A multilevel analysis of the association between social networks and support on leisure time physical activity: evidence from 40 disadvantaged areas in London

The Effect of Social Networks on Active Living in Adolescents: Qualitative Focus Group Study

BACKGROUND

Participation in organized sports and other forms of active living have important health benefits in adolescence and adulthood. Unfortunately, the transition to secondary school has been shown to be a barrier to participation. Social networks can play important roles in activating adolescents, and information and communication technology (ICT) interventions can augment this role. To date, there are few insights into what adolescents themselves think and feel about barriers to and motivators for active living, the role of their social networks in active living, and the potential of ICT for physical activity (PA).

OBJECTIVE

This study aimed to gather insights into the perspectives of adolescents aged 12 to 14 years on active living and sports participation, motivators and demotivators for active living, and the potential roles of their social network and of ICT.

METHODS

A total of 26 adolescents aged 12 to 14 years from different levels of Dutch secondary schools participated in 1 of 5 semistructured focus group interviews, in which they talked about sports and PA, their social networks, their ICT use, and the role of social networks and ICT in PA. All interviews were transcribed and analyzed using a thematic qualitative approach.

RESULTS

The study showed that all participants were physically active, although the transition to secondary school made this difficult, mostly because of time constraints. Participants saw positive physical and mental health effects as important benefits of active living. They regarded social benefits as strong motivators for active living: being together, making friends, and having fun together. However, the social network could also demotivate through negative peer judgment and negative feedback. Participants were willing to share their own positive experiences and hear about those from close peers and friends but would not share their own (and were not interested in others') negative experiences or personal information. Participants were mainly interested in descriptive norms set by others and obtained inspiration from others for PA. With respect to using ICT for active living, participants stated a preference for social challenges among friends, personalized feedback, goals, activities, and rewards. Competition was seen as less important or even unattractive. If mentioned, participants felt that this should be with friends, or peers of a similar level, with fun being more important than the competition itself.

CONCLUSIONS

This study shows that adolescents feel that their social network is and can be a strong driver of active living. They are willing to use ICT-based solutions that make use of social networks for PA as long as these solutions involve their current (close) network and use an approach based on being together and having fun together.

Effects of Social Networks in Promoting Young Adults' Physical Activity among Different Sociodemographic Groups

Introduction: Physical inactivity has become a public health issue as it can trigger many chronic diseases. Studies have found that an individual’s social networks (SNs) influence their engagement in physical activity (PA). However, it remains unclear how the influence varies between different sociodemographic groups. This study examined the associations between the SN structures and the PA of young adults across sociodemographic groups. Method: Data on 14,595 young adults aged 24–32 were obtained from Wave IV of the National Longitudinal Study of Adolescent to Adult Health. Latent class analysis was conducted to identify heterogeneous subgroups of respondents with respect to their engagement in PA and SN structures were measured in terms of the relationship quality, contact frequency, network size, and spatial accessibility. Logistic regression and chi-square tests were used to further test the relationships between PA and SNs as well as the sociodemographic factors. Results: SNs were found to have a significant influence on PA. Relationship quality was identified as the most important feature of an individual’s SN, followed by network size, contact frequency, and accessibility. The effects of SNs on PA varied with the individuals’ gender, ethnicity, income, and educational attainment. For example, male participants tended to be physically active if they had frequent connections with their neighbors, while the engagement in PA of the female participants was strongly related to the frequency of their contact with their children. Conclusions: This research has important implications for practitioners as it suggests that PA intervention programs should be designed to target specific population groups.

Social isolation is a direct determinant of decreased home-cage activity in mice: A within-subjects study using a body-implantable actimeter

NEW FINDINGS

What is the central question of this study? It is generally recognized that social isolation is associated with physical inactivity; however, is social isolation a direct determinant of decreased physical activity? What is the main finding and its importance? We conducted a within-subjects experiment with the aid of a body-implantable actimeter. Our results clearly demonstrated that social isolation decreased home-cage activity in mice. This might have resulted from increased immobility and decreased vigorous activity, suggesting that avoiding social isolation is important to preventing physical inactivity.

ABSTRACT

An inactive lifestyle can negatively affect physiological and mental health. Social isolation is associated with physical inactivity; however, it remains uncertain whether social isolation is a direct determinant of decreased physical activity. Hence, we assessed whether social isolation decreases home-cage activity using a within-subjects design and examined the effects of social isolation on hippocampal neurogenesis in mice. This study used a body-implantable actimeter called nanotag®, which enabled us to measure home-cage activity despite housing the mice in groups. We first examined the influence of the intraperitoneal implantation of nanotag® on home-cage activity. Although nanotag® implantation decreased home-cage activity temporarily, 7 days post-implantation, it recovered to the same level as that of control (non-implanted) mice, suggesting that implantation of nanotag® does not have a negative influence on home-cage activity if mice undergo a 1-week recovery period after implantation. In the main experiment, after the 1-week baseline measurement performed while in group housing, the mice were placed in a group or in isolation. Home-cage activity was measured for an additional 4 weeks. Home-cage activity in isolated mice during the dark period decreased by 26% from pre-intervention to the last week of intervention. Furthermore, the reduction in the number of 5-minute epochs during which the activity count exceeded 301 (an index of vigorous activity) was significantly larger for isolated mice. Contrary to expectations, social isolation did not impair hippocampal neurogenesis. Our results demonstrate that social isolation is a direct determinant of decreased physical activity, possibly because of reduced vigorous physical activity. This article is protected by copyright. All rights reserved.

Types of social networks and starting leisure activities in later life: A longitudinal Japan Gerontological Evaluation Study (JAGES)

Considering beneficial effects of leisure activities in later life on well-being and health, we investigated which type of social network among older adults is associated with starting their participation in leisure activities. We used data from a longitudinal Japan Gerontological Evaluation Study (JAGES) conducted in Japan every three years from 2010 to 2016. We extracted types of social networks of older adults who did not participate in leisure activities in 2013 and responded to items related to social networks (n = 3436) relying on latent class analysis to examine changes in leisure activity participation over a three-year period within each latent class while controlling for participants' activity in 2010. As a result, we identified five latent classes of social networks: the Neighborhood network, the Restricted network, which is characterized by limited social contacts, the Colleagues network, the Same-Interest network, and the Diverse network, from the most to the least prevalent. We found that members of the Neighborhood (Cohen's d = 0.161) and Same-Interest networks (d = 0.660) were significantly more likely to, and members of the Diverse (d = 0.124) and Colleague networks (d = 0.060) were not significantly more likely to start leisure activities than those in the Restricted network. Furthermore, we found that lower age, better mental health, and higher education level were positively associated with starting participation in leisure activities in some latent classes. Horticulture or gardening was most likely to be chosen across all latent classes. Supporting the formation of social networks facilitating leisure activities, and recommending activities that were likely to be selected could be one solution for getting and keeping older adults active.

Personal social capital and self-rated health among middle-aged and older adults: a cross-sectional study exploring the roles of leisure-time physical activity and socioeconomic status

Background

Personal social capital, which refers to the scope and quality of an individual’s social networks within a community, has received increasing attention as a potential sociological factor associated with better individual health; yet, the mechanism relating social capital to health is still not fully understood. This study examined the associations between social capital and self-rated health while exploring the roles of leisure-time physical activity (LTPA) and socioeconomic status (SES) among middle-aged and older adults.

Methods

Cross-sectional data were collected from 662 middle-aged and older adults (Mean age: 58.11 ± 10.59 years old) using the Qualtrics survey panel. Personal Social Capital Scale was used to measure bonding and bridging social capital and the International Physical Activity Questionnaire was used to assess LTPA levels. SES was assessed by education and household income levels. Self-rated health was assessed using a single item, by which the participants were categorized into the two groups, having ‘good’ vs. ‘not good’ self-rated health. A series of univariate and multivariate logistic regression models were established to examine the independent and adjusted associations of social capital with self-rated health and to test mediating and moderating roles of LTPA and SES, respectively.

Results

Bonding and bridging social capital were positively associated with self-rated health (Odds ratios = 1.11 and 1.09; P’s < .05, respectively), independent of LTPA that was also significantly associated with greater self-rated health (P-for-linear trends = .007). After adjusting SES, the associations of social capital were significantly attenuated and there was a significant interaction effect by household income (P-for-interaction = .012). Follow-up analyses stratified by household income showed that beneficial associations of social capital with self-rated health were more apparent among the people with low and high levels of household income; yet, LTPA was the stronger predictor of self-rated health among those in the middle class of household income.

Conclusions

Findings suggest that both social capital and LTPA are associated with better self-rated health; yet, these associations vary by SES. The health policymakers should address both social capital and LTPA for enhancing perceived health among aging populations but may need to consider varying SES backgrounds.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-020-10043-6.

An Interventional strategy of physical activity promotion for reduction of menopause symptoms

Background: Physical activity (PA) programs are inexpensive, non-pharmaceutical and universally accessible options with demonstrated efficacy in reducing menopausal symptoms. The purpose of this study was to determine the effectiveness of a behavioral strategy for initiating and sustaining PA with the hope to reduce or eliminate menopausal symptoms.

Methods : Menopausal and perimenopausal women (n=190) were randomly assigned to intervention (n=95) and non-intervention (n=95) groups using a random-numbers table. The intervention group consisted of 18 neighborhood network subgroups, each consisting of five to six women known to one another. They participated in a 12-week regular PA program, augmented by eight interactive group education and discussion sessions. The Menopause Rating Scale (MRS) self-report instrument was used to determine perceived severity of menopausal symptoms.

Results: The intervention group showed a significant reduction in the frequency and severity of menopausal symptoms (P < 0.001). Those whose symptoms rated severe/very severe for hot flushes were reduced from 30.1% to 11.8%. Also, participants whose sleep problems and joint discomfort rated severe/very severe declined from 28% to 6.5% and joint discomfort rated severe or very severe was reduced from 52.7% to 4.4%, respectively. Conversely in the nonintervention group, hot flushes, sleep problems and joint problems got significantly worse(P < 0.05).

Conclusion: Implementing educational program that increases awareness of PA benefits in combination with existing neighborhood networks that facilitate communication and cooperation may increase PA levels and decrease menopausal symptoms. Such networks offer alow-cost means of improving quality of life (QOL) for perimenopausal and menopausal women.

Social isolation, loneliness, socioeconomic status, and health-risk behaviour in deprived neighbourhoods in Denmark: A cross-sectional study

The importance of social isolation and loneliness on our health is widely recognised in previous research. This study compares loneliness in deprived neighbourhood with that in the general population. It further examines whether social isolation and loneliness are associated with health-risk behaviours (including low intake of fruit or vegetables, daily smoking, high-risk alcohol intake, and physical inactivity and their co-occurrence) in deprived neighbourhoods, and whether social isolation and loneliness modify the associations between socioeconomic status and health-risk behaviours. Cross-sectional data from 5113 residents of 12 deprived neighbourhoods in Denmark were analysed using multiple logistic regression. Data on 14,686 individuals from the nationally representative Danish Health and Morbidity Survey 2010 were used as a comparison group with regard to loneliness. Cohabitation status, frequency of meeting with family and friends, participation in voluntary work were used as an indicator to measure social isolation. A question on feeling often unwillingly alone was used as an indicator to measure loneliness. Compared with the general population, residents of deprived neighbourhoods had higher odds of loneliness. Both social isolation and loneliness were significantly associated with higher odds of health-risk behaviour. When social isolation and loneliness were combined with low socioeconomic status, strong associations with health-risk behaviours were found. Social isolation and loneliness did not significantly modify the associations between socioeconomic status and health-risk behaviour. The findings in this study have important implications for the future planning of health promotion intervention programmes aimed to reduce health-risk behaviour in deprived neighbourhoods.

Reliability and Validity of a Culturally Adaptive Version of the International Physical Activity Questionnaire in Indian Subcontinent: A Cross-sectional Study

BACKGROUND

Physical activity (PA) is one of the prime public health problems occurring globally. Regular PA is associated with a decrease in all-causes of mortality irrespective of gender. The study was conducted to investigate the validity and an aspect of reliability of a modified version of the International Physical Activity Questionnaire (IPAQ) in the Indian subcontinent (InS).

METHODS

Cross-sectional study, to evaluate the validity and reliability of the InS IPAQ-LF compared with a range of biological variables. In total, 198 participants (50% women) with a mean age of 35.6 (SD = 10.3) years selected from neighborhoods with variable socioeconomic status and PA.

RESULTS

The InS IPAQ-LF demonstrated good test-retest reliability for total PA (Intraclass correlation coefficient [ICC] =0.79, 95% CI 0.65 to 0.82), occupational PA (ICC = 0.77, 95% CI 0.68 to 0.82), active transportation (ICC = 0.82, 95% CI 0.75 to 0.87), and vigorous-intensity activities (ICC = 0.82, 95% CI 0.76 to 0.87). Reliability was substantially higher for total PA (ICC = 0.80), occupational PA (ICC = 0.78), leisure-time PA (ICC = 0.75), and active transportation (ICC = 0.80) in men than in women, but domestic PA (ICC = 0.38) and sitting time (ICC = 0.71) demonstrated more substantial reliability coefficients in women than in men.

CONCLUSIONS

The InS IPAQ-LF demonstrated considerate evidence of test-retest reliability and may be valid for evaluating context specific PA mannerisms of adults in InS.

Evidence to Improve Physical Activity among Medically Underserved Older adults: A Scoping Review

BACKGROUND AND OBJECTIVES

Participation in leisure physical activity (PA) and engagement in PA interventions among older adults is influenced by socioeconomic status (SES), race/ethnicity, and environment. However, studies of PA for medically underserved older adults have not yet been systematically evaluated. The objective of this study is to map the nature and extent of research conducted on PA participation, interventions, and components of effective leisure PA programs for medically underserved older adults.

RESEARCH DESIGN AND METHODS

The five-stage approach was used to conduct this scoping review. We searched PubMed, CINAHL, and Cochrane Library for peer-reviewed studies published between 2006 and 2016. Data extracted from selected studies included study population, study type, purpose of intent, evidence level, barriers to PA participation, and components of PA intervention.

RESULTS

Three hundred and ninety-two articles were identified, and 60 studies were included in the final data charting. Existing literature showed that most studies remained descriptive in nature, and few intervention studies have achieved a high level of evidence. Among 21 intervention studies, only 4 were explicitly conducted for older adults. Culturally adapted materials, race/ethnicity-specific barriers and facilitators, and form of intervention were important components for intervention programs.

DISCUSSION AND IMPLICATIONS

Findings indicate that more studies are needed to reduce health disparities related to PA participation for medically underserved older adults. Intervention components such as race/ethnicity-relevant barriers and facilitators and culturally sensitive materials are also needed for PA interventions targeting underserved older adults in order to provide evidence for best practices.

Correlates of Physical Activity Among Disadvantaged Groups: A Systematic Review

CONTEXT

Socioeconomically disadvantaged adults have lower engagement in leisure-time physical activity than those who are more affluent. Identification of correlates of physical activity can inform the design of effective interventions. The aim of this systematic review was to identify consistent correlates of unspecified physical activity and leisure-time physical activity among socioeconomically disadvantaged adults.

EVIDENCE ACQUISITION

PubMed and Scopus were searched up to May 2018, and titles/abstracts and full texts were screened against eligibility criteria. Methodologic quality was assessed, and correlates were synthesized from July to September 2018.

EVIDENCE SYNTHESIS

Seventy-three studies were selected for synthesis; 48 examined unspecified physical activity and 31 examined leisure-time physical activity (6 examined both). Self-rated health, functional capacity, and physical activity self-efficacy were consistently, positively associated with unspecified physical activity. Mental health status and perceived benefits and enjoyment of physical activity were consistently, positively associated with leisure-time physical activity. Most studies were cross-sectional and used validated self-report measures of physical activity; few reported response rates >50%.

CONCLUSIONS

Few factors were consistently associated with either unspecified physical activity or leisure-time physical activity. Based on available evidence, strategies to increase physical activity should consider the needs of, and focus on, those with poor self-rated health and functional capacity and should use strategies to improve physical activity self-efficacy. Strategies to increase leisure-time physical activity should focus on simultaneously addressing leisure-time physical activity and mental health concerns and improving perceptions of physical activity benefits and enjoyment. It is recommended that future studies focus on leisure-time physical activity, focus on men, use longitudinal design, examine variables related to behavioral attributes and skills, and carefully consider and plan recruitment strategies.

Disentangling Race, Poverty, and Place in Disparities in Physical Activity

Significant racial disparities in physical activity-a key protective health factor against obesity and cardiovascular disease-exist in the United States. Using data from the 1999-2004 National Health and Nutrition Examination Survey and the 2000 United States (US) Census, we estimated the impact of race, individual-level poverty, neighborhood-level poverty, and neighborhood racial composition on the odds of being physically active for 19,678 adults. Compared to whites, blacks had lower odds of being physically active. Individual poverty and neighborhood poverty were associated with decreased odds of being physically active among both whites and blacks. These findings underscore the importance of social context in understanding racial disparities in physical activity and suggest the need for future research to determine specific elements of the social context that drive disparities.

Smartphone-Delivered Peer Physical Activity Counseling Program for Individuals With Spinal Cord Injury: Protocol for Development and Pilot Evaluation

Background

Leisure-time physical activity (LTPA) is a critical component of a healthy lifestyle for individuals with spinal cord injury (SCI). However, most individuals are not sufficiently active to accrue health benefits. The Active Living Lifestyles program for individuals with SCI who use manual wheelchairs (ALLWheel) targets important psychological factors that are associated with LTPA uptake and adherence while overcoming some barriers associated with participation restrictions.

Objective

The goal of the paper is to describe the protocol for the development and evaluation of the ALLWheel program for individuals with SCI who use manual wheelchairs.

Methods

The first three stages of the Medical Research Council framework for developing and evaluating complex interventions (ie, preclinical, modeling, exploratory) are described. The preclinical phase will consist of scoping and systematic reviews and review of theory. The intervention will be modeled by expert opinions and consensus through focus groups and Delphi surveys with individuals with SCI, clinicians, and community partners. Finally, the feasibility and potential influence of the ALLWheel program on LTPA and psychological outcomes will be evaluated.

Results

This project is funded by the Craig H Neilsen Foundation, the Fonds de Recherche du Québec–Santé, and the Canadian Disability Participation Project and is currently underway.

Conclusions

Using peer trainers and mobile phone technology may help to cultivate autonomy-supportive environments that also enhance self-efficacy. Following a framework for developing and evaluating a novel intervention that includes input from stakeholders at all stages will ensure the final product (ie, a replicable intervention) is desirable to knowledge users and ready for evaluation in a randomized controlled trial. If effective, the ALLWheel program has the potential to reach a large number of individuals with SCI to promote LTPA uptake and adherence.

International Registered Report Identifier (IRRID)

DERR1-10.2196/10798

Social Network Spatial Model

Our work is motivated by a desire to incorporate the vast wealth of social network data into the framework of spatial models. We introduce a method for modeling the spatial correlations that exist over a social network. In particular, we model attributes measured for each member of the network as a continuous process over the social space created by their connections. Our method simultaneously models the unobserved locations of network members in social space and the spatial process that exists over that space based on the observed network connections and nodal attributes. The model is evaluated through simulation studies and applied to the importance ranking for a network of emergency response organizations and the physical activity habits of teenage girls. The introduced methods incorporate network data into the spatial framework, expanding traditional models to include this often relevant source of additional information.

The power of social networks and social support in promotion of physical activity and body mass index among African American adults

Social support and social networks can elucidate important structural and functional aspects of social relationships that are associated with health-promoting behaviors, including Physical Activity (PA) and weight. A growing number of studies have investigated the relationship between social support, social networks, PA and obesity specifically among African Americans; however, the evidence is mixed and many studies focus exclusively on African American women. Most studies have also focused on either functional or structural aspects of social relationships (but not both) and few have objectively measured moderate-to-vigorous physical activity (MVPA) and body mass index (BMI). Cross-sectional surveys of adult African American men and women living in two low-income predominantly African American neighborhoods in Pittsburgh, PA (N = 799) measured numerous structural features as well as functional aspects of social relationships. Specifically, structural features included social isolation, and social network size and diversity. Functional aspects included perceptions of social support for physical activity from the social network in general as well as from family and friends specifically. Height, weight, and PA were objectively measured. From these, we derived Body Mass Index (BMI) and moderate-to-vigorous physical activity (MVPA). All regression models were stratified by gender, and included age, income, education, employment, marital status, physical limitations, and a neighborhood indicator. Greater social isolation was a significant predictor of lower BMI among men only. Among women only, social isolation was significantly associated with increased MVPA whereas, network diversity was significantly associated with reduced MVPA. Future research would benefit from in-depth qualitative investigations to understand how social networks may act to influence different types of physical activity among African Americans, as well as understand how they can be possible levers for health promotion and prevention.

•

Contributes to research on the social environment and physical activity among African Americans.

•

Social isolation was associated with lower BMI among men.

•

Social isolation was associated with more physical activity among women.

•

More social network diversity was associated with less physical activity among women.

Why are some groups physically active and others not? A contrast group analysis in leisure settings

BACKGROUND

This field study aims to investigate the determinants of physical activity of particularly active and inactive groups in their leisure environments. In order to consider the context in which physical activity occurs and to investigate whether cultural settings may influence physical activity, we conducted the study at pools in different cultural environments - Hawai'i and Germany.

METHODS

This study presents the quantitative data of a systematic (covert) participant observation. We recorded the physical activity of face-to-face interacting groups and analysed categories such as group size, estimated age of the group members, and verbal communication patterns. Total observation period was eight and a half months. In total, we observed 907 groups with the groups' size varying between 2 and 8 members. For the general statistics, we accessed the significance of differences regarding the degree of physical activity dependent on the target variables. To better understand activity promoting and hindering mechanisms, special attention is given to the identification of contrasting factors that characterise groups which are very active or very inactive. For this, we conducted a classification tree analysis.

RESULTS

General statistical analysis shows that, overall, the most differentiating factor regarding physical activity was the body shape of the group members. While obese groups had the lowest average activity level, groups mainly consisting of people with an athletic body shape were the most physically active. Yet, classification tree analysis reveals that obesity itself does not necessarily determine physical inactivity levels. The identification of six contrasting clusters highlights that besides the body shape several factors interact regarding a group's physical level. Such interacting factors were for example the degree of communication within the group, the gender- and age-related composition of the group, but also the equipment that had been brought to the beach/pool. Obese people were particularly inactive when they were members of frequently communicating, age-heterogeneous groups.

CONCLUSIONS

Our study shows that several social factors determine the physical activity of very active and very inactive groups. In order to promote physical activity, future health initiatives should target these factors of a person's network.

Engineering Online and In-Person Social Networks for Physical Activity: A Randomized Trial

BACKGROUND

Social networks can influence physical activity, but little is known about how best to engineer online and in-person social networks to increase activity.

PURPOSE

The purpose of this study was to conduct a randomized trial based on the Social Networks for Activity Promotion model to assess the incremental contributions of different procedures for building social networks on objectively measured outcomes.

METHODS

Physically inactive adults (n = 308, age, 50.3 (SD = 8.3) years, 38.3 % male, 83.4 % overweight/obese) were randomized to one of three groups. The Promotion group evaluated the effects of weekly emailed tips emphasizing social network interactions for walking (e.g., encouragement, informational support); the Activity group evaluated the incremental effect of adding an evidence-based online fitness walking intervention to the weekly tips; and the Social Networks group evaluated the additional incremental effect of providing access to an online networking site for walking as well as prompting walking/activity across diverse settings. The primary outcome was mean change in accelerometer-measured moderate-to-vigorous physical activity (MVPA), assessed at 3 and 9 months from baseline.

RESULTS

Participants increased their MVPA by 21.0 min/week, 95 % CI [5.9, 36.1], p = .005, at 3 months, and this change was sustained at 9 months, with no between-group differences.

CONCLUSIONS

Although the structure of procedures for targeting social networks varied across intervention groups, the functional effect of these procedures on physical activity was similar. Future research should evaluate if more powerful reinforcers improve the effects of social network interventions.

TRIAL REGISTRATION NUMBER

The trial was registered with the ClinicalTrials.gov (NCT01142804).

The Smartphone Peer Physical Activity Counseling (SPPAC) Program for Manual Wheelchair Users: Protocol of a Pilot Randomized Controlled Trial

Background

Physical activity (PA) must be performed regularly to accrue health benefits. However, the majority of manual wheelchair users do not meet PA recommendations. Existing community-based PA programs for manual wheelchair users appear to work, but effect sizes are small and retention is low. Existing PA programs may not fully implement some psychosocial factors that are strongly linked with PA (eg, autonomy). The use of peers and mobile phone technology in the Smartphone Peer PA Counseling (SPPAC) program represents a novel approach to cultivating a PA-supportive environment for manual wheelchair users.

Objective

The primary objective is to compare change in objective PA between the experimental (SPPAC) and control groups from baseline to postintervention (10 weeks) and follow-up (3 months). Changes in and relationships between subjective PA, wheelchair skills, motivation, self-efficacy (for overcoming barriers to PA for manual wheelchair use), satisfaction of psychological needs for PA, and satisfaction with PA participation will be explored (secondary outcome). Program implementation will be explored (tertiary objective).

Methods

A total of 38 community-living manual wheelchair users (≥18 years) will be recruited in a randomized controlled trial (RCT). Participants in both the control and experimental groups will receive existing PA guidelines. Participants in the experimental group will also receive the SPPAC program: 14 sessions (~30 min) over a 10-week period delivered by a peer trainer using a mobile phone. PA activities will be based on individuals’ preferences and goals. Implementation of important theoretical variables will be enforced through a peer-trainer checklist. Outcomes for objective PA (primary) and subjective PA, wheelchair skills, motivation, self-efficacy, satisfaction of psychological needs, and satisfaction with participation will be collected at three time points (baseline, postintervention, follow-up). Multiple imputations will be used to treat missing data. A mixed-model ANCOVA will be conducted, controlling for covariates (primary and secondary objectives). The strength and direction of the relationships between the primary and secondary outcomes will be explored (secondary objective). Descriptive and content analysis will be used to appraise program implementation (tertiary objective).

Results

Funding has been obtained from the Craig Neilsen Foundation and the Canadian Disability Participation Project, with additional funds being sought from the Canadian Institute for Health Research and Fonds de Recherche du Québec-Santé. Pilot evaluation of intervention implementation is currently underway, with enrollment anticipated to begin early 2018.

Conclusions

There may be substantial benefits for the SPPAC program including limited burden on health care professionals, decreased barriers (eg. accessibility, transportation), development of peer social supports, and potential cost savings related to physical inactivity. Before conducting a large and expensive multisite RCT within a small heterogeneous population of manual wheelchair users, a pilot study affords a prudent step to establishing an adequate study protocol and implementation strategies.

Trial Registration

ClinicalTrials.gov NCT02826707; https://clinicaltrials.gov/ct2/show/NCT02826707 (Archived by WebCite at http://www.webcitation.org/6pqIc14dU)

Social context of neighborhood and socioeconomic status on leisure-time physical activity in a Brazilian urban center: The BH Health Study

This study aimed to estimate the prevalence of leisure-time physical activity and investigate its association with contextual characteristics of the social and physical environment in different socioeconomic statuses, using a household survey in Belo Horizonte, Minas Gerais State, Brazil (2008-2009). Leisure-time physical activity was measured by the International Physical Activity Questionnaire; and the social and physical environment by scales arising from perception of neighborhood attributes. Multilevel logistic regression analysis was performed separately for each socioeconomic status stratum. The overall prevalence of leisure-time physical activity was 30.2%, being 20.2% amongst participants of low socioeconomic status, 25.4% in the medium and 40.6% in the high socioeconomic status group. A greater perception of social cohesion was associated with increased leisure-time physical activity only amongst participants of the lowest socioeconomic status even after adjusting for individual characteristics. The results demonstrate the importance of social cohesion for the promotion of leisure-time physical activity in economically disadvantaged groups, supporting the need to stimulate interventions for enhancing social relationships in this population.

Energy expenditure on recreational visits to different natural environments

Physical inactivity poses a significant challenge to physical and mental health. Environmental approaches to tackle physical inactivity have identified natural environments as potentially important public health resources. Despite this, little is known about characteristics of the activity involved when individuals visit different types of natural environment. Using Natural England's Monitor of Engagement with the Natural Environment Survey, we examined 71,603 English respondents' recreational visits to natural environments in the past week. Specifically, we examined the intensity of the activities they undertook on the visits (METs), the duration of their visit, and the associated total energy expenditure (MET minutes). Visits to countryside and urban greenspace environments were associated with more intense activities than visits to coastal environments. However, visits to coastal environments were associated with the most energy expenditure overall due to their relatively long duration. Results differed by the urbanity or rurality of the respondent's residence and also how far respondents travelled to their destination. Knowledge of what types of natural environment afford the highest volumes and intensities of physical activity could inform landscape architecture and exercise prescriptions. Isolating activity-supporting characteristics of natural environments that can be translated into urban design is important in providing physical activity opportunities for those less able to access expansive environments.

Does social support mediate the relationship among neighborhood disadvantage, incivilities, crime and physical activity?

OBJECTIVE

Neighborhood disadvantage (ND), incivilities, and crime disproportionately impact minority women, discouraging physical activity (PA). Social support (SS) is a cultural tool promoting PA in minority women. Socially supportive environments may promote PA in disadvantaged neighborhoods, yet few studies have investigated the mediating role of social support among minority women. This study examined SS as a mediator among ND, incivilities, crime, and PA.

METHODS

The Health Is Power study aimed to increase PA in African American and Hispanic Latina women (N=410) in Houston and Austin, TX. ND and crime data were taken from the National Neighborhood Crime Study. Incivilities were measured using the Pedestrian Environment Data Scan (PEDS). SS was measured using the Family and Friend Support for Exercise Habits scale and physical activity was measured using the International Physical Activity Questionnaire. Linear regression analysis was used to examine SS as a mediator following the Baron and Kenny method.

RESULTS

ND was negatively associated with PA and SS. SS was not a mediator as it was not significantly associated with ND, crime, and incivilities (F(3,264)=2.02, p>.05) or PA (F(1,266)=3.8 p=.052).

CONCLUSION

ND significantly discourages PA and limits SS. Future research should focus on developing strategies to overcoming these negative environmental factors.

"I used to be as fit as a linnet" - beliefs, attitudes, and environmental supportiveness for physical activity in former mining areas in the North-East of England

Studies of geographical variations in physical activity behaviours have suggested that activity levels are particularly low in areas that have undergone employment loss associated with the decline of industry. This is of concern given that affected populations are already at risk of poor health. Applying focus group methodology amongst 19 participants in four groups, this study aims to unpack how broader societal and environmental changes associated with industrial decline affect beliefs and attitudes towards physical activity in ex-mining communities in the North-East of England. Identified core themes comprise the direct impact of deindustrialisation on social and physical environments. Based on our findings, we provide evidence for mechanisms that operate via loss of occupational physical activity as well as the progressive development of environments that are not fit to support population activity levels. Particularly important was the loss of recreational facilities, public green spaces and sports facilities that were owned and organised by the miners themselves with support from the mining companies. Attitudes and beliefs directly related to the areas' industrial past were also seen to be key. We suggest that the development of interventions considering the socio-cultural history and socio-economic reality of communities could be a promising route to encourage more active lifestyles in deprived areas with particularly low levels of physical activity.

•

Reasons for less physical activity previously observed in ex-mining areas unclear.

•

Detailed focus group interviews with community residents to explore influences.

•

Cultures of being physically fit and active present in the past have been lost.

•

Loss of recreational facilities and opportunities associated with colliery closure.

•

Important to consider socio-cultural histories in physical activity interventions.

The impact of public housing on social networks: a natural experiment

OBJECTIVES

We assessed whether 2 types of public housing-scattered among market-rate housing developments or clustered in small public housing projects-were associated with the perceived health and health behaviors of residents' social networks.

METHODS

Leveraging a natural experiment in Montgomery County, Maryland, in which residents were randomly assigned to different types of public housing, we surveyed 453 heads of household in 2011. We asked residents about their own health as well as the perceived health of their network members, including their neighbors.

RESULTS

Residents in scattered-site public housing perceived that their neighbors were more likely to exercise than residents of clustered public housing (24.7% of network members vs 14.0%; P < .001). There were no significant differences in the proportion of network members who were perceived to have major health problems, depressed mood, poor diet, or obesity. Having more network members who smoked was associated with a significantly higher likelihood of smoking.

CONCLUSIONS

Different types of public housing have a modest impact on the health composition of one's social network, suggesting the importance of housing policy for health.

Does walkable neighbourhood design influence the association between objective crime and walking?

Background

Few studies have investigated associations between objectively measured crime and walking, and findings are mixed. One explanation for null or counterintuitive findings emerges from criminology studies, which indicate that the permeable street layouts and non-residential land uses that underpin walkable neighbourhoods are also associated with more crime. This study examined associations between objective crime and walking, controlling for the characteristics of walkable neighbourhoods.

Methods

A population representative sample of adults (25–65 years) (n = 3,487) completed the Western Australian Health and Wellbeing Survey (2006–2008) demographic and walking frequency items. Objective environmental measures were generated for each participant’s 400 m and 1600 m neighbourhood areas, including burglary, personal crime (i.e., crimes committed against people) in public space, residential density, street connectivity and local destinations. Log-linear negative binomial regression models were used to examine associations between crime and walking frequency/week, with progressive adjustment for residential density, street connectivity and local destinations.

Results

Burglary and personal crime occurring within a participant’s 400 m and 1600 m neighbourhoods were positively and significantly associated with walking frequency. For example, for every additional 10 crimes against the person/year within 400 m of a participant’s home, walking frequency increased by 8% (relative change = 1.077, p = 0.017). Associations remained constant after controlling for residential density and street connectivity, but attenuated after adjusting for local destinations (e.g., for personal crime in 400 m: relative change = 1.054, p = 0.104). This pattern of attenuation was evident across both crime categories and both neighbourhood sizes.

Conclusions

The observed positive associations between objective crime and walking appear to be a function of living in a more walkable environment, as the presence of destinations has the capacity to both promote walking and attract crime. This study provides a plausible explanation for some mixed findings emerging from studies examining crime as a barrier to walking. In some settings, the hypothesised deterrent effect of crime on walking may be insufficient to outweigh the positive impacts of living in a more walkable environment.

Social network characteristics associated with health promoting behaviors among Latinos

OBJECTIVE

This study examined the relationship between social network characteristics and health promoting behaviors (having a routine medical check-up, consuming no alcohol, consuming no fast food, and meeting recommendations for leisure-time physical activity and sleep duration) among Latinos to identify potential targets for behavioral interventions.

METHOD

Personal network characteristics and health behavior data were collected from a community sample of 393 adult Latinos (73% women) in San Diego County, California. Network characteristics consisted of size and composition. Network size was calculated by the number of alters listed on a name generator questionnaire eliciting people with whom respondents discussed personal issues. Network composition variables were the proportion of Latinos, Spanish-speakers, females, family, and friends listed in the name generator. Additional network composition variables included marital status and the number of adults or children in the household.

RESULTS

Network members were predominately Latinos (95%), Spanish-speakers (80%), females (64%), and family (55%). In multivariate logistic regression analyses, gender moderated the relationship between network composition, but not size, and a health behavior. Married women were more likely to have had a routine medical check-up than married men. For both men and women, having a larger network was associated with meeting the recommendation for leisure-time physical activity.

CONCLUSION

Few social network characteristics were significantly associated with health promoting behaviors, suggesting a need to examine other aspects of social relationships that may influence health behaviors.

Engineering online and in-person social networks to sustain physical activity: application of a conceptual model

BACKGROUND

High rates of physical inactivity compromise the health status of populations globally. Social networks have been shown to influence physical activity (PA), but little is known about how best to engineer social networks to sustain PA. To improve procedures for building networks that shape PA as a normative behavior, there is a need for more specific hypotheses about how social variables influence PA. There is also a need to integrate concepts from network science with ecological concepts that often guide the design of in-person and electronically-mediated interventions. Therefore, this paper: (1) proposes a conceptual model that integrates principles from network science and ecology across in-person and electronically-mediated intervention modes; and (2) illustrates the application of this model to the design and evaluation of a social network intervention for PA.

METHODS/DESIGN

A conceptual model for engineering social networks was developed based on a scoping literature review of modifiable social influences on PA. The model guided the design of a cluster randomized controlled trial in which 308 sedentary adults were randomly assigned to three groups: WalkLink+: prompted and provided feedback on participants' online and in-person social-network interactions to expand networks for PA, plus provided evidence-based online walking program and weekly walking tips; WalkLink: evidence-based online walking program and weekly tips only; Minimal Treatment Control: weekly tips only. The effects of these treatment conditions were assessed at baseline, post-program, and 6-month follow-up. The primary outcome was accelerometer-measured PA. Secondary outcomes included objectively-measured aerobic fitness, body mass index, waist circumference, blood pressure, and neighborhood walkability; and self-reported measures of the physical environment, social network environment, and social network interactions. The differential effects of the three treatment conditions on primary and secondary outcomes will be analyzed using general linear modeling (GLM), or generalized linear modeling if the assumptions for GLM cannot be met.

DISCUSSION

Results will contribute to greater understanding of how to conceptualize and implement social networks to support long-term PA. Establishing social networks for PA across multiple life settings could contribute to cultural norms that sustain active living.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01142804.

Physical activity in deprived communities in London: examining individual and neighbourhood-level factors

Introduction

The objectives of this study were to examine relationships between neighbourhood-level and individual-level characteristics and physical activity in deprived London neighbourhoods.

Methods

In 40 of the most deprived neighbourhoods in London (ranked in top 11% in London by Index of Multiple Deprivation) a cross-sectional survey (n = 4107 adults aged > = 16 years), neighbourhood audit tool, GIS measures and routine data measured neighbourhood and individual-level characteristics.

The binary outcome was meeting the minimum recommended (CMO, UK) 5×30 mins moderate physical activity per week. Multilevel modelling was used to examine associations between physical activity and individual and neighbourhood-level characteristics.

Results

Respondents living more than 300 m away from accessible greenspace had lower odds of achieving recommended physical activity levels than those who lived within 300 m; from 301–600 m (OR = 0.7; 95% CI 0.5–0.9) and from 601–900 m (OR = 0.6; 95% CI 0.4–0.8). There was substantial residual between-neighbourhood variance in physical activity (median odds ratio = 1.7). Other objectively measured neighbourhood-level characteristics were not associated with physical activity levels.

Conclusions

Distance to nearest greenspace is associated with meeting recommended physical activity levels in deprived London neighbourhoods. Despite residual variance in physical activity levels between neighbourhoods, we found little evidence for the influence of other measured neighbourhood-level characteristics.

"Safe Going": the influence of crime rates and perceived crime and safety on walking in deprived neighbourhoods

Few studies have simultaneously examined the relationship of levels of recorded crime, perceptions of crime and disorder, and safety from crime with rates of physical activity. We developed a series of multilevel ordinal regression models to examine these aspects in relation to self-reported neighbourhood walking frequency in a cross-sectional sample of 3824 British adults from 29 deprived neighbourhoods in Glasgow, UK. Perceptions of several serious local antisocial behaviours (drunkenness and burglary) and feelings of personal safety (feeling safe in the home and if walking alone in the local area at night) were consistently associated, respectively, with less and more frequent walking. Conversely, perceiving drug dealing or drug use as a serious problem was associated with walking more frequently. There was a small but significant association between walking frequency in neighbourhoods with higher recorded person crime (but not property crime) rates when considered in conjunction with other aspects of disorder and crime safety, although not when additionally controlling for sociodemographic, neighbourhood and community aspects. The magnitude of these objective and perceived crime-related effects is modest and features of the psychosocial environment and social cohesion (having a sense of progress from living in the neighbourhood, group participation and positively rating social venues), as well as health and personal income deprivation, may more strongly determine levels of neighbourhood walking. Nevertheless, physical activity benefits may accrue at the population level through provision of environments that are safer from crime. Our study also shows the importance to local walking of neighbourhood management, which reduces problems of disorder, and of social regeneration, which helps strengthen sense of community.