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PA and Health, Week 3

rename
winniesmith2's version from 2017-12-10 21:49

Section 1

Question Answer
Health definition - WHO“Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”
Non-communicable diseases- what are they?• A medical condition or disease that is not caused by infectious agents (non-infectious or non-transmissible) • NCDs can refer to chronic diseases which last for long periods of time and progress slowly • NCDs are the leading cause of death globally
Globally,how many deaths per year are caused by non-communicable disease?40 million
NCDs are accountable for what percentage of deaths globally 70%
NCDs are accountable for what percentage of deaths in low and middle income countries 80%
What 4 diseases account for over 80% of all premature NCD deaths – Cardiovascular diseases (17.7 million people each year) – Cancers (8.8 million) – Respiratory diseases (3.9 million) – Diabetes (1.6 million)
What lifestyle choices effect the risk of NCD's Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets increase the risk of dying from a non-communicable disease
What did the United nations publish in 2011Political declaration of the high-level meeting of the general assembly on the prevention and control of non-communicable disease.
What did the world health organisation publish in 2013 Global action plan; for the prevention and control of noncommunicable diseases. 2013-2020
What were the 9 voluntary global NCD targets for 2025PHYSICAL INACTIVITY 10% REDUCTION .
Premature mortality from NCDs 25% REDUCTION.
Harmful use of alcohol 10% reduction,
salt/sodium intake 30% reduction,
Tobacco use 30% reduction,
Raised blood pressure 25% reduction,
diabetes/obesity 0% increase,
Drug therapy and counseling 50% coverage,
essential NCD medicines and technologies 80% coverage
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Section 2

Question Answer
What did Prof Jerry Morris do • Bus drivers/conductors • Postmen/clerks • Civil servants
What did Prof Ralph Paffenbarger do• San Francisco longshoreman • Harvard Alumni study
What did Prof Steven Blair do • Aerobics Center longitudinal study • ‘Fat but fit’
Key points for '23 1/2 hours' YouTube videp 30 mins of activity/day- bouts of 10 mins. How it can majorly affect your health.
Describe findings of the pooled analysis of dose-response relationship; the "L-shaped" curve.Those meeting the recommended daily amount of exercise (of 7.5 MET h/wk=150 mins) decreased mortality rate by 20% compared to a control group of no exercise. Subsequent increase in MET h/wk decreases mortality risk until 22.5 to <40. PAGE 14. Arem et al.
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Section 3

Question Answer
What study looked at domain-specific relationships with health outcomes (STUDY A)"Associations of specific types of sports and exercise with all-cause and cardio-vascular disease mortality: A cohort study of 80,306 British adults"
What research studies did STUDY A use for data• Health Survey for England • Scottish Health Survey • Linkage to NHS Centre Mortality Register • Interview: number of days and duration for different exercises
What 6 sports/domains did it focus on? • Cycling for any purpose • Swimming • Aerobics: aerobics, keep fit, gymnastics, dance for fitness • Running: running, jogging • Football: football, rugby • Racquet sports: badminton, tennis, squash
Conclusions of STUDY A • Swimming, aerobics and racquet sports were associated with significantly reduced risk of all-cause and cardiovascular disease (CVD) mortality • Cycling associated with all-cause mortality but not CVD mortality • Sport is likely to have important potential to promote public health • Health enhancing sport programmes should be developed – to reach more people and contribute to a greater proportion of population meeting guidelines
Study B; Active commuting and obesity in mid -life: cross-sectional, observational evidence from UK Biobank. What did it do? Looked at adults aged 40-69 years.• Self-report commuting – seven categories • BMI (objectively measured height and weight) • % body fat
Study B: Results (graphs page 18)As active commuting decreases BMI. Highest in cycling. and % Body fat decreases, again biggest decrease in cycling but women slightly more.
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Section 4

Question Answer
What are correlates • Correlates – factors which are associated with physical activity – used to generate hypothesis for further study
What are Determinants – factor which causes physical activity – clear temporal sequence – plausible mechanisms • Sometimes called ‘factors influencing’ or ‘predictors’ of physical activity
Study designs for correlates – cross-sectional designs – only assesses statistical association – no support for determining causal influences
Study designs for determinants – longitudinal observational studies – experimental studies e.g. randomised control trials – Look at the effect of changing the ‘independent’ variable (determinant or causal factor) on the ‘dependent’ variable (outcome = physical activity)
Why do we need to know what these factors are?• Understand why some people are active and some are not • Predict behaviour • Identify non-modifiable factors (moderators) • Identify modifiable factors (mediators) • Intervention design – Target groups – Tailor interventions
What are the 6 different categories of factorsBiological (e.g. fitness or body fatness). Socio-demographic (e.g. socio-economic status). Social (e.g. social support and family interactions). Behavioural (e.g. other behaviours such as smoking, or diet). Psychological (e.g. self-efficacy, intention,stage of change). Environmental (e.g. cycle paths, weather).
Psychological factors: KEY CONSTRUCTS . • Motivation – Reason(s) for acting or behaving in a particular way • Intention – An aim or plan • Self-efficacy – Confidence to be physically active in specific situations • Perceived behavioural control – General perceptions of ability to be physically active
Describe the transtheoretical model (stages of behaviour change)Pre-contemplation, contemplation, preparation, action, maintenance, relapse/termination.
What is stage 1 of the transtheoretical model Pre-contemplation, not meeting PA guidelines, current behaviour of little or no PA, and have no intention to meet guidelines.
What is stage 2 of the transtheoretical model Contemplation, not meeting PA guidelines, current behaviour of little or no PA. but have the intention of meeting guidelines.
What is stage 3 of the transtheoretical model Preparation, Not meeting PA guidelines but current behaviour making small changes in PA, have the intention to meet guidelines.
What is stage 4 of the transtheortical model Action, Meeting PA guidelines, current behaviour; PA for less than 6 months, with the intention of meeting PA guidelines.
What is stage 5 of the transtheoretical model Maintenance, meeting PA guidelines, Current behaviour; PA for more than 6 months, with intention to meet PA guidelines.
What is stage 6 of the transtheoretical model Relapse/termination. Not meeting the PA guidelines,little or no PA, no intention to meet guidelines.
Stages of the socio-ecological model individual--> social--> Built environment---> policy. Multi-level interventions.
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Section 5

Question Answer
Adapted ecological modelpage 50
Systematic review of factors: Lancet 2012 • Identified individual, social and environmental factors influencing physical activity in adults (≥18 years) and children (5-13 years) • Systematic reviews only • Published 1999 – April 2012 • Variables – categorised according to ecological model – coded as correlate, determinant, no relationship (not a correlate/determinant) or not reported . Baumann et al
Systematic review of factors: Lancet 2012. Key results: children and adolescents• 7 reviews identified • Children – 39 correlates – 11 determinants • Adolescents – 44 correlates – 7 determinants
Systematic review of factors: Lancet 2012. Key POSITIVE results: children and adolescents• Male sex (in children aged 4-9) – determinant • Self-efficacy (children and adolescents) – correlate and determinant • Perceived behavioural control (adolescents) – determinant • Previous physical activity behaviour – correlate
Systematic review of factors: Lancet 2012. Key ENVIRONMENT results: children and adolescents• Inconsistent evidence • Children: – Walkability – Traffic speed – Traffic volume – Land use mix – Residential density – Access/proximity to recreation facilities • Adolescents: – Land use mix – Residential density
Systematic review of factors: Lancet 2012.; Adults key results • 9 reviews identified (excluding environmental) • Consistent evidence for: – 36 correlates / 20 determinants
Systematic review of factors: Lancet 2012 ; Adults, key positive results Correlates (but not determinants) • Age (inverse) • Male • Education level • Ethnic origin • Overweight (inverse) • Perceived effort (inverse) • Social support
Systematic review of factors: Lancet 2012 ; Adults, key positive results (correlates and determinants)• Health status • Self-efficacy • Personal history of physical activity • Intention to exercise • Stages of behaviour change
Systematic review of factors: Lancet 2012 ; Adults, environmental and total PA • Neighbourhood design – e.g. walkability and street connectivity • Recreation facilities and location • Transport environment – e.g. presence of pavements and safe road crossings • Social environment • Aesthetics – e.g. greenness and perceived attractiveness
Systematic review of factors: Lancet 2012 ; implications of findings. • Physical activity is complex and correlates/determinants vary by activity domain • Multiple factors at different levels influence physical activity • Small number of consistent correlates • Correlates research is critical for improving intervention development and effectiveness • Evidence may help to identify target groups • Cross-sector partnerships are needed to make environmental changes
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Section 6

Question Answer
Walking and cycling for transport and recreation ; iConnect study ; describe• Postal survey sent to 22,500 adults • UK: Cardiff, Kenilworth and Southampton • Modified version of the International Physical Activity Questionnaire (IPAQ) – Walking for transport, walking for recreation, cycling for transport and cycling for recreation • Perceptions of the neighbourhood environment scale (PENS) – 13 items
Walking and cycling for transport and recreation ; iConnect study ; what did it asses• Scores for six summary environmental constructs: – Supportive infrastructure – Availability of local amenities – Social order – Street connectivity – Traffic safety – General environment quality (12 items) • Scores categorised into perceived low, medium and high support • Assessed the associations between the environmental constructs and participation in each of the four behaviours (no participation compared to some)
Likelihood of walking and cycling: supportive infrastructure1.44 times more likely to walk for transport and 1.47 times for recreation , if the environment has a supportive infrastructure.
Likelihood of walking and cycling: local amenities2.14 times more likely to walk for transport and 1.69 times more likely to cycle for transport
Likelihood of walking and cycling: social order1.44 more likely to cycle for recreation
Likelihood of walking and cycling: street connectivity1.93 more times to cycle for transport
Likelihood of walking and cycling: environmental quality 2.32 times more likely to walk for transport
Implications of findings • Confirms different environmental attributes may be important in supporting participation • Creating supportive ‘activity friendly’ environments is likely to require a combination of environmental improvements • Improvements to infrastructure, access to destinations and the general environment quality should be taken into account in future transport and planning policy
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Section 7

Question Answer
Factors influencing SB - study • DEDIPAC Consortium 2013-2016 • Determinants of Diet and Physical Activity • www.dedipac.eu • Objective – to understand the determinants of dietary, physical activity and sedentary behaviours – to translate this knowledge into more effective promotion of a healthy diet and physical activity
Correlates of sedentary behaviour (adults 18-65)• Five electronic databases searched • January 2000-September 2015 • Search strategy based on four elements: – Sedentary behaviour and synonyms e.g. sedentariness – Correlates / determinants and synonyms e.g. factors – Types of sedentary behaviour – Possible correlates / determinants • Behavioural, environmental and socio-demographic • Reporting against ecological model
Results: study characteristics• 74 papers were included in the review: – North America (21), Europe (23) Australia (24), New Zealand (1), multiple (1), Asia (4) – 71 studies were observational (58 cross sectional) – Participant sample sizes ranged from 10 to 246,920 – 11 studies were female only; 2 studies were male only
Results: measurement• 16 studies used objective measures • 7 studies used self-report and objective measures • 58 used only self-report – Five domains of sedentary behaviour identified in selfreport measures • Total screen time • Television and screen entertainment • Transport sitting time • Total sitting time (including occupational sitting) • Leisure sitting time
Results: individual correlates• Age (14 studies) – older the person, more sedentary • Female (10 studies) – females less sedentary • Body mass index (17 studies) – higher BMI, more sedentary • Chronic disease (3 studies) – Having chronic disease, more sedentary
Results: psychological correlates• Depression, anxiety and tension (5 studies) – Positively related to total screen time • Stress levels (3), perceived tiredness (1) – Positively related to total screen time • Attitude and intention – Negatively related to sedentary time Limited number of studies in this area
Results: physical environment correlateslast page
Implications of findingslast page, text too long had to cut page
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Section 8