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<article xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" article-type="brief-report"><?properties open_access?><front><journal-meta><journal-id journal-id-type="nlm-ta">Prev Chronic Dis</journal-id><journal-id journal-id-type="iso-abbrev">Prev Chronic Dis</journal-id><journal-id journal-id-type="publisher-id">PCD</journal-id><journal-title-group><journal-title>Preventing Chronic Disease</journal-title></journal-title-group><issn pub-type="epub">1545-1151</issn><publisher><publisher-name>Centers for Disease Control and Prevention</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">33416470</article-id><article-id pub-id-type="pmc">7787367</article-id><article-id pub-id-type="publisher-id">20_0262</article-id><article-id pub-id-type="doi">10.5888/pcd17.200262</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Brief</subject></subj-group><series-title>Peer Reviewed</series-title></article-categories><title-group><article-title>Perceived Importance of Physical Activity and Walkable Neighborhoods Among US Adults, 2017</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Carlson</surname><given-names>Susan A.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref></contrib><contrib contrib-type="author"><name><surname>Ussery</surname><given-names>Emily N.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref></contrib><contrib contrib-type="author"><name><surname>Watson</surname><given-names>Kathleen B.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref></contrib><contrib contrib-type="author"><name><surname>Cornett</surname><given-names>Kelly A.</given-names></name><degrees>MS</degrees><xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref></contrib><contrib contrib-type="author"><name><surname>Fulton</surname><given-names>Janet E.</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff1">
<sup>1</sup>
</xref></contrib><aff id="aff1">
<label>1</label>Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia</aff></contrib-group><author-notes><corresp id="cor1">Corresponding Author: Susan A. Carlson, PhD, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, MS F-77, Atlanta, GA 30341. Telephone: 770-488-6091. Email: <email xlink:href="clo3@cdc.gov">clo3@cdc.gov</email>.</corresp></author-notes><pub-date pub-type="collection"><year>2020</year></pub-date><pub-date pub-type="epub"><day>31</day><month>12</month><year>2020</year></pub-date><volume>17</volume><elocation-id>E168</elocation-id><permissions><copyright-year>2020</copyright-year><license license-type="open-access" xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>Preventing Chronic Disease is a publication of the U.S. Government. This publication is in the public domain and is therefore without copyright. All text from this work may be reprinted freely. Use of these materials should be properly cited.</license-p></license></permissions><abstract><p>The importance of physical activity and community-level promotion strategies are well established, but little is known about adult perception of the importance of physical activity. In a nationwide sample of US adults, we examined self-reported importance of regular physical activity and the importance of living in walkable neighborhoods. About 55% of adults strongly agreed that regular physical activity is important, 40% strongly agreed that living in a walkable neighborhood is important, and 31% strongly agreed that both are important. Separately for each measure, estimates were lower among adults with lower education levels and who did not meet the aerobic physical activity guideline. Opportunities exist to improve the perception of the importance of physical activity and the importance of walkable neighborhoods.</p></abstract></article-meta></front><body><boxed-text id="Ba" position="float" orientation="portrait"><caption><title>SUMMARY</title></caption><sec sec-type="other1"><title>What is already known on this topic?</title><p>Regular physical activity can produce long-term health benefits. A key supportive strategy for physical activity is walkable neighborhoods.</p></sec><sec sec-type="other2"><title>What is added by this report?</title><p>In a nationwide sample of US adults, we examined self-reported importance of regular physical activity and living in a walkable neighborhood. The prevalence of strong agreement with importance was 55% for regular physical activity, 40% for living in a walkable neighborhood, and 31% for both. Similar results were found across education levels and physical activity behavior.</p></sec><sec sec-type="other3"><title>What are the implications for public health practice?</title><p>Opportunities exist to improve the perceived importance of regular physical activity and walkable neighborhoods, especially among those who are least active.</p></sec></boxed-text><sec sec-type="other4"><title>Objective</title><p>Regular physical activity can produce long-term health benefits (<xref rid="R1" ref-type="bibr">1</xref>). Evidence-based strategies exist for promoting physical activity, including the creation of walkable communities, where people can safely and easily walk for transportation, relaxation, or exercise (<xref rid="R2" ref-type="bibr">2</xref>). Several national initiatives promote the benefits of physical activity and walkable communities (<xref rid="R2" ref-type="bibr">2</xref>&#x02013;<xref rid="R5" ref-type="bibr">5</xref>). A better understanding of how the perception of importance differs by individual characteristics can help guide physical activity initiatives. We examined the self-reported importance of regular physical activity and of living in walkable neighborhoods by demographic characteristics and by physical activity behavior in a nationwide sample of adults.</p></sec><sec sec-type="methods"><title>Methods</title><p>Porter Novelli&#x02019;s 2017 Styles (<ext-link ext-link-type="uri" xlink:href="https://styles.porternovelli.com">https://styles.porternovelli.com</ext-link>) database gathers data on US consumer insights, including information about health attitudes and behaviors. The panel has about 55,000 panelists. The initial SpringStyles survey was sent during March&#x02013;April 2017 to 10,916 panelists; of these, 6,622 completed the survey (response rate, 60.7%). The summer wave, SummerStyles, was sent during June&#x02013;July to 5,586 adults who completed the SpringStyles survey; of these, 4,107 completed the survey (response rate: 73.5%). Respondents received a small incentive of about $10.</p><p>Respondents were asked how strongly they disagree or agree (ie, strongly disagree, somewhat disagree, neither agree or disagree, somewhat agree, or strongly agree) with the following statements: 1) I think it is important to be physically active on a regular basis, and 2) I think it is important to live in a neighborhood that is walkable. We defined a walkable neighborhood as one that it is safe and easy for people to walk to get somewhere or one that is safe and easy to walk for fun, relaxation, or exercise. Given the small percentage of respondents reporting disagreement, we tabulated estimates for 3 levels of agreement: 1) disagree and neither agree nor disagree, 2) somewhat agree, and 3) strongly agree.</p><p>Respondent demographic characteristics included sex, age, education, race/ethnicity, region (<xref rid="R6" ref-type="bibr">6</xref>), and metropolitan statistical area (MSA) status (<xref rid="R7" ref-type="bibr">7</xref>). Respondents were classified as meeting the aerobic physical activity guideline (&#x02265;150 min/wk of moderate-intensity&#x02013;equivalent physical activity) or not meeting the aerobic physical activity guideline (<xref rid="R1" ref-type="bibr">1</xref>).</p><p>Of the 4,107 SummerStyles respondents, 3,991 had complete data for all variables of interest. Using these cross-sectional data, we examined the importance of regular physical activity and the importance of living in a walkable neighborhood by demographic characteristics. We examined separate and combined importance by physical activity levels. Analyses were conducted using SUDAAN, Release 11 (RTI International) to account for survey weights. Within subgroups, we separately tested pairwise differences in the prevalence of 3 agreement levels using adjusted Wald &#x003c7;<sup>2 </sup>tests with a Bonferroni correction. Trends in prevalence of strong agreement by age and education were tested with orthogonal polynomial contrasts. Results with <italic>P</italic> value &#x0003c;.05 were considered significant.</p></sec><sec sec-type="results"><title>Results</title><p>Overall, an estimated 54.7% of adults (unweighted n = 2,216 respondents) strongly agreed that it is important to be regularly physically active (<xref rid="T1" ref-type="table">Table</xref>). Women compared with men, adults aged 50 or older compared with adults aged 18 to 34, and those who met the aerobic guideline compared with those who did not were more likely to strongly agree that it is important to be regularly physically active. Reports of strong agreement with the importance of regular physical activity increased linearly as education increased (<italic>P</italic> &#x0003c;.001).</p><table-wrap id="T1" orientation="portrait" position="float"><label>Table</label><caption><title>Self-Reported Importance of Regular Physical Activity and Living in a Walkable Neighborhood by Select Characteristics, Adults (N = 3,991), SummerStyles 2017 </title></caption><table frame="hsides" rules="groups"><col width="72" span="1"/><col width="45" span="1"/><col width="85" span="1"/><col width="63" span="1"/><col width="47" span="1"/><col width="78" span="1"/><col width="63" span="1"/><col width="63" span="1"/><thead><tr><th rowspan="3" valign="bottom" align="left" scope="col" colspan="1">Characteristic</th><th rowspan="3" valign="bottom" align="center" scope="col" colspan="1">No.<xref rid="T1FN2" ref-type="table-fn">b</xref>
</th><th valign="bottom" colspan="3" align="center" scope="colgroup" rowspan="1">Importance of regular physical activity<xref rid="T1FN1" ref-type="table-fn">a</xref>
<hr/>
</th><th valign="bottom" colspan="3" align="center" scope="colgroup" rowspan="1">Importance of living in a walkable neighborhood<xref rid="T1FN1" ref-type="table-fn">a</xref>
<hr/>
</th></tr><tr><th rowspan="2" valign="bottom" colspan="1" align="center" scope="colgroup">Disagree/Neither Agree nor Disagree, % (95% CI)</th><th valign="bottom" colspan="2" align="center" scope="colgroup" rowspan="1">Agree% (95% CI)<hr/></th><th rowspan="2" valign="bottom" align="center" scope="col" colspan="1">Disagree/Neither Agree nor Disagree % (95% CI)</th><th valign="bottom" colspan="2" align="center" scope="colgroup" rowspan="1">Agree % (95% CI)<hr/></th></tr><tr><th valign="bottom" colspan="1" align="center" scope="colgroup" rowspan="1">Somewhat</th><th valign="bottom" align="center" scope="col" rowspan="1" colspan="1">Strongly</th><th valign="bottom" colspan="1" align="center" scope="colgroup" rowspan="1">Somewhat</th><th valign="bottom" align="center" scope="col" rowspan="1" colspan="1">Strongly</th></tr></thead><tbody><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">
<bold>Overall</bold>
</td><td valign="top" align="right" rowspan="1" colspan="1">3,991</td><td valign="top" align="right" rowspan="1" colspan="1">15.0 (13.7&#x02013;16.4)</td><td valign="top" align="right" rowspan="1" colspan="1">30.3 (28.7&#x02013;31.9)</td><td valign="top" align="right" rowspan="1" colspan="1">54.7 (52.9&#x02013;56.4)</td><td valign="top" align="right" rowspan="1" colspan="1">27.3 (25.7&#x02013;28.9)</td><td valign="top" align="right" rowspan="1" colspan="1">33.0 (31.4&#x02013;34.7)</td><td valign="top" align="right" rowspan="1" colspan="1">39.7 (38.0&#x02013;41.4)</td></tr><tr><td valign="bottom" colspan="8" align="left" scope="col" rowspan="1">
<bold>Sex</bold>
</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Male</td><td valign="top" align="right" rowspan="1" colspan="1">1,937</td><td valign="top" align="right" rowspan="1" colspan="1">16.9 (15.0&#x02013;19.1)</td><td valign="top" align="right" rowspan="1" colspan="1">32.1 (29.8&#x02013;34.5)</td><td valign="top" align="right" rowspan="1" colspan="1">51.0 (48.4&#x02013;53.5)</td><td valign="top" align="right" rowspan="1" colspan="1">28.3 (26.0&#x02013;30.7)</td><td valign="top" align="right" rowspan="1" colspan="1">33.9 (31.5&#x02013;36.3)</td><td valign="top" align="right" rowspan="1" colspan="1">37.8 (35.4&#x02013;40.3)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Female</td><td valign="top" align="right" rowspan="1" colspan="1">2,054</td><td valign="top" align="right" rowspan="1" colspan="1">13.2 (11.6&#x02013;15.0)</td><td valign="top" align="right" rowspan="1" colspan="1">28.7 (26.5&#x02013;30.9)</td><td valign="top" align="right" rowspan="1" colspan="1">58.1 (55.7&#x02013;60.5)</td><td valign="top" align="right" rowspan="1" colspan="1">26.3 (24.3&#x02013;28.5)</td><td valign="top" align="right" rowspan="1" colspan="1">32.3 (30.1&#x02013;34.5)</td><td valign="top" align="right" rowspan="1" colspan="1">41.4 (39.1&#x02013;43.8)</td></tr><tr><td valign="bottom" colspan="8" align="left" scope="col" rowspan="1">
<bold>Age, y</bold>
</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">18&#x02013;34</td><td valign="top" align="right" rowspan="1" colspan="1">844</td><td valign="top" align="right" rowspan="1" colspan="1">20.7 (17.8&#x02013;24.0)</td><td valign="top" align="right" rowspan="1" colspan="1">30.2 (26.9&#x02013;33.6)</td><td valign="top" align="right" rowspan="1" colspan="1">49.1 (45.4&#x02013;52.8)</td><td valign="top" align="right" rowspan="1" colspan="1">30.5 (27.2&#x02013;34.1)</td><td valign="top" align="right" rowspan="1" colspan="1">32.9 (29.5&#x02013;36.4)</td><td valign="top" align="right" rowspan="1" colspan="1">36.6 (33.1&#x02013;40.3)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">35&#x02013;49</td><td valign="top" align="right" rowspan="1" colspan="1">1,094</td><td valign="top" align="right" rowspan="1" colspan="1">17.2 (14.7&#x02013;20.1)</td><td valign="top" align="right" rowspan="1" colspan="1">27.1 (24.3&#x02013;30.1)</td><td valign="top" align="right" rowspan="1" colspan="1">55.7 (52.4&#x02013;59.0)</td><td valign="top" align="right" rowspan="1" colspan="1">29.0 (26.1&#x02013;32.2)</td><td valign="top" align="right" rowspan="1" colspan="1">31.0 (28.1&#x02013;34.1)</td><td valign="top" align="right" rowspan="1" colspan="1">39.9 (36.8&#x02013;43.2)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">50&#x02013;64</td><td valign="top" align="right" rowspan="1" colspan="1">1,306</td><td valign="top" align="right" rowspan="1" colspan="1">11.2 (9.4&#x02013;13.2)</td><td valign="top" align="right" rowspan="1" colspan="1">30.3 (27.7&#x02013;33.1)</td><td valign="top" align="right" rowspan="1" colspan="1">58.5 (55.6&#x02013;61.4)</td><td valign="top" align="right" rowspan="1" colspan="1">26.3 (23.8&#x02013;28.9)</td><td valign="top" align="right" rowspan="1" colspan="1">34.2 (31.5&#x02013;37.1)</td><td valign="top" align="right" rowspan="1" colspan="1">39.5 (36.6&#x02013;42.4)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">&#x02265;65</td><td valign="top" align="right" rowspan="1" colspan="1">747</td><td valign="top" align="right" rowspan="1" colspan="1">8.9 (6.8&#x02013;11.5)</td><td valign="top" align="right" rowspan="1" colspan="1">34.6 (31.0&#x02013;38.3)</td><td valign="top" align="right" rowspan="1" colspan="1">56.6 (52.7&#x02013;60.4)</td><td valign="top" align="right" rowspan="1" colspan="1">21.7 (18.6&#x02013;25.2)</td><td valign="top" align="right" rowspan="1" colspan="1">34.1 (30.5&#x02013;37.8)</td><td valign="top" align="right" rowspan="1" colspan="1">44.3 (40.4&#x02013;48.2)</td></tr><tr><td valign="bottom" colspan="8" align="left" scope="col" rowspan="1">
<bold>Race/ethnicity</bold>
</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Non-Hispanic White</td><td valign="top" align="right" rowspan="1" colspan="1">2,923</td><td valign="top" align="right" rowspan="1" colspan="1">13.3 (11.9&#x02013;14.7)</td><td valign="top" align="right" rowspan="1" colspan="1">31.3 (29.5&#x02013;33.1)</td><td valign="top" align="right" rowspan="1" colspan="1">55.5 (53.5&#x02013;57.4)</td><td valign="top" align="right" rowspan="1" colspan="1">27.1 (25.3&#x02013;28.9)</td><td valign="top" align="right" rowspan="1" colspan="1">34.6 (32.8&#x02013;36.5)</td><td valign="top" align="right" rowspan="1" colspan="1">38.3 (36.4&#x02013;40.3)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Non-Hispanic Black</td><td valign="top" align="right" rowspan="1" colspan="1">360</td><td valign="top" align="right" rowspan="1" colspan="1">22.3 (17.7&#x02013;27.6)</td><td valign="top" align="right" rowspan="1" colspan="1">26.3 (21.6&#x02013;31.6)</td><td valign="top" align="right" rowspan="1" colspan="1">51.5 (45.8&#x02013;57.1)</td><td valign="top" align="right" rowspan="1" colspan="1">34.0 (28.8&#x02013;39.6)</td><td valign="top" align="right" rowspan="1" colspan="1">24.9 (20.3&#x02013;30.1)</td><td valign="top" align="right" rowspan="1" colspan="1">41.1 (35.7&#x02013;46.7)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Other<xref rid="T1FN3" ref-type="table-fn">c</xref>
</td><td valign="top" align="right" rowspan="1" colspan="1">708</td><td valign="top" align="right" rowspan="1" colspan="1">16.2 (13.3&#x02013;19.6)</td><td valign="top" align="right" rowspan="1" colspan="1">29.6 (26.0&#x02013;33.5)</td><td valign="top" align="right" rowspan="1" colspan="1">54.2 (50.0&#x02013;58.3)</td><td valign="top" align="right" rowspan="1" colspan="1">24.5 (21.1&#x02013;28.3)</td><td valign="top" align="right" rowspan="1" colspan="1">32.7 (29.0&#x02013;36.7)</td><td valign="top" align="right" rowspan="1" colspan="1">42.7 (38.7&#x02013;46.8)</td></tr><tr><td valign="bottom" colspan="8" align="left" scope="col" rowspan="1">
<bold>Education</bold>
</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Some high school</td><td valign="top" align="right" rowspan="1" colspan="1">1,487</td><td valign="top" align="right" rowspan="1" colspan="1">21.9 (19.4&#x02013;24.6)</td><td valign="top" align="right" rowspan="1" colspan="1">32.5 (29.9&#x02013;35.2)</td><td valign="top" align="right" rowspan="1" colspan="1">45.6 (42.7&#x02013;48.5)</td><td valign="top" align="right" rowspan="1" colspan="1">33.5 (30.8&#x02013;36.3)</td><td valign="top" align="right" rowspan="1" colspan="1">31.6 (29.0&#x02013;34.3)</td><td valign="top" align="right" rowspan="1" colspan="1">34.9 (32.2&#x02013;37.8)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Some college</td><td valign="top" align="right" rowspan="1" colspan="1">1,202</td><td valign="top" align="right" rowspan="1" colspan="1">11.9 (10.1&#x02013;14.1)</td><td valign="top" align="right" rowspan="1" colspan="1">32.4 (29.5&#x02013;35.4)</td><td valign="top" align="right" rowspan="1" colspan="1">55.7 (52.5&#x02013;58.8)</td><td valign="top" align="right" rowspan="1" colspan="1">25.8 (23.1&#x02013;28.6)</td><td valign="top" align="right" rowspan="1" colspan="1">34.5 (31.6&#x02013;37.6)</td><td valign="top" align="right" rowspan="1" colspan="1">39.7 (36.6&#x02013;42.8)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">College graduate</td><td valign="top" align="right" rowspan="1" colspan="1">1,302</td><td valign="top" align="right" rowspan="1" colspan="1">9.0 (7.4&#x02013;10.9)</td><td valign="top" align="right" rowspan="1" colspan="1">25.5 (23.0&#x02013;28.2)</td><td valign="top" align="right" rowspan="1" colspan="1">65.5 (62.6&#x02013;68.3)</td><td valign="top" align="right" rowspan="1" colspan="1">20.7 (18.3&#x02013;23.2)</td><td valign="top" align="right" rowspan="1" colspan="1">33.5 (30.8&#x02013;36.3)</td><td valign="top" align="right" rowspan="1" colspan="1">45.8 (42.9&#x02013;48.8)</td></tr><tr><td valign="bottom" colspan="8" align="left" scope="col" rowspan="1">
<bold>Census region</bold>
</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Northeast</td><td valign="top" align="right" rowspan="1" colspan="1">770</td><td valign="top" align="right" rowspan="1" colspan="1">16.1 (13.3&#x02013;19.3)</td><td valign="top" align="right" rowspan="1" colspan="1">27.0 (23.7&#x02013;30.5)</td><td valign="top" align="right" rowspan="1" colspan="1">56.9 (53.0&#x02013;60.8)</td><td valign="top" align="right" rowspan="1" colspan="1">26.2 (23.0&#x02013;29.8)</td><td valign="top" align="right" rowspan="1" colspan="1">32.7 (29.2&#x02013;36.5)</td><td valign="top" align="right" rowspan="1" colspan="1">41.0 (37.2&#x02013;45.0)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Midwest</td><td valign="top" align="right" rowspan="1" colspan="1">873</td><td valign="top" align="right" rowspan="1" colspan="1">14.7 (12.1&#x02013;17.7)</td><td valign="top" align="right" rowspan="1" colspan="1">32.5 (29.1&#x02013;36.0)</td><td valign="top" align="right" rowspan="1" colspan="1">52.8 (49.1&#x02013;56.6)</td><td valign="top" align="right" rowspan="1" colspan="1">28.0 (24.7&#x02013;31.6)</td><td valign="top" align="right" rowspan="1" colspan="1">33.4 (30.0&#x02013;37.0)</td><td valign="top" align="right" rowspan="1" colspan="1">38.6 (35.1&#x02013;42.3)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">South</td><td valign="top" align="right" rowspan="1" colspan="1">1,454</td><td valign="top" align="right" rowspan="1" colspan="1">14.8 (12.7&#x02013;17.1)</td><td valign="top" align="right" rowspan="1" colspan="1">32.8 (30.2&#x02013;35.6)</td><td valign="top" align="right" rowspan="1" colspan="1">52.4 (49.5&#x02013;55.3)</td><td valign="top" align="right" rowspan="1" colspan="1">28.8 (26.2&#x02013;31.5)</td><td valign="top" align="right" rowspan="1" colspan="1">33.4 (30.8&#x02013;36.1)</td><td valign="top" align="right" rowspan="1" colspan="1">37.8 (35.1&#x02013;40.7)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">West</td><td valign="top" align="right" rowspan="1" colspan="1">894</td><td valign="top" align="right" rowspan="1" colspan="1">14.8 (12.3&#x02013;17.8)</td><td valign="top" align="right" rowspan="1" colspan="1">26.9 (23.8&#x02013;30.3)</td><td valign="top" align="right" rowspan="1" colspan="1">58.3 (54.5&#x02013;61.9)</td><td valign="top" align="right" rowspan="1" colspan="1">25.1 (21.9&#x02013;28.5)</td><td valign="top" align="right" rowspan="1" colspan="1">32.4 (29.0&#x02013;35.9)</td><td valign="top" align="right" rowspan="1" colspan="1">42.6 (39.0&#x02013;46.2)</td></tr><tr><td valign="bottom" colspan="8" align="left" scope="col" rowspan="1">
<bold>MSA status<xref rid="T1FN4" ref-type="table-fn">d</xref></bold>
</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Nonmetro</td><td valign="top" align="right" rowspan="1" colspan="1">573</td><td valign="top" align="right" rowspan="1" colspan="1">14.1 (11.0&#x02013;18.0)</td><td valign="top" align="right" rowspan="1" colspan="1">33.0 (29.0&#x02013;37.4)</td><td valign="top" align="right" rowspan="1" colspan="1">52.9 (48.3&#x02013;57.4)</td><td valign="top" align="right" rowspan="1" colspan="1">33.2 (28.9&#x02013;37.7)</td><td valign="top" align="right" rowspan="1" colspan="1">32.9 (28.9&#x02013;37.3)</td><td valign="top" align="right" rowspan="1" colspan="1">33.9 (29.6&#x02013;38.4)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Metro</td><td valign="top" align="right" rowspan="1" colspan="1">3,418</td><td valign="top" align="right" rowspan="1" colspan="1">15.2 (13.8&#x02013;16.7)</td><td valign="top" align="right" rowspan="1" colspan="1">29.9 (28.2&#x02013;31.6)</td><td valign="top" align="right" rowspan="1" colspan="1">55.0 (53.1&#x02013;56.9)</td><td valign="top" align="right" rowspan="1" colspan="1">26.3 (24.7&#x02013;28.0)</td><td valign="top" align="right" rowspan="1" colspan="1">33.0 (31.3&#x02013;34.8)</td><td valign="top" align="right" rowspan="1" colspan="1">40.6 (38.8&#x02013;42.5)</td></tr><tr><td valign="bottom" colspan="8" align="left" scope="col" rowspan="1">
<bold>Aerobic physical activity guideline<xref rid="T1FN5" ref-type="table-fn">e</xref></bold>
</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Does not meet</td><td valign="top" align="right" rowspan="1" colspan="1">1,629</td><td valign="top" align="right" rowspan="1" colspan="1">19.1 (16.9&#x02013;21.4)</td><td valign="top" align="right" rowspan="1" colspan="1">41.2 (38.6&#x02013;44.0)</td><td valign="top" align="right" rowspan="1" colspan="1">39.7 (37.0&#x02013;42.4)</td><td valign="top" align="right" rowspan="1" colspan="1">32.3 (29.7&#x02013;34.9)</td><td valign="top" align="right" rowspan="1" colspan="1">33.3 (30.8&#x02013;35.9)</td><td valign="top" align="right" rowspan="1" colspan="1">34.4 (31.8&#x02013;37.0)</td></tr><tr><td valign="top" align="left" scope="row" rowspan="1" colspan="1">Meets</td><td valign="top" align="right" rowspan="1" colspan="1">2,362</td><td valign="top" align="right" rowspan="1" colspan="1">12.1 (10.6&#x02013;13.8)</td><td valign="top" align="right" rowspan="1" colspan="1">22.6 (20.8&#x02013;24.5)</td><td valign="top" align="right" rowspan="1" colspan="1">65.3 (63.1&#x02013;67.4)</td><td valign="top" align="right" rowspan="1" colspan="1">23.8 (21.9&#x02013;25.8)</td><td valign="top" align="right" rowspan="1" colspan="1">32.8 (30.7&#x02013;35.0)</td><td valign="top" align="right" rowspan="1" colspan="1">43.4 (41.2&#x02013;45.7)</td></tr></tbody></table><table-wrap-foot><fn><p>Abbreviation: MSA, metropolitan statistical area.</p></fn><fn id="T1FN1"><label>a</label><p> Some values for responses to statements are Bonferroni adjusted, <italic>P</italic> &#x0003c;.05.</p></fn><fn id="T1FN2"><label>b</label><p> Estimates were weighted using survey weights provided with the data set. Weights were created to match US Current Population Survey proportions for sex, age, household income, race/ethnicity, household size, education, census region, and MSA status before joining the panel. Of 4,107 respondents (unweighted), 116 were excluded for missing data on importance of regular physical activity or living in a walkable community of physical activity level. Unweighted sample sizes by level of agreement in the importance of regular physical activity: 106 disagree strongly; 66 disagree somewhat; 368 neither agree nor disagree; 1,235 somewhat agree; and 2,216 strongly agree. Sample sizes by level of agreement in the importance of a walkable neighborhood: 98 disagree strongly; 162 disagree somewhat; 800 neither agree nor disagree; 1,371 somewhat agree; and 1,560 strongly agree.</p></fn><fn id="T1FN3"><label>c</label><p> Other race/ethnicity includes Hispanic, American Indian or Alaska Native, Asian, and Native Hawaiian and Other Pacific Islander.</p></fn><fn id="T1FN4"><label>d</label><p> A respondent was defined as living in a metro area if that area is in a core-based statistical area that was associated with at least 1 urbanized area having a population of at least 50,000.</p></fn><fn id="T1FN5"><label>e</label><p> Physical activity was assessed by asking how often and for how long the respondent participated in vigorous- and moderate-intensity activities for at least 10 minutes at a time during leisure time in a usual week. Total volume of moderate-intensity&#x02013;equivalent physical activity (min/wk) was calculated as weekly frequency &#x000d7; duration with each minute of vigorous-intensity physical activity multiplied by 2. Total physical activity was classified in 2 categories: meets the aerobic guideline (&#x02265;150 min/wk of moderate-intensity&#x02013;equivalent activity) and does not meet the aerobic guideline.</p></fn></table-wrap-foot></table-wrap><p>Overall, 39.7% of adults (unweighted n = 1,560) strongly agreed it is important to live in a walkable neighborhood (<xref rid="T1" ref-type="table">Table</xref>). Women compared with men, adults who lived in a metropolitan area compared with those living in a nonmetropolitan area, and those who met the aerobic guideline compared with those who did not were more likely to strongly agree that it is important to live in a walkable neighborhood. Prevalence of strong agreement increased linearly as age group (<italic>P</italic> = .007) and education (<italic>P</italic> &#x0003c;.001) increased. </p><p>Overall, 31.2% of adults (unweighted n = 1,227) strongly agreed that it is important to be regularly physically active and live in a walkable neighborhood (<xref ref-type="fig" rid="F1">Figure</xref>). Prevalence of strong agreement that it is important to be regularly physically active and live in a walkable neighborhood was higher among adults meeting the aerobic guideline (37.5%; 95% CI, 35.3%&#x02013;39.7%) than among those who do not meet the guideline (22.2%; 95% CI, 20.0%&#x02013;24.6%).</p><fig id="F1" fig-type="figure" orientation="portrait" position="float"><label>Figure</label><caption><p>Self-reported importance of regular physical activity and of living in a walkable neighborhood for adults overall, for adults meeting the aerobic physical activity guideline, and for adults not meeting the guideline, SummerStyles 2017.</p></caption><table-wrap orientation="portrait" id="d40e734" position="anchor"><table frame="hsides" rules="groups"><col width="207" span="1"/><col width="85" span="1"/><col width="107" span="1"/><col width="111" span="1"/><thead><tr><th rowspan="2" valign="bottom" align="left" scope="col" colspan="1">Statement Response</th><th rowspan="2" valign="bottom" align="center" scope="col" colspan="1">Disagree/Neither Agree nor Disagree, % (95% CI)</th><th valign="bottom" colspan="2" align="center" scope="colgroup" rowspan="1">Agree<hr/>
</th></tr><tr><th valign="bottom" colspan="1" align="center" scope="colgroup" rowspan="1">Somewhat Agree, % (95% CI)</th><th valign="bottom" align="center" scope="col" rowspan="1" colspan="1">Strongly Agree, % (95% CI)</th></tr></thead><tbody><tr><td valign="bottom" colspan="4" align="left" scope="col" rowspan="1">
<bold>Overall</bold>
<break/>
&#x0201c;I think it is important to live in a walkable neighborhood&#x0201d;
</td></tr><tr><td valign="bottom" align="left" scope="row" rowspan="1" colspan="1">With importance of regular physical activity &#x02014;Disagree/Neither Agree nor Disagree</td><td valign="top" align="right" rowspan="1" colspan="1">11.5 (10.3&#x02013;12.7)</td><td valign="top" align="right" rowspan="1" colspan="1">2.1 (1.7&#x02013;2.7)</td><td valign="top" align="right" rowspan="1" colspan="1">1.4 (1.0&#x02013;1.9)</td></tr><tr><td valign="bottom" align="left" scope="row" rowspan="1" colspan="1">With importance of regular physical activity &#x02014;Somewhat Agree</td><td valign="top" align="right" rowspan="1" colspan="1">7.4 (6.5&#x02013;8.3)</td><td valign="top" align="right" rowspan="1" colspan="1">15.8 (14.6&#x02013;17.2)</td><td valign="top" align="right" rowspan="1" colspan="1">7.1 (6.3&#x02013; 8.0)</td></tr><tr><td valign="bottom" align="left" scope="row" rowspan="1" colspan="1">With importance of regular physical activity &#x02014;Strongly Agree</td><td valign="top" align="right" rowspan="1" colspan="1">8.5 (7.6&#x02013;9.5)</td><td valign="top" align="right" rowspan="1" colspan="1">15.0 (13.9&#x02013;16.3)</td><td valign="top" align="right" rowspan="1" colspan="1">31.2 (29.6&#x02013;32.8)</td></tr><tr><td valign="bottom" colspan="4" align="left" scope="col" rowspan="1">
<bold>Do not meet aerobic guideline</bold>
<break/>&#x0201c;I think it is important to live in a walkable neighborhood&#x0201d;</td></tr><tr><td valign="bottom" align="left" scope="row" rowspan="1" colspan="1">With importance of regular physical activity &#x02014;Disagree/Neither Agree nor Disagree</td><td valign="top" align="right" rowspan="1" colspan="1">14.2 (12.3&#x02013;16.4)</td><td valign="top" align="right" rowspan="1" colspan="1">2.8 (2.1&#x02013;3.8)</td><td valign="top" align="right" rowspan="1" colspan="1">2.1 (1.4&#x02013;3.1)</td></tr><tr><td valign="bottom" align="left" scope="row" rowspan="1" colspan="1">With importance of regular physical activity &#x02014;Somewhat Agree</td><td valign="top" align="right" rowspan="1" colspan="1">11.4 (9.8&#x02013;13.2)</td><td valign="top" align="right" rowspan="1" colspan="1">19.8 (17.7&#x02013;2.0)</td><td valign="top" align="right" rowspan="1" colspan="1">10.1 (8.6&#x02013;11.8)</td></tr><tr><td valign="bottom" align="left" scope="row" rowspan="1" colspan="1">With importance of regular physical activity &#x02014;Strongly Agree</td><td valign="top" align="right" rowspan="1" colspan="1">6.7 (5.4&#x02013;8.1)</td><td valign="top" align="right" rowspan="1" colspan="1">10.8 (9.2, 12.5)</td><td valign="top" align="right" rowspan="1" colspan="1">22.2 (20.0&#x02013;24.6)</td></tr><tr><td valign="bottom" colspan="4" align="left" scope="col" rowspan="1">
<bold>Meet aerobic guideline</bold>
<break/>&#x0201c;I think it is important to live in a walkable neighborhood&#x0201d;</td></tr><tr><td valign="bottom" align="left" scope="row" rowspan="1" colspan="1">With importance of regular physical activity &#x02014;Disagree/Neither Agree nor Disagree</td><td valign="top" align="right" rowspan="1" colspan="1">9.5 (8.2&#x02013;11.1)</td><td valign="top" align="right" rowspan="1" colspan="1">1.7 (1.1&#x02013;2.5)</td><td valign="top" align="right" rowspan="1" colspan="1">0.9 (0.6&#x02013;1.5)</td></tr><tr><td valign="bottom" align="left" scope="row" rowspan="1" colspan="1">With importance of regular physical activity &#x02014;Somewhat Agree</td><td valign="top" align="right" rowspan="1" colspan="1">4.5 (3.7&#x02013;5.5)</td><td valign="top" align="right" rowspan="1" colspan="1">13.1 (11.6&#x02013;14.7)</td><td valign="top" align="right" rowspan="1" colspan="1">5.0 (4.1&#x02013;6.1)</td></tr><tr><td valign="bottom" align="left" scope="row" rowspan="1" colspan="1">With importance of regular physical activity &#x02014;Strongly Agree</td><td valign="top" align="right" rowspan="1" colspan="1">9.7 (8.5&#x02013;11.1)</td><td valign="top" align="right" rowspan="1" colspan="1">18.1 (16.4&#x02013;19.8)</td><td valign="top" align="right" rowspan="1" colspan="1">37.5 (35.3&#x02013;39.7)</td></tr></tbody></table></table-wrap><graphic xlink:href="PCD-17-E168s01"/></fig></sec><sec sec-type="discussion"><title>Discussion</title><p>An estimated 55% of adults strongly agreed that it is important to engage in regular physical activity, 40% strongly agreed that a walkable neighborhood is important, and 31% strongly agreed that both are important. Similar to our findings, an earlier study estimated 52% of adults identified physical inactivity as an important risk factor, and higher physical activity levels were generally associated with greater perceived importance (<xref rid="R8" ref-type="bibr">8</xref>). Some subgroups identified as less physically active in an earlier study, including those with lower education status (<xref rid="R9" ref-type="bibr">9</xref>), were also less likely to strongly agree on the importance of our measures. Tailoring promotion strategies for subgroups may be important to consider (<xref rid="R10" ref-type="bibr">10</xref>). For example, organizations can provide access to programs that help participants overcome barriers to participation, and campaign activities can be designed to resonate with specific audiences (<xref rid="R2" ref-type="bibr">2</xref>).</p><p>Multiple national initiatives promote the benefits of physical activity and walkable communities. Move Your Way, the promotional campaign for the Physical Activity Guidelines for Americans, 2nd edition, provides materials highlighting the importance of physical activity (<xref rid="R1" ref-type="bibr">1</xref>,<xref rid="R4" ref-type="bibr">4</xref>). Step It Up, The Surgeon General&#x02019;s Call to Action to Promote Walking and Walkable Communities, calls on Americans and partners working across sectors to support walking and walkability for people of all ages and abilities (<xref rid="R2" ref-type="bibr">2</xref>). For example, people can participate in planning processes to support walkability in their communities, and the transportation, land use, and community design sectors can help to ensure an equitable distribution of the benefits of walkability (<xref rid="R2" ref-type="bibr">2</xref>). Active People, Healthy Nation, an initiative led by the Centers for Disease Control and Prevention to help 27 million Americans become more physically active by 2027 (<xref rid="R3" ref-type="bibr">3</xref>,<xref rid="R5" ref-type="bibr">5</xref>), encourages people to explore the health benefits of physical activity and learn how to be a part of creating a more active America (<xref rid="R5" ref-type="bibr">5</xref>). Several evidence-based strategies to improve walkability in communities are highlighted in the initiative, including activity-friendly routes to everyday destinations (<xref rid="R5" ref-type="bibr">5</xref>,<xref rid="R11" ref-type="bibr">11</xref>).</p><p>Our study has at least 2 limitations. First, sample selection bias might be associated with use of data from a panel of volunteers, which might limit generalizability of our results. Weighting our data to US Census Bureau proportions, however, might help address this concern. Second, physical activity was self-reported, and reporting bias may have resulted in overestimates of physical activity (<xref rid="R12" ref-type="bibr">12</xref>). </p><p>The health benefits of physical activity are well established. Our findings suggest that opportunities exist to strengthen adult perceptions about the importance of regular physical activity and walkable neighborhoods, especially among adults who do not meet the aerobic physical activity guideline.</p></sec></body><back><ack><title>Acknowledgments</title><p>No funding was obtained for this study. The authors have no financial relationships relevant to this study and no conflicts of interest to disclose. No borrowed materials, copyrighted surveys, instruments, or tools were used for this research brief. The findings and conclusions in this brief are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.</p></ack><fn-group><fn><p>The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions.</p></fn><fn><p>
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