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Neighborhood Social and Built Environment and Disparities in the Risk of Hypertension: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207696. [PMID: 33096878 PMCID: PMC7588916 DOI: 10.3390/ijerph17207696] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/17/2020] [Accepted: 10/20/2020] [Indexed: 12/11/2022]
Abstract
Citizens’ participation in urban environmental quality assessment is important when identifying local problems in the sustainable development and environmental planning policy. The principal aim of this study was to analyze whether any social differences exist between the joint effect of built neighborhood quality and exposure to urban green spaces and the risk of hypertension. The study sample consisted of 580 participants residing in 11 districts in Kaunas city, Lithuania. Using geographic information systems (GIS), individual data on the socioeconomic status (SES) and health were linked to the participants’ perceptions of the environmental quality and exposure to green spaces (NDVI). We used multivariate logistic regression to estimate associations as odds ratios (OR). Those study participants with lower education and those study participants with higher education on low incomes rated their health significantly worse. Low SES persons residing in areas with low exposure to green spaces had a significantly higher risk of hypertension when sex, age, family status, smoking, and income were accounted for (OR 1.83, 95% CI 1.01–3.36). This citizen science study provided evidence that the social environment and the quality of the built environment had a complex effect on disparities in the risk of hypertension.
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Halonen JI, Pulakka A, Pentti J, Kallio M, Koskela S, Kivimäki M, Kawachi I, Vahtera J, Stenholm S. Cross-sectional associations of neighbourhood socioeconomic disadvantage and greenness with accelerometer-measured leisure-time physical activity in a cohort of ageing workers. BMJ Open 2020; 10:e038673. [PMID: 32801206 PMCID: PMC7430423 DOI: 10.1136/bmjopen-2020-038673] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Neighbourhood characteristics may affect the level of physical activity (PA) of the residents. Few studies have examined the combined effects of distinctive neighbourhood characteristics on PA using objective data or differentiated between activity during working or non-working days. We examined the associations of socioeconomic disadvantage and greenness with accelerometer-measured leisure-time PA during working and non-working days. DESIGN Cross-sectional study. SETTING Finnish Retirement and Aging (FIREA) study. PARTICIPANTS 708 workers (604 women, mean age 62.4 ranging from 58 to 64 years,) participating in the FIREA study who provided PA measurement data for at least 1 working and non-working day. PRIMARY AND SECONDARY OUTCOMES PA was measured with wrist-worn accelerometer on average of 4 working and 2 non-working days. Outcomes were total PA, light PA (LPA) and moderate-to-vigorous PA (MVPA). These measurements were linked to data on neighbourhood socioeconomic disadvantage and greenness within the home neighbourhood (750×750 m). Generalised linear models were adjusted for possible confounders. RESULTS On non-working days, higher neighbourhood disadvantage associated with lower levels of total PA (p value=0.07) and higher level of neighbourhood greenness associated with higher level of total PA (p value=0.04). Neighbourhood disadvantage and greenness had an interaction (p value=0.02); in areas of low disadvantage higher greenness did not associate with the level of total PA. However, in areas of high disadvantage, 2 SD higher greenness associated with 46 min/day (95% CI 8.4 to 85) higher total PA. Slightly stronger interaction was observed for LPA (p=0.03) than for the MVPA (p=0.09). During working days, there were no associations between neighbourhood characteristics and leisure-time total PA. CONCLUSIONS Of the disadvantaged neighbourhoods, those characterised by high levels of greenness seem to associate with higher levels of leisure-time PA during non-working days. These findings suggest that efforts to add greenness to socioeconomically disadvantaged neighbourhoods might reduce inequalities in PA.
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Affiliation(s)
- Jaana I Halonen
- Health Security, Finnish Institute for Health and Welfare, Helsinki, Finland
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anna Pulakka
- Centre for Population Health Research, University of Turku, Turku, Finland
- Department of Public Health, University of Turku, Turku, Finland
- Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jaana Pentti
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Centre for Population Health Research, University of Turku, Turku, Finland
- Department of Public Health, University of Turku, Turku, Finland
| | - Minna Kallio
- Geoinformatics Services, Finnish Environment Institute, Helsinki, Finland
| | - Sofia Koskela
- Department of Geography and Geology, University of Turku, Turku, Finland
| | - Mika Kivimäki
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Ichiro Kawachi
- Department of Society Human Development, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Jussi Vahtera
- Centre for Population Health Research, University of Turku, Turku, Finland
- Department of Public Health, University of Turku, Turku, Finland
| | - Sari Stenholm
- Centre for Population Health Research, University of Turku, Turku, Finland
- Department of Public Health, University of Turku, Turku, Finland
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Kjellström S, Andersson AC, Samuelsson T. Professionals' experiences of using an improvement programme: applying quality improvement work in preschool contexts. BMJ Open Qual 2020; 9:e000933. [PMID: 32830121 PMCID: PMC7445333 DOI: 10.1136/bmjoq-2020-000933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 07/10/2020] [Accepted: 07/27/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Improvement work can be used in preschools to enrich outdoor environment for children's better health. Effective improvement work can facilitate the necessary changes, but little is known about professionals' experiences of participation in improvement interventions. The aim was to evaluate how preschool staff experience quality improvement work, using the Breakthrough Series Collaborative improvement programme, to enhance outdoor environments. METHODS An improvement intervention using a breakthrough collaborative was performed at 9 preschools in Sweden and examined with a longitudinal mixed method design. Staff completed questionnaires on 4 occasions (n=45 participants) and interviews took place after the intervention (n=16 participants). RESULTS The intervention was successful in the sense that the staff were content with the learning seminars, and they had triggered physical changes in the outdoor environment. They integrated the quality improvement work with their ordinary work and increasingly involved the children. The staff tested improvement tools but did not find them entirely appropriate for their work, because they preferred existing methods for reflection. CONCLUSIONS The challenges in quality improvement work seem to be similar across contexts. Using the Breakthrough Series Collaborative in a public health intervention is promising but needs to be integrated with preunderstandings, current reflections and quality tools and models.
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Affiliation(s)
- Sofia Kjellström
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | | | - Tobias Samuelsson
- School of Education and Communication, Jönköping University, Jönköping, Sweden
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54
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Orstad SL, Szuhany K, Tamura K, Thorpe LE, Jay M. Park Proximity and Use for Physical Activity among Urban Residents: Associations with Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4885. [PMID: 32645844 PMCID: PMC7369687 DOI: 10.3390/ijerph17134885] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/06/2020] [Accepted: 06/08/2020] [Indexed: 01/04/2023]
Abstract
Increasing global urbanization limits interaction between people and natural environments, which may negatively impact population health and wellbeing. Urban residents who live near parks report better mental health. Physical activity (PA) reduces depression and improves quality of life. Despite PA's protective effects on mental health, the added benefit of urban park use for PA is unclear. Thus, we examined whether park-based PA mediated associations between park proximity and mental distress among 3652 New York City residents (61.4% 45 + years, 58.9% female, 56.3% non-white) who completed the 2010-2011 Physical Activity and Transit (PAT) random-digit-dial survey. Measures included number of poor mental health days in the previous month (outcome), self-reported time to walk to the nearest park from home (exposure), and frequency of park use for sports, exercise or PA (mediator). We used multiple regression with bootstrap-generated 95% bias-corrected confidence intervals (BC CIs) to test for mediation by park-based PA and moderation by gender, dog ownership, PA with others, and perceived park crime. Park proximity was indirectly associated with fewer days of poor mental health via park-based PA, but only among those not concerned about park crime (index of moderated mediation = 0.04; SE = 0.02; 95% BC CI = 0.01, 0.10). Investment in park safety and park-based PA promotion in urban neighborhoods may help to maximize the mental health benefits of nearby parks.
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Affiliation(s)
- Stephanie L. Orstad
- Department of Medicine, Division of General Internal Medicine and Clinical Innovation, New York University (NYU) Grossman School of Medicine, New York, NY 10016, USA
| | - Kristin Szuhany
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY 10016, USA;
| | - Kosuke Tamura
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Lorna E. Thorpe
- Department of Population Health, Division of Epidemiology, NYU Grossman School of Medicine, New York, NY 10016, USA;
| | - Melanie Jay
- Departments of Medicine and Population Health, NYU Grossman School of Medicine, New York, NY 10016, USA;
- Comprehensive Program on Obesity, NYU Langone Health, New York, NY 10016, USA
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55
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Dugan KF, Hidde MC, Chard CA, Graham DJ, Withycombe JS, Leach HJ. Exploring Social Ecological Determinants of Physical Activity Among Adult Survivors of Childhood Cancer. J Adolesc Young Adult Oncol 2020; 10:316-325. [PMID: 32598196 DOI: 10.1089/jayao.2019.0169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Adult survivors of childhood cancer (ASCCs) are at high risk for cardiovascular disease from chemotherapy- and radiation therapy-related cardiotoxicity. Physical activity (PA) can reduce this risk, but the majority of ASCCs do not engage in sufficient PA. The purpose of this study was to identify barriers, facilitators, and resources for PA among ASCCs using the ecological model of physical activity (EMPA) as a theoretical framework. Methods: A concept elicitation survey was distributed independently to ASCCs (diagnosed with cancer before the age of 18, and currently 18-39 years old) and parents/legal guardians of an ASCC. The survey consisted of open-ended questions asking about barriers, facilitators, and resources for PA. Content analysis of open-ended questions categorized responses into levels of the EMPA and identified key themes. Results: Seventeen ASCCs and eight parents of ASCCs completed the survey. The majority of barriers, facilitators, and resources reported were at the individual and microsystem level of the EMPA. Six themes emerged, suggesting that ASCC's PA was related to proximity/access, social support, equipment, time/schedule, finances, and health-related barriers. Conclusion: This is the first study to examine barriers, facilitators, and resources of PA among ASCCs using the EMPA. Findings from this study provide a multilevel perspective on the influences of PA among ASCCs, and can be used for future, in-depth qualitative studies and quantitative survey development, and as a foundational step toward supportive efforts in increasing PA among ASCCs.
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Affiliation(s)
- Kati F Dugan
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
| | - Mary C Hidde
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
| | - Christine A Chard
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA.,Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado, USA
| | - Daniel J Graham
- Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado, USA.,Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | | | - Heather J Leach
- Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA.,Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, Colorado, USA
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56
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Plascak JJ, Schootman M, Rundle AG, Xing C, Llanos AAM, Stroup AM, Mooney SJ. Spatial predictive properties of built environment characteristics assessed by drop-and-spin virtual neighborhood auditing. Int J Health Geogr 2020; 19:21. [PMID: 32471502 PMCID: PMC7257196 DOI: 10.1186/s12942-020-00213-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 05/19/2020] [Indexed: 02/03/2023] Open
Abstract
Background Virtual neighborhood audits have been used to visually assess characteristics of the built environment for health research. Few studies have investigated spatial predictive properties of audit item responses patterns, which are important for sampling efficiency and audit item selection. We investigated the spatial properties, with a focus on predictive accuracy, of 31 individual audit items related to built environment in a major Metropolitan region of the Northeast United States. Methods Approximately 8000 Google Street View (GSV) scenes were assessed using the CANVAS virtual audit tool. Eleven trained raters audited the 360° view of each GSV scene for 10 sidewalk-, 10 intersection-, and 11 neighborhood physical disorder-related characteristics. Nested semivariograms and regression Kriging were used to investigate the presence and influence of both large- and small-spatial scale relationships as well as the role of rater variability on audit item spatial properties (measurement error, spatial autocorrelation, prediction accuracy). Receiver Operator Curve (ROC) Area Under the Curve (AUC) based on cross-validated spatial models summarized overall predictive accuracy. Correlations between predicted audit item responses and select demographic, economic, and housing characteristics were investigated. Results Prediction accuracy was better within spatial models of all items accounting for both small-scale and large- spatial scale variation (vs large-scale only), and further improved with additional adjustment for rater in a majority of modeled items. Spatial predictive accuracy was considered ‘Excellent’ (0.8 ≤ ROC AUC < 0.9) for full models of all but four items. Predictive accuracy was highest and improved the most with rater adjustment for neighborhood physical disorder-related items. The largest gains in predictive accuracy comparing large- + small-scale to large-scale only models were among intersection- and sidewalk-items. Predicted responses to neighborhood physical disorder-related items correlated strongly with one another and were also strongly correlated with racial-ethnic composition, socioeconomic indicators, and residential mobility. Conclusions Audits of sidewalk and intersection characteristics exhibit pronounced variability, requiring more spatially dense samples than neighborhood physical disorder audits do for equivalent accuracy. Incorporating rater effects into spatial models improves predictive accuracy especially among neighborhood physical disorder-related items.
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Affiliation(s)
- Jesse J Plascak
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA. .,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
| | - Mario Schootman
- Department of Clinical Analytics, SSM Health, St. Louis, MO, USA
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Cathleen Xing
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Antoinette M Stroup
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA.,Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.,New Jersey Department of Health, New Jersey State Cancer Registry, Trenton, NJ, USA
| | - Stephen J Mooney
- Department of Epidemiology, University of Washington, Seattle, WA, USA
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57
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Do DP, Frank R. The Diverging Impacts of Segregation on Obesity Risk by Nativity and Neighborhood Poverty Among Hispanic Americans. J Racial Ethn Health Disparities 2020; 7:1214-1224. [PMID: 32291576 DOI: 10.1007/s40615-020-00746-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 03/17/2020] [Accepted: 03/23/2020] [Indexed: 11/25/2022]
Abstract
While racial residential segregation is frequently cited as a fundamental cause of racial health disparities, its health impacts for Hispanic Americans remain unclear. We argue that several shortcomings have limited our understanding of how segregation influences Hispanic health outcomes, most notably a failure to assess the possible diverging impacts of segregation by neighborhood poverty level and the conflation of segregation with ethnic enclaves. We use multiple years of restricted geocoded data from a nationally representative sample of the US population (2006-2013 National Health Interview Survey) to investigate the association between metropolitan-level Hispanic segregation and obesity by nativity and neighborhood poverty level. We find segregation to be protective against obesity for Hispanic immigrants who reside in low poverty neighborhoods. For Hispanic immigrants residing in higher neighborhood poverty, no association between segregation and obesity was found. Among US-born Hispanics, we observe an increased risk of obesity-but only for those in high poverty neighborhoods. No association was found for those in low and medium neighborhood poverty. Results provide evidence to indicate that the relationship between segregation and health for Hispanics is not uniform within a metropolitan area. In the case of obesity, the consequences of metropolitan Hispanic segregation can be either protective, null, or deleterious depending not only on local neighborhood context but also on nativity.
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Affiliation(s)
- D Phuong Do
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | - Reanne Frank
- Department of Sociology, The Ohio State University, Columbus, OH, USA
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58
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Lamb KE, Thornton LE, King TL, Ball K, White SR, Bentley R, Coffee NT, Daniel M. Methods for accounting for neighbourhood self-selection in physical activity and dietary behaviour research: a systematic review. Int J Behav Nutr Phys Act 2020; 17:45. [PMID: 32238147 PMCID: PMC7115077 DOI: 10.1186/s12966-020-00947-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 03/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-selection into residential neighbourhoods is a widely acknowledged, but under-studied problem in research investigating neighbourhood influences on physical activity and diet. Failure to handle neighbourhood self-selection can lead to biased estimates of the association between the neighbourhood environment and behaviour. This means that effects could be over- or under-estimated, both of which have implications for public health policies related to neighbourhood (re)design. Therefore, it is important that methods to deal with neighbourhood self-selection are identified and reviewed. The aim of this review was to assess how neighbourhood self-selection is conceived and accounted for in the literature. METHODS Articles from a systematic search undertaken in 2017 were included if they examined associations between neighbourhood environment exposures and adult physical activity or dietary behaviour. Exposures could include any objective measurement of the built (e.g., supermarkets), natural (e.g., parks) or social (e.g., crime) environment. Articles had to explicitly state that a given method was used to account for neighbourhood self-selection. The systematic review was registered with the PROSPERO International Prospective Register of Systematic Reviews (number CRD42018083593) and was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. RESULTS Of 31 eligible articles, almost all considered physical activity (30/31); few examined diet (2/31). Methods used to address neighbourhood self-selection varied. Most studies (23/31) accounted for items relating to participants' neighbourhood preferences or reasons for moving to the neighbourhood using multi-variable adjustment in regression models (20/23) or propensity scores (3/23). Of 11 longitudinal studies, three controlled for neighbourhood self-selection as an unmeasured confounder using fixed effects regression. CONCLUSIONS Most studies accounted for neighbourhood self-selection by adjusting for measured attributes of neighbourhood preference. However, commonly the impact of adjustment could not be assessed. Future studies using adjustment should provide estimates of associations with and without adjustment for self-selection; consider temporality in the measurement of self-selection variables relative to the timing of the environmental exposure and outcome behaviours; and consider the theoretical plausibility of presumed pathways in cross-sectional research where causal direction is impossible to establish.
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Affiliation(s)
- Karen E Lamb
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia. .,Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia. .,Department of Paediatrics, The University of Melbourne, Melbourne, Australia.
| | - Lukar E Thornton
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
| | - Tania L King
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Kylie Ball
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
| | - Simon R White
- Medical Research Council Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - Rebecca Bentley
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Neil T Coffee
- Health Research Institute, University of Canberra, Canberra, Australia
| | - Mark Daniel
- Health Research Institute, University of Canberra, Canberra, Australia.,Department of Medicine, St Vincent's Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
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Hooper P, Foster S, Edwards N, Turrell G, Burton N, Giles-Corti B, Brown WJ. Positive HABITATS for physical activity: Examining use of parks and its contribution to physical activity levels in mid-to older-aged adults. Health Place 2020; 63:102308. [PMID: 32217278 DOI: 10.1016/j.healthplace.2020.102308] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 02/10/2020] [Accepted: 02/19/2020] [Indexed: 11/26/2022]
Abstract
Studies of parks and physical activity rarely identify the actual spaces participants use. Using data from the HABITAT project, a longitudinal cohort of mid-to older-aged (40-70 years) respondents (n = 11,036) living in Brisbane Australia, this study examined (1) the demographic characteristics of users and non-users of parks; (2) the park used and the characteristics and features of the most popular reported spaces; and (3) the level of physical activity undertaken in the reported parks and whether users had higher total physical activity levels than non-users. Park use was significantly higher (p < 0.01) among dog walkers, couples (over 40) living with children, and those living in least disadvantaged areas. Regular park use was significantly higher among users of larger-sized neighbourhood and district-catchment parks. Park users were 35% more likely to meet the physical activity guidelines (OR = 1.35, 95%CI 1.21-1.50, p < 0.001) compared with those who indicated they did nto regularly use a park. The size of the park used was positively associated with participation in physical activity. Users of larger-sized parks spent more time doing vigorous activity and engaged in more activity sessions than non-users. Future data obtained from large populations, including spatial examination of the actual parks used and their characteristics, are essential to facilitate planning for park provision, optimising the use of these spaces for recreation and physical activity by mid-to older-aged adults, and creating healthy communities.
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Affiliation(s)
- Paula Hooper
- Australian Urban Design Research Centre, School of Design, The University of Western Australia, Perth, Australia.
| | - Sarah Foster
- Centre for Urban Research, Royal Melbourne Institute for Technology University, Melbourne, 3000, Australia
| | - Nicole Edwards
- Australian Urban Design Research Centre, School of Design, The University of Western Australia, Perth, Australia
| | - Gavin Turrell
- Centre for Urban Research, Royal Melbourne Institute for Technology University, Melbourne, 3000, Australia; Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Australia
| | - Nicola Burton
- School of Applied Psychology, Griffith University, Brisbane, Queensland, Australia
| | - Billie Giles-Corti
- Centre for Urban Research, Royal Melbourne Institute for Technology University, Melbourne, 3000, Australia
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Langemeyer J, Wedgwood D, McPhearson T, Baró F, Madsen AL, Barton DN. Creating urban green infrastructure where it is needed - A spatial ecosystem service-based decision analysis of green roofs in Barcelona. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 707:135487. [PMID: 31759703 DOI: 10.1016/j.scitotenv.2019.135487] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/08/2019] [Accepted: 11/10/2019] [Indexed: 06/10/2023]
Abstract
As cities face increasing pressure from densification trends, green roofs represent a valuable source of ecosystem services for residents of compact metropolises where available green space is scarce. However, to date little research has been conducted regarding the holistic benefits of green roofs at a citywide scale, with local policymakers lacking practical guidance to inform expansion of green roofs coverage. The study addresses this issue by developing a spatial multi-criteria screening tool applied in Barcelona, Spain to determine: 1) where green roofs should be prioritized in Barcelona based on expert elicited demand for a wide range of ecosystem services and 2) what type of design of potential green roofs would optimize the ecosystem service provision. As inputs to the model, fifteen spatial indicators were selected as proxies for ecosystem service deficits and demands (thermal regulation, runoff control, habitat and pollination, food production, recreation, and social cohesion) along with five decision alternatives for green roof design (extensive, semi-intensive, intensive, naturalized, and allotment). These indicators and alternatives were analyzed probabilistically and spatially, then weighted according to feedback from local experts. Results of the assessment indicate that there is high demand across Barcelona for the ecosystem services that green roofs potentially might provide, particularly in dense residential neighborhoods and the industrial south. Experts identified habitat, pollination and thermal regulation as the most needed ES with runoff control and food production as the least demanded. Naturalized roofs generated the highest potential ecosystem service provision levels for 87.5% of rooftop area, apart from smaller areas of central Barcelona where intensive rooftops were identified as the preferable green roof design. Overall, the spatial model developed in this study offers a flexible screening based on spatial multi-criteria decision analysis that can be easily adjusted to guide municipal policy in other cities considering the effectiveness of green infrastructure as source of ecosystem services.
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Affiliation(s)
- Johannes Langemeyer
- Institute of Environmental Science and Technology (ICTA), Universitat Autònoma de Barcelona (UAB), Edifici Z (ICTA-ICP), Carrer de les Columnes s/n, Campus de la UAB, 08193 Cerdanyola del Vallès, Spain; Hospital del Mar Medical Research Institute (IMIM), Carrer Doctor Aiguader 88, 08003 Barcelona, Spain.
| | - Diego Wedgwood
- Institute of Environmental Science and Technology (ICTA), Universitat Autònoma de Barcelona (UAB), Edifici Z (ICTA-ICP), Carrer de les Columnes s/n, Campus de la UAB, 08193 Cerdanyola del Vallès, Spain
| | | | - Francesc Baró
- Institute of Environmental Science and Technology (ICTA), Universitat Autònoma de Barcelona (UAB), Edifici Z (ICTA-ICP), Carrer de les Columnes s/n, Campus de la UAB, 08193 Cerdanyola del Vallès, Spain; Hospital del Mar Medical Research Institute (IMIM), Carrer Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Anders L Madsen
- HUGIN EXPERT A/S, DK-9000 Aalborg, Denmark; Aalborg University, DK-9220 Aalborg, Denmark
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Tylavsky FA, Ferrara A, Catellier DJ, Oken E, Li X, Law A, Dabelea D, Rundle A, Gilbert-Diamond D, Hivert MF, Breton CV, Cassidy-Bushrow AE, Mueller NT, Hunt KJ, Arteaga SS, Lombo T, Mahabir S, Ruden D, Sauder K, Hedderson MM, Zhu Y, Polk S, Mihalopoulos NL, Vos M, Pyles L, Roary M, Aschner J, Karagas MR, Trasande L. Understanding childhood obesity in the US: the NIH environmental influences on child health outcomes (ECHO) program. Int J Obes (Lond) 2020; 44:617-627. [PMID: 31649277 PMCID: PMC7060502 DOI: 10.1038/s41366-019-0470-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 09/18/2019] [Accepted: 09/27/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Few resources exist for prospective, longitudinal analysis of the relationships between early life environment and later obesity in large diverse samples of children in the United States (US). In 2016, the National Institutes of Health launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate influences of environmental exposures on child health and development. We describe demographics and overweight and obesity prevalence in ECHO, and ECHO's potential as a resource for understanding how early life environmental factors affect obesity risk. METHODS In this cross-sectional study of 70 extant US and Puerto Rico cohorts, 2003-2017, we examined age, race/ethnicity, and sex in children with body mass index (BMI) data, including 28,507 full-term post-birth to <2 years and 38,332 aged 2-18 years. Main outcomes included high BMI for age <2 years, and at 2-18 years overweight (BMI 85th to <95th percentile), obesity (BMI ≥ 95th percentile), and severe obesity (BMI ≥ 120% of 95th percentile). RESULTS The study population had diverse race/ethnicity and maternal demographics. Each outcome was more common with increasing age and varied with race/ethnicity. High BMI prevalence (95% CI) was 4.7% (3.5, 6.0) <1 year, and 10.6% (7.4, 13.7) for 1 to <2 years; overweight prevalence increased from 13.9% (12.4, 15.9) at 2-3 years to 19.9% (11.7, 28.2) at 12 to <18 years. ECHO has the statistical power to detect relative risks for 'high' BMI ranging from 1.2 to 2.2 for a wide range of exposure prevalences (1-50%) within each age group. CONCLUSIONS ECHO is a powerful resource for understanding influences of chemical, biological, social, natural, and built environments on onset and trajectories of obesity in US children. The large sample size of ECHO cohorts adopting a standardized protocol for new data collection of varied exposures along with longitudinal assessments will allow refined analyses to identify drivers of childhood obesity.
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Affiliation(s)
- Frances A Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | | | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Xiuhong Li
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Andrew Law
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Dana Dabelea
- Departments of Epidemiology and Pediatrics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Denver, CO, USA
| | - Andrew Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Marie-France Hivert
- Division of Chronic Disease Research Across the Lifecourse (CoRAL), Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Carrie V Breton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Noel T Mueller
- Welch Center for Epidemiology, Prevention and Clinical Research, Johns Hopkins University Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kelly J Hunt
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - S Sonia Arteaga
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
| | - Tania Lombo
- NIH Office of the Director, ECHO Program, Bethesda, MD, USA
| | - Somdat Mahabir
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Doug Ruden
- Department of Obstetrics and Gynecology, Institute of Environmental Health Sciences, Wayne State University, Detroit, MI, USA
| | - Katherine Sauder
- Departments of Pediatrics and Epidemiology, University of Colorado, Denver, CO, USA
| | - Monique M Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Yeyi Zhu
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Sarah Polk
- Department of Pediatrics and Centro SOL, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Miriam Vos
- Department of Pediatrics, Emory University, Atlanta, GA, USA
| | - Lee Pyles
- Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV, USA
| | - Mary Roary
- National Institute of Nursing Research and Environmental Influences on Child Health Outcomes Program, National Institutes of Health, Rockville, MD, USA
| | - Judy Aschner
- Department of Pediatrics and Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Margaret R Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Leonardo Trasande
- Departments of Pediatrics, Environmental Medicine and Population Health, NYU School of Medicine, New York, NY, USA.
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Physical Activity in the Summer Heat: How Hot Weather Moderates the Relationship Between Built Environment Features and Outdoor Physical Activity of Adults. J Phys Act Health 2020; 17:261-269. [PMID: 31918409 DOI: 10.1123/jpah.2019-0399] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 09/22/2019] [Accepted: 11/25/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Research has not yet examined how hot weather moderates the relationship between the built environment and outdoor physical activity levels. The authors posited that hot days will increase the magnitude of the expected directional effect of built environment features on physical activity. METHODS This longitudinal study included 134 US adults from the Three city Heat and Electrical failure AdapTation study. Adults self-reported physical activity for multiple summer days (nstudy-days = 742) in 2016. Hot days were defined as ≥90th percentile of daily maximum heat index. Built environment features included density, safety, trees, hilliness, connectivity, access to parks, and access to shops + services. Separate growth curve models with interaction terms (ie, hot day × built environment feature) were run for daily minutes of outdoor physical activity (ie, any activity and recommended activity). RESULTS Neither hot days nor built environment features impacted outdoor physical activity significantly, and hot days did not moderate the relationship between built environment features and physical activity (P > .05). CONCLUSIONS With adults failing to modify behavior on hot days, cities may be placing adults at increased risk of exertional heat illness. The authors recommend incorporating the risk of exertional heat illness in health impact assessments and deploying heat management strategies.
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Hobin E, Swanson A, Booth G, Russell K, Rosella LC, Smith BT, Manley E, Isaranuwatchai W, Whitehouse S, Brunton N, McGavock J. Physical activity trails in an urban setting and cardiovascular disease morbidity and mortality in Winnipeg, Manitoba, Canada: a study protocol for a natural experiment. BMJ Open 2020; 10:e036602. [PMID: 32075847 PMCID: PMC7045157 DOI: 10.1136/bmjopen-2019-036602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Aspects of the built environment that support physical activity are associated with better population health outcomes. Few experimental data exist to support these observations. This protocol describes the study of the creation of urban trials on cardiovascular disease (CVD)-related morbidity and mortality in a large urban centre. METHODS AND ANALYSIS Between 2008 and 2010, the city of Winnipeg, Canada, built four, paved, multiuse (eg, cycling, walking and running), two-lane trails that are 5-8 km long and span ~60 neighbourhoods. Linking a population-based health data with census and environmental data, we will perform an interrupted time series analysis to assess the impact of this natural experiment on CVD-related morbidity and mortality among individuals 30-65 years of age residing within 400-1200 m of the trail. The primary outcome of interest is a composite measure of incident major adverse CVD events (ie, CVD-related mortality, ischaemic heart disease, stroke and congestive heart failure). The secondary outcome of interest is a composite measure of incident CVD-related risk factors (ie, diabetes, hypertension and dyslipidaemia). Outcomes will be assessed quarterly in the 10 years before the intervention and 5 years following the intervention, with a 4-year interruption. We will adjust analyses for differences in age, sex, ethnicity, immigration status, income, gentrification and other aspects of the built environment (ie, greenspace, fitness/recreation centres and walkability). We will also assess trail use and trail user profiles using field data collection methods. ETHICS AND DISSEMINATION Ethical approvals for the study have been granted by the Health Research Ethics Board at the University of Manitoba and the Health Information Privacy Committee within the Winnipeg Regional Health Authority. We have adopted an integrated knowledge translation approach. Information will be disseminated with public and government partners. TRIAL REGISTRATION NUMBER NCT04057417.
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Affiliation(s)
- Erin Hobin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Gillian Booth
- Department of Endocrinology and Metabolism, University of Toronto, Toronto, Ontario, Canada
| | - Kelly Russell
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Brendan T Smith
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Ed Manley
- The Bartlett Centre for Advanced Spatial Analysis (CASA), University College London, London, UK
| | - Wanrudee Isaranuwatchai
- Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | | | - Nicole Brunton
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jonathan McGavock
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Plascak JJ, Rundle AG, Babel RA, Llanos AAM, LaBelle CM, Stroup AM, Mooney SJ. Drop-And-Spin Virtual Neighborhood Auditing: Assessing Built Environment for Linkage to Health Studies. Am J Prev Med 2020; 58:152-160. [PMID: 31862100 PMCID: PMC6927542 DOI: 10.1016/j.amepre.2019.08.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 08/18/2019] [Accepted: 08/19/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Various built environment factors might influence certain health behaviors and outcomes. Reliable, resource-efficient methods that are feasible for assessing built environment characteristics across large geographies are needed for larger, more robust studies. This paper reports the item response prevalence, reliability, and rating time of a new virtual neighborhood audit protocol, drop-and-spin auditing, developed for assessment of walkability and physical disorder characteristics across large geographic areas. METHODS Drop-and-spin auditing, a method where a Google Street View scene was rated by spinning 360° around a point location, was developed using a modified version of the virtual audit tool Computer Assisted Neighborhood Visual Assessment System. Approximately 8,000 locations within Essex County, New Jersey were assessed by 11 trained auditors. Using a standardized protocol, 32 built environment items per a location within Google Street View were audited. Test-retest and inter-rater κ statistics were from a 5% subsample of locations. Data were collected in 2017-2018 and analyzed in 2018. RESULTS Roughly 70% of Google Street View scenes had sidewalks. Among those, two thirds were in good condition. At least 5 obvious items of garbage or litter were present in 41% of Google Street View scenes. Maximum test-retest reliability indicated substantial agreement (κ ≥0.61) for all items. Inter-rater reliability of each item, generally, was lower than test-retest reliability. The median time to rate each item was 7.3 seconds. CONCLUSIONS Compared with segment-based protocols, drop-and-spin virtual neighborhood auditing is quicker and similarly reliable for assessing built environment characteristics. Assessment of large geographies may be more feasible using drop-and-spin virtual auditing.
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Affiliation(s)
- Jesse J Plascak
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey; Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Riddhi A Babel
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Adana A M Llanos
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey; Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | - Celine M LaBelle
- Edward J. Bloustein School of Planning and Public Policy, Rutgers, The State University of New Jersey, New Brunswick, New Jersey
| | - Antoinette M Stroup
- Department of Biostatistics and Epidemiology, School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey; Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey; New Jersey State Cancer Registry, New Jersey Department of Health, Trenton, New Jersey
| | - Stephen J Mooney
- Department of Epidemiology, University of Washington, Seattle, Washington
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Etindele-Sosso FA. Insomnia, excessive daytime sleepiness, anxiety, depression and socioeconomic status among customer service employees in Canada. Sleep Sci 2020; 13:54-64. [PMID: 32670493 PMCID: PMC7347365 DOI: 10.5935/1984-0063.20190133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/28/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE It is the first study investigating deeply symptoms of neuropsychiatric diseases among a large population of customer service employees (n=1238, 640 females and 598 males). The study's goals were document presence of sleep disorders, anxiety and depression among customer service advisors and determine the influence of the socioeconomic status (pSES), duration in position and full-time or part-time shift on the diseases above. METHODS Linear regressions and ANOVA with a Tukey multiple comparisons of means was performed to analyze correlation and differences between citizens, international students and immigrants in their pSES and neuropsychiatric diseases. RESULTS Customer service employees (578 Canadians, 264 immigrants and 358 international students) are in majority undergraduate students (286 men and 289 females) with a high school degree (280 men and 308 women). They work full-time (560 men and 548 women) and are single (420 men and 560 women). Among customer service advisors, the time spent as an advisor was an excellent predictor of insomnia, sleepiness and anxiety (respectively with R2=91,83%, R2=81,23% and R2=87,46%) but a moderate predictor of depression (R2=69,14%). The pSES was a moderate predictor of sleep disorders (respectively R2=62,04% for insomnia and R2=53,62% for sleepiness) and strongly associated with anxiety and depression (R2=82,95% for anxiety and R2=89,77% for depression). DISCUSSION Insomnia, sleepiness and anxiety are more prevalent for full-time employees (higher for immigrants and international students compared to Canadians) compared with part-time employees, while depression was similarly higher for Canadian and immigrants compared to international students. Regarding full-time employees, symptoms of insomnia, anxiety and depression were higher for men compared to women. Regarding part-time employees, symptoms of insomnia and sleepiness were higher for women compared to men. Employees working full-time with rotating shifts are more exposed to insomnia, sleepiness and anxiety than employees working part-time. More research is needed to understand mental health of customer service employees regardless of their area and it is worthy of interest to study the link between sleep disorders and mood disorders with work conditions. Here some practical suggestions are made to reduce neuropsychiatric disorders for customer service employees or to at least mitigate the work burden on their brains.
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Affiliation(s)
- Faustin Armel Etindele-Sosso
- Hôpital du Sacré-Coeur de Montréal, Center for Advanced Research in Sleep Medicine (CEAMS) - Montréal - Qc - Canada
- Université du Québec à Montréal, Institut Santé et Société - Montréal - Qc - Canada
- Douglas Institute of Mental Health, Quebec Network on Suicide, Mood Disorders and Related Disorders (RQSHA) - Montréal - Qc - Canada
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Hino AAF, Rech CR, Gonçalves PB, Reis RS. [Accessibility to public spaces for leisure and physical activity in adults in Curitiba, Paraná State, Brazil]. CAD SAUDE PUBLICA 2019; 35:e00020719. [PMID: 31800780 DOI: 10.1590/0102-311x00020719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 06/13/2019] [Indexed: 11/21/2022] Open
Abstract
The study aimed to analyze the association between accessibility to public spaces for leisure activities, availability of equipment for physical exercise in these spaces, and leisure-time physical activity (PA) in adults. A household survey was conducted with 699 adults from 32 census tracts selected according to income and "walkability". Accessibility to public spaces for leisure activities was determined by geoprocessing according to proximity to public spaces for leisure activities and the amount of such spaces within radiuses of 500 and 1,000 meters around the participants' homes. Presence of equipment for physical exercise in these public spaces was assessed by the observation method and classified as: (a) without equipment for physical exercise; (b) with equipment for physical exercise; (c) equipment for physical exercise for adults; and (d) with three or more pieces of equipment for physical exercise. PA was self-reported, and walking was analyzed separately from moderate-vigorous PA, classified in two levels (≥ 10 minutes/week and ≥ 150 minutes/week). The amount of public spaces for leisure activities in a 500-meter radius with one or more pieces of equipment for physical exercise was negatively associated with walking (OR = 0.84, based on ≥ 150 minutes/week). The amount of public spaces for leisure activities in a 1,000-meter radius was positively associated with moderate-vigorous PA (OR = 1.03). The distance to a public space for leisure activities with three or more pieces of equipment for physical exercise (OR = 0.95) was inversely associated with moderate-vigorous PA. Proximity and amount of public spaces for leisure activities are associated with higher levels of moderate-vigorous PA in adults. The combination of methods can help reveal the contribution that access to (and quality of) public spaces for leisure activities can make to PA.
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Affiliation(s)
- Adriano Akira Ferreira Hino
- Programa de Pós-graduação em Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná, Curitiba, Brasil
| | - Cassiano Ricardo Rech
- Programa de Pós-graduação em Educação Física, Universidade Federal de Santa Catarina, Florianópolis, Brasil
| | - Priscila Bezerra Gonçalves
- Programa de Pós-graduação em Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná, Curitiba, Brasil
| | - Rodrigo Siqueira Reis
- Brown School, Washington University in St. Louis, St. Louis, U.S.A.,Programa de Pós-graduação em Gestão Urbana, Pontifícia Universidade Católica do Paraná, Curitiba, Brasil
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Plans E, Gullón P, Cebrecos A, Fontán M, Díez J, Nieuwenhuijsen M, Franco M. Density of Green Spaces and Cardiovascular Risk Factors in the City of Madrid: The Heart Healthy Hoods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4918. [PMID: 31817351 PMCID: PMC6950753 DOI: 10.3390/ijerph16244918] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 11/30/2019] [Accepted: 12/03/2019] [Indexed: 12/11/2022]
Abstract
The aim of this study is to evaluate the relationship between the density of green spaces at different buffer sizes (300, 500, 1000 and 1500 m) and cardiovascular risk factors (obesity, hypertension, high cholesterol, and diabetes) as well as to study if the relationship is different for males and females. We conducted cross-sectional analyses using the baseline measures of the Heart Healthy Hoods study (N = 1625). We obtained data on the outcomes from clinical diagnoses, as well as anthropometric and blood sample measures. Exposure data on green spaces density at different buffer sizes were derived from the land cover distribution map of Madrid. Results showed an association between the density of green spaces within 300 and 500 m buffers with high cholesterol and diabetes, and an association between the density of green spaces within 1500 m buffer with hypertension. However, all of these associations were significant only in women. Study results, along with other evidence, may help policy-makers creating healthier environments that could reduce cardiovascular disease burden and reduce gender health inequities. Further research should investigate the specific mechanisms behind the differences by gender and buffer size of the relationship between green spaces and cardiovascular risk factors.
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Affiliation(s)
- Elena Plans
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, 28871 Madrid, Spain; (E.P.); (A.C.); (M.F.); (J.D.); (M.F.)
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Pedro Gullón
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, 28871 Madrid, Spain; (E.P.); (A.C.); (M.F.); (J.D.); (M.F.)
- Urban Health Collaborative, Drexel Dornsife School of Public Health, Philadelphia, PA 19104, USA
| | - Alba Cebrecos
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, 28871 Madrid, Spain; (E.P.); (A.C.); (M.F.); (J.D.); (M.F.)
| | - Mario Fontán
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, 28871 Madrid, Spain; (E.P.); (A.C.); (M.F.); (J.D.); (M.F.)
- Servicio de Medicina Preventiva, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Julia Díez
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, 28871 Madrid, Spain; (E.P.); (A.C.); (M.F.); (J.D.); (M.F.)
| | - Mark Nieuwenhuijsen
- ISGlobal, Center for Research in Environmental Epidemiology (CREAL), 08036 Barcelona, Spain;
- Department of Biomedicine, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcala, 28871 Madrid, Spain; (E.P.); (A.C.); (M.F.); (J.D.); (M.F.)
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Sadeh M, Brauer M, Chudnovsky A, Ziv A, Dankner R. Residential greenness and increased physical activity in patients after coronary artery bypass graft surgery. Eur J Prev Cardiol 2019; 28:1184-1191. [DOI: 10.1177/2047487319886017] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 10/10/2019] [Indexed: 11/16/2022]
Abstract
Abstract
Aims
Physical activity is a fundamental component of rehabilitation following coronary artery bypass (CABG) surgery. Proximity to neighbourhood green spaces may encourage physical activity. We investigated the association between residential greenness and exercise-related physical activity post-CABG surgery.
Methods
Participants in a prospective cohort study of 846 patients (78% men) who underwent CABG surgery at seven cardiothoracic units during the time period 2004–2007 were interviewed regarding their physical activity habits one day before and one year after surgery. Exposure to residential neighbourhood greenness (within a 300 m buffer around their place of residence) was measured using the Normalized Difference Vegetative Index. Participation in exercise-related physical activity (yes/no), weekly duration of exercise-related physical activity and the change in exercise-related physical activity between baseline and follow-up were examined for associations with residential greenness, adjusting for socio-demographic factors, propensity score adjusted participation in cardiac rehabilitation and health-related covariates after multiple imputation for missing variables.
Results
Living in a higher quartile of residential greenness was associated with a 52% greater odds of being physically active (OR 1.52, 95% CI 1.22–1.90). This association persisted only (OR 1.75, 95% CI 1.35–2.27) among patients who did not participate in cardiac rehabilitation following surgery and was stronger in women (OR 2.38, 95% CI 1.40–4.07) than in men (OR 1.37, 95% CI 1.07–1.75). Participants who lived in greener areas were more likely to increase their post-surgical physical activity than those who lived in less green areas (OR 1.59, 95% CI 1.25–2.01).
Conclusions
Residential greenness appears to be beneficial in increasing exercise-related physical activity in cardiac patients, especially those not particpating in cardiac rehabilitation after CABG surgery.
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Affiliation(s)
- Maya Sadeh
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler School of Medicine, Tel Aviv University, Israel
| | - Michael Brauer
- School of Population & Public Health, University of British Columbia, Canada
| | - Alexandra Chudnovsky
- AIR-O Lab, Porter School of Environment and Geosciences, Faculty of Exact Sciences, Department of Geography and Human Environment, Tel Aviv University, Israel
| | - Arnona Ziv
- Unit for Data Management and Computerization, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Israel
| | - Rachel Dankner
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler School of Medicine, Tel Aviv University, Israel
- Unit for Cardiovascular Epidemiology, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Israel
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A systematic review of outdoor gym use: Current evidence and future directions. J Sci Med Sport 2019; 22:1335-1343. [DOI: 10.1016/j.jsams.2019.08.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/31/2019] [Accepted: 08/04/2019] [Indexed: 11/16/2022]
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How Does Park Use and Physical Activity Differ between Childhood and Adolescence? A Focus on Gender and Race-Ethnicity. J Urban Health 2019; 96:692-702. [PMID: 31493183 PMCID: PMC6814698 DOI: 10.1007/s11524-019-00388-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Physical activity typically declines between childhood and adolescence. Despite urban parks being a great venue for physical activity, children change both the frequency of park use and their park use habits as they age into adolescence. However, little is known about how these differences vary by gender and how distinct race/ethnicity groups differentially change their park habits. This study analyzed the differences in park use and per capita energy expenditure between children and teenagers of different gender and race/ethnicity backgrounds. Using the System for Observing Play and Recreation in Communities (SOPARC), systematic observations were conducted in 20 New York City parks in 2017, located in low-income areas with high presence of Latino or Asian residents. A total of 9963 scans in 167 distinct target areas counted 16,602 children (5-10 years old) and 11,269 teenagers (11 or older). Using adjusted marginal means, we estimated the number of park users of each age range, gender, and race/ethnicity expected to be found in each park activity setting. Teenagers of both genders and most race/ethnicity groups were less likely to be in a park and had lower per capita energy expenditure, compared with children. The difference in park attendance was greater than the difference in per capita energy expenditure. Dissimilarities were clearly gendered and race/ethnicity dependent. Asian and Latino females showed the greatest divergence between childhood and adolescence. African American boys were the only group to show a positive age contrast in park attendance and per capita energy expenditure.
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The Association between Neighborhood Environments and Physical Activity from Pregnancy to Postpartum: a Prospective Cohort Study. J Urban Health 2019; 96:703-719. [PMID: 31342403 PMCID: PMC6814694 DOI: 10.1007/s11524-019-00376-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The objectives of this study were to determine if neighborhood measures were associated with physical activity cross-sectionally during late pregnancy (27-30 weeks' gestation), 3 months postpartum, and 12 months postpartum, and longitudinally with an increase in physical activity from late pregnancy to 12 months postpartum. Data are from the Pregnancy, Infection, and Nutrition (PIN3) and Postpartum Prospective Cohort Study. Dichotomized self-reported recreation and total physical activity hours/week were explored cross-sectionally at three time points, and as an increase over time. Four factors from a neighborhood environmental audit were examined: arterial or thoroughfare, walkable neighborhood, physical incivilities, and decoration. Secondary spatial data included population density, hilliness, intersection density, distance to nearest major road, distance to nearest park, distance to nearest physical activity facility, and distance to nearest bus stop. Multilevel mixed-effects logistic regression models were used to assess the association between environmental variables and physical activity measures. A number of environmental variables were associated with total and recreation physical activity at the three time points in cross-sectional models. For increase in recreation physical activity over time, a moderate distance to nearest major road was significantly associated with increased recreation physical activity from 3 to 12 months postpartum (tertile 2 OR 2.13, 95% CI 1.08, 4.22). Living the furthest distance from the nearest park was inversely associated with an increase in recreation physical activity from pregnancy to 3 months postpartum (tertile 3 OR 0.50, 95% CI 0.29, 0.85). The findings of this study indicate that several aspects of the neighborhood environment, such as walkability, access to transit, distance to recreation facilities, and road networks, are associated with physical activity during different stages of pregnancy and postpartum. Since physical activity may result in long-term health benefits for both the woman and child, environments that support this activity should be encouraged.
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Zhang R, Wulff H, Duan Y, Wagner P. Associations between the physical environment and park-based physical activity: A systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:412-421. [PMID: 31534816 PMCID: PMC6742676 DOI: 10.1016/j.jshs.2018.11.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 08/21/2018] [Accepted: 09/09/2018] [Indexed: 05/06/2023]
Abstract
BACKGROUND With an increase in the evidence for the associations between park-based physical activity (PA) and physical environments (especially park and neighborhood environments), researchers face an important challenge in interpreting and summarizing the evidence to develop environmental change interventions. An updated review is needed to better inform policymaking and environmental interventions. The current study aimed to systematically review the research on the associations of park-based PA with park and neighborhood environmental characteristics. METHODS We targeted English peer-reviewed articles from 5 electronic databases using keywords related to park-based PA, park environments, and neighborhood environments. Of the 4071 identified papers, 25 studies published between 2008 and 2016 met all the eligibility criteria and were included in this review. RESULTS The characteristics of physical environment that received consistent support included paths/trails, lighting, and incivilities (e.g., broken glasses and litter). Mixed findings were revealed for 6 park environmental factors (unspecified active facilities, playgrounds and skating areas, fitness stations, picnic areas, greenness, and park size) and 2 neighborhood environmental factors (park density and park proximity). CONCLUSION It can be concluded that paths/trails, lighting, and incivilities are 3 key physical environmental attributes of park-based PA. Given the inconsistent findings on park and neighborhood environmental factors, more robust designs such as prospective investigation are required.
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Affiliation(s)
- Ru Zhang
- Department of Sport and Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong 999077, China
- Corresponding author.
| | - Hagen Wulff
- Institute of Exercise and Public Health, Faculty of Sport Sciences, University of Leipzig, Leipzig 04109, Germany
| | - Yanping Duan
- Department of Sport and Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong 999077, China
| | - Petra Wagner
- Institute of Exercise and Public Health, Faculty of Sport Sciences, University of Leipzig, Leipzig 04109, Germany
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73
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Impact of Frequency of Visits and Time Spent in Urban Green Space on Subjective Well-Being. SUSTAINABILITY 2019. [DOI: 10.3390/su11154189] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Exposure to green spaces can reduce the negative effects of stress. This study examines how frequency of visits and time spent in urban green spaces (UGS) affect urban dwellers’ subjective well-being. We also investigated the numbers of respondents visiting UGS, their primary motivation, and constraints on their ability to visit. Using quota sampling, an online survey was conducted of 400 residents of Daejeon City, South Korea. ANOVA results indicated no significant interactions between visit frequency and time spent in UGS. Respondents who had visited UGS within the past two weeks expressed higher positive and lower negative emotions than did non-visitors, regardless of visit frequency, and regular visitors showed higher general life satisfaction levels. These positive effects were confirmed by estimated structural equation models. However, the time spent in UGS did not affect emotions or life satisfaction in general. Heavy users mostly visited UGS to walk, and light/non-users cited the lack of urban green spaces near their home as the major constraint on visiting UGS. The estimated structural equation models clearly show positive effects from motivation and negative effects of constraints and access time to UGS on visit frequency. To improve urban dwellers’ subjective well-being, UGS should prioritize good walking environments and accessibility.
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Cesare N, Nguyen QC, Grant C, Nsoesie EO. Social media captures demographic and regional physical activity. BMJ Open Sport Exerc Med 2019; 5:e000567. [PMID: 31423323 PMCID: PMC6678033 DOI: 10.1136/bmjsem-2019-000567] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2019] [Indexed: 12/04/2022] Open
Abstract
Objectives We examined the use of data from social media for surveillance of physical activity prevalence in the USA. Methods We obtained data from the social media site Twitter from April 2015 to March 2016. The data consisted of 1 382 284 geotagged physical activity tweets from 481 146 users (55.7% men and 44.3% women) in more than 2900 counties. We applied machine learning and statistical modelling to demonstrate sex and regional variations in preferred exercises, and assessed the association between reports of physical activity on Twitter and population-level inactivity prevalence from the US Centers for Disease Control and Prevention. Results The association between physical inactivity tweet patterns and physical activity prevalence varied by sex and region. Walking was the most popular physical activity for both men and women across all regions (15.94% (95% CI 15.85% to 16.02%) and 18.74% (95% CI 18.64% to 18.88%) of tweets, respectively). Men and women mentioned performing gym-based activities at approximately the same rates (4.68% (95% CI 4.63% to 4.72%) and 4.13% (95% CI 4.08% to 4.18%) of tweets, respectively). CrossFit was most popular among men (14.91% (95% CI 14.52% to 15.31%)) among gym-based tweets, whereas yoga was most popular among women (26.66% (95% CI 26.03% to 27.19%)). Men mentioned engaging in higher intensity activities than women. Overall, counties with higher physical activity tweets also had lower leisure-time physical inactivity prevalence for both sexes. Conclusions The regional-specific and sex-specific activity patterns captured on Twitter may allow public health officials to identify changes in health behaviours at small geographical scales and to design interventions best suited for specific populations.
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Affiliation(s)
- Nina Cesare
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Quynh C Nguyen
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Christan Grant
- School of Computer Science, University of Oklahoma, Norman, Oklahoma, USA
| | - Elaine O Nsoesie
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA.,Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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Antonakos CL, Coulton CJ, Kaestner R, Lauria M, Porter DE, Colabianchi N. Built Environment Exposures of Adults in the Moving to Opportunity Experiment. HOUSING STUDIES 2019; 35:703-719. [PMID: 32461709 PMCID: PMC7252208 DOI: 10.1080/02673037.2019.1630560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 06/03/2019] [Accepted: 06/05/2019] [Indexed: 05/25/2023]
Abstract
This paper describes environmental exposures of adult participants in the Moving to Opportunity for Fair Housing (MTO) experiment over a four to seven year period from baseline to the interim evaluation. The MTO experiment randomized participants living in public housing or private assisted housing at baseline into experimental and control groups and provided a housing voucher for experimental group participants to move to neighborhoods with less than 10 percent of the population below the poverty line. However, few studies have examined how this move affected exposures to health promoting environments. We used data on residential locations of MTO participants and archival data on the built and food environment to construct environmental exposure variables. MTO participants in the experimental and Section 8 groups lived in neighborhoods with higher food prices, less high intensity development and more open space relative to the control group. The findings suggest that housing policies can have potential health consequences by altering health-related environmental exposures.
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Affiliation(s)
| | - Claudia J. Coulton
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University. Cleveland OH
| | - Robert Kaestner
- Institute of Government and Public Affairs, University of Illinois, Chicago, Illinois
| | - Mickey Lauria
- College of Architecture, Arts and Humanities, Clemson University, Clemson, SC
| | - Dwayne E. Porter
- Arnold School of Public Health, University of South Carolina, Columbia, SC
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Uijtdewilligen L, Waters CNH, Aw S, Wong ML, Sia A, Ramiah A, Wong M, Müller-Riemenschneider F. The Park Prescription Study: Development of a community-based physical activity intervention for a multi-ethnic Asian population. PLoS One 2019; 14:e0218247. [PMID: 31185057 PMCID: PMC6559668 DOI: 10.1371/journal.pone.0218247] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 05/29/2019] [Indexed: 11/30/2022] Open
Abstract
This mixed-methods study aims to inform the development of a 'Park Prescription' intervention, including face-to-face counseling on physical activity and park use and providing weekly structured exercise sessions in the park to promote physical activity. Participants aged 40-65 years were recruited from regional health screening events in Singapore where they completed a questionnaire (N = 97) and consented to focus group (FG) participation (N = 16). The questionnaire assessed current park use, and the type, duration, and intensity of park-based activities that would be of interest. FGs explored the barriers and facilitators of physical activity (in parks). Short interviews (N = 16) with 'doers', i.e., people already engaging in park-based physical activity, identified motivational factors and ways to overcome common barriers. Participants acknowledged the health benefits of parks and valued them because of their pleasant landscapes, greenery and facilities. However, few participants engaged in physical activity at the parks, because they were too busy or too tired. Participants mostly indicated doing informal activities, such as walking, cycling or playing traditional Asian games when using the parks for exercise. A variety of low-to-moderate intensity park-based activities such as walking, cycling or aerobics were of interest to participants who expressed the willingness to engage in structured exercise sessions on weekday evenings or weekend mornings. Strategies to increase physical activity in parks included: encourage planning, create social support, identify alternatives for bad weather, improve proximity/accessibility to parks and park safety. The effectiveness of the Park Prescription intervention in promoting physical activity, park use, as well as physical and mental well-being will be tested in a one-year Randomized Controlled Trial.
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Affiliation(s)
| | | | - Su Aw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Mee Lian Wong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Angelia Sia
- Centre for Urban Greenery & Ecology, National Parks Board Singapore, Singapore
| | | | - Michael Wong
- Health for Life Centre, Alexandra Health Pte Ltd, Singapore
| | - Falk Müller-Riemenschneider
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Institute for Social Medicine, Epidemiology and Health Economics, Charite Univeristy Medical Centre, Berlin, Germany
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Evenson KR, Williamson S, Han B, McKenzie TL, Cohen DA. United States' neighborhood park use and physical activity over two years: The National Study of Neighborhood Parks. Prev Med 2019; 123:117-122. [PMID: 30898586 PMCID: PMC6534437 DOI: 10.1016/j.ypmed.2019.03.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/08/2019] [Accepted: 03/16/2019] [Indexed: 11/27/2022]
Abstract
The United States lacks surveillance to monitor park use and conditions. The purpose of this study was to use the System for Observing Play and Recreation in Communities (SOPARC) as a surveillance tool to describe the conditions, user characteristics, and physical activity of a national sample of neighborhood parks at two time points. Using a stratified multistage sampling strategy, a representative sample of 174 neighborhood parks in 25 major United States' cities were selected. During 2014 and 2016, park-related use, conditions, and physical activity were assessed using SOPARC in 169 parks. Overall, 74,106 park users were observed at baseline and 69,150 park users were observed two years later (p = 0.37). There were persistent disparities in park use by gender and age, with disproportionately more male than female users in each age group (child, teenager, adult, older adult). Older adults used the park less than other age groups. Almost two-thirds of park users were observed being sedentary (61.9% in 2014, 60.7% in 2016), followed by moderate (30.8%, 32.0%) and vigorous (7.3%, 7.3%) activity. Empty target areas increased over two years (75.3%, 77.6%; p = 0.01) and those that were equipped (2.6%, 1.2%; p = 0.0003), accessible (95.4%, 94.3%; p = 0.01), and organized (2.6%, 1.7%; p = 0.01) decreased. Areas that were usable (97.5%, 97.4%) or provided supervised activities (2.0%, 2.4%) did not change significantly. The findings demonstrate the value of SOPARC as a surveillance tool, identify user groups under represented at parks, and suggest an opportunity to encourage more park-based physical activity among park visitors.
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Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina - Chapel Hill, 123 W Franklin Street, Building C, Suite 410, Chapel Hill, NC 27514, United States.
| | | | - Bing Han
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, United States.
| | - Thomas L McKenzie
- School of Exercise and Nutritional Sciences, San Diego State University, 5127 Walsh Way, San Diego, CA 92115, United States.
| | - Deborah A Cohen
- RAND Corporation, 1776 Main Street, Santa Monica, CA 90407, United States.
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Perception of parks and trails as mobility facilitators and transportation walking in older adults: a study using digital geographical maps. Aging Clin Exp Res 2019; 31:673-683. [PMID: 30666515 DOI: 10.1007/s40520-018-01115-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/29/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Transportation walking represents a promising target for physical activity promotion in older adults. Perceived characteristics of the neighbourhood physical environment may affect older adults' choice of transportation mode for a routine activity such as walking to the grocery store. AIMS To (1) evaluate associations between older adults' perception of parks and trails as outdoor mobility facilitators and transportation walking, specifically to the grocery store; and (2) explore whether the spatial relationship between people's home, perceived facilitator and store was relevant for their transportation choice. METHODS Cross-sectional data were collected in a subsample of the 'Life-space mobility in old age' cohort. Multivariable logistic regression analysis on the binary outcome 'transportation walking' (vs. 'motorized transportation') was used to evaluate the association with perceived mobility facilitators in the neighborhood; in step (1) without and in step (2) with taking spatial relationships into account. RESULTS Perceiving a park as facilitator increased the odds of walking (N = 179; Odds Ratio 9.89; 95% Confidence interval 3.11-31.50). Spatial relationships did not affect transportation choice. Reporting a trail as facilitator was not significantly associated with walking. CONCLUSIONS Our findings suggest that the perception of environmental characteristics in the neighbourhood has an influence on older people's transportation choices. Taking environmental measures or informing older adults on their options in the neighbourhood might be possible ways to increase older adults' transportation walking on a population level.
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Zijlema WL, Stasinska A, Blake D, Dirgawati M, Flicker L, Yeap BB, Golledge J, Hankey GJ, Nieuwenhuijsen M, Heyworth J. The longitudinal association between natural outdoor environments and mortality in 9218 older men from Perth, Western Australia. ENVIRONMENT INTERNATIONAL 2019; 125:430-436. [PMID: 30743148 DOI: 10.1016/j.envint.2019.01.075] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/17/2019] [Accepted: 01/29/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND/AIM Natural outdoor environments may mitigate harmful environmental factors associated with city living. We studied the longitudinal relationship between natural ('green and blue') outdoor environments and mortality in a cohort of older men residing in Perth, Western Australia. METHODS We studied a cohort of 9218 men aged 65 years and older from the Health In Men Study. Participants were recruited in 1996-99 and followed until 2014, during which 5889 deaths were observed. Time-varying residential surrounding greenness based on the Normalized Difference Vegetation Index, and the number and size of parks, natural space and waterbodies were defined to characterize the natural outdoor environment. All-cause non-accidental and cause-specific mortality was ascertained with the Western Australian Data Linkage System. The association of the natural outdoor environment with mortality was examined using Cox regression analysis. RESULTS After adjusting for age, men living in the highest quartile of cumulative average surrounding greenness had a 9% lower rate of all-cause non-accidental mortality (95% confidence interval [CI] 0.84, 0.98; p = .013) compared with those in the lowest quartile. This association was no longer present after adjustment for other risk factors, especially level of education. Living within 500 m of one (vs. no) natural space was associated with decreased mortality risk (adjusted hazard ratio 0.93; 95% CI 0.86, 1.00; p = .046), but no association with mortality was found for two or more natural spaces compared to none and for parks. Associations between waterbodies and mortality were inconsistent, showing non-linear beneficial and harmful associations. CONCLUSIONS In this longitudinal study of older men residing in Perth, we observed evidence suggestive of an association between access to natural spaces and decreased mortality. Associations between surrounding greenness and mortality seemed to be confounded by level of education, and associations with waterbodies were complex and need to be studied further.
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Affiliation(s)
- Wilma L Zijlema
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Catalonia, Spain.
| | - Ania Stasinska
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - David Blake
- Centre for Ecosystem Management, School of Science, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Mila Dirgawati
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Leon Flicker
- Western Australian Centre for Health & Ageing, Centre for Medical Research, The University of Western Australia, Perth, Western Australia, Australia
| | - Bu B Yeap
- Medical School, University of Western Australia, Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia
| | - Jonathan Golledge
- Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Queensland, Australia
| | - Graeme J Hankey
- Medical School, The University of Western Australia, Department of Neurology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Mark Nieuwenhuijsen
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Catalonia, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Catalonia, Spain
| | - Jane Heyworth
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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Using Photovoice to Examine Physical Activity in the Urban Context and Generate Policy Recommendations: The Heart Healthy Hoods Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050749. [PMID: 30832269 PMCID: PMC6427388 DOI: 10.3390/ijerph16050749] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 12/27/2022]
Abstract
A current challenge in physical activity research is engaging citizens with co-creating policies that support physical activity participation. Using Photovoice, a participatory action research method, the objectives of this study were to: 1) Identify community perceptions of urban built, social, and political/economic environment factors associated with physical activity; and 2) generate community-driven policy recommendations to increase physical activity. Two districts in Madrid of varying socio-economic status (SES) were selected. Overall, 24 residents participated in 4 groups stratified by sex and district (6 participants per group). Groups met weekly for 4 weeks to discuss and analyze their photographs. Participants coded photographs into categories, which were then regrouped into broader themes. The categories were transformed into policy recommendations using an adaptation of the logical framework approach. Participants took 161 photos, which were classified into 61 categories and 14 broader themes (e.g., active transportation, sport in the city). After this, participants generated a set of 34 policy recommendations to improve the urban environment to support physical activity (e.g., to redistribute sports facilities). Collaboration between citizens and researchers led to a deeper understanding of the community perceptions of urban built, social, and political/economic environment factors associated with physical activity in two districts of Madrid, while engaging citizens in recommending public policies.
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Jankowska MM, Sears DD, Natarajan L, Martinez E, Anderson CAM, Sallis JF, Matthews SA, Crist K, Dillon L, Johnson E, Barrera-Ng A, Full K, Godbole S, Kerr J. Protocol for a cross sectional study of cancer risk, environmental exposures and lifestyle behaviors in a diverse community sample: the Community of Mine study. BMC Public Health 2019; 19:186. [PMID: 30760246 PMCID: PMC6375220 DOI: 10.1186/s12889-019-6501-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 01/31/2019] [Indexed: 01/08/2023] Open
Abstract
Background Physical inactivity and unhealthy diet are modifiable behaviors that lead to several cancers. Biologically, these behaviors are linked to cancer through obesity-related insulin resistance, inflammation, and oxidative stress. Individual strategies to change physical activity and diet are often short lived with limited effects. Interventions are expected to be more successful when guided by multi-level frameworks that include environmental components for supporting lifestyle changes. Understanding the role of environment in the pathways between behavior and cancer can help identify what environmental conditions are needed for individual behavioral change approaches to be successful, and better recognize how environments may be fueling underlying racial and ethnic cancer disparities. Methods This cross-sectional study was designed to select participants (n = 602 adults, 40% Hispanic, in San Diego County) from a range of neighborhoods ensuring environmental variability in walkability and food access. Biomarkers measuring cancer risk were measured with fasting blood draw including insulin resistance (fasting plasma insulin and glucose levels), systemic inflammation (levels of CRP), and oxidative stress measured from urine samples. Objective physical activity, sedentary behavior, and sleep were measured by participants wearing a GT3X+ ActiGraph on the hip and wrist. Objective measures of locations were obtained through participants wearing a Qstarz Global Positioning System (GPS) device on the waist. Dietary measures were based on a 24-h food recall collected on two days (weekday and weekend). Environmental exposure will be calculated using static measures around the home and work, and dynamic measures of mobility derived from GPS traces. Associations of environment with physical activity, obesity, diet, and biomarkers will be measured using generalized estimating equation models. Discussion Our study is the largest study of objectively measured physical activity, dietary behaviors, environmental context/exposure, and cancer-related biomarkers in a Hispanic population. It is the first to perform high quality measures of physical activity, sedentary behavior, sleep, diet and locations in which these behaviors occur in relation to cancer-associated biomarkers including insulin resistance, inflammation, impaired lipid metabolism, and oxidative stress. Results will add to the evidence-base of how behaviors and the built environment interact to influence biomarkers that increase cancer risk. Trial registration ClinicalTrials.gov NCT02094170, 03/21/2014.
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Affiliation(s)
- Marta M Jankowska
- Calit2/Qualcomm Institute, UCSD, 9500 Gilman Dr, La Jolla, CA, 92093, USA.
| | - Dorothy D Sears
- Nutrition, College of Health Solutions, Arizona State University, 445 N 5th Street, Phoenix, AZ, 85004, USA
| | - Loki Natarajan
- Department of Family Medicine and Public Health, UCSD, 9500 Gilman Dr, La Jolla, CA, 92093, USA.,UCSD Moores Cancer Center, 3855 Health Sciences Dr, La Jolla, CA, 92093, USA
| | - Elena Martinez
- UCSD Moores Cancer Center, 3855 Health Sciences Dr, La Jolla, CA, 92093, USA
| | - Cheryl A M Anderson
- Department of Family Medicine and Public Health, UCSD, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - James F Sallis
- Department of Family Medicine and Public Health, UCSD, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Stephen A Matthews
- Department of Sociology & Criminology, Department of Anthropology, Population Research Institute, Old Main, State College, PA, 16801, USA
| | - Katie Crist
- Department of Family Medicine and Public Health, UCSD, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Lindsay Dillon
- Department of Family Medicine and Public Health, UCSD, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Eileen Johnson
- Department of Family Medicine and Public Health, UCSD, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Angelica Barrera-Ng
- Department of Family Medicine and Public Health, UCSD, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Kelsey Full
- Department of Family Medicine and Public Health, UCSD, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Suneeta Godbole
- Department of Family Medicine and Public Health, UCSD, 9500 Gilman Dr, La Jolla, CA, 92093, USA
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, UCSD, 9500 Gilman Dr, La Jolla, CA, 92093, USA.,UCSD Moores Cancer Center, 3855 Health Sciences Dr, La Jolla, CA, 92093, USA
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Oliphant EL, Hughey SM, Stowe EW, Kaczynski AT, Schipperijn J, Hipp JA. ParkIndex: Using Key Informant Interviews to Inform the Development of a New Park Access Evaluation Tool. JOURNAL OF PARK AND RECREATION ADMINISTRATION 2019; 37:10.18666/JPRA-2019-8926. [PMID: 31692932 PMCID: PMC6830567 DOI: 10.18666/jpra-2019-8926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The relationship between park availability, physical activity, and positive health outcomes has been documented across the globe. However, studying how people access parks and why they use the parks is difficult due to a lack of consensus with respect to measurement approaches and assessment of park environments. Establishing a parsimonious method and tool for quantifying both park availability and park quality represents a major step that could advance park and physical activity research and practice. This paper describes phase one of the effort to develop such a measurement tool, known as ParkIndex. ParkIndex is a two-year National Institutes of Health (NIH)-funded study to create an evidence-based tool that will assist citizens and professionals in understanding and using information regarding community park access and use. Phase one consisted of key informant interviews conducted with research and practice leaders to inform development and provide insight on the essential foundations of ParkIndex. Twelve professionals from practice and academia, including parks and recreation, landscape design, and public health sectors, were interviewed in fall 2016. Key informants were interviewed on four topics concerning the content, value, feasibility, and dissemination of ParkIndex. Trained research assistants employed double, emergent, open, and axial coding methods to develop key themes and concepts to guide phase 2 and further development of ParkIndex. Key themes throughout the interviews included measures for park use, including distance, safety, neighborhood characteristics, route and travel mode to park, and overall park characteristics. Park elements discussed included quality of, and availability of, amenities, activity spaces, programming, and park management, as well as the context of the park and the engagement of the local community. Respondents determined that ParkIndex could benefit park planning and community development and provide for a standardized method for evaluating park access. Interviews and themes offer parks and public health practitioners and researchers-and this specific ParkIndex development team-the opportunity to refine and evaluate measures to be included in a comprehensive park access and use tool. Key informants repeatedly referenced the need, especially within parks and recreation management, for consistent, reliable, and valid measures of park access and use, such as ParkIndex seeks to provide. We believe a well-conceived, integrated index will at the very least allow for greater comparison between parks and park systems and at best will facilitate the many park stakeholders to best design, maintain, program, research, and advocate for their local parks.
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Affiliation(s)
- Elizabeth L Oliphant
- Department of Parks, Recreation, and Tourism Management at North Carolina State University
| | - S Morgan Hughey
- Department of Health and Human Performance at the College of Charleston
| | - Ellen W Stowe
- Department of Health Promotion, Education, and Behavior at the University of South Carolina
| | - Andrew T Kaczynski
- Department of Health Promotion, Education, and Behavior at the University of South Carolina
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics at the University of Southern Denmark
| | - J Aaron Hipp
- Department of Parks, Recreation, and Tourism Management at North Carolina State University
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83
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van den Berg MM, van Poppel M, van Kamp I, Ruijsbroek A, Triguero-Mas M, Gidlow C, Nieuwenhuijsen MJ, Gražulevičiene R, van Mechelen W, Kruize H, Maas J. Do Physical Activity, Social Cohesion, and Loneliness Mediate the Association Between Time Spent Visiting Green Space and Mental Health? ENVIRONMENT AND BEHAVIOR 2019; 51:144-166. [PMID: 30662076 PMCID: PMC6311621 DOI: 10.1177/0013916517738563] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This cross-sectional study investigated whether physical activity, social cohesion, and loneliness mediate the association between time spent visiting green spaces and perceived mental health and vitality. Questionnaire data were collected from 3,948 residents from 124 neighborhoods across four European cities. Multilevel linear regression analysis revealed positive, but weak, associations between time spent visiting green space and Medical Outcome Study Short Form (SF-36) mental health and vitality score, which suggest small mental health benefits. Single mediation analyses showed that different indicators of physical activity (total, during leisure time, and walking during leisure time), social cohesion, and loneliness were mediators. Multiple mediation analyses showed that physical activity during leisure time and loneliness may explain about 25% of the relationship. The unmediated part of the association suggests that other mediators may explain the association.
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Affiliation(s)
- Magdalena M. van den Berg
- Vrije Universiteit Amsterdam, The
Netherlands
- Magdalena M. van den Berg, Department of Public and
Occupational Health, Amsterdam Public Health Institute, VU University Medical Center,
Vrije Universiteit Amsterdam, van der Boechorststraat 7, Amsterdam, NL 1081 BT, The
Netherlands.
| | | | - Irene van Kamp
- National Institute for Public Health and the
Environment, Bilthoven, The Netherlands
| | - Annemarie Ruijsbroek
- National Institute for Public Health and the
Environment, Bilthoven, The Netherlands
| | - Margarita Triguero-Mas
- Barcelona Biomedical Research Park,
Spain
- Universitat Pompeu Fabra, Barcelona,
Spain
- CIBER Epidemiología y Salud Pública, Madrid,
Spain
| | | | - Mark J. Nieuwenhuijsen
- Barcelona Biomedical Research Park,
Spain
- Universitat Pompeu Fabra, Barcelona,
Spain
- CIBER Epidemiología y Salud Pública, Madrid,
Spain
| | | | | | - Hanneke Kruize
- National Institute for Public Health and the
Environment, Bilthoven, The Netherlands
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84
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A multilevel approach for promoting physical activity in rural communities: a cluster randomized controlled trial. BMC Public Health 2019; 19:126. [PMID: 30700262 PMCID: PMC6354358 DOI: 10.1186/s12889-019-6443-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/14/2019] [Indexed: 11/10/2022] Open
Abstract
Background Physical activity (PA) has demonstrated a decreased risk in various cancers and other chronic diseases; however, rural residents are less likely to attain recommended levels of PA compared to urban and suburban counterparts. Given rural residents make up 15% of the United States population, there is a need for novel approaches to increase PA among this population. The goal of the present study is to investigate the effectiveness of a multilevel intervention to increase PA rates among rural residents. Methods/design Guided by an ecological framework, a group-randomized design will be used to evaluate the effects of a three-level intervention for increasing PA among adult residents residing in 6 rural communities (n = 600) along with 6 control communities (n = 600). The intervention includes components at the individual (short message service [SMS] text messages), interpersonal (social support in walking groups), and community levels (events at existing trails). Innovative methods to encourage participation will be employed as well as a focus on life priorities (family, recreation, hobbies) other than health. Aim 1 includes a literature review and key informant interviews to determine the local contexts for intervention adaptation. Aim 2 will employ a set of interventions at the individual, interpersonal, and community-levels to evaluate their impact on moderate-to-vigorous PA as measured by self-reported (telephone survey) and objectively assessed (accelerometry) measures. These data are supplemented by location based on Global Positioning System and community audits, which provide information on recreational amenities, programs/policies, and street segments. Discussion This study is among the first of its kind to test a multilevel intervention in a rural setting, address life priorities that compliment health outcomes, and examine moderation between behavioral interventions and the natural environments where people are physically active. Our results will influence the field by enhancing the ability to scale-up innovative, PA interventions with the potential to reach high-risk, rural populations. Trial registration Clinical Trials NCT03683173, September 25, 2018.
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85
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Smith L, Panter J, Ogilvie D. Characteristics of the environment and physical activity in midlife: Findings from UK Biobank. Prev Med 2019; 118:150-158. [PMID: 30367974 PMCID: PMC6344227 DOI: 10.1016/j.ypmed.2018.10.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Revised: 09/25/2018] [Accepted: 10/21/2018] [Indexed: 11/18/2022]
Abstract
Characteristics of the environment influence health and may promote physical activity. We explored the associations between neighborhood environmental characteristics grouped within five facets (spaces for physical activity, walkability, disturbance, natural environment, and the sociodemographic environment) and objective ('recorded') and self-reported ('reported') physical activity in adults from UK Biobank. Recorded activity was assessed using wrist-worn accelerometers (2013-2015, n = 65,967) and time spent in moderate-to-vigorous physical activity (MVPA), walking, and walking for pleasure was self-reported (2006-2010, n = 337,822). Associations were assessed using linear and multinomial logistic regression models and data were analyzed in 2017. We found participants living in areas with higher concentrations of air pollution recorded and reported lower levels of physical activity and those in rural areas and more walkable areas had higher levels of both recorded and reported activity. Some associations varied according to the specificity of the outcome, for example, those living in the most deprived areas were less likely to record higher levels of MVPA (upper tertile: RRR: 0.80 95% CI: 0.74, 0.86) but were more likely to report higher levels of walking (upper tertile: RRR: 1.09, 95% CI: 1.06, 1.13). Environmental characteristics have the potential to contribute to different physical activities but interventions which focus on a single environmental attribute or physical activity outcome may not have the greatest benefits.
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Affiliation(s)
- Lindsey Smith
- MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, School of Clinical Medicine, Box 285, Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0QQ, UK.
| | - Jenna Panter
- MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, School of Clinical Medicine, Box 285, Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0QQ, UK.
| | - David Ogilvie
- MRC Epidemiology Unit & UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, School of Clinical Medicine, Box 285, Cambridge Biomedical Campus, Cambridge, Cambridgeshire CB2 0QQ, UK.
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86
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Geremia CM, Cain KL, Conway TL, Sallis JF, Saelens BE. Validating and Shortening the Environmental Assessment of Public Recreation Spaces Observational Measure. J Phys Act Health 2018; 16:1-8. [PMID: 30541362 DOI: 10.1123/jpah.2018-0142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Assessment of park characteristics that may support physical activity (PA) can guide the design of more activity-supportive parks. Direct-observation measures are seldom used due to time and resource restraints. METHODS The authors developed shortened versions of the original Environmental Assessment of Public Recreation Spaces (EAPRS) tool and tested their construct validity by comparing scores from 40 parks in San Diego, CA to observe park use and PA. RESULTS PA elements were positively associated with park use and park PA across all versions, with the highest correlations for trails (.45 for use and .51 for PA using EAPRS-Original; .57 use and .62 PA using Abbreviated; and .38 use and .43 PA using Mini). Presence of amenities, using Abbreviated and Mini versions, was correlated with park use (.71, .64) and PA (.67, .59). The overall park quality score using Abbreviated and Mini had similar correlations (adjusted for park size) with park use (.74, .72) and PA (.72, .70) as EAPRS-Original (.71 use and .73 PA). CONCLUSION In all 3 versions, EAPRS overall park scores were strongly related to observed park use and PA. Shorter versions of EAPRS make it more feasible to use park observations in research and practice.
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87
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Stewart OT, Moudon AV, Littman AJ, Seto E, Saelens BE. The Association Between Park Facilities and Duration of Physical Activity During Active Park Visits. J Urban Health 2018; 95:869-880. [PMID: 30232689 PMCID: PMC6286274 DOI: 10.1007/s11524-018-0311-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Public parks provide places for urban residents to obtain physical activity (PA), which is associated with numerous health benefits. Adding facilities to existing parks could be a cost-effective approach to increase the duration of PA that occurs during park visits. Using objectively measured PA and comprehensively measured park visit data among an urban community-dwelling sample of adults, we tested the association between the variety of park facilities that directly support PA and the duration of PA during park visits where any PA occurred. Cross-classified multilevel models were used to account for the clustering of park visits (n = 1553) within individuals (n = 372) and parks (n = 233). Each additional different PA facility at a park was independently associated with a 6.8% longer duration of PA bouts that included light-intensity activity, and an 8.7% longer duration of moderate to vigorous PA time. Findings from this study are consistent with the hypothesis that more PA facilities increase the amount of PA that visitors obtain while already active at a park.
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Affiliation(s)
- Orion T Stewart
- Urban Form Lab, University of Washington, 1107 NE 45th Street Suite 535, Seattle, WA, 98105, USA. .,Institute for Population Health Improvement, University of California, Davis, 1631 Alhambra Blvd, Suite 200, Sacramento, CA, 95816, USA.
| | - Anne Vernez Moudon
- Urban Form Lab, University of Washington, 1107 NE 45th Street Suite 535, Seattle, WA, 98105, USA.,College of Built Environments Department of Urban Design and Planning, University of Washington, Box 355740, Seattle, WA, 98195, USA
| | - Alyson J Littman
- School of Public Health Department of Epidemiology, University of Washington, Box 357236, Seattle, WA, 98195, USA
| | - Edmund Seto
- School of Public Health Department of Environmental & Occupational Health Sciences, University of Washington, Box 357234, Seattle, WA, 98195, USA
| | - Brian E Saelens
- Seattle Children's Research Institute, P.O. Box 5371, M/S: CW8-6, Seattle, WA, 98145, USA.,School of Medicine Department of Pediatrics, University of Washington, Box 356320, Seattle, WA, 98195, USA
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88
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Longitudinal Associations of Physical Activity Among Females from Adolescence to Young Adulthood. J Adolesc Health 2018; 63:466-473. [PMID: 30150167 DOI: 10.1016/j.jadohealth.2018.05.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE We sought to identify individual, social, and environmental factors associated with moderate-to-vigorous physical activity (MVPA) among females from ages 14 to 23years. METHODS A cohort was formed from females originally participating in the Trial of Activity for Adolescent Girls Maryland site. The cohort was recruited from a randomly generated list of eighth grade girls in participating middle schools. A total of 428 females had complete assessments in 2006 (n = 730), 2009 (n = 589), and 2015 (n = 460). The outcome, MVPA, was assessed from accelerometers. Individual and social factors were assessed by questionnaire; body mass index was measured in 2006 and 2009 and self-reported in 2015. Perceived environment was assessed by questionnaire; number of parks near home and distance to parks and schools was assessed by geographic information systems. RESULTS Participants were diverse (45.7% white, 24.8% black, 9.9% Hispanic, and 19.6% other). Over time 274 participants had continuously low MVPA, 123 decreased MVPA from age 17 to 23years, and 31 participants continuously increased MVPA. For each .16-unit decrease in body mass index, MVPA increased 1 minute over time (p = .007). For every 1-unit increase in self-management strategies or social support from friends, there was a 4- to 5-minute increase in MVPA (p < .0001 and p = .03, respectively). A little less than one extra park (.71 parks) within a mile of an individual's home was associated with a 1-minute increase in MVPA (p < .0001). CONCLUSIONS Behavioral strategies combined with neighborhood enhancements may produce the best results for increasing MVPA as adolescent females' transition into adulthood.
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89
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Silva RA, Rogers K, Buckley TJ. Advancing Environmental Epidemiology to Assess the Beneficial Influence of the Natural Environment on Human Health and Well-Being. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2018; 52:9545-9555. [PMID: 30064205 PMCID: PMC8961682 DOI: 10.1021/acs.est.8b01781] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Environmental health research can be oriented across a continuum of effects ranging from adverse to cobenefits to salutogenic. We argue that the salutogenic end of the continuum is insufficiently represented in research and as a basis for environmental protection, even though there is growing evidence that the natural environment plays a critical role in blunting adverse effects and promoting human health and well-being. Thus, we advocate for advancing environmental health research through environmental epidemiology that more fully and directly accounts for the salutogenic effects of the natural environment on individual well-being by (1) defining "natural environments" broadly, from pristine natural areas to urban green infrastructure; (2) considering exposure comprehensively to encompass residential, occupational, and recreational settings, local and distant, day-to-day and occasional; (3) doing individual-level assessments that include both health and well-being outcomes and one's experience of nature, including potential mediation by connectedness to nature and individual perceptions and preferences, as well as sociocultural and demographic effect modifiers; and (4) collecting longitudinal and nationally representative data.
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Affiliation(s)
- Raquel A. Silva
- Oak Ridge Institute for Science and Education (ORISE), U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, United States
- ORISE Postdoctoral Fellow at Office of Research and Development, U.S. Environmental Protection Agency
| | - Kim Rogers
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, United States
| | - Timothy J. Buckley
- Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina 27711, United States
- Corresponding Author:
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90
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Faerstein E, da Silveira IH, Boclin KDLS, Curioni CC, Castro IRRD, Junger WL. Associations of neighborhood socioeconomic, natural and built environmental characteristics with a 13-year trajectory of non-work physical activity among civil servants in Rio de Janeiro, Brazil: The Pro-Saude Study. Health Place 2018; 53:110-116. [PMID: 30098468 DOI: 10.1016/j.healthplace.2018.07.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/21/2018] [Accepted: 07/30/2018] [Indexed: 11/15/2022]
Abstract
Positive influences of natural and built environment characteristics on human physical activity have been observed mainly in high-income countries, but mixed results exist. We explored these relationships in Rio de Janeiro, Brazil, where exuberant nature coexists with high levels of social inequality and urban violence. Data originated from questionnaires self-administered by 1731 civil servants at university campuses who participated in 4 waves (1999, 2001, 2007, 2012) of a longitudinal study, and had their residential addresses geocoded. In multinomial regression models, adjusted for individual sociodemographic characteristics, mutually adjusted associations were estimated between 13-year trajectories of non-work physical activity and 8 contextual variables: distances from waterfronts, cycle paths, outdoor gym equipment, and squares; 2 indicators of exposure to greenness (a vegetation index - NDVI - derived from satellite images, and trees close to home); an indicator of walkability (street density), and neighborhood average income. Compared to participants living in the upper quartile of distance to waterfronts, those living in its lowest quartile had 2.6-fold higher odds (aOR: 2.62, 95% CI: 1.37-5.01) of reporting non-work PA in all 4 study waves. Similar results were observed in relation to distance to cycle paths; no independent associations were observed with other natural and built environment variables.
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Affiliation(s)
- Eduardo Faerstein
- Institute of Social Medicine, State University of Rio de Janeiro, Brazil.
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91
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Schüle SA, Nanninga S, Dreger S, Bolte G. Relations between Objective and Perceived Built Environments and the Modifying Role of Individual Socioeconomic Position. A Cross-Sectional Study on Traffic Noise and Urban Green Space in a Large German City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081562. [PMID: 30042308 PMCID: PMC6121416 DOI: 10.3390/ijerph15081562] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 07/18/2018] [Accepted: 07/21/2018] [Indexed: 01/01/2023]
Abstract
Perceived annoyance due to traffic noise and lack of urban green space is mostly determined using data from self-administered questionnaires. However, there is still no clear evidence to what extent such perceived measures are related to objectively assessed environmental data and whether socioeconomic dimensions modify such relationships. In a cross-sectional study in Dortmund, Germany, georeferenced home addresses from parents with preschool aged children were used to analyse relations between exposures to objectively measured green space and traffic noise and subjective annoyance due to noise and lack of green space with the additional consideration of socioeconomic characteristics as effect modifiers. Higher perceived annoyance correlated with higher objectively measured traffic noise and lower objectively measured green, respectively. Stratified logistic regression models indicated a modifying role of socioeconomic characteristics. The strengths of associations between objectively measured environmental exposures and perceived annoyance differed by socioeconomic strata. Especially for noise, odds ratios were higher in low socioeconomic strata than in high socioeconomic strata. Therefore, using objective measures of the built environment as a proxy for individual perception should be made with caution as negative relations between objectively assessed built environments and health could be underestimated when considering individual socioeconomic position only as a confounder.
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Affiliation(s)
- Steffen Andreas Schüle
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, 28359 Bremen, Germany.
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
| | - Sarah Nanninga
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, 28359 Bremen, Germany.
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
| | - Stefanie Dreger
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, 28359 Bremen, Germany.
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
| | - Gabriele Bolte
- University of Bremen, Institute of Public Health and Nursing Research, Department of Social Epidemiology, 28359 Bremen, Germany.
- Health Sciences Bremen, University of Bremen, 28359 Bremen, Germany.
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92
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Li Y, Yatsuya H, Hanibuchi T, Hirakawa Y, Ota A, Uemura M, Chiang C, Otsuka R, Murata C, Tamakoshi K, Toyoshima H, Aoyama A. The association between objective measures of residence and worksite neighborhood environment, and self-reported leisure-time physical activities: The Aichi Workers' Cohort Study. Prev Med Rep 2018; 11:282-289. [PMID: 30116699 PMCID: PMC6082790 DOI: 10.1016/j.pmedr.2018.07.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 07/17/2018] [Accepted: 07/21/2018] [Indexed: 11/28/2022] Open
Abstract
The possible effects of a neighborhood's built environment on physical activity have not been studied in Asian countries as much as in Western countries. The present study cross-sectionally examined the relationship between geographic information system (GIS) measured residence and worksite neighborhood walkability, and the number of parks/green spaces and sports facilities within a 1 km radius of home and workplace, with self-reported leisure-time habitual (3–4 times per week or more) walking and moderate-to-vigorous intensity habitual exercise among local government workers aged 18 to 64 years living in an urban-suburban area of Aichi, Japan in 2013. A single-level binomial regression model was used to estimate the multivariable odds ratios (ORs) and 95% confidence intervals (95% CIs). Of the 1959 male and 884 female participants, 288 (15%) and 141 (16%) reported habitual walking, respectively, and 18% and 17% reported habitual exercise, respectively. Compared with women who resided in neighborhood with a walkability index of 4–30, those living in an area with that of 35–40 were significantly more likely to engage in leisure-time habitual exercise (multivariable OR: 1.70, 95% CI: 1.08–2.68). Marginally significant positive associations were found between leisure-time habitual exercise and the residential neighborhood's number of parks/green spaces among women, as well as the number of sports facilities among men. In conclusion, a residential neighborhood environment characterized by higher walkability may contribute to the initiation or maintenance of moderate-to-vigorous intensity leisure-time exercise among working women living in an urban-suburban area of Japan. Residential neighborhood walkability was associated with exercise habits of women. No features of residential neighborhood were related to walking habits in both sexes. No association was found for worksite neighborhood environmental features.
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Affiliation(s)
- Yuanying Li
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.,Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomoya Hanibuchi
- School of International Liberal Studies, Chukyo University, Nagoya, Japan
| | - Yoshihisa Hirakawa
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Atsuhiko Ota
- Department of Public Health, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
| | - Mayu Uemura
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Chifa Chiang
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Rei Otsuka
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Chiyoe Murata
- National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Koji Tamakoshi
- Department of Nursing, Nagoya University School of Health Science, Nagoya, Japan
| | - Hideaki Toyoshima
- Rehabili-Park Kurokawa, Geriatric Health Service Facility, Nagoya, Aichi, Japan
| | - Atsuko Aoyama
- Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan
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93
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Stewart OT, Moudon AV, Littman AJ, Seto E, Saelens BE. Why neighborhood park proximity is not associated with total physical activity. Health Place 2018; 52:163-169. [DOI: 10.1016/j.healthplace.2018.05.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 05/18/2018] [Accepted: 05/29/2018] [Indexed: 10/14/2022]
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94
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Colom A, Fiol M, Ruiz M, Compa M, Morey M, Moñino M, Romaguera D. Association between Access to Public Open Spaces and Physical Activity in a Mediterranean Population at High Cardiovascular Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1285. [PMID: 29914206 PMCID: PMC6025464 DOI: 10.3390/ijerph15061285] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 01/09/2023]
Abstract
Background: Regular physical activity is an important preventive factor of cardiovascular disease. Proximity and density of public open spaces are important modifying factors on the practice of physical activity. This article explores the cross-sectional relationship between access to public open spaces (POS) and leisure time physical activity (LTPA) in elderly participants at high cardiovascular risk from PREDIMED-Baleares. Method: 428 elderly subjects at high cardiovascular risk, participating in the PREDIMED trial, from Palma de Mallorca (Spain) were assessed using Geographic Information Systems, and access to POS was determined. The quantity and intensity of LTPA was calculated using the Minnesota Leisure-Time Physical Activity Questionnaire. In order investigate the association between access to POS and LTPA, generalized linear regression models were used. Results: Better access to POS was not consistently associated with total LTPA. Only distance to the nearest park showed a borderline significant positive associated with total LTPA and moderate-vigorous LTPA but was not associated with light LTPA. Conclusions: Although living near POS was not associated to total LTPA, higher levels of moderate-vigorous LTPA were associated to distances to the nearest park. Future work should be conducted on a larger sample size, integrating a longitudinal design, and greater heterogeneity in POS access and introducing objective measures of physical activity.
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Affiliation(s)
- Antoni Colom
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca 07120, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Miguel Fiol
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca 07120, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Maurici Ruiz
- Servicio de SIG y Teledetección, Vicerectorat d'Innovació i Transferència, Universitat de les Illes Balears, Palma de Mallorca 07120, Spain.
| | - Montserrat Compa
- Instituto Español de Oceanografía, Centro Oceanográfico de Baleares, 07015 Palma, Spain.
| | - Marga Morey
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca 07120, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Manuel Moñino
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca 07120, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid 28029, Spain.
| | - Dora Romaguera
- Instituto de Investigación Sanitaria Illes Balears (IdISBa), University Hospital Son Espases, Palma de Mallorca 07120, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid 28029, Spain.
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95
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Hobbs M, Griffiths C, Green MA, Jordan H, Saunders J, McKenna J. Neighbourhood typologies and associations with body mass index and obesity: A cross-sectional study. Prev Med 2018; 111:351-357. [PMID: 29195761 DOI: 10.1016/j.ypmed.2017.11.024] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 11/15/2017] [Accepted: 11/26/2017] [Indexed: 10/18/2022]
Abstract
Little research has investigated associations between a combined measure of the food and physical activity (PA) environment, BMI (body-mass-index) and obesity. Cross-sectional data (n=22,889, age 18-86years) from the Yorkshire Health Study were used [2010-2013]. BMI was calculated using self-reported height and weight; obesity=BMI≥30. Neighbourhood was defined as a 2km radial buffer. Food outlets and PA facilities were sourced from Ordnance Survey Points of Interest (PoI) and categorised into 'fast-food', 'large supermarkets', 'convenience and other food retail outlets' and 'physical activity facilities'. Parks were sourced from Open Street Map. Latent class analysis was conducted on these five environmental variables and availability was defined by quartiles of exposure. Linear and logistic regressions were then conducted for BMI and obesity respectively for different neighbourhood types. Models adjusted for age, gender, ethnicity, area-level deprivation, and rural/urban classification. A five-class solution demonstrated best fit and was interpretable. Neighbourhood typologies were defined as; 'low availability', 'moderate availability', 'moderate PA, limited food', 'saturated' and 'moderate PA, ample food'. Compared to low availability, one typology demonstrated lower BMI (saturated, b=-0.50, [95% CI=-0.76, -0.23]), while three showed higher BMI (moderate availability, b=0.49 [0.27, 0.72]; moderate PA, limited food, b=0.30 [0.01, 0.59]; moderate PA, ample food, b=0.32 [0.08, 0.57]). Furthermore, compared to the low availability, saturated neighbourhoods showed lower odds of obesity (OR=0.86 [0.75, 0.99]) while moderate availability showed greater odds of obesity (OR=1.18 [1.05, 1.32]). This study supports population-level approaches to tackling obesity however neighbourhoods contained features that were health-promoting and -constraining.
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Affiliation(s)
- M Hobbs
- School of Sport, Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK.; School of Social and Health Sciences, Leeds Trinity University, Leeds, UK..
| | - C Griffiths
- School of Sport, Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
| | - M A Green
- School of Environmental Sciences, University of Liverpool, Liverpool, UK
| | - H Jordan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - J Saunders
- Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
| | - J McKenna
- School of Sport, Carnegie, Leeds Beckett University, Leeds LS6 3QT, UK
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96
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Nieuwenhuijsen MJ. Influence of urban and transport planning and the city environment on cardiovascular disease. Nat Rev Cardiol 2018; 15:432-438. [DOI: 10.1038/s41569-018-0003-2] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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97
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Douglas JA, Briones MD, Bauer EZ, Trujillo M, Lopez M, Subica AM. Social and environmental determinants of physical activity in urban parks: Testing a neighborhood disorder model. Prev Med 2018; 109:119-124. [PMID: 29366818 DOI: 10.1016/j.ypmed.2018.01.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 12/26/2017] [Accepted: 01/16/2018] [Indexed: 11/26/2022]
Abstract
The current study examined the nexus of neighborhood disorder-in the form of physical disorder (e.g., broken glass and vandalism) and social disorder (e.g., public drinking and lewd conduct)-and physical activity (PA) in urban public parks to inform public policy addressing chronic disease in at-risk populations. Five hundred and twenty-two unique observations were conducted in 22 public parks from March to September 2016. The study utilized the System for Observing Play and Recreation in Communities (SOPARC) to document age, gender, ethnicity, and PA level of park users. The Physical Activity Resource Assessment (PARA) was used to document observed physical and social disorder incivilities in public parks included in the current study. Males, adults, and Latina/os accounted for the largest number of park users, respectively. Significant PA differences were observed across gender, age, and ethnicity. Multiple linear regression controlling for gender, age, and ethnicity found physical disorder, but not social disorder, generally predicted PA reductions. While it has been demonstrated that physical disorder predicts PA reductions in low-income communities of color, this is the first study to reveal that physical disorder may lead to decreased PA in urban public parks. Thus, remediation of public park incivilities characterized by physical disorder, paired with community outreach, may lead to increased PA in at-risk communities.
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Affiliation(s)
- Jason A Douglas
- San José State University, Department of Environmental Studies, San José, CA, United States.
| | - Maya D Briones
- San José State University, Department of Environmental Studies, San José, CA, United States
| | - Eliane Z Bauer
- San José State University, Department of Environmental Studies, San José, CA, United States
| | - Melissa Trujillo
- San José State University, Department of Environmental Studies, San José, CA, United States
| | - Melissa Lopez
- San José State University, Department of Environmental Studies, San José, CA, United States
| | - Andrew M Subica
- University of California, Riverside School of Medicine, Riverside, CA, United States
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98
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Saelens BE, Arteaga SS, Berrigan D, Ballard RM, Gorin AA, Powell-Wiley TM, Pratt C, Reedy J, Zenk SN. Accumulating Data to Optimally Predict Obesity Treatment (ADOPT) Core Measures: Environmental Domain. Obesity (Silver Spring) 2018; 26 Suppl 2:S35-S44. [PMID: 29575779 PMCID: PMC5875459 DOI: 10.1002/oby.22159] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 01/31/2018] [Accepted: 02/12/2018] [Indexed: 01/08/2023]
Abstract
BACKGROUND There is growing interest in how environment is related to adults' weight and activity and eating behaviors. However, little is known about whether environmental factors are related to the individual variability seen in adults' intentional weight loss or maintenance outcomes. OBJECTIVES The environmental domain subgroup of the Accumulating Data to Optimally Predict obesity Treatment (ADOPT) Core Measures Project sought to identify a parsimonious set of objective and perceived neighborhood and social environment constructs and corresponding measures to include in the assessment of response to adult weight-loss treatment. SIGNIFICANCE Starting with the home address, the environmental domain subgroup recommended for inclusion in future weight-loss or maintenance studies constructs and measures related to walkability, perceived land use mix, food outlet accessibility (perceived and objective), perceived food availability, socioeconomics, and crime-related safety (perceived and objective) to characterize the home neighborhood environment. The subgroup also recommended constructs and measures related to social norms (perceived and objective) and perceived support to characterize an individual's social environment. The 12 neighborhood and social environment constructs and corresponding measures provide a succinct and comprehensive set to allow for more systematic examination of the impact of environment on adults' weight loss and maintenance.
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Affiliation(s)
- Brian E Saelens
- Department of Pediatrics, University of Washington, Seattle Washington, USA
- Seattle Children's Research Institute, Seattle, Washington, USA
| | - S Sonia Arteaga
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - David Berrigan
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Rachel M Ballard
- Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, Maryland, USA
| | - Amy A Gorin
- Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Tiffany M Powell-Wiley
- Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Charlotte Pratt
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Jill Reedy
- Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Shannon N Zenk
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
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Zenk SN, Tarlov E, Powell LM, Wing C, Matthews SA, Slater S, Gordon HS, Berbaum M, Fitzgibbon ML. Weight and Veterans' Environments Study (WAVES) I and II: Rationale, Methods, and Cohort Characteristics. Am J Health Promot 2018; 32:779-794. [PMID: 29214851 PMCID: PMC5876028 DOI: 10.1177/0890117117694448] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To present the rationale, methods, and cohort characteristics for 2 complementary "big data" studies of residential environment contributions to body weight, metabolic risk, and weight management program participation and effectiveness. DESIGN Retrospective cohort. SETTING Continental United States. PARTICIPANTS A total of 3 261 115 veterans who received Department of Veterans Affairs (VA) health care in 2009 to 2014, including 169 910 weight management program participants and a propensity score-derived comparison group. INTERVENTION The VA MOVE! weight management program, an evidence-based lifestyle intervention. MEASURES Body mass index, metabolic risk measures, and MOVE! participation; residential environmental attributes (eg, food outlet availability and walkability); and MOVE! program characteristics. ANALYSIS Descriptive statistics presented on cohort characteristics and environments where they live. RESULTS Forty-four percent of men and 42.8% of women were obese, whereas 4.9% of men and 9.9% of women engaged in MOVE!. About half of the cohort had at least 1 supermarket within 1 mile of their home, whereas they averaged close to 4 convenience stores (3.6 for men, 3.9 for women) and 8 fast-food restaurants (7.9 for men, 8.2 for women). Forty-one percent of men and 38.6% of women did not have a park, and 35.5% of men and 31.3% of women did not have a commercial fitness facility within 1 mile. CONCLUSION Drawing on a large nationwide cohort residing in diverse environments, these studies are poised to significantly inform policy and weight management program design.
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Affiliation(s)
- Shannon N Zenk
- 1 Department of Health Systems Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA
| | - Elizabeth Tarlov
- 1 Department of Health Systems Science, University of Illinois at Chicago College of Nursing, Chicago, IL, USA
- 2 Center of Innovation for Complex Chronic Healthcare (CINCCH), Hines VA Hospital, Hines, IL, USA
| | - Lisa M Powell
- 3 Health Policy and Administration Division, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Coady Wing
- 5 Indiana University-Bloomington School of Public and Environmental Affairs, Bloomington, IN, USA
| | - Stephen A Matthews
- 6 Department of Sociology, Anthropology, and Demography, Pennsylvania State University, University Park, PA, USA
| | - Sandy Slater
- 3 Health Policy and Administration Division, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Howard S Gordon
- 7 Jesse Brown VA Medical Center, Chicago, IL, USA
- 8 Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Michael Berbaum
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
| | - Marian L Fitzgibbon
- 3 Health Policy and Administration Division, University of Illinois at Chicago School of Public Health, Chicago, IL, USA
- 4 Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL, USA
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Abstract
Currently half the world population lives in cities, and this proportion is expected to increase rapidly to 70% over the next years. Over the years, we have created large, mostly grey cities with many high-rise buildings and little green space. Disease rates tend to be higher in urban areas than in rural areas. More green space in cities could reduce these rates. Here, we describe the importance of green space for health, and make recommendations for further research. Green space has been associated with many beneficial health effects, including reduced all-cause and cardiovascular mortality and improved mental health, possibly through mediators, such as reduced air pollution, temperature and stress, and increased physical activity, social contacts, and restoration. Additional studies are needed to strengthen the evidence base and provide further guidelines to transport planners, urban planners, and landscape architects. We need more longitudinal studies and intervention studies, further understanding of the contribution of various mechanisms toward health, and more information on susceptible populations and on where, when, how much, and what type of green space is needed. Also needed are standardized methods for green space quality assessments and evaluations of effectiveness of green prescriptions in clinical practice. Many questions are ideally suited for environmental epidemiologists, who should work with other stakeholders to address the right questions and translate knowledge into action. In conclusion, a growing evidence base supports the hypothesis that greener cities are healthier cities.
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