title: Trajectories in Physical Activity and Sedentary Time Among Women Veterans in the Women's Health Initiative.
abstract: OBJECTIVE
  Trajectories of physical activity (PA) and sedentary time (ST) after military separation are likely important determinants of women's health outcomes later in life, because low PA and high ST are known contributors to premature mortality risk. Our objective was to compare longitudinal trajectories of recreational PA and ST between Veteran and non-Veteran postmenopausal women from the Women's Health Initiative (WHI).
  
  
  METHODS
  Women Veteran (n = 3,719) and non-Veteran (n = 141,800) WHI participants were included. Self-reported participation in recreational PA, converted to metabolic equivalent (MET)-hours/week, was prospectively assessed over 8 years. Self-reported ST, defined as hours/day sitting or lying down, was collected at baseline and at Years 3 and 6. Generalized estimating equations were used to compare trajectories of PA and ST between Veterans and non-Veterans, adjusted for demographics and lifestyle behaviors.
  
  
  RESULTS
  Veterans had higher baseline PA than non-Veterans (13.2 vs 12.5 MET-hours/week, p = .03). PA declined for both groups, with a steeper decline among Veterans (change/visit year -0.19 vs -0.02 MET-hours/week; interaction p < .001). At baseline, Veterans and non-Veterans had similar levels of ST (107.2 vs 105.9 hours/week, p = 0.42). Over time, ST remained stable among Veterans but declined slightly among non-Veterans (change/visit year -0.19 vs -0.49 hours/week; interaction p = .01).
  
  
  CONCLUSIONS
  The less favorable longitudinal trajectories of PA and ST we observed for women Veterans may contribute to worse health among these individuals later in life. Understanding barriers to enhancing PA and reducing ST in women Veterans could lead to more effective approaches to intervening on these health behaviors.
authors.affiliation: VA Health Services Research and Development (HSR&D) Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, California. Geffen School of Medicine, University of California Los Angeles. donna.washington@va.gov.
authors.forename: Donna L
authors.initials: DL
authors.lastname: Washington
authors.affiliation: VA Puget Sound Health Care System, Health Services Research and Development, Seattle. Department of Health Services, University of Washington School of Public Health, Seatle.
authors.forename: Kristen
authors.initials: K
authors.lastname: Gray
authors.affiliation: VA Puget Sound Health Care System, Health Services Research and Development, Seattle. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seatle.
authors.forename: Katherine D
authors.initials: KD
authors.lastname: Hoerster
authors.affiliation: VA Puget Sound Health Care System, Health Services Research and Development, Seattle. Department of Health Services, University of Washington School of Public Health, Seatle. Women's Health Services, VA Office of Patient Care.
authors.forename: Jodie G
authors.initials: JG
authors.lastname: Katon
authors.affiliation: University of Washington School of Nursing, Seatle. Fred Hutchinson Cancer Research Center.
authors.forename: Barbara B
authors.initials: BB
authors.lastname: Cochrane
authors.affiliation: Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: LaMonte
authors.affiliation: VA Palo Alto Health Care System, Sierra Pacific MIRECC and Center for Innovation to Implementation. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Weitlauf
authors.affiliation: VA San Diego Health Services Research and Development Unit, California. Department of Family and Preventive Medicine, University of California San Diego.
authors.forename: Erik
authors.initials: E
authors.lastname: Groessl
authors.affiliation: VA Connecticut Healthcare System.
authors.forename: Lori
authors.initials: L
authors.lastname: Bastian
authors.affiliation: Department of Epidemiology and Prevention, Wake Forest University Health Sciences, Winston-Salem.
authors.forename: Mara Z
authors.initials: MZ
authors.lastname: Vitolins
authors.affiliation: University of Washington School of Nursing, Seatle. Fred Hutchinson Cancer Research Center.
authors.forename: Lesley
authors.initials: L
authors.lastname: Tinker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008137:Longitudinal Studies; D055686:Metabolic Equivalent; D008875:Middle Aged; D011446:Prospective Studies; D011998:Recreation; D057185:Sedentary Behavior; D057566:Self Report; D013997:Time Factors; D014728:Veterans; D016387:Women's Health
keywords: Health behavior; Health trajectory; Longitudinal Study; Physical activity; Postmenopausal; Sedentary behavior; Sedentary lifestyle; Women Veterans