Introduction to the Active Living Research Reference List 2007



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N. Lazaar, J. Aucouturier, S. Ratel, M. Rance, M. Meyer and P. Duche. (2007). Effect of physical activity intervention on body composition in young children: influence of body mass index status and gender. Acta Paediatrica Supplementum.

AIM: To fight overweight and obesity in childhood, this study proposes an additional physical activity (PA) in young children aged 6-10 years. The objective was to evaluate the effect of school-based PA on the body composition according to body mass index (BMI) categories (nonobese vs. obese) and gender. METHODS: This 6-month study examined the effect of this intervention on body composition in 425 children in 14 primary schools (2 weekly PA sessions of 1 h each) compared to 5 control schools. Adiposity indices were evaluated or calculated: BMI, BMI z-score, waist circumference, sum of skinfolds and fat-free mass. RESULTS: No difference in the prevalence of obesity and anthropometric characteristics was found between the intervention and control groups at baseline. In girls, PA intervention had significant effect on all anthropometric variables (p < 0.05 to p < 0.001), except on BMI. In contrast, in boys only BMI z-score (p < 0.001) and fat-free mass (p < 0.001) were affected. CONCLUSIONS: Six months of preventive PA intervention offer an effective means to improve body composition in obese children. The pattern of response related to PA was similar between girls and boys. In contrast, the pattern was different according to BMI category, with a higher response in obese than nonobese children.

L. L. Lee, A. Arthur and M. Avis. (2007). Evaluating a community-based walking intervention for hypertensive older people in Taiwan: A randomized controlled trial. Preventive Medicine.

Objective. To study the effect of a community-based walking intervention on blood pressure among older people. Method. The study design was a randomized controlled trial conducted in a rural area of Taiwan between October 2002 and June 2003. A total of 202 participants aged 60 years and over with mild to moderate hypertension was recruited. Participants randomized to the intervention group (n=102) received a six-month community-based walking intervention based on self-efficacy theory. A public health nurse provided both face-to-face and telephone support designed to assist participants to increase their walking. Control group participants (n = 100) received usual primary health care. Primary outcome was change in systolic blood pressure and secondary outcomes were exercise self-efficacy, self-reported walking and diastolic blood pressure. Results. At six-month follow-up the mean change in systolic blood pressure was a decrease of 15.4 mmHg and 8.4 mmHg in the intervention and control group, respectively. The difference in mean change between the two groups was -7.0 mmHg (95% CI, -11.5 to -2.5 mmHg, p=0.002). Improvement in exercise self-efficacy scores was greater among intervention group participants (mean difference 1.23, 95% Cl, 0.5 to 2.0, p=0.001). Intervention group participants were more likely to report walking more (p < 0.0005) but no differences were observed in diastolic blood pressure (p=0.19). Conclusions. Among hypertensive older people, a six-month community-based walking intervention was effective in increasing their exercise self-efficacy and reducing systolic blood pressure. (c) 2006 Elsevier Inc. All rights reserved.

N. M. Lindberg and V. J. Stevens. (2007). Review: weight-loss interventions with Hispanic populations. Ethnicity and Disease.

OBJECTIVE: To conduct a review of published studies that have addressed the effectiveness of weight-loss interventions for Hispanic individuals in the United States, identify key components of effective interventions for this population, and provide a set of recommendations for the development of effective treatment programs. DATA SOURCE: Online bibliographic databases were searched from 1980 to September 2006. STUDY INCLUSION/EXCLUSION CRITERIA: Two key search dimensions ("Latino" or "Mexican-American" or "Hispanic" or "Spanish-speaker"; and "weight-loss" or "weight-reduction" or "obesity treatment" or "diet intervention") were used to search for articles. DATA EXTRACTION: The methods and findings of all retrieved articles were evaluated, and summary outcome data were taken from published results. DATA SYNTHESIS: The limited number of published articles found, and the lack of identifying information on key variables (eg, manner in which subjects were determined to be "Hispanic," level of acculturation, socioeconomic status [SES], number of years living in the United States, country of origin, etc) precluded conducting a formal meta-analysis on the available outcome data. RESULTS: The review identified only three controlled intervention studies specifically targeting Hispanic populations for weight-loss; most of the available studies were not randomized and did not assess key variables, such as acculturation, type of community of origin, level of education, etc. Most available "culturally sensitive" health-related interventions targeting Hispanic populations do not specify what made the interventions "culturally sensitive" beyond the translation of the materials into Spanish. CONCLUSIONS: Traditional weight-loss interventions developed for use on Anglo-American subjects do not appear to have been effective for Hispanic individuals. There is an urgent need to both develop effective interventions and to improve the methodologic thoroughness in the design, implementation, and reporting of such interventions for this population.


A. L. Liu, X. Q. Hu, G. S. Ma, Z. H. Cui, Y. P. Pan, S. Y. Chang, W. H. Zhao and C. M. Chen. (2007). Report on childhood obesity in China (6) evaluation of a classroom-based physical activity promotion program. Biomed Environ Sci.

OBJECTIVES: To evaluate the effect of Happy 10 program on the promotion of physical activity, physical growth and development of primary-school students, and on obesity control and prevention. METHODS: Two similar primary schools from one district of Beijing, China were selected, one as an intervention school and the other as a control school. Happy 10 program was implemented at least once every school day in the intervention school for two semesters, whereas no intervention was adopted in the control school. The information on energy expenditure and duration of physical activity was collected by a validated 7-day physical activity questionnaire. Height and weight were measured by trained investigators following the standardized procedure. Energy expenditure and intensity of each Happy 10 session was measured by a physical activity monitor. RESULTS: The average energy expenditure and duration of total physical activity per day among students in the intervention school increased significantly from 15.0 to 18.2 kcal/kg, and 2.8 to 3.3 h respectively, whereas the figures significantly decreased in the control school. There was a significant difference in change of weight and BMI between girls in the intervention and control school (2.4 kg vs 4.6 kg, -0.47 kg/m2 vs 0.66 kg/m2). The prevalence of overweight and obesity in the intervention school decreased by 0.4%-5.6%, as compared to the increase by 0.6%-4.5% in the control school. The average energy expenditure and intensity per 10-minute session ranged from 25.0-35.1 kcal, 4.8-6.2 kcal/kg/h respectively in grades 1-5. CONCLUSION: Happy 10 program provides a useful strategy to promote physical activity among school children and also plays a positive role in building up physical growth and development of girls.


C. Lorentzen, Y. Ommundsen, A. K. Jenum and I. Holme. (2007). The "Romsas in Motion" community intervention: program exposure and psychosocial mediated relationships to change in stages of change in physical activity. International Journal Of Behavioral Nutrition And Physical Activity.

Background: Conducting process evaluations of health promoting interventions, and measuring the effectiveness of specific intervention components, may help in the understanding of program failure or success. The purposes of the present study were to examine adults' exposure to and involvement in specific components of a three year long pseudo-experimental community-based physical activity intervention, and to examine the relationship between such exposure and participation and changes in stages of change in physical activity and psychosocial mediators. Methods: 1497 persons in the intervention group attended the baseline survey in 2000 (50.6%) and 1204 (80.4 of baseline attendees) provided data on the outcome variables of the present study. In 2003, 1089 were still living in the area, and were re-invited to follow-up assessments. Current analyses are based on the 603 persons (mean age 49 +/- 10 years) who provided baseline and follow-up data for the current purposes (56.6% follow-up rate). Process data, stages of change in physical activity, and potential psychosocial mediators of change in physical activity were assessed by questionnaires. The theory-based intervention was composed of communication, physical activity, environmental and participatory components. Data were analysed using frequency and descriptive statistics, Chi-square and t-tests, and regression analyses. Results: Exposure and participation rates in the various intervention components varied greatly (1.5-92.7%). Participation in walking groups and aerobic exercise groups, as well as having seen the "Walk the stairs" -poster were significantly and positively related to change in stages of change in physical activity (beta =.12, p =.011; beta =.211, p <.001; beta =.105, p =.014, respectively). Additionally, having used the walk path was significantly and positively related to change in stages in women (beta = -209, p =.001) but not in men (beta = -.011, p =.879), and in Western people (beta =.149, p =.003) but not in non-Westerners (beta = -.293, p =.092). Observed significant relations were partly mediated by positive changes in psychosocial factors as social support from friends, perceived control, and physical activity identity. Conclusion: Findings revealed that particular intervention components, such as participation in physical activity groups, were more strongly related to forward transition in stages of change in physical activity than others. These findings together with results indicating that such transitions were mediated by specific psychosocial influences may improve theory and help to prioritize among specific intervention components in future programs.

D. Low, M. Gramlich and B. W. Engram. (2007). Self-paced exercise program for office workers: impact on productivity and health outcomes. Aaohn J.

The impact of a self-paced exercise program on productivity and health outcomes of 32 adult workers in a large federal office complex was investigated during 3 months. Walking was the sole form of exercise. The first month, during which no walking occurred, was the control period. The second and third months were the experimental period. Participants were divided into three levels based on initial weight and self-determined walking distance goals. Productivity (using the Endicott Work Productivity Scale), walking distance (using a pedometer), and health outcomes (blood pressure, weight, pulse rate, and body fat percentage) were measured weekly. Results from this study, based on a paired t test analysis, suggest that although the self-paced exercise program had no impact on productivity, it lowered blood pressure and promoted weight loss. Further study using a larger sample and a controlled experimental design is recommended to provide conclusive evidence.

D. R. Lubans and K. Sylva. (2007). Mediators of change following a senior school physical activity intervention. Journal of Science and Medicine in Sport.

It has been suggested that the low level of effectiveness of youth interventions is due to a lack of knowledge regarding the mechanisms responsible for behaviour change. The identification of behaviour mediators is necessary for the progression of physical activity research, as it allows researchers to determine which components of an intervention are responsible for mediating behaviour change. The purpose of this study was to identify mediators of behaviour change in a physical activity intervention for senior school students. Participants (n=78) were randomly allocated to control or intervention conditions for a period of 10 weeks. Moderate-to-vigorous physical activity (MVPA) and potential mediators were assessed at baseline and post-intervention (10 weeks). Hypothesized mediators were derived from Bandura's Social Cognitive Theory and included: peer support, exercise self-efficacy and outcome expectancy. Mediation was assessed using the product-of-coefficients test described by MacKinnon and colleagues, based on the criteria for mediation identified by Baron and Kenny. While none of the variables satisfied all four criteria for mediation among males or females, self-efficacy was able to satisfy the first three criteria among females in the study. Exercise self-efficacy may be a mediator of physical activity behaviour in adolescent girls.


H. M. Macdonald, D. M. L. Coupe, S. A. Kontulainen and H. A. McKay. (2007). A school-based physical activity intervention positively affects change in Imax in pre- and early pubertal boys. Journal Of Bone And Mineral Research.

M. Mackey, C. G. Maher, T. Wong and K. Collins. (2007). Study protocol: the effects of work-site exercise on the physical fitness and work-ability of older workers. Bmc Musculoskeletal Disorders.

Background: Older workers have a higher rate and cost of injury than younger workers and with a rapidly ageing work force there is a need to identify strategies to address this problem. Older workers are less physically active and fit than younger workers and so have reduced work ability. The reduced work ability means they are more likely to be fatigued at work and so at greater risk of injury. Exercise could potentially assist this problem. Exercise training has been previously shown to improve fitness in older people however there has been no evaluation of workplace exercise program for older workers. We do not know if the programs are feasible and can improve the fitness and work ability of older workers. We have designed a randomised controlled trial to evaluate whether exercise improves fitness and perceived work-ability of older workers. Methods/Design: This paper describes the protocol for a trial examining the effects of a 12-week physical training program in workers over the age of 45. Participants will be randomized to an exercise or no-intervention control group. The primary outcomes are cardiorespiratory endurance, lifting capacity, upper and lower limb strength and perceived work-ability. Discussion: This trial will test the feasibility of implementing a worksite-based exercise program as a means of improving the physical fitness and work-ability of older workers performing physically demanding work. If we demonstrate the feasibility of the program we will conduct a larger trial that additionally measures injury outcomes.

P. K. Mackreth, C. B. Cooke, M. Crowther, P. Wicker and P. J. Gately. (2007). Assessing the effectiveness of a community based programme for obese children delivered by a local community collaboration. International Journal Of Obesity.

C. Marcus, A. Nordenfelt, G. Nyberg, M. Karpmyr and J. Kowalski. (2007). STOPP; Stockholm Obesity Prevention Programme: effect of a 4 year school-based randomised prevention study on overweight prevalence among children 6-10 years of age. International Journal Of Obesity.
V. V. Martinez, L. M. Sanchez, A. F. Salcedo, V. F. Martinez, L. M. Hernandez, G. R. Franquelo, M. M. Solera and A. F. Rodriguez. (2007). Evaluation of a primary school-based intervention to promote physical activity: cluster randomized trial. The Cuenca Study. International Journal Of Obesity.

V. Martinez Vizcaino, F. Salcedo Aguilar, R. Franquelo Gutierrez, M. Solera Martinez, M. Sanchez Lopez, S. Serrano Martinez, E. Lopez Garcia and F. Rodriguez Artalejo. (2008). Assessment of an after-school physical activity program to prevent obesity among 9- to 10-year-old children: a cluster randomized trial. International Journal of Obesity (London).

OBJECTIVE: To assess the impact of a physical activity program on obesity in primary school children. DESIGN: Cluster-randomized controlled trial with 10 intervention and 10 control schools. PARTICIPANTS: A total of 1044 children, mean age 9.4 years (s.d.=0.7) at baseline, of the Province of Cuenca, Spain. INTERVENTION: Recreational, non-competitive physical activity program conducted after school hours on school premises. The program consisted of three 90-min sessions per week, for 24 weeks. MAIN OUTCOME MEASURES: Body mass index (BMI), triceps skin-fold thickness (TST) and percentage body fat. Secondary measures were blood lipids and blood pressure. Measurements were made at the beginning (September 2004) and at the end of the program (June 2005). Since schools rather than children were randomized, mixed regression models were used to adjust for individual-level covariates under cluster randomization. RESULTS: There were no differences in BMI between the intervention and control groups. Compared with controls, intervention children showed a decrease in TST in both boys (-1.14 mm; 95% confidence interval (CI) -1.71 to -057; P<0.001) and girls (-1.55 mm; 95% CI -2.38 to -0.73; P<0.001), as well as a reduction in the percentage of body fat in girls (-0.58%; 95% CI -1.04 to -0.11; P=0.02). Furthermore, the intervention boys exhibited a decrease in apolipoprotein (apo) B levels (-4.59; 95% CI -8.81 to -0.37; P=0.03) and an increase in apo A-I levels (13.57; 95% CI 7.95-19.20; P<0.001). Blood lipid results in girls were very similar. No changes in total cholesterol, triglycerides or blood pressure were associated with the intervention in either sex, except for an increase in diastolic blood pressure (1.55 mm Hg; 95% CI 0.19-2.91; P=0.03) in the intervention versus control boys. CONCLUSION: An after-school program of recreational physical activity reduced adiposity, increased apo A-I and decreased apo B in primary school children.

D. A. McAlpine, C. U. Manohar, S. K. McCrady, D. Hensrud and J. A. Levine. (2007). An office-place stepping device to promote workplace physical activity. British Journal Of Sports Medicine.

Objective: It was proposed that an office-place stepping device is associated with significant and substantial increases in energy expenditure compared to sitting energy expenditure. The objective was to assess the effect of using an office-place stepping device on the energy expenditure of lean and obese office workers. Methods: The office-place stepping device is an inexpensive, near-silent, low-impact device that can be housed under a standard desk and plugged into an office PC for self-monitoring. Energy expenditure was measured in lean and obese subjects using the stepping device and during rest, sitting and walking. 19 subjects (27 +/- 9 years, 85 +/- 23 kg): 9 lean (BMI, <25 kg/m(2)) and 10 obese (BMI>29 kg/m(2)) attended the experimental office facility. Energy expenditure was measured at rest, while seated in an office chair, standing, walking on a treadmill and while using the office-place stepping device. Results: The office-place stepping device was associated with an increase in energy expenditure above sitting in an office chair by 289 +/- 102 kcal/hour (p<0.001). The increase in energy expenditure was greater for obese (335 +/- 99 kcal/ hour) than for lean subjects (235 +/- 80 kcal/ hour; p=0.03). The increments in energy expenditure were similar to exercise-style walking. Conclusion: The office-place stepping device could be an approach for office workers to increase their energy expenditure. If the stepping device was used to replace sitting by 2 hours per day and if other components of energy balance were constant, weight loss of 20 kg/year could occur.

D. Merom, C. Rissel, P. Phongsavan, B. J. Smith, C. Van Kemenade, W. J. Brown and A. E. Bauman. (2007). Promoting walking with pedometers in the community - The step-by-step trial. American Journal Of Preventive Medicine.

Background: Pedometers have been identified as a potential motivational aid for increasing physical activity, but their efficacy has not been demonstrated in a community-based, nonclinical sample. Design: A randomized controlled trial was conducted from August to December 2005. Analysis was completed in June 2006. Setting/Participants: Inactive adults aged 30-65 years (n=369) recruited from the community. Intervention: Comparison of a theoretically based self-help walking program (WP) and weekly diaries (sent by mail); the same walking program with a pedometer (WPP) (also by mail); and a no-treatment control group (C). Measures: Change in self-reported leisure time in any sports/recreation in the last 3 months, and all-purpose walking (APW) for exercise, recreation, and travel, and other moderate, vigorous physical activity in the last week. Proportions meeting physical activity recommendations (equal to or greater than 150 minutes and equal to or greater than five sessions/week(-1)) were determined. Results: A 3-month follow-up inter-view was conducted with 314 (85%) participants. Intention-to-treat analyses indicated significance within-group increases of APW and leisure-time walking (LTW), but mean and median sessions and minutes changes were greatest in the WPP group. There were no significant between-group differences in regular LTW (walked equal to or greater than 5 sessions/week(-1) for at least 30 minutes/session), but the WPP group increased significantly participation in other sports/recreations and was more likely than the control group to meet physical activity recommendations by all leisure-time physical activity (adjusted odds ratio=2.40, 95% CI=01.17-4.93) by APW (adjusted odds ratio=1.75 95% CI=0.92-3.34) and all physical activity (adjusted odds ratio=1.59 95% CI=0.92-2.79) in the last week. Conclusions: Pedometers enhanced the effects of the self-help walking program. This low-cost intervention should be tested for sustainability.


L. Middelbeek, L. Blokdijk, G. Buijs, J. Schuit and W. Bemelmans. (2007). A national survey on the prevention of overweight at secondary schools in the Netherlands. European Journal Of Public Health.
G. V. Mohatt, R. Plaetke, J. Klejka, B. Luick, C. Lardon, A. Bersamin, S. Hopkins, M. Dondanville, J. Herron and B. Boyer. (2007). The center for Alaska Native Health Research study: A community-based participatory research study of obesity and chronic disease-related protective and risk factors. International Journal Of Circumpolar Health.

Objectives. To describe the background, approach and general results of the Center for Alaska Native Health Research (CANHR) study. Study Design. This was a cross-sectional Community-Based Participatory Research (CBPR) study with one tribal group to assess risk and protection for obesity and the risk factors related to chronic disease, diabetes and cardiovascular disease. Methods. A combination of biological, genetic, nutritional and psychosocial measurements were taken on 922 Alaska Native participants in ten communities in Southwestern Alaska. The paper reports on data from 753 adult participants. Results. The prevalence of type 2 diabetes is 3.3% in the sample population. Metabolic syndrome is significantly lower among the males and equal for females when compared with Caucasians in the NHANES III sample. Obesity among adults is now at the national average. Risk factors for chronic disease include a shift to a Westernized diet, stress, obesity and impaired fasting glucose and protective factors include high levels of polyunsaturated fatty acid dietary intake. Articles in this issue present specific results in these areas. Conclusions. The data strongly indicate that, in general, Yup'ik people in our study are metabolically healthy and that diet and life style provide a delicate combination of protective and risk factors. The results strongly indicate that solution focused research (1) utilizing primary and secondary prevention strategies may provide evidence for how to intervene to prevent further increases of chronic diseases. Research that focuses on relating the intrinsic strengths of indigenous worldviews and practices with basic research may contribute to positive transformations in community health.




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