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Biomedical subjects

Michael Pratt

Publications and source records attributed to Michael Pratt.

At least 19 recordsLinked to original sources
PubMed2006

Dissemination of physical activity evidence, programs, policies, and surveillance in the international public health arena.

The concepts of dissemination can be applied to the international challenges of promoting physical activity. With the 2004 release of the World Health Organization Global Strategy for Diet and Physical Activity, risk factor reduction and noncommunicable disease control are of global health interest. A six-step framework is proposed for understanding the attributes of successful international dissemination. These include the development of clear and evidence based resources or innovations, defining the target audience, selecting communication channels, engaging decision makers, and developing evaluation frameworks around dissemination. Four case studies to illustrate aspects of the framework are presented: (1) learning from dissemination of effective tobacco control initiatives, (2) the experience of developing global measures and surveillance systems for physical activity, (3) case study of disseminating the Agita program-an effective community wide intervention, and (4) disseminating the World Health Organization Global Strategy on Diet and Physical Activity. Substantial similarities across the experiences described in these case studies suggest underlying common themes for international dissemination, but developing a stronger evidence base for dissemination efforts remains a research priority.

Diffusion of Innovation↗
PubMed2006

A framework for evaluating community-based physical activity promotion programmes in Latin America.

A growing interest in promoting physical activity through multi-sectoral community-based programmes has highlighted the need for effective programme evaluation. Meeting in Rio de Janeiro, an international workgroup of behavioural, medical, public health and other scientists and practitioners endorsed the principle of careful evaluation of all programmes and in a consensus process developed the Rio de Janeiro Recommendations for Evaluation of Physical Activity Interventions". Among these recommendations and principles were that when possible, evaluation should 'built into' the programme from the beginning. The workgroup also called for adequate funding for evaluation, setting a goal of about 10% of programme resources for evaluation. The group also determined that evaluations should be developed in conjunction with and the results shared with all appropriate stakeholders in the programme; evaluations should be guided by ethical standards such as those proposed by the American Evaluation Association and should assess programme processes as well as outcomes; evaluation outcomes should be used to revise and refine ongoing programmes and guide decisions about programme continuation or expansion. It was also recognised that additional training in programme evaluation is needed and the Centers for Disease Control and Prevention's Physical Activity Evaluation Handbook could be easily adapted for use in culturally diverse communities, especially in Latin America. This paper describes a 6-step evaluation process and provides the full set of recommendations from the Rio de Janeiro Workgroup. The handbook has been translated and additional case studies from Colombia and Brazil have been added. Spanish and Portuguese language editions of the Evaluation Handbook are available from the Centers for Disease Control and Prevention, Physical Activity and Health Branch.

Community Networks↗
PubMed2006

Implementing national population-based action on physical activity--challenges for action and opportunities for international collaboration.

This paper summarises recent past and current international developments on physical activity looking at the challenges and opportunities they pose. Key elements of the WHO's Global Strategy on Diet, Physical Activity and Health (GSDPAH) are summarised, focusing specifically on the physical activity components, and by drawing upon recent fora (Atlanta, October 2002; Miami, December 2004; Cascais, February 2005; Beijing, October 2005; Bogotá, November 2005), we outline the barriers and areas of support required for successful development and implementation of national, population-based action on physical activity. These gatherings focused particularly on the needs of developing countries, where to date little has been done to augment physical activity at a population level. Unless swift action is taken, these countries will soon suffer significantly from an increased prevalence of non communicable diseases (NCD). Existing initiatives and opportunities for national and international action on physical activity are identified. Specific actions are proposed for advocacy, communication and dissemination, networks and partnerships, fundraising, policy development and implementation, programme implementation and evaluation, surveillance and capacity building. The development of the Global Alliance for Physical Activity (GAPA) provides a structure for international collaboration.

Developing Countries↗
PubMed2006

Muévete Bogotá: promoting physical activity with a network of partner companies.

In 1998 the mayor's office and the District Institute for Sports and Recreation created Muévete Bogotá, a physical activity and health promotion programme for the capital city of Colombia. Muévete means to move or to be active, and this campaign to promote physical activity was designed to improve the health and quality of life of the citizens of Bogotá through regular physical activity. The programme is based on the 1995 recommendations on physical activity of the U.S. Centers for Disease Control and Prevention and the American College of Sports Medicine (Pate el al, 1995), and was developed in close consultation with the Agita São Paulo programme in Brazil (Matsudo el al., 2003). Muévete Bogotá couples a mass media campaign with programmes targeted to change physical activity behaviour. The interventions, which are conducted at work sites, schools, health care centers and in community settings rely on partnerships created among professionals in areas of education and health, business officials and personnel, and community members, to deliver the programmes in each of these settings and populations. Like many developing countries, Colombia suffers from a growing epidemic of chronic diseases. In 1993 35.7% of total mortality in the city of Bogotá was due to chronic diseases (Espinosa, 1993). In 2002 cardiovascular diseases accounted for 40.3% of mortality among the population aged 60 years or older and 26.8% for persons 45 to 59 years of age. (Cardona, 2002) Bogotá has implemented extensive physical and social environmental changes over the last decade, which has increased opportunities for physical activity, but sedentary lifestyle continues to be a significant public health problem in the city. Programmes such as Muévete Bogotá that educate and motivate the population to become more physically active appear to be needed to complement the underlying environmental and policy changes. Muévete Bogotá provides an example of successful implementation of a comprehensive multi-sectoral approach to physical activity promotion in a large metropolitan area. This model may be used as an exemplary effort elsewhere in Latin America and in urban areas in developing countries around the world.

Colombia↗
PubMed2005

A cost-benefit analysis of physical activity using bike/pedestrian trails.

From a public health perspective, a cost-benefit analysis of using bike/pedestrian trails in Lincoln, Nebraska, to reduce health care costs associated with inactivity was conducted. Data was obtained from the city's 1998 Recreational Trails Census Report and the literature. Per capita annual cost of using the trails was 209.28 U.S. dollars (59.28 U.S. dollars construction and maintenance, 150 U.S. dollars of equipment and travel). Per capita annual direct medical benefit of using the trails was 564.41 U.S. dollars. The cost-benefit ratio was 2.94, which means that every 1 U.S. dollar investment in trails for physical activity led to 2.94 U.S. dollars in direct medical benefit. The sensitivity analyses indicated the ratios ranged from 1.65 to 13.40. Therefore, building trails is cost beneficial from a public health perspective. The most sensitive parameter affecting the cost-benefit ratios were equipment and travel costs; however, even for the highest cost, every 1 U.S. dollar investment in trails resulted in a greater return in direct medical benefit.

Bicycling↗
PubMed2004

Economic interventions to promote physical activity: application of the SLOTH model.

Physical inactivity is responsible for major health and economic costs in the United States. Despite widespread recognition of the scope and importance of the problem of physical inactivity, only modest progress has been made in improving overall physical activity in the U.S. population. This paper applies a combined economic and public health perspective to better understand physical activity behavior and to guide a search for promising new economically oriented interventions to increase physical activity at the population level. This perspective is operationalized as the SLOTH model-a time-budget model incorporating Sleep, Leisure, Occupation, Transportation, and Home-based activities. Key economic forces that may influence individuals' choices about utilization of time and physical activity are identified. Potential interventions are proposed in response to each of the important forces and are evaluated on four criteria: (1) economic efficiency, (2) equity, (3) effectiveness, and (4) feasibility. The SLOTH model provides guidance regarding interventions that might increase physical activity in each of the four nonsleep domains. Economic intervention strategies are proposed and compared to economic and public health criteria. The results provide a starting point for selecting and evaluating potentially effective and feasible economic interventions that might be implemented as part of a larger effort to address the health crisis of inactive lifestyles and obesity.

Exercise↗
PubMed2004

Cost effectiveness of a bicycle/pedestrian trail development in health promotion.

BACKGROUND: A persistently low population level of physical activity is a challenge for public health. Data on cost effectiveness of environmental interventions are needed to inform the development and implementing of such interventions. OBJECTIVE: To conduct cost-effectiveness analysis of bicycle/pedestrian trails. DESIGN: The costs of trail development and number of users of four trails in Lincoln, NE, were obtained. The costs were adjusted to 2003 dollars. The physical activity-related outcomes/items are number of users who were more physically active since they began using the trails, number of users who were physically active for general health, and number of users who were physically active for weight loss. Cost-effectiveness measures were derived. Sensitivity analysis was performed. RESULTS: The annual trail development cost US$289,035, 73% of which was construction cost. Of the 3,986 trail users, 88% were active at least 3 days a week. The average annual cost for persons becoming more physically active was US$98 (range US$65-253); the cost was US$142 (range US$95-366) for persons who are active for general health, and US$884 (range US$590-2,287) for persons who are active for weight loss. CONCLUSION: This analysis provides basic cost-effectiveness measures of bicycle/pedestrian trails. Policymakers can use this information in making resource allocation decisions.

Adult↗
PubMed2004

Promoting physical activity in the Americas.

Physical inactivity, obesity, and noncommunicable disease rates are rapidly climbing to epidemic proportions and are becoming the leading causes of death and disability in the Americas and globally. The causes are complex and will require a multifaceted, multisectoral approach. Recognizing this, the World Health Organization adopted a broad-ranging process to develop a Global Strategy for the Promotion of Diet, Physical Activity, and Health, as mandated by the World Health Assembly in May 2002. The results of the yearlong effort are to be presented at the World Health Assembly in May 2004.

Central America↗
PubMed2004

Cost analysis of the built environment: the case of bike and pedestrian trials in Lincoln, Neb.

We estimated the annual cost of bike and pedestrian trails in Lincoln, Neb, using construction and maintenance costs provided by the Department of Parks and Recreation of Nebraska. We obtained the number of users of 5 trails from a 1998 census report. The annual construction cost of each trail was calculated by using 3%, 5%, and 10% discount rates for a period of useful life of 10, 30, and 50 years. The average cost per mile and per user was calculated. Trail length averaged 3.6 miles (range = 1.6-4.6 miles). Annual cost in 2002 dollars ranged from 25,762 to 248,479 (mean = 124,927; median = 171,064). The cost per mile ranged from 5735 to 54,017 (mean = 35,355; median = 37,994). The annual cost per user was 235 (range = 83-592), whereas per capita annual medical cost of inactivity was 622. Construction of trails fits a wide range of budgets and may be a viable health amenity for most communities. To increase trail cost-effectiveness, efforts to decrease cost and increase the number of users should be considered.

Bicycling↗
PubMed2003

International physical activity questionnaire: 12-country reliability and validity.

BACKGROUND: Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. METHODS: Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. RESULTS: Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. CONCLUSIONS: The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.

Adolescent↗
PubMed2003

The impact of community design and land-use choices on public health: a scientific research agenda.

The design of a community's built environment influences the physical and mental health of its residents. Because few studies have investigated this relationship, the Centers for Disease Control and Prevention hosted a workshop in May 2002 to help develop a scientific research agenda on these issues. Workshop participants' areas of expertise included physical activity, injury prevention, air pollution, water quality, urban planning, transportation, architecture, epidemiology, land use, mental health, social capital, housing, and social marketing. This report describes the 37 questions in the resulting research agenda. The next steps are to define priorities and obtain resources. The proposed research will help identify the best practices for designing new communities and revitalizing old ones in ways that promote physical and mental health.

Centers for Disease Control and Prevention, U.S.↗
PubMed2002

Preliminary evaluation of a multicomponent program for nutrition and physical activity change in primary care: PACE+ for adults.

BACKGROUND: Patient-centered Assessment and Counseling on Exercise plus nutrition (PACE+) is an intervention based in primary care settings to help patients change physical activity and dietary behaviors. METHODS: One hundred seventy-three adults were assessed before and after a 4-month intervention. All patients completed a computerized assessment and created tailored "action plans" to change one physical activity and one nutrition behavior that they then discussed with their provider. After the visit, subjects were randomized to one of four extended intervention conditions: control, mail only, infrequent phone and mail, and frequent phone and mail. Self-report of five target behaviors (moderate and vigorous physical activity stage of change, dietary fat, fruit/vegetable intake, and overeating behaviors) was collected at baseline and 4 months. Acceptability measures were also taken. RESULTS: Participants in all conditions improved on all behaviors over time, supporting the utility of the computer and provider counseling components. The extended intervention did not produce differential results with respect to mode (phone or mail) or intensity (frequent or infrequent). However, for each behavior, participants who targeted the behavior to change improved significantly more than those who did not target the behavior. Acceptability of the intervention was high. CONCLUSIONS: Primary care-based, interactive health communication to improve physical activity and dietary behavior is feasible and has promising initial results.

Adult↗
PubMed2002

Pediatrician counseling about preventive health topics: results from the Physicians' Practices Survey, 1998-1999.

OBJECTIVE: Government agencies and national organizations recommend that physicians counsel their child and adolescent patients about preventive health topics. Using data from a national survey, we describe the counseling patterns of pediatricians in regard to 9 recommended preventive health topics. METHODOLOGY: Between October 1998 and April 1999, information was collected from 907 of 1760 primary care pediatricians randomly selected from a nationally representative sample. Through either a telephone interview or a mail survey, pediatricians were asked how frequently in the past month they counseled about 9 preventive health topics during the well-care visits or routine check-ups of their patients. Pediatricians answered questions regarding their patients aged 2 to 5, 6 to 12, and 13 to 18 years. RESULTS: Over 80% of the pediatricians counseled about 1 or more recommended preventive health topics during the well-care visits or routine check-ups of their patients. As compared with pediatricians who did not counsel about any topic, pediatricians who counseled were significantly more likely to be female and spend longer amounts of time with their patients during these visits. The frequency with which specific preventive health topics were discussed varied with the topic and the age of the patient. CONCLUSION: Most pediatricians routinely counsel about some, but not all, recommended preventive health topics. An understanding of why pediatricians selectively counsel about specific topics is needed.

Adolescent↗
PubMedDate not supplied

Physical activity policy and program development: the experience in Finland.

This article describes the development of sports and physical activity policies and programs in Finland during the past 30 years. The past two decades have been marked by a shift in emphasis from competitive and elite sports to health-enhancing physical activity for all, as seen most clearly in two successive sports acts and a government resolution. The new, increasingly multisectoral policies have led to substantial changes in the public funding of sports organizations, services, and construction of sports sites. Furthermore, three successive five-year national physical activity promotion programs have been launched. As a result, increased and new types of opportunities to participate in physical activity have become available, and the infrastructure and networks for provision of services have been strengthened. Until the mid 1990s, leisure time physical activity increased in Finland, but during the last seven to eight years, both leisure time and commuting physical activity have been stable. This finding may be an indication of the difficulty to increase physical activity in an industrialized country with already relatively high levels of physical activity even when systematic, long-term policies and measures are applied.

Exercise↗
PubMedDate not supplied

Physical Activity Policy Development: a synopsis of the WHO/CDC Consultation, September 29 through October 2, 2002, Atlanta, Georgia.

Physical activity is an important part of the World Health Organization's integrated approach to the prevention and control of noncommunicable disease and the promotion of health, and, in particular, to the evolving World Health Organization Global Strategy on Diet and Physical Activity. To assist in these efforts, a joint World Health Organization/Centers for Disease Control and Prevention Consultation on Physical Activity Policy Development took place in Atlanta, Georgia, from September 29 through October 2, 2002. This article summarizes the context and outcomes of the consultation. It also includes elaboration of a Comprehensive Physical Activity Policy Framework developed as a product of the meeting.

Centers for Disease Control and Prevention, U.S.↗