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Humphrey JL, Reid CE, Kinnee EJ, Kubzansky LD, Robinson LF, Clougherty JE. Putting Co-Exposures on Equal Footing: An Ecological Analysis of Same-Scale Measures of Air Pollution and Social Factors on Cardiovascular Disease in New York City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234621. [PMID: 31766340 PMCID: PMC6926874 DOI: 10.3390/ijerph16234621] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 12/13/2022]
Abstract
Epidemiologic evidence consistently links urban air pollution exposures to health, even after adjustment for potential spatial confounding by socioeconomic position (SEP), given concerns that air pollution sources may be clustered in and around lower-SEP communities. SEP, however, is often measured with less spatial and temporal resolution than are air pollution exposures (i.e., census-tract socio-demographics vs. fine-scale spatio-temporal air pollution models). Although many questions remain regarding the most appropriate, meaningful scales for the measurement and evaluation of each type of exposure, we aimed to compare associations for multiple air pollutants and social factors against cardiovascular disease (CVD) event rates, with each exposure measured at equal spatial and temporal resolution. We found that, in multivariable census-tract-level models including both types of exposures, most pollutant-CVD associations were non-significant, while most social factors retained significance. Similarly, the magnitude of association was higher for an IQR-range difference in the social factors than in pollutant concentrations. We found that when offered equal spatial and temporal resolution, CVD was more strongly associated with social factors than with air pollutant exposures in census-tract-level analyses in New York City.
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Affiliation(s)
- Jamie L. Humphrey
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA;
| | - Colleen E. Reid
- Geography Department, University of Colorado Boulder, Boulder, CO 80309, USA;
| | - Ellen J. Kinnee
- University Center for Social and Urban Research, University of Pittsburgh, Pittsburgh, PA 15260, USA;
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Lucy F. Robinson
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA;
| | - Jane E. Clougherty
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA 19104, USA;
- Correspondence: ; Tel.: +1-267-359-6072
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202
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Child ST, Kaczynski AT, Walsemann KM, Fleischer N, McLain A, Moore S. Socioeconomic Differences in Access to Neighborhood and Network Social Capital and Associations With Body Mass Index Among Black Americans. Am J Health Promot 2019; 34:150-160. [PMID: 31665895 DOI: 10.1177/0890117119883583] [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] [Indexed: 11/15/2022]
Abstract
PURPOSE To examine associations between socioeconomic status and two forms of social capital, namely, neighborhood and network measures, and how these distinct forms of capital are associated with body mass index (BMI) among Black residents of low-income communities. DESIGN Respondent-driven sampling was used to engage residents in a household survey to collect data on the respondents' personal network, perceptions about their neighborhood environment, and health. SETTING Eight special emphasis neighborhoods in Greenville, South Carolina. PARTICIPANTS N = 337 black/African American older adults, nearly half of whom have a household income of less than $15 000 and a high school education, were included. MEASURES Neighborhood capital was assessed via three scales on social cohesion, collective efficacy, and social support from neighbors. Network capital was calculated via a position generator, common in egocentric network surveys. Body mass index was calculated with self-reported height and weight. ANALYSIS Multilevel linear regression models were used to examine the association between neighborhood and network capital and obesity among respondents within sampling chains. RESULTS Higher household income was associated with greater neighborhood capital, whereas higher educational attainment was associated with greater network capital. Social cohesion was negatively associated with BMI (b = -1.25, 95% confidence interval [CI]: -2.39 to -0.11); network diversity was positively associated with BMI (b = 0.31, 95% CI: 0.08 to 0.55). CONCLUSION The findings shed light on how social capital may be patterned by socioeconomic status and, further, how distinct forms of capital may be differentially associated with health among black Americans.
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Affiliation(s)
- Stephanie T Child
- Berkeley Population Center, University of California, Berkeley, CA, USA
| | - Andrew T Kaczynski
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Katrina M Walsemann
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
| | - Nancy Fleischer
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Alexander McLain
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Spencer Moore
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC, USA
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203
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Zhu Y, Gao J, Nie X, Dai J, Fu H. Associations of individual social capital with subjective well-being and mental health among migrants: a survey from five cities in China. Int Health 2019; 11:S64-S71. [PMID: 31670819 DOI: 10.1093/inthealth/ihz041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 04/13/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We aimed to examine the associations of cognitive and structural social capital with subjective well-being (SWB) and mental health among internal migrants in five cities in China. METHODS We conducted healthy cities surveys from June 2017 to April 2018. In total, 3038 migrants submitted surveys. Generalized linear regressions for SWB and logistic regressions for mental health were used to examine the associations of social capital, SWB and mental health after controlling for covariates. RESULTS The median level of SWB was 75.7 (interquartile range 62.9-85.7). Self-rated health and physical activity were positively associated with SWB. The SWB level among migrants who perceived high individual social cohesion was much higher than that of their counterparts (unstandardized coefficients, β=7.01 [95% confidence interval {CI} 5.82 to 8.21]). The prevalence of poor mental health was 10.0%. High social cohesion (odds ratio [OR] 0.32 [95% CI 0.24 to 0.44]) and high social participation (OR 0.77 [95% CI 0.57 to 0.97]) were significantly associated with a low ratio of poor mental health when compared with their counterparts. CONCLUSIONS Cognitive social capital is positively associated with SWB, while both cognitive and structural social capitals were negatively associated with poor mental health. It is beneficial to migrants' mental health and SWB to promote social participation and social cohesion.
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Affiliation(s)
- Yongkai Zhu
- Health Communication Institute, School of Public Health, Fudan University, 130 Dong'an Road, Shanghai, 200032 China
| | - Junling Gao
- Health Communication Institute, School of Public Health, Fudan University, 130 Dong'an Road, Shanghai, 200032 China
| | - Xin Nie
- Health Communication Institute, School of Public Health, Fudan University, 130 Dong'an Road, Shanghai, 200032 China
| | - Junming Dai
- Health Communication Institute, School of Public Health, Fudan University, 130 Dong'an Road, Shanghai, 200032 China
| | - Hua Fu
- Health Communication Institute, School of Public Health, Fudan University, 130 Dong'an Road, Shanghai, 200032 China
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204
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Chum A, O'Campo P, Lachaud J, Fink N, Kirst M, Nisenbaum R. Evaluating same-source bias in the association between neighbourhood characteristics and depression in a community sample from Toronto, Canada. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1177-1187. [PMID: 31054019 DOI: 10.1007/s00127-019-01718-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 04/25/2019] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND PURPOSE It is common in prior studies of the influence of neighbourhood characteristics on mental health to use participant-assessed neighbourhood exposures, which can lead to same-source bias since an individual's mental health status may influence their judgement of their neighbourhood. To avoid this potential bias, we evaluated the use of individually assessed neighbourhood exposures to understand how they compare to collectively assessed measures (by aggregating multiple responses within the same neighbourhood). This would increase the validity of the measure by decoupling the neighbourhood measure from an individual's mental health status. METHODS We conducted a stratified-randomised survey of 2411 adults across 87 census tracts in Toronto, Canada (mean of 28 per census tract) to investigate how self-reported (individually assessed) social environmental neighbourhood measures compared to aggregated, collectively assessed, measures for neighbourhood problems/disorder, safety, service quality, and linking, bonding and bridging social capital. The outcome, experience of major depression in the past 12 months, was measured using the Composite International Diagnostic Studies Depression Scale Short Form. RESULTS (1) Individually assessed neighbourhood problems, (2) low (individually assessed) neighbourhood safety, (3) low (individually assessed) neighbourhood service quality, and (4) low (individually assessed) linking social capital were independently associated with depression (all at least p < 0.05). However, when the individually assessed exposures were aggregated over residents in the same neighbourhood, none of them were significantly associated with depression. CONCLUSIONS Our study provides evidence for same-source bias in studies of social environmental determinants of depression that relies on individually assessed neighbourhood measures. We caution future studies from solely relying on individually assessed neighbourhood exposures especially in the study of social environmental influences on mental health outcomes.
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Affiliation(s)
- Antony Chum
- Department of Applied Health Sciences, Brock University, St. Catharines, Canada. .,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
| | - Patricia O'Campo
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - James Lachaud
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Nicolas Fink
- Department of Psychology, York University, Toronto, Canada
| | - Maritt Kirst
- Community Psychology, Wilfrid Laurier University, Waterloo, Canada
| | - Rosane Nisenbaum
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
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Troxel WM, DeSantis A, Richardson AS, Beckman R, Ghosh-Dastidar B, Nugroho A, Hale L, Buysse DJ, Buman MP, Dubowitz T. Neighborhood disadvantage is associated with actigraphy-assessed sleep continuity and short sleep duration. Sleep 2019; 41:5054549. [PMID: 30016507 DOI: 10.1093/sleep/zsy140] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 07/13/2018] [Indexed: 12/30/2022] Open
Abstract
Study Objectives Neighborhood disadvantage has been linked to poor sleep. However, the extant research has primarily focused on self-reported assessments of sleep and neighborhood characteristics. The current study examines the association between objective and perceived neighborhood characteristics and actigraphy-assessed sleep duration, efficiency, and wakefulness after sleep onset (WASO) in an urban sample of African American adults. Methods We examined data from predominantly African American adults (n = 788, mean age 55 years; 77% female) living in two low-income neighborhoods. Perceived neighborhood characteristics included safety, social cohesion, and satisfaction with one's neighborhood as a place to live. Objective neighborhood conditions included walkability, disorder, street lighting, and crime levels. Sleep duration, efficiency, and WASO were measured via 7 days of wrist-worn actigraphy. Analyses estimated each of the sleep outcomes as a function of perceived and objective neighborhood characteristics. Individual-level sociodemographics, body mass index, and psychological distress were included as covariates. Results Greater perceived safety was associated with higher sleep efficiency and shorter WASO. Greater neighborhood disorder and street lighting were associated with poorer sleep efficiency and longer WASO and greater likelihood of short sleep duration (<7 versus 7-9 hr as referent). Higher levels of crime were associated with poorer sleep efficiency and longer WASO, but these associations were only evident in one of the neighborhoods. Conclusions Both how residents perceive their neighborhood and their exposure to objectively measured neighborhood disorder, lighting, and crime have implications for sleep continuity. These findings suggest that neighborhood conditions may contribute to disparities in sleep health.
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Affiliation(s)
| | - Amy DeSantis
- RAND Corporation, Health Division, Pittsburgh, PA
| | | | | | | | | | - Lauren Hale
- Family, Population, and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, NY
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Matthew P Buman
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ
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206
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Caldwell JT, Lee H, Cagney KA. Disablement in Context: Neighborhood Characteristics and Their Association With Frailty Onset Among Older Adults. J Gerontol B Psychol Sci Soc Sci 2019; 74:e40-e49. [PMID: 31529128 PMCID: PMC6748803 DOI: 10.1093/geronb/gbx123] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 09/12/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Frailty, an aggregate expression of risk resulting from age- or disease-associated physiologic accumulation, is responsible for large economic and societal costs. Little is known about how the context in which older adult's live may contribute to differences in frailty. This study clarifies the role of neighborhood structural characteristics and social processes for understanding declines in health status. METHOD Data from two waves of the National Social Life, Health and Aging Project were linked to tract-level information from the 2000 Census (n = 1,925). Frailty was measured with in-home assessments and self-report. Ordered logistic regressions were employed to estimate the role of tract-level structural and social process indicators at baseline on frailty at follow-up. RESULTS Living in a neighborhood characterized with a higher density of African Americans and with more residential instability was associated with higher odds of frailty. Adults in neighborhoods with increasing levels of physical disorder had higher odds of frailty (adjusted odds ratio [AOR]: 1.20, 95% confidence interval [CI]: 1.03, 1.39), while those exposed to more social cohesion had lower odds (AOR: 0.87, CI: 0.78, 0.97). DISCUSSION For older adults, both neighborhood structural and social process characteristics appear to be independently associated with frailty.
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Affiliation(s)
- Julia T Caldwell
- Section of Hospital Medicine, Department of Medicine, University of Chicago, Illinois
| | - Haena Lee
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan
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207
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Chaparro MP, Pina MF, de Oliveira Cardoso L, Santos SM, Barreto SM, Giatti Gonçalves L, Alvim de Matos SM, Mendes da Fonseca MDJ, Chor D, Griep RH. The association between the neighbourhood social environment and obesity in Brazil: a cross-sectional analysis of the ELSA-Brasil study. BMJ Open 2019; 9:e026800. [PMID: 31494597 PMCID: PMC6731797 DOI: 10.1136/bmjopen-2018-026800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate the association between the neighbourhood social environment, including social cohesion, perceived neighbourhood safety, perceived neighbourhood violence, and obesity in Brazil. DESIGN Cross-sectional study. SETTING 6 state capitals in Brazil (Salvador, Vitoria, Belo Horizonte, Porto Alegre, Sao Paulo and Rio de Janeiro) PARTICIPANTS: Current or former employees of five federal universities and one research centre in each of the six Brazilian state capitals who were participants of the baseline wave (2008-2010) of the Brazilian Longitudinal Study of Adult Health (n=11 456; 56% women; 56% White, 28% Brown, and 16% Black). PRIMARY OUTCOME MEASURE Obesity, based on measured weight and height, and defined as having a body mass index ≥30 kg/m2. RESULTS No associations were found between the neighbourhood social environment and obesity among men. In multilevel logistic regression models adjusted for age, education, skin colour, state of residence, and individual-level social cohesion and perceived violence scores, respectively, women living in the least socially cohesive neighbourhoods and in those perceived as most violent had higher odds of obesity compared with their counterparts (OR=1.25, 95% CI=1.02-1.53; OR=1.28, 95% CI=1.04-1.56, respectively). When stratified by neighbourhood socioeconomic status (SES)-defined based on number of people per household, proportion of children 0-4 years, median income and per cent of white residents at the neighbourhood level-results for social cohesion and for violence remained only for women residing in high SES and low SES neighbourhoods, respectively. CONCLUSIONS In this civil-servant sample in six large cities in Brazil, the neighbourhood social environment was associated with obesity among women, but not men. Neighbourhood-level interventions to increase social cohesion and reduce violence may help in the prevention of obesity among women in Brazil.
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Affiliation(s)
- M Pia Chaparro
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Maria Fátima Pina
- Institute for Communication and Information on Health, Fundacao Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
- INEB - Instituto de Engenharia Biomédica, Universidade do Porto, Porto, Portugal
| | - Letícia de Oliveira Cardoso
- Department of Epidemiology and Quantitative Methods, National School of Public Health Sergio Arouca, Fundacao Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Simone M Santos
- Department of Epidemiology and Quantitative Methods, National School of Public Health Sergio Arouca, Fundacao Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Sandhi M Barreto
- School of Medicine & Clinical Hospital, Universidad Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Luana Giatti Gonçalves
- School of Medicine & Clinical Hospital, Universidad Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Maria de Jesus Mendes da Fonseca
- Department of Epidemiology and Quantitative Methods, National School of Public Health Sergio Arouca, Fundacao Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Dora Chor
- Department of Epidemiology and Quantitative Methods, National School of Public Health Sergio Arouca, Fundacao Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rosane Haerter Griep
- Laboratory of Health and Environment Education, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
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Meier HCS, Hussein M, Needham B, Barber S, Lin J, Seeman T, Diez Roux A. Cellular response to chronic psychosocial stress: Ten-year longitudinal changes in telomere length in the Multi-Ethnic Study of Atherosclerosis. Psychoneuroendocrinology 2019; 107:70-81. [PMID: 31112903 PMCID: PMC6635040 DOI: 10.1016/j.psyneuen.2019.04.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 02/14/2019] [Accepted: 04/26/2019] [Indexed: 01/01/2023]
Abstract
Previous studies have demonstrated an inverse association between chronic psychosocial stress and leukocyte telomere length (LTL), a potential marker of cellular aging. However, due to paucity of longitudinal data, responses of LTL and the LTL aging trajectory to changes in chronic stress exposure remain less well understood. Using data from the Stress I and II ancillary studies of the Multi-Ethnic Study of Atherosclerosis, we estimated the 10-year longitudinal (n = 1,158) associations of within-person changes in chronic stress with changes in LTL, as well as the pooled, cross-sectional associations of chronic stress and LTL (total n = 2,231). We measured chronic stress from both individual and neighborhood-environment sources. At the individual level, we calculated a summary score of each participant's rating of their ongoing (>6 months) material/social problems as moderately/very stressful on the Chronic Burden Scale. Neighborhood-level stress was measured using a summary score of reverse-coded MESA Neighborhood safety, aesthetic quality, and social cohesion scales. Quantiles of these scores were empirically categorized as high, moderate, or low stress. We then summed these individual- and neighborhood-level categorical variables for a total stress measure. Longitudinal within-person associations were estimated with fixed-effects models, which control for all time-invariant confounding, with additional control for time-varying demographics, lagged behaviors and chronic conditions, and specimen storage duration, as well as correction for regression to the mean. Change from low to high total chronic stress was associated with telomere shortening by 0.054 units [95% confidence interval: -0.095, -0.013] over 10 years. This was consistent with, though stronger in magnitude than, cross-sectional estimates. Change in individual-level stress was the primary driver of this effect. We also found suggestive evidence that 1) individuals with persistently high stress experienced the least shortening of telomeres, and 2) changes in individual-level stress were associated with stronger telomere shortening among women, whereas changes in neighborhood stress were associated with stronger shortening among men. Our findings provide longitudinal support to existing evidence, and point to interesting dynamics in telomere attrition across stress levels and genders.
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Affiliation(s)
- Helen C S Meier
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th St., Milwaukee, WI, 53205, USA.
| | - Mustafa Hussein
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th St., Milwaukee, WI, 53205, USA.
| | - Belinda Needham
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA.
| | - Sharrelle Barber
- Department of Epidemiology and Biostatistics, and the Urban Health Collaborative, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA, 19104, USA.
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California, San Francisco, 600 16th Street, Room S312F Genentech Hall, San Francisco, CA, 94158, USA.
| | - Teresa Seeman
- Department of Medicine, Division of Geriatrics, University of California, Los Angeles, 10945 Le Conte Avenue, Suite 2339, Los Angeles, CA, 90095, USA.
| | - Ana Diez Roux
- Department of Epidemiology and Biostatistics, and the Urban Health Collaborative, Drexel University Dornsife School of Public Health, 3215 Market St., Philadelphia, PA, 19104, USA.
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209
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Buehler JW, Castro JC, Cohen S, Zhao Y, Melly S, Moore K. Personal and Neighborhood Attributes Associated with Cervical and Colorectal Cancer Screening in an Urban African American Population. Prev Chronic Dis 2019; 16:E118. [PMID: 31469069 PMCID: PMC6716424 DOI: 10.5888/pcd16.190030] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Introduction Assessing individual social determinants of health in primary care might be complemented by consideration of population attributes in patients’ neighborhoods. We studied associations between cervical and colorectal cancer screening and neighborhood attributes among an African American population in Philadelphia. Methods We abstracted demographic and cancer screening information from records of patients seen during 2006 at 3 federally qualified health centers and characterized patients’ census tracts of residence by using census, survey, and other data to define population metrics for poverty, racial segregation, educational attainment, social capital, neighborhood safety, and violent crime. We used generalized estimating equations to obtain adjusted relative risks of screening associated with individual and census tract attributes. Results Among 1,708 patients for whom colorectal cancer screening was recommended, screening was up to date for 41%, and among 4,995 women for whom cervical cancer screening was recommended, screening was up to date for 75%. After controlling for age, sex (for colorectal cancer screening), insurance coverage, and clinic site, people living in the most racially segregated neighborhoods were nearly 10% more likely than others to be unscreened for colorectal cancer. Other census tract population attributes were not associated with differences in screening levels for either cancer. Conclusions The association between lower rates of colorectal cancer screening and neighborhood racial segregation is consistent with known barriers to colonoscopy among African Americans combined with effects of segregation on health-related behaviors. Recognition of the association between segregation and lower colorectal cancer screening rates might be useful in informing and targeting community outreach to improve screening.
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Affiliation(s)
- James W Buehler
- Urban Health Collaborative and Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.,Dornsife School of Public Health, 3215 Market St, 3rd Floor, Philadelphia, PA 19104
| | - Juan C Castro
- Family Practice and Counseling Network, Philadelphia, Pennsylvania
| | - Suzanne Cohen
- Health Federation of Philadelphia, Philadelphia, Pennsylvania
| | - Yuzhe Zhao
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Steven Melly
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Kari Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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Evaluating Neighborhood, Social, and Genetic Influences on Precursors of Alcohol Use Risk Behavior in African American Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16173078. [PMID: 31450589 PMCID: PMC6747126 DOI: 10.3390/ijerph16173078] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 08/05/2019] [Accepted: 08/20/2019] [Indexed: 11/16/2022]
Abstract
Background: Using a socioecological framework, we examined neighborhood and social stressors in concert with genetic risk for alcohol dependence in relation to externalizing behaviors, important precursors to alcohol-related problems. Methods: We used data from African American adolescents and their caregivers in the Gene, Environment, and Neighborhood Initiative, a subsample of the Mobile Youth and Poverty Study. Participants for the current analyses included 112 adolescents who reported ever having at least one full drink of alcohol. Empirical Bayes scores were used to estimate neighborhood-level violence and transitions. Multivariate models tested main effects and then interactions of family stressors, discrimination, and genetic risk with the neighborhood variables. Results: In the main effects model, adolescent externalizing behaviors were positively associated with greater family stressors, more racial discrimination experiences, and genetic liability, while neighborhood variables were nonsignificant. We found three significant interactions. Specifically, the joint effects of neighborhood violence and transitions and between these neighborhood variables and family stressors were significantly associated with externalizing behaviors. Conclusions: Our findings suggest genetic liability and complex interactions between neighborhood context and social stressors are important contributors that should be considered in the development of early prevention programs for adolescents who live in economically disadvantaged areas.
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211
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Zheng Z, Chen H, Yang L. Transfer of Promotion Effects on Elderly Health with Age: From Physical Environment to Interpersonal Environment and Social Participation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E2794. [PMID: 31387307 PMCID: PMC6696029 DOI: 10.3390/ijerph16152794] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 02/06/2023]
Abstract
An important goal of building "age-friendly communities" is to help the elderly to access more opportunities for social participation and better health. However, little is known about the complex relationships between neighborhood environment, social participation, and elderly health. This study examined the mediating role of social participation in the area of neighborhood environment affecting elderly health and explored the discrepancy among different age groups in 43 neighborhoods of Shanghai. Both neighborhood environment and social participation had significant positive effects on elderly health in all the samples. Meanwhile, social participation served as a mediator of the relationship between interpersonal environment and elderly health. Furthermore, remarkably, health promotion effects transferred from the physical environment to interpersonal environment and social participation with age; the influence of physical environment on elderly health decreased with the increase of age, while the influence of interpersonal environment and social participation on the health of the elderly increased with the increase of age. This study found that physical environment, interpersonal environment, and social participation had different effects on elderly health of different ages. Different policies should be applied toward improving the interpersonal environment, optimizing of physical environment, and guiding the community activities.
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Affiliation(s)
- Zhenhua Zheng
- College of Architecture and Urban Planning, Tongji University, 1239 Siping Road, Shanghai 200092, China
| | - Hong Chen
- College of Architecture and Environment, Sichuan University, No.24 First South Section First Ring Road, Chengdu 610065, China.
| | - Liu Yang
- Institute of Local Governance, Yangtze Normal University, 16 Juxian Avenue, Chongqing 408100, China.
- Center for Population and Development Policy Studies, Fudan University, 220 Handan Road, Shanghai 200433, China.
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Lê-Scherban F, Ballester L, Castro JC, Cohen S, Melly S, Moore K, Buehler JW. Identifying neighborhood characteristics associated with diabetes and hypertension control in an urban African-American population using geo-linked electronic health records. Prev Med Rep 2019; 15:100953. [PMID: 31367515 PMCID: PMC6656692 DOI: 10.1016/j.pmedr.2019.100953] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 11/16/2022] Open
Abstract
For health care providers, information on community-level social determinants of health is most valuable when it is specific to the populations and health outcomes for which they are responsible. Diabetes and hypertension are highly prevalent conditions whose management requires an interplay of clinical treatment and behavioral modifications that may be sensitive to community conditions. We used geo-linked electronic health records from 2016 of African American patients of a network of federally qualified health centers in Philadelphia, PA to examine cross-sectional associations between characteristics of patients' residential neighborhoods and hypertension and diabetes control (n = 1061 and n = 2633, respectively). Hypertension and diabetes control were defined to align with the Health Resources and Services Administration (HRSA) Uniform Data System (UDS) reporting requirements for HRSA-funded health centers. We examined associations with nine measures of neighborhood socioeconomic status (poverty, education, deprivation index), social environment (violent crime, perceived safety and social capital, racial segregation), and built environment (land-use mix, intersection density). In demographics-adjusted log-binomial regression models accounting for neighborhood-level clustering, poor diabetes and hypertension control were more common in highly segregated neighborhoods (i.e., high proportion of African American residents relative to the mean for Philadelphia; prevalence ratio = 1.27 [1.02-1.57] for diabetes, 1.22 [1.12-1.33] for hypertension) and less common in more walkable neighborhoods (i.e., higher retail land use). Neighborhood deprivation was also weakly associated with poor hypertension control. An important consideration in making geographic information actionable for providers is understanding how specific community-level determinants affect the patient population beyond individual-level determinants.
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Affiliation(s)
- Félice Lê-Scherban
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.,Department of Epidemiology & Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Lance Ballester
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Juan C Castro
- Family Practice & Counseling Network, Philadelphia, PA, USA
| | - Suzanne Cohen
- Health Federation of Philadelphia, Philadelphia, PA, USA
| | - Steven Melly
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Kari Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - James W Buehler
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.,Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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213
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Topel ML, Kim JH, Mujahid MS, Ko YA, Vaccarino V, Mubasher M, Liu C, Dunbar S, Sims M, Taylor HA, Quyyumi AA, Baltrus P, Lewis TT. Individual Characteristics of Resilience are Associated With Lower-Than-Expected Neighborhood Rates of Cardiovascular Disease in Blacks: Results From the Morehouse-Emory Cardiovascular (MECA) Center for Health Equity Study. J Am Heart Assoc 2019; 8:e011633. [PMID: 31203713 PMCID: PMC6645651 DOI: 10.1161/jaha.118.011633] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Factors promoting cardiovascular health in the face of high risk, ie, resilience, are unknown and may identify novel areas of intervention for reducing racial health disparities. We examined neighborhood perceptions and psychological attributes of blacks living in high and low cardiovascular–risk neighborhoods, as potential characteristics of resilience promoting cardiovascular health. Methods and Results We identified 1433 blacks residing in census tracts of Atlanta, GA, with higher‐than‐expected (“high” risk) or lower‐than‐expected (“low” risk) rates of cardiovascular mortality, hospitalizations, and emergency department visits during 2010–2014. Domains of psychosocial well‐being and neighborhood quality were assessed via telephone survey between August 2016 and October 2016. Using multilevel logistic regression, odds of reporting better resilient characteristics were compared between individuals living in low‐ versus high‐risk neighborhoods. Those from low‐risk (versus high‐risk) neighborhoods reported better neighborhood aesthetic quality (odds ratio [OR], 1.84), healthy food access (OR, 1.69), and absence of violence (OR, 0.67). Individuals from low‐risk neighborhoods reported greater optimism (OR, 1.38), purpose in life (OR, 1.42), and fewer depressive symptoms (OR, 0.69). After full adjustment, these associations remained significant for neighborhood factors (aesthetic quality, healthy food access, violence) and psychosocial well‐being (purpose in life). We found no evidence of differences in self‐reported cardiovascular risk factors or disease history between low‐ versus high‐risk neighborhoods. Conclusions Positive neighborhood environments and psychological characteristics are associated with low cardiovascular–risk neighborhoods, despite similar prevalence of cardiovascular risk factors, in the census tracts studied. These factors may confer cardiovascular resilience among blacks.
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Affiliation(s)
- Matthew L Topel
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Jeong Hwan Kim
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Mahasin S Mujahid
- 2 Division of Epidemiology School of Public Health University of California, Berkeley Berkeley CA
| | - Yi-An Ko
- 3 Department of Biostatistics and Bioinformatics Rollins School of Public Health Emory University Atlanta GA
| | - Viola Vaccarino
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA.,4 Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA
| | - Mohamed Mubasher
- 5 Department of Community Health and Preventive Medicine Morehouse School of Medicine Atlanta GA
| | - Chang Liu
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Sandra Dunbar
- 6 Nell Hodgson Woodruff School of Nursing Emory University Atlanta GA
| | - Mario Sims
- 7 Department of Medicine University of Mississippi Medical Center Jackson MS
| | - Herman A Taylor
- 8 Department of Medicine Morehouse School of Medicine Atlanta GA
| | - Arshed A Quyyumi
- 1 Division of Cardiology Department of Medicine Emory University School of Medicine Atlanta GA
| | - Peter Baltrus
- 5 Department of Community Health and Preventive Medicine Morehouse School of Medicine Atlanta GA.,9 National Center for Primary Care Morehouse School of Medicine Atlanta GA
| | - Tené T Lewis
- 4 Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA
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214
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Borg A, Haughton CF, Sawyer M, Lemon SC, Kane K, Pbert L, Li W, Rosal MC. Design and methods of the Healthy Kids & Families study: a parent-focused community health worker-delivered childhood obesity prevention intervention. BMC OBESITY 2019; 6:19. [PMID: 31171975 PMCID: PMC6545743 DOI: 10.1186/s40608-019-0240-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 03/14/2019] [Indexed: 11/22/2022]
Abstract
Background One third of U.S. children and two thirds of adults are overweight or obese. Interventions to prevent obesity and thus avert threats to public health are needed. This paper describes the design and methods of the Healthy Kids & Families study, which tested the effect of a parent-focused community health worker (CHW)-delivered lifestyle intervention to prevent childhood obesity. Methods Participants were English or Spanish-speaking parent-child dyads (n = 247) from nine elementary schools (grades K-6) located in racial/ethnically diverse low-income communities in Worcester, Massachusetts. Using a quasi-experimental design with the school as the level of allocation, the study compared the lifestyle intervention vs. an attention-control comparison condition. The lifestyle intervention was guided by social cognitive theory and social ecological principles. It targeted the child’s social and physical home environment by intervening with parental weight-related knowledge, beliefs, and skills for managing child obesogenic behaviors; and addressed families’ needs for community resources supportive of a healthy lifestyle. The two-year CHW-delivered intervention was structured based on the 5As model (Agenda, Assess, Advise, Assist, Arrange follow up) and included two in person sessions and two telephone follow-ups per year with the parent, with a personalized letter and print materials sent after each contact. Parents also received quarterly newsletters, Facebook messages, and invitations to community events. The attention-control comparison condition used the same format and contact time as the intervention condition, but targeted positive parenting skills. Measurements occurred at baseline, and at 6-, 12-, 18- and 24-month follow-up. Assessments included anthropometrics, accelerometry, global positioning system (GPS), and self-report surveys. The primary outcome was child body mass index (BMI) z score. Secondary outcomes were parent BMI; and parent and child diet, physical activity, sedentariness, and utilization of community resources supportive of a healthy lifestyle. Discussion A CHW-delivered parent-focused lifestyle intervention may provide a translatable model for targeting the high priority public health problem of childhood obesity among low-income diverse communities. If demonstrated effective, this intervention has potential for high impact. Trial registration ClinicalTrials NCT03028233. Registered January 23,2017. The trial was retrospectively registered.
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Affiliation(s)
- Amy Borg
- 1Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655 USA
| | - Christina F Haughton
- Oak Hill Community Development Corporation, 74 Providence Street, Worcester, MA 01604 USA
| | - Mullen Sawyer
- 3Tufts University Friedman School of Nutrition and Policy, 150 Harrison Avenue, Boston, MA 02111 USA
| | - Stephenie C Lemon
- 1Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655 USA
| | - Kevin Kane
- 1Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655 USA
| | - Lori Pbert
- 1Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655 USA
| | - Wenjun Li
- 1Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655 USA
| | - Milagros C Rosal
- 1Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655 USA
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215
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Kim B, Kim GS, Hyun HS. Development and validation of a tool to assess the rural neighborhood environment for obesity in Korean adults. Public Health Nurs 2019; 36:752-762. [PMID: 31131480 DOI: 10.1111/phn.12621] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/17/2019] [Accepted: 04/26/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to develop and validate a tool that assesses the perceived neighborhood environments influencing obesity development among rural adults in Korea. DESIGN AND SAMPLES Qualitative and quantitative methods were used. Twenty-one adults participated in focus group interviews. Subsequently, two independent surveys were conducted with rural adults aged 19-65. MEASUREMENTS Literature review and focus group interviews were used to generate initial items. An expert's panel evaluation established content validity for these items and pilot testing of the draft tool was performed. Explanatory (n = 328) and confirmatory factor analyses (n = 1,070) were used to establish construct validity, and internal consistency and test-retest reliability were calculated (n = 88). RESULTS The new tool consisting of 37 items was developed and validated. Confirmatory factor analysis revealed an eight-subscale structure (χ2 = 3,738.1, GFI = 0.831, SRMR = 0.060, RMSEA = 0.070). The tool showed moderate test-retest reliability (ICC = 0.519-0.775) and good internal consistency except for Social Influence on Healthy Eating (Cronbach's α = 0.612). CONCLUSIONS The Rural Neighborhood Environment Assessment for Obesity tool might be a valid and reliable instrument for public health practitioners to assess complex social and physical environmental factors related to obesity.
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Affiliation(s)
- Bongjeong Kim
- Department of Nursing, College of Health Science, Cheongju, Korea
| | - Gwang Suk Kim
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - Hye Sun Hyun
- Department of Nursing, Sangmyung University, Cheonan, Korea
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216
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Depressive Symptoms among Industrial Workers in Vietnam and Correlated Factors: A Multi-Site Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091642. [PMID: 31083499 PMCID: PMC6539422 DOI: 10.3390/ijerph16091642] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/30/2019] [Accepted: 05/08/2019] [Indexed: 02/05/2023]
Abstract
Depressive disorders have been found to be a significant health issue among industrial workers, resulting from work-related factors and causing serious burdens for the workers as well as their employers. Literature on mental health problems of Vietnamese industrial workers has been limited, despite the rapid foreign investment-fueled industrialization process of the country. This study aimed to fill the gap in literature by examining the prevalence of depressive disorders and their potential associated factors among a cohort of Vietnamese industrial workers. A cross-sectional study was conducted in 3 industrial areas in Hanoi and Bac Ninh. A total of 289 workers agreed to participate in the study. Generalized linear mixed models were applied to identify associated factors with depression status of respondents. 38.6% of participants reported suffering depression. Factors found to be positively associated with the possibility of having depression and higher PHQ9 score were long working hours, suffering more health problems, and health hazards exposure at work. Meanwhile, being females, having more children, living with parents, engaging in smoking, and being local workers were found to correlate with lower likelihood of being depressed. The findings suggested the importance of regular health screening, work safety assurance, and social support outside of workplace on the mental health of the workers.
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217
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Sadhu M, Nicholson TDF, Garcia R, Lampley S, Rain M, Fritz A, Jalalizadeh B, Van Enkevort E, Palka J, Brown ES. Relationship between trust in neighbors and regional brain volumes in a population-based study. Psychiatry Res Neuroimaging 2019; 286:11-17. [PMID: 30852253 DOI: 10.1016/j.pscychresns.2019.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 02/14/2019] [Accepted: 03/01/2019] [Indexed: 12/30/2022]
Abstract
Trust is a fundamental part of human interpersonal relationships, and among other complex factors it is shown to be linked with demographic characteristics and specific regions of the brain. The authors utilized a large, community-based database gathered from the Dallas Heart Study to determine specific brain regions associated with an individual's trust in neighbors. A trust questionnaire was taken and regional brain volumes were determined from structural magnetic resonance imaging. Two analyses using logistic regressions in a training set and validation set were performed to investigate the association between measures of trust and bilateral brain region volumes and thickness. A total of 1527 participants were included in the final analysis. Right caudal anterior cingulate cortex thickness and left caudate volume were inversely correlated with neighbor trust, while left amygdala volume was positively correlated with neighbor trust. Greater age and higher level of education were positively correlated with neighbor trust. African Americans showed less neighbor trust than Caucasians and Hispanics. Anterior cingulate cortex, caudate, and amygdala are all integral parts of the salience network; thus, results of this study suggest that the salience network, the brain network responsible for functions such as communication and social behavior, may play a role in the formation of interpersonal trust.
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Affiliation(s)
- Mohona Sadhu
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, MC 8849 Dallas, TX, United States
| | - Theresa de Freitas Nicholson
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, MC 8849 Dallas, TX, United States
| | - Rogelio Garcia
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, MC 8849 Dallas, TX, United States
| | - Susana Lampley
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, MC 8849 Dallas, TX, United States
| | - Marian Rain
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, MC 8849 Dallas, TX, United States
| | - Andrew Fritz
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, MC 8849 Dallas, TX, United States
| | - Bayan Jalalizadeh
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, MC 8849 Dallas, TX, United States
| | - Erin Van Enkevort
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, MC 8849 Dallas, TX, United States
| | - Jayme Palka
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, MC 8849 Dallas, TX, United States
| | - E Sherwood Brown
- Department of Psychiatry, The University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, MC 8849 Dallas, TX, United States.
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218
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Health Inequality between Migrant and Non-Migrant Workers in an Industrial Zone of Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091502. [PMID: 31035337 PMCID: PMC6539052 DOI: 10.3390/ijerph16091502] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 11/17/2022]
Abstract
Vietnam has experienced massive internal migration waves from rural to industrialized zones. However, little efforts have been made to understand differences in health conditions and health-related quality of life (HRQOL) between local and migrant industrial workers. This study aimed to examine the inequality in health status and HRQOL between these workers. We conducted a cross-sectional study of 289 Vietnamese workers at three industrial areas in Hanoi and Bac Ninh. Self-reported health status and HRQOL were measured using the EuroQOL-5 dimensions-5 levels (EQ-5D-5L) instrument. Sociodemographic, working, and environmental factors were also investigated. Overall, the mean EQ-5D index was 0.74 (SD = 0.21) and the average number of health problems in the last 12 months in our sample was 1.91 (SD = 1.63) problems. Migrant people had a lower EQ-5D index (β = −0.08, p < 0.01) and more health problems (β = 0.20, p < 0.05) compared to local workers. Those being male, working in the same posture more than 60 min, and exposed to more hazards at work were correlated with a lower EQ-5D index and higher number of health problems. The results highlighted inequalities in health status and HRQOL between migrant and local workers. Reinforcing regular health check-ups, ensuring sufficient protective equipment and working conditions may help improve the health outcomes of the workers.
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219
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Freedman DA, Bell BA, Clark JK, Sharpe PA, Trapl ES, Borawski EA, Pike SN, Rouse C, Sehgal AR. Socioecological Path Analytic Model of Diet Quality among Residents in Two Urban Food Deserts. J Acad Nutr Diet 2019; 119:1150-1159. [PMID: 31031105 DOI: 10.1016/j.jand.2019.02.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/09/2018] [Accepted: 02/21/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Diet is critical to chronic disease prevention, yet there are persistent disparities in diet quality among Americans. The socioecological model suggests multiple factors, operating at multiple levels, influence diet quality. OBJECTIVE The goal was to model direct and indirect relationships among healthy eating identity, perceived control of healthy eating, social support for healthy eating, food retail choice block scores, perceptions of healthy food availability, and food shopping behaviors and diet quality measured using Healthy Eating Index-2010 scores (HEI-2010) for residents living in two urban communities defined as food deserts. DESIGN A cross-sectional design was used including data collected via self-reported surveys, 24-dietary recalls, and through objective observations of food retail environments. PARTICIPANTS/SETTING Data collection occurred in 2015-2016 in two low-income communities in Cleveland (n=243) and Columbus (n=244), OH. MAIN OUTCOME MEASURE HEI-2010 scores were calculated based on the average of three 24-hour dietary recalls using the Nutrition Data System for Research. ANALYSIS Separate path models, controlled for income, were run for each community. Analysis was guided by a conceptual model with 15 hypothesized direct and indirect effects on HEI-2010 scores. Associations were considered statistically significant at P<0.05 and P<0.10 because of modest sample sizes in each community. RESULTS Across both models, significant direct effects on HEI-2010 scores included healthy eating identity (β=.295, Cleveland; β=.297, Columbus, P<0.05) and distance traveled to primary food store (β=.111, Cleveland, P<0.10; β=.175, Columbus, P<0.05). Perceptions of healthy food availability had a significant, inverse effect in the Columbus model (β=-.125, P<0.05). The models explained greater variance in HEI-2010 scores for the Columbus community compared with Cleveland (R2=.282 and R2=.152, respectively). CONCLUSIONS Findings highlight the need for tailored dietary intervention approaches even within demographically comparable communities. Interventions aimed at improving diet quality among residents living in food deserts may need to focus on enhancing healthy eating identity using culturally relevant approaches while at the same time addressing the need for transportation supports to access healthy food retailers located farther away.
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220
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Martínez-García A, Trescastro-López EM, Galiana-Sánchez ME, Pereyra-Zamora P. Data Collection Instruments for Obesogenic Environments in Adults: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1414. [PMID: 31010209 PMCID: PMC6518267 DOI: 10.3390/ijerph16081414] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/10/2019] [Accepted: 04/17/2019] [Indexed: 12/25/2022]
Abstract
The rise in obesity prevalence has increased research interest in the obesogenic environment and its influence on excess weight. The aim of the present study was to review and map data collection instruments for obesogenic environments in adults in order to provide an overview of the existing evidence and enable comparisons. Through the scoping review method, different databases and webpages were searched between January 1997 and May 2018. Instruments were included if they targeted adults. The documents were categorised as food environment or built environment. In terms of results, 92 instruments were found: 46 instruments measuring the food environment, 42 measuring the built environment, and 4 that characterised both environments. Numerous diverse instruments have been developed to characterise the obesogenic environment, and some of them have been developed based on existing ones; however, most of them have not been validated and there is very little similarity between them, hindering comparison of the results obtained. In addition, most of them were developed and used in the United States and were written in English. In conclusion, there is a need for a robust instrument, improving or combining existing ones, for use within and across countries, and more sophisticated study designs where the environment is contemplated in an interdisciplinary approach.
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Affiliation(s)
- Alba Martínez-García
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science-University of Alicante. Campus de Sant Vicent del Raspeig. Ap. 99, E-03080 Alicante, Spain.
| | - Eva María Trescastro-López
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science-University of Alicante. Campus de Sant Vicent del Raspeig. Ap. 99, E-03080 Alicante, Spain.
| | - María Eugenia Galiana-Sánchez
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science-University of Alicante. Campus de Sant Vicent del Raspeig. Ap. 99, E-03080 Alicante, Spain.
| | - Pamela Pereyra-Zamora
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science-University of Alicante. Campus de Sant Vicent del Raspeig. Ap. 99, E-03080 Alicante, Spain.
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221
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Belsky DW, Caspi A, Arseneault L, Corcoran DL, Domingue BW, Harris KM, Houts RM, Mill JS, Moffitt TE, Prinz J, Sugden K, Wertz J, Williams B, Odgers CL. Genetics and the geography of health, behaviour and attainment. Nat Hum Behav 2019; 3:576-586. [PMID: 30962612 DOI: 10.1038/s41562-019-0562-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 02/19/2019] [Indexed: 01/06/2023]
Abstract
Young people's life chances can be predicted by characteristics of their neighbourhood1. Children growing up in disadvantaged neighbourhoods exhibit worse physical and mental health and suffer poorer educational and economic outcomes than children growing up in advantaged neighbourhoods. Increasing recognition that aspects of social inequalities tend, in fact, to be geographical inequalities2-5 is stimulating research and focusing policy interest on the role of place in shaping health, behaviour and social outcomes. Where neighbourhood effects are causal, neighbourhood-level interventions can be effective. Where neighbourhood effects reflect selection of families with different characteristics into different neighbourhoods, interventions should instead target families or individuals directly. To test how selection may affect different neighbourhood-linked problems, we linked neighbourhood data with genetic, health and social outcome data for >7,000 European-descent UK and US young people in the E-Risk and Add Health studies. We tested selection/concentration of genetic risks for obesity, schizophrenia, teen pregnancy and poor educational outcomes in high-risk neighbourhoods, including genetic analysis of neighbourhood mobility. Findings argue against genetic selection/concentration as an explanation for neighbourhood gradients in obesity and mental health problems. By contrast, modest genetic selection/concentration was evident for teen pregnancy and poor educational outcomes, suggesting that neighbourhood effects for these outcomes should be interpreted with care.
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Affiliation(s)
- Daniel W Belsky
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA. .,Robert N. Butler Columbia Aging Center, Columbia University, New York, NY, USA.
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.,Center for Genomic and Computational Biology, Duke University, Durham, NC, USA.,MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Louise Arseneault
- MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - David L Corcoran
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Benjamin W Domingue
- Stanford Graduate School of Education, Stanford University, Palo Alto, CA, USA
| | - Kathleen Mullan Harris
- Carolina Population Center and Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Renate M Houts
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Jonathan S Mill
- Complex Disease Epigenetics Group, University of Exeter Medical School, Exeter, UK
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.,Center for Genomic and Computational Biology, Duke University, Durham, NC, USA.,MRC Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Joseph Prinz
- Center for Genomic and Computational Biology, Duke University, Durham, NC, USA
| | - Karen Sugden
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Jasmin Wertz
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Benjamin Williams
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
| | - Candice L Odgers
- Department of Psychological Science, University of California at Irvine, Irvine, CA, USA. .,Sanford School of Public Policy, Duke University, Durham, NC, USA.
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222
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Petteway R, Mujahid M, Allen A. Understanding Embodiment in Place-Health Research: Approaches, Limitations, and Opportunities. J Urban Health 2019; 96:289-299. [PMID: 30613858 PMCID: PMC6458222 DOI: 10.1007/s11524-018-00336-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Research on how place affects health continues to grow. Within the place-health research field, there is increasing focus on how place becomes embodied-i.e., how place-based social and environmental experiences and exposures "get under our skin" to affect physiological functioning and health. While much has been learned, currently favored place-embodiment research approaches present limitations that inhibit continued gains in understanding. This article presents a brief summary of place-health literature related to place-embodiment, highlighting common approaches. Core limitations are then discussed with an eye towards improving research going forward, highlighting mixed-method, spatially dynamic, and participatory intergenerational approaches as promising considerations.
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Affiliation(s)
- Ryan Petteway
- Oregon Health & Science University-Portland State University School of Public Health, Portland, OR, USA.
| | - Mahasin Mujahid
- University of California, Berkeley School of Public Health, Berkeley, CA, 94720, USA
| | - Amani Allen
- University of California, Berkeley School of Public Health, Berkeley, CA, 94720, USA
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Prince DM, Hohl B, Hunter BA, Thompson AB, Matlin SL, Hausman AJ, Tebes JK. Collective Efficacy as a Key Context in Neighborhood Support for Urban Youth. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 63:179-189. [PMID: 30843253 PMCID: PMC6676898 DOI: 10.1002/ajcp.12311] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Neighborhood context, including the physical and social environment, has been implicated as important contributors to positive youth development. A transactional approach to neighborhood asserts that place and people are mutually constitutive; negative perceptions of place are intrinsically bound with negative portrayals of stigmatized groups, including youth. Adult perceptions of neighborhood youth may contribute to an increased sense of alienation and youth antisocial behavior. This study uses street-intercept interviews with adults (N = 408) to examine the relationship between neighborhood conditions and adult support for neighborhood youth. A path model was used to examine the direct and indirect relationship of neighborhood constructs (safety, aesthetic quality, and walkability) on adult support for neighborhood youth. Neighborhood aesthetic quality and the walking environment were directly associated with adult support for youth, whereas perceived safety was indirectly associated. Collective efficacy partially explained these relationships. Findings support theorized relationships between people and places; improvements to neighborhood physical environment may directly impact resident adults' perceptions of neighborhood young people.
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Affiliation(s)
| | | | | | - Azure B Thompson
- National Center on Addiction and Substance Abuse, Thompson, NY, USA
| | - Samantha L Matlin
- The Scattergood Foundation, Philadelphia, PA, USA
- Yale University, New Haven, CT, USA
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Alexander E, McGinty EE, Wang NY, Dalcin A, Jerome GJ, Miller ER, Dickerson F, Charleston J, Young DR, Gennusa JV, Goldsholl S, Cook C, Appel LJ, Daumit GL. Effects of a behavioural weight loss intervention in people with serious mental illness: Subgroup analyses from the ACHIEVE trial. Obes Res Clin Pract 2019; 13:205-210. [PMID: 30852244 PMCID: PMC7255457 DOI: 10.1016/j.orcp.2019.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 02/01/2019] [Accepted: 02/08/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Persons with serious mental illnesses (SMI) such as schizophrenia and bipolar disorder have an increased risk of obesity and related chronic diseases and die 10-20years earlier than the overall population, primarily due to cardiovascular disease. In the ACHIEVE trial, a behavioural weight loss intervention led to clinically significant weight loss in persons with SMI. As the field turns its attention to intervention scale-up, it is important to understand whether the effectiveness of behavioural weight loss interventions for people with SMI, like ACHIEVE, differ for specific subgroups. METHODS This study examined whether the effectiveness of the ACHIEVE intervention differed by participant characteristics (e.g. age, sex, race, psychiatric diagnosis, body mass index) and/or their weight-related attitudes and behaviours (e.g. eating, food preparation, and shopping habits). We used likelihood-based mixed effects models to examine whether the baseline to 18 month effects of the ACHIEVE intervention differed across subgroups. RESULTS No statistically significant differences were found in the effectiveness of the ACHIEVE intervention across any of the subgroups examined. CONCLUSIONS These findings suggest that the ACHIEVE behavioural weight loss intervention is broadly applicable to the diverse population of individuals with SMI.
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Affiliation(s)
- Eleanore Alexander
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States.
| | - Emma E McGinty
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States
| | - Nae-Yuh Wang
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Arlene Dalcin
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Gerald J Jerome
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Department of Kinesiology, Towson University, Baltimore, MD, 21252, United States
| | - Edgar R Miller
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Faith Dickerson
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD 21204, United States
| | - Jeanne Charleston
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Deborah R Young
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, 91024, United States
| | - Joseph V Gennusa
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States
| | - Stacy Goldsholl
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States
| | - Courtney Cook
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
| | - Gail L Daumit
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, United States; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medicine, Baltimore, MD, 21205, United States
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225
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Zanelatto C, Höfelmann DA, Giehl MWC, Nishida W, Bastos JL. Perception of neighborhood disorder and blood pressure in adults: a multilevel population-based study. CAD SAUDE PUBLICA 2019; 35:e00016418. [PMID: 30785484 DOI: 10.1590/0102-311x00016418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 06/21/2018] [Indexed: 09/20/2023] Open
Abstract
The aim of this study was to verify whether the perception of neighborhood physical and social disorder is associated with increased systolic (SBP) and diastolic blood pressure (DBP), as well as to examine the influence of the residential census tract's socioeconomic status on this association. This was a cross-sectional study that included a representative sample of 1,720 adults 20 to 59 years of age living in Florianópolis, Santa Catarina State, Brazil. Two blood pressure measurements were taken, and information was collected on the perception of neighborhood disorder. The contextual variable was the mean head-of-household's years of schooling in the selected census tracts. Statistical analysis included multilevel models with the first level represented by individuals and the second by census tracts. Interaction terms were examined between schooling tertiles in the census tract and tertiles of perception of neighborhood disorder on blood pressure. No statistically significant overall associations were identified between neighborhood disorder and SBP or DBP. However, the study showed a mean increase in SBP of 7.88mmHg (95%CI: 1.38; 14.40) in subjects that perceived more neighborhood disorder and lived in census tracts with less schooling, when compared to the reference category. Public policies aimed at lowering or that have an impact on SBP and DBP in the population should also address the characteristics of the context where the population lives, specifically in contexts marked by lower levels of schooling.
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Affiliation(s)
- Carla Zanelatto
- Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brasil
| | | | | | - Waleska Nishida
- Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brasil
| | - João Luiz Bastos
- Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brasil
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226
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Petteway RJ, Mujahid M, Allen A, Morello-Frosch R. The body language of place: A new method for mapping intergenerational "geographies of embodiment" in place-health research. Soc Sci Med 2019; 223:51-63. [PMID: 30708171 DOI: 10.1016/j.socscimed.2019.01.027] [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: 07/11/2018] [Revised: 10/23/2018] [Accepted: 01/15/2019] [Indexed: 01/19/2023]
Abstract
Research on place and health has grown rapidly in recent years, including examining the physiological embodiment of place-based exposures. While this research continues to improve understanding of why place matters, there is particular need for work capable of revealing: 1) which places matter, i.e. spatially-specific notions of "place"); 2) how these places matter-processes and mechanisms of the physiological embodiment of place; and 3) potential intergenerational and life stage differences in place-embodiment experiences/perceptions. The research presented here seeks to make contributions in each of these areas through developing the "geographies of embodiment" concept. Drawing from a multi-method intergenerational community-based participatory research project examining place and health, the research presented here specifically highlights X-Ray Mapping as a new methodology to elucidate subjective notions of place-embodiment within place-health research. Participants were recruited as parent-child dyads and trained in four participatory research methods, including X-Ray Mapping. Participants used X-Ray Mapping and a multimedia-enabled web-based mapping platform to map their "geographies of embodiment". X-Ray Mapping results revealed that 49% of youth place-embodiment locations were spatially outside of their residential census tract-with 75% of positive place-embodiment locations outside, and 66% of negative place-embodiment locations inside. Overall, 67% of youth and adult positive place-embodiment locations were outside of their residential census tract. Through mapping "geographies of embodiment" via participatory methods like X-Ray Mapping, we can gain greater insight into what is embodied (i.e. specific experiences/exposures), and where (i.e. spatially-specific). These gains could improve development of quantitative place-health metrics and enhance efforts to uncover/intervene on the "pathways of embodiment"-specifically, those elements of local social, political, economic, and environmental contexts that constitute expressions of social inequality.
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Affiliation(s)
- Ryan J Petteway
- Portland State University, OHSU-PSU School of Public Health Department of Community Health, 506 SW Mill St, Suite 450, Portland, OR 97201 USA.
| | - Mahasin Mujahid
- University of California, Berkeley School of Public Health Division of Epidemiology, Haviland Hall, Berkeley CA 94720-7358, USA
| | - Amani Allen
- University of California, Berkeley School of Public Health Division of Epidemiology, Haviland Hall, Berkeley CA 94720-7358, USA; University of California, Berkeley School of Public Health Division of Community Health Sciences, University Hall, Berkeley, CA 94720-7360, USA
| | - Rachel Morello-Frosch
- University of California, Berkeley School of Public Health Division of Community Health Sciences, University Hall, Berkeley, CA 94720-7360, USA; University of California, College of Natural Resources Department of Environmental Science, Policy, & Management 130 Mulford, Berkeley, CA, 94720, USA
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227
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Neergheen VL, Topel M, Van Dyke ME, Sullivan S, Pemu PE, Gibbons GH, Vaccarino V, Quyyumi AA, Lewis TT. Neighborhood social cohesion is associated with lower levels of interleukin-6 in African American women. Brain Behav Immun 2019; 76:28-36. [PMID: 30686334 PMCID: PMC6370481 DOI: 10.1016/j.bbi.2018.10.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 08/30/2018] [Accepted: 10/23/2018] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Social cohesion is a positive neighborhood characteristic defined by feelings of connectedness and solidarity within a community. Studies have found significant associations between social cohesion and cardiovascular disease (CVD) risk factors and outcomes. Inflammation is one potential physiological pathway linking social cohesion to CVD development, but few studies have evaluated the relationship between social cohesion and inflammatory biomarkers. Prior research has also established that race and gender can modify the effects of neighborhood features, including social cohesion, on CVD risk factors and outcomes. This study aimed to examine the association between social cohesion and the inflammatory biomarkers interleukin-6 (IL-6) and C-reactive protein (CRP) in a cohort of African American and White women and men. MATERIALS AND METHODS Data from the Morehouse and Emory Team Up to Eliminate Health Disparities (META-Health) Study were used to assess the association between social cohesion and inflammation among African American (n = 203) and White (n = 176) adults from the Atlanta metropolitan area. Social cohesion was measured using the social cohesion subscale from the Neighborhood Health Questionnaire. Inflammatory biomarkers were measured from plasma frozen at -70 °C. Multivariable linear regression analyses were conducted, controlling for demographic, clinical, behavioral, and psychosocial factors sequentially. Interaction by race and gender was also examined. RESULTS In models adjusted for age, race, gender, and education, social cohesion was significantly associated with lower levels of IL-6 (β = -0.06, p = 0.03). There was a significant race × social cohesion interaction (p = 0.04), and a marginally significant gender × race × social cohesion interaction (p = 0.09). In race-stratified models controlling for age, gender, and education, social cohesion was associated with lower IL-6 levels in African Americans (β = -0.11, p = 0.01), but not Whites (β = 0.01, p = 0.91). In fully adjusted race- and gender-stratified models, social cohesion was associated with lower levels of IL-6 in African American women only (β = -0.15, p = 0.003). CRP was not associated with social cohesion in fully adjusted models. CONCLUSION The association between social cohesion and lower levels of IL-6 is modified by gender and race, with the strongest association emerging for African American women. Although the pathways through which social cohesion impacts inflammation remain unclear, it is possible that for African American women social cohesion manifests through neighborhood networks.
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Affiliation(s)
- Vanessa L Neergheen
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Matthew Topel
- Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, United States
| | - Miriam E Van Dyke
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Samaah Sullivan
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Gary H Gibbons
- National Heart, Lung, and Blood Institute, Bethesda, MD, United States
| | - Viola Vaccarino
- Rollins School of Public Health, Emory University, Atlanta, GA, United States; Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, United States
| | - Arshed A Quyyumi
- Division of Cardiology, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, GA, United States
| | - Tené T Lewis
- Rollins School of Public Health, Emory University, Atlanta, GA, United States.
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228
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Brooks Holliday S, Dubowitz T, Ghosh-Dastidar B, Beckman R, Buysse D, Hale L, Buman M, Troxel W. Do Sleep and Psychological Distress Mediate the Association Between Neighborhood Factors and Pain? PAIN MEDICINE (MALDEN, MASS.) 2019; 20:278-289. [PMID: 29767771 PMCID: PMC6374133 DOI: 10.1093/pm/pny075] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Pain affects millions of American adults. However, individuals from socioeconomically disadvantaged groups experience higher rates of pain, and individuals from racial/ethnic minorities report greater pain severity and pain-related disability. Some studies find an association between neighborhood socioeconomic status and pain. The present study aimed to further understand the association between neighborhood disadvantage and pain, including the role of objective (e.g., crime rates) and subjective neighborhood characteristics (e.g., perceived safety, neighborhood satisfaction), and to examine sleep and psychological distress as potential mediators of these associations. METHODS The sample included 820 participants from two predominantly African American socioeconomically disadvantaged neighborhoods. Trained data collectors interviewed participants on a number of self-report measures, and objective neighborhood characteristics were obtained from city crime data and street segment audits. RESULTS Subjective characteristics, specifically perceived infrastructure and perceived safety, were associated with pain. Based on bootstrapped regression models, sleep efficiency and psychological distress were tested as mediators of the association between these neighborhood factors and pain. Results of mediation testing indicated that psychological distress served as a significant mediator. Though sleep efficiency was not a mediator, it had a significant independent association with pain. CONCLUSIONS Understanding the contribution of sleep problems and psychological distress to pain among at-risk individuals living in disadvantaged neighborhoods is important to identifying ways that individual- and neighborhood-level interventions may be leveraged to reduce pain-related disparities.
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Affiliation(s)
| | | | | | | | - Daniel Buysse
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lauren Hale
- Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, New York
| | - Matthew Buman
- School of Nutrition and Health Promotion, Arizona State University, Tempe, Arizona, USA
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Joseph RP, Ainsworth BE, Vega-López S, Adams MA, Hollingshead K, Hooker SP, Todd M, Gaesser GA, Keller C. Rationale and design of Smart Walk: A randomized controlled pilot trial of a smartphone-delivered physical activity and cardiometabolic risk reduction intervention for African American women. Contemp Clin Trials 2019; 77:46-60. [PMID: 30576840 PMCID: PMC6344046 DOI: 10.1016/j.cct.2018.12.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 12/07/2018] [Accepted: 12/16/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND African American (AA) women perform low levels of physical activity (PA) and are disproportionally burdened by cardiometabolic disease conditions when compared to White women and the U.S. population as a whole. These disparities emphasize the need for innovative and effective interventions to increase PA and reduce cardiometabolic disease risk among AA women. Recent evidence suggests that mobile health (mHealth) interventions have the potential to increase PA and reduce cardiometabolic disease risk factors. Few studies have examined the efficacy of mHealth PA interventions among racial/ethnic minorities, including AA women. This represents a missed opportunity given the reported success of technology-delivered PA interventions in predominately White populations and the high use of technology among AA women. OBJECTIVE To describe the design, theoretical rationale, and cultural relevance of Smart Walk, a culturally sensitive smartphone-delivered PA intervention for AA women. DESIGN AND METHODS Smart Walk is an 8-month, randomized controlled pilot trial designed to increase PA and reduce cardiometabolic disease risk among AA women. Sixty physically inactive AA women with obesity will be assigned to receive either a culturally relevant intervention designed to increase PA (by targeting leisure-time, household chore/task-related, and occupational PA) or a culturally relevant wellness attention-matched control condition. Outcomes will be assessed at baseline, 4 months, and 8 months, and include feasibility and acceptability of the PA intervention and evaluation of effects on PA and cardiometabolic risk factors. SUMMARY Smart Walk represents a culturally relevant, theory-based approach to promote PA and reduce cardiometabolic disease risk in AA women.
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Affiliation(s)
- Rodney P Joseph
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St, Phoenix, AZ 85004, USA.
| | - Barbara E Ainsworth
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Sonia Vega-López
- College of Health Solutions and Southwest Interdisciplinary Research Center, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Marc A Adams
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Kevin Hollingshead
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Steven P Hooker
- College of Health and Human Services, San Diego State University, 5500 Campanile Drive, San Diego, CA 92182, USA.
| | - Michael Todd
- College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St, Phoenix, AZ 85004, USA.
| | - Glenn A Gaesser
- College of Health Solutions, Arizona State University, 550 N 3rd St, Phoenix, AZ 85004, USA.
| | - Colleen Keller
- Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, 500 N 3rd St, Phoenix, AZ 85004, USA.
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230
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Hicken MT, Katz R, Crews DC, Kramer HJ, Peralta CA. Neighborhood Social Context and Kidney Function Over Time: The Multi-Ethnic Study of Atherosclerosis. Am J Kidney Dis 2019; 73:585-595. [PMID: 30655114 DOI: 10.1053/j.ajkd.2018.10.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 10/31/2018] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVE Although socioeconomic status has been associated with chronic kidney disease (CKD), little is known about its relationship to residential neighborhood context. STUDY DESIGN Secondary analysis of the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study designed to investigate the development and progression of subclinical cardiovascular disease. SETTING & PARTICIPANTS 6,814 men and women who were between 45 and 84 years of age and free of cardiovascular disease were recruited between 2000 and 2002 from Baltimore, MD; Chicago, IL; Forsyth County, NC; Los Angeles, CA; New York, NY; and St. Paul, MN. EXPOSURES A composite neighborhood problem score (calculated based on 7 participant-reported domains at study entry: adequacy of food sources, availability of parks/playground, noise, sidewalks, traffic, trash and litter, and violence) and a social cohesion score (calculated based on 5 participant-reported attributes of people in their neighborhood: close knit; get along; willing to help neighbors; trustworthy; and share values). OUTCOMES Estimated glomerular filtration rate (eGFR; calculated using the CKD-EPI [CKD Epidemiology Collaboration] creatinine-cystatin C equation) and an indicator of eGFR decline > 30% since study entry using follow-up eGFR quantified at 4 examinations: 2000 to 2002, 2004 to 2005, 2005 to 2007, and 2010 to 2011. ANALYTICAL APPROACH Associations between each neighborhood measure (in separate models) and eGFR decline > 30% from baseline and annualized eGFR change were estimated using Cox proportional hazards and linear mixed regression models, respectively, adjusting for potential confounders. RESULTS While neighborhood social context differs by race/ethnicity, neither neighborhood problems nor social cohesion was independently associated with eGFR decline after adjustment for confounders. LIMITATIONS Incomplete capture of the early stages of eGFR decline, reliance on observational data, limited variation in neighborhood measures, and the potential for residual confounding. CONCLUSIONS Although we showed no independent association between neighborhood context and eGFR decline, it is associated with many CKD risk factors and further work is needed to clarify whether it has an independent role in CKD.
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Affiliation(s)
| | - Ronit Katz
- Kidney Research Institute, University of Washington, WA
| | - Deidra C Crews
- Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine; Johns Hopkins Center for Health Equity, Johns Hopkins Medical Institutions; Baltimore MD
| | - Holly J Kramer
- Department of Nephrology and Hypertension, Loyola University School of Medicine, Chicago, IL
| | - Carmen A Peralta
- The Kidney Health Research Collaborative at University of California San Francisco and San Francisco VA Medical Center, San Francisco, CA
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Secretti T, Nunes MAA, Schmidt MI, Stein MC, Santos SM. Characteristics of neighborhood environment (social cohesion and safety) and common mental disorders in ELSA-Brasil study: a multilevel analysis. CAD SAUDE PUBLICA 2019; 35:e00197017. [DOI: 10.1590/0102-311x00197017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 08/17/2018] [Indexed: 11/22/2022] Open
Abstract
The purpose of this study was to determine if self-reported characteristics of social cohesion and local neighborhood safety positively affect the mental health of their residents, regardless of individual characteristics. A sample of participants in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline was used. The Clinical Interview Schedule-Revised (CIS-R) instrument was used for tracking common mental disorders (CMD). Social cohesion and safety were measured by validated scales of neighborhood environment self-reported characteristics. The multilevel logistic regression model was used to estimate the effect in neighborhoods (level 2) and individuals (level 1), as well as the odds ratios for each neighborhood explanatory variable and social characteristics in the CMD. The results showed that part of the variance (2.3%), in the common mental disorders prevalence is attributed to local neighborhoods. The characteristics of social cohesion and safety remained significant, even after the adjustment of individual explanatory variables. This study confirmed the hypothesis that individuals living in neighborhoods where they perceive low social cohesion and safety present a higher chance of developing CMD.
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232
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Ye B, Gao J, Fu H. Associations between lifestyle, physical and social environments and frailty among Chinese older people: a multilevel analysis. BMC Geriatr 2018; 18:314. [PMID: 30547760 PMCID: PMC6295038 DOI: 10.1186/s12877-018-0982-1] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 11/14/2018] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Frailty represents a public health priority and an increasingly prevalent condition in the ageing population. It is seen as reflecting an interaction among individual factors and a range of environmental elements. This study aims to examine the association between frailty and individual factors, physical and social environments among Chinese older people. METHODS The data were from the Shanghai Healthy City Survey in 2017, which sampled 2559 older people aged ≥60 years from 67 neighbourhoods. The FRAIL scale was used to assess frailty, and social and physical environments were assessed using validated and psychometrically tested instruments. Individual factors included age, gender, education, employment, marital status, smoking, drinking, physical exercise, organization participation, self-rated health and psychological well-being. A multilevel analysis was conducted to examine whether physical and social environments were associated with frailty. RESULTS The prevalence of pre-frailty and frailty were 39.5 and 16.9%, respectively. The prevalence of frailty increased with age from 14.6% (60-64 years) to 26.5% (≥75 years). After adjusting for age and/or gender, older age, women, and those with low education, alcohol dependence, physical inactivity, poor self-rated health, or psychological disorders had a higher prevalence of frailty. The multilevel analysis indicated that after controlling for individual covariates, compared to the 1st quartile of aesthetic quality, the odds ratio (OR) of frailty for the 4th quartile was 0.65 (0.47-0.89); compared to the 1st quartile of walking environment, the OR of frailty for the 4th quartile was 0.43 (0.19-0.95); compared to the 1st quartile of social cohesion, the OR of frailty for the 4th quartile was 0.73 (0.54-0.99); compared to the 1st quartile of social participation, the ORs of frailty for the 2nd, 3rd and 4th quartiles were 0.76 (0.59-0.97), 0.59 (0.45-0.77) and 0.59 (0.45-0.77), respectively. CONCLUSIONS Frailty is a highly prevalent health condition among the aged population in China. Healthcare should focus on frail elderly who are older age, women, those with low education, and those with mental health problems. It may decrease frailty among Chinese older people to encourage social participation and healthy behaviours and to build aesthetic, walkable and cohesive neighbourhoods.
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Affiliation(s)
- Bo Ye
- School of Public Health, Fudan University, Shanghai, China
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai, China
| | - Hua Fu
- Fudan Health Communication Institute, School of Public Health, Fudan University, PO Box 248, 138 Yixueyuan Road, Shanghai, 200032 China
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Tsuchiya K, Qian Y, Thomas A, Hill De Loney E, Caldwell CH. The Effects of Multiple Dimensions of Risk and Protective Factors on Depressive Symptoms Among Nonresident African American Fathers. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 62:464-475. [PMID: 30207382 DOI: 10.1002/ajcp.12275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Compared to other groups, African American men experience proportionately greater adverse social and economic circumstances, which have been linked to poor mental health. A growing body of literature has begun to examine depressive symptoms among African American men; however, limited literature has examined the concurrent contributions of risk and protective factors among nonresident African American fathers. This study examined the relative contribution of perceived financial strain, perceived neighborhood characteristics, and interpersonal stress on depressive symptoms among 347 nonresident African American fathers. Social support was examined as a protective factor for depressive symptoms. Results from hierarchical regression analyses indicated interpersonal stress was associated with depressive symptoms even after controlling for perceived financial strain, perceived neighborhood characteristics, and specific sociodemographic factors. Additionally, among fathers with high interpersonal stress, having more social support buffered the negative effect of interpersonal stress on depressive symptoms. Findings suggest experiencing strain from multiple dimensions can increase the risk of depressive symptoms among nonresident African American fathers. We also found that interpersonal stress was especially harmful for mental health. Family service providers and mental health professionals should incorporate stress management techniques to reduce stressful interpersonal relationships as a way to lower depressive symptoms among nonresident African American fathers.
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Affiliation(s)
- Kazumi Tsuchiya
- Department of Health Behavior and Health Education, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | - Yiqing Qian
- Department of Health Behavior and Health Education, University of Michigan, School of Public Health, Ann Arbor, MI, USA
| | | | | | - Cleopatra Howard Caldwell
- Department of Health Behavior and Health Education, University of Michigan, School of Public Health, Ann Arbor, MI, USA
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Lane HG, Deitch R, Wang Y, Black MM, Dunton GF, Aldoory L, Turner L, Parker EA, Henley SC, Saksvig B, Song HJ, Hager ER. "Wellness Champions for Change," a multi-level intervention to improve school-level implementation of local wellness policies: Study protocol for a cluster randomized trial. Contemp Clin Trials 2018; 75:29-39. [PMID: 30342257 PMCID: PMC6594543 DOI: 10.1016/j.cct.2018.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 10/01/2018] [Accepted: 10/16/2018] [Indexed: 12/01/2022]
Abstract
Schools are a recommended place for childhood obesity prevention. Local Wellness Policies (LWPs) establish guidelines for schools to provide opportunities for students to access nutritious foods and be physically active. Little is known about the impact of LWPs, when implemented, on students' behavior and body mass index (BMI). The Wellness Champions for Change trial assesses the student-level impact of providing theory-based training and technical assistance to help schools implement LWPs. This 3-arm, cluster randomized controlled trial will take place in 30 low- or middle-income schools (15 elementary and 15 middle) in five Maryland school districts. Ten schools will receive both Wellness Champions for Change (WCC), which involves training teacher-led wellness teams, and Wellness Champions for Change-Student (WCC-S), which engages students as wellness team members. Ten schools will receive WCC only, and ten control schools will receive a delayed intervention. The RE-AIM framework will guide evaluation. Student Effectiveness measures will include BMI z-scores, self-reported diet patterns, and objectively-measured physical activity. The sample size (1080 students across 30 schools, followed for 2.5 years) will enable power (>0.8) to detect BMI z-score differences. A three-level linear mixed model that accounts for clustering will be used to assess Effectiveness. A mixed methods approach will assess school- and district-level Reach, Adoption, and Implementation. If effective, this approach will represent a sustainable, multi-level, school-based strategy to prevent childhood obesity. The evaluation framework will allow for the description of factors necessary to broadly disseminate this approach for obesity prevention on a large scale.
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Affiliation(s)
- Hannah G Lane
- University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA.
| | - Rachel Deitch
- University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA.
| | - Yan Wang
- University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Epidemiology and Public Health, 737 West Lombard Street, Baltimore, MD 21201, USA.
| | - Maureen M Black
- University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Epidemiology and Public Health, 737 West Lombard Street, Baltimore, MD 21201, USA; RTI International, Research Triangle Park, NC 27709, USA.
| | - Genevieve F Dunton
- University of Southern California, Departments of Preventive Medicine and Psychology, 2001 N. Soto St., Los Angeles, CA 90032, USA.
| | - Linda Aldoory
- University of Maryland College Park, Department of Communication, College of Arts and Humanities, College Park, MD 20742, USA.
| | - Lindsey Turner
- Boise State University, College of Education, 1910 University Drive, #1740, Boise, ID 83725, USA.
| | - Elizabeth A Parker
- University of Maryland School of Medicine, Department of Family and Community Medicine, Center for Integrative Medicine, 520 W. Lombard Street, East Hall, Baltimore, MD 21201, USA.
| | - Shauna C Henley
- University of Maryland Extension, Department of Agriculture and Natural Resources, 1114 Shawan Road, Cockeysville, MD 21030, USA.
| | - Brit Saksvig
- University of Maryland College Park, Department of Epidemiology and Biostatistics, School of Public Health, College Park, MD 20742, USA.
| | - Hee-Jung Song
- University of Maryland College Park, Department of Nutrition and Food Science, College of Agriculture and Natural Resources, College Park, MD 20742, USA.
| | - Erin R Hager
- University of Maryland School of Medicine, Department of Pediatrics, Growth and Nutrition Division, 737 West Lombard Street, Baltimore, MD 21201, USA; University of Maryland School of Medicine, Department of Epidemiology and Public Health, 737 West Lombard Street, Baltimore, MD 21201, USA.
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235
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Yun L, Vanderloo L, Berry TR, Latimer-Cheung AE, O’Reilly N, Rhodes RE, Spence JC, Tremblay MS, Faulkner G. Assessing the social climate of physical (in)activity in Canada. BMC Public Health 2018; 18:1301. [PMID: 30482164 PMCID: PMC6258462 DOI: 10.1186/s12889-018-6166-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 10/30/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Ecological models suggest that a strategy for increasing physical activity participation within a population is to reconstruct the "social climate". This can be accomplished through 1) changing norms and beliefs, 2) providing direct support for modifying environments, and 3) implementing policies to encourage physical activity. Nevertheless, surveillance efforts have paid limited attention to empirical assessment of social climate. This study responds to this gap by assessing the social climate of physical activity in Canada. METHODS A representative sample of Canadian adults (n = 2519, male/female = 50.3%/49.7%, Mage = 49.1 ± 16.3 years) completed an online survey asking them to assess social climate dimensions including social norms of physical (in)activity, perceptions of who causes physical inactivity and who is responsible for solving physical inactivity, and support for physical activity-related policy. Descriptive statistics (frequencies) were calculated. Multinomial logistic regressions were constructed to identify whether demographic variables and physical activity participation associated with social climate dimensions. RESULTS Physical inactivity was considered a serious public health concern by 55% of the respondents; similar to unhealthy diets (58%) and tobacco use (57%). Thirty-nine percent of the respondents reported that they often see other people exercising. Twenty-eight percent of the sample believed that society disapproves of physical inactivity. The majority of respondents (63%) viewed the cause of physical inactivity as both an individual responsibility and other factors beyond an individuals' control. Sixty-seven percent of respondents reported physical inactivity as being both a private matter and a public health matter. Strong support existed for environmental-, individual-, and economic-level policies but much less for legislative approaches. The social climate indicators were associated with respondents' level of physical activity participation and demographic variables in expected directions. CONCLUSION This study is the first known attempt to assess social climate at a national level, addressing an important gap in knowledge related to advocating for, and implementing population-level physical activity interventions. Future tracking will be needed to identify any temporal (in)stability of these constructs over time and to explore the relationship between physical activity participation and indicators of the national social climate of physical activity.
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Affiliation(s)
- Lira Yun
- School of Kinesiology, University of British Columbia, Lower Mall Research Station 337, 2259 Lower Mall, Vancouver, British Columbia V6T 1Z4 Canada
| | | | - Tanya R. Berry
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB Canada
| | | | - Norman O’Reilly
- College of Business and Economics, University of Guelph, Guelph, ON Canada
| | - Ryan E. Rhodes
- School of Exercise Science, University of Victoria, Victoria, BC Canada
| | - John C. Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB Canada
| | - Mark S. Tremblay
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON Canada
| | - Guy Faulkner
- School of Kinesiology, University of British Columbia, Lower Mall Research Station 337, 2259 Lower Mall, Vancouver, British Columbia V6T 1Z4 Canada
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Cummins S, Clark C, Lewis D, Smith N, Thompson C, Smuk M, Stansfeld S, Taylor S, Fahy A, Greenhalgh T, Eldridge S. The effects of the London 2012 Olympics and related urban regeneration on physical and mental health: the ORiEL mixed-methods evaluation of a natural experiment. PUBLIC HEALTH RESEARCH 2018. [DOI: 10.3310/phr06120] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
There is limited evidence for public health policy-makers on the health impacts of urban regeneration programmes.
Objectives
To assess whether or not the London 2012 Olympic and Paralympic Games, and related urban regeneration, were associated with an increase in physical activity and mental health and well-being; to assess whether or not any benefits were sustained over time; and to capture the experiences of residents of the Olympic host boroughs.
Design
Quasi-experimental prospective cohort study of adolescents and their parents/carers, with a nested qualitative longitudinal study of families.
Setting
London boroughs of Newham, Barking and Dagenham, Tower Hamlets and Hackney.
Participants
A cohort of 2254 adolescents in 25 schools; a repeat cross-sectional study of parents/carers and a sample of 20 families for the qualitative study.
Intervention
The London 2012 Olympic and Paralympic Games, and urban regeneration primarily associated with the redevelopment of the Olympic Park for legacy use.
Primary outcome measures
Change in the proportion of respondents meeting physical activity recommendations (using self-reported physical activity); change in the proportion of respondents reporting depression and anxiety and change in well-being score.
Main results
At 6 months, adolescents who became inactive were less likely to come from the intervention borough (Newham) than from comparison boroughs [risk ratio (RR) = 0.69, 95% confidence interval (CI) 0.51 to 0.93]. At 18 months, there were no statistically significant differences between intervention and comparison boroughs for all adolescent physical activity and screen-time transitions. Those who visited the Olympic Park more than once a month were the least likely to remain inactive (RR 0.11, 95% CI 0.02 to 0.48) and the least likely to become inactive (RR 0.38, 95% CI 0.24 to 0.60) compared with those who were active at baseline and at the 18-month follow-up. No impacts on parental/carer physical activity were observed. Adolescents who were ‘no longer depressed’ (RR 1.53, 95% CI 1.07 to 2.20) or ‘remained depressed’ (RR 1.78, 95% CI 1.12 to 2.83) at 6 months were more likely to be from the intervention borough. For well-being, there was no association between boroughs and change in well-being between baseline and the 6-month follow-up. At 18 months’ follow-up, adolescents who ‘remained depressed’ (RR 1.93, 95% CI 1.01 to 3.70) were more likely to be from the intervention borough than from comparison boroughs. No associations were observed for well-being at 18 months. There was limited evidence of change for parental mental health and well-being. The qualitative study found that residents generally welcomed the unexpected chance to live in a cleaner, safer and more unified environment. The findings suggested that the Games temporarily alleviated certain stressors in the social and physical environment. Overall, the Games lessened participants’ sense of social exclusion and appeared to generate a sense of inclusion and respite, even if this was only temporary. Study limitations include the potential for adolescents to not be assigned the correct level of exposure to urban regeneration and the effect of reductions in central and local public budgets owing to the UK Government’s deficit reduction programme.
Conclusions
This study provided the highest quality data to date on the short- and medium-term social and health impacts of sporting mega-events. We found limited evidence that the London 2012 Olympic and Paralympic Games had a positive effect on adolescent or parental physical activity, mental health or well-being.
Funding
The National Institute for Health Research Public Health Research programme.
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Affiliation(s)
- Steven Cummins
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Charlotte Clark
- Centre for Psychiatry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Daniel Lewis
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Neil Smith
- Centre for Psychiatry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Claire Thompson
- Department of Social and Environmental Health Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Melanie Smuk
- Centre for Psychiatry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Stephen Stansfeld
- Centre for Psychiatry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Stephanie Taylor
- Centre for Psychiatry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Amanda Fahy
- Centre for Psychiatry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | | | - Sandra Eldridge
- Centre for Psychiatry, Barts & The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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The "Dark Side" Effects of Social Capital on Harmful Drinking among Chinese Community Residents: A Multilevel Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102249. [PMID: 30326561 PMCID: PMC6210951 DOI: 10.3390/ijerph15102249] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/11/2018] [Accepted: 10/12/2018] [Indexed: 12/20/2022]
Abstract
Background: To determine the effects of social capital on harmful drinking (HD) among Chinese community residents using a multilevel study. Methods: A cross-sectional study conducted from 2017⁻2018. In total, 13,610 participants were randomly interviewed from 29 districts of 3 cities in China with a multi-stage sampling procedure. Social capital, including social cohesion, membership in social organizations, and frequency of social participation, were assessed using validated scales. HD was assessed using the CAGE four-item questionnaire. Multilevel models were developed to determine whether social capital was related to HD when socioeconomic and demographic covariates were controlled. Results: In general, the prevalence of HD was 8.18%, and more specifically, 13.77% for men and 2.74% for women. After controlling for covariates and stratifying by gender, compared to residents in the low individual-level membership of social organizations, we found that the odds ratio (OR) for HD was 1.30 with a 95% confidence interval (CI) of 1.07⁻1.56 among men and 1.95 (95% CI: 1.29⁻2.97) among women. Compared to residents in the low individual-level frequency of social participation groups, the odds ratio of HD among women was 1.58 (95% CI: 1.10⁻2.26). There was no association between district-level social capital and HD. Conclusions: A high level of social capital may promote HD among the residents of Chinese neighborhoods. Intervention to modify social capital under the Chinese drinking culture may help reduce HD.
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Lambotte D, De Donder L, De Roeck EE, Hoeyberghs LJ, van der Vorst A, Duppen D, Van der Elst M, Fret B, Dury S, Smetcoren AS, Kardol MJM, Engelborghs S, De Deyn PP, De Witte N, Schols JMGA, Kempen GIJM, Zijlstra GAR, De Lepeleire J, Schoenmakers B, Verté D, Dierckx E. Randomized controlled trial to evaluate a prevention program for frail community-dwelling older adults: a D-SCOPE protocol. BMC Geriatr 2018; 18:194. [PMID: 30149798 PMCID: PMC6109979 DOI: 10.1186/s12877-018-0875-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 08/06/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Frail community-dwelling older adults, whom might experience problems regarding physical, cognitive, psychological, social and environmental factors, are at risk for adverse outcomes such as disability, institutionalization and mortality. People in need of help do not always find their way to care and support services and are left undetected. The aim of the D-SCOPE project is to detect frail community-dwelling older adults who previously went unnoticed and to improve their access to care and support. Goal is to increase their frailty-balance, quality of life, meaning in life, life satisfaction, mastery, community inclusion and ageing well in place. METHODS/DESIGN The study is a prospective, longitudinal randomized four-armed controlled trial with follow-up at 6 months. The study group aims to include 900 community-dwelling older adults aged 60 years and over from 3 municipalities in Flanders (Belgium). While selecting the study group, risk profiles for frailty will be taken into account. Participants will be randomly selected from the census records in each municipality. Data will be collected prospectively at baseline (T0) and at follow-up, 6 months after baseline (T1). At baseline, participants who are at least mild frail on one of the 5 domains of frailty (CFAI-plus) or feel frail based on the subjective assessment of frailty will be randomly assigned to (1) the study group or (2) the control group. A mixed method design with the inclusion of quantitative and qualitative data analyses will be used to evaluate the efficacy and experiences of the detection and prevention program on frailty. DISCUSSION The study will contribute to an innovative vision concerning the organization of care and support, and a timely and accurate detection and support of community-dwelling older adults at risk for frailty. TRIAL REGISTRATION This trial was registered at ClinicalTrials.gov, on May 26, 2017, identifier: NCT03168204 .
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Affiliation(s)
- Deborah Lambotte
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Liesbeth De Donder
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Ellen E. De Roeck
- Laboratory of Neurochemistry and Behavior, University of Antwerp, 1, Universiteitsplein, Wilrijk, 2610 Belgium
- Department of Clinical and Lifespan Psychology, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Lieve J. Hoeyberghs
- Faculty of Education, Health and Social Work, University College Ghent, 80, Keramiekstraat, Ghent, 9000 Belgium
| | - Anne van der Vorst
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, 6200, MD The Netherlands
| | - Daan Duppen
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Michaël Van der Elst
- Department of Public Health and Primary Care, University of Leuven, 33, Kapucijnenvoer, Leuven, 3000 Belgium
| | - Bram Fret
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Sarah Dury
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
- Research Foundation Flanders (FWO), 5, Egmontstraat, Brussels, 100 Belgium
| | - An-Sofie Smetcoren
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Martinus J. M. Kardol
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Sebastiaan Engelborghs
- Laboratory of Neurochemistry and Behavior, University of Antwerp, 1, Universiteitsplein, Wilrijk, 2610 Belgium
| | - Peter Paul De Deyn
- Laboratory of Neurochemistry and Behavior, University of Antwerp, 1, Universiteitsplein, Wilrijk, 2610 Belgium
| | - Nico De Witte
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
- Faculty of Education, Health and Social Work, University College Ghent, 80, Keramiekstraat, Ghent, 9000 Belgium
| | - Jos M. G. A. Schols
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, 6200, MD The Netherlands
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, 6200, MD The Netherlands
| | - Gertrudis I. J. M. Kempen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, 6200, MD The Netherlands
| | - G. A. Rixt Zijlstra
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, Maastricht, 6200, MD The Netherlands
| | - Jan De Lepeleire
- Department of Public Health and Primary Care, University of Leuven, 33, Kapucijnenvoer, Leuven, 3000 Belgium
| | - Birgitte Schoenmakers
- Department of Public Health and Primary Care, University of Leuven, 33, Kapucijnenvoer, Leuven, 3000 Belgium
| | - Dominique Verté
- Department of Educational Sciences, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
| | - Eva Dierckx
- Department of Clinical and Lifespan Psychology, Vrije Universiteit Brussel, 2, Pleinlaan, Brussels, 1050 Belgium
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Mayne SL, Moore KA, Powell-Wiley TM, Evenson KR, Block R, Kershaw KN. Longitudinal Associations of Neighborhood Crime and Perceived Safety With Blood Pressure: The Multi-Ethnic Study of Atherosclerosis (MESA). Am J Hypertens 2018; 31:1024-1032. [PMID: 29897398 PMCID: PMC6077783 DOI: 10.1093/ajh/hpy066] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 04/06/2018] [Accepted: 04/18/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND High neighborhood crime and low perceptions of safety may influence blood pressure (BP) through chronic stress. Few studies have examined these associations using longitudinal data. METHODS We used longitudinal data from 528 participants of the Multi-Ethnic Study of Atherosclerosis (aged 45-84, nonhypertensive at baseline) who lived in Chicago, Illinois. We examined associations of changes in individual-level perceived safety, aggregated neighborhood-level perceived safety, and past-year rates of police-recorded crime in a 1, ½, or ¼ mile buffer per 1,000 population with changes in systolic and diastolic BPs using fixed-effects linear regression. BP was measured five times between 2000 and 2012 and was adjusted for antihypertensive medication use (+10 mm Hg added to systolic and +5 mm Hg added to diastolic BP for participants on medication). Models were adjusted for time-varying sociodemographic and health-related characteristics and neighborhood socioeconomic status. We assessed differences by sex. RESULTS A standard deviation increase in individual-level perceived safety was associated with a 1.54 mm Hg reduction in systolic BP overall (95% confidence interval [CI]: 0.25, 2.83), and with a 1.24 mm Hg reduction in diastolic BP among women only (95% CI: 0.37, 2.12) in adjusted models. Increased neighborhood-level safety was not associated with BP change. An increase in police-recorded crime was associated with a reduction in systolic and diastolic BPs among women only, but results were sensitive to neighborhood buffer size. CONCLUSIONS Results suggest individual perception of neighborhood safety may be particularly salient for systolic BP reduction relative to more objective neighborhood exposures.
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Affiliation(s)
- Stephanie L Mayne
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kari A Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Tiffany M Powell-Wiley
- Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Richard Block
- Department of Sociology, Loyola University, Chicago, IL, USA
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Wolf JP, Baiocchi A, Argüello T. Child maltreatment reporting in the general population: Examining the roles of community, collective efficacy, and adverse childhood experiences. CHILD ABUSE & NEGLECT 2018; 82:201-209. [PMID: 29920432 DOI: 10.1016/j.chiabu.2018.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/01/2018] [Accepted: 06/04/2018] [Indexed: 06/08/2023]
Abstract
According to bystander theory, factors such as the community environment, collective efficacy, and history of adverse childhood experiences could be related to likelihood of reporting or intervening against maltreatment. An online survey was conducted with 946 general population Californians obtained through mixed-mode random probability and quota-based recruitment methods. Using an experimental vignette design, participants were randomly assigned to two scenarios: a) potential child abuse occurring in their neighborhood; b) potential child abuse in an unfamiliar neighborhood. Weighted multivariate logistic regression models assessed relationships between the vignette condition, collective efficacy, appraisal of the behavior, and likelihood of reporting or intervening. The results suggested that perceiving the vignette as occurring in your own neighborhood was associated with lower odds of viewing the behavior as appropriate and considering it abusive. Higher collective efficacy scores were associated with lower odds of viewing the incident as inappropriate but higher odds of personally intervening. Adverse childhood experiences were positively related to reporting the incident to child protective services and intervening. Bystanders may be more likely to give parents in their own neighborhood "the benefit of the doubt" by viewing their abusive behaviors as less severe, potentially leading to underreporting. Neighborhood collective efficacy might increase willingness to personally intervene, but not contact systems such as child protective services or police, suggesting that enhanced trust in communities does not extend to these institutions. Our findings have implications for neighborhood and education interventions to enhance understanding of and willingness to intervene on behalf of children.
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Affiliation(s)
- Jennifer Price Wolf
- Division of Social Work, California State University, Sacramento, 600 J Street Sacramento, CA 95812, United States.
| | - Arturo Baiocchi
- Division of Social Work, California State University, Sacramento, 600 J Street Sacramento, CA 95812, United States
| | - Tyler Argüello
- Division of Social Work, California State University, Sacramento, 600 J Street Sacramento, CA 95812, United States
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241
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Baldock KL, Paquet C, Howard NJ, Coffee NT, Taylor AW, Daniel M. Gender-specific associations between perceived and objective neighbourhood crime and metabolic syndrome. PLoS One 2018; 13:e0201336. [PMID: 30048521 PMCID: PMC6062143 DOI: 10.1371/journal.pone.0201336] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 07/13/2018] [Indexed: 12/02/2022] Open
Abstract
Much research has considered the relationship between neighbourhood crime and physical activity, but few studies have assessed clinical outcomes consequent to behaviour, such as cardiometabolic risk. Fewer still have simultaneously assessed perceived and objective measures of crime. Perceptions of crime and actual victimisation vary according to gender; thus, this study sought to assess: 1) correspondence between perceived and objective neighbourhood crime; and 2) gender-specific associations between perceived and reported crime and metabolic syndrome, representing cardiometabolic risk. The indirect effect of neighbourhood crime on metabolic syndrome via walking was additionally evaluated. An Australian population-based biomedical cohort study (2004–2007) collected biomedical, socio-demographic, and neighbourhood perceptions data from n = 1,172 urban-dwelling, adults. Area-level reported crime rates were standardised and linked to individual data based on participants' residential location. Correspondence between actual and perceived crime measures was assessed using Pearson correlation coefficients. Cross-sectional associations between crime and metabolic syndrome were analysed using generalised estimating equations regression models accounting for socio-demographic factors and area-level income. Correspondence between perceived and objective crime was small to medium among men and women (r = 0.17 to 0.33). Among men, metabolic syndrome was related to rates of violent (OR = 1.21, 95% CI 1.08–1.35) and total crime (OR = 1.17, 95% CI 1.04–1.32), after accounting for perceived crime. Among women, metabolic syndrome was related to perceived crime (OR = 1.35, 95% CI 1.14–1.60) after accounting for total reported crime. Among women, there were indirect effects of perceived crime and property crime on metabolic syndrome through walking. Results indicate that crime, an adverse social exposure, is linked to clinical health status. Crime rates, and perceptions of crime and safety, differentially impact upon cardiometabolic health according to gender. Social policy and public health strategies targeting crime reduction, as well as strategies to increase perceptions of safety, have potential to contribute to improved cardiometabolic outcomes.
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Affiliation(s)
- Katherine L. Baldock
- Centre for Population Health Research, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
- * E-mail:
| | - Catherine Paquet
- Centre for Population Health Research, School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Natasha J. Howard
- Wardliparingga Aboriginal Research Unit, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Neil T. Coffee
- Centre for Research & Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Anne W. Taylor
- Population Research and Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Mark Daniel
- Centre for Research & Action in Public Health, Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- Department of Medicine, St Vincent’s Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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242
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Hussein M, Diez Roux AV, Mujahid MS, Hastert TA, Kershaw KN, Bertoni AG, Baylin A. Unequal Exposure or Unequal Vulnerability? Contributions of Neighborhood Conditions and Cardiovascular Risk Factors to Socioeconomic Inequality in Incident Cardiovascular Disease in the Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 2018; 187:1424-1437. [PMID: 29186311 DOI: 10.1093/aje/kwx363] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 11/16/2017] [Indexed: 12/12/2022] Open
Abstract
Risk factors can drive socioeconomic inequalities in cardiovascular disease (CVD) through differential exposure and differential vulnerability. In this paper, we show how econometric decomposition directly enables simultaneous, policy-oriented assessment of these 2 mechanisms. We specifically estimate contributions of neighborhood environment and proximal risk factors to socioeconomic inequality in CVD incidence via these mechanisms. We followed 5,608 participants in the Multi-Ethnic Study of Atherosclerosis (2000-2012) to their first CVD event (median length of follow-up, 12.2 years). We used a summary measure of baseline socioeconomic position (SEP). Covariates included baseline demographics, neighborhood characteristics, and psychosocial, behavioral, and biomedical risk factors. Using Poisson models, we decomposed the difference (inequality) in incidence rates between low- and high-SEP groups into contributions of 1) differences in covariate means (differential exposure) and 2) differences in CVD risk associated with covariates (differential vulnerability). Notwithstanding large uncertainty in neighborhood estimates, our analysis suggested that differential exposure to poorer neighborhood socioeconomic conditions, adverse social environment, diabetes, and hypertension accounted for most of the inequality. Psychosocial and behavioral contributions were negligible. Further, neighborhood SEP, female sex, and white race were more strongly associated with CVD among low-SEP (vs. high-SEP) participants. These differentials in vulnerability also accounted for nontrivial portions of the inequality and could have important implications for intervention.
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Affiliation(s)
- Mustafa Hussein
- Joseph J. Zilber School of Public Health, University of Wisconsin–Milwaukee, Milwaukee, Wisconsin
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Mahasin S Mujahid
- Department of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Theresa A Hastert
- Department of Oncology, School of Medicine and Karmanos Cancer Institute, Wayne State University, Detroit, Michigan
| | - Kiarri N Kershaw
- Division of Epidemiology, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Ana Baylin
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan
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243
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Subjective neighborhood assessment and physical inactivity: An examination of neighborhood-level variance. Prev Med 2018; 111:336-341. [PMID: 29197527 PMCID: PMC5930117 DOI: 10.1016/j.ypmed.2017.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 11/14/2017] [Accepted: 11/26/2017] [Indexed: 11/21/2022]
Abstract
Research suggests a linkage between perceptions of neighborhood quality and the likelihood of engaging in leisure-time physical activity. Often in these studies, intra-neighborhood variance is viewed as something to be controlled for statistically. However, we hypothesized that intra-neighborhood variance in perceptions of neighborhood quality may be contextually relevant. We examined the relationship between intra-neighborhood variance of subjective neighborhood quality and neighborhood-level reported physical inactivity across 48 neighborhoods within a medium-sized city, Texas City, Texas using survey data from 2706 residents collected between 2004 and 2006. Neighborhoods where the aggregated perception of neighborhood quality was poor also had a larger proportion of residents reporting being physically inactive. However, higher degrees of disagreement among residents within neighborhoods about their neighborhood quality was significantly associated with a lower proportion of residents reporting being physically inactive (p=0.001). Our results suggest that intra-neighborhood variability may be contextually relevant in studies seeking to better understand the relationship between neighborhood quality and behaviors sensitive to neighborhood environments, like physical activity.
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244
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Carroll SJ, Niyonsenga T, Coffee NT, Taylor AW, Daniel M. Associations between local descriptive norms for overweight/obesity and insufficient fruit intake, individual-level diet, and 10-year change in body mass index and glycosylated haemoglobin in an Australian cohort. Int J Behav Nutr Phys Act 2018; 15:44. [PMID: 29776358 PMCID: PMC5960151 DOI: 10.1186/s12966-018-0675-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 05/06/2018] [Indexed: 01/09/2023] Open
Abstract
Background Descriptive norms (what other people do) relate to individual-level dietary behaviour and health outcome including overweight and obesity. Descriptive norms vary across residential areas but the impact of spatial variation in norms on individual-level diet and health is poorly understood. This study assessed spatial associations between local descriptive norms for overweight/obesity and insufficient fruit intake (spatially-specific local prevalence), and individual-level dietary intakes (fruit, vegetable and sugary drinks) and 10-year change in body mass index (BMI) and glycosylated haemoglobin (HbA1c). Methods HbA1c and BMI were clinically measured three times over 10 years for a population-based adult cohort (n = 4056) in Adelaide, South Australia. Local descriptive norms for both overweight/obesity and insufficient fruit intake specific to each cohort participant were calculated as the prevalence of these factors, constructed from geocoded population surveillance data aggregated for 1600 m road-network buffers centred on cohort participants’ residential addresses. Latent growth models estimated the effect of local descriptive norms on dietary behaviours and change in HbA1c and BMI, accounting for spatial clustering and covariates (individual-level age, sex, smoking status, employment and education, and area-level median household income). Results Local descriptive overweight/obesity norms were associated with individual-level fruit intake (inversely) and sugary drink consumption (positively), and worsening HbA1c and BMI. Spatially-specific local norms for insufficient fruit intake were associated with individual-level fruit intake (inversely) and sugary drink consumption (positively) and worsening HbA1c but not change in BMI. Individual-level fruit and vegetable intakes were not associated with change in HbA1c or BMI. Sugary drink consumption was also not associated with change in HbA1c but rather with increasing BMI. Conclusion Adverse local descriptive norms for overweight/obesity and insufficient fruit intake are associated with unhealthful dietary intakes and worsening HbA1c and BMI. As such, spatial variation in lifestyle-related norms is an important consideration relevant to the design of population health interventions. Adverse local norms influence health behaviours and outcomes and stand to inhibit the effectiveness of traditional intervention efforts not spatially tailored to local population characteristics. Spatially targeted social de-normalisation strategies for regions with high levels of unhealthful norms may hold promise in concert with individual, environmental and policy intervention approaches.
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Affiliation(s)
- Suzanne J Carroll
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Bruce, ACT, Australia.
| | - Theo Niyonsenga
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Bruce, ACT, Australia.,Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, Adelaide, Australia
| | - Neil T Coffee
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Bruce, ACT, Australia.,Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, Adelaide, Australia
| | - Anne W Taylor
- Discipline of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - Mark Daniel
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Bruce, ACT, Australia.,Spatial Epidemiology & Evaluation Research Group, School of Health Sciences and Centre for Population Health Research, University of South Australia, Adelaide, Australia.,Department of Medicine, The University of Melbourne, St Vincent's Hospital, Melbourne, VIC, Australia
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245
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Johnson DA, Hirsch JA, Moore KA, Redline S, Diez Roux AV. Associations Between the Built Environment and Objective Measures of Sleep: The Multi-Ethnic Study of Atherosclerosis. Am J Epidemiol 2018; 187:941-950. [PMID: 29547912 PMCID: PMC5928457 DOI: 10.1093/aje/kwx302] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 05/10/2017] [Accepted: 06/20/2017] [Indexed: 12/26/2022] Open
Abstract
Although dense neighborhood built environments support increased physical activity and lower obesity, these features may also disturb sleep. Therefore, we sought to understand the association between the built environment and objectively measured sleep. From 2010 to 2013, we analyzed data from examination 5 of the Multi-Ethnic Study of Atherosclerosis, a diverse population from 6 US cities. We fit multilevel models that assessed the association between the built environment (Street Smart Walk Score, social engagement destinations, street intersections, and population density) and sleep duration or efficiency from 1-week wrist actigraphy in 1,889 individuals. After adjustment for covariates, a 1-standard-deviation increase in Street Smart Walk Score was associated with 23% higher odds of short sleep duration (≤6 hours; odds ratio = 1.2, 95% confidence interval: 1.0, 1.4), as well as shorter average sleep duration (mean difference = -8.1 minutes, 95% confidence interval: -12.1, -4.2). Results were consistent across other built environment measures. Associations were attenuated after adjustment for survey-based measure of neighborhood noise. Dense neighborhood development may have multiple health consequence. In promoting denser neighborhoods to increase walkability, it is important to also implement strategies that reduce the adverse impacts of this development on sleep, such as noise reductions efforts.
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Affiliation(s)
- Dayna A Johnson
- Division of Sleep and Circadian Disorders, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
| | - Jana A Hirsch
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Kari A Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Harvard Medical School and Brigham and Women’s Hospital, Boston, Massachusetts
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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246
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Cleland V, Nash M, Sharman MJ, Claflin S. Exploring the Health-Promoting Potential of the “parkrun” Phenomenon: What Factors are Associated With Higher Levels of Participation? Am J Health Promot 2018; 33:13-23. [DOI: 10.1177/0890117118770106] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: “ parkrun” is a free and increasingly popular weekly 5-km walk/run international community event, representing a novel setting for physical activity (PA) promotion. However, little is known about who participates or why. This study aimed to identify sociodemographic, health, behavioral, individual, social, and environmental factors associated with higher levels of participation. Design: Cross-sectional. Setting: Tasmania, Australia; June 2016. Participants: Three hundred seventy two adult parkrun participants. Measures: Online survey measuring sociodemographic, health, individual, social and environmental factors, parkrun participation, and PA. Analysis: Descriptive statistics, zero-truncated Poisson regression models. Results: Respondents (n = 371) were more commonly women (58%), aged 35 to 53 years (54%), and occasional or nonwalkers/runners (53%) at registration. A total of 44% had overweight/obesity. Half had non-adult children, most spoke English at home, and 7% reported PA-limiting illness/injury/disability. Average run/walk time was 30.2 ± 7.4 minutes. Compared to regular walkers/runners at registration, nonwalkers/runners were less commonly partnered, more commonly had overweight/obesity, less physically active, and had poorer self-rated health. Multivariate analyses revealed relative parkrun participation was inversely associated with education level and positively associated with interstate parkrun participation, perceived social benefits, self-efficacy for parkrun, and intentions to participate. Conclusion: parkrun attracts nonwalkers/runners and population groups hard to engage in physical activity. Individual- and social-level factors were associated with higher relative parkrun participation. parkrun’s scalability, accessibility, and wide appeal confers a research imperative to investigate its potential for public health gain.
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Affiliation(s)
- Verity Cleland
- Menzies Institute for Medical Research, Hobart Tasmania, Australia
| | - Meredith Nash
- School of Social Sciences, University of Tasmania, Hobart Tasmania, Australia
| | | | - Suzi Claflin
- Menzies Institute for Medical Research, Hobart Tasmania, Australia
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247
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Nam S, Whittemore R, Jung S, Latkin C, Kershaw T, Redeker NS. Physical neighborhood and social environment, beliefs about sleep, sleep hygiene behaviors, and sleep quality among African Americans. Sleep Health 2018; 4:258-264. [PMID: 29776620 DOI: 10.1016/j.sleh.2018.03.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/02/2018] [Accepted: 03/08/2018] [Indexed: 01/13/2023]
Abstract
OBJECTIVES African Americans (AAs) have a higher prevalence of sleep disorders than other racial/ethnic groups. However, little is known about the relationships among individual and neighborhood factors related to sleep quality in AAs. The purposes of this study were to (1) describe beliefs about sleep, sleep hygiene behaviors, and sleep quality among AAs; and (2) examine the relationships among sociodemographic characteristics, neighborhood environment, beliefs about sleep, sleep hygiene behaviors, and sleep quality. METHODS We conducted a cross-sectional study of 252 AA men and women in the Greater New Haven, CT, USA community. We assessed their sociodemographic characteristics, neighborhood environment, beliefs about sleep, sleep hygiene, and sleep quality with the following measures, respectively: the Neighborhood Environment Scale, the brief version of Dysfunctional Beliefs and Attitudes about Sleep, the Sleep Hygiene Practice Scale, the Pittsburgh Sleep Quality Index. We performed descriptive statistics, correlations and multiple hierarchical regression. RESULTS About 72% of the participants (mean age: 53.88 ± 14.17 years, 77.8% women) reported experiencing sleep disturbance. People with poor sleep quality were more likely to report poorer neighborhood social environment (social cohesion), poorer overall neighborhood environment, more dysfunctional beliefs toward sleep, and poorer sleep hygiene than those who had good sleep quality. In the final multivariate model that controlled for a number of chronic comorbid conditions, neighborhood environment, beliefs about sleep, and sleep hygiene behaviors were significantly associated with sleep quality. CONCLUSIONS Future efforts are needed to improve sleep among AAs by considering both the individual's belief about sleep, sleep hygiene behaviors and neighborhood factors.
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Affiliation(s)
- Soohyun Nam
- Yale University, School of Nursing, 400 West Campus Dr., Orange, CT 06477.
| | - Robin Whittemore
- Yale University, School of Nursing, 400 West Campus Dr., Orange, CT 06477
| | - Sunyoung Jung
- Yale University, School of Nursing, 400 West Campus Dr., Orange, CT 06477
| | - Carl Latkin
- Johns Hopkins University, School of Public Health, 624 N. Broadway, Hampton House 737, Baltimore, MD 21205
| | - Trace Kershaw
- Yale University, School of Public Health, 60 College St., New Haven, CT 06520
| | - Nancy S Redeker
- Yale University, School of Nursing, 400 West Campus Dr., Orange, CT 06477
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248
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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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249
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Vaughan CA, Colabianchi N, Hunter GP, Beckman R, Dubowitz T. Park Use in Low-Income Urban Neighborhoods: Who Uses the Parks and Why? J Urban Health 2018; 95:222-231. [PMID: 29427263 PMCID: PMC5906381 DOI: 10.1007/s11524-017-0221-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We examined individual and environmental influences on park use among residents of two low-income predominantly African American neighborhoods to identify determinants of park use in lower-income urban neighborhoods. We analyzed data from interviews of 1003 individuals randomly selected from the neighborhoods, systematic observations of neighborhood parks, and police-recorded crime incidence within a .5-mi buffer around each park. Most participants (82.4%) had previously visited a neighborhood park, and nearly half (46.2%) had visited one in the past month. However, only 8.5% of participants were aware of their closest park. Compared with the parks closest to home, parks that participants reported visiting most were larger and had more amenities and features and fewer incivilities and reported crimes of a serious nature. Park use among residents of lower-income neighborhoods may be increased by offering more amenities and features and ensuring the presence of a well-appointed park within easy walking distance of residents' homes.
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Affiliation(s)
| | - Natalie Colabianchi
- School of Kinesiology, University of Michigan, 1402 Washington Heights, Ann Arbor, MI, 48109-2013, USA
| | - Gerald P Hunter
- RAND Corporation, 4570 Fifth Avenue, Ste 600, Pittsburgh, PA, 15213, USA
| | - Robin Beckman
- RAND Corporation, 1776 Main St, PO Box 2138, Santa Monica, CA, 90407, USA
| | - Tamara Dubowitz
- RAND Corporation, 4570 Fifth Avenue, Ste 600, Pittsburgh, PA, 15213, USA
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250
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Zucker RA, Gonzalez R, Feldstein Ewing SW, Paulus MP, Arroyo J, Fuligni A, Morris AS, Sanchez M, Wills T. Assessment of culture and environment in the Adolescent Brain and Cognitive Development Study: Rationale, description of measures, and early data. Dev Cogn Neurosci 2018; 32:107-120. [PMID: 29627333 PMCID: PMC6436615 DOI: 10.1016/j.dcn.2018.03.004] [Citation(s) in RCA: 110] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Revised: 01/19/2018] [Accepted: 03/06/2018] [Indexed: 11/29/2022] Open
Abstract
Neurodevelopmental maturation takes place in a social environment in addition to a neurobiological one. Characterization of social environmental factors that influence this process is therefore an essential component in developing an accurate model of adolescent brain and neurocognitive development, as well as susceptibility to change with the use of marijuana and other drugs. The creation of the Culture and Environment (CE) measurement component of the ABCD protocol was guided by this understanding. Three areas were identified by the CE Work Group as central to this process: influences relating to CE Group membership, influences created by the proximal social environment, influences stemming from social interactions. Eleven measures assess these influences, and by time of publication, will have been administered to well over 7,000 9-10 year-old children and one of their parents. Our report presents baseline data on psychometric characteristics (mean, standard deviation, range, skewness, coefficient alpha) of all measures within the battery. Effectiveness of the battery in differentiating 9-10 year olds who were classified as at higher and lower risk for marijuana use in adolescence was also evaluated. Psychometric characteristics on all measures were good to excellent; higher vs. lower risk contrasts were significant in areas where risk differentiation would be anticipated.
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Affiliation(s)
- Robert A Zucker
- Addiction Center and Departments of Psychiatry and Psychology, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109, United States.
| | - Raul Gonzalez
- Department of Psychology, Florida International University, 11200 SW 8th Street, Miami, FL 33145, United States.
| | - Sarah W Feldstein Ewing
- Oregon Health & Science University, Department of Child & Adolescent Psychiatry, 3181 SW Sam Jackson Park Rd, M/C DC7P, Portland, OR 97239, United States.
| | - Martin P Paulus
- Laureate Institute for Brain Research, 6655 S Yale Ave, Tulsa, OK 74136-3326, United States.
| | - Judith Arroyo
- National Institute on Alcohol Abuse and Alcoholism, 5635 Fishers Lane Room 2011, Rockville, MD, United States.
| | - Andrew Fuligni
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, United States.
| | - Amanda Sheffield Morris
- Laureate Institute for Brain Research & Department of Psychology, Oklahoma State University, United States.
| | - Mariana Sanchez
- Center for Research on US Latino HIV/AIDS & Drug Abuse, Florida International University, United States.
| | - Thomas Wills
- University of Hawaii, University of Hawaii Cancer Center, United States.
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