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Shannon Gwin, PhD CHES, Krista Kezbers, PhD, Julie Miller-Cribbs MSW, PhD, Frances Wen, PhD, Martina Jelley, MD, MSPH FACP, Kim Coon, EdD; University of Oklahoma School of Community Medicine–Tulsa, Oklahoma

PURPOSE: Adverse childhood experiences have been linked to poor health behaviors and outcomes. The purpose of this exploratory study was to examine the relationship between adverse childhood experiences (ACEs) and exercise habits in underserved adults in ambulatory clinics and early childhood education programs. A secondary objective was to provide further detail on individual explanations for lack of exercise participation. METHODS: In 2012, a survey was designed and distributed to 682 individuals from primary care facilities (patients) and early childhood education programs(parents) located in a Midwestern city. The survey was intended to assess the health risk behaviors of an underserved population and included items related to health risk behaviors, engagement in exercise, reasoning for not exercising, and ACEs scores. A chi-square test of independence was conducted to examine whether exercise participation differed by level of ACEs scores. Reasons for not exercising were examined by a thematic approach to identify recurrent barriers to exercise. RESULTS: Overall ACEs were related to health risk behaviors (i.e., whether or not an individual ate out, ate fast food, and exercised) (p=0.000), meaning the higher the ACEs, the higher the health risk behaviors. However, exercise alone was not related to ACEs. 50%of participants reported they were not engaging in regular exercise. A sub-analysis revealed reasons for not participating in exercise which included health problems (e.g., orthopedic concerns, pain, disabilities and mental health problems), lack of time, lack of motivation, work, and family obligations. CONCLUSIONS: Exercise has been shown to reduce risks of chronic disease and improve quality of life for individuals managing chronic diseases. This study highlights potential barriers to exercise for individuals reporting ACEs. Exercise may play a vital role in helping individuals with ACEs decrease stress hormones and increase endorphins, which have been shown to boost people’s mood. Learning more about the impact of exercise involvement in people with ACEs is crucial in helping these groups improve and maintain health. Future studies should focus on assessing the effects of ACEs on barriers to regular exercise and reducing those barriers in this population with high risk of chronic disease.

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