abstract: The purpose of this pilot randomized control trial was to test the initial efficacy of a 10 week social cognitive theory (SCT)-based intervention to reduce workplace sitting time (ST). Participants were currently employed adults with predominantly sedentary occupations (n=24) working in the Greater Phoenix area in 2012-2013. Participants wore an activPAL (AP) inclinometer to assess postural allocation (i.e., sitting vs. standing) and Actigraph accelerometer (AG) to assess sedentary time for one week prior to beginning and immediately following the completion of the 10 week intervention. Self-reported measures of sedentary time were obtained via two validated questionnaires for overall (International Physical Activity Questionnaire [IPAQ]) and domain specific sedentary behaviors (Sedentary Behavior Questionnaire [SBQ]). SCT constructs were also measured pre and post via adapted physical activity questionnaires. Participants were randomly assigned to receive either (a) 10 weekly social cognitive-based e-newsletters focused on reducing workplace ST; or (b) similarly formatted 10 weekly e-newsletters focusing on health education. Baseline adjusted Analysis of Covariance statistical analyses were used to examine differences between groups in time spent sitting (AP) and sedentary (AG) during self-reported work hours from pre- to post- intervention. Both groups decreased ST and AG sedentary time; however, no significant differences were observed. SCT constructs also did not change significantly between pretest and post test in either group. These results indicate that individualized educational approaches to decreasing workplace sitting time may not be sufficient for observing long term change in behaviors. Future research should utilize a larger sample, measure main outcomes more frequently, and incorporate more environmental factors throughout the intervention. / Dissertation/Thesis / M.S. Exercise and Wellness 2013

Orientador: Aarão Mendes Pinto-Neto / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-16T12:26:22Z (GMT). No. of bitstreams: 1 Carvalho_EullerDuartede_M.pdf: 2535517 bytes, checksum: 29d870c2d30031124c3692499546acf2 (MD5) Previous issue date: 2010 / Resumo: Objetivo: Avaliar o nível de atividade física e a qualidade de vida em mulheres idosas e os fatores associados. Sujeitos e Métodos: Estudo de corte transversal através de entrevistas individuais com 271 mulheres com 60 anos ou mais que frequentavam o Serviço Social do Comércio de Campinas - SESC / Campinas e pacientes do Ambulatório de Menopausa do Centro de Atenção Integral à Saúde da Mulher - CAISM/UNICAMP. Os instrumentos utilizados foram o International Physical Activity Questionnaire (IPAQ - Versão 8) e o World Health Organization Quality of Life in Older Adults (WHOQOL - OLD). Os resultados do IPAQ foram avaliados através de tercis e a associação entre resultados do WHOQOL-OLD e IPAQ e características das mulheres pelos testes de T de Student/Mann-Whitney ou ANOVA/Kruskal - Wallis, e de análises múltiplas. Resultados: A média etária das mulheres foi de 67,4 + 5,3 anos. A análise de cada domínio da atividade física mostrou que 60,8% do tempo foram em atividades sentadas. Ser frequentadora do SESC, ter maior idade, sem companheiro, maior escolaridade e boa autopercepção do estado de saúde foram características que se associaram significativamente à prática de exercícios físicos moderados ou vigorosos. Evidenciou-se com a análise múltipla que frequentar o SESC aumentou 11,4 vezes as chances de praticar exercícios físicos moderados vigorosos, ter 70 anos ou mais aumentaram em 3,3 vezes as chances e escolaridade entre segundo grau completo ou mais em 2,4 vezes as chances de praticar exercícios físicos de intensidade moderada ou vigorosa. O escore médio de qualidade de vida foi de 66,9 + 11,7. O maior valor foi observado no domínio referente às habilidades sensoriais (72,0 + 18,8) e o menor à autonomia (60,3+ 16,2). Mulheres frequentadoras do SESC, com maior idade, sem companheiro, menor escolaridade, com boa autopercepção da saúde, que não usavam medicamentos, sem antecedentes de doenças e de estrato social mais elevado apresentaram melhor escore de qualidade de vida. Com a regressão linear observou-se que uma boa autopercepção da saúde aumentou o escore de qualidade de vida em 7,3 pontos, número maior de medicamentos diminuiu em 4,4 pontos e a pratica de exercícios físicos moderados ou vigorosos aumentou em 4,8 pontos o escore. Observou-se uma associação estatisticamente significativa entre a prática de exercício físico de intensidade moderado/vigorosa e melhores escores de qualidade de vida. Conclusões: Evidenciou-se a necessidade de esforços para a mudança do tipo e intensidade da atividade física em mulheres com 60 anos ou mais, com diminuição significativa do tempo gasto em atividades sentadas, com o objetivo de se atingir as recomendações para uma melhora nas condições físicas e manutenção da saúde. Da mesma maneira são necessários investimentos educacionais, bem como a criação de centros de convívio cultura e lazer, acessíveis a essa e outras populações para que possam compreender cada vez mais a importância da prática de atividades físicas para uma melhor qualidade de vida / Abstract: Objective: To evaluate the level of physical activity and quality of life in elderly women and factors associated. Subjects and Methods: A cross-sectional study was conducted using individual interviews with 271 women aged 60 years or older who belonged to the Trade Social Service (SESC), in Campinas, and patients attended in the Menopause Outpatient Clinic at the Women's Integrated Healthcare Center-CAISM/UNICAMP. The instruments used were the International Physical Activity Questionnaire (IPAQ - Version 8) and World Health Organization Quality of Life in Older Adults (WHOQOL - OLD). IPAQ results were evaluated by tertiles and the association between the WHOQOL-OLD and IPAQ results and subject characteristics was assessed by the Student's t test and Mann-Whitney test or ANOVA/Kruskal - Wallis, and multiple analyses. Results: The mean age of the women was 67.4 + 5.3 years. Analysis of each physical activity domain showed that 60.8% of the time was spent doing sitting activities. Belonging to SESC, being older, having no partner, having a higher school education and a good selfperception of health were characteristics significantly associated with the performance of moderate-intensity or vigorous-intensity physical activity. Multiple analysis indicated that belonging to SESC, being 70 years or older and having finished secondary education (or higher) increased the chance of engaging in moderate-intensity or vigorous-intensity physical activity by 11.4, 3.3 and 2.4 times, respectively. The mean quality of life score was 66.9 + 11.7. The highest value was observed in the domain related to sensory abilities (72.0 + 18.8) and the lowest score related to autonomy (60.3+ 16.2). Women belonging to SESC, those who were older, had no partner, had a lower school education, had a good selfperception of health, did not take medication, had no history of diseases and were from a higher social stratum had better quality of life scores. Using linear regression analysis, it was observed that a good self-perception of health increased the quality of life score by 7.3 points, the amount of medication taken decreased by 4.4 points and the performance of moderate or vigorous-intensity physical activity increased by 4.8 points. A statistically significant association was observed between the performance of moderate/vigorous intensity physical activity and better quality of life scores. Conclusions: It became evident that efforts are needed to change the type and intensity of physical activity in women aged 60 or older to significantly decrease time spent doing sitting activities, with the purpose of carrying out the recommendations for improving physical condition and maintaining health. In a similar manner, it is necessary to make an investment in education, as well as to establish cultural and leisure facilities, accessible to this population (and other populations) so that they may understand the increasing importance of performing physical activity to have a better quality of life / Mestrado / Ciencias Biomedicas / Mestre em Tocoginecologia

Sedentary behavior (SB) contributes to many negative health-related outcomes. Motivation to reduce SB and increase physical activity (PA) are necessary to reduce co-morbidities. Tracking SB and PA provides objective data to help promote wellness. The purposes of this quasi-experimental study were to 1) determine the accuracy of three commercially available activity trackers compared to research-grade accelerometers, and 2) explore whether using these activity trackers led to a change in activity level one week after gathering baseline data. Activity trackers used in this study were Apple Watch, Fitbit Surge, and Microsoft Band 2. A convenience sample of college-age students and community members wore the research-grade ActiGraph 3GTX+ accelerometer on the non-dominant wrist for one week. Participants returned and the activity tracker was added to the non-dominant wrist with the ActiGraph 3GTX+ for another week. All activity trackers significantly differed from the ActiGraph accelerometers. Fitbit Surge had a significant regression equation that could adjust for this difference, but not Apple Watch or Microsoft Band 2. Participants had below average sedentary time, exhibiting 288.4 min/day (SD 100.7) of SB. They also surpassed United States PA standards, averaging 130.3 (SD 48.8) min/day of moderate-to-vigorous physical activity. Few significant changes in activity level transpired between week 1 and week 2. In a group that already has low SB and high PA, activity trackers do not seem to make an impact on activity levels. Further testing is required to determine if activity trackers are motivating to reduce SB and increase PA in groups with different activity profiles.

On average, starting an exercise training program decreases one’s risk for chronic disease. However, there is remarkable individual variability in physiologic responses to exercise training. The activity and inactivity during the remaining 95% of the day (when the individual is not training) is rarely considered. The overall objective of this dissertation was to apply validated sedentary behavior (SB) and physical activity (PA) measurement techniques during an exercise training study to determine if time spent in SB and PA outside of training influences the physiological response to training. Twenty subjects participated in a pilot study to determine the feasibility of reducing SB and the validity of PA monitors for measuring SB compared to direct observation (DO). Participants completed a 1-week baseline period and a 1-week intervention period, where they were instructed to decrease SB. The correlation between the AP and DO was R2=0.94 and the AG100 and DO sedentary minutes was R2=0.39. SB significantly decreased from 67% of wear time (baseline period) to 62.7% of wear time (intervention period) according to AP. Only the AP was able to detect reductions in SB and was more precise than the AG. Study Two was a 12-week randomized controlled study. There were 4-groups that were instructed to: 1) CON: maintain habitual PA and SB 2) rST: reduce and break-up SB and increase daily steps 3) EX: exercise 5-days per week for 40-minutes per session at moderate intensity 4) EX-rST: combination of EX and rST. Cardiovascular disease risk factors were assessed pre-and post-intervention. The AP was used to verify AP between-group differences in activity at four time-points. EX-rST had improvements in insulin action variables that EX did not. All other physiologic responses to training were similar between EX groups and rST has less robust changes than either EX group. These data provide validation of activity monitors for measuring SB and present preliminary evidence that activity outside of exercise training may influence the metabolic response to training. This dissertation shows that what is done outside of exercise training can and should be quantified using objective monitors that assess daily exposure to activity and inactivity behavior.

Cardiometabolic diseases are the leading causes of worldwide mortality, of which metabolic syndrome is a major contributor. Increased sedentary behavior and decreased physical activity have been independently associated with increased risk of developing metabolic syndrome and subsequent maladies. Likewise, the development of more contemporary methodologies of measuring metabolic syndrome allow for a more nuanced examination of risk. However, these new methodologies lack extensive utilization among the physical activity epidemiology literature. The scarcity of research incorporating the independent relations between sedentary behavior, physical activity, and contemporary methodologies to measure metabolic syndrome warrants additional investigation. This dissertation aimed to further discern these relations using three different cohort data sets. Data from the National Health and Nutritional Examination Survey (NHANES), the Jackson Heart Study (JHS), and the Coronary Artery Risk Development in Young Adults (CARDIA) Study were utilized to further elucidate the relations between sedentary behavior, physical activity, and metabolic syndrome in three separate studies. The studies observed the majority of waking hours were spent engaged in sedentary behaviors; although, each cohort also appeared to meet the Physical Activity Guidelines for Americans. Metabolic syndrome positive individuals from NHANES engaged in similar amounts of physical activity as the general population. While the diversity of physical activity type was less, the physical activities engaged in were typically at the same prevalence among metabolic syndrome positive and the general populations. Sedentary behaviors were associated with increased metabolic syndrome severity score, but this relation was attenuated when moderate-to-vigorous physical activity and cardiorespiratory fitness were added to the model for both JHS and CARDIA studies. Decreasing sedentary time and with an equivalent amount of physical activity, of any intensity, is beneficial for cardiometabolic health. Understanding which physical activities subpopulations engage in can be paired with culturally competent interventions to increase physical activity engagement. Exceeding the minimum requirements for the Physical Activity Guidelines for Americans can produce increases in cardiorespiratory fitness, which have an independent positive impact on cardiometabolic health. Strategies should aim to increase physical activity among sedentary individuals, while limiting sedentary time among those physically active.

Master of Science / Department of Horticulture, Forestry, and Recreation Resources / Candice A. Shoemaker / Professionals in health promotion are starting to look at gardening as a strategy for health behavior change. This popular leisure time activity provides access to physical activity and fresh fruits and vegetables for consumption, two behaviors consistently recommended for optimum physical health. Coupled with a lifestyle low in sedentary behavior these behaviors can offset the health risks of the prevailing trends of overweight and obesity. Spending time outdoors is associated with higher levels of physical activity, while screen based behaviors are associated with unhealthy eating. No studies to date have looked at the health behaviors of gardeners, or the effects it may have on their family’s health behaviors. The purpose of this report is to examine, through descriptive research, the health behaviors of gardening and non-gardening parents and their fourth or fifth grade child. Surveys were administered to a convenience sample of 366 fourth and fifth grade students and their guardians within a school district in Riley County, Kansas. The survey assessed the physical health behaviors mentioned above; comparisons were made according to parental classification of gardener (n=189) or non-gardener (n=177). Significant association was found with gardening classification and adult self-reports of the number of days and amount of time respondents participated in moderate to vigorous physical activity. The median days per week parents reported participation in moderate to vigorous physical activity was 3 for non-gardeners, and 4 for gardeners and was influenced by gender. Eighty-seven percent of gardeners compared to 59.3% of non-gardeners reported meeting the current physical activity recommendation of 150 minutes per week of moderate intensity activity.

Master of Science / Department of Food, Nutrition, Dietetics and Health / Sara K. Rosenkranz / Evidence from physical activity interventions suggests that women, in particular, may overcompensate for exercise energy expenditure by increasing caloric intake. Sedentary behavior and poor diet quality are independent risk factors for many major chronic diseases including cardiovascular disease (CVD). It is unknown whether insufficiently active women alter dietary quality or caloric intake when participating in an intervention to reduce sedentary behavior. Insufficiently active women (n=49) working full-time sedentary jobs were randomized into one of two 8-week sedentary interventions occurring during the work week [short breaks (SB) (1-2 min every half hour, n=24) or long breaks (LB) (15 min twice daily, n=25)]. Dietary information was collected through 3-day food records at baseline, week 4 and week 8. Dietary quality was assessed using the Alternative Healthy Eating Index 2010 (AHEI-2010). CVD risk factors (systolic and diastolic blood pressure (BP), fasting cholesterol, triglycerides, and blood glucose, and body mass index) were assessed at baseline and week 8. For all participants there were no changes in AHEI-2010 scores over time (baseline: M=53.4, 95% CI [49.2, 57.6], week 4: M=50.3, 95% CI [45.9, 54.7], week 8: M=48.4, 95% CI [44.1, 52.7], p>0.05). Average caloric intake in the SB group (baseline: M=1943.8 kcals/day, 95% CI [1716.2, 2171.5], week 4: M=1728.8 kcals/day, 95% CI [1462.4, 1995.2], week 8: M=1616.8 kcals/day, 95% CI [1450.2, 1783.4]) decreased significantly from baseline to week 4 (p=0.015) and baseline to week 8 (p=0.002). There were no significant changes in caloric intake in the LB group (p>0.05) at either time point. In all participants, absolute changes in LDL were positively correlated with absolute changes in caloric intake (r=0.473, p=0.005). There were no other significant associations between changes in dietary quality or caloric intake with changes in any other CVD risk factor (p>0.05). Following an 8-week sedentary intervention in the workplace, insufficiently active women did not alter their dietary quality, but decreased caloric intake. Future research should explore sedentary interventions compared to physical activity interventions in women as a means to create negative energy balance, as sedentary breaks throughout the day may be effective for improving health outcomes.

BACKGROUND: Obesity is a major public health problem. Studies have shown that there are racial and ethnic differences in the prevalence of obesity. However, there is limited research that examines the effects of sedentary and poor lifestyle behaviors and obesity among different racial and ethnic groups. Furthermore, most studies focus on the problem of obesity among children. This study was conducted to examine racial differences in determinants of obesity in adults in the United States. METHODS: Data from the 2005 Behavioral Risk Factor Surveillance System was used for this analysis. Demographics, lifestyle behaviors, and existence of chronic diseases were assessed. Data was stratified by race and multiple logistic regression analysis was conducted to examine determinants of obesity by race. RESULTS: The majority of the study participants (59%) were overweight or obese (BMI 22500). The following determinants were found to have a significant association with risk of obesity in whites, blacks and Hispanics: age, marital status, consumption of dietary recommendations of hits and vegetables, smoking status, and alcohol consumption. For whites, education and income level did not show a statistically significant association with obesity. For African Americans, sex, physical activity, and income levels did not have statistically significant associations with obesity. Income did show a statistically significant association with obesity in Hispanics.CONCLUSION: Overall, it was found that the determinants of obesity vary with ethnic groups. In order to effectively combat obesity, smoking cessation must also be paired with a healthy diet and regular exercise. In addition, interventions must be made in correlation with the needs of the community.

Promouvoir l'activité physique durablement à l'adolescence est un enjeu majeur de santé publique. À ce jour, les programmes susceptibles d'être efficients restent discutés. ICAPS, une étude randomisée de quatre ans, a montré l'intérêt d'une approche socioécologique pour promouvoir l'activité physique, limiter la sédentarité et prévenir le surpoids chez l'adolescent. Cependant, le maintien à long terme, l'équité et les mécanismes expliquant l'efficacité de cette intervention restaient à démontrer. Dans ce travail, nous avons montré que les effets d'ICAPS se maintenaient à distance de l'intervention de manière équitable. Les effets étaient similaires quels que soient le genre et le poids initial et tendaient à être plus élevés chez les adolescents les moins socialement favorisés, les plus sédentaires et ne bénéficiant pas de support parental à la pratique d'activité physique. Grâce à l'utilisation de modèles d'équations structurelles, nous avons pu démontrer que l'efficacité de l'intervention reposait bien sur les mécanismes envisagés dans le modèle théorique initial. Les déterminants personnels (perception de l'activité, norme sociale, sentiment d'accomplissement personnel et intention de pratiquer), le support social et l'offre d'activité ont été identifiés comme des médiateurs significatifs. Nous avons de plus montré que le programme avait favorisé des interactions synergiques entre ces facteurs. Autrement dit, grâce à son action sur le support social et l'environnement, ICAPS a permis aux adolescents de mettre en pratique les compétences acquises grâce aux actions ciblant l'individu, renforçant l'efficacité de l'intervention et son maintien à long terme / Promoting long term physical activity practice during adolescence is one of the public health priorities. Nowadays, the question about the program’s efficiency aiming at reaching this objective is still on course. ICAPS, a four year randomized controlled trial, highlighted the benefits of a socioecological approach in the physical activity promotion and the sedentary behavior and overweight preventions in adolescence. However, the sustainability, the equity and the understanding efficacy mechanisms of such a program have still not been studied. In this report, long term effects of the ICAPS program have been established as its efficient equity. ICAPS effects were similar whatever the adolescent’s gender and initial weight status and were stronger among the adolescent’s from a low socioeconomic status, with a higher sedentary behavior and among those considered as having a low parental support towards physical activity practice. Using structural equation modeling, our results confirmed the efficiency mechanisms of the socioecological approach. Individual determinants (physical activity perception, social norm, self efficacy and intention to practice), adolescent’s social support and physical activity offer were identified as significant mediators. Moreover, we have highlighted that the program has promoted synergistic interactions between them. Finally, with its action over the social support and the environment, the ICAPS program allowed the adolescent’s to put into practice the competences they have acquired with the individual centered actions, reinforcing the program efficacy and its long term sustainability

Purpose: Accelerometry is commonly used to objectively measure physical activity (PA), however, differential data collection methods and analysis techniques yield dissimilar outcomes. The aims of this research were to (1) understand how accelerometer output varies among accelerometers worn on the non-dominant wrist (NDW), dominant wrist (DW), and hip; (2) develop site-specific algorithms to predict activity type classification, activity intensity classification, and estimates of metabolic intensity; and (3) compare the algorithms in a free-living setting. Methods: Forty participants (16.8 – 64.2 yr) completed a sequence of sedentary and physical activities in a laboratory while wearing accelerometers on the NDW, DW, and hip. Participants also wore a portable metabolic analyzer to objectively measure oxygen consumption (VO2). One-second accelerometer output was compared across wear locations by activity type and intensity classifications (Aim 1). Accelerometer output data were transformed into variables related to the magnitude (ϒ), horizontal angle (φ), and inclination (θ) of acceleration, and used to develop algorithms for the NDW, DW, and hip. Random forest algorithms were developed to predict activity type classification (i.e., sedentary, lifestyle, and ambulatory) and activity intensity classification (i.e., sedentary, light, moderate, and vigorous), and regression models were built to predict VO2 (Aim 2). Following the laboratory visit, participants simultaneously wore an accelerometer at each of the three locations for three days of free-living data collection. The site-specific algorithms developed in Aim 2 were compared for equivalence (Aim 3). Aim 1 Results: Analysis of variance indicated that accelerometer output differed between the NDW, DW, and hip for all activities completed, except for lying supine. Differences were expected; thus, Pearson correlation coefficients were calculated between the NDW, DW, and hip, and compared across activity type and intensity classifications. For activity type, the relationships between all wear locations were different for all activity types (i.e., sedentary, lifestyle PA, and ambulatory PA). For activity intensity, the relationships between the wrists were significantly different between sedentary and light activities. Additionally, relationships between the NDW, DW, and hip differed between light and moderate, and light and vigorous PA for all wear locations. The disparate correlations indicated that accelerometer signals do not just increase in magnitude as intensity increases; rather they increase differentially by wear location and activity type. Aim 2 Results: Site-specific random forest algorithms were developed to predict activity type and intensity classification. The algorithms utilized 10-15 features of the accelerometer signal related to variability, location, and central tendency. The hip had prediction accuracies of 84.9% for activity type classification and 80.2% for activity intensity classification. The dominant wrist had activity type prediction accuracy of 83.6% and intensity prediction accuracy of 78.9%. The non-dominant wrist had prediction accuracies of 83.1% and 78.0% for activity type and intensity, respectively. The VO2 prediction algorithms had Mean Absolute Errors of 2.96 ml/kg/min for the hip, 3.34 ml/kg/min for the NDW, and 3.49 ml/kg/min for the DW. This equates to an average error of 0.93 metabolic equivalents (METs); algorithms currently used in practice yield errors of 0.89 to 2.00 METs. Aim 3 Results: The site-specific prediction algorithms were applied to free-living data. Using the random forest algorithms, activity type classification estimates differed by 2 to 82 minutes/day, and activity intensity classification estimates differed by 0 to 83 minutes/day; however, these differences were not significantly different. The VO2 prediction models provided estimates of PA within 0 to 57 minutes/day of one another. The hip provided the lowest estimates of MVPA, while the NDW provided the highest estimates, however the VO2 estimates from all wear locations were statistically equivalent to one another. Conclusion: The differential relationships among accelerometer outputs from the NDW, DW, and hip indicate that output differs based on activity type and intensity. This non-systematic error prevents scaling or comparing data collected at different wear locations and supports the need for site-specific analysis methods. Site-specific prediction algorithms provided comparable to improved performance over currently-utilized analysis methods in PA research, and the PA estimates were equivalent across wear locations. This research provides a more nuanced understanding of the impact of wear location on accelerometer output and alternative methods for analysis. Importantly, the algorithms created allow for comparisons to be made among data collected at the NDW, DW, and hip, which has not previously been possible.