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Perri Gaffney concerned citizen

04/02/2018

President Kennedy once made exercise in school a major component of U.S. youth education, orientation, and lifestyle. With childhood obesity and diabetes on a meteoric rise in this country, we need to get back to teaching the importance of being active to get and stay healthy.

Comment ID: 2425

Affiliation: Individual/Professional

Organization: Perri Tales Productions and Publications

Topic:
  • Part C. Background and Key Physical Activity Concepts
  • Part F. Chapter 1. Physical Activity Behaviors: Steps, Bouts, and High Intensity Training
  • Part F. Chapter 11. Promoting Regular Physical Activity
  • Part F. Chapter 5. Cardiometabolic Health and Prevention of Weight Gain
  • Part F. Chapter 7. Youth

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Anonymous

04/02/2018

The Honorable Alex Azar
Secretary
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201
Re: 2018 Physical Activity Guidelines Advisory Committee Scientific Report

Dear Secretary Azar:

The National Coalition for Promoting Physical Activity greatly appreciates your leadership and welcomes the opportunity to provide comments on the 2018 Physical Activity Guidelines Advisory Committee Scientific Report. We applaud HHS for your commitment to update the Physical Activity Guidelines for Americans (PAGs) in 2018. Updating the science for physical activity, physical fitness, and sedentary behavior across the lifespan is essential for providing the most recent evidence-based recommendations for the US population, specifically highlighting the importance of moving more to improve health and well-being. We are excited that the advisory committee’s scientific report covers areas such as physical activity for selected populations including young children and pregnant women, physical activity promotion, sedentary behavior, physical fitness, and the impact of physical activity on brain health, cancer, arthritis, cardiometabolic health, and cardiovascular disease.

In the attached document, we provide some specific feedback for consideration as HHS and the Centers for Disease Control and Prevention translate the scientific report into the Physical Activity Guidelines for Americans. This is an exciting time for physical activity promotion in the United States.

If there is any additional information we can provide, please do not hesitate to contact Ayanna McKnight at NCPPA@heart.org. We look forward to the release of the guidelines and working with you to inspire and empower all Americans to lead more physically active lifestyles.

Thank you.
National Coalition for Promoting Physical Activity

Comment ID: 2424

Affiliation: Other

Organization: National Coalition for Promoting Physical Activity

Topic:
  • Miscellaneous/General Comments
  • Part A. Executive Summary
  • Part C. Background and Key Physical Activity Concepts
  • Part D. Integrating the Evidence
  • Part F. Chapter 1. Physical Activity Behaviors: Steps, Bouts, and High Intensity Training
  • Part F. Chapter 10. Individuals with Chronic Conditions
  • Part F. Chapter 11. Promoting Regular Physical Activity
  • Part F. Chapter 2. Sedentary Behavior
  • Part F. Chapter 3. Brain Health
  • Part F. Chapter 6. All-cause Mortality, Cardiovascular Mortality, and Incident Cardiovascular Disease
  • Part F. Chapter 7. Youth
  • Part F. Chapter 9. Older Adults
  • Part G. Needs for Future Research

Files Attached: 1

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Anonymous

04/02/2018

US Department of Health and Human Services
Re: 2018 Physical Activity Guidelines Advisory Committee Scientific Report

Dear HHS:

On behalf of Lakeshore Foundation, we applaud HHS for your commitment to update the Physical Activity Guidelines for Americans (PAGs) in 2018. We strongly support the continual updating of the science for physical activity, physical fitness, and sedentary behavior across the lifespan and feel this is essential for providing the most recent evidence-based recommendations for the US population. The inclusive messaging of moving more to improve health and well-being is critical. We are pleased that the advisory committee’s scientific report covers areas such as physical activity for selected populations including young children and pregnant women, physical activity promotion, sedentary behavior, physical fitness, and the impact of physical activity on brain health, cancer, arthritis, cardiometabolic health, and cardiovascular disease. However, we do want to emphasize the importance of language and messaging and the importance of including people with disabilities across the lifespan in all areas of the guidelines where relevant.

Healthy People 2020 calls for increasing inclusion of people with disabilities in US health promotion efforts. Data indicate that chronic conditions are prevalent among people with disabilities. The passage of laws and the provision of appropriate services and supports are intended to give people with disabilities the tools and resources they need to thrive in society and achieve optimal health. But these direct measures alone will not transform public health promotion efforts that fail to recognize the presence of inequality and discrimination in the documented health disparities and unequal access experienced by people with disabilities.

We are committed to assisting in the dissemination and amplification of communication efforts that support the 2018 PAGs with the federal government and other national, state and local partners and will target our messaging to people with disability and chronic health conditions across the lifespan.

We will provide specific feedback for consideration as HHS and the Centers for Disease Control and Prevention translate the scientific report into the Physical Activity Guidelines for Americans in the attached letter. We are pleased to be a partner in this important work and welcome collaboration opportunities to support the people that we serve in being physically active.



Sincerely,

Amy Rauworth
Director of Policy and Public Affairs, Lakeshore Foundation
Associate Director, National Center on Health, Physical Activity and Disability (NCHPAD)

Comment ID: 2423

Affiliation: Other

Organization: Lakeshore Foundation

Topic:
  • Miscellaneous/General Comments
  • Part A. Executive Summary
  • Part B. Introduction
  • Part C. Background and Key Physical Activity Concepts
  • Part D. Integrating the Evidence
  • Part E. Systematic Literature Review Search Methodology
  • Part F. Chapter 1. Physical Activity Behaviors: Steps, Bouts, and High Intensity Training
  • Part F. Chapter 10. Individuals with Chronic Conditions
  • Part F. Chapter 11. Promoting Regular Physical Activity
  • Part F. Chapter 2. Sedentary Behavior
  • Part F. Chapter 3. Brain Health
  • Part F. Chapter 4. Cancer Prevention
  • Part F. Chapter 5. Cardiometabolic Health and Prevention of Weight Gain
  • Part F. Chapter 6. All-cause Mortality, Cardiovascular Mortality, and Incident Cardiovascular Disease
  • Part F. Chapter 7. Youth
  • Part F. Chapter 8. Women Who are Pregnant or Postpartum
  • Part F. Chapter 9. Older Adults
  • Part G. Needs for Future Research

Files Attached: 1

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Jamila Porter DrPH, MPH

04/02/2018

I heartily thank the 2018 Physical Activity Guidelines Advisory Committee and the U.S. Department of Health and Human Services (HHS) for creating the Physical Activity Guidelines Advisory Committee Scientific Report. I particularly appreciate recognition of evidence that illustrates links between the built environment, community design, active transit infrastructure, and the promotion of physical activity. However, a highly important injury issue that has been overlooked and warrants further consideration and research is pedestrian injury associated with physical activity.

Walking is the most common and egalitarian form of physical activity. However, walking is inherently dangerous for pedestrians on many of the nation’s roadways. In Part C (pg. C-24), the Committee writes: “the benefits of regular physical activity outweigh the inherent risk of adverse events.” However, this is not necessarily true for individuals that obtain their physical activity by simply walking along streets in their communities, either for recreational or utilitarian purposes. According to the National Highway Traffic Safety Administration (NHTSA), on average, a pedestrian was killed every 1.5 hours in traffic crashes across the United States in 2016. These data exclude nonfatal injuries or near misses, which are likely far higher in number. The Surgeon General’s Call to Action to Promote Walking and Walkable Communities states that “safety concerns can be a barrier to walking” and “several factors can influence pedestrian risk, such as unsafe driver and pedestrian behaviors and challenging physical environments” (HHS, 2015). In keeping, research also shows that perceptions of heavy traffic and a lack of sidewalks are associated with greater odds of obesity (Powell-Wiley et al., 2013).

When people live in communities that are explicitly designed to promote safe physical activity and active transportation, they are more likely to engage in these activities. Policy adoption and implementation are key strategies that can lead to the creation of safer and more active communities. Approaches like “Complete Streets” policies – mandates that require the accommodation of nonmotorized road users (i.e., pedestrians and bicyclists) as a routine part of roadway planning, design, construction, operation, and maintenance – can help ensure that communities are designed with both safety and physical activity in mind. One recent study (Porter et al., 2018) has shown that Complete Streets policies can significantly reduce pedestrian fatalities. Given that Complete Streets policies can enhance safety, they may have positive impacts on physical activity as well.

More research is needed to better understand the relationship between:

1. Perceptions of safety (i.e., traffic safety and neighborhood safety) and physical activity, with a special emphasis on specific subpopulations that may be more adversely impacted by negative perceptions of safety (e.g., women, people of color, children, low-income communities, etc.); and

2. The adoption and implementation of specific built environment and active transportation policies – such as Complete Streets policies – and physical activity.

Thank you for the opportunity to comment on the 2018 Physical Activity Guidelines Advisory Committee Scientific Report. I look forward to seeing future policy recommendations and research that will more strongly connect the forthcoming physical activity guidelines to pedestrian injury prevention.

Comment ID: 2422

Affiliation: Professional Association

Organization: Safe States Alliance

Topic:
  • Part F. Chapter 11. Promoting Regular Physical Activity
  • Part G. Needs for Future Research

Files Attached: 2

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Jim Whitehead

04/02/2018

Dear Colleagues:

The American College of Sports Medicine (ACSM) applauds the individuals and organizations involved with this fundamentally important effort for the health and the prevention of disease and conditions of Americans everywhere. HHS and staff have done a remarkable job with this process. The 2018 Physical Activity Guidelines Advisory Committee was extraordinary, many of whom are members of ACSM.

The important findings of the Committee will be transformative for American health. Such as: The multiple benefits of physical activity, with some occurring as soon as physical activity begins. That physical activity reduces an expanding number of diseases and conditions. These gains from physical activity can be achieved in numerous ways, giving everyone the opportunity to customize the most effective and rewarding approaches.

There has been substantial progress in physical activity and public and patient health in the last decade. New Guidelines will materially improve this country, with people healthier, more productive, and making larger contributions to American success and enabling our collective future to be brighter and full of enlarged promise.

ACSM applauds the development of these Guidelines to reflect new scientific information and its translation into opportunities for improved health. We encourage this process to become standardized so there is an incorporation of scientific discovery into new Guidelines on a regular and predictable schedule. The American people will benefit greatly, as will our country overall.

Again, many thanks and appreciation to all involved. Our today and especially our tomorrow will gain greatly from the tireless efforts underway.

Best wishes,
Jim Whitehead
CEO & Executive Vice President, American College of Sports Medicine

Comment ID: 2421

Affiliation: Professional Association

Organization: American College of Sports Medicine

Topic:
  • Part A. Executive Summary

Files Attached: 0

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Anonymous

04/02/2018

On behalf of Bike Walk Cleveland, I am writing to express appreciation and support for the conclusions relating to the sections regarding to the built environment and community design in the Physical Activity Guidelines Advisory Committee Scientific Report. As an organization that works for and advocates for trails and active transportation networks in Cleveland, TN, we appreciate the importance of physical activity and are looking forward to seeing this long-awaited update to the 2008 Physical Activity Guidelines. Since the Centers for Disease Control and Prevention (CDC) first established these guidelines in 2008, they have informed the nation’s efforts to promote healthy activity, including biking and walking.

I am writing specifically to support and amplify the scientific report’s findings regarding the connection between built environment characteristics that support active transport, community design and characteristics that support recreational physical activity, and promotion of physical activity. As we have worked to develop and build trail networks in Cleveland, we have come to understand how access to safe places to walk and bike can encourage physical activity.

Our current Greenway allows access to local businesses, schools, and parks and is regularly accessed by citizens of Cleveland and Bradley county. We hope to receive grant money to gather more data on the impact our expanding Greenway is having on the health of our community. We know that our area of Tennessee has a very high obesity rate and we are working to promote walking and biking as modes of transportation to encourage physical activity as part of everyday life and to build our community through the personal connections that biking and walking build.

We appreciate the opportunity to comment on the scientific report, and look forward to providing additional input as CDC continues its work updating the Physical Activity Guidelines. Please feel free to contact me at gina.simpson@bikewalktn.org or 931-544-2982 if you have any questions or need additional information.

Sincerely,

Gina Simpson
Chairman Bike Walk Cleveland
www.bikewalktn.org/Cleveland
gina.simpson@bikewalktn.org
931-544-2982

Comment ID: 2420

Affiliation: Professional Association

Organization: Bike Walk Cleveland

Topic:
  • Part C. Background and Key Physical Activity Concepts
  • Part F. Chapter 1. Physical Activity Behaviors: Steps, Bouts, and High Intensity Training
  • Part F. Chapter 11. Promoting Regular Physical Activity

Files Attached: 0

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Anonymous

04/02/2018

U.S. Department of Health and Human Services
Re: 2018 Physical Activity Guidelines Advisory Committee Scientific Report

Dear HHS:

The American Council on Exercise (ACE) appreciates HHS’s commitment and efforts to update the Physical Activity Guidelines for Americans (PAGs) in 2018. We believe it is important to regularly review and update the science behind the guidelines for physical activity, physical fitness, and sedentary behaviors in order to create up-to-date and evidence-based recommendations across the lifespan of the U.S. population, specifically highlighting the importance of moving more to improve health and well-being. We were pleased to see the advisory committee examine new areas such as physical activity for selected populations including young children and pregnant women, physical activity promotion, sedentary behavior, physical fitness, and the impact of physical activity on brain health, cancer, arthritis, cardiometabolic health, and cardiovascular disease. ACE looks forward to serving as an effective conduit to help communicate the 2018 PAGs with our more than 75,000 certified exercise professionals and health coaches, as well as the federal government, consumers, and other national, state, and local partners.

In the attached letter, we provide some comments for consideration as HHS and the Centers for Disease Control and Prevention utilize the scientific report in the revision of the Physical Activity Guidelines for Americans. ACE stands with other national partners ready and willing to support this important work.

Sincerely,
Graham Melstrand
Executive Vice President, Engagement
American Council on Exercise

Comment ID: 2419

Affiliation: Industry/Industry Association

Organization: American Council on Exercise

Topic:
  • Miscellaneous/General Comments
  • Part B. Introduction
  • Part C. Background and Key Physical Activity Concepts
  • Part D. Integrating the Evidence
  • Part F. Chapter 1. Physical Activity Behaviors: Steps, Bouts, and High Intensity Training
  • Part F. Chapter 10. Individuals with Chronic Conditions
  • Part F. Chapter 11. Promoting Regular Physical Activity
  • Part F. Chapter 2. Sedentary Behavior
  • Part F. Chapter 3. Brain Health
  • Part F. Chapter 4. Cancer Prevention
  • Part F. Chapter 5. Cardiometabolic Health and Prevention of Weight Gain
  • Part F. Chapter 7. Youth
  • Part F. Chapter 8. Women Who are Pregnant or Postpartum

Files Attached: 1

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Kate Clabaugh MSW

04/02/2018

The National Recreation and Park Association (NRPA) applauds the 2018 Physical Activity Guidelines Advisory Committee for their research and evaluation of the latest scientific evidence related to physical activity and physical fitness across the lifespan. NRPA supports the development of the guidelines and we are committed to ensuring their adoption by park and recreation agencies across the country once they are released. We encourage the Department to consider local park and recreation sites as a venue for evaluating types of messaging and communication around the final guidelines, particularly as it may relate to varying messaging for more specialized populations.

We are encouraged that the Committee explored considerations in the scientific report related to such influences on physical activity as the built environment and how opportunities to be physical active can vary among age groups. As the national association for local park and recreation agencies nationwide, we work diligently to equip our affiliates on the ground with the tools they need to improve the health and well-being of the communities they serve.

Built environment interventions: We applaud the consideration of a community’s built environment and how it may encourage or hinder opportunities for physical activity. Specifically, we applaud the Committee for recognizing the value of a “combined approach” of increasing access to open and green spaces, such as parks, for physical activity, while also promoting programming available in the space for community members to participate in. We ask that the Department consider the fact that organized activities in parks in low-income communities can increase park use by as much as 25%. We recommend the guidelines stipulate an updated search of the literature, identifying neighborhood studies on parks and specifically identifying how park design and quality increase levels of physical activity among various demographics. We also recommend that the portions of the guidelines referencing facilities for outdoor recreation be referenced as “parks, trails, and green spaces” and inside facilities be referenced as “indoor recreation centers.”

Out-of-school time interventions: Afterschool programs play an important role in improving the health and wellness of our nation’s students. Serving more than 10.2 million children and youth across America for countless hours each day, afterschool programs have great potential to help prevent obesity and instill lifelong healthy habits that can help our nation’s students get healthy, stay healthy and lead healthier lives.

NRPA is actively supporting the implementation of the evidence-based National AfterSchool Association’s Healthy Eating and Physical Activity (HEPA) standards for out-of-school time programs nationwide. The HEPA standards align with the guidelines that youth ages 6 to 17 should engage in at least 60 minutes of daily moderate to vigorous exercise, and that physical activity takes place outdoors when possible. Since the HEPA standards foster the best possible nutrition and physical activity outcomes for kids attending OST programs, we ask that the Physical Activity Guidelines Committee consider listing them as a resource to increase physical activity in OST settings.

We applaud the Committee’s recognition of the value community-based partners can add to the work being done by schools, during the school day and throughout the school year, and the recognition that significant opportunities remain for physical activity interventions among youth through robust summer and afterschool programs. We know that parents want physical activity in afterschool, as 8 out of 10 parents surveyed agreed that afterschool programs should help children be physically active. Additionally, 68% of parents who have a child in afterschool reported that opportunities for physical activity were very important in their decision to select their child’s primary afterschool program. Thus, we encourage the Department to consider out-of-school time sites as a venue for ensuring children have the opportunity to meet the daily physical activity recommendations and encourage the utilization of the HEPA standards as a vehicle for future guideline development.

NRPA thanks the Department for allowing us to comment at this time and we welcome the opportunity to discuss any of these ideas further. If you have any questions, please contact National Recreation and Park Association (NRPA)’s Senior Government Affairs Manager, Kate Clabaugh (kclabaugh@nrpa.org).

Comment ID: 2418

Affiliation: Professional Association

Organization: National Recreation and Park Association

Topic:
  • Part F. Chapter 11. Promoting Regular Physical Activity

Files Attached: 3

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Anonymous

04/02/2018

The Honorable Alex Azar
Secretary of Health and Human Services
200 Independence Avenue, S.W
Washington, D.C. 20201

Dear Secretary Azar,

YMCA of the USA is pleased to comment on the Physical Activity Guidelines for Americans. The Y is one of the leading providers of evidence-based interventions (EBIs) in the country, and physical activity is a driving force in all of them. We are determined to test, scale and continue to improve and evaluate our EBIs with the public, private and philanthropic sectors. We have made great progress over the last 15 years and think you will find many lessons in our experience helpful, including how to test, scale and find sustainable funding mechanisms for physical activity interventions in our health system. It’s critical that we take these guidelines and use them to support the actual implementation of these programs to prevent and control chronic disease and disability.

Attached find a detailed summary of the work we have done to scale physical activity programs that prevent and control diabetes, arthritis, cancer, childhood obesity and assist in the prevention of falls. We are also involved in a trial with the National Institute on Aging to advance physical activity interventions for individuals with early cognitive impairment.

Please do not hesitate to contact us for further information on these important interventions. We very much appreciate the time and effort the Committee took to document the evidence of the benefits of physical activity in preventing and controlling chronic disease and disability and the recommendations for further research. We are on the ground in communities across the nation implementing these very recommendations and furthering the science and the evidence. We very much look forward to taking these recommendations out to communities in the form of programs that work and that deliver real return on investment for the public.

Sincerely,

Katie Adamson
Vice President
Health Partnerships and Policy
YMCA of the USA

Attachment (1)

Comment ID: 2417

Affiliation: Other

Organization: non profit YMCA

Topic:
  • Part A. Executive Summary
  • Part B. Introduction
  • Part D. Integrating the Evidence
  • Part F. Chapter 10. Individuals with Chronic Conditions
  • Part F. Chapter 11. Promoting Regular Physical Activity
  • Part F. Chapter 3. Brain Health
  • Part F. Chapter 4. Cancer Prevention
  • Part F. Chapter 5. Cardiometabolic Health and Prevention of Weight Gain
  • Part F. Chapter 7. Youth
  • Part F. Chapter 9. Older Adults
  • Part G. Needs for Future Research

Files Attached: 1

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Rachele Pojednic EdM, PhD

04/02/2018

The Honorable Alex Azar
Secretary
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201
Re: 2018 Physical Activity Guidelines Advisory Committee Scientific Report

Dear Secretary Azar:

On behalf of the Prescription for Activity (PfA) Task Force, we would like to commend the US Department of Health and Human Services on their tremendous effort to update the Physical Activity Guidelines (PAG) for Americans in 2018. This update represents a critical step forward in understanding how physical activity can be a key strategy to treat and prevent the continuing burden of noncommunicable diseases including cardiovascular disease, type 2 diabetes, cancer, obesity, among others, not to mention its critical role in mental health. We are particularly excited to see the inclusion of a chapter on the promotion of physical activity that specifically highlights counseling patients on physical activity in a clinical setting. As you translate the scientific report into the PAG, it will be important to highlight nurse-directed and primary care-directed physical activity prescriptions and connecting to resources in the community, workplace, and schools for moving more.

The PfA Task Force is comprised of volunteer national stakeholders that include a range of experts from academic, healthcare and community settings. The Task Force has developed a systems-change map illustrating how to mobilize healthcare, working in concert with the communities it serves, to help more Americans achieve the physical-activity guidelines, leading to better health outcomes and reductions in health disparities. More specifically, our goal is to create an environment sparked by healthcare-community collaboration that supports 50 percent or more of Americans in every community, demographic and age group to achieve the recommended levels of physical activity.

In the attached letter we provide specific feedback related to the counseling of physical activity in the clinical setting. The members of the PfA Task Force believe that our goal of achieving the Physical Activity Guidelines for Americans will only happen when environments and opportunities support and empower individuals of all backgrounds to increase their personal level of physical activity. As such, we stand committed to this work, and commend the experts of the Physical Activity Guidelines Advisory Committee for providing their recommendations.

Sincerely,

Rachele Pojednic, PhD, MEd
Executive Director, Interim
Prescription for Activity Task Force

Comment ID: 2415

Affiliation: Professional Association

Organization: Prescription for Activity Task Force

Topic:
  • Part D. Integrating the Evidence
  • Part F. Chapter 10. Individuals with Chronic Conditions
  • Part F. Chapter 11. Promoting Regular Physical Activity
  • Part F. Chapter 2. Sedentary Behavior
  • Part F. Chapter 3. Brain Health
  • Part F. Chapter 4. Cancer Prevention
  • Part F. Chapter 5. Cardiometabolic Health and Prevention of Weight Gain
  • Part F. Chapter 6. All-cause Mortality, Cardiovascular Mortality, and Incident Cardiovascular Disease
  • Part G. Needs for Future Research

Files Attached: 1

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