title: Targeting physical activity interventions for adults: When should intervention occur?
abstract: Understanding demographic differences in transitions across physical activity (PA) levels is important for informing PA-promoting interventions, yet few studies have examined these transitions in contemporary multi-ethnic adult populations. We estimated age-, race/ethnicity-, and sex-specific 1-year net transition probabilities (NTPs) for National Health and Nutrition Examination Survey (2007-2012, n=11,556) and Hispanic Community Health Study/Study of Latinos (2008-2011, n=15,585) adult participants using novel Markov-type state transition models developed for cross-sectional data. Among populations with ideal PA (≥150min/week; ranging from 56% (non-Hispanic black females) to 88% (non-Hispanic white males) at age 20), NTPs to intermediate PA (>0-<149min/week) generally increased with age, particularly for non-Hispanic black females for whom a net 0.0% (95% confidence interval (CI): 0.0, 0.2) transitioned from ideal to intermediate PA at age 20; by age 70, the NTP rose to 3.6% (95% CI: 2.3, 4.8). Heterogeneity in intermediate to poor (0min/week) PA NTPs also was observed, with NTPs peaking at age 20 for Hispanic/Latino males and females [age 20 NTP=3.7% (95% CI: 2.0, 5.5) for females and 5.0% (1.2, 8.7) for males], but increasing throughout adulthood for non-Hispanic blacks and whites [e.g. age 70 NTP=7.8% (95% CI: 6.1, 9.6%) for black females and 8.1% (4.7, 11.6) for black males]. Demographic differences in PA net transitions across adulthood justify further development of tailored interventions. However, innovative efforts may be required for populations in which large proportions have already transitioned from ideal PA by early adulthood.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 137 E. Franklin Street Suite 306, Chapel Hill, NC 27514, USA. Electronic address: khausman@email.unc.edu.
authors.forename: Katelyn M
authors.initials: KM
authors.lastname: Holliday
authors.affiliation: Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 3101 McGavran-Greenburg Hall, Chapel Hill, NC 27514, USA. Electronic address: lin@bios.unc.edu.
authors.forename: Dan Yu
authors.initials: DY
authors.lastname: Lin
authors.affiliation: Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 3101 McGavran-Greenburg Hall, Chapel Hill, NC 27514, USA. Electronic address: sujatro@live.unc.edu.
authors.forename: Sujatro
authors.initials: S
authors.lastname: Chakladar
authors.affiliation: Graduate School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA 92182, USA. Electronic address: scastaneda@mail.sdsu.edu.
authors.forename: Sheila F
authors.initials: SF
authors.lastname: Castañeda
authors.affiliation: Institute for Minority Health Research, University of Illinois at Chicago, 1819 W. Polk Street, Suite 246, Chicago, IL 60612, USA. Electronic address: daviglus@uic.edu.
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 137 E. Franklin Street Suite 306, Chapel Hill, NC 27514, USA. Electronic address: kelly_evenson@unc.edu.
authors.forename: Kelly R
authors.initials: KR
authors.lastname: Evenson
authors.affiliation: Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor Street, Room 625, MC 994, Chicago, IL 60612, USA. Electronic address: marquezd@uic.edu.
authors.forename: David X
authors.initials: DX
authors.lastname: Marquez
authors.affiliation: Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer 1306A, Bronx, NY 10461, USA. Electronic address: qibin.qi@einstein.yu.edu.
authors.forename: Qibin
authors.initials: Q
authors.lastname: Qi
authors.affiliation: Department of Nutrition, University of North Carolina at Chapel Hill, 2201 McGavran- Greenberg Hall, Chapel Hill, NC 27599, USA. Electronic address: chris.shay@unc.edu.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Shay
authors.affiliation: Collaborative Studies Coordinating Center, Department of Biostatistics, University of North Carolina at Chapel Hill, 137 E. Franklin Street, Suite 203, Chapel Hill, NC 27514, USA. Electronic address: dsotres@email.unc.edu.
authors.forename: Daniela
authors.initials: D
authors.lastname: Sotres-Alvarez
authors.affiliation: University of Miami, Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, Suite 1515, Miami, FL 33136, USA. Electronic address: DVidot@med.miami.edu.
authors.forename: Denise C
authors.initials: DC
authors.lastname: Vidot
authors.affiliation: Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, 3101 McGavran-Greenburg Hall, Chapel Hill, NC 27514, USA. Electronic address: dzeng@bios.unc.edu.
authors.forename: Donglin
authors.initials: D
authors.lastname: Zeng
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 137 E. Franklin Street Suite 306, Chapel Hill, NC 27514, USA. Electronic address: christy_avery@unc.edu.
authors.forename: Christy L
authors.initials: CL
authors.lastname: Avery
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054525:Minority Health; D009749:Nutrition Surveys; D044469:Racial Groups; D012737:Sex Factors
keywords: Minority health; Physical activity; Population-based planning