public health promotion of physical activity – filling critical research gaps russell pate, ph.d.,...
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Public Health Promotion Public Health Promotion of Physical Activity – of Physical Activity –
Filling Critical Research Filling Critical Research GapsGaps
Russell Pate, Ph.D., FACSM Russell Pate, Ph.D., FACSM Department of Exercise ScienceDepartment of Exercise ScienceArnold School of Public HealthArnold School of Public HealthUniversity of South CarolinaUniversity of South Carolina
BackgroundBackground
Physical activity (PA) provides Physical activity (PA) provides important health benefitsimportant health benefits
PA GuidelinesPA Guidelines• Adults: 150 minutes of PA per weekAdults: 150 minutes of PA per week• Youth: 60 minutes of PA per dayYouth: 60 minutes of PA per day• Most Americans do not meet these Most Americans do not meet these
guidelinesguidelines
Prevalence of Meeting GuidelinesPrevalence of Meeting GuidelinesAdult Self-Report – BRFSS 2005Adult Self-Report – BRFSS 2005
0
10
20
30
40
50
60
70
80
90
100
Males Females
18-24 y
25-34 y
35-44 y
45-64 y
65 y +
Kruger et al. MMWR 2007;56(46):1209-1212
Perc
en
t
Prevalence of Meeting GuidelinesPrevalence of Meeting GuidelinesAdult Objective Data - NHANESAdult Objective Data - NHANES
0
10
20
30
40
50
60
70
80
90
100
Males Females
20-59 y
60 y +
Troiano et al. Med Sci Sports Exerc 2008;40(1):181-188
Perc
en
t
Prevalence of Meeting GuidelinesPrevalence of Meeting GuidelinesYouth Self-Report – YRBS 2007Youth Self-Report – YRBS 2007
0
10
20
30
40
50
60
70
80
90
100
Males Females
9th
10th
11th
12th
Perc
en
t
Eaton et al. MMWR 2008;(S S04):1-131
0
10
20
30
40
50
60
70
80
90
100
Males Females
6-11 y
12-15 y
16-19 y
Prevalence of Meeting GuidelinesPrevalence of Meeting GuidelinesYouth Objective Data - NHANESYouth Objective Data - NHANES
Troiano et al. Med Sci Sports Exerc 2008;40(1):181-188
Perc
en
t
www.physicalactivityplan.org
Organizational PartnersOrganizational Partners
American Academy of Pediatrics American Academy of Pediatrics American Alliance for Health, Physical American Alliance for Health, Physical
Education, Recreation, and DanceEducation, Recreation, and Dance American Association of Retired PersonsAmerican Association of Retired Persons American Cancer SocietyAmerican Cancer Society American College of Sports MedicineAmerican College of Sports Medicine American Heart AssociationAmerican Heart Association Centers for Disease Control & PreventionCenters for Disease Control & Prevention
A comprehensive plan for promoting A comprehensive plan for promoting physical activity in the American physical activity in the American
population would provide the framework population would provide the framework to support a broad and comprehensive to support a broad and comprehensive
national effort to increase physical activity national effort to increase physical activity throughout the population.throughout the population.
VisionVision• All Americans are physically active and live, work, All Americans are physically active and live, work,
and play in environments that facilitate regular and play in environments that facilitate regular physical activity.physical activity.
MissionMission• Develop a National Plan for Physical Activity that Develop a National Plan for Physical Activity that
produces a marked and progressive increase in the produces a marked and progressive increase in the percentage of Americans who meet physical activity percentage of Americans who meet physical activity guidelines throughout life.guidelines throughout life.
GoalsGoals• Provide a clear roadmap Provide a clear roadmap
for actions that support for actions that support short and long term short and long term progress progress
• Develop strategies for Develop strategies for increasing physical increasing physical activity in all population activity in all population subgroups subgroups
• Create a sustained and Create a sustained and resourced social resourced social movementmovement
Social Ecological ModelSocial Ecological Model
Child or Adolescent
SectorsSectors1.1. Public HealthPublic Health
2.2. EducationEducation
3.3. Transportation, Urban Design, & Transportation, Urban Design, & Community PlanningCommunity Planning
4.4. Mass MediaMass Media
5.5. HealthcareHealthcare
6.6. Business & IndustryBusiness & Industry
7.7. Parks, Recreation, Fitness, & SportsParks, Recreation, Fitness, & Sports
8.8. Volunteer and Non-Profit OrganizationsVolunteer and Non-Profit Organizations
Guide to Community Preventive Guide to Community Preventive ServicesServices
Task Force on Community Preventive Task Force on Community Preventive ServicesServices
Support from the US Department of Health Support from the US Department of Health and Human Services in collaboration with and Human Services in collaboration with public and private partnerspublic and private partners
Reviewed literature for PA interventions:Reviewed literature for PA interventions:• Informational approachesInformational approaches• Behavioral and social approachesBehavioral and social approaches• Environmental and policy approachesEnvironmental and policy approaches
Kahn et al. Am J Prev Med 2002;22(4S): 73-107
Effective Physical Activity Effective Physical Activity InterventionsInterventions
Public HealthPublic Health Strong EvidenceStrong Evidence
• ““Point-of-decision” prompts to Point-of-decision” prompts to encourage stair useencourage stair use
• Community-wide campaignsCommunity-wide campaigns
• Social support in community settingsSocial support in community settings
• Individually-adapted health behavior Individually-adapted health behavior change (most implemented in change (most implemented in community settings)community settings)
EducationEducation
School-Based Physical EducationSchool-Based Physical Education• Strong evidence for effectiveness in Strong evidence for effectiveness in
increasing PA and improving physical increasing PA and improving physical fitnessfitness
EducationEducation Insufficient evidenceInsufficient evidence
• Classroom-based Health Education Classroom-based Health Education (focus on information provision)(focus on information provision)
• Classroom-based Health Education Classroom-based Health Education (focus on reducing TV viewing)(focus on reducing TV viewing)
• College-based Health Education and College-based Health Education and Physical EducationPhysical Education
Transportation, Urban Transportation, Urban Design, & Community Design, & Community
PlanningPlanning Creation of or enhanced access to Creation of or enhanced access to
places for PA combined with places for PA combined with informational outreach activitiesinformational outreach activities• Strong evidence for effectivenessStrong evidence for effectiveness
Mass MediaMass Media
Insufficient evidenceInsufficient evidence• Mass media campaignsMass media campaigns
SectorsSectors1.1. Public Health (4, 0)Public Health (4, 0)
2.2. Education (1, 3)Education (1, 3)
3.3. Transportation, Urban Design, & Community Transportation, Urban Design, & Community Planning (1, 0)Planning (1, 0)
4.4. Mass Media (0, 1)Mass Media (0, 1)
5.5. Healthcare (0, 0)Healthcare (0, 0)
6.6. Business & Industry (0, 0)Business & Industry (0, 0)
7.7. Parks, Recreation, Fitness, & Sports (0, 0)Parks, Recreation, Fitness, & Sports (0, 0)
8.8. Volunteer and Non-Profit Organizations (0, 0) Volunteer and Non-Profit Organizations (0, 0)
Large Scale PA Intervention Large Scale PA Intervention StudiesStudies
EducationEducation• Active by Choice Active by Choice
TodayToday• CATCHCATCH• CHICCHIC• FitKid ProjectFitKid Project• Know Your BodyKnow Your Body• LEAPLEAP• PathwaysPathways
• Planet HealthPlanet Health• PLAYPLAY• Project FABProject FAB• Project GRADProject GRAD• SPARKSPARK• TAAGTAAG
Large Scale PA Intervention Large Scale PA Intervention StudiesStudies
Public HealthPublic Health• Bootheel Heart Health Bootheel Heart Health
ProjectProject• Heart to Heart ProjectHeart to Heart Project• Minnesota Heart Health Minnesota Heart Health
ProjectProject• Stanford Five-City ProjectStanford Five-City Project
Transportation, Urban Transportation, Urban Design & Community Design & Community PlanningPlanning• Active Community Active Community
EnvironmentsEnvironments
HealthcareHealthcare• ACTACT• PACEPACE• PACE+PACE+
Mass MediaMass Media• VERBVERB
Business & IndustryBusiness & Industry• Blair et al. 1986Blair et al. 1986• Bowne et al. 1984Bowne et al. 1984• King et al. 1988King et al. 1988• LIFECHECKLIFECHECK
