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Biomedical subjects

R R Pate

Publications and source records attributed to R R Pate.

At least 19 recordsLinked to original sources
PubMed2006

Implementation of a school environment intervention to increase physical activity in high school girls.

Physical activity levels begin to decline in childhood and continue falling throughout adolescence, with girls being at greatest risk for inactivity. Schools are ideal settings for helping girls develop and maintain a physically active lifestyle. This paper describes the design and implementation of 'Lifestyle Education for Activity Program', or LEAP. LEAP used a health team approach with participatory strategies to provide training and support, instructional capacity building and opportunities to adapt school instructional program and environmental supports to local needs. The social-ecological model, based on social cognitive theory, served as the organizing framework for the LEAP intervention and elements of the coordinated school health program model as intervention channels. For the 12 intervention schools, LEAP staff documented 191 visits and interactions with 850 individuals over the 2-year period. Teachers reported successful implementation of most components of the intervention and demonstrated optimism for sustainability. These results indicate that a facilitative approach to intervention implementation can be used successfully to engage school personnel, and to change instructional programs and school environments to increase the physical activity level of high school girls.

Adolescent↗
PubMed2005

Effect of exercise duration on plasma endothelin-1 concentration.

AIM: Endothelin-1 (ET-1) is a potent vasoconstricting peptide released mostly from vascular endothelial cells. Isolated exercise sessions of relatively long duration (=or>30 min) have produced increases in plasma ET-1 concentration while shorter exercise sessions usually have not. The purpose of the present study was to verify an effect of exercise duration at a steady work rate on plasma ET-1 concentration. METHODS: Eleven endurance-trained males (age 27+/-6 years; maximal oxygen consumption--VO2max--56+/-7 mLxkg-1xmin-1, body fat 11+/-5%; mean+/-SD) exercised on a treadmill at 70% VO2max on 2 occasions separated by at least 2 weeks. During a short-duration session, subjects expended approximately 3,360 kJ (60+/-2 min). During a long-duration session, subjects expended approximately 6,300 kJ (112+/-4 min). Six of the subjects performed the 3,360 kJ session before the 6,300 kJ session while the other 5 subjects performed the 6,300 kJ session first. RESULTS: The short-duration session did not cause plasma ET-1 concentration to change immediately after exercise (0.23+/-0.01 pmolxL-1 before exercise, 0.22+/-0.02 pmolxL-1 after exercise, mean+/-SE). However, 10 of 11 subjects had increased ET-1 after the long-duration session (0.28+/-0.02 pmolxL-1 before exercise, 0.32+/-0.02 pmolxL-1 after exercise, P=0.0004). A treatment-by-time effect was present (P=0.003). CONCLUSION: These results demonstrate an effect of exercise duration on plasma ET-1 concentration. Exercise duration is, therefore, an essential consideration when investigating exercise's effect on ET-1.

Adult↗
PubMed2003

Physical activity in overweight and nonoverweight preschool children.

OBJECTIVE: To compare the physical activity levels of overweight and non overweight 3- to 5-y-old children while attending preschool. A secondary aim was to evaluate weight-related differences in hypothesized parental determinants of child physical activity behavior. DESIGN: Cross-sectional study. SUBJECTS: A total of 245, 3- to 5-y-olds (127 girls, 118 boys) and their parent(s) (242 mothers, 173 fathers) recruited from nine preschools. Overweight status determined using the age- and sex-specific 85th percentile for body mass index (BMI) from CDC Growth Charts. MEASUREMENTS: Physical activity during the preschool day was assessed on multiple days via two independent objective measures-direct observation using the observation system for recording activity in preschools (OSRAP) and real-time accelerometry using the MTI/CSA 7164 accelerometer. Parents completed a take-home survey assessing sociodemographic information, parental height and weight, modeling of physical activity, support for physical activity, active toys and sporting equipment at home, child's television watching, frequency of park visitation, and perceptions of child competence. RESULTS: Overweight boys were significantly less active than their nonoverweight peers during the preschool day. No significant differences were observed in girls. Despite a strong association between childhood overweight status and parental obesity, no significant differences were observed for the hypothesized parental influences on physical activity behavior. CONCLUSIONS: Our results suggest that a significant proportion of overweight children may be at increased risk for further gains in adiposity because of low levels of physical activity during the preschool day.

Child, Preschool↗
PubMed2002

Factorial invariance and latent mean structure of questionnaires measuring social-cognitive determinants of physical activity among black and white adolescent girls.

BACKGROUND: We previously developed questionnaires based on contemporary theories to measure physical activity determinants among youth [Motl et al., Prev Med 2000; 31:584-94]. The present study examined the factorial invariance and latent mean structure of unidimensional models fit to the questionnaires measuring attitude, subjective norm, perceived behavioral control, and self-efficacy about physical activity among black and white adolescent girls. METHODS: Black (n = 896) and white (n = 823) girls in the 8th grade completed the questionnaires measuring attitude, subjective norm, perceived behavioral control, and self-efficacy about physical activity. The responses were subjected to analyses of factorial invariance and latent mean structure using confirmatory factor analysis with full-information maximum likelihood estimation in AMOS 4.0. RESULTS: The unidimensional models of the four questionnaires generally demonstrated invariance of the factor structure, factor loadings, and factor variance across race but not invariance of the variance-covariance matrices or item uniquenesses. The analyses of latent mean structure demonstrated that white girls had higher latent mean scores on the measures of attitude and self-efficacy than black girls; there were similar, but smaller, differences between white and black girls on the measures of subjective norm and perceived behavioral control. CONCLUSIONS: The questionnaires can be employed in interventions to test the mediating influences of attitude, subjective norm, perceived behavioral control, and self-efficacy on participation in physical activity by black and white adolescent girls.

Adolescent↗
PubMed2001

Associations between self-reported and objective physical environmental factors and use of a community rail-trail.

BACKGROUND: To effectively promote physical activIty, researchers and policy makers have advocated for greater use of environmental approaches, such as the construction of community paths and trails. However, research on the use of these facilities is limited. METHODS: In this cross-sectional community study, we examined associations between self-reported and objective physical environmental variables and use of the Minuteman Bikeway (Arlington, MA) in a random sample of 413 adults. Sociodemographic and perceived environmental variables were measured with a mail survey during September 1998. Geographic information system (GIS) data were used to geocode survey respondents' homes and create three objective environmental variables: distance to the Bikeway, steep hill barrier, and a busy street barrier. RESULTS: In logistic models, age and female gender showed statistically significant inverse associations with Bikeway use over the previous 4-week period. Increases in self-reported (OR = 0.65) and GIS distance (OR = 0.57) were associated with decreased likelihood of Bikeway use. Absence of self-reported busy street (OR = 2.01) and GIS steep hill barriers (OR = 1.84) were associated with Bikeway use. CONCLUSIONS: Environmental barriers such as travel distance and hilly terrain should be considered when planning community trails. A better understanding of such factors may lead to more effective promotion of trail use.

Adult↗
PubMed2001

Measuring enjoyment of physical activity in adolescent girls.

BACKGROUND: Enjoyment has been implicated as a determinant of physical activity among youth, but advances in understanding its importance have been limited by the use of measures that were not adequately validated. The present study examined: (1) the factorial validity of the Physical Activity Enjoyment Scale (PACES), and (2) the construct validity of PACES scores. METHODS: Adolescent girls (N=1797), who were randomly assigned to calibration (n=899) and cross-validation (n=898) samples, completed the PACES and measures of factors influencing enjoyment of physical education, physical activity, and sport involvement. The factorial validity of the PACES and the measure of factors influencing enjoyment of physical education was tested using exploratory and confirmatory factor analysis. The hypothesized relationships among the measures were tested using structural equation modeling. RESULTS: Unidimensional models fit the PACES and the measure of factors influencing enjoyment of physical education in the calibration and cross-validation samples. The hypothesized relationships between the PACES and the measures of factors influencing enjoyment of physical education, physical activity, and sport involvement were supported in the entire sample, were similar in African-American and Caucasian girls, and were independent of physical fitness. CONCLUSIONS: Evidence of factorial validity and convergent evidence for construct validity indicate that the PACES is a valid measure of physical activity enjoyment among adolescent girls, suitable for use as a mediator variable in interventions designed to increase physical activity.

Adolescent↗
PubMed2001

Physical activity and determinants of physical activity in obese and non-obese children.

OBJECTIVE: To compare the physical activity (PA) patterns and the hypothesized psychosocial and environmental determinants of PA in an ethnically diverse sample of obese and non-obese middle school children. DESIGN: Cross-sectional study. SUBJECTS: One-hundred and thirty-three non-obese and 54 obese sixth grade children (mean age of 11.4+/-0.6). Obesity status determined using the age-, race- and gender-specific 95th percentile for BMI from NHANES-1. MEASUREMENTS: Objective measurements were collected of PA over a 7-day period using the CSA 7164 accelerometer: total daily counts; daily moderate (3-5.9 METs) physical activity (MPA); daily vigorous physical activity (> or =6 METs; VPA); and weekly number of 5, 10 and 20 min bouts of moderate-to-vigorous physical activity (> or =3 METs, MVPA). Self-report measures were collected of PA self-efficacy; social influences regarding PA, beliefs about PA outcomes; perceived PA levels of parents and peers, access to sporting and/or fitness equipment at home, involvement in community-based PA organizations; participation in community sports teams; and hours spent watching television or playing video games. RESULTS: Compared to their non-obese counterparts, obese children exhibited significantly lower daily accumulations of total counts, MPA and VPA as well as significantly fewer 5, 10 and 20 min bouts of MVPA. Obese children reported significantly lower levels of PA self-efficacy, were involved in significantly fewer community organizations promoting PA and were significantly less likely to report their father or male guardian as physically active. CONCLUSIONS: The results are consistent with the hypothesis that physical inactivity is an important contributing factor in the maintenance of childhood obesity. Interventions to promote PA in obese children should endeavor to boost self-efficacy perceptions regarding exercise, increase awareness of, and access to, community PA outlets, and increase parental modeling of PA.

Australia↗
PubMed2001

Methods for estimating the maximal lactate steady state in trained cyclists.

PURPOSE: Maximal lactate steady state (MLSS) is the highest exercise intensity at which blood lactate concentration (HLa) remains stable. In this study, we examined the validity of simulated 5-km and 40-km time trials (TT) as methods for estimating average speed at MLSS in cyclists. METHODS: Nine trained cyclists reported to the laboratory for five to seven exercise trials. Testing included a VO2max test, a simulated 5-km and 40-km TT, and several 30-min MLSS trials. RESULTS: Mean VO2peak was 4.42 +/- 0.13 L.min-1, whereas VO2 at MLSS (N = 8) was 3.54 +/- 0.15 L.min-1, representing 80.1 +/- 4.1% of VO2peak. HR and HLa at MLSS were 174.7 +/- 2.6 b.min-1 and 6.9 +/- 0.8 mM, respectively. MLSS speed was 36.8 +/- 1.0 km.h-1, which corresponded to 92.1 +/- 1.2% of 5 km average speed (AVS5km). Mean AVS, HLa, and HR during the 40-km TT were 36.6 +/- 0.9 km.h-1, 6.3 +/- 0.7 mM, and 174.1 +/- 2.1 b.min-1, respectively, and did not differ from those at MLSS. CONCLUSIONS: Both the (simulated) 5-km and 40-km TT can be used to estimate the MLSS in cyclists. In addition, HLa at MLSS shows a large degree of variation between riders.

Adult↗
PubMed2001

Physical activity assessment in children and adolescents.

Chronic disease risk factors, including a sedentary lifestyle, may be present even in young children, suggesting that early prevention programmes may be critical to reducing the rates of chronic disease. Accurate assessment of physical activity in children is necessary to identify current levels of activity and to assess the effectiveness of intervention programmes designed to increase physical activity. This article summarises the strengths and limitations of the methods used to evaluate physical activity in children and adolescents. MEDLINE searches and journal article citations were used to locate 59 articles that validated physical activity measurement methods in children and adolescents. Only those methods that were validated against a more stringent measure were included in the review. Based on the definition of physical activity as any bodily movement resulting in energy expenditure (EE), direct observation of the individual's movement should be used as the gold standard for physical activity research. The doubly labelled water technique and indirect calorimetry can also be considered criterion measures for physical activity research, because they measure EE, a physiologic consequence closely associated with physical activity. Devices such as heart rate monitors, pedometers and accelerometers have become increasingly popular as measurement tools for physical activity. These devices reduce the subjectivity inherent in survey methods and can be used with large groups of individuals. Heart rate monitoring is sufficiently valid to use in creating broad physical activity categories (e.g. highly active, somewhat active, sedentary) but lacks the specificity needed to estimate physical activity in individuals. Laboratory and field validations of pedometers and accelerometers yield relatively high correlations using oxygen consumption (r = 0.62 to 0.93) or direct observation (r = 0.80 to 0.97) as criterion measures, although, they may not be able to capture all physical activity. Physical activity has traditionally been measured with surveys and recall instruments. These techniques must be used cautiously in a paediatric population that has difficulty recalling such information. Still, some studies have reported 73.4% to 86.3% agreement between these instruments and direct observation. Future investigations of physical activity instruments should validate the novel instrument against a higher standard. Additional studies are needed to investigate the possibility of improving the accuracy of measurement by combining 2 or more techniques. The accurate measurement of physical activity is critical for determining current levels of physical activity, monitoring compliance with physical activity guidelines, understanding the dose-response relationship between physical activity and health and determining the effectiveness of intervention programmes designed to improve physical activity.

Adolescent↗
PubMed2000

Sports participation and health-related behaviors among US youth.

OBJECTIVE: To examine the relationship between sports participation and health-related behaviors among high school students. DESIGN: Cross-sectional design using data from the 1997 Centers for Disease Control and Prevention Youth Risk Behavior Survey. PARTICIPANTS: A nationally representative sample of 14,221 US high school students. MAIN OUTCOME MEASURES: Prevalence of sports participation among males and females from 3 ethnic groups and its associations with other health behaviors, including diet, tobacco use, alcohol and illegal drug use, sexual activity, violence, and weight loss practices. RESULTS: Approximately 70% of male students and 53% of female students reported participating on 1 or more sports teams in school and/or nonschool settings; rates varied substantially by age, sex, and ethnicity. Male sports participants were more likely than male nonparticipants to report fruit and vegetable consumption on the previous day and less likely to report cigarette smoking, cocaine and other illegal drug use, and trying to lose weight. Compared with female nonparticipants, female sports participants were more likely to report consumption of vegetables on the previous day and less likely to report having sexual intercourse in the past 3 months. Among white males and females, several other beneficial health behaviors were associated with sports participation. A few associations with negative health behaviors were observed in African American and Hispanic subgroups. CONCLUSION: Sports participation is highly prevalent among US high school students, and is associated with numerous positive health behaviors and few negative health behaviors.

Adolescent↗
PubMed2000

Factorial validity and invariance of questionnaires measuring social-cognitive determinants of physical activity among adolescent girls.

BACKGROUND: There are few theoretically derived questionnaires of physical activity determinants among youth, and the existing questionnaires have not been subjected to tests of factorial validity and invariance. The present study employed confirmatory factor analysis (CFA) to test the factorial validity and invariance of questionnaires designed to be unidimensional measures of attitudes, subjective norms, perceived behavioral control, and self-efficacy about physical activity. METHODS: Adolescent girls in eighth grade from two cohorts (N = 955 and 1,797) completed the questionnaires at baseline; participants from cohort 1 (N = 845) also completed the questionnaires in ninth grade (i.e., 1-year follow-up). Factorial validity and invariance were tested using CFA with full-information maximum likelihood estimation in AMOS 4.0. Initially, baseline data from cohort 1 were employed to test the fit and, when necessary, to modify the unidimensional models. The models were cross-validated using a multigroup analysis of factorial invariance on baseline data from cohorts 1 and 2. The models then were subjected to a longitudinal analysis of factorial invariance using baseline and follow-up data from cohort 1. RESULTS: The CFAs supported the fit of unidimensional models to the four questionnaires, and the models were cross-validated, as indicated by evidence of multigroup factorial invariance. The models also possessed evidence of longitudinal factorial invariance. CONCLUSIONS: Evidence was provided for the factorial validity and the invariance of the questionnaires designed to be unidimensional measures of attitudes, subjective norms, perceived behavioral control, and self-efficacy about physical activity among adolescent girls.

Adolescent↗
PubMed2000

Using objective physical activity measures with youth: how many days of monitoring are needed?

PURPOSE: The purpose of this study was to establish the minimal number of days of monitoring required for accelerometers to assess usual physical activity in children. METHODS: A total of 381 students (189 M, 192 F) wore a CSA 7164 uniaxial accelerometer for seven consecutive days. To examine age-related trends students were grouped as follows: Group I: grades 1-3 (N = 92); Group II: grades 4-6 (N = 98); Group III: grades 7-9 (N = 97); Group IV: grades 10-12 (N = 94). Average daily time spent in moderate-to-vigorous physical activity (MVPA) was calculated from minute-by-minute activity counts using the regression equation developed by Freedson et al. (1997). RESULTS: Compared with adolescents in grades 7 to 12, children in grades 1 to 6 exhibited less day-to-day variability in MVPA behavior. Spearman-Brown analyses indicated that between 4 and 5 d of monitoring would be necessary to a achieve a reliability of 0.80 in children, and between 8 and 9 d of monitoring would be necessary to achieve a reliability of 0.80 in adolescents. Within all grade levels, the 7-d monitoring protocol produced acceptable estimates of daily participation in MVPA (R = 0.76 (0.71-0.81) to 0.87 (0.84-0.90)). Compared with weekdays, children exhibited significantly higher levels of MVPA on weekends, whereas adolescents exhibited significantly lower levels of MVPA on weekends. Principal components analysis revealed two distinct time components for MVPA during the day for children (early morning, rest of the day), and three distinct time components for MVPA during the day for adolescents (morning, afternoon, early evening). CONCLUSIONS: These results indicate that a 7-d monitoring protocol provides reliable estimates of usual physical activity behavior in children and adolescents and accounts for potentially important differences in weekend versus weekday activity behavior as well as differences in activity patterns within a given day.

Acceleration↗
PubMed2000

Moderate-intensity physical activity and fasting insulin levels in women: the Cross-Cultural Activity Participation Study.

OBJECTIVE: The purpose of this study was to determine the association between moderate-intensity physical activity (PA) and fasting insulin levels among African-American (n = 47), Native American (n = 46), and Caucasian women (n = 49), aged 40-83 years, enrolled in the Cross-Cultural Activity Participation Study. Associations by race/ethnicity, levels of central obesity, and cardiorespiratory fitness were also examined. RESEARCH DESIGN AND METHODS: Physical activity scores were obtained from detailed PA records that included all PA performed during two consecutive 4-day periods scheduled 1 month apart. Using MET intensity (the associated metabolic rate for a specific activity divided by a standard resting metabolic rate), PA was expressed as MET-min (the product of the minutes for each activity times the MET intensity level) per day of energy expended in moderate (3-6 METs) and moderate/vigorous (> or = 3 METs) PA. Fasting insulin levels were determined by radioimmunoassay. Data were analyzed by multiple linear regression analysis. RESULTS: After adjusting for race/ethnicity, age, educational attainment, and site, an increase of 30 min of moderate-intensity PA was associated with a 6.6% lower fasting insulin level (P < 0.05). The association was similar among races/ethnicities, centrally lean and centrally obese women, and women with low and high cardiorespiratory fitness levels. CONCLUSIONS: These findings lend support to the 1995 Centers for Disease Control and Prevention and American College of Sports Medicine recommendations for an accumulation of 30 min/day in moderate-intensity PA. They also contribute to the growing literature suggesting that moderate amounts of PA have a significant role in reducing the burden of hyperinsulinemia and diabetes among ethnic populations at highest risk for these conditions.

Black or African American↗
PubMed1999

Correlates of objectively measured physical activity in preadolescent youth.

OBJECTIVE: The purpose of this study was to identify the psychosocial and environmental correlates of objectively measured physical activity behavior in a diverse sample of sixth-grade students. DESIGN: Cross-sectional. PARTICIPANTS AND SETTINGS: One hundred ninety-eight sixth-grade students from 4 public middle schools in Columbia, South Carolina. The study group was 52.0% female, 55.1% African-American, with a mean age of 11.4 +/- 0.6 years. MAIN OUTCOME MEASURES: Time spent in moderate physical activity (MPA) and vigorous physical activity (VPA) was assessed using a uniaxial accelerometer (CSA WAM 7164) (Computer Science and Applications Inc., Shalimar, FL). Determinant variables included: age, gender, race/ethnicity (demographic); physical activity self-efficacy, social norms related to physical activity, and beliefs regarding physical activity outcomes (psychosocial); and perceived physical activity habits of parents and peers, involvement in community physical activity organizations, involvement in community-based sports programs, access to fitness/sporting equipment at home, and self-reported hours spent watching television or playing video games (environmental). RESULTS: For boys, physical activity self-efficacy, social norms related to physical activity, and involvement in community physical activity organizations were salient predictors of MPA and VPA. Among girls, only physical activity self-efficacy emerged as a clear predictor of objectively measured physical activity. CONCLUSIONS: These findings are consistent with previous studies using self-reported physical activity and suggest that interventions to increase physical activity in preadolescent youth should endeavor to boost physical activity self-efficacy by offering a wide selection of enjoyable, developmentally-appropriate physical activity options.

Child↗
PubMed1999

Tracking of avoidance of alcohol use and smoking behavior in a fifth grade cohort over three years.

This study examined the maintenance of positive health behavior (avoidance of alcohol use and cigarette smoking) and factors associated with the maintenance of these behaviors from fifth through seventh grade by a cohort of rural students (N = 232). African American and White students showed similar patterns of high avoidance of alcohol until seventh grade. Although more girls avoided use than boys, avoidance decreased in both groups with progression in grade. Mothers', fathers', and best friends' drinking behaviors influenced avoidance behavior; drinking was less likely to occur among those whose parents and friends did not drink. Friends' drinking behavior influenced alcohol use as early as fifth grade. Smoking avoidance was maintained by 74% of the students over the 3 years. Although there were no racial differences in smoking, African Americans started smoking about 1 year earlier than Whites. During seventh grade, an increase in smoking occurred among boys and girls, but was particularly striking among girls. Avoidance of smoking was influenced by mothers' behavior but not fathers'. Best friends' smoking behavior exerted a major influence on avoidance between grades 6 and 7. In grades 5 and 6, those who avoided smoking were more physically active than smokers, but by seventh grade their physical activity declined to a similar level as smokers. Rural adolescent boys seemed to be at early risk for alcohol use and smoking, while rural girls delayed involvement by 1 to 2 years. Communities, schools, and families can help adolescents avoid alcohol use and smoking through early prevention efforts.

Black or African American↗
PubMed1999

Effects of acute exercise on plasma erythropoietin levels in trained runners.

PURPOSE: The purpose of this study was to investigate further the influence of exercise on erythropoietin. METHODS: We observed the effects of high intensity running on plasma erythropoietin concentration in competitive distance runners. A repeated measures design was used to compare the responses of intermittent high intensity (HIGH) exercise to continuous moderate intensity (MOD) exercise and rest (REST). The HIGH treatment consisted of 60 min of exercise alternating 5 min of running at approximately 90% of VO2max with 5 min of brisk walking. The MOD treatment consisted of a continuous 60-min run on the treadmill at 60% of VO2max. Blood samples were collected immediately before the exercise (PRE), immediately following the exercise (POST), and 4 (heart rate (4HR), 12 (12HR), 24 (24HR), and 48 (48HR)) h following the exercise. The variables examined included plasma erythropoietin concentration ([EPO]), hemoglobin (Hb) concentration ([Hb]), hematocrit (Hct), red blood cell count (RBC), and mean corpuscular volume (MCV). RESULTS: ANOVA revealed the expected treatment-by-time interaction for Hct and [Hb] suggesting a hemodilution at 24 and 48 h postexercise for the MOD and HIGH treatments. However, no significant treatment-by-time interactions were observed for [EPO], RBC, or MCV. CONCLUSION: These results indicate that intermittent high intensity exercise does not have a significant effect on [EPO] in trained distance runners.

Adult↗
PubMed1999

Determinants of physical activity in active and low-active, sixth grade African-American youth.

This study compared the determinants of physical activity in active and low-active African-American sixth grade students (N = 108, 57 F, 51 M). Objective assessments of physical activity over a seven-day period were obtained using the CSA 7164 accelerometer. Students were classified as active if they exhibited three or more 20-minute bouts of moderate to vigorous physical activity over the seven-day period. Relative to low-actives, active boys reported significantly higher levels of self-efficacy, greater involvement in community physical activity organizations, and were significantly more likely to perceive their mother as active. Relative to low-actives, active girls reported significantly higher levels of physical activity self-efficacy, greater positive beliefs regarding physical activity outcomes, and were significantly less likely to watch television or play video games for > or = 3 hrs/day. These observations provide preliminary guidance as to the design of physical activity interventions targeted at African-American youth.

Black or African American↗