Many patients do not maintain physical activity (PA) post cardiac rehabilitation (CR),however few studies examine a large enough sample over the long-term. Thus, a retrospective cross-sectional study was carried out to examine PA and its correlates 2-6 years post CR; 584 graduates completed a mailed survey (mean+SD age: 69.8+9.8 years, BMI: 27+5.0 kg/m2, 80% male, 41.4+11.6 months since graduation, 36% response rate). PA was assessed using the Physical Activity Scale for the Elderly (PASE, mean+SD: 122.3+75.9). Seventy five percent of participants met Canadian PA guidelines. Greater PA was significantly associated with male sex, younger age, fear of falling, cholesterol control, self-controlled transportation, marital status, full-time work, rural location, higher VO2max, more comorbid conditions, greater perceived health, PA enjoyment, quality of life (QOL), social support, income, and CR staff support. Age,PA enjoyment, QOL, work status, cholesterol control and CR staff were significant in a multivariate model (R2=0.22, F=18.7, p<0.001).

Background: South Asian girls have reported low levels of physical activity (PA) compared to other Canadian adolescents. Potential explanations include omissions in existing PA measures that don’t capture all types of PA, and factors discouraging PA in this group. Purpose: This study examined the quality and quantity of PA; compared PA participation using two self-report methods; and, examined psychosocial and cultural factors associated with PA in adolescent South Asian girls. Methods: 113 participants were recruited from community sources in Toronto. Data were collected using a structured electronic diary (3 weekdays; 2 weekend days) and a self-administered online questionnaire that included the Leisure Time Exercise questionnaire. Diaries were content analyzed and compared to PA reports in the questionnaire. Bivariate and multivariate regression analyses identified factors associated with PA. Results: Diaries revealed that when a range of PA types were captured, like walking activities and chores, PA levels were similar to representative data for Canadian youth. 92% of respondents reported at least 30 minutes of PA per day across their diary entries. However, 19% did not report any PA at the vigorous intensity level, and PA levels were lowest on weekends. Reports of PA in the diary and questionnaire were inconsistent, with considerably higher levels of PA reported in the questionnaire. Enrolment in physical education, enjoyment, control, fewer barriers, and social provisions were associated with greater PA. Conclusions: Physical activity levels were low, but results did not suggest that South Asian girls are more vulnerable to low levels of activity compared to other Canadian girls. Findings from the diary suggest that PA questionnaires would benefit from including a broader range of activity types with a variety of walking activities, and structured reflections to enhance data quality and minimize the potential for over-reporting. PA levels may be increased through mandatory physical education, curricula that emphasize how girls may engage in vigorous activities outside of classes, and changes to neighbourhood environments that would promote walking.

Many patients do not maintain physical activity (PA) post cardiac rehabilitation (CR),however few studies examine a large enough sample over the long-term. Thus, a retrospective cross-sectional study was carried out to examine PA and its correlates 2-6 years post CR; 584 graduates completed a mailed survey (mean+SD age: 69.8+9.8 years, BMI: 27+5.0 kg/m2, 80% male, 41.4+11.6 months since graduation, 36% response rate). PA was assessed using the Physical Activity Scale for the Elderly (PASE, mean+SD: 122.3+75.9). Seventy five percent of participants met Canadian PA guidelines. Greater PA was significantly associated with male sex, younger age, fear of falling, cholesterol control, self-controlled transportation, marital status, full-time work, rural location, higher VO2max, more comorbid conditions, greater perceived health, PA enjoyment, quality of life (QOL), social support, income, and CR staff support. Age,PA enjoyment, QOL, work status, cholesterol control and CR staff were significant in a multivariate model (R2=0.22, F=18.7, p<0.001).

This thesis, comprising two studies, investigated whether negative expectations and self-perceptions relating to the aging process are associated with less physical activity (Study 1), and whether less active adults are likely to report age as a cause for physical activity failure than more active adults (Study 2). Using Sarkisian et al.’s (2002) Expectations Regarding Aging (ERA-38) survey, Study 1 first developed reliable and valid sub-factors for constructs relating to general aging expectations (GAE) and aging self-perceptions (ASP) by conducting exploratory factor analyses on 167 adults (M age = 59.5). Results revealed three acceptable GAE sub-factors relating to satisfaction/contentment, physical function and cognitive function, and three ASP sub-factors pertaining to functional, social, and sexual health. Subsequent MANOVA analyses showed that active adults reported higher GAE for satisfaction/contentment and cognitive function than less active adults. Regression analyses revealed that physical activity levels positively predicted satisfaction/contentment and physical function expectations among 45-54 yr olds. In Study 2, 177 adults (M age = 60.1) completed our Causal Dimension Scale for Aging (CDSA) and a survey asking whether age was a likely cause of failure in various physical activity contexts. Responses on the CDSA were used to validate ‘General Attributions towards Age’ (GATA), a measure which captured how adults view the aging effects. Subsequent analyses of variance determined that GATA interacted with physical activity status (active, less active) to influence the reported likelihood of age as a cause for failure. Less active adults with stable/uncontrollable GATA reported greater likelihood of age as a cause for failure than all other groups in gym, recreational/community program, and unstructured/spontaneous activity settings. Separate age group analyses indicated that these trends were pronounced in an unstructured/spontaneous activity setting for 45-54 yr olds, and in a generally recently inactive scenario for 55-64 yrs.

This investigation, comprising two studies, examined the number of barriers to physical activity (Study 1) and barrier strength (Study 2) reported by middle-aged and older adults using a social ecological framework (McLeroy et al., 1988). Researchers were interested in assessing age group (45-54; 55-64; 65-74 yrs) by physical activity group (active, less active) effects for barrier responses using analyses of variance. In Study 1, 180 participants completed a physical activity level survey (Godin & Shephard, 1985) and answered open-ended questions about barriers. Results indicated that 45-54 yr-olds reported more barriers overall, and more intrapersonal barriers than older groups. Less active 45-54 yr-olds reported more organizational-interpersonal barriers than the other groups. Descriptive analyses of coded themes demonstrated that common intrapersonal barrier sub-themes cited by younger adults related to family commitments, while sub-themes reported by middle-aged and older adults related to having a health problem or an injury. In the organizational-interpersonal category, the most common barrier sub-theme related to the workplace. In Study 2, 116 participants completed a survey assessing weekly physical activity and barrier strength for items pertaining to ecological categories and barrier sub-factors. Results showed that less active adults reported each of intrapersonal, interpersonal, and physical environment barriers more strongly than active adults, irrespective of age; the intrapersonal category was relatively the most constraining for our participants. In terms of barrier sub-factors, results showed that significantly higher barrier strength scores are most often associated with physical activity level (i.e., less active), and only occasionally associated with age group. The overall investigation can provide valuable information for improving physical activity interventions for middle-aged and older adults.

Background: The high prevalence of children and adolescents not meeting the recommended 60 minutes of physical activity (PA) per day and the associated negative health consequences make it critical to increase PA. Ecological models suggest that the school environment may influence student health behaviour. However, few studies have examined the school environment in relation to student PA. Purpose: To examine between-school variability in students’ time spent in PA, and identify factors of the school built environment that account for the between-school variability in students’ time spent in PA overall as well as by gender and school location, while also considering school physical education (PE) and PA programming and controlling for student-level characteristics and potential environment-level confounders. Methods: This thesis consisted of a secondary data analysis of the School Health Action, Planning and Evaluation System (SHAPES) Ontario project, which included self-report data from administrators and 25,416 students in 76 secondary schools across Ontario. The student- and school-level survey data were supplemented with GIS-derived measures of the built environment within 1-km buffers of the 76 schools. Multilevel modeling was used to examine between-school variability in students’ time spent in PA, as well as environment-level factors associated with PA. Results: There was significant between-school variability in students’ time spent in PA overall as well as by gender and school location, respectively. Schools having another room for PA and schools offering daily PE were positively associated with students’ PA. Schools located in areas with higher land-use mix diversity and walkability were negatively associated with students’ PA. Results of the gender-specific multilevel analyses indicated schools should consider providing another room for PA, especially for offering flexibility activities directed at female students. Schools should also consider offering daily PE to male students in senior grades. Students attending schools in urban and suburban areas that provided another room for PA or were located within close proximity to a shopping mall or fast food outlet spent more time in PA. Conclusions: These findings support the ecological notion that the school environment can influence student PA behaviour. A better understanding of the relationship between the school environment and PA will assist in the development of effective school-based policies, programs and interventions to increase PA.

A child’s level of physical activity is an important component of that child’s health. Our understanding of physical activity patterns in children is limited in rural settings, and virtually absent for climates with snow cover. Opportunities for physical activity intervention need to be identified. PURPOSE: Investigation of the relationships between pedometer-measured physical activity, body composition and aerobic performance in rural children in the winter and examination of within-day variation in stepping behavior using interval pedometry. METHODS: Aerobic performance (20 m shuttle run) with “talk test” validation and body composition (BMI, BF) were measured during mid-winter during the school year in 8 to 10 year old children. Pedometer step counts were recorded at 6 intervals throughout the day for 7 days. RESULTS: Fifty-six subjects (22 males and 34 females, mean age 9.09 (0.49), had the following measurements; BMI 17.9 (3.3), BF% 24.3 (9.5) (tricep/calf), 10,465 (±2506) steps/day, VO2 45.12 ml/kg/min (±2.87), shuttle run stage 3.0 (±1.34). Weekday steps/day (11,422 ±2573) were greater than weekend (8,112, ±3499) steps/day for both boys and girls (p<0.01). Town children recorded 1800 more steps/day than out of town children (p<0.01). All measures of body composition were found to be significantly related to aerobic power (p<0.01). Weekday steps were related to aerobic performance. The fittest (upper 1/3) children were leaner and had more afternoon school steps, and higher afternoon school step rates. CONCLUSION: Daily step counts were 2000-4000 steps lower than other studies and may be an impact of winter in Manitoba or the rural setting. This was consistent with overall low aerobic performance and higher adiposity of the children. Interval pedometry was capable of identifying differences in activity patterns between most and least fit children in rural Manitoba providing for targeted intervention strategies.

Physical Education (PE) includes the development of knowledge and positive attitudes toward physical activity. Regular physical activity participation during childhood and adolescence has many beneficial effects on health. The purpose of the study was (a) to describe student physical activity level, lesson context and teacher behavior, (b) to determine the relationships among physical activity, lesson context and teacher behavior, (c) to investigate the differences among these variables in public and private schools. Nineteen PE teachers from public and private schools in Ankara participated to the study. For data collection, 6th, 7th and 8th, (n=144) grade elementary school students were observed systematically by using SOFIT during 36 lessons. Results showed that students were spending little time in moderate to vigorous physical activity and they were generally standing or sitting in PE lesson. During the active time, they were generally practicing skill in both public and private schools. Teachers spent majority of lesson time on providing instruction for skill practice. However, teachers did not spend time on fitness knowledge and promotion of fitness in PE lessons. The findings of the study showed that there was a significant relationship between student activity level, lesson context and teacher behavior variables. PE teachers in public schools had higher scores of demonstration but teachers in private schools had higher scores of observation. In addition, there were no significant differences in lesson context variable between schools. Physical Education classes require active participation of students for skill and fitness development. However this study indicated that although students were practicing some forms of skills, there were not spending time on fitness development and fitness promotion during classes. Provision of in service training for teachers and revision in PE teachers&rsquo / education curriculum might be needed to improve the health-related physical activity levels and knowledge of adults of future.

Both type 2 diabetes (T2D) and the the metabolic syndrome (MetS) have been shown to increase the risk of cardiovascular disease (CVD). Inflammation and insulin resistance have each been associated with the development of MetS and the onset of T2D as well as the risk of CVD. Inflammation and insulin resistance are therefore suitable targets for public health initiatives and interventions in persons at risk for or living with CVD. Physical inactivity is a major risk factor for CVD as well as MetS and T2D. Conversely, increased physical activity is associated with improved health outcomes for individuals with a high risk for developing CVD. Two possible mechanisms for the deleterious effects of inactivity on health are inflammation and insulin resistance. Researchers have hypothesized that increased adiposity and reduced fitness are partially responsible for the associations between inactivity, inflammation, and insulin resistance. However, these relationships have not been studied extensively in overweight/obese individuals, who are often unfit and sedentary. The purpose of this study was to further examine the relationship between baseline measures of walking activity and sedentary behavior, and inflammation and insulin resistance in a sample of adults with type 2 diabetes and/or metabolic syndrome. This thesis examined baseline data from participants enrolled in either of two studies of patients with T2D (n = 116) or MetS without T2D (n = 126). Participants included low income men and women (not pregnant or nursing) between the ages of 18 and 70 who either show depressed affect (BDI > 11), and were overweight (BMI ≥ 27 kg/m2) and had type 2 diabetes or had at least 3 components of the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) classification of the metabolic syndrome (MetS). Structural equation modeling was used to determine if physical inactivity is associated with inflammation or insulin resistance in these conditions. Possible mediational roles of adiposity and low cardiorespiratory fitness were also examined. Additional analyses were conducted to determine if these relationships can be estimated equally in MetS and T2D conditions. Activity was indirectly related to abdominal adiposity via an indirect, positive association with cardiorespiratory fitness. Abdominal adiposity was positively related to both inflammation and insulin resistance. There were no direct associations between activity and inflammation or insulin resistance in this population. Therefore, walking may be negatively related to cardiovascular risk, insofar as it reduces abdominal adiposity.

The feasibility and outcomes of a 12-week extracurricular family-based intervention led by physical therapists that was designed to increase physical activity (PA) in three Hispanic male middle-school children was examined. This intervention has limited feasibility and may increase physical activity levels for overweight Hispanic middle school children. In a second study, differences in motor proficiency, strength, endurance, and PA among healthy weight, overweight and obese children were examined, and correlations between BMI and physical impairments were explored. Obese children demonstrated impairments in motor proficiency, strength, and endurance when compared to healthy weight children. Among overweight children, higher BMI was associated with more physical impairments. Overweight children were less physically active than healthy weight children. A high proportion of children were not meeting daily step recommendations to maintain a healthy weight. Girls were less active than boys at this crucial stage of development. The findings of this study have important clinical relevance for physical therapists, who are uniquely qualified to assess these identified impairments and activity limitations that may limit a child’s ability to engage in greater levels of physical activity. This information lends support to the role of the physical therapist in addressing current public health recommendations related to the childhood obesity.