Perceptions of neighborhood environment for physical activity: is it "who you are" or "where you live"?

Lack of physical activity among American adults is a serious public health concern. Many factors influence activity levels, and most research has focused on either individual factors, such as race and income, or on characteristics of the physical environment, such as the availability of parks. Our study used a cross-sectional multilevel design to examine the influences of individual- and neighborhood-level characteristics on participant's perceptions of their neighborhood as an appropriate venue for physical activity.

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.

Developing and using the Guide to Community Preventive Services: lessons learned about evidence-based public health.

The Guide to Community Preventive Services (Community Guide) is being developed under the leadership of the independent, nonfederal Task Force on Community Preventive Services. The Task Force makes recommendations for the use of public health programs and policies based on scientific evidence about what practices have worked to improve health. The Community Guide thoroughly searches scientific literature for topic-relevant studies, evaluates their quality according to established criteria, and makes recommendations based on the overall strength of the body of evidence and the size and variability of reported effects.

Linking perceptions of the community to behavior: are protective social factors associated with physical activity?

Although the relationship of psychosocial factors to physical activity has been explored, there is increased interest in how perceptions of the community environment influence behavior. However, few methodological studies have incorporated perceptions of the social and community environment (protective social factors) or addressed key measurement issues. Computer-assisted telephone interviews were administered to a national sample of 1,818 U.

Opportunities for integrating public health and urban planning approaches to promote active community environments.

The growing emphasis on promoting environmental change as a means to increase physical activity has motivated conversation and collaboration between researchers and practitioners in the fields of public health and urban planning. Although these fields share similar objectives, their methodological approaches for examining the association between the environment and behavior often differ in significant ways. To facilitate communication, this article discusses ways these fields can collaborate in developing and applying conceptual frameworks, adopting behavioral and environmental measures, and strengthening study designs.

The epidemiology of walking for physical activity in the United States.

Purpose: The purpose of this paper was to describe the epidemiology of walking for physical activity among respondents to the U.S. Physical Activity Study.

Assessing the competencies and training needs for public health professionals managing chronic disease prevention programs.

The purpose of this study was to assess the competencies and training needs for public health professionals managing chronic disease prevention programs. Focus groups were conducted among representatives from 12 state health departments across the United States, and data from the interviews were analyzed. The findings support additional training to enhance specific competencies for management/leadership, epidemiology/biostatistics, chronic disease prevention/policy development, and evaluation.

Mentorship and competencies for applied chronic disease epidemiology.

To understand the potential and establish a framework for mentoring as a method to develop professional competencies of state-level applied chronic disease epidemiologists, model mentorship programs were reviewed, specific competencies were identified, and competencies were then matched to essential public health services. Although few existing mentorship programs in public health were identified, common themes in other professional mentorship programs support the potential of mentoring as an effective means to develop capacity for applied chronic disease epidemiology. Proposed competencies for chronic disease epidemiologists in a mentorship program include planning, analysis, communication, basic public health, informatics and computer knowledge, and cultural diversity.

The role of epidemiology in chronic disease prevention and health promotion programs.

Although the role for epidemiology is widely accepted in public health programs in general, its role in chronic disease programs is not as widely recognized. One possible barrier to improving epidemiologic capacity in chronic disease prevention and health promotion programs is that chronic disease program managers and public health decision makers may have a limited understanding of basic chronic disease epidemiology functions. We describe the assessment process of data collection, analysis, interpretation, and dissemination, and, using examples from two states, illustrate how this approach can be used to support program and policy development in three areas: by defining the problem, finding programs that work, and evaluating the effects of the program over time.

Improving dietary behavior in African Americans: the Parents As Teachers High 5, Low Fat Program.

Background: The High 5, Low Fat Program (H5LF) for African American parents was developed in partnership with the Parents As Teachers program, and was designed to test a dietary intervention appropriate for national adoption.

Methods: H5LF used a group randomized, nested cohort design with 738 parents. Consistent with organizational goals and methods, parent educators delivered a dietary change program via personal visits, newsletters, and group meetings.

The role of repeat victimization in adolescent delinquent behaviors and recidivism.

Purpose: To report prevalence of adolescent victimization and delinquency recidivism as well as to assess the association between repeat victimization and delinquency recidivism in a large, population-based sample of high school seniors.

Methods: A nationally representative sample of the Monitoring the Future Project (about 17,000 high school seniors from 1996 to 1999) was analyzed as a pooled sample. The analysis was based on self-reported measures of ten different types of delinquent behaviors including violent and property offenses.

Environmental and policy factors associated with overweight among adults in Missouri.

Purpose: To measure the association between environmental and policy factors (i.e., community perceptions, community infrastructure, and worksite infrastructure) and being overweight.

Process evaluation of a monitoring log system for community coalition activities: five-year results and lessons learned.

Purpose: Coalitions can be a successful way to promote healthy initiatives throughout a community. To properly measure the success of coalition-based interventions, it is important to conduct a process evaluation of coalition activities and establish a system for evaluating outcomes. This article describes a process evaluation of a monitoring and feedback system for community coalitions targeting chronic disease risk reduction.

Differential correlates of physical activity in urban and rural adults of various socioeconomic backgrounds in the United States.

Study Objectives: Few studies have analysed the rates and correlates of physical activity in economically and geographically diverse populations. Objectives were to examine: (1) urban-rural differences in physical activity by several demographic, geographical, environmental, and psychosocial variables, (2) patterns in environmental and policy factors across urban-rural setting and socioeconomic groups, (3) socioeconomic differences in physical activity across the same set of variables, and (4) possible correlations of these patterns with meeting of physical activity recommendations.

Design: A cross sectional study with an over sampling of lower income adults was conducted in 1999-2000.

Relationship of satisfaction with body size and trying to lose weight in a national survey of overweight and obese women aged 40 and older, United States.

Background: Despite the potential benefits of weight loss, the factors associated with weight loss behavior are only beginning to be identified. We examined the association between sociodemographic factors, perceived health, satisfaction with body size, and trying to lose weight.

Methods: Data were obtained from the 1996-1997 U.

Motor-vehicle occupant injury: strategies for increasing use of child safety seats, increasing use of safety belts, and reducing alcohol-impaired driving.

The Task Force on Community Preventive Services has conducted systematic reviews of interventions designed to increase use of child safety seats, increase use of safety belts, and reduce alcohol-impaired driving. The Task Force strongly recommends the following interventions: laws requiring use of child safety seats, distribution and education programs for child safety seats, laws requiring use of safety belts, both primary and enhanced enforcement of safety belt use laws, laws that lower the legal blood alcohol concentration (BAC) limit for adult drivers to 0.08%, laws that maintain the minimum legal drinking age at 21 years, and use of sobriety checkpoints.

Epidemiology of environmental tobacco smoke exposure.

The health hazards due to exposure to environmental tobacco smoke (ETS) are increasingly established. ETS contains thousands of chemicals including 43 known carcinogens. One of the most important known health effects of ETS exposure is lung cancer in non-smokers, based on epidemiologic evidence and knowledge of the uptake and metabolism of ETS.

Factors associated with screening for colorectal cancer in a population-based sample.

The results of this study shed light on groups of people with shared characteristics that may be at higher risk for colorectal cancer incidence and mortality based on non-compliance with recommended screening tests. The study showed Missouri has a slightly different pattern of colorectal cancer screening prevalence than the US. Public health efforts need to promote colorectal screening to at-risk Missourians, and should consider strategies that encourage jointly screening for various chronic diseases.

Exploring the effect of the environment on physical activity: a study examining walking to work.

Background: Research on physical activity and the physical environment is at the correlates stage, so it is premature to attribute causal effects. This paper provides a conceptual approach to understanding how the physical design of neighborhoods may influence behavior by disentangling the potential effects of income, university education, poverty, and degree of urbanization on the relationship between walking to work and neighborhood design characteristics.

Methods: The study merges Canadian data from 27 neighborhood observations with information on walking to work from the 1996 census.

Commentary: what contributes to a successful career in epidemiology in the United States?

The authors conducted a study examining perceived enabling factors and barriers to a successful career in epidemiology, the role of mentoring in facilitating one's career, where graduates are most often being employed, and key competencies for future epidemiologic training. During June to August 2001, they surveyed senior epidemiologists across the United States (n = 248) in four sectors: state health departments, the Centers for Disease Control and Prevention, the National Institutes of Health, and schools of public health. The top enabling factors were dedication to hard work and having an intrinsic curiosity and a sense of discovery.

The effectiveness of interventions to increase physical activity. A systematic review.

The Guide to Community Preventive Service's methods for systematic reviews were used to evaluate the effectiveness of various approaches to increasing physical activity: informational, behavioral and social, and environmental and policy approaches. Changes in physical activity behavior and aerobic capacity were used to assess effectiveness. Two informational interventions ("point-of-decision" prompts to encourage stair use and community-wide campaigns) were effective, as were three behavioral and social interventions (school-based physical education, social support in community settings, and individually-adapted health behavior change) and one environmental and policy intervention (creation of or enhanced access to places for physical activity combined with informational outreach activities).

Effects of smoking restrictions in the workplace.

The health hazards caused by exposure to environmental tobacco smoke (ETS) are well established. Workplace exposure to ETS is strongly influenced by the types of workplace and smoking policy-total bans on smoking have become common in many countries. Blue-collar and service workers are more likely than other types of workers to be exposed to ETS in the workplace.