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Editor's Note |

Approaches to Increase Physical Activity

Deborah Grady, MD, MPH
JAMA Intern Med. 2014;174(1):149. doi:10.1001/jamainternmed.2013.11487.
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Haardörfer et al measured physical activity among low-income, predominantly African American women observed in a federally qualified health center in rural Georgia. Most of the study participants were obese, with a mean body mass index (calculated as weight in kilograms divided by height in meters squared) of 38.3. The findings are impressive. The women spent a mean time of less than 1 minute per day in moderate physical activity and no time in vigorous activity. None of the 303 participants met recommendations for a healthy physical activity level. Although these results may not be fully generalizable to other populations served by community health centers, they highlight the crucial problem of almost total lack of physical activity among obese, low-income African American women. Some approaches to increasing physical activity have had modest success. For example, in the Shape Program, 70% of overweight and obese African American women who enrolled in a weight-maintenance program initiated a YMCA membership when provided without charge, and 40% visited the facility at least twice during the 12 months of the study (JAMA Intern Med. doi:10.1001/jamainternmed.2013.9263). However, environmental and cultural barriers that limit opportunities and motivation for safe and inexpensive exercise must be addressed. Successful approaches probably need to link clinical interventions with community-, work-, and home-based activities.

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