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Biomedical subjects

Kelly R Evenson

Publications and source records attributed to Kelly R Evenson.

At least 19 recordsLinked to original sources
PubMed2006

Association between physical activity and proximity to physical activity resources among low-income, midlife women.

INTRODUCTION: The association between levels of physical activity and perceived and objectively measured proximity to physical activity resources is unclear. Clarification is important so that future programs can intervene upon the measure with the greatest association. We examined correlations between perceived and objectively measured proximity to physical activity resources and then examined associations between both measures of proximity and objectively measured physical activity. METHODS: Participants (n = 199) were underinsured women from three counties in southeastern North Carolina. Perceived proximity to physical activity resources (e.g., parks, gyms, schools) was measured using surveys. Objectively measured proximity included geographic information systems road network distance to the closest resource and existence of resources within 1- and 2-mile buffers surrounding participants' homes. To examine the association between proximity to resources and activity, the dependent variable in multiple linear regression models was the natural logarithm of accelerometer-measured moderate to vigorous physical activity in minutes per day. RESULTS: Pearson correlation coefficients for perceptions of distance and objectively measured distance to physical activity resources ranged from 0.40 (gyms, schools) to 0.54 (parks). Perceived distance to gyms and objective number of schools within 1-mile buffers were negatively associated with activity. No statistically significant relationships were found between activity and perceived or objectively measured proximity to parks. CONCLUSION: Results indicate the need for both individual and environmental intervention strategies to increase levels of physical activity among underinsured, midlife women. More work is needed to determine the most effective strategies.

Attitude to Health↗
PubMed2006

Girls' perception of physical environmental factors and transportation: reliability and association with physical activity and active transport to school.

BACKGROUND: Preliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school. METHODS: Test and retest surveys, administered a median of 12 days later, were conducted with 480 sixth- and eighth-grade girls in or near six U.S. communities. The instrument consisted of 24 questions on safety and aesthetics of the perceived environment and transportation and related facilities. Additionally, girls were asked if they were aware of 14 different recreational facilities offering structured and unstructured activities, and if so, whether they would visit these facilities and the ease with which they could access them. Test-retest reliability was determined using kappa coefficients, overall and separately by grade. Associations with physical activity and active transport to school were examined using mixed model logistic regression (n = 610), adjusting for grade, race/ethnicity, and site. RESULTS: Item-specific reliabilities for questions assessing perceived safety and aesthetics of the neighborhood ranged from 0.31 to 0.52. Reliabilities of items assessing awareness of and interest in going to the 14 recreational facilities ranged from 0.47 to 0.64. Reliabilities of items assessing transportation ranged from 0.34 to 0.58. Some items on girls' perceptions of perceived safety, aesthetics of the environment, facilities, and transportation were important correlates of physical activity and, in some cases, active transport to school. CONCLUSION: This study provides some psychometric support for the use of the questionnaire on physical environmental factors and transportation for studying physical activity and active transport to school among adolescent girls. Further work can continue to improve reliability of these self-report items and examine their association of these factors with objectively measured physical activity.

Journal Article↗
PubMed2006

The relationship between leisure, walking, and transportation activity with the natural environment.

The purpose of this study was to quantify the agreement between perceived and objective measures of the natural environment and to assess their associations with physical activity. Perception of the natural environment was obtained through survey data. Objective measures of weather and hills were created using Geographic Information Systems (GIS). When objective measures were compared to respondent's perceptions little agreement was found. Objective measures were not associated with any physical activity outcomes; however, several associations were seen between perceived measures and physical activity. These results indicate that researchers should consider perceptions of the natural environment when developing physical activity interventions.

Adult↗
PubMed2006

Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: a scientific statement from the American Heart Association Council on cardiovascular nursing and stroke council.

Patient delay in seeking treatment for acute coronary syndrome and stroke symptoms is the major factor limiting delivery of definitive treatment in these conditions. Despite decades of research and public education campaigns aimed at decreasing patient delay times, most patients still do not seek treatment in a timely manner. In this scientific statement, we summarize the evidence that (1) demonstrates the benefits of early treatment, (2) describes the extent of the problem of patient delay, (3) identifies the factors related to patient delay in seeking timely treatment, and (4) reveals the inadequacies of our current approaches to decreasing patient delay. Finally, we offer suggestions for clinical practice and future research.

Acute Disease↗
PubMed2006

Physical activity and magnetic field exposure in pregnancy.

BACKGROUND: Peak magnetic field exposure was associated with increased risk of miscarriage in 2 recent studies. Reduced physical activity levels in healthy pregnancies may affect measured exposure and thus bias results. METHODS: We recruited 100 pregnant women to wear an Actigraph accelerometer and EMDEX magnetic field monitor for a 7-day period. We evaluated the association between physical activity and magnetic field exposure (peaks and time-weighted average) using generalized estimating equations and linear mixed models. RESULTS: We found a positive association between level of activity and likelihood of incurring elevated exposure in the person-day analysis, most strongly for cutpoints of 16 or 20 mG, for both working and nonworking women among whom odds ratios in the uppermost quartile ranged from 2.1 to 2.6. A positive association was found using person-minutes only among nonworking women. CONCLUSION: Physical activity may affect peak magnetic field exposure. If the early nausea and later cumbersomeness of healthy pregnancies leads to reduced physical activity, this could distort measured magnetic field-health outcome associations.

Adult↗
PubMed2006

Attitudes toward participation in a pregnancy and child cohort study.

While epidemiological studies aim for high participation rates, it is becoming increasingly difficult to recruit and retain participants in lengthy observational studies. We surveyed women who recently participated in the Pregnancy, Infection, and Nutrition Study during their pregnancy to learn more about what initially motivated them to participate in the study, their attitudes about the study protocol, and whether they would allow their child to participate in future studies. Most women were motivated by their interest in science and learning about their pregnancy. In general, women felt quite comfortable with most aspects of the study. Consent forms, telephone interviews and self-administered questionnaires were the most acceptable components of the study, but even specimen collection was well tolerated by this cohort. Women were less comfortable with the possibility of their child participating in future research. This survey confirmed that once women are enrolled, they tend to be willing to complete most components of an intensive study, suggesting that initial efforts for recruitment are most important.

Adult↗
PubMed2006

Public parks and physical activity among adolescent girls.

OBJECTIVES: Physical activity may be constrained or facilitated by local environments. The availability of neighborhood facilities for physical activity may be particularly relevant for youth, who are unable to drive and whose activity is often limited to the immediate distance they are able to walk or bicycle. Several studies have shown that proximity to recreational facilities and parks is one of the most important predictors of physical activity. Because the United States already has an extensive infrastructure of parks, with 70% of adults indicating that they live within walking distance of a park or playground, parks may be a potential venue for increasing physical activity. This might be particularly important for adolescent girls, whose physical activity levels decline substantially as they go through puberty. The goal of this study was to examine the association between park proximity, park type, and park features and physical activity in adolescent girls. PATIENTS AND METHODS: This was a cross-sectional study using baseline data from the Trial of Activity for Adolescent Girls. It included 1556 grade 6 girls who were randomly selected from 6 middle schools in each of the following 6 field site areas: Washington, DC, and Baltimore, Maryland; Columbia, South Carolina; Minneapolis, Minnesota; New Orleans, Louisiana; Tucson, Arizona; and San Diego, California. Girls wore accelerometers for 6 days to measure metabolic equivalent-weighted moderate-to-vigorous physical activity, a measure accounting for the volume and intensity of activity. Metabolic equivalent-weighted moderate-to-vigorous physical activity was calculated for the hours outside of school time using 2 different cutpoints, activity levels > or = 3.0 metabolic equivalents and > or = 4.6 metabolic equivalents, the latter indicating activity at the intensity of a brisk walk or higher. We mapped all of the parks within 1 mile of each girl's home. Trained staff used a checklist to document the presence of facilities and amenities at each park, including passive amenities, such as drinking fountains, restrooms, and areas with shade, as well as active amenities like basketball courts, multipurpose fields, playgrounds, and tennis courts. RESULTS: Mean nonschool metabolic equivalent-weighted moderate/vigorous physical activity, using the 4.6 metabolic equivalent cutoff, was 611.1 minutes (range: 49.7-4718.6 metabolic equivalent minutes per 6 days) and 1704.8 metabolic equivalent minutes per 6 days (range: 276.2-5792.6 metabolic equivalent minutes per 6 days) when using the 3.0 metabolic equivalent cutpoint. Many girls had multiple parks within a 1-mile radius of their homes: 57% had > or = 1 type of park, the majority being neighborhood or community parks; 42% had between 1 and 3 parks, 37% had > or = 4 parks, and 14% had > or = 8 parks. The type, number, and specific parks features were associated with girls' nonschool metabolic equivalent-weighted moderate/vigorous physical activity. At the 4.6 metabolic equivalent cutpoint, higher levels of nonschool metabolic equivalent-weighted moderate/vigorous physical activity were associated with both neighborhood and community parks (22 metabolic equivalent minutes) and miniparks (40 metabolic equivalent minutes). Each park, regardless of type, in the half-mile around each girl's home was associated with an increase in nonschool metabolic equivalent-weighted moderate/vigorous physical activity by 2.8% or 17.2 nonschool minutes of metabolic equivalent-weighted moderate/vigorous physical activity per 6 days. Beyond a half-mile, each park increased nonschool metabolic equivalent-weighted moderate/vigorous physical activity by 1.1% or 6.7 metabolic equivalent minutes per 6 days. For the average girl with 3.5 parks within a 1-mile radius of home, the presence of parks accounted for 36.5 extra nonschool metabolic equivalent minutes per 6 days, approximately 6% of total nonschool metabolic equivalent-weighted moderate/vigorous physical activity. Using the 3.0 metabolic equivalent cutpoint, this sums to an additional 68 metabolic equivalent minutes of nonschool metabolic equivalent-weighted moderate/vigorous physical activity over 6 days, or 4% of the total. The most common amenities in the parks were playgrounds, multipurpose fields, and picnic areas. Slightly more than one third of girls lived within a half-mile of a park with a basketball court, and > 20% had access to walking paths and tennis courts in their local park. Higher levels of nonschool metabolic equivalent-weighted moderate/vigorous physical activity per 6 days were associated with walking paths (13 metabolic equivalent minutes), running tracks (82 metabolic equivalent minutes), playgrounds (28 metabolic equivalent minutes), and basketball courts (30 metabolic equivalent minutes). Parks with streetlights and floodlights were also associated with an increase of 18 and 22 minutes of nonschool metabolic equivalent-weighted moderate/vigorous physical activity, respectively. With the 3.0 metabolic equivalent cutoff for metabolic equivalent-weighted moderate/vigorous physical activity, additional nonschool metabolic equivalent minutes more than doubled when girls had miniparks (92 metabolic equivalent minutes), natural resource areas (36 metabolic equivalent minutes), walking paths (59 metabolic equivalent minutes), and running tracks (208 metabolic equivalent minutes) within a half-mile of their homes. Skateboard areas and special-use parks were negatively associated with nonschool metabolic equivalent-weighted moderate/vigorous physical activity in adolescent girls. CONCLUSIONS: Adolescent girls who live near more parks, particularly near those with amenities that are conducive to walking and with active features, engage in more nonschool metabolic equivalent-weighted moderate/vigorous physical activity than those with fewer parks. Whether this is because of actual use of the parks or neighborhood choice could not be determined. Although the magnitude of the association between parks and additional minutes of metabolic equivalent-weighted moderate/vigorous physical activity was small for an individual, amounting to an average of 4%-6% of a girl's total nonschool metabolic equivalent-weighted moderate/vigorous physical activity, it is likely to have a large population-level association. Because of the potential population level impact, the use of parks to promote physical activity should be further studied.

Adolescent↗
PubMed2005

Test-retest reliability of a questionnaire to assess physical environmental factors pertaining to physical activity.

BACKGROUND: Despite the documented benefits of physical activity, many adults do not obtain the recommended amounts. Barriers to physical activity occur at multiple levels, including at the individual, interpersonal, and environmental levels. Only until more recently has there been a concerted focus on how the physical environment might affect physical activity behavior. With this new area of study, self-report measures should be psychometrically tested before use in research studies. Therefore the objective of this study was to document the test-retest reliability of a questionnaire designed to assess physical environmental factors that might be associated with physical activity in a diverse adult population. METHODS: Test and retest surveys were conducted over the telephone with 106 African American and White women and men living in either Forsyth County, North Carolina or Jackson, Mississippi. Reliability of self-reported environmental factors across four domains (e.g., access to facilities and destinations, functionality and safety, aesthetics, natural environment) was determined using intraclass correlation coefficients (ICC) overall and separately by gender and race. RESULTS: Generally items displayed moderate and sometimes substantial reliability (ICC between 0.4 to 0.8), with a few differences by gender or race, across each of the domains. CONCLUSION: This study provides some psychometric evidence for the use of many of these questions in studies examining the effect of self-reported physical environmental measures on physical activity behaviors, among African American and White women and men.

Journal Article↗
PubMed2005

Evaluating change in physical activity with the building of a multi-use trail.

BACKGROUND: Cross-sectional studies suggest a positive association between the presence of trails and physical activity participation. Prospective evaluations of the impact of building a multi-use trail, in terms of change in physical activity levels among nearby residents, are needed. DESIGN: The study was designed as a quasi-experimental noncontrol pre-post design. SETTING/PARTICIPANTS: Participants included 366 adults aged > or =18 years living within 2 miles of the evaluated trail. INTERVENTION: A railway of >23 miles was under development for conversion to a multi-use trail in central North Carolina. A segment of the trail was evaluated by randomly selecting and telephone interviewing adults living within 2 miles of the planned trail before trail construction began and approximately 2 months after completion of construction. MAIN OUTCOME MEASURES: Outcomes were time spent in leisure activity, leisure activity near home, walking, bicycling, moderate activity, vigorous activity, and transportation activity. RESULTS: At follow-up, of the 366 adults living within 2 miles of the trail, 11.0% had not heard of the trail, and 23.1% had heard of the trail and had used it at least once. In multivariable logistic models, leisure activity, leisure activity near home, moderate activity, vigorous activity, and walking for transportation did not significantly change for those who used the trail compared to those not using the trail. CONCLUSIONS: This prospective study of the building of a multi-use trail did not demonstrate an increase in physical activity among adults living near the trail. Other prospective studies are encouraged, to take advantage of rigorously evaluating different types of trails that are to be constructed in rural and urban settings.

Adolescent↗
PubMed2005

Test-retest reliability of adult surveillance measures for physical activity and inactivity.

BACKGROUND: Several physical activity measures used in U.S. surveillance systems lack estimates of reliability in this country. This information is needed among diverse populations of women and men, to aid in interpretation and use of the measures. The objective of this study was to document the test-retest reliability of several measures of physical activity and inactivity used in surveillance in a diverse adult population. METHODS: Test and retest surveys were conducted over the telephone with 106 African-American and white women and men living in Forsyth County, North Carolina or Jackson, Mississippi in 2003. Physical activity and inactivity were self-reported using surveillance measures, such as from the Behavioral Risk Factor Surveillance System. Reliability was determined using kappa and intraclass correlation coefficients (ICCs) overall and separately by gender and race. RESULTS: Thirteen percent of the participants met recommendations for physical activity, 44% were insufficiently active, and 43% were inactive. Reliability of the measures to categorize participants into these categories was 0.44 (95% confidence interval [CI]=0.27-0.58). The reliability of several categoric definitions of leisure activity ranged from 0.46 to 0.68. Occupational activity had substantial reliability (0.82, 95% CI=0.72-0.89), while any transportation activity (0.27, 95% CI=0.09-0.44) and walking (0.40, 95% CI=0.23-0.55) were lower. Indicators of inactivity categorized at >7 hours/week included time per week on the computer (0.83, 95% CI=0.57-0.78) and time per week watching television (0.40, 95% CI=0.22-0.54). Some gender and racial differences were noted in the reliability estimates. CONCLUSIONS: In conclusion, this study provides estimates of test-retest reliability for several physical activity and inactivity measures used for surveillance purposes. Validity data, coupled with the reliability estimates reported here and elsewhere, can aid in interpretation and use of these measures in surveillance, as well as in epidemiologic studies.

Black or African American↗
PubMed2005

Physical exertion at work and the risk of preterm delivery and small-for-gestational-age birth.

OBJECTIVE: To assess whether exposure to standing, lifting, night work, or long work hours during 3 periods of pregnancy are associated with an increased risk of preterm or small-for-gestational-age birth. METHODS: The Pregnancy, Infection and Nutrition study is a prospective cohort with a nested case-control component that was conducted through clinic and hospital settings in Central North Carolina. A total of 1,908 women pregnant with a singleton gestation were recruited during prenatal visits from January 1995 through April 2000 and provided information during telephone and face-to-face interviews about physical exertion for the 2 longest-held jobs during pregnancy. RESULTS: No significant elevations in preterm delivery were observed among women who lifted repeatedly or stood at least 30 hours per week, with no changes in risk estimates over the course of pregnancy. A 50% elevation in the risk of preterm delivery (relative risk 1.5, 95% confidence interval 1.0-2.0; first trimester) was observed among women who reported working at night (10:00 PM to 7:00 AM), whereas a 40% reduction in risk was observed among women working at least 46 hours per week (relative risk 0.6, 95% confidence interval 0.4-0.9; first trimester), regardless of period of exposure. No elevations in small-for-gestational-age birth were observed among women exposed to any of the 4 types of occupational exertion. CONCLUSION: Physically demanding work does not seem to be associated with adverse pregnancy outcomes, whereas working at night during pregnancy may increase the risk of preterm delivery. Studies to examine the effect of shift work on uterine activity would help to clarify the possibility of a causal effect on preterm birth.

Adult↗
PubMed2005

Accelerometer use in physical activity: best practices and research recommendations.

Researchers are increasingly interested in the potential of accelerometers to improve our ability to measure and understand the health impacts of physical activity. Although accelerometers have been available commercially for more than 25 yr, broad consensus about how to use these tools has not been established. At a scientific conference in December 2004, a number of scientists were invited to present papers, serve as reactors or moderators to papers, present posters of original research, or serve as members of an audience knowledgeable about the use of accelerometers. During 2 1/2 d, information about best practices of accelerometer use was presented and suggestions for future research were made. From the collective experience of papers presented and discussions held, five areas of accelerometer use were described. This paper summarizes the best practices and future research needs from those five areas: monitor selection, quality, and dependability; monitor use protocols; monitor calibration; analysis of accelerometer data; and integration with other data sources. Suggestions for reporting standards for journal articles also are presented.

Acceleration↗
PubMed2004

Acculturation and physical activity among North Carolina Latina immigrants.

The objective of this study was to examine the association between acculturation and physical activity among first generation Latina (Hispanic women) immigrants living in North Carolina. As part of the multi-site Women's Cardiovascular Health Network, 671 first generation Latina immigrants 20-50 years of age completed in-person interviews on physical activity, acculturation (measured by a language scale, length of residence in the US, and age at arrival in the US) and other potential individual and contextual correlates of physical activity. All statistical models were adjusted for age, general health, number of children in the home, marital status, and education, with self-reported physical activity as the dependent variable. Among participants, 37.4% met recommendations for physical activity, 41.9% reported insufficient activity, and 20.7% reported no moderate or vigorous activity. Latinas with higher English language acculturation were more likely to be physically active than women with lower English language acculturation. Likewise, women who arrived to the US when they were younger than 25 years were more likely to be physically active than women who arrived when they were 25 years or older. Length of residence in the US was not associated with physical activity. These relationships persisted when restricting the sample to Mexican born women. We conclude that among first generation immigrants living in North Carolina, those with higher English language acculturation or who arrived to the US at younger ages were more likely to report being physically active. These findings suggest that future epidemiologic studies and physical activity interventions should measure and tailor programs based on English-language use and age of arrival to the US among Latina immigrants.

Acculturation↗
PubMed2004

Self-reported overweight and obesity are not associated with concern about enough food among adults in New York and Louisiana.

BACKGROUND: A causal relationship between hunger and obesity has been postulated. Two cross-sectional studies have found evidence to suggest an association between obesity and food insecurity among adult women, and a third study suggests an association between underweight and food insecurity among men. The purpose of this study was to investigate the association between concern about enough food and obesity in an adult population at the state level. METHODS: A cross-sectional analysis was conducted using 1999 data from the Behavioral Risk Factor Surveillance System (BRFSS), Social Context Module (n = 3,945). RESULTS: An 8.0% prevalence of concern about enough food was found in Louisiana, and an 11.8% prevalence was found in New York, and was positively associated with morbid obesity, RR = 2.20 (95% CI = 1.24, 3.90) and RR = 2.23 (95% CI = 1.30, 3.84), respectively. However, this association became nonsignificant after controlling for education, income, race/ethnicity, marital status, and general health. CONCLUSION: A very strong apparent relationship between concern about enough food and obesity could be entirely accounted for by the influences of socioeconomic variables. This emphasizes the need for longitudinal research studies using precise measures of weight, height, and food security.

Adult↗
PubMed2004

Effect of cardiorespiratory fitness on mortality among hypertensive and normotensive women and men.

BACKGROUND: The effects of fitness on mortality either from cardiovascular disease (CVD) or from all causes, among hypertensive adults, are not fully understood, especially among women. The objective of this study was to examine the effect of fitness on all-cause and CVD mortality among hypertensive and normotensive women and men. METHODS: Using the Lipids Research Clinics Prevalence Study, we examined the relationship of fitness with mortality among 2712 women and 3000 men followed from 1972-1976 to 1998. Cardiorespiratory fitness was measured using a treadmill test. Sex-specific hazard ratios (HRs) were calculated from proportional hazard models of fitness predicting all-cause or CVD mortality, adjusted for age, education, race, smoking, alcohol, body mass index, and hyperlipidemic sampling strata. RESULTS: Comparing the lowest with the highest quintile of fitness, the adjusted all-cause mortality among hypertensive women was 1.7 (95% confidence interval = 0.9-3.2) and among normotensive women was 2.3 (1.5-3.7). Comparing the same quintiles of fitness, the adjusted all-cause mortality among hypertensive men was 2.0 (1.2-3.4), and among normotensive men it was 1.9 (1.3-2.7). Elevated risks were also observed for CVD mortality. CONCLUSION: Higher levels of fitness were associated with a lower risk of all-cause and CVD mortality among both hypertensive and normotensive women and men.

Adult↗
PubMed2004

Leisure-time physical activity among pregnant women in the US.

Few population-based data exist that describe leisure-time physical activity among pregnant women. The purpose of this study was to characterise the prevalence of leisure activity and to examine characteristics associated with participation in leisure activity during pregnancy. Using data collected from the year 2000 Behavioral Risk Factor Surveillance System, information on leisure activity was collected during telephone interviews from 1979 pregnant women and 44,657 non-pregnant women 18-44 years of age, representative of the US population. The prevalence of any leisure activity in the past month was 65.6%, 95% confidence interval [95% CI] 62.0, 69.1, among pregnant women and 73.1% [95% CI 72.4, 73.9] among non-pregnant women. The prevalence of recommended activity was also lower among pregnant women than non-pregnant women (15.8% vs. 26.1%). The most common leisure activity for pregnant women was walking, followed by activities such as swimming laps, weight lifting, gardening, and aerobics. Among pregnant women, any leisure activity was significantly higher for those with higher education, younger age, and excellent or very good health than for those with fair or poor health. Pregnant women reported less leisure activity than non-pregnant women of the same age. Studies to understand the enablers and barriers to participating in leisure activity during pregnancy are needed.

Adolescent↗
PubMed2004

Pregnancy-related weight gain--a link to obesity?

Past research on maternal weight gain during pregnancy has focused on determinants and consequences of inadequate weight gain with concerns for the health of the infant. However, with the rising prevalence of obesity among women of childbearing ages and the high proportion of women who are gaining in excess of recommendations, a shift in research focus must occur to include consideration of the mother's long-term health status. The few studies that have examined determinants of excessive weight gain and postpartum weight retention in this country were not comprehensive in assessing diet, physical activity and psychosocial factors and suffer from small sample sizes. Information is lacking concerning pregnant women's perceptions about eating and gaining weight, what they actually eat, how consumption and exercise relate to weight gain, and how psychosocial factors influence these behaviors during pregnancy. Likewise, little is known concerning these same attitudes and behaviors during the postpartum period that may contribute to weight retention.

Adult↗