UNIVERSITY OF SOUTH CAROLINA
PREVENTION RESEARCH CENTER NOTES
"Promoting Health through Physical Activity"

Greetings from the faculty, staff, and students in the USC Prevention Research Center. Finally, cooler fall weather is upon us, making it easier to accumulate that "60" minutes of moderate and vigorous activity currently recommended by the National Academies' Institute of Medicine (IOM). (Note from editor: see article below titled "60 Minutes a Day.") Their recommendation may seem hard for some people to achieve, but to maintain a healthy body weight, it may be a realistic assessment of the amount of energy expenditure needed on a daily basis. The IOM recommendation should not negate the health enhancing value of 30 minutes of activity recommended by the Public Health Service to reduce chronic disease risks. It merely focuses on a different health outcome: healthy weight maintenance and maximal cardiovascular health. So, how can a busy adult achieve 60 minutes of activity/exercise per day? How about active commuting to work? Given the traffic, it may take less time to get to where you are going. And, it can't be put off for another day.

On another note, if you haven't had a chance to check out our PRC website (http://prevention.sph.sc.edu), it is a great resource for research updates, current events, and physical activity communication materials. Best wishes for an active, fall season.
Barb Ainsworth

Barb Ainsworth, Director
Dennis Shepard, Deputy Director
Delores Pluto, Newsletter Editor (dmpluto@sc.edu)
http://prevention.sph.sc.edu

*****************************************************************
IN THIS ISSUE - September 2002

NEWS YOU CAN USE: Moving Hearts for Health, Urban Walking Kit, Walk to School Day

WHAT'S HAPPENING IN WASHINGTON: "IMPACT" Bill, Public Input on TEA-21 Reauthorization, America Bikes

RESEARCH NOTES: Barriers to Walking/Cycling to School, School Travel in Georgia, Perceptions of PA among African-American Women, Leisure-Time PA among Adolescents, Walking & Vigorous Exercise

REPORTS, SURVEYS, GUIDELINES, RESOURCES: 60 Minutes a Day, State Legislation Related to PA & Nutrition, Health Care Provider Counseling for PA, PA and Health Strategy (Canada), Changing the Way We Age

PROMOTING ACTIVE COMMUNITIES: Safe Routes to School in Delaware, AIM 2010

UPCOMING CONFERENCES AND WORKSHOPS: ASHC Annual Meeting, CDC Women's Health Conference, NRPA Annual Congress, Cooper Institute Programs

******************************************************************
NEWS YOU CAN USE

MOVING HEARTS FOR HEALTH: The theme of the World Health Organization's Global Embrace this year is "Active Aging: Moving Hearts for Health." The Global Embrace is an annual intergenerational advocacy event of the Global Movement for Active Ageing, to enhance the health of older persons and their communities (http://www.who.int/hpr/ageing). The Global Embrace consists of a chain of locally organized walks and celebrations, encircling the globe during a 24-hour period, drawing attention to the health benefits of walking and physical activity while providing enjoyment to all generations. This year's events will be held in conjunction with the World Heart Day (http://www.worldheartday.com/Home/index.asp).

URBAN WALKING KIT: The SC Coalition for Promoting Physical Activity (SCCPPA) believes that communities should provide supportive environments for physical activity. But until those places are widely available, you can practice "safe steps" using the "Official Urban Walking Kit." Created by SCCPPA's past president Regina Fields, the tongue-in-cheek kit contains a fluorescent light stick (for use in poorly lighted places), sidewalk chalk (to draw crosswalks where needed), a whistle (to get drivers' attention as you cross the street), a surgical mask (to protect you from air pollution), a wrist-wallet (for cab fare in case you get stranded in an unsafe place), and a notepad and pen (to write down unsafe walking conditions so you can report them to city council when you get home). Happy trails!

WALK TO SCHOOL DAY: October 2 is International Walk to School Day. Last year nearly 3 million people from 21 countries walked to school together on Walk to School Day, all hoping to create communities that are safe places to walk. For more information, go to the international site at http://www.iwalktoschool.org/ or the US site at http://www.walktoschool-usa.org/.

For a list of additional PA related observances and events, visit the PA links section of our website at http://prevention.sph.sc.edu/PAlinks/index.html.

WHAT'S HAPPENING IN WASHINGTON

"IMPACT" BILL: Sen. Bill Frist of Tennessee, the only physician in the US Senate, introduced the "Improved Nutrition and Physical Activity Act" or the "IMPACT Act" on July 30, 2002. The purpose of the bill is "to establish grants to provide health services for improved nutrition, increased physical activity, obesity prevention, and for other purposes." There were 8 original co-sponsors: Senators Bingaman (NM), Clinton (NY), Dewine (OH), Dodd (CT), Lugar (IN), Murray (WA), Stevens (AK), and Warner (VA). Sen. Inouye (HI) signed on as a sponsor on Sept. 4. The bill has been referred to the Senate Committee on Health, Education, Labor, and Pensions. If passed as is, the IMPACT Act would provide $10 million per year beginning in FY2003 for several initiatives including local community grants, funds for state departments of education to implement coordinated school health programs, and funds to assist CDC and state health departments to promote healthy eating and PA. For the full text of the bill, go to http://thomas.loc.gov and search for bill S.2821. Information about which Senators are members of the Committee is available at the same website.

PUBLIC INPUT ON TEA-21 REAUTHORIZATION: The U.S. Department of Transportation is soliciting input from the public as part of reauthorizing the Transportation Equity Act for the 21st Century (TEA-21). TEA-21 includes funding provisions for recreational trails, pedestrian and bicycle facilities, and alternative transportation. Input will be accepted until January 1, 2003. Comments may be submitted online at http://www.fhwa.dot.gov/reauthorization/ or by mail to: Docket Clerk, U.S.DOT, Room PL-401, Docket Number OST-2002-12170, 400 Seventh St., SW, Washington, DC 20590. Comments should be categorized in the areas of Environment, Public Transportation, Planning, Safety, Transportation Data, Freight Issues, Security, Finance, Intelligent Transportation Systems, and Research/Technology/Education; comments will be forwarded to Task Forces according to the category. Questions about the public input process can be directed to U.S. DOT at 1-800-647-5527. (Source: "Alliance for a New Transportation Charter" Action Alert, http://www.transact.org/ANTC/about.asp.)

AMERICA BIKES: America Bikes is a "coalition of individuals, businesses and organizations working to include good bicycle provisions in the 2003 federal transportation funding legislation." The America Bikes advocacy agenda has three major emphases: Provide Safe Routes to School; Create a Bicycle-friendly Transportation System; and Strengthen Enhancements, CMAQ, and other TEA-21 Programs. On the coalition's website, http://www.americabikes.org, advocates can sign up to receive regular updates and action alerts. America Bikes also has asked House and Senate candidates to share their views on bicycling issues and is posting results from the survey on the site as responses are received.

RESEARCH NOTES

BARRIERS TO WALKING/CYCLING TO SCHOOL: A recent study from the CDC analyzed data from the national HealthStyles Survey to examine why most children do not walk or bike to school. Nineteen percent of respondents reported that their youngest child walked to school and 6% rode a bike. Collectively, these trips comprised 14% of the children's trips to school. The most common barriers to walking or biking to school were long distances (55%) and traffic danger (40%). Other barriers included adverse weather conditions, crime danger, and opposing school policy. CDC. "Barriers to Children Walking and Biking to School - United States, 1999." MMWR 51(32):701-704, 2002. On the web at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5132a1.htm.

SCHOOL TRAVEL IN GEORGIA: Data from the Georgia Asthma Survey were analyzed to examine modes of transportation to school in Georgia. Results revealed that 4% of children between the ages of 5-15 walked to school most days of the week, 49% rode the bus and 43% were driven to school by an adult. Only 19% of the children who lived within one mile of school walked to school most days of the week. CDC. "School Transportation Modes - Georgia, 2000." MMWR 51(32):704-705, 2002. On the web at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5132a2.htm.

PERCEPTIONS OF PA AMONG AFRICAN-AMERICAN WOMEN: Six focus groups were conducted with African-American women residing in SC to explore their perceptions of physical activity (PA), barriers, and enablers. The 42 women (age 19-51) initially associated PA with structured activities but when prompted were able to identify lifestyle physical activities. Participants also associated being "busy" with PA even if activities did not involve physical movement. Participants associated negative attributes to sedentary African-American women and positive attributes to active African-American women. They also believed that one could be fit and overweight and that fitness and overweight were not necessarily related. Wilcox, Richter, Henderson, Greaney, & Ainsworth. "Perceptions of physical activity and personal barriers and enablers in African-American women." Ethnicity and Disease, 12: 353-362, 2002.

LEISURE-TIME PA AMONG ADOLESCENTS: Results from a 10-year prospective study showed that leisure-time PA levels decrease among adolescent girls. The National Heart, Lung, and Blood Institute Growth and Health Study followed 2379 girls from ages 9 or 10 to ages 18 or 19. By ages 16 or 17, 56% of the black girls and 31% of the white girls reported no regular leisure-time PA. A higher body mass index was associated with greater declines in activity for both races. Pregnancy was associated with a decline in PA levels among black girls, while smoking was associated with a decline among white girls. In addition, low levels of parental education were associated with declines in activity at older and younger ages for white girls but only at older ages for black girls. Kimm, Glynn, Kriska, et al. "Decline in Physical Activity in Black Girls and White Girls during Adolescence." The New England Journal of Medicine, 347(10):709-715, 2002.

WALKING & VIGOROUS EXERCISE: The effects of walking and vigorous exercise on the incidence of coronary and cardiovascular events were explored in 73,743 postmenopausal women (age 50-79) in the Women's Health Initiative Observational Study. A higher weekly energy expenditure score (expressed as a total MET score) showed a strong inverse relationship with both coronary and cardiovascular events. Women who walked or exercised vigorously for at least 2.5 hours per week had a 30% risk reduction for a cardiovascular event. Risk reductions for coronary and cardiovascular events were similar for both walking and vigorous exercise. The relationship between physical activity and risk reduction was similar for white women and black women, as well as for different ages and body mass indices. Walking intensity and time spent sitting also were significantly related to cardiovascular event risk. Manson, Greenland, LaCroix et al. "Walking Compared with Vigorous Exercise for the Prevention of Cardiovascular Events in Women." The New England Journal of Medicine, 347(10):716-725, 2002.

For additional summaries of recent research on promoting physical activity, visit the Research Updates section of our website at http://prevention.sph.sc.edu/updates/index.htm.

REPORTS, SURVEYS, GUIDELINES, RESOURCES

60 MINUTES A DAY: A new report from the National Academies' Institute of Medicine (IOM) recommends 60 minutes of physical activity per day (twice the daily goal recommended by the CDC & ACSM). The IOM report, titled "Dietary Reference Intakes for Energy, Carbohydrates, Fiber, Fat, Protein and Amino Acids," establishes new recommendations for daily energy and nutrition needs while minimizing risk for chronic disease. According to the press release, adults and children (regardless of weight) should spend a total of at least one hour each day in moderately intense physical activity to maintain cardiovascular health at a maximal level. Read the press release at http://www4.nationalacademies.org/news.nsf/isbn/0309085373?OpenDocument. The full report is available from the National Academy Press, (800) 624-6242, or http://www.nap.edu.

STATE LEGISLATION RELATED TO PA & NUTRITION: For a list of state legislation related to PA and nutrition, visit the website of the National Conference of State Legislatures (NCSL) at http://www.ncsl.org/programs/health/phyact.htm. The site has additional links and resources of interest to PA and nutrition policy makers. (From CenterLines, the e-newsletter of the National Center for Bicycling & Walking.)

HEALTH CARE PROVIDER COUNSELING FOR PA: The U.S. Preventive Services Task Force has issued a recommendation titled "Behavioral Counseling for Physical Activity," published in the August 6 issue of Annals of Internal Medicine. The Task Force (sponsored by the Agency for Healthcare Research and Quality) found mixed or inconclusive evidence regarding the role of primary care providers in motivating adult patients and recommended more research. There are a few multi-component interventions that the Task Force feels are promising approaches to encouraging adults to exercise, including patient goal setting, written exercise prescriptions, individually tailored physical activity regimens, and telephone follow-up. In addition, the Task Force notes that linking primary care patients to community programs, targeting groups rather than individuals, may be a helpful approach. The recommendations and a summary of the evidence are found on the AHRQ website:
U.S. Preventive Services Task Force. Behavioral Counseling in Primary Care to Promote Physical Activity: Recommendations and Rationale. July 2002. Originally in Annals of Internal Medicine 2002;137:205-7. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/3rduspstf/physactivity/physactrr.htm
Eden KB, Orleans CT, Mulrow CD, Pender NJ, Teutsch SM. Does Counseling by Clinicians Improve Physical Activity? Summary of the Evidence for the U.S. Preventive Services Task Force. Originally in Annals of Internal Medicine 2002;137:208-15. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/3rduspstf/physactivity/physsum.htm.
Another systematic review of the literature, conducted by Canadian researchers was recently published in the Canadian Family Physician. See Petrella & Lattanzio. "Does counseling help patients get active? Systematic review of the literature." Originally in Canadian Family Physician 2002;48:72-80. http://www.cfpc.ca/English/cfpc/programs/patient care/physical activity/cme/articles counseling/default.asp

PA AND HEALTH STRATEGY (CANADA): The College of Family Physicians of Canada (CFPC) has developed a Physical Activity and Health Strategy to help family doctors help their patients build physical activity into their daily lives. The Strategy also recognizes the importance of promoting active transportation policies by encouraging city planners, health professionals and municipal leaders to work together to design urban and suburban communities that support active living environments. Dr. Andrew Pipe of the CFPC recently presented "Sustainable Community Development: Why It's Good for Health" at the Federation for Canadian Municipalities conference and at the Canadian Urban Transit Association. The PowerPoint presentation and Dr. Pipe's speech can be found at http://www.cfpc.ca/English/cfpc/programs/patient care/physical activity/presentations/sustainable/default.asp.

CHANGING THE WAY WE AGE: In July, the International Council on Active Aging (ICAA) launched a $500,000 media program to support President George Bush's HealthierUS Initiative. "Changing the Way We Age" will educate the media about the concept and process of active aging. The media support program will provide the media with access to the latest cutting-edge information and groundbreaking research, while educating them about how that research can apply to an aging population. For more information, visit the ICAA website at http://www.icaa.cc.

PROMOTING ACTIVE COMMUNITIES

SAFE ROUTES TO SCHOOL IN DELAWARE: According to an AP Press Release, Gov. Ruth Ann Minner signed legislation on Sept. 10, authorizing the Delaware Department of Transportation to establish and administer a "Safe Routes to School" program using federal transportation funds. Under the new law, the DOT will make grants available to schools and school districts through a statewide competition. Proposals must identify safety hazards as well as current and potential walking and bicycling routes. They will be rated on their potential for reducing child injuries and fatalities and encouraging increased walking and bicycling.

AIM 2010: Americans in Motion 2010 (AIM 2010) is recruiting community coalitions to conduct a media-based/internet physical activity behavior change campaign in the spring of 2003. Community coalitions will have access to the Take Charge Challenge website for recruiting social systems (worksites, schools, churches, senior centers, etc.), data collection, report generation, incentives sales, and communication. The TCC website will allow coalitions to generate income to support the campaign. Monthly conference calls are being hosted by CDC's Division of Nutrition and Physical Activity to provide technical assistance to coalitions that are interested in participating. Both the http://www.Takechargechallenge.org and the AIM2010 web sites are under construction. For more information, contact Bruce Leonard at aim2010@bellsouth.net or (770) 978-2289.

UPCOMING CONFERENCES AND WORKSHOPS

ASHC ANNUAL MEETING: The 76th Annual Meeting of the American School Health Conference, "Advocacy for Student Health and School Success," will be held October 2-5, in Charlotte, NC. (http://www.ashaweb.org/conferences.html)

CDC WOMEN'S HEALTH CONFERENCE: "Advancing the Health of Women: Prevention, Practice, and Policy" will meet October 7-9 in Atlanta, GA. (http://www.cdc.gov/od/spotlight/wmconf/index.htm)

COOPER INSTITUTE PROGRAMS: The Cooper Institute Workshop, "Developing Lifestyle Physical Activity Programs" will occur Oct. 14-16 in Dallas TX, followed by the conference series, "Physical Activity: Preventing Physical Disability in Older Adults" on October 17-19. (http://www.cooperinst.org/sciconf.asp, Phone: (972) 341-3247)

For a more complete list of conferences and workshops, visit the PA links section of our website at http://prevention.sph.sc.edu/PAlinks/index.html.

******************************************************************
Writers: Delores Pluto, Regina Fields, Tracy Pearch

This and past issues of the "University of South Carolina Prevention Research Center Notes" are available at our website. If you would like to submit an item, please send it to Delores Pluto at dmpluto@sc.edu.

To subscribe or unsubscribe to this newsletter, e-mail the Prevention Research Center at USCPRC@gwm.sc.edu. When subscribing, please include your name, e-mail address, title, and organizational affiliation. There is no subscription cost.

For continuing discussions about physical activity, join the Physical Activity and Public Health On-Line Network listserv. Instructions are located on our website, at http://prevention.sph.sc.edu.

The USC Prevention Research Center is a member of the CDC Prevention Research Center's National Network, consisting of 26 Centers in the US. For more information about the PRC National Network, visit http://www.cdc.gov/prc/index.htm.
******************************************************************
Prevention Research Center
Norman J. Arnold School of Public Health, University of South Carolina
730 Devine Street, Columbia, South Carolina 29208
803-777-4253

Funded by the Centers for Disease Control and Prevention
******************************************************************