Research articleIdentifying Sedentary Subgroups: The National Cancer Institute’s Health Information National Trends Survey
Introduction
Inactivity has been linked to increased risk of many chronic illnesses,1, 2 including increased risk and carcinogenesis for many cancers.3, 4, 5 Consequently, one of the major goals of the Institute of Medicine report in 2003, Fulfilling the Potential of Cancer Prevention and Early Detection, is the development of prevention strategies to reduce sedentary behavior and obesity.6 The importance of these prevention strategies is highlighted by national surveys indicating that 24% to 28% of adults in the United States are completely sedentary, and that levels of obesity in the nation are growing to epidemic proportions.2, 7A better understanding of the characteristics of sedentary populations is required to develop effective intervention strategies.
Those who are physically inactive (i.e., sedentary) in all likelihood do not represent just one group, but may consist of several subgroups. Yet, the identification of specific inactivity subgroups has received relatively little attention, and attempts to characterize inactive groups have typically taken a unidimensional perspective by classifying subgroups along one domain (e.g., age, gender, ethnicity) or examining multiple correlates without evaluating possible interactions among the variables.8 The characteristics of inactive groups are likely to be complex and an aggregate of various factors. Examining multiple characteristics of sedentary groups may aid in more effective health promotion intervention programs.
Identification of critical communication channels is key to developing effective programs for reaching sedentary subgroups. In addition to traditional face-to-face approaches (e.g., exercise classes), previous physical activity research has focused on either mass media campaigns to promote physical activity or smaller-scale interventions using the telephone and/or print media to provide physical activity advice and information.9 Yet, few studies have simultaneously examined the spectrum of mediated communication channels (e.g., television, newspaper, Internet) available to reach the inactive populations, and how these channels can be used to disseminate effective interventions.
The purposes of this study were to (1) identify distinct subgroups with high proportions of inactivity in a nationally derived sample using signal detection methodology (SDM), and (2) examine the stability of the inactivity patterns using an independent sample.
Section snippets
Data Source
Data came from the 2003 Health Information National Trends Survey (HINTS). This survey was developed to collect nationally representative data about the American public’s need for, access to, and use of cancer-relevant information (see http://cancercontrol.cancer.gov/hints/index.jsp).
Data Collection
Data were collected from October 2002 through April 2003. Trained interviewers used a list-assisted random-digit-dial method from all working “banks” of telephone numbers within the United States. One adult (aged
Results
Descriptive characteristics of the full sample (unweighted data) are displayed in Table 1. Overall, about 28% of respondents were sedentary. Bivariate analysis revealed that inactive respondents were older, less educated, and of lower-income strata; more likely to be women, not married, nonwhite, overweight, and have smoked ≥100 cigarettes in their lifetimes; and less likely to live in metropolitan areas, be in poorer general health, have health insurance, believe that exercise lowers cancer
Discussion and Conclusions
Approximately one quarter of the U.S. adult population remains sedentary. This study was conducted to identify empirically distinct subgroups with varying sedentary levels. Overall, results suggest that subgroups with similar levels of inactivity can have quite different defining characteristics. Furthermore, the inactivity patterns found using SDM were found to be stable in an independent sample.
Previous studies on inactivity have typically not considered the complex interactions among
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The views presented in this paper represent those of the authors and not the National Cancer Institute.
No financial conflict of interest was reported by the authors of this paper.