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Gilbert AS, Salvo D, Tabak RG, Haire-Joshu D. Does the neighborhood built environment moderate the effectiveness of a weight-loss intervention for mothers with overweight or obesity? Findings from the Healthy Eating and Active Living Taught at Home (HEALTH) study. Int J Behav Nutr Phys Act 2022; 19:130. [PMID: 36182908 PMCID: PMC9526987 DOI: 10.1186/s12966-022-01368-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women of childbearing age are vulnerable to weight gain and experience a high prevalence of obesity due to pregnancy and stressors of parenthood. Lifestyle interventions such as the Healthy Eating and Active Living Taught at Home (HEALTH) study have been effective for weight loss; however, little is known about how the built environment (parks, transit, grocery stores, fast food, walkability etc.), where participants live might modify intervention effectiveness. This study examined whether characteristics of the neighborhood built environment modified effectiveness of the HEALTH study on weight loss. METHODS: Secondary data analysis was conducted using data from HEALTH. Using GIS, buffers were built around participant addresses to capture distance to and availability of food (grocery store, convenience store, fast food) and urban design and transit (parks, street connectivity, transit) built environment characteristics. Built environment characteristics were dichotomized into low and high density and distance. Likelihood ratio tests for interaction were conducted to determine if built environment characteristics modified intervention effectiveness on Body mass index (BMI) and waist circumference (WC). Mixed effects linear regression models were then run to estimate the effect of the HEALTH intervention on weight outcomes at 24-months across both strata of built environment characteristics. RESULTS: The analytic sample (n = 151) had baseline mean BMI 34.9 (SD = 5.8) and mean WC 46.0 cm (SD4.9). All urban design and transit and all food environment characteristics modified HEALTH effectiveness on one or both weight outcomes. The built environment modified the HEALTH intervention such that it was mostly effective for mothers residing in neighborhoods with low transit access, low street connectivity, high park access, and low access to grocery stores, convenience stores, and fast food. CONCLUSIONS Result show the HEALTH was most effective for women residing neighborhoods with built environment characteristics suggestive of suburban neighborhood typology. To maximize impact for mothers residing in all types of neighborhoods, future research should explore scaling up HEALTH in suburban settings, while adapting HEALTH to maximize effectiveness in compact neighborhoods most likely, urban core neighborhoods.
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Affiliation(s)
- Amanda S Gilbert
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Deborah Salvo
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA.
- Center for Diabetes Translation Research, Washington University in St. Louis, St. Louis, MO, USA.
- Department of Kinesiology and Health Education, College of Education, The University of Texas at Austin, Bellmont Hall (BEL) at 2109 San Jacinto Blvd., Austin, TX, 78712, USA.
| | - Rachel G Tabak
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
- Center for Diabetes Translation Research, Washington University in St. Louis, St. Louis, MO, USA
| | - Debra Haire-Joshu
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
- Center for Diabetes Translation Research, Washington University in St. Louis, St. Louis, MO, USA
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Giles LV, Koehle MS, Saelens BE, Sbihi H, Carlsten C. When physical activity meets the physical environment: precision health insights from the intersection. Environ Health Prev Med 2021; 26:68. [PMID: 34193051 PMCID: PMC8247190 DOI: 10.1186/s12199-021-00990-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/20/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The physical environment can facilitate or hinder physical activity. A challenge in promoting physical activity is ensuring that the physical environment is supportive and that these supports are appropriately tailored to the individual or group in question. Ideally, aspects of the environment that impact physical activity would be enhanced, but environmental changes take time, and identifying ways to provide more precision to physical activity recommendations might be helpful for specific individuals or groups. Therefore, moving beyond a "one size fits all" to a precision-based approach is critical. MAIN BODY To this end, we considered 4 critical aspects of the physical environment that influence physical activity (walkability, green space, traffic-related air pollution, and heat) and how these aspects could enhance our ability to precisely guide physical activity. Strategies to increase physical activity could include optimizing design of the built environment or mitigating of some of the environmental impediments to activity through personalized or population-wide interventions. CONCLUSIONS Although at present non-personalized approaches may be more widespread than those tailored to one person's physical environment, targeting intrinsic personal elements (e.g., medical conditions, sex, age, socioeconomic status) has interesting potential to enhance the likelihood and ability of individuals to participate in physical activity.
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Affiliation(s)
- Luisa V Giles
- School of Kinesiology, University of the Fraser Valley, 45190 Caen Ave, Chilliwack, British Columbia, V2R 0N3, Canada.
| | - Michael S Koehle
- School of Kinesiology, University of British Columbia, 210-6081 University Boulevard, Vancouver, British Columbia, V6T 1Z1, Canada
- Division of Sport & Exercise Medicine, Faculty of Medicine, University of British Columbia, 2553 Wesbrook Mall, Vancouver, British Columbia, V6T 1Z3, Canada
| | - Brian E Saelens
- Department of Pediatrics, University of Washington, and Seattle Children's Research Institute, 2001 Eighth Ave, Suite 400, Seattle, Washington, 98121, USA
| | - Hind Sbihi
- British Columbia Centre for Disease Control, 655 West 12th Ave, Vancouver, British Columbia, V5Z 4R4, Canada
- Department of Medicine, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, 10th Floor, Vancouver, British Columbia, V5Z 1M9, Canada
| | - Chris Carlsten
- Department of Medicine, Faculty of Medicine, University of British Columbia, 2775 Laurel Street, 10th Floor, Vancouver, British Columbia, V5Z 1M9, Canada
- Legacy for Airway Health, 2775 Laurel Street, 7th Floor, Vancouver, British Columbia, V5Z 1M9, Canada
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, V6T 1Z3, Canada
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3
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Consoli A, Nettel-Aguirre A, Spence JC, McHugh TL, Mummery K, McCormack GR. Associations between objectively-measured and self-reported neighbourhood walkability on adherence and steps during an internet-delivered pedometer intervention. PLoS One 2020; 15:e0242999. [PMID: 33270692 PMCID: PMC7714347 DOI: 10.1371/journal.pone.0242999] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 11/12/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Accumulating evidence suggests that the built environment is associated with physical activity. The extent to which the built environment may support adherence to physical activity interventions is unclear. The aim of this study was to investigate whether the neighbourhood built environment constrains or facilitates adherence and steps taken during a 12-week internet-delivered pedometer-based physical activity intervention (UWALK). METHOD The study was undertaken in Calgary (Canada) between May 2016 and August 2017. Inactive adults (n = 573) completed a telephone survey measuring sociodemographic characteristics and perceived neighbourhood walkability. Following the survey, participants were mailed a pedometer and instructions for joining UWALK. Participants were asked to report their daily pedometer steps into the online program on a weekly basis for 12 weeks (84 days). Walk Score® estimated objective neighbourhood walkability and the Neighbourhood Environment Walkability Scale-Abbreviated (NEWS-A) measured participants self-reported neighbourhood walkability. Regression models estimated covariate-adjusted associations of objective and self-reported walkability with: 1) adherence to the UWALK intervention (count of days with steps reported and count of days with 10000 steps reported), and; 2) average daily pedometer steps. RESULTS On average, participants undertook 8565 (SD = 3030) steps per day, reported steps on 67 (SD = 22.3) of the 84 days, and achieved ≥10000 steps on 22 (SD = 20.5) of the 84 days. Adjusting for covariates, a one-unit increase in self-reported walkability was associated on average with 45.76 (95CI 14.91, 76.61) more daily pedometer steps. Walk Score® was not significantly associated with steps. Neither objective nor self-reported walkability were significantly associated with the UWALK adherence outcomes. CONCLUSION The neighbourhood built environment may support pedometer-measured physical activity but may not influence adherence to pedometer interventions. Perceived walkability may be more important than objectively-measured walkability in supporting physical activity during pedometer interventions.
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Affiliation(s)
- Anna Consoli
- Cumming School of Medicine, University of Calgary, Alberta, Canada
| | | | - John C. Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Alberta, Canada
| | - Tara-Leigh McHugh
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Alberta, Canada
| | - Kerry Mummery
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Alberta, Canada
| | - Gavin R. McCormack
- Cumming School of Medicine, University of Calgary, Alberta, Canada
- Faculty of Kinesiology, University of Calgary, Alberta, Canada
- School of Architecture, Planning and Landscape, University of Calgary, Alberta, Canada
- Faculty of Sport Sciences, Waseda University, Tokyo, Japan
- * E-mail:
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4
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Kadir MA, Rundle-Thiele S. Reported theory use in walking interventions: a literature review and research agenda. Health Promot Int 2020; 34:601-615. [PMID: 29452362 DOI: 10.1093/heapro/day003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
There is mixed evidence with some suggesting walking can be increased up to the recommended level through interventions based on behaviour change models and others showing partial or no effects [Arbour and Ginis (A randomised controlled trial of the effects of implementation intentions on women's walking behaviour. Psychol Health, 2009;24:49-65); Merom et al. (Can a motivational intervention overcome an unsupportive environment for walking-findings from the Step-by-Step Study. Ann Behav Med 2009;38:137-46); Ornes and Ransdell (A pilot study examining exercise self-efficacy as a mediator for walking behavior in college-age women. Perceptual Motor Skills, 2010;110:1098-104)]. Taken together, prior studies suggest that ongoing research attention is warranted. Walking behaviour change intervention studies were searched using key search words 'walking promotion' and 'pedometer' in the PubMed database. Initially, 87 articles were found and 25 walking behaviour change interventions were reviewed to focus attention on reported theory use. Results of the review suggest that interventions that are theoretically underpinned may be no more effective than their counterparts. The Transtheoretical Model (TTM) and Social Cognitive Models were most frequently reported with positive effects noted for TTM use. The review also indicates that using single theory may be better than using multiple theories in a single intervention.
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Affiliation(s)
- Mohammad Abdul Kadir
- Social Marketing @ Griffith, and Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Sharyn Rundle-Thiele
- Social Marketing @ Griffith, and Menzies Health Institute Queensland, Griffith University, Queensland, Australia
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5
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The neighborhood social environment and physical activity: a systematic scoping review. Int J Behav Nutr Phys Act 2019; 16:124. [PMID: 31815626 PMCID: PMC6902518 DOI: 10.1186/s12966-019-0873-7] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 09/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Investigating the association of the neighborhood social environment on physical activity is complex. A systematic scoping review was performed to (1) provide an inventory of studies assessing the influence of the neighborhood social environment on physical activity since 2006; (2) describe methodologies employed; and (3) formulate recommendations for the field. METHODS Two databases were searched using terms related to 'physical activity,' 'neighborhood,' and 'social environment' in January 2017. Eligibility criteria included: 1) physical activity as an outcome; 2) neighborhood social environment as a predictor; 3) healthy population (without diagnosed clinical condition or special population); 4) observational or experimental design. Of 1352 studies identified, 181 were included. Textual data relevant to the social environment measurement and analysis were extracted from each article into qualitative software (MAXQDA) and coded to identify social environmental constructs, measurement methods, level of measurement (individual vs. aggregated to neighborhood), and whether authors explicitly recognized the construct as the social environment. The following measures were generated for each construct: number of unique measurements; % of times measured at an aggregate level; % of times authors referred to the construct as the social environment. Social environmental constructs were then grouped into larger descriptive dimensions. RESULTS/FINDINGS Fifty-nine social environmental constructs were identified and grouped into 9 dimensions: Crime & Safety (n = 133 studies; included in 73% of studies); Economic & Social Disadvantage (n = 55, 33%); Social Cohesion & Capital (n = 47, 26%); Social Relationships (n = 22, 12%); Social Environment (n = 16, 9%); Disorder & Incivilities (n = 15, 8%); Sense of Place/Belonging (n = 8, 4%); Discrimination/Segregation (n = 3, 2%); Civic Participation & Engagement (n = 2, 1%). Across all articles, the social environment was measured using 176 different methods, was measured at an aggregate-level 38% of the time, and referred to as the social environment 23% of the time. CONCLUSIONS Inconsistent terminology, definitions, and measurement of the social environment and the lack of explicit language identifying constructs as the social environment make it challenging to compare results across studies and draw conclusions. Improvements are needed to increase our understanding of social environmental correlates and/or determinants of physical activity and facilitate cross-disciplinary conversations necessary to effectively intervene to promote physical activity. TRIAL REGISTRATION PROSPERO CRD42017059580.
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6
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Zenk SN, Tarlov E, Wing C, Slater S, Jones KK, Fitzgibbon M, Powell LM. Does the built environment influence the effectiveness of behavioral weight management interventions? Prev Med 2019; 126:105776. [PMID: 31330154 PMCID: PMC6878977 DOI: 10.1016/j.ypmed.2019.105776] [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: 02/08/2019] [Revised: 06/01/2019] [Accepted: 07/14/2019] [Indexed: 11/28/2022]
Abstract
Outcomes of behavioral lifestyle interventions for promoting weight loss vary widely across participants. The effectiveness of a weight management intervention may depend on a person's environmental context. This study compared short- and longer-term effects of a structured nationwide weight management program for people living in neighborhoods with different levels of walkability and different access to recreational places (parks, fitness facilities). Drawing on the health production model, we tested competing hypotheses for whether treatment effects of the program complement environmental supports or substitute for environmental constraints. We studied the US Department of Veterans Affairs (VA) MOVE! weight management program using VA electronic heath record data (2009-2014) and a difference-in-differences design with an inverse propensity score matched comparison group. A total of 114,256 program participants and 498,494 non-participants comprised the sample. Built environment features were measured within one-mile of each person's home. We estimated program effects on body mass index (BMI) for subgroups with different built environments at 6-, 12-, 18-, and 24-month follow-up using linear regressions with person and year fixed effects. At 6 months, the program reduced BMI by 0.4-0.6 kg/m2 among men and 0.3-0.5 kg/m2 among women. The effect diminished at 12, 18, and 24 months. The program effect did not vary significantly across subgroups with different walkability, park access, or fitness facility access. The MOVE! program was not sensitive to environmental context. Results did not lend support to either hypothesis that the MOVE! program complements or substitutes for a person's built environment to affect weight management outcomes.
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Affiliation(s)
- Shannon N Zenk
- University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA.
| | - Elizabeth Tarlov
- University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA; Edward Hines Jr. Veterans Affairs Hospital, Hines, IL 60141, USA.
| | - Coady Wing
- Indiana University School of Public and Environmental Affairs, Bloomington, IN 47405, USA.
| | - Sandy Slater
- University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA; University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA.
| | - Kelly K Jones
- University of Illinois at Chicago College of Nursing, 845 S. Damen Ave., Chicago, IL 60612, USA.
| | - Marian Fitzgibbon
- University of Illinois at Chicago Institute for Health Research and Policy, Chicago, IL 60612, USA; University of Illinois at Chicago Department of Pediatrics, Chicago, IL 60612, USA.
| | - Lisa M Powell
- University of Illinois at Chicago Institute for Health Research and Policy, Chicago, IL 60612, USA; University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA.
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7
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Park S, Ntoumanis N, Fenton SAM, Stenling A, Veldhuijzen van Zanten JJCS, Thøgersen-Ntoumani C. A Person-Centered Analysis of Motivation for Physical Activity and Perceived Neighborhood Environment in Residents of Assisted Living Facilities. Int J Aging Hum Dev 2018; 89:257-278. [PMID: 29966431 DOI: 10.1177/0091415018784763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This study sought to identify profiles of individual, social, and perceived neighborhood environmental correlates of physical activity (PA) and to explore differences between the identified profiles in PA. Residents of assisted living facilities ( N = 87, M age = 77.57 years) were recruited for the cross-sectional study. Participants reported their perceived support from important others for PA, basic psychological need satisfaction and motivation for PA, and perceived neighborhood environment around the assisted living facilities. Engagement in light PA and moderate-to-vigorous PA was measured by accelerometers over 1 week. We identified three profiles using latent profile analysis: ‘low self-determined and minimally supported', ‘moderately self-determined and supported', and ‘highly self-determined and supported'. Results showed participants in the highly self-determined and supported profile engaged in higher levels of light PA and moderate-to-vigorous PA than participants from other profiles. Findings showed perceptions of the neighborhood environment should be taken into account with motivation regarding PA.
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Affiliation(s)
- Saengryeol Park
- 1 School of Sport Science, Sungkyunkwan University, Suwon, South Korea
| | - Nikos Ntoumanis
- 2 School of Psychology & Speech Pathology, Curtin University, Perth, Western Australia
| | - Sally A M Fenton
- 3 School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
| | - Andreas Stenling
- 4 Department of Psychology, Umeå Universitet, Sweden.,5 Department of Psychology, University of Gothenburg, Sweden.,6 Department of Psychology, University of Otago, Dunedin, New Zealand
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8
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Wasfi R, Steinmetz-Wood M, Kestens Y. Place matters: A longitudinal analysis measuring the association between neighbourhood walkability and walking by age group and population center size in Canada. PLoS One 2017; 12:e0189472. [PMID: 29261706 PMCID: PMC5736224 DOI: 10.1371/journal.pone.0189472] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 11/28/2017] [Indexed: 11/19/2022] Open
Abstract
This study examined the influence of walkability on walking behaviour and assessed whether associations varied according to life-stage and population center (PC) size. Walkability scores were obtained for the six-digit postal codes of residential neighbourhoods of 11,200 Canadians, who participated in biennial assessments of the National Population Health Survey from 1994 to 2010. Participants were stratified by age-group. Mixed-effects logistic regression models were used to estimate the influence of cumulative exposure to neighborhood walkability on utilitarian and exercise walking by PC size and life-stage. Associations of neighbourhood walkability with utilitarian and exercise walking varied according to age-group and PC size. Exposure to high walkable neighborhoods was associated with utilitarian walking in younger and older adults in all PC sizes, except for older adults living in a medium PC. Living in a highly walkable neighborhood in a large PC was associated with walking for exercise in younger (OR: 1.42; 95%CI: 1.20-1.67) and older adults (OR: 2.09; 95%CI: 1.51-2.89). Living in highly walkable neighbourhood in a medium PC was associated with walking for exercise in older adults (OR: 1.62; 95%CI: 1.15-2.29). These results emphasize the need to consider the size and nature of every community, and the age-group of a population when implementing strategies to promote walking.
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Affiliation(s)
- Rania Wasfi
- Department of Social and Preventive Medicine, École de Santé Publique de l’Université de Montréal (ESPUM), Universite de Montreal, Montreal, Canada
- University of Montreal Hospital Research Centre (CRCHUM), Universite de Montreal, Montreal, Canada
| | - Madeleine Steinmetz-Wood
- University of Montreal Hospital Research Centre (CRCHUM), Universite de Montreal, Montreal, Canada
| | - Yan Kestens
- Department of Social and Preventive Medicine, École de Santé Publique de l’Université de Montréal (ESPUM), Universite de Montreal, Montreal, Canada
- University of Montreal Hospital Research Centre (CRCHUM), Universite de Montreal, Montreal, Canada
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Perez LG, Kerr J, Sallis JF, Slymen D, McKenzie TL, Elder JP, Arredondo EM. Perceived Neighborhood Environmental Factors That Maximize the Effectiveness of a Multilevel Intervention Promoting Physical Activity Among Latinas. Am J Health Promot 2017; 32:334-343. [PMID: 29166779 DOI: 10.1177/0890117117742999] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE This study tested whether a multilevel physical activity (PA) intervention had differential effects on PA according to participants' perceptions of their neighborhood environment. DESIGN Two-group cluster randomized controlled trial. SETTING San Diego, California. SUBJECTS Analytical sample included 319 Latinas (18-65 years) from churches randomized to the following conditions: PA (n = 8 churches, n = 157 participants) or attention control (n = 8 churches, n = 162 participants). INTERVENTION Over 12 months, PA participants were offered free PA classes (6/wk), while attention control participants were offered cancer prevention workshops. MEASURES Baseline and 12-month follow-up measures included self-report and accelerometer-based moderate to vigorous physical activity (MVPA), sociodemographics, and perceived neighborhood environment variables. ANALYSIS Mixed-effects models examined each PA outcome at 12-month follow-up, adjusted for church clustering, baseline PA, and sociodemographics. We tested interactions between 7 baseline perceived environment variables and study condition. RESULTS Neighborhood esthetics was the only significant moderator of intervention effects on accelerometer-based MVPA and self-report leisure-time MVPA. Participants in the PA intervention had significantly higher PA at follow-up than attention control participants, only when participants evaluated their neighborhood esthetics favorably. CONCLUSION Perceived neighborhood esthetics appeared to maximize the effectiveness of a multilevel PA intervention among Latinas. For sustainable PA behavior change, the environments in which Latinas are encouraged to be active may need to be evaluated prior to implementing an intervention to ensure they support active lifestyles.
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Affiliation(s)
- Lilian G Perez
- 1 Joint Doctoral Program in Public Health, Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA.,2 Joint Doctoral Program in Public Health, Graduate School of Public Health, San Diego State University, San Diego, CA, USA.,3 Institute for Behavioral and Community Health, San Diego, CA, USA
| | - J Kerr
- 4 Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - J F Sallis
- 4 Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - D Slymen
- 3 Institute for Behavioral and Community Health, San Diego, CA, USA.,5 Division of Epidemiology and Biostatistics, San Diego State University, San Diego, CA, USA
| | - T L McKenzie
- 3 Institute for Behavioral and Community Health, San Diego, CA, USA.,6 School of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - J P Elder
- 3 Institute for Behavioral and Community Health, San Diego, CA, USA.,7 Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
| | - E M Arredondo
- 3 Institute for Behavioral and Community Health, San Diego, CA, USA.,7 Division of Health Promotion and Behavioral Science, San Diego State University, San Diego, CA, USA
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10
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Thøgersen-Ntoumani C, Wright A, Quested E, Burton E, Hill KD, Cerin E, Biddle SJH, Ntoumanis N. Protocol for the residents in action pilot cluster randomised controlled trial (RiAT): evaluating a behaviour change intervention to promote walking, reduce sitting and improve mental health in physically inactive older adults in retirement villages. BMJ Open 2017; 7:e015543. [PMID: 28645969 PMCID: PMC5734553 DOI: 10.1136/bmjopen-2016-015543] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Ageing is accompanied by increased risks of chronic disease, declined functioning and increased dependency. Physical activity is critical to retaining health and independence, but the majority of older people are insufficiently physically active to achieve these benefits and have high levels of sedentary (sitting) time. Activity programmes are often offered in retirement villages; however, their uptake is limited. Furthermore, although the physical environment in and around these villages can play an important role in decisions to be physically active, its role is often overlooked by research in these settings. We aim to develop, implement and evaluate a proof-of-concept motivationally embellished intervention designed to increase walking, reduce sitting and improve mental health in residents in retirement villages. METHODS AND ANALYSIS This will be a 16-week pilot intervention using a cluster randomised design with retirement villages as the unit of randomisation and residents as the unit of assessment. Fourteen retirement villages around Perth, Western Australia, will be recruited for the intervention. Objective audits of neighbourhood environments around each village will be completed using the Pathway Environmental Audit Tool. Seven villages will be randomised to the experimental arm and seven to the control arm. Only participants in the experimental arm will receive motivational training. All outcomes will be assessed at baseline, end of intervention and 6-month follow-up. Changes in physical activity levels, sitting time and mental health will be examined. Multilevel modelling will be used to analyse the data. A mixed methods process evaluation will also be conducted. ETHICS AND DISSEMINATION Ethics approval was granted by Curtin University's Human Research Ethics Committee (HREC2016-0187). The results of the study will be disseminated via peer-reviewed publications, conference presentations and reports to, and seminars with, stakeholders. TRIAL REGISTRATION The trial is registered with the Australian New Zealand Clinical Trials Registry: ACTRN12616001177448.
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Affiliation(s)
- Cecilie Thøgersen-Ntoumani
- Health Psychology & Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Ashlene Wright
- Health Psychology & Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Eleanor Quested
- Health Psychology & Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Elissa Burton
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Keith D Hill
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Ester Cerin
- Institute for Health and Ageing, Australian Catholic University, Melbourne, Victoria, Australia
- School of Public Health, The University of Hong Kong, Hong Kong, China
| | - Stuart J H Biddle
- Institute of Sport, Exercise & Active Living, Victoria University, Melbourne, Victoria, Australia
- Institute for Resilient Regions, University of Southern Queensland, Springfield, Queensland, Australia
| | - Nikos Ntoumanis
- Health Psychology & Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
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11
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Jankowska MM, Natarajan L, Godbole S, Meseck K, Sears DD, Patterson RE, Kerr J. Kernel Density Estimation as a Measure of Environmental Exposure Related to Insulin Resistance in Breast Cancer Survivors. Cancer Epidemiol Biomarkers Prev 2017; 26:1078-1084. [PMID: 28258052 DOI: 10.1158/1055-9965.epi-16-0927] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Revised: 01/11/2017] [Accepted: 02/20/2017] [Indexed: 11/16/2022] Open
Abstract
Background: Environmental factors may influence breast cancer; however, most studies have measured environmental exposure in neighborhoods around home residences (static exposure). We hypothesize that tracking environmental exposures over time and space (dynamic exposure) is key to assessing total exposure. This study compares breast cancer survivors' exposure to walkable and recreation-promoting environments using dynamic Global Positioning System (GPS) and static home-based measures of exposure in relation to insulin resistance.Methods: GPS data from 249 breast cancer survivors living in San Diego County were collected for one week along with fasting blood draw. Exposure to recreation spaces and walkability was measured for each woman's home address within an 800 m buffer (static), and using a kernel density weight of GPS tracks (dynamic). Participants' exposure estimates were related to insulin resistance (using the homeostatic model assessment of insulin resistance, HOMA-IR) controlled by age and body mass index (BMI) in linear regression models.Results: The dynamic measurement method resulted in greater variability in built environment exposure values than did the static method. Regression results showed no association between HOMA-IR and home-based, static measures of walkability and recreation area exposure. GPS-based dynamic measures of both walkability and recreation area were significantly associated with lower HOMA-IR (P < 0.05).Conclusions: Dynamic exposure measurements may provide important evidence for community- and individual-level interventions that can address cancer risk inequities arising from environments wherein breast cancer survivors live and engage.Impact: This is the first study to compare associations of dynamic versus static built environment exposure measures with insulin outcomes in breast cancer survivors. Cancer Epidemiol Biomarkers Prev; 26(7); 1078-84. ©2017 AACR.
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Affiliation(s)
- Marta M Jankowska
- Qualcomm Institute, California Institute for Telecommunications and Information Technology, University of California, San Diego, California.
| | - Loki Natarajan
- Department of Family Medicine and Public Health, University of California, San Diego, California.,Moores UC San Diego Cancer Center, University of California San Diego, California
| | - Suneeta Godbole
- Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Kristin Meseck
- Department of Family Medicine and Public Health, University of California, San Diego, California
| | - Dorothy D Sears
- Department of Family Medicine and Public Health, University of California, San Diego, California.,Department of Medicine, University of California, San Diego, California
| | - Ruth E Patterson
- Department of Family Medicine and Public Health, University of California, San Diego, California.,Moores UC San Diego Cancer Center, University of California San Diego, California
| | - Jacqueline Kerr
- Department of Family Medicine and Public Health, University of California, San Diego, California.,Moores UC San Diego Cancer Center, University of California San Diego, California
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12
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Merom D, Gebel K, Fahey P, Astell-Burt T, Voukelatos A, Rissel C, Sherrington C. Neighborhood walkability, fear and risk of falling and response to walking promotion: The Easy Steps to Health 12-month randomized controlled trial. Prev Med Rep 2015; 2:704-10. [PMID: 26844140 PMCID: PMC4721485 DOI: 10.1016/j.pmedr.2015.08.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
In older adults the relationships between health, fall-related risk factors, perceived neighborhood walkability, walking behavior and intervention impacts are poorly understood. To determine whether: i) health and fall-related risk factors were associated with perceptions of neighborhood walkability; ii) perceived environmental attributes, and fall-related risk factors predicted change in walking behavior at 12 months; and iii) perceived environmental attributes and fall-related risk factors moderated the effect of a self-paced walking program on walking behavior. Randomized trial on walking and falls conducted between 2009 and 2012 involving 315 community-dwelling inactive adults ≥ 65 years living in Sydney, Australia. Measures were: mobility status, fall history, injurious fall and fear of falling (i.e., fall-related risk factors), health status, walking self-efficacy and 11 items from the neighborhood walkability scale and planned walking ≥ 150 min/week at 12 months. Participants with poorer mobility, fear of falling, and poor health perceived their surroundings as less walkable. Walking at 12 months was significantly greater in "less greenery" (AOR = 3.3, 95% CI: 1.11-9.98) and "high traffic" (AOR = 1.98, 95% CI: 1.00-3.91) neighborhoods. The intervention had greater effects in neighborhoods perceived to have poorer pedestrian infrastructure (p for interaction = 0.036). Low perceived walkability was shaped by health status and did not appear to be a barrier to walking behavior. There appears to be a greater impact of, and thus, need for, interventions to encourage walking in environments perceived not to have supportive walking infrastructure. Future studies on built environments and walking should gather information on fall-related risk factors to better understand how these characteristics interact.
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Affiliation(s)
- D Merom
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751, Australia
| | - K Gebel
- Centre for Chronic Disease Prevention, College of Public Health, Medical & Veterinary Sciences, James Cook University, PO Box 6811, Cairns, QLD 4870, Australia
| | - P Fahey
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751, Australia
| | - T Astell-Burt
- School of Science and Health, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751, Australia
| | - A Voukelatos
- Health Promotion Service, Sydney and South West Sydney Local Health District, Sydney, Camperdown, NSW 2050, Australia; School of Public Health and Community Medicine, University of NSW, Sydney, Australia
| | - C Rissel
- School of Public Health, Level 6, Charles Perkins Centre, University of Sydney, Sydney, NSW 2006, Australia
| | - C Sherrington
- The George Institute for Global Health, Sydney Medical School, University of Sydney, Level 13, 321, Kent St Sydney, NSW 2000, Australia
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13
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Barnes R, Giles-Corti B, Bauman A, Rosenberg M, Bull FC, Leavy JE. Does neighbourhood walkability moderate the effects of mass media communication strategies to promote regular physical activity? Ann Behav Med 2014; 45 Suppl 1:S86-94. [PMID: 23334760 DOI: 10.1007/s12160-012-9429-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Mass media campaigns are widely used in Australia and elsewhere to promote physical activity among adults. Neighbourhood walkability is consistently shown to be associated with walking and total activity. Campaigns may have different effects on individuals living in high and low walkable neighbourhoods. PURPOSE The purpose of this study is to compare pre- and post-campaign cognitive and behavioural impacts of the Heart Foundation's Find Thirty every day® campaign, in respondents living in high and lower walkable neighbourhoods. METHODS Pre- and post-campaign cross-sectional survey data were linked with objectively measured neighbourhood walkability. Cognitive and behavioural impacts were assessed using logistic regression stratified by walkability. RESULTS Cognitive impacts were significantly higher post-campaign and consistently higher in respondents in high compared with lower walkable neighbourhoods. Post campaign sufficient activity was significantly higher and transport walking significantly lower, but only in residents of lower walkable areas. CONCLUSIONS Cognitive impacts of mass media physical activity campaigns may be enhanced by living in a more walkable neighbourhood.
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Affiliation(s)
- R Barnes
- Centre for Built Environment and Health, School of Population Health (M707), The University of Western Australia, 35 Stirling Hwy, Crawley, Perth, WA, 6009, Australia.
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14
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Chisholm A, Hart J, Mann K, Peters S. Development of a behaviour change communication tool for medical students: the 'Tent Pegs' booklet. PATIENT EDUCATION AND COUNSELING 2014; 94:50-60. [PMID: 24113518 DOI: 10.1016/j.pec.2013.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 09/05/2013] [Accepted: 09/07/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE To describe the development and validation of a behaviour change communication tool for medical students. METHODS Behaviour change techniques (BCTs) were identified within the literature and used to inform a communication tool to support medical students in discussing health-related behaviour change with patients. BCTs were organized into an accessible format for medical students (the 'Tent Pegs' booklet) and validated using discriminant content validity methods with 11 expert judges. RESULTS One-sample t-tests showed that judges reliably mapped BCTs onto six of the seven Tent Pegs domains (confidence rating means ranged from 4.0 to 5.1 out of 10, all p≤0.002). Only BCTs within the 'empowering people to change' domain were not significantly different from the value zero (mean confidence rating=1.2, p>0.05); these BCTs were most frequently allocated to the 'addressing thoughts and emotions' domain instead. CONCLUSION BCTs within the Tent Pegs booklet are reliably allocated to corresponding behaviour change domains with the exception of those within the 'empowering people to change' domain. PRACTICE IMPLICATIONS The existing evidence-base on BCTs can be used to directly inform development of a communication tool to support medical students facilitate health behaviour change with patients.
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Affiliation(s)
- Anna Chisholm
- Manchester Centre for Health Psychology, University of Manchester, UK; Institute of Inflammation and Repair, University of Manchester, UK.
| | - Jo Hart
- Manchester Centre for Health Psychology, University of Manchester, UK; Manchester Medical School, University of Manchester, UK
| | - Karen Mann
- Manchester Medical School, University of Manchester, UK; Division of Medical Education, Dalhousie University, Canada
| | - Sarah Peters
- Manchester Centre for Health Psychology, University of Manchester, UK; School of Psychological Sciences, University of Manchester, UK
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15
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Ding D, Sallis JF, Conway TL, Saelens BE, Frank LD, Cain KL, Slymen DJ. Interactive effects of built environment and psychosocial attributes on physical activity: a test of ecological models. Ann Behav Med 2013; 44:365-74. [PMID: 22899301 DOI: 10.1007/s12160-012-9394-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The principle of cross-level interactions of influence on behavior in ecological models is seldom studied. PURPOSE To examine built environment × psychosocial interactive effects on physical activity. METHODS Multi-level mixed regression analyses used data from the Neighborhood Quality of Life Study conducted in neighborhoods in two US regions (n = 2,199 adults). Outcomes were (1) objectively measured moderate-to-vigorous physical activity, (2) reported transport walking, and (3) leisure-walking. Conceptually matched built environment variables were analyzed for domain-specific outcomes. RESULTS With leisure walking as the outcome, built environment × psychosocial interactions were significant in 7 of 20 models tested. Directions of interactions were consistent, indicating a stronger built environment-leisure walking association in adults with less favorable psychosocial status. Little evidence supported such interactions with objectively measured moderate-to-vigorous physical activity or transport walking as outcomes. CONCLUSION The results imply that the built environment may exert stronger influence on adults who are not psychologically predisposed to be active.
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Affiliation(s)
- Ding Ding
- Department of Family and Preventive Medicine, University of California San Diego, San Diego, CA 92103, USA.
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16
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Fuller DL, Gyurcsik NC, Spink KS, Brawley LR. Prospective Examination of Self-Regulatory Efficacy in Predicting Walking for Active Transportation: A Social Cognitive Theory Approach. JOURNAL OF APPLIED SOCIAL PSYCHOLOGY 2012. [DOI: 10.1111/j.1559-1816.2012.00968.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - Nancy C. Gyurcsik
- College of Kinesiology; University of Saskatchewan; Saskatoon; Saskatchewan; Canada
| | - Kevin S. Spink
- College of Kinesiology; University of Saskatchewan; Saskatoon; Saskatchewan; Canada
| | - Lawrence R. Brawley
- College of Kinesiology; University of Saskatchewan; Saskatoon; Saskatchewan; Canada
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The relationship of physical activity and the built environment within the context of self-determination theory. Ann Behav Med 2012; 42:188-96. [PMID: 21818529 DOI: 10.1007/s12160-011-9292-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Evidence is emerging of the combined effects of psychosocial and environmental determinants on exercise. PURPOSE This study aims to examine the moderating effects of convenience, facilities at places of worship, access, crime/safety, and neighborhood characteristics on the relationship between exercise and psychosocial needs satisfaction (autonomy, competence, and relatedness). METHODS Adults from four cities enrolling in a weight loss program (N = 477; 72.1% White, BMI = 32.21 ± 7.67) completed questionnaires on current exercise levels, perceptions of the environment for exercise, and autonomy, competence, and relatedness. RESULTS There were significant interaction effects for neighborhood characteristics with all three psychological needs satisfaction, and for convenience with competence and relatedness, such that the relationship between psychosocial needs satisfaction and exercise is stronger for participants with better perceptions of convenience and neighborhood characteristics. CONCLUSIONS Results indicate that the relationship between exercise and autonomy, competence, and relatedness is different for low and high perceptions of convenience to places for exercise and neighborhood characteristics.
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Im EO, Lee B, Chee W, Stuifbergen A. Attitudes toward physical activity of white midlife women. J Obstet Gynecol Neonatal Nurs 2011; 40:312-21. [PMID: 21585528 DOI: 10.1111/j.1552-6909.2011.01249.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To explore attitudes toward physical activity of White midlife women in the United States using a feminist perspective. DESIGN A cross-sectional qualitative study using a thematic analysis. SETTING Internet communities for midlife women. PARTICIPANTS Twenty-nine White midlife women in the United States recruited using a convenience sampling method. METHODS We used 17 topics on attitudes toward physical activity and ethnic-specific contexts to administer an online forum. We analyzed the data using thematic analysis. RESULTS We found three themes: thinking without action, gendered and sedentary culture, and motivating myself. The women knew and understood the necessity of physical activity for their physical and mental health but in most cases had not been able to take action to increase their physical activities. Although the culture that circumscribed the women's physical activity was sedentary in nature, the women tried to motivate themselves to increase their physical activities through several creative strategies. CONCLUSION The findings strongly suggest that although women were doing their best, American culture itself needs to be changed to help women increase physical activity in their daily lives.
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Affiliation(s)
- Eun-Ok Im
- School of Nursing, University of Texas at Austin, Austin, TX 78701, USA.
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