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Background: Latina women are less likely to report engaging in leisure-time physical activity (PA) than non-Latina white women. This study evaluated the 24-month impact of a faith-based PA intervention targeting Latinas., Methods: The study is a cluster randomized controlled trial of a PA intervention or cancer screening comparison condition, with churches as the randomization unit. A total of 436 Latinas (aged 18-65 years) from 16 churches who engaged in low levels of self-report and accelerometer-based PA were enrolled. The experimental condition was a 24-month PA intervention, with in-person classes, social support, and environmental changes, led by community health workers (i.e., promotoras). At baseline, 12-, and 24 months, we assessed changes in accelerometer-based and self-reported moderate to vigorous physical activity (MVPA; primary outcomes). Secondary outcomes were light intensity activity, sedentary time, body mass index (BMI), and waist circumference., Results: After adjusting for sociodemographic factors, a mixed effects analysis found significant increases in self-reported leisure time MVPA (p < 0.005) and marginal increases in accelerometer-assessed MVPA (p < 0.08) 24 months post-baseline in the intervention compared to the attention-control condition. Data showed significant associations between PA class attendance and engaging in MVPA as assessed by self-report and accelerometry. No significant changes were found for light activity, sedentary time, BMI, or waist circumference., Conclusions: Participants who attended the PA classes at least once a month engaged in significantly higher MVPA compared to those who did not. Maximizing engagement and maintenance strategies to enhance PA maintenance could contribute to important long-term health benefits., Trial Registration: NCT01776632 , Registered March 18, 2011., (© 2022. The Author(s).)

With increased globalization, Latin America is experiencing transitions from traditional lifestyle and dietary practices to those found in higher income countries. Healthy diets, physical activity and optimal body fat can prevent approximately 15% of cancers in low-income and 20% in high-income countries. We discuss links between diet, obesity, physical activity and cancer, emphasizing strategies targeting children to decrease risk of obesity, control obesity-related risk factors, and reduce sedentary lifestyles, as this will have high impact on adult cancer risk. We focus on individual behaviors, economic, cultural and societal changes that may guide future interventions in the Americas., Competing Interests: Declaration of conflict of interests. The authors declare that they have no conflict of interests.

Purpose: This study tested whether a multilevel physical activity (PA) intervention had differential effects on PA according to participants' perceptions of their neighborhood environment., Design: Two-group cluster randomized controlled trial., Setting: San Diego, California., Subjects: Analytical sample included 319 Latinas (18-65 years) from churches randomized to the following conditions: PA (n = 8 churches, n = 157 participants) or attention control (n = 8 churches, n = 162 participants)., Intervention: Over 12 months, PA participants were offered free PA classes (6/wk), while attention control participants were offered cancer prevention workshops., Measures: Baseline and 12-month follow-up measures included self-report and accelerometer-based moderate to vigorous physical activity (MVPA), sociodemographics, and perceived neighborhood environment variables., Analysis: Mixed-effects models examined each PA outcome at 12-month follow-up, adjusted for church clustering, baseline PA, and sociodemographics. We tested interactions between 7 baseline perceived environment variables and study condition., Results: Neighborhood esthetics was the only significant moderator of intervention effects on accelerometer-based MVPA and self-report leisure-time MVPA. Participants in the PA intervention had significantly higher PA at follow-up than attention control participants, only when participants evaluated their neighborhood esthetics favorably., Conclusion: Perceived neighborhood esthetics appeared to maximize the effectiveness of a multilevel PA intervention among Latinas. For sustainable PA behavior change, the environments in which Latinas are encouraged to be active may need to be evaluated prior to implementing an intervention to ensure they support active lifestyles.

Background: Associations between the built environment and physical activity (PA) may vary by sociodemographic factors. However, such evidence from international studies is limited. This study tested the moderating effects of sociodemographic factors on associations between perceived environment and self-reported total PA among adults from the International Prevalence Study., Methods: Between 2002 and 2003, adults from 9 countries (N = 10,258) completed surveys assessing total PA (International Physical Activity Questionnaire-short), perceived environment, and sociodemographics (age, gender, and education). Total PA was dichotomized as meeting/not meeting (a) high PA levels and (b) minimum PA guidelines. Logistic models tested environment by sociodemographic interactions (24 total)., Results: Education and gender moderated the association between safety from crime and meeting high PA levels (interaction P < .05), with inverse associations found only among the high education group and men. Education and gender also moderated associations of safety from crime and the presence of transit stops with meeting minimum PA guidelines (interaction P < .05), with positive associations found for safety from crime only among women and presence of transit stops only among men and the high education group., Conclusions: The limited number of moderating effects found provides support for population-wide environment-PA associations. International efforts to improve built environments are needed to promote health-enhancing PA and maintain environmental sustainability.

Female adolescents are less active than male peers in certain contexts including the neighborhood. Adolescents' physical activity can be explained by interactions between environmental and psychosocial factors, but few studies have tested such interactions in relation to context-specific behaviors. This study tested interactions between neighborhood environmental and psychosocial factors in relation to adolescents' context-specific physical activity. Data were collected in 2009-11 from 910 adolescents and a parent/guardian residing in the Baltimore/Seattle regions. Measures included adolescent-reported neighborhood leisure-time physical activity (LTPA) and non-neighborhood LTPA, accelerometer-based non-school moderate-to vigorous-physical activity (MVPA), psychosocial factors, and objective and parent-perceived neighborhood environmental factors. Gender-stratified mixed effects linear models tested associations of 6 environmental and 4 psychosocial factors and their interactions in relation to each physical activity outcome. The psychosocial factors had consistent associations with the physical activity outcomes but the environmental correlates were context-specific. Decisional balance (weighing of pros and cons of physical activity) moderated the association between recreation facility density and neighborhood LTPA among females, with a negative association only among those with high decisional balance (pros outweighed cons). Decisional balance also moderated associations of neighborhood walkability with non-school MVPA among females and non-neighborhood LTPA among males, with positive associations only among those with high decisional balance. Results support context-specific ecological models of physical activity. Targeting environmental factors that may promote opportunities for physical activity in specific contexts as well as adolescent decision-making may help promote their physical activity in those contexts, potentially leading to increased overall physical activity., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Objectives: To evaluate the impact of a faith-based intervention to promote physical activity in Latinas., Methods: We randomized 16 churches in San Diego County, California, to a physical activity intervention or cancer screening comparison condition (n = 436). The intervention followed an ecological framework and involved promotoras. We examined 12-month intervention effects, including accelerometer-based moderate-to-vigorous physical activity (MVPA; primary outcome) and secondary outcomes. We conducted the study from 2010 to 2016., Results: Mixed effects analyses showed significant increases in accelerometer-based MVPA (effect size = 0.25) and self-report leisure-time MVPA (effect size = 0.38) among Latinas in the intervention versus comparison condition. Participants in the intervention condition had about 66% higher odds of meeting the 2008 Physical Activity Guidelines, had reduced body mass index (effect size = 0.23), and used more behavioral strategies for engaging in physical activity (effect size = 0.42). Program attendance was associated with increased self-reported leisure-time MVPA and the number of motivational interviewing calls was associated with meeting the 2008 Physical Activity Guidelines., Conclusions: A faith-based intervention was effective in increasing MVPA and decreasing body mass index among participants. Process analyses showed the value of program attendance and motivational interviewing calls.

Background: Latinas have disproportionately low levels of physical activity (PA) and the ecological correlates of their PA remain unclear. This study aims to test interactions between individual and environmental factors on Latinas' PA., Methods: We analyzed baseline data from 436 Latinas participating in a PA randomized controlled trial in San Diego, CA [Fe en Acción/Faith in Action]. Measures included demographics, perceived environment, PA and anthropometrics. Mixed effects models examined interactions between individual and environmental factors on self-reported leisure-time and transportation, and accelerometer-assessed PA., Results: Significant positive associations were found between neighborhood aesthetics and leisure-time moderate-to-vigorous PA (MVPA) and between having destinations within walking distance from home and transportation PA (P < 0.05). We found significant interactions of income with aesthetics and sidewalk maintenance as well as between weight status and safety from crime. Favorable aesthetics was related to more leisure-time MVPA only among lower income women (odds ratio (OR) = 1.57; 95% confidence interval (CI): 1.18, 2.08); however, higher income women reporting better sidewalk maintenance reported more leisure-time MVPA (OR = 1.51; 95% CI: 1.06, 2.15). Higher perceived safety from crime was positively related to transportation PA only among overweight/obese women., Conclusions: Subgroup differences should be considered when developing interventions targeting the neighborhood environment to promote Latinas' PA., (© The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: U.S. Latinas do not engage in sufficient leisure-time physical activity. This study examined whether adding promotor-facilitated healthy lifestyle classes to an exercise intervention would promote exercise session attendance and improve health indicators., Methods: The Familias Sanas y Activas II (Healthy and Active Families II) study used a within-subjects, longitudinal design, with measures at baseline and at 6 and 12 months post-baseline. The intervention was developed by the San Diego Prevention Research Center and implemented between May 2011 and June 2014 in South San Diego County. Three organizations each hired a part-time coordinator and trained volunteer promotores (six to ten per organization) to deliver the intervention in various community locations. A convenience sample of 442 Latinas were in the evaluation cohort. Measured variables included a step test, blood pressure, waist circumference, height, and weight; physical activity was self-reported., Results: Attendance at healthy lifestyle classes was positively associated with exercise session attendance (p≤0.001). Mixed effects models showed improvements in systolic and diastolic blood pressure (p≤0.001); waist circumference (p≤0.001); weight (p≤0.05); and BMI (p≤0.05) between baseline and 12 months. At 12 months, fewer participants met clinical guidelines for being hypertensive and having an at-risk waist circumference. Exercise session attendance was associated with improved fitness (p≤0.05) and increased self-reported MET minutes of leisure-time physical activity (p≤0.01)., Conclusions: The intervention represents an effective strategy for improving the health status of Latinas, a population with significant health disparities, including high obesity rates. Research efforts are needed to assess methods for scaling up such interventions., (Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

The effectiveness of community health workers (CHWs) as health educators and health promoters among Latino populations is widely recognized. The Affordable Care Act created important opportunities to increase the role of CHWs in preventive health. This article describes the implementation of CHW-led, culturally specific, faith-based program to increase physical activity among churchgoing Latinas. This study augments previous research by describing the recruitment, selection, training, and evaluation of CHWs for a physical activity intervention targeting multiple levels of the Social Ecological Model.

Purpose: The study aims were to determine: (a) how class structure varies by dance type, (b) how moderate-to-vigorous physical activity (MVPA) and sedentary behavior vary by dance class segments, and (c) how class structure relates to total MVPA in dance classes., Method: Participants were 291 boys and girls ages 5 to 18 years old enrolled in 58 dance classes at 21 dance studios in Southern California. MVPA and sedentary behavior were assessed with accelerometry, with data aggregated to 15-s epochs. Percent and minutes of MVPA and sedentary behavior during dance class segments and percent of class time and minutes spent in each segment were calculated using Freedson age-specific cut points. Differences in MVPA (Freedson 3 Metabolic Equivalents of Tasks age-specific cut points) and sedentary behavior ( < 100 counts/min) were examined using mixed-effects linear regression., Results: The length of each class segment was fairly consistent across dance types, with the exception that in ballet, more time was spent in technique as compared with private jazz/hip-hop classes and Latin-flamenco and less time was spent in routine/practice as compared with Latin-salsa/ballet folklorico. Segment type accounted for 17% of the variance in the proportion of the segment spent in MVPA. The proportion of the segment in MVPA was higher for routine/practice (44.2%) than for technique (34.7%). The proportion of the segment in sedentary behavior was lowest for routine/practice (22.8%)., Conclusion: The structure of dance lessons can impact youths' physical activity. Working with instructors to increase time in routine/practice during dance classes could contribute to physical activity promotion in youth.

Background: Interventions to prevent and control childhood obesity have shown mixed results in terms of short- and long-term changes., Objectives: 'MOVE/me Muevo' was a 2-year family- and recreation centre-based randomized controlled trial to promote healthy eating and physical activity among 5- to 8-year-old children. It was hypothesized that children in the intervention group would demonstrate lower post-intervention body mass index (BMI) values and improved obesity-related behaviours compared with the control group children., Methods: Thirty recreation centres in San Diego County, California, were randomized to an intervention or control condition. Five hundred forty-one families were enrolled and children's BMI, diet, physical activity and other health indicators were tracked from baseline to 2 years post-baseline. Analyses followed an intent-to-treat approach using mixed-effects models., Results: No significant intervention effects were observed for the primary outcomes of child's or parent's BMI and child's waist circumference. Moderator analyses, however, showed that girls (but not boys) in the intervention condition reduced their BMI. At the 2-year follow-up, intervention condition parents reported that their children were consuming fewer high-fat foods and sugary beverages., Conclusions: Favourable implementation fidelity and high retention rates support the feasibility of this intervention in a large metropolitan area; however, interventions of greater intensity may be needed to achieve effects on child's BMI. Also, further research is needed to develop gender-specific intervention strategies so that both genders may benefit from such efforts., (© 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.)

Background: Girls are less physically active than boys, yet no single study has examined the factors that may explain gender differences in children's physical activity (PA)., Methods: This study was a cross-sectional analysis of data from 116 caregivers and their children aged 5-8 years who participated in the MOVE study. Caregivers reported various factors that may relate to children's PA (eg, encouragement for child PA and PA equipment at home). Child PA was measured by 7-day accelerometry. Linear regression tested for the variance in moderate-to-vigorous physical activity (MVPA) explained by gender and several variables. Gender and ethnicity interactions were examined., Results: Caregivers were mostly female (97%), mean age 38 ± 6 years, mean BMI 28 ± 6 (kg/m2). Child's mean age was 8.1 ± 0.7, 54% were female and 40% were overweight/obese. Girls were less physically active than boys (54.1 ± 19.7 vs. 65.2 ± 28.0 daily minutes of MVPA, respectively). Among girls, more days of PE/week was associated with greater MVPA. Among boys, greater parent support for PA, greater parent modeling for PA, and greater number of PA equipment in the home were associated with greater MVPA., Conclusions: This study supports that boys and girls have different correlates for MVPA, which may partly explain gender differences in PA.

Objective: Parents who overestimate their child's physical activity (PA) level may not encourage their children to increase their PA. We assessed parental awareness of child PA, and investigated potential correlates of overestimation., Method: Child PA (accelerometer) and parent-classified child PA ['active' ≥ 60 min/day vs. 'inactive' <60 min/day moderate and vigorous PA (MVPA)] were measured over 7 days [n=329, 44% male, 39% Latino; mean (SD) 9.1 (0.7)years] in an obesity prevention study in San Diego (Project MOVE). Agreement between date-matched objective MVPA and parent-classified child PA was assessed; % days parental overestimation was the outcome variable. Associations between parental overestimation and potential correlates were investigated using three-level mixed-effects linear regression., Results: Children met the PA guidelines on 43% of days. Parents overestimated their children's PA on 75% of days when children were inactive. Most parents (80%) overestimated their child's PA on ≥ 1 measurement day. Parental support for child PA (transport, encouragement and participation with child) (p<0.01) was positively associated with higher overestimation. Parents of girls showed more overestimation than parents of boys (p=0.04)., Conclusion: Most parents incorrectly classified their child as active when their child was inactive. Strategies addressing parental overestimation may be important in PA promotion., (Copyright © 2012. Published by Elsevier Inc.)

Individuals with medical conditions report more depressive symptoms than those without such conditions. This study assessed whether physical activity (PA) plays a mediational role in the association between medical conditions and depressive symptoms among Latino adults. Adjusting for socioeconomic factors, those who reported having been diagnosed with diabetes, cardio-related disease, hypertension, high cholesterol, arthritis, or sleep problems endorsed more symptoms of depression. Vigorous PA mediated the relation between depressive symptoms and hypertension. In other words, people with hypertension who engaged in vigorous PA reported less depressive symptoms. PA may be a promising avenue for improving hypertension and depressive symptoms.

Background: This observational study examined cross-sectional and 24-month longitudinal associations of physical activity and dietary behaviors with change in BMI and percent body fat among children aged 6–9 years old., Methods: Data were from the control group (n = 271; 48% Latino) of a community-based childhood obesity prevention program. Assessments were conducted at baseline and at 24 months and included height and weight, bioelectrical impedance–derived percent body fat, and 10 physical activity and dietary behaviors measured via parent report of their child. Cross-sectional analysis of variances (ANOVA) (normal weight, overweight, obese) and longitudinal mixed-effects linear regression models were used to investigate the relation of each physical activity and dietary behavior with BMI and percent body fat., Results: At baseline, obese children engaged in less physical activity and more sedentary behavior than normal-weight children (p < 0.05). Increased physical activity (p < 0.01) and number of breakfasts eaten with family (p < 0.05) were associated with decreased BMI z-score and percent body fat. Decreased sedentary behavior and sugar-sweetened beverage consumption were associated with decreased percent body fat (p < 0.05) but not BMI., Conclusions: In this cohort of 271 children, increased physical activity and eating breakfast with family and reduced screen-based sedentary behaviors and sugar-sweetened beverage consumption were associated with more favorable trends in adiposity. Therefore, attention to these behaviors may be of particular importance. Results also suggest that future studies should include percent body fat as an outcome for a more precise assessment of the association of behavior with adiposity.

Latino children spend more time in sedentary activities than other American children, and only ~1 in 5 Latino children in public elementary and middle schools meet all 6 fitness standards in statewide fitness testing. Schools that facilitate physical activity (PA) by maintaining playgrounds and providing physical education classes have children who are more active and less overweight. The aims of the present study were to examine the extent to which several social and physical environmental changes in school settings resulted in observed changes in area characteristics and children's activity levels during recess. Thirteen elementary schools serving predominantly Mexican American children were randomized into control or activity and nutrition environmental intervention conditions. Playgrounds and activities were restructured in 6 intervention schools to promote more PA. After 1 y, there were no overall statistical differences between treatment groups in PA or sedentary behavior in these settings and results did not differ by gender. Changing the social and physical environments to promote children's moderate-to-vigorous PA is important to the design of active and healthy recess environments. The present results are not conclusive as to the link between these interventions and actual behavior, but show sufficient promise for further population and setting specific research.

Background: Studies have examined the association between work-related characteristics and physical activity participation; however few studies include U.S. Latinos., Methods: Six hundred and seventy two Latino adults of San Diego County were randomly sampled and surveyed to assess their health behaviors in the fall of 2006. Analyses were conducted with 633 respondents with physical activity data (94% of sample), examining the extent to which job category and hours worked per week were associated with 4 domains of physical activity defined by MET-minutes per week using the long IPAQ., Results: Multivariate analysis of variance models were computed. After adjusting for covariates, occupational MET-minutes per week were associated with job category and hours worked per week, such that blue collar workers expended more MET-minutes per week than white collar or nonworkers, and those who worked 20 hours a week or less expended less occupational physical activity compared with those who worked more than 20 hours per week. In addition, nonworkers reported expending more household MET-minutes per week than blue collar or white collar workers., Conclusions: Efforts are needed to increase the physical activity levels of Mexican immigrants/Mexican-Americans, with interventions designed in consideration of the individual's work status., (©2011 Human Kinetics, Inc.)

Background: As the US population continues to grow and diversify, there is a need for progressive physical activity measurement and cross-cultural research. Studies suggest that US Latinos are among the most sedentary of ethnic groups compared to others; however, study findings may be biased given that some measures may not be culturally sensitive for assessing behaviors that are not characterized as leisure time physical activity., Purpose: The primary objective of this review was to identify and evaluate measures used to quantify physical activity among US Latinos., Methods: A review of the literature was performed and studies examining levels of physical activity among Spanish and English speaking Latinos were documented. This process involved identifying existing guidelines for the purpose of culturally adapting and/or translating (into Spanish) physical activity measures for the Latino population. These guidelines were used as the minimal criteria for the evaluation of the 13 identified measures of physical activity., Results: Of these 13 measures, four were available in English and nine were available in Spanish. One English measure met the guidelines for being culturally adapted for assessing physical activity among Latinos. There were no Spanish measures that met all the guidelines for physical activity assessment among Spanish-speaking Latinos. Lastly, the identified guidelines for developing culturally appropriate measures were improved to advance physical activity measurement among ethnic and cultural groups., Conclusion: Future research should merit the use of culturally appropriate guidelines to increase the understanding of physical activity patterns in the USA.

Objective: To determine if overweight adolescent girls are more likely to overreport physical activity compared to normal-weight girls., Methods: Participation in physical activities and perceived intensity of activities were assessed from the previous day physical activity recall (PDPAR) in 1021 girls aged 11-14 years old (37% overweight). Daily minutes of moderate to vigorous physical activity (MVPA) were measured using accelerometry., Results: Girls in the "at-risk for overweight" and "overweight" categories had 17.7% and 19.4% fewer minutes of MVPA per block reported on the PDPAR compared to normal-weight girls (P<0.05)., Conclusions: Overweight adolescent girls tend to overreport their total amount of physical activity.

Purpose: To evaluate the relationship between depressive symptoms and physical activity in a geographically and ethnically diverse sample of sixth-grade adolescent girls., Methods: The Trial of Activity for Adolescent Girls (TAAG) baseline measurement included a random sample (N = 1721) of sixth-grade girls in 36 schools at six field sites. Measurements were accelerometry and the 3-d Physical Activity Recall (3DPAR) for physical activity, and the Center for Epidemiological Studies-Depression scale (CES-D) for depressive symptoms., Results: Girls with complete data (N = 1397), mean age 12 yr, had an average CES-D score of 14.7 (SD = 9.25) and engaged in an average of about 460 min of sedentary activity, < 24 min of moderate to vigorous physical activity (MVPA), and < 6 min of vigorous physical activity (VPA) in an 18-h day. Thirty-minute segments of MVPA ranged in number from 3.9 to 1.2, and METS for these segments ranged from > 3.0 to > 6.5. Mixed-model regression indicated no relationship between depressive symptoms and physical activity; however, a significant but modest inverse relationship between sedentary activity and depressive symptoms was observed., Conclusion: A sufficient sample size, standardized procedures, and validated instruments characterized this study; however, a relationship between depressive symptoms and physical activity was not observed for sixth-grade girls from diverse geographic locations. The average CES-D score was lower than is considered clinically meaningful for either adolescents or adults, and MET-minutes of sedentary activity were high. This combination of data may be different from other studies and could have contributed to the unexpected finding. This unexpected finding is informative, however, because it shows the need for additional research that includes a wider range of possible combinations of data, especially with young adolescent girls.

Background: Physical activity is important for weight control and good health; however, activity levels decline in the adolescent years, particularly in girls., Design: Group randomized controlled trial., Setting/participants: Middle school girls with English-speaking skills and no conditions to prevent participation in physical activity in 36 schools in six geographically diverse areas of the United States. Random, cross-sectional samples were drawn within schools: 6th graders in 2003 (n=1721) and 8th graders in 2005 (n=3504) and 2006 (n=3502)., Intervention: A 2-year study-directed intervention (fall 2003 to spring 2005) targeted schools, community agencies, and girls to increase opportunities, support, and incentives for increased physical activity. Components included programs linking schools and community agencies, physical education, health education, and social marketing. A third-year intervention used school and community personnel to direct intervention activities., Main Outcome Measures: The primary outcome, daily MET-weighted minutes of moderate-to-vigorous physical activity (MET-weighted MVPA), was assessed using accelerometry. Percent body fat was assessed using anthropometry., Results: After the staff-directed intervention (pre-stated primary outcome), there were no differences (mean= -0.4, 95% CI= -8.2 to 7.4) in adjusted MET-weighted MVPA between 8th-grade girls in schools assigned to intervention or control. Following the Program Champion-directed intervention, girls in intervention schools were more physically active than girls in control schools (mean difference 10.9 MET-weighted minutes of MVPA, 95% CI=0.52-21.2). This difference is about 1.6 minutes of daily MVPA or 80 kcal per week. There were no differences in fitness or percent body fat at either 8th-grade timepoint., Conclusion: A school-based, community-linked intervention modestly improved physical activity in girls.

Objective: To describe the patterns (specifically comparing weekdays and weekends classified by intensities) of physical activity (PA) measured by accelerometry in adolescent girls., Research Methods and Procedures: Healthy sixth grade girls (n=1603), 11 to 12 years old, were randomly recruited from 36 schools participating in the Trial of Activity in Adolescent Girls. Age, ethnicity, socioeconomic status, weight, and height were taken. PA patterns were measured for 6 days using accelerometry., Results: Adolescent girls spend most of their time in sedentary (52% to 57% of the day) and light activity (40% to 45% of the day) on weekdays and weekends. In all girls, total PA comprised 44.5% of the day (41.7% light, 2.2% moderate, and 0.7% vigorous) with sedentary activity comprising 55.4%. Moderate-to-vigorous PA (MVPA) was higher (p<0.001) on weekdays than weekends in all girls, but MVPA was lower in at-risk of overweight+overweight girls (p<0.001) on both weekdays and weekends compared with normal-weight girls., Discussion: Adolescent girls are more active at moderate and vigorous intensities on weekdays than on weekends, and at-risk of overweight and those overweight spend less time engaging in MVPA than normal-weight girls.

Purpose: To assess girls' physical activity (PA) in middle school physical education (PE) as it relates to field site, lesson context and location, teacher gender, and class composition., Methods: We observed girls' PA levels, lesson contexts, and activity promotion by teachers in 431 lessons in 36 schools from six field sites participating in the Trial of Activity for Adolescent Girls. Interobserver reliabilities exceeded 90% for all three categories. Data were analyzed using mixed-model ANOVA with controls for clustering effects by field site and school., Results: Mean lesson length was 37.3 (+/-9.4) min. Time (13.9+/-7.0 min) and proportion of lessons (37.9+/-18.5%) spent in moderate to vigorous PA (MVPA), and time (4.8+/-4.2 min) and proportion of lessons (13.1+/-11.7%) in vigorous PA (VPA) differed by field site (P<0.004). Lesson time for instructional contexts differed by field site, with overall proportions as follows: game play (27.3%), management (26.1%), fitness activities (19.7%), skill drills (12.1%), knowledge (10.6%), and free play (4.4%). Coed classes were 7.9 min longer than girls-only classes (P=0.03). Although 27 s shorter, outdoor lessons were more intense (MVPA%=45.7 vs 33.7% of lesson, P<0.001) and provided 4.0 more MVPA minutes (P<0.001). MVPA, VPA, and lesson contexts did not differ by teacher gender. There was little direct promotion of PA by teachers during lessons., Conclusions: Substantial variation in the conduct of PE exists. Proportion of lesson time girls spent accruing MVPA (i.e., 37.9%) fell short of the Healthy People 2010 objective of 50%. Numerous possibilities exist for improving girls' PA in PE.

Objectives: To test an original scale assessing perceived school climate for girls' physical activity in middle school girls., Methods: Confirmatory factor analysis (CFA) and structural equation modeling (SEM)., Results: CFA retained 5 of 14 original items. A model with 2 correlated factors, perceptions about teachers' and boys' behaviors, respectively, fit the data well in both sixth and eighth graders. SEM detected a positive, significant direct association of the teacher factor, but not the boy factor, with girls' self-reported physical activity., Conclusions: School climate for girls' physical activity is a measurable construct, and preliminary evidence suggests a relationship with physical activity.

The primary aim of the Trial of Activity in Adolescent Girls (TAAG) is to test an intervention to reduce by half the age-related decline in moderate to vigorous physical activity (MVPA) in middle school girls. The intervention will be evaluated using a group-randomized trial involving 36 middle schools. The primary endpoint is the mean difference in intensity-weighted minutes (i.e., MET-minutes) of MVPA between intervention and comparison schools assessed using accelerometry. The TAAG study design calls for two cross-sectional samples, one drawn from 6th graders at the beginning of the study and the second drawn from 8th graders at the end of the study following the 2-year implementation of the intervention. An important strength of this design over a cohort design is the consistency with the goals of TAAG, which focus on environmental-level rather than individual-level interventions to produce change. The study design specifies a recruitment rate of 80% and a smaller sample of girls at baseline (n=48 per school) than at follow-up (n=96 per school). A two-stage model will be used to test the primary hypothesis. In the first stage, MET-weighted minutes of MVPA will be regressed on school, time (baseline or follow-up), their interaction, ethnicity and week of data collection. The second stage analysis will be conducted on the 72 adjusted means from the first stage. In the main-effects model, we will regress the follow-up school mean MET-weighted minutes of MVPA on study condition, adjusting for the baseline school mean. The TAAG study addresses an important health behavior, and also advances the field of group-randomized trials through the use of a study design and analysis plan tailored to serve the main study hypothesis.

School climate refers to various physical and psychosocial structures that shape schools' social and physical environments. The Child and Adolescent Trial for Cardiovascular Health (CATCH) study provided an opportunity to study how aspects of school climate are associated with continued implementation of the CATCH program. Nutrient analysis of menus, observations of physical education (PE) classes, and teacher and staff self-reports were used to measure CATCH program components. Results of this study indicate that aspects of school climate were associated with continued implementation of the CATCH classroom component but not the CATCH food service or PE components. These findings have implications for how we plan for the progression of innovative school health promotion programs from the initial trial stage to institutionalization. Measures of school climate may be useful in determining a school's readiness to adopt and implement an innovative health promotion curriculum.

Physical activity and dietary behaviors are often correlated in adults and adolescents. This association was examined in 351 Anglo- and Mexican-American children between the ages of 4 and 7 years. Behaviors were assessed by structured observations and interviews at home and school. Observed physical activity was significantly correlated with energy intake (r = .43), but was unrelated to the percentage of calories from total fat or saturated fat. Thus, interventions with young children to improve dietary behavior or physical activity should not be expected to automatically lead to changes in the other.

Objective: To assess differences through grade 8 in diet, physical activity, and related health indicators of students who participated in the Child and Adolescent Trial for Cardiovascular Health (CATCH) school and family intervention from grades 3 through 5., Design: Follow-up of the 4-center, randomized, controlled field trial with 56 intervention and 40 control elementary schools., Participants: We studied 3714 (73%) of the initial CATCH cohort of 5106 students from ethnically diverse backgrounds in California, Louisiana, Minnesota, and Texas at grades 6, 7, and 8., Results: Self-reported daily energy intake from fat at baseline was virtually identical in the control (32.7%) and intervention (32.6%) groups. At grade 5, the intake for controls remained at 32.2%, while the intake for the intervention group declined to 30.3% (P<.001). At grade 8, the between-group differential was maintained (31.6% vs 30.6%, P = .01). Intervention students maintained significantly higher self-reported daily vigorous activity than control students (P = .001), although the difference declined from 13.6 minutes in grade 5 to 11.2, 10.8, and 8.8 minutes in grades 6, 7, and 8, respectively. Significant differences in favor of the intervention students also persisted at grade 8 for dietary knowledge and dietary intentions, but not for social support for physical activity. No impact on smoking behavior or stages of contemplating smoking was detected at grade 8. No significant differences were noted among physiologic indicators of body mass index, blood pressure, or serum lipid and cholesterol levels., Conclusion: The original CATCH results demonstrated that school-level interventions could modify school lunch and school physical education programs as well as influence student behaviors. This 3-year follow-up without further intervention suggests that the behavioral changes initiated during the elementary school years persisted to early adolescence for self-reported dietary and physical activity behaviors.

Social interactions are important correlates of physical activity in children. Previous studies used global measures; the present study examined the influence of specific social interactions on immediate physical activity in children with data obtained from the Behaviors of Eating and Activity for Child Health: Evaluation System (BEACHES). The study examined parental and peer prompting of physical activity at home among 178 Mexican-American and 113 Anglo-American children at age 4 years and again at age 6.5 years. Most activity prompts came from adults interacting with children when they were sedentary. A reduction in the frequency of prompts from baseline to follow-up occurred in the prompter group (adult or child peer), gender, ethnicity, and preprompted activity level categories. Children's responses to these prompts showed that as they aged, they seemed to rely less on the interpersonal (especially adult) aspects of their environment for cues to be more active.

We investigated physical activity and encouragement for activity in a bi-ethnic cohort during recess. Activity and associated interactions of 287 children were recorded at preschool and again 2.2 years later. Children expended nearly twice as much energy at preschool recess than at elementary recess. Activity levels declined as recess time elapsed. At preschool, European-American children engaged in more moderate to vigorous activity than Mexican-Americans. As participants moved to elementary school, teachers' prompts to be active decreased and prompts from peers increased. Boys and girls received similar amounts of activity prompts at preschool, but prompts to boys increased over time. The findings suggest that school environments could be altered to promote healthful physical activity among young children.

An integrated system for coding direct observations of children's dietary and physical activity behaviors was developed. Associated environmental events were also coded, including physical location, antecedents, and consequences. To assess the instrument's reliability and validity, 42 children, aged 4 to 8 years, were observed for 8 consecutive weeks at home and at school. Results indicated that four 60-min observations at home produced relatively stable estimates for most of the 10 dimensions. Interobserver reliabilities during live and videotaped observations were high, with the exception of "consequences" categories that occurred in less than 1% of observed intervals. Evidence of validity was provided by findings that antecedents were associated with respective dietary and physical activity behaviors. The five physical activity categories were validated by heartrate monitoring in a second study. The Behaviors of Eating and Activity for Children's Health Evaluation System is appropriate for studying influences on diet and physical activity in children in a variety of settings.

Although personal determinants of exercise behavior have been studied extensively, few investigators have examined the influence of the physical environment on exercise habits. A random sample of 2,053 residents of San Diego, CA, were surveyed regarding exercise habits and other variables. A total of 385 exercise facilities in San Diego were classified into categories of either free or pay. After the addresses of respondents and facilities were located on a grid-map and coded, the density of exercise facilities around each respondent's home address was computed. Subjects who reported engaging in three or more exercise sessions per week reported a statistically greater density of pay facilities near their homes than did those who reported no exercise sessions, after controlling for age, education, and income. The finding suggests an association between proximity of exercise facilities and frequency of exercise.

Most research on relapse from exercise has investigated one relapse episode following a structured program. The present study examined the patterns and determinants of the lifetime history of relapse from exercise in a community population. Subjects were 1.811 randomly selected residents of San Diego, California who completed an extensive mailed survey. Subjects reported the number of times over their lifetime that they had exercised vigorously for at least six months and then stopped exercising for at least three months. Approximately 60% of subjects reported zero relapses, 20% reported one or two relapses, and 20% reported three or more relapses. Relapse histories of current exercisers and current nonexercisers were virtually identical. The most commonly reported reason for the last relapse was injuries for both nonexecisers and exercisers. Multiple regression analyses were used to identify correlates of exercise relapse history. These data indicate that cross-sectional surveys of exercise behavior are inadequate to characterize exercise behavior in a population, and injuries are probably a major cause of relapse.

The purpose of this study was to explore the associations between several social learning theory variables and self-reported vigorous exercise and to consider the implications for exercise promotion. A random sample of adults in San Diego, California, was surveyed by mail. The 2,053 respondents (response rate, 43.4%) overrepresented Caucasian, affluent, and well-educated groups. A model of 24 variables accounted for 0.27 of the variance in exercise, and results strongly supported social learning theory. The strongest correlates were self-efficacy (i.e., confidence in the ability to exercise in specific situations), perceived barriers to exercise, modeling, dietary habits, support from friends, and age. Smoking was inversely associated with exercise in men only. We encourage researchers to conduct intervention trials to test the hypotheses generated in this study.

Female adolescents are less active than male peers in certain contexts including the neighborhood. Adolescents' physical activity can be explained by interactions between environmental and psychosocial factors, but few studies have tested such interactions in relation to context-specific behaviors. This study tested interactions between neighborhood environmental and psychosocial factors in relation to adolescents' context-specific physical activity. Data were collected in 2009-11 from 910 adolescents and a parent/guardian residing in the Baltimore/Seattle regions. Measures included adolescent-reported neighborhood leisure-time physical activity (LTPA) and non-neighborhood LTPA, accelerometer-based non-school moderate-to vigorous-physical activity (MVPA), psychosocial factors, and objective and parent-perceived neighborhood environmental factors. Gender-stratified mixed effects linear models tested associations of 6 environmental and 4 psychosocial factors and their interactions in relation to each physical activity outcome. The psychosocial factors had consistent associations with the physical activity outcomes but the environmental correlates were context-specific. Decisional balance (weighing of pros and cons of physical activity) moderated the association between recreation facility density and neighborhood LTPA among females, with a negative association only among those with high decisional balance (pros outweighed cons). Decisional balance also moderated associations of neighborhood walkability with non-school MVPA among females and non-neighborhood LTPA among males, with positive associations only among those with high decisional balance. Results support context-specific ecological models of physical activity. Targeting environmental factors that may promote opportunities for physical activity in specific contexts as well as adolescent decision-making may help promote their physical activity in those contexts, potentially leading to increased overall physical activity.