Definition

Percentage of adults aged 18 years of age and older who report on the Behavioral Risk Factor Surveillance System (BRFSS) doing at least 150 minutes (2 hours and 30 minutes) a week of moderate-intensity, or 75 minutes (1 hour and 15 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week.

Numerator

Weighted number of adults (18+) who report on the BRFSS engaging in 150 minutes or more total per week of moderate or vigorous exercise where each minute of vigorous exercise contributes two minutes to the total.

Denominator

Weighted number of adults (18+) responding to physical activity questions on the BRFSS, excluding those with missing, "Don't know/Not sure" or "Refused" responses.

Data Interpretation Issues

The Physical Activity Rotating Core (PARC) is part of the BRFSS core asked in odd-numbered yearto measure progress toward meeting 2008 Physical Activity Guidelines for Americans.^4^ The PARC consists of three components of (1) presence of leisure-time physical activity, (2) listing up to two aerobic activities along with their frequency and duration, and (3) the frequency of muscle-building activities.^5^ The first component of no leisure-time physical activity is measured by the question: "During the past month, other than your regular job, did you participate in any physical activities or exercises such as running, calisthenics, golf, gardening, or walking for exercise?" The second component of aerobic activity questions is only asked to respondents who said 'yes' to the no leisure-time physical activity question. It consists of two sets of three questions with the first set being: "What type of physical activity or exercise did you spend the most time doing during the past month?"; "How many times per week or per month did you take part in this activity?"; and "And when you took part in this activity, for how many minutes or hours did you usually keep at it?" The second set of questions is: "What other type of physical activity gave you the next most exercise during the past month?"; "How many times per week or per month did you take part in this activity?"; and "And when you took part in this activity, for how many minutes or hours did you usually keep at it?" The third component of muscle-strengthening activities is measured by the question: "During the past month, how many times per week or per month did you do physical activities or exercises to STRENGTHEN your muscles? Do NOT count aerobic activities like walking, running, or bicycling. Count activities using your own body weight like yoga, sit-ups or push-ups and those using weight machines, free weights, or elastic bands."

Why Is This Important?

Regular physical activity can improve the health and quality of life of Alaskans of all ages, regardless of the presence of a chronic disease or disability. Adults benefit from moderate physical activity, of at least 150 minutes each week. Physical activity is recognized as an independent protective factor against cardiovascular disease. Physical activity has been shown to reduce the risk of some cancers, type 2 diabetes, stroke, and heart disease; and improve general physical and mental health.^1^ Weight-bearing activity can improve bone density, reducing the risk of hip fractures in elderly persons. Regular activity helps to relieve pain from osteoarthritis.^2^ Regular physical activity is also known to improve affective disorders such as depression and anxiety, and increase quality of life and independent living among the elderly.^3^[[br]] [[br]] {{class .SmallerFont # Centers for Disease Control and Prevention. Physical activity and health: a report of the surgeon general. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Promotion; 1996. # Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346(6):393-403. # Kesaniemi, Y., et al. (1994). Dose-response issues concerning physical activity and health: an evidence-based symposium. Medicine and Science in Sports and Exercise, 33(6 suppl), S351-S358 }}

Healthy People Objective: Increase the proportion of adults who engage in aerobic physical activity of at least moderate intensity for at least 150 minutes/week, or 75 minutes/week of vigorous intensity, or an equivalent combination

U.S. Target: 47.9% as measured by the National Health Interview Survey (NHIS) for adults 18 years of age and older.

Other Objectives

Healthy Alaskans 2020 Indicator 6.a: Increase the percentage of adults (age 18 years and older) who meet the 2008 U.S. Dept. of Health and Human Services Physical Activity Guidelines (150 minutes or more total minutes per week of moderate or vigorous exercise) to 61% by 2020. Healthy People Objective PA-2.2: Increase the proportion of adults who engage in aerobic physical activity of at least moderate intensity for more than 300 minutes/week, or more than 150 minutes/week of vigorous intensity, or an equivalent combination. U.S. Target: 31.3% as measured by the National Health Interview Survey (NHIS) for adults 18 years of age and older. Healthy People Objective PA-2.3: Increase the proportion of adults who perform muscle-strengthening activities on 2 or more days of the week. U.S. Target: 24.1% as measured by the National Health Interview Survey (NHIS) for adults 18 years of age and older. Healthy People Objective PA-2.4: Increase the proportion of adults who meet the objectives for aerobic activity and muscle-strengthening activity. U.S. Target: 20.1% as measured by the National Health Interview Survey (NHIS) for adults 18 years of age and older. Healthy Alaskans 2020 Indicator 6.a: Increase the percentage of adults (age 18 years and older) who meet the 2008 U.S. Dept. of Health and Human Services Physical Activity Guidelines (150 minutes or more total minutes per week of moderate or vigorous exercise) to 61% by 2020.

How Are We Doing?

In 2013, the prevalence for getting the recommended equivalent amount of 150 minutes or more per week of moderate or vigorous physical activity was 55.0% for all Alaskan adults and 46.8% for Alaska Native adults, both below the Healthy Alaskans 2020 goal of 61.0%. There was a broad-based decline in the percentage meeting the recommended aerobic physical activity recommendation of 150 or more minutes per week in 2013 compared to the levels obtained by the groups in 2011. However, most groups still maintained a percentage higher than the Healthy People 2020 target of 47.9% for this measure. Alaskan adults in general were also doing better in 2013 than the national average and Healthy People 2020 targets for the 3 other physical activity measures. For the physical activity recommendation of engaging in 300 or more minutes of aerobic physical activity, Alaskan adults were 36.6%, higher than the Healthy People 2020 target of 31.3%. For the recommendation of engaging in muscle-strengthening activities at least 2 times per week, Alaskan adults had a rate of 33.5%, exceeding the Healthy People 2020 target of 24.1%. For the combined measure of meeting recommendations for aerobic physical activity (i.e., 150+ minutes per week) and at least twice weekly muscle-strengthening activities, Alaska adults were 25.0%, exceeding the Healthy People 2020 target of 20.1%. The rates for Alaska Native adults, although slightly lower than the mean for all Alaskan adults, still matched or exceeded the targets. The prevalence rates for the standard aerobic physical activity measure (i.e., 150+ minutes per week) from the BRFSS are initially presented for all Alaskans, Alaska Native people, and the median from states, District of Columbia, and territories for all available years. The aerobic physical activity measure of 300+ minutes per week for additional and more extensive health benefits is presented for all Alaskans and Alaska Native adults. Recommended levels of twice-weekly strength training and overall physical fitness (150+ minutes per week) in conjunction with the strength training are displayed for all Alaskans, Alaska Natives adults, and the national median. Subsequent analyses of the 150+ minutes per week of physical activity recommendation are presented by demographic subpopulations (i.e., sex, age, race/ethnicity, ethnicity, marital status, education, employment status, income, and poverty status). Regional displays of this aerobic physical activity recommendation are presented for the most recent time period allowing reporting for all Alaskans and Alaska Native people: 1) single-year for the 6 Alaska Public Health Regions, 2) two-year averages by the 7 Metropolitan and Micropolitan Statistics Areas and rural remainder, 3) single-year for the 10 behavioral health assessment regions based upon aggregations of 20,000 population, 4) two-year averages for 29 boroughs and census areas, and 5) two-year averages for the 12 tribal health organization regions.

How Do We Compare With the U.S.?

When compared to the national average of adults, Alaskan adults display higher rates of physical activity. In 2013, 55.0% of Alaskan adults met the recommended amount of 150+ minutes per week of aerobic physical activity compared to the national median value of 50.5%. For the measure of twice weekly muscle-strengthening activities, 33.5% of Alaskan adults met the recommendation compared to the national median of 29.8%. One-quarter (25.0%) of Alaskan adults met both the aerobic and muscle-strengthening recommendations compared to just one-fifth (20.1%) for the national median.

What Is Being Done?

The Play Every Day campaign delivers Alaska-specific messages focused on raising awareness about childhood obesity in Alaska and encouraging parents and families to prioritize daily physical activity and serving fewer sugary drinks to their families.^6^ Play Every Day uses community and school events, as well as media and other marketing resources, to create a sustained campaign aimed at increasing youth and family physical activity, promoting participation in the Healthy Futures Challenge and physical activity events, and reducing sugary drink consumption.[[br]] [[br]] {{class .SmallerFont 6. [http://www.dhss.alaska.gov/dph/PlayEveryDay/Pages/default.aspx\ Play Every Day]. Alaska Department of Health and Social Services, Division of Public Health. }}

Evidence-based Practices

As part of the Healthy Alaskans 2020 health improvement process, groups of Alaska subject matter experts met over a period of months in a rigorous review process to identify and prioritize strategies to address the 25 health priorities. Public health partners around the state are aligning work around these approaches adapted to Alaska's unique needs. '''Strategy 1:''' [[br]]Implement a comprehensive social marketing campaign promoting physical activity. Choose campaign topics strategically. '''Evidence Base:''' [[br]]Citing the Community Guide and other reviews, the CDC recommends community-wide campaigns as effective in increasing physical activity. '''Sources:''' [[br]]Centers for Disease Control and Prevention. Increasing physical activity: A report on recommendations of the Task Force on Community Preventive Services. MMWR. 2001; 50(RR-18): 1-16. The Community Guide: [http://www.thecommunityguide.org/pa/index/html] Kahn EB, Ramsey LT, Brownson RC, et al. The effectiveness of interventions to increase physical activity: a systematic review. Am J Prev Med. 2002; 22(4S): 73-107. '''Strategy 2:''' [[br]]Adopt and implement new school physical activity and Nutrition policies, also known as "wellness policies". '''Evidence Base:''' [[br]]Many of the evidence-based strategies to address childhood obesity (such as promoting quality PE and health education, and establishing a Safe Routes to School program) depend on the support of schools, communities, and parents to implement. Therefore a strategy recommended by the CDC, US DHHS and the IOM is to support the adoption and implementation of school physical activity and nutrition policies (also known as "wellness policies") by school districts. '''Sources:''' [[br]][http://www.cdc.gov/healthyyouth/npao/strategies.htm CDC School Health Guidelines]. Institute of Medicine. Progress in preventing childhood obesity: How do we measure up? Koplan JP, Liverman CT, Kraak VI, Wisham, SL editors. Washington: National Academies Press; 2007. US Department of Health and Human Services. The Surgeon General's Vision for a Healthy and Fit Nation. Rockville, MD: US Department of Health and Human Services, Office of the Surgeon General, January 2010. USDA [http://www.gpo.gov/fdsys/pkg/PLAW-111publ296/pdf/PLAW-111publ296.pdf Healthy, Hunger-Free Kids Act of 2010 SEC. 204 Local School Wellness Policy Implementation] A listing of strategies, actions, and key partners on this measure can be found at: [http://hss.state.ak.us/ha2020/assets/Actions-Partners_6_Physical_Activity.pdf].

Relevant Population Characteristics

There are age, gender, and socio-economic related risk factors associated with physical inactivity.

Health Care System Factors

Health care system factors relate primarily to access to care and a reported low rate of health care provider counseling for physical activity recommendations.

Risk Factors

The percentage of persons who reported no physical activity during leisure time was higher among women, older adults, people who were overweight or obese, and those with less formal education and less income.

Health Status Outcomes

Small changes in levels of physical activity such as walking or gardening can lead to big improvements in personal health. In fact, the greatest benefits occur among those who have never exercised regularly. Even moderate amounts of exercise can substantially reduce an individual's chance of dying from heart disease, cancer, or other causes.

Data Notes

U.S. values are based upon the median value of the states, District of Columbia, and territories. This measure is relevant for measuring progress to Healthy People 2020 Objective PA-2.1: Increase the proportion of adults who engage in aerobic physical activity of at least moderate intensity for at least 150 minutes/week, or 75 minutes/week of vigorous intensity, or an equivalent combination with a national target of 47.9%.

Data Notes

Definition: Percentage of adults aged 18 years of age and older who report on the Behavioral Risk Factor Surveillance System (BRFSS) doing at least 300 minutes (5 hours) a week of moderate-intensity, or 150 minutes (2 hours and 30 minutes) a week of vigorous-intensity aerobic physical activity, or an equivalent combination of moderate- and vigorous intensity aerobic activity. Aerobic activity should be performed in episodes of at least 10 minutes, and preferably, it should be spread throughout the week. Numerator: Weighted number of adults (18+) who report on the BRFSS engaging in 300 minutes or more total per week of moderate or vigorous exercise where each minute of vigorous exercise contributes two minutes to the total. Denominator: Weighted number of adults (18+) responding to physical activity questions on the BRFSS, excluding those with missing, "Don't know/Not sure" or "Refused" responses. This measure is relevant for measuring progress to Healthy People 2020 Objective PA-2.2: Increase the proportion of adults who engage in aerobic physical activity of at least moderate intensity for more than 300 minutes/week, or more than 150 minutes/week of vigorous intensity, or an equivalent combination with a national target of 31.3%.

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

The percentage of adults whom strengthen muscles two-times per week is presented because the HHS 2008 Physical Activity Guidelines recommend muscle-strengthening activities that are of moderate to high intensity and involve all major muscle groups on 2 or more days a week.^4^[[br]] [[br]] 4. 2008 Physical Activity Guidelines for Americans. Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, U.S. Department of Health and Human Services. [http://health.gov/paguidelines/guidelines/]

Data Notes

Definition: Respondent reports participation in muscle-strengthening activities at least 2 times per week. Numerator: Those responding to the question: "During the past month, how many times per week or per month did you do physical activities or exercises to STRENGTHEN your muscles? Do NOT count aerobic activities like walking, running, or bicycling. Count activities using your own body weight like yoga, sit-ups or push-ups and those using weight machines, free weights, or elastic bands." Denominator: Weighted number of adults aged 18 years and older responding to physical activity questions, excluding those with missing, "Don't know/Not sure" or "Refused" responses. U.S. values are based upon the median value of the states, District of Columbia, and territories. This measure is relevant for measuring progress to Healthy People 2020 Objective PA-2.3: Increase the proportion of adults who perform muscle-strengthening activities on 2 or more days of the week with a national target of 24.1%.

Data Notes

Definition: Respondent reports participation in muscle-strengthening activities at least 2 times per week AND at least 150 minutes per week of moderate-intensity activity, or at least 75 minutes per week of vigorous-intensity activity, or an equivalent combination of moderate-intensity and vigorous-intensity activity (multiplied by 2) totaling at least 150 minutes per week. Numerator: Weighted number of adults aged 18 years and older who report 150 minutes or more total per week of moderate or vigorous exercise where each minute of vigorous exercise contributes two minutes to the total and participates in muscle-strengthening activities at least 2 times per week. Denominator: Weighted number of adults aged 18 years and older responding to physical activity questions, excluding those with missing, "Don't know/Not sure" or "Refused" responses. This measure is relevant for measuring progress to Healthy People 2020 Objective PA-2.4: Increase the proportion of adults who meet the objectives for aerobic physical activity and for muscle-strengthening activity with a national target of 20.1%. U.S. values are based upon the median value of the states, District of Columbia, and territories.

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Data Notes

** = Data not available due to fewer than 50 respondents in the denominator.

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Data Notes

Ethnicity is defined independent of race.

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Data Notes

Education is based upon education completed by or after 25 years of age. Individuals less than 25 years of age are excluded.

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Poverty thresholds are intended for use as a statistical yardstick, not as a complete description of what people and families need to live. Poverty thresholds are the dollar amounts assigned by the U.S. Census Bureau to determine poverty status. Poverty thresholds are assigned based upon the size of the family and the ages of the members (i.e., adults versus children). The same thresholds are used throughout the United States. Poverty thresholds were originally derived in the 1963-1964 using U.S. Department of Agriculture food budgets designed for families under economic stress and data about what proportion of their income families spent on food. The thresholds are updated annually for inflation using the Consumer Price Index for All Urban Consumers (CPI-U). How the Census Bureau Measures Poverty - U.S. Census Bureau [https://www.census.gov/hhes/www/poverty/about/overview/measure.html]

Data Notes

Poverty thresholds computed using the BRFSS assume that householders are less than 65 years of age as the ages of the household heads are not recorded. The maximum of the income range provided for the household is used to evaluate the proportion of the poverty threshold. This is a conservative approach as there are no errors of misclassification into the lowest poverty group. The category of Poor represents less than 100% of the poverty threshold. Near Poor is 100% through 199% of the poverty threshold. Middle/High income families are 200% or higher of the poverty threshold. How the Census Bureau Measures Poverty - U.S. Census Bureau [https://www.census.gov/hhes/www/poverty/about/overview/measure.html]

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Data Notes

** Data not available due to fewer than 50 respondents in the denominator.

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Data Notes

** = Data not available due to fewer than 50 respondents in the denominator.

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Data Notes

** = Data not available due to fewer than 50 respondents in the denominator.

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

Data Notes

** = Data not available due to fewer than 50 respondents in the denominator.

Data Source

Alaska Data: http://dhss.alaska.gov/dph/Chronic/Pages/brfss/default.aspxBehavioral Risk Factor Surveillance System, Alaska Department of Health and Social Services, Division of Public Health, Section of Chronic Disease Prevention and Health Promotion

References and Community Resources

'''References:''' 1. Centers for Disease Control and Prevention. Physical activity and health: a report of the surgeon general. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Promotion; 1996. 2. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002;346(6):393-403. 3. Kesaniemi, Y., et al. (1994). Dose-response issues concerning physical activity and health: an evidence-based symposium. Medicine and Science in Sports and Exercise, 33(6 suppl), S351-S358 4. [http://health.gov/paguidelines/guidelines/ 2008 Physical Activity Guidelines for Americans]. Office of Disease Prevention and Health Promotion, Office of the Assistant Secretary for Health, Office of the Secretary, U.S. Department of Health and Human Services. 5. Centers for Disease Control and Prevention. A Data Users Guide to the BRFSS Physical Activity Questions. [http://www.cdc.gov/brfss/pdf/PA%20RotatingCore_BRFSSGuide_508Comp_07252013FINAL.pdf How to Assess the 2008 Physical Activity Guidelines for Americans]. Atlanta (GA): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Promotion; 2011. 6. [http://www.dhss.alaska.gov/dph/PlayEveryDay/Pages/default.aspx Play Every Day]. Alaska Department of Health and Social Services, Division of Public Health. '''Resources:''' [http://www.cdc.gov/nccdphp/dnpa CDC's Division of Nutrition and Physical Activity] [http://healthyfuturesak.org/ Healthy Futures]. The [http://www.nhlbi.nih.gov National Heart, Lung, and Blood Institute] has extensive resources on physical activity for patients, health care providers, and general consumers. The University of South Carolina's [http://prevention.sph.sc.edu/index.htm Prevention Research Centers] provide resources and information about physical activity to researchers, public health practitioners, and others who are interested in promoting physical activity in their communities. More information on the [http://www.cdc.gov/brfss/ Behavioral Risk Factor Surveillance System] may be found on the website of the Centers for Disease Control and Prevention.