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Researching Those Who Have the Most to Gain: Focused Physical Activity Promotion in Lower Socioeconomic Populations

  • Physical Activity (DER Warburton, Section Editor)
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Abstract

Physical inactivity is among the most pressing public health challenges facing industrialized nations, and low socioeconomic status (SES) populations report lower rates of physical activity than high SES populations. The Ecologic Model of Physical Activity (EMPA) accounts for individual, social and environmental factors that contribute to physical activity, and can be used to demonstrate possible pathways by which SES may influence physical activity, illuminating strategies for intervention. This review examines current approaches to physical activity promotion in low SES populations couched within the EMPA. Findings suggest that limitations and challenges remain for physical activity promotion in low SES populations. Coordinated and consistent physical activity promotion efforts, targeting multiple levels of influence and a range of settings, including political, corporate and community support, are needed to prevent and treat the disparity in physical activity in this vulnerable population.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Pasini E, Le Douairon Lahaye S, Flati V, Assanelli D, Corsetti G, Speca S, et al. Effects of treadmill exercise and training frequency on anabolic signaling pathways in the skeletal muscle of aged rats. Exp Gerontol. 2012;47(1):23–8.

    Article  PubMed  CAS  Google Scholar 

  2. Zhang H, Zhang C. Vasoprotection by dietary supplements and exercise: role of TNFalpha signaling. Exp Diabetes Res. 2012;2012:972679.

    PubMed  Google Scholar 

  3. Buman MP, Hekler EB, Haskell WL, Pruitt L, Conway TL, Cain KL, et al. Objective light-intensity physical activity associations with rated health in older adults. Am J Epidemiol. 2010;172(10):1155–65.

    Article  PubMed  Google Scholar 

  4. •• Kruk J. Physical activity and health. Asian Pac J Cancer Prev. 2009;10(5):721–8. This paper presents the prevalence, health risks, and economic costs of physical inactivity. It also reports the substantial physical and psychologic health benefits of regular physical activity. It is important to have an accurate estimation of the magnitude of the problem of physical inactivity, and an understanding of the economic and health consequences.

    PubMed  Google Scholar 

  5. Lahti J, Laaksonen M, Lahelma E, Rahkonen O. The impact of physical activity on physical health functioning – a prospective study among middle-aged employees. Prev Med. 2010;50(5-6):246–50.

    Article  PubMed  Google Scholar 

  6. Lante K, Reece J, Walkley J. Energy expended by adults with and without intellectual disabilities during activities of daily living. Res Dev Disabil. 2010;31(6):1380–9.

    Article  PubMed  Google Scholar 

  7. Motl RW, McAuley E. Physical activity, disability, and quality of life in older adults. Phys Med Rehabil Clin N Am. 2010;21(2):299–308.

    Article  PubMed  Google Scholar 

  8. Taylor LM, Spence JC, Raine K, Plotnikoff RC, Vallance JK, Sharma AM. Physical activity and health-related quality of life in individuals with prediabetes. Diabetes Res Clin Pract. 2010;90(1):15–21.

    Article  PubMed  Google Scholar 

  9. Wittink H, Engelbert R, Takken T. The dangers of inactivity; exercise and inactivity physiology for the manual therapist. Man Ther. 2011;16(3):209–16.

    Article  PubMed  CAS  Google Scholar 

  10. Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual medical spending attributable to obesity: payer- and service-specific estimates. Health Aff (Millwood). 2009;28(5):w822–31.

    Article  Google Scholar 

  11. Centers for Disease Control and Prevention. 2008 CDC U.S. Physical Activity Statistics. 2008; Available from: http://apps.nccd.cdc.gov/PASurveillance/DemoCompareResultV.asp?State=0&Cat=2&Year=2008&Go=GO.

  12. Centers for Disease Control and Prevention. Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2010, US Department of Health and Human Services, Editor. 2012, National Center for Health Statistics: Hyatsville, MD.

  13. Ross CE, Mirowsky J. Neighborhood disadvantage, disorder, and health. J Heal Soc Behav. 2001;42(3):258–76.

    Article  CAS  Google Scholar 

  14. Annesi JJ. Relationship of social cognitive theory factors to exercise maintenance in adults. Percept Mot Skills. 2004;99(1):142–8.

    Article  PubMed  Google Scholar 

  15. Black MM, Hager ER, Le K, Anliker J, Arteaga SS, Diclemente C, et al. Challenge! Health promotion/obesity prevention mentorship model among urban, black adolescents. Pediatrics. 2010;126(2):280–8.

    Article  PubMed  Google Scholar 

  16. Bock B, Marcus BH, Pinto BM, Forsyth LH. Maintenance of physical activity following an individualized motivationally tailored intervention. Ann Behav Med. 2001;23(2):79–87.

    Article  PubMed  CAS  Google Scholar 

  17. Dhanapalaratnam R, Fanaian M, Harris MF. Lifestyle intervention – a study on maintenance in general practice. Aust Fam Physician. 2011;40(11):903–6.

    PubMed  Google Scholar 

  18. Eriksson MK, Franks PW, Eliasson M. A 3-year randomized trial of lifestyle intervention for cardiovascular risk reduction in the primary care setting: the Swedish Bjorknas study. PLoS One. 2009;4(4):e5195.

    Article  PubMed  Google Scholar 

  19. Lawton BA, Rose SB, Elley CR, Dowell AC, Fenton A, Moyes SA. Exercise on prescription for women aged 40–74 recruited through primary care: two year randomised controlled trial. BMJ. 2008;337:a2509.

    Article  PubMed  Google Scholar 

  20. Lee RE, Mama SK, Medina A, Orlando Edwards R, McNeill L. SALSA: SAving Lives Staying Active to promote physical activity and healthy eating. J Obes. 2011;2011:436509.

    PubMed  Google Scholar 

  21. •• Lee RE, Medina AV, Mama SK, Reese-Smith JY, O'Connor DP, Brosnan M, et al. Health is power: an ecological, theory-based health intervention for women of color. Contemp Clin Trials. 2011;32(6):916–23. This paper describes the rationale, design and methodology of an intervention to increase physical activity and improve dietary habits in African-American and Hispanic or Latina women in Houston and Austin, Texas. This intervention is unique because it was guided by the principles of group dynamics and anchored within an ecologic model. Theoretically guided interventions that account for multiple levels of influence in behavior initiation and maintenance may improve health outcomes in vulnerable populations.

    Article  PubMed  Google Scholar 

  22. Lee RE, O'Connor DP, Smith-Ray R, Mama SK, Medina AV, Reese-Smith JY, et al. Mediating effects of group cohesion on physical activity and diet in women of color: health is power. Am J Heal Promot. 2012;26(4):e116–25.

    Article  Google Scholar 

  23. Mansyur CL, Pavlik VN, Hyman DJ, Taylor WC, Goodrick GK. Self-efficacy and barriers to multiple behavior change in low-income African Americans with hypertension. J Behav Med. 2012; doi:10.1007/s10865-012-9403-7

  24. Pinto BM, Friedman R, Marcus BH, Kelley H, Tennstedt S, Gillman MW. Effects of a computer-based, telephone-counseling system on physical activity. Am J Prev Med. 2002;23(2):113–20.

    Article  PubMed  Google Scholar 

  25. Plotnikoff RC, Johnson ST, Luchak M, Pollock C, Holt NL, Leahy A, et al. Peer telephone counseling for adults with type 2 diabetes mellitus: a case-study approach to inform the design, development, and evaluation of programs targeting physical activity. Diabetes Educ. 2010;36(5):717–29.

    Article  PubMed  Google Scholar 

  26. Lee RE, Cubbin C, Winkleby M. Contribution of neighbourhood socioeconomic status and physical activity resources to physical activity among women. J Epidemiol Community Health. 2007;61(10):882–90.

    Article  PubMed  Google Scholar 

  27. Lee RE, Mama SK, Medina AV, Ho A, Adamus HJ. Neighborhood factors influence physical activity among African American and Hispanic or Latina women. Health Place. 2012;18(1):63–70.

    Article  PubMed  Google Scholar 

  28. Spence JC, Lee RE. Toward a comprehensive model of physical activity. Psychol Sport Exerc. 2003;4:7–24.

    Article  Google Scholar 

  29. Lee RE, Cubbin C. Striding toward social justice: the ecologic milieu of physical activity. Exerc Sport Sci Rev. 2009;37(1):10–7.

    Article  PubMed  CAS  Google Scholar 

  30. Cohen JE, Planinac LC, O'Connor SC, Lavack AM, Robinson DJ, Thompson FE. Keeping the point-of-sale environment at the forefront. Am J Public Health. 2008;98(1):5–6. Author reply 6–7.

    Article  PubMed  Google Scholar 

  31. Lee RE, Mama SK, McAlexander KP, Adamus H, Medina AV. Neighborhood and PA: neighborhood factors and physical activity in African American public housing residents. J Phys Act Health. 2011;8 Suppl 1:S83–90.

    PubMed  Google Scholar 

  32. • Jarrett RL, Bahar OS, Taylor MA. “Holler, run, be loud:” strategies for promoting child physical activity in a low-income, African American neighborhood. J Fam Psychol. 2011;25(6):825–36. This paper identifies and describes child management practices among a sample of African-American caregivers in a low-income, inner-city neighborhood. Using qualitative methods (interviews, observations) and demographic data on neighborhood disadvantage and family and household characteristics, the research revealed seven caregiver management strategies that promoted child physical activity, despite multiple neighborhood barriers. These findings provide important substantive and theoretical insights into the relationship between neighborhood social context, and child physical activity.

    Article  PubMed  Google Scholar 

  33. •• Magnusson MB, Sjöberg A, Kjellgren KI, Lissner L. Childhood obesity and prevention in different socio-economic contexts. Prev Med. 2011;53(6):402–7. This study assessed recent trends in obesity, health beliefs, and lifestyles in schoolchildren, with a focus on socioeconomic disparities. Comparisons were made before and after a community-based intervention within the low-SES school, and between the low and high-SES school. This study is important because it demonstrates how the effectiveness of an intervention may depend on the income level of the target population.

    Article  PubMed  Google Scholar 

  34. Xie B, Gilliland FD, Li YF, Rockett HR. Effects of ethnicity, family income, and education on dietary intake among adolescents. Prev Med. 2003;36(1):30–40.

    Article  PubMed  Google Scholar 

  35. Eisenmann JC, Alaimo K, Pfeiffer K, Paek HJ, Carlson JJ, Hayes H, et al. Project FIT: rationale, design and baseline characteristics of a school- and community-based intervention to address physical activity and healthy eating among low-income elementary school children. BMC Publ Health. 2011;11:607.

    Article  Google Scholar 

  36. Lee RE, Mama SK, Banda JA, Bryant LG, McAlexander KP. Physical activity opportunities in low socioeconomic status neighbourhoods. J Epidemiol Community Health. 2009;63(12):1021.

    Article  PubMed  CAS  Google Scholar 

  37. • Green CG, Klein EG. Promoting active transportation as a partnership between urban planning and public health: the columbus healthy places program. Public Health Rep. 2011;126 Suppl 1:41–9. Active transportation has been considered as one method to address the American obesity epidemic. To address obesity prevention through built-environment change, the local public health department in Columbus, Ohio, established the Columbus Healthy Places (CHP) program to formally promote active transportation in numerous aspects of community design for the city. In this paper, we present a case study of the CHP program and discuss the review of city development rezoning applications as a successful strategy to link public health to urban planning.

    PubMed  Google Scholar 

  38. Parra-Medina D, Wilcox S, Salinas J, Addy C, Fore E, Poston M, et al. Results of the heart healthy and ethnically relevant lifestyle trial: a cardiovascular risk reduction intervention for African American women attending community health centers. Am J Public Health. 2011;101(10):1914–21.

    Article  PubMed  Google Scholar 

  39. • Millard A, Graham MA, Wang X, Mier N, Sánchez ER, Flores I, et al. Pilot of a diabetes primary prevention program in a hard-to-reach, low-income, immigrant Hispanic population. J Immigr Minor Heal. 2011;13(5):906–13. This study examined an exploratory pilot intervention to prevent type 2 diabetes in low-income rural areas (colonias) through nutrition and physical activity. The study shows that low-income, rural Mexican American families will take ownership of a program that is participatory and tailored to their culture and economic situation.

    Article  Google Scholar 

  40. Slater SJ, Nicholson L, Chriqui J, Turner L, Chaloupka F. The impact of state laws and district policies on physical education and recess practices in a nationally representative sample of US public elementary schools. Arch Pediatr Adolesc Med. 2012;166(4):311–6.

    Article  PubMed  Google Scholar 

  41. Marin Community Foundation. 2009; Available from: www.marincf.org.

  42. Kumanyika SK. Environmental influences on childhood obesity: ethnic and cultural influences in context. Physiol Behav. 2008;94(1):61–70.

    Article  PubMed  CAS  Google Scholar 

  43. Rung AL, Mowen AJ, Broyles ST, Gustat J. The role of park conditions and features on park visitation and physical activity. J Phys Act Health. 2011;8 Suppl 2:S178–87.

    PubMed  Google Scholar 

  44. • Saelens BE, Sallis JF, Frank LD, Cain KL, Conway TL, Chapman JE, et al. Neighborhood environment and psychosocial correlates of adults' physical activity. Med Sci Sports Exerc. 2012;44(4):637–46. This study examined whether objective built (e.g., residential density) and perceived (e.g., esthetics) environmental factors around adults' residence are correlates of their physical activity after accounting for known psychosocial (e.g., self-efficacy, barriers to physical activity) and demographic correlates of physical activity. Environmental factors, particularly the availability of proximal nonresidential destinations designed for pedestrian access, were related to adults' physical activity and walking after accounting for psychosocial and demographic correlates, including reasons for residential selection.

    Article  PubMed  Google Scholar 

  45. Toftager M, Ekholm O, Schipperijn J, Stigsdotter U, Bentsen P, Grønbæk M, et al. Distance to green space and physical activity: a Danish national representative survey. J Phys Act Heal. 2011;8(6):741–9.

    Google Scholar 

  46. US Census Bureau, American Community Survey. 2010.

  47. Gary TL, Batts-Turner M, Yeh HC, Hill-Briggs F, Bone LR, Wang NY, et al. The effects of a nurse case manager and a community health worker team on diabetic control, emergency department visits, and hospitalizations among urban African Americans with type 2 diabetes mellitus: a randomized controlled trial. Arch Intern Med. 2009;169(19):1788–94.

    Article  PubMed  Google Scholar 

  48. Allen JK, Himmelfarb CR, Szanton SL, Bone L, Hill MN, Levine DM. COACH trial: a randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers: rationale and design. Contemp Clin Trials. 2011;32(3):403–11.

    Article  PubMed  Google Scholar 

  49. Kann L, Brener ND, Wechsler H. Overview and summary: school health policies and programs study 2006. J Sch Health. 2007;77(8):385–97.

    Article  PubMed  Google Scholar 

  50. Kriemler S, Zahner L, Schindler C, Meyer U, Hartmann T, Hebestreit H, et al. Effect of school based physical activity programme (KISS) on fitness and adiposity in primary schoolchildren: cluster randomised controlled trial. BMJ. 2010;340:c785.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Texas Obesity Research Center, Department of Health and Human Performance, University of Houston, 3855 Holman Street, Garrison Gym Room 104, Houston, TX, 77204-6015, USA

    Rebecca E. Lee, Heather J. Adamus-Leach, Kyle C. Cheung, Erica G. Soltero, Ygnacio Lopez III, Fiorella Saavedra, Munazza Noor & Scherezade K. Mama

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  1. Rebecca E. Lee
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  2. Heather J. Adamus-Leach
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Correspondence to Rebecca E. Lee.

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Lee, R.E., Adamus-Leach, H.J., Cheung, K.C. et al. Researching Those Who Have the Most to Gain: Focused Physical Activity Promotion in Lower Socioeconomic Populations. Curr Cardiovasc Risk Rep 6, 355–361 (2012). https://doi.org/10.1007/s12170-012-0243-3

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