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Scharfenberg L, Negash S, Kluttig A, Mikolajczyk R. The association between the child's age and mothers' physical activity: results from the population-based German National Cohort study. BMC Public Health 2024; 24:1584. [PMID: 38872147 PMCID: PMC11170828 DOI: 10.1186/s12889-024-19055-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 06/04/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Since physical activity is an important determinant of physical and mental health, lower levels of physical activity among mothers reported in previous research are concerning. The aim of this study was to examine whether physical activity levels differ among mothers depending on the age of the youngest child. METHODS Cross-sectional data from the German National Cohort study, comprising 3959 mothers aged 22-72 years with offspring aged 0-54 years (grouped into 0-5, 6-11, 12-17, 18-29 and > 30 years) was used. The Global Physical Activity Questionnaire (GPAQ) was used to assess physical activity among mothers in leisure time, transport and (occupational and non-occupational) work settings, quantified as MET-minutes per week. Means (with 95% confidence interval) of mothers' weekly MET-minutes were visualized in graphs, stratified by mothers' and the youngest child's age. Linear regression analyses assessed the association between the child's age and self-reported time and intensity of mothers' physical activity within each activity domain and for the total physical activity. RESULTS Adjusted results suggested that the MET-minutes in work settings were lower among mothers with younger children. This association was clearest in mothers whose youngest child was under 12 years old, among whom lower self-reported physical activity at work compared to mothers with children at age 30 and older was found. No association was observed between the age of the youngest child and mothers' MET-minutes in leisure nor in transport settings. The self-reported physical activity of mothers whose youngest child was in the same child age group was found to be lower with increased maternal age. As expected, the work related activity dominated the self-reported physical activity. CONCLUSIONS The results show differences in mothers' self-reported physical activity by the age of the youngest child. The strongest difference was related to physical activity in work settings, indicating the need for supportive actions.
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Affiliation(s)
- Lisa Scharfenberg
- Institute of Medical Epidemiology, Biometry and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany
| | - Sarah Negash
- Institute of Medical Epidemiology, Biometry and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany
| | - Alexander Kluttig
- Institute of Medical Epidemiology, Biometry and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biometry and Informatics, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle (Saale), Germany.
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Akinyelure OP, Jaeger BC, Safford MM, Oparil S, Carson AP, Sims A, Hannon L, Howard G, Muntner P, Hardy ST. Social Determinants of Health and Incident Apparent Treatment-Resistant Hypertension Among White and Black US Adults: The REGARDS Study. J Am Heart Assoc 2024; 13:e031695. [PMID: 38752519 PMCID: PMC11179800 DOI: 10.1161/jaha.123.031695] [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: 07/07/2023] [Accepted: 01/26/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND We examined the association of multilevel social determinants of health with incident apparent treatment-resistant hypertension (aTRH). METHODS AND RESULTS We analyzed data from 2774 White and 2257 Black US adults from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study taking antihypertensive medication without aTRH at baseline to estimate the association of social determinants of health with incident aTRH. Selection of social determinants of health was guided by the Healthy People 2030 domains of education, economic stability, social context, neighborhood environment, and health care access. Blood pressure (BP) was measured during study visits, and antihypertensive medication classes were identified through a pill bottle review. Incident aTRH was defined as (1) systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg, or systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg for those with diabetes or chronic kidney disease while taking ≥3 classes of antihypertensive medication or (2) taking ≥4 classes of antihypertensive medication regardless of BP level, at the follow-up visit. Over a median 9.5 years of follow-up, 15.9% of White and 24.0% of Black adults developed aTRH. A percent of the excess aTRH risk among Black versus White adults was mediated by low education (14.2%), low income (16.0%), not seeing a friend or relative in the past month (8.1%), not having someone to care for them if ill or disabled (7.6%), lack of health insurance (10.6%), living in a disadvantaged neighborhood (18.0%), and living in states with poor public health infrastructure (6.0%). CONCLUSIONS Part of the association between race and incident aTRH risk was mediated by social determinants of health.
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Affiliation(s)
| | - Byron C. Jaeger
- Department of Biostatistics and Data ScienceWake Forest University School of MedicineWinston‐SalemNCUSA
| | | | - Suzanne Oparil
- Department of MedicineUniversity of Alabama at BirminghamBirminghamALUSA
| | - April P. Carson
- Departments of Medicine and Population Health ScienceUniversity of Mississippi Medical CenterJacksonMSUSA
| | - Andrew Sims
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamALUSA
| | - Lonnie Hannon
- Department of Health BehaviorUniversity of Alabama at BirminghamBirminghamALUSA
| | - George Howard
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamALUSA
| | - Paul Muntner
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamALUSA
| | - Shakia T. Hardy
- Department of EpidemiologyUniversity of North Carolina at Chapel HillChapel HillNCUSA
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Paudel S, Mishra GD, Veitch J, Mielke GI, Hesketh KD. Examination of Physical Activity, Organized Sport, and Sitting Time Among Women and Mothers From Culturally and Linguistically Diverse Backgrounds. J Phys Act Health 2024; 21:229-237. [PMID: 38086350 DOI: 10.1123/jpah.2023-0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 10/29/2023] [Accepted: 11/14/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND Little evidence is available from culturally and linguistically diverse (CALD) communities on the association between motherhood and physical activity (PA). This study aimed to examine independent and joint associations of cultural background and motherhood with meeting PA guidelines, participation in organized sports, and high sitting time (>8 h/d). METHODS We used self-reported cross-sectional data from survey 8 of the 1973-1978 cohort of the Australian Longitudinal Study on Women's Health. PA was measured using the Active Australia Survey while organized sport and sitting time were measured using single items. CALD was defined as being born in a non-English speaking country or primarily speaking a non-English language at home. Multivariable-adjusted logistic regression analyses were used to examine independent and joint associations. RESULTS Data from 5967 women (mean age 42.4 [SD 1.5] y, 6.9% CALD, 81.2% mothers) were analyzed. Women of CALD background had lower odds of meeting PA guidelines (odds ratio; 95% confidence interval: 0.80; 0.64-0.98) and participation in organized sports (0.68; 0.54-0.86), but no statistically significant association with sitting time (0.90; 0.72-1.14). Mothers had lower odds of meeting PA guidelines (0.75; 0.64-0.87) and high sitting time (0.42; 0.36-0.49). Compared with non-CALD women without children, mothers (irrespective of cultural background) were less likely to meet PA guidelines and have high sitting time. The association of "cultural background and motherhood" with organized sports participation was only significant for CALD mothers. CONCLUSIONS Increased efforts and investments are needed to ensure that sports and other PA promotion interventions are culturally sensitive and engaging for CALD women and those with children.
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Affiliation(s)
- Susan Paudel
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Gita D Mishra
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Jenny Veitch
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
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Andreae SJ, Casey T, Lindberg A, Doyle K, Pickett KA. An exploratory study of mothers engaging in physical activity in rural communities. Women Health 2024; 64:235-249. [PMID: 38273717 PMCID: PMC10939792 DOI: 10.1080/03630242.2024.2310050] [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: 05/12/2023] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
Gender gaps in physical activity (PA) exist with women being less active than men. Multiple cultural and psychosocial factors influence women's ability to successfully negotiate barriers to PA and other health promoting behaviors. The goal of this exploratory descriptive study was to better understand the daily experiences of mothers in making health promoting decisions for themselves and their families. Semi-structured interviews (N = 17) were conducted with rural dwelling mothers who were the primary caregivers of children in the home. Participants were asked to share their experiences with PA and other health behaviors, focusing on their motivators, barriers, and facilitators. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis. Emerging themes focused on 1) feeling internal and external pressures to prioritize family's needs over one's health, 2) family exerting both positive and negative influences on health choices, and 3) living in a rural community often resulting in a lack of opportunities to engage in physical activity and feelings of being isolated from social networks. To close the gender gap in PA, interventions should support mothers in navigating their multiple roles and competing demands while engaging in health promoting behaviors such as physical activity.
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Affiliation(s)
- Susan J. Andreae
- Kinesiology Department, University of Wisconsin-Madison, Madison, Wisconsin
| | - Thomas Casey
- Kinesiology Department, University of Wisconsin-Madison, Madison, Wisconsin
| | - Anna Lindberg
- Kinesiology Department, University of Wisconsin-Madison, Madison, Wisconsin
| | - Kecia Doyle
- Kinesiology Department, University of Wisconsin-Madison, Madison, Wisconsin
| | - Kristen A. Pickett
- Kinesiology Department, University of Wisconsin-Madison, Madison, Wisconsin
- Program in Occupational Therapy, University of Wisconsin-Madison, Madison, Wisconsin
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He S, Yu S, Ai L, Dai J, Chung CKL. The built environment, purpose-specific walking behaviour and overweight: evidence from Wuhan metropolis in central China. Int J Health Geogr 2024; 23:2. [PMID: 38273303 PMCID: PMC10809537 DOI: 10.1186/s12942-024-00361-y] [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: 09/05/2023] [Accepted: 01/09/2024] [Indexed: 01/27/2024] Open
Abstract
The impact of objective and subjective environmental factors on health outcomes has been a topic of significant debate, with a growing body of research acknowledging the role of a physically active lifestyle in promoting health. However, consensus regarding their precise influence remains elusive. This study contributes to these discussions by exploring how individual health outcomes correlate with transport and leisure walking behaviours, set against both the objective and subjective aspects of environmental influences in the context of Wuhan, an inland Chinese megacity. Street view images, multi-source geospatial data and a questionnaire survey were employed to characterise the "5D + Greenery" objective and perceived characteristics of the neighbourhood environment. Multi-group structural equation modelling was utilised to unravel the complex relationship and gender heterogeneity among environmental factors, purpose-specific walking, and overweight. Our results suggest that both objective land use diversity and perceived convenience are significantly associated with overweight. The accessibility of local service facilities and visible greenery promote both transport and leisure walking. While perceived neighbourhood safety encourages transport walking, perceived walkability is positively correlated with leisure walking. Notably, leisure walking, usually considered beneficial, presents a positive association with overweight conditions, acting as a mediation. Gender disparities exist in pathways between the environment and purpose-specific walking, as well as weight. The findings lend support to the planning of an activity-supporting built environment as a crucial strategy for obesity prevention.
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Affiliation(s)
- Sanwei He
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, 430073, China.
| | - Shan Yu
- Department of Land Economy, University of Cambridge, Cambridge, UK
| | - Lina Ai
- School of Public Administration, Zhongnan University of Economics and Law, Wuhan, 430073, China
| | - Jingya Dai
- Department of Community, Culture and Global Studies, University of British Columbia Okanagan, Kelowna, Canada
| | - Calvin King Lam Chung
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Hong Kong, China
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Tao TJ, Li TW, Liang L, Liu H, Hou WK. Investigating the reciprocity between cognition and behavior in adaptation to large-scale disasters. NPJ MENTAL HEALTH RESEARCH 2023; 2:21. [PMID: 38609531 PMCID: PMC10955933 DOI: 10.1038/s44184-023-00037-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 09/20/2023] [Indexed: 04/14/2024]
Abstract
Cognition and behavior could reciprocally impact each other and together determine mental health amid large-scale disasters such as COVID-19. This study reports a six-month cohort study of a population-representative sample of Hong Kong residents (N = 906) from March-August 2021 (T1) to September 2021-February 2022 (T2). Cross-lagged panel analyses reveal that T1 poor behavioral functioning as indicated by high daily routine disruptions is inversely associated with T2 cognitive adaptation as indicated by self-efficacy and meaning-making but not vice versa. T1 routine disruptions but not cognitive adaptation are positively associated with T2 probable depression/anxiety. The positive link between T1 routine disruptions and T2 probable disorders is mediated by poor cognitive adaptation at T2. The present findings suggest that upholding daily behavioral functioning relative to positive states of mind could have a more pivotal role in mental health amid large-scale disasters. Future studies can test interventions that enhance the sustainment of regular daily routines.
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Affiliation(s)
- Tiffany Junchen Tao
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Tsz Wai Li
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Li Liang
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Huinan Liu
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
- Department of Special Education and Counselling, The Education University of Hong Kong, Hong Kong SAR, China
| | - Wai Kai Hou
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China.
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China.
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Akinyelure OP, Jaeger BC, Oparil S, Carson AP, Safford MM, Howard G, Muntner P, Hardy ST. Social Determinants of Health and Uncontrolled Blood Pressure in a National Cohort of Black and White US Adults: the REGARDS Study. Hypertension 2023; 80:1403-1413. [PMID: 37082942 PMCID: PMC10330022 DOI: 10.1161/hypertensionaha.122.20219] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 03/29/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Determining the contribution of social determinants of health (SDOH) to the higher proportion of Black adults with uncontrolled blood pressure (BP) could inform interventions to improve BP control and reduce cardiovascular disease. METHODS We analyzed data from 7306 White and 7497 Black US adults taking antihypertensive medication from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study (2003-2007). SDOH were defined using the Healthy People 2030 domains of education, economic stability, social context, neighborhood environment, and health care access. Uncontrolled BP was defined as systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg. RESULTS Among participants taking antihypertensive medication, 25.4% of White and 33.7% of Black participants had uncontrolled BP. The SDOH included in the current analysis mediated the Black-White difference in uncontrolled BP by 33.0% (95% CI, 22.1%-46.8%). SDOH that contributed to excess uncontrolled BP among Black compared with White adults included low annual household income (percent-mediated 15.8% [95% CI, 10.8%-22.8%]), low education (10.5% [5.6%-15.4%]), living in a health professional shortage area (10.4% [6.5%-14.7%]), disadvantaged neighborhood (11.0% [4.4%-18.0%]), and high-poverty zip code (9.7% [3.8%-15.5%]). Together, the neighborhood-domain accounted for 14.1% (95% CI, 5.9%-22.9%), the health care domain accounted for 12.7% (95% CI, 8.4%-17.3%), and the social-context-domain accounted for 3.8% (95% CI, 1.2%-6.6%) of the excess likelihood of uncontrolled BP among Black compared with White adults, respectively. CONCLUSIONS SDOH including low education, low income, living in a health professional shortage area, disadvantaged neighborhood, and high-poverty zip code contributed to the excess likelihood of uncontrolled BP among Black compared with White adults.
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Affiliation(s)
| | - Byron C. Jaeger
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC
| | - Suzanne Oparil
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - April P. Carson
- Departments of Medicine and Population Health Science, University of Mississippi Medical Center, Jackson, MS
| | | | - George Howard
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
| | - Shakia T. Hardy
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL
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Garg S. Gender differences in pathways influencing leisure time physical activity: A structural equation analysis. Diabetes Metab Syndr 2023; 17:102761. [PMID: 37119796 DOI: 10.1016/j.dsx.2023.102761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 03/19/2023] [Accepted: 04/10/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND AND AIMS Growing interest in exploring pathways that explain the relationship between various influences on physical activity might help in explaining the complexity of this behavior. This study attempts to identify pathways that interact between the physical and social environment and leisure-time physical activity and identify gender differences in these pathways. METHODS A survey was conducted in the Kottayam district of Kerala in India from July 2018-December 2019 to examine direct and indirect pathways of various factors that impact leisure-time physical activity. 467 adults in the age group of 18-65 years, was enquired about various individual and environmental factors that affect their physical activity levels. Structural equation modeling was employed to test the relationship among different variables. RESULTS The study found that there was a significant indirect effect of intrapersonal and environmental influences in the pathways that affected leisure-time physical activity. Among men, there was a significant association between self-efficacy and motivation and environmental influences (environmental factors, p = 0.019; body-related motivation p = 0.012, motivation for social motives reasons, p = 0.005); however, among women, environmental factors influence only through extrinsic motives related to body image and appearance (environmental factors, p = 0.009, motivation for appearance, p = 0.05). CONCLUSION The study concludes that although intrapersonal factors like self-efficacy and extrinsic motives like health and fitness are salient predictors of physical activity, environmental factors play a supportive role in enhancing engagement in leisure time activity. Future interventions should be tailored to meet gender-specific interests to promote regular physical activity among adults.
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Affiliation(s)
- Shalini Garg
- Sree Chitra Tirunal Institute of Medical Sciences and Technology, Kerala, India.
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Asiamah N, Agyemang SM, Yarfi C, Jnr RAM, Muhonja F, Khan HTA, Kouveliotis K, Sghaier S. Associations of Social Networks with Physical Activity Enjoyment among Older Adults: Walkability as a Modifier through a STROBE-Compliant Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3341. [PMID: 36834040 PMCID: PMC9967423 DOI: 10.3390/ijerph20043341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/08/2023] [Accepted: 02/11/2023] [Indexed: 06/18/2023]
Abstract
The available evidence suggests that social networks can contribute to physical activity (PA) enjoyment, which is necessary for the maintenance of PA over the life course. This study assessed the associations of active and sedentary social networks with PA enjoyment and ascertained whether walkability moderates or modifies these associations. A cross-sectional design compliant with STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) was employed. The participants were 996 community-dwelling older Ghanaians aged 50 years or older. A hierarchical linear regression analysis was used to analyse the data. After adjusting for age and income, the study found that the active social network size (β = 0.09; p < 0.05) and sedentary social network size (β = 0.17; p < 0.001) were positively associated with PA enjoyment. These associations were strengthened by walkability. It is concluded that active and sedentary social networks may better support PA enjoyment in more walkable neighbourhoods. Therefore, enabling older adults to retain social networks and live in more walkable neighbourhoods may be an effective way to improve their PA enjoyment.
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Affiliation(s)
- Nestor Asiamah
- Division of Interdisciplinary Research and Practice, School of Health and Social Care, Colchester CO4 3SQ, UK
- Department of Gerontology and Geriatrics, Africa Centre for Epidemiology, Accra North P.O. Box AN 18462, Ghana
| | - Simon Mawulorm Agyemang
- Department of Science/Health, Physical Education and Sports, Abetifi Presbyterian College of Education, Abetifi-Kwahu P.O. Box 19, Ghana
| | - Cosmos Yarfi
- Department of Physiotherapy and Rehabilitation Sciences, University of Health and Allied Sciences, Ho PMB 31, Ghana
| | - Reginald Arthur-Mensah Jnr
- Department of Nursing and Midwifery, Faculty of Health and Allied Sciences, Pentecost University, Accra P.O. Box KN 1739, Ghana
| | - Faith Muhonja
- Department of Community Health, School of Public Health, Amref International University, Nairobi P.O. Box 27691-00506, Kenya
| | - Hafiz T. A. Khan
- College of Nursing, Midwifery, and Healthcare, University of West London, Paragon House, Boston Manor Road, Brentford TW8 9GB, UK
| | - Kyriakos Kouveliotis
- Berlin School of Business and Innovation, Academic Affairs, 97-99 Karl Marx Strasse, 12043 Berlin, Germany
| | - Sarra Sghaier
- Department of Gerontology and Geriatrics, Africa Centre for Epidemiology, Accra North P.O. Box AN 18462, Ghana
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Makama M, Brown WJ, Lim S, Skouteris H, Harrison CL, Joham AE, Mishra GD, Teede H, Moran LJ. Levels of physical activity and sitting time in women with infants, toddlers and preschoolers: a population-based cross-sectional study. Public Health 2023; 214:1-9. [PMID: 36417813 DOI: 10.1016/j.puhe.2022.10.016] [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: 07/13/2022] [Revised: 09/29/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Insufficient physical activity (PA) and prolonged sitting time (ST) increase the risk of chronic disease and mortality. Caring for young children can potentially impact maternal PA and sedentary behaviours. The aims of this study were to explore the levels of PA and ST in women with young children (infants, toddlers and preschoolers) and sociodemographic and behavioural factors associated with these. STUDY DESIGN This was a population-based cross-sectional study. METHODS Survey 5 data collected in 2009 (n = 4290) of the 1973-1978 birth cohort of the Australian Longitudinal Study on Women's Health were used. Multiple linear and logistic regression models were used to examine associations. RESULTS In adjusted models, compared with women with preschoolers, women whose youngest child was an infant aged 0-6 months, aged >6-12 months or toddler had lower PA (-321.3 MET.min/week [95% confidence interval (CI) -416.2, -226.4], -147.9 MET.min/week [95% CI -237.6, -58.1] and -106.4 MET.min/week [95% CI -172.3, -40.5]). ST was higher in women whose youngest child was an infant aged 0-6 months (0.48 h/day; 95% CI 0.19, 0.77) but lower with infants aged >6-12 months (-0.33 h/day; 95% CI -0.60, -0.05) and toddlers (-0.40 h/day; 95% CI -0.60, -0.20) than in those with preschoolers. The findings were similar in the logistic model. Sociodemographic and behavioural factors such as occupation and marital status also influenced PA and ST. CONCLUSIONS Women with infants and toddlers have lower PA than women with preschoolers. Women are more likely to sit more in the first 6 months after childbirth. These findings can inform resources and intervention development to improve activity levels in women with young children through consideration of the age of the youngest child, sociodemographic and behavioural factors.
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Affiliation(s)
- M Makama
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - W J Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia; Faculty of Health Science and Medicine, Bond University, Gold Coast, Australia
| | - S Lim
- Health Systems and Equity, Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - H Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Warwick Business School, Warwick University, Coventry, United Kingdom
| | - C L Harrison
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia; Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia
| | - A E Joham
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia; Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia
| | - G D Mishra
- Centre for Longitudinal and Life Course Research, University of Queensland, Brisbane, Queensland, Australia
| | - H Teede
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia; Warwick Business School, Warwick University, Coventry, United Kingdom; Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia
| | - L J Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia.
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Pelletier C, White N, Duchesne A, Sluggett L. Rural-urban differences in individual and environmental correlates of physical activity in Canadian Adults. Prev Med Rep 2022; 30:102061. [DOI: 10.1016/j.pmedr.2022.102061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/22/2022] Open
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Evans JT, Phan H, Buscot MJ, Gall S, Cleland V. Correlates and determinants of transport-related physical activity among adults: an interdisciplinary systematic review. BMC Public Health 2022; 22:1519. [PMID: 35945518 PMCID: PMC9363261 DOI: 10.1186/s12889-022-13937-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 07/12/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Transport-related physical activity (TRPA) has been identified as a way to increase physical activity due to its discretionary and habitual nature. Factors thought to influence TRPA span multiple disciplines and are rarely systematically considered in unison. This systematic review aimed to identify cross-sectional and longitudinal factors associated with adult TRPA across multiple research disciplines. METHODS Using four electronic databases, a systematic search of English, peer-reviewed literature from 2010 - 2020 was performed. Studies quantitatively examining factors associated with the outcome of adult TRPA were eligible. RESULTS Seventy-three studies (n = 66 cross-sectional; n = 7 longitudinal) were included, cumulatively reporting data from 1,278,632 observations. Thirty-six factors were examined for potential association with TRPA and presented in a social-ecological framework: individual (n = 15), social (n = 3), and environmental (n = 18). Seven factors were found to be consistently associated with higher adult TRPA: lower socio-economic status, higher self-efficacy, higher social normalization, lower distance of travel, higher destination concentration, more streetlighting, and higher public transportation frequency with a greater number of terminals near route start and endpoints. CONCLUSIONS This is the first comprehensive compilation of the correlates and determinants of adult TRPA. Seven individual, social, and environmental factors demonstrated consistent associations with TRPA. Models formed using these factors may facilitate more effective promotion of TRPA. There is a lack of longitudinal studies as well as studies assessing cognitive/attitudinal and social factors, highlighting gaps for further research. Those developing policies and strategies targeting TRPA need to consider a range of factors at the individual, social, and environmental level to maximise the likelihood of effectiveness.
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Affiliation(s)
- Jack T Evans
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St., 7000, Hobart, Australia
| | - Hoang Phan
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St., 7000, Hobart, Australia
| | - Marie-Jeanne Buscot
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St., 7000, Hobart, Australia
| | - Seana Gall
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St., 7000, Hobart, Australia
- Adjunct Associate Professor, School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Verity Cleland
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool St., 7000, Hobart, Australia.
- Honorary Fellow, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
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13
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Zhu X, Ory MG, Xu M, Towne SD, Lu Z, Hammond T, Sang H, Lightfoot JT, McKyer ELJ, Lee H, Sherman LD, Lee C. Physical Activity Impacts of an Activity-Friendly Community: A Natural Experiment Study Protocol. Front Public Health 2022; 10:929331. [PMID: 35784244 PMCID: PMC9240399 DOI: 10.3389/fpubh.2022.929331] [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] [Received: 04/26/2022] [Accepted: 05/13/2022] [Indexed: 01/07/2023] Open
Abstract
Background Stakeholders from multiple sectors are increasingly aware of the critical need for identifying sustainable interventions that promote healthy lifestyle behaviors. Activity-friendly communities (AFCs) have been known to provide opportunities for engaging in physical activity (PA) across the life course, which is a key to healthy living and healthy aging. Purpose Our purpose is to describe the study protocol developed for a research project that examines: (a) the short- and long-term changes in total levels and spatial and temporal patterns of PA after individuals move from non-AFCs to an AFC; and (b) what built and natural environmental factors lead to changes in PA resulting from such a move, either directly or indirectly (e.g., by affecting psychosocial factors related to PA). Methods This protocol is for a longitudinal, case-comparison study utilizing a unique natural experiment opportunity in Austin, Texas, USA. Case participants were those adults who moved from non-AFCs to an AFC. Matching comparison participants were residents from similar non-AFCs who did not move during the study period. Recruitment venues included local businesses, social and print media, community events, and individual referrals. Objectively measured moderate-to-vigorous PA and associated spatial and temporal patterns served as the key outcomes of interest. Independent (e.g., physical environments), confounding (e.g., demographic factors), and mediating variables (e.g., psychosocial factors) were captured using a combination of objective (e.g., GIS, GPS, Tanita scale) and subjective measures (e.g., survey, travel diary). Statistical analyses will be conducted using multiple methods, including difference-in-differences models, repeated-measures linear mixed models, hierarchical marked space-time Poisson point pattern analysis, and hierarchical linear mixed models. Conclusion Natural experiment studies help investigate causal relationships between health and place. However, multiple challenges associated with participant recruitment, extensive and extended data collection activities, and unpredictable intervention schedules have discouraged many researchers from implementing such studies in community-based populations. This detailed study protocol will inform the execution of future studies to explore how AFCs impact population health across the life course.
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Affiliation(s)
- Xuemei Zhu
- Department of Architecture, Texas A&M University, College Station, TX, United States,Center for Health Systems & Design, Texas A&M University, College Station, TX, United States
| | - Marcia G. Ory
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, United States,Center for Population Health and Aging, Texas A&M University, College Station, TX, United States,*Correspondence: Marcia G. Ory
| | - Minjie Xu
- Center for Health Systems & Design, Texas A&M University, College Station, TX, United States,Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, United States
| | - Samuel D. Towne
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, United States,Center for Population Health and Aging, Texas A&M University, College Station, TX, United States,School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, United States,Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, United States,Southwest Rural Health Research Center, Texas A&M University, College Station, TX, United States
| | - Zhipeng Lu
- Department of Architecture, Texas A&M University, College Station, TX, United States,Center for Health Systems & Design, Texas A&M University, College Station, TX, United States
| | - Tracy Hammond
- Department of Computer Science & Engineering, Texas A&M University, College Station, TX, United States
| | - Huiyan Sang
- Department of Statistics, Texas A&M University, College Station, TX, United States
| | - J. Timothy Lightfoot
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
| | - E. Lisako J. McKyer
- Center for Community Health Development, Texas A&M University, College Station, TX, United States
| | - Hanwool Lee
- Center for Health Systems & Design, Texas A&M University, College Station, TX, United States,Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, United States
| | - Ledric D. Sherman
- Department of Health and Kinesiology, Texas A&M University, College Station, TX, United States
| | - Chanam Lee
- Center for Health Systems & Design, Texas A&M University, College Station, TX, United States,Department of Landscape Architecture and Urban Planning, Texas A&M University, College Station, TX, United States
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14
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Walking Behavior in Temuco, Chile: The Contribution of Built Environment and Socio-Demographic Factors. Behav Sci (Basel) 2022; 12:bs12050133. [PMID: 35621430 PMCID: PMC9137913 DOI: 10.3390/bs12050133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/17/2022] [Accepted: 04/27/2022] [Indexed: 11/18/2022] Open
Abstract
The increase in active travel contributes to maintaining the minimum rate of physical activity and therefore has a positive impact on inhabitants’ public health. The level of walking for daily transport has decreased significantly during the last decades in Temuco, Chile. This study examined the contribution of socio-demographic factors, active family environment, and built environment factors to walking behavior and walking level based on three types of destination in Temuco. The results of Encuesta Origin Destino (EOD 2013), geographic information system (GIS), and, finally, hierarchical multiple regression analysis were used to examine the objectives. Correlations were found between total walking behavior, walking level based on three destination types, and several socio-demographic factors such as age, gender, and access to TV and Internet. Furthermore, correlations were found between walking behavior and active family environment, as well as several built environment factors. For instance, the higher mixed land use as well as number of parks and plazas contribute towards more overall walking as well as two types of walking. Identifying that most persons who walk come from low-income families and the negative impact of network connectivity on overall walking are the major differences between this context and developed countries.
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15
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Wang ML, Narcisse MR, Alatorre S, Kozak AT, McElfish PA. Neighborhood social cohesion and physical activity and obesity outcomes among Native Hawaiian and Pacific Islander individuals. Obesity (Silver Spring) 2022; 30:249-256. [PMID: 34910366 PMCID: PMC11201332 DOI: 10.1002/oby.23298] [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: 05/25/2021] [Revised: 08/25/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Native Hawaiian and Pacific Islander (NHPI) individuals report high obesity rates and low physical activity (PA) levels. This study examined associations between neighborhood social cohesion, obesity, and PA among NHPI adults. METHODS Cross-sectional data from the 2014 NHPI National Health Interview Survey were analyzed. Social cohesion was assessed using a summative scale and categorized as low, medium, and high. PA was measured via self-report and categorized as insufficiently active (0-149 min/wk) or sufficiently active (150+ min/wk). Obesity status was based on self-reported height and weight measures converted into standard BMI categories. Multivariable logistic regression models estimated odds of obesity and sufficient PA associated with social cohesion level. RESULTS The study sample included n = 2,590 NHPI adults. Compared with those in low social cohesion neighborhoods, participants in high social cohesion neighborhoods had increased sufficient PA odds (odds ratio [OR] = 1.59, 95% CI: 1.19-2.12; p = 0.003) and decreased obesity odds (OR = 0.57, 95% CI: 0.40-0.83; p = 0.005). No associations were observed between social cohesion and obesity and PA outcomes comparing individuals in medium versus low social cohesion neighborhoods. CONCLUSIONS High social cohesion was associated with reduced obesity odds and increased sufficient PA odds. Findings highlight the importance of enhancing social connectivity as a potential strategy to promote PA and healthy weight among NHPI individuals.
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Affiliation(s)
- Monica L. Wang
- Boston University School of Public Health, Department of Community Health Sciences, 715 Albany Street, Boston, Massachusetts 02118 USA
- Boston University Center for Antiracist Research, 1 Silber Way, Boston, Massachusetts 02215 USA
- Harvard T.H. Chan School of Public Health, Department of Health Policy and Management, 677 Huntington Avenue, Boston, Massachusetts 02115 USA
| | - Marie-Rachelle Narcisse
- University of Arkansas for Medical Sciences Northwest, College of Medicine, 1125 N. College Avenue, Fayetteville, Arkansas 72703 USA
| | - Selenne Alatorre
- Boston University School of Public Health, Department of Community Health Sciences, 715 Albany Street, Boston, Massachusetts 02118 USA
| | - Andrea T. Kozak
- Department of Psychology, Oakland University, 654 Pioneer Drive. Rochester, Michigan 48309 USA
| | - Pearl A. McElfish
- University of Arkansas for Medical Sciences Northwest, College of Medicine, 1125 N. College Avenue, Fayetteville, Arkansas 72703 USA
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16
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The Contribution of Socio-Demographic Factors to Walking Behavior Considering Destination Types; Case Study: Temuco, Chile. SOCIAL SCIENCES 2021. [DOI: 10.3390/socsci10120479] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The improvement of walking contributes to maintain the minimum rate of physical activity and therefore the residents’ public health. This is while the amount of walking in daily transport of inhabitants has significantly decreased during the last decades in Temuco, Chile. In addition, the impact of socio-demographic as well as social factors on the improvement of walking behavior has been paid less attention in previous studies. This study aims to examine the contribution of socio-demographic factors and the active family environment to walking behavior as well as walking level based on three types of destinations in Temuco. The results of “Encuesta Origin Destino” (EOD) in Temuco were used to examine the objectives. It was found that a high percentage of people who walk in Temuco belong to low-income families. Moreover, most of the people who walk, do not have a driver’s license nor private cars in their household. Certain socio-demographic factors such as age, gender, driver’s license, private cars, and access to TV were found to have associations with overall walking behavior as well as walking level depending on three different destination types. Furthermore, the correlation was found between walking behavior and active family environment. These findings were discussed and their implications were addressed as well.
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17
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Akinyelure OP, Jaeger BC, Moore TL, Hubbard D, Oparil S, Howard VJ, Howard G, Buie JN, Magwood GS, Adams RJ, Bonilha L, Lackland DT, Muntner P. Racial Differences in Blood Pressure Control Following Stroke: The REGARDS Study. Stroke 2021; 52:3944-3952. [PMID: 34470498 PMCID: PMC10032619 DOI: 10.1161/strokeaha.120.033108] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND AND PURPOSE In the general population, Black adults are less likely than White adults to have controlled blood pressure (BP), and when not controlled, they are at greater risk for stroke compared with White adults. High BP is a major modifiable risk factor for recurrent stroke, but few studies have examined racial differences in BP control among stroke survivors. METHODS We used data from the REGARDS study (Reasons for Geographic and Racial Differences in Stroke) to examine disparities in BP control between Black and White adults, with and without a history of stroke. We studied participants taking antihypertensive medication who did and did not experience an adjudicated stroke (n=306 and 7693 participants, respectively) between baseline (2003-2007) and a second study visit (2013-2016). BP control at the second study visit was defined as systolic BP <130 mm Hg and diastolic BP <80 mm Hg except for low-risk adults ≥65 years of age (ie, those without diabetes, chronic kidney disease, history of cardiovascular disease, and with a 10-year predicted atherosclerotic cardiovascular disease risk <10%) for whom BP control was defined as systolic BP <130 mm Hg. RESULTS Among participants with a history of stroke, 50.3% of White compared with 39.3% of Black participants had controlled BP. Among participants without a history of stroke, 56.0% of White compared with 50.2% of Black participants had controlled BP. After multivariable adjustment, there was a tendency for Black participants to be less likely than White participants to have controlled BP (prevalence ratio, 0.77 [95% CI, 0.59-1.02] for those with a history of stroke and 0.92 [95% CI, 0.88-0.97] for those without a history of stroke). CONCLUSIONS There was a lower proportion of controlled BP among Black compared with White adults with or without stroke, with no statistically significant differences after multivariable adjustment.
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Affiliation(s)
- Oluwasegun P. Akinyelure
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Byron C. Jaeger
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Tony L. Moore
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Demetria Hubbard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Suzanne Oparil
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Virginia J. Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - George Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
| | - Joy N. Buie
- Department of Neurology, Medical University of South Carolina, Charleston, SC
| | | | - Robert J. Adams
- Department of Neurology, Medical University of South Carolina, Charleston, SC
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, SC
| | - Daniel T. Lackland
- Department of Neurology, Medical University of South Carolina, Charleston, SC
| | - Paul Muntner
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL
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18
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Westgarth C, Christley RM, Marvin G, Perkins E. Functional and recreational dog walking practices in the UK. Health Promot Int 2021; 36:109-119. [PMID: 32361764 PMCID: PMC7954209 DOI: 10.1093/heapro/daaa051] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Dog walking is a popular everyday activity known to contribute considerably to human health through motivating substantial additional physical activity. However, despite recognition that walking with a dog is substantially different from walking without a dog, little is known sociologically about the practices of dog walking. This study used in-depth interviews with 38 dog owners, combined with autoethnographical observation of dog walking. The aim was to investigate the types of dog walks that occur and the implications of this for the promotion of dog walking to increase human and animal wellbeing. Two distinct types of dog walking were found that had differing influencers and resulting experiences. Functional walks were purposed through feelings of guilt to provide the dog with a convenient form of exercise but were less pleasurable for the owner. In contrast, recreational walks provided significant owner stress-relief and were longer, typically during pleasant weather and at weekends, in less urban environments, and involved more members of the household. Limitations on time availability, conducive weather or accessibility of desirable physical environments for dog walking, generated functional rather than recreational dog walks. These findings have implications for interventions aiming to promote dog walking and for policy relating to the availability of safe and suitable green spaces for encouraging dog walking.
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Affiliation(s)
- Carri Westgarth
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Liverpool CH64 7TE, UK.,Institute of Veterinary Science, University of Liverpool, Liverpool CH64 7TE, UK
| | - Robert M Christley
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Liverpool CH64 7TE, UK.,Institute of Veterinary Science, University of Liverpool, Liverpool CH64 7TE, UK
| | - Garry Marvin
- Department of Life Sciences, University of Roehampton, London SW15 4JD, UK
| | - Elizabeth Perkins
- Department of Health Services Research, Institute of Psychology, Health and Society, University of Liverpool, Liverpool L69 7ZX, UK
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19
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Paydar M, Kamani Fard A. The Hierarchy of Walking Needs and the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7461. [PMID: 34299913 PMCID: PMC8307307 DOI: 10.3390/ijerph18147461] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/27/2022]
Abstract
More than 150 cities around the world have expanded emergency cycling and walking infrastructure to increase their resilience in the face of the COVID 19 pandemic. This tendency toward walking has led it to becoming the predominant daily mode of transport that also contributes to significant changes in the relationships between the hierarchy of walking needs and walking behaviour. These changes need to be addressed in order to increase the resilience of walking environments in the face of such a pandemic. This study was designed as a theoretical and empirical literature review seeking to improve the walking behaviour in relation to the hierarchy of walking needs within the current context of COVID-19. Accordingly, the interrelationship between the main aspects relating to walking-in the context of the pandemic- and the different levels in the hierarchy of walking needs were discussed. Results are presented in five sections of "density, crowding and stress during walking", "sense of comfort/discomfort and stress in regard to crowded spaces during walking experiences", "crowded spaces as insecure public spaces and the contribution of the type of urban configuration", "role of motivational/restorative factors during walking trips to reduce the overload of stress and improve mental health", and "urban design interventions on arrangement of visual sequences during walking".
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Affiliation(s)
- Mohammad Paydar
- Escuela de Arquitectura Temuco, Facultad de Humanidades, Universidad Mayor, Av. Alemania 281, Temuco 4780000, Chile
| | - Asal Kamani Fard
- Universidad Católica del Maule, San Miguel 3605, Talca 3460000, Chile;
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20
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A Scoping Review of How Income Affects Accessing Local Green Space to Engage in Outdoor Physical Activity to Improve Well-Being: Implications for Post-COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249313. [PMID: 33322829 PMCID: PMC7764517 DOI: 10.3390/ijerph17249313] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/02/2020] [Accepted: 12/07/2020] [Indexed: 01/01/2023]
Abstract
Background: The National Institute for Health and Care Excellence (NICE) has set out guidance for promoting physical activity (PA) in the physical environment to promote health and well-being. The aim of this selective scoping review was to investigate the influence of gross income on accessing local green spaces to engage in PA and the associated health benefits. Methods: A scoping review was conducted of international literature to facilitate the clarification of the research question. Findings: 15 papers were critically appraised under two themes: (1) environments and well-being and (2) PA and income/socioeconomic status and impact on the frequency, duration and opportunity to engage in PA. Interpretation: Income is related to differential use of green and blue spaces for PA, due mainly to access issues. People who live in lower socioeconomic areas tend to be more sedentary and there are also gender differences related to PA in built environments. Conclusion: There is an effect of income in using green spaces for PA, but the relationship is non-linear, and there is still a lack of knowledge about what kind of green spaces are best for health benefits. The COVID-19 pandemic highlighted the importance of accessing green local spaces to engage in physical exercise to improve well-being among the public.
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21
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Reis AC, Lokpo K, Bojanic M, Sperandei S. In search of a "vocabulary for recreation": Leisure-time physical activity among humanitarian migrants in regional Australia. PLoS One 2020; 15:e0239747. [PMID: 33052914 PMCID: PMC7556461 DOI: 10.1371/journal.pone.0239747] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 09/13/2020] [Indexed: 11/18/2022] Open
Abstract
This study provides an exploration of the meanings of leisure for humanitarian migrants in regional Australia and these meanings' implications for health. It uses mixed-methods to explore leisure-time physical activity participation and day-to-day experiences of leisure and health. A sample representing approximately one third of the Coffs Coast adult humanitarian migrant population completed the survey, as well as 32 individuals who participated in interviews and focus groups. Findings were organised into three themes and explored issues around mental health and time for leisure, cultural differences in experiencing leisure, and the connections with experiences of other disadvantaged groups. We conclude by arguing that leisure needs to be brought to the fore of discussions around service provision and policy making concerned with the wellbeing of the refugee migrant population, particularly focusing on support for the (re)development of a vocabulary for recreation, as a step forward in the journey to healing and belonging.
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Affiliation(s)
- Arianne C. Reis
- School of Health Sciences, Western Sydney University, Sydney, Australia
- * E-mail:
| | - Komla Lokpo
- Sanctuary Australia Foundation, Coffs Harbour, Australia
| | - Matthew Bojanic
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Sandro Sperandei
- Institute of Scientific and Technological Communication & Information in Health, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
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22
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Morris KA, Arundell L, Cleland V, Teychenne M. Social ecological factors associated with physical activity and screen time amongst mothers from disadvantaged neighbourhoods over three years. Int J Behav Nutr Phys Act 2020; 17:110. [PMID: 32859233 PMCID: PMC7456370 DOI: 10.1186/s12966-020-01015-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 08/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mothers from socioeconomically disadvantaged neighbourhoods are at elevated risk of physical inactivity and high levels of screen time. Yet, little is known regarding the social ecological factors that are longitudinally associated with physical activity and screen time in this target group, and whether the age of their children impacts these relationships. This study aimed to longitudinally examine the social ecological factors associated with physical activity and screen time amongst mothers living in socioeconomically disadvantaged neighbourhoods, and whether these differed according to their child's age. METHODS Data were from 895 mothers living in socioeconomically disadvantaged neighbourhoods (mean age 36.7 years) at baseline and three-year follow-up. Mothers self-reported weekly discretionary physical activity (leisure-time, LTPA; transport-related, TRPA) and screen time durations. Linear regression models assessed associations between five intrapersonal, three social and five physical environmental factors and LTPA, TRPA and screen time, adjusting for confounding factors, clustering by neighbourhood and baseline variables. Interaction analysis was conducted for age of children (younger and older children (n = 442) and mothers with older children (aged 5-12 years) only (n = 453). RESULTS In adjusted models, all intrapersonal factors (self-efficacy, enjoyment, outcome expectations, behavioural intentions and behavioural skill), social support from friends, neighbourhood cohesion and number of televisions were longitudinally associated with LTPA amongst all mothers. Interaction models showed that findings were generally consistent across groups (i.e., those with both younger and older children compared to those with older children only), with three exceptions. Physical activity enjoyment and social support from family were associated with LTPA only among mothers with older children. Neighbourhood cohesion was associated with screen time only amongst mothers with both younger and older children. No associations were detected for TRPA. CONCLUSION Intrapersonal, social and physical environmental factors were longitudinally associated with mother's LTPA, whilst neighbourhood cohesion was longitudinally associated with screen time behaviours amongst mothers. Interventions aimed at increasing LTPA amongst mothers (particularly those from socioeconomically disadvantaged neighbourhoods) may need to target all domains of the social ecological model and may require some tailoring according to the age of children. Further work is needed to identify longitudinal associations with screen time and TRPA in this population group.
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Affiliation(s)
- Kylie A Morris
- Geelong, Australia, School of Exercise and Nutrition Sciences, Deakin University, Melbourne Burwood Campus, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
| | - Lauren Arundell
- Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
| | - Verity Cleland
- Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Megan Teychenne
- Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia
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23
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Tessaro VCZ, Silva AMR, Loch MR. Stages of change for leisure time physical activity in Brazilian adults: longitudinal study. CIENCIA & SAUDE COLETIVA 2020; 26:2969-2980. [PMID: 34378690 DOI: 10.1590/1413-81232021268.18022020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/12/2020] [Indexed: 11/22/2022] Open
Abstract
The objective of this study was to analyze the maintenance of and movement between stages of change for leisure time physical activity (LTPA) after four years and the association with sociodemographic characteristics. A cross-sectional population-based study was conducted with 1,180 individuals aged 40 years or over in 2011. In 2015, 885 participants were reinterviewed. The dependent variables were the maintenance of and movement between stages of change for LTPA behavior. The data was analyzed using adjusted Poisson regression. We found that around 40% of the study participants were still at the same stage they were at in the first assessment, while 31.6% had relapsed and 27% had advanced at least one stage. The stages that showed the highest frequencies were remained in precontemplation and maintenance. The risk of remaining at the precontemplation stage was higher among men (RR=1.59; 95%CI:1.21-2.11), respondents aged ≥60 years (RR=1.35; 95%CI:1.03-1.78), those with a lower level of education (RR=1.24; 95%CI:1.04-2.33), and those from economic classes C and D/E (RR=1.71; 95%CI:1.17-2.49 and RR=1.88; 95%CI:1.12-3.18, respectively). The frequency of individuals who remained at the maintenance stage was significantly lower in economic classes D/E than in classes A/B (RR=0.35; 95%CI:0.14-0.87).
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Affiliation(s)
- Valéria Cristina Zamataro Tessaro
- Programa de Pós-Graduação em Fisioterapia, Universidade Estadual de Londrina. Av. Robert Koch 60 Caixa Postal 791, Bairro Cervejaria. 86038-440 Londrina PR Brasil.
| | - Ana Maria Rigo Silva
- Departamento de Saúde Coletiva, Centro de Ciências da Saúde, Universidade Estadual de Londrina. Londrina PR Brasil
| | - Mathias Roberto Loch
- Departamento de Fundamentos da Educação Física, Centro de Educação Física e Desportos, Universidade Estadual de Londrina. Londrina PR Brasil
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Castrillon CIM, Beckenkamp PR, Ferreira ML, Michell JA, de Aguiar Mendes VA, Luscombe GM, Stamatakis E, Ferreira PH. Are people in the bush really physically active? A systematic review and meta-analysis of physical activity and sedentary behaviour in rural Australians populations. J Glob Health 2020; 10:010410. [PMID: 32373329 PMCID: PMC7182355 DOI: 10.7189/jogh.10.010410] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Physical inactivity is a major risk factor for non-communicable disease and premature mortality. People who live in rural settings are usually regarded as more physically active than those living in urban areas, however, direct comparisons between these populations are scarce. We aimed to summarise the prevalence of physical inactivity and sedentary behaviour in rural settings in Australia, compared to urban counterparts. Methods We searched six databases (AMED, Embase, Medline; CINAHL, SPORTDiscus; and RURAL) and identified 28 observational studies that investigated the levels of physical inactivity and/or sedentary behaviour in adults aged 18 years and over in rural Australia. Random effects meta-analysis was used to generate pooled prevalence estimates. Results Physical inactivity was four percentage points (95% confidence interval (CI) = 0.4 to 8) higher in rural populations compared to urban populations. There was a one percentage point (95% CI = -3 to 5) prevalence difference of physical activity in the rural populations. Rural populations reported on average 7.8 hours of sedentary time per day (95% CI = 5 to 10) and the prevalence of high levels of sedentary behaviour (≥to 8 hours per day) was 7% (95% CI = -8 to -7) greater in urban areas compared to rural areas. Conclusions People living in rural areas are just as physically inactive as people who live in urban areas. Our findings challenge the popular views that rural lifestyles result in people engaging more frequently in physical activity. Public health campaigns promoting physical activity in rural settings are just as necessary as in urban settings.
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Affiliation(s)
| | - Paula R Beckenkamp
- The University of Sydney, Discipline of Physiotherapy, Faculty of Medicine and Health, Sydney, Australia
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jose A Michell
- The University of Sydney, Discipline of Physiotherapy, Faculty of Medicine and Health, Sydney, Australia.,Institute of Bone and Joint Research, The Kolling Institute, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.,University of Sao Paulo, Department of Neuroscience and Behavioral Sciences, Sao Paulo, Brazil.,The University of Sydney, School of Rural Health, Faculty of Medicine and Health, Orange, Australia.,The University of Sydney, Charles Perkins Centre, Faculty of Medicine and Health, School of Health Sciences, Sydney, Australia
| | | | - Georgina M Luscombe
- The University of Sydney, School of Rural Health, Faculty of Medicine and Health, Orange, Australia
| | - Emmanuel Stamatakis
- The University of Sydney, Charles Perkins Centre, Faculty of Medicine and Health, School of Health Sciences, Sydney, Australia
| | - Paulo Henrique Ferreira
- The University of Sydney, Discipline of Physiotherapy, Faculty of Medicine and Health, Sydney, Australia
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25
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Abstract
The purpose of this study is to examine how much variance in self-rated health is attributable to household and administrative-area levels. Additionally, the study investigates the association between physical activity and self-rated health while adjusting for various covariates at the individual, household, and district levels in Seoul, South Korea. A cross-sectional study of the 2009 Seoul Welfare Panel Study conducted by Seoul Welfare Foundation was utilized. The final sample included 7,761 individuals within 3,617 households in 25 administrative areas. Three-level random intercept logistic models were fitted. The results showed that a small proportion (3.52%) of variance in self-rated health was attributed to the administrative-area level, while a relatively large proportion (33.78%) was attributed to the household level. This study also found a positive association between physical activity and self-rated health, even after controlling for covariates at multiple levels. The results indicated that public health interventions promoting physical activity may have a beneficial effect on individual health. Additionally, public health interventions for improving individual health may not be efficient if directed only at the administrative-area level, as only a small portion of variance in self-rated health was attributable to this level.
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Affiliation(s)
- Sehee Han
- Institute of Social Sciences, Kookmin University, Seongbuk-Gu, South Korea
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26
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Cleland V, Cocker F, Canary J, Teychenne M, Crawford D, Timperio A, Ball K. Social-ecological predictors of physical activity patterns: A longitudinal study of women from socioeconomically disadvantaged areas. Prev Med 2020; 132:105995. [PMID: 31954139 DOI: 10.1016/j.ypmed.2020.105995] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 12/10/2019] [Accepted: 01/13/2020] [Indexed: 11/26/2022]
Abstract
Limited longitudinal evidence of the predictors of physical activity (PA) patterns over time exists, particularly among high-risk groups such as women living in socioeconomically disadvantaged areas. This study aimed to: 1) describe leisure-time PA (LTPA) and transport-related PA (TRPA) patterns over time; and 2) identify individual, social and physical environmental predictors of LTPA and TRPA patterns over five years. Baseline (2007-08) data were collected and analysed (2016-18) from n = 4349 women (18-46 years) from disadvantaged areas of Victoria, Australia. Three- and five-year follow-up data were collected in 2010-11 (n = 1912) and 2012 (n = 1560). LTPA and TRPA were self-reported using the International Physical Activity Questionnaire, and patterns categorised as consistently low, persistently increasing, persistently decreasing, or inconsistent. Compared to a consistently low LTPA pattern, greater family support predicted both persistent decreases (odds ratio [OR] 1.20, 95% CI 1.05-1.36) and persistent increases (OR 1.17, 95% CI 1.04-1.32) in LTPA, while access to childcare predicted inconsistent LTPA patterns (OR 1.66, 95% CI 1.03-2.65). For both LTPA and TRPA, PA enjoyment predicted persistent increases (LTPA: OR 1.05, 95% CI 1.02-1.10; TRPA: OR 1.03, 95% CI 1.00-1.07), persistent decreases (LTPA: OR 1.04, 95% CI 1.00-1.08; TRPA OR 1.04, 95% CI 0.99-1.08), and inconsistent patterns (LTPA: OR 1.04, 95% CI 1.02-1.07; TRPA: OR 1.03, 95% CI 1.01-1.06). Although directionality was inconsistent, and the magnitude of effects were small, PA enjoyment, family social support for PA and access to childcare warrant further investigation and consideration as potentially key factors impacting PA patterns among women living in socioeconomically disadvantaged areas.
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Affiliation(s)
- Verity Cleland
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
| | - Fiona Cocker
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Jana Canary
- Department of Developmental Studies, University of Alaska Fairbanks, Fairbanks, AK, United States of America
| | - Megan Teychenne
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | - David Crawford
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | - Anna Timperio
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
| | - Kylie Ball
- Institute for Physical Activity and Nutrition, Deakin University, Melbourne, Victoria, Australia
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27
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Craike M, Bourke M, Hilland TA, Wiesner G, Pascoe MC, Bengoechea EG, Parker AG. Correlates of Physical Activity Among Disadvantaged Groups: A Systematic Review. Am J Prev Med 2019; 57:700-715. [PMID: 31630762 DOI: 10.1016/j.amepre.2019.06.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/25/2019] [Accepted: 06/26/2019] [Indexed: 12/17/2022]
Abstract
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.
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Affiliation(s)
- Melinda Craike
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia; Mitchell Institute, Victoria University, Melbourne, Victoria, Australia.
| | - Matthew Bourke
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Toni A Hilland
- School of Education, College of Design and Social Context, Bundoora, Victoria, Australia
| | - Glen Wiesner
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Michaela C Pascoe
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia; Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Enrique Garcia Bengoechea
- Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Alexandra G Parker
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
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28
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Zhang R, Duan Y, Brehm W, Wagner P. Socioecological Correlates of Park-based Physical Activity in Older Adults: A Comparison of Hong Kong and Leipzig Parks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E3048. [PMID: 31443443 PMCID: PMC6747084 DOI: 10.3390/ijerph16173048] [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: 07/20/2019] [Revised: 08/18/2019] [Accepted: 08/19/2019] [Indexed: 11/16/2022]
Abstract
AIMS The present study aimed to examine and compare the socioecological correlates of park-based physical activity (PA) among Hong Kong and Leipzig older adults in terms of types of activity areas, perceived park environment, psychosocial factors, and the interactions between the perceived park environmental and psychosocial factors. METHODS Based on the SOPARC, systematic observations were conducted in six randomly selected urban parks in each city. A total of 317 Hong Kong (Mage = 69.96; SD = 6.81) and 311 Leipzig (Mage = 72.06; SD = 6.78) older adults from these six parks completed an interviewer-delivered survey measuring their perceived park environment, psychosocial variables, and park-based PA. RESULTS In both cities, the types of activity areas were positively associated with the number of older adults observed being active in parks. Psychosocial factors, especially self-efficacy and perceived barriers, had larger associations with park-based PA compared with the perceived park environment. The interaction between perceived park features and self-efficacy in the association with park-based PA was found in Leipzig, but not in Hong Kong. CONCLUSION Findings of the current study contribute to the cross-cultural understanding of the socioecological correlates of park-based PA among older adults.
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Affiliation(s)
- Ru Zhang
- Department of Sports Science & Physical Education, Faculty of Education, The Chinese University of Hong Kong, Hong Kong 999077, China.
| | - Yanping Duan
- Department of Sport and Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong 999077, China
| | - Walter Brehm
- Institute of Sport Science, Faculty of Humanities and Social Science, University of Bayreuth, 95447 Bayreuth, Germany
| | - Petra Wagner
- Institute of Exercise and Public Health, Faculty of Sport Sciences, University of Leipzig, 04103 Leipzig, Germany
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¡Nosotros corremos, nosotros jugamos! [we run, we play!]: Children’s perceptions of physical activity in Mexican-origin border communities. J Public Health (Oxf) 2019. [DOI: 10.1007/s10389-018-0943-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Bammann K, Drell C, Lübs LL, Stalling I. Cluster-randomised trial on participatory community-based outdoor physical activity promotion programs in adults aged 65-75 years in Germany: protocol of the OUTDOOR ACTIVE intervention trial. BMC Public Health 2018; 18:1197. [PMID: 30352580 PMCID: PMC6199784 DOI: 10.1186/s12889-018-6124-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/15/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Despite its well-known benefits for health and well-being physical activity levels are insufficient and declining with age in Germany. Physical activity promotion programs for older adults are often not successful, one reason is insufficient relevance of intervention measures for the study population. Community-based participatory research (CBPR) is a possible key strategy for tailoring more meaningful intervention programs to a specific community. However, evidence for the effectiveness of CBPR in the general population is scarce. This study aims to formally evaluate the efficacy of a CBPR approach for developing and implementing an outdoor physical activity program for older adults. METHODS/DESIGN The OUTDOOR ACTIVE intervention trial is a cluster-randomised intervention study carried out in a random sample of eight subdistricts in the city of Bremen, Germany. The eight subdistricts are grouped into four homogenous pairs with regard to socioeconomic level and land use mix of the subdistrict. Within the pairs, the subdistricts are assigned randomly to the two study arms: participatory development and implementation of a community-based program to promote outdoor physical activity (intervention) versus no intervention (controls). For evaluation, a survey is carried out before (baseline) and after (follow-up) the intervention period. The measurements include 7-day accelerometer measurement, physical fitness test, blood pressure, basic anthropometry, and self-administered questionnaire. DISCUSSION The OUTDOOR ACTIVE intervention trial will provide detailed information on PA intervention for older adults in an urban setting. Through the participatory nature of the study it will provide valuable insights into drivers and barriers to PA in this group, and it will inform policy makers and other stakeholders how to benefit from the results. TRIAL REGISTRATION German Clinical Trials Register DRKS00015117 (Date of registration 17-07-2018).
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Affiliation(s)
- Karin Bammann
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
| | - Carina Drell
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
| | - Lena Lotte Lübs
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
| | - Imke Stalling
- Institute for Public Health and Nursing Sciences (IPP), University of Bremen, Bremen, Germany
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31
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Psychometric Properties of the Modified Social Environment Questionnaire in Chinese Older Adults. J Aging Phys Act 2018; 26:530-536. [PMID: 29182419 DOI: 10.1123/japa.2017-0044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study evaluated the psychometric properties of a Chinese version of the 24-item Social Environment Questionnaire (SEQ-C). Confirmatory factor analysis was used to examine the factor validity and measurement invariance (Purpose 1) of the SEQ-C in 453 older adults in Hong Kong. Convergent validity (Purpose 2) and test-retest reliability (Purpose 3) were also measured. The results of the confirmatory factor analysis and measurement invariance supported the four-factor structure (representing companionship, encouragement, neighborhood social cohesion, and role models) of the SEQ-C, in a 15-item model that closely fitted the data. The SEQ-C was also found to have acceptable to satisfactory internal consistency, test-retest reliability, composite reliability, and moderate convergent validity in correlating perceived social support. This study showed that the SEQ-C is a suitable means of measuring the social environments of older adults in Hong Kong.
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Golestaneh L, Bellin E, Neugarten J, Lo Y. Avoidable visits to the emergency department(ED) and their association with sex, age and race in a cohort of low socio-economic status patients on hemodialysis in the Bronx. PLoS One 2018; 13:e0202697. [PMID: 30142175 PMCID: PMC6108498 DOI: 10.1371/journal.pone.0202697] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/06/2018] [Indexed: 12/26/2022] Open
Abstract
Background In national samples drawn from the USRDS, female patients utilize the hospital ED and inpatient services at a higher rate than their male counterparts and have a higher rate of re-hospitalization. We wanted to explore the association of sex with avoidable ED visits made by a cohort of patients on hemodialysis in a mostly minority, lower socioeconomic status (SES), population in the Bronx to test the applicability of the USRDS findings. Methods We used Montefiore’s clinical database to build a cohort of patients on hemodialysis with a first ED visit between 2013 and 2017. All ED visits after the index ED visit and those within one year prior to the index visit were recorded. None of the ED visits resulted in a hospitalization and were thus labeled “avoidable”. Bivariate analysis tested the association of demographic and clinical variables with sex. We used negative binomial regression to test the association of each variable with avoidable ED visit count. The multivariate model used negative binomial regression with avoidable ED visit count as outcome and sex as the exposure variable and included ancestral variables age and race. Potential mediators were added to the model to measure their effects on the association of sex with avoidable ED visits. Results Four thousand six hundred and seventy three subjects on hemodialysis were identified as having at least one avoidable ED visit, in the period of 2013–2017 at one of four ED sites affiliated with Montefiore Medical Center in the Bronx. Over 5 years (2012–2017), the median number of ED visits made by the study sample was 4 (25–75% IQR: 2–8). Female patients on hemodialysis in our cohort were older, more commonly black, had lower SES scores, less commonly had commercial insurance and were less commonly married than their male counterparts. Female sex was not significantly associated with a higher rate of avoidable ED visits in the total cohort.(1.053(0.99–1.12) Female sex was significantly associated with outcome in non-Hispanic whites only and in those subjects younger than 44 years old.(IRR 1.30(1.06–1.69), 1.17(1.00–1.38) in non-Hispanic White and younger age group, respectively.) Marital status, SES and hemoglobin levels possibly mediated the association of sex and outcome in our population. (>25% change in the coefficient for sex with respect to outcome when variable added to the model). Conclusion In this single center study of a lower-socioeconomic status, mostly minority dialysis population, the association of female sex with avoidable ED visits was not significant. These results suggest the association of sex with hospitalization outcomes, described by national datasets that determine quality indicators, are not consistent across different types of populations with some mediation possible by SES and marital status in poorer neighborhoods.
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Affiliation(s)
- Ladan Golestaneh
- Department of Medicine, Renal Division, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States of America
- * E-mail:
| | - Eran Bellin
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States of America
| | - Joel Neugarten
- Department of Medicine, Renal Division, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States of America
| | - Yungtai Lo
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States of America
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Sharman MJ, Nash M, Cleland V. Health and broader community benefit of parkrun-An exploratory qualitative study. Health Promot J Austr 2018; 30:163-171. [PMID: 29939453 DOI: 10.1002/hpja.182] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 06/18/2018] [Accepted: 06/22/2018] [Indexed: 11/09/2022] Open
Abstract
ISSUE ADDRESSED parkrun is a free, weekly, timed, international mass community 5-km walk/run event. Unlike other paid events, parkrun attracts populations harder to engage in physical activity (PA) (eg, women, those with overweight/obesity or illness/injury/disability). This exploratory qualitative study investigated the individual, social and environmental factors associated with parkrun's broad appeal in Australia. METHODS Tasmanian parkrunners who completed a quantitative survey (2016) were purposively recruited for a 2017 interview study. Semistructured interviews focused on reasons for parkrun participation. Data saturation was achieved by the tenth interview. Data were analysed thematically. RESULTS Four themes emerged: (a) participation facilitators and barriers; (b) PA gain and broader community benefit; (c) social connections/networks; and (d) organisational issues. Appealing characteristics of parkrun included strong social support, performance gain opportunities, socialising, inclusivity (eg, all ages/abilities), sense of community, positive atmosphere and accessibility (eg, no cost and convenience). Some participants reported that parkrun had stimulated gains in their total PA (not always limited to walking/running) and that parkrun may also result in other community benefits (eg, supporting local businesses, fee-based running club/event participation and "parkrun tourism"). Most participants first attended parkrun because of encouragement from their social networks, and participants subsequently encouraged others to attend. Participants found parkrun events well organised, but identified some potential threats (eg, local politics). CONCLUSIONS Social factors appeared critical in driving initial and ongoing parkrun participation. parkrun may lead to wider community benefits beyond that gained through increased individual PA. These findings highlight the "success factors" driving parkrun participation and provide insights for other community-based PA promotion activities.
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Affiliation(s)
| | - Meredith Nash
- School of Social Sciences, University of Tasmania, Hobart, Tas., Australia
| | - Verity Cleland
- Menzies Institute for Medical Research, Hobart, Tas., Australia
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Sorkin DH, Rook KS, Campos B, Marquez B, Solares J, Mukamel DB, Marcus B, Kilgore D, Dow E, Ngo-Metzger Q, Nguyen DV, Biegler K. Rationale and study protocol for Unidas por la Vida (United for Life): A dyadic weight-loss intervention for high-risk Latina mothers and their adult daughters. Contemp Clin Trials 2018; 69:10-20. [PMID: 29597006 PMCID: PMC5964027 DOI: 10.1016/j.cct.2018.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 03/18/2018] [Accepted: 03/20/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Half of Mexican-American women are under-active and nearly 78% are overweight/obese. The high lifetime risk of developing type 2 diabetes necessitates a culturally appropriate lifestyle intervention. PURPOSE Unidas por la Vida is a novel dyadic intervention that capitalizes on the centrality of family in Latino culture to mobilize an existing family dyad as a resource for health behavior change. The intervention aims to improve health behaviors and promote weight loss in two at-risk members of the same family: mothers with type 2 diabetes and their overweight/obese adult daughters who are at risk for developing diabetes. METHODS Participants (N = 460 mother-adult daughter dyads) will be randomized into one of three conditions: 1) dyadic participation (mothers-daughters) in a lifestyle intervention; 2) individual participation (mothers alone; unrelated daughters alone) in a lifestyle intervention; and 3) mother-daughter dyads in a minimal intervention control group. RESULTS The primary outcome is weight loss. Secondary outcomes include physical activity, dietary intake, physiological measures (e.g. HbA1c), and body composition. Both the dyadic and individual interventions are expected to produce greater weight loss at 6, 12, and 18 months than those in minimal intervention control group, with women assigned to the dyadic intervention expected to lose more weight and to maintain the weight loss longer than women assigned to the individual intervention. CONCLUSION Because health risks are often shared by multiple members of at-risk families, culturally appropriate, dyadic interventions have the potential to increase the success of behavior change efforts and to extend their reach to multiple family members. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02741037.
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Affiliation(s)
- Dara H Sorkin
- Department of Medicine, University of California, Irvine, Irvine, CA, USA.
| | - Karen S Rook
- Department of Psychology and Social Behavior, University of California Irvine, Irvine, CA, USA
| | - Belinda Campos
- Department of Chicano/Latino Studies, University of California Irvine, Irvine, CA, USA
| | - Becky Marquez
- School of Public Health, Brown University, Providence, RI, USA
| | | | - Dana B Mukamel
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Bess Marcus
- School of Public Health, Brown University, Providence, RI, USA
| | - David Kilgore
- Department of Family Medicine, University of California Irvine, Irvine, CA, USA
| | - Emily Dow
- Department of Family Medicine, University of California Irvine, Irvine, CA, USA
| | - Quyen Ngo-Metzger
- Department of Medicine, University of California, Irvine, Irvine, CA, USA; US Preventive Services Task Force, Agency for Healthcare Research and Quality, Rockville, MD, USA
| | - Danh V Nguyen
- Department of Medicine, University of California, Irvine, Irvine, CA, USA; Biostatistics, Epidemiology and Research Design, University of California Irvine, Irvine, CA, USA
| | - Kelly Biegler
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
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Craike M, Wiesner G, Hilland TA, Bengoechea EG. Interventions to improve physical activity among socioeconomically disadvantaged groups: an umbrella review. Int J Behav Nutr Phys Act 2018; 15:43. [PMID: 29764488 PMCID: PMC5952843 DOI: 10.1186/s12966-018-0676-2] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 05/06/2018] [Indexed: 01/08/2023] Open
Abstract
Background People from socioeconomically disadvantaged population groups are less likely to be physically active and more likely to experience adverse health outcomes than those who are less disadvantaged. In this umbrella review we examined across all age groups, (1) the effectiveness of interventions to improve physical activity among socioeconomically disadvantaged groups, (2) the characteristics of effective interventions, and (3) directions for future research. Methods PubMed/MEDLINE and Scopus were searched up to May 2017 to identify systematic reviews reporting physical activity interventions in socioeconomically disadvantaged populations or sub-groups. Two authors independently conducted study screening and selection, data extraction (one author, with data checked by two others) and assessment of methodological quality using the ‘Assessment of Multiple Systematic Reviews’ scale. Results were synthesized narratively. Results Seventeen reviews met our inclusion criteria, with only 5 (30%) reviews being assessed as high quality. Seven (41%) reviews focused on obesity prevention and an additional four focused on multiple behavioural outcomes. For pre school children, parent-focused, group-based interventions were effective in improving physical activity. For children, school-based interventions and policies were effective; few studies focused on adolescents and those that did were generally not effective; for adults, there was mixed evidence of effectiveness but characteristics such as group-based interventions and those that focused on physical activity only were associated with effectiveness. Few studies focused on older adults. Across all ages, interventions that were more intensive tended to be more effective. Most studies reported short-term, rather than longer-term, outcomes and common methodological limitations included high probability of selection bias, low response rates, and high attrition. Conclusions Interventions can be successful at improving physical activity among children from socioeconomically disadvantaged groups, with evidence for other age groups weak or inconclusive. More high-quality studies in this population group are needed, which adopt strategies to increase recruitment rates and reduce attrition, report longer term outcomes, and provide adequate intervention details, to allow determination of the characteristics of effective interventions. We recommend that the benefits of physical activity be recognised more broadly than obesity prevention in future studies, as this may have implications for the design and appeal of interventions. Electronic supplementary material The online version of this article (10.1186/s12966-018-0676-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Melinda Craike
- Institute for Health and Sport, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia.
| | - Glen Wiesner
- Institute for Health and Sport, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia
| | - Toni A Hilland
- Institute for Health and Sport, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia.,School of Education, College of Design and Social Context, RMIT, PO Box 71, Bundoora, VIC, 3083, Australia
| | - Enrique Garcia Bengoechea
- Institute for Health and Sport, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia.,Department of Physical Education and Sport Sciences, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
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Cleland V, Nash M, Sharman MJ, Claflin S. Exploring the Health-Promoting Potential of the “parkrun” Phenomenon: What Factors are Associated With Higher Levels of Participation? Am J Health Promot 2018; 33:13-23. [DOI: 10.1177/0890117118770106] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: “ parkrun” is a free and increasingly popular weekly 5-km walk/run international community event, representing a novel setting for physical activity (PA) promotion. However, little is known about who participates or why. This study aimed to identify sociodemographic, health, behavioral, individual, social, and environmental factors associated with higher levels of participation. Design: Cross-sectional. Setting: Tasmania, Australia; June 2016. Participants: Three hundred seventy two adult parkrun participants. Measures: Online survey measuring sociodemographic, health, individual, social and environmental factors, parkrun participation, and PA. Analysis: Descriptive statistics, zero-truncated Poisson regression models. Results: Respondents (n = 371) were more commonly women (58%), aged 35 to 53 years (54%), and occasional or nonwalkers/runners (53%) at registration. A total of 44% had overweight/obesity. Half had non-adult children, most spoke English at home, and 7% reported PA-limiting illness/injury/disability. Average run/walk time was 30.2 ± 7.4 minutes. Compared to regular walkers/runners at registration, nonwalkers/runners were less commonly partnered, more commonly had overweight/obesity, less physically active, and had poorer self-rated health. Multivariate analyses revealed relative parkrun participation was inversely associated with education level and positively associated with interstate parkrun participation, perceived social benefits, self-efficacy for parkrun, and intentions to participate. Conclusion: parkrun attracts nonwalkers/runners and population groups hard to engage in physical activity. Individual- and social-level factors were associated with higher relative parkrun participation. parkrun’s scalability, accessibility, and wide appeal confers a research imperative to investigate its potential for public health gain.
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Affiliation(s)
- Verity Cleland
- Menzies Institute for Medical Research, Hobart Tasmania, Australia
| | - Meredith Nash
- School of Social Sciences, University of Tasmania, Hobart Tasmania, Australia
| | | | - Suzi Claflin
- Menzies Institute for Medical Research, Hobart Tasmania, Australia
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Oates GR, Phillips JM, Bateman LB, Baskin ML, Fouad MN, Scarinci IC. Determinants of Obesity in Two Urban Communities: Perceptions and Community-Driven Solutions. Ethn Dis 2018; 28:33-42. [PMID: 29467564 DOI: 10.18865/ed.28.1.33] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective In the search of solutions to the rising rates of obesity, community perspectives are important because they highlight areas of need and help determine the level of community support for potential interventions. This study aimed to identify community perceptions of factors associated with obesity in two urban municipalities - one racially mixed and one predominantly African American - and to explore community-driven solutions to the problem of obesity. Methods The study used Photovoice methodology to understand what community members perceived as obesity-promoting factors in their residential environments. Results A total of 96 photographs of factors relevant to obesity were discussed. Most commonly depicted were restaurants, grocery stores, fast food, and fitness centers. In 10 race-stratified focus groups, participants made 592 comments on 12 themes, the most common being restaurants, physical activity, food stores, and proposed solutions. The top three themes - restaurants, physical activity, and food stores - accounted for 58% of all barriers to healthy weight. Proposed solutions ranged from personal efforts and peer support, to educating adults and children, to community action. Conclusions Interventions addressing the immediate food and physical activity environment - restaurants, grocery stores, and resources for physical activity - may have high likelihood of success as they align with community needs and understanding of priorities. Health education and promotion programs that increase food-related knowledge and skills are also needed and likely to receive strong community support.
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Affiliation(s)
- Gabriela R Oates
- The Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham
| | - Janice M Phillips
- The Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham
| | - Lori B Bateman
- The Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham
| | - Monica L Baskin
- The Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham
| | - Mona N Fouad
- The Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham
| | - Isabel C Scarinci
- The Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham
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Kim J, Lee HY, Lee EY. Association between built environment and moderate to vigorous physical activity in Korean adults: a multilevel analysis. J Public Health (Oxf) 2017; 39:227-240. [PMID: 27026688 DOI: 10.1093/pubmed/fdw025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Research on the association between the built environment and moderate and vigorous physical activities (MVPA) is still evolving. Therefore, more evidence is needed. This study examines the relationship between built environment and MVPA in Korean adults. Methods A large sample of 204 324 adults from the 2012 Korean Community Health Survey (KCHS) was analyzed. MVPA was assessed by the International Physical Activity Questionnaire. Individual correlates from the KCHS and community built environment data from the Korean government were collected. A multilevel logistic regression was performed using the GLIMMIX procedure. Results Residents in cities (OR = 0.75, 95% CI 0.60-0.93) and districts (OR = 0.70, 95% CI 0.52-0.94) were less likely to engage in MVPA than residents in counties. While residents in communities with the least amount of physical equipment were less likely to participate in MVPA (OR = 0.72, 95% CI 0.57-0.90), residents in communities with the second smallest area of open space for PA were more likely to be active (OR = 1.37, 95% CI 1.07-1.77). The effect of built environment on MVPA was significant but relatively weak in comparison to the influence of individual correlates. Conclusions To improve MVPA in adults, a community built environment should be considered along with individual correlates.
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Affiliation(s)
- Jimee Kim
- Department of Nursing, Dongnam Health University, Suwon 440-714, Korea
| | - Hye-Young Lee
- Institute for Health and Society, Hanyang University, Seoul 133-791, Korea.,Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul 133-791, Korea
| | - Eun Young Lee
- Institute for Health and Society, Hanyang University, Seoul 133-791, Korea.,Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul 133-791, Korea.
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Guilcher SJT, Kaufman-Shriqui V, Hwang J, O'Campo P, Matheson FI, Glazier RH, Booth GL. The association between social cohesion in the neighborhood and body mass index (BMI): An examination of gendered differences among urban-dwelling Canadians. Prev Med 2017; 99:293-298. [PMID: 28232099 DOI: 10.1016/j.ypmed.2017.02.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 01/31/2017] [Accepted: 02/19/2017] [Indexed: 11/16/2022]
Abstract
Overweight and obesity are major global public health concerns. Obesity is multifactorial in origin and influenced by genetics, psychosocial factors, eating and physical activity behaviors, as well as the environment. The objective of this study is to examine the impact of social cohesion on gender differences in body mass index (BMI) for urban-dwelling Canadians. Cross-sectional data were used from the Neighborhood Effects on Health and Well-being Study (NEHW) in Toronto, Canada (n=2300). Our main outcome, BMI, was calculated from self-reported height and weight (weight (kg)/height (m)2). Using multi-level logistic regression models, we identified a significant interaction between social cohesion and gender on being overweight/obese. Women with higher social cohesion had slightly lower odds of being overweight/obese (OR: 0.96, 95%CI: 0.94 to 0.99) compared to men, after adjusting for other sociodemographic factors (e.g., age, income, education), and neighborhood characteristics (e.g., walkability, neighborhood safety and material deprivation). Future public health research and interventions should consider the differential mechanisms involved in overweight/obesity by gender. The exact mechanisms behind how the social environment influences these pathways are still unclear and require future research.
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Affiliation(s)
- Sara J T Guilcher
- Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, M5S 3M2, Canada; Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, M4N 3M5, Canada.
| | | | - Jongnam Hwang
- Department of Health Promotion, Daegu University, Gyeongsan, Republic of Korea
| | - Patricia O'Campo
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario M5T 3M7, Canada
| | - Flora I Matheson
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario M5T 3M7, Canada
| | - Richard H Glazier
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, M4N 3M5, Canada; Dalla Lana School of Public Health, University of Toronto, Ontario M5T 3M7, Canada; Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, M5G 1V7, Canada
| | - Gillian L Booth
- Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, M5B 1W8, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, M4N 3M5, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, M5S 1A8, Canada
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Sawyer A, Ucci M, Jones R, Smith L, Fisher A. Simultaneous evaluation of physical and social environmental correlates of physical activity in adults: A systematic review. SSM Popul Health 2017; 3:506-515. [PMID: 29349241 PMCID: PMC5769071 DOI: 10.1016/j.ssmph.2017.05.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 04/05/2017] [Accepted: 05/12/2017] [Indexed: 11/27/2022] Open
Abstract
Background Ecological models of physical activity posit that social and physical environmental features exert independent and interactive influences on physical activity, but previous research has focussed on independent influences. This systematic review aimed to synthesise the literature investigating how features of neighbourhood physical and social environments are associated with physical activity when both levels of influence are simultaneously considered, and to assess progress in the exploration of interactive effects of social and physical environmental correlates on physical activity. Methods A systematic literature search was conducted in February 2016. Articles were included if they used an adult (≥15 years) sample, simultaneously considered at least one physical and one social environmental characteristic in a single statistical model, used self-reported or objectively-measured physical activity as a primary outcome, reported findings from quantitative, observational analyses and were published in a peer-reviewed journal. Combined measures including social and physical environment items were excluded as they didn’t permit investigation of independent and interactive social and physical effects. Forty-six studies were identified. Results An inconsistent evidence base for independent environmental correlates of physical activity was revealed, with some support for specific physical and social environment correlates. Most studies found significant associations between physical activity and both physical and social environmental variables. There was preliminary evidence that physical and social environmental variables had interactive effects on activity, although only 4 studies examined interactive effects. Conclusions Inconsistent evidence of independent associations between environmental variables and physical activity could be partly due to unmeasured effect modification (e.g. interactive effects) creating unaccounted variance in relationships between the environment and activity. Results supported multiple levels of environmental influence on physical activity. It is recommended that further research uses simultaneous or interaction analyses to gain insight into complex relationships between neighbourhood social and physical environments and physical activity, as there is currently limited research in this area.
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Affiliation(s)
- Alexia Sawyer
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
| | - Marcella Ucci
- UCL Institute for Environmental Design and Engineering, The Bartlett Faculty of the Built Environment, Central House, University College London, 14 Upper Woburn Place, London WC1H 0NN, UK
| | - Russell Jones
- Glasgow Centre for Population Health, The Olympia Building, University of Glasgow, Glasgow G12 8QQ, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Dept. of Life Sciences, Anglia Ruskin University, UK
| | - Abi Fisher
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, Gower Street, London WC1E 6BT, UK
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Abrantes AM, Farris SG, Garnaat SL, Minto A, Brown RA, Price LH, Uebelacker LA. The Role of Physical Activity Enjoyment on the Acute Mood Experience of Exercise among Smokers with Elevated Depressive Symptoms. Ment Health Phys Act 2017; 12:37-43. [PMID: 28989344 PMCID: PMC5625337 DOI: 10.1016/j.mhpa.2017.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PROBLEM Depressive symptoms are consistently shown to be related to poor smoking cessation outcomes. Aerobic exercise is a potential treatment augmentation that, given its antidepressant and mood enhancing effect, may bolster cessation outcomes for smokers with elevated depressive symptoms. Lower enjoyment of physical activity may inhibit the acute mood enhancing effects of aerobic exercise. The current study investigated the associations between depressive symptoms, physical activity enjoyment and the acute mood experience from exercise among low-active smokers with elevated depressive symptoms. METHOD Daily smokers with elevated depressive symptoms (N=159; Mage = 45.1, SD = 10.79; 69.8% female) were recruited for a randomized controlled exercise-based smoking cessation trial. Participants self-reported levels of depressive symptoms, physical activity enjoyment, and rated their mood experience (assessed as "mood" and "anxiety") before and after a standardized aerobic exercise test. RESULTS Hierarchical regression analysis revealed that depressive symptom severity accounted for significant unique variance in physical activity enjoyment (R2 =.041, t = -2.61, p = .010), beyond the non-significant effects of gender and level of tobacco dependence. Additionally, physical activity enjoyment was a significant mediator of the association between depressive symptom severity and acute mood experience ("mood" and "anxiety") following the exercise test. CONCLUSIONS Physical activity enjoyment may explain, at least in part, how depressive symptom severity is linked to the acute mood experience following a bout of activity. Interventions that target increasing physical activity enjoyment may ultimately assist in enhancing the mood experience from exercise, and therefore improve smoking cessation likelihood, especially for smokers with elevated depressive symptoms.
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Affiliation(s)
- Ana M. Abrantes
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
| | - Samantha G. Farris
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
- The Miriam Hospital, Providence, Rhode Island
| | - Sarah L. Garnaat
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
| | | | - Richard A. Brown
- Alpert Medical School of Brown University, Providence, Rhode
Island
- University of Texas at Austin, Austin, Texas
| | - Lawrence H. Price
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
| | - Lisa A. Uebelacker
- Butler Hospital, Providence, Rhode Island
- Alpert Medical School of Brown University, Providence, Rhode
Island
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Mooney SJ, Joshi S, Cerdá M, Kennedy GJ, Beard JR, Rundle AG. Neighborhood Disorder and Physical Activity among Older Adults: A Longitudinal Study. J Urban Health 2017; 94:30-42. [PMID: 28108872 PMCID: PMC5359178 DOI: 10.1007/s11524-016-0125-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Neighborhood physical disorder-the visual indications of neighborhood deterioration-may inhibit outdoor physical activity, particularly among older adults. However, few previous studies of the association between neighborhood disorder and physical activity have focused on this sensitive population group, and most have been cross-sectional. We examined the relationship between neighborhood physical disorder and physical activity, measured using the Physical Activity Scale for the Elderly (PASE), in a three-wave longitudinal study of 3497 New York City residents aged 65-75 at baseline weighted to be representative of the older adult population of New York City. We used longitudinal mixed linear regression controlling for a number of individual and neighborhood factors to estimate the association of disorder with PASE score at baseline and change in PASE score over 2 years. There were too few subjects to assess the effect of changes in disorder on activity levels. In multivariable mixed regression models accounting for individual and neighborhood factors; for missing data and for loss to follow-up, each standard deviation increase in neighborhood disorder was associated with an estimated 2.0 units (95% CI 0.3, 3.6) lower PASE score at baseline, or the equivalent of about 6 min of walking per day. However, physical disorder was not related to changes in PASE score over 2 years of follow-up. In this ethnically and socioeconomically diverse population of urban older adults, residents of more disordered neighborhoods were on average less active at baseline. Physical disorder was not associated with changes in overall physical activity over time.
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Affiliation(s)
| | - Spruha Joshi
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Magdalena Cerdá
- Department of Emergency Medicine, University of California, Davis, CA, USA
| | | | - John R Beard
- Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland
| | - Andrew G Rundle
- Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
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Adkins A, Makarewicz C, Scanze M, Ingram M, Luhr G. Contextualizing Walkability: Do Relationships Between Built Environments and Walking Vary by Socioeconomic Context? JOURNAL OF THE AMERICAN PLANNING ASSOCIATION. AMERICAN PLANNING ASSOCIATION 2017; 83:296-314. [PMID: 31762526 PMCID: PMC6873812 DOI: 10.1080/01944363.2017.1322527] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
PROBLEM RESEARCH STRATEGY AND FINDINGS Supportive built environments for walking are linked to higher rates of walking and physical activity, but little is known about this relationship for socioeconomically disadvantaged (e.g., low-income and racial/ethnic minority) populations. We review 17 articles and find that most show that the built environment has weaker effects on walking and physical activity for disadvantaged than advantaged groups. Those who lived in supportive built environments walked more and were more physically active than those who did not, but the effect was about twice as large for advantaged groups. We see this difference because disadvantaged groups walked more in unsupportive built environments and less in supportive built environments, though the latter appears more influential. TAKEAWAY FOR PRACTICE Defining walkability entirely in built environment terms may fail to account for important social and individual/household characteristics and other non-built environment factors that challenge disadvantaged groups, including fear of crime and lack of social support. Planners must be sensitive to these findings and to community concerns about gentrification and displacement in the face of planned built environment improvements that may benefit more advantaged populations. We recommend five planning responses: Recognize that the effects of the built environment may vary by socioeconomics; use holistic approaches to improve walkability; expand walkability definitions to address a range of social and physical barriers; partner across agencies, disciplines, and professions; and evaluate interventions in different socioeconomic environments.
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Affiliation(s)
- Arlie Adkins
- Arlie Adkins is an assistant professor of planning in the School of Landscape Architecture and Planning at the University of Arizona. Carrie Makarewicz is an assistant professor in the College of Architecture and Planning at the University of Colorado, Denver. Michele Scanze is a recent graduate of the planning master's program at the University of Arizona. Maia Ingram is the codirector of the Arizona Prevention Research Center at the University of Arizona. Gretchen Luhr is a research associate at the Institute on Aging at Portland State University
| | - Carrie Makarewicz
- Arlie Adkins is an assistant professor of planning in the School of Landscape Architecture and Planning at the University of Arizona. Carrie Makarewicz is an assistant professor in the College of Architecture and Planning at the University of Colorado, Denver. Michele Scanze is a recent graduate of the planning master's program at the University of Arizona. Maia Ingram is the codirector of the Arizona Prevention Research Center at the University of Arizona. Gretchen Luhr is a research associate at the Institute on Aging at Portland State University
| | - Michele Scanze
- Arlie Adkins is an assistant professor of planning in the School of Landscape Architecture and Planning at the University of Arizona. Carrie Makarewicz is an assistant professor in the College of Architecture and Planning at the University of Colorado, Denver. Michele Scanze is a recent graduate of the planning master's program at the University of Arizona. Maia Ingram is the codirector of the Arizona Prevention Research Center at the University of Arizona. Gretchen Luhr is a research associate at the Institute on Aging at Portland State University
| | - Maia Ingram
- Arlie Adkins is an assistant professor of planning in the School of Landscape Architecture and Planning at the University of Arizona. Carrie Makarewicz is an assistant professor in the College of Architecture and Planning at the University of Colorado, Denver. Michele Scanze is a recent graduate of the planning master's program at the University of Arizona. Maia Ingram is the codirector of the Arizona Prevention Research Center at the University of Arizona. Gretchen Luhr is a research associate at the Institute on Aging at Portland State University
| | - Gretchen Luhr
- Arlie Adkins is an assistant professor of planning in the School of Landscape Architecture and Planning at the University of Arizona. Carrie Makarewicz is an assistant professor in the College of Architecture and Planning at the University of Colorado, Denver. Michele Scanze is a recent graduate of the planning master's program at the University of Arizona. Maia Ingram is the codirector of the Arizona Prevention Research Center at the University of Arizona. Gretchen Luhr is a research associate at the Institute on Aging at Portland State University
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Murillo R, Echeverria S, Vasquez E. Differences in neighborhood social cohesion and aerobic physical activity by Latino subgroup. SSM Popul Health 2016; 2:536-541. [PMID: 29349169 PMCID: PMC5757944 DOI: 10.1016/j.ssmph.2016.08.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Revised: 08/02/2016] [Accepted: 08/03/2016] [Indexed: 11/16/2022] Open
Abstract
Previous research has examined the role of neighborhood social cohesion in physical activity outcomes; however, less is known about this relationship across Latino subgroups. The purpose of our study was to examine the association between neighborhood social cohesion and aerobic leisure-time physical activity (LTPA) among Latino adults and to determine whether these associations differ by Latino subgroup. We used cross-sectional 2013-2014 National Health Interview Survey (NHIS) data on Latinos originating from 5 countries/regions (i.e., Latinos of Puerto Rican, Mexican/Mexican-American, Cuban/Cuban-American, Dominican and Central or South American origin) aged ≥18 years (n=11,126). Multivariable logistic regression models were used to estimate associations between self-reported neighborhood social cohesion and meeting aerobic LTPA guidelines. Models were adjusted for age, sex, education, and acculturation. We also investigated whether associations varied by Latino subgroup. In adjusted models for all Latino adults, compared with those reporting low social cohesion, individuals who reported high social cohesion (Odds Ratio [OR]: 1.33; 95% Confidence Interval [CI]: 1.17-1.52) were significantly more likely to meet the aerobic physical activity guideline. When stratified by Latino subgroups, among Mexican/Mexicans-Americans (OR: 1.39; 95% CI: 1.16, 1.66) and Cuban/Cuban Americans (OR: 1.73; 95% CI: 1.00, 2.97) high social cohesion was associated with meeting the aerobic activity guideline. Among Dominicans, those who reported medium social cohesion (OR: 0.52, 95% CI: 0.29, 0.93) were less likely to meet the aerobic activity guideline. When examining aerobic physical activity outcomes in the Latino population, the role of neighborhood social cohesion and the variability among Latino subgroups should be considered.
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Affiliation(s)
- Rosenda Murillo
- University of Houston, Department of Psychological, Health, and Learning Sciences, 3657 Cullen Boulevard, Room 491, Houston, TX 77204-5029, USA
| | - Sandra Echeverria
- City University of New York (CUNY), Graduate School of Public Health and Health Policy, Department of Community Health and Social Sciences, 55W. 125th Street, 5th Floor, New York, New York 10027, USA
| | - Elizabeth Vasquez
- University of Albany State University of New York, Department of Epidemiology and Biostatistics, One University Place, GEC 121, Rensselaer, NY 12144, USA
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van Mulken MRH, McAllister M, Lowe JB. The stigmatisation of pregnancy: societal influences on pregnant women's physical activity Behaviour. CULTURE, HEALTH & SEXUALITY 2016; 18:921-935. [PMID: 26967357 DOI: 10.1080/13691058.2016.1148199] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Many women going through the major life transition of pregnancy experience decreases in physical activity behaviour, which may compromise maternal and infant health and wellbeing. Although research suggests that the social environment plays a large role in influencing women's physical activity behaviour, little is known about the association between societal attitudes and physical activity behaviour during the course of pregnancy. Through a qualitative longitudinal study, we explored women's physical activity experiences throughout pregnancy and how these were formed, supported and/or opposed by their social environment. This research included telephone interviews with 30 pregnant participants, recruited via a regional public hospital. Using a feminist standpoint analysis incorporating modern dialectics, three major tensions were identified, reflecting dominant societal discourses around physical activity and pregnancy: (1) engaging in physical activity and keeping the baby safe, (2) engaging in physical activity and obtaining social approval and (3) listening to oneself and to others. These findings present previously unrecognised opportunities for developing tailored and effective physical activity interventions among pregnant women.
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Affiliation(s)
- Michelle R H van Mulken
- a Centre for Human Factors and Sociotechnical Systems , University of the Sunshine Coast , Sippy Downs , Australia
| | - Margaret McAllister
- b School of Nursing and Midwifery , Central Queensland University , Noosaville , Australia
| | - John B Lowe
- c School of School of Health and Sports Sciences , University of the Sunshine Coast , Sippy Downs , Australia
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Hernández D. Affording Housing at the Expense of Health: Exploring the Housing and Neighborhood Strategies of Poor Families. JOURNAL OF FAMILY ISSUES 2016; 37:921-946. [PMID: 27057078 PMCID: PMC4819250 DOI: 10.1177/0192513x14530970] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Low-income families often simultaneously encounter housing and neighborhood problems pertaining to safety, affordability, and quality issues that necessitate strategies to maximize limited budgets and ensure safety. Such constrained decisions regarding inadequate housing and poor neighborhood conditions, however, may themselves create or exacerbate health risks. Building on the survival strategies literature, this article offers rich and detailed accounts of coping and management strategies on the part of vulnerable families facing housing and neighborhood hardships. The findings are based on in-depth interviews with 72 respondents and ethnographic observations in an urban community. The results illustrate how low-income women avoid neighborhood danger by relegating family life to the home environment, thereby increasing exposure to health risks such as stress, depression, and asthma. The discussion focuses on public health literature linking housing and health and proposes the use of legal strategies and community engagement as resources to complement current approaches to housing and neighborhood problems.
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Baghianimoghaddam MH, Bakhtari-Aghdam F, Asghari-Jafarabadi M, Allahverdipour H, Dabagh-Nikookheslat S, Nourizadeh R. The Effect of a Pedometer-based Program Improvement of Physical Activity in Tabriz University Employees. Int J Prev Med 2016; 7:50. [PMID: 27076888 PMCID: PMC4809126 DOI: 10.4103/2008-7802.177897] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 10/26/2015] [Indexed: 12/02/2022] Open
Abstract
Background: Regular physical activity (PA) has been shown to reduce risk of morbidity and overall mortality. A study has displayed that achieving 10,000 steps/day is associated with important health outcomes and have been used to promote PA. Pedometers are a popular tool for PA interventions in different setting. This study investigated the effects on pedometer-based and self-reported PA among Tabriz University employees. Methods: This experimental study assessed the effects of 16 weeks pedometer-based workplace intervention. Participants (n = 154) were employees of two worksites. Pedometer-based and self-reported PA from one intervention worksite was compared with the data of a comparison workplace. International Physical Activity Questionnaire (IPAQ) for self-reported measure of PA, and demographic (age, marital status, educational level, employment status, and stage of change) variables were obtained. To measure PA objectively pedometer was used. Results: Participants reported to increase the step counts from baseline (end of summer) to posttest (winter). The intervention effect revealed significant increase in the intervention group (8279 ± 2759 steps/day than in the comparison work place (4118 ± 1136). Self-reported based on IPAQ concluded women in intervention worksite had a significant increase in the leisure time domain, but similar finding was not found in the comparison worksite. Conclusions: Pedometer used might rather benefit those individuals who want feedback on their current PA, also walking should be considered to increase PA in employee women.
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Affiliation(s)
| | | | - Mohammad Asghari-Jafarabadi
- Department of Health Education and Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Allahverdipour
- Road Traffic Injury Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Roghaiyeh Nourizadeh
- Department of Reproductive Health, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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48
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Barber S, Hickson DA, Kawachi I, Subramanian SV, Earls F. Double-jeopardy: The joint impact of neighborhood disadvantage and low social cohesion on cumulative risk of disease among African American men and women in the Jackson Heart Study. Soc Sci Med 2016; 153:107-15. [PMID: 26894941 DOI: 10.1016/j.socscimed.2016.02.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/12/2015] [Accepted: 02/01/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Few studies have examined the joint impact of neighborhood disadvantage and low social cohesion on health. Moreover, no study has considered the joint impact of these factors on a cumulative disease risk profile among a large sample of African American adults. Using data from the Jackson Heart Study, we examined the extent to which social cohesion modifies the relationship between neighborhood disadvantage and cumulative biological risk (CBR)-a measure of accumulated risk across multiple physiological systems. METHODS Our analysis included 4408 African American women and men ages 21-85 residing in the Jackson, MS Metropolitan Area. We measured neighborhood disadvantage using a composite score of socioeconomic indicators from the 2000 US Census and social cohesion was assessed using a 5-item validated scale. Standardized z-scores of biomarkers representing cardiovascular, metabolic, inflammatory, and neuroendocrine systems were combined to create a CBR score. We used two-level linear regression models with random intercepts adjusting for socio-demographic and behavioral covariates in the analysis. A three-way interaction term was included to examine whether the relationship between neighborhood disadvantage and CBR differed by levels of social cohesion and gender. RESULTS The interaction between neighborhood disadvantage, social cohesion and gender was statistically significant (p = 0.05) such that the association between living in a disadvantaged neighborhood and CBR was strongest for men living in neighborhoods with low levels of social cohesion (B = 0.63, SE: 0.32). In gender-specific models, we found a statistically significant interaction between neighborhood disadvantage and social cohesion for men (p = 0.05) but not for women (p = 0.50). CONCLUSION Neighborhoods characterized by high levels of economic disadvantage and low levels of social cohesion contribute to higher cumulative risk of disease among African American men. This suggests that they may face a unique set of challenges that put them at greater risk in these settings.
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Affiliation(s)
- Sharrelle Barber
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Avenue, 7th Floor, Boston, MA 02115, United States.
| | - DeMarc A Hickson
- University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216-4505, United States; My Brother's Keeper, Inc., Rigeland, MS, United States
| | - Ichiro Kawachi
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Avenue, 7th Floor, Boston, MA 02115, United States
| | - S V Subramanian
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Avenue, 7th Floor, Boston, MA 02115, United States
| | - Felton Earls
- Harvard T.H. Chan School of Public Health, Department of Social and Behavioral Sciences, 677 Huntington Avenue, 7th Floor, Boston, MA 02115, United States
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49
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Abstract
BACKGROUND Overweight and obesity rates in children and adolescents are concerning, particularly among girls. Social support from friends has been associated with healthier eating and higher levels of physical activity, yet little is known about the relationship between social support and weight loss among adolescents. This aim of this study was to prospectively examine the relationship between baseline social support from friends and family, changes in social support, and weight loss. METHODS Sixty-five adolescent girls completed a one-year weight loss intervention trial. Data were collected at baseline, 6 months, and 12 months. RESULTS At baseline, family support was higher compared to friend support; however, lower friend support at baseline and increases in friend support from baseline to 6 months and 12 months were associated with weight loss. When controlling for other predictors of weight loss, change in friend support for healthy eating was predictive of weight loss at 12 months. CONCLUSIONS These findings suggest that weight loss interventions for adolescent females might consider including strategies to elicit or to create and promote social support for healthy eating from peers. Future studies are needed to test this relationship.
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Affiliation(s)
- Noel Kulik
- Center for School Health, Division of Kinesiology, Health, and Sport Studies, Wayne State University, Detroit, MI
| | - Carmina G. Valle
- Lineberger Comprehensive Cancer Center, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Deborah F. Tate
- Department of Health Behavior, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
- Department of Nutrition, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
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50
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Clark AF, Scott DM. Barriers to Walking: An Investigation of Adults in Hamilton (Ontario, Canada). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:179. [PMID: 26840328 PMCID: PMC4772199 DOI: 10.3390/ijerph13020179] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 12/22/2015] [Accepted: 01/25/2016] [Indexed: 11/16/2022]
Abstract
This study investigates perceived barriers to walking using data collected from 179 randomly-selected adults between the ages of 18 and 92 in Hamilton, Ontario, Canada. A survey (Hamilton Active Living Study) asked questions about socio-demographics, walking, and barriers to walking. A series of binary logit models are estimated for twenty potential barriers to walking. The results demonstrate that different barriers are associated with different sub-groups of the population. Females, senior citizens, and those with a higher body mass index identify the most barriers to walking, while young adults, parents, driver's license owners, and bus pass owners identify the fewest barriers. Understanding who is affected by perceived barriers can help policy makers and health promotion agencies target sub-groups of the population in an effort to increase walking.
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Affiliation(s)
- Andrew F Clark
- Human Environments Analysis Laboratory, Department of Geography, University of Western Ontario, 1151 Richmond St., London, ON N6A 3K7, Canada.
| | - Darren M Scott
- Transportation Research Lab (TransLAB), School of Geography and Earth Sciences, McMaster University, 1280 Main St. West, Hamilton, ON L8S 4K1, Canada.
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