자연주의적 탐구조사(Naturalistic Inquiry)

March 5, 2019 e1 WRITING GROUP MEMBERS Emelia J. Benjamin, MD, ScM, FAHA, Chair Paul Muntner, PhD, MHS, FAHA, Vice Chair Alvaro Alonso, MD, PhD, FAHA Marcio S. Bittencourt, MD, PhD, MPH Clifton W. Callaway, MD, FAHA April P. Carson, PhD, MSPH, FAHA Alanna M. Chamberlain, PhD Alexander R. Chang, MD, MS Susan Cheng, MD, MMSc, MPH, FAHA Sandeep R. Das, MD, MPH, MBA, FAHA Francesca N. Delling, MD, MPH Luc Djousse, MD, ScD, MPH Mitchell S.V. Elkind, MD, MS, FAHA Jane F. Ferguson, PhD, FAHA Myriam Fornage, PhD, FAHA Lori Chaffin Jordan, MD, PhD, FAHA Sadiya S. Khan, MD, MSc Brett M. Kissela, MD, MS Kristen L. Knutson, PhD Tak W. Kwan, MD, FAHA Daniel T. Lackland, DrPH, FAHA Tené T. Lewis, PhD Judith H. Lichtman, PhD, MPH, FAHA Chris T. Longenecker, MD Matthew Shane Loop, PhD Pamela L. Lutsey, PhD, MPH, FAHA Seth S. Martin, MD, MHS, FAHA Kunihiro Matsushita, MD, PhD, FAHA Andrew E. Moran, MD, MPH, FAHA Michael E. Mussolino, PhD, FAHA Martin O’Flaherty, MD, MSc, PhD Ambarish Pandey, MD, MSCS Amanda M. Perak, MD, MS Wayne D. Rosamond, PhD, MS, FAHA Gregory A. Roth, MD, MPH, FAHA Uchechukwu K.A. Sampson, MD, MBA, MPH, FAHA Gary M. Satou, MD, FAHA Emily B. Schroeder, MD, PhD, FAHA Svati H. Shah, MD, MHS, FAHA Nicole L. Spartano, PhD Andrew Stokes, PhD David L. Tirschwell, MD, MS, MSc, FAHA Connie W. Tsao, MD, MPH, Vice Chair Elect Mintu P. Turakhia, MD, MAS, FAHA Lisa B. VanWagner, MD, MSc, FAST John T. Wilkins, MD, MS, FAHA Sally S. Wong, PhD, RD, CDN, FAHA Salim S. Virani, MD, PhD, FAHA, Chair Elect On behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee

Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association

Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports on the most up-to-date statistics related to heart disease, stroke, and cardiovas...

Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association

Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascul...

Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.

The current evidence suggests that many diet and exercise interventions to prevent obesity in children are not effective in preventing weight gain, but can be effective in promoting a healthy diet and increased physical activity levels.Being very overweight (obese) can cause health, psychological and social problems for children. Children who are obese are more likely to have weight and health problems as adults. Programmes designed to prevent obesity focus on modifying one or more of the factors considered to promote obesity.This review included 22 studies that tested a variety of intervention programmes, which involved increased physical activity and dietary changes, singly or in combination. Participants were under 18 and living in Asia, South America, Europe or North America. There is not enough evidence from trials to prove that any one particular programme can prevent obesity in children, although comprehensive strategies to address dietary and physical activity change, together with psycho-social support and environmental change may help. There was a trend for newer interventions to involve their respective communities and to include evaluations.Future research might usefully assess changes made on behalf of entire populations, such as improvements in the types of foods available at schools and in the availability of safe places to run and play, and should assess health effects and costs over several years.The programmes in this review used different strategies to prevent obesity so direct comparisons were difficult. Also, the duration of the studies ranged from 12 weeks to three years, but most lasted less than a year.

/pdf/interventions-for-preventing-obesity-in-children-4arhbcud58.pdf

Interventions for preventing obesity in children

The 1991 paper, “Physical Education's Role in Public Health” described the importance of physical education in addressing public health problems. On its 20th anniversary, this article reviews accomplishments in improving the health impact of physical education and identifies areas lacking progress. Major accomplishments include development of evidence-based programs, documentation of health and academic benefits of physical education, and acceptance of physical education as a public health resource. Additional work is needed to evaluate the uptake of evidence-based programs, improve national surveillance of physical education quantity and quality, establish stronger policies supporting active physical education, and achieve wide acceptance of public health goals within the physical education field. These opportunities constitute an agenda for actualizing the promise of Health-Optimizing Physical Education before the next 20-year anniversary.

/pdf/physical-education-s-role-in-public-health-steps-forward-and-1fil5owigr.pdf

Physical Education's Role in Public Health: Steps Forward and Backward over 20 Years and HOPE for the Future.

Purpose: To describe the sex-specific patterns of school children's daily pedometer-determined physical (PA) during physical education (PE), recess and lunchtime, and before and after school.

Methods: Eighty-one sixth-grade students (28 boys, age = 11.9 ± 0.4 yr, BMI = 18.8 ± 4.1 kg·m-2; 53 girls, 11.8 ± 0.5 yr, BMI = 20.2 ± 4.6 kg·m-2) wore pedometers for four school days and were prompted to record steps accumulated at arrival and departure from school and during pre- and postrecess, lunchtime, and PE class.

Results: Boys took significantly (P < 0.001) more steps per day than girls: 16,421 ± 5,444 vs 12,332 ± 3,056 steps per day, and more steps during release time (e.g., before-school ? = 1289 steps, recess ? = 479 steps, lunchtime ? = 608 steps, and after-school ? = 1872 steps) but the same number of steps during structured PE classes (1429 ± 567 vs 1410 ± 445 steps; P = 0.87). Lunchtime PA represented the most important source of daily PA (15-16%) obtained during school hours for both boys and girls, whereas recess accounted for 8-9% and PE class accounted for 8-11% of total steps per day. Regardless, almost half of daily steps taken are attributable to after-school activities.

Conclusion: These data provide greater understanding of sex-specific PA patterns and the relative contribution of distinct segments of the school day to school children's total PA.

Children's pedometer-determined physical activity during the segmented school day.

http://niost.org/pdf/host/Beets2009_AfterSchool_Program_Impact%20on_Physical_Activity.pdf

After-School Program Impact on Physical Activity and Fitness: A Meta-Analysis

This study examined effects of a school-based intervention called PLAY (Promoting Lifestyle Activity for Youth) on physical activity levels and body mass index (BMI) of students. Participants included 606 fourth-grade students selected from a stratified sample of 35 schools in Arizona and placed into four groups: PLAY & PE, PLAY Only, PE Only, and No Treatment. A treatment-control, post-measurement design assessed physical activity using the YAMAX pedometer, and height and weight data were collected following the intervention. One-way ANOVAs were used to analyze the data. Results indicated the treatment was effective at increasing the physical activity level of children, especially girls. No significant differences between groups were found for BMI. Programs such as PLAY, which can increase the activity level of children, may have significant health implications for youth.

Impact of Promoting Lifestyle Activity for Youth (PLAY) on children's physical activity.

The purpose of this study was to examine children's physical activity during recess and outside of school. Third-, fourth-, and fifth-grade students (N = 270; 121 boys, age = 9.5 +/- 0.9 years; 150 girls, age = 9.6 +/- 0.9 years) wore sealed pedometers during a 15-minute recess period and outside of school for 4 consecutive school days. A factorial analysis of variance (grade by gender) was used to examine differences among grades and between genders for the following variables: recess activity time (RAT), recess step counts (RSC), out-of-school activity time (OAT), and out-of-school step counts (OSC). For all outcome variables, there were no significant interactions between grade and gender and no significant main effect for grade. A significant main effect for gender (F(1,264)= 73.1, p < .001) indicated that boys accumulated more RSC and OSC than girls (1268 +/- 341 vs 914 +/- 261 and 7229 +/- 2877 vs 5808 +/- 2059, respectively) and more RAT and OAT than girls (11.7 +/- 2.4 vs 9.4 +/- 2.2 and 77.3 +/- 28 vs 67.4 +/- 21, respectively). Boys spent 78% and girls spent 63% of their recess time engaged in physical activity. Outside of school, girls spent 20% and boys spent 25% of their time engaged in physical activity. RAT comprised 14% and 16% of total discretionary activity time for girls and boys, respectively. Boys in this study are more active during discretionary time periods compared to girls. Study participants spent the majority of their recess time engaged in physical activity.

Aaron Beighle

Papers

Physical Education's Role in Public Health: Steps Forward and Backward over 20 Years and HOPE for the Future.

Children's pedometer-determined physical activity during the segmented school day.

After-School Program Impact on Physical Activity and Fitness: A Meta-Analysis

Impact of Promoting Lifestyle Activity for Youth (PLAY) on children's physical activity.

Children's Physical Activity during Recess and Outside of School.