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Associations between Perceived Neighborhood Walkability and Walking Time, Wellbeing, and Loneliness in Community-Dwelling Older Chinese People in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101199. [PMID: 28991205 PMCID: PMC5664700 DOI: 10.3390/ijerph14101199] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 11/17/2022]
Abstract
This study examined the cross-sectional associations between perceived neighborhood walkability and walking time, physical activity, wellbeing, and loneliness, and examined which components of walkability were most strongly associated with better wellbeing and less loneliness in older adults. Participants were community-dwelling Chinese adults aged 60+ (n = 181). Walkability was measured using nine items selected from the Chinese version of the abbreviated Neighborhood Environment Walkability Scales (NEWS) and NEWS for Chinese Seniors. Outcomes were walking time, physical activity, wellbeing (life satisfaction, happiness, sense of purpose and meaning in life), and loneliness. The mean age of the participants was 71.7 ± 7.8 years. Walkability was positively associated with walking time (p = 0.001, p for trend <0.001) but not with physical activity. After adjusting for socio-demographic characteristics, health conditions, lifestyle, and negative life events, those who perceived their neighborhoods as walkable had higher scores for life satisfaction (p = 0.002) and happiness (p = 0.002), and lower scores for loneliness (p = 0.019), compared with those who perceived their neighborhoods as less walkable. However, perceived neighborhood walkability was not associated with sense of purpose and meaning in life. Among components of walkability, land use mix-access, infrastructure and safety for walking, and traffic safety showed the strongest associations with the measures of wellbeing. The results of this study support the importance of neighborhood walkability for health behavior and wellbeing of older adults. The wellbeing of older adults may be enhanced through the improvement of land use mix-access, infrastructure for walking, and traffic safety.
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502
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Mayne DJ, Morgan GG, Jalaludin BB, Bauman AE. The contribution of area-level walkability to geographic variation in physical activity: a spatial analysis of 95,837 participants from the 45 and Up Study living in Sydney, Australia. Popul Health Metr 2017; 15:38. [PMID: 28974226 PMCID: PMC5627488 DOI: 10.1186/s12963-017-0149-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 08/25/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Individual-level studies support a positive relation between walkable built environments and participation in moderate-intensity walking. However, the utility of this evidence for population-level planning is less clear as it is derived at much finer spatial scales than those used for regional programming. The aims of this study were to: evaluate if individual-level relations between walkability and walking to improve health manifest at population-level spatial scales; assess the specificity of area-level walkability for walking relative to other moderate and vigorous physical activity (MVPA); describe geographic variation in walking and other MVPA; and quantify the contribution of walkability to this variation. METHODS Data on sufficient walking, sufficient MVPA, and high MVPA to improve health were analyzed for 95,837 Sydney respondents to the baseline survey of the 45 and Up Study between January 2006 and April 2010. We used conditional autoregressive models to create smoothed MVPA "disease maps" and assess relations between sufficient MVPA to improve health and area-level walkability adjusted for individual-level demographic, socioeconomic, and health factors, and area-level relative socioeconomic disadvantage. RESULTS Within-cohort prevalence of meeting recommendations for sufficient walking, sufficient MVPA, and high MVPA were 31.7 (95% CI 31.4-32.0), 69.4 (95% CI 69.1-69.7), and 56.1 (95% CI 55.8-56.4) percent. Prevalence of sufficient walking was increased by 1.20 (95% CrI 1.12-1.29) and 1.07 (95% CrI 1.01-1.13) for high and medium-high versus low walkability postal areas, and for sufficient MVPA by 1.05 (95% CrI 1.01-1.08) for high versus low walkability postal areas. Walkability was not related to high MVPA. Postal area walkability explained 65.8 and 47.4 percent of residual geographic variation in sufficient walking and sufficient MVPA not attributable to individual-level factors. CONCLUSIONS Walkability is associated with area-level prevalence and geographic variation in sufficient walking and sufficient MVPA to improve health in Sydney, Australia. Our study supports the use of walkability indexes at multiple spatial scales for informing population-level action to increase physical activity and the utility of spatial analysis for walkability research and planning.
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Affiliation(s)
- Darren J. Mayne
- Sydney School of Public Health, The University of Sydney, Camperdown, 2006 NSW Australia
- Public Health Unit, Illawarra Shoalhaven Local Health District, Warrawong, 2502 NSW Australia
- Graduate School of Medicine, University of Wollongong, Wollongong, 2500 NSW Australia
- Illawarra Health and Medical Research Institute, Wollongong, 2500 NSW Australia
| | - Geoffrey G. Morgan
- University Centre for Rural Health - North Coast, School of Public Health, The University of Sydney, Camperdown, 2006 NSW Australia
| | - Bin B. Jalaludin
- Ingham Institute, University of New South Wales, Sydney, 2052 NSW Australia
- Epidemiology, Healthy People and Places Unit, Population Health, South Western Sydney Local Health District, Liverpool, 1871 NSW Australia
| | - Adrian E. Bauman
- Sydney School of Public Health, The University of Sydney, Camperdown, 2006 NSW Australia
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503
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Sarkar C, Webster C, Gallacher J. Association between adiposity outcomes and residential density: a full-data, cross-sectional analysis of 419 562 UK Biobank adult participants. Lancet Planet Health 2017; 1:e277-e288. [PMID: 29851626 DOI: 10.1016/s2542-5196(17)30119-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/23/2017] [Accepted: 09/18/2017] [Indexed: 05/10/2023]
Abstract
BACKGROUND Obesity is a major health issue and an important public health target for urban design. However, the evidence for identifying the optimum residential density in relation to obesity has been far from compelling. We examined the association of obesity with residential density in a large and diverse population sample drawn from the UK Biobank to identify healthy-weight-sustaining density environments. METHODS For this full-data, cross-sectional analysis, we used UK Biobank data for adult men and women aged 37-73 years from 22 cities across the UK. Baseline examinations were done between 2006 and 2010. Residential unit density was objectively assessed within a 1 km street catchment of a participant's residence. Other activity-influencing built environment factors were measured in terms of density of retail, public transport, and street-level movement density, which were modelled from network analyses of through movement of street links within the defined catchment. We regressed adiposity indicators of body-mass index (BMI; kg/m2), waist circumference (cm), whole body fat (kg), and obesity (WHO criteria of BMI ≥30 kg/m2) on residential density (units per km2), adjusting for activity-influencing built environment factors and individual covariates. We also investigated effect modification by age, sex, employment status, and physical activity. We used a series of linear continuous and logistic regression models and non-linear restricted cubic spline models as appropriate. FINDINGS Of 502 649 adults in the prospective cohort, 419 562 (83·5%) participants across 22 UK Biobank assessment centres met baseline data requirements and were included in the analytic sample. The fitted restricted cubic spline adiposity-residential density dose-response curve identified a turning point at a residential density of 1800 residential units per km2. Below a residential density of 1800 units per km2, an increment of 1000 units per km2 was positively related with adiposity, being associated with higher BMI (β 0·19 kg/m2, 95% CI 0·14 to 0·24), waist circumference (β 0·41 cm, 0·28 to 0·54), and whole body fat (β 0·40 kg, 0·30 to 0·50), and with increased odds of obesity (odds ratio [OR] 1·10, 1·07 to 1·14). Beyond 1800 units per km2, residential density had a protective effect on adiposity and was associated with lower BMI (β -0·22 kg/m2, -0·25 to -0·20), waist circumference (β -0·54 cm, -0·61 to -0·48), and whole body fat (β -0·38 kg, -0·43 to -0·33), and with decreased odds of obesity (OR 0·91, 0·90 to 0·93). Subgroup analyses identified more pronounced protective effects of residential density among individuals who were younger, female, in employment, and accumulating higher levels of physical activity, except in the case of whole body fat, for which the protective effects were stronger in men. INTERPRETATION Housing-level policy related to the optimisation of healthy density in cities might be a potential upstream-level public health intervention towards the minimisation and offsetting of obesity; however, further research based on accumulated prospective data is necessary for evidencing specific pathways. The findings might mean that governments, such as the UK Government, who are attempting to prevent suburban densification by, for example, prohibiting the subdivision of single lot housing and the conversion of domestic gardens to housing lots, will potentially have the effect of inhibiting the conversion of suburbs into more healthy places to live. FUNDING University of Hong Kong, UK Biobank, and UK Economic & Social Research Council.
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Affiliation(s)
- Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - John Gallacher
- Healthy High Density Cities Lab, HKUrbanLab, University of Hong Kong, Hong Kong Special Administrative Region, China; Department of Psychiatry, Oxford University, Warneford Hospital, Oxford, UK
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504
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Schipperijn J, Cerin E, Adams MA, Reis R, Smith G, Cain K, Christiansen LB, van Dyck D, Gidlow C, Frank LD, Mitáš J, Pratt M, Salvo D, Schofield G, Sallis JF. Access to parks and physical activity: an eight country comparison. URBAN FORESTRY & URBAN GREENING 2017; 27:253-263. [PMID: 29805351 PMCID: PMC5967254 DOI: 10.1016/j.ufug.2017.08.010] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Several systematic reviews have reported mixed associations between access to parks and physical activity, and suggest that this is due to inconsistencies in the study methods or differences across countries. An international study using consistent methods is needed to investigate the association between access to parks and physical activity. The International Physical Activity and Environment Network (IPEN) Adult Study is a multi-country cross-sectional study using a common design and consistent methods. Accelerometer, survey and Geographic Information Systems (GIS) data for 6,181 participants from 12 cities in 8 countries (Belgium, Brazil, Czech Republic, Denmark, Mexico, New Zealand, UK, USA) were used to estimate the strength and shape of associations of 11 measures of park access (1 perceived and 10 GIS-based measures) with accelerometer-based moderate-to-vigorous physical activity (MVPA) and four types of self-reported leisure-time physical activity. Associations were estimated using generalized additive mixed models. More parks within 1 km from participants' homes were associated with greater leisure-time physical activity and accelerometer-measured MVPA. Respondents who lived in the neighborhoods with the most parks did on average 24 minutes more MVPA per week than those living in the neighborhoods with the lowest number of parks. Perceived proximity to a park was positively associated with multiple leisure-time physical activity outcomes. Associations were homogeneous across all cities studied. Living in neighborhoods with many parks could contribute with up to 1/6 of the recommended weekly Having multiple parks nearby was the strongest positive correlate of PA. To increase comparability and validity of park access measures, we recommend that researchers, planners and policy makers use the number of parks within 1 km travel distance of homes as an objective indicator for park access in relation to physical activity.
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Affiliation(s)
- Jasper Schipperijn
- Research Unit for Active Living, Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Marc A Adams
- School of Nutrition and Health Promotion and Global Institute of Sustainability, Arizona State University, Tempe, AZ, USA
| | - Rodrigo Reis
- Prevention Research Center, Brown School, Washington University in St Louis, St Louis, MS, USA
- Federal University of Parana, Curitiba, Brazil
| | | | - Kelli Cain
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Lars B Christiansen
- Research Unit for Active Living, Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Delfien van Dyck
- Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
- Research Foundation Flanders, Brussels, Belgium
| | - Christopher Gidlow
- Center for Sport, Health and Exercise Research, Staffordshire University, Stoke-on-Trent, UK
| | - Lawrence D Frank
- Health and Community Design Lab, Schools of Population and Public Health and Community and Regional Planning, University of British Columbia, Vancouver, Canada
| | - Josef Mitáš
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University, Czech Republic
| | - Michael Pratt
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Deborah Salvo
- Department of Epidemiology, Human Genetics, and Environmental Sciences, & Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health, Austin Regional Campus, Austin, TX, USA
- Center for Nutrition and Health Research, National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | - Grant Schofield
- Human Potential Centre, Auckland University of Technology, New Zealand
| | - James F Sallis
- Department of Family Medicine and Public Health, University of California, San Diego, USA
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505
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Neighborhood Built Environment and Socioeconomic Status in Relation to Active Commuting to School in Children. J Phys Act Health 2017; 14:761-765. [DOI: 10.1123/jpah.2017-0033] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background:The role of neighborhood type in active commuting to school (ACS) has not been extensively studied in children. The purpose of this study was to analyze the association between neighborhood built environment (walkability) and neighborhood socioeconomic status (SES) with ACS among children.Methods:A cross-sectional study of 310 Spanish children (aged 10–12 y; 51% male) was conducted in 2015. Walkability was defined as an index of 3 built environment characteristics (ie, residential density, land-use mix, and street connectivity) based on geographical information system data. Children’s home and school neighborhoods were evaluated. ACS was evaluated by questionnaire. Mixed model regression analyses evaluated ACS in relation to neighborhood walkability and SES.Results:There were no significant SES–walkability interactions for ACS. Children living in more walkable neighborhoods reported 2.5 more trips per week compared with those living in less walkable neighborhoods (P < .001). Children attending schools located in lower SES neighborhoods reported more ACS trips per week than those attending schools in higher SES neighborhoods (P < .05).Conclusions:Home-neighborhood walkability and school-neighborhood SES were associated with ACS. This study highlights the importance of assessing children’s home environment and school environment when ACS behavior is analyzed.
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506
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Salvo D, Sarmiento OL, Reis RS, Hino AAF, Bolivar MA, Lemoine PD, Gonçalves PB, Pratt M. Where Latin Americans are physically active, and why does it matter? Findings from the IPEN-adult study in Bogota, Colombia; Cuernavaca, Mexico; and Curitiba, Brazil. Prev Med 2017; 103S:S27-S33. [PMID: 27609744 PMCID: PMC5337454 DOI: 10.1016/j.ypmed.2016.09.007] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/06/2016] [Accepted: 09/04/2016] [Indexed: 11/26/2022]
Abstract
Latin America (LA) has a unique structural, political, cultural and social environment. This study aimed to identify the places where Latin American adults are physically active; and to determine the association of using public- and restricted-access places with physical activity (PA). We used data from the International PA Environment Network study in Bogota, Colombia (n=1000, accelerometry=249); Cuernavaca, Mexico (n=677, accelerometry=652); and Curitiba, Brazil (n=697, accelerometry=331) (2010-2011). Walking and moderate-to-vigorous PA for leisure were measured with the International Physical Activity Questionnaire. Overall PA and PA within 10-minute bouts were measured with accelerometers. Participants reported use of public- and restricted-access places for PA. Mixed-effects regression models were used to determine the association of using public- and restricted-access places with PA. The streets were the most frequently-reported place for PA, and walking was the most common PA in the studied places. 'Informal', non-exercise-or-sports places (e.g., shopping malls) ranked high for use for PA in Bogota and Cuernavaca. In Curitiba, use of 'formal' places for sports/exercise (e.g., gyms) was more prevalent. Using public-access places was directly related to walking for leisure in all cities, and to additional PA outcomes in Bogota and Cuernavaca. In Cuernavaca and Curitiba, using restricted-access places was also associated with PA. Our study highlights the importance of public-access places for PA in LA. In some contexts, places for social interaction may be as important for PA as places for exercise/sport. Strategies increasing the availability, accessibility and quality of these places may effectively promote PA in LA.
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Affiliation(s)
- Deborah Salvo
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin, TX, USA.
| | - Olga L Sarmiento
- Schools of Medicine and Government, Universidad de los Andes, Bogotá, Colombia
| | - Rodrigo S Reis
- School of Health and Biosciences, Pontifical Catholic University of Parana, Curitiba, Brazil; Federal University of Parana, Curitiba, Brazil
| | - Adriano A F Hino
- School of Health and Biosciences, Pontifical Catholic University of Parana, Curitiba, Brazil
| | - Manuel A Bolivar
- Schools of Medicine and Government, Universidad de los Andes, Bogotá, Colombia; Center for Optimization and Applied Probability (COPA), Universidad de los Andes, Bogotá, Colombia
| | - Pablo D Lemoine
- Schools of Medicine and Government, Universidad de los Andes, Bogotá, Colombia
| | - Priscilla B Gonçalves
- School of Health and Biosciences, Pontifical Catholic University of Parana, Curitiba, Brazil; Federal University of Parana, Curitiba, Brazil
| | - Michael Pratt
- Institute of Public Health, Department of Family Medicine and Public Health, School of Medicine, University of California, San Diego, San Diego, CA, USA
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507
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Adlakha D, Hipp JA, Brownson RC, A Eyler A, K Lesorogol C, Raghavan R. "Can we walk?" Environmental supports for physical activity in India. Prev Med 2017; 103S:S81-S89. [PMID: 27663431 DOI: 10.1016/j.ypmed.2016.09.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 09/05/2016] [Accepted: 09/19/2016] [Indexed: 11/29/2022]
Abstract
India is currently facing a non-communicable disease epidemic. Physical activity (PA) is a preventative factor for non-communicable diseases. Understanding the role of the built environment (BE) to facilitate or constrain PA is essential for public health interventions to increase population PA. The objective of this study was to understand BEs associations with PA occurring in two major life domains or life areas-travel and leisure-in urban India. Between December 2014 and April 2015, in-person surveys were conducted with participants (N=370; female=47.2%) in Chennai, India. Perceived BE characteristics regarding residential density, land use mix-diversity, land use mix-access, street connectivity, infrastructure for walking and bicycling, aesthetics, traffic safety, and safety from crime were measured using the adapted Neighborhood Environment Walkability Scale-India (NEWS-India). Self-reported PA was measured the International Physical Activity Questionnaire. High residential density was associated with greater odds of travel PA (aOR=1.9, 95% CI=1.2, 3.2). Land use mix-diversity was positively related to travel PA (aOR=2.1, 95%CI=1.2, 3.6), but not associated with leisure or total PA. The aggregate NEWS-India score predicted a two-fold increase in odds of travel PA (aOR=1.9, 95% CI=1.1, 3.1) and a 40% decrease in odds of leisure PA (aOR=0.6, 95% CI=0.4, 1.0). However, the association of the aggregated score with leisure PA was not significant. Results suggest that relationships between BE and PA in low-and-middle income countries may be context-specific, and may differ markedly from higher income countries. Findings have public health implications for India suggesting that caution should be taken when translating evidence across countries.
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Affiliation(s)
- Deepti Adlakha
- Brown School, Washington University in St. Louis, St. Louis, MO, USA.
| | - J Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, Center for Geospatial Analytics, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Ross C Brownson
- Brown School, Washington University in St. Louis, St. Louis, MO, USA; Prevention Research Center in St. Louis, Washington University in St. Louis, St. Louis, MO, USA; Division of Public Health Sciences and Alvin J. Siteman Cancer Center, School of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Amy A Eyler
- Brown School, Washington University in St. Louis, St. Louis, MO, USA; Prevention Research Center in St. Louis, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Ramesh Raghavan
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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508
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Living Close to Natural Outdoor Environments in Four European Cities: Adults' Contact with the Environments and Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101162. [PMID: 28974010 PMCID: PMC5664663 DOI: 10.3390/ijerph14101162] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 09/18/2017] [Accepted: 09/21/2017] [Indexed: 01/08/2023]
Abstract
This study investigated whether residential availability of natural outdoor environments (NOE) was associated with contact with NOE, overall physical activity and physical activity in NOE, in four different European cities using objective measures. A nested cross-sectional study was conducted in Barcelona (Spain); Stoke-on-Trent (United Kingdom); Doetinchem (The Netherlands); and Kaunas (Lithuania). Smartphones were used to collect information on the location and physical activity (overall and NOE) of around 100 residents of each city over seven days. We used Geographic Information Systems (GIS) to determine residential NOE availability (presence/absence of NOE within 300 m buffer from residence), contact with NOE (time spent in NOE), overall PA (total physical activity), NOE PA (total physical activity in NOE). Potential effect modifiers were investigated. Participants spent around 40 min in NOE and 80 min doing overall PA daily, of which 11% was in NOE. Having residential NOE availability was consistently linked with higher NOE contact during weekdays, but not to overall PA. Having residential NOE availability was related to NOE PA, especially for our Barcelona participants, people that lived in a city with low NOE availability.
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509
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Springer AE, Evans AE, Ortuño J, Salvo D, Varela Arévalo MT. Health by Design: Interweaving Health Promotion into Environments and Settings. Front Public Health 2017; 5:268. [PMID: 29043248 PMCID: PMC5632521 DOI: 10.3389/fpubh.2017.00268] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/19/2017] [Indexed: 01/06/2023] Open
Abstract
The important influence of the environmental context on health and health behavior—which includes place, settings, and the multiple environments within place and settings—has directed health promotion planners from a focus solely on changing individuals, toward a focus on harnessing and changing context for individual and community health promotion. Health promotion planning frameworks such as Intervention Mapping provide helpful guidance in addressing various facets of the environmental context in health intervention design, including the environmental factors that influence a given health condition or behavior, environmental agents that can influence a population’s health, and environmental change methods. In further exploring how to harness the environmental context for health promotion, we examine in this paper the concept of interweaving of health promotion into context, defined as weaving or blending together health promotion strategies, practices, programs, and policies to fit within, complement, and build from existing settings and environments. Health promotion interweaving stems from current perspectives in health intervention planning, improvement science and complex systems thinking by guiding practitioners from a conceptualization of context as a backdrop to intervention, to one that recognizes context as integral to the intervention design and to the potential to directly influence health outcomes. In exploring the general approach of health promotion interweaving, we examine selected theoretical and practice-based interweaving concepts in relation to four key environments (the policy environment, the information environment, the social/cultural/organizational environment, and the physical environment), followed by evidence-based and practice-based examples of health promotion interweaving from the literature. Interweaving of health promotion into context is a common practice for health planners in designing health promotion interventions, yet one which merits further intentionality as a specific health promotion planning design approach.
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Affiliation(s)
- Andrew E Springer
- Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health-Austin, Michael & Susan Dell Center for Healthy Living, Austin, TX, United States
| | - Alexandra E Evans
- Health Promotion and Behavioral Sciences, University of Texas Health Science Center at Houston School of Public Health-Austin, Michael & Susan Dell Center for Healthy Living, Austin, TX, United States
| | - Jaquelin Ortuño
- St. Edward's University, Austin, TX, United States.,Michael & Susan Dell Center for Healthy Living, University of Texas Health Science Center at Houston School of Public Health-Austin, Austin, TX, United States
| | - Deborah Salvo
- Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health-Austin/Michael & Susan Dell Center for Healthy Living, Austin, TX, United States.,Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
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510
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Hinckson E, Schneider M, Winter SJ, Stone E, Puhan M, Stathi A, Porter MM, Gardiner PA, dos Santos DL, Wolff A, King AC. Citizen science applied to building healthier community environments: advancing the field through shared construct and measurement development. Int J Behav Nutr Phys Act 2017; 14:133. [PMID: 28962580 PMCID: PMC5622546 DOI: 10.1186/s12966-017-0588-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 09/13/2017] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND Physical inactivity across the lifespan remains a public health issue for many developed countries. Inactivity has contributed considerably to the pervasiveness of lifestyle diseases. Government, national and local agencies and organizations have been unable to systematically, and in a coordinated way, translate behavioral research into practice that makes a difference at a population level. One approach for mobilizing multi-level efforts to improve the environment for physical activity is to engage in a process of citizen science. Citizen Science here is defined as a participatory research approach involving members of the public working closely with research investigators to initiate and advance scientific research projects. However, there are no common measures or protocols to guide citizen science research at the local community setting. OBJECTIVES We describe overarching categories of constructs that can be considered when designing citizen science projects expected to yield multi-level interventions, and provide an example of the citizen science approach to promoting PA. We also recommend potential measures across different levels of impact. DISCUSSION Encouraging some consistency in measurement across studies will potentially accelerate the efficiency with which citizen science participatory research provides new insights into and solutions to the behaviorally-based public health issues that drive most of morbidity and mortality. The measures described in this paper abide by four fundamental principles specifically selected for inclusion in citizen science projects: feasibility, accuracy, propriety, and utility. The choice of measures will take into account the potential resources available for outcome and process evaluation. Our intent is to emphasize the importance for all citizen science participatory projects to follow an evidence-based approach and ensure that they incorporate an appropriate assessment protocol. CONCLUSIONS We provided the rationale for and a list of contextual factors along with specific examples of measures to encourage consistency among studies that plan to use a citizen science participatory approach. The potential of this approach to promote health and wellbeing in communities is high and we hope that we have provided the tools needed to optimally promote synergistic gains in knowledge across a range of Citizen Science participatory projects.
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Affiliation(s)
- Erica Hinckson
- Auckland University of Technology, Faculty of Health and Environmental Sciences, National Institute of Public and Mental Health, Centre for Child Health Research Centre for Active Ageing, Private Bag, 92006 Auckland, New Zealand
| | - Margaret Schneider
- Department of Planning, Policy and Design, School of Social Ecology, University of California, Irvine, Irvine, CA USA
| | - Sandra J. Winter
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA USA
| | - Emily Stone
- University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - Milo Puhan
- University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | | | - Michelle M. Porter
- University of Manitoba, Faculty of Kinesiology and Recreation Management, Centre on Aging, Winnipeg, Canada
| | - Paul A. Gardiner
- The University of Queensland, Faculty of Medicine, Brisbane, Australia
| | | | - Andrea Wolff
- Friedrich-Alexander University Erlangen, Institute of Sport Science and Sport (ISS), Nuremberg, Germany
| | - Abby C. King
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA USA
- Division Of Epidemiology, Department Of Health Research & Policy, Stanford University School Of Medicine, Stanford, CA USA
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511
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Lim KK, Kwan YH, Tan CS, Low LL, Chua AP, Lee WY, Pang L, Tay HY, Chan SY, Ostbye T. The association between distance to public amenities and cardiovascular risk factors among lower income Singaporeans. Prev Med Rep 2017; 8:116-121. [PMID: 29021948 PMCID: PMC5633842 DOI: 10.1016/j.pmedr.2017.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 08/21/2017] [Accepted: 09/09/2017] [Indexed: 01/05/2023] Open
Abstract
Existing evidence on the association between built environment and cardiovascular disease (CVD) risk factors focused on the general population, which may not generalize to higher risk subgroups such as those with lower socio-economic status (SES). We examined the associations between distance to 5 public amenities from residential housing (public polyclinic, subsidized private clinic, healthier eatery, public park and train station) and 12 CVD risk factors (physical inactivity, medical histories and unhealthy dietary habits) among a study sample of low income Singaporeans aged ≥ 40 years (N = 1972). Using data from the Singapore Heart Foundation Health Mapping Exercise 2013–2015, we performed a series of logistic mixed effect regressions, accounting for clustering of respondents in residential blocks and multiple comparisons. Each regression analysis used the minimum distance (in km) between residential housing and each public amenity as an independent continuous variable and a single risk factor as the dependent variable, controlling for demographic characteristics. Increased distance (geographical inaccessibility) to a train station was significantly associated with lower odds of participation in sports whereas greater distance to a subsidized private clinic was associated with lower odds of having high cholesterol diagnosed. Increasing distance to park was positively associated with higher odds of less vegetable and fruits consumption, deep fried food and fast food consumption in the preceding week/month, high BMI at screening and history of diabetes, albeit not achieving statistical significance. Our findings highlighted potential effects of health-promoting amenities on CVD risk factors in urban low-income setting, suggesting gaps for further investigations. We examined associations between access to 5 amenities and 12 CVD risk factors. Only 2/60 associations were statistically significant. Poorer access to train station was associated with lower odds of sports. Poorer access to primary care was associated with lower high cholesterol diagnosis.
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Affiliation(s)
- K K Lim
- Health Systems & Services Research, Duke NUS Medical School, Republic of Singapore
| | - Y H Kwan
- Health Systems & Services Research, Duke NUS Medical School, Republic of Singapore
| | - C S Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Republic of Singapore
| | - L L Low
- Department of Family Medicine & Continuing Care, Singapore General Hospital, Republic of Singapore
| | - A P Chua
- Department of Medicine, Ng Teng Fong General Hospital, 1 Jurong East Street 21, 609606, Republic of Singapore
| | - W Y Lee
- Saw Swee Hock School of Public Health, National University of Singapore, Republic of Singapore.,Department of Medical Informatics, Jurong Health Services, 1 Jurong East Street 21, 609606, Republic of Singapore
| | - L Pang
- Saw Swee Hock School of Public Health, National University of Singapore, Republic of Singapore
| | - H Y Tay
- Singapore Heart Foundation, 9 Bishan Place #07-01 Junction 8 (Office Tower), 579837, Republic of Singapore
| | - S Y Chan
- Department of Pharmacy, Faculty of Science, National University of Singapore, Block S4A, Level 3, 18 Science Drive 4, 117543, Republic of Singapore
| | - T Ostbye
- Health Systems & Services Research, Duke NUS Medical School, Republic of Singapore
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512
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Arbillaga-Etxarri A, Gimeno-Santos E, Barberan-Garcia A, Benet M, Borrell E, Dadvand P, Foraster M, Marín A, Monteagudo M, Rodriguez-Roisin R, Vall-Casas P, Vilaró J, Garcia-Aymerich J. Socio-environmental correlates of physical activity in patients with chronic obstructive pulmonary disease (COPD). Thorax 2017; 72:796-802. [PMID: 28250201 PMCID: PMC5738536 DOI: 10.1136/thoraxjnl-2016-209209] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 01/12/2017] [Accepted: 02/05/2017] [Indexed: 01/21/2023]
Abstract
BACKGROUND Study of the causes of the reduced levels of physical activity in patients with COPD has been scarce and limited to biological factors. AIM To assess the relationship between novel socio-environmental factors, namely dog walking, grandparenting, neighbourhood deprivation, residential surrounding greenness and residential proximity to green or blue spaces, and amount and intensity of physical activity in COPD patients. METHODS This cross-sectional study recruited 410 COPD patients from five Catalan municipalities. Dog walking and grandparenting were assessed by questionnaire. Neighbourhood deprivation was assessed using the census Urban Vulnerability Index, residential surrounding greenness by the satellite-derived Normalized Difference Vegetation Index, and residential proximity to green or blue spaces as living within 300 m of such a space. Physical activity was measured during 1 week by accelerometer to assess time spent on moderate-to-vigorous physical activity (MVPA) and vector magnitude units (VMU) per minute. FINDINGS Patients were 85% male, had a mean (SD) age of 69 (9) years, and post-bronchodilator FEV1 of 56 (17) %pred. After adjusting for age, sex, socio-economic status, dyspnoea, exercise capacity and anxiety in a linear regression model, both dog walking and grandparenting were significantly associated with an increase both in time in MVPA (18 min/day (p<0.01) and 9 min/day (p<0.05), respectively) and in physical activity intensity (76 VMU/min (p=0.05) and 59 VMUs/min (p<0.05), respectively). Neighbourhood deprivation, surrounding greenness and proximity to green or blue spaces were not associated with physical activity. CONCLUSIONS Dog walking and grandparenting are associated with a higher amount and intensity of physical activity in COPD patients. TRIAL REGISTRATION NUMBER Pre-results, NCT01897298.
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Affiliation(s)
- Ane Arbillaga-Etxarri
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Physical Activity and Sports Sciences, Faculty of Psychology and Education, University of Deusto, Donostia-San Sebastián, Spain
| | - Elena Gimeno-Santos
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Anael Barberan-Garcia
- Respiratory Clinic Institute, Hospital Clinic of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Marta Benet
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - Payam Dadvand
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Maria Foraster
- Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Alicia Marín
- Pneumology Department, Hospital Germans Trias i Pujol, CIBER Respiratory Diseases (CIBERES), Badalona, Spain
| | - Mònica Monteagudo
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
- Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain
| | - Robert Rodriguez-Roisin
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Pere Vall-Casas
- Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Jordi Vilaró
- FCS Blanquerna, Research Group on Health, Physical Activity and Sport (SAFE), Ramon Llull University, Barcelona, Spain
| | - Judith Garcia-Aymerich
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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513
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Hobbs M, Green MA, Griffiths C, Jordan H, Saunders J, Grimmer H, McKenna J. Access and quality of parks and associations with obesity: A cross-sectional study. SSM Popul Health 2017; 3:722-729. [PMID: 29349259 PMCID: PMC5769035 DOI: 10.1016/j.ssmph.2017.07.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2017] [Revised: 07/20/2017] [Accepted: 07/21/2017] [Indexed: 12/30/2022] Open
Abstract
Public health is increasingly engaging with multi-faceted obesity prevention efforts. Although parks represent key community assets for broader public health, they may not be distributed equitably and associations with obesity are equivocal. We investigated park access and quality relative to deprivation and obesity with individual-level data from the Yorkshire Health Study. Compared to the least deprived areas, the moderately and most deprived areas had a greater park access and park quality in terms of features and amenities. However, parks in the moderately and most deprived areas also had the most safety concerns and incivilities. Although deprivation was associated with obesity, contrary to current policy guidance, both park access and quality appear less important for understanding variations in obesity within this study. Although sub-group analyses by deprivation tertile revealed that low quality park amenities in highly and moderately deprived areas may be important for understanding obesity prevalence, all other associations were non-significant.
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Affiliation(s)
- M Hobbs
- Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK.,School of Social and Health Sciences, Leeds Trinity University, LS18 5HD, UK
| | - Mark A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - C Griffiths
- Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
| | - H Jordan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - J Saunders
- Carnegie, Leeds Beckett University, Leeds LS6 3QS, UK
| | - H Grimmer
- Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
| | - J McKenna
- Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
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514
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Roswall N, Ammitzbøll G, Christensen JS, Raaschou-Nielsen O, Jensen SS, Tjønneland A, Sørensen M. Residential exposure to traffic noise and leisure-time sports – A population-based study. Int J Hyg Environ Health 2017; 220:1006-1013. [DOI: 10.1016/j.ijheh.2017.05.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 05/16/2017] [Accepted: 05/18/2017] [Indexed: 12/11/2022]
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515
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Kerr J, Anderson C, Lippman SM. Physical activity, sedentary behaviour, diet, and cancer: an update and emerging new evidence. Lancet Oncol 2017; 18:e457-e471. [PMID: 28759385 PMCID: PMC10441558 DOI: 10.1016/s1470-2045(17)30411-4] [Citation(s) in RCA: 363] [Impact Index Per Article: 51.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 04/21/2017] [Accepted: 04/27/2017] [Indexed: 12/11/2022]
Abstract
The lifestyle factors of physical activity, sedentary behaviour, and diet are increasingly being studied for their associations with cancer. Physical activity is inversely associated with and sedentary behaviour is positively (and independently) associated with an increased risk of more than ten types of cancer, including colorectal cancer (and advanced adenomas), endometrial cancers, and breast cancer. The most consistent dietary risk factor for premalignant and invasive breast cancer is alcohol, whether consumed during early or late adult life, even at low levels. Epidemiological studies show that the inclusion of wholegrain, fibre, fruits, and vegetables within diets are associated with reduced cancer risk, with diet during early life (age <8 years) having the strongest apparent association with cancer incidence. However, randomised controlled trials of diet-related factors have not yet shown any conclusive associations between diet and cancer incidence. Obesity is a key contributory factor associated with cancer risk and mortality, including in dose-response associations in endometrial and post-menopausal breast cancer, and in degree and duration of fatty liver disease-related hepatocellular carcinoma. Obesity produces an inflammatory state, characterised by macrophages clustered around enlarged hypertrophied, dead, and dying adipocytes, forming crown-like structures. Increased concentrations of aromatase and interleukin 6 in inflamed breast tissue and an increased number of macrophages, compared with healthy tissue, are also observed in women with normal body mass index, suggesting a metabolic obesity state. Emerging randomised controlled trials of physical activity and dietary factors and mechanistic studies of immunity, inflammation, extracellular matrix mechanics, epigenetic or transcriptional regulation, protein translation, circadian disruption, and interactions of the multibiome with lifestyle factors will be crucial to advance this field.
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Affiliation(s)
- Jacqueline Kerr
- Moores Cancer Center, University of California, La Jolla, San Diego, CA, USA; Department of Family Medicine and Public Health, University of California, La Jolla, San Diego, CA, USA
| | - Cheryl Anderson
- Moores Cancer Center, University of California, La Jolla, San Diego, CA, USA; Department of Family Medicine and Public Health, University of California, La Jolla, San Diego, CA, USA
| | - Scott M Lippman
- Moores Cancer Center, University of California, La Jolla, San Diego, CA, USA; Department of Medicine, University of California, La Jolla, San Diego, CA, USA.
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516
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Salvo D, Banda JA, Sheats JL, Winter SJ, Lopes Dos Santos D, King AC. Impacts of a Temporary Urban Pop-Up Park on Physical Activity and Other Individual- and Community-Level Outcomes. J Urban Health 2017; 94:470-481. [PMID: 28646369 PMCID: PMC5533666 DOI: 10.1007/s11524-017-0167-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Physical inactivity is a known risk factor for obesity and a number of chronic diseases. Modifying the physical features of neighborhoods to provide residents with equitable and convenient access to spaces for physical activity (PA) is a promising strategy for promoting PA. Public urban recreation spaces (e.g., parks) play an important role in promoting PA and are potentially an important neighborhood element for optimizing social capital and liveability in cities. Most studies examining the effects of park availability and use on PA have focused on traditional, permanent parks. The aims of this study were to (1) document patterns of park use and park-based PA at a temporary urban pop-up park implemented in the downtown business district of Los Altos, California during July-August 2013 and May-June 2014, (2) identify factors associated with park-based PA in 2014, and (3) examine the effects of the 2014 pop-up park on additional outcomes of potential benefit for park users and the Los Altos community at large. Park use remained high during most hours of the day in 2013 and 2014. Although the park attracted a multigenerational group of users, children and adolescents were most likely to engage in walking or more vigorous PA at the park. Park presence was significantly associated with potentially beneficial changes in time-allocation patterns among users, including a reduction in screen-time and an increase in overall park-time and time spent outdoors. Park implementation resulted in notable use among people who would otherwise not be spending time at a park (85% of surveyed users would not be spending time at any other park if the pop-up park was not there-2014 data analysis). Our results (significantly higher odds of spending time in downtown Los Altos due to park presence) suggest that urban pop-up parks may also have broader community benefits, such as attracting people to visit downtown business districts. Pending larger, confirmatory studies, our results suggest that temporary urban pop-up parks may contribute to solving the limited access to public physical activity recreation spaces many urban residents face.
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Affiliation(s)
- Deborah Salvo
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth), School of Public Health, Austin Campus, 1616 Guadalupe St, Suite 6.300, Austin, TX, 78701, USA.
- Center for Nutrition and Health Research, National Institute of Public Health of Mexico, Cuernavaca, Morelos, Mexico.
| | - Jorge A Banda
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Jylana L Sheats
- Department of Global Community Health & Behavioral Sciences, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, USA
| | - Sandra J Winter
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Daniela Lopes Dos Santos
- Department of Methods and Sports Techniques, Universidade Federal de Santa Maria, Santa Maria, RS, Brazil
| | - Abby C King
- Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, USA
- Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
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517
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Mendonça G, Florindo AA, Rech CR, Freitas DKSD, Farias Júnior JCD. Perceived neighborhood environmental characteristics and different types of physical activity among Brazilian adolescents. J Sports Sci 2017; 36:1068-1075. [DOI: 10.1080/02640414.2017.1356024] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Gerfeson Mendonça
- Associate Graduate Program in Physical Education - UPE/UFPB, Joao Pessoa, Brazil
- Research Study Group in the Epidemiology of Physical Activity - GEPEAF, Joao Pessoa, Brazil
| | | | | | | | - José Cazuza de Farias Júnior
- Associate Graduate Program in Physical Education - UPE/UFPB, Joao Pessoa, Brazil
- Research Study Group in the Epidemiology of Physical Activity - GEPEAF, Joao Pessoa, Brazil
- Federal University of Paraiba - UFPB, Joao Pessoa, Brazil
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518
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Althoff T, Sosič R, Hicks JL, King AC, Delp SL, Leskovec J. Large-scale physical activity data reveal worldwide activity inequality. Nature 2017; 547:336-339. [PMID: 28693034 PMCID: PMC5774986 DOI: 10.1038/nature23018] [Citation(s) in RCA: 490] [Impact Index Per Article: 70.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 06/06/2017] [Indexed: 12/14/2022]
Abstract
To be able to curb the global pandemic of physical inactivity and the associated 5.3 million deaths per year, we need to understand the basic principles that govern physical activity. However, there is a lack of large-scale measurements of physical activity patterns across free-living populations worldwide. Here we leverage the wide usage of smartphones with built-in accelerometry to measure physical activity at the global scale. We study a dataset consisting of 68 million days of physical activity for 717,527 people, giving us a window into activity in 111 countries across the globe. We find inequality in how activity is distributed within countries and that this inequality is a better predictor of obesity prevalence in the population than average activity volume. Reduced activity in females contributes to a large portion of the observed activity inequality. Aspects of the built environment, such as the walkability of a city, are associated with a smaller gender gap in activity and lower activity inequality. In more walkable cities, activity is greater throughout the day and throughout the week, across age, gender, and body mass index (BMI) groups, with the greatest increases in activity found for females. Our findings have implications for global public health policy and urban planning and highlight the role of activity inequality and the built environment in improving physical activity and health.
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Affiliation(s)
- Tim Althoff
- Computer Science Department, Stanford University, Stanford, California, USA
| | - Rok Sosič
- Computer Science Department, Stanford University, Stanford, California, USA
| | - Jennifer L Hicks
- Department of Bioengineering, Stanford University, Stanford, California, USA
| | - Abby C King
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, USA.,Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Scott L Delp
- Department of Bioengineering, Stanford University, Stanford, California, USA.,Department of Mechanical Engineering, Stanford University, Stanford, California, USA
| | - Jure Leskovec
- Computer Science Department, Stanford University, Stanford, California, USA.,Chan Zuckerberg Biohub, San Francisco, California, USA
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519
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Islami F, Miller KD, Siegel RL, Fedewa SA, Ward EM, Jemal A. Disparities in liver cancer occurrence in the United States by race/ethnicity and state. CA Cancer J Clin 2017; 67:273-289. [PMID: 28586094 DOI: 10.3322/caac.21402] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Accepted: 04/25/2017] [Indexed: 12/11/2022] Open
Abstract
Liver cancer is highly fatal, and death rates in the United States are increasing faster than for any other cancer, having doubled since the mid-1980s. In 2017, it is estimated that the disease will account for about 41,000 new cancer cases and 29,000 cancer deaths in the United States. In this article, data from the Surveillance, Epidemiology, and End Results (SEER) Program and the National Center for Health Statistics are used to provide an overview of liver cancer incidence, mortality, and survival rates and trends, including data by race/ethnicity and state. The prevalence of major risk factors for liver cancer is also reported based on national survey data from the Centers for Disease Control and Prevention. Despite the improvement in liver cancer survival in recent decades, only 1 in 5 patients survives 5 years after diagnosis. There is substantial disparity in liver cancer death rates by race/ethnicity (from 5.5 per 100,000 in non-Hispanic whites to 11.9 per 100,000 in American Indians/Alaska Natives) and state (from 3.8 per 100,000 in North Dakota to 9.6 per 100,000 in the District of Columbia) and by race/ethnicity within states. Differences in risk factor prevalence account for much of the observed variation in liver cancer rates. Thus, in contrast to the growing burden, a substantial proportion of liver cancer deaths could be averted, and existing disparities could be dramatically reduced, through the targeted application of existing knowledge in prevention, early detection, and treatment, including improvements in vaccination against hepatitis B virus, screening and treatment for chronic hepatitis C virus infections, maintaining a healthy body weight, access to high-quality diabetes care, preventing excessive alcohol drinking, and tobacco control, at both the state and national levels. CA Cancer J Clin 2017;67:273-289. © 2017 American Cancer Society.
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Affiliation(s)
- Farhad Islami
- Strategic Director, Cancer Surveillance Research, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Kimberly D Miller
- Epidemiologist, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Rebecca L Siegel
- Strategic Director, Surveillance Information Services, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Stacey A Fedewa
- Strategic Director, Risk Factors and Screening Surveillance, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
| | - Elizabeth M Ward
- Senior Vice President, Intramural Research, American Cancer Society, Atlanta, GA
| | - Ahmedin Jemal
- Vice President, Surveillance and Health Services Research, American Cancer Society, Atlanta, GA
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520
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Webel AR, Perazzo JD, Dawson-Rose C, Smith C, Nicholas PK, Rivero-Méndez M, Solís-Báez SS, Eller LS, Johnson MO, Corless IB, Lindgren T, Holzemer WL, Kemppainen JK, Reid P, Mogobe KD, Matshediso E, Nokes K, Portillo CJ. A multinational qualitative investigation of the perspectives and drivers of exercise and dietary behaviors in people living with HIV. Appl Nurs Res 2017; 37:13-18. [PMID: 28985914 DOI: 10.1016/j.apnr.2017.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 06/07/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
Abstract
Globally, people living with HIV (PLWH) are at remarkably high risk for developing chronic comorbidities. While exercise and healthy eating reduce and mitigate chronic comorbidites, PLWH like many others, often fail to engage in recommended levels. We qualitatively examined the perspectives and contextual drivers of diet and exercise reported by PLWH and their health care providers. Two hundred and six participants across eight sites in the United States, Puerto Rico and Botswana described one overarching theme, Arranging Priorities, and four subthemes Defining Health, Perceived Importance of Diet and Exercise, Competing Needs, and Provider Influence. People living with HIV and their health care providers recognize the importance of eating a healthy diet and engaging in regular exercise. Yet there are HIV-specific factors limiting these behaviors that should be addressed. Health care providers have an important, and often underutilized opportunity to support PLWH to make improvements to their exercise and diet behavior.
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Affiliation(s)
- Allison R Webel
- Case Western Reserve University, Frances Payne Bolton School of Nursing, 10900 Euclid Avenue Cleveland, OH 44122, USA.
| | - Joseph D Perazzo
- Case Western Reserve University, Frances Payne Bolton School of Nursing, 10900 Euclid Avenue Cleveland, OH 44122, USA
| | - Carol Dawson-Rose
- University of California San Francisco, School of Nursing, Dept. of Community Health Systems San Francisco, CA, USA
| | - Carolyn Smith
- Case Western Reserve University, Frances Payne Bolton School of Nursing, 10900 Euclid Avenue Cleveland, OH 44122, USA
| | - Patrice K Nicholas
- Brigham and Women's Hospital and MGH Institute of Health Professions Boston, USA
| | | | | | | | - Mallory O Johnson
- University of California San Francisco, School of Nursing, Dept. of Community Health Systems San Francisco, CA, USA
| | - Inge B Corless
- Brigham and Women's Hospital and MGH Institute of Health Professions Boston, USA
| | | | | | | | - Paula Reid
- University of North Carolina Wilmington Wilmington, NC, USA
| | | | - Ella Matshediso
- Faculty of Health Sciences University of Botswana, 00712, Gaborone, Botswana
| | | | - Carmen J Portillo
- University of California San Francisco, School of Nursing, Dept. of Community Health Systems San Francisco, CA, USA
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521
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Kline L, Jones-Smith J, Jaime Miranda J, Pratt M, Reis RS, Rivera JA, Sallis JF, Popkin BM. A research agenda to guide progress on childhood obesity prevention in Latin America. Obes Rev 2017; 18 Suppl 2:19-27. [PMID: 28741906 PMCID: PMC5560467 DOI: 10.1111/obr.12572] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 05/03/2017] [Indexed: 11/27/2022]
Abstract
Childhood obesity rates in Latin America are among the highest in the world. This paper examines and evaluates the many efforts underway in the region to reduce and prevent further increases in obesity, identifies and discusses unique research challenges and opportunities in Latin America, and proposes a research agenda in Latin America for the prevention of childhood obesity and concomitant non-communicable diseases. Identified research gaps include biological challenges to healthy growth across the life cycle, diet and physical activity dynamics, community interventions promoting healthy child growth, and rigorous evaluation of national food and activity programs and regulatory actions. Addressing these research gaps is critical to advance the evidence-based policy and practice in childhood obesity tailored to the Latin American context that will be effective in addressing obesity.
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Affiliation(s)
- L Kline
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | - J Jones-Smith
- Department of Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - J Jaime Miranda
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - M Pratt
- University of California, San Diego School of Medicine, Institute for Public Health, La Jolla, CA, USA
| | - R S Reis
- George Warren Brown School of Social Work, Washington University in St. Louis, Saint Louis, MO, USA
| | - J A Rivera
- National Institute of Public Health, Cuernavaca, Mexico
| | - J F Sallis
- Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - B M Popkin
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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522
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Browning M, Lee K. Within What Distance Does "Greenness" Best Predict Physical Health? A Systematic Review of Articles with GIS Buffer Analyses across the Lifespan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017. [PMID: 28644420 PMCID: PMC5551113 DOI: 10.3390/ijerph14070675] [Citation(s) in RCA: 151] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Is the amount of "greenness" within a 250-m, 500-m, 1000-m or a 2000-m buffer surrounding a person's home a good predictor of their physical health? The evidence is inconclusive. We reviewed Web of Science articles that used geographic information system buffer analyses to identify trends between physical health, greenness, and distance within which greenness is measured. Our inclusion criteria were: (1) use of buffers to estimate residential greenness; (2) statistical analyses that calculated significance of the greenness-physical health relationship; and (3) peer-reviewed articles published in English between 2007 and 2017. To capture multiple findings from a single article, we selected our unit of inquiry as the analysis, not the article. Our final sample included 260 analyses in 47 articles. All aspects of the review were in accordance with PRISMA guidelines. Analyses were independently judged as more, less, or least likely to be biased based on the inclusion of objective health measures and income/education controls. We found evidence that larger buffer sizes, up to 2000 m, better predicted physical health than smaller ones. We recommend that future analyses use nested rather than overlapping buffers to evaluate to what extent greenness not immediately around a person's home (i.e., within 1000-2000 m) predicts physical health.
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Affiliation(s)
- Matthew Browning
- Department of Recreation, Sport and Tourism, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA.
- Illinois Informatics Institute, University of Illinois at Urbana-Champaign, Champaign, IL 61802, USA.
| | - Kangjae Lee
- Illinois Informatics Institute, University of Illinois at Urbana-Champaign, Champaign, IL 61802, USA.
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523
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Politis CE, Mowat DL, Keen D. Pathways to policy: Lessons learned in multisectoral collaboration for physical activity and built environment policy development from the Coalitions Linking Action and Science for Prevention (CLASP) initiative. Canadian Journal of Public Health 2017. [PMID: 28621656 DOI: 10.17269/cjph.108.5758] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The Canadian Partnership Against Cancer funded 12 large-scale knowledge to action cancer and chronic disease prevention projects between 2009 and 2016 through the Coalitions Linking Action and Science for Prevention (CLASP) initiative. Two projects, Healthy Canada by Design (HCBD) and Children's Mobility, Health and Happiness (CMHH), developed policies to address physical activity and the built environment through a multisectoral approach. A qualitative analysis involving a review of 183 knowledge products and 8 key informant interviews was conducted to understand what policy changes occurred, and the underlying critical success factors, through these projects. SETTING Both projects worked at the local level to change physical activity and built environment policy in 203 sites, including municipalities and schools. Both projects brought multisectoral expertise (e.g., public health, land use planning, transportation engineering, education, etc.) together to inform the development of local healthy public policy in the areas of land use, transportation and school travel planning. INTERVENTION Through the qualitative analysis of the knowledge products and key informant interviews, 163 policies were attributed to HCBD and CMHH work. OUTCOMES Fourteen "pathways to policy" were identified as critical success factors facilitating and accelerating the development and implementation of physical activity and built environment policy. Of the 14 pathways to policy, 8 had a focus on multisectoral collaboration. IMPLICATIONS The lessons learned from the CLASP experience could support enhanced multisectoral collaborations to accelerate the development and implementation of physical activity and built environment policy in new jurisdictions across Canada and internationally.
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524
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The Recreovía of Bogotá, a Community-Based Physical Activity Program to Promote Physical Activity among Women: Baseline Results of the Natural Experiment Al Ritmo de las Comunidades. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14060633. [PMID: 28608844 PMCID: PMC5486319 DOI: 10.3390/ijerph14060633] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/29/2017] [Accepted: 06/04/2017] [Indexed: 11/17/2022]
Abstract
Community-based physical activity (PA) programs in Latin America have been recognized because of the use of available environmental resources to offer PA classes. Yet, the evaluation of programs focused on PA classes involving dancing in public spaces is limited. The aim of this study was to assess the physical activity levels, park use, and the contextual characteristics of public parks with and without the Recreovía in Bogotá in Colombia. Al Ritmo de las Comunidades is a natural experiment conducted in nine parks (3 parks implementing new Recreovías, 3 control parks and 3 parks with existing Recreovías) during 2013. We used the System for Observing Play and Recreation in Communities to evaluate park use (gender, age, and physical activity level) and target areas. A total of 4925 people were observed during 702 observation visits to parks. The percentage of women was higher in parks with Recreovía, compared to parks without Recreovía (53% vs. 40% vs. 33%; p < 0.001). Women using parks with Recreovía compared to women in parks without Recreovía were less likely to be sedentary (25% vs. 39%; p < 0.0001) and more likely to engage in moderate-to-vigorous activity (75% vs. 61%; p < 0.0001). Among men, the activity pattern was the opposite. The Recreovía is a promising strategy to promote park use and PA, especially among women who are less likely to meet PA recommendations during their leisure time. The provision of a cost-free community program may be an effective approach and a good investment for health.
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525
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Hamer M, Aggio D, Knock G, Kipps C, Shankar A, Smith L. Effect of major school playground reconstruction on physical activity and sedentary behaviour: Camden active spaces. BMC Public Health 2017; 17:552. [PMID: 28592241 PMCID: PMC5463303 DOI: 10.1186/s12889-017-4483-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 06/01/2017] [Indexed: 11/23/2022] Open
Abstract
Background The physical school environment is a promising setting to increase children’s physical activity although robust evidence is sparse. We examined the effects of major playground reconstruction on physical activity and sedentary time in primary schools using a quasi-experimental design (comparison group pre-test/post-test design). Methods Five experimental and two control schools from deprived areas of inner city London were recruited at baseline. Main outcome was physical activity and sedentary time measured from objective monitoring (Actigraph accelerometer) at one year follow up. Pupils’ impressions of the new playground were qualitatively assessed post construction. Results A total of 347 pupils (mean age = 8 years, 55% boys; 36% Caucasian) were recruited into the study at baseline; 303 provided valid baseline Actigraph data. Of those, 231 (76%) completed follow-up (n = 169 intervention; n = 62 control) and 77.4% of the sample recorded at least 4 days of Actigraph wear. In mixed models adjusted for age, sex, ethnicity, ratio activity or sedentary/wear time at baseline, wear time at follow up, and school, no differences were observed in total moderate – vigorous activity (B = −1.4, 95% CI, −7.1, 4.2 min/d), light activity (B = 4.1, 95% CI, −17.9, 26.1), or sedentary time (B = −3.8, 95% CI, −29.2, 21.6 min/d) between groups. There were significant age interactions for sedentary (p = 0.002) and light intensity physical activity (p = 0.008). We observed significant reductions in total sedentary (−28.0, 95% CI, −1.9, −54.1 min/d, p = 0.037) and increases in total light intensity activity (24.6, 95% CI, 0.3, 48.9 min/d, p = 0.047) for children aged under 9 yrs. old in the intervention. Conclusion Major playground reconstruction had limited effects on physical activity, but reduced sedentary time was observed in younger children. Qualitative data suggested that the children enjoyed the new playgrounds and experienced a perceived positive change in well-being and social interactions. Electronic supplementary material The online version of this article (doi:10.1186/s12889-017-4483-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mark Hamer
- School of Sport, Exercise & Health Sciences, National Centre for Sport & Exercise Medicine, Loughborough University, Leicestershire, UK. .,Department of Epidemiology & Public Health, University College London, London, UK.
| | - Daniel Aggio
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Georgina Knock
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Courtney Kipps
- Institute Sport, Exercise & Health, University College London Hospital, London, UK
| | - Aparna Shankar
- Population Health Research Institute, St. George's, University of London, London, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Department of Life Sciences, Anglia Ruskin University, Cambridge, UK
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526
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Gullón P, Bilal U, Cebrecos A, Badland HM, Galán I, Franco M. Intersection of neighborhood dynamics and socioeconomic status in small-area walkability: the Heart Healthy Hoods project. Int J Health Geogr 2017; 16:21. [PMID: 28587623 PMCID: PMC5461703 DOI: 10.1186/s12942-017-0095-7] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/31/2017] [Indexed: 11/29/2022] Open
Abstract
Background Previous studies found a complex relationship between area-level socioeconomic status (SES) and walkability. These studies did not include neighborhood dynamics. Our aim was to study the association between area-level SES and walkability in the city of Madrid (Spain) evaluating the potential effect modification of neighborhood dynamics. Methods All census sections of the city of Madrid (n = 2415) were included. Area-level SES was measured using a composite index of 7 indicators in 4 domains (education, wealth, occupation and living conditions). Two neighborhood dynamics factors were computed: gentrification, proxied by change in education levels in the previous 10 years, and neighborhood age, proxied by median year of construction of housing units in the area. Walkability was measured using a composite index of 4 indicators (Residential Density, Population Density, Retail Destinations and Street Connectivity). We modeled the association using linear mixed models with random intercepts. Results Area-level SES and walkability were inversely and significantly associated. Areas with lower SES showed the highest walkability. This pattern did not hold for areas with an increase in education level, where the association was flat (no decrease in walkability with higher SES). Moreover, the association was attenuated in newly built areas: the association was stronger in areas built before 1975, weaker in areas built between 1975 and 1990 and flat in areas built from 1990 on. Conclusion Areas with higher neighborhood socioeconomic status had lower walkability in Madrid. This disadvantage in walkability was not present in recently built or gentrified areas. Electronic supplementary material The online version of this article (doi:10.1186/s12942-017-0095-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pedro Gullón
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain.,Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Usama Bilal
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, 21205, MD, USA
| | - Alba Cebrecos
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain.,Department of Geology, Geography and Environmental Sciences, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain
| | - Hannah M Badland
- Center for Urban Research, RMIT University, Melbourne, 3000, VIC, Australia
| | - Iñaki Galán
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, 28029, Spain
| | - Manuel Franco
- Social and Cardiovascular Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain. .,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, 21205, MD, USA.
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527
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Regis MF, Oliveira LMFTD, Santos ARMD, Leonidio ADCR, Diniz PRB, Freitas CMSMD. Urban versus rural lifestyle in adolescents: associations between environment, physical activity levels and sedentary behavior. EINSTEIN-SAO PAULO 2017; 14:461-467. [PMID: 28076591 PMCID: PMC5221370 DOI: 10.1590/s1679-45082016ao3788] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 10/25/2016] [Indexed: 11/21/2022] Open
Abstract
Objective To analyze the levels of physical activity and sedentary behavior in adolescents living in urban and rural areas. Methods An epidemiological, cross-section study with quantitative design, carried out at the regional level. The sample comprised 6,234 students aged 14 to 19 years, selected using random cluster sampling. The χ2 test and binary logistic regression were used in the analysis. Results A total of 74.5% of adolescents lived in urban areas. After adjustment, rural residents spent less time watching television (odds ratio - OR: 0.45; 95% confidence interval - 95%CI: 0.39-0.52), using a computer and/or playing video games (OR: 0.30; 95%CI: 0.22-0.42), or sitting down (OR: 0.66; 95%CI: 0.54-0.80); chose passive leisure less often (OR: 0.83; 95%IC: 0.72-0.95) and were less likely to be classified as insufficiently active (OR: 0.88; 95%IC: 0.78-0.99) when compared to urban residents, regardless of sex or age. The fact that adolescents living in rural areas who did not work were more likely to be classified as insufficiently active (OR: 2.59; 95%CI: 2.07-3.24) emphasized the significant role of occupation in physical activity levels in this group. Conclusion Adolescents living in rural areas were less exposed to the sedentary behaviors, chose more active leisure, and had higher levels of physical activity. Place of residence and occupation may play a major role in youth lifestyle. Objetivo Analisar os níveis de atividade física e o comportamento sedentário em adolescentes das áreas urbanas e rurais. Métodos Estudo epidemiológico, transversal, com abordagem quantitativa e abrangência estadual, cuja amostra foi constituída por 6.234 estudantes (14 a 19 anos), selecionados por meio de uma estratégia de amostragem aleatória de conglomerados. As análises foram realizadas por meio do teste χ2 e da regressão logística binária. Resultados Na amostra, 74,5% dos adolescentes eram residentes em área urbana. Após o ajuste, constatou-se que os adolescentes oriundos da área rural usavam menos televisão (odds ratio - OR: 0,45; intervalo de confiança de 95% - IC95%: 0,39-0,52), computador e/ou videogame (OR: 0,30; IC95%: 0,22-0,42), passavam menos tempo sentados (OR: 0,66; IC95%: 0,54-0,80), optaram menos pelo lazer passivo (OR: 0,83; IC95%: 0,72-0,95) e tinham menos chances de serem classificados como insuficientes ativos (OR: 0,88; IC95%: 0,78-0,99), quando comparados àqueles que residiam na área urbana, independentemente do sexo e da idade. Os adolescentes da área rural que não trabalhavam apresentaram mais chances de serem classificados como insuficientemente ativos (OR: 2,59; IC95%: 2,07-3,24), mostrando que a ocupação tinha um papel importante no nível de atividade física deste grupo. Conclusão Os adolescentes residentes na área rural estiveram menos expostos aos comportamentos sedentários, optaram mais por um lazer ativo e apresentaram um melhor nível de atividade física, podendo a zona de domicílio e a ocupação influenciar no estilo de vida deles.
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528
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Guilcher SJT, Kaufman-Shriqui V, Hwang J, O'Campo P, Matheson FI, Glazier RH, Booth GL. The association between social cohesion in the neighborhood and body mass index (BMI): An examination of gendered differences among urban-dwelling Canadians. Prev Med 2017; 99:293-298. [PMID: 28232099 DOI: 10.1016/j.ypmed.2017.02.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 01/31/2017] [Accepted: 02/19/2017] [Indexed: 11/16/2022]
Abstract
Overweight and obesity are major global public health concerns. Obesity is multifactorial in origin and influenced by genetics, psychosocial factors, eating and physical activity behaviors, as well as the environment. The objective of this study is to examine the impact of social cohesion on gender differences in body mass index (BMI) for urban-dwelling Canadians. Cross-sectional data were used from the Neighborhood Effects on Health and Well-being Study (NEHW) in Toronto, Canada (n=2300). Our main outcome, BMI, was calculated from self-reported height and weight (weight (kg)/height (m)2). Using multi-level logistic regression models, we identified a significant interaction between social cohesion and gender on being overweight/obese. Women with higher social cohesion had slightly lower odds of being overweight/obese (OR: 0.96, 95%CI: 0.94 to 0.99) compared to men, after adjusting for other sociodemographic factors (e.g., age, income, education), and neighborhood characteristics (e.g., walkability, neighborhood safety and material deprivation). Future public health research and interventions should consider the differential mechanisms involved in overweight/obesity by gender. The exact mechanisms behind how the social environment influences these pathways are still unclear and require future research.
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Affiliation(s)
- Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, M5S 3M2, Canada; Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, M4N 3M5, Canada.
| | | | - Jongnam Hwang
- Department of Health Promotion, Daegu University, Gyeongsan, Republic of Korea
| | - Patricia O'Campo
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario M5T 3M7, Canada
| | - Flora I Matheson
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario M5T 3M7, Canada
| | - Richard H Glazier
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario M5T 3M7, Canada; Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, M5G 1V7, Canada
| | - Gillian L Booth
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, M4N 3M5, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, M5S 1A8, Canada
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529
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Yu Y, Davey R, Cochrane T, Learnihan V, Hanigan IC, Bagheri N. Neighborhood walkability and hospital treatment costs: A first assessment. Prev Med 2017; 99:134-139. [PMID: 28216377 DOI: 10.1016/j.ypmed.2017.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 01/19/2017] [Accepted: 02/13/2017] [Indexed: 10/20/2022]
Abstract
Health system expenditure is a global concern, with hospital cost a major component. Built environment has been found to affect physical activity and health outcomes. The purpose of the study was a first assessment of the relationship between neighborhood walkability and hospital treatment costs. For 88 neighborhoods in the Australian Capital Territory (ACT), 2011-2013, a total of 30,690 public hospital admissions for the treatment of four diagnostic groups (cancers, endocrine, nutritional and metabolic diseases, circulatory diseases and respiratory diseases) were extracted from the ACT admitted patient care database and analyzed in relation to the Walk Score® index as a measure of walkability. Hospital cost was calculated according to the cost weight of the diagnosis related group assigned to each admission. Linear regressions were used to analyze the associations of walkability with hospital cost per person, admissions per person and cost per admission at the neighborhood level. An inverse association with neighborhood walkability was found for cost per person and admissions per person, but not cost per admission. After adjusting for age, sex and socioeconomic status, a 20-unit increase in walkability was associated with 12.1% (95% CI: 7.1-17.0%) lower cost and 12.5% (8.1-17.0%) fewer admissions. These associations did not vary by neighborhood socioeconomic status. This exploratory analysis suggests the potential for improved population health and reduced hospital cost with greater neighborhood walkability. Further research should replicate the analysis with data from other urban settings, and focus on the behavioral mechanisms underlying the inverse walkability-hospital cost association.
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Affiliation(s)
- Yan Yu
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, ACT, Australia; School of Demography, Australian National University, ACT, Australia.
| | - Rachel Davey
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, ACT, Australia
| | - Tom Cochrane
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, ACT, Australia
| | - Vincent Learnihan
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, ACT, Australia
| | - Ivan C Hanigan
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, ACT, Australia
| | - Nasser Bagheri
- School of Population Health, Australian National University, ACT, Australia
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530
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Jaeschke L, Luzak A, Steinbrecher A, Jeran S, Ferland M, Linkohr B, Schulz H, Pischon T. 24 h-accelerometry in epidemiological studies: automated detection of non-wear time in comparison to diary information. Sci Rep 2017; 7:2227. [PMID: 28533553 PMCID: PMC5440390 DOI: 10.1038/s41598-017-01092-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 03/23/2017] [Indexed: 01/12/2023] Open
Abstract
Estimation of physical activity using 24 h-accelerometry requires detection of accelerometer non-wear time (NWT). It is common practice to define NWT as periods >60 minutes of consecutive zero-accelerations, but this algorithm was originally developed for waking hours only and its applicability to 24 h-accelerometry is unclear. We investigated sensitivity and specificity of different algorithms to detect NWT in 24 h-accelerometry compared to diary in 47 ActivE and 559 KORA participants. NWT was determined with algorithms >60, >90, >120, >150, or >180 minutes of consecutive zero-counts. Overall, 9.1% (ActivE) and 15.4% (KORA) of reported NWT was >60 minutes. Sensitivity and specificity were lowest for the 60-min algorithm in ActivE (0.72 and 0.00) and KORA (0.64 and 0.08), and highest for the 180-min algorithm in ActivE (0.88 and 0.92) and for the 120-min algorithm in KORA (0.76 and 0.74). Nevertheless, when applying these last two algorithms, the overlap of accelerometry with any diary based NWT minutes was around 20% only. In conclusion, only a small proportion of NWT is >60 minutes. The 60-min algorithm is less suitable for NWT detection in 24 h-accelerometry because of low sensitivity, specificity, and small overlap with reported NWT minutes. Longer algorithms perform better but detect lower proportions of reported NWT.
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Affiliation(s)
- Lina Jaeschke
- Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Agnes Luzak
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Astrid Steinbrecher
- Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Stephanie Jeran
- Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany
| | - Maike Ferland
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Birgit Linkohr
- Institute of Epidemiology II, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Holger Schulz
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
| | - Tobias Pischon
- Molecular Epidemiology Group, Max Delbrueck Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany. .,Charité - Universitätsmedizin Berlin, Berlin, Germany. .,DZHK (German Center for Cardiovascular Research), partner site Berlin, Germany.
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531
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Pawlowski CS, Winge L, Carroll S, Schmidt T, Wagner AM, Nørtoft KPJ, Lamm B, Kural R, Schipperijn J, Troelsen J. Move the Neighbourhood: Study design of a community-based participatory public open space intervention in a Danish deprived neighbourhood to promote active living. BMC Public Health 2017; 17:481. [PMID: 28526028 PMCID: PMC5438546 DOI: 10.1186/s12889-017-4423-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 05/14/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A limited amount of research has examined the effect of changing public open spaces on active living. This paper will present the study protocol of a community-based intervention study co-designed in an interdisciplinary collaboration with community members to develop urban installations highly tailored to promote active living among children (10-13-years-old) and seniors (>60-years-old) in a deprived neighbourhood in Copenhagen. METHODS The study builds on a quasi-experimental study design with two sub-studies: 1) a children study and 2) a senior study. The interventions will be developed, designed and implemented in collaboration with local children and seniors, respectively, using different co-design tools and methods. We will evaluate the effect of the interventions on children's and senior's use of the new-built urban installations using accelerometers in combination with GPS as well as systematic observation using the System for Observing Play and Recreation in Communities (SOPARC). A process evaluation with focus groups consisting of the various stakeholders in the two sub-studies will be used to gain knowledge of the intervention processes. DISCUSSION The paper presents new approaches in the field of public open space interventions through interdisciplinary collaboration, participatory co-design approach and combination of measurements. Using both effect and process evaluations the study will provide unique insights in the role and importance of the interdisciplinary collaboration, participatory processes, and tailoring changes in public open space to local needs and wishes. These results can be used to guide urban renewal projects in deprived neighbourhoods in the future. TRIAL REGISTRATION Retrospectively registered with study ID ISRCTN50036837 . Date of registration: 16 December 2016.
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Affiliation(s)
- Charlotte Skau Pawlowski
- Research unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Laura Winge
- Research Unit of Landscape Architecture and –Urbanism, Division of Landscape Architecture and Planning, Department of Geosciences and Natural Resource Management, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark
| | - Sidse Carroll
- Institute of Architecture, Urbanism & Landscape, The Royal Danish Academy of Fine Arts, Schools of Architecture, Design, and Conservation, Philip de Langes Allé 10, 1435 Copenhagen K, Denmark
| | - Tanja Schmidt
- Research unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Anne Margrethe Wagner
- Research Unit of Landscape Architecture and –Urbanism, Division of Landscape Architecture and Planning, Department of Geosciences and Natural Resource Management, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark
| | - Kamilla Pernille Johansen Nørtoft
- Institute of Architecture, Urbanism & Landscape, The Royal Danish Academy of Fine Arts, Schools of Architecture, Design, and Conservation, Philip de Langes Allé 10, 1435 Copenhagen K, Denmark
| | - Bettina Lamm
- Research Unit of Landscape Architecture and –Urbanism, Division of Landscape Architecture and Planning, Department of Geosciences and Natural Resource Management, University of Copenhagen, Rolighedsvej 23, 1958 Frederiksberg C, Denmark
| | - René Kural
- Institute of Architecture, Urbanism & Landscape, The Royal Danish Academy of Fine Arts, Schools of Architecture, Design, and Conservation, Philip de Langes Allé 10, 1435 Copenhagen K, Denmark
| | - Jasper Schipperijn
- Research unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Jens Troelsen
- Research unit for Active Living, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
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532
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Fromel K, Kudlacek M, Groffik D, Svozil Z, Simunek A, Garbaciak W. Promoting Healthy Lifestyle and Well-Being in Adolescents through Outdoor Physical Activity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050533. [PMID: 28513541 PMCID: PMC5451984 DOI: 10.3390/ijerph14050533] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/10/2017] [Accepted: 05/10/2017] [Indexed: 01/02/2023]
Abstract
Health-enhancing physical activities (PA) performed outdoors could markedly contribute to the adoption of a healthy lifestyle in adolescence. The differences between PA preferences and actual opportunities for these PA are an issue that has received frequent attention. To date, the extent to which these differences are reflected in adolescents meeting PA recommendations and their well-being has not been explored. In total, 10,086 respondents took part in an on-line research project regarding PA preferences. Of them, 2446 also completed the International Physical Activity Questionnaire (Long Form) and the World Health Organization (WHO) W-5 questionnaire to assess well-being. Finally, 1278 of these respondents were involved in objective PA monitoring using pedometers. The study aimed to explore the prevalence and trends regarding outdoor PA. Moreover, we assessed whether the agreement between preferred PA and PA actually undertaken was associated with higher odds for meeting PA recommendations and achieving a higher level of well-being. Of a selection of outdoor activities, Czech and Polish boys preferred cycling, swimming, and downhill skiing, while girls preferred swimming activities, skating, and cycling. The agreement between preferred and PA actually undertaken was associated with higher odds for meeting the weekly PA recommendations and higher levels of well-being both in boys and girls. Evaluation of outdoor PA preferences and taking these preferred activities into account when forming conditions for them was important in the efficient promotion of the physical and mental health of adolescents.
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Affiliation(s)
- Karel Fromel
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic.
- The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland.
| | - Michal Kudlacek
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic.
| | - Dorota Groffik
- The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland.
| | - Zbynek Svozil
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic.
| | - Adam Simunek
- Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic.
| | - Wieslaw Garbaciak
- The Jerzy Kukuczka Academy of Physical Education, 40-065 Katowice, Poland.
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533
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Niedermeier M, Einwanger J, Hartl A, Kopp M. Affective responses in mountain hiking-A randomized crossover trial focusing on differences between indoor and outdoor activity. PLoS One 2017; 12:e0177719. [PMID: 28520774 PMCID: PMC5433751 DOI: 10.1371/journal.pone.0177719] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 04/27/2017] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Affective responses during physical activity (PA) are important for engagement in PA programs and for adherence to a physically active lifestyle. Little is known about the affective responses to PA bouts lasting longer than 45 minutes. Therefore, the aims of the present study were to analyse acute effects on affective responses of a three-hour outdoor PA intervention (mountain hiking) compared to a sedentary control situation and to an indoor treadmill condition. METHODS Using a randomized crossover design, 42 healthy participants were randomly exposed to three different conditions: outdoor mountain hiking, indoor treadmill walking, and sedentary control situation (approximately three hours each). Measures included the Feeling Scale, Felt Arousal Scale and a Mood Survey Scale. Repeated measures ANOVAs were used to analyse differences between the conditions. RESULTS Compared to the control situation, the participants showed a significant increase in affective valence (d = 1.21, p < .001), activation (d = 0.81, p = .004), elation (d = 1.07, p < .001), and calmness (d = 0.84, p = .004), and a significant decrease in fatigue (d = -1.19, p < .001) and anxiety (d = -.79, p < .001) after mountain hiking. Outdoor mountain hiking showed significantly greater positive effects on affective valence, activation, and fatigue compared to indoor treadmill walking. DISCUSSION The results indicate that a three-hour PA intervention (mountain hiking) elicits higher positive and lower negative affective responses compared to a sedentary control situation and to an indoor PA condition. Outdoor mountain hiking can be recommended by health professionals as a form of PA with the potential to positively influence affective responses. TRIAL REGISTRATION ClinicalTrials.gov NCT02853760. https://clinicaltrials.gov/. Date of registration: 08/02/2016 (retrospectively registered). Date of enrolment of the first participant to the trial: 05/01/2014.
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Affiliation(s)
- Martin Niedermeier
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
- * E-mail:
| | | | - Arnulf Hartl
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | - Martin Kopp
- Department of Sport Science, University of Innsbruck, Innsbruck, Austria
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534
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Perceived Health Benefits and Willingness to Pay for Parks by Park Users: Quantitative and Qualitative Research. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050529. [PMID: 28505123 PMCID: PMC5451980 DOI: 10.3390/ijerph14050529] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 05/01/2017] [Accepted: 05/01/2017] [Indexed: 11/22/2022]
Abstract
Whilst a growing body of evidence demonstrates people derive a range of health and wellbeing benefits from visiting parks, only a limited number of attempts have been made to provide a complementary economic assessment of parks. The aim of this exploratory study was to directly estimate the perceived health and wellbeing benefits attained from parks and the economic value assigned to parks by park users in Victoria, Australia. The research employed a mixed methods approach (survey and interviews) to collect primary data from a selection of 140 park users: 100 from two metropolitan parks in Melbourne and 40 from a park on the urban fringe of Melbourne, Victoria. Our findings suggest that park users derive a range of perceived physical, mental/spiritual, and social health benefits, but park use was predominantly associated with physical health benefits. Overall, our exploratory study findings suggest that park users are willing to pay for parks, as they highly value them as places for exercising, socialising, and relaxing. Importantly, most people would miss parks if they did not exist. The findings aim to provide park managers, public health advocates, and urban policy makers with evidence about the perceived health and wellbeing benefits of park usage and the economic value park visitors place on parks.
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535
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Van Dyck D, Cardon G, De Bourdeaudhuij I. Which psychological, social and physical environmental characteristics predict changes in physical activity and sedentary behaviors during early retirement? A longitudinal study. PeerJ 2017; 5:e3242. [PMID: 28507817 PMCID: PMC5429733 DOI: 10.7717/peerj.3242] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 03/28/2017] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND In the context of healthy ageing, it is necessary to identify opportunities to implement health interventions in order to develop an active lifestyle with sufficient physical activity and limited sedentary time in middle-aged and older adults. The transition to retirement is such an opportunity, as individuals tend to establish new routines at the start of retirement. Before health interventions can be developed, the psychological, social and physical environmental determinants of physical activity and sedentary behaviors during early retirement should be identified, ideally with longitudinal studies. The aim of this paper was first to examine whether psychological, social and physical environmental factors at the start of retirement predict longitudinal changes in physical activity and sedentary behaviors during the first years of retirement. Second, moderating effects of gender and educational levels were examined. METHODS This longitudinal study was conducted in Flanders, Belgium. In total, 180 recently retired (>1 month, <2 years at baseline) adults completed a postal questionnaire twice (in 2012-2013 and two years later in 2014-2015). The validated questionnaire assessed socio-demographic information, physical activity, sedentary behaviors, and psychological, social and physical environmental characteristics. Multiple moderated hierarchic regression analyses were conducted in SPSS 22.0. RESULTS Higher perceived residential density (p < 0.001) and lower aesthetics (p = 0.08) predicted an increase in active transportation (adjusted R2 = 0.18). Higher baseline self-efficacy was associated with an increase in leisure-time physical activity (p = 0.001, adjusted R2 = 0.13). A more positive perception of old age (p = 0.04) and perceiving less street connectivity (p = 0.001) were associated with an increase in screen time (adjusted R2 = 0.06). Finally, higher baseline levels of modeling from friends (p = 0.06) and lower perceived land use mix access (p = 0.09) predicted an increase in car use (adjusted R2 = 0.06). A few moderating effects, mainly of educational level, were found. DISCUSSION Walkability characteristics (perceived residential density) and self-efficacy at the start of retirement are the most important predictors of longitudinal changes in active transportation and leisure-time physical activity. Few moderating effects were found, so health interventions at the start of retirement focusing on self-efficacy and specific walkability characteristics could be effective to increase physical activity in recently retired adults. No firm conclusions can be drawn on the importance of the examined predictors to explain change in car use and screen time, possibly other factors like the home environment, or automatic processes and habit strength are more important to explain sedentary behaviors.
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Affiliation(s)
- Delfien Van Dyck
- Research Foundation Flanders, Brussels, Belgium.,Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Greet Cardon
- Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
| | - Ilse De Bourdeaudhuij
- Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Ghent University, Ghent, Belgium
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536
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Grasser G, van Dyck D, Titze S, Stronegger WJ. A European perspective on GIS-based walkability and active modes of transport. Eur J Public Health 2017; 27:145-151. [PMID: 28013244 DOI: 10.1093/eurpub/ckw118] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background The association between GIS-based walkability and walking for transport is considered to be well established in USA and in Australia. Research on the association between walkability and cycling for transport in European cities is lacking. The aim of this study was to test the predictive validity of established walkability measures and to explore alternative walkability measures associated with walking and cycling for transport in a European context. Methods Outcome data were derived from the representative cross-sectional survey ( n  = 843) ‘Radfreundliche Stadt’ of adults in the city of Graz (Austria). GIS-based walkability was measured using both established measures (e.g. gross population density, household unit density, entropy index, three-way intersection density, IPEN walkability index) and alternative measures (e.g. proportion of mixed land use, four-way intersection density, Graz walkability index). ANCOVAs were conducted to examine the adjusted association between walkability measures and outcomes. Results Household unit density, proportion of mixed land use, three-way intersection density and IPEN walkability index were positively associated with walking for transport, but the other measures were not. All walkability measures were positively associated with cycling for transport. Conclusion The established walkability measures were applicable to a European city such as Graz. The alternative walkability measures performed well in a European context. Due to measurement issues the association between these walkability measures and walking for transport needs to be investigated further.
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Affiliation(s)
- Gerlinde Grasser
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria.,Health Management in Tourism, FH JOANNEUM, University of Applied Sciences, Bad Gleichenberg, Austria
| | - Delfien van Dyck
- Department of Movement and Sport Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Research Foundation Flanders, Brussels, Belgium
| | - Sylvia Titze
- Institute of Sport Science, University of Graz, Graz, Austria
| | - Willibald J Stronegger
- Institute of Social Medicine and Epidemiology, Medical University of Graz, Graz, Austria
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537
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Buscemi S, Giordano C. Physical activity and cardiovascular prevention: Is healthy urban living a possible reality or utopia? Eur J Intern Med 2017; 40:8-15. [PMID: 28215975 DOI: 10.1016/j.ejim.2017.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 02/13/2017] [Indexed: 01/05/2023]
Abstract
Favoring correct lifestyles is the most important measure to contrast cardiovascular diseases and the epidemic of high cardiovascular risk conditions, such as obesity, diabetes, and hypertension. Lifestyle is a broad expression that includes diet, physical exercise, and psychological and socio-economic factors, each of which must be taken into due consideration because of their intertwining influences, which may be a barrier to healthy changes at both the individual and population levels. While physical activity has probably received less attention in the last decades, it is likely the most important among the modifiable risk factors for cardiovascular diseases. Improving the habitual physical activity level is an achievable goal, and even small improvements may have important favorable effects on health. Strategies at the population level have to be urgently taken, and involve not only public health, but also administrators and politicians, starting from a rethinking of our cities.
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Affiliation(s)
- Silvio Buscemi
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS) - University of Palermo, Italy; UOC di Endocrinologia, Malattie del Ricambio e della Nutrizione - AOU Policlinico "P. Giaccone", Palermo, Italy.
| | - Carla Giordano
- Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS) - University of Palermo, Italy; UOC di Endocrinologia, Malattie del Ricambio e della Nutrizione - AOU Policlinico "P. Giaccone", Palermo, Italy
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538
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Weimann H, Rylander L, van den Bosch MA, Albin M, Skärbäck E, Grahn P, Björk J. Perception of safety is a prerequisite for the association between neighbourhood green qualities and physical activity: Results from a cross-sectional study in Sweden. Health Place 2017; 45:124-130. [DOI: 10.1016/j.healthplace.2017.03.011] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 03/17/2017] [Accepted: 03/23/2017] [Indexed: 11/30/2022]
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539
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Psychosocial and Environmental Correlates of Sedentary Behaviors in Spanish Children. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4728924. [PMID: 28536697 PMCID: PMC5425827 DOI: 10.1155/2017/4728924] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 03/31/2017] [Accepted: 04/09/2017] [Indexed: 11/18/2022]
Abstract
Purpose. To evaluate children's psychosocial and environmental factors associated with sedentary behavior (SB). Method. The study involved a total of 420 children (mean 9.2 years; 52.9% girls) from the community of Madrid, Spain. SB and physical activity (PA) were objectively measured using accelerometers. TV viewing and potential correlates were assessed by questionnaire. Mixed-model regression analysis, adjusted for clustering within school locations, evaluated the relation of each independent variable with SBs. Results. Girls showed higher levels of SB than boys, whereas boys reported more TV viewing (p < .001 in all cases). Regression analysis showed that MVPA levels were negatively related to objective SB measurement in both boys and girls (p < .001). Parent and friend support to PA were negatively associated with SB on weekdays in boys and girls, respectively (p < .05). In the boys' group, parental professional level was a positive predictor of SB on weekend days (p = .011). Boys with more positive neighborhood perceptions spent less time watching TV (p < .001), whereas mother's leisure-time PA level was a negative correlate of TV viewing in girls' group (p < .01). Conclusion. Different psychosocial and environmental correlates of SB were identified. Present findings are promising targets for interventions to improve children's health.
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540
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Fujiwara T, Takamoto I, Amemiya A, Hanazato M, Suzuki N, Nagamine Y, Sasaki Y, Tani Y, Yazawa A, Inoue Y, Shirai K, Shobugawa Y, Kondo N, Kondo K. Is a hilly neighborhood environment associated with diabetes mellitus among older people? Results from the JAGES 2010 study. Soc Sci Med 2017; 182:45-51. [PMID: 28412640 DOI: 10.1016/j.socscimed.2017.04.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 04/01/2017] [Accepted: 04/07/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND Although living in a hilly environment may promote muscular activity in the daily lives of residents, and such activity may prevent diabetes mellitus, few studies have focused on the impact of living in a hilly environment on diabetes mellitus. The purpose of this study was to investigate the impact of a hilly neighborhood environment on DM in older people. METHODS We used data from the Japan Gerontological Evaluation Study, a population-based, cross-sectional study of individuals aged 65 or older without long-term care needs in Japan, which was conducted in 2010. A total of 8904 participants in 46 neighborhoods had responded to the questionnaire and undergone a health check. Diabetes mellitus was diagnosed as HbA1c ≥ 6.5% and those undergoing treatment for diabetes mellitus. Poorly controlled diabetes mellitus was diagnosed in those without other chronic diseases who had an HbA1c > 7.5%, and in those with other chronic diseases if their HbA1c was >8.0%. Neighborhood environment was evaluated based on the percentage of positive responses in the questionnaire and geographical information system data. A multilevel analysis was performed, adjusted for individual-level risk factors. Furthermore, sensitivity analysis was conducted for those who were undergoing treatment for diabetes mellitus (n = 1007). RESULTS After adjustment for other physical environmental and individual covariates, a 1 interquartile range increase (1.48°) in slope in the neighborhood decreased the risk of poorly controlled diabetes mellitus by 18% (odds ratio [OR]: 0.82, 95% confidence interval [CI]: 0.70-0.97). Sensitivity analysis confirmed that larger slopes in the neighborhood showed a significant protective effect against diabetes mellitus among those who were undergoing treatment for diabetes mellitus (OR: 0.73, 95% CI: 0.59-0.90). CONCLUSION A hilly neighborhood environment was not associated with diabetes mellitus, but was protective against poorly controlled diabetes mellitus.
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Affiliation(s)
- Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Iseki Takamoto
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Airi Amemiya
- Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Masamichi Hanazato
- Center for Preventive Medical Sciences, Chiba University, Chiba City, Chiba, Japan
| | - Norimichi Suzuki
- Center for Preventive Medical Sciences, Chiba University, Chiba City, Chiba, Japan
| | - Yuiko Nagamine
- Center for Preventive Medical Sciences, Chiba University, Chiba City, Chiba, Japan
| | - Yuri Sasaki
- Center for Preventive Medical Sciences, Chiba University, Chiba City, Chiba, Japan
| | - Yukako Tani
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Aki Yazawa
- Department of Human Ecology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yosuke Inoue
- Carolina Population Center, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Kokoro Shirai
- Department of Human Sciences, School of Law and Letters, University of the Ryukyus, Okinawa, Japan
| | - Yugo Shobugawa
- Division of International Health, Graduate School of Medical and Dental Science, Niigata University, Niigata, Japan
| | - Naoki Kondo
- Department of Health Education and Health Sociology, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Katsunori Kondo
- Center for Well-being and Society, Nihon Fukushi University, Aichi, Japan; Department of Gerontology and Evaluation Study, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Aichi, Japan
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541
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Loo CKJ, Greiver M, Aliarzadeh B, Lewis D. Association between neighbourhood walkability and metabolic risk factors influenced by physical activity: a cross-sectional study of adults in Toronto, Canada. BMJ Open 2017; 7:e013889. [PMID: 28391234 PMCID: PMC5775455 DOI: 10.1136/bmjopen-2016-013889] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 01/27/2017] [Accepted: 02/16/2017] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To determine whether neighbourhood walkability is associated with clinical measures of obesity, hypertension, diabetes and dyslipidaemia in an urban adult population. DESIGN Observational cross-sectional study. SETTING Urban primary care patients. PARTICIPANTS 78 023 Toronto residents, aged 18 years and over, who were formally rostered or had at least 2 visits between 2012 and 2014 with a primary care physician participating in the University of Toronto Practice Based Research Network (UTOPIAN), within the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). MAIN OUTCOME MEASURES Differences in average body mass index (BMI), systolic and diastolic blood pressure, fasting blood glucose, haemoglobin A1c (HbA1C), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and triglyceride between residents in the highest versus the lowest quartile of neighbourhood walkability, as estimated using multivariable linear regression models and stratified by age. Outcomes were objectively measured and were retrieved from primary care electronic medical records. Models adjusted for age, sex, smoking, medications, medical comorbidities and indices of neighbourhood safety and marginalisation. RESULTS Compared with those in the lowest walkability quartile, individuals in the highest quartile had lower mean BMI (-2.64 kg/m2, 95% CI -2.98 to -2.30; p<0.001), systolic blood pressure (-1.35 mm Hg, 95% CI -2.01 to -0.70; p<0.001), diastolic blood pressure (-0.60 mm Hg, 95% CI 1.06 to -0.14; p=0.010) and HbA1c (-0.063%, 95% CI -0.11 to -0.021; p=0.003) and higher mean HDL (0.052 mmol/L, 95% CI 0.029 to 0.075; p<0.001). In age-stratified analyses, differences in the mean BMI were consistently observed for adults aged 18 to under 40 (-4.44 kg/m2, 95% CI -5.09 to -3.79; p<0.001), adults aged 40-65 (-2.74 kg/m2, 95% CI -3.24 to -2.23; p<0.001) and adults aged over 65 (-0.87 kg/m2, 95% CI -1.48 to -0.26; p=0.005). CONCLUSIONS There was a clinically meaningful association between living in the most walkable neighbourhoods and having lower BMI in adults of all ages.
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Affiliation(s)
- C K Jennifer Loo
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Michelle Greiver
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- North York General Hospital, Toronto, Ontario, Canada
| | - Babak Aliarzadeh
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
- North York General Hospital, Toronto, Ontario, Canada
| | - Daniel Lewis
- Department of Social and Environmental Health Research, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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542
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Ogilvie D, Foley L, Nimegeer A, Olsen JR, Mitchell R, Thomson H, Crawford F, Prins R, Hilton S, Jones A, Humphreys D, Sahlqvist S, Mutrie N. Health impacts of the M74 urban motorway extension: a mixed-method natural experimental study. PUBLIC HEALTH RESEARCH 2017. [DOI: 10.3310/phr05030] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background
Making travel easier can improve people’s access to opportunities, but motor transport also incurs substantial undesirable health and social impacts.
Aims
To assess how a new urban motorway affected travel and activity patterns, road accidents and well-being in local communities, and how these impacts were experienced and brought about.
Design
The Traffic and Health in Glasgow study, a mixed-method controlled before-and-after study.
Setting
Glasgow, UK.
Participants
Repeat cross-sectional survey samples of 1345 and 1343 adults, recruited in 2005 and 2013, respectively. Of these, 365 formed a longitudinal cohort, 196 took part in a quantitative substudy using accelerometers and global positioning system receivers and 30, living within 400 m of the new motorway, took part in a qualitative substudy along with 12 other informants. Complementary analyses used police STATS19 road traffic accident data (1997–2014) and Scottish Household Survey travel diaries (2009–13).
Intervention
A new 5-mile, six-lane section of the M74 motorway, opened in 2011 and running through predominantly deprived neighbourhoods in south-east Glasgow, with associated changes to the urban landscape.
Main outcome measures
Differences in self-reported travel behaviour (1-day travel record), physical activity (short International Physical Activity Questionnaire) and well-being [Short Form 8 Health Survey (SF-8) and a short version of the Warwick–Edinburgh Mental Well-being Scale], and in the incidence of road traffic accidents.
Methods
A combination of multivariable cohort, cross-sectional, repeat cross-sectional and interrupted time series regression analyses comparing residents of the ‘M74 corridor’ intervention area and two matched control areas, complemented by novel qualitative spatial methods. Graded measures of the proximity of the motorway to each participant’s home served as a further basis for controlled comparisons.
Results
Both benefits and harms were identified. Cohort participants living closer to the new motorway experienced significantly reduced mental well-being (mental component summary of the SF-8 scale) over time compared with those living further away [linear regression coefficient –3.6, 95% confidence interval (CI) –6.6 to –0.7]. In the area surrounding an existing motorway, this association was concentrated among those with chronic conditions. In repeat cross-sectional analyses, participants living closer to a new motorway junction were more likely to report using a car at follow-up than those living further away (odds ratio 3.4, 95% CI 1.1 to 10.7). We found weaker quantitative evidence of a decline in physical activity participation and no quantitative evidence of an overall change in either active travel or accidents associated with motorway exposure. Qualitative evidence suggested that, although the new motorway improved connectivity for those with dispersed social networks and access to motor vehicles, the impacts were more complex for others, some of whom found the motorway to be a cause of severance. Changes in community composition and cohesion, and perceptions of personal safety, were widely perceived as more important to local people.
Limitations
A key limitation of natural experimental studies is that the risk of residual confounding cannot be eliminated.
Conclusions
Overall, these findings highlight the potential for urban infrastructural projects of this kind to add further burdens to already disadvantaged communities, exacerbating inequalities and contributing to poorer health outcomes. The health and social impacts of such initiatives should be more fully taken into account in planning and research.
Funding
The National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- David Ogilvie
- Medical Research Council (MRC) Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Louise Foley
- Medical Research Council (MRC) Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Amy Nimegeer
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Jonathan R Olsen
- Centre for Research on Environment, Society and Health, Institute of Health and Well-being, University of Glasgow, Glasgow, UK
| | - Richard Mitchell
- Centre for Research on Environment, Society and Health, Institute of Health and Well-being, University of Glasgow, Glasgow, UK
| | - Hilary Thomson
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Fiona Crawford
- NHS Greater Glasgow & Clyde, Glasgow, UK
- Glasgow Centre for Population Health, Glasgow, UK
| | - Richard Prins
- Medical Research Council (MRC) Epidemiology Unit and Centre for Diet and Activity Research (CEDAR), School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Shona Hilton
- Medical Research Council/Chief Scientist Office (MRC/CSO) Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Andy Jones
- Norwich Medical School and Centre for Diet and Activity Research (CEDAR), University of East Anglia, Norwich, UK
| | - David Humphreys
- Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Shannon Sahlqvist
- School of Exercise and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Nanette Mutrie
- Physical Activity for Health Research Centre, University of Edinburgh, Edinburgh, UK
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543
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Cerin E, Mitáš J, Cain KL, Conway TL, Adams MA, Schofield G, Sarmiento OL, Reis RS, Schipperijn J, Davey R, Salvo D, Orzanco-Garralda R, Macfarlane DJ, De Bourdeaudhuij I, Owen N, Sallis JF, Van Dyck D. Do associations between objectively-assessed physical activity and neighbourhood environment attributes vary by time of the day and day of the week? IPEN adult study. Int J Behav Nutr Phys Act 2017; 14:34. [PMID: 28320422 PMCID: PMC5359924 DOI: 10.1186/s12966-017-0493-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Accepted: 03/13/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To more accurately quantify the potential impact of the neighbourhood environment on adults' physical activity (PA), it is important to compare environment-PA associations between periods of the day or week when adults are more versus less likely to be in their neighbourhood and utilise its PA resources. We examined whether, among adults from 10 countries, associations between objectively-assessed neighbourhood environment attributes and moderate-to-vigorous physical activity (MVPA) varied by time of the day and day of the week. The secondary aim was to examine whether such associations varied by employment status, gender and city. METHODS This cross-sectional study included 6,712 adults from 14 cities across 10 countries with ≥1 day of valid accelerometer-assessed MVPA and complete information on socio-demographic and objectively-assessed environmental characteristics within 0.5 and 1 km street-network buffers around the home. Accelerometer measures (MVPA min/h) were created for six time periods from early morning until late evening/night, for weekdays and weekend days separately. Associations were estimated using generalized additive mixed models. RESULTS Time of the day, day of week, gender and employment status were significant moderators of environment-MVPA associations. Land use mix was positively associated with MVPA in women who were employed and in men irrespective of their employment status. The positive associations between MVPA and net residential density, intersection density and land use mix were stronger in the mornings of weekdays and the afternoon/evening periods of both weekdays and weekend days. Associations between number of parks and MVPA were stronger in the mornings and afternoon/evenings irrespective of day of the week. Public transport density showed consistent positive associations with MVPA during weekends, while stronger effects on weekdays were observed in the morning and early evenings. CONCLUSIONS This study suggests that space and time constraints in adults' daily activities are important factors that determine the impact of neighbourhood attributes on PA. Consideration of time-specific associations is important to better characterise the magnitude of the effects of the neighbourhood environment on PA. Future research will need to examine the contribution of built environment characteristics of areas surrounding other types of daily life centres (e.g., workplaces) to explaining adults' PA at specific times of the day.
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Affiliation(s)
- Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia. .,School of Public Health, The University of Hong Kong, Hong Kong, China. .,Baker IDI Heart and Diabetes Institute, Melbourne, Australia.
| | - Josef Mitáš
- Institute of Active Lifestyle, Faculty of Physical Culture, Palacký University, Olomouc, Czech Republic
| | - Kelli L Cain
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Terry L Conway
- Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Marc A Adams
- School of Nutrition and Health Promotion & Global Institute of Sustainability, Arizona State University, Phoenix, USA
| | - Grant Schofield
- Faculty of Health and Environmental Sciences, AUT University, Auckland, New Zealand
| | | | - Rodrigo Siqueira Reis
- Prevention Research Center, Brown School, Washington University in St. Louis, St. Louis, USA.,Graduate Program on Physical Education, Federal University of Parana, Curitiba, Brazil
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Rachel Davey
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australia
| | - Deborah Salvo
- The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, TX, USA.,Center for Nutrition and Health Research, National Institute of Public Health of Mexico, Cuernavaca, Mexico
| | | | | | | | - Neville Owen
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia.,Swinburne University of Technology, Melbourne, Australia
| | - James F Sallis
- Institute for Health and Ageing, Australian Catholic University, Level 6, 215 Spring Street, Melbourne, VIC, 3000, Australia.,Department of Family Medicine and Public Health, University of California, San Diego, USA
| | - Delfien Van Dyck
- Ghent University, Ghent, Belgium.,Research Foundation Flanders, Brussels, Belgium
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544
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Walkosz BJ, Scott MD, Buller DB, Andersen PA, Beck L, Cutter GR. Prevalence of Sun Protection at Outdoor Recreation and Leisure Venues at Resorts in North America. AMERICAN JOURNAL OF HEALTH EDUCATION 2017; 48:90-99. [PMID: 29147456 DOI: 10.1080/19325037.2016.1271755] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background Exposure to solar ultra violet radiation (UVR) is a primary risk factor for skin cancer. Vacationers often fail to protect themselves from harmful UVR. Purpose The study assessed the sun protection practices of resort guests in various outdoor leisure and recreation venues during warm-weather seasons. Method 41 North American resorts were enrolled in a quasi-experimental randomized controlled trial. Adult guests were observed (n=4091) and surveyed (n=3694) in a cross sectional sample. Data collection was conducted in recreation and leisure venues with outdoors commons/reception areas acting as the comparison condition. Results The mean percent of vacationers at pools and beaches were more likely (p < 0.001) to wear sunscreen than in commons areas but less likely (p < 0.001) to wear cover-up clothing or use shade. In both samples, the combined sun protection scores were higher in commons areas compared to all venues except for outdoor dining (p < 0.001). Discussion Sun safety was suboptimal in all venues and was potentially mitigated by venue type. Translation to Health Education Practice Approaches are needed to encourage vacationers to practice comprehensive sun protection and to work with resorts to construct built environments that facilitate rather than act as barriers to sun safety.
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Affiliation(s)
- Barbara J Walkosz
- Senior Scientist, Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401
| | - Michael D Scott
- Professor Emeritus at California State University and President Mikonics, Inc., 40 B Old Road South, Santa Fe, NM 87540
| | - David B Buller
- Senior Scientist and Director of Research, Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO 80401
| | - Peter A Andersen
- Professor Emeritus, School of Communication, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182
| | - Larry Beck
- Professor, L. Robert Payne School of Hospitality and Tourism Management, Room PSFA 445, San Diego State University, San Diego, CA 92182
| | - Gary R Cutter
- Professor, Department of Biostatistics, School of Public Health, RPHB 401B, University of Alabama, 1720 2Avenue South, Birmingham, AL 35294
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545
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Built environmental factors and adults' travel behaviors: Role of street layout and local destinations. Prev Med 2017; 96:124-128. [PMID: 28007494 DOI: 10.1016/j.ypmed.2016.12.021] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Revised: 12/15/2016] [Accepted: 12/17/2016] [Indexed: 11/22/2022]
Abstract
Street layout is consistently associated with adults' travel behaviors, however factors influencing this association are unclear. We examined associations of street layout with travel behaviors: walking for transport (WT) and car use; and, the extent to which these relationships may be accounted for by availability of local destinations. A 24-h travel diary was completed in 2009 by 16,345 adult participants of the South-East Queensland Household Travel Survey, Australia. Three travel-behavior outcomes were derived: any home-based WT; over 30min of home-based WT; and, over 60min of car use. For street layout, a space syntax measure of street integration was calculated for each Statistical Area 1 (SA1, the smallest geographic unit in Australia). An objective measure of availability of destinations - Walk Score - was also derived for each SA1. Logistic regression examined associations of street layout with travel behaviors. Mediation analyses examined to what extent availability of destinations explained the associations. Street integration was significantly associated with travel behaviors. Each one-decile increment in street integration was associated with an 18% (95%CI: 1.15, 1.21) higher odds of any home-based WT; a 10% (95%CI: 1.06, 1.15) higher odds of over 30min of home-based WT; and a 5% (95%CI: 0.94, 0.96) lower odds of using a car over 60min. Local destinations partially mediated the effects of street layout on travel behaviors. Well-connected street layout contributes to active travel partially through availability of more local destinations. Urban design strategies need to address street layout and destinations to promote active travel among residents.
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546
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Dobbinson SJ, Veitch J, Salmon J, Wakefield M, Staiger PK, MacInnis RJ, Simmons J. Study protocol for a natural experiment in a lower socioeconomic area to examine the health-related effects of refurbishment to parks including built-shade (ShadePlus). BMJ Open 2017; 7:e013493. [PMID: 28399511 PMCID: PMC5337679 DOI: 10.1136/bmjopen-2016-013493] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Parks in disadvantaged suburbs often have low quality and few amenities, which is likely to result in them being underutilised for recreation and physical activity. Refurbishment of parks, including shade, walking paths and other amenities, may have broad health-related benefits. METHODS AND ANALYSIS The study design, methods and planned analyses for a natural experiment examining the effects of refurbishments including built-shade added to parks in disadvantaged outer suburbs of Melbourne are described. Three intervention parks and three comparison parks matched for equivalence of park and neighbourhood characteristics were selected. Using mixed methods, the outcomes will be assessed during three consecutive spring-summer periods (T1: 2013-2014; T2: 2014-2015: T3: 2015-2016). Primary outcomes included: observed park use, physical activity and shade use. Self-reported social connectedness, community engagement and psychological well-being were assessed as secondary outcomes. ETHICS AND DISSEMINATION This study was approved by Cancer Council Victoria's Human Research Ethics Committee. Studies such as ShadePlus can improve understanding of the broader effects of park refurbishments (including physical activity levels and sun protection behaviours, as well as social connectedness and psychological well-being). The study findings will be disseminated through established urban planning and parks and recreation networks, peer review publications and conference presentations.
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Affiliation(s)
- S J Dobbinson
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - J Veitch
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences,Geelong, Australia
| | - J Salmon
- Deakin University, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences,Geelong, Australia
| | - M Wakefield
- Cancer Council Victoria, Melbourne, Victoria, Australia
| | - P K Staiger
- Deakin University, School of Psychology, Faculty of Health, Geelong, Victoria, Australia
| | - R J MacInnis
- Cancer Council Victoria, Melbourne, Victoria, Australia
- University of Melbourne, Centre for Epidemiology and Biostatistics, Melbourne, Victoria, Australia
| | - J Simmons
- Cancer Council Victoria, Melbourne, Victoria, Australia
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547
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James P, Hart JE, Hipp JA, Mitchell JA, Kerr J, Hurvitz PM, Glanz K, Laden F. GPS-Based Exposure to Greenness and Walkability and Accelerometry-Based Physical Activity. Cancer Epidemiol Biomarkers Prev 2017; 26:525-532. [PMID: 28196848 DOI: 10.1158/1055-9965.epi-16-0925] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/30/2017] [Accepted: 02/06/2017] [Indexed: 12/16/2022] Open
Abstract
Background: Physical inactivity is a risk factor for cancer that may be influenced by environmental factors. Indeed, dense and well-connected built environments and environments with natural vegetation may create opportunities for higher routine physical activity. However, studies have focused primarily on residential environments to define exposure and self-reported methods to estimate physical activity. This study explores the momentary association between minute-level global positioning systems (GPS)-based greenness exposure and time-matched objectively measured physical activity.Methods: Adult women were recruited from sites across the United States. Participants wore a GPS device and accelerometer on the hip for 7 days to assess location and physical activity at minute-level epochs. GPS records were linked to 250 m resolution satellite-based vegetation data and Census Block Group-level U.S. Environmental Protection Agency (EPA) Smart Location Database walkability data. Minute-level generalized additive mixed models were conducted to test for associations between GPS measures and accelerometer count data, accounting for repeated measures within participant and allowing for deviations from linearity using splines.Results: Among 360 adult women (mean age of 55.3 ± 10.2 years), we observed positive nonlinear relationships between physical activity and both greenness and walkability. In exploratory analyses, the relationships between environmental factors and physical activity were strongest among those who were white, had higher incomes, and who were middle-aged.Conclusions: Our results indicate that higher levels of physical activity occurred in areas with higher greenness and higher walkability.Impact: Findings suggest that planning and design policies should focus on these environments to optimize opportunities for physical activity. Cancer Epidemiol Biomarkers Prev; 26(4); 525-32. ©2017 AACRSee all the articles in this CEBP Focus section, "Geospatial Approaches to Cancer Control and Population Sciences."
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Affiliation(s)
- Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. .,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - J Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, North Carolina State University, Raleigh, North Carolina.,Center for Geospatial Analytics, North Carolina State University, Raleigh, North Carolina
| | - Jonathan A Mitchell
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jacqueline Kerr
- Department of Family Medicine & Public Health, University of California, San Diego, San Diego, California
| | | | - Karen Glanz
- Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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548
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Islami F, Torre LA, Drope JM, Ward EM, Jemal A. Global Cancer in Women: Cancer Control Priorities. Cancer Epidemiol Biomarkers Prev 2017; 26:458-470. [PMID: 28183824 DOI: 10.1158/1055-9965.epi-16-0871] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/08/2016] [Indexed: 11/16/2022] Open
Abstract
This review is an abbreviated version of a report prepared for the American Cancer Society Global Health department and EMD Serono, Inc., a subsidiary of Merck KGaA, Darmstadt, Germany, which was released at the Union for International Cancer Control World Cancer Congress in Paris in November 2016. The original report can be found at https://www.cancer.org/health-care-professionals/our-global-health-work/global-cancer-burden/global-burden-of-cancer-in-women.html. Staff in the Intramural Research Department of the American Cancer Society designed and conducted the study, including analysis, interpretation, and presentation of the review. The funding sources had no involvement in the study design, data analysis and interpretation, or preparation of the reviewThe global burden of cancer in women has recently received much attention, but there are few comprehensive reviews of the burden and policy approaches to reduce it. This article, second in series of two, summarizes the most important cancer control priorities with specific examples of proven interventions, with a particular focus on primary prevention in low- and middle-income countries (LMIC). There are a number of effective cancer control measures available to countries of all resource levels. Many of these measures are extremely cost-effective, especially in the case of tobacco control and vaccination. Countries must prioritize efforts to reduce known cancer risk factors and make prevention accessible to all. Effective treatments and palliative care are also needed for those who develop cancer. Given scarce resources, this may seem infeasible in many LMICs, but past experience with other diseases like HIV, tuberculosis, and malaria have shown that it is possible to make affordable care accessible to all. Expansion of population-based cancer registries and research in LMICs are needed for setting cancer control priorities and for determining the most effective interventions. For LMICs, all of these activities require support and commitment from the global community. Cancer Epidemiol Biomarkers Prev; 26(4); 458-70. ©2017 AACRSee related article by Torre et al. in this CEBP Focus section, "Global Cancer in Women."
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Affiliation(s)
- Farhad Islami
- Intramural Research, American Cancer Society, Atlanta, Georgia.
| | - Lindsey A Torre
- Intramural Research, American Cancer Society, Atlanta, Georgia
| | - Jeffrey M Drope
- Intramural Research, American Cancer Society, Atlanta, Georgia
| | | | - Ahmedin Jemal
- Intramural Research, American Cancer Society, Atlanta, Georgia
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549
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Laatikainen TE, Broberg A, Kyttä M. The physical environment of positive places: Exploring differences between age groups. Prev Med 2017; 95 Suppl:S85-S91. [PMID: 27986540 DOI: 10.1016/j.ypmed.2016.11.015] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 11/04/2016] [Accepted: 11/24/2016] [Indexed: 11/16/2022]
Abstract
Features of the physical environment have an impact on the human behaviour. Thus, planners and policymakers around the world should aim at providing environments that are perceived as being of good quality, in which the residents enjoy spending time and moving around in. It is widely acknowledged that urban environmental quality associates with well-being, but there is currently very little research examining which features of urban environments people of different ages perceive as appealing in their living environments. Individuals experience different age-related developmental environments throughout their life course. Thus, the usage and perceptions of different spaces can also differ between various age groups. Public Participation GIS datasets collected in 2009 and 2011 in Helsinki Metropolitan Area were used to study places perceived as being positive by adults (n=3119) and children (n=672). Participants marked points on a map that were overlaid with GIS data to study whether the physical environment of positive places of different age groups differed. The results demonstrated that the physical environment differs significantly in the positive places of different age groups. The places of adult age groups were characterized by green, blue and commercial spaces, whereas sports, residential and commercial spaces characterize children's and adolescents' places. Older adults' places were found to be closest to home, while adolescents' places were the most distant. Providing appealing environments for all age groups in one setting remains problematic but should nevertheless be strived for, especially in the urban context where a constant competition over different usages of space occurs.
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Affiliation(s)
- Tiina E Laatikainen
- Department of Built Environment, Aalto University, P.O. Box 12200, 00076 Aalto, Finland.
| | - Anna Broberg
- Department of Built Environment, Aalto University, P.O. Box 12200, 00076 Aalto, Finland.
| | - Marketta Kyttä
- Department of Built Environment, Aalto University, P.O. Box 12200, 00076 Aalto, Finland.
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550
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Frank LD, Fox EH, Ulmer JM, Chapman JE, Kershaw SE, Sallis JF, Conway TL, Cerin E, Cain KL, Adams MA, Smith GR, Hinckson E, Mavoa S, Christiansen LB, Hino AAF, Lopes AAS, Schipperijn J. International comparison of observation-specific spatial buffers: maximizing the ability to estimate physical activity. Int J Health Geogr 2017; 16:4. [PMID: 28114945 PMCID: PMC5259997 DOI: 10.1186/s12942-017-0077-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 01/14/2017] [Indexed: 11/19/2022] Open
Abstract
Background Advancements in geographic information systems over the past two decades have increased the specificity by which an individual’s neighborhood environment may be spatially defined for physical activity and health research. This study investigated how different types of street network buffering methods compared in measuring a set of commonly used built environment measures (BEMs) and tested their performance on associations with physical activity outcomes. Methods An internationally-developed set of objective BEMs using three different spatial buffering techniques were used to evaluate the relative differences in resulting explanatory power on self-reported physical activity outcomes. BEMs were developed in five countries using ‘sausage,’ ‘detailed-trimmed,’ and ‘detailed,’ network buffers at a distance of 1 km around participant household addresses (n = 5883). Results BEM values were significantly different (p < 0.05) for 96% of sausage versus detailed-trimmed buffer comparisons and 89% of sausage versus detailed network buffer comparisons. Results showed that BEM coefficients in physical activity models did not differ significantly across buffering methods, and in most cases BEM associations with physical activity outcomes had the same level of statistical significance across buffer types. However, BEM coefficients differed in significance for 9% of the sausage versus detailed models, which may warrant further investigation. Conclusions Results of this study inform the selection of spatial buffering methods to estimate physical activity outcomes using an internationally consistent set of BEMs. Using three different network-based buffering methods, the findings indicate significant variation among BEM values, however associations with physical activity outcomes were similar across each buffering technique. The study advances knowledge by presenting consistently assessed relationships between three different network buffer types and utilitarian travel, sedentary behavior, and leisure-oriented physical activity outcomes.
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Affiliation(s)
- Lawrence D Frank
- Health and Community Design Lab, Schools of Population and Public Health and Community and Regional Planning, University of British Columbia, Vancouver, BC, Canada. .,Urban Design 4 Health, Inc., Rochester, NY, USA.
| | - Eric H Fox
- Urban Design 4 Health, Inc., Rochester, NY, USA
| | | | | | | | - James F Sallis
- Department of Family and Preventive Medicine, University of California San Diego, San Diego, CA, USA
| | - Terry L Conway
- Department of Family and Preventive Medicine, University of California San Diego, San Diego, CA, USA
| | - Ester Cerin
- School of Public Health, The University of Hong Kong, Hong Kong, China.,Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia
| | - Kelli L Cain
- Department of Family and Preventive Medicine, University of California San Diego, San Diego, CA, USA
| | - Marc A Adams
- Exercise Science and Health Promotion Program, School of Nutrition and Health Promotion, Global Institute of Sustainability, Arizona State University, Phoenix, AZ, USA
| | - Graham R Smith
- Institute for Environment, Sustainability and Regeneration, Staffordshire University, Stoke-on-Trent, UK
| | - Erica Hinckson
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Suzanne Mavoa
- McCaughey VicHealth Community Wellbeing Unit, School of Population and Global Health, University of Melbourne, Melbourne, Australia.,SHORE and Whāriki Research Centre, School of Public Health, Massey University, Palmerston North, New Zealand
| | - Lars B Christiansen
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Adriano Akira F Hino
- Department of Physical Education, School of Life Science, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - Adalberto A S Lopes
- Department of Physical Education, Centro Universitario Campos de Andrade, Curitiba, Brazil
| | - Jasper Schipperijn
- Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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