Physical Activity Knowledge And Behavior:

A Survey Of San Francisco Adults

INTRODUCTION

Background
Regular participation in moderate and vigorous physical activity has been associated with reduced risk of cardiovascular disease, the leading cause of death and disability among U.S. adults (Wang, et al, 2004). Medical costs from treating cardiovascular and chronic diseases such as diabetes are estimated at more than US$ 76.6 billion, with spending at over US$ 5 billion for health conditions resulting from inactive lifestyles (Pratt, et al, 2002). Cardiovascular and chronic diseases disproportionately affect African American men and women (Bassett, et al, 2002; Ferdinand, 2006), Latinos (Lerman-Garber, et al, 2004), and economically disadvantaged groups, including many minorities (Liburd, et al, 2006; Henderson and Ainsworth, 2000; Petersen, et al, 2006). In addition, inadequate physical activity has been implicated in the high prevalence of obesity-and its associated health consequences-among ethnic minority groups (Kumanyika, 1994).

Research suggests that lack of knowledge of the benefits of physical activity remains one barrier to participation in health promotion programs (Chinn, et al, 2006). Community-based educational programs have been found to increase knowledge about health and physical activity and in intentions to be physically active and have been recommended as an effective strategy for promoting physical activity by the Task Force on Community Preventive Services, a Division of the Centers for Disease Control (Task Force, 2002). However, few community-based physical activity interventions adequately consider the specific needs and interests of local populations, sometimes resulting in high numbers of “non- participants” thereby reducing possible health benefits (Chinn, et al, 2006).

Recent research has focused on the relationship between the built environment and physical activity behavior; facilities conveniently located near home are used by more respondents than facilities located elsewhere (Giles-Corti & Donovan, 2002).Yet, minority populations often have reduced access to physical activity facilities and programs, and these disparities have been linked with lower rates of engagement in health-related leisure time physical activity (Ahmed, et al, 2005; Liao, et al, 2004), higher overweight patterns (Gordon-Larsen, et al, 2006), and body mass index, an important general health indicator (Robert & Reither, 2004) than for white populations. African Americans, for example, also underestimate the extent of their overweight, and therefore their risk for cardiovascular disease (Bennett, et al, 2006). However, the social and contextual correlates of physical activity behavior among minority and disadvantaged populations remain under-explored (Fleury & Lee, 2006; Wolin, et al, 2006).

To increase physical activity involvement and reduce the rate of non-participation that results from lack of appropriate programming, particularly as it is experienced by ethnic minorities, a survey of local community interests and physical activity behavior would be useful. At this time, local communities must assume the responsibility for providing health -benefiting physical activity programs and assessment as there is no national plan for targeting physical activity as a strategy for reducing chronic disease risk factors (CDC, 2005; Yancey, et al, 2004). In addition, California is not yet involved with the State Plan Index, a project in which CDC and state public health experts guide and assess physical activity, nutrition, and obesity program planning in states receiving CDC funds.
 

Objective of this Project
Currently there are no data that describe in detail, the physical activity behavior of San Francisco adults by neighborhood, socioeconomic status, race and ethnicity, and other demographic markers. The purpose of this project is to assess and develop a detailed map of the physical activity behavior of the adult population of San Francisco with specific attention to African Americans, Asians (selected groups for which CHIS health data is available including Chinese, Filipino, Korean, and Vietnamese adults), and Latinos. An assessment of attitudes towards and held knowledge about the health benefits of physical activity will also be conducted to gain further understanding about the respondents’ physical activity practices. This information is important to the development of demographically appropriate programs, facilities, and policies to improve health-related physical activity behavior among this city’s diverse population.

Hypothesis: Economically disadvantaged individuals will report limited knowledge about the health benefits of physical activity.
Hypothesis: Racial and ethnic inequalities in socioeconomic position will contribute to racial and ethnic disparities in health-benefiting physical activity behavior.
Hypothesis: Ethnic minorities and economically disadvantaged individuals who report chronic health conditions will also report lower levels of physical activity.
Hypothesis: Ethnic minorities and economically disadvantaged individuals will experience greater numbers and types of barriers (e.g. environmental and resource) to engaging in physical activity.

SCOPE OF THE STUDY
This project applies the “ecological” model that identifies the intrapersonal, social environment, and physical environment factors that influence physical activity behavior (Sallis and Owen, 1997), although this model has been applied in limited ways toward understanding physical activity behavior of minority populations (Fleury and Lee, 2006).

There are two phases to the project:
 

Phase I will be the development of a survey tool through the use of citizen focus groups. The members of each focus group will review a set of established questions about physical activity knowledge and behavior (e.g. selected from the International Physical Activity Questionnaire and other appropriate sources, Pardini, et al, 2001), for relevance, scope, and cultural sensitivity. Assessing the extent to which adults participate in health-related physical activity is difficult; survey questions often lack sensitivity to ethnic group behavior differences and definitions of “health-related physical activity” vary widely.

During Phase II, the survey tool developed and validated by the focus groups will be mailed to adults selected according to the stratification methodology used in constructing the focus groups. It is anticipated that Phase II will be conducted as a joint project between the Survey Research Center and the Public Research Institute of San Francisco State University. A database will be created from the responses to the survey to:

1. Develop a “map” detailing physical activity behavior among San Francisco adults to identify differences by neighborhood, socioeconomic status, gender, ethnicity, age, and other demographic markers;

2. Develop an inventory of public and private facilities and resources used by residents for physical activity;

3. Analyze the physical activity behavior of this population in relation to expressed knowledge of its health benefits, chronic health conditions experienced by respondents, and articulation of specific barriers, including environmental, to engagement.
    

References
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Centers for Disease Control and Prevention. Overweight and obesity: State-based programs. Division of Nutrition and Physical Activity, National Center for Chronic Disease Prevention and Health Promotion. 2005. http://www.cdc.gov/NCCdphp/dnpa/obesity/state_programs/index.htm

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