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?

Health Promotion in Nursing Practice

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

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

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 is an intergenerational approach to increasing activity, reducing the risk of obesity, and improving health awareness in an urban community. The purpose of this research was to explore the impact of community engagement in Dance for Health on graduate nurse practitioner (NP) students and inner city high school (HS) students, and to describe the factors that impact project sustainability. Qualitative surveys were administered to all students to explore their experience with community engagement. Attendance was taken and quantitative surveys were administered to community participants to evaluate the factors impacting sustainability of the intervention. We deduced the following themes from the student surveys: 1) Intergenerational togetherness, 2) Positive environment, 3) Increased awareness, 4) HS student leaders, 5) Health careers exposure for HS students, 6) Community exposure for NP students, 7) Rewarding collaboration. Eighty-eight percent of community participants continued to attend the events two months after the University involvement ceased.  Community participants most commonly responded that they attended the events because it was good exercise, fun, safe, and made them “feel good”. Students who were involved stated that engagement in a community-driven, culturally relevant intervention enriched their education and leadership skills. To increase this kind of activity and improve community health overtime, universities must promote sustainability of their interventions by partnering with communities to understand their goals and priorities, and providing a culturally relevant, positive environment for physical activity and education.

/pdf/dance-for-health-the-importance-of-community-engagement-and-25n1tpqw9k.pdf

Dance for health: The importance of community engagement and project sustainability

A Renaissance in College Engagement.

Purpose:To describe perceptions of physical activity, opinions, on intergenerational approaches to physical activity and a vision for increasing physical activity in an underresourced urban communi...

/pdf/engaging-with-the-community-to-promote-physical-activity-in-2gzoh98nus.pdf

Engaging With the Community to Promote Physical Activity in Urban Neighborhoods

Urban colleges and universities not only have a responsibility to engage in activities designed to improve the educational attainment of local urban youth, but also have extensive financial, human, intellectual, and organizational resources that may be directed productively toward this purpose. This article describes the multipronged approach that the University of Pennsylvania is using to improve college opportunities for students attending Philadelphia high schools. We conclude by offering lessons that other institutions may draw from this example.

/pdf/understanding-the-role-of-research-universities-in-improving-1mj4aq285q.pdf

Understanding the Role of Research Universities in Improving College Preparation and Access at Local Urban High Schools

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