Characteristics related to meeting CDC/ACSM physical activity guidelines in adults – Centers for Disease Control and Prevention – American College of Sports Medicine – study examines characteristics of adults meeting physical activity standards
Lorraine Silver Wallace
Abstract: This study examined characteristics associated with meeting current moderate (e”5d [wk.sup.-1] and vigorous (e”3d [wk.sup.-1]) CDC/ACSM physical activity recommendations in a sample of 680 adults with a mean age of 27.45 [+ or -] 8.2years. Overall, the mean numbers of days per week for moderate and vigorous activity were lower than the CDC/ACSM guidelines. Being male, perceiving the consequences of inactivity as severe, and greater social support for physical activity from peers and family were associated with greater likelihood of meeting either the moderate or vigorous CDC/ACSM guidelines. Results warrant further investigation of additional behavioral and environmental characteristics associated with physical activity participation.
Physical activity is recognized as an essential component of a healthy lifestyle. Unfortunately, the majority of American adults do not engage in sufficient regular physical activity to reap the many positive health benefits associated with this important behavior. The publication of the Surgeon General’s Report (SGR) on physical activity and health (U.S. Department of Health and Human Services [USDHHS], 1996) has brought heightened awareness regarding the importance of a physically active lifestyle in the prevention of numerous chronic health problems, such as type II diabetes mellitus, osteoporosis, coronary heart disease, hypertension and depression (Pate et al., 1995).
The Centers for Disease Control and Prevention and American College of Sports Medicine (CDC/ ACSM) developed guidelines for moderate and vigorous activity based on an accumulation of epidemiological research over the past several decades (ACSM, 1998; Pate et al., 1995). Recommended level of moderate activity (MACT) is at least 30 minute on 3 5d [wk.sup.-1], while at least 30 minutes or more for a minimum of 3 d [wk.sup.-1] is suggested for vigorous activity (VACT). To date, very few studies have been conducted that specifically examine physical activity in relation to CDC/ACSM recommendations. The purposes of this study were to examine the proportion of young to middle-aged adults who meet the CDC/ ACSM guidelines and identify characteristics associated with participation.
This study is based on a secondary analysis of data and examines different, yet important research questions. The primary study tested the applicability of the entire Transtheoretical Model of behavior change (i.e, stage of change, self-efficacy, decisional balance, processes of change) in predicting exercise behavior in nontraditional college students (Wallace & Buckworth, 2001). A secondary analysis was warranted because few studies have been conducted that assess physical activity participation in relation to CDC/ACSM guidelines. Further, physical activity was evaluated quantitatively (i.e., minutes per session, days per week) and social support for physical activity has shown to be a central determinant of an active lifestyle (Sallis, Grossman, Pinski, Patterson, & Nader, 1987; Wallace, Buckworth, Kirby, & Sherman, 2000). This manuscript focuses on exploring three research questions: “What proportion of individuals were meeting CDC/ ACSM physical activity guidelines?”; “Were there differences in social support (peer and family) and perceived severity of inactivity as a function of meeting CDC/ACSM guidelines?”; and,” What characteristics predicted whether an individual met the CDC/ACSM guidelines for either MACT or VACT?” The University Human Subject Institutional Review board approved the study methods employed in this study.
The sample was composed of undergraduate students enrolled at a primarily upper-division university. All faculty members teaching undergraduate classes during spring semester were contacted, and 65% agreed to have the primary researcher distribute valid and reliable written questionnaire packets to students during regularly scheduled class meetings. Of the 680 students who completed the questionnaires, most were female (n=427, 62.8%), Caucasian (n=584, 85.9%), and enrolled full-time (B=571, 85%). The mean age of the sample was 27.45 [+ or -] 8.2 years (range 18-70). Students were informed that their participation was voluntary and anonymity was assured. To increase participation, students who completed the questionnaire were entered into a drawing for one of five cash ($20.00) prizes.
Only measures related to the research questions examined in this study will be discussed.
Moderate and Vigorous Physical Activity. Days per week of MACT and VACT were assessed using the items from the National College Health Risk Behavior Survey (Douglas et al., 1997). Students were asked to indicate on how many of the past 7 days they had engaged in MACT (“On how many of the past 7 days did you walk in bicycle for at least 30 minutes at a time?”) and VACT (“On how many of the past 7 days did you exercise or participate in sports activities for at least 20 minutes that made you sweat and breathe hard such as basketball, jogging, swimming laps, tennis, fast bicycling, or similar aerobic activities?”).
Social Support for Physical Activity. The Social Support and Exercise Survey (Sallis et al., 1987) was used to measure both friend and family social support related to physical activity over the previous 3 months. This survey comprises two 12-item, 5-point Likert scales (ranging from 1, “none” to 5, “very often”). The ratings of all 12 items were summated for a total score. Concurrent criterion-related validity has been demonstrated by correlating social support factor scales and physical activity behavior (Sallis et al., 1987). Sallis et al. (1987) reported a 2-week test-retest reliability of 0.79 for both scales combined and internal consistencies of 0.84 (friend subscale) and 0.91 (family subscale). Wallace et al. (2000) reported one-week test-retest reliabilities of O.90 for the friend subscale and 0.80 for the family subscale in a college population. In our study, internal consistencies were 0.93 for the friend subscale and 0.91 for the family subscale.
Perceived Severity of Physical Inactivity Perceived severity of physical inactivity was assessed using a 7-point Likert scale (ranging from 1, “strongly disagree” to 7, “strongly agree”) based on scales previously reported in the literature (Courneya, 1995;Wurtele, 1988). Items were summed and divided by three for a total score. The items included “A lack of physical activity could have a major negative impact on my health” and “A lack of physical activity could have a major negative impact on my lifestyle.” Courneya (1995) reported an internal consistency of 0.74 for this scale. In our study, we found an internal consistency of 0.81.
The Statistical Package for the Social Sciences (SPSS+[R]) for Windows Version 10.0 was used for statistical analyses (SPSS+[R], 1999). Alpha (a) was set at 0.05 a priori. Descriptive statistics (means, standard deviations, frequencies, percentages) were calculated. Chi-square analyses ([c.sub.2]) and one-way analyses of variance (ANOVAs) were performed to determine whether there were differences in meeting CDC/ ACSM guidelines as a function of gender, race, age, perceived severity of inactivity, peer social support, and family social support. Logistic regression analyses were used to calculate odds ratios for gender, race, age, perceived severity of inactivity, peer social support, and family social support to determine their importance in predicting attainment of CDC/ACSM guidelines.
PROPORTION OF INDIVIDUALS MEETING THE ACSM/CDC PHYSICAL ACTIVITY GUIDELINES
The mean numbers of days per week for MACT and VACT were lower than the CDC/ACSM guidelines. Gender differences were tested, and males reported significantly more days of VACT per week as compared to females (1.97 [+ or -] 1.92 vs. 1.47 [+ or -] 1.79), F(1,672)=11.66, P<.01. There were no differences between males and females in average number of days of MACT per week (1.71 [+ or -] 2.19 vs. 1.65 [+ or -] 1.96).
Figure 1 presents the percentages of individuals meeting MACT and VACT CDC/ACSM guidelines. Approximately, 37% (n=250) of the sample met either the MACT (3 5 d [wk.sub.-1]) or VACT (3 3 d [wk.sub.-1]) CDC/ACSM guideline. Males (44.8%) were more likely to meet the VACT or MACT CDC/ACSM guideline than females (32.8%), [c.sup.2](672) = 9.61, p<.01. A small proportion of the sample (8.4%, n=58) met both the MACT and VACT CDC/ACSM guidelines.
[FIGURE 1 OMITTED]
Almost one third of the sample met the ACT CDC/ACSM guideline (31.3%, n=216). Males (40%) were more likely to meet the VACT guideline recommendation than females (27.4%), [c.sub.2](674) = 11.54, p<.01. Fewer individuals (13.6%, n=94) met the MACT CDC/ACSM guideline, and there was no difference in the proportion of males (16.9%) and females (12.2%) meeting the MACT recommendation. Significant differences were not observed in meeting either the MACT or VACT CDC/ACSM guideline as a function of race or age.
Social Support (Peer and Family) and Perceived Severity of Inactivity as a Function of Meeting CDC/ ACSM Guidelines
There were significant differences in social support (peer and family) and perceived severity of inactivity as a function of gender and meeting CDC/ ACSM guidelines for both MACT and VACT (See Table 1). Family and peer social support for physical activity was significantly higher among those meeting MACT and VACT recommendations for both males and females. Perceived severity of inactivity differentiated all groups with the exception of males meeting the current MACT guideline.
CHARACTERISTICS PREDICTED WHETHER AN INDIVIDUAL MET THE ACSM/CDC GUIDELINES
Table 2 presents significant results of the logistic regression analyses. Of the six characteristics entered into the model, age and race were insignificant predictors of meeting either the moderate or vigorous CDC/ ACSM guideline. Being male (113%), perceiving the consequences of inactivity as severe (19%), and re porting greater social support for physical activity from peers (6%) and family (4%) improved the odds ratio significantly of meeting either the MACT or VACT CDC/ACSM guideline.
A large segment of individuals in this sample (55% males; 67% females) did not satisfy minimum CDC/ ACSM guidelines for either MACT or VACT. Martin, Morrow, Jackson, and Dunn (2000) reported that 68% of a random sample of U.S. adults did not meet the guidelines for either moderate or vigorous activity set forth by the CDC/ACSM. Despite differences in definitions used to measure physical activity level in the literature, national surveys have consistently documented that a majority of American adults are irregularly active or completely sedentary (USDDHS, 1996, p.177). The small proportion (13.6%) of our sample meeting MACT recommendation raises a concern about maintenance of an active lifestyle since lower intensity exercise has better adherence rates than VACT (Dishman & Buckworth, 1996).
In our sample, age and race did differentiate those meeting and not meeting CDC/ACSM criterion. Increasing age and non-Caucasian race have consistently been found to be related to decreased participation in physical activity (USDDHS, 1996, p. 181). Our findings are most likely attributable to the homogeneous nature of the study sample, since 73% of the subjects were between the ages of 21 and 30 and 85% were Caucasian. Results from the logistic regression analyses found that gender was the best predictor of meeting CDC/ACSM guidelines. Males have consistently been shown to more active across all age groups and race/ethnic groups as compared to females (Pate et al., 1995; USDHHS, 1996, p.177).
Perceived severity of inactivity improved the odds ratio of meeting CDC/ACSM guidelines by 19% in this sample. Martin et al., (2000) found that per ceived importance of physical activity was a strong predictor of whether an individual was currently meeting the physical activity recommendations set forth by the CDC/ACSM. Courneya (1995) reported that perceived severity was significantly lower among subjects who were currently inactive and had no intentions of becoming active in the near future. These findings suggest that many young adults may need basic information outlining the health benefits of associated with a regularly active lifestyle. Although, knowledge itself is insufficient in changing long-term health behavior, raising awareness of the negative health consequences of an inactive lifestyle may be important to motivate the completely sedentary to become more active.
Social support from both family and peers was a significant predictor of meeting CDC/ACSM guidelines. In our sample, participants with greater family and peer social support were more likely to meet VACT recommendations. In 1996, Caron, Hausenblas, and Mack conducted a men-analysis of 87 studies to quantify the relationship between social influence and exercise behavior. The most important influences were family support and attitudes about exercise, important others and attitudes about exercise, and family support and compliance behavior. Wallace et al. (2000) found that social support for physical activity was a major predictor of stage of exercise behavior change among a random sample of undergraduate students at a large Midwestern university. In their study, family support was more important for females, while peer support was more influential among males. Increasing social support for physical activity is an important variable to target for those involved in developing interventions to promote active lifestyles. For example, it may be beneficial to design programs that focus on including a friend or family member in usual exercise routines
This study examined several characteristics associated with current participation in recommended CDC/ACSM guidelines. Of the characteristics explored, gender, perceived severity of inactivity, and social support (peer and family) for physical activity were the best predictors of meeting current CDC/ ACSM standards. Future research should continue to examine these characteristics, in addition to other behavioral and environmental factors.
IMPLICATIONS AND RECOMMENDATIONS
Health educators must appreciate the importance of a physically active lifestyle and realize that the majority of American adults fall short of current recommendations. Individuals need basic information describing current CDC/ACSM physical activity guidelines and health benefits associated with an active lifestyle. For instance, it would be beneficial to inform individuals that reduced mortality has been documented in adults who walk briskly for 30 minutes or more on most days of the week (Stefan, DiPietro, Davis, Kohl, Blair, 1998). Since women are less active than men, it is especially important that women are encouraged to begin a moderate physical activity routine. Health educators should focus on assisting individuals to increase their current level of physical activity. Recognizing that behavior change does not occur overnight, individuals should be provided with strategies that can be easily is incorporated into their lives (e.g., using the stairs instead of the elevator while at work, parking as far away as possible from the door at the mall). Encouraging social support is an important determinant of physical activity, the health educator could develop programs that emphasis exercising with a friend or family member (i.e., buddy system). Health educators can play an instrumental role in assisting individuals to adopt and maintain an active lifestyle, thus contributing to improving the proportion of individuals who meet current CDC/ACSM objectives.
Table 1. Social Support (Peer and Family) and Perceived Severity of
Inactivity as a Function of Gender and Meeting CDC/ACSM Guidelines for
Moderate (MACT) and Vigorous (VACT) Physical Activity.
Peer Social Support Family Social Support
M SD F M SD F
VACT (+) 30.17 13.54 82.77 28.99 13.97 46.83
VACT (-) 21.94 9.46 *** 22.45 10.22 ***
MACT (+) 28.91 13.19 15.46 28.92 13.60 14.96
MACT (-) 23.89 11.13 *** 23.84 11.44 ***
VACT (+) 30.56 13.99 43.75 32.22 14.27 47.54
VACT (-) 22.68 9.52 *** 23.57 10.30 ***
MACT (+) 28.81 12.25 7.18 31.79 14.04 13.82
MACT (-) 24.30 11.23 ** 25.20 11.66 ***
VACT (+) 29.71 13.05 43.41 25.16 12.64 12.42
VACT (-) 20.42 9.16 *** 20.15 9.68 ***
MACT (+) 29.05 14.45 8.89 25.29 12.26 4.39
MACT (-) 23.15 10.93 ** 21.38 10.63 *
Perceived Severity of Inactivity
M SD F
VACT (+) 6.15 1.11 19.35
VACT (-) 5.70 1.30 ***
MACT (+) 6.13 1.17 5.75
MACT (-) 5.80 1.26 *
VACT (+) 6.20 1.18 13.40
VACT (-) 5.66 1.38 ***
MACT (+) 6.21 1.05 5.26
MACT (-) 5.75 1.37 *
VACT (+) 6.10 1.03 5.44
VACT (-) 5.78 1.10 *
MACT (+) 6.04 1.32 .72
MACT (-) 5.89 1.01
Note. (+) currently meeting guideline; (-) currently not meeting
VACT=[sup.3]30 min; [sup.3]3 d*w[k.sup.-1]
MACT=[sup.3]30 min; [sup.3]5 d*w[k.sup.-1]
* p<.05 ** p<.01 *** p<.001
Table 2. Logistic Regression Results: Summary of Significant
Characteristics Predicting Satisfying CDC/ACSM Guidelines.
Characteristic p R Odds Ratio 95% CI
Gender (a) .000 .169 2.13 1.47/3.08
Perceived Severity of Inactivity .032 .163 1.19 1.02/1.38
Peer Social Support .000 .109 1.06 1.04/1.07
Family Social Support .000 .140 1.04 1.03/1.06
Note. CI=confidence interval
(a) 0, female; 1 male
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Lorraine Silver Wallace, Ph.D. is an Assistant Professor in the Department of Family Medicine at The University of Tennessee. Janet Buckworth, Ph.D. is an Associate Professor in the Department of Sport and Exercise Science Health at The Ohio State University. Address all correspondence to Lorraine S. Wallace, PhD, The University of Tennessee Graduate School of Medicine, Department of Family Medicine, 1924 Alcoa Highway, U-67, Knoxville, TN 37920; PHONE: 865.544.9352; FAX: 865.544.6532; E-MAIL: firstname.lastname@example.org.
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