Physical Activity and Leisure-time Study (PALS)

219 Pages·2016·3.22 MB·English

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Doctoral Dissertations Graduate School
5-2011
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Jeremy Adam Steeves
University of Tennessee - Knoxville, [email protected]
Follow this and additional works at: https://trace.tennessee.edu/utk_graddiss
Part of the Other Kinesiology Commons
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Steeves, Jeremy Adam, "Can America’s Top Sedentary Activity be Made More Active?: Physical Activity
and Leisure-time Study (PALS). " PhD diss., University of Tennessee, 2011.
https://trace.tennessee.edu/utk_graddiss/1029
This Dissertation is brought to you for free and open access by the Graduate School at TRACE: Tennessee
Research and Creative Exchange. It has been accepted for inclusion in Doctoral Dissertations by an authorized
administrator of TRACE: Tennessee Research and Creative Exchange. For more information, please contact
[email protected].
To the Graduate Council:
I am submitting herewith a dissertation written by Jeremy Adam Steeves entitled "Can
America’s Top Sedentary Activity be Made More Active?: Physical Activity and Leisure-time
Study (PALS)." I have examined the final electronic copy of this dissertation for form and content
and recommend that it be accepted in partial fulfillment of the requirements for the degree of
Doctor of Philosophy, with a major in Kinesiology and Sport Studies.
Dixie L. Thompson, Major Professor
We have read this dissertation and recommend its acceptance:
David R. Bassett, Eugene C. Fitzhugh, Hollie A. Raynor
Accepted for the Council:
Carolyn R. Hodges
Vice Provost and Dean of the Graduate School
(Original signatures are on file with official student records.)
Can America’s Top Sedentary Activity be Made More Active?: Physical
Activity and Leisure-time Study (PALS)

A Dissertation
Presented for the
Doctor of Philosophy
Degree
The University of Tennessee, Knoxville

Jeremy Adam Steeves
May 2011
Acknowledgements
I have been blessed throughout my life with the chance to follow my dreams. I been
given all I have ever asked for and more. Through him all things are possible, for that I
give praise to God, without him guiding my paths none of this would be possible. Your
word is a lamp to my feet and a light for my path. Psalm 119:105
To My Major Professor, Dr. Thompson: Thank you for your mentorship, guidance,
and infinite patience, which has allowed me to successfully complete this study. You
gave me the freedom to pursue my own research interests, and provided the necessary
instruction to help me complete it with high research quality and excellence. Because of
the training that you have provided for me, I am confident in my abilities as a both a
researcher and an educator.
To My Committee Members, Drs. Bassett, Fitzhugh, and Raynor: Thank you for all
of the effort and guidance that you have given me with this project, first with writing the
ACSM grant and then throughout the development and implementation of the study
intervention. You have each brought your own unique expertise, strengthening and
improving this dissertation. In addition to this project, you have each given me the
opportunity to work with you on other research projects, thank you for your willingness
to mentor, teach and collaborate with me.
To my parents, family and friends: I love you and thank you for your prayers,
understanding, interest, and support throughout my studies and years away from Canada.
It has been the quickest 5 years of my life. I miss you and love you, and cherish the days
(few as they may be) we get to spend together each year. This educational journey was
only possible and tolerable through your support, and cheerleading efforts along the way.
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Mom and Dad, hard work is something you instilled in me from an early age. Without
this one attribute, none of my dreams could have come to fruition. I hope you are proud
of your little boy.
To Betsy: My best friend and wife, day by day in every way we are getting better.
Our time in Tennessee is coming to a close, Knoxville will be hard to leave- that’s where
it all started- but if we trust in the Lord he will be faithful and guide our ways. Thanks for
being there always, being the reason I stayed at UT, and being willing to leave UT to join
me for our next adventure in Baltimore.
I also need to thank my PALS participants for their efforts, the time they devoted to
this project, and for being willing to give my TV walking idea a try. Any time is a good
time for a walk, or a TV walk.
As any good researcher knows, it’s all of the little details that take up so much time in
organizing and implementing a study. Attention to these details, can add up to the
success or failure of a project. Thanks to Ashley Miller, Kirby Talman, Andrew Howard,
Jessica Chandler, Vaishali Keshani for their hard work on this project and for helping me
be able to keep up with the details. A big “thanks!” goes out to Pam, Jane, Betty, Frankie,
Jenny Flynn, and Dr. Coe for your assistance and support throughout my time at UT.
A special thanks goes to Scott Conger for his advise, perspective, and being my
Tuesday, Thursday AM work out partner. Though I was seldom on time, those workouts
were a wonderful escape from my office/home away from home.
This research was supported by the Plus One Active Research Grant on Wellness from
the American College of Sports Medicine Foundation.
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Abstract

This dissertation investigated 1) the energy expenditure of stepping in place
during TV commercials (commercial stepping), 2) determined the best objective tool to
measure commercial stepping, 3) and assessed the efficacy of commercial stepping to
increase the activity levels of sedentary, overweight adults.
First, twenty-three adults (normal to obese) had their energy expenditure
measured while at rest, sitting, standing, stepping in place and walking at 3.0 mph on the
treadmill, followed by one hour each of sedentary TV viewing and commercial stepping
in the laboratory. Stepping in place, walking at 3.0 mph, and commercial stepping, had a
higher caloric requirement than either rest, or sedentary TV viewing. One hour of
commercial stepping resulted in an average of 2111 actual steps. The waist mounted
Digiwalker and New Lifestyles pedometers counted 72% and 80% of steps, while the
ankle mounted Omron and Stepwatch counted 100% and 98% of actual steps
respectively.
Having established commercial stepping as a moderate intensity-measurable
activity, eleven adults, participated in a 3-week pilot study to investigate the effects of
commercial stepping at home (one week baseline, followed by two weeks commercial
stepping across ≥90 min/day of TV watching). Compared to baseline, adults took more
steps when watching TV, and watched 34% less TV during the 2nd two weeks. In the
free-living environment, the StepWatch counted significantly more steps than the Omron
pedometers (ankle and waist).
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Thirdly, this study compares two physical activity prescriptions: 1) commercial
stepping across ≥90 min/day of TV watching; and 2) walking ≥30 min/day in 58
sedentary overweight adults. Outcomes were daily steps, adherence, dietary intake, TV
watching and weight after 12 wks in a behavioral intervention. Both groups adhered
equally to their prescriptions, and daily steps significantly (P<0.05) increased (~3000
steps/day) from 0 to 12-wks, with no difference between groups. TV viewing was
significantly (P<0.05) reduced in both groups. Despite a reduction (P<0.05) in self-
reported dietary intake, there were no changes in weight in either group. Instructing
people to step in place during 90 minutes of TV watching results in a change in daily
steps roughly equivalent to encouraging people to walk 30 min/day.

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TABLE OF CONTENTS

PART I:
INTRODUCTION.............................................................................................................1
Statement of the Problem.....................................................................................................3
Statement of the Purpose.....................................................................................................3
Significance of these Studies...............................................................................................4
References............................................................................................................................6

PART II: REVIEW OF LITERATURE.........................................................................8
Physical Activity and Health...............................................................................................9
Physical Activity Recommendations.................................................................................10
An Epidemic: Physical Inactivity in America .................................................................12
Consequences of Physical Inactivity = ‘Globesity’ and Other Chronic Diseases.............14
Behavior Modification Programs .....................................................................................22
Physical Activity Interventions..........................................................................................23
Home- vs. Group-Based Exercise Interventions................................................................23
Multiple Short Bout vs. Continuous Exercise Interventions.............................................26
Different Intensity (Moderate vs. Vigorous) and Frequency (3-day vs. 5-day/wk) Exercise
Interventions......................................................................................................................30
Pedometer-Based Physical Activity Interventions.............................................................31
Interventions Attempting to Increase Access to Physical Activity...................................38
Physical Activity Interventions Attempting to Reduce Access to Sedentary Behavior....40
Physical Activity Intervention Summary...........................................................................42
Summary............................................................................................................................43
References..........................................................................................................................49

PART III: ENERGY COST OF STEPPING IN PLACE WHILE WATCHING TV
COMMERCIALS............................................................................................................65
Abstract..............................................................................................................................66
Introduction........................................................................................................................67
Methods..............................................................................................................................70
Participants.........................................................................................................................70
Procedures..........................................................................................................................70
Part I: Energy cost of stepping in place compared to other activities................................71
Part II: Energy cost and steps during one hour of TV commercial stepping.....................72
Statistical Analysis
…………………………………………………………………………………………….7
3
Results................................................................................................................................74
Part I: Energy cost of stepping in place compared to other activities................................74
Steps taken during stepping in place vs. treadmill walking at 3 mph................................77
Part II: Energy cost and steps during one hour of TV commercial stepping.....................77
Discussion..........................................................................................................................79
References..........................................................................................................................83
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PART IV: USE OF TV COMMERCIAL STEPPING TO INCREASE PHYSICAL
ACTIVITY IN ADULTS: A PILOT STUDY.........................................................87
Abstract..............................................................................................................................88
Introduction........................................................................................................................90
Methods..............................................................................................................................92
Participants.........................................................................................................................92
Pedometers.........................................................................................................................93
Procedures..........................................................................................................................94
Phase 1...............................................................................................................................94
Phase 2...............................................................................................................................95
Statistical Analysis.............................................................................................................96
Results................................................................................................................................97
Discussion........................................................................................................................104
References........................................................................................................................112

PART V: TV COMMERCIAL STEPPING: CAN AMERICA’S TOP SEDNETARY
ACTIVITY BE MADE MORE ACTIVE?: PHYSICAL ACTIVITY AND
LEISURE-TIME STUDY (PALS)..............................................................................118
Abstract............................................................................................................................119
Introduction......................................................................................................................121
Methods............................................................................................................................124
Participants.......................................................................................................................124
Study Design....................................................................................................................124
PA Intervention................................................................................................................126
Assessment Procedures ...................................................................................................128
Statistical Analysis...........................................................................................................131
Results............................................................................................................................. 133
Discussion........................................................................................................................149
References........................................................................................................................157

APPENDICES..............................................................................................................165
Appendix A. Part III – Informed Consent Form and Flyer .............................................166
Appendix B. Part IV - Informed Consent Form..............................................................170
Appendix C. Part V - Informed Consent Forms, Recruitment Letter, Flyer, and
Newspaper Advertisement...............................................................................................173
Appendix D. Part V - Health History Questionnaire ......................................................183
Appendix E. Part V - Physical Activity Questionnaires..................................................186
Appendix F. Part V - Three-Day Dietary Record............................................................200
Appendix G. Part V- Supplemental Results....................................................................203
Vita .................................................................................................................................207

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LIST OF TABLES

Part III: Energy Cost of Stepping in Place while Watching TV Commercials

Table 1.1: Physical characteristics of participants ............................................................74

Part V: TV Commercial Stepping: Can America’s Top Sedentary Activity
be Made More Active: Physical Activity and Leisure-Time Study (PALS)

Table 3.1: Baseline personal, anthropometric, and leisure-time characteristics of
participants…………………………………………………………………………...…135
Table 3.2: Anthropometric and leisure-time variables measured at baseline and 12 weeks
for TV commercial stepping (N=29) and 30-min walk (N=29) participants….....…......141
Table 3.3: StepWatch determined variables measured at 12 wks for TV commercial
stepping (N=24) and 30-min walk (N=24) participants...................................................146

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