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Search Results: 1 - 10 of 226633 matches for " Kelly R. Evenson "
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Measuring physical activity among pregnant women using a structured one-week recall questionnaire: evidence for validity and reliability
Kelly R Evenson, Fang Wen
International Journal of Behavioral Nutrition and Physical Activity , 2010, DOI: 10.1186/1479-5868-7-21
Abstract: To assess concurrent-related validity, 177 pregnant women (median 18 weeks' gestation, interquartile range (IQR) 15 -23) kept a structured diary and wore an accelerometer (Actigraph) for one week. At the conclusion of the week, they completed the Pregnancy Infection and Nutrition 3 (PIN3) physical activity questionnaire over the telephone. To assess evidence for test-retest reliability, 109 pregnant women (median 19 weeks' gestation, IQR 18-27) completed the questionnaire twice over the telephone, within 48 hours apart, recalling the same two time periods. Spearman correlation coefficients (SCC) and intraclass correlation coefficients (ICC) were used to assess evidence for validity and reliability, respectively.Comparison of the questionnaire to the structured diary was moderate to substantial (SCC 0.47 to 0.69) for several measures of moderate or vigorous physical activity using either perceived or absolute intensity. Comparison of moderate to vigorous physical activity from the questionnaire (absolute intensity using MET-hours/week) to the accelerometer ranged from 0.12 to 0.23 using SCC for absolute intensity (MET-hours/week) and 0.28 to 0.34 using relative intensity (hours/week) (n = 177). Test-retest reliability was moderate to almost perfect for moderate to vigorous physical activity, with the ICC ranging from 0.56 to 0.82 for both perceived and absolute intensities.The PIN3 one-week recall questionnaire assessed moderate to vigorous physical activity in the past week with evidence for reliability and validity.Several decades of research supports the benefits of physical activity during pregnancy [1,2]. In acknowledgment of this, several physician organizations endorse physical activity during pregnancy with position statements, such as in Canada [3], the United Kingdom [4], and the United States (US) [5]. In addition, the US government included a section on pregnancy recommendations in its national "2008 Physical Activity Guidelines for Americans" [1].To eval
Test-retest reliability of a questionnaire to assess physical environmental factors pertaining to physical activity
Kelly R Evenson, Aileen P McGinn
International Journal of Behavioral Nutrition and Physical Activity , 2005, DOI: 10.1186/1479-5868-2-7
Abstract: Test and retest surveys were conducted over the telephone with 106 African American and White women and men living in either Forsyth County, North Carolina or Jackson, Mississippi. Reliability of self-reported environmental factors across four domains (e.g., access to facilities and destinations, functionality and safety, aesthetics, natural environment) was determined using intraclass correlation coefficients (ICC) overall and separately by gender and race.Generally items displayed moderate and sometimes substantial reliability (ICC between 0.4 to 0.8), with a few differences by gender or race, across each of the domains.This study provides some psychometric evidence for the use of many of these questions in studies examining the effect of self-reported physical environmental measures on physical activity behaviors, among African American and White women and men.Physical activity improves health and quality of life and reduces the risk for several leading causes of death [1]. Yet despite these documented benefits, many adults do not obtain the recommended amounts of physical activity [1]. Barriers to physical activity occur at multiple levels: individual, interpersonal, organizational, community, and public policy or society factors. These factors fit within the framework of the socioecologic model [2,3]. Several studies have reviewed the literature on correlates of physical activity among adults and each has shown that until more recently the focus has been on individual and interpersonal levels of this framework and not on the broader contextual measures [4-7].In a 1998 review, Sallis et al [8] recommended pursuing a range of strategies to improve the conceptualization of the environment for physical activity, identifying behavior settings in which people are most likely to be physically active, and identifying characteristics of settings that appear to decrease or increase the likelihood of physical activity in that setting. Since that time the research in this
Physical activity patterns during pregnancy through postpartum
Katja Borodulin, Kelly R Evenson, Amy H Herring
BMC Women's Health , 2009, DOI: 10.1186/1472-6874-9-32
Abstract: This study was part of the third Pregnancy, Infection and Nutrition Postpartum Study at the University of North Carolina Hospitals. A cohort of 471 women was followed at 17-22 and 27-30 weeks' gestation and at 3 and 12 months postpartum. The participants reported the mode, frequency, duration, and intensity of all physical activities that increased their breathing and heart rate in the past week.Overall physical activity for the cohort decreased from 17-22 weeks to 27-30 weeks of gestation, but rebounded up at 3 months postpartum and remained stable at 12 months postpartum. The mean MET h/wk values for each time point were 24.7 (standard deviation, SD 26.8), 19.1 (SD 18.9), 25.7 (SD 29.3), and 26.7 (SD 31.5). In postpartum, women reported more care-giving and recreational activity and less indoor household activity, as compared to their activity level during pregnancy.For health benefits and weight management, health care professionals are encouraged to provide pregnant and postpartum women with information on recommendations of physical activity, particularly regarding the minimum duration and intensity level.For health benefits, regular physical activity is recommended for pregnant and postpartum women [1,2]. Previous prospective studies have reported lower levels of recreational, occupational, and overall physical activity during pregnancy [3-5]. However, less is known about physical activity during postpartum and the change in activity from pregnancy to postpartum. Prospective and retrospective studies have suggested, somewhat inconsistently, decreased [6,7], increased [8-11], or unchanged [12,13] physical activity at postpartum as compared to pre-pregnancy or pregnancy levels. Walking is reported to be the most common type of activity during pregnancy [6,14-16] and may remain unchanged from pre-pregnancy to postpartum [8].Previous studies often collected only recreational physical activity [6-9,11-13], while only a few studies have reported changes in other mod
Developing measures on the perceptions of the built environment for physical activity: a confirmatory analysis
Jennifer L Gay, Kelly R Evenson, Jessalyn Smith
International Journal of Behavioral Nutrition and Physical Activity , 2010, DOI: 10.1186/1479-5868-7-72
Abstract: To assess measurement invariance, a random sample of 1,534 adults living in North Carolina or Mississippi completed a computer assisted telephone interview that included items examining perceptions of the neighborhood for physical activity. Construct level test-retest reliability data were collected from a purposeful sample of 106 participants who were administered the questionnaire twice, approximately two weeks apart. Fit indices, Cronbach's alpha, Mokken H and Spearman correlation coefficients (SCC) were used to evaluate configural and co/variance invarianc,e and intraclass correlation coefficients (ICC) were used to assess reliability.Construct test-retest reliability was strong (ICC 0.90 to 0.93). SCC for Neighborhood Characteristics and Crime/Safety were weak with Access (0.21 and 0.25), but strong between Crime/Safety and Neighborhood Characteristics (0.62). Acceptable fit and evidence of measurement invariance was found for gender, race (African American and White), geographic location, and level of physical activity. Fit indices consistently approached or were greater than 0.90 for goodness of fit index, normed fit index, and comparative fit index which is evidence of configural invariance. There was weak support of variance and covariance invariance for all groups that was indicative of factorial validity.Support of the validity and reliability of the three-factor model across groups expands the possibilities for analysis to include latent variable modeling, and suggests these built environment constructs may be used in other settings and populations.With the advent of ecological models, physical activity research now frequently incorporates built environment measures [1]. While there is a clear cross-sectional association between built environmental characteristics and physical activity, the majority of research is conducted at the item level [2]. Analysis of individual items ignores the potential underlying themes or constructs that may exist, particular
Comparing objective measures of environmental supports for pedestrian travel in adults
Elizabeth Shay, Daniel A Rodriguez, Gihyoug Cho, Kelly J Clifton, Kelly R Evenson
International Journal of Health Geographics , 2009, DOI: 10.1186/1476-072x-8-62
Abstract: Using data collected in 2005-2006 for a sample of 251 adult residents of Montgomery County, MD, we examined associations between pedestrian facilities and walking behaviors (pedestrian trips and average daily steps). Adjusted negative binomial and ordinary least-squares regression models were used to compare three different data aggregation techniques (raw averages, length weighting, distance weighting) for measures of pedestrian facilities that included presence, condition, width and connectivity of sidewalks, and presence of crossing aids and crosswalks.Participants averaged 8.9 walk trips during the week; daily step counts averaged 7042. The three aggregation techniques revealed different associations between walk trips and the various pedestrian facilities. Crossing aids and good sidewalk conditions were associated with walk trips more than were other pedestrian facilities, while sidewalk facilities and features showed associations with steps not observed for crossing aids and crosswalks.Among three methods of aggregation examined, the method that accounted for distance from participant's home to the pedestrian facility (distance weighting) is promising; at the same time, it requires the most time and effort to calculate. This finding is consistent with the behavioral assumption that travelers may respond to environmental features closer to their residence more strongly than to more distant environmental qualities.Consensus is growing that the built environment has the potential to influence walking--both positively and negatively. Because pedestrian-supportive features of the built environment often are expensive and relatively permanent, and thus should be designed and placed carefully, it is important to understand the nuances of which facilities in which contexts are associated with changes in walking behavior. This understanding can increase the likelihood that environmental design will produce desirable effects among travelers. Extensive research has looke
The importance of accurate road data for spatial applications in public health: customizing a road network
Brian G Frizzelle, Kelly R Evenson, Daniel A Rodriguez, Barbara A Laraia
International Journal of Health Geographics , 2009, DOI: 10.1186/1476-072x-8-24
Abstract: A custom road network dataset was developed to examine associations between health behaviors and the environment among pregnant and postpartum women living in central North Carolina in the United States. Three analytical measures were developed to assess the comparative accuracy and utility of four publicly and commercially available road datasets and the custom dataset in relation to participants' residential locations over three time periods. The exclusion of road segments and positional errors in the four comparison road datasets resulted in between 5.9% and 64.4% of respondents lying farther than 15.24 meters from their nearest road, the distance of the threshold set by the project to facilitate spatial analysis. Agreement, using a Pearson's correlation coefficient, between the customized road dataset and the four comparison road datasets ranged from 0.01 to 0.82.This study demonstrates the importance of examining available road datasets and assessing their completeness, accuracy, and currency for their particular study area. This paper serves as an example for assessing the feasibility of readily available commercial or public road datasets, and outlines the steps by which an improved custom dataset for a study area can be developed.Over the last two decades, the public health field has increasingly adopted the use of Geographic Information Systems (GIS) for analyzing environments in which people live and how those environments affect health. One subset of this research focuses on the impacts of road networks, examining accessibility to health care along those networks [1-3]. Another area of research has examined the geographic location of road networks relative to other locations of interest, such as places of residence, schools, or other community facilities, and how such proximity affects health outcomes. Specifically, this research has used road networks in GIS to examine exposures such as traffic [4], air pollution [5-8], and degree of urbanicity [9] and t
Built and socioeconomic environments: patterning and associations with physical activity in U.S. adolescents
Janne Boone-Heinonen, Kelly R Evenson, Yan Song, Penny Gordon-Larsen
International Journal of Behavioral Nutrition and Physical Activity , 2010, DOI: 10.1186/1479-5868-7-45
Abstract: We used principal factor analysis to describe inter-relationships between a large set of Geographic Information System-derived built and socioeconomic environment measures for adolescents in the National Longitudinal Study of Adolescent Health (Wave I, 1995-96, n = 17,294). Using resulting factors in sex-stratified multivariate negative binomial regression models, we tested for confounding of associations between built and socioeconomic environment characteristics and moderate to vigorous physical activity (MVPA). Finally, we used knowledge gained from factor analysis to construct replicable environmental measures that account for inter-relationships and avoid collinearity.Using factor analysis, we identified three built environment constructs [(1) homogenous landscape; 2) development intensity with high pay facility count; 3) development intensity with high public facility count] and two socioeconomic environment constructs [1) advantageous economic environment, 2) disadvantageous social environment]. In regression analysis, confounding of built environment-MVPA associations by socioeconomic environment factors was stronger than among built environment factors. In fully adjusted models, MVPA was negatively associated with the highest (versus lowest) quartile of homogenous land cover in males [exp(coeff) (95% CI): 0.91 (0.86, 0.96)] and intensity (pay facilities) [exp(coeff) (95% CI): 0.92 (0.85, 0.99)] in females. Single proxy measures (Simpson's diversity index, count of pay facilities, count of public facilities, median household income, and crime rate) representing each environmental construct replicated associations with MVPA.Environmental characteristics are inter-related. Both built and SES environments should be incorporated into analysis in order to minimize confounding. Single environmental measures may be useful proxies for environmental constructs in longitudinal analysis and replication in external populations, but more research is needed to better unde
Reliability and validity of the Safe Routes to school parent and student surveys
Noreen C McDonald, Amanda E Dwelley, Tabitha S Combs, Kelly R Evenson, Richard H Winters
International Journal of Behavioral Nutrition and Physical Activity , 2011, DOI: 10.1186/1479-5868-8-56
Abstract: Students and parents from two Charlotte, NC (USA) elementary schools participated. Tallies were conducted on two consecutive days using a hand-raising protocol; on day two students were also asked to recall the previous days' travel. The recall from day two was compared with day one to assess 24-hour test-retest reliability. Convergent validity was assessed by comparing parent-reports of students' travel mode with student-reports of travel mode. Two-week test-retest reliability of the parent survey was assessed by comparing within-parent responses. Reliability and validity were assessed using kappa statistics.A total of 542 students participated in the in-class student travel tally reliability assessment and 262 parent-student dyads participated in the validity assessment. Reliability was high for travel to and from school (kappa > 0.8); convergent validity was lower but still high (kappa > 0.75). There were no differences by student grade level. Two-week test-retest reliability of the parent survey (n = 112) ranged from moderate to very high for objective questions on travel mode and travel times (kappa range: 0.62 - 0.97) but was substantially lower for subjective assessments of barriers to walking to school (kappa range: 0.31 - 0.76).The student in-class student travel tally exhibited high reliability and validity at all elementary grades. The parent survey had high reliability on questions related to student travel mode, but lower reliability for attitudinal questions identifying barriers to walking to school. Parent survey design should be improved so that responses clearly indicate issues that influence parental decision making in regards to their children's mode of travel to school.Low levels of physical activity among youth and the rise in childhood overweight and obesity have focused attention on interventions to increase physical activity [1,2]. The federal Safe Routes to School (SRTS) program aims to increase rates of walking and biking to and from school
A systematic review of interventions for promoting active transportation to school
Palma Chillón, Kelly R Evenson, Amber Vaughn, Dianne S Ward
International Journal of Behavioral Nutrition and Physical Activity , 2011, DOI: 10.1186/1479-5868-8-10
Abstract: A systematic review was conducted to identify intervention studies of active transportation to school published in the scientific literature through January 2010. Five electronic databases and a manual search were conducted. Detailed information was extracted, including a quantitative assessment comparing the effect sizes, and a qualitative assessment using an established evaluation tool.We identified 14 interventions that focused on active transportation to school. These interventions mainly focused on primary school children in the United States, Australia, and the United Kingdom. Almost all the interventions used quasi-experimental designs (10/14), and most of the interventions reported a small effect size on active transportation (6/14).More research with higher quality study designs and measures should be conducted to further evaluate interventions and to determine the most successful strategies for increasing active transportation to school.Currently, there is evidence that daily activities, including active transportation to school (defined as the use of active means, such as walking and bicycling to and from school), may have important health implications for young people. Active travel has been positively associated with higher daily levels of physical activity [1,2] and higher cardiorespiratory fitness [3,4]; but rates of active transportation to school have declined dramatically over the past 30 years [5]. Initiatives such as Safe Routes to School (SRTS), the Walking School Bus (WSB), or the Walk to School (WTS) program have been implemented to increase children's walking and bicycling to school with some success.The earliest peer-reviewed intervention study targeting walking and bicycling to and from school was published in 2003, and since then the field has progressed in the design and development of interventions. Research in this area has grown in recent years, and literature reviews have been conducted on patterns of commuting to school and relations
Residential self-selection bias in the estimation of built environment effects on physical activity between adolescence and young adulthood
Janne Boone-Heinonen, David K Guilkey, Kelly R Evenson, Penny Gordon-Larsen
International Journal of Behavioral Nutrition and Physical Activity , 2010, DOI: 10.1186/1479-5868-7-70
Abstract: We used cohort data from the National Longitudinal Study of Adolescent Health (United States; Wave I, 1994-95; Wave III, 2001-02; n = 12,701) and a time-varying geographic information system. Longitudinal relationships between moderate to vigorous physical activity (MVPA) bouts and built and socioeconomic environment measures (landcover diversity, pay and public physical activity facilities per 10,000 population, street connectivity, median household income, and crime rate) from adolescence to young adulthood were estimated using random effects models (biased by unmeasured confounders) and fixed effects models (within-person estimator, which adjusts for unmeasured confounders that are stable over time).Random effects models yielded null associations except for negative crime-MVPA associations [coefficient (95% CI): -0.056 (-0.083, -0.029) in males, -0.061 (-0.090, -0.033) in females]. After controlling for measured and time invariant unmeasured characteristics using within-person estimators, MVPA was higher with greater physical activity pay facilities in males [coefficient (95% CI): 0.024 (0.006, 0.042)], and lower with higher crime rates in males [coefficient (95% CI): -0.107 (-0.140, -0.075)] and females [coefficient (95% CI): -0.046 (-0.083, -0.009)]. Other associations were null or in the counter-intuitive direction.Comparison of within-person estimates to estimates unadjusted for unmeasured characteristics suggest that residential self-selection can bias associations toward the null, as opposed to its typical characterization as a positive confounder. Differential environment-MVPA associations by residential relocation suggest that studies examining changes following residential relocation may be vulnerable to selection bias. The authors discuss complexities of adjusting for residential self-selection and residential relocation, particularly during the adolescent to young adult transition.Built environment characteristics such as walkability [1,2] and availabi
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