Rural adults engage in less physical activity and are less likely to meet activity recommendations than urban or suburban adults. Understanding determinants of this behavior can help design interventions for increasing activity levels. This series of studies examined the perceived determinants of physical activity in the social, physical, and policy environments of rural adults, using the following aims: Aim 1: A secondary analysis was conducted of a cross-sectional survey among 407 adults from two rural towns to examine determinants of physical activity separately by the domain in which this behavior occurs (i.e. home care, active living, etc.). Multiple regression analyses found that social characteristics (such as support from friends), policy attitudes (such as workplace incentives for exercise), and physical environmental factors (such as an activity-friendly neighborhood) were positively associated with total physical activity, active living, and sport. Barriers were negatively associated with these domains. No factors were associated with physical activity in work or home care. Physical activity determinants are specific to the domain of physical activity, and more research needs to be done to determine factors associated with physical activity in home or work. Aim 2: Measurement tools should be culturally relevant to a specific population for accurate measurement. Three focus groups were conducted (n=19) in a rural Midwestern county to tailor existing measurement tools to this population. Focus group members were asked about the activities they engaged in and facilitators and barriers to those activities. Important factors associated with physical activity include social support and modeling active behavior. Focus group members desired to see community buildings be open to the public for exercise. This study revealed contextual issues and cultural language for tailoring physical activity measurement tools for rural adults. Aim 3: Ecological models propose that the environment impacts behavior on several different levels. Using a tailored survey instrument, this study examined social, environmental, and policy-level determinants of physical activity at different levels of an ecological approach. A cross-sectional survey was given to 143 individuals residing in a rural Midwestern county. Test-retest reliability was examined using correlations and kappa statistics, and was found to be very good to substantial. Multiple regression analyses were conducted using general linear modeling. Social factors were associated with total physical activity; environmental factors were associated with active transport, house and yard work, vigorous activity, and walking; and policy factors were associated with physical activity at work, and moderate-intensity activity. Findings can be used to tailor physical activity interventions using an ecological approach in rural adults, based on the specific domain and intensity in which the activity occurs. These studies provide insight into the contextual factors that are associated with physical activity in rural Midwestern adults, and provide evidence that determinants should be examined and presented by the domain and intensity in which this behavior occurs. It is clear that social and physical environments and policy attitudes are associated with domain- and intensity-specific physical activity in this population.

Environments that support physical activity (PA) engagement are now seen as an important part of the solution for accumulating daily physical activity which confers health benefits, particularly transport-related PA (TPA). Despite this recognition, understanding the determinants of health-related PA has traditionally focused on identifying associations between the social environment and non-specific PA domains. As such, prior to commencing this thesis little was known about the relationships between the built environment and overall PA engagement within the New Zealand context. Little was also known about associations between TPA attitudes and behaviours, and urban design. This research sought to overcome this paucity of knowledge by investigating associations between overall PA and TPA engagement and perceptions, health outcomes, urban design, and socio-demographic variables from a public health perspective. The body of research was initiated with two literature reviews that formed the context for the following six empirical chapters. Data in the empirical chapters were drawn from three self-report surveys using adult samples. The research commenced by examining associations between urban design and overall PA engagement, and then narrowed towards TPA-specific relationships. TPA relationships were identified through the development and implementation of a reliable survey that captured associated behaviours and attitudes. Several new findings were drawn from this body of work. Overall, 21% of adults recognised they could replace automobile journeys on at least two days per week, and walking was deemed an acceptable travel alternative. Adult TPA engagement levels were low; 7% commuted to place of work/study and 32% travelled to the convenience shop by TPA modes. Furthermore, when compared with those who commuted to an occupation by TPA, respondents who used motorised travel were less likely to be classified as active (odds ratio (OR)=0.5) and be of normal body mass index (OR=0.5). No significant health relationships existed for convenience shop travel. As well, 4% of adults reported no automobile availability. When this group was compared with those with unrestricted automobile availability, they were less likely to be classified as active (OR=0.3), but were more likely to engage in TPA modes to access destinations (occupation, OR=6.3; convenience shop, OR=9.8). Occupation-related commute distances also revealed interesting findings. Overall, 50% of respondents perceived they could, and 10% of the sample actually did, commute by TPA modes for distances less than five kilometres, and relationships were strongly mediated by distance. Other urban design variables were objectively assessed with TPA engagement for occupation-related commute distances less than five kilometres. Those who travelled along the most connected street networks were more likely to engage in TPA modes (OR=6.9) when compared with respondents travelling along the least connected networks. No relationships were found with other urban design variables and TPA engagement.This research substantially contributes to this research area by identifying associations between overall PA and TPA engagement and perceptions with urban design. It is likely that shifting the perceptions of adults who recognise they can employ TPA modes, into actual TPA engagement will result in promising population health gains. Future PA initiatives with adults should consider promoting walking for transport as a sustainable solution. A lack of TPA interventions is evident; however, methodological issues need to be resolved before developing such initiatives. Although strategies aimed towards changing perceptions may be valuable for future TPA interventions, it is likely macro-scale urban design modifications (e.g., improved job-housing balance, highly-grained street networks) and legislation (e.g., automobile restrictions) will have the greatest success for increasing TPA engagement in the adult population.

[Truncated abstract] The Dogs and Physical Activity (DAPA) study sought to examine the relationship between dog ownership and physical activity, in particular walking. It used an ecological model to examine the socio-demographic, intrapersonal, social environmental, physical environmental and policy-related factors affecting dog owners walking with their dog. Results from this study are presented as a series of papers four which are published, in press or accepted for publication. A review of the dog ownership, health and physical activity literature and results from qualitative research of the potential barriers and motivators to dog owners being physically active with their dogs were used to develop and test an instrument for measuring dog walking behaviour. The DAPA tool was designed to measure the amount of physical activity people undertake with their dog and dog-specific individual and environmental factors affecting people walking with their dog. It was developed as a supplementary tool for the second RESIDential Environments (RESIDE) survey. RESIDE is a 5-year longitudinal study of the physical activity levels of people building homes in new housing estates in Western Australia. Findings from the baseline survey of 1813 RESIDE participants (44% dog owners) showed that dog owners were 60% more likely than non-owners to achieve sufficient physical activity and sufficient walking and almost 80% more likely than non-owners to achieve sufficient walking for recreation in the neighbourhood after controlling for demographic, intrapersonal and environmental differences. ... Findings from the DAPA study highlight the importance of the local policy and physical environment in encouraging dog walking behaviour. Perceived lack of accessible public open space (POS) and dogspecific exercise areas were identified by focus group participants as major barriers to dog owners walking with their dog. Objective measurement of the local physical environment of dog owners supported their concerns; no dog owners in this study had access to a sign-posted off-leash park [greater than or equal to] 2 acres within their neighbourhood. Furthermore, access to local POS with dog-supportive infrastructure was associated with being a regular dog walker. Overall, the results of this study draw attention to the needs of dog owners in the allocation and design of POS. The prospective component of the DAPA study enabled examination of the causal relationship between dog ownership and physical activity. After adjusting for baseline variables, dog acquisition significantly increased minutes of recreational walking within the neighbourhood by 37 minutes. However, after further adjustment for changes in baseline variables, the increase in minutes of recreational walking within the neighbourhood from dog acquisition reduced to 21 minutes and was no longer statistically significant. Increase in intention to walk appeared to mediate the relationship between dog acquisition and increased recreational walking. This study highlights a number of important physical activity benefits associated with dog ownership and provides evidence to suggest that dog walking has the potential to positively affect the proportion of the community who are sufficiently active.

The Healthy Start Summer Program (HSSP) is a seven-week summer program that strives to provide health and wellness education in a manner that is applicable to everyday living. The primary goal of the HSSP is to improve physical fitness levels and the psychosocial variables associated with exercise in a minority adolescent population, while providing the tools necessary for students to maintain these changes for four months after the program. Participants and control subjects were evaluated at the beginning and end of their respective summer programs, then followed up four months post-program to evaluate the maintenance of these changes. The students who participated in both the HSSP and the control summer programs were primarily of Hispanic, African-American, or Haitian descent and were recruited from high schools that serve low socioeconomic areas. Participation in the HSSP was associated with improved physical fitness levels that remained elevated at the follow-up evaluation; however, physical fitness improvement during the program was negatively associated with maintenance after the program. In general, the expected associations between physical fitness and psychosocial variables were not found in our population, nor did psychosocial variables change significantly during or following the program. Findings indicate that the expected associations between physical and psychosocial variables are either not present or that the tools used to measure them were not sufficiently sensitive in this minority population. However, the fact that cardiovascular fitness remained elevated above baseline four months after the program represents an improvement from interventions previously reported in the literature. Future research should be conducted to more fully understand the factors related to the maintenance of physical fitness.

Numerous studies have investigated the relationship between physical activity and physiological health (e.g., Burke et al., 2006; Irwin, 2004). Less attention has been paid to the contribution of physical activity on psychological well-being (Fox et al., 2000), and more specifically eudaimonic well-being, which reflects optimal psychological functioning and development at ones maximum potential (Ryff, 1989, 1995). This study investigated the role that health-enhancing physical activity (HEPA; any form of physical activity that benefits health and functional capacity; Miilunpalo et al., 2000) plays in eudaimonic well-being, which Ryff conceptualizes in terms of six dimensions: (1) Autonomy (i.e., being self-determined and independent); (2) Environmental Mastery (i.e., having a sense of mastery and competence in managing the environment); (3) Personal Growth (i.e., having a feeling of continued development); (4) Positive Relations with Others (i.e., having warm, satisfying, and trusting relationships with others); (5) Purpose in Life (i.e., having goals and a sense of direction in life); and, (6) Self-acceptance (i.e., possessing a positive attitude toward the self).<p> Employing Ryffs (1989, 1995) perspective of eudaimonic well-being, this study explored whether or not experiencing eudaimonia during HEPA moderates the relationship between HEPA and eudaimonic well-being. Additionally, it explored whether or not the relationship between experiencing eudaimonia during HEPA and eudaimonic well-being is mediated by basic need satisfaction. Undergraduate university students (N = 524; Mage = 20.7 years) completed an online survey including the Scales of Psychological Well-Being (Ryff & Keyes, 1995), the Short Questionnaire to Assess Health-enhancing Physical Activity (Wendel-Vos et al., 2003), the Hedonic and Eudaimonic Motives for Activity scale (Huta & Ryan, 2008), and the Psychological Need Satisfaction in Exercise Scale (Wilson, Rogers, et al., 2006). While level of HEPA was not significantly related to eudaimonic well-being (r = .05, p = .24), experiencing hedonia during HEPA (i.e., enjoying oneself, experiencing pleasure; r = .40, p < .01), experiencing eudaimonia during HEPA (r = .37, p < .01), and basic need satisfaction (r = .46, p < .01) were significantly related to eudaimonic well-being. Although experiencing eudaimonia during HEPA did not moderate the relationship between HEPA and eudaimonic well-being, experiencing eudaimonia during HEPA accounted for a significant 2.2% unique variance in eudaimonic well-being beyond HEPA and experiencing hedonia during HEPA (the full model accounted for a significant 18.2% of the variance in eudaimonic well-being).<p> Furthermore, the data were consistent with a model of partial mediation in that basic need satisfaction partially accounted for the relationship between experiencing eudaimonia during HEPA and eudaimonic well-being, supporting the proposition put forth by Ryan et al. (2008) that positive psychological well-being is a result of eudaimonic living that facilitates the satisfaction of our basic psychological needs. Findings from this study suggest that what appears to be significant in the relationship between HEPA and eudaimonic well-being is not the level of activity, but rather what is experienced during the activity. Future research may explore the directionality of the relationship by examining the extent to which eudaimonic well-being influences what is experienced during activity.

Background: Hypertension is synonymous with high blood pressure, where blood exerts a great force on the arterial walls. Smoking cigarettes is known to cause negative health outcomes, specifically increase blood pressure. Adversely, physical activity is known to provide many health benefits, including the reduction of blood pressure. This study examines the impact of physical activity on the association between smoking and hypertension. Methods: Using secondary data from National Health and Nutrition Examination Survey (NHANES) 2007-2008, demographics of the population were described via descriptive statistics. Regressions were run using different models, controlling for various variables (age, ethnicity, sex, poverty to income ratio (PIR), body mass index (BMI), and interaction (smoking x physical activity)) to determine the association between smoking and hypertension. Odds ratios and 95% confidence intervals were used to determine statistical significance throughout all the analyses performed. Results: In total, 10,149 cases were included in the study analysis. 10.9% of the cases were smokers, 48.1% were physically activity, and 28.6% were hypertensive. OR’s for the various models observing smoking and hypertension were 1.48 (1.29, 1.69), 1.42 (1.22, 1.65), 1.37 (1.12, 1.67), and 1.36 (1.10, 1.68). In the final model which controlled for all variables including the interaction term, the OR was 1.12 (0.47, 2.67). Conclusions: Smokers had significantly higher rates of hypertension in all the models. The final model which observed smokers who were physical active found that the relationship between smoking and hypertension was no longer significant. This study suggests physical activity as a mode of intervention to reduce blood pressure in smokers.

Numerous studies have investigated the relationship between physical activity and physiological health (e.g., Burke et al., 2006; Irwin, 2004). Less attention has been paid to the contribution of physical activity on psychological well-being (Fox et al., 2000), and more specifically eudaimonic well-being, which reflects optimal psychological functioning and development at ones maximum potential (Ryff, 1989, 1995). This study investigated the role that health-enhancing physical activity (HEPA; any form of physical activity that benefits health and functional capacity; Miilunpalo et al., 2000) plays in eudaimonic well-being, which Ryff conceptualizes in terms of six dimensions: (1) Autonomy (i.e., being self-determined and independent); (2) Environmental Mastery (i.e., having a sense of mastery and competence in managing the environment); (3) Personal Growth (i.e., having a feeling of continued development); (4) Positive Relations with Others (i.e., having warm, satisfying, and trusting relationships with others); (5) Purpose in Life (i.e., having goals and a sense of direction in life); and, (6) Self-acceptance (i.e., possessing a positive attitude toward the self).<p> Employing Ryffs (1989, 1995) perspective of eudaimonic well-being, this study explored whether or not experiencing eudaimonia during HEPA moderates the relationship between HEPA and eudaimonic well-being. Additionally, it explored whether or not the relationship between experiencing eudaimonia during HEPA and eudaimonic well-being is mediated by basic need satisfaction. Undergraduate university students (N = 524; Mage = 20.7 years) completed an online survey including the Scales of Psychological Well-Being (Ryff & Keyes, 1995), the Short Questionnaire to Assess Health-enhancing Physical Activity (Wendel-Vos et al., 2003), the Hedonic and Eudaimonic Motives for Activity scale (Huta & Ryan, 2008), and the Psychological Need Satisfaction in Exercise Scale (Wilson, Rogers, et al., 2006). While level of HEPA was not significantly related to eudaimonic well-being (r = .05, p = .24), experiencing hedonia during HEPA (i.e., enjoying oneself, experiencing pleasure; r = .40, p < .01), experiencing eudaimonia during HEPA (r = .37, p < .01), and basic need satisfaction (r = .46, p < .01) were significantly related to eudaimonic well-being. Although experiencing eudaimonia during HEPA did not moderate the relationship between HEPA and eudaimonic well-being, experiencing eudaimonia during HEPA accounted for a significant 2.2% unique variance in eudaimonic well-being beyond HEPA and experiencing hedonia during HEPA (the full model accounted for a significant 18.2% of the variance in eudaimonic well-being).<p> Furthermore, the data were consistent with a model of partial mediation in that basic need satisfaction partially accounted for the relationship between experiencing eudaimonia during HEPA and eudaimonic well-being, supporting the proposition put forth by Ryan et al. (2008) that positive psychological well-being is a result of eudaimonic living that facilitates the satisfaction of our basic psychological needs. Findings from this study suggest that what appears to be significant in the relationship between HEPA and eudaimonic well-being is not the level of activity, but rather what is experienced during the activity. Future research may explore the directionality of the relationship by examining the extent to which eudaimonic well-being influences what is experienced during activity.

The purpose of this study was to compare pre-service and in-service teachers and coaches attitudes toward instructing children and adolescents with exceptionalities as part of the regular physical education and athletic programs. Surveys were distributed to approximately 100 in-service teachers (i.e., classroom teachers, special educators, and physical educators from kindergarten through to grade eight) from an urban school division in Saskatchewan and 100 pre-service teachers enrolled in a college of education at a Western Canadian university to explore their attitudes toward instructing students with exceptionalities as part of the regular physical education/athletic program. Seventy-seven pre-service teachers and 92 in-service teachers completed an adapted version of the Physical Educators Attitude Toward Teaching Individuals with Disabilities-III (PEATID-III) (Rizzo, 1993).<p> Descriptive, inferential (analysis of variance), and correlational analyses were used to compare and explore relationships between survey factors and participants individual characteristics (e.g., independent variables of gender, age, years of experience, number of physical education classes taken). Significant differences were found between teachers and coaches years of experience teaching/coaching students with exceptionalities (no experience to less than six months, 6 months to 2 years experience, and 2 or more years experience) and teachers attitudes toward the outcomes of teaching students with specific learning disabilities (SLD), Attention Deficit/Hyperactivity Disorder (ADHD), and mild to moderate cognitive delay (COGN). No statistically significant differences were found between years of experience teaching/coaching students with exceptionalities and the outcomes of teaching students with emotional behavioural disorders (EBD). Correlational analyses were used to determine relationships between independent variables (e.g., pre-service and in-service teachers/coaches years of teaching/coaching) and the outcomes of instructing students with exceptionalities in regular physical education/athletic programs (Factor 1). Both pre-service and in-service teachers rated the overall quality of their teaching/coaching experience with students with exceptionalities as satisfactory to very good. Yet, the majority of participants reported a competence rating of not at all competent to somewhat competent (e.g., 58.6% of participants had a competence rating of somewhat competent). Inconsistent teacher/coach responses may have been affected by participants answering the questions in a manner which they considered to be in agreement with socially acceptable perceptions of inclusion. Furthermore, educators believed that more training, experience, and education would improve competency levels in effective instruction. Practical implications for practice and direction for future research are discussed.

Experiences of Barriers and Facilitators for Physical Activity from People with Mental Disorders who Participated in a Physical Activity Project - An Interview Study   Purpose: To explore the experiences regarding perceived barriers and facilitators for physical activity of three participants with mental disorders who took part in the Norwegian Physical Activity Mentor project. Design and methods: Descriptive qualitative design. Individual semi-structured interviews were used for data collection. Data from the interviews was used in two separate bachelor theses, written by Swedish and Norwegian physiotherapy students. This cooperation was part of the NordPlus Higher Education Program Joint Physiotherapy Education in Bachelor Thesis Module. Qualitative content analysis was used in processing the data. Findings: Perceived barriers for physical activity were: mental disorder symptoms, antipsychotics, undertaking physical activity independently and physical experiences. Perceived facilitators for physical activity were: positive mental effects, intrinsic and extrinsic motivational factors, goal setting and routine. The experiences from the Physical Activity Mentor project, including the possibility of self-selected activities, were mainly positive. The support provided by the physical activity mentor was an important facilitator. Conclusion: Disease-related problems were perceived as barriers for physical activity. The most important perceived facilitator for physical activity was mental benefits from being physically active. External support from a physical activity mentor might facilitate physical activity for psychiatric outpatients.     Key words: mental disorder, physical activity, barriers, facilitators, mentor / NordPlus Higher Education Program Joint Physiotherapy Education in Bachelor Thesis Module

The purpose of this study was to examine the obstacles and problems prescribers of exercise on prescription (EoP) in primary care in Bollnäs and Söderhamn experience when using the method. It also aimed at examining if the barriers identified in previous studies also will be found in Bollnäs and Söderhamns municipalities. A qualitative study was made and four interviews with the managers of health centers in Bollnäs and Söderhamns municipalities were completed. The only inclusion criteria was that it would be a licensed health care professional at the clinic who work with, and prescribe the EoP. A content analysis was performed, which categorized the statements made according to their content. The results of the study showed that prescribers experienced obstacles and problems with the method. The main reason was lack of time, particularly insufficient time to provide information on adequate physical activity. Another obstacle was difficulties to motivate patients to become more physically active, as well as interoperability issues with politicians and complicated prescription forms. The study confirmed previous research regarding the barriers identified. The basis for the study was small and it is therefore not possible to generalize from the results obtained.