Biomedical subjects

Kelly R Evenson

Publications and source records attributed to Kelly R Evenson.

At least 37 records · Page 2Linked to original sources

PubMed2003

Statewide prevalence and correlates of walking and bicycling to school.

BACKGROUND: Travel to and from school can be an important and regular source of physical activity for youth. Few US studies have documented the prevalence and correlates of walking and bicycling to school. OBJECTIVE: To examine the prevalence and correlates of walking and bicycling to school among middle and high school youth. DESIGN: Cross-sectional survey. SETTING: Sixty middle schools and 62 high schools selected in North Carolina. PARTICIPANTS: Students in 6th through 8th grades (n = 2151) and in 9th through 12th grades (n = 2297) during the spring of 2001. MAIN OUTCOME MEASURES: Walking or bicycling to school in a usual week. RESULTS: Among middle school students, 9.4% usually walked to school and 4.1% usually bicycled to school at least 1 day per week. Among high school students, 4.9% usually walked to school and 2.8% usually bicycled to school at least 1 day per week. For middle school youth, walking or bicycling to school was more prevalent among boys and among nonwhites. For high school youth, walking or bicycling to school was also more prevalent among nonwhites. For middle school youth (but not high school youth), a higher body mass index (85th to less than 95th percentile) was associated with a reduced odds of walking to school. For high school youth (but not middle school youth), participating in physical education 1 to 4 days per week or never having an adult at home immediately after school was associated with walking or bicycling to school. Higher parental educational level was associated with a reduced odds of walking to school among high school youth. CONCLUSIONS: The descriptive information provided by this study broadens our limited understanding of the prevalence and correlates of walking and bicycling to school in the United States. Further qualitative and quantitative descriptive data are needed to develop successful interventions to increase walking and bicycling to school.

Adolescent↗

PubMed2003

Quantitative study of correlates of physical activity in women from diverse racial/ethnic groups: Women's Cardiovascular Health Network Project--introduction and methodology.

BACKGROUND: Physical activity is an important aspect of cardiovascular disease prevention. However, data show a high prevalence of physical inactivity among women and ethnic minority and low-income populations. The purpose of this introduction is to describe the Women's Cardiovascular Health Network Project and implementation of the Women and Physical Activity Survey. The goal of the survey was to identify personal, social environmental, and physical environmental factors that are associated with physical activity status among diverse groups of women. METHODS: Seven universities were funded to study factors that influence physical activity among African-American, Native American, Latina, and white women residing in rural, suburban, and urban living environments. An ecologic model was used to design a quantitative questionnaire that was implemented by telephone or face-to-face interviews in seven sites across the United States. RESULTS: The survey was completed by a total 4122 women, with group totals ranging from 300 to 1000. Results from each site are presented in individual articles in this issue. A summary of results that compare and contrast the groups is presented in an additional report. CONCLUSION: This study provides important information on the assessment of physical activity among women. Results can be used to help improve assessments and to develop more effective policies and interventions for unique groups of women.

Cardiovascular Diseases↗

PubMed2003

Test-retest reliability of a questionnaire on physical activity and its correlates among women from diverse racial and ethnic groups.

BACKGROUND: A better understanding of physical activity and its correlates is needed, especially among diverse populations of women. The objective of this study was to examine the test-retest reliability of a survey designed to measure physical activity and its correlates among women from diverse racial and ethnic groups. METHODS: Test and retest surveys were conducted in person or over the telephone with 344 white, Latina, African-American, and Native American women aged 20 to 50 years living in rural and urban areas of the United States. Reliability of self-reported physical activity and its correlates were determined using intraclass correlation coefficients (ICC) overall and separately by site and race/ethnicity. RESULTS: Of the women responding, 45% of the participants met recommendations for physical activity, 40% were insufficiently active, and 15% were inactive. Reliability for the physical activity measure was 0.69 (95% confidence interval [CI], 0.62-0.74), with an ICC of 0.30 to 0.95 across sites. Overall, the seven items on the physical environment had substantial reliability (ICC=0.64-0.91). The sense of community scale (0.79; 95% CI, 0.74-0.83), social issues (0.68; 95% CI, 0.61-0.74), social roles (0.64; 95% CI, 0.56-0.71), and self-efficacy for exercise (0.72; 95% CI, 0.66-0.77) all had acceptable reliability overall and across most sites. CONCLUSIONS: This study provides psychometric evidence that the questionnaire on physical activity and its correlates is reliable among diverse women aged 20 to 50 years from various racial and ethnic groups. These results suggest that test-retest reliability is not an obstacle to comparison of associations between physical activity and several hypothesized correlates of activity.

Adult↗

PubMed2003

Personal, social, and environmental correlates of physical activity in North Carolina Latina immigrants.

BACKGROUND: Few studies have examined the correlates of physical activity for Latinas (Latino women) that provide critical information for developing culturally competent interventions. The objective of this study was to describe physical activity and the personal, social environmental, and physical environmental correlates for Latina immigrants. METHODS: As part of the multisite Women's Cardiovascular Health Network Project, 671 first-generation Latina immigrants, aged 20 to 50 years who were living in North Carolina, completed an in-person interview. All statistical models were adjusted for acculturation, with self-reported physical activity as the dependent variable. RESULTS: Only 37% of the Latinas reported meeting vigorous or moderate recommendations for physical activity, with 42% insufficiently active and 21% inactive. Women with more self-efficacy (confidence that they could exercise more) were less likely to meet recommendations for activity. Social environmental factors, such as knowing people who exercise or seeing people exercise in the neighborhood, were more likely among women who reported any activity or who met recommendations for activity. Physical environmental factors, such as vehicular traffic and street lighting, were not strongly associated with physical activity. Living in a community where places to exercise were available was associated with any activity. CONCLUSIONS: This study underscores the importance of understanding personal characteristics and addressing factors that reflects the social and physical environment where Latinas live. Future programs aimed at increasing physical activity among Latina immigrants should consider such factors, particularly factors from the social environment.

Adult↗

PubMed2003

Quantitative study of correlates of physical activity in women from diverse racial/ethnic groups: The Women's Cardiovascular Health Network Project--summary and conclusions.

BACKGROUND: Physical activity is an important aspect of cardiovascular disease prevention. However, the populations that show high risk of cardiovascular disease also have high rates of physical inactivity. The purpose of this article was to summarize findings from the Women and Physical Activity Survey, part of the Women's Cardiovascular Health Network Project. The goal of the survey was to identify personal, social environmental, cultural, and physical environmental factors that are associated with physical activity status among a diverse group of women. METHODS: Seven universities were funded to study factors that influence physical activity among white, African American, Latina, and Native American women residing in rural, suburban, and urban living environments. An ecologic model and qualitative data from these population groups were used to design a quantitative questionnaire. The survey was implemented by telephone and face-to-face interviews in seven sites across the United States. RESULTS: Younger age, good general health, and high self-efficacy were the most consistent personal correlates associated with physical activity. Knowing people who exercise and attending religious services were the only social environmental factors with significant associations across population groups. With the exception of safety from crime, no physical environmental factors were consistently related to physical activity. Most groups had intervention suggestions that included access to facilities. CONCLUSION: This study identifies pertinent factors related to physical activity in women and addresses the differences in assessment among the groups. Because each group may have unique characteristics, it is important to assess all levels that could influence physical activity such as personal, social, environmental, and policy. The information can then be used to tailor interventions for the various groups.

Adult↗

PubMed2003

Occupational physical activity in the atherosclerosis risk in communities study.

PURPOSE: Accumulation of physical activity throughout the day is recommended to reduce health risks and enhance quality of life. Yet, many epidemiologic studies measure leisure activity only, without assessment of occupational activity. The purposes of this study were to describe occupational activity and to quantify the association between occupational and leisure activity in 2991 African American and 8566 White middle-aged adults. METHODS: Physical activity was measured by the Baecke questionnaire in 1987-89 for participants 45 to 64 years of age in the Atherosclerosis Risk in Communities Study. RESULTS: Reported occupational activity was greater among African American men and women compared to White men and women. Leisure activity was greater among White men and women compared to African American men and women. Work indices (range-1 (low) to 5 (high)) were highest among African American women (2.78) and men (2.72), followed by White men (2.55) and women (2.45), adjusted for age, study center, body mass index, and perceived health status. Those with the highest occupational activity had lower participation in any sport or exercise than those with lower occupational activity across race-gender groups. CONCLUSIONS: This data suggests that studies relying solely on leisure activity may miss important information provided by occupational physical activity.

Arteriosclerosis↗

PubMed2003

The effect of regular leisure physical activity on birth outcomes.

OBJECTIVES: The purpose of this study was to determine the effect of regular leisure physical activity (RLPA) on two different adverse birth outcomes: timeliness of delivery (<37 weeks, preterm; 37-42 weeks, term; and >42 weeks, postterm) and low birth weight (<1500 g, very low; 1500-2499 g, low). METHODS: The present sample, consisting of 9089 women, was obtained from the 1988 National Maternal and Infant Health Survey (NMIHS) data. The NMIHS was developed to examine adverse birth outcomes by assessing various maternal characteristics such as demographic, behavioral, and health care factors not found in vital statistics data. RESULTS: The specified adjusted models obtained by logistic regression indicate that women who failed to engage in RLPA before and during their pregnancy were more likely to give birth to a very low birth weight baby [OR = 1.75; 95% CI (1.50, 2.04)] but not to a low birth weight baby [OR = 1.15: 95% CI (0.99, 1.34)] compared with women who remained active before and during pregnancy. Moreover, previously active women who stopped physical activity during pregnancy were more likely to give birth to a low birth weight [OR = 1.28; 95% CI (1.05, 1.56)] or a very low birth weight [OR = 2.05; 95% CI (1.69, 2.48)] baby than women who remained active before and during pregnancy. There was no significant relationship between RLPA and timeliness of delivery. Similar results were found after controlling for maternal medical risk. CONCLUSIONS: RLPA during pregnancy had no deleterious effect on birth outcomes among these women. RLPA may also reduce the risk of low birth weight outcomes.

Adolescent↗

PubMed2003

The effects of widowhood on physical and mental health, health behaviors, and health outcomes: The Women's Health Initiative.

This study examined whether widowhood was associated with physical and mental health, health behaviors, and health outcomes using a cross-sectional (N=72,247) and prospective (N=55,724) design in women aged 50-79 years participating in the Women's Health Initiative observational study (85.4% White). At baseline, married women reported better physical and mental health and generally better health behaviors than widowed women. Whereas women who remained married over the 3-year period showed stability in mental health, recent widows experienced marked impairments and longer term widows showed stability or slight improvements. Both groups of widows reported more unintentional weight loss over the 3-year period. Changes in physical health and health behaviors were inconsistent, with generally small effect sizes. Findings underscore the resilience of older women and their capacity to reestablish connections, but point to the need for services that strengthen social support among women who have difficulty during this transition.

Aged↗

PubMed2003

The effect of cardiorespiratory fitness and obesity on cancer mortality in women and men.

PURPOSE: The purpose of this study was to determine the independent and combined effects of cardiorespiratory fitness and obesity on all-cause cancer mortality for women and men. METHODS: Using the Lipids Research Clinics Prevalence Study, we examined the relationship of fitness and obesity on cancer mortality among 2585 women and 2890 men followed from 1972-1976 to 1998. Cardiorespiratory fitness was measured using a treadmill test and obesity was assessed using body mass index (BMI) calculated from measured height and weight. Gender-specific hazard ratios (HR) were calculated from proportional hazard models, which included covariates for age, education, smoking, alcohol intake, Keys score, and menopause (women only). RESULTS: Adjusted cancer mortality was significantly lower in the most fit quintile relative to the other four quintiles for men (HR = 0.47; 95% CI, 0.27-0.81) but not for women (HR = 0.84; 95% CI, 0.52-1.36). Adjusted cancer mortality was significantly higher in the highest BMI quintile relative to the other four BMI quintiles for women (HR = 1.49; 95% CI, 1.06-2.09) but not for men (HR = 1.05; 95% CI, 0.77-1.43). Further adjustment for BMI on fitness and adjustment for fitness on BMI did not meaningfully change the HR. There were no significant interactions between fitness and obesity in predicting cancer mortality for either women or men. CONCLUSION: In this study, high fitness was a stronger predictor of cancer mortality in men, whereas high BMI was a stronger predictor of cancer mortality in women.

Adult↗

PubMed2003

Change in the prevalence of leisure activity with the number of activities recalled.

PURPOSE: The purpose of this study was to examine how the estimated prevalence of leisure activity changed when respondents self-reported up to four activities, compared with using information only from the respondent's one, two, and three most commonly performed leisure activities. METHODS: Information on leisure activities, sociodemographics, and body mass index (BMI) categories was collected in the year 2000 during a telephone interview of 1813 randomly selected adults living in six North Carolina counties. Recommended activity was defined as moderate leisure activity > or =5x wk(-1) for > or =30 min per session or vigorous leisure activity > or =3x wk(-1) for > or =20 min per session. RESULTS: Among respondents, 32.1% reported participation in no leisure activity, 41.7% reported one activity, 21.5% reported two activities, 3.8% reported three activities, and 0.9% reported four activities during the past month. The largest change in prevalence occurred when using two activities compared with one activity for recommended activity, overall and by sociodemographic and BMI categories. The prevalence of recommended activity determined by using 1, 2, 3, or 4 activities was 21.0%, 26.0%, 26.5%, and 26.7%, respectively. CONCLUSION: In this study, collecting information on two leisure activities was the most efficient balance for population specific accuracy of recommended activity.

Adolescent↗

PubMed2002

Vigorous leisure activity through women's adult life: the Women's Health Initiative Observational Cohort Study.

This study described differences in vigorous activity participation recalled across the life span, assessed whether reports of past vigorous activity were associated with current participation, and examined factors associated with participation in current vigorous activity among women. After the exclusion of women aged 50-54 years, the study population included 71,837 multiethnic postmenopausal women aged 55-79 years who were participating in the Women's Health Initiative Observational Cohort Study, 1993-1998. Vigorous activity was assessed retrospectively for ages 18, 35, and 50 years and currently at enrollment into the study (median age, 65 years). Current participation in vigorous activity (>3 days/week) was low and consistent across racial/ethnic groups (13-16%). The prevalence of vigorous activity declined with age, with the largest decrease in vigorous activity occurring after age 50 years for all racial/ethnic groups. Current vigorous activity was generally higher among women with a lower body mass index, not currently smoking, in excellent general health, and of higher socioeconomic status across racial/ethnic groups. These data suggest that a lower prevalence of vigorous activity in the postmenopausal period is part of a complex of health-related attitudes and behaviors that transcends race/ethnicity. The perimenopausal period may be a critical juncture at which targeted and tailored interventions may help to achieve maintenance of physical activity into the postmenopausal period.

Adolescent↗

PubMed2002

Fitness and fatness as predictors of mortality from all causes and from cardiovascular disease in men and women in the lipid research clinics study.

The relative size of the effects of fitness and fatness on longevity has been studied in only one cohort. The authors examined this issue using data from 2,506 women and 2,860 men in the Lipid Research Clinics Study. The mean age was 46.6 years in women and 45.1 years in men at baseline (1972-1976). Fitness was assessed using a treadmill test, and fatness was assessed as body mass index calculated from measured height and weight. Participants were followed for vital status through 1998. Hazard ratios were calculated using proportional hazard models that included covariates for age, education, smoking, alcohol intake, and the dietary Keys score. Fitness and fatness were both associated with mortality from all causes and from cardiovascular disease. For mortality from all causes, the adjusted hazard ratios were 1.32 among the fit-fat, 1.30 among the unfit-not fat, and 1.57 among the unfit-fat women compared with fit-not fat women. Among men the same hazard ratios were 1.25, 1.44, and 1.49 [corrected]. There were no significant interactions between fitness and fatness in either men or women. The authors conclude that both fitness and fatness are risk factors for mortality, and that being fit does not completely reverse the increased risk associated with excess adiposity.

Adult↗

PubMed2002

Influence of retirement on leisure-time physical activity: the atherosclerosis risk in communities study.

Cross-sectional data suggest that leisure-time physical activity may increase during retirement. Prospective population-based studies are necessary to characterize leisure activity patterns through retirement among the same persons to verify this observation. Therefore, the purpose of this study was to describe the influence of retirement on leisure activity using data from Atherosclerosis Risk in Communities Study cohort participants aged 45-64 years at baseline. Physical activity was measured by the Baecke questionnaire in 1,825 African-American and 5,957 White participants who were working at the initial visit (1986-1989) and either retired or working 6 years later (1993-1995). Participants who retired during follow-up were more likely to increase their sport participation and television watching than those who continued to work over the 6-year period. Among those reporting sport or exercise at baseline, those retiring over follow-up were more likely to maintain their sport and exercise participation than those who continued to work across race-gender groups. Among those not reporting sport or exercise at baseline, those who retired were more likely to adopt activity than those who continued to work except for African-American women. In this study, retirement was associated with gains in sport and exercise participation as well as television watching.

Black or African American↗

PubMed2002

Correlates of physical activity among women from diverse racial/ethnic groups.

OBJECTIVE: Women have lower rates of participation in leisure time physical activity than men and have been studied to a lesser extent than men. Because physical activity plays a vital role in overall health, it is important to identify factors than can help increase physical activity rates for women. METHODS: Defining and understanding correlates of physical activity is critical for at-risk populations and for planning effective interventions. This paper reviews research conducted in the past two decades on correlates of physical activity in women. An ecological model with an added physical environment component was used to organize the correlates. Studies conducted among adult white, black, American Indian, Asian, and Hispanic women are included. A total of 91 studies were reviewed. Many studies included white women, fewer studies included black and Hispanic women, and even fewer included American Indian women, and only 3 studies included Asian women. RESULTS: The correlates most studied are sociodemographic variables, with nonwhite race, lower educational levels, and older age most consistently associated with lower levels of physical activity. Few studies focused on environmental and policy correlates. Social support was an overwhelmingly positive determinant of physical activity for all groups of women. CONCLUSIONS: Based on these findings, we recommend that future research include more diverse groups of women and evaluate modifiable factors, such as psychological, interpersonal, and environmental correlates. Future research also should include more intervention and longitudinal studies.

Ethnicity↗

PubMed2002

Vigorous leisure activity and pregnancy outcome.

BACKGROUND: Preterm birth is the leading cause of perinatal mortality in North America and Europe and a major predictor of neonatal and infant morbidity. Postterm birth is associated with increased infant mortality and morbidity, as well as increased frequency of surgical or induced labor. Because vigorous leisure activity may affect timing of delivery, this study examined association between vigorous leisure activity and birth outcomes. METHODS: Women (N = 1,699) with a singleton pregnancy were recruited at 24-29 weeks' gestation from prenatal clinics in central North Carolina between 1995 and 1998. The type and duration of any regular vigorous leisure activity was assessed in a telephone interview covering the 3-month period before pregnancy and during the first and second trimesters of pregnancy. RESULTS: The prevalence of vigorous leisure activity was 22% before pregnancy, 14% during the first trimester, and 8% during the second trimester. Vigorous leisure activity before pregnancy was unrelated to preterm (<37 weeks) as compared with term delivery (37 to <42 weeks). The risk of preterm birth was somewhat reduced with vigorous leisure activity during the first trimester (odds ratio = 0.80; 95% confidence interval = 0.48-1.35) and more so during the second trimester (odds ratio = 0.52; 95% confidence interval = 0.24-1.11). Vigorous leisure activity before pregnancy or during the first or second trimester was not associated with postterm delivery (>/=42 weeks). CONCLUSIONS: Vigorous leisure activity during the first trimester, and even more so in the second trimester, was associated with a reduced risk of preterm birth. There was no association with postterm birth. To address the etiologic role of activity on pregnancy outcome and to overcome self-selection, a randomized clinical trial would be needed.

Female↗

PubMed2002

Environmental, policy, and cultural factors related to physical activity in a diverse sample of women: the Women's Cardiovascular Health Network Project--introduction and methodology.

Ethnic minority and low-income populations have some of the highest rates of cardiovascular disease (CVD) and the highest rates of physical inactivity, an independent risk factor for CVD. Ethnic minority and low-income women are especially at risk. Because programs designed to increase physical activity have the potential to reduce CVD rates in specific populations, research in this area is expanding. As part of the Women's Cardiovascular Health Network funded by the Centers for Disease Control and Prevention, the goal of this multi-site project is to identify factors, particularly environmental, policy, and cultural factors, that may influence physical activity among ethnic minority and low-income women ages 20-50 years. To achieve this goal, 42 focus groups were conducted in various locations throughout the United States with African American, American Indian, Latina and White women. Groups represented both urban and rural living environments. This article explains the basis for this project and the methodology used. Other articles in this series explain the results from the focus groups in detail.

Adult↗

PubMed2002

Environmental, policy, and cultural factors related to physical activity among Latina immigrants.

According to national surveillance studies, participation in leisure-time physical activity remains low among minority women. Furthermore, the correlates of such activity in this group are not well understood. To better understand the environmental, policy, and sociocultural correlates of physical activity among Latina immigrants, six focus groups were conducted in rural North Carolina. Among the 49 participants, median age was 32 years and median education 11 years. Participants were first generation immigrants from Mexico (n = 43), El Salvador (n = 3), Colombia (n = 1), the Dominican Republic (n = 1), and Honduras (n = 1). Environmental and policy barriers to activity were identified, including transportation, lack of facilities, cost, and safety. Sociocultural correlates of activity included gender roles for activity, importance of support from the family and husband, child care issues tied to having few relatives who lived close by, language, and isolation in the community. The women suggested changes and programs that could promote physical activity through multiple channels, especially involving the family. This information can be used to develop culturally appropriate interventions to increase physical activity among Latinas.

Adult↗

PubMed2002

Environmental, policy, and cultural factors related to physical activity in a diverse sample of women: The Women's Cardiovascular Health Network Project--summary and discussion.

Ethnic minority and low-income populations have the highest rates of cardiovascular disease and the lowest rates of leisure-time physical activity. Because physical activity reduces the risk of premature death and disability from cardiovascular disease, researching correlates to such activity in these populations is an important aspect of health promotion in the US. To identify environmental, policy, and cultural barriers to physical activity in women, The Women's Cardiovascular Health Network Project conducted focus groups with White, African American, Latina, and American Indian women aged 20-50 years. The focus groups were audiotaped, transcribed, and analyzed with QSR NUD*IST qualitative software using a set of codes developed a priori by the research team. Family priorities were a main barrier to physical activity in all the groups. Having multiple roles as wife, mother, daughter, and as an active community member was mentioned as time-consuming and difficult, leaving little time or energy for exercise. Cultural barriers, which varied among the groups, included acculturation issues, lack of community support, and lack of past experience with exercise. Physical activity interventions suggested involved work programs, family-friendly programs, increased social support, and the availability of safer places to exercise such as parks, well-lit walking trails, and recreation centers. Many of the barriers were common to all groups (e.g., family priority) while some were unique (e.g., lack of community support). Assessing and addressing the issues raised should be considered when planning physical activity-interventions for these populations.

Adult↗