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Woldamanuel Y, Bergman P, von Rosen P, Johansson UB, Hagströmer M, Rossen J. Association between Weather and Self-Monitored Steps in Individuals with Prediabetes and Type 2 Diabetes in Sweden over Two Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:379. [PMID: 38673292 PMCID: PMC11050403 DOI: 10.3390/ijerph21040379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Many studies have identified key factors affecting the rates of engagement in physical activity in older adults with chronic disease. Environmental conditions, such as weather variations, can present challenges for individuals with chronic diseases, such as type 2 diabetes when engaging in physical activity. However, few studies have investigated the influence of weather on daily steps in people with chronic diseases, especially those with prediabetes and type 2 diabetes. OBJECTIVE This study investigated the association between weather variations and daily self-monitored step counts over two years among individuals with prediabetes and type 2 diabetes in Sweden. METHODS The study is a secondary analysis using data from the Sophia Step Study, aimed at promoting physical activity among people with prediabetes and type 2 diabetes, which recruited participants from two urban primary care centers in Stockholm and one rural primary care center in southern Sweden over eight rounds. This study measured physical activity using step counters (Yamax Digiwalker SW200) and collected self-reported daily steps. Environmental factors such as daily average temperature, precipitation, and hours of sunshine were obtained from the Swedish Meteorological and Hydrological Institute. A robust linear mixed-effects model was applied as the analysis method. RESULTS There was no association found between weather variations and the number of steps taken on a daily basis. The analysis indicated that only 10% of the variation in daily steps could be explained by the average temperature, precipitation, and sunshine hours after controlling for age, gender, and BMI. Conversely, individual factors explained approximately 38% of the variation in the observations. CONCLUSION This study revealed that there was no association between weather conditions and the number of daily steps reported by individuals with prediabetes and type 2 diabetes taking part in a physical activity intervention over two years. Despite the weather conditions, women and younger people reported more steps than their male and older counterparts.
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Affiliation(s)
- Yohannes Woldamanuel
- Department of Health Promoting Science, Sophiahemmet University, 114 86 Stockholm, Sweden; (U.-B.J.); (M.H.); (J.R.)
| | - Patrick Bergman
- Department of Medicine and Optometry, eHealth Institute, Linnaeus University, 391 82 Kalmar, Sweden;
| | - Philip von Rosen
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Stockholm, Sweden;
| | - Unn-Britt Johansson
- Department of Health Promoting Science, Sophiahemmet University, 114 86 Stockholm, Sweden; (U.-B.J.); (M.H.); (J.R.)
| | - Maria Hagströmer
- Department of Health Promoting Science, Sophiahemmet University, 114 86 Stockholm, Sweden; (U.-B.J.); (M.H.); (J.R.)
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 141 83 Stockholm, Sweden;
- Academic Primary Care Center, Region Stockholm, 113 65 Stockholm, Sweden
| | - Jenny Rossen
- Department of Health Promoting Science, Sophiahemmet University, 114 86 Stockholm, Sweden; (U.-B.J.); (M.H.); (J.R.)
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Gomez SL, Chirikova E, McGuire V, Collin LJ, Dempsey L, Inamdar PP, Lawson-Michod K, Peters ES, Kushi LH, Kavecansky J, Shariff-Marco S, Peres LC, Terry P, Bandera EV, Schildkraut JM, Doherty JA, Lawson A. Role of neighborhood context in ovarian cancer survival disparities: current research and future directions. Am J Obstet Gynecol 2023; 229:366-376.e8. [PMID: 37116824 PMCID: PMC10538437 DOI: 10.1016/j.ajog.2023.04.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/01/2023] [Accepted: 04/20/2023] [Indexed: 04/30/2023]
Abstract
Ovarian cancer is the fifth leading cause of cancer-associated mortality among US women with survival disparities seen across race, ethnicity, and socioeconomic status, even after accounting for histology, stage, treatment, and other clinical factors. Neighborhood context can play an important role in ovarian cancer survival, and, to the extent to which minority racial and ethnic groups and populations of lower socioeconomic status are more likely to be segregated into neighborhoods with lower quality social, built, and physical environment, these contextual factors may be a critical component of ovarian cancer survival disparities. Understanding factors associated with ovarian cancer outcome disparities will allow clinicians to identify patients at risk for worse outcomes and point to measures, such as social support programs or transportation aid, that can help to ameliorate such disparities. However, research on the impact of neighborhood contextual factors in ovarian cancer survival and in disparities in ovarian cancer survival is limited. This commentary focuses on the following neighborhood contextual domains: structural and institutional context, social context, physical context represented by environmental exposures, built environment, rurality, and healthcare access. The research conducted to date is presented and clinical implications and recommendations for future interventions and studies to address disparities in ovarian cancer outcomes are proposed.
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Affiliation(s)
- Scarlett L Gomez
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA.
| | - Ekaterina Chirikova
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Valerie McGuire
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Lindsay J Collin
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Lauren Dempsey
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Pushkar P Inamdar
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA
| | - Katherine Lawson-Michod
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Edward S Peters
- Department of Epidemiology, University of Nebraska Medical Center College of Public Health, Omaha, NE
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Juraj Kavecansky
- Department of Hematology and Oncology, Kaiser Permanente Northern California, Antioch, CA
| | - Salma Shariff-Marco
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA
| | - Lauren C Peres
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Paul Terry
- Department of Medicine, University of Tennessee, Knoxville, TN
| | - Elisa V Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Joellen M Schildkraut
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Jennifer A Doherty
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT
| | - Andrew Lawson
- Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, Charleston, SC; Usher Institute, School of Medicine, University of Edinburgh, Edinburgh, United Kingdom
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Abshire DA, Wippold GM, Wilson DK, Pinto BM, Probst JC, Hardin JW. A qualitative study of ecological and motivational factors to inform weight management interventions for Black men in the rural South of the United States. Soc Sci Med 2023; 326:115898. [PMID: 37087973 PMCID: PMC10354809 DOI: 10.1016/j.socscimed.2023.115898] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 04/06/2023] [Accepted: 04/08/2023] [Indexed: 04/25/2023]
Abstract
RATIONALE AND OBJECTIVE Black men in the rural South of the United States (US) are underrepresented in weight management behavioral trials. Qualitative research is needed to inform interventions that can reduce obesity and health disparities in this population. We explored how intrapersonal, social, and environmental factors affect motivation and weight-related behaviors and how to culturally adapt behavioral interventions for Black men in the rural South. METHODS We conducted individual telephone interviews with 23 Black men (mean age 50 ± 14 years) with overweight or obesity living in rural South Carolina communities in 2020 and 2021. Interviews were audio recorded, professionally transcribed, and coded by two men's health researchers who achieved an intercoder reliability of 70%. Content analysis using QSR NVivo 12 was used to generate themes using deductive and inductive approaches. RESULTS Physical health and health behaviors were perceived as key determinants of overall health. Family, friends, and other social contacts often provided positive social support that increased motivation but also hindered motivation by engaging in behaviors men were trying to avoid. Younger participants had stronger views of rural environments not supporting healthy lifestyles, which compounded personal challenges such as time constraints and lack of motivation. Comfort was discussed as a critical program consideration, and gender concordance among program participants and facilitators was perceived as promoting comfort. Participants noted preferences and benefits of in-person, group programs emphasizing physical activity, and younger participants more strongly endorsed programs that incorporated sports and competition. CONCLUSIONS Findings from this study provide important evidence to inform the development of weight management interventions for Black men in the rural US South. Based on these findings, an innovative, competitive "football-themed" weight management program promoting peer support and integrating competitive physical activities is being evaluated for younger Black men in the rural South.
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Affiliation(s)
- Demetrius A Abshire
- University of South Carolina College of Nursing, 1601 Greene Street, Columbia, SC, 29208, USA.
| | - Guillermo M Wippold
- University of South Carolina, Department of Psychology, Barnwell College 224, 1512 Pendleton Street, Columbia, SC, 29208, USA.
| | - Dawn K Wilson
- University of South Carolina, Department of Psychology, Barnwell College 224, 1512 Pendleton Street, Columbia, SC, 29208, USA.
| | - Bernardine M Pinto
- University of South Carolina College of Nursing, 1601 Greene Street, Columbia, SC, 29208, USA.
| | - Janice C Probst
- University of South Carolina, Arnold School of Public Health, 915 Greene Street, Columbia, SC, 29208, USA.
| | - James W Hardin
- University of South Carolina, Arnold School of Public Health, 915 Greene Street, Columbia, SC, 29208, USA.
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Ghazaryan A, Carlson AC, Rhone A, Roy K. Association Between County-Level Food Retail and Socioeconomic Environment and Nutritional Quality of Household Food Purchases, 2015. J Acad Nutr Diet 2023; 123:796-808. [PMID: 37096644 PMCID: PMC10848244 DOI: 10.1016/j.jand.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 10/12/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND About 40 million Americans do not have easy access to affordable nutritious foods. Healthier foods are less likely to be available to those living in rural and/or lower-income communities. OBJECTIVE The objective of this study was to analyze the association between nutritional quality of household food purchases and county-level food retail environment; county-level demographic, health, and socioeconomic indicators; and household composition, demographic characteristics, and socioeconomic characteristics. DESIGN This study is a secondary analysis of the 2015 Information Resources Inc Consumer Network panel; Purchase-to-Plate Crosswalk, which links US Department of Agriculture nutrition databases to Information Resources Inc scanner data; County Health Rankings; and the Food Environment Atlas data. PARTICIPANTS AND SETTINGS A total of 63,285 households, representative of the contiguous US population, consistently provided food purchase scanner data from retail stores throughout 2015. MAIN OUTCOME MEASURES Nutritional quality of retail food purchases was assessed using the Healthy Eating Index 2015 (HEI-2015). STATISTICAL ANALYSIS Multivariate linear regression analysis was used to simultaneously test the relationship between the main outcome and household-level demographic and socioeconomic characteristics as well as the county-level demographic, health, socioeconomic, and retail food environment. RESULTS Household heads who had higher education and households with higher incomes purchased food of better nutritional quality (ie, higher HEI-2015 scores). Also, the association between retail food purchase HEI-2015 scores and the food environment was weak. Higher density of convenience stores was associated with lower retail food purchase nutritional quality for higher-income households and households living in urban counties, whereas low-income households in counties with higher specialty (including ethnic) store density purchased higher nutritional quality food. Both in the full sample and when stratified by household income or county rural vs urban status, no association was found between grocery store, supercenters, fast-food outlets, and full-service restaurant densities and retail food purchase HEI-2015 scores. HEI-2015 scores were negatively correlated with the county average number of mental health days for higher income and urban households. CONCLUSIONS The study findings suggest that availability of healthier food alone may not improve healthfulness of retail food purchases. Future studies examining the influence of demand-side factors/interventions, such as habits, cultural preferences, nutrition education, and cost/affordability, on household purchasing patterns could provide complementary evidence to inform effective intervention strategies.
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Affiliation(s)
- Armen Ghazaryan
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia.
| | - Andrea C Carlson
- Food Economics Division, Economic Research Service, US Department of Agriculture, Washington, DC
| | - Alana Rhone
- Food Economics Division, Economic Research Service, US Department of Agriculture, Washington, DC
| | - Kakoli Roy
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Chamblee, Georgia
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Yang J, Xia Y, Sun Y, Guo Y, Shi Z, Cristina do Vale Moreira N, Zuo H, Hussain A. Effect of lifestyle intervention on HbA1c levels in overweight and obese adults with type 2 diabetes across ethnicities: A systematic review and meta-analysis of randomized controlled trials. Diabetes Res Clin Pract 2023; 199:110662. [PMID: 37028602 DOI: 10.1016/j.diabres.2023.110662] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 04/09/2023]
Abstract
AIMS Weight reduction is fundamental for the management and remission of diabetes. We aimed to assess ethnic differences in the effects of lifestyle weight-loss interventions on HbA1c levels in overweight or obese adults with type 2 diabetes mellitus (T2DM). METHODS We systematically searched PubMed/MEDLINE and Web of Science online databases up to 31 Dec 2022. Randomized controlled trials using lifestyle weight-loss interventions in overweight or obese adults with T2DM were selected. We performed subgroup analyses to explore the heterogeneity across different ethnicities (Asians, White/Caucasians, Black/Africans and Hispanics). A random effects model was applied to calculate weighted mean difference (WMD) with 95% confidence interval (CI). RESULTS Thirty studies including 7580 subjects from different ethnicities were identified according to the predefined inclusion and exclusion criteria. HbA1c levels were significantly reduced by lifestyle weight-loss intervention. Notably, a significantly beneficial effect on HbA1c was observed in White/Caucasians (WMD = -0.59, 95% CI: -0.90, -0.28, P < 0.001) and Asians (WMD = -0.48, 95% CI: -0.63, -0.33, P < 0.001), but not in the Black/African or Hispanic group (both P > 0.05). The findings remained essentially unchanged in the sensitivity analysis. CONCLUSIONS Lifestyle weight-loss interventions had distinct beneficial effects on HbA1c levels in different ethnic groups with T2DM, especially in Caucasians and Asians.
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Affiliation(s)
- Jie Yang
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Yujia Xia
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Yanan Sun
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Yufei Guo
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Zumin Shi
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Qatar
| | | | - Hui Zuo
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, Suzhou, China.
| | - Akhtar Hussain
- Faculty of Health Sciences, NORD University, Bodø, Norway; Faculty of Medicine, Federal University of Ceará (FAMED-UFC), Brazil; International Diabetes Federation. 166 Chaussee de La Hulpe B-1170, Brussels, Belgium.
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Bikomeye JC, Balza JS, Kwarteng JL, Beyer AM, Beyer KMM. The impact of greenspace or nature-based interventions on cardiovascular health or cancer-related outcomes: A systematic review of experimental studies. PLoS One 2022; 17:e0276517. [PMID: 36417344 PMCID: PMC9683573 DOI: 10.1371/journal.pone.0276517] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 10/10/2022] [Indexed: 11/24/2022] Open
Abstract
SIGNIFICANCE Globally, cardiovascular disease (CVD) and cancer are leading causes of morbidity and mortality. While having different etiologies, CVD and cancer are linked by multiple shared risk factors, the presence of which exacerbate adverse outcomes for individuals with either disease. For both pathologies, factors such as poverty, lack of physical activity (PA), poor dietary intake, and climate change increase risk of adverse outcomes. Prior research has shown that greenspaces and other nature-based interventions (NBIs) contribute to improved health outcomes and climate change resilience. OBJECTIVE To summarize evidence on the impact of greenspaces or NBIs on cardiovascular health and/or cancer-related outcomes and identify knowledge gaps to inform future research. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 and Peer Review of Electronic Search Strategies (PRESS) guidelines, we searched five databases: Web of Science, Scopus, Medline, PsycINFO and GreenFile. Two blinded reviewers used Rayyan AI and a predefined criteria for article inclusion and exclusion. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale (NOS). This review is registered with PROSPERO, ID # CRD42021231619. RESULTS & DISCUSSION Of 2565 articles retrieved, 31 articles met the inclusion criteria, and overall had a low risk of bias. 26 articles studied cardiovascular related outcomes and 5 studied cancer-related outcomes. Interventions were coded into 4 categories: forest bathing, green exercise, gardening, and nature viewing. Outcomes included blood pressure (BP), cancer-related quality of life (QoL) and (more infrequently) biomarkers of CVD risk. Descriptions of findings are presented as well as visual presentations of trends across the findings using RAW graphs. Overall studies included have a low risk of bias; and alluvial chart trends indicated that NBIs may have beneficial effects on CVD and cancer-related outcomes. CONCLUSIONS & IMPLICATIONS (1) Clinical implication: Healthcare providers should consider the promotion of nature-based programs to improve health outcomes. (2) Policy implication: There is a need for investment in equitable greenspaces to improve health outcomes and build climate resilient neighborhoods. (3) Research or academic implication: Research partnerships with community-based organizations for a comprehensive study of benefits associated with NBIs should be encouraged to reduce health disparities and ensure intergenerational health equity. There is a need for investigation of the mechanisms by which NBIs impact CVD and exploration of the role of CVD biological markers of inflammation among cancer survivors.
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Affiliation(s)
- Jean C. Bikomeye
- Division of Epidemiology & Social Sciences, PhD Program in Public and Community Health, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Joanna S. Balza
- Division of Epidemiology & Social Sciences, PhD Program in Public and Community Health, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Jamila L. Kwarteng
- Division of Community Health, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, United States of America
- MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Andreas M. Beyer
- MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, United States of America
- Division of Cardiology, Department of Medicine, Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Kirsten M. M. Beyer
- Division of Epidemiology & Social Sciences, PhD Program in Public and Community Health, Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, United States of America
- MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, United States of America
- * E-mail:
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Bell CN, Robles B, Singleton CR, Thomas Tobin CS, Spears EC, Thorpe RJ. Association between Proximity to Food Sources and Dietary Behaviors in Black and White College Graduates. Am J Health Behav 2022; 46:515-527. [PMID: 36333832 DOI: 10.5993/ajhb.46.5.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Unequal access to healthy food environments is often implicated in racial inequities in health and behaviors that are largest among college graduates. The aim of this study was to determine associations between perceived proximity to food sources and dietary behaviors between black and white college graduates. METHODS In a cross-sectional online survey of dietary behaviors between black and white adults who have a ≥ 4-year bachelor's degree, respondents were asked how long it typically takes for them to get to grocery stores and fast-food restaurants from home. We used ordinal logit regression models to assess associations between perceived proximity to food sources and dietary behaviors. RESULTS Among black men, perceiving that a grocery store was ≥ 10 minutes from their home was associated with lower fruit consumption (beta=-0.94, SE=0.48). Perceiving that a grocery store was ≥ 10 minutes from their home was associated with more frequent fast-food consumption among black men (beta=1.21, SE=0.39), Black women (beta=0.98, SE=0.34), and white men (beta=0.74, SE=0.30). CONCLUSIONS The associations between perceived proximity to food sources and dietary behaviors differ by race and sex among college graduates with important implications for racial disparities in diet quality and obesity across SES.
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Affiliation(s)
- Caryn N Bell
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, United States
| | - Brenda Robles
- Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, CA, United States
| | - Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health & Tropical Medicine, New Orleans, LA, United States
| | - Courtney S Thomas Tobin
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Erica C Spears
- Louisiana Public Health Institute, New Orleans, LA, United States
| | - Roland J Thorpe
- Department of Health, Behavior, and Society, and Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Luningham JM, Seth G, Saini G, Bhattarai S, Awan S, Collin LJ, Swahn MH, Dai D, Gogineni K, Subhedar P, Mishra P, Aneja R. Association of Race and Area Deprivation With Breast Cancer Survival Among Black and White Women in the State of Georgia. JAMA Netw Open 2022; 5:e2238183. [PMID: 36306134 PMCID: PMC9617173 DOI: 10.1001/jamanetworkopen.2022.38183] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/02/2022] [Indexed: 12/04/2022] Open
Abstract
Importance Increasing evidence suggests that low socioeconomic status and geographic residence in disadvantaged neighborhoods contribute to disparities in breast cancer outcomes. However, little epidemiological research has sought to better understand these disparities within the context of location. Objective To examine the association between neighborhood deprivation and racial disparities in mortality among Black and White patients with breast cancer in the state of Georgia. Design, Setting, and Participants This population-based cohort study collected demographic and geographic data from patients diagnosed with breast cancer between January 1, 2004, and February 11, 2020, in 3 large health care systems in Georgia. A total of 19 580 patients with breast cancer were included: 12 976 from Piedmont Healthcare, 2285 from Grady Health System, and 4319 from Emory Healthcare. Data were analyzed from October 2, 2020, to August 11, 2022. Exposures Area deprivation index (ADI) scores were assigned to each patient based on their residential census block group. The ADI was categorized into quartile groups, and associations between ADI and race and ADI × race interaction were examined. Main Outcomes and Measures Cox proportional hazards regression models were used to compute hazard ratios (HRs) and 95% CIs associating ADI with overall mortality by race. Kaplan-Meier curves were used to visualize mortality stratified across racial and ADI groups. Results Of the 19 580 patients included in the analysis (mean [SD] age at diagnosis, 58.8 [13.2] years), 3777 (19.3%) died during the course of the study. Area deprivation index contributed differently to breast cancer outcomes for Black and White women. In multivariable-adjusted models, living in a neighborhood with a greater ADI (more deprivation) was associated with increased mortality for White patients with breast cancer; compared with the ADI quartile of less than 25 (least deprived), increased mortality HRs were found in quartiles of 25 to 49 (1.22 [95% CI, 1.07-1.39]), 50 to 74 (1.32 [95% CI, 1.13-1.53]), and 75 or greater (1.33 [95% CI, 1.07-1.65]). However, an increase in the ADI quartile group was not associated with changes in mortality for Black patients with breast cancer (quartile 25 to 49: HR, 0.81 [95% CI, 0.61-1.07]; quartile 50 to 74: HR, 0.91 [95% CI, 0.70-1.18]; and quartile ≥75: HR, 1.05 [95% CI, 0.70-1.36]). In neighborhoods with an ADI of 75 or greater, no racial disparity was observed in mortality (HR, 1.11 [95% CI, 0.92-1.36]). Conclusions and Relevance Black women with breast cancer had higher mortality than White women in Georgia, but this disparity was not explained by ADI: among Black patients, low ADI was not associated with lower mortality. This lack of association warrants further investigation to inform community-level approaches that may mitigate the existing disparities in breast cancer outcomes in Georgia.
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Affiliation(s)
- Justin M. Luningham
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Ft Worth
| | - Gaurav Seth
- Department of Biology, College of Arts and Sciences, Georgia State University, Atlanta
| | - Geetanjali Saini
- Department of Biology, College of Arts and Sciences, Georgia State University, Atlanta
| | - Shristi Bhattarai
- Department of Biology, College of Arts and Sciences, Georgia State University, Atlanta
| | - Sofia Awan
- School of Public Health, Georgia State University, Atlanta
| | - Lindsay J. Collin
- Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City
| | - Monica H. Swahn
- Department of Health Promotion and Physical Education, Wellstar College of Health and Human Services, Kennesaw State University, Kennesaw, Georgia
| | - Dajun Dai
- Department of Geosciences, Georgia State University, Atlanta
| | - Keerthi Gogineni
- Department of Hematology–Medical Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
- Department of Surgery, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
- Georgia Cancer Center for Excellence, Grady Health System, Atlanta
| | - Preeti Subhedar
- Department of Surgery, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
| | - Pooja Mishra
- Georgia Cancer Center for Excellence, Grady Health System, Atlanta
| | - Ritu Aneja
- Department of Biology, College of Arts and Sciences, Georgia State University, Atlanta
- Department of Clinical and Diagnostic Sciences, School of Health Professions, University of Alabama at Birmingham
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Kegler MC, Gauthreaux N, Hermstad A, Arriola KJ, Mickens A, Ditzel K, Hernandez C, Haardörfer R. Inequities in Physical Activity Environments and Leisure-Time Physical Activity in Rural Communities. Prev Chronic Dis 2022; 19:E40. [PMID: 35797473 PMCID: PMC9336193 DOI: 10.5888/pcd19.210417] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Differential access to environments supportive of physical activity (PA) may help explain racial and socioeconomic disparities in leisure-time physical activity (LTPA) in rural communities. METHODS We used baseline data from a mailed survey (N = 728) conducted in 2019 as part of an evaluation of The Two Georgias Initiative to examine the relationships among LTPA, sociodemographic characteristics, and perceived access to supportive PA environments (eg, areas around the home/neighborhood, indoor and outdoor exercise areas, town center connectivity) in 3 rural Georgia counties. RESULTS More than half of respondents (53.5%) engaged in LTPA in the previous month. Perceptions of PA environments were generally neutral to somewhat negative. In multivariable models, overall PA environment was associated with LTPA (OR, 1.58; 95% CI, 1.06-2.35), as was annual household income >$50,000 relative to ≤$20,000 (OR, 2.72; 95% CI, 1.53-4.83) and race, with Black respondents less likely to engage in LTPA than White respondents (OR, 0.49; 95% CI, 0.29-0.85). Of the 5 PA environment domains examined, town center connectivity was significantly associated with LTPA (OR, 1.68, 95% CI, 1.20-2.36). Both the overall PA score (β = -0.014; 95% CI, -0.029 to -0.002) and town center connectivity (β = -0.020; 95% CI, -0.038 to -0.005) partially mediated associations between annual household income and LTPA. Areas supportive of PA around the home/neighborhood partially mediated the association by race (β = 0.016; 95% CI, 0.001-0.034). CONCLUSION Findings lend support for investing in town centers and racially diverse neighborhoods to increase walkability and PA infrastructure as potential strategies to reduce inequities in LTPA.
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Affiliation(s)
- Michelle C. Kegler
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Nicole Gauthreaux
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - April Hermstad
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kimberly Jacob Arriola
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Kelley Ditzel
- Public Administration, Georgia College & State University, Milledgeville, Georgia
| | - Clarisa Hernandez
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Regine Haardörfer
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
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Letarte L, Samadoulougou S, McKay R, Quesnel-Vallée A, Waygood EOD, Lebel A. Neighborhood deprivation and obesity: Sex-specific effects of cross-sectional, cumulative and residential trajectory indicators. Soc Sci Med 2022; 306:115049. [PMID: 35724583 DOI: 10.1016/j.socscimed.2022.115049] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 04/09/2022] [Accepted: 05/15/2022] [Indexed: 11/29/2022]
Abstract
Obesity is a long-term health issue that is becoming increasingly prevalent. Very few studies have considered the life course effects of neighborhood characteristics on obesity. In a sample of 35,856 adult participants (representative of the population of the Province of Quebec in Canada), we measured the association between neighborhood deprivation and obesity using logistic modelling on indicators of cross-sectional neighborhood deprivation, cumulative neighborhood deprivation and trajectories of neighborhood deprivation. For cross-sectional exposure, we found that females in our sample had higher odds of being affected by obesity when living in high-deprivation (OR 1.73, CI 1.41-2.13) or medium-deprivation neighborhoods (OR 1.27, CI 1.07-1.51) compared to females living in low-deprivation neighborhoods. Males also had higher odds of being affected by obesity when living in medium or high deprivation. For cumulative exposure to neighborhood deprivation, only females in the second highest category for longitudinal exposure to deprived neighborhoods had significantly higher odds of living with obesity (OR 1.89 CI 1.12-3.19) compared to females in the low cumulative exposure category. Using sequence analysis to determine neighborhood deprivation trajectories for up to 17 years, we found that females with a Deprived upward (OR 1.75 CI 1.10-2.78), an Average downward (OR 1.75 CI 1.08-2.84) or a Deprived trajectory (OR 1.81 CI 1.45-2.86) had higher odds of living with obesity compared to the Privileged trajectory. For males, there were no significant associations. Using trajectory indicators was beneficial to our analyses because this method shows that not only are individuals in low socioeconomic status neighborhoods at the end of their trajectory more susceptible to living with obesity, but so are those exposed to neighborhood deprivation at the beginning of their trajectory. These results could help to more precisely identify individuals at higher risk of developing obesity-related health issues.
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Affiliation(s)
- Laurence Letarte
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada; Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada.
| | - Sekou Samadoulougou
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada; Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
| | - Rachel McKay
- McGill Observatory on Health and Social Services Reforms, McGill University, Montreal, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Canada
| | - Amélie Quesnel-Vallée
- McGill Observatory on Health and Social Services Reforms, McGill University, Montreal, Canada; Department of Sociology, McGill University, Montreal, Canada
| | | | - Alexandre Lebel
- Center for Research in Regional Planning and Development (CRAD), Laval University, Quebec, Canada; Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
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11
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Recchia D, Perignon M, Rollet P, Vonthron S, Tharrey M, Darmon N, Feuillet T, Méjean C. Associations between retail food environment and the nutritional quality of food purchases in French households: The Mont’Panier cross-sectional study. PLoS One 2022; 17:e0267639. [PMID: 35476754 PMCID: PMC9045620 DOI: 10.1371/journal.pone.0267639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 04/12/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose The purpose of this study was to assess whether the retail food environment, measured by multiple indicators around the home and in activity space, was associated with the nutritional quality of food purchases. Methods This cross-sectional study included 462 households from a quota sampling survey conducted in the south of France (Montpellier Metropolitan Area). The revised Healthy Purchase Index was implemented in order to assess the nutritional quality of food purchases. Food environment indicators (presence, number, relative density and proximity of food outlets) were calculated around the home and in activity space using a geographical information system. Six different types of food outlets were studied: supermarkets, markets, greengrocers, bakeries, other specialized food stores (butcher’s, fishmonger’s and dairy stores) and small grocery stores. Associations between food environment and the nutritional quality of food purchases were assessed using multilevel models, and geographically weighted regressions to account for spatial non-stationarity. Models were adjusted for households’ socioeconomic and demographic characteristics. Results The nutritional quality of food purchases was positively associated with the number of greengrocers around the home (1 vs. 0: β = 0.25, 95%CI = [0.01, 0.49]; >1 vs. 0: β = 0.25, 95%CI = [0.00, 0.50]), but negatively associated with the number of markets around the home (1 vs. 0: β = -0.20, 95%CI = [-0.40, 0.00]; >1 vs. 0: β = -0.37, 95%CI = [-0.69, -0.06]). These associations varied across space in the area studied. For lower income households, the number of greengrocers in activity space was positively associated with the nutritional quality of food purchases (1 vs. 0: β = 0.70, 95%CI = [0.12, 1.3]; >1 vs. 0: β = 0.67, 95%CI = [0.22, 1.1]). Conclusions Greengrocers might be an effective type of food store for promoting healthier dietary behaviors. Further studies, particularly interventional studies, are needed to confirm these results in order to guide public health policies in actions designed to improve the food environment.
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Affiliation(s)
- Daisy Recchia
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
- * E-mail:
| | - Marlène Perignon
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Pascaline Rollet
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Simon Vonthron
- INNOVATION, Univ Montpellier, CIRAD, INRAE, Institut Agro, Montpellier, France
| | - Marion Tharrey
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Nicole Darmon
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
| | - Thierry Feuillet
- University Paris 8, LADYSS, UMR 7533 CNRS, Saint-Denis, France
- Nutritional Epidemiology Research Team (EREN), Inserm, Inrae, Cnam, Epidemiology and Statistics Research Center, Bobigny, France
| | - Caroline Méjean
- MoISA, Univ Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Institut Agro, IRD, Montpellier, France
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12
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Training Computers to See the Built Environment Related to Physical Activity: Detection of Microscale Walkability Features Using Computer Vision. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084548. [PMID: 35457416 PMCID: PMC9028816 DOI: 10.3390/ijerph19084548] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/04/2022] [Accepted: 04/06/2022] [Indexed: 02/02/2023]
Abstract
The study purpose was to train and validate a deep learning approach to detect microscale streetscape features related to pedestrian physical activity. This work innovates by combining computer vision techniques with Google Street View (GSV) images to overcome impediments to conducting audits (e.g., time, safety, and expert labor cost). The EfficientNETB5 architecture was used to build deep learning models for eight microscale features guided by the Microscale Audit of Pedestrian Streetscapes Mini tool: sidewalks, sidewalk buffers, curb cuts, zebra and line crosswalks, walk signals, bike symbols, and streetlights. We used a train−correct loop, whereby images were trained on a training dataset, evaluated using a separate validation dataset, and trained further until acceptable performance metrics were achieved. Further, we used trained models to audit participant (N = 512) neighborhoods in the WalkIT Arizona trial. Correlations were explored between microscale features and GIS-measured and participant-reported neighborhood macroscale walkability. Classifier precision, recall, and overall accuracy were all over >84%. Total microscale was associated with overall macroscale walkability (r = 0.30, p < 0.001). Positive associations were found between model-detected and self-reported sidewalks (r = 0.41, p < 0.001) and sidewalk buffers (r = 0.26, p < 0.001). The computer vision model results suggest an alternative to trained human raters, allowing for audits of hundreds or thousands of neighborhoods for population surveillance or hypothesis testing.
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Abstract
African Americans experience high rates of obesity and food insecurity in part due to structural racism, or overlapping discriminatory systems and practices in housing, education, employment, health care, and other settings. Nutrition education and nutrition-focused policy, systems, and environmental changes may be able to address structural racism in the food environment. This scoping review aimed to summarize the available literature regarding nutrition interventions for African Americans that address structural racism in the food environment and compare them to the "Getting to Equity in Obesity Prevention" framework of suggested interventions. An electronic literature search was conducted with the assistance of a research librarian encompassing 6 databases-MEDLINE, PyscINFO, Agricola, ERIC, SocINDEX, and ProQuest Dissertations & Theses. A total of 30 sources were identified detailing interventions addressing structural barriers to healthy eating. The majority of nutrition interventions addressing structural racism consisted of policy, systems, and/or environmental changes in combination with nutrition education, strategies focused on proximal causes of racial health disparities. Only two articles each targeted the "reduce deterrents" and "improve social and economic resources" aspects of the framework, interventions which may be better suited to addressing structural racism in the food environment. Because African Americans experience high rates of obesity and food insecurity and encounter structural barriers to healthy eating in the food environment, researchers and public health professionals should address this gap in the literature.
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14
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Food deserts and food swamps in a Brazilian metropolis: comparison of methods to evaluate the community food environment in Belo Horizonte. Food Secur 2021. [DOI: 10.1007/s12571-021-01237-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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15
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Min SH, Whittemore R, Kennedy HP, Nam S. Reflections on obesity-related health behaviors over time and suggestions for health promotion programs from African American women. J Women Aging 2021; 34:487-500. [PMID: 34495818 DOI: 10.1080/08952841.2021.1974268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
African American (AA) women have the highest rate of obesity in the United States. To date, there are mixed findings on AA women's perception on obesity and their perceived changes in health behaviors over time that may have contributed to obesity. Therefore, the aims of this current qualitative descriptive study were to explore: 1) AA women's perception on obesity and perceived changes in health behaviors related to obesity through their reflection on life; 2) AA women's perceived facilitators and barriers to maintaining healthy behaviors; and 3) AA women's suggestions for future health promotion programs to manage obesity. Semi-structured interviews with ended questions were conducted with 21 AA women. Luborsky's method for thematic analysis was used to analyze data. Three main themes with subthemes were identified. First main theme was the AA culture that served as a facilitator and barrier to maintaining healthy lifestyle from childhood to young adulthood. Second main theme was gradual changes in their healthy lifestyle due to social and physical environment from young adulthood to middle adulthood. Third main theme was AA women's various suggestions for future health promotion programs. This study found obesity to be a multifactorial phenomenon that is a result of complex interaction of culture, environment, and social networks. Therefore, clinicians need to address the issue of obesity from a holistic perspective for AA women to actively engage with their primary health care. Future health promotion programs should incorporate culturally tailored lifestyle components and increase knowledge on healthy lifestyle against obesity through community-based programs.
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Affiliation(s)
- Se Hee Min
- School of Nursing, Duke University, Durham, North Carolina, USA
| | | | | | - Soohyun Nam
- School of Nursing, Yale University, Orange, Connecticut, USA
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16
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Alejandre JC, Lynch M. "Kids Get in Shape with Nature": A Systematic Review Exploring the Impact of Green Spaces on Childhood Obesity. J Nutr Sci Vitaminol (Tokyo) 2021; 66:S129-S133. [PMID: 33612581 DOI: 10.3177/jnsv.66.s129] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Green and blue spaces (GABS) are vital components of sustainable and healthy communities. Evidence suggest that GABS positively affect population health and wellbeing. However, few studies examine GABS influence on childhood obesity. This systematic review investigates the impact of GABS on childhood obesity particularly on children's physical activity and eating behavior. The search protocol identified 544 studies from PubMed, Medline, PsycINFO, CINAHL, and Web of Science. A two-tier screening process document using the PRISMA flow diagram identified 16 studies which underwent quality analysis using the National Heart, Lung, and Blood Institute (NHLBI) and Critical Appraisal Skills Programme (CASP) tools. Data were interpreted using thematic analysis and narrative synthesis. Selected studies show varying sociodemographic characteristics of sampled populations located in urban and rural settings. The influence of GABS on children's physical activity and eating behaviour depends on the type, location, proximity, density, facilities, and activity types that interplay with gender, ethnicity, and parent-child relationship. The review demonstrates the significant effect of GABS on children's physical activity and eating behaviour. GABS provide children with safe venues for socialisation and long, intensive, and enjoyable physical activity; and influence children's perceptions on vegetable consumption supporting healthier eating behaviour. These spaces have the potential to eradicate childhood obesity if policy, social, economic, environmental, and organisational considerations are addressed.
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17
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Bikomeye JC, Namin S, Anyanwu C, Rublee CS, Ferschinger J, Leinbach K, Lindquist P, Hoppe A, Hoffman L, Hegarty J, Sperber D, Beyer KMM. Resilience and Equity in a Time of Crises: Investing in Public Urban Greenspace Is Now More Essential Than Ever in the US and Beyond. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8420. [PMID: 34444169 PMCID: PMC8392137 DOI: 10.3390/ijerph18168420] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/31/2021] [Accepted: 08/01/2021] [Indexed: 01/14/2023]
Abstract
The intersecting negative effects of structural racism, COVID-19, climate change, and chronic diseases disproportionately affect racial and ethnic minorities in the US and around the world. Urban populations of color are concentrated in historically redlined, segregated, disinvested, and marginalized neighborhoods with inadequate quality housing and limited access to resources, including quality greenspaces designed to support natural ecosystems and healthy outdoor activities while mitigating urban environmental challenges such as air pollution, heat island effects, combined sewer overflows and poor water quality. Disinvested urban environments thus contribute to health inequity via physical and social environmental exposures, resulting in disparities across numerous health outcomes, including COVID-19 and chronic diseases such as cancer and cardiovascular diseases (CVD). In this paper, we build off an existing conceptual framework and propose another conceptual framework for the role of greenspace in contributing to resilience and health equity in the US and beyond. We argue that strategic investments in public greenspaces in urban neighborhoods impacted by long term economic disinvestment are critically needed to adapt and build resilience in communities of color, with urgency due to immediate health threats of climate change, COVID-19, and endemic disparities in chronic diseases. We suggest that equity-focused investments in public urban greenspaces are needed to reduce social inequalities, expand economic opportunities with diversity in workforce initiatives, build resilient urban ecosystems, and improve health equity. We recommend key strategies and considerations to guide this investment, drawing upon a robust compilation of scientific literature along with decades of community-based work, using strategic partnerships from multiple efforts in Milwaukee Wisconsin as examples of success.
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Affiliation(s)
- Jean C. Bikomeye
- Institute for Health & Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (S.N.); (C.A.)
| | - Sima Namin
- Institute for Health & Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (S.N.); (C.A.)
| | - Chima Anyanwu
- Institute for Health & Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (S.N.); (C.A.)
| | - Caitlin S. Rublee
- Department of Emergency Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA;
| | - Jamie Ferschinger
- Sixteenth Street Community Health Centers, Environmental Health & Community Wellness, 1337 S Cesar Chavez Drive, Milwaukee, WI 53204, USA;
| | - Ken Leinbach
- The Urban Ecology Center, 1500 E. Park Place, Milwaukee, WI 53211, USA;
| | - Patricia Lindquist
- Wisconsin Department of Natural Resources, Division of Forestry, 101 S. Webster Street, P.O. Box 7921, Madison, WI 53707, USA;
| | - August Hoppe
- The Urban Wood Lab, Hoppe Tree Service, 1813 S. 73rd Street, West Allis, WI 53214, USA;
| | - Lawrence Hoffman
- Department of GIS, Groundwork Milwaukee, 227 West Pleasant Street, Milwaukee, WI 53212, USA;
| | - Justin Hegarty
- Reflo—Sustainable Water Solutions, 1100 S 5th Street, Milwaukee, WI 53204, USA;
| | - Dwayne Sperber
- Wudeward Urban Forest Products, N11W31868 Phyllis Parkway, Delafield, WI 53018, USA;
| | - Kirsten M. M. Beyer
- Institute for Health & Equity, Medical College of Wisconsin, 8701 Watertown Plank Rd., Milwaukee, WI 53226, USA; (J.C.B.); (S.N.); (C.A.)
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18
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Food Environment in and around Primary School Children's Schools and Neighborhoods in Two Urban Settings in Kenya. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105136. [PMID: 34066180 PMCID: PMC8151559 DOI: 10.3390/ijerph18105136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/29/2021] [Accepted: 05/07/2021] [Indexed: 11/17/2022]
Abstract
We conducted a cross-sectional study to provide an overview primary school children food environment in two urban settings in Kenya. Six schools, catering to children from low-, medium- and high-income households in the cities of Nairobi and Kisumu in Kenya, participated in the study. Data on types of food places and foods offered were collected and healthy and unhealthy food availability scores calculated for each place. We utilized prevalence ratio analysis to examine associations between food availability, food place characteristics and neighborhood income levels. Altogether, 508 food places, located within 1 km of the schools and the school children’s neighborhoods were observed. Open-air market sellers and kiosks were most common. The proportion of food places with high healthy food availability was 2.2 times greater among food places in Nairobi compared to Kisumu, 1.9 times greater in food places with multiple cashpoints, 1.7 times greater in medium/large sized food places and 1.4 times greater in food places located in high income neighborhoods. These findings highlight differences in availability of healthy foods and unhealthy foods across types of food places and neighborhood income levels and inform public health interventions aimed at promoting healthy food environments in Kenya.
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Dixon BN, Ugwoaba UA, Brockmann AN, Ross KM. Associations between the built environment and dietary intake, physical activity, and obesity: A scoping review of reviews. Obes Rev 2021; 22:e13171. [PMID: 33369097 PMCID: PMC8629168 DOI: 10.1111/obr.13171] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/28/2020] [Accepted: 10/28/2020] [Indexed: 02/06/2023]
Abstract
There exists a large body of literature examining the association between built environment factors and dietary intake, physical activity, and weight status; however, synthesis of this literature has been limited. To address this gap, we conducted a scoping review of reviews and identified 74 reviews and meta-analyses that investigated the association between built environment factors and dietary intake, physical activity, and/or weight status. Results across reviews were mixed, with heterogeneous effects demonstrated in terms of strength and statistical significance; however, preliminary support was identified for several built environment factors. For example, quality of dietary intake appeared to be associated with the availability of grocery stores, higher levels of physical activity appeared to be most consistently associated with greater walkability, and lower weight status was associated with greater diversity in land-use mix. Overall, reviews reported substantial concern regarding methodological limitations and poor quality of existing studies. Future research should focus on improving study quality (e.g., using longitudinal methods, including natural experiments, and newer mobile sensing technologies) and consensus should be drawn regarding how to define and measure both built environment factors and weight-related outcomes.
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Affiliation(s)
- Brittney N Dixon
- Department of Health Services Research, Management and Policy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Umelo A Ugwoaba
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Andrea N Brockmann
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Kathryn M Ross
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
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20
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Lam TM, Vaartjes I, Grobbee DE, Karssenberg D, Lakerveld J. Associations between the built environment and obesity: an umbrella review. Int J Health Geogr 2021; 20:7. [PMID: 33526041 PMCID: PMC7852132 DOI: 10.1186/s12942-021-00260-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 01/16/2021] [Indexed: 12/21/2022] Open
Abstract
Background In the past two decades, the built environment emerged as a conceptually important determinant of obesity. As a result, an abundance of studies aiming to link environmental characteristics to weight-related outcomes have been published, and multiple reviews have attempted to summarise these studies under different scopes and domains. We set out to summarise the accumulated evidence across domains by conducting a review of systematic reviews on associations between any aspect of the built environment and overweight or obesity. Methods Seven databases were searched for eligible publications from the year 2000 onwards. We included systematic literature reviews, meta-analyses and pooled analyses of observational studies in the form of cross-sectional, case–control, longitudinal cohort, ecological, descriptive, intervention studies and natural experiments. We assessed risk of bias and summarised results structured by built environmental themes such as food environment, physical activity environment, urban–rural disparity, socioeconomic status and air pollution. Results From 1850 initial hits, 32 systematic reviews were included, most of which reported equivocal evidence for associations. For food- and physical activity environments, associations were generally very small or absent, although some characteristics within these domains were consistently associated with weight status such as fast-food exposure, urbanisation, land use mix and urban sprawl. Risks of bias were predominantly high. Conclusions Thus far, while most studies have not been able to confirm the assumed influence of built environments on weight, there is evidence for some obesogenic environmental characteristics. Registration: This umbrella review was registered on PROSPERO under ID CRD42019135857.
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Affiliation(s)
- Thao Minh Lam
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands. .,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands. .,Department of Epidemiology and Data Science, Amsterdam University Medical Centers (VUmc Location), De Boelelaan 1089a, 1081HV, Amsterdam, the Netherlands.
| | - Ilonca Vaartjes
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Dutch Health Foundation, The Hague, the Netherlands
| | - Diederick E Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Julius Global Health, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands
| | - Derek Karssenberg
- Department of Physical Geography, Utrecht University, Utrecht, the Netherlands.,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands
| | - Jeroen Lakerveld
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Global Geo Health Data Center, University Medical Center Utrecht & Utrecht University, Utrecht, the Netherlands.,Department of Epidemiology and Data Science, Amsterdam University Medical Centers (VUmc Location), De Boelelaan 1089a, 1081HV, Amsterdam, the Netherlands
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21
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Laddu D, Paluch AE, LaMonte MJ. The role of the built environment in promoting movement and physical activity across the lifespan: Implications for public health. Prog Cardiovasc Dis 2021; 64:33-40. [PMID: 33428966 DOI: 10.1016/j.pcad.2020.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 12/30/2020] [Indexed: 12/15/2022]
Abstract
Engaging in regular physical activity (PA) and reducing time spent in sedentary behaviors is critically important to prevent and control non-communicable diseases (NCDs). However, global public health efforts to promote and encourage maintenance of PA behavior on a population level remains challenging. To address what is now described as a global physical inactivity pandemic, a breadth of research has focused on understanding the relation of built environment characteristics, including aspects of urban design, transportation and land-use planning, to PA behavior across multiple domains in life, and subsequently how changes in environmental attributes influence changes in PA patterns in diverse populations and subgroups. This review describes the role the built environment has on improving the promotion and the engagement of PA, particularly in the context of active transportation and leisure time domains of PA. An additional focus will be on the disparities in access to activity-promoting environments and the differential effects of environmental interventions in disadvantaged populations. This paper will further discuss opportunities for public health and policy to advocate for and prioritize the implementation of equitable and effective interventions that aim to expand/improve activity-supportive infrastructures within neighborhoods and communities with the ultimate goal of meaningful population-level increases in PA.
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Affiliation(s)
- Deepika Laddu
- Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL, USA; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL, USA.
| | - Amanda E Paluch
- Department of Kinesiology, University of Massachusetts, Amherst, MA, USA
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, University at Buffalo, The State University of New York, Buffalo, USA
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22
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Kang A, Dulin A, Risica PM. Relationship between adherence to diet and physical activity guidelines and self-efficacy among black women with high blood pressure. J Health Psychol 2020; 27:663-673. [PMID: 33081506 DOI: 10.1177/1359105320967105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Hypertension prevalence is highest among Black women in America. Understanding the relationship between adherence to diet and physical activity using socio-cognitive approaches (e.g. self-efficacy and social support) may be effective approaches in understanding hypertension management. This study found that dietary self-efficacy was associated with dietary adherence, and family social support was associated with both diet and physical activity self-efficacy. Social support mediated the relationship between dietary self-efficacy and dietary adherence. A paradoxical finding emerged where participants in the highest self-efficacy tertile also had higher measured systolic blood pressure. More research is necessary to explore culture-specific factors underlying hypertension treatment management among Black women.
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23
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Stein RA, Ometa O. When public health crises collide: Social disparities and COVID-19. Int J Clin Pract 2020; 74:e13524. [PMID: 32408388 PMCID: PMC7261993 DOI: 10.1111/ijcp.13524] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 04/30/2020] [Indexed: 02/06/2023] Open
Affiliation(s)
- Richard A. Stein
- Department of Chemical and Biomolecular EngineeringNYU Tandon School of EngineeringBrooklynNYUSA
- Department of Natural SciencesLaGuardia Community CollegeCity University of New YorkNew YorkNYUSA
| | - Oana Ometa
- Journalism and Digital Media DepartmentFaculty of Political, Administrative and Communication Sciences Babes‐BolyaiBabes‐Bolyai UniversityCluj‐NapocaRomania
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24
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Iroz-Elardo N, Schoner J, Fox EH, Brookes A, Frank LD. Active travel and social justice: Addressing disparities and promoting health equity through a novel approach to Regional Transportation Planning. Soc Sci Med 2020; 261:113211. [PMID: 32745821 PMCID: PMC7939113 DOI: 10.1016/j.socscimed.2020.113211] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 06/15/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
Public health impacts of transportation policies and infrastructure investment are becoming better understood, particularly for those associated with physical activity. Yet health impacts are not routinely evaluated within the context of the development of a Regional Transportation Plan (RTP) and subsequent programming and investment processes. This is particularly concerning because the spatial distribution of planned transportation infrastructure potentially has significant health equity implications for vulnerable populations at greater risk of chronic disease. This study discusses the application of the National Public Health Assessment Model (NPHAM) - a new approach that expands several scenario planning tools to include health - for the San Joaquin Council of Governments 2018 RTP. It demonstrates how quantifying health impacts at a finer spatial scale (census block groups) helps assess the extent to which RTP strategies are likely to benefit or harm health. It further enables a spatial form of health equity analysis that can help planners understand where infrastructure is most needed to meet social equity goals. To the knowledge of the authors, this is the first example of a quantified, health equity analysis of transport physical activity and a health outcome - body mass index - associated with an RTP; it demonstrates significant advancement in transportation planning practice and policy.
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Affiliation(s)
- Nicole Iroz-Elardo
- Urban Design 4 Health, Inc., 24 Jackie Circle East, Rochester, NY, 14612, USA; University of Arizona, School of Landscape Architecture and Planning, 1040 N. Olive Rd, Tucson, AZ, 85719, USA(1).
| | - Jessica Schoner
- Urban Design 4 Health, Inc., 24 Jackie Circle East, Rochester, NY, 14612, USA; Toole Design Group, 212 3rd Ave N #352, Minneapolis, MN, 55401, USA(1).
| | - Eric H Fox
- Urban Design 4 Health, Inc., 24 Jackie Circle East, Rochester, NY, 14612, USA.
| | - Allen Brookes
- U.S. Environmental Protection Agency, 200 SW 35th St, Corvallis, OR, 97333, USA.
| | - Lawrence D Frank
- Urban Design 4 Health, Inc., 24 Jackie Circle East, Rochester, NY, 14612, USA.
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25
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Owen CG, Limb ES, Nightingale CM, Rudnicka AR, Ram B, Shankar A, Cummins S, Lewis D, Clary C, Cooper AR, Page AS, Procter D, Ellaway A, Giles-Corti B, Whincup PH, Cook DG. Active design of built environments for increasing levels of physical activity in adults: the ENABLE London natural experiment study. PUBLIC HEALTH RESEARCH 2020. [DOI: 10.3310/phr08120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Low physical activity is widespread and poses a serious public health challenge both globally and in the UK. The need to increase population levels of physical activity is recognised in current health policy recommendations. There is considerable interest in whether or not the built environment influences health behaviours, particularly physical activity levels, but longitudinal evidence is limited.
Objectives
The effect of moving into East Village (the former London 2012 Olympic and Paralympic Games Athletes’ Village, repurposed on active design principles) on the levels of physical activity and adiposity, as well as other health-related and well-being outcomes among adults, was examined.
Design
The Examining Neighbourhood Activities in Built Environments in London (ENABLE London) study was a longitudinal cohort study based on a natural experiment.
Setting
East Village, London, UK.
Participants
A cohort of 1278 adults (aged ≥ 16 years) and 219 children seeking to move into social, intermediate and market-rent East Village accommodation were recruited in 2013–15 and followed up after 2 years.
Intervention
The East Village neighbourhood, the former London 2012 Olympic and Paralympic Games Athletes’ Village, is a purpose-built, mixed-use residential development specifically designed to encourage healthy active living by improving walkability and access to public transport.
Main outcome measure
Change in objectively measured daily steps from baseline to follow-up.
Methods
Change in environmental exposures associated with physical activity was assessed using Geographic Information System-derived measures. Individual objective measures of physical activity using accelerometry, body mass index and bioelectrical impedance (per cent of fat mass) were obtained, as were perceptions of change in crime and quality of the built environment. We examined changes in levels of physical activity and adiposity using multilevel models adjusting for sex, age group, ethnic group, housing sector (fixed effects) and baseline household (random effect), comparing the change in those who moved to East Village (intervention group) with the change in those who did not move to East Village (control group). Effects of housing sector (i.e. social, intermediate/affordable, market-rent) as an effect modifier were also examined. Qualitative work was carried out to provide contextual information about the perceived effects of moving to East Village.
Results
A total of 877 adults (69%) were followed up after 2 years (mean 24 months, range 19–34 months, postponed from 1 year owing to the delayed opening of East Village), of whom 50% had moved to East Village; insufficient numbers of children moved to East Village to be considered further. In adults, moving to East Village was associated with only a small, non-significant, increase in mean daily steps (154 steps, 95% confidence interval –231 to 539 steps), more so in the intermediate sector (433 steps, 95% confidence interval –175 to 1042 steps) than in the social and market-rent sectors (although differences between housing sectors were not statistically significant), despite sizeable improvements in walkability, access to public transport and neighbourhood perceptions of crime and quality of the built environment. There were no appreciable effects on time spent in moderate to vigorous physical activity or sedentary time, body mass index or percentage fat mass, either overall or by housing sector. Qualitative findings indicated that, although participants enjoyed their new homes, certain design features might actually serve to reduce levels of activity.
Conclusions
Despite strong evidence of large positive changes in neighbourhood perceptions and walkability, there was only weak evidence that moving to East Village was associated with increased physical activity. There was no evidence of an effect on markers of adiposity. Hence, improving the physical activity environment on its own may not be sufficient to increase population physical activity or other health behaviours.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 8, No. 12. See the NIHR Journals Library website for further project information. This research was also supported by project grants from the Medical Research Council National Prevention Research Initiative (MR/J000345/1).
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Affiliation(s)
- Christopher G Owen
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Elizabeth S Limb
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Claire M Nightingale
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Alicja R Rudnicka
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Bina Ram
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Aparna Shankar
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Steven Cummins
- Population Health Innovation Lab, London School of Hygiene & Tropical Medicine, London, UK
| | - Daniel Lewis
- Population Health Innovation Lab, London School of Hygiene & Tropical Medicine, London, UK
| | - Christelle Clary
- Population Health Innovation Lab, London School of Hygiene & Tropical Medicine, London, UK
| | - Ashley R Cooper
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, Faculty of Social Sciences and Law, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Angie S Page
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, Faculty of Social Sciences and Law, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Duncan Procter
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, Faculty of Social Sciences and Law, University of Bristol, Bristol, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Anne Ellaway
- Medical Research Council and Scottish Government Chief Scientist Office Social and Public Health Sciences Unit, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Billie Giles-Corti
- National Health and Medical Research Council Centre of Research Excellence in Healthy Liveable Communities, Centre for Urban Research, Royal Melbourne Institute of Technology University, Melbourne, VIC, Australia
| | - Peter H Whincup
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Derek G Cook
- Population Health Research Institute, St George’s, University of London, London, UK
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Antonakos C, Baiers R, Dubowitz T, Clarke P, Colabianchi N. Associations between body mass index, physical activity and the built environment in disadvantaged, minority neighborhoods: Predictive validity of GigaPan® imagery. JOURNAL OF TRANSPORT & HEALTH 2020; 17:100867. [PMID: 32368490 PMCID: PMC7196415 DOI: 10.1016/j.jth.2020.100867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 04/12/2020] [Accepted: 04/29/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The built environment has been shown to influence health in studies of disadvantaged populations using different measurement methods. This study determined whether environmental exposures derived from GigaPan® images could serve as valid predictors of body mass index (BMI), walking and moderate to vigorous physical activity (MVPA) in a longitudinal study of low-income adults living in two primarily African American neighborhoods in Pittsburgh, Pennsylvania, USA. GigaPan® is a robotic system used to obtain high-resolution, panoramic images of environments. METHODS Microscale environmental features along 481 streets were audited in 2015-2016 using an audit form. Environmental exposures were estimated for 731 adult participants, using a sample of street segments within a 0.4 km (0.25 mile) network distance from each participant's residential address. Summary environmental exposures were constructed using factor analysis. We tested associations between participant-level environmental exposures and objectively measured BMI, self-reported walking and objectively measured MVPA in regression models controlling for baseline health and demographic variables. RESULTS Three factors representing participants' environmental exposures were constructed: pedestrian bicycle-amenities; hilly-vacant-boarded; physical activity-recreation/low housing density. Environments with infrastructure and amenities supportive of walking and bicycling were associated with lower BMI (Coef. = ‒0.47, p = 0.02). Frequent walking was less likely in environments with more physical activity and recreation venues/low housing density (OR = 0.81, 95% CI [0.67, 0.96]). MVPA was not associated with any of the environmental measures and the hilly-vacant-boarded factor was not associated with any of the outcomes. CONCLUSIONS Predictive validity was demonstrated for an environmental exposure factor that captured features supportive of walking and cycling in a model predicting BMI, using built environment audit data from GigaPan® imagery. A complementary analysis found lower odds of frequent walking in the neighborhood among participants with exposure to more physical activity and recreational features, but fewer types and lower density of housing.
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Affiliation(s)
- Cathy Antonakos
- Environment and Policy Lab, School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | - Ross Baiers
- Environment and Policy Lab, School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
| | | | - Philippa Clarke
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Natalie Colabianchi
- Environment and Policy Lab, School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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27
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Heredia N, Nguyen N, McNeill LH. The Importance of the Social Environment in Achieving High Levels of Physical Activity and Fruit and Vegetable Intake in African American Church Members. Am J Health Promot 2020; 34:886-893. [PMID: 32410458 DOI: 10.1177/0890117120925361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE African Americans experience a high burden of chronic diseases and cancers that are prevented and ameliorated with physical activity (PA) and fruit and vegetable (FV) intake. The purpose of this study is to identify individual, social, and neighborhood variables associated with African Americans attaining high levels of both behaviors. DESIGN This study is a cross-sectional analysis. SETTINGS AND PARTICIPANTS Cohort of African Americans adults recruited from black churches in the Greater Houston area. MEASURES Self-administered questionnaires collected in 2012 assessed correlates and behavioral outcome variables (PA and FV consumption). A combined 4-category behavioral outcome was created: high PA/high FV, low PA/high FV, high PA/low FV, and low PA/low FV. ANALYSIS Standard and stepwise multinomial logistic regression examined the association between the various variables and the behavioral outcome. RESULTS This sample (n = 1009) had a mean age of 49 years, was mostly female, and obese. Compared to the low PA/low FV intake group, the high PA/high FV intake group had significantly lower odds of individual-level variables (worrying about getting cancer, perceived stress, loneliness, and financial strain) and higher odds of social-level variables (social status, social cohesion, social organization involvement, and social norms). Only social-level variables remained significantly associated with higher odds of high PA/high FV intake in stepwise regression. CONCLUSION These findings indicate that social influences may be most critical for high PA and FV intake in African Americans adults.
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Affiliation(s)
- Natalia Heredia
- Department of Health Disparities, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Nga Nguyen
- Department of Health Disparities, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorna H McNeill
- Department of Health Disparities, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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28
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Hooper P, Foster S, Bull F, Knuiman M, Christian H, Timperio A, Wood L, Trapp G, Boruff B, Francis J, Strange C, Badland H, Gunn L, Falconer R, Learnihan V, McCormack G, Sugiyama T, Giles-Corti B. Living liveable? RESIDE's evaluation of the "Liveable Neighborhoods" planning policy on the health supportive behaviors and wellbeing of residents in Perth, Western Australia. SSM Popul Health 2020; 10:100538. [PMID: 32072006 PMCID: PMC7016024 DOI: 10.1016/j.ssmph.2020.100538] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 01/07/2020] [Accepted: 01/08/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The RESIDential Environments (RESIDE) project is a unique longitudinal natural experiment designed to evaluate the health impacts of the "Liveable Neighbourhoods" planning policy, which was introduced by the Western Australian government to create more walkable suburbs. OBJECTIVES To summarize the RESIDE evidence of the impact of the planning policy on a range of health-supportive behaviours and wellbeing outcomes and to assess the consistency and direction of the estimates of associations. METHODS An audit of 26 RESIDE research papers (from 2003 to 2012) identified the number of positive associations (statistically significant and consistent with policy expectations), negative associations (statistically significant and inconsistent with policy expectations), and null findings from multiple-exposure models between objective and perceived measures of 20 policy design requirements and 13 health-supportive behaviors and wellbeing outcomes. RESULTS In total 332 eligible estimates of associations (n = 257 objective measures and n = 75 perceived measures) were identified. Positively significant findings were detected for: 57% of walking estimates with objectively measured policy design features (negative = 3%; null = 40%) (n = 115) and 54% perceived measures (negative = 0%; null = 33%) (n = 27); 42% of sense of community estimates with objectively measured of policy design features (negative = 8%; null = 50%) (n = 12) and 61% perceived measures (negative = 8%; null = 31%) (n = 13); 39% of safety or crime-related estimates with objectively measured of policy design features (negative = 22%; null = 39%) (n = 28) and 100% perceived measures (n = 7). All (n = 4) estimates for mental health outcomes with objectively measured policy-related design features were positively significant. CONCLUSIONS The synthesis of findings suggests that new suburban communities built in accordance with the "Liveable Neighbourhoods" policy have the potential to encourage health supportive behaviors and wellbeing outcomes including transport and recreation walking, and to create neighborhoods with a stronger sense of community where residents may feel safer.
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Affiliation(s)
- Paula Hooper
- Australian Urban Design Research Centre, School of Design, The University of Western Australia, Perth, Australia
| | - Sarah Foster
- Centre for Urban Research, RMIT University, Melbourne, Victoria, Australia
- School of Agriculture and Environment, The University of Western Australia, Perth, Australia
| | - Fiona Bull
- School of Health Sciences, The University of Western Australia, Perth, Australia
- Department of Prevention of Non-communicable Diseases, World Health Organization, Geneva, Switzerland
| | - Matthew Knuiman
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Hayley Christian
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Lisa Wood
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Gina Trapp
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Bryan Boruff
- School of Agriculture and Environment, The University of Western Australia, Perth, Australia
| | - Jacinta Francis
- Telethon Kids Institute, The University of Western Australia, Perth, Australia
| | - Cecily Strange
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Hannah Badland
- Centre for Urban Research, RMIT University, Melbourne, Victoria, Australia
| | - Lucy Gunn
- Centre for Urban Research, RMIT University, Melbourne, Victoria, Australia
| | | | - Vincent Learnihan
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, ACT, Australia
| | - Gavin McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, NW Calgary, Alberta, Canada
| | - Takemi Sugiyama
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Billie Giles-Corti
- Centre for Urban Research, RMIT University, Melbourne, Victoria, Australia
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Letarte L, Pomerleau S, Tchernof A, Biertho L, Waygood EOD, Lebel A. Neighbourhood effects on obesity: scoping review of time-varying outcomes and exposures in longitudinal designs. BMJ Open 2020; 10:e034690. [PMID: 32213520 PMCID: PMC7170601 DOI: 10.1136/bmjopen-2019-034690] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
CONTEXT AND OBJECTIVES Neighbourhood effect research on obesity took off in the early 2000s and was composed of mostly cross-sectional observational studies interested in various characteristics of the built environment and the socioeconomic environment. To limit biases related to self-selection and life course exposures, many researchers apply longitudinal designs in their studies. Until now, no review has specifically and exclusively examined longitudinal studies and the specific designs of these studies. In this review, we intend to answer the following research question: how are the temporal measurements of contextual exposure and obesity outcomes integrated into longitudinal studies that explore how neighbourhood-level built and socioeconomic environments impact adult obesity? DESIGN A systematic search strategy was designed to address the research question. The search was performed in Embase, Web of Science and PubMed, targeting scientific papers published before 1 January 2018. The eligible studies reported results on adults, included exposure that was limited to neighbourhood characteristics at the submunicipal level, included an outcome limited to obesity proxies, and reported a design with at least two exposure measurements or two outcome measurements. RESULTS This scoping review identified 66 studies that fit the eligibility criteria. A wide variety of neighbourhood characteristics were also measured, making it difficult to draw general conclusions about associations between neighbourhood exposure and obesity. We applied a typology that classified studies by whether exposure and outcome were measured as varying or fixed. Using this typology, we found that 32 studies reported both neighbourhood exposure and obesity outcomes that were varying in time; 28 reported varying outcomes but fixed exposures; and 6 had fixed outcomes and varying exposures. CONCLUSION Our typology illustrates the variety of longitudinal designs that were used in the selected studies. In the light of our results, we make recommendations on how to better report longitudinal designs and facilitate comparisons between studies.
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Affiliation(s)
- Laurence Letarte
- Planning and Development Research Center, Université Laval, Quebec city, Québec, Canada
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute, Quebec city, Québec, Canada
| | - Sonia Pomerleau
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute, Quebec city, Québec, Canada
- School of Nutrition, Université Laval, Quebec city, Québec, Canada
| | - André Tchernof
- School of Nutrition, Université Laval, Quebec city, Québec, Canada
- Quebec Heart and Lung Institute Research Centre, Université Laval, Quebec city, Québec, Canada
| | - Laurent Biertho
- Quebec Heart and Lung Institute Research Centre, Université Laval, Quebec city, Québec, Canada
- Departement of Surgery, Université Laval, Quebec city, Québec, Canada
| | - Edward Owen D Waygood
- Department of Civil, Geological and Mining Engineering, Polytechnique Montreal, Montreal, Québec, Canada
| | - Alexandre Lebel
- Planning and Development Research Center, Université Laval, Quebec city, Québec, Canada
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Research Institute, Quebec city, Québec, Canada
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Bauer AG, Berkley-Patton J, Bennett K, Catley D, Bowe-Thompson C, Lister S, Christensen K. Dietary Intake Among Church-Affiliated African Americans: The Role of Intentions and Beliefs. JOURNAL OF BLACK PSYCHOLOGY 2019. [DOI: 10.1177/0095798419887629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Diabetes and heart disease disproportionately burden African Americans, who tend to have worse nutritional intake than Whites. Many Black churches are influential institutions in the Black community, with potential to assist with promotion of healthy eating behaviors. The purpose of the current study was to use the Theory of Planned Behavior (TPB) to examine intention to eat a healthy diet and dietary behaviors among church-affiliated African Americans. It was hypothesized that TPB constructs would positively predict intention to eat a healthy diet and that intention to eat a healthy diet would be a predictor of fat and fruit and vegetable intake. It was also hypothesized that control beliefs would predict reduced fat intake and increased fruit and vegetable intake. Path analyses indicated behavioral, normative, and control beliefs were predictive of intention to eat a healthy diet. Intention to eat healthy was a significant predictor of dietary intake behaviors. These findings provide support for the use of the TPB in examining diet among church-affiliated African Americans. This study represents an opportunity to inform dietary interventions for the African American faith community.
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Affiliation(s)
| | | | - Kym Bennett
- University of Missouri–Kansas City, Kansas City, MO, USA
| | | | | | - Sheila Lister
- University of Missouri–Kansas City, Kansas City, MO, USA
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31
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Dean CA, Zhang D, Kulchycki KT, Ventline B, Jagirdar R, Milan RA. Social Determinants of Cardiovascular Disease among Michigan Residents: A Call to Action for Population Health Initiatives. J Racial Ethn Health Disparities 2019; 7:144-161. [PMID: 31713223 DOI: 10.1007/s40615-019-00644-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/30/2019] [Accepted: 09/24/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Little is known about the cardiovascular health (CVH) and social determinants of cardiovascular diseases (SDCVDs) among Michigan residents by race and ethnicity. Therefore, the objective of this cross-sectional study was to determine the CVH of Michigan residents and to examine the relationship between CVH and SDCVDs by race/ethnicity and age. METHODOLOGY Michigan-level data consisting of 10,889 participants was extracted from the 2017 Behavioral Risk Factor Surveillance System data. Descriptive statistics examined the adjusted proportions of the CVH measures and determined the adjusted mean CVH score for the SDCVDs among racial/ethnic groups by age. Generalized ordinal logistic regression analyses assessed the relationship between residents' CVH and SDCVDs by racial/ethnic status. All analyses were performed using STATA MP14. RESULTS Residents from each racial/ethnic group did not meet the criteria for ideal BMI. The mean CVH score was found to be low for Black (2.65; 95% CI, 2.41-2.89) and Hispanic (2.84; 95% CI, 2.29-3.40) residents ≥ 50 years old with a high school degree or less. Black residents unemployed for more than a year were less likely to have a high CVH score (OR = 0.45; 95% CI, 0.21-80.97) compared with Black residents employed for wages. CONCLUSION Michigan residents' CVH is lacking across multiple dimensions. Multifaceted population health initiatives are warranted to address influential SDCVDs to diminish the CVH disparities identified across racial/ethnic and age groups.
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Affiliation(s)
- Caress A Dean
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA.
| | - Diana Zhang
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA
| | - Kevin T Kulchycki
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA
| | - Brittany Ventline
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA
| | - Rachita Jagirdar
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA
| | - Rebecca A Milan
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA
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Cesare N, Dwivedi P, Nguyen Q, Nsoesie EO. Use of Social Media, Search Queries, and Demographic Data to Assess Obesity Prevalence in the United States. PALGRAVE COMMUNICATIONS 2019; 5:106. [PMID: 32661492 PMCID: PMC7357895 DOI: 10.1057/s41599-019-0314-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/13/2019] [Indexed: 06/11/2023]
Abstract
Obesity is a global epidemic affecting millions. Implementation of interventions to curb obesity rates requires timely surveillance. In this study, we estimated sex-specific obesity prevalence using social media, search queries, demographics and built environment variables. We collected 3,817,125 and 1,382,284 geolocated tweets on food and exercise respectively, from Twitter's streaming API from April 2015 to March 2016. We also obtained searches related to physical activity and diet from Google Search Trends for the same time period. Next, we inferred the gender of Twitter users using machine learning methods and applied mixed-effects state-level linear regression models to estimate obesity prevalence. We observed differences in discussions of physical activity and foods, with males reporting higher intensity physical activities and lower caloric foods across 40 and 48 states, respectively. Additionally, counties with the highest percentage of exercise and food tweets had lower male and female obesity prevalence. Lastly, our models separately captured overall male and female spatial trends in obesity prevalence. The average correlation between actual and estimated obesity prevalence was 0.789 (95% CI, 0.785, 0.786) and 0.830 (95% CI, 0.830, 0.831) for males and females, respectively. Social media can provide timely community-level data on health information seeking and changes in behaviors, sentiments and norms. Social media data can also be combined with other data types such as, demographics, built environment variables, diet and physical activity indicators from other digital sources (e.g., mobile applications and wearables) to monitor health behaviors at different geographic scales, and to supplement delayed estimates from traditional surveillance systems.
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Affiliation(s)
- Nina Cesare
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
| | - Pallavi Dwivedi
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Quynh Nguyen
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, Maryland, USA
| | - Elaine O. Nsoesie
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, USA
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA
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How Does the Built Environment in Compact Metropolitan Cities Affect Health? A Systematic Review of Korean Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162921. [PMID: 31416292 PMCID: PMC6720808 DOI: 10.3390/ijerph16162921] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/09/2019] [Accepted: 08/10/2019] [Indexed: 12/15/2022]
Abstract
This systematic review aimed to examine the associations between health-related outcomes and the built environment (BE) characteristics of compact metropolitan cities in Korea using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Searching the three Korean academic databases and PubMed, two independent reviewers identified 27 empirical articles published between 2011 and 2016. Data extracted for review included the study characteristics, the variables and measurement methods related to the BE and health-related outcomes, and the findings on the associations between the BE characteristics and health-related outcomes. Vote counting was used to assess the consistency of associations and the direction of associations between the BE characteristics and health-related outcomes. All of the reviewed studies used cross-sectional designs. The objective BE qualities were commonly examined. The BE characteristics associated with health-related outcomes in the reviewed articles included land use, street environment, transportation infrastructure, green and open spaces, and neighborhood facilities. Street environment, transportation infrastructure, and green and open spaces had consistent positive associations with physical health. Mixed land use and neighborhood facilities, however, had inconsistent associations with physical health. Generally, insufficient findings were reported in the association between the BE characteristics and mental and social health. The accessibility of the BE in a compact urban environment was the prominent attribute related to health promotion, health challenges, and health equity. An international comparative analysis of compact cities with different urban contexts and scale is required. Interdisciplinary urban health strategies are recommended based on the associations between the BE characteristics and health-related outcomes.
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Abshire DA, Wilson DK, Sweeney AM, Pinto BM. Correlates of Moderate-to-Vigorous Physical Activity and Exercise Motivation in Underserved African American Men. Am J Mens Health 2019; 13:1557988319855155. [PMID: 31148501 PMCID: PMC6545657 DOI: 10.1177/1557988319855155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Effective interventions are needed to increase physical activity (PA) in African American men, but little is known about correlates of PA and exercise motivation in this population. Using an ecological approach that considers cognitive, social, and environmental factors, correlates of moderate-to-vigorous physical activity (MVPA) and exercise motivation in underserved African American men were examined. Greater exercise motivation, greater social support for exercise, and more favorable environmental perceptions were hypothesized to be associated with higher MVPA, and greater social support and environmental perceptions were hypothesized to be associated with higher exercise motivation. This secondary analysis used baseline data from the Positive Action for Today’s Health (PATH) trial. African American men (n = 166, aged 48 ± 15 years) completed surveys that assessed cognitive, social, and environmental factors theoretically relevant to MVPA. Accelerometers were used to obtain a 7-day estimate of MVPA. Hierarchical linear regression analyses showed that exercise motivation was positively associated with MVPA (B = 1.15, SE = .41, p = .006). Exercise attitudes (B = .16, SE = .07, p = .037), exercise self-concept (B = .28, SE = .06, p < .001), exercise support from friends (B = .12, SE = .06, p = .048), and places for walking and cycling (B = .13, SE = .06, p = .032) were positively associated with exercise motivation. Interventions that improve exercise motivation and associated variables may be warranted to increase MVPA in underserved African American men. ClinicalTrials.gov # NCT01025726
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Affiliation(s)
| | - Dawn K Wilson
- 2 Department of Psychology, University of South Carolina, College of Arts and Sciences, Columbia, SC, USA
| | - Allison M Sweeney
- 2 Department of Psychology, University of South Carolina, College of Arts and Sciences, Columbia, SC, USA
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Johnson-Lawrence V, Bailey S, Sanders PE, Sneed R, Angel-Vincent A, Brewer A, Key K, Lewis EY, Johnson JE. The Church Challenge: A community-based multilevel cluster randomized controlled trial to improve blood pressure and wellness in African American churches in Flint, Michigan. Contemp Clin Trials Commun 2019; 14:100329. [PMID: 30886933 PMCID: PMC6402374 DOI: 10.1016/j.conctc.2019.100329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 01/09/2019] [Accepted: 01/18/2019] [Indexed: 01/07/2023] Open
Abstract
Chronic disease carries high morbidity and mortality in the United States, with large racial and ethnic disparities observed in chronic disease. Physical activity and healthy food are vital for chronic disease prevention yet challenging to access in economically distressed areas. Public health prevention efforts have become particularly prominent within faith-based organizations over the last three decades. This manuscript describes the protocol of the Church Challenge, a multilevel cluster-randomized controlled nutrition and physical activity trial across 24 churches to reduce blood pressure by 6 mmHg among 576 residents in Flint, MI. The Church Challenge was developed using community-based participatory approaches and is rooted in a church-based program developed by and for primarily African-American Flint church congregations. This three-level intervention addresses health at the community (level 3), church (level 2), and individual (level 1) to reduce blood pressure, reduce chronic disease risk, and promote health equity and wellbeing in Flint. Churches are randomized in a 1:1 ratio to a 16-week physical activity and nutrition program or a 4-session health and wellness workshop. Flint is not a unique community but has a history of traumatic community wide events; even now, the public health infrastructure continues to be a challenge and distract residents from focusing on their health. This trial is highly significant and innovative because it uses a combination of evidence-based practices simultaneously supporting health behavior change for individuals and their faith organizations, and evaluates multilevel efforts to sustain long-term health promotion activities in vulnerable communities like Flint.
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Affiliation(s)
- Vicki Johnson-Lawrence
- Division of Public Health, College of Human Medicine, Michigan State University, 200 E 1st St, Flint, MI, 48502, USA
| | | | - Patrick E. Sanders
- Community Outreach for Families and Youth, 1015 Carpenter Rd, Flint, MI, 48505, USA
| | - Rodlescia Sneed
- Division of Public Health, College of Human Medicine, Michigan State University, 200 E 1st St, Flint, MI, 48502, USA
| | - Ariel Angel-Vincent
- Division of Public Health, College of Human Medicine, Michigan State University, 200 E 1st St, Flint, MI, 48502, USA
| | - Allysoon Brewer
- Division of Public Health, College of Human Medicine, Michigan State University, 200 E 1st St, Flint, MI, 48502, USA
| | - Kent Key
- Division of Public Health, College of Human Medicine, Michigan State University, 200 E 1st St, Flint, MI, 48502, USA
| | | | - Jennifer E. Johnson
- Division of Public Health, College of Human Medicine, Michigan State University, 200 E 1st St, Flint, MI, 48502, USA
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Travert AS, Sidney Annerstedt K, Daivadanam M. Built Environment and Health Behaviors: Deconstructing the Black Box of Interactions-A Review of Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1454. [PMID: 31022911 PMCID: PMC6517917 DOI: 10.3390/ijerph16081454] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 04/13/2019] [Accepted: 04/15/2019] [Indexed: 01/08/2023]
Abstract
A review of reviews following a scoping review study design was conducted in order to deconstruct the black box of interactions between the built environment and human behaviors pertaining to physical activity and/or diet. In the qualitative analysis 107 records were included, 45 of which were also coded. Most review papers confirmed the influence of the built environment on the behaviors of interest with some noting that a same built environment feature could have different behavioral outcomes. The conceptual model developed sheds light on these mixed results and brings out the role of several personal and behavioral factors in the shift from the measured to the perceived built environment. This shift was found to shape individuals' behaviors critically and to have the power of redefining the strength of every interaction. Apart from its theoretical relevance, this model has high practical relevance especially for the design and implementation of interventions with a behavioral component. Intervention researchers can use the model developed to identify and label the built environment and individual factors that can be measured objectively or perceived as facilitators, concurrent options and barriers, in order to develop comprehensive and multi-component intervention strategies.
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Affiliation(s)
- Anne-Sophie Travert
- School of Public Affairs, Sciences Po, 75007 Paris, France.
- Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden.
| | | | - Meena Daivadanam
- Department of Public Health Sciences, Karolinska Institutet, 171 77 Stockholm, Sweden.
- Department of Food Studies, Nutrition and Dietetics, Uppsala University; 751 22 Uppsala, Sweden.
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Bell CN, Kerr J, Young JL. Associations between Obesity, Obesogenic Environments, and Structural Racism Vary by County-Level Racial Composition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050861. [PMID: 30857286 PMCID: PMC6427384 DOI: 10.3390/ijerph16050861] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 02/14/2019] [Accepted: 02/28/2019] [Indexed: 11/29/2022]
Abstract
Obesity rates in the U.S. are associated with area-level, food-related characteristics. Studies have previously examined the role of structural racism (policies/practices that advantaged White Americans and deprived other racial/ethnic minority groups), but racial inequalities in socioeconomic status (SES) is a novel indicator. The aim of this study is to determine the associations between racial inequalities in SES with obesity and obesogenic environments. Data from 2007–2014 County Health Rankings and 2012–2016 County Business Patterns were combined to assess the associations between relative SES comparing Blacks to Whites with obesity, and number of grocery stores and fast food restaurants in U.S. counties. Random effects linear and Poisson regressions were used and stratified by county racial composition. Racial inequality in poverty, unemployment, and homeownership were associated with higher obesity rates. Racial inequality in median income, college graduates, and unemployment were associated with fewer grocery stores and more fast food restaurants. Associations varied by county racial composition. The results demonstrate that a novel indicator of structural racism on the county-level is associated with obesity and obesogenic environments. Associations vary by SES measure and county racial composition, suggesting the ability for targeted interventions to improve obesogenic environments and policies to eliminate racial inequalities in SES.
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Affiliation(s)
- Caryn N Bell
- Department of African American Studies, University of Maryland, College Park, MD 20724, USA.
| | - Jordan Kerr
- School of Public Health, University of Maryland, College Park, MD 20724, USA.
| | - Jessica L Young
- Department of Health Studies, American University, Washington, DC 20016, USA.
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Bell CN, Holder MB. The Interrelationship between Race, Social Norms, and Dietary Behaviors among College-attending Women. Am J Health Behav 2019; 43:23-36. [PMID: 30522564 PMCID: PMC7370700 DOI: 10.5993/ajhb.43.1.3] [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] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Objective: The association between social norms and dietary behaviors is well-documented, but few studies examine the role of race. The aim of this study was to determine the interrelationships among race, social norms, and dietary behaviors. Methods: We used data from the Healthy Friends Network Study (a pilot study of women attending a southern university). Dietary behaviors, social norms, and self-identified race were obtained. Results: African Americans had lower odds of daily vegetable (OR = 0.55, 95% CI = 0.38-0.79) and fruit consumption (OR = 0.45, 95% CI = 0.30-0.67), but no race difference in frequent consumption of fatty/fried/salty/sugary foods was observed in fully adjusted models. Proximal descriptive norms were associated with all dietary behaviors, but distal injunctive social norms were associated with lower odds of frequent unhealthy food consumption (OR = 0.10, 95% CI = 0.05-0.21). Race differences in family descriptive norms were found to mediate race differences in vegetable and fruit consumption by 7%-9%. However, race differences in friend and family injunctive norms mediated 20%-50% of the effects of race on frequent unhealthy food consumption. Conclusions: Proximal injunctive norms account for race differences in unhealthy food consumption. Future studies should further explicate the mechanisms and seek to utilize social norms in behavior change interventions.
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Affiliation(s)
- Caryn N Bell
- University of Maryland, College Park, Department of African American Studies, College Park, MD;,
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Zhang H, Yin L. A Meta-analysis of the Literature on the Association of the Social and Built Environment With Obesity: Identifying Factors in Need of More In-Depth Research. Am J Health Promot 2018; 33:792-805. [DOI: 10.1177/0890117118817713] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objective: This study aims to identify groups of the social and built environment factors that have been studied substantially along with factors that need further attention, to guide the research, designing, and planning of the social and built environment for reducing obesity prevalence. Data Source: A systematic search of literature was undertaken from PubMed, Google Scholar, and Web of Knowledge. Study Inclusion and Exclusion Criteria: Keyword combination of “built environment,” “social environment,” and “obesity” were used to expand the search scope. Exclusion criteria included (1) any article with less than 50 citations from 2005 to 2010, and those with less than 25 citations from 2011 to 2015. In this way we included the most prominent peer-reviewed studies published in recent years while excluding less influential publications; (2) any article published in a language other than English; (3) literature review articles; (4) any article studying health outcomes not obesity related. We included research on eating behaviors since the studies contributed profoundly to food environment research. Data Synthesis: A meta-analysis of 153 empirical studies, selected from 2005 to 2015 based on a series of criteria, was conducted using factor analysis. The exploratory factor analysis was undertaken to group the prevalence and use of the social and built environment factors associated with obesity. Results: The findings suggested that the research community has gained a substantial understanding of the D variables of the built environment, including density, diversity, design, distance to transit, and destination access. Factors concerning different age groups, minority populations, groups with low socioeconomic status, food environment, and street-level urban design features have been less examined. Conclusions: The findings are important to guide future research directions, giving more attention to the factors in need of more in-depth research.
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Affiliation(s)
- Hao Zhang
- Department of Urban and Regional Planning, School of Architecture and Planning, University at Buffalo, Buffalo, NY, USA
| | - Li Yin
- Department of Urban and Regional Planning, School of Architecture and Planning, University at Buffalo, Buffalo, NY, USA
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Gary-Webb TL, Bear TM, Mendez DD, Schiff MD, Keenan E, Fabio A. Evaluation of a Mobile Farmer's Market Aimed at Increasing Fruit and Vegetable Consumption in Food Deserts: A Pilot Study to Determine Evaluation Feasibility. Health Equity 2018; 2:375-383. [PMID: 30582097 PMCID: PMC6301430 DOI: 10.1089/heq.2018.0003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: In November 2015, Greater Pittsburgh Community Food Bank implemented a pilot phase of the Green Grocer mobile market, a program aimed at improving access to locally sourced fresh foods in low-resource neighborhoods. We conducted an evaluation of this pilot phase. Methods: We conducted baseline surveys of residents in six neighborhoods that received Green Grocer in the pilot phase to understand the food environment, including perceptions of fresh food availability, and another survey of Green Grocer consumers to evaluate their experiences and satisfaction. We measured respondent intake of fruit and vegetable in the terms of days per week and servings per day. We used Poisson regression with cluster-robust standard errors to model the average change in produce consumption pre-post intervention. Results: Residents of select communities observed meaningful improvements in intake. After covariate adjustment, Homewood residents observed an average 13% increase in vegetable intake (days/week) rates post-Green Grocer (p=0.04). Clairton residents also showed marked increases, with an average 20% increase in vegetable intake (servings/day) (p=0.049). After 6 months, declines in produce purchase from discount stores and supercenters were observed alongside increases in procurement from Green Grocer, farmer's markets, gardens, and other sources. Conclusion: Our preliminary work provides support that this mobile market serving under-resourced areas was valued by consumers and showed increases in vegetable consumption in several neighborhoods. When scaled-up, this program had the potential to reduce geographically-based food and health disparities.
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Affiliation(s)
- Tiffany L Gary-Webb
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.,Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Todd M Bear
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Dara D Mendez
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Mary D Schiff
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Ehrrin Keenan
- Greater Pittsburgh Community Food Bank, Pittsburgh, Pennsylvania
| | - Anthony Fabio
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
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University⁻Community Partnerships Using a Participatory Action Research Model to Evaluate the Impact of Dance for Health. Behav Sci (Basel) 2018; 8:bs8120113. [PMID: 30558171 PMCID: PMC6316364 DOI: 10.3390/bs8120113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/05/2018] [Accepted: 12/09/2018] [Indexed: 01/02/2023] Open
Abstract
Little is known about fostering sustainable, collaborative community-academic partnerships that effectively improve physical activity and health in residents of under resourced communities using Participatory Action Research (PAR) driven models. The purpose of this PAR study was to evaluate the impact of an urban, intergenerational, and physical activity dance program by identifying community preferred measurable outcomes that promote program participation and sustainability. A descriptive, qualitative design was employed using semi-structured interview guides to facilitate discussions for two adult focus groups and one youth focus group. Exactly 19 community-residing adults and six youth who lived in urban neighborhoods in West Philadelphia participated in the discussions. The audiotapes were transcribed and analyzed using directed content analysis. Five outcome themes emerged and included: (1). Enhancing the psychological and emotional well-being of the individual, (2). Enhancement of social well-being and management of interpersonal relationships and responsibilities (3). Enhancing and promoting physiologic well-being (4). Changes in health promoting behaviors and skill acquisition, and (5). Concerns about accessibility of dance for health and other physical activity programs in the community. Focused attention to measuring community preferred outcomes can promote sustainability of Dance for Health and possibly other urban-based physical activity dance programs.
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Coughenour C, Bungum TJ, Regalado MN. Healthy Food Options at Dollar Discount Stores Are Equivalent in Quality and Lower in Price Compared to Grocery Stores: An Examination in Las Vegas, NV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2773. [PMID: 30544503 PMCID: PMC6313477 DOI: 10.3390/ijerph15122773] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 11/22/2018] [Accepted: 12/04/2018] [Indexed: 11/16/2022]
Abstract
Food deserts indicate limited access to and affordability of healthy foods. One potential mediator is the availability of healthy food in non-traditional outlets such as dollar-discount stores, stores selling produce at the fixed $1 price. The purpose of this study was to compare availability, quality, price differences in 'healthier' versus 'regular' food choices, price per each food item, and summary score in dollar-discount stores to grocery stores in Las Vegas using the NEMS-S; a protocol consisting of three subscores-availability, quality, price of healthier versus regular food, and a summary score. A 25% sample of grocery stores (n = 40) and all dollar-discount stores (n = 14) were evaluated. t-tests showed that dollar-discount stores were less likely to price healthy options lower than their unhealthy alternatives (mean (M) = 1.0 vs. M = 2.5; p < 0.001) and had reduced availability (M = 20.50 vs. M = 23.80; p < 0.001) compared to grocery stores. The quality of produce did not differ (M = 5.93 vs. M = 6.00; p = 0.34). Price comparisons revealed that 84.2% of produce and 89.5% of other food items were significantly less expensive at the dollar-discount stores, with only two items being more expensive. While dollar-discount stores did have lower availability, they provided quality fresh and healthy foods which were usually less expensive. Findings indicate that dollar discount stores may be an existing community asset, and considering them as such may aid in efforts to strengthen the overall food system. Practitioners should consider dollar discount stores when assessing the community food environment and designing and implementing outreach programs, as they may bridge some disparities in access.
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Affiliation(s)
- Courtney Coughenour
- School of Community Health Sciences, University of Nevada, 4505 S. Maryland Parkway Box 3064, Las Vegas, NV 89154, USA.
| | - Timothy J Bungum
- School of Community Health Sciences, University of Nevada, 4505 S. Maryland Parkway Box 3064, Las Vegas, NV 89154, USA.
| | - M Nikki Regalado
- School of Community Health Sciences, University of Nevada, 4505 S. Maryland Parkway Box 3064, Las Vegas, NV 89154, USA.
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Nykiforuk CIJ, Atkey K, Brown S, Caldwell W, Galloway T, Gilliland J, Kongats K, McGavock J, Raine KD. Promotion of physical activity in rural, remote and northern settings: a Canadian call to action. Health Promot Chronic Dis Prev Can 2018; 38:419-435. [PMID: 30430816 PMCID: PMC6262980 DOI: 10.24095/hpcdp.38.11.03] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION The lack of policy, practice and research action on physical activity and features of the physical (built and natural) environments in rural, remote and northern settings is a significant threat to population health equity in Canada. This paper presents a synthesis of current evidence on the promotion of physical activity in non-urban settings, outcomes from a national priority-setting meeting, and a preliminary call to action to support the implementation and success of population-level initiatives targeting physical activity in non-urban settings. METHODS We conducted a "synopses of syntheses" scoping review to explore current evidence on physical activity promotion in rural, remote, northern and natural settings. Next, we facilitated a collaborative priority-setting conference with 28 Canadian experts from policy, research and practice arenas to develop a set of priorities on physical activity in rural, remote and northern communities. These priorities informed the development of a preliminary Canadian call to action. RESULTS We identified a limited number of reviews that focused on physical activity and the built environment in rural, remote and northern communities. At the prioritysetting conference, participants representing rural, remote and northern settings identified top priorities for policy, practice and research action to begin to address the gaps and issues noted in the literature. These priorities include self-identifying priorities at the community level; compiling experiences; establishing consistency in research definitions and methods; and developing mentorship opportunities. CONCLUSION Coordinated action across policy, practice and research domains will be essential to the success of the recommendations presented in this call to action.
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Affiliation(s)
| | - Kayla Atkey
- Alberta Policy Coalition for Chronic Disease Prevention, Edmonton, Alberta, Canada
| | - Sara Brown
- NWT Association of Communities, Yellowknife, Northwest Territories, Canada
| | - Wayne Caldwell
- School of Environmental Design and Rural Development, University of Guelph, Guelph, Ontario, Canada
| | - Tracey Galloway
- Department of Anthropology, University of Toronto, Toronto, Ontario, Canada
| | - Jason Gilliland
- Department of Geography, Western University, London, Ontario, Canada
| | - Krystyna Kongats
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jonathan McGavock
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Carducci B, Oh C, Keats EC, Gaffey MF, Roth DE, Bhutta ZA. PROTOCOL: Impact of the food environment on diet-related health outcomes in school-age children and adolescents in low- and middle-income countries: a systematic review. CAMPBELL SYSTEMATIC REVIEWS 2018; 14:1-55. [PMID: 37131391 PMCID: PMC8428038 DOI: 10.1002/cl2.198] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
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Maharana A, Nsoesie EO. Use of Deep Learning to Examine the Association of the Built Environment With Prevalence of Neighborhood Adult Obesity. JAMA Netw Open 2018; 1:e181535. [PMID: 30646134 PMCID: PMC6324519 DOI: 10.1001/jamanetworkopen.2018.1535] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
IMPORTANCE More than one-third of the adult population in the United States is obese. Obesity has been linked to factors such as genetics, diet, physical activity, and the environment. However, evidence indicating associations between the built environment and obesity has varied across studies and geographical contexts. OBJECTIVE To propose an approach for consistent measurement of the features of the built environment (ie, both natural and modified elements of the physical environment) and its association with obesity prevalence to allow for comparison across studies. DESIGN The cross-sectional study was conducted from February 14 through October 31, 2017. A convolutional neural network, a deep learning approach, was applied to approximately 150 000 high-resolution satellite images from Google Static Maps API (application programing interface) to extract features of the built environment in Los Angeles, California; Memphis, Tennessee; San Antonio, Texas; and Seattle (representing Seattle, Tacoma, and Bellevue), Washington. Data on adult obesity prevalence were obtained from the Centers for Disease Control and Prevention's 500 Cities project. Regression models were used to quantify the association between the features and obesity prevalence across census tracts. MAIN OUTCOMES AND MEASURES Model-estimated obesity prevalence (obesity defined as body mass index ≥30, calculated as weight in kilograms divided by height in meters squared) based on built environment information. RESULTS The study included 1695 census tracts in 6 cities. The age-adjusted obesity prevalence was 18.8% (95% CI, 18.6%-18.9%) for Bellevue, 22.4% (95% CI, 22.3%-22.5%) for Seattle, 30.8% (95% CI, 30.6%-31.0%) for Tacoma, 26.7% (95% CI, 26.7%-26.8%) for Los Angeles, 36.3% (95% CI, 36.2%-36.5%) for Memphis, and 32.9% (95% CI, 32.8%-32.9%) for San Antonio. Features of the built environment explained 64.8% (root mean square error [RMSE], 4.3) of the variation in obesity prevalence across all census tracts. Individually, the variation explained was 55.8% (RMSE, 3.2) for Seattle (213 census tracts), 56.1% (RMSE, 4.2) for Los Angeles (993 census tracts), 73.3% (RMSE, 4.5) for Memphis (178 census tracts), and 61.5% (RMSE, 3.5) for San Antonio (311 census tracts). CONCLUSIONS AND RELEVANCE This study illustrates that convolutional neural networks can be used to automate the extraction of features of the built environment from satellite images for studying health indicators. Understanding the association between specific features of the built environment and obesity prevalence can lead to structural changes that could encourage physical activity and decreases in obesity prevalence.
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Affiliation(s)
- Adyasha Maharana
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle
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Ding D, Nguyen B, Learnihan V, Bauman AE, Davey R, Jalaludin B, Gebel K. Moving to an active lifestyle? A systematic review of the effects of residential relocation on walking, physical activity and travel behaviour. Br J Sports Med 2018; 52:789-799. [PMID: 29858466 DOI: 10.1136/bjsports-2017-098833] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To synthesise the literature on the effects of neighbourhood environmental change through residential relocation on physical activity, walking and travel behaviour. DESIGN Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number CRD42017077681). DATA SOURCES Electronic databases for peer-reviewed and grey literature were systematically searched to March 2017, followed by forward and backward citation tracking. ELIGIBILITY CRITERIA A study was eligible for inclusion if it (1) measured changes in neighbourhood built environment attributes as a result of residential relocation (either prospectively or retrospectively); (2) included a measure of physical activity, walking, cycling or travel modal change as an outcome; (3) was quantitative and (4) included an English abstract or summary. RESULTS A total of 23 studies was included in the review. Among the eight retrospective longitudinal studies, there was good evidence for the relationship between relocation and walking (consistency score (CS)>90%). For the 15 prospective longitudinal studies, the evidence for the effects of environmental change/relocation on physical activity or walking was weak to moderate (CS mostly <45%), even weaker for effects on other outcomes, including physical activity, cycling, public transport use and driving. Results from risk of bias analyses support the robustness of the findings. CONCLUSION The results are encouraging for the retrospective longitudinal relocation studies, but weaker evidence exists for the methodologically stronger prospective longitudinal relocation studies. The evidence base is currently limited, and continued longitudinal research should extend the plethora of cross-sectional studies to build higher-quality evidence.
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Affiliation(s)
- Ding Ding
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Binh Nguyen
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Vincent Learnihan
- Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Adrian E Bauman
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Rachel Davey
- Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Bin Jalaludin
- Department of Epidemiology, Healthy People and Places Unit, Population Health, South Western Sydney Local Health District, Liverpool, New South Wales, Australia.,Ingham Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Klaus Gebel
- Prevention Research Collaboration, Charles Perkins Centre, Sydney School of Public Health, University of Sydney, Camperdown, New South Wales, Australia.,School of Allied Health, Australian Catholic University, North Sydney, New South Wales, Australia.,Centre for Chronic Disease Prevention, College of Public Health, Medical and Veterinary Sciences, James Cook University, Smithfield, Queensland, Australia
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Bivoltsis A, Cervigni E, Trapp G, Knuiman M, Hooper P, Ambrosini GL. Food environments and dietary intakes among adults: does the type of spatial exposure measurement matter? A systematic review. Int J Health Geogr 2018; 17:19. [PMID: 29885662 PMCID: PMC5994245 DOI: 10.1186/s12942-018-0139-7] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 06/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The relationships between food environments and dietary intake have been assessed via a range of methodologically diverse measures of spatial exposure to food outlets, resulting in a largely inconclusive body of evidence, limiting informed policy intervention. OBJECTIVE This systematic review aims to evaluate the influence of methodological choice on study outcomes by examining the within-study effect of availability (e.g., counts) versus accessibility (e.g., proximity) spatial exposure measures on associations with diet. METHODS (PROSPERO registration: CRD42018085250). PubMed, Web of Science, Scopus and ScienceDirect databases were searched for empirical studies from 1980 to 2017, in the English language, involving adults and reporting on the statistical association between a dietary outcome and spatial exposure measures of both availability and accessibility. Studies were appraised using an eight-point quality criteria with a narrative synthesis of results. RESULTS A total of 205 associations and 44 relationships (i.e., multiple measures of spatial exposure relating to a particular food outlet type and dietary outcome) were extracted from 14 eligible articles. Comparative measures were dominated by counts (availability) and proximity (accessibility). Few studies compared more complex measures and all counts were derived from place-based measures of exposure. Sixteen of the 44 relationships had a significant effect involving an availability measure whilst only 8 had a significant effect from an accessibility measure. The largest effect sizes in relationships were mostly for availability measures. After stratification by scale, availability measure had the greatest effect size in 139 of the 176 pairwise comparisons. Of the 33% (68/205) of associations that reached significance, 53/68 (78%) were from availability measures. There was no relationship between study quality and reported study outcomes. CONCLUSIONS The limited evidence suggests that availability measures may produce significant and greater effect sizes than accessibility measures. However, both availability and accessibility measures may be important concepts of spatial exposure depending on the food outlet type and dietary outcome examined. More studies reporting on multi-method effects are required to differentiate findings by the type of spatial exposure assessment and build an evidence base regarding the appropriateness and robustness of measures under different circumstances.
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Affiliation(s)
- Alexia Bivoltsis
- School of Population and Global Health, The University of Western Australia, M451, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia.
| | - Eleanor Cervigni
- School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Gina Trapp
- School of Population and Global Health, The University of Western Australia, M451, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia.,Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, WA, 6872, Australia
| | - Matthew Knuiman
- School of Population and Global Health, The University of Western Australia, M451, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia
| | - Paula Hooper
- School of Agriculture and Environment and the School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia
| | - Gina Leslie Ambrosini
- School of Population and Global Health, The University of Western Australia, M451, 35 Stirling Highway, Crawley, Perth, WA, 6009, Australia
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Physical Activity in Parents of Young African American Children: The Application of Social Cognitive Theory. Res Theory Nurs Pract 2018. [DOI: 10.1891/1541-6577.32.1.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background:Social cognitive theory (SCT) proposes that personal and environmental factors influence behavior bidirectionally. Research examining the personal and environmental factors of physical activity (PA) among African Americans (AAs) framed by SCT is scarce.Purpose:The purpose of this article is to enhance knowledge of SCT as a foundation for health promotion and PA research, in general, and among AAs. Findings from a previous study provide exemplars for key factors and relationships in SCT.Implications for Research and Practice:The SCT serves as a good framework for researchers studying health promotion and PA in generalamong AA parents.
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Asaduzzaman M, Chowdhury S, Shahed JH, Kafi MAH, Uzzaman MN, Flowra MT, Ahmed MM. Prevalence of Type 2 Diabetes Mellitus Among Urban Bihari Communities in Dhaka, Bangladesh: A Cross-sectional Study in a Minor Ethnic Group. Cureus 2018; 10:e2116. [PMID: 29593946 PMCID: PMC5871323 DOI: 10.7759/cureus.2116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction The prevalence, disease progression, and treatment outcomes for patients with type 2 diabetes vary significantly between ethnic groups. The Bihari community constitutes one of the most vulnerable populations in Bangladesh on the basis of access to health services and other fundamental rights. Our study aimed at finding out the prevalence and risk factors of type 2 diabetes among the Bihari adults in Dhaka city. Methods This cross-sectional community-based study was carried out among stranded Pakistanis (known as Bihari) living in camps in the Mirpur area from July 2014 to June 2015. Laboratory-based oral glucose tolerance test (OGTT) was the basis for the diagnosis of type 2 diabetes mellitus (DM). Anthropometric measurements, blood pressure, biochemical tests, family history, and socioeconomic information were obtained to determine the risk factors. Results The prevalence of diabetes mellitus (DM), impaired glucose tolerance (IGT), and impaired fasting glucose (IFG) were estimated at 10.11%, 8.74%, and 4.55%, respectively. Increased diastolic blood pressure, serum triglyceride, and cholesterol level were observed to be significantly (p < 0.05) associated with diabetes. Also, the presence of diabetes, high blood pressure, and obesity among relatives significantly increased the probability of diabetes. Conclusions To the best of our knowledge, this is the first study on diabetes prevalence among the Bihari community in Bangladesh. The prevalence of type 2 diabetes mellitus was found to be higher among the Bihari community compared to the general population in Bangladesh. Health planners and policymakers should realize the alarming situation and identified risk factors and consider the minor ethnic groups during decision-making regarding prevention and control of diabetes and other noncommunicable diseases.
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Affiliation(s)
- Muhammad Asaduzzaman
- Laboratory Sciences & Services Division, International Centre for Diarrhoeal Disease Research Bangladesh (icddr,b)
| | - Shahanaz Chowdhury
- Department of Community Health, Bangladesh University of Health Sciences,dhaka,bangladesh
| | | | | | - Md Nazim Uzzaman
- Technical Training Unit, International Centre for Diarrhoeal Disease Research, Bangladesh (Icddr,B)
| | | | - Msa Mansur Ahmed
- Department of Community Medicine, Bangladesh University of Health Sciences,dhaka,bangladesh
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