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Biomedical subjects

Thomas L Schmid

Publications and source records attributed to Thomas L Schmid.

9 recordsLinked to original sources

Are self-reported physical activity levels associated with perceived desirability of activity-friendly communities?

People living in activity-friendly communities (AFCs) are more active but the self-selection influence is unknown. From 4856 respondents we explored mediating variables with expressed desire to live in AFCs. Association with desire to live in AFCs included ages 18-24 years (odds ratio [OR]=1.9), African American (OR=1.9) or Hispanic (OR=1.5), and believing AFCs would support activity-based transportation (OR=2.4). Regular physical activity (PA) was marginally associated with desire to live in AFCs (OR=1.3). These findings suggest that PA may be a significant factor in communities of this style. Strategies for social marketing along with changes to the built environment to increase PA levels are discussed.

Adolescent↗

Characteristics of physical activity levels among trail users in a U.S. national sample.

BACKGROUND: The Task Force on Community Preventive Services strongly recommends environmental interventions that include enhanced access to opportunities for physical activity, such as walking and cycling trails. Although accumulating evidence indicates that trails can be effective in increasing physical activity, little is known about trail users. METHODS: Cross-sectional analysis of a national sample of 3717 adults from the HealthStyles and ConsumerStyles surveys using logistic regression to determine physical activity patterns and sociodemographic correlates related to trail use, and to identify support regarding trail development policies. RESULTS: Almost 13% (12.7%) of the sample reported using trails at least once a month and 24.3% at least once a week. People who reported using trails at least once a week were twice as likely than people who reported rarely or never using trails to meet physical activity recommendations (odds ratio=2.3, 95% confidence interval=1.9-2.8). Nearly half (43.6%) of the non-trail users supported expanded public spaces for people to exercise, and 36.4% of the non-trail users reported that they would be willing to pay more taxes to build more parks and trails in their community. CONCLUSIONS: Community trails facilitate physical activity, and almost half of frequent trail users report that access to trails and other green space is important in choosing a place to live. These results support the need for prospective research on whether newly built trails promote physical activity in previously inactive people.

Adolescent↗

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↗

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↗

Linking objectively measured physical activity with objectively measured urban form: findings from SMARTRAQ.

BACKGROUND: To date, nearly all research on physical activity and the built environment is based on self-reported physical activity and perceived assessment of the built environment. OBJECTIVE: To assess how objectively measured levels of physical activity are related with objectively measured aspects of the physical environment around each participant's home while controlling for sociodemographic covariates. METHODS: Objective measures of the built environment unique to each household's physical location were developed within a geographic information system to assess land-use mix, residential density, and street connectivity. These measures were then combined into a walkability index. Accelerometers were deployed over a 2-day period to capture objective levels of physical activity in 357 adults. RESULTS: Measures of land-use mix, residential density, and intersection density were positively related with number of minutes of moderate physical activity per day. A combined walkability index of these urban form factors was significant (p =0.002) and explained additional variation in the number of minutes of moderate activity per day over sociodemographic covariates. Thirty-seven percent of individuals in the highest walkability index quartile met the > or =30 minutes of physical activity recommended, compared to only 18% of individuals in the lowest walkability quartile. Individuals in the highest walkability quartile were 2.4 times more likely (confidence interval=1.18-4.88) than individuals in the lowest walkability quartile to meet the recommended > or =30 minutes of moderate physical activity per day. CONCLUSIONS: This research supports the hypothesis that community design is significantly associated with moderate levels of physical activity. These results support the rationale for the development of policy that promotes increased levels of land-use mix, street connectivity, and residential density as interventions that can have lasting public health benefits.

Adult↗

A community-based approach to promoting walking in rural areas.

BACKGROUND: Ecologic models are often recommended to promote physical activity, yet sparse data exist on their effectiveness. DESIGN: A quasi-experimental design examined changes in walking behavior in six rural intervention communities in the Missouri "bootheel" region and in six comparison communities in Arkansas and Tennessee. SETTING/ PARTICIPANTS: The communities ranged in population from 2399 to 17,642; interventions focused on adults aged >/=18 years. INTERVENTION: Interventions were developed with community input and included individually tailored newsletters, interpersonal activities that stressed social support, and community-wide events such as walk-a-thons. MAIN OUTCOME MEASURES: Primary outcomes were rates of walking-trail use, total number of minutes walked in the past week, and total minutes walked for exercise. RESULTS: Among persons who used trails at baseline (16.9% of the total population), 32.1% reported increases in physical activity since they began using the trail. From community-wide samples, two subgroups indicated a positive net change in rates of 7-day total walking: people with high school degrees or less and people living in households with annual incomes of <==$20,000. However, no studied group showed a statistically significant net intervention effect. CONCLUSIONS: Although there was an increase in the rate of walking-trail use, a community-wide change in walking rates in rural communities was not documented. Results of this study should provide guidance for future projects.

Adolescent↗

Obesity relationships with community design, physical activity, and time spent in cars.

BACKGROUND: Obesity is a major health problem in the United States and around the world. To date, relationships between obesity and aspects of the built environment have not been evaluated empirically at the individual level. OBJECTIVE: To evaluate the relationship between the built environment around each participant's place of residence and self-reported travel patterns (walking and time in a car), body mass index (BMI), and obesity for specific gender and ethnicity classifications. METHODS: Body Mass Index, minutes spent in a car, kilometers walked, age, income, educational attainment, and gender were derived through a travel survey of 10,878 participants in the Atlanta, Georgia region. Objective measures of land use mix, net residential density, and street connectivity were developed within a 1-kilometer network distance of each participant's place of residence. A cross-sectional design was used to associate urban form measures with obesity, BMI, and transportation-related activity when adjusting for sociodemographic covariates. Discrete analyses were conducted across gender and ethnicity. The data were collected between 2000 and 2002 and analysis was conducted in 2004. RESULTS: Land-use mix had the strongest association with obesity (BMI >/= 30 kg/m(2)), with each quartile increase being associated with a 12.2% reduction in the likelihood of obesity across gender and ethnicity. Each additional hour spent in a car per day was associated with a 6% increase in the likelihood of obesity. Conversely, each additional kilometer walked per day was associated with a 4.8% reduction in the likelihood of obesity. As a continuous measure, BMI was significantly associated with urban form for white cohorts. Relationships among urban form, walk distance, and time in a car were stronger among white than black cohorts. CONCLUSIONS: Measures of the built environment and travel patterns are important predictors of obesity across gender and ethnicity, yet relationships among the built environment, travel patterns, and weight may vary across gender and ethnicity. Strategies to increase land-use mix and distance walked while reducing time in a car can be effective as health interventions.

Adult↗

Local ordinances that promote physical activity: a survey of municipal policies.

In this Utah-based study, we sought to identify the types of municipal employees responsible for physical activity policies, identify municipal ordinances that may influence physical activity, and determine local governments' intentions to implement policies. In 2001, we mailed a survey to all of the state's municipalities with the goal of measuring 6 physical activity domains: sidewalks, bicycle lanes, shared-use paths, work sites, greenways, and recreational facilities. Data from 74 municipalities revealed that planners made up a small proportion of municipal staff. Relative to cities experiencing slow or medium growth, high growth cities reported more ordinances encouraging physical activity. Physical activity policies can be monitored across municipalities. Moreover, evidence-based public health practice provides direction for limited staff and funding resources.

Bicycling↗

Policy tools for the childhood obesity epidemic.

The rapid increases in childhood and adolescent overweight between 1980 and 1999 can only be explained by environmental factors. Historically, the most effective strategies to address nutritional problems that have caused such widespread disease have been policy-driven environmental changes. To develop effective public policy responses to the obesity epidemic, we must expand the science base linking environmental conditions and policies to health behaviors and conditions; establish effective intersectoral coalitions of stakeholders; and create effective policy at the national and state levels. Although the childhood obesity epidemic is still evolving, this article provides several examples of potentially effective strategic approaches to address it.

Adolescent↗