scholarly journals P66 Estimating inequalities in moderate-vigorous physical activity among adolescents in England and the US using hurdle models

2020 ◽  
Author(s):  
S Scholes ◽  
JS Mindell
Keyword(s):  
Physical Activity ◽  
Vigorous Physical Activity ◽  
Hurdle Models ◽  
The Us

scholarly journals Income-based inequalities in self-reported moderate-to-vigorous physical activity among adolescents in England and the United States: a cross-sectional study

2020 ◽  
Author(s):  
Shaun Scholes ◽  
Jennifer S Mindell
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Vigorous Physical Activity ◽  
The United States ◽  
Cross Sectional Study ◽  
High Income ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Us ◽  
Low Income Households

Objective: Quantify inequalities in self-reported moderate-to-vigorous physical activity (MVPA) in England and the United States (US). Design: Population-based cross-sectional study. Participants: 4019 adolescents aged 11-15 years in England (Health Survey for England 2008, 2012, 2015) and 4312 aged 12-17 years in the US (National Health and Nutrition Examination Survey 2007-16). Main outcome measures: Three aspects of MVPA: (1) doing any, (2) average min/day (MVPA: including those who did none), and (3) average min/day conditional on participation (MVPA-active). Using hurdle models, we quantified inequalities (average marginal effects: AMEs) using the absolute difference in marginal means. Results: In England, adolescents in high-income households were more likely than those in low-income households to have done any formal sports/exercise in the last seven days (boys: 11%; 95% CI: 4% to 17%; girls: 13%; 95% CI: 6% to 20%); girls in high-income households did more than their low-income counterparts (MVPA: 6 min/day, 95% CI: 2 to 9). Girls in low-income households spent more time in informal activities than girls in high-income households (MVPA: 21 min/day; 95% CI: 10 to 33), whilst boys in low-income versus high-income households spent longer in active travel (MVPA: 21 min/week; 95% CI: 8 to 34). In the US, in a typical week, recreational activity was greater among high-income versus low-income households (boys: 15 min/day; 95% CI: 6 to 24 min/day; girls: 19 min/day; 95% CI: 12 to 27). In contrast, adolescents in low-income versus high-income households were more likely to travel actively (boys: 11%; 95% CI: 3% to 19%; girls: 10%; 95% CI: 3% to 17%) and do more. Conclusions: Policy actions and interventions are required to increase MVPA across all income groups in England and the US. Differences in formal sports/exercise (England) and recreational (US) activities suggest that additional efforts are required to reduce inequalities.

scholarly journals Inequalities in participation and time spent in moderate-to-vigorous physical activity: analysis using the Health Surveys for England 2008, 2012, and 2016

2020 ◽  
Author(s):  
Shaun Scholes ◽  
Jennifer S Mindell
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Vigorous Physical Activity ◽  
High Income ◽  
Hurdle Models ◽  
Domain Specific ◽  
Confounder Adjustment ◽  
Average Marginal Effects ◽  
Reported Data ◽  
Low Income Households

Abstract Background Evidence is unclear on whether inequalities in average levels of moderate-to-vigorous physical activity (MVPA) reflect differences in participation, differences in the amount of time spent active, or both. Using self-reported data from 24,882 adults (Health Survey for England 2008, 2012, 2016), we examined gender-specific inequalities in these separate aspects for total and domain-specific MVPA. Methods Hurdle models accommodate continuous data with excess zeros and positive skewness. Such models were used to assess differences between income groups in three aspects: (1) the probability of doing any MVPA, (2) the average hours/week spent in MVPA, and (3) the average hours/week spent in MVPA conditional on participation (MVPA-active). Absolute inequalities were summarised using average marginal effects (AMEs) after confounder adjustment. Results Inequalities were robust to adjustment in each aspect for total MVPA and for sports/exercise. Differences between adults in high-income versus low-income households in sports/exercise MVPA were 2.2 hours/week among men (95% confidence interval (CI): 1.6, 2.8) and 1.7 hours/week among women (95% CI: 1.3, 2.1); differences in sports/exercise MVPA-active were 1.3 hours/week (95% CI: 0.4, 2.1) and 1.0 hours/week (95% CI: 0.5, 1.6) for men and women, respectively. Heterogeneity in associations was evident for the other domains. For example, adults in high-income versus low-income households were more likely to do any walking (men: 13.0% (95% CI: 10.3, 15.8%); women: 10.2% (95% CI: 7.6, 12.8%)). Among all adults (including those who did no walking), the average hours/week spent walking showed no difference by income. Among those who did any walking, adults in high-income versus low-income households walked on average 1 hour/week less (men: -0.9 hours/week (95% CI: -1.7, -0.2); women: -1.0 hours/week (95% CI: -1.7, -0.2)). Conclusions Participation and the amount of time spent in MVPA typically favours those in high-income households. Monitoring inequalities requires assessing different aspects of the distribution within each domain. Reducing inequalities in sports/exercise requires policy actions and interventions to move adults in low-income households from inactivity to activity, and to enable those already active to do more. Measures to promote walking should focus efforts on reducing the sizeable income gap in the propensity to do any walking.

scholarly journals Calibration and validation of the Youth Activity Profile as a physical activity and sedentary behaviour surveillance tool for English youth

2019 ◽  
Author(s):  
Stuart J Fairclough ◽  
Danielle L Christian ◽  
Pedro F Saint-Maurice ◽  
Paul R Hibbing ◽  
Robert J Noonan ◽  
...  
Keyword(s):  
Physical Activity ◽  
Sedentary Behaviour ◽  
Primary Schools ◽  
Vigorous Physical Activity ◽  
Self Report ◽  
Group Level ◽  
Activity Profile ◽  
The Us ◽  
Youth Activity ◽  
Out Of School

Abstract Background Calibration algorithms applied to the Youth Activity Profile (YAP) self-report questionnaire in the US have accurately estimated moderate-to-vigorous physical activity (MVPA) and sedentary behaviour (SB). However, the efficacy of the calibration algorithms may vary when applied to different populations. We aimed to: (1) assess the accuracy of US-generated YAP calibration algorithms for MVPA and SB with English youth, (2) validate English-specific YAP calibration algorithms, (3) examine their potential surveillance utility to assess compliance to MVPA guidelines. Methods Four primary schools and five secondary schools were recruited. Four-hundred-and-two participants (aged 9-16 years; 212 boys) wore SenseWear Armband Mini devices (SWA) for eight days and completed the YAP on the eighth day. For aim (1) the original US calibration algorithms were applied to the YAP scores, which were matched to SWA-estimated in-school, out-of-school, and weekend MVPA and out-of-school SB data. For aim (2) new calibration algorithms for the equivalent time-segments were generated from the English YAP data using quantile regression. The algorithms were applied in an independent cross-validation sample, and individual- and group-level agreement were assessed using bias, mean absolute percent error (MAPE) and equivalency tests, respectively. For aim (3) the utility of the English YAP algorithms to assess compliance to MVPA guidelines was examined using kappa, sensitivity, and specificity. Results Agreement between the US calibration algorithms and SWA estimates of MVPA and SB was poor. Group-level MAPE for the English YAP-estimates of in-school, out-of-school, and weekend MVPA ranged from 3.6% to 17.3%. Bias for these estimates were 17.2 (34.4), 31.6 (14.0), and -4.9 (3.6) min·week-1, respectively. Out-of-school SB was over-predicted by 109.2 (11.8) min·week-1 (MAPE=11.8%). Predicted YAP values were within 15%-20% equivalence of the SWA estimates. Classification accuracy of the English YAP MVPA estimates for compliance to 60 min·day-1 and 30 min·school-day-1 MVPA recommendations were 91%/37% and 89%/57% sensitivity/specificity, respectively. Conclusions The English YAP generated robust group-level estimates of MVPA and SB and has potential for surveillance to monitor compliance with MVPA guidelines. The YAP’s accuracy may be further improved through research work with more representative UK samples to enhance the calibration process and to refine the resultant algorithms.

scholarly journals Income-based inequalities in self-reported moderate-to-vigorous physical activity among adolescents in England and the United States: comparisons from two cross-sectional surveys

2020 ◽  
Author(s):  
Shaun Scholes ◽  
Jennifer S Mindell
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Vigorous Physical Activity ◽  
The United States ◽  
Active Travel ◽  
High Income ◽  
Absolute Difference ◽  
Cross Sectional ◽  
The Us ◽  
Low Income Households

Abstract Background: Inequalities in moderate-to-vigorous intensity physical activity (MVPA) may reflect differences in the propensity to do any, the amount of time spent active, or both. Using self-reported data from 4019 adolescents aged 11-15 years in England (Health Survey for England 2008, 2012, 2015) and 4312 aged 12-17 years in the US (National Health and Nutrition Examination Survey 2007-16) we examined inequalities in MVPA.Methods: Hurdle models estimated inequalities by household income in three aspects: (1) doing any, (2) average minutes/day (MVPA: including those who did none), and (3) average minutes/day conditional on participation (MVPA-active). Inequalities after confounder adjustment (average marginal effects: AMEs) were quantified by computing the absolute difference in marginal means (low-income households as reference).Results: In England, adolescents in high-income households were more likely than those in low-income households to have done any formal sports/exercise in the last seven days (AMEs boys: 11%; 95% CI: 4, 17; girls: 13%; 6, 20); girls in high-income households spent more time being active than their low-income counterparts (AME formal MVPA: 6 minutes/day, 95% CI: 2, 9). Girls in low-income households spent more time in informal activities than girls in high-income households did (AME informal MVPA: 21 minutes/day; 95% CI: 10, 33), whilst boys in low-income versus high-income households spent longer in active travel (AME active travel MVPA: 21 minutes/week; 95% CI: 8, 34). In the US, in a typical week, recreational activity was greater among high-income versus low-income households (AMEs recreational boys: 15 minutes/day; 95% CI: 6, 24; girls: 19 minutes/day; 95% CI: 12, 27). In contrast, adolescents in low-income versus high-income households were more likely to travel actively (AMEs boys: 11%; 95% CI: 3, 19; girls: 10%; 95% CI: 3, 17) and spend more time engaged. Conclusions: Policy actions and interventions are required to increase levels of MVPA across all income groups in England and the US. Differences in formal sports/exercise (England) and recreational (US) activities suggest that additional efforts are required to move adolescents in low-income households from inactivity to activity, and to enable those already active to do more.

scholarly journals Inequalities in participation and time spent in moderate-to-vigorous physical activity: analysis using the Health Surveys for England 2008, 2012, and 2016

2020 ◽  
Author(s):  
Shaun Scholes ◽  
Jennifer S Mindell
Keyword(s):  
Physical Activity ◽  
Low Income ◽  
Vigorous Physical Activity ◽  
High Income ◽  
Hurdle Models ◽  
Domain Specific ◽  
Confounder Adjustment ◽  
Average Marginal Effects ◽  
Reported Data ◽  
Low Income Households

Abstract BackgroundEvidence is unclear on whether inequalities in average levels of moderate-to-vigorous physical activity (MVPA) reflect differences in participation, differences in the amount of time spent active, or both. Using self-reported data from 24 882 adults (Health Survey for England 2008, 2012, 2016), we examined gender-specific inequalities in these separate aspects for total and domain-specific MVPA.MethodsHurdle models can accommodate continuous data with excess zeros and positive skewness. Such models were used to assess differences between income groups in three aspects: (1) the probability of doing any MVPA, (2) the average hours/week spent in MVPA, and (3) the average hours/week spent in MVPA conditional on participation (MVPA-active). Inequalities were summarised on the absolute scale using average marginal effects (AMEs) after confounder adjustment.ResultsInequalities were robust to adjustment in each aspect for total MVPA and for sports/exercise. Differences between adults in high-income versus low-income households in sports/exercise MVPA were 2.2 hours/week among men (95% confidence interval (CI): 1.7, 2.6) and 1.7 hours/week among women (95% CI: 1.4, 2.1); differences in sports/exercise MVPA-active were 1.3 hours/week (95% CI: 0.7, 1.9) and 1.0 hours/week (95% CI: 0.5, 1.6) for men and women, respectively. Heterogeneity in associations was evident for the other domains. For example, adults in high-income versus low-income households were more likely to do any walking (men: 13.0% (95% CI: 11.0, 15.0%); women: 10.2% (95% CI: 7.5, 12.9%)), yet showed no difference in hours/week walking, whilst among those doing any walking, women in high-income households spent less time walking (-1.0 hours/week; 95% CI: -1.6, -0.4).ConclusionsMonitoring inequalities in MVPA requires assessing different aspects of the distribution within each domain.

Differences in physical function and metabolic syndrome risk factors according to the level of physical activity in elderly Korean men: a pilot study

2020 ◽  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Metabolic Syndrome ◽  
Physical Function ◽  
Vigorous Physical Activity ◽  
Density Lipoprotein ◽  
The Elderly ◽  
Berg Balance Scale ◽  
Lower Percentage ◽  
Mineral Density

Background and objective: Managing the decrease in physical function in the elderly is a major task in aging societies globally. Here, we aimed to compare the physical function and metabolic syndrome (MetS) risk factors according to levels of physical activity (PA). Material and methods: We measured PA in 77 elderly Korean men (74.21 ± 6.26 years old) with an accelerometer and recorded body composition, physical function, and MetS-related risk factors. Participants were divided into three groups based on daily moderate-vigorous physical activity (MVPA): low (under 60 min), middle (60-120 min), and high (over 120 min). The groups were compared using a one-way analysis of variance and the Scheffe post hoc test. Odds ratios (OR) were calculated by logistic regression analysis. Results: Significant differences were found between the groups for sedentary behavior time (P < 0.001), light PA (P < 0.05), moderate PA (P < 0.001), vigorous PA (P < 0.05), and total energy expenditure (P < 0.001). The high PA group showed a significantly lower percentage of body fat and fat mass and higher muscle mass than did the low and middle PA groups (P < 0.05). The 6-min walk test was significantly better in the high PA group than in the low and middle PA groups (P < 0.05). Grip strength and the Berg balance scale were also significantly better in the high PA group (P < 0.05). Bone mineral density (BMD) and high-density lipoprotein cholesterol (HDL-C) were significantly higher in the high PA group than in the low PA group (P < 0.05). Systolic blood pressure (SBP) was significantly higher in the middle PA group than in the low PA group (P < 0.05). Participants with more than three MetS criteria showed an OR of 0.09 (95% confidence interval 0.01-0.82) in the high PA group as compared with the low PA group (P < 0.05). Conclusions: Moderate-vigorous physical activity of more than 120 min daily showed better physical function and lower OR of MetS than did lower MVPA levels in elderly Korean men.

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