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Koohsari MJ, Oka K, Nakaya T, Vena J, Williamson T, Quan H, McCormack GR. Urban design and cardio-metabolic risk factors. Prev Med 2023; 173:107552. [PMID: 37211251 DOI: 10.1016/j.ypmed.2023.107552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/23/2023]
Abstract
Accumulating evidence suggests that the built environment may be associated with cardiovascular disease via its influence on health behaviours. The aim of this study was to estimate the associations between traditional and novel neighbourhood built environment metrics and clinically assessed cardio-metabolic risk factors among a sample of adults in Canada. A total of 7171 participants from Albertas Tomorrow Project living in Alberta, Canada, were included. Cardio-metabolic risk factors were clinically measured. Two composite built environment metrics of traditional walkability and space syntax walkability were calculated. Among men, space syntax walkability was negatively associated with systolic and diastolic blood pressure (b = -0.87, 95% CI -1.43, -0.31 and b = -0.45, 95% CI -0.86, -0.04, respectively). Space syntax walkability was also associated with lower odds of overweight/obese among women and men (OR = 0.93, 95% CI 0.87, 0.99 and OR = 0.88, 95% CI 0.79, 0.97, respectively). No significant associations were observed between traditional walkability and cardio-metabolic outcomes. This study showed that the novel built environment metric based on the space syntax theory was associated with some cardio-metabolic risk factors.
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Affiliation(s)
- Mohammad Javad Koohsari
- School of Knowledge Science, Japan Advanced Institute of Science and Technology, Japan; Faculty of Sport Sciences, Waseda University, Japan; School of Exercise and Nutrition Sciences, Deakin University, Australia.
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Japan
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Japan.
| | - Jennifer Vena
- Alberta's Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.
| | - Tyler Williamson
- Centre for Health Informatics and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.
| | - Hude Quan
- Centre for Health Informatics and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.
| | - Gavin R McCormack
- Faculty of Sport Sciences, Waseda University, Japan; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada; Faculty of Kinesiology, University of Calgary, Canada; School of Architecture, Planning and Landscape, University of Calgary, Canada.
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Wang ML, Narcisse MR, McElfish PA. Higher walkability associated with increased physical activity and reduced obesity among United States adults. Obesity (Silver Spring) 2023; 31:553-564. [PMID: 36504362 PMCID: PMC9877111 DOI: 10.1002/oby.23634] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 10/03/2022] [Accepted: 10/11/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study examined associations among perceived neighborhood walkability, physical activity (PA), and obesity among United States adults. METHODS Data from the 2020 National Health Interview Survey were analyzed. Walkability was assessed using a summative scale and was categorized as low, medium, or high. PA was categorized as insufficient (0-149 min/wk) or sufficient (150+ min/wk). Multivariable regressions estimated an association between obesity and BMI and PA/walkability. Mediation analysis was used to partition contribution of PA as a mediator. Effect modification by race and ethnicity in the association between walkability and BMI was explored. RESULTS The sample included N = 31,568 adults. Compared with those in low-walkability neighborhoods, participants in high-walkability neighborhoods had increased odds of sufficient PA (odds ratio [OR] = 1.48; 95% CI: 1.30-1.69) and decreased obesity odds (OR = 0.76; 95% CI: 0.66-0.87). PA partially mediated the association between walkability and BMI (23.4%; 95% CI: 14.6%-62.7%). The association between walkability and BMI was modified by race and ethnicity (F[5,567] = 2.75; p = 0.018). Among White, Black, Hispanic, and Asian adults, BMI decreased with increasing walkability; among American Indian/Alaska Native and multiracial/other adults, BMI increased with increasing walkability. CONCLUSIONS The findings highlight the importance of investing in the built environment to improve perceptions of walkability and promote PA and healthy weight, as well as developing interventions to target racial and ethnic disparities in these outcomes.
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Affiliation(s)
- Monica L. Wang
- Boston University School of Public Health, Department of Community Health Sciences, 715 Albany St., Boston, MA 02118, USA
- Boston University Center for Antiracist Research, 1 Silber Way, Boston, MA 02215, USA
- Harvard T.H. Chan School of Public Health, Department of Health Policy and Management, 677 Huntington Ave., Boston, MA 02115, USA
| | - Marie-Rachelle Narcisse
- University of Arkansas for Medical Sciences Northwest, College of Medicine, 2708 S. 48 St., Springdale, AR 72762, USA
| | - Pearl A. McElfish
- University of Arkansas for Medical Sciences Northwest, College of Medicine, 2708 S. 48 St., Springdale, AR 72762, USA
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Gupta N, Crouse DL, Miah P, Takaro T. Individual physical activity, neighbourhood active living environment and mental illness hospitalisation among adults with cardiometabolic disease: a Canadian population-based cohort analysis. BMJ Open 2023; 13:e067736. [PMID: 36725097 PMCID: PMC9896238 DOI: 10.1136/bmjopen-2022-067736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES This population-based observational study explores the associations between individual-level and neighbourhood-level indices of active living with inpatient mental healthcare use among adults with an underlying chronic cardiometabolic condition. DESIGN AND SETTING Data from the 2013-2014 Canadian Community Health Survey were linked longitudinally to hospital records from the 2013/2014‒2017/2018 Discharge Abstract Database and to a geocoded measure of active living environments (ALE). Relationships between individuals' leisure-time physical activity and neighbourhood ALE with risk of hospital admission for mental health disorders were assessed using multivariable Cox regressions. PARTICIPANTS A national cohort was identified from the survey data of 24 960 respondents aged 35 years and above reporting having been diagnosed with diabetes, hypertension and/or heart disease. OUTCOME MEASURE Potentially avoidable hospitalisation for a mood, anxiety or substance use disorder over a 5-year period. RESULTS More than half (52%) of adults aged 35 years and above with a cardiometabolic disease were physically inactive in their daily lives, and one-third (34%) resided in the least activity-friendly neighbourhoods. The rate of being hospitalised at least once for a comorbid mental disorder averaged 8.1 (95% CI: 7.0 to 9.3) per 1000 person-years of exposure. Individuals who were at least moderately active were half as likely to be hospitalised for a comorbid mental health problem compared with those who were inactive (HR: 0.50 (95% CI: 0.38 to 0.65)). No statistically discernible associations between neighbourhood ALE and hospitalisation risks were found after controlling for individuals' behaviours and characteristics, including in separate models stratified by age group and by sex. CONCLUSIONS The evidence base to support prioritisation of interventions focusing on the built environment favouring mental health-promoting physical activity among higher-risk adults at the population level, independently of individual-level behaviours and characteristics, remains limited.
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Affiliation(s)
- Neeru Gupta
- University of New Brunswick, Fredericton, New Brunswick, Canada
| | | | - Pablo Miah
- University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Tim Takaro
- Simon Fraser University, Burnaby, British Columbia, Canada
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Mohamed NA, Alanzi ARA, Azizan NA, Azizan SA, Samsudin N, Jenatabadi HS. Evaluation of depression and obesity indices based on applications of ANOVA, regression, structural equation modeling and Taguchi algorithm process. Front Psychol 2023; 14:1060963. [PMID: 36910750 PMCID: PMC9993013 DOI: 10.3389/fpsyg.2023.1060963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/19/2023] [Indexed: 02/24/2023] Open
Abstract
Introduction Depression and obesity are the main threat among women which have been considered by many research scholars in psychology studies. In their analysis for measuring and estimating obesity and depression they were involving statistical functions. Methods Regression, Analysis of Variance (ANOVA), and in the last two decades Structural Equation Modeling are the most familiar statistical methods among research scholars. Taguchi algorism process is one the statistical methods which mostly have been applying in engineering studies. In this study we are looking at two main objectives. The first one is to introduce Taguchi algorism process and apply it in a case study in psychology area. The second objective is challenging among four statistical techniques include ANOVA, regression, SEM, and Taguchi technique in a same data. To achieve those aims we involved depression and obesity indices with other familiar indicators contain socioeconomic, screen time, sleep time, and usage fitness and nutrition mobile applications. Results and discussion Outputs proved that Taguchi technique is able to analyze some correlations which are not achieved by applying ANOVA, regression, and SEM. Moreover, SEM has a special capability to estimate some hidden correlations which are not possible to evaluate them by using ANOVA, regression, and even Taguchi method. In the last, we found that some correlations are significant by SEM, however, in the same data with regression those correlation were not significant. This paper could be a warning for psychology research scholars to be more careful with involving statistical methods for measuring and estimating of their research variables.
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Affiliation(s)
- Nur Anisah Mohamed
- Faculty of Science, Institute of Mathematical Sciences, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Ayed R A Alanzi
- Department of Mathematics, College of Science and Arts in Gurayat, Jouf University, Gurayat, Saudi Arabia
| | - Noor Azlinna Azizan
- College of Business Administration, Prince Sultan University, Riyadh, Saudi Arabia
| | - Suzana Ariff Azizan
- Department of Science and Technology Studies, Faculty of Science, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Nadia Samsudin
- Department of Science and Technology Studies, Faculty of Science, Universiti Malaya, Kuala Lumpur, Malaysia.,Faculty of Social Sciences and Liberal Arts, UCSI University, Kuala Lumpur, Malaysia
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Abstract
OBJECTIVES Young adults' physical activity (PA) is a foundation of creating future healthy lifestyles. The purpose of this study was to explore differences in PA, sedentary behaviour, walkability and health beliefs among young adults with different levels of cardiometabolic risks and the influence of moderate-to-vigorous PA. DESIGN A cross-sectional study was conducted using a structured questionnaire. PARTICIPANTS Totally, 1149 valid responses were received for a response rate of 86.32%. According to the self-reported worst health condition, participants were categorised into healthy adults, and adults at levels 1 (overweight), 2 (obese), 3 (hypertensive, hyperlipidaemic, and/or hyperglycaemic), and 4 (with a diagnosis of cardiometabolic diseases) of cardiometabolic risks. PRIMARY OUTCOME MEASURES PA, sedentary time, walkability and health beliefs. RESULTS Significant differences in PA (F=3.78, p<0.01) and sedentary time (F=2.39, p<0.05) among groups with various cardiometabolic risk levels were found. Healthy adults and adults at level 1 risk had significantly higher PA than adults at risk levels 2 and 3. Young adults at risk level 3 were less likely to participate in moderate-to-vigorous PA than were healthy adults (OR=0.64 (95% CI 0.41 to 0.99), p<0.05). Individuals who perceived that there were more recreational facilities (OR=1.27 (1.05 to 1.53), p<0.05), who had higher benefits of exercise (OR=1.73 (1.30 to 2.31), p<0.001), and who had lower barriers to exercise (OR=0.42 (0.32 to 0.55), p<0.001) were more likely to participate in moderate-to-vigorous PA. CONCLUSIONS Being aware of body weight changes could be a danger sign of a lack of PA. Developing environmental and psychological strategies to promote engaging in PA is necessary to promote the cardiometabolic health of young adults.
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Affiliation(s)
- Hsin-Yen Yen
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Ching Li
- Graduate Institute of Sport, Leisure and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan
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Nichani V, Koohsari MJ, Oka K, Nakaya T, Shibata A, Ishii K, Yasunaga A, Turley L, McCormack GR. Associations between the traditional and novel neighbourhood built environment metrics and weight status among Canadian men and women. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2021; 112:166-174. [PMID: 32696142 PMCID: PMC7851194 DOI: 10.17269/s41997-020-00365-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 06/08/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Neighbourhood characteristics can impact the health of residents. This study investigated associations between objectively derived neighbourhood characteristics, including novel space syntax metrics, and self-reported body mass index (BMI) among Canadian men and women. METHODS Our study included survey data collected from a random cross-section of adults residing in Calgary, Alberta (n = 1718). The survey, conducted in 2007/2008, captured participants' socio-demographic characteristics, health, and weight status (BMI). Participants' household postal codes were geocoded and 1600-m line-based network buffers estimated. Using a geographical information system, we estimated neighbourhood characteristics within each buffer including business destination density, street intersection density, sidewalk length, and population density. Using space syntax, we estimated street integration and walkability (street integration plus population density) within each buffer. Using adjusted regression models, we estimated associations between neighbourhood characteristics and BMI (continuous) and BMI categories (healthy weight vs. overweight including obese). Gender-stratified analysis was also performed. RESULTS Business destination density was negatively associated with BMI and the odds of being overweight. Among men, street intersection density and sidewalk length were negatively associated with BMI and street intersection density, business destination density, street integration, and space syntax walkability were negatively associated with odds of being overweight. Among women, business destination density was negatively associated with BMI. CONCLUSION Urban planning policies that impact neighbourhood design have the potential to influence weight among adults living in urban Canadian settings. Some characteristics may have a differential association with weight among men and women and should be considered in urban planning and in neighbourhood-focussed public health interventions.
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Affiliation(s)
- Vikram Nichani
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
| | - Mohammad Javad Koohsari
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
- Behavioural Epidemiology Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Sendai, Miyagi, 980-8577, Japan
| | - Ai Shibata
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Ibaraki, 305-8577, Japan
| | - Kaori Ishii
- Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Akitomo Yasunaga
- Faculty of Liberal Arts and Sciences, Bunka Gakuen University, Shibuya City, Tokyo, 151-8523, Japan
| | - Liam Turley
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
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Abstract
BACKGROUND Midlife black women are at a high risk for cardiovascular disease and experience higher morbidity and mortality rates. Chronic life stress contributes to the existent cardiovascular-related disparities for midlife black women. OBJECTIVES The purpose of this qualitative study was to describe stress reduction strategies relevant to midlife black women, identify barriers, and generate ideas for the development of a stress reduction wellness intervention for midlife black women. METHODS A community advisory board consisting of 11 midlife black women from the Midwest was established and charged with exploring life stress and stress-related issues for women like themselves. The community advisory board was led through a series of focus group discussions using open-ended questions focused on stress reduction strategies used by midlife black women, what kept them from incorporating stress reduction strategies into their daily routines, and what would be helpful in a stress reduction routine. Discussions were audiotaped, transcribed, coded, and analyzed using content analysis. RESULTS Stress reduction strategies identified included exercise, faith and prayer, self-care, sisterhood, volunteerism, and mindfulness. Barriers to adopting stress reduction behaviors included time, finances, physical limitations, health status, health insurance, and guilt. Suggested modes of delivery for an intervention included informative lectures and coaching, demonstration, team sessions, social media, and continued access. CONCLUSIONS Findings from this study were consistent with those from a preliminary study focused on midlife black women from the West Coast. Recommendations will inform development of a stress reduction wellness intervention for midlife black women.
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Nichani V, Turley L, Vena JE, McCormack GR. Associations between the neighbourhood characteristics and body mass index, waist circumference, and waist-to-hip ratio: Findings from Alberta's Tomorrow Project. Health Place 2020; 64:102357. [PMID: 32479266 DOI: 10.1016/j.healthplace.2020.102357] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/27/2020] [Accepted: 05/11/2020] [Indexed: 12/19/2022]
Abstract
This study estimated the associations between neighbourhood characteristics and self-reported body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) risk categories among Canadian men and women. Using data from the Alberta's Tomorrow Project (n = 14,550), we estimated 3- and 4-way intersections, business destinations, population count, and normalized difference vegetation index (NDVI) within a 400 m radius of participant's home. Intersections, business destinations, and population count (z-scores) were summed to create a walkability score. Four-way intersections and walkability were negatively associated with overweight and obesity. Walkability was negatively associated with obesity. NDVI was negatively associated with high-risk WHR and population count and walkability positively associated with high-risk WHR. Among men, population count and walkability were negatively associated with obesity, and business destinations and walkability were negatively associated with overweight and obesity. Among women, NDVI was negatively associated with overweight (including obesity), obesity, and high-risk WC. Interventions promoting healthy weight could incorporate strategies that take into consideration local built environment characteristics.
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Affiliation(s)
- Vikram Nichani
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
| | - Liam Turley
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
| | - Jennifer E Vena
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada; Cancer Control Alberta, Alberta Health Services, 1820 Richmond Road SW, Calgary, Alberta, T2T 5C7, Canada.
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
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Tarlov E, Silva A, Wing C, Slater S, Matthews SA, Jones KK, Zenk SN. Neighborhood Walkability and BMI Change: A National Study of Veterans in Large Urban Areas. Obesity (Silver Spring) 2020; 28:46-54. [PMID: 31804004 PMCID: PMC6925327 DOI: 10.1002/oby.22611] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 07/15/2019] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Improving neighborhood walkability has been proposed as a policy intervention to reduce obesity. The objective of this study was to evaluate longitudinal relationships between neighborhood walkability and body weight among adults living in large urban areas. METHODS In this retrospective longitudinal study of United States military veterans using Department of Veterans Affairs health care, Veterans Affairs clinical and administrative data (2007-2014) were linked to environmental measures constructed from public (2006-2014) and proprietary (2008-2014) sources, and linear regression models with person fixed effects were used to estimate associations between walkability and BMI among 758,434 men and 70,319 women aged 20 to 80 years in 2009 to 2014. RESULTS Neighborhood walkability was associated with small reductions in BMI. Effects were most pronounced among men aged 30 to 49 and 50 to 64. For women, differences were largest in the two youngest age groups, 20 to 29 and 30 to 49, though only estimates for all women combined were statistically significant. For women aged 30 to 49, effect sizes grew when the sample was limited to those who remained in the same neighborhood during the entire follow-up period. CONCLUSIONS Investments in the built environment to improve walkability may be a useful strategy for weight control in some segments of the adult population.
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Affiliation(s)
- Elizabeth Tarlov
- College of Nursing, University of Illinois at Chicago, Illinois, USA
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA
| | - Abigail Silva
- Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA
- Department of Public Health Sciences, Loyola University Chicago, Maywood, IL, USA
| | - Coady Wing
- School of Public and Environmental Affairs, Indiana University, Bloomington, IN, USA
| | - Sandy Slater
- School of Pharmacy, Concordia University Wisconsin, Mequon, WI, USA
| | - Stephen A. Matthews
- Department of Sociology and Criminology, Department of Anthropology, The Pennsylvania State University, University Park, PA, USA
| | - Kelly K. Jones
- National Socio-Environmental Synthesis Center, Annapolis, MD, USA
| | - Shannon N. Zenk
- College of Nursing, University of Illinois at Chicago, Illinois, USA
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Lee EY, Lee S, Choi BY, Choi J. Influence of Neighborhood Environment on Korean Adult Obesity Using a Bayesian Spatial Multilevel Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203991. [PMID: 31635403 PMCID: PMC6843842 DOI: 10.3390/ijerph16203991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 12/11/2022]
Abstract
Previous studies using spatial statistical modeling that account for spatial associations between geographic areas are scarce. Therefore, this study examines the association between neighborhood environment and obesity using a Bayesian spatial multilevel model. Data from 78,014 adults living in Gyeonggi province in Korea were drawn from the 2013–2014 Korean Community Health Survey. Korean government databases and ArcGIS software (version 10.1, ESRI, Redlands, CA) were used to measure the neighborhood environment for 546 administrative districts of Gyeonggi province. A Bayesian spatial multilevel model was implemented across gender and age groups. The findings indicate that women aged 19–39 years who lived in neighborhoods farthest away from parks were more likely to be obese. Men aged 40–59 years who lived in neighborhoods farther from public physical activity facilities and with lower population density were more likely to be obese. Obesity for women aged 19–39 years was the most spatially dependent, while obesity for women aged 40–59 years was the least spatially dependent. The results suggest that neighborhood environments that provide more opportunities for physical activity are negatively related to obesity. Therefore, the creation of physical activity in favorable neighborhood environments, considering gender and age, may be a valuable strategy to reduce obesity.
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Affiliation(s)
- Eun Young Lee
- Institute for Health and Society, Hanyang University, Seoul 04763, Korea.
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea.
| | - Sugie Lee
- Department of Urban Planning and Engineering, Hanyang University, Seoul 04763, Korea.
| | - Bo Youl Choi
- Institute for Health and Society, Hanyang University, Seoul 04763, Korea.
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea.
| | - Jungsoon Choi
- Department of Mathematics, Hanyang University, Seoul 04763, Korea.
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Yen HY, Li C. Determinants of physical activity: A path model based on an ecological model of active living. PLoS One 2019; 14:e0220314. [PMID: 31348815 PMCID: PMC6660076 DOI: 10.1371/journal.pone.0220314] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 07/12/2019] [Indexed: 11/27/2022] Open
Abstract
Maintaining physical activity is necessary to promote health in our daily lives. The Ecological Model of Active Living was proposed to examine whether individuals participate in active living. The purpose of this study was to understand the determinants of physical activity and create a predictive path model of the intrapersonal, perceived environment, behavior settings, and policy environment domains. Data were obtained from open government data and questionnaires, including the International Physical Activity Questionnaire, Health Belief Model Inventory, Physical Activity Neighborhood Environment Survey, and Accessibility of Open Spaces. Participants comprised 1085 healthy adults who completed a self-reported internet survey. An analysis of the intrapersonal domain revealed that the variables of female, an older age, and a low educational level, and individuals with obesity or cardiometabolic diseases presented lower odds ratios for active living. We found significant statistical support for our path model (The Ecological Model of Active Living), with a predictive power of 23.1%. The predictive path model is a good approach to quantitatively measure the impacts of various determinants on active living that suggests further lines of research in approaches for modeling relationships.
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Affiliation(s)
- Hsin-Yen Yen
- School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan
- * E-mail:
| | - Ching Li
- Graduate Institute of Sport, Leisure, and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan
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