels and race, rather than on weight status alone.

Examining the link between program implementation and behavior outcomes in the lifestyle education for activity program (LEAP).

Lifestyle Education for Activity Program (LEAP) was a comprehensive, school-based intervention designed to promote physical activity in high school girls. The intervention focused on changes in instructional practices and the school environment to affect personal, social, and environmental factors related to physical activity. Multiple process evaluation tools and an organizational assessment tool were developed to monitor program implementation from a framework called the LEAP essential elements, which characterized complete and acceptable intervention delivery; secular trends were also monitored. Using process data, LEAP intervention schools were categorized into low- and high-implementing groups and compared with control schools on nine essential elements assessed at the organizational level. The Wilcoxon scores test revealed that low- and high-implementing intervention, and control schools differed significantly on two of nine administrator-reported organizational-level components: having a physical activity team and having a faculty-staff health promotion program. A mixed-model analysis of covariance indicated that, compared to control schools, a greater percentage of girls in high-implementing schools reported engaging in vigorous physical activity. Process evaluation can be used to understand the relationship between level of implementation and successful program outcome.

Physical activities and sedentary pursuits in African American and Caucasian girls.

The purposes of this study were to describe and compare the specific physical activity choices and sedentary pursuits of African American and Caucasian American girls. Participants were 1,124 African American and 1,068 Caucasian American eighth-grade students from 31 middle schools. The 3-Day Physical Activity Recall (3DPAR) was used to measure participation in physical activities and sedentary pursuits. The most frequently reported physical activities were walking, basketball, jogging or running, bicycling, and social dancing. Differences between groups were found in 11 physical activities and 3 sedentary pursuits. Participation rates were higher in African American girls (p < or = .001) for social dancing, basketball, watching television, and church attendance but lower in calisthenics, ballet and other dance, jogging or running, rollerblading, soccer, softball or baseball, using an exercise machine, swimming, and homework. Cultural differences of groups should be considered when planning interventions to promote physical activity.

Physical activity in young African American women.

African American women are reported to be less physically active than other population groups. This study examined personal behavioral and psychosocial and environmental factors associated with physical activity in African American women living at or below poverty. Most participants engaged in some moderate physical activity through housework and child care; 71% engaged in activity such as walking from one to seven times per week; but only 5% were vigorously active. Seventy-seven percent were active in the past, but 80% dropped out within 6 months, citing "lack of time and feeling bad" as the main reasons. Exercise self-efficacy was positively correlated with beliefs about physical and social outcomes of activity, with more active than inactive women believing that physical activity had more physical health outcomes. One-third of the women reported that family or friends disapproved of their spending time being physically active, and 45% had never been encouraged to be active by a health professional. However, health professionals' influence was positively correlated with weight reduction but not physical activity participation.

Differences in physical activity between black and white girls living in rural and urban areas.

This study examined the relationship of race and rural/urban setting to physical, behavioral, psychosocial, and environmental factors associated with physical activity. Subjects included 1,668 eighth-grade girls from 31 middle schools: 933 from urban settings, and 735 from rural settings. Forty-six percent of urban girls and 59% of rural girls were Black. One-way and two-way ANOVAs with school as a covariate were used to analyze the data. Results indicated that most differences were associated with race rather than setting. Black girls were less active than White girls, reporting significantly fewer 30-minute blocks of both vigorous and moderate-to-vigorous physical activity. Black girls also spent more time watching television, and had higher BMIs and greater prevalence of overweight than White girls. However, enjoyment of physical education and family involvement in physical activity were greater among Black girls than White girls. Rural White girls and urban Black girls had more favorable attitudes toward physical activity. Access to sports equipment, perceived safety of neighborhood, and physical activity self-efficacy were higher in White girls than Black girls.

Predictors of initiation of early sex in black and white adolescent females.

This study examined the extent to which problem solving, self-image, and other health-related factors predict age at first intercourse among Black and White adolescent females. The volunteer sample was 16 to 19 years old; 52% were Black (n=105), and 48% (n=97) were White. Adolescents were recruited from family planning clinics throughout South Carolina. Stratified analyses identified race as a modifier of the relationship between problem solving and time of first intercourse (early or delayed). Logistic regression revealed three predictors of early age at first intercourse in Black girls, but only one predictor in White girls. There were no race differentials in either age or the proportion of girls initiating early intercourse. However, Black girls who had less problem solving skill than their peers were five times more likely to have early intercourse, three times more likely to practice fewer health-promoting behaviors, and seven times more likely to have 10 or fewer years of education. Early intercourse was significantly associated with unprotected first intercourse. Our findings suggest that interventions may need to be tailored for different risk groups within Black populations of adolescent girls.