A randomized controlled trial of continuous activity, short bouts, and a 10,000 step guideline in inactive adults. Moderate to Vigorous Physical Activity and Weight Outcomes: Does Every Minute Count? A randomized trial of physical activity interventions: design and baseline data from project active. Very short intermittent vs continuous bouts of activity in sedentary adults. A randomised controlled trial of three pragmatic approaches to initiate increased physical activity in sedentary patients with risk factors for cardiovascular disease. Compliance with physical activity guidelines in a group of UK-based postal workers using an objective monitoring technique Spectral and bout detection analysis of physical activity patterns in healthy, prepubertal boys and girls Design and baseline characteristics of the Short bouTs of Exercise for Preschoolers (STEP) study Patterns of Sedentary Behavior and Mortality in U.S. Middle-Aged and Older Adults A brief intervention to increase physical activity in sedentary working women. Prevalence of Physical Activity in the United States: Behavioral Risk Factor Surveillance System, 2001 A randomized trial comparing structured and lifestyle goals in an internet-mediated walking program for people with type 2 diabetes A controlled trial of physician counseling to promote the adoption of physical activity. Ongoing physical activity advice by humans versus computers: the Community Health Advice by Telephone (CHAT) trial. Pilot Study of a Faith-Based Physical Activity Program Among Sedentary Blacks Randomized pilot test of a lifestyle physical activity intervention for breast cancer survivors. Participation by US adults in sports, exercise, and recreational physical activities.
OBJECTIVE Although several studies have examined the effect of accumulated bouts on health outcomes , the impact of recommending short bouts on activity-related behavior in health promotion efforts has received minimal investigation . METHOD During this 5-week study in 2007 - 2008 , 43 university employees ( 8 male , 35 female ) in the Southeastern United States were r and omly assigned to a group recommended to achieve ( a ) 10,000 steps ( 10 K ) , ( b ) 30-minutes ( 30 min ) of continuous physical activity , or ( c ) 30-minutes of activity in bouts of at least 10 minutes ( bouts ) . RESULTS AND CONCLUSIONS Repeated measures ANOVA revealed that the 10 K group showed the largest increase in step counts whereas the bouts group showed the smallest change over the intervention period , p=0.01 . Condition differences were most pronounced on days in which participants met their activity recommendation . Accelerometer results revealed that the 10 K ( d=1.1 ) and 30 min groups ( d=0.89 ) showed large increases in minutes of moderate to vigorous activity ( MVPA ) , whereas the bouts group showed minimal change ( d=0.11 ) . Although activity recommendations did not differentially affect self-efficacy , participants from all conditions showed decreased self-efficacy across the intervention ( p=0.02 ) , highlighting the need to develop strategies to increase self-efficacy in activity promotion efforts Purpose . The purpose of this study was to test if moderate to vigorous physical activity ( MVPA ) in less than the recommended ≥ 10-minute bouts related to weight outcomes . Design . Secondary data analysis . Setting . R and om sample from the U.S. civilian noninstitutionalized population included in the National Health and Nutrition Examination Survey ( NHANES ) . Participants . A total of 4511 adults aged 18 to 64 years from the 2003–2006 NHANES . Method . Clinical ly measured body mass index ( BMI ) and overweight/obese status were regressed on accelerometer measures of minutes per day in higher-intensity long bouts ( ≥ 10 minutes , ≥ 2020 accelerometer counts per minute [ cpm ] ) , higher-intensity short bouts ( < 10 minutes , ≥ 2020 cpm ) , lower-intensity long bouts ( ≥ 10 minutes , 760–2019 cpm ) , and lower-intensity short bouts ( < 10 minutes , 760–2019 cpm ) . Socioeconomic and demographic characteristics were controlled . Results . Both higher-intensity short bouts and long bouts of PA  related to lower BMI and risk of overweight/obesity . Neither lower-intensity short bouts nor long bouts related to BMI or risk of overweight/obesity Conclusion . The current ≥ 10-minute MVPA bouts guideline was based on health benefits other than weight outcomes . Our findings showed that for weight gain prevention , accumulated higher-intensity PA bouts of < 10 minutes are highly beneficial , supporting the public health promotion message that “ every minute counts . We report here the design and baseline data from Project Active , a 2-yr r and omized trial design ed to compare the effectiveness of a Lifestyle physical activity intervention with the traditional Structured exercise prescription approach . Primary outcome measures are energy expenditure in physical activity ( estimated by kcal per kilogram of body weight of energy expenditure ) and cardiorespiratory fitness ( measured by maximal oxygen uptake ) . The participants , 235 initially sedentary and apparently healthy adults , were r and omized into either the Lifestyle or Structured intervention groups . The Lifestyle treatment consists of a personalized approach that accounts for an individual 's motivational readiness and preferences for integrating physical activity into daily routines . The Structured approach is the familiar exercise prescription that is based on a frequency , intensity , and duration formula . The primary hypothesis to be tested is that there will be a difference in physical activity and cardiorespiratory fitness measures between the two conditions at the end of 24 months . The secondary hypothesis is that both groups will make significant improvements from baseline in physical activity and cardiorespiratory fitness at the end of 6 months . Six months of active intervention are followed by 18 months of a tapered follow-up maintenance intervention in both groups . Primary outcome measures are measured after 6 and 24 months OBJECTIVE Whether accumulating short intermittent bouts of light-to-moderate physical activity ( LMPA ) can elicit significant improvements in the fitness of sedentary adults , compared to one longer continuous bout . METHODS Fifty sedentary 35- to 60-year-old adults in Hong Kong were r and omly appointed to one of two gender-balanced intervention programs : Exercise Prescription Model ( EPM ) of 30-minute continuous activity , 3 - 4 days per week , or a Lifestyle group ( LIFE ) of 6-minute activity , 5 times per day , 4 - 5 days per week . Aerobic fitness ( VO(2)max ) , mass , body composition , blood pressure , waist-to-hip ratio , and body mass index ( BMI ) were assessed at baseline ( December 1995 ) and after 8 weeks . RESULTS Nearly half of bouts by the LIFE group were < or = 6 min , while 85 % of the EPM bouts were > or = 30 min , with no differences in additional energy expenditure between groups ( EPM : 163.0+/-89.6 MET h vs LIFE : 148.2+/-71.6 MET h ) . Both groups significantly improved their VO(2)max , 7.4 % ( ES=0.36 ) and 5.3 % ( ES=0.24 ) for the EPM and Lifestyle groups respectively ( F((1,43))=34.0 , p<0.0001 ) . CONCLUSIONS Accumulating multiple short bouts of LMPA , of which approximately 50 % were < or = 6 min , can provide significant improvements in the fitness of sedentary adults that is not dissimilar as one continuous bout of similar total duration BACKGROUND Physical activity is a major modifiable risk factor for cardiovascular disease , but it is unclear what combination of feasible approaches , using existing re sources in primary care , work best to initiate increased physical activity . AIM To assess three approaches to initiate increased physical activity . DESIGN OF STUDY R and omised controlled ( 2 X 2 X 2 ) factorial trial . SETTING Four general practice s. METHOD One hundred and fifty-one sedentary patients with computer documented risk factors for cardiovascular disease were r and omised to eight groups defined by three factors :  prescription by general practitioners ( GPs ) for brisk exercise not requiring a leisure facility ( for example , walking ) 30 minutes per day , 5 days per week ; counselling by practice nurses , based on psychological theory to modify intentions and perceived control of behaviour , and using behavioural implementation techniques ( for example , contracting , ' rehearsal ' ) ; use of the Health Education Authority booklet ' Getting active , feeling fit ' . RESULTS Single interventions had modest effects . There was a trend from the least intensive interventions ( control + /- booklet ) to the more intensive interventions ( prescription and counselling combined + /- booklet ) for both increased physical activity and fitness ( test for trend , P = 0.02 and P = 0.05 , respectively ) . Only with the most intense intervention ( prescription and counselling combined ) were there significant increases in both physical activity and fitness from baseline ( Godin score = 14.4 , 95 % confidence interval [ CI ] = 7.8 to 21 , which was equivalent to three 15-minute sessions of brisk exercise and a 6-minute walking distance = 28.5 m , respectively , 95 % CI = 11.1 to 45.8 ) . Counselling only made a difference among those individuals with lower intention at baseline . CONCLUSION Feasible interventions using available staff , which combine exercise prescription and counselling explicitly based on psychological theory , can probably initiate important increases in physical activity Compliance with physical activity ( PA ) recommendations was assessed using objective PA monitoring of ambulatory activity , in two healthy groups of individuals with active and sedentary occupations . The study showed generally low compliance with the guidelines ( 53 % with 10,000 steps a day ; 10 % with 30 min of moderate activity a day ; and 1 % with 30 min of moderate activity a day in bouts of at least 10 min ( ACSM ) ) . Adherence to guidelines decreased as more rigorous conditions were applied to the PA data . Use of an objective monitor revealed that health enhancing bouts of activity were performed in periods of approximately 1-min duration , which may be due to unavoidable environmental interruptions . These bouts of activity are much shorter than those advocated in the ACSM guidelines , raising questions regarding how actual behaviour , based on objective monitoring , can be reconciled with guidelines based on self-reported PA Little is known about the frequency‐intensity patterns of naturally occurring physical activity in children . A data set obtained previously by direct observation of  physical activity in 8 girls and 7 boys ( all prepubertal , ages 6–10 ) was analyzed with spectral analysis to detect significant frequency‐intensity relationships . Pulse detection algorithms were used to characterize the number of exercise bouts , their duration and relative intensity . Spectral analysis revealed that physical activity bouts were frequent , pulsatile , and r and om with no significant frequencies detected during many 24‐min periods of observation . An average of 83 ± 11 bouts per hour were observed in boys and 89 ± 12 bouts per hour in girls , and the mean duration of an exercise bout was 21 ± 5 sec for boys and 20 ± 4 sec for girls ( NS ) . While high‐intensity exercise bouts comprised less than 20 % of the time spent in physical activity , duration of high intensity exercise bouts tended to be longer and accounted for about 40 % of the energy expenditure associated with physical activity . Spontaneous physical activity in prepubertal children is characterized by frequent bouts of brief , mostly low intensity exercise , r and omly interspersed with less frequent , but metabolically substantial high intensity bouts . These findings are potentially useful in assessing the impact of disease on quality of life in children , investigating the relationship between physical activity and mechanisms of growth and development , and creating new approaches for in‐laboratory exercise testing in children . Am . J. Hum . Biol . 10:289–297 , 1998 . © 1998 Wiley‐Liss , Background Most preschool centers provide two 30-min sessions of gross-motor/outdoor playtime per preschool day . Within this time frame , children accumulate most of their activity within the first 10 min . This paper describes the design and baseline participant characteristics of the Short bouTs of Exercise for Preschoolers ( STEP ) study . The STEP study is a cluster r and omized controlled study design ed to examine the effects of short bouts of structured physical activity ( SBS-PA ) implemented within the classroom setting as part of design ated gross-motor playtime on during-school physical activity ( PA ) in preschoolers . Methods / Design Ten preschool centers serving low-income families were r and omized into  SBS-PA versus unstructured PA ( UPA ) . SBS-PA schools were asked to implement age-appropriate 10 min structured PA routines within the classroom setting , twice daily , followed by 20 min of usual unstructured playtime . UPA intervention consisted of 30 min of supervised unstructured free playtime twice daily . Interventions were implemented during the morning and afternoon design ated gross-motor playtime for 30 min/session , five days/week for six months . Outcome measures were between group difference in during-preschool PA ( accelerometers and direct observation ) over six-months . Ten preschool centers , representing 34 classrooms and 315 children , enrolled in the study . The average age and BMI percentile for the participants was 4.1 ± 0.8 years and 69th percentile , respectively . Participants spent 74 % and 6 % of their preschool day engaged in sedentary and MVPA , respectively . Discussion Results from the STEP intervention could provide evidence that a PA policy that exposes preschoolers to shorter bouts of structured PA throughout the preschool day could potentially increase preschoolers ’ PA levels . Trial registration Clinical trials.gov , Adults are sedentary for an alarming 9 to 10 hours per day ( 1 ) . Accordingly , the popular press has coined the phrase sitting is the new smoking to describe a current epidemic of developed nations ( 24 ) . Evidence indicates that sedentary time is associated with incident cardiovascular disease , incidence of cardiovascular diseaserelated risk factors , and mortality ( 5 , 6 ) . Of note , the risk conferred by prolonged sedentariness is eliminated only by high levels of moderate- to vigorous-intensity physical activity ( MVPA ) ( about 60 to 75 min/d ) , which exceed physical activity recommendations ( 7 , 8) . As such , sedentary behavior is now believed to represent a clinical ly important aspect of a person 's physical activity profile and is no longer considered simply the extreme low end of the physical activity continuum ( 5 ) . Studies linking sedentary behavior to health outcomes have relied almost exclusively on self-reported  sedentary time  , which is subject to reporting bias and measurement error ( 9 ) . A 2015 systematic review ( 5 ) identified only 1 study ( NHANES [ National Health and Nutrition Examination Survey ] ) that examined the association between objective ly measured sedentary time and health outcomes , a study limited by a small event rate ( 10 ) . New studies using NHANES data have since been published , with longer follow-up and higher event rates ( 1115 ) . However , some of these studies have reported an association between objective ly measured sedentary time and mortality ( 11 , 14 , 15 ) , but others have not ( 12 , 13 ) . Additional cohort studies are thus needed to rectify evidence gaps . Furthermore , studies using accelerometers to objective ly measure sedentary behavior conventionally operationalize sedentary time as the total number of sedentary minutes per day . This approach ignores patterns of accumulated sedentary behavior over time . For example , accumulation of sedentary time in a few long bouts or many short bouts represents 2 distinct patterns of sedentary time accrual . Experimental studies have shown that acute periods of prolonged , uninterrupted sedentary behavior cause greater detrimental cardiometabolic effects than sedentary behavior that is periodically interrupted ( 1618 ) , suggestive that it is not just total sedentary time that is relevant to health outcomes , but also the manner in which it is accumulated . Few longitudinal studies , however , have explored the association between prolonged , uninterrupted sedentary behavior and mortality to corroborate these findings . To inform guidelines on reducing sedentary behavior ( target reductions in overall sedentary time or target interruption of prolonged sedentary bouts ) , evidence from prospect i ve studies is needed to 1 ) confirm the association between total sedentary time and mortality using objective measures , 2 ) determine whether prolonged sedentary bouts confer risk for death , and 3 ) eluci date whether the total volume of sedentary time and its pattern of accumulation individually or jointly contribute to risk for death . The purpose of this study , therefore , was to examine the association between objective ly measured sedentary time ( both total volume and accrual in prolonged bouts ) and all-cause mortality in a national cohort of U.S. middle-aged and older adults enrolled in the REGARDS ( Reasons for Geographic and Racial Differences in Stroke ) study . Methods Study Population REGARDS is a population -based study design ed to examine racial and regional disparities in stroke . It comprises 30239 white and black adults aged 45 years or older enrolled between 2003 and 2007 from across the contiguous United States ( 19 , 20 ) . Detailed design and methods for REGARDS are described elsewhere ( 21 ) . Briefly , demographic and cardiovascular risk factor data were collected by telephone interview and an in-home physical assessment on enrollment . A detailed summary of baseline measures is provided in the Supplement . Participants ( or their proxies ) were then followed for 6-month intervals to ascertain vital status . Objective measurements of sedentary behavior were collected from active REGARDS participants from 2009 to 2013 ( mean time from study enrollment , 5.7 years [ SD , 1.5 ] ; range , 1.9 to 9.5 years ) ( 22 ) . A total of 7985 participants adhered to accelerometer wear requirements ( 4 days with accelerometer wear 10 hours ) , provided follow-up data , and were available for the current analyses ( Supplement Figure 1 ) . Supplement Table 1 shows the characteristics of included versus excluded REGARDS participants . The REGARDS study protocol was approved by the institutional review boards of participating institutions . All participants provided informed consent . Supplement . Supplementary Material Accelerometer Data Collection Methods for accelerometer data collection are described elsewhere ( 22 ) . Briefly , participants were fitted with an Actical ( Philips Respironics ) accelerometer secured to their right hip using a nylon belt and were instructed to wear the device during waking hours for 7 consecutive days . The Actical had been vali date d formeasurement of physical activity and sedentary behavior and was shown to have acceptable reliability ( 2325 ) . Activity counts were summed over 1-minute epochs . Nonwear periods were defined as at least 150 consecutive minutes of 0 activity counts . This nonwear algorithm was previously vali date d against daily log sheets in REGARDS participants ( 26 ) . Measurements of 0 to 49 , 50 to 1064 , and at least 1065 counts per minute were defined as sedentary behavior , light-intensity physical activity , and MVPA , respectively , as determined in a laboratory-based calibration study ( 27 ) . A sedentary bout was defined as consecutive minutes in which the accelerometer registered fewer than 50 counts per minute . A sedentary break was defined as at least 1 minute in which 50 or more counts per minute were registered after a sedentary bout . Both sedentary bouts and breaks were exclusively continuous periods , with no interruptions or nonwear intervals allowed in the definition . Outcome Ascertainment All-cause mortality was the primary outcome , defined as any death after completion of the accelerometer protocol regardless of cause . Date s of death were confirmed through review of death certificates , medical records , and administrative data bases . Deaths through 4 September 2015 were included in the current analysis . Statistical Analysis Sedentary and physical activity variables were averaged across compliant days ( 10 hours of wear ) . Because of a high correlation between total sedentary time and wear time ( Supplement Figure 2 ) , we corrected for the influence of wear time by st and ardizing total sedentary time to 16 hours of wear time per day using the residuals obtained when regressing total sedentary time on wear time ( see Methods section of the Supplement ) ( 2830 ) . Participants were stratified into quartiles according to total sedentary time and , separately , mean sedentary bout duration ( a measure of overall prolonged , uninterrupted sedentary behavior ) . Cox proportional hazards regression modeling was used to calculate the hazard ratio ( HR ) for all-cause mortality associated with quartiles of total sedentary time ( and separately , mean sedentary bout length ) . Crude HRs were initially calculated . Subsequent HRs were calculated after adjustment for age , race , sex , region of residence , education , and season the accelerometer was worn ( model 1 ) , with further adjustment for current smoking , alcohol use , body mass index ( BMI ) , diabetes , hypertension , dyslipidemia , estimated glomerular filtration rate less than 60 mL/min/1.73 m2 , atrial fibrillation , history of coronary heart disease , and history of stroke ( model 2 ) . Models were additionally adjusted for MVPA expressed continuously ( model 3 ) . Tests for linear trend across quartiles were conducted by including the quartile for each participant as an ordinal variable in regression models . Proportional hazards assumptions were confirmed with a Kolmogorov-type supremum test ( 31 ) . The above analyses were then repeated in a fully adjusted model , testing interactions for age ( < 65 and 65 years ) , sex ( male and female ) , race ( black and white ) , BMI category ( normal weight and overweight or obese ) , and MVPA category ( < 150 min/wk and 150 min/wk ) . As a secondary analysis , we examined the continuous doseresponse relationship between each sedentary characteristic and all-cause mortality in a fully adjusted model ( model 3 ) using restricted cubic splines ( 32 ) . Cubic polynomials were fitted with the mean of each sedentary characteristic set as the reference and knots placed at the 5th , 35th , 65th , and 95th percentiles ( 33 ) . Nonlinear associations were evaluated using the likelihood ratio test . For nonlinear associations , spline models were used to describe the associations and when the association was determined to be linear , a linear model was used . Because of multicollinearity between total sedentary time and mean sedentary bout duration ( r= 0.61 ) , both variables were not included in the same model . Alternatively , to examine the individual and joint associations of total sedentary time and prolonged , uninterrupted sedentary behavior with mortality , participants were classified into 4 categories : low total sedentary time ( < 750 min/d ) and low prolonged sedentary bout time ( < 10 min/bout ) , low total sedentary time  and high prolonged sedentary bout time  ( 10 min/bout ) , high total sedentary time  ( 750 min/d ) and low prolonged sedentary bout time , and high total sedentary time and high prolonged sedentary bout time . Hazard ratios for all-cause mortality were calculated for each joint category in comparison with the lowlow group in a fully adjusted model ( model 3 ) . Thresholds for total sedentary time ( 750 min/d ) and mean sedentary bout duration ( 10 min/bout ) were selected on the basis of the restricted cubic splines and were confirmed using a method described by Contal and O'Quigley ( see Methods section of the Supplement ) ( 34 ) . To allow for the possibility that sedentary bouts The purpose of this study was to determine whether a brief , tailored counselling intervention is effective for increasing physical activity in sedentary women when delivered in the workplace . This prospect i ve r and omized trial used a brief intervention based on the Transtheoretical Model . The intervention group received health screening , a brief intervention , and , 2 weeks later , a booster telephone call from a nurse practitioner . The intervention was tailored to each woman 's reported exercise behaviour . The 134 women r and omized to the intervention were compared with 153 women in a control group who received health counselling not tailored to their exercise behaviour and no telephone call . Six weeks later , the intervention group , when compared to baseline , had significantly improved their physical activity , increasing their amount of weekend physical activity as well as minutes walked for exercise , on err and s , total walking , and total daily blocks walked . When compared to controls , they showed significantly greater gains . This test of a brief , tailored strategy provides a critical contribution to the search for efficient , effective ways for nurses to deliver workplace health promotion interventions Introduction The health benefits of regular cardiovascular exercise are well-known . Such exercise , however , has traditionally been defined as vigorous physical activity , such as jogging , swimming , or aerobic dance . Exercise of moderate intensity also promotes health , and many U.S. adults may be experiencing the health benefits of exercise through lifestyle activities of moderate intensity , such as yard work , housework , or walking for transportation . Until recently , public health surveillance systems have not included assessment s of this type of physical activity , focusing on exercise of vigorous intensity . We used an enhanced surveillance tool to describe the prevalence and amount of both moderate-intensity and vigorous-intensity physical activity among U.S. adults . Methods We analyzed data from the 2001 Behavioral Risk Factor Surveillance System , a state-based , r and om-digit  – dialed telephone survey administered to U.S. adults aged 18 years and older ( n = 82,834 men and 120,286 women ) .  Physical activity behavior was assessed using questions design ed to quantify the frequency of participation in moderate- or vigorous-intensity physical activities performed during leisure time or for household chores and transportation . Results Overall , 45 % of adults ( 48 % of men and 43 % of women ) were active at recommended levels during nonworking hours ( at least 30 minutes five or more days per week in moderate-intensity activities , equivalent to brisk walking , or at least 20 minutes three or more days per week in vigorous activities , equivalent to running , heavy yard work , or aerobic dance ) . Less than 16 % of adults ( 15 % of men and 17 % of women ) reported no moderate or vigorous activity in a usual week . Conclusion Integrating surveillance of lifestyle activities into national systems is possible , and doing so may provide a more accurate representation of the prevalence of recommended levels of physical activity . These results , however , suggest that the majority of U.S. adults are not active at levels associated with the promotion and maintenance of health Background The majority of individuals with type 2 diabetes do not exercise regularly . Pedometer-based walking interventions can help ; however , pedometer-based interventions targeting only total daily accumulated steps might not yield the same health benefits as physical activity programs specifying a minimum duration and intensity of physical activity bouts . Methods This pilot r and omized trial compared two goal - setting strategies : 1 ) lifestyle goals targeting total daily accumulated step counts and 2 ) structured goals targeting bout steps defined as walking that lasts for 10 minutes or longer at a pace of at least 60 steps per minute . We sought to determine which goal - setting strategy was more effective at increasing bout steps . Participants were sedentary adults with type 2 diabetes . All participants : wore enhanced pedometers with embedded USB ports ; uploaded detailed , time-stamped step-count data to a website called Stepping Up to Health ; and received automated step-count feedback , automatically calculated goals , and tailored motivational messages throughout the six-week intervention . Only the automated goal calculations and step-count feedback differed between the two groups . The primary outcome of interest was increase in steps taken during the previously defined bouts of walking ( lasting at least 10 minutes or longer at a pace of at least 60 steps per minute ) between baseline and end of the intervention . Results Thirty-five participants were r and omized and 30 ( 86 % ) completed the pilot study . Both groups significantly increased bout steps , but there was no statistically significant difference between groups . Among study completers , bout steps increased by 1921 ± 2729 steps a day . Those who received lifestyle goals were more satisfied with the intervention ( p = 0.006 ) and wore the pedometer more often ( p < 0.001 ) than those who received structured goals . Conclusion In this six-week intervention , Lifestyle Goals group participants achieved increases in bout steps comparable to the increases seen in the Structured Goals group , representing almost a mile a day of additional moderate intensity bout activity . Pedometer-based walking programs that emphasize total accumulated step counts are more acceptable to participants and are as effective at increasing moderate intensity bouts of physical activity as programs that use structured goals .Trial registration BACKGROUND In accordance with one of the Year 2000 Health Objectives , the current study tests the efficacy of brief physician-based counseling to increase physical activity in sedentary patients in a nonr and omized controlled trial . METHODS Control and intervention physicians were matched on medical practice variables . Two hundred fifty-five apparently healthy , sedentary , adult patients were recruited from 17 physician offices ( mean age = 39 years , 84 % female , 28 % ethnic minority ) . Intervention physicians delivered 3 to 5 min of structured physical activity counseling during a well visit or follow-up for a chronic condition . A health educator made a brief booster phone call to patients 2 weeks after receiving physician counseling .  Self-reported physical activity and stage of change ( i.e. , behavioral readiness to adopt or maintain activity ) were collected at baseline and at 4- to 6-week follow-up . Objective activity monitoring was conducted on a sub sample . RESULTS Intervention patients reported increased walking more than control patients ( + 37 min/week vs. + 7 min/week ) . There was a significant intervention effect on the activity monitor . Intervention participants also demonstrated a greater increase in readiness to adopt activity than control subjects . CONCLUSIONS Physician-based counseling for physical activity is efficacious in producing short-term increases in moderate physical activity among previously sedentary patients PURPOSE Given the prevalence of physical inactivity among American adults , convenient , low-cost interventions are strongly indicated . This study determined the 6- and 12-month effectiveness of telephone interventions delivered by health educators or by an automated computer system in promoting physical activity . DESIGN Initially inactive men and women age 55 years and older ( N = 218 ) in stable health participated . Participants were r and omly assigned to human advice , automated advice , or health education control . MEASURES The vali date d 7-day physical activity recall interview was used to estimate minutes of moderate to vigorous physical activity . Physical activity differences by experimental arm were verified on a r and om sub sample via accelerometry . RESULTS Using intention-to-treat analysis , at 6 months , participants in both interventions , although not differing from one another , showed significant improvements in weekly physical activity compared with controls . These differences were generally maintained at 12 months , with both intervention arms remaining above the target of 150 min per week of moderate to vigorous physical activity on average . CONCLUSION Automated telephone-linked delivery systems represent an effective alternative for delivering physical activity advice to inactive older adults Introduction Physical activity participation is low among blacks , and strategies are needed to successfully create immediate and sustained behavior change related to physical activity . Churches can play an important role in health promotion efforts among blacks because of their central role in spiritual guidance , communication , social support , and networking . This pilot study evaluated the feasibility and acceptability of implementing a physical activity program for sedentary black adults in churches . Methods We used a preintervention/postintervention single-group design to evaluate the effect of a 3-month faith-based physical activity intervention on  daily walking and moderate- and vigorous-intensity physical activity  among sedentary blacks . Eighty-seven black adults participated in eight group sessions that included discussion of physical activity-related topics , an instructor-led physical activity session , and weekly incentives to promote physical activity . We used a question naire to assess moderate and vigorous physical activity in minutes per week at baseline and after 3 months . Walking was assessed weekly in steps per day by using a pedometer . Results Participants ( mean age , 52 yrs ; mean body mass index , 35 kg/m2 ) reported 27 ± 54 and 10 ± 25 minutes per week in moderate-intensity and vigorous-intensity physical activity , respectively , and walked 4822 ± 2351 steps per day at baseline . After 12 weeks , moderate- and vigorous-intensity physical activity increased by 67 ± 78 and 44 ± 66 minutes per week , respectively ( P ≤ .01 ) , and daily walking increased by 1373 ± 728 steps per day ( P < .001 ) . Conclusion These data suggest that a faith-based physical activity intervention may be an appropriate strategy for increasing physical activity among sedentary black adults . Future research will determine the impact of this program in a r and omized , controlled design OBJECTIVE This paper will report the results of a pilot test of a 6-month , 21-session intervention to increase breast cancer survivors ' physical activity by teaching them to incorporate short periods of moderate activity into their daily routines ( lifestyle intervention ) . The effect of the intervention on physical performance , quality of life , and physical activity are reported . METHODS Sixty breast cancer survivors were r and omized to either a  lifestyle intervention  or a  st and ard care control group .  Physical performance , quality of life ( Medical outcomes study short form-36 [ SF-36 ] ) , and physical activity ( 7-day recall and motivation readiness ) , were assessed at baseline and 6 months . RESULTS The lifestyle group had significantly better performance in the 6-min walk task than the controls ( p=0.005 ) at 6 months . The intervention had positive effects on the bodily pain ( p=0.020 ) and general health ( p=0.006 ) subscales from the SF-36 . The lifestyle group had a greater motivational readiness for physical activity at 6-month than st and ard care , but no significant differences were seen between the two in terms of number of minutes of moderate or more intense physical activity or number of days on which they did > or = 30 min of moderate or more intense activity . CONCLUSIONS Despite the small sample size , the lifestyle intervention showed promise for improving physical functioning and quality of life and increasing physical activity , and should be tested in a larger r and omized trial . PRACTICE IMPLICATION S If the lifestyle approach is shown to be effective in a larger trial , it represents a highly feasible intervention that it can be delivered to cancer survivors by health care institutions or community organizations without dedicated exercise facilities and equipment BACKGROUND Given the evidence that regular physical activity produces substantial health benefits , participation in sports , exercise , and recreation is widely encouraged . The objective of this study was to describe participation in sports , exercise , and recreational physical activities among US adults . METHODS Data from 2 national surveys of respondents age 18 years and older were analyzed . Respondents to the American Time Use Survey ( ATUS ) from 2003 through 2005 ( N=45,246 ) reported all activities on 1 r and omly selected survey day . Respondents to the National Health and Nutrition Examination Survey ( NHANES ) from 1999 through 2004 ( N=17,061 ) reported leisure-time physical activities in the 30 days before the interview . RESULTS One-quarter of adults participated in any  sport , exercise , or recreational activity  on a r and om day , and 60.9 % of adults participated in any leisure-time activity in the previous 30 days . The most common types of activities were walking , gardening and yard work , and other forms of exercise . The sports and recreational activities had typical duration s of 1/2 to 3 hours per session , and the exercise activities typically lasted 1 hour or less . CONCLUSIONS The prevalence of sports , exercise , and recreational physical activities is generally low among US adults ; exercise is the most commonly reported type of activity
Interventions integrating physical activity into organizational routine during everyday life have demonstrated modest but consistent benefits , particularly for physical activity , and these are promising avenues of investigation .
The proportionately longer-term outcomes available in these studies compared with individual-level studies suggest that physical activity promotion strategies at the organizational level may be more sustainable
CONTEXT Recommended daily physical activity accumulated in short intervals ( e.g. , < 10 minutes ) may be more feasible and appealing to the relatively sedentary populace than longer bouts .
The purpose of this paper is to present a systematic review of the evidence for the effectiveness of short activity bouts incorporated into organizational routine as part of the regular " conduct of business . "