ContextPhysically active women have lower coronary heart disease (CHD) rates
than inactive women. However, whether the association differs by intensity
of activity or in women at high risk for CHD is unclear.ObjectiveTo examine the relation between physical activity, specifically investigating
walking (a light-to-moderate activity depending on pace), and CHD among women,
including those at high risk for CHD.Design, Setting, and ParticipantsCohort study of 39 372 healthy female health professionals aged
45 years or older, enrolled throughout the United States between September
1992 and May 1995, with follow-up to March 1999. Recreational activities,
including walking and stair climbing, were reported at study entry.Main Outcome MeasureCorrelation of CHD with energy expended on all activities, vigorous
activities, and walking.ResultsA total of 244 cases of CHD occurred. Adjusting for potential confounders,
the relative risks (RRs) of CHD for less than 200, 200-599, 600-1499, and
1500 or more kcal/wk expended on all activities were 1.00 (referent), 0.79
(95% confidence interval [CI], 0.56-1.12), 0.55 (95% CI, 0.37-0.82), and 0.75
(95% CI, 0.50-1.12), respectively (P for linear trend
= .03). Vigorous activities were associated with lower risk (RR, 0.63; 95%
CI, 0.38-1.04 comparing highest and lowest categories). Walking also predicted
lower risk among women without vigorous activities. Among these women, the
multivariate RRs for walking 1 to 59 min/wk, 1.0 to 1.5 h/wk, and 2 or more
h/wk, compared with no regular walking, were 0.86 (95% CI, 0.57-1.29), 0.49
(95% CI, 0.28-0.86), and 0.48 (95% CI, 0.29-0.78), respectively. For walking
paces of less than 3.2 km/h (2.0 mph), 3.2 to 4.7 km/h (2.0-2.9 mph), and
4.8 km/h (3.0 mph) or more, compared with no regular walking, RRs were 0.56
(95% CI, 0.32-0.97), 0.71 (95% CI, 0.47-1.05), and 0.52 (95% CI, 0.30-0.90),
respectively. When analyzed simultaneously, time spent walking (P for linear trend = .01) but not walking pace (P for linear trend = .55) predicted lower risk. The inverse association
between physical activity and CHD risk did not differ by weight or cholesterol
levels (P for interaction = .95 and .71, respectively),
but there were significant interactions by smoking and hypertension status.
Physical activity was inversely related to risk in current smokers but not
hypertensive women (P for interaction = .01 and .001,
respectively).ConclusionsThese data indicate that even light-to-moderate activity is associated
with lower CHD rates in women. At least 1 hour of walking per week predicted
lower risk. The inverse association with physical activity was also present
in women at high risk for CHD, including those who were overweight, had increased
cholesterol levels, or were smokers.

Physical Activity and Coronary Heart Disease in Women: Is “No Pain, No Gain” Passé?

OBJECTIVE
Interventions to increase levels of physical activity (PA) in socio-economically disadvantaged communities are needed but little is known about their effectiveness. This review examines the effectiveness of interventions designed to increase PA in these communities and the theoretical frameworks and components used.


METHODS
Five databases were searched for papers published in English between January 2000 and December 2010 that reported outcomes of PA interventions in socio-economically disadvantaged communities. Studies targeting individuals with pre-existing disease and not reporting a measure of free-living PA were excluded. Two reviewers independently extracted data and evaluated quality of evidence against pre-defined criteria.


RESULTS
Of 478 publications identified, 27 were included. We found that group-based interventions were effective for adults but not for children; evidence for the effectiveness of interventions targeting individuals was insufficient; limited evidence suggested that community-wide interventions produced small changes in PA. Interventions underpinned by any theoretical framework, compared to none, were more likely to be effective. Several effective interventions included education, PA and social support components.


CONCLUSION
Compared to other approaches, multi-component adult group-based interventions with theoretical frameworks are most effective in increasing PA in socio-economically disadvantaged communities. More robust evaluations of interventions targeting individuals in these 'hard-to-reach' communities are required.

Physical activity interventions in socio-economically disadvantaged communities: A systematic review

Despite the reported benefits of intergenerational programming, relatively few empirical studies have reported outcomes specific to older adult participants. We conducted a scoping review to assess...

Documented Outcomes for Older Adults in Intergenerational Programming: A Scoping Review

https://hesso.tind.io/record/4468/files/published_version.pdf

Effects of dance activities on patients with chronic pathologies: scoping review

The effect of dance interventions on cognition, neuroplasticity, physical function, depression, and quality of life for older adults with mild cognitive impairment: A systematic review and meta-analysis

Dance for Health: An Intergenerational Program to Increase Access to Physical Activity.

Objectives: The purpose of this study is to determine the social impact and meaning of "Dance for Health" for participants who attended this community driven, intergenerational, physical activity dance program. Methods:This study employed a descriptive, qualitative design and utilized a participatory action research approach to obtain pilot data on fourteen participants between the ages 18 to 75. One focus group discussion with 13 participants and an individual interview with a female participant was conducted. Data collection took place in the community where intervention sessions were held. Audiotapes from one focus group discussion and one in depth individual interview were transcribed by a professional transcription service. The NVIVO computer program was used to organize the data. Directed content analysis of the data took place utilizing primary and secondary coding, category and theme development. Results: Three broad themes emerged representing the social impact of Dance for Health and included: (1) Enhancing the Well-being of the Individual, (2) Fostering Interpersonal Relationships and Connections, (3) Fostering Connections with the Community. Conclusion: A participatory action research approach facilitates successful collaborations between community organizations and academic institutions and can be used to evaluate the impact of physical activity programs on urban community residents. Participants experienced interpersonal and social benefits from regular attendance at the "Dance for Health" program, subsequently contributing to program sustainability. Focused attention to social determinants of physical activity participation can improve physical activity maintenance in residents who reside in under-resourced communities.

David Earley

Papers

Dance for Health: An Intergenerational Program to Increase Access to Physical Activity.

Partnerships to Evaluate the Social Impact of Dance for Health: A Qualitative Inquiry.